Sunteți pe pagina 1din 5

2ULJLQDO $UWLFOHV

Evaluation of expected outcomes of nursing interventions to


address the nursing diagnosis of fatigue among patients with
congestive heart failure*

$YDOLDomR GDV LQWHUYHQo}HV H GRV UHVXOWDGRV HVSHUDGRV SDUD R GLDJQyVWLFR GH HQIHUPDJHP )DGLJD HP
SRUWDGRUHV GH ,QVXILFLrQFLD &DUGtDFD

(YDOXDFLyQ GH ODV LQWHUYHQFLRQHV \ GH ORV UHVXOWDGRV HVSHUDGRV SDUD HO GLDJQyVWLFR GH HQIHUPHUtD
)DWLJD HQ SDFLHQWHV FRQ ,QVXILFLHQFLD &DUGLDFD &RQJHVWLYD 

&LQWKLD&DOVLQVNLGH$VVLV$OED/~FLD%RWWXUD/HLWHGH%DUURV0DUFHOD
=DQDWWD *DQ]DUROOL

ABSTRACT
2EMHFWLYH7RHYDOXDWHH[SHFWHGRXWFRPHVRI QXUVLQJLQWHUYHQWLRQVWRDGGUHVVWKHQXUVLQJGLDJQRVLVRI IDWLJXH0HWKRGV$FURVVVHFWLRQDO
TXDVLH[SHULPHQWDOGHVLJQZDVXVHG7KHVDPSOHFRQVLVWHGRIFRURQDU\FDUHXQLWLQSDWLHQWZLWKFRQJHVWLYHKHDUWIDLOXUHDQGIDWLJXH$
VSHFLILFWRROGHVLJQHGIRUWKLVVWXG\ZDVXVHGWRFROOHFWVSHFLILFGDWDRQRXWFRPHVRIQXUVLQJLQWHUYHQWLRQVWRPDQDJHWKHQXUVLQJGLDJQRVLV
RIIDWLJXH5HVXOWV1XUVLQJLQWHUYHQWLRQVWRPDQDJHSDWLHQWVIDWLJXHKDGSRVLWLYHRXWFRPHV&RQFOXVLRQ7KHXVHRIWKHQXUVLQJSURFHVV
WRLGHQWLI\WKHQXUVLQJGLDJQRVLVRIIDWLJXHGHVLJQDQGLPSOHPHQWVSHFLILFQXUVLQJLQWHUYHQWLRQVDQGHYDOXDWHSDWLHQWRXWFRPHVOHDGVWR
TXDOLW\QXUVLQJFDUH
.H\ZRUGV+HDUWIDLOXUHFRQJHVWLYH1XUVLQJGLDJQRVLV)DWLJXH3DWLHQWFDUHSODQQLQJ1XUVLQJSURFHVV

RESUMO
2EMHWLYR$YDOLDURVUHVXOWDGRVDOFDQoDGRVDSyVLQWHUYHQo}HVGHHQIHUPDJHPSDUDRGLDJQyVWLFRGHHQIHUPDJHP)DGLJD0pWRGRV(VWXGR
TXDVHH[SHULPHQWDOWHPSRVpULHHWUDQVYHUVDOUHDOL]DGRHP+RVSLWDO8QLYHUVLWiULRSRUPHLRGDLPSOHPHQWDomRGHLQWHUYHQo}HVHDYDOLDomR
GLiULDGRVUHVXOWDGRVHPSDFLHQWHVFRPGLDJQyVWLFRGHLQVXILFLrQFLDFDUGtDFDHGHHQIHUPDJHPIDGLJDLQWHUQDGRVQD8QLGDGHGH&DUGLRORJLD
H87,&RURQiULD)RLHODERUDGRXPLQVWUXPHQWRGHFROHWDGHGDGRVFRPSRVWRSRULQWHUYHQo}HVHUHVXOWDGRVGHHQIHUPDJHP5HVXOWDGRV)RL
REVHUYDGD ERD HYROXomR GH WRGRV RV LQGLFDGRUHV DYDOLDGRV $V LQWHUYHQo}HV GH HQIHUPDJHP DWLQJLUDP VDWLVIDWRULDPHQWH RV UHVXOWDGRV
HVSHUDGRV&RQFOXVmR$RVLVWHPDWL]DUDDVVLVWrQFLDGHHQIHUPDJHPDOFDQoDPRVUHVXOWDGRVIDYRUiYHLVHPVXDVHYLGrQFLDVFOtQLFDV
'HVFULWRUHV,QVXILFLrQFLDFDUGtDFDFRQJHVWLYD'LDJQyVWLFRGHHQIHUPDJHP)DGLJD3ODQHMDPHQWRGHDVVLVWrQFLDDRSDFLHQWH3URFHVVRVGH
HQIHUPDJHP

RESUMEN
2EMHWLYR(YDOXDUORVUHVXOWDGRVDOFDQ]DGRVGHVSXpVGHODVLQWHUYHQFLRQHVGHHQIHUPHUtDSDUDHOGLDJQyVWLFRGHHQIHUPHUtD)DWLJD0pWRGRV
6HWUDWDGHXQHVWXGLRFXDVLH[SHULPHQWDOWLHPSRVHULH\WUDQVYHUVDOUHDOL]DGRHQXQ+RVSLWDO8QLYHUVLWDULRSRUPHGLRGHODLPSOHPHQWDFLyQ
GHLQWHUYHQFLRQHV\HYDOXDFLyQGLDULDGHORVUHVXOWDGRVHQ SDFLHQWHVFRQGLDJQyVWLFRGHLQVXILFLHQFLDFDUGLDFD\GHHQIHUPHUtDIDWLJD
LQWHUQDGRVHQOD8QLGDGGH&DUGLRORJtD\8&,&RURQDULD)XHHODERUDGRXQLQVWUXPHQWRGHUHFROHFFLyQGHGDWRVFRPSXHVWRSRULQWHUYHQFLRQHV
\UHVXOWDGRVGHHQIHUPHUtD5HVXOWDGRV)XHREVHUYDGDEXHQDHYROXFLyQGHWRGRVORVLQGLFDGRUHVHYDOXDGRV/DVLQWHUYHQFLRQHVGHHQIHUPHUtD
DOFDQ]DURQGHPDQHUDVDWLVIDFWRULDORVUHVXOWDGRVHVSHUDGRV&RQFOXVLyQ$OVLVWHPDWL]DUODDVLVWHQFLDGHHQIHUPHUtDDOFDQ]DPRVUHVXOWDGRV
IDYRUDEOHVHQVXVHYLGHQFLDVFOtQLFDV
'HVFULSWRUHV ,QVXILFLHQFLD FDUGLDFD FRQJHVWLYD 'LDJQyVWLFR GH HQIHUPHUtD )DWLJD 3ODQLILFDFLyQ GH DWHQFLyQ DO SDFLHQWH 3URFHVRV GH
HQIHUPHUtD


