This study was aimed to explore challenges of students with disabilities in higher education institutions in Namibia, as narrated and illustrated by themselves. Mixed methodologies, with specific reference to a small-scale quantitative survey and extensive qualitative design were employed as tools to understand the prevalence, extent and nature of challenges of students with disabilities in their pursuance of higher education in Namibia. Data was thus collected in two phases. The first phase consisted of a ten-item quantitative-survey which was largely used to determine the prevalence of students with disabilities in higher education institutions, and basic information regarding institutional standpoints pertaining to students with disabilities. Data acquired through this survey confirmed the prevalence of students with disabilities in Namibian higher education institutions. The second phase represented the qualitative design whereby data was collected through three main methodologies namely a narrative diary-based approach, a photo-voice and individual interviews. These methodologies ensured reliability of the data through triangulation. The study confirmed that inclusive education at the higher education level in Namibia was largely achieved through the goal of access, as all higher education institutions have admitted students with observable as well as hidden disabilities. However, a major finding of the study was that support and provision for students with disabilities was rendered in fragmented portions within and across institutions, and that the goals of equity and equality have not yet been achieved to the desired degree, if inclusive education was to become a reality for students with disabilities in higher education in Namibia. Students reported challenges related to physical accessibility of institutions; unavailability of educational material in alternative, as opposed to traditional formats; lack of sensitivity and skills of staff; as well as lack of structured support systems. The study also revealed that, notwithstanding the challenges students faced in their institutions, students with disabilities continued to perform their academic duties to the best of their abilities and were driven by their individual personal philosophies, many of which spoke of perseverance and courage, to make a success of their studies. / D. Ed. (Inclusive Education) / Language Education Arts and Culture

The thesis entitled "Stimulation of people with physical and multiple disabilities - using the TheraSuit Method" focuses on the using of different stimulation methods in the care of people with physical and multiple disabilities and is aimed in particular mentioned method TheraSuit and its modifications (Klim-Therapy) whose main element is a special support suit. In the Czech Republic, this method has been used for relatively short time. It is a little widespread, especially due to financial demands. The clients have to pay the therapy almost themselves. Therefore, the thesis aims to gather available information about the method using special support suit. Another objective is to obtain a quantitative overview of the research on the awareness and attitudes of adult clients of selected institutions for people with physical and multiple disabilities, their parents of children with physical and multiple disabilities and staff who work with these people, to discuss methods and new methods of stimulation at all. The thesis also focuses on other stimulation methods used in selected institutions providing services to peoples with physical and multiple disabilities.

Title: Changes in preparation exercises in handbike riders training Objectives: The aim of work is to collect and systematically process available information about sports discipline handbike and thereby expand knowledge about the theory and sport practice especially to persons with physical disabilities Methods: Implementation of data collection was accomplished through semi- structured interview (interview with instructions). Information gathering was carried out by one-time survey (testimony) of respondents. There was carried out repeated terrain inquiries of the respondents, followed by evaluation of statements. Results: Findings of this work form information about sports discipline known as handbike and allow insight into the issues of this sports industry. Primarily it deals with the material aspects and implementation of training program. Findings of this work can be used to popularize handbike discipline. Keywords: Sport for people with special needs, physical disability, handbike, handcycle, handicap, sports training.

