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Até aos anos 60 do século passado, o estado de saúde de uma população estimava-se, quase exclusivamente, em termos de mortalidade e morbilidade. Contudo, o aumento das doenças crónicas influenciou a mudança de uma visão de tradição clínica da saúde para uma visão de saúde pública, permitindo a afirmação de um paradigma epidemiológico complementar ao paradigma biomédico. Este caminho reflete o interesse dos investigadores em medir os resultados e benefícios em saúde das pessoas e populações, assim como o seu impacto na vida dos doentes e suas famílias. Esta mudança de atitude dos investigadores tem por base o princípio de que uma boa saúde é um indicador universal de qualidade de vida, porque uma vida com qualidade, em geral, pode tornar as pessoas mais saudáveis. Neste sentido, a avaliação da qualidade de vida relacionada com a saúde é um meio importante para estudar parte dos efeitos das doenças crónicas sobre as pessoas. A qualidade de vida relacionada com a saúde é uma variável de resultado importante nos estudos sobre as doenças crónicas. O primeiro estudo sobre esclerose múltipla e qualidade de vida foi publicado em 1992, revelando que este tipo de pesquisa é ainda relativamente recente. A esclerose múltipla afeta o doente ao nível comportamental, ao nível do seu desempenho social, sobrecarregando a sua família com a necessidade de cuidados, com a perda de rendimento, com a necessidade de alteração das tarefas domésticas, com modificações nos papéis sociais e nos relacionamentos familiares, com a necessidade de reforçar o apoio social ao doente e com a necessidade de engendrar estratégias de reação às dificuldades diárias. Tendo em consideração a amplitude dos fatores que podem influenciar a qualidade de vida dos doentes com esclerose múltipla, a investigação tem dedicado, nos últimos 20 anos, alguma atenção à função do apoio social na sua qualidade de vida. Os trabalhos sobre o efeito buffer do apoio social contra as condições psicossociais adversas da esclerose múltipla demostraram que ele melhora a qualidade de vida e diminui os sintomas depressivos dos doentes. O objetivo central deste trabalho é analisar o efeito buffer do apoio social na qualidade de vida e nos sintomas depressivos dos doentes, descrever as suas características sociodemográficas e incapacidades físicas e relacioná-las com a qualidade de vida ligada à saúde. Para isso, avaliámos as caraterísticas sociodemográficas de 150 doentes com esclerose múltipla, as suas incapacidades físicas, a sua qualidade de vida, os sintomas depressivos e o apoio social recebido ou percecionado como disponível. Usámos a regressão múltipla para determinar o efeito das variáveis sociodemográficas, caraterísticas da doença e do apoio social na qualidade de vida dos doentes e nos sintomas depressivos. Encontrámos diferenças estatisticamente significativas entre a idade dos doentes, o nível de escolaridade, a situação profissional, as incapacidades físicas e a sua qualidade de vida. A idade, o nível de escolaridade e o apoio psicológico determinam as variações estatisticamente mais significativas em todas as dimensões da qualidade de vida dos doentes com esclerose múltipla. A idade, o nível de escolaridade, o apoio psicológico, o tempo de evolução da doença e as formas progressivas da esclerose múltipla determinam as variações estatisticamente mais significativas nos sintomas depressivos dos doentes. O apoio psicológico é o fator com maior efeito sobre a qualidade de vida e sintomas depressivos dos doentes comparativamente com as caraterísticas sociodemográficas, incapacidades físicas e parâmetros da esclerose múltipla. Concluímos que os doentes mais jovens com melhores níveis de escolaridade, empregados, com menor tempo de evolução da esclerose múltipla e menores incapacidades físicas têm melhor qualidade de vida do que os outros doentes. No modelo testado, o apoio social é o determinante mais importante da qualidade de vida e o fator com maior peso explicativo dos sintomas depressivos dos doentes com esclerose múltipla.
