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Advisor(s)
Abstract(s)
Introdução: A política de não institucionalização de pessoas idosas dependentes, iniciada na década de 70, deu origem à criação dos Centros de Dia, equipamentos sociais dispensados de fornecer serviços de saúde, contrariando a melhor evidência que aconselha o envolvimento interdisciplinar.
Objetivos: Traçar o perfil relativo à funcionalidade dos idosos que frequentam os Centros de Dia da cidade do Porto e identificar as transições que carecem de respostas profissionais potencialmente sensíveis aos cuidados de enfermagem
Métodos: A investigação seguiu um desenho misto. Um estudo de caso múltiplo que caracterizou a vulnerabilidade individual associada ao processo de transição para o Centro de Dia; um estudo observacional, analítico, transversal, com uma amostra representativa da população dos Centros de Dia da cidade do Porto, que determinou a dimensão dos défices de funcionalidade e explorou as relações entre os fenómenos sensíveis aos cuidados de Enfermagem; por último, um estudo observacional, analítico, longitudinal, com uma amostra de 55 pessoas, onde se caracterizou a evolução da funcionalidade ao longo de dois anos de permanência no Centro de Dia.
Resultados: As pessoas recorrem ao suporte social após um progressivo período de declínio funcional ou um evento crítico gerador de dependência. A incapacidade para satisfazer autonomamente os requisitos de autocuidado e a indisponibilidade para tomar conta, por parte dos familiares, suportam a decisão de ingressar no Centro. O início não é isento de emoções negativas mas o suporte social percecionado ajuda a pessoa a adaptar-se à condição de dependente. Na população dos Centros de Dia da cidade do Porto, o estudo de fenómenos como o desempenho cognitivo, sono, dor, acuidade visual, status nutricional, autocuidado, equilíbrio corporal, confiança para realizar as atividades, exercício físico, gestão do regime medicamentoso, morbilidade, utilização dos recursos de saúde e autoperceção de saúde, demonstrou que estão altamente afetados, influenciando negativamente a funcionalidade. A avaliação do perfil funcional ao longo do tempo comprovou o progressivo declínio em quase todas as áreas em estudo.
Conclusões: Existem áreas da funcionalidade sensíveis aos Cuidados de Enfermagem que podem ser trabalhadas nos Centros de Dia. É necessário repensar a necessidade de desenvolver respostas integradas centradas na promoção, manutenção e reabilitação da saúde em contexto de Centro de Dia, para atingir o almejado Envelhecimento Saudável preconizado pela Organização Mundial da Saúde.
Introduction: The policy of non-institutionalization of dependent elderly people, started in the 70’s, gave rise to the creation of Day Centers, social facilities that are exempt from providing health services to support aging, contrary to the best evidence that advises interdisciplinary involvement. Objective: To trace the profile related to the functionality of the elderly attending the Day Centers of the city of Porto and identify the transitions that require professional responses potentially sensitive to nursing care. Methods: The research followed a mixed design. First a multiple case study that characterized the individual vulnerability associated with the transition process to the Day Center; this was followed by an observational, analytical, cross-sectional study with a representative sample of the population of the Day Centers of the city of Porto, which determined the extent of functional deficits and explored the relationships between the phenomena sensitive to Nursing care; finally, an observational, analytical, longitudinal study with a sample of 55 people, characterizing the evolution of the functionality over two years of permanence in the Day Center. Results: People resort to social support after a progressive period of functional decline or a critical event that generates dependency. The inability to meet the self-care requirements independently and the unavailability to take care of the relatives, support the decision to join the Center. The beginning is not free of negative emotions but perceived social support helps the person to adapt to the dependent condition. The study of phenomena such as cognitive performance, sleep, pain, visual acuity, nutritional status, self-care, body balance, confidence to perform activities, physical exercise, management of the drug regimen, morbidity , use of health resources and self-perception of health, have shown that they are highly affected, negatively influencing the functionality. The evaluation of the functional profile over time proved the progressive decline in almost all the study areas. Conclusions: There are areas of Nursing Care-sensitive functionality that can be worked out in Day Care Centers. It is necessary to rethink the need to develop integrated responses focused on health promotion, maintenance and rehabilitation in the context of a Day Center to achieve the desired Ageing and Health advocated by the World Health Organization.
Introduction: The policy of non-institutionalization of dependent elderly people, started in the 70’s, gave rise to the creation of Day Centers, social facilities that are exempt from providing health services to support aging, contrary to the best evidence that advises interdisciplinary involvement. Objective: To trace the profile related to the functionality of the elderly attending the Day Centers of the city of Porto and identify the transitions that require professional responses potentially sensitive to nursing care. Methods: The research followed a mixed design. First a multiple case study that characterized the individual vulnerability associated with the transition process to the Day Center; this was followed by an observational, analytical, cross-sectional study with a representative sample of the population of the Day Centers of the city of Porto, which determined the extent of functional deficits and explored the relationships between the phenomena sensitive to Nursing care; finally, an observational, analytical, longitudinal study with a sample of 55 people, characterizing the evolution of the functionality over two years of permanence in the Day Center. Results: People resort to social support after a progressive period of functional decline or a critical event that generates dependency. The inability to meet the self-care requirements independently and the unavailability to take care of the relatives, support the decision to join the Center. The beginning is not free of negative emotions but perceived social support helps the person to adapt to the dependent condition. The study of phenomena such as cognitive performance, sleep, pain, visual acuity, nutritional status, self-care, body balance, confidence to perform activities, physical exercise, management of the drug regimen, morbidity , use of health resources and self-perception of health, have shown that they are highly affected, negatively influencing the functionality. The evaluation of the functional profile over time proved the progressive decline in almost all the study areas. Conclusions: There are areas of Nursing Care-sensitive functionality that can be worked out in Day Care Centers. It is necessary to rethink the need to develop integrated responses focused on health promotion, maintenance and rehabilitation in the context of a Day Center to achieve the desired Ageing and Health advocated by the World Health Organization.
Description
Keywords
Funcionalidade Envelhecimento Centro de dia Vulnerabilidade Enfermagem Functionality Ageing Day center Vulnerability Nursing