Nayara Priscila Dantas de Oliveira

Depressive Symptoms and Associated Factors in Institutionalized Elderly

Background/Study Context: Depression is a common psychiatric disorder in the elderly that leads to a decrease in quality of life and functional impairment, among other health problems. The study of depressive symptoms in institutionalized elderly is scarce in Latin America and can contribute to plan prevention and treatment actions in order to improve health conditions for the residents as well as quality of life. Therefore, the aim of this study is to determine the prevalence of depressive symptoms and identify its associated factors in institutionalized elderly. Methods: A cross-sectional study is presented herein, carried out in 10 nursing homes of the municipality of Natal (Northeast Brazil). All individuals over the age of 60 were included. The Geriatric Depression Scale (GDS-15) was applied to verify the depressive symptoms, as well as sociodemographic variables related to the institution and health conditions (comorbidities, medication, body mass index, level of physical activity, mobility, and functional and cognitive capacities). Bivariate analysis was carried out using the chi-square Pearson’s test (or Fisher’s test) and the linear trend chi-square. Finally, logistic regression was utilized for multivariate analysis. Results: The final sample was constituted of 142 elderly, mostly of the female sex (78.9%), with an average age of 79.3 (SD: 8.2). Of these, 65 individuals presented depressive symptoms, with a 45.77% prevalence (95% confidence interval [CI]: 37.80–53.97%). The final model verified an association between the presence of depressive symptoms and functional impairment, prevalence ratio (PR) = 1.58 (95% CI: 1.04–2.42), and arterial hypertension, PR = 1.57 (95% CI: 1.07–2.31), adjusted by fecal incontinence, sex, and age. Conclusion: Depressive symptoms were present in almost half of the sample of institutionalized elderly, and this condition was associated with functional impairment and arterial hypertension. The results of this work indicate the importance of monitoring depression as well as intervening on these modifiable aspects, to avoid the cascade of negative outcomes associated with this disease and also improve the quality of life of this population group.

Autopercepção da saúde em idosos institucionalizados

This study aimed to verify health self-perception, its prevalence and associated factors in institutionalized elderly. A cross-sectional study is presented herein, conducted in 10 Long-Term care Institutions for the Elderly (LTIE) in the city of Natal (Northeast Brazil), between October and December 2013. Sociodemographic variables were analyzed, along with institution-related and health state variables. Descriptive and bivariate analyses were carried out (Chi-squared test, Fishers exact test or linear trend Chi-squared test), as well as multivariate analysis (logistic regression). The final sample consisted of 127 elderly. The prevalence of negative self-perceived health was 63.19% (CI 95%: 55.07-70.63), and was associated with weight loss (PR: 1.54; CI 95%: 1.19-1.99), rheumatic disease (PR: 1.46; CI 95%: 1.05-2.01) and not-for-profit LTIE (PR: 1.37; CI 95%: 1.03-1.83), adjusted by sex. More than half of the elderly reported negative self-perceived health, which was associated with weight loss, rheumatic disease and type of institution. Actions must be developed to promote better health conditions in LTIE, such as nutrition consulting and physical therapy, to improve quality of life.Resumo Este trabalho objetivou determinar a autopercepcao da saude em idosos institucionalizados, assim como verificar a prevalencia de percepcao negativa da saude e seus fatores associados. Trata-se de estudo transversal realizado em 10 instituicoes de longa permanencia para idosos (ILPI) da cidade de Natal, entre outubro e dezembro de 2013. Foram analisadas variaveis sociodemograficas, relacionadas a ILPI e as condicoes de saude. Realizou-se a analise descritiva, bivariada mediante os testes qui-quadrado, exato de Fisher ou qui-quadrado de tendencia linear, assim como multivariado mediante regressao logistica. A amostra foi de 127 idosos. A prevalencia de autopercepcao negativa da saude foi de 63,19% (IC 95%: 55,07-70,63), e esteve associada a perda de peso (RP: 1,54; IC 95%: 1,19-1,99), doenca reumatica (RP: 1,46; IC 95%: 1,05-2,01) e ILPI sem fins lucrativos (RP: 1,37; IC 95%: 1,03-1,83), ajustado por sexo. E fundamental desenvolver acoes de promocao da saude nas ILPI, como aquelas baseadas na nutricao e fisioterapia que atuem sobre esses agravos a saude, com vistas a melhorar a qualidade de vida.

Activity Limitations in Brazilian Institutionalized Older Adults.

Background and Purpose: Although functional assessments and programs to prevent activity limitations are fundamental for efficient geriatric evaluations and interventions, these procedures have not been satisfactorily explored at nursing homes in Brazil. Literature is scarce on the evaluation of disability in Brazilian institutionalized older people. Methods: A cross-sectional study was conducted in 10 nursing homes in the city of Natal (Northeast Brazil). Sociodemographic and health data were collected and activity limitations were assessed by the Katz Index. Results and Discussion: The prevalence of activity limitations was 72.9% (95% confidence interval: 67.8-77.5) and the most affected activity was “bathing” (71.6%), followed by “dressing” (65.4%) and “toileting” (62.0%). The final model revealed associations with private (for-profit) institutions (odds ratio [OR] = 3.33; P < .001), age ≥ 83 years (OR = 2.34; P = .003), institutionalization due to lack of caregiver (OR = 1.80; P = .033), and presence of osteoporosis (OR = 2.94; P = .045), adjusted by sex. Conclusions: Activity limitations affected almost 73% of institutionalized older people in this sample and were associated with private nursing homes, age, osteoporosis, and institutionalization due to lack of caregiver. Activity limitations exact high socioeconomic impacts and affect the quality of life of older people. The results obtained herein emphasized the importance of planning strategies for their prevention and treatment, directed to reduce the prevalence of this health issue.

