Cintia Hitomi Yamashita

Validade aparente de um índice de vulnerabilidade das famílias a incapacidade e dependência

Este estudo teve como objetivo propor e validar um indice para identificar familias em situacao de vulnerabilidade a incapacidades e dependencia. Adaptou-se o Indice de Desenvolvimento da Familia, acrescentando indicadores associados ao surgimento de incapacidade e dependencia. Para validacao aparente, utilizou-se a tecnica Delphi e foram consultados cinco experts no assunto. Foi adotado nivel de concordância de 80% entre os juizes. Apos duas rodadas de avaliacao, foram realizados ajustes quanto a forma e ao conteudo do instrumento. Itens foram transferidos de componente, outros acrescentados e alguns, excluidos. O Indice resultante e composto por oito dominios, 38 componentes e 103 questoes. A contribuicao multiprofissional para a construcao de um Indice que se propoe a captar a vulnerabilidade fisica e social das familias resultou na primeira etapa para o desenvolvimento de uma ferramenta de diagnostico e intervencao para profissionais de saude que prestam assistencia as familias na Atencao Basica.This study aimed to propose and validate an index to identify families in a vulnerable situation to disability and dependency. It was adapted from the Index of Family Development (IFD), by adding indicators associated with the emergence of disability and dependency. Delphi technique was used to validation and five experts were consulted in the matter. The adopted level of agreement between judges was 80%. After two rounds of evaluations, adjustments were made related to the form and content of the instrument. Items were transferred from one component to another, some were added, others, deleted. The resulting Index is composed of eight domains, 38 components and 103 questions. The resulting Index is composed of eight domains, 38 components and 103 questions. The multidisciplinary contribution to the construction of an index that aims to capture the physical and social vulnerability of the families to disability and dependence provided the first step for the development of a tool for diagnosis and intervention that can be used by health professionals enrolled in primary care.

Avaliação da fragilidade de idosos atendidos em uma unidade da Estratégia Saúde da Família

Frailty is an important health status indicator in the elderly. The Edmonton Frail Scale, a multidimensional tool validated and culturally adapted into Brazilian Portuguese, may be used for its assessment. A cross-sectional, descriptive study was developed to identify the presence of frailty in the elderly assisted by the Family Health Program in a city in Sao Paulo, Brazil. All ethical considerations were observed. A sample of 128 older adults was interviewed. There was predominance of female older adults, aged between 60 and 69 years, with low education and personal income. Considering all the older adults who answered all the questions in the scale, 103 had their level of frailty assessed. Of these, 21.4% were apparently vulnerable and 30.1% had some level of frailty, varying among low, moderate and severe. The 25 older adults who failed to answer all questions presented vulnerability to frailty. In conclusion, the scale is suitable for frailty assessment in primary care, as long as it is adjusted to the characteristics of the target population. DESCRIPTORS: Frail elderly. Family Health Program. Primary health care. Public healthLa fragilidad es un indicador importante del estado de salud de los ancianos. La Edmonton Frail Scale, herramienta multidimensional validada y culturalmente adaptada al portugues de Brasil, pode ser usada para su evaluacion. Estudio transversal, descriptivo, con el objetivo de identificar la presencia de fragilidad en personas mayores atendidas por la Estrategia de Salud de la Familia en un municipio de Sao Paulo. Todas las consideraciones eticas fueron observadas. Se entrevistaron 128 ancianos. Hubo predominio del sexo femenino, entre 60 y 69 anos de edad, bajo nivel educativo y con ingresos propios. Solo 103 personas mayores que contestaran a todas las preguntas de la escala tuvieran su grado de fragilidad evaluado. De estos, el 21, 4% eran aparentemente vulnerables y el 30, 1% tenia algun grado de fragilidad, entre leve, moderada y severa. Los 25 que no responderan a todas las preguntas presentaban vulnerabilidad a la fragilidad. Se conclui que la escala es adecuada para la evaluacion de la fragilidad en la Atencion Primaria, se adecuada a las caracteristicas de la poblacion-objetivo.

