Drug addictions in Malaysia: a mini-review on drug types, rehabilitation centers and therapeutic programs.

Drug addiction remains one of the most complex social problems worldwide that has yet to be resolved. In Malaysia, abuse of various types of drugs has been reported which warrants the government to take immediate strategies in managing drug addicts. Despite implementing various strategies to treat drug addiction, statistics show the number of relapses continues to skyrocket over the years. This calls for urgent attention to improve the effectiveness of substance abuse treatment services in Malaysia. Moreover, emerging evidence shows a change in trend in the type of drug being abused. This factor could potentially contribute to the ineffectiveness of the strategies employed in the treatment of substance abuse. Therefore, this review provides an overview of the major types of drugs commonly abused in Malaysia. Additionally, in an effort to search for ways to improve the effectiveness of substance abuse treatment services, we identified the public institutions responsible for managing drug addicts in Malaysia and discussed the therapeutic programs offered at the institutions. Review findings support the need for future research on the effectiveness of these therapeutic programs and recommend the implementation of evidence-based programs to improve the effectiveness of substance abuse treatments in Malaysia.

Return to Work in Breast Cancer Patients following an Interdisciplinary Rehabilitation Program in a Community-Based Cancer Rehabilitation Center: A Pilot Study.

Despite curative treatment and discharge from acute hospital settings, breast cancer patients often have cancer- and treatment-related morbidity which impairs them from returning to work. Hence, the role of community-based return to work rehabilitation programs is important to help these patients transition back to work. This was a retrospective cohort study involving patients with breast cancer conducted at a community-based cancer rehabilitation center. Patients were involved in an interdisciplinary vocational rehabilitation program involving physiatrists, occupational therapists, physiotherapists and social workers. We recruited 63 patients for this study cohort, with 46 (73.0%) patients ≤ 60 years old. After undergoing the rehabilitation program, there were 37 (58.7%) participants who successfully returned to work. These participants returned to work at either within 6 months (27.0%), 12 months (29.7%) or 24 months (43.2%) after enrollment into the program, with a majority enrolling in white collar jobs. Multivariate regression analysis revealed that significant negative factors for return to work were advanced stage of cancer (p = 0.004), along with clinically significant fatigue, measured on the Brief Fatigue Inventory (p < 0.001). However, perceived work ability (p = 0.020) was found to be a positive factor.

Designing a Fall Prediction Model for Inpatient Rehabilitation Facilities Using Readily Available Data.

OBJECTIVE: To create a fall risk assessment tool for inpatient rehabilitation facilities (IRFs) using available data and compare its predictive accuracy with that of the Morse Fall Scale (MFS). DESIGN: We conducted a secondary analysis from a retrospective cohort study. Using a nomogram that displayed the contributions of QI codes associated with falls in a multivariable logistic regression model, we created a novel fall risk assessment, the Inpatient Rehabilitation Fall Scale (IRF Scale). To compare the predictive accuracy of the IRF Scale and MFS, we used receiver operator characteristic (ROC) curve analysis. SETTING: We included data from 4 IRFs owned and operated by Intermountain Health. PARTICIPANTS: Data came from the medical records of 1699 patients. All participants were over the age of 14 and were admitted and discharged from 1 of the 4 sites between January 1 and December 31, 2020. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE(S): We assigned point values on the IRF Scale based on the adjusted associations of QI codes with falls. Using ROC curve analysis, we discovered an optimal cutoff score, sensitivity, specificity, and overall AUC of the IRF Scale and MFS. RESULTS: ROC curve analysis revealed the optimal IRF Scale cutoff score of 22.4 yielded a sensitivity of 0.74 and a specificity of 0.63. With an AUC of 0.72, the IRF Scale demonstrated acceptable accuracy at identifying patients who fell in our retrospective cohort. CONCLUSIONS: Because the IRF Scale uses readily available data, it minimizes staff assessment and outperforms the MFS at identifying patients who previously fell. Prospective research is needed to investigate if it can adequately identify in advance which patients will fall during their IRF stay.

Centros Especializados em Reabilitação: avaliando os desafios à implementação do modelo biopsicossocial nas práticas assistenciais à pessoa com deficiência / Specialized rehabilitation centers: assessing the challenges in implementing the biopsychosocial model in caring for people with disabilities / Centros Especializados en Rehabilitación: evaluación de los desafíos para la implementación del modelo biosicosocial en las prácticas asistenciales para la persona con discapacidad

Avaliamos, em conjunto com profissionais dos serviços, os desafios à implementação do modelo biopsicossocial nos Centros Especializados em Reabilitação. Por meio da articulação da Avaliação de Quarta Geração e Roda de Conversa (Método Paideia), abordamos os modelos implementados de assistência à pessoa com deficiência, partindo das seguintes questões: trabalhar em reabilitação; prontuário e avaliação; atendimento compartilhado e qualificação da alta. Do conteúdo das rodas emergiram três categorias empíricas: o processo de trabalho em reabilitação; o trabalho em rede; o modelo de cuidado. A identificação de entraves e facilitadores poderá favorecer a plena implementação do modelo biopsicossocial na atenção às pessoas com deficiência, gerando subsídios para o avanço rumo à integralidade do cuidado às pessoas com deficiência representado neste modelo.(AU)

We assessed challenges in implementing the biopsychosocial model in specialized rehabilitation centers together with the professionals working in these services. Using fourth generation assessment and conversation circles (the Paideia method), we explored models of care for people with disabilities focusing on the following issues: working in rehabilitation; health records and evaluation; shared appointments; and improving discharge. Three empirical categories emerged from the conversation circles: rehabilitation work processes; the network-based approach; and the care model. The identification of constraints and enabling factors can help promote the effective implementation of the biopsychosocial model, generating important insights to help drive progress towards the delivery of comprehensive care to people with disabilities represented in this model.(AU)

Evaluamos en conjunto con profesionales de los servicios, los desafíos para la implementación del modelo biosicosocial en los centros especializados en rehabilitación. Por medio de la articulación de la Evaluación de Cuarta Generación y Rueda de Conversación (Método Paideia), abordamos los modelos implementados de asistencia a la persona con discapacidad, partiendo de las siguientes cuestiones: trabajar en rehabilitación; historial médico y evaluación; atención compartida y calificación del alta. Del contenido de las ruedas surgieron tres categorías empíricas: el proceso de trabajo en rehabilitación; el proceso en red; el modelo de cuidado. La identificación de obstáculos y facilitadores podrá favorecer la plena implementación del modelo biosicosocial en la atención a las personas con discapacidad, generando subsidios para el avance hacia la integralidad del cuidado a las personas con discapacidad representado en este modelo.(AU)

Impact of telephone follow-up on COPD outcomes in pulmonary rehabilitation patients: A randomized clinical trial.

