Facilitadores do acesso da pessoa com deficiência aos serviços de saúde: revisão de escopo

Autores

  • Simone Vieira da Silva Universidade de São Paulo. Faculdade de Medicina
  • Karina Aparecida Padilha Clemente Universidade de São Paulo. Faculdade de Medicina
  • Gislene Inoue Vieira Prefeitura Municipal de São Paulo
  • Maritsa Carla de Bortoli Secretaria de Estado da Saude de Sao Paulo. Instituto de Saude
  • Tereza Toma Secretaria de Estado da Saude de Sao Paulo. Instituto de Saude
  • Vinícius Delgado Ramos Universidade de São Paulo. Faculdade de Medicina
  • Christina May Moran de Brito Instituto do Cancer do Estado de São Paulo

DOI:

https://doi.org/10.11606/issn.2317-0190.v29i3a194435

Palavras-chave:

Pessoas com Deficiência, Acessibilidade aos Serviços de Saúde, Serviços de Saúde para Pessoas com Deficiência, Direito à Saúde

Resumo

Objetivo: Este estudo tem como objetivo analisar as evidências científicas globais e locais relativas aos facilitadores que promovem o acesso de pessoas com deficiência aos serviços de saúde. Métodos: Realizou-se uma revisão de escopo, estabelecendo-se a pergunta norteadora: “Quais são os principais facilitadores que as pessoas com deficiência encontram no acesso a serviços de saúde?” O levantamento dos artigos foi realizado em julho de 2019, em seis bases de dados de literatura científica. Dos 1.155 documentos identificados nas buscas, após seleção por título e resumo, foram lidas 170 publicações na íntegra e incluídas 76 revisões da literatura, que foram categorizadas conforme referencial teórico. Resultados: A revisão elenca os facilitadores identificados por prestadores de serviços e por pessoas com deficiência e os seus familiares e/ou cuidadores, em todos os níveis de complexidade dos cuidados de saúde. Os facilitadores foram categorizados pelas diferentes dimensões do acesso e da Lei Brasileira de Inclusão. Os principais facilitadores identificados, tanto pelos usuários dos serviços quanto pelos prestadores de serviço, incluem a disponibilidade de programas de promoção à saúde, profissionais capacitados, informações sobre os serviços prestados, orientação em cuidados de saúde, serviços de cuidados específicos de reabilitação e suporte social. Conclusões: Evidenciamos que faltam estudos nacionais sobre esta temática e que os facilitadores para o acesso aos serviços de saúde para as pessoas com deficiência precisam ser mais profundamente abordados na literatura cientifica como um todo. O melhor entendimento desta realidade é de grande valia para o incremento de políticas públicas e implementação de estratégias voltadas à promoção do acesso aos serviços de saúde.

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Referências

Interdonato GC, Greguol M. Promoção da saúde de pessoas com deficiência: uma revisão sistemática. HU Rev. 2011;37(3):369-75.

Nogueira GC, Schoeller SD, Ramos FRDS, Padilha MI, Brehmer LCDF, Marques AMFB. Perfil das pessoas com deficiência física e Políticas Públicas: a distância entre intenções e gestos. Ciênc Saúde Coletiva. 2016:21;3131-42. Doi: https://doi.org/10.1590/1413-812320152110.17622016

Di Nubila HBV, Buchalla CM. O papel das Classificações da OMS-CID e CIF nas definições de deficiência e incapacidade. Rev Bras Epidemiol. 2008:11(2);324-35. Doi: https://doi.org/10.1590/S1415-790X2008000200014

Randström KB, Asplund K, Svedlund M. Impact of environmental factors in home rehabilitation--a qualitative study from the perspective of older persons using the International Classification of Functioning, Disability and Health to describe facilitators and barriers. Disabil Rehabil. 2012;34(9):779-87. Doi: https://doi.org/10.3109/09638288.2011.619621

Battistella LR, Brito CMM. Classificação Internacional de Funcionalidade (CIF). Acta Fisiátr. 2002;9(2):98-101. Doi: https://doi.org/10.5935/0104-7795.20020003

Brasil. Decreto nº 6.949, de 25 de agosto de 2009. Promulga a Convenção Internacional sobre os Direitos das Pessoas com Deficiência e seu Protocolo Facultativo, assinados em Nova York, em 30 de março de 2007. Diário Oficial da Republica Federativa do Brasil, Brasília (DF); 2009 Ago 26; Seção 1:3-9.

