Objective: to evaluate the healing of pressure injuries in home care patients.Method: longitudinal observational study with an intentional sample of 38 patients conducted in a home care service. Sociodemographic and clinical data were collected as well as the characteristics of the pressure injuries between April and October of 2015. Healing was evaluated by using the Pressure Ulcer Scale for Healing instrument, by measuring planimetry and depth of pressure injuries. Data were collected during home visits at the patient's admission to the service and then after four and six weeks. Data from patient records were also collected. The comparison of the variables related to healing was performed by using the Friedman test and the Kaplan-Meier method was used for the probability of healing.Results: 50% of the patients were women and 60.5% were elderly. There was an average of 2 pressure injuries per patient. Pressure injury stage 2 (48.3%) and 3 (35.6%) predominated and 47.1% of the wounds healed. The Pressure Ulcer Scale for Healing score, planimetry and depth varied significantly over the study period (p<0.05). The probability of healing increased over time, with the average time of healing being 44 days.Conclusion: there was a favorable evolution in healing according to the measurement methods used. DESCRIPTORS:Home care services. Home patients. Pressure ulcer. Wound healing. Longitudinal study. CICATRIZAÇÃO DE LESÕES POR PRESSÃO EM PACIENTES ACOMPANHADOS POR UM SERVIÇO DE ATENÇÃO DOMICILIARRESUMO Objetivo: avaliar a cicatrização de lesões por pressão em pacientes na atenção domiciliar. Método: estudo longitudinal observacional com amostra intencional de 38 pacientes conduzido em um serviço de atenção domiciliar. Foram coletados dados sociodemográficos, clínicos e as características das lesões entre abril e outubro de 2015. A cicatrização foi avaliada pelo instrumento Pressure Ulcer Scale for Healing, por planimetria e pela profundidade das lesões por pressão. A coleta de dados ocorreu durante as visitas domiciliares realizadas na admissão do paciente no serviço e após quatro e seis semanas. Dados em prontuário também foram coletados. A comparação das variáveis referentes à cicatrização foi realizada pelo Teste de Friedman e a probabilidade de cicatrização, pelo método Kaplan-Meier. Resultados: dos pacientes, 50% eram mulheres e 60,5%, idosos. A mediana de lesões por paciente foi 2. Predominaram os estágios 2 (48,3%) e 3 (35,6%), e 47,1% das feridas cicatrizaram. O escore do Pressure Ulcer Scale for Healing, a planimetria e a profundidade variaram significativamente no período do estudo (p<0,05). A probabilidade de cicatrização aumentou com o passar do tempo, sendo a mediana de cicatrização 44 dias. Conclusão: houve evolução favorável na cicatrização de acordo com os métodos de mensuração utilizados. DESCRITORES: Serviços de assistência domiciliar. Pacientes domiciliares. Úlcera por pressão. Cicatrização de feridas. Estudo longitudinal. Texto Contexto Enferm, 2018; 27(2):e5180016 Machado DO, Mahmud SJ, Coelho RP, Ce...
Objective: To analyze the association between filial responsibility and the overload of the children when caring for their older parents. Method: Cross-sectional study with 100 caregiver children of older adults. Filial liability was assessed by the attitudes of the responsible child (scale of expectation and filial duty) and by care behaviors (assistance in activities of daily living, emotional and financial support, and keeping company). The overload was assessed by the Caregiver Burden Inventory. To assess the associations, the correlation coefficients of Pearson and Spearman, Kruskal-Wallis Test, and Mann-Whitney were employed. Variables that presented p-value<0.20 in the bivariate analysis were inserted in a multivariate linear regression model. Results: The factors associated with overload were: formal employment (p=0.002), feelings regarding family life (p<0.001), financial support (p=0.027), and assistance with Activities of Daily Living (ADLs) (p<0.001). Conclusion: Children who were more involved with the ADLs and provided financial support showed higher levels of overload.
