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Castro SS, Bassichetto KC, Lima MG, Cesar CLG, Goldbaum M, Barros MBDA. Impairments and related social inequalities among adults: a population-based study in São Paulo city, Brazil. Cien Saude Colet 2024; 29:e16962022. [PMID: 38655955 DOI: 10.1590/1413-81232024294.16962022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 06/23/2023] [Indexed: 04/26/2024] Open
Abstract
The study of the association of social variables with the prevalence of impairments can provide subsidies for more adequate care and health policies for the most needy people by incorporating social aspects. This article aims to estimate the prevalence of diverse types of impairments, the degree of difficulty, limitations, and the need for help they cause and attest whether this prevalence differ by educational attainment in individuals aged 20 years or older. This is a populational cross-sectional study (2015 Health Survey of São Paulo-ISA Capital). Data from 3184 individuals were analyzed via educational attainment as exposure variable and outcome variables related to visual, hearing, intellectual, and mobility impairments. 19.9% of participants had visual, 7.8%, hearing, 2.7%, intellectual, and 7.4%, mobility impairments. Mobility and intellectual impairments limited participants' daily activities the most, 70.3% and 63.3%, respectively; who, thus, needed the most help: 48.9% and 48.5%, respectively. Lower schooling was associated with a higher prevalence of impairments, greater need for help due to visual and intellectual impairments, and greater limitations due to hearing and visual impairments.
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Affiliation(s)
- Shamyr Sulyvan Castro
- Departamento de Fisioterapia, Universidade Federal do Ceará. R. Doutor José Lourenço 816 apto 2101. 60115-281 Fortaleza CE Brasil.
| | | | | | - Chester Luiz Galvão Cesar
- Departamento de Epidemiologia, Faculdade de Saúde Pública, Universidade de São Paulo. São Paulo SP Brasil
| | - Moisés Goldbaum
- Departamento de Medicina Preventiva, Universidade de São Paulo. São Paulo SP Brasil
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de Lima EA, Castro SS, Viana-Júnior AB, Sobreira-Neto MA, Leite CF. Could an increased risk of obstructive sleep apnoea be one of the determinants associated with disability in individuals with cardiovascular and cerebrovascular diseases? Sleep Breath 2024:10.1007/s11325-024-02989-3. [PMID: 38252255 DOI: 10.1007/s11325-024-02989-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 11/21/2023] [Accepted: 01/03/2024] [Indexed: 01/23/2024]
Abstract
PURPOSE To investigate a possible association between the risk of obstructive sleep apnoea (OSA) and disability in individuals with cardiovascular or cerebrovascular diseases. METHODS Cross-sectional study was conducted with 373 individuals (313 with cardiovascular or cerebrovascular diseases and 60 healthy). Disability was assessed by the 12-item World Health Organization Disability Assessment Schedule (WHODAS), and the risk of OSA was assessed by STOP-BANG. Anxiety and depression symptoms, daytime sleepiness, and cognition were assessed by the Hospital Anxiety and Depression Scale (HADS), Epworth Sleepiness Scale (ESS), and Mini Mental State Examination (MMSE). RESULTS Greater disability was found in individuals with intermediate or high risk of OSA, considering healthy individuals (p=0.03), or individuals diagnosed with arrhythmia (p<0.01) or coronary artery disease (p=0.04). A high risk of OSA and higher WHODAS scores was significant among women as well as between OSA risk categories (p<0.01). Cognitive deficit and level of education also showed differences between OSA risk categories. Age, depression, and sleepiness were also associated with the subjects' disability (p<0.01). Gamma regression model showed higher WHODAS scores in female, in those with intermediate and high risk of OSA, and in those with depressive symptoms and cognitive deficit. Age also showed a correlation with higher WHODAS scores. The presence of all investigated cardio and cerebrovascular diseases showed an increase in the WHODAS score, implying a greater disability compared to healthy individuals. CONCLUSION Moderate and high risk of OSA is associated with disability, as well as gender, age, depressive symptoms, cognitive deficit, and cardiovascular diseases.
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Affiliation(s)
- Eriádina Alves de Lima
- Graduate Program in Cardiovascular Sciences, Federal University of Ceara, Fortaleza, Ceara, Brazil
| | - Shamyr Sulyvan Castro
- Master Program in Physiotherapy and Functioning, Federal University of Ceara, Fortaleza, Ceara, Brazil
| | - Antonio Brazil Viana-Júnior
- Clinical Research Unit of Hospital Universitário Walter Cantidio, Federal University of Ceara/EBSERH, Fortaleza, Ceara, Brazil
| | | | - Camila Ferreira Leite
- Graduate Program in Cardiovascular Sciences, Federal University of Ceara, Fortaleza, Ceara, Brazil.
- Master Program in Physiotherapy and Functioning, Federal University of Ceara, Fortaleza, Ceara, Brazil.
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Lima EA, Rodrigues G, Mota BC, Castro SS, Mesquita RB, Leite CF. Which Components of The International Classification of Functioning, Disability and Health (ICF) are Covered by Cardiac Rehabilitation Assessment Tools among Individuals with Heart Failure? Heart Lung 2024; 63:65-71. [PMID: 37806100 DOI: 10.1016/j.hrtlng.2023.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 09/14/2023] [Accepted: 09/19/2023] [Indexed: 10/10/2023]
Abstract
BACKGROUND The therapeutic assessment of functioning in cardiac rehabilitation from the perspective of the International Classification of Functioning, Disability and Health (ICF) can provide a biopsychosocial approach to health care. However, it is unclear which components are reflected in the instruments used for cardiac rehabilitation in individuals with heart failure (HF). OBJECTIVES To investigate which ICF components (body function, structures, activities, participation, environmental factors, and personal factors) are represented in the assessment instruments used in individuals with HF and to identify the most appropriate instrument to use based on the inclusion of these factors. METHODS Forty-four clinical trials included in an updated Cochrane systematic review that investigated the effects of exercise-based cardiac rehabilitation in patients with HF were reviewed. The instruments were analyzed to extract significant concepts linked to the ICF codes. RESULTS A total of 12 outcomes and 40 instruments were identified. The concepts were linked to 2466 codes in the following ICF components: body functions (41.8%), activities (29.7%), participation (8.4%), environmental factors (3.8%), personal factors (1.3%), and body structures (1.0%); other concepts (13.9%) were classified as not covered by ICF. None of the instruments presented concepts linked to all ICF components. The Minnesota Living with Heart Failure Questionnaire (MLHFQ), however, demonstrated comprehensive coverage of the ICF components, with the exception of body structure. CONCLUSIONS Body function was the most frequently detected ICF component. Individual instruments did not provide a comprehensive perspective on the functioning level of individuals with HF. The MLHFQ provided the greatest coverage of ICF components.
