Maria Eliana Peixoto Bessa

Motivações para o ingresso dos idosos em instituições de longa permanência e processos adaptativos: um estudo de caso

Estudio de caso cuyo objetivo es conocer cuales son los principales factores que conducen un anciano a buscar una institucion de larga permanencia, y de que manera logra su adaptacion a este ambiente. Para la recoleccion de los datos se utilizaron las tecnicas de historia de vida y la observacion no participante. El periodo de recoleccion fue de abril a julio de 2006. Fueron entrevistadas nueve ancianas. El analisis de los datos fue realizado por medio de la tecnica de analisis del discurso. Los resultados indican que el ingreso en la institucion resulta de la soledad, de la necesidad de cuidados, de los conflictos familiares y de la perdida de seres queridos. La adaptacion ocurrio de la insercion en las actividades cotidianas, o por ya haber vivido en otras instituciones semejantes. La adaptacion de forma satisfactoria para la anciana transcurre de las motivaciones del ingreso. En algunos casos no hubo adaptacion y si una acomodacion a esa realidad.

Avaliação da fragilidade de idosos institucionalizados

OBJECTIVE: To assess the presence of frailty and its relationship to sociodemographic and clinical characteristics in institutionalized elderly. METHODS: Cross-sectional study with 54 elderly residents in long-stay institutions in the Northeast of Brazil. The data collection instruments were the Edmonton Frail Scale, socioeconomic assessmentand health profiles. Data were analyzed using descriptive statistics and Chi-square test, with significance level of 0.05. RESULTS: The mean age was 72.4 (± 8.5) years, 61.1% were male and 74.1% had some level of frailty. There were positive correlations between frailty, gender, age, comorbidities, body mass index and the need and amount of medicines. CONCLUSION: Frailty in institutionalized elderly is influenced by sociodemographic and clinical characteristics.

Família e redes sociais de apoio para o atendimento das demandas de saúde do idoso

A proposta foi avaliar as redes sociais de apoio das familias com idosos segundo o modelo Calgary de avaliacao de familia (MCAF). Estudo quantitativo do tipo transversal de carater exploratorio e descritivo, desenvolvido juntos as familias com idosos residentes em bairros perifericos de Fortaleza-CE, de novembro/2008 a janeiro/2009. Dados obtidos de 218 familias atraves de entrevista em domicilio ao responsavel pelos cuidados da familia. Nas redes sociais de apoio, a atuacao do enfermeiro foi bastante expressiva (32,1%); em situacao de doenca, a demanda de apoio de outros foi de 68,3% e a da familia em apoio a outros foi de 76,6%. Quanto a ajuda financeira, percebe-se que 58,7% afirmam faze-la; no entanto, apenas 36,2% pedem esse tipo de ajuda. A estrutura de familia com idosos merece atencao na busca por conhecimentos cientificos diante do holismo para subsidiar a pratica profissional do enfermeiro.

Idosas residentes em instituições de longa permanência: uso dos espaços na construção do cotidiano

