Disfunção familiar em nonagenários e centenários: importância das condições de saúde e suporte social / Family dysfunction in nonagenarians and centenarians: the importance of health conditions and social support

Resumo O presente estudo tem como objetivo avaliar os fatores relacionados à disfunção familiar (DF) entre 227 nonagenários e centenários identificados e avaliados no domicílio, aleatoriamente selecionados, em Porto Alegre, Rio Grande do Sul. A DF foi avaliada pelo instrumento "APGAR da família", sendo considerado, no presente estudo, de zero a seis com DF e de sete a dez sem DF. Foram avaliados, entre abril e novembro de 2016, dados sociodemográficos, econômicos, funcionalidade física, autopercepção de saúde, comorbidades, sintomas depressivos, função cognitiva, suporte e interação social. A média do APGAR foi de 9,05±1,81, a DF ocorreu em 9,69% dos participantes. Foram relacionados à DF a autopercepção de saúde (p=0,0003), número de sintomas depressivos (p<0,0001), ter ajuda em caso de doença (p=0,0090) e necessidade de ajuda para administrar medicamentos (p=0,0602). Na análise ajustada, foram independentemente associados à DF em nonagenários e centenários a autopercepção de saúde, a presença de sintomas depressivos e a necessidade de ajuda para administrar medicamentos. Conclui-se que esses fatores parecem interferir na satisfação do nonagenário ou centenário com suas relações familiares.

Abstract The scope of this study is to evaluate factors related to family dysfunction (FD) among 227 randomly selected nonagenarians and centenarians in Porto Alegre, State of Rio Grande do Sul, who were visited and assessed in their homes. FD was evaluated by the "Family APGAR score," being considered with FD from 0 to 6, and without FD from 7 to 10 in this study. Sociodemographic and economic data, physical functionality, health self-perception, comorbidities, depressive symptoms, cognitive function, social support and interaction were evaluated. The mean APGAR score was 9.05±1.81, and FD occurred in 9.69% of the participants. Among the health conditions, the self-perception of health (p=0.0003), the number of depressive symptoms (p<0.0001), receiving visits (p=0.0994), having recourse to help in case of illness (p=0.0090), and the need for help to administer medication (p=0.0602), were significantly related to FD. In the adjusted analysis, self-perception of health, the presence of depressive symptoms and the need for help in administering medication were associated with FD among nonagenarians and centenarians. These factors may influence the satisfaction of nonagenarians and centenarians with their family relationships.

Representações sociais da qualidade de vida de pessoas vivendo com HIV: consensos e dissensos em municípios de médio e grande porte do Estado do Rio de Janeiro / Social representations of the quality of life of people living with HIV: consensus and differences in medium and large cities in the state of Rio de Janeiro

Este estudo objetivou analisar as semelhanças e diferenças das representações sociais da qualidade de vida de pessoas vivendo com HIV, observadas em municípios de médio e grande porte do Estado do Rio de Janeiro. Trata-se de um estudo descritivo, transversal, com abordagem qualitativa, apoiado na Teoria de Representações Sociais, a partir da abordagem processual. Participaram do estudo 68 pessoas vivendo com HIV, sendo 34 de munícipio de grande porte (Rio de Janeiro) e 34 dos munícipios de médio porte (17 de Macaé e 17 de Rio das Ostras). A coleta de dados foi realizada com um questionário de caracterização socioeconômica e clínica dos participantes e um roteiro de entrevista semiestruturada. Os dados foram analisados pelos softwares SPSS e Iramuteq de análise lexical. Na análise do grupo geral foi identificada a multidimensionalidade da qualidade de vida, com conteúdos representacionais relacionados ao processo saúde-doença e construções simbólicas referentes às memórias construídas em torno do HIV. Os consensos observados nos dois grupos de médio e grande porte referem-se a importância do programa nacional de combate ao HIV/Aids e a atuação da equipe multiprofissional, às relações familiares e sociais e a permanência do preconceito e do estigma voltados as pessoas vivendo com HIV. A especificidade dos municípios de médio porte refere-se aos conhecimentos acerca da doença, ao processo de adaptação do uso da TARV, às práticas sexuais e aos sentimentos relacionados ao apoio social e familiar. A qualidade de vida para esse grupo é concebida como expressão horizontal, perpassando os campos do convívio cotidiano. A especificidade do município de grande porte é observada nos elementos constitutivos da qualidade de vida afeitos aos hábitos de vida saudável, atividade física, trabalho, família e a normalização da vida cotidiana. Conclui-se que foram observadas diferenças nos conteúdos das representações sociais da qualidade de vida nos dois grupos analisados, remetendo a construções culturais e sócio históricas típicas dos modos de vida e das relações interpessoais. Esse achado aponta para a adoção de estilos de vida voltados a busca de uma melhor qualidade de vida no município de grande porte, e a manutenção de valores conservadores no que se refere aos modos de viver nos municípios de médio porte. Estes resultados poderão possibilitar aos profissionais de saúde e aos enfermeiros a compreensão dos sentidos atribuídos à qualidade de vida e suas implicações para as práticas de cuidados de saúde.

