Rosemeiry Capriata de Souza Azevedo

Produção bibliográfica sobre adesão/não-adesão de pessoas ao tratamento de saúde

Analise critica da producao bibliografica latino-americana dos ultimos dez anos, acerca da adesao/nao-adesao ao tratamento de pessoas portadoras de problemas cronicos de saude: hanseniase, tuberculose, hipertensao, diabetes e aids. Foram analisados 36 artigos, identificando-se as variaveis: ano de publicacao, area de publicacao e tipo de estudo. A maior parte dos artigos (27) foi produzida por profissionais da area de Medicina em estudos epidemiologicos e da area de Enfermagem (7) em estudos qualitativos e quanti-qualitativos. A producao cientifica sobre o assunto cresceu ate 2002, caindo a partir desse ano. Nas definicoes descritas pelos autores, a ideia recorrente foi a de que o papel do paciente e o de ser submisso as recomendacoes dos profissionais de saude e que ele tem autonomia para seguir ou nao o tratamento, mas o profissional exime-se da responsabilidade sobre as consequencias dessa decisao. A maioria dos fatores apontados pelos autores como contribuintes para a nao-adesao esta relacionada ao paciente, mostrando que a maior carga de responsabilidade pela adesao/nao-adesao e conferida a ele. As medidas assinaladas pelos autores para a resolucao do problema permitem a identificacao da responsabilidade dos profissionais, servicos de saude, governos e instituicoes de ensino.

Incidence and predicting factors of falls of older inpatients

OBJECTIVE To estimate the incidence and predicting factors associated with falls among older inpatients. METHODS Prospective cohort study conducted in clinical units of three hospitals in Cuiaba, MT, Midwestern Brazil, from March to August 2013. In this study, 221 inpatients aged 60 or over were followed until hospital discharge, death, or fall. The method of incidence density was used to calculate incidence rates. Bivariate analysis was performed by Chi-square test, and multiple analysis was performed by Cox regression. RESULTS The incidence of falls was 12.6 per 1,000 patients/day. Predicting factors for falls during hospitalization were: low educational level (RR = 2.48; 95%CI 1.17;5.25), polypharmacy (RR = 4.42; 95%CI 1.77;11.05), visual impairment (RR = 2.06; 95%CI 1.01;4.23), gait and balance impairment (RR = 2.95; 95%CI 1.22;7.14), urinary incontinence (RR = 5.67; 95%CI 2.58;12.44) and use of laxatives (RR = 4.21; 95%CI 1.15;15.39) and antipsychotics (RR = 4.10; 95%CI 1.38;12.13). CONCLUSIONS The incidence of falls of older inpatients is high. Predicting factors found for falls were low education level, polypharmacy, visual impairment, gait and balance impairment, urinary incontinence and use of laxatives and antipsychotics. Measures to prevent falls in hospitals are needed to reduce the incidence of this event.

Cuidado realizado pelo cuidador familiar ao idoso dependente, em domicílio, no contexto da estratégia de Saúde da Família

