Assessment of pain and associated factors in people living with HIV/AIDS

Objetivo: avaliar a dor em pessoas que vivem com o vírus da imunodeficiência humana/síndrome da imunodeficiência adquirida e relacionar com fatores sociodemográficos, clínicos, sintomas depressivos e qualidade de vida relacionada à saúde. Método: estudo descritivo, analítico, observacional, de corte transversal e de caráter quantitativo. Participaram trezentas e duas (302) pessoas de um serviço de atendimento especializado. Foram utilizados instrumentos para avaliação de dados sociodemográficos, clínicos, sintomas depressivos e qualidade de vida relacionada à saúde. Empregou-se análise descritiva, bivariada e regressão logística múltipla. Resultados: foram encontrados 59,27% de presença de dor de intensidade leve, recorrente na cabeça, com interferência no humor, a maioria do sexo feminino e em indivíduos sem/baixa escolaridade. As mulheres apresentaram maior probabilidade de ter dores moderadas ou severas. Pessoas de 49 a 59 anos apresentaram maior intensidade de dor do que as de 18 a 29 anos. Sintomas depressivos e dor são variáveis diretamente proporcionais. Quanto maior o nível da qualidade de vida relacionada à saúde e escolaridade, menor a possibilidade da presença de dor. Conclusão: a presença de dor encontrada é preocupante e possui associação com o sexo feminino, sem/ baixa escolaridade, pior nível da qualidade de vida relacionada à saúde e presença de sintomas depressivos.Objetivos: evaluar el dolor en las personas que viven con el virus de la inmunodeficiencia humana/síndrome de inmunodeficiencia adquirida y relacionarse con factores sociodemográficos, clínicos, síntomas depresivos y calidad de vida relacionada con la salud. Método: estudio descriptivo, analítico, observacional, de corte transversal y de carácter cuantitativo. Participaron trescientos y dos (302) personas de un servicio de atención especializado. Se utilizaron instrumentos para la evaluación de datos sociodemográficos, clínicos, síntomas depresivos y calidad de vida relacionada con la salud. Se empleó el análisis descriptivo, bivariada y regresión logística múltiple. Resultados: se encontró un 59,27% de presencia de dolor de intensidad leve, recurrente en la cabeza, con interferencia en el humor, la mayoría del sexo femenino y en individuos sin/baja escolaridad. Las mujeres presentaron una mayor probabilidad de sufrir dolores moderados o severos. Las personas de 49 a 59 años presentaron mayor intensidad de dolor que las de 18 a 29 años. Los síntomas depresivos y dolor son variables directamente proporcionales. Cuanto mayor es el nivel de la calidad de vida relacionada con la salud y la escolaridad, menor es la posibilidad de la presencia de dolor. Conclusión: la presencia de dolor encontrado es preocupante y tiene asociación con el sexo femenino, sin/baja escolaridad, peor nivel de la calidad de vida relacionada a la salud y la presencia de síntomas depresivos.Objective: to evaluate pain in people living with human immunodeficiency virus/acquired immunodeficiency syndrome and to relate it to sociodemographic and clinical factors, depressive symptoms and health-related quality of life. Method: descriptive, analytical, observational, crosssectional and quantitative study. Three hundred and two (302) people assisted at a specialized care service participated in the study. Instruments were used to evaluate sociodemographic and clinical data, depressive symptoms, and health-related quality of life. Descriptive, bivariate analysis and multiple logistic regression were used. Results: the incidence of pain of mild intensity was 59.27%, recurrent in the head, with interference in mood, mostly affecting females and individuals with no schooling/low schooling. Women were more likely to have moderate or severe pain. People aged 49 to 59 years had greater pain intensity than people aged 18 to 29 years. The variables depressive symptoms and pain were directly proportional. The higher the health-related quality of life and schooling, the lower was the possibility of presence of pain. Conclusion: presence of pain is of concern and has association with female sex, lack of schooling/low schooling, worse level of health-related quality of life and presence of depressive symptoms

Perfil de saúde de cuidadores familiares de idosos e sua relação com variáveis do cuidado: um estudo no contexto rural

Objective: to analyze the profile of a population of caregivers from a city in a rural area of the state of São Paulo, Brazil, and identify their health complaints and the characteristics of care provided. Method: a prospective cross-sectional study was performed based on a domicile survey of 99 caregivers and their elderly care recipients. Information about the profile, context of care and health complaints of the caregivers was collected. The caregivers responded to the Zarit Burden Inventory and the Geriatric Depression Scale-15 and the elderly underwent a cognition and functionality assessment. The chi-squared test with odds ratio (OR) was performed to test associations. Result: the majority of the caregivers were women (n=76), elderly (n=83), with a median age 65.8 (±10.4) years and 4.9 (±4.2) years of formal schooling. The most frequent health complaints were pain, systemic hypertension, insomnia, back problems and vision problems. The elderly care recipients were men (n=75), with an average age of 72.0 (±8.2) years. Analysis of associations revealed that caregivers who received emotional support had a lower chance of being highly overburdened (OR=0.37; CI95% 0.15-0.90). Caring for over five years was associated with arthritis (OR=2.50; CI95% 1.0-6.56). Caring of an elderly person with cognitive impairment was strongly associated with peripheral vascular diseases (OR=2.70; CI95% 1.11-6.85) and other diseases (OR=6.94; CI95% 1.43-33.63). Conclusion: A better understanding of the reality of care in rural and remote areas and the identification of factors related to the health care of caregivers provides better care management for the elderly and caregivers, who themselves are aging

