Autoeficácia de fisioterapeutas após capacitação em reabilitação nas doenças respiratórias crônicas: um estudo na rede SUS de Governador Valadares

Abstract

Introduction: The physiotherapist is one of the essential professionals in the teams existing in the Unified Health System (SUS). Its activities occur comprehensively, through health promotion, disease prevention and user rehabilitation, at three levels of care: primary, secondary and tertiary, also known as Basic, Medium and High Complexity Care, respectively. Professional work with the Family Health Strategy (ESF) and in communication with other services in the SUS network is extremely important, as it allows greater resolution of demands in the Basic Health Unit scenario. Among the emerging demands are cases of users with Chronic Respiratory Diseases (CKD) and who, due to the multisystemic nature of the disease, may present cardiac, musculoskeletal and psychological demands, requiring management through rehabilitation. Given this scenario, many health professionals still feel unprepared to welcome and care for this specific population, which can lead to professional insecurity and malpractice when caring for patients. The belief that an individual has about their ability to successfully carry out a certain activity can be called self-efficacy, a construct proposed by Albert Bandura, a Canadian psychologist. Self-efficacy is built throughout life, but can be developed through training. As it is a SUS guideline, training for the acquisition of knowledge, skills and attitudes that result in better performance at work is a frequent investment by health services, aiming at the continuous improvement of human resources for actions in response to the dynamic demands of health care scenarios. health. It is expected, therefore, that these educational processes will be made viable in order to respond to these demands, increasing the self-efficacy of their human resources with consequent transformations in their results in real work. Objective: Promote professional training for the care of users with chronic respiratory diseases and analyze the influence of this training on the specific self-efficacy of Physiotherapists in Primary and Medium Complexity Care in the SUS Network of Governador Valadares. Materials and Methods: This is a case study, with a quantitative approach. Physiotherapists who work in the SUS network of Governador Valadares-MG participated in this study. The study was carried out in three stages: 1) baseline assessment of Physiotherapists (individual characteristics, specific self-efficacy and general self-efficacy); 2) offering training in rehabilitation in chronic respiratory diseases (course lasting eight hours, online and in-person practice); 3) measure of post-training self-efficacy; Standardized instruments and instruments designed and tested by the research authors were used. Professionals responded to these instruments online. Results: the majority of participants were female (64%) with a mean age of 35 ± 6 years. The training time varied between 1.6 and 20 years, and the majority of participants studied at private institutions (81.8%). 55% of participants had a postgraduate degree in areas other than physiotherapy, and 81% stated that they had not completed courses or improvements whose theme was Rehabilitation of Chronic Respiratory Diseases. All professionals worked in care, 45.5% in primary care, 36.4% in secondary care and 18.2% in tertiary care. The specific self-efficacy value pre and post training were 55 ± 11.4 and 64.64 ± 10, respectively (range 15 to 75 points). The results of the paired t test for independent samples (n=11 in both groups) were performed to compare the means of the two training moments. The p value found in the test was 0.03. The effect size (d=0.89) indicated a large effect. There was an increase in the proportion of professionals who reported a high level of self-efficacy for all items of the instrument when comparing the pre- and post-training moments, although this difference was not significant when the items were evaluated individually using the Chi-Square test, with Fisher correction. Conclusion: Training aimed at physiotherapists can be implemented with the aim of contributing to maintaining or increasing the self-efficacy of these professionals in dealing with users with CKD. Thinking about self-efficacy as an important professional attribute helps to shape training programs and adapt them to the reality of the professionals who will be involved. The adoption of evaluation methods makes it possible to concretely demonstrate the efficiency of training actions and, consequently, enhance the Continuing Health Education Policy.