Leprosy and Physiotherapy: a necessary approach
DOI:
https://doi.org/10.7322/jhgd.v29.9541Keywords:
higher education, learning, professional practice, leprosy, physiotherapyAbstract
Introduction: New cases of leprosy occur due to a set of factors associated with the lack of knowledge about the disease, both by health professionals and patients, favoring late diagnosis, the development of physical and social disabilities, stigma and prejudice.
Objective: To verify the knowledge of students completing the physiotherapy course on leprosy and professional practice in the care of patients with the disease.
Methods: A qualitative exploratory descriptive study was conducted with 68 undergraduate students from physiotherapy courses from public and private universities (AU, UB, UC), in the State of Mato Grosso do Sul. Data were collected through a questionnaire with ten open questions about knowledge, practical action, motivations, interests and teaching-learning process about leprosy. To organize and analyze the data, the
collective subject discourse technique was used.
Results: It was found that 60% of aU students, 63% of UB and 30.8% of UC have a general conception about the disease. 46.7% of aU students, 77.8% of UB and 80.9% of UC never had contact with leprosy patients. More than half of the students at the three universities said they were unaware of the physiotherapy approaches and practices in leprosy. Almost 100% of ub and UC students stated that the subject was not addressed during the course and therefore did not feel prepared to provide health education and to guide on how to prevent physical deficiencies resulting from leprosy. 73.3% of AU students, 96.3% of UB and 100% of UC recorded negative evaluations, qualifying the course as precarious, insufficient and weak in the leprosy approach.
Conclusion: It is concluded that leprosy should be included in physiotherapy courses systematically, providing practical care activities, developing skills from prevention to rehabilitation, seeking greater motivation and identification of his work in this area.
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References
1. World Health Organization (WHO). Global leprosy strategy 2016-2020: accelerating towards a leprosy-free world. [cited 2017 Apr 4] Available from: http://www.searo.who.int/entity/global_leprosy_programme/ documents/global_leprosy_strategy_2020/en/.
2. Brasil. Ministério da Saúde. Secretaria de Vigilância em Saúde. Coordenação-Geral de Desenvolvimento da Epidemiologia em Serviços. Guia de Vigilância em Saúde: recurso eletrônico. Brasília: Ministério da Saúde, 2016.
3. Sillo S, Lomax C, Wildt G, Fonseca MS, Galan NGA, Prado RBR. A temporal and sociocultural exploration of the stigma experiences of leprosy patients in Brazil. Lepr Rev. 2016;87(3):378-95.
4. Henry M, Galan N, Teasdale K, Prado R, Amar H, Rays MS, et al. Factors contributing to the delay in diagnosis and continued transmission of leprosy in Brazil – an explorative, quantitative, questionnaire based study. PLoS Negl Trop Dis. 2016;10(3):e0004542. DOI: https://doi.org/10.1371/journal.pntd.0004542
5. Silva MCD, Paz EPA. Health education in the leprosy control program: the experience of the multidisciplinary team. Esc Anna Nery. 2010;14(2):223-9. DOI: http://dx.doi.org/10.1590/S141481452010000200003
6. Nakae MF. Nada será como antes – o discurso do sujeito coletivo hanseniano. Psic. 2002;3(2):54-73.
7. Serrano-Coll H, Vélez JD, Trochez D, Beltrán JC, Suanca D, Monsalve F, et al. Effectiveness of an individual physical rehabilitation programme in a group of patients with Hansen’s disease. Lepr Rev. 2016;87(3):355-67.
8. Dias A, Cyrino EG, Lastória JC. Knowledge and necessities of learning of physiotherapy’s students about Leprosy. Hansen Int. 2007;32(1):9-18.
9. Lefèvre F, Lefèvre AMC. Discurso do sujeito coletivo: um novo enfoque em pesquisa qualitativa (desdobramentos). Porto Alegre: Educs, 2003.
