Atenção multidisciplinar ao idoso e seu impacto sobre hipertensão arterial sistêmica e diabetes mellitus
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2014-09-15
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A hipertensão arterial sistêmica e o diabetes mellitus são problemas de
saúde pública em todo o mundo, afetando principalmente os idosos. Os
hipertensos e diabéticos podem ter sua qualidade de vida prejudicada em
razão das comorbidades inerentes às doenças em questão. Dessa forma, a
atividade física vem sendo cada vez mais recomendada como terapêutica não
farmacológica dessas moléstias, visto que contribui para redução de
incapacidades em indivíduos com e sem doenças cardiovasculares. Nesse
sentido, o presente estudo teve como objetivo avaliar e comparar o
desenvolvimento de um programa educativo-assistencial aos idosos portadores
de HAS e DMII no que contribui para a sua autonomia nas AVDs. A atividade
física foi realizada durante dois anos, duas vezes por semana, em dias
alternados. Para avaliação de qualidade de vida, conhecimento e atitudes
frente às doenças foram utilizados os seguintes questionários: WHOQOL,
MINICHAL, IPAq, ATT19 e DKN-A e a classificação dos CCEB além das
variáveis quantitativas: IMC, PAS,PAD, C Abd, FC, VEF1, FEF, CVF, PImáx,
PEmáx, antes e após um programa educativo-assistencial. A amostra foi
dividida em dois grupos, o intervenção e o controle, sendo que apenas o grupo
de idosos intervenção realizaram o programa educativo-assistencial. Na análise
estatística, utilizaram-se os testes Kolmogorov-Smirnov para verificar a
normalidade dos dados, bem como o t de Student, considerando significativo p
< 0,05. Observou-se que as orientações sobre conhecimento, manejo e
cuidados com as doenças associadas à prática de atividade física habitual
trazem benefícios à qualidade de vida dos idosos e uma “feminilização” nos
grupos analisados. O nível socioeconômico dos idosos foi considerado de
médio a baixo. Os resultados apontaram elevado poder explicativo tanto para o
IMC quanto para a C Abd na HAS como na DMII. Observou-se um perfil
respiratório característico do processo de envelhecimento, porém minimizado
pela prática de atividade física regular. Há uma predominância, pelos idosos de
ambos os grupos, às atividades físicas moderadas e vigorosas no lazer e/ou
recreação. Como indicadores de qualidade de vida a autoestima, a mobilidade,
o ambiente no lar, a espiritualidade, a religião e as crenças pessoais foram as
mais citadas pelos idosos. Além da implantação de programas de atividades
físicas eficientes e direcionados ao respectivo público, principalmente para os
idosos com idades mais avançadas, os programas devem ter como meta
melhorar as capacidades físicas dos indivíduos e conscientizá-los sobre a
importância da prática como um fator de melhoria da qualidade de vida, do
quadro clínico de saúde e de adesão regular aos programas.
Hypertension and diabetes are public health problems worldwide, affecting mainly the elderly. The hypertension and diabetes may have impaired their quality of life as a result of the comorbidities associated to such diseases. Thus, physical activity has been increasingly recommended as a nonpharmacological therapy for these diseases, since it contributes to reduce disability in individuals with and without cardiovascular disease. In this sense, this study is aimed at evaluating and comparing the development of an educational program for elderly-care patients with SAH and DMII in order to contribute to their independence in everyday activities. Physical activities were held for two years, twice a week, on alternate days. The following questionnaires were applied to assess quality of life, knowledge and attitudes towards disease: WHOQOL, MINICHAL, IPAq, ATT19 and DKN-A and beyond CCEB classification of quantitative variables: BMI, SBP, DBP, Abd C, FC, FEV1, FEF, FVC, PImáx, PEmáx, before and after an educational healthcare program. Statistical analysis used the Kolmogorov-Smirnov test to assess the normality of the data, as well as T-Student considering significant p <0.05. The guidelines on knowledge, management and care of diseases associated with regular physical activity showed to be beneficial to seniors’ quality of life and to some "feminization" in groups. The socioeconomic status of the elderly was considered medium to low. The results showed high explanatory power for both BMI and C for the SAH Abd as in DMII. There was a respiratory profile characteristic of the aging process, though minimized by regular physical activity. The elderly from both groups showed predominance towards moderate and vigorous physical activity during leisure and / or recreation. Self-esteem, mobility, home environment, spirituality, religion and personal beliefs were most cited by the elderly as indicators of quality of life. Besides the implementation of physical activity programs both efficient and targeted to their audience, especially for the elderly at older ages, programs should be aimed at improving the physical capabilities of individuals and educating them on the importance of practice as an improvement factor towards quality of life, clinical health and adherence to regular programs.
Hypertension and diabetes are public health problems worldwide, affecting mainly the elderly. The hypertension and diabetes may have impaired their quality of life as a result of the comorbidities associated to such diseases. Thus, physical activity has been increasingly recommended as a nonpharmacological therapy for these diseases, since it contributes to reduce disability in individuals with and without cardiovascular disease. In this sense, this study is aimed at evaluating and comparing the development of an educational program for elderly-care patients with SAH and DMII in order to contribute to their independence in everyday activities. Physical activities were held for two years, twice a week, on alternate days. The following questionnaires were applied to assess quality of life, knowledge and attitudes towards disease: WHOQOL, MINICHAL, IPAq, ATT19 and DKN-A and beyond CCEB classification of quantitative variables: BMI, SBP, DBP, Abd C, FC, FEV1, FEF, FVC, PImáx, PEmáx, before and after an educational healthcare program. Statistical analysis used the Kolmogorov-Smirnov test to assess the normality of the data, as well as T-Student considering significant p <0.05. The guidelines on knowledge, management and care of diseases associated with regular physical activity showed to be beneficial to seniors’ quality of life and to some "feminization" in groups. The socioeconomic status of the elderly was considered medium to low. The results showed high explanatory power for both BMI and C for the SAH Abd as in DMII. There was a respiratory profile characteristic of the aging process, though minimized by regular physical activity. The elderly from both groups showed predominance towards moderate and vigorous physical activity during leisure and / or recreation. Self-esteem, mobility, home environment, spirituality, religion and personal beliefs were most cited by the elderly as indicators of quality of life. Besides the implementation of physical activity programs both efficient and targeted to their audience, especially for the elderly at older ages, programs should be aimed at improving the physical capabilities of individuals and educating them on the importance of practice as an improvement factor towards quality of life, clinical health and adherence to regular programs.
Descrição
Tese de Doutoramento em Ciências do Desporto
Palavras-chave
Atividade física , Envelhecimento , Hipertensão , Diabetes mellitus , Qualidade de vida