Violência contra a pessoa idosa no contexto rural em tempos de COVID-19: velhas e novas emergências / Violencia contra los adultos mayores en el contexto rural en tiempos de COVID-19: viejas y nuevas emergencias / Elder abuse in the rural context in times of COVID-19: old and new emergencies

RESUMO Objetivo ampliar o debate sobre os fatores presentes no cotidiano da população idosa rural do Brasil, que contribuem para o aumento da violência contra a pessoa idosa (VCPI) na pandemia. Método estudo teórico-reflexivo, que apresenta como referenciais a Política Nacional de Saúde Integral das Populações do Campo e da Floresta e a Teoria da Vulnerabilidade, proposta por Ayres, que buscam compreender a exposição dos indivíduos a desfechos agravantes à saúde. O desenvolvimento se pautou na literatura nacional e internacional, e foi organizado pelo eixo condutor "as vulnerabilidades, redes formais e informais de proteção contra VCPI: reflexões em tempos de pandemia de COVID-19 em contexto de ruralidades". Resultados o distanciamento social necessário para a mitigação da pandemia de COVID-19 pode estar impactando negativamente os idosos da zona rural a enfrentarem a VCPI. Acredita-se que o conjunto de estratégias das redes formais e informais não tem atingido adequadamente as necessidades dos idosos da área rural. Considerações finais e implicações para a prática é de fundamental importância que, em meio à pandemia do coronavírus, haja implantação de estratégias para a manutenção e ampliação dos equipamentos sociais da rede formal e informal de proteção contra VCPI, levando em consideração as necessidades da área rural.

RESUMEN Objetivo ampliar el debate sobre los factores presentes en el cotidiano de la población anciana rural en Brasil, que contribuyen al aumento de la violencia contra los ancianos (VCA) en la pandemia. Método estudio teórico-reflexivo que presenta como referencias la Política Nacional de Salud Integral de las Poblaciones Rurales y Forestales y la Teoría de la Vulnerabilidad, propuesta por Ayres, que buscan comprender la exposición de los individuos a resultados agravantes de salud. El desarrollo se basó en la literatura nacional e internacional, y fue organizado por el eje rector "las vulnerabilidades, redes formales e informales de protección a las VCA: reflexiones en tiempos de la pandemia del COVID-19 en el contexto de las ruralidades". Resultados el distanciamiento social necesario para mitigar la pandemia de COVID-19 puede estar impactando negativamente a las personas mayores rurales que enfrentan la VCA. Se cree que el conjunto de estrategias de las redes formales e informales no han atendido adecuadamente las necesidades de los adultos mayores en las zonas rurales. Consideraciones finales e implicaciones para la práctica es de fundamental importancia que, en medio de la pandemia del coronavirus, se implementen estrategias para el mantenimiento y ampliación de los equipamientos sociales en la red formal e informal de protección contra la VCA, teniendo en cuenta las necesidades de la zona rural.

ABSTRACT Objective to expand the debate on factors present in the daily life of rural older adults in Brazil, which contribute to the increase in elder abuse (EA) in the pandemic. Method a theoretical-reflective study, which presents the Brazilian National Comprehensive Health Policy for Rural and Forest Populations and the Vulnerability Theory as frameworks, proposed by Ayres, that seek to understand the exposure of individuals to aggravating health outcomes. The development was based on national and international literature, and was organized by the guiding axis "vulnerabilities, formal and informal networks of protection against EA: reflections in times of the COVID-19 pandemic in a context of rurality". Results the social distancing necessary for mitigating the COVID-19 pandemic may be negatively impacting rural older adults facing EA. It is believed that the set of strategies of formal and informal networks has not adequately met older adults' needs in rural areas. Final considerations and implications for practice it is of fundamental importance that, amidst the coronavirus pandemic, strategies are implemented for maintenance and expansion of the formal and informal network social equipment of protection against EA, taking into account rural people's needs.

