Care trajectories of COVID-19 patients: from preventive measures to rehabilitation

Detalhes bibliográficos
Autor(a) principal: Fidelis de Almeida, Patty
Data de Publicação: 2023
Outros Autores: Casotti, Elisete, Fidelis Lima Silvério, Rafaela
Tipo de documento: Artigo
Idioma: por
eng
Título da fonte: Cadernos de Saúde Pública
Texto Completo: https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8272
Resumo: This study aims to analyze the care trajectories of patients diagnosed with COVID-19 who were hospitalized and are currently undergoing rehabilitation regarding their use of and access to the healthcare network (HN). An evaluative, qualitative study was carried out based on interviews with patients in the city of Niterói, Rio de Janeiro State, Brazil. The care trajectories were reconstructed at three different occasions that express their experiences with the healthcare and support network during the pandemic: prevention, support and diagnosis measures; hospitalization; post-COVID-19 care, rehabilitation and support. The results indicate that the main source of information about COVID-19 was TV newscasts. Preventive hygiene measures were the most widely adopted. The family was the main support network. There was no waiting time for admission to the municipal referral hospital. Hospitalization was very well evaluated in terms of user embracement, multidisciplinary care, virtual visits and daily contact between doctor and family members. A post-discharge “care vacuum” was identified, with no follow-up by primary health care (PHC) and other public services. Low-cost health insurance plans and private specialized post-COVID-19 services were frequently and spontaneously sought until the implementation of the rehabilitation service. In summary, solitary and discontinuous care trajectories of individuals and families shed light on several challenges to the health system, including guaranteed access to coordinated PHC and expanded offer of specialized public services and rehabilitation, aligned with the principles of humanized care, in addition to the maintenance of social support measures.
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spelling Care trajectories of COVID-19 patients: from preventive measures to rehabilitationTrayectorias asistenciales de usuarios con el COVID-19: de las medidas preventivas a la rehabilitaciónTrajetórias assistenciais de usuários com COVID-19: das medidas preventivas à reabilitaçãoPandemia COVID-19Trajetórias AssistenciaisAcesso aos Serviços de SaúdePandemia de COVID-19Trayectorias ClínicasAccesibilidad a los Servicios de SaludCOVID-19 PandemicsCare PathwaysHealth Services AccessibilityThis study aims to analyze the care trajectories of patients diagnosed with COVID-19 who were hospitalized and are currently undergoing rehabilitation regarding their use of and access to the healthcare network (HN). An evaluative, qualitative study was carried out based on interviews with patients in the city of Niterói, Rio de Janeiro State, Brazil. The care trajectories were reconstructed at three different occasions that express their experiences with the healthcare and support network during the pandemic: prevention, support and diagnosis measures; hospitalization; post-COVID-19 care, rehabilitation and support. The results indicate that the main source of information about COVID-19 was TV newscasts. Preventive hygiene measures were the most widely adopted. The family was the main support network. There was no waiting time for admission to the municipal referral hospital. Hospitalization was very well evaluated in terms of user embracement, multidisciplinary care, virtual visits and daily contact between doctor and family members. A post-discharge “care vacuum” was identified, with no follow-up by primary health care (PHC) and other public services. Low-cost health insurance plans and private specialized post-COVID-19 services were frequently and spontaneously sought until the implementation of the rehabilitation service. In summary, solitary and discontinuous care trajectories of individuals and families shed light on several challenges to the health system, including guaranteed access to coordinated PHC and expanded offer of specialized public services and rehabilitation, aligned with the principles of humanized care, in addition to the maintenance of social support measures.Este artículo tiene por objetivo analizar las trayectorias asistenciales de usuarios diagnosticados, hospitalizados y en rehabilitación por el COVID-19 en cuanto al uso y acceso a las redes de atención a la salud (RAS). Se realizó un estudio cualitativo, evaluativo, a partir de entrevistas con usuarios en el municipio de Niterói, Rio de Janeiro, Brasil. A partir del análisis temático, las trayectorias asistenciales se reconstituyeron en tres momentos que expresan las