Experiências dos prestadores de cuidados a idosos institucionalizados durante a pandemia de covid-19: uma perspectiva qualitativa / Experiences of providers of care for institutionalized elderly people during the covid-19 pandemic: a qualitative perspective / Vivencias de cuidadoras de personas mayores institucionalizadas, durante la pandemia por covid 19: mirada cualitativa

RESUMO Objetivo: Desvelar as vivências de cuidadores de idosos que residem em instituições de longa permanência, durante o confinamento no contexto da pandemia de Covid-19. Método: Método: pesquisa qualitativa, descritiva, através de estudo de caso intrínseco. Amostra intencionada por critério e conveniência de seis cuidadores, Região de Los Ríos, Chile, entrevista semiestruturada foi realizada no ano de 2021. Análise através de comparação constante e redução progressiva. A validade foi garantida pelo cumprimento de critérios de rigor, triangulação por especialistas. Resultados: 489 unidades de significado deram origem a quatro grupos temáticos: Significado de ter vivido a experiência, fatores facilitadores, fatores dificultadores e recomendações. Emergiram dois domínios: Contribuição dos cuidadores para o reforço do seu papel durante a pandemia e Contribuição para o reforço da gestão. Conclusões: permite reconhecer e validar o vínculo afetivo, o empenho e a vocação dos prestadores de cuidados, aspectos fundamentais a reforçar através do aconselhamento e da formação para garantir a qualidade dos cuidados.

ABSTRACT Objective: Uncover the experiences of caregivers of elderly people living in long-term care institutions, during confinement in the context of the Covid-19 pandemic. Method: Qualitative, descriptive research, through an intrinsic case study. Intentional sample by criteria and convenience of six caregivers, Los Ríos Region, Chile; a semi-structured interview was carried out in 2021. Analysis applying the constant comparative method and progressive focusing approach. Validity was ensured by compliance with the criteria of rigor and researcher triangulation. Results: 489 units of meaning gave rise to four thematic groups: Meaning of having lived the experience, facilitating factors, hindering factors and recommendations. Two domains emerged: Contribution of caregivers to strengthening their role during the pandemic and Contribution to strengthening management. Conclusions: it allows recognizing and validating the emotional bond, commitment and vocation of care providers, key aspects to be reinforced through counseling and training to guarantee the quality of care.

RESUMEN Objetivo: develar las vivencias de cuidadores de personas mayores que residen en instituciones de larga permanencia, durante el confinamiento en contexto de pandemia por Covid-19. Método: investigación cualitativa, descriptiva, mediante estudio intrínseco de casos. Muestra intencionada por criterios y conveniencia de seis cuidadoras, Región de Los Ríos, Chile, se realizó entrevista semiestructurada, en el año 2021. Análisis a través de comparación constante y reducción progresiva. Se cauteló validez cumpliendo criterios de rigor, triangulación por expertos. Resultados: 489 unidades de significado originaron cuatro núcleos temáticos: Significado de haber vivido la experiencia, factores facilitadores del trabajo, factores que lo dificultan y recomendaciones. Emergieron dos dominios: Aportes de las cuidadoras para fortalecer su rol durante la pandemia y Contribución para fortalecer la gestión. Conclusiones: permite reconocer y validar el vínculo afectivo, compromiso y vocación de las cuidadoras, aspectos fundamentales a fortalecer mediante consejería y capacitación para asegurar la calidad de los cuidados.

Guía de práctica clínica para el manejo de la Enfermedad Renal Crónica estadíos 3b, 4 y 5 en el Seguro Social de Salud del Perú (EsSalud)

