Marília Pilotto de Oliveira

Trabalho e qualidade de vida relacionada à saúde de pacientes em diálise peritoneal

Objective: To describe and compare Health Related Quality of Life (HRQoL) of patients on peritoneal dialysis (PD) who had and who did not have paid work. Methods: A cross-sectional and populational study with 82 patients from the two PD services in Ribeirão Preto (SP), Brazil. Data collection was conducted by interviews between December/2009 and March/2010. The questionnaires for the characterization of patients, the Mini Mental State Examination and the Kidney Disease and Quality of Life-Short Form were used. Analyses were performed using exploratory univariate and bivariate statistics, and the confirmatory bivariate among the independent variables and the dimensions of HRQoL. Results: Patients with paid work presented higher mean scores reflecting better HRQoL for the majority of the dimensions of the instrument used. Conclusion: Work is an important facet of life for these patients and merits the attention of health professionals in the search for strategies that promote and incentivize its maintenance and the reintegration of patients into the labor market.

O idoso em diálise

Aging and changes in the epidemiologic profile of the population are contributing factors for the increasing number of older adults undergoing renal replacement therapy. This study describes the main characteristics of older adults undergoing dialysis and the health care delivery system, including the specialized and individualized nursing care to address the needs of the older adults attending dialysis centers.Em decorrencia, principalmente, do envelhecimento populacional e mudancas no perfil epidemiologico, tem-se observado um crescente aumento do numero de idosos em terapia renal substitutiva. O presente relato aponta e descreve os principais aspectos e as caracteristicas do idoso em dialise; e destaca como imprescindivel o atendimento em saude, incluindo o cuidado de enfermagem, direcionado e especializado, diante das especificidades e necessidades desta parcela de pacientes nos centros de dialise.

Older adults undergoing dialysis

Aging and changes in the epidemiologic profile of the population are contributing factors for the increasing number of older adults undergoing renal replacement therapy. This study describes the main characteristics of older adults undergoing dialysis and the health care delivery system, including the specialized and individualized nursing care to address the needs of the older adults attending dialysis centers.Em decorrencia, principalmente, do envelhecimento populacional e mudancas no perfil epidemiologico, tem-se observado um crescente aumento do numero de idosos em terapia renal substitutiva. O presente relato aponta e descreve os principais aspectos e as caracteristicas do idoso em dialise; e destaca como imprescindivel o atendimento em saude, incluindo o cuidado de enfermagem, direcionado e especializado, diante das especificidades e necessidades desta parcela de pacientes nos centros de dialise.

Work and health-related quality of life of patients on peritoneal dialysis

Objective: To describe and compare Health Related Quality of Life (HRQoL) of patients on peritoneal dialysis (PD) who had and who did not have paid work. Methods: A cross-sectional and populational study with 82 patients from the two PD services in Ribeirão Preto (SP), Brazil. Data collection was conducted by interviews between December/2009 and March/2010. The questionnaires for the characterization of patients, the Mini Mental State Examination and the Kidney Disease and Quality of Life-Short Form were used. Analyses were performed using exploratory univariate and bivariate statistics, and the confirmatory bivariate among the independent variables and the dimensions of HRQoL. Results: Patients with paid work presented higher mean scores reflecting better HRQoL for the majority of the dimensions of the instrument used. Conclusion: Work is an important facet of life for these patients and merits the attention of health professionals in the search for strategies that promote and incentivize its maintenance and the reintegration of patients into the labor market.

Older adults hospitalized in a teaching hospital: clinical characteristics and outcomes

