Automanejo, adherencia al tratamiento farmacológico, apoyo social percibido y su relación con indicadores de impacto en personas con multimorbilidad.
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Date
2025
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Publisher
Universidad de Concepción
Abstract
Introducción: En Chile las condiciones crónicas y la multimorbilidad continúan representando un desafío de salud pública, lo que motivó la implementación de la Estrategia de Cuidado Integral Centrado en las Personas, orientada en fortalecer el automanejo, la adherencia terapéutica y el apoyo social.
Objetivo: Conocer el nivel de automanejo, adherencia al tratamiento farmacológico, apoyo social percibido y su relación con los indicadores de impacto, entre ellos, hospitalización por descompensación clínica, número de asistencia a los servicios de urgencias y autopercepción de salud en los usuarios con multimorbilidad categorizados como nivel de riesgo alto G3 pertenecientes al programa de Cuidado Integral Centrado en las Personas de los Centros de Salud Familiar de la comuna de Hualpén, en el año 2024.
Método: Estudio de abordaje cuantitativo, descriptivo, correlacional y de corte transversal. El tipo de muestreo utilizado fue no probabilístico, por conveniencia. Los instrumentos aplicados fueron: cuestionario biosociodemográfico, cuestionario de adherencia Morisky Green Levine-8, Escala Multidimensional de Percepción de Apoyo Social de Zimet y escala de automanejo Socios en Salud.
Resultados: Participaron 80 personas, en su mayoría mujeres (62,5%) y el promedio de edad fue de 67,1 años. El nivel de automanejo fue alto (97,5%), apoyo social moderado-alto (43,8 y 43,8% respectivamente) y una adherencia al tratamiento farmacológico moderada-alta (33,8 y 43,8 respectivamente). En el análisis bivariado, el automanejo se asoció significativamente con el nivel educativo, con las consultas a los servicios de urgencias y la autopercepción de salud. Por otro lado, la adherencia al tratamiento farmacológico se asoció positivamente con el número de consultas a servicios de urgencias. Las consultas a urgencias se asociaron significativamente con el sexo. La autopercepción de salud se asoció significativamente con el sexo y el apoyo social. En el modelo multivariado, en las variables predictoras solo el apoyo social se relacionó significativamente con la autopercepción de salud.
Aspectos éticos: Estudio con rigurosidad ética guiado por los ocho principios éticos de Ezequiel Emanuel. Contó con evaluaciones independientes por Comité Éticos Científicos.
Introduction: In Chile, chronic conditions and multimorbidity continue to represent a public health challenge, which motivated the implementation of the comprehensive care strategy centered on people, aimed at strengthening self management, therapeutic adherence, and social support. Objective: This study aimed to determine the level of self-management, adherence to pharmacological treatment, perceived social support and its relationship with impact indicators, including hospitalization due to clinical decompensation, number of attendance at emergency services and self-perception of health in users with multimorbidity categorized as high risk level G3 belonging to the Comprehensive People Centered Care program of the Family Health Centers in the commune of Hualpén, in the year 2024. Method: A quantitative, descriptive, correlational, and cross sectional approach was studied. The type of sampling used was non-probabilistic, for convenience. The instruments applied were: biosociodemographic questionnaire, Morisky Green Levine-8 adherence questionnaire, Zimet Multidimensional Scale of Perception of Social Support, and Partners in Health self-management scale. Results: A total of 80 participants participated in the study, mostly women (62.5%) and the mean age was 67.1 years. The level of self management was high (97.5%), moderate-high social support (43.8 and 43.8% respectively) and moderate-high adherence to pharmacological treatment (33.8 and 43.8 respectively). In the bivariate analysis, self-management was significantly associated with educational level, emergency department visits, and self-perception of health. On the other hand, adherence to pharmacological treatment was positively associated with the number of visits to emergency departments. Emergency department visits were significantly associated with sex. Self-perception of health was significantly associated with sex and social support. In the multivariate model, in the predictor variables, only social support was significantly related to self-perception of health. Ethical aspects: Study with ethical rigor guided by the eight ethical principles of Ezequiel Emanuel. It was independently evaluated by the Scientific Ethics Committee.
Introduction: In Chile, chronic conditions and multimorbidity continue to represent a public health challenge, which motivated the implementation of the comprehensive care strategy centered on people, aimed at strengthening self management, therapeutic adherence, and social support. Objective: This study aimed to determine the level of self-management, adherence to pharmacological treatment, perceived social support and its relationship with impact indicators, including hospitalization due to clinical decompensation, number of attendance at emergency services and self-perception of health in users with multimorbidity categorized as high risk level G3 belonging to the Comprehensive People Centered Care program of the Family Health Centers in the commune of Hualpén, in the year 2024. Method: A quantitative, descriptive, correlational, and cross sectional approach was studied. The type of sampling used was non-probabilistic, for convenience. The instruments applied were: biosociodemographic questionnaire, Morisky Green Levine-8 adherence questionnaire, Zimet Multidimensional Scale of Perception of Social Support, and Partners in Health self-management scale. Results: A total of 80 participants participated in the study, mostly women (62.5%) and the mean age was 67.1 years. The level of self management was high (97.5%), moderate-high social support (43.8 and 43.8% respectively) and moderate-high adherence to pharmacological treatment (33.8 and 43.8 respectively). In the bivariate analysis, self-management was significantly associated with educational level, emergency department visits, and self-perception of health. On the other hand, adherence to pharmacological treatment was positively associated with the number of visits to emergency departments. Emergency department visits were significantly associated with sex. Self-perception of health was significantly associated with sex and social support. In the multivariate model, in the predictor variables, only social support was significantly related to self-perception of health. Ethical aspects: Study with ethical rigor guided by the eight ethical principles of Ezequiel Emanuel. It was independently evaluated by the Scientific Ethics Committee.
Description
Tesis presentada para optar al grado de Magíster en Enfermería.
Keywords
Autogestión (Psicología), Adhesión al tratamiento, Enfermedades crónicas