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Casassola GM, Schmidt CJ, Affeldt GH, Morais DS, Alvarenga LKB, Miller C, Ziegler B. Functional status of hospitalized pediatric patients with COVID-19 in southern Brazil: a prospective cohort study. J Bras Pneumol 2023; 48:e20220153. [PMID: 36651435 PMCID: PMC9747171 DOI: 10.36416/1806-3756/e20220153] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 09/27/2022] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE The present study aimed to assess the functional status of children diagnosed with COVID-19 at the time of hospitalization and the associations with clinical features. METHODS This prospective cohort study was carried out with children diagnosed with COVID-19 admitted to a tertiary hospital. The patients' functioning was assessed using the pediatric Functional Status Scale (FSS). RESULTS A total of 62 children with a median age of 3 years old were included in the study, and 70% had some comorbidity prior to the diagnosis of COVID-19. The median length of stay was nine days, during which period five patients died. The FSS assessment of the sample showed that approximately 55% had some functional alteration. The group of patients with the highest FSS scores presented a lengthier hospital stay (p = 0.016), required more oxygen therapy (p < 0.001), mechanical ventilation (p = 0.001), and intensive care unit admissions (p = 0.019), and had more cardiac (p = 0.007), neurological (p = 0.003), and respiratory (p = 0.013) comorbidities. In the multivariate analysis, there was an association between the dependent variable length of stay and the total FSS score (b = 0.349, p = 0.004) and the presence of comorbidities (b = 0.357, p = 0.004). CONCLUSIONS We observed that more than half of the children hospitalized due to COVID-19 had some level of functional change. Greater alterations in functional status were associated with the presence of previous comorbidities, a greater need for ventilatory support, and longer hospital stays.
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Affiliation(s)
| | | | - Guilherme Hoff Affeldt
- . Programa de Pós-Graduação em Pneumologia, Universidade Federal do Rio Grande do Sul, Porto Alegre (RS), Brasil
| | | | | | - Cristina Miller
- . Hospital de Clínicas de Porto Alegre, Porto Alegre (RS), Brasil
| | - Bruna Ziegler
- . Hospital de Clínicas de Porto Alegre, Porto Alegre (RS), Brasil
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da Cunha MAO, Santos HF, de Carvalho MEL, Miranda GMD, de Albuquerque MDSV, de Oliveira RS, de Albuquerque AFC, Penn-Kekana L, Kuper H, Lyra TM. Health Care for People with Disabilities in the Unified Health System in Brazil: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:1472. [PMID: 35162497 PMCID: PMC8834994 DOI: 10.3390/ijerph19031472] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 01/18/2022] [Accepted: 01/21/2022] [Indexed: 12/10/2022]
Abstract
People with disabilities have greater need for healthcare on average, but often face barriers when accessing these services. The Brazilian government launched the National Health Policy for People with Disabilities (PNSPD) in 2002 to address this inequality. PNSPD has six areas of focus: quality of life, impairment prevention, comprehensive health care, organization and functioning of health services, information mechanisms, and training of human resources. The aim of this article was to undertake a scoping review to assess the evidence on the experience of people with disabilities in Brazil with respect to the six themes of the PNSPD. The scoping review included articles published between 2002 and 2019, from four electronic databases: PUBMED/MEDLINE, LILACS, Science Direct, and Scielo. In total, 8076 articles were identified, and after review of titles, abstracts, and full texts by two independent reviewers, 98 were deemed eligible for inclusion. The evidence was relatively limited in availability and scope. However, it consistently showed large gaps in delivery of healthcare to people with disabilities across the six dimensions considered. There was lack of actions aimed at promoting quality of life; insufficient professional training about disability; little evidence on the health profile of people with disabilities; large gaps in the availability of care due to widespread physical, informational, and attitudinal barriers; and poor distribution of the supply and integration of services. In conclusion, the policy framework in Brazil is supportive of the inclusion of people with disabilities in health services; however, large inequalities remain due to poor implementation of the policy into practice.
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Affiliation(s)
| | | | | | - Gabriella Morais Duarte Miranda
- Academic Area of Public Health, Center for Medical Sciences, Federal University of Pernambuco, Recife 50070-460, Brazil; (G.M.D.M.); or (M.d.S.V.d.A.); (R.S.d.O.)
- Department of Collective Health, Aggeu Magalhães Institute, FIOCRUZ, Recife 50670-420, Brazil;
| | - Maria do Socorro Veloso de Albuquerque
- Academic Area of Public Health, Center for Medical Sciences, Federal University of Pernambuco, Recife 50070-460, Brazil; (G.M.D.M.); or (M.d.S.V.d.A.); (R.S.d.O.)
- Department of Collective Health, Aggeu Magalhães Institute, FIOCRUZ, Recife 50670-420, Brazil;
| | - Raquel Santos de Oliveira
- Academic Area of Public Health, Center for Medical Sciences, Federal University of Pernambuco, Recife 50070-460, Brazil; (G.M.D.M.); or (M.d.S.V.d.A.); (R.S.d.O.)
