• JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
 
  Bookmark and Share
 
 
Master's Dissertation
DOI
https://doi.org/10.11606/D.7.2006.tde-17102006-120739
Document
Author
Full name
Luciane Vasconcelos Barreto de Carvalho
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2006
Supervisor
Committee
Pierin, Angela Maria Geraldo (President)
Chaves, Eliane Correa
Riccio, Grazia Maria Guerra
Title in Portuguese
Características de pacientes após síndromes coronarianas agudas e fatores relacionados à adesão ao tratamento.
Keywords in Portuguese
Adesão
Síndromes coronarianas agudas
Tratamento
Abstract in Portuguese
Introdução: As doenças cardiovasculares constituem a principal causa de morbimortalidade nacional e apresentam-se principalmente na forma de doença arterial coronariana, cujas principais manifestações se caracterizam pelas síndromes coronarianas agudas: angina instável e infarto agudo do miocárdio. Nesse sentido, realizou-se um estudo com o objetivo de caracterizar o perfil bio-psico-social dos pacientes após síndromes coronarianas agudas, identificando os fatores que possam interferir na adesão ao tratamento no que diz respeito ao não comparecimento às consultas, interrupção do tratamento e controle de pressão arterial, além de associar o perfil bio-psico-social dos pacientes com fatores relacionados à adesão. Casuística e Método: Estudo descritivo e exploratório, realizado em um hospital universitário da cidade de São Paulo, analisou 85 pacientes com diagnóstico de síndromes coronarianas agudas. Após receberem alta, os pacientes foram entrevistados em ambulatórios para obtenção de dados estruturais, socioeconômicos, hábitos de vida, conhecimento da doença e do tratamento. Com o intuito de avaliar o bem estar psicológico dos pacientes, o questionário de saúde geral de Goldberg foi aplicado. Os dados foram processados no sistema SPSS v.7.5. O nível de significância adotado foi 0,05. Resultados: Foram estudados 85 pacientes, 56% homens, 69% com companheiro, 59±9,6 anos, 85% pertencentes à etnia branca, 52% com ensino fundamental, 54% com renda entre 2 e 5 salários, 79% com antecedentes de hipertensão arterial, 62% com dislipidemia e 40% para infarto agudo do miocárdio. Cerca de 35% relataram o não comparecimento às consultas e a interrupção do tratamento. Em relação à atitude frente à necessidade de tomar medicamentos, 63% dos pacientes relatou esquecimento esporádico ou constante dos remédios. A análise de regressão logística indicou a associação independente para as seguintes variáveis (OD Odds ratio, IC intervalo de confiança a 95%): 1- não comparecimento às consultas, etnia branca (OR=0,27 IC 95% 0,08-0,86) e hábitos alimentares inadequados (OR=1,07 IC 1,00-1,45); 2- interrupção do tratamento associado com faltas às consultas (OR=6,09 IC 1,81-20,49), consumo de bebida alcoólica (OR=5,05 IC 1,61-15,76) e automedicação (OR=7,89 IC 2,39-26,05); 3- pressão arterial não controlada (=140/90 mmHg) com acompanhamento no ambulatório de coronária (OR=2,78, IC 1,01-7,65). A maior freqüência de alteração no quarto percentil nos domínios do questionário de saúde geral de Goldberg foram associados às seguintes variáveis: 1- estresse associado à automedicação (OR=6,09 IC 1,32-14,5) e HDLc =40mg/dL (OR=1,04 IC 1,00-1,08); 2- auto-eficácia com acompanhamento no ambulatório de coronária (OR=2,78 IC 1,19-12,23), automedicação (OR=4,62 IC 1,46-14,95) e HDLc =40mg/dL (OR=1,04 IC 1,19-12,23); 3- distúrbios do sono associados com referência de ansiedade (OR=5,61 IC 1,65-19,09), e colesterol total = 200 mg/Dl (OR=4,42 IC 1,36- 14,38); 4- distúrbios psicossomáticos associados ao sexo feminino (OR=6,57 IC 1,96-22,0) e relato de ansiedade (OR=4,06 IC 1,24-13,3); 5- severidade da ausência de saúde mental associado ao sexo feminino (OR=3,96 IC 1,26- 12,43) e automedicação (OR=3,39 IC 95% 1,07-10,70). Conclusão: Características estruturais e psicológicas, hábitos de vida inadequados e atitudes frente ao tratamento medicamentoso influenciaram aspectos da adesão ao tratamento, tais como o não comparecimento às consultas e a interrupção do tratamento. Em face dos dados obtidos, os profissionais de saúde devem implementar estratégias para atender os pacientes com síndrome coronariana aguda, visando à prevenção secundária.
Title in English
Characteristics of the patients right after acute coronary syndrome and factors related to the adherence to the treatment.
Keywords in English
Acute coronary syndrome
Adherence
Treatment
