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Abstract(s)
Contexto: A Doença Pulmonar Obstrutiva Crónica (DPOC) é considerada uma das principais causas de mortalidade mundial. O conhecimento dos doentes acerca da sua doença é baixo, comprometendo a sua gestão. A dispneia, ansiedade, depressão, impacto elevado da doença, capacidade funcional e qualidade vida comprometida, são frequentemente observados. Os programas educacionais na DPOC têm demonstrado benefícios nestes doentes. Objetivos do Estudo: Analisar a influência de um programa educacional com ênfase na reabilitação no Questionário de Avaliação de Conhecimentos acerca da DPOC (QDPOC), no COPD Assessment Test (CAT), no Medical Research Council Dyspnoea Questionnaire (MRCDQ), no Hospital Anxiety and Depression Scale (HADS), no London Chest Activity of Daily Living (LCADL) e no The St. George’s Respiratory Questionnaire (SGRQ) em doentes com DPOC estáveis. O programa foi realizado em grupo e de curta duração em meio hospitalar. Avaliar a influência das variáveis sociodemográficas no QDPOC no momento inicial. Métodos: Estudo de intervenção, longitudinal, prospetivo, comparativo, de características quantitativas. Composto por um grupo inicial (T0) de 47 doentes, intermédio (T1) e final (T2) de 35 doentes, seguidos no Centro Hospitalar Universitário Cova da Beira (CHUCB) e selecionados por conveniência. Foi elaborado um questionário individual constituído por: dados sociodemográficos e clínicos; QDPOC; MRCDQ; HADS; LCADL e SGRQ. Resultados: 91.5% dos doentes em T0 eram homens e 85.1% idosos. 53.2% residiam no meio rural, 17% viviam sozinhos, 83% eram reformados e 74.4% apresentavam o 1.º ciclo de ensino. Perfil clínico: 29.8% dos doentes com classificação da DPOC de GOLD II-Grupo B e 27.7% de GOLD IV-Grupo D; 25.5% apresentaram hábitos tabágicos; 68.1% reportaram história prévia de exposição a fatores de risco; 46.8% utilizavam oxigenoterapia de longa duração e 17% oxigenoterapia de deambulação. Os níveis de conhecimentos em T0 revelaram-se insuficientes (QDPOC: M=41.85; DP=17.70). Observou-se um impacto médio da doença (CAT: M=19.91; DP=8.67), grau de dispneia elevado (MRCDQ, média: grau 3), sintomatologia ansiosa (68.10%) e depressiva (53.20%), capacidade funcional comprometida (LCADL: M=27.62; DP=12.13) e baixa qualidade de vida (SGRQ: M=56.51; DP=18.43). No final da intervenção verificou-se uma melhoria dos valores médios no nível de conhecimento dos doentes acerca da doença, do impacto da DPOC, no nível de dispneia funcional, nos níveis de ansiedade e de depressão, da capacidade funcional percecionada e da qualidade de vida, com diferenças estatisticamente significativas. No follow-up de 6 meses, constatou-se que os ganhos em saúde obtidos após as sessões educacionais se mantiveram, como o nível de dispneia funcional, a capacidade funcional subjetiva e a sintomatologia ansiosa, e até mesmo melhoraram, como o nível de conhecimento dos doentes, o impacto da DPOC, a sintomatologia depressiva e a qualidade de vida. O programa educacional influenciou assim, o nível de conhecimento dos doentes em todos os momentos de avaliação (ρ˂0.001); a CAT entre T0-T2 (ρ˂0.05), e T1-T2 (ρ˂0.01); a MRCDQ entre T0-T1, T0-T2 (ρ˂0.01); a LCADL entre T0-T1, T0-T2 (ρ˂0.001); a HADS-A entre T0-T1, T0-T2 (ρ˂0.001); a HADS-D entre T0-T1 (ρ˂0.05), T0-T2 (ρ˂0.001), T1-T2 (ρ˂0.01); a SGRQ entre T0-T1, T0-T2 (ρ˂0.001) e T1-T2 (ρ˂0.01). Em relação às diferenças entre o nível de conhecimento dos doentes e as variáveis sociodemográficas em To, verificou-se que o local de residência (ρ˂0.05) e o nível de escolaridade (ρ˂0.01) influenciaram estatisticamente o QDPOC. Conclusão: O programa educacional com ênfase na reabilitação influenciou positivamente o nível de conhecimento dos doentes, o impacto da doença, o grau de dispneia funcional, a capacidade funcional na realização das atividades da vida diária (AVD’s), a ansiedade, a depressão e a qualidade de vida na maioria dos momentos de avaliação comparados, com a manutenção e aumento dos ganhos em saúde obtidos após 6 meses. Concluiu-se também que o local de residência e o nível de escolaridade influenciaram o nível de conhecimento. Esta investigação reforça, assim, a importância da implementação destes programas educacionais com ênfase na reabilitação com os doentes com DPOC, demonstrando benefícios em saúde.
