Bruna Moretti Luchesi

Evaluation of depressive symptoms in older caregivers

Background The number of older caregivers is getting bigger and it is important to know if they experience depressive symptoms because there can be consequences for both caregiver and care recipient. Objective To analyze the recent publications related to the assessment of depressive symptoms in elderly caregivers. Methods Lilacs and PubMed databases were reviewed associating the descriptors “caregivers” AND “aged” AND “depression”. Inclusion criteria were texts including primary data in Portuguese, Spanish or English, published between 2009-2013, also data which evaluated elderly caregivers (≥ 60) and depression or depressive symptoms. There were found n = 1129 texts and after applying the inclusion criteria n = 17 were selected and analyzed. Results Geriatric Depressive Scale (-30 and -15 items) and Center for Epidemiologic Studies Depression scale were the most used scales to evaluate depressive symptoms in older caregivers. Caregivers were in the most of the cases female and cared for a family member with dementia. The majority of the texts that compared older caregivers to older non-caregivers found that caregivers had more depressive symptoms. Discussion Early identification of depressive symptoms can help professionals to minimize damage in caregivers and in care recipient and to plan interventions focusing on improving quality of life of this specific caregiver group.

Idosos vítimas de trauma: doenças preexistentes, medicamentos em uso no domicílio e índices de trauma

The objective was to identify the sociodemographic profile of the elderly victims of trauma, to characterize preexisting conditions and medications taken at home, and to calculate indices of trauma and clinical outcomes. This is a retrospective and exploratory analysis from a database of a general hospital between 2008 and 2010. There were studied 131 elderly, mean age 69.9 years, 73.3% male, 55.1% married, 54.7% retired, 65.6% had preexisting conditions and 48.9% used drugs at home. There was a representative number of falls (31.3%), followed by running over (28.2%), with the head/neck region being the most affected (59.5%). Moderate trauma prevailed (44.3%), with conditions of survival after the event (80.2%). There was an association between mechanism of trauma and preexisting disease (p=0.01) and between mechanism of trauma and sex (p=0.03). The knowledge of the variables involved with the elderly victims of trauma enables healthcare professionals to plan preventive measures aimed at improving the assistance. Key words: Aged; Wounds and Injuries; Disease; Drug Utilization.The objective was to identify the sociodemographic profile of the elderly victims of trauma, to characterize preexisting conditions and medications taken at home, and to calculate indices of trauma and clinical outcomes. This is a retrospective and exploratory analysis from a database of a general hospital between 2008 and 2010. There were studied 131 elderly, mean age 69.9 years, 73.3% male, 55.1% married, 54.7% retired, 65.6% had preexisting conditions and 48.9% used drugs at home. There was a representative number of falls (31.3%), followed by running over (28.2%), with the head/neck region being the most affected (59.5%). Moderate trauma prevailed (44.3%), with conditions of survival after the event (80.2%). There was an association between mechanism of trauma and preexisting disease (p=0.01) and between mechanism of trauma and sex (p=0.03). The knowledge of the variables involved with the elderly victims of trauma enables healthcare professionals to plan preventive measures aimed at improving the assistance.

Suporte social e contato intergeracional: estudando idosos com alterações cognitivas