Objective: development and validation the content of a nursing care protocol with educational interventions for family caregivers of elderly people after stroke. Methods: a methodological study conducted in three stages: (1) protocol development through literature review; (2) pretest with multidisciplinary team, analyzed with literature articulation; (3) protocol validation by the Delphi Technique. Results: the protocol was structured in the following areas: Disease Guidelines; Emotional Support; Using the Health Care Network; Diet; Airways; Medications; Hygiene; Skin Care; Disposal; Dressing/Undressing; Positioning and Transfer; Fall Prevention. In the pretest, eight experts assessed protocol clarity and content. In validation, there were two rounds by the Delphi Technique. The validated protocol consisted of 12 domains, containing 42 items and 240 care guidelines. Conclusion: the protocol qualifies the transition of care after hospital discharge assisting nurses in home care practice.
Objective to construct and validate an educational manual for family caregivers of older adult dependent on care after a stroke. Method a methodological study with four stages: focus group with five family caregivers, to identify doubts and difficulties regarding home care for older adults with stroke; preparation of the manual by six researchers; content validation by 18 specialist nurses, and face validation by 12 family caregivers. For data analysis, thematic analysis was performed, the Content Validity Index (CVI) was calculated, and the consensus of the target population was verified. Results from the focus group, the experiences and challenges faced by the caregivers in caring for aged family members with a stroke were identified, which supported the elaboration of an educative manual, in the second stage. In the expert consensus, a global CVI of 0.97 was obtained and, in face validation, a consensus of 95.51% by the target population. Conclusion an educational manual for family caregivers of older adults after a stroke was built, which was validated in terms of content and appearance. In view of this, it can be used as complementary material to the guidelines of the professionals, enabling improvement of the care provided by family members to the older adult dependent on care after a stroke.
Objective. To characterize the elderly population and their caregivers and to verify the association of depressive symptoms of the elderly and the caregiver's burden with the variables of interest. Methods. A cross-sectional study with 80 elderly people and 78 caregivers in a Primary Health Service in southern Brazil. Retrospective collection conducted in a structured database based on the multidimensional evaluation tool applied to home care for the elderly participants and their caregivers. Results. Most elderly participants were women (71.3%), with an average age of 82.1 years and 52.6% reported sadness or discouragement. Systemic arterial hypertension was the most frequent morbidity (68.8%). Most caregivers were women (85.7%), daughters of the elderly person (53.2%), mean age 57.8 years and 38.7% reported feeling the burden. The presence of depressive symptoms in the elderly 211Depressive symptoms of the elderly people and caregiver's burden in home careInvest Educ Enferm. 2017; 35 (2) was associated with Parkinson's disease (p=0.016) and to have a male caregiver (p=0.006). Caregiver's burden was associated with daily life activities such as bathing (p=0.021). Conclusion. There was evidence of differences in caregiver's gender in the presence of depressive symptoms and differences in the assistance in daily life activities for the caregiver's burden.Descriptors: home visit; caregivers; aged; nursing; primary health care; depression; cross-sectional studies; retrospective studies.Síntomas depresivos en los ancianos y cuidadores de sobrecarga en la atención domiciliariaObjetivo. Caracterizar a los ancianos y a sus cuidadores, verificando la asociación de los síntomas depresivos del anciano y la sobrecarga del cuidador con las variables de interés. Métodos. Estudio transversal con 80 ancianos y 78 cuidadores en una Unidad de Atención Primaria en el sur de Brasil. La recolección retrospectiva de la información se hizo utilizando una base de datos estructurada realizada a partir de un instrumento de evaluación multidimensional aplicado en la atención domiciliaria a los ancianos y sus cuidadores. Resultados. La mayoría de los ancianos eran mujeres (71.3%), con edad media de 82.1 años. 52.6% informó tristeza o abatimiento. La hipertensión fue la morbilidad más frecuente (68.8%). En cuanto a los cuidadores, la mayoría eran mujeres (85.7%), hijas de los ancianos (53.2%) con una edad media de 57.8 años. El 38.7% informó que se sentía con sobrecarga. La presencia de síntomas depresivos en los ancianos se asociaron con la enfermedad de Parkinson (p=0.016) y que tiene cuidador de sexo masculino (p=0.006). La sobrecarga del cuidador se relacionó con la ayuda en las actividades de la vida diaria, como el baño (p=0.021). Conclusión. Fue evidente la diferencia en cuanto al sexo del cuidador y la presencia de síntomas depresivos y en la asistencia en las actividades de la vida diaria del anciano para la sobrecarga del cuidador.Descriptores: visita domiciliaria; cuidadores; anciano; enfermería; atención primaria de salud; depr...
