Adélia Yaeko Kyosen Nakatani

Capacidade de idosos da comunidade para desenvolver Atividades de Vida Diária e Atividades Instrumentais de Vida Diária

OBJETIVOS: Identificar algumas caracteristicas sociais e demograficas de idosos de uma comunidade em Goiânia (GO); avaliar a capacidade dos mesmos para as atividades de vida diaria (AVD) e atividades instrumentais de vida (AIVD). METODOS: Estudo transversal, envolvendo 95 idosos da comunidade de uma area de abragencia do Programa Saude da Familia, em Goiânia. Foram realizadas: entrevista e avaliacao de AVD e AIVD. RESULTADOS: Participaram 95 idosos, com predominio da faixa etaria de 60 a 69 anos (60%), sexo feminino (60%), estado civil casado (49,5%), religiao catolica (54,7%) renda menor ou igual a 1 salario minimo (45,3%) e moradia propria (89,5%). Foram identificados independencia maxima nas AVD (57,9%) e comprometimento nas AIVD (72,6%). CONCLUSAO: Os participantes apresentaram, predominantemente, independencia para as atividades no domicilio e dependencia para as atividades fora dele.Objectives: To identify social and demographic characteristics of elderly people and to measure their capability to perform activities of daily living (ADLs) and instrumental activities of dalily living (IADLs). Methods: This was transversal study, involving 95 elders from the Family Healths Program at Goiânia, Brazil. Data were colleted thought interviews and evaluations of the elderly capability to perform ADLs and IADLs. Results: Participants had an age between 60 and 69 years old (60,0%), were women (60,0%), married (49,5%), Catholic (54,7%), home owners and had income bleow or equal to a basic minimum wage (89,5%). Participants had maximal independence in the ADLS (57.9%) and IADLs (72.6%). Conclusion: Most of the participants were cpable to perform indendently ADLs and IADLs.

Capacidade funcional, condições socioeconômicas e de saúde de idosos atendidos por equipes de Saúde da Família de Goiânia (GO, Brasil)

O envelhecimento populacional e um desafio para os profissionais de saude. Este estudo objetivou avaliar a capacidade funcional e identificar os fatores associados a dependencia para as atividades de vida diaria (AVD) e instrumentais de vida diaria (AIVD) e descrever o perfil socioeconomico, demografico e de saude de idosos. Trata-se de pesquisa transversal realizada com idosos atendidos pelas equipes de Saude da Familia do Distrito Sanitario Leste de Goiânia (GO). Aplicou-se questionario para obtencao de dados socioeconomicos e demograficos, fatores relacionados a saude e escalas de avaliacao funcional. Para analise, utilizou-se o teste Qui-Quadrado, considerando o nivel de significância de 5%. A amostra foi composta por 388 idosos, sendo 57,5% entre 60 e 69 anos, 58,5% do sexo feminino, 39,7% analfabetos, 77,3% com renda 80 anos. Esses resultados denotam que os idosos estao vivenciando envelhecimento caracterizado por comorbidades e dependencia para realizar as atividades diarias.

Fatores associados à autoavaliação de saúde ruim em idosos usuários do Sistema Único de Saúde

This article reports on prevalence of poor self-rated health and associated factors among elderly users of the Brazilian Unified National Health System (SUS) in Goiânia, Goiás State, Brazil. The article is based on a cross-sectional study with a proportional sample of elderly in the nine health districts of Goiânia. Data were collected after a pilot study and training of field staff. The measure of association was the prevalence ratio (PR) and respective confidence interval (95%CI). Multivariate analysis was performed using hierarchical Poisson regression. In 403 elderly, prevalence of poor self-rated health was 27.5% (95%CI: 23.2-32.2). The rate was 29.7% in women and 29.1% among seniors aged 60-64 years. Variables associated with poor self-rated health according to multivariate analysis were: less than one year of schooling, lack of physical exercise, use of five or more medications, and recent weight loss. The results showed high prevalence of poor self-rated health and associated factors, including both adverse social conditions and individual health and lifestyle factors.

