Thesis (Ph. D.)--Texas State University-San Marcos, 2006. / Vita. Appendices: leaves 196-198. Includes bibliographical references (leaves 199-208).

Background: Many interventions aim to alleviate well-documented problems of malnutrition in residential care homes and improve residents’ health and wellbeing. Despite some positive findings, little is known about how and why mealtime interventions might be effective, and in particular, what effects residents’ experiences of mealtimes have on health outcomes. Aim: The aim of this project was to gain an insight into residents’ experiences of mealtimes in order to inform the development of a mealtime intervention. By addressing the issues that impact on residents’ enjoyment of meals, interventions may target improvements in the health and wellbeing of residents more effectively. Methods: This thesis is comprised of three pieces of empirical work conducted using multiple methods. In a systematic review of stakeholder perceptions of mealtimes, five databases were searched from inception to November 2015, followed by thematic analysis of extracted data. In a second study, semi-structured interviews were conducted with eleven residents from four care homes in the South West UK. Thematic analysis was used to derive content and meaning from transcribed interviews. These studies informed the development of a staff-focussed training programme (study three) using the process of Intervention Mapping (IM) as a guide. The feasibility of this intervention was assessed using qualitative surveys and analysed using multiple methods. Fourteen staff from two care homes participated in the feasibility study, which investigated the deliverability of the training programme and the acceptability of its content. Findings: The systematic review and resident interview study revealed that the dining experience was a focal point for residents’ broader experiences of residing in a care home. Whilst meal quality and enjoyment impacted on the dining experience, the provision of care was pivotal in determining mealtime culture and resident agency within the home. This had implications for self-efficacy and social relationships, particularly in the context of transitioning from independent living to a care home community. These findings informed the development of a mealtime intervention, which was found to be deliverable and acceptable to staff. Conclusion: Mealtimes are a mainstay of life in a care home through which residents’ experiences are characterised, exemplified and magnified. Understanding how residents interact with one another, accommodating their preferences and encouraging autonomy may enhance their mealtime experiences. Evidence from the empirical work supports the development of interventions aimed at mealtime staff to improve resident self-efficacy. This thesis has established the necessary groundwork for a pilot trial and future definitive trial to assess resident (and staff) outcome measures including social (e.g., collective engagement) and psychological outcomes (e.g., wellbeing), as well as health outcomes (e.g., nutritional status).

Made available in DSpace on 2014-06-11T19:29:35Z (GMT). No. of bitstreams: 0 Previous issue date: 2008-05-16Bitstream added on 2014-06-13T19:17:56Z : No. of bitstreams: 1 doine_mq_me_botfm.pdf: 382775 bytes, checksum: 0acf616a47c656373cf76d88dece2d58 (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Diabetes Mellitus é uma síndrome decorrente da falta de insulina ou da incapacidade desta de exercer adequadamente seus efeitos metabólicos. Sua prevalência vem aumentando nos últimos anos, decorrente de fatores envolvidos com hábitos de vida, e também com o aumento da longevidade. Em idosos esta prevalência se eleva. As complicações crônicas do DM subdividem-se em vasculares e neurológicas. São elas: retinopatia; nefropatia; eventos cardiovasculares como infarto do miocárdio, acidente vascular cerebral e arteriopatia periférica; neuropatias e a síndrome do pé diabético. O presente estudo avaliou uma série de casos de idosos diabéticos, que foram examinados a partir de uma avaliação multidimensional