scholarly journals Atendimento integral à saúde do idoso residente em instituição de longa permanência: uma experiência interdisciplinar

Author(s):  
Gislaine Cristina Vagetti ◽  
Marlei Salete Weinheimer ◽  
Valdomiro de Oliveira

Resumo: A população idosa residente em instituições de longa permanência, conveniadas ao Ministério do Desenvolvimento Social e Combate à Fome (MDS), é de 24.964 idosos (CAMARANO, 2004). O cuidado ao idoso, nestas instituições, requer atenção integral e ações interdisciplinares, portanto o objetivo deste projeto é desenvolver o conhecimento e a prática geriátrica e gerontológica a partir de um modelo biopsicossocial. Sua implantação se deu em uma Instituição de Longa Permanência (ILP) de caráter filantrópico que atende 63 idosos de ambos os sexos, com idade entre 60 a 92 anos, sendo 30% portadores de déficit na capacidade funcional. As atitudes desenvolvidas incluem atendimento psicológico, exercícios físicos, cuidados de enfermagem, lazer, atenção odontológica e atenção farmacêutica. Além da prática profissional desenvolvem-se pesquisas interdisciplinares entre os profissionais e os acadêmicos. Os resultados mostraram que, a partir de uma abordagem biopsicossocial, os idosos obtiveram melhoras na capacidade funcional, recuperação da integridade cutâneo-mucosa, menor índice de desidratação e desnutrição, diminuição de conflitos pessoais e diminuição do índice de sintomas depressivos. Diante do exposto conclui-se que a Instituição para idosos cumpre uma importante função social junto aos idosos carentes, abandonados que não conseguem sobreviver com recursos próprios. Contudo a perda de identidade e independência são ameaças constantes. A implantação de um projeto de atenção integral às necessidades do idoso possibilita a garantia de uma maior qualidade de vida a partir de ações pautadas no método científico, na ética e no humanismo. Palavras-chave: Instituições de Longa Permanência. Idoso e Modelo Biopsicossocial. Abstract: The resident senior population in institutions of long permanence in Brazil is 24.964. The care to the elderly, in these institutions, requests integral attention and interdisciplinary actions. Therefore, the purpose of this project is developing a geriatric and gerontological practice and knowledge, starting from a biopsychosocial model. Its implantation takes place in a philanthropic long-permanence institution that assists 63 senior of both sexes, from 60 to 92 years old, which 30% has a deficit in their functional capacity. The developed attitudes include psychological service, physical exercise, nursing cares, leisure, and deontological and pharmaceutical attention. Besides the professional practice, interdisciplinary research was developed among the professionals and academics. The results depicted that when treated by a biopsychosocial approach, the seniors reached improvements in the functional capacity, showed recovery of their cutaneous-mucous integrity membrane, presented lower dehydration index and malnutrition, decrease of personal confl icts and less occurrence of depressive symptoms. As a conclusion, we can state that the Elderly Institution accomplishes an important social function with the disfavored, abandoned seniors, who cannot afford their own surveillance. However, loss of identity and independence are constant threats. The implantation of an integral attention project to the senior’s needs can guarantee a better life quality, following a scientifi cmethod, the ethics and the humanism. Keywords: Long-Permanence Institutions. Senior and Biopsychosocial Model.

Author(s):  
Angel L. Ball ◽  
Adina S. Gray

Pharmacological intervention for depressive symptoms in institutionalized elderly is higher than the population average. Among the patients on such medications are those with a puzzling mix of symptoms, diagnosed as “dementia syndrome of depression,” formerly termed “pseudodementia”. Cognitive-communicative changes, potentially due to medications, complicate the diagnosis even further. This discussion paper reviews the history of the terminology of “pseudodementia,” and examines the pharmacology given as treatment for depressive symptoms in the elderly population that can affect cognition and communication. Clinicians can reduce the risk of misdiagnosis or inappropriate treatment by having an awareness of potential side effects, including decreased attention, memory, and reasoning capacities, particularly due to some anticholinergic medications. A team approach to care should include a cohesive effort directed at caution against over-medication, informed management of polypharmacology, enhancement of environmental/communication supports and quality of life, and recognizing the typical nature of some depressive signs in elderly institutionalized individuals.


