ABSTRACT
PURPOSE: Despite the advancements in renal replacement therapy, patients with end-stage renal disease face several limitations, with significant impacts on health-related quality of life (HRQoL) and mortality. This study aims to examine associations between quality of life and risk of death in Brazilian patients who underwent dialysis therapy between 2007 and 2015. METHODS: Observational, prospective, non-concurrent cohort study of patients who underwent dialysis therapy at the Brazilian Public Health System (SUS) and were followed up for 8 years. Semi-structured questionnaires interrogating socioeconomic and demographic characteristics, as well as HRQoL measures (36 Item Short-Form Health Survey, SF-36), were employed. The Cox proportional risk model was used to investigate associations between HRQoL and risk of death. RESULTS: Our sample comprised 1162 patients; of these, 884 were on hemodialysis (HD) and 278 on peritoneal dialysis (PD). Among the HD patients, death was associated with the physical (HR: 0.993; 95% CI: 0.989-0.997) and physical summary component (HR: 0.994; 95% CI: 0.989-0.999) domains of HRQoL. Regarding the PD patients, death was associated with the bodily pain (HR: 0.994; 95% CI: 0.990-0.998), mental health (HR: 0.094; 95% CI: 0.990-0.998), emotional problems (HR: 0.993; 95% CI: 0.987-0.998), social functioning (HR: 1.012; 95% CI: 1.002-1.023), physical problems (HR: 0.992; 95% CI: 0.986-0.998) and mental summary component (HR: 0.989; 95% CI: 0.981-0.997) domains of HRQoL. CONCLUSIONS: Our data suggest that early and timely intervention measures aiming to enhance the HRQoL of dialysis patients are an essential component of professional practice and may contribute to improving the management of factors associated with dialysis patients' mortality.
Subject(s)
Kidney Failure, Chronic/mortality , Kidney Failure, Chronic/psychology , Peritoneal Dialysis/psychology , Quality of Life/psychology , Renal Dialysis/psychology , Adolescent , Adult , Aged , Brazil , Cohort Studies , Female , Humans , Kidney Failure, Chronic/therapy , Male , Mental Disorders/psychology , Mental Health , Middle Aged , Pain/etiology , Pregnancy , Proportional Hazards Models , Prospective Studies , Surveys and Questionnaires , Young AdultABSTRACT
O objetivo deste estudo é discutir a forma como confi gura-se o Itinerário Terapêutico de pessoas com diagnóstico de câncer, do município da Zona da Mata Mineira. Estudo de natureza qualitativa realizado com 4 pacientes com câncer, diagnosticados entre os anos de 2014 e 2015. Os dados foram coletados por meio de entrevista em janeiro de 2016, e apresentados sob a forma de narrativa. Os preceitos éticos foram respeitados. A análise dos itinerários terapêuticos permitiu perceber que o sistema de saúde apresenta difi culdades relacionadas ao diagnóstico e ações de prevenção e promoção à saúde, ao passo que os tratamentos se apresentaram como efetivos, aproximando-se da rede de cuidados de atenção oncológica ideal. O itinerário terapêutico permite visualizar a trajetória dos pacientes e torna-se uma ferramenta fundamental no estabelecimento de um plano de cuidados mais efi caz pelos profi ssionais de saúde, com destaque para a Enfermagem
This study aims to discuss the way that the Therapeutic Itinerary is built on of cancer patients of the Mata Mineira Zone. A qualitative study carried out with 4 cancer patients which had the diagnoses between 2014 and 2015. Data were collected through interviews on January 2016 and analyzed by the narrative. Ethical precepts have been respected. The analysis of the therapeutic itineraries allowed to perceive that the health system presents diffi culties related to the diagnosis, prevention and promotion of health, considering that the treatments were effective, getting closer to the ideal oncology healthcare system. The therapeutic itinerary allows visualizing the patients' trajectory and becomes a fundamental tool in the establishment of a more effective care plan by health professionals, with emphasis on Nursing care
