Perfil de cuidadores de idosos com doença de Alzheimer associado à resiliência

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.

Burden, Stress, and Depression in Informal Caregivers of Patients Pre and Post Liver Transplant

BACKGROUND

Caring for a patient with chronic liver disease involves exposure to factors that increase family caregivers' vulnerability to developing mental disorders. This study reassessed the scores of burden, stress, and depression in informal (family) caregivers of patients with liver disease after liver transplant.

METHODS

In this observational and descriptive study, the caregivers were reassessed for the same outcomes 4 to 10 years following the initial assessment pre-transplant. The data were obtained from the identification card, the interview script, the Brazilian version of the Caregiver Burden Scale, the Lipp Inventory of Stress Symptoms for Adults, and the Beck Depression Inventory. Descriptive statistics of pre- and post-liver transplant phases were calculated, and the Wilcoxon signed rank test was used to compare the burden scores.

RESULTS

The 5 caregivers were women, with a mean age of 51.6 (SD, 8.38) years. All of the caregivers' (100%) burden score increased, 2 caregivers needed to seek some form of help, and 3 caregivers showed an indication of burden risk. Regarding stress symptoms, 3 caregivers (60%) maintained a score indicating no stress, 2 caregivers (40%) presented increased scores, and the predominant symptoms changed from psychological to physical. Regarding depression, 3 caregivers (60%) maintained the minimum level of symptoms for depression, and 2 caregivers (40%) presented increased scores.

CONCLUSION

After liver transplant, caregivers' burden scores increased, and levels of stress and depression increased for caregivers who already showed symptoms in the pre-transplant phase.

Resilience in Carers of People With Young-Onset Alzheimer Disease

Young-onset Alzheimer disease (YOAD) causes psychological and emotional difficulties for carers. However, even in the face of considerable caregiving demands and burden, some carers are resistant to stress, which may be a sign of resilience. This study investigated whether the clinical symptoms of the person with YOAD might be associated with resilience in their carers. A consecutive series of 43 persons with YOAD and their 43 family caregivers were assessed. The carers showed moderate to high level of resilience, low level of anxiety and depressive symptoms, and moderate level of burden. No relationship was found between resilience and sociodemographic characteristics of both carers and care recipient and with clinical characteristics of persons with YOAD. A linear regression analysis showed that resilience was inversely associated with carers' depressive symptoms. The findings suggest that resilience may mainly be related to carers' mental health.

Sobre o cuidar e o ser cuidado na atenção domiciliar

RESUMO O objetivo deste artigo é evidenciar experiências do cuidar e ser cuidado e apresentar a visão de cuidadores familiares sobre um Serviço de Atenção Domiciliar. É um estudo de caso que aplica a cartografia como ethos no campo de pesquisa para captar as experiências durante as visitas domiciliares e entrevistas com cinco cuidadoras. Para análise da dimensão empírica, foram eleitos Planos de Corte e, dentro destes, Planos de Visibilidade para exercício da reflexividade. A alteridade vivida pelos cuidadores e a sobrecarga de responsabilidades são algumas expressões captadas no campo de pesquisa que indicam a necessidade de associar serviços de saúde a serviços de apoio sociais.

Caracterização de cuidadores de idosos da região metropolitana de Porto Alegre (RS): perfil do cuidado

RESUMO Este trabalho visa a caracterizar cuidadores de idosos da região metropolitana de Porto Alegre quanto a: capacitação para a profissão, seus sentimentos frente ao idoso, sobrecarga de trabalho, estado cognitivo e condição física. Entre janeiro e fevereiro de 2015, 20 participantes responderam a um questionário sobre idade, gênero, escolaridade, estado civil, breve investigação de estado de saúde e sentimentos frente ao cuidado e à Escala de Zarit Burden Interview, Escala de Depressão Geriátrica Abreviada, Mini Exame do Estado Mental, Escala de Avaliação do Equilíbrio e da Marcha de Tinneti. Verificou-se que as participantes nunca fizeram capacitação e apresentam perdas de saúde.