Brasil. Lei nº 13.146, de 6 de julho de 2015. Institui a Lei Brasileira de Inclusão da Pessoa com Deficiência (Estatuto da Pessoa com Deficiência). Diário Oficial da Republica Federativa do Brasil, Brasília (DF); 2015 Jul 7; Seção 1:2-11.

Brasil. Constituição 1988. Constituição da República Federativa do Brasil. Brasília (DF): Senado; 1988.

Dlugosz VP. O impacto juridico e social na vida da pessoa com deficiência adquirida. AnaisEVINCI-UniBrasil. 2015;1(4);1101-17.

McVeigh J, MacLachlan M, Gilmore B, McClean C, Eide AH, Mannan H, et al. Promoting good policy for leadership and governance of health related rehabilitation: a realist synthesis. Global Health. 2016;12(1):49. Doi: https://doi.org/10.1186/s12992-016-0182-8

Peters MDJ, Godfrey C, McInerney P, Munn Z, Tricco AC, Khalil, H. Chapter 11: Scoping Reviews (2020 version). In: Aromataris E, Munn Z (Editors). JBI Manual for Evidence Synthesis: Melbourne: JBI; 2020. Doi: https://doi.org/10.46658/jbimes-20-12

Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71. Doi: http://dx.doi.org/10.1136/bmj.n71

Levesque JF, Harris MF, Russell G. Patient-centred access to health care: conceptualising access at the interface of health systems and populations. Int J Equity Health. 2013;12:18. Doi: https://doi.org/10.1186/1475-9276-12-18

Breckenridge JP, Devaney J, Kroll T, Lazenbatt A, Taylor J, Bradbury-Jones C. Access and utilisation of maternity care for disabled women who experience domestic abuse: a systematic review. BMC Pregnancy Childbirth. 2014;14(1):234. Doi: https://doi.org/10.1186/1471-2393-14-234

Robertson J, Roberts H, Emerson E, Turner S, Greig R. The impact of health checks for people with intellectual disabilities: a systematic review of evidence. J Intellect Disabil Res. 2011;55(11):1009-19. Doi: https://doi.org/10.1111/j.1365-2788.2011.01436.x

Robertson J, Hatton C, Emerson E, Baines S. The impact of health checks for people with intellectual disabilities: an updated systematic review of evidence. Res Dev Disabil. 2014;35(10):2450-62. Doi: https://doi.org/10.1016/j.ridd.2014.06.007

Brown M, Macarthur J, Higgins A, Chouliara Z. Transitions from child to adult health care for young people with intellectual disabilities: A systematic review. J Adv Nurs. 2019;75(11):2418-34. Doi: https://doi.org/10.1111/jan.13985

Turnpenny A, Beadle-Brown J. Use of quality information in decision-making about health and social care services--a systematic review. Health Soc Care Community. 2015;23(4):349-61. Doi: https://doi.org/10.1111/hsc.12133

Mlenzana NB, Frantz JM, Rhoda AJ, Eide AH. Barriers to and facilitators of rehabilitation services for people with physical disabilities: A systematic review. Afr J Disabil. 2013;2(1):22. Doi: https://doi.org/10.4102/ajod.v2i1.22

Bright T, Kuper H. A systematic review of access to general healthcare services for people with disabilities in low and middle income countries. Int J Environ Res Public Health. 2018;15(9):1879. Doi: https://doi.org/10.3390/ijerph15091879

Bright T, Wallace S, Kuper H. A systematic review of access to rehabilitation for people with disabilities in low-and middle-income countries. Int J Environ Res Public Health. 2018;15(10):2165. Doi: https://doi.org/10.3390/ijerph15102165

Hithersay R, Strydom A, Moulster G, Buszewicz M. Carer-led health interventions to monitor, promote and improve the health of adults with intellectual disabilities in the community: a systematic review. Res Dev Disabil. 2014;35(4):887-907. Doi: https://doi.org/10.1016/j.ridd.2014.01.010

