ABSTRACT
OBJECTIVE - To assess mortality and the psychological repercussions of the prolonged waiting time for candidates for heart surgery. METHODS - From July 1999 to May 2000, using a standardized questionnaire, we carried out standardized interviews and semi-structured psychological interviews with 484 patients with coronary heart disease, 121 patients with valvular heart diseases, and 100 patients with congenital heart diseases. RESULTS - The coefficients of mortality (deaths per 100 patients/year) were as follows: patients with coronary heart disease, 5.6; patients with valvular heart diseases, 12.8; and patients with congenital heart diseases, 3.1 (p<0.0001). The survival curve was lower in patients with valvular heart diseases than in patients with coronary heart disease and congenital heart diseases (p<0.001). The accumulated probability of not undergoing surgery was higher in patients with valvular heart diseases than in the other patients (p<0.001), and, among the patients with valvular heart diseases, this probability was higher in females than in males (p<0.01). Several patients experienced intense anxiety and attributed their adaptive problems in the scope of love, professional, and social lives, to not undergoing surgery. CONCLUSION - Mortality was high, and even higher among the patients with valvular heart diseases, with negative psychological and social repercussions
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Waiting Lists , Heart Diseases , Cardiac Surgical Procedures , Time Factors , Brazil , Survival Analysis , Interviews as Topic , Coronary Disease , Heart Defects, Congenital , Heart Valve Diseases , Myocardial RevascularizationABSTRACT
Este artigo, a partir de dados e projecoes tecnologicas, epidemiologicas, demograficas e socio-economicas procura tracar alguns cenarios que tera a administracao hospitalar no futuro. Grande enfase e dada ao desenvolvimento tecnologico, a programas e servicos ambulatoriais e de atendimento domiciliar, bem como boa parte do trabalho e dirigido a aspectos ligados aos recursos humanos, item preponderante para o sucesso da administracao hospitalar.
Subject(s)
Hospital Administration , Hospitals , Organization and AdministrationABSTRACT
A utilizaçao de indicadores que mostrem a qualidade de vida de um indivíduo data de tempos recentes e, segundo alguns autores, permanece mal definida; porém, dentro de um senso médico, constituem um agregado de representaçao de incapacidade, desconforto e sofrimento, resultante de uma doença e/ou uma açao médica. Nesta pesquisa avaliaram-se 672 pacientes, divididos em quatro estratos ocupacionais, que foram submetidos a revascularizaçao do miocárdio, por implantaçao de ponte de safena e/ou artéria mámaria, ou angioplastia transluminal coronária, quanto às condiçoes físicas, psicológicas e sociais apresentadas após o procedimento terapêutico. As entrevistas, em número de duas, foram realizadas antes do procedimento e no quarto mês após o mesmo. Somente 5,06 por cento dos pacientes relataram nao estar desfrutando a vida com prazer, apresentando insônia, ansiedade, medo da morte, dificuldades de relacionamento, dor e cansaço.