Objetivo: Identificar o perfil dos pacientes com câncer e em cuidados paliativos e suas demandas referentes ao atendimento multidisciplinar existente em um Serviço de Atenção Domiciliar. Métodos: Estudo transversal com coleta de dados secundários dos pacientes oncológicos em cuidados paliativos atendidos pelo Programa de Atenção Domiciliar do Grupo Hospitalar Conceição, no ano de 2013. Aprovado pelo Comitê de Ética e Pesquisa sob o número 13.203. Resultados: Foram acompanhados 63 pacientes com diagnóstico de neoplasia. Dentre esses, 71,5% (n=45) estavam em cuidados paliativos. As medianas do tempo de acompanhamento dos pacientes foram de 22 (3-146) dias e do número de visitas realizadas pela equipe foi 6 (1-34). Além das visitas semanais realizadas pelas equipes, os pacientes receberam assistência de nutricionista, fisioterapeuta e assistente social. Considerando as 45 internações, os principais cuidados foram controle da dor, curativos em feridas, controle glicêmico, e antibioticoterapia endovenosa. A principal intercorrência clínica foi a repassagem de cateter nasoenteral (n=5). A alta em condições estáveis de saúde ocorreu em 10 pacientes. Conclusão: O presente estudo permitiu a identificação das principais demandas dos pacientes em cuidados paliativos oncológicos atendidos por um serviço de Atenção Domiciliar. Observa-se na prática deste serviço que a maioria dos pacientes apresentou necessidade de cuidados complexos, mas possíveis de serem realizados no domicílio pela equipe de saúde e/ou cuidador capacitado.
Background and PurposeThe Portuguese instrument for informal caregivers' skills providing care of aged people after a stroke (ECPICID-AVC) evaluates the capacities that informal caregivers must have for supporting aged stroke survivors. The purpose was to adapt and validate the ECPICID-AVC to be used in Brazil.MethodsA methodological study was conducted.ResultsThe terms with the lowest degree of comprehension were adapted. The factor analysis suggested the exclusion of three items and that the remaining be grouped into six domains. The factor loadings varied from 0.525 to 0.924. The internal intra-assessor consistency was satisfactory (ICC = 0.94, CI 95%). Total reliability was considered excellent (Cronbach's alpha = 0.914).ConclusionsThe ECPICID-AVC is considered appropriate for using in Brazil.
Aim:To characterize the profile of adult patients of the Home Care Program (HCP) of the Conceição Hospital Group (CHG) and their demands for nursing support. Method: This is a descriptive exploratory study incorporating retrospective data collection. Results: Of the 826 adult patients supported by HCP/CHG (median follow-up of 21 days and five visits), the majority were female (53.9%) and over 65 years of age (50.6%). The main pathologies were thromboembolism (10.9%) and cerebrovascular accident (10.3%). The main demands in terms of nursing care were dressing (32.4%) and monitoring blood glucose levels (19.7%). Discussion:The prevalence of elderly in the sample can be explained by population aging. This data, together with pathologies associated with greater physical dependence, can justify the need for specific nursing care. Conclusion:The characterization of patients can contribute to the evaluation of the complexity of home care and provide better guidance in terms of care in place.
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