Homeyard C, Montgomery E, Chinn D, Patelarou E. Current evidence on antenatal care provision for women with intellectual disabilities: a systematic review. Midwifery. 2016;32:45-57. Doi: https://doi.org/10.1016/j.midw.2015.10.002

Ziviani J, Feeney R, Rodger S, Watter P. Systematic review of early intervention programmes for children from birth to nine years who have a physical disability. Aust Occup Ther J. 2010;57(4):210-23. Doi: https://doi.org/10.1111/j.1440-1630.2010.00850.x

Lawang W, Horey D, Blackford J, Sunsern R, Riewpaiboon W. Support interventions for caregivers of physically disabled adults: a systematic review. Nurs Health Sci. 2013; 15(4):534-45. Doi: https://doi.org/10.1111/nhs.12063

Kuhlthau KA, Bloom S, Van Cleave J, Knapp AA, Romm D, Klatka K, et al. Evidence for family-centered care for children with special health care needs: a systematic review. Acad Pediatr. 2011:11(2):136-43. Doi: https://doi.org/10.1016/j.acap.2010.12.014

Cohen E, Jovcevska V, Kuo DZ, Mahant S. Hospital-based comprehensive care programs for children with special health care needs: a systematic review. Arch Pediatr Adolesc Med. 2011;165(6):554-61. Doi: https://doi.org/10.1001/archpediatrics.2011.74

Almasri NA, An M, Palisano RJ. Parents’ perception of receiving family-centered care for their children with physical disabilities: a meta-analysis. Phys Occup Ther Pediatr. 2018;38(4):427-43. https://doi.org/10.1080/01942638.2017.1337664

Young C, Hall AM, Gonçalves-Bradley DC, Quinn TJ, Hooft L, van Munster BC et al. Home or foster home care versus institutional long-term care for functionally dependent older people. Cochrane Database Syst Rev. 2017;4(4):CD009844. Doi: https://doi.org/10.1002/14651858.CD009844.pub2

Lin LP, Lin JD. Perspectives on intellectual disability in Taiwan: epidemiology, policy and services for children and adults. Current opinion in psychiatry. 2011;24(5):413-8. Doi: https://doi.org/10.1097/YCO.0b013e328346176e

Rose A, Rosewilliam S, Soundy A. Shared decision making within goal setting in rehabilitation settings: A systematic review. Patient Educ Couns. 2017;100(1):65-75. Doi: https://doi.org/10.1016/j.pec.2016.07.030

Grandisson M, Hébert M, Thibeault R. A systematic review on how to conduct evaluations in community-based rehabilitation. Disabil Rehabil. 2014;36(4):265-75. Doi: https://doi.org/10.3109/09638288.2013.785602

Bray N, Noyes J, Edwards RT, Harris N. Wheelchair interventions, services and provision for disabled children: a mixed-method systematic review and conceptual framework. BMC Health Serv Res. 2014; 14(1):309. Doi: https://doi.org/10.1186/1471-2393-14-234

Doig E, Fleming J, Kuipers P, Cornwell PL. Comparison of rehabilitation outcomes in day hospital and home settings for people with acquired brain injury – a systematic review. Disabil Rehabil. 2010;32(25):2061-77. Doi: https://doi.org/10.3109/09638281003797356

Lam N, Leat S J. Reprint of: barriers to accessing low-vision care: The patient’s perspective. Can J Ophthalmol. 2015;50(1):34-9. Doi: https://doi.org/10.1016/j.jcjo.2015.04.007

Khan F, Ng L, Gonzalez S, Hale T, Turner‐Stokes L. Multidisciplinary rehabilitation programmes following joint replacement at the hip and knee in chronic arthropathy. Cochrane Database Syst Rev. 2008;16(2):CD004957. Doi: https://doi.org/10.1002/14651858.CD004957.pub3

Lindsay S, Kingsnorth S, Mcdougall C, Keating H. A systematic review of self-management interventions for children and youth with physical disabilities. Disabil Rehabil. 2014;36(4):276-88. Doi: https://doi.org/10.3109/09638288.2013.785605

