Anelise Crippa

Aspectos bioéticos nas publicações sobre cuidados paliativos em idosos: análise crítica

AbstractThe present study aimed to identify existing studies of bioethics and palliative care among the elderly, and describes cases encountered with a publication date between 2002 and 2013. Publications in the PubMed, Cochrane, Embase, Lilacs, SciELO and Ibecs databases were identified using the keywords “bioethics” AND “palliative care” AND “aged”. Following methodological selection, 16 articles were identified. There were few studies relating to bioethics and palliative care, confirming a lack of literature in this area. Therefore additional studies are required to increase understanding of this theme and the ethical knowledge of health professionals.Keywords: Bioethics. Palliative care. Aged. Resumo Aspectos bioeticos nas publicacoes sobre cuidados paliativos em idosos: analise criticaA presente investigacao objetivou identificar as publicacoes existentes sobre bioetica e cuidados paliativos em idosos no periodo entre 2002 e 2013, descrevendo os casos encontrados. Para isso, foram investigadas as bases de dados PubMed, Cochrane, Embase, Lilacs, SciELO e Ibecs, buscando publicacoes com as palavras--chave “A presente investigacao objetivou identificar as publicacoes existentes sobre bioetica e cuidados paliativos em idosos no periodo entre 2002 e 2013, descrevendo os casos encontrados. Para isso, foram investigadas as bases de dados PubMed, Cochrane, Embase, Lilacs, SciELO e Ibecs, buscando publicacoes com as palavras-chave “bioethics” AND “palliative care” AND “aged”. Foram encontrados 16 artigos que realmente tratavam de bioetica e cuidados paliativos em idosos. Pode-se verificar que sao poucos os estudos relacionando bioetica e cuidados paliativos, comprovado pela escassa literatura sobre o tema. Assim, o levantamento indica a necessidade de outros trabalhos destinados a aprofundar a tematica e aprimorar o conhecimento eticamente correto dos profissionais da saude.

Avaliação da capacidade de decisão de idosos diagnosticados com depressão maior

*** Assessment of the decision-making capacity of elderly individuals diagnosed with major depression *** AIMS: To verify if there are changes in the decision-making capacity of elderly patients with major depression. METHODS: This is a prospective cohort study with an initial cross-sectional analysis conducted between January 2014 and September 2015. Treatment-naive elderly patients from the Cerebral Aging Outpatient Clinic at PUCRS Sao Lucas Hospital, in Porto Alegre, Brazil, all diagnosed with major depressive disorder, were selected. The control group was composed of elderly individuals from the same community who had neither depression nor cognitive problems. For evaluation of the decision-making capacity, the Assessment Scale for Decision-Making Capacity was designed and validated in a previous stage of the research. This instrument is divided into four domains: daily activity, financial management, self-management, and well-being. The Geriatric Depression Scale (short version) and the Mini-International Neuropsychiatric Interview (detailed version) were used to evaluate the presence of depression. The Vellore Screening Instrument for Dementia and the Addenbrooke’s Cognitive Examination (revised version) were applied to evaluate cognitive decline. Decision-making capacity was compared between the two groups of elderly individuals. The same evaluation was conducted with elderly patients with depression after six months of psychiatric treatment. The statistical analysis included Student’s t, Pearson’s chi-square, Mann-Whitney, and Wilcoxon tests. Statistical significance was set at p≤0.05. RESULTS: Forty-eight elderly patients with major depression and 144 elderly individuals from the control group participated in the study. The Assessment Scale for Decision-Making Capacity average score in depression patients was 70.5±17.9, compared to 94.6±9.6 (p<0.001) in the control group, which indicates poorer decision-making capacity among patients with major depression. The domains with the most striking differences in the average scores were self-management (depression patients 65.0±23.3 and control group 97.8±6.2) and well-being (depression patients 52.2±27.1 and control group 91.8±16.7). When comparing patients with depression before and after treatment, regarding both the general score and the four domains of the Assessment Scale for Decision-Making Capacity, the decision-making capacity was higher after the treatment. CONCLUSIONS: The group of elderly patients with current major depression had a lower decision-making capacity compared to the control group. Their decision-making capacity improved after six months of psychiatric treatment.

