Avaliação da qualidade de vida e do grau de dependência dos idosos apoiados pelo serviço de apoio domiciliário da Penha de França da Santa Casa da Misericórdia de Lisboa
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2014
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Objetivos: Este estudo que surge na conclusão do Iº Mestrado em Cuidados Continuados
Integrados, da Escola de Ciências e Tecnologias da Saúde da Universidade Lusófona de
Humanidades e Tecnologias de Lisboa, está diretamente relacionado com a prática dos
Cuidados Continuados e tem como objetivo melhorar o conhecimento sobre a população
idosa apoiada pelo Serviço de Apoio Domiciliário (SAD) da Penha de França (PDF) da
Santa Casa da Misericórdia de Lisboa (SCML), através da Avaliação da sua Qualidade de
Vida e dos seus Graus de Dependência, verificando ainda a existência de correlações entre
os resultados dos instrumentos.
Métodos: Realizou-se um estudo exploratório descritivo-correlacional, quantitativo e
qualitativo, em que a seleção da amostra teve como critério de exclusão o défice cognitivo
em que participantes não teriam diagnosticada doença Psiquiátrica, e como fatores de
inclusão ter mais de 65 anos e beneficiar do serviços de SAD da PDF da SCML. Aos 40
idosos que assinaram o consentimento informado, representando cerca de 20% da
população total, foi aplicado o Formulário de recolha de dados demográficos, os Índices de
avaliação: das Atividades Básicas da Vida Diária (ABVD), de Barthel (IB); da avaliação
das Atividades Instrumentais da Vida Diária (AIVD), de Lawton & Brody (IL&B); e, por
último, o instrumento de avaliação da Qualidade de Vida Diária, WHOQOL-OLD.
Resultados: A amostra é 80% do sexo Feminino, com idades a variar entre os 65 e os 93
anos, e com um valor médio de 81,8 anos com DP = 6,46, em que a maioria é viúvo(a),
com a quarta classe, reside sozinha, aufere menos que 485€ mensais, e ao nível do Grau de
Dependência das ABVD encontrava-se em média com uma Dependência Leve, e em
relação ao Grau de Dependência, ao nível das AIVD, a amostra encontra-se em média com
uma Dependência Moderada. Na Avaliação da Qualidade de Vida, através da utilização do
Instrumento WHOQOL-OLD da Organização Mundial de Saúde (que se encontra
atualmente a ser validado para Portugal pela Drª Manuela Vilar em Tese de
Doutoramento), evidenciou-se que a amostra pontuou numa escala de 0 – 100 de
Qualidade de vida, em que zero corresponde à menor Qualidade de vida e 100 à melhor
Qualidade de Vida, os seguintes valores em pontuação nas sete facetas: Morte e Morrer
(64,37); Família e Vida Familiar (57,03); Funcionamento Sensorial (58,74); Autonomia
(55,31); Presente e Futuro (46,56); Participação Social (42,97) e Intimidade (27,19).
Verificou-se ainda a existência de várias correlações entre: os IB e IL&B; Entre o IB e as facetas: Autonomia Passado, Presente e Futuro e Participação Social; Entre IL&B e a
faceta Autonomia; Entre várias facetas da WHOQOL-OLD e os IB e IL&B e as questões:
Tempo de Acamado, Nível de escolaridade e Tempo de Acamado.
Discussão: Se interpretarmos em conjunto as quatro facetas que apresentam os valores
mais altos de qualidade de vida, verifica-se que apesar dos baixos rendimentos e da idade
avançada, os idosos desta amostra revelam que têm uma perceção positiva na relação com:
a Morte e o Morrer; Relações Familiares; Autonomia e Liberdade na gestão e toma de
decisões. Relativamente às correlações encontradas entre as variáveis, existe uma
correlação positiva entre os Índices de Barthel e de Lawton & Brody, ou seja sempre que o
grau de independência de um aumenta o outro acompanha o seu aumento.
