Antonio Carlos Duarte de Carvalho

Reflexões de idosos participantes de grupos de promoção de saúde acerca do envelhecimento e da qualidade de vida

O aumento no numero de idosos nas ultimas decadas tem motivado o interesse pelo estudo do envelhecimento e dos fatores associados a qualidade de vida desta populacao. No Brasil, importantes avancos no campo da saude tem sido conquistados, sendo que a Estrategia Saude da Familia (ESF) surge com potencial para tornar concreta a participacao da comunidade e a integralidade das acoes. Neste sentido, objetivou-se analisar as percepcoes dos idosos em relacao a sua qualidade de vida apos a adesao a Grupos de Promocao de Saude (GPS). A pesquisa foi feita na abordagem qualitativa, sendo os dados coletados por meio da entrevista semiestruturada e da observacao participante. Nas analises, realizadas atraves da analise de conteudo tematico, foram identificados seis grandes temas: Sentimentos em relacao a como e ser idoso no Brasil; Satisfacao com a Saude; Significados de qualidade de vida; Satisfacao com a vida; Importância das atividades sociais e de lazer para qualidade de vida; Os GPS. Estes sugerem que os sujeitos da pesquisa valorizam a independencia e autonomia na realizacao de suas atividades e atribuem uma vida saudavel a comportamentos adequados em relacao aos cuidados com a saude, destacando as atividades de lazer, a participacao nos GPS e os bons relacionamentos como imprescindiveis para satisfacao com a vida, apontando para uma visao de saude positiva, na qual tais atividades, em especial a participacao nos GPS, tornaram-se relevantes para a qualidade de vida e para a formacao de uma rede social de cuidado que integrou a comunidade e os servicos de saude.O aumento no numero de idosos nas ultimas decadas tem motivado o interesse pelo estudo do envelhecimento e dos fatores associados a qualidade de vida desta populacao. No Brasil, importantes avancos no campo da saude tem sido conquistados, sendo que a Estrategia Saude da Familia (ESF) surge com potencial para tornar concreta a participacao da comunidade e a integralidade das acoes. Neste sentido, objetivou-se analisar as percepcoes dos idosos em relacao a sua qualidade de vida apos a adesao a Grupos de Promocao de Saude (GPS). A pesquisa foi feita na abordagem qualitativa, sendo os dados coletados por meio da entrevista semiestruturada e da observacao participante. Nas analises, realizadas atraves da analise de conteudo tematico, foram identificados seis grandes temas: Sentimentos em relacao a como e ser idoso no Brasil; Satisfacao com a Saude; Significados de qualidade de vida; Satisfacao com a vida; Importância das atividades sociais e de lazer para qualidade de vida; Os GPS. Estes sugerem que os sujeitos da pesquisa valorizam a independencia e autonomia na realizacao de suas atividades e atribuem uma vida saudavel a comportamentos adequados em relacao aos cuidados com a saude, destacando as atividades de lazer, a participacao nos GPS e os bons relacionamentos como imprescindiveis para satisfacao com a vida, apontando para uma visao de saude positiva, na qual tais atividades, em especial a participacao nos GPS, tornaram-se relevantes para a qualidade de vida e para a formacao de uma rede social de cuidado que integrou a comunidade e os servicos de saude.

Medicalização de mulheres idosas e interação com consumo de calmantes

Abstract In this study we researched into the interaction be-tween gender, aging and particularized consumptionof tranquilizers (benzodiazepines), aiming to unders-tand how, within the process of medicalization of so-ciety, this interaction interferes in the way of usingand in conceptions about tranquilizers, and how theyare (re)signified by their cons umers. In the study, semi-structured interviews with 18 elderly females wereperformed and a qualitative approach was used in theanalysis of the collected data. These women belongedto low-income classes in the city of Ribeirao Preto(state of Sao Paulo). They were psychiatric patientsassisted in the public outpatient clinic of the MentalHealth Nucleus of the Health Teaching Centre at theRibeirao Preto Medical School, University of Sao Pau-lo (FMRP-USP). We observed that the consumption oftranquilizers is intensified among elderly females,as they begin to deal with conflicts and daily mattersby using medications. As the elderly females havebeen attending the health services for several years,the psychiatric ones among them, they manage to in-corporate knowledge and experiences about the useof tranquilizers, promoting their diffusion in the so-cial circle.Keywords: Gender; Old Age; Elderly individuals; Tran-quilizers; Benzodiazepines; Medicalization.

