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Contributos do enfermeiro especialista em enfermagem de reabilitação na gestão das atividades de vida diárias do utente com DPOC: programa de reabilitação respiratória
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Abstract(s)
A Doença Pulmonar Obstrutiva Crónica é uma doença respiratória com elevada
prevalência em Portugal, afetando aproximadamente 800 mil portugueses e estima-se que
seja a terceira causa de morte a nível global.
As alterações fisiopatológicas desta patologia vão-se instalando no decurso da
doença agravando os sintomas, nomeadamente a dispneia. Na tentativa de diminuir os
sintomas, instala-se um ciclo vicioso que conduz ao descondicionamento físico,
comprometendo as Atividades de Vida Diárias. Os Programas de Reabilitação Respiratória
constituem uma estratégia fundamental para travar este ciclo da doença.
O Enfermeiro Especialista em Enfermagem de Reabilitação no âmbito das suas
competências específicas, desempenha um contributo importante na conceção,
implementação e avaliação destes Programas de Reabilitação Respiratória, com objetivo,
de otimizar a capacidade funcional, melhorar a autonomia para as Atividades de Vida
Diárias, capacitar o utente para melhor gerir a sua doença e melhorar a sua qualidade de
vida.
A realização deste estudo teve como propósito avaliar o impacto na realização das
Atividades de Vida Diárias dos utentes com Doença Pulmonar Obstrutiva Crónica,
submetidos a um Programa de Reabilitação Respiratória. Os objetivos traçados foram:
caracterizar os utentes com Doença Pulmonar Obstrutiva Crónica que integraram o
programa e comparar a capacidade para o desempenho das Atividades de Vida Diárias dos
utentes com Doença Pulmonar Obstrutiva Crónica antes e após o Programa de Reabilitação
Respiratória.
Realizou-se um estudo retrospetivo-correlacional, no período compreendido entre
janeiro e dezembro de 2018, num centro hospitalar da zona norte do país, com uma amostra
de 46 participantes, com diagnóstico de Doença Pulmonar Obstrutiva Crónica. Na sua
maioria do género masculino (67,39%) com uma idade média de 63 anos.
Os principais resultados do estudo evidenciaram ganhos ao nível da autonomia para
as Atividades de Vida Diárias, verificando-se uma melhoria estatisticamente significativa
nos diferentes domínios da escala London Chest Activity of Daily Living. O domínio onde
as diferenças são mais significativas é o domínio das “tarefas domésticas” seguido do
domínio “cuidado pessoal”, sendo que o domínio do “lazer” é o que traduz menor diferença
estatística. Demonstrou-se que a limitação da capacidade respiratória também diminuiu
com significado estatístico.
Este estudo contribuiu para demonstrar a relevância e o papel ativo que o
Enfermeiro Especialista em Enfermagem de Reabilitação tem nos Programas de
Reabilitação Respiratória, nomeadamente ao nível da autonomia e capacitação para a
gestão da doença crónica e adoção de estratégias adaptativas para as Atividades de Vida
Diárias, na implementação dos programas de treino para melhoria da intolerância à
atividade.
