Soraia Assad Nasbine Rabeh

Capacidade funcional em indivíduos com lesão de medula espinhal

Objectives: To investigate the characteristics of individuals with spinal cord injury being treated in public hospitals, in Ribeirao Preto, Sao Paulo, and to assess the functional independence according to the degree of injury, the time after injury and the rehabilitation. Methods: Is a cross-sectional observational study conducted from January 2003 to July 2006, comprising 22 patients being treated on these hospitals, with assessment of functional capacity through the Functional Independence Measure (FIM) scale. Results: Of 22 patients who survived after hospital discharge, 91 % were men, with age from 30 to 39 years (36.4 %). The main etiology of the above-mentioned injury was an accident of traffic (50%), 11 patients (50%) presented cervical injury, 10 (45.5%) had chest injury and lumbar injury. In individuals with cervical injury the total FIM score was low, implying less functional capacity. It was observed an increase of the FIM scores with the increase of time after injury, regardless of participation in rehabilitation programs. Conclusions: The results suggest the essential aspects found in this research must be proposed in rehabilitation programs to treat the population within the studied context.

Burden of care and its impact on health-related quality of life of caregivers of individuals with spinal cord injury

OBJETIVO: analisar a sobrecarga do cuidado e impacto na Qualidade de Vida Relacionada a Saude (QVRS) dos cuidadores de individuos com lesao medular traumatica (LMT). METODO: este e um estudo observacional, de corte transversal, realizado por revisao de prontuarios e aplicacao de questionarios. Foram utilizadas as escalas Short Form 36 (SF-36) para avaliar a QVRS, Caregiver Burden Scale (CBScale) para sobrecarga do cuidado, e os resultados foram analisados quantitativamente. A maioria dos individuos com LMT era do sexo masculino, com media de idade de 35,4 anos, com predominio de lesao toracica, seguida de lesao cervical. A maioria dos cuidadores era do sexo feminino, com media de idade de 44,8 anos. RESULTADO: das caracteristicas clinicas que contribuiram para maior sobrecarga do cuidado e pior QVRS destacaram-se individuos com tetraplegia e com complicacoes secundarias. Ao associar a sobrecarga do cuidado com a QVRS, obteve-se que quanto maior a sobrecarga pior a QVRS. CONCLUSAO: prevenir a sobrecarga do cuidado por meio de estrategias de preparo para alta, integracao da rede de apoio e acesso a servicos de saude, poderia minimizar os efeitos da sobrecarga do cuidado e contribuir para melhor QVRS.OBJECTIVE to analyze the impact and burden of care on the Health-Related Quality of Life (HRQOL) of caregivers of individuals with a spinal cord injury (SCI). METHOD cross-sectional observational study carried out by reviewing medical records and applying questionnaires. The scale Short Form 36 (SF-36) was used to assess HRQOL and the Caregiver Burden Scale (CBScale) for care burden. Results were analyzed quantitatively. Most patients with SCIs were male, aged 35.4 years old on average, with a predominance of thoracic injuries followed by cervical injuries. Most caregivers were female aged 44.8 years old on average. RESULTS tetraplegia and secondary complications stand out among the clinical characteristics that contributed to greater care burden and worse HRQOL. Association between care burden with HRQOL revealed that the greater the burden the worse the HRQOL. CONCLUSION Preventing care burden through strategies that prepare patients for hospital discharge, integrating the support network, and enabling access to health care services are interventions that could minimize the effects arising from care burden and contribute to improving HRQOL.

Sobrecarga do cuidado e impacto na qualidade de vida relacionada à saúde de cuidadores de indivíduos com lesão medular

OBJETIVO: analisar a sobrecarga do cuidado e impacto na Qualidade de Vida Relacionada a Saude (QVRS) dos cuidadores de individuos com lesao medular traumatica (LMT). METODO: este e um estudo observacional, de corte transversal, realizado por revisao de prontuarios e aplicacao de questionarios. Foram utilizadas as escalas Short Form 36 (SF-36) para avaliar a QVRS, Caregiver Burden Scale (CBScale) para sobrecarga do cuidado, e os resultados foram analisados quantitativamente. A maioria dos individuos com LMT era do sexo masculino, com media de idade de 35,4 anos, com predominio de lesao toracica, seguida de lesao cervical. A maioria dos cuidadores era do sexo feminino, com media de idade de 44,8 anos. RESULTADO: das caracteristicas clinicas que contribuiram para maior sobrecarga do cuidado e pior QVRS destacaram-se individuos com tetraplegia e com complicacoes secundarias. Ao associar a sobrecarga do cuidado com a QVRS, obteve-se que quanto maior a sobrecarga pior a QVRS. CONCLUSAO: prevenir a sobrecarga do cuidado por meio de estrategias de preparo para alta, integracao da rede de apoio e acesso a servicos de saude, poderia minimizar os efeitos da sobrecarga do cuidado e contribuir para melhor QVRS.OBJECTIVE to analyze the impact and burden of care on the Health-Related Quality of Life (HRQOL) of caregivers of individuals with a spinal cord injury (SCI). METHOD cross-sectional observational study carried out by reviewing medical records and applying questionnaires. The scale Short Form 36 (SF-36) was used to assess HRQOL and the Caregiver Burden Scale (CBScale) for care burden. Results were analyzed quantitatively. Most patients with SCIs were male, aged 35.4 years old on average, with a predominance of thoracic injuries followed by cervical injuries. Most caregivers were female aged 44.8 years old on average. RESULTS tetraplegia and secondary complications stand out among the clinical characteristics that contributed to greater care burden and worse HRQOL. Association between care burden with HRQOL revealed that the greater the burden the worse the HRQOL. CONCLUSION Preventing care burden through strategies that prepare patients for hospital discharge, integrating the support network, and enabling access to health care services are interventions that could minimize the effects arising from care burden and contribute to improving HRQOL.

