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Protelamento de alta hospitalar por motivos não clínicos: perspetivas de pessoas mais velhas e de assistentes sociais
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A permanência de idosos em hospitais sem necessidade clínica representa um desafio complexo para os sistemas de saúde. O presente estudo teve como objetivo conhecer perspetivas e vivências de utentes mais velhos e de assistentes sociais sobre a permanência em internamento hospitalar sem critério clínico. Para além de fazer uma caracterização da pessoa mais velha internada sem critério clínico e sentimentos vivenciados nesse processo; também procurou identificar possíveis fatores associados ao internamento e protelamento da alta das pessoas mais velhas; e ainda compreender o papel dos Assistentes Sociais face a estas situações de protelamento de alta. Realizou-se uma investigação de natureza mista, numa unidade de saúde, com 31 pessoas idosas internadas sem critério clínico e 6 assistentes sociais. Às pessoas mais velhas foi aplicado um questionário sociodemográfico e a Escala de Solidão UCLA, e às assistentes sociais uma entrevista semiestruturada. Os resultados indicam uma feminização da população idosa hospitalizada e um período de internamento sem critério clínico que varia entre os
12 e 224. Referem sentir solidão, tristeza, frustração e sentimento de abandono, verificando-se, com a aplicação da Escala UCLA, prevalecer “solidão moderadamente elevada” e “solidão elevada” (61,3%). As assistentes sociais entrevistadas identificaram diferentes motivos de internamento; constrangimentos à alta hospitalar; consequências do protelamento de alta; as suas experiências e sentimentos perante a problemática; e mudanças necessárias e possíveis para a reverter. As conclusões deste estudo remetem para a necessidade de conhecer mais detalhadamente as necessidades e sentimentos de pessoas mais velhas internadas sem critério clínico, bem como de se lhes proporcionar uma resposta de continuidade de cuidados digna e promotora da sua saúde e bem-estar. No que diz respeito aos assistentes sociais, conclui-se que a sua visão holística e crítica face a esta problemática deve ser integrada na elaboração e implementação de medidas sociais e de saúde que diminuam a incidência e o impacto do protelamento de altas hospitalares na população mais velha.
The prolonged hospitalization of elderly individuals without clinical necessity represents a complex challenge for healthcare systems. The present study aimed to explore the perspectives and experiences of older patients and social workers regarding hospital stays without clinical justification. In addition to characterizing older individuals hospitalized without clinical criteria and the emotions experienced during this process, the study sought to identify potential factors associated with hospitalization and delays in discharge for the elderly, as well as to understand the role of social workers in these discharge delays. A mixed-methods investigation was conducted in a healthcare unit, involving 31 elderly individuals hospitalized without clinical criteria and 6 social workers. A sociodemographic questionnaire and the UCLA Loneliness Scale were administered to the elderly participants, while social workers participated in a semi-structured interview. The results indicate a feminization of the hospitalized elderly population, with hospitalization without clinical justification ranging from 12 to 224 days. The elderly participants reported feelings of loneliness, sadness, frustration, and abandonment, with the UCLA Loneliness Scale showing that "moderately elevated loneliness" and "high loneliness" were prevalent (61.3%). The interviewed social workers identified various reasons for hospitalization, constraints on discharge, the consequences of discharge delays, their experiences and emotions regarding the issue, and necessary and possible changes to address the problem. The study's conclusions emphasize the need to gain a more detailed understanding of the needs and emotions of elderly individuals hospitalized without clinical justification, as well as to provide them with a dignified and health-promoting continuity of care that fosters their well-being. Concerning social workers, it is concluded that their holistic and critical perspective on this issue should be integrated into the development and implementation of social and health policies that reduce the incidence and impact of delayed hospital discharges among the elderly population.
The prolonged hospitalization of elderly individuals without clinical necessity represents a complex challenge for healthcare systems. The present study aimed to explore the perspectives and experiences of older patients and social workers regarding hospital stays without clinical justification. In addition to characterizing older individuals hospitalized without clinical criteria and the emotions experienced during this process, the study sought to identify potential factors associated with hospitalization and delays in discharge for the elderly, as well as to understand the role of social workers in these discharge delays. A mixed-methods investigation was conducted in a healthcare unit, involving 31 elderly individuals hospitalized without clinical criteria and 6 social workers. A sociodemographic questionnaire and the UCLA Loneliness Scale were administered to the elderly participants, while social workers participated in a semi-structured interview. The results indicate a feminization of the hospitalized elderly population, with hospitalization without clinical justification ranging from 12 to 224 days. The elderly participants reported feelings of loneliness, sadness, frustration, and abandonment, with the UCLA Loneliness Scale showing that "moderately elevated loneliness" and "high loneliness" were prevalent (61.3%). The interviewed social workers identified various reasons for hospitalization, constraints on discharge, the consequences of discharge delays, their experiences and emotions regarding the issue, and necessary and possible changes to address the problem. The study's conclusions emphasize the need to gain a more detailed understanding of the needs and emotions of elderly individuals hospitalized without clinical justification, as well as to provide them with a dignified and health-promoting continuity of care that fosters their well-being. Concerning social workers, it is concluded that their holistic and critical perspective on this issue should be integrated into the development and implementation of social and health policies that reduce the incidence and impact of delayed hospital discharges among the elderly population.
Descrição
Palavras-chave
Idosos Hospitalizados Abandono Alta Hospitalar Protelamento Serviço Social Elderly Hospitalization Abandonment Hospital Discharge Delay Social Work