Objective: To understand the way in which the institutionalized elderly organize their living spaces for their daily life. Methods: A qualitative study that used the strategy of a case study, conducted in a long-term institution for the elderly (LTCF), located in the city of Fortaleza - CE (Brazil). Participating as subjects were nine elderly residents of this institution, during the period between April and May, 2006. To collect data, we used direct nonparticipant observation, with the field notes on the interview kept in a journal based on the script of life history. Results: The reconstruction of individualized spaces was marked by the institutions organizational structure, use of common spaces and such as the elderly rearranges his own universe. Conclusions: The (re)construction of the daily life of elderly in the LTCF context is a complex process that requires effort of the elderly. In this study, we observed that the elderly are able to restructure their lives. Keywords: Aged; Homes for the aged; Housing for the elderly; Adaptation; Case studies rEsumo Objetivo: conhecer o modo como a pessoa idosa institucionalizada organiza seus espacos para viver o cotidiano. Metodos: Estudo de aborda- gem qualitativa que utilizou a estrategia de estudo de caso, realizado em uma instituicao de longa permanencia para idosos (ILPI), localizada na cidade de Fortaleza-CE. Participaram como sujeitos nove idosas residentes nessa instituicao no periodo de abril e maio de 2006. Para a coleta de dados, foram usadas a observacao direta nao participante, com registro no diario de campoe a entrevista baseada no roteiro de historia de vida. Resultados: A reconstrucao dos espacos individualizados foi pautada pela estrutura organizacional da instituicao, utilizacao dos espacos comuns e como a idosa reorganiza seu universo particular. Conclusoes: A (re) construcao do cotidiano do idoso no contexto asilar e um processo complexo que necessita de esforco do idoso. Neste estudo, observou-se que as idosas estao conseguindo reestruturar suas vidas. Descritores: Idoso; Instituicao de longa permanencia para idosos; Habitacao para idosos; Adaptacao; Estudos de casos rEsumEn Objetivo: conocer el modo como la persona anciana institucionalizada organiza sus espacios para vivir el cotidiano. Metodos: Estudio de abordaje cualitativo que utilizo la estrategia del estudio de caso, realizado en una institucion de larga estancia para ancianos (ILPI), localizada en la ciudad de Fortaleza-CE. Participaron como sujetos nueve ancianas residentes en esa institucion en el periodo de abril y mayo del 2006. Para la recoleccion de los datos, se utilizo la observacion directa no participante, con el registro en el diario de campo de la entrevista basada en la guia de historia de vida. Resultados: La reconstruccion de los espacios individualizados fue marcada por la estructura organizacional de la institucion, utilizacion de los espacios comunes y como la anciana reorganiza su universo particular. Conclusiones: La (re) construccion del cotidiano del anciano en el contexto asilar es un proceso complejo que necesita de esfuerzo del mismo. En este estudio, se observo que las ancianas estan consiguiendo reestructurar sus vidas. Descriptores: Anciano;Hogares para ancianos; Viviendas para ancianos; Adaptacion; Estudios de casos

Elderly residents in long-term institutions: the use of spaces in the construction of everyday life*

Objective: To understand the way in which the institutionalized elderly organize their living spaces for their daily life. Methods: A qualitative study that used the strategy of a case study, conducted in a long-term institution for the elderly (LTCF), located in the city of Fortaleza - CE (Brazil). Participating as subjects were nine elderly residents of this institution, during the period between April and May, 2006. To collect data, we used direct nonparticipant observation, with the field notes on the interview kept in a journal based on the script of life history. Results: The reconstruction of individualized spaces was marked by the institutions organizational structure, use of common spaces and such as the elderly rearranges his own universe. Conclusions: The (re)construction of the daily life of elderly in the LTCF context is a complex process that requires effort of the elderly. In this study, we observed that the elderly are able to restructure their lives. Keywords: Aged; Homes for the aged; Housing for the elderly; Adaptation; Case studies rEsumo Objetivo: conhecer o modo como a pessoa idosa institucionalizada organiza seus espacos para viver o cotidiano. Metodos: Estudo de aborda- gem qualitativa que utilizou a estrategia de estudo de caso, realizado em uma instituicao de longa permanencia para idosos (ILPI), localizada na cidade de Fortaleza-CE. Participaram como sujeitos nove idosas residentes nessa instituicao no periodo de abril e maio de 2006. Para a coleta de dados, foram usadas a observacao direta nao participante, com registro no diario de campoe a entrevista baseada no roteiro de historia de vida. Resultados: A reconstrucao dos espacos individualizados foi pautada pela estrutura organizacional da instituicao, utilizacao dos espacos comuns e como a idosa reorganiza seu universo particular. Conclusoes: A (re) construcao do cotidiano do idoso no contexto asilar e um processo complexo que necessita de esforco do idoso. Neste estudo, observou-se que as idosas estao conseguindo reestruturar suas vidas. Descritores: Idoso; Instituicao de longa permanencia para idosos; Habitacao para idosos; Adaptacao; Estudos de casos rEsumEn Objetivo: conocer el modo como la persona anciana institucionalizada organiza sus espacios para vivir el cotidiano. Metodos: Estudio de abordaje cualitativo que utilizo la estrategia del estudio de caso, realizado en una institucion de larga estancia para ancianos (ILPI), localizada en la ciudad de Fortaleza-CE. Participaron como sujetos nueve ancianas residentes en esa institucion en el periodo de abril y mayo del 2006. Para la recoleccion de los datos, se utilizo la observacion directa no participante, con el registro en el diario de campo de la entrevista basada en la guia de historia de vida. Resultados: La reconstruccion de los espacios individualizados fue marcada por la estructura organizacional de la institucion, utilizacion de los espacios comunes y como la anciana reorganiza su universo particular. Conclusiones: La (re) construccion del cotidiano del anciano en el contexto asilar es un proceso complejo que necesita de esfuerzo del mismo. En este estudio, se observo que las ancianas estan consiguiendo reestructurar sus vidas. Descriptores: Anciano;Hogares para ancianos; Viviendas para ancianos; Adaptacion; Estudios de casos

