ABSTRACT
BACKGROUND: The relevance that adherence to treatment plays in liver transplantation, and the impact this factor may have on the success of treatment, are fundamental in assessing the variables which affect patient adherence during the pretransplantation period. OBJECTIVES: This study aims to determine factors that affect liver transplant candidates' adherence to treatment, and analyze the association between adherence, socioeconomic and demographic factors, clinical characteristics, and patient understanding about the disease and liver transplantation. METHODS: This epidemiological, observational, and prospective study included 62 patients registered in the technical database of the Universidade Federal de São Paulo during the period November 2012-May 2014. The dependent variable was adherence to treatment among liver transplantation candidates, and the independent variables included understanding the disease and the transplantation process, and depression and anxiety symptoms among liver transplantation candidates. RESULTS: Work situation (P = .038), understanding about the disease (P = .002), and use of laxatives (P = .045) were the factors related to statistically significant adherence, and it can be concluded that implementation of an educational program may increase adherence up to 3.48 times in the pretransplantation phase, as adherence was 3.48 times lower in patients who reported little or no knowledge of the disease or the procedure.
Subject(s)
Liver Transplantation , Patient Compliance/statistics & numerical data , Patient Education as Topic , Adult , Female , Health Knowledge, Attitudes, Practice , Humans , Male , Middle Aged , Prospective StudiesABSTRACT
Kidney transplantation is considered to be the best treatment for people with chronic kidney failure, because it improves the patients' quality of life and increases their length of survival compared with patients undergoing dialysis. The kidney transplantation process in Brazil is defined through laws, decrees, ordinances, and resolutions, but there is no visual representation of this process. The aim of this study was to analyze official documents to construct a representation of the kidney transplantation process in Brazil with the use of business process modeling notation (BPMN). The methodology for this study was based on an exploratory observational study, document analysis, and construction of process diagrams with the use of BPMN. Two rounds of validations by specialists were conducted. The result includes the kidney transplantation process in Brazil representation with the use of BPMN. We analyzed 2 digital documents that resulted in 2 processes with 45 total of activities and events, 6 organizations involved, and 6 different stages of the process. The constructed representation makes it easier to understand the rules for the business of kidney transplantation and can be used by the health care professionals involved in the various activities within this process. Construction of a representation with language appropriate for the Brazilian lay public is underway.
