Habilidades sociais e estratégias de enfrentamento de estresse: relação com indicadores de bem-estar psicológico em cuidadores de idosos de alta dependência

Benefits Perceived by Caregivers of Patients with Alzheimer's Disease on Physical and Emotional Health in an Interdisciplinary Program: A Qualitative Study

Alzheimer's disease is the most common type of dementia, severely affecting the families and caregivers who live with those affected. The aim was to explore the physical, psychological, and behavioral benefits for caregivers of people with Alzheimer's disease. Fifteen semi-structured interviews were conducted with informal Alzheimer's caregivers upon completion of the program. Following a discussion on the topics, categories, and codes among the researchers, a consensus was reached to obtain the final themes and categories. Three main categories were obtained: (1) perceived benefits by the participants; (2) applicability of the knowledge; and (3) proposals for improvement. Participants expressed having perceived improvements in their ability to manage emotions and cope with the situation created by the disease, physical capacity, and in their relationships. In this sense, the application of the contents addressed during the intervention became a fundamental tool for the participants' daily lives. This study showed how an interdisciplinary intervention with psychological sessions, health education, and physical activities could be beneficial for improving both the physical and mental health of caregivers.

Evidence of internal validity of the social skills inventory for caregivers (SSI-CE) in Brazil

With population aging, it is important to develop studies on psychological skills that can facilitate the task of caregivers of a dependent older adult. The Social Skills Inventory for Caregivers of the Elderly (SSI-CE) is an assessment tool for this purpose. Even considering that the instrument already has evidence of validity, the aim of this study is to seek additional evidence of validity for the SSI-CE. To this end, 533 family caregivers of older adults with an average age of 49.7 years were investigated by responding to the following instruments: Sociodemographic Questionnaire, Brazil Economic Classification Criteria, and SSI-CE. Initially, two factor models for the SSI-CE were compared (second-order and bifactor models). Then, analyses were performed for measurement invariance and sample heterogeneity of the SSI-CE in relation to the variables age, gender, presence of dementia in the elderly care receiver, and type of data collection (online or in-person). Finally, the instrument's reliability values were checked. After comparing the models, the second-order model was the most appropriate, as it displayed reliability values ranging from ω = 0.66 to ω = 0.89. In invariance analysis, variability was found for sample heterogeneity in the variables gender, presence of dementia, and type of data collection. In conclusion, the calculation of a global score for the SSI-CE is pertinent, with good evidence of internal validity. However, specific rules should be established, considering different sample characteristics.

Nursing outcomes and interventions associated with the nursing diagnoses: Risk for or actual frail elderly syndrome

PURPOSE

To clinically validate nursing outcomes and interventions associated with the nursing diagnoses of Risk for Frail elderly syndrome or Frail elderly syndrome.

METHODS

This cross-sectional study utilized an instrument containing assessment cues, nursing diagnoses, outcomes, and interventions in a sample of 28 older adults. The Generalized Estimation Equation model, complemented by the Bonferroni test, was used for statistical analysis.

RESULTS

Twenty-three (82%) older adults were diagnosed with Risk for Syndrome and five (18%) with Frail elderly syndrome. Ten outcomes and three interventions were validated with significant differences statistically.

CONCLUSIONS

The clinical validation made it possible to demonstrate the clinical evolution of these patients under follow-up.

IMPLICATIONS FOR NURSING PRACTICE

Those outcomes and interventions are a linkages proposal between them and the nursing diagnoses.

OBJETIVO

Validar clinicamente os resultados e intervenções de enfermagem associados ao diagnóstico de enfermagem Risco para Síndrome do Idoso Frágil ou Síndrome do Idoso Frágil. MÉTODOS: Estudo transversal que utilizou um instrumento contendo possibilidades de avaliação, diagnóstico de enfermagem, resultados e intervenções em uma amostra de 28 idosos. A análise estatística utilizou o modelo de Equações de Estimativas Generalizadas, complementado pelo teste de Bonferroni.