O'Halloran R, Grohn B, Worrall L. Environmental factors that influence communication for patients with a communication disability in acute hospital stroke units: a qualitative metasynthesis. Arch Phys Med Rehabil. 2012;93(1 Suppl):S77-85. Doi: https://doi.org/10.1016/j.apmr.2011.06.039

Zhou H, Roberts P, Dhaliwal S, Della P. Transitioning adolescent and young adults with chronic disease and/or disabilities from paediatric to adult care services - an integrative review. J Clin Nurs. 2016;25(21-22):3113-30. Doi: https://doi.org/10.1111/jocn.13326

Allison R, Shelling L, Dennett R, Ayers T, Evans PH, Campbell JL. The effectiveness of various models of primary care-based follow-up after stroke: a systematic review. Prim Health Care Res Dev. 2011;12(3):214-22. Doi: https://doi.org/10.1017/S146342361100003X

Ellis G, Mant J, Langhorne P, Dennis M, Winner S. Stroke liaison workers for stroke patients and carers: an individual patient data meta‐analysis. Cochrane Database Syst Rev, 2010;2010(5):CD005066. Doi: https://doi.org/10.1002/14651858.CD005066.pub2

Zhou H, Roberts P, Dhaliwal S, Della P. Transitioning adolescent and young adults with chronic disease and/or disabilities from paediatric to adult care services - an integrative review. J Clin Nurs. 2016;25(21-22):3113-30. Doi: https://doi.org/10.1111/jocn.13326

Lakhani A, McDonald D, Zeeman H. Perspectives of self‐direction: a systematic review of key areas contributing to service users’ engagement and choice‐making in self‐directed disability services and supports. Health Soc Care Community. 2018;26(3):295-313. Doi: https://doi.org/10.1111/hsc.12386

Olaussen SJ, Renzaho AMN. Establishing components of cultural competence healthcare models to better cater for the needs of migrants with disability: a systematic review. Aust J Prim Health. 2016;22(2):100-12. Doi: https://doi.org/10.1071/PY14114

Lund EM. Community-based services and interventions for adults with disabilities who have experienced interpersonal violence: a review of the literature. Trauma Violence Abuse. 2011;12(4):171-82. Doi: https://doi.org/10.1177/1524838011416377

Iemmi V, Blanchet K, Gibson LJ, Kumar KS, Rath S, Hartley S, et al. Community-based rehabilitation for people with physical and mental disabilities in low- and middle-income countries: a systematic review and meta-analysis. J Dev Effect. 2016;8(3):368-87. Doi: https://doi.org/10.1080/19439342.2016.1157623

Iemmi V, Kumar KS, Blanchet K, Gibson L, Hartley S, Murthy GVS, et al. Community-based rehabilitation for people with physical and mental disabilities in low- and middle-income countries. Cochrane Database Syst Rev. 2017;7(3):CD010617. Doi: http://dx.doi.org/10.1002/14651858.CD010617.pub2

Kairy D, Lehoux P, Vincent C, Visintin M. A systematic review of clinical outcomes, clinical process, healthcare utilization and costs associated with telerehabilitation. Disabil Rehabil. 2009;31(6):427-47. Doi: https://doi.org/10.1080/09638280802062553

Peterson-Besse JJ, Walsh ES, Horner-Johnson W, Goode TD, Wheeler B. Barriers to health care among people with disabilities who are members of underserved racial/ethnic groups: a scoping review of the literature. Med Care. 2014;52(10 Suppl 3):S51-63. Doi: https://doi.org/10.1097/MLR.0000000000000195

Peterson-Besse JJ, O'Brien MS, Walsh ES, Monroe-Gulick A, White G, Drum CE; Expert Panel on Health Disparities among Individuals with Disabilities. Clinical preventive service use disparities among subgroups of people with disabilities: a scoping review. Disabil Health J. 2014;7(4):373-93. Doi: https://doi.org/10.1016/j.dhjo.2014.04.005

Barr M, Duncan J, Dally K. A systematic review of services to DHH children in rural and remote regions. J Deaf Stud Deaf Educ. 2018;23(2):118-30. Doi: https://doi.org/10.1093/deafed/enx059

