This study used a mixed qualitative-quantitative design to describe attachment in a sample of one-hundred fifty-four healthy community-living older adults. Life-span development and attachment theory combined to define the philosophical and theoretical orientation that guided the investigation. The idea of an "attachment structure" was conceptualized by the investigator to frame attachment--an approach that allowed attachment to involve multiple attachment objects from any or all of six different attachment object types (things, ideas, people, groups of people, animals, or places). The purpose of this study was to explore and describe the attachment structure as it presented in, and developed in later life. In phase one of the study, 154 older adults were administered a questionnaire designed to elicit descriptive information about the newly conceptualized "attachment structure". This information was used to guide theoretical sampling in the qualitative, second phase. In phase two, a grounded theory methodology was used to explore the developmental changes that occurred in attachment structures in later life. Sixteen subjects from phase one were selected, based on their responses to the quantitative phase, as those subjects most likely to advance the theory developing focus of this study. Analysis supported the attachment structure as a meaningful representation of socio-emotional development in later life. The existence of multiple attachment objects of multiple object types was supported by both quantitative and qualitative data. Significantly, in addition to close family and friends, subjects reported attachments to ideas like independence and freedom. A grounded process called "reconfiguring" was identified from qualitative analysis that described how older people make changes in their attachment structures to maintain a sense of security in the face of diminishing contact with attachment objects. Two pathways, the structural stimulation pathway and the reconfiguring pathway, describe the dynamics of the attachment structure. The reconfiguring pathway was identified as a developmental resource of aging--a process available to older people to address developmental challenges in aging that affect one's quality and quantity of interaction with attachment objects.

The purposes of this secondary study were to explore the case detection phenomena of elder abuse by determining the congruence between nurses' assessments of abuse and elders' self-reports of abuse; to identify factors that may account for differences between abusive situations and nonabusive situations; then to describe differences between abused elders correctly identified and abused elders incorrectly identified by nurses. Both quantitative and qualitative data were used. The theory of attribution directed this research. The conceptual framework consisted of four concepts: structural factors, relationship factors, elder factors, and caregiver factors. A descriptive-comparison design was used to address the research questions. The sample included 48 elder-caregiver dyads, of whom 24 were self-reported abused elders and 24 self-reported nonabused elders. Descriptive analysis was used, including chi-square and t-tests. Results indicated that the nurses' assessments of elder abuse and elders' self reports of abuse were congruent in only one-fifth (N = 5) of the abused cases (N = 24). The findings confirmed allegations that nurses have difficulty identifying elder abuse unless outright battering is observed. Five variables were significant between abused and nonabused elders, and 10 variables were significant between abused elders correctly identified by nurses and abused elders incorrectly identified by nurses.

According to the United States Department of Health and Human Services (1999), between 10-15% of children and adolescents in the United States show some symptoms of depression that interfere with their functioning at home and school. This same report indicated that only 20-25% of these children get the treatment they need to cope with this significant debilitating condition. Adults often turn to spirituality in order to find comfort, hope and relief from distress. Spirituality refers to one's own beliefs, experiences and ideals concerning how to cope with a crisis (Elkins & Cavendish, 2004). However, most work in spirituality has been done with adults; little is known about the ways in which spirituality may be used or expressed by children who are facing difficulty in life, and especially among clinically children with depression (Elkins et al., 2004).The purpose of this study was to investigate experiences and views that promote well-being among school-age children (ages 9-12 years) who had been diagnosed with depression, and specifically what role spirituality has in this process. The goal was to better understand the process of how these children express and find purpose and meaning in their life in order to find a sense of hope, comfort and strength in order to cope during their experience with depression. The method used for this study was grounded theory, designed to examine an underlying social process (Glaser & Strauss, 1967). The sample consisted of 7 English speaking children ages 9-12 that had been diagnosed with depression not otherwise specified or dysthymia. Children were patients at a counseling center in Arizona. A semi-structured interview schedule ensured that the research questions were answered. Data were analyzed using constant comparison of themes across and within data from the participants and other text-based sources.Self-regulation, which included spiritually-related approaches, was found to be a key underlying process of coping in this group of children. Understanding the process of spiritual self-regulation was useful in providing more definitive knowledge for theory-guided practice with clinically depressed school-aged children.