representativa de todos os idosos do município de Botucatu – SP. Teve como objetivo descrever a presença de complicações crônicas instaladas, bem como os fatores de risco presentes para o aparecimento das mesmas. A prevalência do DM encontrada para essa faixa etária no inquérito domiciliar foi de 16%. Para os idosos examinados foi de 18,4%. Analisando-se estes últimos, detectou-se que 37,8% deles tinham pelo menos 10 anos de evolução da doença e que 84,7% apresentavam retinopatia diabética. O percentual de idosos diabéticos que referiram ser portadores de HAS foi de 80,4%. Níveis de pressão arterial elevados foram encontrados em 57,1% dos mesmos no momento do exame clínico. Sobrepesos e obesos corresponderam a 61,4%. Obesidade abdominal alcançou percentuais de 96,7% em mulheres e de 64,3% em homens. Cinqüenta e cinco por cento dos idosos diabéticos que coletaram amostra de sangue, apresentaram nível de Hemoglobina A1c acima do limite tolerável. Para colesterol-HDL, 63,3% dos que coletaram amostras Mauro Queiroz Doine 10 tiveram níveis abaixo do valor recomendado. Os achados não diferem daquilo que é citado na bibliografia... / Lacky of insulin or its incapacity to adequately exerts its metabolic actions results in the syndrome of DM. Its prevalence has been increasing in the last years due to factors related either to people life style or to the aging of the population. The prevalence of DM increases in elder people. Chronic complications of the DM subdivide in cardiovascular and neurological ones. They are: retinopathy; nephropathy; cardiovascular events such as myocardium infartaction, cerebral vascular accidents, peripheral arteriopathy; neuropathies and the syndrome of diabetic foot. The present study evaluated a series of cases of diabetic aged, which was examined from a multidimensional evaluation representative of all aged people of Botucatu city – SP. It had like object describe the presence of chronic complications already installed, as well as the presence of factors of risk that may lead to the onset of them. Prevalence of DM for the people inquired at home was of 16%. For the examined old people was of 18,4%. When analised the last ones, it showed that 37,8% of the aged diabetics had at least 10 years of DM going on and 84,7% had diabetic retinopathy. Aged diabetics percentage who referred Sistemic Arterial Hipertension was 80,4%. High levels of blood pressure were found in 57,1% of them at the clinical examination. Fat people and overweighted ones were up to 61,4%. Abdominal obesity was observed in 96,7% of old women and in 64,3% of old men. Of Hemoglobin A1c evaluation, 55% of diabetic old people showed higher levels than tolerable values. Blood sample of 63,3% old diabetic people had lower values for cholesterol-HDL than the recommended. These data are similar to those found in the related literature, but Mauro Queiroz Doine 12 claims special attention the high percentage of old female people with abdominal obesity, very expression data in the population of Botucatu – SP... (Complete abstract click electronic access below)

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Este estudo teve por objetivo analisar a acurÃcia das caracterÃsticas definidoras do diagnÃstico de enfermagem MemÃria prejudicada em idosos. Trata-se de um estudo de acurÃcia diagnÃstica, com corte transversal, desenvolvido em uma instituiÃÃo de longa permanÃncia para idosos, situada na cidade de Fortaleza. A amostra foi constituÃda por indivÃduos de ambos os sexos, com idade acima de 60 anos e cadastrados na referida instituiÃÃo, totalizando uma amostra de 123 idosos. Elaborou-se um instrumento especÃfico para a coleta de dados baseado nas caracterÃsticas definidoras do diagnÃstico em questÃo, conforme apresentadas na versÃo atual da NANDA Internacional, alÃm de dados sÃcio demogrÃficos dos idosos. Os dados foram analisados estatisticamente com o apoio do pacote estatÃstico R versÃo 3.0.2. Para verificar a sensibilidade e especificidade de cada caracterÃstica definidora, foi utilizado o mÃtodo de anÃlise de classes latentes. Os dados sÃcios demogrÃficos mostraram uma pequena