Thesis (Ph. D. (Education))--Rhodes University, 2006.

Thesis (MNutr (Interdisciplinary Health Sciences. Human Nutrition))--University of Stellenbosch, 2009. / Embargo expiry date: 2010-07-31 plt 2010 / ENGLISH ABSTRACT: The prevalence of chronic diseases of lifestyle such as cardiovascular disease, cancer, type 2 diabetes mellitus and obesity are increasing worldwide due to changes in lifestyle patterns, including changes in the food consumption patterns of consumers. There are numerous players who need to be involved in addressing current lifestyle patterns and in encouraging positive behaviour change. Food companies have a role in evaluating the composition of the products that they offer, as well as in educating consumers with regard to healthy eating practices through both the on-pack information that they supply and in their nutrition strategies and programmes. The main objective of the study was to investigate the nutrition strategies that food companies in South Africa use to communicate with the consumers and to compare it with the knowledge, attitudes and practices of the consumers towards the nutrition information that they receive. The secondary objective was to develop guidelines for food companies in their promotion of the prevention of chronic diseases of lifestyle. Methodology The study population consisted of a sample of 7 food companies operating in South Africa and a sample of 230 South African consumers. Data were collected through test questionnaires aimed at each specific study population. The data were analysed statistically for each study population and the data between the two study populations were compared. Results Most food companies that participated stated that they have a nutrition strategy which outlines their consumer communication policy, but none of these were made available to the researcher. Seventy-one percent of the food companies also indicated that they address chronic diseases of lifestyle in their nutrition strategies, with cardiovascular disease being the main focus. The medium used most frequently by food companies for nutrition education of the consumer is the food label. The majority of food companies agree that they do have a responsibility towards the education of the consumer, but stated that it is not solely their responsibility. Ninety-six percent of consumers read (always or sometimes) the labels of food products when making a purchase. The older the consumer, the more unlikely they are to read the ingredients statement on the label. Consumers are most concerned with cardiovascular disease when purchasing food products. Ninety-five percent of consumers agreed that food companies have a responsibility towards them with regard to nutrition education. The consumers indicated that they prefer food labels and television as the medium for nutrition education, but that they trust doctors and nutritionists the most to relay nutrition messages. Conclusion Consumer education on the prevention of chronic diseases of lifestyle is essential if the behaviour change, necessary to address their rising prevalence, is to become a part of consumers’ lifestyles. Food companies should be actively involved with consumer education pertaining to healthy eating and healthy lifestyle habits. Communication with regard to nutrition education is critical and should be consistent with an integrated approach involving all the role players including the food industry, the Department of Health (DOH) and the Department of Education (DOE). / AFRIKAANSE OPSOMMING: Die prevalensie van kroniese lewensstyl siektes soos hartvatsiektes, kanker, tipe 2 diabetes mellitus en vetsug is wêreldwyd aan die toeneem weens ’n verandering in die lewenstyl van verbruikers wat ’n weer ‘n verandering in eetgewoontes teweeg bring. Daar is verskeie rolspelers betrokke wat ’n bydrae kan lewer om die huidige lewensstyl patrone van verbruikers aan te spreek en om positiewe gedragsveranderinge te bevorder. Voedselmaatskappye speel ‘n tweeledige rol: deur die samestelling van voedselprodukte wat hulle versprei te evalueer, en deur die verbruiker op te voed oor gesonde eetgewoontes. Maatskappye