Made available in DSpace on 2014-12-17T14:46:40Z (GMT). No. of bitstreams: 1 WalquiriaGN_DISSERT.pdf: 1866144 bytes, checksum: 27f53dafb0bd014b243a5f2b0a779e90 (MD5) Previous issue date: 2009-10-30 / Descriptive study aimed to analyze the quality of life (QOL) of patients with venous ulcers (UV) outpatient clinic of a university hospital in Natal / RN. The aim of the study population was composed of 50 patients with UV treated at the cardiology clinic of a university teaching hospital at the tertiary level. The study was approved by the Ethics Committee of the Federal University of Rio Grande do Norte (Protocol 279/09). Data collection was performed over a period of two months by the very a masters degree and an academic nursing through the application of a form concerning the socio-demographic, clinical, and health care, and the instruments WHOQOL and WHOQOL - old. The data were analyzed with SPSS 15.0, using descriptive and inferential statistics presented in the form of tables, charts and graphs. Of the surveyed, female predominance, age range 59 years, Catholic, low education, married, with up to 03 children, not working, retired, or with occupations requiring long periods in one position, wage income of up to 02 minimum wages, inadequate sleep, patients with chronic venous insufficiency and other chronic diseases such as diabetes and hypertension, were taking medications for treatment, being a minority to IVC. In patients with predominant only one injury, time of injury up to five years, inadequate rest, pain, edema and lesions colonized. The assistance the UV patients began treatment of the injury until four months after the onset of the ulcer, and services primary health care most wanted, access to angiologist by reference form, commuted by public transportation, received support regarding the treatment of injuries. The topical product most used in the lesion was healing, and few were using compression therapy. respondents suffer discrimination in society, showed changes in quality of life after the occurrence of ulcer in relation to leisure, pain, restriction of social / school / transportation; barring employment / financial / social ladder; Physical appearance / discrimination and restriction of domestic activity. These changes were related to the time of injury and found that the more chronic injury is the most negative changes occur in their QV (ρ = 0.000). Analyzing the characteristics of QV measured by the WHOQOL-bref, we found for the two general questions they are dissatisfied with their health (ρ = 0.023) and all areas have significant difference compared with the worst QV have the injury of more than 5 years (ρ = 0.000). The QV measured by the WHOQOL-old, we found that these patients had no changes from the time of injury. We conclude that the QV of patients with UV was considered unsatisfactory when compared to the time of injury on more than 5 years which shows that the quality of life worsens with time the chronic UV. / Estudo transversal e descritivo que objetivou analisar a qualidade de vida (QV) de pessoas com ?lcera venosa (UV) atendidos no ambulat?rio de um hospital universit?rio em Natal/RN. A popula??o alvo do estudo foi composta por 50 pacientes com UV atendidos no ambulat?rio de angiologia de um hospital universit?rio de ensino no n?vel terci?rio. O estudo obteve parecer favor?vel do Comit? de ?tica da Universidade Federal do Rio Grande do Norte (Protocolo n? 279/09). A coleta de dados foi realizada num per?odo de dois meses pela pr?pria mestranda e uma acad?mica de enfermagem, por meio da aplica??o de um formul?rio referente as caracter?sticas s?cio-demogr?fica, cl?nico, de sa?de e assistencial, e dos instrumentos WHOQOL-bref e WHOQOL-old. Os dados foram analisados no SPSS 15.0, atrav?s de estat?stica descritiva e inferencial apresentados na forma de tabelas, quadros e gr?ficos. Dos pesquisados, predominaram o sexo feminino, faixa et?ria at? 59 anos, religi?o cat?lica, baixa escolaridade, casado, com at? 03 filhos, sem v?nculo empregat?cio, aposentados ou com ocupa??es que exigem longos per?odos numa mesma posi??o, renda salarial de at? 02 sal?rios m?nimos, sono inadequado, portadores de Insufici?ncia Venosa Cr?nica e outras doen?as cr?nicas como DM e HAS, faziam uso de medicamento para tratamento cl?nico, sendo uma minoria para IVC. Nos pesquisados predominaram apenas uma les?o, tempo de les?o de at? cinco anos, repouso inadequado, dor