O processo de trabalho do centro especializado em reabilitação: Um olhar para a fisioterapia

Abstract

Introduction: A person with a disability is one who has a long-term impairment of a physical, mental, intellectual or sensory nature, which, in interaction with one or more barriers, may hinder their full and effective participation in society on an equal basis with others. In order to implement and carry out care for this population segment, the Care Network for Persons with Disabilities (RCPCD) by Ordinance GM/MS 793 of April 24, 2012, places the Specialized Rehabilitation Center (CER) as an outpatient care point paramount. The CERs are regulated reference services, which operate on a territorial basis and provide specialized care to people with disabilities, thus being the reference place for care and protection for users, family members and companions in the processes of auditory, physical, mental rehabilitation. intellectual, visual, ostomies and multiple disabilities whose view of the physiotherapist is of paramount importance for this care process. Objective: To analyze the performance of physiotherapists working in Specialized Rehabilitation Centers in the State of Paraíba in order to elucidate the care offered to the population of people with disabilities. Methodology: This is a cross-sectional field study with a qualitative approach. Data collection took place between February and June 2022. The first step was through a structured questionnaire whose data were submitted to descriptive statistics in order to characterize the sample. In the second stage, the subjects were interviewed, the speeches were recorded, transcribed and submitted to content analysis using the Bardin method and the IRAMUTEQ software version 0.7 based on the Descending Hierarchical Classification analysis in four categories: Flow and access to the physical rehabilitation service offered by the CER; Flow and Prescription of Orthoses, Prostheses and Mobility Aids; Multiprofessionality, Interdisciplinarity and Collaborative Practice in the CER and Work Process in Health. As a criterion for inclusion in the study, the physiotherapist should have worked at the CER for at least 6 months. Exclusion was due to the absence of the professional at the time of data collection. Results: In all, 23 physiotherapists from three CERs from two different health regions in the State of Paraíba participated. There was a predominance of female physiotherapists, with a specialist title, aged between 30-49 years, with an employment relationship weakened by a service provision contract and a workload of 30 hours per week. For the flow category, access facilities were verified by the global assessment and predetermined flowchart; for the prescription of Orthoses, Prostheses and Mobility Aids (OPM) this is a fundamental area of activity for physiotherapists; services relegate case discussions to informality and the work process is centered on “Dead Work” with hard and soft hard technologies and the non-use of the Singular Therapeutic Project (PTS). Conclusion: The CER has proven to be a powerful health service for providing care to people with disabilities, but adjustments in the management model and organization of the work process are necessary for effective care. In this context, the professional physiotherapist has contributed significantly to the effectiveness of care for the disabled population.