ABSTRACT
El paciente con enfermedad renal crónica avanzada (ERCA) presenta una elevada carga de síntomas que contribuyen a un aumento del sufrimiento y disminuyen su calidad de vida. El uso de instrumentos de evaluación es esencial para el control de síntomas. El objetivo de esta revisión es obtener una visión contrastada de los instrumentos más usados para evaluar síntomas en ERCA, realizando una descripción de la prevalencia de síntomas en esta población. Método: Se realizó una revisión de la literatura publicada sobre estudios en los que se utilizara algún instrumento para medir la intensidad de varios síntomas en pacientes con ERCA. La búsqueda se realizó en Pubmed, Cochrane, SciELO, TESEO, PROQOLID y BiblioPRO. Los criterios de inclusión fueron: estudios realizados con pacientes en ERCA, que evaluaran la sintomatología con algún instrumento de medición de síntomas, y que además, indicaran la prevalencia de varios síntomas. Resultados: Los instrumentos identificados fueron el Memorial Symptom Assessment Scale Short Form(MSAS-SF), el Dialysis Symptom Index (DSI), el Edmonton Symptom Assessment System (ESAS) y el Palliative care Outcome Scale-Symptoms Renal (POS-S RENAL). En pacientes adultos con ERCA sometidos a tratamiento renal sustitutivo con hemodiálisis y diálisis peritoneal, los síntomas más prevalentes fueron el cansancio, prurito, estreñimiento, anorexia, dolor, alteraciones del sueño, ansiedad, disnea, nauseas, piernas inquietas, y depresión. Éstos síntomas fueron similares en pacientes con manejo renal conservador, y presentaron un patrón común con la sintomatología de otras enfermedades avanzadas. Concluimos que existe necesidad de investigar sobre prevalencia y evaluación de síntomas en esta población, y que el uso sistemático de los instrumentos específicos de evaluación de síntomas como medida de resultados es fundamental (AU)
The patient with advanced chronic kidney disease (ACKD) has a high symptom burden that contribute to increased suffering and diminish their quality of life. The use of symptom assessment tools is essential for the control of symptoms. The aim of this review is to obtain a contrasted vision of the instruments commonly used to assess symptoms in ACKD, making a description of the prevalence of symptoms in this population. Method: A review of the literature on studies in which an instrument is used to measure the intensity of several symptoms in patients with ACKD was undertaken. The search was conducted in PubMed, Cochrane, SciELO and TESEO. Inclusion criteria were: studies in patients with ACKD, evaluating symptoms with an assessment tool, and also indicate the prevalence of various symptoms. Results: The instruments identified were the Memorial Symptom Assessment Scale Short Form (MSAS-SF), the Dialysis Symptom Index (DSI), the Edmonton Symptom Assessment System (ESAS) and the Palliative Care Outcome Scale-Symptoms Kidney (POS-S RENAL). In adult patients with ACKD undergoing renal replacement therapy with hemodialysis and peritoneal dialysis, the most prevalent symptoms were fatigue, pruritus, constipation, anorexia, pain, sleep disturbance, anxiety, dyspnea, nausea, restless legs, and depression. These symptoms were similar in patients with renal conservative management, and showed a common pattern to the symptoms of others advanced diseases. We conclude that we need to research about the prevalence and evaluation of symptoms in this population, and a systematic use of specific instruments for evaluating symptoms as an outcome measure is necessary (AU)
Subject(s)
Female , Humans , Male , Renal Insufficiency, Chronic/epidemiology , Renal Insufficiency, Chronic/prevention & control , Signs and Symptoms/methods , Signs and Symptoms/trends , Palliative Care/methods , Hospice and Palliative Care Nursing/methods , Hospice and Palliative Care Nursing/standards , Nephrology Nursing/organization & administration , Nephrology Nursing/standards , Renal Insufficiency, Chronic/nursing , Surveys and Questionnaires , Monitoring, Physiologic/instrumentation , Monitoring, Physiologic/methodsSubject(s)
Humans , Female , Child , Encephalitis/etiology , Paralysis/etiology , Signs and Symptoms/trends , Rabies virus/pathogenicity , Cats/virology , Chiroptera/virologyABSTRACT
Los síntomas en medicina de familia no son señales de enfermedad, sino «de vida»; en la consulta «entra, junto al paciente, toda su vida». Cada consulta es primariamente un problema biopsicosocial: el individuo en relación con su Yo y su contexto percibe una disfunción o alteración. Fundamentar la valoración en la sola molestia física expuesta por el paciente puede ser un error al no haber identificado el problema real. Las distintas tipologías posibles de los síntomas están «enmarañadas» o encadenadas unas con otras: los síntomas pueden ser apropiados o inevitables; ser expresiones de alteraciones bioquímicas, símbolos para el paciente, expresiones del contexto grupal, o modos de afrontar una situación; y dependen del funcionamiento psicológico previo del paciente, la severidad del déficit de la función psicológica asociada a la enfermedad, las habilidades residuales, la adaptación y el afrontamiento de las limitaciones funcionales, la relación médico-paciente, así como de la influencia del contexto(AU)
