Living with the Children/Adolescent in Home Care: the Influence on the Family Dynamics from the Perspective of the Family Caregiver
Introduction: Increased survival, especially for the elderly and children with chronic health problems, increased hospital costs, stimulating the use of the home as an option for the continuation of health care, being called in the private sector as Home Care (Wilknson & Leuven, 2012). When it comes to children, health care demands specific skills in the areas of rehabilitation, social and family education. In addition to being permeated by challenges, physical and emotional frailties that make it difficult to care for and reflect on intra-family relationships (DeLima; et al). The purpose of this study is to understand the influence of Home Care on the dynamics of the child/adolescent family. Method: Qualitative study, conducted with 14 family caregivers of children/adolescents who were hospitalized at home between the ages of two and sixteen years, attended by a private Home Care company. The data were collected through a semistructured interview and analyzed according to the Qualitative Analysis of Conventional Content, having as theoretical reference the Symbolic Interactionism and Calgary Family Assessment Model. The conventional content analysis was elaborated throughout the discourse analysis, in four stages, which include: data coding, categorization, category integration and description (Hsieh, 2005). Results: From the content expressed by caregivers, the thematic category "Experiencing the impact of Home Care on the family routine" emerged. In this sense, the complexity of the actions, the close relationship with the family routine and the strategies are represented in the subcategories: Being difficult to get home for the first time in the presence of Home Care, Suffering from change in the family routine, Having to deal with lack of freedom and privacy, Facing sleep deprivation, despite the presence of the professional, Suffering from limited social contact, Recognizing Home Care's interference in the interaction of the family with the child, Resigning the home to the demands of child care, Having to adapt to the routines of Home Care and Concerning the safety of the family. Conclusion: Home Care requires these caregivers to face new challenges and to adapt to difficulties, which they reflect in the psychosocial context and in the interactions between the members of their family and the multiprofessional team. In this way, this research contributed to demonstrate the importance of the use of the qualitative method in order to understand the relationships, perceptions and meanings attributed by the family inserted in the context in Home Care.