Introduction: Stroke puts a burden on the society as half of the stroke survivors have long term care needs. After six months many stroke survivors cannot independently perform basic daily life activities, which makes living independently at home challenging. Stroke survivors who received occupational therapy are more independent for those activities. As more and more stroke survivors are discharged home faster, having an insight into the continued rehabilitation in the home environment is of great importance for the future. Aim: The aim of this review was to map which occupation-based interventions occupational therapists use in home-based stroke rehabilitation with the goal to improve basic activities of daily life. Methods: A scoping review was chosen to map and to summarize the research content and to identify possible research gaps. Data for this study was systematically collected by following Arksey and O’Malley’s framework. In total, six studies were obtained that met the inclusion criteria. Results: The results show that a combination of intervention strategies is used and besides Control Induced Movement Therapy the usage of activities as treatment came to the fore. Conclusion: The results lead to the conclusion that occupation-based activities are used to improve basic activities of daily life. The lack of detailed explanation of the interventions makes it difficult to implement those in daily life practice and therefore more descriptive interventions should be published to encourage evidence-based practice.

INTRODUÇÃO: O envelhecimento populacional é uma problemática para o setor saúde, que pelas suas características são mais freqüentes os processos de hospitalização, que conseqüentemente favorecem a presença de incapacidades funcionais temporais ou permanentes nos idosos, fato que não é priorizado em pacientes hospitalizados e que requer estratégias de solução visando a melhora da qualidade de vida. OBJETIVO: estudar o impacto de uma intervenção comunicativa fundamentada na concepção de Paulo Freire na capacidade funcional dos idosos, por meio de atividades básicas da vida diária (ABVD). METODOLOGIA: estudo quase-experimental em 184 pacientes, divididos em grupo controle (n=92), experimental (n=92), no hospital HGDIMP, San Luis de Potosí, México. Prévia aprovação do comitê de ética, foi aplicado o índice de Barthel por meio de entrevista para as ABVD: duas semanas antes da hospitalização, na admissão, após 48 horas da hospitalização, na alta e duas semanas depois da alta hospitalar. O instrumento \"índice de Bartel \" foi submetido a uma adaptação cultural e a uma prova piloto em 96 idosos. Foi aplicado o questionário de Pfiffer (SPMSG), validado ao espanhol, para identificar o estado cognitivo e um questionário para dados gerais e antecedentes de saúde. A intervenção comunicativa iniciou 48 horas após hospitalização e terminou duas semanas depois da alta hospitalar. Aplicaram-se estatísticas descritivas, análise multivariada de perfis, testes t de student e exato de Fisher; para tanto, foi utilizado o programa SPSS versão 13.0. RESULTADOS: A idade média dos participantes foi 70 ± 7,7 anos, 60% casados, 41,9% com ensino fundamental completo e 40,2% analfabetos.As principais causas de hospitalização foram por doenças cardiovasculares (40,2%) As co-morbidades mais freqüentes foram hipertensão arterial (49,5%) e Diabetes Mellitus (33,2%) . Antes da hospitalização 37,0% consumiam um medicamento, 25,5% consumiam dois, sendo os mais utilizados os antihipertensivos (39,1%) e hipoglicemiantes (30,4%). O nível de saúde percebido foi 50,5% para \"regular\" e 38,6% para \"bom\". Antes da hospitalização as ABVD mais afetadas foram subir e descer escadas (18,5%), tomar banho (17,4%) e todas as ABVD, de ambos os grupos apresentaram p>0,050, não apresentando diferenças significantes. Na admissão ao hospital observou-se aumento da dependência em todas as ABVD, principalmente tomar banho, vestir-se e caminhar; porém analisando as ABVD, entre os grupos controle e experimental, encontrou-se p=0,015 para caminhar e para transferência da cama para a cadeira p=0.030. Encontrou-se diferença significante entre os grupos. Após 48 de hospitalização houve recuperação das ABVD no grupo controle (media 50,1) e no grupo experimental 40,2 p=0,003; portanto, houve significância estatística. Após finalizar a intervenção, a média do grupo experimental aumentou para 90,0 e o grupo controle apresentou 67,0, p=0,001, observando-se diferenças significantes. Ao comparar os perfis médios encontrou-se p<0.001, razão pela qual conclui-se que não houve paralelismo. A média das ABVD foi maior no grupo experimental em relação ao controle. CONCLUSÕES: o presente estudo mostrou a efetividade de uma intervenção comunicativa, na melhoria da capacidade funcional em pacientes idosos hospitalizados, além de identificar fatores de risco que podem ser controlados. Considera-se que a proposta contribui na recuperação e obtenção da melhora do grau de independência dos idosos por médio de sua participação ativa. / INTRODUCTION: Population aging is a problem for the health sector. Due to its characteristics, hospitalization processes are more frequent, consequently favoring the presence