Avaliação da prática do autocuidado de pacientes com prótese cardíaca valvar mecânica

Abstract

Patients with mechanical heart valve prostheses require regu lar monitoring of the health team during life, in order to practice self - care recovery and promoting their health. The main objective was evaluate the practice of self - care of patients with mechanical valve prosthesis, acco mpanied in nursing consultation . Specific objectives are to: identify the determining factors for the practice of self - care, considering sociodemographic and clinical indicators; verify the practices of self - care and self - care deficits in patients with mechanical valve prosthesis, and the consequent rise resulting from self - care deficit. This is a descriptive, cross - sectional quantitative study was carried out in two outpatient valve disease teaching hospitals in Fortaleza - Ceará - Brazil. T he sample was composed by 127 patients with mechanic al valve prostheses. Data were collected through individual interviews and assessment of blood pressure and anthropometric measurements. The project was approved by the Ethics and Research (N 422098). As a result of the conditioning factors predominated: f emale ( 56 , 7% ), aged 40 - 59 years ( 50, 4% ), studied more than 5 years (69 , 2%), married/common - law marriage (63 ,8%), coming from Fortaleza (54, 3%), family income up to the minimum wage ( 53 , 5% ), non - white color of the skin ( 55 , 1 % ) and not exercising labor acti vity ( 80 , 3% ). The universal self - care practices of highest incidence were: personal hygiene ( hair washed - 97 , 6 % , daily bath 92 , 1 % ) , oral hygiene (brushing teeth before sleep - 87, 4 %), fluid intake (eat drinking water - 95,2%), food intake (salt intake < 2g/d ia - 92,1%, consumption of vegetables and fruit daily - 79 , 5 % ); bowel eliminations ( without blood , mucus or pu rulent - 96% , no parasites - 94, 4%) ; urina ry elimination (no blood or pus - 96,8%, urination 4 to 6 times a day - 96%). As requirements of developmental self - care predomin ated: never used illegal drugs , nor smoked, nor drank or stopped in the discovery of the disease ( 70% ). As requirements for health deviation self - care have: makes use of certain medication at the right dose (95 , 2 % ), attending medical appointm ents, health team (cardiologist - 92,1% ; nursing - 84,2%), control INR (iden tifies signs of bleeding - 85,8%), and knowledge ( 57 , 4%) . The deficits were universal self - care: hygiene ( large or dirty fingernails - 43,6%, makes hair removal device manual - 77, 2 % ), oral hygiene (does not use tooth wire 70 , 9% , use toothpick - 71, 7 % do not visit the dentist regular - 65,4%), food intake (consumption dereg ulate food containing vitamin K - 33,1 % , makes fewer meals per day - 36 , 3%), exercise training physical (not wear clothes ap propriate - 62,3%, e xercise less than 30 min - 65,4 % , exercise less than 5 times in week - 70, 9% ), sleep and rest (sleep delay - 37, 1%) . As self - care health deviation deficit stood out: does not perform laboratory INR control (55 , 2%). Consequent of AC deficit pre dominated: bleeding events (55 , 1%) and thromboembolic ( 13 , 4% ). It is concluded that no patient with mechanical heart valve follows all the self - care practices in universal, developmental, and health deviation of recommended requirements , t hus as no practic e is followed by all study participants. Therefore, it is necessary that the Outpatient Professional valvopathies establish strategies for reducing the self - care deficit, considering the factors that influence self - care of patients