Tábatta Renata Pereira de Brito

The relationship between social support and functional capacity in elderly persons with cognitive alterations

The objective of this study was to identify the relationship between social support and the functional capacity of elderly persons with cognitive alterations. It is a descriptive, cross-sectional and quantitative study. The subjects were 101 elderly persons registered in Family Health Centers whose performance in the Mini-Exam for Mental Status was below a certain specified level in a previous study. The Medical Outcomes Study questionnaire, Katz Index and Pfeffer Questionnaire were applied. The dimensions of material, affective, emotional, informational and positive social interaction support resulted in an average final score of 74.32 points, indicating a better level of material and affective support in relation to the other dimensions of support. There was a statistically significant correlation between emotional support and the Katz Index. Knowledge about this relationship favors the development of a nursing care pathway for the elderly which is capable of maintaining their functional capacity and ensuring satisfactory social relations.El objetivo de este estudio fue identificar la relacion entre el apoyo social y la capacidad funcional de personas mayores con deterioro cognitivo. Es un estudio descriptivo, transversal y cuantitativo. Los sujetos fueron 101 mayores inscritos en Unidades de Salud Familiar que mostro rendimiento en Mini Examen del Estado Mental por debajo del umbral en estudio anterior. Se aplico Medical Outcomes Study, Indice Katz y cuestionario Pfeffer. Las dimensiones del apoyo material, afectivo, emocional, interaccion social positiva y de informacion dio lugar a una puntuacion media final de 74,43 puntos, lo que indica mayor nivel de apoyo material y afectivo con relacion a otras dimensiones de apoyo. Hubo una correlacion estadisticamente significativa entre apoyo emocional e indice de Katz. El conocimiento de esta relacion favorece el desarrollo de una linea de atencion de enfermeria a los mayores, capaz de mantener su capacidad funcional, y garantizar relaciones sociales satisfactorias

Nutritional status and risk for disability in instrumental activities of daily living in older Brazilians.

OBJECTIVE The aim of the present study was to examine the association between nutritional status and the incidence of disability regarding instrumental activities of daily living (IADL) among older adults. DESIGN The study is part of the longitudinal SABE (Saúde, Bem-Estar e Envelhecimento; Health, Wellbeing and Ageing) Study that began in 2000 (first wave) with a multistage, clustered, probabilistic sample (n 2143) of older adults (≥60 years). The second wave was carried out in 2006, when 1115 elders were re-interviewed. The dependent variable was the occurrence of disability in 2006 (report of difficulty on ≥1 IADL). Nutritional status (measured at baseline) was classified on the basis of BMI: ≤23·0 kg/m2 (underweight); >23·0 and <28·0 kg/m2 (ideal range - reference); ≥28·0 and <30·0 kg/m2 (overweight); and ≥30·0 kg/m2 (obesity). SETTING São Paulo, Brazil. SUBJECTS One thousand and thirty-four individuals without difficulties regarding IADL in 2000 were selected, 611 of whom were re-interviewed in 2006. RESULTS In the multiple logistic regression analysis adjusted for baseline variables (gender, age, number of chronic diseases, stroke, osteoarthritis and cognitive status), underweight (OR = 2·03; P = 0·034) and obesity (OR = 1·79; P = 0·022) remained associated with disability. CONCLUSIONS Both underweight and obesity are associated with an increased risk of developing disability regarding IADL among older adults, in an independent fashion of other risk factors. Thus, adequate nutritional status is a key point to consider in the establishment of preventive measures.

