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Master's Dissertation
DOI
https://doi.org/10.11606/D.5.2016.tde-20092016-160109
Document
Author
Full name
Delcina Jesus Figueredo
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2016
Supervisor
Committee
Jacob Filho, Wilson (President)
Farfel, José Marcelo
Ferretti-Rebustini, Renata Eloah de Lucena
Fló, Claudia Marina
Title in Portuguese
Autocuidado em idosos internados numa enfermaria geriátrica de um hospital-escola: comparação das avaliações subjetivas e objetiva
Keywords in Portuguese
Autocuidado
Autonomia pessoal
Cuidadores
Idoso
Pacientes internados
Abstract in Portuguese
Estudo observacional quantitativo longitudinal prospectivo em idosos e seus cuidadores, de ambos os sexos, internados na enfermaria de geriatria de um hospital-escola, com coleta de dados no período de agosto de 2013 a março de 2014. Objetivo: Avaliar a condição funcional subjetiva e objetiva de idosos internados em uma enfermaria geriátrica; entre os relatos de desempenho no autocuidado e suas necessidades de ajuda. Método: avaliações subjetivas e objetiva, usando o instrumento Performance test of Activities of Daily Living (PADL), com 16 tarefas associado a três itens da Escala de Atividades Instrumentais de Vida Diária (AIVD). Resultados: o sexo feminino predominou dentre os idosos (32 - 58,2%) e os cuidadores (46 - 83,6%); a idade dos clientes variou entre 64 e 99 (x=80) anos, e dos cuidadores entre 37 e 84 anos (x=58,7a); a escolaridade básica foi mais frequente entre os idosos (36 - 65,4%) e a superior (18 - 32,7%) para os cuidadores; quanto ao parentesco dos cuidadores, 30 (54,4%) eram filhas e 12 (21,5%) esposas. Para comparar as funcionalidades subjetivas e objetiva no desempenho do autocuidado, calculou-se o Índice de Concordância (Ind.Con%), que variou de 62 a 93%, com Kappa oscilando entre 0,20 e 0,59. Tanto os idosos como os cuidadores referiram desempenhar as tarefas sem ou com ajuda, porém, na avaliação objetiva, detectou-se maior necessidade de ajuda ou a incapacidade da realização da tarefa. Saliente-se que os idosos se autoavaliaram um pouco melhor que os seus cuidadores. Discussão: Nas avaliações subjetivas idosos e subjetivas cuidadores, em comparação com a objetiva, as respostas dos idosos para o autocuidado foram confirmadas na avaliação objetiva e com os relatos reportados subjetivamente pelos cuidadores. Verificou que o Nível de funcionalidade nos idosos, na maioria foi o nível 3 (fazer sem ajuda) para as atividades de vida diária PADL e atividades instrumentais AIVD. Os relatos subjetivos idosos em comparação com a avaliação objetiva podem apresentar que alguns idosos fazem as atividades sem ajuda, outros com ajuda e aqueles que não fazem as tarefas sozinhos, e, assim, necessitaram de algum tipo de ajuda. As informações subjetivas reportadas pelos cuidadores foram discordantes em comparações com a avaliação objetiva em alguns itens das escalas. Os idosos tendem a se avaliar melhor que seus cuidadores. Os cuidadores reportam que os idosos conseguem realizar a tarefa, mas, na avaliação objetiva, alguns não fazem. Conclusões: Há importantes diferenças entre as capacidades funcionais relatadas pelo próprio idoso e seus cuidadores quando comparadas com a observação direta destas tarefas pelo enfermeiro, o que indica a necessidade de basear as ações e os cuidados muito mais na avaliação direta do que exclusivamente nos relatos dos clientes e de seus cuidadores
Title in English
Self care of elderly people admitted at a geriatric ward of a school hospital: comparison between subjective and objective evaluations
Keywords in English
Aged
Caregivers
Inpatients
Personal autonomy
Self care
Abstract in English
Prospective, longitudinal quantitative study in elderly people and their proxies, of both genders, admitted at a geriatric ward of a school hospital, whose data collection was August 2013 to March 2014. Objective: to evaluate subjective and objective functional condition of elderly people admitted at a geriatric ward; among the reports of self care performance and their needs for help. Method: subjective and objective evaluations using the instrument Performance test of Activities of Daily Living (PADL), with 16 tasks associated to 3 items of Instrumental Activities of Daily Living (IADL). Results: Female gender was predominant among the elderly (32 - 58.2%) and the proxies (46 - 83.6%); clients´ age varied between 64 and 99 (x=80) years old and their proxies between 37 and 84 years old (x=58.7y); basic education was more frequent among the elderly (36 - 65.4%) and higher (18 - 32.7%) for their proxies. Regarding the family connection of proxies, 30 (54.4%) were daughters and 12 (21.5%) wives. In order to compare the subjective and objective functionalities to perform self care, it was calculated the Concordance Index (CI), which varied from 62 to 93%, whose Kappa was between 0.20 and 0.59. Both elderly people and their proxies referred performing tasks with or without help. However, on the objective evaluation it was detected greater need for help or incapability to perform a task. It must be highlighted that elderly people evaluated themselves a little better than their proxies. Discussion: elderly subjective and proxy subjective evaluations in comparison to objective ones, elderly responses for self care were confirmed in objective evaluation and the reports provided subjectively by their proxies. It was verified that the functionality level of elderly people in majority was level 3 (do it without help) for PADL daily life activities and IADL instrumental activities. Elderly subjective reports in comparison to objective evaluation, it can be seen that some elderly people perform their activities without help, others with help and the ones who don´t perform tasks by themselves required some kind of help. Subjective information reported by proxies was discordant in comparison to objective evaluation in some items of the instruments. Elderly people are more prone to evaluate themselves better than their proxies. Proxies reported that elderly people can perform their tasks, but in the objective evaluation it was not observed. Conclusions: there are important differences between the functional capacities reported by elderly themselves and their proxies when compared to the direct observation of these tasks by the nurse, which points to the need of actions and care more focused on the direct evaluation rather than reports by clients and their proxies
 
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Publishing Date
2016-09-21
 
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