Demanda assistencial de pessoas idosas residentes no município de São Paulo: necessidade de cuidado e ultilização dos serviços de saúdedissertation
Аннотация: Introduction:The presence of functional limitations in the elderly determines the need for care.This necessity represents challenging demands for the family and the health services as it presents a complex group. Objective:To analyze the need for care, utilization of health care services of elderly residents in the city of São Paulo and the changes associated with this need over time.Method: This was a longitudinal and analytical homebased study, which used the database of the SABE study (Health, Wellbeing and Aging) in the years 2006 and 2010.The sample consisted of 1.413 elderly individuals (≥ 60 years).It was considered as the need for care, the difficulty of the elderly in the performance of basic and instrumental activities of daily living according to aid demands in these activities.To identify the care need levels, we used the Guttman Scaling.To evaluate factors associated with the need for care and determinants of change, the analysis of Multiple Logistic and Multiple Multinomial regression were used.Results: Regarding the hierarchy of activities of daily living, good internal consistency was found (α=0.92), a coefficient of reproducibility of 98%, an error probability of 2%, a scalability factor of 0.84 and minimum marginal reproducibility of 0.87.In relation to the classification of the need for care, 53.3% were independent for care, 26.7% had minimal need, 10.5% moderate need and 9.4% maximum need.Among the elderly in need of care, 73.0% reported having someone to help with requirements.The largest proportion of elderly maximum need were found between those used those who used health services such as medical consultations, urgent/emergency and hospitalization (43.8%) and those who used only emergency service/emergency and hospitalization (54.1%).Among the independent elderly, the determining factors for minimum need were female (RRR = 1.81,CI 95%: 1.05 -3.13), have 80 and over (RRR = 2.84, CI 95%: 1.17 -6.86), impaired physical mobility (RRR = 2.94, CI 95%: 1.02 -8.43); for moderate need, aged 80 years and over (RRR= 5.58; CI 95%: 1.55 -20.00) and cognitive decline (RRR = 7.83, 95% CI: 1.60 -38.24); and maximum need, be between 70 to 79 years (RRR = 2.60; CI 95%: 1.13 -5.96), have 80 and over (RRR = 5.59, CI 95%: 1.87 -16.62) and multimorbidity (RRR = 3.50; CI 95%: 1.32 -9.30).Process of frailty (OR = 2.12; 95% CI: 1.05 -4.27) and impaired physical mobility (OR = 1.77; 95% CI: 1.01 -3.12) Conclusion: Classifying the need for care enables identification of elderly individuals requiring help in the activities of daily living and directs health professionals when developing a range of care.Public policies should be developed for caregivers, considering the health and social services as support for the providers of care.
Год издания: 2016
Авторы: Daniella Pires Nunes
Ключевые слова: Health, Nursing, Elderly Care, Health disparities and outcomes, Health Systems, Economic Evaluations, Quality of Life
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