Assessment of functioning and disability of postpartum women: a study based on the International Classification of Functioning, Disability and Health
DOI:
https://doi.org/10.1590/Keywords:
International Classification of Functioning, Disability and Health, Postpartum Period; Women’s Health, PhysiotherapyAbstract
The puerperium begins soon after placental
expulsion, with local and systemic changes in the woman’s
body. This transition is associated with the woman’s
functioning. The International Classification of Functioning,
Disability and Health (ICF) underlie the application of
the biopsychosocial model. This study investigated the
functioning and disability of postpartum women in the
immediate, late, and remote puerperal subperiods. This
is a cross-sectional, observational, quantitative study.
An anamnesis form was applied with sociodemographic,
anthropometric and obstetric data and with questions related
to the ICF. The self-administered 36-item WHODAS 2.0 was applied to investigate disability. Qualitative variables were described
by frequency and percentage distribution and quantitative variables
with descriptive statistics. For group comparison, Kruskal-Wallis
and Dunn’s post hoc tests were applied with 5% significance.
A total of 82 postpartum women participated in the study.
We obtained 32 ICF categories, with structure and function being
the most frequent. In WHODAS 2.0, for total sample and for each
puerperal subperiod, the (D5) domain – Activities of Life – was
more compromised. When comparing domains with puerperal
subperiods, immediate puerperium showed less disability, differing
from remote puerperium and late puerperium for cognition 10.42
(p=0.0365) and participation 18.75 (p=0.0197). The (D2) domain –
Mobility – showed a difference between late puerperium and remote
puerperium, with remote puerperium having less disability 17.50
(p=0.0212). Based on the diversity of filled-in items in the ICF,
it is concluded that functioning can be affected in the puerperium,
and disability may be presented at all times
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References
Cabral FB, Oliveira DLLC. Vulnerabilidade de puérperas na visão
de Equipes de Saúde da Família: ênfase em aspectos geracionais
e adolescência. Rev Esc Enferm USP. 2010;44(2):368-75.
doi: 10.1590/S0080-62342010000200018
Andrade RD, Santos JS, Maia MAC, Mello DF. Fatores
relacionados à saúde da mulher no puerpério e repercussões
na saúde da criança. Esc Anna Nery. 2015;19(1):181-6.
doi: 10.5935/1414-8145.20150025
Holanda CSM, Alchieri JC, Morais FRR, Maranhão TMO.
Estratégias de desenvolvimento, acompanhamento e avaliação
do atendimento da gestante no ciclo gravídico-puerperal. Rev
Panam Salud Publica. 2015;37(6):388-94.
CIF: classificação internacional de funcionalidade, incapacidade
e saúde. São Paulo: Edusp; 2003.
McIntyre A, Tempest S. Two steps forward, one step back?
A commentary on the disease-specific core sets of the International
Classification of Functioning, Disability and Health (ICF). Disabil
Rehabil. 2007;29(18):1475-9. doi: 10.1080/09638280601129181
Leite CF, Castro SS. 50 Casos Clínicos em Fisioterapia. Salvador:
Sanar; 2017.
Biz MCP, Chun RYS. Operacionalização da Classificação
Internacional de Funcionalidade, Incapacidade e Saúde,
CIF, em um Centro Especializado em Reabilitação. CoDAS.
;32(2):e20190046. doi: 10.1590/2317-1782/20192019046
Organização Mundial da Saúde. Como usar a CIF: Um manual
prático para o uso da Classificação Internacional de
Funcionalidade, Incapacidade e Saúde (CIF). Versão preliminar
para discussão. Genebra: OMS; 2013.
Senturk V, Hanlon C, Medhin G, Dewey M, Araya M, et al. Impact
of perinatal somatic and common mental disorder symptoms
on functioning in Ethiopian women: The P-MaMiE populationbased
cohort study. J Affect Disord. 2012;136(3):340-9.
doi: 10.1016/j.jad.2011.11.028
Silveira C, Parpinelli MA, Pacagnella RC, Camargo RSD, Costa
ML, et al. Adaptação transcultural da Escala de Avaliação
de Incapacidades da Organização Mundial de Saúde
(WHODAS 2.0) para o Português. Rev Assoc Med Bras.
