Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 231
Filter
1.
rev.cuid. (Bucaramanga. 2010) ; 14(3): 1-11, 20230901.
Article in Portuguese | LILACS, BDENF, COLNAL | ID: biblio-1525818

ABSTRACT

Introdução: O Diabetes Mellitus ocasiona a diminuição das reservas e capacidades funcionais. Sua associação com a síndrome da fragilidade acarreta declínio gradativo no sistema biológico, causando prejuízos globais à saúde da população idosa e, portanto, comprometendo sua qualidade de vida. Objetivo: analisar a evolução da fragilidade e fatores associados em pessoas idosas com Diabetes Mellitus. Materiais e Métodos: Estudo longitudinal caracterizado por duas avaliações com intervalo de 18 meses, envolvendo 49 participantes com idade ≥ 60 anos e de ambos os sexos com diagnóstico clínico de Diabetes Mellitus. Na análise dos dados foram utilizadas medidas de tendência central, dispersão, proporções, teste não paramétrico de Wilcoxon pareado e análise linear múltipla. Resultados: Na avaliação do seguimento, ocorreu um aumento da fragilidade e comprometimento da capacidade funcional entre as duas avaliações. Fatores associados, como as atividades instrumentais da vida diária e o número total de doenças, impactaram negativamente sobre a fragilidade dos participantes. Discussão: Os resultados encontrados no estudo convergem com a literatura cientifica relacionada à associação de doenças crônicas como a Diabetes Mellitus no aumento da fragilidade. Conclusão: A presença de uma doença crônica como a Diabetes Mellitus pode ocasionar o aumento da fragilidade e comprometer a funcionalidade. A avaliação destas condições nos serviços de saúde para identificação precoce é fundamental para estabelecer estratégias assertivas para a manutenção de um envelhecimento com qualidade de vida.


Introduction: Diabetes Mellitus causes a decrease in reserves and functional capabilities. Its association with frailty syndrome leads to a gradual decline in the biological system, causing global harm to the health of the elderly population and, therefore, compromising their quality of life. Objective: to analyze the evolution of frailty and associated factors in elderly people with Diabetes Mellitus. Materials and Methods: Longitudinal study characterized by two assessments 18 months apart, involving 49 participants aged ≥ 60 years and of both sexes with a clinical diagnosis of Diabetes Mellitus. In data analysis, measures of central tendency, dispersion, proportions, paired Wilcoxon non-parametric test and multiple linear analysis were used. Results: In the follow-up assessment, there was an increase in frailty and impairment of functional capacity between the two assessments. Associated factors, such as instrumental activities of daily living and the total number of illnesses, had a negative impact on the participants' frailty. Discussion: The results found in the study converge with the scientific literature related to the association of chronic diseases such as Diabetes Mellitus with increased frailty. Conclusion: The presence of a chronic disease such as Diabetes Mellitus can cause increased frailty and compromise functionality. The assessment of these conditions in health services for early identification is essential to establish assertive strategies for maintaining aging with quality of life.


Introducción: La Diabetes Mellitus provoca una disminución de las reservas y capacidades funcionales. Su asociación con el síndrome de fragilidad conduce a un paulatino deterioro del sistema biológico, provocando un daño global a la salud de la población anciana y, por tanto, comprometiendo su calidad de vida. Objetivo: analizar la evolución de la fragilidad y factores asociados en personas mayores con Diabetes Mellitus. Materiales y Métodos: Estudio longitudinal caracterizado por dos evaluaciones con 18 meses de diferencia, involucrando a 49 participantes con edad ≥ 60 años y de ambos sexos con diagnóstico clínico de Diabetes Mellitus. En el análisis de los datos se utilizaron medidas de tendencia central, dispersión, proporciones, prueba no paramétrica de Wilcoxon pareada y análisis lineal múltiple. Resultados: En la evaluación de seguimiento, hubo un aumento de la fragilidad y el deterioro de la capacidad funcional entre las dos evaluaciones. Los factores asociados, como las actividades instrumentales de la vida diaria y el número total de enfermedades, tuvieron un impacto negativo en la fragilidad de los participantes. Discusión: Los resultados encontrados en el estudio convergen con la literatura científica relacionada con la asociación de enfermedades crónicas como la Diabetes Mellitus con mayor fragilidad. Conclusión: La presencia de una enfermedad crónica como la Diabetes Mellitus puede provocar aumento de fragilidad y comprometer la funcionalidad. La evaluación de estas condiciones en los servicios de salud para su identificación temprana es fundamental para establecer estrategias asertivas para mantener el envejecimiento con calidad de vida.


Subject(s)
Aged , Risk Factors , Diabetes Mellitus , Frailty
2.
Alerta (San Salvador) ; 6(2): 142-148, jul. 19, 2023.
Article in Spanish | LILACS, BISSAL | ID: biblio-1442686

ABSTRACT

El envejecimiento ocasiona un aumento en la vulnerabilidad del adulto mayor. El ejercicio multicomponente se ha propuesto como una práctica para mejorar la funcionalidad física y cognitiva del adulto mayor, reducir la frecuencia de caídas y fracturas y prevenir la sarcopenia. Por tanto, en esta revisión bibliográfica se propone determinar los efectos del ejercicio multicomponente en el adulto mayor para evitar la progresión del síndrome de fragilidad. Se realizó una búsqueda bibliográfica en las bases de datos Hinari, PubMed, Scopus y Embase utilizando los operadores booleanos «AND¼ y «OR¼ y como palabras clave «fragilidad¼, «adulto mayor¼, «caídas¼, «fracturas¼, «sarcopenia¼ para delimitar literatura de utilidad a esta investigación. Se tomaron en cuenta artículos de revisión bibliográfica, casos y controles, metaanálisis, artículos originales, revisiones sistemáticas con vigencia menor a cinco años, en los idiomas inglés y español. El ejercicio multicomponente ocasiona una mejoría en la funcionalidad física, dependencia, prevención de caídas y reducción de la sarcopenia, siendo una herramienta útil para la regresión del síndrome de fragilidad en el adulto mayor


Aging causes an increase in the vulnerability of older adults. The practice of multicomponent exercise has been proposed to improve the physical and cognitive functionality of the older adult, reduce the frequency of falls and fractures, and prevent sarcopenia. Therefore, this literature review aims to determine the effects of multicomponent exercise in the older adult to prevent the progression of frailty syndrome. A literature search was performed in the Hinari, PubMed, Scopus and Embase databases, using the Boolean operators "AND" and "OR" and as keywords "frailty", "older adult", "falls", "fractures", "sarcopenia" to delimit useful literature for this research. Literature review articles, case-controls, meta-analysis, original articles, systematic reviews less than five years old, published in both English and Spanish were taken into account. Multicomponent exercise causes an improvement in physical functionality, independence, fall prevention, and reduction of sarcopenia, being a useful tool for the regression of frailty syndrome in the elderly.


Subject(s)
Humans , Aged , Aged , Exercise , Frailty , El Salvador
4.
Chinese Journal of Preventive Medicine ; (12): 626-633, 2023.
Article in Chinese | WPRIM | ID: wpr-985454

ABSTRACT

Objective: To investigate the association of the levels of high sensitivity C-reactive protein (hs-CRP) with frailty and its components among the elderly over 65 years old in 9 longevity areas of China. Methods: Cross-sectional data from the Health Ageing and Biomarkers Cohort Study (HABCS, 2017-2018) were used and the elderly over 65 years old were included in this study. Through questionnaire interview and physical examination, the information including demographic characteristics, behavior, diet, daily activity, cognitive function, and health status was collected. The association between hs-CRP and frailty and its components in the participants was analyzed by multivariate logistic regression model and restrictive cubic spline. Results: A total of 2 453 participants were finally included, the age was (84.8±19.8) years old. The median hs-CRP level was 1.13 mg/L and the prevalence of frailty was 24.4%. Compared with the low-level group (hs-CRP<1.0 mg/L), the OR (95%CI) value of the high-level group (hs-CRP>3.0 mg/L) was 1.79 (1.35-2.36) mg/L. As for the components, the hs-CRP level was also positively associated with ADL disability, IADL disability, functional limitation and multimorbidity. After adjusting for confounding factors, compared with the low-level group, the OR (95%CI) values of the high-level group for the four components were 1.68 (1.25-2.27), 1.88 (1.42-2.50), 1.68 (1.31-2.14) and 1.39 (1.12-1.72), respectively. Conclusion: There is a positive association between the levels of hs-CRP and the risk of frailty among the elderly over 65 years old in 9 longevity areas of China. The higher hs-CRP level may increase the risk of frailty by elevating the risk of four physical functional disabilities, namely ADL disability, IADL disability, functional limitation and multimorbidity.


