Ana Cristina Mancussi e Faro

A situação social do idoso no Brasil: uma breve consideração

ABSTRACT The national and international literature suggest that the process of becoming old in an issue of great interest for researchers,statisticians, and epidemiologists. The literature shows that the population of elderly worldwide is increasing rapidly. Particularly incountries in development, this population has been increasing significantly but the resources and support systems necessary to attendthis population is not expanding at the same rate. Therefore, concerns regarding this population profile have led to many seriousdiscussions and studies to provide data to those in political position to create adequate programs and policies to attend to the specificneeds of the elderly population without isolating them from society. Thus, the goal of this paper is to discuss the social situation of theelderly in Brazil taken into consideration demographic, epidemiologic, and psychosocial. Emphasis is placed on retirement, the importanceof the family, and on the interpersonal relationships.The national and international literature suggest that the process of becoming old in an issue of great interest for researchers, statisticians, and epidemiologists. The literature shows that the population of elderly worldwide is increasing rapidly. Particularly in countries in development, this population has been increasing significantly but the resources and support systems necessary to attend this population is not expanding at the same rate. Therefore, concerns regarding this population profile have led to many serious discussions and studies to provide data to those in political position to create adequate programs and policies to attend to the specific needs of the elderly population without isolating them from society. Thus, the goal of this paper is to discuss the social situation of the elderly in Brazil taken into consideration demographic, epidemiologic, and psychosocial. Emphasis is placed on retirement, the importance of the family, and on the interpersonal relationships.

Cuidar de pessoa incapacitada por acidente vascular cerebral no domicílio: o fazer do cuidador familiar

Estudio exploratorio, descriptivo y cuantitativo que busca identificar y describir las actividades del familiar que cuida de personas incapacitadas por ACV en el domicilio. La muestra estuvo constituida de 35 cuidadores familiares, predominantemente mujeres, esposas o hijas. Los cuidados realizados se relacionan con el grado de incapacidad del familiar. Las orientaciones recibidas denotan falta de compromiso de los profesionales con la continuidad del cuidado. El cuidador aprende a cuidar en el cotidiano, con base en la observacion y el auxilio prestado a enfermeria durante el internamiento. Las dificultades se pautan en el esfuerzo fisico, en la desinformacion y en el miedo, en el recelo y en la verguenza para lidiar con el cuerpo del otro. El estudio enfoca la necesidad de preparacion para la alta hospitalaria y resalta la familia como espacio concreto para el cuidado; el aumento de la expectativa de vida es una constatacion.An exploratory descriptive and quantitative study aimed at identifying and describing the activity of relatives in charge of caring at home for people incapacitated by cerebral vascular accident. The sample was comprised of 35 family caregivers, most of them women, wives or daughters. The care given is directly related to the degree of incapacity of the person who is being cared for. The orientation received indicated no commitment of professionals for the continuity of the care. The caregivers learn in daily practice how to care, based on observation and assistance to nursing during the internment period. The difficulties are related to physical effort, to lack of information and fear, to the embarassment and the shame of handling someone elses body. The study focuses on the need for preparation for hospital discharge, emphasizes the family as a concrete space for care; and observed an increase in life expectancy.

Técnica Delphi na validação das intervenções de enfermagem

O saber, a ciencia sao universais e vem se desenvolvendo muito rapidamente e, o enfermeiro, tem conhecimento de sua responsabilidade neste desenvolvimento cientifico. Com o objetivo de analisar a Tecnica Delphi, descrevendo a sua utilizacao na validacao das intervencoes de enfermagem aos lesados medulares em reabilitacao, foi possivel resultados fidedignos, por meio de uma tecnica de carater flexivel e, sobretudo, por valorizar a opiniao ou o conhecimento de cada um dos enfermeiros que atuam junto aos lesados medulares. Delphi permitiu aos especialistas apontarem as intervencoes preconizadas a esta clientela, mas este contexto teve requisitos necessarios que identificam o pensar-fazer em enfermagem.

Aspectos fisiopatológicos e assistenciais de enfermagem na reabilitação da pessoa com lesão medular

O traumatismo raquimedular e uma agressao a medula espinhal que pode ocasionar danos neurologicos, tais como alteracao das funcoes motora, sensitiva e autonoma. Este artigo tem como proposito relatar detalhadamente as principais complicacoes clinicas resultantes desse tipo de lesao, e apresentar as intervencoes assistenciais de enfermagem que possam auxiliar na promocao do bem estar e na melhoria da qualidade de vida dos pacientes, seja em carater de acometimento ja instalado ou profilatico.: Spinal cord injury can cause neurological damage such as alterations in the motor, sensitive and autonomic function. In this paper, details of clinical complications such as PVT, infection, respiratory insufficiency, pressure ulcers, autossomic disreflection, orthostatic hypotension, sphincteral-vesical and intestinal disfunctions, are related. And will also present prophylactic and therapeutic nursing care interventions designed for the well-being and improvement in life quality for patients.

