Efficacy of iSupport-Brasil for unpaid caregivers of people living with dementia: protocol for a randomized and controlled clinical trial.

Unpaid caregivers of people living with dementia tend to suffer mental health problems as a result of the negative effects associated with the care tasks. Thus, psychosocial interventions for this population group are necessary. iSupport is an online support program for caregivers that was created by the World Health Organization. Objective: To describe the design of a randomized clinical trial to measure the efficacy of the iSupport-Brasil version on caregivers' mental health and well-being. Methods: The participants will be randomized into Intervention Group (IG) (n=195) and Control Group (CG) (n=195). For three months, the IG will access the iSupport-Brasil platform, the CG will enter the electronic page of the Brazilian Alzheimer's Association, and both groups will be emailed the preliminary version of the "Guia de cuidados para a pessoa idosa" e-book (a guide to providing care to the elderly) from the Ministry of Health. The data will be collected at three moments: baseline, and three and six months after the beginning of the intervention. Results: It is expected that it will be possible to provide diverse validity evidence about iSupport-Brasil as an online and free intervention alternative, as a preventive means and as a way to promote mental health among caregivers of people living with dementia. Conclusion: Through the evaluation protocol of this randomized clinical trial on the effects of the iSupport-Brasil program, it may become a reference for countries that plan to adapt and improve the iSupport program using digital health solutions.

Cuidadores informais de pessoas que vivem com demência tendem a sofrer problemas de saúde mental como resultado dos efeitos negativos associados às tarefas de cuidado. Assim, intervenções psicossociais para essa população são necessárias. O iSupport é um programa de apoio online para cuidadores criado pela Organização Mundial da Saúde. Objetivo: Descrever o desenho de um ensaio clínico randomizado para medir a eficácia da versão iSupport-Brasil na saúde mental e no bem-estar de cuidadores. Métodos: Os participantes serão randomizados em Grupo Intervenção (GI) (n=195) e Grupo Controle (GC) (n=195). Durante três meses, o GI acessará a plataforma iSupport-Brasil, o CG entrará na página eletrônica da Associação Brasileira de Alzheimer e ambos os grupos receberão por e-mail a versão preliminar do e-book Guia de cuidados para a pessoa idosa, do Ministério da Saúde. Os dados serão coletados em três momentos: linha de base, três e seis meses após o início da intervenção. Resultados: Espera-se que seja possível fornecer diversas evidências sobre os efeitos do iSupport-Brasil como alternativa de intervenção online e gratuita, de forma a promover a saúde mental entre os cuidadores de pessoas que vivem com demência. Conclusão: O protocolo de avaliação deste ensaio clínico randomizado sobre os efeitos do programa iSupport-Brasil pode se tornar uma referência para os países que planejam adaptar e melhorar esta intervenção, usando soluções digitais de saúde.

Mapping Research Conducted on Long-Term Care Facilities for Older People in Brazil: A Scoping Review.

This scoping review aimed to explore the characteristics, strengths, and gaps in research conducted in Brazilian long-term care facilities (LTCFs) for older adults. Electronic searches investigating the residents (≥60 years old), their families, and the LTCF workforce in Brazil were conducted in Medline, EMBASE, LILACS, and Google Scholar, within the timescale of 1999 to 2018, limited to English, Portuguese, or Spanish. The reference lists were hand searched for additional papers. The Mixed Methods Appraisal Tool (MMAT) was used for critical appraisal of evidence. Data were reported descriptively considering the study design, using content analysis: 327 studies were included (n = 159 quantitative non-randomized, n = 82 quantitative descriptive, n = 67 qualitative, n = 11 mixed methods, n = 6 randomized controlled trials, and n = 2 translation of assessment tools). Regardless of the study design, most were conducted in a single LTCF (45.8%), in urban locations (84.3%), and in non-profit settings (38.7%). The randomized trials and descriptive studies presented the lowest methodological quality based on the MMAT. This is the first review to provide an overview of research on LTCFs for older people in Brazil. It illustrates an excess of small-scale, predominantly qualitative papers, many of which are reported in ways that do not allow the quality of the work to be assured.

Psychometric Properties of the Brazilian Version of the Nurses' Knowledge of High-Alert Medications Scale: A Pilot Study.

BACKGROUND AND PURPOSE: High-alert medication is considered to be a medication that presents a high risk of causing significant patient harm when used erroneously and its consequences can be fatal. The Nurses' Knowledge of High-Alert Medication scale (NKHAM) is a tool available to evaluate the knowledge of nurses in practice about this issue. AIM: This pilot study aimed to measure the reliability and known-groups validity of the Brazilian version of the NKHAM. METHODS: This pilot psychometric study was carried out at the Faculty of Nursing and University Hospital of the University of Campinas, São Paulo, Brazil. Forty nursing students and 44 registered nurses working in complex clinical or surgical settings completed a sociodemographic questionnaire and the Brazilian version of the NKHAM. The Kuder-Richardson 20 (KR-20) coefficient and Mann-Whitney test were used to establish reliability and known-groups validity. A significance level of ≤ 0.05 was adopted for all the analyses. RESULTS: Analyses demonstrated preliminary acceptable reliability scores of 0.55 and 0.60 in domains A and B of NKHAM, respectively. A significant difference was found between the nursing students' and the registered nurses' knowledge of high-alert medications, demonstrating the scale's ability to discriminate between the two groups. IMPLICATIONS FOR PRACTICE: Although this is pilot study, results suggest that the Brazilian version of the NKHAM might be a reliable and valid tool to measure nurses' knowledge of high-alert medications.

Variables related to the anticipated support for care in community-dwelling older adults.

OBJECTIVE: to compare the anticipated support for care, living arrangements and variables related to health as functions of gender and age in older adults in the community. METHOD: data was used from the Research network "Frailty in Brazilian Older Adults" (FIBRA network), sample for Campinas (n=671) analyses of data description and comparison were made. RESULT: compared to the men, the women are in worse socio-demographic conditions and have poorer perception of their health and dependency and lower expectations of support for care; those who have expectations anticipate receiving help from only one person. Advanced age was related to lower incapacity percentages and the majority of the older adults assess their health as good or very good, irrespective of their age, although the women predominate in the group composed of those who assess their own health as bad or very bad. CONCLUSION: this study guides the nurse in identifying older adults in situations of risk of lack of support for care and indicates the need for interventions aiming at giving support to this group.

[Care to the elderly in Campinas-SP: qualitative study of managers and politicians]. / Cuidado ao idoso em Campinas-SP: estudo qualitativo com gestores e representantes políticos.

The study aimed to identify, describe and analyze the practices carried out in the health of the elderly in the city of Campinas-SP, in the perspective of the health government representatives of the elderly, based on the National Policies. This is a qualitative study with thematic content analysis, from the perspective of individuals who assume strategic roles in the conduct of policy directed to the elderly in the county. Five central themes emerged from their comments: time and places; access conditions; population demands; human resources; health promotion and prevention of diseases and disorders; management. Health practices for the elderly health in Campinas-SP are in development, need to be evaluated, extended and systematized in both, the structural issues of human resources, finance and management, and in direct assistance to the elderly.