Cross-cultural adaptation of the Caregiver Reaction Assessment for use in Brazil with informal caregivers of the elderly

This study aimed to carry out the cross-cultural adaptation of the Caregiver Reaction Assessment CRA for use in Brazil with informal caregivers of dependent elderly METHOD A methodological study, of five steps: initial translation, synthesis of translations, retro-translation, evaluation by a judge committee and a pre-test, with 30 informal caregivers of older persons in Fortaleza, Brazil. Content validity was assessed by five experts in gerontology and geriatrics. The cross-cultural adaptation was rigorously conducted, allowing for inferring credibility. RESULTS The Brazilian version of the CRA had a simple and fast application (ten minutes), easily understood by the target audience. It is semantically, idiomatically, experimentally and conceptually equivalent to the original version, with valid content to assess the burden of informal caregivers for the elderly (Content Validity Index = 0.883). CONCLUSION It is necessary that other psychometric properties of validity and reliability are tested before using in care practice and research.UNLABELLED This study aimed to carry out the cross-cultural adaptation of the Caregiver Reaction Assessment CRA for use in Brazil with informal caregivers of dependent elderly METHOD A methodological study, of five steps: initial translation, synthesis of translations, retro-translation, evaluation by a judge committee and a pre-test, with 30 informal caregivers of older persons in Fortaleza, Brazil. Content validity was assessed by five experts in gerontology and geriatrics. The cross-cultural adaptation was rigorously conducted, allowing for inferring credibility. RESULTS The Brazilian version of the CRA had a simple and fast application (ten minutes), easily understood by the target audience. It is semantically, idiomatically, experimentally and conceptually equivalent to the original version, with valid content to assess the burden of informal caregivers for the elderly (Content Validity Index = 0.883). CONCLUSION It is necessary that other psychometric properties of validity and reliability are tested before using in care practice and research.

CONCEITOS DE SAÚDE E DOENçA SEGUNDO A ÓPTICA DOS IDOSOS DE BAIXA RENDA

This study aimed to analyze the concepts of health and illness of elders with low income. It is a qualitative exploratory-descriptive study focusing 50 elders in their residence. The data had been collected using a structured interview with script, approaching the sociodemographics data and health and illness conceptions. It was observed that the health concepts are related with the following aspects: absence of illnesses, state and emotional wellness, capacity to carry through the activities of daily life and to work besides partner-sanitary conditions. The illness concepts are related with subjective aspects, absence of health, social problems, physical symptoms and carelessness. It was verified that the health-illness process is related to the cultural and social context; life of the elders, and the knowledge they acquire through contact they have with health professionals. The conceptions of health guide the search of professional aid highlighting the importance of these concepts as part of the knowledge of those ones who deal with the elders.This study aimed to analyze the concepts of health and illness of elders with low income. It is a qualitative exploratory-descriptive study focusing 50 elders in their residence. The data had been collected using a structured interview with script, approaching the sociodemographics data and health and illness conceptions. It was observed that the health concepts are related with the following aspects: absence of illnesses, state and emotional wellness, capacity to carry through the activities of daily life and to work besides partner-sanitary conditions. The illness concepts are related with subjective aspects, absence of health, social problems, physical symptoms and carelessness. It was verified that the health-illness process is related to the cultural and social context; life of the elders, and the knowledge they acquire through contact they have with health professionals. The conceptions of health guide the search of professional aid highlighting the importance of these concepts as part of the knowledge of those ones who deal with the elders.

Qualidade de vida do idoso fragilizado e institucionalizado

Objective To assess the quality of life of institutionalized frail elderly. Methods Cross-sectional study including 33 frail and pre-frail elderly, classified based on the Edmonton Frailty Scale. An instrument was applied to characterize the sociodemographic aspects and the World Health Organization Quality of Life for Older Persons to assess the quality of life. Results The female sex was predominant (54.5%) and the mean age was 76.8 years (±9.3). A significant association was observed between the quality of life and all of its facets, and a strong relation was found between quality of life and “past, present and future activities” (r=0.715; p<0.001). Conclusion The presence of frailty did not interfere directly in the elderly’s quality of life and showed a significant association with the motive for the institutionalization.

