Celmira Lange

Política nacional de atenção ao idoso e a contribuição da enfermagem

Este estudo objetivou descrever e avaliar a Politica Nacional de Atencao ao Idoso no Brasil e sua relacao com a enfermagem. Foi realizada uma revisao bibliografica do tema, o que permitiu a sua caracterizacao sob a forma de leis, decretos, textos e artigos em periodicos e livros. Os atores sociais envolvidos na Politica Nacional de Atencao ao Idoso foram os idosos, as familias, a comunidade e a equipe de saude, com destaque para a enfermagem. Apos analise da literatura consultada, concluiu-se que esta politica tem proporcionado, aos atores sociais envolvidos, conscientizacao para justica social e garantia plena dos direitos aos idosos. Concluiu-se, tambem, que a insercao da enfermagem na Politica Nacional de Atencao ao Idoso envolve o processo de cuidar no ciclo de vida e nos varios niveis de atencao a saude, onde se inclui a saude do idoso, assim como a participacao na elaboracao e implementacao dessa politica.

The demands of family caregivers of elderly individuals with dementia

As finalidades deste estudo foram identificar as caracteristicas dos cuidadores de idosos demenciados, os tipos de demandas de cuidados e relacionar a demanda com o estagio da demencia. O estudo seccional e observacional foi conduzido em 2004, com 104 idosos e 90 cuidadores, em Ribeirao Preto/SP, por meio do instrumento OARS e de um questionario para o cuidador. Dos 104 idosos, 66.3% eram mulheres, a idade media de 75.5 anos, sendo que 86.5% deles tinham cuidadores. Entre os cuidadores, 80% eram mulheres, membros da familia, com idade media de 52.3 anos. Dedicavam 15.10 horas/dia para a atividade de cuidar, sem nenhuma ajuda. Encontrou-se importante relacao entre a sobrecarga do cuidador, o esforco fisico e emocional, e o estagio da demencia. A sobrecarga emocional foi maior nos estagios iniciais e tardios da demencia, mas a diferenca foi estatisticamente nao-significante. Os resultados atuais revelam a urgente necessidade de planejar estrategias de suporte formal e informal para cuidadores de idosos brasileiros com demencia.The purpose of this cross-sectional observational study was to identify characteristics of caregivers of elderly people with dementia, types of care demands and to relate demands to the stage of dementia. The study was carried out in 2004 with 104 older adults and 90 caregivers in Ribeirão Preto, state of São Paulo. The OARS instrument was utilized and a questionnaire answered by caregivers. Among older adults, 66.3% were female, aged 75.5 years in average and 86.5% had caregivers. Eighty percent of the caregivers were women family members, aged 52.3 years in average. They spent 15.10 hours/day with care, without help. An important relationship was observed between caregivers burden, physical and emotional effort and stage of dementia. Emotional overburden was higher at dementia early and late stages, this difference was statistically non-significant. Results reveal the urgent need to plan formal and informal support strategies to caregivers of Brazilian elderly people with dementia.

Prevalence of cognitive impairment and associated factors among the elderly in Bage, Rio Grande do Sul, Brazil.

It is estimated that until 2020 the elderly will represent 13% of the total Brazilian population, and there is increasing concern about healthy aging and low rates of cognitive impairment. This cross-sectional study aimed to identify the prevalence of cognitive impairment, using the Mini-Mental State Examination (MMSE) in a sample of 1,593 elderly aged 60 years old and more who were living in the community of the city of Bagé, Southern Brazil, in 2008. The Poisson regression model was used for estimating crude and adjusted prevalence ratios; their related 95% confidence intervals and p-values lower than 0.05 were considered statistically significant. The prevalence of cognitive impairment was of 34% and statistically associated with gender (female), age (older), schooling (less educated), lower economic classes, without retirement, with depression and functional limitation. The high magnitude with increased occurrence among poor and vulnerable groups contributes to the implementation of public policies in order to improve care, prevent diseases and promote the independence and autonomy of the elderly population.

