Cuidadores informais de idosos em pós-operatório de cirurgia de fêmur proximal: prevenção de novas quedas

The objectives of this study were to investigate the sociodemographic characteristics of informal caregivers of elderly persons who had undergone surgery for hip fractures caused by a fall, explore the level of caregiver's knowledge regarding fall prevention, and assess the relationship between this knowledge and the use of preventative measures in practice. This investigation consists of a cross-sectional study using nonprobability sampling methods conducted over a period of 12 months and involving 89 caregivers. The majority of caregivers were female (76.4%) and sons or daughters of the patients (64%). Environmental modification was the predominant preventative measure used by caregivers (88.2%). 58.1% of caregivers believed it was possible to prevent falls in the elderly and there was a significant association (p = 0,002) between believing it was possible to prevent falls and carrying out modifications in the home and/or to the daily routine of the older person. Informal caregivers with wide or partial knowledge of fall prevention put preventative measures into practice. These findings demonstrate that the number of falls among older persons could be significantly reduced if health care programmes widened their actions to include the guiding principles of the WHO falls prevention model.Os objetivos foram caracterizar sociodemograficamente os cuidadores informais de idosos vítimas de queda seguida por fratura de fêmur proximal e verificar o conhecimento mínimo que possuíam acerca da prevenção de novas quedas, assim como caracterizar a relação entre esse conhecimento e o emprego de medidas preventivas. Trata-se de estudo transversal, com amostragem intencional, realizado em 12 meses, incluindo 89 cuidadores. Predominaram cuidadores do sexo feminino (76,4%) e filhas(os) (64%). A modificação ambiental foi a medida preventiva predominante apontada por eles (88,2%). Houve associação significativa (p = 0,002), entre os 58,1% dos cuidadores que achavam ser possível prevenir quedas e os relatos sobre mudanças na casa e/ou rotina do idoso. Observou-se que cuidadores informais que apresentavam conhecimento sobre prevenção de quedas em idosos, mesmo que incompletos, empregavam medidas de prevenção para novos eventos. Esses achados sinalizam que o número de quedas entre idosos pode ser reduzido significantemente se os programas de atenção à saúde ampliarem suas ações apoiando-as no modelo de prevenção de quedas da Organização Mundial de Saúde.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Universidade Estadual Paulista (Unesp), Departamento de Enfermagem, Faculdade de Medicina de Botucatu (FMB), Distrito de Rubião Júnior snº, Centro. 18618-970, Botucatu SP BrasilUniversidade Estadual Paulista (Unesp), Departamento de Cirurgia e Ortopedia, FBM, Unesp.Universidade Estadual Paulista (Unesp), Departamento de Enfermagem, Faculdade de Medicina de Botucatu (FMB), Distrito de Rubião Júnior snº, Centro. 18618-970, Botucatu SP BrasilUniversidade Estadual Paulista (Unesp), Departamento de Cirurgia e Ortopedia, FBM, Unesp

Acidente ocupacional por material perfurocortante entre profissionais de saúde de um Centro Cirúrgico

