Falls among the non-institutionalized elderly in northern Minas Gerais, Brazil: prevalence and associated factors / Quedas em idosos não institucionalizados no norte de Minas Gerais: prevalência e fatores associados

Abstract Objective: To identify the prevalence of falls and associated factors in non-institutionalized elderly persons. Methods: A cross-sectional study featuring a population-based sample of non-institutionalized elderly persons in a city in the north of Minas Gerais was performed. Interviews were conducted in households by trained staff using validated instruments. We investigated the associations between falls and demographic, socioeconomic and health-related factors. After bivariate analysis, the variables associated with falls to a level of 20% were analyzed together using logistic regression, assuming at this stage a significance level of 5%. Results: The studied population was predominantly female, married and with a low educational level. The prevalence of falls was 28.4%. The factors that were associated with falls were: female gender (OR=1.67; 95% CI:1.13 to 2.47); negative self-evaluation of health (OR=1.49; 95% CI: 1.02 to 2.20); impaired functional mobility (Timed Up and Go test >20 seconds) (OR=1.66; 95CI: 1.02-2.74); the occurrence of hospitalization in the previous 12 months (OR=1.82; 95% CI: 1.17 to 2.84); and frailty measured by the Edmonton Frail Scale (OR=1.73; 95% CI: 1.14 to 2.64). Conclusions: The prevalence of falls was high for the population studied and was related to the individual health conditions of the elderly. AU

Resumo Objetivo: Estimar a prevalência de quedas e os fatores associados em idosos não institucionalizados. Métodos: Estudo transversal com amostra de base populacional de idosos não institucionalizados em cidade polo do norte de Minas Gerais. Foram conduzidas entrevistas nos domicílios por equipe especialmente treinada utilizando instrumentos validados. Investigou-se a associação entre a ocorrência de quedas e variáveis demográficas, socioeconômicas e relacionadas à saúde. Após análise bivariada, as variáveis associadas até o nível de 20% foram analisadas conjuntamente por meio de regressão logística, assumindo-se nessa fase o nível de significância de 5%. Resultados: A população avaliada era predominantemente feminina, casada e com baixa escolaridade. A prevalência de quedas foi de 28,4%. Os fatores que se mostraram associados à ocorrência de quedas foram: sexo feminino (OR=1,67; IC95%:1,13-2,47); a autopercepção negativa da saúde (OR=1,49; IC95%:1,02-2,20); comprometimento da mobilidade funcional (teste Timed Up and Go > 20 segundos) (OR=1,66; IC95%:1,02- 2,74); o registro de internação nos 12 meses precedentes (OR=1,82; IC95%:1,17-2,84); e fragilidade aferida pela Edmonton Frail Scale (OR=1,73; IC95%:1,14-2,64). Conclusões: A prevalência de quedas mostrou-se elevada para a população estudada e relacionada especialmente às condições de saúde dos idosos. AU

Perception of primary care doctors and nurses about care provided to sickle cell disease patients

To analyze the perception of primary care physicians and nurses about access to services and routine health care provided to sickle cell disease patients.METHODS: This descriptive exploratory study took a qualitative approach by surveying thirteen primary care health professionals who participated in a focus group to discuss access to services and assistance provided to sickle cell disease patients. The data were submitted to thematic content analysis.RESULTS: Access to primary care services and routine care for sickle cell disease patients were the categories that emerged from the analysis. Interaction between people with sickle cell disease and primary care health clinics was found to be minimal and limited mainly to scheduling appointments. Patients sought care from the primary care health clinics only in some situations, such as for pain episodes and vaccinations. The professionals noted that patients do not recognize primary care as the gateway to the system, and reported that they feel unprepared to assist sickle cell disease patients.CONCLUSION: In the perception of these professionals, there are restrictions to accessing primary care health clinics and the primary care assistance for sickle cell disease patients is affected...

Community healthcare workers' perception of an educational intervention in the care of patients with sickle cell disease in Brazil.

INTRODUCTION: Despite advances in the management of sickle cell disease, gaps still exist in the training of primary healthcare professionals for monitoring patients with the disease. OBJECTIVE: To assess the perception of community healthcare workers about the care and monitoring of patients with sickle cell disease after an educational intervention. METHOD: This exploratory, descriptive, and the qualitative study was conducted in Montes Claros, state of Minas Gerais, Brazil. The intervention involved the educational training of community healthcare workers from the Family Health Program of the Brazilian Unified Health System. The focus group technique was used to collect the data. The following topics were covered in the discussion: assessment of educational workshops, changes observed in the perception of professionals after training, profile of home visits, and access to and provision of basic healthcare services to individuals with sickle cell disease. The discussions were tape-recorded and transcribed verbatim. The data were subjected to content analysis and empirically organized into two categories. RESULTS: Changes in the healthcare practices of community health workers were observed after the educational intervention. The prioritization of healthcare services for patients with sickle cell disease and monitoring of clinical warning signs in healthcare units were observed. Furthermore, changes were observed in the profile of home visits to patients, which were performed using a script provided in the educational intervention. CONCLUSION: The educational intervention significantly changed the work process of community health workers concerning patient monitoring in primary healthcare.