Perfil de funcionalidade, incapacidade e saúde de indivíduos acometidos pelo acidente vascular cerebral e usuários de unidade básica de saúde da cidade de Belo Horizonte

Abstract

Stroke has high incidence and prevalence rates and is considered the health condition responsible for most chronic disabilities worldwide. Stroke must be a priority for national public health and requires that the affected individuals receive comprehensive and continuous care, as recommended by the Care Line in Stroke (Brazil / Ministry of Health) and by stroke guidelines. The aim of the present study was to determine the functioning, disability and health profile of individuals with stroke and users of a Primary Care Unit (PCU) of the health district northeast of the Belo Horizonte city. From the medical records and home visits, data were collected regarding health status, assistance received from the PCU, personal and environmental contextual factors. Data were also collected regarding functioning and disability, organized according to the conceptual framework of the International Classification of Functioning, Disability and Health (ICF). Test and instruments with adequate measurement properties and commonly applied in the assessment of individuals with stroke were used. The final sample consisted of all individuals with stroke and users of the PCU identified by the family health teams and the professionals of the "Núcleo de Apoio à Saúde da Família" (NASF) (n = 44, 69.23 ± 13.12 years and 67.00 ± 66.52 months of stroke). According to the descriptive analysis performed, the main results were that most individuals: had hypertension (81.8%) and hypercholesterolemia (56.8%) as associated diseases, was classified as inactive (86.5%), had self-perception of health classified from reasonable to bad (61%), had negative test for changes in cognitive function (83.3%) and positive test for suspected depression (62.9%), upper limb motor impairment ranging from mild to moderate (63%), lower limb motor impairment ranging from severe to moderate (68%) and global motor impairment ranging from severe to moderate (67%), had no change in muscle tone (>55%), showed impaired motor coordination of lower limbs (10-96,4%), good upper limbs motor coordination, and muscular weakness of the paretic side, had good self-perception of manual ability, was classified from limited to complete community ambulation (88%), with capacity to improve their natural gait speed, showed alterations in balance (51%) and in functional mobility (54.2%), with indicative of risk of falls, had negative self-perception of quality of life and perceived the environment factors as obstacles. In general, the subjects were classified with moderate to mild disability (52.3%). The majority of the individuals used the PCU to renew drugs prescription (54.5%), did not present records of care by NASF professionals 9 at their medical chart (54.5%), and did not receive any information from health professionals related to stroke (72.3%), even though they consider it important to receive such information (79.5%). Finally, it was concluded that the subjects who participated in the present study have chronic disabilities associated with impairments, activity limitations and participation restrictions. They require a multidisciplinary and continuous health attention. However, the majority of the subjects had the health care aimed at medicalized practices, did not have any record of care from the NASF professionals and had no access to health education-related practices. All of these health needs should be considered to a better management of the public health practices to provide a comprehensive care for subjects with stroke as recommended by the Care Line in Stroke (Brazil / Ministry of Health) and by stroke guidelines.