Health-Related Quality of Life Among Caregivers of Individuals With Spinal Cord Injury.

ABSTRACT:The consequences of spinal cord injury (SCI) not only affect patients’ health-related quality of life (HRQoL) but also extend to the entire family. The health condition the injury imposes requires the participation of a family caregiver, who will be responsible for taking care of the individual in a disabling condition. This is an observational, exploratory study using a cross-sectional design that aimed to study the association between HRQoL and gender, age, presence of comorbidities, and characteristics of the care among caregivers of individuals with SCI with the purpose of identifying potential factors that are associated with HRQoL in this population. Participants were 59 caregivers of individuals with traumatic SCI. The data were collected by consulting the patient histories and applying questionnaires. To assess the caregivers’ HRQoL, the Short Form-36 was used. For analysis, exploratory and inferential statistics were used. Most of the caregivers of the individuals with SCI were female, with a mean age of 44.8 years. The domains that most contributed to a worse HRQoL were physical aspects, pain, vitality, and emotional aspects. No statistically significant associations were found between HRQoL and the variables gender, hours per day spent on care, and length of activity as caregiver. The associations between HRQoL and self-reported diseases and age were statistically significant. The results support the planning of nursing interventions from the perspective of aspects of the care demands, which can affect the caregiver’s HRQoL. Relevance to clinical practice: Interventions to prepare the individuals with SCI and their caregivers are a strategy aimed at improving the HRQoL of both.

Functional ability in individuals with spinal cord injury

Objectives: To investigate the characteristics of individuals with spinal cord injury being treated in public hospitals, in Ribeirao Preto, Sao Paulo, and to assess the functional independence according to the degree of injury, the time after injury and the rehabilitation. Methods: Is a cross-sectional observational study conducted from January 2003 to July 2006, comprising 22 patients being treated on these hospitals, with assessment of functional capacity through the Functional Independence Measure (FIM) scale. Results: Of 22 patients who survived after hospital discharge, 91 % were men, with age from 30 to 39 years (36.4 %). The main etiology of the above-mentioned injury was an accident of traffic (50%), 11 patients (50%) presented cervical injury, 10 (45.5%) had chest injury and lumbar injury. In individuals with cervical injury the total FIM score was low, implying less functional capacity. It was observed an increase of the FIM scores with the increase of time after injury, regardless of participation in rehabilitation programs. Conclusions: The results suggest the essential aspects found in this research must be proposed in rehabilitation programs to treat the population within the studied context.

Cuidadores de indivíduos com lesão medular: sobrecarga do cuidado

A sectional study that had as its objectives to assess caregiver burden of for caregivers of individuals with Traumatic Spinal Cord Injury (TSCI) and its association with sociodemographic variables (age and sex), health status (self-reported illnesses) and caregiver characteristics (care time in years and daily hours of care). Data were collected by consultation of patient files and individual interviews at home using the instrument, Caregiver Burden Scale (CBScale). The results showed that most burden occurred in the domains: environment, disappointment and general strain. Presenting health problem (for all domains of the CBScale) and spending more hours per day in care (in the domain disappointment) represented the variables associated with burden. Studies of a more confirmatory nature than exploratory between the variables studied can be used to measure the burden obtained in this population of caregivers of individuals with TSCI.Estudio transversal que tuvo como objetivo evaluar la carga del cuidado de los cuidadores de las personas con Lesion Traumatica de Medula Espinal (LTME) y su asociacion con variables sociodemograficas (edad y sexo), estado de salud (auto-reporte de enfermedades) y caracteristicas de la atencion (tiempo de atencion en los ultimos anos y las horas de atencion). Los datos fueron recogidos por los registros hospitalarios y entrevistas en el hogar utilizando el instrumento Caregiver Burden Scale (CBScale). Los resultados mostraron que la mayor sobrecarga ocurrido en areas: ambiente, decepcion y tension general. Problema de salud actual (para todas las areas de CBScale) y pasar mas horas por dia en la atencion (en el campo decepcion) representaran las variables asociadas con a sobrecarga. Estudios de una confirmacion, mas que exploratorio entre variables se pueden utilizar para medir la sobrecarga obtenido en esta poblacion de los cuidadores de los individuos con LTME.

