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Previous issue date: 2007 / Introdução: Atualmente, o transplante de coracao representa o tratamento definitivo para pacientes portadores de miocardiopatia, com insufiCiência cardiaca (IC) refrataria a terapeutica medicamentosa maxima e que apresenta impossibilidade de tratamento por cirurgia convencional. Alem das condicoes clinicas do paciente, nos programas de transplantes cardiacos sao elaboradas avaliacoes sociais para verificar a ocorrencia dos mais adversos fatores que possam vir a impedir a inclusao de pacientes nestes programas, identificando o quadro social do paciente a partir da classificacao de algumas categorias extraidas da vida cotidiana, estruturadas em: aceitabilidade, dinamica familiar, acesso e condicao socio-economica. Um dos aspectos importantes e a presenca do cuidador. Os cuidadores sao as pessoas responsaveis pelos cuidados, aquelas que estimulam o paciente durante as atividades reabilitadoras, alem de serem tambem aquelas que estabelecem o contato com a equipe terapeutica. Na maioria das vezes, o cuidador e um membro da familia, com ou sem experiencia na area da Saúde, que assume os cuidados do paciente no domicilio, ajudando-o a suprir suas necessidades, proporcionando conforto, lazer e garantindo o bem-estar a pessoa necessitada. A literatura a respeito dos cuidadores e escassa, sobretudo relacionada aos candidatos a transplantes de orgaos. Objetivos: identificar o principal cuidador dos pacientes candidatos a transplante do coracao acompanhados no ambulatorio de cirurgia cardiovascular da UNIFESP; caracterizar os cuidadores segundo os seus dados socio-demograficos; comparar diferencas entre as informacoes coletadas com os pacientes e aquelas obtidas com os cuidadores; e classificar os cuidadores segundo a sua dedicacao e efiCiência na assistencia ao paciente e correlaciona-los com os dados socio-demograficos. Metodo: Trata-se de um estudo prospectivo: longitudinal e analitico, com abordagem quantitativa, previamente aprovado pelo Comite de Etica em Pesquisa da UNIFESP. A amostra foi constituida de 21 pacientes candidatos a transplante do coracao, acompanhados no Ambulatorio de Cirurgia Cardiovascular e seus respectivos cuidadores, que responderam a entrevista estruturada e aceitaram participar do estudo, assinando termo de consentimento livre e esclarecido. Os dados foram coletados no periodo de outubro de 2004 a marco de 2005. Resultados: O principal cuidador dos pacientes candidatos a transplante do coracao acompanhados no ambulatorio de cirurgia cardiovascular da UNIFESP e um membro da familia (95 por cento), sendo na maioria das vezes o conjuge. A amostra estudada foi constituida de 13 mulheres (81 por cento) e 3 homens (19 por cento), com idade variando de 24 a 65 anos (media de 44,38 anos). 56 por cento dos cuidadores eram casados e 43,8 por cento declararam-se catolicos. Houve uma certa homogeneidade com relacao ao grau de escolaridade, pois a pesquisa demonstrou que 29 por cento dos cuidadores cursaram o ensino fundamental, 24 por cento relataram ter completado o ensino medio e 14 por cento completaram o ensino superior. A maioria (68,8 por cento) dos cuidadores relatou exercer alguma atividade profissional, dentro ou fora de casa, e 81,4 por cento tem uma renda propria (em dois casos, proveniente de aposentadoria e nao de atividade profissional), para auxiliar ou mesmo proporcionar o orcamento domestico. Verificou-se, tambem, que todos (100 por cento) dos cuidadores residiam na mesma casa que o seu paciente. Houve algumas discrepancias entre as informacoes coletadas com os pacientes e aquelas obtidas com os cuidadores, com relacao as atividades de acompanhamento. Os dados coletados foram agrupados de forma a possibilitar o estabelecimento de um escore que permitiu classificar os cuidadores em bom, regular ou ruim, no que diz respeito a sua dedicacao e aplicacao as necessidades do paciente. Dentre os 16 cuidadores avaliados, 8 (50 por cento) receberam o escore bom, 7 (43,7 por cento) foram avaliados como regulares e apenas 1 (6,3 por cento) foi considerado ruim. Os escores foram correlacionados com alguns dos dados socio¬demograficos (escolaridade, atividade profissional e renda), e nenhuma destas variaveis apresentou correlacao estatisticamente significante com o perfil dos escores. Conclusao: Os objetivos propostos foram atingidos, permitindo caracterizar o perfil dos cuidadores de pacientes candidatos a transplante do coracao. Entretanto, ha necessidade de realizar novos estudos sobre esta populacao, para subsidiar o planejamento de estrategias que permitam oferecer melhores condicoes para estas pessoas. / Introduction: Currently, heart transplant is the ultimate treatment for miocardiopathy patients, for those who have heart failure (CHF), who will not respond to maximum-effort drug treatment, and for whom conventional surgery treatment is not possible. In the heart transplant