Fatores influentes no abandono do acompanhamento clínico ambulatorial por pessoas vivendo com HIV/Aids
Autor(a) principal: | |
---|---|
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 |
Resumo: | 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. |
id |
UFPB_cdf8d0a90d2810d98a0de05fc51c2d1c |
---|---|
oai_identifier_str |
oai:repositorio.ufpb.br:tede/9050 |
network_acronym_str |
UFPB |
network_name_str |
Biblioteca Digital de Teses e Dissertações da UFPB |
repository_id_str |
|
spelling |
Fatores influentes no abandono do acompanhamento clínico ambulatorial por pessoas vivendo com HIV/AidsVírus da Imunodeficiência Humana - HIVSíndrome da Imunodeficiência AdquiridaPacientes desistentes do tratamentoAnálise de regressãoAnálise de sobrevidaAcquired immunodeficiency syndromePatient dropoutsRegression analysisSurvival analysisCIENCIAS DA SAUDE::SAUDE COLETIVAThe 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.Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPESO cuidado direcionado às pessoas vivendo com HIV/Aids requer um manejo clínico adequado e contínuo para garantir uma assistência resolutiva atendendo às principais necessidades demandadas por essa clientela. Desta forma, garantir a continuidade do acompanhamento clínico ambulatorial é crucial para a efetividade da terapia antirretroviral (TARV) e, consequentemente, para a melhoria do estado clínico desses indivíduos. O estudo teve, como objetivo, construir modelos preditivos, a partir das características sociodemográficas, clínicas e hábitos de vida das pessoas vivendo com HIV/Aids, para identificar a susceptibilidade ao abandono do acompanhamento clínico ambulatorial. Trata-se de um estudo epidemiológico, observacional, analítico do tipo coorte histórica (retrospectivo), de abordagem quantitativa. O estudo foi realizado a partir de dados de fontes secundárias de uma amostra de 260 pessoas vivendo com aids diagnosticadas entre os anos de 2007 e 2013, atendidos em um serviço ambulatorial especializado de referência no estado da Paraíba. Nas análises estatísticas, inicialmente, foi realizada uma análise univariada para verificar a associação entre a ocorrência do acompanhamento clínico ambulatorial e as variáveis independentes e, posteriormente foram obtidos dois modelos que melhor explicaram a ocorrência desse desfecho entre os participantes. O modelo final de regressão logística apresentou as variáveis: idade na 1ª consulta (anos) (OR= 0,963); tomar menos de 4 comprimidos/dia (OR= 0,520) e uso regular da TARV (OR= 0,278) como fator de proteção para o desfecho investigado, ao passo que ter registro de antecedentes psiquiátricos (OR= 2,981) apresenta-se como fator de risco para a ocorrência do abandono. O segundo modelo, utilizou a análise de sobrevivência, aplicando o estimador de Kaplan-Maier e também o teste de log-rank para averiguar se havia diferença para a ocorrência do abandono entre os grupos das variáveis independentes. Em seguida, obteve-se o Modelo de regressão de Cox, que apresentou ao final as variáveis: idade na 1ª consulta (anos) (HR= 0,945); ter mais de 3 drogas no esquema de TARV (HR= 0,559); tempo de uso da TARV (meses) (HR= 0,971) e uso regular da TARV (HR= 0,393) com influência para diminuir o risco de ocorrência do abandono, e a variável, registro de antecedentes psiquiátricos (HR= 2,583), como a única que acentua o risco de abandono do acompanhamento clínico ambulatorial no serviço especializado. A predição de fatores influentes no abandono do acompanhamento clínico representa para os profissionais do ambulatório especializado a possibilidade de atuar com mais autonomia e eficácia sobre a prevenção desde desfecho, contribuindo, assim, com a provisão de cuidado contínuo fundamental a qualidade de vida de pessoas vivendo com HIV/Aids.Universidade Federal da ParaíbaBrasilCiências Exatas e da SaúdePrograma de Pós-Graduação em Modelos de Decisão e SaúdeUFPBNascimento, Joao Agnaldo dohttp://lattes.cnpq.br/6866270928240455Ribeiro, Kátia Suely Queiroz Silvahttp://lattes.cnpq.br/7564660473747042Medeiros, Leidyanny Barbosa de2017-07-05T14:56:49Z2018-07-21T00:22:07Z2018-07-21T00:22:07Z2016-02-16info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisapplication/pdfMEDEIROS, Leidyanny Barbosa de. Fatores influentes no abandono do acompanhamento clínico ambulatorial por pessoas vivendo com HIV/Aids. 2016. 