This minithesis provides an ethnographic account of the life world of older people in the community of Belhar in the Cape Peninsula, which was historically categorised as a &lsquo / coloured&rsquo / community during the implementation of the Group Areas Act. By content analysing newspaper articles published in the early 1980s and specifically during the implementation of the Group Areas Act I found that many of the residents reported that they lived in fear of their lives, in what was once known as a &lsquo / prestige suburb&rsquo / . At the present time the community of Belhar is an intensely gang-infested area. From preliminary research done by myself at a senior citizen centre in Belhar, the high incidence of violence was a recurring theme throughout discussions with older people. In fact when I posed the question Why do you come to the centre five days a week? to a group of older people they answered without hesitation It is unsafe for an older person to be alone during the day. Answers like these to many of the questions that I posed would almost always be followed with Things were better then. It also was apparent that the older people in this community remember (or perhaps reconstruct) the past in the context of their present living situation. This became the leading theme in my study and is also the background against which I had formulated my research questions. However this study not only focused on the impact of the high incidence of violence on the community of older people but also essentially looked at elderly residents&rsquo / everyday lived experiences in Belhar. The research sample consisted of twenty elderly residents and four key informants. The latter provided mainly infrastructural data on the community. Primary data was collected by using ethnographic techniques of inquiry which included participant observation and unstructured interviews. Results revealed that older people occupy a liminal space both in the community and in their households. I also found that the elderly stroke victim is twice silenced and marginalized due to the constraints brought on by their chronic illness and their status as an older person in the community.

The Black community within the foster care system has received minimal empirical attention as it pertains to the impact of media intake, caregiver navigation and levels of self-perceptions. A quantitative, cross-sectional study was conducted to examine the correlations between these variables. The nonrandom snowball sampling method was used to recruit 18 Black women, who were eighteen years old or older and former foster youth, to participate in a self-administered online survey. The nonparametric test, Spearman's Rho, was chosen to analyze both research questions due to the sample size violating a Pearson's Correlation assumption. The relationship between media intake and levels of self-perceptions had a p value of .394, whereas, the relationship between caregiver navigation and levels of self-perceptions had a p value of .109. Therefore, the findings for research question one revealed that there were no correlations between levels of self-perceptions and media intake. Similarly, research question two identified no significant relationships among the levels of self-perceptions and caregiver navigation. This study highlights the importance for additional research, as Black foster care youth are an underserved population with many unidentified needs; this includes that of parental guidance to heighten self-perceptions and buffer the potentially negative impact of the media.

A vulnerabilidade é uma condição presente no envelhecimento que pode se manifestar em diferentes dimensões. Ampliar a discussão sobre esse conceito poderá contribuir com a construção de políticas públicas mais abrangentes e adequadas às necessidades das pessoas idosas. Este estudo teve como objetivo traçar o perfil das condições de vida e saúde dos idosos física e socialmente vulneráveis residentes no Município de São Paulo e a associação dessas condições com os desfechos: declínio funcional, fragilidade e óbito. Esta pesquisa é parte do Estudo SABE - Saúde, Bem-estar e Envelhecimento e caracteriza-se como longitudinal, descritiva, exploratória, analítica e de caráter quantitativo. A amostra compôs-se de 2.143 idosos entrevistados em 2000 dos quais 1.115 foram reavaliados em 2006, sendo a diferença devido à obitos, mudanças, institucionalização, não localização e recusas. As pessoas idosas fisicamente vulneráveis foram identificadas pelo Vulnerable Elders Survey (VES-13), traduzido, adaptado e com suas propriedades de medida analisadas para utilização em nosso meio. Para a avaliação da vulnerabilidade social, utilizou-se o Índice Paulista de Vulnerabilidade Social (IPVS). A análise de