Abordajes para la intervención desde enfermería en la Díada en condiciones de cronicidad

Abstract

The objective of this investigation was to describe the way in which the Dyad has been approached and intervened from Nursing in chronic conditions and pluripathology. The methodology of Integrative Review was used, following the steps of Whittemore and Knafl. The search engines used were: Ovid Nursing, Science Direct, VHL and the Ebsco metasearch engine (the latter were used: Medline, Medline Complete, Academic Search Complete and OmniFile Full Text Mega (HW Wilson). 70 pieces of research were identified in all the databases, of which 2,022 pieces were left in the process of debugging by title and summary, and when reviewing the full text the published review for the study was 70 pieces. The most significant findings are related to the databases and the contribution that each of them had, where EBSCO had a significantly higher participation than the others. The countries from which more research was taken into account was also an important result, the place that Colombia has in this, since it is only surpassed by the United States and Spain, the pathologies that were studied the most were: first, Chronic Obstructive Pulmonary Disease, cancer in its different classifications, Chronic Kidney Disease, Heart Failure, Diabetes Mellitus and Alzheimer's. The investigations approach out in Dyads represent 48.57% of all the investigations, which shows the importance of addressing both members of the same, since such investigations have a greater impact on society, and most of them seek not only to characterize them but also seek to improve the quality of life of both individuals. The representativeness of the year of publication, shows that the researchers have set their eyes on chronic patients and on the Dyad, since as of 2013 the increase has been increasing and its peak occurs in 2016, and the 2017 also contributes a large part of the studies, since it has become clear how important it is to understand the Dyad, and generate changes in it to improve their quality of life. Of the 5,530 documents reviewed, only one speaks of pluripathology, as it´s a relatively new concept, even so, that term is already found in world literature, although it is true that multi morbidity continues to be a term used quite frequently, also it is true that concepts have significant differences, particularly in the first they may have comorbidities and in pluripathology entities are independent of each other. The dating has been intervened mainly from the educational aspect, in order to provide the necessary tools to continue with their care process, in terms of the approach, in most cases the two members a dyad, in another large proportion only the caregivers is addressed, and in a small percentage it is done only with the patient, this in general term of chronicity, as only a study of development of pluripathology.

Las investigaciones realizadas con abordaje de diada representan el 48.57% de todas las investigaciones, lo que demuestra la importancia que tiene abordar a ambos miembros de la misma, pues dichas investigaciones tienen mayor impacto en la sociedad, y la mayoría busca no solo caracterizarlos sino que, también buscan mejorar la calidad de vida de ambos individuos. La representatividad del año de publicación, muestra que los investigadores han puesto sus ojos en los pacientes crónicos y en la Díada, pues a partir del 2013 el aumento ha sido cada vez mayor y su pico se da en el año 2016, y el 2017 también aporta gran parte de los estudios, pues se ha evidenciado lo importante que es entender a la Díada, y generar cambios en ella para mejorar su calidad de vida. De los 70 documentos revisados, solo uno habla de pluripatología, pues es un concepto relativamente nuevo, aun así, ya se encuentra ese término en la literatura mundial, pues si bien es cierto que la multimorbilidad continúa siendo un término empleado con bastante frecuencia, también es cierto que ambos conceptos tienen diferencias significativas, particularmente en que los primeros pueden tener comorbilidades y en la pluripatología, todas las entidades patológicas son independientes unas de otras. La díada se ha intervenido principalmente desde el aspecto educativo, con el fin de brindar las herramientas necesarias para que continúen con su proceso de cuidado, en cuanto al abordaje, en la mayoría de los casos se aborda a ambos miembros de la díada, en otra gran proporción se aborda solo al cuidador y en un pequeño porcentaje se hace solo con el paciente, esto en términos generales de cronicidad, pues solo un estudio develó pluripatología