Funcionalidad familiar y sobrecarga de cuidadores familiares de usuarios con trastornos mentales

Andrade, Jaciquely José da Costa; Silva, Andrea Cristina Oliveira; Frazão, Iracema da Silva; Perrelli, Jaqueline Galdino Albuquerque; Silva, Thassia Thame de Moura; Cavalcanti, Ana Márcia Tenório Souza

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Revista Brasileira de Enfermagem

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ORIGINAL ARTICLE • Rev. Bras. Enferm. 74 (05) • 2021 • https://doi.org/10.1590/0034-7167-2020-1061 copiar

Funcionalidad familiar y sobrecarga de cuidadores familiares de usuarios con trastornos mentales

Autoría SCIMAGO INSTITUTIONS RANKINGS

RESUMEN

Objetivo:

verificar la diferencia de media o mediana en las puntuaciones de funcionalidad familiar y sobrecarga de los cuidadores familiares de personas con trastornos mentales.

Métodos:

estudio transversal realizado en un Centro de Atención Psicosocial, con 61 cuidadores familiares. Se utilizaron instrumentos para la caracterización sociodemográfica, el proceso de cuidado, el Índice de Apgar Familiar y el Family Burden Interview Schedule. Se adoptaron pruebas de diferencia de media/mediana.

Resultados:

las mujeres con trastornos mentales y la presencia de hijos en el hogar disminuyeron la mediana del Apgar familiar. La dificultad en la relación entre cuidador/usuario, nerviosismo/tensión, agresión física y agitación del paciente aumentaron el promedio global de carga subjetiva.

Conclusiones:

las intervenciones de enfermería para reducir la carga y promover la funcionalidad familiar deben priorizar a los cuidadores de mujeres con trastornos mentales, asistirlos en el manejo de conductas problemáticas y sensibilizar al núcleo familiar sobre la corresponsabilidad del cuidado del enfermo, especialmente en familias con niños que demandan cuidados diarios.

Descriptores:
Familia; Cuidadores; Transtornos Mentales; Salud de la Familia; Enfermería

Variables	n	%	Median	Medium Post	p value
Woman with mental disorders
Yes	29	47.5	7.00	23.88	0.016^* * Median test;
No	32	52.5	8.50	37.45	0.003^ Mann-Whitney U test.
Presence of children in the same residence
Yes	16	26.2	4.50	18.78	0.014^* * Median test;
No	45	73.8	8.00	35.34	<0.001^ Mann-Whitney U test.

Subscales	Items	Objective		Subjective
		Low %	High %	Low %	High %
		1 and 2¹	4 and 5²	1 and 2³	3 and 4⁴/ 4 and 5⁵
A: Assistance to patients in daily life	Hygiene	41.0	54.1	52.7	47.3
	Medication	24.6	65.6	68.8	31.2
	House chores	45.9	50.8	60.6	39.4
	Purchases	67.2	16.4	85.2	14.8
	Food	27.8	55.7	91.1	8.9
	Transportation	29.5	36.1	90.0	10.0
	Money	62.3	29.5	90.6	9.4
	Time occupation	36.1	54.1	79.4	20.6
	Medical consultation	42.6	27.9	86.6	13.4
B: Supervision of patients' troublesome behaviors	Troublesome behaviors	59.0	27.9	16.2	83.8
	Asking for excessive attention	60.7	27.8	32.0	68.0
	Night disturbance	72.2	23.0	23.8	76.2
	Hetero-aggression	68.8	13.2	36.0	64.0
	Self-harm	65.6	18.0	0.0	37.7
	Smoking or drinking too much (soft drinks)	67.2	22.9	36.3	63.7
C: Expenses	Weight of patient expenses	-	-	31.1	55.7
D: Impact on caregivers' lives	Delays or absences from appointments	42.6	23.0	-	-
	Changes in caregiver leisure	37.7	37.7	-	-
	Changes in home service/routine	59.0	24.6	-	-
	Decreased attention to other family members	44.2	22.9	-	-
E: Concern about patients	Physical security	-	-	8.0	22.9
	Quality of treatment	-	-	51.6	30.7
	Social life	-	-	24.2	61.3
	Health	-	-	9.7	79.1
	Housing	-	-	56.5	32.2
	Finances	-	-	4.8	80.7
	Future	-	-	1.6	93.6

