Investigating the Effect of a Structured Intervention on the Development of Self-Care Behaviors With Arteriovenous Fistula in Hemodialysis Patients

This study aimed to assess the effectiveness of a structured intervention on the frequency of self-care behaviors with arteriovenous fistula (AVF) by patients on hemodialysis. This is a quasi-experimental study with pre- and post-measurements. Participants were assigned to an intervention group (IG) (n=48) or to a control group (CG) (n=41). IG patients were subject to a structured intervention on self-care with AVF (SISC-AVF) consisting of both a theoretical and a practical part. After SISC-AVF application, patients in the IG showed better overall self-care behaviors with AVF than patients in the CG (79.2% and 91.4%, respectively, p<.001) as well as better self-care concerning both the management of signs and symptoms (90.1% and 94.4% respectively, p=.004) and the prevention of complications (72.7% and 89.5%, respectively, p<.001). The study results suggest that the SISC-AVF had positive effects on patients in the IG.info:eu-repo/semantics/publishedVersio

Resiliência em cuidadores familiares de idosos com doença de Alzheimer

Introduction: Resilience is the ability of individuals or groups to overcome adversity without presenting physical or mental disorders, or even become better against unfavorable conditions. It is seen as being essential to obtain a healthier lifestyle. Objectives: evaluate factors associated to resilience in family caregivers of elderly with Alzheimer's disease. Method: This is a cross-sectional study, descriptive, comparative, correlational quantitative character. Were interviewed 66 family caregivers of elderly with Alzheimer's disease (AD), followed in a teaching clinic at a public university. The group was divided into three subgroups of caregivers: DA mild, moderate and advanced. As a control group, were interviewed 30 family caregivers of people with diabetes, DM group, followed in a primary care unit in São Carlos. Results: The majority of caregivers in both groups were women, wives or daughters, with an average age of 56 years (AD) and 53 years (DM). In terms of schooling, the DA group reached an average of 8.0 years and the DM group had an average of 5.3 years of schooling. Most caregivers of all groups / subgroups showed moderate levels of resilience. Multiple linear regression analysis showed that some factors contribute to the increase of resilience in the AD group, namely: overhead, number of days devoted to the care, parentage spouse degree, good self perception of physical health and the practice of other activities. As for the DM group, the significant variables were only depression and age. Other factors were related to resilience, such as stress, overload and other variables. Caregivers of elderly patients with AD presented higher levels of anxiety, stress, overload and depression compared to caregivers of people with diabetes. Conclusions: caring relatives with chronic diseases, neurodegenerative or not, creates anxiety, stress, depression and overload. These variables are more pronounced in caregivers of elderly patients with AD.Financiadora de Estudos e ProjetosIntrodução: Resiliência é a capacidade de indivíduos ou grupos de superarem adversidades sem apresentarem transtornos físicos ou mentais, ou até mesmo tornarem-se melhores frente a condições desfavoráveis. É vista como sendo essencial para a obtenção de uma vida saudável. Objetivos: avaliar fatores associados à resiliência em cuidador familiar de idosos com doença de Alzheimer. Método: Trata-se de estudo de corte transversal, descritivo, comparativo, correlacional de caráter quantitativo. Foram entrevistados 66 cuidadores familiares de idosos com diagnóstico de doença de Alzheimer (DA), acompanhados em um ambulatório de ensino em uma universidade pública. O grupo foi dividido em três subgrupos de cuidadores: DA leve, moderada e avançada. Como grupo comparativo, foram entrevistados 30 cuidadores familiares de pessoas com diabetes, grupo DM, acompanhados em unidade de atenção primária no município de São Carlos. Resultados: a maioria dos cuidadores dos dois grupos eram mulheres, esposas ou filhas, com média de idade de 56 anos (DA), e 53 anos (DM). Quanto à escolaridade, o grupo DA atingiu média de 8,0 anos e o grupo DM obteve média de 5,3 anos de estudo. A maioria dos cuidadores de todos os grupos/subgrupos apresentou níveis moderados de resiliência. As análises de regressão linear múltipla mostraram que alguns fatores contribuem para o aumento de resiliência no grupo DA, sendo estes: sobrecarga, número de dias dedicados ao cuidado, grau de parentesco cônjuge, boa auto percepção de saúde física e a prática de outras atividades. Quanto ao grupo DM, as variáveis significativas foram apenas depressão e idade. Outros fatores foram relacionados à resiliência, tais como estresse, sobrecarga e outras variáveis. Cuidadores de idosos com DA apresentaram maiores níveis de ansiedade, estresse, sobrecarga e depressão comparados a cuidadores de pessoas com diabetes. Conclusões: cuidar de familiares com doenças crônicas, neurodegenerativas ou não, gera ansiedade, estresse, depressão e sobrecarga. Essas variáveis encontram-se mais acentuadas em cuidadores de idosos com DA

Resilience of family caregivers of elderly with Alzheimer

Resilience is the capacity that people have to cope positively with adversities. A cross-sectional, quantitative study, that aimed to assess factors associated with the resilience of family caregivers of elderly with Alzheimer’s disease. Sixty-six caregivers composed the sample, who were accompanied in a neurology ambulatory. Most caregivers presented moderate resilience. Linear regression showed that some factors interfered with caregivers’ resilience, being those: overload, the increment of days dedicated to caregiving, the level of kinship daughter-in-law/son-in-law or spouse, and practice of other activities besides caregiving. The findings can be useful in care-related areas, once we identified variables interfering in resilience, and those can be worked and improved to benefit the caregiver and the patient