intensa, edema e les?es colonizadas. Quanto ? assist?ncia os pacientes iniciaram o tratamento da les?o at? quatro meses ap?s o surgimento da ?lcera, sendo os servi?os de aten??o b?sica ? sa?de mais procurados, acesso ao angiologista por ficha de refer?ncia, se deslocavam por meio de transporte coletivo, recebiam apoio em rela??o ao tratamento das les?es. No tratamento t?pico o produto mais utilizado na les?o era cicatrizante, e poucos faziam uso de terapia compressiva. No que se refere ? discrimina??o, os pesquisados sofrem discrimina??o da sociedade, apresentaram mudan?as na qualidade de vida ap?s o surgimento da ?lcera em rela??o ao lazer/dor/restri??o social/escolar/locomo??o; Restri??o laboral/financeira/progress?o social; Apar?ncia f?sica/discrimina??o e restri??o de atividade dom?stica. Essas mudan?as foram relacionadas com o tempo de les?o e verificado que quanto mais cr?nica for a les?o mais mudan?as negativas ocorrer?o em sua QV (ρ=0,000). Ao analisarmos as caracter?sticas da QV medidas pelo WHOQOL-bref, verificamos em rela??o ?s duas quest?es gerais eles est?o insatisfeitos com sua sa?de (ρ=0,023) e todos os dom?nios apresentam significativa diferen?a em rela??o ? pior QV com ter a les?o com mais de 5 anos (ρ=0,000). Quanto ? QV medida pelo WHOQOL-old, verificamos que esses pacientes n?o tiveram mudan?as em rela??o ao tempo de les?o. Conclu?mos que a QV de pessoas com UV foi considerada insatisfat?ria quando comparada ao tempo de les?o atual superior a 5 anos que denota que a qualidade de vida piora com o tempo de cronicidade das UV.

Made available in DSpace on 2014-12-17T14:46:41Z (GMT). No. of bitstreams: 1 EuridesAB_DISSERT.pdf: 1529063 bytes, checksum: 46f57edf4d0aa894f7c5271dd17b17dd (MD5) Previous issue date: 2009-12-11 / Analytical study of therapeutic nonrandomized intervention type, intra-group controlled, with the aim of analyzing the cost-effectiveness of compression therapy with manipulated Unna boot in relation to conventional therapy in the healing of venous ulcers (VU) of patients treated in ambulatory clinic. The study population was composed by patients with VU treated by angiologists in Surgical Clinic Ambulatory of the Onofre Lopes University Hospital (HUOL) with a sample of 18 patients. It obtained the assent of the HUOL Ethics in Research Committee (Protocol 276/09). Data collection was performed over a period of four months by the own master's student and 34 nursing students, through the application of the research instrument in the admission of patients to the study and in the ten subsequent evaluations, performed at the time of changing Unna boot, weekly, for a maximum period of 10 weeks. The data were analyzed with SPSS 15.0 software, using descriptive and inferential statistics, and presented as tables, charts and graphs. Among those surveyed, prevailed: females, mean age 57.6 years, low education and income levels, most retired, unemployed or off work, with the standing position more than six hours per day and up to eight hours daily of domestic or occupational activities. In health status profile of respondents there were predominantly sleep, rest and inadequate elevation of the lower limbs, no smoking and/or alcohol use, presence of hypertension and no use of drugs. Most presented the first VU for over 10 years, recurrences, present VU for more than five years, involvement of left leg, in malleolar and / or distal leg region, mild edema, hyperpigmentation, lipodermatosclerosis, telangiectasies, reticular and varicose veins, mild pain, serous exudate in moderate quantity, small lesions (up to 50cm2), with predominance of granulation tissue and / or epithelialization and demarcated, elevated and irregular borders, with crusts and macerated. Most patients reported that in the 10 weeks prior to admission, made bandages at home and / or Basic Health Unit and / or ambulatory, with nursing aides or technicians, daily, and on weekends or holidays, performed by patients themselves, using healing ointment on the lesion, being observed granulation / epithelialization and increase in VU prevalent in the 10 weeks of traditional treatment. After follow up with manipulated Unna boot, was observed a decrease of lesions in all study patients, with complete healing in 27.8% of those between 1 and 5 weeks of treatment, with satisfactory evolution of the lesions, pain and ankle and calf circumferences, and unsatisfactory development of