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Affiliation(s)
- Eriadina Alves Lima
- Graduate Program in Cardiovascular Sciences, Federal University of Ceara, Fortaleza, Ceara, Brazil.
| | - Gezabell Rodrigues
- Master Program in Physiotherapy and Functioning, Federal University of Ceara, Fortaleza, Ceara, Brazil.
| | - Beatriz Carneiro Mota
- Department of Physical Therapy, Federal University of Ceara, Fortaleza, Ceara, Brazil.
| | - Shamyr Sulyvan Castro
- Master Program in Physiotherapy and Functioning, Federal University of Ceara, Fortaleza, Ceara, Brazil.
| | - Rafael Barreto Mesquita
- Graduate Program in Cardiovascular Sciences, Federal University of Ceara, Fortaleza, Ceara, Brazil; Master Program in Physiotherapy and Functioning, Federal University of Ceara, Fortaleza, Ceara, Brazil.
| | - Camila Ferreira Leite
- Graduate Program in Cardiovascular Sciences, Federal University of Ceara, Fortaleza, Ceara, Brazil; Master Program in Physiotherapy and Functioning, Federal University of Ceara, Fortaleza, Ceara, Brazil.
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Silva TFCE, Medeiros PMDSS, Leite CF, Castro SS, Nunes ACL, Jesus-Moraleida FR. Is it time to rethink disability assessment in low back pain? Reliability, internal consistency, and construct validity of the Brazilian WHODAS 2.0 for chronic low back pain. Physiother Res Int 2023; 28:e2025. [PMID: 37231998 DOI: 10.1002/pri.2025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 04/13/2023] [Accepted: 05/14/2023] [Indexed: 05/27/2023]
Abstract
BACKGROUND AND PURPOSE The World Health Disability Assessment Schedule 2.0 (WHODAS 2.0) was developed to assess health and disability based on the biopsychosocial model. The WHODAS 2.0 has not been validated for Brazilians with chronic non-specific low back pain (LBP). We aimed to evaluate the reliability, internal consistency, and construct validity of the Brazilian version of the WHODAS 2.0 in patients with chronic LBP. METHODS Methodological study. The Brazilian version of the WHODAS 2.0 was applied to 100 volunteers with chronic nonspecific LBP. Test-retest reliability, internal consistency, and construct validity were assessed using the Spearman correlation test, Cronbach's alpha (α) coefficient, and Spearman's correlation test between WHODAS 2.0, the Oswestry Disability Index (ODI), Roland-Morris Disability Questionnaire (RMDQ), and Fear Avoidance Beliefs Questionnaire (FABQ), respectively. RESULTS WHODAS 2.0 showed satisfactory test-retest reliability with a moderate correlation for total WHODAS 2.0 (r = 0.75, p < 0.05). Internal consistency was adequate for all domains and total score (α = 0.82-0.96). Regarding construct validity, WHODAS 2.0, ODI (r = 0.70, p < 0.05), and WHODAS 2.0 and RMDQ (r = 0.71, p < 0.05) had significant correlations. Total WHODAS 2.0 and FABQ-Phys subscale scores correlated moderately (r = 0.66, p < 0.05). DISCUSSION The Brazilian WHODAS 2.0 was proved to be a valid and reliable tool for patients with chronic LBP. The item referring to sexual intercourse had 27% and 30% of the missing values during the test and retest stage, respectively and had a high percentage of missing data for work-related questions (41% missing data) in the life activities domain; therefore, the data must be interpreted with caution. IMPLICATIONS FOR PHYSIOTHERAPY PRACTICE WHODAS 2.0 can be used as a disability assessment strategy from a biopsychosocial perspective in this population.
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Affiliation(s)
- Tuyra Francisca Castro E Silva
- Master Program in Physiotherapy and Functioning, Federal University of Ceará, Fortaleza, Brazil
- Federal Institute of Education, Science and Technology of Ceará, Fortaleza, Brazil
| | | | - Camila Ferreira Leite
- Master Program in Physiotherapy and Functioning, Federal University of Ceará, Fortaleza, Brazil
| | - Shamyr Sulyvan Castro
- Master Program in Physiotherapy and Functioning, Federal University of Ceará, Fortaleza, Brazil
- Master Program of Public Health, Federal University of Ceará, Fortaleza, Brazil
| | - Ana Carla Lima Nunes
- Master Program in Physiotherapy and Functioning, Federal University of Ceará, Fortaleza, Brazil
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Silva ÉGCD, Castro SS, Sabariego C, Monteiro KS, Lima NMFV. Translation and cross-cultural adaptation of the Model Disability Survey (MDS) for Brazil. Rev Saude Publica 2023; 57:33. [PMID: 37377329 DOI: 10.11606/s1518-8787.2023057004759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 06/14/2022] [Indexed: 06/29/2023] Open
Abstract
OBJECTIVE This study has as objective the translation and cross-cultural adaptation of the Model Disability Survey (MDS), a World Health Organization instrument that provides comprehensive information on disability/functioning, for Brazil. METHODS This is a cross-sectional methodological study, carried out through five stages - initial translation, synthesis of translations, reverse translation, review by a specialist committee, and pre-test -, considering properties such as semantic, idiomatic, experimental, and conceptual equivalence. Translators, researchers, a mediating team, health professionals, a methodologist and a language specialist were needed to pass through the stages. Statistical analysis was produced from absolute and relative frequencies, measures of central tendency and dispersion, normality tests and content validity index (CVI) > 0.80. RESULTS The MDS has 474 items, which generated 1,896 analyzes of equivalence. Of these, 160 items had a CVI < 0.80 in at least one of the four types of equivalence and required adjustments. After adaptations and approval by the judges, the pre-final version went on to the pre-test with 30 participants from four regions of the Brazilian Northeast. Regarding this sample, 83.3% are women, single, with an average age of 33.7 years (SD 18.8), self-declared as black or brown, active workers, with technical education and living with three residents. Interviews lasted 123 minutes on average, where 127 health conditions were mentioned, and the most frequent cited were anxiety and back pain. Answers were analyzed and 63 items were cited as needing some adjustment, two of which were submitted for analysis by the committee because they presented a CVI < 0.80. The instrument, guide and presentation cards were adjusted after a new pre-test. CONCLUSIONS The MDS was translated and cross-culturally adapted to Brazilian Portuguese and showed adequate content validity.