Subject(s)
Humans , Aged , Aged, 80 and over , C-Reactive Protein/analysis , Frailty/epidemiology , Cohort Studies , Cross-Sectional Studies , China/epidemiology
5.
Chinese Journal of Preventive Medicine ; (12): 607-613, 2023.
Article in Chinese | WPRIM | ID: wpr-985452

ABSTRACT

Objective: To explore the association between sleep duration and the risk of frailty among the elderly over 80 years old in China. Methods: Using the data from five surveys of the China Elderly Health Influencing Factors Follow-up Survey (CLHLS) (2005, 2008-2009, 2011-2012, 2014, and 2017-2018), 7 024 elderly people aged 80 years and above were selected as the study subjects. Questionnaires and physical examinations were used to collect information on sleep time, general demographic characteristics, functional status, physical signs, and illness. The frailty state was evaluated based on a frailty index that included 39 variables. The Cox proportional risk regression model was used to analyze the correlation between sleep time and the risk of frailty occurrence. A restricted cubic spline function was used to analyze the dose-response relationship between sleep time and the risk of frailty occurrence. The likelihood ratio test was used to analyze the interaction between age, gender, sleep quality, cognitive impairment, and sleep duration. Results: The age M (Q1, Q3) of 7 024 subjects was 87 (82, 92) years old, with a total of 3 435 (48.9%) patients experiencing frailty. The results of restricted cubic spline function analysis showed that there was an approximate U-shaped relationship between sleep time and the risk of frailty. When sleep time was 6.5-8.5 hours, the elderly had the lowest risk of frailty; Multivariate Cox proportional risk regression model analysis showed that compared to 6.5-8.5 hours of sleep, long sleep duration (>8.5 hours) increased the risk of frailty by 13% (HR: 1.13; 95%CI: 1.04-1.22). Conclusion: There is a nonlinear association between sleep time and the risk of frailty in the elderly.


Subject(s)
Aged , Humans , Aged, 80 and over , Frailty/epidemiology , Sleep Duration , Prospective Studies , Sleep/physiology , China/epidemiology
6.
Chinese Medical Journal ; (24): 1026-1036, 2023.
Article in English | WPRIM | ID: wpr-980887

ABSTRACT

With the rapid aging of the global population posing a serious problem, frailty, a non-specific state that reflects physiological senescence rather than aging in time, has become more widely addressed by researchers in various medical fields. A high prevalence of frailty is found among kidney transplant (KT) candidates and recipients. Therefore, their frailty has become a research hotspot in the field of transplantation. However, current studies mainly focus on the cross-sectional survey of the incidence of frailty among KT candidates and recipients and the relationship between frailty and transplantation. Research on the pathogenesis and intervention is scattered, and relevant review literature is scarce. Exploring the pathogenesis of frailty in KT candidates and recipients and determining effective intervention measures may reduce waiting list mortality and improve the long-term quality of life of KT recipients. Therefore, this review explains the pathogenesis and intervention measures for frailty in KT candidates and recipients to provide a reference for the formulation of effective intervention strategies.


Subject(s)
Humans , Frailty/epidemiology , Risk Factors , Quality of Life , Kidney Failure, Chronic , Kidney Transplantation/adverse effects , Cross-Sectional Studies , Transplant Recipients
7.
Singapore medical journal ; : 196-202, 2023.
Article in English | WPRIM | ID: wpr-969655

ABSTRACT

INTRODUCTION@#Our aim was to study the prevalence of frailty and its associated factors in a subacute geriatric ward.@*METHODS@#This was a cross-sectional study of 167 participants between June 2018 and June 2019. Baseline demographics and participants' Mini Nutritional Assessment, Geriatric Depression Scale, Mini Mental State Examination, Charlson's Comorbidity Index and LACE index scores were obtained. Functional measurements such as modified Barthel's Index scores and hand grip strength (HGS) were taken. Frailty was assessed using the Clinical Frailty Scale (CFS) and the FRAIL scale. Data on history of healthcare utilisation, medications, length of stay, selected blood investigations and presence of geriatric syndromes were also collected.@*RESULTS@#The prevalence of pre-frailty (CFS 4) and frailty (CFS ≥ 5) was 16.2% and 63.4%, respectively. There were significant associations between CFS and age (pre-frail vs. non-frail: odds ratio [OR] 1.14, 95% confidence interval [CI] 1.04-1.25, P = 0.006; frail vs. non-frail: OR 1.08, 95% CI 1.01-1.15, P = 0.021), HGS at discharge (frail vs. non-frail: OR 0.90, 95% CI 0.82-0.99, P = 0.025), serum albumin (frail vs. non-frail: OR 0.90, 95% CI 0.82-0.99, P = 0.035) and the presence of urinary incontinence (frail vs. non-frail: OR 3.03, 95% CI 1.19-7.77, P = 0.021).@*CONCLUSION@#Frailty is highly prevalent in the subacute geriatric setting and has many associated factors. In this study, independent factors associated with frailty were age, HGS at discharge, serum albumin and urinary incontinence. This has implications for future resource allocation for frail older inpatients and may help direct further research to study the effectiveness of frailty-targeted interventions.


Subject(s)
Humans , Aged , Frailty/epidemiology , Frail Elderly , Hand Strength , Prevalence , Singapore/epidemiology , Cross-Sectional Studies , Fatigue Syndrome, Chronic , Geriatric Assessment , Urinary Incontinence , Serum Albumin
8.
Journal of Central South University(Medical Sciences) ; (12): 621-627, 2023.
Article in English | WPRIM | ID: wpr-982330

ABSTRACT

The high incidence of dual sleep and frail disorders in the elderly people, often occurring together, seriously affects the physical and mental health of the older people, effective research on the dynamics of dual sleep and frail disorders is important for improving the quality of life for the older people and responding to global ageing trend. While trajectory studies provide a unique practical scientific perspective to grasp the dynamics of development, dual trajectories unite dual barriers provide an opportunity to study the dynamic dependence of both sleep and frailty simultaneously sleep trajectories and frailty trajectories in older people are interrelated and interacted through deeper mechanisms. Therefore, it is necessary for the study not only focus on the ongoing development of health problems, but also needs to consider multiple aspects and propose targeted intervention program.


Subject(s)
Aged , Humans , Frail Elderly , Frailty , Quality of Life , Aging , Sleep
9.
Rev. med. Urug ; 39(1): e205, 2023.
Article in Spanish | LILACS, BNUY | ID: biblio-1431908

ABSTRACT

La fragilidad determina una incapacidad para enfrentar estresores debido a la disminución de las reservas fisiológicas multisistémicas. El acto anestésico quirúrgico constituye un evento estresante y la presencia de fragilidad es un factor de riesgo independiente de morbimortalidad perioperatoria. Identificarla permitiría abordar los factores reversibles que la determinan con la intención de disminuir los riesgos inherentes a dicho acto. Su detección en la valoración perioperatoria aporta información relevante que no se obtiene con una evaluación tradicional. Este enfoque se ha convertido en un estándar en la valoración perioperatoria de personas mayores. El objetivo del estudio es valorar la prevalencia de fragilidad en la cirugía electiva de personas mayores en el Hospital de Clínicas. Es un estudio prospectivo y descriptivo. Fue aprobado por el Comité de Ética institucional. Se reclutaron 206 pacientes de 65 años y más, coordinados para cirugía electiva, entre marzo del 2019 y marzo del 2020. Se aplicó la Escala de Fragilidad de Edmonton Reportada (REFS) para la detección de la fragilidad. La prevalencia de fragilidad fue del 22,8% con un IC 16-29,6, por lo que decimos que es alta en esta población y similar al de otros contextos quirúrgicos y no quirúrgicos. Se encontraron un número significativamente mayor de hipertensión arterial, arritmias, diabetes, hipotiroidismo y tabaquismo entre los pacientes frágiles. Su prevalencia e impacto en la morbimortalidad operatoria constituyen razones de peso para su inclusión en la valoración perioperatoria en nuestro sistema de salud así como la capacitación de los anestesiólogos en la detección de la fragilidad a través del uso de herramientas prácticas, válidas y confiables.


Frailty determines an inability to cope with stressors due to decreased multisystem physiologic reserves. The surgical anesthetic act is a stressful event and the presence of frailty is an independent risk factor for perioperative morbidity and mortality Detection of frailty would allow for addressing reversible factors causing it, with the intention of reducing the risks that are inherent to anesthetic acts. Detection in the perioperative assessment provides relevant information that is not obtained in a traditional evaluation. This approach has become the standard in perioperative assessment of geriatric surgical patients. The study aims to assess the prevalence of frailty in elective surgery for the elderly at Clínicas Hospital. Method: prospective, descriptive study approved by the institutional Ethics Committee. 206 patients aged 65 years old and over who had been coordinated for elective surgery were recruited for the study between March, 2019 and March, 2020. The Reported Edmonton Frailty Scale (REFS) was applied to detect frailty. Prevalence of frailty was 22.8% with a CI of 16-29 in this population, rather high and similar to the frail patients percentages in other surgical and non-surgical settings. Significantly higher numbers of arterial hypertension, arrhythmias, diabetes and hypothyroidism cases and tobacco users were found among frail patients. Prevalence and impact of frailty on operative morbidity and mortality are compelling reasons for its inclusion in the perioperative assessment of our health system, as well as the training of anesthesiologists in the detection of frailty through the use of practical, valid and reliable tools.


