Assessment of functioning and disability of postpartum women: a study based on the International Classification of Functioning, Disability and Health

ABSTRACT 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. RESUMEN El periodo de puerperio empieza tras el alumbramiento de la placenta, provocando modificaciones locales y sistemáticas en el cuerpo de la mujer. Esta transición se asocia con la funcionalidad de la mujer. La Clasificación Internacional de la Funcionalidad, la Discapacidad y la Salud (CIF) proporciona la base para la aplicación del modelo biopsicosocial. El estudio investigó la funcionalidad y la discapacidad en puérperas durante el periodo puerperal inmediato, tardío y remoto. Se trata de un estudio transversal observacional de carácter cuantitativo. Se aplicó una ficha de anamnesis con datos sociodemográficos, antropométricos y obstétricos con preguntas relacionadas con la CIF. Para investigar la discapacidad, se aplicó el WHODAS