Construção e validação de modelo lógico para Centros Especializados em Reabilitação

Autores

DOI:

https://doi.org/10.11606/s1518-8787.2021055002976

Palavras-chave:

Centros de Reabilitação, organização & administração, Pessoas com Deficiência, reabilitação, Gestão de Recursos da Equipe de Assistência à Saúde, Avaliação de Processos e Resultados em Cuidados de Saúde, Administração de Recursos Humanos

Resumo

OBJETIVO Construir e validar um modelo lógico para a atenção nos Centros Especializados em Reabilitação (CER) a partir da análise do processo de trabalho e de questões organizativas de centros do Rio Grande do Norte. MÉTODOS Estudo metodológico desenvolvido em três etapas: 1) estudo documental de legislações e portarias relacionadas ao serviço de saúde e à Rede de Cuidados à Pessoa com Deficiência (RCPD); 2) realização de grupos focais, com estudo censitário dos CER do Rio Grande do Norte, para compreender e avaliar o cotidiano do serviço; e 3) sistematização das informações coletadas e, por fim, proposição e validação do modelo lógico avaliativo. RESULTADOS O modelo englobou cinco categorias centrais do processo de trabalho e organizacional: “demandas”, “recursos” (insumos, financeiros e força de trabalho), “processos”, “produtos e resultados” e “missão, valores e fatores externos”. CONCLUSÃO O modelo lógico construído foi adequado para representação gráfica do processo de trabalho e questões organizativas dos CER. Evidenciou-se que o funcionamento dos serviços está alinhado com as normativas. Contudo, ainda há lacunas organizacionais que precisam ser abordadas a fim de melhorar a resolutividade do serviço e a articulação com outros pontos da rede.

Referências

Heinemann Aw, Feuerstein M, Frontera WR, Gard AS, Kaminsky LA, Negrini S, et al. Rehabilitation is a global health priority. Arch Phys Med Rehabil. 2020;101(4):728-9. https://doi.org/10.1016/j.apmr.2019.08.468 [ Links ]

Rauch A, Negrini S, Cieza A. Toward strengthening rehabilitation in health systems: methods used to develop a Who package of rehabilitation interventions. Arch Phys Med Rehabil. 2019;100(11):2205-11. https://doi.org/10.1016/j.apmr.2019.06.002 [ Links ]

World Health Organization. Disability. Geneva: WHO; 2020 [cited 2020 Jan 26]. Available from: http://www.who.int/disabilities/en/ [ Links ]

Brazilian Institute of geography and Statistics. Demographic Census 2010: general characteristics of the population, religion and disability. Rio de Janeiro: IBGE; 2012. [ Links ]

Ministry of Health (BR). Ordinance No. 793 of 24 April 2012. It establishes the Care Network for people with disabilities within the Unified Health System. Brasília, DF; 2012 [cited 2020 Jul 29]. Available from: https://bvsms.saude.gov.br/bvs/saudelegis/gm/2012/prt0793_24_04_2012.html [ Links ]

Pereira JS, Machado WCA. Implementation of specialized rehabilitation center: advantages and disadvantages pointed out by municipal health managers. Rev Ter Ocup Univ São Paulo. 2015;26(3):373-81. https://doi.org/10.11606/issn.2238-6149.v26i3p373-381 [ Links ]

Mills T, Lawton R, Sheard L. Advancing complexity science in healthcare research: the logic of logic models. BMC Med Res Methodol. 2019;19(1):55. https://doi.org/10.1186/s12874-019-0701-4 [ Links ]

Rohwer AA, Booth a, Pfadenhauer L, Brereton L, Gerhardus a, Mozygemba K, et al. Guidance on the use of logic models in health technology assessments of complex interventions. Bremen (DE): Integrate HTA; 2016. [ Links ]

PetersenD, Taylor EF, Peikes D. The Logic Model: the foundation to implement, study, and refine patient-centered medical home models. Rockville, MD: Agency for Healthcare Research and Quality; 2013. AHRQ Publication Nº 13-0029-EF. [ Links ]

Cassiolate MMMC, Gueresi S. How to develop logical model: roadmap for formulating programs and organizing evaluation. Brasília, DF: Intituto De Pesquisa Econômica Aplicada; 2010. (IPEA Technical Note; No. 6). [ Links ]

Dall’agnol CM, Magalhães AMM, mano GCM, Olschowsky A, Silva FP. The notion of task in focus groups. Rev Gaucha Sick. 2012;33(1):186-90. https://doi.org/10.1590/S1983-14472012000100024 [ Links ]

Machado FCA, Souza GCA, Noro LRA. Proposition of indicators for oral health surveillance of adolescents. Cienc Collective Health. 2018;23(1):187-202. https://doi.org/10.1590/1413-81232018231.20842015 [ Links ]

Tamaki EM, Tanaka OU, Felisberto E, Alves CKA, Drumond Junior M, Bezerra LCA, et al. Methodology of building a panel of indicators for monitoring and evaluation of SUS management. Cienc Collective Health. 2012;17(4):839-49. https://doi.org/10.1590/S1413-81232012000400007 [ Links ]