Introducción: El presente artículo resume la guía de práctica clínica (GPC) para el manejo de la enfermedad renal crónica estadíos 3b, 4 y 5 en el Seguro Social del Perú (EsSalud). Objetivo: Proveer recomendaciones clínicas basadas en evidencia para el manejo de pacientes con enfermedad renal crónica estadíos 3b, 4 y 5 en EsSalud. Métodos: Se conformó un grupo elaborador de la guía (GEG) que incluyó especialistas y metodólogos. El GEG formuló 9 preguntas clínicas. Se realizó búsquedas sistemáticas de revisiones sistemáticas y estudios primarios en PubMed entre diciembre del 2020 y agosto del 2021. Se seleccionó la evidencia para responder a las preguntas clínicas planteadas. La certeza de la evidencia fue evaluada usando la metodología Grading of Recommendations Assessment, Development, and Evaluation (GRADE). El GEG usó la metodología GRADE para revisar la evidencia y formular recomendaciones, los puntos de buena práctica clínica (BPC) y los flujogramas de manejo. Finalmente, la GPC fue aprobada con Resolución N° 88-IETSI-ESSALUD-2021. Resultados: La presente GPC abordó 9 preguntas clínicas. En base a dichas preguntas se formularon 17 recomendaciones (7 fuertes y 10 condicionales), 28 BPC, y 4 flujogramas de manejo. Conclusión: El presente artículo resume la metodología y las conclusiones basadas en evidencias de la GPC para el manejo de la Enfermedad Renal Crónica estadíos 3b, 4 y 5 en EsSalud.

Introduction: This article summarizes the clinical practice guideline (CPG) for the management of stage 3b, 4, and 5 chronic kidney disease (CKD) in the Social Security of Peru (EsSalud). Objective: To provide evidence-based clinical recommendations for the management of stage 3b, 4, and 5 CKD in EsSalud. Methods: A guideline development group (GDG) was formed, including specialists and methodologists. The GDG formulated 9 clinical questions. Systematic searches for systematic reviews and primary studies were conducted in PubMed from December 2020 to August 2021. Evidence was selected to answer the clinical questions posed. The certainty of the evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. The GDG used the GRADE methodology to review the evidence and formulate recommendations, points of good clinical practice (GPC), and management flowcharts. Finally, the CPG was approved with Resolution No. 88-IETSI-ESSALUD-2021. Results: This CPG addressed 9 clinical questions. Based on these questions, 17 recommendations (7 strong and 10 conditional), 28 GPC points, and 4 management flowcharts were formulated. Conclusion: This article summarizes the methodology and evidence-based conclusions of the CPG for the management of stage 3b, 4, and 5 CKD in EsSalud.

Resiliencia, estrés y ansiedad de cuidadores formales durante la pandemia por COVID-19 / Resilience, anxiety and stress among formal caregivers for institutionalized older people

BACKGROUND: Caregiver stress is a common problem observed in nursing homes. AIM: To determine the association between the level of resilience and stress, anxiety and depression in formal caregivers of older people institutionalized in long-stay establishments during the COVID-19 pandemic. MATERIAL AND METHOD: One hundred ninety eight formal caregivers working at 11 long term residences for older people in southern Chile were invited to answer the SV-RES resilience and the DASS-21 anxiety and depression scales and 102 agreed to participate. RESULTS: We observed a significant association between the resilience scale score and variables such as weekly working hours (p < 0.01), current hours of sleep (p < 0.01), self-perception of sleep (p < 0.01), anxiety level (p < 0.01) and stress level (p < 0.01). Conclusions: A higher score on the Resilience Scale was associated with the absence of anxiety and stress, working between 22 and 43 hours per week, sleeping between 7 and 8 hours of sleep and a satisfactory self-perception of sleep. Studying the factors associated with resilience in formal caregivers of the elderly allows healthcare personnel to focus preventive actions, intervening promptly in risk areas associated with the work context, and strengthening the personal resources of caregivers.

Depressive symptoms, symptoms of insomnia and stressful events in hypertensive older adults: Cross-sectional study.

OBJECTIVES: the aim of this study was to determine whether symptoms of insomnia and intensity of stressful life events are independently associated with depressive symptoms in community-dwelling hypertensive older adults. METHODS: this was an observational cross-sectional study. Participants were 438 older adults with arterial hypertension who completed questionnaires about depressive symptoms, stressful events, self-reported symptoms of insomnia and socio-demographic characteristics. Cluster analysis was performed to obtain groups according to insomnia symptoms. The following groups were identified: Poor Sleep Quality, Early Waking and Good Sleep Quality. Associations were tested using linear regression analysis and multiple Poisson regression analysis. RESULTS: The factors that independently contributed to the increase of depressive symptoms were belonging to the Poor Sleep Quality group (p<.001) and Early Waking group (p=.005), reporting higher intensity of stressful life events (p<.001) and having less schooling (p=.003). CONCLUSION: older adults with hypertension need a comprehensive approach to their health care that considers depressive symptoms and their relationship with intensity of stressful events, insomnia symptoms and schooling.

