Sancti Spíritus se encuentra entre las provincias más envejecidas de Cuba y en la tercera edad se encuentra con frecuencia la diabetes mellitus, una enfermedad crónica que acarrea múltiples complicaciones, entre ellas la temida úlcera del pie diabético.
Con el propósito de contribuir a paliar este padecimiento, desde el 2015 se desarrolla en el Policlínico Sur de la ciudad espirituana el proyecto “Estrategia de autocuidado en los adultos mayores con úlcera neuropática en la comunidad”, una investigación de la Doctora en Ciencias de la Enfermería Ydalsys Naranjo, que recientemente obtuvo el Premio Academia de Ciencias.
La idea, que se extenderá hasta el 2021, recontextualiza la teoría del déficit de autocuidado de la enfermera norteamericana Dorothea Elizabeth Orem: “El paciente, aunque tenga el Heberprot P, la enfermera capacitada y el médico del consultorio a su disposición, necesita aprender a cuidarse por sí mismo”, asegura la estudiosa espirituana.
Y agrega que “el anciano nunca debe estar solo, debe tener un familiar o un cuidador por la Asistencia Social porque una diabetes complicada es un riesgo. Vemos en la comunidad ancianos que van al policlínico, les hacen una buena cura y les administran el Heberprot-P, pero después andan con un carrito, de mensajeros en la comunidad y así no se pueden curar porque el polvo de la calle, el ejercicio, la falta de reposo no los ayudan. Tienen que autocuidarse, poner el miembro afectado más alto que el resto del cuerpo para que la circulación mejore. Todo está en el cuidado”.
Entre las prescripciones para el autocuidado de los ancianos diabéticos con vistas a evitar una amputación aparecen la dieta, hiposódica, hipoglúcida, hipograsa, con grasa vegetal, utilizando solo la que vaya a consumir en el día, sin refreírla. Además deben tener seis comidas diarias, en pequeñas cantidades, con menos de seis gramos de sal.
Así mismo, resulta importante que realicen ejercicios físicos, tengan higiene con énfasis en los miembros inferiores; el cortado de las uñas debe ser con un podólogo; deben utilizar las medias al revés y secar bien los espacios interdigitales con el objetivo de que no quede humedad causante de lesiones.
“También recomendamos evitar el hábito de fumar porque la nicotina aumenta la glicemia; asistir a las consultas programadas del consultorio; tomar los hipoglucemiantes orales o la administración de la insulina media hora antes de cada comida; asistir al estomatólogo, al oftalmólogo para que de forma sistemática esté bien controlado. El temido pie diabético no solo trae un gran sufrimiento humano, sino también un aumento de los costos al sistema de salud. Con esta estrategia de autocuidado se evita la hospitalización reiterativa y prolongada con un ahorro para la economía del país”, detalla la Doctora en Ciencias de la Enfermería.
El proyecto, que inicialmente involucró a cerca de un centenar de enfermos y más de 40 enfermeros, logró cambios significativos en el actuar de este personal de asistencia y la recuperación de la infinita mayoría de los pacientes, a quienes se les curó la úlcera y compensó la glicemia.
La investigación, que se ha presentado en diferentes eventos y publicado en revistas especializadas, actualmente se continúa aplicando aquí y además constituye un proyecto de estudiantes residentes en los policlínicos Norte y de Guayos, y —por su impacto—, podría generalizarse en el resto de la provincia dados los altos niveles de envejecimiento existentes.
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