Context: The Chronic Obstructive Pulmonary Disease (COPD) is considered one of the major causes of mortality in the world. The patients have little knowledge about their disease, compromising its management. The high impact, dyspnea, anxiety, depression, impaired functional capacity and low quality of life are frequently observed. Educational programs in COPD have shown benefits in these patients. Study Objectives: Analyze the influence of an educational program with an emphasis on rehabilitation in: Knowledge Assessment Questionnaire about COPD, COPD Assessment Test (CAT), Medical Research Council Dyspnoea Questionnaire (MRCDQ), Hospital Anxiety and Depression Scale (HADS), London Chest Activity of Daily Living (LCADL) and The St. George’s Respiratory Questionnaire (SGRQ) in the patients with stable COPD. Performed in a group and of short duration in a hospital environment. Assess the influence of sociodemographic variables on QDPOC at the initial moment. Methods: Intervention study, longitudinal, prospective, comparative, with quantitative characteristics. Composed of an initial group (T0) of 47 patients, intermediate (T1) and final (T2) of 35 patients, followed in the Centro hospitalar Universitário Cova da Beira (CHUCB) and selected by convenience. The questionnaire used consisted on: sociodemographic and clinical data; QDPOC; MRCDQ; HADS; LCADL and SGRQ. Results: 91.5% of the patients included in T0 were men and 85.1% were elderly. 53.2% lived in rural areas, 17% lived alone, 83% were retired and 74.4% had the 1st cycle of education. Clinical profile: 29.8% of patients with COPD classification of GOLD II-Group B and 27.7% of GOLD IV-Group D; 25.5% had smoking habits; 68.1% reported a previous history of exposure to risk factors; 46.8% used long-term oxygen therapy and 17% used ambulation oxygen therapy. The level of knowledge in the T0 proved to be insufficient (QDPOC: M=41.85; SD=17.70). There was a medium impact (CAT: M=19.91; SD=8.667), high degree of dyspnea (MRCDQ, average: grade 3), anxious symptomatology (68.10%) and depressive symptoms (53.20%), impaired functional capacity (LCADL: M=27.62; SD=12.133) and low quality of life (SGRQ: M=56.51; SD=18.43). At the end of the intervention, there was an improvement in the average values in the level of knowledge of patients about the disease, the impact of COPD, the level of functional dyspnea, the levels of anxiety and depression, the perceived functional capacity and the quality of life, with statistically significant differences. In the 6-month follow-up, it was found that the health gains obtained after the educational sessions were maintained, such as the level of functional dyspnea, subjective functional capacity and anxious symptoms, and even improved, such as the level of knowledge of patients, the impact of COPD, depressive symptoms and quality of life. The educational program, influenced the level of knowledge of patients in at all times of evaluation (ρ˂0.001); the CAT between T0-T2 (ρ˂0.05), and T1-T2 (ρ˂0.01); to MRCDQ between T0-T1, T0-T2 (ρ˂0.01); LCADL between T0-T1, T0-T2 (ρ˂0.001); HADS-A between T0-T1, T0-T2 (ρ˂0.001); HADS-D between T0-T1 (ρ˂0.05), T0-T2 (ρ˂0.001), T1-T2 (ρ˂0.01); SGRQ between T0-T1, T0-T2 (ρ˂0.001) and T1-T2 (ρ˂0.01). Regarding the differences between the patients' level of knowledge and the sociodemographic variables in To, it was found that the place of residence (ρ˂0.05) and the level of education (ρ˂0.01) statistically influenced the QDPOC. Conclusion: The educational program with an emphasis on rehabilitation positively influenced the level of knowledge of patients, the impact of the disease, the degree of functional dyspnea, the functional activities of daily living, anxiety, depression and quality of life in most of the compared samples, with the maintenance and increase in health gains obtained after 6 months. It was also concluded that the place of residence and the level of education influenced the level of knowledge. This investigation reinforces the importance of implementing these educational programs with an emphasis on rehabilitation for patients with COPD, demonstrating health benefits.
