La Ciencia de la Enfermería por una vejez saludable, sin violencia ni maltrato / The Nursing Science for a Health Old Age, without Violence or Mistreatment

Introducción: Cuba se ubica en la actualidad entre los tres primeros países de América Latina con mayor envejecimiento poblacional y los pronósticos indican que en los próximos años estará al frente del listado. Objetivo: Reflexionar sobre las particularidades de los retos de la Ciencia de la Enfermería, en favor de una vejez saludable, sin violencia ni maltrato. Métodos: A través de la sistematización de literatura científica, se realizó un ensayo teórico, en el cuarto trimestre del año 2022, concebido como una argumentación reflexiva, al hacer una aproximación a los retos a afrontar por la Ciencia de la Enfermería, en favor de una vejez saludable, sin violencia ni maltrato. La búsqueda se realizó en las bases de datos SciELO, Redalyc, Lilacs, Medline PubMed, e-libro y Google Scholar, con las palabras clave "violencia"; "enfermería"; "anciano"; "maltrato al anciano". Se incluyeron artículos publicados entre 2017 y 2022 en idioma inglés, español y portugués. Para el análisis se utilizó el método análisis de contenido de Bardin. Conclusiones: Los profesionales de la Enfermería en su interacción con las personas son conscientes de los cambios, necesidades, expectativas y realidades de los adultos mayores en la actualidad. Cuba es un ejemplo en el avance de la promoción de los derechos humanos de las personas de la tercera edad a nivel mundial, por lo que se necesita un proceso de readaptación a las nuevas realidades, y ahí está el más grande de los retos a afrontar por la Ciencia de la Enfermería(AU)

Introduction: Cuba is currently among the first three countries in Latin America with the highest population aging and forecasts indicate that, in the coming years, it will be at the top of this list. Objective: To reflect on the particularities of the challenges faced by the nursing science in favor of a healthy old age, without violence or mistreatment. Methods: Through the systematization of scientific literature, a theoretical essay was carried out in the fourth quarter of the year 2022, conceived as a reflective argumentation, by making an approach to the challenges to be faced by the nursing science in favor of a healthy old age, without violence or mistreatment. The search was performed in the SciELO, Redalyc, Lilacs, Medline PubMed, e-book and Google Scholar databases, with the keywords Violencia [Violence], Enfermería [nursing], Anciano [elderly], Maltrato al anciano [elder mistreatment]. Articles published between 2017 and 2022 in the English, Spanish and Portuguese languages were included. Bardin's method was used for content analysis. Conclusions: Nursing professionals, in their interaction with people, are aware of the changes, needs, expectations and realities of older adults today. Cuba is an example regarding the advancement in the promotion of the human rights of the elderly worldwide, a reason why a process of readaptation to the new realities is needed; and therein lies the greatest challenge to be faced by the nursing science(AU)

Older adults abuse in three Brazilian cities / Violencia contra personas mayores en tres municipios brasileños / Violência contra idosos em três municípios brasileiros

ABSTRACT Objective: To analyze the police reports filed by older adults who suffered abuse in order to identify the socio-demographic characteristics of victims and aggressors, type of violence, location, as well as to compare rates in three Brazilian cities in the period from 2009 to 2013. Method: Ecological study, in which 2,612 police reports registered in Police Stations were analyzed. An instrument was used to obtain data from the victim, the aggressor and the type of violence. Results: Psychological abuse predominated and most cases occurred in the older adults own home. In the cities of Ribeirão Preto and João Pessoa, the older adults presented similar rates for both gender. Regarding the standardized rates, in João Pessoa, there was a rise of this type of abuse in the two first years, and later there was a certain stability. In the city of Teresina, there was an increase, also observed in the city of Ribeirão Preto in the three first years, followed by a decrease. Conclusion: Older adults abuse is a cultural phenomenon difficult to be reported by them, since it occurs in the family context.

RESUMEN Objetivo: Analizar las denuncias policiales registradas por los ancianos que han sufrido violencia, con el fin de identificar las características sociodemográficas de las víctimas y de los autores, los diversos tipos de violencia y los lugares del suceso, así como también comparar el índice de violencia entre tres municipios brasileños durante el período comprendido entre 2009 y 2013. Método: Estudio ecológico, en el que se analizaron 2.612 denuncias registradas en Comisarías de Familia. Se utilizó un determinado instrumento para obtener datos de la víctima, del agresor y del tipo de violencia. Resultados: La violencia predominante es la psicológica y en la mayoría de los casos ocurre en la residencia de la persona mayor. En Ribeirão Preto y João Pessoa, el porcentaje de violencia contra los ancianos más jóvenes era igual entre ambos sexos. Comparando las tasas estándar, en João Pessoa el índice fue más alto en los dos primeros años, estabilizándose tras ese periodo. En Teresina y Ribeirão Preto el porcentaje aumentó en los tres primeros años y luego fue disminuyendo. Conclusión: La violencia es un fenómeno cultural de difícil notificación de parte de la persona mayor, ya que ocurre en el contexto familiar.

