Fátima Corrêa Oliver

A utilização de Tecnologia Assistiva na vida cotidiana de crianças com deficiência

The scope of this study is to understand the use of assistive technology in the everyday life of children with disabilities, based on the concept of everyday life as a space for expression of particularity and generality of individuals. It was developed from documentary research of medical records, application of a form, observation of daily activities of children and their families and semi-structured interviews. Five children were studied, representatives in age, sex, diagnosis and use of technological resources, who were attended in primary healthcare units in Sao Paulo. The resources are used in homes, schools and other environments and their use is influenced by family and social relations and by the possibility of accessing products and services. It was established that the everyday activities and the use of resources are organized according to the time, space, ways in which children and, mainly, their caregivers act, showing the presence of pragmatism, economy and spontaneity typical of everyday life. The results revealed elements that can guide the practice of professionals working with assistive technology and can contribute to enable the appraisal of providing equipment in the Unified Health System.

Participação e exercício de direitos de pessoas com deficiência: análise de um grupo de convivência em uma experiência comunitária

A partir do desenvolvimento de projeto de Reabilitacao Baseada na Comunidade em bairro do municipio de Sao Paulo, investiga-se a proposicao e gestao entre profissionais e familiares de iniciativa de atencao a criancas e jovens com deficiencia - Grupo de Convivencia - realizado durante 12 meses. E estudo qualitativo que reconstruiu a experiencia a partir do sentido a ela atribuido por diferentes atores, realizado por meio de entrevistas em grupo focal com mulheres participantes dessa iniciativa e de depoimentos de moradores e representantes de equipamentos sociais locais. Destaca-se a importância da participacao de maes e moradores no diagnostico da situacao das pessoas com deficiencia e na construcao compartilhada de estrategia para abordar o isolamento domiciliar vivido. O Grupo de Convivencia possibilitou enfrentar intenso sofrimento psiquico, especialmente revelado pelas maes, e estabelecer trocas sociais e afetivas implicando apoio social, construcao de emancipacao e autonomia. O processo levou a conscientizacao de direitos sociais e a legitimacao das demandas desse segmento social. Contribuiu para dar maior visibilidade a problematica da deficiencia no territorio e para reafirmar a importância de propostas de atencao fundadas sobre o eixo da integracao socio-familiar a fim de minimizar a vulnerabilidade de cuidadores/familiares e pessoas com deficiencia, diminuindo processos de exclusao social.

Inclusão de crianças com deficiência na escola regular numa região do município de São Paulo: conhecendo estratégias e ações

Including students with special needs in regular education requires preparation by the school community in order to promotes participation of all students. The purpose of this study is to understand from the point of view of primary and secondary municipal public school teachers, the pedagogical strategies these teachers used to include children with special needs in regular classes. This required conducting semi-structured individual interviews and later semi-structured group interviews with 11 teachers of 5 schools, 1 representative of the Centro de Formacao e Acompanhamento a Inclusao (Inclusion Training and Monitoring Center) and 1 Learning and Teaching Coordinator. The interviews were recorded and transcribed and after several readings it was possible to identify the key topics: the perceptions and mental images of the teacher on disability, the training of the teacher to promote actual inclusion, as well as the use of dedicated teaching strategies and the formation of a support network at school. The participants used general strategies such as lectures and debates, and specific strategies such as student assessments, adaptation of teaching materials, activities in pairs, and joint work with the assistant teacher and inclusion monitor. Part of the participants shared a positive idea about the special needs students, demonstrating they believed these students had potential for learning. The discourse of the other participants showed that they did not believe in these potentialities. The teachers identified the need for institutional support for their work, such as on-going teacher training based on daily demands. Part of the challenge of implementing an Inclusive Education program integrated to the Educacao para Todos (Education for All) idea requires us to face demands such as these in order to effectively enforce the rights of children with special learning needs.

