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Introdução: As evidências científicas acerca das especificidades da atuação do terapeuta ocupacional nas doenças cardiovasculares são insuficientes. Objetivos: Conhecer o panorama teórico-prático da terapia ocupacional na atenção à saúde cardiovascular ao adulto e ao idoso. Método: Revisão bibliográfica integrativa da literatura indexada nas bases de dados PSYcInfo; Cochrane; Web of Science; PUBMED; SCOPUS; EMBASE; LILACS; SciELO; CINAHL; Rehabilitation & Sports Medicine Source; Academic Searcher Premier, com recorte temporal de 1917 a 2020. Resultados: Identificou-se que diferentes aspectos são abordados nas intervenções, tais como: educação em saúde, conservação de energia, aumento da autopercepção da saúde, otimização da capacidade funcional residual e retorno ao máximo possível da condição anterior ao evento cardíaco, engajamento em atividades significativas, apoio emocional e estímulo à mobilidade, ao gerenciamento do estresse, à participação comunitária. Conclusão: Identificou-se atuação da Terapia Ocupacional na atenção à saúde cardiovascular, em especial no contexto hospitalar em equipes de reabilitação cardíaca, o que mostra a necessidade de outros estudos que evidenciem sua relevância em contextos territoriais. : Introduction: Scientific evidence about the occupational therapist's practice in cardiovascular diseases is insufficient. Objective: Comprehend occupational therapy's theoretical-practical overview in cardiovascular care for adults and older adults. Method: An integrative bibliographic review was conducted with the indexed literature in the following databases: PsycInfo; Cochrane; Web of Science; PUBMED; SCOPUS; EMBASE; LILACS; SciELO; CINAHL; Rehabilitation & Sports Medicine Source; Academic Searcher Premier, from 1917 to 2020. Results: It was identified that the interventions comprehended different aspects such as: health education, energy conservation, increasing self-perception of health, optimization of residual functional capacity, the resumption as much as possible of the prior condition before the cardiac event, engaging in meaningful activities, providing emotional support and encouraging mobility, stress management, and community participation. Conclusion: It addressed the practice of occupational therapy in cardiovascular health, especially in hospital care with cardiac rehabilitation teams, which highlights the need for further research that evidences its relevance in territorial contexts.

Hospitalization is a complex condition that potentially triggers suffering for the person in the process of becoming ill and for those who accompany them. The occupational therapist uses different approaches to favor the integrality and humanization of care, one of which is the group approach. Objectives: To analyze a group experience developed by occupational therapy with users, family members/companions in the medical clinic ward of a university hospital. Method: Qualitative study based on thematic content analysis of documents, with these records of users participating in groups, carried out from June 2018 to December 2019. Results: 22 records of users were analyzed, most of them adults and with a balance between the sexes. The themes of the group were about: construction of collaborative work among the professional team; expression of feelings and strengthening of bonds; rescue of activities, singularities and life projects; resignification and humanization of hospital routine. Conclusions: The group approach evidences a humanized practice in health, which favors the collaborative work of the team, the support for the elaboration of the illness and the promotion of the user's well-being. When adopted and systematized, it expands its possibilities and potential in the context of hospitalization. A hospitalização configura-se como condição complexa e potencialmente desencadeadora de sofrimento para a pessoa em processo de adoecimento e para aqueles que a acompanham. O terapeuta ocupacional se utiliza de diferentes abordagens para favorecer a integralidade e humanização do cuidado, sendo uma delas a grupal. Objetivos: Analisar uma experiência grupal desenvolvida pela terapia ocupacional com usuários, familiares/acompanhantes na enfermaria de clínica médica de um hospital universitário. Método: Estudo qualitativo com base na análise de conteúdo temática de documentos, sendo esses prontuários dos usuários participantes de grupos, realizados de junho de 2018 a dezembro de 2019. Resultados: Analisados 22 prontuários dos usuários, a maioria adultos e com equilíbrio entre os sexos. As temáticas do grupo versaram sobre: construção de trabalho colaborativo entre a equipe multiprofissional; expressão de sentimentos e potencialização de vínculos; resgate de atividades, singularidades e projetos de vida; ressignificação e humanização do cotidiano hospitalar. Conclusões: A abordagem grupal evidencia uma prática humanizada em saúde, que favorece o trabalho colaborativo em equipe, o apoio à elaboração do adoecimento e a promoção do bem-estar do usuário. Ao ser adotada e sistematizada, amplia possibilidades e potencialidades de seu uso no contexto da hospitalização.

Introduction: Circulatory System Diseases have become the leading causes of adult and elderly population mortality and hospitalization worldwide over the years. Such reality was observed in the prevalence of hospitalized patients due to these diagnoses in a University Hospital. Objective: This study aimed to describe and analyze the occupational therapeutic strategies developed by Occupational Therapy in a medical clinic Ward of a medium-complexity hospital with this population during hospitalization. Method: The research has an exploratory and retrospective qualitative character, carried out between June and September 2019, based on documentary research referring to the Occupational Therapy records and the discharge summary of patients from 2014 and 2018. Result: Forty-six of 200 medical records selected with Diseases of the Circulatory System were analyzed. Most of them were male and over 60 years old and about half 22 (49%) reported diseases related to stroke. All participants showed some degree of dependence in the Modified Barthel Index. The themes and occupational therapeutic strategies were diversified and focused on functionality, subjective aspects of the patients, multi-professionality, and follow-up in the service network, and out-of-hospital care. Conclusion: Occupational Therapy favored the development of therapeutic strategies centered on the patients' demands from the perspective of humanization and comprehensiveness of care in line with SUS principles and guidelines and contributed to the expansion of knowledge about the contribution of Occupational Therapy in people's care who have CAD in the context of hospitalization

Introduction: The rapid advance of the aging process contributes to the increase of chronic-degenerative diseases, such as Mild Neurocognitive Disorder (MND). Elderly with MND may present difficulties in performing instrumental activities of daily living and social participation, in addition to a higher conversion rate for dementias, compared to healthy elderly individuals. Objective: To describe and analyze a group intervention in Occupational Therapy with elderly with probable MND. Method: Prospective, quantitative, quasi-experimental study of “before and after” conception. A total of two interventions were carried out at the University Hospital of the Universidade de São Paulo, in 2014 and 2015. Each intervention covered 8 meetings and had the participation of 11 elderly. Dynamics were used to sensitize the tasks and cognitive abilities most affected in the elderly with MND and to share compensatory mnemonic strategies. For the analysis of the interventions, the instruments were applied before and after: Rivermead Memory Behavior Test; Pfeffer's Questionnaire and Subjective Memory Complaints Questionnaire. For intragroup statistical analysis, we used the Shapiro-Wilk and the non-parametric Wilcoxon tests. Results: There was a statistically significant change in total score of all the instruments applied. Thus, it showed the improvement of cognitive performance, improvement of ability in instrumental activities performance that involve more directly cognitive abilities and reduction of subjective complaints of memory of participants. Conclusion: Intervention is a potent resource for the intervention of the occupational therapist with the elderly with MND, favoring independence in daily occupations, reduction of memory complaints and improvement in cognitive performance.

Residências multiprofissionais têm contribuído para o desenvolvimento de práticas colaborativas em saúde. Objetivo: Identificar práticas colaborativas em saúde, desenvolvidas em uma enfermaria de clínica médica de um hospital universitário, envolvendo residentes terapeutas ocupacionais e alguns fatores demográficos, funcionais e diagnóstico clínico, associados a essas práticas. Método: Estudo de natureza quantitativa, retrospectivo, transversal, de abordagem descritiva, realizado por meio de análise documental e testes de associação estatística. Foi utilizado Teste T para verificar diferença na média dos grupos contemplados ou não por práticas colaborativas e o Qui-Quadrado para verificar fatores associados a essas práticas. Resultados: Há diferença na média do grupo contemplado em relação ao grupo não contemplado por práticas colaborativas em saúde envolvendo residentes terapeutas ocupacionais (p-valor 0.000295) e associação entre funcionalidade e práticas colaborativas com profissionais da reabilitação (p=0.012). Ações com usuários são a principal prática colaborativa e na maioria dos casos essas práticas se desenvolveram com fisioterapeutas e fonoaudiólogos. Conclusão: A residência tem viabilizado práticas colaborativas no hospital, porém existem desafios para a prática do cuidado integral.