This exploratory-descriptive study was performed using a qualitative approach, with the objective to describe how family caregivers perform care to a dependent aged person. The data were collected through semi-structured interviews, performed with 24 caregivers, at their homes. The results showed that the care that is delivered with the dependent aged person is an activity that leads to changes in the lives of the caregivers, which can generate physical, emotional and social stressors. Nursing, as an essential element of the Family Health Strategy, should be careful regarding the health needs of dependent aged individuals, while also being close to caregivers, in the sense of guiding them and following the care being provided, with the purpose of providing comprehensive healthcare support, i.e., to the aged person and his or her family. DESCRIPTORS: Caregivers. Aged. Nursing. Family health. Home nursing. EL CUIDADO BRINDADO POR EL FAMILIAR CUIDADOR DE ANCIANOS DEPENDIENTES EN EL HOGAR EN EL CONTEXTO DE LA ESTRATEGIA DE SALUD DE LA FAMILIA RESUMEN: Estudio exploratorio-descriptivo de abordaje cualitativo que tuvo como objetivo describir cómo los cuidadores familiares realizan la atención a las personas mayores en situación de dependencia. Los datos fueron recolectados a través de entrevistas semiestructuradas con 24 cuidadores en sus hogares. Los resultados indicaron que la atención a las personas mayores en situación de dependencia desarrollados, es una actividad que lleva a cambios en la vida de los cuidadores, que puede generar un estrés físico, emocional y social. La enfermería como elemento clave de la Estrategia Salud de la Familia, debe estar atento a las necesidades de los mayores dependientes, y, más cerca de los cuidadores con el fin de orientar y supervisar la atención prestada, con el fin de apoyar la atención integral para, es decir, las personas mayores y sus familias. DESCRIPTORES: Cuidadores. Anciano. Enfermería. Salud de la familia. Atención domiciliaria de salud. 543This exploratory-descriptive study was performed using a qualitative approach, with the objective to describe how family caregivers perform care to a dependent aged person. The data were collected through semi-structured interviews, performed with 24 caregivers, at their homes. The results showed that the care that is delivered with the dependent aged person is an activity that leads to changes in the lives of the caregivers, which can generate physical, emotional and social stressors. Nursing, as an essential element of the Family Health Strategy, should be careful regarding the health needs of dependent aged individuals, while also being close to caregivers, in the sense of guiding them and following the care being provided, with the purpose of providing comprehensive healthcare support, i.e., to the aged person and his or her family. DESCRIPTORS: Caregivers. Aged. Nursing. Family health. Home nursing. CUIDADO REALIZADO PELO CUIDADOR FAMILIAR AO IDOSO DEPENDENTE, EM DOMICILIO, NO CONTEXTO DA ESTRATEGIA DE SAUDE DA FAMILIA RESUMO: Estudo exploratorio-descritivo de abordagem qualitativa, que teve por objetivo descrever a maneira como os cuidadores familiares realizam o cuidado aos idosos em condicao de dependencia. Os dados foram coletados por meio de entrevista semiestruturada, aplicada a 24 cuidadores, em seus domicilios. Os resultados apontaram que o cuidado desenvolvido ao idoso em condicao de dependencia e uma atividade que leva a mudancas na vida dos cuidadores, o que pode gerar estressores de ordem fisica, emocional e social. A enfermagem, como elemento essencial da Estrategia de Saude da Familia, deve estar atenta as necessidades de saude dos idosos dependentes, bem como, mais proxima dos cuidadores, no sentido de orienta-los, e acompanhar o cuidado realizado, a fim de oferecer suporte assistencial de forma integral, ou seja, ao idoso e sua familia. DESCRITORES: Cuidadores. Idoso. Enfermagem. Saude da familia. Assistencia domiciliar. EL CUIDADO BRINDADO POR EL FAMILIAR CUIDADOR DE ANCIANOS DEPENDIENTES EN EL HOGAR EN EL CONTEXTO DE LA ESTRATEGIA DE SALUD DE LA FAMILIA RESUMEN: Estudio exploratorio-descriptivo de abordaje cualitativo que tuvo como objetivo describir como los cuidadores familiares realizan la atencion a las personas mayores en situacion de dependencia. Los datos fueron recolectados a traves de entrevistas semiestructuradas con 24 cuidadores en sus hogares. Los resultados indicaron que la atencion a las personas mayores en situacion de dependencia desarrollados, es una actividad que lleva a cambios en la vida de los cuidadores, que puede generar un estres fisico, emocional y social. La enfermeria como elemento clave de la Estrategia Salud de la Familia, debe estar atento a las necesidades de los mayores dependientes, y, mas cerca de los cuidadores con el fin de orientar y supervisar la atencion prestada, con el fin de apoyar la atencion integral para, es decir, las personas mayores y sus familias. DESCRIPTORES: Cuidadores. Anciano. Enfermeria. Salud de la familia. Atencion domiciliaria de salud. 543Estudo exploratorio-descritivo de abordagem qualitativa, que teve por objetivo descrever a maneira como os cuidadores familiares realizam o cuidado aos idosos em condicao de dependencia. Os dados foram coletados por meio de entrevista semiestruturada, aplicada a 24 cuidadores, em seus domicilios. Os resultados apontaram que o cuidado desenvolvido ao idoso em condicao de dependencia e uma atividade que leva a mudancas na vida dos cuidadores, o que pode gerar estressores de ordem fisica, emocional e social. A enfermagem, como elemento essencial da Estrategia de Saude da Familia, deve estar atenta as necessidades de saude dos idosos dependentes, bem como, mais proxima dos cuidadores, no sentido de orienta-los, e acompanhar o cuidado realizado, a fim de oferecer suporte assistencial de forma integral, ou seja, ao idoso e sua familia.