of temporary or permanent disabilities in the elderly, a fact that is not prioritized in hospitalized patients and that demands solution strategies with a view to a better quality of life. OBJECTIVE: To study the impact a communication intervention based on Paulo Freire\'s conception exerts on elderly people\'s functional capacity through basic activities of daily living (ADL). METHODOLOGY: Quasi-experimental study of 184 patients, divided in a control (n=92) and experimental group (n=92), at the HGDIMP hospital in San Luis de Potosí, Mexico. After approval from the ethics committee was obtained, the Barthel index was applied to the BADL through an interview: two weeks before the hospitalization, at the time of hospitalization, after 48 hours of hospitalization, upon discharge and two weeks after discharge from hospital. The \"Barthel index\" was submitted to cultural adaptation and to a pilot test involving 96 elderly. Pfiffer\'s questionnaire was applied (SPMSG), in its version validated for Spanish, in order to identify the cognitive state, while a questionnaire was used to collect general data and health antecedents. The communication intervention started 48 hours after hospitalization and finished two weeks after discharge from hospital. Descriptive statistics and multivariate profile analyses were applied, as well as student\'s t and Fisher\'s exact test, using SPSS software version 13.0. RESULTS: The participants\' mean age was 70 ± 7.7 years, 60.0% were married, 41.9% had finished basic education and 40.2% were illiterate. The main causes of hospitalization were cardiovascular diseases (40.2%). The most frequent comorbidities were arterial hypertension (49.5%) and Diabetes Mellitus (33.2%). Before hospitalization, 37.0% used to take one and 25.5% two medications. The most frequently used drugs were antihypertensive (39.1%) and hypoglicemic agents (30.4%). The perceived health level was 50.5% for \"regular\" and 38.6% for \"good\". Before two weeks of hospitalization, the most affected BADL were climbing and moving down stairs (18.5%), bathing (17.4%) and all BADL in both groups displayed p>0.050, without significant differences. Upon hospital admission, increased dependence was observed on all BADL, mainly bathing, dressing and walking; however, when analyzing the BADL between the control and experimental groups, p=0.015 was found for walking, and p=0.030 for moving from the bed to the chair. A significant difference was found between the groups. After 48 of hospitalization, recovery of BADL was found in the control group (mean 50.1) and in the experimental group 40.2 p= 0.003; thus, statistical significance was found. After finishing the intervention, the mean of the experimental group increased to 90.0 and that of the control group to 67.0 p=0.001, observing significant differences. When comparing the mean profiles, p<0.001 was found. Therefore, it was concluded that no parallelism occurred. The mean score of BADL was higher in the experimental than in the control group. CONCLUSIONS: this study showed the efficacy of a communication intervention for the improvement of functional capacity in hospitalized elderly patients, and also identified risk factors that can be controlled. The proposal contributes to the elderly people\'s recovery and achievement of a better independence level through their active participation.

INTRODUÇÃO: O envelhecimento populacional é uma problemática para o setor saúde, que pelas suas características são mais freqüentes os processos de hospitalização, que conseqüentemente favorecem a presença de incapacidades funcionais temporais ou permanentes nos idosos, fato que não é priorizado em pacientes hospitalizados e que requer estratégias de solução visando a melhora da qualidade de vida. OBJETIVO: estudar o impacto de uma intervenção comunicativa fundamentada na concepção de Paulo Freire na capacidade funcional dos idosos, por meio de atividades básicas da vida diária (ABVD). METODOLOGIA: estudo quase-experimental em 184 pacientes, divididos em grupo controle (n=92), experimental (n=92), no hospital HGDIMP, San Luis de Potosí, México. Prévia aprovação do comitê de ética, foi aplicado o índice de Barthel por meio de entrevista para as ABVD: duas semanas antes da hospitalização, na admissão, após 48 horas da hospitalização, na alta e duas semanas depois da alta hospitalar. O instrumento \"índice de Bartel \" foi submetido a uma adaptação cultural e a uma prova piloto em 96 idosos. Foi aplicado o questionário de Pfiffer (SPMSG), validado ao espanhol, para identificar o estado cognitivo e um questionário para dados gerais e antecedentes de saúde. A intervenção comunicativa iniciou 48 horas após hospitalização e terminou duas semanas depois da alta hospitalar. Aplicaram-se estatísticas descritivas, análise multivariada de perfis, testes t de student e exato de Fisher; para tanto, foi utilizado o programa SPSS versão 13.0. RESULTADOS: A idade média dos participantes foi 70 ± 7,7 anos, 60% casados, 41,9% com ensino fundamental completo e 40,2% analfabetos.As principais causas de hospitalização foram por doenças cardiovasculares (40,2%) As co-morbidades mais freqüentes foram hipertensão arterial (49,5%) e Diabetes