As práticas corporais são parte significativa da formação e dos recursos terapêuticos utilizados por terapeutas ocupacionais. Sua aprendizagem implica na compreensão e experimentação da aplicação de diferentes técnicas, bem como do entendimento das diversas dimensões e relações destas com o corpo. Assim, o ensino das práticas corporais na pandemia por covid-19 trouxe desafios e aprendizados. Objetivo: Refletir sobre o ensino remoto ministrado na disciplina de Terapia Ocupacional e as Práticas Corporais II no Curso de Terapia Ocupacional da Universidade de São Paulo, campus capital. Método: Relato de experiência do ensino remoto desta disciplina no período da pandemia por Covid-19. Resultados: Identificou-se o aprendizado dos conteúdos, dos métodos e sua aplicação supervisionada em familiares/amigos dos estudantes, ainda que o ensino remoto de práticas corporais esteja longe do ideal. A maioria dos estudantes avaliou positivamente a oferta da disciplina valorizando as ferramentas digitais e estratégias para aprender a cuidar de si e do outro. Porém, foram evidenciadas desigualdades de acesso ao ensino remoto e às condições de moradia para participação na disciplina. Conclusão: Ainda que a disciplina tenha atingido seus objetivos possibilitando espaços de cuidado essenciais no período de pandemia constatou-se perdas no processo de ensino e aprendizagem.

The integral care of people with disabilities is weakened by the non-organization and systematization of information. The objective of this study was to organize and systematize data of people with disabilities accompanied in municipal health services in the context of primary and mild complexity care, in Sao Paulo capital, concerning socio-demographic profile, access to professional care and aiding equipment and service accessibility. It also aimed to establish an association between sociodemographic aspects and types of disability. Qualitative, retrospective, exploratory, descriptive and documentary research were based on analyses of users’ medical records and data from local health information systems. Information was collected on 166 people, 89 men (53.6%) and 83 (50%) adults between 19 and 59 years old; 44 (43.1%) users completed or did not complete elementary school. Of the 102 people who reported employment status, 38 (37.3%) were not working and among those who worked, 22 (41.5%) were men. Multiple disabilities (33.4%), physical disabilities (24.5%) and intellectual disabilities (21.6%) were recorded more often. A statistical association (p=0.005) was identified between age and type of disability, where physical disability was the most frequent among those between 6 and 14 years, and multiple disability was associated among the elderly. In primary care, users predominantly accessed doctors and nurses, and in mild complexity care, they contacted occupational therapists, physiotherapists and psychologists. Among the equipment, the use of wheelchairs prevailed. Architectural barriers were observed in services of mild complexity and there was a low offer of public transportation. There is a need to improve recording information, however it was possible to organize data on the part of people with disabilities, a fundamental action for networked care.

Introduction: The Unified Health System considers that hospital care is important for the construction of integrality. Residents in a a Multi-professional Residency Program to the Hospital Universitário da Universidade de São Paulo indicated, difficulties of the medical and nursing staff were identified to detecting demands for rehabilitation at hospital discharge, which encouraged residents to create a support group to hospital discharge. Objective: To verify the sociodemographic and health profile of users accompanied by the support group, identify challenges for insertion of these users in the rehabilitation care network and identify strategies of the support group to face these challenges. Method: Retrospective, exploratory and descriptive study, based on the documentary analysis. Results: We analyzed forms of 251 users, 83 (33%) received a referral for rehabilitation at discharge and 17 (6.7%) received referral after guidelines of the discharge support group; 95 (37.8%) sought rehabilitation services. Of these, 60 were effectively included in the services, of which 46 (18.3%) were extra-hospital, such as rehabilitation centers, basic health units and 14 (5.6%) in the Hospital Home Care Program. Concerning professional areas, 34 (13.5%) started physical therapy treatment, 29 (11.6%), speech therapy and 11 (4.9%), therapeutic-occupational. It was identified insufficiency of professional referrals and difficulties of users regarding access and continuity of care. To cope with challenges, the support group has reinforced prescribed referrals or directed obtaining referrals in medical consultations on the network. Conclusion: The group has tried to understand user demands by professional area, oriented users to access services and to get treatments. The users have valued the receptiveness of the support group, being a strategy to promote integral health care.

Introduction: Chronic renal insufficiency (CRI) and its treatment cause restrictions and damages to the physical, mental, functional and social health of the affected users. The attention developed by Occupational Therapy with this population from the perspective of integral care during the period of hospitalization contributes to improve the setting, qualification of hospitalization time, functional recovery and emotional support. Objective: To identify and analyze the contributions of Occupational Therapy in health care of users with CRI in hospital context. Method: Qualitative study of descriptive type that used documentary analysis of the occupational therapy reports referring to the appointments made by this professional from April 2015 to April 2018. Results: 42 occupational therapy reports were analyzed, the majority of users were male, aged 60 or over and with some degree of functional dependence. The interventions of the Occupational Therapy were categorized in four main themes: initial contact and reception of the needs; support for resignification of the health-disease process; assistance to adapt to the new health condition and preparation for hospital discharge and the new routine of care. Conclusion: The Occupational Therapy allowed that aspects of patients’ life altered by the CRI, hospitalization and changes in lifestyle due to the disease, were approached through different therapeutic techniques aimed at the reception of needs, stimulation of functional capacity, promotion of independence, (re) organization of daily life and insertion into the service network.

Resumo Introdução A insuficiência renal crônica (IRC) e o tratamento a ela relacionado causam restrições e prejuízos à saúde física, mental, funcional e social dos usuários acometidos. A atenção desenvolvida pela terapia ocupacional com essa população na perspectiva da integralidade do cuidado durante o período de hospitalização contribui para melhorar a ambientação, qualificação do tempo de internação, recuperação funcional e confere apoio emocional. Objetivo Identificar e analisar as contribuições da terapia ocupacional no atendimento a usuários com IRC no contexto de hospitalização. Método Estudo qualitativo do tipo exploratório e descritivo que utilizou análise documental dos-relatórios de terapia ocupacional, referentes aos atendimentos realizados por este profissional no período de abril de 2015 a abril de 2018. Resultados Foram analisados 42 relatórios, sendo a maioria de usuários do sexo masculino, com idade igual ou maior de 60 anos e com algum nível de dependência funcional. As intervenções da terapia ocupacional foram categorizadas em quatro principais temáticas: contato inicial e acolhimento das necessidades; apoio para ressignificação do processo saúde-doença; auxílio para adaptação à nova condição de saúde e preparo para a alta e a nova rotina de cuidados. Conclusão A terapia ocupacional permitiu que aspectos de vida dos usuários alterados pela IRC, pela hospitalização e pelas mudanças no modo de vida decorrentes da doença fossem abordados por meio de técnicas terapêuticas diversas voltadas ao acolhimento das necessidades, estímulo à capacidade funcional, promoção da independência, (re) organização do cotidiano e inserção na rede de serviços. Abstract Introduction Chronic renal insufficiency (CRI) and its treatment cause restrictions and damages to the physical, mental, functional and social health of the affected users. The attention developed by Occupational Therapy with this population from the perspective of integral care during the period of hospitalization contributes to improve the setting, qualification of hospitalization time, functional recovery and emotional support. Objective To identify and analyze the contributions of Occupational Therapy in health care of users with CRI in hospital context. Method Qualitative study of descriptive type that used documentary analysis of the occupational therapy reports referring to the appointments made by this professional from April 2015 to April 2018. Results 42 occupational therapy reports were analyzed, the majority of users were male, aged 60 or over and with some degree of functional dependence. The interventions of the Occupational Therapy were categorized in four main themes: initial contact and reception of the needs; support for resignification of the health-disease process; assistance to adapt to the new health condition and preparation for hospital discharge and the new routine of care. Conclusion The Occupational Therapy allowed that aspects of patients’ life altered by the CRI, hospitalization and changes in lifestyle due to the disease, were approached through different therapeutic techniques aimed at the reception of needs, stimulation of functional capacity, promotion of independence, (re) organization of daily life and insertion into the service network.