experiencias con la red de salud y de apoyo durante la pandemia: las medidas de prevención, apoyo y diagnóstico; la experiencia de hospitalización; y los cuidados, rehabilitación y apoyo post-COVID-19. Los resultados muestran que los telediarios fueron la principal fuente de información sobre el COVID-19. Las medidas preventivas más adoptadas fueron las de higiene. La familia fue la principal red de apoyo. No hubo tiempo de espera para el ingreso en el hospital municipal de referencia. La hospitalización fue muy bien evaluada debido a la recepción, atención multidisciplinaria, visitas virtuales y contacto diario del médico con los familiares. Se identificó un “vacío asistencial” posterior al alta, sin seguimiento por parte de la atención primaria de salud (APS) y otros servicios públicos. Hubo una frecuente búsqueda espontánea de planes populares y pago directo para acceder a servicios especializados post-COVID-19 hasta la implementación del servicio de rehabilitación. Por lo tanto, las trayectorias asistenciales solitarias y discontinuas de individuos y familias revelan varios desafíos para el sistema de salud, entre ellos la garantía de acceso y coordinación de la atención por parte de la APS, la ampliación de la oferta de servicios públicos especializados y la rehabilitación en redes, combinada con los principios de cuidado humanizado, además del mantenimiento de las medidas de apoyo social.O objetivo deste trabalho é analisar as trajetórias assistenciais, relativas ao uso e acesso às redes de atenção à saúde (RAS), de usuários diagnosticados, internados e em reabilitação decorrente da COVID-19. Foi realizado estudo avaliativo, qualitativo, com base em entrevistas com usuários, no Município de Niterói, Rio de Janeiro, Brasil. As trajetórias assistenciais, a partir da análise temática, foram reconstituídas em três momentos que expressam as experiências com a rede de saúde e apoio durante a pandemia: medidas de prevenção, apoio e diagnóstico; a experiência da internação; cuidados, reabilitação e apoio pós-COVID-19. Os resultados apontam que a principal fonte de informação sobre a doença foram os telejornais; as medidas preventivas de higienização, as mais adotadas; e a família foi a principal rede de apoio. Não houve tempos de espera para internação no hospital municipal de referência. A internação foi muito bem avaliada em função do acolhimento, cuidado multiprofissional, visitas virtuais e contato diário do médico com os familiares. Identificou-se, porém, “vácuo assistencial” pós-alta, com ausência de seguimento pela atenção primária à saúde (APS) e demais serviços públicos. Foi frequente a busca espontânea por planos populares e pagamento direto para acesso aos serviços especializados no pós-COVID-19, até a implantação do serviço de reabilitação. Em síntese, trajetórias assistenciais solitárias e descontínuas de indivíduos e famílias revelam diversos desafios ao sistema de saúde, entre os quais a garantia de acesso e coordenação dos cuidados pela APS, ampliação da oferta de serviços públicos especializados e de reabilitação em redes, alinhados aos princípios do cuidado humanizado, além da manutenção das medidas de apoio social.Reports in Public HealthCadernos de Saúde Pública2023-07-02info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/xmlapplication/pdfapplication/pdfhttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8272Reports in Public Health; Vol. 39 No. 2 (2023): FebruaryCadernos de Saúde Pública; v. 39 n. 2 (2023): Fevereiro1678-44640102-311Xreponame:Cadernos de Saúde Públicainstname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZporenghttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8272/18477https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8272/18478https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8272/18479Copyright (c) 2023 Cadernos de Saúde Públicainfo:eu-repo/semantics/openAccessFidelis de Almeida, PattyCasotti, EliseteFidelis Lima Silvério, Rafaela2023-07-19T13:01:02Zoai:ojs.teste-cadernos.ensp.fiocruz.br:article/8272Revistahttps://cadernos.ensp.fiocruz.br/ojs/index.php/csphttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/oaicadernos@ensp.fiocruz.br||cadernos@ensp.fiocruz.br1678-44640102-311Xopendoar:2024-03-06T13:09:26.403614Cadernos de Saúde Pública - Fundação Oswaldo Cruz (FIOCRUZ)true
dc.title.none.fl_str_mv Care trajectories of COVID-19 patients: from preventive measures to rehabilitation
Trayectorias asistenciales de usuarios con el COVID-19: de las medidas preventivas a la rehabilitación
Trajetórias assistenciais de usuários com COVID-19: das medidas preventivas à reabilitação
title Care trajectories of COVID-19 patients: from preventive measures to rehabilitation
spellingShingle Care trajectories of COVID-19 patients: from preventive measures to rehabilitation
Fidelis de Almeida, Patty