O acesso às tecnologias de informação e comunicação tem impactado significativamente a forma como as pessoas se relacionam com o mundo. Essas mudanças afetam a realização de atividades do dia-a-dia, as relações humanas, o trabalho e a aprendizagem. Para as pessoas com deficiência física, o desenvolvimento dos recursos de tecnologia tem possibilitado maneiras de interagir, de se comunicar e de participar em contextos diversos superando as barreiras impostas pelas suas limitações e pelo meio. A vigência de políticas públicas e de ações concretas em prol da inclusão contempla a diversidade humana e o direito de acesso à tecnologia para a comunicação, aprendizagem e trabalho para os cidadãos com deficiência. Para a efetivação da participação e aprendizagem dos alunos com deficiência nas escolas públicas brasileiras são disponibilizados os serviços do Atendimento Educacional Especializado (AEE) com vistas à eliminação de barreiras para o acesso à construção do conhecimento. É através da tecnologia assistiva apropriada que esses alunos poderão desenvolver suas competências possibilitando maior autonomia e independência na vida social de acordo com suas necessidades e interesses. Desta forma, este trabalho teve como foco principal a proposição de uma metodologia para avaliação em acessibilidade ao computador e à comunicação alternativa para alunos com deficiência física. Para tanto, utilizou-se do design de recursos e estratégias em Tecnologia Assistiva com apoio de produtos assistivos envolvendo um conjunto de recursos para acessibilidade ao computador e a comunicação alternativa. No cenário de estudo buscou-se o desenvolvimento da pesquisa-ação envolvendo a participação dos professores do AEE e de quatro alunos com deficiência física (paralisia cerebral) da rede municipal de educação de Florianópolis - SC. Os quatro alunos foram previamente selecionados por necessitarem de alternativas em recursos e estratégias para o acesso ao computador e à comunicação. Fizeram-se estudos de campo no ano letivo de 2010, e complementos no início de 2011. Sistematicamente, após os dados coletados durante as sessões com os alunos e professores, fez-se a análise e avaliação dos mesmos, e foram propostos fluxogramas para orientar na experimentação e implementação dos recursos de acesso ao computador. Finalmente, a construção de fluxogramas que orientam o processo de avaliação resultou em uma ferramenta útil de apoio aos professores e demais profissionais de equipes interdisciplinares. Assim, estas equipes formadas por educadores, profissionais da saúde, designers, engenheiros, e tendo os usuários como protagonistas, poderão realizar um processo de avaliação eficaz para seleção da tecnologia assistiva para o acesso ao computador e à comunicação alternativa, bem como o desenvolvimento de novos produtos e recursos inclusivos. / The access to information and communication technology has impacted the way people relate to the world. These changes affect the accomplishment of daily routine activities, human relationships, work and learning. For the people with physical disabilities, the development of technology resources has enabled them to interact, to communicate and to participate in different contexts overcoming the barriers set by the limitations and the environment. The present policies and actions towards inclusion consider the human diversity and the rights to access technology for communication, learning and work, by the citizens with disabilities. For the effectiveness of participation and learning approaches of students with disabilities in the Brazilian public schools, there are specialized educational services available. One of the objectives of these services is to eliminate the barriers for knowledge access. Providing the appropriate assistive technology, these students can develop their competences enabling them to achieve a greater autonomy and independence in social life according to their needs and interests. The main focus of this research is to propose a methodology for the assessment of computer and alternative communication access for students with physical disabilities. To do so, the design of resources and strategies in assistive technology was considered involving a collection of resources for the accessibility to the computer and communication. In the research scenario, an action-research was developed, which involved the participation of the specialized educational service teachers and four students with physical disabilities (cerebral palsy) from the municipal education system of Florianópolis –SC. The students were previously selected as they needed alternatives in resources and strategies for computer and communication access. The field studies were conducted in the school year of 2010 and complemented in the beginning of 2011. Systematically, after the data collected during the assessment sessions with the students and teachers, the analyses and evaluation of the data were done and flowcharts were proposed as a guide to consider the trials and implementation of computer access resources. Finally, the flowcharts proposed resulted in a useful tool to support teachers and members of interdisciplinary teams in the assessment processes. This way, teachers, health care providers, designers, engineers, together with the users as protagonists, can go through an efficient assessment process in assistive technology for the computer and alternative communication access as well as the development of new products and inclusive resources.

Spinal muscular atrophy (SMA) is a hereditary disease characterized by progressive loss of -motoneurons of the spinal front corners, the consequence of which atrofizaci of muscles occurs. As a result, children become disabled and infirm dependent on the help and care of others at an early age. This is a relatively rare disease, the prevalence is about 1: 6,000 children. Spinal muscular atrophy is divided into 4 types according to its severity and time of onset of symptoms. Despite significant longtime research, it has failed to find a drug that could cure this disease so far. To the present date, there are only methods that slow the progression. The survey also contained 4 research questions, namely: What are the principles of treating a child with spinal muscular atrophy ? What are the most common problems in the care of a child with spinal muscular atrophy ? Are parents adequately educated on the issue of child with spinal muscular atrophy ? What impact has the presence of a child with spinal muscular atrophy in his family? Qualitative research was used in the implementation of the empirical part . Two qualitative methods were used to collect the data, a semi-structured interview and a hidden observation of the participant . Interviews were conducted with 3 research files, with 11 general nurses from the České Budejovice Hospital and University Hospital Motol, 7 mothers of children with I and II. type SMA of a summer camp for children with SMA and with 5 personal assistants. This thesis should help nurses and the public to gain awareness of the disease of Spinal Muscular Atrophy. It refers to all aspects of care of such a sick child, with which their parents daily struggle. Caring for a child with SMA is very difficult for their caregivers and requires considerable restrictions for the whole family. Information observed during the research were presented at a seminar for nurses in the České Budejovice Hospital in January 2015.