Resumo Introdução O rápido avanço do processo de envelhecimento contribui para o aumento das doenças crônico-degenerativas, como o Transtorno Neurocognitivo Leve (TNL). Idosos com TNL podem apresentar dificuldades no desempenho de atividades instrumentais de vida diária e de participação social, além de índice de conversão maior para demências, comparados a idosos saudáveis. Objetivo Descrever e analisar intervenção grupal em terapia ocupacional a idosos com provável TNL. Método Estudo prospectivo, quantitativo, quasi-experimental de concepção “antes e depois”. Analisaram-se em conjunto duas intervenções realizadas no Hospital Universitário da Universidade de São Paulo, em 2014 e 2015. Cada intervenção abrangeu 8 encontros, com participação de 11 idosos ao todo. Foram utilizadas dinâmicas para sensibilização acerca de tarefas e habilidades cognitivas reconhecidamente mais afetadas em idosos com TNL e compartilhamento de estratégias mnemônicas compensatórias. Para análise das intervenções, aplicaram-se antes e depois os instrumentos: Teste Comportamental de Memória de Rivermead; Questionário de Pfeffer e Questionário de Queixas Subjetivas de Memória. Para análise estatística intragrupo, foram utilizados o teste de Shapiro-Wilk e o teste não-paramétrico de Wilcoxon. Resultados Houve mudança estatisticamente significativa no escore total de todos os instrumentos aplicados. Assim, houve melhora do desempenho cognitivo, melhora da capacidade no desempenho de atividades instrumentais que envolvem mais diretamente habilidades cognitivas e redução das queixas subjetivas de memória dos participantes. Conclusão Acredita-se que a intervenção é um potente recurso para atuação do terapeuta ocupacional junto a idosos com TNL por favorecer independência nas ocupações cotidianas, diminuição de queixas de memória e melhora no desempenho cognitivo. Abstract Introduction The rapid advance of the aging process contributes to the increase of chronic-degenerative diseases, such as Mild Neurocognitive Disorder (MND). Elderly with MND may present difficulties in performing instrumental activities of daily living and social participation, in addition to a higher conversion rate for dementias, compared to healthy elderly individuals. Objective To describe and analyze a group intervention in Occupational Therapy with elderly with probable MND. Method Prospective, quantitative, quasi-experimental study of “before and after” conception. A total of two interventions were carried out at the University Hospital of the Universidade de São Paulo, in 2014 and 2015. Each intervention covered 8 meetings and had the participation of 11 elderly. Dynamics were used to sensitize the tasks and cognitive abilities most affected in the elderly with MND and to share compensatory mnemonic strategies. For the analysis of the interventions, the instruments were applied before and after: Rivermead Memory Behavior Test; Pfeffer's Questionnaire and Subjective Memory Complaints Questionnaire. For intragroup statistical analysis, we used the Shapiro-Wilk and the non-parametric Wilcoxon tests. Results There was a statistically significant change in total score of all the instruments applied. Thus, it showed the improvement of cognitive performance, improvement of ability in instrumental activities performance that involve more directly cognitive abilities and reduction of subjective complaints of memory of participants. Conclusion Intervention is a potent resource for the intervention of the occupational therapist with the elderly with MND, favoring independence in daily occupations, reduction of memory complaints and improvement in cognitive performance.

O OBJETIVO DESTE ESTUDO FOI DESCREVER A CONTRIBUIÇÃO DA ATUAÇÃO HUMANIZADA EM SAÚDE DESENVOLVIDA A UM USUÁRIO EM VULNERABILIDADE SOCIAL, A PARTIR DE UM ESTUDO DE CASO ACOMPANHADO NO HOSPITAL UNIVERSITÁRIO DA UNIVERSIDADE DE SÃO PAULO. TRATA-SE DE UMA PESQUISA DESCRITIVA DE CARÁTER QUALITATIVO FUNDAMENTADA NOS REGISTROS EM PRONTUÁRIO E VIVÊNCIAS DE RESIDENTES DE TERAPIA OCUPACIONAL E FISIOTERAPIA. OS RESULTADOS MOSTRARAM QUE A PARTIR DE UMA RELAÇÃO TERAPÊUTICA HUMANIZADA CENTRADA NAS NECESSIDADES DO USUÁRIO FORAM DESENVOLVIDAS ESTRATÉGIAS DE REABILITAÇÃO DE FORMA INTEGRADA COM A TERAPIA OCUPACIONAL E A FISIOTERAPIA, E ARTICULADAS COM A EQUIPE COM VISTA A PRODUÇÃO DE VIDA CORROBORANDO COM O QUE É PRECONIZADO PELA POLÍTICA NACIONAL DE HUMANIZAÇÃO. ALÉM DAS AÇÕES DIRETAS COM O USUÁRIO, REALIZARAM-SE AÇÕES COM A REDE SOCIAL E SERVIÇO HOSPITALAR DE LONGA PERMANÊNCIA. DADA À NATUREZA DAS DEMANDAS SOCIAIS E DE SAÚDE DO USUÁRIO FOI POSSÍVEL RECONHECER A IMPORTÂNCIA À INTERDEPENDÊNCIA E COMPLEMENTARIDADE DAS AÇÕES COMPARTILHADAS COM A EQUIPE PROFISSIONAL PARA A HUMANIZAÇÃO E INTEGRALIDADE DO CUIDADO DURANTE A HOSPITALIZAÇÃO.

Introduction: Multiple sclerosis is a more common autoimmune, demyelinating disease of the central nervous system, which affects mainly adults and causes significant impacts on occupational performance and social participation. Objective: To analyze and systematize the knowledge produced by Occupational Therapy related to interventions in people with multiple sclerosis, between 2012 and 2017. Method: Integrative literature review using the Scientific Electronic Library Online databases, Virtual Health Library, National Library of Medicine National Institutes of Health of United States, and the national journals: Brazilian Journal of Occupational Therapy, Journal of Occupational Therapy University of São Paulo and Brazilian International Journal of Occupational Therapy. Results: Publications were identified in fifteen different journals, being only two national articles and twenty foreign ones. The articles were classified in the following themes: Individualized Intervention / Self-Management, Home Intervention, Use of Technology for Intervention, Group Intervention and Client-Centered Intervention. The studies indicate the diversity of interventions in the individual, group, course, with the use of videoconference and videogame, in the home and work context. Conclusion: The interventions developed by the professionals indicate a decrease in symptoms, improvement of functionality, and greater knowledge of potentialities, self-control, self-care, and promotion of quality of life. The study contributed to greater dissemination and, consequently, greater recognition of the effectiveness of Occupational Therapy activities and indicated the need for national research, given the scarcity of articles published in Brazil on the subject.

Resumo: Introdução A esclerose múltipla é uma doença autoimune, desmielinizante mais comum do sistema nervoso central, que afeta principalmente adultos e causa impactos significativos no desempenho ocupacional e na participação social. Objetivo Analisar e sistematizar o conhecimento produzido pela terapia ocupacional relacionado às intervenções com pessoas com esclerose múltipla, no período entre 2012 e 2017. Método Revisão integrativa da literatura tendo como fonte de busca as bases de dados Scientific Eletronic Library Online, Biblioteca Virtual em Saúde, National Library of Medicine, National Institutes of Health of United States e os periódicos nacionais: Cadernos Brasileiros de Terapia Ocupacional, Revista de Terapia Ocupacional da Universidade de São Paulo e Revista Internacional Brasileira de Terapia Ocupacional. Resultados Foram identificadas publicações em quinze periódicos diferentes, sendo apenas dois artigos nacionais e vinte estrangeiros. Os artigos foram classificados nas seguintes temáticas: Intervenção Individualizada/Autogestão, Intervenção Domiciliar, Uso da Tecnologia para Intervenção, Intervenção Grupal e Intervenção Centrada no Cliente. Os estudos apontam diversidade de intervenções na forma individual, grupal, curso, com uso de videoconferência e videogame, no contexto domiciliar e de trabalho. Conclusão As intervenções desenvolvidas pelos profissionais apontam diminuição dos sintomas, melhora da funcionalidade, maior conhecimento das potencialidades, autocontrole, autocuidado e promoção da qualidade de vida. O estudo contribui para maior divulgação e, consequentemente, maior reconhecimento da efetividade das práticas da terapia ocupacional, indicando a necessidade de pesquisas no âmbito nacional, visto a escassez de artigos publicados no Brasil sobre a temática. Abstract: Introduction Multiple sclerosis is a more common autoimmune, demyelinating disease of the central nervous system, which affects mainly adults and causes significant impacts on occupational performance and social participation. Objective To analyze and systematize the knowledge produced by Occupational Therapy related to interventions in people with multiple sclerosis, between 2012 and 2017. Method Integrative literature review using the Scientific Electronic Library Online databases, Virtual Health Library, National Library of Medicine National Institutes of Health of United States, and the national journals: Brazilian Journal of Occupational Therapy, Journal of Occupational Therapy University of São Paulo and Brazilian International Journal of Occupational Therapy. Results Publications were identified in fifteen different journals, being only two national articles and twenty foreign ones. The articles were classified in the following themes: Individualized Intervention / Self-Management, Home Intervention, Use of Technology for Intervention, Group Intervention and Client-Centered Intervention. The studies indicate the diversity of interventions in the individual, group, course, with the use of videoconference and videogame, in the home and work context. Conclusion The interventions developed by the professionals indicate a decrease in symptoms, improvement of functionality, and greater knowledge of potentialities, self-control, self-care, and promotion of quality of life. The study contributed to greater dissemination and, consequently, greater recognition of the effectiveness of Occupational Therapy activities and indicated the need for national research, given the scarcity of articles published in Brazil on the subject.

Introduction: Multiple sclerosis is a neurological chronic disease with continuous and differentiated evolution, it demands body self-knowledge for better understanding of preserved capacities, gradual losses and repercussion in the performance of activities and social participation. Objective: To analyze the group experience of the application of physical techniques based on self-healing method for health promotion and rehabilitation of people with multiple sclerosis, developed by Occupational Therapy. Method: Documental qualitative research referring to written records and audio transcripts of group sessions. Data analysis used the Collective Subject Discourse method. Results: Ten adults with multiple sclerosis, with varying ages and disease times, participated in the therapeutic group. Five participants reported representations and experiences due to the disease and the effect of learning the physical techniques of self-sealing. The benefits include a greater body awareness, decreased symptoms, improved functional capacity and recognition of the need of body practice routine. Conclusion: The therapeutic use of self-healing method demonstrated its applicability to promote the health benefits, rehabilitation, according to health policies. Due to limited literature on the benefits of using the self-healing method indicates the development of new studies.

