Angélica Gonçalves Silva Belasco

Qualidade de vida de cuidadores de idosos com doença de Alzheimer

Objectives: To evaluate quality of life among caregivers of elders with Alzheimer’s disease and to examine the relationship between patients’ quality of life score measured with the Katz Quality of Life Index and the relationship between the caregivers’ quality of life measured with the SF-36 and depression score measured with the Beck Depression Inventory (BDI). Methods: This study was conducted in a geriatric clinic (Nucleo de Envelhecimento Cerebral) of the Sao Paulo Hospital of the Federal University of Sao Paulo. The sample consisted of 118 patients with Alzheimer’s disease and their caregivers. Sociodemographic and cormobidity data and the Katz score of quality of life and the mini-mental status examination (MMSE) score of the patients with Alzheimer’s disease were obtained through chart review. Data from caregivers comprised sociodemographic and comorbidity data and the SF-36 score of quality of life and the BDI score of depression. Results: SF-36 scores that were indicative of depression among caregivers were vitality (score = 56.8) and the scores on physical and emotional components were = 58.1, respectively. There was a significantly negative correlation between the caregivers’ BDI score and the patients’ Katz score, and between the caregivers’ SF-36 and BDI scores. There was also a significantly positive correlation between the scores of the caregivers’ SF-36 and the patients’ Katz scores and between the patient’s Katz and MMSE scores. Conclusion: The quality of life of caregivers of patients with Alzheimer’s disease was compromised, which could influence the quality of care they provided to the patients. The quality of life of the caregivers got worse when the functional capacity of the elders with Alzheimer’s disease was compromised.

Diagnósticos de enfermagem em portadores da Síndrome da Imunodeficiência Adquirida

Os objetivos deste estudo foram identificar os diagnosticos de enfermagem mais frequentes segundo a taxonomia II da NANDA em pacientes adultos portadores de HIV/aids e verificar com que frequencia as caracteristicas definidoras, os fatores relacionados e de risco deram suporte para a elaboracao destes. O levantamento dos dados foi realizado pelos pesquisadores nos 60 pacientes internados com HIV/aids e depois feita a verificacao se os requisitos propostos pela NANDA para realizacao dos DE eram adequados. Foram selecionados 13 dos 38 diagnosticos com frequencia igual ou superior a 80%. Os resultados indicaram concordância e adequacoes para identificacao. Porem, novos estudos serao necessarios tanto para confirmacao dos achados, assim como trazer novos conhecimentos ao assunto e estimular a pesquisa nesta populacao de pacientes.

Co-morbidade e mortalidade de pacientes em início de diálise

OBJECTIVES: to identify to the co-morbity and causes of mortality of the patients in beginning of dialysis and to analyze if the personal variables, the co-morbity, the laboratory results, the number of days of internment and number of dialysis sessions are factors of risk for mortality. METHODS: was included in this study 102 patients who had initiated dialysis treatment in a university hospital. The prospective record was realized to collect personals data, laboratory data, morbity and mortality. RESULTS: the arterial hypertension and the infection was more frequent causes of co-morbity (58,8%). The infection locality more frequent was the blood circulation in 30 (50%). CONCLUSION: the majority of the patients who had arrived at the service was in dialysis urgency; the morbity most prevalent was the arterial hypertension and the infection; the infection locality more frequent was the blood circulation related to the use of the central venous catheter; and that the male sex, the white race, the uremia, and the morbity arterial hypertension and infection, had been the ones that more contributed for the increase of the mortality risk.OBJETIVOS: identificar el co-morbidad y las causas de la mortalidad de los pacientes en el principio de la dialisis y analizar si resultan las variables personales, el co-morbidad, los dados laboratoriais, del numero de dias de la internacion y del numero de las sesiones de la dialisis son factores del riesgo para la mortalidad. METODOS: fueron incluido 102 pacientes en el estudio que habian iniciado el tratamiento de la dialisis en un hospital de la universidad. Fue realizado uno registro de los dados personales, laboratoriais, de la morbidad y de la mortalidad. RESULTADOS: la hipertension arterial y las infecciones eram las mas frecuente causas de la co-morbidad (58,8%). El local de la infeccion mas frecuente era la circulacion del sangre en 30 (50%). CONCLUSAO: la mayoria de los pacientes que habian llegado el servicio estaban en urgencia de la dialisis; el morbidad mas frecuente era el hipertension arterial y la infeccion; el local de la infeccion mas frecuente era la circulacion del sangre relacionada con el uso del cateter venoso central; y que el sexo masculino, la raza blanca, la uremia y las morbidad la hipertension arteriale y la infeccion, habian sido los ese contribuido mas para el aumento del riesgo de la mortalidad.