se voedingstrategieë en programme, asook die verpakking van produkte, kan gebruik word om voedingsinligting te verskaf. Die studie se hoof doelwit was om die voedingstrategieё te ondersoek wat deur voedselmaatskappye in Suid Afrika gebruik word en om dit te vergelyk met die kennis, houding en praktyke van die verbruiker teenoor voedingsinligting wat hulle ontvang. Die sekondêre doelwit was om riglyne vir voedselmaatskappye te ontwikkel ter ondersteuning van die maatskappye se inisiatiewe om kroniese lewensstyl siektes te voorkom. Metodologie Die studiepopulasie het bestaan uit ’n steekproef van 7 voedselmaatskappye wat in Suid Afrika werksaam is en ‘n steekproef van 230 Suid Afrikaanse verbruikers. Data is ingesamel deur twee uitgetoetsde vraelyste te gebruik wat spesifiek geteiken was vir elke studie populasie. Die data is statisties geanaliseer vir elke studie populasie en die studie populasies is ook met mekaar vergelyk. Resultate Die meeste voedselmaatskappye wat deelgeneem het aan die studie verklaar dat hulle ‘n voedingstrategie het wat die wyse waarop daar met die verbruiker kommunikeer word uitstippel, nogtans was geeneen van die voedingstrategieë beskikbaar gestel aan die navorser nie. Een en sewentig persent van die voedselmaatskappye het ook aangedui dat kroniese lewensstyl siektes aangespreek word in hul voedingstrategieë en dat daar gefokus word op hartvatsiektes. Voedselmaatskappye gee voorkeur aan die voedseletiket as medium vir voedingvoorligting aan die verbruiker. Die meeste voedselmaatskappye het saamgestem dat hul wel ‘n verantwoordelikheid het teenoor die verbruiker ten opsigte van voedingvoorligting, maar beskou dit nie as uitsluitlik hul verantwoordelikheid nie. Ses en negentig persent van die verbruikers lees voedsel etikette (altyd of soms) wanneer hul aankope doen. Dit blyk dat die ouer verbruiker minder geneig is om die bestanddelelys te lees. Verbruikers is oorwegend bekommerd oor hartvatsiektes wanneer hulle voedselaankope doen. Vyf en negentig persent van die verbruikers stem saam dat voedselmaatskappye ‘n verantwoordelikheid het teenoor verbruikers ten opsigte van voedingvoorligting. Die verbruikers gee voorkeur aan die voedsel etiket en televisie as mediums vir voedingvoorligting, maar hul vertrou meestal op dokters en voedingkundiges om die voedingboodskappe oor te dra. Gevolgtrekking Om gedragsverandering by verbruikers mee te bring met die oog daarop om die toename in kroniese lewensstyl siektes aan te spreek, is dit essensiëel om die verbruiker toe te rus met die nodige kennis oor die voorkoming van kroniese lewenstyl siektes. Voedselmaatskappye behoort aktief betrokke wees by verbruiker opvoeding oor gesonde leef- en eetgewoontes. Kommunikasie ten opsigte van voedingvoorligting moet konsekwent wees en ‘n geїntegreerde benadering moet deur alle rolspelers gevolg word, insluitende voedselmaatskappye, die Departement Gesondheid en die Onderwysdepartement.

93f. / Submitted by Suelen Reis (suziy.ellen@gmail.com) on 2013-04-04T12:44:24Z No. of bitstreams: 1 Olivia%20Almeida.pdf: 986220 bytes, checksum: 9a6cb323a6ec4e11aae4744cdf8cda54 (MD5) / Approved for entry into archive by Rodrigo Meirelles(rodrigomei@ufba.br) on 2013-04-09T16:21:03Z (GMT) No. of bitstreams: 1 Olivia%20Almeida.pdf: 986220 bytes, checksum: 9a6cb323a6ec4e11aae4744cdf8cda54 (MD5) / Made available in DSpace on 2013-04-09T16:21:03Z (GMT). No. of bitstreams: 1 Olivia%20Almeida.pdf: 986220 bytes, checksum: 9a6cb323a6ec4e11aae4744cdf8cda54 (MD5) Previous issue date: 2009 / Este é um estudo que teve por objetivo compreender os significados de ser diabéticos tipo 2. O estudo exploratório­descritivo, com abordagem qualitativa foi realizado em um ambulatório de diabetes, privado, na cidade de Salvador­BA, no período de Janeiro a Julho de 2008, com 15 pacientes que tinham diabetes tipo 2 há mais de 1 ano e concordaram em participar do estudo. Utilizou como instrumento de coleta de dados um roteiro para entrevista semi­estruturada e análise documental, cujos dados foram analisados com base na Análise Temática de Conteúdo. Os resultados revelaram que Ser diabético significa conviver com o