A relação entre o nível de multimorbidade e o de qualidade de vida relacionada à saúde: influência da personalidade e do suporte social

• Autor(a) principal: Coscarelli, Pedro Guimarães
• Data de Publicação: 2016
• Outros Autores: [e-mail]
• Tipo de documento: Tese
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações da UERJ
• Texto Completo: http://www.bdtd.uerj.br/handle/1/19277
• topic: Multimorbidity; Quality of life; Personality; Internal medicine; Multimorbidade; Qualidade de vida; Personalidade; Clínica médica; Assistência à saúde; Apoio social; Medicina clínica; CIENCIAS DA SAUDE::MEDICINA::CLINICA MEDICA

Background: Previous research has shown the influence of personality and social support on health-related quality of life (HRQoL) in patients with single diagnosis, limiting generalization of the results to patientes with multimorbidity. We conduct a study of the influence of personality and social support on health-related quality of life in a group of patients with high prevalence of multimorbidity. Experimental Design: This is a cross-sectional study of 178 subjects seen in a ambulatory setting in Hospital Universitário Pedro Ernesto, Rio de Janeiro (RJ), Brazil. These patients are expected to have multiple comorbid diseases, including rare and atypical presentations. The HRQoL was measured with the SF-36; multimorbidity with the Cummulative Illness Rating Scale (CIRS) - a measure of burden of disease; personality with the Cloninger's Temperament and Character Inventory (TCI); and social support with the Sarason's Social Support Questionnaire (SSQ). Psychopathology was evaluated with the Symptoms Checklist-90 (SCL-90) and the Beck Depression Inventory. Regression analysis with generalized linear models was used examine the association of multimorbidity and HRQoL and the influence of personality and social support. Psycopathology was intended to be included as covariates in the models. Results: Multimorbidity is associated with five of eight HRQoL SF-36 subscales: physical functioning (PF), general health (GH), vitality (VI), role social (RS) e mental health (MH). After the inclusion of the personality dimensions in the models, the effect of multimorbidity vanishes in the subscales PF and MH, suggesting a mediation effect, but not in the subscales GH, VI, RS. The personality dimensions harm avoidance and self-directedness have the largest effects on HRQoL. The limitations of the study includes the small number of respondents of the social support questionnaire and the presence of statistical artifacts - probably due to colinearity - that precludes the inclusion of psychopathology in the models. Conclusions: In a group of subjects with an expected high prevalence of multimorbidity, the burden of disease is associated with most dimensions of HRQoL. We also observed some personality dimensions influences this association.