SOCIOECONOMIC AND HEALTH CONDITIONS ASSOCIATED WITH QUALITY OF LIFE OF ELDERLY QUILOMBOLAS

Reflexão sobre o controle do acesso de quilombolas à saúde pública brasileira

OBJETIVO: refletir acerca do acesso de quilombolas brasileiros ao sistema de saúde pública a partir da perspectiva do pensamento do filósofo francês Michael Foucault.SÍNTESE DE CONTEÚDO: ao refletir sobre o acesso dos quilombolas ao sistema de saúde pública, é importante reconhecer a existência de micropoderes nos serviços de saúde e na relação com os usuários deste serviço. Reflete-se sobre a necessidade de exercer o controle social como forma de garantia de direitos à saúde. Assim, apesar do Sistema Único de Saúde possuir avanços, o acesso a este serviço apresenta dificuldades como também inadequação de gerenciamento, além de escassez no exercício do controle social, como pontos a serem questionados.CONCLUSÃO: percebe-se que, à luz do referencial teórico de Michael Foucault, o “poder” político, existente nas relações das comunidades quilombolas referentes aos serviços de saúde pública, cria dificuldades diversas e que há anos se perpetua.

Quality of life of elderly quilombolas in the Brazilian northeast

Abstract Objective: To evaluate the quality of life (QoL) of elderly quilombolas (residents of quilombo settlements first established by escaped slaves) in mixed urban and rural residential developments (agrovilas) in Alcântara, Maranhão, Brazil. Method: An observational, cross-sectional and descriptive study was performed. The sample consisted of 129 elderly people of both genders, aged 60 years or older and living in northeastern Brazil. The sample was allocated into three groups, distributed according to geographic space. Quality of life was assessed using the WHOQoL-Bref instrument and a sociodemographic questionnaire was applied. The comparison between groups was carried out using the Anova test (one-way) and subsequently the Bonferroni Post-Hoc test. The correlation was obtained by the Pearson test, p<0.05. Results: Elderly quilombolas had a mean age of 69.7 years (±7.9) and were predominantly men with low income and schooling. Quality of life had higher scores in the social domain (values) and lower in the environmental domain (values). Quality of life as measured by the psychological domain was higher in group I than in groups II (p=0.012) and III (p=0.002). The facets of QoL correlated with facets of health for group I (r=0.357; p=0.032) and III (r=0.461; p<0.001). Conclusion: The situation of the quilombola population surveyed is considered vulnerable and psychological factors influence QoL.

FACTORS ASSOCIATED WITH THE QUALITY OF LIFE OF PATIENTS UNDERGOING HEMODIALYSIS

ABSTRACT Objective: to identify factors associated with the quality of life/spirituality, religion and personal beliefs of patients with chronic kidney disease undergoing hemodialysis. Method: correlational cross-sectional study. The following instruments were applied through individual interviews: the WHOQOL-Bref, the WHOQOL-SRPB, along with a questionnaire to characterize the participants. The sample consisted of 110 participants with chronic kidney disease undergoing hemodialysis. Descriptive analysis was performed along with univariate and multiple logistic regression to identify associated factors. Results: low level of albumin was mainly associated with the “physical” and “social relationships” domains of the WHOQOL-BREF. Participants without an occupation presented the greatest compromise in the domains “Connectedness to a spiritual being or force” and “Awe”. In the domain “spiritual strength”, participants worth an occupation presented higher chances of low quality of life. Conclusion: the factors associated with the domains of quality of life of patients with chronic kidney disease undergoing hemodialysis were: occupation, marital status, sex, education, religion, levels of hematocrit and albumin, and overall health.