Telessaúde em tempos de pandemia da covid 19: percepção de fisioterapeutas e de terapeutas ocupacionais do estado de São Paulo
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Data
2022-08-26
Autores
Luz, Larissa da Silva
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Universidade Estadual Paulista (Unesp)
Resumo
Introdução. A literatura aponta que a Telessaúde (TS) é uma modalidade de prestação de serviço adequada e eficaz que viabiliza o processo de reabilitação remotamente por meio de tecnologias da informação e comunicação. No Brasil, a TS foi legalmente implantada nas áreas de Fisioterapia e Terapia Ocupacional em função da pandemia causada pela COVID-19, que acarretou o fechamento temporário de clínicas destinadas à reabilitação de pessoas com deficiência, incapacidades e/ou outras condições de saúde que requerem atendimento especializado em F e TO. Assim, compreender como o fisioterapeuta e terapeuta ocupacional perceberam a TS e implementaram suas intervenções para enfrentar o cenário pandêmico, nos parece um caminho importante para a promoção de discussões sobre as possibilidades que as práticas em TS oferecem ao campo da reabilitação. Objetivo. Investigar o conhecimento, benefícios e limites da prestação de serviço em TS, sob a perspectiva do fisioterapeuta (Ft) e do terapeuta ocupacional (TO). Método. Estudo transversal descritivo, com abordagens quantitativa e qualitativa. Participaram 110 profissionais, com experiência em TS, atuantes no estado de São Paulo (ESP). Para a coleta de dados elaborou-se um questionário na plataforma Google Forms, que possui questões fechadas e abertas, dividido em três partes. Na primeira, buscou-se caracterizar os participantes, na segunda, investigou-se o nível de conhecimento sobre as práticas em TS, e na terceira, investigou-se a concordância e satisfação frente a essa modalidade de prestação de serviço. O questionário foi enviado por e-mail a instituições de ensino e centros de reabilitação localizados no ESP, foi divulgado no site oficial do CREFITO 03 e, em redes sociais, além disso, utilizou-se o método snowball. Realizou-se análise descritiva e estatística dos dados. Os resultados das questões abertas foram submetidos à análise de conteúdo. Resultados. Dos 110 profissionais, 41 eram Ft e 69 TO, a maioria do sexo feminino, com mais de 10 anos de formação graduada (83,48%). A maior parte deles (TO=91,3%; Ft=87,8%) referiu conhecer a Resolução COFFITO Nº 516/2020 que legalizou o atendimento remoto; conhecer parcialmente aspectos relacionados a prática em TS (TO=66,67%; Ft= 65,85%), e referiram que a intervenção foi realizada na forma de teleconsulta e telemonitoramento. A maioria considerou o smartphone o recurso mais viável para a realidade brasileira, e o seu uso predominou na prática destes profissionais (TO=92,75%; Ft=87,8%). As principais dificuldades encontradas dizem respeito à falta de capacitação em TS e o acesso à internet. As variáveis formação graduada e população atendida exerceram efeito significativo sobre a concordância com a TS, evidenciando que TO tendem a uma maior concordância do que Ft (p=0,01). Da mesma maneira, profissionais que atenderam somente crianças e adolescentes tendem a concordar mais com a TS (p=0,005). Com relação à satisfação com a TS, nenhuma das variáveis analisadas apresentou efeito significativo. A análise qualitativa revelou que os benefícios da TS referem-se à manutenção do processo terapêutico frente a doenças contagiosas; possibilidade de intervenção de qualidade; maior vínculo e engajamento da família. As limitações relacionam-se à ausência de contato físico; falta de acesso do paciente aos recursos tecnológicos e falta de capacitação profissional voltada às práticas em TS. Conclusão. Com este estudo, evidenciou-se que a TS possibilitou enfrentar o cenário pandêmico, e trouxe benefícios que se considerados podem colaborar para a implementação da TS como uma prática substitutiva, em alguns casos, ou como adicional ao atendimento remoto. Entretanto, considera-se necessária a ampliação da investigação em TS no Brasil, a fim de se ter subsídios, pautados em evidências científicas que sustentem a implementação desse modelo de prática em saúde, o qual pode contribuir para o acesso aos serviços em áreas remotas, minimizar custos de deslocamentos, dentre outros.