10. Brasil Ministério da Saúde. Secretaria de Vigilância em Saúde. Departamento de Vigilância das Doenças Transmissíveis. Diretrizes para vigilância, atenção e eliminação da hanseníase como problema de saúde pública. Brasília: Ministério da Saúde, 2016.
11. Castro SS, Abreu GB, Fernandes LFRM, Santos JPP, Oliveira VR. Leprosy incidence, characterization of cases and correlation with household and cases variables of the Brazilian states in 2010. An Bras Dermatol. 2016; 91(1):28-33. DOI: http://dx.doi.org/10.1590/abd1806-4841.20164360
12. Monteiro LD, Martins-Melo FR, Brito AL, Alencar CH, Heukelbach J. Physical disabilities at diagnosis of leprosy in a hyperendemic area of Brazil: trends and associated factors. Lepr Rev. 2015;86(3):240-50.
13. Lima AS, Pinto KC, Bona MPS, Mattos SML, Hoffmann MP, Mulinari-Brenner FA, et al. Leprosy in a University Hospital in Southern Brazil. An Bras Dermatol. 2015;90(5):654-9. DOI: http://dx.doi.org/10.1590/abd1806-4841.20153959
14. Pellizzari VDZV, Arruda GO, Marcon SS, Fernandes CAM. Perceptions of people with leprosy about disease and treatment. Rev Rene. 2016; 17(4):466-74. DOI: https://doi.org/10.15253/2175-6783.2016000400005
15. Silveira MGB, Coelho AR, Rodrigues SM, Soares MM, Camilo GN. Hansen's disease patients: psychological impact of the diagnosis. Psicol Soc. 2014;26(2):517-27. DOI: http://dx.doi.org/10.1590/S0102-71822014000200027
16. Lana FCF, Lanza FM, Carvalho APM, Tavares APN. Stigma associated with hansen’s disease and its relation to control actions. Rev Enferm UFSM. 2014;4(3):556-65. DOI: http://dx.doi.org/10.5902/2179769212550
17. Teasdale K, Wildt G, Pranab K, Virmond Mda C, Galan NG, Prado RB, et al. The patient perspective of the diagnostic process for leprosy in Brazil. An exploratory study. Lepr Rev. 2015;86(1):21-36.
18. Santos DCM, Nascimento RD, Gregório VRN, Silva MRF. The Hansen’s disease and its diagnostic process. Hansen Int. 2007;32(1):19-26.
19. Malviya GN. Disabilities in leprosy - the new concepts. Indian J Lepr. 2014; 86(3):121-7.
20. Sermrittirong S, Van Brakel WH. Stigma in leprosy: concepts, causes and determinants. Lepr Rev. 2014;85(1):36-47.
21. Lopes JP. Conhecimento de alunos sobre Hanseníase. Saúde Rev. 2016;16(42):1-10. DOI: http://dx.doi.org/10.15600/2238-1244/sr.v16n42p1-10
22. Rodini FCB, Gonçalves M, Barros ARSB, Mazzer N, Elui VMC, Fonseca MCR. Disability prevention in leprosy using a self-care manual for patients. Fisioter Pesqui. 2010;17(2):157-66. DOI: http://dx.doi.org/10.1590/S1809-29502010000200012
23. Véras LST, Vale RGS, Mello DB, Castro JAF, Lima V, Trott A, et al. Electromyography function, disability degree, and pain in leprosy patients undergoing neural mobilization treatment. Rev Soc Bras Med Trop. 2012;45(1):83-8. DOI: http://dx.doi.org/10.1590/S0037-86822012000100016
24. Araujo AERA, Aquino DMC, Goulart IMB, Pereira SRF, Figueiredo IA, Serra HO, et al. Factors associated with neural alterations and physical disabilities in patients with leprosy in São Luis, State of Maranhão, Brazil. Rev Soc Bras Med Trop. 2014;47(4):490-7. DOI: http://dx.doi.org/10.1590/0037-8682-0119-2014
25. Beluci ML, Borgato MH, Galan NGA. Evaluation of multidisciplinary courses in leprosy. Hansen Int. 2012;37(2):47-53.
26. Gonçalves SD, Sampaio RF, Antunes CMF. Predictive factors of disability in patients with leprosy. Rev Saúde Pública. 2009;43(2):267-74. DOI: http://dx.doi.org/10.1590/S0034-89102009000200007
27. Caldas AM, Aquino DMC, Caldas AJM, Silva RSO, Silva SMF. Action of physical therapy multipurpose team in the monitoring of patients with leprosy. Rev Hosp Universitário UFMA. 2007;8(2):17-22.
