Transition of care for the elderly after cerebrovascular accidents - from hospital to the home

OBJECTIVE: to examine the transition of care in families caring for elderly persons who suffered the first episode of a cerebrovascular accident. METHODOLOGY: an instrumental ethnographic case study was used. The sample comprised 20 subjects: 10 caregivers and 10 elderly persons aged 65 or over, of both sexes, with diagnoses of first episode of cerebrovascular accident, capable of communicating, and requiring care from a main carer in their family. The data was collected through interviews, observation, existing documentation and field notes. Qualitative analysis techniques were used to codify and classify the data and to formulate significant categories, which generated typologies of care. RESULTS AND DISCUSSION: The central idea was the Transition of Care and showed the context in three typologies: The care process for the dependent elderly person, Strategies for the care process and Impact and acceptance of the limitations. CONCLUSION: The data indicates that caring for an elderly person after a cerebrovascular accident is a challenge for the family. The data permitted it possible to elaborate a proposal for a model for the organization of the work, with a view to holistic care delivery in the health services, forming a care network, which constitutes an advance for the area of nursing

Women's strategies for coping with urinary incontinence

RESUmo Este artigo é parte de uma pesquisa qualitativa mais abrangente que utilizou como referencial teórico-metodológico a Grounded Theory e o Interacionismo Simbólico, resultando no modelo teórico denominado "Entre o sofrimento e a esperança: a reabilitação da incontinência urinária como componente interveniente". Com a intenção de comunicar todo o conhecimento produzido, apresenta-se parte desse modelo, referente ao processo de enfrentamento da incontinência urinária por mulheres sem perspectivas de acesso ao tratamento cirúrgico, após falha dos procedimentos conservadores. Ao inter--relacionar os componentes (categorias e subcategorias) relativos à experiência dessas mulheres, buscando compará-los e analisá-los para compreender a interação entre eles, notou-se vulnerabilidade moral e psicossocial no movimento da experiên-cia do grupo, suscetibilizando-o a riscos à saúde e ao comprometimento da qualidade de vida. Pesquisas são necessárias para aprofundar a compreensão de experiên-cias em que haja barreira ao tratamento cirúrgico por descrédito do profissional médico sobre sua efetividade. Original article AbStRAct This article is part of a more comprehensive qualitative study which used grounded theory and symbolic interactionism as theoretical and methodological frameworks, resulting in the theoretical model entitled, Between suffering and hope: rehabilitation of urinary incontinence as an intervenient component. In order to communicate all the knowledge produced, part of this model is presented, and it refers to the process of coping with urinary incontinence by women without perspectives of access to surgical treatment after failure of conservative procedures. When interrelating the components (categories and subcategories) of these women's experience in order to compare and analyze them to understand their interaction, moral and psychosocial vulnerability were noticed within the experience of the group, which makes them susceptible to health risks and to compromise of their quality of life, observed in the movement of the group's experience. Research is needed to further understand experiences in which there are barriers to surgical treatment due to physicians' disbelief in its effectiveness. dEScRiPtoRS Urinary incontinence Women Rehabilitation Surgery Life change events RESUmEn El artículo forma parte de una investigación cualitativa más abarcadora que utilizó como referencial teórico-metodológico la Grounded Theory y el Interaccionismo Simbólico, resultando en el modelo teóri-co denominado "Entre el sufrimiento y la esperanza: la rehabilitación de la incontinencia urinaria como componente interviniente". Con intención de comunicar el conocimiento producido, se presenta parte de dicho modelo, referido al proceso de enfrentamiento de la incontinencia urinaria en mujeres sin perspectivas de acceso a tratamiento quirúrgico, habiendo fallado los procedimientos conservadores. Al interrelacionarse los componentes (categorías y subcategorías) relativos a la experiencia de dichas mujeres, buscando compararlos y analizarlos para entender su interacción, se notó vulnerabilidad moral y psicosocial en el tránsito de experiencia grupal, susceptibilizándolo a riesgos de salud y al compromiso de calidad de vida. Serán necesarias investigaciones que profundicen la comprensión de experiencias en las que existan obstáculos al tratamiento quirúrgi-co por descreer el profesional médico sobre su efectividad. dEScRiPtoRES Incontinencia urinaria Mujeres Rehabilitación Cirugía Acontecimientos que cambian la vid