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Master's Dissertation
DOI
https://doi.org/10.11606/D.5.2011.tde-27102011-093455
Document
Author
Full name
Maria Abadia Consuelo Machado e Silva Gomide
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2011
Supervisor
Committee
Grumach, Anete Sevciovic (President)
Criado, Paulo Ricardo
Rotta, Osmar
Title in Portuguese
Avaliação da qualidade de vida de pacientes com angioedema hereditário
Keywords in Portuguese
Angioedemas hereditários
Índice de gravidade da doença
Qualidade de vida
Abstract in Portuguese
INTRODUÇÃO: O angioedema hereditário (AEH) é uma doença rara, causada pela deficiência do inibidor de C1 esterase (C1-INH), que se manifesta por ataques recorrentes e imprevisíveis de edema em face, extremidades, genitais, tronco e trato gastrintestinal. O edema em vias superiores pode levar a asfixia e morte; enquanto que as crises de dor abdominal podem conduzir à laparatomias desnecessárias. Por suas características, o AEH afeta profundamente a qualidade de vida (QV) de seus portadores, tanto na esfera física, como psicológica e social. O presente estudo teve como objetivo avaliar a qualidade de vida relacionada à saúde destes pacientes. MÉTODOS: Foi aplicado um instrumento genérico 36-Item Short Form Health Survey Questionnaire (SF-36) em 35 pacientes com idade superior a 15 anos, com comprovação clínica e laboratorial ou somente laboratorial de deficiência do inibidor de C1, procedentes de quatro regiões distintas do país. Paralelo a esta medida, foi aplicado um questionário contendo dados pessoais e de história clínica dos pacientes nos últimos seis meses. Com base neste último questionário, foi avaliada a gravidade clínica do AEH através de escore de seis critérios. RESULTADOS: Os pacientes foram preponderantemente do sexo feminino (71,4%), provenientes da zona urbana (85,7%), com nível de escolaridade médio (42,9%) e nível sócio-econômico médio-baixo (57,1%). Em relação à avaliação da QV pelo SF-36, noventa por cento dos pacientes apresentaram escore médio do SF-36 abaixo de 70. Os escores obtidos dos oito domínios tiveram variação de 51,03 a 75,95; sendo os domínios mais comprometidos vitalidade, aspectos sociais e dor. A consistência interna do instrumento foi demonstrada pelo coeficiente alfa de Cronbach acima de 0,7. Não se verificou correlação entre SF-36 médio e os parâmetros sexo, idade, escolaridade, tempo de evolução da doença sem diagnóstico e escore de gravidade clínica considerado neste estudo. CONCLUSÕES: A qualidade de vida dos pacientes com AEH é afetada em vários domínios, porém há necessidade de estudos com questionários doença específicos para melhor caracterização dos prejuízos causados por esta doença em seus portadores. Estas informações poderão ser aplicadas em medidas de promoção da saúde que repercutirão na melhora biopsicosocial destes pacientes
Title in English
Quality of life assessment in patients with hereditary angioedema
Keywords in English
Hereditary angioedema
Quality of life
Severity
Abstract in English
INTRODUCTION: Hereditary angioedema (HAE) is a rare illness, caused by a deficiency of C1 esterase inhibitor (C1-INH), which manifests as recurring unexpected attacks of edema of the face, extremities, genitals, chest and gastrointestinal tract. Edemas in the upper airways can cause asphyxiation and death; while the attacks of abdominal pain can lead to unnecessary laparotomies. Due to its characteristics, HAE deeply affects the quality of life of those affected, physically as well as psychologically and socially. This study aims to evaluate the quality of life related to the health of these patients. METHODS: A generic instrument was applied 36 Item Short Form Health Survey Questionnaire (SF-36) to 35 patients over 15 years of age, with clinical and laboratory evidence or simply laboratory evidence of a deficiency of the C1 inhibitor, from four distinct regions of the country. In addition to this measure, a questionnaire containing personal data and clinical history of the patients in the last six months was applied. Based on this last questionnaire, the clinical severity of the HAE was evaluated through a score of six criteria. RESULTS: The patients were predominantly of female gender (71.4%), from urban areas (85.7%), with an average level of education (42.9%) and medium-low socio-economic level (57.1%). In relation to the evaluation of the QL by SF-36, ninety per-cent of the patients presented average SF-36 scores of below 70. The scores of the eight dimensions showed a variation from 51.03 to 75.95; the most negatively affected scales being vitality, social functioning and pain. The internal consistency of the evaluation was demonstrated by a Cronbach alpha coefficient of above 0.7. No correlation was found between the mean SF-36 scores and the parameters of gender, age, education, duration of the disease without diagnosis and clinical severity score, considered in this study. CONCLUSIONS: The quality of life of the patients with HAE is affected in several domains, however there is a need for studies with disease specific questionnaires to better characterize the damage caused by this disease to its sufferers. This information could be applied in health promotion measures which will have repercussions on the bio-psycho-social improvement of these patients
 
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Publishing Date
2011-10-31
 
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