Abstract in English
Introduction: The cardiovascular diseases are the most important cause of mortality in the country and show mainly in the form of coronary arterial disease, which the main manifestations are characterized by the acute coronary syndrome: instable angina, acute attack of the myocardium. In this way, a study was made with the aim to characterized the bio-psychosocial profile of the patients after the acute coronary syndrome, recognizing the factors which could interfere in the adherence to the treatment about the non attendance to the appointments, interruption of the treatment and the control of the blood pressure, besides the association of the bio-psychosocial profile of the patients to the factors connected to the adherence. Method and Casuistic: A descriptive and exploring study, made in a University hospital in the city of São Paulo that analyzed 85 patients with the diagnostics of the acute coronary syndrome. After receiving the doctor’s avail to leave the hospital, the patients were interviewed in ambulatories in order to collect structure, socioeconomic, habits of life, knowledge of the disease and of the treatment data. The main purpose was to evaluate the psychological welfare state of the patients; the questionnaire of general health was used. The results were run in the system SPSS v. 7.5. and the significance level adopted was 0,05. Results: 85 patients were studied, 56% men, 69% ith companion, 59+-9,6 years old, 85% white, 52% finished the elementary school, 54% with the income of between 2 and 5 salaries, 79% with the precedents of high blood pressure, 62% with high blood cholesterol and 40% for the acute myocardium attack. About 35% of them spoke about the non attendance to the appointments and the interruption of the treatment. About the attitude towards the necessity to take medicines, 63% of the patients spoke about the constant or periodical carelessness of the medicines. The analysis of logistic regression indicated the independent association to the following varieties: (OD odds ratio, IC confidence break around 95%): 1 – non attendance to the appointments, white ethnic (OR = 0,27 IC 95% 0,08- 0,86) and bad eating habits (OR=1,07 IC 1,00-1,45); 2 – interruption of the treatment associated to the non attendance to the appointments (OR=6,09 IC 1,81-20,49), the alcoholic drinks consumption (OR=5,05 IC 1,61-15,76), and auto medication (OR=7,89 IC 2,39-26,05); 3 – high blood pressure out of control (=140/90 mmHg) with the accompaniment in the coronary ambulatory (OR=2,78, IC 1,01-7,65). The higher frequency of the alterations in the percentage board in the Goldberg’s general health questionnaire dominions was associated to the following variations: 1 – Stress associated to auto medication (OR=6,09 IC 1,32-14,5) and HDLc =40mg/dL (OR=1,04 IC 1,00-1,08); 2 – auto efficiency with accompaniment in the coronary ambulatory (OR=2,78 IC 1,19-12,23), auto medication (OR=4,62 IC 1,46-14,95) and HDLc =40mg/dL (OR=1,04 IC 1,19-12,23); 3 – Sleeping disturbance associated to anxiety reference (OR=5,61 IC 1,65- 19,09) and total cholesterol total = 200 mg/Dl (OR=4,42 IC 1,36-14,38); 4 – psychosomatic disturbances associated to the female genre (OR=6,57 IC 1,96-22,0) and the report of anxiety (OR=4,06 IC 1,24-13,3); 5 – health general rate of evaluation associated to the female genre (OR=3,96 IC 1,26-12,43) and auto medication (OR=4,06 IC 1,24-13,3); Conclusion: The structural and psychological characteristics, inadequate life habits and attitudes facing the medicine treatment influence the aspects of adherence to the treatment, such as the non attendance to the appointments and the interruption of the treatment. Facing all the searched data, the health professionals must implement strategies to support the patients with acute coronary syndrome, looking for the secondary prevention.
 
WARNING - Viewing this document is conditioned on your acceptance of the following terms of use:
This document is only for private use for research and teaching activities. Reproduction for commercial use is forbidden. This rights cover the whole data about this document as well as its contents. Any uses or copies of this document in whole or in part must include the author's name.
Publishing Date
2006-11-23
 
WARNING: Learn what derived works are clicking here.
All rights of the thesis/dissertation are from the authors
CeTI-SC/STI
Digital Library of Theses and Dissertations of USP. Copyright © 2001-2024. All rights reserved.