ABSTRACT. The degree of burden related to the demands of daily care provided to a dependent older adult is important to evaluate due to the negative influence exerted on caregivers’ physical and psychological health. Objective: To analyze the validity of the 12-item version of the Zarit Burden Interview administered to older caregivers of community-dwelling older dependent individuals and suggest a cut-off score based on quartiles. Methods: Three hundred and forty-one older caregivers (mean age: 69.6±7.1 years; 76.8% women) registered with primary healthcare centers were evaluated using the ZBI-12. Additional evaluations addressed stress (Perceived Stress Scale [PSS]), depressive symptoms (Geriatric Depression Scale [GDS]) in the older caregivers and the degree of dependence of the older care recipients (Lawton and Brody [L&B]). Results: Cronbach’s alpha demonstrated very good internal consistency (α=0.81). Correlations were found between all ZBI-12 items and overall score on the PSS (r=0.53; p<0.01). GDS (r=0.43; p<0.01) and L&B (r= -0.23; p<0.01) scale scores. The PSS demonstrated the strongest correlation with ZBI-12 score and proved to be the standard reference. Based on caregivers with a higher degree of stress considering the PSS score quartiles, a cut-off score of 13 points on the ZBI-12 is suggested for screening burden in community-dwelling older caregivers, but should not be assumed as normative data. Conclusion: The ZBI-12 can be considered valid for evaluation of burden in clinical practice and research as a fast, efficient option for screening burden among older caregivers of community-dwelling older adults.

The objective of this study was to identify the strategies used by the nursing team in the neonatal unity care of a school-hospital during the preparation of the family for the premature baby discharge. It is a descriptive study with qualitative approach. The data was collected between March and June 2011, by means of observation and semi-structured interviews. From the discourse analysis two categories appeared: Orientations and professional strategies in preparing the family for the premature baby hospital discharge and Difficulties and potentialities in the neonatal attention space. The main strategy mentioned was the family early insertion in the caring process and the stressed difficulty was the parents' absence during the child's hospital staying. The potentialities and limitations pointed out in this study revealed that the assistance process is dynamic, asking for constant correction and adequacies to effectively and wholly care for the premature baby and its family.

OBJECTIVE Comparing the differences in the sociodemographic, care and health profiles of elderly caregivers of the elderly living in urban, rural, and high social vulnerability contexts. METHOD A cross-sectional study developed with elderly caregivers enrolled in the Family Health Units of a municipality in the interior of São Paulo. Household interviews and evaluations were conducted on: Activities of Daily Living (ADL), self-reported pain, frailty, cognition, life satisfaction, family functionality, burden, stress and hope. RESULTS A total of 343 elderly caregivers of elderly individuals participated in the study, of which 55.1% lived in an urban context, 23.6% in rural areas, and 21.3% in a context of high social vulnerability. The majority of elderly caregivers were women across the three contexts, with a median age of 67 years and caring for their spouse. Caregivers from regions of high social vulnerability had lower education level, received less emotional and material help to care, were less satisfied with life, more fragile, in more cognitive decline, had worse family functionality and a lower level of hope when compared to caregivers of urban and rural contexts (p≤0.05). However, caregivers from areas of high vulnerability were more independent for ADL. CONCLUSION Professionals working in Primary Care should consider these differences when planning interventions aimed at the specific group of caregivers.

Objective: to investigate the association between frailty, loneliness and depressive symptoms of elderly caregivers. Method: a cross - sectional study carried out with 341 elderly caregivers enrolled in Family Health Units of a city in the countryside of São Paulo State. The interviews were domiciliary and included questionnaire for characterization of the caregiver, Fried’s frailty phenotype, family APGAR (family functionality), Geriatric Depression Scale (depressive symptoms) and item 3 of the Herth Hope Scale (loneliness). Logistic regression was used to analyze the association between depressive symptoms and solitude (independent variables), and frailty and pre-frailty (dependent variables). Results: there was an association between frailty, loneliness and depressive symptoms. Elderly caregivers had increased odds of 158% presenting pre-frailty, and 360% of frailty. Elderly caregivers with depressive symptoms had an increased chance of 242% of presenting fragility. Conclusion: elderly and lonely caregivers with depressive symptoms are more likely to be frail and pre-frail.

Objective: to identify factors associated with depressive symptoms in elderly caregivers with chronic pain. Method: the study included people 60 years of age or older who reported chronic pain and cared for another elderly person living in the same household (n=186). Statistical analyzes were performed using the Mann-Whitney test, univariate and multiple logistic regression. Results: most participants had no depressive symptoms (70.4%), 24.2% had mild depressive symptoms and 5.4% had severe symptoms. Univariate analysis showed that the variables family income, number of diseases, number of medications in use, pain intensity, overload and perceived stress were associated with depressive symptoms. Multivariate analysis found an association with perceived stress (95% CI 1.101-1207) and number of medications (95% CI 1.139-1.540) in use. Conclusion: factors associated with depressive symptoms in elderly caregivers with chronic pain were stress and the number of medications in use.

