Sônia Maria Soares

O desenvolvimento de políticas públicas de atenção ao idoso no Brasil

Analisis documental objetivando discutir aspectos legales del desarrollo de politicas de atencion al anciano en Brasil, en el contexto socio-historico-politico, apuntando a los aspectos que delinean el bienestar de una persona anciana. Datos recolectados de junio a setiembre de 2010, en webs gubernamentales. Fueron incluidos documentos con vinculacion al objetivo propuesto; los que contenian articulacion con politicas de atencion al anciano insertas en las politicas para la ancianidad en 2006 y la ley Eloi Chaves de 1923. Este analisis indico que el bienestar de los ancianos depende significativamente de destinar recursos a sectores que van mas alla de lo estrictamente sanitario, destacando al anciano en el mercado laboral y la feminizacion de la vejez. Se espera de la poblacion y gobernantes la discusion sobre necesidades de esta poblacion la integracion de redes de atencion para la persona anciana que aun expresa escasez de conocimientos para la heterogeneidad de esta poblacion.Analisis documental objetivando discutir aspectos legales del desarrollo de politicas de atencion al anciano en Brasil, en el contexto socio-historico-politico, apuntando a los aspectos que delinean el bienestar de una persona anciana. Datos recolectados de junio a setiembre de 2010, en webs gubernamentales. Fueron incluidos documentos con vinculacion al objetivo propuesto; los que contenian articulacion con politicas de atencion al anciano insertas en las politicas para la ancianidad en 2006 y la ley Eloi Chaves de 1923. Este analisis indico que el bienestar de los ancianos depende significativamente de destinar recursos a sectores que van mas alla de lo estrictamente sanitario, destacando al anciano en el mercado laboral y la feminizacion de la vejez. Se espera de la poblacion y gobernantes la discusion sobre necesidades de esta poblacion la integracion de redes de atencion para la persona anciana que aun expresa escasez de conocimientos para la heterogeneidad de esta poblacion.The objective of this documental analysis is to discuss the legal aspects involved in the development of elderly care policies in Brazil, considering the socio-historical-political context, and in view of the aspects that outline the wellbeing of an aged individual. Data collection was performed between June and September of 2010 via governmental websites. Documents were included if they complied with the proposed objective; were connected with elderly care policies, and lay within the legal accomplishments regarding elderly care policies in 2006 and the Elói Chaves Law of 1923. This analysis indicated that elderly wellbeing depends significantly on resource allocation in sectors other than the healthcare area, with emphasis on the elderly in the labor market and the feminization of old age. It is expected that the community and administrators will discuss the needs of the elderly population and the integration of care networks that remain necessary for the heterogeneity of this population.

A família no contexto do cuidado ao portador de nefropatia diabética: demanda e recursos

A doenca renal cronica e o tratamento dialitico constituem um grande problema para a pessoa doente e sua familia, modificando seus habitos de vida. Essas mudancas exigem da familia esforco, dedicacao e adaptacoes na rotina de vida de seus membros. Objetivou-se neste estudo identificar as principais demandas e recursos da familia no conviver e no cuidar de pessoas com nefropatia diabetica. Trata-se de uma pesquisa qualitativa, conduzida pelos pressupostos do Modelo Calgary de Avaliacao da Familia (MCAF), desenvolvido com sete familias em duas unidades de terapia renal substitutiva em Belo Horizonte/MG. Os resultados da pesquisa foram apresentados sob a forma de demandas e recursos, alicercadas num conjunto de crencas e valores que interferem no enfrentamento da doenca. Os dados obtidos sugerem que cada familia pesquisada possui recursos mesmo em face de demandas de saude, alertando para a necessidade de enxergamos a familia como foco do cuidado de enfermagem.Chronic renal disease and dialytic treatment are a great problem for a sick person and their family, altering their living habits. These changes demand effort, dedication and adaptation in life routine of the family members. It was aimed at in this study to identify the main demands and resources of the family in living and caring for people with diabetic nephropathy. This is a qualitative research, guided by the assumptions of the Calgary Model of Family Evaluation, carried out with seven families in two renal therapy units in Belo Horizonte, Minas Gerais, Brazil. The results of the research were presented as demands and resources, based on sets of beliefs and values that intervene in facing the disease. The data obtained suggest that each researched family has resources, even as they are faced by health demands, which shows the need for looking at the family as a focus of nursing care.

