Ansiedad en pacientes con trasplante renal de una clínica de alta complejidad en la ciudad de Barranquilla
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Fecha
2020
Autores
Charris Aguado, Iren Susan
Bermejo Galán, Ely Johanna
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Ediciones Universidad Simón Bolívar
Facultad de Ciencias de la Salud
Facultad de Ciencias de la Salud
Resumen
Antecedentes: La enfermedad renal crónica (ERC) es el deterioro de la función renal determinado por una tasa de filtración glomerular (TFG) menor a 60 ml/min por 1.73m2, que persistan durante por lo menos 3 meses. En estas situaciones, los pacientes requieren tratamiento como el trasplante renal que prolongue el buen estado de salud y que proporcione años de sobrevivencia con una calidad de vida elevada.
Los problemas que afectan la adherencia al tratamiento relacionado con la salud de los pacientes incluyen los aspectos sociodemográficos y médicos, como edad, sexo del paciente, nivel educativo, estado civil, estrato socioeconómico, ingresos y el tiempo trascurrido después del trasplante renal, entre otras; a su vez se pueden desencadenar síntomas emocionales que inicialmente pueden ser no patológicos por el estrés que atraviesan; sin embargo podemos estar ante síntomas emocionales que pueden alterar la funcionalidad global del individuo y llevarlos a presentar trastornos de salud mental como lo es la ansiedad; patología psiquiátrica prevalentes en la población general y en el paciente renales que puede generar alteraciones en el sistema Psico-neuro-inmune-endócrino, alterando la homeostasis con sus respectivas complicaciones y al mismo tiempo generando fallas en el afrontamiento relacionadas con una deficiente respuesta al tratamiento que puede ser evitado y/o corregido a tiempo antes y después del trasplante con un manejo multidisciplinario.
Objetivo: Determinar el grado de ansiedad en pacientes con trasplante renal en una clínica de alta complejidad.
Materiales y métodos: Estudio descriptivo de corte trasversal, una muestra de 54 pacientes que se les realizo trasplante renal. Para recolectar la información se realizó la estrategia de teleconsulta y se aplicó el test de Hamilton valorando particularmente el grado de ansiedad. Se utilizó un muestreo no probabilístico por
conveniencia, aplicando intervalo de confianza al 95% y se utilizó la prueba de Chi2, con un valor de p<0.05 como estadísticamente significativo.
Resultados: El 53,7% de los pacientes trasplantados eran hombres, el grupo etáreo con mayor frecuencia fue de 36 a 50 años. El 68,5% eran receptores de un órgano de donante cadavérico; los síntomas gastrointestinales junto con los síntomas somáticos generales- sensoriales como el mareo se encontraron en el 53.7% y el insomnio con los síntomas genitourinarios fue de 51.9% respectivamente. En cuanto al grado de ansiedad, se evidenció que el 38,9 % no presentó ansiedad, el 31,5% se encontraba con ansiedad leve y un 29,6% con ansiedad moderada a grave, para un total de 61.1% de algún grado de ansiedad. No se hallaron diferencias estadísticamente significativas (p=<0,005) entre los grados de ansiedad.
Conclusión: El grado de ansiedad de mayor prevalencia fue la leve, seguida de aquellos pacientes que no presentaron alguna sintomatología de ansiedad. Tanto hombres como mujeres padecen ansiedad moderada a grave en un menor porcentaje, siendo en hombres más evidente algún grado de ansiedad. Los síntomas que más presentaron los pacientes fueron los síntomas gastrointestinales, síntomas somáticos generales – sensoriales, insomnio y síntomas genitourinarios.
No hay diferencias estadísticamente significativas entre algún grado de ansiedad de la escala de Hamilton con respecto a las variables sociodemográficas evaluadas en el presente estudio.
