Aos meus pais, Edson e Maria Ophelia, que me deram a vida e formaram meu caráter e personalidade. À minha esposa, Heico, companheira valorosa, com quem divido os prazeres e as agruras da vida. Aos meus filhos, Fábio e Carolina, a quem ajudei a dar a vida e duas das grandes razões do meu viver. À Ligia Py e à Tomiko Born, amigas estimadas, que lutam em prol da Gerontologia vida afora. Aos idosos, motivo do meu caminhar profissional, que muito me ensinam a respeito da vida. ? À minha querida família. Gratíssimo pela paciência, compreensão, carinho, suporte e espera. escala de Likert necessitará de reformulação. Numa etapa posterior, a lista de itens, agora modificada, será reduzida através de duas técnicas, impacto clínico e análise fatorial. A distribuição dos itens resultantes em dimensões comporá o instrumento, cujo formato já está desenhado: Satisfação

ResumoIntrodução: As redes de atenção à saúde são fundamentais para assistir a população idosa em seus diversos aspectos. A assistência domiciliar, o Programa Acompanhante de Idosos da Secretaria Municipal da Saúde da cidade de São Paulo e as instituições de longa permanência para idosos compõem as redes de assistência à pessoa idosa. Fazse necessário analisar como a rede entre esses serviços se estabelece e contempla essa demanda de cuidado. Objetivo: Descrever e comparar os serviços assistência domiciliar, Programa Acompanhante de Idosos e instituições de longa permanência para idosos quanto às possíveis diferenças e semelhanças, demanda dos usuários, fluxo assistencial e gestão de serviços. Metodologia: Realizou-se uma revisão bibliográfica não exaustiva da literatura nacional publicada nas bases eletrônicas de dados SciELO e LILACS, em referências literárias e eletrônicas, no período de 1997 a 2012. Resultados: No total, 32 estudos foram incluídos na revisão. Observou-se que a população atendida é predominantemente do sexo feminino, com idade avançada, e recebe assistência multiprofissional. Os serviços de assistência domiciliar e o Programa Acompanhante de Idosos valorizam a manutenção da família e da comunidade como ambiente terapêutico, postergando a institucionalização. A presença do cuidador mostrouse como um dos fatores de maior influência para a permanência dos cuidados domiciliares. Conclusão: Conclui-se que os serviços revisados possuem objetivos que contemplam as demandas dos idosos. Espera-se que a integração dos equipamentos de saúde estabeleça suas ações de acordo com o perfil dos idosos e as características de cuidado oferecidas em cada serviço.

INTRODUCTION: Substantial medical research has established an inverse relationship between quality of life and illness. However, there exists minimal evidence for such a connection in the context of stable and controlled diseases. OBJECTIVE: We wished to correlate multimorbidity with quality of life for elderly patients who suffer from stable chronic diseases. METHODS: We used a tool to evaluate quality of life, namely World Health Organization quality of life-BRIEF, together with a scale of multimorbidity known as the Cumulative Illness Rating Scale - Geriatric Version. Furthermore, the quality of life data were correlated with scores recorded on the Cumulative Illness Rating Scale - Geriatric Version, the number of drugs used, and individual perceptions of health and age. RESULTS: We studied 104 elderly patients who suffered from chronic diseases. The patients had exhibited neither acute events nor secondary complications, their cognition was intact, and they were functionally independent. The Cumulative Illness Rating Scale - Geriatric Version showed an inverse correlation with the physical domain (p= 0.008) and a tendency toward an inverse correlation with the psychological domain (p= 0.052). Self-perception of health showed a high correlation with the physical domain (p= 0.000), psychological domain (p= 0.000) and environmental domain (p= 0.000). The number of drugs used correlated only with the physical domain (p= 0.004). Age and social domain showed a tendency toward a positive correlation (p= 0.054). DISCUSSION: We uncovered an inverse relationship between quality of life and multimorbidity in a group of patients who suffered from stable chronic diseases, with no functional limitations, pain or complications. Our data suggest that a patient’s knowledge that they have a certain clinical condition changes their subjective assessment of quality of life in the related domain. CONCLUSION: The perceived quality of life of the sample was affected by multimorbidity in the physical domain, with a tendency toward commensurate effects in the psychological domain.

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Paschoal SMP, Jacob Filho W, Litvoc J. Development of an Elderly Quality of Life Index-EQoLI: Theoretical-conceptual framework, chosen methodology, and relevant items generation. Clinics. 2007;62(3):279-88. PURPOSE:To describe the initial steps of the construction process of a quality of life evaluation instrument for the elderly-the theoretic-conceptual framework for the construct, Quality of Life in Old Age; the construction methodology; and the generation of relevant items. METHODS: The first step was to conceptualize and define the construct, determining how much the elderly are able to perform of what they believe to be important in their lives and whether they are satisfied with what was possible to perform. The next step was to select and describe the construction methodology (the Clinical Impact Method) and the phase of generation of relevant items for the research object. The necessary procedures were delineated through a pilot study, which helped to establish all phases of the used methodology. The viability of the construction of the Quality of Life in Old Age evaluation instrument was demonstrated along with the needed adaptations. RESULTS: From 1032 answers by older people, 138 relevant items for the construct were identified by the items generation process. The pilot study demonstrated the suitability of the application of the methodology and established modifications to the preliminary items list, resulting in a new 139-item list. DISCUSSION: Now that the theoretical-conceptual framework of the construct as well as the construction methodology and the items generation are established, the next step will consist of administering the resulting list to a sample of elderly people for item reduction and distribution of items into dimensions.