28. Ferreira JLPM, Cerdeira DQ, Nunes TTV, Guimarães DF, Liberato FRC. Role of physical therapy in the follow-up of patients with leprosy. Fisioter Bras. 2016;17(5):472-79.
29. Brasil Serviço Público Federal. Conselho Regional de Fisioterapia e Terapia Ocupacional da 11ª Região – DF e GO. Protocolo de Fisioterapia e Terapia Ocupacional para prevenção de incapacidades físicas e reabilitação em hanseníase recomendado pelo Creffito 11. Brasília: 2015.
30. Oliveira JM, Torquato SG, Mello D, Dantas EHM. [Experience report on the use of low-power laser in the treatment of neurotrophic ulcers]. ?Rev enferm ufpe on line. 2014 May;8(5):1330-6. doi: 10.5205/reuol.5863-50531-1-ed.0805201430. Portuguese.
31. Xavier EM, Ferreira J, Raniero LJ, Batista JRX, Freitas MLL, Sousa M, et al. Wound healing leprosy induced by low intensity laser. Hansen Int. 2012;37(1):51-7.
32. Lima GM, Miranda MGR, Ferreira TCR. Action of therapeutic exercises in patients with chronic neuritis holders of leprosy, accompanied at the Reference Unit Specialized in Sanitary Dermatology Dr. Marcello Candia. Hansenol Int. 2009;34(1):9-16.
33. Diaz AF, Moro FL, Binotto JM, Fréz AR. Preliminary comparative study between proprioceptive and passive static stretching in patients with leprosy sequelae. Fisioter Pesqui. 2008;15(4):339-44. DOI: http://dx.doi.org/10.1590/S1809-29502008000400004
34. Reis FJJ, Gomes MK, Alves D, Cabral R, Cunha AJLA. Leprosy: knowledge and social representations among physical therapy students. Fisioter Bras. 2014;15(3):178-83.
35. Kanodia SK, Dixit AM, Shukla SR, Seth AK, Balothia V, Gupta R. A study on knowledge, beliefs and attitude towards leprosy in students of Jaipur, Rajasthan. Indian J Lepr. 2012;84(4):277-85.
36. Alves CRP, Ribeiro MMF, Melo EM, Araújo MG. Teaching leprosy: current challenges. An Bras Dermatol. 2014;89(3):454-9. DOI: http://dx.doi.org/10.1590/abd1806-4841.20142444
2. Brasil. Ministério da Saúde. Secretaria de Vigilância em Saúde. Coordenação-Geral de Desenvolvimento da Epidemiologia em Serviços. Guia de Vigilância em Saúde: recurso eletrônico. Brasília: Ministério da Saúde, 2016.
3. Sillo S, Lomax C, Wildt G, Fonseca MS, Galan NGA, Prado RBR. A temporal and sociocultural exploration of the stigma experiences of leprosy patients in Brazil. Lepr Rev. 2016;87(3):378-95.