The aim of this study was to investigate the relationship between social support to elderly patients with cognitive alterations in different contexts of social vulnerability and the presence of children living in the same household. A descriptive, cross-sectional study assessed 85 elderly individuals in different contexts of social vulnerability; all of them presented results below the cut-off point in the mini mental state examination. All ethical guidelines were respected. A sociodemographic and family characterization tool, the mini mental state examination, and the Medical Outcomes Study (MOS) were applied. The results showed good levels of social support received by elderly individuals and a statistically significant correlation between the extent of emotional support and the presence of children in the household (t=2.16, p<0.01). These results enable a better understanding on the relationships between elderly people and children by evidencing that intergenerational contact favors the perception of satisfactory social support by the elderly. Descriptors: Aged; Child; Social Support; Family; Geriatric Nursing. RESUMO Este estudo teve por objetivo verificar a relação entre apoio social de idosos com alterações cognitivas que residem em diferentes contextos de vulnerabilidade social e a presença de crianças vivendo no mesmo domicílio. Trata-se de um estudo descritivo, transversal, que avaliou 85 idosos residentes em diferentes contextos de vulnerabilidade social, e que apresentaram resultado no Mini Exame do Estado Mental abaixo da nota de corte. Todos os cuidados éticos foram observados. Foram aplicados instrumento de caracterização sociodemográfica e familiar, Mini Exame do Estado Mental e o Medical Outcomes Study (MOS). Os resultados revelaram bons níveis de apoio social recebidos pelos idosos e correlação estatisticamente significativa entre a dimensão de apoio emocional e a presença de crianças no domicílio (t=2,16, sendo p<0,01). Esses resultados possibilitam conhecer melhor a relação entre idosos e crianças ao revelar que o contato intergeracional favorece a percepção de apoio social satisfatório pelos idosos. Descritores: Idoso; Criança; Apoio Social; Família; Enfermagem Geriátrica. Luchesi BM, Brito TRP, Costa RS, Pavarini SCI. Rev. Eletr. Enf. [Internet]. 2015 jul/sep;17(3). Available from: http://dx.doi.org/10.5216/ree.v17i3.25597. 2 INTRODUCTION The number of people aged over 60 worldwide is growing faster than any other age group. Particularly in the last 60 years the number of elderly people in Brazil has increased significantly. In 1950, this age group represented 4.9% of the total population; in 2010 the number of elderly people was 19.6 million, corresponding to 10.2% of the population. Considering that over the next 40 years this group will grow at a rate of 3.2% per year the number of elderly people will reach 64 million in 2050, corresponding to 29.7% of the total population. This percentage is very similar to that found for Japan, currently the country with the highest number of elderly people in the world. Population ageing increases the interaction between people and intergenerational relationships, leading to a society composed of four generations, as many elderly individuals experience the opportunity to meet their grandchildren and great-grandchildren. Also, the existence of family arrangements in which the elderly live together with younger generations is increasingly common. According to data from the SABE Study (Health, Welfare and Ageing) conducted in São Paulo in 2006, 30.3% of the elderly lived with their children, 23.9% lived only with the spouse, 20.4% lived with children and grandchildren, 13.3% lived alone and 12.1% lived in other type of arrangements. Of the 147 elderly individuals aged over 80 that were interviewed in Ribeirão Preto, in the state of São Paulo, 10.9% were living in trigenerational arrangements and 2% were living with grandchildren. Considering that ageing may increase the demand for elderly care and that family is the main source of assistance, the presence of children living with elderly people may affect the exchange of support in the household. Such interpersonal exchanges involving affection, affirmation and care define the term “social support”. In turn, the social networks are the set of relationships maintained by each individual; social support is the motivation for the establishment of networks. In general, people who engage in social networks live longer and healthier than people who do not. The effect of social networks on the health of elderly people has been demonstrated, particularly in quality of life, subjective well-being, functionality, mortality and cognitive impairment. In relation to cognitive aspects, social support works as a protective factor against cognitive impairment. The engagement in social networks helps to maintain the independence of elderly people within their family and socio-cultural context, which is fundamental for cognitive functions and psychological well-being. There is an emotional complexity permeating the relationships among seniors, adult children and grandchildren and the quality of these relationships is associated with the physical and mental conditions of the elderly. In this sense, the relationship between elderly people and children increases the possibilities of social support exchange in old age, which may improve the quality of life of elderly people. Therefore, considering that children living with elderly people is quite usual and that social support may be a protective factor for cognitive impairment, the present study aimed at investigating the relationship between social support for elderly people with cognitive alterations and the presence of children living in the same household. METHODOLOGY A descriptive, cross-sectional, quantitative study was conducted in a city located in the central region of the state of São Paulo. The study subjects consisted of elderly people (people over 60 years old) (n=85) registered in Family Health Units (FHUs) located in different regions of social vulnerability according to the São Paulo Social Luchesi BM, Brito TRP, Costa RS, Pavarini SCI. Rev. Eletr. Enf. [Internet]. 2015 jul/sep;17(3). Available from: http://dx.doi.org/10.5216/ree.v17i3.25597. 3 Vulnerability Index (IPVS, as per its acronym in Portuguese). Inclusion criteria included: being over 60 years old, being registered in one of the FHUs of the city that are rated in the IPVS, presenting result below the cut-off score in the mini mental state examination, having no severe speech or understanding impairment, and agreeing to participate in the study. A database consisting of 755 assessments of elderly individuals from the FHUs rated in the IPVS of the city was used for sample selection. Of these, the elderly with indication of cognitive alterations consisted of 195 individuals who presented results below the cut-off score in the mini mental state examination. Discarding losses by death and household migration, the present study reassessed 101 elderly individuals. After reapplication of the mini mental state examination, 16 individuals presenting result above the cut-off score were excluded. Thus, the final sample consisted of 85 elderly individuals. Individual and in-home assessments were conducted between August and November 2009, respecting a prior appointment with the individuals. The data collection

