The Institute of Nutrition Quality of Life Scale for the Elderly (INQLS) was studied and then modified by the researcher. The new version was referred to as the modified INQLS. In the modified INQLS, nutritional quality of life is defined as the satisfactory intake and utilization of nutrients as influenced by social support, financial status, perceived health status (physical, mental and emotional), and physical well-being. The modified INQLS was pretested in the Petersburg, Virginia area among participants in the Crater Area Agency on Aging program. Field testing of the final modified INQLS was done in Richmond, Virginia, and the New River Valley area of Virginia. Both sheltered and free-living individuals were field tested. In the study, there were 94 respondents (70 women, 24 men) between the ages of 65 and 102. Statistical analyses of the scores from the modified INQLS included frequencies, correlational analysis, multiple regression equations, and ANOVA. No statistical significance were found between the Nutrition scale score and the independent variables of Socia-Economic score, Health and Well-Being scale score, Mobility scale score, Emotional scale score, Age, or Sex. / Master of Science

Yes / Bradford, one of the most deprived cities in the United Kingdom, has a wide range of public health problems associated with socioeconomic deprivation, including an infant mortality rate almost double that for England and Wales. Infant mortality is highest for babies of Pakistani origin, who comprise almost half the babies born in Bradford. The Born in Bradford cohort study aims to examine environmental, psychological and genetic factors that impact on health and development perinatally, during childhood and subsequent adult life, and those that influence their parents' health and wellbeing. This protocol outlines methods for the recruitment phase of the study. METHODS: Most Bradford women attend for antenatal care and give birth at the Bradford Royal Infirmary, which has approximately 5,800 births per year. Women are eligible for recruitment if they plan to give birth here. Babies born from March 2007 are eligible to participate, recruitment is planned to continue until 2010. Fathers of babies recruited are invited to participate. Women are usually recruited when they attend for a routine oral glucose tolerance test at 26-28 weeks gestation. Recruitment of babies is at birth. Fathers are recruited whenever possible during the antenatal period, or soon after the birth. The aim is to recruit 10,000 women, their babies, and the babies' fathers. At recruitment women have blood samples taken, are interviewed to complete a semi-structured questionnaire, weighed, and have height, arm circumference and triceps skinfold measured. Umbilical cord blood is collected at birth. Within two weeks of birth babies have their head, arm and abdominal circumference measured, along with subscapular and triceps skinfold thickness. Fathers self-complete a questionnaire at recruitment, have height and weight measured, and provide a saliva sample. Participants are allocated a unique study number. NHS numbers will be used to facilitate record linkage and access to routine data. A wide range of hospital and community sources is being accessed to provide data for the women and children. Data are checked for accuracy and consistency. CONCLUSION: Born in Bradford will increase understanding of the factors that contribute to health and wellbeing, and identify factors that influence differences in them between people of Pakistani and European origin.

Health related quality of life (HRQoL) refers to the impact of disease and treatment on disability and daily living. Living with a venous leg ulcer (VLU) has a negative impact on HRQoL. The aim of the present study was to investigate the aspects of HRQoL affected by VLUs in a local SA sample. A post hoc research design was utilised comparing 30 VLU patients and 30 non-VLU participants. Four hypotheses were investigated: (1) the experience of having a VLU on HRQoL, (2) the relation between gender and HRQoL of VLU patients, (3) the relation between age and HRQoL of VLU patients and (4) the interrelation between the underlying constructs of HRQoL of VLU patients. A structured questionnaire was used to obtain information on demographic variables and HRQoL using the SF-36 questionnaire. Interviews were conducted to obtain qualitative data to complete the investigation. Correlation analysis and t-tests confirmed that having a VLU negatively affected HRQoL and that interrelations existed among the constructs of HRQoL. There were no significant relations between gender, age and HRQoL of VLU patients. In line with the social constructivist approach, social support and restructuring a sense of meaning in life to increase HRQoL, are important goals in the management of VLUs. / Psychology / M.Sc. (Psychology)

