Fatores associados à capacidade de autocuidado de pessoas com condições crônicas hospitalizadas em setor clínico

Jennifer de Mello Derigge; Andressa Rueda de Lima; Cristina Mara Zamarioli; Aline Helena Appoloni Eduardo

doi:10.5294/aqui.2025.25.2.4

Authors

Jennifer de Mello Derigge Author Federal University of São Carlos https://orcid.org/0009-0009-4802-9834
Andressa Rueda de Lima Author Federal University of São Carlos https://orcid.org/0000-0002-0900-381X
Cristina Mara Zamarioli Author University of São Paulo https://orcid.org/0000-0002-4757-7611
Aline Helena Appoloni Eduardo Author Federal University of São Carlos https://orcid.org/0000-0003-1577-3383

DOI:

https://doi.org/10.5294/aqui.2025.25.2.4

Keywords:

Nursing, self-care, nursing theories, observational study, chronic conditions

Abstract

Objective: To identify the factors associated with self-care capacity in people with chronic conditions hospitalized in a clinical ward. Materials and Methods: This was an observational study conducted in an adult clinical inpatient unit. Data was collected using a form to characterize the participants and the Revised Self-Care Agency Assessment Scale (ASAS-R). Data was then analyzed using descriptive statistics and association tests (Pearson’s correlation coefficient, Student’s t-test for independent samples, and ANOVA). A significance level of 5 % was applied to all analyses. Results: A total of 100 patients participated, with a prevalence of men; with a mean age of 59.78 years; most had incomplete primary education, were married, and retired. Based on the application of the ASAS-R, the patients demonstrated the power to self-care; however, they showed reduced self-care capacity, as indicated by the mean ASAS-R score (53.56). The individual characteristics associated with lower self-care capacity were being male (p = 0.006), having a low level of education (p = 0.022), having no religious bond (p = 0.050), having been hospitalized for a long time (p = 0.016), and not taking medication daily (p = 0.004). Conclusion: The results indicate that people with chronic conditions hospitalized in a clinical ward have a reduced capacity for self-care, associated with individual and clinical factors.

Downloads

Download data is not yet available.

References

Orem DE. Nursing concepts of pratice. 6ª ed. Saint Louis: Mosby; 2001.

Santos MC, Bittencourt GK, Beserra PJ, Nóbrega MM. Teoria geral do autocuidado segundo o modelo de análise de teorias de Meleis. Revista de Enfermagem Referência. 2022; 6(1):e21047. DOI: https://doi.org/10.12707/RV21047

Oliveira L, Teixeira A, Duarte I. The Appraisal of Self-Care Agency Scale-Revised (ASAS-R): Reliability and Validity among Portuguese Medical Students. Int. J. Environ. Res. Public Health. 2022;19(17):10848. DOI: https://doi.org/10.3390/ijerph191710848

Deng Q, Kang L, Zhu S, Luo W, Qing J, Zhong S et al. Effects of nursing based on Orem’s self-care model on self-care efficacy, quality of life and adverse emotions in patients with advanced lung cancer. Am J Transl Res. 2021;13(4):2983-89. Disponível em: https://pubmed.ncbi.nlm.nih.gov/34017465

Iovino P, Lyons KS, De Maria M, Vellone E, Ausili D, Lee CS, Riegel B, Matarese M. Patient and caregiver contributions to self-care in multiple chronic conditions: A multilevel modelling analysis. Int J Nurs Stud. 2021;116:103574. DOI: https://doi.org/10.1016/j.ijnurstu.2020.103574

Yildiz ÇŞ, Özlü ZK. Examınatıon of self-care agency and quality of life in individuals with chronic venous disease. J Vasc Nurs. 2021;39(4):114-9. DOI: https://doi.org/10.1016/j.jvn.2021.08.001

Demirci PY, Yeşilot SB, Eskimez Z. The Role of Sex and Other Personal Characteristics in the Effects of Symptoms Severity on Self-Care Agency in Individuals with Multiple Sclerosis. Brain Behav. 2024;14(10):e70091. DOI: https://doi.org/10.1002/brb3.70091

