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    Adaptation of the Barriers to Access to Care Evaluation (BACE) scale to the Brazilian social and cultural context
    (Associação de Psiquiatria do Rio Grande do Sul, 2013-12-01) Silva, Leticia [UNIFESP]; Silva, Paula Freitas Ramalho da [UNIFESP]; Gadelha, Ary [UNIFESP]; Clement, Sarah; Thornicroft, Graham; Mari, Jair de Jesus [UNIFESP]; Brietzke, Elisa [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); King's College Institute of Psychiatry Health Services and Population Research Department
    INTRODUCTION:A significant gap between the number of individuals who need mental health care and the ones who actually have access to it has been consistently demonstrated in studies conducted in different countries. Recognizing the barriers to care and their contributions to delaying or preventing access to mental health services is a key step to improve the management of mental health care. The Barriers to Access to Care Evaluation (BACE) scale is a 30-item self-report instrument conceived to evaluate obstacles to proper mental health care. The main constraint in the investigation of these barriers in Brazil is the lack of a reliable instrument to be used in the Brazilian social and cultural context.OBJECTIVE:To describe the translation and adaptation process of the BACE scale to the Brazilian social and cultural context.METHOD:The translation and adaptation process comprised the following steps: 1) translation from English to Brazilian Portuguese by two authors who are Brazilian Portuguese native speakers, one of whom is a psychiatrist; 2) evaluation, comparison and matching of the two preliminary versions by an expert committee; 3) back-translation to English by a sworn translator who is an English native speaker; 4) correction of the back-translated version by the authors of the original scale; 5) modifications and final adjustment of the Brazilian Portuguese version.RESULTS AND CONCLUSION:The processes of translation and adaptation described in this study were performed by the authors and resulted in the Brazilian version of a scale to evaluate barriers to access to mental health care.
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    Perspectives of intellectual disability in Latin American countries: epidemiology, policy, and services for children and adults
    (Lippincott Williams & Wilkins, 2009-09-01) Mercadante, Marcos T. [UNIFESP]; Evans-Lacko, Sara; Paula, Cristiane S.; Universidade Federal de São Paulo (UNIFESP); Kings Coll London; Univ Prebiteriana Mackenzie
    Purpose of reviewThe prevalence of intellectual disability is an estimated 1-4% worldwide. Etiological factors such as malnutrition, lack of perinatal care, and exposure to toxic and infectious agents, which are more common in low-income and middle-income (LAMI) countries, may contribute to a higher prevalence of intellectual disability in Latin America. This review summarizes the data on intellectual disability coming from Latin America, which is published in scientific journals and is available from official websites and discusses potential health policy and services implications of these studies.Recent findingsMethodologically rigorous studies on intellectual disability in Latin America are lacking. This paucity of basic epidemiological information is a barrier to policy and services development and evaluation around intellectual disability. Only two studies, one from Chile and another from Jamaica, allow for adequate population estimates of intellectual disability. Interestingly, the countries with the highest scientific production in Latin America, Brazil and Mexico, did not produce the most informative research in epidemiology, policy or services related to intellectual disability.SummaryThe main conclusion of this review is that a lack of scientific evidence makes it difficult to properly characterize the context of intellectual disability in Latin America. Insufficient data is also a barrier to policy and services development for governments in Latin America. Although recently there have been efforts to develop government programs to meet the needs of the intellectual disability population in Latin America, the effectiveness of these programs is questionable without proper evaluation. There is a need for studies that characterize the needs of people with intellectual disability specifically in Latin America, and future research in this area should emphasize how it can inform current and future policies and services for people with intellectual disability.