Denúncias de violência psicológica contra idosos no Brasil, 2011-2018 / Complaints of psychological violence against elderly in Brazil, 2011-2018 / Denuncias de violencia psicológica contra los ancianos en Brasil, 2011-2018

Objetivo: Analisar a frequência de registros de denúncias de violência psicológica direcionadas a pessoas idosas, identificadas no "Brasil", nos anos de "2011 a 2018". Método: Pesquisa exploratória, descritiva, comparativa e quantitativa. Os dados foram adquiridos no "Disque 100, Disque Direitos Humanos do Ministério da Mulher, da Família e dos Direitos Humanos" (MMFDH). Resultados: Foi identificado o universo de 277.778 registros, com média e desviopadrão (34.722,3±11.770,2). O ano de 2013 registrou a maior preponderância quando comparado aos anos analisados, registrando 18% (n=49.869). A maior preponderância registrada por região brasileira e unidade federativa (UF) foi identificada no Nordeste (NE) com 38% (n=105.642) e no estado de Sergipe (SE) com 12,7% (n=35.284). A hostilização foi o tipo de violência psicológica mais direcionada a idosos, registrando 38,5% (n=104.211). Considerações finais: Por meio da presente pesquisa foi identificado aumento na frequência de registros de denúncias de violência psicológica contra idosos no recorte geográfico e histórico analisados

Objective: To analyze the frequency of records of reports of psychological violence directed to elderly people, identified in "Brazil", in the years "2011 to 2018". Method: Exploratory, descriptive, comparative and quantitative research. Data were acquired from "Dial 100, Dial Human Rights of the Ministry of Women, Family and Human Rights" (MMFDH). Results A universe of 277,778 records was identified, with mean and standard deviation (34,722.3±11,770.2). The year 2013 registered the highest preponderance when compared to the years analyzed, registering 18% (n=49,869). The greatest preponderance recorded by Brazilian region and federative unit (FU) was identified in the Northeast (NE) with 38% (n=105,642) and in the state of Sergipe (SE) with 12.7% (n=35,284). Hostilization was the type of psychological violence most directed at the elderly, registering 38.5% (n=104,211). Final considerations: Through the present research, an increase in the frequency of records of reports of psychological violence against the elderly was identified in the geographical and historical scope analyzed.

Objetivo: Analizar la frecuencia de registros de denuncias de violencia psicológica dirigida a ancianos, identificados en "Brasil", en los años "2011 a 2018". Método: Investigación exploratoria, descriptiva, comparativa y cuantitativa. Los datos fueron adquiridos de "Dial 100, Dial Derechos Humanos del Ministerio de la Mujer, Familia y Derechos Humanos" (MMFDH). Resultados: Se identificó un universo de 277.778 registros, con media y desviación estándar (34.722,3±11.770,2). El año 2013 registró la mayor preponderancia en comparación con los años analizados, registrando un 18% (n=49.869). La mayor preponderancia registrada por región brasileña y unidad federativa (FU) se identificó en el Nordeste (NE) con 38% (n=105.642) y en el estado de Sergipe (SE) con 12,7% (n=35.284). La hostilización fue el tipo de violencia psicológica más dirigida a los ancianos, registrando el 38,5% (n=104.211). Consideraciones finales: A través de la presente investigación, se identificó un aumento en la frecuencia de registros de denuncias de violencia psicológica contra los ancianos en el ámbito geográfico e histórico analizado.

Os desafios da rede de proteção no enfrentamento à violência contra a pessoa idosa em Manaus, Amazonas, Brasil / The challenges of the protection network and coping with violence against older people in Manaus, Amazonas, Brazil

Resumo Objetivo Conhecer a rede de proteção, seus desafios e elementos que interferem na proteção, enfrentamento e atendimento à pessoa idosa, vítima de violência a cidade de Manaus, AM, Brasil. Método Trata-se de um estudo descritivo estruturado a partir de uma pesquisa qualitativa com utilização de pesquisa de campo. Foram entrevistados 16 profissionais que estão à frente das principais instituições que integram a Rede de Proteção no Enfrentamento à Violência contra a Pessoa Idosa na cidade de Manaus no período de 29/07 a 21/11/2020. Resultados apesar de extensa e atuante, a rede não possui a articulação necessária para atender e acompanhar as demandas dos idosos de modo satisfatório. Também não existe um fluxo de atendimento estabelecido assim como não há acompanhamento dos casos de violência contra a pessoa idosa no município. Conclusão É necessária a integração e a articulação entre as diferentes instituições uma vez que a abordagem multidisciplinar e o trabalho na perspectiva intersetorial e articulado podem resultar em potencialidade no enfrentamento da violência contra a pessoa idosa na cidade de Manaus.