This study aims to analyze the similarities and differences in the social representations of the quality of life of people living with HIV, observed in medium and large cities in the State of Rio de Janeiro. This is a descriptive, cross-sectional study with a qualitative approach, supported by the Theory of Social Representations, based on the procedural approach. A total of 68 people living with HIV participated in the study, 34 from large cities (Rio de Janeiro) and 34 from medium-sized cities (17 from Macaé and 17 from Rio das Ostras). Data collection was carried out with a questionnaire of socioeconomic and clinical characterization of the participants and a semi-structured interview. Data analysis was performed using the SPSS and Iramuteq lexical analysis software. In the analysis of the general group, the multidimensionality of quality of life was identified, with representational content related to the health-disease process and symbolic constructions referring to the memories built around HIV. The consensus observed in the two medium and large groups refers to the importance of the national program to combat HIV/Aids and the performance of the multi-professional team, to family and social relationships and the permanence of prejudice and stigma towards people living with HIV. The specificity of medium-sized municipalities refers to knowledge about the disease, the process of adapting the use of antiretroviral, sexual practices and feelings related to social and family support. The quality of life for this group is conceived as a horizontal expression, permeating the fields of daily living. The specificity of the large municipality are observed in the constituent elements of quality of life, related to healthy living habits, physical activity, work, family and the normalization of daily life. It is concluded that differences in the contents of the social representations of quality of life were observed in the two groups analyzed, referring to cultural and socio-historical constructions typical of the ways of life and interpersonal relationships. This finding points to the adoption of lifestyles aimed at the search for a better quality of life in the large municipality, and the maintenance of conservative values regarding the ways of living in medium-sized municipalities. These results may enable health professionals and nurses to understand the meanings attributed to quality of life and its implications for health care practices.

Calidad de Vida Relacionada con Salud Oral y Autopercepción de Salud: Encuesta Nacional de Calidad de Vida y Salud 2015-2016 en Chile / Quality of Life Related to Oral Health and Self-Perception of Health: National Survey of Quality of Life and Health 2015-2016 in Chile

RESUMEN: La calidad de vida relacionada con salud oral permite evaluar como los problemas bucodentales pueden ser determinantes el estado de su salud, relaciones sociales, trabajo y bienestar. El objetivo del estudio es determinar la asociación entre la percepción de calidad de vida relacionada a salud oral y la autopercepción de la salud. Estudio transversal de datos de la Encuesta Nacional de Calidad de Vida y Salud (ENCAVI 2015-2016) del Ministerio de Salud, de personas mayores de 15 años de las 15 regiones de Chile. La calidad de vida relacionada con salud oral se midió a través de la versión abreviada del instrumento Oral Health Impact Profile (OHIP-7). La autopercepción de salud se midió con una pregunta única. Se ajustaron modelos de regresión logística para identificar la asociación en términos de Odds Ratio utilizando STATA v15.0. De 7041 encuestas el 50,8 % son mujeres, la media de edad fue de 42,3 años (d.t. 0,41), el 60,3 % tiene menos de 12 años de educación, el 36 % declara tener alguna enfermedad crónica. El 18,5 % percibe que sus problemas de salud oral impactan en su calidad de vida. Los factores que se asociaron significativamente con una mala percepción de calidad de vida relacionada con salud oral fueron mala autopercepción de salud general OR=4,84 (IC95 % 3,51; 6,67), edad (45-54 años) OR=1,98 (IC95 % 1,26;3,12) y uso frecuente de medicamentos (>3) OR=3,67 (IC95 % 2,17;6,). La calidad de vida relacionada con salud oral está asociada con la autopercepción en salud, es decir que una mala autopercepción de salud tiene probablemente más riesgo de tener una peor calidad de vida asociada a salud oral, siendo más fuerte a medida que avanza la edad y con el uso frecuente de medicamentos.