6WXG\FDUULHGRXWDW&DUGLRORJ\,QLWDQG,QWHQVLYH&DUH8QLWRI +RVSLWDO6mR3DXOR

3RVWJUDGXDQGDWWKH)HGHUDO8QLYHUVLW\RI 6DR3DXOR81,)(636DR3DXOR 63 %UD]LO

)XOO3URIHVVRUDWWKH1XUVLQJ'HSDUWPHQW)HGHUDO8QLYHUVLW\RI 6DR3DXOR81,)(636DR3DXOR 63 %UD]LO

3RVWJUDGXDQGDWWKH)HGHUDO8QLYHUVLW\RI 6DR3DXOR81,)(636DR3DXOR 63 %UD]LO

$XWRU &RUUHVSRQGHQWH &LQWKLD &DOVLQVNL GH $VVLV $UWLJR UHFHELGR HP  H DSURYDGR HP 
$O,UDp$SWR0RHPD6mR3DXOR63
&HS  (PDLO FLBFDOVLQVNL#WHUUDFRPEU
$FWD3DXO(QIHUP  
358 $VVLV&&%DUURV$/%/*DQ]DUROOL0=

,1752'8&7,21 FRQWULEXWLQJ WR NQRZOHGJH GHYHORSPHQW DQG


VROLGLILFDWLRQLQQXUVLQJVFLHQFH
&RQJHVWLYHKHDUWIDLOXUHLVGHILQHGDVDFOLQLFDOV\QGURPH 'XHWRWKHLPSRUWDQFHRIFRQJHVWLYHKHDUWIDLOXUHLWLV
LQ ZKLFK D VWUXFWXUDO RU IXQFWLRQDO GLVRUGHU RI WKH KHDUW EHOLHYHGWKDWWKHFDUHQXUVHVGHOLYHUWRWKHVHSDWLHQWVPXVW
UHVXOWVLQWKHGHFUHDVHRI WKHYHQWULFOHVFDSDFLW\WRHMHFW EHSODQQHGV\VWHPL]HGDQGEDVHGRQVFLHQWLILFNQRZOHGJH
EORRG DQGRU EH ILOOHG ZLWK EORRG LQ WKH SK\VLRORJLFDO 7KLVNLQGRIDFWLRQDLPVWRGHOLYHUSURSHUQXUVLQJFDUHWR
ILOOLQJ SUHVVXUHV   7KLV GLVRUGHU FDQ KDSSHQ GXH WR D WKHSDWLHQWFRQVWUXFWHGWKURXJKWKHGHWHFWLRQRISUREOHPV
GLPLQLVKHG FDSDFLW\ RI P\RFDUGLDO FRQWUDFWLRQ RU WR DQ DQGVXUYH\RI QXUVLQJGLDJQRVHV7KHSURSHULGHQWLILFDWLRQ
H[FHVVRISUHVVXUHYROXPHLPSRVHGRQWKHKHDUW   RI  WKH SUHVHQWHG SUREOHPV SHUPLWV DSSURSULDWH FDUH
,Q%UD]LOWKHUHDUHQRHSLGHPLRORJLFDOVWXGLHVUHODWHG SODQQLQJDLPLQJWRDFKLHYHWKHH[SHFWHGQXUVLQJUHVXOWV 
WRFRQJHVWLYHKHDUWIDLOXUHEXWDFFRUGLQJWRRWKHUFRXQWULHV E\LPSOHPHQWLQJWKHQXUVLQJLQWHUYHQWLRQVVHOHFWHGRQWKH
LWFDQEHHVWLPDWHGWKDWXSWRPLOOLRQ%UD]LOLDQSHRSOH EDVLVRIWKHLGHQWLILHGGLDJQRVLV  
KDYHWKLVFRQGLWLRQ$VVKRZQE\GDWDFROOHFWHGIURPWKH 7KLVDUWLFOHDLPVWRDVVHVVWKHUHVXOWVDFFRUGLQJWRWKH
686 %UD]LOLDQ 6LQJOH +HDOWK 6\VWHP  IURP WKH +HDOWK 12& FODVVLILFDWLRQ DIWHU SHUIRUPLQJ LQWHUYHQWLRQV
0LQLVWU\ LQ  DURXQG  WKRXVDQG KRVSLWDOL]DWLRQV VXJJHVWHGE\WKH1,&IRUWKHQXUVLQJGLDJQRVLV)DWLJXH
RFFXUUHGGXHWRFRQJHVWLYHKHDUWIDLOXUHZLWKGHDWKV LQSDWLHQWVZLWKFRQJHVWLYHKHDUWIDLOXUH
$URXQGDWKLUGRIWKHSHRSOHKRVSLWDOL]HGLQWKH686ZLWK
D KHDUW FRQGLWLRQ KDV FRQJHVWLYH KHDUW IDLOXUH %HVLGHV 0(7+2'6
DPRQJSDWLHQWVRYHUFRQJHVWLYHKHDUWIDLOXUHLVWKHPDLQ
KRVSLWDOL]DWLRQFDXVH7KHUHIRUHFRQJHVWLYHKHDUWIDLOXUHLV 4XDVLH[SHULPHQWDODQGFURVVVHFWLRQDOWLPHVHULHVVWXG\
WXUQLQJ LQWR D VHYHUH SXEOLF KHDOWK SUREOHP DOO RYHU WKH FRQGXFWHGDWD8QLYHUVLW\+RVSLWDOZLWKWKHLPSOHPHQWDWLRQ
ZRUOG%HVLGHVKLJKKRVSLWDOFRVWVIRUHPHUJHQF\VHUYLFHV RI LQWHUYHQWLRQVDQGGDLO\DVVHVVPHQWRI UHVXOWV
FRQJHVWLYHKHDUWIDLOXUHFDXVHVDYLVLEOHORVVLQTXDOLW\RI 7KH FRQYHQLHQFH VDPSOH GHWHUPLQHG D VWXG\
OLIH RIWHQ UHVXOWLQJ LQ HDUO\ UHWLUHPHQW DQG D KLJK SRSXODWLRQWKDWFRPSULVHGDOOSDWLHQWVFOLQLFDOO\WUHDWHG
VRFLRHFRQRPLFFRVWIRUWKHFRXQWU\   EHWZHHQ$SULODQG-XO\ Q  ZLWKFRQJHVWLYHKHDUW
0RGHUQQXUVLQJLVDWWHPSWLQJWRFUHDWHLWVRZQERG\ IDLOXUHKRVSLWDOL]HGDWWKH&DUGLRORJ\8QLWDQG,QWHQVLYH
RINQRZOHGJHJUDQWLQJWKHSURIHVVLRQDVFLHQWLILFDFWLRQ &DUH8QLWRIWKHUHVHDUFKLQVWLWXWLRQ
SDWWHUQ 7KLV DWWHPSW KDV UHVXOWHG LQ WKH 1XUVLQJ :RUN ,QFRPSOLDQFHZLWKFXUUHQWUXOHVWKHVWXG\SURSRVDO
3URFHVVZKLFKLVXVHGDVDV\VWHPDWLFFDUHGHOLYHU\PHWKRG ZDVDSSURYHGE\WKH5HVHDUFK(WKLFV&RPPLWWHHDWWKH
DLPHGDWFUHDWLQJFRQGLWLRQVWRKHOSLQDQLQGLYLGXDOL]HG LQVWLWXWLRQEHIRUHWKHEHJLQQLQJRIGDWDFROOHFWLRQ7KH
ZD\ VXSSRUWLQJ JUHDWHU LQWHJUDWLRQ EHWZHHQ QXUVHV DQG DSSURYDOIRUSDUWLFLSDWLRQE\WKHUHVHDUFKVXEMHFWVZDV
SDWLHQWVIDPLOLHVWKHFRPPXQLW\DQGWKHPXOWLSURIHVVLRQDO IRUPDOL]HG E\ VLJQLQJ WKH IUHH DQG LQIRUPHG FRQVHQW
WHDPIDYRULQJWKHLPSURYHPHQWLQFDUHTXDOLW\   WHUPLQOLQHZLWKOHJDORULHQWDWLRQV
7KHQXUVLQJZRUNSURFHVVKDVEHHQGHILQHGLQ%UD]LO 7KHIROORZLQJSDWLHQWVZHUHH[FOXGHGDJHXQGHU
DVWKHG\QDPLFVRIV\VWHPL]HGDQGLQWHUUHODWHGDFWLRQV VDLG WKDW WKH\ GLG QRW ZDQW WR SDUWLFLSDWH LQ WKH VWXG\
DLPLQJDWFDUHGHOLYHU\WRKXPDQEHLQJV,QWKLVSURSRVDO GLVDJUHHGZLWKWKHIUHHDQGLQIRUPHGFRQVHQWWHUPZHUH
WKHSURFHVVZDVGLYLGHGLQKLVWRU\GLDJQRVLVFDUHSODQ QRW FRQVLVWHQW RU VHGDWHG ZHUH WUDQVIHUUHG IURP D
SUHVFULSWLRQ HYROXWLRQ DQG SURJQRVLV RI QXUVLQJ ZRUN KRVSLWDOL]DWLRQXQLW