Incidence of bloodstream infection among patients on hemodialysis by central venous catheter

O objetivo deste estudo foi avaliar a incidencia e os fatores de risco de infeccao da corrente sanguinea (ICS) em pacientes com cateter venoso central (CVC) duplo lumen, para hemodialise (HD) e identificar os micro-organismos isolados na corrente sanguinea. Como metodo, usou-se o follow up, realizado no periodo de um ano, incluindo todos os 156 pacientes que estavam em tratamento de HD por CVC duplo lumen, na Universidade Federal de Sao Paulo - UNIFESP. Os resultados mostraram que dos 156 pacientes estudados, 94 apresentaram ICS, desses, 39 tiveram culturas positivas no local de insercao do cateter. Dos 128 micro-organismos isolados da corrente sanguinea, 53 eram S.aureus, dos quais 30 eram sensiveis a metilcilina e 23 resistentes. Entre as complicacoes relacionadas a ICS, houve 35 casos de septicemia e 27 casos de endocardite, dos quais 15 progrediram a obito. A incidencia de ICS neste grupo de pacientes mostrou-se bastante elevada bem como sua progressao para quadros infecciosos de grande magnitude e obito.This study evaluated the incidence and risk factors of bloodstream infection (BSI) among patients with a double-lumen central venous catheter (CVC) for hemodialysis (HD) and identified the microorganisms isolated from the bloodstream. A follow-up included all patients (n=156) who underwent hemodialysis by double-lumen CVC at the Federal University of São Paulo-UNIFESP, Brazil, over a one-year period. From the group of patients, 94 presented BSI, of whom 39 had positive cultures at the central venous catheter insertion location. Of the 128 microorganisms isolated from the bloodstream, 53 were S. aureus, 30 were methicillin-sensitive and 23 were methicillin-resistant. Complications related to BSI included 35 cases of septicemia and 27 cases of endocarditis, of which 15 cases progressed to death. The incidence of BSI among these patients was shown to be very high, and this BSI progressed rapidly to the condition of severe infection with a high mortality rate.

Qualidade de vida de pacientes com acidente vascular cerebral em reabilitação

OBJETIVOS: Avaliar e correlacionar a qualidade de vida e depressao de pacientes apos acidente vascular cerebral em reabilitacao. METODOS: Estudo transversal realizado em dois servicos de reabilitacao, com pacientes de acidente vascular cerebral. As informacoes coletadas foram sociodemograficas, o Medical Outcome Study 36 - item short-form health survey, o Stroke Specific Quality of Life Scale, o Indice de Barthel e o Inventario de Depressao de Beck. RESULTADOS: A amostra foi constituida de 139 pacientes, idade media 59,4 anos e 59% eram homens. Houve comprometimento dos escores da qualidade de vida geral e especifica. Segundo o Indice de Barthel 49,6% dos pacientes apresentavam dependencia moderada a severa e 49,7% tinham sintomas depressivos, conforme Inventario de Depressao de Beck, nao havendo correlacao positiva entre estes dados e qualidade de vida geral e especifica. CONCLUSAO: A qualidade de vida geral e especifica dos pacientes com acidente vascular cerebral, em reabilitacao, apresentou dominios comprometidos.