Sánchez-Ortega MA, Lluch-Canut MT, Roldán-Merino J, Agüera Z, Hidalgo-Blanco MA, Moreno-Poyato AR, Tinoco-Camarena J, Moreno-Arroyo C, Puig-Llobet M. Nursing Intervention to Improve Positive Mental Health and Self-Care Skills in People with Chronic Physical Health Conditions. Int J Environ Res Public Health. 2022;20(1):528. DOI: https://doi.org/10.3390/ijerph20010528

Masadeh AB, Saleh AM. The Effect of a Diabetes Self-Management Mobile Application on Self-Efficacy, Self-Care Agency, and Self-Care Management Among Patients with Type 1 Diabetes Mellitus. Creat Nurs. 2023;29(3):286-94. DOI: https://doi.org/10.1177/10784535231211693

Bláhová H, Bártová A, Dostálová V, Holmerová I. The needs of older patients in hospital care: a scoping review. Aging Clin Exp Res. 2021;33(8):2113-22. DOI: https://doi.org/10.1007/s40520-020-01734-6

França AA, Barbosa JAG, Guimarães FP, Guimarães GL, Guimarães JB. Avaliação da adesão ao autocuidado em diabetes após intervenção educativa realizada com pacientes hospitalizados. Revista Brasileira de Ciências da Saúde. 2020;24(supl. 2). DOI: https://doi.org/10.22478/ufpb.2317-6032.2020v24nSupl.2.47260

Yip JYC. Theory-Based Advanced Nursing Practice: A Practice Update on the Application of Orem’s Self-Care Deficit Nursing Theory. SAGE Open Nurs. 202120;7:23779608211011993. DOI: https://doi.org/10.1177/23779608211011993

Browner WS, Newman TB, Cummings SR, Grady SR, Huang AJ, Kanaya AM, Pletcher MJ. Delineando a pesquisa clínica de Hulley. 5ª ed. Porto Alegre: Artmed; 2024.

Schönenberg A, Teschner U, Prell T, Mühlhammer HM. Validation and Psychometric Analysis of the German Translation of the Appraisal of Self-Care Agency Scale-Revised. Healthcare (Basel). 2022;10(9):1785. DOI: https://doi.org/10.3390/healthcare10091785

Stacciarini TSG, Pace AE. Confirmatory factor analysis of the Appraisal of Self-Care Agency Scale — Revised. Rev Latino-Am Enfermagem. 2017;25:e2856. DOI: https://doi.org/10.1590/1518-8345.1378.2856

Brasil. Ministério da Saúde. Conselho Nacional de Saúde. Resolução nº 466, de 12 de dezembro de 2012. Trata sobre as diretrizes e normas regulamentadoras de pesquisa envolvendo seres humanos. Diário Oficial da União. 13 jun. 2013. Disponível em: https://www.inca.gov.br/publicacoes/legislacao/resolucao-cns-466-12

Brasil. Ministério da Saúde. Conselho Nacional de Saúde. Resolução no 510, de 7 de abril de 2016. Trata sobre as diretrizes e normas regulamentadoras de pesquisa em ciências humanas e sociais. Diário Oficial da União. 24 maio 2016. Disponível em: https://bvsms.saude.gov.br/bvs/saudelegis/cns/2016/res0510_07_04_2016.html

Yildirim Z, Kasikçi M. The effect of education on self-care agency and rational drug use of patients with COPD. Patient Educ Couns. 2023;114:107804. DOI: https://doi.org/10.1016/j.pec.2023.107804

Yoshimura J, Tanimura C, Matsumoto H, Tokushima Y, Inoue K, Park D et al. Relationship of Physical Activity to Self-Care Agency and Physical Condition Among Older Adults in a Rural Area. Yonago Acta Med. 2021;64(1):18-29. DOI: https://doi.org/10.33160/yam.2021.02.004

