Aspectos Psicossociais Da Qualidade De Vida De Receptores De Transplante Hepático

Abstract

RESUMO Objetivo: avaliar a dimensão psicossocial da qualidade de vida de pacientes antes e depois do transplante hepático. Método: estudo descritivo, transversal, com abordagem quantitativa, com 150 pacientes submetidos ao transplante de fígado em seguimento a partir do sexto mês, no ambulatório de um centro de referência em transplante hepático. A coleta de dados foi realizada a partir da aplicação de um instrumento com dados sociodemográficos/clínicos e do questionário Liver Disease Quality of Life. Foi utilizada análise estatística descritiva, teste t de Student para comparação das médias dos domínios e Games-Howell para comparações múltiplas. Resultados: houve melhoria nos níveis de qualidade de vida pós-transplante nos quatro domínios avaliados (<0,0001), com maior elevação de escores para os domínios: preocupação (55,5 vs 87,9) e estigma da doença hepática (58,6 vs 93,7). Conclusão: o estudo demonstrou que os pacientes submetidos ao transplante hepático obtiveram uma melhoria significativa da percepção da qualidade de vida no que diz respeito à dimensão psicossocial, sendo mais perceptiva nos domínios preocupação e estigma da doença hepática.

Alta hospitalar do paciente transplantado hepático: revisão integrativa

“…The findings indicate that, when knowing their health conditions and possible changes, the patient becomes autonomous, safe and with expertise to act as an agent of transformation in their lifestyle, in addition to helping to reduce anxiety when they are acquainted with and know how to deal with their own care and promote self-management. [21][22][23]25 Regarding the planning of educational strategies for the prevention of intercurrent illnesses and complications, the first category proposes that the patient knows how to identify clinical signs of rejection, infection, neurological and renal complications. In addition to knowing the importance of health care such as personal and environmental hygiene, care related to the preservation of kidney function through fluid intake and, mainly, with the adjustment of medication doses, so that nephrotoxicity does not occur.…”

“…[1][2][3] The evidence point to the importance of the team making sure that this information is understood, given that, provided with this data, they will have the opportunity to prevent injuries, graft loss and readmissions. 1,12,16,17,20,21 Evidence of care in post-liver transplantation Wachholz LF, Knihs NS, Martins SR, Magalhães ALP, Brehmer LCF, Martins MS 2°) Recommendations for the use of medicines -promoting self-management and adherence to treatment. This category points out evidence for health care actions regarding the use of drugs.…”

“…8,13 This professional can assist the medical team in adjusting doses, medication associations and supervising treatment adherence, minimizing health risks or even nephrotoxicity, neurotoxicity, graft loss, skin cancer and decreased libido. 1,16,17,19,21 3°) Activities and daily care at home -support and self-confidence, shows effective strategies to promote care, such as: elaborating a physical activity plan to be performed at home, with the objective of improving physical conditioning, preventing injuries and minimizing comorbidities, prevent hypertension and lung diseases. 14 It is recommended that patients do glycemic control three times a day, in addition to the controlling of foods that favor hyperglycemia.…”

“…18 The team must promote the learning of such tasks during hospitalization under the supervision of professionals. 21,22 4°) Changes in body image and daily life -importance of the support network, indicates how difficult it is for the patient to adapt to the new health reality imposed by the transplant. The difficulty in accepting and dealing with changes in body image, often caused by edema and side effects of medications.…”

“…It is important that this network is expanded to friends, other family members and primary care, and that these people, progressively, can empower and encourage the patient to face the challenges imposed in this new stage of life. 12,19,21,22…”