Referred speech-language and hearing complaints in the western region of São Paulo, Brazil

OBJECTIVE: The aim of this study was to characterize the epidemiological profile of the population attending primary health care units in the western region of the city of São Paulo, Brazil, highlighting referred speech-language and hearing complaints. METHOD: This investigation was a cross-sectional observational study conducted in primary health care units. Household surveys were conducted and information was obtained from approximately 2602 individuals, including (but not limited to) data related to education, family income, health issues, access to public services and access to health services. The speech-language and hearing complaints were identified from specific questions. RESULTS: Our results revealed that the populations participating in the survey were heterogeneous in terms of their demographic and economic characteristics. The prevalence of referred speech-language and hearing complaints in this population was 10%, and only half the users of the public health system in the studied region who had complaints were monitored or received specific treatment. CONCLUSIONS: The results demonstrate the importance of using population surveys to identify speech-language and hearing complaints at the level of primary health care. Moreover, these findings highlight the need to reorganize the speech-language pathology and audiology service in the western region of São Paulo, as well as the need to improve the Family Health Strategy in areas that do not have a complete coverage, in order to expand and improve the territorial diagnostics and the speech-language pathology and audiology actions related to the prevention, identification, and rehabilitation of human communication disorders.

Community-based Rehabilitation (CBR) and the Social Inclusion of People with Disabilities: The Brazilian Experience

Abstract This article describes and examines possible links between the difficulties experienced by people with disabilities in Brazil and the Community-Based Rehabilitation (CBR) proposal, which is understood here as a set of practices aimed at expanding access to health care and rehabilitation. It reports some experiences developed in Brazilian cities such as projects and/or local initiatives, which included the participation of occupational therapists. This article also discusses the contributions of occupational therapists to Brazilian CBR programs, highlighting their abilities to identify and characterize the needs of people with disabilities, the needs of their families and the community, from a comprehensive perspective, and to encourage their participation in meaningful activities and in finding local solutions for existing problems. This article supports the idea that the aim of occupational therapy is to build processes of emancipation and social integration for people with disabilities, their families and community; processes which consider the need for achieving and exercising human rights.

DIAGNÓSTICO SITUACIONAL DE PESSOAS COM DEFICIÊNCIA ACOMPANHADAS EM TERAPIA OCUPACIONAL EM UMA UNIDADE BÁSICA DE SAÚDE

This work is a situational diagnosis of adults with disabilities, identified by a basic health unit, in the city of São Paulo, SP. We sought to recognize their main health needs in order to contextualize, expand assistance and improve interdisciplinary action. The research was conducted in two phases. 1. through medical chart and Basic Assistance Information System review, for information of social-demographic as well as health aspects of 139 adults. 2. home visits and interviews with 21 adults with any type of limitation, aiming to detail the situational diagnosis. The results showed a higher number of male subjects, of working age, but excluded from the labor market, with low education and fewer opportunities of access to goods and services. The most sought care facilities were the Basic Health Unit and the hospital service, with emphasis on receiving clinical care. However, the interviewed identified needs in the rehabilitation treatment field. The study of living conditions, transport difficulties, access to culture and leisure activities, as well as perception and experiencing of violent situations, pointed to related factors that may facilitate some social vulnerability and impair access to social rights. The recognition of such needs is mandatory to plan and implement contextualized actions considering this population’s critical life conditions in an effort to build a comprehensive and articulated care network.

Trajetória docente e a formação de terapeutas ocupacionais para atenção primária à saúde

Objetivou-se identificar e analisar a trajetoria docente e a formacao de terapeutas ocupacionais para Atencao Primaria a Saude (APS) no estado de Sao Paulo, Brasil. Pesquisa de abordagem qualitativa por meio da realizacao de entrevistas com 17 docentes de terapia ocupacional. Os dados foram categorizados em dois temas. 1) A trajetoria docente foi identificada com a APS a partir de experiencias de formacao, de pratica profissional e de anseios de mudancas para as possibilidades extramuros de atuacao territorial e comunitaria da terapia ocupacional. 2) As docentes apontaram a realizacao da formacao para APS nos cursos por meio de diferentes estrategias de ensino, pesquisa e extensao. A trajetoria docente na APS e a aprendizagem teorico-pratica deve ser valorizada na formacao de terapeutas ocupacionais para APS.

Trayectoria docente y la formación de terapeutas ocupacionales para la atención primaria a la salud

Objetivou-se identificar e analisar a trajetoria docente e a formacao de terapeutas ocupacionais para Atencao Primaria a Saude (APS) no estado de Sao Paulo, Brasil. Pesquisa de abordagem qualitativa por meio da realizacao de entrevistas com 17 docentes de terapia ocupacional. Os dados foram categorizados em dois temas. 1) A trajetoria docente foi identificada com a APS a partir de experiencias de formacao, de pratica profissional e de anseios de mudancas para as possibilidades extramuros de atuacao territorial e comunitaria da terapia ocupacional. 2) As docentes apontaram a realizacao da formacao para APS nos cursos por meio de diferentes estrategias de ensino, pesquisa e extensao. A trajetoria docente na APS e a aprendizagem teorico-pratica deve ser valorizada na formacao de terapeutas ocupacionais para APS.

