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Efeitos de um programa de autogestão nos resultados clínicos de adultos com AVC: um estudo quase-experimental
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Advisor(s)
Abstract(s)
Introdução: O suporte de autogestão a utentes com AVC é recomendado
internacionalmente, com evidência de melhorarias significativas dos resultados clínicos.
Contudo, em Portugal não são conhecidos programas de autogestão, apesar de
investigação anterior reportar as dificuldades na participação dos utentes, a sua
dependência dos profissionais de saúde e declínio funcional ao longo do tempo. Tendo
em conta os resultados anteriores, foi proposto o programa “ComVida: há vida após
AVC”, um programa de intervenção híbrida personalizada para suporte à autogestão após
AVC, tendo por base os princípios do Bridges Self Management Program.
Objetivo: Este projeto tem como objetivo analisar a viabilidade e a implementação de
um programa de autogestão em utentes com AVC ao nível da autoeficácia, função física,
estado emocional e qualidade de vida às seis e doze semanas de implementação.
Métodos: Foi utilizado um desenho quase-experimental com avaliação realizada em três
momentos, nomeadamente T1: durante a primeira semana de tratamento, T2; seis
semanas após a primeira avaliação e T3: doze semanas após a primeira intervenção.
Foram incluídos no estudo 28 participantes a que foram implementadas intervenções
baseadas nos princípios chave do programa Bridges, não havendo grupo de controlo.
Resultados: Na diferença global ao nível da autoeficácia, avaliada com a SSEQ, obtevese uma diferença média significativa de 10,036 (95% intervalo de confiança 7,560 a
12,512; p<0,001) entre os três momentos, indicando um nível autoeficácia
significativamente maior em T3, quando comparado com T1. Também os outros
outcomes avaliados tiveram diferenças médias significativas (p<0,001). Todas as
correlações são significativas a um nível de p=0,01, observa-se que, ao longo do tempo,
as correlações se mantêm altas, especialmente entre T2 e T3, indicando consistência nos
resultados.
Conclusão: Os resultados deste estudo demonstraram que aplicação de um programa
baseado na autogestão após o AVC do utente pode apresentar melhorias significativas na
autoeficácia, qualidade de vida, estado emocional e função física do utente.
Introduction: Self-management support for stroke patients is internationally recommended, with evidence of significant improvements in clinical outcomes. However, in Portugal there are no known self-management programs, despite previous research reporting difficulties in user participation, their dependence on health professionals and functional decline over time. Considering the previous results, the program "ComVida: there is life after stroke" was proposed, a personalized hybrid intervention program to support self-management after stroke, based on the principles of the Bridges SelfManagement Program. Objective: This project aims to analyse the feasibility and implementation of a selfmanagement program in stroke patients in terms of self-efficacy, physical function, emotional state and quality of life at six and twelve weeks of implementation. Methods: A quasi-experimental design was used with evaluation carried out at three moments, namely T1: during the first week of treatment, T2; six weeks after the first assessment and T3: twelve weeks after the first assessment. The study included 28 participants who implemented interventions based on the key principles of the Bridges program, and there was no control group. Results: In the overall difference in self-efficacy, assessed with the SSEQ, there was a significant mean difference of 10.036 (95% confidence interval 7.560 to 12,512; p<0.001) among the three time points, indicating a significantly higher level of self-efficacy at T3 compared to T1. Other outcomes assessed also showed significant mean differences (p<0.001). All correlations were significant at a p=0.01 level, and it was observed that, over time, the correlations remained high, particularly between T2 and T3, indicating consistency in the results. Conclusion: The results of this study demonstrated that the implementation of a selfmanagement program for stroke patients can lead to significant improvements in selfefficacy, quality of life, emotional state, and patient physical function.
Introduction: Self-management support for stroke patients is internationally recommended, with evidence of significant improvements in clinical outcomes. However, in Portugal there are no known self-management programs, despite previous research reporting difficulties in user participation, their dependence on health professionals and functional decline over time. Considering the previous results, the program "ComVida: there is life after stroke" was proposed, a personalized hybrid intervention program to support self-management after stroke, based on the principles of the Bridges SelfManagement Program. Objective: This project aims to analyse the feasibility and implementation of a selfmanagement program in stroke patients in terms of self-efficacy, physical function, emotional state and quality of life at six and twelve weeks of implementation. Methods: A quasi-experimental design was used with evaluation carried out at three moments, namely T1: during the first week of treatment, T2; six weeks after the first assessment and T3: twelve weeks after the first assessment. The study included 28 participants who implemented interventions based on the key principles of the Bridges program, and there was no control group. Results: In the overall difference in self-efficacy, assessed with the SSEQ, there was a significant mean difference of 10.036 (95% confidence interval 7.560 to 12,512; p<0.001) among the three time points, indicating a significantly higher level of self-efficacy at T3 compared to T1. Other outcomes assessed also showed significant mean differences (p<0.001). All correlations were significant at a p=0.01 level, and it was observed that, over time, the correlations remained high, particularly between T2 and T3, indicating consistency in the results. Conclusion: The results of this study demonstrated that the implementation of a selfmanagement program for stroke patients can lead to significant improvements in selfefficacy, quality of life, emotional state, and patient physical function.
Description
Keywords
Autogestão Acidente Vascular Cerebral Autoeficácia Self-management Stroke Self-efficacy