Stressful events, depressive symptoms, and frailty associated to older adults' survival and mortality.

This study analyzed factors associated with survival and mortality risk of community-dwelling older adults, considering the intensity of stressful life events, depressive symptoms, insomnia, frailty, multimorbidity, and sociodemographic factors. This is a longitudinal study on survival of older adults interviewed between 2008-2009, with follow-up after 8 years. Survival and mortality risks were analyzed using the Kaplan-Meier curve, Log Rank test, and Cox proportional-hazards model (p < 0.05). Stressful events affecting older adults' children or grandchildren were associated with higher mortality risk; depressive symptoms and frailty were associated with lower survival. Comprehensive care for older adults must involve events regarding their family relationships, especially those affecting their progeny, due to the impact they can have on older adults' survival, besides evaluating depressive symptoms and frailty.

Síntomas depresivos, síntomas de insomnio y eventos estresantes en ancianos hipertensos: estudio de corte transversal / Depressive symptoms, symptoms of insomnia and stressful events in hypertensive older adults: Cross-sectional study

Objetivos: El objetivo de este estudio fue determinar si los síntomas de insomnio y la intensidad de los eventos de vida estresantes se asocian de forma independiente con los síntomas depresivos en ancianos hipertensos que viven en la comunidad. Métodos: Estudio de tipo observacional transversal. Los participantes fueron 438 ancianos con hipertensión arterial que completaron cuestionarios sobre síntomas depresivos, eventos estresantes, síntomas de insomnio y características sociodemográficas. Se realizó un análisis de conglomerados para obtener grupos según los síntomas de insomnio. Se identificaron los siguientes grupos: mala calidad del sueño, despertar temprano y buena calidad del sueño. Las asociaciones se probaron mediante un análisis de regresión lineal y un análisis de regresión de Poisson múltiple. Resultados: Los factores que contribuyeron de manera independiente al aumento de los síntomas depresivos fueron: pertenecer al grupo de mala calidad del sueño (p<0,001) y al grupo despertar temprano (p=0,005), reportando mayor intensidad de eventos de vida estresantes (p<0,001) y tener menos escolaridad (p=0,003). Conclusión: Las personas mayores con hipertensión arterial necesitan un abordaje integral de su atención en salud, considerando los síntomas depresivos y su relación con la intensidad de los eventos estresantes, los síntomas de insomnio y la escolaridad.(AU)

Objectives: The aim of this study was to determine whether symptoms of insomnia and intensity of stressful life events are independently associated with depressive symptoms in community-dwelling hypertensive older adults. Methods: This was an observational cross-sectional study. Participants were 438 older adults with arterial hypertension who completed questionnaires about depressive symptoms, stressful events, self-reported symptoms of insomnia and socio-demographic characteristics. Cluster analysis was performed to obtain groups according to insomnia symptoms. The following groups were identified: Poor Sleep Quality, Early Waking and Good Sleep Quality. Associations were tested using linear regression analysis and multiple Poisson regression analysis. Results: The factors that independently contributed to the increase of depressive symptoms were belonging to the Poor Sleep Quality group (P<.001) and Early Waking group (P=.005), reporting higher intensity of stressful life events (P<.001) and having less schooling (P=.003). Conclusion: older adults with hypertension need a comprehensive approach to their health care that considers depressive symptoms and their relationship with intensity of stressful events, insomnia symptoms and schooling.(AU)

[Resilience, anxiety and stress among formal caregivers for institutionalized older people]. / Resiliencia, estrés y ansiedad de cuidadores formales durante la pandemia por COVID-19.