Background: Chronic kidney disease (CKD) is the deterioration of kidney function determined by a glomerular filtration rate (GFR) lower than 60 ml / min per 1.73m2, which persists for at least 3 months. In these situations, patients require treatment such as kidney transplantation that prolongs good health and provides years of survival with a high quality of life. The problems that affect adherence to treatment related to the health of patients include sociodemographic and medical aspects, such as age, sex of the patient, educational level, marital status, socioeconomic status, income and time elapsed after kidney transplantation, among others. ; in turn, emotional symptoms can be triggered that may initially be non-pathological due to the stress they are going through; However, we may be faced with emotional symptoms that can alter the overall functionality of the individual and lead them to present mental health disorders such as anxiety; Psychiatric pathology prevalent in the general population and in the kidney patient that can generate alterations in the psycho-neuro-immune-endocrine system, altering homeostasis with its respective complications and at the same time generating failures in coping related to a poor response to treatment that can be avoided and / or corrected in time before and after transplantation with multidisciplinary management. Objective: To determine the degree of anxiety in kidney transplant patients in a highly complex clinic. Materials and methods: Descriptive cross-sectional study, a sample of 54 patients who underwent kidney transplantation. To collect the information, the teleconsultation strategy was carried out and the Hamilton test was applied, particularly assessing the degree of anxiety. Non-probabilistic convenience sampling was used, applying a 95% confidence interval and the Chi2 test was used, with a value of p <0.05 as statistically significant. Results: 53.7% of the transplanted patients were men, the age group most frequently between 36 and 50 years. 68.5% were recipients of a cadaveric donor organ; Gastrointestinal symptoms together with general somatic-sensory symptoms such as dizziness were found in 53.7% and insomnia with genitourinary symptoms was 51.9% respectively. Regarding the degree of anxiety, it was evidenced that 38.9% did not present anxiety, 31.5% had mild anxiety and 29.6% with moderate to severe anxiety, for a total of 61.1% of some degree of anxiety. No statistically significant differences (p = <0.005) were found between degrees of anxiety. Conclusion: The most prevalent degree of anxiety was mild, followed by those patients who did not present any anxiety symptoms. Both men and women suffer from moderate to severe anxiety in a lower percentage, with some degree of anxiety being more evident in men. The symptoms that the patients presented the most were gastrointestinal symptoms, general somatic - sensory symptoms, insomnia and genitourinary symptoms. There are no statistically significant differences between any degree of anxiety on the Hamilton scale with respect to the sociodemographic variables evaluated in the present study.
Background: Chronic kidney disease (CKD) is the deterioration of kidney function determined by a glomerular filtration rate (GFR) lower than 60 ml / min per 1.73m2, which persists for at least 3 months. In these situations, patients require treatment such as kidney transplantation that prolongs good health and provides years of survival with a high quality of life. The problems that affect adherence to treatment related to the health of patients include sociodemographic and medical aspects, such as age, sex of the patient, educational level, marital status, socioeconomic status, income and time elapsed after kidney transplantation, among others. ; in turn, emotional symptoms can be triggered that may initially be non-pathological due to the stress they are going through; However, we may be faced with emotional symptoms that can alter the overall functionality of the individual and lead them to present mental health disorders such as anxiety; Psychiatric pathology prevalent in the general population and in the kidney patient that can generate alterations in the psycho-neuro-immune-endocrine system, altering homeostasis with its respective complications and at the same time generating failures in coping related to a poor response to treatment that can be avoided and / or corrected in time before and after transplantation with multidisciplinary management. Objective: To determine the degree of anxiety in kidney transplant patients in a highly complex clinic. Materials and methods: Descriptive cross-sectional study, a sample of 54 patients who underwent kidney transplantation. To collect the information, the teleconsultation strategy was carried out and the Hamilton test was applied, particularly assessing the degree of anxiety. Non-probabilistic convenience sampling was used, applying a 95% confidence interval and the Chi2 test was used, with a value of p <0.05 as statistically significant. Results: 53.7% of the transplanted patients were men, the age group most frequently between 36 and 50 years. 68.5% were recipients of a cadaveric donor organ; Gastrointestinal symptoms together with general somatic-sensory symptoms such as dizziness were found in 53.7% and insomnia with genitourinary symptoms was 51.9% respectively. Regarding the degree of anxiety, it was evidenced that 38.9% did not present anxiety, 31.5% had mild anxiety and 29.6% with moderate to severe anxiety, for a total of 61.1% of some degree of anxiety. No statistically significant differences (p = <0.005) were found between degrees of anxiety. Conclusion: The most prevalent degree of anxiety was mild, followed by those patients who did not present any anxiety symptoms. Both men and women suffer from moderate to severe anxiety in a lower percentage, with some degree of anxiety being more evident in men. The symptoms that the patients presented the most were gastrointestinal symptoms, general somatic - sensory symptoms, insomnia and genitourinary symptoms. There are no statistically significant differences between any degree of anxiety on the Hamilton scale with respect to the sociodemographic variables evaluated in the present study.
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Palabras clave
Trasplante renal, Ansiedad, Salud Mental, Kidney transplant, Anxiety, Mental Health