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Prevalência de sintomas e qualidade de vida em doentes com VIH/SIDA
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Resumo(s)
Introdução
A avaliação da qualidade de vida (QDV) na infeção pelo Vírus da Imunodeficiência Humana (VIH) é fundamental para compreender a forma como vive uma pessoa com o seu diagnóstico. Com o avanço da ciência médica, deu-se um aumento da esperança de vida das pessoas que vivem com VIH e/ou Síndrome da Imunodeficiência Humana Adquirida (SIDA), contudo maior tempo de vida não é sinónimo de qualidade e atendendo às suas especificidades, esta doença traz repercussões ao nível da QDV dos seus portadores. O presente estudo pretende analisar a prevalência e a intensidade de sintomas apresentados pelos doentes com VIH/SIDA e perceber a afetação na sua QDV.
Métodos
Foram inquiridos 100 doentes com VIH/SIDA de Fevereiro de 2018 a Março de 2019, seguidos numa consulta externa de Infecciologia.
Para obter uma avaliação multidimensional dos doentes foram usados os seguintes instrumentos: ESAS-r (Escala de Avaliação de Sintomas de Edmonton); EQ-5D (medição da QDV relacionada com a saúde) e Termómetro de Emoções.
Resultados
Os resultados obtidos indicam que 56% dos participantes eram do sexo feminino, 46% solteiro, casado/junto 37%, 10% divorciado/separado e 7% viúvo, a nível de escolaridade 2% referem ser analfabetos, 36% com escolaridade ao nível do ensino básico, 42% ao nível do secundário, 9% com ensino médio e 11% com ensino superior e 54% com rendimento mensal inferior a 500€. Os sintomas presentes com uma intensidade mais elevada são o cansaço (21%) e a ansiedade (20%). Dos inquiridos, 10% referem que a sua QDV é prejudicada de forma grave pela sua ansiedade/depressão e 6% por dor/mal-estar. O estado emocional mais referido com uma percentagem de 28% foi a revolta. Com o estudo podemos concluir uma correlação entre a idade e a dor, os resultados mostram que quanto mais velhos os participantes maiores são os valores de sintoma dor (r = .24; p = .016); mais afetada será a QDV em fatores como a mobilidade (r = .37; p < .001), dor/mal-estar e menos a sonolência (r = -.34; p = .001). Quanto maior o tempo de exposição ao VIH menor é a mobilidade. O estudo mostra que a comorbilidade, VIH, correlaciona-se positivamente e de forma estatisticamente significativa com os sintomas dor, apetite e depressão, com os fatores de QDV mobilidade, atividades habituais, dor/mal-estar, ansiedade e depressão e com todos os estados emocionais.
Conclusões
Os dados permitem concluir que existe um cluster de sintomas e que o cansaço, a sonolência são comuns nas pessoas inquiridas mas também a ansiedade, bem-estar, depressão e apetite têm impacto na afetação da QDV de cada um e, em suma, da união de esforços e conhecimentos das diferentes especialidades, Infeciologia, Cuidados Paliativos e outras, o doente e a sua família beneficiam não só do tratamento da doença como do alívio de sintomas com consequente melhoria da QDV e do modo como é vivida a doença.