As práticas lúdicas no cotidiano do cuidar em enfermagem pediátrica

Although the playfultherapy has therapeutic value in the hospitalization and need to be incorporate in the process of taking care in Pediatric Nursing, her use is not effective in the Brazilian institutions. Being like this, it is aimed to apprehend from the academics of Nursing doing playful practices with children hospitalized during the professional studies. Methodologically was adopted the approach qualitative phenomenological, with sample of 16 academics of the eighth period of the Nursing Course at the Universidade Federal de Alfenas, after Free Consent and Clarification. It was used open interviews with the subject oriented: How are the playful activities applied in the daily of work in Pediatric Unit? The results are evidenced by the categories motivation/gratification, lack of pledge and initiative, and impotence. Consequently, it was considered that the insert of the playful in pediatrics is a gradual process, and that doing playful practices implicates in reviewing the academic studies, turning the articulation strong and coherent teaching/research/extension, for the contents to emphasize the humanization and the assistance integralization.Aun cuando la ludoterapia tiene valor terapeutico en el ambito de la hospitalizacion y es importante incorporarla al proceso del cuidado de enfermeria pediatrica, en las instituciones brasilenas esta tecnica no es puesta en practica. Por lo tanto, el objetivo concreto es aprender de los estudiantes de enfermeria como realizar estas practicas ludicas con ninos hospitalizados durante su formacion profesional. La metodologia utilizada en el presente estudio fue el abordaje cualitativo fenomenologico. Participaron 17 estudiantes del octavo periodo del curso de enfermeria de la Universidad Federal de Alfenas, con previa autorizacion de los mismos. Se utilizo la entrevista abierta, y la siguiente pregunta como guia: ?Como son las actividades recreativas en el trabajo cotidiano en la Unidad de Pediatria? Una mejor percepcion de los resultados se presento al organizar el material bajo las siguientes categorias: la motivacion/gratificacion, la falta de compromiso e iniciativa, y la impotencia. Por lo tanto, se concluyo que la inclusion de elementos ludicos en las practicas pediatricas se presento de forma paulatina, y que el hecho de realizar practicas ludicas implica hacer una revision de la formacion academica, convirtiendo la coyuntura ensenanza-investigacion - educacion en un vinculo fuerte y coherente, logrando asi, que los contenidos enfaticen la humanizacion e integracion de la asistencia.Ainda que a ludicoterapia tenha valor terapeutico na hospitalizacao e necessite ser incorporada no processo de cuidar em Enfermagem Pediatrica, sua utilizacao nao e efetiva nas instituicoes brasileiras. Sendo assim, objetiva-se apreender dos academicos de Enfermagem o fazer praticas ludicas com criancas hospitalizadas durante a formacao profissional. Metodologicamente, adotou-se a abordagem qualitativa fenomenologica, considerando 16 academicos do oitavo periodo do Curso de Enfermagem da Universidade Federal de Alfenas, apos Consentimento Livre e Esclarecido. Utilizou-se entrevista aberta com a questao norteadora: Como sao as atividades ludicas no cotidiano de trabalho em Unidade Pediatrica? Os resultados sao evidenciados pelas categorias motivacao/gratificacao, falta de empenho e iniciativa, e impotencia. Por conseguinte, considerou-se que a insercao do ludico em pediatria se processa gradativamente, e que o fazer praticas ludicas implica rever a formacao academica, tornando a articulacao ensino/pesquisa/extensao forte e coerente, para que os conteudos enfatizem a humanizacao e integralizacao da assistencia.

[The elderly with cognitive alterations in the context of poverty: a study of the social support network].

The objective of this study was to analyze the structure and role of social support networks for the elderly with cognitive alterations, who lived in a context of high or very high social vulnerability, and identify the associations between the characteristics of the networks and functional capacity. The participants were 38 aged individuals living in a context of high or very high social vulnerability whose score on the Mini-Mental State Examination was below the cut-off point. All ethical considerations were observed. The following were administered: Mini-Mental State Examination, Convoy of Social Support, Katz Index, and Pfeffer Questionnaire. The results show that the elderly participants have a large social network, with most members in their inner circle, but only a few of the members play functional roles. A correlation was observed between the gender variable and the number of social network members. No significant correlation was observed between network characteristics and the functional capacity of the elderly.The objective of this study was to analyze the structure and role of social support networks for the elderly with cognitive alterations, who lived in a context of high or very high social vulnerability, and identify the associations between the characteristics of the networks and functional capacity. The participants were 38 aged individuals living in a context of high or very high social vulnerability whose score on the Mini-Mental State Examination was below the cut-off point. All ethical considerations were observed. The following were administered: Mini-Mental State Examination, Convoy of Social Support, Katz Index, and Pfeffer Questionnaire. The results show that the elderly participants have a large social network, with most members in their inner circle, but only a few of the members play functional roles. A correlation was observed between the gender variable and the number of social network members. No significant correlation was observed between network characteristics and the functional capacity of the elderly.

