Atividade, participa??o social e fatores contextuais de adultos com paralisia cerebral

O presente trabalho foi realizado com apoio do Programa Institucional de Inicia??o Cient?fica - PIBIC/CNPq.Grande parte dos estudos concentram-se em crian?as com paralisia cerebral (PC) e pouco se sabe sobre a trajet?ria de sa?de a longo prazo entre os adultos com PC. Ao se considerar o modelo biopsicossocial, a realiza??o de atividades, a participa??o e a influ?ncia de barreiras e facilitadores ambientais, torna-se um aspecto importante de ser explorado. Compreender e descrever a funcionalidade e a incapacidade dos indiv?duos pode ter papel significativo na organiza??o dos processos cotidianos de trabalho das equipes de sa?de. A identifica??o de aspectos relacionados ? sa?de de adultos com PC ? importante para que profissionais da sa?de possam gerar abordagens terap?uticas adequadas e direcionadas, contribuir para o desenvolvimento de estrat?gias de interven??es. Este estudo se prop?s a avaliar 30 indiv?duos adultos com paralisia cerebral em acompanhamento e egressos de um Centro Especializado em Reabilita??o, localizado no Vale do Jequitinhonha no estado de Minas Gerais. Este trabalho ser? apresentado em formato de dois artigos cient?ficos. O primeiro refere-se ? caracteriza??o da participa??o social e os fatores ambientais associados, avaliados por meio do Measure of the Quality of the Environment (MQE-Brasil). Neste estudo os participantes consideraram importante o aprimoramento de sua participa??o social, no entanto, n?o julgara seu desempenho ruim e indicaram estar satisfeitos com a sua participa??o social em ambientes comunit?rios. Al?m disto, apontaram mais facilitadores do que barreiras ambientais. A an?lise de regress?o multivariada demonstrou que ter o apoio das pessoas em sua volta, dispositivos de aux?lio e o uso de comunica??o eletr?nica, explicaram grande parte, 68% da participa??o social. O segundo artigo, descritivo teve o objetivo de analisar a percep??o dos participantes quanto a import?ncia, desempenho e satisfa??o na realiza??o de atividades funcionais. Por meio da aplica??o da Medida Canadense de Desempenho Ocupacional (COPM), os participantes listaram atividades que apresentaram import?ncia nos dom?nios de autocuidado, produtividade e lazer, com pontua??es mais baixas para desempenho do que para satisfa??o. Houve queixas espec?ficas para cada participante classificado a partir dos diferentes tipos do Sistema de Classifica??o da Fun??o Motora Grossa (GMFCS), no entanto de um modo geral, o vestu?rio e a alimenta??o foram destaques para autocuidado, assim como o andar e mover-se e o desejo de realizar atividades de artesanato em produtividade como forma de gera??o de renda extra. Os resultados dos dois estudos evidenciam que adultos com paralisia cerebral tem queixas espec?ficas sobre a realiza??o de suas atividades, assim como as principais barreiras ambientais; necessitando de acompanhamento por equipe multidisciplinar, embora a maioria receba alta dos servi?os de reabilita??o neste per?odo do ciclo da vida.Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico (CNPq)Disserta??o (Mestrado Profissional) ? Programa de P?s-Gradua??o em Sa?de, Sociedade e Ambiente, Universidade Federal dos Vales do Jequitinhonha e Mucuri, 2021.Most studies focus on children with cerebral palsy (CP) and little is known about the long-term health trajectory among adults with CP. When considering the biopsychosocial model, the performance of activities, participation and the influence of environmental barriers and facilitators, becomes an important aspect to be explored. Understanding and describing the functionality and disability of individuals can play a significant role in the organization of the health teams' daily work processes. The identification of health-related aspects of adults with CP is important so that health professionals can generate appropriate and targeted therapeutic approaches, contributing to the development of intervention strategies. This study aimed to evaluate 30 adult individuals with cerebral palsy in follow-up and discharged from a Specialized Rehabilitation Center, located in Vale do Jequitinhonha in the state of Minas Gerais. This work will be presented in the format of two scientific articles. The first refers to the characterization of social participation and the associated environmental factors, evaluated through the Measure of the Quality of the Environment (MQE-Brazil). In this study, the participants considered it important to improve their social participation, however, they did not judge their performance to be poor and indicated that they were satisfied with their social participation in community environments. Furthermore, they pointed out more facilitators than environmental barriers. Multivariate regression analysis showed that having the support of people around you, assistive devices and the use of electronic communication explained a large part, 68% of social participation. The second article, descriptive, aimed to analyze the participants' perception of the importance, performance and satisfaction in performing functional activities. Through the application of the Canadian Occupational Performance Measure (COPM), the participants In this study, the participants considered it important to improve their social participation, however, they did not judge their performance to be poor and indicated that they were satisfied with their social participation in community environments. Furthermore, they pointed out more facilitators than environmental barriers. The second article, descriptive, aimed to analyze the participants' perception of the importance, performance and satisfaction in performing functional activities. Through the application of the Canadian Occupational Performance Measure (COPM), the participants Multivariate regression analysis showed that having the support of people around you, assistive devices and the use of electronic communication explained a large part, 68% of social participation. Through the application of the Canadian Occupational Performance Measure (COPM), the participants listed activities that were important in the domains of self-care, productivity and leisure, with lower scores for performance than for satisfaction. There were specific complaints for each participant classified from the different types of the Gross Motor Function Classification System (GMFCS), however in general, clothing and food were highlights for self-care, as well as walking and moving and the desire to carry out handicraft activities in productivity as a way to generate extra income. The results of the two studies show that adults with cerebral palsy have specific complaints about performing their activities, as well as the main environmental barriers; needing follow-up by a multidisciplinary team, although most are discharged from rehabilitation services during this period of their life cycle