Assessment of health-related quality of life and related factors in patients with chronic liver disease

ABSTRACT BACKGROUND AND OBJECTIVES: Assessing health-related quality of life is an important aspect of clinical practice. Thus, the present study attempts to assess the health-related quality of life of patients with chronic liver disease. METHODS: A cross-sectional survey was conducted on 133 chronic liver disease patients, using three instruments: a demographic questionnaire, the Chronic Liver Disease Questionnaire, and Model for End-Stage Liver Disease index. Variables were expressed as frequencies, percentages, means, and standard deviations. The statistical analysis included Pearson's correlation, Student's t-test, and analysis of variance (p < 0.05 was considered significant). RESULTS: The mean age of included subjects was 50.5 ± 13.3 years. The majority were male (66.2%), Caucasian (70.7%), and had a family income of US$329-US$658.2. Over half of the patients (56.4%) were infected by hepatitis C virus and 93.2% had low Model for End-Stage Liver Disease scores. Model for End-Stage Liver Disease score was related to age (r = 0.185;p = 0.033). Higher mean Chronic Liver Disease Questionnaire scores were obtained for emotional function (39.70/SD ± 12.98) and while lower scores were obtained for abdominal symptoms (16.00/SD ± 6.25). Fifty-two patients (39.1%) presented overall low (<5) Chronic Liver Disease Questionnaire scores. Furthermore, Chronic Liver Disease Questionnaire score was related to family income (r = 0.187, p = 0.031). CONCLUSION: Most individuals presented high mean Chronic Liver Disease Questionnaire scores, indicating low health-related quality of life, especially individuals with low family income.

Plano municipal de saúde: análise do instrumento de gestão / Health municipal plan: analyse of management's instrument

Dentre os instrumentos fundamentais do planejamento que devem ser utilizados pelas instâncias gestoras do Sistema Único de Saúde destaca-se o Plano Municipal de Saúde. Este deve ser construído coletivamente apresentando as intenções políticas, diretrizes, prioridades, objetivos, quadro de metas, estimativa de recursos e gastos necessários para o alcance das metas do setor saúde. O objetivo deste trabalho foi analisar os planos, quanto ao atendimento aos preceitos legais que regem o Sistema Único de Saúde, sua constituição e apresentação dos itens essenciais. Foram incluídos no estudo três municípios do Estado de São Paulo. A técnica de pesquisa adotada foi a análise documental. Verificou-se que nem todos planos apresentaram a análise situacional com descrição detalhada da situação geral do município, e somente um deles realizou análise crítica de seus dados epidemiológicos; assim como, a receita financeira aplicada à saúde foi descrita por apenas um município. Em relação à programação, todos os municípios descreveram os principais problemas e suas soluções. Embora contasse com o quadro de metas, a questão da estimativa de gastos para se atingir as metas não foi abordada. Nenhum apresentou uma revisão anual, estando um deles desatualizado há mais de dois anos. Não foi observada a participação do Conselho Municipal de Saúde na elaboração e revisão dos planos. Concluiu-se que há deficiência nos planos analisados. Sugere-se a execução da educação permanente dos gestores quanto à importância da elaboração sistemática dos planos e da promoção da participação ativa Conselho Municipal de Saúde objetivando concretizar o controle social das ações de saúde.

Among planning instruments used by manager instances of Brazilian Health System it pointed the Health Municipal Plan (PMS) that should be built collectively showing political intentions, directresses, priorities, objectives, goals framework, estimative of resources and need costs to get the goals of the health sector. The aim of this work was to analyze the plans in relation to attendance of legal requirements which manage the Brazilian Health System, its constitution and showing of essential items. The study included three municipalities form São Paulo State. It was used the documental analysis as research technique. Near all plans showed an analysis of situation with detailed descriptions of general situation of municipality, and only one of them realized critical analysis of their epidemiological data; the financial income applied on health was decrypted by only one municipality. About programming, all municipalities described the main problems and its solutions. Although they had goals framework, the question about cost estimative to get the goals was not approached. Any municipality showed an annual review, being one of them delayed over than two years. It was observed no participation of Municipal Health Council on elaboration and review of plans. It was concluded that there was a deficiency in the plans analyzed. It's necessary to execute continuing education with managers in relation to importance of systematic elaboration of plans and to incentive the promotion of active participation of Municipal Health Council promotion of aiming to became true the social control of health actions.