Perfil epidemiológico e atenção à saúde do paciente com amputação por pé diabético

Abstract

Introduction: Diabetes Mellitus (DM) is a disease in expansion worldwide and it presents as one of its main complications the diabetic foot, with consequences that can be dramatic for the life of the individual, since chronic wounds and infections to amputations of lower limbs. Amputation may be associated with increased survival; however, it may result in partial or total dependence on other people, as well as causing major impacts at social, economic and psychological levels. Objective: To evaluate the health care of patients with diabetic foot amputation at a hospital in the city of Campina Grande, Paraíba. Methodology: Exploratory, descriptive study, with quantitative-qualitative approach. In the quantitative approach, the sample was filled from 208 records. It was used a relative and absolute frequency descriptive statistics, Pearson's Chi-square association test or Fisher's exact test. In the variables that presented association with statistical significance < 0,15, Poisson regressions were adopted, with a robust estimator. Exp (B) was considered as a measure of prevalence ratio and p <0.05 was accepted as statistical significance. In the qualitative approach, the sample corresponded to 8 nurses. The analysis was performed using the technique of content analysis proposed by Bardin. Results: In the study, there was a greater percentage of male patients, over 61 years old and without occupation, who did not use insulin, with a glycemic state at admission of <200mg/dL, and who presented with Systemic Arterial Hypertension (SAH) as the most prevalent comorbidity. Regarding amputation, there were more cases of a first amput ation, with a higher level and the most predominant site, was the transfemoral one. There was statistical significance in the regression in some associations. From the analysis of the speech emerged 5 thematic categories, in which the nurses characterized the diabetic foot as a complication of DM, which makes the patient more susceptible to hospitalization, highlighting the lack of care as the main cause of diabetic foot impairment. Due to the lack of an assistance protocol, the professionals act in an individualized manner, and stress as difficulties faced, little humanization in care and lack of human resources. Conclusions: The health care of men should be more evident, as well as those who are more advanced, since they were the most affected and because they already represent risk factors for this condition, shows that health care needs to be more efficient. With the prevalence of a first amputation, it is concluded that the control of the disease is not happening, that several are the gaps that exist in the search for a better quality of life of these people. With the research was perceived the lack of knowledge on the subject by the nurses, as well as the interest in providing a differentiated care, which in some way influences the process of rehabilitation of the patient. Since hospitalization should be considered an opportunity to evaluate self-care skills and strengthen health education.