| | | | - Loveday Penn-Kekana
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK;
| | - Hannah Kuper
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK;
| | - Tereza Maciel Lyra
- Department of Collective Health, Aggeu Magalhães Institute, FIOCRUZ, Recife 50670-420, Brazil;
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Tavares Netto AR, Wiesiolek CC, Brito PM, Rocha GAD, Tavares RMF, Lambertz KMF. Functionality, school participation and quality of life of schoolchildren with cerebral palsy. FISIOTERAPIA EM MOVIMENTO 2020. [DOI: 10.1590/1980-5918.033.ao29] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Introduction: The quality of life (QoL) of schoolchildren with cerebral palsy (CP) should be evaluated considering the functional variability of the child with CP with an extended view on functionality in the school context and the determinants of QoL. Objective: to evaluate the school participation and the QoL of schoolchildren with CP in Recife's municipal public network, as well as to analyze the influence of GMFCS levels and motor performance on these variables in the study population. Method: This is an exploratory observational study whose evaluation model was structured based on the International Classification of Functioning, Disability and Health (CIF). Children with CP were classified in the Gross Motor Function Classification System (GMFCS) and evaluated according to Gross Motor Function Measure-88 (GMFM-88). The School Function Assessment (SFA) and the Quality of Life Questionnaire for Cerebral Palsy (CPQOL-Caregiver) were answered by teachers and mothers, respectively. Results: In the study population, the higher the GMFCS level, the lower the participation and the lower the independence in school activities, aspects that add to the QoL construct, mainly with less functionality, less emotional well-being and self-esteem, and lower family health. Conclusion: GMFCS levels and motor performance of schoolchildren with CP can affect school participation and QoL, and it is important to consider each child's individual and contextual factors. These results can help the development of functional, care, inclusion and pedagogical strategies for students with CP.
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Sá MRCD, Vieira ACD, Castro BSM, Agostini O, Smythe T, Kuper H, Moreira MEL, Moreira MCN. [The need to act together in every way possible: inter-sector action in health and education for children living with the congenital Zika syndrome]. CAD SAUDE PUBLICA 2019; 35:e00233718. [PMID: 31800795 DOI: 10.1590/0102-311x00233718] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 06/03/2019] [Indexed: 11/22/2022] Open
Abstract
The experience with an intervention program conducted in an educational institution and targeted to families of children with congenital Zika syndrome, which includes multiple disabilities, revealed the challenges and strides with the entry of these families in the school system. This article aimed to explore the findings from a study conducted after the conclusion of an intervention program, using semi-open interviews with professional staff at the institution and the possible contributions towards establishing inter-sector relations aimed at school inclusion of children with disabilities. A change was seen, as a result of the program, in the relationship between the families and the professionals at the educational institution, whereby the families had room to voice their fears and discuss the school's role in the lives of their children with disabilities. The professionals thus came to see the families taking a more active stance. This experience can favor other services and municipalities that seek school inclusion for children and adolescents with disabilities, as well as their social inclusion and that of their families.
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Affiliation(s)
- Miriam Ribeiro Calheiros de Sá
- Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
| | - Ana Carolina Dias Vieira
- Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
| | - Barbara S Madeira Castro
- Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
| | - Olivia Agostini
- Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
| | - Tracey Smythe
- London School of Hygiene and Tropical Medicine, London, U.K
| | - Hannah Kuper
- London School of Hygiene and Tropical Medicine, London, U.K
| | - Maria Elisabeth Lopes Moreira
- Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
| | - Martha Cristina Nunes Moreira
- Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
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Santos PDD, Silva FCD, Ferreira EG, Iop RDR, Bento GG, Silva RD. Instrumentos que avaliam a independência funcional em crianças com paralisia cerebral: uma revisão sistemática de estudos observacionais. FISIOTERAPIA E PESQUISA 2016. [DOI: 10.1590/1809-2950/15260723032016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Este artigo teve como objetivo fazer uma revisão sistemática de instrumentos que avaliam a independência funcional de crianças com paralisia cerebral. As bases eletrônicas da MEDLINE/PubMed, Scopus e Web of Science foram usadas para as buscas. Estudos observacionais dos últimos cinco anos, com texto completo disponível e sem restrição de idioma foram incluídos nesta revisão. Foram encontrados 222 artigos, dos quais, 63 foram analisados e 24 foram incluídos no estudo. Os principais instrumentos encontrados foram: PEDI, WeeFIM, ASK, PODCI, VABS-II, LIFE-H e CAPE/PAC.
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Zuculo GM, Knap CCF, Pinato L. Correlation between sleep and quality of life in cerebral palsy. Codas 2014; 26:447-56. [DOI: 10.1590/2317-1782/20140201435] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2014] [Accepted: 07/01/2014] [Indexed: 11/21/2022] Open
Abstract
PURPOSE: To investigate and correlate the sleep pattern and quality of life in individuals with cerebral palsy (CP) compared to healthy controls. METHODS: Seventy-eight subjects (aged 4-18 years, both genders) comprised two groups: CP, composed of 43 individuals with CP, and control, composed of 35 individuals without neurodevelopmental disorders. General Sleep Habits Questionnaire, Sleep Disturbance Scale for Children, sleep diary, Child Health Questionnaire, and Children's Quality of Life Scale were used. RESULTS: This study identified that 60.5% individuals with CP had sleep disorders. The respiratory disorders (25.6%) and the sleep hyperhidrosis (34.9%) were the most common disturbances in the group with CP. Moreover, 23.2% individuals of the group with CP reported awaking in the middle of the night and 37.2% of them snore, both percentages were higher than those in the control group. The sleep diary showed that individuals in the group with CP spend more time to initiate sleep (around 21 minutes). The group with CP also showed deficits in all parameters analyzed by the Child Health Questionnaire, except in family activity and the sleep-wake pattern, and quality of life showed negative correlation in several respects. CONCLUSION: The altered pattern of sleep in individuals with CP directly affects their physical and emotional well-being.
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Affiliation(s)
| | | | - Luciana Pinato
- Universidade Estadual Paulista Júlio de Mesquita Filho, Brazil
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