Robson da Fonseca Neves

Acessibilidade de pessoas com deficiência ou restrição permanente de mobilidade ao SUS

The scope of this study was to monitor the access of persons with disabilities and permanent mobility restrictions to the Unified Health System in Joao Pessoa, State of Pernambuco. This is a descriptive field study, consisting of a random sample of 523 people with disabilities or permanent mobility restrictions. Data collection occurred between August 2007 and December 2008 and consisted of home interviews. The neuromusculoskeletal functions and those related to movement (52%) were among the most affected body functions, with a higher incidence among body structures related to movement (44.2%) and those of the nervous system (39.2%), with special emphasis on the high number of cases (14%) due to the sequelae from strokes. Among the respondents, 63.9% stated that there had not been sufficient and appropriate means to lessen the physical obstacles between their homes and the places where they received healthcare, and 41.7% claimed that there were no special facilities for the handicapped in the healthcare offices. Brazilian law ensures rights for people with disabilities, which were not broadly respected. Action is necessary to prevent the development of disabilities, especially those resulting from the sequelae from strokes.

Facilitadores e barreiras de retorno ao trabalho de trabalhadores acometidos por LER/DORT

Introduction: Repetitive Strain Injury (RSI)/Work-related musculoskeletal disorders (WMSDs) frequently cause a great number of work leaves. Objective: understand and systematize the way the factors related to RSI-WMSDs affected workers’ returnto-work are described in literature as facilitating factors or barriers. Methods: a critical review of the literature from January 2005 to October 2010, available in Lilacs, Medline and SciELO databases. Information was systematized in three categories of factors that influenced return-to-work, as facilitating factors or barriers, of personal nature, of work organizational nature, and related to the characteristics of services, systems and polices. Results: from the 633 articles first analyzed, 21 met the inclusion criterion. The most relevant identified factors: personal nature – pain, psychosocial factors, work leave; organizational – employment changes, psychological work demand, organizational support, co-workers’ and bosses’ support; related to services, systems and polices – a back-to-work program, leave duration and support services. Conclusion: This study showed that return-to-work is a complex process, that it demands intersectorial polices technical cooperation and consonance of the involved actors towards the aimed targets.

Support networks and people with physical disabilities: social inclusion and access to health services

This study seeks to identify the formation of social support networks of people with physical disabilities, and how these networks can help facilitate access to health services and promote social inclusion. It is a cross-sectional study, with data collected via a form applied to physically disabled persons over eighteen years of age registered with the Family Health Teams of the municipal district of João Pessoa in the state of Paraíba. It was observed that the support networks of these individuals predominantly consist of family members (parents, siblings, children, spouses) and people outside the family (friends and neighbors). However, 50% of the interviewees declared that they could not count on any support from outside the family. It was observed that the support network contributes to access to the services and participation in social groups. However, reduced social inclusion was detected, due to locomotion difficulties, this being the main barrier to social interaction. Among those individuals who began to interact in society, the part played by social support was fundamental.

Estado cognitivo dos usuários com AVE na atenção primária à saúde em João Pessoa - PB