regressão linear utilizou o Qui-Quadrado de Pearson ajustado pelo Rao Scott para amostras complexas, considerando o nível de confiança de 95%. Os desfechos foram analisados por meio de Regressão Múltipla, utilizando a técnica stepwise forward. A validação do VES-13 mostrou que o instrumento é confiável no que diz respeito à repetibilidade e à consistência interna de suas medidas. A vulnerabilidade física esteve presente em 38,1% dos idosos em 2000 e 52,7% em 2006. A maioria dos idosos residia em contextos de muito baixa e baixa vulnerabilidade social (71,9%). Os idosos fisicamente vulneráveis apresentaram maior distribuição na categoria média, alta e muito alta vulnerabilidade social (43,1% em 2000 e 60,1% em 2006). A vulnerabilidade física foi associada à fragilidade (92,8%; p=0,000), redução da capacidade funcional para atividades de vida diária básicas (65,7%;p=0,000) e instrumentais (57,2%; p=0,000) e óbito (57,2%; p=0,000). A vulnerabilidade social foi associada apenas ao óbito (p=0,014). O idoso fisicamente vulnerável tem maior chance de se tornar frágil (OR=2,61; p=0,000), dependente em atividades básicas (OR=2,48; p=0,001) e instrumentais de vida diária (OR=1,46; p=0,051) e de se tornar socialmente vulnerável (OR=1,50; p=0,005). O idoso socialmente vulnerável tem maior chance de óbito (OR=1,58; p=0,024) e de se tornar fisicamente vulnerável (OR=1,54; p=0,005). Pode-se concluir que existe associação entre vulnerabilidade física e vulnerabilidade social. Os desfechos, declínio funcional e fragilidade foram associados à vulnerabilidade física, e o desfecho óbito mostrou-se associado à vulnerabilidade social. Tais achados reforçam a importância da compreensão da vulnerabilidade nos idosos, permitindo a identificação e a priorização de recursos para o acompanhamento daqueles com maiores possibilidades de desfechos adversos. / The vulnerability is a condition found in aging that can appear in several dimensions. Extending the discussion about this concept can contribute to the construction of public policies comprehensive and appropriate to the needs of the elderly. The aims of this study was to identify and describe the living and health conditions of elderly physical and socially vulnerable in the city of São Paulo, Brasil and verify association with the outcomes: functional decline, frailty and death, six years later. This research is part of a project called Health, Well-being and Aging (SABE Study) described as longitudinal, descriptive, exploratory, analytical and quantitative study. The sample was composed by the 2.143 elders interviewed in 2000 of which 1.115 were reevaluated in 2006. The difference due to deaths, moves, institutionalization, non finding and refusal. The physically vulnerable elders were identified thorough the Vulnerable Elders Survey (VES-13), translated and culturally adapted for Brazilian Portuguese. The social vulnerability was identified thought the Paulista Index of Social Vulnerability (IPVS). Rao-Scott tests weighted to account for sample design effects were used to evaluate associations of the variable origin with the independent variables considering the level of confidence of 95%. Multiple Regression with stepwise forward technique was used to analyse the outcomes. Good reliability and face validity were demonstrated by this Brazilian Portuguese version of the VES-13. The physical vulnerability was presented in 38,1% of the elders in 2000 and 52,7% in 2006. Most of the elders lived in a context of very low and low social vulnerability (71,9%). The physically vulnerable elders presented higher distribution in the medium, high and very high social vulnerability category (43,1% in 2000 and 60,1% in 2006). The physical vulnerability was associated to frailty (92,8%; p=0,000), functional decline for basic (65,7%; p=0,000) and instrumental (57,2%; p=0,000) activities of daily living and death (57,2%; p=0,000). The social vulnerability was only associated with death (p=0,015). The physically vulnerable elderly has risk to become frail (2,61; p=0,000), to suffer functional decline for basic (2,48; p=0,001) and for instrumental (1,46; p=0,051) activities of daily living and has risk of social vulnerability(1,50; p=0,005). The socially vulnerable elderly has risk of death (1,58; p=0,024) and risk to become physically vulnerable (1,54; p=0,005). Thus, physical vulnerability and social vulnerability were associated and the outcomes functional decline and frailty were associated with physical vulnerability, while the outcome death was associated with social vulnerability. These findings suggest the importance of understanding the vulnerability in elderly, allowing the identification and prioritization of resources for the monitoring of those with higher possibility of adverse outcomes.

