Rosalina Aparecida Partezani Rodrigues

Causas e conseqüências de quedas de idosos atendidos em hospital público

OBJETIVO: Investigar a historia da queda relatada por idosos, identificando fatores possivelmente relacionados, assim como local de ocorrencia, causas e consequencias. METODOS: A amostra da investigacao constou de 50 idosos, de ambos os sexos, com idade de 60 anos ou mais, residentes em Ribeirao Preto, SP, que haviam sido atendidos em duas unidades de um hospital publico. Foram consultados prontuarios e realizadas visitas domiciliares para aplicacao de um questionario estruturado com perguntas abertas, fechadas e mistas relativas a queda. RESULTADOS: Os dados obtidos mostraram uma realidade que nao difere substancialmente daquela encontrada em outros paises. A maioria das quedas ocorreu entre idosos do sexo feminino (66%), com idade media de 76 anos, no proprio lar do idoso (66%). As causas foram principalmente relacionadas ao ambiente fisico (54%), acarretando serias consequencias aos idosos, sendo as fraturas as mais frequentes (64%). A queda teve grande impacto na vida do idoso no que se refere as atividades da vida diaria. Provocou maior dependencia para a realizacao de atividades como: deitar/levantar-se, caminhar em superficie plana, cortar unhas dos pes, tomar banho, caminhar fora de casa, cuidar das financas, fazer compras, usar transporte coletivo e subir escadas. CONCLUSOES: O estudo demonstrou que a queda ocorrida entre os idosos traz serias consequencias fisicas, psicologicas e sociais, reforcando a necessidade de prevencao da queda, garantindo ao idoso melhor qualidade de vida, autonomia e independencia.

Stroke-Independent Association Between Metabolic Syndrome and Functional Dependence, Depression, and Low Quality of Life in Elderly Community-Dwelling Brazilian People

OBJECTIVES: Metabolic syndrome (Met.S) is a risk factor for stroke, dementia, and ischemic heart disease (IHD). It is unclear whether Met.S is an independent risk factor for functional dependence, depression, cognitive impairment, and low health‐related quality of life (HRQoL) in a population free of clinical stroke.

Cross-cultural adaptation and validity of the 'Edmonton Frail Scale - EFS' in a Brazilian elderly sample.

This study aimed to assess the cross-cultural adaptation of the Edmonton Frail Scale (EFS) and its validity in a Brazilian elderly sample. Translation and back-translation were performed, as well as discussion with professionals and elderly for conceptual equivalence, semantic validation and pre-test of the scale. The scale was applied to 137 elderly aged 65 years or older who lived in the community. In the know-groups validation of the frailty diagnosis between gender, age and cognitive deficit, elder elderly, female and with a cognitive deficit scored higher on the frailty diagnosis. A negative convergent correlation was found between the EFS and the Functional Independence Measure (FIM) (-0.53, p< 0.01) and the total score of the Mini-Mental State Examination (MMSE) (-0.60, p< 0.01). The watch test presented high sensitivity and low specificity levels. The Portuguese version of the EFS was considered valid in the study sample.El objetivo de este estudio fue evaluar la adaptacion cultural de la Edmonton Frail Scale (EFS) y su validez enuna muestra de ancianos brasilenos. Fueron realizadas las etapas de traduccion y retrotraduccion, discusioncon profesionales y ancianos para equivalencia conceptual, validacion semantica y prueba piloto de la escala.El instrumento fue aplicado en 137 ancianos, con 65 anos o mas de edad, que vivian en la comunidad. En lavalidacion de grupos conocidos, del diagnostico de fragilidad entre sexo, edad y deficit cognitivo, los ancianoscon edad mas avanzada, sexo femenino y con deficit cognitivo tuvieron mayor puntuacion en el diagnostico defragilidad. Hubo una correlacion convergente negativa de la EFS con la Medida de Independencia Funcional(MIF) (-0,53, p<0,01) y el puntaje bruto del Mini-Examen del Estado Mental (MEEM) (-0,60, p<0,01). La pruebadel reloj presento alta sensibilidad y baja especificidad. La version para la lengua portuguesa de la EFS fueconsiderada valida en la muestra estudiada.DESCRIPTORES: anciano fragil; investigacion metodologica en enfermeria; comparacion transcultural; estudiosde validacion