Consumo de medicamentos por idosos, Goiânia, Brasil

OBJETIVO: Analisar o padrao de consumo de medicamentos entre idosos e sua associacao com aspectos socioeconomicos e autopercepcao de saude. METODOS: Estudo de base populacional e delineamento transversal com 934 idosos de Goiânia, GO, Brasil, entre dezembro de 2009 e abril de 2010. Os dados foram coletados por meio de questionario. As variaveis estudadas foram: numero de medicamentos consumidos, sexo, estado civil, escolaridade, tipo de moradia, idade, renda e autopercepcao de saude. Os medicamentos foram classificados segundo o Anatomical Therapeutic and Chemical Classification. Os medicamentos improprios para idosos foram identificados segundo o Criterio de Beers-Fick. Os testes utilizados foram Qui-quadrado (X2) e exato de Fisher e p foi considerado significativo quando < 0,05. RESULTADOS: Os idosos consumiam 2.846 medicamentos (3,63 medicamentos/idoso). Os mais usuais atuavam no aparelho cardiovascular (38,6%). A prevalencia de polifarmacia foi de 26,4% e da automedicacao de 35,7%. Os medicamentos mais ingeridos por automedicacao foram os analgesicos (30,8%); 24,6% dos idosos consumia medicamento considerado improprio. Mulheres, viuvos, idosos com 80 anos ou mais e com pior autopercepcao de saude praticavam mais a polifarmacia. A maior pratica da automedicacao esteve associada com menor escolaridade e pior autopercepcao de saude. CONCLUSOES: O padrao do consumo de medicamentos por idosos foi semelhante ao encontrado em idosos de outras regioes do Brasil. O numero de medicamentos usados, a prevalencia das praticas da polifarmacia e automedicacao e consumo de medicamentos improprios estiveram dentro da media nacional.OBJECTIVE To analyze the pattern of use of medications use in aged people and associate it with socioeconomic aspects and with the self-rated health. METHODS A population-based cross-sectional design study with 934 elderly people from Goiania, Midwestern Brazil, between December 2009 and April 2010. Data were collected through a questionnaire. The dependent variable was the number of medications consumed and the independent variables were sex, marital status, education, type of residence, age, income, and self-rated health. Drugs were classified according to the Anatomical Therapeutic Chemical Classification. The inappropriate drugs for the elderly were identified according to the Beers-Fick criteria. The tests used were Chi-square and Fishers exact test, p was considered significant when < 0.05. RESULTS The elderly consumed 2,846 medicines (3.63 medications/person). The most commonly consumed were those which act in the cardiovascular system (38.6%). The prevalence of polypharmacy was 26.4% and self-medication was 35.7%. The most used drugs for self-medication were analgesics (30.8%), 24.6% of the elderly consumed drug considered inappropriate. Women, widows, those aged 80 or over and with worse self-rated health were more likely to practiced more polypharmacy. Most self-medication was associated with lower levels of education and worse self-rated health. CONCLUSIONS The pattern of drug use by the elderly was similar to that found in the elderly in other regions of Brazil. The number of drugs used, the prevalence of self-medication and practice of polypharmacy and inappropriate drug use were within the national average.

Prevalence and intensity of chronic pain and self-perceived health among elderly people: a population-based study