4. Henry M, Galan N, Teasdale K, Prado R, Amar H, Rays MS, et al. Factors contributing to the delay in diagnosis and continued transmission of leprosy in Brazil – an explorative, quantitative, questionnaire based study. PLoS Negl Trop Dis. 2016;10(3):e0004542. DOI: https://doi.org/10.1371/journal.pntd.0004542
5. Silva MCD, Paz EPA. Health education in the leprosy control program: the experience of the multidisciplinary team. Esc Anna Nery. 2010;14(2):223-9. DOI: http://dx.doi.org/10.1590/S141481452010000200003
6. Nakae MF. Nada será como antes – o discurso do sujeito coletivo hanseniano. Psic. 2002;3(2):54-73.
7. Serrano-Coll H, Vélez JD, Trochez D, Beltrán JC, Suanca D, Monsalve F, et al. Effectiveness of an individual physical rehabilitation programme in a group of patients with Hansen’s disease. Lepr Rev. 2016;87(3):355-67.
8. Dias A, Cyrino EG, Lastória JC. Knowledge and necessities of learning of physiotherapy’s students about Leprosy. Hansen Int. 2007;32(1):9-18.
9. Lefèvre F, Lefèvre AMC. Discurso do sujeito coletivo: um novo enfoque em pesquisa qualitativa (desdobramentos). Porto Alegre: Educs, 2003.
10. Brasil Ministério da Saúde. Secretaria de Vigilância em Saúde. Departamento de Vigilância das Doenças Transmissíveis. Diretrizes para vigilância, atenção e eliminação da hanseníase como problema de saúde pública. Brasília: Ministério da Saúde, 2016.
11. Castro SS, Abreu GB, Fernandes LFRM, Santos JPP, Oliveira VR. Leprosy incidence, characterization of cases and correlation with household and cases variables of the Brazilian states in 2010. An Bras Dermatol. 2016; 91(1):28-33. DOI: http://dx.doi.org/10.1590/abd1806-4841.20164360
12. Monteiro LD, Martins-Melo FR, Brito AL, Alencar CH, Heukelbach J. Physical disabilities at diagnosis of leprosy in a hyperendemic area of Brazil: trends and associated factors. Lepr Rev. 2015;86(3):240-50.
13. Lima AS, Pinto KC, Bona MPS, Mattos SML, Hoffmann MP, Mulinari-Brenner FA, et al. Leprosy in a University Hospital in Southern Brazil. An Bras Dermatol. 2015;90(5):654-9. DOI: http://dx.doi.org/10.1590/abd1806-4841.20153959
14. Pellizzari VDZV, Arruda GO, Marcon SS, Fernandes CAM. Perceptions of people with leprosy about disease and treatment. Rev Rene. 2016; 17(4):466-74. DOI: https://doi.org/10.15253/2175-6783.2016000400005
15. Silveira MGB, Coelho AR, Rodrigues SM, Soares MM, Camilo GN. Hansen's disease patients: psychological impact of the diagnosis. Psicol Soc. 2014;26(2):517-27. DOI: http://dx.doi.org/10.1590/S0102-71822014000200027
16. Lana FCF, Lanza FM, Carvalho APM, Tavares APN. Stigma associated with hansen’s disease and its relation to control actions. Rev Enferm UFSM. 2014;4(3):556-65. DOI: http://dx.doi.org/10.5902/2179769212550
17. Teasdale K, Wildt G, Pranab K, Virmond Mda C, Galan NG, Prado RB, et al. The patient perspective of the diagnostic process for leprosy in Brazil. An exploratory study. Lepr Rev. 2015;86(1):21-36.
18. Santos DCM, Nascimento RD, Gregório VRN, Silva MRF. The Hansen’s disease and its diagnostic process. Hansen Int. 2007;32(1):19-26.
