Inovação nos serviços públicos de reabilitação: propostas para a sistematização da coleta de informações funcionaiscentradas no usuário

Abstract

The accelerated aging of the population, accompanied by the increase in chronic health conditions many of them causing transient or permanent disabilities have been challenging the health systems by increasing the demand for rehabilitation services. These changes have led services to rethink their organization as well as rethink the theoretical model that guides their actions. Since 2008, the Brazilian Ministry of Health recommends the use of the International Classification ofFunctioning, Disability and Health (ICF) biopsychosocial model as a guide to understanding human functioning. In 2012, the same Ministry determined the use of ICF in different areas of the Unified Health System (SUS) and Supplementary Health. In the ICF model, the functioning and disability of an individual are mediated by various biological, environmental, individual, and social factors. Thus, during theidentification of functional demands of individuals seeking rehabilitation services, the individuals perceptions on its functioning and disability should be considered, by the use of data collection tools and protocols that can capture functional information. In this context, the purpose of this study was to develop, translate, adapt and evaluate tools for the collection of functional information, which could be used to characterizeand monitor the functionality of the population that seeks public rehabilitation services in Brazil. This is an observational study, developed in public rehabilitation services of Belo Horizonte, Minas Gerais, from 2012 to 2015. This study was developed in three steps: 1) The development and improvement of the Protocol for Identification of Problems for Rehabilitation (PLPR), the development of a scoring forthe Brief Functional Description PLPR, and the description of the characteristics and functional demands of patients who seek the public rehabilitation services in Belo Horizonte; 2) The translation, cultural adaptation, and the understanding evaluation of the Activity Measure for Post Acute Care (AM-PAC) Outpatient Short-form version; 3) The analysis of the Brazilian version of the P-Scale regarding its suitabilityto assess the ability of participation perceived by the patients of public rehabilitation services. This study used quantitative methods (descriptive and inferential statistics and Rasch analysis), as well as qualitative methods (cognitive interview). It is expected that the results of this study could help to improve the work processes in public rehabilitation services, especially in how the patients information is collectedand recordecould contribute to a better identification of functional demands of individuals seeking rehabilitation services, to better define a more appropriate care plan for each individual, and to improve the organization of the public rehabilitation services network. Thus, it is expected that this study can contribute to a rehabilitation care model anchored in best practices and innovations in order to improve the efficiency of services and outcomes for users.d. The availability of these instruments to collect functional information