Beckers LW, Schnackers ML, Janssen-Potten YJ, Kleijnen J, Steenbergen B. Feasibility and effect of home-based therapy programmes for children with cerebral palsy: a protocol for a systematic review. BMJ Open. 2017;7(2):013687. Doi: http://dx.doi.org/10.1136/bmjopen-2016-013687

Marrocco A, Krouse HJ. Obstacles to preventive care for individuals with disability: Implications for nurse practitioners. J Am Assoc Nurse Pract. 2017;29(5):282-93. Doi: https://doi.org/10.1002/2327-6924.12449

Balogh R, McMorris CA, Lunsky Y, Ouellette‐Kuntz H, Bourne L, Colantonio A, et al. Organising healthcare services for persons with an intellectual disability. Cochrane Database Syst Rev. 2016;4(4):CD007492. Doi: https://doi.org/10.1002/14651858.CD007492.pub2

Furlan AD, Irvin E, Munhall C, Giraldo-Prieto M, Fullerton L, Mcmaster R, et al. Rehabilitation service models for people with physical and/or mental disability living in low-and middle-income countries: a systematic review. J Rehabil Med. 2018;50(6):487-98. Doi: https://doi.org/10.2340/16501977-2325

Robertson J, Hatton C, Baines S, Emerson E. Systematic reviews of the health or health care of people with intellectual disabilities: a systematic review to identify gaps in the evidence base. J Appl Res Intellect Disabil. 2015;28(6):455-523. Doi: https://doi.org/10.1111/jar.12149

Pelleboer-Gunnink HA, Van Oorsouw WMWJ, Van Weeghel J, Embregts PJCM. Mainstream health professionals' stigmatising attitudes towards people with intellectual disabilities: a systematic review. J Intellect Disabil Res. 2017;61(5):411-34. Doi: https://doi.org/10.1111/jir.12353

Hamilton C, Lovarini M, McCluskey A, Folly de Campos T, Hassett L. Experiences of therapists using feedback-based technology to improve physical function in rehabilitation settings: a qualitative systematic review. Disabil Rehabil. 2018;41(15):1739-50. Doi: https://doi.org/10.1080/09638288.2018.1446187

Oral A, Rapidi CA, Votava J, Roussos N, Michail X, Kujawa J, et al. Evidence based position paper on Physical and Rehabilitation Medicine (PRM) professional practice for ageing people with disabilities. The European PRM position (UEMS PRM Section). Eur J Phys Rehabil Med. 2017;53(5):802-11. Doi: https://doi.org/10.23736/S1973-9087.17.04864-X

Noorani HZ, Brady B, McGahan L, Teasell R, Skidmore B, Doherty TJ. Stroke rehabilitation services: systematic reviews of the clinical and economic evidence [text on the Internet]. Ottawa: Canadian Coordinating Office for Health Technology Assessment (CCOHTA); c2003 [cited 2022 jan 26]. Available from: http://www.cadth.ca/index.php/en/hta/reports-publications

Malouf R, Redshaw M, Kurinczuk JJ, Gray R. Systematic review of heath care interventions to improve outcomes for women with disability and their family during pregnancy, birth and postnatal period. BMC Pregnancy Childbirth.2014;14(1):58. Doi: https://doi.org/10.1186/1471-2393-14-58

Liebel DV, Friedman B, Watson NM, Powers BA. Review of nurse home visiting interventions for community-dwelling older persons with existing disability. Med Care Res Rev. 2009;66(2):119-46. Doi: https://doi.org/10.1177/1077558708328815

Forster A, Young J, Lambley R, Langhorne P. Medical day hospital care for the elderly versus alternative forms of care. Cochrane Database Syst Rev. 20088;(4):CD001730. Doi: https://doi.org/10.1002/14651858.CD001730.pub2

Green A, DiGiacomo M, Luckett T, Abbott P, Davidson PM, Delaney J, et al. Cross-sector collaborations in Aboriginal and Torres Strait Islander childhood disability: a systematic integrative review and theory-based synthesis. Int J Equity Health. 2014;13:126. Doi: https://doi.org/10.1186/s12939-014-0126-y

Robards F, Kang M, Usherwood T, Sanci L. How marginalized young people access, engage with, and navigate health-care systems in the digital age: systematic review. J Adolesc Health. 2018;62(4):365-81. Doi: https://doi.org/10.1016/j.jadohealth.2017.10.018