6LQFHWKDWPRPHQWVHYHUDO%UD]LOLDQDXWKRUVKDYHEHHQ 7ZR SDWLHQWV IURP WKH VDPSOH GLHG WKUHH GLG QRW
FDOOLQJ DWWHQWLRQ WR WKH DSSOLFDWLRQ RI WKLV SURFHVV DV D ZDQWWRSDUWLFLSDWHLQWKHVWXG\DQGRQHZDVWUDQVIHUUHG
PHWKRGWRV\VWHPL]HQXUVLQJFDUHLQKRVSLWDOVDVZHOODV WRDQRWKHUXQLW  
LQRXWSDWLHQWFDUH   )RUGDWDFROOHFWLRQDPRQJSDWLHQWVZLWKFRQJHVWLYHKHDUW
1XUVLQJFDUHSODQQLQJLVEDVHGRQQXUVLQJGLDJQRVHV IDLOXUHRI IXQFWLRQDOW\SH,,,,,,DQG,9ZHXVHGWKHGDWD
LGHQWLILHG WKURXJK D KLJK OHYHO RI LQWHOOHFWXDO VNLOOV DQG FROOHFWLRQLQVWUXPHQWXVHGDWWKH&DUGLRORJ\8QLWDOUHDG\
NQRZOHGJH 7KH\ FRQVWLWXWH WKH EDVLV IRU SODQQLQJ YDOLGDWHGLQSUHYLRXVVWXGLHV  7KLVLQVWUXPHQWXVHVWKH
LQWHUYHQWLRQDQGSDWLHQWDVVHVVPHQW   IROORZLQJ PRGHOV DV UHIHUHQFHV +RUWD 2UHP
$V KHDUW GLVHDVHV DUH UHVSRQVLEOH IRU WKH KLJKHVW (SLGHPLRORJLFDO5LVNDQG%LRPHGLFDO  VXSSRUWHGE\WKH
QXPEHURIGHDWKVLQ%UD]LOWKHDPRXQWRISDWLHQWVZLWK LGHQWLILFDWLRQ RI WKH 1XUVLQJ 'LDJQRVLV   SUHVHQWHG E\
WKHQXUVLQJGLDJQRVLVRI)DWLJXHLVHTXDOO\VLJQLILFDQW WKHSDWLHQWVZKRVXIIHUHGIURPWKHSDWKRORJ\XQGHUDQDO\VLV
+HQFHHYDOXDWLQJWKHLQWHUYHQWLRQVSURSRVHGLQWKH1,& 7KHDXWKRULGHQWLILHGWKHGLDJQRVLVWKURXJKDQDPQHVLV
1XUVLQJ,QWHUYHQWLRQ&ODVVLILFDWLRQ FODVVLILFDWLRQ  DQG DQG D SK\VLFDO H[DP $PRQJ WKH LGHQWLILHG GLDJQRVHV
WKH UHVXOWV JURXSHG LQ WKH 12& 1XUVLQJ 2XWFRPHV )DWLJXH ZDV IRXQG LQ PRUH WKDQ  RI WKH SDWLHQWV
&ODVVLILFDWLRQ  ZLOOIDYRUFDUHTXDOLW\DVVHVVPHQWWKURXJK ZKLFK JDYH ULVH WR WKH LQWHUHVW WR HYDOXDWH WKH QXUVLQJ
REVHUYHG DQG V\VWHPDWLFDOO\ PHDVXUHG UHVXOWV WKXV LQWHUYHQWLRQVDQGUHVXOWVIRUWKLVGLDJQRVLV

