Burden of informal caregivers of patients with pressure ulcers in a primary care setting.

OBJECTIVE: The aim of this study was to assess the burden experienced by the caregivers of patients with pressure ulcers (PUs) and the variables that might contribute to its manifestation. METHOD: This cross-sectional study enrolled primary care patients and their informal caregivers. To assess the burden experienced by the caregivers, the Zarit Burden Interview, short-form version (ZBI) was used. This instrument was self-applied by the caregiver. We assessed PU status, demographic and clinical variables. The Kolmogorov-Smirnov test was used to test for normality, the Spearman's rank correlation coefficient (rs) test to assess the correlation between variables, and paired Student's t-test to compare the difference between the groups, with and without burden. RESULTS: Patients (n=54) were older, mean age 82±9.92 years, mainly female (64.8%), with an average of 1.47±0.73 PUs. The informal caregivers (n=46) were: primarily female (84.8%); mean age 57.13±11.87 years; 20.8% were unemployed; 14.6% were retired; 60.4% were the patient's offspring and 14.8% were spouses. Informal caregivers reported that they spent on average 10.20±8.10 hours each day taking care of their patient. The caregivers' (n=46) ZBI score was, on average, 14.63±9.60, and 37.0% reported a high burden. We did not find any correlation between caregiver burden and number of PUs (p=0.148), number of hours spent taking care of the patient (p=0.364) and age of the caregiver (p=0.259). CONCLUSION: Over one-third of the informal caregivers of the PU patients in this study reported a high burden. We did not find any correlation with the variables analysed, probably due to the small sample size.

Ingestão cáustica pediátrica em Minas Gerais ­ Brasil: um estudo observacional do Hospital Universitário de Uberlândia / Pediatric caustic ingestion in Minas Gerais ­ Brazil: an observational study at the University Hospital of Uberlândia

Introdução: Crianças menores de cinco anos são as principais vítimas de acidentes por ingestão de cáusticos, assim considerando a epidemiologia brasileira e dos riscos à exposição desses agentes ressalta-se a importância deste estudo que objetiva realizar uma análise descritiva dos casos de acidentes cáusticos em pacientes pediátricos atendidos em um hospital universitário de Minas Gerais. Método: Este é um estudo transversal descritivo, de caráter quantitativo, a partir dos dados obtidos de prontuários de pacientes pediátricos (0-13 anos) atendidos por ingestão de substâncias cáusticas, no Hospital de Clínicas da Universidade Federal de Uberlândia (Minas Gerais, Brasil). Resultados: Foram levantados 132 prontuários de crianças atendidas por ingestão de substâncias cáusticas de janeiro de 2011 a abril de 2018. Os acidentes acometeram crianças na faixa etária de 08 meses a 12 anos, sendo que 82,60% dos casos ocorreram em ambiente domiciliar. Entre as principais substâncias ingeridas estão os produtos de limpeza, quanto à sua composição química predominaram soda cáustica, hipoclorito de sódio e amoníaco. A endoscopia digestiva alta (EDA) foi realizada em 104 pacientes. Quase 13% das crianças apresentaram estenose esofágica e necessitaram de dilatação esofágica. No período estudado, foram realizados 296 procedimentos de dilatações, com média de 17,4 procedimentos por paciente. Discussão: Considerando que os acidentes cáusticos são prevalentes em crianças menores de cinco anos e em ambiente domiciliar, as principais substâncias ingeridas são aquelas de caráter alcalino, que causam lesão no trato respiratório e gastrointestinal, sendo a principal consequência a estenose esofágica. Ademais, não há protocolos bem definidos para o manejo e a condução de pacientes que fizeram a ingestão dessas substâncias. As principais limitações do estudo foram o preenchimento incompleto dos prontuários analisados e os trâmites burocráticos para o acesso aos mesmos. Conclusão: Predominaram os acidentes cáusticos domiciliares e em crianças menores de 2 anos, o que implica a necessidade de ações educativas e preventivas. [au]

Introduction: Children under five years old are the principal victims of accidents caused by the ingestion of caustics, so considering Brazilian epidemiology and the risks of exposure to these agents the importance of this study is emphasized. This study aims to carry out a descriptive analysis of cases of caustic accidents in pediatric patients treated in a university hospital in Minas Gerais. Method: This is a descriptive cross-sectional study, with a quantitative character, based on data obtained from medical records of pediatric patients (0-13 years old) treated for ingestion of caustic agents at the Hospital of the Federal University of Uberlândia (Minas Gerais, Brazil). Results: We collected 132 medical records of children treated for ingestion of caustic substances from January 2011 to April 2018. The accidents affected children aged between 8 months and 12 years, with 82.60% of the cases occurring in the home environment. Among the main substances ingested are cleaning products, as for their chemical composition, caustic soda, sodium hypochlorite, and ammonia predominated. Upper digestive endoscopy (UGE) was performed in 104 patients. Almost 13% of the children had esophageal strictures and required esophageal dilation. During the study period, 296 dilatation procedures were performed, with an average of 17.4 procedures per patient. Discussion: Considering that caustic accidents are prevalent in children under five years of age and the home environment, the main substances ingested are those of an alkaline nature, which cause injury to the respiratory and gastrointestinal tract, the main consequence being esophageal stenosis. Furthermore, there are no well-defined protocols for the management of patients who have ingested these substances. The main limitations of the study were the incomplete filling of the medical records analyzed and the bureaucratic procedures for accessing them. Conclusion: Caustic accidents predominated in children under two years old in the home environment, which implies the need for educational and preventive actions. [au]