Subscales	Dimensions	Mean	Median	p value^* * Kolmogorov-Smirnov test (normality).
A: Assistance to patients in daily life	Objective	2.989 (±0.850)	2.889	0.200
A: Assistance to patients in daily life	Subjective	1.107 (±0.717)	1.000	<0.001
B: Supervision of troublesome behaviors	Objective	2.068 (±0.887)	2.000	0.046
B: Supervision of troublesome behaviors	Subjective	1.216 (±0.981)	1.167	0.016
D: Impact on routine	Objective	2.451 (±1.193)	2.000	<0.001
E: Concerns about patients	Subjective	3.850 (±0.692)	3.857	0.200
Overall objective burden score	--	2.503 (±0.805)	2.287	0.048
Overall subjective burden score	--	2.058 (±0.577)	1.976	0.200

Variables	n	%	Mean	SD	p value
Subjective burden
Relationship with patients
Unsatisfactory	4	6.55	3.557	0.403	0.002^** * ANOVA test;
Satisfactory	37	60.65	2.775	0.617
Very satisfactory	20	32.80	2.349	0.671
Nervousness/tension
Yes	25	40.99	2.989	0.639	0.003^ T test;
No	36	59.01	2.476	0.646	0.003^ T test;
Physical aggressiveness
Yes	21	34.40	2.967	0.622	0.017^ T test;
No	40	65.60	2.539	0.680
Agitation
Yes	27	44.30	2.937	0.700	0.011^ T test;
No	34	55.70	2.487	0.616
Subscale A - Subjective
Caregiver sex
Women	45	73.78	1.826	0.125	0.013^* ***** Mann-Whitney U test;
Men	16	26.22	1.270	0.101
Presence of children at home
Yes	16	26.22	2.028	0.232	0.049^* ***** Mann-Whitney U test;
No	45	73.78	1.556	0.104
Relationship with patients
Unsatisfactory	4	6.55	2.750	0.479	<0.001^* * Kruskal-Wallis test.
Satisfactory	37	60.65	1.760	0.109
Very satisfactory	20	32.80	1.319	0.170
Refusing medication
Yes	14	22.95	2.083	0.232	0.029^* ***** Mann-Whitney U test;
No	47	77.05	1.560	0.106	0.019^** ****** Median test;
Nervousness/tension
Yes	25	40.99	2.000	0.184	0.014^* ***** Mann-Whitney U test;
No	36	59.01	1.458	0.099
Lack of hygiene
Yes	18	29.50	2.115	0.229	0.013^* ***** Mann-Whitney U test;
No	43	70.50	1.498	0.094	0.027^** ****** Median test;
Subscale E - Subjective
Physical aggressiveness
Yes	21	34.40	4.197	0.641	0.004^ T test;
No	40	65.60	3.668	0.654
Agitation
Yes	27	44.30	4.048	0.626	0.043^ T test;
No	34	55.70	3.693	0.710
Nervousness/tension
Yes	25	40.99	4.063	0.640	0.042^ T test;
No	36	59.01	3.702	0.697

Variables	n	%	Mean	SD	p value
Subscale A - Objective
Verbal threats/aggression
Yes	20	32.80	3.394	0.834	0.011^ T test;
No	41	67.20	2.791	0.794	0.011^ T test;
Nervousness/tension
Yes	25	40.99	3.293	0.823	0.019^ T test;
No	36	59.01	2.778	0.814	0.019^ T test;
Soliloquy
Yes	22	36.06	3.439	0.714	<0.001^ T test;
No	39	63.94	2.735	0.822
Subscale B - Objective
Presence of other sick people in the house
Yes	25	40.99	2.250	0.233	0.035^* ***** Mann-Whitney U test;
No	36	59.01	2.004	0.130	0.011^** ****** Median test.
Breaking objects
Yes	18	29.50	2.352	0.194
No	43	70.50	1.950	0.136	0.030^** ****** Median test.
Nervousness/tension
Yes	25	40.99	2.307	0.186
No	36	59.01	1.903	0.138	0.043^** ****** Median test.
Subscale D - Objective
Breaking objects
Yes	18	29.50	2.861	0.264
No	43	70.50	2.279	0.182	0.041^** ****** Median test.
Nervousness/tension
Yes	25	40.99	2.890	0.261	0.025^* ***** Mann-Whitney U test;
No	36	59.01	2.146	0.170
Soliloquy
Yes	22	36.06	3.068	0.245	0.002^* ***** Mann-Whitney U test;
No	39	63.94	2.103	0.173	0.013^** ****** Median test.

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[1] Corresponding author: Jaciquely Jose da Costa Andrade E-mail: jaciquelyandradeufpe@gmail.com