Acta Paul Enferm 2007;20(3):257-61.


(YDOXDWLRQ RI H[SHFWHG RXWFRPHV RI QXUVLQJ LQWHUYHQWLRQV WR DGGUHVV WKH QXUVLQJ GLDJQRVLV RI IDWLJXH DPRQJ SDWLHQWV ZLWK FRQJHVWLYH KHDUW IDLOXUH 359

 %DVHG RQ OLWHUDWXUH   ZH FKRVH WKH UHVXOWV DQG 3UHVHQFHRIRUFRPPLWPHQW
QXUVLQJ LQWHUYHQWLRQV WKDW ZHUH PRVW SURSHU IRU WKH  /DFN RI RU QRQFRPPLWPHQW
SDUWLFLSDQWVSURILOH$IWHUWKLVVHOHFWLRQZHGHVLJQHGD )RU WKH UHVXOW DQDO\VLV ZH FRPSDUHG WKH PD[LPXP
FOLQLFDOHYDOXDWLRQLQVWUXPHQW VFRUH  IRUHDFKLWHPRQWKHILUVWDQGLQWKHVHYHQWKGD\
)RUWKHQXUVLQJGLDJQRVLVXQGHUDQDO\VLVZHVHOHFWHG RI  KRVSLWDOL]DWLRQ :H XVHG WKHVH VHYHQ GD\V RI
WKHQXUVLQJLQWHUYHQWLRQV  (QHUJ\&RQWURODQG([HUFLVH KRVSLWDOL]DWLRQ WR FRPSDUH WKH VFRUHV DV WKLV ZDV WKH
3URPRWLRQ 7KLV VHOHFWLRQ REH\HG WR WKH FULWHULRQ RI DULWKPHWLF DYHUDJH RI SDWLHQWV KRVSLWDOL]DWLRQ WLPH
JUHDWHULPSRUWDQFHIRUWKHGLDJQRVLV PHDVXUHGLQGD\V
7KHH[SHFWHGRXWFRPH  FKRVHQIRUWKHVHLQWHUYHQWLRQV $OOSDWLHQWVUHFHLYHGWKHQXUVLQJDFWLYLWLHVDVWKHVH
ZDV $FWLYLW\ WROHUDQFH 7KLV UHVXOW FRPSULVHG RI WKH KDGEHHQSUHVFULEHGDQGZHUHFKHFNHGLQWKHFRQWURO
IROORZLQJLQGLFDWRUVR[\JHQVDWXUDWLRQLQUHVSRQVHWRWKH VKHHWRI WKHFRURQDU\,&8DQGRI WKH&DUGLRORJ\:DUG
DFWLYLW\ LQVLGH H[SHFWHG SDUDPHWHUV ,(3  KHDUW EHDW LQ
UHVSRQVHWRWKHDFWLYLW\,(3EORRGSUHVVXUHLQUHVSRQVHWR 5(68/76
WKHDFWLYLW\,(3VNLQFRORUZLWKLQQRUPDOSDWWHUQV :13 
GDLO\OLIHDFWLYLWLHVSHUIRUPHG,(3DELOLW\WRVSHDNGXULQJ 7ZRVXEMHFWV  ZHUHEHWZHHQDQG\HDUV
WKHH[HUFLVHDELOLW\WRDFNQRZOHGJHHQHUJ\OLPLWDWLRQVXVH ROGWKUHH  EHWZHHQDQG\HDUVROG 
HQHUJ\SUHVHUYDWLRQWHFKQLTXHVDGDSWOLIHVW\OHEDVHGRQ EHWZHHQ  DQG  \HDUV ROG DQG VHYHQ   ROGHU
WKH HQHUJ\ OHYHO PDLQWDLQ DSSURSULDWH QXWULWLRQ VKRZ WKDQ\HDUV0RVWSDWLHQWVZHUHPHQ Q  
FRQFHQWUDWLRQ,(3GLVSOD\QRUPDODSSHWLWHGHPRQVWUDWH )RUWKHQDPLQJRI WKHGLDJQRVLV)DWLJXHQLQHGHILQLQJ
LQWHUHVWLQGLVSOD\LQJWKHFRUUHFWHQHUJ\OHYHO FKDUDFWHULVWLFV '& ZHUHLGHQWLILHGLQWKHSRSXODWLRQXQGHU
7KHFOLQLFDOHYDOXDWLRQLQVWUXPHQWFRQVLVWHGRIWKHGLDJQRVLV DQDO\VLV$OOVXEMHFWVSUHVHQWHGWKH'&QHHGIRUDGGLWLRQDO
GHILQLWLRQXQGHUGLVFXVVLRQLWVGHILQLQJFKDUDFWHULVWLFVDQGUHODWHG HQHUJ\SUHVHQWHGLQDELOLW\WRPDLQWDLQURXWLQHVDQG
IDFWRUVWKHQXUVLQJDFWLYLWLHVVXJJHVWHGE\WKHLQWHUYHQWLRQVDQG VDLGWKH\ODFNHGHQHUJ\7DEOHGLVSOD\VWKHRFFXUUHQFH
WKHLQGLFDWRUVWREHHYDOXDWHGDVOLVWHGLQWKHUHVXOW DQGGLVWULEXWLRQRI WKH'&VLQWKHVWXG\VXEMHFWV
7KHDFWLYLWLHVZHUHSUHVFULEHGDQGSHUIRUPHGE\WKH
UHVHDUFKHUGXULQJWKHQLJKWVKLIWDQGE\WKHXQLWQXUVHV 7DEOH   'HILQLQJ FKDUDFWHULVWLFV RI  WKH QXUVLQJ
DQGRUQXUVLQJDLGVLQWKHPRUQLQJRUDIWHUQRRQSHULRGV GLDJQRVLV)DWLJXHLGHQWLILHGLQSDWLHQWVKRVSLWDOL]HGLQ
)RUSDWLHQWHYDOXDWLRQDVFDOHZDVXVHGWKDWGHVLJQDWHV WKH&DUGLRORJ\8QLWDQG&RURQDU\,&86mR3DXOR
DQXPHULFYDOXHWRHDFKHYDOXDWHGLWHPDFFRUGLQJWRWKH
FRPPLWPHQWGHJUHHDVIROORZV 'HILQLQJFKDUDFWHULVWLFV Q 
3HUFHLYHGQHHGIRUDGGLWLRQDOHQHUJ\  
+LJKO\FRPPLWWHG
,QDELOLW\WRPDLQWDLQXVXDOURXWLQHV  
6XEVWDQWLDOO\FRPPLWWHG 9HUEDOL]DWLRQRIODFNRIHQHUJ\  
0LOGO\FRPPLWWHG ,QFUHDVHLQSK\VLFDOFRPSODLQWV  
6OLJKWO\FRPPLWWHG (PRWLRQDOLQVWDELOLW\LUULWDWLRQ  
 1RW FRPPLWWHG /HWKDUJLFDQGRUDJLWDWLRQ  
+RZHYHULQVRPHFDVHVGXHWRWKHODFNRIHYDOXDWLRQ &RPSURPLVHGFRQFHQWUDWLRQ  
LQWKHJUDGHGVFDOHRQHRIWZRYDOXHVZDVVHOHFWHGIRU 'HFUHDVHGSHUIRUPDQFH  
WKHHYDOXDWHGLWHP 'LVLQWHUHVWLQWURVSHFWLRQ  