RESULTADOS

Vinte e três (82%) idosos foram diagnosticados com Risco de Síndrome e cinco (18%) idosos com Síndrome. Dez resultados e três intervenções foram validados com diferença estatisticamente significativa. CONCLUSÕES: A validação clínica permitiu demonstrar a evolução clínica desses pacientes em acompanhamento. Implicações para a prática de enfermagem. Esses resultados e intervenções são uma proposta de vínculo entre eles e os diagnósticos de enfermagem.

Novos estudos psicométricos para o Inventário de Habilidades Sociais para Cuidadores de Idosos (IHS-CI)

Cuidar de um idoso dependente é uma tarefa cada vez mais comum. Com isso, para avaliar habilidades sociais de cuidadores de idosos, foi desenvolvido o Inventário de Habilidades Sociais para Cuidadores de Idosos (IHS-CI). O objetivo deste estudo foi verificar evidências de validade adicionais relativas à estrutura interna dos itens e as baseadas na relação com outras variáveis. Participaram 252 cuidadores de idosos familiares, com idade média de 50 anos (DP = 14.4) e maioria do sexo feminino (86.9%), que responderam ao IHS-CI e a um questionário sociodemográfico. Desses, 74 responderam também ao Inventário de Empatia. A estrutura fatorial do IHS-CI mostrou-se adequada (RMSEA = 0.07, CFI = 0.92 e x2/gl = 2.35) e se correlacionou positivamente com os escores de empatia. O IHS-CI é um instrumento relevante e sua interpretação pode servir para avaliar intervenções em cuidadores, assim como orientar quais classes de habilidades sociais precisam ser aprimoradas.

Elderly caregivers of other elderly living with and without children: burden, optimism and coping strategies

Abstract This article aims to compare level of burden, optimism and coping strategies among elderly caregivers of other elderly individuals who reside with and without children. A cross-sectional study was with a sample of 301 elderly caregivers of elderly Brazilians seen in primary health care. Among the 301 caregivers interviewed, 44 resided with children and 257 did not. Evaluations involved the administration of the Zarit Burden Inventory, Spirituality Scale (optimism) and Coping Strategies Inventory. Either the Student’s t-test or the Mann-Whitney U-test was used for the comparisons between the two groups. Burden level was significantly higher among elderly caregivers who resided with children (p = 0.01). No significant differences were found with regard to optimism. Elderly caregivers who did not reside with children reported significantly greater use of coping strategies focused on the expression of negative emotions (p < 0.01), religiosity (p < 0.01) and the inhibition of negative emotions (p = 0.01). The elderly caregivers of other elderly individuals who resided with children had a higher level of burden and used coping strategies less than those who did not reside with children.

DETERMINING FACTORS IN THE SITUATIONAL TRANSITION OF FAMILY MEMBERS WHO CARE OF ELDERLY PEOPLE WITH PARKINSON'S DISEASE

ABSTRACT Objective: to investigate the facilitator and inhibitory factors in the transition of elderly caregivers with Parkinson's disease. Method: a qualitative, exploratory and descriptive study, based on the family transition nursing theory developed with 20 elderly caregivers of elderly people with Parkinson 's disease, enrolled in the Associação Parkinson de Santa Catarina, from March to August 2015. To analyze and interpret the data, we used the thematic analysis of content proposed by Bardin, with the help of the ATLAS.ti software for data organization. Results: some factors were identified and considered as facilitators for the process of transition from the familiar to the exercise of the role of caregiver, such as: previous experiences as caregiver; spirituality and religiosity; family support network and health services. Other factors were identified as inhibiting factors for transition: emotional and physical health conditions; advanced age; personal life activities/commitments; family financial burden; and inadequate family support. It was observed that most family caregivers reported having previous experience in caring, having advanced age, and being able to care for the elderly with the disease. However, he considers his condition of emotional and physical health insufficient, resulting in overload. Lack of access to health services and family and financial support make it difficult to provide care. Conclusion: nurses should seek strategies to direct attention to facilitating factors in the family context in order to help the family to achieve well-being and healthy transition to the role of caregiver.