19. Malviya GN. Disabilities in leprosy - the new concepts. Indian J Lepr. 2014; 86(3):121-7.
20. Sermrittirong S, Van Brakel WH. Stigma in leprosy: concepts, causes and determinants. Lepr Rev. 2014;85(1):36-47.
21. Lopes JP. Conhecimento de alunos sobre Hanseníase. Saúde Rev. 2016;16(42):1-10. DOI: http://dx.doi.org/10.15600/2238-1244/sr.v16n42p1-10
22. Rodini FCB, Gonçalves M, Barros ARSB, Mazzer N, Elui VMC, Fonseca MCR. Disability prevention in leprosy using a self-care manual for patients. Fisioter Pesqui. 2010;17(2):157-66. DOI: http://dx.doi.org/10.1590/S1809-29502010000200012
23. Véras LST, Vale RGS, Mello DB, Castro JAF, Lima V, Trott A, et al. Electromyography function, disability degree, and pain in leprosy patients undergoing neural mobilization treatment. Rev Soc Bras Med Trop. 2012;45(1):83-8. DOI: http://dx.doi.org/10.1590/S0037-86822012000100016
24. Araujo AERA, Aquino DMC, Goulart IMB, Pereira SRF, Figueiredo IA, Serra HO, et al. Factors associated with neural alterations and physical disabilities in patients with leprosy in São Luis, State of Maranhão, Brazil. Rev Soc Bras Med Trop. 2014;47(4):490-7. DOI: http://dx.doi.org/10.1590/0037-8682-0119-2014
25. Beluci ML, Borgato MH, Galan NGA. Evaluation of multidisciplinary courses in leprosy. Hansen Int. 2012;37(2):47-53.
26. Gonçalves SD, Sampaio RF, Antunes CMF. Predictive factors of disability in patients with leprosy. Rev Saúde Pública. 2009;43(2):267-74. DOI: http://dx.doi.org/10.1590/S0034-89102009000200007
27. Caldas AM, Aquino DMC, Caldas AJM, Silva RSO, Silva SMF. Action of physical therapy multipurpose team in the monitoring of patients with leprosy. Rev Hosp Universitário UFMA. 2007;8(2):17-22.
28. Ferreira JLPM, Cerdeira DQ, Nunes TTV, Guimarães DF, Liberato FRC. Role of physical therapy in the follow-up of patients with leprosy. Fisioter Bras. 2016;17(5):472-79.
29. Brasil Serviço Público Federal. Conselho Regional de Fisioterapia e Terapia Ocupacional da 11ª Região – DF e GO. Protocolo de Fisioterapia e Terapia Ocupacional para prevenção de incapacidades físicas e reabilitação em hanseníase recomendado pelo Creffito 11. Brasília: 2015.
30. Oliveira JM, Torquato SG, Mello D, Dantas EHM. [Experience report on the use of low-power laser in the treatment of neurotrophic ulcers]. ?Rev enferm ufpe on line. 2014 May;8(5):1330-6. doi: 10.5205/reuol.5863-50531-1-ed.0805201430. Portuguese.
31. Xavier EM, Ferreira J, Raniero LJ, Batista JRX, Freitas MLL, Sousa M, et al. Wound healing leprosy induced by low intensity laser. Hansen Int. 2012;37(1):51-7.
32. Lima GM, Miranda MGR, Ferreira TCR. Action of therapeutic exercises in patients with chronic neuritis holders of leprosy, accompanied at the Reference Unit Specialized in Sanitary Dermatology Dr. Marcello Candia. Hansenol Int. 2009;34(1):9-16.
33. Diaz AF, Moro FL, Binotto JM, Fréz AR. Preliminary comparative study between proprioceptive and passive static stretching in patients with leprosy sequelae. Fisioter Pesqui. 2008;15(4):339-44. DOI: http://dx.doi.org/10.1590/S1809-29502008000400004
34. Reis FJJ, Gomes MK, Alves D, Cabral R, Cunha AJLA. Leprosy: knowledge and social representations among physical therapy students. Fisioter Bras. 2014;15(3):178-83.
35. Kanodia SK, Dixit AM, Shukla SR, Seth AK, Balothia V, Gupta R. A study on knowledge, beliefs and attitude towards leprosy in students of Jaipur, Rajasthan. Indian J Lepr. 2012;84(4):277-85.
36. Alves CRP, Ribeiro MMF, Melo EM, Araújo MG. Teaching leprosy: current challenges. An Bras Dermatol. 2014;89(3):454-9. DOI: http://dx.doi.org/10.1590/abd1806-4841.20142444
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Published
2019-12-12
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