Análise da sobrecarga e do apoio social entre cuidadores informais de pessoas em hemodiálise: estudo de método misto

Abstract

Chronic renal disease and hemodialysis have repercussions that compromise the multidimensionality of the sick person, which makes the presence of the caregiver essential to develop activities related to physical and psychosocial well-being. However, the caregiver may suffer from the increasing demand for daily and uninterrupted care, which can lead to physical, mental and social overload and stress. Social support may be one of the possibilities to relieve the burden suffered by the caregiver. This study aims to analyze the burden and social support of informal caregivers of people with chronic renal disease on hemodialysis. This is a mixed method study, conducted in a highly complex service in southern Minas Gerais, with 55 participants. To collect data, we used four instruments: sociodemographic characterization questionnaire, Social Support Scale, Zarit Overload Scale and a script with guiding questions to conduct the qualitative stage of this research. For the the quantitative data analysis we used the Spearman correlation coefficient and the Mann-Whitney test to assess the degree of association between the variables under study; the Braun and Clarke Thematic Analysis for the qualitative data. It was found a predominance of female caregivers (74%), from 31 to 50 years old (43,7%), married (58,2%), catholic (69,1%), with monthly family income of less than two minimum wages (47,3%), elementary school (58,2%), who did not engage in physical activities (72,7%), for leisure (54,5%) or labor (56,4%), with care time of more than three years (50,9%), with hours of care for people on hemodialysis between 16 and 24 hours (43,7%), not residing with the sick person (50,9%). High level of perceived social support was evidenced, especially in relation to the affective dimension (median 100) and a slight overload (47,3%). There was a significant correlation between the variables "positive social interaction" and "overload" (r = -0.272; p = 0.045). From the qualitative analysis was created the central theme: the experiences of the informal caregiver of the person on hemodialysis: between the weight of responsibility and the search for meaning and subthemes: the meanings of caring for the person with chronic renal insufficiency on hemodialysis, the day by day of the caregiver and the duality in recognizing the overload, the encounters and mismatches in the search of social support. Although quantitative results pointed to an overload overload link, the caregivers reported tiredness, isolation and changes in daily life, which emphasize the duality in their recognition. This study contributes to the knowledge of the needs applied to overload and social support among caregivers of people with chronic kidney disease, as well as to the advancement of nursing practice in the treatment of this population, which should be included in the nursing care plan. Furthermore it collaborates to the reflection regarding the recognition of the importance of support networks for these caregivers, such as actions in the waiting room as a therapeutic space