the borders of ulcers, edema, sleep, rest and elevation of the lower limbs, especially in more chronic patients. Furthermore, patients who achieved total healing and exhibited the greatest percentage reduction of lesions had a higher number of wound healing factors (ρ = 0.01 and ρ = 0.027, respectively). The manipulated Unna boot showed better results in those patients with shorter duration of injury, leading them to a satisfactory outcome within a short period of treatment. After the cost-effectiveness analysis, we conclude that the manipulated Unna boot is more effective than conventional therapy in the healing process of VU and is more cost-effective in patients with shorter lesions (ρ = 0.001), shorter treatment (ρ = 0.000) and greater number of wound healing factors (ρ = 0.005). / Estudo anal?tico de interven??o do tipo terap?utico n?o randomizado com controle intragrupo, com o objetivo de analisar o custo-efetividade da terapia compressiva com bota de Unna manipulada em rela??o ? terapia convencional, no processo de cicatriza??o de ?lceras venosas (UV) de pacientes atendidos em ambulat?rio. A popula??o alvo do estudo foi composta por portadores de UV atendidos por angiologistas no ambulat?rio de Cl?nica Cir?rgica do Hospital Universit?rio Onofre Lopes (HUOL), com amostra de 18 pacientes. Obteve parecer favor?vel do Comit? de ?tica em Pesquisa do HUOL (Protocolo n? 276/09). A coleta de dados foi realizada num per?odo de quatro meses pela pr?pria mestranda e 34 acad?micos de enfermagem, por meio da aplica??o do instrumento de pesquisa na admiss?o dos pacientes ao estudo e nas dez avalia??es subsequentes, realizadas no momento das trocas da bota de Unna semanais, por um per?odo m?ximo de 10 semanas. Os dados foram analisados no SPSS 15.0, atrav?s de estat?stica descritiva e inferencial, e apresentados na forma de tabelas, quadros e gr?ficos. Entre os pesquisados, predominaram: o sexo feminino, idade m?dia de 57,6 anos, baixo n?vel de escolaridade e de renda, maioria aposentada, desempregada ou afastada do trabalho, com posi??o ortost?tica maior que seis horas por dia e com at? oito horas di?rias de atividades dom?sticas ou ocupacionais. No perfil do estado de sa?de dos pesquisados houve predom?nio de sono, repouso e eleva??o dos membros inferiores inadequados, aus?ncia de tabagismo e/ou etilismo, presen?a de hipertens?o arterial e a n?o utiliza??o de medicamentos. A maioria apresentou a primeira UV h? mais de 10 anos, recidivas, UV atual h? mais de cinco anos, acometimento do MIE, em regi?o maleolar e/ou distal da perna, edema discreto, hiperpigmenta??o, lipodermatoesclerose, telangiectasias, veias reticulares, veias varicosas, dor leve, exsudato seroso, em moderada quantidade, les?es pequenas (at? 50cm2), com predomin?ncia de tecido de granula??o e/ou epiteliza??o e bordas delimitadas, elevadas, irregulares, com crostas e maceradas. A maioria dos pacientes relatou que, nas 10 semanas anteriores ? admiss?o, realizaram curativos em domic?lio e/ou UBS e/ou ambulat?rio, com auxiliares ou t?cnicos de enfermagem, diariamente, sendo nos fins de semana ou feriado executados pelos pr?prios pacientes, com utiliza??o de cicatrizantes na les?o, sendo observada granula??o/epiteliza??o predominantes e aumento das UVs nas 10 semanas de tratamento tradicional. Ap?s o acompanhamento com bota de Unna manipulada, foi observada redu??o das les?es em todos os pacientes do estudo, com cicatriza??o total em 27,8% destes entre 1 e 5 semanas de tratamento, com evolu??o satisfat?ria do leito lesional, da dor e das circunfer?ncias do tornozelo e panturrilha, e evolu??o insatisfat?ria da borda das ?lceras, edema, sono, repouso e eleva??o dos MMII, principalmente nos pacientes mais cr?nicos. Al?m disso, os pacientes que obtiveram cicatriza??o total e os que apresentaram maior percentual de redu??o das les?es tinham maior n?mero de fatores de cicatriza??o (ρ=0,01 e ρ = 0,027, respectivamente). A bota de Unna manipulada apresentou melhores resultados naqueles pacientes com menor tempo de les?o, levando-os a uma evolu??o satisfat?ria num curto per?odo de tratamento. Ap?s as an?lises de custo-efetividade, conclu?mos que a bota de Unna manipulada ? mais efetiva do que a terapia convencional no processo de cicatriza??o de UV, sendo mais custo-efetiva em pacientes com menor tempo de les?o (ρ= 0,001), menor tempo de tratamento (ρ =0,000) e com maior n?mero de fatores de cicatriza??o (ρ= 0,005).

