Life satisfaction and health self-assessment of older adults assisted through home care

Predebon, Mariane Lurdes; Ramos, Gilmara; Pizzol, Fernanda Laís Fengler Dal; Soares, Juana Vieira; Paskulin, Lisiane Manganelli Girardi; Rosset, Idiane

doi:10.1590/0034-7167-2020-0357

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Brasil

Revista Brasileira de Enfermagem

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ORIGINAL ARTICLE • Rev. Bras. Enferm. 74 (Suppl 2) • 2021 • https://doi.org/10.1590/0034-7167-2020-0357 copy

Life satisfaction and health self-assessment of older adults assisted through home care

Autoevaluación de salud y satisfacción con la vida de ancianos seguidos por atención domiciliaria

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

to identify sociodemographic and health characteristics according to age groups and to analyze the association between self-assessed health status and satisfaction with regular/bad life with sociodemographic characteristics, global functioning and falls of older adults linked to home care within the primary health care network.

Method:

cross-sectional study with 124 older adults, conducted using home interviews. A sociodemographic data and health status questionnaire was used, together with Barthel Index, Lawton Instrumental Activities of Daily Living Scale (IADL), the Mini-Mental State Examination, the Geriatric Depression Scale and the Timed Up and Go Test. Bivariate and multivariate analyses (Poisson regression) were applied.

Results:

there was a predominance of female octogenarians. Self-assessment of regular/bad health was associated with mild (p=0.002) and severe (p<0.001) depressive symptoms. Satisfaction with regular/bad life was associated with fear of falling (p=0.019) and with mild (p<0.001) and severe (p<0.001) depressive symptoms.

Conclusion:

depressive symptoms were associated with a worse life satisfaction and health self-assessment.

Descriptors:
Personal Satisfaction; Aged; Geriatric Nursing; Home Nursing; Primary Health Care

Variables	Total sample	60 to 79 years	80 to 89 years	≥ 90 years	p ^* * Pearson’s chi-squared test supplemented by the analysis of adjusted residues;
Variables	N=124 (100%)	n=40 (32.3%)	n=54 (43.5%)	n=30 (24.2%)
Gender					0.001
Male	30 (24.2)	18 (45.0)^ statistically significant association according to the test of adjusted residues at 5% significance;	6 (11.1)	6 (20.0)
Female	94 (75.8)	22 (55.0)	48 (88.9)^ statistically significant association according to the test of adjusted residues at 5% significance;	24 (80.0)
Education					0.121
0 to 4 years	56 (45.2)	13 (32.5)	25 (46.3)	18 (60.0)
5 to 8 years	37 (29.8)	14 (35.0)	14 (25.9)	9 (30.0)
> 8 years	31 (25.0)	13 (32.5)	15 (27.8)	3 (10.0)
Marital status					0.003
Married	33 (26.6)	16 (40.0)^ statistically significant association according to the test of adjusted residues at 5% significance;	12 (22.2)	5 (16.7)
Single/Divorced	32 (25.8)	13 (32.5)	16 (29.6)	3 (10.0)
Widowed	59 (47.6)	11 (27.5)	26 (48.1)	22 (73.3)^ statistically significant association according to the test of adjusted residues at 5% significance;
Family income^* ***** minimum wage of 2018: R$ 954.00.					0.299
1 to 2 minimum wages	43 (34.7)	15 (37.5)	18 (33.3)	10 (33.3)
3 to 5 minimum wages	58 (46.8)	22 (55.0)	23 (42.6)	13 (43.3)
> 5 minimum wages	23 (18.5)	3 (7.5)	13 (24.1)	7 (23.3)
BADLs – Dependence					0.236
Moderate/Severe/Total	57 (46.0)	14 (35.0)	28 (51.9)	15 (50.0)
Slight/Independent	67 (54.0)	26 (65.0)	26 (48.1)	15 (50.0)
IADLs					0.012
< 12	64 (51.6)	13 (32.5)	32 (59.3)	19 (63.3)
≥ 12	60 (48.4)	27 (67.5)^ statistically significant association according to the test of adjusted residues at 5% significance;	22 (40.7)	11 (36.7)
Cognitive decline					0.967
With	61 (49.2)	19 (47.5)	27 (50.0)	15 (50.0)
Depressive symptoms					0.565
Normal	63 (50.8)	19 (47.5)	26 (48.1)	18 (60.0)
Mild	47 (37.9)	18 (45.0)	21 (38.9)	8 (26.7)
Severe	14 (11.3)	3 (7.5)	7 (13.0)	4 (13.3)
Mobility					0.025
< 20 s	27 (21.8)	13 (32.5)^ statistically significant association according to the test of adjusted residues at 5% significance;	12 (22.2)	2 (6.7)
≥ 20 s	48 (38.7)	10 (25.0)	20 (37.0)	18 (60.0)^ statistically significant association according to the test of adjusted residues at 5% significance;
Bedridden/Wheelchair user	49 (39.5)	17 (42.5)	22 (40.7)	10 (33.3)
Fall during the last year					0.325
Yes	49 (39.5)	12 (30.0)	24 (44.4)	13 (43.3)
Fear of falling					0.163
Yes	88 (71.0)	24 (60.0)	42 (77.8)	22 (73.3)

