Fatores influentes no abandono do acompanhamento clínico ambulatorial por pessoas vivendo com HIV/Aids

• Autor(a) principal: Medeiros, Leidyanny Barbosa de
• Data de Publicação: 2016
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações da UFPB
• Texto Completo: https://repositorio.ufpb.br/jspui/handle/tede/9050
• topic: Vírus da Imunodeficiência Humana - HIV; Síndrome da Imunodeficiência Adquirida; Pacientes desistentes do tratamento; Análise de regressão; Análise de sobrevida; Acquired immunodeficiency syndrome; Patient dropouts; Regression analysis; Survival analysis; CIENCIAS DA SAUDE::SAUDE COLETIVA

The care to people living with HIV/Aids requires adequate and ongoing clinical management to ensure a resolutive assistance, meeting the main needs of these clients. Thus, ensuring continuity of outpatient clinical follow-up is crucial for the effectiveness of antiretroviral therapy (ART) and consequently, to improve the clinical statusof these patients. The present study aimed to build predictive models from the sociodemographic and clinical characteristics and life habits of people living with HIV/Aids, in order to identify the susceptibility to abandon the outpatient clinical follow-up. It is an epidemiological, observational, analytical study of historical cohort type (retrospective) andquantitative approach. It was conducted from secondary source data of a sample of 260 people living with aids diagnosed between the years 2007 and 2013 and seen at a specialized outpatient service that is reference in the state of Paraíba. In the statistical analyzes, a univariate analysis was initially performed to determine the association between the occurrence of outpatient clinical follow-up and the independent variables. Later, were obtained two models that best explained the occurrence of this outcome among participants. The final logistic regression model presented the following variablesas protective factors for the investigated outcome: age at 1st consultation (years) (OR = 0.963); daily intake of less than 4 tablets (OR = 0.520) and regular use of ART (OR = 0.278). On the other hand, records of psychiatric history (OR = 2,981) appeared as a risk factor for the occurrence of abandonment. The survival analysis was used in the second model, applying the Kaplan-Maier estimator and the log rank testto determine if there were differences in the occurrence of abandonment among the groups of independent variables. Subsequently, was obtained the Cox regression model that showed the following variables at the end: age at 1st consultation (years) (HR = 0.945); more than three drugs in the ART regimen (HR = 0.559); time using the ART (months) (HR = 0.971) and regular use of ART (HR = 0.393), which influenced in the reduction of risk of abandonment. The record of psychiatric history (HR = 2.583) was the only variable that increased the risk of abandonment of outpatient clinical follow-up in specialized services. For professionals in the specialized clinic, the prediction of influential factors in the abandonment of clinical follow-up represents the possibility to act with more autonomy and effectiveness since prevention until the outcome, thus contributing to the provision of basic continuous care and the quality of life of people living with HIV/Aids.