Pandemia COVID-19
Trajetórias Assistenciais
Acesso aos Serviços de Saúde
Pandemia de COVID-19
Trayectorias Clínicas
Accesibilidad a los Servicios de Salud
COVID-19 Pandemics
Care Pathways
Health Services Accessibility
title_short Care trajectories of COVID-19 patients: from preventive measures to rehabilitation
title_full Care trajectories of COVID-19 patients: from preventive measures to rehabilitation
title_fullStr Care trajectories of COVID-19 patients: from preventive measures to rehabilitation
title_full_unstemmed Care trajectories of COVID-19 patients: from preventive measures to rehabilitation
title_sort Care trajectories of COVID-19 patients: from preventive measures to rehabilitation
author Fidelis de Almeida, Patty
author_facet Fidelis de Almeida, Patty
Casotti, Elisete
Fidelis Lima Silvério, Rafaela
author_role author
author2 Casotti, Elisete
Fidelis Lima Silvério, Rafaela
author2_role author
author
dc.contributor.author.fl_str_mv Fidelis de Almeida, Patty
Casotti, Elisete
Fidelis Lima Silvério, Rafaela
dc.subject.por.fl_str_mv Pandemia COVID-19
Trajetórias Assistenciais
Acesso aos Serviços de Saúde
Pandemia de COVID-19
Trayectorias Clínicas
Accesibilidad a los Servicios de Salud
COVID-19 Pandemics
Care Pathways
Health Services Accessibility
topic Pandemia COVID-19
Trajetórias Assistenciais
Acesso aos Serviços de Saúde
Pandemia de COVID-19
Trayectorias Clínicas
Accesibilidad a los Servicios de Salud
COVID-19 Pandemics
Care Pathways
Health Services Accessibility
description This study aims to analyze the care trajectories of patients diagnosed with COVID-19 who were hospitalized and are currently undergoing rehabilitation regarding their use of and access to the healthcare network (HN). An evaluative, qualitative study was carried out based on interviews with patients in the city of Niterói, Rio de Janeiro State, Brazil. The care trajectories were reconstructed at three different occasions that express their experiences with the healthcare and support network during the pandemic: prevention, support and diagnosis measures; hospitalization; post-COVID-19 care, rehabilitation and support. The results indicate that the main source of information about COVID-19 was TV newscasts. Preventive hygiene measures were the most widely adopted. The family was the main support network. There was no waiting time for admission to the municipal referral hospital. Hospitalization was very well evaluated in terms of user embracement, multidisciplinary care, virtual visits and daily contact between doctor and family members. A post-discharge “care vacuum” was identified, with no follow-up by primary health care (PHC) and other public services. Low-cost health insurance plans and private specialized post-COVID-19 services were frequently and spontaneously sought until the implementation of the rehabilitation service. In summary, solitary and discontinuous care trajectories of individuals and families shed light on several challenges to the health system, including guaranteed access to coordinated PHC and expanded offer of specialized public services and rehabilitation, aligned with the principles of humanized care, in addition to the maintenance of social support measures.
publishDate 2023
dc.date.none.fl_str_mv 2023-07-02
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dc.identifier.uri.fl_str_mv https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8272
url https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8272
dc.language.iso.fl_str_mv por
eng
language por
eng
dc.relation.none.fl_str_mv https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8272/18477
https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8272/18478
https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8272/18479
dc.rights.driver.fl_str_mv Copyright (c) 2023 Cadernos de Saúde Pública
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Copyright (c) 2023 Cadernos de Saúde Pública
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv text/xml
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application/pdf
dc.publisher.none.fl_str_mv Reports in Public Health
Cadernos de Saúde Pública
publisher.none.fl_str_mv Reports in Public Health
Cadernos de Saúde Pública
dc.source.none.fl_str_mv Reports in Public Health; Vol. 39 No. 2 (2023): February
Cadernos de Saúde Pública; v. 39 n. 2 (2023): Fevereiro
1678-4464
0102-311X
reponame:Cadernos de Saúde Pública
instname:Fundação Oswaldo Cruz (FIOCRUZ)
instacron:FIOCRUZ
instname_str Fundação Oswaldo Cruz (FIOCRUZ)
instacron_str FIOCRUZ
institution FIOCRUZ
reponame_str Cadernos de Saúde Pública
collection Cadernos de Saúde Pública
repository.name.fl_str_mv Cadernos de Saúde Pública - Fundação Oswaldo Cruz (FIOCRUZ)
repository.mail.fl_str_mv cadernos@ensp.fiocruz.br||cadernos@ensp.fiocruz.br
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