Adesão ao tratamento, complexidade farmacoterapêutica do doente crónico e bem-estar psicológico
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2020-03-03
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Enquadramento - O estágio de natureza profissional foi desenvolvido na Unidade de Cuidados de Saúde Personalizados (UCSP) do Centro de Saúde Chaves I, ACeS Alto Tâmega e Barroso, no âmbito do Curso de Mestrado em Enfermagem de Saúde Familiar da Escola Superior de Saúde da UTAD. No desenvolvimento do presente relatório de estágio e tendo em conta os objetivos definidos, analisam-se as competências desenvolvidas, tendo como referência o Regulamento n.º 428/2018. Apresenta-se ainda o estudo intitulado “Adesão ao tratamento, complexidade da farmacoterapia do doente crónico e bem-estar psicológico”, que permitiu o desenvolvimento de competências em metodologias de investigação.
Objetivos - Desenvolver as competências específicas do enfermeiro especialista em enfermagem comunitária na área de enfermagem de saúde familiar e uma investigação no âmbito da enfermagem familiar. Assim, para além das atividades realizadas na UCSP-B, desenvolvemos um estudo que tinha por objetivo analisar a relação entre o índice de complexidade da farmacoterapia e a adesão aos tratamentos e bem-estar psicológico, nos utentes diagnosticados com hipertensão e diabetes mellitus, inscritos na UCSP-B do Centro de Saúde Chaves I.
Métodos - No presente relatório utilizou-se a análise crítico-reflexiva sobre as competências específicas na área de enfermagem de saúde familiar. Realizou-se um estudo de natureza observacional, transversal com uma abordagem quantitativa. Para a recolha de dados utilizou-se um questionário, constituído por variáveis sociodemográficas, clínicas, adesão aos tratamentos, estilo de vida, bem-estar psicológico e complexidade da farmacoterapia. Para analisar a relação entre as variáveis utilizou-se o teste rhó de Spearman (), para o cálculo de correlações de modo a verificar a intensidade e sentido da relação entre variáveis quantitativas.
Resultados - A amostra do estudo foi constituída por 31 participantes, com uma média de idades de 55,9 anos e desvio padrão de 8,3, sendo 51,6% do sexo masculino e 48,4% do feminino. Verificou-se que a maioria (75,6%) dos participantes mostrou adesão aos tratamentos. Analisada a correlação entre a medida de adesão aos tratamentos e a frequência da dose dos fármacos, uma das seções do índice de complexidade da farmacoterapia, verificamos uma correlação moderada positiva (=0,430) e significativa (p=0,016), indicando que à medida que aumenta a frequência da dose dos fármacos, também aumenta a adesão aos tratamentos. Quanto à correlação entre a medida de adesão aos tratamentos e o índice total de complexidade da farmacoterapia, observou-se uma correlação positiva baixa (=0,03), e não significativa (p=0,98), o que indica que a adesão aos tratamentos não se relaciona com o índice de complexidade da farmacoterapia. No que respeita à correlação entre a medida de adesão aos tratamentos e os domínios do estilo de vida fantástico, verificou-se que: quanto à nutrição apresentou uma correlação negativa baixa ( = - 0,166) e não mostrou uma relação significativa (p=0,372), e também não se verificou relação entre o domínio atividade física e a medida de adesão aos tratamentos ( =0,065; p=0,729 ). No concerne à correlação entre a medida de adesão aos tratamentos e bem-estar psicológico, foi baixa e negativa ( = - 0,191; p=0,303) e não se verificou relação entre estas variáveis.
Conclusão - O presente relatório mostra o percurso realizado em contexto de estágio, nomeadamente, a aquisição de competências específicas do enfermeiro especialista na área de enfermagem de saúde familiar e o cumprimento dos objetivos propostos. Durante o estágio desenvolvemos um saber agir responsável e assertivo, sustentado na reflexão crítica. Os resultados obtidos pelo estudo permitiram constatar que a adesão aos tratamentos é elevada, e que à medida que aumenta frequência da dose dos fármacos aumenta a adesão aos tratamentos. Os resultados desta investigação pretendem contribuir para a adequação e melhoria das intervenções de enfermagem.