OBJECTIVE: to identify the prevalence and intensity of chronic pain among elderly people of the community and to analyze associations with the self-perceived health status. METHOD: cross-sectional study with a populational sample (n=934), conducted through household interviews in the city of Goiânia, Brazil. The intensity of chronic pain (existing for 6 months or more) was measured using a numerical scale (0-10) and the self-perceived health through a verbal scale (very good, good, fair, poor, very poor). For the statistical analysis, the absolute frequency and percentage, CI (95%), Chi-square test, Odds ratio, and regression analysis were used. Significance of 5%. RESULTS: The prevalence of chronic pain was 52.8% [CI (95%):49.4-56.1]; most frequently located in the lower limbs (34.5%) and lumbar region (29.5%); with high or the worst possible intensity for 54.6% of the elderly people. The occurrence of chronic pain was associated with (p<0.0001) a worse self-perception of health (OR=4.2:2.5-7.0), a greater number of chronic diseases (OR=1.8:1.2-2.7), joint disease (OR=3.5:2.4-5.1) and the female gender (OR=2.3:1.7-3.0). A lower intensity of chronic pain was associated with a better self-perception of health (p<0.0001). CONCLUSION: the majority of the elderly people of the community reported chronic pain, of a severe intensity, and located in areas related to movement activities, thus influencing the morbidity and mortality of this population.OBJETIVO: identificar a prevalencia e a intensidade de dor cronica entre idosos da comunidade e analisar associacoes com a autopercepcao do estado de saude. METODO: estudo transversal, com amostra populacional (n=934), conduzido por meio de entrevista domiciliar, na cidade de Goiânia, Brasil. A intensidade da dor cronica (existente ha 6 meses ou mais) foi mensurada por meio de escala numerica (0-10) e a autopercepcao de saude por meio de escala verbal (muito boa, boa, regular, ruim, muito ruim). Para analise estatistica utilizou-se frequencia absoluta e porcentual, IC (95%), teste do qui-quadrado, Odds ratio e analise de regressao. Significância de 5%. RESULTADOS: a prevalencia de dor cronica foi de 52,8% [IC (95%):49,4-56,1]; localizada com maior frequencia em membros inferiores (34,5%) e regiao lombar (29,5%); de intensidade forte ou pior possivel para 54,6% dos idosos. Ocorrencia de dor cronica associou-se (p<0,0001) a pior autopercepcao de saude (OR=4,2:2,5-7,0), numero de doencas cronicas (OR=1,8:1,2-2,7), doenca articular (OR=3,5:2,4-5,1) e sexo feminino (OR=2,3:1,7-3,0). Menor intensidade de dor cronica associou-se a melhor autopercepcao de saude (p<0,0001). CONCLUSAO: a maioria dos idosos da comunidade relata dor cronica, de elevada intensidade, e localizada em regioes relacionadas as atividades de deslocamento, podendo influenciar na morbimortalidade dessa populacao.

Estudo longitudinal dos aspectos multidimensionais da saúde de idosos institucionalizados

OBJECTIVE: This study aimed to analyze the evolution of multidimensional aspects of the health of institutionalized elderly in the city of Goiânia, in two years. METHODS: A longitudinal, prospective and observational clinical study was conducted. Two assessments were carried out within an interval of two years, comprising 59 elderly living at long-term care institutions in the city of Goiânia, State of Goias, Brazil. It was used a set of standardized tools comprising different dimensions such as socio-demographic aspects, health-disease situations, psycho-emotional aspects and functional abilities. The Marginal Homogeneity and McNemars tests were used to compare health aspects in two moments of assessment, by means of the SPSS® software version 10.0 and a p value of less than 0.05. RESULTS: There was a health decline on the following aspects: stroke (p = 0,031); other diseases (p = 0,031); upper limb motor impairment (p = 0,007); use of antidepressant drugs (p = 0,039); decrease on the number of independencies for daily living activities (p = 0,017), specially the ones related to personal hygiene (p = 0,031). CONCLUSION: The results of this study highlight the areas of vulnerability of institutionalized elderly in Goiânia and the need of effective actions to promote and maintain their health.