ABSTRACT: Quality of life related to oral health assessment oral problems affect an individual´s health, social relations, work and well-being. The objective of the study is to determine the association between the perception of the quality of life related with oral health and self-perception of health. A cross-sectional study of data from the National Survey of Quality of Life and Health (2015-2016) of the Ministry of Health was carried out, for people older than 15 years of age, reported from the 15 regions of Chile. Impact profile in oral health (OHIP-7) used to measure Quality of life related to oral health. The self-perception of health was measured with one question. Logistic regression models were adjusted to identify the association in terms of Odds Ratio using STATA v15.0. Out of 7041 surveys, 50.8 % were women, the average age was 42.3 years (d.s., 0.41), 60.3 % had less than 12 years of education, 36 % reported having a chronic disease. 18.5 % perceive that their oral health problems impact on their quality of life. Factors that are associated with poor perception of the quality of life related to oral health, were a poor self-perception of health OR = 4.84 (95 % CI 3.51, 6.67), age (45-54) years) OR = 1.98 (95 % CI 1.26, 3.12) and frequent use of medications (> 3) OR = 3.67 (95 % CI 2.17, 6,). In conclusion, quality of life related to oral health, is directly related to poor selfperception of health and becomes significantly worse with age, as well as with the frequent use of medications.

Percepción de personas de orientación homosexual respecto del enfoque hacia la diversidad sexual utilizado en Atención Primaria de Salud Valdivia, Chile / Homosexual individuals' perception of primary health care services' approach to sexual diversity in Valdivia, Chile

INTRODUCCIÓN: La población diversa sexualmente ha sido poco considerada en su especificidad por el sistema de salud, el que omite sus requerimientos y demandas particulares. OBJETIVO: Describir las percepciones de usuarios/as homosexuales respecto a la atención brindada en el nivel primario de salud en la ciudad de Valdivia, en el sur de Chile, en su enfoque hacia la diversidad sexual. MÉTODO: Se realizó un estudio cualitativo, descriptivo. La información se recolectó mediante entrevista semiestructurada, y procesada utilizando análisis de contenido. RESULTADOS: Los temas específicos que afectan y preocupan a esta población son la prevención de infecciones de trasmisión sexual y salud mental. A su vez, existe preocupación por la salud de mujeres lesbianas, asociado a la pesquisa tardía de cáncer cervino uterino y mamas debido a la inasistencia a controles ginecológicos y las dificultades de ejercer su derecho reproductivo. Emerge, por último, la preocupación por la calidad de vida de los adultos mayores pertenecientes a la diversidad sexual. DISCUSIÓN Y CONCLUSIONES: Hay preocupación por algunos temas específicos de salud que coinciden con la literatura. Se perfila claramente la necesidad de generar cambios en nuestro sistema público de salud, los cuales han de abordar su complejidad cultural e institucional a través de acciones que trasciende la mera capacitación del personal de salud. Estos cambios deben originarse desde las autoridades gubernamentales, adecuando transversalmente el modelo de salud familiar e implementando programas específicos de salud que aborden la diversidad sexual.

INTRODUCTION: Sexually diverse individuals have been given little consideration in the health system, which does not address their particular needs and demands. OBJECTIVE: To describe the perceptions of homosexual users with regard to the care provided by primary health services in the city of Valdivia, in southern Chile, and their approach to sexual diversity. METHODS: qualitative, descriptive study. The information collected was through a semi-structured interview, and processed using content analysis. RESULTS: The specific issues that affect and concern this population are the prevention of sexually transmitted infections and mental health. In turn, there is concern for the health of lesbian women, in terms of the late detection of cervical and breast cancer, due to their irregular attendance to gynecological appointments, and the difficulties they face in exercising their reproductive rights. Finally, the concern for the quality of life of older adults belonging to sexual diversity emerges. DISCUSSION AND CONCLUSIONS: There is expressed concern for specific health issues that coincide with the literature. There is a clear need to generate changes in our public health system, which must address its cultural and institutional complexity through actions that go beyond the mere training of health personnel. These changes must be spearheaded by governmental authorities, who should transversally adapt these to the family health model and implement specific health programs that address sexual diversity.

The work and the health of elderly butchers: case reports from a municipal market / O trabalho e a saúde de açougueiros idosos: relato de casos em um mercado municipal

Abstract The present study aimed to verify the health and work conditions of seven elderly workers carrying out informal labor activities in a municipal market and to describe the accidents they suffered at work. A qualitative case study was carried out with seven elderly butcher workers from a municipal market in Bahia, Brazil. The participants were men and women with limited schooling (up to high school level in one case), who lived with others at home and had worked for an average of 31 years in the butcher business. Despite the stress involved, such as uncomfortable physical positioning and few days off, all the participants said they were satisfied with their jobs. They were affected by chronic diseases, especially arterial hypertension, and said they were aware of the risks involved in their work. They had suffered accidents at work from finger cuts to amputation. Such workers require activities that promote health and protection from work-related accidents and injuries to avoid the problems that transform the process of senescence into senility.

