Funcionalidade e estigma em pessoas acometidas pela hanseníase: um estudo em um centro de referência de Minas Gerais

Abstract

INTRODUCTION: Leprosy is a contagious and chronic infectious disease, which, although curable, is still considered endemic in several regions of the world, and in Brazil is considered an important challenge in public health. In addition to the physical problems that leprosy can cause, the diagnosis of the disease can have a great psychological impact on the individual's life, triggering fear, anxiety, loneliness, depression, which negatively affects their lives, limiting their activities and participation. Despite treatment for the disease and recovery or improvement of disabilities, these are important factors when it comes to limiting activities, restricting social participation and stigma, and should therefore be evaluated in order to show their repercussions on the individual's daily life. OBJECTIVES: To identify the functionality profile and the impacts of the stigma resulting from leprosy in individuals assisted at the Sanitary Dermatology Service of Hospital Eduardo de Menezes, Belo Horizonte, Minas Gerais. MATERIALS AND METHODS: An observational, cross- sectional study will be carried out with users of the referred leprosy reference service. The sample will be non-probabilistic. Inclusion criteria for the study will be to present a diagnosis of leprosy, be undergoing clinical treatment or being treated for a reactional outbreak at the referred service, be aged between 18 and 59 years old; and sign the Informed Consent Form (ICF). Data collection will be carried out from april/2024 to september/2024, through forms used in the service such as the Simplified Neurological Assessment; and by standardized instruments: Activity Limitation and Risk Awareness Screening Scale (SALSA), Stigma Scale Explanatory Model Interview Catalogue for People Affected by Leprosy (EMIC-AP), the latter suggested by Ordinance SCTIE/MS number 67, of July 7, 2022, which instituted the Clinical Protocol and Therapeutic Guidelines for Leprosy (CPTGL). Data analysis consisted of descriptive and explority analysis using a linear regression model considering the outcomes variables and also the independent variables with association of p less than 0,20. RESULTS: The study evaluated 43 individuals treated in the physiotherapy and occupational therapy sector of Hospital Eduardo de Menezes in the pre-determinated period, mostly man (60,5%), with an average age of 38,8 years. The lepromatous clinical form was predominant (55,8%) and 95,3 % of participants were classified as multibacillary. Regarding complaints, 76.7% reported symptoms in the lower limbs, and 78.5% had some degree of physical disability (GIF >0). On the SALSA scale, 72% demonstrated activity limitations (≥ 25points), and 69.8% had some level of risk awareness. The stigma score (EMICAP) ranged from 0 to 34, with a median of 14, with 60,5% of respondents preferring people not to know about the diagnosis, and 44,2% staying away from social or work groups. Linear regression indicated that activity limitation was predicted bay age (p=0,036), stigma (p=0,008) and risk awareness (p=0,000), explaining 73,1% of the variability (adjusted R2= 0,731; p=0,000). Stigma, in turn, was significantly explained by the SALSA score (p=0,008; adjusted R2= 0,376; p= 0,003). These findings highlight the importance of functional and psychosocial assessment in leprosy, highlighting the influence of stigma and activity limitations on the quality of life of affected individuals. CONCLUSION: The results of this study contributed with the knowledge about functionality and stigma of people affected by leprosy and to show the importance of adopting approaches that go beyond medical and biological aspects, also addressing psychosocial and functional aspects. The findings of this study also reinforced the importance of the relationship activities limitation and stigma, in addition to physical disabilities involving sensitivity, strength and presence of deformities.