Background: The educational component is a comprehensive part of Pulmonary Rehabilitation (PR), and telephone follow-up (TFU) is an alternative to reinforce face-to-face education. The objective was to determine the effect of telephone follow-up on educational needs, dyspnea, quality of life and functional capacity in Chronic Obstructive Pulmonary Disease (COPD) patients undergoing PR. Methods: Double-blind randomized controlled clinical trial in patients with COPD in a PR program in Cali-Colombia, allocation by randomization tables. All patients received 24 sessions of PR, which included face-to-face education sessions. In addition, the experimental group received telephone calls twice a week to reinforce the face-to-face educational content. The Lung Information Needs Questionnaire (LINQ) was used to measure disease knowledge, the Saint George's Respiratory Questionnaire to measure quality of life, the modified Medical Research Council (mMRC) scale to measure dyspnea, and the 6-minute walking test (6MWT) to measure functional capacity. Results: Thirty-four patients were randomized and 31 were analyzed. PR group with conventional education (PRTE) n=15 and PR group with education plus telephone follow-up (PRTETFU) n=16. Significant improvement from baseline to endpoint in both groups: LINQ (PRTE 4±1.1, p=0.003, PRTETFU 5.8±10.6, p=0.000), mMRC (PRTE 1.6±0.3, p=0.000, PRTETFU 0.6±0.3, p=0.036) and functional capacity (PM6M: PRTE 45.9m±16.1, p=0.013, PRTETFU 62.8m±21.4, p=0.010). Analysis showed differences between groups for changes in LINQ knowledge domain after intervention, with greater improvement for PRTETFU (p=0.018). Discussion: The TFU is an alternative to reinforce the education. This study demonstrated greater positive effects for the autonomous management of the pathology. Conclusion: Adding educational reinforcement through phone calls to patients with COPD during PR leads to improved knowledge and skills for managing the disease.

Phenotypic Characterization of Oral Mucor Species from Eurasian Vultures: Pathogenic Potential and Antimicrobial Ability.

Due to poisoning and decline in the food resources of Eurasian vultures, there has been a rise in the number of Griffon (Gyps fulvus) and Cinereous vultures (Aegypius monachus) needing veterinary care. In captivity, vultures often develop oral and other infectious diseases which can affect their survival and the probability of reintroduction in the wild. Therefore, it is important to characterize relevant microbial species present in the oral cavity of vultures, such as Mucor spp. In this work, seven Mucor spp. isolates previously obtained from Gyps fulvus and Aegypius monachus oral swabs collected at two rehabilitation centers in Portugal were characterized regarding their pathogenic enzymatic profile and antimicrobial activity. Isolates were identified by macro and microscopic observation, and PCR and ITS sequencing. Their antimicrobial activity was determined using a collection of pathogenic bacteria and two yeast species. Results showed that 86% of the isolates produced α-hemolysis, 71% expressed DNase, 57% produce lecithinase and lipase, 29% expressed gelatinase, and 29% were biofilm producers. Four isolates showed inhibitory activity against relevant human and veterinary clinical isolates, including Escherichia coli, Enterococcus faecium, Neisseria zoodegmatis, and Staphylococcus aureus. In conclusion, accurate management programs should consider the benefits and disadvantages of Mucor spp. presence in the oral mucosa.

Bio-Psycho-Social Profile of People with Substance Use Disorders Treated in Locally Assigned Treatment Facilities in Kandahar, Afghanistan.

Background: Substance use and its associated bio-psycho-social problems are public health concerns with harmful individual and social consequences. Objective: This study assessed the bio-psycho-social profile of people with substance use disorders (SUD) treated at locally assigned treatment facilities in Kandahar, Afghanistan. Methods: We conducted this facility-based cross-sectional study among 621 substance users receiving care at three locally assigned treatment facilities in November-December 2022. We performed multiple linear regression to determine factors associated with psychological symptoms. Results: The mean age of the participants was 34.41 (± 10.10 SD) years. The majority of our subjects (81.2%) perceived their physical health as very good or fair. More than two-thirds (73.4%) rated their social support as high. Of all participants, 541 (87.1%) had symptoms of depression, 569 (91.6%) of anxiety, and 442 (71.2%) of stress. The prevalence of severe depression, anxiety, and stress was 34.8%, 65.8%, and 27.3%, respectively. The multiple linear regression showed that several attributes of people with substance use disorders [ie, having a low level of education (ß=0.12, p=<0.001), being unemployed (ß=0.31, p=<0.001), having a low level of social support (ß=-0.35, p=<0.001), had a pre-existing medical condition (ß=-0.28, p=<0.001), and having lived abroad in the past ten years (ß=0.10, p=0.001)] were significantly associated with higher DASS-21 total scores. Conclusion: This study highlights the importance of providing bio-psycho-social support programs and implementing therapeutic interventions to help people with substance use disorders, particularly those who are most susceptible to higher levels of bio-psycho-social problems.

Produção assistencial de um Centro Especializado em Reabilitação: análise de atendimentos por modalidade e especialidades / Assistance provided by a Specialized Rehabilitation Center: an analysis of the care offered per modality and specialties / Producción asistencial de un Centro Especializado de Rehabilitación: análisis de la atención por modalidad y especialidades

Introdução: a assistência à pessoa com deficiência no Brasil vem sendo ampliada ao longo dos anos, a partir do avanço das discussões sobre os Direitos Humanos e legislações publicadas pelo Ministério da Saúde. Objetivo: analisar a produção assistencial de um Centro Especializado em Reabilitação. Métodos: trata-se de estudo observacional, descritivo, transversal, realizado com dados secundários de produção ambulatorial do período de abril de 2019 a março de 2020. Resultados: foi possível observar maior número de usuários assistidos na modalidade auditiva, posteriormente na modalidade física, intelectual e visual. Houve maior proporção de atendimentos multidisciplinares na modalidade intelectual e física; ao sexo feminino, exceto na modalidade intelectual; e a crianças, exceto na modalidade auditiva. Quanto às equipes mínimas, na modalidade auditiva, o fonoaudiólogo foi o profissional que realizou maior número de atendimentos; na física, o fisioterapeuta; na intelectual, o fisioterapeuta, seguido pelo fonoaudiólogo e terapeuta ocupacional; na reabilitação visual, o terapeuta ocupacional. Houve diferença com significância estatística quando comparadas as modalidades visual e intelectual em relação ao sexo; e o número de atendimentos por especialidades quando comparado à faixa etária. Conclusão: o estudo retrata a estrutura e oferta de atendimentos multidisciplinares realizados para as pessoas com deficiência que frequentam um serviço especializado em reabilitação. (AU)