Resumo Este estudo teve por objetivo verificar as condições de saúde e laborais e descrever os acidentes de trabalho sofridos por sete trabalhadores idosos que desenvolvem atividades informais em um mercado municipal da Bahia, Brasil. Foi realizada uma pesquisa qualitativa, do tipo estudo de casos, junto a sete trabalhadores idosos que desenvolvem atividades laborais em açougues de um mercado municipal da Bahia. Os participantes foram homens e mulheres com poucos anos de estudo (até o ensino médio em um caso), coabitam com outras pessoas em domicílio, e estão, em média, a 31 anos no ramo de açougue. Apesar do estresse referido, de posições incômodas, de poucas folgas, todos concordaram que estão satisfeitos com o trabalho. São acometidos por doenças crônicas, especialmente hipertensão arterial. Referem conhecer os riscos presentes no processo de trabalho. Sofreram acidentes laborais, desde corte em dedos até amputações. Os trabalhadores necessitam de atividades de promoção à saúde e de proteção a eventos e agravos voltados ao processo de trabalho, com vistas a não ocorrência de problemas que transformem o processo de senescência em senilidade.

Multimorbidity associated with polypharmacy and negative self-perception of health / Multimorbidade associado à polifarmácia e autopercepção negativa de saúde

Abstract Objective: to verify the association between the multimorbidity of the elderly and sociodemographic variables, self-perception of health and polypharmacy. Method: a cross-sectional study was performed. The research data was collected using the Health, Well-Being and Aging questionnaire. The sample was composed of 676 people aged 60 years or more, who were residents of small towns in the north of the state of Rio Grande do Sul, Brazil. The dependent variable was multimorbidity, that is, the occurrence of two or more chronic non-communicable diseases in the same person. The independent variables were demographic, socioeconomic and health-related characteristics. Poisson's raw and robust regression model was used to analyze the effect of the independent variables in relation to the outcome and p was considered significant when <0.05. Result: among the elderly interviewed, 45% presented multimorbidity, 51.1% reported a self-perception of poor/very poor health and 37.1% used polypharmacy. After the analysis was adjusted to the occurrence of multimorbidity, association with the following variables was found: health perception (regular/poor/very poor) PR=1.15 (CI95%; 1.09 - 1.22) and use of polypharmacy PR=1.29 (CI95%; 1.22 - 1.35). Conclusion: Multimorbidity may interfere negatively in the self-perception of health of the elderly contributing to increased medicine consumption. AU

Resumo Objetivo: verificar a associação entre multimorbidade em idosos e variáveis sociodemográficas, autopercepção de saúde e polifarmácia. Método: Estudo de corte transversal, para a coleta de dados utilizou-se o questionário Saúde, Bem-estar e Envelhecimento. A amostra foi constituída de 676 indivíduos com 60 anos de idade ou mais residentes em municípios de pequeno porte do norte do estado do Rio Grande do Sul, Brasil. A variável dependente foi a multimorbidade, isto é, a ocorrência de duas ou mais doenças crônicas não transmissíveis no mesmo indivíduo. As variáveis independentes foram as características demográficas, socioeconômicas e relativas à saúde. O modelo de regressão de Poisson bruta e ajustada foi utilizado para analisar o efeito das variáveis independentes em relação ao desfecho e p foi considerado significativo quando <0,05. Resultados: Dos idosos entrevistados, 45% apresentam multimorbidade, 51,1% relatam autopercepção de saúde ruim/muito ruim e 37,1% faz uso de polifarmácia. Após análise ajustada à ocorrência de multimorbidade, apresentou-se associação às variáveis: percepção de saúde negativa. RP=1,15; (IC95%; 1,09 - 1,22) e uso de polifarmácia RP=1,29; (IC95%; 1,22 - 1,35). Conclusão: A multimorbidade pode interferir negativamente na autopercepção de saúde dos idosos contribuindo para o aumento do consumo de medicamentos. AU

Perception of Weight and Health Status among Women Working at Health Centres of Tehran.

Perception of body-weight status is an important determinant of weight-related behaviours and may affect the burden of weight disturbances as a public-health problem. No study has assessed self-perception of the weight status regarding body-fat distribution among health workers to date. The aim of this study was to evaluate the association of the perception of weight and health status among 542 women working at health centres of Tehran. We assessed their perceived body-weight and health status and measured waist- and hip-circumference, weight, and height to calculate waist-to-hip ratio (WHR) as a measure of fat distribution and body mass index (BMI, kg/m2). Women reported their sociodemographic information, and the perceived weight and health status were compared with their actual fatness status, defined based on WHR and BMI, to determine misperception of weight status. Multivariate logistic regression models were performed to assess the predictive effects of various sociodemographic factors and actual fatness on the perception of weight and health status. The results showed that more than 40% of women with normal BMI overestimated their body-weight status while only 15.8% of these women had central obesity. BMI was the most important variable associated with misperceived weight status as normal-weight women had significantly more misperception (OR 8.16, 95% CI 4.82-13.82) than overweight/obese women. WHR did not show any significant relationships with perceived weight status. In addition, perception of health status was not associated with actual fatness indices. It is concluded, BMI was the main predictor of the perception of weight status in female employees. The importance of using body-fat distribution in the perceptions of weight and health status should be emphasized.