2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Zeng-Rong Luo ◽  
Dong-Shan Liao ◽  
Liang-Wan Chen

Abstract Background To compare postoperative sexual dysfunction (SD) and quality of life (QOL) in Type A Aortic Dissection (AAD) Patients of Different Ages. Methods From January 2018 to December 2019, 204 AAD postoperative survivors in Union Hospital of Fujian Medical University were selected and were divided into young group (less than 50 years old) and elderly group (more than 50 years old). We evaluated SD according to the male International Erectile Dysfunction Index (IIEF-5) and female sexual function index (FSFI). The Short Form 12 Health Survey Questionnaire (SF-12) and Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q) were used to investigate the QOL, Quick Inventory Depressive Symptomatology-Self Report (QIDS-SR) and the Beck Depression Inventory-II (BDI-II) to investigate depressive symptoms. Results One hundred seventy-five patients completed all the questionnaire (85.8%). The total SD prevalence rate was 38.9% (68 cases), with 27.4% of the young (20 cases) and 47.1% of the elderly (48 cases). The age of non-SD and SD patients was 49.0 ± 11.5 and 56.9 ± 10.8 years, respectively (P = 0.03). Compared with non-SD patients, the total physical health of SD patients was significantly worse (P = 0.04), however, the mental health was not significantly worse (P = 0.77); the depressive symptoms did not expressed a significant difference between the SD and non-SD groups (QIDS-SR P = 0.15, BDI-II P = 0.06). Total physical health scores in the young SD group did not show significant better than elderly SD group (P = 0.24), however, total mental health scores showed significantly worse (P = 0.04), depressive symptoms scores were significantly higher (QIDS-SR P = 0.03, BDI-II P = 0.04). Conclusion The postoperative AAD SD prevalence of elderly is higher than that of young, and the total physical health of SD patients is poorer than those without SD patients. The young SD patients did not show a significant higher physical health scores than the elderly SD patients, instead, the young SD patients were more psychologically affected than the elderly SD patients, whose mental health was worse, and depression symptoms were more obvious, suggesting that the factors affecting the QOL of postoperative SD patients are related to physical factors, but the young postoperative SD patients mainly affected by psychological factors.


2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Jannika M. John ◽  
Vanessa Haug ◽  
Ansgar Thiel

Abstract Background Physical activity behavior is a complex and multidimensional phenomenon. For its analysis, transdisciplinary biopsychosocial approaches yield great potential. In health research, the biopsychosocial model has experienced a renaissance. Researchers have tried to grasp the complex interplay of biological, psychological, and social factors. With this scoping review, we aimed to examine how the ‘biopsychosocial’ has been conceptualized in scientific work related to physical activity behavior. Methods The scoping review was informed by the PRISMA guidelines for scoping reviews (PRISMA-ScR). A systematic literature search was conducted in Web of Science, SportDiscus, PsycArticles, PsycInfo, and PubMed. Only articles published in peer-reviewed journals that contained all three components of a biopsychosocial approach (e.g., bio/physio/genetic, psycho/mental, and socio/cultural/environmental) were included. We only included articles in our narrative synthesis that integrated physical activity behavior into a biopsychosocial model, or investigated or described physical activity behavior on the basis of such a model. Results Thirteen studies met the inclusion criteria; eight articles pursued a biopsychosocial approach in the tradition of Engel, five employed a socio-ecological approach. The models in the analyzed articles referred to either correlates of physical activity behavior, or the influence of physical activity on health or aging. Only a minority of the articles, however, referred to interactions between biological, psychological, and social factors. Conclusions The included articles were quite heterogeneous in their approach to physical activity from a biopsychosocial perspective. The included articles illustrate that the adoption of a biopsychosocial perspective may assist to capture and understand the complex phenomenon of physical activity behavior and might inform future transdisciplinary physical activity research.


2021 ◽  
pp. 104365962110214
Author(s):  
Lei Lei ◽  
Quanxi Gan ◽  
Chunyan Gu ◽  
Jing Tan ◽  
Yu Luo

Introduction With the global aging process intensified, the demand for end-of-life care has surged, especially in China. However, its development is restricted. Understanding the life and death attitude among the elderly and its formation process, and clarifying their needs, are so important to promote social popularization of end-of-life care. Methodology This qualitative study included 20 elderly residents in Nan and Shuangbei Communities, Chongqing City, People’s Republic of China. Data were collected through semistructured in-depth individual interviews and processed by thematic analysis method. Results Three themes and eight subthemes were identified: Characteristics of formation process (passive thinking, closed and single), life-and-death attitude (cherish and enjoy life, quality of life priority, let death take its course) and expectations of end-of-life care (preferences, basic needs, good death). Discussion Life-and-death attitude and end-of-life care expectations of the elderly support the development and delivery of end-of-life care. Furthermore, the individual-family-hospital linkage discussion channel needs to be further explored.


