RCAAP Repository

ABSTRACT Objective: to understand the vulnerabilities of older adults with physical disabilities regarding their body, physical and social environments. Method: this was a qualitative study based on Alfred Schütz’ social phenomenology, with 15 older adults with physical disability from Cuiabá, state of Mato Grosso, Brazil. Open-ended questionnaires were administered to the participants in 2017. The units of meaning that emerged were organized into thematic categories. Results: physical decline, associated with the permanence of environmental and social barriers intensified the vulnerabilities of older adults. Gaps in health services are mitigated by informal social support networks and access to work was a form of social inclusion. Final considerations: vulnerabilities in the old age of persons with physical disabilities did not reside only in the body dimension, but also the physical and social environment, countering healthcare models based on the logic of reverting their dysfunctional body.

ABSTRACT Objective: To evaluate the relationship between functional capacity and life expectancy of quilombola elders. Method: A quantitative, descriptive, cross-sectional study involving fifty-nine older adults from the quilombola community of Curiaú, Macapá-Amapá. A sociodemographic form was used to characterize the sample, and Lawton’s and Herth’s Hope Scales were used to measuring functional capacity and life expectancy, respectively. In the relationship study, the Spearman correlation test was applied. Results: Elderly males aged 60-69 years (52.5%) and married (35.6%) prevailed. Functional capacity had a mean score of 22.4 (± 4.6) and a life expectancy of 41.5 (± 5.1), the correlation between the scale scores was positive and significant (R = 0.475; p <0.001). Conclusion: From the results concluded, when related levels of independence and life expectancy among themselves were significantly associated with being functionally independent elderly and having a better life expectancy.

ABSTRACT Objective: To determine the prevalence and risk factors for incontinence-associated dermatitis in the elderly. Method: Cross-sectional exploratory study carried out in public hospitals. The dermatitis prevalence and associations were obtained by calculating the ratio. The effect dimension was estimated by the odds ratio with a 95% confidence interval and statistical significance p <0.05. Results: 138 elderly people were included, with an average age of 77.2 years old (± 9.3); 69 (50%) had combined fecal and urinary incontinence. The dermatitis prevalence was 36.2% (50); 28% (14) had pressure injuries; 14% (7), candidiasis. Risk factors were: longer hospital stay (Odds Ratio = 5.8 [2.6-12.9]), obesity (Odds Ratio = 3.6 [1.2-10.4]), high level of dependence (Odds Ratio = 2.4 [1,1-5,0]) and high risk for pressure injury (Odds Ratio = 6.1 [1,4-26,9]). Conclusion: The study found a high prevalence of dermatitis associated with incontinence. The early recognition of risk factors favors effective preventive actions.

ABSTRACT Objective: to understand the meanings attributed by nurses about conditions that interfere in defending of the elderly’s autonomy on the terminality of life in the context of hospitalization. Method: qualitative and exploratory study, which applied the Grounded Theory. Data were collected between November 2016 and May 2017, in the internal medicine wards of a hospital in Rio de Janeiro, Brazil, through non-participant observation and semi-structured interviews. Three sample groups composed of ten nurses, eight doctors, and 15 nursing technicians were investigated. Results: the conditions are related to the medical power, subordination of nurses, family influences; the functional decline of the elderly; and biomedical model. Final considerations: the elderly’s autonomy is veiled and violated since their abilities are subjugated, and the family’s will and professional paternalism may prevail. However, this right must guide contemporary care models and integrate palliative care.

ABSTRACT Objective: To describe the contribution of an awareness-raising workshop for nursing students on Alzheimer’s disease in the context of the elderly/family. Methods: Strategic action-research developed with 15 university students from the sixth to the eighth semester of Nursing at a university institution in the Rio Grande do Sul. The data collected through semi-structured interviews, before and after an awareness-raising workshop on Alzheimer’s disease in elderly/family, were subjected to thematic content analysis. Results: Six categories were identified that concern (Mis) perception of Alzheimer’s disease in the context of elderly/ family, from the characterization; risk factors; diagnosis; treatment of Alzheimer’s disease; from care to family members/caregivers; and care strategies for the elderly with Alzheimer’s disease. Conclusion: The awareness-raising workshop enabled the students to broaden and deepen the knowledge on the theme of Alzheimer’s disease in the elderly.

