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Evid?ncias de validade do Millon Behavioral Medicine Diagnostic: avalia??o de indicadores de ades?o ao tratamento em pacientes com hipertens?oDantas, Brenda Luanna Fernandes Cort?s 13 August 2014 (has links)
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Previous issue date: 2014-08-13 / A Hipertens?o Arterial Sist?mica - HAS- ? definida como s?ndrome cuja caracter?stica principal ? a presen?a de n?veis tensionais elevados, associada a altera??es de n?veis funcionais ou estruturais nos ?rg?os aos quais atinge. Suas causas espec?ficas n?o s?o bem delimitadas e possui car?ter assintom?tico. Devido ? sua cronicidade exige ader?ncia ao plano de tratamento de forma permanente e sistem?tica, implicando em mudan?as no estilo de vida, combinadas ou n?o com uso de medicamentos. Os invent?rios de personalidade t?m sido largamente utilizados no delineamento de tra?os indicativos de dificuldades com ades?o ao tratamento. Nesse sentido, desenvolvido por Theodore Millon, o Millon Behavioral Medicine Diagnostic - MBMD ? um instrumento elaborado a partir do consenso entre profissionais de sa?de, visando identificar fatores psicol?gicos que venham a comprometer tratamentos m?dicos para que sejam conduzidos de modo a viabilizar uma melhor ades?o. Objetivos: avalia??o de evidencias de validade do Millon Behavioral Medicine Diagnostic - MBMD para p?blico de pacientes com hipertens?o, com vistas ? investiga??o de indicadores implicados na ades?o ou n?o ao tratamento anti-hipertensivo. M?todo: contou-se com amostra de 200 participantes, dos sexos masculino e feminino, com faixa et?ria entre 20 e 70 anos, recrutados presencialmente em um Hospital Universit?rio da cidade de Natal/RN. Foi administrado um protocolo de entrevista para obter informa??es sobre dados s?cio demogr?ficos, hist?ria cl?nica, h?bitos de cuidado e forma de conduzir o tratamento, e posteriormente segui-se a administra??o do pr?prio MBMD. Resultados: Por meio de An?lise Fatorial Confirmat?ria verificou-se que a organiza??o proposta pelos fatores ? favor?vel e se ajusta ? teoria, permitindo a visualiza??o de outros constructos subjecentes ?s escalas, com ?ndices de ajustes adequados e indicadores satisfat?rios de Alpha de Cronbach. Al?m disso, o MBMD revelou-se sens?vel ?s diferen?as intragrupais quanto as vari?veis sexo, idade, escolaridade, estado civil, profiss?o, renda, hist?rico de HAS, tempo de diagn?stico, uso de medica??o, presen?a de comorbidades, acompanhamento m?dico, uso de ?lcool e tabaco, dieta hiposs?dica, suporte social e crit?rios de ades?o. A utiliza??o de tal instrumento na avalia??o de ades?o ao tratamento anti-hipertensivo apresenta, portanto, indicadores de validade. / Systemic Arterial Hypertension ? SAH ? is defined as the syndrome which its main feature is the presence of high tensional levels, associated with alterations of functional or structural levels in the organs that it strikes. Its specific causes are not very well bounded and have an asymptomatic character. Due to its chronicity it requires adherence to the treatment plan in a systematic and permanent manner, implicating in lifestyle changes, combined or not with the use of medication. The personality inventories have been largely used in the lineation of indicative traits of difficulties with the adherence to the treatment. In this sense, developed by Theodore Millon, the Millon Behavioural Medicine Diagnostic ? MBMD is an instrument made from the consensus among healthcare professionals, aiming at identifying psychological factors that may compromise medical treatment so that they can be conducted in a way to enable a better adherence. Objective: evaluation of the evidence of validity of the Millon Behavioural Medicine Diagnostic ? MBMD for a public of patients with hypertension, aiming at investigating the indicators implicated in the adherence or not to the anti-hypertensive treatment. Method: there was a group of 200 participants in a university hospital in the city of Natal/RN, males and females, ranging from 20 to 70 years old. An interview protocol was administered in order to obtain information about socio-demographic data, clinical history, healthcare habits and way of conducting treatment, and after, the administration of the MBMD followed. Results: by means of Factor Analysis it was verified that the organization proposed by the factors is favorable and it adjusts to the theory, allowing the visualization of other underlying constructs to the scales, with adequate adjustment indexes and satisfactory Cronbach?s alpha indicators. Besides, the MBMD revealed itself sensitive to the intragroup differences relative to the sex, age, schooling, marital status, profession, income, SAH history, diagnostic time, medication use, comorbidity presence, hyposodic diet, social support and adherence criteria variables. The utilization of such instrument in the evaluation of the adherence to the anti-hypertensive treatment show, therefore, indicators of validity.
