Fernanda Aparecida Cintra

Orientações para idosas que cuidam de idosos no domicílio

Trata-se de um relato de experiencia de um programa de orientacao para idosas cuidadoras de idosos no domicilio, realizado pelo Grupo de Atencao a Saude do Idoso (GRASI), do Hospital de Clinicas da Universidade Estadual de Campinas. Esse programa foi elaborado e desenvolvido para atender uma solicitacao de idosas cuidadoras, e participantes do GRASI. Ao final das atividades, as participantes relataram que o programa possibilitou o melhor enfrentamento das dificuldades, a compreensao das distintas alteracoes presentes na velhice, e o desenvolvimento de procedimentos que facilitam a relacao com o idoso no dia-a-dia.(AU)This is a report of experience about the development of a program designed especially for the orientation of elderly people who care for elderly relatives at home. It was carried out by the coordinators of the Group of Attention for Elderly Peoples Health (GRASI), of the Campinas State Universitys Clinics Hospital. This program was developed based on the needs reported by elderly caregivers who take part in the activities of the GRASI. The participants reported that the program made coping with the difficulties related to caregiving better; that there had been an improvement in the understanding of the changes brought by the aging process; and that it made possible the development of procedures that make easier the daily relationship with the elderly that is being cared for.

Relationship between lower-limb muscle strength and frailty among elderly people

CONTEXT AND OBJECTIVE Sarcopenia is the main factor involved in the development of frailty syndrome. The aims here were to investigate relationships between lower-limb muscle strength and the variables of sex, age and frailty criteria; compare lower-limb muscle strength with each frailty criterion; and assess the power of each criterion for estimating the risk of frailty among elderly outpatients. DESIGN AND SETTING Cross-sectional study at the Geriatrics Outpatient Clinic of a university hospital in Campinas. METHOD A non-probabilistic convenience sample of 150 elderly people of both sexes who were followed up as outpatients was assessed. Sociodemographic data (sex and age) and physical health data (frailty criteria and the five-times sit-to-stand test) were gathered. Descriptive, comparative and multivariate logistic regression analyses were performed. RESULTS The majority of the elderly people (77.3%) were 70 years of age or over, with predominance of females (64.2%) and had a low score for the five-times sit-to-stand test (81.4% scored 0 or 1); 55.3% of the elderly people presented three or more frailty criteria. A significant association was found between lower-limb muscle strength and the variables of age and number of frailty criteria. CONCLUSIONS Lower levels of lower-limb muscle strength were associated with advanced age and greater presence of signs of frailty. Moreover, lower-limb muscle strength was also associated with the criteria of reduced walking speed criteria and hand-grip strength.

Atividades de lazer em idosos durante a hospitalização

This study intended to: 1. Identify the leisure activities available in the hospital and those in which the elderly participate; 2. Relate elderly hospitalization with their participation in leisure activities; 3. Assess the factors that motivate and inhibit elderly participation in leisure activities. This is a descriptive/exploratory study carried out with one hundred hospitalized elderly patients. Available leisure activities were television and magazines. Most participants (99%) said they participate in leisure activities such as family/friends conversations and visits. Involvement in leisure activities decreases with associated diseases and increases with hospitalization time. Leisure was motivated by the elderlys personal characteristics, the reduction of the hospitalizations negative effects, and the benefits it brings to the health. Its limitation was associated to intrinsic aspects of the elderly and to the institutional context.This study intended to: 1. Identify the leisure activities available in the hospital and those in which the elderly participate; 2. Relate elderly hospitalization with their participation in leisure activities; 3. Assess the factors that motivate and inhibit elderly participation in leisure activities. This is a descriptive/exploratory study carried out with one hundred hospitalized elderly patients. Available leisure activities were television and magazines. Most participants (99%) said they participate in leisure activities such as family/ friends conversations and visits. Involvement in leisure activities decreases with associated diseases and increases with hospitalization time. Leisure was motivated by the elderlys personal characteristics, the reduction of the hospitalizations negative effects, and the benefits it brings to the health. Its limitation was associated to intrinsic aspects of the elderly and to the institutional context.Este estudio tuvo como objetivos: 1. Identificar las actividades recreativas disponibles en el hospital y las realizadas por los ancianos; 2. Relacionar el internamiento con participacion en las actividades recreativas; 3. Evaluar los factores que motivan e impiden la participacion en estas actividades. Se trata de una investigacion descriptiva/exploratoria, con 100 ancianos hospitalizados. Las actividades disponibles fueron: television y revistas. La mayoria de los sujetos (99%) afirmo participar de actividades recreativas, destacandose la conversacion, la visita de familiares/amigos. La participacion en otras actividades disminuye con las comorbilidades y aumenta con el internamiento. La recreacion fue motivada por las caracteristicas personales de los ancianos, reduccion de los efectos de la hospitalizacion y beneficios para la salud. Su limitacion se asocio a los aspectos intrinsecos de los ancianos y al contexto institucional.

