O Itinerário terapêutico de pessoas com obesidade no sus: uma experiência na região oeste do Paraná

Abstract

Introduction: The increasing prevalence of overweigh and obesity constitutes one of the main challenges for contemporary public health, compromising health systems. In this context, understanding the therapeutic itinerary of obese individuals referred for bariatric surgery can contribute to improvements in care practies and multidisciplinary follow-up strategies. Objectives: To analyze the characteristics of the therapeutic itinerary of individuals indicated for bariatric surgery, attended by a specialized service of a public teaching hospital in the western region of Paraná; To describe current situation of obesity in the municipalities that refer patients to the bariatric surgery and obesity service; To evaluate the relevance of interdisciplinay follow-up in the tratament of obesity; And to identify patients perceptions of facilitators and barries encountered along the preoperative therapeutic itinerary. Methods: This is a mixed-methods study (qualitative and quantitative), based on the inductive method, with an observational cohort design and longitudinal charater. Quantitative data were obtaained from the monitoring sreadsheets of users participating in the bariatric surgery and obesity service and analyzed using Quantum GIS softwere. Qualitative data derived from semistructured interviews with 19 participants followed for 12 months, verified according to the content analysis technique proposed by Bardin, with the support of TAMS Analyser software. Results and discussion: the qualitative analysis allowed us to understand the current obesity status of the studied group, it is clinical and social aspects. From the analysis of the interviews, five thematic categories were identified: contemporary eating habits; physical aactivity in daily digital life; emotions and self-image; social determinants of health; and access to health care. After this analysis, we can identify errors and success in the therapeutic itinerari, which helps us reflect on what measures could be tken to improve the treatment of obese patients in the western region of Paraná.