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Avalia??o da sa?de mental e da qualidade de vida relacionada ? sa?de de crian?as brasileiras com asmaArmelin, Bruna Dal Fiume 31 March 2017 (has links)
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Previous issue date: 2017-03-31 / Introduction: Asthma is an inflammatory disease of the airways that affects millions of
children and adolescents, being considered the most common chronic disease in childhood. The
treatment of asthma is usually effective for most symptoms, but this does not mean that the
patient will not suffer any influence in his daily life because he is a carrier of this chronic
disease. Respiratory symptoms, sleep impairment, and school absenteeism are some of the
reasons that may hinder the healthy development of the patient, which is in the middle of a
crucial stage of life for proper emotional development. For a comprehensive treatment of the
asthmatic patient, one should evaluate how the limitations and symptoms of the disease interfere
in mental health, since emotional effects also influence asthma. Psychological disorders have
been little studied in children with asthma. Objective: To evaluate the mental health and quality
of life of children diagnosed with asthma in outpatient care. Methods: A prospective crosssectional
study was conducted with children and adolescents with asthma between the ages of
7 and 17 years, in outpatient follow-up. Questionnaires were used to assess anxiety (SCARED),
depression (CDI), difficulties (SDQ) and health-related quality of life (PAQLQ). Results: 33
children participated in the study. The mean age was 11.3 ? 2.6, with 60.6% of females. 24.2%
of the children presented scores suggestive of depression, but only 9.1% of the parents reported
a perception of this disorder. The scores assessed for anxiety were elevated for the five domains
and for the total score, but showed very similar scores and no statistical differences when
compared with control of disease (p = 0.153, 0.287, 0.539, 0.503, 0.490 and 0.122,
consecutively ). 87.9% reported abnormal scores on abilities and difficulties (SDQ), according
to parents' perception, with the main limitations being the domains of emotional problems
(57.6%). In the assessment of asthma-related health-related quality of life (PAQLQ) correlating
domains and total scores between the controlled and uncontrolled asthma groups, the scores
demonstrated a significant positive correlation between the increase in ACT/C-ACT score and
increased domain scores and total PAQLQ scores. Conclusion: Anxiety and depression appear
to be common disorders in children with asthma. The evaluation of abilities and difficulties
indicated a high index of abnormal values. Parents' perceptions are not consistent with the
children's reports regarding symptoms of depression, but they show a greater similarity to the
symptoms of anxiety. The high rates of interference in the mental health of children with asthma
require greater attention to psychological aspects in the follow-up of these patients. / Introdu??o: a asma ? uma doen?a inflamat?ria das vias a?reas que acomete milh?es de crian?as
e adolescentes, sendo considerada a patologia mais comum na inf?ncia. O tratamento da asma
costuma ser efetivo para a maioria dos sintomas, mas isso n?o significa que o paciente n?o
sofrer? influencias no seu cotidiano por ser portador dessa doen?a cr?nica. Sintomas
respirat?rios, preju?zo no sono e prov?veis faltas escolares s?o alguns dos motivos que podem
prejudicar o desenvolvimento saud?vel do jovem, que atravessa uma fase de vida crucial para
o adequado desenvolvimento emocional. Para um tratamento integral do paciente asm?tico,
deve-se avaliar como as limita??es e os sintomas da doen?a interferem na sua sa?de mental, j?
que efeitos emocionais tamb?m influenciam a asma. Transtornos psicol?gicos tem sido pouco
estudados ainda em crian?as com asma. Objetivo: Avaliar a sa?de mental e a qualidade de vida
de crian?as com diagn?stico de asma em acompanhamento ambulatorial. M?todos: foi
realizado um estudo transversal prospectivo com crian?as e adolescentes com asma, entre 7 e
17 anos, em acompanhamento ambulatorial. Foram aplicados question?rios para avaliar a
ansiedade (SCARED), a depress?o (CDI), as dificuldades (SDQ) e a qualidade de vida
relacionada a sa?de (PAQLQ). Resultados: participaram do estudo 33 crian?as. A idade m?dia
foi de 11,3?2,6, sendo 60,6% do sexo feminino. 24,2% das crian?as apresentaram valores
sugestivos de depress?o, mas apenas 9,1% dos pais relataram percep??o desse transtorno. Os
valores avaliados para ansiedade foram elevados para os cinco dom?nios e para o escore total,
mas demonstraram valores muito semelhantes e sem diferen?as estat?sticas quando levado em
compara??o o controle da doen?a (p=0,153; 0,287; 0,539; 0,503; 0,490 e 0,122,
consecutivamente). 87,9% relataram escores anormais na avalia??o das capacidades e
dificuldades (SDQ), segundo percep??o dos pais, tendo como principais limita??es os dom?nios
de problemas emocionais (57,6%). Na avalia??o da qualidade de vida relacionada ? sa?de por
asma (PAQLQ), correlacionando os dom?nios e escore total entre os grupos de asma controlada
e n?o controladas, os valores expressos demonstram uma correla??o positiva expressiva entre
o aumento da pontua??o do ACT/C-ACT e o aumento da pontua??o dos dom?nios e escore total
do PAQLQ. Conclus?o: ansiedade e depress?o parecem ser transtornos comuns em crian?as
com asma. A avalia??o das capacidades e dificuldades indicou alto ?ndice de valores anormais.
A percep??o dos pais n?o condiz com o relato das crian?as com rela??o a sintomas de depress?o,
mas mostra maior similaridade com rela??o aos sintomas de ansiedade. Os elevados ?ndices de
interfer?ncia na sa?de mental de crian?as com asma mostram a necessidade de maior aten??o
aos aspectos psicol?gicos no acompanhamento desses pacientes.
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