Brazil is located in Latin America. It is the fifth most populated country according to the US Department of State (US Department of State, 2010). Brazil is home to an estimated 196 million people (US Department of State, 2010). As indicated by the Brazilian government, Brazil is a presidential democracy. The country is often referred to as “The Federative Republic of Brazil” (Brazilian Government, 2005). The Brazilian government developed a policy named “Zero Hunger”. The “Zero Hunger” policy is described in this view:
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Zero Hunger is a public policy that aims at eradicating hunger and social exclusion. It is a policy because it expresses the Federal Government’s decision to consider hunger a central national issue, rather than an individual fatality. It is public because apart from the State it involves society as a whole (Brazilian Government, 2005).
Brazil has public and private options for healthcare. In reference to the Brazilian government the public healthcare is established for public treatment. An example of this development is “preventative and outpatient care with programs being carried out in rural areas: sanitation, food safety and care for the elderly, women and children” (Brazilian Government, 2005). Improvements for public and private healthcare are still growing (Brazilian Government, 2005). The country of Brazil has been influenced by Indian, European, and African cultures. The influences of these nations have created norms for the Brazilian people. For example, music is a widespread custom in Brazil that dates back to the 17th century (Brazilian Government, 2005). Brazil has six occupational therapy schools. To become an occupational therapist in Brazil, a student must complete four to five years of occupational therapy curriculum at the offering university. Depending on what university the student attends that will determine the duration of their schooling (World Federation of Occupational Therapists, 2004).
Based on the research found for occupational therapy, Brazil appears to have a driving focus toward people with physical disabilities. Most of the research found pertained to physically disabled adults. However, there were few studies concerning pediatrics as well. For the most part, the focused research highlighted physical disabilities in the upper extremity. In addition, research was found that supported rehabilitation services, incorporates models for disabled adults returning to work, supports theories based on review, and functional advancements for persons who are disabled. “In occupational therapy, we assist a population whose daily routine reveals disorganized “doing” and that faces difficulties in participating in the social and cultural world” (Takatori & Bemtempo, 2007, p. 48). This was quoted from a Brazilian study for children, but it could be taken into consideration for all levels of occupational therapy. The following paragraphs include research from Brazil used to educate the world of occupational therapy.
“Work-related hand injures: Case analyses in a Brazilian rehabilitation service” is the study conducted by Sampaio, Mancini, Sliva, Figueiredo, Vaz, and Alves, 2006, p. 803. This study promotes the idea that the “results of this study provide evidence for functional gains in clients treated in a rehabilitation service and supply information about the relation between specific components and functional performance” (Sampaio et.al, 2006, p. 803). This study by Sampaio et al., 2006, was designed to depict the changes in patients who underwent therapy at hospitals in Brazil. The treatment began after the patient had a work related accident. The accident resulted in the patient having an upper extremity disability. The patient was observed by an occupational therapist at two different times. The first time was at the entrance of treatment, and the other was at the release of their treatment. The authors included outside measurements in their study. “The Canadian Occupational Performance Measure (COPM) was used to assess participants’ self-perception of their occupational performance and satisfaction. COPM is a standardized functional assessment instrument in the format of a semi structured interview based on proposed for client-centered practice” (Sampaio et al., 2006, p. 805). After rehabilitation was completed the grip strength of the patients had improved. Also there was an increase of the COPM at the time of discharge (Sampaio et al., 2006, p.806). In addition, more research by Figueiredo, Sampaio, Mancini & Nascimento et al. (2006) also agrees that receiving intervention especially occupational therapy will increase the COPM and the grip strength. After the study was completed the research shows that people who have rehabilitation therapy will see “significant increase in grip strength values, with mean value at discharge showing to be twice the magnitude observed at admission” (Sampaio et al., 2006, p. 807). “in Brazil, few rehabilitation services currently use client-centered functional evaluation tools in clinical practice, and most are not familiar with such instruments. However, client-centered approaches are becoming popular within rehabilitation facilities, especially in North America (Sampaio et al., 2006). This study in Brazil is good for moving rehabilitation research forward because it demonstrates how research from other countries can be implemented. This shows that having countries create research together can enhance a common goal. Also, the research illustrates how there are positive outcomes for this topic. Occupational therapists questioning the idea of rehabilitation services for hand therapy can read this study, and then formulate their own opinions based on the findings of Sampaio and other researchers.