Made available in DSpace on 2014-12-17T14:46:46Z (GMT). No. of bitstreams: 1 IsabelleKFC_DISSERT.pdf: 1938690 bytes, checksum: 22cd4a4b6a66ab1a100e508363b67a58 (MD5) Previous issue date: 2011-03-29 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / Venous ulcer (VU) is a lower limbs injury resulting from inadequate return of venous blood in feet or legs. Although it is not a deadly disease, it causes chronic wounds, which seriously undermine patients? quality of life (QOL) and sometimes leads to drastic family, social, economic and psychological changes. In this sense, there are several aspects that may influence the venous ulcers patients? QOL. The study?s objective aimed on the association of socio-demographic and health, health care and clinical injury on UV patients‟ QOL. Analytical studies, which consider the complexity of factors involved in changes in UV patients‟ QOL has a cross-sectional and quantitative approach. The HUOL Ethics Committee approved this project (n.279/09). The collection of data lasted a period of 3 months in 2010 and it took place at the clinic of Angiology at Hospital Universit?rio Onofre Lopes (HUOL). The data sample consisted of 60 patients treated by UV angiologists in the HUOL Surgical Clinic. The results were analyzed with SPSS 15.0 by descriptive and inferential statistics. The study was based on UV patients that were predominantly female, average age of 61.4 years, that had low education level and low family income, with occupations requiring long periods of standing or sitting, but mostly retired, unemployed or laid off due to the disease and/or due to chronic diseases associated with the UV. The study took also into consideration patients that used inappropriate products, that were improperly treated by a professional caregiver, that lacked of adequate guidance and compression therapy, that performed no lifting of the lower limbs and regular exercise, that the time of injury were greater than or equal to six months, that were missing specific laboratory tests. The study‟s reference were on recurrent lesions, medium to large lesions area, bed of the lesion (injuries) with fibrin and/or necrosis, with amount of exudate with medium to large, odorless and no signs of infection, with tissue loss between 1st and 2nd degree, without collecting swab or biopsy and with pain. In general, QOL of researched individuals were considered low, the maximum score was 69 points, which the areas that were mostly influenced were the total scores of QOL functional capacity (0.021), emotional (0.000) and social functioning (0.080). Of the 60 individuals, 53.3% had scores between 40 and 69 points in SF-36, and they had the best scores in sociodemographic and health variables (ρ = 0.049). In respect to the assistance and injury characteristics, patients who scored between 40 and 69 points in SF-36 had better scores on these characteristics. By combining the socio-demographic variables, health, and handling characteristics of the injury, we observed a significant difference (ρ = 0.032) when linking them with the QOL total scores. When analyzing separately the domains of the SF-36 scores on the quality of life, we find that the areas that showed statistical significance were functional ability (ρ = 0.035), appearance (ρ = 0.019), emotional (ρ = 0.000), and mental health (ρ = 0.050). Among the socio-demographic characteristics studied, gender and marital status contributed more to the reduction of QOL and among the variables of assistance and the injury, orientation, reference and area of UV contributed the most. By analyzing these five variables all together in accordance with the overall score obtained in the quality of life, we found a significant correlation (ρ = 0.002); with 6.23 times more chances of patients have better QOL in the presence of these five positive factors. By conducting the Mann Whitney U test between all the five