incômodo, o desconforto e a dor das injeções de insulina e das lancetas; com o medo das complicações; com restrição alimentar, em especial, aos doces; com esperança da cura, ou ao menos do controle glicêmico. Constatou­se, também, que as pessoas que tiveram apoio de familiares e/ou profissionais de saúde possuíam um significado mais positivo em relação à doença. Deste modo, o significado de se cuidar implica reconhecer­se portador de limitação importante, determinada pela doença crônica. A enfermeira deve buscar conhecer estes significados para poder criar estratégias que ajudem o paciente a lidar melhor com a doença, obter controle metabólico adequado e uma melhor qualidade de vida. / Salvador

The purpose of this study was to assess the epidemiology of preventable risk factors for NCDs among the adult population in Tigray, Northern Ethiopia. A quantitative descriptive cross-sectional design was employed to describe the distribution of behavioural and biological risk factors for NCDs, assess the status of knowledge, perceptions, attitude and behaviour of the study participants for NCDs and their risk factors, and a matched case-control study to identify the determinants of hypertension. The data was collected using a structured questionnaire for the interview, physical measurements including weight and height scales, non-elastic measuring tape for waist and hip circumferences, Omron digital BP apparatus for blood pressure and heart rate; Accutrend Plus for measuring fasting blood glucose, cholesterol and triglycerides. For the descriptive cross-sectional study a total of 2347 participants were included, and for the matched case control study a total of 117 cases and 235 controls participated. Behavioural and biological risk factors were assessed. Only 0.8% of the study participants used optimal fruit serving per day. The prevalence of low level physical activity (<600 MET-minutes/week) was 44.8%. The magnitude of ever alcohol consumption was 66.8%. However, the magnitude of khat chewing and tobacco smoking among the study participants was not as high as the other risk factors i.e. 3.3% and 2.3% respectively. The magnitude of hypertension, central obesity, hyperglycaemia, hypercholesterolemia and hypertriglyceridemia was 9.9%, 22.2%, 3.5%, 30.3% and 32.2% respectively. Factors associated with the risks aforementioned were gender, age, place of residence, education, knowledge status on NCDs, mental stress and others. The status of knowledge on CVDs, breast and cervical cancers, diabetes and their potential risk factors was low and not comprehensive. Misconceptions on NCDs and body size and shape were pervasive. Risky behaviours underlying NCDs were rampant in the study population. Factors related to poor knowledge on NCDs were gender, age, place of residence, education and misconceptions on NCDs. The determinants of hypertension were physical inactivity, duration of alcohol intake, central obesity and mental stress. Awareness raising interventions on NCDs and their risk factors; improving socio-economic status and accessibility to health care settings have to be in place to curb these formidable problems. / Health Studies / D. Litt. et Phil. (Health Studies)

Submitted by Valquíria Barbieri (kikibarbi@hotmail.com) on 2017-09-01T20:22:37Z No. of bitstreams: 1 DISS_2014_Elizana de Fatima Garcia Soares.pdf: 682407 bytes, checksum: 63ff9d3d2f58d56550bc5ea6348f049e (MD5) / Approved for entry into archive by Jordan (jordanbiblio@gmail.com) on 2017-09-12T13:08:34Z (GMT) No. of bitstreams: 1 DISS_2014_Elizana de Fatima Garcia Soares.pdf: 682407 bytes, checksum: 63ff9d3d2f58d56550bc5ea6348f049e (MD5) / Made available in DSpace on 2017-09-12T13:08:34Z (GMT). No. of bitstreams: 1 DISS_2014_Elizana de Fatima Garcia Soares.pdf: 682407 bytes, checksum: 63ff9d3d2f58d56550bc5ea6348f049e (MD5) Previous issue date: 2014-05-30 / CNPq / O perfil epidemiológico da população brasileira aponta para um aumento das doenças crônicas não transmissíveis - DCNT, que atualmente representam a primeira causa de morbidade e mortalidade no Brasil. OBJETIVO - Analisar as prevalências das doenças crônicas não transmissíveis