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A forma??o de um grupo de hipertensos para o autocuidado: uma pesquisa-a??oMaia, Joel D?cio de Souza 12 August 2016 (has links)
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Previous issue date: 2016-08-12 / Os modos de viver das pessoas mudaram consideravelmente nas ?ltimas d?cadas, em todo o mundo, sobretudo em pa?ses em desenvolvimento como o Brasil. Essas mudan?as trouxeram novas formas de adoecer, com destaque para as doen?as cr?nicas e as degenerativas. Uma das doen?as cr?nicas que mais acomete as sociedades contempor?neas, inclusive a brasileira, ? a hipertens?o arterial sist?mica, que tem alta preval?ncia e se configura como um grande risco para doen?as do sistema circulat?rio. A Estrat?gia de Sa?de da Fam?lia est? na primeira linha de enfrentamento dessa patologia e necessita de a??es que tenham sustentabilidade nessa empreitada. Por essa raz?o, consideramos importante desenvolver um estudo para detectar a percep??o de uma equipe da Estrat?gia de Sa?de da Fam?lia acerca da forma??o de grupos, do conceito e da import?ncia do autocuidado e da Educa??o Popular em Sa?de, para, a partir de ent?o, formar um grupo de autocuidado para usu?rios portadores de hipertens?o arterial ? luz da Educa??o Popular em Sa?de. Os instrumentos empregados para a coleta dos dados foram uma entrevista com os profissionais da Estrat?gia Sa?de da Fam?lia para conhecer sua percep??o a respeito do tema foco da pesquisa, e um di?rio de campo, para captar outras informa??es. A an?lise dos dados coletados foi feita com base na An?lise de Conte?do proposta por Bardin. No final do estudo, conclu?mos que os trabalhadores que comp?em a equipe estudada tinham uma percep??o limitada de educa??o em sa?de, que a entendem basicamente como forma de prevenir doen?as, como uma forma de educar e informar a popula??o e desconhecem o modelo proposto pela Educa??o Popular em Sa?de. As pr?ticas desenvolvidas pela equipe eram basicamente palestras proferidas na comunidade sem cronograma ou regularidade. Problemas como apenas parte da equipe desenvolvendo as a??es de educa??o em sa?de, falta de ades?o de alguns profissionais a essas pr?ticas e calend?rios de atendimento muito apertados e incompat?veis foram alguns dos entraves que constatamos na realidade pesquisada. Os trabalhadores da equipe t?m alguma experi?ncia com o trabalho com grupos de usu?rios e boas expectativas quanto aos resultados que um grupo de usu?rios portadores de hipertens?o arterial pode trazer, por?m a maioria n?o sabe o quanto ? importante o autocuidado para essas pessoas. Para discutir sobre esse tema com a equipe, ministramos oficinas, por meio das quais pudemos confirmar esses resultados e concluir que a equipe precisa se engajar nas atividades de educa??o em sa?de e ter uma agenda de trabalho para que esses momentos sejam respeitados, al?m de mais espa?os para discutir sobre esses e outros temas. Depois das oficinas de capacita??o, a equipe optou por organizar uma a??o experimental seguindo os moldes da Educa??o Popular em Sa?de pela equipe para os hipertensos da ?rea de abrang?ncia, a qual trouxe excelentes resultados e sustentabilidade no ?mbito local. Acreditamos que essa foi a semente plantada para fundar o grupo de hipertensos, com vistas ao autocuidado, guiado pela Educa??o Popular em Sa?de, e o in?cio da mudan?a das pr?ticas de educa??o desenvolvidas pela referida equipe. / Throughout the world the lifestyle of people have changed drastically in the last decades, especially in developing countries like Brazil. These changes brought new ways of getting ill, among these illnesses stand above chronic and degenerative diseases. One of the illnesses of most incidence in contemporary society is hypertension, including in Brazil, which is in high prevalence and is of a great risk to diseases in the circulatory system. Brazil's Family Health Strategy is prioritizing the cope of this pathology and it needs sustainable actions in this matter. Considering this, it turned out to have a great value to develop a study in order to find out the perception of a team of the Family Health Strategy regarding the formation of groups, concept and importance of self-care and Popular Health Education. Promoting from that the formation of a group of self-care to users carriers of hypertension under the light of the Popular Health Education. As data collection instrument an interview was performed in order to acknowledge the perception of such professionals regarding the subject approached. To collect other kinds of information we used a field journal. The data analysis was based on Bardin's content analysis. At the end of the study, we were able to observe that the workers of the chosen team have a limited perception of health education, understanding it as only a way of preventing diseases and as a way of educate and inform the population. They do not understand the model proposed by the Popular Health Education. The practices currently developed by the team are basically lectures performed in the community without schedule, not even following a regular basis. Problems such as only part of the team developing the actions of health education, some professionals not willing to be part of such practices and a very tight or incompatible schedule are some of the existing hinders found in the reality studied. The workers of the team studied presented some experience working with user groups. They have good expectations of which positive results a group of hypertensive patients may bring, however, most of them do not know the importance of self-care to those patients. It was necessary to develop workshops to the discussion of such subjects with this team. These workshops made possible the confirmation of the results of this research. It was possible to observe that the whole team needs a better involvement in health education activities, a proper schedule, and an ongoing education to the discussion of this and other important subjects. After these workshops, the team decided to organize an experimental action following the models of Popular Health Education to the hypertensive patients in their area, showing excellent results locally. We believe this was a seed to the formation of a group of hypertensive patients in order to develop self-care guided by the Popular Health Education, as well as the start of changes in the educational practices developed by the team studied.
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