Avaliação de famílias no contexto hospitalar: uma aproximação entre o modelo Calgary e a taxonomia da NANDA

This study aimed at assessing the nursing diagnoses of the North American Nursing Diagnosis Association (2006) identified within families accompanying patients in treatment for non-communicable chronic diseases, by using the Calgary Assessment Model. This descriptive, quantitative, qualitative study was carried out in a medical clinic at a university hospital in the Mid-western region of Brazil from January to June of 2006. Interviews with 12 families were recorded. The data was then subjected to categorization, identification of gaps and divergences, grouping of standards, diagnostic inference, and relationship determination, from which the diagnostic was established. Among the 12 identified diagnostic categories, the most frequent were: tension due to the caregiver role (100%), impaired verbal communication from the family (75%), impaired home maintenance management (66%), alterations in family processes (66%), and impaired social interactions (25%). This profile identifies whole nursing care priority areas for those families in situations of accompanying family members in the hospital. RESUMEN: El objetivo de esta investigación es el de analizar los diagnósticos de la enfermería de acuerdo con la North American Nursing Diagnosis Association (2006), los cuales fueron identificados en familias en situación de acompañamiento de personas hospitalizadas para el tratamiento de enfermedades crónicas no transmisibles, utilizando para ello el Modelo Calgary de Evaluación. Se trata de una investigación descriptiva, de carácter cuantitativo y cualitativo, realizada en la clínica médica de un hospital-escuela situado en la región centro-oeste, entre enero y junio del 2006. Para la investigación fueron realizadas entrevistas gravadas con 12 familias. Los datos recolectados pasaron por un proceso de categorización, en los que se identificaron vacíos y divergencias, agrupamiento de patrones estándares, inferencia diagnóstica y determinación de las relaciones, a partir de las cuales el diagnóstico fue establecido. Entre las 12 categorías diagnósticas identificadas, las más frecuentes fueron: tensión debido al papel de cuidador (100%), comunicación verbal de la familia perjudicada (75%), sustento del hogar perjudicado (66%), relacionamientos familiares interrumpidos (66%), interacción social perjudicada (25%). En ese perfil se identifican áreas con prioridad de cuidado integral del sector de enfermería, para las familias en situación de acompañamiento de personas hospitalizadas. P A L A V R A S C H A V E : E n f e r m a g e m . F a m í l i a . Diagnóstico de enfermagem. Enfermagem familiar.

Medicine use by the elderly in Goiania, Midwestern Brazil

OBJETIVO: Analisar o padrao de consumo de medicamentos entre idosos e sua associacao com aspectos socioeconomicos e autopercepcao de saude. METODOS: Estudo de base populacional e delineamento transversal com 934 idosos de Goiânia, GO, Brasil, entre dezembro de 2009 e abril de 2010. Os dados foram coletados por meio de questionario. As variaveis estudadas foram: numero de medicamentos consumidos, sexo, estado civil, escolaridade, tipo de moradia, idade, renda e autopercepcao de saude. Os medicamentos foram classificados segundo o Anatomical Therapeutic and Chemical Classification. Os medicamentos improprios para idosos foram identificados segundo o Criterio de Beers-Fick. Os testes utilizados foram Qui-quadrado (X2) e exato de Fisher e p foi considerado significativo quando < 0,05. RESULTADOS: Os idosos consumiam 2.846 medicamentos (3,63 medicamentos/idoso). Os mais usuais atuavam no aparelho cardiovascular (38,6%). A prevalencia de polifarmacia foi de 26,4% e da automedicacao de 35,7%. Os medicamentos mais ingeridos por automedicacao foram os analgesicos (30,8%); 24,6% dos idosos consumia medicamento considerado improprio. Mulheres, viuvos, idosos com 80 anos ou mais e com pior autopercepcao de saude praticavam mais a polifarmacia. A maior pratica da automedicacao esteve associada com menor escolaridade e pior autopercepcao de saude. CONCLUSOES: O padrao do consumo de medicamentos por idosos foi semelhante ao encontrado em idosos de outras regioes do Brasil. O numero de medicamentos usados, a prevalencia das praticas da polifarmacia e automedicacao e consumo de medicamentos improprios estiveram dentro da media nacional.OBJECTIVE To analyze the pattern of use of medications use in aged people and associate it with socioeconomic aspects and with the self-rated health. METHODS A population-based cross-sectional design study with 934 elderly people from Goiania, Midwestern Brazil, between December 2009 and April 2010. Data were collected through a questionnaire. The dependent variable was the number of medications consumed and the independent variables were sex, marital status, education, type of residence, age, income, and self-rated health. Drugs were classified according to the Anatomical Therapeutic Chemical Classification. The inappropriate drugs for the elderly were identified according to the Beers-Fick criteria. The tests used were Chi-square and Fishers exact test, p was considered significant when < 0.05. RESULTS The elderly consumed 2,846 medicines (3.63 medications/person). The most commonly consumed were those which act in the cardiovascular system (38.6%). The prevalence of polypharmacy was 26.4% and self-medication was 35.7%. The most used drugs for self-medication were analgesics (30.8%), 24.6% of the elderly consumed drug considered inappropriate. Women, widows, those aged 80 or over and with worse self-rated health were more likely to practiced more polypharmacy. Most self-medication was associated with lower levels of education and worse self-rated health. CONCLUSIONS The pattern of drug use by the elderly was similar to that found in the elderly in other regions of Brazil. The number of drugs used, the prevalence of self-medication and practice of polypharmacy and inappropriate drug use were within the national average.

