Eficacia del manejo integral en el paciente con esquizofrenia paranoide: revisión narrativa
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Fecha
2018
Autores
Villarreal Fernandez, Alberto Luis
Rangel Trespalacios, Tania del Carmen
Páez caballero, Daniel Alfonso
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Editor
Ediciones Universidad Simón Bolívar
Facultad de Ciencias de la Salud
Facultad de Ciencias de la Salud
Resumen
Antecedentes: La naturaleza multi etiológica y multifactorial de la esquizofrenia paranoide, obliga al personal de salud a instaurar terapias que integren diferentes servicios en pro del beneficio del paciente, siempre apuntando a mejorar la calidad de vida y reducir en la medida de lo posible. En el contexto de este estudio definimos algunos de estos “pilares” del tratamiento como son: Terapia Farmacológico, Terapia Psicológica, Terapia Familiar, Terapia Laboral y aquellas terapias experimentales o no ligadas a alguna de las anteriores. Aunque cada una por separado ofrece ventajas al paciente, la verdadera importancia se encuentra en la interacción de estas, ya que entre si se potencian y aseguran la adherencia al tratamiento, disminuyendo a su ves el desarrollo de resistencia a este.
Objetivos: Describir la importancia y eficacia del tratamiento integral de la esquizofrenia paranoide.
Materiales y Métodos: Para la realización de este artículo de revisión se realizó una investigación de tipo descriptiva-retrospectiva ya que se revisaron 50 artículos
publicados entre los años 2008 y 2018 analizando de forma integral cada uno con el propósito fundamental de establecer la efectividad de la terapia integral en el paciente con esquizofrenia paranoide.
Resultados: En la gran mayoría de los artículos revisados, aun en aquellos en donde se exponía uno de los pilares de forma especializada, se recomendaba el
tratamiento con diferentes terapias asociadas. Algunos artículos recomendaban el colocar un pilar del tratamiento como principal, y alrededor de este organizar el tratamiento integral. De estos artículos, muchos recomendaban el centrar el tratamiento en el manejo farmacológico, y llevar el resto de terapias a asegurar la
adherencia al tratamiento.
Conclusiones: La naturaleza multifactorial y la gran variedad etiológica de la
esquizofrenia, orienta acerca de la necesidad de integrar al paciente en un esquema
terapéutico que permita brindar un apoyo efectivo, completo y que lleve al paciente
a una mejoria, inclusión social e independencia en sus labores cotidianas.
De manera clásica recomendamos la instauración de un eje central de tratamiento,
basado en una terapia farmacológica de primera línea acompañada en un principio
de labores terapéuticas psicológicas, familiares y laborales, que permitan una
correcta adherencia al tratamiento. Es necesario que en esta primera etapa se
brinde a la familia del paciente una educación básica en lo referente a la
enfermedad, tolerancia hacia el paciente y apoyo emocional hacia los mismos
familiares, con el objetivo de fortalecer el entorno familiar e integrar a la propia
familia al manejo integral del paciente.
Background: The multi etiological and multifactorial nature of paranoid schizophrenia, forces health personnel to establish therapies that integrate different services for the benefit of the patient, always aiming to improve the quality of life and reduce as much as possible. In the context of this study we define some of these "pillars" of the treatment such as: Pharmacological Therapy, Psychological Therapy, Family Therapy, Labor Therapy and those experimental therapies or not linked to any of the above. Although each one separately offers advantages to the patient, the real importance lies in the interaction of these, since among them they enhance and ensure adherence to treatment, decreasing in turn the development of resistance to it. Objective: To describe the importance and efficacy of the integral treatment of paranoid schizophrenia. Materials and Methods: To carry out this review article, a descriptive-retrospective study was carried out, since 50 articles published between 2008 and 2018 were reviewed, analyzing each one in an integral way with the fundamental purpose of establishing the effectiveness of integral therapy. in the patient with paranoid schizophrenia. Results: In the vast majority of the articles reviewed, even in those where one of the pillars was exposed in a specialized manner, treatment with different associated therapies was recommended. Some articles recommended placing a pillar of treatment as the main one, and around this to organize the integral treatment. Of these articles, many recommended focusing treatment on pharmacological management, and taking other therapies to ensure adherence to treatment. Conclusions: The multifactorial nature and the great etiological variety of schizophrenia, guides about the need to integrate the patient into a therapeutic scheme that allows to provide effective, complete support and that leads the patient to an improvement, social inclusion and independence in their daily tasks. . Classically, we recommend the establishment of a central axis of treatment, based on a first-line pharmacological therapy accompanied initially by psychological, family and work therapeutic tasks, which allow correct adherence to treatment. In this first stage, it is necessary that the patient's family be provided with a basic education regarding the disease, tolerance towards the patient and emotional support towards the relatives themselves, with the aim of strengthening the family environment and integrating the family itself to the integral management of the patient.
Background: The multi etiological and multifactorial nature of paranoid schizophrenia, forces health personnel to establish therapies that integrate different services for the benefit of the patient, always aiming to improve the quality of life and reduce as much as possible. In the context of this study we define some of these "pillars" of the treatment such as: Pharmacological Therapy, Psychological Therapy, Family Therapy, Labor Therapy and those experimental therapies or not linked to any of the above. Although each one separately offers advantages to the patient, the real importance lies in the interaction of these, since among them they enhance and ensure adherence to treatment, decreasing in turn the development of resistance to it. Objective: To describe the importance and efficacy of the integral treatment of paranoid schizophrenia. Materials and Methods: To carry out this review article, a descriptive-retrospective study was carried out, since 50 articles published between 2008 and 2018 were reviewed, analyzing each one in an integral way with the fundamental purpose of establishing the effectiveness of integral therapy. in the patient with paranoid schizophrenia. Results: In the vast majority of the articles reviewed, even in those where one of the pillars was exposed in a specialized manner, treatment with different associated therapies was recommended. Some articles recommended placing a pillar of treatment as the main one, and around this to organize the integral treatment. Of these articles, many recommended focusing treatment on pharmacological management, and taking other therapies to ensure adherence to treatment. Conclusions: The multifactorial nature and the great etiological variety of schizophrenia, guides about the need to integrate the patient into a therapeutic scheme that allows to provide effective, complete support and that leads the patient to an improvement, social inclusion and independence in their daily tasks. . Classically, we recommend the establishment of a central axis of treatment, based on a first-line pharmacological therapy accompanied initially by psychological, family and work therapeutic tasks, which allow correct adherence to treatment. In this first stage, it is necessary that the patient's family be provided with a basic education regarding the disease, tolerance towards the patient and emotional support towards the relatives themselves, with the aim of strengthening the family environment and integrating the family itself to the integral management of the patient.
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Palabras clave
Manejo integral, Calidad de vida, Adherencia al tratamiento, Efectos adversos, Terapia Psicológica, Terapia Laboral, Terapia Farmacológica, Terapia Familiar, Integral management, Quality of life, Adherence to treatment, Adverse effects, Psychological Therapy, Labor Therapy, Pharmacological Therapy, Family Therapy