scholarly journals O olhar do terapeuta ocupacional para as infâncias: reflexões a partir de uma experiência em uma escola pública/The ocupational herapist's view of childhood: reflections from an experience in a public school

Author(s):  
Sarah Silva do Nascimento ◽  
Amanda Oliveira Ferreira ◽  
Melissa Ribeiro Teixeira

Introdução: A unificação do conceito de infância é uma produção sócio-histórica, que se reverbera até os dias atuais, gerando desigualdades por não ser coerente a todas as realidades. No campo da saúde, ainda se produz cuidado pautado em um paradigma dominante: branco, burguês e higienista, refletindo em intervenções que não consideram o contexto de escassez de recursos vivenciado por muitas crianças brasileiras. Objetivo: Este estudo tem o objetivo de problematizar o olhar unificado da infância nas intervenções da Terapia Ocupacional, no campo da saúde e sua interface com a educação, a partir da experiência com crianças moradoras de um complexo de favelas no município do Rio de Janeiro/RJ. Método: Trata-se de um estudo, de caráter exploratório, de base qualitativa, que adotou a observação direta e notas em um diário de campo como ferramentas metodológicas no decurso da pesquisa. Resultado/Discussão: As crianças acompanhadas nesta pesquisa apresentaram o encargo do cuidado da casa e de crianças menores e, aparente, normalização da violência como modo de viver a constante negação de direitos básicos. Os profissionais da escola relatam os responsáveis como desinteressados e ausentes quanto à vida escolar dos alunos, contudo, na narrativa trazida pelas crianças, essa ausência se justifica pelas longas jornadas de trabalho enfrentadas pelos responsáveis. Conclusão: Sugere-se que mais literaturas abordando esse tema sejam produzidas e discutidas para que a prática da Terapia Ocupacional se alinhe cada vez mais aos contextos reais tão diversos vividos pelas pessoas. Palavras-chave: Infâncias. Vulnerabilidade. Saúde. Favela. EscolaAbstractIntroduction: The unification of the concept of childhood is a socio-historical production that reverberates to the present day, generating inequalities because it isn’t coherent to all realities. In the field of health care we still produce a practice based on a dominant paradigm: white, bourgeois and hygienist, reflecting on interventions that do not consider the context of scarcity of resources experienced by many Brazilian children. Objective: This study aims to problematize the unified view of childhood in occupational therapy interventions in the field of health care and its interface with education, based on the experience with children living in a slum complex in the city of Rio de Janeiro / RJ.  Method: This is an exploratory, qualitative study that adopted direct observation and notes in a field diary as methodological tools in the course of the research. Result/Discussion: The children monitored in this research presented the burden of caring for the home and younger children and apparent normalization of violence as a way of living the constant denial of basic rights. The school professionals report the guardians as disinterested and absent as to the students' school life, however in the narrative brought by the children, this absence is justified by the long working hours faced by the guardians. Conclusion: It is suggested that more literature addressing this theme be produced and discussed so that the practice of Occupational Therapy is more and more aligned with these contexts so real and so diverse experienced by these people.Keywords: Childhood. Vulnerability. Health. Slum. Shanty town. School. ResumenIntroducción: La unificación del concepto de infancia es una producción socio histórica que repercute hasta la actualidad, ocasionando desigualdades por no ser coherente con todas las realidades. En el campo de la salud se sigue produciendo a partir de un paradigma dominante: blanco, burgués e higienista, reflejando sobre intervenciones que no consideran el contexto de escasez de recursos que viven muchos niños brasileños. Objetivo: Este estudio tiene como objetivo problematizar la visión unificada de la infancia en las intervenciones de terapia ocupacional en el campo de la salud y su interfaz con la educación, a partir de la experiencia con niños que viven en un complejo de tugurios en la ciudad de Rio de Janeiro/RJ. Método: Se trata de un estudio exploratorio, cualitativo que adoptó la observación directa y las anotaciones en un diario de campo como herramientas metodológicas en el curso de la investigación. Resultado/Discusión: Los niños monitoreados en esta investigación presentaron la carga de cuidar de los niños más pequeños y la aparente normalización de la violencia como una forma de vivir la constante negación de los derechos básicos. Los profesionales de la escuela relatan que los padres, estos niños, son desinteresados y ausentes en cuanto a la vida escolar de los alumnos, sin embargo, en la narrativa que traen los niños esta ausencia se justifica por las largas jornadas laborales que enfrentan los padres y madres. Conclusión: Se sugiere producir y discutir más literatura que aborde este tema para que la práctica de la Terapia Ocupacional esté cada vez más alineada con los contextos reales tan diversos vividos por las personas.Palabras clave: Infancia. Vulnerabilidad. Salud. Tugurios. Escuela.