Grupos operativos de aprendizagem nos serviços de saúde: sistematização de fundamentos e metodologias

Trata-se de uma pesquisa com abordagem qualitativa, modalidade estudo de caso, que teve como objetivo analisar a aplicacao da teoria e da metodologia dos grupos operativos, proposta por Pichon-Riviere em grupos de portadores de doencas cronico-degenerativas. Foi desenvolvida em um hospital universitario da cidade de Belo Horizonte Minas Gerais/Brasil, por meio de entrevistas e observacao direta de um grupo de sete adultos com diabetes tipo 1, com idade entre 18 e 45 anos, durante os encontros no grupo operativo. A analise dos dados fundamentou-se no referencial dos indicadores do processo grupal, propostos por Pichon-Riviere (1998): afiliacao e pertenca, cooperacao, comunicacao, aprendizagem e pertinencia. A aplicacao da teoria e da metodologia proposta por Pichon-Riviere permitiu ao coordenador do grupo operativo e as pesquisadoras ampliar o olhar em relacao a dinâmica grupal, o que contribuiu para que os conteudos subjetivos, implicitos nas interacoes dos participantes fossem trabalhados, mas nao verbalizados. Alem disso, os indicadores do processo grupal permitiram reavaliar e adaptar o desenvolvimento do grupo operativo, norteando as acoes desenvolvidas a cada encontro. Fundamentadas nos achados deste estudo, as autoras acreditam que esta pode ser uma estrategia eficaz para os profissionais de saude, na construcao de modelos que envolvam trabalhos com grupos.

Cut-off point for WHOQOL-bref as a measure of quality of life of older adults

OBJECTIVE To propose a cut-off for the World Health Organization Quality of Life-Bref (WHOQOL-bref) as a predictor of quality of life in older adults. METHODS Cross-sectional study with 391 older adults registered in the Northwest Health District in Belo Horizonte, MG, Southeastern Brazil, between October 8, 2010 and May 23, 2011. The older adults’ quality of life was measured using the WHOQOL-bref. The analysis was rationalized by outlining two extreme and simultaneous groups according to perceived quality of life and satisfaction with health (quality of life good/satisfactory – good or very good self-reported quality of life and being satisfied or very satisfied with health – G5; and poor/very poor quality of life – poor or very poor self-reported quality of life and feeling dissatisfied or very dissatisfied with health – G6). A Receiver-Operating Characteristic curve (ROC) was created to assess the diagnostic ability of different cut-off points of the WHOQOL-bref. RESULTS ROC curve analysis indicated a critical value 60 as the optimal cut-off point for assessing perceived quality of life and satisfaction with health. The area under the curve was 0.758, with a sensitivity of 76.8% and specificity of 63.8% for a cut-off of ≥ 60 for overall quality of life (G5) and sensitivity 95.0% and specificity of 54.4% for a cut-off of < 60 for overall quality of life (G6). CONCLUSIONS Diagnostic interpretation of the ROC curve revealed that cut-off < 60 for overall quality of life obtained excellent sensitivity and negative predictive value for tracking older adults with probable worse quality of life and dissatisfied with health.

OFICINAS SOBRE SEXUALIDADE NA ADOLESCÊNCIA: REVELANDO VOZES, DESVELANDO OLHARES DE ESTUDANTES DO ENSINO MÉDIO

Se trata de investigacion con los adolescentes de una escuela estatal del distrito municipal al Norte de Minas Gerais - Brasil con el objetivo de entender como ellos viven y ellos ejercen su sexualidad. El estudio se desarrollo por los talleres ludico-pedagogicos en el acercamiento cualitativo. El punto de los resultados que el concepto de sexualidad se limita a las relaciones sexuales entre dos personas de sexo opuesto. Los estudiantes dieron enfasis al riesgo de un embarazo no deseado y reconocieron la importancia del uso de metodos anticoncepcionales. Los talleres propiciaron una atmosfera favorable para la discusion de cambios de actitud para los adolescentes por la informacion, reflexion y expresion de ideas y sentimientos, representando un proceso a ser complementado por la familia, escuela y politica sociales locales.

