Continuity of care: trust-based relationship and availability of personalized information in user experience

This article analyzes the continuity of care in the relational domain based on user experience. This is a qualitative case study based on 45 interviews with person living with HIV (PLH) followed-up in polyclinics and 38 interviews with users diagnosed with systemic arterial hypertension (SAH) registered in basic health units (BHU) in a large city in the state of Rio de Janeiro, Brazil. The results were analyzed according to two dimensions of relational continuity: trust-based relationship and availability of personalized information. The strongest trust-based relationships and the protagonism in the availability of health information were established with the family health team (FHT) physician and the infectious disease specialist in the polyclinics. Among the differences, according to users with SAH, the relationship bonds were broken by health care provider turnover. In the absence of relationships with other FHT professionals, continuity and access were simultaneously affected. Among PLH users, nursing professionals played an important role in care. In both cases, the results showed a care with little concern for interprofessional practices, collective actions and promotional initiatives to strengthen continuity. The lack of technology-mediated communication required users to attend health care services to solve their demands and contact professionals. The results indicate the importance of a regular point of care for establishment of the bond and consequent relational continuity. However, health care work management-related problems in the Brazilian Unified National Health System aggravate health care provider turnover and favor disruptions in therapeutic follow-up.