Another research titled named “Disabilities of the arm, shoulder, and hand (DASH): Factor analysis of the version adapted to Portuguese/Brazil” by Cheng, Sampaio, Mancini, Fonseca, and Cotta (2008) also has a focus on upper extremity disabilities. DASH has been used in a practical setting, and has been converted into other languages for the enrichment of shared research (Cheng et al., 2008). The purpose of this study was “To investigate the psychometric properties (construct and discriminate validities) of the translated and validated version of DASH in the Portuguese language” (Cheng et al., 2008, p. 1901). Since this is the first performance of the Brazilian DASH:
Another aspect to be considered is that this is the first study to analyze the performance of the items in the Brazilian version of the instrument, which along with the scarcity of the studies that investigate performance of the instrument items, hinders comparisons (Cheng et al., 2008, p. 1908).
Seeing how Brazil is now implementing the method of DASH shows that they are trying to expand their knowledge. Brazil is teaming up with other countries to utilize research. Since occupational therapists might be facilitating treatment to persons with upper extremity disabilities, constructing research for this problem in this country is important. Due to the fact that Brazil has “strong manufacturing, agriculture, mining, and service sector” (Frumkin & Ca^mara, 1991, p. 1619), the need for DASH and occupational therapy could effectively help the disabled workers.
One article ” describes the application of a model for analyzing industrial tasks that was developed to identify jobs that could potentially be filled by people with disabilities (DP) and to serve as a guideline for a company hiring policy” (Simonelli & Camarotto (2008), p. 150). “Analysis of industrial tasks as a tool for the inclusion of people with disabilities in the work market” is the name of the article (Simonelli & Camarotto, 2008, p. 150). This model could be used in other countries where seen fit. In the countries where disabled people want to work, a model would be a good foundation to restart employment. “A survey conducted in 1997 by the United Nations Scientific and Cultural Organization found that 10% of the world’s population has some form of disability” (Simonelli & Camarotto, 2008, p. 151). Brazil has approximately 20 million people who are disabled according to the World Health Organization (WHO, 1996). However, only 2% of the DP have a routine job. Brazil contributed this research on the basis that “in Brazil, Law No 8213/91 makes it obligatory to hire DP based on the quotas that are established according to the number of employees in a public and private company” (Simonelli & Camarotto, 2008, p. 150).
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“The model consists of three stages: analysis of the task, study of the activity and description of the jobs indicated for DP. Each job involves a set of tasks that can be subdivided into stages or subtasks” (Simonelli & Camarotto, 2008, p. 153). In the realm of occupational therapy this research will use “a set of methods and techniques based on the ergonomic work analysis and on occupational therapy, we sought to build a model to indicate the skills required to perform industrial tasks” (Simonelli & Camarotto, 2008, p. 150). “The model was applied at 19 workstations at a Brazilian aircraft manufacture in 2002” (Simonelli & Camarotto, 2008, p. 150). Occupational therapy patients wanting to get back in the workforce could possibly perform this model (Simonelli & Camarotto, 2008). “The model would then serve as a guide in the company’s policy for hiring DP” (Simonelli & Camarotto, 2008, p. 153). By Brazil conducting this research and developing this model, occupational therapists can try to get their patients back to work across the world. In addition, if the model shows independence for their particular patient they can show their evidence to the employer.
Based on additional research found children are another focus of Brazilian exploration. For example, the article “The implications of Winnicott’s theory of play for the work of occupational therapy’s observation with children with physical disabilities” demonstrates that “play is an activity that reveals personal aspects of the person engaging in it; and play experiences embody aspects of the subject’s internal reality, according to D. W. Winnicott’s theory” (Takatori & Bemtempo, 2007, p. 47). This study brings the idea of evaluating the disabled child in their home. There were three children that participated in the study. All three of the children had a physical disability. The goal of this study was to show how important it is to observe a child. This study demonstrates that if an occupational therapist can observe and see how a child plays, they can in turn make progress with the disabled child. One article conveyed that “it is the concept of play that we use to understand the person with disabilities, his/her activities and his/her social participation” (Takatori & Bemtempo, 2007, p.50). With this being said play observation can be put into practice in unique therapy sessions.
The focus of occupational therapy in Brazil appears to be on disabilities based on the research found. However, this does not mean it is the most popular, most important, or most well-known. Brazil is in the process of making their research more assessable to people of other countries (Barreto & Barata, 2008). In addition:
Brazil is the only Portuguese-speaking country that has a network of scientific journals in public health/epidemiology. As to the languages papers published, these journals usually publish in Portuguese, English, or Spanish, although most of the papers are published in Portuguese” (Barreto & Barata, 2008).
This is a mature step in the right direction for Brazil. Putting their research out there for other countries to use is not only good for occupational therapy, but for all other health care fields. Moving the body of research forward in Brazil will only enhance knowledge of their country and other countries.
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