predominÃncia do sexo masculino, predomÃnio de idosos provenientes de cidades do interior do Estado e mÃdia de idade de 74,21 anos (+7,73). AlÃm disso, verificou-se que metade da amostra tinha mais de trÃs anos de permanÃncia na instituiÃÃo, menos de 2 anos de escolaridade e renda familiar inferior a R$724,00. Todas as dez caracterÃsticas definidoras avaliadas foram encontradas na amostra. Entretanto, algumas apresentaram percentual baixo. As caracterÃsticas mais frequentes no estudo foram Incapacidade de determinar se uma aÃÃo foi efetuada (67,21%), Incapacidade de reter novas informaÃÃes (59,35%) e Incapacidade de executar habilidades previamente aprendidas (55,28%). Em todos os modelos de classe latente, a prevalÃncia estimada do diagnÃstico de enfermagem MemÃria prejudicada ficou entre 31,05% e 36,43%. As caracterÃsticas que apresentaram as melhores medidas de acurÃcia para inferÃncia de espectros iniciais do diagnÃstico em estudo foram Incapacidade de aprender novas habilidades e Incapacidade de reter novas habilidades na amostra total. No sexo masculino, a caracterÃstica Incapacidade de executar habilidades previamente aprendidas foi a Ãnica que apresentou significÃncia estatÃstica tanto para a sensibilidade quanto para a especificidade. Jà no sexo feminino, Incapacidade de aprender novas habilidades e Incapacidade de reter novas habilidades apresentaram valores altos de sensibilidade e especificidade. A importÃncia destes achados se dà frente ao potencial para auxiliar os enfermeiros no momento de inferir o diagnÃstico MemÃria prejudicada em idosos, o que contribui para um julgamento clÃnico mais preciso, o que à essencial para a elaboraÃÃo de um plano de cuidados adequado. / This study aims to analyze the accuracy of the defining characteristics of the nursing diagnosis Impaired memory in the elderly. It is a diagnostic accuracy study with a cross-sectional approach, developed in a long-term care institution in the city of Fortaleza. The sample consisted of individuals of both sexes, aged above 60 years old and registered in the long-term institution, totaling a sample of 123 elderly. A specific form for data collection was constructed based on the defining characteristics of the diagnosis in question, as presented in the current version of the NANDA-International taxonomy. The form also contained socio demographic data of the elderly. The data were statistically analyzed with the support of the statistical package R version 3.0.2. To verify the sensitivity and specificity of each defining characteristic, we used the method of latent class analysis. The data showed a small demographic predominance of males, predominance of elderly people from other cities of the State and an average age of 74.21 years (+7.73). In addition, it was found that half of the sample had more than three years of stay in the institution, less than 2 years of education and family income less than R$724. All ten defining characteristics evaluated were found in the sample. However, some of them presented low percentage. The most common defining characteristics in the study were Inability to determine whether an action was performed (67.21%), Inability to retain new information (59.35%), and Inability to perform a previously learned skill (55.28%). In all the latent class models, the estimated prevalence of the nursing diagnosis Impaired memory was between 31.05% and 36.43%. The defining characteristics that presented the best measures of accuracy in the study were Inability to learn new skills and Inability to retain new skills in the total sample. In males, the characteristic Inability to perform previously learned skills was the only one that showed statistical significance for both sensitivity and specificity. In the female, Inability to learn new skills and Inability to retain new skills presented high values of sensitivity and specificity. The importance of these findings is the potential to assist the nurses to infer the diagnosis Impaired memory in the elderly, which contributes to a more precise clinical judgment, which is essential for the elaboration of an appropriate plan of care.

