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RepresentaÃÃes sociais de pacientes renais crÃnicos sobre a hipotensÃo arterial / Representation theory the pacient chronic renal disease with hypotension

CoordenaÃÃo de AperfeiÃoamento de NÃvel Superior / A doenÃa renal CrÃnica està sendo considerada patologia de carÃter progressivo e importante problema de saÃde publica. O nÃmero de pessoas mantidas nas diversas modalidades de diÃlise no Brasil aumenta consideravelmente. Nesse tempo, inÃmeras complicaÃÃes podem ocorrer, entre elas a hipotensÃo arterial, que acomete 25% das sessÃes de hemodiÃlise. O estudo objetivou conhecer as representaÃÃes sociais sobre a hipotensÃo arterial de pacientes com InsuficiÃncia Renal CrÃnica em tratamento de hemodiÃlise e comparar entre os homens e as mulheres. A pesquisa do tipo exploratÃria descritiva de natureza quanti qualitativa com suporte na Teoria das RepresentaÃÃes Sociais foi realizada no perÃodo de marÃo a maio de 2009 em uma clÃnica de hemodiÃlise de Fortaleza conveniada ao SUS. Os sujeitos constituÃdos de 50 pacientes renais crÃnicos que apresentavam hipotensÃo arterial durante o tratamento de hemodiÃlise foram submetidos a uma abordagem com multimÃtodos e a coleta de dados realizada nos prontuÃrios, com estÃmulos indutores no Teste de AssociaÃÃo livre de palavras e por meio da entrevista narrativa e colagens. A organizaÃÃo dos dados quantitativos, do prontuÃrio e das associaÃÃes livres de palavras, foram realizadas por meio das planilhas do programa Excel, enquanto os dados qualitativos, entrevista narrativa e as colagens, se efetuaram pelas linhas narrativas (Spink) e tÃcnica de expressÃo, respectivamente. Foram respeitados os preceitos Ãticos-legais conforme a ResoluÃÃo N 196/96 que normatiza a pesquisa com seres humanos . Os resultados mostraram que houve predomÃnio do sexo feminino; faixa etÃria entre os maiores de 60 anos; analfabetos; casados; catÃlicos; aposentados; renda familiar em torno de um salÃrio mÃnimo e com procedÃncia da Capital, com o predomÃnio do HAS e DM como causas prevalentes entre eles. Evocaram 200 palavras que foram selecionadas quanto ao nÃcleo central e perifÃrico. Nas entrevistas narrativas, 30 sujeitos participaram, sendo identificadas sete categorias. Por fim, 45 deles utilizaram as colagens, classificando-as em 13 categorias especificas. Percebemos que os homens, as representaÃÃes sociais sÃo mais pessimistas e negativas; associaram a HA com suor, o medo e a vista ruim e morte; descreveram que, apÃs o inÃcio do tratamento, as limitaÃÃes impostas pela doenÃa dificultaram a maneira de viver, alegaram mudanÃas na realizaÃÃo de atividades desenvolvidas anteriormente; associaram as limitaÃÃes da doenÃa com a falta de liberdade, prisÃo e fogo. As representaÃÃes sociais da mulheres foram expressas de maneira mais cautelosa e sentimentalista; associaram a HA com suor; medo e vista ruim e dor; relataram atitudes positivas, o bom convÃvio com a doenÃa; os aspectos religiosos e os planos futuros como consequÃncias voltadas para enfrentamento da doenÃa e objeto de superaÃÃo; predominaram imagens compartilhadas sobre as dificuldades na convivÃncia com os novos hÃbitos alimentares, mas ressaltando o poder de conformidade. ConcluÃmos que hà muito a fazer pelos pacientes renais crÃnicos, bem como pelos profissionais que deles cuidam, pois, conhecendo a singularidade de cada individuo, serà possÃvel aplicar os princÃpios da promoÃÃo da saÃde com vistas a uma melhor qualidade de vida. / The chronic renal disease is considered a progressive pathology and an important public health problem. In Brazil, the number of patients undergoing any of the different dialysis modalities keeps growing. During the dialysis sessions, countless complications may occur, such as arterial hypotension, which occurs in 25% of the sessions. This study was aimed to screen the representation by gender within the chronic renal disease patient population with hypotension episodes during hemodialysis. The study was carried out between March and May 2009, using a descriptive, exploratory, quantitative and qualitative methodology based on the Social Representation Theory. The study was done at a hemodialysis clinic in the City of Fortaleza serving the state-run health service (SUS), over a population of 50 chronic renal patients suffering from arterial hypotension episodes during dialysis. Data were obtained from the patients clinical history by a multi-method approach, a free association of words with inducing stimuli, narrative interviews and collages. Data obtained from the clinical histories and from the free association of words were organized in Excel spreadsheets, while the qualitative data, i.e. the interview and collage, were organized by narrative lines (Spink) and the expression technique, respectively. All legal and ethics norms were followed pursuant to Resolution 196/96, which regulates the research on human beings. The results show a dominance of women, an age range of over 60 years, illiterate, married, catholic, retired, patients with a family income of about one minimum wage, residents of the capital city, mainly with HAS and DM as the cause for dialysis. They evoked 200 words, chosen regarding the central core and periphery. 30 patients were interviewed and were classified in 7 categories. Finally, 45 patients used the collage and were classified into 13 categories. We noticed that the social representations are more pessimistic and negative in men. They associated AH to sweating, fear, bad sight and death, and reported that after the initiation of treatment the limitations imposed by the illness made their daily life more difficult. They also reported changes in previously developed activities and associated the illness limitations to a lack of freedom, prison and fire. The social representations of women were expressed in a more cautious and sentimental way. They associated AH to sweating, fear, bad sight and pain. They reported positive attitudes, dealt well with the condition, and mentioned religious aspects and future plans as tools to face and overcome the illness. Shared images related to the difficulties related to the new dietary habits were common, yet highlighting their ability to come to terms with it. We concluded that many things can be done for chronic renal patients as well as for the professionals taking care of them. By knowing the particularities of each individual, it would be possible to apply healthcare promotion principles aimed to improve the patients quality of life.

Identiferoai:union.ndltd.org:IBICT/oai:www.teses.ufc.br:3170
Date12 November 2009
CreatorsFernanda Celedonio de Oliveira
ContributorsMaria Dalva Santos Alves, Maria Josefina da Silva, Maria Sueuda Costa, Maria LÃcia Duarte Pereira
PublisherUniversidade Federal do CearÃ, Programa de PÃs-GraduaÃÃo em Enfermagem, UFC, BR
Source SetsIBICT Brazilian ETDs
LanguagePortuguese
Detected LanguageEnglish
Typeinfo:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis
Formatapplication/pdf
Sourcereponame:Biblioteca Digital de Teses e Dissertações da UFC, instname:Universidade Federal do Ceará, instacron:UFC
Rightsinfo:eu-repo/semantics/openAccess

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