Background Disability rates increase with age. In 2012, Peruvian older adults ( 65 years) represented 9% of the population. Additionally, older population reported disabilities at about 5 times the rate of Peruvians between 36 and 64 years old, and 30% of older population lived in poverty. Peruvian seniors living in extreme poverty experience disabilities and the extent of their access to healthcare is unknown. Objective This study assesses associations between disability and access to healthcare among Peruvians older individuals living in extreme poverty. Methods Secondary analysis of a national representative population based survey that utilizes information from Peru’s 2012 survey Health and Wellbeing in Older Adults (ESBAM), which includes older adults living in extreme poverty. We define disability in terms of the Activities of Daily Living (ADL disability) framework. Healthcare access was assessed as having any of Peru’s available health insurance schemes combined with preventive health services (vision assessment, influenza vaccination, blood pressure assessment, diabetes screening, and cholesterol assessment). Poisson robust regression models were used to evaluate the associations among relevant variables. Prevalence Ratios and 95% confidence intervals (95%CI) were reported. Results Data from 3869 individuals (65 to 80 years old), of whom 1760 (45.5%) were females, were analyzed. The prevalence of ADL disability was 17.3% (95%CI: 16.0%-18.4%). In addition, more than 60% had never received any of the preventive measures evaluated, except for the blood pressure assessment. In the adjusted model, people with ADL disability had 63% less probability of having extensive insurance, compared to those without disability (p<0.05). Conclusions This study shows that this Peruvian older population living in extreme poverty has limited access to healthcare services. Although there was no consistent association between ADL disability and the healthcare access, there is an urgent need to reduce the inequitable access to healthcare of this poor Peruvian older population. / Wellcome Trust / Revisión por pares

Submitted by NATHANE RUIZ SCHINCARIOLI RODRIGUES null (nathaneruiz@hotmail.com) on 2016-07-07T12:45:38Z No. of bitstreams: 1 tese PDF.pdf: 1042766 bytes, checksum: 06bf706f9269bde0c17d5715a11ef0eb (MD5) / Rejected by Ana Paula Grisoto (grisotoana@reitoria.unesp.br), reason: Solicitamos que realize uma nova submissão seguindo a orientação abaixo: O arquivo submetido está sem a ficha catalográfica. A versão submetida por você é considerada a versão final da dissertação/tese, portanto não poderá ocorrer qualquer alteração em seu conteúdo após a aprovação. Corrija esta informação e realize uma nova submissão contendo o arquivo correto. Agradecemos a compreensão. on 2016-07-07T20:36:03Z (GMT) / Submitted by NATHANE RUIZ SCHINCARIOLI RODRIGUES null (nathaneruiz@hotmail.com) on 2016-07-12T13:48:15Z No. of bitstreams: 1 Nathane Ruiz Schincarioli Rodrigues PDF.pdf: 1216367 bytes, checksum: 6af8e15d11ac85ffb26b6b5aa23efc3e (MD5) / Approved for entry into archive by Ana Paula Grisoto (grisotoana@reitoria.unesp.br) on 2016-07-12T14:41:08Z (GMT) No. of bitstreams: 1 rodrigues_nrs_dr_bot.pdf: 1216367 bytes, checksum: 6af8e15d11ac85ffb26b6b5aa23efc3e (MD5) / Made available in DSpace on 2016-07-12T14:41:09Z (GMT). No. of bitstreams: 1 rodrigues_nrs_dr_bot.pdf: 1216367 bytes, checksum: 6af8e15d11ac85ffb26b6b5aa23efc3e (MD5) Previous issue date: 2016-02-26 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / O objetivo deste estudo foi avaliar a atividade de vida diária (AVD)no momento pré e pós-operatório de pacientes com câncer de mama (CM) e tratadas por cirurgia. Métodos: Trata-se de um estudo prospectivo, de intervenção de pré e pós-operatório com 64 pacientes do sexo feminino com diagnóstico de CM. Foi aplicado um questionário de AVD no momento do pré e pós-operatório. Para análise estatística, empregaram-se os testes Wilcoxon e Qui-Quadrado. Resultados: Pôde -se observar que as pacientes apresentaram diferenças significativas na aplicação do questionário no momento pós-operatório, quando comparadas ao pré-operatório nas seguintes perguntas: limpar a louça que sujou; lavar as roupas sujas da semana; deixar a casa limpa, arrumando a cama, lavando a louça do café, e passando um pano na casa; fazer uma faxina de esfregar as janelas e azulejos 1 vez por semana na sua casa; andar uns 200m se precisar ir à padaria, ponto