Properties of the Duke Religious Index in a sample of postgraduate students

Address correspondence to: Edson Zangiacomi Martinez. Departamento de Medicina Social. Faculdade de Medicina de Ribeirao Preto, USP. Av. Bandeirantes, 3900, Monte Alegre – 14049-900 – Ribeirao Preto, SP, Brasil. E-mail: edson@fmrp.usp.br Dear Editor, Several studies have shown an association between religiousness and different aspects of physical or mental health1, and this makes important the articles as the one published by Taunay et al.2, which aimed to study the psychometric properties of the Brazilian version of the Duke Religious Index (P-DUREL) in psychiatric and university student samples. The instrument showed adequate internal consistency and test-retest reliability in both samples2. We wish to add that using data from a study conducted by our group (not yet published) about the associations between religiousness and attitudes towards blood donation among postgraduate students of courses in the health area, we found a Cronbach’s alpha of 0.88 for the P-DUREL and 0.89 for the intrinsic religiosity (IR) scale in a sample of 160 individuals. We found Spearman correlation coefficients between the domains of organizational (OR) and non-organizational (NOR) religiosity of 0.58, between the domains of IR and OR 0.58, and between NOR and IR of 0.62 (all p-values less than 0.01). These results are similar to those of Taunay et al.2, suggesting that the psychometric properties of P-DUREL are also satisfactory for this specific group. In addition, a single factor with eigenvalue equal to 3.5 was retained in an exploratory factor analysis (principal components), expla ining 70.2% of the variance. The KMO (Kaiser-Meyer-Olkin) index of sample adequacy was 0.85, suggesting the adequacy of the factor analysis. These results are similar to those obtained by Storch et al.3 considering the English version of the instrument. In our data, we not found significant correlation between the age of the subjects and the OR, NOR and IR scores. We found positive Spearman correlations between the P-DUREL scores and the two subscales of the Spiritual Well-Being (SWB) questionnaire of Paloutzian and Ellison4 [OR and Religious Well-Being (RWB), r = 0.51; OR and Existential Well-Being (EWB), r = 0.23; NOR and RWB, r = 0.65; NOR and EWB, r = 0.26; IR and RWB, r = 0.77, IR and EWB, r = 0.43, all pvalues less than 0.01]. We observed that women tend to have higher scores in all three domains of P-DUREL than males (Wilcoxon test, p-values less than 0.01, result already showed by Lucchetti et al.5). Although in our sample the Evangelical and Protestant respondents have shown higher mean scores for the three domains (17.2 for the IR, 4.9 for the OR and 4.3 for the NOR; compared with means of 15.4 for the IR, 4.0 for the OR and 4.4 for the NOR when considered the Catholic respondents, and 15.7 for the IR, 4.0 for the OR and 4.2 for the NOR when considered the Spiritist respondents), we have no evidence of a ceiling effect for the scales. These findings support the psychometric properties of the scale P-DUREL, indicating their applicability in health studies.

O papel de mulheres idosas consumidoras de calmantes alopáticos na popularização do uso destes medicamentos

O consumo de calmantes alopaticos (benzodiazepinicos) possui dimensao social e cultural, e nao esta restrito a uma relacao entre medico e paciente. Objetivamos mostrar, portanto, que o consumo de calmantes e particularizado de acordo com os contextos social e cultural em que seus consumidores estao envolvidos. Buscamos entao, utilizando abordagem qualitativa com entrevistas semi-estruturadas, as concepcoes sobre calmantes alopaticos de 18 mulheres idosas, pacientes psiquiatricas do Nucleo de Saude Mental do Centro Saude Escola da Faculdade de Medicina de Ribeirao Preto da Universidade de Sao Paulo (FMRP-USP), da cidade de Ribeirao Preto-SP, Brasil, consumidoras de benzodiazepinicos ha mais de um ano. Concluimos que o consumo de calmantes esta envolvido em uma rede de relacoes sociais, enredando vizinhos, parentes e amigos. As mulheres entrevistadas mostraram ter autonomia e conhecimento sobre o uso dos calmantes, sentindo-se capazes de utilizar, indicar, oferecer, emprestar, ou nao, esses medicamentos, de acordo com suas concepcoes.The consumption of allopathic tranquilizers (benzodiazepines) has social and cultural dimensions, not being restricted to a relation between physician and patient. Therefore, we aimed to show that the consumption of tranquilizers is particularized according to the social and cultural contexts their consumers are involved in. Using a qualitative approach with semistructured interviews, we search for conceptions about allopathic tranquilizers in 18 elderly women, psychiatric patients attended to in the Mental Health Centre of the Health Teaching Centre at the, University of São Paulo at Ribeirão Preto Medical School, (FMRP-USP), in the city of Ribeirão Preto (SP), Brazil, who were consumers of benzodiazepines for more than one year. We concluded that the consumption of tranquilizers is entangled in a network of social relations, including neighbors, relatives and friends. The interviewed women showed to have autonomy, feeling able to use, indicate, offer and lend, or not, these medicines, according to their conceptions.

