Impacto del programa interdisciplinar I²AO² liderado por enfermería sobre la obesidad y comorbilidad

Abstract

Introduction: obesity has become a health problem of epidemic proportions. The analyzed population of Murcia (Spain) exceeds Spanish prevalence figures. The failures attributed to the conservative treatment of obesity are due to the development of programs based on unidirectional therapies, promoted and carried out by a single professional group. It has provoked sometimes the treatment is surgical. In addition, we have only found a few studies addressing interdisciplinary interventions coordinated by nurses. Objective: to determine the efficacy and effectiveness of the I²AO² program on obesity, associated metabolic and psychological comorbidity and its impact on quality of life in the short (6 months), medium (12 months) and long term (24 months). Material and methods: a randomized controlled clinical trial with 74 obese and overweight men and women (experimental group, n = 37; control group, n = 37). An interdisciplinary program (physical activity, cognitive behavioral therapy and dietary management) of 12 months was applied -with measures at pretest, 6 months, 12 months and 1 year follow-up- coordinated by nurse. Anthropometric and cardiovascular measures were taken. Results: show a beneficial effect regarding all anthropometric parameters evaluated. Tests for weight (F3;216=79.99; p < 0.001) and body mass index (F3;216=77.47; p < 0.001) indicate great efficacy of intervention: the experimental group had a weight loss of 7.2 kg (-8.3%) compared to a 0.9 kg (+ 1.0%) gain in the control group. Cardiovascular health has improved in the experimental group. Systolic (F3;216 = 34.73; p < 0.001) and diastolic (F3;216 = 63.09; p < 0.001) blood pressure has improved greater in the experimental group. Forced vital capacity has also increased (F2;144 = 16.45; p < 0.001). There was also a positive response of metabolic comorbidities in the intervention group. The interdisciplinary program has significantly improved health-related quality of life (SF-36), both in physical health parameters as well as in mental health. The anxiety analysis shows that there is no effect of the intervention on S-STAI (F2; 144 = 0.246; p = 0.782), which has increased in both groups. However, there is an effect on T-STAI (F2; 144 = 8,872; p <0.001), which only increases in the control group. Conclusion: the I²AO² program has demonstrated its effectiveness and effectiveness, obtaining in the subjects who carried out the interdisciplinary intervention, an improvement in the different parameters for obesity and its associated comorbidity, both metabolic and psychological, impacting on an improvement in the quality of life (6 months), medium (12 months) and long term (24 months).