na população com 18 anos e mais, residentes em Cuiabá e a sua associação com variáveis demográficas, socioeconômicas, e comportamentos relacionados à saúde, no ano de 2008. MÉTODOS - Estudo epidemiológico de delineamento transversal de base populacional, com residentes de Cuiabá, Mato Grosso, no ano de 2008, utilizando as informações do Sistema de Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico - VIGITEL. As prevalências das doenças crônicas foram estimadas e a sua associação com as demais variáveis estudadas foi feita por meio do teste de qui-quadrado de Pearson (Rao-Scott), sendo consideradas estatisticamente significativas as associações com p≤0,05. As análises estatísticas foram feitas no módulo survey do programa Stata versão 11. RESULTADOS – A doença crônica mais prevalente foi a hipertensão arterial (22,25%) seguida de asma/bronquite (8,68%), diabetes mellitus (4,16%) e osteoporose (4,15%). Maiores prevalências de hipertensão e osteoporose foram observadas nas mulheres e nos idosos. A prevalência de diabetes foi maior nos idosos, sem diferença entre os sexos e a asma/bronquite teve suas frequências distribuídas semelhantemente entre todas as faixas etárias. O excesso de peso e a obesidade também apresentaram associações estatisticamente significativas com a hipertensão e diabetes. Verificou-se que a hipertensão, diabetes e osteoporose são estatisticamente associadas entre si e possuem relação inversa com a escolaridade e avaliação o estado de saúde. CONCLUSÃO - Os resultados do presente estudo confirmam a necessidade do controle das doenças crônicas em Cuiabá visando a redução da prevalência, incentivo de práticas de atividade física, educação alimentar e melhoria da assistência à saúde. / The epidemiological profile of the population indicates an increase in non-communicable chronic diseases - NCDs, which currently represent the first cause of morbidity and mortality in Brazil. OBJECTIVE - To analyze the prevalence of chronic diseases in the population aged 18 years and older living in Cuiabá and its association with demographic and socioeconomic variables, overweight, obesity, lifestyle and health status. METHODS - A population based cross-sectional Epidemiological study with residents of Cuiabá, Mato Grosso, in 2008, using information from the Surveillance System and Risk Factors for Chronic Diseases and Protection Telephone Survey - VIGITEL. The prevalence of chronic diseases were estimated and its association with the other variables was performed using chi-square (Rao-Scott) test, and considered statistically significant associations with p ≤ 0.05. Statistical analyses were performed using ‘svy’ commands in Stata version 11. RESULTS - The most prevalent chronic disease was hypertension (22.25%) followed by asthma / bronchitis (8.68%), diabetes mellitus (4.16%) and osteoporosis (4.15%). Higher prevalence of hypertension and osteoporosis were observed in women and the elderly. The prevalence of diabetes was higher in the elderly, with no difference between sexes and asthma / bronchitis had their frequencies similarly distributed among all age groups. Overweight and obesity also showed statistically significant associations with hypertension and diabetes. It was found that hypertension, diabetes and osteoporosis are statistically associated with each other and have an inverse relation to the level of education and self-rated health. CONCLUSION - The results of this study confirm the necessity of controlling chronic diseases in Cuiabá aimed at reducing the prevalence, encouraging practices of physical activity, nutrition education and improving health care.

目的：全面而系統的評價中醫藥對慢性萎縮性胃炎伴腸上皮化生的臨床總體療效、胃鏡療效、病理療效，及中醫藥對腸上皮化生的逆轉率。 方法：電腦檢索中國期刊全文資料庫、重慶維普中文科技期刊資料庫、中國知網資料庫、中國生物醫學文獻資料庫網路版、萬方資料庫、PUBMED 和中國中醫藥期刊文獻資料庫，查找有關中醫藥治療，慢性萎縮性胃炎伴腸上皮他生的隨機對照試驗，檢索從2006 年至2015 年12 月發表的論文。按照納入標準、排除標準及結局指標的統計進行文獻篩查，採用Jadad 評分標準對文獻進行評估，採用Review Manager5 軟體進行Meta分析。 結果： 共納入的項臨床研究，未發現隨機雙盲實驗。共納入1559 例慢性萎縮性胃炎伴腸上皮化生患者，未發現嚴重不良反應。Meta 分析結果顯示，在臨床有效性方面， 中醫藥個體化方案治療組與中成藥治療組相比OR=5.18,95%CI(3.59, 7.64)]，中醫藥個體化方案治療組與單純西醫西藥治療組相比OR=5.46, 95%CI (3.42,8.70），中醫中藥合輔助治療組與此外其他療法治療組OR=6.66 , 95%CI (2.69,16.49），試驗組療效均優於對照組。在胃鏡療效和病理療效方面，中醫中藥治療組與此外其他療法治療名且對胃粘膜萎縮改善情況對比結果OR=2.81，95%CI(1.76,4.47）, 對腸上皮化生改善情況的對比結果OR=4.14, 95%CI (2.87, 5.99 ）中醫中藥治療組與中成藥治療組對綜合胃鏡結果改善情況的對比結果OR =2.68, 95%CI (0.96, 6.8），對綜合病理結果改善情況的對比結果OR=2.80, 95%CI(1.79, 4.38）, 試驗組優於對照在且。中醫中藥治療組與此外其他方法治療組對腸上皮化生逆轉情況的對比結果，共在內人病例數1552 例，結果顯示OR=3.61, 95%CI(2.76, 4.72）,試驗組優於對照組。 結論：中醫藥治療慢性萎縮性胃炎伴腸上皮化生具有很好的臨床療效，主要體現在改善綜合胃鏡情況， 改善綜合病理情況以及逆轉腸上皮他生的情況。但由於臨床試驗設計的局限，不能對中醫藥對該疾病的作用進行全面的判斷，故仍需嚴謹的大樣本多中心的隨機雙盲試驗加以驗證。