Background - The professional internship was develop at the Personalized Health Care Unit of the Chaves I Health Center, Alto Tâmega e Barroso, within the at ambit of the Master's Course in Family Health Nursing at the School of Health at UTAD. In this internship report, I took into account the defined objectives, analyzed the skills developed with reference to Regulation no. 428/2018. I developed the study entitled “Adherence to treatment, complexity of pharmacotherapy for chronic patients and psychological well-being” it is also presented, which allowed the development of skills in research methodologies. Objectives - To develop the specific skills of the specialist nurse in community nursing in the area of family health nursing and an investigation in the field of family nursing. Thus, in addition to the activities carried out at UCSP-B, we developed a study that aimed to analyze the relationship between the complexity index of pharmacotherapy and adherence to treatments and psychological well-being, in patients diagnosed with hypertension and diabetes mellitus, enrolled at UCSP-B of the Chaves I Health Center. Methods - This report used a critical-reflective analysis on specific skills in the area of family health nursing. An observational, cross-sectional study carried out with a quantitative approach. For data collection, we used a questionnaire, consisting of sociodemographic, clinical variables and adherence to treatments, lifestyle, psychological well-being and complexity of pharmacotherapy. Spearman's rhó test () was used to analyze the relationship between quantitative variables, in order to verify the intensity and direction of correlation. Results - The study sample consisted of 31 participants, with an average age of 55.9 years and standard deviation of 8.3, with 51.6% being male and 48.4% female. It found that the majority (75.6%) of the participants showed adherence to treatments. Analyzing the correlation between the measure of adherence to treatments and the frequency of dose of medicines, one of the sections of the pharmacotherapy complexity index, we found a moderate positive correlation ( = 0.430) and significant (p = 0.016), indicating that as increases the frequency of the dose, also increases adherence to treatments. As for the correlation between the measure of adherence to treatments and the total index of complexity of pharmacotherapy, there was a positive and low correlation ( = 0.03), and not significant (p = 0.98), which indicates that the adherence to treatments it is not related to the complexity of pharmacotherapy index. With regard the correlation between the measure of adherence to treatments and the domains of fantastic lifestyle, it was found that: regarding nutrition, it presented a negative and low correlation ( = - 0.166) and didn’t show a significant relationship (p = 0.372), and there was also no relationship between the physical activity domain and the measure of adherence to treatments ( = 0.065; p = 0.729). Regarding the correlation between the measure of adherence to treatments and psychological well-being, it was low and negative ( = - 0.191; p = 0.303) and there was no relationship between these variables. Conclusions - This report shows detailed the path in the context of the internship, namely, the acquisition of specific skills of the specialist nurse in the area of family health nursing and the fulfillment of the proposed objectives. During the internship, we developed a knowledge of acting responsibly and assertively, based on critical reflection. The results obtained by the study showed that adherence to treatments is high, and that as the frequency of the dose of drugs increases, adherence to treatments increases. The results of this investigation are intend to contribute to the adequacy and improvement of nursing interventions.
Background - The professional internship was develop at the Personalized Health Care Unit of the Chaves I Health Center, Alto Tâmega e Barroso, within the at ambit of the Master's Course in Family Health Nursing at the School of Health at UTAD. In this internship report, I took into account the defined objectives, analyzed the skills developed with reference to Regulation no. 428/2018. I developed the study entitled “Adherence to treatment, complexity of pharmacotherapy for chronic patients and psychological well-being” it is also presented, which allowed the development of skills in research methodologies. Objectives - To develop the specific skills of the specialist nurse in community nursing in the area of family health nursing and an investigation in the field of family nursing. Thus, in addition to the activities carried out at UCSP-B, we developed a study that aimed to analyze the relationship between the complexity index of pharmacotherapy and adherence to treatments and psychological well-being, in patients diagnosed with hypertension and diabetes mellitus, enrolled at UCSP-B of the Chaves I Health Center. Methods - This report used a critical-reflective analysis on specific skills in the area of family health nursing. An observational, cross-sectional study carried out with a quantitative approach. For data collection, we used a questionnaire, consisting of sociodemographic, clinical variables and adherence to treatments, lifestyle, psychological well-being and complexity of pharmacotherapy. Spearman's rhó test () was used to analyze the relationship between quantitative variables, in order to verify the intensity and direction of correlation. Results - The study sample consisted of 31 participants, with an average age of 55.9 years and standard deviation of 8.3, with 51.6% being male and 48.4% female. It found that the majority (75.6%) of the participants showed adherence to treatments. Analyzing the correlation between the measure of adherence to treatments and the frequency of dose of medicines, one of the sections of the pharmacotherapy complexity index, we found a moderate positive correlation ( = 0.430) and significant (p = 0.016), indicating that as increases the frequency of the dose, also increases adherence to treatments. As for the correlation between the measure of adherence to treatments and the total index of complexity of pharmacotherapy, there was a positive and low correlation ( = 0.03), and not significant (p = 0.98), which indicates that the adherence to treatments it is not related to the complexity of pharmacotherapy index. With regard the correlation between the measure of adherence to treatments and the domains of fantastic lifestyle, it was found that: regarding nutrition, it presented a negative and low correlation ( = - 0.166) and didn’t show a significant relationship (p = 0.372), and there was also no relationship between the physical activity domain and the measure of adherence to treatments ( = 0.065; p = 0.729). Regarding the correlation between the measure of adherence to treatments and psychological well-being, it was low and negative ( = - 0.191; p = 0.303) and there was no relationship between these variables. Conclusions - This report shows detailed the path in the context of the internship, namely, the acquisition of specific skills of the specialist nurse in the area of family health nursing and the fulfillment of the proposed objectives. During the internship, we developed a knowledge of acting responsibly and assertively, based on critical reflection. The results obtained by the study showed that adherence to treatments is high, and that as the frequency of the dose of drugs increases, adherence to treatments increases. The results of this investigation are intend to contribute to the adequacy and improvement of nursing interventions.
Descrição
Relatório de estágio de natureza profissional apresentado à Universidade Trás-os-Montes e Alto Douro
Palavras-chave
Adesão aos tratamentos , Complexidade da farmacoterapia