| Name: | Description: | Size: | Format: | |
|---|---|---|---|---|
| 1.52 MB | Adobe PDF |
Advisor(s)
Abstract(s)
Introdução: A Insuficiência Cardíaca (IC) representa um problema grave de saúde pública
que afeta globalmente mais de 20 milhões de pessoas (Jaarsma et al., 2009). A prevalência
da IC tem vindo a aumentar nos últimos anos, sendo particularmente sentida na população
mais idosa. Esta tendência parece que se irá manter no futuro devido ao aumento da
esperança média de vida e dos fatores de risco para esta doença. Portugal não escapa a esta
realidade, apresentando valores semelhantes aos vividos no resto do mundo.
Estudos têm demonstrado que o internamento da pessoa com IC geralmente está associado
a práticas insuficientes de autocuidado, que decorrem de uma gestão ineficaz do regime
terapêutico (Jaarsma et al., 2003; Britz & Dunn, 2009); e que conduzem a desequilíbrios na
condição de saúde que estão na origem dos episódios de recursos ao serviço de urgência e
internamentos (Britz e Dunn, 2009). Estes contribuem para um elevado consumo de recursos
hospitalares, e aumento da despesa na saúde. Desta forma, é fundamental o desenvolvimento
de competências de autocuidado nas pessoas com IC para o controlo, tratamento da doença,
e para a gestão eficaz do regime terapêutico.
Objetivos: Determinar a prevalência da adesão à terapêutica farmacológica e do autocuidado
na pessoa com IC, e relacioná-las com diversas variáveis, tais como: sociodemográficas,
clínicas, farmacológicas, apoio familiar, estilos de vida e crenças acerca da medicação.
Métodos: Estudo de natureza quantitativa, descritiva correlacional, analítico e transversal,
realizado com 103 doentes com IC, acompanhados em consulta médica de seguimento num
hospital da zona centro do país. A recolha de dados foi efetuada através de um questionário
a que integrava dados sociodemográficos e clínicos, bem como as seguintes escalas: Apgar
Familiar, Escala Europeia de Autocuidado na IC, Crenças acerca dos Fármacos e Medida de
Adesão aos Tratamentos.
Resultados: Numa amostra de 103 participantes observou-se uma média de idade de 71,48
± 11,38 anos, 61,2% (n= 63) eram do género masculino, 70,9% (n=73) viviam “com
companheiro”, 89,3% tinham escolaridade “até ao “4º ano”, 63,1% (n= 63) residiam em “área
rural”, 88,3% (n= 91) eram profissionalmente “inativos”, 70,9% (n= 73) auferiam um
rendimento inferior a um “ordenado mínimo” e 68,0% (n= 70) referiram “não ter condições
económicas para cumprir medicação e consultas”.
A prevalência da adesão farmacológica foi superior à adesão do “autocuidado adequado”
(54,4% vs 43,7%).
As pessoas com IC que aderiram à medicação foram aquelas tinham uma família “altamente
funcional”, por outro lado as que, possuíam uma família “altamente funcional”, tiveram 4 ou
mais fatores de risco e com estilos de vida saudáveis apresentaram um adequado
autocuidado.
Conclusão: Os resultados deste trabalho corroboram com a investigação nacional e
internacional, confirmando a baixa prevalência na adesão ao tratamento farmacológico e ao
autocuidado adequado da pessoa com IC.
Os resultados são consistentes com a investigação nacional e internacional, confirmando a
baixa prevalência na adesão ao regime terapêutico. Alguns fatores clínicos, estilos de vida e
sociofamiliares revelaram-se preditores da adesão. Todavia, não se confirmou a relação entre
as variáveis sociodemográficas, clínicas e crenças e a adesão ao regime terapêutico da
pessoa com IC.
Palavras-chave: Adesão, Autocuidado, Determinantes de Adesão, Insuficiência Cardíaca.
