RCAAP Repository

ABSTRACT Objective: To identify the frequency and factors associated to incontinence associated dermatitis in elderly people. Methods: Cross-sectional study with 202 elderly patients admitted to a university hospital between September 2017 and January 2018. Data collection included: cognitive screening, sociodemographic and clinical questionnaire. It was performed exploratory and descriptive analysis, where prevalence and ratios (PR) were calculated. Results: Prevalence of injury was 9.4%, age range 70-79 years (13.5%), African American (21.4%), hospitalization period ≥ 21 days (44.4%), in use of nasogastric tube (33.3%), medical device (11.3%), restricted mobility (18.5%). It was associated with hospitalization period, use of nasogastric tube, restricted mobility, medical devices, and cognition. Conclusion: It was confirmed an average frequency of incontinence associated dermatitis in elderly patients and association to factors such as hospitalization period, immobility, cognition, use of nasogastric tube and devices. It must be highlighted the importance of prevention measures, early detection, assessment and monitoring of this type of injury.

ABSTRACT Objective: To identify the level of health literacy in informal caregivers of elders with Alzheimer’s disease. Methods: Descriptive study with a quantitative and qualitative approach, with health literacy as a theoretical framework. Research carried out with 42 informal caregivers of elders with Alzheimer’s from a geriatrics outpatient clinic, using a questionnaire with sociodemographic data and the Health Literacy instrument. Results: The functional and conceptual levels were more prevalent, with regards to elders with Alzheimer’s, than the empowering level. Caregivers searched, evaluated, and used health information and expressed abilities to use and judge the information received. Final considerations: The predominance of categories in the cognitive level of learning indicates the need to strengthen the empowering level of these caregivers. Health literacy made it possible to reveal the demands of informal caregivers of elders with Alzheimer’s, evaluating their individual ability to offer this type of assistance. It is also a tool capable of reaching better health results.

ABSTRACT Objective: To reveal the Comfort needs as perceived by hospitalized elders, using Kolcaba’s theory. Methods: Descriptive and qualitative study, with 11 elders hospitalized in a university hospital, aiming to identify their needs for Comfort. Results: Discourses were categorized in four thematic units: Physical, Environmental, Sociocultural, and Psychospiritual. In the Physical context, several subcategories were found, namely, Symptom Relief; Daily Life Activities; Hygiene and personal care; Diet; Sleep and rest. In the Environmental context, the Comfort was considered to be superior than in the elders’ home; in the Sociocultural one, family bonds were found to become more distant, triggering feelings of missing one’s family and isolation, in the Psychospiritual context, spirituality and religiosity stood out. Final considerations: The Comfort needs of the hospitalized elders enable one to reflect on nursing care, offering information to improve the quality of assistance and to attend to the real needs of the elderly.

ABSTRACT Objective: To understand the nurse entrepreneur experience in long term institutions for elderly (LTIE) and to elaborate a theorical model regarding that experience process. Methods: Qualitative research with theorical saturation, through analysis of the 10th nondirective interview, audio-recorded and transcribed, according to the Grounded Theory, with nurses in activity and those who had to quit the business. Results: Three subprocesses emerged: (A) looking at the LTIE as a promising business to offer to the aging population; (B) discovering herself/himself without entrepreneur training/experience to carry on a social enterprise; (C) changing from preservation, expansion, and finally business discontinuance. The core category (process) was abstracted from the realignment of those subprocesses components: From the dream to expansion, preservation, and business abandonment: nurse training/experience for social enterprise as an intervening component. Final considerations: In light of the Business Model Canvas, it showed the experiential process little instrumented by the fundamentals of business management, to support the proposal, overview and altering business.

ABSTRACT Objective: to assess the effects of a problematization educational intervention to promote healthy habits in elderly people with diabetes. Methods: a randomized clinical trial conducted with 202 individuals drawn for the intervention group and the control group. The intervention consisted of problematization educational activities on a monthly basis for over six months. The control group participated in conventional monitoring at the health unit. Data were collected through semi-structured interviews before and after the intervention, in addition to laboratory tests. Results: after the intervention, when compared to the control group, there was an increase in knowledge about the disease (p<0.001), positive attitude towards self-care (p=0.011), physical activity (p=0.020), diet variety (p=0.002), and lower consumption of oils and fats (p<0.05). Conclusion: the intervention performed has a beneficial effect to promote healthy habits.

