Influência da espiritualidade sobre a função renal em pacientes transplantados renais
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Data
2018-03-03
Autores
Bravin, Ariane, Moysés
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
Introdução: Diversas pesquisas têm sido realizadas envolvendo os conceitos de religião e espiritualidade na prática clínica. No transplante renal, poucos estudos abordaram esta questão. Objetivo: Avaliar a influência da espiritualidade na função renal, em pacientes transplantados renais ao longo de 12 meses como variável independente. Método: Trata-se de um estudo transversal, de centro único, que avaliou uma amostra de conveniência de 81 transplantados renais entre 30 dias e 60 meses de pós-transplante, seguidos por 12 meses. Os pacientes foram divididos em dois grupos com base na mediana da espiritualidade: grupo espiritualizado (n=52) e menos espiritualizado (n=29). A espiritualidade foi avaliada pelo questionário de DUREL. Resultados: As características clínicas, de imunossupressão, o apoio social, a adesão ao tratamento medicamentoso, a qualidade de vida e a depressão não apresentaram diferenças entre os grupos. A função renal ao longo de um ano foi significativamente maior no grupo espiritualizado a partir do nono mês. Ao fim de 12 meses, a percentagem de pacientes com clearance de creatinina superior a 60ml/min foi de 61,5% no grupo espiritualizado e 34,5% no grupo menos espiritualizado (p=0,02). A análise multivariada mostrou que o grupo menos espiritualizado apresentou um risco de 4,7 vezes [1,4 – 16,8] maior para pior função renal (p=0,013). Conclusão: Os pacientes mais espiritualizados apresentaram melhor função renal e este efeito foi independente. Sugere-se que a espiritualidade seja um parâmetro mais sensível para identificar pacientes em risco de pior evolução no pós-transplante renal.
Introduction: Several researches have been designed for concepts of religion and spirituality in clinical practice. There was no renal transplantation.Objective: To assess the influence of spirituality on renal function in renal transplant patients over 12 months as an independent variable. Method: This is a single-center cross-sectional study that evaluated a convenience sample of 81 kidney transplant recipients between 30 days and 60 months post-transplantation followed by 12 months. Patients were divided into two groups based on the median of spirituality in a spiritualized group (n=52) and less spiritualized (n=29). Spirituality was assessed by the DUREL questionnaire. Results: The clinical characteristics, immunosuppression and the questionnaires of social support, adherence, quality of life and depression did not present the groups. Renal function over one year was significantly greater in the spiritualized group from the ninth month. After 12 months, the percentage of patients with creatinine clearance greater than 60 ml/min was 61.5% in the spiritualized group and 34.5% in the less spiritualized group (p=0.02). The multivariate analysis showed that the less spiritualized group presented a risk of 4.7 times [1,4-16,8] higher for worse renal function (p=0.013). Conclusion:The more spiritual patients presented better renal function and this effect was independent. We suggest that the spirituality questionnaire be a more sensitive parameter to identify patients at risk for evolution, not post-renal transplantation.
Introduction: Several researches have been designed for concepts of religion and spirituality in clinical practice. There was no renal transplantation.Objective: To assess the influence of spirituality on renal function in renal transplant patients over 12 months as an independent variable. Method: This is a single-center cross-sectional study that evaluated a convenience sample of 81 kidney transplant recipients between 30 days and 60 months post-transplantation followed by 12 months. Patients were divided into two groups based on the median of spirituality in a spiritualized group (n=52) and less spiritualized (n=29). Spirituality was assessed by the DUREL questionnaire. Results: The clinical characteristics, immunosuppression and the questionnaires of social support, adherence, quality of life and depression did not present the groups. Renal function over one year was significantly greater in the spiritualized group from the ninth month. After 12 months, the percentage of patients with creatinine clearance greater than 60 ml/min was 61.5% in the spiritualized group and 34.5% in the less spiritualized group (p=0.02). The multivariate analysis showed that the less spiritualized group presented a risk of 4.7 times [1,4-16,8] higher for worse renal function (p=0.013). Conclusion:The more spiritual patients presented better renal function and this effect was independent. We suggest that the spirituality questionnaire be a more sensitive parameter to identify patients at risk for evolution, not post-renal transplantation.
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Espiritualidade, Religião, Transplante de rim, Adesão à medicação, Enfermagem, Spirituality, Religion, Kidney transplantation, Adhesion to medication, Nursing