O acesso às tecnologias de informação e comunicação tem impactado significativamente a forma como as pessoas se relacionam com o mundo. Essas mudanças afetam a realização de atividades do dia-a-dia, as relações humanas, o trabalho e a aprendizagem. Para as pessoas com deficiência física, o desenvolvimento dos recursos de tecnologia tem possibilitado maneiras de interagir, de se comunicar e de participar em contextos diversos superando as barreiras impostas pelas suas limitações e pelo meio. A vigência de políticas públicas e de ações concretas em prol da inclusão contempla a diversidade humana e o direito de acesso à tecnologia para a comunicação, aprendizagem e trabalho para os cidadãos com deficiência. Para a efetivação da participação e aprendizagem dos alunos com deficiência nas escolas públicas brasileiras são disponibilizados os serviços do Atendimento Educacional Especializado (AEE) com vistas à eliminação de barreiras para o acesso à construção do conhecimento. É através da tecnologia assistiva apropriada que esses alunos poderão desenvolver suas competências possibilitando maior autonomia e independência na vida social de acordo com suas necessidades e interesses. Desta forma, este trabalho teve como foco principal a proposição de uma metodologia para avaliação em acessibilidade ao computador e à comunicação alternativa para alunos com deficiência física. Para tanto, utilizou-se do design de recursos e estratégias em Tecnologia Assistiva com apoio de produtos assistivos envolvendo um conjunto de recursos para acessibilidade ao computador e a comunicação alternativa. No cenário de estudo buscou-se o desenvolvimento da pesquisa-ação envolvendo a participação dos professores do AEE e de quatro alunos com deficiência física (paralisia cerebral) da rede municipal de educação de Florianópolis - SC. Os quatro alunos foram previamente selecionados por necessitarem de alternativas em recursos e estratégias para o acesso ao computador e à comunicação. Fizeram-se estudos de campo no ano letivo de 2010, e complementos no início de 2011. Sistematicamente, após os dados coletados durante as sessões com os alunos e professores, fez-se a análise e avaliação dos mesmos, e foram propostos fluxogramas para orientar na experimentação e implementação dos recursos de acesso ao computador. Finalmente, a construção de fluxogramas que orientam o processo de avaliação resultou em uma ferramenta útil de apoio aos professores e demais profissionais de equipes interdisciplinares. Assim, estas equipes formadas por educadores, profissionais da saúde, designers, engenheiros, e tendo os usuários como protagonistas, poderão realizar um processo de avaliação eficaz para seleção da tecnologia assistiva para o acesso ao computador e à comunicação alternativa, bem como o desenvolvimento de novos produtos e recursos inclusivos. / The access to information and communication technology has impacted the way people relate to the world. These changes affect the accomplishment of daily routine activities, human relationships, work and learning. For the people with physical disabilities, the development of technology resources has enabled them to interact, to communicate and to participate in different contexts overcoming the barriers set by the limitations and the environment. The present policies and actions towards inclusion consider the human diversity and the rights to access technology for communication, learning and work, by the citizens with disabilities. For the effectiveness of participation and learning approaches of students with disabilities in the Brazilian public schools, there are specialized educational services available. One of the objectives of these services is to eliminate the barriers for knowledge access. Providing the appropriate assistive technology, these students can develop their competences enabling them to achieve a greater autonomy and independence in social life according to their needs and interests. The main focus of this research is to propose a methodology for the assessment of computer and alternative communication access for students with physical disabilities. To do so, the design of resources and strategies in assistive technology was considered involving a collection of resources for the accessibility to the computer and communication. In the research scenario, an action-research was developed, which involved the participation of the specialized educational service teachers and four students with physical disabilities (cerebral palsy) from the municipal education system of Florianópolis –SC. The students were previously selected as they needed alternatives in resources and strategies for computer and communication access. The field studies were conducted in the school year of 2010 and complemented in the beginning of 2011. Systematically, after the data collected during the assessment sessions with the students and teachers, the analyses and evaluation of the data were done and flowcharts were proposed as a guide to consider the trials and implementation of computer access resources. Finally, the flowcharts proposed resulted in a useful tool to support teachers and members of interdisciplinary teams in the assessment processes. This way, teachers, health care providers, designers, engineers, together with the users as protagonists, can go through an efficient assessment process in assistive technology for the computer and alternative communication access as well as the development of new products and inclusive resources.