Os idosos mais velhos no meio rural: realidade de vida e saúde de uma população do interior gaúcho

Trata-se de estudo epidemiologico transversal com objetivo de descrever e analisar os dados demograficos, socio-economicos e as condicoes de saude dos idosos com 80 anos ou mais, residentes no meio rural de Encruzilhada do Sul - RS. Para coleta dos dados dos 137 idosos foram realizadas entrevistas domiciliares entre marco a junho de 2006. Os dados foram analisados empregando-se estatistica descritiva e inferencial. A idade media das idosas foi de 84,1 (dp= 3,8), e dos idosos, de 85,3 (dp=3,5). Quanto ao estado civil e a escolaridade, existe diferenca significativa entre homens e mulheres, 80,0% sao idosas e viuvas (p<0,001), e 77,2% analfabetas (p=0,013). O reumatismo e a hipertensao arterial sao as morbidades mais referidas. O estudo contribui para dar maior visibilidade a essa parcela populacional, para compreensao do processo de envelhecimento e adequacao das politicas publicas.

O idoso institucionalizado: avaliação da capacidade funcional e aptidão física

This study analyzed the relationship between physical fitness and functional capacity in 78 residents of long-stay institutions for low-income elderly located in five regions of Brazil. The majority of the sample consisted of women, and mean age was 77.4 years (SD = 7.9). Physical fitness was assessed with the AAHPERD test, adjusted for institutionalized elderly. The Katz scale was used for functional capacity. The five components of physical fitness rated fair for flexibility, coordination, agility, and aerobic endurance and good for strength. The mean general physical fitness (GPF) index was fair. According to the findings, the greater the degree of dependency in institutionalized elderly, the lesser their strength and GPF level; meanwhile, better coordination and agility are associated with greater independence for performing activities of daily living. The results can contribute to appropriate physical exercise programs for maintenance and/or recovery of functionality.

Idosos com insuficiência renal crônica: alterações do estado de saúde

This study aimed to describe health condition changes as experienced by elderly with Chronic Kidney Failure (CKF), under Continuous Ambulatory Peritoneal Dialysis (CAPD) treatment at the Dialysis and Kidney Transplantation Unit of a public hospital in Ribeirão Preto -- SP, Brazil. Participants were six elderly under CAPD treatment, aged 61 to 74 years. The theoretical and methodological framework was thematic oral history as proposed by Meihy. Data analysis led to the category of changes in elderlys health condition and disclosed the diagnosis of the disease, signs and symptoms of CKF, causes and irreversibility.Descrever as alteracoes do estado de saude vivenciadas por idosos portadores de Insuficiencia Renal Cronica (IRC), em tratamento de Dialise Peritonial Continua Ambulatorial (DPCA), atendidos na Unidade de Dialise e Transplante Renal de um Hospital Publico de Ribeirao Preto-SP foi o objetivo deste estudo. Participaram seis idosos, com idade entre 61 e 74 anos, em tratamento com DPCA. O referencial teorico metodologico utilizado foi a historia oral tematica, proposta por Meihy. Na analise, foi construida a categoria: alteracoes no estado de saude dos idosos e evidenciado o diagnostico da doenca, sinais e sintomas da IRC, causas e irreversibilidade.