Introduction: assistance to people with disabilities in Brazil has been expanded over the years, from the advancement of discussions on Human Rights, and legislation published by the Ministry of Health. Objective: to analyze the care production of a Specialized Center in Rehabilitation. Methods: this is an observational, descriptive, cross-sectional study, conducted with secondary data of outpatient production from April 2019 to March 2020. Results: it was possible to observe a greater number of users assisted in the auditory modality, later in the physical, intellectual and visual modality, there was a higher proportion of multidisciplinary care in the intellectual and physical modality; female gender, except in the intellectual modality; and children, except in the auditory mode. As for the minimum teams, in the auditory modality the speech therapist was the professional who performed the highest number of consultations; in physics the physiotherapist; in the intellectual the physiotherapist, followed by the speech therapist and occupational therapist; in visual rehabilitation the occupational therapist. There was a statistically significant difference when comparing the visual and intellectual modalities in relation to gender; and the number of visits by specialties when compared to age group. Conclusion: the study portrays the structure and offer of multidisciplinary care provided to people with disabilities, who attend a specialized service in rehabilitation. (AU)

Introducción: la asistencia a las personas con discapacidad em Brasil se ha ampliado a lo largo de los años, a partir del avance de las discusiones sobre Derechos Humanos y la legislación publicada por el Ministerio de Salud. Objetivo: analizar la producción asistencial de un Centro Especializado em Rehabilitación. Métodos: se trata de un estúdio observacional, descriptivo, transversal, realizado con datos secundarios de producción ambulatoria de abril de 2019 a marzo de 2020. Resultados: fue posible observar un mayor número de usuários atendidos en la modalidade auditiva, posteriormente en la modalidade física, intelectual y visual, hubo una mayor proporción de atención multidisciplinaria en la modalidade intelectual y física; género femenino, excepto en la modalidade intelectual; y niños, excepto em el modo auditivo. En cuanto a los equipos mínimos, en la modalidade auditiva el logopeda fue el profesional que realizó mayor número de consultas; em física el fisioterapeuta; em el intelectual el fisioterapeuta, seguido por el logopeda y el terapeuta ocupacional; em rehabilitación visual el terapeuta ocupacional. Hubo uma diferencia estadísticamente significativa al comparar las modalidades visuales e intelectuales em relación con el género; y el número de visitas por especialidades em comparación con el grupo de edad. Conclusión: el estúdio retrata la estructura y la oferta de atención multidisciplinaria prestada a las personas con discapacidad, que asisten a un servicio especializado em rehabilitación. (AU)

Perfil epidemiológico dos pacientes amputados acompanhados em um grande centro referência em reabilitação de Pernambuco / Epidemiological profile of amputee patients monitored at a large reference rehabilitation center in Pernambuco

A amputação de um membro se reveste de maior dramaticidade e limitações sensório-motoras em pacientes jovens, assim como, na população adulta ou idosa com comorbidades. Objetivo: Traçar o perfil demográfico e epidemiológico dos pacientes atendidos em um grande centro de referência em reabilitação em Pernambuco. Métodos: Realizou-se um estudo de corte transversal com revisão de prontuários ativos. Os resultados foram tratados pelo Microsoft Excel® e o programa utilizado para os cálculos estatísticos foi o IBM® SPSS® na versão 23. Resultados: Observou-se idade média de 48,36 anos, gênero masculino (76,6%), casados (47,7%), ensino fundamental (64,8%) e oriundos de todas as regiões do estado. Quanto à amputação, sem predileção por lado, mais frequente nos membros inferiores transfemoral (55,1%), cotos de comprimento variável e causas vasculares e traumáticas mais frequentes. No exame físico, cotos em condições de reabilitação, utilização de aditamento comunitário ou domiciliar na primeira consulta e sem uso prévio de prótese. Em 83,6% dos casos, os pacientes usavam sua prótese mais de 7h/dia e 58,6% possuíam marcha independente na comunidade, com durabilidade da prótese em até 36 meses (75,8%). Conclusão: A amputação ocorre em idade jovem, sendo os homens mais acometidos, as doenças vasculares e acidentes envolvendo veículos motorizados são as principais causas, as cirurgias ocorrem mais nas diáfises ósseas. O tempo de terapias foi efetivo. Fazem-se necessárias políticas públicas que agilizem o acesso do paciente a centros especializados e desses aos centros de reabilitação e para melhoria dos materiais e componentes que compõem as próteses oferecidas pelo SUS

The amputation of a limb is more dramatic and sensorimotor limitations in young patients, as well as in the adult or elderly population with comorbidities. Objective: This study outlined the demographic and epidemiological profile of patients treated at a large referral rehabilitation center in Pernambuco. Methods: A cross-sectional study was carried out with a review of active medical records. The results were processed by Microsoft Excel® and the program used for the statistical calculations was the IBM® SPSS® version 23. Results: It was observed a mean age of 48.36 years, male gender (76.6%), married (47.7%), elementary education (64.8%) and from all regions of the state. As for amputation, with no predilection for the side, more frequent in the lower limbs transfemoral (55.1%), variable length stumps and more frequent vascular and traumatic causes. On physical examination, stumps in rehabilitation conditions, use of community or home addition in the first consultation and no previous use of prosthesis. In 83.6% of the cases, the patients used their prosthesis more than 7h/day and 58.6% had independent walking in the community, with prosthesis durability of up to 36 months (75.8%). Conclusion: Amputation occurs at a young age, with men being more affected, vascular diseases and accidents involving motor vehicles are the main causes, surgeries occur more in bone diaphyses. The therapy time was effective. Public policies are needed to speed up patient access to specialized centers and from them to rehabilitation centers and to improve the materials and components that make up the prostheses offered by the SUS.

Independência funcional de pacientes com síndrome de Guillain-Barré internados para reabilitação / Functional independence of patients with Guillain-Barré syndrome hospitalized for rehabilitation

Objetivo: Analisar a evolução da independência funcional de pacientes com Síndrome de Guillain-Barré (SGB) internados para reabilitação. Método: Estudo retrospectivo e longitudinal. Foram analisados prontuários de pacientes com diagnóstico de SGB internados para reabilitação, de janeiro de 2015 a março de 2020, que possuíam a Medida de Independência Funcional (MIF) na admissão e alta hospitalar devidamente preenchida, sem distinção de idade. A comparação da MIF antes e depois da internação para reabilitação foi feita por meio do teste t de Student e McNemar. Resultados: A amostra foi composta por 26 pacientes, com média de idade de 41,96 ± 19,67 anos. Os participantes tinham em média 66,07 ± 69,56 dias entre os primeiros sintomas e a admissão para internação para reabilitação. O tempo médio de internação foi de 38,96± 28,36 dias. Houve diferença significativa entre as médias das pontuações, na admissão e alta, nos domínios motor (37,58 - 59,62; p<0,001) e cognitivo (23,19 - 33,35; p<0,001) e escore total da MIF (60,77 - 92,96; p<0,001). Observou-se também aumento do número de pacientes com independência completa após internação para reabilitação (2 - 15; p<0,001). Conclusão: Pacientes com SGB internados para reabilitação apresentam melhora da independência funcional. É importante acesso a esta modalidade terapêutica multiprofissional aos pacientes com SGB.