demographic variables, health, and clinical care, we found that this combination also proved to be significant (ρ = 0.006). Therefore, patients with these five variables positive tend to have a better QOL. Based on these results, we reject the null hypothesis (H0) and accept the alternative hypothesis (H1) proposed in this study because we noted that the QOL of patients with UV is associated with sociodemographic and health, health care and clinical aspects of the injury / A ?lcera Venosa (UV) ? uma les?o dos membros inferiores resultante do inadequado retorno de sangue venoso nos p?s ou pernas. Embora n?o fatais, tais feridas cr?nicas comprometem seriamente a qualidade de vida (QV) dos doentes trazendo mudan?as por vezes dr?sticas no ?mbito familiar, social, econ?mico e psicol?gico. Nesse sentido, s?o diversos os aspectos que podem estar associados ? QV da pessoa com UV. O estudo teve o objetivo de analisar a associa??o dos aspectos sociodemogr?ficos e de sa?de, de assist?ncia ? sa?de e cl?nicos da les?o na QV dos portadores de UV. Estudo anal?tico, com delineamento transversal e abordagem quantitativa. O projeto obteve parecer favor?vel do Comit? de ?tica do HUOL (n.279/09). A coleta de dados realizou-se no ambulat?rio de angiologia do Hospital Universit?rio Onofre Lopes (HUOL), num per?odo de tr?s meses em 2010. A amostra foi de 60 pessoas com UV atendidos por angiologistas no ambulat?rio de Cl?nica Cir?rgica do HUOL. Os resultados foram processados no programa SPSS 15.0 por estat?stica descritiva e inferencial. Identificamos usu?rios com UV predominantemente do sexo feminino, idade m?dia de 61,4 anos, baixo n?vel de escolaridade e de renda familiar, com profiss?es que exigiam longos per?odos em p? ou sentados, aposentados, desempregados ou afastados do trabalho devido ? doen?a e com doen?as cr?nicas associadas, em uso de produtos inadequados, curativos realizados por profissional ou cuidador sem treinamento, aus?ncia de terapia compressiva e orienta??es adequadas, sem realizar eleva??o de membros inferiores e exerc?cios regulares, com tempo de les?o maior ou igual a seis meses, falta de exames laboratoriais espec?ficos, sem registro no prontu?rio, com les?es recidivantes, ?rea de m?dia a grande, leito da les?o com fibrina e/ou necrose, exsudato com quantidade de m?dia a grande, sem odor e sinais de infec??o, perda tecidual entre grau I e II, sem coleta de swab ou biopsia e com presen?a de dor. Em geral, a QV dos pesquisados foi considerada baixa, com pontua??o m?xima de 69 pontos. Sendo os dom?nios que mais influenciaram nos escores totais da QV a capacidade funcional (0,021), aspecto emocional (0,000) e aspecto social (0,080). Dos 60 pesquisados, 53,3% tiveram pontua??o entre 40 a 69 pontos no SF-36, e apresentaram os escores melhores nas vari?veis sociodemogr?ficas e de sa?de (ρ=0,049). Quanto ?s caracter?sticas da assist?ncia e da les?o, os pacientes que tiveram pontua??o entre 40 a 69 pontos no SF-36 apresentaram escores melhores em tais caracter?sticas. Ao associar as vari?veis sociodemogr?ficas, de sa?de, caracter?sticas da assist?ncia e da les?o, verificamos que houve uma diferen?a significante (ρ=0,032) ao relacion?-las com o escore total da QV. Analisando separadamente os dom?nios do SF-36 com os escores obtidos na QV, verificamos que os dom?nios que apresentaram signific?ncia estat?stica foram a capacidade funcional (ρ= 0,035), aspecto f?sico (ρ= 0,019), aspecto emocional (ρ= 0,000) e sa?de mental (ρ= 0,050). Dentre as caracter?sticas sociodemogr?ficas estudadas, o sexo e estado civil contribu?ram mais para a redu??o da QV; e entre as vari?veis da assist?ncia e da les?o destacam-se as vari?veis: orienta??es, refer?ncia e ?rea da UV. Ao analisarmos o conjunto dessas cinco vari?veis de acordo com o escore geral obtido na QV, verificamos correla??o significativa (ρ= 0,002), sendo 6,23 vezes maior a chance de os pacientes apresentarem melhor QV na