Resumo OBJETIVO Compreender a experiência de pessoas adultas e idosas frente à adesão aos cuidados com a úlcera varicosa. MÉTODO Pesquisa qualitativa fundamentada em pressupostos da Fenomenologia Social de Alfred Schütz, com 12 pessoas adultas e idosas, em tratamento de úlcera varicosa em Serviço Especializado, em Minas Gerais. Os depoimentos foram obtidos de outubro a novembro de 2015 e analisados, categorizados e discutidos a partir do referencial teórico-filosófico adotado e literatura temática. RESULTADOS Dos depoimentos emergiram as categorias temáticas: “Crenças, atividades pessoais e sociais dificultando a adesão ao cuidado”; “Ser protagonista na relação de cuidado com a úlcera varicosa” e “Motivação para aderir ao cuidado”. CONCLUSÕES A relação intersubjetiva estabelecida entre as pessoas com úlcera varicosa e os profissionais de saúde emergiu como força potencializadora da adesão ao cuidado. Valorizar a relação de reciprocidade de perspectivas entre estes atores sociais pode promover maior adesão ao cuidado com a úlcera varicosa.
Objetivou-se refletir sobre o ambiente terapêutico e comportamentos de hipertensos de uma Atenção Básica. Investigação qualitativa descritiva com alicerce teórico no modelo adaptativo de Roy, realizada em uma Unidade de Atenção Básica de Minas Gerais, Brasil, com 30 participantes hipertensos. Foram coletados dados de caracterização sociodemográfica e realizadas entrevistas individuais em profundidade, com questões norteadoras, gravadas, entre os meses de agosto e outubro de 2019. Tratamento de dados com análise de conteúdo realizado com apoio dos softwares SPSS versão 24 e NVivo Pro11®. Adensamento teórico (Pearson ≥0,7). Atenderam-se todos os aspectos ético-legais de pesquisa. O ambiente terapêutico foi compreendido pelos participantes como componente de suas relações cotidianas na díade profissionais/usuários, mediante sua dependência pelo uso dos serviços de atenção básica, visto sua condição atual de saúde. Conclui-se que o controle dos estímulos, mecanismos de enfrentamento e comportamentos ineficazes requerem maior atenção pelo enfermeiro.
Funding Acknowledgements Type of funding sources: None. Introduction Cardiac rehabilitation (CR) programs are established interventions to improve cardiovascular health, despite asymmetries in referral. With covid 19 outbreak, cardiac rehabilitation home based (CR-HB) programs emerged as an alternative. However, its adherence and implementation may vary greatly with socio-demographic factors. Purpose To assess adherence to the various components of a CR-HB program. Methods Prospective cohort study which included patients (pts) who were participating in a centre-based CR program and accepted to participate in a CR-HB after the centre-based CR program closure due to COVID-19. The CR-HB consisted in a multidisciplinary digital CR program, including: 1.patient clinical and exercise risk assessment; 2.psychological tele-appointments; 3. online exercise training sessions; 4.structured online educational program for patients and family members/caregivers; 5. follow-up questionnaires; 6. nutrition tele-appointments; 7. physician tele-appointments Adherence to the program was assessed by drop-out rate; number of exercise sessions in which each patient participated; number of educational sessions attended and a validated questionnaire on therapeutic adherence (composed of 7 questions with minimum punctuation of 7 and maximum of 40 points). Results 116 cardiovascular disease (CVD) pts (62.6 ± 8.9 years, 95 males) who were attending a Centre-based CR program were included in a CR-HB program. Almost 90% (n = 103) of the participants had coronary artery disease; 13.8% pts had heart failure; the mean LVEF was 52 ± 11%. Regarding risk factors, obesity was the most common risk factor (74.7 %) followed by hypertension (59.6%), family history (41.8%), dyslipidaemia (37.9%), diabetes (18.1%), and smoking (12.9%). Ninety-eight pts (85.5%) successfully completed the program. Almost half (46.9%) of the participants did at least one online exercise training session per week. Among the pts who did online exercise training sessions, 58% did 2-3 times per week, 27% once per week and 15% more than 4 times per week. The pts participated, on average, in 1.45 ± 2.6 education sessions (rate of participation of 13,2%) and therapeutic adherence was high (39,7 ± 19; min 35-40). Regarding educational status of the pts, 33 pts (45,2%) had a bachelor degree. These pts tended to participate more in exercise sessions (1,7 ± 1,7 vs 1,2 ± 1,4 sessions per week) and in education sessions (2.13 vs 1.6), although this difference was not statistically significant. The therapeutic adherence did not vary with patients’ level of education. Conclusion Our results showed that a high percentage of patients completed the program and almost half were weekly physically active. However, in regard to educational sessions, the degree of participation was much lower. Educational status seemed to correlate with a higher degree of participation and, in the future, patient selection might offer better results in these kinds of programs.
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