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Previous issue date: 2013-03-19 / The first choice of treatment for patients with Metabolic Syndrome (MS) is the lifestyle changing, which includes the practice of physical exercise and healthy eating, being the Transtheoretical Model of Change (TTM) one of the most used approaches to intervene in relation to these behaviors. However, the literature points out, despite the paucity of studies, that patients have difficulty in adhere to the proposed orientations and keep the changes achieved after the end of treatment. This dissertation sought to address these two subjects and was composed of two sections. The first compared the baseline characteristics between subjects with MS who completed and did not complete a randomized clinical trial, based on TTM, in order to modify the lifestyle and cardiovascular risk (MERC), and identified factors associated with treatment completion. Were assessed, 127 subjects with a mean age of 49.58 years (SD = 7.77) and diagnosis of MS, enrolled at MERC between the years 2010 and 2012. Most of the sample completed the intervention (p <0.01), whereas those individuals older than 50 years (OR: 7.5, 95% CI 1.2 to 46.7, p <0.05 ), who exercise (OR: 1.9, 95% CI: 1.0 - 7.0, p <0.05), have religion (OR: 4.6, 95% CI 1.1 to 13.2; p <0.05), high self-efficacy for regular eating habits (OR: 1.2, 95% CI: 1.0 - 2.3, p <0.05), don t have binge eating (OR: 6.1 95% CI: 2.1 to 23.8, p <0.05) and don t have depression (OR: 4.9, 95% CI: 1.4 to 19.4, p <0.05), are more likely to complete the treatment. The second section conducted the follow-up (T3) of the MERC program participants, on average, one year after the initial assessment (T1). The sample consisted of 55 individuals with MS and an average age of 51.9 years (SD = 6.5), divided into 3 groups: Group Intervention - GI (n = 19); Individual Intervention - II (n = 20); Standard Intervention - SI (n = 16). Time effect was significant (<0.001), with a decrease in weight, body mass index, waist circumference, diastolic and systolic blood pressure (SBP) means. There were differences between groups only regarding weight, wherein just the individuals of GI and II maintained treatment outcomes and still showed a significant reduction when compared T3 and T1, and SBP, with II standing out in relation to others. At T3, most individuals were motivated, but with selfefficacy on average for regulating eating habit and medium/low to perform physical exercise, which reinforces the need for monitoring continuously these patients. The results show that an interdisciplinary program, aimed at lifestyle changing, based on MTT, is effective in the management of patients with MS, not only in relation to adherence promotion, but also in maintenance of treatment outcomes. / A primeira escolha de tratamento para pacientes com S?ndrome Metab?lica ? a mudan?a do estilo de vida, que contempla a pr?tica de exerc?cio f?sico e alimenta??o saud?vel, sendo o Modelo Transte?rico de Mudan?a (MTT) uma das abordagens mais utilizadas para intervir em rela??o a estes comportamentos. No entanto, a literatura aponta, apesar da escassez de estudos, que os pacientes t?m dificuldade de aderir ?s orienta??es propostas e manter as mudan?as alcan?adas ap?s o t?rmino do tratamento. Esta disserta??o buscou contemplar estas duas quest?es e foi composta por duas se??es. A primeira comparou as caracter?sticas da linha de base entre indiv?duos com SM que conclu?ram e n?o conclu?ram um ensaio cl?nico randomizado, visando ? modifica??o do estilo de vida e risco cardiovascular (MERC), baseado no MTT, e identificou os fatores associados ? conclus?o do tratamento. Foram avaliados 127 sujeitos com m?dia de idade de 49,58 anos (DP=7,77) e diagn?stico de SM, que participaram do programa MERC entre os anos de 2010 e 2012. A maior parte da amostra concluiu a interven??o (p<0,01), sendo que, aqueles indiv?duos com idade acima de 50 anos (OR: 7,5; IC95%: 1,2 46,7; p<0,05), que fazem exerc?cio (OR: 1,9; IC95%: 1,0 - 7,0; p<0,05), t?m religi?o (OR: 4,6; IC95%: 1,1-13,2; p<0,05), auto-efic?cia alta para regular h?bito alimentar (OR: 1,2; IC95%: 1,0 2,3; p<0,05), n?o apresentam compuls?o alimentar (OR: 6,1; IC95%: 2,1 23,8; p<0,05) e n?o possuem depress?o (OR: 4,9; IC95%: 1,4 19,4; p<0,05), t?m mais chance de concluir o tratamento. A segunda se??o realizou o seguimento (T3) dos participantes do programa MERC, em m?dia, um ano ap?s a avalia??o inicial (T1). A amostra foi composta por 55 indiv?duos, com SM e idade m?dia de 51,9 anos (DP= 6,5), divididos em 3 grupos: Interven??o Grupal IG (n=19); Interven??o Individual - II (n=20); Interven??o Padr?o - IP (n=16). O efeito do tempo foi significativo (<0,001), com uma diminui??o das m?dias do peso, ?ndice de massa corporal, circunfer?ncia abdominal, press?o arterial sist?lica (PAS) e diast?lica. Houve diferen?a entre os grupos apenas em rela??o ao peso, em que somente os indiv?duos da II e da IG mantiveram os resultados do tratamento e ainda apresentaram uma redu??o significativa quando comparados T3 e T1, e ? PAS, com a II sobressaindo-se em rela??o ?s demais. No T3, grande parte dos indiv?duos ainda estava motivada, mas com auto-efic?cia m?dia para regular h?bito alimentar e m?dia/baixa para realizar exerc?cio f?sico, o que refor?a a necessidade de realizar o acompanhamento cont?nuo destes pacientes. Os resultados apontam que um programa interdisciplinar, visando ? mudan?a de estilo de vida, baseado no MTT, ? efetivo no manejo de pacientes com SM, n?o s? em rela??o ? promo??o da ades?o, como ? manuten??o dos resultados do tratamento.
| Identifer | oai:union.ndltd.org:IBICT/oai:tede2.pucrs.br:tede/830 |
| Date | 19 March 2013 |
| Creators | Susin, Nath?lia |
| Contributors | Oliveira, Margareth da Silva |
| Publisher | Pontif?cia Universidade Cat?lica do Rio Grande do Sul, Programa de P?s-Gradua??o em Psicologia, PUCRS, BR, Faculdade de Psicologia |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis |
| Format | application/pdf |
| Source | reponame:Biblioteca Digital de Teses e Dissertações da PUC_RS, instname:Pontifícia Universidade Católica do Rio Grande do Sul, instacron:PUC_RS |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | 2588426296948062698, 500, 600, 2599381623216554467 |
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