A fragilidade determina uma incapacidade de lidar com estressores devido à diminuição das reservas fisiológicas multissistêmicas. O ato anestésico cirúrgico é um evento estressante e a presença de fragilidade é um fator de risco independente para morbimortalidade perioperatória. Identificá-lo permitiria abordar os fatores reversíveis que o determinam com o intuito de reduzir os riscos inerentes ao referido ato. Sua detecção na avaliação perioperatória fornece informações relevantes que não são obtidas com uma avaliação tradicional. Essa abordagem tornou-se padrão na avaliação perioperatória de idosos. O objetivo do estudo é avaliar a prevalência de fragilidade em cirurgias eletivas para idosos no Hospital de Clínicas. Realizou-se um estudo prospectivo e descritivo, aprovado pelo Comitê de Ética institucional. 206 pacientes com 65 anos ou mais, coordenados para cirurgia eletiva, foram recrutados entre março de 2019 e março de 2020. A Reported Edmonton Frailty Scale (REFS) foi aplicada para detectar fragilidade. A prevalência de fragilidade foi de 22,8% com um IC de 16-29,6, pelo que podemos dizer que é elevada nesta população e semelhante à de outros contextos cirúrgicos e não cirúrgicos. Números significativamente maiores de hipertensão arterial, arritmias, diabetes, hipotireoidismo e tabagismo foram encontrados entre os pacientes frágeis. A prevalência e impacto da fragilidade na morbimortalidade operatória são razões convincentes para sua inclusão na avaliação perioperatória em nosso sistema de saúde, bem como para o treinamento de anestesistas na detecção de fragilidade por meio do uso de ferramentas práticas, válidas e confiáveis.


Subject(s)
Humans , Aged , Aged, 80 and over , Prevalence , Frailty , Risk Assessment , Perioperative Care
10.
Psicol. ciênc. prof ; 43: e245027, 2023.
Article in Portuguese | LILACS, INDEXPSI | ID: biblio-1431133

ABSTRACT

Este artigo versa sobre o processo de desligamento institucional por maioridade de jovens que residem em serviços de acolhimento. Aposta-se em uma política do sensível para visibilizar os encontros e desencontros que acontecem entre as e os jovens e as políticas públicas brasileiras. Para tanto, realizaram-se encontros com jovens que já haviam passado pelo processo de desligamento e com jovens que logo completariam 18 anos e teriam de sair das instituições de acolhimento. Para tornar visíveis essas existências, investiu-se na escrita de biografemas, inspirados na obra de Roland Barthes. Os conceitos de necropolítica e vidas precárias foram fundamentais para compreender as omissões do Estado no momento do desligamento. Verificou-se que o Estado pode maximizar a precariedade de algumas vidas, especialmente daquelas marcadas por características de raça, gênero e classe culturalmente marginalizados. Contudo, é também o encontro com as políticas públicas que garante melhores condições de vida para alguns, facilitando o acesso à universidade e ao mercado de trabalho. A pesquisa aponta que, diante do abandono, as e os jovens se fazem vagalumes, produzindo luminosidades em meio à escuridão e reivindicando o direito à vida.(AU)


This article discusses the process of institutional removal of young people that reside in foster care institutions for reaching adulthood. It relies on a politics of the sensitive to make visible the encounters and mismatches that take place between young people and Brazilian public policies. To do so, meetings were held with young people who had already experienced the removal process and with young people who would soon turn 18 and would have to leave the host institutions. To make these existences visible, this study invested in the writing of biographems, inspired by the works of Roland Barthes. The concepts of necropolitics and precarious lives were fundamental to understand the omissions of the State at the time of removal. It was also found that the State can maximize the precariousness of some lives, especially those marked by culturally marginalized race, gender, and class characteristics. However, it is also the encounter with public policies that ensures better living conditions for some, facilitating access to the university and the labor market. This research points out that, in the face of abandonment, young people become fireflies, producing luminosity amid the darkness and claiming the right to life.(AU)


Este artículo aborda el proceso de desconexión institucional justificado por la edad adulta de los jóvenes que residen en los servicios de acogida. Utilizamos una política sensible para hacer visibles las reuniones y los desajustes que tienen lugar entre los jóvenes y las políticas públicas brasileñas. Con este fin, se celebraron reuniones con los jóvenes que ya habían pasado por el proceso de desconexión institucional y también con los jóvenes que pronto cumplirían los 18 años y tendrían que abandonar las instituciones de acogida. Para hacer visibles estas existencias, se redactaron biografemas, inspirados en el trabajo de Roland Barthes. Los conceptos de necropolítica y vida precaria fueron fundamentales para comprender las omisiones del Estado en el momento de la desconexión. Se encontró que el Estado puede maximizar la precariedad de algunas vidas, principalmente de aquellas marcadas por características de raza, género y clase culturalmente marginadas. Sin embargo, el encuentro con las políticas también puede garantizar mejores condiciones de vida para algunos, facilitándoles el acceso a la universidad y al mercado laboral. Esta investigación señala que, ante el abandono, los jóvenes se convierten en luciérnagas, produciendo luminosidad en medio de la oscuridad y reclamando el derecho a la vida.(AU)


Subject(s)
Humans , Male , Female , Public Policy , Adolescent , Deinstitutionalization , Institutionalization , Orientation , Personal Satisfaction , Pregnancy in Adolescence , Prejudice , Psychology , Safety , Self Concept , Sex Offenses , Social Behavior Disorders , Social Change , Social Control, Formal , Social Problems , Social Responsibility , Social Support , Social Welfare , Socioeconomic Factors , Sociology , Unemployment , Violence , Behavior and Behavior Mechanisms , Child Labor , Biographies as Topic , Bereavement , Child Custody , Adaptation, Psychological , Career Mobility , Charities , Child Abuse , Child Advocacy , Child, Institutionalized , Child Welfare , Organizations , Health , Mental Health , Data Collection , Life Expectancy , Mortality , Adolescent, Institutionalized , Coercion , Homeless Youth , Crime , Criminal Law , Shelter , Armed Conflicts , Culture , Custodial Care , Personal Autonomy , Moral Obligations , Public Power , Death , Law Enforcement , Minors , Vulnerable Populations , Human Rights Abuses , Dependency, Psychological , Growth and Development , Education , Empathy , Employee Discipline , Employment , Social Investment Projects , Resilience, Psychological , Bullying , Racism , Community Integration , Drug Trafficking , Emotional Adjustment , Underage Drinking , Criminal Behavior , Social Segregation , Psychosocial Support Systems , Frailty , Foster Home Care , Survivorship , Recidivism , Freedom , Self-Neglect , Emotional Abuse , Social Interaction , Citizenship , Family Support , Helplessness, Learned , Homicide , Human Rights , Income , Juvenile Delinquency , Malpractice
11.
Psicol. ciênc. prof ; 43: e252476, 2023. graf
Article in Portuguese | LILACS, INDEXPSI | ID: biblio-1448942

ABSTRACT

Este artigo tem como objetivo analisar a vivência de trabalho precoce de adolescentes e jovens em cumprimento de medida socioeducativa, no estado da Paraíba. Os instrumentos utilizados foram um Questionário Mosquito Diagnóstico e uma Entrevista Semiestruturada. A análise foi realizada com o software Iramuteq, (Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires), através da Análise Hierárquica Descendente, que gerou seis classes: significado do trabalho; infância e escola; condições objetivas de vida; trabalho, drogas e ato infracional; consequências do trabalho infantil; e trabalho infantojuvenil. A perspectiva teórica utilizada foi a psicologia histórico-cultural e os dados discutidos a partir do conceito de vivência. Conclui-se que as vivências e situações sociais de desenvolvimento foram caracterizadas pelo trabalho precoce que oportunizou o envolvimento com atos infracionais e as instituições responsáveis pela garantia de direitos em vez de garantir a proteção social, criminalizaram por meio de medidas socioeducativas.(AU)


This article aims to analyze the experience of child labor of adolescents and youngsters that are complying a social-educational measure, in the State of Paraíba. The instruments utilized were a Questionnaire Mosquito Diagnóstico and a Semi-Structured Interview. The analysis was performed by using the Iramuteq software (Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires), by using Descending Hierarchical Analysis, which generated six classes: meaning of labor; childhood and school; objective conditions of life; labor, drugs, and act of infraction; consequences of child labor; and child labor. The theoretical perspective used was historical-cultural psychology and the data were discussed from the concept of experience. It was concluded that the experiences and social situations of development were characterized by child labor, which enabled the involvement with acts of infraction; and the institutions responsible for guaranteeing rights, instead of guaranteeing social protection, criminalized by using social-educational measures.(AU)


