Perceptions of graves' disease: a clinical-qualitative study of patients reports with euthyroidism and ophthalmopathy under specialized university outpatient follow-up

Abstract

The psychological/emotional management of patients is a permanent challenge for clinical professionals. Understanding the universe of people's mental and cultural meanings allows approximation of languages and consequent desired, enlightened adherence, of patients and the population to therapeutic and preventive measures. Either clinicians understand the meanings hidden in their patients' statements or they will make scientifically well-founded interventions, but without consonance and commitment. Information is necessary, but it is insufficient. It is necessary to understand the symbolic game of falling ill and caring for good clinical success. Graves' disease is a systemic autoimmune disorder mediated by the antibody against TSH receptor. It is the most common cause of hyperthyroidism, with an annual incidence rate of 20 to 50 cases per 100,000 people. The excess of thyroid hormones affects the various systems, therefore, the signs and symptoms associated with Graves' disease can vary enormously and significantly influence the general condition. Graves' ophthalmopathy is an immunomediated inflammatory disorder that causes the expansion of orbital muscles and fat from edema and deposition of glycosaminoglycans and collagen. Most individuals who have fat expansion, develop eyelid retraction, proptosis, in addition to the manifestations of eye exposure. It is emphasized that there are gaps on qualitative discussions on Graves' disease to be filled in the literature, that is, on the search for symbolic meanings of this disease in the structuring of people's lives. Objective: to explore and interpret emotional/symbolic meanings of perceptions of itself reported by patients with Graves' disease in euthyroidism and with ophthalmopathy under specialized university outpatient follow-up. Participants and Method: (a) Sample constructed intentionally and sequentially, by referral from the physician in charge of the Thyroid Clinic at HC-Unicamp; and closed by exhaustion (all eligible, if the population is small) or by saturation of theoretical information. (b) The Clinical-Qualitative Method - humanistic investigative approach developed for care settings will be used. Motto: "The Clinical-Qualitative Method (MCQ) is born from the Clinic and returns to the Clinic". (c) Use of the technique of the Semi-Directed Interview of Open Questions in Depth; in addition to free, complementary observations in the collection of the participants' statements. (d) Operationalization in the field preceded by a phase of acculturation and setting to promote the insertion of the researcher in the chosen care setting, as well as in the language of future interviewees. (e) The treatment of the data will be done by the Clinical-Qualitative Content Analysis. Expected results: (a) published conclusions should contribute to a better understanding of the emotional representations of the problem on the part of readers/consumers of the scientific literature, thus improving the professional-patient relationship, allowing clear and effective guidance to patients and families, and therefore increasing adherence to individual clinical treatments and collective and preventive programs. (b) the immediate return of content interpretations to the local team should also benefit the outpatient population's treatments.