Objective: to investigate the causes of older adult hospitalizations, demographic and clinical profiles, and patient outcome. Method: quantitative cross-sectional study conducted with 14,892 electronic medical records during 12 months. We carried out a descriptive analysis of the variables of the sample characterization, and an associative test using chi-square statistics. Results: most patients assessed were male, had primary education, lived with a partner, were white and Catholics, and had cardiovascular diseases, followed by neoplasms and gastrointestinal diseases in both sexes. The average age of the patients was 72.1 years, and the average length of hospital stay was 5.9 days. There was a significant association between diagnosed diseases, sex (p <0.001), and ethnicity (p = 0.023) of the patients. The most common outcome was hospital discharge. Conclusion: chronic diseases were the main causes of older adult hospitalizations and led to increased length of hospital stay. The assessment of these factors provides subsidies for identifying problems and performing best nursing interventions. Descriptors: Older Adult; Hospitalization; Clinical Evolution. RESUMO Objetivo: investigar as causas de internação dos idosos hospitalizados, o perfil demográfico, o perfil clínico e o desfecho. Método: estudo quantitativo, transversal de análise de 14.892 prontuários eletrônicos, no período de 12 meses. Foi realizada uma análise descritiva das variáveis de caracterização amostral e aplicação do teste associativo pela estatística qui-quadrado. Resultados: a maioria dos pacientes avaliados era do sexo masculino, com grau de instrução fundamental, com companheiro, do lar, brancos, católicos e com doenças cardiovasculares, seguidas de neoplasias e doenças gastrointestinais em ambos os sexos. A idade dos pacientes apresentou média de 72,1 anos e a média da permanência hospitalar foi de 5,9 dias. Houve associação significativa entre as doenças diagnosticadas, o sexo (p <0,001) e a etnia (p = 0,023) dos pacientes. O desfecho mais comum foi a alta dos pacientes. Conclusão: as doenças crônicas foram as principais causas de hospitalização dos idosos, acarretando mais tempo na hospitalização. A investigação destes fatores fornece subsídios para identificação dos problemas e realizar melhores ações de enfermagem. Descritores: Idoso; Hospitalização; Evolução Clínica. RESUMEN Objetivo: investigar las causas de hospitalización de adultos mayores, perfil demográfico, perfil clínico y desenlaces. Método: estudio cuantitativo transversal con análisis de 14.892 registros médicos electrónicos de un período de 12 meses. Se realizó un análisis descriptivo de las variables de caracterización de la muestra y se aplicó la prueba chi-cuadrado. Resultados: la mayoría de los pacientes evaluados eran hombres, con educación primaria, vivían en pareja, eran blancos, católicos y tenían enfermedades cardiovasculares, seguidas de neoplasias y enfermedades gastrointestinales en ambos sexos. El promedio de edad de los pacientes fue de 72,1 años y de la estancia hospitalaria fue de 5,9 días. Hubo una asociación significativa entre enfermedades diagnosticadas, sexo (p <0.001) y etnia (p = 0.023) de los pacientes. El resultado más común fue el alta hospitalaria. Conclusión: las enfermedades crónicas fueron las principales causas de hospitalización de los adultos mayores, llevando a un tiempo más prolongado de internación. La investigación de estos factores proporciona subsidios para identificación de problemas y realizar mejores intervenciones de enfermería. Descritores: Adulto Mayor; Hospitalización; Evolución Clínica. Nurse, Master’s Degree in Nursing, São José do Rio Preto School of Medicine (FAMERP). São José do Rio Preto, SP, Brazil. E-mails: ca.c.rodrigues@hotmail.com; samaris.enf@hotmail.com; Nurse, Ph.D., Professor at the Department of General Nursing and the Nursing Graduate Program, São José do Rio Preto School of Medicine (FAMERP). São José do Rio Preto, SP, Brazil. E-mails: ricardo.rita@terra.com.br; claudiacesarino@famerp.br; Nurse, Ph.D., Professor at the União das Faculdades dos Grandes Lagos University (UNILAGO) and the Nursing Graduate Program, São José do Rio Preto School of Medicine (FAMERP). São José do Rio Preto, SP, Brazil. Email: danielacomelisbertolin@gmail.com; Nurse, Master’s Degree candidate in Nursing, São José do Rio Preto School of Medicine (FAMERP). São José do Rio Preto, SP, Brazil. E-mail: rib_renato@hotmail.com; Nurse, Ph.D., Professor at the São José do Rio Preto School of Medicine (FAMERP), University of São Paulo (USP). Ribeirão Preto, SP, Brazil. E-mails: mariliapilotto@yahoo.com.br; kusumota@eerp.usp.br ORIGINAL ARTICLE Rodrigues CC, Ribeiro RCHM, Cesarino CB et al. Older adults hospitalized in a teaching...

Health-related quality of life as a predictor of mortality in patients onperitoneal dialysis