O trauma desponta como mais uma doença a que os idosos podem estar vulneráveis. Além disso, tendo em vista o aumento desta faixa etária, é possível que, em breve, a realidade do trauma nesta população também cresça. Dessa forma, é fundamental que os profissionais dos serviços de saúde conheçam as alterações que ocorrem com o processo de envelhecimento e as características específicas do trauma, com a finalidade de melhor assistir esta população. Assim, os objetivos deste estudo foram: identificar o perfil sociodemográfico de idosos, vítimas de trauma; caracterizar as doenças preexistentes e os medicamentos em uso; descrever as características do trauma e sua evolução; verificar a existência de associação entre variáveis sociodemográficas, doenças preexistentes, características e evolução do trauma; verificar a existência de correlação entre dias internados em CTI e ISS. Trata-se de um estudo não experimental, retrospectivo e exploratório. Realizado a partir da análise de dados de natureza secundária contidos em um banco de dados do Núcleo Hospitalar de Epidemiologia do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, referentes às notificações dos pacientes, vítimas de trauma, atendidos na Unidade de Emergência, deste hospital, no período de 2008 a 2010. Dessa forma, a coleta dos dados seguiu as informações contidas no referido banco, além da busca nos prontuários médicos para identificação de doenças preexistentes, do uso de medicamentos em domicílio e das complicações clínicas após o trauma. Foram estudados 131 idosos, vítimas de trauma, média de idade 69,9 anos (s=7,7); 73,3% eram homens; 55,1%, casados; 54,7%, aposentados; 65,6% possuíam doenças preexistentes, sendo 38,9% hipertensão arterial sistêmica e 19,8% etilismo, média de doenças 2,3 (s=1,4); 48,9% tomavam medicação em domicílio, média 3,2 medicamentos (s=2,3). Quanto às características do trauma, para 31,3%, o mecanismo de trauma foi queda e para 28,2%, pedestre; 83,2% por trauma contuso; 59,5% possuíam lesão em cabeça/pescoço, 45,8% em extremidades e ossos da pelve, média 1,8 (s=1,0); 44,3% obtiveram ISS entre 9 e 15 (trauma moderado) e 30,5% ISS de 25 ou mais (trauma muito grave); 80,2% apresentaram TRISS entre 51% ou mais (francas condições de se evitar o óbito). Com relação à evolução do trauma, 30,5% internaram em CTI, média de 4,2 dias; 62,6% desenvolveram complicações clínicas, sendo 43,5% infecciosas e 30,5% cardiovasculares; 46,1% foram submetidos à cirurgia ortopédica; 66,4% sobreviveram ao trauma, 47,3% receberam alta hospitalar com limitações moderadas e 33,6% faleceram, sendo 36,4% por traumatismo cranioencefálico e 22,7% por sepse. Houve associação entre mecanismo do trauma e doença preexistente (p=0,01) e associação entre mecanismo do trauma e sexo (p=0,03); a presença de doenças aumentou em 3,10 a chance para desenvolver complicações em relação aos que não apresentavam doenças (p=0,02); para os internados em CTI, a chance de ter complicações aumenta em 28,2 (p<0,01); conforme aumenta o índice de gravidade do trauma, maiores são as chances de complicações, odds = 3,07 entre ISS 16 e 24 (grave) e odds = 6,50 com ISS 25+ (muito grave) em relação ao ISS 9 a 15 (moderado); para idosos com complicações, a chance de morte aumenta em 5,56, quando comparados com aqueles que não apresentaram (p<0,01); para idosos com TRISS <50% (sobrevida inesperada), a chance de óbito foi de 10,13 em relação àqueles com TRISS >=50% (morte evitável) (p<0,01); a correlação entre os dias de internação no CTI e os escores do ISS foi fraca e positiva (r=0,18), indicando que quanto maior o número de dias de internação no CTI maiores são os índices de gravidade do trauma (p=0,03). O conhecimento das características e da evolução do trauma pode possibilitar aos profissionais de saúde o planejamento de medidas