Avaliação da função sexual e sua associação com qualidade de vida e sintomas de ansiedade e depressão em receptores de transplantes renais

Abstract

Kidney transplant recipients experience fears, restrictions, reduced sexual function, symptoms of anxiety and depression, with great impairment of quality of life. The success of kidney transplantation is assessed by the survival rate, but the level and factors related to the quality of life of transplanted individuals should be a concern of health professionals. The objective to evaluate sexual function and its association with quality of life and symptoms of anxiety and depression in kidney transplant recipients. It was used as a study methodology, cross-sectional study, quantitative approach conducted in a University Hospital in northeastern Brazil, from January to December 2019, approved by the Ethics and Research Committee of the University Hospital of the Federal University of Maranhão under opinion nº 4,236,312. A sample consisted of 240 renal transplant patients older than 18 years of age, in regular outpatient follow-up, a form was used for sociodemographic and clinical characterization, in addition to validated instruments to evaluate: sexual function (Sexual quotient: male version - QSM and female version - QSF); anxiety and depression (Hospital anxiety and depression measurement scale - HADS) and quality of life - QOL (WHOQOL-Bref). Analysis of the instruments followed criteria established by the authors. Categorical variables described by frequencies and percentage and quantitative variables by mean and standard or median deviation and interquartile interval. In the evaluation of the difference in proportion between categorical variables, the Chi-square or Fisher's exact tests were used, in the comparison of means, student's t-test was used for independent samples or variance analysis (ANOVA). Mann Whitney, Kruskal-Wallis or Dunnet were used in the absence of normality. Spearman's correlation coefficient was used in the correlation of the variables. The analyses were carried out in Data Analysis and Statistical Software (STATA®) version 25.0. Established significance level of 5% (p<0.05). The results obtained were: the 240 participants had a mean age of 42 years, women (123) had lower scores for general QOL (p=0.001), low sexual function (p<0.001), higher levels of anxiety symptoms (p = 0.002) and depressive symptoms (p < 0.001). It was concluded that: sexual function was strongly influenced by gender, age, marital status, education, work situation, type of donor, physical activity and anxiety. QoL was negatively influenced by female gender, age ≥ 60 years, having up to 9 years of schooling, monthly income <1 salary, hemodialysis time > 10 years, being renal transplant > 10 years, not practicing physical activity, presence of anxiety and depression. Higher levels of anxiety and depression were influenced by gender, age, marital status, and schooling. It is emphasized that knowledge about personal, environmental, and clinical factors and their influence on QoL is essential for the development of interventions that improve QoL and sexual function and minimize symptoms of anxiety and depression.