IMPLEMENTATION OF A SINGULAR THERAPEUTIC PROJECT WITH A FOCUS ON IMPROVING THE QUALITY OF LIFE IN PATIENTS WITH CHRONIC PATHOLOGIES: AN EXPERIENCE REPORT

• DOI: https://doi.org/10.22533/at.ed.159492423017

• Palavras-chave: Medical Students, Home Visit, Healthcare, Parkinson's Disease

• Keywords: Medical Students, Home Visit, Healthcare, Parkinson's Disease

• Abstract:

  Introduction: The Singular Therapeutic Project (PTS) is a primary health care tool that seeks to provide individualized care to individuals, families or communities, taking into consideration, the specificities of patients. The PTS encompasses a series of proposals and therapeutic approaches with an emphasis on the guidelines and guiding principles of the SUS, such as humanization and comprehensive care 1. For the correct functioning of the Project, it is essential that there is multidisciplinarity 2. The following report is based on monitoring of two patients, both suffering from hypertension and diabetes, conditions that currently represent one of the main causes of global mortality and are risk factors for cardiovascular diseases 3. Furthermore, it was observed that one of the patients has Parkinson's disease, a life-limiting disease, degenerative, which affects both motor and non-motor systems, whose tremor is one of its classic signs 4. 
   
  This case will illustrate how PTS can positively influence therapeutic approaches and the quality of life of these patients, considering their individual and family circumstances, as well as their social context. Objectives: Report the experience of medical students in implementing a PTS for patients with chronic pathologies, with a focus on improving quality of life. Experience Report: The PTS was carried out in 3 home visits. In the first, a complete anamnesis was carried out on each of the family members. The main complaints were reported, highlighting the difficulty of leaving the Parkinson's patient alone due to periodic falls in recent months. From the first visit, the students were received in a very helpful manner, and had the opportunity to have extensive conversations with the family, which allowed them to ensure a complete anamnesis and family history, but also to create bonds of trust with the patients. Thus, they were open to intervention proposals and this way the students developed action plans to improve the family's quality of life. The proposals were discussed with the health team responsible for the family and implemented at the second meeting. The proposals included the installation of support bars around the house in order to help Parkinson's patients with their support and autonomy; encouraging practices that train memory and reasoning through a memory game given as a gift; and also, guidance on healthy eating and the importance of physical activity for health. At the last meeting, an analysis of adherence to the proposals suggested by students and the health team was carried out. A decrease in the incidence of fall episodes was observed, but the family did not report using exercises to improve, without gripping bars and physical exercises. Reflection on the experience: The PTS experience, carried out in three home visits, illustrates the complexity of healthcare in the home environment and the importance of direct and continuous involvement with patients 1. In the context of Parkinson's disease, frequent falls are a constant concern and often represent a major challenge for caregivers and family members 6.,
   
  The proposed solutions, such as grab bars and memory games, demonstrate a holistic approach considering both the physical safety and cognitive health of the patient 5,6. The involvement of the health team with the teacher and the group of students, when discussing the proposals, reinforces the importance of teamwork and collaboration in patient care. Through group discussion, intervention proposals were developed and, with different points of view, it was possible to formulate proposals that aimed to ensure that the family's needs were fully met. However, even with reports of improvement in relation to falls, the lack of adherence to bars and physical exercises shows that the proposed solutions do not always align with the patients' needs or lifestyle. This highlights the importance of continuous monitoring with patients to review and adapt the proposed interventions 1. Given this, the PTS highlighted, for us students, the importance of a personalized approach, collaboration between professionals and flexibility to adapt care to the needs and realities of patients. It was a valuable experience on the need to get closer to patients, understand their realities and be willing to adjust interventions to obtain results. Conclusion or recommendations: It is concluded that the application of the PTS in the context of the academic training of medical students is very relevant, encouraging them to gain greater insight into the needs of patients in an integral way and promoting reasoning about the application of the concept of health as a whole. Likewise, the PTS promotes teamwork in an interdisciplinary way, including the participation of students, teachers and healthcare staff. Finally, it is stated that the inclusion of practical activities and contact with patients in the initial semesters of medical training proves to be beneficial for both students, patients and the community who benefit from projects such as PTS.