Articulação do serviço social hospitalar com a rede de apoio informal em cuidados continuados

Objective: The study aimed to analyze the mediation between healthcare and informal social support in the continuing healthcare process. Participants: fifty-seven patients were referred in 2019 by a hospital to the Rede Nacional de Cuidados Continuados Integrados in Portugal (a continuing healthcare services network). The sample was mostly female (63.2%; n = 36), with an average age of 80 years old (DP = 9.2), predominantly from rural areas (64.9%; n = 37), married (56.1%; n = 32), and 35.0% lived alone (n = 20).  Methods: Descriptive study with univariate quantitative analysis and categorical content analysis of social work data. Results: Of the 57 patients referred to the Network, deaths and cancellations were registered in 32 cases (56.1%). Of the 25 patients discharged from the Network in the post-discharge period, all needed informal and/or formal support, while at the hospital referral date, only 20.0% of the sample needed support (p < .001). Of those who had support, about a third had support from the primary social network, mostly from their sons or daughters, and about half of the patients had emigrant children. At post-discharge 64.0% (n = 16 out of 25) had informal support. We also found that 8.8% of the patients were caregivers and began to require care. Conclusion: The study confirms the importance of ensuring continued care for citizens who have seen their vulnerability increased by illness, as well as the centrality of the informal support system for patients.