Taking care of children with cancer: evaluation of the caregivers' burden and quality of life

El cancer es una enfermedad de alta incidencia entre ninos, los que necesitan de un cuidador durante el tratamiento. Se tuvo por objetivo evaluar la sobrecarga de cuidado y la calidad de vida (CV) de los cuidadores de ninos/adolescentes portadores de cancer durante el tratamiento quimioterapico, y relacionarlas entre si y a los datos sociodemograficos, y a la presencia y grado de senales de depresion. Se trata de un estudio transversal, con 32 cuidadores. Fueron recolectados datos sociodemograficos, sobrecarga de cuidado (Caregiver Burden Scale) y de CV a traves del SF-36. El 87,5% de los cuidadores eran madres, la edad promedio fue 35 anos, el puntaje general de sobrecarga fue 1,92±0,09 y los puntajes del SF-36 mas comprometidos fueron: aspectos emocionales (59,3), vitalidad (60,0) y dolor (60,9). Se encontro correlacion significativa entre sobrecarga, salud mental y vitalidad. Concluimos que los cuidadores presentaron sobrecarga de cuidado y aspectos de CV comprometidos y posiblemente necesitan de intervenciones que promuevan el bienestar fisico, el social y el emocional, para disminuir la sobrecarga y mejorar la CV, y asi consecuentemente mejorar la asistencia.El cancer es una enfermedad de alta incidencia entre ninos, los que necesitan de un cuidador durante el tratamiento. Se tuvo por objetivo evaluar la sobrecarga de cuidado y la calidad de vida (CV) de los cuidadores de ninos/adolescentes portadores de cancer durante el tratamiento quimioterapico, y relacionarlas entre si y a los datos sociodemograficos, y a la presencia y grado de senales de depresion. Se trata de un estudio transversal, con 32 cuidadores. Fueron recolectados datos sociodemograficos, sobrecarga de cuidado (Caregiver Burden Scale) y de CV a traves del SF-36. El 87,5% de los cuidadores eran madres, la edad promedio fue 35 anos, el puntaje general de sobrecarga fue 1,92±0,09 y los puntajes del SF-36 mas comprometidos fueron: aspectos emocionales (59,3), vitalidad (60,0) y dolor (60,9). Se encontro correlacion significativa entre sobrecarga, salud mental y vitalidad. Concluimos que los cuidadores presentaron sobrecarga de cuidado y aspectos de CV comprometidos y posiblemente necesitan de intervenciones que promuevan el bienestar fisico, el social y el emocional, para disminuir la sobrecarga y mejorar la CV, y asi consecuentemente mejorar la asistencia.

Evaluation of quality of life and depression in nursing technicians and nursing assistants

O objetivo deste estudo foi avaliar a qualidade de vida (QV) e depressao e relaciona-los as caracteristicas sociodemograficas de tecnicos e auxiliares de enfermagem de um hospital privado. Trata-se de estudo epidemiologico e transversal. A quantidade de tecnicos e auxiliares que participaram deste estudo foi de 266. Os instrumentos aplicados foram o WHOQOL-bref e o inventario de depressao de Beck. A avaliacao da qualidade de vida dos tecnicos e auxiliares de enfermagem apresentou valores proximos aqueles encontrados em individuos com patologias cronicas. A presenca de problemas de saude levou a maior indice de depressao e menor escore de QV no aspecto geral e psicologico e se correlacionaram a atividade laboral. Trabalhadores do periodo noturno apresentaram escores mais elevados de depressao. Conhecer fatores desencadeantes dos problemas de saude e alteracao da qualidade de vida, relacionados as atividades profissionais, pode instrumentalizar a busca de alternativas para sanar ou minimizar seus efeitos.The aim of this study was to evaluate the quality of life (QoL) and depression, and relate them to the sociodemographic characteristics of nursing technicians and nursing assistants in a private hospital. This was an epidemiological and cross-sectional study. The number of technicians and assistants who participated in this study was 266. The instruments used were the WHOQOL-BREF and the Beck Depression Inventory. The evaluation of quality of life of nursing technicians and assistants showed similar values to those found in individuals with chronic diseases. The presence of health problems led to higher indices of depression and lower QoL scores in the general and psychological domains and correlated to labor activity. Night-shift workers had higher scores of depression. Understanding factors, related to professional activities, which trigger health problems and alter quality of life, can provide tools in the search for alternatives to remedy or mitigate their effects.