Abstract Objective To know the protection network, its challenges and elements that interfere in the protection, coping and care of the older person, victim of violence in the city of Manaus, AM, Brazil. Method This is a descriptive study structured from a qualitative research using field research. Sixteen professionals were interviewed who are in charge of the main institutions that are part of the Protection Network in Confronting Violence against Older People in the city of Manaus from 07/29 to 11/21/2020. Results despite being extensive and active, the network does not have the necessary articulation to meet and monitor the demands of older people in a satisfactory way. There is also no established service flow, nor is there any monitoring of cases of violence against older people in the city. Conclusion Integration and articulation between the different institutions is necessary, since the multidisciplinary approach and work from an intersectoral and articulated perspective can result in potentiality in confronting violence against older people in the city of Manaus.

Magnitude of depression and its determinants among older persons in urban community of Agra

Background: With increasing life expectancy people are living longer but they are not necessarily healthier than before. Nearly a quarter (23%) of the overall global burden of death and illness is in people aged over 60, and much of this burden is attributable to long-term illness like non-communicable diseases and mental health problems. Aims & Objectives: Aim of the study the magnitude of depression among elderly population of Agra. Objectives To estimate the prevalence of depression in elderly population of Agra. 2. To study the factors associated with depression among elderly population of Agra. Material and Methods: This study was conducted among 355 elderly in urban Agra. Data was collected by house to house visit using pre-designed and pre-tested schedule. Geriatric depression scale (GDS-30) was used to assess the burden of depression in study population. Results: The mean age of the study participants was 68.05 years. Depression was found in 50.1% among study population and 15.5% had severe depression. Depression was more among the Illiterates, Muslims, financial dependents, those who were suffering from chronic disease/s, encountered a stressor in the last 6 months, less religious, not living with partner or suffered elderly abuse. Conclusion: High burden of depression was found among the victims of elderly abuse. Stressful life events and absence of spouse were found to be significant risk factors for depression. To deal with these factors we suggest a link worker Geriatric Age Social Health Agent (G-ASHA) to act as a link between family, community and authorities.

Relationship between Emotional Abuse and Depression among Community-Dwelling Older Adults in Korea

Despite recent advances, there is little research on factors associated with emotional abuse among Korean older adults. The present study investigated the relationships between depression and emotional abuse among community-dwelling Korean older adults. We analyzed the dataset from the Survey of Living Conditions and Welfare Needs of Korean Older Persons conducted by the Korea Institute for Health and Social Affairs in 2011. Older adults (aged >65 years, n=10674) were randomly selected. Multivariate logistic regression was used to investigate factors associated with emotional abuse in terms of sociodemographic, health-related, and psychological variables, including depression using the short version of the Geriatric Depression Scale. In our study, 9.4% of the older adults reported experiencing emotional abuse in the previous year. In addition, 44.0% of those experiencing emotional abuse suffered from depression. Multiple logistic regression modeling showed that depression in older adults was independently associated with emotional abuse [odds ratio (OR)=1.788, p < 0.001]. Along with depression, poor social support (OR for no social support=1.712, p < 0.001) and having chronic illnesses (OR for more than 3=1.481, p < 0.005) were associated an increased risk of emotional abuse. Our results showed that emotional abuse among older adults in Korea is prevalent. Our findings suggest that depression, poor social support, and having chronic illnesses are significant factors associated with emotional abuse among the Korean older adult population. Addressing these factors with preventive interventions could have significant public health implications. Further studies are warranted to gain a better understanding of emotional abuse in older Korean adults.

Medical students' clinical performance of dealing with patients in the context of domestic violence / 한국의학교육

PURPOSE: The aim of this study was to inquire about the clinical performance and determine the performance pattern of medical students in standardized patient (SP) based examinations of domestic violence (DV). METHODS: The clinical performance sores in DV station with SP of third-year (n=111, in 2014) and 4th-year (n=143, in 2016) medical students of five universities in the Busan-Gyeongnam Clinical Skills Examination Consortium were subjected in this study. The scenarios and checklists of DV cases were developed by the case development committee of the consortium. The students’ performance was compared with other stations encountered in SP. The items of the checklists were categorized to determine the performance pattern of students investigating DV into six domains: disclosure strategy (D), DV related history taking (H), checking the perpetrator’s psychosocial state (P), checking the victim’s condition (V), negotiating and persuading the interviewee (N), and providing information about DV (I). RESULTS: Medical students showed poorer performance in DV stations than in the other stations with SP in the same examination. Most students did confirm the perpetrator and commented on confidentiality but ignored the perpetrator’s state and patient’s physical and psychological condition. The students performed well in the domains of D, H, and I but performed poorly in domains P, V, and N. CONCLUSION: Medical students showed poor clinical performance in the DV station. They performed an ‘event oriented interview’ rather than ‘patient centered’ communication. An integrated educational program of DV should be set to improve students’ clinical performance.