programs, in addition to the patient’s clinical condition, social evaluations are conducted in order to check for the presence of a number of factors that may prevent the inclusion of patients in such programs, identifying the patient’s social profile based on the classification of some categories found in everyday life, organized as follows: acceptability, family dinamics, access and socioeconomic status. One of the most important factor is the presence of the caregiver. Caregivers are the individuals in charge of taking care of the patient, those who stimulate the patient throughout the rehabilitation activities. They are also those who establish contact with the therapeutic team. On most occasions, the caregiver is a family member, who may or may not have some experience in the healthcare environment, who takes it upon him/herself to care for the patient at home, helping the patient meet his/her requirements, providing comfort, leisure and guaranteeing the welfare of the individual in need of attention. There is sparse literature available on caregivers, especially with regard to organ-transplant candidates. Purpose: To identify the main caregiver of patients who are on the waiting list for heart transplants, to be found with their charges at UNIFESP’s cardiovascular outpatient clinic; classify caregivers according to their social-demographic data; compare the differences between information obtained from the patients and that obtained from the caregivers; and classify caregivers according to their commitiment and effectiveness while assisting the patient and relate them with the socialdemograpic data. Method: This is a prospective, longitudinal and and analytical method, with a quantitative approach. It has been granted prior approval by UNIFESP’s Research Ethic Committee. The sampling comprises 21 patients on the heart transplant waiting list, who are accompanied, at the Cardiovascular Surgery Outpatient Clinic, by their caregivers, who took the structured interview and who agreed to participate in the study, by signing a consent form of their own free will. The data were gathered from October 2004 to March 2005. Results: The main caregiver of the patients on the heart transplant waiting list, present, with their charges, at UNIFESP’s cardiovascular outpatient clinic is a family member (95%). On most occasions, the caregiver is the spouse. The smapling for this study comprised 13 women (81%) and 3 men (19%), aged 24 to 65 (average age was 44.38 years). 56% of the caregivers were married and 43.8% stated they were Roman Catholics. There was a certain degree of evenness regarding education, since the study showed that 29% of caregivers had finished elementary school, 24% were high school graduates and, 14% had college degrees. Most (68.8%) caregivers stated they were engaged in some sort of professional activity, at the home or elsewhere, and 81.4% have some income (in two cases, such income was provided by a pension, not by a professional activity), in order to supplement the household budget or even to provide for such budget in its entirety). It was also established that all (100%) caregivers shared a home with the patient. There were some inconsistencies between the information obtained from the patients and those obtained from the caregivers, with regard to the care activities. The data collected were put together so as to enable us to set up a “score”, in order to to classify caregivers as good, fair or poor, with regard to commitment and effort to meet the patient’s requirements. Within the 16 caregivers who were evaluated, 8 (50%) scored as “good”, 7 (43%) scored as “fair”, and only one (6.3%) was classified as “poor” Scores were correlated with some social-demographic data (education, professional activity and income), and none of these variables had a significantly meaningful correlation with the score’s profile. Conclusion: The stated goals were reached, enabling the researchers to establish both the caregivers’ profile and that of the patients who are on the waiting list for heart transplant. Nevetheless, new studies must be made about this population, in order to provide subsidies for strategic planning so that these individuals may be offered better conditions. / BV UNIFESP: Teses e dissertações
| Identifer | oai:union.ndltd.org:IBICT/oai:repositorio.unifesp.br:11600/23453 |
| Date | January 2007 |
| Creators | Machado, Regimar Carla [UNIFESP] |
| Contributors | Universidade Federal de São Paulo (UNIFESP), Branco, João Nelson Rodrigues [UNIFESP] |
| Publisher | Universidade Federal de São Paulo (UNIFESP) |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | Portuguese |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis |
| Format | 68 p. |
| Source | reponame:Repositório Institucional da UNIFESP, instname:Universidade Federal de São Paulo, instacron:UNIFESP |
| Rights | info:eu-repo/semantics/openAccess |
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