Made available in DSpace on 2015-04-14T13:54:05Z (GMT). No. of bitstreams: 1 452219.pdf: 1453324 bytes, checksum: 98a507fc83ff16002d7bfddc8094c849 (MD5) Previous issue date: 2013-10-17 / Fragility Syndrome Aging is a clinical syndrome that causes damage in the physical, psychological and social, leading to functional decline being determined by social risk factors, biological, environmental and psychological. Objective: To detect the presence of the syndrome of frailty in elderly in patients and the definition of fragility in the perception of professional nursing in the emergency department. Methodology: A quantitative cross-sectional and elderly aged over 60 years and nurses of the Emergency Department of the S?o Lucas Hospital. Scale was applied to Edmonton to fragility and specific questionnaire for the elderly and Teixeira Scale for nurses. The data were analyzed using the Student t test, chi-square test or the Fisher exact Poisson regression model. The significance level was 5%. The study was approved by the Research Ethics Comeettee of PUCRS under number 139242. Results: Both groups showed a mean age of 72.81?8.29 years, ranging from 60 to 92 years, 55.2% male, 41.1% were married, 81% live with family, 72.4 % retirees or pensioners, 87.7% of patients with previous disease and with an average of 3.81 medications per day. The majority of elderly patients (66.26%) is situated in the range classed as moderate and severe weakness, 25 (15.34%) with mild weakness, 29 (17.79%) with moderate brittleness and 79 (48,47% ) with severe weakness. The factors associated with frailty were age (PR = 1.21, 95% CI: 1.03 to 1.42), marital status (PR = 1.19, 95% CI :1,02-1, 37), use of medications (PR = 1.16, 95% CI 1.02 to 1.31), infectious diseases (PR = 1.17, 95% CI 1.03 to 1.32), neoplasms (PR = 1.22, 95 %: 1.06 to 1.42) and hospital stay of one or two times in the last year (PR = 1.35, 95% CI 1.15 to 1.58) (PR = 1.30, 95% CI: 1, 10 to 1.53). Regarding the sample of 12 nurses, there was a group of average age 29?3.3 years, ranging between 23 and 34 years, with 83.3% female, 58.3% single, 66.7% natural from Porto Alegre city and 58.3% without post graduation completed. Nurses to be fragile, should be the criterion vulnerability to environmental stress, disease and falls (100%), have comorbidities (91.7%), at an advanced age (83.4%) and perform fewer social activities (75%). Regarding the characteristics of fragility must be unintentional weight loss (100%), self-reported fatigue (75%), decreased grip strength (66.7%), reduction of physical activity (91.7%), cognitive impairment (83.3%), depression (100%) and reduction of social relations (100%). Consequences of weakness involving the decline of functional capacity (100%), hospitalization (58.3%), disability (58.3%) and death (58.3%). Conclusion: The fragility is important public health problem and demand more studies focusing on its definition targeting assistance on the part of health professionals with quality and effectiveness. / A S?ndrome da Fragilidade do Idoso ? uma s?ndrome cl?nica que gera preju?zos nos dom?nios f?sico, psicol?gico e social, levando ao decl?nio funcional sendo determinada por fatores de risco sociais, biol?gicos, ambientais e psicol?gicos. Objetivo: Detectar a presen?a da s?ndrome de fragilidade nos idosos internados e a defini??o de fragilidade na percep??o do profissional de enfermagem no Pronto Atendimento. Metodologia: Estudo quantitativo e transversal com idosos com idade igual ou superior a 60 anos e profissionais enfermeiros do Pronto Atendimento do Hospital S?o Lucas da PUCRS. Foi aplicada a Escala de Edmonton para fragilidade e question?rio espec?fico para os idosos e a Escala de Teixeira para os enfermeiros. Os dados foram analisados atrav?s do teste t de Student, teste qui-quadrado de Pearson ou exato de Fisher pelo modelo de Regress?o de Poisson. O n?vel de signific?ncia adotado foi de 5%. O estudo foi aprovado pelo Comit? de ?tica em Pesquisa da PUCRS sob o n?mero 139242. Resultados: Os idosos mostraram uma m?dia de idade de 72,81?8,29 anos, variando de 60 a 92 anos, 55,2% do sexo masculino, 41,1% casados, 81% residem com a fam?lia, 72,4% aposentados ou pensionistas, 87,7% portadores de doen?a pr?via e com uma m?dia de 3,81 medicamentos por dia. A maior parte dos idosos (66,26%) est? situada na faixa classificada como fragilidade moderada e severa, 25 (15,34%) com fragilidade leve, 29 (17,79%) com