ABSTRACT Objective: To evaluate the predictive dimensions of clinical-functional conditions and the cognitive capacity of elderly people living at home. Method: Cross-sectional, population-based, analytical, quantitative study was utilized. For data collection, an instrument with sociodemographic and behavioral variables, the Functional Clinical Vulnerability Index; and, to assess cognition, the Mini-Mental State Examination (MMSE) was used. Descriptive analyzes and statistical tests were conducted. Results: 305 elderly subjects, living at home, in urban and rural areas participated in the study. They were classified as robust (71.8%), pre-frail (22%) and frail (6.2%). As for cognition, 24.9% of them had cognitive impairment. It was shown that cognitive impairment predicts the development of functional disability. Conclusion: It is considered that health professionals should both act in order to maintain the functional and cognitive conditions of the robust and pre-frail elderly people and pay attention to the rehabilitation of the disabilities installed in those elderly people who are in a situation of frailty.

ABSTRACT Objective: to understand faith and spirituality in the meaning of life of the elderly with Chronic Kidney Disease. Methods: a qualitative research based on Viktor Emil Frankl’s Logotherapy and Existential Analysis. Twenty elderly people were interviewed between August 2018 and January 2019, between 60 and 79 years old, who underwent dialysis in a private unit, a reference in nephrology in the city of Salvador, Bahia, Brazil. Results: two categories of analysis emerged: Meaning of faith in the lived of the elderly with Chronic Kidney Disease; Faith as a forerunner of the meaning of life. Final considerations: faith and spirituality were understood as a fundamental foundation in the search for the meaning of the study participants’ lives, besides unveiling itself as an important strategy of resilience to the experienced of the elderly person with Chronic Kidney Disease.

ABSTRACT Objective: to analyze social representations of individuals over 50 years old living with the Human Immunodeficiency Virus. Methods: qualitative study, interviewing 13 individuals living with HIV, attending by a care assistance facility specialized in infectious diseases. Semi-structured interviews were used to collect data, which later were analyzed by dialectical hermeneutics, by applying the Social Representations Theory. Results: after significant reports a few empirical categories emerged: the moment when the diagnosis was disclosed and their feelings afterwards, social representation on aging with Human Immunodeficiency Virus and redefining life. Final considerations: the study proved the reality of discrimination against aging people infected with HIV in social interactions as a whole, which requires changes in society’s perceptions of this subject, the HIV-positive people themselves and the health system, making possible the emancipation of the individual living with HIV while aging and having quality of life.

ABSTRACT Objective: to estimate the mechanical restraint prevalence in Nursing Homes in Brazil and the factors associated with its performance. Methods: this cross-sectional study was carried out in 14 institutions, with a final sample of 443 elderly people. Mechanical restraint was considered as a dependent variable. Results: there was a 7.45% prevalence of mechanical restraint considering bed rails and 3.84% without considering bed rails. Main justification for restraint use was risk of falls (66.7%), and restraint duration was 24 hours (84.8%). The factors associated with the dependent variable were: wandering (p=0.000); MMSE, with cognitive loss (p=0.000); Katz Index, with dependence for Activities of Daily Living (p=0.000); and Alzheimer’s comorbidity (p=0.001) Conclusion: prevalence was lower than international studies, but there was an association with worsening of wandering, dependence, cognitive worsening, and Alzheimer’s Disease, showing the need for alternative interventions to mechanical restraint.

ABSTRACT Objective: To identify factors associated with leisure activities of elderly residents in rural areas. Method: Quantitative cross-sectional study carried out with 258 elderly living in the rural area of Paraná. The collection instrument addressed sociodemographic, economic, and self-reported leisure activities. The association between variables and leisure activities was verified by means of bivariate and multivariate analysis. Results: Among the elderly interviewed, 63.9% were female, and 36.1% were male, with an average of 68.3 years old (± 5.8 years). Participation in leisure activities was high (79.8%), and the factors associated with their practice were: marital status, gender, and education. Conclusion: Considering that the practice of leisure activities promotes better living and health conditions, we reinforce the need to implement actions and instruments that provide individual and collective leisure in rural areas.

ABSTRACT Objective: To develop and apply educational gerontotechnology through the articulation of playfulness, aimed at promoting the health of the elderly undergoing haemodialysis. Method: Convergent Care Research, following phases: conception, research structure (problem, objective and literature review); instrumentation, involving decisions about delimitation/detailing of the location (haemodialysis clinic), participants (ten elderly patients on haemodialysis), data collection instruments (semi-structured interview, participant observation and documentary/medical analysis); screening, rigorous investigation of haemodialysis treatment and analysis, guided by apprehension, synthesis, theorization and transfer. Results: Health needs of emerging elderly: Complications and worsening of chronic kidney disease; Self-care; Empowerment; Deficit of activities; Health promotion and Nursing care; and Importance of the family. Gerontotechnology developed: Game of Attitudes; its application aroused feelings - overcoming, occupation and knowledge. Final considerations: Game of attitudes makes it possible to remodel the care of the elderly undergoing haemodialysis; it is a tool that enriches the practice, allows innovation, aiding in the success of the treatment.

