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      Conocimiento de la Rehabilitación Basada en la Comunidad por parte de fonoaudiólogos de la región de Valparaíso, Chile Translated title: Knowledge of Community Based Rehabilitation by speech and language pathologist of Valparaíso, Chile

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          Abstract

          Resumen La Rehabilitación Basada en la Comunidad (RBC) representa un nuevo ámbito de trabajo para fonoaudiólogos(as) en Chile. En la región de Valparaíso co-existen organizaciones no gubernamentales (ONG) y otras instituciones donde la RBC constituye un marco de acción para el quehacer profesional. A la fecha y desde la fonoaudiología, no se ha descrito el manejo teórico-práctico de los profesionales que se desempeñan en este sector. El objetivo de esta investigación fue describir el conocimiento que poseen los fonoaudiólogos respecto a la estrategia RBC y cómo estos saberes se ajustan a su práctica profesional. Investigación convergente paralela a partir de un estudio observacional-descriptivo, de corte transversal, complementado con un diagnóstico participativo. Un 22% de los informantes comunica que las instituciones donde trabajan adscriben a la RBC, el 78% cuenta con contratos inferiores a 12 horas semanales y 83% considera que su jornada no le permite realizar acciones atingentes a la estrategia. Un 50% define de forma adecuada la RBC y el 88% acierta al identificar los pilares de la misma. Un 75% de los consultados refiere el ser agente de salud como eje central de su labor y un 25% comunica que sus responsabilidades han de centrarse en la ejecución de talleres comunitarios. Los profesionales observan a la comunidad como un otro al cual asisten sanitariamente y declaran la necesidad de transitar hacia un paradigma donde domine la promoción y la prevención. El conocimiento de la RBC por parte de fonoaudiólogos participantes del estudio, es aún intuitivo no existiendo coherencia entre los saberes teóricos y prácticos declarados. Es necesario fortalecer la formación a nivel de pre y posgrado, con objeto de alinear la práctica fonoaudiológica con las recomendaciones internacionales de la RBC.

          Translated abstract

          Abstract Community Based Rehabilitation (CBR) represents a new field of work for Speech and Language Pathologists (SLPs) in Chile. In the fifth region of Valparaíso-Chile, non-governmental organizations (NGOs) and other institutions coexist and the CBR represents a framework of action for professional work. To date and from SLP, the theoretical-practical management of professionals working in this field has not been described. The objective of this research was to describe the knowledge that SLPs have regarding the CBR strategy and how this knowledge fits their professional practice. Parallel convergent study based on a cross-sectional observational-descriptive study, complemented by a participatory diagnosis. Twenty-two percent of the informants reported that the institutions where they work are aligned with CBR, 78% have contracts of less than 12 hours per week and 83% consider that their workday does not allow them to carry out actions related to the strategy. Fifty percent adequately defines the CBR and 88% can identify the pillars of it. Seventy-five percent of those consulted refer to being a health agent as the central axis of their work and 25% report that their responsibilities should focus on the execution of community workshops. The professionals observe the community as “another” to which they healthily assist and declare the need to move towards a paradigm where promotion and prevention dominate. The knowledge of the CBR by SLPs is still intuitive and there is no coherence between the theoretical and practical knowledge declared. It is necessary to strengthen pre and postgraduate training, in order to align the SLPs practice with the international guidelines of the CBR.

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            Análisis del Rol del Fonoaudiólogo(a) en el Sector Salud en Chile