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Affiliation(s)
| | | | - Carla Sabariego
- University of Lucerne. Department of Health Sciences and Medicine. Lucerne, Switzerland
| | - Karolinne Souza Monteiro
- Universidade Federal do Rio Grande do Norte. Faculdade de Ciências da Saúde do Trairi. Santa Cruz, RN, Brasil
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Silva TFCE, Nunes ACL, Barreto MCA, Castro SS, Jesus-Moraleida FR. Questionnaires that assess disability in children and adolescents with low back pain adhere to the concepts of the International classification of functioning, disability and health (ICF), but lack validity for this population: a systematic review. Disabil Rehabil 2023:1-11. [PMID: 37326065 DOI: 10.1080/09638288.2023.2221901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 05/25/2023] [Accepted: 05/27/2023] [Indexed: 06/17/2023]
Abstract
PURPOSE We aimed to identify Patient-Reported Outcome Measures (PROMs) that assess disability in children and adolescents with low back pain (LBP), analyzing their adherence to the International Classification of Functioning, Disability and Health (ICF) biopsychosocial model; and to describe the measurement properties of these PROMs. METHODS We searched Pubmed, Embase and CINAHL databases. The review included searches up to March 2022. Meaningful concepts of the PROMs were linked to ICF domains, and we manually searched for the measurement properties of each included PROM. RESULTS We included 23 studies, of which eight PROMs were analyzed. We retrieved 182 concepts in total. Activities was the domain with the highest number of linked concepts, whereas personal factors had no linked concepts. The modified Hannover Functional Ability Questionnaire (mHFAQ) and the Micheli Functional Scale (MFS) had measurement properties tested in children and adolescents, but had no information about construct validity. CONCLUSION Although most of the identified PROMs had broad coverage of their concepts in the ICF, only two PROMs had measurement properties tested in the population of interest in this review, in which the mHFAQ presented wide coverage in relation to the ICF. Further studies are needed to investigate content validity of these PROMs.
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Affiliation(s)
| | - Ana Carla Lima Nunes
- Master Program in Physiotherapy and Functioning, Federal University of Ceará, Fortaleza, Brazil
| | | | - Shamyr Sulyvan Castro
- Master Program in Physiotherapy and Functioning, Federal University of Ceará, Fortaleza, Brazil
- Master Program of Public Health, Physical Therapy Department, Federal University of Ceará, Fortaleza, Brazil
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Leonardi M, Lee H, Kostanjsek N, Fornari A, Raggi A, Martinuzzi A, Yáñez M, Almborg AH, Fresk M, Besstrashnova Y, Shoshmin A, Castro SS, Cordeiro ES, Cuenot M, Haas C, Maart S, Maribo T, Miller J, Mukaino M, Snyman S, Trinks U, Anttila H, Paltamaa J, Saleeby P, Frattura L, Madden R, Sykes C, van Gool CH, Hrkal J, Zvolský M, Sládková P, Vikdal M, Harðardóttir GA, Foubert J, Jakob R, Coenen M, Kraus de Camargo O. 20 Years of ICF-International Classification of Functioning, Disability and Health: Uses and Applications around the World. Int J Environ Res Public Health 2022; 19:ijerph191811321. [PMID: 36141593 PMCID: PMC9517056 DOI: 10.3390/ijerph191811321] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 08/31/2022] [Accepted: 09/02/2022] [Indexed: 05/14/2023]
Abstract
The International Classification of Functioning Disability and Health (ICF) was approved in 2001 and, since then, several studies reported the increased interest about its use in different sectors. A recent overview that summarizes its applications is lacking. This study aims to provide an updated overview about 20 years of ICF application through an international online questionnaire, developed by the byline authors, and sent to each World Health Organization Collaborating Centers of the Family of International Classifications (WHO-FIC CCs). Data was collected during October 2020 and December 2021 and descriptive content analyses were used to report main results. Results show how, in most of the respondent countries represented by WHO-FIC CCs, ICF was mainly used in clinical practice, policy development and social policy, and in education areas. Despite its applications in different sectors, ICF use is not mandatory in most countries but, where used, it provides a biopsychosocial framework for policy development in health, functioning and disability. The study provides information about the needs related to ICF applications, that can be useful to organize targeted intervention plans. Furthermore, this survey methodology can be re-proposed periodically to monitor the use of the ICF in the future.