Subjective memory complaints associated with depression and cognitive impairment in the elderly: A systematic review

The aging process can be accompanied by a slight decline in cognitive functioning, and subjective memory complaints (SMC) appear to be common in the elderly population. OBJECTIVE: To determine whether SMC is associated with cognitive loss or depression and can predict dementia. METHODS: A systematic review of the literature was conducted. Articles were selected on the following databases, LILACS, SCOPUS, SCiELO, PubMed and Web of Science from August to October 2013. Article selection was based on inclusion and exclusion criteria. Studies published between 2010 and 2013, written in English, Spanish or Portuguese, involving populations 65 years or older, were included. Reviews were excluded. RESULTS: After the selection, a summary of the 20 articles retrieved was carried out. Of the total articles retrieved, fifteen were cross-sectional studies and five were longitudinal studies. Most of the cross-sectional studies associated SMC with depression, objective cognitive impairment and anxiety. The emergence of dementia in people with SMC was evidenced in longitudinal studies. Albeit less frequently, SMC were also associated with reduced quality of life, impairment in Activities of Daily Living (ADL), emergence of neuropsychiatric symptoms, lower hippocampal volume, amygdala volume reduction, increased activation of the left temporal, bilateral thalamus, caudate and posterior cingulate, and with the occurrence of ApoE &#949;4. CONCLUSION: SMC may be associated with changes in mood and/or cognition, and its occurrence appears to increase the likelihood of dementia. In order to further our understanding of the topic, future studies should consider the recruitment of representative samples with control groups and longitudinal designs

Subjective memory complaints associated with depression and cognitive impairment in the elderly: A systematic review

The aging process can be accompanied by a slight decline in cognitive functioning, and subjective memory complaints (SMC) appear to be common in the elderly population. OBJECTIVE: To determine whether SMC is associated with cognitive loss or depression and can predict dementia. METHODS: A systematic review of the literature was conducted. Articles were selected on the following databases, LILACS, SCOPUS, SCiELO, PubMed and Web of Science from August to October 2013. Article selection was based on inclusion and exclusion criteria. Studies published between 2010 and 2013, written in English, Spanish or Portuguese, involving populations 65 years or older, were included. Reviews were excluded. RESULTS: After the selection, a summary of the 20 articles retrieved was carried out. Of the total articles retrieved, fifteen were cross-sectional studies and five were longitudinal studies. Most of the cross-sectional studies associated SMC with depression, objective cognitive impairment and anxiety. The emergence of dementia in people with SMC was evidenced in longitudinal studies. Albeit less frequently, SMC were also associated with reduced quality of life, impairment in Activities of Daily Living (ADL), emergence of neuropsychiatric symptoms, lower hippocampal volume, amygdala volume reduction, increased activation of the left temporal, bilateral thalamus, caudate and posterior cingulate, and with the occurrence of ApoE ε4. CONCLUSION: SMC may be associated with changes in mood and/or cognition, and its occurrence appears to increase the likelihood of dementia. In order to further our understanding of the topic, future studies should consider the recruitment of representative samples with control groups and longitudinal designs

Effects of demographic and clinical character on differences in self‐care behavior levels with arteriovenous fistula by hemodialysis patients: An ordinal logistic regression approach

Introduction: Hemodialysis (HD) patients should be trained to develop selfcare behaviors in order to prevent and preserve their arteriovenous fistula (AVF). The aim of this study was identifying the factors that affect the levels of self-care behavior with AVF by HD patients. Methods: A cross-sectional study was conducted involving 89 patients. Results: Self-care levels were negatively affected by patients' location (Azores) and positively affected by marital status, education, employment, AVF duration, and absence of complications with the AVF. Concerning the management of signs and symptoms, self-care levels were negatively affected by patients' location. Regarding prevention of complications, self-care levels were negatively affected by age and marital status and positively affected by marital status, employment, chronic kidney disease etiology, AVF duration, and previous AVF. Conclusion: Further studies are required in order to confirm whether the considered factors affect levels of self-care behaviors with AVF, or whether other factors are needed as well.info:eu-repo/semantics/publishedVersio

Scale of Assessment of Self-Care Behaviors with Arteriovenous Fistula in Hemodialysis: A Psychometric Study in Brazil

The purpose of this study was to evaluate the psychometric properties of the Brazilian Scale for the Assessment of Self-Care Behaviors with Arteriovenous Fistula in Hemodialysis. Cross-sectional validation study, followed the recommendation provided by Sousa and Rojjanasrirat. Content validity, explanatory and confirmatory factor analyses used to check validity and Cronbach's alpha was the reliability measure. Three hundred hemodialysis patients with arteriovenous fistula were included in the study. The expert committee assessed the content validity. Exploratory factor analysis confirmed the same two-factor structure found for the original scale, explaining 60.10% of the variance. Such solution was checked by confirmatory factor analysis with Cronbach's alpha equal to 0.920, 0.810, and 0.884 for the overall scale, the self-care in management of signs and symptoms and the self-care in prevention of complications subscales respectively. The scale has good psychometric properties to assess self-care behaviors and can be used with Brazilian patients on hemodialysis with arteriovenous fistula.info:eu-repo/semantics/publishedVersio