Orientador: Maria Ines Rubo de Souza Nobre / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-21T06:28:15Z (GMT). No. of bitstreams: 1 Zimmermann_AnaBeatriz_M.pdf: 1435162 bytes, checksum: b4c9ce47e60113462690e7d8723f2d96 (MD5) Previous issue date: 2012 / Resumo: A Medida Canadense de Desempenho Ocupacional (COPM) foi criada para favorecer uma prática centrada no cliente, tendo como foco a autopercepção da pessoa sobre seu desempenho ocupacional. Avaliações padronizadas são cada vez mais utilizadas no âmbito da reabilitação, no entanto, a maioria dos instrumentos buscam favorecer a independência em atividades pré-estabelecidas, baseadas no que é esperado pela sociedade, podendo não contemplar necessidades individuais dos clientes. Atividades e Participação são aspectos centrais da Terapia Ocupacional e os terapeutas ocupacionais reconhecem que o envolvimento e o desempenho ocupacional contribuem e apoiam à saúde. O modelo proposto na Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF), em 2001, reconhece a influência das atividades e participação, assim como dos fatores contextuais e funções e estruturas do corpo na condição de saúde. Tem-se por objetivo verificar a autopercepção do desempenho ocupacional por meio da COPM em usuários adultos e idosos de um centro de reabilitação no estado do Paraná e classificar os problemas de desempenho ocupacional segundo a CIF. Realizou-se um estudo descritivo com usuários acometidos por lesão medular ou lesão encefálica adquirida em processo de reabilitação entre o período de agosto/2010 a fevereiro /2011. A COPM foi aplicada por meio de entrevista semiestruturada e os problemas de desempenho ocupacional identificados pelos 28 usuários foram classificados segundo a CIF. Entre os 122 problemas classificados, houve maior frequência nos seguintes domínios do componente Atividade e Participação: Mobilidade (36%), Vida Comunitária Social e Cívico (24%) e Cuidado Pessoal (15%). Sugere-se que dificuldades relacionadas a Vida Comunitária, Social e Cívica são mais frequentes dependendo do tempo de lesão e do contexto de tratamento. Percebe-se a abrangência e variedade de problemas identificados por meio da COPM pode colaborar no processo de reabilitação com o estabelecimento de objetivos mais congruentes às demandas e experiências de vida diária dos clientes. Tem-se o desafio de se construir e conduzir práticas de saúde na área de reabilitação à pessoa com deficiência em conjunto com outros setores, ampliando nosso olhar de forma a contemplar as várias dimensões da funcionalidade humana. A classificação dos problemas de desempenho ocupacional de acordo com a CIF pode favorecer a comparação entre estudos que utilizam diferentes instrumentos de avaliação e que por vezes possuem terminologias distintas. Por outro lado, há desafios no processo de codificação no tocante a utilização de categorias abrangentes e inespecíficas para atividades e situações não tão comuns, pois permite interpretações variadas entre os usuários da CIF / Abstract: In the context of rehabilitation, standardized assessments are being more utilized in order to evaluate the impact of the impairment on the individual's daily routine. Most of the assessment instruments focus on favoring the independence on predefined activities, based on what is expected by society, and may not be meeting the client's individual needs. The COPM was created to facilitate a client-centered practice, allowing the client to identify his/her own limitations and restrictions lived on the occupational performance. The model proposed on CIF (International Classification of Functionality, Impairment and Health) in 2001 states that environmental and personal factors, activities and participation, body functions and structures, and health conditions are in dynamic interaction, so that any modifications in one of these components have the potential of generating changes on the others. Activity and participation are core aspects of occupational therapy. Occupational therapists recognize that the involvement and occupational performance contributes and promotes health. One of the goals is to verify self-perception of the occupational performance through COPM on adults and elderly from a rehabilitation center in the state of Paraná and classify the problems of occupational performance in CIF. A descriptive study was performed on users stricken by spinal cord injury or brain injury, obtained during the rehabilitation process between August of 2010 and February of 2011. COPM was applied through semi-structured interviews and the problems of occupational performance identified by 28 participants were classified in CIF. Among the 122 problems of occupational performance classified in CIF, there was a greater frequency on the following domains of the Activity and Participation component: Mobility (36%), Community, Social and Civic Life (24%) and Personal Care (15%). It is suggested that the difficulties related to Community, Social and Civic Life are more frequent depending on the time of injury and on the treatment context. It is noticed that the scope and variety of problems identified through COPM can collaborate in the process of rehabilitation, with the setting of objectives that are more congruent with the demands and experiences of the clients' daily lives. There is a challenge of building and conducting health practices on the area of rehabilitation to the person with disability along with other sectors, expanding our view in order to contemplate the various dimensions of human functionality. The classification of occupational performance problems in CIF can favor the comparison between studies that utilize different evaluation instruments and that sometimes have distinct terminologies. On the other hand, there are challenges related to the selection of codes: comprehensive and non-specific items can facilitate the classification of uncommon and unlikely elements, but at the same time can generate semantic accumulations and increase disagreements on the choice made by the evaluators / Mestrado / Interdisciplinaridade e Reabilitação / Mestra em Saúde, Interdisciplinaridade e Reabilitação