Background: The ability to measure health and the value of improving or declining health is crucial to the evaluation of health care interventions. Many generic and disease specific health status measures exist for use in patients with rheumatoid arthritis (RA). The Overall Status in Rheumatoid Arthritis (OSRA) measure is a new and simple measure with early evidence of construct validity. Generic health profiles with attached utility weights such as the EuroQol EQ-5D and the SF-6D (calculated from the Medical Outcome Study 36-item short-form health survey) allow the quantification of a patient's health relative to perfect health and death, and can be used to estimate quality adjusted life years (QALYs). The EQ-5D is extensively used in RA, but has potential limitations. The SF-6D appears to have potential, but needs further evaluation. The aim of this thesis was to assess the validity and responsiveness of the EQ5D, SF-6D and OSRA in UK RA patients, and compare the performance and implications of the use of the EQ-5D and SF-6D.Methods and subjects: Patient data were obtained from three sources; the Steroids in Very Early Arthritis (STIVEA) (n=256) and British Rheumatoid arthritis Outcome Study Group (BROSG) (n=466) randomised controlled trials, and the British Society for Rheumatology Biologics Register (BSRBR) (n=129). The data used included lifestyle and demographic factors, disease activity (DAS28), functional disability (HAQ), X-rays to assess erosive damage, the EQ-5D and the SF-6D. The OSRA was collected only in the BROSG trial. Visual analogue scales (VAS) of pain and fatigue were collected in BROSG and STIVEA. Construct validity was tested by correlating the EQ-5D, SF-6D and OSRA with a range of outcome measures for RA. Responsiveness to change was assessed using minimum important differences (MID), effect size (ES) and standardised response means (SRM), and compared using ratios. EQ-5D profiles placing arthritis patients in utility states 'worse than death' (negative scores) were described and assessed using linear and logistic regression. The implications of using the EQ-5D and SF-6D in economic evaluation were compared by cost-effectiveness analyses of the BROSG trial. Results: The correlation of the EQ-5D and SF-6D was moderate to high (0.67). Both measures had moderate to high correlations with disease activity, physical function, joint damage and fatigue. The OSRA Activity (OSRA-A) and Damage (OSRA-D) correlated strongly with measures of related aspects of disease. The EQ-5D, SF-6D and OSRA discriminated between known differences in health status across groups defined by social deprivation and disease activity. The EQ-5D MID was 0.04 for improvement and 0.10 for deterioration. The SF-6D MID was 0.04 in both directions. The SF-6D was more responsive to improvement (EQ-5D: SF-6D ES ratio 0.78-0.88) and the EQ-5D more responsive to deterioration (ES ratio 1.14) in health. The OSRA-A was the most sensitive disease specific measure in the BROSG trial, and the OSRA-D was more responsive than the HAQ. The factors associated with being in a 'worse than death' health state were male gender, the HAQ, SF-36 mental composite scale, pain VAS, and erythrocyte sedimentation rate (a marker of inflammation). Pain was the predominant factor and was scored at the most extreme level in every worse than death profile. The cost-effectiveness analyses (BROSG trial), found net quality adjusted life years (QALYs) were greater for the EQ-5D (0.07) than the SF-6D (0.05), but had higher variance than the SF-6D. Conclusions: The EQ-5D and SF-6D appear valid and responsive to changes in health in RA, but measure subtly different aspects of health. There are issues with both measures, and cost-effectiveness conclusions of a study could differ according to which measure was used. The EQ-5D may be more likely to demonstrate that an intervention is cost effective than the SF-6D, due to its larger mean change in response to change in health status. The OSRA is valid for use in RA and its responsiveness suggests potential for inclusion in clinical trials.

