Itinerário terapêutico de pacientes atendidos no serviço de assistência de alta complexidade ao indivíduo com obesidade, do Hospital Universitário do Oeste do Paraná (HUOP)

Abstract

In the western macro region of the State of Paraná was created, on February 2014, a High Complexity Assistance Service for Individual with Obesity at the University Hospital of Western Paraná. Because it is a relatively new service, it is important to know the profile of the patients and their motivations as well as the path taken by them in the search for treatment of obesity. For this purpose, the objective was: To characterize the socio-demographic profile of the registered patients; Analyze the health care demand behavior of patients; Describe the process of creating and deploying the service. The research was characterized as exploratory and descriptive and used quantitative and qualitative analytic procedures. The demographic profile of the patients was identified based on information obtained from the service database. The health care demand behavior was analyzed from Kleinman’s reference point which defends the interference of three subsystems in the Therapeutic Itinerary taken by people in search of a solution to health problems: family, popular and professional. Twenty-one of the 75 active patients in the service were interviewed, one from each municipality. For the description of the service two of its creators were interviewed; for the perceptions of the patients regarding the changes that occurred in their implementation through interviews. A total of 148 patients registered: 18.25% male and 81.75% female; 85% in the age group between 30 and 59 years old, from 38 different municipalities. The onset of obesity occurred, to 40.54%, in childhood and adolescence, and to 32.43% between 20 and 30 years. The obesity degree, according to the Body Mass Index, was grade III, for 59.46% of the cases, and grade IV for 25.0%. The waiting time for specialized care in obesity was less than one year, for 8.11%; more than three years, for 25.00%; and more than five years or more, for 5.4%. There were 53 different occupations, and the most reported were: housewives, with 25.0% and retired people, with 7.45% of the cases. In the family subsystem, it was observed family and friends support in the search for clinical treatment for obesity; few patients adhered to alternative treatments, typical of the popular subsystem; and the intervention/orientation of health professionals (professional subsystem) has proved to be decisive in the search for obesity specialized treatment. It was observed, in the process of implementing the service, a strong link between the health team and users; 99.8% considered the service from very good to excellent. It was concluded that the organization of the overweight and obesity care line in the Network for Health Care of People with Chronic Diseases is fundamental to reduce the waiting time in specialized services; it would prevent overweight and reduce gain weight speed, while avoiding advanced degrees of obesity. Knowing the Therapeutic Itinerary of patients with obesity, accompanied in specialized services, is important to rethink the practices and approaches, in the different levels of the system and for the prevention and treatment of this public health problem. And humanization in health makes it possible to look at each subject in its specificity.