BACKGROUND: Caregiver stress is a common problem observed in nursing homes. AIM: To determine the association between the level of resilience and stress, anxiety and depression in formal caregivers of older people institutionalized in long-stay establishments during the COVID-19 pandemic. MATERIAL AND METHODS: One hundred ninety eight formal caregivers working at 11 long term residences for older people in southern Chile were invited to answer the SV-RES resilience and the DASS-21 anxiety and depression scales and 102 agreed to participate. RESULTS: We observed a significant association between the resilience scale score and variables such as weekly working hours (p < 0.01), current hours of sleep (p < 0.01), self-perception of sleep (p < 0.01), anxiety level (p < 0.01) and stress level (p < 0.01). CONCLUSIONS: A higher score on the Resilience Scale was associated with the absence of anxiety and stress, working between 22 and 43 hours per week, sleeping between 7 and 8 hours of sleep and a satisfactory self-perception of sleep. Studying the factors associated with resilience in formal caregivers of the elderly allows healthcare personnel to focus preventive actions, intervening promptly in risk areas associated with the work context, and strengthening the personal resources of caregivers.

Guía de práctica clínica para el tamizaje, diagnóstico y manejo de la enfermedad renal crónica en estadios 1 al 3 en el Seguro Social del Perú (EsSalud) / Clinical practice guideline for the screening, diagnosis, and management of chronic kidney disease stages 1-3 for the Peruvian Social Security (EsSalud)

RESUMEN El presente artículo resume la guía de práctica clínica (GPC) para tamizaje, diagnóstico y manejo de los pacientes con enfermedad renal crónica (ERC) en los estadios 1 al 3 en el Seguro Social del Perú (EsSalud). Para el desarrollo de esta GPC, se conformó un grupo elaborador de la guía (GEG) que incluyó especialistas clínicos y metodólogos, el cual formuló ocho preguntas clínicas. Para responder cada pregunta se realizaron búsquedas sistemáticas de revisiones sistemáticas y, cuando fue considerado pertinente, de estudios primarios; y se seleccionó la evidencia pertinente. La certeza de la evidencia fue evaluada usando la metodología Grading of Recommendations Assessment, Development, and Evaluation (GRADE). En reuniones periódicas, el GEG usó la metodología GRADE para revisar la evidencia y emitir las recomendaciones. Se emitieron ocho recomendaciones (cuatro fuertes y cuatro condicionales), 29 puntos de buena práctica clínica, y tres flujogramas.

ABSTRACT This paper summarizes the clinical practice guidelines (CPG) for the screening, diagnosis, and management of patients with chronic kidney disease (CKD) stages 1-3 in the Social Security of Peru (EsSalud). A guideline development group (GDG) was established for develop this CPG, which included clinical and methodology specialists, who formulated 08 clinical questions. Systematic searches of systematic reviews and, when considered necessary, primary studies were conducted to answer each question; and relevant evidence was selected. The certainty of the evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. In periodic work meetings, the GDG used the GRADE methodology for reviewing the evidence and for developing recommendations. At the end, this CPG formulated 08 recommendations (04 strong and 04 conditional), 29 points of good clinical practice, and 03 flowcharts were formulated.

Effectiveness of adherence to a renal health program in a health network in Peru.

OBJECTIVE To evaluate the effectiveness of adherence to a multidisciplinary renal health program in reducing mortality and progression to hemodialysis. METHODS We used a database that included patient monitoring (2013-2017), dialysis admissions and all cause of mortality in Peru. Adherence to the program was established by meeting minimum visits during the first year of monitoring. The outcome of interest was hemodialysis admissions or all cause-mortality. Kaplan-Meier curves, Log-Rank test and competing survival analysis methods were used to estimate the differential risk between adherent and non-adherent patients. RESULTS A total of 20,354 participants was evaluated; 54.1% were male, 72.1 years old in average, 2.2 years average follow-up, and 15,279 (75.1%) belonged to the early stages (1 to 3a) of Chronic Kidney Disease. Adherence decreased the risk of renal replacement therapy in 41.0% (HR = 0.59, 95%CI 0.41-0.85) in the low-risk group and mortality in the high-risk group was 31.0% (HR = 0.69, 95%CI 0.57-0.83). CONCLUSIONS The multidisciplinary care strategy with standardized assessments by stage is effective in reducing admission to .0when the patient is identified in early stages and in reducing mortality in advanced stages.

