ABSTRACT
Los niños con enfermedad renal crónica encuentran un riesgo aumentado de presentar compromiso de su neurodesarrollo. El objetivo de este trabajo fue la evaluación cognitiva y adaptativa de 15 niños con insuficiencia renal crónica en tratamiento de reemplazo con diálisis peritoneal ambulatoria. El desarrollo cognitivo fue normal o superior en 3 pacientes (20%) y retrasado en 12 (80%). La conducta adaptativa fue adecuada en 8 (53%) y baja o muy baja en 7 (47%). No hubo relación entre el desarrollo cognitivo y la escolaridad materna o el nivel socio económico, ni entre la conducta adaptativa y el nivel de escolaridad materna. La relación entre el NSE y la conducta adaptativa fue significativa (p 0.04). Esto sugeriría que si bien la enfermedad renal crónica compromete el desarrollo cognitivo, un nivel socioeconómico medio/alto puede proveer oportunidades para una mejor conducta adaptativa.
Children with chronic kidney disease are at increased riskof having impaired neurodevelopment. The objective of thepresent study was to perform a cognitive and adaptive eva-luation of 15 children with chronic renal insufficiency onoutpatient peritoneal dialysis. Cognitive development wasnormal or above normal in 3 patients (20%) and delayed in12 (80%). Adaptive behavior was adequate in 8 (53%) andlow or very low in 7 (47%). No correlation was found eitherbetween cognitive development and maternal education orsocio-economic level or between adaptive behavior andeducation of the mother. A significant correlation was foundbetween socio-economic level and adaptive behavior (p0.04). This would suggest that although chronic kidney dise-ase compromises cognitive development, middle or uppersocio-economic level may provide opportunities for impro-ved adaptive behavior.
Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adaptation, Psychological , Child Development , Peritoneal Dialysis, Continuous Ambulatory/psychology , Renal Insufficiency, Chronic/complications , Renal Insufficiency, Chronic/psychology , Renal Insufficiency, Chronic/therapy , ArgentinaABSTRACT
PURPOSE: This study was to evaluate the effects of a physical activity reinforcement program on exercise compliance, depression, and anxiety in continuous ambulatory peritoneal dialysis(CAPD) patients. METHOD: A nonequivalent control group with a pre-post test was designed. Data collection was done from December, 2002 to June, 2003 at a hoapital. The degree of depression and anxiety of the patients was assessed by the score of SCL-90-R, and exercise compliance was measured by exercise period, frequency, time and intensity. The experimental group was composed of 19 participants who were educated based on an exercise education protocol and carried out walking exercises two to four times a week after hearing verbal persuasion biweekly through the telephone or a face-to-face interview for 12 weeks, while 17 participants in control group received no intervention. RESULT: 1. The experimental group showed significant improvement in self-efficacy of exercise compliance (U=79.00, p=.01), exercise period (x2=20.84, p=.00), exercise frequency (x2=9.03, p=.01), exercise time (x2=9.03, p=.01) and exercise intensity (x2=11.09, p=.00) compared to those of the control group. 2. The experimental group showed a lower depression score (U=84.50, p=.01) than the results of the control group. 3. However, there were no changes in anxiety level compared to the control group. CONCLUSION: The physical activity reinforcement program was found to have an effect on exercise compliance and the depression score of CAPD patients. The results provided evidence for the importance of physical activity and verbal persuasion in CAPD patients.
Subject(s)
Adolescent , Adult , Female , Humans , Male , Middle Aged , Anxiety/diagnosis , Depression/diagnosis , Exercise , Patient Compliance , Peritoneal Dialysis, Continuous Ambulatory/psychologyABSTRACT
Com o avanço tecnológico e cientifico no tratamento dos doentes renais crônicos, o aumento da sobrevida desses pacientes em tratamento dialítico é uma realidade. A atençäo portanto, deve estar voltada para proporcionar um método de diálise que ofereça, também uma melhor qualidade de vida a esses doentes renais. Objetivos: Analisar o impacto da Diálise Ambulatorial contínua (CAPD) na qualidade de vida de doentes renais crônicos submetidos a esse tratamento. Método: Através de um estudo qualitativo de cunho exploratório, e utilizando a metodologia do Discurso do Sujeito Coletivo (DSC), procurou-se selecionar todos os doentes renais em programas de CAPD numa clinica de diálise de Feira de Santana-Ba. Foram estudados 23 doentes renais e , após serem submetidos a uma entrevista semi-estruturada, gravada e transcrita literalmente, selecionaram-se as idéias centrais com suas expressöes-chaves correspondentes, com as quais foram construídos os DSCs. Esses Discursos, que é fala dos sujeitos, permitiram compreender os significados atribuídos as vivências experimentadas por esses doentes renais enquanto usuários da CAPD. Consideraçöes finais: A partir da analise dos Discursos pode-se considerar que a qualidade de vida desses doentes renais melhorou após uso da CAPD, tendo apresentado os seguintes resultados: maior disposiçäo e liberdade para desempenharem as tarefas do dia-a-dia; permaneceram em suas casas desfrutando da companhia dos familiares, cuidando de si mesmos e recebendo apoio dos seus; oportunidade de voltar a trabalhar, estudar, viajar, passear e manter uma vida social normal; melhora no relacionamento com os amigos, por poder estar tempo perto deles; permissäo para adotar dieta sem restriçäo; e finalmente em relaçäo a sexualidade, uma parte dos entrevistados refere que näo houve alteraçäo. Aqueles que referem diminuiçäo da atividade sexual näo atribuem ao CAPD.