Adaptação de longevos no domicílio após hospitalização na unidade de terapia intensiva

Abstract

INTRODUCTION: As a result of the demographic transition and the aging of the population, an increase in the proportion of elderly, frequency of comorbidities and the incidence of functional decline attributed to this age group is observed, which may lead to a need for hospitalization. It is increasingly common the admission of elderly patients in the Intensive Care Unit (ICU), and it is fundamental to plan and perform health actions for these patients during and after hospitalization. After hospital discharge, the elderly person may present fragility and a high degree of dependence and loss of autonomy when returning to the domicile. Such limitations may be permanent or transient, and in both situations, performing routine activities of daily living can become a challenge to the elderly and their relative. OBJECTIVES: To know the adaptation of the elderly in the domicile, after hospitalization in the ICU; apprehend facilities, difficulties and needs related to daily life, in the domicile, after hospitalization in the ICU. METHODOLOGY: This is a descriptive study, with a qualitative approach, performed with elderly who were hospitalized in the ICU of a public hospital in the Southwest of Bahia. The data collection took place through an open interview, from October 2017 to February 2018. The research was conducted in two places: data were initially collected in the records of patients hospitalized in the ICU of the hospital to identify those aged 80 years or more, who were hospitalized for more than 24 hours and were already discharged of the hospital. After that, a telephone call was made to schedule a visit to the domicile of the elderly identified in the ICU and who were already discharged from hospital. After that, an interview was made with the elderly people in their domiciles. For the procedure of data analysis the principles of content of Bardin, based in the light of the Theory of Adaptation of Callista Roy, were used. The project was approved by the Research Ethics Committee under Opinion no. 2.266.652 of 9/11/2017 and the ethical and legal care based on Resolution 466/12 of the National Health Council were strictly respected during all phases of the research. RESULTS: A total of 11 elderly subjects participated in the study, six females and five males, aged 80 to 94 years. From the participants' statements, two categories emerged: Stimuli experienced by the elderly in the domicile after hospitalization in the ICU and behavioral responses of the elderly in the domicile after ICU hospitalization. CONCLUSION: The study showed that the main stimuli that contributed to an adaptive behavior of the elderly were the return to their home and family support. On the other hand, the stimuli that negatively affect adaptation were fear, lack of information and difficulties in the continuity of care. Behavioral responses were related to the physiological and psychosocial modes, which culminated in dependence and loss of autonomy to perform basic life activities, as well as feelings of sadness and dissatisfaction.