O acidente ocupacional por material perfurocortante constitui uma preocupação para instituições e trabalhadores de saúde, devido à elevada frequência de procedimentos invasivos, e a dinâmica do trabalho. Objetivou-se identificar a incidência dos acidentes, dos materiais envolvidos, dos fatores contribuintes e das condutas tomadas pós-acidente. Participaram de um estudo transversal 127 funcionários do centro cirúrgico. Registraram-se 23,6% (30/127) acidentes com envolvimento de agulha (73,3%), lâmina de bisturi (6,7%) e eletrocautério (6,7%). Os fatores contribuintes para o acidente foram: falta de atenção (36,7%), más condições de trabalho (20,0%), descuido (13,3%), pressa (10%) e acaso/azar (6,7%). Somente 15,4% dos acidentes foram registrados. A subnotificação deveu-se à irrelevância do acidente, desconhecimento do protocolo de rotina, displicência e sobrecarga de trabalho. Os resultados alertam para a importância de se implementar estratégias para adoção/revisão de protocolos pós-acidentes, visando a redução dos acidentes e de sua subnotificação.El accidente laboral por elementos corto-punzantes constituye una preocupación para instituciones y trabajadores de la salud, debido a la elevada frecuencia con la que se realizan procedimientos invasivos y por la dinámica del trabajo. Se objetivó identificar la incidencia de los accidentes, los materiales involucrados, los factores contribuyentes y las conductas tomadas con posterioridad al accidente. Participaron de un estudio transversal 127 trabajadores de un centro quirúrgico. Sobre un porcentaje de accidentados del 23,6% (30/127), el 73,3% sufrió accidentes involucrando agujas, 6,7% se accidentó con hojas de bisturí y 6,7% se accidentó con electrocauterizador. Los factores que contribuyeron a los accidentes fueron: falta de atención (36,7%), malas condiciones de trabajo (20,0%), descuido (13,3%), prisa (10,0%) y casualidad / azar (6,7%). Sólo el 15,4% de los accidentes fueron registrados. La falta de notificación se debió a la irrelevancia del accidente, desconocimiento del protocolo de rutina, displicencia y sobrecarga de trabajo. Los resultados alertan sobre la importancia de implementar estrategias para adopción / revisión de protocolos post accidentes, apuntando a la reducción de la cantidad de accidentes y a evitar la ausencia de registro de los mismos.Occupational accidents involving piercing-cutting material are a concern for institutions and health workers due to the high frequency of invasive procedures and the dynamics involved in their practice. The objective of the present study was to identify the incidence of accidents, devices involved, contributing factors and post-accident behaviors. A cross-sectional study was conducted among 127 healthcare workers from the operating center. Of the total number of accidents reported, 23.6% (30/127) involved piercing-cutting materials, including needles (73.3%), scalpels (6.7%) and electrocautery (6.7%). The factors contributing to the accident were: lack of attention (36.7%), poor working conditions (20.0%), neglect (13.3%), rushing (10%) and accident/chance (6.7%). Only 15.4% of the accidents were recorded. Underreporting was due to: irrelevance of the accident, unaware of the protocol of routine, negligence and work overload. Results show the importance of implementing strategies for adopting/reviewing post-accident protocols aiming at reducing accidents and their underreporting

Quality of life and burden in carers for persons with Chronic Obstructive Pulmonary Disease receiving oxygen therapy

OBJECTIVE:to assess the quality of life and burden of caregivers to Chronic Obstructive Pulmonary Disease patients on Long-Term Oxygen Therapy and to investigate the factors influencing this burden.METHOD:this is an analytical, cross-sectional study of 80 persons with Chronic Obstructive Pulmonary Disease on Long-Term Oxygen Therapy who used the specialized outpatient center of the Federal University of São Paulo, and their carers. The following instruments were used: Medical Outcomes Studies 36 (SF-36), Caregiver Burden Scale (CBS) and the Katz Index, along with socio-demographic and clinical variables.RESULTS:the most compromised scores on the carers' quality of life questionnaire were for Vitality and Mental Health. On the Caregiver Burden Scale, the domain which created the greatest burden for carers was the Environment. With the exception of Emotional Involvement, all the domains of quality of life were affected negatively by the domains of caregiver burden.CONCLUSION:it was shown that carers' quality of life was compromised and that they were overburdened with care tasks, confirming that assisting persons with Chronic Obstructive Pulmonary Disease is an important element in carers' quality of life.OBJETIVO:evaluar la calidad de vida y la sobrecarga de cuidados experimentada por cuidadores de portadores de la Enfermedad Pulmonar Obstructiva Crónica en uso de Oxigenoterapia Domiciliar Prolongada e investigar los factores que influencian esa sobrecarga.MÉTODO:se trata de estudio transversal analítico, con 80 portadores de la Enfermedad Pulmonar Obstructiva Crónica en uso de Oxigenoterapia Domiciliar en el ambulatorio especializado de la Universidad Federal de São Paulo y de sus respectivos cuidadores, aplicando los instrumentos: Medical Outcomes Studies 36 (SF-36), Caregiver Burden Scale (CBS), índice de Katz y variables sociodemográficas y clínicas.RESULTADOS:los puntajes del cuestionario de calidad de vida de los cuidadores más comprometidos fueron la Vitalidad y la Salud Mental. El Ambiente fue el dominio del Caregiver Burden Scale que generó mayor sobrecarga de cuidados. Con excepción del Envolvimiento Emocional, todos los dominios de calidad de vida fueron influenciados de forma negativa por los dominios de sobrecarga de cuidados.CONCLUSIÓN:se demostró que la calidad de vida y la sobrecarga de cuidados, de los cuidadores, estaban comprometidos, confirmando que cuidar a los portadores de Enfermedad Pulmonar Obstructiva Crónica, es un importante interviniente en la calidad de vida del cuidador.OBJETIVO:avaliar a qualidade de vida e a sobrecarga de cuidados, vivenciada por cuidadores de portadores de Doença Pulmonar Obstrutiva Crônica, em uso de Oxigenoterapia Domiciliar Prolongada, e investigar os fatores que influenciam essa sobrecarga.MÉTODO:trata-se de estudo transversal analítico, com 80 portadores de Doença Pulmonar Obstrutiva Crônica em uso de Oxigenoterapia Domiciliar do ambulatório especializado da Universidade Federal de São Paulo e seus respectivos cuidadores, aplicando-se os instrumentos: Medical Outcomes Studies 36, Caregiver Burden Scale, índice de Katz e variáveis sociodemográficas e clínicas.RESULTADOS:os escores do questionário de qualidade de vida dos cuidadores mais comprometidos foram vitalidade e saúde mental. O ambiente foi o domínio do Caregiver Burden Scale que gerou maior sobrecarga de cuidados. Com exceção do envolvimento emocional, todos os domínios de qualidade de vida foram influenciados de forma negativa pelos domínios de sobrecarga de cuidados.CONCLUSÃO:demonstrou-se comprometimento da qualidade de vida e sobrecarga de cuidados dos cuidadores, confirmando que assistir portadores de Doença Pulmonar Obstrutiva Crônica é um importante interveniente na qualidade de vida do cuidador.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de EnfermagemUniversidade Federal de São Paulo (UNIFESP) Hospital São PauloUNIFESP, Escola Paulista de Enfermagem (EPE)UNIFESP, Hospital São PauloSciEL