Objective: To analyze the evolution of the functional independence of patients with Guillain-Barré Syndrome (GBS) hospitalized for rehabilitation. Method: Retrospective and longitudinal study. Medical records of patients with diagnosis of GBS hospitalized for rehabilitation were analyzed, from January 2015 to March 2020, who had the Functional Independence Measure (FIM) at admission and hospital discharge duly filled, regardless of age. The comparison of FIM before and after hospitalization for rehabilitation was performed using Student's t-test and McNemar's test. Results: The sample consisted of 26 patients, with a mean age of 41.96 ± 19.67 years. Participants had a mean of 66.07 ± 69.56 days between the first symptoms and hospital admission for rehabilitation. The mean length of stay was 38.96 ± 28.36 days. There was a significant difference between the mean scores, at admission and discharge, in the motor domain (37.58-59.62; p<0.001) and cognitive domain (23.19-33.35; p<0.001) and total FIM score (60.77-92.96; p<0.001). There was also an increase in the number of patients with complete independence after hospitalization for rehabilitation (2-15; p<0.001). Conclusion: Patients with GBS hospitalized for rehabilitation show improved functional independence. Access to this multiprofessional therapeutic modality is important for patients with GBS.

Características demográficas, socioeconômicas e da procura dos usuários em um serviço de reabilitação física de referência estadual, Mato Grosso, 2021 / Demographic, socioeconomic and service demand features of users in a state reference physical rehabilitation service, Mato Grosso, 2021 / Características demográficas, socioeconómicas y de la demanda de los usuarios en un servicio de rehabilitación física de referencia estatal, Mato Grosso, 2021

Introdução: O estudo dos fatores sociodemográficos e socioeconômicos de usuários doSistema Único de Saúde éimportante para o planejamento e a avaliação das ações dos serviços de saúde procurados por esta população. Objetivo:Descrever as características demográficas, socioeconômicas e da procura dos usuários adultos com demanda dereabilitação física ortopédica e neurológica emum Centro Especializado em Reabilitação de referência no Estado de Mato Grosso. Metodologia:Estudo observacional descritivo baseado nos prontuários dosetor de acolhimento de um Centro Especializado em Reabilitação de Mato Grosso,de fevereiro a maio de 2021. Foram analisados dados demográficos e socioeconômicos de usuários adultos de ambos os sexos. Utilizou-se o teste de qui-quadrado de Pearson para as associações entre as variáveis segundo eixo de reabilitação (ortopédica e neurológica). Resultados:Dos196 prontuários analisados,94% dos usuários eram procedentes de Cuiabá, comidade média de 50,3 anos, sendo 52,55% do sexo feminino. Aprocura pelo serviçofoi de 69%pela reabilitação ortopédica (69%) e de 31%reabilitação neurológica. Observaram-se diferenças estatisticamente significantes entre as frequências nos dois eixos dereabilitação física estudados nas variáveis idade (p=0,0005), escolaridade (p=0,0031), principal atividade de trabalho (p=0,0045), doenças concomitantes (p=0,0016), tratamento em outro estabelecimento de saúde (p=0,0041) e motivo da procura pela reabilitação (p<0,0001). Conclusões:Osresultados mostraram que os casos neurológicos possuem maior idade, baixo nível de escolaridadeepequeno percentual de trabalho remuneradoem relação aos casos ortopédicos. Tais resultados sugerem que as necessidades de saúde e de reabilitação dependem da singularidade dos casos e podem subsidiara efetivação depolíticas públicas que favoreçam a reorganização dos serviços e a articulação intersetorial entre saúde, educação emercado de trabalho (AU).

Introduction: Assessing sociodemographic and socioeconomic factors related to Unified Health System's users is essential to plan and evaluate the actions by the health services sought by them.Aim: Describing the demographic and socioeconomic features of adult users, and their search for having their orthopedic and neurological-physical rehabilitation demands fulfilled by a Specialized Center in Orthopedic and Neurological Rehabilitation in Mato Grosso State.Methodology: Observational descriptive study based on medical records collected between February and March 2021, provided by the welcoming sector of a Specialized Center in Rehabilitation in Mato Grosso State. Demographic and socioeconomic records of adult users belonging to both sexes were analyzed. Person's chi-square test was adopted to associate the variables based on the orthopedic and neurological rehabilitation axes.Results: In total, 94% of the 196 analyzed medical records regard patients from Cuiabá, in the mean age group 50.3 years; 52.55% of them belonged to the female sex. The search for orthopedic rehabilitation reached 69% and that for neurological rehabilitation recorded 31%. There were significant statistical differences between frequencies on the two assessed physical rehabilitation axes based on variables such as age (p=0.0005), schooling (p=0.0031), main labor activity (p=0.0045), concomitant diseases (p=0.0016), treatment provided in another health establishment (p=0.0041) and reason for seeking rehabilitation (p<0.0001). Conclusions: Results have shown that neurological cases are linked to older age, low schooling and low rate of paid work in comparison to orthopedic cases. These results have suggested that health and rehabilitation needs depend on cases' particularities; moreover, they can subsidize the process to make public policies to reinforce services'organization, as well as inter-sectoral articulation among health, education and labor market, effective (AU).

