Abstract
To analyze the effects of an educational intervention in the light of the Meaningful Learning Theory on the knowledge and attitude of Primary Health Care physicians and nurses in the assessment of the degree of physical disability in leprosy. An intervention study of the before-and-after type, conducted with 122 professionals (84 nurses and 38 physicians) from the Primary Health Care of João Pessoa, Paraíba, in a training course on the assessment of the degree of physical disability in leprosy. The data were collected with the research's own instrument validated and analyzed by the chi-square adherence and proportion test, with a 5% significance level. There was an increase in the scores of all items of the instrument, with a statistically significant difference (p < 0.05) in 20 of the 32 items, with emphasis on those related to the professional's technical ability to conduct the stages of anamnesis, palpation of peripheral nerves, sensory and motor evaluation. It is also noteworthy that, after the intervention, 5 items obtained 100% of correct answers. The educational intervention grounded on the Meaningful Learning Theory improved the health professionals' knowledge and attitude in the assessment of the degree of physical disability in people with leprosy.
Highlights
Leprosy is a dermatoneurological disease that can cause physical disabilities in the face and in the upper and lower limbs, causing a series of problems, such as limitation to perform activities of daily living, reduced ability to perform work functions and restriction to participate in society, in addition to arousing stigma and prejudice[1,2]
Most of the study participants have been working in the FHS for more than 10 years (47.5%), which allows supposing that they know the problem involved in the care that should be provided to people with leprosy in Primary Health Care (PHC), only nearly half of the professionals (50.8%) knew the Simplified Neurological Assessment (SNA) form, indicated to assess integrity of the neural function and to determine the patients’ Degree of Physical Disability (DPD), which goes against the national guidelines for the management and prevention of physical disabilities resulting from the disease[14]
Considering that these correct answer frequencies rose to 80.3%, 85.2%, 87.7% and 79.5% in the post-test, it is verified that, throughout the educational intervention, the professionals were able to develop clinical reasoning related to the disease, something fundamental to assist in the decision-making process and, manage changes in the spaces in which they are inserted, enabling improvements in access, quality and humanization of the care provided to the population[12]
Summary
Leprosy is a dermatoneurological disease that can cause physical disabilities in the face and in the upper and lower limbs, causing a series of problems, such as limitation to perform activities of daily living, reduced ability to perform work functions and restriction to participate in society, in addition to arousing stigma and prejudice[1,2]. Such disabilities can be classified in degrees ranging from 0, when the sensory and motor functions are preserved; 1, indicating changes in sensitivity and/or muscle strength; and 2, in the presence of visible deformities resulting from the disease, composing epidemiological indicators used for monitoring the disease[3]. In view of this situation, the reduction of cases diagnosed with physical disability has been listed as a priority in the “2019–2022 National Strategy against Leprosy”, which requires professionals to perform early diagnosis, timely and appropriate treatment of cases and prevention of disabilities, so that cure of the disease is attained with minimal sequelae[6,7].
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