Impactos da pandemia de covid-19 no acompanhamento de prematuros no ambulatório de neonatologia de um hospital universitário

Abstract

Introduction: The Covid-19 pandemic is a worldwide threat, due to its high dissemination, becoming the biggest public health problem globally. Social isolation deprived many children of regular health monitoring, as is the case with premature infants, who must be frequently monitored by the outpatient team, due to possible changes and delays in neurodevelopment. Objective: To analyze the impact of the Covid-19 pandemic on consultations of premature children in the outpatient clinic of a University Hospital. Methodology: This is a mixed survey, carried out between February and July 2022, with the participants being 10 guardians and 12 premature children aged zero to two years, attended at the neonatology outpatient clinic between 2019 and 2021. Data collection took place through semi-structured interviews and subsequently, the analysis of 258 medical records was carried out, in order to know the clinical and socioeconomic profile of the patients. Quantitative analysis was performed using descriptive statistics, and qualitative analysis, using inductive thematic analysis. Results: In the 258 charts analyzed, there was a predominance of males (60.5%), late preterm delivery (48.1%), diagnosis of pre-eclampsia during pregnancy (24.4%) and cesarean section as the route delivery (81.8%). In the qualitative analysis, the following categories emerged: 1) repercussions of the pandemic on premature care; 2) challenges through the pandemic context; and 3) coping strategies and quality in preterm outpatient care. The main difficulties faced included the reduction of consultations compared to the non-pandemic period, unemployment, fear of contamination and child mourning. Strengthening aspects were the use of some strategies, such as scheduling face-to-face consultations at spaced times to avoid crowds in the waiting room and the use of teleconsultation in specific cases, although infrequent. Final considerations: Despite the negative feelings brought about by the pandemic context, such as fear, anxiety, anguish, and financial instability, the reorganization of the outpatient service was of great importance for the non-discontinuity of the premature health care. It is concluded that the organization of the flow of care and reformulation of the work routine adopted by the health service, such as adherence to sanitary measures and spacing between consultations, maintaining face-to-face support associated with technology, was an essential factor for the satisfaction of those responsible for the assistance provided.