Resumo Introdução O Sistema Único de Saúde considera o cuidado hospitalar como importante eixo para a construção da integralidade. Os residentes do Programa de Residência Multiprofissional, do Hospital Universitário da Universidade de São Paulo, identificaram dificuldades da equipe médica e de enfermagem em detectar demandas em reabilitação na alta hospitalar, levando residentes a criarem um grupo de apoio à alta. Objetivo Verificar o perfil sociodemográfico e de saúde dos usuários acompanhados pelo grupo de apoio, identificar os desafios para inserção dos usuários na rede de serviços de reabilitação e as estratégias do grupo de apoio para enfrentamento desses desafios. Método Estudo retrospectivo, exploratório e descritivo, baseado em análise documental. Resultados Foram analisados formulários de 251 usuários, 83 (33%) receberam encaminhamento para reabilitação por ocasião na alta hospitalar e 17 (6,7%), a partir das orientações do grupo de apoio à alta; 95 (37,8%) procuraram serviços de reabilitação. Desses, 60 foram efetivamente inseridos em serviços, sendo 46 (18,3%) extra-hospitalares, como centros de reabilitação e unidades básicas de saúde, e 14 (5,6%) no Programa de Atendimento Domiciliar do hospital. Quanto às áreas profissionais, 34 (13,5%) iniciaram tratamento fisioterápico, 29 (11,6%), fonoaudiológico e 11 (4,9%), terapêutico-ocupacional. Identificaram-se insuficiência de encaminhamentos profissionais e dificuldades dos usuários quanto ao acesso e continuidade de atenção. Conclusão O grupo de apoio tem reforçado encaminhamentos prescritos ou sua obtenção em consultas médicas na rede, acolhido demandas por área profissional, orientado usuários para acessar serviços e inserir-se em tratamentos. Os usuários valorizaram a escuta e o acolhimento do grupo de apoio, no qual se configuram estratégias para promoção do cuidado integral em saúde. Abstract Introduction The Unified Health System considers that hospital care is important for the construction of integrality. Residents in a Multi-professional Residency Program to the Hospital Universitário da Universidade de São Paulo indicated, difficulties of the medical and nursing staff were identified to detecting demands for rehabilitation at hospital discharge, which encouraged residents to create a support group to hospital discharge. Objective To verify the sociodemographic and health profile of users accompanied by the support group, identify challenges for insertion of these users in the rehabilitation care network and identify strategies of the support group to face these challenges. Method Retrospective, exploratory and descriptive study, based on the documentary analysis. Results We analyzed forms of 251 users, 83 (33%) received a referral for rehabilitation at discharge and 17 (6.7%) received referral after guidelines of the discharge support group; 95 (37.8%) sought rehabilitation services. Of these, 60 were effectively included in the services, of which 46 (18.3%) were extra-hospital, such as rehabilitation centers, basic health units and 14 (5.6%) in the Hospital Home Care Program. Concerning professional areas, 34 (13.5%) started physical therapy treatment, 29 (11.6%), speech therapy and 11 (4.9%), therapeutic-occupational. It was identified insufficiency of professional referrals and difficulties of users regarding access and continuity of care. To cope with challenges, the support group has reinforced prescribed referrals or directed obtaining referrals in medical consultations on the network. Conclusion The group has tried to understand user demands by professional area, oriented users to access services and to get treatments. The users have valued the receptiveness of the support group, being a strategy to promote integral health care.

Introduction: The Core Set is a group of typical and significant functionality categories of the International Classification of Functioning, Disability and Health – ICF used for certain health conditions. Objective: The study reviewed the application of the component categories Activities and Participation based on the ICF Checklist for multiple sclerosis (MS) and its relationship with the comprehensive and validated Core Sets by occupational therapists. Method: Descriptive quantitative research from collection and organization of data questionnaire based on the components Activities and Participation of the ICF Checklist - Version 2.1ª. Clinical form for the ICF containing 25 categories belonging to 6 domains and analysis of its relationship with the Core Sets. Participated 115 people with relapsing-remitting MS without disability to moderate disability, treated at the Central Institute of Hospital Clinics of the Faculty of Medicine University of São Paulo. We created database in Excel and made descriptive analysis of frequencies. Results: Most participants were women (85), mean age 32 years and 1 month (± 7.4). Study broadens the evidence of the applicability of the Comprehensive Core Set with 88% (22) and Core Set validated by occupational therapists with 72% (18) compared evaluated categories. More significant difficulties were encountered in the categories d640 Doing housework, d430 Lifting and carrying objects and d850 Remunerative employment, which reflected on the performance of various activities and social participation. Conclusion: Studies on application of the Core Set validated by occupational therapists are recommended to extend the evidence of professional clinical practice and inclusion of categories depending on the context.

Introducao: O Core Set e um conjunto de categorias da Classificacao Internacional de Funcionalidade, Incapacidade e Saude – CIF, tipicas e significativas, relacionadas a funcionalidade, utilizadas para determinadas condicoes de saude. Objetivo: O estudo analisou a aplicacao de categorias do componente Atividades e Participacao baseadas na Checklist da CIF para esclerose multipla (EM) e sua relacao com o Core Set abrangente e o Core Set validado por terapeutas ocupacionais. Metodo: Pesquisa quantitativa descritiva, a partir de coleta e organizacao de dados de questionario baseado no componente Atividades e Participacao Checklist da CIF - Versao 2.1.a - Formulario Clinico para a CIF, contendo 25 categorias pertencentes a seis dominios, e analise de sua relacao com os Core Sets. Participaram 115 pessoas com EM remitente-recorrente, sem incapacidade ate incapacidade moderada, acompanhadas no Instituto Central do Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo. Foi criado banco de dados em Excel e feita analise descritiva das frequencias. Resultados: A maioria dos participantes eram mulheres (85) com idade media de 32 anos e 1 mes (±7,4). Estudo amplia as evidencias da aplicabilidade do Core Set abrangente com 88% (22) das categorias e do Core Set validado por terapeutas ocupacionais com 72% (18), em relacao as categorias avaliadas. Dificuldades mais expressivas foram encontradas nas categorias d640 Realizacao das tarefas domestica, d430 Levantar e carregar objetos e d850 Trabalho remunerado. Conclusao: Recomendam-se estudos sobre aplicacao do Core Set por terapeutas ocupacionais para ampliar as evidencias da pratica clinica profissional e para a inclusao de categorias, conforme o contexto.

Introducao: O adoecimento e a hospitalizacao de longa duracao para pessoas adultas jovens podem causar importantes rupturas e mudancas em seu cotidiano. A terapia ocupacional propoe atividades significativas para amenizar as alteracoes decorrentes do adoecimento e da hospitalizacao na vida diaria e promover saude, ampliando modos de organizacao da atencao. Objetivo: Descrever e refletir sobre a atencao desenvolvida pela terapia ocupacional a duas jovens hospitalizadas. Metodo: Foi realizado estudo de caso, retrospectivo, de natureza qualitativa, com base em analise documental relativa aos percursos terapeuticos trilhados por duas jovens acompanhadas pela terapia ocupacional em uma enfermaria de clinica medica de um hospital universitario. Resultado s : Foram desenvolvidas atividades expressivas, artesanais, utilizacao do computador e acesso as redes sociais, para estimulo de novas possibilidades de vida e cuidado. Foram tambem adotadas tecnicas terapeuticas de posicionamento, mobilizacao e conservacao de energia para alivio de sintomas fisicos, melhora funcional e do autocuidado. A atencao da terapia ocupacional em articulacao com aquela prestada pela equipe de enfermagem e por voluntarios possibilitou o reconhecimento das atividades produzidas pelas usuarias e o compartilhamento de suas experiencias com demais usuarios e familiares. Conclusao: As vivencias de atividades, de tecnicas e os vinculos terapeuticos construidos entre as terapeutas ocupacionais e as usuarias, compuseram seus percursos terapeuticos e possibilitaram acolhimento, resgate e desenvolvimento de habilidades diversas, incluindo as de autocuidado, configurando-se importantes estrategias para a promocao da saude. Abstract Introduction : Illness and long-term hospitalization for young adults may cause major disruption in their daily life with changes in their daily routine. Occupational therapy proposes significant activities to alleviate the changes due to illness and hospitalization in daily living and promote health, increasing ways of organizing care. Objective : To describe and reflect on the care provided by occupational therapy to two young women hospitalized. Method : A retrospective qualitative case study was carried out based on a documentary analysis of the therapeutic pathways taken by two young women accompanied by occupational therapy in an internal medical ward of a university hospital. Results : Expressive, handcrafted activities, computer use and access to social networks were developed. Therapeutic techniques of positioning, mobilization, massage and conservation of energy also were adopted for relief of physical symptoms and functional improvement and self-care. The attention of the occupational therapy in articulation with the nursing team and volunteers allowed the recognition of the activities produced by the users and the sharing of their experiences with other users and their families. Conclusions : The proposed therapeutic enabled the users to develop strategies for self-knowledge and self-care, improvement of their health, reorganization of their daily routine inside and outside of the hospital and potentialization of their abilities. Keywords: Human activities; Hospitalization; Humanization of hospital care; Health promotion; Occupational therapy.

