Processos adaptativos do doente renal crônico à hemodiálise: na perspectiva da teoria de Calista Roy

Abstract

ABSTRACT

SILVA, A.C. Adaptive processes of the chronic renal patient to the Hemodialysis: from the perspective of the Calista Roy theory. 2018.

Introduction: Chronic Kidney Disease (CKD) is currently considered a macro-public health problem with global proportions, negatively impacting patients' expectancy and quality of life (QoL), requiring a significant part of the resources and expenditures for health. It is defined as an abnormality of function or structure of the kidneys, acting for more than three months, with repercussions and implications for the health of its patients. Objective: To describe the adaptive processes of chronic patients on hemodialysis under the light of Calista Roy's Nursing Theory. Method: This is a cross-sectional, descriptive study with a quantitative approach. The simple random sample consisted of 150 individuals. The data were collected through an interview, using a questionnaire with questions related to sociodemographic, clinical data, hemodialysis treatment and (QV) instrument (Kidney Disease-Quality of Life Short Form KDQOL-SF-36). The data were collected between March and July 2018. The data were organized and analyzed statistically in the Statistical Package for Social Sciences (SPSS) version 21, were described and analyzed, according to the variables of interest. The categorical variables were absolute (n) and relative (%), and for numeric variables in numerical measures (mean, median, standard deviation). Results: The study included 150 participants, with a mean age of 53.67 years, the majority of whom were men (54,%), married (53.40%), mean of 3.9 years of schooling, 79.3% capital, 18.7% in the interior and 2% in other states in the North. Family income, 49.3% receive a minimum wage. Most 76% receive invalidity / illness benefits. About religion, 48% self-referred to be evangelicals. With regard to associated diseases, 85.3% reported being hypertensive and having 44% Diabetes type 2. The health service most sought was the public service 87.3%, and 12.7% in the private service. Over time in years of hemodialysis (HD) treatment: 70.6% one to five years, and Arteriovenous Fistula (AVF) (80%) is the most used type of vascular access to hemodialysis. About KDQOL-SF36, dimensions indicated low QoL for physical function (17.39%), overload of patients' renal disease (36.46%), work (25.33%) and emotional function (37.39%). QoL good dimensions: encouragement of the dialysis team in the treatment (83.42%) and sexual function (83.85%). The associations between the dimensions of QoL, sociodemographic and clinical aspects showed significance with p value> 0.05 between: list of symptoms and problems; overload of disease; social support; encouragement of the dialysis team; physical function; pain; general health; emotional well-being; social role; energy / fatigue. Conclusion: The CKD and its correlation with the dimensions of QoL were negatively affected in health dimensions. The socioeconomic determinants of health / disease show levels of impairment in QoL. The low socioeconomic, limiting and / or distant aspects of the interviewees' clinic, associated with the location of the dwelling, has been shown to be detrimental to those who live far from the HD clinic. The physiological-physical mode and interdependence in the adaptation to the patients in HD and the confrontation of the patients indicate loss during the treatment. The role of nurses, especially in the application of theoretical frameworks and data collection by the nursing team to detect situations of vulnerability, contributes to the support in this dimension, with more social support.