Camila Caminha Caro

Independence and cognition post-stroke and its relationship to burden and quality of life of family caregivers

Background: Stroke is a chronic disease responsible for changes in the functional capacity of the patients. Patient care is usually provided by family caregivers, but with great burden and negative impact on their quality of life. Objectives: (1) To investigate whether a correlation existed between the levels of independence and cognition in stroke patients and the burden and quality of life of their caregivers; (2) to assess whether periods of injury, rehabilitation and care, and age of the stroke patients interfered with these correlations. Methods: This was a cross-sectional and correlational study that included 60 participants, of which 30 were post-stroke patients and 30 were their caregivers. The data collection instruments were the Mini Mental State Examination and the Functional Independence Measure for the post-stroke participants, and the Zarit Burden Interview Scale and the World Health Organization Quality of Life-BREF, for the caregivers. The Pearson’s product-moment correlation was used for the data analysis. Results: Independence and cognition showed no correlation with the burden and quality of life of the caregivers. We identified a strong positive correlation between independence and cognition (r = 0.882), and a moderate negative correlation between independence and rehabilitation period (r = −0.398) and between burden and quality of life of the caregivers (r = −0.414). Conclusions: Our data suggest the need for health interventions aimed not only at stroke patients, but also at their family caregivers, given the association between the burden and the low levels of quality of life of the caregivers.

Burden and Quality of Life of Family Caregivers of Stroke Patients

ABSTRACT The purpose of this study was to identify the level of burden and quality of life of family caregivers of stroke patients and to investigate the correlation between burden, quality of life (including physical, social, psychological, and environmental domains), age of caregivers, and the care period. A descriptive correlational cross-sectional study was performed, with a convenience sample of family caregivers (n = 30) of stroke patients in São Paulo, Brazil. Data were collected using a questionnaire on participants’ characteristics, the Zarit Burden Interview Scale (ZBIS), and the World Health Organization Quality of Life-BREF (WHOQOL-BREF) instrument. A descriptive analysis was performed, and correlations between variables were analyzed using Pearsons product-moment correlation coefficient. The average burden score on the ZBIS was 29.6, representing a moderate burden, and the average overall quality of life score on the WHOQOL-BREF was 62.06%, which indicates moderate quality of life. A significant weak negative correlation was observed between burden and environmental domains (r = −0.470; p =.009), quality of life (r = −0.414; p =.023), and physical domains (r = −0.394; p =.031). No significant correlations were found between burden and quality of life, and variables in the psychological and social domains, age of caregivers, or care period. Caregivers for stroke patients presented with moderate levels of burden and reduction in quality of life. Levels of burden correlated negatively with environmental domains, quality of life levels, and physical domains; however, these correlations were weak, indicating the possible interference of other factors.

Perfil de Segurados em Períodos Crônicos de Auxílio-Doença em um Regime Próprio de Previdência / Profile of Beneficiaries in Chronic Periods of Sick Leave in a System of Social Security