Submitted by Dayane Cristina Queiroz (dayanecristina_45@yahoo.com.br) on 2018-04-26T13:57:31Z No. of bitstreams: 1 Dissertação Final - Dayane Cristina Queiroz.pdf: 1409189 bytes, checksum: 3169693862475b542779a92e70841858 (MD5) / Approved for entry into archive by Claudia Adriana Spindola null (claudia@fct.unesp.br) on 2018-04-26T14:09:43Z (GMT) No. of bitstreams: 1 queiroz_dc_me_prud.pdf: 1409189 bytes, checksum: 3169693862475b542779a92e70841858 (MD5) / Made available in DSpace on 2018-04-26T14:09:43Z (GMT). No. of bitstreams: 1 queiroz_dc_me_prud.pdf: 1409189 bytes, checksum: 3169693862475b542779a92e70841858 (MD5) Previous issue date: 2018-03-23 / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / O alto índice de doenças crônicas têm se associado diretamente com elevados custos relacionados à saúde, influenciando diretamente na diminuição da qualidade de vida. Entretanto, estudos brasileiros que avaliam custo-utilidade através de medidas de qualidade de vida e recursos gastos com saúde, ainda são escassos na literatura. Dessa forma, o objetivo do estudo foi avaliar a razão custo-utilidade do tratamento de pacientes da rede primária de saúde de Presidente Prudente/SP. A amostra foi composta por 292 pacientes, de ambos os sexos, com idade igual ou superior a 50 anos. Os pacientes foram avaliados quanto: i) qualidade de vida; ii) QALY; iii) custos com saúde; iv) nível de atividade física; e v) uso de medicamentos. Para análise estatística, foram usados valores de média, desvio padrão, mediana, diferença entre quartil e valores percentuais para estatística descritiva, teste t para amostras independentes, correlação de Pearson para variáveis numéricas e o teste de qui-quadrado para variáveis categóricas. Para o custo-utilidade dos tratamentos, foram utilizados valores de QALY e o custo médio/ano para cada tratamento. A significância estatística (p-valor) foi pré-fixada em valores inferiores a 5%. O software utilizado foi o BioEstat (versão 5.0). Houve correlação negativa entre o domínio atividade física no lazer e locomoção com consultas e custos adicionais (pvalor<0,05), medicamentos e custos totais (p-valor<0,01), e atividade física habitual com consultas, custos adicionais e custos totais (p-valor<0,01). Consultas, custos adicionais, medicamentos e custo total foram maiores em pacientes que reportaram maior número de doenças (p-valor=0,001). O custo-utilidade do tratamento dos pacientes da atenção primária foi maior no grupo tratamento medicamentoso, seguida do grupo medicamentoso atrelada ao exercício físico que se apresentou custo-efetivo com média de QALY alto. Maiores escores de QV foi observado em homens quando comparados mulheres. Entretanto, variáveis como peso, IMC e presença de hipertensão arterial se associaram com menores escores para QV. Além disso, dados quanto internações e cirurgias foram analisados impactando a QV dos avaliados e por fim custos associados aos serviços de saúde também apresentaram relação com a QV. / The high index of chronic diseases has been directly associated with high costs related to health, directly influencing the reduction of quality of life. However, Brazilian studies that evaluate cost-utility through measures of quality of life and resources spent on health are still scarce in the literature. Thus, the objective of the study was to evaluate the cost-utility ratio of the treatment of patients in the primary health network of Presidente Prudente/SP. The sample consisted of 292 patients, of both sexes, aged 50 years or more. Patients were assessed for: i) quality of life; ii) QALY; iii) health costs; iv) level of physical activity; and v) use of medications. For statistical analysis, mean values, standard