Desenvolvimento e avaliação de uma metodologia de cuidado interprofissional para idosos com demência mediada pelo Sistema Móvel de Assistência ao Idoso (SMAI)

Abstract

The general study objective is to evaluate the methodology of interprofessional care for older adults with dementia mediated by the Mobile Assistance System for the Elderly (Sistema Móvel de Assistência ao Idoso, SMAI) and specific objectives were: to describe the caregivers' perception of interprofessional care for the elderly with dementia mediated by the SMAI Caregiver application at six, twelve and eighteen months of use; describe the perception of professionals from the outpatient team about interprofessional care for the elderly with dementia mediated by the SMAI Doctor at the end of the 18-month period; analyze the content of messages exchanged between caregivers and professionals and analyze the patient and caregiver reports sent by SMAI Caregiver from the dataset produced over 18 months. This is a quantitative and qualitative study analysis in the use of a mobile health application for remote monitoring of the elderly and social support for caregivers. The use of this application is part of the multiprofessional intervention in caring for elderly people with dementia and functional dependence in an outpatient geriatric service. Quantitative data were obtained through descriptive statistical analysis of sociodemographic, clinical variables and variables from patient and caregiver reports. The qualitative data included the analysis of the content of conversations in the focus groups with caregivers and professionals and the analysis of the content of messages exchanged between caregivers and professionals through the application. Thirty-eight caregivers were selected, who used the SMAI Caregiver application with varying participation time and amount of reports sent. Twenty caregivers participated in the focus groups regarding their experience of using the systems at six, twelve and eighteen months. The role of caregiver was carried out by family members, who lived with the elderly and who had or not any assistance from a formal caregiver or shared care with other family members. A total of 7,785 patient reports were sent and the analysis of the dataset produced during the period of use of the SMAI Caregiver application showed significant variation in the number of reports sent. A strong association was found between the variables falling and behavior change, showing that in patients who presented behavior change, the prevalence of falling was 60.9%. Regarding the variables falling and skin injury, it was observed there is evidence that the patient has higher prevalence of skin damage when falling, 93.8%. The results showed that the methodology of interprofessional care can serve as a health care model for people with dementia. It is possible to structure a telemedicine program within the scope of Brazilian health system as a way to optimize health care, minimize expenses with patient displacement and provide social assistance and psychological support to family caregivers of the elderly. Therefore, the SMAI met the objectives proposed since its conception, designed to improve communication between family caregivers and professionals in the geriatric service through remote monitoring of the home-based care routine.