The present study aimed to analyze the use of a group, treated by Occupational Therapy, as a strategy for the rehabilitation of adults with sequelae resulting from stroke. The group strategy was developed at the Center for Teaching and Research of the University of São Paulo - USP from August 2009 to October 2010. This is a qualitative and descriptive study based on the documental analysis of records using thematic analysis. The group was composed of eight members, four women and four men, aged between 32 and 62 years old. Group rehabilitation enabled people to relate with their own difficulties and potentialities, developing individual and group strategies to overcome the difficulties derived from the disability. Self-esteem was upgraded, social relationships were reestablished, functional capacity was improved, and meaningful activities that had been abandoned after the stroke were rescued.

0 0 1 143 820 Universidade de Sao Paulo 6 1 962 14.0 96 800x600 Normal 0 false false false PT-BR JA X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman";} O estudo objetivou analisar a experiencia de um grupo desenvolvido pela Terapia Ocupacional enquanto estrategia de reabilitacao de pessoas com sequelas decorrentes de acidente vascular cerebral desenvolvido no Centro de Docencia e Pesquisa da Universidade de Sao Paulo, entre agosto de 2009 e outubro de 2010. Trata-se de um estudo qualitativo descritivo realizado por meio de analise documental dos registros de prontuarios utilizando-se de analise tematica. O grupo foi composto por oito integrantes, quatro mulheres e quatro homens, com idade entre 32 e 62 anos. A estrategia de grupo no contexto da reabilitacao propiciou o contato das pessoas com as proprias dificuldades e potencialidades, bem como o desenvolvimento de possibilidades individuais e coletivas de superacao das dificuldades advindas da deficiencia. As repercussoes foram identificadas no aumento da autoestima, no estabelecimento de relacoes sociais, uso das capacidades funcionais e resgate de atividades significativas que haviam sido abandonadas apos o acidente vascular cerebral.

O presente estudo objetivou a sistematizacao do conhecimento produzido pela Terapia Ocupacional relacionado ao tema acidente vascular cerebral, nos ultimos dez anos (2003-2013). Trata-se de uma revisao integrativa nacional da literatura realizada a partir das bases de dados: Scientific Eletronic Library Online – SciELO Brazil e Biblioteca Virtual em Saude e Literatura Latino-Americana e do Caribe de Ciencias da Saude – LILACS. Foram encontrados 17 artigos sobre o tema estudado. Identificou-se que ha uma maior tendencia nas producoes nacionais voltadas para a categoria de Estrategias e Intervencoes Terapeuticas do que a Fundamentacao Teorica e a Analise da Pratica. Os estudos demonstraram que a atuacao do terapeuta ocupacional proporciona melhora no desempenho funcional, na independencia e na qualidade de vida aos pacientes com AVC. A producao cientifica recente em Terapia Ocupacional sobre o tema AVC contribuiu para maior divulgacao e melhor desenvolvimento de praticas terapeuticas voltadas ao cuidado as pessoas com AVC e para um maior reconhecimento da necessidade e da importância do terapeuta ocupacional pelos demais profissionais. Recomenda-se uma producao mais diversificada, para atender aos padroes cientificos internacionalmente reconhecidos, indo ao encontro da tendencia das praticas de saude. O estudo aponta a necessidade de intensificar a realizacao de pesquisas para divulgacao do conhecimento produzido pela Terapia Ocupacional e seu reconhecimento no campo da reabilitacao de pessoas com AVC.

RESUMO Objetivo Avaliar atributos essenciais (acesso de primeiro contato, longitudinalidade, integralidade e coordenação da atenção) e derivados (orientação familiar e comunitária) da Atenção Primária em Saúde (APS) na percepção de usuários com e sem deficiência. Método Estudo transversal observacional utilizando o questionário Primary Care Assesment Tool em usuários autodeclarados com e sem deficiência de cinco unidades básicas de saúde de um município no qual 55% da população depende do SUS. Foram atribuídos escores para as respostas dadas a cada atributo de atenção primária à saúde avaliado. Resultados Participaram 93 usuários (67 com e 26 sem deficiência). Não houve diferença estatisticamente significante para nenhum dos atributos na comparação entre pessoas com e sem deficiência. Para o grupo como um todo, obtiveram-se escores acima do critério de corte: Grau de afiliação, Acesso de primeiro contato (utilização), Longitudinalidade e Coordenação da atenção (sistema de informação). Receberam pior avaliação: Acesso de primeiro contato (acessibilidade), Coordenação da atenção (integralidade do cuidado), Integralidade (serviços disponíveis e prestados) e Orientação familiar e comunitária. Os usuários reconhecem que as equipes identificam problemas de locomoção e movimentação, mas que existem falhas no reconhecimento de problemas para ouvir, falar e enxergar; e na orientação das pessoas que necessitam de auxílio e das que prestam cuidados. Conclusão Os usuários com e sem deficiência avaliaram de forma semelhante a atenção que recebem e indicaram fragilidades no reconhecimento de demandas específicas. Há necessidade de mudanças (estruturais e do processo de trabalho) para assegurar acessibilidade, integralidade do cuidado e orientação familiar e comunitária e, assim, melhor qualificar a APS. ABSTRACT Purpose To evaluate the core (First Contact, Longitudinality, Comprehensiveness, and Coordination of Services) and derivative (Family Orientation, Community Orientation) attributes of primary health care (PHC) from the perspective of users with and without disabilities. Methods Observational, cross-sectional study using the Primary Care Assessment Tool (PCAT) with users with and without disabilities of five basic health units (BHU) in a municipality where 55% of the population depends on the Brazilian Unified Health System (SUS). Scores were assigned to the responses given to each of the PHC attributes evaluated. Results Study participants were 93 (67 physically disabled and 26 without disabilities) PHC users. No statistically significant differences were observed for any attribute on the comparison between the populations. For both groups, the attributes Degree of Affiliation, First Contact - Utilization, Longitudinality, and Coordination of Services - Information System received satisfactory (above cutoff) scores, whereas the attributes First Contact - Accessibility, Coordination of Services - Care Integration, Comprehensiveness, Family Orientation, and Community Orientation received unsatisfactory (below cutoff) scores. Users reported that the health teams are able to satisfactorily identify mobility issues, but there are failures in the recognition of problems of hearing, voice/speech and vision, and in the orientation of services available and services provided. Conclusion Users with and without disabilities evaluated the health care received similarly, indicating fragilities on the recognition of specific demands. Structural and work process changes should be conducted to ensure Accessibility, Comprehensiveness, and Family and Community Orientation, and thus increase the quality of PHC.

To evaluate the core (First Contact, Longitudinality, Comprehensiveness, and Coordination of Services) and derivative (Family Orientation, Community Orientation) attributes of primary health care (PHC) from the perspective of users with and without disabilities.Observational, cross-sectional study using the Primary Care Assessment Tool (PCAT) with users with and without disabilities of five basic health units (BHU) in a municipality where 55% of the population depends on the Brazilian Unified Health System (SUS). Scores were assigned to the responses given to each of the PHC attributes evaluated.Study participants were 93 (67 physically disabled and 26 without disabilities) PHC users. No statistically significant differences were observed for any attribute on the comparison between the populations. For both groups, the attributes Degree of Affiliation, First Contact - Utilization, Longitudinality, and Coordination of Services - Information System received satisfactory (above cutoff) scores, whereas the attributes First Contact - Accessibility, Coordination of Services - Care Integration, Comprehensiveness, Family Orientation, and Community Orientation received unsatisfactory (below cutoff) scores. Users reported that the health teams are able to satisfactorily identify mobility issues, but there are failures in the recognition of problems of hearing, voice/speech and vision, and in the orientation of services available and services provided.Users with and without disabilities evaluated the health care received similarly, indicating fragilities on the recognition of specific demands. Structural and work process changes should be conducted to ensure Accessibility, Comprehensiveness, and Family and Community Orientation, and thus increase the quality of PHC.Avaliar atributos essenciais (acesso de primeiro contato, longitudinalidade, integralidade e coordenação da atenção) e derivados (orientação familiar e comunitária) da Atenção Primária em Saúde (APS) na percepção de usuários com e sem deficiência.Estudo transversal observacional utilizando o questionário Primary Care Assesment Tool em usuários autodeclarados com e sem deficiência de cinco unidades básicas de saúde de um município no qual 55% da população depende do SUS. Foram atribuídos escores para as respostas dadas a cada atributo de atenção primária à saúde avaliado.Participaram 93 usuários (67 com e 26 sem deficiência). Não houve diferença estatisticamente significante para nenhum dos atributos na comparação entre pessoas com e sem deficiência. Para o grupo como um todo, obtiveram-se escores acima do critério de corte: Grau de afiliação, Acesso de primeiro contato (utilização), Longitudinalidade e Coordenação da atenção (sistema de informação). Receberam pior avaliação: Acesso de primeiro contato (acessibilidade), Coordenação da atenção (integralidade do cuidado), Integralidade (serviços disponíveis e prestados) e Orientação familiar e comunitária. Os usuários reconhecem que as equipes identificam problemas de locomoção e movimentação, mas que existem falhas no reconhecimento de problemas para ouvir, falar e enxergar; e na orientação das pessoas que necessitam de auxílio e das que prestam cuidados.Os usuários com e sem deficiência avaliaram de forma semelhante a atenção que recebem e indicaram fragilidades no reconhecimento de demandas específicas. Há necessidade de mudanças (estruturais e do processo de trabalho) para assegurar acessibilidade, integralidade do cuidado e orientação familiar e comunitária e, assim, melhor qualificar a APS.