Mellitus (33,2%) . Antes da hospitalização 37,0% consumiam um medicamento, 25,5% consumiam dois, sendo os mais utilizados os antihipertensivos (39,1%) e hipoglicemiantes (30,4%). O nível de saúde percebido foi 50,5% para \"regular\" e 38,6% para \"bom\". Antes da hospitalização as ABVD mais afetadas foram subir e descer escadas (18,5%), tomar banho (17,4%) e todas as ABVD, de ambos os grupos apresentaram p>0,050, não apresentando diferenças significantes. Na admissão ao hospital observou-se aumento da dependência em todas as ABVD, principalmente tomar banho, vestir-se e caminhar; porém analisando as ABVD, entre os grupos controle e experimental, encontrou-se p=0,015 para caminhar e para transferência da cama para a cadeira p=0.030. Encontrou-se diferença significante entre os grupos. Após 48 de hospitalização houve recuperação das ABVD no grupo controle (media 50,1) e no grupo experimental 40,2 p=0,003; portanto, houve significância estatística. Após finalizar a intervenção, a média do grupo experimental aumentou para 90,0 e o grupo controle apresentou 67,0, p=0,001, observando-se diferenças significantes. Ao comparar os perfis médios encontrou-se p<0.001, razão pela qual conclui-se que não houve paralelismo. A média das ABVD foi maior no grupo experimental em relação ao controle. CONCLUSÕES: o presente estudo mostrou a efetividade de uma intervenção comunicativa, na melhoria da capacidade funcional em pacientes idosos hospitalizados, além de identificar fatores de risco que podem ser controlados. Considera-se que a proposta contribui na recuperação e obtenção da melhora do grau de independência dos idosos por médio de sua participação ativa. / INTRODUCTION: Population aging is a problem for the health sector. Due to its characteristics, hospitalization processes are more frequent, consequently favoring the presence of temporary or permanent disabilities in the elderly, a fact that is not prioritized in hospitalized patients and that demands solution strategies with a view to a better quality of life. OBJECTIVE: To study the impact a communication intervention based on Paulo Freire\'s conception exerts on elderly people\'s functional capacity through basic activities of daily living (ADL). METHODOLOGY: Quasi-experimental study of 184 patients, divided in a control (n=92) and experimental group (n=92), at the HGDIMP hospital in San Luis de Potosí, Mexico. After approval from the ethics committee was obtained, the Barthel index was applied to the BADL through an interview: two weeks before the hospitalization, at the time of hospitalization, after 48 hours of hospitalization, upon discharge and two weeks after discharge from hospital. The \"Barthel index\" was submitted to cultural adaptation and to a pilot test involving 96 elderly. Pfiffer\'s questionnaire was applied (SPMSG), in its version validated for Spanish, in order to identify the cognitive state, while a questionnaire was used to collect general data and health antecedents. The communication intervention started 48 hours after hospitalization and finished two weeks after discharge from hospital. Descriptive statistics and multivariate profile analyses were applied, as well as student\'s t and Fisher\'s exact test, using SPSS software version 13.0. RESULTS: The participants\' mean age was 70 ± 7.7 years, 60.0% were married, 41.9% had finished basic education and 40.2% were illiterate. The main causes of hospitalization were cardiovascular diseases (40.2%). The most frequent comorbidities were arterial hypertension (49.5%) and Diabetes Mellitus (33.2%). Before hospitalization, 37.0% used to take one and 25.5% two medications. The most frequently used drugs were antihypertensive (39.1%) and hypoglicemic agents (30.4%). The perceived health level was 50.5% for \"regular\" and 38.6% for \"good\". Before two weeks of hospitalization, the most affected BADL were climbing and moving down stairs (18.5%), bathing (17.4%) and all BADL in both groups displayed p>0.050, without significant differences. Upon hospital admission, increased dependence was observed on all BADL, mainly bathing, dressing and walking; however, when analyzing the BADL between the control and experimental groups, p=0.015 was found for walking, and p=0.030 for moving from the bed to the chair. A significant difference was found between the groups. After 48 of hospitalization, recovery of BADL was found in the control group (mean 50.1) and in the experimental group 40.2 p= 0.003; thus, statistical significance was found. After finishing the intervention, the mean of the experimental group increased to 90.0 and that of the control group to 67.0 p=0.001, observing significant differences. When comparing the mean profiles, p<0.001 was found. Therefore, it was concluded that no parallelism occurred. The mean score of BADL was higher in the experimental than in the control group. CONCLUSIONS: this study showed the efficacy of a communication intervention for the improvement of functional capacity in hospitalized elderly patients, and also identified risk factors that can be controlled. The proposal contributes to the elderly people\'s recovery and achievement of a better independence level through their active participation.