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Affiliation(s)
- Matilde Leonardi
- Neurology, Public Health, Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy
- Correspondence: ; Tel.: +39-02-2394-2511 (ext. 2521); Fax: +39-02-2363-973
| | - Haejung Lee
- Department of Physical Therapy, College of Health and Welfare, Silla University, Busan 46958, Korea
| | - Nenad Kostanjsek
- Classification, Terminology and Standards Unit, World Health Organization (WHO), 1211 Geneva, Switzerland
| | - Arianna Fornari
- Neurology, Public Health, Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy
| | - Alberto Raggi
- Neurology, Public Health, Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy
| | - Andrea Martinuzzi
- Department of Conegliano-Pieve di Soligo, IRCCS E. Medea Scientific Institute, 31015 Conegliano, Italy
| | - Manuel Yáñez
- General Directorate of Health Information and Research, Ministry of Health, Mexico City 03100, Mexico
| | | | - Magdalena Fresk
- National Board of Health and Welfare, 10333 Stockholm, Sweden
| | - Yanina Besstrashnova
- Albrecht Federal Scientific Centre of Rehabilitation of the Disabled, 195067 St. Petersburg, Russia
| | - Alexander Shoshmin
- Albrecht Federal Scientific Centre of Rehabilitation of the Disabled, 195067 St. Petersburg, Russia
| | - Shamyr Sulyvan Castro
- Department of Physical Therapy, Universidade Federal do Ceará—UFC, Fortaleza 60020-181, Brazil
| | - Eduardo Santana Cordeiro
- International Society of Experts and Researchers on Functioning and the ICF, University of São Paulo, São Paulo 05508-220, Brazil
| | - Marie Cuenot
- School of Public Health, École des Hautes Études en Santé Publique (EHESP), 35043 Rennes, France
| | | | - Soraya Maart
- Department of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of Cape Town, Cape Town 7700, South Africa
| | - Thomas Maribo
- Department of Public Health, Aarhus University, 8000 Aarhus, Denmark
- DEFACTUM, Corporate Quality-Central Denmark Region, 8000 Aarhus, Denmark
| | - Janice Miller
- Canadian Institute for Health Information (CIHI), Ottawa, ON K2A 4H6, Canada
| | - Masahiko Mukaino
- Department of Rehabilitation Medicine, School of Medicine, Fujita Health University, Toyoake 470-1101, Aichi, Japan
| | - Stefanus Snyman
- Centre for Community Technologies, Nelson Mandela University, Gqeberha 6019, South Africa
- WHO-FIC Collaborating Centre, South African Medical Research Council, Cape Town 8000, South Africa
| | - Ulrike Trinks
- The German Institute for Medical Documentation and Information (DIMDI), 51149 Cologne, Germany
| | - Heidi Anttila
- Finnish Institute for Health and Welfare (THL), 00271 Helsinki, Finland
| | - Jaana Paltamaa
- School of Health and Social Studies, JAMK University of Applied Sciences, 40200 Jyväskylä, Finland
| | - Patricia Saleeby
- Department of Sociology, Criminology, and Social Work, Bradley University, Peoria, IL 61625, USA
| | - Lucilla Frattura
- Classification Area, Azienda Sanitaria Universitaria Giuliano Isontina, 34128 Trieste, Italy
| | - Ros Madden
- Faculty of Health Sciences, University of Sydney, Sydney, NSW 2006, Australia
| | - Catherine Sykes
- Faculty of Health Sciences, University of Sydney, Sydney, NSW 2006, Australia
| | - Coen H. van Gool
- National Institute for Public Health and the Environment, 3721 Bilthoven, The Netherlands
| | - Jakub Hrkal
- Institute of Health Information and Statistics of the Czech Republic, 128 01 Prague, Czech Republic
| | - Miroslav Zvolský
- Institute of Health Information and Statistics of the Czech Republic, 128 01 Prague, Czech Republic
| | - Petra Sládková
- Institute of Health Information and Statistics of the Czech Republic, 128 01 Prague, Czech Republic
| | - Marie Vikdal
- Centre Head of NordClass, Department of Classifications and Terminology in Healthcare, The Norwegian Directorate of e-Health, 0277 Oslo, Norway
| | | | - Josephine Foubert
- Census and Disability Analysis Office for National Statistics, Swyddfa Ystadegau Gwladol, Newport SA42, UK
| | - Robert Jakob
- Classification, Terminology and Standards Unit, World Health Organization (WHO), 1211 Geneva, Switzerland
| | - Michaela Coenen
- Institute for Medical Information Processing, Biometry, and Epidemiology-IBE, Chair of Public Health and Health Services Research, LMU Munich, 80539 Munich, Germany
- Pettenkofer School of Public Health, 80539 Munich, Germany
| | - Olaf Kraus de Camargo
- CanChild—Centre for Childhood Disability Research, McMaster University, Hamilton, ON L8S 4L8, Canada
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Castro SS. Discussion on the assessment of functioning in people under 18 years of age. Qual Life Res 2022; 31:3513. [PMID: 35857206 DOI: 10.1007/s11136-022-03188-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2022] [Indexed: 11/30/2022]
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Gomes JES, Castro SS, Andrade RF, Sampaio JJC, Collares PM. Occupational health among primary care workers: situational diagnosis. Rev Bras Med Trab 2022; 20:454-461. [PMID: 36793472 PMCID: PMC9904842 DOI: 10.47626/1679-4435-2022-751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 07/14/2021] [Indexed: 11/09/2022] Open
Abstract
Introduction The field of workers' health within the scope of the Brazilian Unified Health System needs to revitalize its space in terms of coordinating care in primary health care based on social determinants of health. Objectives To contextualize and describe the health-related situational diagnosis of primary care workers from the metropolitan region of Fortaleza, state of Ceará, Brazil. Methods This was a descriptive, quantitative, and exploratory study conducted at a primary care unit in the metropolitan region of Fortaleza, Ceará, from January to March 2019. The study population was composed of 38 health care professionals from the primary care unit. The following questionnaires were applied to obtain the situational diagnosis: the World Health Organization Disability Assessment Schedule and the Occupational Health Questionnaire. Results Most participants were women (89.47%) and community health agents (18,42%). There were negative impacts on health conditions, such as work-related physical and mental discomfort, which was evidenced by sleep problems, sedentary lifestyle, poor access to health care services, and type of physical activity, which difer in terms of function and hierarchical levels in the field of work. Conclusions This study showed that the questionnaires provide useful inputs regarding occupational health through the situational diagnosis and adequately address the health-disease process, as seen in primary care workers. Comprehensive care, comprehensive worker health surveillance, and participatory administration of health services should be optimized.