O cuidar do enfermeiro especialista em reabilitação físico-motora

O processo de reabilitacao fisico-motora tem por objetivo principal a adaptacao das pessoas com deficiencia fisica as novas condicoes de vida. Este trabalho tem por objetivo descrever as atividades desenvolvidas pelo enfermeiro de reabilitacao em uma unidade de internacao de pacientes em reabilitacao fisico-motora e destacar sua importância frente a equipe de reabilitacao. Dentre as principais atividades desenvolvidas destacamos a manutencao das necessidades fisiologicas, onde a equipe de Enfermagem executa, orienta, demonstra, supervisiona e reavalia as condicoes de autocuidado destes pacientes. O enfermeiro atua, tambem, na prevencao de possiveis complicacoes que podem ocorrer frente a suscetibilidade peculiar desta clientela.The main objective of the physical-motor rehabilitation process is to help people with physical deficiency adapt to their new condition of life. This paper aims to describe the activities developed by the rehabilitation nurse in a unit for patients undergoing physical-motor rehabilitation and to detail his/her importance for the rehabilitation team. Among the most important activities carried out are the maintenance of the patients physiological needs, which the nursing staff executes, orients, demonstrates and supervises, and the reevaluation of the conditions of such patients to care for themselves. The nurse also acts in the prevention of possible complications that could occur given the unique susceptibility of this clientele.

Avaliação funcional de idoso vítima de fraturas na hospitalização e no domicílio

Trauma is often related to functional impairment, representing an important social, economic and health issue. This study intended to evaluate the functional independence of aged individuals with fractures, at admission, discharge and after one month from their regressing home. Furthermore, this study also intended to verify the relationship between functional independence and demographic and health variables. Thirty-four aged individuals hospitalized at the Orthopedics and Traumatology Institute of the University of São Paulo Faculty of Medicine were interviewed and submitted to the application of the Functional Independence Measure (FIM). Among all fractures, 67.6% were femur fractures. The motor and total FIM scores increased at discharge; on the other hand, the total FIM score decreased one month after their returning home. Functional impairment increased with age and also with longer length of stay. Hypothyroidism was related to cognitive impairment, while dementia and depression were related to motor impairment.Trauma is often related to functional impairment, representing an important social, economic and health issue. This study intended to evaluate the functional independence of aged individuals with fractures, at admission, discharge and after one month from their regressing home. Furthermore, this study also intended to verify the relationship between functional independence and demographic and health variables. Thirty-four aged individuals hospitalized at the Orthopedics and Traumatology Institute of the University of Sao Paulo Faculty of Medicine were interviewed and submitted to the application of the Functional Independence Measure (FIM). Among all fractures, 67.6% were femur fractures. The motor and total FIM scores increased at discharge; on the other hand, the total FIM score decreased one month after their returning home. Functional impairment increased with age and also with longer length of stay. Hypothyroidism was related to cognitive impairment, while dementia and depression were related to motor impairment.

Enfermagem em Reabilitação: ampliando os horizontes, legitimando o saber

The author makes reflections on Rehabilitation Nursing, marking the trajectory of this area in Nursing in terms of care, teaching and research. She discusses concepts and their applicability in Rehabilitation Nursing practice and presents the current demand for care in rehabilitation, as well as the capacity-building of nurses to work in this market, highlighting the pioneering initiatives of public institutions and higher education establishments in the city of Sao Paulo, which has made possible the specialization of nurses in Rehabilitation.

Fatores de risco para úlcera de pressão: subsídios para a prevenção

Uma das complicacoes mais severas para a pessoa com lesao medular e a ulcera de pressao. Sendo assim a prevencao destas feridas e a identificacao de fatores de risco sao necessidades prementes para o enfermeiro. Trata-se de um estudo decorrente de uma pesquisa mais abrangente, que abordou a assistencia de enfermagem ao lesado medular em reabilitacao buscando identificar os fatores de risco para ulcera de pressao utilizando os registros das enfermeiras nos historicosde enfermagem e a Taxonomia I da NANDA e analisar as intervencoes de enfermagem preconizados face ao diagnostico potencial para prejuizo na integridade da pele. Os fatores de risco identificados referem-se as alteracoes decorrentes da lesao neurologica, historia previa de ferida e lesao inicial. As intervencoes de enfermagem preconizadas totalizaram. 16, com carater de orientacao ao paciente e a familia voltadas para higiene corporal, mudanca de decubito, posicionamento no leito e em cadeira de rodas, denotando pertinencia ao diagnostico elaborado.

