An?lise da ades?o ao tratamento e da qualidade de vida de pessoas com ?lcera venosa

Made available in DSpace on 2014-12-17T14:47:07Z (GMT). No. of bitstreams: 1 SamillyMDL_DISSERT.pdf: 2432551 bytes, checksum: 39a06155ddac056ef776f3527c721cf7 (MD5) Previous issue date: 2014-08-01
The therapeutic adherence is still a big problem among people with venous ulcers (VU) because the treatment is long, expensive and demand changes in lifestyle. In this context, this study aims to examine treatment adherence and quality of life (QOL) of people with VU assisted at primary health care. This is an analytical, cross-sectional study with a quantitative approach to treatment and data analysis. The study had the scenario 13 Family Health Units and 02 Units Mixed of Natal. The target population consisted of 44 persons with UV indicated by the teams of the Family Health Strategy between February and April 2014. Three instruments were used: an instrument to characterize the sociodemographic, health and care aspects, the Multidimensional Scale of Adherence Therapy composed of the dimensions: healthy lifestyle, compressive therapy and neurovascular monitoring and the Charing Cross Venous Ulcer Questionnaire (CCVUQ) that evaluates QOL in persons with VU composed by the domains: Total Score, Social Interaction, Domestic Activities, Aesthetics and Emotional State. The study was approved by the Ethics Committee in Research of the Federal University of Rio Grande do Norte, CAAE: 07556312.0.0000.5537. The data concerning the sociodemographic characteristics showed that there was a predominance of females (65.9%), age range as of 60 years (59.1%) and income of up to 1 minimum wage (81.8%). With the characterization of health, it was evident that most people reported chronic diseases (63.6%), sleep more than 6 hours (81.8%), present pain (81.8%), denying alcoholism (86 4%) and smoking (77.3%) and showed a number greater than or equal to 1 (77.3%) recurrences. Concerning the therapeutic adherence was found that in the dimension compressive therapy there poor adherence. No associations between the domains of adherence and sociodemographic and health variables were found. Was observed, however, better adherence among individuals without pain and with higher schooling. When analyzed the averages of the dimensions of therapeutic adherence with the care characteristics there was statistical significance between: adherence to compression therapy and guidance for use of compressive therapy (p = 0.002) and guidance for regular exercise (p = 0.026). Considering the mean of total score of CCVUQ (mean 51.47, SD 18.33) it is observed that the overall QOL of respondents has approximate value of the median of the scale (50). The mean of the domain Social Interaction (mean 44.23, SD 21.38) and Domestic Activities (mean 45.70, SD 23.21) were those who reported better QOL. There were weak correlations but significant between adherence to healthy lifestyle and Domains Total Score (p = 0.012), social interaction (p-value = 0.048), Aesthetics (p-value = 0.025) and Emotional State (0.017) of CCVUQ. From the data analysis it is concluded that among people with UV, there poor adherence to compressive therapy. Furthermore, we found no statistically significant association between treatment adherence and sociodemographic and health characteristics. It is added that there was a correlation between the healthy lifestyle dimension and domains CCVUQ
A ades?o terap?utica ainda ? um grande problema entre pessoas com ?lceras venosas (UV), uma vez que a presen?a dessa les?o demanda um tratamento longo, dispendioso, e altera??es no estilo de vida. Nesse contexto, este estudo tem como objetivo geral analisar a ades?o ao tratamento e a qualidade de vida (QV) das pessoas com UV atendidas na aten??o prim?ria ? sa?de. Trata-se de estudo anal?tico, transversal, com abordagem quantitativa de tratamento e an?lise de dados. O estudo teve como cen?rio 13 Unidades de Sa?de da Fam?lia e duas Unidades Mistas da cidade de Natal. A amostra foi composta por 44 pessoas com UV indicadas pelas equipes da Estrat?gia Sa?de da Fam?lia entre fevereiro e abril de 2014. Utilizaram-se tr?s instrumentos: instrumento de caracteriza??o dos aspectos sociodemogr?ficos, de sa?de e assistenciais; a Escala Multidimensional de Ades?o Terap?utica, composta pelas dimens?es: estilo de vida saud?vel, terapia compressiva e vigil?ncia neurovascular; e o Charing Cross Venous Ulcer Questionnaire (CCVUQ), que avalia QV em pessoas com UV atrav?s de quatro dom?nios: Intera??o Social, Atividades Dom?sticas, Est?tica e Estado Emocional, al?m de gerar um Escore Total. A pesquisa obteve parecer favor?vel do Comit? de ?tica em Pesquisa da Universidade Federal do Rio Grande do Norte, CAAE: 07556312.0.0000.5537. Os dados referentes ? caracteriza??o sociodemogr?fica demonstraram que houve predomin?ncia do sexo feminino (65,9%), da faixa et?ria a partir de 60 anos (59,1%) e renda de at? 1 sal?rio m?nimo (81,8%). A caracteriza??o de sa?de evidenciou que a maioria das pessoas relatou doen?as cr?nicas associadas (63,6%), sono maior que 6 horas (81,8%), presen?a de dor (81,8%) e mais de uma recidiva (77,3%). A maior parte negou etilismo (86,4%) e tabagismo (77,3%). Em rela??o ? ades?o terap?utica verificou-se pior ades?o na dimens?o terapia compressiva. N?o foram encontradas associa??es entre os dom?nios da ades?o e as vari?veis sociodemogr?ficas e de sa?de. Observou-se, no entanto, melhor ades?o entre os indiv?duos sem dor e com maior escolaridade. Ao analisar a rela??o das dimens?es da ades?o terap?utica com as caracter?sticas da assist?ncia observou-se associa??o entre: ades?o ? terapia compressiva e orienta??es para uso de terapia compressiva (p-valor = 0,002) e para exerc?cios regulares (p-valor = 0,026). Considerando a m?dia do escore total do CCVUQ (m?dia 51,47 e DP 18,33) observa-se que a QV geral dos pesquisados tem valor aproximado ao da mediana da escala (50). Os participantes apresentaram melhor qualidade de vida nos dom?nios Intera??o Social e Atividades Dom?sticas. Verificaram-se correla??es significativas, por?m fracas, entre ades?o ao estilo de vida saud?vel e o Escore Total (p = 0,012), Intera??o Social (p = 0,048), Est?tica (p = 0,025) e Estado Emocional (p = 0,017) do CCVUQ. A partir da an?lise dos dados conclui-se que a maior dificuldade de ades?o entre as pessoas com UV refere-se ? terapia compressiva. Observou-se correla??o apenas entre a dimens?o estilo de vida saud?vel e os dom?nios do CCVUQ