Experiência de familiares em cuidar de idosos e avaliação de serviços de gerenciamento da terapia medicamentosa oferecidos a pacientes geriátricos.

Abstract

Population aging leads to an increase in chronic conditions requiring prolonged use of medications and may cause functional disability and the need for a caregiver. The present thesis consists of three studies. The first aimed at synthesizing qualitative evidence on the experience of family caregivers in caring for older people. To this end, a systematic review was conducted, and the results were synthesized through thematic analysis. A total of 4,912 publications were identified. Among them, 18 met the inclusion criteria, and from them, three analytical themes were generated. Several conflicting feelings regarding care emerged, highlighting the complexity of this context. Regardless of the feelings, caregivers leave their lives on hold for the sake of care. However, they seek a balance between caring for themselves and the older person through coping strategies such as formal and informal support and spirituality. The second qualitative study aimed to understand the experience of family caregivers in caring for older people during the COVID-19 pandemic. This study was developed using the grounded theory methodology. Sixteen caregivers were interviewed. Uncomfortable emotions emerged and drove the caregivers' actions towards adopting preventive measures to protect the older person from contracting the coronavirus, ensure their health care, and raise awareness about the pandemic. However, when these emotions manifested themselves in exacerbated ways, they needed to be softened so that they could adopt such initiatives. Thus, the emotions felt by caregivers can compromise their health and quality of life. Therefore, health professionals need to create strategies to ensure that they are well assisted and guide them about the pandemic. The third study evaluated the clinical impact of the Comprehensive Medication Management (CMM) service offered to geriatric and hypertensive patients cared for in primary health care (PHC). A quasi-experimental study was performed with a single group of patients inserted in a CMM service. It was found that this service can contribute to the reach of the pressure control of geriatric and hypertensive patients. The frequency of Drug-related Problems (DRP) was high, but most of them were solved by pharmacists. Thus, this study's results infer the effectiveness of this clinical service in PHC. The findings of this thesis contribute to health professionals and public policymakers understand the process of the older person's care at home, favoring the implementation of practical actions directed to the support, training and care of family caregivers. This understanding and the offer of the CMM service will possibly raise the provision of adequate care to older people.