Plantas medicinais utilizadas por idosos com diagnóstico de Diabetes mellitus no tratamento dos sintomas da doença

Este trabalho teve como objetivo investigar as plantas medicinais utilizadas por idosos assistidos em uma Unidade Basica de Saude de Pelotas-RS, com diagnostico de Diabetes mellitus, como terapia complementar no tratamento dos sintomas da doenca. Caracterizou-se por pesquisa qualitativa, realizada em julho de 2009, no municipio de Pelotas-RS. Foram entrevistados 18 idosos com idade entre 60 e 77 anos, sendo 14 do sexo feminino. Os participantes citaram 20 plantas medicinais utilizadas como terapia complementar no tratamento do Diabetes mellitus. Entre estas, as mais citadas utilizadas para diminuir os niveis de glicose no sangue foram Sphagneticola trilobata, Bauhinia spp. e Syzygium cumini, sendo que para as duas ultimas ha comprovacao cientifica do efeito hipoglicemiante. A infusao foi a forma de preparo predominante. Considera-se importante a realizacao de estudos farmacologicos que investiguem os efeitos das plantas utilizadas pela populacao, a fim de que o uso proporcione os beneficios desejados e nao cause danos a saude.

Alterações na funcionalidade/cognição e depressão em idosos institucionalizados que sofreram quedas

Objecti ve: To analyze the influence of changes in function/cognition and the presence of depression in institutionalized elderly who have suffered falls, in order to prevent these accidents. Methods: Quantitative exploratory and descriptive research, conducted with 30 elderly individuals in Rio Grande do Sul (Brazil), using five data collection instruments. The analysis was conducted using SPSS 13.0. Results: We found that: the majority were women; had low levels of education; the risk of falls increased with age; older people with less time in an institution had fallen more. We identified the influence of medication use on falls. In relation to functional capacity, the elderly who had fallen, had independence for activities of daily living; of 20 elderly with scores suggestive of cognitive impairment, ten suffered falls. There was no significant influence between depression and falls in our investigation. Conclusion: Results show the importance of determining the influence of functional / cognitive changes and the presence of depression, and in episodes of falls in institutionalized elderly.OBJETIVE: To analyze the influence of changes in function/cognition and the presence of depression in institutionalized elderly who have suffered falls, in order to prevent these accidents. METHODS: Quantitative exploratory and descriptive research, conducted with 30 elderly individuals in Rio Grande do Sul (Brazil), using five data collection instruments. The analysis was conducted using SPSS 13.0. RESULTS: We found that: the majority were women; had low levels of education; the risk of falls increased with age; older people with less time in an institution had fallen more. We identified the influence of medication use on falls. In relation to functional capacity, the elderly who had fallen, had independence for activities of daily living; of 20 elderly with scores suggestive of cognitive impairment, ten suffered falls. There was no significant influence between depression and falls in our investigation. CONCLUSION: Results show the importance of determining the influence of functional / cognitive changes and the presence of depression, and in episodes of falls in institutionalized elderly.

The chronic patient in face of falling ill and the treatment compliance

Objective It has, as its purpose, to know these patients’ perceptions on the reasons that make them comply, or not, with the treatment. Methods: Qualitative descriptive approach, with five inpatients at a Medical Clinic Unit in a university hospital in Southern Brazil. Results: The data were collected in semi-structured interviews and analyzed when three themes were present: perception of the disease, importance of the therapeutics and difficulty to perform the therapeutics. Conclusion: It was made evident that, when complying with the treatment, there are several factors involved that add to the complexity of this issue, being related to people’s behavior and their motivations, and becoming an important challenge to be overcome by the healthcare professionals.OBJETIVO: Conhecer a percepcao desses pacientes sobre os motivos que os levam a aderir, ou nao, ao tratamento. METODOS: Em relacao a metodologia, foi empregada uma abordagem qualitativa e descritiva, com cinco sujeitos hospitalizados em uma Unidade de Clinica Medica de um Hospital Universitario do Sul do Brasil. RESULTADOS: Quanto aos resultados, os dados foram coletados atraves de entrevista semi-estruturada e analisados quando surgiam tres temas: a percepcao da doenca; a importância da terapeutica e a dificuldade de realizacao da terapeutica. CONCLUSAO: Assim, evidenciou-se que, na aderencia ao tratamento, existe uma diversidade de fatores envolvidos que tornam essa questao complexa, tendo relacao com o comportamento das pessoas e suas motivacoes, tornando-se um grande desafio a ser enfrentado pelos profissionais de saude.