The association between the functional incapacity of the older adult and the family caregiver's burden

OBJECTIVE: to identify the association between the older adult's functional capacity and the caregiver's burden. METHOD: a cross-sectional, quantitative study, undertaken in a municipality in the north of the Brazilian state of Paraná, with 178 older adults with functional incapacity, and their caregivers. The Functional Independence Measure was used for evaluating the older adults' functional capacity, and the Zarit Burden Interview was used for evaluating the caregiver burden, with the results being analyzed quantitatively. The majority of the older adults were females, widowed, with a mean age of 79.9 years old, and needing assistance for up to 50% of the daily living tasks. The majority of the caregivers were females, daughters, married, and had a mean age of 56.7 years old. RESULT: the majority of the caregivers reported moderate burden; the men presented higher probabilities of lower burden than the women; and the more independent the older adult was, the higher the probabilities of the caregiver having low burden. CONCLUSION: encouraging actions directed at the promotion of active and healthy ageing centered on the maintenance of functional capacity and the older adult's autonomy, and implanting strategies for the organizing of care in the home which include the caregiver's health, can contribute to minimizing the effects of burden and improve quality of life

Elderly patients attended in emergency health services in Brazil: a study for victims of falls and traffic accidents

The article aims to describe the profile of elderly victims of falls and traffic accidents from the data of the Surveillance Survey of Violence and Accidents (VIVA). The VIVA Survey was conducted in the emergency health-services of the Unified Health System in the capitals of Brazil in 2011. The sample of elderly by type of accident was subjected to the two-step cluster procedure. Of the 2463 elderly persons in question, 79.8% suffered falls and 20.2% were the victims of traffic accidents. The 1812 elderly who fell were grouped together into 4 clusters: Cluster 1, in which all had disabilities; Cluster 2, all were non-white and falls took place in the home; Cluster 3, younger and active seniors; and Cluster 4, with a higher proportion of seniors 80 years old or above who were white. Among cases of traffic accidents, 446 seniors were grouped into two clusters: Cluster 1 of younger elderly, drivers or passengers; Cluster 2, with higher age seniors, mostly pedestrians. The main victims of falls were women with low schooling and unemployed; traffic accident victims were mostly younger and male. Complications were similar in victims of falls and traffic accidents. Clusters allow adoption of targeted measures of care, prevention and health promotion