preventivas, além de viabilizar melhor atendimento aos idosos na atenção intra-hospitalar e após a alta, com vistas a melhorar a qualidade de vida. / Trauma emerges as another condition to which elderly individuals are vulnerable. Considering the increase in this population, trauma events are also likely to increase among older individuals. Hence, it is essential that health care providers are aware of changes that may occur with the aging process and the specific characteristics of trauma aiming to better care for this population. This study identifies the sociodemographic profile of elderly trauma victims; characterizes pre-existent diseases and used medications; describes the characteristics of trauma and its progression; verifies potential correlation between days hospitalized in ICU and Injury Severity Score (ISS). This non-experimental, retrospective and exploratory study was based on secondary data collected from a database of the Hospital Epidemiology Center at the Hospital das Clinicas, Medical School, University of São Paulo at Ribeirão Preto concerning reports of elderly trauma victims cared for in the hospital\'s emergency department from 2008 to 2010. Data collection was based on information contained in the database and search on medical charts to identify pre-existent diseases, medication used at home, and clinical complications after the trauma. A total of 131 elderly trauma victims participated in the study: 69.9 years old in average (sd=7.7); 73.3% men; 55.1% married; 54.7% retired; 65.6% with pre-existent diseases: 38.9% systemic arterial hypertension, and 19.8% alcoholism; average of diseases 2.3 (sd=1.4); 48.9% took medication at home, average of 3.2 medications (sd=2.3). In relation to the characteristics of trauma: 31.3% was caused by falls and 28.2% pedestrian; 83.2% was contusion trauma; 59.5% had head and neck injury; 45.8% had limbs and pelvic bones affected, average 1.8 (sd=1.0); 44.3% obtained ISS between 9 and 15 (moderate trauma) and 30.5% ISS was 25 or above (very severe trauma); 80.2% presented Trauma and Injury Severity Score (TRISS) between 51% or above (real conditions to avoid death). In relation to trauma progression, 30.5% was hospitalized in ICU, 4.2 days in average; 62.6% developed clinical complications: 43.5% infections and 30.5% cardiovascular; 46.1% was submitted to orthopedic surgery; 66.4% survived, 47.3% was discharged with moderate impairment and 33.6% died: 36.4% due to brain injury and 22.7% due to sepsis. An association between the mechanism of trauma and pre-existent diseases was found (p=0.01) as well as association between mechanism of trauma and gender (p=0.03). Pre-existent diseases increased 3.10 times the chance of complications comparing to those with no pre-existent diseases (p=0.02). The chances of complications increased 28.2 times for those hospitalized in ICU (p<0.01); the higher the index of trauma severity, the greater the chances of complications, odds = 3.07 between ISS 16 to 24 (severe) and odds = 6.50 with ISS 25+ (very severe) in relation to ISS 9 to 15 (moderate). The chances of dying increased 5.56 times for those with complications compared to those with no complications (p<0.01); chances of death was 10.13 times higher for individuals with TRISS <50% (unexpected survival) in relation to those with TRISS >=50% (evitable death) (p<0.01). Correlation between duration of hospitalization in ICU and ISS scores was weak and positive (r=0.18) indicating that the longer the hospitalization in ICU, the higher the trauma severity index (p=0.03). Knowledge concerning the trauma characteristics and progression can enable health care providers to plan preventive measures and provide better care to elderly individuals both at the hospital and after discharge aiming to improve their quality of life.