Avaliação qualitativa do processo de trabalho em um centro de atenção psicossocial no Brasil

OBJETIVO: Este estudo teve por objetivo avaliar o processo de trabalho em um centro de atencao psicossocial. Procuramos apontar questionamentos, lacunas, falhas, potencialidades e experiencias compartilhadas pelos protagonistas que fazem a saude mental no cotidiano do servico (usuarios, familiares e profissionais de saude). METODOS: Estudo de avaliacao, de natureza qualitativa, que utilizou como referencial teorico-metodologico a avaliacao de quarta geracao. RESULTADOS: Observamos algumas caracteristicas fundamentais que revelam o modo de organizacao do processo de trabalho em saude mental, na visao dos grupos de interesse investigados. Destacam-se a utilizacao de tecnologias de cuidado inclusivas, alem de mecanismos de gestao do cuidado em equipe pautados na interdisciplinaridade e centrados no usuario. CONCLUSOES: Os resultados contribuem para uma re-leitura do processo de consolidacao da reforma psiquiatrica no contexto brasileiro, de modo a problematizar o fazer, o saber, os objetivos, filosofias e tambem o objeto de trabalho em saude.

Atividades terapeuticas: compreensao de familiares e profissionais de um centro de atencao psicossocial

Objective: To analyze the understanding of family members and mental health professionals concerning the therapeutic activities implemented in the routines of Psychosocial Care Centers. Aims: This qualitative study was conducted in a Psychosocial Care Center in the state of Santa Catarina, Brazil. Results: The therapeutic activities reveal many possibilities for implementing actions and practices according to new trends guiding care in the field. The results also reveal there is a risk of services adopting authoritarian and crystallized postures compatible with traditional care models, which the Psychiatric Reform campaign has struggled for more than 20 years to overcome. Conclusions: This study is expected to encourage a new perspective of Psychiatric Reform in the studied context and discussions about the teamwork processes and the relationships between services and patients. 1 PhD in Nursing. Adjunct Professor of Nursing School and Postgraduate Program in Nursing at Federal University of Rio Grande do Sul. Porto Alegre-RS. Brasil. E-mail: Lbpinho@ufrgs.br 2 PhD in Nursing. Associate Professor of Nursing Faculty and Postgraduate Program in Nursing at Federal University of Pelotas. Pelotas-RS. Brasil. E-mail: kantorski@uol.com.br 3 PhD in Nursing. Adjunct Professor of Nursing School at Federal University of Rio Grande do Sul. Porto Alegre-RS. Brasil. E-mail: cwetzel@ibest.com.br, 4 PhD in Nursing. Associate Professor of Nursing Faculty and Postgraduate Program in Nursing at Federal University of Pelotas. Pelotas-RS. Brasil. E-mail: eschwartz@ terra.com.br 5 PhD in Nursing. Associate Professor of Nursing Faculty and Postgraduate Program in Nursing at Federal University of Pelotas. Pelotas-RS. Brasil. E-mail: celmira_lange@ terra.com.br 6 PhD student at Federal University of Santa Catarina. Brasil. E-mail: juzillmer@gmail.com RESEARCH PESQUISA INVESTIGACION Atividades terapeuticas: compreensao de familiares e profissionais de um centro de atencao psicossocial Esc Anna Nery (print)2013 Jul-Sep; 17 (3):534 541 Leandro Barbosa de Pinho1, Luciane Prado Kantorski2, Christine Wetzel3, Eda Schwartz4, Celmira Lange5, Juliana Graciela Vestena Zillmer6 Actividades terapeuticas: comprension de familiares y profesionales de un centro de atencion psicosocial Psychiatric Nursing; Mental Health; Health Policies.