Introducción: El estudio de los factores sociodemográficos y socioeconómicos de los usuarios del Sistema Único de Salud es importante para planificar y evaluar las acciones de los servicios de salud buscados por esta población.Objetivo: Describir las características demográficas, socioeconómicas y de demanda de usuarios adultos con demanda de rehabilitación física ortopédica y neurológica en un Centro Especializado de Rehabilitación de Referencia en el Estado de Mato Grosso.Metodología: Estudio observacional descriptivo basado en las historias clínicas del sector de acogimiento de un Centro Especializado de Rehabilitación en Mato Grosso, de febrero a mayo de 2021. Se analizaron datos demográficos y socioeconómicos de usuarios adultos de ambos sexos. Se utilizóla prueba de chi-cuadrado de Pearson para las asociaciones entre las variables según el eje de rehabilitación (ortopédico y neurológico).Resultados: De las 196 historias clínicas analizadas, 94% de los usuarios provenían de Cuiabá, con una edad promedio de 50,3 años, de los cuales 52,55% eran de sexo femenino. La demanda del servicio fue del 69% para la rehabilitación ortopédica (69%) y del 31% para la rehabilitación neurológica. Se observaron diferencias estadísticamente significativas entre las frecuencias en los dos ejes de rehabilitación física estudiados en las variables edad (p=0,0005), escolaridad (p=0,0031), actividad laboral principal (p=0,0045), enfermedades concomitantes (p=0,0016), tratamiento en otro establecimiento de salud (p=0,0041) y motivo de búsqueda de rehabilitación (p <0,0001). Conclusiones:Los resultados mostraron que los casos neurológicos tienen mayor edad, bajo nivel de educación y un pequeño porcentaje de trabajo remunerado en relación con los casos ortopédicos. Estos resultados sugieren que las necesidades de salud y rehabilitación dependen de la singularidad de los casos y pueden apoyar la implementación de políticas públicas que favorezcan la reorganización de los servicios y la articulación intersectorial entre salud, educación y mercado laboral (AU).

Using Quality Indicator Codes to Identify Patients' Fall Risk in Inpatient Rehabilitation Facilities.

OBJECTIVE: To discover if quality indicator (QI) codes are associated with patient falls in inpatient rehabilitation facilities (IRFs). DESIGN: This retrospective cohort study explored differences between patients who fell and those who did not fall. We analyzed potential associations between QI codes and falls using univariable and multivariable logistic regression models. SETTING: We collected data from electronic medical records at 4 IRFs. PARTICIPANTS: In 2020, our 4 data collection sites admitted and discharged a total of 1742 patients older than 14 years . We only excluded patients (N=43) from statistical analysis if they were discharged before admission data had been assigned. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Using a data extraction report, we collected age, sex, race and ethnicity, diagnosis, falls, and QI codes for communication, self-care, and mobility performance. Staff documented communication codes on a 1-4 scale and self-care and mobility codes on a 1-6 scale, with higher codes representing greater independence. RESULTS: Ninety-seven patients (5.71%) fell in the 4 IRFs over a 12-month period. The group who fell had lower QI codes for communication, self-care, and mobility. When adjusting for bed mobility, transfer, and stair-climbing ability, low performance with understanding, walking 10 feet, and toileting were significantly associated with falls. Patients with admission QI codes below 4 for understanding had 78% higher odds of falling. If they were assigned admission QI codes below 3 for walking 10 feet or toileting, they had 2 times greater odds of falling. We did not find a significant association between falls and patients' diagnosis, age, sex, or race and ethnicity in our sample. CONCLUSIONS: Communication, self-care, and mobility QI codes appear to be significantly associated with falls. Future research should explore how to use these required codes to better identify patients likely to fall in IRFs.

Síndrome orbitofrontal en un interno con infracciones por secuestro agravado, violación sexual y muerte de una menor de edad

El síndrome orbitofrontal se caracteriza por la ausencia de inhibición, escaso control de impulsos, transgresión de normas sociales y, en determinados casos, con la materialización de conductas delictivas. Se presenta el caso de un interno varón de 18 años con infracciones por secuestro, violación sexual y homicidio de una menor de edad, a quien se evaluó a través de entrevistas y uso del test de Eysenck (Forma B), test de matrices progresivas de Raven, test de la figura compleja de Rey (Forma A), test de percepción de diferencias (Caras-R), test de Stroop (colores y palabras), test Mini-Mental y Cuestionario de cólera, irritabilidad y agresión (CIA). El evaluado muestra un lenguaje y vocabulario de acuerdo con su edad, no presenta problemas orgánicos, ni alteraciones en atención, lenguaje, escritura, lectura, praxias, cálculo, percepción y memoria. Los resultados destacan un coeficiente intelectual superior al término medio con óptimas capacidades cognitivas, temperamento melancólico con pensamientos depresivos, personalidad introvertida con baja sensibilidad a los cambios en el ambiente, escasa sociabilidad, ensimismamiento y evasión. Asimismo, evidencia tendencias perfeccionistas, con cambios emocionales bruscos y dificultad para reorientar patrones conductuales, alta tendencia a la impulsividad y escaso control inhibitorio; elementos característicos de un síndrome orbitofrontal. Finalmente, se destaca el uso de pruebas psicométricas y evaluaciones neuropsicológicas para el diagnóstico del síndrome orbitofrontal, necesarias a incorporar incorporar para el adecuado manejo de internos en los centros penitenciarios y/o de rehabilitación que no tienen acceso a estudios de neuroimagen y a partir de los cuales pueden diseñarse programas de intervención estratégicos.

Orbitofrontal syndrome is characterized by disinhibition, impulsiveness, transgression of social norms and sometimes the development of criminal behavior. This is the case of an 18-year-old male offender incarcerated for kidnapping, rape and homicide of a minor. He was evaluated through interviews and the use of the Eysenck personality questionnaire (Form B), Raven's progressive matrices (RPM), Rey-Osterrieth complex figure (Form A), Differences perception test (FACES-R), Stroop color and word test (SCWT), Mini-Mental state examination (MMSE) and Aggression questionnaire (AGQ). The research subject showed age-appropriate speech, language and vocabulary, and had neither physical problems nor attention, language, writing, reading, praxis, calculation, perception and memory disorders. The results highlight a higher-than-average intelligence quotient, optimal cognitive skills, melancholic temperament with depressive thoughts, introverted personality with low environmental sensitivity, poor social skills, self-absorption and avoidance. Additionally, perfectionist tendencies, sudden emotional changes, difficulty changing behavioral patterns, impulsiveness and disinhibition, all of which are characteristics of orbitofrontal syndrome. Finally, the research highlights the use of psychometric tests and neuropsychological evaluations for the diagnosis of orbitofrontal syndrome. Said tests and evaluations are necessary for the proper management of offenders incarcerated in prisons and/or detention centers who do not have access to neuroimaging; moreover, they may be used to design strategic intervention programs.

Promoting Evidence-Based Practice: The Influence of Novel Structural Change to Accelerate Translational Rehabilitation.