125 f. Dissertação (Mestrado em Modelos de Decisão e Saúde) - Universidade Federal da Paraíba, João Pessoa, 2016.https://repositorio.ufpb.br/jspui/handle/tede/9050porinfo:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da UFPBinstname:Universidade Federal da Paraíba (UFPB)instacron:UFPB2018-09-06T01:08:04Zoai:repositorio.ufpb.br:tede/9050Biblioteca Digital de Teses e Dissertaçõeshttps://repositorio.ufpb.br/PUBhttp://tede.biblioteca.ufpb.br:8080/oai/requestdiretoria@ufpb.br|| diretoria@ufpb.bropendoar:2018-09-06T01:08:04Biblioteca Digital de Teses e Dissertações da UFPB - Universidade Federal da Paraíba (UFPB)false |
dc.title.none.fl_str_mv |
Fatores influentes no abandono do acompanhamento clínico ambulatorial por pessoas vivendo com HIV/Aids |
title |
Fatores influentes no abandono do acompanhamento clínico ambulatorial por pessoas vivendo com HIV/Aids |
spellingShingle |
Fatores influentes no abandono do acompanhamento clínico ambulatorial por pessoas vivendo com HIV/Aids Medeiros, Leidyanny Barbosa de 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 |
title_short |
Fatores influentes no abandono do acompanhamento clínico ambulatorial por pessoas vivendo com HIV/Aids |
title_full |
Fatores influentes no abandono do acompanhamento clínico ambulatorial por pessoas vivendo com HIV/Aids |
title_fullStr |
Fatores influentes no abandono do acompanhamento clínico ambulatorial por pessoas vivendo com HIV/Aids |
title_full_unstemmed |
Fatores influentes no abandono do acompanhamento clínico ambulatorial por pessoas vivendo com HIV/Aids |
title_sort |
Fatores influentes no abandono do acompanhamento clínico ambulatorial por pessoas vivendo com HIV/Aids |
author |
Medeiros, Leidyanny Barbosa de |
author_facet |
Medeiros, Leidyanny Barbosa de |
author_role |
author |
dc.contributor.none.fl_str_mv |
Nascimento, Joao Agnaldo do http://lattes.cnpq.br/6866270928240455 Ribeiro, Kátia Suely Queiroz Silva http://lattes.cnpq.br/7564660473747042 |
dc.contributor.author.fl_str_mv |
Medeiros, Leidyanny Barbosa de |
dc.subject.por.fl_str_mv |
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 |
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 |
description |
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. |
publishDate |
2016 |
dc.date.none.fl_str_mv |
2016-02-16 2017-07-05T14:56:49Z 2018-07-21T00:22:07Z 2018-07-21T00:22:07Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/masterThesis |
format |
masterThesis |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
MEDEIROS, Leidyanny Barbosa de. Fatores influentes no abandono do acompanhamento clínico ambulatorial por pessoas vivendo com HIV/Aids. 2016. 125 f. Dissertação (Mestrado em Modelos de Decisão e Saúde) - Universidade Federal da Paraíba, João Pessoa, 2016. https://repositorio.ufpb.br/jspui/handle/tede/9050 |
identifier_str_mv |
MEDEIROS, Leidyanny Barbosa de. Fatores influentes no abandono do acompanhamento clínico ambulatorial por pessoas vivendo com HIV/Aids. 2016. 125 f. Dissertação (Mestrado em Modelos de Decisão e Saúde) - Universidade Federal da Paraíba, João Pessoa, 2016. |
url |
https://repositorio.ufpb.br/jspui/handle/tede/9050 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Universidade Federal da Paraíba Brasil Ciências Exatas e da Saúde Programa de Pós-Graduação em Modelos de Decisão e Saúde UFPB |
publisher.none.fl_str_mv |
Universidade Federal da Paraíba Brasil Ciências Exatas e da Saúde Programa de Pós-Graduação em Modelos de Decisão e Saúde UFPB |
dc.source.none.fl_str_mv |
reponame:Biblioteca Digital de Teses e Dissertações da UFPB instname:Universidade Federal da Paraíba (UFPB) instacron:UFPB |
instname_str |
Universidade Federal da Paraíba (UFPB) |
instacron_str |
UFPB |
institution |
UFPB |
reponame_str |
Biblioteca Digital de Teses e Dissertações da UFPB |
collection |
Biblioteca Digital de Teses e Dissertações da UFPB |
repository.name.fl_str_mv |
Biblioteca Digital de Teses e Dissertações da UFPB - Universidade Federal da Paraíba (UFPB) |
repository.mail.fl_str_mv |
diretoria@ufpb.br|| diretoria@ufpb.br |
_version_ |
1801842912919552000 |