Variables (N=124)	Self-assessed health status			Satisfaction with life
Variables (N=124)	Regular/Bad n=47 (%)	PR (CI 95%)	p ^* * Poisson regression bivariate analysis;	Regular/Bad n=49 (%)	PR (CI 95%)	p ^* * Poisson regression bivariate analysis;
Gender
Male (n=30)	10 (33.3)	1.00		11 (36.7)	1.00
Female (n=94)	37 (39.4)	1.18 (0.67 a 2.08)	0.564	38 (40.4)	1.10 (0.65 a 1.87)	0.718
Age group
60 to 79 years (n=40)	13 (32.5)	1.00		17 (42.5)	1.00
80 to 89 years (n=54)	23 (42.6)	1.31 (0.76 a 2.26)	0.329	21 (38.9)	0.92 (0.56 a 1.50)	0.723
≥ 90 years (n=30)	11 (36.7)	1.13 (0.59 a 2.16)	0.715	11 (36.7)	0.86 (0.48 a 1.56)	0.625
Education
0 to 4 years (n=56)	10 (32.3)	1.27 (0.70 a 2.32)	0.429	23 (41.1)	0.98 (0.58 a 1.65)	0.937
5 to 8 years (n=37)	14 (37.8)	1.17 (0.61 a 2.26)	0.634	13 (35.1)	0.84 (0.46 a 1.53)	0.565
> 8 years (n=31)	23 (41.1)	1.00		13 (41.9)	1.00
Marital status
Married (n=33)	10 (30.3)	1.00		12 (36.4)	1.00
Single/Divorced (n=32)	17 (53.1)	1.75 (0.95 a 3.23)	0.072	20 (62.5)	1.72 (1.02 a 2.91)	0.043
Widowed (n=59)	20 (33.9)	1.12 (0.60 a 2.10)	0.727	17 (28.8)	0.79 (0.43 a 1.45)	0.450
Family income^ minimum wage of 2018: R$ 954.00.
1 to 2 minimum wages (n=43)	19 (44.2)	1.13 (0.61 a 2.08)	0.696	20 (46.5)	0.97 (0.57 a 1.66)	0.918
3 to 5 minimum wages (n=58)	19 (32.8)	0.84 (0.45 a 1.57)	0.580	18 (31.0)	0.65 (0.37 a 1.15)	0.140
> 5 minimum wages (n=23)	9 (39.1)	1.00		11 (47.8)	1.00
BADLs – Dependency
Moderate/Severe/Total (n=57)	28 (49.1)	1.73 (1.09 a 2.75)	0.020	27 (47.4)	1.44 (0.93 a 2.24)	0.101
Slight/Independent (n=67)	19 (28.4)	1.00		22 (32.8)	1.00
IADLs
< 12 (n=64)	31 (48.4)	1.82 (1.11 a 2.97)	0.017	31 (48.4)	1.62 (1.02 a 2.56)	0.042
≥12 (n=60)	16 (26.7)	1.00		18 (30.0)	1.00
Cognitive decline
Without (n=63)	21 (33.3)	1.00		23 (36.5)	1.00
With (n=61)	26 (42.6)	1.28 (0.81 a 2.02)	0.289	26 (42.6)	1.17 (0.75 a 1.81)	0.487
Depressive symptoms
Normal (n=63)	9 (14.3)	1.00		9 (14.3)	1.00
Mild (n=47)	25 (53.2)	3.72 (1.92 a 7.22)	<0.001	27 (57.4)	4.02 (2.09 a 7.73)	<0.001
Severe (n=14)	13 (92.9)	6.50 (3.49 a 12.1)	<0.001	13 (92.9)	6.50 (3.49 a 12.1)	<0.001
Mobility
<20 s (n=27)	9 (33.3)	1.00		8 (29.6)	1.00
≥ 20 s (n=48)	17 (35.4)	1.06 (0.55 a 2.05)	0.856	21 (43.8)	1.48 (0.76 a 2.87)	0.250
Bedridden/Wheelchair user (n=49)	21 (42.9)	1.29 (0.69 a 2.40)	0.430	20 (40.8)	1.38 (0.70 a 2.69)	0.350
Fall
Without (n=75)	23 (30.7)	1.00		26 (34.7)	1.00
With (n=49)	24 (49.0)	1.60 (1.02 a 2.49)	0.039	23 (46.9)	1.35 (0.88 a 2.08)	0.167
Fear of falling
Yes (n=88)	38 (43.2)	1.73 (0.93 a 3.19)	0.081	42 (47.7)	2.46 (1.22 a 4.94)	0.012
No (n=36)	9 (25.0)	1.00		7 (19.4)	1.00