Validation of educational booklet for HIV/Aids prevention in older adults

Objective To describe the process of manufacturing and validation of an educational booklet for HIV/Aids prevention in older adults. Methods Methodological study developed in two phases - manufacturing of the booklet and validation of the educational material by judges. The manufacturing process involved a situational diagnosis with older adults, and its result indicated gaps in the knowledge with respect to HIV/Aids. The validation process was performed by nine judges, selected by convenience. It was considered an agreement index of at least 0.80, analyzed through the content validity index. Results We opted for a dialogue between two older adults divided into three categories: myths and taboos; ignorance; and prevention and importance of diagnosis. The average of the items was 0.90. The suggestions made by the judges were observed and modified for the final version. Conclusion The material had relevant content for the judges, in addition to being able to be used by health professionals in the education and clarification of issues on the subject.

Health policies for the elderly and their families: an integrative literature review

ABSTRACT Objective: to analyse the trends in scientific production on public policies aimed at elderly and family. Method : it an integrative literature review that guided the question: what the evidence of scientific production on publics policies aimed at elderly and the family? We used four databases: LILACS , MEDLINE , Scielo and Library COCHRANE. The search period was between February and june 2010. Results: of a sample of 603 articles were selected only six, which showed an increase in disability in the elderly while the increase in life expectancy. There is also an increase in charge of Social Security, to be a challenge to public policies promote a active aging, being necessary for this, a reconfiguration of the heath sector. Conclusion: study showed a complexity in implementing public policies , as well as a literature scarce , according to the adopted approach. To instigate , then, new scientific production in area of nursing in order to promote the construction of new strategies, as well as the real applicability of existing ones to make the elderly an active part of society . Descriptors: politics; aged; family; nursing research. RESUMO Objetivo : analisar as tendencias na producao cientifica sobre as politicas publicas voltadas ao idoso e familia. Metodo : trata-se de uma revisao integrativa da literatura que se norteou pelo seguinte questionamento: quais as evidencias das producoes cientificas sobre as Politicas Publicas voltadas ao idoso e a familia? Foram utilizadas quatro bases de dados: LILACS; MEDLINE; Scielo e Biblioteca COCHRANE. O periodo da busca foi entre os meses de fevereiro a junho de 2010. Resultados : de uma amostra de 603 artigos selecionaram-se apenas seis, onde se evidenciou um aumento das incapacidades em idosos simultaneamente ao acrescimo da expectativa de vida. Ha tambem um aumento nos encargos da Previdencia Social, sendo um desafio as politicas publicas a promocao de um envelhecimento ativo, sendo necessario para este, uma reconfiguracao do setor saude. Conclusao : o estudo evidenciou uma complexidade em implementar politicas publicas, bem como um literatura escassa, de acordo com a abordagem adotada. Instiguem-se, entao, novas producoes cientificas na area da enfermagem, de maneira a fomentar a construcao de novas estrategias, bem como a real aplicabilidade das existentes, de modo a tornar o idoso parte ativa da sociedade. Descritores : politica; idoso; familia; pesquisa em enfermagem. RESUMEN Objetivo : analizar la evolucion de la produccion cientifica en las politicas publicas dirigidas a ancianos y la familia. Metodo : se trata de uma revision de la literatura de integracion que guio a los pregunta: ?cual ES la evidencia de la producion cientifica em las politicas publicas dirigidas a ancianos y la familia? Hemos utilizado cuatro bases de datos: LILACS, MEDLINE, Scielo y la Biblioteca COCHRANE. El periodo de busqueda fue entre febrero y junio de 2010. Resultados : de uma muestra de 603 articulos fueron seleccionados solo seis, que mostraron um aumento en discapacidad em los ancianos, mientras que el aumento de la esperanza de vida. Tambien hay um aumento a cargo de la Seguridad Social, a ser um desafio para las politicas publicas para promover un envejecimiento activo, siendo necesario para ello, uma reconfiguracion del sector de salud. Conclusion : estudio mostro una complejidad en la implementacion de politicas publicas , asi como una literatura escasos , de acuerdo con el enfoque adoptado . Impulsar, a continuacion, la nueva produccion cientifica em area de enfermeria con el fin de promover la construccion de nuevas estrategias, asi como el real aplicabilidad de las existentes para que los ancianos sean parte activa de la sociedad. Descritores : politica; anciano; familia; investigacion en enfermeria.