Associação entre o apoio social e o perfil de cuidadores familiares de pacientes com incapacidades e dependência

Estudo descritivo, transversal, cujo objetivo foi analisar a associacao entre as dimensoes de apoio social e o perfil de cuidadores familiares de pacientes com dependencia. Entrevistaram-se 110 cuidadores, utilizando os seguintes instrumentos: questionario de caracterizacao sociodemografica, Social Network Index , Medical Outcomes Study e Indice de Barthel. Os testes U de Mann-Whitney e Kruskal-Wallis foram usados para comparar as dimensoes de apoio social e as variaveis qualitativas, e a correlacao de Spearman para as variaveis quantitativas. Cuidadores que nao sabiam ler nunca haviam estudado apresentaram melhor percepcao de apoio social em todas as dimensoes, exceto na afetiva. Na dimensao interacao positiva, aqueles que possuiam companheiro e negaram sobrecarga apresentaram media superior a dos demais grupos. O numero de familiares e amigos apresentou correlacao com todas as dimensoes de apoio social. Os resultados indicam que a rede social e importante para a percepcao de apoio.This is a descriptive cross-sectional study that analyzes the association between dimensions of social support and the profiles of family caregivers. The following instruments were used to interview 110 caregivers: a socio-demographic questionnaire, the Social Network Index, the Medical Outcomes Study, and the Barthel Index. The Mann-Whitney and Kruskal-Wallis tests were used to compare dimensions of social support and the qualitative variables as well as to determine the Spearman correlation for the quantitative variables. Caregivers who could not read or had never studied showed better perception of social support in all dimensions except the affective. In the positive interaction dimension, groups who had a partner and denied being overloaded showed a higher average than others. In addition, the number of family members and friends correlated with all dimensions of social support. Thus, the results indicate that ones social network is important for the perception of support.

Face validity of an index of family vulnerability to disability and dependence

Este estudo teve como objetivo propor e validar um indice para identificar familias em situacao de vulnerabilidade a incapacidades e dependencia. Adaptou-se o Indice de Desenvolvimento da Familia, acrescentando indicadores associados ao surgimento de incapacidade e dependencia. Para validacao aparente, utilizou-se a tecnica Delphi e foram consultados cinco experts no assunto. Foi adotado nivel de concordância de 80% entre os juizes. Apos duas rodadas de avaliacao, foram realizados ajustes quanto a forma e ao conteudo do instrumento. Itens foram transferidos de componente, outros acrescentados e alguns, excluidos. O Indice resultante e composto por oito dominios, 38 componentes e 103 questoes. A contribuicao multiprofissional para a construcao de um Indice que se propoe a captar a vulnerabilidade fisica e social das familias resultou na primeira etapa para o desenvolvimento de uma ferramenta de diagnostico e intervencao para profissionais de saude que prestam assistencia as familias na Atencao Basica.This study aimed to propose and validate an index to identify families in a vulnerable situation to disability and dependency. It was adapted from the Index of Family Development (IFD), by adding indicators associated with the emergence of disability and dependency. Delphi technique was used to validation and five experts were consulted in the matter. The adopted level of agreement between judges was 80%. After two rounds of evaluations, adjustments were made related to the form and content of the instrument. Items were transferred from one component to another, some were added, others, deleted. The resulting Index is composed of eight domains, 38 components and 103 questions. The resulting Index is composed of eight domains, 38 components and 103 questions. The multidisciplinary contribution to the construction of an index that aims to capture the physical and social vulnerability of the families to disability and dependence provided the first step for the development of a tool for diagnosis and intervention that can be used by health professionals enrolled in primary care.

Association between social support and the profiles of family caregivers of patients with disability and dependence

