Person-centered Care for Institutionalized Older Adults in the Context of the Covid-19 Pandemic in Brazil

Marina Celly Martins Ribeiro de Souza, Natália de Cássia Horta, M. Pereira, Júlia das Graças Rodrigues de Almeida, J. Yee, Leonardo Ayres Cordeiro, Tainá Pinto, C. Kartoz
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Abstract

Objective: This study aims to discuss the caregiving practices developed by Long-term Care Facilities (LTCFs) during the COVID-19 pandemic and analyze the daily care practices in long-term institutions for older adults in Brazil, all in light of the PCC framework. Methods: This is a mixed methods study in which data were collected through interviews with managers from 10 LTCFs. The qualitative discussion was carried out through the PCC framework divided into 5 categories: leisure, accommodation, food, hygiene and comfort, and clinical care. The quantitative data collected were analyzed in a descriptive way, being discussed in the light of the literature. Results: Analyzed LTCFs are unaware of our present difficulties in the implementation of PCC, with a greater presence of the traditional biomedical model being recognized. Given the vulnerabilities that the LTCFs present, PCC is an important alternative for LTCFs to promote the quality of life and autonomy of residents. Deconstructing the vision of LTCFs as a last resort of care and investing in the quality of care is an urgent and essential imperative for dignified and comprehensive care. Conclusions: This study highlights the need for a change in culture and understanding of the LTCFs not only as a place to provide healthcare, but also as a residents’ home that fosters their autonomy, and feeling of belonging. Thus, it is essential to ensure that healthcare teams in LTCFs know about PCC and that further studies investigate the impact on the costs of PCC for institutionalized older adults.
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巴西Covid-19大流行背景下机构老年人以人为本的护理
目的:本研究旨在讨论COVID-19大流行期间长期护理机构(ltcf)制定的护理实践,并根据PCC框架分析巴西长期老年人机构的日常护理实践。方法:这是一项混合方法研究,通过对10个长期信托基金经理的访谈收集数据。通过PCC框架进行定性讨论,该框架分为5类:休闲、住宿、食品、卫生和舒适以及临床护理。收集的定量数据以描述性的方式进行了分析,并根据文献进行了讨论。结果:所分析的ltcf没有意识到我们目前在实施PCC方面的困难,传统生物医学模式的存在得到了更多的认可。鉴于ltcf存在的脆弱性,PCC是ltcf提高居民生活质量和自治的重要替代方案。要实现有尊严和全面的护理,当务之急是打破长期护理基金作为最后护理手段的愿景,并投资于护理质量。结论:本研究强调需要改变文化和对ltcf的理解,不仅要将其作为提供医疗保健的地方,还要将其作为促进居民自主性和归属感的家园。因此,有必要确保ltcf的医疗团队了解PCC,并进一步研究对制度化老年人PCC成本的影响。
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