Hidden violence against the institutionalized elderly / Violência oculta contra idosos institucionalizados

The aim of this study was to investigate the occurrence of violent actions performed by caregivers against the institutionalized elderly. This cross-sectional study, deals with an analytical, qualitative, and quantitative research carried out with the caregivers of 38 elderly residents of long-term care facilities in the cities of São Paulo State, Brazil. A questionnaire based on the Caregiver Abuse Screen (CASE) was used. Only one trained researcher performed the study, and all ethical and legal aspects were respected. The quantitative data were analyzed by Epi-Info software, version 3.5.4, and Fisher's tests and ANOVA were applied. The qualitative data were analyzed by content categorization. Among the results, all the CASE's questions showed some affirmative answers, indicating the occurrence of violence, and only 21.1% of caregivers said that they had never committed any violent act. In that sense, the main caregivers actions were "to act in a coarse way" (21%) or "to do nothing that they were able to do for the elderly" (39.5%) to help seniors, aiming to obtain control of situations regarding their aggressiveness and behavior. Additionally, a majority (87%) of the caregivers realized that violence exists in the caregivers physical, psychosocial and negligence domains regarding the institutionalized elderly, mainly in hidden forms.

O objetivo deste estudo foi investigar a ocorrência de ações violentas realizadas por cuidadores contra idosos institucionalizados. Trata-se de um estudo transversal, de pesquisa analítica, qualitativa e quantitativa realizado com os 38 cuidadores de idosos residentes em unidades de longa permanência nas cidades do Estado de São Paulo. Utilizou-se um questionário baseado no Caregiver Abuses Screen (CASE). Apenas um pesquisador treinado realizou o estudo, e todos os aspectos éticos e legais foram respeitados. Os dados quantitativos foram analisados pelo software Epi-Info, versão 3.5.4, e os testes de Fisher e ANOVA foram aplicados. Os dados qualitativos foram analisados por categorização de conteúdo. Dentre os resultados, todas as questões do CASE mostraram algumas respostas afirmativas, indicando a ocorrência de violência, e apenas 21,1% dos cuidadores disseram que nunca haviam cometido nenhum ato violento. Nesse sentido, as principais ações dos cuidadores foram "agir de forma grosseira" (21%) ou "não fazer nada que pudessem fazer pelos idosos" (39,5%) para ajudar idosos, visando obter controle De situações de agressividade e comportamento. Além disso, a maioria (87%) dos cuidadores percebeu que existe violência nos domínios físico, psicossocial e de negligência dos cuidadores em relação aos idosos institucionalizados, principalmente em formas ocultas.

Las actitudes de los cuidadores: un factor de riesgo de maltrato a los ancianos / Caregiver attitudes: a risk factor for elderly abuse

Resumen:

Actualmente, la prevalencia de maltrato hacia los mayores en España se estima en 3-10%, siendo mayor en personas de más de 80 años. Entre las causas se encuentran: la sobrecarga de sus cuidadores y las actitudes negativas hacia los ancianos. Objetivo: este trabajo analiza estos aspectos, así como las diferencias existentes entre cuidadores familiares y cuidadores profesionales. Metodología: el estudio ha sido experimental-descriptivo, con metodología cuantitativa y cualitativa, sobre una población de 70 cuidadores españoles, mediante la cumplimentación de un cuestionario. Resultados: se ha encontrado que la población de cuidadores profesionales percibe una mayor sobrecarga y muestra actitudes más negativas hacia los ancianos, respecto a los cuidadores del propio entorno familiar. Conclusiones: estos resultados confirman el papel de dos variables identificadas en la literatura como predictoras de riesgo de maltrato: la carga percibida por los cuidadores y la actitud de estos hacia la persona que cuidan.

