The aging process can be accompanied by a slight decline in cognitive functioning, and subjective memory complaints (SMC) appear to be common in the elderly population.ObjectiveTo determine whether SMC is associated with cognitive loss or depression and can predict dementia.MethodsA systematic review of the literature was conducted. Articles were selected on the following databases, LILACS, SCOPUS, SCiELO, PubMed and Web of Science from August to October 2013. Article selection was based on inclusion and exclusion criteria. Studies published between 2010 and 2013, written in English, Spanish or Portuguese, involving populations 65 years or older, were included. Reviews were excluded.ResultsAfter the selection, a summary of the 20 articles retrieved was carried out. Of the total articles retrieved, fifteen were cross-sectional studies and five were longitudinal studies. Most of the cross-sectional studies associated SMC with depression, objective cognitive impairment and anxiety. The emergence of dementia in people with SMC was evidenced in longitudinal studies. Albeit less frequently, SMC were also associated with reduced quality of life, impairment in Activities of Daily Living (ADL), emergence of neuropsychiatric symptoms, lower hippocampal volume, amygdala volume reduction, increased activation of the left temporal, bilateral thalamus, caudate and posterior cingulate, and with the occurrence of ApoE ε4.ConclusionSMC may be associated with changes in mood and/or cognition, and its occurrence appears to increase the likelihood of dementia. In order to further our understanding of the topic, future studies should consider the recruitment of representative samples with control groups and longitudinal designs.

The task of caring for a family member with dementia is associated with caregiver physical and emotional problems. The patient's decline in health and specific needs contribute directly to this situation. Objective: To evaluate burden, stress, depression and anxiety symptoms in family caregivers of elderly with Alzheimer's disease. Methods: A cross-sectional, descriptive, correlational and quantitative study was carried out. The sample consisted of 66 family caregivers of elderly with Alzheimer's disease, whom attended the Cognitive and Behavioral Neurology Outpatient Clinic of the Federal University of São Carlos, in the city of São Carlos, SP, Brazil. Results: Of the caregivers evaluated in the severe AD subgroup, 47.3% had intense burden; 86, 4% exhibited significant stress levels; 57% presented severe anxiety levels and 36.9% presented mild depression symptoms. Conclusion: Caring for a family member with Alzheimer's disease generates burden, stress, anxiety and depression. Support groups comprising a multiprofessional team can be set up to assist caregivers. These actions can help caregivers cope with the daily demands and challenges and ensure better care quality in an increasingly aging population. TRANSTORNOS EMOCIONAIS EVIDENCIADOS POR CUIDADORES FAMILIARES DE IDOSOS COM DOENÇA DE ALZHEIMERRESUMO. A tarefa de cuidar de um familiar com demência está relacionada a problemas físicos e emocionais no cuidador. O declínio do paciente e suas demandas específicas contribuem diretamente para essa situação. Objetivo: Avaliar sintomas de sobrecarga, estresse, depressão e ansiedade em cuidadores familiares de idosos com doença de Alzheimer. Métodos: Estudo transversal, descritivo, correlacional e de caráter quantitativo. A amostra foi composta por 66 cuidadores familiares de idosos com doença de Alzheimer, atendidos no Ambulatório de Neurologia da Universidade Federal de São Carlos, na cidade de São Carlos, SP, Brasil. Resultados: Dos cuidadores alocados no subgrupo DA avançada, 47,3% foram avaliados com sobrecarga intensa; 86,4% apresentaram níveis de estresse significativo; 57% apresentaram níveis graves de ansiedade e 36,9% apresentaram sintomas de depressão leve. Conclusão: Cuidar de um familiar com doença crônica e degenerativa como a doença de Alzheimer gera sobrecarga, assim como estresse, ansiedade e depressão. Grupos de apoio compostos por uma equipe multiprofissional podem ser implantados no sentido de garantir o acompanhamento desses cuidadores. Tais ações podem auxiliar a lidar com as demandas e os enfrentamentos diários e ainda garantir uma melhor qualidade no cuidado prestado, considerando o avanço do envelhecimento populacional. Palavras-chave: doença de Alzheimer, idoso, cuidadores, família, demência, enfermagem geriátrica.

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.

Resiliência é uma capacidade das pessoas de enfrentar de forma positiva as adversidades. O estudo transversal, quantitativo, teve por objetivo avaliar fatores associados à resiliência em cuidador familiar de idosos com doença de Alzheimer. A amostra foi composta por 66 cuidadores de idosos, acompanhados em um ambulatório de neurologia. A maioria dos cuidadores apresentou resiliência moderada.  Análise de regressão linear mostrou que alguns fatores interferem na resiliência dos cuidadores sendo estes: sobrecarga, aumento do número de dias dedicados ao cuidado, grau de parentesco nora/genro ou cônjuge, e prática de outras atividades além do cuidado. Os achados poderão ser úteis em áreas ligadas ao cuidado, e uma vez que foram identificadas variáveis que interferem na resiliência, estas poderão ser trabalhadas e melhoradas em benefício do cuidador e do paciente.