No mundo, o nÃmero de indivÃduos cuja idade à superior a 60 anos crescerà exponencialmente e, em 2025, espera-se uma elevaÃÃo de 694 milhÃes no nÃmero de pessoas mais velhas. O envelhecimento à um processo complexo que afeta uma variedade de funÃÃes, incluindo o desenvolvimento e a manutenÃÃo do sistema imunolÃgico. Dessa forma, os idosos sÃo mais freqÃentemente acometidos por infecÃÃes e neoplasias do que os jovens. Essas patologias podem ser atribuÃdas, em parte, ao envelhecimento do sistema imunolÃgico, chamado imunossenescÃncia. O objetivo deste trabalho foi descrever o perfil imunolÃgico de uma populaÃÃo de idosos saudÃveis. Foram colhidas amostras de 35 voluntÃrios com idade igual ou superior a 60 anos, de ambos os sexos, onde foi utilizado, como controle, o mesmo nÃmero de voluntÃrios com idade entre 20 e 38 anos. Foram realizados 16 exames laboratoriais diferentes para definir as principais alteraÃÃes na imunossenescÃncia. Os resultados evidenciaram alteraÃÃes tanto na imunidade inata, quanto na imunidade adaptativa no organismo idoso. As alteraÃÃes encontradas na imunidade inata foram: aumento do nÃmero de neutrÃfilos no sangue venoso; aumento da concentraÃÃo do componente C4 do complemento; e aumento da concentraÃÃo de interleucina-6. As alteraÃÃes da imunidade adaptativa foram: reduÃÃo na quantidade dos linfÃcitos (leucograma) e das subpopulaÃÃes linfocitÃrias CD2+, CD3+ e CD8+ (imunofenotipagem); e aumento na concentraÃÃo da imunoglobulina IgA e diminuiÃÃo da concentraÃÃo de IgM. Podemos concluir, dessa forma, que este trabalho foi de grande relevÃncia para definir os parÃmetros normais do sistema imunolÃgico de um indivÃduo idoso saudÃvel e aperfeiÃoar a nossa compreensÃo deste sistema. Assim, tambÃm se constitui num passo necessÃrio no sentido de identificar, no futuro, formas de melhor tratar as causas subjacentes da imunossenescÃncia e suas conseqÃÃncias. / Worldwide, the number of individuals whose age is over 60 years will grow exponentially. Is provided an increase of 694 million in the number of older people in 2025. Ageing is a complex process that negatively impacts the development of the immune system and its ability to function. Immunosenescence is a multifactorial condition leading to many pathologically significant health problems in the aged population, it is becoming recognized that the immune system declines with age, a term known as immunosenescence, which leads to a higher incidence of infections, neoplasia and autoimmune diseases. This study attempts to describe the immunological profile of a population of healthy elderly. Thirty five elderly patients aged 60 years were subjected to a study and the same numbers of young volunteers aged between twenty and thirty eight were examinated like control group. Were investigated sixteen laboratorial exams to define the main changes in immunosenescence. The results showed changes in both innate immunity and adaptive immunity in the elderly body. The changes found in innate immunity were: increase the number of neutrophils in venous blood, increasing the concentration of C4 complement component, and increased levels of interleukin-6. Changes in adaptative immunity were: reduction in the number of lymphocytes (WBC) and lymphocyte subsets CD2 +, CD3 + and CD8 + (immunophenotyping) and increased concentration of immunoglobulin IgA and decreased IgM concentration. In cloncusion, this work was important to define the normal parameters of the immune system of a healthy elderly and improve our understanding of this system. Thus, it also constitutes a necessary step to identify how best to treat the underlying causes of immunosenescence and its consequence.

CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / O cuidado integral com Diabetes Mellitus e suas complicaÃÃes à um desafio para a equipe de saÃde. à imprescindÃvel a identificaÃÃo de comportamentos inadequados para poder revertÃ-los e conhecer as variÃveis que possam interferir na mudanÃa de comportamento para o autocuidado. O presente estudo teve como objetivo geral: avaliar as competÃncias de idosos diabÃticos para a prÃtica de aÃÃes de autocuidado; e como objetivos especÃficos: caracterizar a populaÃÃo idosa segundo variÃveis socioeconÃmicas e clÃnicas; analisar o conhecimento dos idosos diabÃticos assistidos na atenÃÃo primÃria sobre o tratamento e o diabetes mellitus; verificar a relaÃÃo entre as caracterÃsticas sociodemogrÃficas e individuais relacionadas ao diabetes e a competÃncia dos indivÃduos para o autocuidado. Estudo descritivo de corte transversal do tipo correlacional. A populaÃÃo do estudo foi composta por idosos acompanhados nas unidades bÃsicas de saÃde sorteadas inseridas nas seis Secretarias Executivas Regionais de Fortaleza-CE. A coleta de dados foi realizada no perÃodo de marÃo a julho de 2009 nos domicÃlios dos idosos, atravÃs da utilizaÃÃo de um formulÃrio e a Escala para IdentificaÃÃo de CompetÃncias para o Autocuidado em Diabetes (ECDAC), elaborada por NUNES (1982). Os dados foram agrupados e analisados estatisticamente, atravÃs do programa Statistical Package for the Social Sciences-SPSS versÃo 14.0. A pesquisa foi aprovada pelo Comità de Ãtica em Pesquisa da Universidade Federal do CearÃ, com protocolo n 17/09. Os resultados mostraram que a maioria dos participantes constituiu-se de mulheres (76%), com idade mÃnima de 60 anos e mÃxima de 85 anos. A amostra apresentou grau de escolaridade bastante heterogÃneo: 37% eram analfabetos O tempo de diagnÃstico variou de 4 a 46 anos, com mÃdia de 10 anos de diagnÃstico da doenÃa (DP= 6,9 anos). Na Subescala I, que avalia a Capacidade FÃsica dos idosos, obtiveram pontuaÃÃo mÃnima de 11 pontos e pontuaÃÃo mÃxima de 24 pontos, mÃdia de 23,21 e desvio padrÃo de 5,72. Na Subescala III, que avalia a Capacidade Mental, os idosos obtiveram pontuaÃÃo mÃnima de 11 pontos, pontuaÃÃo mÃxima de 39 pontos, mÃdia de 23,21 e desvio padrÃo de 5,72. Somente 38% dos idosos obtiveram pontuaÃÃo entre 25-44 pontos, considerada pontuaÃÃo satisfatÃria para competÃncia para o autocuidado em diabetes. Jà na pontuaÃÃo total da ECDAC, somente 6% dos idosos atingiram pontuaÃÃo entre 78 -108 pontos, sendo que apenas estes se classificaram como competentes para o autocuidado em diabetes. Conforme os resultados apresentados, observa-se que um nÃmero reduzido de idosos, apenas 6%, foi considerado competente para o autocuidado em diabetes, fato que enfatiza a importÃncia do desenvolvimento de aÃÃes de promoÃÃo da saÃde direcionados para esta parcela da populaÃÃo que possui limitaÃÃes fÃsicas, mentais ou motivacionais para o autocuidado em diabetes, tendo como premissas a avaliaÃÃo de competÃncias para o autocuidado em diabetes.

CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / A ocorrÃncia de quedas constitui sÃrio problema de saÃde em idade mais avanÃada. Dessa forma, os fatores envolvidos devem ser continuamente avaliados com vistas à melhoria da qualidade de vida do idoso. Teve-se como objetivo investigar as circunstÃncias de ocorrÃncia das quedas nos Ãltimos seis meses em idosos com e sem AVE, assim como os fatores intrÃnsecos e extrÃnsecos a eles relacionados. Estudo do tipo caso-controle, realizado em trÃs AssociaÃÃes Beneficentes Cearenses de ReabilitaÃÃo e um Centro de ReferÃncia da AssistÃncia Social na cidade de Fortaleza no perÃodo de janeiro a abril de 2010. Estabeleceram-se um grupo caso e trÃs grupos controles, cada um com quinze idosos, pareados por idade e sexo, com base na ocorrÃncia ou nÃo de quedas nos Ãltimos seis meses e de acidente vascular encefÃlico. Utilizou-se um formulÃrio organizado em quatro partes para a caracterizaÃÃo do paciente, condiÃÃes intrÃnsecas e extrÃnsecas atuais, ocorrÃncia de quedas e fatores ambientais envolvidos. Com a aprovaÃÃo por Comità de Ãtica em Pesquisa, a coleta de dados ocorreu no dia em que o idoso se encontrava na unidade, apÃs esclarecimento dos objetivos e assinatura do Termo de Consentimento Livre e Esclarecido. Os dados obtidos foram analisados pelo Predictive Analysis Software 18.0. Em sua maioria, os grupos foram formados por mulheres, aposentados, com companheiro, baixa renda per capita e escolaridade. Os idosos tiveram uma mÃdia de 1,4 AVE, em um tempo mÃdio de 5,6 anos e hemiparesia como principal sequela. Quanto Ãs variÃveis com associaÃÃo estatÃstica, destacaram-se: Uso de anti-hipertensivos entre os grupos que sofreram quedas independente de ocorrÃncia de AVE; Uso de inibidores da ECA no caso de idosos com AVE com ou sem quedas; AlteraÃÃes nos pÃs entre o grupo caso e indivÃduos sem queda e sem AVE. Com relaÃÃo Ãs variÃveis ForÃa diminuÃda em membros inferiores, Excesso de mÃveis em casa, Dificuldade na marcha e Mobilidade fÃsica prejudicada, encontrou-se associaÃÃo em todos os casos entre o grupo de indivÃduos com AVE e quedas e aqueles sem AVE e sem quedas. Dificuldade na marcha e Mobilidade fÃsica prejudicada tambÃm estiveram estatisticamente associadas entre o grupo caso e indivÃduos sem AVE e com relato de quedas. As variÃveis Ãndice de Barthel, Atividades Instrumentais de Vida DiÃria, Escala GeriÃtrica e de Tinetti, alÃm de ForÃa de preensÃo palmar direita tambÃm apresentaram associaÃÃo estatÃstica entre o grupo caso de indivÃduos com AVE e quedas e aqueles sem AVE, com ou sem quedas. As quedas aconteceram predominantemente no perÃodo da manhÃ, em ambiente iluminado, sem corrimÃo ou objetos, com piso Ãspero e seco, uso de chinelo com solado de borracha. NÃo se constatou ser o AVE um evento associado Ãs quedas, fortalecendo a relaÃÃo causal multifatorial. As variÃveis envolvidas com o evento queda estiveram fortemente relacionadas aos fatores intrÃnsecos envolvidos com o equilÃbrio. Os fatores extrÃnsecos, contudo, podem ser os mais facilmente modificÃveis. Nesse Ãmbito, os profissionais de saÃde devem avaliar rotineiramente todas as variÃveis envolvidas com o evento queda, no intuito de melhorar a qualidade de vida desses indivÃduos. / The falls occurrence represents a serious health problem for aged. Therefore the factors involved must be continuous assess in order to improve the aged life quality. The aim was to investigate the falls occurrence in the last six months at elderly with and without stroke and to identify the intrinsic and extrinsic factors involved. A case-control study carried at three Beneficent Associations of Rehabilitation from Cearà and a Reference Center of Social Worker in Fortaleza city from January to April 2010. A case group and three control groups were established with 15 elderly paired off by sex, age, falls occurrence in the last six months and stroke occurrence. It was used a form organized in four parts with the objective to characterize the patient, actual intrinsic and extrinsic conditions, falls occurrence and environment factors involved. The data were gathered with the Research Ethical Committee approval and when the elderly were enlightened at the collected data unit about the aim of the research, and the patient signing of authorization term. The data obtained was analyzed by Predictive Analysis Software 18.0. The groups were mainly composed by women, retired people, persons with partners, low school grade and low financial income. The elderly with stroke presented an average of 1,4 occurrence in an average period of 5,6 years and the main consequence was hemiparesis. As far as statistical associated variables concern, the followings were here highlighted: Use of antihypertensive among the groups with falls despite the occurrence of a stroke; Use of ACE inhibitor at aged with stroke whom were fallers or not; Foot alterations between the case group and people without falls neither stroke. Besides the variables Decreased strength at lower members, excess of home furniture, Gait difficulty and Impaired physical mobility was found in all association among the fallers participants with stroke and those without stroke neither falls. Gait difficulty and Impaired physical mobility were statistically associated between the case group and people without stroke and fall occurrence. The Barthel index, daily instrumental life activities, Geriatric scale and Tinetti scale, besides right hand grip strength, also found statistical association between the case group and aged without stroke fallers or not. The falls occurred mostly in the morning, in bright environment without handrail or objects, in rough and dry floor, use of rubber slippers. It was not verified to be the stroke an event associated to falls, a fact that strengthens the multifarious cause relation. The variables involved with fall event were strongly related to intrinsic factors involved with the balance issue. The extrinsic factors, however, could be easily modified. Therefore health professionals should routinely assess all fall variables involved in order to improve the life quality of elderly people.

