Programa educativo para pacientes con enfermedad arterial coronaria: resultados después de un año

Arantes, Eliana de Cássia; Dessotte, Carina Aparecida Marosti; Dantas, Rosana Aparecida Spadoti; Rossi, Lidia Aparecida; Furuya, Rejane Kiyomi

doi:10.1590/0034-7167-2017-0280

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RESEARCH • Rev. Bras. Enferm. 71 (6) • Nov-Dec 2018 • https://doi.org/10.1590/0034-7167-2017-0280 copiar

Programa educativo para pacientes con enfermedad arterial coronaria: resultados después de un año

Autoría SCIMAGO INSTITUTIONS RANKINGS

RESUMEN

Objetivo:

Evaluar resultados a largo plazo de un programa educativo comparado con el cuidado usual.

Método:

Estudio longitudinal con 56 participantes de un estudio previo (ensayo clínico controlado y aleatorizado), que fueron evaluados 12 meses después de la intervención coronaria percutánea (ICP). La calidad de vida relacionada con la salud (CVRS) fue evaluada por el Cuestionario de Salud SF-36 (36-Item Short Form) y los síntomas de ansiedad y depresión por la Escala de Ansiedad y Depresión Hospitalaria (sigla en inglés: HADS). Se realizó un análisis de varianza de medidas repetidas (nivel de significancia 0,05).

Resultados:

Los participantes del programa educativo presentaron mejoría de la CVRS en el dominio Rol Emocional, mientras que los participantes del cuidado usual no presentaron alteración (p=0,05). Con el tiempo, ambos grupos presentaron mejoría en los dominios Rol Físico (p=0,001) y Dolor Corporal (p=0,01). No hubo diferencias en los síntomas de ansiedad y depresión.

Conclusión:

Un año después de la ICP, hubo diferencias significativas entre los grupos sólo para el dominio Rol Emocional del SF-36.

Descriptores:
Enfermedad de las Coronarias; Angioplastia; Educación en Salud; Rehabilitación Cardiaca; Telemedicina

Variable	T0 (FURUYA, 2015)⁽⁴⁾4 Furuya RK, Arantes EC, Dessotte CA, Ciol MA, Hoffman JM, Schmidt A, et al. A randomized controlled trial of an educational programme to improve self-care in Brazilian patients following percutaneous coronary intervention. J Adv Nurs[Internet]. 2015[cited 2017 Apr 11];71(4):895-908. Available from: http://onlinelibrary.wiley.com/doi/10.1111/jan.12568/epdf http://onlinelibrary.wiley.com/doi/10.11... Before PCI		p value	T1(Current study)After 12 months		p value
Variable	IG (n=29)	CG (n=27)	p value	IG (n=29)	CG (n=27)	p value
Age (in years) [M, (SD)]	63.5 (12.5)	60.2 (8.8)	0.26	64.6 (12.5)	61.3 (8.8)	0.26
Years of study [M, (SD)]	3.9 (2.9)	5.5 (4.2)	0.11	3.9 (2.9)	5.5 (4.2)	0.11
Number of dependents [M, (SD)]	3.41 (1.9)	3.1 (1.5)	0.52	2.7 (1.7)	2.7 (1.6)	0.91
Monthly family income (in Reais) [M, (SD)]	1670 (1173)	2579 (4646)	0.31	1362 (723)	1913 (1339)	0.06
Sex % (n)			0.61^* * p value from the Chi-square test (sex, marital status, performance of paid occupational activities); for the other p values, test of comparison of means (Student’s t for independent samples).			0.61^* * p value from the Chi-square test (sex, marital status, performance of paid occupational activities); for the other p values, test of comparison of means (Student’s t for independent samples).
Male	58.6 (17)	51.9 (14)		58.6 (17)	51.9 (14)	-
Female	41.4 (12)	48.1 (13)		41.4 (12)	48.1 (13)	-
Marital status % (n)			0.88^* * p value from the Chi-square test (sex, marital status, performance of paid occupational activities); for the other p values, test of comparison of means (Student’s t for independent samples).			0.87^* * p value from the Chi-square test (sex, marital status, performance of paid occupational activities); for the other p values, test of comparison of means (Student’s t for independent samples).
Married/consensual union	75.8 (22)	74.1 (20)		72.4 (21)	70.4 (19)
Single/widowed or separated	24.2 (7)	25.9 (7)		24.1 (8)	29.6 (8)
Performance of paid occupational activities % (n)			0.63^* * p value from the Chi-square test (sex, marital status, performance of paid occupational activities); for the other p values, test of comparison of means (Student’s t for independent samples).			0.17^* * p value from the Chi-square test (sex, marital status, performance of paid occupational activities); for the other p values, test of comparison of means (Student’s t for independent samples).
No	65.5 (19)	59.3 (16)		82.8 (24)	66.7 (18)
Yes	34.5 (10)	40.7 (11)		17.2 (5)	33.3 (9)

Variable	Control Group (n=27)		Intervention Group (n=29)
	^* * T0 = Initial measurement collected before the PCI (FURUYA et al., 2015); T0	^ T1 = final measurement collected 12 months after the PCI (Current study); T1	^* * T0 = Initial measurement collected before the PCI (FURUYA et al., 2015); T0	^ T1 = final measurement collected 12 months after the PCI (Current study); T1
	Mean (SD)^a (a) SD = Standard Deviation; HADS: Hospital Anxiety and Depression Scale.	Mean (SD)^a (a) SD = Standard Deviation; HADS: Hospital Anxiety and Depression Scale.	Mean (SD)^a (a) SD = Standard Deviation; HADS: Hospital Anxiety and Depression Scale.	Mean (SD)^a (a) SD = Standard Deviation; HADS: Hospital Anxiety and Depression Scale.
SF-36 domains
Social Functioning	69.9 (29.5)	72.7 (29.2)	74.6 (25.5)	74.6 (25.5)
Vitality	61.7 (24.0)	61.5 (24.9)	61.4 (23.2)	66.9 (24.5)
Mental Health	61.3 (19.9)	63.2 (13.5)	60.7 (13.7)	65.5 (14.0)
General Health	61.1 (20.5)	60.2 (21.1)	64.2 (15.0)	65.6 (21.7)
Role-Emotional	60.5 (41.4)	60.5 (43.4)	51.7 (37.3)	75.9 (35.5)
Physical Functioning	57.4 (26.7)	54.1 (31.6)	64.3 (24.1)	66.4 (24.6)
Bodily Pain	39.2 (34.3)	59.0 (27.1)	45.9 (37.5)	56.5 (28.4)
Role-Physical	32.4 (33.8)	51.8 (43.3)	29.3 (34.8)	55.2 (44.0)
HADS Subscales
Anxiety	7.3 (3.6)	6.3 (3.5)	7.0 (4.0)	6.3 (3.9)
Depression	5.5 (4.0)	5.9 (4.3)	6.5 (3.9)	5.3 (3.4)

Variable	p values by factors
Variable	Time	Group	Interaction(time x group)
SF-36 Domains
Social Functioning	0.20	0.24	0.56
Vitality	0.41	0.65	0.37
Mental Health	0.10	0.82	0.47
General Health	0.93	0.34	0.68
Role-Emotional	0.05	0.70	0.05
Physical Functioning	0.83	0.15	0.36
Bodily Pain	0.01	0.75	0.40
Role-Physical	0.001	0.99	0.61
HADS Subscales
Anxiety	0.10	0.89	0.84
Depression	0.40	0.84	0.11

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[1] CORRESPONDING AUTHOR: Lidia Aparecida Rossi. E-mail: rizzardo@eerp.usp.br