Dans ce mémoire, différentes architectures pour le contrôle et la surveillance des systèmes techniques complexes de grande dimension (STCGD) sont discutées. Les problématiques de maintenance conditionnelle et d'évaluation de l'état de santé sont définies. Les types de diagnostic et de pronostic sont présentés afin d'aboutir à une évaluation de l'état de santé des STCGD. Les études relatives au diagnostic décentralisé sont discutées puis les apports des NTIC et des technologies distribuées au diagnostic sont présentés. Par la suite, le diagnostic distribué et les travaux relatifs à ce mode de déploiement sont introduits. Les limites des approches centralisées et décentralisées du diagnostic sont présentées et confrontées à l'apport des approches distribuées. Les informations et/ou les connaissances supports aux diagnostic et au pronostic ainsi que leur modélisation afin de les exploiter sont décrites et formalisées. Une caractérisation des statuts que peut prendre un composant est proposée. Il est décrit les pré-requis nécessaires pour la couche de surveillance des STCGD et les principes du diagnostic et du pronostic sont ensuite présentés sous la forme de différents algorithmes. Enfin, une méthode d'évaluation de l'état de santé des STCGD est proposée. Plusieurs déploiements peuvent être envisagés pour l'évaluation de la santé des STCGD. Une plateforme de simulation a été développée pour évaluer les performances des déploiements centralisés et distribués. La plateforme a eu pour but de se comporter comme la couche de surveillance d'un STCGD. Un cas d'étude paramétrable est proposé pour chacun des deux déploiements et leurs performances sont comparées. / In this dissertation, various architectures for the control and the monitoring of Large Scale Complex Technical Systems (LSCTS) are discussed. The problematic of condition-based maintenance and health status assessment is defined. A diagnostic and prognostic typology is presented leading to the assessment of the health status of LSCTSs. Decentralized diagnosis studies are discussed then the contributions of the ICT and of the distributed technologies for the diagnosis are presented. Thereafter, the distributed diagnosis and works relative to this kind of deployments are introduced. The limits of the centralized and decentralized diagnosis approaches are presented. Then the centralized approaches are compared to the distributed ones. Information and/or knowledge that support the diagnosis and the prognosis as well as their modeling in order to exploit them are described and formalized. A characterization is proposed for the different status of a component can be in. Requirements are described for the monitoring layer of the LSCTSs are described in order to implement the proposed diagnosis and prognosis principles that are then specified by the means of algorithms. Eventually, a health assessment method of the LSCTSs is also proposed. Several deployments can be considered to implement the health assessment of the LSCTSs. A simulation platform, which was developed to evaluate the performances of the centralized and the distributed deployments, is presented. Among the purposes of the platform, one is to behave as the monitoring layer of a LSCTS. A use case is proposed for two deployments and their performances are compared.

Estudo exploratório, de delineamento longitudinal, com 81 pacientes em uso de anticoagulante oral e que foram avaliados durante internação e dois meses após a alta. Os objetivos foram acompanhar a evolução quanto á terapia de anticoagulação oral e adesão ao tratamento; comparar o estado geral de saúde e a presença de sintomas de ansiedade e depressão. Foram utilizados instrumentos específicos para avaliar adesão ao tratamento medicamentoso (Medida de Adesão aos Tratamentos), estado geral de saúde (Escala Visual Analógica) e presença de sintomas de ansiedade (HADS-Ansiedade) e depressão (HADS- Depressão). As análises estatísticas realizadas foram: Teste t de Student pareado para comparar as médias do estado geral de saúde e da HADS; Modelo Linear de Efeitos Mistos para analisar a associação entre estado geral de saúde, ansiedade, depressão e tempo de avaliação no estudo. O nível de significância adotado foi 0,05. Entre os participantes, 54,3% eram mulheres, com idade média de 59,5 anos e nível médio de instrução de 5,1 anos. A principal indicação clínica para uso do medicamento foi formação de trombos (34,6%), sendo a varfarina o anticoagulante oral mais utilizado (97,5%). Dois meses após a alta, todos os pacientes foram classificados como aderentes ao tratamento e 42% mantiveram o INR na faixa terapêutica. As diferenças entre as médias do estado