O teatro em foco: estratégia lúdica para o trabalho educativo na saúde da família

Resumen Se informa sobre la experiencia de los estudiantes de enfermería que utilizaron el teatro como estrategia lúdica para el trabajo educativo con equipos de Salud de la Familia. Se realizó el Diagnóstico Situacional de Salud en el interior del Estado de Minas Gerais; las morbidades más prevalentes se emplearon como temás por tratar en las parodias. En tres meses se escribieron nueve parodias para un público diversificado. Se observó una ruptura en el cotidiano de la comunidad porque, en la dimensión lúdica, el personas dejaron fluir el aspecto placentero de la vida, decodificando el mundo a su manera, una mezcla agradable de arte y ciencia. El teatro permitió vislumbrar las distintas aplicaciones en Salud de la Familia: como estrategia lúdica eficaz para adquirir conceptos de salud, como recurso de ocio y como espacio de convivencia. Habría que promover capacitación de multiplicadores en la comunidad para que continúen armando talleres de teatro en prol de la construcción del conocimiento colectivo. Palabras clave: Educación en Salud. Promoción de la Salud. Programa de Salud Familiar. Creatividad. Enfermería. 1Doutora em Saúde Pública. Docente do Departamento de Enfermagem Básica da Escola de Enfermagem da Universidade Federal de Minas Gerais – EEUFMG. Coordenadora do Núcleo de Estudos e Pesquisas em Cuidado e Desenvolvimento Humano da EEUFMG Belo Horizonte-MG. Brasil. Email: smsoares.bhz@terra.com.br; 2Mestre em Enfermagem pela EEUFMG. Servidora pública da Prefeitura Municipal de Betim/MG. Membro do Núcleo de Estudos e Pesquisas em Cuidado e Desenvolvimento Humano da EEUFMG Belo Horizonte-MG. Brasil. Email: ligemeasbh@yahoo.com.br; 3 Enfermeira. Mestranda da EEUFMG. Membro do Núcleo de Estudos e Pesquisas em Cuidado e Desenvolvimento Humano da EEUFMG Belo Horizonte-MG. Brasil. Email: patriciaaparecidabarbosasilva@yahoo.com.br RELATO DE EXPERIÊNCIA EXPERIENCE REPORT EXPERIENCIA DE INFORME It reports on the experience of nursing students who used the theatre as a ludic strategy for the educational work with family healthcare teams. A Situational Health Diagnosis was completed in the State of Minas Gerais inland. Its more frequent illnesses were used then as arguments to be addressed in the scenes. In three months nine acts were written and performed for a varied audience. We observed a rupture in the community daily routine in which, under a ludic dimension , the people allowed the flowing of a more pleasant side of life and interpreted the world their own way in an agreeable combination of art and science. This experience in drama therapy allowed us to witness its many uses in the context of Family Healthcare. It constitutes a valuable ludic strategy for the acquisition of health concepts, an effective leisure alternative and a get together space. It is necessary however to train community agents so they would be able to carry on the organization of theatre workshops towards the construction of a collective knowledge.It reports on the experience of nursing students who used the theatre as a ludic strategy for the educational work with family healthcare teams. A Situational Health Diagnosis was completed in the State of Minas Gerais inland. Its more frequent illnesses were used then as arguments to be addressed in the scenes. In three months nine acts were written and performed for a varied audience. We observed a rupture in the community daily routine in which, under a ludic dimension , the people allowed the flowing of a more pleasant side of life and interpreted the world their own way in an agreeable combination of art and science. This experience in drama therapy allowed us to witness its many uses in the context of Family Healthcare. It constitutes a valuable ludic strategy for the acquisition of health concepts, an effective leisure alternative and a get together space. It is necessary however to train community agents so they would be able to carry on the organization of theatre workshops towards the construction of a collective knowledge.

