Reduced version of the Activity Measure for Post-Acute Care (AM-PAC) for inpatients, "6-clicks": Brazilian-Portuguese cross-cultural adaptation and measurement properties.

BACKGROUND: The "6-clicks" is the reduced version of the Activity Measure for Post-Acute Care for inpatients that assesses limitations in basic mobility, daily activity, and applied cognitive, simply and quickly. OBJECTIVE: Cross-culturally adapt the "6-clicks" into Brazilian-Portuguese and verify its measurement properties. METHODS: Cross-cultural adaptation followed recommendations from international guidelines. Reliability indices, standard error of measurement and minimum detectable difference were calculated. Participants included 13 professionals, 13 patients and 13 companions. Test of measurement properties involved 101 patients' of both sexes, hospitalized in the infirmary, under physical therapy care, able to understand and respond to commands and with no discharge expectation. Their 30 companions were also included. RESULTS: Minor changes implemented to the original version. The three domains showed adequate internal consistency (α>0.65). Inter-rater reliability (n=50) and test-retest reliability, when administer to patients (n=51) and to companions (n=30), showed good for basic mobility domain (ICC2.1=0.81, 0.83 and 0.82, respectively), good to moderate for daily activity (ICC2.1=0.78 and ICC3.1=0.71 and 0.82, respectively) and moderate to poor for applied cognitive (ICC2.1=0.64, 0.36 and ICC3.1=0.63), respectively. The highest agreements among patients/companions were also in basic mobility. Standard error of measurement ranged from 2.03 to 2.64 while the minimum detectable difference ranged from 5.63 to 7.32. CONCLUSION: Translated and adapted Brazilian version of the "6-clicks" showed acceptable measurement properties. The functional data provided by the instrument could be used to enhance care and help treatment follow-up.

Cross-cultural adaptation to Brazilian Portuguese of the Activity Measure for Post-Acute Care (AM-PAC) short forms for outpatients in rehabilitation.

BACKGROUND: The Activity Measure for Post-Acute Care was developed to evaluate the limitations of activities of adult individuals with different health conditions. OBJECTIVES: To translate and cultural adapt the Activity Measure for Post-Acute Care short forms for outpatients into Portuguese-Brazilian, to verify the comprehension of the items and categories of the responses by users of the rehabilitation services and to analyze the reliability indices of the instrument. METHODS: Translation and back-translation were conducted by two independent teams. Cognitive interviews (n=2) evaluated the comprehension of the translated version among patients. Item reliability and consistency was also investigated. RESULTS: There was conceptual equivalence between the translated and original versions. For some items, the information was modified in order to attend to the measurement units used in Brazil. Comparative analyses of the translated versions chose the most appropriate term to capture the English content. The few discrepancies identified in the back-translation were solved by consensus. The cognitive interviews detected few comprehension problems, which were solved by means of repetition of the item statement and use of examples to clarify the specificity of the information. The final translated short forms of the instrument showed excellent test-retest reliability and inter-examiner reliability indices, as well as high internal consistency. CONCLUSION: The Portuguese version of the Activity Measure for Post-Acute Care short forms will provide Brazilian clinicians and researchers with an up-to-date instrument for the evaluation of functioning of adults with various clinical conditions who attend outpatient rehabilitation settings.

Characteristics and functional demands of patients at a local rehabilitation network: analysis from first contact. / Características e demandas funcionais de usuários de uma rede local de reabilitação: análise a partir do acolhimento.

The cross sectional study aims to create the patients' profile and understand their demands for seeking public rehabilitation services from Belo Horizonte. Data were analyzed from 516 patients who gained entry into the health care system by means of the Protocol for Identification of Problems for Rehabilitation (PLPR). It allows for gathering information related to one's health and the social context, including a brief functional description (BFD) with 25 items. Most patients were females, mean age of 57 years, and 54% declared to be responsible for the family income. Severe or complete difficulty in at least one item from the BFD was reported by 87%. Pain and Mobility domains showed greater disability. The patient's demand for services referred them mostly to physical therapy (89%), and psychology (14%); 77% were referred to basic care (BC) and 21% to specialized care (SC). Those that started rehabilitation in SC were younger, had increased number of high ratings in item's qualifiers and higher total score in the BFD, indicating increased functional limitation and restriction. It is intended that the information provided by the PLPR may contribute to the organization of patients' flow and the planning of actions.

Características e demandas funcionais de usuários de uma rede local de reabilitação: análise a partir do acolhimento / Characteristics and functional demands of patients at a local rehabilitation network: analysis from first contact

Resumo Este estudo transversal objetiva traçar o perfil e conhecer as demandas dos usuários que buscaram os serviços públicos de reabilitação de Belo Horizonte, Minas Gerais. Foram analisados dados de 516 usuários acolhidos por meio do Protocolo de Levantamento de Problemas para a Reabilitação (PLPR), que permite a coleta de informações sobre a saúde, contexto social e inclui uma Breve Descrição Funcional (BDF) com 25 itens, em 10 domínios. A maioria dos usuários era de mulheres, média de idade de 57 anos e 54% declararam ser o responsável pela renda familiar. Dificuldade grave ou completa foi relatada por 87%, em pelo menos um dos itens da BDF, sendo os domínios Dor e Mobilidade os de maior incapacidade. A demanda por profissionais foi, principalmente, para Fisioterapeuta (89%), e Psicólogo (14%); 77% foram indicados para iniciar o tratamento na Atenção Básica (AB) e 21% na Atenção Especializada (AE). Aqueles que iniciaram na AE eram mais jovens; com maior número de qualificadores altos e elevada pontuação na BDF, indicando maior limitação/restrição funcional. Espera-se que as informações disponibilizadas pelo PLPR possam contribuir para a organização do fluxo e o planejamento de ações.

Abstract The cross sectional study aims to create the patients’ profile and understand their demands for seeking public rehabilitation services from Belo Horizonte. Data were analyzed from 516 patients who gained entry into the health care system by means of the Protocol for Identification of Problems for Rehabilitation (PLPR). It allows for gathering information related to one’s health and the social context, including a brief functional description (BFD) with 25 items. Most patients were females, mean age of 57 years, and 54% declared to be responsible for the family income. Severe or complete difficulty in at least one item from the BFD was reported by 87%. Pain and Mobility domains showed greater disability. The patient’s demand for services referred them mostly to physical therapy (89%), and psychology (14%); 77% were referred to basic care (BC) and 21% to specialized care (SC). Those that started rehabilitation in SC were younger, had increased number of high ratings in item’s qualifiers and higher total score in the BFD, indicating increased functional limitation and restriction. It is intended that the information provided by the PLPR may contribute to the organization of patients’ flow and the planning of actions.