Resilience in aging: literature review

Psychological resilience is comprised of an adaptive functioning standard before the current and accumulated risks of life. Furthermore, it has a comprehensive range of psychological resources which are essential to overcome adversities, such as personal competences, self-beliefs and interpersonal control which interact with the social networks support. The objectives are to show the concepts of psychological resilience in elderly, relative to dominant theoretical models and the main data about psychological resilience in aging, found in an international and Brazilian review from 2007 to 2013. The descriptors "resilience, psychological resilience and aging", "resiliência e envelhecimento, velhice e velho", were used in PubMed, PsychInfo, SciELO and Pepsic databases. Fifty three international and eleven national articles were selected. The international articles were classified in four categories: psychological and social coping resources, emotional regulation before stressing experiences, successful resilience and aging and correlates, and resilience measures. The Brazilian articles were grouped in three: psychological and social resources, resilience in carers and theory review. Articles on psychological resources and on emotional regulation prevailed as key factors associated with psychological resilience in aging.

[Effectiveness of non-pharmacological interventions in the quality of life of caregivers of Alzheimer]

OBJECTIVE

Explore the effectiveness of non-pharmacological interventions to improve the quality of life of family caregivers of Alzheimer's patients.

METHODS

We conducted a systematic review, in pairs, in the following databases: PubMed, Scopus, CINAHL, PsycINFO, WOS, Cochrane Library, IME, Cuiden Plus and Dialnet. Inclusion criteria were: 1. Studies published between 2010-2015. 2. Language: English, Portuguese and Spanish. 3. Randomized controlled clinical trials. 4. Score greater than or equal to 3 on the Jadad scale.

RESULTS

13 studies were included. Four performed a psychosocial intervention with family caregivers, three psychotherapeutic, two psychoeducational, two multicomponent, one educational and another with mutual support groups. The tools to assess quality of life: three studies used the Health Status Questionnaire (HSQ), three EuroQol-5D (two only used the EVA), two health questionnaire SF-36, two WHOQOL-BREF, two Quality of Life SF-12 and one Perceived Quality of Life Scale (PQoL). Regarding the effectiveness of non-pharmacological interventions, five studies obtained favorable results in the quality of life after psychotherapeutic interventions and community-type multicomponent training.

CONCLUSION

The diversity of non-pharmacological interventions used and contents, differences in the number of sessions and hours, and variability of valuation tools used to measure quality of life of family caregivers, leads us to reflect on the appropriateness to standardize criteria, for the sake to improve clinical practice.

Factors associated with the resilience of family caregivers of persons with dementia: a systematic review

Abstract Background: Resilience is the ability of individuals or groups to overcome adversity without displaying physical or mental disorders, or even learning to deal with unfavorable conditions more efficiently. There have been many studies on resilience, which try to identify the conditions under which people in situations of deprivation or adversity overcome such challenges. Objective: The present article aimed to identify factors associated the with development of resilience in family caregivers of people with dementia and the possible outcomes of resilience for the caregiver and receiver of care. Method: The study consisted of a systematic literature review carried out in accordance with the PRISMA methodology with searches in the Lilacs, PsycInfo, PubMed, SciELO, SCOPUS and Web of Science databases, using pre-established descriptors. Results: After synthesis of the extracted data and the considerations of this review, it was possible to identify possible factors associated with the development of resilience in family caregivers of persons with dementia: depression, anxiety, burden, drug use, the relationship with the person receiving care and health conditions are associated with the resilience of family caregivers. Conclusion: We found in literature that the development of resilience by family caregivers of people with Alzheimer's is influenced by factors related to the patient and the caregiver himself or herself.