ABSTRACT Objective: To identify immediate transfusion reactions in elders hospitalized in a public hospital in the Federal District. Methods: This is an observational, retrospective, documental, and analytical research, with a quantitative analysis of 516 transfusions of packed red blood cells in elders hospitalized in the largest public hospital, who required blood components, from June to December 2017, through descriptive statistics. Results: The sample corresponded to 46.36% of the total number of transfusions in elders in the period. The mean age was 70 years old. There were adverse effects (reactions to the transfusion) in 12 (2.3%) transfusions. Respiratory alterations (33.3%) and fever (23.8%) were the most common events. Conclusion: The incidence of reactions to the transfusion is below national and international rates, indicating probable undernotification, which could be associated to a lack of knowledge regarding its clinical manifestations and the lack of systematic monitoring of the transfusion.

ABSTRACT Objective: Propose the concept of vulnerability of the elderly based on the Hybrid Concept Development Model. Method: Methodological study with a qualitative approach, based on the theoretical-methodological framework of the Hybrid Concept Development Model. Initially, an integrative literature review was carried out, followed by empirical collection through semi-structured interviews with 12 professionals. As a method of analysis of the interviews, the Grounded Theory was used. The final analytical phase constituted the interface between theoretical and empirical evidence. Results: When carrying out the theoretical survey, it became possible to outline the attributes, antecedents and consequences of the studied phenomenon. After analyzing the empirical data, two phenomena emerged: Unveiling the multiple changes arising from the human aging process; and Understanding the multiple dimensions of the elderly person’s vulnerability construct. Final considerations: The vulnerability of the elderly person consists of a multifaceted construct, in which individual and collective conditions interact with each other.

ABSTRACT Objective: to build and validate educational video for elderly individuals about fall risks. Methods: methodological study with video building. validated by 22 judges and assessed by 22 elderly individuals. Content was selected from the Fall Prevention Model and items from the Falls Risk Awareness Questionnaire. Items with an agreement greater than 0.80 were considered valid. verified through Content Validation Index (CVI) and binomial test. Results: building the video was guided by the Cognitive Theory of Multimedia Learning. Digital animation and audio narration were used. It lasted ten minutes and five seconds and included biological. socioeconomic. behavioral and environmental risks as well as precautions to avoid them. The CVI of judges had an average of 0.99. and of elderly individuals. an average of 1.0. Conclusion: the video was built and validated for content and understanding and can be used to prevent falls in elderly individuals.

ABSTRACT Objective: to propose a structural model of active ageing among elderly community members based on the World Health Organization’s theoretical framework and to identify the most relevant determinants of active ageing to the proposed model. Methods: a cross-sectional and analytical study conducted with 957 elderly community members. Confirmatory factor analysis and structural equation modeling were performed. Results: the final measurement model was composed of the six determinants of active ageing: behavioral (R²=0.66); personal (R²=0.74); physical environment (R²=0.70); social (R²=0.77); economic (R²=0.44); and social and health services (R²=0.95). The last one showed good quality of adjustment: χ2/gl=3.50; GFI=0.94; CFI=0.92; TLI=0.90; RMSEA=0.05. By analyzing the trajectories between determinants and active ageing, the most representative was social and health services  active ageing (λ=0.97; p<0.001). Conclusion: satisfaction with access to health services and positive self-assessment of health status were the factors that most contributed to active ageing in this population.

ABSTRACT Objective: To understand the meaning of well-being of older persons in situation of abandonment. Methods: a qualitative phenomenological study, carried out in a nursing home in Tepic, Nayarit, from 2017 to 2019. Intentional sampling with 12 older persons aged 60 and above. Data collection occurred by phenomenological interview. The ethical criteria of the General Health Law were respected. Participants signed the Informed Consent Form. Data analysis took place through phenomenological analysis. Results: four themes have emerged: 1. Living Activities of Daily Living; 2. Attention to physical needs; 3. Coexistence; 4. Spirituality experience. Conclusion: for older persons, living institutionalized implies a process of adaptation and transformation to their context and state of life, restructuring their needs that provide well-being. It is important to approach these scenarios to establish ways of experiencing aging that favor a full quality of life.