Until the sixties of the last century, the health of a population and the benefits of health care were estimated almost exclusively in terms of mortality and morbidity. However, the increase in chronic diseases influenced a change of the vision of a tradition of health clinic to a vision of public health, allowing the assertion of an epidemiological paradigm complementary to the biomedical paradigm. This path reflects the interest of researchers to measure the results and benefits in health of individuals and populations, as well as its impact on the lives of patients and their families. This change of attitude of researchers is based on the principle that good health is a universal indicator of quality of life, because a quality life in general can also turn people into healthier people. In this sense, the assessment of quality of life related to health is an important tool to study the effects of chronic diseases on people. The quality of life related to health is an important outcome variable of studies on chronic diseases. The first study of multiple sclerosis and quality of life was published in 1992, revealing that this type of research is still relatively recent. Multiple sclerosis affects the patient at a behavioral level, at the level of their social performance, burdening your family with care needs, with income loss, with a need of a change in household tasks, with changes in social roles and relationships familiar with the need to strengthen social support to the patient and the need of devising strategies for dealing with daily’s difficulties. Given the breadth of factors that can influence the quality of life of patients with multiple sclerosis, research has devoted some attention in the past 20 years, to the role of social support of quality of life of these patients. Thus, works on the buffer effect of social support against adverse psychosocial conditions of multiple sclerosis have shown that it improves quality of life and decreases the depressive symptoms of patients. The aim of this paper is to analyze the buffer effect of social support on quality of life and depressive symptoms of patients, describe their sociodemographic characteristics and physical di- sabilities and relating them to the quality of life related to health. For this, we evaluated the sociodemographic characteristics of 150 patients with multiple sclerosis, their disabilities, their quality of life, depressive symptoms and social support received or perceived as available. We used multiple regression to determine the effect of sociodemographic variables, disease characteristics and social support on quality of life of patients. We found statistically significant differences between patients’ age, educational level, professional status, physical disabilities and their quality of life. Age, educational level and psychological changes were determined as statistically significant in all dimensions of quality of life of patients with multiple sclerosis. Also age, level of education, psychological support, duration of the disease and the progressive forms of multiple sclerosis determine the most statistically significant changes in depressive symptoms of patients. Psychological support is the greatest effect on quality of life and depressive symptoms compared with patient sociodemographic characteristics, physical disabilities and parameters of multiple sclerosis. We conclude that younger patients with better levels of education, employees with shorter evolution of multiple sclerosis and minor physical disabilities have better quality of life than other patients. Social support is the most important factor of quality of life and with greater weight factor explaining the depressive symptoms of patients with multiple sclerosis.
Until the sixties of the last century, the health of a population and the benefits of health care were estimated almost exclusively in terms of mortality and morbidity. However, the increase in chronic diseases influenced a change of the vision of a tradition of health clinic to a vision of public health, allowing the assertion of an epidemiological paradigm complementary to the biomedical paradigm. This path reflects the interest of researchers to measure the results and benefits in health of individuals and populations, as well as its impact on the lives of patients and their families. This change of attitude of researchers is based on the principle that good health is a universal indicator of quality of life, because a quality life in general can also turn people into healthier people. In this sense, the assessment of quality of life related to health is an important tool to study the effects of chronic diseases on people. The quality of life related to health is an important outcome variable of studies on chronic diseases. The first study of multiple sclerosis and quality of life was published in 1992, revealing that this type of research is still relatively recent. Multiple sclerosis affects the patient at a behavioral level, at the level of their social performance, burdening your family with care needs, with income loss, with a need of a change in household tasks, with changes in social roles and relationships familiar with the need to strengthen social support to the patient and the need of devising strategies for dealing with daily’s difficulties. Given the breadth of factors that can influence the quality of life of patients with multiple sclerosis, research has devoted some attention in the past 20 years, to the role of social support of quality of life of these patients. Thus, works on the buffer effect of social support against adverse psychosocial conditions of multiple sclerosis have shown that it improves quality of life and decreases the depressive symptoms of patients. The aim of this paper is to analyze the buffer effect of social support on quality of life and depressive symptoms of patients, describe their sociodemographic characteristics and physical di- sabilities and relating them to the quality of life related to health. For this, we evaluated the sociodemographic characteristics of 150 patients with multiple sclerosis, their disabilities, their quality of life, depressive symptoms and social support received or perceived as available. We used multiple regression to determine the effect of sociodemographic variables, disease characteristics and social support on quality of life of patients. We found statistically significant differences between patients’ age, educational level, professional status, physical disabilities and their quality of life. Age, educational level and psychological changes were determined as statistically significant in all dimensions of quality of life of patients with multiple sclerosis. Also age, level of education, psychological support, duration of the disease and the progressive forms of multiple sclerosis determine the most statistically significant changes in depressive symptoms of patients. Psychological support is the greatest effect on quality of life and depressive symptoms compared with patient sociodemographic characteristics, physical disabilities and parameters of multiple sclerosis. We conclude that younger patients with better levels of education, employees with shorter evolution of multiple sclerosis and minor physical disabilities have better quality of life than other patients. Social support is the most important factor of quality of life and with greater weight factor explaining the depressive symptoms of patients with multiple sclerosis.
Descrição
Palavras-chave
Esclerose múltipla - Incapacidade Esclerose múltipla - Aspectos sociodemográficos Esclerose múltipla - Apoio social Esclerose múltipla - Qualidade de vida Esclerose múltipla - Sintomas depressivos
Contexto Educativo
Citação
Editora
Universidade da Beira Interior