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Da incapacidade para gerir o regime terapêutico medicamentoso, ao nível de suporte necessário
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Advisor(s)
Abstract(s)
Face à magnitude da doença crónica e à complexidade dos regimes terapêuticos medicamentosos hoje adoptados
os pro%ssionais de saúde confrontam-se com frequência com situações de ine%cácia desse mesmo regime.
As di%culdades da gestão vão desde questões de falta de conhecimento à não adesão, não sendo desprezível, no
entanto, a questão da capacidade da pessoa versus a complexidade desse regime medicamentoso.
Objectivo: Identi%car diferentes níveis de suporte à gestão do regime terapêutico medicamentoso face à capacidade/
incapacidade da pessoa para a gestão desse regime.
Métodos: Foi realizado um estudo multicasos, com follow-up durante cerca de um ano e meio, em que foram
realizadas entrevistas, observação participante e consulta de processos clínicos. Fizeram parte do estudo 22 participantes
com regimes terapêuticos complexos e com múltiplos internamentos desde Janeiro 2006 a Setembro de
2008. Os dados foram analisados pelo método proposto por Strauss e Corbin.
Resultados: Neste estudo encontrámos situações de sub-diagnóstico de incapacidade para a gestão do regime
terapêutico, por vezes identi%cadas como situações de não adesão. Face à capacidade para gerir o regime terapêutico
emergem dois temas: a capacidade económica, para adquirir os medicamentos; e a capacidade da pessoa para
saber, tomar, avaliar e controlar os medicamentos. Face a esta última, encontrámos três categorias relacionadas
com a capacidade cognitiva, a memória e a percepção, propondo-se um 3uxograma com o nível de suporte
necessário por um prestador de cuidados pro%ssional ou familiar, em função dos diferentes níveis de capacidade
versus incapacidade
Conclusão: A desvalorização da capacidade para a pessoa com doença crónica gerir o seu regime terapêutico
medicamentoso pode conduzir a situações inadequadas de dependência de um prestador de cuidados, diminuindo
o nível de autonomia. A não identi%cação de situações de incapacidade pode conduzir à ine%cácia da gestão
com as consequências daí inerentes, com reinternamentos e diminuição da qualidade de vida da pessoa.
Given the magnitude of chronic disease and the complexity of drug regimens, health professionals are o4en faced with situations of ine5ectiveness of therapeutic regime. Self-management di7culties ranging from lack of knowledge until noncompliance, not being despicable, however, the individual ability versus the complexity of drug regimen. Objective: To identify di5erent levels of support to the management of drug treatment regimen given the ability / disability of the person to manage the scheme. Methods: We conducted a study multicasos with follow-up for about a year and a half, in which we conducted interviews, participant observation and clinical processes. Study participants were 22 participants with complex regimens, with multiple hospitalizations, since January 2006 to September 2008. Data were analyzed by the method proposed by Strauss and Corbin. Results: In this study, we found situations of under-diagnosis of inability to manage the therapeutic regimen, sometimes identi%ed as instances of noncompliance. <e ability to manage the therapeutic regimen emerging as a major category, with two other themes: the economic capacity to acquire the prescribed drugs, and the person’s ability to “learn”, to “make”, to “evaluate” and to “control” medication e5ect. Given the person’s capability, we %nd three categories related to cognitive ability, memory and perception. In this study we propose a 3owchart with the level of support required, by a professional provider or family member, depending on the di5erent levels of ability versus disability. Conclusion: <e devaluation of the capacity for people with chronic illness, manage their treatment regimen may lead to inappropriate situations of dependence on a caregiver, decreasing the level of autonomy. Failure to identify situations of incapacity can lead to ine7cient management with the implications associated with readmission and decreased quality of life of the person.
Given the magnitude of chronic disease and the complexity of drug regimens, health professionals are o4en faced with situations of ine5ectiveness of therapeutic regime. Self-management di7culties ranging from lack of knowledge until noncompliance, not being despicable, however, the individual ability versus the complexity of drug regimen. Objective: To identify di5erent levels of support to the management of drug treatment regimen given the ability / disability of the person to manage the scheme. Methods: We conducted a study multicasos with follow-up for about a year and a half, in which we conducted interviews, participant observation and clinical processes. Study participants were 22 participants with complex regimens, with multiple hospitalizations, since January 2006 to September 2008. Data were analyzed by the method proposed by Strauss and Corbin. Results: In this study, we found situations of under-diagnosis of inability to manage the therapeutic regimen, sometimes identi%ed as instances of noncompliance. <e ability to manage the therapeutic regimen emerging as a major category, with two other themes: the economic capacity to acquire the prescribed drugs, and the person’s ability to “learn”, to “make”, to “evaluate” and to “control” medication e5ect. Given the person’s capability, we %nd three categories related to cognitive ability, memory and perception. In this study we propose a 3owchart with the level of support required, by a professional provider or family member, depending on the di5erent levels of ability versus disability. Conclusion: <e devaluation of the capacity for people with chronic illness, manage their treatment regimen may lead to inappropriate situations of dependence on a caregiver, decreasing the level of autonomy. Failure to identify situations of incapacity can lead to ine7cient management with the implications associated with readmission and decreased quality of life of the person.
Description
Keywords
Gestão do regime terapêutico Prestador de Cuidados Doença crónica Família
Citation
Publisher
Escola Superior de Enfermagem do Porto