Post-stroke rehabilitation: identification of speech-language disorders signs and symptoms by physicians and nurses in Primary Health Care
Reabilitação pós-AVC: identificação de sinais e sintomas fonoaudiológicos por enfermeiros e médicos da Atenção Primária à Saúde
Paula Anderle; Sheila Petry Rockenbach; Bárbara Niegia Garcia de Goulart
Abstract
Purpose: Stroke is a common disease for people and a global public health concern in terms of mortality, disability, and cost demand. This study aims to assess which groups of comorbidities related to speech-language disorders are identified by physicians and nurses of the Family Health Strategy (FHS) as to be referred to post-stroke speech-language rehabilitation at Primary and Secondary Health Care. Methods: Twenty-two physicians and nurses, from the FHS supported by the Family Health Support Center in southern Brazil, answered a questionnaire developed for this study, exploring socio-demographic variables, education background, professional performance and conduct to post-stroke patients. A descriptive data analysis (absolute and relative frequencies) was performed in SPSS Software 22. Results: Among the participants, 77.3% refer post-stroke patients to physiotherapy and 54.5% to speech-language rehabilitation. None refer to patients to treatment due to cognitive comprehension sequelae; 90.0% refer for significant speech-language disorders. In case of changes in the stomatognathic system, 80.0% of physicians do not refer to speech-language pathologists, and 83.3% of nurses usually do. Conclusion: The professionals showed difficulty in identifying speech-language pathological signs and symptoms related to cognition and the stomatognathic system, not referring to speech-language rehabilitation at primary or secondary health care. The results highlight the importance of continuing education and improvement of the knowledge of the primary health care teams, so that speech-language sequelae are properly identified and sent for rehabilitation.
Keywords
Resumo
Objetivo: O Acidente Vascular Cerebral (AVC) é um agravo comum para a população e um problema para a saúde pública global em termos de mortalidade, deficiência e demanda de custos. O objetivo deste estudo é verificar quais grupos de comorbidades ligados aos distúrbios fonoaudiológicos são identificados por médicos e enfermeiros das equipes de Estratégia de Saúde da Família (ESF) para encaminhamento à reabilitação fonoaudiológica e continuidade do cuidado de pacientes pós-AVC nas Atenções Primária e Secundária à Saúde (APS). Método: Participaram 22 médicos e enfermeiros das equipes de ESF apoiadas pelo Núcleo de Apoio à Saúde da Família, no sul do Brasil. Um questionário desenvolvido para este estudo foi respondido, explorando variáveis sociodemográficas, histórico de formação, atuação profissional e condutas ao paciente com AVC. Análise descritiva dos dados (frequências absoluta e relativa) foi realizada no Software SPSS 22. Resultados: Dos entrevistados, 77,3% encaminham pacientes pós-AVC para fisioterapia e 54,5%, para reabilitação fonoaudiológica. Nenhum profissional realiza encaminhamento por sequelas cognitivas de compreensão; 90,0% encaminham por distúrbios de linguagem expressiva na fala. Para alterações do sistema estomatognático, 80,0% dos médicos não encaminham para fonoaudiólogo e 83,3% dos enfermeiros o fazem. Conclusão: Os profissionais demonstraram dificuldade em identificar distúrbios fonoaudiológicos ligados à cognição e ao sistema estomatognático, não encaminhando para reabilitação fonoaudiológica nas Atenções Primária e Secundária à Saúde. Os resultados apontam para a necessidade de ações que auxiliem no processo de educação permanente e melhorem o conhecimento das equipes de APS, para que as sequelas fonoaudiológicas sejam devidamente identificadas e encaminhadas para reabilitação.
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References
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Submitted date:
02/07/2018
Accepted date:
10/03/2018
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