Desafios da atenção e formação continuada em profissionais de instituições de longa permanências para pessoas idosas

• Ano de defesa: 2025
• Autor(a) principal: Félis, Keila Cristina
• Orientador(a): Silva, Henrique Salmazo da
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Católica de Brasília
• Programa de Pós-Graduação: Programa Stricto Sensu em Gerontologia
• Departamento: Escola de Saúde e Medicina
• País: Brasil
• Palavras-chave em Português: Pessoa idosa; Cuidados; Saúde; Instituição de longa permanência para idosos; Educação; Gerontologia
• Palavras-chave em Inglês: Elderly; Care; Health; Long-stay institutions for the elderly; Education; Gerontology
• Área do conhecimento CNPq: CNPQ::CIENCIAS DA SAUDE
• Link de acesso: https://bdtd.ucb.br:8443/jspui/handle/tede/3669

In recent years, although the literature has made progress in investigating the quality of care in Long-Term Care Facilities for the Elderly (LTCFs), the humanization of care in these services still faces numerous challenges. Among them are the lack of funding, human resources, government subsidies, and mismatches between the health needs of residents and the care offered. In Brazil, the implementation of this type of care requires short-, medium-, and long term interventions, with a view to training professionals who work with elderly people, raising awareness in society and government representatives for the creation of public policies, offering educational interventions to care providers, and increasing research and studies on the subject. Based on this, the objectives of this study were: a) to investigate the difficulties and challenges of care in LTCFs from the perspective of professionals working in Brazilian institutions; b) to verify possible relationships between measures of well-being, attitudes towards old age, job satisfaction and individual-centered care practices in professionals working in LTCFs; and c) to verify the possible contributions of an educational intervention in the scenario of care offered. To this end, professionals working in Brazilian public, philanthropic and private LTCFs were investigated during the first and second half of 2022. Participants were assessed using semi structured questionnaires, an inventory of attitudes towards old age, an inventory of practices related to individual-centered care, and satisfaction and work-related overload. To assess the difficulties and challenges associated with care, data from a focus group conducted via web conference were analyzed, followed by a training and updating cycle on the care offered in LTCFs, consisting of eight meetings lasting 120 minutes. Qualitative data were transcribed and analyzed based on the thematic analysis proposed by Minayo (2010), and quantitative data were analyzed using parametric and nonparametric statistical tests, with a significance value <0.05. Regarding the challenges related to the quality of care in LTCFs in Brazil, professionals highlighted factors such as social and health demands, lack of resources, inadequate training of professionals, and stigmas associated with institutionalization that directly impact care. To overcome these challenges, participants suggested that LTCFs should act as mediators, promoting qualified listening and integrating the family into care. In the field of public policies, ways to overcome violations and shortages stand out, while in education, it is vital to train professionals capable of dealing with the needs of older adults. The focus group analysis showed the limits and advances in care during the 2022 pandemic, reflecting the need to reconfigure both work in institutions and public policies and financing. Regarding possible associations between variables, associations were observed between negative attitudes towards old age and symptoms of Burnout; and an association between lower levels of job satisfaction (except in the “Policy and strategy” domain) and poorer quality of person-centered care in LTCFs. In addition, the length of time working with older people, and not the length of time in LTCFs, is also related to job dissatisfaction. The results reinforce the need for educational interventions to qualify professionals and improve working conditions, which may result in an increase in the supply of qualified care. Regarding the educational intervention, there were no differences between measures of job satisfaction, attitudes towards old age, Burnout and person-centered care among participants who remained in the intervention and among those who discontinued the continuing education program. However, the training cycle proved useful in promoting a collaborative environment and in reflecting on professional practices, although the direct impact on working conditions and the quality of care provided was not statistically significant. The continuity of such programs, with a focus on collaboration between different social actors, is essential to improve working conditions and the quality of care in LTCFs. In Brazil, there are few programs for care and continued training for professionals working in LTCFs. It is expected that this work will contribute to the articulation; construction and strengthening of a line of continued care for institutionalized elderly people in Brazil.