Care completeness: conceptions and practice of nursing graduation professors in Goiás State

Care completeness has been defined as a leading axle of the changing process into the nurse formation. In this context, a descriptive-exploratory study was performed aiming to analyze the conceptions of completeness care present in the professors speech and the used strategies to the apprehension of care completeness by students. The research involved three institutions of higher education (HE). The data were collected through interviews with professors and documental analysis of teaching plans. The material was submitted to content analysis according to Bardin(1). Three conceptions emerged: Care completeness - from singular to global; Care completeness - the ways to SUS; Care completeness - strategies to teaching. The study showed the reasons of taking care of human being in his social reality, with specificities and subjectivities; the idea of care and social net into the care practice; strategies to teaching how to care incorporating the learn how to learn, to do, to be and to live together. We want that the results contribute for the reflection of the professors on the directions of the completeness of the care, as well as to reorient the formation process, giving potency to the human resources and to the strategies that have already been used in the direction of the construction of completeness.

Elder's community capacity to develop Daily Life Activities and Daily Instrumental Life Activities

OBJETIVOS: Identificar algumas caracteristicas sociais e demograficas de idosos de uma comunidade em Goiânia (GO); avaliar a capacidade dos mesmos para as atividades de vida diaria (AVD) e atividades instrumentais de vida (AIVD). METODOS: Estudo transversal, envolvendo 95 idosos da comunidade de uma area de abragencia do Programa Saude da Familia, em Goiânia. Foram realizadas: entrevista e avaliacao de AVD e AIVD. RESULTADOS: Participaram 95 idosos, com predominio da faixa etaria de 60 a 69 anos (60%), sexo feminino (60%), estado civil casado (49,5%), religiao catolica (54,7%) renda menor ou igual a 1 salario minimo (45,3%) e moradia propria (89,5%). Foram identificados independencia maxima nas AVD (57,9%) e comprometimento nas AIVD (72,6%). CONCLUSAO: Os participantes apresentaram, predominantemente, independencia para as atividades no domicilio e dependencia para as atividades fora dele.Objectives: To identify social and demographic characteristics of elderly people and to measure their capability to perform activities of daily living (ADLs) and instrumental activities of dalily living (IADLs). Methods: This was transversal study, involving 95 elders from the Family Healths Program at Goiânia, Brazil. Data were colleted thought interviews and evaluations of the elderly capability to perform ADLs and IADLs. Results: Participants had an age between 60 and 69 years old (60,0%), were women (60,0%), married (49,5%), Catholic (54,7%), home owners and had income bleow or equal to a basic minimum wage (89,5%). Participants had maximal independence in the ADLS (57.9%) and IADLs (72.6%). Conclusion: Most of the participants were cpable to perform indendently ADLs and IADLs.