deviation, median, difference between quartile and percentage values were used for descriptive statistics, t-test for independent samples, Pearson's correlation for numerical variables and the chisquare test for categorical variables. For the cost-utility of the treatments, values of QALY and the mean cost / year for each treatment were used. Statistical significance (p-value) was set at values below 5%. The software used was BioEstat (version 5.0). There was a negative correlation between the physical activity domain in leisure and locomotion with additional consultations and costs (p-value <0.05), medication and total costs (p-value <0.01), and habitual physical activity with consultations, additional costs and total costs (p-value <0.01). Consultations, additional costs, medications and total cost were higher in patients who reported higher number of diseases (pvalue = 0.001). The cost-utility of the treatment of primary care patients was higher in the drug treatment group, followed by the drug group linked to physical exercise that was cost-effective with a high QALY mean. Higher QOL scores were observed in males when compared to females. However, variables such as weight, BMI and presence of arterial hypertension were associated with lower QOL scores. In addition, data regarding hospitalizations and surgeries were analyzed impacting the QoL of the evaluated patients and, finally, costs associated with health services were also related to QoL. / FAPESP: 2016/12071-8

Thesis (MTech (Biomedical Technology))--Cape Peninsula University of Technology, 2014. / Over the past few decades, it has been shown that various critical diseases including heart disease, cancer, and diabetes associated with free radical generation and low endogenous antioxidant capacity, lead to oxidative stress and cell injury. In recent years, numerous studies have also reported that antioxidants, present in various beverages, vegetables and some foods have attracted a significant research interest due to their potential benefits to human health. However, epidemiological evidence shows a correlation between the intake of food rich in antioxidants and the reduced incidence of some mortality of chronic diseases, certain cancers and coronary heart disease. The aims of this study were to determine the effects of rooibos teas (fermented and unfermented) and green tea as a comparison on the biochemical parameters and the trace element absorption in a rat model. In this study 4 groups of experimental animals were used. All groups had ad libitum access to standard rat chow. Group A, the controls (11 animals), were fed with tap water; group B (11 animals) were fed with the liquid extract of fermented rooibos tea; group C (9 animals) were fed with the liquid extracts of unfermented rooibos and group 0 (9 animals) were fed with the liquid extract of green tea. All groups were fed for a period of 10 weeks. After the feeding period, the animals were sacrificed by euthanization with intraperitoneal injections of pentobarbital. Blood was sampled by cardiac puncture and centrifuged to obtain the serum. Some elemental analyses were performed with X-ray emission and backscattering. ICP-OES was used to determine the magnesium content. For X-ray emission, backscattering and ICP-OES analyses, 100 µL of each serum sample in a group were added to 2 ml freeze-drying tube. Of the combined specimen, 100 µL was used for the magnesium determination by ICP-OES. The remainder of the combined serum specimens for each group were freeze-dried at -80°C and then pressed into a pellet. The pellet was coated with carbon and analyzed using X-ray emission and backscattering. The elemental X-rays of P, S, Ca, Mn, Fe, Cu, Co, Zn, Mo, Ca and Se emitted were quantified to obtain the respective concentrations. Biochemical chemistry analyses were performed on each serum sample of each animal. The biochemical parameters tested for were total protein, albumin, globulin, total bilirubin, lactate dehydrogenase, blood urea nitrogen, uric acid, total cholesterol, aspartate aminotransferase, alanine aminotransferase, creatine phosphokinase and creatinine.