geral de saúde, HADS-Ansiedade e HADS-Depressão durante a internação e dois meses após a alta não foram estatisticamente significantes (p=0,78; p=0,27 e p=0,40, respectivamente). Em relação á presença de ansiedade, quando associamos as duas variáveis de forma categórica, com e sem sintomas, e o tempo de avaliação, 38 (46,9%) pacientes foram classificados como \"sem sintomas\" de ansiedade e 22 (27,1%) \"com sintomas\", sendo esta associação estatisticamente significante (p<0,001). Para depressão, a maioria (55; 67,9%) foi classificada como \"sem sintomas\" e 11 (13,6%) \"com sintomas\", sendo tal associação estatisticamente significante (p<0,001). Ao analisarmos as médias do estado geral de saúde segundo tempo e grupo de sintomas, resultados estatisticamente significantes foram obtidos apenas quando comparamos os valores entre os grupos sem sintomas de depressão (M=80,5; D.P.=23,46) e com sintomas (M=62,5; D.P.=26,07) (p=0,021), dois meses após a alta e quando comparamos as médias do grupo com sintomas de depressão, na internação (M= 75,37; D.P.=25,02) e dois meses após a alta (M=62,5; D.P.=26,07) (p=0,046). Identificar o perfil clínico de pacientes em uso de anticoagulante oral, desde a internação até dois meses de seguimento ambulatorial; conhecer sua percepção sobre estado de saúde, presença de sintomas de ansiedade e de depressão e a adesão ao tratamento são ações importantes a serem consideradas no atendimento desses pacientes. Tais resultados poderão ser utilizados para nortear mudanças na organização do ambulatório de anticoagulação oral e no planejamento da assistência de enfermagem a tais pacientes. / This exploratory and longitudinal research involved 81 patients under oral anticoagulation treatment, who were evaluated during hospitalization and two months after discharge. The objectives were to follow the patients\' clinical evolution, considering the oral anticoagulation therapy and treatment adherence; and to compare the general health condition and the presence of anxiety and depression symptoms. Specific instruments were used to assess adherence to medication treatment (Treatment Adherence Measure), general health condition (visual analogue scale) and the presence of anxiety (HADS-Anxiety) and depression symptoms (HADS-depression). For the sake of statistical analysis, the following were applied: Student\'s paired t-test to compare the mean scores for the general health condition and HADS scores; the Linear Fixed Effects Model to analyze the association between general health condition, anxiety, depression and research moment. Significance was set at 0.05. Among the participants, 54.3% were women, with a mean age of 59.5 years and a mean education time of 5.1 years. The main clinical indication for medication use was the formation of thrombi (34.6%), with warfarin as the most used oral anticoagulant drug (97.5%). AT two months after discharge, all patients were classified as adherent to the treatment and 42% maintained their INR within the therapeutic range. The differences between the mean general health, HADS-Anxiety and HADS-Depression scores during hospitalization and two months after discharge were not statistically significant (p=0.78; p=0.27 and p=0.40, respectively). As regards the presence of anxiety, when the two variables are associated categorically, with and without symptoms, and the research moment, 38 (46.9%) patients were classified as \"without symptoms\" of anxiety and 22 (27.1%) \"with symptoms\", with a statistically significant association (p<0.001). As for depression, the majority (55; 67.9%) was classified as \"without symptoms\" and 11 (13.6%) \"with symptoms\", a statistically significant association (p<0.001). The analysis of the mean general health condition scores according to the research moment and group of symptoms only revealed statistically significant results when comparing the groups without (M=80.5; S.D.=23.46) and with symptoms (M=62.5; S.D.=26.07) (p=0.021) two months after the discharge and when comparing the mean scores for the group with depression symptoms during hospitalization (M= 75.37; S.D.=25.02) and two months after the discharge (M=62.5; S.D.=26.07) (p=0.046). Identifying the clinical profile of patients under oral anticoagulant therapy since hospitalization and after two months of outpatient monitoring and getting to know their perceived health condition, presence of anxiety and depression symptoms and treatment adherence are important actions for consideration in care delivery to these patients. These results can be used to guide changes in the organization of the oral anticoagulation outpatient clinic and in nursing care planning for these patients.

