The interface of occupational therapists practices with regards primary health care attributes

Silva, Rodrigo Alves dos Santos; Oliver, Fátima Corrêa

doi:10.4322/2526-8910.ctoAO2029

Acessibilidade / Reportar erro

Brasil

Cadernos Brasileiros de Terapia Ocupacional

Español English

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

Original Article • Cad. Bras. Ter. Ocup. 28 (03) • Jul-Sep 2020 • https://doi.org/10.4322/2526-8910.ctoAO2029 copy

The interface of occupational therapists practices with regards primary health care attributes¹ 1 The research complies with the principles of Resolution 466/2012 (Brasil, 2012) and approved by the Research Ethics Committee of the Federal University of São Carlos (CEP/UFSCar), according to CAAE nº 68134317.0.0000.5504.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Introduction

The specific dialogue of occupational therapy with Primary Health Care (APS) has weaknesses, which requires in-depth understanding.

Objective

To identify and analyze the practices of occupational therapists in APS and its interface with the essential and derived attributes of this level of care.

Method

Research of mixed methods (explanatory sequential) through three phases: Phase 1 - a collection of quantitative and qualitative data by an Internet Surveys with 105 occupational therapists from APS; Phase 2 - qualitative approach starting the Grounded Theory, through interviews and observations of the practice with 8 professionals from the first phase; Phase 3 - Discussion and analyzing of results.

Results

Phase 1 - 93.3% of the participants were women, mostly from state capitals and metropolitan regions, and from the Extended Family Health and Primary Care Center (NASF-AB). Regarding the orientation of their practices by APS attributes, the following results were identified: first contact attention (92.3%), longitudinality (84.7%), completeness (95.2%), care coordination (83.8%), family orientation (90.4%), community orientation (76.1%) and cultural competence (60.9%). Phase 2 - Eight NASF-AB occupational therapists from southeastern and northeastern capitals and metropolitan regions reported the work process in APS and their analysis indicated the following categories: practice characteristics and rationale, occupational therapy in clinical and pedagogical support, and challenges of practice.

Conclusion

It was possible to verify that the occupational therapists’ practices interface with the APS attributes, which indicates their relevance and insertion in this level of care.

Keywords:
Primary Health Care; Occupational Therapy; Professional Practice; Unified Health System; Research/methods

Characteristics	N	%
Gender
Female	98	93.3
Male	7	6.7
Age group (years old)
Up to 29 years old	31	29.5
30 to 39 years old	51	48.6
More than 40 years old	23	21.9
Post-graduation in APS/Public Health/Collective Health
Yes	64	61
No	41	39
Country Region
Southeast	58	55.3
Northeast	30	28.6
South	10	9.5
North	6	5.7
Midwest	1	0.9
Size of the municipality where the professional works
≤50 thousand inhabitants	14	13.3
Between 50 and 100 thousand inhabitants	7	6.7
> 100,000 inhabitants	21	20
Capitals and metropolitan regions	63	60
Time working in the APS
Up 3 years	52	49.5
Between 3 and 7 years	44	41.9
> 7 years	9	8.6
Type of service
NASF-AB	74	70.5
UBS	14	13.3
Multi-professional Residence	7	6.7
Street Office	2	1.9
Home Care/Better at Home	2	1.9
Primary Prison Care	1	0.9
Others	5	4.8
Hours working in APS
20 hours	41	39.1
30 hours	46	43.8
40 hours	6	5.7
60 hours	12	11.4
*Participation of APS services that OT works in the National Program to Improve Access and Quality of Primary Care (PMAQ-AB)**
Yes	82	78.1
No	12	11.4
I do not know	11	10.5
Knowledge of OT about the percentage of current APS coverage in the municipality that works**
Yes	47	44.8
No	58	55.2