Author(s):  
Luis De-Bernardi-Ojuel ◽  
Laura Torres-Collado ◽  
Manuela García-de-la-Hera

This scoping review aims to describe occupational therapy interventions carried out with multiple sclerosis (MS) and amyotrophic lateral sclerosis (ALS) patients in occupational therapy. A peer review of the literature was conducted in different databases: Pubmed, Scopus, Web of Science and Embase, and in some occupational therapy journals. A search of the literature published was carried out before December 2019. The inclusion criteria were as follows: (1) articles evaluating the intervention of occupational therapy in MS or ALS including experimental, randomized, nonrandomized and exploratory studies; (2) written in English or Spanish; (3) adult population (over 18 years old). The initial search identified 836 articles of which we included 32 divided into four areas of intervention: fatigue-targeted interventions, cognitive interventions, physical interventions and others. Only 16 studies were carried out exclusively by occupational therapists. Most occupational therapy interventions are aimed at fatigue and physical rehabilitation. The majority of the studies in our review included MS patients, with little representation from the ALS population. These interventions have shown an improvement in perceived fatigue, manual dexterity, falls prevention and improvement in cognitive aspects such as memory, communication, depression and quality of life in the MS and ALS populations.


2002 ◽  
Vol 65 (10) ◽  
pp. 469-475 ◽  
Author(s):  
Muriel Kelly ◽  
Surya Shah

Based on selected contemporary research, this paper presents a critical analysis of central nervous system (CNS) reorganisation following insult and the need for therapists better to understand the processes that constitute reorganisation and their possible contribution to the development of spasticity. In the treatment of the sequelae of CNS lesions, the synaptic reorganisation as a result of losses caused by injury - in the form of axonal sprouting - is illustrated, focusing on neuronal reconnectivity. Critical analysis of laboratory, electron microscopy and other animal and human studies is also conducted to integrate the controversies identified and to highlight the concepts that become relevant for occupational therapists, in order to optimise therapeutic intervention for maximising restitution in patients with CNS insult. The paper further discusses the capacity of the CNS to compensate and the need to utilise occupational therapy interventions, such as imagining, mental rehearsals, constraint-induced therapy, virtual reality, biofeedback and the traditional repetitive tasks, which leads to ensuring and facilitating the emergence of new synapses to perform motor tasks and manual skills and to prevent secondary changes. These external stimulations provided by the therapists are likely to stimulate both the damaged hemisphere cross-innervation and/or collateral sprouting. These scientifically based treatment strategies and neurological rehabilitation programmes would, in turn, contribute to improving the quality of life of people with CNS insult.


2021 ◽  
Vol 76 (1) ◽  
Author(s):  
Whitney Lucas Molitor ◽  
Diana R. Feldhacker ◽  
Helene Lohman ◽  
Angela M. Lampe ◽  
Lou Jensen

Importance: Interventions that prevent falls, facilitate discharge after hospitalization, and reduce hospital readmissions assist occupational therapy practitioners in demonstrating professional value, improving quality, and reducing costs. Objective: In this systematic review, we address three outcome areas of the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014: prevention and reduction of falls, facilitation of community discharge and reintegration, and prevention of hospital readmission. Data Sources: We conducted a search of the literature published between 2009 and 2019. Study Selection and Data Collection: We developed operational definitions to help us identify articles that answered the search question for each outcome area. This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Findings: We found 53 articles that address the three outcome areas. Regarding the prevention and reduction of falls, low strength of evidence is available for interventions focusing on a single fall risk and for customized interventions addressing multiple risks. Moderate strength of evidence supports structured community fall risk prevention interventions. Low strength of evidence was found for community discharge and reintegration interventions that include physical activity and educational programming. Low to moderate strength of evidence was found for readmission prevention interventions for patients with four types of condition. Conclusion and Relevance: Several intervention themes in the three outcome areas of interest are supported by few studies or by studies with a moderate risk of bias. Additional research is needed that supports the value of occupational therapy interventions in these outcome areas. What This Article Adds: Our study provides important insights into the state of the evidence related to occupational therapy interventions to address three outcome areas of the IMPACT Act.


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