Calidad de vida, ansiedad y depresión en pacientes con enfermedad pulmonar obstructiva crónica

Lima, César de Andrade de; Oliveira, Regina Celia de; Oliveira, Simone Andrade Gonçalves de; Silva, Mônica Alice Santos da; Lima, Alcione de Andrade; Andrade, Maria Sandra; Pinho, Clarissa Mourão

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Revista Brasileira de Enfermagem

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ARTIGO ORIGINAL • Rev. Bras. Enferm. 73 (Suppl 1) • 2020 • https://doi.org/10.1590/0034-7167-2019-0423 copiar

Calidad de vida, ansiedad y depresión en pacientes con enfermedad pulmonar obstructiva crónica

Autoría SCIMAGO INSTITUTIONS RANKINGS

RESUMEN

Objetivo:

Estudiar la calidad de vida, ansiedad y depresión em pacientes con Enfermedad Pulmonar Obstructiva Crónica.

Método:

Se trata de un estudio transversal, cuantitativo, desarrollado en un hospital de referencia para el tratamiento de enfermedades pulmonares. Fueron evaluados 70 pacientes, usando una encuesta socio demográfica y clínica, inventario de ansiedad y depresión de Beck y la escala de calidad de vida SF-36.

Resultados:

Los participantes presentaron mejor calidad de vida en los parámetros de: vitalidad, salud mental y aspecto social (mediana=50,0) y la peor evaluación fue relacionada a los aspectos físicos y emocionales. (mediana = 0,0 pontos). Ansiedad, depresión y la dependencia de oxígeno, estuvieron asociados a los peores resultados en los parámetros de calidad de vida.

Conclusión:

Todos los pacientes fueron clasificados con un nivel grave de ansiedad y predominando los niveles moderados de depresión. Em la evaluación de la calidad de vida, los pacientes presentaron bajos niveles en todos los parámetros analizados.

Descriptores:
Enfermedad pulmonar obstructiva, crónica; Calidad de vida; Ansiedad; Depresión; Enfermería

Variables	n	%	p value¹ 1 P value of the Chi-square test for comparison of proportions.
Gender
Female	21	30.0	0.001
Male	49	70.0	0.001
Age
39 tom59 years	20	28.6	< 0.001
60 years or more	50	71.4	< 0.001
Origin
Recife	23	32.9	< 0.001
Metropolitan Region of Recife	23	32.9
Interior of state	23	32.9
Other state	1	1.3
Work activity
Unemployed	7	10.0	< 0.001
Retired	37	52.9
Social benefit	14	20.0
Employed	3	4.3
Self-employed	7	10.0
Other	2	2.9
Marital status
Single	5	7.1	< 0.001
Common-law	2	2.9
Married	55	78.6
Widower	8	11.4
Level of education
Illiterate	4	5.7	< 0.001
Literate	2	2.9
Elementary school	33	47.1
High school	27	38.6
Higher education	4	5.7
Religion
Catholic	44	62.9	< 0.001
Evangelical	18	25.7
None	4	5.7
Other	4	5.7

Variables	n	%	p value¹ 1 P value of the Chi-square test for comparison of proportions.
Time since diagnosis
1 a 2 years	29	41.4	0.211
3 a 5 years	24	34.3
6 years or more	17	24.3
Minimum - Maximum	1.0 - 20.0		-
Mean ± Standard deviation	4.9 ± 4.3		-
Outpatient Follow-up
Yes	56	80.0	< 0.001
No	14	20.0	< 0.001
Previous hospitalization
Yes	52	74.3	< 0.001
No	18	25.7	< 0.001
Number of hospitalizations
Minimum - Maximum	1.0 - 7.0		-
Mean ± Standard deviation	2.6 ± 1.3		-
Inhalaed medications
Formoterol fumarate/ Budesonide	10	14.3	< 0.001
Formoterol fumarate/ Budesonide + tiotropium bromide	31	44.3
Salbutamol	1	1.4
Salbutamol + Formoterol fumarate/ Budesonide + tiotropium bromide	18	25.7
Salbutamol + tiotropium bromide	2	2.9
Salbutamol + Formoterol fumarate / Budesonide	7	10.0
Fenoterol hydrobromide + Formoterol fumarate / Budesonide	1	1.4