ABSTRACT Objective: to assess the conformity of nursing care concerning best evidence in transitional care from hospital to home for older people. Methods: a project to implement best evidence based on the model proposed by the Joanna Briggs Institute in surgical clinic of a university hospital with older people, caregivers or family members, and nurses, between July and August 2019. Eight evidence-based criteria have been audited through interviews, medical records and computerized system, presented in percentages. Results: the highest non-compliance rate found in a baseline audit was absence of continued training on transitional care and hospital discharge plan. Identifying barriers to best practices included educational programs; afterwards, there was an improvement in compliance rates in all the criteria assessed. Final considerations: the criteria based on audited evidence showed an increase in compliance rates with the strategies implemented, contributing to improving transitional care for older people.

ABSTRACT Objective: To analyze the socio-demographic and health conditions of the elderly living in the community and describe the pillars for the design of a rehabilitation nursing program in the community. Methods: Descriptive, cross-sectional study, with participation of 48 elderly selected by convenience sampling. Data collection took place between September 2018 and July 2019, in a health unit in northern Portugal, using a form. Results: All the elderly have pathological processes and overweight. Most of them are sedentary, have feelings of loneliness and inappropriate relational behaviors. In the last six months, 25% have fallen at least once, with notable changes in balance, lifestyles and perceived health status. Conclusion: The need for rehabilitation nurses to design and implement active aging programs that ensure individual accompaniment of the elderly by valuing lifestyles, balance training and promotion of social participation was highlighted.

ABSTRACT Objective: To analyze the relationship between the functional capacity of elderly community members and the sociodemographic and violence characteristics. Methods: Cross-sectional, epidemiological, analytical study with 159 elderly people. For data collection, a questionnaire was used for sociodemographic characterization; the Katz, Lawton and Brody scale; a questionnaire adapted from the FIBRA network; and the Conflict Tactics Scales, analyzed using descriptive and inferential statistics using Pearson’s chi-square test, Fisher’s exact test and multiple logistic regression models. Results: It was observed that the sociodemographic variables influence the prevalence of functional dependence for basic activities of daily living and reduction in advanced activities in elderly people with psychological and physical violence. Conclusion: The dependence of the elderly for basic and intermediate activities is related to characteristics such as advanced age, work exercise and knowing how to read and write. The participants’ functional dependence can favor violent outcomes, whether physical or psychological.

ABSTRACT Objectives: To describe the profile of Brazilian older adults who use the Internet, the means of Internet access and the purpose of Internet use and to verify the existence of association between socio-demographic variables and variables related to Internet use. Method: Cross-sectional study with Brazilian older adults who used the social networks Facebook and WhatsApp. Descriptive, univariate, and bivariate analysis were conducted. Results: 384 older adults participated in the study, mostly women (52.08%), with a mean age of 64.6 years old and who used the Internet to address health concerns (65.36%). The main activities on the internet were reading, listening to music, playing games, watching videos and photos (37.30%). The main benefits pointed out were interaction (74.5%), learning (19.2%) and entertainment (19.25%). There were statistically significant differences between time spent online and the variables gender, age, and civil status. Conclusion: This study showed characteristics of older adults who use the Internet and revealed the possibility of using digital technologies to optimize health care for this population.

ABSTRACT Objective: to understand the experiences and expectations of obese elderly people on the care they received in the primary health care network. Methods: phenomenological study, in which 16 obese elderly people living in a municipality in the state of Minas Gerais, Brazil, were interviewed. Their statements were organized into categories and analyzed according to Alfred Schütz’s social phenomenology and thematic literature. Results: the following categories emerged: “Care neglected to obese elderly people in the primary health care network”, “Group activities as a way to provide primary health care to obese elderly people: a present past”, and “Qualified longitudinal care, centered in the needs of obese elderly people”. Final considerations: offering comprehensive and longitudinal primary health care to obese older people was difficult, and there was instability in the consolidation of public policies, which pointed out the need for effective bonds between different healthcare network services and between professionals and users.

