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Perspetivas de utentes com lesão vertebro-medular sobre a autogestão na prevenção das complicações secundárias
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Autores
Orientador(es)
Resumo(s)
O impacto das complicações secundárias após a lesão vertebro-medular (LVM) é
considerável, conduzindo a uma alta utilização dos serviços de saúde A autogestão é
considerada estratégia essencial na prevenção dessas situações. Uma maior compreensão do
significado de autogestão e dos facilitadores e barreiras à sua implementação, na perspetiva
de pessoas com LVM, irá contribuir para o desenvolvimento de programas de autogestão
personalizados.
Objetivos: Este estudo teve como objetivos caracterizar perfis de indivíduos com LVM em
termos de independência funcional e autoeficácia, e compreender as suas perspetivas em
relação à autogestão e identificar os facilitadores e barreiras à sua implementação.
Metodologia: Na primeira fase quantitativa, com 54 participantes, por amostragem não-
probabilística por conveniência, recolheu-se informação por medidas de autoreporte (Medida
de Independência Funcional para utentes com LVM-SCIM II e Escala de Autoeficácia para
Utilizadores de Cadeira de Rodas) e um questionário de caracterização sociodemográfica e
clínica. A segunda fase qualitativa, com amostragem intencional, compreendeu a realização
de oito entrevistas semiestruturadas, seguindo uma metodologia de análise temática indutiva.
Resultados: Foram encontradas correlações entre autoeficácia e independência funcional,
prevalência de complicações e nível de conhecimento, e identificados dois perfis (Perfil 1
baixa autoeficácia e independência funcional e Perfil 2 alta autoeficácia e independência
funcional). A análise temática sugeriu a importância da Responsabilidade Interna na
perspetiva da autogestão, relacionada ao Autocuidado e à Participação Social Ativa. Na
identificação dos facilitadores e barreiras à adoção de comportamentos de autogestão,
emergiram 6 temas: Apoios e Recursos Financeiros, Profissionais e Serviços de Saúde,
Responsabilidade Interna, Suporte Social, Fatores Ambientais e Sociais, e Dependência
Funcional e Complicações Secundárias.
Conclusões: Os resultados deste estudo permitiram conhecer a perspetiva e necessidades das
pessoas com LVM, relativamente à autogestão. Com este estudo espera-se contribuir para
uma mudança de paradigma, reconhecendo a autogestão como elemento fundamental para o
bem-estar de indivíduos com LVM.
The considerable impact of secondary complications following spinal cord injury (SCI) leads to high utilization of healthcare services. To prevent such situations, self-management is considered an essential strategy. Tailored self-management programs can be developed by gaining a better understanding of the meaning of self-management and the facilitators and barriers to its implementation from the perspective of people with SCI. Objectives: This study aimed to profile individuals with SCI in terms of functional independence and self-efficacy, and to explore their perspectives on self-management. Additionally, it sought to identify the facilitators and barriers to implementing self- management. Methodology: The methodology involved a two-phase approach. The first phase was quantitative, with 54 participants selected through non-probabilistic convenience sampling. Information was collected using self-report measures such as the Functional Independence Measure for individuals with SCI (SCIM II) and the Self-Efficacy Scale for Wheelchair Users, along with a sociodemographic and clinical questionnaire. The second phase was qualitative, involving eight semi-structured interviews conducted through intentional sampling. The data obtained from these interviews was subjected to an inductive thematic analysis methodology. Results: The study revealed correlations between self-efficacy and functional independence, prevalence of complications and level of knowledge. Two profiles were identified: Profile 1 with low self-efficacy and functional independence, and Profile 2 with high self-efficacy and functional independence. Thematic analysis highlighted the significance of Internal Responsibility in self-management, particularly in relation to Self-Care and Active Social Participation. Six themes emerged when identifying facilitators and barriers to adopting self- management behaviours: Financial Support and Resources, Professionals and Health Services, Internal Responsibility, Social Support, Environmental and Social Factors, and Functional Dependence and Secondary Complications. Conclusions: This study provides insights into the perspective and needs of individuals with LVM in terms of self-management. It aims to contribute to a paradigm shift by recognizing self-management as a fundamental element for enhancing the well-being of individuals with LVM.
The considerable impact of secondary complications following spinal cord injury (SCI) leads to high utilization of healthcare services. To prevent such situations, self-management is considered an essential strategy. Tailored self-management programs can be developed by gaining a better understanding of the meaning of self-management and the facilitators and barriers to its implementation from the perspective of people with SCI. Objectives: This study aimed to profile individuals with SCI in terms of functional independence and self-efficacy, and to explore their perspectives on self-management. Additionally, it sought to identify the facilitators and barriers to implementing self- management. Methodology: The methodology involved a two-phase approach. The first phase was quantitative, with 54 participants selected through non-probabilistic convenience sampling. Information was collected using self-report measures such as the Functional Independence Measure for individuals with SCI (SCIM II) and the Self-Efficacy Scale for Wheelchair Users, along with a sociodemographic and clinical questionnaire. The second phase was qualitative, involving eight semi-structured interviews conducted through intentional sampling. The data obtained from these interviews was subjected to an inductive thematic analysis methodology. Results: The study revealed correlations between self-efficacy and functional independence, prevalence of complications and level of knowledge. Two profiles were identified: Profile 1 with low self-efficacy and functional independence, and Profile 2 with high self-efficacy and functional independence. Thematic analysis highlighted the significance of Internal Responsibility in self-management, particularly in relation to Self-Care and Active Social Participation. Six themes emerged when identifying facilitators and barriers to adopting self- management behaviours: Financial Support and Resources, Professionals and Health Services, Internal Responsibility, Social Support, Environmental and Social Factors, and Functional Dependence and Secondary Complications. Conclusions: This study provides insights into the perspective and needs of individuals with LVM in terms of self-management. It aims to contribute to a paradigm shift by recognizing self-management as a fundamental element for enhancing the well-being of individuals with LVM.
Descrição
Palavras-chave
Autogestão Lesão vertebro-medular Facilitadores Barreiras Estudo misto Self-management Spinal cord injury Facilitator Barrier Mixed study