Orientador: Marilisa Berti de Azevedo Barros / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-10T14:41:14Z (GMT). No. of bitstreams: 1 Lima_MargarethGuimaraes_M.pdf: 2056906 bytes, checksum: 13b1d46ec5a5b5af98aded6bf9f1c90b (MD5) Previous issue date: 2008 / Resumo: O processo de envelhecimento está acontecendo de maneira rápida, principalmente nos países em desenvolvimento. Esse processo gera vários desafios para a saúde pública, entre eles, melhorar a qualidade dos anos de vida conquistados (WHO, 2005). Este estudo teve como objetivo analisar a qualidade de vida relacionada à saúde (QVRS) de idosos e avaliar a influência de fatores demográficos e socioeconômicos e o impacto de doenças crônicas sobre as várias dimensões da qualidade de vida. A pesquisa utilizou dados do Inquérito Multicêntrico de Saúde no Estado de São Paulo, ISA-SP e o instrumento usado para medir a QVRS foi o Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). É um estudo transversal de base populacional, com amostra de conglomerados, estratificada e em múltiplos estágios. Foram analisados 1958 idosos com 60 anos ou mais, residentes em 4 áreas do Estado de São Paulo. A QVRS dos idosos estudados apresentou-se em melhores condições nos domínios: aspectos emocionais (86,1), sociais (85,9) e físicos (81,2) e as piores condições foram encontradas em vitalidade (64,4), saúde mental (69,9) e estado geral de saúde (70,1). Segundo determinantes demográficos e socioeconômicos, a QVRS revelou-se em piores condições nos idosos do sexo feminino; naqueles com idade mais avançada; com menores rendas; com menor nível de escolaridade e nos idosos da religião evangélica, comparados aos da religião católica, principalmente nos domínios capacidade funcional e aspectos físicos. Segundo doenças crônicas, encontrou-se que as condições que exercem maior influência na QVRS dos idosos são: acidente vascular cerebral, depressão/ansiedade e osteoporose, principalmente nos domínios dor e estado geral de saúde. Apresentar maior número de doenças crônicas também é fator de pior situação de qualidade de vida, principalmente a presença de três ou mais, em que os domínios de capacidade funcional, dor, estado geral de saúde e vitalidade foram os mais prejudicados. Os resultados sugerem que programas relacionados à saúde do idoso considerem a abordagem multidimensonal da qualidade de vida e priorizem as atenções voltadas para os subgrupos mais vulneráveis / Abstract: A longer aging process is occurring rapidly, especially in developing countries. This process generates a number of challenges to public health, including improving the quality of the additional years of life. The aim of the present study was to analyze health-related quality of life (HRQOL) among elderly individuals and assess the influence of demographic and socioeconomic factors as well as the impact of chronic illness on different quality of life dimensions. The research used data from the Multi-Centric Health Inquiry in the state of Sao Paulo (Brazil) and the instrument used to measure HRQOL was the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). A population-based cross-sectional study was carried out in multiple stages on a stratified sample determined by clusters. 1958 elderly individuals were analyzed. Subjects were aged 60 years or more and residents in four areas of the state of Sao Paulo. HRQOL of these elderly individuals scored better in the following SF-36 domains: role-emotional (86.1), social functioning (85.9) and role-physical (81.2), whereas the worst scores were found in vitality (64.4), mental health (69.9) and general health (70.1). According to demographic and socioeconomic determinants, HRQOL was worse among women, individuals at more advanced ages; those with lower incomes; those with low levels of schooling; and those who practiced evangelist religions when compared to those who followed the catholic religion, especially in the physical functioning and role-physical domains. Regarding chronic illness, the following conditions were found to exercise a greater influence on HRQOL among the elderly: vascular cerebral accident (stroke), depression/anxiety and osteoporosis, especially in the bodily pain and general health domains. Having a higher number of chronic illnesses was also a factor for a worse quality of life, especially the presence of three illnesses or more; the physical functioning, bodily pain, general health and vitality domains were the most affected. The results suggest that programs addressing elderly health should consider a multi-dimensional approach to quality of life and prioritize actions directed at more vulnerable subgroups / Mestrado / Epidemiologia / Mestre em Saude Coletiva