Association between religiousness and blood donation among Brazilian postgraduate students from health-related areas

Objective The aim of this study was to examine the association between religiousness and blood donation among postgraduate students. Methods The Portuguese-language version of the Duke University Religion Index was administered to a sample of 226 Brazilian students with ages ranging from 22 to 55 years. All study participants had completed undergraduate courses in health-related areas. Results In the present study, 23.5% of the students were regular donors. Organizational religiousness was found to be associated with attitudes related to blood donation. This study also shows evidence that regular blood donors have a higher intrinsic religiousness than subjects who donate only once and do not return. Conclusion This study shows that the attitudes concerning blood donation may have some association with religiosity.

Investigação das propriedades psicométricas do Duke Religious Index no âmbito da pesquisa em Saúde Coletiva

Religiosity is an important variable in health research, given its known association with the health-disease process and important questions about the well-being, attitudes, practices and satisfaction with care and services. However, in the research in Public Health, it is often used religious affiliation as the only dimension of religiosity. This study aims to investigate the appropriateness of using the Duke Religious Index scale (DUREL) in the context of the Public Health research, evaluating the psychometric capabilities of the instrument when applied to a representative sample of users of primary care services to health in a medium-sized city of the interior of Sao Paulo State, Southeast Brazil. It was found an adequate internal consistency for the instrument and satisfactory convergent-discriminant validity. The results suggest that the use of DUREL is not restricted to research in mental health, and that its use can bring new perspectives for the understanding of events of interest in the field of Public Health.

Conhecimento, crença e uso de medicina alternativa e complementar por fonoaudiólogas

O objetivo do presente estudo e entender o conhecimento, as crencas e o uso das medicinas alternativas e complementares entre fonoaudiologas que atuam no setor publico de saude. O estudo foi realizado em um hospital terciario de Ribeirao Preto, SP. Um questionario desenvolvido para os propositos do estudo foi administrado em uma casuistica de 40 fonoaudiologas. Os itens do questionario foram criados conforme uma revisao da literatura. A aceitacao de medicinas alternativas e complementares, como acupuntura e homeopatia, e expressiva entre as profissionais entrevistadas. Os resultados do presente estudo sugerem que o uso e a pratica destas medicinas sao feitos de forma racional, com certa prudencia. As entrevistadas admitem que um tratamento complementar deve ser submetido a testes cientificos antes de sua aceitacao, e que e desaconselhavel a um paciente buscar um tratamento alternativo ou complementar sem antes consultar o medico.

Notas sobre a versão em língua portuguesa da Escala de Bem-Estar Espiritual

OBJECTIVE: This study aims to test the factor structure of the Portuguese-language version of the Spiritual Well-being Scale (SWB) in a sample of postgraduate students of courses in the health area, assessing its psychometric qualities. Among the different instruments used to measure the spirituality, the SWB was recently adapted into Portuguese language. The 20 items of this instrument are originally divided into two dimensions: Religious Well-Being (RWB) and Existential Well-Being (EWB) subscales. METHODS: The internal consistency of the subscales was assessed by the Cronbachs alpha coefficient. A factor analysis with oblique rotation was used to assess the latent factor structure. Four hundred and forty-one individuals answered the SWB scale. RESULTS: The instrument has satisfactory internal consistency, but the factor analysis suggests that the items of the EWB subscale are distributed in two distinct factors, which draws attention to the complexity of the factor structure of the instrument. CONCLUSION: The factorial structure of the instrument is unclear, and the presence of a ceiling effect for religious groups may hinder the studies about the associations between spirituality and health-related characteristics. The use of the SWB scale requires caution and a subsequent revision of the scale is needed.