2020 ◽  
Vol 36 (1) ◽  
Author(s):  
Nesreen Fathi Mahmoud ◽  
Huda Zahran ◽  
Sherif Abdelmonam

Abstract Background This study focuses on the self-perception of the voice in the elderly as assessed by the Voice-Related Quality of Life (V-RQOL) questionnaire. This work aimed to compare differences in the voice-related quality of life outcomes between (1) elderly with and without voice disorders, (2) female and male elderly with voice disorders, and (3) different types of voice disorders, and to explore the correlation between the V-RQOL and perceptual analysis done by the clinician. Forty-three dysphonic and 44 non-dysphonic elderly filled out the Voice-Related Quality of Life (V-RQOL) protocol that analyzes the impact of dysphonia on life quality. Vocal perceptual assessment of each subject with dysphonia was made by three voice therapists, followed by a flexible nasofibrolaryngoscope. Results A significant statistical difference was found between the means of total V-RQOL scores and its subdomains for each group (dysphonic and non-dysphonic). No significant differences were found between male and female elderly with dysphonia. The statistical analysis showed a significant correlation with the vocal assessment made by the clinicians and the V-RQOL self-assessment made by the subjects. Conclusions This study provides valuable information regarding the risk factors that contribute to vocal quality in the elderly population. Our results revealed that different types of voice disorders are common among the elderly population with significant negative effects on quality of life. It was observed that the poorest score on the V-RQOL was for functional voice disorders, followed by neoplastic lesions, whereas MAPLs had the best score on the V-RQOL.


2001 ◽  
Vol 35 (2) ◽  
pp. 246-248 ◽  
Author(s):  
Rosalie Hill ◽  
Christopher Haslett ◽  
Shailesh Kumar

Objective: To demonstrate a case of anorexia nervosa in the elderly and to highlight the need for broadening of current diagnostic criteria. Clinical picture: First onset of anorexia nervosa in a 72-year-old woman following bereavement of her husband. Treatment: Nine treatments of electroconvulsive therapy. Outcome: Treatment resulted in remission of the depressive symptoms and improvement of eating behaviour. Conclusions: Anorexia nervosa does occur in the elderly and can be difficult to detect. Where comorbid depression exists it requires aggressive treatment.


1997 ◽  
Vol 27 (1) ◽  
pp. 119-129 ◽  
Author(s):  
A. S. HENDERSON ◽  
A. E. KORTEN ◽  
P. A. JACOMB ◽  
A. J. MACKINNON ◽  
A. F. JORM ◽  
...  

Background. We report the outcome of depressive states after 3-4 years in a community sample of the elderly.Methods. A sample of 1045 persons aged 70+ years in 1990–1 was re-interviewed after 3·6 years.Results. Mortality (21·7%) and refusal or non-availability (10·4%) were higher in those who initially had had a diagnosis or symptoms of depression. Of those with an ICD-10 depressive episode in 1990–1, 13% retained that diagnosis. Of those who were not depressed initially only 2·5% had become cases. Depression was unrelated to age or apolipoprotein E genotype. The best predictors of the number of depressive symptoms at follow-up was the number at Wave 1, followed by deterioration in health and in activities of daily living, high neuroticism, poor current health, poor social support, low current activity levels and high service use. Depressive symptoms at Wave 1 did not predict subsequent cognitive decline or dementia.Conclusions. Non-random sample attrition is unavoidable. ICD-10 criteria yield more cases than other systems, while continuous measures of symptoms confer analytical advantages. Risk factors for depressive states in the elderly have been further identified. The prognosis for these states is favourable. At the community level, depressive symptoms do not seem to predict cognitive decline, as they do in referred series.


2011 ◽  
Vol 15 (6) ◽  
pp. 1087-1092 ◽  
Author(s):  
Alan C Tsai ◽  
Tsui-Lan Chang ◽  
Shu-Hwang Chi

AbstractObjectiveThe study evaluated the association between consumption frequencies of the major food categories and the risk of new depression four years later in older Taiwanese.DesignA prospective cohort study with multistage random sampling. Logistic regression analysis evaluated the significance of the longitudinal associations of intake frequencies of the major food categories with future (4 years later) risk of new depression, controlled for possible confounding factors with or without adjustment for cognitive status.SettingPopulation-based free-living elderly.SubjectsMen and women (n 1609) ≥65 years of age.ResultsIn a regression model that controlled for demographic, socio-economic, lifestyle and disease/health-related variables but not cognitive status, both fruits (OR = 0·66, 95 % CI 0·45, 0·98, P = 0·038) and vegetables (OR = 0·38, 95 % CI 0·17, 0·86, P = 0·021) were protective against depressive symptoms 4 years later. However, when the same regression model was also adjusted for cognitive status, only vegetables (OR = 0·40, 95 % CI 0·17, 0·95, P = 0·039) were protective against depressive symptoms. Higher consumption of eggs was close to being significant in both regression models (P = 0·087 and 0·069, respectively). Other food categories including meat/poultry, fish, seafood, dairy, legumes, grains and tea showed no significant associations.ConclusionsResults suggest that although confounding factors cannot be totally ruled out, more frequent consumption of vegetables seems to be protective against depressive symptoms in the elderly. Further studies are needed to elucidate the causal role and the mechanism of the association.


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