Qualidade de vida dos pacientes portadores de insuficiência cardíaca atendidos pelo Programa de Boas Práticas Clínicas em Cardiologia

Abstract

Introduction: Heart failure is considered the common final pathway of heart diseases. The increased prevalence and aging of the population make primary care the ideal level of intervention, in which knowledge about the disease, self-care and the management of signs and symptoms are also guided by a specialist nurse. Quality of life assessment is an important tool to indicate nursing actions, especially focused on education. Objective: To compare patients the quality of life of with decompensated chronic cardiac insufficiency at hospital admission and at 180 days after discharge by applying the World Health Organization (WHO) quality of life questionnaire by the research team, from March 2016 to December 2018. The specific objectives were to describe the patient's profile, to assess the overall rehospitalization rate and overall mortality within 180 days. Method: Retrospective cohort with quantitative approach to quality of life. Results: Amongst the 145 initial patients, 99 had the quality of life questionnaire answered at admission and 41 answered at 180 days after discharge. The physical domain average showed a statistically significant improvement (35,19±17,23 x 39,98±18,32 p 0,021) at 180 days. The psychological domain was also statistically significant and worsened at 180 days (58,33±18,06 x 53,66±19,30 p 0,024); between the averages of social and environmental domains there were no statistical differences. Discussion: The fact that the study participants present, predominantly, NYHA III and IV classification impacts directly the patient's physical limitation, justifying that the physical domain average is the lowest at both admission and 180 days. Regarding to the psychological domain, it can be related to the fact that, when hospitalized, the participant has the security of the provided care, with professionals around him; while, at 180 days, already at home, he would have to perform it by himself, which, sometimes, brings insecurity for fear of not doing it properly. Moreover, patients with this diagnosis face psychological challenges, including anxiety and depression, however, in this study, only 2.8% of patients have depression and, when compared to the 180 days after discharge, the decline of the psychological domain is noted. Conclusion: There was a consistent improvement in the physical domain; in contrast, the psychological domain showed significant worsening, which suggests care with greater psychological support. The social and environmental domains showed no significant differences.