Suporte social e contato intergeracional: estudando idosos com alterações cognitivas

The aim of this study was to investigate the relationship between social support to elderly patients with cognitive alterations in different contexts of social vulnerability and the presence of children living in the same household. A descriptive, cross-sectional study assessed 85 elderly individuals in different contexts of social vulnerability; all of them presented results below the cut-off point in the mini mental state examination. All ethical guidelines were respected. A sociodemographic and family characterization tool, the mini mental state examination, and the Medical Outcomes Study (MOS) were applied. The results showed good levels of social support received by elderly individuals and a statistically significant correlation between the extent of emotional support and the presence of children in the household (t=2.16, p<0.01). These results enable a better understanding on the relationships between elderly people and children by evidencing that intergenerational contact favors the perception of satisfactory social support by the elderly. Descriptors: Aged; Child; Social Support; Family; Geriatric Nursing. RESUMO Este estudo teve por objetivo verificar a relação entre apoio social de idosos com alterações cognitivas que residem em diferentes contextos de vulnerabilidade social e a presença de crianças vivendo no mesmo domicílio. Trata-se de um estudo descritivo, transversal, que avaliou 85 idosos residentes em diferentes contextos de vulnerabilidade social, e que apresentaram resultado no Mini Exame do Estado Mental abaixo da nota de corte. Todos os cuidados éticos foram observados. Foram aplicados instrumento de caracterização sociodemográfica e familiar, Mini Exame do Estado Mental e o Medical Outcomes Study (MOS). Os resultados revelaram bons níveis de apoio social recebidos pelos idosos e correlação estatisticamente significativa entre a dimensão de apoio emocional e a presença de crianças no domicílio (t=2,16, sendo p<0,01). Esses resultados possibilitam conhecer melhor a relação entre idosos e crianças ao revelar que o contato intergeracional favorece a percepção de apoio social satisfatório pelos idosos. Descritores: Idoso; Criança; Apoio Social; Família; Enfermagem Geriátrica. Luchesi BM, Brito TRP, Costa RS, Pavarini SCI. Rev. Eletr. Enf. [Internet]. 2015 jul/sep;17(3). Available from: http://dx.doi.org/10.5216/ree.v17i3.25597. 2 INTRODUCTION The number of people aged over 60 worldwide is growing faster than any other age group. Particularly in the last 60 years the number of elderly people in Brazil has increased significantly. In 1950, this age group represented 4.9% of the total population; in 2010 the number of elderly people was 19.6 million, corresponding to 10.2% of the population. Considering that over the next 40 years this group will grow at a rate of 3.2% per year the number of elderly people will reach 64 million in 2050, corresponding to 29.7% of the total population. This percentage is very similar to that found for Japan, currently the country with the highest number of elderly people in the world. Population ageing increases the interaction between people and intergenerational relationships, leading to a society composed of four generations, as many elderly individuals experience the opportunity to meet their grandchildren and great-grandchildren. Also, the existence of family arrangements in which the elderly live together with younger generations is increasingly common. According to data from the SABE Study (Health, Welfare and Ageing) conducted in São Paulo in 2006, 30.3% of the elderly lived with their children, 23.9% lived only with the spouse, 20.4% lived with children and grandchildren, 13.3% lived alone and 12.1% lived in other type of arrangements. Of the 147 elderly individuals aged over 80 that were interviewed in Ribeirão Preto, in the state of São Paulo, 10.9% were living in trigenerational arrangements and 2% were living with grandchildren. Considering that ageing may increase the demand for elderly care and that family is the main source of assistance, the presence of children living with elderly people may affect the exchange of support in the household. Such interpersonal exchanges involving affection, affirmation and care define the term “social support”. In turn, the social networks are the set of relationships maintained by each individual; social support is the motivation for the establishment of networks. In general, people who engage in social networks live longer and healthier than people who do not. The effect of social networks on the health of elderly people has been demonstrated, particularly in quality of life, subjective well-being, functionality, mortality and cognitive impairment. In relation to cognitive aspects, social support works as a protective factor against cognitive impairment. The engagement in social networks helps to maintain the independence of elderly people within their family and socio-cultural context, which is fundamental for cognitive functions and psychological well-being. There is an emotional complexity permeating the relationships among seniors, adult children and grandchildren and the quality of these relationships is associated with the physical and mental conditions of the elderly. In this sense, the relationship between elderly people and children increases the possibilities of social support exchange in old age, which may improve the quality of life of elderly people. Therefore, considering that children living with elderly people is quite usual and that social support may be a protective factor for cognitive impairment, the present study aimed at investigating the relationship between social support for elderly people with cognitive alterations and the presence of children living in the same household. METHODOLOGY A descriptive, cross-sectional, quantitative study was conducted in a city located in the central region of the state of São Paulo. The study subjects consisted of elderly people (people over 60 years old) (n=85) registered in Family Health Units (FHUs) located in different regions of social vulnerability according to the São Paulo Social Luchesi BM, Brito TRP, Costa RS, Pavarini SCI. Rev. Eletr. Enf. [Internet]. 2015 jul/sep;17(3). Available from: http://dx.doi.org/10.5216/ree.v17i3.25597. 3 Vulnerability Index (IPVS, as per its acronym in Portuguese). Inclusion criteria included: being over 60 years old, being registered in one of the FHUs of the city that are rated in the IPVS, presenting result below the cut-off score in the mini mental state examination, having no severe speech or understanding impairment, and agreeing to participate in the study. A database consisting of 755 assessments of elderly individuals from the FHUs rated in the IPVS of the city was used for sample selection. Of these, the elderly with indication of cognitive alterations consisted of 195 individuals who presented results below the cut-off score in the mini mental state examination. Discarding losses by death and household migration, the present study reassessed 101 elderly individuals. After reapplication of the mini mental state examination, 16 individuals presenting result above the cut-off score were excluded. Thus, the final sample consisted of 85 elderly individuals. Individual and in-home assessments were conducted between August and November 2009, respecting a prior appointment with the individuals. The data collection

