Relationship among self-efficacy, quality of care and quality of life for people with physical disabilities / 中国康复理论与实践

ObjectiveTo investigate the status of self-efficacy, quality of care and quality of life of people with physical disabilities, and analyze the relationship among them. MethodsFrom January, 2019 to December, 2020, 357 people with physical disabilities in Shandong were selected with cluster stratified random sampling, and all the participants were investigated with a general questionnaire, World Health Organization Quality of Life-Disability Scales, General Self-Efficacy Scale and World Health Organization Quality of Care and Support Scale-Disability Scale on internet. ResultsA total of 357 questionnaires were collected, in which 350 were valid. The total score was (115.00±20.70) for quality of life, (23.33±5.78) for self-efficacy, and (50.43±10.56) for quality of care. The quality of life and its each domain was positively correlated with self-efficacy (r > 0.282, P < 0.01), quality of care, care information acquisition, care giving and care environment (r > 0.369, P < 0.01). Employment, self-efficacy and quality of care associated with the quality of life (t > 4.386, P < 0.001); employment, self-efficacy, care giving and care environment associated with the physiological, psychological and environment domains of the quality of life (t > 2.926, P < 0.01); parents as main caregivers, employment, self-efficacy, care giving and care environment associated with social relationships domain of the quality of life (|t| > 2.525, P < 0.05); parents as main caregivers, employment, care giving and care environment associated with the disability domain of the quality of life (|t| > 2.209, P < 0.05). ConclusionThe quality of life needs to be improved for the people with physical disabilities. Self-efficacy and quality of care may impact the quality of life; and it is needed to focus on the people with physical disabilities who are unemployed and whose parents are the main caregivers.

Custos adicionais da pessoa com deficiência física ­ São Paulo e Brasil / Additional costs of living for people with physical disabilities ­ São Paulo and Brazil

Objetivo: Calcular os custos adicionais da pessoa com deficiência física e investigar o seu impacto na renda familiar. Métodos: Seguindo a Classificação Internacional de Funcionalidade, identificaram-se quatro perfis de deficiência com graus diferentes de severidade quanto à mobilidade dos membros inferiores e superiores. Foi construída uma matriz de necessidades para estimar os custos adicionais, seguindo o Método de Padrão Orçamentário, a partir de grupos focais. Dados foram coletados em 2013. Utilizou-se o salário mínimo nacional de 2015 (R$ 816,52) para estimar os custos. Resultados: Os custos adicionais variaram de 2 a 14 vezes o salário mínimo nacional. O perfil de menor custo adicional foi o 2, seguido do 1, 3 e 4. O perfil 4 foi o de maior custo adicional devido à grande incapacidade das pessoas. Há exigência de alta intensidade de assistência pessoal e de oferta de equipamentos. Na assistência pessoal, calculou-se o trabalho dos cuidadores dividindo-o por um período de 2, 4, 8 e 24 horas, para São Paulo, Rio de Janeiro, Santa Catarina, Paraná e Brasil. Os custos com assistência pessoal são relevantes no total dos custos e variam conforme a região. Conclusões: Demonstrou-se que há um custo adicional para as pessoas com deficiência física em todos os perfis. Há risco de empobrecimento porque esses custos absorvem a renda dessas pessoas e de sua família, a qual não pode gastar em outros serviços. A renda pode ser, assim, insuficiente para as necessidades primordiais, ficando clara a necessidade de políticas públicas para prover serviços necessários ou benefícios financeiros.

Objective: To calculate the additional costs of living for people with physical disabilities and to investigate their impact on family income. Methods: We identified four profiles of deficiency with different grades of severity, according to the International Classification of Functioning, Disability and Health. They were related to the extent of mobility of upper and lower limbs. Additional costs were evaluated through focal groups following the Budgetary Pattern Method. We also set up a matrix to express the additional costs. Data were collected in 2013. The national minimum wage from 2015 (R$ 816,52) was considered to estimate the proportional costs. Results: Additional costs fluctuated between 2 to 14 times the national minimum wage. The profile with the minor additional cost was 2, succeeded by 1, 3 and 4. Profile 4 showed the highest additional cost since people with physical disabilities need huge intensity of personal assistance and equipment supply. In personal assistance, we calculated the work of caregivers by sharing it into 2, 4, 8 and 24 hours/day. Costs with personal assistance diversify amongst São Paulo, Rio de Janeiro, Santa Catarina, Paraná and Brazil due to distinct minimum wage. Conclusions: This research showed the presence of an additional cost for people with physical disabilities in all profiles. There is a risk of impoverishment with sacrifice in family's income since they cannot waste in other domestic services. Thus, it is clear that there is a strong need of public policies to underpin these families with more health services or financial benefit.