7DEOH   (YROXWLRQ RI  PD[LPXP VFRUH   IRU HDFK LQGLFDWRU RI  WKH $FWLYLW\ 7ROHUDQFH UHVXOW RQ WKH ILUVW DQG
VHYHQWKGD\RI KRVSLWDOL]DWLRQ6mR3DXOR
' '
,QGLFDWRUV  
Q Q
7DLORULQJOLIHVW\OHWRWKHHQHUJ\OHYHO    
6NLQFRORULQVLGHQRUPDOSDWWHUQV    
([HFXWLRQRIGDLO\OLYLQJDFWLYLWLHV    
$ELOLW\WRVSHDNGXULQJWKHH[HUFLVH    
$FNQRZOHGJLQJHQHUJ\OLPLWDWLRQV    
8VLQJHQHUJ\SUHVHUYDWLRQWHFKQLTXHV    
.HHSLQJWKHULJKWQXWULWLRQ    
6KRZQRUPDODSSHWLWH    
6KRZFRQFHQWUDWLRQ    
+HDUWEHDWLQUHVSRQVHWRWKHDFWLYLW\    
5HVSLUDWRU\IUHTXHQF\DQGUK\WKPLQUHVSRQVHWRDFWLYLW\    
2[\JHQVDWXUDWLRQLQUHVSRQVHWRDFWLYLW\    

Acta Paul Enferm 2007;20(3):257-61.


