Tecnologias para assistência domiciliar na atenção básica: em busca de ferramentas que subsidiem o trabalho da equipe de saúde da família

Abstract

Introduction: Despite the growing trend of Home Health Care (HHC) in the Single Health System (SUS), there are a few tools and pieces of applied knowledge that health professionals have to acknowledge. When you get into the homes of individuals, there is an interaction with companionship, conflict and the dynamics of privacy, as well as the socio-economic poverty, which affects the majority of the Brazilian population, who are SUS users. The current research questions that technologies use for the systematization of Home Health Care at a Primary Health Care level, are based on the development of tools for managing care and subsidizing the work of family health teams (FHT). It starts from the assumption that the technology-based questionnaires that enable clinical, socioeconomic and family users, as well as the predictive models for classifying the type of home health care to guide the programming of the actions of professionals, provide subsidies for the incorporation of knowledge to the process of health work, qualifying the assistance. Objectives: 1-To Analyze the available technologies in the FHT to standardize the Home Health Care in Primary Care, 2-To evaluate the process of working from the FHT professionals in the systematization of Home Health Care in Primary Care. 3-To develop questionnaires to enable the clinical evaluation, the degree of care for the Activities of Daily Living (ADL), the risk of pressure ulcers (PU) and the socio-family users who require Home Health Care on the scope of the FHT/ Primary Care of Belo Horizonte, 4-To discuss with the professionals of the Family Health Teams the application of the tools for the systematization of Home Health Care in Primary Care; 5-To implement, from investigations, instruments for home health care systematization in Primary Care. Methodology: Evaluative research with triangulation of methods and techniques, a quantitative and qualitative case study, from 2 Basic Health Units (BHU)/ Municipal Health Secretariat of Belo Horizonte (MHS-BH).Data analysis: logistic regression and multiple in the quantitative phase and content analysis in qualitative stage. The study design occurs in three stages: 1st- participant observation of the working process of the FHT to build an instrument that assists integral Home Health Care to the users of the coverage area. 2nd- survey with patients, families and caregivers who require home health care at the BHU/MHS-BH, with classification of home health care needs of the families visited in type HHC1 and HHC2. Definition of Prediction Models for programming the required assistance; 3rd-workshops for discussion with health professionals from BHU to evaluate the suitability of the instrument, the classification of types of HHC and the management of the proposed assistance. The study was approved by the Research Ethics of the Federal University of Minas Gerais (UFMG), Opinion n ETIC 449/08, and the Municipal Health Secretariat of Belo Horizonte, protocol 007/2008. Results: There is limited availability of technologies for Home Health Care in Primary Care, compromising the care provided. From these results, a flowchart was created to assist in managing home health care in primary care, based on a predictive model for classification of the user type of home health care required (HHC 1 and HHC 2) and instruments which support the actions of the FHT. Conclusion: The questionnaires, the care plan for the user and family, and the flowchart and programming assistance proposal was considered appropriate and relevant by the health professionals from the BHU investigated.