Este artículo tiene como objetivo analizar la vivencia precoz de adolescentes y jóvenes que cumplen medidas socioeducativas en el estado de Paraíba (Brasil). Los instrumentos utilizados fueron un Cuestionario Mosquito Diagnóstico y una entrevista semiestructurada. El análisis se realizó con el software Iramuteq (Interface de R pour les Multidimensionnelles Analyzes de Textes et de Questionnaires), mediante análisis jerárquico descendente, que generó seis clases: Significado del trabajo; Infancia y escuela; Condiciones objetivas de vida; Trabajo, drogas y acto de infracción; Consecuencias del trabajo infantil; y Trabajo infantojuvenil. La perspectiva teórica que se utilizó fue la psicología histórico-cultural, y los datos se discutieron desde el concepto de vivencia. Se concluye que las vivencias y situaciones sociales de desarrollo se caracterizaron por trabajo infantil que permitió la participación en infracciones y que las instituciones responsables de garantizar los derechos en lugar de la protección social los criminalizaron mediante medidas socioeducativas.(AU)


Subject(s)
Humans , Male , Female , Adolescent , Young Adult , Child Labor , Adolescent , Education , Personality , Play and Playthings , Poverty , Prejudice , Sex Work , Psychology , Public Policy , Punishment , Schools , Self Concept , Social Change , Social Class , Social Conditions , Social Support , Socialization , Socioeconomic Factors , Stereotyping , Student Dropouts , Suicide, Attempted , Theft , Violence , Behavior and Behavior Mechanisms , Work Hours , Child Abuse, Sexual , Mainstreaming, Education , Occupational Risks , Accidents, Occupational , Family , Illicit Drugs , Child, Abandoned , Child Advocacy , Child, Institutionalized , Child Welfare , Self-Injurious Behavior , Civil Rights , Family Planning Policy , Sexual Harassment , Communication , Adult , Legislation , Counseling , Crime , Dangerous Behavior , Adolescent Health , Death , Deinstitutionalization , Friends , Minors , Aggression , Human Rights Abuses , Educational Status , Employment , Health Vulnerability , Job Market , Bullying , Remuneration , Social Discrimination , Drug Trafficking , Enslaved Persons , Social Capital , Emotional Adjustment , Underage Drinking , Literacy , Help-Seeking Behavior , Self-Control , Psychiatric Rehabilitation , Psychosocial Support Systems , Work-Life Balance , Frailty , Survivorship , Recidivism , Academic Failure , Adverse Childhood Experiences , Cyberbullying , Data Analysis , Involuntary Commitment , Return to School , Sustenance , Emotional Abuse , Financial Stress , Life Course Perspective , Housing Instability , Social Vulnerability , Citizenship , Homicide , Household Work , Human Rights , Institutionalization , Juvenile Delinquency , Language , Mental Health Services
12.
Psicol. ciênc. prof ; 43: e253659, 2023.
Article in Portuguese | LILACS, INDEXPSI | ID: biblio-1448943

ABSTRACT

Partindo da pergunta "Como tem sido ser mulher e mãe em tempos de pandemia?", o presente estudo convidou mulheres que são mães, em redes sociais virtuais, a partilhar um relato de suas experiências com a readaptação parental em função do distanciamento social causado pela pandemia de covid-19. O objetivo foi refletir sobre a experiência de ser mulher e mãe em tempos de covid-19 e distanciamento social, apontando algumas ressonâncias do cenário pandêmico na subjetividade dessas mulheres. O estudo teve como base o referencial psicanalítico, tanto na construção da pesquisa e análise dos relatos quanto na sua discussão. A análise dos cerca de 340 relatos coletados, os quais variaram de uma breve frase a longos parágrafos, apontou para uma série de questionamentos, pontos de análise e reflexões. A pandemia, e o decorrente distanciamento social, parece ter colocado uma lente de aumento sobre as angústias das mulheres que são mães, evidenciando sentimentos e sofrimentos sempre presentes. Destacaram-se, nos relatos, a sobrecarga das mulheres com as tarefas de cuidado dos filhos e da casa, a culpa, a solidão, a exaustão, e o sentimento de que não havia espaço nesse contexto para "ser mulher", sendo isso entendido especialmente a questões estéticas e de vaidade.(AU)


Starting from the question "How does it feel to be a woman and a mother in pandemic times?", this study invited women who are mothers, in virtual social networks, to share their experiences regarding parental adaptations due to social distancing caused by the COVID-19 pandemic. The objective was to reflect on the experience of being a woman and a mother in the context of COVID-19 and of social distancing, pointing out some resonances of the pandemic scenario in the subjectivity of these women. The study was based on the psychoanalytical framework, both in the construction of the research and analysis of the reports and in their discussion. The analysis of about 340 collected reports, which ranged from a brief sentence to long paragraphs, pointed to a series of questions, analysis topics, and reflections. The pandemic, and the resulting social distancing, seems to have placed a magnifying glass over the anguish of women who are mothers, showing ever-present feelings and suffering. The reports highlighted women's overload with child and house care tasks, the guilt, loneliness, exhaustion, and the feeling that there was no space in this context to "be a woman," and it extends to aesthetic and vanity related questions especially.(AU)


A partir de la pregunta "¿cómo te sientes siendo mujer y madre en tiempos de pandemia?", este estudio invitó por las redes sociales a mujeres que son madres a compartir un relato de sus experiencias sobre la readaptación parental en función del distanciamiento social causado por la pandemia del covid-19. Su objetivo fue reflexionar sobre la experiencia de ser mujer y madre en tiempos del covid-19 y el distanciamiento social, señalando algunas resonancias del escenario pandémico en la subjetividad de estas mujeres. Este estudio se basó en el marco psicoanalítico, tanto en la construcción de la investigación y análisis de los informes como en su discusión. El análisis de los casi 340 relatos, que variaron de una pequeña frase a largos párrafos, generó en las investigadoras una serie de cuestionamientos y reflexiones. La pandemia y el consecuente distanciamiento social parece haber agrandado las angustias de las mujeres que son madres, evidenciando sentimientos y sufrimientos siempre presentes. En los relatos destacan la sobrecarga de las mujeres con las tareas de cuidado de los hijos y del hogar, la culpa, la soledad, el cansancio, así como el sentimiento de que no hay espacio em este contexto para "ser mujer", relacionado principalmente a cuestiones estéticas y de vanidad.(AU)


Subject(s)
Humans , Female , Pregnancy , Psychoanalysis , Women , Parenting , Pandemics , COVID-19 , Anxiety , Parent-Child Relations , Paternal Behavior , Paternity , Prenatal Care , Psychology , Psychology, Social , Relaxation , Self Care , Self Concept , Social Adjustment , Social Responsibility , Socialization , Socioeconomic Factors , Stereotyping , Stress, Physiological , Stress, Psychological , Women's Rights , Work Hours , Body Image , Burnout, Professional , Activities of Daily Living , Pregnancy , Adaptation, Biological , Family , Marriage , Child , Child Development , Child Rearing , Quarantine , Hygiene , Mental Health , Family Health , Immunization , Sex Characteristics , Universal Precautions , Employment, Supported , Cost of Illness , Confusion , Feminism , Self Efficacy , Affect , Culture , Parturition , Depression , Postpartum Period , Educational Status , Ego , Employment , Fear , Femininity , Sexism , Work-Life Balance , Frailty , Occupational Stress , Androcentrism , Freedom , Self-Neglect , Frustration , Body Dissatisfaction , Psychological Distress , Social Comparison , Teleworking , Physical Distancing , Gender Equity , Family Support , Family Structure , Guilt , Health Promotion , Household Work , Identification, Psychological , Identity Crisis , Income , Individuation , Anger , Leisure Activities , Loneliness , Love , Maternal Behavior , Maternal Welfare , Mothers
13.
São Paulo; s.n; 2023. 109 p.
Thesis in Portuguese | LILACS | ID: biblio-1451496

