A experiência da enfermidade na perspectiva de pessoas que sobreviveram ao acidente vascular cerebral.

Abstract

The recovery after stroke (CVA) is complex and it involves biomedical, social and psychological aspects associated to health and quality of life. The experience of experiencing stroke can lead the person and family caregivers to face the demands arising from dysfunctions resulting from this condition. Currently there is a broad, multidisciplinary scientific debate about the advances necessary to promote health and quality of life to people who survive stroke, through health care models that use a comprehensive approach of health, with emphasis on rehabilitation process. The aim of the study was to analyze the meanings of the illness experience from the perspective of people who survived the stroke. This is a qualitative case study, which involved eight adult and elderly, treated at a general hospital in the south of Bahia, from January 2011 to December 2012. Data were collected through semi-structured interviews in houses and the interpretive analysis conducted through the stages of reduction, organization of data, identification of meaning units, construction of core themes and interpretation of results. The experience of the disease was understood as a biographical disruption, a situation between life and death, disability, loss of autonomy and inability to work. The social support from family and religion were essential to deal with the changes in everyday life after stroke. Needs related to rehabilitation interventions in the home and community context were identified, and the participants mentioned difficulties in the process of rehabilitation after discharge. The stroke experience marked a break in the lifestyle and the way people work and understand the disease. The absence of a program of rehabilitation and upgrading is a clear distortion between the ideal employee for public policy and the actual neglect of the poor service that contributes to the dehumanization of health care. Participants and their families were left without support for treatment and continuity of care network. It became apparent dismantling of the organizational structure of health care networks, and their unpreparedness to meet the demands of health care to patients with chronic diseases, especially in inner cities whose human and technological resources are scarce. These results suggest the need to enhance the strategies of educational interventions and multidisciplinary care, as well as revising the process of self-management of health and to strengthen the network of social support, especially from family that will meet the demands of care associated with population aging and coping with chronic diseases, especially stroke.