Effectiveness of adherence to a renal health program in a health network in Peru / Efectividad de la adherencia a un programa de salud renal en una red sanitaria de Perú

ABSTRACT OBJECTIVE To evaluate the effectiveness of adherence to a multidisciplinary renal health program in reducing mortality and progression to hemodialysis. METHODS We used a database that included patient monitoring (2013-2017), dialysis admissions and all cause of mortality in Peru. Adherence to the program was established by meeting minimum visits during the first year of monitoring. The outcome of interest was hemodialysis admissions or all cause-mortality. Kaplan-Meier curves, Log-Rank test and competing survival analysis methods were used to estimate the differential risk between adherent and non-adherent patients. RESULTS A total of 20,354 participants was evaluated; 54.1% were male, 72.1 years old in average, 2.2 years average follow-up, and 15,279 (75.1%) belonged to the early stages (1 to 3a) of Chronic Kidney Disease. Adherence decreased the risk of renal replacement therapy in 41.0% (HR = 0.59, 95%CI 0.41-0.85) in the low-risk group and mortality in the high-risk group was 31.0% (HR = 0.69, 95%CI 0.57-0.83). CONCLUSIONS The multidisciplinary care strategy with standardized assessments by stage is effective in reducing admission to .0when the patient is identified in early stages and in reducing mortality in advanced stages.

RESUMEN OBJETIVO Evaluar la efectividad de la adherencia a un programa de salud renal en la reducción de mortalidad y progresión a hemodiálisis. MÉTODOS Utilizamos una base de datos que condensaba el seguimiento de los pacientes (2013-2017), los ingresos a diálisis de los mismos y la mortalidad por todas las causas en Perú. La adherencia al programa se estableció con el cumplimiento de visitas mínimas durante su primer año de seguimiento. La efectividad de la adherencia al programa se midió en términos de debut a hemodiálisis o muerte por todas las causas. Se utilizaron curvas de Kaplan-Meier, test de diferencias en la distribución (Log-Rank test) y métodos de análisis de supervivencia. Los análisis se realizaron utilizando R estudio 3.5.0 RESULTADOS Fueron evaluados 20.354 participantes, 54,1% varones, edad media de 72,1 años, con un seguimiento medio de 2,2 años; 15.279 (75.1%) tuvieron ERC en estadios tempranos (estadio 1 al 3a). La adherencia disminuyó en un 41,0% el riesgo de terapia de reemplazo renal (HR = 0,59; IC95% 0,41-0,85) en el grupo de bajo riesgo y en un 31,0% (HR = 0,69; IC95% 0,57-0,83) la mortalidad en el grupo de alto riesgo. CONCLUSIONES La estrategia de cuidado multidisciplinario con evaluaciones estandarizadas según estadio es efectiva en reducir el ingreso a terapia de reemplazo renal cuando se identifica al paciente en estadios tempranos y en reducir la mortalidad en estadios avanzados.

Dança de salão para idosos: estratégia de educação em saúde / Ballroom dance for the elderly: health education strategy

Objetivo: relatar a experiência de desenvolvimento da oficina de dança de salão associada às ações de educação em saúde e envelhecimento saudável. Método: trata-se de estudo descritivo, tipo relato de experiência, de um projeto de extensão desenvolvido na grade curricular de uma disciplina do curso de pós-graduação. Resultados: realizaram-se cinco oficinas. Realizou-se, na primeira oficina, um diagnóstico inicial a partir das demandas surgidas e no questionário de Índice de Vulnerabilidade clínico funcional. Trataram-se os temas: benefícios da dança de salão, memória e alimentação saudável. Sincronizaram-se, em cada momento educativo, música e dança, e seguiu-se das aulas práticas de dança. Constatou-se que a idade dos participantes (n=33) variou de 51 a 80 anos, 76% sendo com mais de 60 anos e 90,9% sendo mulheres. Conclusão: destaca-se que a união da dança de salão e da educação como um só valoriza a participação do idoso como figura ativa em seu contexto sociocultural e pode transformar-se uma potente estratégia para promover o envelhecimento ativo.(AU)