Avaliação da atitude de crianças que convivem com idosos em relação à velhice

Com o envelhecimento populacional, e importante conhecer como outras faixas etarias percebem os idosos. Trata-se de um estudo quantitativo, transversal e descritivo, que teve como objetivo avaliar a atitude de criancas que convivem com idosos, em relacao a velhice. Realizaram-se entrevistas com 54 criancas de sete a dez anos, que moravam com idosos. Apos a caracterizacao sociodemografica, foi aplicada a Escala Todaro para Avaliacao de Atitudes de Criancas em Relacao a Idosos, a qual avalia dominios persona, cognicao, relacionamento social e agencia. A maioria das criancas tinha nove anos, era do sexo masculino e morava com um idoso ha mais de cinco anos. Os resultados apontaram atitudes consideradas positivas. O dominio persona apresentou relacao com o tempo de moradia com o idoso. Os resultados deste trabalho permitem que as equipes de saude planejem acoes de intervencao educacional, visando manter e melhorar as atitudes de criancas em relacao aos idosos.

Avaliação da atitude das crianças que residem com idosos em relação à velhice

Objective To evaluate the attitude of children who live with seniors with non-transmissible chronic diseases toward aging and the related sociodemographic variables. Methods This cross-sectional study included 48 children aged seven to ten years. We used the following instruments: sociodemographic questionnaire and attitude scale for children in relation to aging. This instrument includes four domains and evaluates the attitude toward aging on a scale ranging from 1 (more positive attitude) to 3 (more negative attitude). Results Mean score was 1.79±0.19. Between domains, the domain showing the lowest mean value was the Persona domain (1.70±0.33). The highest value was seen in the Agency domain (1.84±0.40). Variables that showed a relation (p<0.05) with attitudes were family income, degree of kinship and time of contact daily with senior and the type of non-transmissible chronic disease of the elderly. Conclusion Children had more positive than negative attitudes toward aging.

[Elderly victims of trauma: preexisting conditions, medications taken at home and indexes of trauma].

The objective was to identify the sociodemographic profile of the elderly victims of trauma, to characterize preexisting conditions and medications taken at home, and to calculate indices of trauma and clinical outcomes. This is a retrospective and exploratory analysis from a database of a general hospital between 2008 and 2010. There were studied 131 elderly, mean age 69.9 years, 73.3% male, 55.1% married, 54.7% retired, 65.6% had preexisting conditions and 48.9% used drugs at home. There was a representative number of falls (31.3%), followed by running over (28.2%), with the head/neck region being the most affected (59.5%). Moderate trauma prevailed (44.3%), with conditions of survival after the event (80.2%). There was an association between mechanism of trauma and preexisting disease (p=0.01) and between mechanism of trauma and sex (p=0.03). The knowledge of the variables involved with the elderly victims of trauma enables healthcare professionals to plan preventive measures aimed at improving the assistance. Key words: Aged; Wounds and Injuries; Disease; Drug Utilization.The objective was to identify the sociodemographic profile of the elderly victims of trauma, to characterize preexisting conditions and medications taken at home, and to calculate indices of trauma and clinical outcomes. This is a retrospective and exploratory analysis from a database of a general hospital between 2008 and 2010. There were studied 131 elderly, mean age 69.9 years, 73.3% male, 55.1% married, 54.7% retired, 65.6% had preexisting conditions and 48.9% used drugs at home. There was a representative number of falls (31.3%), followed by running over (28.2%), with the head/neck region being the most affected (59.5%). Moderate trauma prevailed (44.3%), with conditions of survival after the event (80.2%). There was an association between mechanism of trauma and preexisting disease (p=0.01) and between mechanism of trauma and sex (p=0.03). The knowledge of the variables involved with the elderly victims of trauma enables healthcare professionals to plan preventive measures aimed at improving the assistance.