This study aimed to assess the effectiveness of a structured intervention on the frequency of self-care behaviors with arteriovenous fistula (AVF) by patients on hemodialysis. This is a quasi-experimental study with pre- and post-measurements. Participants were assigned to an intervention group (IG) ( n = 48) or to a control group (CG) ( n = 41). IG patients were subject to a structured intervention on self-care with AVF (SISC-AVF) consisting of both a theoretical and a practical part. After SISC-AVF application, patients in the IG showed better overall self-care behaviors with AVF than patients in the CG (79.2% and 91.4%, respectively, p < .001) as well as better self-care concerning both the management of signs and symptoms (90.1% and 94.4% respectively, p = .004) and the prevention of complications (72.7% and 89.5%, respectively, p < .001). The study results suggest that the SISC-AVF had positive effects on patients in the IG.

BACKGROUND AND OBJECTIVES: Recent studies show that religion and spirituality are important for the dialysis patient since these variables have been shown to influence important aspects of quality of life and to cope with the disease. In addition, spirituality may be effective in coping with chronic kidney disease and relieving symptoms arising from hemodialysis. The objective of this study was to evaluate the attitudes towards the pain in patients with chronic kidney disease on hemodialysis and its relation with spirituality. METHODS: This is a co-relational and cross-sectional study of 50 patients with chronic kidney disease on hemodialysis. The data were collected through an individual interview, using the sociodemographic characterization questionnaire, Brief Pain Inventory and the Pinto and Pais-Ribeiro Spirituality Scale. RESULTS: Regarding attitudes facing chronic pain measured by the Brief Pain Inventory, the lowest mean score was in the "Solicitude" domain (1.48±1.35) and the highest in "Incapacity" (3.05±1.37). As for spirituality, the mean scores were 3.80±0.39 and 3.36±0.67 in the beliefs and hope/optimism dimensions, respectively. A positive, moderate-magnitude correlation was observed between the hope/ optimism dimension of the Pinto and Pais-Ribeiro Spirituality Scale and the solicitude domains (r=0.315, p=0.026) and emotion (r=0.299, p=0.035) of the Brief Pain Inventory. CONCLUSION: The relationship between attitudes facing pain and the level of spirituality of the chronic renal patient was confirmed. Therefore, these aspects should be considered in the care provided to help in coping with the treatment and the disease.

The purpose of this study was to evaluate the psychometric properties of the Brazilian Scale for the Assessment of Self-Care Behaviors with Arteriovenous Fistula in Hemodialysis. Cross-sectional validation study, followed the recommendation provided by Sousa and Rojjanasrirat. Content validity, explanatory and confirmatory factor analyses used to check validity and Cronbach’s alpha was the reliability measure. Three hundred hemodialysis patients with arteriovenous fistula were included in the study. The expert committee assessed the content validity. Exploratory factor analysis confirmed the same two-factor structure found for the original scale, explaining 60.10% of the variance. Such solution was checked by confirmatory factor analysis with Cronbach’s alpha equal to 0.920, 0.810, and 0.884 for the overall scale, the self-care in management of signs and symptoms and the self-care in prevention of complications subscales respectively. The scale has good psychometric properties to assess self-care behaviors and can be used with Brazilian patients on hemodialysis with arteriovenous fistula.

According to a Brazilian consensus, frailty consists of a state of physiological age-related vulnerability that is produced through reduction of homeostatic reserves and reduced capacity of the organism in response to negative health outcomes, such as hospital admissions, falls and functional loss, with increased likelihood of death. 1 Despite being a complex syndrome, frailty can be reversed or mitigated through effective interventions, but for this to occur, it is recommended that screening for frailty should be done early, while patients are still in care. 2 Although the concept of frailty is well established from the physical point of view, it is not an exclusively physical syndrome. It also encompasses biopsychosocial factors that depend on a holistic view of frail individuals. 3,4 The population with chronic kidney disease (CKD) has high incidence and prevalence of physical and cognitive impairment, and is more predisposed to early development of frailty. 5In addition, the process of CKD, from diagnosis to treatment with hemodialysis, leads to several biopsychosocial changes in patients' lives. 6 Mansur, Damasceno and Bastos carried out a study among 146 patients with CKD undergoing conservative treatment (CT), hemodialysis (HD) or peritoneal dialysis (PD), with the aim of assessing the prevalence of frailty and the factors associated with it. 7 They pointed out that frailty occurs frequently among patients with CKD undergoing conservative or dialysis treatment, even among those who are not elderly. In addition, a systematic review by Chowdhury et al. showed that frailty was associated with an increased risk of mortality and hospitalization. 8 In view of this scenario, screening for frailty among patients with CKD is extremely important: not only for elderly individuals but also for younger ones. At early stages of kidney disease, individuals