Fragilidad y asociaciones de riesgo en adultos mayores de una comunidad urbana / Frailty and risk associations in older adults from an urban community

Introducción: fragilidad en adultos mayores es un síndrome caracterizado por una disminución de la resistencia y de las reservas fisiológicas. Objetivo: describir la prevalencia de fragilidad en relación con variables biopsicosociales y funcionales. Métodos: estudio descriptivo, de corte transversal, puerta a puerta, de prevalencia, y analítico, estudio de casos y testigos. Se seleccionaron 315 adultos mayores, que habitan en el municipio La Lisa. Se diagnosticó fragilidad según criterios de expertos. Para buscar factores de riesgo se realizó análisis univariado entre cada una de las covariables explicativas y la variable de respuesta, mediante la prueba de chi cuadrado. Se realizó regresión de Poisson para el análisis univariado, calculando la razón de prevalencia. Resultados: la prevalencia de fragilidad fue del 42,9 %. Se constató mayor prevalencia en las féminas (59,5 %) y en aquellos con: comorbilidad (61,9 %), polifarmacia (63,8 %), deficiente movilidad (61,3 %), bajo peso (51,9 %), depresión severa (100,0 %), deterioro cognitivo (100,0 %), discapacidad (84,0 %), mala autopercepción de salud (75,0 %) y con apoyo familiar subordinado a crisis (71,4 %). La presencia de comorbilidad, alteraciones de las pruebas de flexibilidad y movilidad, estado nutricional bajo peso, deterioro cognitivo, discapacidad, caídas y mala autopercepción de salud, aparecieron como los factores que se asociaron a la aparición del síndrome en la población. Conclusiones: la prevalencia del síndrome de fragilidad es alta en la comunidad estudiada y se asociaron a factores biomédicos, psicológicos y funcionales de riesgo para la salud.

Introduction: frailty in older adults is a syndrome characterized by a reduction in resistance and physiological reserves. Objective: describe the prevalence of frailty in terms of biopsychosocial and functional variables. Methods: descriptive analytical cross-sectional door-to-door case-control prevalence study. 315 elderly persons were selected from the municipality of La Lisa. Frailty was diagnosed on the basis of expert criteria. With the purpose of finding risk factors, a univariate analysis was conducted between each of the explanatory covariables and the response variable, using the chi-square test. Poisson regression was performed for the univariate analysis, estimating the prevalence ratio. Results: the prevalence of frailty was 42.9 %. A higher prevalence was found among women (59.5 %) and among subjects with comorbidity (61.9 %), polypharmacy (63.8 %), poor mobility (61.3 %), low weight (51.9 %), severe depression (100.0 %), cognitive impairment (100.0 %), disability (84.0 %), poor self-perception of health (75.0 %) and family support limited to critical events (71.4 %). Comorbidity, altered mobility and flexibility test results, nutritional status, low weight, cognitive impairment, disability, falls and poor self-perception of health were the factors associated with the emergence of the syndrome in the population. Conclusions: prevalence of the frailty syndrome was found to be high in the community studied, and was associated to biomedical, psychological and functional health risk factors.

Avaliação do processo de aconselhamento pré-teste nos Centros de Testagem e Aconselhamento (CTA) no Estado do Rio de Janeiro: a percepção dos usuários e profissionais de saúde / Evaluation of the pre-test counseling process in the HIV Testing and Counseling Centers in Rio de Janeiro State: the perception of users and health professionals

Este estudo objetiva avaliar o processo de aconselhamento pré-teste nos Centros de Testagem e Aconselhamento (CTA) do estado do Rio de Janeiro, tendo como base a percepção dos usuários e dos profissionais de saúde. Foi realizado inquérito populacional com aplicação de questionário estruturado para uma amostra de usuários e aconselhadores de nove CTA. A análise foi realizada de forma quantitativa, avaliando o grau de satisfação nos indicadores de infraestrutura; acolhimento; relação usuário-aconselhador; e, territorialidade, acesso e disponibilidade. Dos usuários entrevistados 58,1% referiram estar muito satisfeitos com o serviço oferecido, e 38,7% satisfeitos, segundo análise do conjunto dos indicadores. Grande parte dos profissionais de saúde entrevistados (80,9%) também disse estar satisfeita. Embora tenha sido encontrado um alto índice de satisfação, foram identificadas queixas quanto aos aspectos estruturais e processuais que demandam atenção dos gestores e profissionais de saúde para a melhoria da qualidade do serviço prestado.