RESUMO Objetivo: Analisar os boletins de ocorrência registrados por idosos que sofreram violência, a fim de identificar características sociodemográficas das vítimas e dos agressores, tipo de violência, local, bem como comparar as taxas em três municípios brasileiros no período de 2009 a 2013. Método: Estudo ecológico, em que foram analisados 2.612 boletins de ocorrência registrados em Delegacias do Idoso. Utilizou-se um instrumento para obter dados da vítima, do agressor e tipo de violência. Resultados: Predominou a violência psicológica, na maioria dos casos na própria residência do idoso. Em Ribeirão Preto e João Pessoa, os idosos mais jovens apresentaram taxas semelhantes entre ambos os sexos. Na comparação das taxas padronizadas, em João Pessoa, houve ascensão deste tipo de violência nos dois primeiros anos, e, posteriormente, certa estabilidade. Em Teresina, houve ascensão, também observada em Ribeirão Preto nos três primeiros anos, seguida de decréscimo. Conclusão: A violência é um fenômeno cultural de difícil notificação pelo idoso, por ocorrer no contexto familiar.

Maltrato institucional hacia el adulto mayor: percepciones del prestador de servicios de salud y de los ancianos / Institutional abuse toward the elderly: Perceptions of health care providers and older adults

Objetivo. Analizar la percepción que el prestador de servicios de salud y el adulto mayor (AM) tienen sobre el maltrato al AM en los servicios públicos de salud, en ciudades seleccionadas de México. Material y métodos. De 2009 a 2012 se realizó un estudio con diseño cualitativo y estrategia de triangulación de fuentes de datos; se efectuaron entrevistas semiestructuradas a 13 prestadores y a 12 ancianos para recuperar su experiencia en el tema. El análisis utilizó procedimientos de la Teoría Fundamentada. Resultados. El maltrato contra el AM es una práctica naturalizada por el personal y por el anciano, la cual se manifiesta de formas diversas. Conclusiones. La institucionalización, profesionalización histórica y falta de conciencia sobre las necesidades de los AM demandan cambios de planeación, organización y supervisión del Sistema de Salud. El personal requiere intervenciones de formación, capacitación y cambio de actitudes/comportamiento, para otorgar atención integral, digna, humana y de respeto a los Derechos Humanos de los AM.

Objective. To analyze the health care providers (HCP) and elderly patients' perceptions about abuse of the elderly by health personnel of public health services, in selected cities in Mexico. Materials and methods. A qualitative study and a strategy of data triangulation were performed during 2009 and 2012; 13 HCPs and 12 elders were interviewed, in order to obtain their experience regarding elder abuse. Grounded Theory proceedings were used for the analysis. Results. Elder abuse is a naturalized practice, from HCP and elderly people's point of view; these perceptions are showed in different ways. Conclusion. Institutionalization, historical professionalization and lack of consciousness about needs of the elderly (sociocultural and economic), require changes in planning, organization and monitoring process in the Health System; training and educational interventions on staff and exchange attitudes and behavior are necessary in order to offer a health care that is comprehensive, decent, human and with respect for the human rights.

Association between social support and mistreatment on elderly in the rural community of Hubei province / 中华流行病学杂志

Objective This study was to estimate the prevalence of elderly mistreatment (EM) in rural community and to examine the association between social support and the risk of the EM.Methods A cross-sectional descriptive study was performed in three rural communities (17 villages) in Macheng city of Hubei province.2000 subjects aged 60 years or older were selected using cluster sampling.Questionnaire being developed would include general information,a scale to measure social support,and a modified vulnerability on abuse screening scale (VASS) to measure the EM.Results The prevalence rates of EM,physical abuse,emotional abuse,neglect and financial exploitation for rural elderly people in Macheng city were 36.2％,4.9％,27.3％,15.8％,and 2.0％respectively.After adjusting for potential confounding factors,necessary practical support from family (OR=1.28,95％CI:1.01-1.63) was the risk factor causing EM while having got practical support (OR=0.76,95％CI:0.58-0.98) or moral support (OR=0.63,95％CI:0.49-0.82) from family and moral support from friends (OR=0.73,95％CI:0.59-0.90) when in need were the protective factors.The protective factors on physical abuse,emotional abuse,neglect and financial exploitation would include:getting practical support from family when in need (OR=0.59,95％CI:0.35-0.99),getting moral support from family (OR=0.67,95％ CI:0.51-0.89) and friends (OR=0.67,95％ CI:0.54-0.84) and getting practical support from family when in need (OR=0.63,95％CI:0.45-0.88),getting practical support from family ( OR =0.38,95％ CI:0.14-0.98 ) and getting moral support from friends when in need (OR=0.42,95％CI:0.20-0.87),respectively.Conclusion High prevalence of EM was seen in the rural areas of Macheng city.Social support was an important protective factor for EM in this population.

