Adherencia terapéutica y funcionalidad familiar en personas con artritis reumatoide / Adherence and family functioning in people with rheumatoid arthritis

La Artritis Reumatoide (AR) se ha incrementado de manera alarmante, el Instituto Nacional de Artritis y Enfermedades Musculo esqueléticas y de la Piel en los EU, reporta que 1:10 habitantes la desarrolla; en México un millón 700 mil personas entre 20 y 50 años la padecen, lo que coincide con la edad productiva, constituye un grave problema de Salud Pública su costo anual es de 600 dólares por paciente, la incidencia es mayor en las mujeres con respecto a los hombres 3:1; el panorama se agudiza ante ausencias laborales recurrentes por discapacidad debido a la presencia de dolor, deformidad, rigidez e inflamación articular y la disminución de la fuerza muscular, suscitando impacto económico y emocional para el individuo afectado así como para los integrantes de la familia, impulsándolos a reorganizarse y en la mayoría a desintegrarse como lo estableció Virginia Satir; la baja Adherencia Terapéutica (AT) condiciona resultados desfavorables y gastos innecesarios para el sector salud. Es necesario identificar la adherencia terapéutica y la funcionalidad familiar en las personas con AR, se realizó un estudio observacional, proyectivo, descriptivo y transversal; la población se conformó por 100 pacientes, usuarios del Hospital General Ignacio Zaragoza, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado. (ISSSTE); con una media de edad de 47 (±10.7), 74 mujeres y 26 hombres, con un mes de tratamiento antirreumático. Al análisis por sexo se observa mayor frecuencia de mujeres (n=38) en pertenecer a una familia conflictiva y baja AT, mientras los hombres (n=22) ubicados en familias nutricias en mayor proporción y mediana AT; revisando la AT por etapas de la vida, se descubre que el adulto joven y el maduro ocupan 30 y 32 casos respectivamente, con baja y mediana AT; este dato es importante si la esperanza de vida en México es de 80 años; cabría preguntarse qué calidad de vida les espera a estos pacientes.

Rheumatoid Arthritis (RA) has increased alarmingly, the National Institute of Arthritis and Musculoskeletal and Skin Diseases in the US, reports that develops 1:10 inhabitants; in Mexico one million 700 thousand people between 20 and 50 years suffer, which coincides with the productive age, is a serious public health problem annual cost is $ 600 per patient, the incidence is higher in women compared to men 3: 1; the outlook worsens with recurrent absenteeism disability due to the presence of pain, deformity, stiffness and joint swelling and decreased muscle strength, raising economic and emotional impact for the affected individual and for family members, urging to reorganize and most established to disintegrate as Virginia Satir; Low Adherence Therapy (AT) conditions unfavourable results and unnecessary costs to the health sector. You need to identify adherence and family functioning in people with RA, an observational, projective, descriptive, cross-sectional study; the population was formed by 100 patients, users of General Ignacio Zaragoza Hospital, ISSSTE; with a mean age of 47 (± 10.7), 74 women and 26 men, with a month antirheumatic treatment. Analysis by sex more often in women (n = 38) belong to a family conflict and low AT is observed, while men (n = 22) located in nurturing families in greater proportion and medium AT; AT reviewing the stages of life, discovers that the young adult and mature occupy 30 and 32 cases respectively, low and medium AT; this is important if life expectancy in Mexico is 80 years; one might ask what quality of life awaits these patients.

Disability Intervention Model for Older Adults with Arthritis: An Integration of Theory of Symptom Management and Disablement Process Model

To evolve a management plan for rheumatoid arthritis, it is necessary to understand the patient's symptom experience and disablement process. This paper aims to introduce and critique two models as a conceptual foundation from which to construct a new model for arthritis care. A Disability Intervention Model for Older Adults with Arthritis includes three interrelated concepts of symptom experience, symptom management strategies, and symptom outcomes that correspond to the Theory of Symptom Management. These main concepts influence or are influenced by contextual factors that are situated within the domains of person, environment, and health/illness. It accepts the bidirectional, complex, dynamic interactions among all components within the model representing the comprehensive aspects of the disablement process and its interventions in older adults with rheumatoid arthritis. In spite of some limitations such as confusion or complexity within the model, the Disability Intervention Model for Older Adults with Arthritis has strengths in that it encompasses the majority of the concepts of the two models, attempts to compensate for the limitations of the two models, and aims to understand the impact of rheumatoid arthritis on a patient's physical, cognitive, and emotional health status, socioeconomic status, and well-being. Therefore, it can be utilized as a guiding theoretical framework for arthritis care and research to improve the functional status of older adults with rheumatoid arthritis.

Adaptação ao contexto cultural brasileiro e validação do "Caregiver Burden scale" / Adaptation and validation of the caregiver burden scale to Brazilian cultural milieu

Objetivo: Traduzir para a língua portuguesa, adaptar culturalmente e validar para o Brasil um instrumento para medir o impacto subjetivo das doenças crônicas na vida dos cuidadores: Caregiver Burden Scale (CB scale). Material e métodos: o CB scale foi traduzido e adaptado ao contexto brasileiro seguindo normas propostas pela literatura pertinente. O questionário adaptado foi aplicado em 30 cuidadores de pacientes com doenças reumáticas, em três momentos diferentes, para determinar a reprodutibilidade. A validade de construção foi testada por correlações com variáveis clínicas e de qualidade de vida de 62 cuidadores e 62 pacientes com artrite reumatóide. Resultados: Todas as 22 questões do CB scale foram consideradas aplicáveis no contexto cultural brasileiro e modificações foram feitas em quatro questões. Os coeficientes de reprodutibilidade intra e interobservador foram 0,87 e 0,92, respectivamente. A validade do instrumento foi comprovada por meio de correlações com outras variáveis dos cuidadores. Conclusões: A versão em português do CB scale mostrou ser um instrumento válido e reproduzível