Context: The Chronic Obstructive Pulmonary Disease (COPD) is considered one of the major causes of mortality in the world. The patients have little knowledge about their disease, compromising its management. The high impact, dyspnea, anxiety, depression, impaired functional capacity and low quality of life are frequently observed. Educational programs in COPD have shown benefits in these patients. Study Objectives: Analyze the influence of an educational program with an emphasis on rehabilitation in: Knowledge Assessment Questionnaire about COPD, COPD Assessment Test (CAT), Medical Research Council Dyspnoea Questionnaire (MRCDQ), Hospital Anxiety and Depression Scale (HADS), London Chest Activity of Daily Living (LCADL) and The St. George’s Respiratory Questionnaire (SGRQ) in the patients with stable COPD. Performed in a group and of short duration in a hospital environment. Assess the influence of sociodemographic variables on QDPOC at the initial moment. Methods: Intervention study, longitudinal, prospective, comparative, with quantitative characteristics. Composed of an initial group (T0) of 47 patients, intermediate (T1) and final (T2) of 35 patients, followed in the Centro hospitalar Universitário Cova da Beira (CHUCB) and selected by convenience. The questionnaire used consisted on: sociodemographic and clinical data; QDPOC; MRCDQ; HADS; LCADL and SGRQ. Results: 91.5% of the patients included in T0 were men and 85.1% were elderly. 53.2% lived in rural areas, 17% lived alone, 83% were retired and 74.4% had the 1st cycle of education. Clinical profile: 29.8% of patients with COPD classification of GOLD II-Group B and 27.7% of GOLD IV-Group D; 25.5% had smoking habits; 68.1% reported a previous history of exposure to risk factors; 46.8% used long-term oxygen therapy and 17% used ambulation oxygen therapy. The level of knowledge in the T0 proved to be insufficient (QDPOC: M=41.85; SD=17.70). There was a medium impact (CAT: M=19.91; SD=8.667), high degree of dyspnea (MRCDQ, average: grade 3), anxious symptomatology (68.10%) and depressive symptoms (53.20%), impaired functional capacity (LCADL: M=27.62; SD=12.133) and low quality of life (SGRQ: M=56.51; SD=18.43). At the end of the intervention, there was an improvement in the average values in the level of knowledge of patients about the disease, the impact of COPD, the level of functional dyspnea, the levels of anxiety and depression, the perceived functional capacity and the quality of life, with statistically significant differences. In the 6-month follow-up, it was found that the health gains obtained after the educational sessions were maintained, such as the level of functional dyspnea, subjective functional capacity and anxious symptoms, and even improved, such as the level of knowledge of patients, the impact of COPD, depressive symptoms and quality of life. The educational program, influenced the level of knowledge of patients in at all times of evaluation (ρ˂0.001); the CAT between T0-T2 (ρ˂0.05), and T1-T2 (ρ˂0.01); to MRCDQ between T0-T1, T0-T2 (ρ˂0.01); LCADL between T0-T1, T0-T2 (ρ˂0.001); HADS-A between T0-T1, T0-T2 (ρ˂0.001); HADS-D between T0-T1 (ρ˂0.05), T0-T2 (ρ˂0.001), T1-T2 (ρ˂0.01); SGRQ between T0-T1, T0-T2 (ρ˂0.001) and T1-T2 (ρ˂0.01). Regarding the differences between the patients' level of knowledge and the sociodemographic variables in To, it was found that the place of residence (ρ˂0.05) and the level of education (ρ˂0.01) statistically influenced the QDPOC. Conclusion: The educational program with an emphasis on rehabilitation positively influenced the level of knowledge of patients, the impact of the disease, the degree of functional dyspnea, the functional activities of daily living, anxiety, depression and quality of life in most of the compared samples, with the maintenance and increase in health gains obtained after 6 months. It was also concluded that the place of residence and the level of education influenced the level of knowledge. This investigation reinforces the importance of implementing these educational programs with an emphasis on rehabilitation for patients with COPD, demonstrating health benefits.
Description
Keywords
Doença Pulmonar Obstrutiva Crónica (DPOC) Educação Conhecimento Impacto Dispneia Ansiedade Depressão Funcionalidade Qualidade de Vida