Master's Dissertation
DOI
https://doi.org/10.11606/D.17.2023.tde-10082023-091052
Document
Author
Full name
Camila Chiazuto Catai
Institute/School/College
Knowledge Area
Date of Defense
Published
Ribeirão Preto, 2023
Supervisor
Committee
Jorge, Cristine Homsi (President)
Baldon, Vanessa Santos Pereira
Monteiro, Juliana Cristina dos Santos
Title in Portuguese
Iniciativa Choosing Wisely Brasil para a fisioterapia em saúde da mulher: o que não fazer em fisioterapia obstétrica
Keywords in Portuguese
Choosing Wisely
Fisioterapia
Obstetrícia
Abstract in Portuguese
Introdução: A Iniciativa Choosing Wisely visa promover discussões entre pacientes e profissionais de saúde sobre comportamentos que podem ser desnecessários ou, em alguns casos, trazer riscos aos pacientes. Objetivo: Descrever o processo de elaboração da lista Choosing Wisely brasileira de Fisioterapia Obstétrica. Métodos: Este estudo transversal foi realizado online usando o Google Forms. Os métodos foram reportados de acordo com Checklist for Reporting Results of Internet E-Surveys (CHERRIES). A pesquisa constou de 3 etapas. Na 1ª, um grupo de especialistas enviou sugestões de recomendações com justificativas. Na 2ª, o grupo de pesquisa analisou as recomendações e suas justificativas e na 3ª etapa, fisioterapeutas com mais de 2 anos de experiência em fisioterapia na Saúde da Mulher votaram nas recomendações para escolha da lista final. Resultados: A 1ª etapa contou com 16 especialistas (41,81 ± 10,6 anos) que enviaram 34 recomendações. Depois de discutidas na 2ª etapa, 16 recomendações foram votadas na 3ª etapa por 224 fisioterapeutas (38,45 ± 08,06 anos). A lista final incluiu 5 recomendações que receberam mais de 80% dos votos, a saber: 1- Não realize exercícios físicos de alto impacto e esportes de contato com alto risco de trauma abdominal e quedas para gestantes, 2- Não utilize ultrassom, micro-ondas, ondas curtas e outros recursos terapêuticos que proporcionem calor profundo na região lombar, abdominal e pélvica de gestantes, 3- Não faça exercícios que possam aumentar muito a temperatura corporal de gestantes, principalmente no primeiro trimestre de gestação , 4- Não realize exercícios aeróbicos e resistidos em gestantes com sangramento, placenta prévia, cerclagem, pré-eclâmpsia descompensada, febris e/ou desidratadas e 5- Reflita antes de usar dilatadores vaginais para prevenir laceração perineal e/ou episiotomia no parto. Conclusão: As recomendações Choosing Wisely para fisioterapia obstétrica ajudará fisioterapeutas e pacientes a dialogar sobre comportamentos desnecessários e nocivos.
Title in English
Choosing Wisely Brazil Initiative for physical therapy in women's health: what not to do in obstetric physical therapy
Keywords in English
Choosing Wisely
Obstetrics
Physical therapy
Abstract in English
Background: The Choosing Wisely Initiative aims to promote discussions between patients and health professionals about behaviors that may be unnecessary or, in some cases, bring risks to patients. Purpose: To describe the development process of the Brazilian Choosing Wisely list of obstetric physiotherapy. Methods:This cross-sectional study was carried out online using Google Forms. The methods of are reported according to the Checklist for Reporting Results of Internet E-Surveys (CHERRIES). The research consisted of 3 stages. In the 1st one, a group of specialists sent suggestions of recommendations with justifications. In the 2nd, the research group analyzed the recommendations and their justifications and in the 3rd stage, physiotherapists with more than 2 years of experience in Women's Health physiotherapy voted for the recommendations to choose the final list. Results: The 1st stage included 16 experts (41.81 ± 10.6 years old) who sent 34 recommendations. After being discussed in the 2nd stage, 16 recommendations were voted in the 3rd stage by 224 physiotherapists (38.45 ± 08.06 years old). The final list included 5 recommendations that received over 80% of the votes as follow: 1- Do not perform high-impact physical exercises and contact sports that have a high risk of abdominal trauma and falls for pregnant women, 2- Do not use therapeutic ultrasound, microwaves, short waves and other therapeutic resources that provide deep heat in the lumbar, abdominal and pelvic region of pregnant women, 3- Do not do exercises that can greatly increase the body temperature of pregnant women, especially in the first trimester of pregnancy, 4- Do not perform aerobic and resistance exercises in pregnant women with bleeding, placenta previa, cerclage, decompensated preeclampsia, and who are feverish and/or dehydrated and 5- Reflect before using vaginal dilators to prevent perineal laceration and/or episiotomy in childbirth. Conclusion: Choosing Wisely recommendations for obstetrics physiotherapy will help physiotherapists and patients dialogue about unnecessary and harmful behaviors.
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Publishing Date
2023-08-22