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Qualidade de vida, sintomas depressivos, aspectos psicossociais e cl?nicos de doadores vivos de rim ap?s a doa??oVigueras, Evelyn Soledad Reyes 28 March 2012 (has links)
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Previous issue date: 2012-03-28 / Conselho Nacional de Pesquisa e Desenvolvimento Cient?fico e Tecnol?gico - CNPq / INTRODUCTION: When discussing the living transplant donation, the focus is, most
of the times, in the organ?s receptor. After all, he is the sick ne, the patient, the
reason of the process development that culminates in the surgery for function
substitution. However, the donor is a complicated and fundamental part on the
procedure, so that in the contrary of the other part, is an healthy subject that
becomes a patient. Accepts mutilation, after emphatic identification with the one
whose life quality is modified by a dysfunction. Various researchers have been
studying the psychological, social and ethical implications involving kidney donors
(BURROUGHS et al., 2003; STERNER et al., 2006; NEUHAUS et al., 2005).
The donor subject that offers a body part for transplant will be bequeathing an
invaluable gift and who receives the organ accepts it. To give and receive a present
of that value may be the most important in this story filled with meanings of the
human organ transplant. This extraordinary present, on the other hand, is not and
private transaction between donor and receptor. On the contrary, happens inside a
complex personal relationship network, wich is extended to families, doctors and all
the other members of the health team that are involved in the operation. Inside the
relationship network, a complex exchange happens, in which considerably more than
an organ is transferred. (FOX & SWAZEY, 1978).
OBJECTIVES: To know the donor subject profile and hos perception after the kidney
donation in kidney transplantation.
METHODOLOGY: The study proposed was observational, explanatory and
transverse. The data were analyzed both in qualitative and quantitative ways. The
subjects were called to enter the study, submmited toclinical and psychological
evaluation (application of SF-36, Beck?s Depression Scale, and structured interview).
The studied sample consisted of 47 individuals. The average pos-donation time of
the evaluated subjects was 4 [1 ? 8] min 0 29 max.
RESULTS: The main relationship between donor and receptor was maternal, being
the characteristics in that case: woman, about 45 years old, overweighed,
consanguineous to the receptor, with incomplete fundamental scholarship, living with
companion and children. Clinically, after tga donation, the donors presented, mostly,
overweight (IMC 27,6), blood pressure between the normal limits (123 ? 18,1/78,5 ?
10 mmHg), protein?ria in urine sample of 6 mg [5 mg; 8 mg], 131,55? 70,58 of
creatinina in urine sample and 1,28 (1,28? 0,27) of creatinina s?rica. The transplant
surgery was 74,5% realized by Videolaparoscopia and 25,5% by open surgery.
The quality of life, evaluated by the SF 36, presented a variation of 59,2 ? 24,9
(Vitality) to 79,4 ? 24,3 (Functional Capability). The depression can be classified in
the following way: 33 (70,21%) with minimal depression, 6 (12,70%) with low
depression, 5 (10,63%) with moderated depression and 3 (6,30%) with severe
depression. About the parental factor, 11 donors were not-related and 36 were
related. In their majority, 41 (87,3%) the donors keep contact with the receptors, 28
(59,6%) referred that the relationship has not changed after the donation, 24 (51,1%)
referred that had some kind of emotional limitation, 11 (23,4%) referred that the pain
they felt was the most negative factor of the donation, 40 (85,1%) said that seeing
the receptor well was the most positive aspect, 5 (10,6%) felt pressure to donate, 4
(8,5%) regretted on donating.