Manifestaciones de violencia intrafamiliar hacia adultos mayores diabéticos. Pinar del Rio, 2012 / Manifestations of domestic violence towards the elderly individuals with diabetes. Pinar del Rio, 2012

La violencia contra el adulto mayor es un problema que requiere de sensibilización por parte del equipo de salud para ser visualizado.Objetivo: caracterizar las manifestaciones de violencia intrafamiliar hacia el adulto mayor diabético en un consultorio de la provincia de Pinar del Río.Métodos: se realizó un estudio descriptivo transversal durante el primer semestre del año 2012, en el Consultorio número 10 del Policlínico Universitario Hermanos Cruz. El universo (U=86) estuvo constituido por el total de adultos mayores diabéticos; la muestra quedó conformada por 52 adultos mayores diabéticos. Las variables estudiadas fueron: edad, sexo, tipo de maltrato recibido, notificación, principal agresor e identificar la necesidad de información sobre el tema. Para la recolección de información se diseñó y aplicó un cuestionario por el equipo de investigación. Se utilizó el porcentaje como medida de resumen.Resultados: el grupo de edad más maltratado fue el de 60 a 69 años, predominando el sexo femenino. Los agresores más cercanos resultaron ser los hijos. La muestra estudiada manifestó que existe una insuficiente divulgación sobre el tema.Conclusiones: en el consultorio donde se realizó la investigación existen manifestaciones de violencia intrafamiliar en adultos mayores diabéticos, a pesar de que la comunidad no la reconoce como uno de sus problemas de salud...

Violence against elderly individuals is a problem that requires awareness on part of the health care staff for further visualization.Objective: to characterize manifestations of domestic violence towards the elderly with diabetes in a Doctor's Office in Pinar del Rio Province.Methods: a descriptive cross-sectional study was conducted during the first semester of the year 2012 in the Doctor's Office No 10 of Hermanos Cruz University Polyclinic. The universe (U=86) was composed of the total of elderly individuals with diabetes; the sample was comprised of 52 diabetic elderly individuals. The variables studied were: age, sex, type of abuse, notification, main aggressor and identification of the need for information about the topic. For the collection of information, a questionnaire was designed and applied by the research staff. The percentage was used as summary measure.Results: the most abused age group was from 60 to 69 years, predominantly the female sex. The closest aggressors resulted to be children. The sample studied showed that there is an insufficient spread of the topic.Conclusions: a manifestation of domestic violence in the elderly individuals with diabetes was observed in the doctor's office where this research was conducted, even though the community does not recognize it as one of its health problems...

Revisão sistemática da produção acadêmica brasileira sobre causas externas e violências contra a pessoa idosa / Systematic review of the Brazilian academic production about external causes and violence against the elderly

Apresenta-se revisão sistemática sobre violência contra a pessoa idosa no período de 2000 a 2009. A base de dados para a pesquisa é o acervo de artigos, livros, capítulos de livros, manuais e planos de ação da Biblioteca Virtual em Violência e Saúde. Foram categorizados e analisados 115 documentos segundo os subtemas: quedas; causas externas e violência em geral; estudos epidemiológicos e socioepidemiológicos; prevenção da violência; violência e acidentes no contexto familiar; revisão conceitual e metodológica; ordem legal e denúncias; violência sob o olhar de quem a vivencia; serviços de saúde, profissionais e cuidadores; e construção e revalidação de instrumentos de pesquisa. Os resultados mostram relevante aumento da produção e aprimoramento metodológico nas áreas de saúde pública, serviço social, direito, fisioterapia, enfermagem, psicologia, otorrinolaringologia e na formulação de políticas e planos de ação. No entanto, há temas pouco aprofundados como acidentes de trânsito, homicídios, suicídios, afogamentos e sufocações.

This article presents a review about violence against the elderly, covering the period of 2000 to 2009. The database used in this research was the collection of articles, books, book chapters, manuals and plans of action of the Virtual Library on Violence and Health. We analyzed 115 documents divided into the following categories: falls; external causes and violence in general; epidemiological and socio-epidemiological studies; prevention of violence; violence and accidents in the family; conceptual and methodological review; legal order and denunciation; violence from the elderly's point of view; health services, professionals and caretakers; and construction and validation of research instruments. The results show a relevant increase in production and methodological improvement in public health, social work, law, physiotherapy, nursing, psychology and otorhinolaryngology. However, there are issues that have not been sufficiently approached such as traffic accidents, homicides, suicides, drowning and suffocation.