O Ministério da Saúde preconiza que o cuidado pré-natal deva ser realizado de forma regular e completa, com o número mínimo de seis consultas. Considerando esse aspecto, a análise da distribuição de indicador de cobertura pré-natal, segundo áreas geográficas, é um instrumento valioso na pesquisa em saúde materno-infantil por contribuir para o entendimento dos processos envolvidos na determinação das condições de saúde da mulher e do recém-nascido. O objetivo do estudo foi analisar a distribuição espacial da cobertura pré-natal em relação as características maternas em São Luís/MA. Trata-se de uma pesquisa do tipo ecológico realizada em São Luís/MA com uma amostra aleatória de 2.019 mulheres. A coleta de dados de nascimentos, ocorridos em 2012, foi no período de julho a outubro de 2013, na Secretaria Municipal de Saúde de São Luís, por meio do Sistema de Informação de Nascidos Vivos. Os endereços da amostra foram corrigidos com a utilização do Google Earth, versão 7.1.2.2041, e a busca das coordenadas latitude e longitude pelo site http://batchgeo.com/ para serem georreferenciadas pelo programa TerraView, versão 4.2.2. As coordenadas geográficas do município foram obtidas pela projeção lat/long e datum WGS-84 e foram convertidas para SIRGAS 2000/UTM. Foram obtidos padrões de densidade espaciais por meio de análise estatística espacial, segundo a técnica de alisamento de Kernel e elaboração dos mapas no ArcGis, versão 10.1. Os resultados demonstraram que a maioria das mães estava na fase adulta (85,29%), 96,53% tinham mais de 9 anos de estudo, 65,77% possuíam companheiro, 80,14% não tiveram filhos mortos, 51,42% eram primíparas, 97,67% com gravidez única, 56,76% realizaram parto cesáreo e 67,27% foram a termo. Quanto às consultas prénatais, 13,72% realizaram o número de consultas insuficientes, 38,24% foram regulares e 48,04%, suficientes. Observou-se uma associação estatisticamente significativa. Observou-se uma associação estatisticamente significativa entre idade materna (p<0,0000), anos de estudo (p<0,0000), paridade (p<0,0000), idade gestacional (p<0,0000) e tipo de parto com a cobertura pré-natal (p<0,0000), como também situação conjugal (p=0,0007) e nascidos mortos (p=0,0319). Quanto à condição da cobertura pré-natal por Distritos Sanitários, observou-se que as consultas pré-natais suficientes foram em maior porcentagem nos Distritos Cohab (56,9%), Vila Esperança (54,5%) e Bequimão (51,6%); as consultas pré-natais regulares foram mais expressivas nos Distritos Centro (51,3%) e Itaqui- Bacanga (42,4%); e as consultas insuficientes variaram entre 11,5% e 17,6% em todos os Distritos. Os resultados evidenciam uma forte concentração da cobertura pré-natal suficiente nos distritos Tirirical e Cohab, demostrando a necessidade de vigilância contínua nos outros distritos que apresentaram concentração da cobertura regular a insuficiente / The Ministry of Health recommends that prenatal care should be performed regularly and completely, with the minimum number of six visits. Considering this aspect, the analysis of the distribution of indicator prenatal coverage, according to geographical areas, is a valuable tool for research in maternal and child health by contributing to the understanding of the processes involved in determining the health of women and newborns. The objective of the study was to analyze the spatial distribution of antenatal coverage compared maternal characteristics in São Luís/MA. This is a research of the ecological type carried out in São Luís/MA with a random sample of 2,019. The data collection of births occurred in 2012, was the period from July to October 2013, the Municipal Health Secretary of São Luís, throught the Live Birth Information System. The sample`s addresses were corrected with the use of Google Earth, version 7.1.2.2041, and the pursuit of latitude and longitude coordinates for http://batchgeo.com/ site to be georeferenced by terraView, version 4.2.2 program. The geographic coordinates of the city were obtained by projecting lat/long and datum WGS-84 and were converted to SIRGAS 2000/UTM. Patterns of spatial density using spatial statistical analysis were obtained using the technique of kernel smoothing and preparation of maps in ArcGIS, version 10.1. The results showed that most mothers were in adulthood (85,29%), 96,53% had more than 9 years of education, 65,77% had a partner, 80,14% had children dead, 51,42 % were primiparous, 97,67% with single pregnancy, 56,76% underwent cesarean delivery and 67,27% were full-term. As for antenatal visits, 13,72% had insufficient number of queries, 38,24% were regular and 48,04% were sufficient. There was a significant association of maternal age (p<0,0000), years of education (p<0,0000), parity (p<0,0000), gestational age (p<0,0000) and mode of delivery with prenatal coverage (p <0.0000), as well as marital status (p=0,0007) and stillbirths (p=0,0319). As the condition of prenatal coverage by health districts, it was observed that sufficient prenatal visits were done in the Districts Cohab with the highest percentage (56,9%), Vila Esperança (54,5%) and Bequimão (51,6 %); regular antenatal visits were more expressive in Center Districts (51,3%) and Itaqui-Bacanga (42,4%); and insufficient consultations ranged between 11,5% and 1,.6% in all Districts. The results show a strong concentration of sufficient prenatal coverage in Tirirical and Cohab districts, demonstrating the need for continued vigilance in other districts who presented concentration of regular coverage until insufficient