Orientadores: Maria Filomena Ceolim, Sofia Cristina Iost Pavarini / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Enfermagem / Made available in DSpace on 2018-08-24T03:00:51Z (GMT). No. of bitstreams: 1 Santos_ArieneAngelinidos_D.pdf: 2651821 bytes, checksum: e865bb00398742e6323757327a1c9a21 (MD5) Previous issue date: 2013 / Resumo: Objetivo. Analisar a relação entre cochilos e fragilidade em idosos residentes na comunidade. Métodos. Trata-se de um estudo descritivo, correlacional, transversal, recorte do projeto multicêntrico Fragilidade em Idosos Brasileiros (FIBRA). A amostra foi composta por 3.075 idosos do banco de dados do Projeto Fibra UNICAMP, os quais foram avaliados por meio de questionário sociodemográfico, questão sobre cochilo quanto à ocorrência, frequência e duração (Minnesota Leisure Activity Questionnaire) e fenótipo de fragilidade proposto por Linda Fried. Para comparar a fragilidade com relação à frequência e duração dos cochilos foram aplicados os testes Mann-Whitney e Kruskal-Wallis. Para estudar as associações entre a ocorrência de cochilo e os critérios de fragilidade foi utilizado o teste Qui-quadrado. Para analisar a associação entre as variáveis de interesse e a ocorrência de cochilo foi utilizada a análise de regressão logística, modelos simples e múltiplo. Além disso, foi aplicado um modelo de regressão linear múltiplo para a duração dos cochilos com relação às demais covariáveis, exceto os critérios de fragilidade. O nível de significância adotado foi de 5%. Resultados. Para a ocorrência de cochilos foram encontradas associações entre: gênero masculino e renda familiar de 3,1 a 5,0 salários mínimos. Quanto à frequência semanal de cochilos, verificou-se associação significativa apenas entre o critério de fragilidade "gasto calórico em atividade física". Em relação à duração dos cochilos, verificou-se associação significativa entre: ser frágil, gênero masculino e o critério de fragilidade "força de preensão palmar". Conclusão. As hipóteses deste estudo foram parcialmente confirmadas. Estudos longitudinais são necessários para identificar a direção das associações encontradas. Sugere-se que a avaliação do sono e do hábito de cochilar seja incorporada no atendimento de idosos que ingressam nos serviços de saúde. Linha de pesquisa. Processo de Cuidar em Saúde e Enfermagem. / Abstract: Objective. Analyze the relationship between naps and frailty in community-dwelling elderly. Method. This is a descriptive, cross-sectional study that utilized data from the multicenter study Frailty in Brazilian Elderly (FIBRA). The sample was composed of 3,075 elderly, which were assessed using a sociodemographic questionnaire, specific questions about napping regarding its occurrence, frequency and duration (Minnesota Leisure Activity Questionnaire), and assessment of the presence of frailty criteria according to the phenotype proposed by Linda Fried. Frequency and duration of naps were compared according to sociodemographic data and frailty criteria by means of Mann-Whitney and Kruskal Wallis tests. Chi-square test was used to assess the association between the occurrence of nap and frailty criteria. Univariate and multiple logistic regression models were utilized to analyze the association between variables of interest and the occurrence of naps. Additionally, multiple linear regression models were applied to evaluate the influence of some covariates, except frailty criteria, on the duration of naps. The significance level was 5%. Results. We found significant association between the occurrence of naps and: male gender; family income between 3.1 and 5.0 minimum wages. As for the weekly frequency of naps, there was a significant association with the criterion