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A experiência de pessoas com AVC com o modelo de prática centrada na pessoa: um estudo qualitativo
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| 1.44 MB | Adobe PDF |
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Abstract(s)
Introdução: O Acidente Vascular Cerebral (AVC) é uma das principais causas de morte e
incapacidade, com impacto significativo a vários níveis, para o próprio e respetivas famílias.
Apesar da recomendação de uma prática centrada nas pessoas com AVC, estudos internacionais
prévios sugerem que esta não é efetivamente implementada e que os cuidados tendem a ser
descoordenados e insuficientes. Atualmente, desconhece-se a realidade em Portugal acerca do
modelo de prática na fisioterapia após AVC. Neste sentido, este estudo teve como objetivos
compreender as perspetivas das pessoas com AVC acerca do modelo de cuidados de fisioterapia
recebido, bem como que atitudes e fatores, são associados ao modelo de prática centrada na pessoa
com AVC.
Métodos: Foi realizado um estudo qualitativo de análise temática híbrida com pessoas adultas
portuguesas, com diagnóstico de AVC, que tivessem realizado fisioterapia e se encontrassem
inseridas na comunidade. Foi utilizada amostragem intencional, com inclusão de 16 participantes
(média das idades=50±11), dos quais três com problemas de comunicação. Os dados foram
recolhidos através de grupos focais, como método principal e entrevistas semiestruturadas
individuais para pessoas com alterações da comunicação. Foi utilizada uma abordagem híbrida,
combinando uma análise dedutiva e indutiva dos dados.
Resultados: Da análise dos resultados foram identificados três temas do modelo de Prática
Centrada na Pessoa em Reabilitação. Dos resultados obtidos, a díade pessoa-fisioterapeuta foi
caracterizada num modelo centrado na pessoa. Os principais fatores reportados relacionam-se
com o respeito pela pessoa com AVC, a relação terapêutica e as tomadas de decisão partilhadas.
No que diz respeito aos níveis microssistema e macrossistema, estes parecem não se enquadrar
num modelo centrado na pessoa. No nível microssistema, fatores associados à inclusão de pessoas
significativas, a existência de equipas interdisciplinares e o ambiente da fisioterapia foram
abordados. Já no nível macrossistema, a organização da equipa de fisioterapeutas e a preparação
do planeamento da alta foram as principais características abordadas pelos participantes. Conclusão: Este estudo demonstrou aspetos importantes a ter em conta, para uma prática centrada
na pessoa com AVC, nos vários níveis associados à fisioterapia. O respeito pela individualidade
de cada pessoa, a inclusão de pessoas relevantes com objetivos e limites definidos, uma equipa
interdisciplinar centrada na pessoa, a organização da equipa de fisioterapeuta e o processo de alta
são fatores a considerar para que o modelo de prática da fisioterapia seja centrado na pessoa com
AVC.
ntroduction: Stroke is one of the main causes of death and disability, with a significant multi-level impact on individuals and their families. Despite the recommendation of a practice centred on people with stroke, previous studies suggest that this is not being effectively implemented and that care tends to be uncoordinated and insufficient. Currently, the reality in Portugal regarding physiotherapy’s model of care after stroke is unknown. Therefore, this study aimed to understand the perception of people with stroke regarding the physiotherapy model of care, and which attitudes and factors are associated with the person-centred practice model. Methods: A qualitative study using a hybrid thematic analysis was carried out with portuguese adults, diagnosed with stroke, who had undergone physiotherapy and were living in the community. Intentional sampling was used, including 16 participants (average age=50±11), of which three had communication problems. For data collection, focus groups were conducted as the main method and individual semi-structured interviews for people with communication disorders. A hybrid approach was used combining deductive and inductive data analysis. Results: From the results obtained, three themes of Person-Centered Rehabilitation Model were identified. The person-professional dyad was characterised in a person- centered model. Respect for the person with stroke, therapeutic relationships and shared decision-making were the main facilitators reported by participants. Regarding the microsystem and macrosystem levels, these do not seem to fit into a person-centered model. At the microsystem level, factors associated with the inclusion of significant others, the existence of interdisciplinary teams and the physiotherapy environment were addressed. At the macrosystem level, the physiotherapists organization and the preparation of discharge planning were the main characteristics addressed by the participants. Conclusion: This study revealed important aspects to take into consideration for a person with stroke-centered practice, at various levels related to physiotherapy. Respect for the individuality of each person, the inclusion of relevant people with defined objectives and limits, an interdisciplinary team centred on the person, the organization of the physiotherapist team and the discharge process are factors to consider so that the physiotherapy practice model is centred on the person with stroke.
ntroduction: Stroke is one of the main causes of death and disability, with a significant multi-level impact on individuals and their families. Despite the recommendation of a practice centred on people with stroke, previous studies suggest that this is not being effectively implemented and that care tends to be uncoordinated and insufficient. Currently, the reality in Portugal regarding physiotherapy’s model of care after stroke is unknown. Therefore, this study aimed to understand the perception of people with stroke regarding the physiotherapy model of care, and which attitudes and factors are associated with the person-centred practice model. Methods: A qualitative study using a hybrid thematic analysis was carried out with portuguese adults, diagnosed with stroke, who had undergone physiotherapy and were living in the community. Intentional sampling was used, including 16 participants (average age=50±11), of which three had communication problems. For data collection, focus groups were conducted as the main method and individual semi-structured interviews for people with communication disorders. A hybrid approach was used combining deductive and inductive data analysis. Results: From the results obtained, three themes of Person-Centered Rehabilitation Model were identified. The person-professional dyad was characterised in a person- centered model. Respect for the person with stroke, therapeutic relationships and shared decision-making were the main facilitators reported by participants. Regarding the microsystem and macrosystem levels, these do not seem to fit into a person-centered model. At the microsystem level, factors associated with the inclusion of significant others, the existence of interdisciplinary teams and the physiotherapy environment were addressed. At the macrosystem level, the physiotherapists organization and the preparation of discharge planning were the main characteristics addressed by the participants. Conclusion: This study revealed important aspects to take into consideration for a person with stroke-centered practice, at various levels related to physiotherapy. Respect for the individuality of each person, the inclusion of relevant people with defined objectives and limits, an interdisciplinary team centred on the person, the organization of the physiotherapist team and the discharge process are factors to consider so that the physiotherapy practice model is centred on the person with stroke.
Description
Keywords
AVC Fisioterapia Prática centrada na pessoa Stroke Physiotherapy Person-centred care