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

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

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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 copiar

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

Autoría SCIMAGO INSTITUTIONS RANKINGS

RESUMEN

Objetivos:

Identificar características sociodemográficas y de salud según fajas etarias y analizar asociación de autoevaluación del estado de salud y de satisfacción con la vida regular/mala con características sociodemográficas, funcionalidad global y caídas de ancianos en seguimiento por Atención Domiciliaria de la Atención Básica.

Métodos:

Estudio transversal con 124 ancianos, realizado mediante entrevistas domiciliarias. Se utilizó cuestionario de datos sociodemográficos y condiciones de salud, Índice de Barthel, Escala de Lawton, Mini Examen del Estado Mental, Escala de Depresión Geriátrica y Test Timed Up and Go. Se aplicó análisis bivariado y multivariado (Regresión de Poisson).

Resultados:

Predominaron octogenarias de sexo femenino. Autoevaluación de salud regular/mala presentó asociación con síntomas depresivos leves (p=0,002) y severos (p<0,001). Satisfacción con la vida regular/mala estuvo asociada con miedo a caer (p=0,019) y con síntomas depresivos leves (p<0,001) y severos (p<0,001).

Conclusión:

Los síntomas depresivos estuvieron asociados con peor autoevaluación de salud y satisfacción con la vida.

Descriptores:
Satisfacción Personal; Anciano; Enfermería Geriátrica; Atención Domiciliaria de Salud; Atención Primaria de Salud

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