This study sought to evaluate the pre-test counseling process in the HIV Testing and Counseling Centers (CTA) in Rio de Janeiro State, based on the perceptions of users and health professionals. A population survey was performed, based on a structured questionnaire given to a sample of users and counselors of nine CTAs. Quantitative analyses were employed to evaluate the degree of satisfaction in relation to infrastructure indicators of the way patients are received and treated, the user-counselor relationship, and territoriality, accessibility and availability. Among the CTA users interviewed, 58.1% were very satisfied and 38.7% were satisfied with the care received, according to analysis of set of indicators. The majority of health professionals (80.9%) interviewed also declared their satisfaction. Despite the high level of satisfaction, some complaints regarding structural and procedural aspects were identified, which call for the attention of the health managers and professionals for the enhancement of the quality of the service rendered.

Agir em empresas de pequena e média dimensão para promover a saúde dos trabalhadores: o caso do setor de alimentos e bebidas / Actions in small companies to promote occupational health: the case of the food and beverage sector

OBJETIVOS: Descrever as condições de trabalho em micro e pequenas empresas do setor de alimentos e bebidas e avaliar a saúde e a capacidade para o trabalho dos trabalhadores selecionados. MÉTODOS: Foram analisados dados previdenciários e registros de exames médicos periódicos. Para as observações das condições de trabalho, utilizou-se uma ficha criada especificamente para aplicar o Diagnóstico Ergonômico Curto e, para o inquérito, o Índice de Capacidade para o Trabalho (ICT) e o Perfil de Saúde de Nottingham (PSN). RESULTADOS: Os seguintes fatores de risco e situações geradoras de desconforto foram observados: transporte manual de cargas; trabalho em pé e em série; bancadas improvisadas; instalações perigosas e ferramentas em mau estado de conservação. A maioria dos trabalhadores eram homens, com idade aproximada de 32 anos. O escore médio encontrado para o ICT foi de 43 (DP=4,25), indicando boa capacidade para o trabalho. As doenças musculoesqueléticas foram as mais diagnosticadas e os sintomas mais autorrelatados. Segundo o PSN, o estado geral de saúde dos trabalhadores pode ser considerado bom. CONCLUSÕES: Apesar da relevância das empresas de pequena dimensão na economia nacional, a base familiar e o reduzido capital explicam os baixos investimentos na estrutura física e nos processos produtivos. Ainda, a falta de conhecimento sobre segurança e saúde no trabalho gera situações de risco para o empregado. Vislumbram-se resultados positivos, que poderão ser documentados por meio de monitoramento longitudinal, após esta experiência que aliou investigação, formação e intervenção para apoiar essas empresas, geralmente excluídas de ações sociais mais amplas.

OBJECTIVES: To describe working conditions in small companies in the food and beverage sector and to assess the health and the work ability of the selected workers. METHODS: Social security data and records from periodic medical examinations were analyzed. For the observations of the work conditions, we used a data sheet created specifically for this study to apply the Short Ergonomic Assessment. For the survey, the Work Ability Index (WAI) and the Nottingham Health Profile (NHP) were used. RESULTS: The following risk factors and distress-generating situations were observed: manual transport of loads; work performed while standing and in production lines; improvised workbenches; hazardous facilities; and poorly maintained machines. Most of the workers were male with a mean age of 32 years. The mean WAI score was 43 (SD=4.25), suggesting good work ability. Musculoskeletal diseases were the conditions most frequently diagnosed and the most frequently self-reported symptoms. According to the NHP, the workers' general health status could be considered good. CONCLUSIONS: Despite the relevance of small companies in the national economy, many of them are family-based and lack the capital needed to invest in infrastructure and productive processes. Furthermore, the lack of knowledge about occupational health and safety puts employees at risk. Positive results were discerned following the present study that included investigation, training and intervention to support small companies, which are generally excluded from broader social actions. The results could be documented through the longitudinal monitoring of the companies.

Evaluación sobre las características del proceso de envejecimiento a través de relatos de vida / Avaliação sobre as características do processo de envelhecimento por meio de histórias de vida / Assesment of the process of ageing through life reports of elder people

En esta investigación se evalúa la percepción que presentan los mayores sobre los factores que influyen en su salud y el desarrollo vital a través del tiempo como punto de partida para mejorar su calidad de vida. Se analizan 147 relatos de vida de pacientes con edades comprendidas entre los 65 y 90 años. Se aborda una investigación evaluativa desde un enfoque biográfico-narrativo. Como resultados y conclusiones hay que destacar que las personas mayores compaginaron su trabajo en el sector industrial o servicios con las labores del campo. En cuanto a las actividades que realizan en su tiempo libre destacan para las mujeres coser y para los varones los juegos de cartas y seguir los deportes por televisión. Están satisfechos con la asistencia sanitaria que reciben, aunque demandan nuevos servicios de especialidad y formación en educación para la salud. En general los pacientes se enfrentan positivamente al deterioro de la salud.