ABSTRACT

Introdução: A população mundial demonstra uma transição epidemiológica e a aceleração do envelhecimento. Estes fenômenos induzem cada vez mais o uso inadequado de medicamentos por idosos, os quais podem expô-los a desfechos indesejáveis, assim como se associar a diversos problemas, dentre eles a fragilidade. A complexidade da farmacoterapia pode induzir a ocorrência de competição terapêutica. Esta ocorre quando um medicamento aplicado a uma determinada doença afeta negativamente outro problema de saúde também presente, podendo piorar ou induzir o surgimento de outros agravantes em idosos. Objetivo: Caracterizar a presença de competições terapêuticas e avaliar sua associação com a síndrome de fragilidade de idosos do município de São Paulo. Método: Estudo transversal, de base populacional, realizado pela base de dados do Estudo Saúde, Bem-Estar e Envelhecimento (SABE), estudo longitudinal de múltiplas coortes sobre as condições de vida e saúde dos idosos residentes no município de São Paulo. Foi utilizada a coorte entrevistada em 2015, com 1.224 idosos (pessoas com 60 anos ou mais). A análise descritiva foi apresentada pelas médias e desvios-padrão das variáveis quantitativas e frequências relativas das variáveis qualitativas. A presença de fragilidade foi estipulada com base nos componentes definidos por Fried (2001). A presença de competições terapêuticas foi determinada por meio de evidências já definidas em trabalhos anteriores. A análise de associação foi realizada por meio de regressão logística multinomial. Resultados: 11,2% dos idosos eram frágeis e 56,1% pré-frágeis. Idosos frágeis utilizavam mais medicamentos, sendo 46,7% em polifarmácia (uso de cinco ou mais medicamentos). As classes farmacológicas mais utilizadas foram estatinas (agentes modificadores lipídicos - 28,1%), inibidores da bomba de prótons (usados em distúrbios gástricos - 23,6%) e inibidores da enzima conversora de angiotensina (anti-hipertensivos - 23,1%). A prevalência de competições terapêuticas foi de 13,2% no total de idosos e maior no grupo de idosos frágeis (18,7%, valor-p: 0,0152). Competições terapêuticas envolvendo diabetes (5,1%), doença osteoarticular (3,5%) e hipertensão (3,2%) foram as mais identificadas. A competição terapêutica mais prevalente foi a que envolvia diabetes e doença cardiovascular (4,2% no total de idosos e 6,8% em idosos frágeis), principalmente com o uso de biguanidas e inibidores da enzima conversora de angiotensina. A presença de competição terapêutica foi associada à fragilidade na análise univariada odds ratio 1,84 (IC95% 1,07-3,16) em idosos pré-frágeis e 2,43 (IC95%: 1,22-4,84) em frágeis. A chance de pré-fragilidade foi 2,41 vezes maior (IC95%: 1,04-5,61) em idosos que apresentavam duas competições terapêuticas no modelo múltiplo. Conclusão: verificou-se um número significativo de competições terapêuticas em idosos, com percentual mais elevado entre idosos frágeis. A presença de duas competições terapêuticas foi associada à presença de pré-fragilidade em idosos.


Introduction: The world population demonstrates an epidemiological transition and the acceleration of aging. Associated with the increase in the prevalence of non-communicable chronic diseases and the advancement of health technologies, these phenomena increasingly induce the inappropriate use of drugs by the elderly, which can expose them to undesirable outcomes, as well as being associated with several problems, including frailty. The complexity of pharmacotherapy can induce the occurrence of therapeutic competition. This occurs when a drug applied to a certain disease negatively affects another health problem also present, which can worsen or induce the emergence of other aggravating factors in the elderly. Objective: To characterize the presence of therapeutic competitions and evaluate their association with the frailty syndrome of the elderly in the city of São Paulo. Method: Cross-sectional, population-based study, carried out using Health, Well-being and Aging Study (SABE) database, a longitudinal study of multiple cohorts on the living and health conditions of elderly people living in the city of São Paulo. The cohort interviewed in 2015 was used, with 1,224 elderly (people aged 60 and over). Descriptive analysis was presented by means and standard deviations of quantitative variables and relative frequencies of qualitative variables. The presence of frailty was stipulated based on the components defined by Fried (2001). The presence of therapeutic competitions was determined by means of evidence already defined in previous works. Association analysis was performed using multinomial logistic regression. Results: 11.2% of the elderly were frail and 56.1% were pre-frail. Frail elderly used more medications, with 46.7% in polypharmacy (use of five or more drugs). The most used pharmacological classes were statins (lipid modifying agents - 28.1%), proton pump inhibitors (used in gastric disorders - 23.6%) and angiotensin-converting enzyme inhibitors (antihypertensives - 23.1%). The prevalence of therapeutic competitions was 13.2% in the total number of elderly and higher in the frail elderly group (18.7%, p-value: 0.0152). Therapeutic competitions involving diabetes (5.1%), osteoarticular disease (3.5%) and hypertension (3.2%) were the most identified. The most prevalent therapeutic competition was that involving diabetes and cardiovascular disease (4.2% of the total elderly and 6.8% of frail elderly), mainly with the use of biguanides and angiotensin-converting enzyme inhibitors. The presence of therapeutic competition was associated with frailty in the univariate analysis - odds ratio 1.84 (CI95% 1.07-3.16) in pre-frail elderly and 2.43 (CI95%: 1.22-4.84) in frail individuals. The odd of pre-frailty was 2.41 higher (CI95%: 1.04-5.61) in elderly people who had two therapeutic competitions in the multiple model. Conclusion: there was a significant number of therapeutic competitions in the elderly, with a higher percentage among frail elderly people. The presence of two therapeutic competitions was associated with the presence of pre-frailty in the elderly.


Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Aged , Aging , Drug Interactions , Drug-Related Side Effects and Adverse Reactions , Frailty
14.
Psicol. ciênc. prof ; 43: e243885, 2023. graf, ilus
Article in Portuguese | LILACS, INDEXPSI | ID: biblio-1422418

ABSTRACT

Esta é uma pesquisa qualitativa, em formato de ensaio, que realiza o estudo comparado de duas obras literárias, de A. Von Chamisso e E. T. A. Hoffmann, e de uma anotação do diário deste último para problematizar a repercussão de algumas formas de desestabilizações do Eu na dinâmica psíquica da neurose. O foco dos textos referidos está no fenômeno do duplo na sua forma negativizada, isto é, como o desaparecimento da imagem exterior que dá suporte ao Eu. As ausências da sombra e do reflexo são entendidas como representações metafóricas de uma alteração do Eu que engendra repercussões importantes na homeostase psíquica, sobretudo nas relações sociais de troca. Explora-se daí a menção no diário de Hoffmann de instrumentos ópticos para interrogar o uso desses aparelhos como modelos metapsicológicos na psicanálise. Salienta-se, ainda, a participação de processos de natureza estética na dinâmica psíquica do infamiliar, tomando como referência a ligação entre o conto de Hoffmann e o relato de Stendhal sobre a sua estadia em Florença.(AU)


This is a qualitative research, in essay format, which performs the comparative study of two literary works, by A. Von Chamisso and E. T. A. Hoffmann, and an annotation in the latter's diary to problematize the repercussion of some forms of destabilization of the Ego's in the psychic dynamics of neurosis. The focus of the referred texts is on the phenomenon of the double in its negative form, that is, as the disappearance of the outer image that supports the Ego. The absences of the shadow and the reflection are understood as metaphorical representations of an alteration of the Ego that generates important repercussions on psychic homeostasis, above all in social relationships of exchange. Thus, we analyze the mention of optical instruments in Hoffmann's diary to question the use of these devices as metapsychological models in psychoanalysis. Note, also, the participation of processes of aesthetic nature in the psychic dynamics of the uncanny, taking as reference the connection between Hoffmann's short story and Stendhal's account of his stay in Florence.(AU)


Este ensayo cualitativo realiza un estudio comparativo de dos obras literarias de A. Von Chamisso y de E. T. A. Hoffmann, junto con una anotación en el diario de este último para problematizar la repercusión de algunas formas de desestabilizaciones de la función del Yo en la dinámica psíquica de la neurosis. Los textos se centran en el fenómeno del doble en su forma negativa, como la desaparición de la imagen exterior que sostiene el Yo. Se entienden las ausencias de la penumbra y el reflejo como una representación metafórica de una alteración de la función del Yo que genera importantes repercusiones en la regulación psíquica, sobre todo en las relaciones de intercambio social. Se analiza la presencia en el diario de Hoffmann de instrumentos ópticos para discutir el uso de estos dispositivos como modelos metapsicológicos en psicoanálisis. Se destaca la reverberación de procesos de naturaleza estética en la dinámica psíquica de lo ominoso, tomando como referencia la conexión entre el cuento de Hoffmann y el relato de Stendhal sobre su estancia en Florencia.(AU)


Subject(s)
Humans , Psychoanalysis , Family , Literature , Narcissism , Personal Satisfaction , Personality Development , Psychology , Psychosexual Development , Psychosomatic Medicine , Regression, Psychology , Self Concept , Social Alienation , Stress, Psychological , Sublimation, Psychological , Awareness , Superego , Unconscious, Psychology , Behavioral Sciences , Behavioral Symptoms , Body Image , Letter , Consciousness , Intuition , Metaphor , Diary , Essay , Affect , Death , Narration , Comprehension , Dependency, Psychological , Depersonalization , Ego , Extraversion, Psychological , Fantasy , Problem Behavior , Metacognition , Romanticism , Graphic Novel , Folklore , Frailty , Freudian Theory , Germany , Homeostasis , Identification, Psychological , Imagination , Individuation , Inhibition, Psychological , Linguistics , Loneliness , Mental Processes , Oedipus Complex
15.
Geriatr., Gerontol. Aging (Online) ; 17: 0230034, 2023. tab
Article in English | LILACS | ID: biblio-1510610

