Tratamento de adultos obesos usuários do SUS: uma proposta interdisciplinar

Abstract

Obesity can be defined as a Chronic Non-Communicable Disease, degenerative with a complex and multifactorial etiology, with epigenetic interactions, constituting a relevant risk factor for the development of other comorbidities. It has an increasing prevalence, representing a burden for society and for the public health system as it is associated with important morbidity and mortality. Although obesity is recognized as a multifactorial disease that requires intersectoral and interdisciplinary care, the treatments conventionally used are unidisciplinary. Therefore, the present study aimed to develop and implement an interdisciplinary proposal for the treatment of obese adults using SUS. The methodology used for this research was qualitative and quantitative in an uncontrolled experimental design which compared different indicators of subjects who participated in an interdisciplinary group intervention, performed at two different times. The first moment considered the starting line and, moment two took place nine weeks after the end of the actions developed in each group. Three groups were formed, with 33 individuals selected for each one. The first group ended with 16 participants, the second with 17 and the third with 11, characterizing a sample loss of 44% of those selected. Anthropometric and biochemical parameters were collected before and after the intervention. The groups were conducted by a nutritionist, a psychologist and a physical educator, and the main techniques used were cognitive restructuring, qualitative quantitative, gamification, the coping card and nutritional education. For the qualitative analysis, the target population consisted of four members from each group who had significant results from the quantitative analysis. Of the total of 12 participants selected for this stage, nine participated in the interview, featuring a sample loss of 25%. The intervention was carried out in the municipality of Ponta Grossa - PR, from October 2018 to June 2019.The instruments used were a clinical and sociodemographic questionnaire and semistructured interview for qualitative analysis. Quantitative data were analyzed using SPSS software, version 21.0, using the McNemar tests, Wilcoxon test, and t test, considered significant from p <0.05. For the analysis of qualitative data, the content analysis described by Bardin and the software QDAS Nvivo 11 were used. There was a decrease of 3.4% in weight, 6.99% in waist circumference, 3.2% in body mass index.,5% of the relative fat mass and 8.57% in the waist / height ratio, a statistically significant difference between the parameters (p <0.001). The prevalence of Metabolic Syndrome (MetS) found in the sample was 61.66%, with 25.9% of people having no MetS at the end of the intervention, with a statistically significant difference (p = 0.016). The results found indicate that the interdisciplinary group intervention showed satisfactory results in behavioral change and in the biochemical and metabolic parameters. The importance of this study is focused on offering an intervention model designed and tested to be reproduced in the public health system, with significant social impact and low cost of implementation.