de ônibus ou supermercado, subir um lance de escada com 15 degraus. Conclusão: Houve piores escores nos momentos pós-operatório do questionário aplicado quando comparados ao momento pré-operatório. / The objective of this study was to evaluate the activity of daily living in the moment pre and postoperative patients with breast cancer and treated by surgery. Methods: This was a prospective study, intervention pre- and postoperatively with 64 female patients diagnosed with breast cancer (BC ) . A questionnaire of daily living activity was applied ( ADL) at the time of pre and postoperative , the questionnaire had 10 questions and was punctuated with scores . Statistical analysis employed in the Wilcoxon tests and Qui-square. Results: It might be understood that the patients showed significant differences in the questionnaire in the post- operative period compared to preoperative the following questions: clean the dishes that soiled ; wash the dirty clothes of the week; leave the house clean , making the bed , washing the dishes coffee , and passing a cloth in the house ; do some housekeeping to scrub the windows and tiles one day a week at his home ; walk about 200m if you need to go to the bakery , bus stop or supermarket , climb a flight of stairs with 15 steps. Conclusion: Through this specific standard instrument used in this study to evaluate the ADL after cirugico breast cancer treatment , we conclude that there were differences in the questionnaire at the time of the postoperative period , there is the importance and necessitade the preparation of a questionnaire ADL that perimite us to evaluate the potential of the functional status of patients and their ability to develop AVD postoperatively

Orientador: Gilberto Uemura / Resumo: O objetivo deste estudo foi avaliar a atividade de vida diária (AVD)no momento pré e pós-operatório de pacientes com câncer de mama (CM) e tratadas por cirurgia. Métodos: Trata-se de um estudo prospectivo, de intervenção de pré e pós-operatório com 64 pacientes do sexo feminino com diagnóstico de CM. Foi aplicado um questionário de AVD no momento do pré e pós-operatório. Para análise estatística, empregaram-se os testes Wilcoxon e Qui-Quadrado. Resultados: Pôde -se observar que as pacientes apresentaram diferenças significativas na aplicação do questionário no momento pós-operatório, quando comparadas ao pré-operatório nas seguintes perguntas: limpar a louça que sujou; lavar as roupas sujas da semana; deixar a casa limpa, arrumando a cama, lavando a louça do café, e passando um pano na casa; fazer uma faxina de esfregar as janelas e azulejos 1 vez por semana na sua casa; andar uns 200m se precisar ir à padaria, ponto de ônibus ou supermercado, subir um lance de escada com 15 degraus. Conclusão: Houve piores escores nos momentos pós-operatório do questionário aplicado quando comparados ao momento pré-operatório. / Abstract: The objective of this study was to evaluate the activity of daily living in the moment pre and postoperative patients with breast cancer and treated by surgery. Methods: This was a prospective study, intervention pre- and postoperatively with 64 female patients diagnosed with breast cancer (BC ) . A questionnaire of daily living activity was applied ( ADL) at the time of pre and postoperative , the questionnaire had 10 questions and was punctuated with scores . Statistical analysis employed in the Wilcoxon tests and Qui-square. Results: It might be understood that the patients showed significant differences in the questionnaire in the post- operative period compared to preoperative the following questions: clean the dishes that soiled ; wash the dirty clothes of the week; leave the house clean , making the bed , washing the dishes coffee , and passing a cloth in the house ; do some housekeeping to scrub the windows and tiles one day a week at his home ; walk about 200m if you need to go to the bakery , bus stop or supermarket , climb a flight of stairs with 15 steps. Conclusion: Through this specific standard instrument used in this study to evaluate the ADL after cirugico breast cancer treatment , we conclude that there were differences in the questionnaire at the time of the postoperative period , there is the importance and necessitade the preparation of a questionnaire ADL that perimite us to evaluate the potential of the functional status of patients and their ability to... (Complete abstract click electronic access below) / Doutor