Autonomia do idoso: escala de avaliação de capacidade de decisão

The objective of this paper was to create and validate an instrument capable of assisting in actions related to interdiction, allowing for a uniform evaluation among cases. For this purpose, a construct with 30 questions was developed and subjected to expert evaluation. Thus, the ESCADE - Decisional Capacity Assessment Scale was created, with 18 final questions, adequate reliability and validity and Cronbach’s alpha of 0.814, being divided into four domains: daily activity, financial management, self-management and well-being. It is concluded, therefore, that this is an auxiliary questionnaire seeking to instrumentalize the judicial analysis with pertinence and effectiveness for this task, and it is also important to highlight the feasibility of identifying, through the presented domains, the area of greatest difficulty presented by a possible interdiction, which may lead to its use for supported decision-making as well.

Abstracts from the 10th South-Brazilian Congress of Geriatrics and Gerontology and de 19th Winter Meeting of the Brazilian Society of Geriatrics and Gerontology – Rio Grande do Sul

PAJAR (Pan American Journal of Aging Research) presents to the scientific community its first supplement with the Abstracts from the 10th South-Brazilian Congress of Geriatrics and Gerontology and de 19th Winter Meeting of the Brazilian Society of Geriatrics and Gerontology – Rio Grande do Sul, held in the city of Bento Goncalves / RS in the period of July 6 to 8, 2017.

Elderly and Social Security: aid application for disease affected by the depression of the insured

In Brazil, by contributing to Social Security, workers are supported in cases of old age, death, maternity, illness and disability through stipends. This article seeks answers about the possibility of granting sick pay due to depression of the Social Security insured. For this purpose, we analyzed how this fundamental right to social security works by granting the benefit on grounds of this illness. Firstly, the concept, history and legal provision of Social Security is addressed. Secondly, the benefit in question is investigated, and its concept, legal provision and requirements needed for getting it are presented. Lastly, a study of depression and its symptoms is conducted. This article is based on bibliographic and documentary research, with an exploratory and descriptive nature, through the collection of data from laws, legal articles, standards, resolutions, jurisprudence, on-line searches, among others dealing with the subject. It was demonstrated that it is possible to grant sick pay for depression, however, on a secondary basis, as the total disability of the worker must be proven and a medical examination is required. Nevertheless, even if in certain cases the benefit is denied, no affront to this fundamental right has been evidenced.

Aspectos bioéticos en las publicaciones sobre los cuidados paliativos en las personas mayores: análisis crítico

AbstractThe present study aimed to identify existing studies of bioethics and palliative care among the elderly, and describes cases encountered with a publication date between 2002 and 2013. Publications in the PubMed, Cochrane, Embase, Lilacs, SciELO and Ibecs databases were identified using the keywords “bioethics” AND “palliative care” AND “aged”. Following methodological selection, 16 articles were identified. There were few studies relating to bioethics and palliative care, confirming a lack of literature in this area. Therefore additional studies are required to increase understanding of this theme and the ethical knowledge of health professionals.Keywords: Bioethics. Palliative care. Aged. Resumo Aspectos bioeticos nas publicacoes sobre cuidados paliativos em idosos: analise criticaA presente investigacao objetivou identificar as publicacoes existentes sobre bioetica e cuidados paliativos em idosos no periodo entre 2002 e 2013, descrevendo os casos encontrados. Para isso, foram investigadas as bases de dados PubMed, Cochrane, Embase, Lilacs, SciELO e Ibecs, buscando publicacoes com as palavras--chave “A presente investigacao objetivou identificar as publicacoes existentes sobre bioetica e cuidados paliativos em idosos no periodo entre 2002 e 2013, descrevendo os casos encontrados. Para isso, foram investigadas as bases de dados PubMed, Cochrane, Embase, Lilacs, SciELO e Ibecs, buscando publicacoes com as palavras-chave “bioethics” AND “palliative care” AND “aged”. Foram encontrados 16 artigos que realmente tratavam de bioetica e cuidados paliativos em idosos. Pode-se verificar que sao poucos os estudos relacionando bioetica e cuidados paliativos, comprovado pela escassa literatura sobre o tema. Assim, o levantamento indica a necessidade de outros trabalhos destinados a aprofundar a tematica e aprimorar o conhecimento eticamente correto dos profissionais da saude.