fragilidade moderada e 79 (48,47%) com fragilidade severa. Os fatores associados ? fragilidade foram idade (RP=1,21; IC 95%:1,03 1,42), estado civil (RP= 1,19; IC95%:1,02-1,37), uso de medica??es (RP=1,16; IC95%:1,02 1,31), doen?as infecciosas (RP= 1,17; IC95%:1,03 1,32), neoplasias (RP= 1,22; IC95%: 1,06 1,42) e interna??o de uma ou duas vezes no ?ltimo ano (RP=1,35; IC95%: 1,15 1,58) (RP= 1,30; IC95%: 1,10 1,53). Em rela??o ? amostra dos 12 enfermeiros, verificou-se uma idade m?dia et?ria de 29?3,3 anos, variando entre 23 e 34 anos, com 83,3% do sexo feminino, 58,3% solteiros, 66,7% naturais da cidade de Porto Alegre e 58,3% sem p?s gradua??o conclu?da. Para os enfermeiros para ser fr?gil, deve haver o crit?rio vulnerabilidade aos estresses ambientais, patologias e quedas (100%), apresentar comorbidades (91,7%), ter idade avan?ada (83,4%) e realizar poucas atividades sociais (75%). Quanto ?s caracter?sticas de fragilidade deve haver perda de peso n?o intencional (100%), auto-relato de fadiga (75%), diminui??o da for?a de preens?o palmar (66,7%), redu??o das atividades f?sicas (91,7%), d?ficit cognitivo (83,3%), depress?o (100%) e diminui??o das rela??es sociais (100%). As consequ?ncias da fragilidade envolvem o decl?nio da capacidade funcional (100%), hospitaliza??o (58,3%), incapacidade (58,3%) e o ?bito (58,3%). Conclus?o: A fragilidade ? importante problema de sa?de p?blica e demanda maiores estudos com foco na sua defini??o visando uma assist?ncia por parte dos profissionais de sa?de com qualidade e efetividade.

Submitted by PPG Gerontologia Biom?dica (geronbio@pucrs.br) on 2018-05-14T11:59:04Z No. of bitstreams: 1 MATTOS_CARINE_ MAGALH?ES_ ZANCHI_ DE_TESE.pdf: 3553557 bytes, checksum: d8c79ba72829ccdf3f56f89af1d23a2b (MD5) / Approved for entry into archive by Sheila Dias (sheila.dias@pucrs.br) on 2018-05-17T17:05:36Z (GMT) No. of bitstreams: 1 MATTOS_CARINE_ MAGALH?ES_ ZANCHI_ DE_TESE.pdf: 3553557 bytes, checksum: d8c79ba72829ccdf3f56f89af1d23a2b (MD5) / Made available in DSpace on 2018-05-17T17:16:28Z (GMT). No. of bitstreams: 1 MATTOS_CARINE_ MAGALH?ES_ ZANCHI_ DE_TESE.pdf: 3553557 bytes, checksum: d8c79ba72829ccdf3f56f89af1d23a2b (MD5) Previous issue date: 2017-12-15 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / The conditions and way of life of street people deserve to be studied due to the complexity of phenomena such as the demographic transition in the street, the difficulty of social reintegration, structural unemployment, social deconstruction and the devaluation of Individual, setting up this layer as who lives in extreme misery, unlinked from social production, and who is dedicated to marginal activities (FERNANDES; RAIZER; BR?TAS, 2007). This study will contribute to a gap in the area of knowledge, because studies on elderly people in the street are incipient. This is a descriptive and qualitative study whose general objective is to analyze the conditions, way of life and the repercussions of aging for people over sixty years of age who live in a street situation in Porto Alegre. Nineteen elderly people were selected on the street, by simple random sampling and theoretical closure by theoretical saturation, interviewed in the FASC reception services and also on the streets in the period from 2015 to 2017, respecting the ethical precepts of Resolution 466/12. Discursive textual analysis was performed as proposed by Roque Moraes. The majority of those surveyed are between 60 and 69 years old, are black or brown, have incomplete elementary education, work or do not have income, stay in the streets and are in this condition for a period between 1 and 5 years, due to family disagreements and difficult financial conditions. They declare being on the streets for lack of opportunities and access to fundamental rights. Survival strategies include the use of sheltered places, the use of shelter (shelter, shelter...), the link with acquaintances who donate clothes and food, informal work and, in the case of women, the relationship with a life partner. For people on the street, quality of life is having access to what they do not have, such as health, food, family / caretaker / wife and a "little house" to live in. They express the structural violence and intersectionality experienced since birth, the neglect of the State in the lack of access to a good birth, a school, followed by the experience of child labor, non-access to formal work, with gender