Primary Health Care in transitional care of people with stroke

• Published in: Revista Brasileira de Enfermagem Vol. 77; no. 3; pp. e20230468 - 8
• Main Authors: Magagnin, Adriana Bitencourt, Silva, Kenia Lara da, Melo, Giane Zupellari Dos Santos, Heidemann, Ivonete Teresinha Schulter Buss
• Format: Journal Article
• Language: English
• Published: Brazil Associação Brasileira de Enfermagem 01-01-2024
• Subjects: Caregivers; Case studies; Comprehensive Health Care; Continuity of care; Continuity of Patient Care; Continuity of Patient Care - standards; Data collection; Disease prevention; Female; Health care; Health promotion; Hospitals; Humans; Male; Medical personnel; Middle Aged; Original; Primary care; Primary Health Care; Primary Health Care - standards; Professional ethics; Professionals; Qualitative Research; Stroke; Stroke - therapy; Teams; Transitional Care; Transitional Care - standards; Transitional Care - trends; Brazil
• ISSN: 0034-7167; 1984-0446
• DOI: 10.1590/0034-7167-2024-0468

to understand the role of Primary Health Care teams in caring for people with stroke after hospital discharge.
single case study, with integrated units of analysis, with a qualitative approach. Data triangulation occurred through interviews with professionals and family caregivers involved in transition of care, in addition to direct observations in rounds and document analysis. For the analyses, the analytical strategies of theoretical propositions and construction of explanations were used, with the help of ATLAS.ti®.
the importance of counter-referral, the role of community health workers and the multidisciplinary team, health promotion, secondary prevention, home visits as a visceral attribute and nurses as care managers are evident.
the high demand on teams and the Social Determinants of Health interfere with adequate continuity of care. Transitional care programs that enable continuity of care are recommended.