Alocação da equipe de enfermagem e ocorrência de eventos adversos/incidentes em unidade de terapia intensiva

A seguranca do paciente representa um desafio para a excelencia da qualidade no setor saude. Este estudo objetivou: verificar a adequacao entre a alocacao da equipe de enfermagem e as horas de cuidado requeridas pelos pacientes, bem como identificar a relacao entre essa alocacao com eventos adversos/incidentes (EA/I). Trata-se de pesquisa observacional, descritiva e prospectiva, desenvolvida nas Unidades de Terapia Intensiva Clinicas do 4o andar e 6o andar de um Hospital Universitario, do municipio de Sao Paulo, Brasil, no periodo de 01/11/07 a 10/12/07, com 46 pacientes. Nas UTIs 4o andar e 6o andar, respectivamente, 43,3% e 10,3% das alocacoes foram inadequadas (p = 0,000). Houve diferenca na frequencia de EA/I nas alocacoes adequadas e inadequadas da equipe de enfermagem da UTI 4o andar e UTI 6o andar, p = 0,0004 e p = 0,000, respectivamente. Concluiu-se que, quanto maior a diferenca entre as horas disponiveis e requeridas de cuidado nas alocacoes de enfermagem, menor a frequencia de EA/I.Patient safety is a challenge for the quality in health care system. This study aimed to analyze the appropriateness of the allocation of nursing staff according to the hours of care required by patients and to identify the relationship between this allocation and adverse events/incidents (EA/I). This research was observational, descriptive and prospective, developed in Clinics ICU located in the 4th floor and 6th floor at a university hospital, in São Paulo, Brazil, from 01/11/07 to 10/12/07, with 46 patients. In the 4th floor and 6th floor ICU, respectively, 43,3% and 10.3% of allocations were inadequate (p=0.000). There was a difference in the frequency of EA/I between the adequate and inadequate allocation of nursing staff in the 4th floor and 6th floor ICU, p=0.0004 and p=0.000, respectively. It was concluded that the greater the difference between available and required hours of care in nursing allocations, the lower the frequency of EA/I.

Nursing allocation and adverse events/incidents in intensive care units

A seguranca do paciente representa um desafio para a excelencia da qualidade no setor saude. Este estudo objetivou: verificar a adequacao entre a alocacao da equipe de enfermagem e as horas de cuidado requeridas pelos pacientes, bem como identificar a relacao entre essa alocacao com eventos adversos/incidentes (EA/I). Trata-se de pesquisa observacional, descritiva e prospectiva, desenvolvida nas Unidades de Terapia Intensiva Clinicas do 4o andar e 6o andar de um Hospital Universitario, do municipio de Sao Paulo, Brasil, no periodo de 01/11/07 a 10/12/07, com 46 pacientes. Nas UTIs 4o andar e 6o andar, respectivamente, 43,3% e 10,3% das alocacoes foram inadequadas (p = 0,000). Houve diferenca na frequencia de EA/I nas alocacoes adequadas e inadequadas da equipe de enfermagem da UTI 4o andar e UTI 6o andar, p = 0,0004 e p = 0,000, respectivamente. Concluiu-se que, quanto maior a diferenca entre as horas disponiveis e requeridas de cuidado nas alocacoes de enfermagem, menor a frequencia de EA/I.Patient safety is a challenge for the quality in health care system. This study aimed to analyze the appropriateness of the allocation of nursing staff according to the hours of care required by patients and to identify the relationship between this allocation and adverse events/incidents (EA/I). This research was observational, descriptive and prospective, developed in Clinics ICU located in the 4th floor and 6th floor at a university hospital, in São Paulo, Brazil, from 01/11/07 to 10/12/07, with 46 patients. In the 4th floor and 6th floor ICU, respectively, 43,3% and 10.3% of allocations were inadequate (p=0.000). There was a difference in the frequency of EA/I between the adequate and inadequate allocation of nursing staff in the 4th floor and 6th floor ICU, p=0.0004 and p=0.000, respectively. It was concluded that the greater the difference between available and required hours of care in nursing allocations, the lower the frequency of EA/I.