OBJECTIVE: To evaluate changes in clinicians' use of evidence-based practice (EBP), openness toward EBP, and their acceptance of organizational changes after a rehabilitation hospital transitioned to a new facility designed to accelerate clinician-researcher collaborations. DESIGN: Three repeated surveys of clinicians before, 7-9 months, and 2.5 years after transition to the new facility. SETTING: Inpatient rehabilitation hospital. PARTICIPANTS: Physicians, nurses, therapists, and other health care professionals (n=410, 442, and 448 respondents at Times 1, 2, and 3, respectively). INTERVENTIONS: Implementation of physical (architecture, design) and team-focused (champions, leaders, incentives) changes in a new model of care to promote clinician-researcher collaborations. MAIN OUTCOME MEASURES: Adapted versions of the Evidence-Based Practice Questionnaire (EBPQ), the Evidence-Based Practice Attitudes Scale (EBPAS), and the Organizational Change Recipients' Beliefs Scale (OCRBS) were used. Open-ended survey questions were analyzed through exploratory content analysis. RESULTS: Response rates at Times 1, 2, and 3 were 67% (n=410), 69% (n=422), and 71% (n=448), respectively. After accounting for familiarity with the model of care, there was greater reported use of EBP at Time 3 compared with Time 2 (adjusted meant2=3.51, standard error (SE)=0.05; adj. meant3=3.64, SE=0.05; P=.043). Attitudes toward EBPs were similar over time. Acceptance of the new model of care was lower at Time 2 compared with Time 1, but rebounded at Time 3 (adjusted meant1=3.44, SE=0.04; adj. meant2=3.19, SE=0.04; P<.0001; adj. meant3=3.51, SE=0.04; P<.0001). Analysis of open-ended responses suggested that clinicians' optimism for the model of care was greater over time, but continued quality improvement should focus on cultivating communication between clinicians and researchers. CONCLUSIONS: Accelerating clinician-researcher collaborations in a rehabilitation setting requires sustained effort for successful implementation beyond novel physical changes. Organizations must be responsive to clinicians' changing concerns to adapt and sustain a collaborative translational medicine model and allow sufficient time, probably years, for such transitions to occur.

Perspectiva dos profissionais de saúde sobre o uso da telessaúde no contexto da pandemia da covid-19 / Perspective of healthcare professionals on the use of telehealth in the context of the covid-19 pandemic / Perspectiva de los profesionales de la salud sobre el uso de telesalud en el contexto de la pandemia del covid-19

O objetivo deste estudo foi analisar o uso e os impactos da telessaúde em um Centro Especializado em Reabilitação (CER), sob a perspectiva dos profissionais de saúde, durante a pandemia da covid-19. Trata-se de um estudo transversal analítico realizado com profissionais da saúde de um CER. Utilizou-se questionário desenvolvido pelos pesquisadores sobre o perfil sociodemográfico e a percepção do profissional em relação aos atendimentos realizados à distância. Os dados foram analisados com pacote estatístico SPSS (26,0). Foi adotado nível de significância de 5% (p < 0,05).Amostra composta por 79 profissionais, a maioria formados há mais de dez anos, sem experiências com telessaúde. Houve relação significativa entre quantidade de ferramentas utilizadas com grau de dificuldade, e presença de treinamento com a autossatisfação sobre o atendimento. A escolha da ferramenta está intrinsecamente ligada à disponibilidade, à habilidade e à tarefa a ser realizada. O treinamento prévio demonstrou redução de barreiras e satisfação profissional

The objective of this study was to analyze the use and impacts of telehealth in a Specialized Rehabilitation Center (SRC), from the perspective of health professionals, during the covid-19 pandemic. This is an analytical cross-sectional study carried out with health professionals from a SRC. A questionnaire developed by the researchers was used on the sociodemographic profile and perception of the professional in relation to the consultations performed at a distance. Data were analyzed using the SPSS statistical package (26.0). A significance level of 5% (p < 0.05) was adopted. Sample composed of 79 professionals, most of them graduated for more than ten years, with no experience with telehealth. There was a significant relationship between the number of tools used and the degree of difficulty, and the presence of training, with self-satisfaction with the service. The choice of tool is intrinsically linked to availability, skill and task to be performed. Previous training demonstrated a reduction in barriers and job satisfaction.

El objetivo de este estudio fue analizar el uso y los impactos de la telesalud en un Centro Especializado de Rehabilitación (CER), desde la perspectiva de los profesionales de la salud, durante la pandemia del covid-19. Se trata de un estudio transversal analítico realizado con profesionales de la salud de un CER. Se utilizó un cuestionario elaborado por los investigadores sobre el perfil sociodemográfico y de percepción del profesional en relación a las consultas realizadas a distancia. Los datos se analizaron utilizando el paquete estadístico SPSS (26,0). Se adoptó un nivel de significancia del 5% (p < 0,05). Muestra compuesta por 79 profesionales, la mayoría graduados hace más de diez años, sin experiencia en telesalud. Hubo una relación significativa entre el número de herramientas utilizadas y el grado de dificultad, y la presencia de formación, con la autosatisfacción con el servicio. La elección de la herramienta está intrínsecamente ligada a la disponibilidad, habilidad y tarea a realizar. La formación previa demostró una reducción de las barreras y la satisfacción laboral.

Molecular surveillance of potential SARS-CoV-2 reservoir hosts in wildlife rehabilitation centers.

BACKGROUND: The COVID-19 pandemic, caused by SARS-CoV-2 infection, has become the most devastating zoonotic event in recent times, with negative impacts on both human and animal welfare as well as on the global economy. Although SARS-CoV-2 is considered a human virus, it likely emerged from animals, and it can infect both domestic and wild animals. This constitutes a risk for human and animal health including wildlife with evidence of SARS-CoV-2 horizontal transmission back and forth between humans and wild animals. AIM: Molecular surveillance in different wildlife rehabilitation centers and wildlife associated institutions in Chile, which are critical points of animal-human interaction and wildlife conservation, especially since the aim of wildlife rehabilitation centers is to reintroduce animals to their original habitat. MATERIALS AND METHODS: The survey was conducted in six WRCs and three wildlife associated institutions. A total of 185 samples were obtained from 83 individuals belonging to 15 different species, including vulnerable and endangered species. Each specimen was sampled with two different swabs: one oropharyngeal or nasopharyngeal according to the nostril diameter, and/or a second rectal sample. RNA was extracted from the samples and two different molecular assays were performed: first, a conventional RT-PCR with pan-coronavirus primers and a second SARS-CoV-2 qPCR targeting the N and S genes. RESULTS: All 185 samples were negative for SARS-CoV-2. CLINICAL RELEVANCE: This study constitutes the first report on the surveillance of SARS-CoV-2 from wildlife treated in rehabilitation centers in Chile, and supports the biosafety procedures adopted in those centers.