Lerma C, Lima-Zapata LI, Amaya-Aguilar JA, Leonardo-Cruz I, Lazo-Sámchez M, Bermúdes LA et al. Gender-Specific Differences in Self-Care, Treatment-Related Symptoms, and Quality of Life in Hemodialysis Patients. Int J Environ Res Public Health. 2021;18:13022. DOI: https://doi.org/10.3390/ijerph182413022

Batı S, Polat HT, Akkuş H. Determination of the Relationship Between Self-Care Agency and Death Anxiety Among Elderly Individuals. Omega (Westport). 2022;29:302228221095907. DOI: https://doi.org/10.1177/00302228221095907

Garcia LHC, Cardoso NDO, Bernardi CMCN. Autocuidado e adoecimento dos homens: uma revisão integrativa nacional. Rev Psicol Saúde. 2019;11(3):19-33. DOI: https://doi.org/10.20435/pssa.v11i3.933

Yildiz ÇŞ, Özlü ZK. Examınatıon of self-care agency and quality of life in individuals with chronic venous disease. J Vasc Nurs. 2021;39(4):114-9. DOI: https://doi.org/10.1016/j.jvn.2021.08.001

Cho H, Park E. Canonical Correlation Between Self-Care Agency and Health-Related Self-Efficacy with Chronic Viral Hepatitis Patients. Osong Public Health Res Perspect. 2019;10(5):281-8. DOI: https://doi.org/10.24171/j.phrp.2019.10.5.04

Hauenstein EJ, Davey A, Clark RS, Daly S, You W, Merwin EI. Self-care capacity and its relationship to age, disability, and Perceived well-being in medicare beneficiaries. Nurs Res. 2022;71(1):21-32. DOI: https://doi.org/10.1097/NNR.0000000000000551

Isik K, Cengiz Z, Doğan Z. The Relationship Between Self-Care Agency and Depression in Older Adults and Influencing Factors. J Psychosoc Nurs Ment Health Serv. 2020;58(10):39-47. DOI: https://doi.org/10.3928/02793695-20200817-02

Vargas-Escobar LM, Valle-Ballesteros R, Alemán-Parra CM, Parrado-Sarmiento AC, Cortes-Muñoz F, Sánchez-Casas C. Relationship Among Treatment Adherence, Family Functioning, and Self-Care Agency in Colombian Patients with Cardiovascular Disease. Journal of Nursing Research, 2019;30(4):e224. DOI: https://doi.org/10.1097/jnr.0000000000000504

Tok Yildiz F, Kaşikçi M. Impact of Training Based on Orem’s Theory on Self-Care Agency and Quality of Life in Patients With Coronary Artery Disease. J Nurs Res. 2020;28(6):e125. DOI: https://doi.org/10.1097/JNR.0000000000000406

Virgens BD, Rocha MSD. A implicação do letramento em saúde no autocuidado. Revista Internacional de Debates da Administração Pública. 2019;4(1):191-206.

Yao L, Wu F, Mu H, Wang X, Liu J, Lu H. Mediating effect of health literacy on social support and self-care ability in older patients undergoing percutaneous coronary stent implantation. Cardiovasc Diagn Ther. 2024;14(5):821-31. DOI: https://doi.org/10.21037/cdt-24-50

Mendes NS, Malaguti C, Dos Anjos Sena L, Lucchetti G, de Jesus LAS, Vitorino LM et al. Spirituality and religiosity are associated with physical and psychological status in patients with chronic obstructive pulmonary disease. J Clin Nurs. 2022;31(5-6):669-78. DOI: https://doi.org/10.1111/jocn.15926

Chen Z, Jiang Y, Chen M, Baiyila N, Nan J. Resilience as a Mediator of the Association between Spirituality and Self-Management among Older People with Chronic Obstructive Pulmonary Disease. Healthcare (Basel). 2021;9(12):1631. DOI: https://doi.org/10.3390/healthcare9121631