CONCLUSION: It is concluded that it was possible to know the donors profile and
their perception after the kidney donation and kidney transplantation. / INTRODU??O: Quando se discute a doa??o inter vivos em transplante, o foco da
aten??o na maior parte das vezes ? o receptor de ?rg?o. Afinal, ele ? o doente, o
paciente, o motivo do desenvolvimento do processo que culmina em cirurgia para
substitui??o de fun??o. No entanto, o doador ? parte implicada e fundamental no
procedimento, tanto que ao contr?rio do outro, ? um sujeito h?gido que torna-se
paciente. Aceita mutila??o, ap?s identifica??o emp?tica com aquele cuja qualidade
de vida encontra-se modificada por uma disfun??o
O sujeito doador que oferece uma parte de seu corpo para transplante est?
legando um inestim?vel presente e quem recebe o ?rg?o aceita o presente sem
pre?o. Dar e receber um presente com este valor talvez seja o mais importante nesta
hist?ria recheada de significados do transplante de ?rg?os humanos. Este
extraordin?rio presente, por outro lado, n?o ? uma transa??o privada entre o doador
e o receptor. Pelo contr?rio, ocorre dentro de uma complexa rede de
relacionamentos pessoais que se estende para fam?lias, m?dicos e todos os
membros da equipe de sa?de que est?o envolvidos na opera??o. Dentro desta rede
de rela??es, uma complexa troca ocorre, pela qual,consideravelmente, mais do que
o ?rg?o ? transferido. (FOX & SWAZEY, 1978).
OBJETIVOS: Conhecer o perfil do sujeito doador e sua percep??o ap?s a doa??o
de rim em transplante renal.
METODOLOGIA: O estudo proposto foi observacional,explorat?rio e transversal. Os
dados analisados de forma qualitativa e quantitativa. Os sujeitos foram convocados
a participar do estudo, avaliados clinica e psicologicamente (aplica??o dos
instrumentos SF-36 e Escala de Depress?o de Beck, al?m de estruturada). A
amostra estudada foi composta por 47 indiv?duos. O tempo m?dio p?s-doa??o dos
sujeitos avaliados foi de 4 anos.
RESULTADOS: A principal rela??o entre o doador e o receptor foi materna, sendo
neste caso as caracter?sticas: mulher, ao redor dos 45 anos, com sobrepeso,
consang??nea com o receptor, com escolaridade de ensino fundamental incompleto,
vivendo com companheiro e filhos. Clinicamente, ap?s a doa??o, os doadores
apresentaram, em sua maioria, sobrepeso (IMC 27,6), press?o arterial dentro dos
limites da normalidade (123 ? 18,1/78,5 ? 10 mmHg) e fun??o renal normal
(creatinina s?rica m?dia de 1,28 mg/dl e aus?ncia de protein?ria [protein?ria em
amostra urin?ria de 0,0456 mg/g de creatinina]). A cirurgia de transplante foi
realizada por v?deolaparoscopia em 74,5% e por cirurgia aberta 25,5% .
A qualidade de vida, avaliada atrav?s do SF 36, apresentou uma varia??o
entre 59,2 ? 24,9 (Vitalidade) at? 79,4 ? 24,3 (Capacidade funcional). A depress?o
pode ser classificada da seguinte maneira: 33 (70,21%) com depress?o m?nima, seis
(12,70%) com depress?o leve, 5 (10,63%) com depress?o moderada, e 3 (6,30%)
com depress?o grave. Quanto ao fator parentesco, 11 doadores eram n?o-parentes
e 36 eram parentes. Em sua maioria,(87,3%), os doadores mant?m contato com os
receptores, 28(59,6%) referem que o relacionamento n?o mudou ap?s a doa??o, 24(
51,1%) referem que tiveram alguma limita??o emocional, 11(23,4%) referiram que a
dor que sentiram foi o aspecto mais negativo da doa??o, 40(85,1%) disseram que
ver o receptor bem foi o aspecto mais positivo, 5(10,6%) se sentiram pressionados
para doar e 4( 8,5%) se arrependeram de doar.
CONCLUS?O: Conclui-se que foi poss?vel conhecer o perfil dos doadores e sua
percep??o ap?s a doa??o de rim em transplante renal.
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