Classificação socioeconômica e qualidade de vida de familiares de crianças e adolescentes com deficiência auditiva

RESUMO: Objetivo: investigar a relação da classificação socioeconômica e a percepção da qualidade de vida de pessoas que possuem um familiar com deficiência auditiva. Métodos: trata-se de uma pesquisa exploratória de caráter quantitativo e descritivo desenvolvida com familiares de crianças e adolescentes com deficiência auditiva, inseridos no Sistema Único de Saúde. Foram utilizados na pesquisa o Critério de Classificação Econômica Brasil e o questionário de Qualidade de Vida WHOQOL-BREF. Todos os dados foram tabulados e submetidos à análise estatística. Foi realizada estatística descritiva e análise gráfica das variáveis. Resultados: participaram da pesquisa 20 familiares de pacientes com deficiência auditiva. Ao analisar de forma descritiva as respostas do Critério de Classificação Econômica Brasil, percebeu-se que a maioria dos participantes pertence às classes B2 e C1, correspondentes a 35% cada. A menor parte da amostra encontra-se na classe C2, correspondente a 10%, e 20% está inscrita na classe B1. Percebeu-se melhor qualidade de vida no domínio social (69,1) e pior qualidade de vida no domínio ambiental (55,1). Conclusão: o estudo mostrou que houve relação entre a classificação socioeconômica e a percepção da qualidade de vida dos familiares, pois quanto menor a classificação socioeconômica, pior foi a percepção de qualidade de vida em todos os domínios, exceto para o domínio ambiental.

Quality of life of caregivers of octogenarians: a study using the WHOQOL-BREF

OBJECTIVE

To evaluate the quality of life of octogenarians and to identify the domains related to quality of life and health.

METHODOLOGY

A cross-sectional, quantitative study conducted in 2010 in the Family Health Units of Campina Grande/PB, Brazil. The study sample consisted of 52 subjects that met the eligibility criteria of: 18 years or older, being a lay caregiver of octogenarians, and having no apparent cognitive problem. A questionnaire containing a sociodemographic section and the WHOQOL-BREF that is composed of two questions about the perceptions of quality of life and health, and 24 on the physical, psychological, social relationships and environmental domains. The Cronbach's-alpha test and the logical regression analysis of the data were conducted using SPSS. The project was approved by the Research Committee of the Center for Development and Higher Education (CAAE nº0490.0.133.000-08).

RESULTS

The Cronbach's alpha was 0.72, attesting to the reliability of the instrument used. The domain scores were: environmental (59.43), psychological (59.01), social relationships (46.77) and physical (43.86), whose values indicate dissatisfaction of subjects with regard to aspects related to quality of life. The environmental domain was correlated with quality of life (p=0.014) and the physical domain with perceptions of health (p=0.019); the daily safety and pain aspects had the highest correlations with quality of life (p=0.001).

CONCLUSION

The perception of the caregivers regarding quality of life was not good. The environmental and physical domains had the highest correlations with quality of life and health.

CARE OF THE ELDERLY WITH ALZHEIMER'S FAMILY CAREGIVER: A UNIVERSITY EXTENSION ACTIVITY

ABSTRACT An academic experience report of the university extension project: Mutual Help Group for Relatives of Elderly Living with Alzheimer's or Related Diseases. Alzheimer's is a progressive neurodegenerative disease, which is part of the group of dementias, being characterized by the deterioration of the mental functions resulting in cognitive impairment. Therefore, the family caregivers of elderly patients with Alzheimer's needs care and guidance to promote management and care for themselves and for the patients. It is important to involve health professionals in this scenario, especially nurses, acting directly in the health education process. Thus, the academic involvement in the extension project enriches the college education based on the contact with a certain community and, in this context, provides for further interaction with the complexity involving families and elderly people with Alzheimer's.

Conduta do tratamento medicamentoso por cuidadores de idosos

O envelhecimento populacional está ampliando o número de cuidadores de idosos no Brasil. A farmacoterapia compreende um sistema complexo de atividades e a sua condução está presente no rol de tarefas desempenhadas por esses atores. Além disso, a conduta do tratamento pode estar sujeita a diversos problemas na sua execução, com destaque para: dificuldades de administração dos medicamentos, falta de acesso aos medicamentos, obstáculos na realização de observação clínica, assim como os desafios presentes no estabelecimento de uma comunicação efetiva com os idosos e profissionais de saúde. O presente estudo trata de uma revisão cujo objetivo é ampliar as discussões sobre os aspectos supracitados, de modo que este debate dê subsídios teóricos aos programas e serviços na área de gerontologia.