Background: The International Classification of Function, Disability and Health (ICF) describes health using 1424 categories from 4 components: body functions (BF), body structures (BS), activities and participation (AP) and contextual factors (environmental (EF) and personal (PF)). In this study the ICF was used to describe and compare aspects of ANCA-Associated Vasculitis (AAV) measured in clinical trials and those important to clinicians and patients. Methods: Individual interviews and focus groups were used to capture the perspective of AAV patients. Clinicians’ perspective was obtained with an email-based questionnaire. Outcomes used in AAV randomized trials were extracted from results of a systematic review of literature. Identified concepts were mapped to the ICF according to previously published ICF linking rules, and the resulting lists of relevant AAV outcomes were compared descriptively. Results: Twelve individual interviews and 2 focus groups represented the patient perspective while responses from 27 clinicians yielded the clinicians’ perspective. Systematic literature review identified 67 clinical trials and 28 abstracts from which measured outcomes were extracted. All three perspectives demonstrated detailed coverage of ICF components BF and BS. In the component AP patients and clinicians identified similar ICF categories, a number of which were under-sampled by AAV trials. Contextual factors appear to be significantly more relevant to patients than clinicians and researchers. Conclusion: Patients and clinicians have different views of the relevance of various AAV outcomes, and these views differ from what is measured in clinical trials of AAV. This highlights the need for a broad and standardized approach to developing and selecting outcomes for complex medical conditions such as AAV.

Purpose: In the absence of a gold standard, this study illustrates the process involved in the cross-cultural translation and adaptation of the FOCUS© and its shortened version, FOCUS-34© (the Parent Form and Instruction Sheet, as well as the Clinician Form and Instruction Sheet), while also determining the social validity and clinical applicability of the translated measure. The target language used as example was Afrikaans, one of the 11 official languages of South Africa. Method: A two-phase cross-cultural translation model was employed in which Phase 1 (comprising a six-step blind back-translation procedure) was sequentially followed by Phase 2 (social validation and clinical applicability of the measure, using focus groups with stakeholders). Result: The extensive process followed in Phase 1 resulted in a clear and appropriate translation acceptable to both stakeholder groups (parents and speech-language pathologists). Both groups questioned the meaning of certain concepts, explored cultural differences and requested the extension of some items. Parents also shared their emotional reactions towards assessment, while therapists focussed on editorial changes to the measures. Conclusion: A framework is proposed for cross-cultural translation and adaptation of assessment measures with suitability in the speech-language pathology discipline.