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Affiliation(s)
- José Edmilson Silva Gomes
- Gerência de Pós-Graduação em
Saúde, Escola de Saúde Pública do Ceará, Fortaleza, CE,
Brazil. ,Correspondence address: José Edmilson Silva Gomes –
Gerência de Pós-Graduação em Saúde – Avenida
Antônio Justa, 3161, Meireles – CEP: 60165-090 – Fortaleza (CE), Brazil –
e-mail:
| | - Shamyr Sulyvan Castro
- Departamento de Fisioterapia, Universidade Federal do Ceará
(UFC), Fortaleza, CE, Brazil
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Barreto MCA, Moraleida FRJ, Graminha CV, Leite CF, Castro SS, Nunes ACL. Functioning in the fibromyalgia syndrome: validity and reliability of the WHODAS 2.0. Adv Rheumatol 2021; 61:58. [PMID: 34530930 DOI: 10.1186/s42358-021-00216-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 09/06/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Fibromyalgia syndrome (FMS) is both a challenging and disabling condition. The International Association for the Study of Pain (IASP) classifies FMS as chronic primary pain, and it can negatively impact individuals' functioning including social, psychological, physical and work-related factors. Notably, while guidelines recommend a biopsychosocial approach for managing chronic pain conditions, FMS assessment remains clinical. The WHODAS 2.0 is a unified scale to measure disability in the light of the International Classification of Functioning, Disability and Health. Thus, this study aimed to evaluate the reliability and validity of the Brazilian version of WHODAS 2.0 for use in individuals with FMS. METHODS Methodological study of the validity and reliability of the Brazilian version of the 36-item WHODAS 2.0 with 110 individuals with FMS. The instrument gives a score from 0 to 100, the higher the value, the worse the level of functioning. We assessed participants with Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) (0-100), Fibromyalgia Impact Questionnaire (FIQ) (0-10) and Beck Depression Inventory instrument (BDI) (0-63). The construct validity, internal consistency, and test-retest stability. We used SF-36, FIQ and BDI to study construct validity analysis. For statistical analysis, we performed the intraclass correlation (ICC), Spearman correlation, and Cronbach's alpha, with a statistical level of 5%. RESULTS Most participants were female (92.27%), aged 45 (± 15) years. The test-retest reliability analysis (n = 50) showed stability of the instrument (ICC = 0.54; ρ = 0.84, p < 0.05). The test-retest correlation between the domains was moderate to strong (ρ > 0.58 and < 0.90). Internal consistency was satisfactory for total WHODAS 2.0 (0.91) and also for domains, ranging from 0.44 to 0.81. The construct validity showed satisfactory values with all moderately correlated with WHODAS 2.0 instruments (> 0.46 and < 0.64; p < 0.05). WHODAS 2.0 evaluates the functioning encompassing components of health-related quality of life, functional impact, and depressive symptoms in those with FMS. CONCLUSIONS WHODAS 2.0 is a reliable and valid instrument to evaluate functioning of Brazilians with FMS. It provides reliable information on individuals' health through of a multidimensional perspective, that allows for individual-centered care.
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Affiliation(s)
| | | | | | - Camila Ferreira Leite
- Department of Physical Therapy, Federal University of Ceará, Major Weyne Street, 1440, Fortaleza, CE, 60430-450, Brazil
| | - Shamyr Sulyvan Castro
- Department of Physical Therapy, Federal University of Ceará, Major Weyne Street, 1440, Fortaleza, CE, 60430-450, Brazil
| | - Ana Carla Lima Nunes
- Department of Physical Therapy, Federal University of Ceará, Major Weyne Street, 1440, Fortaleza, CE, 60430-450, Brazil.
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Zacarias LC, Câmara KJDC, Alves BM, Morano MTAP, Viana CMS, Mont'Alverne DGB, Castro SS, Leite CF. Validation of the World Health Organization Disability Assessment Schedule (WHODAS 2.0) for individuals with COPD. Disabil Rehabil 2021; 44:5663-5668. [PMID: 34261374 DOI: 10.1080/09638288.2021.1948117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE COPD fits the profile of disabling health conditions. This study aims to validate the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) in individuals with COPD. MATERIAL AND METHODS 100 participants with COPD responded to the Brazilian 36-item version of the WHODAS 2.0, as well as the Saint George's Respiratory Questionnaire (SGRQ), and the COPD Assessment Test (CAT). Spirometric data was extracted from medical records. RESULTS The internal consistency analysis showed coefficients for all WHODAS 2.0 domains with a strong correlation (0.70-0.85) except for Life activities, which had a moderate correlation (coefficient = 0.60). In the construct analysis, the coefficients for the WHODAS and SGRQ domains presented a consistent correlation among them, varying from 0.40 to 0.69. No correlation was evidenced among the WHODAS domains and the spirometric data, highlighting that linear measures fail when associated with the functioning of an individual with COPD. Discriminative analysis revealed a capacity for the WHODAS 2.0 to distinguish among COPD different levels of clinical impact obtained from CAT excluding the Getting along domain. CONCLUSION The WHODAS 2.0 shows as a valid instrument that can sensibly assess functioning differences related to the clinical impact classification level in subjects with COPD.IMPLICATIONS FOR REHABILITATIONWHODAS 2.0 is a valid tool to assess functioning in subjects with COPD.WHODAS 2.0 is sensitive to functioning differences related to classification level and to clinical impact in individuals with COPD.As a Patient-Reported Outcome Measure (PROM), WHODAS 2.0 offers the opportunity to develop clinical patient-centered interventions, improving the health care.As a low-cost, easy-to-use tool, WHODAS can be a useful resource in the process of clinical assessment of patient functioning.