ABSTRACT

OBJECTIVE: To investigate changes in the frailty levels of older adults in a context of high social vulnerability. METHODS: We conducted a prospective cohort study. Data were collected from 2 surveys conducted in 2015 and 2018. The frailty phenotype and sociodemographic and health characterization instruments were used. Descriptive statistical analysis was performed, including non-parametric tests, test for equality of proportions, and multivariate multinomial logistic regression. The use of the database was authorized, and the research was approved by the Ethics Committee. RESULTS: In 2015, 346 community-dwelling older adults participated in the study. After 36 months, a final sample of 223 participants was obtained. In 2015, the prevalence of non-frail, pre-frail, and frail older adults was 13.0%, 56.5%, and 30.5%, respectively. In 2018, 22.9% were non-frail, 56.0% were pre-frail, and 21.1% were frail. Higher education and better quality of life reduced the likelihood of becoming pre-frail and frail, respectively. CONCLUSION: There was a change in the pattern of frailty among socially vulnerable older adults over a 36-month period.


OBJETIVO: Verificar alterações nos níveis de fragilidade de pessoas idosas em contexto de alta vulnerabilidade social. METODOLOGIA: Trata-se de um estudo de coorte prospectivo. Foram coletados dados de dois inquéritos realizados em 2015 e 2018. Utilizou-se o Fenótipo de Fragilidade e instrumentos de caracterização sociodemográfica e de saúde. Análises estatísticas descritivas foram realizadas, incluindo testes não-paramétricos, teste de igualdade de proporções e regressão logística multinomial multivariada. O uso do banco de dados foi autorizado, e a pesquisa foi aprovada pelo Comitê de Ética. RESULTADOS: Em 2015, 346 idosos comunitários participaram do estudo. Após o período de 36 meses, obteve-se uma amostra final de 223 participantes. Em 2015, a prevalência de não frágeis, pré-frágeis e frágeis foi de 13,0, 56,5 e 30,5%, respectivamente. Em 2018, 22,9% eram não frágeis, 56,0% pré-frágeis e 21,1% frágeis. Maior escolaridade e qualidade de vida diminuíram a probabilidade de se tornar pré-frágil e frágil, respectivamente. CONCLUSÃO: Observou-se uma mudança do padrão de fragilidade entre idosos socialmente vulneráveis no período de 36 meses.


Subject(s)
Humans , Male , Female , Aged , Frail Elderly/statistics & numerical data , Social Determinants of Health/trends , Frailty , Social Vulnerability , Prospective Studies , Cohort Studies , Follow-Up Studies , Sociodemographic Factors
16.
Psicol. ciênc. prof ; 43: e243764, 2023. graf
Article in Portuguese | LILACS, INDEXPSI | ID: biblio-1422423

ABSTRACT

A população em situação de rua (PSR), em seu cotidiano, se relaciona com diferentes pessoas, grupos e/ou coletivos ligados à execução das políticas públicas, às organizações não governamentais, familiares ou a membros da sociedade civil. Pensar nessas dinâmicas de trabalho, cooperação e auxílio remete a pensar sobre uma rede de apoio que constrói estratégias com essa população. Tendo presente essas problematizações, este estudo teve como objetivo analisar as narrativas das pessoas em situação de rua sobre como é produzida sua rede de apoio. Para tanto, foi realizado um estudo qualitativo, de orientação etnográfica, sendo utilizada a observação participante, registros em diário de campo e entrevistas narrativas. Participaram seis pessoas em situação de rua que recebem alimentação ofertada por projetos sociais em uma cidade do interior do Rio Grande do Sul. Os dados produzidos foram analisados a partir da Análise Temática. As análises expressam as especificidades das narrativas das trajetórias de vida associadas à chegada às ruas e à composição de uma rede de apoio na rua. Ao conhecer como se produz e opera essa rede de apoio, a partir das narrativas das pessoas em situação de rua, problematiza-se a complexidade dessa engrenagem e o desafio de produzir ações integradas entre as diferentes instâncias da rede. Nisso, destaca-se a potencialidade de práticas que levem conta à escuta, ao diálogo e à articulação na operacionalização de políticas públicas atentas às necessidades dessa população.(AU)


The street population, in their daily lives, relates to different people, groups and/or collectives linked to the execution of public policies, to non-governmental organizations, family members, or to members of civil society. Thinking about these dynamics of work, cooperation, and assistance leads to thinking about a support network that builds strategies with this population. Having these problematizations in mind, this study aims to analyze the narratives of homeless people about how their support network is produced. To this end, a qualitative study was carried out, with ethnographic orientation, using participant observation, records in a field diary, and narrative interviews. Participated in the research six homeless people who receive food offered by social projects in a municipality in the interior of Rio Grande do Sul. The data produced were analyzed using the Thematic Analysis. The analyzes express the specifities of the narratives of life trajectories associated with the arrival on the streets and the composition of a support network on the street. By knowing how the support network is produced and operated, the complexity of this gear and the challenge of producing integrated actions between the different instances of the network are problematized. Thus, it highlights the potential of practices that consider listening, dialogue, and articulation in the operationalization of public policies that are attentive to the needs of this population.(AU)


Las personas en situación de calle en su cotidiano se relacionan con distintas personas, grupos y/o colectivos, que están vinculados a la ejecución de políticas públicas, organizaciones no gubernamentales, familiares o miembros de la sociedad civil. Pensar en estas dinámicas de trabajo, cooperación y ayuda nos lleva a una red de apoyo que construye estrategias con estas personas. Teniendo en cuenta esta problemática, este estudio tiene como objetivo analizar las narrativas de las personas en situación de calle acerca de cómo se produce su red de apoyo. Con este fin, se realizó un estudio cualitativo, etnográfico, utilizando observación participante, registros de diario de campo y entrevistas narrativas. Este estudio incluyó a seis personas en situación de calle que reciben alimentos ofrecidos por proyectos sociales en una ciudad del interior de Rio Grande do Sul (Brasil). Se utilizó el Análisis Temático. Los análisis expresan las especificidades de las narrativas de las trayectorias de vida asociadas con la llegada a las calles y la composición de una red de apoyo en la calle. Al saber cómo se produce y opera la red de apoyo, a partir de las narrativas de las personas en la calle, se problematizan la complejidad de este equipo y el desafío de producir acciones integradas entre las diferentes instancias de la red. Destaca el potencial de las prácticas que tienen en cuenta la escucha, el diálogo y la articulación en la implementación de políticas públicas que estén atentas a las necesidades de esta población.(AU)


Subject(s)
Humans , Male , Adult , Middle Aged , Aged , Public Policy , Ill-Housed Persons , Community Support , Poverty , Primary Health Care , Psychology , Relief Work , Safety , Social Change , Social Conditions , Social Isolation , Social Support , Socialization , Socioeconomic Factors , Sociology , Tobacco Use Disorder , Unemployment , Violence , Emergency Feeding , Health Surveillance , Occupational Risks , Illicit Drugs , Charities , Hygiene , Disease , Acquired Immunodeficiency Syndrome , Hunger , Crack Cocaine , Clothing , Interview , Community Health Services , Community Participation , Substance-Related Disorders , Criminology , Shelter , Disaster Vulnerability , Health Risk , Personal Autonomy , Gift Giving , Human Rights Abuses , Alcoholism , Economics , User Embracement , Existentialism , Family Conflict , Drug Users , Alcoholics , Social Stigma , Emergency Shelter , Social Discrimination , Social Marginalization , Food Deprivation , Frailty , Freedom , Self-Neglect , Solidarity , Life Course Perspective , Housing Instability , Social Status , Citizenship , Family Support , Health Services Needs and Demand , Human Rights , Income , Mental Disorders
17.
São Paulo; s.n; 2023. 125 p.
Thesis in Portuguese | LILACS | ID: biblio-1452175