A significação do glaucoma e a mediação dos significados de velhice na perspectiva vygotskiana: subsídios para a educação à saúde

Visando obter subsidios para a educacao a saude de idosos portadores de glaucoma, realizou-se o estudo coin tres sujeitos glauco matosos, acima de 60 anos, por meio de entrevista individual e grupal. Foram identificados e analisados os sentidos e significados da doenca e da propria vida e a relacao entre eles, na perspectiva vygotskiana. A significacao do glaucoma se configura no decurso da constituicao emocional dos sujeitos e das suas experiencias, reestruturando a sua subjetividade e a realidade em que vivem. A motivacao central dessa significacao e a esperanca na cura da doenca, a manutencao da autonomia e da independencia.The objective was to obtain support to the health education of elderly with glaucoma. We interviewed three glaucoma patients, with ages above 60 years, individually, prior to a group session. We identified and analyzed the senses and meanings of glaucoma and of life itself as well the relationship between them, from the Vygotskys perspective. The significance of glaucoma takes form during the patients emotional constitution and experiences, remodelling of their subjective condition and their lives. The central motivation in this significance is the hope of a cure for glaucoma and the desire to preserve the autonomy and independence.

Maus-tratos contra idosos: atualização dos estudos brasileiros

O envelhecimento populacional trouxe consigo temas emergentes como os maus-tratos contra idosos, que em decorrencia de seu carater biopsicossocial, aspira por investigacoes mais profundas e solucoes urgentes. A pouca disseminacao das informacoes sobre maus-tratos aos idosos contribui para a perpetuacao da violencia e, frente a este cenario, o presente estudo objetivou realizar uma atualizacao ampla da literatura atraves da caracterizacao dos tipos de violencia, do perfil do agressor e vitima, principais locais de ocorrencia, indicadores, epidemiologia, instrumentos de deteccao e propostas de resolucao com base nos dados dos ultimos anos de pesquisa cientifica (2001 a 2008). No desenvolvimento desta producao, nos deparamos com a escassez de dados epidemiologicos atualizados que expressem a verdadeira dimensao estatistica do problema, alem da ausencia de exploracao cientifica minuciosa das diversas faces da violencia contra o idoso. Sendo assim, este possui, tambem, o intuito de enfatizar a necessidade de futuras producoes cientificas abordando a presente questao visto que, por meio do maior entendimento e desenvolvimento de pesquisas acerca do assunto, serao ampliadas as condicoes para prevencao, autuacao e condutas adequadas, tanto por parte de orgaos e profissionais, que sejam ou nao da area da saude, quanto pelos proprios idosos que necessitam de maior respaldo de orientacao.

Implantação do Grupo de Atenção à Saúde do Idoso (GRASI) no Hospital de Clínicas da Universidade Estadual de Campinas (SP): relato de experiência

This study aims at reporting the experience of establishing the Group for Elderly Care (GRASI) in an outpatient clinic at a General University Hospital (Hospital de Clinicas - Universidade Estadual de Campinas), with the goal of elaborating and developing an educative program to elderly and their families. The program approached topics requested by the clients, such as increased risk for falls, changes in memory, sleep and vision, as well as issues considered important by the researchers, such as self-care, emotional aspects, senescence and senility. The experience was evaluated as a significant contribution to elderly daily life as well as a good opportunity for acquiring new knowledge and new friendships.This study aims at reporting the experience of establishing the Group for Elderly Care (GRASI) in an outpatient clinic at a General University Hospital (Hospital de Clínicas--Universidade Estadual de Campinas), with the goal of elaborating and developing an educative program to elderly and their families. The program approached topics requested by the clients, such as increased risk for falls, changes in memory, sleep and vision, as well as issues considered important by the researchers, such as self-care, emotional aspects, senescence and senility. The experience was evaluated as a significant contribution to elderly daily life as well as a good opportunity for acquiring new knowledge and new friendships.

Health-related quality of life among the elderly with heart failure: a generic measurement

CONTEXT AND OBJECTIVE Health-related quality-of-life (HRQoL) instruments have been greatly used among patients with heart failure (HF), although few of them are specific for elderly people. Among the generic instruments, the Medical Study 36-item Short-Form Health Survey (SF-36) is widely used. The aim here was to evaluate HRQoL among elderly individuals with HF through this generic instrument. DESIGN AND SETTING Cross-sectional study at two university hospitals in São Paulo, Brazil. METHODS 170 elderly people with HF who were being followed up as outpatients were interviewed. To evaluate HRQoL, SF-36 was used. RESULTS The sample was composed of subjects with a mean age of 67.5 (± 6.2) years, with a diagnosis of HF for 65.9 (± 42.4) months, in functional class I (38.8%; 66) or II (42.9%; 73) and with reduced left ventricular ejection fraction (LVEF) (51.2%). The mental and social HRQoL domains did not seem to be compromised, since they presented high scores. Patients with HF typically had impaired physical capacity, which may explain the lower scores in the physical domain. Cronbachs alpha coefficients were greater than 0.77 for all dimensions, except for general health status. CONCLUSION The HRQoL measurements using SF-36 presented a high level of reliability when applied to Brazilian elderly individuals with HF. This population presented lower scores for the functional capacity and physical dimensions. This provides support for intervention studies aiming towards optimization of HRQoL in this group.