Diferenciais socioeconômicos e de saúde entre duas comunidades de idosos longevos

OBJETIVO: Identificar diferencias demograficas y socioeconomicas relacionadas con el estado de salud de ancianos mas viejos residentes en dos ciudades de diferentes regiones de Brasil. METODOS: Estudio epidemiologico transversal y comparativo de ancianos mas viejos (>80 anos) residentes en Ribeirao Preto (RP - Sureste de Brasil) y Caxias do Sul (Sur), con muestra probabilistica de 117 sujetos en CS y 155 en RP, realizados entre 2007 y 2008. El instrumento de colecta incluyo datos demograficos y socioeconomicos mini-examen del estado mental, Medida de Independencia Funcional, numero de comorbilidades autoreferidas y Escala de Depresion Geriatrica. RESULTADOS: La edad promedio fue similar, con predominancia de mujeres (~70%) y viudos (~60%) en ambos municipios. La escolaridad promedio no difirio estadisticamente, pero la renta promedio del anciano fue mayor en RP que en CS (p=0,05). RP presento mayor concentracion de individuos en los extremos de escolaridad y renta que CS. El escore promedio del mini-examen del estado mental fue similar entre los dos grupos y mayor para individuos del sexo masculino, con edad entre 80 y 84 anos, casados y con mayor escolaridad. Se observo mejor desempeno funcional entre ancianos de 80 a 84 anos en ambos municipios, entre los de mayor escolaridad en RP; y entre los de sexo masculino y los casados en CS. Ancianos de CS presentaron mayor numero de comorbilidades que los de RP (p<0,001). Ancianos del sexo masculino, casados, y con mayor renta presentaron menos sintomas depresivos en ambos grupos; y los de RP presentaron mayor escores en la Escala de Depresion Geriatrica que los de CS (p<0,001). CONCLUSIONES: Aunque los ancianos de CS presenten menor desigualdad socioeconomica y menos sintomas depresivos, poseen tambien mayor numero promedio de comorbilidades y menor nivel de independencia funcional, al compararlos con los de RP.OBJECTIVE To identify demographic and socioeconomic differentials associated with the health status of oldest-old individuals living in two cities of different Brazilian regions. METHODS A comparative and cross-sectional epidemiological study was conducted with the oldest-old (> 80 years), living in the cities of Ribeirão Preto (RP, Southeastern Brazil) and Caxias do Sul (CS, Southern). The probabilistic sample included 117 individuals in CS and 155 in RP, and data were collected between 2007 and 2008. The instrument included demographic and socioeconomic data, Mini-Mental State Examination, Functional Independence Measure, number of self-reported comorbidities and Geriatric Depression Scale. RESULTS Mean age was similar, with predominance of women (~70%) and widowed individuals (~60%) in both cities. Mean level of education did no differ statistically, although mean income was higher in RP than in CS (p = 0.05). RP showed a higher concentration of individuals in the extreme levels of education and income than that of CS. Mean score of the Mini-Mental State Examination was similar in both groups and higher among men, individuals aged between 80 and 84 years, married and with a higher level of education. Better functional performance was observed in elderly individuals aged between 80 and 84 years in both cities, in those with higher level of education in RP; and in males and married individuals in CS. Elderly individuals in CS showed higher number of comorbidities than those in RP (p < 0.001). Male elderly individuals, married and with -higher income level showed fewer depressive symptoms in both groups; and those in RP showed higher Geriatric Depression Scale score than the others in CS (p < 0.001). CONCLUSIONS Although the oldest old in CS showed lower socioeconomic inequality and fewer depressive symptoms, they also had a higher mean number of comorbidities and lower level of functional independence, when compared to those in RP.

