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      Qualidade de vida em portadores de doença arterial coronária: comparação entre gêneros Translated title: Quality of life in patients with coronary artery disease: comparison between genders

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          Abstract

          OBJETIVO: Avaliar a qualidade de vida em portadores de doença arterial coronária (DAC) submetidos a um dos três tratamentos: clínico, cirúrgico ou por angioplastia, comparando possíveis diferenças entre gêneros. MÉTODOS: O estudo incluiu 542 sujeitos com DAC submetidos aos tratamentos, sendo 376 homens (58,5 ± 8,7 anos) e 166 mulheres (61,8 ± 9,2 anos). O instrumento de avaliação foi o Questionário Genérico de Avaliação de Qualidade de Vida (SF-36), aplicado no início do tratamento, após 6 e 12 meses. A análise estatística foi realizada pelo teste Anova. RESULTADOS: Em relação aos componentes físicos, o grupo cirúrgico exibiu escores de 46, 63 e 68, respectivamente, na fase inicial, 6 e 12 meses; o clínico 52, 65 e 62 e a angioplastia 57, 66 e 70. Os escores dos componentes mentais do tratamento cirúrgico foram 58, 71 e 74, do clínico 61, 69 e 69 e da angioplastia 64, 74 e 74. As diferenças foram significantes ao longo do tempo e entre tratamentos (p<0,01). Na comparação entre gêneros, notou-se que os componentes físicos nos homens apresentaram respectivamente escores 56*, 69 e 77* e nas mulheres 41*, 64 e 62*; os componentes mentais nos homens revelaram 61*, 73 e 80* e nas mulheres 51*, 68 e 62* (* p<0,0001). CONCLUSÃO: Os sujeitos submetidos ao tratamento cirúrgico mostraram evolução mais favorável. Os homens apresentaram melhor qualidade de vida no início, beneficiando-se progressivamente após 6 e 12 meses dos tratamentos, enquanto nas mulheres a melhora ocorreu aos 6 meses, reduzindo-se aos 12.

          Translated abstract

          OBJECTIVE: To analyze the quality of life of people with coronary artery disease (CAD) who underwent distinct therapeutic interventions and compare the possible differences between genders. METHODS: This study comprised 542 subjects, 376 men (58.5 ± 8.7 years) and 166 women (61.8 ± 9.2 years), with CAD who underwent surgical, medical treatment or angioplasty. Quality of life was assessed with The Medical Outcomes Study 36-item Short-Form Health Survey (SF-36) administered at the beginning of treatment and after 6 and 12 months. The applied statistical method was the ANOVA test. RESULTS: Those who underwent surgical treatment had scores of 46, 63, 68, for physical components; 52, 65, 62 for medical treatment, and 57, 66, 70 for angioplasty, respectively, in the initial, six, and twelve months phases. For mental components, results were 58, 71, 74 for the surgical intervention; 61, 69, 69 for the medical treatment, 64, 74, 74 for angioplasty. The differences over time and between treatments reached a statistical significance (p<0.001). In comparing genders, physical component scores in men were 56*, 69, 77*, and 41*, 64, 62* in women, respectively; mental component scores in men were 61*, 73, 80* and 51*, 68, 62* in women (*p<0.0001). CONCLUSIONS: Subjects who underwent surgical treatment had the most favorable evolution. Men when compared to women had a better quality of life in the beginning of treatment with a progressive improvement after six and twelve months, while women, after an improvement at six months, presented a decrease at twelve.

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          The World Health Organization Quality of Life Assessment (WHOQOL): development and general psychometric properties.

          This paper reports on the field testing, empirical derivation and psychometric properties of the World Health Organisation Quality of Life assessment (the WHOQOL). The steps are presented from the development of the initial pilot version of the instrument to the field trial version, the so-called WHOQOL-100. The instrument has been developed collaboratively in a number of centres in diverse cultural settings over several years; data are presented on the performance of the instrument in 15 different settings worldwide.
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            Datasus: informações de saude

            (2003)
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              Quality of life after coronary angioplasty or bypass surgery. 1-year follow-up in the Coronary Angioplasty versus Bypass Revascularization investigation (CABRI) trial.

              Coronary artery bypass grafting (CABG) and percutaneous transluminal coronary angioplasty (PTCA) have both been shown to be safe and effective in the treatment of coronary artery disease. Nine randomized studies comparing CABG and PTCA have delivered consistent results, with no significant differences in mortality between the methods, either in single or in multivessel coronary artery disease. An important outcome measurement after intervention is the patient's subjective appraisal of the intervention. Results from the CABRI substudy on quality of life at 1 year follow-up are presented in this report. CABRI is a multicentre, randomized, open comparison of patients assigned to either PTCA or CABG. Patients were recruited from 26 high volume European hospitals over a 53 month period starting in July 1988. A quality of life substudy was also set up, but participation was optional. Seven out of 26 centres took part in the study. One hundred and fifty-four (14.6%) out of the 1054 main study patients participated. Perceived health status was assessed at baseline and 1 year after revascularization by means of The Nottingham Health Profile and a set of 12 other questions. A significant improvement in quality of life in terms of the total score and in the Nottingham Health Profile for both groups, as compared with baseline, was found. A trend towards better outcome concerning energy was found favouring CABG. This trend might be due to the fact that the CABRI protocol permitted incomplete revascularization in the PTCA arm and did not exclude patients with totally occluded vessels. When adjusted for baseline differences, no difference in health-related quality of life at follow-up was found between the sexes, or between the PTCA and the CABG groups. A significant correlation was found between improvement in quality of life and severity of angina when adjusted for baseline values. This study has shown that there is no general difference in health-related quality of life 1 year after bypass surgery or angioplasty; however, data presented are suggestive of a more favourable outcome in degree of perceived energy in the bypass group. Copyright 1999 The European Society of Cardiology.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                ramb
                Revista da Associação Médica Brasileira
                Rev. Assoc. Med. Bras.
                Associação Médica Brasileira (São Paulo )
                1806-9282
                August 2006
                : 52
                : 4
                : 236-241
                Affiliations
                [1 ] Universidade de São Paulo Brazil
                Article
                S0104-42302006000400023
                10.1590/S0104-42302006000400023
                b5367198-e645-430f-8394-985983052673

                http://creativecommons.org/licenses/by/4.0/

                History
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                SciELO Brazil

                Self URI (journal page): http://www.scielo.br/scielo.php?script=sci_serial&pid=0104-4230&lng=en
                Categories
                MEDICINE, GENERAL & INTERNAL

                Internal medicine
                Quality of life,Coronary artery disease,Gender differences,Psychology,Qualidade de vida,Coronariopatia,Gênero,Aspectos psicológicos

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