A relevância do exame físico do idoso para a assistência de enfermagem hospitalar

Background: In nursing practice, it has been noticed that those examinations are rarely done in a singular and systematic way. Aim: To verify the importance attributed by nurses to the physical examination in elderly, for hospital nursing assistance. Method: Twenty five nurses from the following wards were interviewed: Surgery, Gastroenterology, Cardiology and Pneumology, and Adult General ward I – II at the Clinical Hospital, Campinas State University. Results: Only one of the informants had no information on physical examination during graduation and most of them had lack of information or no information at all on senescence and senility. Most informants (88%) perform the physical examination and show motivation to execute it, though they do it in an incomplete way. Final Considerations: This results show the requirement of capacitation for nurses who treats the aged, considering that physical examination in elderly has its specificities.INTRODUCAO: O exame fisico do idoso fornece dados relevantes para a assistencia, contudo observa-se na pratica de enfermagem que raramente ele e realizado de forma singular e sistematizado. OBJETIVO: foi verificar a importância atribuida por enfermeiros ao exame fisico do idoso, para a assistencia de enfermagem hospitalar. METODO: foram entrevistados 25 enfermeiros das unidades de internacao: Gastroclinica e Gastrocirurgia, Cardiologia e Pneumologia, e Enfermaria Geral de Adultos I e II do Hospital de Clinicas da Universidade Estadual de Campinas. RESULTADOS: apenas um enfermeiro nao foi contemplado com conteudo sobre exame fisico durante a graduacao, e que para grande parte dos entrevistados os temas senescencia e senilidade foram abordados de forma deficitaria ou nao foram abordados. A maioria dos entrevistados (88%) realiza o exame fisico e mostra-se motivada para efetua-lo, embora o faca de maneira incompleta. CONSIDERACOES FINAIS: Os achados revelam a necessidade de capacitar os enfermeiros que lidam com idosos, tendo em vista as peculiaridades do exame fisico e as necessidades dessa clientela.

Evaluation of an educational program for patients with glaucoma

PURPOSE To analyze the results of an educational program applied to glaucoma patients; to serve as a guideline for a definitive educational program to be developed at the Glaucoma Service of the University of Campinas. METHODS Fifty glaucoma patients were given information about the disease and its treatment by an experienced nurse and answered the same questionnaire before and 2.7 months after the initial explanation. The technique of eyedrop instillation was compared before and after the educational program. RESULTS There was no significant improvement concerning the knowledge of the identification of the ocular disease, the side effects, the meaning of glaucoma, the importance of treatment, the purpose of medications and the normal value of intraocular pressure. There was a significant improvement in all steps of eyedrop instillation (p < 0.01) and in knowledge regarding the importance of heredity (p < 0.001) and the purpose of perimetry (p=0.033). CONCLUSION Although a significant improvement was observed in the technique of eyedrop instillation, the authors conclude that this plan was not complete enough for its contents fully to be understood. These findings may be secondary to the vertical teaching-learning process, which is inappropriate for the patient, and to the difficulty in comprehending the information, which is associated with low cultural and instruction levels, and to psychosocial factors related to their disease.

Quality of life in older adults with heart failure: assessment with a specific instrument

Objective: To assess the quality of life in elderly patients with heart failure. Methods: Cross-sectional study conducted in two university hospitals. Interviews were conducted with 170 elderly patients with heart failure in an outpatient setting. To assess the quality of life, the Minnesota Living With Heart Failure Questionnaire was used. Results: The results showed a minor impact of illness on the emotional dimension of quality of life. However, indicators related to the physical dimension, including fatigue and breathlessness, showed a greater impact on quality of life for elderly patients. The internal consistency of the instrument-specific to quality of life was high, indicating satisfactory reliability (α> 0.80). Conclusion: This study enabled the assessment of quality of life of elderly patients living with heart failure, demonstrating that the physical dimension was the most compromised. It is essential to implement strategies to improve physical functioning in these patients.Objective: To assess the quality of life in elderly patients with heart failure. Methods: Cross-sectional study conducted in two university hospitals. Interviews were conducted with 170 elderly patients with heart failure in an outpatient setting. To assess the quality of life, the Minnesota Living With Heart Failure Questionnaire was used. Results: The results showed a minor impact of illness on the emotional dimension of quality of life. However, indicators related to the physical dimension, including fatigue and breathlessness, showed a greater impact on quality of life for elderly patients. The internal consistency of the instrument-specific to quality of life was high, indicating satisfactory reliability (α> 0.80). Conclusion: This study enabled the assessment of quality of life of elderly patients living with heart failure, demonstrating that the physical dimension was the most compromised. It is essential to implement strategies to improve physical functioning in these patients.