Impacto de la carga de trabajo del paciente crónico en la adherencia terapéutica

Ylenia de los Ángeles Martín Santana; Juan José Suárez Sánchez; Alfonso Miguel García Hernández

Ylenia de los Ángeles Martín Santana Consultorio Playa de Mogán (Las Palmas, España)
Juan José Suárez Sánchez Universidad de Las Palmas de Gran Canaria (Las Palmas, España)
Alfonso Miguel García Hernández Departamento de Enfermería. Facultad de Ciencias de la Salud. Universidad de La Laguna (San Cristóbal de La Laguna, Santa Cruz de Tenerife, España)

Palabras clave: Carga de Trabajo, Adherencia al tratamiento, Enfermedad crónica, Cuestionarios, Enfermería

Key-words: Treatment burden, Adherence to treatment, Chronic disease, Questionnaires, Nursing

Palavras chave: Carga de trabalho, Aderência ao tratamento, Doença crónica, Questionários, Enfermagem

Resumen

Objetivo: Relacionar la carga de trabajo del paciente crónico independiente con la adherencia terapéutica. Método: Estudio analítico observacional de tipo transversal. La muestra consta de 390 pacientes de la Zona Básica de Salud de Mogán (Gran Canaria), seleccionados de forma sistemática según cumplieran el criterio de paciente crónico mayor de 50 años con enfermedad cardiovascular establecida incluyéndose diagnósticos de Infarto Agudo de Miocardio, Fibrilación Auricular e Insuficiencia cardíaca (IAM, FA e IC). Enfermedad Pulmonar Obstructiva Crónica (EPOC) y enfermedad neurológica con los diagnósticos de ICTUS y Parkinson. Se utilizó el cuestionario “Treatment Burden Questionnarie” (TBQ) para cuantificar la carga de trabajo, y la Escala de Adherencia al Tratamiento de Morisky (MMAS-8) para la adherencia. Resultados: El 40,5% de la muestra presenta una carga moderada y adherencia moderada (38,2%)-baja (35,4%). La baja-moderada adherencia se asoció con una puntuación elevada del TBQ (puntuación media de 64,8 puntos). Los grupos de enfermedades que mayor carga tienen son las neurológicas (puntuación media TBQ 74,73 puntos), EPOC (puntuación media TBQ de 69,08 puntos), y, por último, las enfermedades cardiovasculares (puntuación media TBQ de 64,47 puntos). Existe una asociación estadísticamente significativa entre la carga de trabajo y la adherencia terapéutica x2= 68,343 p <0,000. Conclusiones: Los pacientes crónicos con mayor carga de trabajo presentan una menor adherencia terapéutica

Abstract

Aim: To relate the treatment burden of the independent chronic patient to adherence to treatment. Method: Cross-sectional observational analytical study. The sample consisted of 390 patients from the Basic Health Area of Mogán (Gran Canaria) systematically selected according to the criteria of chronic patient over 50 years of age with established cardiovascular disease including diagnoses of Acute Myocardial Infarction, Atrial Fibrillation and Heart Failure (AMI, AF and HF). Chronic Obstructive Pulmonary Disease (COPD) and neurological disease with the diagnoses of stroke and Parkinson's disease. The Treatment Burden Questionnaire (TBQ) was used to quantify workload, and the Morisky Treatment Adherence Scale (MMAS-8) was used for adherence. Results: 40.5% of the sample had moderate burden and moderate (38.2%)-low (35.4%) adherence. Low-moderate treatment adherence was associated with a high TBQ score (mean score 64.8 points). The disease groups with the highest burden were neurological diseases (mean TBQ score 74.73 points), COPD (mean TBQ score 69.08 points), and finally cardiovascular diseases (mean TBQ score 64.47 points). There is a statistically significant association between workload and adherence x2= 68.343 p<0.000. Conclusions: Chronic patients with higher workload present lower therapeutic adherence

Resumo

Objectivo: Relacionar a carga de trabalho do paciente crónico independente com a aderência ao tratamento. Método: Estudo analítico observacional transversal. A amostra consistiu em 390 pacientes da Área de Saúde Básica de Mogán (Gran Canaria), sistematicamente seleccionados de acordo com os critérios de paciente crónico com mais de 50 anos de idade com doença cardiovascular estabelecida, incluindo diagnósticos de Infarto Agudo do Miocárdio, Fibrilação Atrial e Insuficiência Cardíaca (IAM, FA e IC). Doença Pulmonar Obstrutiva Crónica (DPOC) e doença neurológica com o diagnóstico de AVC e doença de Parkinson. O Questionário de Carga de Tratamento (TBQ) foi utilizado para quantificar a carga de trabalho, e a Escala de Adesão ao Tratamento Morisky (MMAS-8) foi utilizada para a aderência. Resultados: 40,5% da amostra teve carga moderada e aderência moderada (38,2%)-baixa (35,4%). A adesão ao tratamento com baixa moderação foi associada a uma pontuação elevada de TBQ (pontuação média de 64,8 pontos). Os grupos de doenças com maior carga são as doenças neurológicas (nota média TBQ de 74,73 pontos), DPOC (nota média TBQ de 69,08 pontos), e finalmente as doenças cardiovasculares (nota média TBQ de 64,47 pontos). Existe uma associação estatisticamente significativa entre carga de trabalho e aderência x2= 68.343 p<0.000. Conclusões: Os doentes crónicos com maior carga de trabalho têm menor aderência terapêutica

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Impacto de la carga de trabajo del paciente crónico en la adherencia terapéutica

Impact of chronic patient treatment burden on adherence to treatment

Impacto da carga de trabalho crónica do paciente na aderência ao tratamento

Resumen

Abstract

Resumo

Bibliografía