Influence of Diabetes complications and limitations on health-related quality of life: a study in a southeastern Brazilian city.

PURPOSE: The aim of this study was to measure how diabetes, its complications, and limitations are associated to the domains of health-related quality of life (HRQoL). METHODS: A population-based cross-sectional study was conducted with 2178 individuals from the 2014/2015 City of Campinas Health Survey. The SF-36 was used to measure HRQoL. Mean scores were calculated. Crude and adjusted beta coefficients were estimated using multiple linear regression. RESULTS: Diabetes was associated with a significant reduction in the scores of five SF-36 domains. However, no significant reduction of scores was found among diabetics without complications and with no reports of limitations. The reduction in HRQoL was more accentuated with the increase in the number of complications. Three domains were affected in diabetics with one complication and all were affected in those with two or more complications, especially the role physical, role emotional, and physical functioning. Five domains were affected among diabetics who reported some degree of limitation and all were affected in those who reported high degree of limitation. Patients who reported limitation even in the absence of complications had reductions of the scores especially in the role emotional and social functioning. CONCLUSIONS: The results reveal that the association between diabetes and HRQoL only prevail in the occurrence of complications and limitations imposed by the disease, indicating the necessity to avoid or delay the emergence of chronic complications with adequate control methods and paying attention to the perception of limitation reported by the patient.

Prevalence and factors associated with suicidal ideation among family caregivers of people with mental disorders.

AIMS AND OBJECTIVES: This study aimed to analyse the prevalence and factors associated with suicidal ideation among family caregivers of people with mental disorders. BACKGROUND: Studies conducted with family caregivers of people with dementia and cancer point out a high prevalence of suicidal ideation among these subjects; however, this aspect has not yet been investigated among family caregivers of people with mental disorders. DESIGN: This is a cross-sectional study, conducted with 537 family caregivers of patients from 16 Psychosocial Care Centers (CAPS) of the 21st Health Region of the state of Rio Grande do Sul, Brazil. METHODS: Question 17 of the Self-Reporting Questionnaire (SRQ-20) was used for suicidal ideation screening. The prevalence of suicidal ideation was calculated according to sociodemographic and care variables, with confidence interval estimate (95% CI). Crude and adjusted odds ratios were calculated by logistic regression. The Guidelines to Reporting of Observational Studies in Epidemiology (STROBE Statement) was adhered in this study (See File S1). RESULTS: The prevalence of suicidal ideation found in this study for the 30 days preceding the interview was 12.5% (95% CI: 10-15). The factors associated with the outcome were lower age, lower schooling, feeling of burden, self-report of stress problem and dissatisfaction with family relationships. CONCLUSION: The prevalence of suicidal ideation among the studied family caregivers was high and strongly associated with issues regarding care, showing the need for interventions that provide support. RELEVANCE FOR CLINICAL PRACTICE: Nurses are a large part of the workforce of the community mental health services. The careful characterisation of the subjects who show suicidal ideation, as performed in this study, may reveal specificities capable of refining the diagnostic potential for establishment of action plans in a timely manner, avoiding possible attempts or even the consummation of suicide.

Napping, functional capacity and satisfaction with life in older adults: A population-based study.

AIM AND OBJECTIVE: To analyse the association between napping, functional capacity and satisfaction with life in older adult residing in the community. METHOD: A cross-sectional population-based study using data from a health survey conducted in a city of the state of São Paulo. Information on sociodemographic and clinical variables was collected through a questionnaire, as well as the occurrence or not of napping and satisfaction with life. Functional capacity was assessed using the Katz Index and Lawton-Brody Scale. Statistical analysis was performed using the Rao-Scott chi-square test and a hierarchical analysis using stepwise backward multiple Poisson regression. p-Values <0.05 were considered significant. In this paper, we adhere to STrengthening the Reporting of OBservational studies in Epidemiology guidelines. RESULTS: There was predominance of the 60-69 years age group (51.3%) and of females (60.8%). The majority of the older adults (57.5%), of both sexes, reported napping. A higher prevalence of napping was found in the older subjects, the male sex, the subjects without children, those with health problems and those that were partially dependent in instrumental activities of daily living. CONCLUSIONS: The study showed that naps are prevalent in older adults. The need to identify the issues that permeate napping is emphasised, in order to promote health in individuals of this age group, before classifying the practice as beneficial or harmful. RELEVANCE TO CLINICAL PRACTICE: It is essential that health professionals, in their practices, consider the complaints and reports of naps in the elderly, in an attempt to detect and reduce possible consequences in activities of daily living.

Factors associated with the fragmentation and stability of the rest-activity rhythm in adults and older adults.

This cross-sectional study aimed to identify factors related to the fragmentation and stability of the rest-activity rhythm (RAR) in adults and older adults. It is part of a larger research project investigating aspects concerning sleep duration, quality, and disorders in a representative subsample of the population. Sociodemographic data, lifestyle, health habits and subjective sleep variables were obtained; RAR records were collected by means of actigraphy and analyzed using non-parametric variables (IS, IV, M10, L5, RA, sL5, and sM10). Study participants were 313 individuals with complete actigraphy records. There was a prevalence of older adults (50.2%) and females (51.1%). Females, individuals with 4-8 y of education, and those who used alcohol abusively exhibited lower RAR fragmentation. Higher fragmentation was observed in individuals who napped and those reporting poor sleep quality. Greater rhythm stability was evident in females, older adults, those with 4-8 y of education, and those who had a partner. Smokers demonstrated lower RAR stability. These findings may contribute valuable insights for decision-making aimed at preventing and treating issues related to fragmentation and instability of the rhythm and its possible consequences to health.

Leisure-time physical activity and sports in the Brazilian population: A social disparity analysis.

OBJECTIVES: To estimate the prevalence of leisure-time physical activity (LTPA) or sports in the Brazilian population according to demographic and income variables. METHODS: Data from 60,202 Brazilian individuals (18 years and over) were analyzed, belonging to the National Health Survey 2013 sample. The prevalence of different modalities of LTPA and sports was estimated according to age, sex, skin color and income. The adjusted prevalence ratios were estimated by Poisson regression. RESULTS: Of every thousand Brazilians, 695 do not practice LTPA or sports. Walking is the most practiced LTPA (98/1000), followed by soccer (68/1000) and weight training (45/1000). For poor and black men, the most frequent LTPA was soccer, and, for women, gymnastics and walking. The prevalence of weight training and gymnastics was higher for white people compared with black people. All LTPA practices were more prevalent in individuals with higher income, except for soccer. Running on a treadmill and weight training had, respectively, 24.7 and 6.4 times higher prevalence in the richer quartile. CONCLUSIONS: The study allowed identifying the type of LTPA and sport reported as the most frequent by the Brazilian population according to age, sex, skin color, and income, detecting strong social disparities in these practices.