Regional and gender differences in laryngeal cancer mortality: trends and predictions until 2030 in Brazil

OBJECTIVE Analysis of laryngeal cancer mortality trends in Brazil and its geographic regions for the period 1996-2010 and calculation of mortality predictions for the period 2011-2030. STUDY DESIGN An epidemiologic, ecologic, demographic-based study, which utilized information from the Mortality Information System on all cancer-related deaths in Brazil, is presented here. Mortality trends were analyzed by Joinpoint regression, and Nordpred was utilized for the calculation of predictions. RESULTS When comparing the last observed period and the last predicted period for men, an increase of 10,588 deaths is expected, representing an increase of 69%. For women, the expected increase in the number of deaths will be 2217, representing an increase of 104%. Laryngeal cancer mortality rates will increase in the North and Northeast regions for men and in the Northeast and Southeast regions for women. CONCLUSIONS Despite the current high mortality for laryngeal cancer, rates will continue to increase until 2030 in Brazil.

Body Image of Women Submitted to Breast Cancer Treatment

Background: The study of body image includes the perception of women regarding the physical appearance of their own body. The objective of the present study was to verify the prevalence of body image dissatisfaction and its associated factors in women submitted to breast cancer treatment. Methods: A cross-sectional study carried out with 103 female residents of the municipality of Natal (Northeast Brazil), diagnosed with breast cancer who had undergone cancer treatment for at least 12 months prior to the study, and remained under clinical monitoring. The variable body image was measured through the validated Body Image Scale (BIS). Socioeconomic variables and clinical history were also collected through an individual interview with each participant. The Pearson’s chi-squared test (Fisher’s Exact) was utilized for bivariate analysis, calculating the prevalence ratio with 95% confidence interval. Poisson regression with robust variance was utilized for multivariate analysis. The statistical significance considered was 0.05. Results: The prevalence of body image dissatisfaction was 74.8% CI (65%-82%). Statistically significant associations were observed between body image and multi-professional follow-up (p=0.009) and return to employment after treatment (p=0.022). Conclusion: It was concluded that women who reported employment after cancer treatment presented more alterations in self-perception concerning their appearance. Patients who did not receive multi-professional follow-up reported negative body image, evidencing the need for strategies that increase and improve healthcare, aiming to meet the demands of this population.

Avaliação do nível de conhecimento e aplicabilidade da Classificação Internacional de Funcionalidade, Incapacidade e Saúde

RESUMO A pesquisa foi conduzida com o objetivo de avaliar o nivel de conhecimento e aplicabilidade da Classificacao Internacional de Funcionalidade, Incapacidade e Saude por profissionais de saude do municipio de Natal (RN). Trata-se de um estudo transversal, que avaliou 186 profissionais de saude, mediante questionario eletronico semiestruturado, composto de questoes sobre o nivel de conhecimento em relacao a classificacao e sua aplicabilidade. Concluiu-se que os profissionais de saude possuem pouco conhecimento sobre a ferramenta. Alem disso, os que relataram conhece-la, dela fazem pouco uso devido as dificuldades para seu entendimento e aplicacao.

Functional Disability in Women Submitted to Breast Cancer Treatment

The objective of the study presented herein was to verify the prevalence of functional disability and its associated factors in women submitted to breast cancer treatment. A cross-sectional study was carried out, in 101 women diagnosed with malignant breast cancer neoplasm, who underwent cancer treatment at least 12 months before the study, and remained under clinical monitoring. Functional disability was measured by the DASH instrument. Data collection included variables related to socioeconomic characteristics, life habits, health conditions, clinical tumor characteristics and therapeutic approach. Bivariate analysis was carried out by Pearson’s chi-square test or Fisher’s exact test, calculating the prevalence ratio with a 95% confidence interval. Multivariate analysis utilized Poisson’s Regression with robust variance. A statistical significance of 0.05 was considered. Prevalence of functional disability in the studied sample was 22.8% (CI95% 13.9-31.6). Functional disability was statistically significantly associated with age (p = 0.035) and access to health services (p = 0.028). It was concluded that younger patients suffered higher impact of breast cancer treatment on disability. Regarding access to health services, women that received public clinical monitoring reported higher occurrences of functional disability. This pointed towards the necessity of more organized, less bureaucratic, and effective health services in the assistance network, directed to the minimization of the impacts of cancer treatment on health and life conditions of breast cancer survivors.

Prevalence of falls and evaluation of mobility among institutionalized elderly persons

Objective: The present study aimed to estimate the prevalence of falls among institutionalized elderly persons and identify associated factors. Method: A cross-sectional study of elderly residents of Care Facilities For the Elderly in Natal, Rio Grande do Norte, was carried out. The elderly persons could walk independently and did not have severe cognitive impairment. Data was obtained about the institution and socio-demographic and health information was collected. A physical examination was performed to evaluate frailty, mobility and balance (Timed up and go, Berg Balance Scale, Gait speed and Sitting-rising Test - SRT). Statistical analysis was performed using the Chi-squared Test for a 5% significance level. Results: Sixty-three elderly persons were within the search criteria. Of these 22.2% had fallen in the past year. Only the SRT was associated with these falls. Conclusion: It was concluded that the studied population has a low prevalence of falls, and the ability to perform less than 5 repetitions in the SRT was associated with episodes of falling.