Objetivo: caracterizar las muertes ocurridas y verificar la asociacion entre las variables sociodemograficas, clinicas, de laboratorio, de calidad de vida relacionada a la salud con el resultado de muerte de pacientes en dialisis peritoneal, en un periodo de dos anos, despues de una primera evaluacion. Metodo: investigacion poblacional, observacional y prospectiva con 82 pacientes en dialisis peritoneal. Fueron utilizados, para la primera etapa de recoleccion de datos, los instrumentos: Miniexamen del Estado Mental, cuestionario de caracterizacion sociodemografica, economica, clinica y de laboratorio y el Kidney Disease and Quality of Life-Short Form. Dos anos despues fueron recolectados los datos de caracterizacion y ocurrencia de los muertes en el periodo. En el analisis estadistico, fue calculado el riesgo relativo del resultado de muerte, estimado el riesgo de muerte por las curvas de supervivencia de Kaplan-Meier y determinados los predictores de muerte, utilizando el modelo de riesgos proporcionales de Cox. Resultados: de los 82 participantes iniciales, 23 tuvieron como resultado la muerte en el periodo de dos anos. El riesgo aumentado para el resultado de muerte fue asociado con menor puntaje promedio de calidad de vida relacionada a la salud, en la dimension funcionamiento fisico. Conclusion: la peor calidad de vida relacionada a la salud, en la dimension funcionamiento fisico, puede ser considerada predictora de muerte.Objective: to characterize deaths that occurred, and the association between socio-demographic, clinical, laboratory variables and health-related quality of life and the outcome of death in patients on peritoneal dialysis, over a two year period after an initial assessment. Method: observational, prospective population study with 82 patients on peritoneal dialysis. The instruments used for the first stage of data collection were the mini-mental state examination, a sociodemographic, economic, clinical and laboratory questionnaire and the Kidney Disease and Quality of Life-Short Form. After two years, data for characterization and occurrence of death in the period were collected. The relative risk of death outcome was calculated through statistical analysis; the risk of death was estimated by the survival Kaplan-Meier curve, and determined predictors of death by the Cox Proportional Hazards Model. Results: of the 82 original participants, 23 had as an outcome death within two years. The increased risk for the outcome of death was associated with a lower mean score of health-related quality of life in the physical functioning domain. Conclusion: the worst health-related quality of life in the physical functioning domain, could be considered a predictor of death.

Calidad de vida relacionada a la salud como predictora de muerte de pacientes en diálisis peritoneal

Objetivo: caracterizar las muertes ocurridas y verificar la asociacion entre las variables sociodemograficas, clinicas, de laboratorio, de calidad de vida relacionada a la salud con el resultado de muerte de pacientes en dialisis peritoneal, en un periodo de dos anos, despues de una primera evaluacion. Metodo: investigacion poblacional, observacional y prospectiva con 82 pacientes en dialisis peritoneal. Fueron utilizados, para la primera etapa de recoleccion de datos, los instrumentos: Miniexamen del Estado Mental, cuestionario de caracterizacion sociodemografica, economica, clinica y de laboratorio y el Kidney Disease and Quality of Life-Short Form. Dos anos despues fueron recolectados los datos de caracterizacion y ocurrencia de los muertes en el periodo. En el analisis estadistico, fue calculado el riesgo relativo del resultado de muerte, estimado el riesgo de muerte por las curvas de supervivencia de Kaplan-Meier y determinados los predictores de muerte, utilizando el modelo de riesgos proporcionales de Cox. Resultados: de los 82 participantes iniciales, 23 tuvieron como resultado la muerte en el periodo de dos anos. El riesgo aumentado para el resultado de muerte fue asociado con menor puntaje promedio de calidad de vida relacionada a la salud, en la dimension funcionamiento fisico. Conclusion: la peor calidad de vida relacionada a la salud, en la dimension funcionamiento fisico, puede ser considerada predictora de muerte.Objective: to characterize deaths that occurred, and the association between socio-demographic, clinical, laboratory variables and health-related quality of life and the outcome of death in patients on peritoneal dialysis, over a two year period after an initial assessment. Method: observational, prospective population study with 82 patients on peritoneal dialysis. The instruments used for the first stage of data collection were the mini-mental state examination, a sociodemographic, economic, clinical and laboratory questionnaire and the Kidney Disease and Quality of Life-Short Form. After two years, data for characterization and occurrence of death in the period were collected. The relative risk of death outcome was calculated through statistical analysis; the risk of death was estimated by the survival Kaplan-Meier curve, and determined predictors of death by the Cox Proportional Hazards Model. Results: of the 82 original participants, 23 had as an outcome death within two years. The increased risk for the outcome of death was associated with a lower mean score of health-related quality of life in the physical functioning domain. Conclusion: the worst health-related quality of life in the physical functioning domain, could be considered a predictor of death.

Health-related quality of life as a predictor of mortality in patients on peritoneal dialysis