Chronic Obstructive Pulmonary Disease is highly prevalent in Portugal, affecting approximately 800,000 Portuguese and is estimated to be the third leading cause of death globally. The pathophysiological changes of this pathology appear gradually during the course of the disease, worsening the symptoms, namely dyspnoea. In an attempt to reduce symptoms, a vicious cycle takes place, which leads to physical deconditioning, compromising Daily Living Activities. Respiratory Rehabilitation Programs consist in a fundamental strategy to stop this disease cycle. The Specialist Nurse in Rehabilitation Nursing within the scope of specific competences, plays an important contribution in the design, implementation and evaluation in these Respiratory Rehabilitation Program, as goal, to optimize functional capacity, improve autonomy in Daily Living Activities, capacitate patient to better manage his disease and improve his life quality. The purpose of this study was to evaluate the impact on the performance of the Daily Living Activities for patients with Chronic Obstructive Pulmonary Disease, submitted to a Respiratory Rehabilitation Program. The objectives outlined were: to characterize patients with Chronic Obstructive Pulmonary Disease who were part of the program and to compare the capacity to perform the Daily Living Activities of patients with Chronic Obstructive Pulmonary Disease before and after the Respiratory Rehabilitation Program. A retrospective-correlational study was carried out, in the period between january and december 2018, in a hospital center in the north of the country, with a sample of 46 participants, diagnosed with Chronic Obstructive Pulmonary Disease, mostly male (67.39%) with an average age of 63 years. The main results of the study evidence gains in terms of autonomy for Daily Living Activities, with a statistically significant improvement in the different domains of the London Chest Activity of Daily Living scale. The domain where the differences are most significant are in the "household chores" domain, followed by the "personal care" domain, and the "leisure" domain shows the least statistical difference. It has been demonstrated that the respiratory capacity limitations also decreased with statistical significance. This study contributed to demonstrate the relevance and the active role that the Specialist Nurse in Rehabilitation Nursing has in the Respiratory Rehabilitation Program, particularly in terms of autonomy, training for the management of chronic disease and adaptative strategies adoption for Daily Living Activities, on the implementation in the training programs to improve activity intolerance.
Chronic Obstructive Pulmonary Disease is highly prevalent in Portugal, affecting approximately 800,000 Portuguese and is estimated to be the third leading cause of death globally. The pathophysiological changes of this pathology appear gradually during the course of the disease, worsening the symptoms, namely dyspnoea. In an attempt to reduce symptoms, a vicious cycle takes place, which leads to physical deconditioning, compromising Daily Living Activities. Respiratory Rehabilitation Programs consist in a fundamental strategy to stop this disease cycle. The Specialist Nurse in Rehabilitation Nursing within the scope of specific competences, plays an important contribution in the design, implementation and evaluation in these Respiratory Rehabilitation Program, as goal, to optimize functional capacity, improve autonomy in Daily Living Activities, capacitate patient to better manage his disease and improve his life quality. The purpose of this study was to evaluate the impact on the performance of the Daily Living Activities for patients with Chronic Obstructive Pulmonary Disease, submitted to a Respiratory Rehabilitation Program. The objectives outlined were: to characterize patients with Chronic Obstructive Pulmonary Disease who were part of the program and to compare the capacity to perform the Daily Living Activities of patients with Chronic Obstructive Pulmonary Disease before and after the Respiratory Rehabilitation Program. A retrospective-correlational study was carried out, in the period between january and december 2018, in a hospital center in the north of the country, with a sample of 46 participants, diagnosed with Chronic Obstructive Pulmonary Disease, mostly male (67.39%) with an average age of 63 years. The main results of the study evidence gains in terms of autonomy for Daily Living Activities, with a statistically significant improvement in the different domains of the London Chest Activity of Daily Living scale. The domain where the differences are most significant are in the "household chores" domain, followed by the "personal care" domain, and the "leisure" domain shows the least statistical difference. It has been demonstrated that the respiratory capacity limitations also decreased with statistical significance. This study contributed to demonstrate the relevance and the active role that the Specialist Nurse in Rehabilitation Nursing has in the Respiratory Rehabilitation Program, particularly in terms of autonomy, training for the management of chronic disease and adaptative strategies adoption for Daily Living Activities, on the implementation in the training programs to improve activity intolerance.
Description
Curso de Mestrado ministrado em parceria com Escola Superior de Enfermagem S. José de Cluny e Escola Superior de Enfermagem Dr. José Timóteo Montalvão Machado
Keywords
Doença Pulmonar Obstrutiva Crónica Atividades de Vida Diárias Enfermeiro Especialista em Enfermagem de Reabilitação Programa de Enfermagem de Reabilitação
Citation
Rodrigues, M. F. R. (2021). Contributos do Enfermeiro Especialista em Enfermagem de Reabilitação na gestão das atividades de vida diárias do utente com DPOC: Programa de Reabilitação Respiratória (Master's thesis, Escola Superior de Saúde de Santa Maria)