Estudo descritivo, transversal, cujo objetivo foi analisar a associacao entre as dimensoes de apoio social e o perfil de cuidadores familiares de pacientes com dependencia. Entrevistaram-se 110 cuidadores, utilizando os seguintes instrumentos: questionario de caracterizacao sociodemografica, Social Network Index , Medical Outcomes Study e Indice de Barthel. Os testes U de Mann-Whitney e Kruskal-Wallis foram usados para comparar as dimensoes de apoio social e as variaveis qualitativas, e a correlacao de Spearman para as variaveis quantitativas. Cuidadores que nao sabiam ler nunca haviam estudado apresentaram melhor percepcao de apoio social em todas as dimensoes, exceto na afetiva. Na dimensao interacao positiva, aqueles que possuiam companheiro e negaram sobrecarga apresentaram media superior a dos demais grupos. O numero de familiares e amigos apresentou correlacao com todas as dimensoes de apoio social. Os resultados indicam que a rede social e importante para a percepcao de apoio.This is a descriptive cross-sectional study that analyzes the association between dimensions of social support and the profiles of family caregivers. The following instruments were used to interview 110 caregivers: a socio-demographic questionnaire, the Social Network Index, the Medical Outcomes Study, and the Barthel Index. The Mann-Whitney and Kruskal-Wallis tests were used to compare dimensions of social support and the qualitative variables as well as to determine the Spearman correlation for the quantitative variables. Caregivers who could not read or had never studied showed better perception of social support in all dimensions except the affective. In the positive interaction dimension, groups who had a partner and denied being overloaded showed a higher average than others. In addition, the number of family members and friends correlated with all dimensions of social support. Thus, the results indicate that ones social network is important for the perception of support.

Frailty assessment in the elderly assisted at a Family Heath Unit

Frailty is an important health status indicator in the elderly. The Edmonton Frail Scale, a multidimensional tool validated and culturally adapted into Brazilian Portuguese, may be used for its assessment. A cross-sectional, descriptive study was developed to identify the presence of frailty in the elderly assisted by the Family Health Program in a city in Sao Paulo, Brazil. All ethical considerations were observed. A sample of 128 older adults was interviewed. There was predominance of female older adults, aged between 60 and 69 years, with low education and personal income. Considering all the older adults who answered all the questions in the scale, 103 had their level of frailty assessed. Of these, 21.4% were apparently vulnerable and 30.1% had some level of frailty, varying among low, moderate and severe. The 25 older adults who failed to answer all questions presented vulnerability to frailty. In conclusion, the scale is suitable for frailty assessment in primary care, as long as it is adjusted to the characteristics of the target population. DESCRIPTORS: Frail elderly. Family Health Program. Primary health care. Public healthLa fragilidad es un indicador importante del estado de salud de los ancianos. La Edmonton Frail Scale, herramienta multidimensional validada y culturalmente adaptada al portugues de Brasil, pode ser usada para su evaluacion. Estudio transversal, descriptivo, con el objetivo de identificar la presencia de fragilidad en personas mayores atendidas por la Estrategia de Salud de la Familia en un municipio de Sao Paulo. Todas las consideraciones eticas fueron observadas. Se entrevistaron 128 ancianos. Hubo predominio del sexo femenino, entre 60 y 69 anos de edad, bajo nivel educativo y con ingresos propios. Solo 103 personas mayores que contestaran a todas las preguntas de la escala tuvieran su grado de fragilidad evaluado. De estos, el 21, 4% eran aparentemente vulnerables y el 30, 1% tenia algun grado de fragilidad, entre leve, moderada y severa. Los 25 que no responderan a todas las preguntas presentaban vulnerabilidad a la fragilidad. Se conclui que la escala es adecuada para la evaluacion de la fragilidad en la Atencion Primaria, se adecuada a las caracteristicas de la poblacion-objetivo.

Family functioning of elderly with depressive symptoms

OBJECTIVE To classify families of elderly with depressive symptoms regarding their functioning and to ascertain the presence of an association between these symptoms, family functioning and the characteristics of the elderly. METHOD This was an observational, analytical, cross-sectional study performed with 33 teams of the Family Health Strategy in Dourados, MS. The sample consisted of 374 elderly divided into two groups (with and without depressive symptoms). The instruments for data collection were a sociodemographic instrument, the GeriatricDepression Scale (15 items) and the Family Apgar. RESULTS An association was observed between depressive symptoms and family dysfunction, female gender, four or more people living together, and physical inactivity. CONCLUSION The functional family may represent effective support for the elderly with depressive symptoms, because it offers a comfortable environment that ensures the well-being of its members. The dysfunctional family can barely provide necessary care for the elderly, which can exacerbate depressive symptoms.Objetivo: Classificar familias de idosos com sintomas depressivos quanto a funcionalidade e verificar a presenca de associacao entre tais sintomas, a funcionalidade familiar e as caracteristicas dos idosos. Metodo: Estudo analitico, observacional, transversal, realizado em 33 equipes da Estrategia Saude da Familia de Dourados, MS. A amostra foi composta por 374 idosos divididos em dois grupos (com e sem sintomas depressivos). Os instrumentos para coleta de dados foram um formulario para caracterizacao sociodemografica, a Escala de Depressao Geriatrica (15 itens) e o Apgar de Familia. Resultados: Observou-se a associacao entre sintomas depressivos e disfuncao familiar, sexo feminino, quatro e mais pessoas residindo no domicilio e inatividade fisica. Conclusao: A familia funcional pode representar apoio efetivo para idosos com sintomas depressivos, pois oferece um ambiente de conforto que assegura o bem-estar de seus membros. Ja a familia disfuncional dificilmente consegue prover a atencao necessaria ao idoso, o que pode agravar os sintomas depressivos.Objective : To classify families of elderly with depressive symptoms regarding their functioning and to ascertain the presence of an association between thes...

