Saúde mental de pacientes com doença renal crônica e cuidadores e sua associação com alterações clínicas

Abstract

Introduction: To treat Chronic Kidney Disease (CKD) at the final stage, performance of Renal Replacement Therapies (RRT) is required, these require important changes in living habits and patients frequently need caregivers. These are risk groups for development of physical and psychological symptoms. Objective: evaluate predominance of anxiety, depression, stress, fatigue, social support and quality of life in patients with CKD and their caregivers. Method; cross study of 21 patients and their caregivers, during the period from January to September 2015. Sample according to convenience where patients over 18 years old were included, with at least 6 months of treatment and family member caregivers. Social, demographic, clinical, laboratory and psychological variables were evaluated. Descriptive analysis and association between patients and caregivers were performed. Results: Among patients we observed that 38.1% had symptoms that indicated anxiety and depression. Averages for Practical Social Support were 3.15±0,769 and for Emotional Social Support were 3.16±0,79. As for Fatigue, 14.3% of patients declare themselves extremely tired and 14.3% declared doing all activities they usually performed before. 57.1% presented stress, of these, 66.7% were at the Resistance Stage with predominance of psychological symptoms in 60.0%. The Quality of life domain of Functional Capacity (FC) presented a correlation with Hemoglobin (r=0.581, p=0.006) and non-anemic patients presented better FC. We observed symptoms that indicated anxiety and depression in 33.3% of caregivers. Caregivers obtained average of 2.88 ±0.77 for Practical Social Support and 3.0±0.72 for Emotional Social Support. 14.3% reported being extremely tired and 28.8% declared doing all activities they usually performed before. When comparing both groups we observed they present similar results for presence of anxiety, depression and fatigue. Caregivers receive less social support than patients. Both groups present similar predominance of stress levels, however, patients presented more predominance of psychological symptoms. For Quality of life, patients and caregivers presented similar results for Social Aspects, Vitality, Mental Health and the great Mental Domain. We concluded that Mental Health of patients and caregivers presents similar levels and both, within the context of dialysis renal disease must undergo specific interventions.