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Aspectos clinicos e psicossociais de pacientes em pÃs-alta de HansenÃase no municipio de Fortaleza-CE. / PHYSICAL DISABILITY, AND LIMITATION OF ACTIVITY SOCIAL PARTICIPATION IN PERSON AT THE MOMENT AFTER HIGH LEPROSY IN FORTALEZA-CEJorgiana de Oliveira Mangueira 03 December 2009 (has links)
FundaÃÃo Cearense de Apoio ao Desenvolvimento Cientifico e TecnolÃgico / Caracterizar as incapacidades fÃsicas, a limitaÃÃo de atividade e restriÃÃo da participaÃÃo social de pessoas no momento pÃs-alta de hansenÃase diagnosticadas no perÃodo de 2004-2006 no MunicÃpio de Fortaleza/CE. METODOLOGIA. Estudo transversal realizado em unidades bÃsicas de saÃde da Secretaria Executiva Regional III, no perÃodo de agosto de 2008 a maio de 2009. Foram avaliados 45 pacientes em pÃs-alta de hansenÃase. Realizou-se avaliaÃÃo simplificada das funÃÃes neurais. AlÃm disso, foram aplicados a escala Triagem para LimitaÃÃo de Atividade e ConsciÃncia de Risco (âSALSAâ) e a escala de ParticipaÃÃo Social. RESULTADOS. A populaÃÃo do estudo foi composta em sua maioria por mulheres (60%), com idade mÃdia de 53,5 anos. Os participantes, em sua maioria, eram multibacilares (55,6%). Constatou-se um aumento de pacientes com graus 1 e 2 na atualidade, comparado com o momento da alta da poliquimioterapia. 60% dos pacientes apresentaram escore EHF (eye, hand, foot) 0. A maioria (84,4%) dos pacientes nÃo apresentou restriÃÃo à participaÃÃo social, 66,6% nÃo apresentaram limitaÃÃo funcional, mas 75,5% exibiram consciÃncia de risco 0. Houve correlaÃÃes significativamente positivas entre os escores SALSA e EHF (p=0,0254; rho=0,3330), SALSA e ParticipaÃÃo Social (p=0,0004; rho=0,5056) e ParticipaÃÃo Social e EHF (p=0,0100; 0,3800). CONCLUSÃES. Existe necessidade da continuidade da assistÃncia visando à integralidade da atenÃÃo, de forma a assegurar aÃÃes preventivas, curativas e de reabilitaÃÃo. O perÃodo pÃs-alta da doenÃa necessita de cuidados e acompanhamento dos pacientes, em razÃo do risco do desenvolvimento de reaÃÃes, incapacidades fÃsicas e restriÃÃo à participaÃÃo social dos indivÃduos. / To describe clinical and psychosocial aspects of leprosy patients after release from treatment, who were diagnosed from 2004-2006 in the city of Fortaleza (Cearà State, Brazil); to describe in these patients activity limitation, safety awareness and social participation. METHODS. A cross-sectional study was carried out in primary health care centers of Fortaleza, from August 2008 to May 2009. Forty-five patients after release from treatment were included. A structured questionnaire was applied, and neural functions of peripheral nerves were assessed. In addition, the Screening of Activity Limitation and Safety Awareness (SALSA) and the Social Participation scale were applied. RESULTS. The majority of the study population consisted of females (60%), with a mean age of 53,5 years, mainly of underprivileged socio-cultural status. 55,6% were classified as multibacillary. We observed an increase of disability grading 1 and 2, as compared to the date of release from treatment with multidrug therapy. Sixty % of the patients presented with an EHF score of 0. The majority (84,4%) did not show any restriction of social participation, 66,6% did not have any functional limitation, and 75,5% did not present any safety awareness. There was a positive correlation between SALSA and EHF scores (p=0,0254; rho=0,3330), SALSA and Social Participation (p=0,0004; rho=0,5056), and Social Participation and EHF score (p=0,0100; rho=0,3800). CONCLUSIONS. Considering the fact that a considerable part of patients presented with sequels and light functional limitations, and that few had low safety awareness, we conclude that patients need special attention after release from multidrug therapy. Health education activities should be intensified, as the majority of patients, even after treatment, had limited knowledge about the disease and as a considerable part suffered from discrimination.
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