This article analyzes the implications of the acquisition of physical disability on everyday life situations of persons under occupational therapy care using the International Classification of Functioning, Disability and Health – ICF, with emphasis on contextual factors. The study included 11 adults and elderly with physical impairments resulting from neurological disorders who were under Occupational Therapy care at the Center for Teaching and Research at the University of Sao Paulo from 2009 to 2010. It’s an exploratory qualitative research conducted through documentary study and semi-structured interview for the administration of the ICF components. Changes in body functions are diverse, both mental and related to movement, and when coupled with contextual factors may result in different levels and types of disabilities, preventing participation in life situations. The analysis of contextual factors helps to identify and relate personal and environmental aspects and their dynamic interaction reflects processes that may cause disability, establishing the ICF as a valuable guide for research and development of rehabilitation practices that consider the different aspects of the reality of a person’s life.

The increasing of the elderly population is related to better material conditions for survival and progress of health practices.Bodily practices are recognized as an important strategy for health promotion and disease prevention for this population.This study aims to analyze the benefits of participating in groups of bodily practices under the perspective of Meir Schneider’sSelf-healing technique, developed with adults and the elderly. Groups took part from March to September 2012 intwelve meetings, coordinated by the INTEGRA Laboratory of the Occupational Therapy School at the University of SaoPaulo. A semi-structured questionnaire and the SF-36 were used. There were 25 participants; most of them women (88%),with an average age of 65.8 years (ranging from 57 to 76) and an average of 3.6 years of education. Most participantsperformed the guidelines taught in the group at home, with referred physical, mental and emotional benefits. There werestatistically significant improvements in SF36’s physical, emotional and bodily pain domains. The effects on the mind-bodyrelationship were identified by positive results in all domains of the SF-36 and the semi-structured questionnaire. Resultsindicate that the method used is effective and beneficial for functional capacity and quality of life of this population.

The urgent need to train professionals capable of working in teams from a humanist perspective, conceiving this action on the basis of comprehensiveness of care, has been widely debated. In this context, active methods of teaching and learning have proven to be relevant because they stimulate the critical capacity and autonomy of learners. In this experience report, we aimed to discuss the use of active methodology, in this case problem methodology, in the teaching-learning process of senior undergraduate students at the College of Occupational Therapy of the ‘Pontifícia Universidade Católica de Campinas’ - PUC-Campinas, São Paulo state, particularly considering the isciplines related to field practice and/or supervised therapeutic practice (STP). To this end, the following instruments were used for data collection: records of meetings of the evaluation stages, evaluation reports of supervision, the educational project of the Occupational Therapy course, and the experience of the teachers who taught those discipline. The analysis of the collected material, together with the reflections relevant to the experience of teachers showed that the strategies and devices used in the educational isciplines, by relying on problem methodology, resulted in greater awareness and accountability of students, as well as greater autonomy and capacity to plan and develop intervention procedures required under different development scenarios of those disciplines. Moreover, we also observed the capacity of students to transform the situations experienced into knowledge, enabling the expansion of the decision-making perspective and the construction of a more reflective attitude. All these aspects have ensured the existence of a teaching-learning perspective that sought to encompass personal, social, cognitive, technical and ethical dimensions.

This article aims to contribute to the understanding of medium-complexity ambulatory care delivered to persons with physical impairments and disabilities resulting from these occurrences, through practice developed by the Occupational Therapy with this population at the Center for Teaching and Research of the Department of Physical, Speech and Occupational Therapy at the University of São Paulo, from March 2009 to December 2010, on a weekly basis. Due to the lack of studies on medium complexity health care, official documents of Public Health Policy were used as a guide for reflection on this practice. The research was carried out using a qualitative exploratory approach developed from the documentary study of the records of twenty-two users. It proposes the use of individual, group and body approaches as a means of body reappropriation and capability development to produce one´s own health. For most people, the experience was a chance to receive, albeit partially, their health and rehabilitation needs. The emphasis on the group approach associated with the body approach contributed to improve the user’s ability to self-care, and the integration of the knowledge acquired as a result of interventions with strategies adopted in personal daily life activities.

This article aims to contribute to the understanding of medium-complexity ambulatory care delivered to persons with physical impairments and disabilities resulting from these occurrences, through practice developed by the Occupational Therapy with this population at the Center for Teaching and Research of the Department of Physical, Speech and Occupational Therapy at the University of Sao Paulo, from March 2009 to December 2010, on a weekly basis. Due to the lack of studies on medium complexity health care, official documents of Public Health Policy were used as a guide for reflection on this practice. The research was carried out using a qualitative exploratory approach developed from the documentary study of the records of twenty-two users. It proposes the use of individual, group and body approaches as a means of body reappropriation and capability Resumo: O presente artigo visa a contribuir para a compreensao da atencao ambulatorial de media complexidade as pessoas com deficiencia fisica e incapacidades que dela decorrem, por meio da pratica desenvolvida pela Terapia Ocupacional com essa populacao no Centro de Docencia e Pesquisa do Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional da Universidade de Sao Paulo, no periodo de marco de 2009 a dezembro de 2010, com periodicidade semanal. Pela escassez de estudos sobre a atencao de media complexidade, foram utilizados os documentos oficiais referentes as politicas publicas da area como referencia para a reflexao da pratica. Para a analise da experiencia foi realizado um estudo qualitativo, do tipo exploratorio, a partir de estudo retrospectivo documental dos registros de prontuario de 22 usuarios acompanhados. Propoe a utilizacao de abordagens individuais, grupais e corporais como meio da reapropriacao do corpo e do lugar de sujeito produtor da propria saude. Para a maioria das pessoas, a experiencia representou uma possibilidade de acolher e contemplar, mesmo que parcialmente, as necessidades de saude e reabilitacao. A enfase na estrategia grupal, aliada a corporal, possibilitou fortalecer a capacidade de o usuario cuidar de si, valorizar e integrar o aprendizado adquirido por meio das intervencoes com estrategias pessoais adotadas nas atividades do cotidiano. Palavras-chave: Reabilitacao, Pessoas com Deficiencia Fisica, Atencao Secundaria a Saude, Grupo, Corpo, Terapia Ocupacional.

Introducao: o Programa de Residencia Multiprofissional ora descrito e desenvolvido em um hospital publico universitario de media complexidade desde 2012, sendo constituido, entre outras areas de concentracao, pela area de Saude do Adulto e do Idoso. a area de concentracao ocorre em colaboracao entre docentes e profissionais de fisioterapia, fonoaudiologia, terapia ocupacional e farmacia. o programa integra atividades de ensino em servico, pesquisa e extensao. a perspectiva multiprofissional compoe os paradigmas de promocao da saude e cuidado, tendo em vista que o alivio do sofrimento humano requer um planejamento multiprofissional, com atuacao integrada de diversas areas de atuacao. Objetivo: Apresentar os programas criados a partir do trabalho multiprofissional envolvendo a Terapia Ocupacional. Metodos: Trata-se de um trabalho descritivoreflexivo acerca dos projetos desenvolvidos na residencia multiprofissional pela Area de Concentracao do Adulto e do Idoso dos quais a Terapia Ocupacional participa. Resultados: Os programas criados a partir da analise das demandas dos usuarios abrangem a atencao hospitalar, ambulatorial e apos a alta visando maior integralidade do cuidado nohospital e a partir dele. o projeto de atencao na enfermaria de clinica medica e desenvolvido as pessoas adultas e idosas que apresentam limitacao na realizacao das atividades. o programa de apoio a alta realiza encaminhamentos para a rede de servicos da regiao apos a saida do hospital bem como o seguimento via telefone para apoiar o acesso aos diferentes servicos de saude e sociais. Quanto as propostas ambulatoriais destacam-se o projeto de atencao ao paciente neurologico, saude da mulher, o programa de estimulacao da memoria e reabilitacao vestibular, e a insercao nos grupos de prevencao de quedas ja desenvolvidos. Discussao: Todos os projetos sao multiprofissionais e almejam uma atuacao etica, critica e efetiva utilizando-se dos norteadores da promocao de saude, integralidade e humanizacao do cuidado. Entretanto, enfrentam-se alguns desafios para a sustentacao de uma atuacao hospitalar orientada para a multiprofissionalidade em um ambiente pouco acostumado a tais intervencoes e identificada com uma atencao centrada nos sintomas e na doenca, o que compromete em muitas ocasioes a identificacao, compreensao e a atencao as multiplas necessidades sociais e de saude da populacao. Tambem se mostra desafiadora a prestacao da atencao integral em rede servicos, que ainda funcionam de forma desarticulada e muitas vezes pouco resolutiva. Conclusao: Considera-se que a atuacao do terapeuta ocupacional na perspectiva da multiprofissionalidade e essencial para a sua formacao, contribuindo para a melhoria da qualidade da atencao a saude das pessoas, das familias e grupos sociais atendidos no hospital e uma oportunidade privilegiada para o reconhecimento da contribuicao desse profissional no contexto da operacionalizacao das politicas do Sistema Unico de Saude.

