Physiotherapy access for children and adolescents with physical disabilities in public institutions

Abstract This study aims to identify the factors that hinder physically disabled children and adolescent’s access to physiotherapy in establishments accredited by the Unified Health System in Curitiba, Paraná, Brazil. This is a cross-sectional study that interviewed managers, physiotherapists, parents or guardians of children with physical disabilities. The perception of difficulties of each interviewed group was compared through descriptive statistics, considering the following realms: availability, purchasing power, information and acceptability. Considering the realm of availability, we identified the following hindrances: distance between the physiotherapy location and user’s residence, inadequate supply of services and waiting list. Regarding the purchasing power, we observed the lack of financial resources among parents. Regarding information and acceptability, the lack of information about diagnosis and denial were reported by participants. We can conclude that the physiotherapy service has not been timely assured to children’s motor development, so it is necessary to review the organization and distribution of services, and effective policies are required to ensure their use.

摘要 本研究旨在探明巴西巴拉那州库里蒂巴市经统一卫生系统（Unified Health System）认证的康复机构中，阻碍肢体残疾儿童与青少年获取物理治疗（physiotherapy）服务的相关因素。本研究为横断面研究（cross-sectional study），对管理人员、物理治疗师以及肢体残疾儿童的父母或监护人进行了访谈。本研究采用描述性统计（descriptive statistics）对比不同受访群体对所面临困难的认知，分析维度涵盖可及性、支付能力、信息获取与可接受性四个方面。在可及性维度下，我们识别出以下障碍：物理治疗机构与服务使用者住所距离过远、服务供给不足以及候诊排队问题。在支付能力维度下，我们观察到患儿父母普遍缺乏经济资源。在信息获取与可接受性维度下，受访对象报告存在两大问题：诊断相关信息匮乏以及服务被拒的情况。本研究结论表明，当前物理治疗服务未能为儿童的运动发育提供及时保障，因此有必要重新审视服务的组织架构与分布布局，同时需制定有效政策以保障该服务的合理使用。