ABSTRACT
Introduction: The primary Brazilian occupational therapists goal is to enable their clients to participate in the activities of everyday life. Thus, it is important that therapists have tools that capture their clients' activities repertoires. The Paediatric Activity Card Sort (PACS) is a client-centred tool designed to capture the activity repertoire of children. However, the PACS is based on the activities of Canadian children, leading to questions regarding its use in other countries. Objective: To determine the acceptability and applicability of the PACS with Brazilian children. Method: Sixty children between 5 and 14 years participated in a descriptive cross-sectional study. A questionnaire was used to gather sociodemographic information. Behavioural observations were used to judge the acceptability of the PACS. Item responses and their relation to sociodemographic variables were used to examine applicability. Descriptive statistics were used to describe demographics and item responses. Differences in the PACS scores between gender, race, presence of siblings, parents' educational levels and marital status were assessed using non-parametric statistics. Results: Reported participation in PACS activities ranged from 95.7% (personal care) to 15.1% (sports). Eleven PACS activities had a participation rate of less than 10% and a number of new activities, not included in the PACS, were identified. Differences were found among gender and presence of siblings. Conclusion: With adjustments for the Brazilian context the PACS can be a useful tool to capture children activity suggesting the potential usefulness of a Brazilian PACS.
ABSTRACT
Os terapeutas ocupacionais sempre se dedicaram ao estudo da ocupação humana, no entanto, no decorrer desta trajetória, nem sempre o cliente era percebido como um ser ocupacional, com necessidades, interesses e metas individuais. O interesse no engajamento de clientes em suas ocupações, ao invés do interesse na restauração dos componentes de desempenho, juntamente com a mudança do conceito de ocupação, exige do profissional uma ampliação do escopo da prática. As teorias mais atuais relacionadas à prática da terapia ocupacional têm preconizado o uso de abordagens centradas no cliente e baseadas em ocupações. Na prática centrada no cliente e baseada em ocupação, o cliente participa ativamente nas escolhas das metas, sendo estas prioritárias e centrais no processo de avaliação, intervenção e resultados. Existem numerosas evidências na literatura, com resultados significativamente positivos e que apoiam o uso destas abordagens. Estas abordagens se baseiam na premissa de que as metas e objetivos das intervenções devem ser focados em ocupações e atividades significativas para o cliente e refletem os valores centrais da terapia ocupacional: uma perspectiva centrada na ocupação que respeita as escolhas do cliente, suas metas e valores, promovendo e habilitando o engajamento em ocupações significativas.
Occupational therapists have always been dedicated to the human occupation study, however the client hasn't always been seen as an occupational being, with needs, interests and individual goals. The concern for our clients' engagement in occupation, rather than the acquisition or restoration of performance components, together with the gradual modification of the concept of occupation from work-related activities to purposeful human activity, requires a broadening of our scope of practice. The most current theories related to occupational therapy practice have highlightes the use of client centered and occupational based practices. In occupation-based, client-centred practice the client participates actively in negotiating goals, and client occupational goals are given priority and are placed at the centre of assessment, intervention and outcomes. There are numerous evidences in the literature with significantly positive results supporting these approaches. These approaches are based on the premises that goals and objectives of interventions should be focused in occupation and significant activities to the client and reflect the occupational therapy core values: an occupational-centred perspective that respects client's choices, goals and values, promoting and supporting the engagement on meaningful activities.