As investigações acerca da relação entre as áreas de saúde e ambiente são atuais no debate sobre desenvolvimento sustentável, embora abordem fenômenos complexos e envolvendo incerteza de conhecimento. O uso de medidas síntese representa uma maneira de apreender parte da realidade nesses temas a fim de subsidiar atividades e tomadas de decisões. O objetivo dessa tese foi integrar informações de saúde e de ambiente e propor um indicador para avaliação de países desenvolvidos e em desenvolvimento. Para tanto foram desenvolvidos dois estudos com o uso de fundamentos da Teoria de Conjuntos Fuzzy. O primeiro estudo destinava- se a avaliar os estados e capitais do Brasil, com base em indicadores no escopo da atenção primária em saúde e cobertura de serviços de saneamento básico, integrados em uma medida síntese: o Índice Agregado de Saúde Ambiental. Os resultados do modelo fuzzy, comparados com outras medidas de sustentabilidade, sugerem situações de desigualdades no país. As regiões norte, nordeste e parte da centro-oeste apresentaram os menores valores do indicador em contrapartida aos maiores valores encontrados nas regiões sul e sudeste. O Índice Agregado de Saúde Ambiental tem potencial para formulação de hipóteses e também colaborar no debate acerca do desenvolvimento sustentável. O segundo estudo visou classificar o cenário de saneamento ambiental dos municípios do Algarve, litoral de Portugal, com uso de informações quantitativas, qualitativas e, também, medidas de opinião. A medida síntese integrada recebeu a denominação de Índice de Saneamento Ambiental. A elaboração do modelo fuzzy envolveu a participação de especialistas do Ministério da Saúde de Portugal. Os resultados do modelo fuzzy sugerem uma assimetria intra- regional com um grupo de municípios Alcoutim, Monchique e Silves que reúnem os menores valores dessa medida síntese e de outros indicadores de sustentabilidade. Por fim, as medidas de ambos os estudos foram comparadas com outras de sustentabilidade e encerram evidências da viabilidade de medidas integradas de saúde e ambiente e apontam para propriedades do uso de métodos com a lógica fuzzy. / The relation between environmental characteristics and health is one of the priorities in the debate about sustainable development. The environmental health area addresses complex phenomena and involves uncertainty regarding knowledge. The apprehension of a portion of the reality in this area using indicators is important to decision support. The main objective of this study is to present two proposals based on the Fuzzy Logic which aggregate specific indicators of health and environment in order to produce an index to the analysis of developing and developed countries. The first proposal has been designed to evaluate Brazils states and capitals based on indicators in the scope of primary health care and coverage of sanitations services. The indicators have been integrated into a summary measure named Index of Environmental Health. The results have been compared with other measures of sustainability. The northern, northeastern and central-western regions of Brazil have shown the lowest index. In contrast, the highest values of that index have been found in the south and the southeast regions of Brazil. These results may reveal situations of inequality in Brazil. The Index of Environmental Health has shown the potential for formulating hypotheses in the debate about sustainable development. The second proposal has aimed to classify the environmental sanitation status in the Algarvians cities, in Portugal, using quantitative and qualitative information and also opinion based measures. The integrated summary measure has been named Index of Environmental Sanitation. The development of this measure has involved the participation of experts from the Ministry of Health. The results have been compared with sustainability measures. They have shown that the worst values of this summary measure have occurred in Alcoutim, Monchique and Silves. In conclusion this study evidences some contributions for decision support obtained from environmental health integrated measures using fuzzy logic.