Fatores que influenciam a qualidade de vida do cuidador familiar do idoso com demência

The progression of symptoms of dementia leads to loss of autonomy and independence of the elderly. This progression suggests that a family member will assume the functions of caregiver, which can adversely affect his/her quality of life (QOL). This research is an integrative review that sought to analyze the available evidence on the factors that influence quality of life of family caregivers of the elderly with dementia. Articles published in the BDENF, Lilacs and Medline databases were examined and 477 studies were selected, of which 11 met the inclusion criteria and comprised the sample of this review. It was found that the factors that influence quality of life of caregivers are: depression; poor sleep quality; dementia type and neuropsychiatric symptoms; support, social support and access to health services; leisure; pre-existing health problems; interventions for caregiver training and spirituality. It is suggested that the nursing professional identifies the needs of the caregivers, such that strategies of care can be defined.

Comparison between ability and performance: a study on the functionality of dependent elderly individuals

OBJETIVO: comparar la capacidad y el desempeno para la realizacion de las Actividades Basicas de la Vida Diaria en ancianos dependientes atendidos por el Centro de Referencia del Anciano. METODO: se trata de un estudio transversal, observacional, con abordaje cuantitativo. La Medida de Independencia Funcional (MIF) fue aplicada en 109 ancianos atendidos en un Centro de Referencia del Anciano. De estos, 60 ancianos fueron clasificados como dependientes para las actividades basicas de la vida diaria y fueron descritos de acuerdo con la Clasificacion Internacional de Funcionalidad Incapacidad y Salud (CIF). El proceso de triangulacion reforzo la confiabilidad de los datos obtenidos, en el cual consideramos las informaciones de pacientes y acompanantes en conjunto con la ficha medica y evaluacion objetiva. RESULTADOS: el promedio de edad fue de 81,0±7,1, con predominancia del genero femenino. La diferencia entre la capacidad y el desempeno fue estadisticamente significativa (p<0,05) en la mayoria de las tareas de lo cotidiano. CONCLUSION: la contribucion de este estudio en la utilizacion de la CIF fue la interpretacion de sus calificadores de manera semicuantitativa, lo que permitio comparaciones e inferencias mas objetivas y evidencio una clara distancia entre el desempeno y la capacidad de esos ancianos en gran parte de las actividades evaluadas.OBJECTIVE to compare the ability and performance of Basic Activities of Daily Living of dependent elderly individuals cared for in a geriatric healthcare center. METHOD cross-sectional, observational study with quantitative approach. The Functional Independence Measure (FIM) was applied in 109 elderly individuals cared for in a geriatric healthcare center. Of these, 60 individuals were classified as dependent in the case of basic activities of daily living described according to the International Classification of Functionality, Disability and Health (ICF). The process of triangulation reinforced reliability of data, which included information provided by patients and caregivers and that contained in medical files and objective assessment. RESULTS the average age was 81.0±7.1 with a predominance of women. The difference between ability and performance was statistically significant (p<0.05) in most daily tasks. CONCLUSION the contribution of this study in using ICF was semi-quantitatively interpreting its qualifiers, which enabled more objective comparisons and inferences, and revealed a clear distance between the performance and ability of these individuals in most of the assessed activities.