Submitted by Mariam Magnavita (mariamhusein@hotmail.com) on 2018-03-22T17:46:49Z No. of bitstreams: 1 disst_mariam (1).pdf: 2119380 bytes, checksum: 2e8cd3fe1d01776ae2a701375db5f10c (MD5) / Approved for entry into archive by Maria Auxiliadora da Silva Lopes (silopes@ufba.br) on 2018-03-26T17:37:03Z (GMT) No. of bitstreams: 1 disst_mariam (1).pdf: 2119380 bytes, checksum: 2e8cd3fe1d01776ae2a701375db5f10c (MD5) / Made available in DSpace on 2018-03-26T17:37:03Z (GMT). No. of bitstreams: 1 disst_mariam (1).pdf: 2119380 bytes, checksum: 2e8cd3fe1d01776ae2a701375db5f10c (MD5) / A inclusão escolar de alunos com deficiência é um dos elementos chave da atual política de educação inclusiva brasileira, assim, é cada vez maior o número desses alunos na escola regular. Entretanto, muitas vezes, a escola não dispõe dos meios adequados para oferecer a esse alunado uma educação de qualidade. É neste con-texto que alunos com osteogênese imperfeita (OI) são incluídos na escola regular. A OI é uma doença rara que tem como principal característica a fragilidade óssea. Alunos com esta patologia desenvolvem deficiência física, necessitam de cuidados constantes para evitar a ocorrência de fraturas e de tratamento médico regular, o que os afastam da escola periodicamente, podendo passar longos meses sem fre-quentar as aulas para tratar das fraturas recorrentes ou de complicações da doença. Assim, estudantes com OI necessitam dos recursos e apoios oferecidos pela Educa-ção Especial. Diante disso, este estudo teve como objetivo precípuo analisar o pro-cesso de inclusão escolar de alunos com OI que realizam o tratamento para a doen-ça em um hospital universitário localizado no município de Salvador, no Estado da Bahia. Para tanto, foi empreendida uma pesquisa de caráter qualitativo constituída de um estudo de caso realizado com 5 adolescentes com OI e suas mães, totalizan-do 10 participantes de pesquisa. Para coletar os dados foram utilizados 3 instrumen-tos: a entrevista estruturada, a entrevista semiestrururada e a análise documental. A análise dos dados foi realizada segundo o método de análise de conteúdo descrito por Bardin (2011). Os resultados revelaram que os alunos com osteogênese imper-feita não encontram na escola regular todas as condições necessárias para sua ple-na participação nas atividades de ensino-aprendizagem, pois há falta de acessibili-dade nas escolas desses estudantes, assim como existem barreiras pedagógicas e atitudinais que interferem em seu processo de inclusão escolar. A pesquisa revelou, ainda, que as iniciativas das escolas para diminuir as consequências das interrup-ções na frequência escolar desses educandos ou não existem ou se mostram insuficientes para contribuir de maneira efetiva para seu retorno à escola. / ABSTRACT The school inclusion of students with disabilities is one of the key elements of the current policy of inclusive Brazilian education, thus, the number of these students in the regular school is increasing. However, it is common that the school does not have the appropriate means to offer this student a quality education. It is in this con-text that students with osteogenesis imperfecta (OI) are included in the regular school. The OI is a rare disease that has bone fragility as its main characteristic. Stu-dents with this pathology develop a physical deficiency in a progressive way, they need constant care to avoid the occurrence of fractures and periodic medical treat-ment, which deviate them from school periodically, and they can spend many months without attending classes to treat recurrent fractures or complications of the disease. Thus students with osteogenesis imperfecta need the resources and support offered by Special Education. Therefore, this study aimed to analyze the process of school inclusion of students with OI who makes the treatment for the disease in a university hospital located in Salvador city, State of Bahia. For that, a qualitative research was carried out, constituted in a case study carried out with 5 adolescents with OI and their mothers, totaling 10 research participants. Three instruments were used to col-lect the data, the structured interview, the semi-structured interview and the docu-mentary analysis. Data analysis was performed according to the content analysis method described by Bardin (2011). The results showed that students with osteo-genesis imperfecta do not find in the regular school all the necessary conditions for their full participation in teaching-learning activities, since there is a lack of accessibil-ity in the schools of these students, as well as there are pedagogical and attitudinal barriers that interfere in their process of school inclusion. The research also revealed that the initiatives of schools to reduce the consequences of interruptions in the school attendance of these students do not exist or are insufficient to contribute ef-fectively to their return to school.

