Preparo familiar para alta hospitalar de crianças com doenças crônicas: uma abordagem de métodos mistos

Abstract

Introduction: The family is responsible for the home care of children with chronic diseases and must be prepared to manage them during hospitalization. Objective: To evaluate three modalities for the preparation of relatives of children with chronic diseases for hospital discharge, from the perspective of care management. Method: A convergent mixed-method research study conducted from December 2017 to January 2019 in a hospital in the state of Paraíba with 25 children with chronic diseases, allocated to intervention group (IG), extension group (EG), and sectorial group (SG), with different modalities for the preparation for discharge and observance of the ethical precepts in the research. Data collection was carried out at two moments, by applying two scales for measuring the uncertainty level (Michel) and family management disease (FaMM), with interviews in both periods, one of which was two months after hospital discharge. By means of inductive thematic analysis, a qualitative examination of the data was performed, with descriptive and inferential statistics and quantitative analysis, followed by integration and comparison of the results to create the metainferences. Results: The IG showed a tendency to minimize the uncertainty level (p = 0.074) and identified approximation and dialog to set out their doubts and expectations in relation to the preparation and a better perception of the children’s life after hospital discharge (p = 0.074) as possible factors when giving voice to the families, as a result of understanding the child’s life beyond the disease, combined with the clinical stability he presented. The EG showed a tendency to having less difficulty in relation to the disease after discharge (p = 0.080), and the testimonies from this group signal to the support of the care network after the extension project contact with the municipalities where these families lived, to the resolution of the problem that interfered in the child’s health, accomplished during hospitalization, and to the training received to care for him at home. In the SG, in turn, the tendency achieved (p = 0.058) revealed a higher level of worry in the families with the disease and its repercussions on the lives of the relatives and of the child himself, for not having sound knowledge that could help them evaluate the child and make decisions, linked to the inconsistency of the information given about the disease and the treatment. Conclusions: The IG and the EG showed potential in the preparation of the hospital discharge to the family management of children with chronic diseases in the home.