Resumo Análise crítica da produção bibliográfi-ca latino-americana dos últimos dez anos

OBJECTIVE To estimate the incidence and predicting factors associated with falls among older inpatients.METHODS Prospective cohort study conducted in clinical units of three hospitals in Cuiaba, MT, Midwestern Brazil, from March to August 2013. In this study, 221 inpatients aged 60 or over were followed until hospital discharge, death, or fall. The method of incidence density was used to calculate incidence rates. Bivariate analysis was performed by Chi-square test, and multiple analysis was performed by Cox regression.RESULTS The incidence of falls was 12.6 per 1,000 patients/day. Predicting factors for falls during hospitalization were: low educational level (RR = 2.48; 95%CI 1.17;5.25), polypharmacy (RR = 4.42; 95%CI 1.77;11.05), visual impairment (RR = 2.06; 95%CI 1.01;4.23), gait and balance impairment (RR = 2.95; 95%CI 1.22;7.14), urinary incontinence (RR = 5.67; 95%CI 2.58;12.44) and use of laxatives (RR = 4.21; 95%CI 1.15;15.39) and antipsychotics (RR = 4.10; 95%CI 1.38;12.13).CONCLUSIONS The incidence of falls of older inpatients is high. Predicting factors found for falls were low education level, polypharmacy, visual impairment, gait and balance impairment, urinary incontinence and use of laxatives and antipsychotics. Measures to prevent falls in hospitals are needed to reduce the incidence of this event.

Severe perineal lacerations were associated with operative delivery, primiparity, gestational age, and epidural anesthesia. Episiotomy was not protective.

Introduction: Malaria remains an important public health problem despite recent scientific breakthroughs regarding knowledge about malaria and treatment strategies. The objective of this study was to analyze malaria patients' knowledge about the disease, its treatment and prevention, linking it to drug treatment adherence. Methodology: A descriptive, cross-sectional, epidemiological survey study was conducted in the district of Três Fronteiras-MT. The study included 618 individuals who were interviewed and examined for Plasmodium infection. Of the 52 patients diagnosed with malaria, 27 were visited at home for an interview about malaria knowledge and treatment adherence. Treatment adherence was evaluated by self-reports and drug conference. Results: A total of 18 patients had satisfactory knowledge (66.6%) and 9 were evaluated as having unsatisfactory knowledge (33.4%) about malaria. Of the 27 malaria patients, 21 (77.8%) reported having taken all the medication as prescribed, in the correct period of time and dosage, and had no medication tablets remaining. The majority (72.2%) of patients who had satisfactory knowledge, as well as the majority (88.8%) of those who had unsatisfactory knowledge, adhered to the malaria treatment. Conclusions: This study revealed a high proportion of patients with satisfactory prior knowledge about malaria and revealed that this knowledge was not related to disease treatment adherence. These results have implications for planning strategies for malaria control in the region and could contribute to the reduction in the cases of non-adherence to malaria treatment.

Objective: to verify the prevalence of and factors associated with polypharmacy among elderly residents of the city of Cuiabá, in the state of Mato Grosso. Method: a cross-sectional study of 573 people aged 60 and over was performed. Polypharmacy was defined as the use of five or more medications. To investigate the association between polypharmacy and sociodemographic variables, health and access to medication, the Mantel Haenszel chi square test was used in bivariate analysis and Poisson regression was used in multivariate analysis. The significance level adopted was 5%. Result: the prevalence of polypharmacy was 10.30%. Statistically significant associations were found between polypharmacy and living with others, describing suffering from circulatory, endocrine, nutritional and digestive tract diseases, and referring to financial difficulties for the purchase of medicines. Conclusion: some social and health condition factors play an important role in the use of multiple medications among the elderly.

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Estudo exploratório-descritivo de abordagem qualitativa, que teve por objetivo descrever a maneira como os cuidadores familiares realizam o cuidado aos idosos em condição de dependência. Os dados foram coletados por meio de entrevista semiestruturada, aplicada a 24 cuidadores, em seus domicílios. Os resultados apontaram que o cuidado desenvolvido ao idoso em condição de dependência é uma atividade que leva a mudanças na vida dos cuidadores, o que pode gerar estressores de ordem física, emocional e social. A enfermagem, como elemento essencial da Estratégia de Saúde da Família, deve estar atenta às necessidades de saúde dos idosos dependentes, bem como, mais próxima dos cuidadores, no sentido de orientá-los, e acompanhar o cuidado realizado, a fim de oferecer suporte assistencial de forma integral, ou seja, ao idoso e sua família.

Estudo exploratório, descritivo, transversal. O objetivo foi estimar a frequência de adesão ao tratamento da malária no distrito de Três Fronteiras, município de Colniza, Mato Grosso, descrevendo os fatores que contribuem para a sua ocorrência. Participaram 27 pacientes selecionados na busca ativa. A coleta de dados foi por meio de entrevista e a medida de adesão ao tratamento deu-se pelo autorrelato e contagem de medicamentos. A frequência de adesão foi de 77,8%. Entre os fatores que contribuíram para a adesão ao tratamento da malária, destacaram-se os relacionados ao paciente, principalmente o desejo de melhorar e a confiança na efetividade dos medicamentos. A frequência de adesão encontrada foi ligeiramente inferior à de outros estudos realizados em regiões endêmicas do país. Concluindo, ações de educação em saúde sobre a necessidade de adesão ao tratamento devem ser enfatizadas e intensificadas para minimizar ou eliminar o abandono de tratamento.