The symptoms in family medicine are not signs of disease, but "signs of life"; in the consultation "all patient life comes together with him". Every consultation is primarily a biopsicosocial problem: the person perceives a dysfunction or alteration in relation with himself and his context. To do a diagnosis only with physical symptoms, can be a mistake because these do not identify the real problem. The different types of symptoms are "entangled" or chained some in others: the symptoms can be fitted or inevitable; to be expressions of biochemical alterations, symbols for the patient, group context expressions, or kinds of facing the facts; and they depend on the previous psychological patient performance, the severity of the deficit of the psychological function associated with the disease, the residual skills, the adjustment and the confrontation of the functional limitations, the relation doctor-patient, as well as on the influence of the context(AU)
Subject(s)
Humans , Male , Female , Signs and Symptoms/history , Family Practice/ethics , Signs and Symptoms/methods , Signs and Symptoms/trends , Family Practice/methods , Disease , Signs and Symptoms , Signs and Symptoms/therapeutic use , Signs and Symptoms/classification , Family Practice/trends , Preventive Medicine/methods , Preventive Medicine/trendsABSTRACT
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Subject(s)
Humans , Family Practice/education , Physicians, Family/education , Signs and Symptoms , Signs and Symptoms/education , Signs and Symptoms/trends , Family Practice/trends , Rural Health/educationSubject(s)
Humans , Alzheimer Disease/diagnosis , Alzheimer Disease/drug therapy , Dementia/diagnosis , Dementia/pathology , Withholding Treatment/ethics , Alzheimer Disease/nursing , Alzheimer Disease/prevention & control , Signs and Symptoms/statistics & numerical data , Signs and Symptoms/trends , Dementia/complications , Dementia/epidemiology , Dementia/prevention & control , Withholding Treatment/legislation & jurisprudence , Withholding Treatment/standards , Withholding TreatmentABSTRACT
Objetivos: Avaliar a prevalência de asma brônquica em alunos da primeira à décima segunda fase do curso de medicina da Universidade do Sul de Santa Catarina (Unisul), no Município de Tubarão SC, utilizando o questionário escrito módulo asma do International Study of Asthma and Allergies in Childhood (ISAAC). Métodos: Foi realizado um estudo transversal, utilizando o questionário escrito módulo asma do ISAAC em 180 alunos do curso de medicina da Unisul, selecionadospor amostragem aleatória. Foi utilizado um ponto de corte de 5 para diferenciar asmáticos de não asmáticos. Resultados: A prevalência de asma brônquica napopulação estudada foi de 16,7%. Dos participantes, 92 (51,1%) eram do gênero masculino e 88 (48,9%) do gênero feminino. Dos 180 alunos que responderam o questionário, 167 (92,8%) eram caucasianos. A idade variou entre 18 e 38 anos, sendo a idade média de 22,2 anos (DP ± 3).Conclusões: A prevalência de asma brônquica entre os alunos do curso de medicina da Unisul foi muito próxima da média estimada nacional que é de 20%
Objectives: To estimate the prevalence os asthma among the medical students from the first to twelfth term of the Universidade do Sul de Santa Catarina (Unisul) Tubarão SC, using the International Study of Asthma and Allergies in Childhood (ISAAC) written questionaire of asthma. Methods: A cross-sectional study, using the ISAACwritten questionaire of asthma, evaluating 180 randomly selected medical students was performed. The cut off point to selected asthmatic students was 5. Results: The prevalence of asthma among the studied population was 16,7% of those surveyed, 92 (55,1%) were male and 88 (48,9%) were female. From the 180 students who answered the questionaire, 167 (92,8%) were caucasian. The age ranged of 18 to 38 years old, and the mean age was 22,2 years old (DP ± 3).Conclusions: The prevalence of asthma among medical students of Unisul was very similar to the national average (20%), which was also obtained by using the ISAAC written questionaire.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Asthma , Respiratory Sounds , Signs and Symptoms , Asthma/diagnosis , Asthma/history , Signs and Symptoms/classification , Signs and Symptoms/trends , Respiratory Sounds/diagnosis , Respiratory Sounds/physiologyABSTRACT
Os "novos sintomas" mostram os limites de nossa prática sob transferência porque são paradigmáticos desta época de rechaço do saber, de decadência das referências ligadas ao ideal, de vacilação dos semblantes da cultura.
The new symptoms show the boundaries of our practice under transference because they are typical of this age of knowledge rejection, of decadence of ideal references, of vacillation of cultural aspects.
Subject(s)
Signs and Symptoms/trends , PsychoanalysisABSTRACT
Os "novos sintomas" mostram os limites de nossa prática sob transferência porque são paradigmáticos desta época de rechaço do saber, de decadência das referências ligadas ao ideal, de vacilação dos semblantes da cultura.
The new symptoms show the boundaries of our practice under transference because they are typical of this age of knowledge rejection, of decadence of ideal references, of vacillation of cultural aspects.
