Adolescentes e jovens renais crônicos em diálise: interfaces entre a qualidade de vida e as dimensões do homem em tempos de pandemia

Abstract

Introduction: Chronic Kidney Failure is a highly prevalent condition characterized as a syndrome with progressive and irreversible damage to the kidneys whose hemodialysis is one of the treatments. Kidney disease presents itself as a public health problem occurring at any stage of life and compromising human dimensions. The biopsychosocial spheres can be significantly affected and interfere with the quality of life of adolescents and young people on dialysis, especially in the midst of the pandemic context experienced in recent years. Objective: To understand the life context of adolescents and young people with chronic renal failure, related to the human dimensions that affect QOL and to the conservation principles of Levine's Holistic Theory. Methods: This is an exploratory, descriptive study, configured as a mixed methods research and concomitant triangulation of data. In the quantitative approach, there was a cross-sectional design to identify how human dimensions affect quality of life, and, in the qualitative approach, a cross-sectional study was carried out to analyze the life experience of adolescents and young people with kidney disease with their treatment and the meanings attributed to the human dimensions that affect their quality of Life. The target audience of the two approaches was composed of adolescents and young people with kidney disease on hemodialysis, from a reference hospital and satellite clinic in the city of Sobral-CE. Two instruments were applied: a sociodemographic form and a Brazilian version of the Medical Outcomes Study-36- -36), which assesses quality of life. Data collection took place in November and December 2021. Data were coded and typed

into Microsoft Excel and later analyzed using descriptive statistics. Also, semi- structured interviews were carried out in order to understand the nexus of meaning

between the phenomenon and the symbol, that is, between the experience of the human dimensions proposed by Mondin and the quality of life. Content Analysis took place in its thematic modality of the resulting data with the support of the IRaMuTeQ software. After previous selection of patients, the researcher approached each one individually, inviting them to participate in the research, with due clarification of the objectives of this and honoring all aspects ethics involved. The research complied with all the recommendations of Resolution No466/2012 of the National Health Council. Results: Twenty-one patients participated in the study and a median age of 25 years (IQR: 23 27) was observed, 61.9% (n=13) were male, 47.6% (n=10) had high school complete and 71.4% (n=15) had an income of one minimum wage. Participants had a median time of 31 months (IQI: 18 48) in the current modality of renal replacement therapy, 24 months (IQI: 12 48) of follow-up at transplantation, and 24 months (IQI: 12 60) of waiting at transplant queue. Most participants (52.4%; n=11) reported having some comorbidity, mainly systemic arterial hypertension. The domains of the quality of life scale, general health status and social aspects presented the lowest mean and median among the participants. None of the sociodemographic characteristics showed a significant association with the quality of life domains. Patients reported changes in the body's energy balance, physical changes, changes in self-esteem and social changes when experiencing CKD, especially in the context of the new coronavirus pandemic. Mondin's human dimensions, involving Homo somaticus, Homo vivens, Homo faber, Homo volens, Homo sapiens, Homo socialis, Homo religiosus and Homo ludens, and the conservation principles of Levine's theoretical model present intersections capable of favoring the integrality of

adolescents and young kidney patients on dialysis with the possibility to strengthen and expand holistic care for these patients. Final considerations: It is necessary to understand the synchronic and transversal relationship of the dimensions of man that are affected in adolescents and young kidneys on dialysis involving Homo somaticus, Homo vivens, Homo faber, Homo volens, Homo sapiens, Homo socialis, Homo religiosus and Homo ludens and the conservation principles of Levine's Holistic Theory. The principles of energy conservation, structural integrity, personal integrity and social integrity are all altered in the lives of adolescents and young people with kidney disease undergoing hemodialysis. The sociodemographic characteristics and their relationship with the quality of life domains support the understanding of the human dimensions that affect the quality of life of these patients.