Objetivo. Este estudo foi realizado com o objetivo de avaliar a autopercepção das condições bucais em idosos. Material e Métodos. Participaram do estudo 337 pessoas, com 60 anos e mais de idade, funcionalmente independentes, que freqüentavam um centro de saúde em Araraquara, SP. Foi aplicado formulário com questões sobre as características sócio-demográficas da amostra, autopercepção da condição bucal e o índice GOHAI. Realizou-se exame clínico para determinar a prevalência das principais doenças bucais. Os testes estatísticos realizados tiveram como objetivo determinar a associação entre as variáveis sócio-demográficas, clínicas e o índice GOHAI com a autopercepção e também identificar os preditores da auto-avaliação. Resultados. O exame clínico revelou que 40,4% das pessoas eram desdentadas, e entre os dentados a cárie e a doença periodontal tiveram grande prevalência. Entre os dentados, 42,7% avaliaram sua condição bucal como regular, enquanto 55,8% dos desdentados afirmaram que era boa. As variáveis associadas à auto-avaliação foram: a classe social, o GOHAI, os dentes cariados e com extração indicada entre os dentados, e a escolaridade e o GOHAI entre os desdentados. A análise multivariada mostrou que os preditores da auto-avaliação foram o GOHAI (em dentados e desdentados), os dentes com extração indicada e o CPITN em dentados. Estes preditores explicaram no máximo 30% da variabilidade da auto-avaliação. Conclusões. Entre outros aspectos concluiu-se que a percepção teve pouca influência das condições clínicas e por isso seria importante o desenvolvimento de ações educativas e preventivas junto a esta população. / Objective. The purpose of this study was to assess the self-perception of oral health status of the elderly. Methods. Results are based on interviews and clinical assessment of 337 subjects aged 60 years and over, functionally independents and who used to go to a Health Care in Araraquara, Brazil. A questionnaire with questions about the social characteristics of the sample, self-perception of oral health status and the GOHAI index was applied. A clinical examination was made to determine the prevalence of the main oral diseases. The objective of statistical tests was to determine the association among the social and clinic variables and the GOHAI index with the self-perception. Moreover the tests had to identify the self-assess predictors. Results. The clinical examination revealed that 40.4% of the people were edentulous and among the dentate the dental caries and the periodontal disease had a significant prevalence. 42.7% of the dentate assessed their oral health status as regular and 55.8% of the edentulous assessed theirs as good. The social class, the GOHAI index and the decayed and missing teeth among the dentate, and also the level of education and the GOHAI among the edentulous, were associated to the self-assess. The multivariate analysis showed that the predictors of the self-assess were the GOHAI index (among dentate and edentulous), the missing teeth and the CPITN among dentate. These predictors explained 30% of the self-assess variability. Conclusions. As the perception had a small influence on the clinical conditions, the development of educated and preventive actions for these people are recommended.

Estudo exploratório, de delineamento longitudinal, com 81 pacientes em uso de anticoagulante oral e que foram avaliados durante internação e dois meses após a alta. Os objetivos foram acompanhar a evolução quanto á terapia de anticoagulação oral e adesão ao tratamento; comparar o estado geral de saúde e a presença de sintomas de ansiedade e depressão. Foram utilizados instrumentos específicos para avaliar adesão ao tratamento medicamentoso (Medida de Adesão aos Tratamentos), estado geral de saúde (Escala Visual Analógica) e presença de sintomas de ansiedade (HADS-Ansiedade) e depressão (HADS- Depressão). As análises estatísticas realizadas foram: Teste t de Student pareado para comparar as médias do estado geral de saúde e da HADS; Modelo Linear de Efeitos Mistos para analisar a associação entre estado geral de saúde, ansiedade, depressão e tempo de avaliação no estudo. O nível de significância adotado foi 0,05. Entre os participantes, 54,3% eram mulheres, com idade média de 59,5 anos e nível médio de instrução de 5,1 anos. A principal indicação clínica para uso do medicamento foi formação de trombos (34,6%), sendo a varfarina o anticoagulante oral mais utilizado (97,5%). Dois meses após a alta, todos os pacientes foram classificados como aderentes ao tratamento e 42% mantiveram o INR na faixa terapêutica. As diferenças entre as médias do estado geral de saúde, HADS-Ansiedade