Relación entre apoyo social y capacidad funcional de los mayores con los cambios cognitivos

The objective of this study was to identify the relationship between social support and the functional capacity of elderly persons with cognitive alterations. It is a descriptive, cross-sectional and quantitative study. The subjects were 101 elderly persons registered in Family Health Centers whose performance in the Mini-Exam for Mental Status was below a certain specified level in a previous study. The Medical Outcomes Study questionnaire, Katz Index and Pfeffer Questionnaire were applied. The dimensions of material, affective, emotional, informational and positive social interaction support resulted in an average final score of 74.32 points, indicating a better level of material and affective support in relation to the other dimensions of support. There was a statistically significant correlation between emotional support and the Katz Index. Knowledge about this relationship favors the development of a nursing care pathway for the elderly which is capable of maintaining their functional capacity and ensuring satisfactory social relations.El objetivo de este estudio fue identificar la relacion entre el apoyo social y la capacidad funcional de personas mayores con deterioro cognitivo. Es un estudio descriptivo, transversal y cuantitativo. Los sujetos fueron 101 mayores inscritos en Unidades de Salud Familiar que mostro rendimiento en Mini Examen del Estado Mental por debajo del umbral en estudio anterior. Se aplico Medical Outcomes Study, Indice Katz y cuestionario Pfeffer. Las dimensiones del apoyo material, afectivo, emocional, interaccion social positiva y de informacion dio lugar a una puntuacion media final de 74,43 puntos, lo que indica mayor nivel de apoyo material y afectivo con relacion a otras dimensiones de apoyo. Hubo una correlacion estadisticamente significativa entre apoyo emocional e indice de Katz. El conocimiento de esta relacion favorece el desarrollo de una linea de atencion de enfermeria a los mayores, capaz de mantener su capacidad funcional, y garantizar relaciones sociales satisfactorias

Elderly and caregiver demand: proposal for a care need classification

OBJECTIVE To propose a care need classification for elderly people by identifying their functional demands. METHOD Cross-sectional study carried out in São Paulo, in 2006, with 1,413 elderly (≥ 60 years old), participants in the Health, Well-being and Aging study (SABE - Saúde, Bem Estar e Envelhecimento). For the care need classification, we used the Guttman Scaling method e the frequency of assistance required by the elderly. RESULTS The hierarchy of activities of daily living had good internal consistency (α = 0.92) and satisfactory coefficients of reproducibility (98%), scalability (84%) and minimum marginal reproducibility (87%). Care need was categorized into: no need (requires no caregiver), minimum need (requires caregiver sporadically), moderate need (requires caregiver intermittently) and maximum need (requires full-time caregiver). CONCLUSION This classification will allow identifying elderly that need assistance in everyday activities and will orientante health professionals in the development of a line of care.