markers for being a woman, ethnic because it is black, territory for being on the street, social for having low or no income and so on. Institutional violence is expressed in the looks and care they receive or through neglect, and gender violence is so common that it significantly reduces the number of women on the street, so they look for other ways of surviving. They report that they would have quality of life if they had another story, with access to their rights as a home, work, health, bonds, food and water. The discourses of daily suffering and violations also affect them directly. While they experience deprivation of rights, they believe that there is no quality except the faith that sustains them. The study concluded that it is important to create spaces to discuss these issues at the national level, in the academy and in the practice of public policies, guaranteeing the basic rights and giving a voice so that this population can express their reality of life, without prejudice or stigmas common to common sense. Providing fairness of basic rights for the entire population, as well as the national structural preparation to meet this new demand for street elderly, is essential for health promotion and active aging for all, including those living on the margins of society. / As condi??es e modo de vida das pessoas em situa??o de rua merecem ser estudadas devido ? complexidade de fen?menos como a transi??o demogr?fica na rua, a dificuldade de reinser??o social, o desemprego estrutural, a desconstru??o social e a desvaloriza??o do indiv?duo, configurando essa camada como quem vive na mis?ria extrema, desvinculada da produ??o social, e que se dedica a atividades marginais (FERNANDES; RAIZER; BR?TAS, 2007). Este estudo ir? contribuir para suprir uma lacuna na ?rea do conhecimento, pois estudos sobre idosos em situa??o de rua s?o incipientes. Este ? um estudo de natureza descritiva e abordagem qualitativa cujo objetivo geral ? compreender as condi??es, o modo de vida e as repercuss?es do envelhecimento para pessoas com mais de sessenta anos de idade, que vivem em situa??o de rua em Porto Alegre. Foram selecionadas 19 pessoas idosas em situa??o de rua, por amostragem aleat?ria simples e fechamento amostral por satura??o te?rica, entrevistadas nos servi?os de acolhimento da FASC e tamb?m nas ruas no per?odo de 2015 a 2017. Foi realizada an?lise textual discursiva conforme proposta por Roque Moraes. A maior parte dos pesquisados t?m entre 60 e 69 anos, s?o negros ou pardos, t?m ensino fundamental incompleto, trabalham ou n?o t?m renda, ficam nas ruas e est?o nessa condi??o h? um per?odo entre 1 a 5 anos, em decorr?ncia de desentendimentos familiares e dif?ceis condi??es financeiras. Declaram estar nas ruas por falta de oportunidades e acesso aos direitos fundamentais. T?m como estrat?gias de sobreviv?ncia o recurso a locais movimentados, o uso dos dispositivos de acolhimento institucional, o v?nculo com conhecidos que doam roupas e alimentos, o trabalho informal e, no caso das mulheres, o relacionamento com um companheiro. Para as pessoas em situa??o de rua, qualidade de vida ? ter acesso ?quilo que n?o possuem, como sa?de, alimenta??o, fam?lia/cuidador/esposa e uma ?pecinha? para morar. Expressam a viol?ncia estrutural e a interseccionalidade vivenciadas desde o nascimento, na neglig?ncia do Estado, na falta de acesso ?s pol?ticas p?blicas de trabalho, educa??o, sa?de, habita??o, entre outras. Suas experi?ncias sociais s?o influenciadas tamb?m por marcadores de diferen?a de g?nero, de etnia, de territ?rio, de classe social, de condi??o f?sica, entre outros. A viol?ncia institucional se expressa nos atendimentos que recebem ou pela neglig?ncia e a viol?ncia de g?nero ? t?o comum que chega a reduzir significativamente o n?mero de mulheres em situa??o de rua, de forma que procuram quaisquer outras maneiras de sobreviv?ncia. Relatam que teriam qualidade de vida se tivessem uma outra hist?ria, com acesso aos seus direitos b?sicos de cidadania. Enquanto vivenciam a priva??o de direitos, acreditam que n?o h? qualidade de vida, exceto a f? que os mant?m. O estudo concluiu que ? importante que se criem espa?os para discutir essas quest?es a n?vel nacional, na academia e no ?mbito das pol?ticas p?blicas, dando voz para que essa popula??o expresse suas demandas e que o Estado possa garantir os direitos b?sicos dessa popula??o, ponto fundamental para promo??o de um envelhecimento ativo.