Percepção dos usuários de centro especializado em reabilitação física sobre barreiras de acessibilidade e mobilidade urbana / Perception of physical rehabilitation center users about accessibility barriers and urban mobility / Percepción de los usuarios de centros de rehabilitación física sobre las barreras de accesibilidad y movilidad urbana

Objetivo: compreender a percepção dos usuários de programa de reabilitação física sobre suas experiências no enfrentamento de barreiras de acessibilidade e mobilidade urbana para comparecer nos atendimentos em Centro Especializado de Reabilitação. Método:estudo descritivo, abordagem qualitativa, realizado na região Metropolitana I do Rio de Janeiro, Brasil. Dados coletados através de entrevistas semiestruturadas, analisados à luz da análise de conteúdo, abordagem temática. Resultados: da análise emergiram quatro categorias que evidenciaram reiteradas experiências desafiadoras no percurso de suas residências para agendamentos no programa de reabilitação, se deparando com ambientes de mobilidade urbana inadequados à circulação de pessoas com algum tipo de deficiência ou mobilidade reduzida. Considerações Finais: os participantes experimentam situações constrangedoras que os fazem se sentir impotentes, desmotivados, frustrados e com baixa autoestima, requerendo das equipes de reabilitadoras a adoção de estratégias acolhedoras de atendimentos para que não comprometam o alcance de metas planejadas no programa de reabilitação.

Objective: to understand the perception of users of a physical rehabilitation program about their experiences in facing barriers to accessibility and urban mobility to attend consultations at a Specialized Rehabilitation Center. Method: descriptive study, qualitative approach, in the Metropolitan Region I of Rio de Janeiro, Brazil. Data collected through semi-structured interviews, analyzed in the light of content analysis, thematic approach. Results: from the analysis, four categories emerged that showed repeated challenging experiences in the course of their residences for scheduling in the rehabilitation program, facing urban mobility environments unsuitable for the circulation of people with some type of disability or reduced mobility. Final Considerations: participants experience embarrassing situations that make them feel powerless, unmotivated, frustrated and with low self-esteem, requiring rehabilitation teams to adopt welcoming strategies for care so that they do not compromise the achievement of goals planned in the rehabilitation program.

Objetivo: comprender la percepción de los usuarios de un programa de rehabilitación física sobre sus experiencias frente a las barreras de accesibilidad y movilidad urbana para asistir a consultas en un Centro Especializado de Rehabilitación. Método: estudio descriptivo, abordaje cualitativo, realizado en la Región Metropolitana I de Río de Janeiro, Brasil. Datos recolectados a través de entrevistas semiestructuradas, analizados a la luz del análisis de contenido, abordaje temático. Resultados: del análisis surgieron cuatro categorías que evidenciaron reiteradas experiencias desafiantes en el transcurso de sus residencias para la inserción en el programa de rehabilitación, frente a ambientes de movilidad urbana no aptos para la circulación de personas con algún tipo de discapacidad o movilidad reducida. Consideraciones Finales: los participantes viven situaciones bochornosas que los hacen sentir impotentes, desmotivados, frustrados y con baja autoestima, requiriendo que los equipos de rehabilitación adopten estrategias acogedoras de atención para que no comprometan el logro de las metas previstas en el programa de rehabilitación.

Vivências de pessoas com deficiência durante o processo de reabilitação: Teoria Fundamentada nos Dados / Experiences of people with disabilities during their rehabilitation process: Grounded Theory

RESUMO Objetivo construir um modelo teórico representativo da vivência de pessoas com deficiência durante o processo de reabilitação física. Métodos pesquisa qualitativa, pautada no referencial da Teoria Fundamentada nos Dados. Realizou-se entrevista com 28 participantes em três grupos amostrais. Utilizou-se amostragem teórica e circularidade de dados para análise em codificações inicial, focalizada e teórica. Resultados compuseram o fenômeno "Vivenciando o processo de reabilitação" 66 códigos conceituais. Foram condições as categorias: Enfrentando a nova condição e Vivenciando o desafio da reabilitação. Como ação-interação: Encontrando motivação para reabilitação; e, como consequência: Adaptando-se à condição. Conclusão o modelo teórico destaca a necessidade de enfrentamento da condição de deficiência, levando o indivíduo a aprender a lidar com os desafios, reconhecendo a natureza gradual e desafiadora da reabilitação. Contribuição para a prática o modelo teórico inova ao compreender o processo de reabilitação em pessoas com deficiência, enfatizando a importância de enfrentar a nova condição, encontrar motivação e adaptar-se. Destaca ainda o papel crucial da equipe de saúde e do contato com outros que passam pelo mesmo processo. Sua aplicação promete ampliar a eficácia da reabilitação, culminando em uma maior qualidade de vida para os pacientes.

ABSTRACT Objective to construct a theoretical model that can represent the experience of people with disabilities during the physical rehabilitation process. Methods qualitative research, based on the theoretical framework of Grounded Theory. We interviewed 28 participants in three sample groups, using a theoretical sampling and data circularity to analyze initial, focused, and theoretical codings. Results the phenomenon "Experiencing the process of rehabilitation" was formed by 66 conceptual codes. Its conditions were the categories: "Coping with the new condition", "Experiencing the challenge of rehabilitation". Action-interaction: "Finding motivation for rehabilitation"; consequence: "Adapting to the condition". Conclusion the theoretical model highlights the need to cope with the disability, leading the individual to learn how to deal with challenges and to recognize the gradual and challenging nature of rehabilitation. Contributions to practice the theoretical model is innovative for explaining the rehabilitation process in people with disabilities, highlighting the importance of facing the new condition, finding motivation, and adapting. The crucial role of the health team also stands out, as do the relevance of getting in touch with others who have been through the same process. The application of this model is expected to increase rehabilitation efficiency, culminating in higher quality of life for patients.

Specialized Rehabilitation Centers (CER) in the SUS and the impact of the covid-19 pandemic / Centros Especializados em Reabilitação (CER) no SUS e o impacto da pandemia de covid-19

ABSTRACT OBJECTIVE To analyze the impact of the covid-19 pandemic on the functioning of Specialized Rehabilitation Centers (CER) in the SUS. METHODS An analysis of the variation in outpatient production of the CER was carried out based on data from the Outpatient Information System of the Unified Health System (SIA-SUS) from March 2019 to December 2021. Such results were compared with CER managers' perceptions about the impacts of the pandemic on the units, measured by a web survey applied between November 2020 and February 2021. Monthly averages of 247 procedures were calculated, organized into 18 groups, for three periods - year before the pandemic (YBP) and first (YP1) and second (YP2) years of the pandemic. Through the online form, information was collected on: operation and organization of services; post-covid-19 rehabilitation; actions to support the needs of users and professionals; strategies and challenges experienced. RESULTS There was a 33.3% reduction in the total number of procedures in YP1 compared to YBP. There were no reductions in procedures performed by nurses and for ostomates. There was greater impairment for group activities, visual therapies and home visits. In YP2, there was a recovery of averages in relation to YBP in 11 groups of procedures, with an increase of 104.1% in Cardiorespiratory Physiotherapy. In the answers to the online form, 91.7% of the managers indicate structural and/or organizational changes in the CER, such as: creation of prioritization criteria for assistance; introduction of telerehabilitation; changes in the work process and; provision of professional training. Half of the CER already treated people with covid-19 sequelae, but not all of them had been trained to do so. Limitations in participation and social support for PWD were identified. CONCLUSIONS There was a severe impact of the covid-19 pandemic on the CER. Added to the damming up of previous demands are those of post-covid-19 users, configuring a challenging picture. It is necessary to strengthen the Care Network for Persons with Disabilities, with expansion and greater integration of services and a more inclusive organization to overcome these challenges.

