Abstract

Objective: to evaluate the conditions of functional health literacy of an elderly diabetics group. Method: cross-sectional and descriptive study, with diabetic's elderly assisted in the SUS (N=114). The social and health conditions were evaluated as well as functional health literacy by S-TOFHLA test (short version); the simple proportions, average, standard deviation and Pearson's Chi-square were described by SPSS software (20.0) with α=5% value. Results: the mean age was 67.4 years, 74.0% of the elderly were women, had up to four years of schooling; 29.8% had a long-standing illness, 64.0% reported having high blood pressure, 47.4% smoke or were smokers, 73.7% had low functional health literacy, which was associated with schooling p=0.001. Conclusions: the low functional health literacy could be a self-care conditioning and can be infl uenced by low schooling because it implies to have skills to understand and make decisions aimed at self-management of health. Key words: Health Literacy; Elderly; Diabetes; Gerontological Nursing, Collective Health. RESUMO Objetivo: foi avaliar as condições de letramento funcional em saúde de um grupo de idosos diabéticos. Método: estudo seccional e descritivo, com idosos diabéticos assistidos no SUS (N = 114). Avaliaram-se os condicionantes sociais e da saúde, bem como de letramento funcional em saúde pelo teste S-TOFHLA (versão-breve); descreveram-se as proporções simples, média, desvio-padrão e teste do Qui-quadrado de Pearson pelo software SPSS (20.0) com valor α = 5%. Resultados: a média da idade foi 67,4 anos, 74,0% dos idosos eram mulheres, possuíam até 4 anos de escolaridade; 29,8% tinham a doença de longa data, 64,0% relataram ter hipertensão arterial, 47,4% eram ou foram fumantes, 73,7% apresentaram baixo letramento funcional em saúde, que se mostrou associado com a escolaridade p=0,001. Conclusões: o baixo letramento funcional em saúde pode ser condicionante do autocuidado e pode ser infl uenciado pela baixa escolaridade, pois implica em ter habilidades para compreender e tomar decisões voltadas à autogestão da saúde. Descritores: Alfabetização em Saúde; Idoso; Diabetes; Enfermagem Gerontológica, Saúde Coletiva. RESUMENObjetivo: fue evaluar las condiciones de alfabetización funcional en la salud de un grupo de ancianos diabéticos. Método: estudio seccional y descriptivo, con ancianos diabéticos asistidos en el SUS (N = 114). Se evaluaron las condicionantes sociales y de la salud, así como de alfabetización funcional en la salud por la prueba S-TOFHLA (versión breve); se describieron las proporciones simples, media, desviación estándar y prueba del Chi-cuadrado de Pearson por el software SPSS (20.0) con valor α = 5%. Resultados: la media de edad fue 67,4 años, 74,0% de los ancianos eran mujeres, poseían hasta 4 años de escolaridad; 29,8% tenían la enfermedad desde hacía mucho tiempo, 64,0% relataron tener hipertensión arterial, 47,4% eran o fueron fumadores, 73,7% presentaron baja alfabetización funcional en salud, que se mostró asociada con la escolaridad p=...

Objective: to verify the association between the multimorbidity of the elderly and sociodemographic variables, self-perception of health and polypharmacy. Method: a cross-sectional study was performed. The research data was collected using the Health, Well-Being and Aging questionnaire. The sample was composed of 676 people aged 60 years or more, who were residents of small towns in the north of the state of Rio Grande do Sul, Brazil. The dependent variable was multimorbidity, that is, the occurrence of two or more chronic non-communicable diseases in the same person. The independent variables were demographic, socioeconomic and health-related characteristics. Poisson's raw and robust regression model was used to analyze the effect of the independent variables in relation to the outcome and p was considered significant when <0.05. Result: among the elderly interviewed, 45% presented multimorbidity, 51.1% reported a selfperception of poor/very poor health and 37.1% used polypharmacy. After the analysis was adjusted to the occurrence of multimorbidity, association with the following variables was found: health perception (regular/poor/very poor) PR=1.15 (CI95%; 1.09 -1.22) and use of polypharmacy PR=1.29 (CI95%; 1.22 -1.35). Conclusion: Multimorbidity may interfere negatively in the self-perception of health of the elderly contributing to increased medicine consumption.

ResumeObjective:to identify the prevalence of falls among older adults and the extrinsic factors associated with them. Method:population-based cross-sectional study with 350 older adults. A household survey was conducted using a questionnaire addressing socio-demographic, clinical, and environmental characteristics. Data were analyzed using Stata Software V.10. Pearson’s chi-square test and logistic regression analysis were used with stepwise criteria for selection of variables in the model, with measures of effect expressed in Prevalence Ratio. For input into the multiple model, the variables with p ≤ 0.20 were considered. All ethical care regarding research on human beings has been observed and respected. Results:the prevalence of falls was 46.9%. The extrinsic factors associated with falls were: stairs, uneven floor and pets in the main entrance, lack of anti-slip loose throw rugs and slippery floor in the kitchen, lack of anti-slip loose throw rugs and objects on the floor in the room, lack of grab bars in the shower, lack of grab bars in the toilet and switch away from the bathroom door (p <0.05). Conclusion:falls are frequent in long-lived adults. The identification of the extrinsic factors associated with the occurrence of this event can help in its prevention.