Background Participation in the workforce is one of the main social evaluations all individuals are subject to in modern society. Public policies supporting social justice for persons with disabilities have gained prominence in several nations in the last decades and it is critical to ensure that those who want to work are afforded the opportunity to do so. Meanwhile they remain under represented in the labor market within the contemporary world. Objective The purpose of this study was to identify facilitators or barriers faced by people with disability within the workforce. Participants Ten workers with disabilities from various companies and performing diverse professional job functions participated in semi-structured interviews. Method The Discourse of the Collective Subject method was employed as a means to organize and analyze qualitative data of a verbal nature. Results Reasonable work conditions, adjustments, and accommodations facilitate performance and job retention. Social participation through employment leads to social recognition and the feeling of citizenship. On the other hand prejudice, unequal opportunities, workers' low educational attainment, and lack of training opportunities lead to employment exclusion. Conclusion To include people with disabilities in the workforce, it is necessary to focus on attaining equal levels of education, an unbiased and inclusive process for entering the labor market, and continued management of disability issues within the workplace. Together, these elements create equal opportunities for workers with disabilities to advance in their careers, which in turn enables participation, social recognition and guaranties their rights as citizens.

OBJECTIVE. We evaluated the test–retest reliability, internal consistency, and construct validity of the Brazilian version of the Late-Life Function and Disability Instrument. METHOD. A sample of 118 older adults provided data for testing construct validity and internal consistency, and 14 provided data for testing test–retest reliability. Factor analysis with varimax rotation was used to assess construct validity. RESULTS. The Function component had excellent test–retest and total internal consistency reliability. Factor analysis revealed that the Upper Extremity Function and Advanced Lower Extremity Function domains were similar to the original analysis. The Disability component showed adequate to excellent test–retest reliability, except in the Management role; total internal consistency was excellent. Factor analysis revealed that its domains were similar to the original analysis, except for some items. CONCLUSION. The Late-Life Function and Disability Instrument is recommended for assessment of Brazilian community-dwelling older adults who are functionally independent and who do not require mobility assistance.

This paper presents the cross-cultural adaptation of the “Late-Life FunctionDisability Instrument - LLFDI” into Brazilian Portuguese. LLFDI is designed to assess the degreeof functional independence of community dwelling people over 60 years old and to capturechanges in functional level and the degree of disability. It comprises two components: Functionand Disability. The Function component assesses the degree of diffi culty in performing activitiesand the Disability component assesses two dimensions: the frequency of performing activities andthe degree of limitations as perceived by the subjects. The adaptation process involved translation,back translation, review by the Expert Committee and pre-test conducted with 47 subjects. Theresulting brazilian portuguese version “Instrumento de Avaliacao da Funcao e da Incapacidade paraa Populacao Idosa” (LLFDI-Br) was fully understood and may constitute as an important assessmenttool for this population. Further studies are required to evaluate its psychometric properties.

The VI Latin American Meeting of Schools and Teachers of Occupational Therapy (OT) took place in October 2011, at the Faculty of Medicine of USP, being associated with the XII Brazilian and IX Latin American Occupational Therapy Congress, held in Sao Paulo. The meeting was organized by the Latin American Confederation of Occupational Therapists (CLATO), the National Network of Education and Research in Occupational Therapy (RENETO) and the Departmentof Physical Therapy, Speech Therapy and Occupational Therapy of FMUSP. At the event 160 professionals were present among which 117 Brazilian and 43 from eight Latin American countries and two European. Fifty percent of the Brazilian educational institutions were represented, mainly from the southeast, and 35.8% of the Latin American ones. Invited researchers exhibited about the education in Brazil and Latin America and, about the challenges for higher education in the region. CLATO characterized OT education and, round tables were held about the undergraduate and graduate programs by teachers from Brazil and Latin America. Thirty-five papers were presented in the form of posters: 27 on undergraduate education, 3 on graduate education and 5 on higher education. The final meeting of the event recommended the participation of students in future events, the expansion of the event for two days, and the creation of working groups to organize in advance the thematic debates on the difficulties and potentialities of undergraduate and graduate OT Education for the VII Meeting to be held in Venezuela in 2013.

O estudo buscou refletir sobre as experiencias voltadas a preparacao e inclusao no mercado de trabalho de pessoas com deficiencia intelectual desenvolvidas por instituicoes especializadas. A pesquisa foi realizada em 2007, por meio de entrevistas aos profissionais das instituicoes. Evidenciou-se a preocupacao das instituicoes quanto a qualificacao e atualizacao dos projetos e acoes para a inclusao de seus usuarios no mercado formal ou informal de trabalho. As principais dificuldades para a inclusao no mercado de trabalho sao decorrentes da desinformacao e desconhecimento da sociedade acerca da deficiencia intelectual, promotoras de atitudes preconceituosas, da defasagem entre as exigencias das empresas e o nivel de formacao e escolarizacao dos individuos. As contratacoes estao, geralmente, atreladas as exigencias das legislacoes e o oferecimento de vagas nem sempre sao compativeis com as possibilidades dos individuos. Porem, verificam-se alguns avancos em direcao a profissionalizacao e inclusao das pessoas com deficiencia intelectual no mercado de trabalho.

The present article seeks to contemplate concerning the people with deficiency's opinions regarding the legislation of vacancies reservation in the job market. The national data point that great social inequalities refering to the people with deficiency's inclusion in the job market, even with the current politics measures of quotas that seek to laboral inclusion. The study was accomplished through interview with ten workers handling different types of physical and visual deficiency inserted in the job market. As data analysis technique was adopted the Collective Subject's Speech methodology. The legislation was considered necessary due to the historical condition of exclusion experienced by people with deficiency, considering the lack of training opportunities and low educational level. The legislation contributed to the conquest of rights to the workfield and larger social visibility of the people with deficiency's needs. However, the maintenance of the laws should be harnessed the changes of values and attitudes of the society and the avaiability of conditions for laboral inclusion of this population. O presente artigo visou refletir acerca da opinião das pessoas com deficiência a respeito da legislação referente à reserva de vagas no mercado de trabalho. Os dados nacionais apontam grandes desigualdades sociais no que se refere à inclusão de pessoas com deficiência no mercado de trabalho, mesmo com as medidas decorrentes da política de cotas que visam à inclusão laboral. O estudo foi realizado através de entrevista com dez trabalhadores com diferentes tipos de deficiência física e visual inseridas no mercado de trabalho. Como técnica de análise adotou-se o Discurso do Sujeito Coletivo. A legislação foi considerada necessária devido à condição histórica de exclusão vivida pelas pessoas com deficiência, o que levou a falta de oportunidades de capacitação e baixa escolaridade. A legislação contribuiu para a conquista do direito ao trabalho e maior visibilidade social das necessidades das pessoas com deficiência. No entanto, a manutenção das leis deve estar atrelada as mudanças de valores e de atitudes da sociedade e a disponibilização de condições para a inclusão laboral desta população.