Bioethical issues in publications about palliative care of the elderly: critical analysis

AbstractThe present study aimed to identify existing studies of bioethics and palliative care among the elderly, and describes cases encountered with a publication date between 2002 and 2013. Publications in the PubMed, Cochrane, Embase, Lilacs, SciELO and Ibecs databases were identified using the keywords “bioethics” AND “palliative care” AND “aged”. Following methodological selection, 16 articles were identified. There were few studies relating to bioethics and palliative care, confirming a lack of literature in this area. Therefore additional studies are required to increase understanding of this theme and the ethical knowledge of health professionals.Keywords: Bioethics. Palliative care. Aged. Resumo Aspectos bioeticos nas publicacoes sobre cuidados paliativos em idosos: analise criticaA presente investigacao objetivou identificar as publicacoes existentes sobre bioetica e cuidados paliativos em idosos no periodo entre 2002 e 2013, descrevendo os casos encontrados. Para isso, foram investigadas as bases de dados PubMed, Cochrane, Embase, Lilacs, SciELO e Ibecs, buscando publicacoes com as palavras--chave “A presente investigacao objetivou identificar as publicacoes existentes sobre bioetica e cuidados paliativos em idosos no periodo entre 2002 e 2013, descrevendo os casos encontrados. Para isso, foram investigadas as bases de dados PubMed, Cochrane, Embase, Lilacs, SciELO e Ibecs, buscando publicacoes com as palavras-chave “bioethics” AND “palliative care” AND “aged”. Foram encontrados 16 artigos que realmente tratavam de bioetica e cuidados paliativos em idosos. Pode-se verificar que sao poucos os estudos relacionando bioetica e cuidados paliativos, comprovado pela escassa literatura sobre o tema. Assim, o levantamento indica a necessidade de outros trabalhos destinados a aprofundar a tematica e aprimorar o conhecimento eticamente correto dos profissionais da saude.

Pedidos judiciais de idosos para tratamento de fisioterapia no Tribunal de Justiça do Rio Grande do Sul analisados à luz dos princípios bioéticos

Introducao : A Carta Magna brasileira garante a sua populacao o direito a saude. Muitos sao os casos de pedidos judiciais para poder fazer jus ao que lhe e assegurado. Nesta seara insere-se a fisioterapia, tratamento de reabilitacao, promocao e prevencao. Essas formas estao previstas tambem no Estatuto do Idoso, como um direito a saude. Os principios bioeticos da beneficencia e da justica justificam em seu prisma, os pedidos relativos a esse direito. A beneficencia se associa com a benevolencia, buscando o bem e interesses do paciente, e da justica atraves de tratamento equitativo e apropriado. Objetivos : Identificar no Tribunal de Justica do Rio Grande do Sul, a quantidade de pedidos que os idosos fazem para tratamento de fisioterapia; o sexo do idoso envolvido; a comarca do pedido original; o motivo que resultou no pedido; e o tipo do pedido. Metodos : Analise jurisprudencial, no ano de 2012, dos pedidos judiciais envolvendo o vocabulo fisioterapia. Os dados foram armazenados em planilha Excel. Resultados : Foram encontrados 105 pedidos judiciais, em 2012, com o vocabulo “fisioterapia”. Desses, apenas 10 correspondiam a pedidos feitos por idosos. Destes 50% foram feitos por homens e 50% por mulheres. Oito comarcas envolviam pedidos de idosos para tratamento de fisioterapia: Caxias do Sul (1), Porto Alegre (2), Santa Maria (1), Santana do Livramento (1), Santo Ângelo (1), Sao Leopoldo (1), Sao Pedro do Sul (2) e Vacaria (1). Apenas dois casos (20%) relataram a causa do tratamento: queda dentro de um coletivo e um esbarrao. A maioria dos pedidos requereu a fisioterapia genericamente. Apenas uma das demandas especificou o pedido para fisioterapia motora e respiratoria. Consideracoes finais : Apesar da fisioterapia ser um direito de todos pode-se perceber a necessidade das pessoas em ingressar com processos para ter esse direito atendido. Destaca-se tambem o reduzido numero de casos envolvendo idosos.