The development of public policies for elderly care in Brazil

Analisis documental objetivando discutir aspectos legales del desarrollo de politicas de atencion al anciano en Brasil, en el contexto socio-historico-politico, apuntando a los aspectos que delinean el bienestar de una persona anciana. Datos recolectados de junio a setiembre de 2010, en webs gubernamentales. Fueron incluidos documentos con vinculacion al objetivo propuesto; los que contenian articulacion con politicas de atencion al anciano insertas en las politicas para la ancianidad en 2006 y la ley Eloi Chaves de 1923. Este analisis indico que el bienestar de los ancianos depende significativamente de destinar recursos a sectores que van mas alla de lo estrictamente sanitario, destacando al anciano en el mercado laboral y la feminizacion de la vejez. Se espera de la poblacion y gobernantes la discusion sobre necesidades de esta poblacion la integracion de redes de atencion para la persona anciana que aun expresa escasez de conocimientos para la heterogeneidad de esta poblacion.Analisis documental objetivando discutir aspectos legales del desarrollo de politicas de atencion al anciano en Brasil, en el contexto socio-historico-politico, apuntando a los aspectos que delinean el bienestar de una persona anciana. Datos recolectados de junio a setiembre de 2010, en webs gubernamentales. Fueron incluidos documentos con vinculacion al objetivo propuesto; los que contenian articulacion con politicas de atencion al anciano insertas en las politicas para la ancianidad en 2006 y la ley Eloi Chaves de 1923. Este analisis indico que el bienestar de los ancianos depende significativamente de destinar recursos a sectores que van mas alla de lo estrictamente sanitario, destacando al anciano en el mercado laboral y la feminizacion de la vejez. Se espera de la poblacion y gobernantes la discusion sobre necesidades de esta poblacion la integracion de redes de atencion para la persona anciana que aun expresa escasez de conocimientos para la heterogeneidad de esta poblacion.The objective of this documental analysis is to discuss the legal aspects involved in the development of elderly care policies in Brazil, considering the socio-historical-political context, and in view of the aspects that outline the wellbeing of an aged individual. Data collection was performed between June and September of 2010 via governmental websites. Documents were included if they complied with the proposed objective; were connected with elderly care policies, and lay within the legal accomplishments regarding elderly care policies in 2006 and the Elói Chaves Law of 1923. This analysis indicated that elderly wellbeing depends significantly on resource allocation in sectors other than the healthcare area, with emphasis on the elderly in the labor market and the feminization of old age. It is expected that the community and administrators will discuss the needs of the elderly population and the integration of care networks that remain necessary for the heterogeneity of this population.

Comunicação sazonal sobre a dengue em grupos socioeducativos na atenção primária à saúde

OBJETIVO: Analizar como se establece la comunicacion estacional en los grupos socioeducativos de los equipos de Salud de la Familia para prevencion y control del dengue. PROCEDIMIENTOS METODOLOGICOS: Estudio cualitativo, descriptivo y exploratorio con 25 coordinadores de grupos socioeducativos, distribuidos en ocho unidades basicas de salud de Belo Horizonte, Sureste de Brasil. La colecta de datos ocurrio de marzo a julio de 2009, por medio de observacion no participante y entrevista semi-estructurada con los coordinadores. En la interpretacion de los datos, se emplearan analisis de contenido y los referenciales teoricos sobre la comunicacion y salud. ANALISIS DE LOS RESULTADOS: Se encontraron tres nucleos tematicos: comunicacion estacional; contenidos discutidos y canales vehiculadores de informaciones sobre el dengue; e informacion versus comunicacion para la accion. Las acciones de prevencion y control del dengue en los grupos eran abordadas principalmente en epocas de surto, basandose en acciones previamente programadas por el Ministerio de la Salud. Los temas abordados se referian a epidemiologia, ciclo de vida, modos de transmision, sintomatologia, prevencion, visita domiciliar del equipo de zoonosis y vacunacion contra el dengue. CONCLUSIONES: La practica comunicativa predominante es el repase de informaciones por el coordinador, centrado en el discurso comportamentalista y prescriptivo. Se recomiendan practicas comunicativas pautadas en el dialogo, permitiendo al coordinador y miembros del equipo la libertad con relacion a las situaciones emergentes del grupo y que aprendan a reconocerla y problematizarla reflexivamente en su contexto.OBJECTIVE To analyze how seasonal communication for dengue control and prevention is conveyed in educational peer groups of Family Health teams. METHODOLOGICAL PROCEDURES An exploratory and descriptive qualitative study was performed with 25 coordinators of peer education groups, distributed among eight basic health units of Belo Horizonte, Southeastern Brazil. Data collection occurred from March to June 2009, by non-participant observation and semi-structured interviews with coordinators. Content analysis and the principal theories in health communication were utilized in data interpretation. ANALYSIS OF RESULTS Three thematic units were identified: seasonal communication; subjects discussed and information sources about dengue; and information versus communication for action. Dengue prevention and control actions were principally discussed in groups during outbreaks, based on actions previously programmed by the Ministry of Health. The topics addressed focused on epidemiology, life cycle, modes of transmission, symptoms, prevention, domiciliary visits by zoonosis control units and vaccination for dengue. CONCLUSIONS The predominant communication action is information conveyance by the coordinator, centered on a behavioralist and prescriptive discourse. Communication practices focused on dialogue is recommended, allowing the coordinator and group members freedom in regards to emergent issues in the group, so they learn to recognize and reflexively discuss them in context.