I - How people, families, and communities have access to the practices of occupational therapists in APS	N	%
Matrix Support - pedagogical [discussion of cases, specific topics for permanent education and coordination of network care]	85	81
Referrals	77	73.3
Active search based on epidemiological indicators	43	41
Direct access to care and monitoring	40	38.1
Others	8	7.6
II - Characterization of the type of practice*	N	%
Attention to users, family, and community [individual, family, groups, and articulation in the health and intersectoral network]	103	98.1
Service or team management	24	22.9
Teaching activities [preceptorship and/or tutoring for occupational and/or multi-professional therapy]	24	22.9
Others	10	9.5
III – Do you recognize interprofessional work in planning and implementing practices in APS?	N	%
Yes	95	90.5
No	10	9.5
IV - Place of the practice of occupational therapists in APS	N	%
UBS	96	91.4
People and/or family homes	89	84.8
Territory equipment [schools, daycare centers, community centers, shelters]	87	82.9
Public spaces [squares, parks, streets]	54	51.4
V - Use of assessment instruments with people, families and the community that the occupational therapist assists or follows up in APS	N	%
Use of instruments developed by the professional or the APS service	64	61
Use of specific and standardized assessment tools for occupational therapy	46	43.8
Does not use assessment tools	26	24.8
Others	6	5.7
VI - Type of record/documentation of actions performed by occupational therapists in APS	N	%
Paper record by E-SUS service	57	54.3
Medical records or multi/interprofessional records	56	53.3
Electronic service record by E-SUS	33	31.4
Medical records or exclusive occupational therapy records	16	15.2
Others	13	12.3
VII - Specific demand, populations, health needs and/or problems assisted by occupational therapists in APS	N	%
Specific demand
People with an impairment and/or difficulty in participating and carrying out their daily activities/occupations	96	91.4
Lifecycles
Prenatal, pregnant women and newborns care	62	59
Children and adolescents	92	87.6
Adults	91	86.7
Seniors	96	91.4
Health and/or problem needs
People with chronic diseases	89	84.8
People in psychological distress	86	81.9
Bedridden people	85	81
Disabled people	82	78.1
People restricted to the home (not bedridden)	77	73.3
People in situations of social vulnerability	76	72.4
People with needs resulting from the abusive use of tobacco, alcohol and other drugs	65	61
Victims of violence	52	49.5
People with communicable diseases	47	44.8
Homeless people	24	22.9
People deprived of their liberty	3	2.9
Others	6	5.7

Participant	Region	Work Hours	Time working in APS	Type of Participation
Participant 1 [Salvador]	Northeast	20 hours	> 3 years ≤ 5 years	Interview (online)
Participant 2 [Recife]		20 hours	> 3 years ≤ 5 years	Interview (face-to-face) and Practice Observation
Participant 3 [Metropolitan region - Recife]		20 hours	> 1 years ≤ 3 years	Interview (face-to-face)
Participant 4 [Maceió]		30 hours	> 3 years ≤ 5 years	Interview (face-to-face)
Participant 5 [São Paulo – South area]	Southeast	30 hours	> 5 years ≤ 7 years	Interview (online)
Participant 6 [Rio de Janeiro]		30 hours	> 3 years ≤ 5 years	Interview (online)
Participant 7 [Belo Horizonte]		40 hours	> 3 years ≤ 5 years	Interview (online)
Participant 8 [São Paulo – north area]		20 hours	> 3 years ≤ 5 years	Interview (face-to-face) and Practice Observation

Universidade Federal de São Carlos, Departamento de Terapia Ocupacional Rodovia Washington Luis, Km 235, Caixa Postal 676, CEP: , 13565-905, São Carlos, SP - Brasil, Tel.: 55-16-3361-8749 - São Carlos - SP - Brazil
E-mail: cadto@ufscar.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] Author’s Contributions Rodrigo Alves dos Santos Silva performed data collection, organization, and data analysis, and worked on the writing and review the text. Fátima Corrêa Oliver was responsible for guiding the research, reviewing the data analysis, writing, and reviewing the text. All authors approved the final version of the text.