            RESUMEN En Chile, los fonoaudiólogos2 han estado incorporados laboralmente en instituciones de salud, desde la apertura de la carrera a nivel nacional; sin embargo, el rol que el profesional cumple en dicho sector no está declarado, lo que ha dificultado su vinculación labo ral en el sector público, particularmente en atención primaria. Objetivos: Conocer la percepción de los fonoaudiólogos sobre las habilidades y tareas profesionales demandadas en el sector salud dentro del contexto nacional, y a partir de esta, generar una pro puesta del rol profesional en dicho ámbito laboral. Método: Diseño no experimental, tipo analítico, descriptivo y transversal. Se aplicó el protocolo "Autorreflexión del desempeño profesional en Salud" a 19 fonoaudiólogos, que cumplían con los criterios de inclusión. Resultados: Las responsabilidades profesionales más demandadas son: evaluación, intervención, derivación y colaboración; habilida des interpersonales, supervisión, gestión, e identificación, cobran menor importancia; acciones de prevención evidencian poca reali zación. Conclusiones: conocer el rol del fonoaudiólogo que trabaja en salud en Chile permite configurar su actuar, generando una gama de funciones, habilidades, responsabilidades y técnicas a dominar, que retroalimentan la formación profesional y orientan en la creación de políticas públicas, facilitando la transición del fonoaudiólogo a otros ámbitos dentro del propio sector salud, como la atención primaria.
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              A systematic review of the effectiveness of alternative cadres in community based rehabilitation

              Background The Millennium Development Goals (MDGs) aim to improve population health and the quality and dignity of people’s lives, but their achievement is constrained by the crisis in human resources for health. An important potential contribution towards achieving the MDGs for persons with disabilities will be the newly developed Guidelines for Community Based Rehabilitation (CBR), launched in 2010. Given the global shortage of medical and nursing personnel and highly skilled rehabilitation practitioners, effective implementation of the CBR guidelines will require additional health workers, with improved distribution and a new skill set, allowing them to work across the health, education, livelihoods, social, and development sectors. Methods We conducted a systematic review to evaluate existing evidence regarding the effectiveness of alternative cadres working in CBR in low and middle income countries. We searched the following databases: PUBMED, LILACS, SCIE, ISMEAR, WHOLIS, AFRICAN MED IND. We also searched the online archive of the Asia Pacific Disability Rehabilitation Journal (available from 2002 to 2010), which was not covered by any of the other databases. There was no limit set on inclusion with regard to how recent a publication was in the general search. Results The search yielded 235 abstracts, only 6 of which addressed CBR through some type of evaluative component. Three of the studies explored the effects of CBR interventions, mainly related to physical disabilities, while three explored issues concerned with the work performance of rehabilitation workers. Altogether the studies covered four different countries. Conclusion All six studies related to specific service delivery in local contexts, using outcome measures that were not comparable across studies. We do not, therefore, feel that the current results provide adequate methodology or evidence for reliably generalizing their results. Due to the dearth of evidence regarding the effectiveness of alternative cadres in CBR, systematic research is needed on the training, performance and impacts of rehabilitation workers, including their capability of working across sectors and engaging with and making use of health systems research.
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                Author and article information

                Journal
                cuhsotem
                CUHSO (Temuco)
                CUHSO (Temuco)
                Universidad Católica de Temuco. Facultad de Ciencias Sociales y Humanidades. (Temuco, , Chile )
                2452-610X
                December 2020
                : 30
                : 2
                : 189-202
                Affiliations
                [3] Santiago de Chile orgnameUniversidad de Chile orgdiv1Departamento de Tecnología Médica Chile rodperez@ 123456ug.uchile.cl
                [2] Viña del Mar Santiago de Chile orgnameUniversidad Santo Tomás orgdiv1Facultad de Salud orgdiv2Escuela de Fonoaudiología Chile mdelcampo2@ 123456santotomas.cl
                [1] Viña del Mar Santiago de Chile orgnameUniversidad Santo Tomás orgdiv1Facultad de Salud orgdiv2Escuela de Fonoaudiología Chile asilvar@ 123456santotomas.cl
                Article
                S2452-610X2020000200189 S2452-610X(20)03000200189
                10.7770/2452-610x.2020.cuhso.03.a06
                5ff0b72a-fe34-45af-a2bd-6fb223a8224e

                This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

                History
                : 16 March 2020
                : 10 May 2019
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 28, Pages: 14
                Product

                SciELO Chile

                Categories
                Artículos de Investigación

                rehabilitación basada en la comunidad,public health,Speech and language pathology,community based rehabilitation,salud pública,rehabilitation,Fonoaudiología

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