Desenvolvimento de um protótipo para apoio à decisão do fisioterapeuta no cuidado ao idoso

Abstract

As a result of the increase in life expectancy, population aging has been considered a major demographic phenomenon of the century. In Brazil, this process has been happening in an accelerated way and there is not enough time to reorganize the health service to supply this demand, becoming a challenge for public health system. In this context, the Health Information System (SIS), in the brazilian abbreviation, shall be seen as an important tool to follow the behavior of Chronic Non-communicable Diseases (NCD), responsible for compromising the functionality of the elderly, to implement effective prevention actions and institute an adequate surveillance system for the control of these diseases. Considering that the issue of ISIS in the area of physiotherapy is not yet widely discussed and researched, and the implementation of an information system allows that the decision-making are based on evidences and health actions are programmed in a more assertive way, the present thesis sought to develop a software prototype to support the clinical decision-making of the Physiotherapist in the elaboration of the elderly care plan, based on the use of artificial intelligence. For that, a methodological research of the applied type was carried out, developed in seven stages: the first was the construction of a software prototype, from the physiotherapeutic assessment form directed to the elderly; the second, an addition of other relevant data to the prototype; the third, the elaboration of a decision model, from the literature used to subsidize the study; fourth, the implementation of decision rules related to physiotherapeutic procedures; fifth, constitution of a database; sixth, evaluation and validation of physical therapy proposed by the prototype; seventh, development of the software prototype, called the Physiotherapy Information System, SISFISIO, in the Brazilian Portuguese abbreviation. For the evaluation and validation of physiotherapeutic conduct, it was necessary the participation of two specialists in the area of Physiotherapy in the health of the elderly; and for the development of the database and the prototype, the team of teachers and students of the Computer Science Course of the University Center in João Pessoa - Unipê. The study was initially developed in the Fábrica de Software, a software company, and followed in the Clinical School of Physiotherapy, both part of the referred educational institution. Students of the seventh period of the Physiotherapy Course took part of the study, as well as the teachers of the curricular component Physiotherapy in the health of the elderly and the elderly patients who are individually assisted by this component. Concerning to the data analysis, the Rules Based Model was used to construct the Decision Support Model and the R software to evaluate the descriptive measures, in order to validate the elaborated physiotherapeutic protocols by the system. Regarding the results, considering the common part in the physiotherapeutic protocols pointed by the specialists as the most representative measure to be compared with the protocol elaborated by the system, it was verified that these protocols presented normal distribution according to the Shapiro-Wilk test and, when compared by the t-paired test, it was noticed that there is no difference between the physiotherapeutic common protocols to both specialists and the physiotherapeutic protocol proposed by the system. Thus, despite the need for some adjustments and the limitations of the prototype constructed and presented in this research, it can be verified that this corresponds to an important methodological tool for the teaching and learning process and also for the health service, by providing a look and care, as well as assisting in the decision making.