Repercussões sociais da aquisição de uma deficiência física na vida de idosos / Social repercussions of the acquisition of a physical disability in elderly living / Repercusiones sociales de la adquisición de una discapacidad física en la vida de las personas mayores

O objetivo foi analisar as repercussões sociais na vida de idosos que adquiriram deficiência física na velhice, identificando e discutindo as mudanças, desafios e adaptações que ocorreram após esta aquisição. Estudo exploratório, descritivo, com abordagem qualitativa realizado em um Centro Especializado em Reabilitação Física e Auditiva, com 22 idosos que apresentavam deficiência física adquirida, utilizando-se como instrumentos o questionário sociobiodemográfico e a entrevista. Para a análise dos dados, foi empregado o softwear NVivo e a análise de conteúdo temática. A aquisição da deficiência física na velhice gerou dependência, isolamento social, tristeza, afastamento do trabalho e preconceito, mas foi possível se adaptar e superar tal situação.

The objective to know the social impact on the lives of older people who have acquired disabilities. A descriptive, exploratory study with a qualitative approach conducted in a Specialized Center for Physical Rehabilitation and Hearing with 22 elderly people who had acquired physical disability, using as instruments the sociobiodemográfico questionnaire and interview. For the analysis of data was used NVivo softwear and thematic content analysis. The acquisition of disability in old age generated dependency, social isolation, sadness, absence from work and prejudice, but it is possible to adapt and overcome such situation.

El objetivo fue conocer el impacto social en la vida de las personas mayores que han adquirido la discapacidad. Estudio exploratorio descriptivo, con enfoque cualitativo, realizado en un centro especializado para la rehabilitación física y la audición con 22 personas de edad avanzada que habían adquirido la discapacidad física utilizando como instrumentos sociobiodemográfico cuestionario y la entrevista. Para la análisis de los datos se utilizó NVivo softwear y análisis de contenido temático. La adquisición de la discapacidad en la vejez la dependencia generada, el aislamiento social, la tristeza, la ausencia del trabajo y los prejuicios, pero es posible adaptar y superar tal situación.

Research on Unmet Needs and Services of Rehabilitation for People with Physical Disabilities in Rural Areas in Henan, China / 中国康复理论与实践

Objective To research the unmet needs and services of rehabilitation for people with physical disabilities in rural areas in Henan, China. Methods The data of 2016 Basic Service Status and Unmet Needs for People with Disabilities in Henan, China were ana-lyzed. Results A total of 1,028,598 people with physical disabilities from all 19 cities had been surveyed, accounting for 61.7% male. In terms of rehabilitation needs, there were 19,348 (1.9%) responsed surgery, 202,855 (19.7%) responsed medical treatment, 197,592 (19.2%) responsed functional training, 360,754 (35.1%) responsed assistive products, and 158,012 (15.4%) responsed nursing, there were significant differences in the number of people who needed rehabilitation among different disability levels (χ2>18.080, P15.920, P19.182, P<0.001). Con-clusion The unmet needs and services of rehabilitation for people with physical disabilities in rural areas in Henan were explicated. It recom-mended to train rehabilitation professionals and improve the service delivery capacity, to raise awareness, increase investment in rehabilita-tion services and provide reasonable accommodation for people with disabilities.

Processo de trabalho em reabilitação de pessoas com deficiência física / Work process in the rehabilitation of people with physical disability / Proceso de trabajo en la rehabilitación de personas con discapacidad física

Propostas terapêuticas estruturalmente biomédicas não alcançam a integralidade do cuidado, traduzindo-se emtrabalhos fragmentados na saúde. O objetivo deste estudo foi compreender o processo de trabalho de fisioterapiaem reabilitação para propor uma estratégia na produção de trabalho interdisciplinar no cuidado integral às pessoascom deficiência física. Pesquisa qualitativa realizada mediante observação sistemática do processo de trabalho daequipe de atendimento, composta por 21 profissionais, no município de Itajaí (SC). A análise das observações foinorteada pela hermenêutica dialética. Obteve-se como principal resultado a ausência de estratégia para trabalhointerdisciplinar em reabilitação, ainda que haja proposta de integralidade das ações, necessária ao cuidado daspessoas com deficiência física. Concluiu-se que há desarticulações no processo de trabalho de fisioterapia emreabilitação que são inviáveis à interdisciplinaridade.

Structurally biomedical therapeutic approaches do not achieve complete care, resulting in fragmented work inhealth. The aim of this study was to understand the physiotherapy work process in rehabilitation, in order to proposea strategy for producing interdisciplinary work in the comprehensive care of people with physical disabilities. Aqualitative research, performed through systematic observation of the work process of the healthcare team, comprisedof 21 professionals, in the municipality of Itajaí (SC). The analysis of the observations was guided by dialecticalhermeneutics. The main result obtained was the lack of strategy for interdisciplinary work in rehabilitation, thoughthere is a proposed integrality of actions for the care of people with physical disabilities. It was concluded that thereare disarticulations in the physiotherapy work process in rehabilitation that are unfeasible to interdisciplinarity.

