Fernanda Amendola

Qualidade de vida dos cuidadores de pacientes dependentes no programa de saúde da família

La investigacion tuvo como objetivo evaluar la asociacion entre la calidad de vida de los cuidadores familiares de enfermos dependientes atendidos por el Programa Salud de la Familia y las caracteristicas sociales, demograficas, y de salud, asi como el grado de sobrecarga percibido y el grado de independencia funcional del enfermo. Fueron entrevistados 66 cuidadores, en el periodo de diciembre 2006 a marzo 2007, utilizando un cuestionario de caracterizacion WHOQOL-bref, Zarit Burden Interview y la Medida de Independencia Funcional para los enfermos. Hubo el predominio de mujeres cuidadoras, amas de casa, con un promedio de 50,5 anos de edad. La media de la medida de independencia funcional fue 57,82, clasificando los enfermos en dependencia modificada. La escala Zarit se correlaciono negativamente con todos los dominios del WHOQOL-bref. Las variables independientes estadisticamente relacionadas a la calidad de vida general, en el modelo multiple, fueron: escala de sobrecarga, la presencia del companero y la presencia de enfermedad en el cuidador.The objective of this study was to evaluate the association between the quality of life of family caregivers of dependent patients served by the Brazilian Family Health Program healthcare teams and socio-demographic characteristics, health condition, level of perceived burden, and degree of functional independence of the patient. Interviews were administered to 66 caregivers between December, 2006 and March, 2007, and utilizing the WHOQOL-bref; Zarit Burden Interview, and Functional Independence Measure of the patients as instruments. The caregivers were predominantly women, housewives, with an average age of 50.5 years. The average functional independence measure was 57.82, classifying the sample of patients in modified dependence. The Zarit was negatively correlated with all domains of the WHOQOL-bref. The statistically independent variables related to overall quality of life in the multiple model were: burden scale, the presence of a companion, and the presence of disease in the caregiver.

Validação, no Brasil, do Índice de Barthel em idosos atendidos em ambulatórios

Objective: To validate the Barthel Index for elderly patients being attended in outpatient clinics in Brazil through analysis of reliability and validity. Methods: To prove the reliability, it was used the internal consistency and to verify its validity was used the factor analysis and the validity criterions of convergence and discriminancy. Results: The reliability calculated with the alpha of Cronbach presented the value of 0.90 for the total scale. The validity analysis of convergent criterion, using the Functional Independence Measure, identified a satisfactory correlation for most areas. In the factor analysis, which retained only one domain and the 10 items of the original scale, the variance explained was 63.8%. Conclusion: The results recommend its use for evaluating the functional ability of elderly patients being treated in outpatient care in Brazil.

Rede de suporte social do idoso atendido por equipes de Saúde da Família

The aging process has specific aspects marked by the class of individuals and social groups as well as cultural, political, socio-economic and sanitary conditions of the collective groups. Social support systems are essential for meeting the specific needs of the elderly. The aim of this paper is to describe the socio-demographic profile and the social support networks of elderly patients served by the Family Health Strategy. Its a cross-sectional study with elderly patients living in Dourados, in the state of Mato Grosso do Sul (Brazil). Data were collected using a socio-demographic questionnaire and a Minimum Relationships Map for the Elderly (MMRI). Of the 503 elderly patients interviewed, 69% were female, 53.1% were illiterate, 58.3% earned less than one minimum salary and 82.9% lived with others. The MMRI showed that the family was the most important provider of care in all the dimensions assessed, but the elderly have their own small social networks. Elderly patients attended by the Family Health teams have low incomes and little formal education, and social support networks that are too small to meet their needs.

Influence of social support on the quality of life of family caregivers while caring for people with dependence

O objetivo deste estudo foi avaliar a qualidade de vida de cuidadores familiares de pessoas dependentes atendidas por equipes de Saude da Familia e a relacao com o apoio social. Foram entrevistados 66 cuidadores, utilizando o WHOQOL-bref para avaliacao da qualidade de vida, e Zarit Burden Interview para a sobrecarga. O dominio Relacoes Sociais do WHOQOL-bref obteve o segundo melhor escore. Na analise de regressao linear multipla, cuidadores do sexo feminino com menores escores de sobrecarga e aqueles que recebiam ajuda de alguem para realizar o cuidado alcancaram os maiores escores. Da mesma forma, cuidadoras com companheiros apresentaram maior escore medio na avaliacao global da qualidade de vida e saude do que as sem companheiros. Os resultados fornecem indicios da influencia da rede de apoio social na qualidade de vida e sobrecarga dos cuidadores familiares.The objective of this study was to evaluate the Quality of Life (QOL) of family caregivers of handicapped people attended at home by Family Health Teams and the relationship with their social support. Sixty-six family caregivers were interviewed using the WHOQOL-bref for a QOL evaluation and Zarit Burden Interview for the burden. The Social Relations domain of the WHOQOL-bref received the second best score within the domains of the instrument. During multiple linear regressions analysis, female caregivers, with low burden scores and who had received help from someone to perform the care, obtained the highest scores. Similarly, caregivers with partners had higher mean scores in the overall global assessment for QOL and health than those without partners. The results provide evidence of the influence of social support regarding Quality of Life and the burden perceived by family caregivers.

