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Challenges to the shared care management concept between caregivers and professionals of the Brazilian Home Care Service

Abstract

Home Care (HC) promotes dehospitalization of users in a stable clinical condition and humanization of health care in opposition to the exclusive valorization of medical knowledge; organized by the Home Care Service (SAD), it is in line with the Unified Health System (SUS) and gives special importance to the active participation of users and caregivers. This article derives from a study that analyzed the effects of the SAD-caregivers interface on the management of the care process in a city in the interior of São Paulo. The experience of caregivers and professionals in the care partnership dedicated to service users was investigated: ten caregivers were interviewed, and seven professionals participated in a focus group. Thematic Content Analysis was used to understand the data, allowing to identify four categories: hierarchy of the care relationship; therapeutic effect of the team-user relationship; infantilization of the user; and gender influence on care. Considerations of the team in the focus group corroborate the perception of the interviewed caregivers, legitimizing the need for a strategy to bring teams and caregivers closer together. Shared care management, a modality that aims to promote the resumption of autonomy and appropriation of the work process by professionals, tends to reduce fragmentation and favor interdisciplinarity and integration, actively promoting conditions to integrate the knowledge of users and caregivers in care.

Keywords:
care management; health integration; caregivers

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