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Children and adolescents with cerebral palsy (CP) often receive botulinum toxin (BoNT-A) to manage spasticity. Our 2014 study developed an inventory of parents’ goals for BoNT-A treatment, but reasons for selecting these goals were unclear. The current study aimed to describe and categorize the effects of BoNT-A that parents observed according to WHO’s International Classification of Functioning, Disability and Health (ICF) framework. This qualitative study used interpretive description. Fifteen parents of non-ambulatory young people with CP (mean age 10.2 years, SD 3.9, 7 males) who received BoNT-A were recruited through McMaster Children’s Hospital’s Spasticity Management Clinic. Interviews were conducted in-person or by telephone for 20-60 minutes. The research team read the initial transcript, identified codes, and finalized the coding framework. Member checking was conducted to enhance trustworthiness. The key theme was that parents needed to find the right path to do what is best for their child. Parents described how they learned about both positive and negative effects of BoNT-A treatment: some parents emphasized the child’s pain during BoNT-A injections (negative), but also felt that BoNT-A was helpful for their child (positive). Most effects of BoNT-A were coded at the ICF activity level, such as dressing These observations helped inform parents’ decision to continue with BoNT-A and identify future goals. This study provides insight into parents’ journey of learning about BoNT-A and goal-setting for their child. Parents’ perspectives will be used to refine the 2014 inventory of goals to facilitate collaborative goal-setting for BoNT-A treatment. / Thesis / Master of Science (MSc) / Children diagnosed with cerebral palsy (CP) receive botulinum toxin (BoNT-A) as a treatment to reduce muscle tone. Current research on the use of BoNT-A injections in non-ambulatory children with CP is scarce and may not incorporate the perspectives of the family about their goals for treatment. This study interviewed parents to ask about the effects that they observed in their child after BoNT-A treatment. Fifteen parents were interviewed and all parents spoke about their journey of “finding the right path to do what is best for my child” as they learned about the possible effects of BoNT-A treatment for their child. By learning about parents’ journey, informational resources can be developed and shared with other parents about the effects of BoNT-A treatment. It is important to help parents understand these effects, which would allow them to discuss and identify appropriate goals with healthcare professionals in future BoNT-A treatment sessions.

Background: Individuals with neurodevelopmental disorders are unemployed or underemployed at staggering rates. Employment for this population is impacted by many factors, including contextual issues. This review was conducted to enhance understanding of contextual factors influencing employment procurement for individuals with neurodevelopmental disorders. Methodology: The Arksey and O’Malley scoping review framework was utilized to examine five databases and sources of grey literature regarding the contextual factors influencing employment procurement for individuals with neurodevelopmental disorders. Articles were analyzed using the International Classification of Functioning, Disability and Health criteria for Contextual Factors, including both Environmental and Personal Factors. Results: The findings from 41 articles indicate that Contextual Factors, Environmental Factors and Personal Factors influence employment procurement by creating both barriers and facilitators to obtaining employment for individuals with neurodevelopmental disorders. Conclusion: A focus on contextual factors that impact individuals with neurodevelopmental disorders may provide further insight into the facilitators and barriers influencing employment outcomes. Further research should aim to understand the strength of relationships and to expand the use and application of the International Classification of Functioning, Disability and Health’s biopsychosocial framework. This research can aid in promoting the employment outcomes for individuals with neurodevelopmental disorders. / Thesis / Master of Science (MSc)

yes / Purpose: This paper discusses the experiences of a group of ten user and carer researchers from mental health and learning disability services who worked together in a research and evaluation project between 2009 and 2012. The research project aimed to identify changes that took place as over 300 people moved from hostel accommodation into independent tenancies in flats and bungalows. These moves were part of a three year project involving a partnership between a local authority and a housing association. Design / approach: The paper describes the process of involving user and carers in the research process, identifying the challenges and benefits of involving users and carers. The ways in which people were trained and supported to take part and stay involved are outlined, as well as how the group felt they learnt new skills and increased their confidence. Findings: User involvement in research can mean different things with different levels of involvement, from consultation through to user-controlled research. The collaborative study had a range of benefits for the lives of the co-researchers, as well as contributing to the development of a new independent living service. A number of factors contribute to the success of user involvement in research and these are listed. Originality / value: This paper adds the voices of the co-researchers to the literature and provides ‘lessons learned’ for other researchers in this area.

