PROPUESTA DE UN MODELO DE HOSPITAL PARA LA IMPLICACIÓN DEL PACIENTE EN EL AUTOCUIDADO

Souza, Andrieli Daiane Zdanski de; Magalhães, Ana Maria Müller de; Inchauspe, Juciane Aparecida Furlan; Camatta, Marcio Wagner; Costa, Diovane Ghignatti da; Moura, Gisela Maria Schebella Souto de

Andrieli Daiane Zdanski de Souza

Study design

Data collection

Data analysis and interpretation

Discussion of results

Writing and/or critical review of content

Review and final approval of the final version

Agreement with all aspects of the manuscript in terms of veracity or completeness of information

Universidade Federal do Rio Grande do Sul, Programa de Pós-Graduação em Enfermagem. Porto Alegre, Rio Grande do Sul, Brasil.

https://orcid.org/0000-0002-3235-0182

Ana Maria Müller de Magalhães

Data analysis and interpretation

Discussion of results

Writing and/or critical review of content

Review and final approval of the final version

Agreement with all aspects of the manuscript in terms of veracity or completeness of information

Universidade Federal do Rio Grande do Sul, Escola de Enfermagem, Programa de Pós-Graduação em Enfermagem. Porto Alegre, Rio Grande do Sul, Brasil.

https://orcid.org/0000-0003-0691-7306

Juciane Aparecida Furlan Inchauspe

Writing and/or critical review of content

Agreement with all aspects of the manuscript in terms of veracity or completeness of information

Universidade Federal do Rio Grande do Sul, Programa de Pós-Graduação em Enfermagem. Porto Alegre, Rio Grande do Sul, Brasil.

https://orcid.org/0000-0002-2386-1378

Marcio Wagner Camatta

Writing and/or critical review of content

Agreement with all aspects of the manuscript in terms of veracity or completeness of information

Universidade Federal do Rio Grande do Sul, Programa de Pós-Graduação em Enfermagem. Porto Alegre, Rio Grande do Sul, Brasil.

https://orcid.org/0000-0002-4067-526X

Diovane Ghignatti da Costa

Writing and/or critical review of content

Agreement with all aspects of the manuscript in terms of veracity or completeness of information

Universidade Federal de Santa Catarina, Programa de Pós-Graduação em Enfermagem. Florianópolis, Santa Catarina, Brasil.

https://orcid.org/0000-0002-0754-8314

Gisela Maria Schebella Souto de Moura

Study design

Data analysis and interpretation

Discussion of results

Writing and/or critical review of content

Review and final approval of the final version

Agreement with all aspects of the manuscript in terms of veracity or completeness of information

Universidade Federal do Rio Grande do Sul, Escola de Enfermagem. Porto Alegre, Rio Grande do Sul, Brasil.

https://orcid.org/0000-0002-4744-478X

CORRESPONDING AUTHOR
Andrieli Daiane Zdanski de Souza andriele_zdanski@hotmail.com

CONFLICT OF INTEREST

There is no conflict of interest.

EDITORS

Associated Editors: Leticia de Lima Trindade, Maria Lígia Bellaguarda. Editor-in-chief: Elisiane Lorenzini.

Thematic matrix	Excerpts from the professionals
Clear and effective communication	When it is said easily, which is not a scientific term, I understand much more. (Pat1)
Clear and effective communication	I think clear communication, like that, without imposing. I believe that patients can understand me much better than imposing themselves. (Prof1)
Features of communication	I understand that it is necessary to transport yourself to their reality, with adaptations, sometimes with figures of speech. (Prof8)
	I had a complication in the recovery room, [...] and they decided to leave me there for a little longer, however, they had already informed my family, there is good communication between them. (Pat1)
	I emphasize that the main thing is that the patient sees meaning in what is being said [...]. I try to get in tune with the patient’s interests [...] (Prof9)
Contribution of written information to dialogue	I read, because it helps. It’s something you have in your body, so you need to study it to understand it, you have to read the material provided. (Pat7)
Communication failures	The professionals explained and if we asked anything, they were polite and answered. There are some [professionals] like that and I look at them and think: I’ll ask. Because we see that they are more willing [...] (Pat2)
Communication failures	[...] if you are surrounded by professionals who take good care of you, who are affectionate, because, when the professional is patient, they give us more security, they feel free to get involved in the care and ask everything. (Pat1)
Welcoming behavior of professionals	Now, if you see that the nurse doesn’t want to give an answer, then you don’t have the courage to ask either. [...] It has happened that professionals speak more aggressively, that we call, that they don’t like us calling. (Pat1)
Patient as observer in their hospitalization process	[...]The patient calls me and asks why, on the other shift, the medicine came in a saline solution and now it was administered in a syringe. Soon, the patient begins to feel insecure, because they no longer know which one is correct. (Prof6)

