Ocupação social nas instituições de longa permanência para idosos na percepção dos terapeutas ocupacionais antes e durante a pandemia de COVID-19: um estudo qualitativo

Abstract

The increase in the population’s life expectancy is causing changes regarding the care of older adults. Different forms of care are being requested and nursing homes for older adults have been increasingly sought after. These institutions are collective households which offer health services, including occupational therapy, which aims to optimize the occupational performance of older adults in Activities of Daily Living (ADL) and favor participation in occupations, such as social occupation. These occupations aim at social interaction, give meaning to life and keep people connected. However, the engagement of older adults in nursing homes in this occupation can be a challenge due to the need to readjust their social roles due to the COVID-19 pandemic. This study aimed to understand and discuss the perception of occupational therapists about the accomplishment of social occupation by older adults in nursing homes before and during the COVID-19 pandemic. Thus, a qualitative study based on sociological phenomenology was conducted. Data collection took place through a questionnaire and semi-structured interview. The number of participants was defined by the saturation criterion. Data were analyzed using the thematic analysis technique. A total of 15 occupational therapists who worked in philanthropic and private nursing homes in the city of Belo Horizonte and metropolitan region in Minas Gerais, Brazil participated. The results were grouped into three themes: “Structured social occupation and group work: a space for sharing”; “Unplanned social occupation: the everyday construction of engagement in the institutional environment”; and “Social occupation and the pandemic context: facilitators and difficulties”. The interviewees pointed out the groups of activities proposed before the pandemic as a place to carry out a structured social occupation, and a space for sharing experiences. They reported the occurrence of spontaneous social occupation before and during the pandemic as informal conversations among the older adults, and between them and health professionals. In the pandemic context, they highlighted the use of electronic resources and adjustments in the work process as a facilitator. They described the interruption of group activities as difficulties for engaging in social occupation. Respondents indicated a reorganized work process by reducing the number of older adults in groups, holding groups in open places and activities which do not require exchanging therapeutic resources among the older adults as strategies to favor social occupation. The results of this study may contribute to greater understanding of the potential of social occupation with older adults in nursing homes, and to improve the clinical practice of occupational therapists.