Care performed by family caregivers to dependent elderly, at home, within the context of the Family Health strategy

This exploratory-descriptive study was performed using a qualitative approach, with the objective to describe how family caregivers perform care to a dependent aged person. The data were collected through semi-structured interviews, performed with 24 caregivers, at their homes. The results showed that the care that is delivered with the dependent aged person is an activity that leads to changes in the lives of the caregivers, which can generate physical, emotional and social stressors. Nursing, as an essential element of the Family Health Strategy, should be careful regarding the health needs of dependent aged individuals, while also being close to caregivers, in the sense of guiding them and following the care being provided, with the purpose of providing comprehensive healthcare support, i.e., to the aged person and his or her family. DESCRIPTORS: Caregivers. Aged. Nursing. Family health. Home nursing. EL CUIDADO BRINDADO POR EL FAMILIAR CUIDADOR DE ANCIANOS DEPENDIENTES EN EL HOGAR EN EL CONTEXTO DE LA ESTRATEGIA DE SALUD DE LA FAMILIA RESUMEN: Estudio exploratorio-descriptivo de abordaje cualitativo que tuvo como objetivo describir cómo los cuidadores familiares realizan la atención a las personas mayores en situación de dependencia. Los datos fueron recolectados a través de entrevistas semiestructuradas con 24 cuidadores en sus hogares. Los resultados indicaron que la atención a las personas mayores en situación de dependencia desarrollados, es una actividad que lleva a cambios en la vida de los cuidadores, que puede generar un estrés físico, emocional y social. La enfermería como elemento clave de la Estrategia Salud de la Familia, debe estar atento a las necesidades de los mayores dependientes, y, más cerca de los cuidadores con el fin de orientar y supervisar la atención prestada, con el fin de apoyar la atención integral para, es decir, las personas mayores y sus familias. DESCRIPTORES: Cuidadores. Anciano. Enfermería. Salud de la familia. Atención domiciliaria de salud. 543This exploratory-descriptive study was performed using a qualitative approach, with the objective to describe how family caregivers perform care to a dependent aged person. The data were collected through semi-structured interviews, performed with 24 caregivers, at their homes. The results showed that the care that is delivered with the dependent aged person is an activity that leads to changes in the lives of the caregivers, which can generate physical, emotional and social stressors. Nursing, as an essential element of the Family Health Strategy, should be careful regarding the health needs of dependent aged individuals, while also being close to caregivers, in the sense of guiding them and following the care being provided, with the purpose of providing comprehensive healthcare support, i.e., to the aged person and his or her family. DESCRIPTORS: Caregivers. Aged. Nursing. Family health. Home nursing. CUIDADO REALIZADO PELO CUIDADOR FAMILIAR AO IDOSO DEPENDENTE, EM DOMICILIO, NO CONTEXTO DA ESTRATEGIA DE SAUDE DA FAMILIA RESUMO: Estudo exploratorio-descritivo de abordagem qualitativa, que teve por objetivo descrever a maneira como os cuidadores familiares realizam o cuidado aos idosos em condicao de dependencia. Os dados foram coletados por meio de entrevista semiestruturada, aplicada a 24 cuidadores, em seus domicilios. Os resultados apontaram que o cuidado desenvolvido ao idoso em condicao de dependencia e uma atividade que leva a mudancas na vida dos cuidadores, o que pode gerar estressores de ordem fisica, emocional e social. A enfermagem, como elemento essencial da Estrategia de Saude da Familia, deve estar atenta as necessidades de saude dos idosos dependentes, bem como, mais proxima dos cuidadores, no sentido de orienta-los, e acompanhar o cuidado realizado, a fim de oferecer suporte assistencial de forma integral, ou seja, ao idoso e sua familia. DESCRITORES: Cuidadores. Idoso. Enfermagem. Saude da familia. Assistencia domiciliar. EL CUIDADO BRINDADO POR EL FAMILIAR CUIDADOR DE ANCIANOS DEPENDIENTES EN EL HOGAR EN EL CONTEXTO DE LA ESTRATEGIA DE SALUD DE LA FAMILIA RESUMEN: Estudio exploratorio-descriptivo de abordaje cualitativo que tuvo como objetivo describir como los cuidadores familiares realizan la atencion a las personas mayores en situacion de dependencia. Los datos fueron recolectados a traves de entrevistas semiestructuradas con 24 cuidadores en sus hogares. Los resultados indicaron que la atencion a las personas mayores en situacion de dependencia desarrollados, es una actividad que lleva a cambios en la vida de los cuidadores, que puede generar un estres fisico, emocional y social. La enfermeria como elemento clave de la Estrategia Salud de la Familia, debe estar atento a las necesidades de los mayores dependientes, y, mas cerca de los cuidadores con el fin de orientar y supervisar la atencion prestada, con el fin de apoyar la atencion integral para, es decir, las personas mayores y sus familias. DESCRIPTORES: Cuidadores. Anciano. Enfermeria. Salud de la familia. Atencion domiciliaria de salud. 543Estudo exploratorio-descritivo de abordagem qualitativa, que teve por objetivo descrever a maneira como os cuidadores familiares realizam o cuidado aos idosos em condicao de dependencia. Os dados foram coletados por meio de entrevista semiestruturada, aplicada a 24 cuidadores, em seus domicilios. Os resultados apontaram que o cuidado desenvolvido ao idoso em condicao de dependencia e uma atividade que leva a mudancas na vida dos cuidadores, o que pode gerar estressores de ordem fisica, emocional e social. A enfermagem, como elemento essencial da Estrategia de Saude da Familia, deve estar atenta as necessidades de saude dos idosos dependentes, bem como, mais proxima dos cuidadores, no sentido de orienta-los, e acompanhar o cuidado realizado, a fim de oferecer suporte assistencial de forma integral, ou seja, ao idoso e sua familia.