L'objectif de cette étude ethnographique est d'analyser la subjectivation des adultes atteints d´un handicap cérébral moteur et de dépendance physique à partir des stratégies quotidiennes conduisant à l´autonomie. Les résultats montrent trois éléments liés à l´action autonomisante :(1) le processus d'infantilisation : qui fonctionne comme un « modeleur » de la subjectivité. L´autonomie sera, alors, le résultat de la dynamique entre la résistance des sujets aux effets de l'infantilisation ; (2) la dépendance physique et les soins : un élément qui pose problème au projet d'autonomie en tant que détachement de l'autre. Le soin demandé par le corps abimé met en cause l'idéal d'autonomie comme auto- suffisance, ce qui exige une analyse qui prend en compte les deux pôles de la relation (soignant-soigné) ; (3) l'action autonomisante et l´invention de soi : l'autonomie est liée à des processus subjectifs et ne peut être vue qu´à travers les mouvements quotidiens d´auto-production qui ont lieu dans les rapports à l'autre et dans le monde culturel. L'accent est mis sur les stratégies (les actions, les interactions, les réactions) qui permettent aux personnes handicapées de s'inventer de façon originale et unique. L'hypothèse centrale est que le désir, plutôt que la raison, a un rôle central dans la quête de l'autonomie. / The objective of this ethnographic study is to analyze the subjectivation process of adults with cerebral palsy and physical dependence in everyday strategies for gaining autonomy. The results show three elements in the characterization of autonomy for physically dependents individuals:(1) the process of infantilization: which acts as a molder for subjectivity. Autonomy is, thus, the result from the dynamic range between resistance and submission on the effects of infantilization;(2) physical dependence and care: this is a problem-solving element of the project of autonomy. The demanded care puts into question the ideal of autonomy as self-sufficiency and requires an analysis that takes into account the two poles of the relation (caregiver – care recipient), (3) the automizating action and the invention of the self: autonomy is related to subjectivation process and as such can only be captured by means of daily movements of self-production which takes place into intersubjectivity. The emphasis is on strategies (actions, interactions, and reactions) used by individuals with disabilities to resist to the circumscription of the self and to invent an original and unique way of life. The central hypothesis is that the desire (rather than reason) has a central role in the quest for autonomy. / Nas últimas décadas, observa-se um deslocamento dos discursos médicos em direção a uma concepção sócio-construcionista sobre as pessoas com deficiência, o que tem animado os debates a respeito da autonomia e a inserção social desse grupo. No entanto, a dualidade estabelecida por essa nova abordagem entre social- biológico não parece dar conta da complexidade que o processo de autonomia assume na vida desses sujeitos e não se sustenta sob a luz das teorias aportadas pelo pensamento pós-estruturalista. Assim, a partir da crítica ao racionalismo e ao individualismo moderno – levantada pelas reflexões feministas sobre cuidado – a contribuição da fenomenologia e das filosofias da diferença, a presente tese propõe uma análise da relação entre dependência, deficiência e autonomia de modo a considerar os elementos frequentemente descarados nos discursos militantes sobre o tema. O objetivo do trabalho consiste em analisar o processo de subjetivação de adultos com paralisia cerebral e dependência física a partir das estratégias cotidianas de conquista da autonomia. A pesquisa de campo teve duração de 14 meses, ao longo dos quais foi realizada observação participante sobre a vida cotidiana de dois indivíduos adultos com paralisia cerebral e dependência física. Entrevistas semidiretivas foram desenvolvidas com os familiares e os sujeitos com deficiência de modo a reconstituir a trajetória pessoal de cada um deles. Os resultados apontam três elementos que se articulam no fazer-autônomo dos sujeitos sob dependência física: (1) o processo de infantilização – que funciona como uma espécie de força de formatação