Physical rehabilitation in the context of a landslide that occurred in Brazil
Physical rehabilitation in the context of a landslide that occurred in Brazil
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DOI：
10.1186/s12889-019-7964-x
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发表时间：
2019-12-02
影响因子：
4.5
通讯作者：
Miranda, E. S.
中科院分区：
文献类型：
--
作者：
Carvalho, M. L.;Freitas, C. M.;Miranda, E. S.
灾害后身体康复的研究和培训工作是近年来在世界范围内开展的。2011年1月11日晚至1月12日，巴西发生了最大规模的自然灾害，里约热内卢山区多个地区出现了特大暴雨、突发洪水和山体滑坡。这项研究的目的是调查的挑战，在物理康复提供了这一事件方法的横断面混合方法的研究，这是在新弗里堡市进行的，使用两个不同的数据来源：灾前和灾后创伤的医院记录，以及与关键线人的访谈-与灾难有关的受伤受害者，市康复服务专业人员以及市卫生服务管理部门。皮尔森卡方检验用于评估给定事件的周数与损伤类型之间的统计学显著性。通过内容分析转录和分析了访谈。结果共分析了2326份病历和27次访谈。在市政急救服务中，创伤性伤害的比例从灾前一周的16%增加到灾后一周的40%（p < 0.0001）。查明了不同的伤害：多处骨折、挤压、截肢、软组织穿孔、吸入灰尘和因压力造成的慢性病。尽管如此，在接受采访的16名卫生专业人员中，有12人没有观察到灾后门诊康复服务需求的增加。与受害者的访谈显示，获得护理的途径遇到了不同的障碍。在接受访谈的11名受害者中，只有一人通过该市的公共卫生服务机构得到了全面的理疗护理，而其他所有人都雇用了额外的援助，接受志愿服务，在其他城市得到援助，或仍然没有康复。结论灾后重建需求增加，但由于不同的障碍，如竞争性需求和可能缺乏医疗转诊，需求被压抑。提出了一些建议，包括采取行动寻找有康复需要的受害者。
Backgrounds The efforts to develop research and training on physical rehabilitation in regards to disasters is considered recent worldwide. In the late evening of the 11th up until the 12th of January of 2011, the most massive natural disaster occurred in Brazil with extremely heavy downpour, abrupt flood, as well as landslides on multiple areas of the Mountain Region of Rio de Janeiro. The objective of this research was to investigate the challenges in terms of physical rehabilitation provided by this event Methods The cross-sectional mixed method's study, which was conducted in the city of Nova Friburgo, used two different data sources: hospital records on traumatic injuries pre and post disaster, and interviews with key informants - victims who suffered injuries related to the disaster, professionals from rehabilitation services in the municipality, and also the city's health service management. Pearson's chi-squared test was performed to evaluate statistical significance between the week of a given incident and the type of injury. Interviews were transcribed and analysed through content analysis. Results A total of 2326 hospital records and 27 interviews were analysed. The proportion of traumatic injury in the municipal emergency service increased from 16% in the prior week, to 40% in the week post-disaster (p < 0.0001). Different injuries were identified: multiple fractures, crushing, amputation, perforation of soft tissues, inhalation of dust and establishment of chronic conditions through stress. Despite this scenario, out of the 16 health professionals interviewed, twelve did not observe an increase in the demand for outpatient rehabilitation services after the disaster. Interviews with the victims revealed that the pathways for care ran into different barriers. From 11 victims interviewed, only one received complete physiotherapy care through the public health services in the city, while all others hired additional assistance, received volunteer services, had assistance in other cities or remained without rehabilitation. Conclusions The needs for rehabilitation increased after the disaster; however, the demand was repressed due to different barriers such as competing needs and possible lack of medical referral. Recommendations were made, including the action of performing a search of victims with rehabilitation needs.