RCAAP Repository

ABSTRACT Objective: to construct and validate an educational gerontechnology on frailty in elderly people. Method: a methodological study developed in three stages: educational video construction, validation by expert judges and elderly people. Validation was carried out by 22 judges and 22 elderly people. Educational Content Validation Instrument was used for judges and questions adapted from the Suitability Assessment of Materials questionnaire for elderly people. For validation, agreement criterion greater than 80% was considered, verified using Content Validation Index and binomial test. Results: the video addresses recommendations for elderly people at risk of frailty and health-promoting habits, using cordel literature. An agreement greater than 80% was verified in all items assessed by judges and the target audience. Conclusion: the video proved to be valid in terms of content and appearance by judges and elderly people, with the potential to mediate health-promoting educational practices in healthy aging.

ABSTRACT Objective: to know the social and health responses for the elderly in sub-Saharan Africa. Methods: An integrative literature review. Results: There is a lack of specialized health care to meet the real needs of the elderly, and the shortage of health professionals does not contribute favorably to this situation. There is a small number of facilities for the elderly and most of them are inadequate. Although there are models of care as well as social and health support policies for the elderly, there are still inequities/inequalities in access to these policies, especially for the most disadvantaged populations. Conclusion: Social and health policies for the elderly in Sub-Saharan Africa are below standard and appropriate economic, political and social intervention is required.

ABSTRACT Objective: To ascertain the characteristics of the nursing care provided to institutionalized elderly people with dementia. Methods: Integrative review of studies published between 2013 and 2017, in English, Spanish, and Portuguese, from the databases BDENF, LILACS, CINAHL, PubMed, SciELO, TRIP, and National Guideline Clearing House. Thematic data analysis was used. Results: From the data collected in the 41 included studies, three themes emerged: Care with a focus on the needs of elderly people in LTCIEs; Care based on the work process of the nursing team; and Shared care. Final considerations: Elderly care can take place from different perspectives: that of the elderly; the nursing team; and it can be shared among the different parties involved. The importance of communication must be stressed, as do the development of skills and attitudes of the team, as well as proper training and support, good environment in the care process, and an approach centered on the institutionalized elderly.

ABSTRACT Objective: To analyze the concept of “frailty syndrome” in the literature, according to the method proposed by Walker and Avant. Methods: It is a concept analysis, guided by the method proposed by Walker and Avant, made operational through an integrative literature review. The search in a scientific database was carried out using the descriptors: Frail elderly, syndrome, phenotype, geriatric assessment, and aging. The literary corpus comprised 66 studies. Results: The study found the antecedents and attributes (categorized as physical, sociodemographic, and behavioral/environmental) that integrate the signs and symptoms evidenced in the “frailty syndrome,” as well as the consequences of this concept. The variables were analyzed with emphasis on the conceptions that influence the frailty process of the elderly. Conclusion: The study demonstrated the complexity arising from the multifactorial genesis of the referred syndrome, emphasizing the specificities of the elderly’s frailty. However, we recommend conducting further research involving the phenomenon in question to understand the construct better.

ABSTRACT Objective: Analyze the state of the art about instruments, at national and international levels, for assessing the risk of suicide in elderly people with depression assisted in the community. Methods: Integrative review of 38 complete articles, published in journals indexed in the databases: US National Library of Medicine (PubMed Central), Scopus, CINAHL and Web of Science, located using controlled descriptors combined with Boolean operators: elderly OR aged OR older OR elder OR geriatric AND depression AND suicide AND risk assessment. Results: Six instruments were found, all international and published in the English language, in order to identify suicidal behavior and ideation in the elderly. Of these, two are specific scales for assessing the risk of suicide in the elderly in the community: 5-item GDS subscale and Geriatric Suicide Ideation Scale. Final considerations: With the scarcity of national instruments to assess such risk, research is recommended to cross-culturally adapt one of these scales to the Brazilian Portuguese language.

