Assistência às pessoas com doenças crônicas: vivências de enfermeiros/enfermeiras da atenção primária

Abstract

In Brazil, with the aim of promoting the systemic integration of health actions and services for the population, the Health Care Network (RAS) was established in 2010. Currently, in Brazil, chronic diseases represent the majority of causes of death and these diseases generate a high burden of associated morbidities, resulting in an increase in the number of hospitalizations and a drop in quality of life. As a result, the Health Care Network for People with Chronic Diseases (RASPDC) was set up with the aim of providing continuous care for these people. Considering the significant epidemiological transition, in which the main causes of death are due to chronic diseases, there are gaps in scientific production on the RASPDC from the perspective of Family Health Strategy (FHS) nurses. In view of this, the aim of this study was to analyze health care for people with chronic illnesses, from the perspective of FHS nurses. This was a descriptive study, with a qualitative approach, carried out in a municipality in the Triângulo Mineiro, with 22 nurses. For data collection, semi-structured interviews were carried out, guided by a validated script, audio-recorded and transcribed in full. The questions sought to identify Critical Incidents, using this technique to collect primary data. Data analysis was based on content analysis. The project was developed in compliance with the precepts of Resolution 510/2016 on research involving human beings. From the interviews, 29 situations emerged, of which 16 (55.2%) had negative references and 13 (44.8%) positive; 274 behaviors, of which 199 (72.6%) were positive and 75 (27.4%) negative; as well as 93 consequences, of which 69 (74.2%) were positive and 24 (25.8%) negative. It should be noted that the positive references indicate aspects that facilitate health communication and the negative ones those that hinder it. The findings referring to situations, behaviors and consequences that facilitate care for people with chronic illnesses were considered facilitators, and were more frequent with regard to the relationships of bonding and trust between health professionals and these people, the need for support from the RASPDC points of care, the health team and family members in order to achieve successful care. The results relating to negative situations hindered care for people with chronic illnesses, due to people's lack of knowledge about caring for these illnesses; difficulty in carrying out, following or adhering to treatment; fragile communication between those involved in care and obstacles to care at different points in the RASPDC. Based on the positive behaviors revealed, it stands out that ESF nurses transcend technical and procedural care in their work. They value and seek to promote the empowerment of people with chronic illnesses so that they can take care of themselves and achieve greater autonomy, which can have a positive impact on improving their quality of life and health status.