e reificação da subjetivação desses indivíduos. A autonomia resultaria da dinâmica entre a resistência à infantilização e os efeitos desta na vida dos sujeitos com deficiência. São descritos na tese três pontos que constituem a infantilização: o argumento da vulnerabilidade como explicação para a necessidade de controle e cerceamento, a negação da sexualidade e da desejabilidade do corpo deficiente e a afirmação da razão como meio de ascensão à vida adulta; (2) dependência física e cuidado – trata-se de um elemento problematizador do projeto de autonomia como desvinculação do outro e que não pode ser descartado na compreensão deste fenômeno. O cuidado demandado pelo corpo dependente coloca em xeque o ideal de autonomia como autossuficiência presente na concepção de indivíduo moderno e exige uma análise que leve em consideração os dois polos da relação (cuidador – pessoa sob cuidado); (3) ação automizadora e invenção de si – a autonomia está intrinsecamente relacionada com os processos de subjetivação e, como tal, só pode ser percebida a partir dos movimentos cotidianos de autoprodução na relação com o outro e com o mundo. A ênfase é dada nas estratégias (ações, interações, reações) utilizadas pelos indivíduos com deficiência para resistir à circunscrição da subjetividade e para inventarem a si mesmos de modo original e singular. A hipótese central é de que o desejo (tanto quanto a razão) tem um papel determinante na busca pela autonomia. Tornar-se adulto (logo, autônomo) para as pessoas com deficiência física grave não significa necessariamente assumir a rigidez e a retidão comumente associada a essa fase da vida. Mas guiar-se pelo devir-criança e pelo prazer de experimentar a diferença a partir da multiplicidade que abriga o conceito de deficiência.

This study was aimed to explore challenges of students with disabilities in higher education institutions in Namibia, as narrated and illustrated by themselves. Mixed methodologies, with specific reference to a small-scale quantitative survey and extensive qualitative design were employed as tools to understand the prevalence, extent and nature of challenges of students with disabilities in their pursuance of higher education in Namibia. Data was thus collected in two phases. The first phase consisted of a ten-item quantitative-survey which was largely used to determine the prevalence of students with disabilities in higher education institutions, and basic information regarding institutional standpoints pertaining to students with disabilities. Data acquired through this survey confirmed the prevalence of students with disabilities in Namibian higher education institutions. The second phase represented the qualitative design whereby data was collected through three main methodologies namely a narrative diary-based approach, a photo-voice and individual interviews. These methodologies ensured reliability of the data through triangulation. The study confirmed that inclusive education at the higher education level in Namibia was largely achieved through the goal of access, as all higher education institutions have admitted students with observable as well as hidden disabilities. However, a major finding of the study was that support and provision for students with disabilities was rendered in fragmented portions within and across institutions, and that the goals of equity and equality have not yet been achieved to the desired degree, if inclusive education was to become a reality for students with disabilities in higher education in Namibia. Students reported challenges related to physical accessibility of institutions; unavailability of educational material in alternative, as opposed to traditional formats; lack of sensitivity and skills of staff; as well as lack of structured support systems. The study also revealed that, notwithstanding the challenges students faced in their institutions, students with disabilities continued to perform their academic duties to the best of their abilities and were driven by their individual personal philosophies, many of which spoke of perseverance and courage, to make a success of their studies. / D. Ed. (Inclusive Education) / Language Education Arts and Culture