Introduction The assessment of quality of life (QOL) in Human Immunodeficiency Virus (HIV) patients is critical to understanding how a person lives with their diagnosis. With the advancement of medical science, life expectancy has increased for people living with HIV and/or Acquired Human Immunodeficiency Syndrome (AIDS), however longer life is not synonymous of quality, this disease specificities have repercussions on the QOL of its patients. This study aims to analyze the prevalence and intensity of symptoms presented by patients with HIV/AIDS and to understand the affect on their QOL. Methods From February 2018 to March 2019 one hundred HIV/AIDS patients were surveyed, followed by an external Infectious Disease consultation. To obtain a multidimensional patient assessment, the following instruments were used: ESAS-r (Edmonton Symptom Rating Scale); EQ-5D (health-related QOL measurement) and Emotion Thermometer. Results The results obtained indicate that 56% of the participants were female, 46% single, 37% married/together, 10% divorced/separated and 7% widow; on an education level 2% report illiteracy, 36% have primary education, 42% have secondary education, 9% have high school and 11% have higher education and 54% have a monthly income of less than 500 €. Symptoms with higher intensity are tiredness (21%) and anxiety (20%). Of the respondents, 10% report that their QOL is severely impaired by their anxiety/depression and 6% by pain/malaise. The most reported emotional state with a percentage of 28% was revolt. With the study we can conclude a correlation between age and pain, the results show that the older the participants the higher are their pain symptom values (r = .24; p = .016); the QOL is most affected by some factors such as mobility (r = .37; p <.001), pain/malaise and less sleepiness (r = -.34; p = .001). The longer the exposure to HIV virus lower is the mobility. The study shows that comorbidity is positively and statistically significantly correlated with pain, appetite and depression symptoms, QOL factors of mobility, habitual activities, pain/malaise, anxiety and depression, and all emotional states. Conclusions The data shows that there is a cluster of symptoms and that symptoms such as tiredness, drowsiness are common in the respondents, but also anxiety, well-being, depression and appetite have an impact on their QOL. By combining efforts and knowledge of different specialties, Infectious Diseases, Palliative Care and others, the patient and his family benefit not only from treating the disease but also from relieving symptoms with consequent improvement in QOL and how the disease is lived.
Introduction The assessment of quality of life (QOL) in Human Immunodeficiency Virus (HIV) patients is critical to understanding how a person lives with their diagnosis. With the advancement of medical science, life expectancy has increased for people living with HIV and/or Acquired Human Immunodeficiency Syndrome (AIDS), however longer life is not synonymous of quality, this disease specificities have repercussions on the QOL of its patients. This study aims to analyze the prevalence and intensity of symptoms presented by patients with HIV/AIDS and to understand the affect on their QOL. Methods From February 2018 to March 2019 one hundred HIV/AIDS patients were surveyed, followed by an external Infectious Disease consultation. To obtain a multidimensional patient assessment, the following instruments were used: ESAS-r (Edmonton Symptom Rating Scale); EQ-5D (health-related QOL measurement) and Emotion Thermometer. Results The results obtained indicate that 56% of the participants were female, 46% single, 37% married/together, 10% divorced/separated and 7% widow; on an education level 2% report illiteracy, 36% have primary education, 42% have secondary education, 9% have high school and 11% have higher education and 54% have a monthly income of less than 500 €. Symptoms with higher intensity are tiredness (21%) and anxiety (20%). Of the respondents, 10% report that their QOL is severely impaired by their anxiety/depression and 6% by pain/malaise. The most reported emotional state with a percentage of 28% was revolt. With the study we can conclude a correlation between age and pain, the results show that the older the participants the higher are their pain symptom values (r = .24; p = .016); the QOL is most affected by some factors such as mobility (r = .37; p <.001), pain/malaise and less sleepiness (r = -.34; p = .001). The longer the exposure to HIV virus lower is the mobility. The study shows that comorbidity is positively and statistically significantly correlated with pain, appetite and depression symptoms, QOL factors of mobility, habitual activities, pain/malaise, anxiety and depression, and all emotional states. Conclusions The data shows that there is a cluster of symptoms and that symptoms such as tiredness, drowsiness are common in the respondents, but also anxiety, well-being, depression and appetite have an impact on their QOL. By combining efforts and knowledge of different specialties, Infectious Diseases, Palliative Care and others, the patient and his family benefit not only from treating the disease but also from relieving symptoms with consequent improvement in QOL and how the disease is lived.
Descrição
Tese de mestrado, Cuidados Paliativos, Universidade de Lisboa, Faculdade de Medicina, 2020
Palavras-chave
Cuidados paliativos Avaliação de sintomas Infeção por vírus da imunodeficiência humana (VIH) Síndrome da imunodeficência humana adquirida (SIDA) Qualidade de vida Teses de mestrado - 2020