e HADS-Depressão durante a internação e dois meses após a alta não foram estatisticamente significantes (p=0,78; p=0,27 e p=0,40, respectivamente). Em relação á presença de ansiedade, quando associamos as duas variáveis de forma categórica, com e sem sintomas, e o tempo de avaliação, 38 (46,9%) pacientes foram classificados como \"sem sintomas\" de ansiedade e 22 (27,1%) \"com sintomas\", sendo esta associação estatisticamente significante (p<0,001). Para depressão, a maioria (55; 67,9%) foi classificada como \"sem sintomas\" e 11 (13,6%) \"com sintomas\", sendo tal associação estatisticamente significante (p<0,001). Ao analisarmos as médias do estado geral de saúde segundo tempo e grupo de sintomas, resultados estatisticamente significantes foram obtidos apenas quando comparamos os valores entre os grupos sem sintomas de depressão (M=80,5; D.P.=23,46) e com sintomas (M=62,5; D.P.=26,07) (p=0,021), dois meses após a alta e quando comparamos as médias do grupo com sintomas de depressão, na internação (M= 75,37; D.P.=25,02) e dois meses após a alta (M=62,5; D.P.=26,07) (p=0,046). Identificar o perfil clínico de pacientes em uso de anticoagulante oral, desde a internação até dois meses de seguimento ambulatorial; conhecer sua percepção sobre estado de saúde, presença de sintomas de ansiedade e de depressão e a adesão ao tratamento são ações importantes a serem consideradas no atendimento desses pacientes. Tais resultados poderão ser utilizados para nortear mudanças na organização do ambulatório de anticoagulação oral e no planejamento da assistência de enfermagem a tais pacientes. / This exploratory and longitudinal research involved 81 patients under oral anticoagulation treatment, who were evaluated during hospitalization and two months after discharge. The objectives were to follow the patients\' clinical evolution, considering the oral anticoagulation therapy and treatment adherence; and to compare the general health condition and the presence of anxiety and depression symptoms. Specific instruments were used to assess adherence to medication treatment (Treatment Adherence Measure), general health condition (visual analogue scale) and the presence of anxiety (HADS-Anxiety) and depression symptoms (HADS-depression). For the sake of statistical analysis, the following were applied: Student\'s paired t-test to compare the mean scores for the general health condition and HADS scores; the Linear Fixed Effects Model to analyze the association between general health condition, anxiety, depression and research moment. Significance was set at 0.05. Among the participants, 54.3% were women, with a mean age of 59.5 years and a mean education time of 5.1 years. The main clinical indication for medication use was the formation of thrombi (34.6%), with warfarin as the most used oral anticoagulant drug (97.5%). AT two months after discharge, all patients were classified as adherent to the treatment and 42% maintained their INR within the therapeutic range. The differences between the mean general health, HADS-Anxiety and HADS-Depression scores during hospitalization and two months after discharge were not statistically significant (p=0.78; p=0.27 and p=0.40, respectively). As regards the presence of anxiety, when the two variables are associated categorically, with and without symptoms, and the research moment, 38 (46.9%) patients were classified as \"without symptoms\" of anxiety and 22 (27.1%) \"with symptoms\", with a statistically significant association (p<0.001). As for depression, the majority (55; 67.9%) was classified as \"without symptoms\" and 11 (13.6%) \"with symptoms\", a statistically significant association (p<0.001). The analysis of the mean general health condition scores according to the research moment and group of symptoms only revealed statistically significant results when comparing the groups without (M=80.5; S.D.=23.46) and with symptoms (M=62.5; S.D.=26.07) (p=0.021) two months after the discharge and when comparing the mean scores for the group with depression symptoms during hospitalization (M= 75.37; S.D.=25.02) and two months after the discharge (M=62.5; S.D.=26.07) (p=0.046). Identifying the clinical profile of patients under oral anticoagulant therapy since hospitalization and after two months of outpatient monitoring and getting to know their perceived health condition, presence of anxiety and depression symptoms and treatment adherence are important actions for consideration in care delivery to these patients. These results can be used to guide changes in the organization of the oral anticoagulation outpatient clinic and in nursing care planning for these patients.