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Affiliation(s)
- Laíla Cândida Zacarias
- Graduate Program in Cardiovascular Sciences, Federal University of Ceara, Fortaleza, Brazil
| | | | | | | | | | | | - Shamyr Sulyvan Castro
- Master Program in Physiotherapy and Functioning, Federal University of Ceara, Fortaleza, Brazil
| | - Camila Ferreira Leite
- Graduate Program in Cardiovascular Sciences, Federal University of Ceara, Fortaleza, Brazil.,Master Program in Physiotherapy and Functioning, Federal University of Ceara, Fortaleza, Brazil
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Castro SS. Correspondence: Functioning assessment by the World Health Organization Disability Assessment Schedule 2.0 - WHODAS. J Physiother 2021; 67:72. [PMID: 33246850 DOI: 10.1016/j.jphys.2020.11.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 11/03/2020] [Indexed: 10/22/2022] Open
Affiliation(s)
- Shamyr Sulyvan Castro
- Master Program in Physiotherapy and Functioning, Federal University of Ceará, Fortaleza, Brazil
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Silveira LS, Castro SS, Leite CF, Oliveira NML, Salomão AE, Pereira K. Validade e confiabilidade da versão brasileira do World Health Organization Disability Assessment Schedule em pessoas com cegueira. Fisioter Pesqui 2019. [DOI: 10.1590/1809-2950/17013126012019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
RESUMO O World Health Organization Disability Assessment Schedule (WHODAS 2.0) é uma ferramenta desenvolvida pela Organização Mundial de Saúde (OMS) para medir deficiência e incapacidade, apoiando o modelo da Classificação Internacional de Saúde, Incapacidade e Funcionalidade. A versão brasileira do WHODAS 2.0 foi traduzida e disponibilizada para uso pela OMS em 2015. Assim, este estudo pretende validar a versão brasileira do WHODAS 2.0 para uso em pessoas com cegueira. Participaram 56 pessoas com cegueira (idade média: 48,4±13,6 anos). Foram utilizadas duas ferramentas de avaliação: a versão de 36 itens do WHODAS 2.0 e o World Health Organization Quality of Life-bref (WHOQOL-abreviado). As propriedades psicométricas testadas foram consistência interna, teste-reteste e validade de critério. Houve boa confiabilidade teste-reteste (ICC≥0,63). Os valores de a de Cronbach mostraram boa consistência interna na maioria das áreas, exceto no subdomínio de atividades escolares ou de trabalho (a=0,55). A validade do critério foi adequada, com correlações moderadas entre os domínios do WHODAS 2.0 e áreas do WHOQOL-abreviado. Os resultados indicaram a validade do WHODAS 2.0 para avaliar a funcionalidade de pessoas com cegueira.
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Abstract
Abstract Introduction: Chronic kidney disease and hemodialysis normally have an impact on the functioning. Objective: To validate the Brazilian version of the World Health Organization Disability Assessment Schedule 2.0 in individuals with chronic kidney disease on hemodialysis treatment. Methods: The 36-item version was applied to interview 51 individuals with chronic kidney disease undergoing dialysis treatment. To ascertain the instrument’s applicability, its internal consistency and test-retest stability were studied. To check the validity, a convergent/divergent analysis was performed. Results: The participants answered the questions on the main instrument at two timepoints and on the World Health Organization Quality of Life Abbreviated instrument and the Kidney Disease Quality of Life - Short FormTM 1.3 once each. Cronbach’s α coefficient was appropriate in all domains except the “Getting along” domain. The test-retest coefficients were above the recommended value (> 0.70). Convergent and divergent validity analysis also showed consistent results by correlation coefficient assessment. Conclusion: The instrument is valid and reliable. This study supports the use of the questionnaire by presenting its appropriate psychometric properties. We suggest that some care should be taken specifically in the sexual questions of the “Getting along” domain.
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Abstract
ABSTRACT The World Health Organization (WHO) planned a new functioning assessment tool - the WHODAS 2.0 (World Health Assessment Disability Schedule 2.0) - a user-friendly application instrument based on the theoretical framework of the ICF. The aim of this article is to introduce the Brazilian version of WHODAS to clinical and academic users interested in the assessment of functioning. The process was conducted according to the Translation Package offered by WHO, in addition to the permission for translating the tool. Three translators worked in this research to produce the definitive version of the manual and a set of linguistic evaluation forms. Finally, the Brazilian version was approved by WHO. All documents about WHODAS were translated and are free to download on the internet. WHODAS 2.0 addresses functioning according to the ICF domains and keeps the multifactorial and biopsychosocial perspective of the phenomenon. As it has an ICF differentiate presentation, the data collection is faster (20 minutes, on average) and more objective. Besides, it was planned to be a generic and transcultural tool. WHODAS was translated and is available on Internet to use. It is expected that the use of WHODAS will be widespread in Brazil, in clinical and research settings, aiming at the biopsychosocial approach of the functioning, as endorsed by WHO.