ABSTRACT

Introdução: A anorexia do envelhecimento (AE) é considerada uma síndrome multicausal que desregula e reduz o consumo alimentar e aumenta o risco de desnutrição. O questionário Simplified Nutritional Appetite Questionnaire (SNAQ) foi proposto para monitorar o apetite. Considerando a importância da anorexia e apetite como indicadores de desnutrição, a possibilidade do uso do SNAQ em serviços de saúde, para atendimento de pacientes idosos, pode ser uma estratégia importante na prevenção de agravos a saúde. Objetivos: 1-Traduzir e adaptar culturalmente o questionário de rastreio de anorexia do envelhecimento SNAQ para português do Brasil; 2- Identificar a força das associações entre perda de apetite, fragilidade e fatores psicossociais em pessoas idosas; 3-Verificar a aplicabilidade clínica do critério GLIM (identificação de desnutrição proposto por Global Leadership Initiative on Malnutrition) para pessoas idosas que vivem na comunidade, incluindo o SNAQ nesta avaliação. Métodos: a presente tese foi desenvolvida no formato de três artigos científicos. Artigo 1 (A1)- Versão em português do questionário SNAQ: tradução e adaptação cultural - desenvolvido em cinco etapas: tradução, retrotradução, avaliação semântica, compreensão de conteúdo, pré teste e desenvolvimento da versão final; Artigo 2 (A2)- Associação entre perda de apetite, fragilidade e fatores psicossociais em pessoas idosas da comunidade - análise transversal na coorte MiMiCS-FRAIL sediada em Jundiaí, São Paulo, Brasil. Foram testados modelos de associação entre a perda de apetite (variável dependente - SNAQ) e a fragilidade (FI-36), sintomas depressivos (GDS) e estado socioeconômico (proxies: etnia e escolaridade) utilizando modelos de regressão logística (simples e múltiplo); Artigo 3 (A3)- Aplicabilidade do critério GLIM em pessoas idosas da comunidade no Brasil: dados do estudo MiMiCS-FRAIL - utilizando uma amostra da mesma coorte do A2, foram desenvolvidas 21 combinações dos critérios fenotípicos (perda de peso não intencional-PP, baixo Índice de Massa Corpórea-IMC e massa muscular reduzida - circunferência de panturrilha-CP) e etiológicos (redução do consumo alimentar-SNAQ e carga de doença-Índice de Comorbidade de Charlson-ICC) para as análises de melhor combinação GLIM. Estas combinações do GLIM foram comparadas com a classificação da MAN completa ("semi-padrão ouro" para desnutrição). Para tal, foram analisadas curvas ROC. As melhores combinações, conforme sensibilidade (S) e especificidade (E) foram testadas em relação a associação a fragilidade (FI-36) e sarcopenia (SARC-F). Resultados principais: A1-A versão brasileira do SNAQ manteve o significado em relação a original, requerendo modificações como inclusão de outras opções em respostas e definição do significado de refeição; A2-Os modelos de regressão múltiplos indicaram associação significativa entre perda de apetite e as seguintes variáveis independentes: idade (OR=1,11; IC95%=1,03-1,20, p<0,01), ser de etnia não branca (OR=6,47; IC95%=1,63-25,58; p<0,01) e apresentar sintomas depressivos (OR=8,38; IC95%=2,31-30,47, p<0,01); A3-A melhor combinação para identificação da desnutrição foi o GLIM1 - IMC e SNAQ (AUC=0,98; IC95%=0,97-0,99; S=1,0; E=0,96), que identificou 4,2% de desnutrição nesta amostra. Em relação a fragilidade, o GLIM20 - CP, PP, SNAQ e ICC, teve significativamente o melhor valor de beta ajustado e menor IC (ß ajustado=0,050; s=0,01; p=0,01; IC95%=0,010-0,080). Não houve associação signficativas entre GLIM e sarcopenia. Conclusões: O questionário SNAQ - versão brasileira demonstra associações com outros quadros clínicos e psicossociais que inteferem na saúde de pessoas idosas; sua fácil aplicabilidade e baixo custo indicam a possibilidade de compor o diagnósticos de desnutrição por meio do critério GLIM na nossa amostra, composta por pessoas idosas que vivem independentemente.


Background: The Anorexia of aging (AA) is a multicausal syndrome that affects food intake and decreases food consumption, leading to increased risk of malnutrition. The Simplified Nutritional Appetite Questionnaire (SNAQ) was developed to monitor appetite. Anorexia and and appetite loss are initial aspects of malnutrition. So, the possibility to use the SNAQ in healthcare services for older adults evaluation might be an important strategy to prevent health negative outcomes. Objectives: 1- To translate and culturally adapt the anorexia of aging questionnaire SNAQ for Brazilian Portuguese language; 2-To identify the association between appetite loss, frailty and psychosocial factors in a group of community-dweling older adults; 3-To verify the applicability of the GLIM criteria to identify malnutrition in community-dwelling older adults, including the SNAQ in this evaluation. Methods: this thesis was developed in a three scientific article format. Article 1 (A1) - Portuguese version of the SNAQ questionnaire: translation and cultural adaptation - developed in five steps: translation, backtranslation, semantic evaluation, comprehension of content; pre-test and the SNAQ final version development; Article 2 (A2) - The association between appetite loss, frailty and psychosocial factors in community-dwelling older adults - cross-sectional analysis from the MiMiCS-FRAIL cohort located in Jundiaí, São Paulo, Brazil. Association models tested appetite loss (SNAQ - dependent variable) against frailty (FI-36), depressive symptoms (GDS) and socialeconomic variables (schooling and ethnicity as proxies) through logistic regression models (single and multiple); Article 3 (A3) - Applicability of GLIM criteria in community-dwelling older adults from Brazil: data from MiMiCS-FRAIL cohort - It were tested 21 GLIM combinations from phenotypic (unintentional weight loss-WL, low Body Mass Index-BMI and reduced muscle mass - calf circunference-CP) and etiological (reduced food intake-SNAQ and disease burden- Charlson Comorbidity Index-CCI) criteria for best GLIM combinations to this sample. Each combination was tested against a tool indicated as a "semi-gold standard" (the Mini-Nutritional Assessment- full form; MNA-FF). Therefore ROC curves were analysed; the best combinations, according to sensibility (SE) and specificity (SP), were tested in regression models to verify the association with frailty (FI-36) and sarcopenia (SARC-F). Main Results: A1 - SNAQ Portuguese version maintained the original meaning and referral; It was required some modifications as inclusion of other options to the answers of some questions and a meal definition; A2-The multiple regression models showed association between appetite loss and age (OR=1.11; 95%CI=1.03-1.20, p<0.01), being non-white (OR=6.47; 95%CI=1.63-25.58; p<0.01) and presence of depressive symptoms (OR=8.38; 95%CI=2.31-30.47, p<0.01); A3-GLIM1-BMI and SNAQ was the best combination for malnutrition (AUC=0.98; 95%CI=0.97-0.99; SE=1,0; SP=0.96) and identified 4.2% of malnutrition on this sample. For frailty, GLIM20 - CC, WL, SNAQ and CCI had the best adjusted beta and lowest CI (Adj. ß=0.050; SE=0.01; p=0.01; 95%CI=0.010-0.080). There was no significant association with sarcopenia. Conclusions: Portuguese version of the SNAQ questionnaire demonstrates association to other clinical and psychosocial aspects in older adults; its easy and low-cost applicability demonstrate the possibility to be included in GLIM criteria for malnutrition evaluation in our sample, which was composed by community-dwelling older adults.


Subject(s)
Appetite , Aged , Aging , Anorexia , Nutritional Status , Malnutrition , Frailty
18.
Curitiba; s.n; 20221206. 168 p. ilus, graf, mapas, tab.
Thesis in Portuguese | LILACS, BDENF | ID: biblio-1425727

ABSTRACT

Resumo: Trata-se de estudo quantitativo de corte transversal, que objetivou analisar a relação entre internação hospitalar e ocorrência de delirium em idosos na condição de fragilidade. Este estudo integra o projeto de pesquisa intitulado "Fragilidade física e os desfechos clínicos, funcionais, nutricionais e a demanda de cuidados em idosos hospitalizados", aprovado pelo Comitê de Ética em Pesquisa em Seres Humanos do Setor de Ciências da Saúde da Universidade Federal do Paraná, parecer no 4.985.540 e pelo Comitê de Ética em Pesquisa em Seres Humanos da Secretaria Municipal de Saúde de Curitiba, parecer no 5.055.260. O estudo foi desenvolvido no Hospital Municipal do Idoso Zilda Arns, Curitiba, Paraná. Os participantes foram idosos, com idade = 60 anos, hospitalizados para tratamento clínico e/ou cirúrgico nas unidades de internação. Calculou-se o tamanho mínimo da amostra (n=300 idosos) utilizando-se o período pré-pandêmico, ano de 2019, como recorte temporal, no qual ocorreram 7.254 internações, sendo 4.146 = 60 anos. Os dados foram coletados por meio de questionários sociodemográfico e clínico e testes que compreendem o fenótipo da fragilidade física e o Confusion Assessement Method no período de março a julho de 2022. Realizaram-se análises descritivas para as variáveis sociodemográficas, internação, laboratoriais, histórico médico e estimaram-se as odds ratio ajustadas para as variáveis fragilidade e delirium. Dos 320 idosos avaliados, o delirium foi evidenciado em 67 (21,14%) no momento da admissão. Houve predomínio de idosos pré-frágeis (n=157; 49%), seguidos dos frágeis (n=116; 36,25%) e não frágeis (n=44; 13,75%). A proporção de idosos frágeis que apresentaram delirium foi de 71,64% e entre os pré frágeis 28,36% (p<0,0001). O modelo preditivo indicou associação entre a ocorrência de delirium e fragilidade (OR 1,22; IC95% 1,07 a 1,38), idade > 80 anos (OR 1,14; IC95% 1,01 a 1,32), diagnóstico de epilepsia (OR 1,38; IC95% 1,09 a 1,76) e diagnóstico de demência (OR 1,58; IC95% 1,37 a 1,82). Outrossim, encontrou-se associação entre a ocorrência de delirium e valores de Proteína C-Reativa acima dos valores de referência (OR 3,13; IC95% 1,10 a 11,36) e história prévia de acidente vascular encefálico (OR 1,14; IC95% 1,03 a 1,26). Durante a internação hospitalar, idosos frágeis mostraram maior probabilidade de desenvolverem delirium. Pré-fragilidade e fragilidade foram condições prevalentes no ambiente hospitalar, tornando-se importante seu rastreio e gerenciamento durante o internamento. Houve maior propensão ao desenvolvimento de delirium em idosos acima de 80 anos. Medidas de prevenção ao delirium devem ser implementadas nessa faixa etária minimizando-se as consequências deletérias. Destaca-se a importância da realização de anamnese que busque a identificação do diagnóstico de demência, epilepsia e acidente vascular encefálico prévio para ampliar as medidas de prevenção do delirium pela equipe multiprofissional.


