Extended rehabilitation program: a multidimensional approach to the occupational rehabilitation process
DOI:
https://doi.org/10.11606/issn.2317-0190.v16i2a103169Keywords:
Occupational Health, Cumulative Trauma Disorders, Mental Disorders, RehabilitationAbstract
The Extended Rehabilitation Program (PRA - Programa de Reabilitaçao Ampliado) was developed in response to a demand from the Public Labor Ministry (MPT) of the 12th District following reports of a high rate (10%) of occupational diseases-especially RSI/WRULD and mental disorders in a meat-packing company in mid-western Santa Catarina. Since the establishment of a partnership between the INSS, Centro de Referência Estadual em Saúde do Trabalhador (CEREST/ SC) - the State Reference Center for Occupational Health (CEREST/ SC), Universidade Federal de Santa Catarina (UFSC) - the Federal University of Santa Catarina (UFSC), and the 12th District MPT, the PRA was developed as a proposal of Conduct Adjustment Terms (TAC - Termo de Ajuste de Conduta). This is the only such project in Brazil and has three aspects: 1) assistance; 2) monitoring; and 3) requalification. Eighteen professionals were part of a multidisciplinary team who offer such services as: physiotherapy, occupational therapy (OT), psychology, acupuncture, postural re-education, tai chi chuan, massage therapy, circle dances, information groups, physical conditioning, water exercises, supplementary therapies, and social assistance. This program, starting in November of 2007 and ending in September of 2008, attended 425 persons. The main goals of this paper are: 1) to delineate the structure of the ERP and its procedures regarding the assistance and requalification aspects; and 2) to present the results. This is a cross-sectional, quantitative study collecting data at two points - the outset and the termination. Data was analyzed using descriptive and inferential statistics (mean and standard deviation), T-test, and chi-square. A large number of workers showed significant improvement in quality of life, general health, functional capacity, depression, and increase in range of movement. Approximately 271 (64%) of the attended workers returned or are returning to work, 68 (16%) remain on sick leave, 32 (approx. 7%) have retired, 24 (approx. 6%) have developed other pathologies unforeseen by the program, 19 (approx. 4%) are still doing some treatment, and 11 (3%) have abandoned the rehabilitation program. What we can conclude from this experience is that the rehabilitation professional must approach this challenge from a bio-psycho-social perspective. The main focus of the rehabilitation team should not be the pathology itself, but the reestablishing of functionality and the developing of new possibilities based on the worker's functional and educational level.
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