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Affiliation(s)
| | - Camila Ferreira Leite
- Universidade Federal do Triângulo Mineiro, Brazil; Universidade Federal do Ceará, Brazil
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Abstract
Abstract Introduction: Under the new conceptual model described by the International Classification of Functioning Disability and Health (ICF) for a biopsychosocial health analysis, it is necessary to consider that it is not arising only from biological conditions, but also environmental, social, cultural and politics involved in this process. Objective: To review the publications that had the Brazilians elderly functioning as outcome by analyzing the instruments used and to verify its consistency with the ICF model. Methods: A systematic review of the Brazilian literature on elderly was performed in SciELO, PubMed, Scopus, and Lilacs databases. Publications starting in 2001, in English, Portuguese or Spanish, studies with experimental design or intervention, having the Brazilian elderly as the only subject. For evaluating the quality of the papers, the Downs and Black checklist were used. Results: From 3070 items first found in the research, 29 articles remained for this study. Of these, 25 instruments were used to measure the eldery functioning. The frequency of the ICF domains were: health condition (0.28%), body structure and function (1.71%), activity (82.34%), participation (3.42%), environmental factors (12.25%) and personal factors (0%). Conclusion: Despite the ICF be much discussed today, it was possible to detect remaining gaps in the studies about the subject. The results of this study indicate that the conceptual model has not being fully and equitably used when it comes to the eldery functioning.
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Castro SS, Rowe M, Andrade LF, Cyrino EG. Developing competencies among health professions students related to the care of people with disabilities: a pilot study. ACTA ACUST UNITED AC 2017. [DOI: 10.1590/1807-57622016.0684] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This is a two-phase study, the first was a literature review that aimed to identify a set of competencies for professional practice that would be relevant for the health care of People with disabilities (PwD). These competencies were then used to plan a thirty-hour multidisciplinary course for undergraduate health care students. The educational intervention led to improvements in the students’ learning experiences, including the development of empathy and knowledge related to the care of PwD, improved knowledge around accessibility, and an awareness of the need to humanize the care of PwD. Students reported enhanced learning experiences and an increase in knowledge related to the care of PwD, and also highlighted the need to humanize the care.
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Castaneda L, Silveira H, Castro SS. [Response to the debate: "The use of ICF in health research: a reflection on limits and possibilities"]. Rev Bras Epidemiol 2016; 19:688-689. [PMID: 27849282 DOI: 10.1590/1980-5497201600030019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Luciana Castaneda
- Instituto Federal de Educação, Ciência e Tecnologia do Rio de Janeiro - Rio de Janeiro (RJ), Brasil
| | - Heitor Silveira
- Laboratório de Neuropsiquiatria Geriátrica, Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro - Rio de Janeiro (RJ), Brasil
| | - Shamyr Sulyvan Castro
- Departamento de Fisioterapia, Universidade Federal do Ceará - Fortaleza (CE), Brasil
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Mendonça AP, Castro SS, Stone JH, Andrade PMO. Work process related to cerebral palsy of neurological rehabilitation centers. Dev Neurorehabil 2016; 18:252-9. [PMID: 23869698 DOI: 10.3109/17518423.2013.796418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To evaluate the work process for CP cases in different rehabilitation centers according to Brazilian health policies and recommendations from the "World Report on Disability". METHODS A questionnaire - Evaluation Process of Rehabilitation of Children with CP was applied to the Coordinators of 13 services. This instrument has a maximum score of 108 points. RESULTS The results of the questionnaire varied from 28 to 64 points. The mean and SD were 43.5 and 10.9, respectively. The main administrative difficulties were: (a) presence of unmet demand, (b) patient absenteeism, (c) referral to primary care services, (d) inadequate physical facilities, (e) the scarce provision of prosthetics and orthotics, (f) insufficient financial resources, (g) human resources training, (h) difficulties with the use of the information system and (i) transportation difficulties for patients. CONCLUSION Administrative and clinical guidelines are needed for uniformity of the work process of the rehabilitation centers.
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Affiliation(s)
- Ana Paula Mendonça
- Department of Physical Therapy, Federal University of Jequitinhonha and Mucuri Valleys (UFVJM) , Diamantina, MG , Brazil
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Castro SS, Castaneda L, Silveira H. Identification of common content between the questionnaire of the Health Survey (ISA-SP) and the International Classification of Functionality, Disability, and Health. Rev Bras Epidemiol 2015; 17:59-70. [PMID: 24896783 DOI: 10.1590/1415-790x201400010006eng] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2012] [Accepted: 10/31/2012] [Indexed: 11/22/2022] Open
Abstract
The purpose of this paper was to identify the common contents between São Paulo's Health Survey Questionnaire (Physical Disability and Emotional Health Blocks) and the International Classification of Functionality, Disability, and Health. The first stage of the research consisted of the search for the modules of São Paulo's Health Survey, which addressed the issue of disability, and the passages about this theme were highlighted and inserted into a new file. In the second stage, the significant contents were extracted. In the last one, these contents were codified to the codes of the International Classification of Functionality, Disability, and Health by two independent researchers. For the descriptive statistical analysis, crude numbers, percentages, and simple frequencies were used. The degree of agreement between the two professionals was calculated using Kappa's coefficient and the confidence interval. The most common domains were those about functions and body structures and about activities and participation, in which the domain of environmental factors presented a lower frequency of approach.
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Affiliation(s)
- Shamyr Sulyvan Castro
- Departamento de Fisioterapia Aplicada, Instituto de Ciências da Saúde, Universidade Federal do Triângulo Mineiro, Uberaba, MG, Brasil
| | - Luciana Castaneda
- Instituto Brasileiro de Medicina de Reabilitação, Laureate Universities, Rio de Janeiro, RJ, Brasil
| | - Heitor Silveira
- Instituto de Psiquiatria Universitária Brasileira, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
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Castro SS, Carandina L, Barros MBDA, Goldbaum M, Cesar CLG. Associação entre deficiências físicas e hospitalizações na população da cidade de São Paulo, Brasil. CAD SAUDE PUBLICA 2013. [DOI: 10.1590/s0102-311x2013000500016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
O objetivo foi verificar a associação entre presença de deficiências físicas e hospitalizações na cidade de São Paulo, Brasil. Foi realizado inquérito de saúde na cidade de São Paulo em 2008. Utilizou-se processo de amostragem probabilística, estratificada (sexo/idade) e por conglomerados em dois estágios (setores censitários e domicílios). Os dados foram coletados por entrevistas por meio de um questionário estruturado, com 21 blocos, com a maioria das questões fechadas. A análise inferencial foi realizada com o uso de razões de prevalência (RP) bruta e ajustada e intervalo de 95% de confiança (IC95%) pelo método de regressão de Poisson. O módulo survey do programa Stata 9.2 foi usado para as análises, com significância de 5%. Foram entrevistadas 2.690 pessoas, com idade média de 38,75 anos (IC95%: 37,54-39,96). A hospitalização foi associada à deficiência (auditiva, RP = 1,59; física, RP = 3,77; múltipla, RP = 3,26). As pessoas com deficiência (auditiva, física - paralisia/amputação e múltipla) relataram internações com mais frequência que aquelas sem deficiência.