The role of elderly female consumers of allopathic tranquilizers in the popularization of the use of these medicines

O consumo de calmantes alopaticos (benzodiazepinicos) possui dimensao social e cultural, e nao esta restrito a uma relacao entre medico e paciente. Objetivamos mostrar, portanto, que o consumo de calmantes e particularizado de acordo com os contextos social e cultural em que seus consumidores estao envolvidos. Buscamos entao, utilizando abordagem qualitativa com entrevistas semi-estruturadas, as concepcoes sobre calmantes alopaticos de 18 mulheres idosas, pacientes psiquiatricas do Nucleo de Saude Mental do Centro Saude Escola da Faculdade de Medicina de Ribeirao Preto da Universidade de Sao Paulo (FMRP-USP), da cidade de Ribeirao Preto-SP, Brasil, consumidoras de benzodiazepinicos ha mais de um ano. Concluimos que o consumo de calmantes esta envolvido em uma rede de relacoes sociais, enredando vizinhos, parentes e amigos. As mulheres entrevistadas mostraram ter autonomia e conhecimento sobre o uso dos calmantes, sentindo-se capazes de utilizar, indicar, oferecer, emprestar, ou nao, esses medicamentos, de acordo com suas concepcoes.The consumption of allopathic tranquilizers (benzodiazepines) has social and cultural dimensions, not being restricted to a relation between physician and patient. Therefore, we aimed to show that the consumption of tranquilizers is particularized according to the social and cultural contexts their consumers are involved in. Using a qualitative approach with semistructured interviews, we search for conceptions about allopathic tranquilizers in 18 elderly women, psychiatric patients attended to in the Mental Health Centre of the Health Teaching Centre at the, University of São Paulo at Ribeirão Preto Medical School, (FMRP-USP), in the city of Ribeirão Preto (SP), Brazil, who were consumers of benzodiazepines for more than one year. We concluded that the consumption of tranquilizers is entangled in a network of social relations, including neighbors, relatives and friends. The interviewed women showed to have autonomy, feeling able to use, indicate, offer and lend, or not, these medicines, according to their conceptions.

El papel de mujeres adultas mayores consumidoras de calmantes alopáticos en la popularización del uso de estes medicamentos

O consumo de calmantes alopaticos (benzodiazepinicos) possui dimensao social e cultural, e nao esta restrito a uma relacao entre medico e paciente. Objetivamos mostrar, portanto, que o consumo de calmantes e particularizado de acordo com os contextos social e cultural em que seus consumidores estao envolvidos. Buscamos entao, utilizando abordagem qualitativa com entrevistas semi-estruturadas, as concepcoes sobre calmantes alopaticos de 18 mulheres idosas, pacientes psiquiatricas do Nucleo de Saude Mental do Centro Saude Escola da Faculdade de Medicina de Ribeirao Preto da Universidade de Sao Paulo (FMRP-USP), da cidade de Ribeirao Preto-SP, Brasil, consumidoras de benzodiazepinicos ha mais de um ano. Concluimos que o consumo de calmantes esta envolvido em uma rede de relacoes sociais, enredando vizinhos, parentes e amigos. As mulheres entrevistadas mostraram ter autonomia e conhecimento sobre o uso dos calmantes, sentindo-se capazes de utilizar, indicar, oferecer, emprestar, ou nao, esses medicamentos, de acordo com suas concepcoes.The consumption of allopathic tranquilizers (benzodiazepines) has social and cultural dimensions, not being restricted to a relation between physician and patient. Therefore, we aimed to show that the consumption of tranquilizers is particularized according to the social and cultural contexts their consumers are involved in. Using a qualitative approach with semistructured interviews, we search for conceptions about allopathic tranquilizers in 18 elderly women, psychiatric patients attended to in the Mental Health Centre of the Health Teaching Centre at the, University of São Paulo at Ribeirão Preto Medical School, (FMRP-USP), in the city of Ribeirão Preto (SP), Brazil, who were consumers of benzodiazepines for more than one year. We concluded that the consumption of tranquilizers is entangled in a network of social relations, including neighbors, relatives and friends. The interviewed women showed to have autonomy, feeling able to use, indicate, offer and lend, or not, these medicines, according to their conceptions.