Implantação de um protocolo de avaliação e acolhimento baseado na Classificação Internacional de Funcionalidade, Incapacidade e Saúde em um centro especializado de reabilitação

O Protocolo de Levantamento de Problemas para a Reabilitação (PLPR) é um instrumento de triagem baseado no modelo da Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF), que sistematiza o acolhimento e possibilita a formação de bancos de dados sobre as demandas funcionais dos usuários de serviços de reabilitação. Objetivo: Relatar e analisar a partir da percepção dos profissionais o processo de implantação do PLPR em uma Unidade de Tratamento Neurológico Adulto de um Centro Especializado de Reabilitação (CER II). Métodos: Trata-se de uma pesquisa descritiva exploratória do tipo qualitativa. Para coleta dos dados foram utilizadas informações documentais e um grupo focal, adotado para compreender a percepção dos profissionais sobre as mudanças no processo de triagem após implementação do PLPR. Utilizou-se como ferramentas de processamento dos dados o software IRAMUTEQ. Resultados: A classificação hierárquica descendente apresentou cinco categorias temáticas de análise: Fluxo e Rede; Acolhimento e Cuidado; PLPR; Triagem; Reabilitação. Conclusão: A falta de uma rede de cuidados à pessoa com deficiência constituída e consolidada foi apontada como uma barreira importante que influencia o processo de reabilitação. A equipe demonstrou compreender a necessidade de reformular os atendimentos, através do modelo conceitual da CIF. Ressaltando que a aplicação do PLPR foi a primeira ação de estruturação deste modelo no serviço, todavia, não houve um consenso se o uso do instrumento promoveu um atendimento mais próximo deste modelo.The Protocol for Identification of Problems for Rehabilitation (PLPR) is a screening tool based on the International Classification of Functioning, Disability and Health (ICF) model, which systematizes the reception and enables the formation of databases on the functional demands of users of rehabilitation services. Objective: Report and evaluate, from the perception of professionals, the process of implementing the PLPR in an Adult Neurological Treatment Unit of a Specialized Rehabilitation Center (CER II). Methods: This is a descriptive exploratory qualitative research. For data collection, documentary information and a focus group were used to understand the perception of professionals about the changes in the triage process after the implementation of PLPR. IRAMUTEQ software was used as data processing tools. Results: The descending hierarchical classification presented five thematic categories of analysis: Flow and Network; Reception and Care; PLPR; Triage; Rehabilitation. Conclusion: The lack of a consolidated care network for people with disabilities was pointed out as an important barrier that influences the rehabilitation process. The team showed an understanding of the need to reformulate care through the ICF conceptual model. It is noteworthy that the application of the PLPR was the first action to structure this model in the servisse, however, there was no consensus whether the use of the instrument promoted a care closer to this model

Disability after stroke: a systematic review

Introduction: Stroke is the most common cause of disability in Western countries, yet there is no consensus in the literature on how to measure and describe disability from stroke. Objective: To conduct a systematic literature review on disability in stroke survivors. Method: Observational studies published in the PubMed, LILACS and SciELO online databases were selected, to evaluate disability in adults and in the elderly after stroke in the period 20022012. The Downs and Black checklist for non-randomized studies was used to assess the quality of the articles. Results: 212 articles were found from which 16 were selected to compose the study. The mean age of participants was 67 years, and disability affected 24% to 49% of the population evaluated. With regard to measurement instruments, 31% of the studies analyzed presented results of disability by means of the modified Rankin Scale; 19% by means of the World Health Organizations International Classification of Functioning, Disability and Health; 19% by means of Katz Index of Independence in Activities of Daily Living; 12.5% by means of the London Handicap Scale; 12.5 % by means of the Barthel Index; and 6.25% by means of the Functional Independence Measure. Conclusion: Literature is not uniform as regards means of measuring disability after stroke, but considering the preference of articles in assessing physical performance in activities of daily living, it can be concluded that a quarter to half of the population that survives stroke has some degree of disability

Disability after stroke: a systematic review

Introduction Stroke is the most common cause of disability in Western countries, yet there is no consensus in the literature on how to measure and describe disability from stroke. Objective To conduct a systematic literature review on disability in stroke survivors. Method Observational studies published in the PubMed, LILACS and SciELO online databases were selected, to evaluate disability in adults and in the elderly after stroke in the period 2002–2012. The Downs and Black checklist for non-randomized studies was used to assess the quality of the articles. Results 212 articles were found from which 16 were selected to compose the study. The mean age of participants was 67 years, and disability affected 24% to 49% of the population evaluated. With regard to measurement instruments, 31% of the studies analyzed presented results of disability by means of the modified Rankin Scale; 19% by means of the World Health Organization’s International Classification of Functioning, Disability and Health; 19% by means of Katz’ Index of Independence in Activities of Daily Living; 12.5% by means of the London Handicap Scale; 12.5 % by means of the Barthel Index; and 6.25% by means of the Functional Independence Measure. Conclusion Literature is not uniform as regards means of measuring disability after stroke, but considering the preference of articles in assessing physical performance in activities of daily living, it can be concluded that a quarter to half of the population that survives stroke has some degree of disability