Esse estudo tem por objetivo validar o Michigan Alcoholism Screening Test - Geriatric Version (MAST-G) e identificar os problemas relacionados ao uso de bebida alcoólica entre os idosos usuários da Unidade Saúde da Família (USF) do município de São Carlos (SP). O desenho metodológico do estudo é do tipo descritivo de abordagem quantitativa. Os dados foram coletados por meio de um questionário contendo as informações sociodemográficas e o MAST-G, seguindo as etapas de tradução e adaptação transcultural. A amostra foi constituída por 111 pessoas com idade igual ou superior a 60 anos cadastrados na USF do município de São Carlos. Do resultado, a idade média foi de 70 anos, sendo 45% do sexo masculino e 55% do sexo feminino, escolaridade média de 3 anos e 92% residem com a família. O MAST-G apresentou um bom índice de confiabilidade, com Alfa de Cronbach ? = 0,7873 e por meio da curva de ROC mostrou uma boa especificidade e sensibilidade no valor de corte de 5 respostas positivas, corroborando a literatura internacional. Pode-se concluir que o instrumento é de fácil aplicação e pouco intimidativo, além de ser possível averiguar diversas questões acerca do comportamento do beber do idoso e assim, possibilitando um atendimento especializado, pontual para que o idoso tenha uma assistência de qualidade. / This study aims to validate the Michigan Alcoholism Screening Test - Geriatric Version (MAST-G) and to identify the pattern of consumption and alcohol use among elderly users of Family Health Units (USF) in the municipality of São Carlos (SP), Brazil. The methodological design of the study is a descriptive quantitative approach. Data were collected using an instrument that contains sociodemographic information and the MAST-G, following the steps of translation and cultural adaptation. The sample consisted of 111 people aged over 60 years who were enrolled in the USF of São Carlos. The result, the average age was 70 years, 45% male and 55% female, average schooling for 3 years and 92% living with family. The MAST-G had a good level of reliability, with Cronbach\'s alpha ? = 0.7873 and shows a good specificity and sensitivity in cut-off of 5 positive answers, as observed by the ROC curve, in good agreement with the literature. It could be concluded that the instrument is easy to be applied and less intimidating, besides being able to ascertain other questions about the behavior of the life of the elderly so it can allow a specialized service, timely so that the elderly have a better quality of assistance.

Os objetivos deste estudo foram: caracterizar os idosos internados na Clínica Médica de um Hospital Geral Terciário, do interior paulista, segundo: variáveis sociodemográficas, estilo de vida, condições de saúde, acesso aos serviços de saúde e rede de apoio familiar e social; identificar a capacidade cognitiva, a capacidade funcional e a presença de sintomas de depressão desses idosos; verificar a existência de associação entre a variável queda com as variáveis faixa etária, sexo, déficit cognitivo, uso de óculos, hábito de beber e presença de sintomas de depressão; e verificar a existência de associação entre a variável déficit cognitivo com as variáveis faixa etária, sexo e estado conjugal. Trata-se de um estudo não experimental, descritivo e transversal. Realizado com idosos, internados na Clínica Médica, do referido hospital, no período de abril a julho de 2011. Para a coleta de dados, utilizaram-se o Miniexame do Estado Mental (MEEM), uma readaptação do Older Americans Resources and Services (OARS) e a Escala de Depressão Geriátrica (EDG). Foram estudados 105 idosos, média de idade de 73,8 anos (s=8,9); 59,0% eram homens; 62,9% moravam com esposo(a) ou companheiro(a); 47,6% estudaram de um a quatro anos; 90,5% eram aposentados. Quanto ao estilo de vida, 80,0% não fumavam atualmente; 71,4% consumiam bebida alcoólica; 66,7% não praticavam