Objetivo: O presente estudo teve por objetivo tracar o perfil de segurados em periodos cronicos de auxilio-doenca em um regime proprio de previdencia social de um municipio do interior do estado de Sao Paulo. Metodo: Trata-se de um estudo exploratorio descritivo tipo estudo de caso com abordagem quantitativa, desenvolvido a partir de um estudo documental de 123 processos de auxilio-doenca. Para a coleta de dados realizou-se leitura e analise dos registros realizados nos processos, cujos afastamentos deram-se entre marco de 2014 e janeiro de 2016. A analise dos dados debrucou-se sobre uma abordagem quantitativa, utilizando-se da analise descritiva simples. Resultados: Observou-se um perfil de segurados com idade media de 51 anos, preponderantemente do sexo feminino, advindos da Secretaria Municipal de Educacao da Prefeitura Municipal, cargo de professor de ensino basico. As doencas motivadoras da licenca-saude mais prevalentes foram os transtornos mentais e de comportamento e o tempo medio de afastamento foi de 13,4 meses, com incidencia de 50% de afastamentos anteriores, predominando aqueles pelo mesmo motivo ou motivos correlacionados. Conclusao: O perfil dos segurados em longos periodos de auxilio-doenca deste estudo traz indicios de possiveis relacoes entre o exercicio laboral, especialmente no campo da educacao, e adoecimentos decorrentes de transtornos mentais e de comportamento. A luz disso fazem-se necessarias politicas publicas preventivas no âmbito do servico publico, sobretudo destinadas aos profissionais da educacao, bem como acoes no âmbito da reabilitacao profissional em regimes proprios, vislumbrando reinsercao laboral de forma a garantir o direito ao trabalho, respeitando as particularidades dos sujeitos. Palavras-chaves: Licenca Medica. Setor Publico. Perfil De Saude. Saude Do Trabalhador. ABSTRACT Objective: The purpose of this study was to outline a profile of people absent from work for a chronic period of time due to illness and insured by a Specific System of Social Security from a city of upstate Sao Paulo. Method: It is a descriptive exploratory case study with a quantitative approach developed from a documental study of 123 cases of sick leave. The researchers read and analyzed the records of those cases which were referred to absences that occurred in a period of time from March of 2014 and January of 2016 to collect all the data. The data was analyzed through a quantitative approach, using a simple descriptive analysis. Results: The study showed a profile of beneficiaries with average of 51 years, predominantly of female sex, allocated in the Education Department, working as teachers of Elementary school. As for the diseases concerning the sick leaves, it was found that mental and behavior disorders prevailed and the average time of absence was 13.4 months, with incidence of 50% of previous absence predominating those by the same or correlated reason. Conclusion: The profile of beneficiaries in long periods of sick leave in this study brings evidence of possible relations between work, especially in the Education field and mental and behavior disorders. That being brought up it urges to preventive public policies in Public Service mainly for education professionals and also to work in professional rehabilitation scope, aiming an adequate labor reinsertion and guaranteeing rights. Key words: Sick Leave. Public System. Health Profile. Worker Health.

ENTRE PERDAS E GANHOS: OS PAPEIS OCUPACIONAIS DE PESSOAS PÓS-ACIDENTE VASCULAR ENCEFÁLICO

Introducao: os papeis ocupacionais sao representacoes sociais de como um sujeito se ve a partir dos papeis que desempenha. Esses papeis contemplam diversas atividades e abrangem as ocupacoes humanas que as pessoas realizam em sua vida diaria. Individuos com sequelas de um Acidente Vascular Encefalico (AVE) poderao encontrar dificuldades em desempenhar um ou mais papeis ocupacionais em funcao de estruturas e funcoes corporais afetadas pela lesao, por fatores pessoais e/ou ambientais, que, de uma forma ou de outra, influenciam nas atividades e participacao. Objetivos: identificar os papeis ocupacionais de sujeitos pos-AVE e o grau de importância atribuido para cada papel. Metodologia: foram selecionados trinta e quatro sujeitos (n=34), de ambos os sexos, sem comprometimentos cognitivos que impedissem a coleta dos dados. O instrumento utilizado foi a Lista de Identificacao de Papeis Ocupacionais, validado no Brasil. Os dados foram coletados em conjunto com os sujeitos, em forma de entrevista. Resultados: os sujeitos reportaram uma diminuicao dos papeis ocupacionais pos-lesao, entretanto, com perspectivas de retorno a esses papeis no futuro. Alem do desejo em resgatar os papeis perdidos, foi identificada a intencao do desempenho de novos papeis. Conclusao: esses achados poderao incrementar as praticas de reabilitacao com metas de intervencao voltadas para o engajamento em ocupacoes significativas e importantes para essa populacao. Palavras-chave : Terapia ocupacional. Atividades cotidianas. Politicas publicas. Pessoas com deficiencia. Papel (figurativo). ABSTRACT Introduction: occupational roles are social representations of the way in which individuals see themselves in society due to the roles they perform. These roles comprise several activities that represent human occupations in their daily lives. Individuals who have suffered a stroke may find it difficult to perform one or more occupational roles related with body structures and functions affected by their, personal and environmental factors, which in one way or another, influence the way in which activities and participation may be limited. Objectives: To describe the occupational roles after a stroke. Methodology: thirty four individuals (n = 34), of both genders, without cognitive problems participated in the research. The instrument used was the “Role Checklist”, validated in Brazil. Data were collected through an interview, at the individuals’ homes. Results: the participants reported a decrease in occupational roles after stroke, however, they showed an intention to return to these roles in the future. Individuals also showed a desire to perform new occupational roles, not performed in the past and present. Conclusion: these findings may improve the rehabilitation practice using intervention goals that aim to engage this population in meaningful and important occupations. Keywords : Occupational therapy. Activities of daily living. Public policies. Disabled persons. Role.