ABSTRACT Objective: to analyze factors associated with the use of potentially inappropriate medications by elderly people with hypertension. Method: a cross-sectional study, conducted in the first semester of 2016, with elderly people undergoing treatment for hypertension, living in the city of Maringá. Interviews, medical records analysis, and measurement of clinical and anthropometric parameters of the participants were carried out. Inferential analysis was used. Results: a total of 260 elderly people who used potentially inappropriate medications participated in the study. The high use of these medications was associated with clinical and anthropometric conditions, such as obesity (p=0.022), smoking (p=0.004), polypharmacy (p=0.034) and the health services provided, such as organizationally accessible treatment (p=0.027) and consultation time (p=0.007), predisposing to low adherence to routine consultations (p=0.003). Conclusion: it was shown that the factors associated with the use of potentially inappropriate medications were associated with anthropometric, clinical, and organizational variables, intrinsic to the family health strategy.

ABSTRACT Objective: to describe the contributions of awareness-raising workshops to the knowledge of students in health courses about care (geronto)technologies for elderly people/family. Methods: a strategic action research, developed with 12 students from the last semester of nursing, physiotherapy, dentistry and occupational therapy from a university in Rio Grande do Sul, Brazil. Data were collected from September to December 2019, through semi-structured interviews, before and after awareness-raising workshops, and submitted to content analysis. Results: the analyzed data, before the workshops, allowed constructing two categories that dealt with lack of knowledge and non-use of care (geronto)technologies. After the workshops, five categories made it possible to understand (geronto)technologies in the form of products and in the form of processes/strategies/knowledge. Conclusion: carrying out awareness-raising workshops contributed to knowledge production regarding the conceptual aspect and identification of their usefulness in the care setting.

ABSTRACT Objective: To identify the knowledge and attitudes of doctors and nurses in tracking, diagnosing, treating, and monitoring dementias and their educational needs in this area. Method: Cross-sectional study, carried out among 195 doctors and 274 nurses working in teams of the Family Health Strategy (FHS) in the city of São Paulo. The instrument used was Health Care for Dementia: the Primary Care perspective. The data were submitted for descriptive statistics. Results: Among physicians, 64.1% reported routinely diagnosing dementia, but only 23.1% in the mild phase; 89.2% mentioned difficulties in identifying cases of the disease; 94.9%, difficulties in the treatment and monitoring of patients, including the needs to support the caregiver (28.2%); 84.6% of doctors and 79.2% of nurses reported difficulties in monitoring severe cases of the disease. Conclusion: Gaps in knowledge were identified regarding the tracking and diagnosis of dementia, patient monitoring, diagnostic information, and support for the caregiver.

ABSTRACT Objective: Describe the knowledge and practices of the Primary Health Care nurse on sarcopenia screening in the elderly. Methods: Qualitative study conducted with 24 Primary Health Care nurses. The data was collected through semi-structured interviews, recorded and later transcribed. The speeches were grouped in thematic categories, later analyzed, supported by Paulo Freire’s reference. Results: The findings showed that the primary care nurses’ knowledge of sarcopenia screening in the elderly was incipient and fragile. This reality is reflected in a gap in practice, although some instruments already require the registration of characteristics indicative of sarcopenia, such as the evaluation of the calf circumference. Final Considerations: The need to train nurses to perform sarcopenia screening and to implement a promotional and preventive care plan, which will result in improving the quality of life of the elderly assisted in Primary Care, was highlighted.

ABSTRACT Objective: To understand the management of home care by family caregivers of dependent elderly people after hospital discharge. Methods: Qualitative research guided by hermeneutics-dialectic, anchored in the theory of communicative action. Data collection took place using a semi-structured interview with 11 participants. Results: Two categories were constructed: Management of the many types of care by the caregiver and the relationship between family caregiver and health care network. Care and management actions carried out routinely cause major changes in the family caregiver’s life. He/she does not recognize planning, home care periodicity or support in required procedures. Final Considerations: The management of home care for dependent elderly people after hospital discharge is complex, involving physical and emotional overloads, as well as difficulties in getting support from health services. The planning shared between the health team and the family since the discharge is required, and the better visibility of the role of primary care when the patient is assisted by a home care service.