Conclusões: Este estudo concretizou os objetivos a que se propôs, tanto quanto ao objetivo
inicial de Avaliar a Qualidade de Vida e o Grau de Dependência dos idosos apoiados pelo
Apoio Domiciliário da Penha de França da Santa Casa da Misericórdia de Lisboa, bem
como quanto às 4 questões de investigação. Os resultados obtidos neste estudo com uma
amostra de 40 idosos desta freguesia revelam que em média os idosos apoiados naquele
período apresentavam Dependência Leve ao nível das Atividades Básicas da Vida Diária
(Índice de Barthel), em média apresentam Dependência Moderada (Índice de Lawton e
Brody) e na média dos 7 domínios da Avaliação da Qualidade de Vida (WHOQOL-OLD,
versão ainda em validação para Portugal, pela Mestre Manuela Vilar – Faculdade de
Psicologia da Universidade de Coimbra), pontuaram 50,31 pontos numa escala de 0 – 100,
de qualidade de vida.
Objectives: This study that comes at the conclusion of the Ist Master Course in Integrated Continuous Care, at the School of Health Sciences and Technologies of the Lusophone University of Humanities and Technologies of Lisbon, is directly related to the practice of Continuing Care and aims to improve knowledge on the elderly population supported by the Home Support Service (DSS) of Penha de França (PDF) of the Santa Casa da Misericórdia de Lisboa (SCML), through the evaluation of their quality of life and their degrees of dependence, still checking the statistical correlations between the results of the instruments. Methods: We conducted a descriptive exploratory-correlational, quantitative and qualitative study, in which the selection of the sample had as an exclusion criterion any cognitive deficit and participants should have no diagnosed psychiatric illness, while inclusion factors were defined for age over 65 years and benefit from the services of the DPS PDF SCML. To the 40 seniors who signed informed consent forms, representing about 20% of the total population, we applied the Form collection of demographic data, the assessment indices reviewing the Basic Activities of Daily Living (ADL), Barthel (IB), the review of Instrumental Activities of Daily Living (IADL), Lawton & Brody (IL & B), and, finally, the evaluation tool Quality of Daily Life, WHOQOL-OLD. Results: The sample is 80 % female, with ages varying between 65 and 93 years, with an average of 81.8 years with SD = 6.46 , where the majority is a widow (er ) , with the fourth class (basic school), lives alone, earns less than € 485 per month, and the degree of dependence of ABVD level was in average with a Lightweight Dependency; and in relation to the degree of dependence, the level of the AIVD, overall sample is in average with Moderate Dependence. In Assessment of Quality of Life , using the WHOQOL -OLD World Health Organization (which is currently being validated for Portugal by Dr. Manuela Vilar in a PhD Thesis), it was observed that the sample scored on a scale of 0-100 of quality of life , where zero is the lowest quality of life and 100 the best quality of life. The following figures in scoring in all seven facets were recorded: Family and Family Life (57.03); Sensory Functioning (58.74), Autonomy (55.3); Death and Dying (64.37) Present and Future (46.56); Social Participation (42.97) and Intimacy (27,19). It was further found that there are several correlations between: the IB and IL &B; Between IB and facets: Autonomy in the Past, Present and Future and Social Participation; Between IL & B and facet Autonomy; Among various facets of WHOQOL-OLD and IB and IL & B and issues: Time Bedridden, Level of Education and time Bedridden. Discussion: If we interpret together the four facets that have the highest values of quality of life, it appears that despite low incomes and the elderly, the elderly show that this sample have a positive perception in relation to: Death and Dying ; Family Relations; Autonomy and Freedom in the management and decision making. Regarding the correlations between variables, there is a positive correlation between the Barthel Index and Lawton & Brody, ie when the degree of independence of one increases the other accompanying its increase. Conclusions: This study demonstrated the goals it has set itself, much as the initial aim of evaluate the quality of life and the degree of dependence of elderly supported by the Home Care of Penha de Franca Santa Casa da Misericordia de Lisboa, as well as the 4 issues research. The results obtained in this study with a sample of 40 subjects of this parish reveal that on average the elderly at that time had supported Lightweight Dependency level of Basic Activities of Daily Living (Barthel Index) on average have faced Dependency Index (Lawton and Brody ) and the average of the 7 areas of Evaluation of Quality of Life (WHOQOL-OLD version still validation for Portugal, by Master Manuela Vilar - Faculty of Psychology, University of Coimbra), scored 50.31 points on a scale 0-100 , quality of life.