The word that disappeared - A scientific essay on the child-rearing responsibilities and practical professional knowledge of preschool educators This scientific essay examines how child-rearing tasks of the preschool educator relates to their practical knowledge from a hermeneutical perspective considered in the light of Hannah Arendt's concept of responsibility. The study consists of six subject narratives and an ethno-logical field study carried out at two preschools. Participatory observations and interviews were used as a method. Explored here is how professional responsibility, regulated in the preschool's governing documents, balances out against interpersonal responsibility in an activity where children spend most of their wakening hours and where attention is given to various factors such as the need for freedom, organisation and security. Examined too is how rules, companion education, self-regulation, leadership, adult authority and the application of governing documents weigh up against the concepts of children's' participation, influence and power. The concept of rearing in preschool is a controversial one: This may be due perhaps to connotations of rigid rules and nagging adults, but also that activities of the last decade have developed towards more school-based learning. Preschool teaching contains so much more however. In the daily workings of the enterprise security is established, while children are also learning to deal with materials and environments, learning to take on their own responsibility—exercising independence on a gradual basis. Alongside free play and creative activities, rearing therefore forms a vital element of children's non-cognitive learning that even affects interaction and communication. A concept that has been a part of the preschool world for over a century rearing has now been removed from the preschool curriculum.  Results demonstrate that the task of child-rearing is an element presupposed in a teachers’ practical knowledge. Based on a complex number of variables, children’s best interests are constantly considered. An unspoken gap sometimes arises between the professional’s responsibility and the interpersonal responsibility that they require to bridge the gap. This becomes particularly evident when children require the response of adults with whom they feel secure. In this manner child-rearing activities, previously seen as solely the parents concern, now also fall upon the educator, even if this remains unsaid. It is therefore assumed that the work of child-rearing will remain in preschools even if the word itself disappears. Responsibility, content and praxis, in the question of child-rearing therefore needs to be discussed and highlighted together with parenting to maintain a socially sustainable future. / I denna vetenskapliga essä undersöks hur förskolepedagogers fostransansvar yttrar sig i förhållande till deras praktiska yrkeskunnande ur ett hermeneutiskt perspektiv och i förhållande till Hannah Arendts ansvarsbegrepp. Studien består av sex egenupplevda berättelser och en etnologisk fältstudie utförd på två förskolor där deltagande observationer och intervjuer använts som metod. Här utforskas hur det professionella ansvaret, som regleras i förskolans styrdokument, balanseras mot ett mer mellanmänskligt ansvar i en verksamhet där de flesta barn vistas större delen av sin vakna tid och där hänsyn ska tas till olika faktorer som behov av frihet, organisation och säkerhet. Därför undersöks också hur regler, kamrat-fostran, självreglering, ledarskap, vuxenauktoritet och tillämpning av styrdokument avvägs mot begrepp som barns delaktighet, inflytande och makt. Fostransbegreppet är omstritt i förskolan. Det kan bero på att det förknippas med stelbenta regler och tjatiga vuxna, men det kan även spela en roll att verksamheten utvecklats i riktning mot ett mer skolämnesbaserat lärande under de senaste tio åren. Undervisningen i förskolan är dock så mycket mer. I grund-verksamhetens dagliga rutiner etableras trygghet samtidigt som barnen lär sig att hantera material och miljöer liksom att ta ansvar för sig själva och stegvis utöva självständighet. Tillsammans med fri lek och skapande aktiviteter utgör därför fostran en viktig del av barns icke-kognitiva lärande som även berör samspel och kommunikation. Ett begrepp som varit en del av förskolans värld i över hundra år och som nu stryks ur förskolans läroplan.   Resultatet visar att fostransuppdraget existerar som en förgivettagen del av pedagogernas praktiska kunskap. Utifrån en mängd komplexa variabler görs ständiga överväganden för barnens bästa. Ibland uppstår även ett outtalat tomrum mellan yrkesansvaret och det mellanmänskliga ansvaret som de behöver överbrygga. Något som blir särskilt tydligt när barn kräver gensvar av vuxna som de känner sig trygga med. Fostranshandlingar som tidigare sågs som föräldrarnas ensak blir på så vis också pedagogernas även om det förblir outtalat. Man kan därför anta att arbetet med fostran kommer att leva kvar i förskolan även om själva ordet försvinner. Ansvar, innehåll och praktiskt handlande i fostransfrågan behöver därför diskuteras och lyftas fram tillsammans med föräldrasamverkan för en socialt hållbar framtid.