Produção bibliográfica sobre o processo de enfermagem

ABSTRACT Objective: To evaluate the bibliographic production on nursing process for the last 10 years in Brazil. Methods: This bibliographic studyused a mixed methods approach. Data were collected from April to May 2008 in the CAPES journals. Results: Seventy-seven publicationswere evaluated. There was an increase in publications on nursing process after 2004. The Latin American Journal of Nursing published thegreatest number of papers (n = 32, 41.55%). Quantitative studies were the most common types of research design. The point of views ofthe authors of these papers regarding the nursing process varied. Conclusion: Systematic nursing care, caring, and nursing intervention wereused as synonyms of the nursing process in Brazil. The bibliographic productions in Brazil were focused mainly on nursing diagn osis, whichis one of the steps of the nursing process. Keywords: Nursing; Nursing process; Nursing assistance RESUMEN Objetivo: Analizar la produccion bibliografica de los ultimos 10 anos respecto al proceso de enfermeria.

Prevalência de dependência em idosos e fatores de risco associados

Objective: To verify the prevalence of dependence among elderly assisted by teams of the Family Health Strategy in the city of Cuiaba (MT) and the associated risk factors. Methods: A study with a transversal design, of the survey type. The study sample was of 352 elderly with data collection conducted in their homes between the months of June and September of 2010, using the Katz Index questionnaire and the Lawton and Brody Scale. Results: The prevalence of dependency among the elderly was 38.6%. The statistical analysis showed that the sociodemographic characteristics and health were significantly associated with dependence, and there were several levels of prevalence rates of dependence among the elderly. Conclusion: The prevalence of dependency of 38.6% identified among the elderly study participants was higher than that reported in similar studies and suggests that this dependence results from the influence of the sociodemographic characteristics and health presented by these elderly.