Ancianos víctimas de trauma: condiciones preexistentes, medicamentos tomados en el hogar e índices de trauma

The objective was to identify the sociodemographic profile of the elderly victims of trauma, to characterize preexisting conditions and medications taken at home, and to calculate indices of trauma and clinical outcomes. This is a retrospective and exploratory analysis from a database of a general hospital between 2008 and 2010. There were studied 131 elderly, mean age 69.9 years, 73.3% male, 55.1% married, 54.7% retired, 65.6% had preexisting conditions and 48.9% used drugs at home. There was a representative number of falls (31.3%), followed by running over (28.2%), with the head/neck region being the most affected (59.5%). Moderate trauma prevailed (44.3%), with conditions of survival after the event (80.2%). There was an association between mechanism of trauma and preexisting disease (p=0.01) and between mechanism of trauma and sex (p=0.03). The knowledge of the variables involved with the elderly victims of trauma enables healthcare professionals to plan preventive measures aimed at improving the assistance. Key words: Aged; Wounds and Injuries; Disease; Drug Utilization.The objective was to identify the sociodemographic profile of the elderly victims of trauma, to characterize preexisting conditions and medications taken at home, and to calculate indices of trauma and clinical outcomes. This is a retrospective and exploratory analysis from a database of a general hospital between 2008 and 2010. There were studied 131 elderly, mean age 69.9 years, 73.3% male, 55.1% married, 54.7% retired, 65.6% had preexisting conditions and 48.9% used drugs at home. There was a representative number of falls (31.3%), followed by running over (28.2%), with the head/neck region being the most affected (59.5%). Moderate trauma prevailed (44.3%), with conditions of survival after the event (80.2%). There was an association between mechanism of trauma and preexisting disease (p=0.01) and between mechanism of trauma and sex (p=0.03). The knowledge of the variables involved with the elderly victims of trauma enables healthcare professionals to plan preventive measures aimed at improving the assistance.

Evaluation of the attitudes of children living with seniors toward aging

Com o envelhecimento populacional, e importante conhecer como outras faixas etarias percebem os idosos. Trata-se de um estudo quantitativo, transversal e descritivo, que teve como objetivo avaliar a atitude de criancas que convivem com idosos, em relacao a velhice. Realizaram-se entrevistas com 54 criancas de sete a dez anos, que moravam com idosos. Apos a caracterizacao sociodemografica, foi aplicada a Escala Todaro para Avaliacao de Atitudes de Criancas em Relacao a Idosos, a qual avalia dominios persona, cognicao, relacionamento social e agencia. A maioria das criancas tinha nove anos, era do sexo masculino e morava com um idoso ha mais de cinco anos. Os resultados apontaram atitudes consideradas positivas. O dominio persona apresentou relacao com o tempo de moradia com o idoso. Os resultados deste trabalho permitem que as equipes de saude planejem acoes de intervencao educacional, visando manter e melhorar as atitudes de criancas em relacao aos idosos.

Evaluación de la actitud de los niños que viven con ancianos relacionadas a la vejez

Com o envelhecimento populacional, e importante conhecer como outras faixas etarias percebem os idosos. Trata-se de um estudo quantitativo, transversal e descritivo, que teve como objetivo avaliar a atitude de criancas que convivem com idosos, em relacao a velhice. Realizaram-se entrevistas com 54 criancas de sete a dez anos, que moravam com idosos. Apos a caracterizacao sociodemografica, foi aplicada a Escala Todaro para Avaliacao de Atitudes de Criancas em Relacao a Idosos, a qual avalia dominios persona, cognicao, relacionamento social e agencia. A maioria das criancas tinha nove anos, era do sexo masculino e morava com um idoso ha mais de cinco anos. Os resultados apontaram atitudes consideradas positivas. O dominio persona apresentou relacao com o tempo de moradia com o idoso. Os resultados deste trabalho permitem que as equipes de saude planejem acoes de intervencao educacional, visando manter e melhorar as atitudes de criancas em relacao aos idosos.