RESUMO OBJETIVO Analisar o impacto da pandemia de covid-19 no funcionamento dos Centros Especializados em Reabilitação (CER) no SUS. MÉTODOS Realizou-se análise da variação da produção ambulatorial dos CER com base nos dados do Sistema de Informações Ambulatoriais do Sistema Único de Saúde (SIA-SUS) no período de março de 2019 a dezembro de 2021. Tais resultados foram cotejados com as percepções de gestores de CER acerca dos impactos da pandemia nas unidades, aferidas por websurvey aplicado entre novembro de 2020 e fevereiro de 2021. Foram calculadas as médias mensais de 247 procedimentos, organizados em 18 grupos, para três períodos - ano anterior à pandemia (APP), primeiro (AP1) e segundo (AP2) anos de pandemia. Por meio do formulário on-line foram coletadas informações sobre: funcionamento e organização dos serviços; reabilitação pós-covid-19; ações de apoio às necessidades de usuários e profissionais; estratégias e desafios vivenciados. RESULTADOS Houve redução de 33,3% do total de procedimentos em AP1 em relação a APP. Não foram reduzidos procedimentos realizados por enfermeiros e para pessoas ostomizadas. Ocorreu maior prejuízo para atividades em grupo, terapias visuais e visitas domiciliares. Em AP2, houve recuperação das médias em relação a APP em 11 grupos de procedimentos, com aumento de 104,1% de Fisioterapia Cardiorrespiratória. Nas respostas ao formulário on-line, 91,7% dos gestores indicam mudanças estruturais e/ou organizacionais nos CER como: criação de critérios de priorização para atendimentos; introdução de telerreabilitação; modificações no processo de trabalho e; disponibilização de capacitações profissionais. Metade dos CER já atendiam pessoas com sequelas de covid-19, mas nem todos haviam sido instrumentalizados para tanto. Identificaram-se limitações na participação e no suporte social para PCD. CONCLUSÕES Houve severo impacto da pandemia de covid-19 nos CER. Ao represamento de demandas prévias se somam aquelas de usuários pós-covid-19, configurando um quadro desafiador. Faz-se necessário fortalecimento da Rede de Cuidados à Pessoa com Deficiência, com ampliação e maior integração dos serviços e organização mais inclusiva para a superação desses desafios.

Indicadores de acesso nos serviços de reabilitação física das desordens musculoesqueléticas em Belo Horizonte (MG) / Indicadores de acceso en servicios de rehabilitación física para trastornos musculoesqueléticas en Belo Horizonte (MG) / Access indicators in physical rehabilitation services for musculoskeletal disorders in Belo Horizonte (MG)

RESUMO A crescente demanda por atendimento nos serviços de reabilitação física do Sistema Único de Saúde (SUS) excede a oferta, o que resulta em longas filas de espera. Neste estudo, realizou-se uma pesquisa quantitativa de cunho exploratório que teve por objetivo a apresentação de indicadores para facilitar o acesso aos serviços de reabilitação física no que tange às desordens musculoesqueléticas. Os dados foram colhidos dos prontuários de usuários residentes nas regiões noroeste e oeste de Belo Horizonte (MG), com mais de 18 anos de idade, submetidos a acolhimento no Centro Especializado em Reabilitação IV no ano de 2019. Obtiveram-se os seguintes indicadores: absenteísmo no momento da avaliação; tempo médio para início do tratamento de acordo com a prioridade; tempo médio de tratamento; e média de usuários atendidos ao mês. A análise deste estudo foi pautada em 362 prontuários. O tempo médio para início de tratamento foi de aproximadamente 69 dias e o período médio de tratamento, de 94 dias. O serviço absorveu cerca de 30 novos usuários ao mês e apresentou índice de absenteísmo de 16,8%. Acredita-se que os indicadores apresentados possivelmente favorecerão a gestão e o controle das filas de espera dos serviços de reabilitação do SUS.

RESUMEN La creciente demanda de atención en los servicios de rehabilitación física del Sistema Único de Salud (SUS) supera la oferta, lo que se traduce en largas colas de espera. Este estudio es una investigación cuantitativa exploratoria, que tuvo como objetivo presentar indicadores para facilitar el acceso a los servicios de rehabilitación física con respecto a los trastornos musculoesqueléticos. Se recolectaron datos de las historias clínicas de los usuarios residentes en las regiones noroeste y oeste de Belo Horizonte (en Mina Gerais, Brasil), mayores de 18 años de edad y que ingresaron al Centro Especializado en Rehabilitación IV en 2019. Se obtuvieron los siguientes indicadores: Absentismo al momento de la evaluación; tiempo medio para iniciar el tratamiento según la prioridad; tiempo medio de tratamiento y número medio de usuarios atendidos por mes. El análisis de este estudio se basó en 362 historias clínicas. El tiempo medio para iniciar el tratamiento fue de aproximadamente 69 días y el período medio de tratamiento, 94 días. El servicio recibió cas 30 nuevos usuarios al mes y presentó una tasa de absentismo del 16,8%. Los indicadores presentados pueden favorecer la gestión y control de las listas de espera de los servicios de rehabilitación del SUS.

ABSTRACT The growing demand for care in the physical rehabilitation services of the Unified Health System (SUS) exceeds the supply, resulting in long waiting lines. This study is an exploratory quantitative research, which aims to present indicators to ease the access to physical rehabilitation services related to musculoskeletal disorders. Data were collected from the medical records of users residing in the northwest and west regions of Belo Horizonte (MG), who were over 18 years old and underwent treatment at the Specialized Rehabilitation Center IV (CER-IV) in 2019. The following indicators were obtained: absenteeism at the time of assessment; average time to start treatment according to priority; mean treatment time; and average number of users served per month. The analysis was based on 362 medical records. The mean time to start treatment was approximately 69 days and the mean treatment period was 94 days. The service absorbed around 30 new users per month and presented an absenteeism rate of 16.8%. It is believed that the indicators presented will possibly favor the management and control of the SUS rehabilitation services waiting lines.