Limitações E Incapacidades Físicas No Pós-Alta Em Hanseníase: Uma Revisão Integrativa

Abstract

Objetivo: sintetizar informações produzidas sobre limitações e incapacidades físicas no pós-alta em hanseníase. Método: revisão integrativa realizada nos meses de maio e junho de 2015, nas bases de dados CINAHL, LILACS, PubMed e Scopus, utilizando os descritores indexados Hanseníase, Alta do Paciente e Pessoas com Deficiência, e seus correspondentes em inglês e espanhol, associado ao operador boleano and. Resultados: selecionaram-se 15 estudos, dos quais 26,6% estão voltados para avaliação da limitação de atividades e participação social do indivíduo no pós-alta em hanseníase, e outros 26,6%, para a avaliação das incapacidades físicas. Na análise temática, foram identificadas três categorias: caracterização de usuários no pós-alta em hanseníase; repercussão social; e possibilidades terapêuticas e acompanhamento pós-alta. Conclusão: estudos mostraram predominância de casos multibacilares com incapacidades físicas, limitações de atividades e de participação social entre os usuários no pós--alta em hanseníase, sugerindo a necessida de continuidade da assistência após a alta medicamentosa. Descritores: Hanseníase; Alta do Paciente; Pessoas com Deficiência; Saúde.Objective: to summarize the information produced about limitations and disabilities in post-treatment for leprosy. Method: integrative review conducted in May and June 2015 in CINAHL, LILACS, PubMed and Scopus databases, using the indexed descriptors: Leprosy, Patient Discharge and People with Disabilities and their counterparts in English and Spanish, together with the Boolean and operator. Results: we selected 15 studies, of which 26.6% are focused on evaluating the limitation of activities and social participation of the individual in post-treatment for leprosy and another 26.6% for the assessment of physical disabilities. Three categories were identified through thematic analysis: Profile of users in post-treatment for leprosy; Social impact; and post-treatment therapeutic possibilities and followup. Conclusion: studies have shown predominance of multibacillary cases with physical disabilities, limitations in activities and of social participation among users in post-treatment for leprosy, suggesting the need for the continuity of care after release from medication.

Análise contextual da atenção à saúde na alta em hanseníase: uma revisão integrativa

“…The selected articles (14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27) to compose the present integrative review present different levels of evidence. According to the level of evidence proposed by Melnyk and Fineout-Overholt (35) , two studies were classified in level IV (related to evidence from a cohort study) (14,24) and 12 studies were considered at the level of evidence VI, i.e., those that include evidence derived from a single descriptive or qualitative study (15)(16)(17)(18)(19)(20)(21)(22)(23)(25)(26)(27) .…”

“…The search was made without using a temporal cut-off related to the year of publication of the studies and was performed using the indexed descriptors Leprosy and dis-charge (or Leprosy and Patient Discharge, for selection via MeSH), associated with the Boolean operator AND, obtaining a total of 145 publications. After exclusion according to the eligibility criteria and repeated publications, 14 articles (14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27) were included for the study, as explained in Flowchart 1. In order to carry out the analysis, in addition to the articles selected, we also searched for convenience, in a non-systematized way, publications (4,(28)(29)(30)(31)(32)(33)(34) of the authors' knowledge, because it is seen necessary and relevant for contextual analysis.…”

“…The criteria for termination of treatment for leprosy defined by the MOH relate to the number of doses of MDT administered in a given period of time, whether paucibacillary (PBs) or multibacillary (MBs). At the conclusion of the drug therapy, called discharge by cure, ceases to be an infectious disease and moves to the scope of chronic diseases (15)(16)(17)(18) .…”

“…Its chronic evolution is often associated with the development of reactional episodes for up to five years after completion of PCT. In post-discharge neural damage occurs and the consequent installation and worsening of physical disabilities, indicating the need for qualified and comprehensive care for these patients considered cured (16)(17)(18)(19)(20) .…”

Compreendendo a “alta em hanseníase”: uma análise de conceito

“…Regarding the nurse, it is the provision of a care plan that integrates the recognition of the subjectivity of individuals as more than a biological body, due to the historical context of segregation and stigma surrounding leprosy (37)(38)(39) . The antecedent and consequent attributes of the concept "patient discharge in leprosy", which complement and expand the understanding of the concept are shown in Chart 1.…”