A parada cardiorrespiratória é uma situação grave e frequente na sociedade, sendo de fundamental importância a capacitação da população em geral para o seu atendimento. Objetivando conhecer a percepção de crianças sobre parada cardiorrespiratória, realizou-se uma pesquisa de natureza qualitativa, com crianças de 8 a 10 anos, matriculadas em uma escola privada de ensino com proposta construtivista. A coleta dos dados ocorreu entre os meses de outubro e novembro de 2013, por meio de entrevista coletiva gravada. Como critério para a inclusão os alunos deveriam estar matriculados na instituição e aceitarem participar da pesquisa mediante consentimento do responsável. Participaram do estudo 31 crianças. Os alunos foram divididos em quatro turmas: 5º ano, 4º ano, 3º ano A e 3º ano B, com média de 08 alunos em cada turma. As entrevistas foram analisadas utilizando como método a análise de conteúdo de Bardin. A partir dos discursos emergiram duas categorias: Conhecimento prévio das crianças sobre parada cardiorrespiratória e o saber agir frente à situação de parada cardiorrespiratória. As crianças associam o evento de parada cardiorrespiratória à parada súbita das funções do coração, do pulmão ou de ambos e relataram que chamar ajuda é uma das principais ações a serem realizadas se uma pessoa encontra-se inconsciente. Observou-se que os alunos do 5º ano possuíam conhecimento prévio mais elaborado que os demais. A abordagem da temática nas escolas mostrou-se positiva, contribuindo para a troca de experiências, conscientização e construção de novos saberes, devendo portanto ser continuada. ResumoCardiorespiratory arrest (CRA) is a serious situation that occurs frequently in public environments, which makes assistance training of the general population of great importance. The objective was to understand the perception of children on CRA. Qualitative research conducted with children 8-10 years old enrolled in a private elementary school with a constructive proposal. Data collection occurred between the months of October and November 2013 in a recorded collective interview. As a criterion for inclusion students should be enrolled in the institution and accept to participate in the research with the consent of a guardian. Thirty Palavras-chave: Crianças. Parada cardíorrespiratória. Educação em saúde.

Objective: Understanding and characterizing chronic pain in elderly caregivers, verifying the cognitive performance of the elderly of the sample and verifying whether there is difference in the cognitive performance of elderly caregivers with and without chronic pain. Method: Participants were people aged 60 years or older who lived with another elderly person in the same household and who were registered in Family Health Units. Data collection took place at participants' homes. Pain was assessed by the EMADOR and cognition was assessed by ACE-R. Statistical analyzes were performed using Shapiro-Wilk's and Mann-Whitney U tests. Results: The study included 187 elderly caregivers with chronic pain and 133 without chronic pain, with a higher frequency of women. Chronic pain was present in 58.4% of the participants. Regarding the sociodemographic variables, there was no difference between the groups except for the gender variable (p=0.025). No difference was found in cognitive performance among the elderly with chronic pain and those without chronic pain for any domain of the ACE-R instrument. Conclusion: The results contradicted the initial hypothesis that there would be a difference between the groups; however, there is a gap in the scientific knowledge on chronic pain and cognition, especially in elderly caregivers, opening perspectives for future investigations.

Objective: To determine whether there are differences in the intensity of chronic pain of elderly caregivers who are frail, pre-frail and non-frail. Methods: Quantitative, descriptive and cross-sectional study. The subjects were 187 elderly caregivers evaluated with a Multidimensional Pain Assessment Scale and the Fried Frailty Phenotype Assessment Components. Descriptive and comparative analyzes, Pearson's chi-square test and Kruskal-Wallis test were used. Results: 24.1% of the caregivers were frail, 55.1% pre-frail and 20.9% non-frail. The only socio-demographic variable that differed between the three groups was age (p=0.03). Mean pain intensity values were as follows: frail elderly (6.98), pre-frail (6.38) and non-frail (5.85). However, these differences were not significant (p=0.150). Conclusions:The present study did not find a significant difference in the intensity of chronic pain in elderly. Nevertheless, it is essential that health professionals and health care public policies give special attention to older caregivers. Keywords: Caregivers. Frail elderly. Chronic pain. RESUMO Objetivo:Verificar se existe diferença na intensidade da dor crônica de idosos cuidadores frágeis, pré-frágeis e não frágeis. Métodos: Estudo quantitativo, descritivo, transversal. Foram avaliados 187 idosos, utilizando-se a Escala Multidimensional de Avaliação da Dor e o fenótipo dos cinco componentes da fragilidade. Realizaram-se análises descritivas e comparativas, Teste de QuiQuadrado de Pearson e Teste de Kruskal-Wallis. Resultados: 24,1% dos cuidadores eram frágeis, 55,1%, pré-frágeis e 20,9%, não-frágeis. A única variável sociodemográfica diferente entre os três grupos foi a idade (p=0,03). A intensidade média da dor de idosos frágeis foi 6,98, de pré-frágeis, 6,38 e de não frágeis, 5,85. Porém, essas diferenças não foram significativas (p=0,150). Conclusões: Não foi possível verificar diferença significativa na intensidade da dor crônica de idosos cuidadores, no entanto, é primordial que haja uma maior atenção dos profissionais de saúde e políticas públicas de atenção à saúde voltadas ao idoso cuidador. Palavras-chave: Cuidadores. Idoso fragilizado. Dor crônica. RESUMEN Objetivo:Determinar si existen diferencias en la intensidad del dolor crónico de los cuidadores de edad avanzada que son frágiles, prefrágiles y no frágiles. Métodos: Estudio cuantitativo, descriptivo y transversal. Se evaluaron 187 cuidadores de ancianos utilizando Escala Multidimensional de Evaluación del Dolor y el fenotipo de los cinco componentes de la fragilidad. Los análisis descriptivos y comparativos, se utilizaron, prueba de chi-cuadrado de Pearson y la prueba de Kruskal-Wallis. Resultados: El 24,1% de los cuidadores era frágil, el 55,1% de prefrágil y el 20,9% no frágil. La única variable sociodemográfica que fue diferente entre los tres grupos fueron la edad (p=0,03). La intensidad media del dolor de los ancianos frágiles era 6,98, el prefrágil 6.38, y no frágil 5,85. Sin embargo, estas diferencias no fueron significativas (p=0,150). Co...