Influencia de variaveis psicossociais, clinicas e sociodemograficas na evolução intra-hospitalar de pacientes em pos-operatorio de cirurgia cardiaca

AUTOR(ES)
DATA DE PUBLICAÇÃO

2004

RESUMO

This study was developed in three steps: the first one was an exploratory study, the second was a methodological (confirming the validity of ínstruments), and the third one was a descriptive-corre1ation. The aim of the study was to verify if psychosocial, clinical and sociodemographics variables of patients related to cardiac surgery were associated with postoperative evolution in-hospital stay. This research was conducted in 125 male and female patients in waiting period prior to cardiac surgery, admitted in the Cardiology ward at the Hospital de Clínicas of Campinas State University- UNICAMP. Individual interviews were conducted in order to collect sociodemographic data, and subsequent1y, it was applied the SPCC (Meanings of Patients related to Cardiac Surgery) and CVSCC (Beliefs, Values and Feelings related to Cardiac Surgery) instruments. The clinical variables that composed the study model were obtained from medical patients registries. The data were analyzed throughout Cronbach s alpha coefficient, factor analysis wíth PARSIMAX rotatíon, Pearson s coefficient, Mann-Whitney and Kruskal-Wallis tests, univariate and multivariate logistic regression analysis. There was a líttle predomínance of male wíth medían age of 55.2 years old. The majority of subjects were white, catholics, and had low leveI of education, they had one partner and lived with another person. It was showed that 49.6% of the subjects were unemployed. The content validity of the instruments was assured by the judgment of five experts that considered the items clear and suitable. The Cronbach s alpha coefficient showed values varying from 0,69 to 0,93, confirming an internal consistence of the instruments. The factors analysis showed three factors for SPCC and six factors for CVSCC, and provided support to construct validity of the instruments. There was weak correlation, although with statistical significance, between some factors of the two instruments. The sociodemographic and clinical variables that correlated with factors were: age, number of children, time of induced cardiac arrest, body temperature during cardiopulmonary by pass (CPB) and income. There was a difference between genders related to Factor 1 (Negative feelings related to cardiac surgery); race related to Factor A (positive meanings), among leveI of education related to Factor 5 (Positíve that the surgery is necessary). Years of education were correlated with Factor 3 (Trust on health staff and also in cardiac surgery) and 5 (positive that the surgery is necessary). The variables have shown associated with a postoperative evolution were: age, body mass index (BMI), preoperative leveI of serum creatinine, time of cardiopulmonary bypass, time of aortic cross-clamp, time of reperfusion, time of induced cardiac arrest, and blood pressure during CPB. The variables that influenced separately the postoperative evolution were age, ejection fraction, preoperative heart failure, intraoperative arrhythmia,intraoperative blood transfusion, BMI, and Factor 1 (Negative feelings related to cardiac surgery), 5 (Positive that the surgery is necessary) and 6 (Uncertainty about the results of cardiac surgery). The multivariate logistic regression has shown that aging, time of cardiopulmonary bypass over than 97 minutes and Factor l(Negative feelings related to cardiac surgery) have had an independent influence in postoperative evolution. The re-operation has influenced time of hospitalization. It was concluded that there are sociodemographic variables (age), psychosocial variables (attitudes) and clinical variables (time of cardiopulmonary bypass over than 97 minutes) which influence in-hospital postoperative evolution of patients who underwent cardiac surgery. These data indicated that the postoperative evolution of patients underwent cardiac surgery procedure is multifaceted.

ASSUNTO(S)

atitude (psicologia) significado (psicologia) coração - cirurgia

ACESSO AO ARTIGO

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