ABSTRACT Objective: Identify in literature the social determinants of health related to suicide in the elderly, according to the model proposed by Dahlgren and Whitehead. Method: Integrative review of articles indexed in the databases BDENF, CINAHL, LILACS, and MEDLINE, with the following main descriptors: aged, suicide, social determinants of health, and risk factors. Primary studies were included which addressed social determinants of health and suicide in the elderly. Results: From the 19 articles analyzed, three categories emerged: proximal social determinants of health (male gender, mental disorders, physical illnesses, white race, 70-74 years old); intermediate social determinants of health (substance abuse, use of alcohol or psychotropic drugs, marital status, marital, social, and family problems, violence, previous suicide attempt, history of admission to psychiatric service); and distal social determinants of health (schooling, economic issues, sanitation, stressful events). Conclusion: Proximal determinants have more effects on suicide. Intermediate determinants are composed mainly of changeable factors. Distal determinants showed lesser associations.

ABSTRACT Objective: To identify the needs of caregivers of dependent older people related to self-care in the transition from hospital to home. Methods: Integrative literature review that followed a predefined protocol, carried out from March to May 2019 in the platforms EBSCO, B-On, Scopus, Web of Science, and Joanna Briggs Institute. Descriptors and eligibility criteria were defined for the bibliographic sample, which was ten articles. The search was limited to articles published between 2015 and 2019 to guarantee evidence topicality. Results: The needs of caregivers related to transitional care can be grouped into five categories: needs in the transition into the role of caregiver; needs related to self-care of caregivers themselves; health needs; economic needs; and social and collective needs. Final considerations: The work developed by nurses regarding transitional care of caregivers must have two focuses: managing care provided to dependent older people and managing the needs of caregivers and the care offered to them.

ABSTRACT Objective: to reflect on the connection between self-image, self-esteem, active sexuality, and quality of life in ageing; identify which measurement instruments in Brazilian and international literature interconnectively address the connections referred to in the general objective. Method: a theoretical-reflexive essay. Results: the reflection was described in the guiding axes: Connections between self-image, self-esteem, active sexuality, and quality of life in ageing; Interlocutions and instruments for measuring the connection between sexuality and ageing. Instruments in Brazilian and international literature are unable to address this topic in an interconnected way. Limitations and disadvantages of application with elderly individuals are presented. Final considerations: carrying out qualitative research and validating quantitative instruments that show connections and interlocutions, without stigmas and reprimands, common in this age group, should be encouraged in the scientific field and in social spaces.

ABSTRACT Objectives: to analyze social inequalities in spatial distribution of fetal and infant mortality by avoidable causes and identify the areas of greater risk of occurrence. Methods: avoidable deaths of fetal and infant residents of Recife/Brazil were studied. The rates of avoidable fetal and infant mortality were calculated for two five-year periods, 2006-2010 and 2011-2015. The scan statistics was used for spatial analysis and related to the social deprivation index. Results: out of the total 2,210 fetal deaths, 80% were preventable. Avoidable fetal mortality rates increased by 8.1% in the five-year periods. Of the 2,846 infant deaths, 74% were avoidable, and the infant mortality rate reduced by 0.13%. Conclusions: in the spatial analysis, were identified clusters with higher risk for deaths. The social deprivation index showed sensibility with areas of worse living conditions.

ABSTRACT Objectives: to translate and culturally adapt the Infant Feeding Intentions Scale for pregnant women in Brazil. Methods: methodological study that included stages of translation, synthesis, face and content validation, back translation and semantic assessment. In the face and content and semantic validation stages, we used the Content Validity Index for individual items and for the overall scale for clarity and representativeness. Results: nine (100.0%) experts participated in face and content validation, and the average index obtained was 85.0% for representativeness. In the semantic assessment, performed with 31 (100.0%) pregnant women, the tool was considered clear, obtaining an average index of 91.0%. Conclusions: the Brazilian version of the scale was considered representative and clear. After assessing psychometric properties, the scale is expected to be valid and reliable to assess maternal intention to breastfeed exclusively until the infant’s six months of life in different Brazilian settings.

