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Função cognitiva global e independência funcional da população com traumatismo crânio-encefálico e acidente vascular cerebral alvo de cudados de enfermagem de reabilitação na região autónoma da Madeira: Um estudo descritivo-correlacional
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| 3.85 MB | Adobe PDF |
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Abstract(s)
ENQUADRAMENTO: O traumatismo crânio-encefálico (TCE) e o acidente vascular cerebral (AVC) são as duas principais causas de incapacidade adquirida nos adultos face, especialmente, às alterações nas funções cognitivas que afetam a capacidade de viver independente.
OBJETIVOS: Caracterizar os clientes com TCE ou AVC, alvo dos cuidados de Enfermagem de Reabilitação na Região Autónoma da Madeira (RAM), em relação à função cognitiva global (Montreal Cognitive Assessment - MoCA) e à independência funcional (Índice de Barthel) e analisar a relação existente entre estas variáveis.
DESENHO DO ESTUDO: Estudo quantitativo, transversal, descritivo e correlacional.
RESULTADOS: 12 clientes com TCE e 55 clientes com AVC participaram neste estudo. Mais da metade dos participantes revelou défice cognitivo e estes apresentaram elevados níveis de défice na maioria dos domínios cognitivos, com maior défice na “função executiva”. A maioria dos participantes com TCE (66.7%) e AVC (61.8%) encontrava-se moderadamente a totalmente dependente. No grupo com TCE, apenas a “orientação” revelou uma grande correlação positiva com a independência funcional (rho = .652, n = 10, p = .041). No grupo com AVC, para além da função cognitiva global ter demonstrado uma grande correlação positiva com a independência funcional (r = .596, n = 40, p ˂ .001), a “função executiva” (r = .560, n = 40, p ˂ .001), a “capacidade visuo-espacial” (r = .599, n = 40, p ˂ .001) e a “atenção, concentração e memória de trabalho” (r = .538, n = 40, p ˂ .001) também revelaram uma grande correlação positiva com a independência funcional e a “orientação” (r = .370, n = 40, p = .019), uma correlação média positiva.
CONCLUSÃO: O presente estudo reforça a relação existente entre a função cognitiva e a independência funcional. Os resultados justificam a pertinência do rastreio cognitivo aos clientes com TCE e AVC, assim como, a implementação de intervenções específicas e dirigidas a estas duas dimensões.
BACKGROUND: Traumatic brain injury and stroke are the two main causes of acquired disability in adults, especially due to changes in cognitive functions that affect their ability to live independently. OBJECTIVES: To characterize clients with TBI or stroke, target of Rehabilitation Nursing care in the Autonomous Region of Madeira (RAM), in relation to global cognitive function (Montreal Cognitive Assessment - MoCA) and functional independence (Barthel Index) and to analyze the relationship between these variables. STUDY DESIGN: Quantitative, cross-sectional, descriptive and correlational study. RESULTS: 12 clients with TBI and 55 clients with stroke participated in this study. More than half of the participants revealed cognitive impairment and they had high levels of deficit in most cognitive domains, with a greater deficit in “executive function”. Most participants with TBI (66.7%) and stroke (61.8%) were moderately to totally dependent. In the TBI group, only “orientation” revealed a large positive correlation with functional independence (rho = .652, n = 10, p = .041). In the stroke group, in addition to the global cognitive function showing a strong positive correlation with functional independence (r = .596, n = 40, p ˂ .001), the “executive function” (r = .560, n = 40, p ˂ .001), “visuospatial ability” (r = .599, n = 40, p ˂ .001) and “attention, concentration and working memory” (r = .538, n = 40 , p ˂ .001) also revealed a strong positive correlation with functional independence and "orientation" (r = .370, n = 40, p = .019), a positive mean correlation. CONCLUSION: The present study reinforces the relationship between cognitive function and functional independence. The results justify the relevance of cognitive screening of clients with TBI and stroke, as well as the implementation of specific and directed interventions to these two dimensions.
BACKGROUND: Traumatic brain injury and stroke are the two main causes of acquired disability in adults, especially due to changes in cognitive functions that affect their ability to live independently. OBJECTIVES: To characterize clients with TBI or stroke, target of Rehabilitation Nursing care in the Autonomous Region of Madeira (RAM), in relation to global cognitive function (Montreal Cognitive Assessment - MoCA) and functional independence (Barthel Index) and to analyze the relationship between these variables. STUDY DESIGN: Quantitative, cross-sectional, descriptive and correlational study. RESULTS: 12 clients with TBI and 55 clients with stroke participated in this study. More than half of the participants revealed cognitive impairment and they had high levels of deficit in most cognitive domains, with a greater deficit in “executive function”. Most participants with TBI (66.7%) and stroke (61.8%) were moderately to totally dependent. In the TBI group, only “orientation” revealed a large positive correlation with functional independence (rho = .652, n = 10, p = .041). In the stroke group, in addition to the global cognitive function showing a strong positive correlation with functional independence (r = .596, n = 40, p ˂ .001), the “executive function” (r = .560, n = 40, p ˂ .001), “visuospatial ability” (r = .599, n = 40, p ˂ .001) and “attention, concentration and working memory” (r = .538, n = 40 , p ˂ .001) also revealed a strong positive correlation with functional independence and "orientation" (r = .370, n = 40, p = .019), a positive mean correlation. CONCLUSION: The present study reinforces the relationship between cognitive function and functional independence. The results justify the relevance of cognitive screening of clients with TBI and stroke, as well as the implementation of specific and directed interventions to these two dimensions.
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Keywords
traumatismo crânio-encefálico acidente vascular cerebral função cognitiva global independencia funcional enfermagem de reabilitação