L’insuffisance rénale chronique (IRC) est une pathologie entraînant des complications sur la santé. Au stade terminal, le patient doit avoir recours à un traitement curatif. La qualité de vie s’en retrouve altérée et l’identité de la personne en est malmenée. L’activité physique adaptée (APA), ancrée dans un programme d’éducation thérapeutique du patient, va octroyer de nouveaux rôles. Nous nous intéressons à 10 patients IRC qui bénéficient d’un programme d’APA durant 6 mois. La pensée systémique de la santé nous permet d’évaluer les effets de cette prise en charge globale sur les dynamiques identitaires des patients. Le recours à la méthode mixte nous donne l’occasion de combiner des mesures quantitatives et qualitatives. Le programme APA se centre sur le patient qui devient acteur et prend alors possession d’une identité propre qui fluctue au même rythme que la maladie. L’APA va alors servir de support et de fil d’Ariane, comme une ligne constante dans cet état mouvant. / Chronickidneydisease (CKD) leads to health complications. At the end-stage, CKD patients need to undergo curative treatment. Adapted physical activity (APA) implemented through a therapeutic patient education programme, gives them new roles. This study examines 10 CKD patients involved in an APA programme for 6 months. Systemic thinking in health enables us to evaluate the effects of global patient care on their identity dynamics. A mixed-method approach gives us the opportunity to combine quantitative and qualitative measurements. The APA programme focuses on patients who play an active role and take ownership of their own identity. Reconstruction of individual identity is continuous. It fluctuates in relation with the disease. APA acts as a support for patients, guiding them as a steady guideline through their shifting condition.

Submitted by Cássia Santos (cassia.bcufg@gmail.com) on 2015-01-30T10:30:43Z No. of bitstreams: 2 license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Dissertacao - Victoria Araujo Ganzaroli Amador - Nutricao - 2014.pdf: 1063435 bytes, checksum: b8e4c4199661a67af87da230149f1de2 (MD5) / Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2015-01-30T12:16:53Z (GMT) No. of bitstreams: 2 license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Dissertacao - Victoria Araujo Ganzaroli Amador - Nutricao - 2014.pdf: 1063435 bytes, checksum: b8e4c4199661a67af87da230149f1de2 (MD5) / Made available in DSpace on 2015-01-30T12:16:53Z (GMT). No. of bitstreams: 2 license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Dissertacao - Victoria Araujo Ganzaroli Amador - Nutricao - 2014.pdf: 1063435 bytes, checksum: b8e4c4199661a67af87da230149f1de2 (MD5) Previous issue date: 2014-03-31 / Fundação de Amparo à Pesquisa do Estado de Goiás - FAPEG / Weight excess is one of the risk factors of chronic kidney disease, so it is important to evaluate the nutritional status of population with renal function markers to monitor and prevent the increase of renal failure. The aims of this study was to evaluate the association of nutritional status indicators and renal function markers in adults and seniors. It is a cross-sectional study with 279 adults and seniors assisted by eight primary healthcare units from east Goiânia. Data were collected utilizing a standard questionnaire which included sociodemographic, life style and clinical information. Body mass index and waist circumference were taken for nutritional status evaluation; chronic kidney disease was defined as an glomerular filtration rate of less than 60 mL/min/1,73m²; microalbuminury were considerated with albumin/creatinine ratio righer than 30mg/g.Chronic kidney disease was prevalent in 8.9% and microalbuminuria in 34.8%. The prevalence of overweight was 57%. Waist circumference and body mass index had a positive association with the glomerular filtration rate, characterized as glomerular hyperfiltration. Microalbuminuria had a positive association with body mass index in women. There were a high prevalence of chronic kidney disease and overweight in the studied population. The overweight had a positive association with the glomerular filtration rate. Body mass index should be often used as it is a cheap and efficient anthropometric measurement method and is an early detection indicator of renal function in population / O excesso de peso é um dos fatores de risco para doença renal crônica e com isso, torna-se importante a avaliação nutricional da população associada à avaliação de marcadores de função renal a fim de monitorar e controlar o aumento da prevalência de insuficiência renal. O objetivo deste trabalho foi avaliar a associação entre indicadores do estado nutricional e marcadores da função renal em adultos e idosos. Trata-se de um estudo transversal realizado com 279 adultos e idosos atendidos por oito Unidades de Atenção Básica à Saúde da Família da Região Leste de Goiânia, por meio de visitas domiciliares. Foram coletados dados socioeconômicos, de estilo de vida e clínicosutilizando-se questionário padronizado. Para avaliação do estado nutricional foi considerado o Índice de Massa Corporal e circunferência da cintura.Para o diagnóstico de doença renal crônica foi considerada uma taxa de filtração glomerular <60 mL/min/1,73m² e para detecção de presença de microalbuminúria foi considerada a relação albumina/creatinina urinária > 30mg/g. A prevalência de doença renal crônica encontrada foi de 8,9%, enquanto que de albuminúria foi de 34,8%. O excesso de peso foi detectado em 57% da população. Houve associação significativa do índice de massa corporal e circunferência da cintura com a taxa de filtração glomerular, caracterizando um quadro de hiperfiltração glomerular. Quanto à albuminúria, a associação foi encontrada somente para o índice de massa corporal aumentado em mulheres. A amostra apresentou alta prevalência de doença renal crônica e excesso de peso, sendo que os indicadores antropométricos apresentaram associação positiva com a taxa de filtração glomerular. Com isso, sugere-se que o índice de massa corporal, um método barato e de fácil aplicabilidade, seja usado como indicador precoce para detecção de alterações na função renal em grupos de risco para doença renal crônica.