Self-Care Deficits Related to Vesical Elimination and Intestinal Elimination in Multiple Sclerosis

Abstract
Introduction: Multiple sclerosis (MS) is a neurological, chronic, autoimmune and degenerative disease caused by the destruction of myelin, a key protein in the transmission of the nerve impulse, which affects the Central Nervous System (CNS) (1). Initial symptoms of the disease are sensory impairment including visual field impairment, total or temporary loss of vision (accompanied by eye pain and eye movement), loss of sensation in some region of the body persistently, paralysis, unexplained persistent pain without cause regional or focal specific, tingling (paresthesia), urinary and intestinal incontinence (2). Objective: To characterize patients with Multiple Sclerosis according to gender, age, skin color, schooling, time of disease diagnosis, rehabilitation time, profession / occupation, medications in use; assessing functional capacity by the Barthel Index; to identify major self-care deficits related to bladder and bowel eliminations. Method: Descriptive, field, quantitative exploratory study performed at the Rehabilitation Center and CATEM of the Central Hospital of the Irmandade Santa Casa de Misericórdia, São Paulo. Data were collected from August to October 2016 and April 2017 through the application of 3 instruments. (CEP/ISCMSP: CAAE: 56356616.0.0000.5479 e CAAE: 56355816.3.0000.5479). Results: The sample consisted of 27 patients with a predominance of 66.7% female; age group from 56 to 65 years old 40.8%; white skin color 77.8%; high school education 51.9%; time of discovery of the diagnosis over 20 years 29.7%; time that the patient does rehabilitation until a maximum of 6 months 66.7%; profession / occupation with 66.7% retired without any occupation; 55.5% using medications to control Multiple Sclerosis. The Barthel Index showed 48.1% of patients with moderate degree of dependence. The main self-care deficits related to bladder elimination identified 37.0% of the sample with voiding frequency less than 3 hours, 55.6% presenting urine losses in the clothing; related to intestinal elimination identified 22.3% of the sample referring to evacuation once a week, 40.7% referring to elimination of hardened stools. Conclusion: The studied sample has characteristics of urinary incontinence and intestinal constipation, being an important role of the nurse next to patients with Multiple Sclerosis.