RESUMO
RESUMEN Fundamento: el cuidado humano es la base de enfermería, por esa razón debe ser visto de forma holística. Los pacientes con pie diabético con o sin tratamiento adquieren daño físico, como amputaciones y alteraciones emocionales que propician estados de depresión; por tal motivo el enfermero debe considerar al paciente como un ente bio-psico-socia, ofreciendo apoyo que mejore su estado de salud, proporcione seguridad al paciente y la institución, lo que facilita mayor adherencia al tratamiento y mejor evolución de la enfermedad. Objetivo: determinar la calidad del cuidado humanizado desde la percepción de los pacientes diagnosticados con pie diabético. Métodos: se realizó un estudio descriptivo de diseño trasversal con un enfoque cuantitativo, aplicando un método deductivo en la Unidad de Atención Integral de Pie Diabético del Hospital General Santo Domingo-Ecuador, con una población de 50 pacientes que desearon participar y firmaron consentimiento informado. Se aplicó el instrumento del cuestionario PCHE 3ra versión que consta de 32 preguntas, el cual fue adaptado de acuerdo a las variables de estudio. Resultados: la calidad del cuidado humanizado en base a la percepción de los pacientes con pie diabético fue positiva en 92-94 % y la gran mayoría considera que existe una adecuada relación enfermero-paciente. Existe buena atención, comunicación y trato por parte del personal de enfermería hacia los pacientes, pero existen dificultades que impiden que el cuidado sea humano en su totalidad. Conclusiones: el cuidado humanizado hacia el paciente por el profesional de enfermería es positivo en cuanto a sus servicios, sin embargo, también se identifican deficiencias en ciertas características para que el cuidado sea humanizado en su totalidad.
ABSTRACT Background: human care is the basis of nursing, for this reason it must be viewed holistically. Patients with diabetic foot with or without treatment acquire damages such as amputations and emotional disturbances such as depression, so the nurse must look at the patient in a bio-psychosocial way, contributing to the improvement of their health, providing security to both the patient and to the institution, making him feel safe and leading him to have good adherence to treatment. Objective: to determine the quality of humanized care from the perception of patients diagnosed with diabetic foot. Methods: a descriptive cross-sectional design study was carried out with a quantitative approach applying a deductive method in the Comprehensive Care Unit for Diabetic Foot of the General Hospital Santo Domingo- Ecuador, with a population of 50 patients who wished to participate and signed informed consent for the respective sample. The instrument of the 3rd version PCHE questionnaire consisting of 32 questions was applied, which was adapted according to the study variables. Results: the quality of humanized care based on the perception of patients with diabetic foot is positive in 92-94% consider that there is adequate communication between the patient nurse, but there is still a deficit of certain characteristics for the care to be human in its entirety. Conclusions: the patient's humanized care by the nursing staff is positive regarding its services, however, there is still a deficit of certain characteristics for the care to be human in its entirety.
RESUMO
OBJETIVO: Diabetes mellitus é uma doença crônica prevalente, associada a inúmeras complicações. A neuropatia periférica diabética é a mais comum, acometendo 50% dos diabéticos, mas muitas vezes não é diagnosticada. Por cursar com insensibilidade distal e alterações arquiteturais dos pés, predispõe a úlceras, podendo culminar no pé diabético com risco de amputação. O diabetes mellitus é responsável por 70% das amputações de membros, que poderiam ser prevenidas com o diagnóstico precoce da neuropatia periférica diabética. Sugere-se avaliar o grau de neuropatia em diabéticos por meio de escores, visando homogeneizar o diagnóstico, quantificar a prevalência e promover medidas preventivas. MÉTODOS: Realizou-se entrevista, exame físico e coleta de dados de diabéticos atendidos ambulatorialmente, para pontuação e qualificação no Escore de Sintomas Neuropáticos e no Escore de Comprometimento Neuropático, validados na língua portuguesa para avaliar neuropatia periférica diabética, além de análise das características clínicas e epidemiológicas associadas. RESULTADOS: Foram incluídos 116 pacientes, constatando-se neuropatia periférica diabética em 31,9%. Houve correlação significativa de neuropatia periférica diabética coma idade dos pacientes, mas não com as demais variáveis clínicas e laboratoriais. Os pacientes avaliados apresentaram médias de idade de 55±15 anos e tempo de diabetes de 14,8±10,9 anos, sendo predominantemente caucasianos, mulheres e portadores de diabetes mellitus tipo 2. Eram hipertensos 67,2% e 42,2%, obesos. CONCLUSÃO: A prevalência encontrada corrobora a literatura, embora poucos estudos tenham utilizado critérios similares para diagnosticar neuropatia periférica diabética. Empregando os escores padronizados, de baixo custo e fácil aplicação possibilitamos o diagnóstico precoce e embasado dessa entidade, sendo possível, com isso, reduzir a prevalência de graves complicações do pé diabético e disseminar informações a respeito.
OBJECTIVE: Diabetes mellitus is a prevalent chronic disease, associated with numerous complications. Diabetic peripheral neuropathy is the most common, affecting 50% of diabetics, although is often not diagnosed. Presenting with distal numbness and architectural alterations of the feet, it predisposes ulcers and may culminate in diabetic foot at risk for amputation. Diabetes mellitus is responsible for 70% of limb amputations, which could be prevented with early diagnosis of diabetic peripheral neuropathy. This study aims to evaluate the degree of neuropathy in diabetics through validated scores, in order to standardize the diagnosis, quantify the prevalence and promote preventive actions. METHODS: We performed an interview, physical examination and data collection of diabetic outpatients, for rating in the Neuropathy Symptom Score and the Neuropathy Disability Score, validated in Portuguese, to assess diabetic peripheral neuropathy, in addition to analysis of clinical and epidemiological associated characteristics. RESULTS: We included 116 patients and diabetic peripheral neuropathy was found in 31.9%. There was significant correlation diabetic peripheral neuropathy with age, but not with other clinical and laboratory variables. The mean age was 55±15 years, diabetes duration was 14.8±10.9 years and patients were predominantly Caucasian, women and had type 2 diabetes mellitus. Of the patients, 67.2 % were hypertensive and 42.2% obese. CONCLUSION: The prevalence found is supported by previous data, although few studies have used similar criteria to diagnose diabetic peripheral neuropathy. Employing the standard scores, of low cost and easy implementation, we enable early and accurate diagnosis of this condition, allowing to reduce the prevalence of severe diabetic foot complications and spread information about it.