Domain	Minimum	Maximum	Median	Interquartile range
Physical functioning	0.00	65.00	15.00	10.00
Physical role functioning	0.00	25.00	0.00	0.00
Bodily pain	0.00	54.00	41.00	2.50
General health perceptions	5.00	45.00	25.00	5.00
Vitality	10.00	70.00	50.00	5.00
Social role functioning	0.00	62.50	50.00	0.00
Emotional role functioning	0.00	33.33	0.00	0.00
Mental health	36.00	68.00	50.00	4.00

Domain	Minimal effort dyspnea		p value¹ 1 Mann-Whitney test (if p value<0.05 there is a difference between the groups). (-) no interquartile range; BDI = Beck Depression Inventory; BAI = Beck Anxiety Inventory.	Dependent on O₂ therapy		p value¹ 1 Mann-Whitney test (if p value<0.05 there is a difference between the groups). (-) no interquartile range; BDI = Beck Depression Inventory; BAI = Beck Anxiety Inventory.
Domain	Yes	No		Yes	No
Capacidade funcional	15.0 (10.0)	15.0 (40.0)	0.037	0.0 (2.5)	15.0 (5.0)	< 0.001
Limitação por aspectos físicos	0.0 (0.0)	0.0 (0.0)	0.782	0.0 (0.0)	0.0 (0.0)	0.633
Dor	41.0 (5.0)	41.0 (5.5)	0.564	31.0 (10.0)	41.0 (0.0)	0.051
Estado de saúde geral	25.0 (5.0)	30.0 (20.0)	0.450	25.0 (5.0)	25.0 (10.0)	0.010
Vitalidade	50.0 (7.5)	50.0 (32.5)	0.132	50.0 (12.5)	50.0 (2.5)	0.727
Aspecto social	50.0 (0.0)	50.0 (18.8)	0.657	37.5 (18.8)	50.0 (0.0)	< 0.001
Aspecto emocional	0.0 (0.0)	0.0 (0.0)	0.693	0.0 (0.0)	0.0 (0.0)	0.496
Saúde mental	48.0 (4.0)	52.0 (18.0)	0.287	48.0 (8.0)	52.0 (4.0)	0.278
BDI (Depressão)	30.0 (10.0)	27.0 (11.0)	0.398	38.0 (8.5)	29.0 (8.5)	0.001
BAI (Ansiedade)	49.0 (7.0)	45.0 (12.0)	0.039	56.0 (16.5)	48.0 (5.5)	0.027

Domain	Factors assessed
Domain	BDI (Depression)	BAI (Anxiety)
Physical functioning	ρ = -0.478; p < 0.001¹ 1 significant p value, Spearman test at 5%; BDI = Beck Depression Inventory; BAI = Beck Anxiety Inventory.	ρ = -0.356; p = 0.003¹ 1 significant p value, Spearman test at 5%; BDI = Beck Depression Inventory; BAI = Beck Anxiety Inventory.
Physical role functioning	ρ = -0.021; p = 0.864	ρ = -0.027; p = 0.825
Bodily pain	ρ = -0.362; p = 0.002¹ 1 significant p value, Spearman test at 5%; BDI = Beck Depression Inventory; BAI = Beck Anxiety Inventory.	ρ = -0.264; p = 0.027¹ 1 significant p value, Spearman test at 5%; BDI = Beck Depression Inventory; BAI = Beck Anxiety Inventory.
General health perceptions	ρ = -0.195; p = 0.105	ρ = -0.143; p = 0.237
Vitality	ρ = -0.250; p = 0.037¹ 1 significant p value, Spearman test at 5%; BDI = Beck Depression Inventory; BAI = Beck Anxiety Inventory.	ρ = -0.008; p = 0.950
Social role functioning	ρ = -0.533; p < 0.001¹ 1 significant p value, Spearman test at 5%; BDI = Beck Depression Inventory; BAI = Beck Anxiety Inventory.	ρ = -0.354; p = 0.003¹ 1 significant p value, Spearman test at 5%; BDI = Beck Depression Inventory; BAI = Beck Anxiety Inventory.
Emotional role functioning	ρ = -0.011; p = 0.930	ρ = -0.038; p = 0.753
Mental health	ρ = -0.308; p = 0.009¹ 1 significant p value, Spearman test at 5%; BDI = Beck Depression Inventory; BAI = Beck Anxiety Inventory.	ρ = -0.429; p < 0.001¹ 1 significant p value, Spearman test at 5%; BDI = Beck Depression Inventory; BAI = Beck Anxiety Inventory.

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[1] Corresponding author: Maria Sandra Andrade E-mail: sandra.andrade@upe.br