Idosos com úlceras venosas atendidos nos níveis primário e terciário em Natal/RN: caracterização sociodemográfica, saúde e assistência

Abstract

Objective: to characterize assistance of 88 elderly with venous ulcers attended in the tertiary and primary levels of health service in Natal city. Methods: integrative and descriptive study, from quantitative approach, with retrospective data of patients with venous ulcers who were studied in two dissertations presented at the Post-Graduate Program in Nursing/UFRN and a search report of CNPQ. Data was carried out from 2005 to 2007 through structured interview, physical examination and observation of the exchange of dressing, being organized in Excel and transported to the SPSS 14.0. These studies were approved by the Committees of Ethics in Research of the Federal University of Rio Grande do Norte (55/05; 54/05; 196/06). Results: we studied 88 elderly, mainly female sex (68,2%), literate (81,8%), outcomes two basic salary (69,3%), (52,3%) with edema (69,3%) and pain (86,4%). The main mismatches in assistance were: dressing kit (71,6%), angiologist consultation (60,2%) and monitoring specialist (56.8%). Conclusion: the assistance was considered inappropriate, mainly in the tertiary level, fragmented, with low resolution level and integration between the levels of complexity of the Public Health System. Descriptors: venous ulcerations; elderly people; health assistance.

Caracterización de las personas con úlcera venosa en Brasil y Portugal: estudio comparativo

“…Algunos estudios señalan el acceso a este profesional en Brasil, en un estudio sobre la asistencia a los ancianos con UV atendidos en los servicios de salud en los niveles primario y terciario de asistencia del SUS, en Natal/Brasil, hubo un bajo nivel (39,8%) de acceso a la consulta con el angiólogo, siendo 20,5% en nivel terciario y 19,3% en primario. El acompañamiento especializado, la continuidad al tratamiento y la realización de exámenes (p= < 0,001) fueron más frecuentes en nivel primario de atención a la salud con 27,3%, 43,2% e 53,4%, respectivamente (23) . No obstante, otro estudio realizado a nivel ambulatorial en la red municipal de salud de Goiânia/Brasil revela que entre los que disponían de atención del médico, 67,2% de los investigados referían seguimiento del tratamiento con angiólogo, 13,8% con médico general, 6,9% con dermatólogo, 5,2% con cirugía general y solo 1,7% con médico de la Estrategia Salud de la Familia (10) .…”

Sociodemographic, clinic and health characterization of people with venous ulcers attended at the family health strategy

“…11 Besides occupation, another factor to be considered in Harrison points out that there is evidence that low socioeconomic status negatively influences healthy behavior in the home environment, access to health services, health care and access to material resources. 13 Household income is an important aspect in the planning of actions, as it determines the living conditions of this population, often making it difficult to implement actions, prolonging treatment and chronicity of lesions.…”

“…6 With regard to health characteristics, several studies have reported that healthy lifestyle habits, such as not smoking, sleeping at least six hours, having a balanced diet, do not drink alcohol and take control of underlying diseases and risk factors, contribute positively to the healing of venous ulcers. [10][11][13][14] Corroborating this study, research conducted in a referral hospital for treatment to people with VU identified risk factors such as family history of venous disease; history (proven or suspected) of DVT; prior venous surgery or other sources; activities for long periods of standing or sitting; pregnancy; diabetes; heart disease; chronic venous insufficiency; hypertension and stroke. 15 Margolis identified chronic diseases such as hypertension (38,9%), lung disease (16,7%) and diabetes mellitus (11,1%).…”

“…This characterization reflects an apparent chronicity of wounds and lack of response capacity of health services. 11,14 Pain in patients with venous ulcers has been a frequent feature, performing worse at night, causing limited mobility of the affected lower limb, disrupting sleep and being described by many patients as the factor with the greatest impact on their quality of life. 15 Other studies showed percentages ranging from 66,6% to 86,5% over the ulcer pain or in the limb.…”

“…15 Other studies showed percentages ranging from 66,6% to 86,5% over the ulcer pain or in the limb. 6,11,14 In addition to pain, researches showed the importance of describing the characteristics of the lesions, such as: depth, shape, edge, fabric bed, and exudate and perform measurement of the area during treatment. These aspects are relevant in poor wound healing and usually present as unfavorable in this study.…”