Background: Physical activity questionnaires (PAQ) have been extensively used to determine physical activity (PA) levels. Most PAQ are derived from an energy expenditure-based perspective and assess activities with a certain intensity level. Activities with a moderate or vigorous intensity level are predominantly used to determine a person’s PA level in terms of quantity. Studies show that the time spent engaging in moderate and vigorous intensity PA does not appropriately reflect the actual PA behavior of older people because they perform more functional, everyday activities. Those functional activities are more likely to be considered low-intense and represent an important qualitative health-promoting activity. For the elderly, functional, light intensity activities are of special interest but are assessed differently in terms of quantity and quality. The aim was to analyze the content of PAQ for the elderly.

Bendras darbo tikslas: Įvertinti asmenų, patyrusių trauminį galvos smegenų pažeidimą, pažintinių funkcijų ir savarankiškumo sutrikimus ūmiu ligos periodu, panaudojant specializuotus vertinimo metodus bei Tarptautinę funkcionavimo, negalumo, ir sveikatos klasifikaciją. 1. Potemės „Pažintinių funkcijų vertinimas asmenims, patyrusiems trauminį galvos smegenų pažeidimą“ uždaviniai: 1. Įvertinti pacientų, patyrusių galvos smegenų traumą, pažintinių funkcijų lygį ūmiame periode. 2. Nustatyti pacientų, patyrusių galvos smegenų traumą, pažintinių funkcijų lygį, priklausomai nuo amžiaus, galvos smegenų traumos sunkumo. 3. Įvertinti pacientų, patyrusių galvos smegenų traumą, pažintines funkcijas panaudojant Tarptautinę funkcionavimo, negalumo ir sveikatos klasifikaciją. 4. Įvertinti pacientų, patyrusių galvos smegenų traumą, pažintinių funkcijų pokytį priklausomai nuo amžiaus, galvos smegenų traumos sunkumo. 2. Potemės „Savarankiškumo vertinimas asmenims, patyrusiems trauminį galvos smegenų pažeidimą“ uždaviniai: 1. Įvertinti pacientų, patyrusių galvos smegenų traumą, savarankiškumo gebėjimus ūmiame periode. 2. Nustatyti pacientų savarankiškumo lygį, priklausomai nuo amžiaus, galvos smegenų traumos sunkumo bei pažintinių funkcijų lygio. 3. Įvertinti pacientų, patyrusių galvos smegenų traumą, savarankiškumą panaudojant Tarptautinę funkcionavimo, negalumo ir sveikatos klasifikaciją. 4. Įvertinti pacientų, patyrusių galvos smegenų traumą, savarankiškumo gebėjimų pokytį priklausomai nuo... [toliau žr. visą tekstą] / The aim of the study: Evaluation of cognitive functions and self-dependence during the period of acute disease for the persons after traumatic brain injury (TBI), using specialized methods of evaluation and International Classification of Functioning, Disability and Health. 1.Goals of sub-theme: ,,Evaluation of cognitive functions and self-dependence for the patients after traumatic brain injury (TBI). 1. Evaluate person‘s after traumatic brain injury cognitive level in acute period. 2. Determine patient‘s level of cognitive functions after traumatic brain injury, according to their age, difficulty of brain injury. 3. Evaluate patient‘s after traumatic brain injury, cognitive functions with the help of International Classification of Functioning, Disability and Health. 4. Evaluate patient‘s after traumatic brain injury change of cognitive functions according to their age, difficulty of brain injury . 2. Goals of sub-theme: „Evaluation of self-dependence for the persons after traumatic brain injury (TBI)“: 1.Evaluate person‘s abilities of self-dependence during the acute period. 2. Determine patient’s after traumatic brain injury, level of cognitive functions, according to their age, difficulty of brain injury. 3. Evaluate patient‘s after brain injury change of cognitive functions with the help of International Classification of Functioning, Disability and Health. 4. Evaluate patient‘s after traumatic brain injury change of cognitive functions, according to their age... [to full text]