Ancianos con alteración cognitiva en ámbito de pobreza: estudiando la red de apoyo social

The objective of this study was to analyze the structure and role of social support networks for the elderly with cognitive alterations, who lived in a context of high or very high social vulnerability, and identify the associations between the characteristics of the networks and functional capacity. The participants were 38 aged individuals living in a context of high or very high social vulnerability whose score on the Mini-Mental State Examination was below the cut-off point. All ethical considerations were observed. The following were administered: Mini-Mental State Examination, Convoy of Social Support, Katz Index, and Pfeffer Questionnaire. The results show that the elderly participants have a large social network, with most members in their inner circle, but only a few of the members play functional roles. A correlation was observed between the gender variable and the number of social network members. No significant correlation was observed between network characteristics and the functional capacity of the elderly.The objective of this study was to analyze the structure and role of social support networks for the elderly with cognitive alterations, who lived in a context of high or very high social vulnerability, and identify the associations between the characteristics of the networks and functional capacity. The participants were 38 aged individuals living in a context of high or very high social vulnerability whose score on the Mini-Mental State Examination was below the cut-off point. All ethical considerations were observed. The following were administered: Mini-Mental State Examination, Convoy of Social Support, Katz Index, and Pfeffer Questionnaire. The results show that the elderly participants have a large social network, with most members in their inner circle, but only a few of the members play functional roles. A correlation was observed between the gender variable and the number of social network members. No significant correlation was observed between network characteristics and the functional capacity of the elderly.

The playful in the daily practices of care in pediatric nursing

Although the playfultherapy has therapeutic value in the hospitalization and need to be incorporate in the process of taking care in Pediatric Nursing, her use is not effective in the Brazilian institutions. Being like this, it is aimed to apprehend from the academics of Nursing doing playful practices with children hospitalized during the professional studies. Methodologically was adopted the approach qualitative phenomenological, with sample of 16 academics of the eighth period of the Nursing Course at the Universidade Federal de Alfenas, after Free Consent and Clarification. It was used open interviews with the subject oriented: How are the playful activities applied in the daily of work in Pediatric Unit? The results are evidenced by the categories motivation/gratification, lack of pledge and initiative, and impotence. Consequently, it was considered that the insert of the playful in pediatrics is a gradual process, and that doing playful practices implicates in reviewing the academic studies, turning the articulation strong and coherent teaching/research/extension, for the contents to emphasize the humanization and the assistance integralization.Aun cuando la ludoterapia tiene valor terapeutico en el ambito de la hospitalizacion y es importante incorporarla al proceso del cuidado de enfermeria pediatrica, en las instituciones brasilenas esta tecnica no es puesta en practica. Por lo tanto, el objetivo concreto es aprender de los estudiantes de enfermeria como realizar estas practicas ludicas con ninos hospitalizados durante su formacion profesional. La metodologia utilizada en el presente estudio fue el abordaje cualitativo fenomenologico. Participaron 17 estudiantes del octavo periodo del curso de enfermeria de la Universidad Federal de Alfenas, con previa autorizacion de los mismos. Se utilizo la entrevista abierta, y la siguiente pregunta como guia: ?Como son las actividades recreativas en el trabajo cotidiano en la Unidad de Pediatria? Una mejor percepcion de los resultados se presento al organizar el material bajo las siguientes categorias: la motivacion/gratificacion, la falta de compromiso e iniciativa, y la impotencia. Por lo tanto, se concluyo que la inclusion de elementos ludicos en las practicas pediatricas se presento de forma paulatina, y que el hecho de realizar practicas ludicas implica hacer una revision de la formacion academica, convirtiendo la coyuntura ensenanza-investigacion - educacion en un vinculo fuerte y coherente, logrando asi, que los contenidos enfaticen la humanizacion e integracion de la asistencia.Ainda que a ludicoterapia tenha valor terapeutico na hospitalizacao e necessite ser incorporada no processo de cuidar em Enfermagem Pediatrica, sua utilizacao nao e efetiva nas instituicoes brasileiras. Sendo assim, objetiva-se apreender dos academicos de Enfermagem o fazer praticas ludicas com criancas hospitalizadas durante a formacao profissional. Metodologicamente, adotou-se a abordagem qualitativa fenomenologica, considerando 16 academicos do oitavo periodo do Curso de Enfermagem da Universidade Federal de Alfenas, apos Consentimento Livre e Esclarecido. Utilizou-se entrevista aberta com a questao norteadora: Como sao as atividades ludicas no cotidiano de trabalho em Unidade Pediatrica? Os resultados sao evidenciados pelas categorias motivacao/gratificacao, falta de empenho e iniciativa, e impotencia. Por conseguinte, considerou-se que a insercao do ludico em pediatria se processa gradativamente, e que o fazer praticas ludicas implica rever a formacao academica, tornando a articulacao ensino/pesquisa/extensao forte e coerente, para que os conteudos enfatizem a humanizacao e integralizacao da assistencia.

