Scharan K1, Duarte de Lima Moser A1
1PUCPR, Post Graduation Program of Health Technology, Curitiba, Brazil
Background: Health professionals clinical practice translates into approaches to patients and is guided by models learned during professional training. In Physical Therapy predominates the biomedical model with focus on biophysiological aspects. In 2001, ICF proposed a biopsychosocial model that considers health activities, participation and the influence of environmental factors, as well as biopsychosocial aspects. The WHO recommends the ICF use as a standard language framework of health status and functionality, and as an educational tool to the registry of health information. Its use has been recommended in professional training to enrich diagnostic and therapeutic practices by broadening the clinical approach to the different health components
Purpose: To identify how ICF model has been operacionalized in a physiotherapeutic clinical approach.
Methods: Qualitative descriptive study. Qualitative information of physiotherapeutic evaluation records of a reference orthopedics physiotherapy service in a private university in Curitiba were analyzed between July and August of 2018. The information was sought and registered to identify terms that denote ICF contents, through content analysis. The evaluations were filled by students of the last 4th year of Physitoherapy graduation, during their mandatory internship who received ICF classes through the graduation degree since the first year. The extracted contents were also compared with the diagnosis and objectives of physiotherapeutic treatment.
Results: 47 physiotherapeutic evaluation were analyzed, 3 were excluded due to insufficient content for analysis. The 44 included presented all ICF components (Body Function, Body Structure, Activities and Participation, Environmental Factors) in more or less degree, denoting comprehensiveness of the collected content. Body Functions was predominant with all evaluations guided by the complaint pain, Activities and participation was the second most frequent (81,8% n=36). The following components were Body Structures (52,2% n=23) and the environmental factors (22,7% n=10). Regarding the physiotherapeutic objectives, there was focus for pain reduction, reestablishment of strength and muscle stretching, with consequent progress in the range of motion denoting biomedical model influence in the individual treatment approach. Activities and Participation and Environmental Factors content were not explored in detail by the students in their objectives and in the individual goal. The students did not report ICF categories in their evaluation.
Conclusion(s): Although evaluations contemplate content of all ICF components, the evaluation approach prevails over the pain complaint , muscular weaknesses and shortenings, without the student exploring and assessing the difficulties related activities and participation and the impact of environmental and personal factors on the individual. The evaluations, in general, require a deductive logic response so that the student sets his goals according to the limitation in activity and participation reported by the patient, using all his technical knowledge to minimize such demand.
Implications: Biopsychosocial model has been operacionalizated in more or less degree in physiotherapeutic clinical approach, however, strategies to connect the information collected and express it to minimize the patient´s demands are necessary to improve ICF categories operation. In addition, the use of coded categories would be a source of information capable of assisting the patient´s follow-up and the achievement of treatment goals and goals.
Keywords: International Classification of Functioning, Disab, Education, Physiotherapy
Funding acknowledgements: CAPES
Purpose: To identify how ICF model has been operacionalized in a physiotherapeutic clinical approach.
Methods: Qualitative descriptive study. Qualitative information of physiotherapeutic evaluation records of a reference orthopedics physiotherapy service in a private university in Curitiba were analyzed between July and August of 2018. The information was sought and registered to identify terms that denote ICF contents, through content analysis. The evaluations were filled by students of the last 4th year of Physitoherapy graduation, during their mandatory internship who received ICF classes through the graduation degree since the first year. The extracted contents were also compared with the diagnosis and objectives of physiotherapeutic treatment.
Results: 47 physiotherapeutic evaluation were analyzed, 3 were excluded due to insufficient content for analysis. The 44 included presented all ICF components (Body Function, Body Structure, Activities and Participation, Environmental Factors) in more or less degree, denoting comprehensiveness of the collected content. Body Functions was predominant with all evaluations guided by the complaint pain, Activities and participation was the second most frequent (81,8% n=36). The following components were Body Structures (52,2% n=23) and the environmental factors (22,7% n=10). Regarding the physiotherapeutic objectives, there was focus for pain reduction, reestablishment of strength and muscle stretching, with consequent progress in the range of motion denoting biomedical model influence in the individual treatment approach. Activities and Participation and Environmental Factors content were not explored in detail by the students in their objectives and in the individual goal. The students did not report ICF categories in their evaluation.
Conclusion(s): Although evaluations contemplate content of all ICF components, the evaluation approach prevails over the pain complaint , muscular weaknesses and shortenings, without the student exploring and assessing the difficulties related activities and participation and the impact of environmental and personal factors on the individual. The evaluations, in general, require a deductive logic response so that the student sets his goals according to the limitation in activity and participation reported by the patient, using all his technical knowledge to minimize such demand.
Implications: Biopsychosocial model has been operacionalizated in more or less degree in physiotherapeutic clinical approach, however, strategies to connect the information collected and express it to minimize the patient´s demands are necessary to improve ICF categories operation. In addition, the use of coded categories would be a source of information capable of assisting the patient´s follow-up and the achievement of treatment goals and goals.
Keywords: International Classification of Functioning, Disab, Education, Physiotherapy
Funding acknowledgements: CAPES
Topic: Education: clinical; Professional practice: other; Orthopaedics
Ethics approval required: Yes
Institution: Pontifical Catholic University of Paraná
Ethics committee: Comitê de Ética em Pesquisa
Ethics number: 2,727,875
All authors, affiliations and abstracts have been published as submitted.
