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Previous issue date: 2012-07-20 / Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico / ABSTRACT
Introduction: The cerebrovascular accident (CVA) is an important cause of neurological
impairment. Few data about the factors associated with morbidity of cerebrovascular accident are
found in Brazil. Objectives: Evaluate sociodemographic characteristics, sleep habits, cognitive
and functional status of patients with cerebrovascular accident. Methods: The patients evaluated
through questionnaire Step 1 to survey the sociodemographic characteristics and Modified
Rankin Scale for functional assessment. The neurological degree was evaluated by the National
Institutes of Health Stroke Scale (NIHSS), the sleep Habits questionnaire for sleep and cognitive
status by the Mini-Examination of the Mental State (MEMS). The data were analyzed using the
chi-square test to determine differences in proportions of variables and linear regression analysis.
Results: 305 patients were evaluated and the larger number of subjects was between 50 and 69
years (40%), most patients had no formal education (40.3%) and had ischemic type of
cerebrovascular accident (72.5%). In the analysis of the functionality it was found that most
patients had moderate impairment (55.1%). The results of the sleep habits showed that 63,6% of
patients had one more person in the bedroom,12,3% complained about too much noise in the
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room and 35% of too much light. From these patients 5,8% were smokers, 7,8% and 70,1% drank
coffee drinkers, 28,6% had difficulty in initiate to sleep and woke up 37,6% in the middle of the
night. Were showed complaints about nightmares (11%), feeling of suffocation (37,7%) and 35%
felt very sleepy during the day. In addition, 95% were unemployed, 80,5% did not perform
physical activities and 95,4% did not perform mental activities. The cognitive screening
conducted a determined association of cognitive status with age and education level and
neurological status. Conclusion: The study showed a high frequency of cases of cerebrovascular
accident with functional dependence in a moderate degree, identified that many patients do not
follow hygienic measures of sleep and found that the assessment of cognitive deficits must take
into consideration the age, educational level and degree of neurological patients. We suggest the
need for programs of assistance to victims of cerebrovascular accident patients, with a
multidimensional approach including the rehabilitation team, the role of sleep medicine and
Neuropsychology, so that patients have access to a more appropriate functional rehabilitation,
develop a lifestyle that ensures a good sleep quality and are evaluated and rehabilitated with
regard to cognitive impairment / Introdu??o: O Acidente Vascular Cerebral (AVC) ? uma importante causa de comprometimento
neurol?gico. Poucos dados ? respeito dos fatores associados ? morbidade do AVC s?o
encontrados no Brasil. Objetivos: Avaliar as caracter?sticas sociodemogr?ficas, h?bitos de sono,
estado cognitivo e funcional de pacientes com AVC. M?todos: Os pacientes foram avaliados
atrav?s do question?rio Step 1 para levantamento das caracter?sticas sociodemogr?ficas e Escala
Modificada de Rankin para avalia??o funcional. O grau neurol?gico foi avaliado pela National
Institute of Health Stroke Scale (NIHSS), o sono pelo Question?rio de H?bitos de sono e o estado
cognitivo pelo Mini-Exame do Estado Mental (MEEM). Os dados foram analisados atrav?s do
teste Qui-quadrado para verificar diferen?as nas propor??es das vari?veis estudadas e an?lise de
regress?o linear. Resultados: Foram avaliados 305 pacientes e o maior n?mero de indiv?duos
estava entre 50 e 69 anos (40%), grande parte dos pacientes n?o possu?a estudo formal (40,3%) e
tinham AVC do tipo isqu?mico (72,5%). Na an?lise da funcionalidade constatou-se que a maioria
dos pacientes tinha incapacidade moderada (55,1%). Os resultados dos h?bitos de sono
apontaram que 63,6% dos pacientes apresentavam mais uma pessoa no quarto de dormir, 12,3%
se queixavam de muito barulho no quarto e 35% de muita ilumina??o. Dos pacientes avaliados
5,8% fumavam, 7,8% bebiam e 70,1% tomavam caf?, 28,6% apresentavam dificuldade de iniciar
o sono e 37,6% acordavam no meio da noite. Foram apresentadas queixas de pesadelos (11%),
sensa??o de sufoco (37,7%) e 35% sentiam muito sono durante o dia. Al?m disso, 95% n?o
trabalhavam, 80,5% n?o realizavam atividades f?sicas e 95,4% n?o realizavam atividades
mentais. O rastreamento cognitivo realizado determinou uma associa??o do estado cognitivo com
a idade e escolaridade e o grau neurol?gico. Conclus?o: O estudo conseguiu evidenciar uma
frequ?ncia elevada de casos de AVC com depend?ncia funcional de grau moderado, identificou
que muitos pacientes n?o seguem medidas de higiene do sono e verificou que a avalia??o de
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d?ficits cognitivos deve levar em considera??o a idade, escolaridade e o grau neurol?gico dos
pacientes. Sugerimos a necessidade de programas de aten??o aos pacientes v?timas do AVC, com
uma abordagem multidimensional incluindo a equipe de reabilita??o, a atua??o da Medicina do
sono e da Neuropsicologia, a fim de que os pacientes tenham acesso a uma reabilita?ao funcional
mais adequada, desenvolvam um estilo de vida que garanta uma boa qualidade de sono e sejam
bem avaliados e reabilitados quanto aos comprometimentos cognitivos
| Identifer | oai:union.ndltd.org:IBICT/oai:repositorio.ufrn.br:123456789/17226 |
| Date | 20 July 2012 |
| Creators | Souza, Ana Am?lia Torres |
| Contributors | CPF:60336641400, http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4784002J7, Silva, K?tia Karina do Monte, CPF:03666828493, http://lattes.cnpq.br/1081515399161086, Ara?jo, Maria das Gra?as Rodrigues de, CPF:12233315472, http://lattes.cnpq.br/8958668447668876, Guerra, Ricardo Oliveira, CPF:39643069400, http://lattes.cnpq.br/4265185619165890, Cavalcanti, Fabr?cia Azevedo da Costa, CPF:00847101444, http://lattes.cnpq.br/9579107830132166, Campos, T?nia Fernandes |
| Publisher | Universidade Federal do Rio Grande do Norte, Programa de P?s-Gradua??o em Psicobiologia, UFRN, BR, Estudos de Comportamento; Psicologia Fisiol?gica |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/doctoralThesis |
| Format | application/pdf |
| Source | reponame:Repositório Institucional da UFRN, instname:Universidade Federal do Rio Grande do Norte, instacron:UFRN |
| Rights | info:eu-repo/semantics/openAccess |
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