In this paper, we assess elderly people's perception of the factors that influence their health and their vital development as a starting point to improve their quality of life. We analyze 147 life stories of patients aged between 65 and 90, in an evaluative research with a biographical-narrative approach. As results and conclusions, we emphasize that the elderly reconciled their work in the industrial or services sectors with ploughing. The most common activities they perform in their free time are sewing for women and card games and watching sports on TV for men. They are satisfied with the medical assistance they receive, although they demand new specialty services and health education. Most of the patients face the deterioration of their health in a positive way.

Avalia-se a percepção que apresentam as pessoas idosas sobre os fatores que influenciam sua saúde e seu desenvolvimento vital como ponto de partida para melhorar sua qualidade de vida. São analisadas 147 histórias de vida dos pacientes com idades entre 65 e noventa anos, em uma investigação avaliativa com abordagem biográfico-narrativa. Como resultados e conclusões, ressalta-se que as pessoas idosas conciliaram seu trabalho no setor industrial, ou de serviços, com a lavoura no campo. Quanto às atividades que realizam no seu tempo livre, destacam-se a costura para as mulheres e os jogos de cartas e a programação desportiva da televisão para os homens. Estão satisfeitos com a assistência que recebem na saúde, embora demandem novos serviços de especialidade e formação na educação para a saúde. De um modo geral, os pacientes defrontam-se com a deterioração da saúde positivamente.

Calidad de vida en el adulto mayor: estado físico y relaciones sociales / Quality of life of senior citizens: physical status and social relations

Estudio descriptivo correlacional, que obtuvo información respecto de la calidad de vida de los adultos mayores de la comuna de Concepción y los factores asociados a ella. La técnica empleada fue la encuesta social. El universo estuvo constituido por los adultos mayores inscritos en el Programa del Adulto Mayor -PAM- de los consultorios de Atención Primaria de la comuna de Concepción. La muestra fue formada por procedimiento aleatorio simple y quedó conformada por 408 adultos mayores de 60 años. Se analizaron para el presente artículo dos ámbitos del concepto de Calidad de Vida: “Físico” y de “Relaciones Sociales”. El grupo estudiado pertenece mayoritariamente a mujeres que se ubican en edades entre los 61 y 78 años, y el hallazgo principal es que tienen una percepción de calidad de vida en el ámbito físico, “muy bueno”, y a la vez una percepción en el ámbito de relaciones sociales, “muy bueno”. Se encontró una asociación altamente significativa entre percepción de calidad de vida tanto para el ámbito físico (percepción de salud) como para el ámbito de relaciones sociales, y las variables “relaciones familiares” y “relaciones de pareja”. Los resultados permiten destacar la importancia de estimular la interacción social, y el autocuidado para fortalecer la autonomía de los ancianos. Se contribuirá así a una mejor calidad de vida y de salud de este grupo.

This descriptive correlational study provided information regarding the quality of life and related factors, of the elderly in the city of Concepción. The technique used was the social survey. The study population consisted of participants in the “Programa del Adulto Mayor (PAM)” in community health centers of Concepción. The random sample, consisted of 408 adults, 60 years old or over. Two dimensions of the concept of Quality of Life are analyzed: “Physical Aspects” and “Social Relations”. The majority of the study group were women aged 61 to 78 years. The main finding was that they have a “Very Good” perception of the physical aspect of their lives, as well as of their “Social Relations”. A highly significant association was found between their perception of their Quality of Life both in terms of health and social relations and the variables “Family relations” and “Couple Relations”. The findings of this study illustrate the importance of stimulating social interaction and self care in order to strengthen the autonomy of the elderly, thus contributing to the improvement of their quality of life and health.

Lifestyle and Health State in Individuals with Frequent Nocturnal Sleep Interruption

