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Advisor(s)
Abstract(s)
Enquadramento: A insuficiência cardíaca constitui um problema grave de saúde pública que
atinge um elevado número de indivíduos, apresentando taxas de morbilidade e mortalidade
elevadas, estando associada a 12,5% dos óbitos ocorridos em Portugal em 2014. A
reabilitação cardíaca integra um conjunto de intervenções que promovem a otimização da
capacidade física, a melhoria da capacidade funcional, e a diminuição da sintomatologia
relacionada com a Insuficiência Cardíaca, com consequente melhoria da qualidade de vida.
Objetivos: Avaliar a efetividade dos programas de reabilitação cardíaca (Fase II) nos
indivíduos com Insuficiência Cardíaca Classe Funcional II e III (segundo a classificação da
NYHA) e encontrar evidências para a prática clínica.
Metodologia: Efetuou-se uma revisão sistemática da literatura com base na metodologia
PICO, a partir da pesquisa nas bases de dados eletrónicas Pubmed, Cochrane Central Register
of Controlled Trials, CINAHL Complete, PEDro, SciELO e google académico de estudos
publicados entre janeiro de 2015 e dezembro de 2018. Foram selecionados quatro estudos
para o corpus do trabalho de acordo com os critérios de avaliação metodológica.
Resultados: Da análise dos estudos selecionados constatou-se que os programas de
reabilitação cardíaca baseados no exercício físico favorecem o controle dos fatores de risco
cardiovascular (diminuição da TA, IMC, perímetro abdominal e hábitos tabágicos) (p<0,01),
melhoram o nível de capacidade funcional e a qualidade de vida dos indivíduos com
Insuficiência Cardíaca e estão associados à diminuição do risco de hospitalização por
Insuficiência Cardíaca (p=0,0004). Existem ainda evidências, de que os programas de
reabilitação cardíaca independentemente da modalidade do programa de exercício físico têm
impacto positivo na melhoria da capacidade funcional e da qualidade de vida dos doentes com
insuficiência cardíaca.
Conclusão: As evidências científicas disponíveis demonstram que os programas de
reabilitação cardíaca constituem um regime terapêutico com impacto positivo, na reabilitação
dos doentes com Insuficiência cardíaca. Contudo, os programas de reabilitação cardíaca são
ainda subaproveitados em Portugal, sendo crucial a sua promoção e implementação, como
tratamento adjuvante nos doentes com Insuficiência Cardíaca, destacando-se a importância do
enfermeiro especialista em enfermagem de reabilitação integrado na equipa multidisciplinar
na capacitação do doente para realização de exercício físico e monitorização dos fatores de
risco.
Abstract Background: Heart failure is a serious public health problem, affecting a high number of individuals, with high mortality and morbidity rates, and associated with 12,5% of all deaths in Portugal in 2014. Cardiac rehabilitation integrates a set of interventions that promote the optimisation of physical capacity, the improvement of the functional capacity, and the improvement in symptomatology related to heart failure, with the consequent improvement of the quality of life. Objective: Assess the effectiveness of cardiac rehabilitation programs (Phase II) on patients with heart failure and New York Herat Association class II and III and, find evidences to the clinical practice. Methods: A systematic review was made based on methodology PICO, from researching studies from the electronic databases Pubmed, Cochrane Central Register of Controlled Trials, CINAHL Complete, PEDro, SciELO and academic google published between January 2015 and December 2018. Were selected four studies according to the methodological evaluation criteria. Results: The cardiac rehabilitation programs based on physical exercice promote the control of the cardiovascular risk factors (improvement of blood pressure, body mass index, waist circumference and smoking habits) (p<0,01), improve the level of functional capacity and the quality of life of patients with heart failure and are associted with the decrease of the risk of hospitalization due to heart failure ((p=0,0004). There are some evidence that the cardiac rehabilitation programs, irrespective of the method of phyisical exercise, have a positive effect on improving the functional capacity and the quality of life of patients with heart failure. Conclusion: The scientific findings available demonstrates that cardiac rehabilitation programs constitute a therapeutic regimen with a positive impact on the rehabilitation of patients with Heart Failure. However, the cardiac rehabilitation programs are still underused in Portugal, so, is crucial their promotion and implementation in the adjuvante treatment in patients with heart failure, includind the importance of the expert nurse on rehabilitation integrated into the multidisciplnary team on empowering the patient to carry out phyisical exercise and control the risk factors.
Abstract Background: Heart failure is a serious public health problem, affecting a high number of individuals, with high mortality and morbidity rates, and associated with 12,5% of all deaths in Portugal in 2014. Cardiac rehabilitation integrates a set of interventions that promote the optimisation of physical capacity, the improvement of the functional capacity, and the improvement in symptomatology related to heart failure, with the consequent improvement of the quality of life. Objective: Assess the effectiveness of cardiac rehabilitation programs (Phase II) on patients with heart failure and New York Herat Association class II and III and, find evidences to the clinical practice. Methods: A systematic review was made based on methodology PICO, from researching studies from the electronic databases Pubmed, Cochrane Central Register of Controlled Trials, CINAHL Complete, PEDro, SciELO and academic google published between January 2015 and December 2018. Were selected four studies according to the methodological evaluation criteria. Results: The cardiac rehabilitation programs based on physical exercice promote the control of the cardiovascular risk factors (improvement of blood pressure, body mass index, waist circumference and smoking habits) (p<0,01), improve the level of functional capacity and the quality of life of patients with heart failure and are associted with the decrease of the risk of hospitalization due to heart failure ((p=0,0004). There are some evidence that the cardiac rehabilitation programs, irrespective of the method of phyisical exercise, have a positive effect on improving the functional capacity and the quality of life of patients with heart failure. Conclusion: The scientific findings available demonstrates that cardiac rehabilitation programs constitute a therapeutic regimen with a positive impact on the rehabilitation of patients with Heart Failure. However, the cardiac rehabilitation programs are still underused in Portugal, so, is crucial their promotion and implementation in the adjuvante treatment in patients with heart failure, includind the importance of the expert nurse on rehabilitation integrated into the multidisciplnary team on empowering the patient to carry out phyisical exercise and control the risk factors.
Description
Keywords
Insuficiência cardíaca Reabilitação cardíaca Actividade física Enfermagem Eficiência Revisão Cardiac rehabilitation Efficiency Heart failure Review