Teses produzidas nos programas de Pós-Graduação em Enfermagem de 1983 a 2001

Este estudo descreve a relacao das teses de doutorado em enfermagem defendidas nos Programas de Pos-Graduacao em Enfermagem, no Brasil, com as linhas de pesquisas definidas pela area da Enfermagem, em tres campos: profissional, assistencial e organizacional. E uma pesquisa descritiva-exploratoria, com base nos relatorios dos programas de Pos-Graduacao, avaliados pela Capes e no Catalogo Informacoes sobre Pesquisas e Pesquisadores em Enfermagem CEPEn/ABEn, referentes ao periodo de 1983-2001, totalizando 448 resumos. O campo assistencial alberga o maior numero de producao, seguido do organizacional e do profissional. As investigacoes evidenciam uma tendencia para estudos de abordagem qualitativa, descortinando possibilidades de aprofundamento do conhecimento da realidade ou compreensao de fenomenos sociais que tangenciam a pratica da enfermagem, porem, os estudos de intervencao na pratica profissional e de desenvolvimento de tecnologia ainda estao em fase de construcao.This study describes the relationship between nursing doctoral dissertations and research lines defined by the Brazilian Nursing field in three areas: professional, care and organizational. It isa descriptive-exploratory research, based on reports of Graduate Programs evaluated by CAPES and on The Informative Guide of Nursing Research and Researchers CEPEn/ ABEn, from 1983 to 2001, totalling 448 abstracts. The care field includes the greatest production, followed by the organizational and professional areas. The studies disclose tendency towards the qualitative approach revealing possibilities for a more profound knowledge about reality or a more through understanding of social phenomena related to nursing practice. On the other hand, studies on interventions in professional practice and technological development are still under construction.

Quedas de idosos institucionalizados: ocorrência e fatores associados

Quedas entre pessoas idosas constituem importante problema de saude publica, devido a sua incidencia, as complicacoes para a saude e aos altos custos assistenciais. Estudos realizados no Brasil e em outros paises referem que as quedas sao mais frequentes em idosos institucionalizados e apresentam causa multifatorial. Com o objetivo de verificar a ocorrencia de quedas em idosos institucionalizados e identificar seus fatores associados, foi realizado um levantamento de dados de 105 individuos com idade igual ou superior a 60 anos, residentes em quatro instituicoes asilares do municipio de Catanduva, Sao Paulo. O metodo utilizado para a coleta dos dados foi entrevista. Foram utilizados os instrumentos: Escala de Depressao Geriatrica e Mini-Exame do Estado Mental, instrumentos estes destinados a avaliacao dos estados de humor e cognitivo, respectivamente. Os achados mostraram que 40% dos idosos relataram quedas nos ultimos seis meses, e os fatores de risco considerados significativos foram: sexo feminino (p=0,035), uso de medicamentos (p=0,047), visao deficiente (p=0,029), ausencia de atividade fisica (p=0,035), presenca de osteoartrose (p=0,000), depressao (p=0,034), deficit de forca de preensao palmar (p=0,0165) e disturbios no equilibrio e marcha (p=0,038). Os resultados apontam para a necessidade da implementacao de programas de prevencoes de quedas em instituicoes asilares, atraves de intervencao multidisciplinar buscando, portanto, uma melhoria na qualidade de vida dessa populacao.

O idoso após acidente vascular cerebral: alterações no relacionamento familiar

The aims of this study were: to identify aged persons who were victims of Cerebrovascular Accident and received care at the Emergency Unit of a Public Hospital in Ribeirão Preto-SP, Brazil, and their respective families, as well as to identify the changes in family relations that occurred after the event. In order to identify these changes, the adapted Critical Incident Technique was used, while the analysis was based on the idea of Current of Thought. The sample consisted of 11 families, totaling 34 participants. The analysis of the consequences displayed the changes in family relations, which made up 13 subcategories, 5 of which were positive and 8 negative, totaling 58 alterations, 30 of which were positive and 28 negative. The study revealed the need to work with the family in order to identify changes and develop an action plan to favor the familys relations and adaptation to the demands, with a view to improving the living conditions of its members, including the aged person.The aims of this study were: to identify the aged persons who were victims of Cerebrovascular Accident and received care at the Emergency Unit of a Public Hospital in Ribeirao Preto-SP, Brazil, and their respective families, as well as to identify the changes in family relations that occurred after the event. In order to identify these changes, the adapted Critical Incident Technique was used, while the analysis was based on the idea of Current of Thought. The sample consisted of 11 families, totaling 34 participants. The analysis of the consequences displayed the changes in family relations, which made up 13 subcategories, 5 of which were positive and 8 negative, totaling 58 alterations, 30 of which were positive and 28 negative. The study revealed the need to work with the family in order to identify changes and develop an action plan to favor the family’s relations and adaptation to the demands, with a view to improving the living conditions of its members, including the aged person.