Orientador: Mônica Sanches Yassuda / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-17T01:05:41Z (GMT). No. of bitstreams: 1 Nicolosi_GloriaTeixeira_M.pdf: 6680790 bytes, checksum: cccd4cb42c6b54c818b4920e2ea16968 (MD5) Previous issue date: 2010 / Resumo: Estudos gerontológicos apontam a influência de variáveis biológicas e psicossociais na etiologia da sintomatologia depressiva na velhice. Objetivos: O presente estudo busca investigar as correlações existentes entre sintomas depressivos, variáveis sociodemográficas (renda mensal, escolaridade, idade e gênero), doenças autorrelatadas, problemas de saúde autorrelatados e avaliação subjetiva de saúde. Métodos: Trata-se de um estudo de corte transversal, quantitivo que utilizou o banco de dados do Projeto "Estudo da fragilidade em idosos brasileiros - Rede Fibra". A amostra avaliada referiu-se ao subdistrito de Ermelino Matarazzo-SP e foi composta por 303 idosos. Resultados: Análises estatísticas descritivas demonstraram que amostra (N=384) foi composta por idosos na faixa etária de 65 a 69 anos (38.02%; M=72,32; DP= 5,77), do gênero feminino (67,19%), com nível de escolaridade primário completo (60,21%; M=3,42, DP=2,82) e renda familiar de um a três salários mínimos (53,75%, M= 3,38, DP=3,10). A maioria da amostra apresentou o escore não compatível com depressão (79,21%) e boa avaliação subjetiva de saúde (40,53%). As doenças autorrelatadas mais prevalentes foram hipertensão (64,45%), artrite (36,21%), osteoporose (26,25%) e diabetes (24,25%). Os problemas de saúde mais prevalentes foram medo de cair (60,13%), memória (51,32%) e tristeza (38,74%). Os testes de Mann-Whitney e Kruskall Wallis indicaram maiores escores da GDS entre idosos com diabetes, artrite, incontinência urinária, incontinência fecal, tristeza, perda de apetite, quedas, que estiveram em condição acamada, que apresentam problemas de memória, e medo de cair. As análises de regressão linear univariada indicaram relação significativa entre escolaridade, renda, gênero, problemas de saúde e número de doenças autorrelatadas. As análises de regressão multivariada pelo critério stepwise indicaram o aumento de 0,64 unidade no escore da GDS a cada problema de saúde. Ter avaliação subjetiva de saúde muito ruim ou regular representou um escore da GDS 1,06 unidade maior que ter avaliação subjetiva de saúde muito boa ou excelente. Cada ano de escolaridade acarretou redução de 0,14 unidade do escore da GDS. O nível de significância adotado para os testes estatísticos foi de 5% (P<0,05). Conclusão: A presença de sintomas depressivos associou-se ao maior número de doenças e de problemas de saúde autorrelatados, pior avaliação subjetiva de saúde e menor escolaridade / Abstract: Gerontological studies have found the influence of several biological and psychosocial factors for the etiology of symptomatology of depression in elderly people. Objectives: This research aimed to investigate the correlation among depressive symptoms, socio-demographic variables (monthly income, education, age and gender), self-reported illness, self-reported health problems and selfrated health condition. Methods: A cross sectional and quantitative study using the database of the "Study of Frailty in the Community-Dwelling Elderly in Brazil - Fibra Study". The sample selected refers to the subdistrict of Ermelino Matarazzo, in Sao Paulo and included 303 elderly individuals. Results: descriptive statistical analyses have shown that the sample (N=384) was mostly formed by elderly individuals aged 65 to 69 (38.02%; M=72,32; DP= 5,77), from the female gender (67,19%), with elementary education (60,21%; M=3,42, DP=2,82) and family income from one to three Brazilian minimum wages (53,75%, M= 3,38, DP=3,10). Most of the sample did not show GDS score compatible with depression (79,21%) and most participants indicated good self-rated health condition (40,53%). The most prevalent self-reported illnesses were: hypertension (64, 45%), arthritis (36,21%), osteoporosis (26,25%) and diabetes (24,25%). The most prevalent health problems were: fear of falling (60,13%), memory loss (51,32%) and sadness (38,74%). Mann-Whitney and Kruskall Wallis tests indicated higher GDS scores among elderly with diabetes, arthritis, urinary incontinence, fecal incontinence, sadness, poor appetite, falls, bed rest condition, memory loss and fear of falling. Single-variable linear regression analysis indicated significant relations among education, income, gender, health problems and number of self-reported illness. Multivariate stepwise regression analysis indicated the increase of 0,64 units in GDS score to each reported health problem. Having very low or regular self-rated health represented a GDS score of 1,06 unit higher than having very good or excellent self-rated health. Each year of education meant a reduction of 0,14 units in GDS scores. Conclusion: The presence of depressive symptoms was associated with a higher number of illnesses, higher self-reported health problems, worse self-rated health and lower education / Mestrado / Mestre em Gerontologia