Caracterización de patrones clínicos del paciente fumador antes y después de una intervención terapéuticaun análisis cualitativo y de minería de datos

Resumo

Smoking is an addictive disease with a high prevalence, morbidity, and mortality in the world, making it essential to assist smokers through smoking cessation interventions. Objective: Characterization of clinical patterns of the smoker before and after a therapeutic intervention. Design: Prospective study. Subjects:116 smokers treated consecutively in Stop Smoking Unit of the Pneumology Service of Hospital Clínico Universitario de Santiago de Compostela. Procedure: In the initial visit, a semi-structured clinical interview was carried out that included the patient's report on his experience of smoking, questionnaires for the diagnosis of smoking, level of dependence, anxiety, and depression together with physical examination, general analysis, co-oximetry, and spirometry. In this phase, psychological treatment for smoking was be started and drugs against nicotine addiction were prescribed. At six months, a follow-up visit was carried out with a new semi-structured interview including the patient's report on the experience of smoking and the impact of the treatment, questionnaires to assess the level of anxiety and depression together with the physical examination, general analysis, co-oximetry, and spirometry. Questionnaires were carried out to assess the effectiveness of the anti-smoking intervention, withdrawal symptoms and drug side effects. Analysis: The narrative of the patient about his experience of smoking was analyzed, obtained from the clinical interview, before and after the anti-smoking intervention, using qualitative methodology and text mining. Data mining was be carried out to relate the variables minería de textos. Tamén se aplicaron técnicas de minería de datos para relacionar as variables adquiridas antes e despois da intervención antitabaco e extraer os patróns clínicos correspondentes. Resultados: a dependencia da nicotina e o tabaquismo son o eixo central do informe do fumador durante a visita de referencia tras aplicar diferentes metodoloxías (estatística descritiva e inferencial, análise cualitativa e de contido e técnicas de minería de textos). Obsérvanse modificacións no corpus textual do suxeito fumador como consecuencia do efecto da intervención para deixar de fumar, particularmente nos seguintes atributos: tabaquismo, dependencia, motivación, autoeficacia, abstinencia, emocionalidade e rabia. Ademais, a minería de textos e datos permite obter varios grupos de pacientes durante a visita de referencia e despois da intervención. Conclusións: A aplicación da narrativa do paciente fumador á práctica clínica nunha Unidade de Cesación do Tabaquismo permitirá identificar novas cualidades neste paciente, ademais de personalizar os tratamentos, mellorando as taxas de efectividade deste tipo de intervencións.