Serviços de atenção domiciliar: sobrecarga e satisfação do cuidador

Abstract

The global aging, in addition to the growing prevalence of chronic diseases, diminishes the functional capacity of the elderly. who end up needing a full-time caregiver at home, who in most cases is informal and lacks training and experience in this function. In Brazil, the Home Care Service (HCS) as public policy strategy provides this process. Objectives: This study analyzed home care assistance from the perspective of the caregivers, aiming at characterizing the patient and his caregiver and assessing the burden before and after the actions performed by the Home Care Service, and the degree of satisfaction with this service. Methods: This is a cross-sectional descriptive-analytical study. Data collection was carried out at the patients' homes registered by the HCS of the municipality of São José do Rio Preto, from July 2019 to September 2020, in two moments: the insertion of the patient in the service and two months later. The study sample comprised 264 patients and their caregivers, with a descriptive and statistical analysis. Results: Regarding the characterization; 78.7% of the patients were over 60 years old, with low education and low remuneration, there was a predominance of patients with a diagnostic hypothesis of stroke (31%); 64.8% were temporary bedridden; 50.8% had less than three months of dependence; 67.0% had severe dependence according to the Independence Index in Activities of Daily Living, and 98.9% had severe dependence in the assessment of functional capacity related to the instrumental activity of daily living. Regarding caregivers, the median age was 56 years; 84.5% were female; 34.1% had more than 10 years of study, however 86.7% had no training in the caregiver role. The family bond was confirmed in 95.1%, and 84.1% of the caregivers lived in the same house as the patient, with more than 12 hours a day spent on care and 93.2% did not receive a salary. In this study, a statistically significant difference was found regarding the patient's difficulty in locomotion (p=0.034); time of patient dependence (p=0.031); time that the caregiver has been performing this role (p=0.002), age of the caregiver (p = 0.029), presence of caregiver health problems such as spine disorders (p = 0.050), anxiety (p <0.001) and depression (p = 0.002), and also between the initial burden and the current burden (p = 0.011) , demonstrating the importance of HCS in reducing the burden. When analyzing the caregiver's satisfaction with the HCS team; 99.2% reported being satisfied or very satisfied with the service. Conclusion: This study has contributed to the analysis of caregivers' burden, aiming at subsidizing the development of strategies beyond their training; since they need to be the focus of sustainable public policies and be provided with an effective supporting network so that their own health is not impaired.