;59(3):234-40. doi: 10.1016/j.ramb.2012.11.005
Agranonik M, Hirakata VN. Cálculo de tamanho de amostra:
proporções. Rev HCPA. 2011;31(3):382-8.
World Health Organization. Measuring Health and
Disability: Manual for WHO Disability Assessment Schedule
(WHODAS 2.0). Malta: WHO; 2015.
Organização Mundial da Saúde. Modelo de escore do
questionário WHODAS com 36 itens. [201-] [cited 2024 10 09].
Available from: https://cdn.who.int/media/docs/default-source/
classification/icf/whodas/36item-scoring-template-complexscoring.
xlsx?sfvrsn=de1228b3_2
Silveira C, Parpinelli MA, Pacagnella RC, Andreucci CB, Ferreira
EC, et al. A cohort study of functioning and disability among
women after severe maternal morbidity. Int J Gynecol Obstet.
;134(1):87-92. doi: 10.1016/j.ijgo.2015.10.027
Alves AB, Pereira TRC, Aveiro MC, Cockell FF.
Functioning and support networks during postpartum.
Rev Bras Saude Mater Infant. 2022;22(3):667-73.
doi: 10.1590/1806-9304202200030013
Bulhões ERFN, Dantas THDM, Dantas JH, Souza IND,
Castaneda L, et al. Functioning of women in the postpartum
period: an International Classification of Functioning, Disability
and Health-based consensus of physical therapists. Braz J
Phys Ther. 2021;25(4):450-9. doi: 10.1016/j.bjpt.2020.12.003
Van Der Woude DAA, Pijnenborg JMA, De Vries J. Health
status and quality of life in postpartum women: a systematic
review of associated factors. Eur J Obstet Gynecol Reprod Biol.
;185:45-52. doi: 10.1016/j.ejogrb.2014.11.041
Godoy MB, Gomes FA, Stefanello J, Monteiro JCS, Nakano AMS.
Work situation of women in the gravidic-puerperal cycle. Invest
Educ Enferm. 2011;29(1):47-53. doi: 10.17533/udea.iee.8518
Carrizo E, Domini J, Quezada RYJ, Serra SV, Soria EA,
et al. Variaciones del estado cognitivo en el puerperio y sus
determinantes: una revisión narrativa. Cien Saude Colet.
;25(8):3321-34. doi: 10.1590/1413-81232020258.26232018
Henry JF, Sherwin BB. Hormones and cognitive functioning
during late pregnancy and postpartum: A longitudinal study.
Behav Neurosci. 2012;126(1):73-85. doi: 10.1037/a0025540
Glynn LM. Giving birth to a new brain: hormone exposures
of pregnancy influence human memory. Psyneuen.
;35(8):1148-55. doi: 10.1016/j.psyneuen.2010.01.015
Kim P, Dufford AJ, Tribble RC. Cortical thickness variation
of the maternal brain in the first 6 months postpartum:
associations with parental self-efficacy. Brain Struct Funct.
;223(7):3267-77. doi: 10.1007/s00429-018-1688-z
Finlayson K, Crossland N, Bonet M, Downe S. What matters
to women in the postnatal period: A meta-synthesis
of qualitative studies. PLoS ONE. 2020;15(4):e0231415.
doi: 10.1371/journal.pone.0231415
Burti JS, Cruz JDPDS, Silva ACD, Moreira IDL. Assistência ao
puerpério imediato: o papel da fisioterapia. Rev Fac Cienc Med
Sorocaba. 2016;18(4):193-8. doi: 10.5327/Z1984-4840201625440
Al Rehaili BO, Al-Raddadi R, ALEnezi NK, ALYami AH.
Postpartum quality of life and associated factors: a crosssectional
study. Qual Life Res. 2023;32(7):2099-106. doi: 10.1007/
s11136-023-03384-3
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