RCAAP Repository

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.

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.