Abstract: This is quantitative and cross-sectional study whose objective was to analyze the relationship between hospitalization and occurrence of delirium in frail older adults. This study is part of the research project entitled "Physical frailty, clinical, functional and nutritional outcomes and care demand in hospitalized older adults", approved by the Committee of Ethics in Research with Human Beings from the Health Sciences Sector of the Federal University of Paraná with opinion No. 4,985,540, and by its counterpart belonging to the Curitiba Municipal Health Department with opinion No.5,055,260. The study was developed in the Zilda Arns Municipal Hospital for Older Adults, Curitiba, Paraná. The participants were older adults aged = 60 years old and admitted for clinical and/or surgical treatment in the hospitalization units. Sample size (n=300 older adults) was calculated considering the pre-pandemic period (2019) as time frame, in which there were 7,254 hospitalizations, with 4,146 patients aged = 60 years old. The data were collected by means of sociodemographic and clinical questionnaires and of tests that include the physical frailty phenotype and the Confusion Assessment Method from march to July 2022. Descriptive analyses were performed for the sociodemographic, hospitalization, laboratory and medical history variables, and the adjusted odds ratios were estimated for the frailty and delirium variables. Among the 320 older adults evaluated, delirium was evidenced in 67 (21.14%) at admission. There was predominance of pre-frail aged individuals (n=157; 49%), followed by frail (n=116; 36.25%) and non-frail (n=44; 13.75%). The percentage of frail older adults that presented delirium was 71.64% and, for the prefrail, it was 28.36% (p<0.0001). The predictive model indicated an association between occurrence of delirium and frailty (OR: 1.22; 95%CI: 1.07-1.38), age > 80 years old (OR: 1.14; 95%CI: 1.01-1.32), epilepsy diagnosis (OR: 1.38; 95%CI: 1.09-1.76) and dementia diagnosis (OR: 1.58; 95%CI: 1.37-1.82). Furthermore, an association was also found between occurrence of delirium and Reactive C Protein above the reference values (OR: 3.13; 95%CI: 1.10-11.36) and previous stroke history (OR: 1.14; 95%CI: 1.03-1.26). During hospitalization, frail older adults were more likely to develop delirium. Pre-frailty and frailty were prevalent conditions in the hospital environment, with their screening and management becoming important during hospitalization. Propensity to develop delirium was higher in older adults aged over 80 years old. Measures to prevent delirium should be implemented in this age group, minimizing the deleterious consequences. The importance of performing anamnesis seeking to identify previous dementia, epilepsy and stroke diagnoses is emphasized, in order to expand the measures to prevent delirium by the multiprofessional team.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Aged , Cross-Sectional Studies , Delirium , Frailty , Hospitalization
19.
Poblac. salud mesoam ; 19(2)jun. 2022.
Article in Spanish | LILACS, SaludCR | ID: biblio-1386958

ABSTRACT

Resumen Introducción: la fragilidad es un indicador del estado de salud en la vejez y un síndrome clínico común en adultos mayores; conlleva un elevado riesgo de resultados deficientes de salud que incluyen caídas, incidentes de discapacidad, hospitalización y mortalidad. Este estudio tuvo como objetivo identificar las diferentes trayectorias de la fragilidad y los factores relacionados con esta entre adultos mayores mexicanos a lo largo del tiempo. Metodología: los datos provienen de un panel de cuatro rondas compuesto por adultos mayores mexicanos y desarrollado de 2001 a 2015 por el Estudio Nacional de Salud y Envejecimiento en México (ENASEM). La fragilidad es la acumulación de déficits a partir de un índice de fragilidad. Se aplicó un análisis multinivel, utilizando modelos jerárquicos para conocer los cambios de trayectorias de fragilidad y qué factores se relacionan con ella. Resultados: ser mujer mayor, viuda y tener un bajo nivel educativo fueron factores de riesgo para un índice de fragilidad alto y una menor satisfacción financiera o realizar actividades en el hogar tienen efectos adversos. Conclusiones: se halló una prevalencia de la fragilidad según la proporción de déficits que poseen los individuos y sus primordiales componentes asociados. Se requiere mejorar las condiciones socioeconómicas de salud en fases previas a la vejez con miras a evitar la presencia de fragilidad en el futuro.


Abstract Introduction: Frailty is an indicator of health status in old age and a common clinical syndrome in older adults that carries an increased risk of poor health outcomes, including falls, incidents of disability, hospitalization, and mortality. This study aimed to identify the different trajectories of frailty and the factors related to frailty among Mexican older adults over time. Methods: Data are from a four-wave panel composed of older Mexican adults from 2001 to 2015 of the Mexican Health and Aging Study (MHAS). Frailty is the accumulation of deficits using a frailty index. A multilevel analysis, using hierarchical models, was applied to know the changes of frailty trajectories and what factors are related to it. Results: Being female, older, being widowhood, and having a lower level of education were risk factors for having a high frailty index and lower financial satisfaction doing activities at home have adverse effects. Conclusion: The findings of this work present information about the prevalence of frailty considering the proportion of deficits that individuals possess and their main associated components in older Mexican adults. It is necessary to improve socioeconomic health conditions in phases before old age to avoid developing frailty in the future.


Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Aging , Frailty , Longitudinal Studies , Mexico
20.
São Paulo med. j ; 140(3): 356-365, May-June 2022. tab, graf
Article in English | LILACS | ID: biblio-1377379

ABSTRACT

ABSTRACT CONTEXT: Dyspnea is a symptom present in several chronic diseases commonly seen among older adults. Since individuals with dyspnea tend to stay at rest, with consequently reduced levels of physical activity, they are likely to be at greater risk of developing frailty, especially at older ages. DESIGN AND SETTING: Cross-sectional study at community level, Brazil. OBJECTIVE: To analyze the relationships between self-reported dyspnea, health conditions and frailty status in a sample of community-dwelling older adults. METHOD: Secondary data from the follow-up of the Frailty in Brazilian Elderly (FIBRA) study, involving 415 community-dwelling older adults (mean age: 80.3 ± 4.68 years), were used. The variables analyzed were sociodemographic characteristics, reported dyspnea, clinical data and frailty phenotype. Associations between dyspnea and other variables (age, sex, education and body mass index) were verified through the crude (c) and adjusted (a) odds ratios. RESULTS: The prevalence of dyspnea in the entire sample was 21.0%. Dyspnea was more present in individuals with pulmonary diseases, heart disease, cancer and depression. Older adults with multimorbidities (adjusted odds ratio, ORa = 2.91; 95% confidence interval, CI = 1.41-5.99) and polypharmacy (ORa = 2.02; 95% CI = 1.15-3.54) were more likely to have dyspnea. Those who reported dyspnea were 2.54 times more likely to be frail (ORa = 2.54; 95% CI = 1.08-5.97), and fatigue was their most prevalent phenotype component. CONCLUSION: Dyspnea was associated with different diseases, multimorbidities, polypharmacy and frailty. Recognizing the factors associated with dyspnea may contribute to its early identification and prevention of its negative outcomes among older adults.


Subject(s)
Humans , Aged , Frailty/epidemiology , Brazil/epidemiology , Geriatric Assessment , Cross-Sectional Studies , Frail Elderly , Dyspnea/epidemiology , Independent Living , Self Report
SELECTION OF CITATIONS
SEARCH DETAIL