O estudo tem como objetivo conhecer as ofertas de profissionalizacao para as pessoas com deficiencia desenvolvidas por instituicoes governamentais e nao governamentais no municipio de Campinas. A motivacao do mesmo se deu pela falta de informacoes sobre programas e projetos de capacitacao e formacao profissional para o encaminhamento desta populacao. O delineamento metodologico envolveu estudos teoricos de temas sobre o trabalho, a pessoa com deficiencia e legislacao nacional, alem de pesquisa exploratoria para identificar e conhecer as propostas realizadas pelas instituicoes especificas para pessoas com deficiencia e aquelas que as incluem. Para a coleta de dados realizou-se levantamento das instituicoes, contato telefonico, visita e aplicacao de entrevista. Identificou-se 13 instituicoes sendo que 2 desenvolvem projetos de profissionalizacao especificos para pessoas com deficiencia e 11 incluem estes usuarios. O acesso das pessoas com deficiencia aos servicos e reduzido, se comparado as necessidades que estas apresentam em relacao ao trabalho, renda e vida social. As instituicoes estudadas apresentam programas com pouca variedade de atividades profissionais, sistemas frageis de comunicacao e nao estao localizadas, de modo geral, nas regioes mais vulneraveis e de maior densidade populacional do municipio.

Based on the user's opinion, this study proposes to analyze the quality of the Adult Program developed at the Occupational Therapy Outpatient Department of the School of Occupational Therapy of PUC-Campinas. For this purpose, a questionnaire was elaborated and applied in order to collect qualitative and quantitative information, based on studies about the assessment of health services and programs. The present study takes into account the implementation of SUS that foresees the participation of the users. Thus, it sought to value their opinion and satisfaction in order to improve assistance. Most of the users made a positive evaluation about the help provided by the service, both from the technical and the interpersonal points of view. The majority of users did not manifest any need for changes to be implemented in the program. The study therefore contributed to the improvement of the service in aspects related to the assistance provided and its administration.

Os trabalhadores acometidos por doenças ocupacionais têm vivenciado muitas dificuldades para retornar ao trabalho devido às limitações funcionais e aos obstáculos vivenciados junto às empresas, à previdência social e aos serviços de saúde. Restrição laboral e retorno ao trabalho são aspectos dos mais complexos nas políticas de atenção à saúde do trabalhador. Visando identificar os facilitadores e as barreiras para o retorno ao trabalho de trabalhadores com longo período de permanência e sem resolutividade no serviço, em 2008, realizou-se um estudo exploratório, de natureza empírica, com abordagem qualitativa, desenvolvido a partir de estudo documental de 10 prontuários de trabalhadores acompanhados em grupo pela terapia ocupacional de um Centro de Referência em Saúde do Trabalhador da cidade de São Paulo. A organização e a análise dos dados foram realizadas segundo os componentes da CIF. O uso da CIF favoreceu ampliar a visão das condições de saúde dos trabalhadores e compreender a influência de serviços, sistemas e políticas nas diferentes áreas. As principais barreiras ao retorno ao trabalho foram: ausência de adequados programas de reabilitação profissional e insuficiente comunicação entre os atores dos diferentes níveis administrativos e políticos. Os principais facilitadores foram as atitudes e os comportamentos individuais dos profissionais de saúde do CRST, que forneceram acolhimento e suporte. After being affected by occupational diseases, workers face difficulties to return to work due to their functional limitations and obstacles presented by employers, social welfare and health services. Labor restrictions and return to work are complex aspects within worker's health policies. The purpose of this qualitative exploratory study conducted in the second half of 2008 was to identify the facilitating factors and the barriers for returning to work of workers with long unsuccessful treatment. It was based on the documental analysis of 10 clinical records of participants in a occupational therapy group at a Worker's Health Reference Center (CRST) in the city of São Paulo. Data were organized and analyzed according to ICF (International Classification of Functioning, Disability, and Health) components. Working within ICF framework widened our views on workers' health conditions and helped us understand the influence of services, systems, and policies in different areas. Main barriers for returning to work were the lack of adequate occupational rehabilitation programs and the miscommunication among actors at different administrative and political levels. The main facilitator was the individual attitude and the behavior of the CRST staff, providing holding and support to workers.

A Atenção Primária à Saúde (APS) apresenta atributos que lhe conferem complexidade, destacando-se a busca pela integralidade do cuidado em saúde, dada a diversidade e amplitude das necessidades dos usuários e do território. Para obtenção de qualidade do cuidado na APS, conforme preconizado pelo SUS, torna-se fundamental a implementação de práticas colaborativas interprofissionais. O estudo teve como objetivo identificar e analisar as potências e os desafios para o desenvolvimento de práticas colaborativas na perspectiva interprofissional em uma unidade básica de saúde (UBS) tradicional da cidade de São Paulo. Foi utilizada metodologia de pesquisa de abordagem qualitativa, caracterizada como estudo exploratório, descritivo, retrospectivo, a partir de análise documental de atividades desenvolvidas, com base na prática interprofissional e prospectivo, com realização de grupo focal remoto com profissionais da UBS em estudo. Os dados coletados foram organizados e analisados através da análise de conteúdo com base na análise temática. Os resultados demonstraram evidências de potências e desafios da prática colaborativa interprofissional. Com relação às potências, verificou-se que o trabalho interprofissional promoveu o aumento de possibilidade de construção do cuidado baseado na integralidade, permitindo que uma variedade de tecnologias fosse mobilizada e articulada, favorecendo a resolutividade com ampliação do olhar e atenção centrada na pessoa e não somente em sintomas e doenças. Possibilitou aos profissionais a divisão de responsabilidades e angústias, evitando o isolamento e a sobrecarga de trabalho, a ampliação do olhar e da escuta com compreensão de outras dimensões do cuidado. Constatou-se que o ambiente de trabalho colaborativo se mostrou gratificante e estimulante, oportunizou fluidez e trocas entre os profissionais, favorecendo a aprendizagem mútua, a articulação e a integração dos diferentes saberes. Quanto às dificuldades, o estudo possibilitou identificar uma cultura entre usuários de busca do acolhimento como um pronto atendimento, com expectativas de respostas rápidas com foco em tecnologias biomédicas e consultas com especialistas, o que dificulta a longitudinalidade, a predominância de metas quantitativas individuais, que ocupam as agendas e dificultam a manutenção de espaços de diálogo e de compartilhamento; a falta de apoio e estabilidade de diretrizes da gestão e a carência de investimento na formação pessoal e profissional dos trabalhadores. Embora tenha sido atribuído dificuldades de origem microssocial, como a falta de espaços de comunicação e macrossocial como o predomínio de metas quantitativas individuais baseadas em indicadores biomédicos, destaca-se no estudo a importância do engajamento e do apoio dos profissionais da equipe como elemento primordial para a superação dos desafios e manutenção do trabalho interprofissional na APS. Nesse sentido, para apoiar os profissionais, tanto em seus locais de trabalho como em propostas de ações da educação permanente em saúde, foi construído um produto educacional no formato de um áudio vídeo, o qual pode ser utilizado como ferramenta para estimular o desenvolvimento e aprimoramento de estratégias com ênfase em práticas colaborativas interprofissionais na rotina dos serviços. Primary Health Care (PHC) has attributes that give it complexity, highlighting the search for comprehensive health care given the diversity and breadth of the needs of users and the territory. and the comprehensiveness that is essential in the construction of health care with the provision of services based on prevention, promotion, healing and rehabilitation with intersectoriality considering the diversity and breadth of the needs of users and the territory. For the execution and obtaining of quality of care in PHC, the implementation of interprofessional collaborative practice becomes essential. The study aimed to identify and analyze the strengths and challenges for the development of collaborative practices from an interprofessional perspective in a traditional Basic Health Unit in the city of São Paulo. A qualitative research methodology was used, characterized as an exploratory, descriptive, retrospective study based on document analysis of activities developed based on interprofessional and prospective practice, with a remote focus group with professionals from the basic health unit under study. The collected data were organized and analyzed through content analysis based on thematic analysis. The results showed evidence of the strengths and challenges of interprofessional collaborative practice. Regarding the strenghts, it was found that the interprofessional work promoted an increase in the possibility of building care based on comprehensiveness allowing a variety of technologies to be mobilized and articulated, favoring resoluteness with a broader view and person-centered attention and not only in symptoms and diseases. It enabled professionals to share responsibilities and anxieties, avoiding isolation and work overload, the expansion of looking and listening with understanding of other dimensions of care. It was found that the collaborative work environment proved to be rewarding and stimulating it provided fluidity and exchanges between professionals, favoring mutual learning, articulation and integration of different knowledge. As for the difficulties, the study made it possible to identify the a culture among users of seeking reception as an emergency care, presenting expectations for fast responses with a focus on biomedical technologies and consultations with experts making longitudinality difficult, the predominance of individual quantitative targets occupying agendas and making it difficult to maintain spaces for dialogue and sharing, the lack of support and stability of management guidelines and the personal and professional training of workers. It was concluded that although difficulties of microsocial origin have been attributed, such as the lack of communication spaces and macrosocial as the predominance of individual quantitative targets based on biomedical indicators, the importance of engagement and support of team professionals is highlighted as a key element for overcoming challenges and maintaining interprofessional work in primary health care. In this sense, to support professionals, both in their workplaces and in proposals for continuing education in health, an educational product was built in the format of an audio video, which can be used as a tool to stimulate the development and improvement of strategies. with emphasis on interprofessional collaborative practices in the routine of services.