How congenital Zika virus impacted my child's functioning and disability: a Brazilian qualitative study guided by the ICF

Introduction The Zika virus outbreak in Brazil has had devasting social, medical and financial consequences for families. Both researchers and clinicians are measuring longer-term outcomes to understand the impact of the Zika on child development, functioning and disability. Outcomes and tools used to measure them are very varied and we are unclear how meaningful they are to families and children. This study aimed to identify the parents’ perspectives on relevant areas of functioning and disability that should be included as outcome measures for children with congenital Zika syndrome (CZS), as guided by the International Classification of Functioning, Disability and Health (ICF).Methods This qualitative study included parents or caregivers of children aged 0–5 years with confirmed CZS from two states in northeastern Brazil. Interviews were conducted using focus groups. Content mapping followed the WHO’s ICF linking rules. Three raters analysed the content using NVivo V.11.Results Thirty-two caregivers participated in six focus groups, 88% were mothers with an average age of 30 years. Most children were male (59%) and all were level V (severe) to on the Gross Motor Function Classification System (GMFCS). Overall, 825 themes were mapped to 36 ICF categories. Although parents mentioned areas across all ICF domains, they reported that areas of mobility, eating and recreation were most relevant for them. In addition, environmental factors were highly identified as barriers, specifically services, policies and access to assistive devices. The most predominant facilitators within the environment were; immediate family support, kind relationships with therapists and support from the extended family.Conclusions Although parents emphasised issues related to mobility, their greatest concerns involved environmental factors, such as access and quality of health and social services, systems and policies. These results reinforce the importance of including parents’ perspectives when selecting or developing outcome measures for CZS

Ações de Enfermagem na Promoção da Saúde de Idosos Institucionalizados: uma revisão integrativa / Nursing Actions in Health Promotion for Institutionalized Elderly: an integrative review

As Instituições de Longa Permanência para Idosos (ILPIs) são estabelecimentos para atendimento integral de pessoas com 60 anos ou mais, dependentes ou independentes, que não dispoem de condições para permanecer com a familia ou em domicilio unicelular. O objetivo do estudo é descrever as ações de enfermagem na promoção da saúde de idosos institucionalizados. Trata-se de um estudo de abordagem qualitativa, onde foi realizada uma revisão integrativa de literatura com referência às bases de dados da Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) e a Scientific Electronic Library Online entre os dias 15 de julho a 22 de julho de 2020. Por mais que existam politicas e estatutos voltados à saúde da população idosa, é importante que se faça necessária uma maior introdução gerontologica e geriátrica nas bases de formação profissional, para que assim aja uma prática de promoção da saúde do idoso com maior eficácia e eficiência. Para o alcance da promoção da saúde da pessoa idosa, destacam-se como ações de Enfermagem Gerontogeriátricas: adquirir conhecimentos específicos de Gerontologia; diferenciar as alterações fisiológicas e patológicas no processo de envelhecimento; capacitar as pessoas idosas, família, comunidade, estudantes, professores e trabalhadores acerca do processo de envelhecimento, por meio ações de promoção da saúde.mNesse estudo foi possível identificar que as ações educativas são ferramentas de suma importância no processo de cuidar frente à saúde de idosos institucionalizados, pois sistematiza o cuidado, contribui para promoção de autonomia e independência de idosos, e identifica e preveni futuros danos à pessoa idosa. 

Implementation of the International Classification of Functioning, Disability, and Health (ICF) Core Sets for Children and Youth with Cerebral Palsy: Global Initiatives Promoting Optimal Functioning

Background: The International Classification of Functioning, Disability, and Health (ICF) Core Sets for children and youth with cerebral palsy (CP) offer service providers and stakeholders a specific framework to explore functioning and disability for assessment, treatment, evaluation, and policy purposes in a global context. Objective: Describe global initiatives applying the ICF Core Sets for children and youth with CP, with a focus on contributions to clinical practice and challenges in their implementation. Methods: This is a descriptive cross-sectional study. Ongoing initiatives applying the ICF Core Sets for CP in Russia, Poland, Malawi, and Brazil are included. Results: The main contributions of applying the ICF Core Sets for children and youth with CP include: (1) an objective description of abilities and limitations in everyday activities; (2) a consistent identification of facilitators and barriers influencing functioning; (3) a practical communication tool promoting client-centered care and multidisciplinary teamwork; and, (4) a useful guideline for measurement selection. The main challenges of adopting the ICF Core Sets are related to lack of ICF knowledge requiring intense training and translating results from standardized measures into the ICF qualifiers in a consistent way. Conclusions: Global initiatives include research and clinical applications at the program, service and system levels. The ICF Core Sets for CP are useful tools to guide service provision and build profiles of functioning and disability. Global interprofessional collaboration, capacity training, and informatics (e-records) will maximize their applications and accelerate adoption