Introduction. The literature points out that Telehealth (TH) represents a modality of adequate and effective service which enables the remote rehabilitation process through information and communication technologies. In Brazil, TH was implemented legally in the areas of Physiotherapy (PT) and Occupational Therapy (OT) due to the pandemic caused by COVID-19, which resulted in the temporary closure of clinics for the rehabilitation of people with disabilities, disabilities with or without other health conditions which require specialized care in PT and OT. Thus, understanding how PTs and OTs perceived TH and implemented their interventions to face the pandemic scenario seems to be a significant way to promote discussions about the possibilities TH practices offer to the field of rehabilitation. Objective. To investigate the knowledge, benefits, and limits of service provision in TH from the perspective of physiotherapists and occupational therapists. Method. Descriptive cross-sectional study, with qualitative and quantitative approaches. The research participants were 110 professionals with experience in TH working in São Paulo State (SPS). For data collection: a closed and open questions questionnaire divided into three sections on the Google Forms platform. The first section was for gathering professional information; The second was for investigating the knowledge about the practices related to TH, and the third was for the agreement and satisfaction with this type of service provision research. Educational institutions and rehabilitation centers in SPS received the questionnaire by e-mail. In addition, the snowball method-based publication on the official website of CREFITO-03 and social networks. Descriptive and statistical analysis of the data was performed. The results of the open questions were submitted to contente analysis. Results. Of the 110 professionals, 41 were PTs and 69 OTs, most female, with more than ten years of graduate training (83.48%). Most (TO=91.3%; PTs=87.8%) reported being aware of COFFITO Resolution No. 516/2020, which legalized remote service; more than half know aspects related to the practice in TH (OTs=66.67%; PTs=65.85%), and mentioned that they carried out the intervention in the form of teleconsultation and telemonitoring. Almost all considered the smartphone the most viable resource for Brazilian reality. Its use predominated in the practice of these professionals (OTs=92.75%; PTs=87.8%). The main difficulties encountered relate to the lack of training in TH and to access to the internet. According to the professionals, most patients adhered to the TH and felt satisfied and welcomed by the opportunity of remote care. The variables “graduation area" and "attended population" had a significant effect on the agreement with the TH, showing that OTs tend to agree more than PTs (p=0.01). Likewise, professionals who only cared for children and adolescents tend to agree more with the TH (p=0.005) than those who cared for adults and the elderly. Regarding TH satisfaction, none of the variables analyzed had a significant effect. The qualitative analysis revealed that the benefits of TS refer to the maintenance of the therapeutic process in the face of contagious diseases; possibility of quality intervention; greater family bonding and engagement. Limitations are related to the absence of physical contact; lack of patient access to technological resources and lack of professional training focused on ST practices. Conclusion. This study showed that TH was a great ally in the COVID-19 pandemic. It brought benefits that can collaborate for TH implementation as a substitutive practice or as an addition to remote care. However, it is critical to expanding research on TH in Brazil. It's urgent to have scientific evidence to support the implementation of this health model practice, which can contribute to access to services in remote areas and minimize travel costs, among others.
Introduction. The literature points out that Telehealth (TH) represents a modality of adequate and effective service which enables the remote rehabilitation process through information and communication technologies. In Brazil, TH was implemented legally in the areas of Physiotherapy (PT) and Occupational Therapy (OT) due to the pandemic caused by COVID-19, which resulted in the temporary closure of clinics for the rehabilitation of people with disabilities, disabilities with or without other health conditions which require specialized care in PT and OT. Thus, understanding how PTs and OTs perceived TH and implemented their interventions to face the pandemic scenario seems to be a significant way to promote discussions about the possibilities TH practices offer to the field of rehabilitation. Objective. To investigate the knowledge, benefits, and limits of service provision in TH from the perspective of physiotherapists and occupational therapists. Method. Descriptive cross-sectional study, with qualitative and quantitative approaches. The research participants were 110 professionals with experience in TH working in São Paulo State (SPS). For data collection: a closed and open questions questionnaire divided into three sections on the Google Forms platform. The first section was for gathering professional information; The second was for investigating the knowledge about the practices related to TH, and the third was for the agreement and satisfaction with this type of service provision research. Educational institutions and rehabilitation centers in SPS received the questionnaire by e-mail. In addition, the snowball method-based publication on the official website of CREFITO-03 and social networks. Descriptive and statistical analysis of the data was performed. The results of the open questions were submitted to contente analysis. Results. Of the 110 professionals, 41 were PTs and 69 OTs, most female, with more than ten years of graduate training (83.48%). Most (TO=91.3%; PTs=87.8%) reported being aware of COFFITO Resolution No. 516/2020, which legalized remote service; more than half know aspects related to the practice in TH (OTs=66.67%; PTs=65.85%), and mentioned that they carried out the intervention in the form of teleconsultation and telemonitoring. Almost all considered the smartphone the most viable resource for Brazilian reality. Its use predominated in the practice of these professionals (OTs=92.75%; PTs=87.8%). The main difficulties encountered relate to the lack of training in TH and to access to the internet. According to the professionals, most patients adhered to the TH and felt satisfied and welcomed by the opportunity of remote care. The variables “graduation area" and "attended population" had a significant effect on the agreement with the TH, showing that OTs tend to agree more than PTs (p=0.01). Likewise, professionals who only cared for children and adolescents tend to agree more with the TH (p=0.005) than those who cared for adults and the elderly. Regarding TH satisfaction, none of the variables analyzed had a significant effect. The qualitative analysis revealed that the benefits of TS refer to the maintenance of the therapeutic process in the face of contagious diseases; possibility of quality intervention; greater family bonding and engagement. Limitations are related to the absence of physical contact; lack of patient access to technological resources and lack of professional training focused on ST practices. Conclusion. This study showed that TH was a great ally in the COVID-19 pandemic. It brought benefits that can collaborate for TH implementation as a substitutive practice or as an addition to remote care. However, it is critical to expanding research on TH in Brazil. It's urgent to have scientific evidence to support the implementation of this health model practice, which can contribute to access to services in remote areas and minimize travel costs, among others.
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Palavras-chave
Telessaúde, Covid-19, Fisioterapia, Terapia Ocupacional, Telehealth, Covid-19, Physiotherapy, Occupational therapy