Malta DC, Stopa SR, Canuto R, Gomes NL, Mendes VLF, Goulart BNG, et al. Self-reported prevalence of disability in Brazil, according to the National Health Survey, 2013. Cienc Collective Health. 2016;21(10):3253-64. https://doi.org/10.1590/1413-812320152110.17512016 [ Links ]

Munguba MC, Vieira ACVC, Porto CMV. From invisibility to social participation: health promotion in people with disabilities. Rev Bras Promoç. Health. 2015;28(4):463-6. https://doi.org/10.5020/18061230.2015.p463 [ Links ]

Viana ALD, Bousquat AM, Arantes G, Negri Filho a, Medina MG. Regionalization and Health Networks. Cienc Collective Health. 2018;23(6):1791-8. https://doi.org/10.1590/1413-81232018236.05502018 [ Links ]

Wade DT. What is rehabilitation? An empirical investigation leading to an evidence-based description. Rehabil Clin. 2020;34(5):571-83. https://doi.org/10.1177/0269215520905112 [ Links ]

Stucki G, Zampolini M, Selb M, Ceravolo MG, Delargy M, Varela Donoso E, et al. European Framework of Rehabilitation Services Types: the perspective of the Physical and Rehabilitation Medicine Section and Board of the European Union of Medical Specialists. Eur J Phys Rehabil Med. 2019;55(4):411-7. https://doi.org/10.23736/S1973-9087.19.05728-9 [ Links ]

Graham LA. Organization of rehabilitation services. In: Barnes MP, Good DC, editors. Neurological rehabilitation. Amsterdam (NL): Elsevier; 2012. Chapter 10; p; 113-20. (Handbook of Clinical Neurology; vol. 110). [ Links ]

Stucki G, Rubinelli S, Bickenbach J. We need an operationalisation, not a definition of health. Disabled Rehab. 2020;42(3):442-4. https://doi.org/10.1080/09638288.2018.1503730 [ Links ]

Ministry of Health (BR). Ordinance No. 1,060 of June 5, 2002. Approves the National Health Policy of the person with disabilities. Official Journal of the Union. 10 June 2002; Section 1: 21. [ Links ]

Brazil. Presidency of the Republic. Decree No. 6,949 of 25 August 2009. Promulgates the International Convention on the rights of Persons with disabilities and its Optional Protocol, signed in New York on 30 March 2007. Brasília, DF; 2009. [ Links ]

Campos MF, Souza LAP, Mendes VLF. The care network of the Unified Health System for the health of people with disabilities. Interface (Botucatu). 2015;19(52):207-10. https://doi.org/10.1590/1807-57622014.0078 [ Links ]

Gulley SP, Rasch EK, Bethell CD, Carle AC, Druss BG, Howtrow AJ, et al. At the intersection of chronic disease, disability and health services research: a scoping literature review. Disabil Health J. 2018; 11 (2): 192-203. https://doi.org/10.1016/j.dhjo.2017.12.012 [ Links ]

Alves MA, Ribeiro FF, Sampaio RF. Potential for change in health practices: the perception of workers of a Rehabilitation Network in (trans)training. Physio Pesq. 2016;23 (2):185-92. https://doi.org/10.1590/1809-2950/14945923022016 [ Links ]

Dantas DS, Correa AP, Buchalla CM, Castro SS, Castaneda L. Biopsychosocial model in health care: reflections in the production of functioning and disability data. Purple Physio. 2020; 33: e003321. https://doi.org/10.1590/1980-5918.033.ao21 [ Links ]

Machado WCA, Pereira JS, Schoeller SD, Júlio LCT, Martins MMFPS, Figueiredo NMA. Comprehensiveness in the care network regarding the care of the disabled person. Context Inferm Text. 2018; 27(3): e4480016. https://doi.org/10.1590/0104-07072018004480016 [ Links ]

Machado WCA, Silva VM, Silva RA, Ramos RL, Figueiredo NMA, Castelo Branco SEM, et al. Hospital discharge of patients with disabling neurological injury: necessary referrals to rehabilitation. Cienc Collective Health. 2016;21(10):3161-70. https://doi.org/10.1590/1413-812320152110.17232016 [ Links ]

Pryor W, Newar P, Retis C, Urseau I. Compliance with standards of practice for health-related rehabilitation in low and middle-income settings: development and implementation of a novel scoring method. Disab Rehabil. 2019;41(19):2264-71. https://doi.org/10.1080/09638288.2018.1462409 [ Links ]

Bright T, Wallace S, Kuper H. A systematic review of access to rehabilitation for people with disabilities in low - and middle-income countries. Int J Environ Res Public Health 2018;15 (10): E2165. https://doi.org/10.3390/ijerph1510216 [ Links ]

Publicado

2021-10-01

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Artigos Originais

Como Citar

Valentim, R. de S., Dantas, T. H. de M. ., Machado, F. C. de A., Araújo, C. M., Silva, M. S. da, Castaneda, L., & Dantas, D. (2021). Construção e validação de modelo lógico para Centros Especializados em Reabilitação. Revista De Saúde Pública, 55, 54. https://doi.org/10.11606/s1518-8787.2021055002976

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