Access to speech-language pathology therapy and continuity of assistance in Primary Health Care for victims of motorcycle accidents

Silva, Maria Gabriella Pacheco da; Silva, Vanessa de Lima; Nascimento, Cynthia Maria Barboza do; Vilela, Mirella Bezerra Rodrigues; Lima, Maria Luiza Lopes Timóteo de

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Original Article • CoDAS 32 (1) • 2020 • https://doi.org/10.1590/2317-1782/20192017097 copy

Access to speech-language pathology therapy and continuity of assistance in Primary Health Care for victims of motorcycle accidents

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Purpose

To verify the access to speech-language pathology (SLP) therapy and continuity of assistance in Primary Health Care (PHC) for victims of motorcycle accidents.

Methods

A quantitative and qualitative study was conducted at a large hospital in the city of Recife, Pernanbuco state, Brazil. Among the 99 victims recruited between June and July 2014, 30 had SLP complaints as a result of the accidents. After hospital discharge, all victims were contacted for investigation of the SLP rehabilitation process. Absolute and relative frequencies were used for the analysis in PHC, and data were displayed in tables for the therapy cases.

Results

Among the 30 individuals who reported having alterations of the stomatognathic system, eight were undergoing rehabilitation and 18 reported residing in an area covered by the Family Health Strategy (primary care modality). Seeking and obtaining continuity of treatment (medication and bandaging) in primary care were frequent; in contrast, home visits were less frequent. The main obstacles to access SLP therapy were distance to the service and waiting time to begin treatment.

Conclusion

This study identified obstacles that hamper access to SLP therapy in PHC, such as the low frequency of home visits, contributing to the fragmentation of continuous and complete care for victims.

Keywords
Speech, Language and Hearing Sciences; Primary Health Care; Rehabilitation; Accidents; Motorcycles

Case	Age	Sex	Municipality of residence	Injuries resulting from motorcycle accident	Hospital stay (days)	Registered with FHU
1	54	Male	Jurema-PE	Severe head trauma; multiple facial fractures; lower limb fracture	84	Yes
2	32	Male	Saloá-PE	Severe head trauma; multiple facial fractures; upper limb fracture	200	Yes
3	25	Male	Recife-PE	Mild head trauma; facial fracture	47	Yes
4	21	Male	Olinda-PE	LeFort I and II facial trauma; tooth loss	21	No
5	34	Male	Belo Jardim	Mild head trauma; facial facture; extensive tongue laceration	33	Yes
6	21	Female	Goiana-PE	Severe head trauma; facial fracture; dental trauma	45	No
7	24	Male	Goiana-PE	LeFort I facial trauma; nasoorbitoethmoidal fracture; dental trauma.	4	Yes
8	23	Female	Recife-PE	Mild head trauma; complex fracture of middle third of face; amputation of lower limb	30	Yes

Case	Stomatognathic complaints	Waiting time to begin treatment	Speech-language rehabilitation service	Reported difficulty regarding access to speech therapy	Return to labor activities
1	Facial pain; Change in food consistency; Difficulty chewing and swallowing; Choking on liquids; Altered speech	2 weeks	Polyclinic of public healthcare system in municipality of residence	Distance to rehabilitation service	No
2	Diminished facial mobility; Change in food consistency;	2 weeks	FHSC team	Difficulty obtaining speech therapy	No
2	Difficulty chewing and swallowing; Choking on liquids; Altered speech.	2 weeks	FHSC team	Difficulty obtaining speech therapy	No
3	Limited jaw movements; Facial swelling; Change in occlusion and food consistency; Difficulty chewing; Change in food consistency; Difficulty chewing and swallowing; Choking on liquids; Altered speech.	3 months	Teaching clinic of institution of higher education	Not being orientated on where to seek speech therapy by public healthcare system	No
4	Facial pain; Limited jaw movements; Diminished facial mobility; Change in occlusion; Change in food consistency; Difficulty chewing and swallowing; Choking on liquids; Altered speech.	2 months	Private service in neighboring municipality	Not being orientated on where to seek speech therapy by public healthcare system	No
5	Facial pain; Limited jaw movements; Diminished facial mobility; Change in occlusion; Change in food consistency; Difficulty chewing; Altered speech.	1 month	Public rehabilitation service in other municipality	Distance and transportation to service	No
6	Facial pain; Limited jaw movements; Diminished facial mobility; Change in occlusion; Change in food consistency; Difficulty chewing and swallowing; Altered speech.	3 weeks	Private service in municipality of residence	Absence of public service in municipality of residence	No
7	Facial pain; Limited jaw movements;	40 days	Public rehabilitation service in other municipality	Distance to rehabilitation service	Yes
7	Change in occlusion; Change in food consistency; Difficulty chewing; Altered speech.	40 days	Public rehabilitation service in other municipality	Distance to rehabilitation service	Yes
8	Facial pain; Limited jaw movements; Change in occlusion; Change in food consistency; Difficulty chewing; Altered speech.	2 months	Public rehabilitation service	Waiting time	No

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E-mail: revista@codas.org.br

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[1] Conflict of interests: nothing to declare.