ABSTRACT Objectives: to investigate the presumption of sexual abuse through the records of live births with mothers up to 13 years of age. Methods: this is a quantitative study, with an ecological design, carried out in Maceió, with data from the Brazilian Live Birth Information System from 2009 to 2017, based on Law 12,015/2009, on sexual crimes against the vulnerable, applying the presumption of violence in children under 14 years old. Results: nine hundred fifty-three births of children with mothers aged 10 to 13 years were recorded; 1.3% were reported as victims of sexual abuse; 20.3% declared to be married or living in a stable relationship. Records were concentrated in 04 neighborhoods, Guaxuma, Benedito Bentes, Tabuleiro do Martins, and Jacintinho. Conclusions: there was a prevalence of pregnancy and marriage in girls under 14 years of age and scarcity of reporting presumed sexual abuse by health professionals.

ABSTRACT Objectives: to explore the influence of health care practices on the burden of caregiver mothers of children with special health needs. Methods: observational, analytical, cross-sectional, quantitative study. Participation of 100 caregiver mothers, who responded the following instruments: characterization instrument; Burden Interview for Informal Caregivers; Perceptions of Family-Centered Care - Parents version; Evaluation Instrument for Primary Care - Child Version. For statistical analysis, were used the Spearman’s Correlation and univariate and multivariate linear regression analysis. Results: the mean burden score was 47.99. There was a negative correlation between the burden and the domains of collaboration and support of the Perceptions of Family-Centered Care scale. In the multivariate linear regression model, the longitudinality variable maintained a significant relation with the burden (p = 0.023). Conclusions: a shared, longitudinal and integrated care between families and health services can ease the burden of caregiver mothers.

ABSTRACT Objectives: to analyze the adequacy of maternal and child-care in prenatal care, childbirth and the puerperal period, in the public health service. Methods: longitudinal study carried out in a city in Paraná with 357 puerperal women in a public maternity ward, outpatient clinic for immediate puerperal return and home visit 42 days postpartum. Four care domains were grouped (1 - Prenatal, 2 - Maternity, 3 - Immediate puerperal return, 4 - Late puerperal return). Mean, median, standard deviation and coefficient of variance were calculated considering adequate assistance when ≥ 70%; and inadequate, inferior. Results: lowest suitability average in Domain 3 (39.37%) and highest for Domain 4 (74.82%); median of 50.00% at 3 and 76.90% at 4. The largest standard deviation, in Domain 3 (25.18%); and high coefficient of variance for 1 and 3. Conclusions: in maternal and child follow-up, rates close to adequate in maternity care and higher in late puerperal return, meanwhile prenatal and immediate puerperal return were below the recommended in the health care network.

ABSTRACT Objectives: to unveil the experience of mothers of children who had a cerebrovascular accident due to sickle cell disease. Methods: qualitative, phenomenological research based on Martin Heidegger’s philosophical framework. Ten mothers participated in the Association of People with Sickle Cell Disease of Minas Gerais. For the interpretative analysis of the reports, we performed the vague and medium understanding followed by hermeneutics. Results: the study revealed that, for the mother, the experience means remembering the diagnosis of the disease that had a significant impact. These women are in the center of care, and the consequences of stroke cause suffering. In this wandering, they seek to educate their children as close as possible to normal. Final Considerations: the study pointed out that we should look at these mothers seeking to see the multiple facets of their existence to the challenge of caring for the existential complexity of the human being.

ABSTRACT Objectives: to assess the sexual function of pregnant women and the influence of sociodemographic, obstetric, and behavioral factors on sexual dysfunction. Methods: cross-sectional study conducted with 141 pregnant women attended by the Single Health System and 120 by one private service, totaling 261 participants. A questionnaire containing sociodemographic, obstetric, and behavioral variables was applied, as well as the Female Sexual Function Index instrument, which was used to assess sexual function. Associations between variables and sexual dysfunction were made using the chi-square test, considering a statistically significant result when p < 0.05. Results: among the participants, 32.1% had sexual dysfunction, and the variables “age”, “income” and “type of health service” had an influence on sexual dysfunction. The prevalence of pregnant women was between 21 and 30 years old (p < 0.001), with an income between 1 and 2 minimum wages (p = 0.048) and used the public health system network (p = 0.000). Conclusions: the factors associated with sexual dysfunction are “young pregnant women”, “low income” and “attended in the public health service”.