Objective: to report the experience of developing ballroom dance workshops associated with actions in health education and healthy aging. Method: descriptive, experience-report type study, of an extension project developed in the curriculum of a subject of the post-graduate course. Results: five workshops were carried out. In the first workshop, there was an initial diagnosis from the demands arising and the questionnaire of functional clinical Vulnerability Index. The following themes were addressed: benefits of ballroom dance, memory and healthy eating. Every moment of education synchronized music and dance and was followed by the practical dancing lessons. The participants' age (n=33) varied from 51 to 80 years, with 76% aged over 60 years and 90.9% women. Conclusion: the union of ballroom dance and education as one values the participation of elderly people as active figures in their sociocultural context and can become a powerful strategy to promote active aging.(AU)

Objetivo: reportar la experiencia de desarrollo de talleres de danza de salón asociadas a las acciones de educación en salud y envejecimiento saludable. Método: se realizó un estudio descriptivo, del tipo relato de experiencia, de un proyecto de extensión, desarrollado en el programa de estudios de una disciplina del curso de posgrado. Resultados: se realizaron cinco talleres. El primer taller fue un diagnóstico inicial de las demandas surgidas y un cuestionario clínico funcional del Índice de Vulnerabilidad. Se abordaron los temas: beneficios de la danza de salón, memoria y nutrición saludable. Cada momento de la educación sincronizó música y danza y fue seguido por las enseñanzas prácticas de la danza. La edad de los participantes (n=33) varió de 51 a 80 años, el 76% con más de 60 años y el 90,9% son mujeres. Conclusión: la unión de danza de salón y educación como una sola valorizó la participación de los ancianos como figura activa en su contexto sociocultural y puede convertirse en una poderosa estrategia para promover el envejecimiento activo.(AU)

Quality of life, burden, family emotional support: a model for older adults who are caregivers.

OBJECTIVE: To investigate associations between quality of life, sex, age, burden, and nature of emotional support available in the family in older adults who are caregivers of older relatives. METHOD: Cross-sectional and correlational study on 148 caregivers gathered in public and private healthcare services, who were subjected to psychological measures of quality of life, burden, exchange of emotional support, sex, and age. Data were analyzed using Chi-square, Fisher's exact test and path analyses (p < 0.05). RESULTS: A total of 77% women, average age of 69.7 years. There were significant associations between exchange of support and burden due to the provided assistance, being a woman and satisfaction with the received support, satisfaction with the received support and burden, burden and quality of life, and satisfaction with the received support and feeling of burden due to the provided support. CONCLUSION: Satisfaction with the received emotional support moderate the association between sex and burden, and such moderate the association between satisfaction with emotional support and perceived quality of life.

Quality of life, burden, family emotional support: a model for older adults who are caregivers / Calidad de vida, sobrecarga, apoyo emocional familiar: un modelo en ancianos cuidadores / Qualidade de vida, sobrecarga, apoio emocional familiar: um modelo em idosos cuidadores

ABSTRACT Objective: To investigate associations between quality of life, sex, age, burden, and nature of emotional support available in the family in older adults who are caregivers of older relatives. Method: Cross-sectional and correlational study on 148 caregivers gathered in public and private healthcare services, who were subjected to psychological measures of quality of life, burden, exchange of emotional support, sex, and age. Data were analyzed using Chi-square, Fisher's exact test and path analyses (p < 0.05). Results: A total of 77% women, average age of 69.7 years. There were significant associations between exchange of support and burden due to the provided assistance, being a woman and satisfaction with the received support, satisfaction with the received support and burden, burden and quality of life, and satisfaction with the received support and feeling of burden due to the provided support. Conclusion: Satisfaction with the received emotional support moderate the association between sex and burden, and such moderate the association between satisfaction with emotional support and perceived quality of life.

RESUMEN Objetivo: Investigar relación entre calidad de vida, sexo, edad, sobrecarga y tipos de apoyo emocional disponibles en la familia de ancianos cuidadores de parientes ancianos. Método: Estudio transversal y correlacional con 148 cuidadores reclutados en servicios públicos y privados de salud, fueron sometidos a medidas psicológicas de calidad de vida, sobrecarga, intercambio de apoyo emocional, sexo y edad. Los datos fueron analizados mediante test Chi-cuadrado, prueba exacta de Fisher y path análisis (p <0,05). Resultados: 77% eran mujeres, con edad media de 69,7 años. Resultaron asociaciones significativas entre intercambio de apoyo y sentimiento de carga por el apoyo ofertado, ser mujer y satisfacción por el apoyo recibido, satisfacción por el apoyo recibido y sobrecarga, sobrecarga y calidad de vida, y satisfacción por el apoyo recibido con sentimiento de carga por el apoyo ofertado. Conclusión: Satisfacción con apoyo emocional recibido modera la relación entre sexo y sobrecarga, y esta modera la relación entre satisfacción con apoyo emocional y calidad de vida percibida.