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Affiliation(s)
| | - Luana Carandina
- Universidade Estadual Paulista Júlio de Mesquita Filho, Brasil
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Castro SS, Carandina L, Barros MBDA, Goldbaum M, Cesar CLG. [Physical disability and hospitalization in São Paulo, Brazil]. CAD SAUDE PUBLICA 2013; 29:992-998. [PMID: 23703004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2012] [Accepted: 01/17/2013] [Indexed: 06/02/2023] Open
Abstract
This study aimed to verify the association between physical disability and hospitalization in São Paulo, Brazil, based on a health survey conducted in 2008. The study used a probabilistic stratified sampling process (sex/age) with two-stage clustering (census tracts and households). Data were collected through structured interviews including thematic 21 sections, using mostly multiple-choice questions. The analysis used crude and adjusted prevalence ratios (PR) and 95% confidence intervals (95%CI) with Poisson regression. The survey module of Stata 9.2 was used, with significance set at 5%. A total of 2,690 persons were interviewed, with a mean age of 38.75 years (95%CI: 37.54-39.96). Hospitalization was associated with disability (hearing, PR = 1.59; physical, PR = 3.77; multiple PR = 3.26). People with disabilities (hearing, physical - paralysis/amputation, and multiple) reported more hospitalizations than those without disabilities.
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Affiliation(s)
- Shamyr Sulyvan Castro
- Instituto de Ciências da Saúde, Universidade Federal do Triângulo Mineiro, Uberaba, Brasil.
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Castro SS, Lefèvre F, Lefèvre AMC, Cesar CLG. Acessibilidade aos serviços de saúde por pessoas com deficiência. Rev Saude Publica 2011; 45:99-105. [DOI: 10.1590/s0034-89102010005000048] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2010] [Accepted: 07/02/2010] [Indexed: 11/21/2022] Open
Abstract
OBJETIVO: Analisar as dificuldades de acessibilidade aos serviços de saúde vividas por pessoas com deficiência. PROCEDIMENTOS METODOLÓGICOS: Estudo qualitativo realizado com pessoas que relataram ter algum tipo de deficiência (paralisia ou amputação de membros; baixa visão, cegueira unilateral ou total; baixa audição, surdez unilateral ou total). Foram entrevistados 25 indivíduos (14 mulheres) na cidade de São Paulo, SP, de junho a agosto de 2007, que responderam perguntas referentes a deslocamento e acessibilidade aos serviços de saúde. A metodologia utilizada para análise foi o discurso do sujeito coletivo e as análises foram conduzidas com recurso do programa Qualiquantisoft. ANÁLISE DOS RESULTADOS: A análise dos discursos sobre o deslocamento ao serviço de saúde mostrou diversidade quanto ao usuário ir ao serviço sozinho ou acompanhado, utilizar carro particular, transporte coletivo, ir a pé ou de ambulância e demandar tempo variado para chegar ao serviço. Com relação às dificuldades oferecidas de acessibilidade pelos serviços de saúde, houve relatos de demora no atendimento, problemas com estacionamento, falta de rampas, elevadores, cadeiras de rodas, sanitários adaptados e de médicos. CONCLUSÕES: As pessoas com algum tipo de deficiência fizeram uso de meios de transporte diversificados, necessitando de companhia em alguns casos. Problemas na acessibilidade dos serviços de saúde foram relatados pelos sujeitos com deficiências, contrariando o princípio da eqüidade, preceito do Sistema Único de Saúde.
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Castro SS, Pelicioni AF, Cesar CLG, Carandina L, Azevedo Barros MBD, Alves MCGP, Goldbaum M. Use of medicines by persons with disabilities in São Paulo state areas, Southeastern Brazil. Rev Saude Publica 2010; 44:601-10. [PMID: 20676552 DOI: 10.1590/s0034-89102010000400003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2009] [Accepted: 04/26/2010] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To analyze the use of medicines and the main therapeutic groups consumed by persons with physical, hearing and visual disabilities. METHODS A cross-sectional study was performed, where data from the 2002 Inquérito Multicêntrico de Saúde no Estado de São Paulo (ISA-SP - São Paulo State Multicenter Health Survey), as well as the 2003 Inquérito de Saúde no Município de São Paulo (ISA-Capital - City of São Paulo Health Survey), Southeastern Brazil, were analyzed. Respondents who reported having disabilities were studied, according to variables that comprise the database: geographic area, gender, income, age group, ethnic group, use of medicines and types of drugs consumed. RESULTS The percentage of use of drugs by persons with disabilities was 62.8% among the visually impaired; 60.2% among the hearing impaired; and 70.1% among the persons with physical disabilities. Individuals with physical disabilities consumed 20% more medications than non-disabled ones. Among persons with visual disabilities, the most frequently consumed drugs were diuretics, agents of the renin-angiotensin system and analgesics. Persons with hearing disabilities used more analgesics and agents of the renin-angiotensin system. Among those with physical disabilities, analgesics, antithrombotics and agents of the renin-angiotensin system were the most frequently consumed medicines. CONCLUSIONS There was a greater use of medicines among persons with disabilities than non-disabled ones. Persons with physical disabilities were those who most consumed medicines, followed by the visually impaired and the hearing impaired.
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