An action that has been carried out in different hospitals in the country allows for greater proximity between patients and the medical team
The affective record (AP) is a project that has been used in many Brazilian hospitals. It is different from the conventional medical record, which comprises technical issues related to the patient’s health, such as allergies and medications.
The PA contains the patient’s personal information such as musical taste, hobbies, religion, profession, surname, name of parents, children, friends and pet. Thus, this record allows the medical team to know a little more about the hospitalized person.
It is these details that have helped, since April, professionals at the Dr. César Cals General Hospital (HGCC) in Fortaleza (CE) to humanize care for those infected by COVID-19 who, regardless of whether they are in the ICU or in the ward, they need to stay in isolation, out of contact with their family.
“With hospitalization, the patient faces difficult situations and one of them is the process of total depersonalization. He ceases to be a subject and is reduced to a number of beds, medical records and diagnosis”, points out the psychologist of the ICU and COVID ward of the HGCC, Karleynayra de Castro. “Psychology uses the affective record as a way to rescue the subjectivity of these hospitalized patients, many of them intubated, without communication and in isolation, contributing to a more humanized care”, he adds.
Karleynayra points out that there are many results achieved by using the PA. “Strengthening the bond of the patient, family and team triad, rescue of affections that involve human relationships, rescue of subjectivity, a more humanized care and approximation of family members”, he lists.
Due to the restrictions imposed by the pandemic, medical teams no longer have direct contact with the patients’ families and, therefore, they know little about the hospitalized people in their care, especially those who are unconscious in ICU beds.
“The objective of the affective record is to show professionals that that person is someone’s love and, also, to take a little bit of the family to that patient who is in isolation”, adds the hospital’s social worker, Tayná Araújo Fragoso.
Affective record in practice
Social worker Tayná shares that she was already on the other side, when she experienced the death of a cousin due to the coronavirus. She reinforces that social isolation is a very distressing process for both the patient and family members.
“It’s an extremely uncomfortable place, we feel powerless. I saw how important it was to bring the family together for care, even with the restrictions imposed by the pandemic”, says the social worker.
She also states that the affective record brings more than humanization to the hospital environment: “It brings a caress to our heart in this very difficult moment that we are experiencing”.
Who also understands the importance of the affective record is the farmer and student Mara Luciana Cavalcante, 26. “For me, [o projeto] has been showing the affection and dedication that Health people have with us. The affective record is a way of telling the families that the patient is well and is being well assisted”, he comments in a video provided by the HGCC to the report of the SÃO PAULO.
Mara was hospitalized at César Cals for about a month as a result of COVID-19 and, as a result, she had to stay away from her loved ones. She was one of the first patients at the hospital to have an affective record.
The video provided by the HGCC was recorded during his treatment. In it, the farmer also emphasizes that, even isolated, she did not feel alone; on the contrary, through the humanized care at the hospital, he felt his family close by. “It’s a way to ease and to know you’ll be okay, for later [poder] stay with everyone, family and friends”.
work done by many hands
At Hospital César Cals, the work is being developed in a multidisciplinary way, involving the entire medical team (nursing, physiotherapy, nutrition, psychology, etc.) of the ICU and the COVID-19 care ward, social assistance and the communication team, which starts the process.
“It is a medical team responsible for issuing the clinical report of the patient admitted to the ICU or COVID ward. This communication is done via remote. In this contact, professionals request information such as hobbies, I know [o paciente] it’s grandmother, father, mother, son, what music he likes to listen to, whether he has a religion, which team he supports, among other things”, explains Karleynayra.
She details that this process of gathering information is also carried out by psychology during family care, which can be remote or in person. The next step is the playful making of the PA. “It is handcrafted by psychology with a lot of dedication, empathy and affection”, emphasizes Karleynayra, who works in partnership with also psychologist Ana Carolina Aguiar.
Affective records are attached to the side or on top of the patient’s bed, so that they are visible to all who provide assistance. “This multidisciplinary project allows us to work not only with organic and psychosocial rehabilitation, but also with the recovery of human dignity”, assures the psychologist. She points out that although the AP is being developed for patients with COVID-19, the goal is to cover all hospitalized patients.
The PA in intubated patients
In the case of COVID-19 patients who are intubated, although the affective record is prepared in the same way as those in the ward, the performance occurs through auditory stimulation.
“The family sends audio to our Whatsapp, as if they were talking to the patient. We put this audio in his ear or the music [enviada]. Some families ask us to read a Psalm. We perform these auditory stimuli at the bedside”, explains Karleynayra.
The psychologist also reinforces that the team that provides assistance, seeing the affective record, during medical procedures, talks to the patient based on that information. Talk about children, family and hobbies.
The AP has also been important to establish bonds between on-call staff and patients, since these professionals, who work on a rotating basis, do not always have time to get to know the patients.
“The affective record makes a more affective bond with these professionals [plantonistas] who are moving in that body that is sick and needs to be healed, and that is a person, someone’s darling. So, it reinforces this issue of humanization even more”, assures the psychologist.