RESUMO Objetivo: Investigar relações entre qualidade de vida, sexo, idade, sobrecarga e natureza dos apoios emocionais disponíveis na família, em idosos cuidadores de parentes idosos. Método: Estudo transversal e correlacional com 148 cuidadores recrutados em serviços públicos e privados de saúde foram submetidos a medidas psicológicas de qualidade de vida, sobrecarga, intercâmbio de apoio emocional, sexo e idade. Os dados foram analisados através de qui-quadrado, exato de Fisher e path análises (p < 0.05). Resultados: 77% mulheres, idade média 69,7 anos. Resultaram associações significativas entre intercâmbio de apoios e ônus pelo apoio oferecido, ser mulher e satisfação pelo apoio recebido, satisfação pelos apoios recebidos e sobrecarga, sobrecarga e qualidade de vida, e satisfação pelos apoios recebidos e senso de ônus pelo apoio oferecido. Conclusão: Satisfação com apoio emocional recebido modera a relação entre sexo e sobrecarga, e esta modera a relação entre satisfação com apoio emocional e qualidade de vida percebida.

Satisfaction with family relations and support according to elderly persons caring for elderly relatives / Satisfação com as relações e apoios familiares segundo idosos cuidadores de idosos

Objective: The aim of the presentstudy was to investigate the associations between the satisfaction of family caregivers and family relations; sociodemographic variables; the type and direction, sufficiency and burden of family support, and the number of social partners involved. Method: A total of 148 caregivers of elderly relatives who were physically and cognitively dependent were recruited from medical clinics and home care services in cities in the state of São Paulo and invited to respond to a questionnaire about family support, and to a scale of satisfaction with family relationships with reference to adaptation, partnership, growth, affection and resolutive capacity. The chi-squared and Fisher's exact tests were used to compare frequencies for the scores of the two satisfaction levels (low and intermediate, and high). To analyze the relationship between high levels of satisfaction and other variables, univariate and hierarchical logistic regression analysis was used. Results: High levels of satisfaction were related to the reciprocity and suffiency of received emotional support, and absence of burden associated to giving support. The adequacy of emotional support was most strongly associated with high levels of satisfaction with family relationships. Conclusion: For the satisfaction of caregivers of elderly persons with family functioning, quality of support is better than quantity, reciprocity is more important than unidirectionality and emotional is the most important type of support.

Objetivo: Investigar associações entre a satisfação de cuidadores familiares de idosos com as relações familiares; variáveis sociodemográficas; tipos, direções, suficiência e ônus dos apoios familiares; e número de parceiros sociais envolvidos. Método: Estudo transversal descritivo e analítico com amostra de conveniência de 148 idosos cuidadores de familiares que respondiam pelo cuidado a idosos com dependência física e cognitiva, recrutados em clínicas médicas e serviços domiciliares em cidades do interior de São Paulo, Brasil. Responderam escala de funcionalidade familiar (adaptação, companheirismo, crescimento, afetividade e capacidade resolutiva) e a questões sobre estrutura da família, dinâmica e avaliação dos apoios. Utilizou-se os testes qui-quadrado e exato de Fisher para comparar frequências para pontuação dos dois níveis de satisfação (baixo e intermediário, e alto). Para analisar relações entre alta satisfação e demais variáveis usou-se análise de regressão logística univariada e hierárquica. Resultados: Alta satisfação associou-se com reciprocidade e suficiência dos apoios emocionais e com ausência de ônus na oferta de ajudas instrumentais. Suficiência dos apoios emocionais foi a variável que se associou de forma mais robusta com alta satisfação com às relações familiares. Conclusão: Para a satisfação de cuidadores de idosos com a funcionalidade familiar, a qualidade do apoio é melhor do que quantidade, a reciprocidade é mais importante do que unidirecionalidade e o suporte emocional mais importante do que outros tipos de suporte.