ADESÃO E REAÇÕES DE USUÁRIOS AO TRATAMENTO DA MALÁRIA: IMPLICAÇÕES PARA A EDUCAÇÃO EM SAÚDE

This descriptive and exploratory study proposed to describe the user adherence and their reactions to anti-malaria treatment in a municipality in the western region of Brazil. Data was collected through interviewing 16 users and analyzed using Content Analysis. The study revealed that there are people who adhere partially to anti-malaria treatment and others who seek alternative treatments. The results showed that upon the first signs and symptoms starting, most users sought health care services for diagnosis and treatment, probably from knowledge about the disease, transmission, and treatment. Justifications given for such decision were for the ease of access the public health service, which offers free diagnosis and treatment, and the good rapport with the health care workers. It was concluded that although some government actions to control malaria have seen success there is still need for investment in health education actions and health surveillance. DESCRIPTORS: Health behavior. Patient compliance. Health education. Malaria.This descriptive and exploratory study proposed to describe the user adherence and their reactions to anti-malaria treatment in a municipality in the western region of Brazil. Data was collected through interviewing 16 users and analyzed using Content Analysis. The study revealed that there are people who adhere partially to anti-malaria treatment and others who seek alternative treatments. The results showed that upon the first signs and symptoms starting, most users sought health care services for diagnosis and treatment, probably from knowledge about the disease, transmission, and treatment. Justifications given for such decision were for the ease of access the public health service, which offers free diagnosis and treatment, and the good rapport with the health care workers. It was concluded that although some government actions to control malaria have seen success there is still need for investment in health education actions and health surveillance. DESCRIPTORS: Health behavior. Patient compliance. Health education. Malaria. ADHESION Y REACCIONES DE LOS USUARIOS AL TRATAMIENTO DE LA MALARIA: IMPLICACIONES PARA LA EDUCACION EN SALUD RESUMEN: Se trata de un estudio exploratorio descriptivo con el objetivo de describir la adhesion y las reacciones de los usuarios en relacion al tratamiento contra la malaria en un municipio de Mato Grosso, Brasil. La recoleccion de los datos se hizo por medio de entrevistas semiestructuradas a 16 usuarios, y se analizaron utilizando el Analisis de Contenido. El estudio revelo que hay personas que adhieren en parte al tratamiento de la malaria y otras que buscan tratamientos alternativos. Los resultados mostraron que a los primeros signos y sintomas de la malaria, la mayoria de los usuarios buscan los servicios de salud, probablemente por tener conocimiento sobre la enfermedad, su transmision y tratamiento; por la facilidad de acceso a la salud publica con diagnostico y tratamiento gratuito, y por la buena relacion con los trabajadores de la salud. Se concluyo que a pesar del exito de algunas acciones del gobierno para controlar la malaria, hay necesidad de invertir en educacion y vigilancia de la salud. DESCRIPTORES: Conducta de salud. Cooperacion del paciente. Educacion en salud. Malaria.

Arqueologia e genealogia como opçöes metodológicas de pesquisa na enfermagem

This article is based on the historical contextualization about the development of research in nursing, presents the categories/lines of interest that support the human knowledge applied in the Doctorate Thesis in Nursing in Brazil, points out the archeological and genealogical methods proposed by Michel Foucault, and their possibility to make more difficult the day-to-day tasks of the nursing profession Whether in Institutions, Public Policies, Health Reform, and Vocational Training, in the attempt to understand which strategies, challenges, knowledge base, and practices have influenced the building of the subjects.This article is based on the historical contextualization about the development of research in nursing, presents the categories/lines of interest that support the human knowledge applied in the Doctorate Thesis in Nursing in Brazil, points out the archeological and genealogical methods proposed by Michel Foucault, and their possibility to make more difficult the day-to-day tasks of the nursing profession whether in Institutions, Public Policies, Health Reform, and Vocational Training, in the attempt to understand which strategies, challenges, knowledge base, and practices have influenced the building of the subjects.

Factors associated with recurrent falls in a cohort of older adults

Objective To analyze the factors associated with recurrent falls in community-dwelling older adults from Cuiabá. Methods This is an epidemiological, prospective, concurrent cohort study with a two-year follow-up. In-home surveys were conducted in 2012 and 2013. The data were treated by the software Epi Info and SPSS. Bivariate analysis investigated associations between risk factors and recurrent falls by calculating the relative risk (RR) of the cumulative incidences with a confidence interval of 95% (95%CI). Multiple analysis with Poisson regression included all variables with p < 0.20 in the crude analyses. The significance level of 5% (p < 0.05) was adopted as significant association for remaining in the final model. Results Most older adults (77.6%) had recurrent falls. The variables significantly associated with recurrent falls were older adults income of up to two minimum salaries (RR = 1.62; 95%CI 1.04-1.77), absence of arthritis or arthrosis (RR = 1.32; 95%CI 1.10-1.48), having regular to very bad self-perceived health (RR = 1.44; 95%CI 1.12-2.04), and having visual impairment (RR = 1.23; 95%CI 1.01 -1.69). Conclusions Falls in older adults are associated with low education levels, regular to very bad self-perceived health, visual impairment, and recurrent falls.

Autoavaliação de saúde ruim e fatores associados em idosos residentes em zona urbana

The purpose of this study was to examine the prevalence of bad self-rated health in the elderly and associated demographic and socioeconomic factors. This was an epidemiological, cross-sectional study. Data were collected through interviews using the BOAS (Brazil Old Age Schedule) questionnaire. The study included 573 elderly residents in the urban area of Cuiabá-MT, Brazil.The adopted measure of association was the prevalence ratio. For multivariate analysis, multiple Poisson regression was used. The prevalence of poor/very poor self-rated health was 30.9% and the associated factors were income, number of morbidities and urinary incontinence. The association of demographic and socioeconomic factors with poor/very poor self-rated health among the elderly in this study shows the need for assistance and policies that minimize the impact of these factors on the lives and health of the elderly.