O Acidente Vascular Encefalico (AVE) apresenta alta prevalencia em todo o mundo, desencadeando incapacidades neurologicas em adultos. O deficit cognitivo e uma das sequelas mais importantes, sendo dificil o seu reconhecimento, podendo interferir no processo de reabilitacao e acarretar impactos na qualidade de vida dos usuarios acometidos. Objetivo: Estimar a prevalencia de deficit cognitivo em usuarios com AVE na Atencao Primaria a Saude (APS), bem como descrever as caracteristicas sociodemograficas, clinicas e dimensoes cognitivas afetadas. Metodo: Estudo de corte transversal desenvolvido no Municipio de Joao Pessoa-PB com 140 individuos adscritos no Programa Saude da Familia que foram acometidos por AVE nos ultimos cinco anos. Resultados: Mais da metade dos individuos analisados apresenta quadro sugestivo de comprometimento cognitivo (54,9%), nas seguintes dimensoes: memoria de evocacao (70%), atencao e calculo (60%) e ler e executar (60%); alem disso, a maioria era de idosos (73,1%);no que se refere as caracteristicas clinicas do AVE declaram que nos ultimos cinco anos tiveram apenas um episodio (64,2%) desencadeado nos ultimos 13 meses ou mais (76,1%). A metade dos participantes nao soube informar o tipo de AVE (50,7%). Conclusao: As dimensoes cognitivas afetadas pelo AVE precisam de maiores investigacoes, afim de fornecer mais subsidios para melhorar a assistencia prestada no âmbito da APS.Received on November 4, 2011. Accepted on January 26, 2012. ABSTRACT Cerebrovascular Accident orStroke (CVA) has a high prevalence worldwide causing neurological disability in adults. Cognitive deficit is one of the most important consequences, since its recognition is difficult and thus may interfere with the rehabilitation process and lead to impacts on the life quality of affected people. Objective: The goal was to estimate the prevalence of cognitive impairment in stroke among those with Primary Health Care (PHC), as well as to describe the clinical and sociodemographic characteristics, and the cognitive dimensions affected. Method: This was a cross-sectional study carried out in the city of João Pessoa PB with 140 people enrolled in the Family Health Program that had been affected by stroke within the previous five years. Results: Over half of the people studied had manifestations suggesting cognitive impairment (54.9%) in the following dimensions: memory recall (70%), attention and calculation (60%), and read and apply (60%). In addition, the majority was elderly (73.1%) and, regarding the clinical characteristics of stroke, had declared that in the previous five years had had only one episode (64.2%) triggered in the last 13 months or more (76.1%). Also, half of the participants (50.7%) were unable to tell us the type of stroke they had suffered. Conclusion: The cognitive dimensions affected by stroke require further investigation in order to provide more funding to improve the assistance provided under the PHC.

A ABORDAGEM FENOMENOLÓGICA NA INVESTIGAÇÃO DO RETORNO AO TRABALHO NOS CASOS DE TRANSTORNO MENTAL

The aim of this study is to present and discuss the methodological basis underlying the analytical choices adopted to investigate the experiences and meanings of the return to work in cases of mental disorder. For this, was adopted the fundamentals of the phenomenological theory of Alfred Schutz on meaningful experience, world of life and stock of knowledge, as well as Paul Ricoeur’s approach to action transformed into text. This articulation can advance the interpretive process by strengthening the individual experience as an element capable of revealing social, political,cultural and economic aspects, among others. Moreover, it points to the possibility of a critical position to the transformation of the society, the participant and the researcher.

Analysis of impacts from environmental factors evaluated by icf in individuals post-cva

Introduction: The CVA is the second cause of death in Brazil, presenting with serious clinical repercussions and as a public health issue. Live with the disabilities caused by it requires facing daily situations, which can increase the disability, such as the ones imposed by the environment inside or outside home. Objective: Analyze the environmental factors of ICF with a facilitator or barrier for victims of Stroke. Materials and methods: A cross-sectional study, 152 individuals; span of less than 60 months involvement and enrolled in the Family Health Units in Joao Pessoa, Brazil. A questionnaire was used to characterize the socio-economic and clinical form and the Core Set for stroke to identify environmental factors. The data were stored in EpiInfo 7. Associations between environmental factors and the variables age, gender, and marital status verified by chi-square test. Results: Assistive technologies and products or substances for personal consumption were the main factors recognized as facilitators, followed by interpersonal relationships. The most prevalent factors as barriers were the physical structures of public and private spaces, highlighting the physical geography of their residence. It was found that the immediate family was associated with variable marital status, use of products and technology for personal use in daily life was associated with age and, friends partnered with variable gender. Conclusions: The Core Set is shown as a sensitive instrument to capture the barriers and facilitators in population surveys. Their findings point to the need to think about public policy more appropriate for this population.{#}