Objectives: This study that comes at the conclusion of the Ist Master Course in Integrated Continuous Care, at the School of Health Sciences and Technologies of the Lusophone University of Humanities and Technologies of Lisbon, is directly related to the practice of Continuing Care and aims to improve knowledge on the elderly population supported by the Home Support Service (DSS) of Penha de França (PDF) of the Santa Casa da Misericórdia de Lisboa (SCML), through the evaluation of their quality of life and their degrees of dependence, still checking the statistical correlations between the results of the instruments. Methods: We conducted a descriptive exploratory-correlational, quantitative and qualitative study, in which the selection of the sample had as an exclusion criterion any cognitive deficit and participants should have no diagnosed psychiatric illness, while inclusion factors were defined for age over 65 years and benefit from the services of the DPS PDF SCML. To the 40 seniors who signed informed consent forms, representing about 20% of the total population, we applied the Form collection of demographic data, the assessment indices reviewing the Basic Activities of Daily Living (ADL), Barthel (IB), the review of Instrumental Activities of Daily Living (IADL), Lawton & Brody (IL & B), and, finally, the evaluation tool Quality of Daily Life, WHOQOL-OLD. Results: The sample is 80 % female, with ages varying between 65 and 93 years, with an average of 81.8 years with SD = 6.46 , where the majority is a widow (er ) , with the fourth class (basic school), lives alone, earns less than € 485 per month, and the degree of dependence of ABVD level was in average with a Lightweight Dependency; and in relation to the degree of dependence, the level of the AIVD, overall sample is in average with Moderate Dependence. In Assessment of Quality of Life , using the WHOQOL -OLD World Health Organization (which is currently being validated for Portugal by Dr. Manuela Vilar in a PhD Thesis), it was observed that the sample scored on a scale of 0-100 of quality of life , where zero is the lowest quality of life and 100 the best quality of life. The following figures in scoring in all seven facets were recorded: Family and Family Life (57.03); Sensory Functioning (58.74), Autonomy (55.3); Death and Dying (64.37) Present and Future (46.56); Social Participation (42.97) and Intimacy (27,19). It was further found that there are several correlations between: the IB and IL &B; Between IB and facets: Autonomy in the Past, Present and Future and Social Participation; Between IL & B and facet Autonomy; Among various facets of WHOQOL-OLD and IB and IL & B and issues: Time Bedridden, Level of Education and time Bedridden. Discussion: If we interpret together the four facets that have the highest values of quality of life, it appears that despite low incomes and the elderly, the elderly show that this sample have a positive perception in relation to: Death and Dying ; Family Relations; Autonomy and Freedom in the management and decision making. Regarding the correlations between variables, there is a positive correlation between the Barthel Index and Lawton & Brody, ie when the degree of independence of one increases the other accompanying its increase. Conclusions: This study demonstrated the goals it has set itself, much as the initial aim of evaluate the quality of life and the degree of dependence of elderly supported by the Home Care of Penha de Franca Santa Casa da Misericordia de Lisboa, as well as the 4 issues research. The results obtained in this study with a sample of 40 subjects of this parish reveal that on average the elderly at that time had supported Lightweight Dependency level of Basic Activities of Daily Living (Barthel Index) on average have faced Dependency Index (Lawton and Brody ) and the average of the 7 areas of Evaluation of Quality of Life (WHOQOL-OLD version still validation for Portugal, by Master Manuela Vilar - Faculty of Psychology, University of Coimbra), scored 50.31 points on a scale 0-100 , quality of life.
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Orientação: Maria
do Céu Costa
Palavras-chave
CUIDADOS CONTINUADOS, QUALIDADE DE VIDA, IDOSOS, APOIO SOCIAL, APOIO DOMICILIÁRIO, TESTES PSICOLÓGICOS, ÍNDICE DE LAWTON, WHOQOL (OLD...), CONTINUING CARE MASTER, ELDERLY, SOCIAL SUPPORT, DOMICILIARY CARE, SANTA CASA DA MISERICÓRDIA DE LISBOA, PSYCHOLOGICAL TESTS, TESTES PSICOLÓGICOS, MESTRADO EM CUIDADOS CONTINUADOS INTEGRADOS, MMSE (AVALIAÇAO...)