ABSTRACT Objective: To analyze the repercussions on the life of the elderly after joining a coexistence center and the existing challenges from the perspective of the participants and their families. Methods: Qualitative research conducted with 16 elderly from a coexistence center and 14 family members. Data were collected through individual interviews and subjected to content analysis. Results: Two thematic categories were identified: “Before and after: changes in the life of the elderly after joining the coexistence center” and “Aspects needed to improve care in the coexistence center”. Final Considerations: The benefits of older people’s participation in the service are evidenced by changes in lifestyle and interrelationships. However, there is a need to expand assistance in these institutions, with a multidisciplinary team trained in gerontogeriatric care, as well as to consider the importance of nursing as a science of care and insert it in this service.

ABSTRACT Objective: To identify, among elderly people victims of violence, factors associated with depressive symptoms and cognitive function. Method: This was a cross-sectional study carried out with 56 elderly people classified in situation of violence. To do so it was used the Brazil Old Age Shedule (BOAS), the Conflict Tactics Scales Form R, the Geriatric Depression Scale (GDS) and the Mini-mental State examination (MMSE). Results: Depressive symptoms were more predominant in elderly men, over 70 years old, without partner, illiterate, with no job, receiving up to 1 minimum wage and who lived alone; and the cognitive deficit prevailed in women, over 70 years old, without partner, illiterate, who did not work, receiving up to 1 minimum wage and who lived alone. Conclusion: Among the elderly population victim of violence, lack of a partner and cognitive impairment were associated to depressive symptoms; and finding themselves living alone, with no partner and being illiterate were associated to cognitive deficit.

ABSTRACT Objective: Describe the construct validation process of the instrument “Nursing care for the assessment, prevention and treatment of cutaneous xerosis in the elderly”. Method: Methodological study carried out with 101 nurses in four hospitals in the great João Pessoa, between July and September 2018. Construct validation was performed through exploratory and confirmatory factor analysis, in addition to the consistency check by Cronbach’s alpha. Results: Through the factorial analysis, three factors of the instrument construct were defined: treatment performed for cutaneous xerosis, preventive care for cutaneous xerosis and skin evaluation, with a total explanation variance of 47.77%. In Bartlett’s sphericity test, p <0.001 was obtained, and the general Cronbach’s alpha was 0.811. Conclusion: The instrument proved to be valid and reliable, contributing to the training and practice of nurses as an integral part in the process of caring for the elderly.

ABSTRACT Objective: To assess Functional Health Literacy and the associated sociodemographic, health, information sources and health media factors in older adults with hypertension assisted at the Family Health Strategy. Methods: A quantitative cross-sectional study with an exploratory-descriptive approach, carried out with a total of 264 older adults. A sociodemographic and health characterization instrument was used for the data collection, and another one that evaluated the Functional Health Literacy. For the analysis, a descriptive and inferential statistics were performed. Results: Most of the participants in the study had inadequate literacy (59.5% - 157), and the variables education, income, hospital stay and internet as a source of information are related to the averages of Functional Health Literacy. Conclusion: Knowing the Functional Health Literacy of older adults with hypertension and its associated factors can provide subsidies for the planning of health education strategies that, in fact, meet their health needs.

ABSTRACT Objective: to analyze the relationship between frailty, depressive symptoms, and quality of life of elderly caregivers of other elderly living in high social vulnerability. Methods: a descriptive, correlational and cross-sectional study conducted with 40 elderly caregivers. A questionnaire to characterize elderly caregivers, the Fried frailty phenotype, the Geriatric Depression Scale (to screen depressive symptoms) and the Short-Form 6 Dimension (to assess quality of life) were used. For data analysis, Student’s t-test, ANOVA, Pearson’s χ2 and Fisher’s exact test were used. Results: most were pre-frail (52.5%) and had no evidence of depressive symptoms (57.5%). They presented, on average, a score of 0.76 (±0.1) in relation to quality of life. Statistical significance was observed between the average scores of quality of life with depressive symptoms (p=0.012) and frailty level (p=0.004). Conclusion: frail elderly caregivers with depressive symptoms had a worse perception of quality of life.

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.