Quality of life among caregivers of elders with Alzheimer's disease

Objectives: To evaluate quality of life among caregivers of elders with Alzheimer’s disease and to examine the relationship between patients’ quality of life score measured with the Katz Quality of Life Index and the relationship between the caregivers’ quality of life measured with the SF-36 and depression score measured with the Beck Depression Inventory (BDI). Methods: This study was conducted in a geriatric clinic (Nucleo de Envelhecimento Cerebral) of the Sao Paulo Hospital of the Federal University of Sao Paulo. The sample consisted of 118 patients with Alzheimer’s disease and their caregivers. Sociodemographic and cormobidity data and the Katz score of quality of life and the mini-mental status examination (MMSE) score of the patients with Alzheimer’s disease were obtained through chart review. Data from caregivers comprised sociodemographic and comorbidity data and the SF-36 score of quality of life and the BDI score of depression. Results: SF-36 scores that were indicative of depression among caregivers were vitality (score = 56.8) and the scores on physical and emotional components were = 58.1, respectively. There was a significantly negative correlation between the caregivers’ BDI score and the patients’ Katz score, and between the caregivers’ SF-36 and BDI scores. There was also a significantly positive correlation between the scores of the caregivers’ SF-36 and the patients’ Katz scores and between the patient’s Katz and MMSE scores. Conclusion: The quality of life of caregivers of patients with Alzheimer’s disease was compromised, which could influence the quality of care they provided to the patients. The quality of life of the caregivers got worse when the functional capacity of the elders with Alzheimer’s disease was compromised.

Perfil epidemiológico dos pacientes portadores de doença inflamatória intestinal do estado de Mato Grosso

Estudos epidemiologicos recentes sugerem que a incidencia da doenca de Crohn (DC) e da retocolite ulcerativa (RCUI) esta aumentando no Brasil, apesar de desconhecermos sua taxa real. OBJETIVO: Descrever o perfil epidemiologico dos pacientes com doenca inflamatoria intestinal (DII) que residem no estado de Mato Grosso. RESULTADOS: Foram avaliados 220 pacientes com doenca inflamatoria intestinal, 125 eram do sexo feminino e 95 do sexo masculino. Do total de casos, 117 tinham RCUI, 86 doenca de Crohn e 17 colite indeterminada. A doenca foi mais frequente em casados (66,0%), em pacientes de cor parda (48,0%) e em nao fumantes (61,8%). A media da idade foi de 39 anos, variando de 6 a 80 anos. Em algum momento da evolucao da doenca, 77 (35%) pacientes necessitaram de tratamento cirurgico. A media de anos dos pacientes estudados foi de 9,17 anos, variando de 0 a 20 anos estudados. CONCLUSAO: Apesar da pouca literatura sobre a doenca, os dados deste estudo revelam que os portadores de DII, no estado de Mato Grosso, apresentam caracteristicas epidemiologicas semelhantes aos portadores de outros estados do Brasil.

Risk factors for bloodstream infection in patients at a Brazilian hemodialysis center: a case–control study

BackgroundInfection is the leading cause of morbidity and the second leading cause of mortality in patients on renal replacement therapy. The rates of bloodstream infection in hemodialysis patients vary according to the type of venous access used. Gram-positive bacteria are most frequently isolated in blood cultures of hemodialysis patients. This study evaluated risk factors for the development of bloodstream infections in patients undergoing hemodialysis.MethodsRisk factors associated with bloodstream infections in patients on hemodialysis were investigated using a case–control study conducted between January 2010 and June 2013. Chronic renal disease patients on hemodialysis who presented with positive blood cultures during the study were considered as cases. Controls were hemodialysis patients from the same institution who did not present with positive blood cultures during the study period. Data were collected from medical records. Logistic regression was used for statistical analysis.ResultsThere were 162 patients included in the study (81 cases and 81 controls). Gram-positive bacteria were isolated with the highest frequency (72%). In initial logistic regression analysis, variables were hypertension, peritoneal dialysis with previous treatment, type and time of current venous access, type of previous venous access, previous use of antimicrobials, and previous hospitalization related to bloodstream infections. Multiple regression analysis showed that the patients who had a central venous catheter had an 11.2-fold (CI 95%: 5.17–24.29) increased chance of developing bloodstream infections compared with patients who had an arteriovenous fistula for vascular access. Previous hospitalization increased the chance of developing bloodstream infections 6.6-fold (CI 95%: 1.9–23.09).ConclusionsInfection prevention measures for bloodstream infections related to central venous catheter use should be intensified, as well as judicious use of this route for vascular access for hemodialysis. Reducing exposure to the hospital environment through admission could contribute to a reduction in bloodstream infections in this population.