atividade física. Com relação à saúde, 72,4% a autoavaliaram como \"Boa\"; 56,2% tinham diagnóstico de hipertensão arterial e 22,9 de fibrilação atrial; para 78,1% todos os medicamentos eram receitados pelo médico; 91,4% avaliaram sua visão como \"Boa\"; 23,9% faziam uso dos óculos; 39,0% caíram nos últimos 12 meses; 23,8% caíram de três a quatro vezes. Quanto ao acesso aos serviços de saúde e à rede de apoio familiar e social, 96,2% utilizavam Hospital Público e estavam satisfeitos; para 45,7%, o esposo(a) ou companheiro(a) foi a primeira menção para cuidador na presença de incapacidades. Na avaliação cognitiva pelo MEEM, 34,3% apresentaram cognição comprometida. Quanto ao desempenho para as AVDs, no momento da admissão, 81,9% apresentavam algum grau de dificuldade nas ABVDs e 86,7% nas AIVDs; durante a hospitalização, 89,5% e, no momento da alta, 84,8% realizavam as atividades básicas com dificuldades. Os sintomas de depressão estiveram presentes em 54,3% dos idosos, média de 5,4 (s=2,5). Observou-se associação entre a presença de quedas e o uso de óculos (p<0,01) e entre a presença de déficit cognitivo e a faixa etária (p=0,04). A identificação do perfil e das necessidades dos idosos hospitalizados pode subsidiar o planejamento da assistência, com enfoque multiprofissional. / The objectives of this study were to characterize elderly individuals hospitalized in the medical clinic of a tertiary general hospital in the interior of São Paulo, Brazil according to the following socio-demographic variables: lifestyle, health conditions, access to health services and family and social support network; to identify cognitive and functional capacity and depression symptoms among these patients; to verify potential association between the variable \'fall\' with age, gender, cognitive deficit, use of glasses, alcohol consumption, and depression symptoms; and also to verify potential association between the variable \'cognitive deficit\' with age, gender and marital status. This non-experimental, descriptive and cross-sectional study addressed elderly individuals hospitalized in the medical clinic of the mentioned hospital from April to July 2011. The Mini-Mental State Examination (MMSE), a readaptation of Older Americans Resources and Services (OARS), and the Geriatric Depression Scale (GDS) were used to collect data. A total of 105 elderly individuals aged 73.8 years old in average (s=8.9) participated in the study; 59.0% were men; 62.9% lived with spouses or partners; 47.6% studied from one to four years; 90.5% were retired. In relation to lifestyle, 80.0% did not smoke at the time; 71.4% consumed alcohol; 66.7% did not exercise. In relation to their health condition, 72.4% reported it was \"good\"; 56.2% had hypertension, and 22.9 had atrial fibrillation; 78.1% had all medications prescribed by a physician; 91.4% reported their eyesight was \"good\"; 23.9% wore glasses; 39,0% fell in the last 12 months; 23.8% fell from three to four times. In regard to access to health services and family and social support network, 96.2% used public hospitals and were satisfied; 45.7% reported the spouse or partner would be the primary caregiver in case of disability. A total of 34.3% presented compromised cognition in the MMSE cognitive evaluation. In relation to the performance of ADLs at the time of admission, 81.9% presented some level of difficulty in BADLs and 86.7% in IADLs; 89.5% and 84.8% performed basic activities with difficulty during hospitalization and at time of discharge, respectively. Depression symptoms were observed in 54.3% of the elderly individuals, average of 5.4 (s=2.5). Association between falls and the use of glasses (p<0.01) and between cognitive deficit and age (p=0.04) was observed. The identification of the profile and needs of hospitalized elderly individuals can support planning of care with a multidisciplinary focus.

