RESUMO
Objetivo: apreender aspectos que influenciam no abandono do tratamento e que mobilizam a disposição para retomá-lo, na perspectiva de pessoas que vivem com HIV. Método: estudo qualitativo, realizado em um serviço ambulatorial, com dados coletados entre abril e agosto de 2021, após aprovação pelo Comitê de Ética em Pesquisa, mediante consulta aos prontuários e entrevistas com 24 usuários, submetidas à análise de conteúdo. Resultados: os motivos para o abandono do tratamento referidos com maior frequência foram isolamento social imposto pela pandemia, dificuldade de acesso/locomoção até o serviço e efeitos colaterais dos medicamentos. O desejo de sentir-se saudável, desempenhar papeis sociais, cultivar laços familiares, reconhecer que já superou fases piores e o sentimento de mais valia após busca ativa, foram as motivações para retorno ao serviço. Considerações finais: os resultados apontam a importância do atendimento individualizado para conhecer as motivações de retorno ao tratamento as quais oferecem subsídios para o planejamento de ações de busca ativa.
Objective: to identify factors that influence the decision to abandon treatment or foster a willingness to resume it, from the perspective of persons living with HIV. Method: this qualitative study was carried out between April and August 2021 in an outpatient service, after approval by the research ethics committee. Data were collected by consulting medical records and interviewing 24 users, and were treated by content analysis. Results: reasons for abandoning treatment most frequently mentioned were the social isolation imposed by the pandemic, difficulty in accessing or commuting to the service, and the drugs' side effects. The motivations for returning to the service were the desire to feel healthy, play social roles, cultivate family ties, recognize that he has overcome worse phases and the feeling of added value after active search. Final considerations: the findings point to the importance of individualized care to understanding the motivations for returning to treatment, which can inform the planning of active search actions.
Objetivo: comprender aspectos que influyen en el abandono del tratamiento y que movilizan la voluntad para retomarlo, en la perspectiva de las personas que viven con VIH. Método: estudio cualitativo, realizado en un servicio de consulta externa, con datos recolectados entre abril y agosto de 2021, después de la aprobación del Comité de Ética en Investigación, mediante consulta de historias clínicas y entrevistas con 24 usuarios, sometidos a análisis de contenido. Resultados: los motivos de abandono del tratamiento mencionados más frecuentemente fueron el aislamiento social impuesto por la pandemia, la dificultad de acceso/traslado al trabajo y los efectos secundarios de los medicamentos. El deseo de sentirse saludable, desempeñar roles sociales, cultivar lazos familiares, entender que ha superado fases peores y la sensación de plusvalía luego de una búsqueda activa, fueron las motivaciones para volver al servicio. Consideraciones finales: los resultados apuntan hacia la importancia de la atención individualizada para comprender las motivaciones de retorno al tratamiento, que ofrecen subsidios para la planificación de acciones de búsqueda activa.
RESUMO
RESUMEN Fundamento: El estudio de la Adherencia Terapéutica es de vital importancia si se quiere que un paciente con condiciones crónicas se ciña a un esquema de tratamiento y es una de las áreas de investigación en la psicología, que permite la exploración e investigación para la implementación de pautas en esta área, por lo que contar con instrumentos que tengan adecuadas propiedades psicométricas facilita la labor de conocimiento sobre el tema. Objetivo: En esta investigación, se estudiaron las propiedades psicométricas de la Escala de Adherencia Terapéutica, en personas con diferentes enfermedades. Método: Se realizaron análisis factoriales, uno inicial de tipo exploratorio y luego uno de tipo confirmatorio. Se obtuvieron los estadísticos de bondad, así como la confiabilidad y la validez de la escala en su versión final. Resultados: En una primera fase se realizó un análisis factorial exploratorio con 193 participantes; los reactivos tuvieron un buen ajuste, agrupándose en una estructura de dos factores. En una segunda fase se confirmó la estructura de la EAT con 231 participantes. Los resultados demuestran que los estadísticos de bondad de ajuste fueron buenos; la confiabilidad de la EAT (Factor 1 α = 0,93, Factor 2 α = 0,76 y fiabilidad global α = 0,83), es adecuada con dos factores. En la tercera fase, se efectuaron análisis descriptivos, se compararon algunas variables sociodemográficas y se realizaron correlaciones entre variables, demostrándose que hay diferencias significativas por la presencia o no de hijos y que el puntaje total de la EAT se relaciona con la edad, la escolaridad y el número de hijos. Conclusiones: La EAT, tiene adecuadas propiedades psicométricas para su utilización en investigación sobre la adherencia al tratamiento en algunas condiciones médicas y probó que su modelo en dos factores, tiene adecuada bondad de ajuste.
ABSTRACT Foundation: the study of therapeutic adherence is of vital importance to ensure that a patient with chronic conditions adheres to a treatment scheme. This is a research area of psychology, which allows exploration for the implementation of guidelines in this regard. Having instruments that have adequate psychometric properties facilitates the work of knowledge on the subject. Objective: to describe psychometric properties of the therapeutic adherence scale, in people with different diseases. Methods: analyzes of factors were performed, an initial exploratory and then a confirmatory one. Goodness statistics were obtained, as well as the reliability and validity of the scale in its final version. Results: an exploratory factor analysis (first phase) was carried out with 193 participants; the reactive had a good fit, grouping into a two-factor structure. In a second phase, the scale structure was confirmed with 231 participants. Goodness-of-fit statistics were good; the scale reliability (factor 1 α = 0.93; factor 2 α = 0.76 and overall reliability α = 0.83), is adequate with two factors. In the third phase, descriptive analyzes, correlations between variables were carried out and some sociodemographic variables were compared. There were significant differences due to the presence or not of children; the total scale score is related to age, schooling and the number of children. Conclusions: the therapeutic adherence scale has adequate psychometric properties to be used in research on treatment adherence in some medical conditions; its two-factor model has adequate goodness of fit.
RESUMO
Poor patient adherence to medication is one of the major factors contributing to poor disease control, in particular in asymptomatic chronic diseases like hypertension and dyslipidaemia. The physical and economic burden on patients and the health care system as a result of non-adherence is great. It is estimated that poor adherence to hypertension medication accounts for as many as 7.1 million preventable deaths annually. Hence recognising and identifying non-adherence is the first step to addressing this problem. Medication adherence can be measured in various ways including self-report to electronic monitoring. In order to be more successful in managing non-adherence, attention must be paid to barriers to adherence, namely the interplay of patient factors, the health care providers themselves and the health care system itself. Taking these into account will probably have the greatest impact on improving medication adherence. Consequently strategies to help overcome these barriers are of paramount importance. Some of these strategies will include education of patients, improving communication between patients and health care providers, improving dose scheduling, providing drugs with less adverse effects, and improving accessibility to health care. Poor mediation adherence continues to be a huge challenge. While the patient is ultimately responsible for the taking of medication, good communication, involving the patient in decision making about their care and simplifying drug regimens go a long way in improving it.