Biopsychosocial aspects and the complexity of care of hospitalized elderly

Gutierrez, Beatriz Aparecida Ozello; Silva, Henrique Salmazo da; Shimizu, Helena Eri

doi:10.1590/19820194201400071

Cited by 3 publications

(5 citation statements)

References 17 publications

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“…2 In the hospitalized elderly, although the biological domain is commonly the most affected, it is also observed that psychological and social changes can make this population more susceptible to disease and disability. 3 In addition, with regard to the ICU, it is possible to observe that even in the elderly who have a good functional status upon admission to the unit, there is a significant degradation of their status at the time of hospital discharge. 4 Older people experience an aging process that imposes them to a degree of fragility and requires qualified attention when returning home after hospital discharge since at home, elderly and family will share new demands for care, which require adaptation and institutional support capable of preventing complications and readmissions.…”

Section: Introductionmentioning

confidence: 99%

Adaptation of Long-Lived Elders at Home After Hospitalization in the Intensive Care Unit and Hospital Discharge

Santos

Pedreira

Amaral

et al. 2019

Texto contexto - enferm.

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Objective: to identify stimuli that interfere with the adaptation of long-lived elders at home after hospitalization in the intensive care unit and hospital discharge. Method: a descriptive study with a qualitative approach, conducted with elderly individuals who were hospitalized in the intensive care unit and were already at home after hospital discharge. Data collection took place through open interviews and was performed at the intensive care unit of the hospital and at the home of the elderly. Home visits took place between December 2017 and February 2018, and were conducted in seven cities. Bardin's content analysis was used, and the discussion was based on Callista Roy's Adaptation Theory. Ethical and legal cares were strictly respected. Results: eleven long-lived elders, aged between 80 and 94 years old, took part in the study. Two categories emerged from the participants' testimonies: Stimuli that contribute to adaptive behavioral responses in the long-lived elders and Stimuli that negatively affect the adaptation of the long-lived elders. Conclusion: the main stimuli that contributed to the adaptive behavior of the long-lived elders were the return to their homes, family support and the social support network. In contrast, the stimuli that negatively affected adaptation were fear, lack of information and difficulties in continuing the care. The critical role of the health professionals in the intensive care unit and the hospital unit in preparing longevity the long-lived elders their families for hospital discharge and home return is highlighted.

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Section: Introductionmentioning

confidence: 99%

Adaptation of Long-Lived Elders at Home After Hospitalization in the Intensive Care Unit and Hospital Discharge

Santos

Pedreira

Amaral

et al. 2019

Texto contexto - enferm.

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“…The patients considered that interview length was brief and, objectively, the length was less than found in studies from specialized services 37 . The complexity of healthcare needs and the interview length had a positive relationship (p = 0.005).…”

Section: Discussionmentioning

confidence: 98%

“…Complications of chronic diseases, impairments that affect functionality 34 , mental, social barriers, and not adhering to the care theirself 37 implies an increase in the risk of health services use (scheduled consultations, hospitalizations, emergency, and specialist's visits). In the first studies about INTERMED 35 , the researchers discussed the relationship between the psychological domain and the increased risk of specialist and emergency room visits, including the rehospitalizations.…”

Section: Discussionmentioning

confidence: 99%

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A complexidade das necessidades de saúde na atenção básica avaliada pelo INTERMED

Oliveira¹

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Introduction: The use of INTERMED in Primary Health Care can contribute to the provision of personalized care plans and integrated care if it shows adequate psychometric properties in that setting. Objectives: The objective of the study was to analyze the validity and applicability of INTERMED in PHC. Methods: The first step of the work consisted of a literature review, in order to analyze its psychometric properties, focusing on patients with mental disorders. The selection of articles was carried out in the databases National Library of Medicine (PubMed), American Psychological Association (PsycINFO), Latin American and Caribbean Literature in Health Sciences (LILACS) and Scientific Electronic Library Online (SciELO). The second stage was the evaluation of its validity and applicability in 230 patients from three PHC services in the city of Ribeirão Preto, using data from interviews and health records. Spearman's correlation coefficients measured the concurrent validity of the scores of each INTERMED domain (biological, psychological, social, health services) with the total score of the Charlson Comorbidity Index, HADS, MOS-SSS and WOQOL-BRE instruments. Pearson's X 2 measured associations of the sum of INTERMED's current state variables with the use of PHC, other health services and medications. Cronbach's alpha assessed internal consistency. We evaluate the applicability of INTERMED through: a) the opinions of patients (the understanding of its questions and answers, relevance to describe aspects of health important for planning care and on the time required for its application); b) the time required for application measured objectively; and c) information about the INTERMED variables already in the patients' medical records. Results: The analyzed articles showed that the INTERMED method had positive results in the identification of patients who need complex care, which directed the performance of rapid psychiatric interventions that decreased the length of stay in the hospital, the number of hospitalizations and improved the quality of patients' life; however, there were no articles regarding its use in PHC. In the second stage, 230 patients completed the assessment (mean age 45.92, 56.1% female). Spearman's correlation coefficients were between 0.44 -0.65. Pearson's coefficients were p = 0.020 (X2 = 26.812 and X2 = 26.883) and p = 0.013 (X2 = 28.270).Cronbach's Alpha was 0.802. More than 93% of patients considered INTERMED to be well understood, with short application time and providing relevant information to help with their care. The average duration of the application was 8.58 minutes. Only the biological domain of INTERMED already had all its variables present in more than 50% of the medical records. Conclusion:INTERMED has good potential for use in the context of PHC and can replace or complement other standardized instruments to assist health professionals and staff. However, further studies are needed, mainly to assess its predictive validity in relation to the use of health services and to assess it...

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“…SILVA ;SHIMIZU, 2014;WILD et al, 2011), com esclerose múltipla (HOOGERVORST et al, 2003), nos cuidados paliativos (KISHI et al, 2010;MAZZOCATO et al, 2000), todos…”

Section: Intermedunclassified

Aplicabilidade do instrumento INTERMED na classificação do nível de complexidade e na elaboração do Projeto Terapêutico Singular de casos clínicos fictícios por profissionais de saúde da atenção primária à saúde

Camargo¹

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Biopsychosocial aspects and the complexity of care of hospitalized elderly

Cited by 3 publications

References 17 publications

Adaptation of Long-Lived Elders at Home After Hospitalization in the Intensive Care Unit and Hospital Discharge

Adaptation of Long-Lived Elders at Home After Hospitalization in the Intensive Care Unit and Hospital Discharge

A complexidade das necessidades de saúde na atenção básica avaliada pelo INTERMED

Aplicabilidade do instrumento INTERMED na classificação do nível de complexidade e na elaboração do Projeto Terapêutico Singular de casos clínicos fictícios por profissionais de saúde da atenção primária à saúde

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