Mudança do estilo de vida : adesão e manutenção do tratamento

• Ano de defesa: 2013
• Autor(a) principal: Susin, Nathália
• Orientador(a): Oliveira, Margareth da Silva
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Pontifícia Universidade Católica do Rio Grande do Sul
• Programa de Pós-Graduação: Programa de Pós-Graduação em Psicologia
• Departamento: Faculdade de Psicologia
• País: BR
• Palavras-chave em Português: PSICOLOGIA; SÍNDROME METABÓLICA; HÁBITO ALIMENTAR; COMPORTAMENTO (PSICOLOGIA); MUDANÇA - ASPECTOS PSICOLÓGICOS
• Área do conhecimento CNPq: CNPQ::CIENCIAS HUMANAS::PSICOLOGIA
• Link de acesso: http://tede2.pucrs.br/tede2/handle/tede/830

The first choice of treatment for patients with Metabolic Syndrome (MS) is the lifestyle changing, which includes the practice of physical exercise and healthy eating, being the Transtheoretical Model of Change (TTM) one of the most used approaches to intervene in relation to these behaviors. However, the literature points out, despite the paucity of studies, that patients have difficulty in adhere to the proposed orientations and keep the changes achieved after the end of treatment. This dissertation sought to address these two subjects and was composed of two sections. The first compared the baseline characteristics between subjects with MS who completed and did not complete a randomized clinical trial, based on TTM, in order to modify the lifestyle and cardiovascular risk (MERC), and identified factors associated with treatment completion. Were assessed, 127 subjects with a mean age of 49.58 years (SD = 7.77) and diagnosis of MS, enrolled at MERC between the years 2010 and 2012. Most of the sample completed the intervention (p <0.01), whereas those individuals older than 50 years (OR: 7.5, 95% CI 1.2 to 46.7, p <0.05 ), who exercise (OR: 1.9, 95% CI: 1.0 - 7.0, p <0.05), have religion (OR: 4.6, 95% CI 1.1 to 13.2; p <0.05), high self-efficacy for regular eating habits (OR: 1.2, 95% CI: 1.0 - 2.3, p <0.05), don t have binge eating (OR: 6.1 95% CI: 2.1 to 23.8, p <0.05) and don t have depression (OR: 4.9, 95% CI: 1.4 to 19.4, p <0.05), are more likely to complete the treatment. The second section conducted the follow-up (T3) of the MERC program participants, on average, one year after the initial assessment (T1). The sample consisted of 55 individuals with MS and an average age of 51.9 years (SD = 6.5), divided into 3 groups: Group Intervention - GI (n = 19); Individual Intervention - II (n = 20); Standard Intervention - SI (n = 16). Time effect was significant (<0.001), with a decrease in weight, body mass index, waist circumference, diastolic and systolic blood pressure (SBP) means. There were differences between groups only regarding weight, wherein just the individuals of GI and II maintained treatment outcomes and still showed a significant reduction when compared T3 and T1, and SBP, with II standing out in relation to others. At T3, most individuals were motivated, but with selfefficacy on average for regulating eating habit and medium/low to perform physical exercise, which reinforces the need for monitoring continuously these patients. The results show that an interdisciplinary program, aimed at lifestyle changing, based on MTT, is effective in the management of patients with MS, not only in relation to adherence promotion, but also in maintenance of treatment outcomes.