Thematic matrix	Excerpts from the professionals
Intrinsic factors of the patient and their previous experiences	The fact that I have been hypertensive for years makes it easier for me to get involved with the disease, as I learned more and more. (Pat3)
	In relation to patient involvement, there is also a lot of life history, personality [...] (Prof8)
Patient’s health status	Of course, the state of my health interferes with my involvement, as I was very anxious before coming here [...]. In the state I was in, when the professionals guided me, I didn’t understand (Pat8)
Religion and faith	I think I pray a lot, I believe in God and this gives me strength in my hospitalization process (Pat7)
Presence of the family in the hospitalization process	Of course, the presence of a family member is very important. My grandson, [...], helped me so much here, it always gives me security to have a family member and it also helps to better understand the care when I am discharged from the hospital. (Pat8)
Family member being a healthcare professional	As my son is a doctor, he explained to me that I have to be careful not to fall, use crutches, I won’t go down steps. My other daughter is a nurse and also guides me. (Pat5)
Patient co-responsibility for their care	What I really care about is television, for me, it’s a college, I look for information. [...] you just have to know how to select. (Pat7)
Patient co-responsibility for their care	The patient’s involvement [...] is how much they get involved with their problems, whether they take care of themselves, because the patient also has to take initiative. (Pat5)
Education	Patients who have a higher education level are able to get more involved and understand more. (Prof8)
Health education by the multidisciplinary team	I understand that it is up to the patient to know what is happening, [...] what they can do to be part of this care. [...] therefore, I believe that patient involvement is related to education. (Prof6)
Health education by the multidisciplinary team	It means that moments of education are also built together with the patient. (Prof8)
Patient-staff partnership	Overall, I can build a partnership with the patient. Often, this partnership during hospitalization is very effective, however, I don’t know how long this lasts after [...] (Prof9)
Patient co-responsibility for their care	I understand that involving the patient in their care is also promoting health, it is going beyond the treatment itself. It is an autonomous patient who decides for themselves in their care that they leave the hospital with responsibilities. (Prof8)
Patient co-responsibility for their care	We ourselves become our own doctor, because we learn to know our body. (Pat7)

Thematic matrix	Excerpts from the professionals
Organizational culture	I think it’s a process that needs to be built, I think that, sometimes, what we believe to be is different from what the patient understands. (Prof6)
Organizational culture	I think that despite being a single institution, there are several institutions within the same hospital [...]. Why is the patient coming here? Due to health problems, sometimes due to aspects that would be avoidable if the patient had greater involvement in their care. (Prof3)
Leadership	My leadership, as far as possible, talks about the subject, but there is no specific moment when we talk about patient involvement, we don’t have a working group. I think there are so many demands, that involvement, because it is something new, [...] it ends up being secondary, if there is time left, we talk about it. (Prof8)
Staff sizing	The number of patients per professional is high, we would need more professionals to be able to better involve the patient in self-care. (Prof5)
Staff sizing	The sizing is not adequate at all. The story of the short blanket, you know? If I were to serve all the patients in the health insurance unit, without consultation [...] I would not be able to serve another specific unit. (Prof8)
Physical structure of the unit	There are bigger rooms in this health insurance unit, we can sit down and do things more calmly. Sometimes the issue of the bed is already a physical barrier in SUS units, because there is no way to stay in a suitable position to talk for a long time with the family member or the patient. (Prof3)
Physical structure of the unit	In the agreement you have a good structure, the door is closed, this is also a difference between a private unit and the SUS unit. You can have greater privacy [...] (Prof8)

[1] CORRESPONDING AUTHOR
Andrieli Daiane Zdanski de Souza andriele_zdanski@hotmail.com

Brazil

Brazil

PROPUESTA DE UN MODELO DE HOSPITAL PARA LA IMPLICACIÓN DEL PACIENTE EN EL AUTOCUIDADO

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