The Role Of The Social Worker Concerning Intestinal Rehabilitation And Transplantation In A Latin American Center

Introduction: Social work is fundamental for patients with intestinal failure (FIG), especially regarding the decision to include them in home parenteral nutrition (HPD) program or indication for intestinal transplantation. This activity inspires multidisciplinary norms for the indication of these procedures that involve high complexity, high monetary cost and the need for bioethical regulations concerning allocation of resources for this procedures. In this study, we evaluated the socioeconomic profile of FIG patients in HC-FMUSP NPD program and/or with indication for intestinal or multivisceral transplantation. Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo is the public Hospital reference for HPN and intestinal transplantation in Brazil. Methods: Adult patients from HC-FMUSP with FIG, under HPD program and/or indication for intestinal or multivisceral transplantation were included in this survey. To assess the socioeconomic profile, a single social worker specialized in organ transplantation applied a social report system form to evaluate patient’s age, gender, civil status, work situation, local of origin, monetary income and schooling. Results: From January 2017 to December of 2019, twenty patients from HC-FMUSP with FIG were evaluated, 13 were male and 7 female. The period of patient’s DPN dependence ranged from nine months to 8 years. Patients age ranged from 15 to 56 years old, nine were married, 8 were singles, 3 divorced and 65% came outside from HCFMUSP region. Only one patient were actively working when the report were performed. 40% of the patients obtained fundamental education, 50% median education and 10% superior education. 45% earned 204-408 USD/month, 40% earned 408-816 USD/month and just 15% earned more than 816 USD/month. Four patients died during this survey period, two obtained DPN weaning and three were submitted to intestinal transplantation. Conclusions: Social worker evaluation is fundamental to assess the level of patient’s treatment adherence and to support the treatment team and families to surround the changes of life-style and quality of life. Patients from HC-FMUSP under HPN and/or with indication for intestinal or multivisceral transplantation obtained 80% of survival during this study period and encloses low superior education and monetary income.