Resumo:Introdução: O número de pessoas amputadas de membro inferior é crescente e está relacionado principalmente ao estilo de vida e aos acidentes com meios de transporte. Hoje no Brasil as políticas públicas visam amparar essa população por meio de leis e diretrizes. Objetivo: Conhecer as percepções sobre as barreiras e facilitadores do retorno ao trabalho das pessoas amputadas de membros inferiores. Método: Trata-se de uma pesquisa qualitativa que utilizou a técnica Grupo Focal com oito participantes adultos, de ambos os sexos, amputados de membros inferiores. Trabalhou-se a temática de retorno ao trabalho a partir dos temas geradores: acessibilidade, aposentadoria, trabalho informal e mobilidade, e com isso permitiu-se visualizar o consenso e os contrastes das opiniões dos participantes a partir de suas vivências diárias. A roda de conversa foi gravada e transcrita, sendo as falas analisadas através da análise de discurso crítica, tendo como referencial as diretrizes e leis relacionadas à atenção à pessoa amputada. Resultados: As percepções revelaram insatisfação relacionada à acessibilidade e inclusão social, dificultando uma vida ativa e o retorno às atividades profissionais. Aspectos contraditórios entre as percepções e as políticas vigentes foram percebidos em relação ao retorno ao trabalho. Conclusão: Os participantes não estão satisfeitos com o processo de inclusão social em relação ao retorno ao trabalho, pois ainda há muitos obstáculos no dia a dia do trabalhador que apresenta necessidades especiais. As leis e diretrizes para assistência de pessoas amputadas não são suficientes. Palavras-chave: Amputação, Legislação, Percepção, Retorno ao trabalho. Barriers and facilitators to return to work experienced for amputees of lower limbs over Brazilian guidelines opticsAbstract: Introduction: The number of lower limb amputees is growing and the main reasons are lifestyle and transport accidents. Current Brazilian public policies aim to support this population through laws and guidelines. Objective: To understand lower limbs amputees perceptions on the barriers and facilitators when returning to work. Method: This qualitative study used a focus group technique and has eight participants, all adult amputees of both sexes. We evaluated the return to work from the generating topics: accessibility, retirement, informal work and mobility. We were able to view the consensus and contrasts of participants opinions based on their daily experiences. The discussion was recorded and transcribed, and the lines assessed by critical discourse analysis. We used guidelines and laws directed to health and amputees as references. Results: Perceptions revealed dissatisfaction regarding accessibility and social inclusion, hindering an active life and the return to professional activities. Contradictory aspects between perceptions and current policies were perceived regarding the return to work. Conclusion: Participants are not satisfied with the process of social inclusion regarding their return to work, as there are still many ...
Objective: In order to characterize the profile of lower limb amputation surgeries by external cause, performed in public hospitals in the state of Santa Catarina. Method: This descriptive, epidemiological and hospital based study analyzed hospital admissionpermits (AIH) (N= 4158) in between 2008-2014. Results: There has been a prevalence of male population (79,1%), age group between 18 and 29 years (17,7%). The most incident form of amputation was by partial or complete traumatic injury with involvement of a finger. The three most affected counties were Chapecó, Criciúma and Brusque. There has been a decrease in the number of amputations mainly in the last four years. Conclusion: Despite this fact, amputations are a globally recognized public health problem. Epidemiological follow-up the AIH´s translates as an indicator to monitor and trigger improvement actions of specialized assistance to amputated patients with a view to prevention, organization of services, and training of multi professional teams.
After the first diagnosis of COVID-19 in Wuhan, in December 2019, many studies were published in an attempt to clarify the clinical picture and the ways in which the disease is transmitted. To date, more than 186,737,584 million cases have been confirmed worldwide, and about 15% of infected patients will need oxygen therapy and another 5% will evolve into a severe form of the disease, evoking intensive care. In parallel, the virus has a high degree of transmissibility, increasing the risk of contamination for the healthcare team. In this context, during hospitalization of this population and admission to Intensive Care Units, physical therapy activities have been widely recommended. However, there is little evidence in the literature about the appropriate guidelines and protocols for the safe application of therapeutic approaches in this scenario. In this
Lower limb (LL) amputation compromises the individual's quality of life and functionality, requiring immediate rehabilitation through the assistance of a multi-professional team. This research describes the sociodemographic and physical-functional profile of the LL amputee, evaluated at the hospital bedside in the immediate postoperative period. This is a descriptive and cross-sectional study in which patients from the Unified Health System were evaluated, who underwent LL of any etiology in a public hospital. The collection was designated through notifications from the hospital staff regarding cases of newly amputees, totaling fourteen subjects. The average age of the participants was 44 years old, being 86% male. The etiology of the predominant amputation was automobile trauma due to motorcycle accidents and transtibial level. From the perimetry, it was found that 43% of the individuals presented edema in the stump when compared to the contralateral limb. Regarding stump pain, 93% of subjects reported feeling, while 78% reported feeling phantom pain and phantom sensation. Concerning normal muscle strength in the amputated limb, it was present in only 1% of patients, in contrast to the intact limb was present in 48% of individuals for any muscle group. In bed mobility, 32% of individuals had complete independence. In unipodal orthostatism, no patient was able to stand independently. From the collected data it was possible to conclude that the physical therapist should pay attention to the muscular strength, bed mobility, and static balance of the amputee to avoid muscle contractures and facilitate prosthesis.