Living with the elderly is related to a better performance in the recognition of facial expressions of emotion among older individuals

Background: Cohabitation with the elderly may bring benefits to social relationships and exert an influence on the recognition of facial expressions of emotion. Objective: Compare emotion recognition skills between a cohabitation group (CHG) of older adults who live with a dependent elderly individual and a non-cohabitation group (NCHG) of older adults who do not live with an elderly individual. Methods: Interviews were conducted with 62 older adults in the CHG and 56 in the NCHG. The two groups were similar with regard to gender, age, schooling, degree of dependence, cognitive performance, and depressive symptoms. A dynamic task with six emotions (anger, disgust, happiness, surprise, sadness, and fear) and four levels of intensity was administered to evaluate the recognition of facial emotions. Results: The CHG performed better than the NCHG regarding the correct identification of emotions, specifically surprise (60%), disgust (60%, 80%, and 100%), fear (80%), and sadness (80% and 100%). Discussion: Cohabitation with an elderly individual seems to offer benefits to older adults in terms of recognizing facial expressions of emotion

Idosos cuidadores em diferentes arranjos de moradia: comparação do perfil de saúde e de cuidado

Objetivo: Comparar o perfil de saúde física, cognitiva e psicológica e o contexto decuidado de idosos cuidadores de idosos em diferentes arranjos de moradia.Método: Estudo quantitativo e transversal realizado com 349 cuidadores divididos emarranjos de moradia unigeracional, bigeracional e multigeracional. Para avaliação foramutilizados questionários sociodemográfico e de cuidado, e instrumentos de avaliações dasaúde física, cognitiva e psicológica. Para análises dos dados foram utilizados os testesQui-quadrado e U Mann Whitney.Resultados: Os idosos cuidadores de lares unigeracionais eram mais velhos eindependentes para as atividades instrumentais de vida diária. Nos arranjos de moradiamultigeracionais houve proporção significativamente maior de cuidadores queconsideravam a renda familiar insuficiente, recebiam ajuda emocional e sentiam-se maissobrecarregados e estressados.Conclusão: As diferenças identificadas entre os grupos podem contribuir para elaboraçãode políticas de cuidado e promoção da saúde de idosos cuidadores.Palavras-chave: Idoso. Cuidadores. Família. Relações familiares

Relação entre sistema de cuidado, suporte social e fragilidade de idosos cuidadores

