Aspectos cognitivos, emocionais e qualidade de vida de pacientes renais crônicos e estratégias de enfrentamento
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Data
2020-08-21
Autores
Ribas, Maria Fernanda Assis
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Universidade Estadual Paulista (Unesp)
Resumo
A hemodiálise (HD) é um método de Terapia Renal Substitutiva, que oferece melhora na sobrevida, entretanto, proporciona uma rotina rígida e impõe ao indivíduo limitações que afetam os aspectos biológicos, psicológicos e sociais, com uma ruptura em seu estilo de vida. Os pacientes com Doença Renal Crônica (DRC) apresentam alto risco de Transtorno Neurocognitivo Leve (TNL) que pode estar associado ao um quadro depressivo e afetar diretamente a percepção da qualidade de vida. Nesse sentido, o presente estudo teve como objetivo avaliar o funcionamento cognitivo, emocional e a qualidade de vida de pacientes com DRC em hemodiálise, bem como suas estratégias de enfrentamento. O estudo investigou, ainda, as associações das características sociodemográficas e clínicas dos indivíduos avaliados, com relação a TNL no que concerne aos sintomas de depressão e ansiedade, qualidade de vida e estratégias de enfrentamento. Participaram do estudo 59 pacientes de ambos os sexos, com idade de 20 a 65 anos, que realizavam HD no centro de terapia renal substitutiva de um Hospital Geral localizando no interior do estado de São Paulo. Tratou-se de um estudo de corte transversal em uma amostra por conveniência. Os dados foram coletados por meio de instrumentos que avaliaram as funções cognitivas, qualidade de vida, sintomas depressivos e ansiedade, e um inventário de estratégia de enfrentamento. A média etária dos pacientes foi M= 47,38 (± 12,34) anos e a média de anos de estudos foi M= 9,25 (± 3,59) anos. O estudo indicou alta prevalência de TNL (64,4%) mesmo em pacientes não idosos e com escolaridade mais baixa. O TNL esteve associado à baixa escolaridade (p= 0,022), sintomas de ansiedade (p= <0,001) e sintomas de depressão (p= <0,001). Além disso, ter menor escolaridade, sintomas de ansiedade e de depressão foram preditores de TNL. No entanto, o TNL não se associou à piora da qualidade de vida, embora, outras variáveis como depressão, ansiedade, sexo e idade se associaram com a qualidade de vida. E as estratégias de enfrentamento de pacientes com TNL associadas com a qualidade de vida foram piores do que de pacientes sem TNL.
Hemodialysis (HD) is a method of Substitutive Renal Therapy, which offers improved survival time. However, it provides a rigid routine and imposes limitations on the individual that affect biological, psychological, and social aspects, with a significant disruption in your lifestyle. Patients with Chronic Kidney Disease (CKD), they are at high risk for Mild Neurocognitive Disorder (mNCD) which may be associated with a depressive condition and directly affect the perception of quality of life. In this sense, the present study was aimed at assessing the cognitive, emotional functioning and quality of life of patients with CKD on hemodialysis, as well as their coping strategies. The study also investigated the associations of sociodemographic and clinical characteristics of the individuals assessed, relating mNCD to depression symptoms and anxiety, quality of life and coping strategies. The study included 59 patients of both genders, aged 20 to 65 years, who performed HD in the renal replacement therapy center of a general hospital located in an inland city of Sao Paulo state. It was a cross-sectional study in a convenience sample. Data were collected using instruments that assessed cognitive functions, quality of life, depressive symptoms and anxiety, and an inventory of coping strategies. The mean age of patients was M= 47.38(± 12.34) years, and the mean of years study was M= 9.25 (± 3.59) years. The study indicated a high prevalence of mNCD (64.4%) even in non-elderly patients. mNCD was associated low education (p= 0.022), symptoms of anxiety (p= <0.001) and symptoms of depression (p= <0.001). In addition, to having less education, symptoms of anxiety anda depression were predictors of mNCD. However, mNCD was not associated with worsening quality of life, although other variables such as depression, anxiety, sexual gender and age were associated with quality of life. And coping strategies for patients with mNCD associated with quality of life were worse than patients without mNCD.
Hemodialysis (HD) is a method of Substitutive Renal Therapy, which offers improved survival time. However, it provides a rigid routine and imposes limitations on the individual that affect biological, psychological, and social aspects, with a significant disruption in your lifestyle. Patients with Chronic Kidney Disease (CKD), they are at high risk for Mild Neurocognitive Disorder (mNCD) which may be associated with a depressive condition and directly affect the perception of quality of life. In this sense, the present study was aimed at assessing the cognitive, emotional functioning and quality of life of patients with CKD on hemodialysis, as well as their coping strategies. The study also investigated the associations of sociodemographic and clinical characteristics of the individuals assessed, relating mNCD to depression symptoms and anxiety, quality of life and coping strategies. The study included 59 patients of both genders, aged 20 to 65 years, who performed HD in the renal replacement therapy center of a general hospital located in an inland city of Sao Paulo state. It was a cross-sectional study in a convenience sample. Data were collected using instruments that assessed cognitive functions, quality of life, depressive symptoms and anxiety, and an inventory of coping strategies. The mean age of patients was M= 47.38(± 12.34) years, and the mean of years study was M= 9.25 (± 3.59) years. The study indicated a high prevalence of mNCD (64.4%) even in non-elderly patients. mNCD was associated low education (p= 0.022), symptoms of anxiety (p= <0.001) and symptoms of depression (p= <0.001). In addition, to having less education, symptoms of anxiety anda depression were predictors of mNCD. However, mNCD was not associated with worsening quality of life, although other variables such as depression, anxiety, sexual gender and age were associated with quality of life. And coping strategies for patients with mNCD associated with quality of life were worse than patients without mNCD.
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Doença renal crônica, Hemodiálise, Transtorno neurocognitivo leve, Chronic kidney disease, Hemodialysis, Mild neurocognitive disorder