Resumo Este estudo objetivou analisar a associação entre multimorbidade e depressão e qualidade de vida em idosos da Estratégia de Saúde da Família (ESF), por meio de estudo transversal com cadastrados na ESF de Senador Guiomard, Acre. Utilizou-se a Escala de Depressão Geriátrica (EDG-15) e o Questionário de Qualidade de Vida (WHOQOL-Bref). As diferenças das variáveis descritivas por idosos com e sem multimorbidade foram estimadas pelo teste qui-quadrado de Pearson e as associações entre multimorbidade e depressão e qualidade de vida foram estimadas com técnica de regressão logística. Observou-se que idosos com depressão representaram 27% da amostra, sendo essa doença em maior proporção entre os com multimorbidade em comparação àqueles sem. Os idosos com multimorbidade tiveram duas vezes mais chance de apresentar depressão. Similarmente, os indivíduos com multimorbidade tiveram maior chance de pior qualidade de vida total e nos domínios físico, psicológicos, social (todos com p ≤ 0,010), exceto no domínio ambiental (p = 0,493). Assim, a multimorbidade em idosos está associada à presença de depressão e pior qualidade de vida, impondo à ESF o desafio de garantir a essa população viver a senescência sem sofrimento e redução da qualidade de vida.
Objectives: To verify the prevalence of a low quality of life and analyze the morbidities associated with such a condition among elderly persons registered with the Family Health Strategy of the municipality of Senador Guiomard. Method: A cross-sectional study was performed of elderly persons registered with the Family Health Strategy in the urban area of the municipality of Senador Guiomard in the state of Acre. A comparison between men and women regarding morbidities and quality of life was performed using Pearson's chi-squared test. The associations between the tertiles of quality of life and morbidities were estimated by odds ratio through multivariate logistic regression analysis. Results: There were differences between men and women in the reporting of hypertension ( p=0.015), diabetes ( p=0.033), in the psychological domain ( p=0.009) and in total quality of life (<0.001). Elderly people classified in the lower tertile of the physical and social domains of quality of life were more likely to suffer from hypertension, cardiovascular disorders and anemia. Those in the lower tertile of the psychological domain were also more likely to suffer from hypertension, cardiovascular disorders and insomnia, as well as anemia. Elderly individuals in the lower overall tertile were more likely to suffer from hypertension, cardiovascular disorders, insomnia and anemia. No statistically significant associations were found for the environmental domain. Conclusion: The total quality of life and the physical, psychological and social domains of quality of life can be considered good indicators of the described morbidities among the elderly. The environmental domain, however, was not a useful indicator.
O presente estudo foi realizado nas microbacias hidrográficas do Parque Nacional do Descobrimento (DNP). Foram estabelecidos sete pontos de amostragem nos principais rios e no campo, foram determinados os parâmetros físico-químicos (pH, condutividade elétrica, temperatura, potencial redox e concentração de oxigênio dissolvido). No laboratório, foram realizadas determinações de alcalinidade e as amostras foram fracionadas por filtração. Os filtros foram usados para determinar a concentração de partículas em suspensão (SPM) usando gravimetria. As concentrações de N-NH4+, N-NO3-, N-NO2-, P-PO4-3 foram determinadas usando métodos colorimétricos. A qualidade da água nos rios analisados do DNP está de acordo com os parâmetros estabelecidos pela resolução. As razões N/P sugerem que os rios do DNP têm razões típicas de rios naturais. A composição química fluvial no DNP indica que as concentrações de P-PO4-3 e NH4 não estão associadas com o SPM e tendem a diminuir o pH, temperatura e concentração de oxigênio dissolvido (DO) nos cursos dos rios. Outro fator importante que controla a hidroquímica nos pontos estudados é o processo de oxi-redução, que controla o comportamento de diferentes formas químicas de N presentes no meio. A hidroquímica fluvial nos rios DNP também é controlada pelo sistema carbonato, considerando que a alcalinidade das águas fluviais está relacionada com a condutividade no meio e inversamente relacionada com o potencial redox. Os dados gerados neste estudo fornecem informações essenciais que podem ser utilizadas na gestão do Parque Nacional do Descobrimento. Study of Fluvial Biogeochemistry in the Descobrimento National Park Domains, in the Southernmost Part of Bahia. AbstractThe present study was carried out in the hydrographic micro basins of the Descobrimento National Park (DNP). Seven sampling points were established on the main rivers and in the field, the physicochemical parameters (pH, electrical conductivity, temperature, redox potential, and dissolved oxygen concentration) were determined. In the laboratory, alkalinity determinations were carried out and samples were fractionated by filtration. The filters were used to determine the concentration of suspended particulate matter (SPM) using gravimetry. Concentrations of N-NH4+, N-NO3-, N-NO2-, P-PO4-3 were determined using colorimetric methods. The water quality in the analyzed rivers of the DNP is in accordance with the parameters established by the resolution. The N/P ratios suggest that the rivers of the DNP have ratios typical of natural rivers. The fluvial chemical composition in the DNP indicates that the concentrations of P-PO4-3 and NH4 are not associated with the SPM and tend to decrease the pH, temperature and dissolved oxygen (DO) concentration in the river courses. Another important factor controlling the hydrochemistry at the studied points is the oxi-reduction process, which controls the behavior of different chemical forms of N present in the medium. The fluvial hydrochemistry in the DNP rivers is also controlled by the carbonate system, considering that the alkalinity of the riverine waters is related to the conductivity in the medium and inversely related to the redox potential. The data generated in this study provide essential information that can be used by the management of the Descobrimento National Park.Keywords: Hydrochemistry, River Water, Conservation Units.
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