Population aging is a global phenomenon related to changes in family structures and functions that bring consequences to the elderly, such as: change in living conditions, challenges in the care and social support, among others. This study aims to analyze the relationship between care system, social support and the fragility of senior caregivers in the context of high social vulnerability. It is an exploratory and analytical study, using the quantitative method of investigation. The population analyzed consisted of people aged 60 or over, who takes care of the seniors and were registered in the ”Unidades de Saúde da Família” (Public Family Health Units) in a city in the state of São Paulo and who are under the care of “ Núcleo de Apoio a Saúde da Família (NASF)” (Center for Support for Family Health), in the region of ARES “Cidade Aracy” (Aracy City). Interviews were conducted in the homes of elderly caregivers and used the following instruments for data collection: Semi-Structured Interviews, The Addenbrooke's Cognitive Examination Revised (ACE R), Geriatric Depression Scale (GDS), Fragility Assessment according to phenotype Fried, family APGAR, Genogram and ecomap. Most of the caregivers are spouses (83.6%), carefully time 1-4 years (46.5%) and spending one to four hours taking care (52%) of the elderly. The most mentioned institution that assists these seniors was a health institution. The main care provided to the elderly was feeding (82.2%), followed by lead to medical appointments (63.6%). There was a statistically significant association of low-income seniors with worse cognitive performance and the negative influence of the largest number of people living at home with worse results in cognition test. It is necessary to investigate the profile of these caregivers, as most are pre-fragile, and takes care of another pre-fragile elderly. It is noteworthy that the vast majority of the elderly in this study lives in houses with a large number of people, which is common in the context of high social vulnerability and low education; it was found that this factor interferes in the cognitive performance. More studies are necessary in order to investigate the conditions offered by the society and what these seniors, families and their social network can do in favor of a healthy aging.Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)O envelhecimento populacional é um fenômeno mundial relacionado às mudanças nas estruturas e funções familiares que geram consequências para as pessoas idosas, tais como: mudança nas condições de vida, desafios no cuidado e apoio social, entre outros. Este estudo tem como objetivo analisar a relação entre sistema de cuidado, suporte social e fragilidade de idosos cuidadores em contexto de alta vulnerabilidade social. Trata-se de um estudo exploratório, correlacional, analítico, com a utilização do método quantitativo de investigação. A população foi composta por pessoas com 60 anos ou mais, que cuidavam de idosos e estavam cadastradas nas Unidades de Saúde da Família de um município no interior do estado de São Paulo e que estão na cobertura do Núcleo de Apoio a Saúde da Família (NASF), da região da ARES “Cidade Aracy”. As entrevistas foram realizadas no domicílio dos idosos cuidadores e utilizados como instrumentos para a coleta de dados : Entrevista Semi-Estruturada, The Addenbrooke’s Cognitive Examination Revised (ACE- R), Escala de Depressão Geriátrica (GDS), Avaliação da Fragilidade segundo o fenótipo de Fried , APGAR de família, Genograma e Ecomapa. A maioria dos cuidadores era cônjuge (83,6%), com tempo de cuidado de 1 a 4 anos (46,5%) e despendendo de uma a quatro horas diárias de cuidado com o idoso (52%). A entidade mais citada que auxiliava na prestação do cuidado foi a instituição de saúde. O principal cuidado fornecido ao idoso foi a alimentação (82,2%), seguido por levar a consultas médicas (63,6%). Observou-se associação estatisticamente significante dos idosos de baixa renda com o pior desempenho cognitivo e, também, a influência negativa do maior número de pessoas que residem no domicílio com piores resultados nos teste de cognição. É necessário investigar o perfil destes cuidadores, pois a maioria é pré-frágil, que exerce o cuidado de outro idoso, também, pré-frágil. Chama atenção que a maioria dos idosos deste estudo vive em casas com um grande número de pessoas, o que é comum em contexto de alta vulnerabilidade social e baixa escolaridade, porém, foi encontrado que este fator interfere no desempenho cognitivo. Mais estudos devem ser desenvolvidos buscando aprofundar as condições oferecidas pela sociedade e as que estes idosos, famílias e suas redes sociais podem planejar em favor do envelhecimento saudável

Relationship between cognition and frailty in elderly: A systematic review

OBJECTIVE: The aim of this study was to analyze the relationship between cognition and frailty in the elderly. METHODS: A systematic review on the currently existing literature concerning the subject was carried out. The search strategy included LILACS, SCOPUS, SciELO, PsycINFO, PubMed and Web of Science databases. RESULTS: A total of 19 studies were selected for review, from which 10 (52.6%) were cross-sectional and 9 (47.4%) longitudinal, and the majority Brazilian. All of the studies established a link between cognition and frailty. There was a relationship between components of frailty and the cognitive domains. Risk of Mild Cognitive Impairment (MCI), dementia and mortality were all evidenced in the relationship between frailty and cognitive impairment. CONCLUSION: The theory remains limited, but results show the variables that appear to be linked to cognition and frailty in elderly. This data can help in implementing actions to improve the quality of life among elderly

Relationship between cognition and frailty in elderly: A systematic review

OBJECTIVE: The aim of this study was to analyze the relationship between cognition and frailty in the elderly. METHODS: A systematic review on the currently existing literature concerning the subject was carried out. The search strategy included LILACS, SCOPUS, SciELO, PsycINFO, PubMed and Web of Science databases. RESULTS: A total of 19 studies were selected for review, from which 10 (52.6%) were cross-sectional and 9 (47.4%) longitudinal, and the majority Brazilian. All of the studies established a link between cognition and frailty. There was a relationship between components of frailty and the cognitive domains. Risk of Mild Cognitive Impairment (MCI), dementia and mortality were all evidenced in the relationship between frailty and cognitive impairment. CONCLUSION: The theory remains limited, but results show the variables that appear to be linked to cognition and frailty in elderly. This data can help in implementing actions to improve the quality of life among elderly

Elderly who take care of elderly: a study on the Frailty Syndrome

ABSTRACT Objective: Identifying prevalence of frailty in elderly caregivers inserted in a high social vulnerability context and its correlation with sociodemographic and health aspects. Method: Descriptive, correlational and cross-sectional study. Forty elderly caregivers were evaluated with: questionnaire for caregiver characterization, Mini Mental State Examination, Katz Index, Lawton instrumental activities of daily living scale, Geriatric Depression Scale and the frailty phenotype proposed by Fried. Interviews were conducted at their residences and scheduled in advance. All ethical precautions were observed. Data were analyzed with the Stata statistical program version 11.0. Results: 10% of elderly caregivers were frail. There was a significant correlation between frailty and sex, instrumental activities of daily living and cognition. Conclusion: Female caregivers, partially dependent individuals regarding instrumental activities of daily living and with worse cognitive state deserve a special attention from health services