Ramjan L, Cotton A, Algoso M, Peters K. Barriers to breast and cervical cancer screening for women with physical disability: a review. Women Health. 2016;56(2):141-56. Doi: https://doi.org/10.1080/03630242.2015.1086463

van de Velde D, Coussens M, De Baets S, Sabbe L, Vanderstraeten G, Vlerick P, et al. Application of participation in clinical practice: key issues. J Rehabil Med. 2018;50(8):679-95. Doi: https://doi.org/10.2340/16501977-2363

Lawthers AG, Pransky GS, Peterson LE, Himmelstein JH. Rethinking quality in the context of persons with disability. Int J Qual Health Care. 2003;15(4):287-99. Doi: https://doi.org/10.1093/intqhc/mzg048

Zaal-Schuller IH, Vos MA, Ewals FV, van Goudoever JB, Willems DL. End-of-life decision-making for children with severe developmental disabilities: the parental perspective. Res Dev Disabil. 2016;49-50:235-46. Doi: https://doi.org/10.1016/j.ridd.2015.12.006

Meester-Delver A, Beelen A, Hennekam R, Hadders-Algra M, Nollet F. Predicting additional care in young children with neurodevelopmental disability: a systematic literature review. Dev Med Child Neurol. 2006;48(2):143-50. Doi: https://doi.org/10.1017/S0012162206000314

Robertson J, Baines S, Emerson E, Hatton C. Service responses to people with intellectual disabilities and epilepsy: a systematic review. J Appl Res Intellect Disabil. 2017;30(1):1-32. Doi: https://doi.org/10.1111/jar.12228

Beverley CA, Bath PA, Booth A. Health information needs of visually impaired people: a systematic review of the literature. Health Soc Care Community. 2004;12(1):1-24. Doi: https://doi.org/10.1111/j.1365-2524.2004.00460.x

Huss A, Stuck A, Rubenstein LZ, Egger M, Clough-Gorr, KM. Multidimensional preventive home visit programs for community-dwelling older adults: a systematic review and meta-analysis of randomized controlled trials. J Gerontol A Biol Sci Med Sci. 2008;63(3):298-307. Doi: https://doi.org/10.1093/gerona/63.3.298

Jeffrey AE, Newacheck PW. Role of insurance for children with special health care needs: a synthesis of the evidence. Pediatrics. 2006;118(4):1027-38. Doi: https://doi.org/10.1542/peds.2005-2527

Condessa AM, Giordani JMDA, Neves M, Hugo FN, Hilgert JB. Barreiras e facilitadores à comunicação no atendimento de pessoas com deficiência sensorial na atenção primária à saúde: estudo multinível. Rev Bras Epidemiol. 2020; 23:e200074. Doi: https://doi.org/10.1590/1980-549720200074

Holanda CMDA, Andrade FLPD, Bezerra MA, Nascimento JPDS, Neves RDF, Alves SB. Redes de apoio e pessoas com deficiência física: inserção social e acesso aos serviços de saúde. Ciênc Saúde Coletiva. 2015; 20(1):175-84. Doi: https://doi.org/10.1590/1413-81232014201.19012013

Jang Y, Kim G, Chiriboga DA. Health, healthcare utilization, and satisfaction with service: barriers and facilitators for older Korean Americans. J Am Geriatr Soc. 2005;53(9):1613-7. Doi: https://doi.org/10.1111/j.1532-5415.2005.53518.x

Organização das Nações Unidas. Objetivos de desenvolvimento sustentável no Brasil [texto na Internet]. Brasília (DF): ONU; c2022 [citado 2022 jan 26]. Disponível em: https://brasil.un.org/pt-br/sdgs

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Silva SV da, Clemente KAP, Vieira GI, Bortoli MC de, Toma T, Ramos VD, Brito CMM de. Facilitadores do acesso da pessoa com deficiência aos serviços de saúde: revisão de escopo. Acta Fisiátr. [Internet]. 27 de setembro de 2022 [citado 6 de fevereiro de 2023];29(3):219-31. Disponível em: https://www.revistas.usp.br/actafisiatrica/article/view/194435

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