Fatores contextuais e individuais associados à hipertensão arterial entre idosos brasileiros (Pesquisa Nacional de Saúde - 2013)

Lopes

et al. 2022

Int J of Nursing Knowl

Purpose To analyze the accuracy of the clinical indicators of the nursing diagnosis Ineffective Health Management in people with hypertension. Methods This is a cross‐sectional diagnostic accuracy study. The ineffective health management was investigated in 120 people with hypertension in a referral public outpatient clinic in Brazil between August and November 2020. The accuracy measures were analyzed using Rasch analysis, considering the difficulty of clinical indicator and person's ability. Results Ineffective health management is probably present in 37.5% of people with hypertension. ‘Failure to include treatment regimen in daily living’ was the clinical indicator with the highest sensitivity value, and ‘failure to take action to reduce risk factor’ had the highest specificity value. Conclusions Rasch analysis demonstrated that all clinical indicators contribute significantly to estimating the presence of ineffective health management in people with hypertension in the outpatient scenario. Implications for Nursing Practice This research contributes by providing accurate clinical indicators of ineffective health management, helping nurses prescribe and deliver the appropriate nursing interventions for people with hypertension by telenursing.

Section: Discussionmentioning

confidence: 72%

Ineffective health management in people with hypertension: Accuracy study

Lopes

et al. 2022

Int J of Nursing Knowl

“…24 A systematic review found that low levels of education increased the probability of multimorbidity by 64% (OR: 1.64, 95%CI 1.41-1.91), and that this association is stronger in aging populations than in younger ones. 25 Bento et al 26 investigated the association between contextual and individual variables and SAH in Brazilian older adults and observed an inverse association between hypertension and education. This result likely reflects the greater difficulty that older adults with low education levels experience in recognizing their health needs and adhering to treatments, as well as a reflection of poor medical care, poorer functional literacy and difficulties in accessing health services.…”

Section: Discussionmentioning

confidence: 99%

“…This result likely reflects the greater difficulty that older adults with low education levels experience in recognizing their health needs and adhering to treatments, as well as a reflection of poor medical care, poorer functional literacy and difficulties in accessing health services. 25,26 DM is another very important CNCD, since it is associated with functional disability, multisystem complications (cardiovascular, renal and neurological), high rates of hospitalization and premature mortality. 27 Estimates indicate that between 2010 and 2030 there will be a 69% increase in the number of adults with DM in developing countries and a 20% increase in developed countries.…”

Section: Discussionmentioning

confidence: 99%

Chronic non-communicable diseases considering sociodemographic determinants in a cohort of older adults

Rev. bras. geriatr. gerontol.

Assumpção

Francisco

et al. 2022

Objective To analyze the differences between the proportions of chronic non-communicable diseases (CNCDs) at two time periods, in a cohort of older adults, based on sociodemographic determinants. Method This is a retrospective longitudinal study with baseline data obtained in 2008-2009 and follow-up in 2016-2017, from the FIBRA Study. The McNemar test was used to compare the frequencies of CNCDs according to sex, age, and education, with a significance level of 5% (p<0.05). Results The sample consisted of 453 older adults (mean age 72±5.2 years old; 69.4% women). There was an increase in the proportions of arterial hypertension (64.4% versus 71.1%) and diabetes mellitus (21.9% versus 27.5%) in the periods studied, and a reduction in rheumatologic disease (43.6% versus 35.8%) and depression (21.7% versus 15.7%). Hypertension increased in older women, in those aged 65-74 years old and those with low education levels. Diabetes increased in older men, in those over 65 years of age and those with low education levels. A reduction in the proportions of rheumatologic diseases and depression was observed in women, in those aged 65-74 years old and those with low education levels. Conclusion The data reflect the need to understand the sociodemographic health determinants involved in the health-disease-care process to reduce social inequities and the burden of CNCDs in the most vulnerable population segments, especially in the older adult population with multimorbidity.

“…Uma revisão sistemática identificou que o baixo nível de escolaridade aumentou em 64% as chances de multimorbidade (OR: 1,64, IC95% 1,41-1,91), sendo essa associação mais forte em populações mais idosas do que nas mais jovens 25 . Bento et al 26 investigaram a associação de variáveis contextuais e individuais com HAS em idosos brasileiros e observaram associação inversa entre hipertensão e escolaridade. Esse resultado pode refletir a maior dificuldade de idosos com baixa escolaridade em reconhecer as necessidades de saúde e de aderir a tratamentos, assim como pode ser um reflexo de uma assistência médica precária, de pior letramento funcional e de dificuldades de acesso aos serviços de saúde 25,26 .…”

Section: Discussionunclassified

Doenças crônicas não transmissíveis considerando determinantes sociodemográficos em coorte de idosos

Rev. bras. geriatr. gerontol.

Assumpção

Francisco

et al. 2022

Resumo Objetivo Analisar as diferenças entre as proporções de doenças crônicas não transmissíveis (DCNT), em dois momentos, em uma coorte de idosos a partir de determinantes sociodemográficos. Método Trata-se de estudo longitudinal retrospectivo com dados obtidos do Estudo FIBRA linha de base (2008-2009) e seguimento (2016-2017). O teste de McNemar foi utilizado para comparar as frequências de DCNT segundo sexo, idade e escolaridade, com nível de significância de 5% (p<0,05). Resultados A amostra foi composta por 453 idosos (idade média 72±5,2 anos; 69,4% do sexo feminino). Observou-se aumento nas proporções de hipertensão arterial (64,4% versus 71,1%) e diabetes mellitus (21,9% versus 27,5%) no período estudado, e redução nas de doença reumatológica (43,6% versus 35,8%) e depressão (21,7% versus 15,7%). A hipertensão aumentou no sexo feminino, e nos idosos com 65-74 anos e com baixa escolaridade; o diabetes aumentou nos idosos do sexo masculino e nos indivíduos com idade acima de 65 anos e com baixa escolaridade; observou-se redução das proporções de doenças reumatológicas e de depressão no decorrer do estudo nas mulheres, naqueles com 65-74 anos de idade e com nível mais baixo de escolaridade. Conclusão Os dados refletem a necessidade de compreensão dos determinantes sociodemográficos de saúde envolvidos no processo saúde-doença-cuidado para a redução de iniquidades sociais e da carga de DCNT nos segmentos populacionais mais vulneráveis, especialmente na população idosa com multimorbidade.