presen?a desses cinco fatores positivos. Ao realizarmos o Teste de Mann Whitney U entre o conjunto das cinco vari?veis sociodemogr?ficas, de sa?de, cl?nica e assistencial, verificamos que tal conjunto tamb?m demonstrou ser significativo (ρ=0,006). Portanto, os pacientes que apresentam essas cinco vari?veis positivas tendem a ter melhor QV. Diante dos resultados obtidos, rejeitamos a hip?tese nula (H0) e aceitamos a hip?tese alternativa (H1) proposta no estudo, pois evidenciamos que a QV dos portadores de UV est? associada aos aspectos sociodemogr?ficos e de sa?de, de assist?ncia ? sa?de e dos aspectos cl?nicos da les?o

Made available in DSpace on 2014-12-17T14:46:57Z (GMT). No. of bitstreams: 1 AnaBAM_DISSERT.pdf: 1776639 bytes, checksum: 9dc2b0f2bd1577d9a228259236a9a66f (MD5) Previous issue date: 2013-02-01 / The venous ulcer is an epidemiological problem of high prevalence, causing disability and dependence. Assess the tissue impairment level of patients with venous lesions, within a nursing referential, is relevant for the implementation of a directed assistance to specific clientele. Thus, this work aims to characterize the health status regarding the integrity the lower limbs skin of patients with venous ulcers, according to the of tissue integrity outcome indicators from the Nursing Outcomes Classification. A cross-sectional study conducted in a university hospital in Natal - Rio Grande do Norte. The sample consisted of 50 participants, selected through consecutive sampling. Data collection occurred through a interview and physical examination form and a operational definitions tool for indicators of the nursing Tissue Integrity outcome directed to patients with venous ulcer, applied from February to June 2012. Data analysis was done by descriptive statistics and nonparametric tests (Spearman, Kruskal-Wallis and Mann-Whitney tests). The project was approved by the Research Ethics Committee with protocol 608/11 and Presentation Certificate to Ethical Consideration No. 0038.0.294.000-11. The results were presented using three scientific articles derivatives of research. It was found that the indicators show moderate impairment, light and not impaired, as the median. The respondents had an average of 59.72 years, 66% female, 50% were retired, 60% with a partner, 44% had arterial hypertension, 26% allergies, 20% diabetes mellitus, 96% were sedentary, 14% drank alcohol and 6% were smokers. There was a statistically significant correlation of low intensity between age and hydration (p=0.032; rs=-0.304) and skin desquamation (p=0.026; rs=-0.316), family income and necrosis (p=0.012; rs=-0.353); Ankle Brachial Index and tissue perfusion (p=0,044; rs=-0,329); Diabetes Mellitus and texture (p=0.015) and tissue perfusion (p=0.026); allergy and texture (p=0.034), physical activity and hydration (p=0.034), smoking and thickness (p=0.018), and alcohol consumption and exudate (p=0.045). We conclude that the patients had light to moderate impairment, indicating a good state of health on the integrity of the skin of the lower limbs, according to the indicators of the outcome of tissue integrity Classification Nursing Outcomes valued in the present study. It is believed that the evaluation of impairment tissue using a self-nursing system and its relation with socioeconomic, clinical and risk factors are unique tools in the care planning and in the wound healing / A ?lcera venosa ? um problema epidemiol?gico de alta preval?ncia, que provoca incapacidade e depend?ncia. Avaliar o n?vel de comprometimento tissular de pacientes com les?es venosas, dentro de um referencial pr?prio da Enfermagem, ? relevante para a implementa??o de uma assist?ncia direcionada ?s especificidades da clientela. Destarte, o objetivo deste trabalho ? caracterizar o estado de sa?de referente ? integridade da pele dos membros inferiores de pacientes com ?lcera venosa, de acordo com os indicadores do