360 $VVLV&&%DUURV$/%/*DQ]DUROOL0=

7KH PDLQ QXUVLQJ LQWHUYHQWLRQV ZHUH FODVVLILHG DV WLVVXHVLVRQHRIWKHPDLQFKDUDFWHULVWLFVRIFRQJHVWLYH


GHSHQGHQW DFWLYLWLHV RU VWDUWHG E\ SK\VLFLDQV DQG KHDUWIDLOXUH,QWKHDEVHQFHRIWKHVHHOHPHQWVWKHUHLVD
LQGHSHQGHQWDFWLYLWLHVRUVWDUWHGE\QXUVHV  :HQRWLFHG VLJQLILFDQW GURS LQ SDWLHQWV SK\VLFDO DELOLW\ IURP WKH
WKDWIRUWKHH[HFXWLRQRI WKHVXJJHVWHGDFWLYLWLHVIRUWKH VLPSOHVWWRWKHPRVWFRPSOH[  7KLVDFNQRZOHGJHPHQW
(QHUJ\3URPRWLRQLQWHUYHQWLRQRI WKHDFWLYLWLHV ZDV GHPRQVWUDWHG E\  RI WKH SDWLHQWV RQ WKH ILUVW
ZHUHLQGHSHQGHQW)RUWKH(QHUJ\&RQWUROLQWHUYHQWLRQ GD\RIKRVSLWDOL]DWLRQDQGE\RQGD\VHYHQ
RIWKHDFWLYLWLHVZHUHLQGHSHQGHQW 8VLQJ HQHUJ\ SUHVHUYDWLRQ WHFKQLTXHV WKLV '& ZDV
$VWRWKHVFRUHVGHVLJQHGWRHDFKLQGLFDWRURIWKHUHVXOW RQO\HYDOXDWHGDIWHUSRVVLEOHDFWLRQVKDGEHHQWDXJKWWR
$FWLYLW\7ROHUDQFHDOOHYDOXDWHGLWHPVSUHVHQWHGDQLPSURYHPHQW WKHSDWLHQWVVXFKDVEUXVKLQJWKHWHHWKVHDWHGRUVLWWLQJ
LQWKHVHFRQGHYDOXDWLRQDVVKRZQLQ7DEOH GRZQ WR EDWKH IRU H[DPSOH 2Q WKH ILUVW GD\ RI
KRVSLWDOL]DWLRQ QR SDWLHQW NQHZ DERXW WKH HQHUJ\
',6&866,21 SUHVHUYDWLRQWHFKQLTXHVZKLOHRQGD\VHYHQRI WKH
SDWLHQWVXVHGWKHWHFKQLTXHVWKH\ZHUHWDXJKW
7KHLQGLFDWRUVIRUWKH$FWLYLW\7ROHUDQFHUHVXOWZLOOEH .HHSLQJWKHULJKWQXWULWLRQLWLVWKHLQWDNHRIVHYHUDO
GLVFXVVHG LQGLYLGXDOO\ FRPSDULQJ WKH ILUVW DQG VHYHQWK QXWULHQWV LQ SURSHU DPRXQWV IRU ERG\ QHHGV VXFK DV
KRVSLWDOL]DWLRQGD\ YLWDPLQV DQG PLQHUDOV ZLWK D YLHZ WR DSSURSULDWH
7DLORULQJOLIHVW\OHWRWKHHQHUJ\OHYHOVLWXDWLRQLQZKLFK PHWDEROLF IXQFWLRQLQJ   7KLV LQGLFDWRU ZDV HYDOXDWHG
WKHSDWLHQWWDLORUVKLVKHUDFWLYLWLHVWRWKHDYDLODEOHHQHUJ\ WKURXJKWKHLGHQWLILFDWLRQRIWKHIRRGJURXSVFRQVXPHG
OHYHO7DLORULQJPHDQVWRILWRQHWKLQJWRWKHRWKHUVKDSLQJ E\ WKH SDWLHQWV DQG WKH FDOFXODWLRQ RI WKHLU ERG\ PDVV
PDNH SURSHU DQG DGMXVW %\ DQDO\]LQJ WKH SDWLHQWV LQGH[ %0, 2QWKHILUVWGD\RIKRVSLWDOL]DWLRQRI
VLWXDWLRQGXULQJWKHKRVSLWDOL]DWLRQLWFDQEHFRQFOXGHG WKHSDWLHQWVSUHVHQWHGVFRUHZKLOHRQGD\VHYHQ
WKDWKHVKHQHHGVDGDSWDWLRQLQVHYHUDODVSHFWV2QWKH SUHVHQWHGVFRUH
ILUVW KRVSLWDOL]DWLRQ GD\ QR SDWLHQW SUHVHQWHG WKLV 6KRZQRUPDODSSHWLWHLWZDVHYDOXDWHGLI WKHDSSHWLWH
DGDSWDWLRQ +RZHYHU WKURXJK WKH DSSOLFDWLRQ RI WKH ZDVQRUPDOIRUWKHLQGLYLGXDOFRPSDULQJKLPKHUZLWK
SURSRVHGLQWHUYHQWLRQVRQGD\VHYHQRI WKHSDWLHQWV KLPKHUVHOI RQRWKHUGD\VZKHQSRVVLEOH7KHIDPLO\V
VDLGWKH\ZHUHDGDSWHG KHOSZDVUHTXHVWHGZKHQQHHGHG$QRUH[LDDQGQDXVHD
6NLQFRORUZLWKLQWKHQRUPDOSDWWHUQVGHSHQGVRQWKH DUHFDXVHGE\WKHFRQJHVWLRQRIEHOO\RUJDQVFDXVLQJD