Prácticas lúdicas en el contexto del cuidado en enfermería pediátrica

Although the playfultherapy has therapeutic value in the hospitalization and need to be incorporate in the process of taking care in Pediatric Nursing, her use is not effective in the Brazilian institutions. Being like this, it is aimed to apprehend from the academics of Nursing doing playful practices with children hospitalized during the professional studies. Methodologically was adopted the approach qualitative phenomenological, with sample of 16 academics of the eighth period of the Nursing Course at the Universidade Federal de Alfenas, after Free Consent and Clarification. It was used open interviews with the subject oriented: How are the playful activities applied in the daily of work in Pediatric Unit? The results are evidenced by the categories motivation/gratification, lack of pledge and initiative, and impotence. Consequently, it was considered that the insert of the playful in pediatrics is a gradual process, and that doing playful practices implicates in reviewing the academic studies, turning the articulation strong and coherent teaching/research/extension, for the contents to emphasize the humanization and the assistance integralization.Aun cuando la ludoterapia tiene valor terapeutico en el ambito de la hospitalizacion y es importante incorporarla al proceso del cuidado de enfermeria pediatrica, en las instituciones brasilenas esta tecnica no es puesta en practica. Por lo tanto, el objetivo concreto es aprender de los estudiantes de enfermeria como realizar estas practicas ludicas con ninos hospitalizados durante su formacion profesional. La metodologia utilizada en el presente estudio fue el abordaje cualitativo fenomenologico. Participaron 17 estudiantes del octavo periodo del curso de enfermeria de la Universidad Federal de Alfenas, con previa autorizacion de los mismos. Se utilizo la entrevista abierta, y la siguiente pregunta como guia: ?Como son las actividades recreativas en el trabajo cotidiano en la Unidad de Pediatria? Una mejor percepcion de los resultados se presento al organizar el material bajo las siguientes categorias: la motivacion/gratificacion, la falta de compromiso e iniciativa, y la impotencia. Por lo tanto, se concluyo que la inclusion de elementos ludicos en las practicas pediatricas se presento de forma paulatina, y que el hecho de realizar practicas ludicas implica hacer una revision de la formacion academica, convirtiendo la coyuntura ensenanza-investigacion - educacion en un vinculo fuerte y coherente, logrando asi, que los contenidos enfaticen la humanizacion e integracion de la asistencia.Ainda que a ludicoterapia tenha valor terapeutico na hospitalizacao e necessite ser incorporada no processo de cuidar em Enfermagem Pediatrica, sua utilizacao nao e efetiva nas instituicoes brasileiras. Sendo assim, objetiva-se apreender dos academicos de Enfermagem o fazer praticas ludicas com criancas hospitalizadas durante a formacao profissional. Metodologicamente, adotou-se a abordagem qualitativa fenomenologica, considerando 16 academicos do oitavo periodo do Curso de Enfermagem da Universidade Federal de Alfenas, apos Consentimento Livre e Esclarecido. Utilizou-se entrevista aberta com a questao norteadora: Como sao as atividades ludicas no cotidiano de trabalho em Unidade Pediatrica? Os resultados sao evidenciados pelas categorias motivacao/gratificacao, falta de empenho e iniciativa, e impotencia. Por conseguinte, considerou-se que a insercao do ludico em pediatria se processa gradativamente, e que o fazer praticas ludicas implica rever a formacao academica, tornando a articulacao ensino/pesquisa/extensao forte e coerente, para que os conteudos enfatizem a humanizacao e integralizacao da assistencia.