Enfoques terapéuticos estructuralmente biomédicas no logran la integralidad de la atención, lo que resulta entrabajos fragmentados en salud. El objetivo de este estudio fue comprender el proceso de trabajo de fisioterapia en larehabilitación para proponer una estrategia para producir el trabajo interdisciplinario en la atención integral a laspersonas con discapacidades físicas. Pesquisa cualitativa realizada por medio de observación sistemática del procesode trabajo del equipo de atención con 21 profesionales, en la municipalidad de Itajaí (SC). El análisis de datos fuepor medio de hermenéutica dialéctica. Se obtuvo como resultado principal la falta de estrategia para el trabajointerdisciplinario, aunque haya propuesta de atención integral, necesaria para el cuidado de las personas condiscapacidades físicas. Se concluyó que hay inconsistencias en el proceso de trabajo de fisioterapia en rehabilitaciónque son inviables para la interdisciplinariedad.

Cuidados populares de las familias en situación de pobreza con personas ancianas que presentan limitación física / Popular care of poor families with old age members with physical disabilities

Se describen los cuidados populares de las familias en situación de pobreza con personas ancianas que presentan limitación física, de cinco barrios de Bogotá-Colombia. El estudio etnográfico utilizó observación participante y entrevistas etnográficas. El análisis manual siguió las fases propuestas por Leininger. Los resultados aportan tres temas culturales: 1) "Estar pendiente en la familia: un dar y recibir entre lo visible e invisible", 2) "En la familia sabemos lo que nos pasa y hacemos lo que sea necesario para aliviarnos", y 3) "Como familia hemos aprendido a movernos en medio de las dificultades y con las ayudas". Con estos temas culturales se logra plasmar el cuidado popular como la trayectoria de las familias para aliviar o curar la salud física, mental y espiritual. Al mismo tiempo, los cuidados populares permiten ver la dinámica familiar permeada por la reciprocidad, el compromiso, el afecto, el deseo de ayudar a los demás, y el desarrollo de una solidaridad dentro del contexto familiar y sociocultural en la búsqueda de metas familiares e individuales visibles e invisibles.

The popular care of poor families with old age members with physical disabilities in five neighborhoods of Bogota-Colombia are described. This ethnographic research employed participant observation as well as ethnographic interviews. The manual analysis was conducted through Leininger's phases. The results contribute in three cultural themes: 1) "To look after family: giving and receiving among the visible and invisible", 2) "In the family we know what happens to us and we do as required to relieve each other", and 3) "As a family we have learnt to cope with difficulties and with aids". With these cultural themes it was possible to depict the popular care as the path that families follow to relieve or heal physically, mentally and spiritually. Simultaneously, popular care allow seeing family dynamics infused by reciprocity, commitment, affection, the will to help others, and the development of solidarity within the family and sociocultural context in the pursuit of visible and invisible family and individual goals.

A Influência de ser atleta na identidade social de portadores de deficiência física / The influence of being an athlete over the social identity of people with physical disabilities

O estudo busca evidenciar as diferenças nos padrões de respostas que sustentam uma percepção diferenciadas de quatro categorias sociais distintas: a dos portadores de deficiência física não-atletas, a dos portadores de deficiência física atleta, a dos não portadores de deficiência física não-atletas e dos não portadores de deficiência física atletas. Foram considerados os resultados que indicassem a influência de ser atleta no julgamento dos participantes em relação aos portadores de deficiência física,contando com uma amostra de 96 participantes. Utilizou-se um procedimento de escalonamento comparativo que permitiu a eles observar suas diversas respostas para cada item. Os resultados indicaram diferenças de julgamento entre os grupos, principalmente em relação aos atletas portadores de deficiência física, avaliados mais positivamente que os portadore não atletas e algumas vezes, surpreendentemente, mais dos que o não portador, evidenciado uma idealização e superestimação da condição de ser atleta. Acredita-se que os resultados apresentados por esse estudo possam oferecer indícios para o desenvolvimento de estratégias, utilizando o esporte como ferramente, para uma identidade social mais positiva do portador de deficiência física.

t's the objective of this study to evidence the differences between the answering patterns which sustain adifferent perception of four distinct social categories: the non-athlete people with physical disabilities, theathletes with physical disabilities, the non-athlete people with no physical disabilities and the athletes withno physical disabilities. Where were considered the results which indicated the influence over the people withphysical disabilities of being an athlete on the judgment of the participants, counting with a sample of 96participants. It was used a comparative scheduling that allowed themselves to observe their several answersto each item. The results indicated differences of judgment between the groups, specially concerned to theathletes with physical disabilities, which were more positively evaluated than the non-athlete people withphysical disabilities, and sometimes, surprising, more than the people without disabilities, evidencing anidealization and super estimating the condition of being an athlete. It is given credit that the results presentedby this study can offer indications to the development of strategies using the sport as a tool for a more positivesocial identity of the people with physical disabilities