Abstract Introduction: Currently, heart failure (HF) represents a serious public health problem that affects globally more than 20 million people (Jaarsma et al., 2009). The prevalence of HF has been increasing in recent years and is particularly felt in the older population. This trend seems to be maintained in the future due to the increase in the average life expectancy and the risk factors for this disease. Portugal does not escape this reality, presenting values similar to those experienced in the rest of the world. Studies have shown that hospitalization of the person with HF is usually associated with insufficient self-care practices, which result from ineffective management of the therapeutic regimen (Jaarsma et al., 2003; Britz & Dunn, 2009); And leading to imbalances in the health condition that are at the origin of the episodes of emergency and hospitalization resources (Britz and Dunn, 2009). These contribute to a high consumption of hospital resources, and an increase in health expenditure. Thus, the development of self-care skills in people with HF is essential for the control, treatment of the disease, and for the effective management of the therapeutic regimen. Objectives: To determine the prevalence of adherence to pharmacological therapy and selfcare in people with HF, trying to relate them to several variables, such as sociodemographic, clinical, pharmacological, family support, lifestyles and beliefs about medication. Methods: A quantitative, descriptive, correlational and cross-sectional study was carried out with 103 patients with HF, followed up at a follow-up medical visit at a hospital in the central region. Data collection was done through a questionnaire that included socio-demographic and clinical data, as well as the following scales: Family Apgar, European Self-Care Scale in HF, Drug Beliefs and Treatment Adherence Measure. Results: A mean age of 71.48 ± 11.38 years was observed in a sample of 103 participants, 61.2% (n = 63) were males, 70.9% (n = 73) lived “with a partner”, 89,3% had studied “until the 4th grade”, 63,1% (n= 63) lived in "rural areas", 88.3% (n = 91) were professionally "inactive", 70, 9% (n = 73) had an income lower than a "minimum wage" and 68.0% (n = 70) reported "not having the economic conditions to comply with medication and consultations". The prevalence of pharmacological adherence was higher than adherence to "adequate selfcare" (54.4% vs 43.7%). People with HF who adhered to the medication were those who had a "highly functional" family, however, they had 4 or more risk factors and healthy lifestyles showed adequate self-care. Conclusion: The results of this study corroborate national and international research, confirming the low prevalence of adherence to pharmacological treatment and adequate selfcare of the person with HF. The results are consistent with national and international research, confirming the low prevalence of adherence to the therapeutic regimen. Some clinical, lifestyle and socio-familiar factors were predictors of adherence. However, the relationship between sociodemographic, clinical and belief variables and adherence to the therapeutic regimen of the person with HF was not confirmed. Key words: Adherence, Self-care, Determinants of adherence, Heart Failure.
Abstract Introduction: Currently, heart failure (HF) represents a serious public health problem that affects globally more than 20 million people (Jaarsma et al., 2009). The prevalence of HF has been increasing in recent years and is particularly felt in the older population. This trend seems to be maintained in the future due to the increase in the average life expectancy and the risk factors for this disease. Portugal does not escape this reality, presenting values similar to those experienced in the rest of the world. Studies have shown that hospitalization of the person with HF is usually associated with insufficient self-care practices, which result from ineffective management of the therapeutic regimen (Jaarsma et al., 2003; Britz & Dunn, 2009); And leading to imbalances in the health condition that are at the origin of the episodes of emergency and hospitalization resources (Britz and Dunn, 2009). These contribute to a high consumption of hospital resources, and an increase in health expenditure. Thus, the development of self-care skills in people with HF is essential for the control, treatment of the disease, and for the effective management of the therapeutic regimen. Objectives: To determine the prevalence of adherence to pharmacological therapy and selfcare in people with HF, trying to relate them to several variables, such as sociodemographic, clinical, pharmacological, family support, lifestyles and beliefs about medication. Methods: A quantitative, descriptive, correlational and cross-sectional study was carried out with 103 patients with HF, followed up at a follow-up medical visit at a hospital in the central region. Data collection was done through a questionnaire that included socio-demographic and clinical data, as well as the following scales: Family Apgar, European Self-Care Scale in HF, Drug Beliefs and Treatment Adherence Measure. Results: A mean age of 71.48 ± 11.38 years was observed in a sample of 103 participants, 61.2% (n = 63) were males, 70.9% (n = 73) lived “with a partner”, 89,3% had studied “until the 4th grade”, 63,1% (n= 63) lived in "rural areas", 88.3% (n = 91) were professionally "inactive", 70, 9% (n = 73) had an income lower than a "minimum wage" and 68.0% (n = 70) reported "not having the economic conditions to comply with medication and consultations". The prevalence of pharmacological adherence was higher than adherence to "adequate selfcare" (54.4% vs 43.7%). People with HF who adhered to the medication were those who had a "highly functional" family, however, they had 4 or more risk factors and healthy lifestyles showed adequate self-care. Conclusion: The results of this study corroborate national and international research, confirming the low prevalence of adherence to pharmacological treatment and adequate selfcare of the person with HF. The results are consistent with national and international research, confirming the low prevalence of adherence to the therapeutic regimen. Some clinical, lifestyle and socio-familiar factors were predictors of adherence. However, the relationship between sociodemographic, clinical and belief variables and adherence to the therapeutic regimen of the person with HF was not confirmed. Key words: Adherence, Self-care, Determinants of adherence, Heart Failure.
Description
Keywords
Adesão à medicação Auto-cuidado Cooperação do doente Insuficiência cardíaca Qualidade de vida Heart failure Medication adherence Patient compliance Quality of life Self care