Submitted by Valquíria Barbieri (kikibarbi@hotmail.com) on 2017-09-05T21:36:20Z No. of bitstreams: 1 DISS_2014_Leticia Gomes Costa.pdf: 1248977 bytes, checksum: 3433ac22c60edee4d30d0ba5a8080fb3 (MD5) / Approved for entry into archive by Jordan (jordanbiblio@gmail.com) on 2017-09-12T13:22:14Z (GMT) No. of bitstreams: 1 DISS_2014_Leticia Gomes Costa.pdf: 1248977 bytes, checksum: 3433ac22c60edee4d30d0ba5a8080fb3 (MD5) / Made available in DSpace on 2017-09-12T13:22:14Z (GMT). No. of bitstreams: 1 DISS_2014_Leticia Gomes Costa.pdf: 1248977 bytes, checksum: 3433ac22c60edee4d30d0ba5a8080fb3 (MD5) Previous issue date: 2014-03-12 / CAPES / Hanseníase constitui relevante problema de saúde pública, devido a sua magnitude, e seu alto potencial incapacitante. Objetivo: Analisar os fatores associados à piora das incapacidades físicas durante o tratamento dos casos novos de hanseníase diagnosticados no Brasil em 2009. Método: Estudo de corte transversal sobre os fatores associados à piora do grau de incapacidade física durante o tratamento de coortes de casos de hanseníase PB e MB. Os dados foram provenientes do Sistema de Informação de Agravos de Notificação Nacional (SINAN). Realizou-se análise descritiva das variáveis e comparação das proporções de piora e não piora do grau de incapacidade por meio do teste qui-quadrado ao nível de 5%. Para analisar as variáveis associadas à piora do grau do GIF foi utilizada regressão logística para verificar a razão de chances (odds ratio), com intervalo de confiança de 95%. Resultados: Dentre as regiões brasileiras, os pacientes da região Sul foram os que apresentaram a maior chance de piora do grau de incapacidade física (ORaj = 2,19; IC: 1,85 – 2,58), em seguida estão os casos da região Sudeste com 1,53 vezes a chanceaj de piora (IC: 1,36 – 1,73), ambos comparados aos da região Norte. Também apresentaram chance de piora, os casos multibacilares de 3,09 vezes (IC: 2,82 – 3,39) o sexo masculino de 1,27 vezes (IC: 1,17 – 1,37). Os idosos e adultos quando comparados às crianças apresentaram 2,67 e 1,95 vezes a chanceaj de piora (IC: 2,13 – 3,34; 1,58 – 2,40 respectivamente), e os casos que apresentaram episódios reacionais tiveram 2,42 vezes maior chance de piora (IC: 2,22 – 2,64). Conclusão: Os fatores associados à piora do grau de incapacidade física durante o tratamento é composto pelos pacientes residentes nas regiões Sul e Sudeste, os casos do sexo masculino, os multibacilares, os que apresentaram episódios reacionais, idosos e adultos, os casos irregulares, bem como aqueles com baixa escolaridade. / Leprosy is a relevant public health problem due to its magnitude, and high disabling potential. Objective: To analyze factors associated with worsening physical disability grade during treatment of newly diagnosed cases of leprosy in Brazil in 2009. Methods: Cross-sectional study about associated factors of worsening physical disability grade during the treatment of PB and MB cohort leprosy cases. Data were collected from the National Reportable Diseases Database (SINAN). It was applied descriptive analysis of the variables and chi–square test at 5% level to compare proportions of worsening and not worsening of the disability grade. To analyze the variables associated with the worsening disability grade, logistic regression was used to determine the odds ratio (OR), with a confidence interval of 95%. Results: Among the Brazilian regions, patients in the Southern region were those with the greatest odds of worsening the physical disability grade (OR = 2.19; CI: 1.85 - 2.58), following were the Southeast cases with odds of 1.53 (CI: 1.36 to 1.73 ), both compared to the North region patients. Multibacillary presented odds ratioadj of 3.09 (CI: 2.83 - 3.40) and male cases of 1.27 (CI: 1.17 - 1,37) to worse. Seniors and adults compared to children had odds of 2.67 and 1.95 of worsening (CI: 2.13-3.34; 1.58-2.40 respectively), and the reactional cases had odds of 2.35 to worse (CI: 2.15 - 2:56). Conclusion: The factors associated with worsening physical disability grade during the treatment are composed by the patients residents in the South and Southeast regions, male cases, multibacillary, those that presented reactional episodes, seniors and adults, irregular cases as well as those with low scholarity.