of frailty "caloric expenditure in physical activity". The duration of naps were significantly related to: being frail; male gender; and the criterion of frailty "handgrip strength". Conclusion. The hypotheses of this study were partially confirmed. Longitudinal studies are needed to identify the direction of the associations found. We suggest that the assessment of sleep and napping habits should be incorporated in the comprehensive evaluation of elderly people who come in health services. Line research. Process of Care in Health and Nursing. / Doutorado / Enfermagem e Trabalho / Doutora em Ciências da Saúde

Abstract The prevalence of coronary heart disease (CHD) and associated manifestations with ischaemic resting electrocardiogram (ECG) changes, clinical findings and sociodemographic factors were studied in 1990–1991 among an elderly population in southwestern Finland. One of the specific aims was to describe the health-related quality of life of elderly coronary heart disease patients, i.e. the associations between CHD and physical, psychological, cognitive and social functioning. 488 men and 708 women aged 64 years and over (93% of those eligible) participated in this cross-sectional epidemiological survey in the rural district of Lieto. The participants were examined and interviewed during two visits to the local health centre. An ECG and a chest x-ray were taken and a clinical examination was made by a doctor. The Rose questionnaire was used to determine the prevalence of angina pectoris (AP). The Minnesota codes were used in the analyses of ECG findings. The medical records were reviewed. The prevalence of AP was 9.1% (95% Confidence Interval 6.7–12.0) among men and 4.9% (3.5–6.8) among women. The respective figures for past myocardial infarction (MI) (based on the medical records or a major or moderate Q/QS item on ECG, codes 1.1–1.2) were 13.9% (10.9–17.0) and 6.5% (4.8–8.6). Ischaemic ECG findings (codes 1.1–1.3, 4.1–4.4, 5.1–5.3, 7.1) were common: 32.9% (28.7–37.1) of men and 39.3% (35.7–43.0) of women had such changes. The total prevalence of CHD, including AP, MI, past coronary bypass surgery or angioplasty or ischaemic ECG findings, was 37.7% (33.4–42.0) in men and 42.0% (38.3–45.6) in women. The patients and controls were mainly aged, non-institutionalized, community-living persons. The patients with CHD (AP and/or a past MI) had more difficulties in physical functioning than their age- and sex-matched controls. According to logistic regression analyses, CHD was not independently associated with difficulties in physical functioning. However, physical disability was associated with the use of cardiovascular drugs and also with old age, the use of psychotropic drugs, depression and cancer. More male patients than controls had depression measured on the Zung Self-Rating Depression Scale. The depression had often gone undiagnosed, especially among men. Among men, the most important factors associated with depression were difficulties in physical functioning and widowhood or divorce, while among women, previous depression and the use of ACE inhibitors emerged as significant. There were no differences between the patients and controls in cognitive functioning. The male patients had a higher frequency in visiting activity than the controls. Old age, difficulties in physical functioning, CHD and chronic obstructive pulmonary disease were associated with impaired social functioning. In conclusion, CHD is common in the Finnish elderly. The clinical picture of CHD in elderly people is varying. It seems that CHD has no independent impact on functional disability in the elderly. Old age, sociodemographic factors, medication and other chronic diseases are also contributors.