Objetivo: caracterizar las muertes ocurridas y verificar la asociacion entre las variables sociodemograficas, clinicas, de laboratorio, de calidad de vida relacionada a la salud con el resultado de muerte de pacientes en dialisis peritoneal, en un periodo de dos anos, despues de una primera evaluacion. Metodo: investigacion poblacional, observacional y prospectiva con 82 pacientes en dialisis peritoneal. Fueron utilizados, para la primera etapa de recoleccion de datos, los instrumentos: Miniexamen del Estado Mental, cuestionario de caracterizacion sociodemografica, economica, clinica y de laboratorio y el Kidney Disease and Quality of Life-Short Form. Dos anos despues fueron recolectados los datos de caracterizacion y ocurrencia de los muertes en el periodo. En el analisis estadistico, fue calculado el riesgo relativo del resultado de muerte, estimado el riesgo de muerte por las curvas de supervivencia de Kaplan-Meier y determinados los predictores de muerte, utilizando el modelo de riesgos proporcionales de Cox. Resultados: de los 82 participantes iniciales, 23 tuvieron como resultado la muerte en el periodo de dos anos. El riesgo aumentado para el resultado de muerte fue asociado con menor puntaje promedio de calidad de vida relacionada a la salud, en la dimension funcionamiento fisico. Conclusion: la peor calidad de vida relacionada a la salud, en la dimension funcionamiento fisico, puede ser considerada predictora de muerte.Objective: to characterize deaths that occurred, and the association between socio-demographic, clinical, laboratory variables and health-related quality of life and the outcome of death in patients on peritoneal dialysis, over a two year period after an initial assessment. Method: observational, prospective population study with 82 patients on peritoneal dialysis. The instruments used for the first stage of data collection were the mini-mental state examination, a sociodemographic, economic, clinical and laboratory questionnaire and the Kidney Disease and Quality of Life-Short Form. After two years, data for characterization and occurrence of death in the period were collected. The relative risk of death outcome was calculated through statistical analysis; the risk of death was estimated by the survival Kaplan-Meier curve, and determined predictors of death by the Cox Proportional Hazards Model. Results: of the 82 original participants, 23 had as an outcome death within two years. The increased risk for the outcome of death was associated with a lower mean score of health-related quality of life in the physical functioning domain. Conclusion: the worst health-related quality of life in the physical functioning domain, could be considered a predictor of death.

Qualidade de vida relacionada à saúde como preditor de óbito de pacientes em diálise peritoneal

Objetivo: caracterizar las muertes ocurridas y verificar la asociacion entre las variables sociodemograficas, clinicas, de laboratorio, de calidad de vida relacionada a la salud con el resultado de muerte de pacientes en dialisis peritoneal, en un periodo de dos anos, despues de una primera evaluacion. Metodo: investigacion poblacional, observacional y prospectiva con 82 pacientes en dialisis peritoneal. Fueron utilizados, para la primera etapa de recoleccion de datos, los instrumentos: Miniexamen del Estado Mental, cuestionario de caracterizacion sociodemografica, economica, clinica y de laboratorio y el Kidney Disease and Quality of Life-Short Form. Dos anos despues fueron recolectados los datos de caracterizacion y ocurrencia de los muertes en el periodo. En el analisis estadistico, fue calculado el riesgo relativo del resultado de muerte, estimado el riesgo de muerte por las curvas de supervivencia de Kaplan-Meier y determinados los predictores de muerte, utilizando el modelo de riesgos proporcionales de Cox. Resultados: de los 82 participantes iniciales, 23 tuvieron como resultado la muerte en el periodo de dos anos. El riesgo aumentado para el resultado de muerte fue asociado con menor puntaje promedio de calidad de vida relacionada a la salud, en la dimension funcionamiento fisico. Conclusion: la peor calidad de vida relacionada a la salud, en la dimension funcionamiento fisico, puede ser considerada predictora de muerte.Objective: to characterize deaths that occurred, and the association between socio-demographic, clinical, laboratory variables and health-related quality of life and the outcome of death in patients on peritoneal dialysis, over a two year period after an initial assessment. Method: observational, prospective population study with 82 patients on peritoneal dialysis. The instruments used for the first stage of data collection were the mini-mental state examination, a sociodemographic, economic, clinical and laboratory questionnaire and the Kidney Disease and Quality of Life-Short Form. After two years, data for characterization and occurrence of death in the period were collected. The relative risk of death outcome was calculated through statistical analysis; the risk of death was estimated by the survival Kaplan-Meier curve, and determined predictors of death by the Cox Proportional Hazards Model. Results: of the 82 original participants, 23 had as an outcome death within two years. The increased risk for the outcome of death was associated with a lower mean score of health-related quality of life in the physical functioning domain. Conclusion: the worst health-related quality of life in the physical functioning domain, could be considered a predictor of death.

Trabajo y Calidad de Vida Relacionada a la Salud de pacientes en Diálisis Peritoneal

Objective: To describe and compare Health Related Quality of Life (HRQoL) of patients on peritoneal dialysis (PD) who had and who did not have paid work. Methods: A cross-sectional and populational study with 82 patients from the two PD services in Ribeirão Preto (SP), Brazil. Data collection was conducted by interviews between December/2009 and March/2010. The questionnaires for the characterization of patients, the Mini Mental State Examination and the Kidney Disease and Quality of Life-Short Form were used. Analyses were performed using exploratory univariate and bivariate statistics, and the confirmatory bivariate among the independent variables and the dimensions of HRQoL. Results: Patients with paid work presented higher mean scores reflecting better HRQoL for the majority of the dimensions of the instrument used. Conclusion: Work is an important facet of life for these patients and merits the attention of health professionals in the search for strategies that promote and incentivize its maintenance and the reintegration of patients into the labor market.