After the first diagnosis of COVID-19 in Wuhan, in December 2019, many studies were published in an attempt to clarify the clinical picture and the ways in which the disease is transmitted. To date, more than 186,737,584 million cases have been confirmed worldwide, and about 15% of infected patients will need oxygen therapy and another 5% will evolve into a severe form of the disease, evoking intensive care. In parallel, the virus has a high degree of transmissibility, increasing the risk of contamination for the healthcare team. In this context, during hospitalization of this population and admission
Em março de 2020 o vírus SARS-CoV-2 potencialmente contagioso causador da COVID 19 deflagrou uma pandemia de proporção mundial segundo a Organização Mundial de Saúde. Nesse contexto, observa-se que no período prévio a pandemia, não há uma Rede de Atenção à Saúde para o acolhimento da pessoa que sofreu uma amputação desde os cuidados de urgência até a finalização do processo de reabilitação com a equipe multiprofissional impossibilitando o retorno precoce e efetivo às atividades de vida diária (AVD’S) e atividade laboral. Trata-se de um estudo exploratório descritivo, com abordagem qualitativa. O objetivo deste estudo foi apresentar a autopercepção dos pacientes amputados sobre sua mobilidade funcional, adaptação protética, atividade física e reabilitação antes e durante a pandemia da COVID-19. A partir da auto percepção dos pacientes em seus depoimentos a pandemia da COVID-19 afetou: a mobilidade funcional, a adaptação protética, a prática de atividade física e a reabilitação dos pacientes amputados antes e durante a pandemia. A Telefisioterapia é uma estratégia inovadora e contribui na manutenção da saúde e qualidade de vida da pessoa amputada. A partir dos relatos, é possível perceber os benefícios do teleatendimento para a população amputada.
Introdução: Aos pacientes cuja morte iminente é esperada e que não há benefício na continuidade da ventilação mecânica, a extubação paliativa (EP) é vista como um conforto, uma vez que a presença do tubo endotraqueal pode ser um prolongador da morte agonizante, uma medida obstinada que proporciona a distanásia aos pacientes. Objetivo: Sistematizar e elaborar um protocolo de EP para ser aplicado pela equipe multiprofissional ao paciente em cuidado paliativo, em situação de processo ativo de morte. Metodologia: Trata-se de uma pesquisa de revisão de literatura. O protocolo de EP foi elaborado com base em buscas em bancos de dados com as palavras chaves: cuidados paliativos, extubação, cuidados para prolongar a vida, palliative care, air way extubation, life support care. Resultados: O protocolo pode ser dividido em seis fases: Fase 1 - Preparação/acolhimento familiar; Fase 2 - Pré Extubação; Fase 3 - Extubação; Fase 4 - Pós extubação; Fase 5 - Controle rigoroso de sintomas; Fase 6 - Acompanhamento. Conclusão: Com base na pesquisa da literatura atual foi possível elaborar um protocolo destinado a ser um ponto de assistência para equipe multiprofissional e segurança ao paciente por se tratar em um guia de etapas. Os resultados obtidos poderão contribuir na diminuição de medidas prolongadoras da vida, prevenindo assim a distanásia. A redução de custos com medidas fúteis também é um fator que deve-se levar em conta, além de proporcionar uma finitude digna e humanizada do indivíduo.
Introduction: With scientific and technological advances, the survival of critically ill patients has increased over the years. However, some patients require prolonged invasive mechanical ventilation (IMV), which can increase the length of stay in the intensive care unit (ICU) and lead to ICU-acquired muscle weakness (ICUAW). There are several tools to diagnose ICUAW, however, most of them depend on patient collaboration, and often, due to sedation, this becomes unfeasible. Objective: To describe the ICUAW assessment instruments in critically ill patients. Methodology: A bibliographic search was carried out in PubMed, MedLine (International Literature and Health), LILACS (Latin America and the Caribbean in Health Sciences) and Cochrane databases between 1995 and December 2019 using the keywords: muscle weakness, muscle strength and intensive care unit. Conclusion: The assessment of muscle weakness is of great importance to verify the health status of critically ill patients admitted to the ICU and to guide them towards the most appropriate treatment plan. Thus, it is essential for the physical therapist to know the various instruments for assessing muscle weakness acquired in the ICU.
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