Influência do apoio social na qualidade de vida do cuidador familiar de pessoas com dependência

O objetivo deste estudo foi avaliar a qualidade de vida de cuidadores familiares de pessoas dependentes atendidas por equipes de Saude da Familia e a relacao com o apoio social. Foram entrevistados 66 cuidadores, utilizando o WHOQOL-bref para avaliacao da qualidade de vida, e Zarit Burden Interview para a sobrecarga. O dominio Relacoes Sociais do WHOQOL-bref obteve o segundo melhor escore. Na analise de regressao linear multipla, cuidadores do sexo feminino com menores escores de sobrecarga e aqueles que recebiam ajuda de alguem para realizar o cuidado alcancaram os maiores escores. Da mesma forma, cuidadoras com companheiros apresentaram maior escore medio na avaliacao global da qualidade de vida e saude do que as sem companheiros. Os resultados fornecem indicios da influencia da rede de apoio social na qualidade de vida e sobrecarga dos cuidadores familiares.The objective of this study was to evaluate the Quality of Life (QOL) of family caregivers of handicapped people attended at home by Family Health Teams and the relationship with their social support. Sixty-six family caregivers were interviewed using the WHOQOL-bref for a QOL evaluation and Zarit Burden Interview for the burden. The Social Relations domain of the WHOQOL-bref received the second best score within the domains of the instrument. During multiple linear regressions analysis, female caregivers, with low burden scores and who had received help from someone to perform the care, obtained the highest scores. Similarly, caregivers with partners had higher mean scores in the overall global assessment for QOL and health than those without partners. The results provide evidence of the influence of social support regarding Quality of Life and the burden perceived by family caregivers.

Validation of the Barthel Index in elderly patients attended in outpatient clinics, in Brazil

Objective: To validate the Barthel Index for elderly patients being attended in outpatient clinics in Brazil through analysis of reliability and validity. Methods: To prove the reliability, it was used the internal consistency and to verify its validity was used the factor analysis and the validity criterions of convergence and discriminancy. Results: The reliability calculated with the alpha of Cronbach presented the value of 0.90 for the total scale. The validity analysis of convergent criterion, using the Functional Independence Measure, identified a satisfactory correlation for most areas. In the factor analysis, which retained only one domain and the 10 items of the original scale, the variance explained was 63.8%. Conclusion: The results recommend its use for evaluating the functional ability of elderly patients being treated in outpatient care in Brazil.

Quality of life of family caregivers of patients dependent on the family health program

La investigacion tuvo como objetivo evaluar la asociacion entre la calidad de vida de los cuidadores familiares de enfermos dependientes atendidos por el Programa Salud de la Familia y las caracteristicas sociales, demograficas, y de salud, asi como el grado de sobrecarga percibido y el grado de independencia funcional del enfermo. Fueron entrevistados 66 cuidadores, en el periodo de diciembre 2006 a marzo 2007, utilizando un cuestionario de caracterizacion WHOQOL-bref, Zarit Burden Interview y la Medida de Independencia Funcional para los enfermos. Hubo el predominio de mujeres cuidadoras, amas de casa, con un promedio de 50,5 anos de edad. La media de la medida de independencia funcional fue 57,82, clasificando los enfermos en dependencia modificada. La escala Zarit se correlaciono negativamente con todos los dominios del WHOQOL-bref. Las variables independientes estadisticamente relacionadas a la calidad de vida general, en el modelo multiple, fueron: escala de sobrecarga, la presencia del companero y la presencia de enfermedad en el cuidador.The objective of this study was to evaluate the association between the quality of life of family caregivers of dependent patients served by the Brazilian Family Health Program healthcare teams and socio-demographic characteristics, health condition, level of perceived burden, and degree of functional independence of the patient. Interviews were administered to 66 caregivers between December, 2006 and March, 2007, and utilizing the WHOQOL-bref; Zarit Burden Interview, and Functional Independence Measure of the patients as instruments. The caregivers were predominantly women, housewives, with an average age of 50.5 years. The average functional independence measure was 57.82, classifying the sample of patients in modified dependence. The Zarit was negatively correlated with all domains of the WHOQOL-bref. The statistically independent variables related to overall quality of life in the multiple model were: burden scale, the presence of a companion, and the presence of disease in the caregiver.

Avaliação do risco nutricional em idosos atendidos por Equipes de Saúde da Família

Alteracoes do estado nutricional contribuem para o aumento da morbi-mortalidade em idosos. O instrumento The Nutrition Screening Initiative (NSI) foi desenvolvido para identificar riscos nutricionais nesse grupo populacional. Este estudo tem por objetivos descrever o perfil sociodemografico e avaliar o risco nutricional de idosos atendidos por equipes da Estrategia Saude da Familia. O estudo e transversal, com amostra de 503 idosos residentes em Dourados (MS). Instrumentos: NSI e questionario estruturado para as variaveis sociodemograficas de saude. Verificou-se o predominio de idosos do sexo feminino, entre 60 a 69 anos, viuvos, analfabetos, de renda per capita de ate um salario minimo, com hipertensao e auto-avaliacao regular de saude. O NSI permitiu identificar 33,2% de idosos com alto risco nutricional, o que se mostrou significativamente associado ao baixo nivel de escolaridade, a baixa renda per capita e as doencas cronicas. Como metodo de rastreio, o NSI mostrou-se util para identificar os determinantes sociais e de saude que contribuem para o risco nutricional.UNLABELLED Changes in the nutritional state contribute to an increase of morbi-mortality among the elderly. The instrument Nutrition Screening Initiative (NSI) was developed in order to identify nutritional risks in this population group. This study aims to describe the socio-demographic profile and evaluate the nutritional risk of the elderly assisted by Family Health Strategy teams. It is a cross-sectional study with a sample of 503 older people living in Dourados (MS). INSTRUMENTS NSI and structured questionnaire for the health socio-demographic variables. There was a prevalence of female people, aged between 60 and 69 years old, widowers, illiterate, with a per capita income up to one minimum salary with hypertension and regular health self-evaluation. The NSI allowed to identify 33.2% of the elderly with high nutritional risk, which was significantly associated to the low level of education, low per capita income and chronic diseases. As a tracking method, the NSI was useful to identify the social and health determinants that contribute to the nutritional risk.

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.