Efetividade da educação a distância no conhecimento de enfermeiros sobre estomias intestinais de eliminação

Objetivo: Avaliar a efetividade da educacao a distância no conhecimento de enfermeiros da atencao primaria sobre estomias intestinais de eliminacao. Metodos: Estudo quase-experimental, do tipo antes-depois, realizado com 41 enfermeiros, no periodo de junho a julho de 2015, por meio de instrumento construido e validado no Brasil. Para comparar os escores de acertos no pre e pos-teste foi utilizado o Teste de Wilcoxon. Foram considerados estatisticamente significantes os resultados dos testes que apresentaram α menor ou igual a 0,05. Resultados: Na avaliacao do conhecimento dos enfermeiros verificou-se que cinco obtiveram acertos superiores a 80% no pre-teste. Apos a educacao a distância, o numero de enfermeiros que obtiveram acertos superiores a 80% aumentou para 32. Houve diferenca estatistica significativa no conhecimento dos enfermeiros apos intervencao educativa (p=0,000), com percentual de melhoria de 96,7% no geral. Conclusoes: A educacao a distância pode ser uma metodologia efetiva para educacao permanente de enfermeiros. Palavras-chave: Estomia. Atencao primaria a saude. Educacao a distância. Educacao continuada. Enfermagem.

Bowel rehabilitation of individuals with spinal cord injury: video production

OBJECTIVE produce and validate an educational video about bowel emptying maneuvers for training of individuals with neurogenic bowel in bowel rehabilitation process. METHOD this is a methodological study developed in four stages: script/storyboard production, validation, educational video production and pilot study, which was conducted from January 2013 to July 2015. Instruments for validation, which was performed from December 2014 to February 2015 by a group of experts. A value equal to or greater than 70% was considered for validation of agreement and relevance of the script and storyboard, using descriptive statistics for data analysis. RESULTS the script and storyboard were validated by 94% of the experts in the subject and 100% of the technicians. After validation and video recording, the pilot study was conducted with six individuals with neurogenic bowel - 100% of them evaluated the video positively. CONCLUSION the video may contribute to the education of individuals with neurogenic bowel.

Development of an ICF Core Set Based Instrument for Individuals withNon-traumatic Spinal Cord Injury

Introduction: The International Classification of Functioning, Disability and Health (ICF), describes the functioning and individuals with particular health condition and how context factors can modulate it. The nontraumatic spinal cord injury (NTSCI) has several effects on the functioning. The ICF Core Set for spinal cord injury (CSSCI) can be an innovative assessment of people with NTSCI functioning, but has not been applied in this context and there are no standardization proposals for its implementation. Objective: To develop a user-friendly instrument based in the International Classification of Functioning, Disability and Health core set for spinal cord injury (CSSCI) to operationalize functioning data of non-traumatic patients. Method: By studying, the particular uses of CSSCI categories to non-traumatic individuals, the researchers developed specific questions with richly described answer alternatives according with the descriptions of ICF qualifiers. For some categories, validated instruments were adapted, for some others new questions were formulated. Results: A questionnaire containing 43 sub-items was developed covering aspects of 9 body functions, 4 body structures, 21 activities and participation and 9 environmental factors. Health professional who tested it did not report difficulties to understand or apply the questionnaire, although it may time consuming. Conclusion: Besides proposing a method to develop ICF based questionnaires, this study developed a functional assessment tool that is very broad in the evaluation of functioning and adds the impact of environmental factors on the overall experience of disability.

Cuidadores de individuos con lesión medular: sobrecarga del cuidado

A sectional study that had as its objectives to assess caregiver burden of for caregivers of individuals with Traumatic Spinal Cord Injury (TSCI) and its association with sociodemographic variables (age and sex), health status (self-reported illnesses) and caregiver characteristics (care time in years and daily hours of care). Data were collected by consultation of patient files and individual interviews at home using the instrument, Caregiver Burden Scale (CBScale). The results showed that most burden occurred in the domains: environment, disappointment and general strain. Presenting health problem (for all domains of the CBScale) and spending more hours per day in care (in the domain disappointment) represented the variables associated with burden. Studies of a more confirmatory nature than exploratory between the variables studied can be used to measure the burden obtained in this population of caregivers of individuals with TSCI.Estudio transversal que tuvo como objetivo evaluar la carga del cuidado de los cuidadores de las personas con Lesion Traumatica de Medula Espinal (LTME) y su asociacion con variables sociodemograficas (edad y sexo), estado de salud (auto-reporte de enfermedades) y caracteristicas de la atencion (tiempo de atencion en los ultimos anos y las horas de atencion). Los datos fueron recogidos por los registros hospitalarios y entrevistas en el hogar utilizando el instrumento Caregiver Burden Scale (CBScale). Los resultados mostraron que la mayor sobrecarga ocurrido en areas: ambiente, decepcion y tension general. Problema de salud actual (para todas las areas de CBScale) y pasar mas horas por dia en la atencion (en el campo decepcion) representaran las variables asociadas con a sobrecarga. Estudios de una confirmacion, mas que exploratorio entre variables se pueden utilizar para medir la sobrecarga obtenido en esta poblacion de los cuidadores de los individuos con LTME.