Teaching career path and training of occupational therapists to primary health care

Objetivou-se identificar e analisar a trajetoria docente e a formacao de terapeutas ocupacionais para Atencao Primaria a Saude (APS) no estado de Sao Paulo, Brasil. Pesquisa de abordagem qualitativa por meio da realizacao de entrevistas com 17 docentes de terapia ocupacional. Os dados foram categorizados em dois temas. 1) A trajetoria docente foi identificada com a APS a partir de experiencias de formacao, de pratica profissional e de anseios de mudancas para as possibilidades extramuros de atuacao territorial e comunitaria da terapia ocupacional. 2) As docentes apontaram a realizacao da formacao para APS nos cursos por meio de diferentes estrategias de ensino, pesquisa e extensao. A trajetoria docente na APS e a aprendizagem teorico-pratica deve ser valorizada na formacao de terapeutas ocupacionais para APS.

Avaliação da atenção primária em saúde por usuários com e sem deficiência

PURPOSE To evaluate the core (First Contact, Longitudinality, Comprehensiveness, and Coordination of Services) and derivative (Family Orientation, Community Orientation) attributes of primary health care (PHC) from the perspective of users with and without disabilities. METHODS Observational, cross-sectional study using the Primary Care Assessment Tool (PCAT) with users with and without disabilities of five basic health units (BHU) in a municipality where 55% of the population depends on the Brazilian Unified Health System (SUS). Scores were assigned to the responses given to each of the PHC attributes evaluated. RESULTS Study participants were 93 (67 physically disabled and 26 without disabilities) PHC users. No statistically significant differences were observed for any attribute on the comparison between the populations. For both groups, the attributes Degree of Affiliation, First Contact - Utilization, Longitudinality, and Coordination of Services - Information System received satisfactory (above cutoff) scores, whereas the attributes First Contact - Accessibility, Coordination of Services - Care Integration, Comprehensiveness, Family Orientation, and Community Orientation received unsatisfactory (below cutoff) scores. Users reported that the health teams are able to satisfactorily identify mobility issues, but there are failures in the recognition of problems of hearing, voice/speech and vision, and in the orientation of services available and services provided. CONCLUSION Users with and without disabilities evaluated the health care received similarly, indicating fragilities on the recognition of specific demands. Structural and work process changes should be conducted to ensure Accessibility, Comprehensiveness, and Family and Community Orientation, and thus increase the quality of PHC.PURPOSE To evaluate the core (First Contact, Longitudinality, Comprehensiveness, and Coordination of Services) and derivative (Family Orientation, Community Orientation) attributes of primary health care (PHC) from the perspective of users with and without disabilities. METHODS Observational, cross-sectional study using the Primary Care Assessment Tool (PCAT) with users with and without disabilities of five basic health units (BHU) in a municipality where 55% of the population depends on the Brazilian Unified Health System (SUS). Scores were assigned to the responses given to each of the PHC attributes evaluated. RESULTS Study participants were 93 (67 physically disabled and 26 without disabilities) PHC users. No statistically significant differences were observed for any attribute on the comparison between the populations. For both groups, the attributes Degree of Affiliation, First Contact - Utilization, Longitudinality, and Coordination of Services - Information System received satisfactory (above cutoff) scores, whereas the attributes First Contact - Accessibility, Coordination of Services - Care Integration, Comprehensiveness, Family Orientation, and Community Orientation received unsatisfactory (below cutoff) scores. Users reported that the health teams are able to satisfactorily identify mobility issues, but there are failures in the recognition of problems of hearing, voice/speech and vision, and in the orientation of services available and services provided. CONCLUSION Users with and without disabilities evaluated the health care received similarly, indicating fragilities on the recognition of specific demands. Structural and work process changes should be conducted to ensure Accessibility, Comprehensiveness, and Family and Community Orientation, and thus increase the quality of PHC.