Objective: to identify the factors associated with the institutionalization of the elderly. Method: a case-control, population-based study was performed with 387 elderly people. The study considered cases of elderly people (n=191) living in long-term care facilities, and a control group (n=196) who lived in homes in urban areas of the city. Both groups were identified from the records of the Family Health Strategy and were randomly selected. Institutionalization was considered a dependent variable, and sociodemographics, clinical factors, functional status, and cognitive impairment were considered independent variables. Comparison between groups was analyzed using the Chi-squared and Pearson tests and the logistic regression model was used in adjusted analysis, with measurements of effect expressed as odds ratio with a 95% confidence interval. Variables with p≤0.20 were considered for entry in the multiple model. Results: variables that remained associated with institutionalization in multiple analysis were: not having a partner (OR=9.7), not having children (OR=4.0), presenting cognitive impairment (OR=11.4), and depending on others to perform basic activities of daily living (OR=10.9). Conclusion: cognitive impairment and dependency for basic activities of daily living were more strongly associated with institutionalization. Home care strategies and preventive actions for risk factors should be stimulated to delay the referral of elderly people to Long Term Care Facilities for the Elderly, and to develop strategies that allow the elderly to remain socially active.

ResumoObjetivo: Identificar os desafios e perspectivas de trabalho nas instituições de longa permanência para idosos (ILPI) na interpretação da equipe multiprofissional. Metodologia: Estudo de abordagem qualitativa, exploratória e descritiva, recorte da pesquisa intitulada "Cenários de cuidados de longa duração: possibilidades avaliativas, interventivas e educacionais na atenção gerontológica". A pesquisa foi desenvolvida no município de Passo Fundo-RS, de março a agosto de 2013, contemplando 14 ILPIs. Resultados: As situações desafiadoras do trabalho aludem ao aspecto de gestão, sistematização de ações, manutenção, convivência e mediação de conflitos profissionais e interpessoais, e no que se refere ao paradigma da institucionalização. As perspectivas da atuação em ILPIs correspondem à valorização com inserção profissional nos cenários de atenção, considerando a Gerontologia especialidade emergente no cumprimento dos preceitos legais e com maior incentivo do poder público. Conclusões: Os desafios são múltiplos e de ordem diversa. A perspectiva é que, num futuro próximo, possa existir uma equipe multiprofissional mais homogênea atendendo à legislação vigente. AbstractObjective: To identify the challenges and prospects of work in long-term institutions for the elderly (ILPI) in the viewpoint of the multidisciplinary team. Methodolog y: Qualitative, exploratory and descriptive study, part of a research entitled "Scenarios of long-term care: evaluative, intervention and educational possibilities in geriatric attention". Research was conducted in the city of Passo Fundo-RS, Brazil, from March to August 2013, involving 14 ILPI's. Results: The challenging situations at work allude to management aspect, systematic actions, maintenance, coexistence and mediation of professional and interpersonal conflicts, as well as to the institutionalization paradigm.

Objective: To perform an integrative review of literature on functional health literacy from the perspective of Gerontological Nursing. Method: a study was made of the MEDLINE, PubMed, LILACS, IBECS, BDENF and CidSaúde databases, and studies published in Brazilian and international publications during the period of 2005-2014 were included. The studies were selected by main subject, such as education of patient, health literacy, schooling, the elderly, health education and self-care. Results: 58 studies were found, of which 33 were pre-selected, but only 17 composed the final sample, 15 of which were international and two of which were Brazilian. Conclusions: the results indicate an integration of knowledge of the assessment of functional health literacy among the elderly. Inadequate literacy was evident, indicating an excessive impact on health management, especially among those with chronic disease. Additionally, inadequate understanding of times and doses when taking medicine highlights that new strategies can be designed to bring empowerment and greater control to health.

Brazil's Family Health Strategy (FHS) leads public health policies and actions regarding community health, addressing arterial hypertension (AH) in primary care settings. In this scenario, the use of communication technologies becomes appropriate for the monitoring of patients with AH. To preliminary verify the intervention approach and the effects of using an m-Health application on the health conditions of patients with AH for a future study, we conducted a non-randomized, controlled, non-blind trial (N = 39), comparing the use of a mobile health app (m-Health) with conventional AH monitoring over 3 months. During the study, we promoted health information workshops to engage patients from both intervention and control groups. Pre and post-intervention, we compared measurements of systolic and diastolic blood pressure; food frequency questionnaire; Appraisal of Self-Care Agency Scale; blood tests of hemogram, creatinine, uric acid, sodium, potassium, lipid profile, and glycemia. Improvements were identified in both groups due to the workshops, including the reduction in total and non-HDL cholesterol, healthier consumption of salads and sugary drinks, and increased selfcare scores. Exclusively in the intervention group, which used the m-Health app, there was a change in systolic and diastolic pressure towards more adequate levels. In addition, the intervention group had improved levels of glucose and HDL cholesterol and reduced consumption of ultra-processed foods. In conclusion, the use of an m-Health app had positive effects on the health conditions of patients with AH under treatment within FHS, especially when combined with health information. On the context of FHS, the use of technology is encouraging supporting better health conditions. Arterial hypertension (AH) is one of the main modifiable risk factors for diseases of the circulatory system. With a high prevalence, AH is considered one of the most important public health problems. The World Health Organization estimates that about 600 million people have AH and, annually, 7.1 million individuals die from this disease, substantially burdening health systems 1. Among the AH modifiable factors, either by medication or by altering habits and behavior, there is obesity, sedentary lifestyle, eating habits, and stress. Controlling blood pressure can still be a challenge since, with everyday activities and lack of time, many people do not bother to maintain their normal blood pressure levels 2. Among the main non-medicinal recommendations that should be followed, there are healthy eating, physical activity, reduction of sodium and alcohol consumption, and non-consumption of tobacco 3 .