Almeida Patty Fidelis de, Santos Adriano Maia Dos, Silvério Rafaela Fidelis Lima, Ribeiro Amanda Maria Villas Bôas, Silva Drieli Oliveira, Vilasbôas Ana Luiza Queiroz
Instituto de Saúde Coletiva, Universidade Federal Fluminense, Niterói, Brasil.
Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista, Brasil.
Cad Saude Publica. 2025 Jul 18;41(6):e00109524. doi: 10.1590/0102-311XEN109524. eCollection 2025.
This article analyzes the continuity of care in the relational domain based on user experience. This is a qualitative case study based on 45 interviews with person living with HIV (PLH) followed-up in polyclinics and 38 interviews with users diagnosed with systemic arterial hypertension (SAH) registered in basic health units (BHU) in a large city in the state of Rio de Janeiro, Brazil. The results were analyzed according to two dimensions of relational continuity: trust-based relationship and availability of personalized information. The strongest trust-based relationships and the protagonism in the availability of health information were established with the family health team (FHT) physician and the infectious disease specialist in the polyclinics. Among the differences, according to users with SAH, the relationship bonds were broken by health care provider turnover. In the absence of relationships with other FHT professionals, continuity and access were simultaneously affected. Among PLH users, nursing professionals played an important role in care. In both cases, the results showed a care with little concern for interprofessional practices, collective actions and promotional initiatives to strengthen continuity. The lack of technology-mediated communication required users to attend health care services to solve their demands and contact professionals. The results indicate the importance of a regular point of care for establishment of the bond and consequent relational continuity. However, health care work management-related problems in the Brazilian Unified National Health System aggravate health care provider turnover and favor disruptions in therapeutic follow-up.
本文基于用户体验分析了关系领域中的连续性护理。这是一项定性案例研究,对在综合诊所接受随访的45名艾滋病毒感染者(PLH)进行了访谈,并对巴西里约热内卢州一个大城市基层卫生单位(BHU)登记的38名被诊断为系统性动脉高血压(SAH)的用户进行了访谈。根据关系连续性的两个维度对结果进行了分析:基于信任的关系和个性化信息的可获取性。与综合诊所的家庭健康团队(FHT)医生和传染病专家建立了最强的基于信任的关系,并且在健康信息的可获取性方面发挥了主导作用。在差异方面,根据SAH患者的说法,医疗服务提供者的更替破坏了关系纽带。在与其他FHT专业人员没有关系的情况下,连续性和可及性同时受到影响。在PLH用户中,护理专业人员在护理中发挥了重要作用。在这两种情况下,结果都表明护理很少关注跨专业实践、集体行动和加强连续性的促进举措。缺乏技术介导的沟通要求用户前往医疗服务机构解决他们的需求并联系专业人员。结果表明,定期护理点对于建立联系以及随之而来的关系连续性很重要。然而,巴西统一国家卫生系统中与医疗工作管理相关的问题加剧了医疗服务提供者的更替,并助长了治疗随访的中断。