Social network of family caregivers of disabled and dependent patients

Cross-sectional study that used the Social Network Index and the genogram to assess the social network of 110 family caregivers of dependent patients attended by a Home Care Service in São Paulo, Brazil. Data were analyzed using the test U of Mann-Whitney, Kruskal-Wallis and Spearman correlation. Results were considered statistically significant when p<0,05. Few caregivers participated in activities outside the home and the average number of people they had a bond was 4,4 relatives and 3,6 friends. Caregivers who reported pain and those who had a partner had higher average number of relatives who to trust. The average number of friends was higher in the group that reported use of medication for depression. Total and per capita incomes correlated with the social network. It was found that family members are the primary caregivers social network.Estudio transversal que utiliza el Indice de la Red Social y el genograma para evaluar la red social de los 110 cuidadores familiares de enfermos dependientes atendidos por un servicio de cuidados en el hogar, en Sao Paulo. Los datos fueron analizados por las pruebas de Mann-Whitney, Kruskal-Wallis y la correlacion de Spearman. Los resultados se consideraron estadisticamente significativos cuando p<0,05. Pocos cuidadores participaban en actividades fuera del hogar y el numero promedio de personas con las cuales tenian vinculo fueran 4,4 personas de la familia y 3,6 amigos. Los que informaron dolor en el cuerpo y los que tenian una pareja tenian mayor numero medio de familiares en que confiar. El numero medio de amigos fue mayor en el grupo que informo el uso de medicacion para la depresion. Los ingresos totales y per capita se correlacionaron con la red social. Se encontro que los miembros de la familia son la principal red social del cuidador.

Vulnerabilidade de famílias de idosos assistidos pela Estratégia Saúde da Família

OBJECTIVE the present descriptive, exploratory, cross-sectional study aimed to identify the vulnerability of families of elderly citizens cared for by the Family Health Strategy (FHS). METHOD the research employed home interviews and was developed with a sample of 500 families of aged people cared for by 32 FHS teams in the city of Dourados, MS, Brazil. The Family Development Index (FDI) was adapted in order to classify the families according to their degree of vulnerability. RESULTS the results revealed the presence of multigenerational families with low educational levels among individuals over the age of 20 and high illiteracy rates among elderly citizens. There were 403 families whose vulnerability was acceptable, 95 in severe vulnerability, and two families in a condition of very severe vulnerability. The most critical dimensions of the FDI were the access to knowledge and to work. CONCLUSION the study identified that there is still a need for further investments that can assist these aged people and their families in the Primary Health Care.

Vulnerability of families of elderly citizens cared for by the Family Health Strategy.

OBJECTIVE the present descriptive, exploratory, cross-sectional study aimed to identify the vulnerability of families of elderly citizens cared for by the Family Health Strategy (FHS). METHOD the research employed home interviews and was developed with a sample of 500 families of aged people cared for by 32 FHS teams in the city of Dourados, MS, Brazil. The Family Development Index (FDI) was adapted in order to classify the families according to their degree of vulnerability. RESULTS the results revealed the presence of multigenerational families with low educational levels among individuals over the age of 20 and high illiteracy rates among elderly citizens. There were 403 families whose vulnerability was acceptable, 95 in severe vulnerability, and two families in a condition of very severe vulnerability. The most critical dimensions of the FDI were the access to knowledge and to work. CONCLUSION the study identified that there is still a need for further investments that can assist these aged people and their families in the Primary Health Care.