Rosé Colom Toldrá

Atenção ambulatorial de média complexidade em saúde e reabilitação de pessoas com deficiência física no âmbito da terapia ocupacional: reflexões a partir da prática

O presente artigo visa a contribuir para a compreensao da atencao ambulatorial de media complexidade as pessoas com deficiencia fisica e incapacidades que dela decorrem, por meio da pratica desenvolvida pela Terapia Ocupacional com essa populacao no Centro de Docencia e Pesquisa do Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional da Universidade de Sao Paulo, no periodo de marco de 2009 a dezembro de 2010, com periodicidade semanal. Pela escassez de estudos sobre a atencao de media complexidade, foram utilizados os documentos oficiais referentes as politicas publicas da area como referencia para a reflexao da pratica. Para a analise da experiencia foi realizado um estudo qualitativo, do tipo exploratorio, a partir de estudo retrospectivo documental dos registros de prontuario de 22 usuarios acompanhados. Propoe a utilizacao de abordagens individuais, grupais e corporais como meio da reapropriacao do corpo e do lugar de sujeito produtor da propria saude. Para a maioria das pessoas, a experiencia representou uma possibilidade de acolher e contemplar, mesmo que parcialmente, as necessidades de saude e reabilitacao. A enfase na estrategia grupal, aliada a corporal, possibilitou fortalecer a capacidade de o usuario cuidar de si, valorizar e integrar o aprendizado adquirido por meio das intervencoes com estrategias pessoais adotadas nas atividades do cotidiano. http://dx.doi.org/10.4322/cto.2013.031

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.

Reliability and Validity of the Brazilian Version of the Late-Life Function and Disability Instrument

OBJECTIVE We evaluated the test-retest reliability, internal consistency, and construct validity of the Brazilian version of the Late-Life Function and Disability Instrument. METHOD A sample of 118 older adults provided data for testing construct validity and internal consistency, and 14 provided data for testing test-retest reliability. Factor analysis with varimax rotation was used to assess construct validity. RESULTS The Function component had excellent test-retest and total internal consistency reliability. Factor analysis revealed that the Upper Extremity Function and Advanced Lower Extremity Function domains were similar to the original analysis. The Disability component showed adequate to excellent test-retest reliability, except in the Management role; total internal consistency was excellent. Factor analysis revealed that its domains were similar to the original analysis, except for some items. CONCLUSION The Late-Life Function and Disability Instrument is recommended for assessment of Brazilian community-dwelling older adults who are functionally independent and who do not require mobility assistance.