Variables	Self-assessed health status		Satisfaction with life
Variables	PR (CI 95%)	p ^* * Poisson regression multivariate analysis;	PR (CI 95%)	p ^* * Poisson regression multivariate analysis;
Marital status
Married	1.00		1.00
Single/Divorced	1.43 (0.84 a 2.43)	0.186	1.37 (0.81 a 2.33)	0.243
Widowed	0.92 (0.54 a 1.56)	0.750	0.67 (0.39 a 1.14)	0.139
Family income^ minimum wage of 2018: R$ 954.00.
1 to 2 minimum wages	------	------	0.91 (0.48 a 1.70)	0.760
3 to 5 minimum wages	------	------	0.66 (0.40 a 1.11)	0.115
> 5 minimum wages	------	------	1.00
BADLs – Dependency
Moderate/Severe/Total	1.25 (0.79 a 1.96)	0.345	1.06 (0.63 a 1.77)	0.840
Slight/Independent	1.00		1.00
IADLs
< 12	1.02 (0.59 a 1.77)	0.947	0.98 (0.57 a 1.66)	0.926
≥12	1.00		1.00
Depressive symptoms
Normal	1.00		1.00
Mild	3.09 (1.54 a 6.19)	0.002	3.34 (1.79 a 6.25)	<0.001
Severe	5.64 (2.86 a 11.1)	<0.001	5.93 (2.95 a 11.9)	<0.001
Fall
Without	1.00		1.00
With	1.39 (0.94 a 2.06)	0.103	1.10 (0.78 a 1.56)	0.595
Fear of falling
Yes	1.19 (0.68 a 2.11)	0.542	2.02 (1.12 a 3.63)	0.019
No	1.00		1.00

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[1] Corresponding author: Mariane Lurdes Predebon E-mail: predebon11@gmail.com