resultado Integridade tissular da Classifica??o dos Resultados de Enfermagem. Estudo transversal, realizado em um hospital universit?rio de Natal - Rio Grande do Norte. A amostra foi composta por 50 participantes, selecionados por amostragem consecutiva. A coleta dos dados aconteceu atrav?s de um formul?rio de entrevista e exame f?sico e de um instrumento de defini??es operacionais para indicadores do resultado de enfermagem Integridade tissular direcionado aos pacientes com ?lcera venosa, aplicados nos meses de fevereiro a junho de 2012. A an?lise dos dados se deu por meio de estat?stica descritiva e testes n?o-param?tricos (teste de Spearman, Kruskal-Wallis e Mann-Whitney). O projeto foi aprovado pelo Comit? de ?tica em Pesquisa com protocolo 608/11 e Certificado de Apresenta??o para Aprecia??o ?tica n? 0038.0.294.000-11. Os resultados foram apresentados por meio de 3 artigos cient?ficos derivados da pesquisa. Verificou-se que os indicadores apresentam comprometimento moderado, leve e n?o comprometido, quanto ? mediana. Os entrevistados tinham uma m?dia de 59,72 anos, 66% do sexo feminino, 50% aposentados e 60% com companheiro, 44% apresentavam hipertens?o arterial, 26% alergias, 20% Diabetes Mellitus, 96% eram sedent?rios, 14% consumiam bebidas alco?licas e 6% eram fumantes. Houve correla??o estatisticamente significativa, de intensidade fraca, entre idade e hidrata??o (p=0,032; rs=-0,304) e descama??o cut?nea (p=0,026; rs=-0,316); renda familiar e necrose (p=0,012; rs=-0,353); ?ndice Tornozelo/Braquial e perfus?o tissular (p=0,044; rs=-0,329); Diabetes Mellitus e textura (p=0,015) e perfus?o tissular (p=0,026); alergia e textura (p=0,034); atividade f?sica e hidrata??o (p=0,034); tabagismo e espessura (p=0,018); e etilismo e exsudato (p=0,045). Conclui-se que os pacientes apresentaram comprometimento de leve a moderado, indicando um bom estado de sa?de referente ? integridade da pele dos membros inferiores, de acordo com os indicadores do resultado Integridade tissular da Classifica??o dos Resultados de Enfermagem avaliados no presente estudo. Acredita-se que a avalia??o do comprometimento tissular utilizando um sistema pr?prio da enfermagem e a rela??o deste com fatores socioecon?micos, cl?nicos e de risco, s?o ferramentas singulares no planejamento da assist?ncia e no processo de cicatriza??o tecidual

Made available in DSpace on 2015-03-03T14:03:54Z (GMT). No. of bitstreams: 1 Sarah_DVM_DISSERT_PARCIAL.pdf: 746876 bytes, checksum: f638a2adc04ebb6e7a39258725abbfde (MD5) Previous issue date: 2009-09-28 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / Uma glucana insol?vel foi isolada de fermento biol?gico (Saccharomyces cerevisiae), o qual foi submetido a um tratamento com base e o res?duo acidificado. An?lises qu?micas e resson?ncia magn?tica nuclear (NMR) em uma e duas dimens?es (1D e 2D) mostraram que uma ?-(1 3) glucana linear foi purificada, a qual n?o estava contaminada com outros carboidratos, prote?nas ou compostos fen?licos. Os efeitos desta glucana na cicatriza??o de feridas foi avaliado em ?lceras venosas humanas por an?lise histopatol?gica ap?s 30 dias de tratamento. A ?-(1 3) glucana favoreceu a cicatriza??o das ?lceras, promovendo o aumento da hiperplasia epitelial, das c?lulas inflamat?rias, angiog?nese e prolifera??o fibrobl?stica. Este foi o primeiro estudo que investigou o efeito da ?-(1 3) glucana na cicatriza??o de ?lceras venosas em humanos. Os achados sugerem que a glucana ? um potente modificador da resposta biol?gica na cicatriza??o de feridas