Introdução: O uso de métodos prescritivos na programação do aparelho de amplificação sonora individual (AASI) tem como principal objetivo a aplicação da amplificação recomendada aos usuários, melhorando a audibilidade de sons suaves e fala conversacional e garantindo conforto para sons fortes. Diferentes métodos, no entanto, podem ter diferentes objetivos de ajuste. Considerando as modificações nas estruturas do meato acústico externo do indivíduo idoso, se faz necessário um direcionamento do processo de seleção e adaptação do AASI nessa população, propondo um protocolo individualizado e que leve em conta os ajustes recomendados pelos métodos de prescrição. Objetivo: Analisar comparativamente os métodos prescritivos NAL-NL2 e DSL v5.0a de acordo com programação individualizada do AASI para o indivíduo idoso com deficiência auditiva. Metodologia: Participaram do estudo 60 indivíduos idosos com deficiência auditiva. Após a assinatura do Termo de Consentimento Livre e Esclarecido, os participantes do estudo foram submetidos à realização da meatoscopia, mensuração da RECD (Real Ear to Coupler Difference) e programação individualizada do AASI com os métodos prescritivos NAL-NL2 e DSL v5.0a. A verificação do desempenho com cada prescrição foi realizada por meio das medidas da REAR (Real Ear Aided Response), cálculo do SII (Speech Intelligibility Index) e teste HINT (Hearing In Noise Test). A análise estatística comparativa dos dados obtidos nas duas situações foi realizada por meio dos testes t pareado e de Wilcoxon. Resultados: Houve diferença estatisticamente significante com melhor desempenho do método NAL-NL2 na avaliação da REAR nas faixas de frequências baixas e altas para sons de entrada de média e forte intensidade, na faixa de frequência alta para sons de entrada de fraca intensidade, e no cálculo do índice de inteligibilidade de fala para sons de entrada fracos. O método DSL v5.0a apresentou melhores resultados com diferença estatisticamente significante na avaliação da REAR em frequências médias para sons de entrada médios, em frequências baixas e médias para sons de entrada fracos, no cálculo do índice de inteligibilidade de fala para sons de entrada médios e fortes, e no teste HINT nas situações de silêncio e ruído. Conclusões: Não foi possível estabelecer um método mais adequado em todos os parâmetros avaliados. Na avaliação da percepção de fala houve uma diferença importante com melhor resultado para o método DSL v5.0a, o que oferece uma alternativa satisfatória em relação à percepção de fala no silêncio e no ruído e viabiliza a utilização deste método com a população idosa. A continuidade de estudos envolvendo o indivíduo idoso é de extrema relevância, considerando as características individuais desta população e a necessidade de estabelecer uma prática clínica específica para a mesma. O estabelecimento de diferentes perfis audiológicos dentre esta população é importante para determinar qual a melhor conduta para cada um no contexto da programação e adaptação do AASI, conforme todas as etapas e parâmetros a serem levados em consideração para um melhor resultado. / Introduction: The use of prescriptive methods in the hearing aids programming has as main objective the application of the recommended amplification to the users, improving the audibility of soft sounds and conversational speech and guaranteeing comfort for loud sounds. Different methods, however, may have different adjustment goals. Considering the modifications in the structures of the external acoustic meatus of the elderly patient, an orientation of the hearing aids selection and adaptation process in this population is necessary, proposing an individualized protocol that take into account the adjustments recommended by the prescription methods. Objective: To comparatively analyze the NAL-NL2 and DSL v5.0a prescriptive methods according to the hearing aids individualized programming for the elderly with hearing impairment. Methodology: The study included 60 elderly individuals with hearing impairment. After signing the Free Informed Consent Form, the participants of the study underwent a meatoscopy, RECD (Real Ear to Coupler Difference) measurement and hearing aids individualized programming with the prescriptive methods NAL-NL2 and DSL v5.0a. Performance verification for each prescription was performed using REAR measurements (Real Ear Aided Response), SII calculation (Speech Intelligibility Index) and HINT (Hearing In Noise Test). Comparative statistical analysis of the data obtained in both situations was performed using the paired t test and the Wilcoxon test. Results: There were statistically significant differences with a better performance of the NAL-NL2 method in the REAR evaluation in low and high frequency bands for medium and loud intensity input sounds, in the high frequency range for low intensity input sounds, and in the speech intelligibility index calculation for soft input sounds. DSL v5.0a presented better results with statistically significant difference in the REAR evaluation in medium frequencies for medium input sounds, in low and medium frequencies for soft input sounds, in the speech intelligibility index calculation for medium and loud input sound, and in the HINT test in silence and noise situations. Conclusions: It was not possible to determine a most suitable method for all evaluated parameters. On the speech perception evaluation there was an important difference having the DSL v5.0a method achieved better results, which offers a satisfactory alternative regarding speech perception in silence and noise conditions and allows the use of this method with the elderly population. The continuity of studies involving the elderly is extremely relevant considering the individual characteristics of this population and the need to establish a specific clinical practice for them. The establishment of different audiological profiles among this population is important to determine the best conduct for each one in the context of hearing aids programming and adaptation, according to all the steps and parameters to be taken into account for a better result.