SLJPHQWV LQ WKH EDVDO OD\HU RI  WKH HSLGHUPLV DQG LWV IDOVHIHHOLQJRIVDWLVIDFWLRQRUDEGRPLQDOGLVFRPIRUWDQG
FRQFHQWUDWLRQWKLFNQHVVDQGPLFURFLUFXODWLRQQHWZRUN   WKLVFDQHQGXSFDXVLQJDGHFUHDVHLQWKHGHVLUHWRHDWLQ
,WZDVQRWLFHGWKDWRQWKHILUVWKRVSLWDOL]DWLRQGD\RQO\ SDWLHQWVZLWKFRQJHVWLYHKHDUWIDLOXUH  2QWKHILUVWGD\
RIWKHSDWLHQWVZHUHHYDOXDWHGZLWKVFRUHDJDLQVW RIKRVSLWDOL]DWLRQRQO\RIWKHSDWLHQWVVKRZHGVFRUH
RQGD\VHYHQ ZKLOHRQGD\VHYHQRIWKHSDWLHQWVSUHVHQWHGWKLV
([HFXWLRQRI GDLO\OLYLQJDFWLYLWLHVDELOLW\WRSHUIRUP VFRUH
URXWLQHDFWLYLWLHVVXFKDVEUXVKLQJWHHWKEDWKLQJDQGHDWLQJ 6KRZFRQFHQWUDWLRQEUDLQK\SR[LDFDXVHGE\ORZKHDUW
,W ZDV QRWLFHG WKDW RQ WKH ILUVW KRVSLWDOL]DWLRQ GD\ QR EHDW FDQ RULJLQDWH K\SR[LF HQFHSKDORSDWK\ QRWLFLQJ
SDWLHQW SUHVHQWHG VFRUH  DQG  SUHVHQWHG VFRUH  LUULWDWLRQ ORVV RI DWWHQWLRQ DQGRU FRQFHQWUDWLRQ DQG
ZKLFK UHSUHVHQWHG WKH FKDQJHV LQ UHVW %\ DSSO\LQJ WKH DJLWDWLRQ  ,QWKHHYDOXDWLRQRIWKLVLQGLFDWRURI
SURSRVHGLQWHUYHQWLRQRQGD\VHYHQRI WKHKRVSLWDOL]DWLRQ WKH SDWLHQWV UHFHLYHG VFRUH  RQ WKH ILUVW GD\ RI
RQO\RIWKHSDWLHQWVSUHVHQWHGVFRUH KRVSLWDOL]DWLRQDJDLQVWRQGD\VHYHQ
$ELOLW\WRVSHDNGXULQJWKHH[HUFLVHLWLVFRPSULVHGRI +HDUWEHDWLQUHVSRQVHWRWKHDFWLYLW\ZLWKLQQRUPDO
SHUIRUPLQJDQH[HUFLVHDFWLYLW\DQGVSHDNLQJDWWKHVDPH SDWWHUQVZHIRXQGRIWKHSDWLHQWVZLWKVFRUHRQ
WLPH7KHGLPLQLVKHGKHDUWEHDWGXHWRFRQJHVWLYHKHDUW WKHILUVWGD\RIKRVSLWDOL]DWLRQDQGRQGD\VHYHQ
IDLOXUHSURGXFHVJHQHUDOL]HGPDQLIHVWDWLRQVEHFDXVHWKH +HDUWEHDWDQGUHVSLUDWRU\UK\WKPLQUHVSRQVHWRWKH
EORRGWKDWUHDFKHVWKHWLVVXHVDQGRUJDQVLVQRWHQRXJKWR DFWLYLW\ ZLWKLQ QRUPDO SDWWHUQV RQ WKH ILUVW GD\ RI
RIIHU WKH QHFHVVDU\ R[\JHQ DPRXQW 7KLV FDQ UHVXOW LQ KRVSLWDOL]DWLRQ QRQH RI WKH SDWLHQWV UHDFKHG VFRUH 
GL]]LQHVV FRQIXVLRQ IDWLJXH DQG PDLQO\ DFWLYLW\ DJDLQVWRQGD\VHYHQ
LQWROHUDQFH7KXVRQWKHILUVWGD\RIKRVSLWDOL]DWLRQ 2[\JHQVDWXUDWLRQLQUHVSRQVHWRWKHDFWLYLW\ZLWKLQ
RIWKHSDWLHQWVZHUHDEOHWRVSHDNZKLOHH[HUFLVLQJZKLOH QRUPDOSDWWHUQVR[\JHQUHFHSWLRQKDSSHQVSULPDULO\LQ
RQGD\VHYHQRIWKHSDWLHQWVWDONHGGXULQJDQDFWLYLW\ WKH OXQJV FRQVWLWXWLQJ WKH ILUVW VWHS LQ WKH SURFHVV RI
FRQVLGHUHGDVDQH[HUFLVH   RIIHULQJR[\JHQWRWKHWLVVXHV2QFHUHFHLYHGWKHR[\JHQ
$FNQRZOHGJLQJHQHUJ\OLPLWDWLRQVVWDWHLQZKLFKWKH LVWUDQVSRUWHGLQWKHEORRGGLVVROYHGLQWKHSODVPD 
SDWLHQWFDQDFNQRZOHGJHWKHLQWHQVLW\DWZKLFKKHVKHFDQ RUFRPELQHGZLWKWKHKHPRJORELQ   2QWKHILUVW
RUFDQQRWSHUIRUPDQDFWLYLW\7KHGLVSURSRUWLRQEHWZHHQ GD\ RI KRVSLWDOL]DWLRQ  RI WKH SDWLHQWV SUHVHQWHG
WKHHQWUDQFHDQGQHHGRIR[\JHQDQGRWKHUQXWULHQWVLQ VDWXUDWLRQ ZLWKLQ QRUPDO SDWWHUQV DQG DIWHU WKH