O reconhecimento pela equipe da estratégia saúde da família da violência intrafamiliar contra idosos / The recognition of domestic elder abuse by the team of family health strategy

A violência intrafamiliar é umas das situações a que os idosos estão expostos com o avançar da idade. Conhecer este fenômeno, suas causas, seus fatores de riscos, as formas de rastreamento e os tipos de violência tornam-se um desafio para os profissionais da Atenção Básica de Saúde. Esta dissertação é uma pesquisa exploratória, que teve como objetivo identificar as formas de reconhecimentos da violência intrafamiliar contra idosos, referidos pelos integrantes da equipe de Estratégia Saúde da Família (ESF) da Secretaria Municipal de Saúde de Curitiba/PR. A pesquisa foi realizada de abril a junho de 2008 por meio da amostragem por etapa ou estágio duplo. Os dados foram coletados mediante entrevista com um roteiro estruturado com 96 sujeitos, sendo: 9 enfermeiros, 9 odontólogos, 9 técnicos em higiene dental, 27 auxiliares e 33 agentes comunitários de saúde. Constatou-se nesta pesquisa que 91% (87) dos integrantes da ESF percebem a violência intrafamiliar contra os idosos na cidade de Curitiba, principalmente casos de abandono/negligência, de acordo com 25% (75) das respostas dos entrevistados. Apesar de identificarem esses tipos de maus tratos causados pela família, 74% (71) deles não referem utilizar instrumento de identificação de violência específico para esta faixa etária, sendo a visita domiciliar o meio mais comum para tal reconhecimento em 52% (83). Os fatores de risco mais comuns relacionados aos maus-tratos referem-se à família totalizando 33% (229) das respostas. Entre as principais dificuldades de identificação deste fenômeno destaca-se o fato de que o idoso não fala a respeito da violência 16% (81), em segundo lugar a doença mental 15% (79), e em terceiro a dificuldade de comunicação 14% (75). Outra questão importante constada é o uso de apenas uma rede social de apoio para resolver o problema da violência, e a Fundação de Ação Social foi a mais citada pelos participantes com 62% (88). Portanto, os dados encontrados nesta pesquisa, nos levam a uma reflexão, que nos faz repensar no atendimento oferecido à população idosa, na capacitação dos profissionais, e em um mecanismo de rastreamento que permita prevenir esse fenômeno na sociedade.

Domestic abuse is one of the situations that elders are exposed to as they are aging. Learning about this phenomenon, its causes, its risk factors, detection ways and the kinds of abuse have become a challenge for professionals in primary health care. This dissertation is an exploratory research study which objectifies to identify ways of recognizing domestic elder abuse referred to by the team of Family Health Strategy (FHS) from the Municipal Health Secretary of Curitiba/Paraná State - Brazil. The research study was held from April to June/2008 by means of a two-stage sampling or double sampling. Data were collected through interviews using an oriented structured instrument with 96 subjects: 9 nurses, 9 dentists, 9 dental hygienists, 27 assistants and 33 community health agents. It was verified in this study that 91% (87) members of the FHS team can detect domestic elder abuse in the city of Curitiba, mainly cases of abandonment/ neglect, according to 25% (75) of the interviewed. In spite of detecting this kind of family mistreatment, 74% (71) of them did not refer to use any specific abuse detection instruments for this age group; the commonest way of identification is home visit - 52% (83). The commonest risk factors of elder mistreatment are family-related accounting for 33% (229) of the answers. Among the main difficulties in identifying this phenomenon, it is pointed out the fact that elders do not mention the abuse ­ 16% (81), secondly, mental illness ­ 15% (79) and thirdly, the difficulty in communication ­ 14% (75). Another important issue to be mentioned is that a single social support network has been used to solve the problem, and Social Action Foundation (Fundação de Ação Social) was the most mentioned by the participants ­ 62% (88). Therefore, the data found in this study are thought-provoking; they make us think over elderly population's care delivery, professional qualification and a detection mechanism which enables the prevention from this social phenomenon.