RESUMEN
INTRODUÇÃO: A Paraparesia Espástica Tropical / Mielopatia Associada ao HTLV-1 (HAM/TSP) apresenta alterações crônico-degenerativas que comprometem os indivíduos nas atividades diárias, principalmente aquelas ligadas à locomoção. A acessibilidade é um parâmetro importante para a adesão à fisioterapia nestas pessoas. OBJETIVO: investigar o impacto da acessibilidade na adesão ao tratamento fisioterapêutico em pessoas infectadas pelo HTLV-1, com HAM/TSP. MÉTODO: estudo com abordagem qualitativa, com 38 participantes, maiores de 18 anos, com diagnóstico confirmado de HAM/TSP. Excluídos aqueles com dificuldade de compreensão dos questionamentos ou de comunicação. Para a coleta das informações, foram realizados 11 grupos focais e 12 entrevistas semiestruturadas. Os depoimentos foram gravados e depois transcritos. As informações foram sistematizadas pela análise do conteúdo temática-Categorial. RESULTADOS: Após as análises dos grupos focais e entrevistas, emergiram as seguintes categorias: dificuldade de acesso, dependência externa (climática/de acompanhante), dependência financeira e dependência de consultas médicas. CONCLUSÃO: A precariedade da infraestrutura e acessibilidade na cidade de Salvador, além da condição econômica, mudanças climáticas e dificuldades ao acesso do Sistema Único de Saúde, impactam diretamente na adesão ao tratamento fisioterapêutico. O não comparecimento à fisioterapia pode afetar a evolução do tratamento e a saúde dessa população.
| INTRODUCTION: Tropical Spastic Paraparesis / Myelopathy Associated with HTLV-1 (HAM / TSP) presents chronic degenerative changes that compromise individuals in their daily activities, especially those related to locomotion. Accessibility is an important means of adhering to physical therapy for all these people. OBJECTIVE: To investigate the impact of accessibility on adherence to physical therapy treatment in people infected with HTLV-1 with HAM / TSP. METHOD: a study with a qualitative approach, with 38 participants, over 18 years old, with a confirmed diagnosis of HAM / TSP. Those with difficulty understanding the questionnaires or communicating were excluded. For the collection of information, 11 focus groups and 12 semi-structured changes were performed. The researcher herself recorded and then transcribed the statements. The analysis of thematic-Categorial content systematized the information. RESULTS: After analyzing the focus groups and related, the following categories emerged: access difficulty, external dependence (climatic/accompanying), financial dependence, and dependence on medical appointments. CONCLUSION: The precariousness of infrastructure and accessibility in the city of Salvador, in addition to the economic condition, climate change, and difficulties in accessing the Unified Health System, directly impact adherence to physical therapy treatment. Failure to attend physical therapy can affect the evolution of treatment and the health of this population.
Asunto(s)
Paraparesia Espástica Tropical , Modalidades de Fisioterapia , Accesibilidad a los Servicios de SaludRESUMEN
HTLV-1 creates a chronic health condition that involves moderate to severe pain with a negative impact on quality of life (QoL). There is no consensus on which attitudes to pain are more related to the worsening of QoL in HTLV-1 infected patients. The aim of this study was to investigate the correlation between QoL and multidimensional aspects of pain in patients with HTLV-1. A cross-sectional study was conducted in Salvador, Bahia, Brazil. The study included individuals diagnosed with HTLV-1. The Short Form 36 Questionnaire was used to analyze QoL, and the Brief Pain Inventory was used to assess multidimensional aspects of pain. The mean pain intensity was 4.88±3.06 on the visual pain scale, and the average impact on QoL corresponded to a loss of approximately 40%. Moderate to high correlations between pain intensity and all domains of QoL were observed and compared reaction attitudes for general activity, mood, ability to walk, ability to work, relationships, sleep, and ability to enjoy life (r>0.40; p<0.05). Moderate correlations were found between all domains of QoL, pain intensity, and reactive attitudes to pain. The greatest pain intensity impacts involved difficulty to walk and to work, and interpersonal relationships in the emotional aspect of QoL.