Síndrome metabólicoanálisis poblacional, evaluación del tratamiento integral y propuesta de nomenclatura enfermera

Abstract

Introduction: metabolic syndrome (MS) is the epidemic of the 21st century. It is paradoxical that a disease with a modifiable base, without ignoring the genetic load, constitutes one of the greatest challenges of public health today. This suggests that comprehensive research in tackling this epidemic is still necessary. Aim: to evaluate the effectiveness of an interdisciplinary program led by nursing in relation to MS and cardiovascular risk (CVR). To determine the efficacy of bariatric surgery, in particular the Roux-en-Y Gastric Bypass (RYGB) technique, on obesity and MS, as well as to explore the influence of this surgical procedure on psychiatric comorbidity and cardiovascular risk in the study population. To expand the attention and improve the nurse practice in patients with MS. Methods: a compendium of methods were used. A randomized clinical trial (RCT) supervised clinical test using 74 subjects diagnosed with obesity as sample. The trial management was based on a 12-months program (with pre-test, 12 months and 24 months follow-up) performed by different health care professionals lead by nurses. A retrospective view of the cohort study performed on 146 clinical patients having undergone RYGB between January 1, 2011, and January 1, 2014, allowed us to gather data regarding obesity, metabolic and psychiatric comorbidity, and cardiovascular risk, at 3 stages: prior to surgery, and 3 and 4 months after it. Identification study proposed by Gordon (1996), in the international nomenclature of the nursing discipline, which has been accepted by the three international reference organizations. Results: RCT, a progressive significant reduction was individually found for all clinical, biochemical and anthropometric parameters analyzed at different time points. In the EG, a remission of 48.1% of the MS in the short-term was observed (83.8% in the medium-term), maintained 12 months post-intervention. Unlike the CG which increased the prevalence by 2.7% from the initial evaluation to the completion of the study. A similar trend was observed for CVR: 100% of the EG presented moderate to low risk after 24 months as opposed to the CG that was represented in all CVR categories. Retrospective study, a progressive and statistically relevant reduction of MS and all biochemical parameters was found as consequence of surgery, excluding high-density lipoprotein cholesterol, which significantly increased (beneficial) in value. Also, CVR displayed an identical tendency whereby all subjects were classified as low risk during the final assessment. The publication of a NANDA diagnosis to label patients with MS is presented, a NOC result to objectify the analytical variations involved in it, NIC interventions into the alterations of the pathologies involved in that metabolic entity . Conclusion: A population study conducted shows that the prevalence of MS in the Murcia population is the highest in Spain. However, our research has shown that the surgery and conservative treatment were effective in addressing this issue. This proposal has been presented under the nursing nomenclature (NANDA, NOC, NIC) for the integral approach as a way to reduce this.