Association between social support and quality of life of relative caregivers of elderly dependents

Objective: to ascertain the association between the social support and the quality of life of relative caregivers of elderly dependents at home.Method: a cross-sectional study conducted with 58 relative caregivers of elderly dependents, registered in the Family Health Strategy. Data were collected from the Katz instrument, sociodemographic, Zarit Burden Interview, WHOQOL-bref, and analyzed using descriptive statistics and multiple linear regression.Results: the majority of caregivers were women, who took care full-time and presented moderate to severe burden. Most caregivers are satisfied with their social relationships and the social support received. It is found that the burden and the time of care correlated with the social relationships domain, which is associated with social support, and consequently, reduced quality of life.Conclusion: social support for caregivers is important to prevent health implications, burden, biopsychosocial stress, and provide favorable conditions for quality of life, by allowing greater freedom to develop their daily activities.

Resilience of caregivers of people with dementia: a systematic review of biological and psychosocial determinants

Introduction: Although caregivers of people with dementia may face difficulties, some positive feelings of caregiving may be associated with resilience.Objective: This study systematically reviewed the definitions, methodological approaches and determinant models associated with resilience among caregivers of people with dementia.Methods: Search for articles published between 2003 and 2014 in ISI, PubMed/MEDLINE, SciELO and Lilacs using the search terms resilience, caregivers and dementia.Results and conclusions: Resilience has been defined as positive adaptation to face adversity, flexibility, psychological well-being, strength, healthy life, burden, social network and satisfaction with social support. No consensus was found about the definition of resilience associated with dementia. We classified the determinant variables into biological, psychological and social models. Higher levels of resilience were associated with lower depression rates and greater physical health. Other biological factors associated with higher levels of resilience were older age, African-American ethnicity and female sex. Lower burden, stress, neuroticism and perceived control were the main psychological factors associated with resilience. Social support was a moderating factor of resilience, and different types of support seemed to relieve the physical and mental overload caused by stress.

Quality of life of relative caregivers of elderly dependents at home

The objective of this study was to analyze the relationship of sociodemographic characteristics and activity overload with the quality of life of relative caregivers of elderly dependents at home. This is an epidemiological, transversal study, conducted with 58 relative caregivers of elderly people registered in Family Health Programs in a municipality in the state of Bahia. Sociodemographic data were collected; in addition, the Katz Index of Independence, Zarit Burden Interview, and WHOQOL-bref were administered. The data were analyzed using correlation and multiple linear regression. The Zarit scale was negatively associated with all areas of the WHOQOL-bref domain, which was corroborated by the multiple regression model, which identified that the Zarit scale alone was able to predict the impact of care on quality of life of the studied caregivers. There is evidence of a need for expansion of social and health support to caregivers in an attempt to minimize overload, improving the quality of life of these individuals.

Perfil dos cuidadores e as dificuldades enfrentadas no cuidado ao idoso, em Ananindeua, PA

OBJETIVO: Descrever o perfil dos cuidadores de idoso, bem como sua importância e principais dificuldades no ato de cuidar do idoso. METODOLOGIA: Trata-se de estudo transversal descritivo e exploratório realizado pela equipe PET Saúde, em uma Estratégia de Saúde da Família (ESF), no município de Ananindeua, Pará. A coleta de dados foi feita por meio de um questionário semiestruturado abordando aspectos sociodemográficos e questões referentes a importância e dificuldades encontradas pelos cuidadores de idosos. RESULTADOS: Foram entrevistados 31 cuidadores, predominando sexo feminino, estado civil casado, com ensino médio completo, renda entre dois e três salários mínimos, tempo de exercício da função maior que 12 meses, em sua abrangência cuidadores informais e com vínculo de parentesco com o idoso. Os cuidadores reconheceram que é importante a presença de um cuidador e consideraram o idoso sob seu cuidado como saudável. CONCLUSÃO: A maioria dos cuidadores era do tipo informal, caracterizada por mulheres, com vínculo familiar, que destacaram a paciência e a falta de conhecimento como as principais dificuldades do cuidador. Os dados deste estudo se limitam a uma realidade local, necessitando de mais pesquisas para fomentar as particularidades e dificuldades enfrentadas pelos cuidadores.