Paciente crônico frente ao adoecer e a aderência ao tratamento

Objective It has, as its purpose, to know these patients’ perceptions on the reasons that make them comply, or not, with the treatment. Methods: Qualitative descriptive approach, with five inpatients at a Medical Clinic Unit in a university hospital in Southern Brazil. Results: The data were collected in semi-structured interviews and analyzed when three themes were present: perception of the disease, importance of the therapeutics and difficulty to perform the therapeutics. Conclusion: It was made evident that, when complying with the treatment, there are several factors involved that add to the complexity of this issue, being related to people’s behavior and their motivations, and becoming an important challenge to be overcome by the healthcare professionals.OBJETIVO: Conhecer a percepcao desses pacientes sobre os motivos que os levam a aderir, ou nao, ao tratamento. METODOS: Em relacao a metodologia, foi empregada uma abordagem qualitativa e descritiva, com cinco sujeitos hospitalizados em uma Unidade de Clinica Medica de um Hospital Universitario do Sul do Brasil. RESULTADOS: Quanto aos resultados, os dados foram coletados atraves de entrevista semi-estruturada e analisados quando surgiam tres temas: a percepcao da doenca; a importância da terapeutica e a dificuldade de realizacao da terapeutica. CONCLUSAO: Assim, evidenciou-se que, na aderencia ao tratamento, existe uma diversidade de fatores envolvidos que tornam essa questao complexa, tendo relacao com o comportamento das pessoas e suas motivacoes, tornando-se um grande desafio a ser enfrentado pelos profissionais de saude.

Capacidade funcional para atividades da vida diária de idosos da Estratégia de Saúde da Família da zona rural

This article describes the socioeconomic profile and functional capacity of older persons living in rural areas in the Municipality of Pelotas-RS, Brazil based on the following sociodemographic characteristics: age, sex, income, schooling and chronic diseases. A cross-sectional analytical study was conducted between July and October 2014 using a sample of 820 older persons. We used the Pearson chi square test of homogeneity for nominal variables and the test for trend for ordinal variables. The majority of the sample was made up of women aged,60-69 years, who were white and living with a partner. With regard to functional capacity to perform basic activities of daily living (BADL), 81.8% of individuals were classified as independent, while 54.6% were deemed completely independent for performing instrumental activities of daily living (IADL). Variables such as sex (male), age (60-69 years age group) and not having any heart problems were closely associated with the ability to perform BADL , while the ability to perform IADL was associated with age (60-69 years age group), income (1-2 salaries), education (5-8 years), and no osteoporosis. The majority of the people assessed by this study were able to perform both basic and instrumental activities of daily living.This article describes the socioeconomic profile and functional capacity of older persons living in rural areas in the Municipality of Pelotas-RS, Brazil based on the following sociodemographic characteristics: age, sex, income, schooling and chronic diseases. A cross-sectional analytical study was conducted between July and October 2014 using a sample of 820 older persons. We used the Pearson chi square test of homogeneity for nominal variables and the test for trend for ordinal variables. The majority of the sample was made up of women aged,60-69 years, who were white and living with a partner. With regard to functional capacity to perform basic activities of daily living (BADL), 81.8% of individuals were classified as independent, while 54.6% were deemed completely independent for performing instrumental activities of daily living (IADL). Variables such as sex (male), age (60-69 years age group) and not having any heart problems were closely associated with the ability to perform BADL , while the ability to perform IADL was associated with age (60-69 years age group), income (1-2 salaries), education (5-8 years), and no osteoporosis. The majority of the people assessed by this study were able to perform both basic and instrumental activities of daily living.