Acta Paul Enferm 2007;20(3):257-61.


(YDOXDWLRQ RI H[SHFWHG RXWFRPHV RI QXUVLQJ LQWHUYHQWLRQV WR DGGUHVV WKH QXUVLQJ GLDJQRVLV RI IDWLJXH DPRQJ SDWLHQWV ZLWK FRQJHVWLYH KHDUW IDLOXUH 361

LQWHUYHQWLRQV  RI  WKHP SUHVHQWHG QRUPDO SDWWHUQV IDLOXUHQRPHQFODWXUHFODVVLILFDWLRQDQGULVNVWUDWLILFDWLRQ


RQGD\VHYHQ $P+HDUW- 6XSSO 6
$JRRGHYROXWLRQLQDOOHYDOXDWHGLQGLFDWRUVZDVQRWLFHG  %UDXQZDOG ( 6REHO %( +HDUW GLVHDVH $ WH[W ERRN RI
FDUGLRYDVFXODUPHGLFLQH3KLODGHOSKLD(OVHYLHU6DXQGHUV
1XUVLQJLQWHUYHQWLRQVUHDFKHGWKHH[SHFWHGUHVXOWV
 ,,GLUHWUL]SDUDRGLDJQyVWLFRHWUDWDPHQWRGDLQVXILFLrQFLD
:KHQFRPSDULQJWKHVHVWXG\UHVXOWVZLWKVLPLODUSDSHUV FDUGtDFD$UT%UDVGH&DUGLRO 6XSSO 
FRQFOXVLRQVDSSHDUWKDWVXSSRUWWKLVUHVHDUFKVFRQFOXVLRQV  %DUURV$/%/27UDEDOKRGRFHQWHDVVLVWHQFLDOGHHQIHUPDJHP
,QDVWXG\DERXWWKHDFWLYLW\WROHUDQFHGLDJQRVLVRQO\RQH QR+RVSLWDO6mR3DXORGD81,)(63(30>WHVH@6mR3DXOR
SDWLHQW  GLGQRWSUHVHQWWKHH[SHFWHGHYROXWLRQUHODWHG 8QLYHUVLGDGH )HGHUDO GH 6mR 3DXOR (VFROD 3DXOLVWD GH
WRWKHVFRUHVGD\VRIKRVSLWDOL]DWLRQ  ,QDQRWKHUUHVHDUFK 0HGLFLQD
RQWKHQXUVLQJGLDJQRVLV([FHVVLYHIOXLGYROXPHRQWKH  +RUWD:$3URFHVVRGHHQIHUPDJHP6mR3DXOR(GLWRUD
3HGDJyJLFDH8QLYHUVLWiULDF
ILUVW GD\ RI KRVSLWDOL]DWLRQ  RI WKH SDWLHQWV UHDFKHG
 &DPSHGHOOL0&RUJDQL]DGRUD3URFHVVRGHHQIHUPDJHPQD
VFRUHDJDLQVWRQGD\VHYHQDOVRGHPRQVWUDWLQJDQ SUiWLFD6mR3DXORWLFD
H[SHFWHGHYROXWLRQ    &ODUN - /DQJ 1 1XUVLQJV QH[W DGYDQFH DQ LQWHUQDO
FODVVLILFDWLRQ IRU QXUVLQJ SUDFWLFH ,QW 1XUV 5HY 
&21&/86,21   
 %XOHFKHN *0 0F&ORVNH\ -& 'HILQLQJ DQG YDOLGDWLQJ
3DWLHQWVDUHOLPLWHGE\WKHFOLQLFDOFKDUDFWHULVWLFVRIFRQJHVWLYH QXUVLQJLQWHUYHQWLRQV1XUV&OLQ1RUWK$P  
KHDUWIDLOXUHVLJQLILFDQWO\GHFUHDVLQJWKHLUTXDOLW\RIOLIH 
 0F&ORVNH\-&%XOHFKHN*0HGLWRUV1XUVLQJ,QWHUYHQWLRQ
,WLVREYLRXVWKDWSDWLHQWVFOLQLFDOLPSURYHPHQWFDQQRW &ODVVLILFDWLRQ 1,& ,RZDLQWHUYHQWLRQSURMHFW6W/RXLV
RQO\EHDWWULEXWHGWRWKHSHUIRUPHGQXUVLQJDFWLRQVEHFDXVH 0RVE\
WKHLUSRVLWLYHHYROXWLRQUHVXOWVIURPDVHWRIIDFWRUVVXFK  -RKQVRQ 0 0DDV 0 0RRUKHDG 6HGLWRUV 1XUVLQJ
DVQXUVLQJDFWLYLWLHVDQGSKDUPDFHXWLFDOWKHUDS\DQGWKH RXWFRPHVFODVVLILFDWLRQ 12& 6W/RXLV0RVE\
OLPLWDWLRQVRIWKLVVWXG\VKRXOGDOVREHWDNHQLQWRDFFRXQW  0LFKHO-/0%DUURV$/%/$XWLOL]DomRGDHQWUHYLVWDHP
:H FRQVLGHU WKDW WKH FDUH GHOLYHUHG WR VXEMHFWV JUXSRIRFDOSDUDYDOLGDomRGHFRQWH~GRGHXPLQVWUXPHQWR
KRVSLWDOL]HGIRUFRQJHVWLYHKHDUWIDLOXUHLQYROYHVPXOWLSOH GHFROHWDGHGDGRVGHHQIHUPDJHP$FWD3DXO(QIHUPDJHP
 1(VS3W 
SURIHVVLRQDOVDQGIDFWRUV  1$1'$1XUVLQJ'LDJQRVHVGHILQLWLRQVDQGFODVVLILFDWLRQ
$IWHUDQDO\]LQJWKHGDWDDVZHOODVWKHVLPLODULWLHVIRXQG 6W/RXLV1$1'$,QWHUQDWLRQDO
LQRWKHUVWXGLHVWKHLPSURYHPHQWRIQXUVLQJGLDJQRVHV  %DWHV%+RFNHOPDQ5$3URSHGrXWLFDPpGLFD5LRGH-DQHLUR
WKURXJK WKH FODVVLILFDWLRQ RI  LQWHUYHQWLRQV DQG UHVXOWV *XDQDEDUD.RRJDQ
EHFRPHVHYLGHQW  5DPRV-U-6HPLRWpFQLFDGDREVHUYDomRFOtQLFD6mR3DXOR
:HFDQFRQFOXGHWKDWWKHSURSRVHGQXUVHLQWHUYHQWLRQV 6DUYLHU
VXFFHVVIXOO\OHDGWRWKHUHVXOWVXJJHVWHGIRUWKHGLDJQRVLV  *X\WRQ$&-RQHV&(&ROHPDQ7*7UDWDGRGHILVLRORJLD
PpGLFDDHG6mR3DXOR,QWHUDPHULFDQD
XQGHUVWXG\
 5RGULJXHV )* $QGUDGH )& $YDOLDomR GR UHVXOWDGR GH
:KHQWKHSDWLHQWUHFHLYHVDEHWWHUSODQQHGQXUVLQJFDUHEDVHG HQIHUPDJHP WROHUkQFLD j DWLYLGDGH 12&  HP SDFLHQWHV
RQVFLHQWLILFNQRZOHGJHDQGHYLGHQFHDVZHOODVRQQXUVLQJ SRUWDGRUHVGH,&&WLSRIXQFLRQDO,,,H,9DSyVDVDWLYLGDGHV
FODVVLILFDWLRQVWKHHYDOXDWLRQRIWKHLPSURYHPHQWLQWKHREWDLQHG GH HQIHUPDJHP UHDOL]DGDV 1,& ,Q  &RQJUHVVR GH
UHVXOWVVKRZVWKHHIILFLHQF\RIWKHSURSRVHGLQWHUYHQWLRQV ,QLFLDomR&LHQWtILFDGD8QLYHUVLGDGH)HGHUDOGH6mR3DXOR
:HVXJJHVWWKHFUHDWLRQRI VXJJHVWHGFDUHSURWRFROV 
IRUWKHSUHYDLOLQJQXUVLQJGLDJQRVLVDWFOLQLFDODQGVXUJLFDO  /RSHV -/ %DUURV $/%/ 9DOLGDomR GDV SULQFLSDLV
XQLWVWKXVWXUQLQJFDUHV\VWHPL]DWLRQLQWRDIHDVLEOHDQG LQWHUYHQo}HV GH HQIHUPDJHP GD 1XUVLQJ ,QWHUYHQWLRQ
&ODVVLILFDWLRQ 1,& HGRVUHVXOWDGRVVXJHULGRVSHOD1XUVLQJ
FOHDUO\HIIHFWLYHWRROLQSDWLHQWFDUH 2XWFRPHV &ODVVLILFDWLRQ 12&  SDUD R GLDJQyVWLFR GH
HQIHUPDJHP ([FHVVR GH 9ROXPH GH /tTXLGRV ,Q ;
5()(5(1&(6 &RQJUHVVRGH,QLFLDomR&LHQWtILFD 3,%,& 6mR3DXOR
$QDLVGR3,%,&6mR3DXOR3Uy5HLWRULDGH*UDGXDomR
 )HONHU*0$GDPV.)-U.RQVWDP0$2&RQQRU&0 GD81,)(63H&RQVHOKR1DFLRQDOGH'HVHQYROYLPHQWR
*KHRUJKLDGH 0 7KH SUREOHP RI GHFRPSHQVDWHG KHDUW &LHQWtILFRH7HFQROyJLFRYS

Acta Paul Enferm 2007;20(3):257-61.

S-ar putea să vă placă și