Fatores contextuais da CIF no acesso a reabilitação em indivíduos pós-AVC

Abstract

Cerebral Vascular Accident (CVA) is a vascular disorder that compromises brain functions, causing changes in the cognitive and sensorimotor planes, being one of the most common causes of disability. There are numerous challenges faced by individuals who have suffered a stroke as well as by their families and which are closely linked to access and success of physiotherapeutic interventions. It is in this context that the International Classification of Functioning, Disability and Health (ICF) emerges as a way of assisting health professionals in implementing therapeutic plans that are specific and adapted to the needs of patients. The present work aims to investigate the association between contextual factors related to the International Classification of Functioning, Disability and Health in access to Rehabilitation for post-stroke individuals. The present work is a cross-sectional study carried out with post-stroke patients whose main outcome is access to rehabilitation, more specifically, to Physiotherapy after hospital discharge. The main outcome variable was access to rehabilitation, specifically Physiotherapy after the stroke episode. Other outcomes were collected and included, such as age, socioeconomic profile, education level, number of people living in the same household and referral to rehabilitation. To assess socioeconomic level, specific questions were used, such as the amount of wages received by the family. The Modified Rankin Scale (MRS) was used to categorize the level of stroke severity/disability. To screen for changes in cognition, the Minimental mental state examination instrument was used. In total, 67 individuals were recruited and included. After performing a T test for the independent variables (Modified Rankin Scale, number of people living in the same household and age), it was observed that none of them were statistically significant (p > 0.05). Regarding the presence of cognitive changes, a statistically significant difference was observed (P< 0.001). We can conclude that personal contextual factors such as education level, age and environmental factors such as the number of people living in the residence did not show differences between individuals with and without access to rehabilitation. Only cognitive changes influenced access to post-stroke Physiotherapy.