Clientes com doença renal crônica: avaliação de Enfermagem sobre a competência para o autocuidado

Abstract

Resumo Abstract ResumenThe admission in dialysis therapies in inappropriate conditions demand discomfort and suffering to the clients with chronicle renal disease (CRD), besides the cost to the health system and of the nursing work. Aim to encourage the client for the adhesion to the treatment that preserves this pathology, it has as objective: to evaluate the competency and the deficit to the self care of the client with CRD. It was implanted the epidemiologic method trough interviews with 51 clients of the clinics of uremia of the HUPE/UERJ, in 2005. It became evident the deficit of the knowledge about the consequences of the arterial hypertension and diabetes linked to the CRD and the limits in the choice and adhesion of the medical therapies, nutritional and of nursing. It was conclude that the doubts about this disease, permeates the life of the clients and may interfere in the adhesion to the treatment and to compromise the client's quality of life. This found it is a reinforcement to the importance of the self care learning to demonstrate its potential to face the CRD.El ingreso en terapias dialíticas en condiciones inadecuadas demanda incomodidad y sufrimiento a los clientes con enfermedad renal crónica (ERC), allende costas al sistema de salud y del trabajo de enfermería. Teniendo en vista incentivar el cliente para la adhesión al tratamiento conservador de esta patología, se objetiva: evaluar la competencia y el déficit para el auto cuidado del cliente con ERC. Implementóse el método epidemiológico por entrevista con 51 clientes del ambulatorio de uremia del HUPE/UERJ, en 2005. Evidencióse el déficit del conocimiento sobre las consecuencias de la hipertensión ar terial y diabetes asociados a la ERC y los limites en la elección y adhesión de las terapéuticas médica, nutricional y de enfermería. Concluyese que dudas sobre esa enfermedad atravesan la vida de los clientes y poden interferir en la adhesión al tratamiento y comprometer su cualidad de vida. Ese hallado refuerza la importancia de la enseñanza del auto cuidado para demostrar su potencial para enfrentar la ERC.

Adherence to immunosuppressive treatment in post-renal transplant patientes: a descriptive-exploratory study

“…Chronic Kidney Diseases (CKD) result from the reduction in the ability of glomerular filtering by the kidneys due to the accumulation of toxins in the blood stream and the loss of electrolytes needed for the functioning of the organic system (1) . The treatment indicated with regard to CKD consists of the prescription of immunosuppressive medication, hemodialysis and renal transplant (2) .…”

“…Based on that, the adherence to treatment and the risks that patients are facing because of non-adherence is being studied in many research projects (4,5,6,9,11) . In this sense, it is extremely important to make the patient feel responsible, as the treatment directly affects the quality of that person's life (14) and requires an adaptation of the lifestyle due to the new situations and personal demands that affect adherence to therapy (2) . These include such aspects as treatment, reduction of…”

“…The need to assuage the doubts of the patients, as well as to calm them, demands some guidelines for the whole team and some nursing care. In this sense, the nurse must act as a base, giving psychological and educational support to the patients and relatives (2,4) , as data show that many patients who are non-adherents to drug treatment have little information regarding the effects of renal substitution therapy (10) .…”

“…These benefits can reduce the negative consequences of the disease, and moreover, the delay in terms of renal transplants and the promotion of the quality of life (2) .…”

Autocuidado e recursos assistenciais aos portadores de hepatite B

“…A articulação entre conceitos de epidemiologia descritiva (9,10) e de autocuidado (7,8) permitiu propor uma configuração conceitual prévia como referencial de análise, considerando especialmente a cronificação do problema de saúde. Talvez a condição de cronicidade ou longa permanência do problema de saúde possa ser mais bem compreendida e conduzida com a abordagem teórico-prática do autocuidado, como apontam vários estudos (11)(12)(13)(14) . A cronificação se caracteriza por desvio de saúde, e nessa condição o portador de hepatite B necessita de ações específicas, desenvolvidas com o apoio da equipe de enfermagem no serviço de saúde, as quais compreendem orientação, educação, sensibilização e esclarecimento para a tomada de consciência e engajamento ao autocuidado.…”