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Doctoral Thesis
DOI
https://doi.org/10.11606/T.22.2005.tde-23062005-113139
Document
Author
Full name
Celmira Lange
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
Ribeirão Preto, 2005
Supervisor
Committee
Rodrigues, Rosalina Aparecida Partezani (President)
Ferretti, Ceres Eloah de Lucena
Goncalves, Lucia Hisake Takase
Haas, Vanderlei José
Vale, Francisco de Assis Carvalho do
Title in Portuguese
"Acidentes domésticos em idosos com diagnóstico de demência atendidos em um ambulatório de Ribeirão Preto, SP"
Keywords in Portuguese
acidentes domésticos
demência
estado cognitivo
idosos
Abstract in Portuguese
O estudo teve por objetivo descrever os acidentes domésticos ocorridos com idosos portadores do diagnóstico de demência, relacionando estes às suas condições de vida. Trata-se de um estudo descritivo e seccional, realizado no período de 2001 a 2002. Participaram do estudo 110 idosos demenciados, residentes na zona urbana de Ribeirão Preto, SP, atendidos em um ambulatório terciário de um hospital público. Os dados foram coletados no domicílio por meio de entrevistas, previamente agendadas, com idosos e cuidadores. Os resultados evidenciaram que 65,5% dos idosos eram do sexo feminino e 34,5% do masculino, variando a idade de 63 a 91 anos, com uma média de 76 anos. Quanto à escolaridade, 45,5% dos idosos tinham até 4 anos de escolaridade, os analfabetos e os que sabem ler e escrever somaram 35,5%. O resultado dos escores dos idosos no Mini Exame do Estado Mental (MEEM) foi padronizado em baixo e alto desempenho, de acordo com a escolaridade de cada um, sendo que 91% tiveram baixo desempenho e 9% alto desempenho. Do total dos idosos, 65,5% sofreram algum tipo de acidente doméstico, com a seguinte distribuição: 58,2% quedas, 29,1% aspirações e engasgos, 7,3% queimaduras, 6,4% cortes e ferimentos, 3,6% intoxicações e 0,9% ingestão de corpo estranho. Quanto ao tipo de queda, 50% foram da própria altura, sendo que 34,4% dos idosos que caíram afirmaram ter medo de novas quedas. No que se refere ao momento da queda, foram relatados 63,6% de fatores intrínsecos (alteração de equilíbrio, dificuldade para caminhar, fraqueza muscular), enquanto os extrínsecos (piso escorregadio e/ou com desnível, banheiro sem barras) atingiram 36,4%. As lesões mais relatadas, após a queda, foram os ferimentos na cabeça com necessidade de sutura. As aspirações e engasgos foram causados por alimentos de diversas consistências e a tosse esteve presente em 96,6% dos eventos. As queimaduras ocorreram na cozinha, durante o preparo de alimentos, sendo 89,5% delas nos membros superiores. Essas foram causadas em 41,2% pelo contato direto com objeto quente e/ou chama/fogo. Os acidentes com objetos cortantes foram causados por facas, lâminas de barbear, maçaneta, tesoura, vidro, ferro e as partes do corpo mais atingidas foram mãos, braços e faces. A intoxicação por ingestão de medicamento foi referida por três idosos e a de corpo estranho foi causada por deglutição de pedaços de sabão; 90,5% dos acidentes aconteceram com idosos de baixo desempenho no MEEM e apenas 9,5% ocorreram com idosos de alto desempenho. A faixa etária com maior freqüência de acidentes está entre 75 a 79 anos. Esses dados mostram que os idosos com baixo desempenho no MEEM e idade entre 75 a 79 anos estão mais predisponentes a sofrer acidentes. A equipe de saúde e a família devem constantemente realizar avaliação tanto nos fatores intrínsecos quanto nos extrínsecos para estabelecer estratégias de prevenção de acidentes.
Title in English
Domestic accidents among aged persons with dementia attended at a Ribeirão Preto outpatient clinic
Keywords in English
cognitive state
dementia
domestic accidents
elderly
Abstract in English
This study aimed to describe domestic accidents involving aged persons with dementia relating those accidents with their living conditions. It is a descriptive and cross sectional study developed in 2001 and 2002. Study participants were 110 elderly who live in the urban area of Ribeirão Preto, SP, Brazil, and were attended at the tertiary outpatient ambulatory of a public hospital. Data were collected at home, by means of previously arranged interviews with these aged persons and their caregivers. The results demonstrated that 65.5% of the elderly were women and 34.5% men. Age ranged from 63 to 91 years, with 76 as the average. With respect to educational level, 45.5% of the elderly had up to 4 years of education; illiterate and those who can barely read and write totalized 35.5%. The results of the participants’ scores on the Mini-Mental State Exam (MMSE) were standardized into low and high performance, in accordance with each person’s educational level. 91% of the aged achieved a low and 9% a high performance on the MMSE. 65.5% of the total number of elderly had suffered some kind of domestic accident, distributed as follows: 58.2% falls, 29.1% aspiration and choking, 7.3% burns, 6.4% cuts and wounds, 3.6% intoxication and 0.9% ingestion of a foreign body. As to types of falls, 50% occurred from the subjects’ own height, with 34.4% of the elderly victims being afraid of falling again. In what concerns the moment of falling, 63.6% of the subjects mentioned intrinsic factors (change in balance, difficulty to walk, muscle weakness), while extrinsic factors (slippery and/or unequal floor, bathroom without support bars) affected 36.4%. The most mentioned injuries after falls were head wounds that needed suturing. Aspiration and choking were caused by food items with different consistencies and coughing was present in 96.6% of the occurrences. Burns occurred in the kitchen, while preparing food, and 89.5% of them affected the upper limbs. 41.2% of these were caused by direct contact with a hot object and/or flame/fire. Accidents involving cutting objects were caused by knives, razor blades, doorknobs, scissors, glass, iron and the affected body parts were hands, arms and faces. Three participants mentioned intoxication through medication ingestion, while intoxication due to the ingestion of a foreign body was caused by swallowing pieces of soap; 90.5% of the accidents involved elderly who achieved a low performance level on the MMSE, while only 9.5% affected those with a high performance. The age range with the highest accident frequency goes from 75 to 79 years. These data show that elderly persons with a low performance on the MMSE, who are between 75 and 79 years old, reveal a greater tendency to suffer accidents. The health team and the family should constantly evaluate both intrinsic and extrinsic factors viewing to establish accident prevention strategies.
 
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LANGE_C.pdf (3.25 Mbytes)
Publishing Date
2005-07-04
 
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