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Authors
Advisor(s)
Abstract(s)
Enquadramento: A Artrite Reumatoide (AR) é uma doença autoimune, crónica e progressiva, que origina incapacidade grave e morte prematura, e exige um acompanhamento ao longo da vida. A prevalência em Portugal é de 0.7%. Tradicionalmente, os utentes com AR são monitorizados em consultas médicas a cada 3-12 meses; no entanto, vários estudos recentes têm demonstrado que este trabalho pode efetivamente ser realizado por enfermeiros.
Objetivo: Determinar a eficácia da consulta de Enfermagem no controlo da atividade da doença, capacidade funcional, fadiga, qualidade de vida, dor, auto-eficácia e satisfação dos doentes com AR, em conjugação ou comparação com as consultas realizadas pelo reumatologista.
Metodologia: Realizada uma revisão sistemática da literatura, seguindo os princípios propostos pelo Cochrane Handbook. Realizada pesquisa em Inglês na Pubmed, EBSCO e Embase, de estudos publicados entre janeiro de 2005 e dezembro de 2015, com updates mensais até 31 de agosto de 2016. Incluíram-se estudos experimentais, que comparassem a eficácia da realização da consulta de follow-up realizada por enfermeiros com a que é realizada pelos reumatologistas, em adultos portadores de AR com baixa atividade da doença ou em remissão. Dois investigadores isoladamente realizaram a análise crítica, extração e síntese de dados.
Resultados: Seis randomized controlled trials e um estudo de coorte foram incluídos no corpus do estudo. A análise dos estudos revela que existem diferenças significativas, revelando benefícios numa monitorização realizada por enfermeiros, a doentes com AR com doença estabilizada, na atividade da doença, capacidade funcional, qualidade de vida, dor, auto-eficácia e na satisfação global com os cuidados.
Conclusão: Os cuidados realizados pelos enfermeiros são efetuados com segurança e eficácia comparativamente ao previsto pelos reumatologistas, mostrando ainda benefícios clínicos no que respeita à atividade da doença, capacidade funcional, qualidade de vida, dor, auto-eficácia e satisfação global com os cuidados. Recomenda-se a implementação de consultas de Enfermagem como parte dos cuidados de acompanhamento ao doente com AR estabilizada.
PALAVRAS-CHAVE: Artrite Reumatoide, Cuidados de Enfermagem; Eficácia.
Abstract Background: Rheumatoid arthritis (RA) is a chronic, progressive, autoimmune disease that causes severe disability and premature death, and requires lifelong follow-up. In Portugal the prevalence is 0.7%. Traditionally RA patients are managed by planned medical consultations every 3–12 months; however several recent studies have been demonstrated that this work can be effectively performed by trained nurses. Objective: To determine the effectiveness of nurse led appointments in disease activity, physical function, fatigue, quality of life, pain, self-efficacy and satisfaction of patients with RA, in conjunction or comparison with rheumatologist appointments. Methods: A systematic review of literature was performed, following the principles proposed by the Cochrane Handbook. A research was conducted in English on PubMed, Embase and EBSCO from January 2005 to 30 December 2015, with monthly updated until 31 August 2016. It was included experimental studies comparing the effectiveness of the follow-up consultations performed by nurses with that performed by rheumatologists in adults with RA with low disease activity or in remission. Two reviewers independently performed a critical analysis, extraction and data synthesis. Results: Six randomized controlled trials and one cohort study met the inclusion criteria and were included in study corpus. Analysis of the studies show that there are significant differences, revealing benefits in a nurse-led care, in RA outpatients with low disease activity, in disease activity, physical function, quality of life, pain, self-efficacy and global satisfaction with care. Conclusion: Nurses’ care is performed with the same safety and efficacy when compared to predicted by rheumatologists, showing clinical benefits in terms of disease activity, physical function, quality of life, pain, self-efficacy and satisfaction with care. The implementation of nursing consultations is recommended as part of the follow-up care to the patient with low stabilized RA. Recomenda-se a implementação de consultas de Enfermagem como parte dos cuidados de acompanhamento ao doente com AR estabilizada. KEY WORDS: Rheumatoid Arthritis, Nurse led-care; Effectiveness.
Abstract Background: Rheumatoid arthritis (RA) is a chronic, progressive, autoimmune disease that causes severe disability and premature death, and requires lifelong follow-up. In Portugal the prevalence is 0.7%. Traditionally RA patients are managed by planned medical consultations every 3–12 months; however several recent studies have been demonstrated that this work can be effectively performed by trained nurses. Objective: To determine the effectiveness of nurse led appointments in disease activity, physical function, fatigue, quality of life, pain, self-efficacy and satisfaction of patients with RA, in conjunction or comparison with rheumatologist appointments. Methods: A systematic review of literature was performed, following the principles proposed by the Cochrane Handbook. A research was conducted in English on PubMed, Embase and EBSCO from January 2005 to 30 December 2015, with monthly updated until 31 August 2016. It was included experimental studies comparing the effectiveness of the follow-up consultations performed by nurses with that performed by rheumatologists in adults with RA with low disease activity or in remission. Two reviewers independently performed a critical analysis, extraction and data synthesis. Results: Six randomized controlled trials and one cohort study met the inclusion criteria and were included in study corpus. Analysis of the studies show that there are significant differences, revealing benefits in a nurse-led care, in RA outpatients with low disease activity, in disease activity, physical function, quality of life, pain, self-efficacy and global satisfaction with care. Conclusion: Nurses’ care is performed with the same safety and efficacy when compared to predicted by rheumatologists, showing clinical benefits in terms of disease activity, physical function, quality of life, pain, self-efficacy and satisfaction with care. The implementation of nursing consultations is recommended as part of the follow-up care to the patient with low stabilized RA. Recomenda-se a implementação de consultas de Enfermagem como parte dos cuidados de acompanhamento ao doente com AR estabilizada. KEY WORDS: Rheumatoid Arthritis, Nurse led-care; Effectiveness.
Description
Keywords
Artrite reumatóide Assistência ao convalescente Cuidados de enfermagem Revisão Aftercare Arthritis, rheumathoid Nursing care Review