BACKGROUND: Many studies have demonstrated that excessively long or short sleep duration and insomnia are associated with high risk of mortality. We intended to investigate the lifestyle and the state of health in frequently sleep interrupted people. METHODS: We have examined 2,540 subjects who visited a comprehensive medical testing center from January 2001 to June 2003. We divided into two groups of sleep disturbance into frequently interrupted group (two or more times per night) and infrequently interrupted group (less than twice per night). After frequency matching by age and sex, 1,900 subjects (each group of 950 subjects) were selected. Lifestyle, self-health perception, symptoms, clinical laboratory data and past history were compared by chi-square test and student's t-test. To identify the factors that influenced on sleep interruption, multiple logistic regression analysis was done. RESULTS: Sleep duration was not significantly different in both groups (P=0.486). The frequently interrupted group were likely to perceive themselves as bad state of health being in a (P=0.008) and to complain of various symptoms, i.e., fatigue (P<0.001), headache (P= 0.001), etc. Also, they had more incidence of mood disorders (P= 0.002), fatty liver (P=0.008), and arthritis (P=0.001) than the other group. By multiple logistic regression analysis, alcohol consumption (OR: 1.344, P= 0.007), irregular diet (OR: 1.325, P=0.003), and coffee intake (OR: 0.786, P= 0.013) were significantly different between the frequently interrupted group and the other group. CONCLUSION: Patients who complain of insomnia should be evaluated on both sleep duration and interruption. The evaluation of sleep interruption is needed in patients who perceive themselves as being in a bad state of health, who complain of various symptoms (fatigue, headache, etc.), or have a history of mood disorder, fatty liver, or arthritis.

Nutrient Intake of the Rural Elderly Living in Kyungnam -Focusing on Health and Aging Status, and Life-Satisfaction / 대한지역사회영양학회지

The purpose of this study was to investigate the difference in nutrient intake according to the level of self-perception of health status, aging status and life satisfaction of the rural elderly. The factors for the study were surveyed by interview method. The subjects were 270 people(71 male, 129 female) aged over 65 years(73.5 +/- 5.6ys) in the Ham-an area. The obtained results as follows : By evaluation of self-perception of health status, 57.5% of subjects answered they are in a bad health condition. The 91.5% of subjects had diseases(rheumatitis & arthritis 31.4%, cardiovascular disease 20.2%, gastric disease 10.2%). The women had more diseases than the men(p<0.01). The subjects took medical treatment in private hospital(40.5%) and public health centers(35.0%). The men showed better level of aging status(p<0.001) and life satisfaction index(p<0.01) than the worsen. Living with spouse influenced the aging status(p<0.05) and the more pocket money influenced life satisfaction(p<0.05) and aging status(p<0.05). The elderly who eat regularly 3 times a day(p<0.05) and have a good appetite(p<0.001) appeared to have positive effect on the self perception of health status and aging status. An increasing level of the self-perception of health status and regular exercise worked to improve aging status(p<0.001). The habits of smoking and alcohol drinking, however had no effect on any index. The self-perception of health status affected the nutrient intake, but only in female elderly. The aging status and the life satisfaction index related overall positively to the intake of nutrients. In conclusion, the study shows that gender did influence nutrient intake in the elderly. The women who live alone rated lowest in social resources and health condition therefore their nutrient intake was also extremely in deficit. For successful aging, a program for rural elderly is needed, i.e. actions to provide minimum economic life, food delivery and psychological/physical health care through regional public health centers.

The Association of Perception of Health Status with Lifestyle of Yanbian Koreans and Yanbian Chinese / 예방의학회지

To find the association of perception of health status with lifestyle of different ethnic groups living in north-eastern part of China, a cross-sectional questionnaire survey was done by 10 local health workers for 375 Korean immigrants and 217 Chinese whose age was 30 years old or more. Because Korean immigrants showed higher mortality than Chinese, we expected to find significant lifestyle related with perception of health status which was known to be a predictor of mortality by different ethnic groups. The results were as follows: 1. We found that 59.7% of Yanbian Koreans and 42.9% of Yanbian Chinese felt unhealthy (p=0.000). 2. For Yanbian Koreans, significant variables associated with perception of health status were selected through logistic regression analysis and they were sex; female to male with an OR=2.45 (95% confidence interval[CI]: 1.06, 5.64), prevalence of chronic illness with an OR=8.48 (95% CI: 4.62, 15.56), amount of meal; small or moderate to full with an OR=2.67 (95% CI: 1.40, 5.09), preference of spicy food with an OR=1.78 (95% CI: 1.04, 3.04), and less amount intake of vitamin B2 with an OR=2.29 (95% CI: 1.33, 3.93). 3. For Yanbian Chinese, significant variables associated with perception of health status were prevalence of chronic illness with an OR=4.97 (95% CI: 2.11, 11.68), history of taking ginseng with an OR=3.72 (95% CI: 1.33, 10.43), and less intake of vitamin C with an OR=0.18 (95% CI: 0.07, 0.46). In conclusion, sex, presence of chronic illness, dietary habit, and amount of vitamin- B1 intake were associated with perception of health status in Yanbian Koreans. Presence of chronic illness, experience of ginseng intake, and amount of vitamin C intake were associated with perception of health status in Yanbian Chinese. To prove cause-effect relation between perception of health status and lifestyle, further study is needed for these different ethnic groups.