O empowerment como resultado na autogestão da doença crónica e regime terapêutico

Abstract

Background: The development of therapeutic regimens of self-management´s skills in people with chronic diseases is relevant for Empowerment growth and this is an indirect result of care nursing. People with a high level of Empowerment are able to incorporate the necessary knowledge that allows them to live with their chronic illness. Therefore, this result could provide health gains for the population and decrease the use of health services and systems. Objectives: Characterize the Empowerment ´s level, as a result, in people with chronic disease, identify the Empowerment facilitators and inhibitors factors and potentially influenced by the nursing therapeutics. Methodology: A two-stage study. In the first, a cross-sectional study was developing with 271 participants of both gender, aged between 18 and 65 years and with chronic diseases, in which we characterized their Empowerment level´s and identified related factors. In the second phase, we had interviewed nine participants with a high level of Empowerment. They were from the first phase of the study and we had used the Grounded Theory method`s to orient data analysis. Results: The control of chronic disease and its stabilization are relating with a higher level of Empowerment and a predominance of the Responsible score. We found that the probability of a higher Empowerment ´s level would be in persons with a predominance of the Responsible score relative to the score of the other styles. However, this level decreases in people with predominance in the score Negligent or Formally Guided. Through multiple linear regression, we checked that a higher interference in instrumental activities, personal relationship and development, as well as interaction with professionals, have a negative impact on Empowerment, diminishing it. On the other hand, higher levels of management style of the therapeutic regimen Responsible type, self-control and favorable attitude towards the disease promote the development of level Empowerment ´s. The qualitative phase result´s clarify the Empowerment´s constructing process as a result from the perspective of the person with chronic illness: "Facilitating the decision according to the" head of each one ", and this phase deepen the factors involved in this process. Discussion: This study corroborates the hypothesis that there is a statistically significant association between the Empowerment level of and the therapeutic regimen style Responsible. The facilitators / inhibitors factors of Empowerment as a result are personal attributes; the management style of the therapeutic regimen; social and family support, interference in people's lives. Conclusion: The study is a contribution in identifying factors that predict the individual Empowerment of people with chronic disease. Allowing nurses to implement individualized and empowering therapies of Empowerment as a result

Date of Award	2 May 2019
Original language	Portuguese
Supervisor	Fernanda Santos Bastos (Supervisor) & Margarida Maria Vieira (Co-Supervisor)