ABSTRACT Objectives: to analyze the relationship between maternal age and the source of healthcare payment with mode of delivery in public and private national hospitals between the years 2012 to 2017, and the length of hospital stay. Methods: cross-sectional study of 91,894 women who had children in public and private hospitals between 2012 and 2017. Data were collected from the Diagnosis-Related Groups Brazil system and a comparative analysis was performed between patients in public care and those in supplementary healthcare. Results: in public care, the majority were vaginal deliveries and the reverse occurred in supplementary health. The proportion of cesarean sections was higher in the age group 31 to 40 years old in both services. The hospital stay was longer among women who underwent a cesarean section. Conclusions: high maternal age and the source of healthcare payment influence the mode of delivery, which interfere with the length of hospital stay.

ABSTRACT Objectives: to analyze how children with type 1 diabetes mellitus and their families explain the pathology, based on their understanding of the factors related to the discovery of diabetes, the etiology, treatment, and prognosis of the disease. Methods: qualitative methodological approach, based on medical anthropology and the narrative method. In-depth interviews were conducted with 12 families of children with type 1 diabetes mellitus attending follow-up consultations at a specialized center. The statements were subjected to inductive thematic analysis. Results: the explanatory models identified describe the families search for the clarification of the signs and symptoms that the child had. Faced with the disease, families reorganized themselves to meet new health care needs of children, such as adequate nutrition, physical exercise, and blood glucose monitoring. Final Considerations: knowing the explanatory models allows the understanding of how families give meaning to the child’s illness, favoring daily nursing care and an effective control of the disease.

ABSTRACT Objectives: to identify the female homicide profile in the city of Goiânia. Methods: a cross-sectional, descriptive study that characterized female deaths by homicide from 2008 to 2015. They occurred in Goiânia, and registered in the Mortality Information System. Cases of homicide of women aged ≥ 10 years were eligible. Other causes of death were excluded. Descriptive statistical analysis with frequencies. Results: three hundred seventy-six women died from assault, with an increase in the percentage of deaths annually. Most of the victims were young (57.5%), single (78.8%), mixed-ethnicity (61.1%) and with low education (58.4%). The most frequent means of assault was firearm (64.0%). The health districts with the highest record of female deaths due to assault were southwest, center and northwest. Conclusions: the predominant profile of women victims of femicide was young, mixed-ethnicity, single, with low level of education and living in less favored regions.

ABSTRACT Objectives: to investigate the factors associated with the mode of delivery in pregnant women in the city of Belo Horizonte. Methods: cross-sectional study developed with data from the study “Being born in Belo Horizonte: survey on childbirth and birth” carried out in seven maternity hospitals in Belo Horizonte - Minas Gerais. The final sample consisted of 1088 pregnant/postpartum women. In this study, to verify the magnitude of the association between the outcome variable and its possible determinants (exposure variables) logistic regression models were constructed to estimate the Odds Ratio. Results: increasing age, the lack of companionship, the hospital’s private financing for performing delivery and being a first-time pregnant woman increased the chance of delivery by cesarean section. Final Considerations: the knowledge of factors associated with the prevalence of cesarean sections can support reflections among health professionals about this surgical procedure in certain situations, especially when there are no precise clinical indications.

ABSTRACT Objectives: to evaluate and compare the prevalence of cardiometabolic risk factors among high school adolescents with or without jobs, and to establish an association between risk factors and changes in lifestyle after starting to work. Methods: quantitative cross-sectional study. An instrument was applied to assess socio-demographic characteristics and habits. Dietary pattern was assessed by the Brazilian Healthy Eating Index. Nutritional status was assessed by the Z-score. Data were submitted to statistical analysis and comparison between groups and periods, as well as association and correlation was done. Results: the prevalence of high blood pressure was 7.7%. High BP affected 4.5% of non-workers and 10.9% of workers. Dietary patterns were inappropriate and 51.2% did not engage in physical activity. The prevalence of obesity was 28.3%. The results showed an association between work and alcohol consumption, lack of physical activity and reduced sleep quality. Conclusions: work increased exposure to certain cardiometabolic risk factors.