Made available in DSpace on 2014-12-17T15:16:20Z (GMT). No. of bitstreams: 1 CibeleTDR_DISSERT.pdf: 1600601 bytes, checksum: 17a20c970bdc4a9e7d51aa44c7922b20 (MD5) Previous issue date: 2014-02-04 / Chronic venous disease (CVD) is evident among the chronic diseases and affects the elderly population and primarily is responsible for leg ulcers in this population. The use of dressings in the care of a venous ulcer is a fundamental part of the treatment for healing, however, evidence to assist in choosing the best dressing is scarce. The main objective of this study was to evaluate the effectiveness of treatment with hydrogel in the healing of venous ulcers using search methods, synthesis of information and statistical research through a systematic review and meta-analysis. Randomized controlled trials were selected in the following databases: CENTRAL; DARE; NHS EED; MEDLINE; EMBASE; CINAHL. Beyond these databases three websites were consulted to identify ongoing studies: ClinicalTrials.gov, OMS ICTRP e ISRCTN. The primary outcomes were analyzed: complete wound healing, incidence of wound infection and the secondary were: changes in ulcer size, time to ulcer healing, recurrence of ulcer, quality of life of participants, pain and costs of treatment. Four studies are currently included in the review with a total of 250 participants. The use of hydrogel appears to be superior to conventional dressing, gauze soaked in saline, for the healing of venous leg ulcers; 16/30 patients showed complete healing of ulcers (RR 5,33, 95%CI [1,73,16,42]). The alginate gel was shown to be more effective when compared to the hydrogel dressing in reduction of the wound area; 61,2% (? 26,2%) with alginate e 19,4% (? 24,3%) with hydrogel at the end of four weeks of treatment. Manuka honey has shown to be similar to the hydrogel dressings in percentage of area reduction. This review demonstrated that there is no evidence available about the effectiveness of the hydrogel compared to other types of dressings on the healing of venous leg ulcers of the lower limbs, thus demonstrating the need of future studies to assist health professionals in choosing the correct dressing. / A doen?a venosa cr?nica (DVC) evidencia-se entre as doen?as cr?nicas por acometer a popula??o idosa e ser a principal respons?vel pelas ?lceras de membros inferiores nesta popula??o. O uso de adesivos no cuidado de uma ?lcera venosa ? parte fundamental no tratamento para a cicatriza??o, no entanto, as evid?ncias para auxiliar na escolha do melhor adesivo s?o escassas. O objetivo principal do estudo foi avaliar a efic?cia do tratamento com o hidrogel na cicatriza??o de ?lceras venosas mediante m?todos de busca, s?ntese de informa??o e an?lise estat?stica atrav?s de uma revis?o sistem?tica com meta-an?lise. Foram selecionados estudos controlados randomizados nas seguintes bases de dados: CENTRAL; DARE; NHS EED; MEDLINE; EMBASE; CINAHL. Al?m dessas bases foram consultados tr?s websites para identificar estudos em andamento: ClinicalTrials.gov, OMS ICTRP e ISRCTN. Os desfechos prim?rios analisados foram: cicatriza??o completa das ?lceras e incid?ncia de infec??o das ?lceras e os secund?rios foram: altera??es no tamanho da ?lcera, tempo de cicatriza??o das ?lceras, recorr?ncia das ?lceras, qualidade de vida dos participantes, dor e custos do tratamento. Quatro estudos est?o atualmente inclu?dos na revis?o com um total de 250 pacientes. O uso do hidrogel parece ser superior ao curativo convencional, gaze embebida em salina, para a cicatriza??o de ?lceras venosas de membros inferiores; 16/30 pacientes apresentaram cicatriza??o completa das ?lceras (RR 5,33, 95%CI [1,73,16,42]). O gel de alginato demonstrou ser mais efetivo quando comparado ao hidrogel quanto ? redu??o da ?rea da ?lcera; 61,2% (? 26,2%) com o alginato e 19,4% (? 24,3%) com o hidrogel ao final das quatro semanas de tratamento. O mel de Manuka demonstrou ser similar ao hidrogel em rela??o ? porcentagem de redu??o da ?rea. Esta revis?o mostrou que n?o existem evid?ncias dispon?veis a respeito da efic?cia do hidrogel em rela??o aos outros tipos de curativo na cicatriza??o de ?lceras venosas de membros inferiores, demonstrando assim a necessidade de futuras pesquisas para auxiliar os profissionais da sa?de na escolha do adesivo correto