Componentes centrais dos programas de reabilitação cardíaca na pessoa submetida a cirurgia cardíaca: uma Scoping Review
DOI:
https://doi.org/10.33194/rper.2024.385Palavras-chave:
Cirurgia Cardíaca, Reabilitação, Qualidade de Vida, Exercício FísicoResumo
Introdução: Atualmente, o número de cirurgias cardíacas tem aumentado, sendo uma opção de fim de linha quando o tratamento médico não consegue dar resposta aos problemas dos indivíduos, objetivando a reparação da disfunção do funcionamento mecânico do coração. A reabilitação cardíaca (RC) corresponde a uma intervenção multidimensional, que contempla a educação e a modificação dos fatores de risco cardiovasculares, no sentido de melhorar a qualidade de vida dos indivíduos. O exercício físico sendo um componente central dos programas de RC constitui uma estratégia que promove a melhoria da performance física, assim como a redução da sintomatologia associada à doença e cirurgia. Por estes motivos, face às implicações resultantes dos processos patológico e cirúrgico no doente submetido a cirúrgica cardíaca é necessário definir, implementar e avaliar intervenções que possibilitem minimizar o impacte funcional nos indivíduos afetos a estas condições.
Objetivos: Mapear e analisar os programas de RC fase II, que incluam indivíduos submetidos a cirurgia cardíaca clássica, com foco nas componentes do exercício físico.
Metodologia: Scoping Review (ScR) com base nos princípios preconizados pelo Joanna Briggs Institute®. Dois revisores independentes realizaram a análise de relevância dos artigos, a extração e síntese dos dados. Foram definidos como critérios de elegibilidade estudos de qualquer nível de evidência, que descrevam claramente a intervenção realizada na fase II da RC e que na sua população alvo incluam indivíduos submetidos a cirurgia de revascularização do miocárdio e cirurgia valvular cardíaca. Foi efetuada pesquisa sem limite temporal nas fontes de dados EBSCOHost, Web of Science, Scopus e literatura cinzenta.
Resultados: Foram incluídas 28 publicações nesta revisão. A intervenção varia entre as 3 semanas e os 12 meses, com sessões de treino diárias a 2-5 vezes por semana, com duração de 30 a 60 minutos. A intensidade e o tipo de exercício prescrito foram áreas com uma grande dispersão, sendo que a maioria dos estudos privilegiam o treino anaeróbio, de baixa a moderada intensidade.
Discussão: A avaliação dos programas é realizada, maioritariamente, no início, a meio e no fim dos mesmos, recorrendo a escalas como forma de medir a qualidade de vida, capacidade cardiorrespiratória e funcionalidade. As características da intervenção, duração e os instrumentos de avaliação divergem entre os estudos.
Conclusão: Mais investigação deve ser realizada, de forma a que se consiga aferir qual a amplitude dos critérios frequência, intensidade, tipo e duração do exercício físico a implementar na pessoa submetida a cirurgia cardíaca, na fase II da RC. O mapeamento das intervenções que passíveis de serem utilizadas nos programas de RC fase II poderão ajudar a aferir quais os principais componentes a considerar nos programas de intervenção, para uma tomada de decisão em Enfermagem de Reabilitação fundamentada, bem como identificar áreas prioritárias de investigação.
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