Narratives on illness: cases of the elderly with osteomyelitis in an orthopedic hospital.
Elderly, hospitalization, chronic illness, hospital psychology.
During the aging process, all component structures of the locomotor apparatus are affected, which contributes to imbalances and falls in old age. The elderly when falling, tends to undergo orthopedic surgery, requiring prolonged hospitalization that may impact on their socio-emotional state. Chronic osteomyelitis is one of the biggest challenges in the area of orthopedic surgery. It occurs in most cases due to complications of open fractures or surgical contamination. The present study investigated psychosocial aspects present in the prolonged hospitalization experience of elderly with osteomyelitis, in order to understand their consequent needs and demands for psychological follow-up in the hospital context. This is a qualitative approach research with multiple case study. Three elderly people participated, two men and one woman, aged between 66 and 78 years, admitted to an orthopedic hospital located in the city of Rio de Janeiro. For data collection, the Hospital Anxiety and Depression Scale (HADS) was applied and a semi-structured interview was conducted to obtain information about the prolonged hospitalization experience according to the participants' own narrative. Hospitalization was perceived as a period of ruptures and losses, including removal from family, break of routine and lack of personal effects and pets, which reflected in the emotional state of the participants. The most mentioned emotional changes were nervousness, easy crying, persistent sadness and thoughts linked to death. On the other hand, it was observed satisfaction regarding the care received from the health team and the fact of being hospitalized in a reference hospital in the area. Psychological counseling and emotional support provided by psychologists were identified as beneficial and essential for dealing with present stressors and expressing sadness regarding hospitalization. This study attested to the need to develop effective hospital psychological practices based on the characteristics of each target audience, in this case the elderly, especially in the knowledge of their peculiarities.