Qualidade de vida na perspectiva de idosos institucionalizados no Município de Natal - RN

A descriptive and exploratory Study, quantitative in nature, with the aim to assess the Quality of Life (QL) of the elderly leaving in a Long Residence Institution (LRI) according to their own perception. It was conducted in six Public Institutions of Long Residence for Seniors, in the municipality of Natal - RN, in the period of July to August 2007. The data was collected using two structured interview forms: the first, containing questions about socio-demographic aspects and the second - the WHOQUOL-OLD, prepared by the World Health Organization to assess elderly s quality of life. The reference population was 266 old persons, and a random sample, of 43, being 28 women and 15 men, who account for 30%. The results indicated there is a predominance of older women (65.1%) and the average age is 76.6 years; the predominant religion is the Catholic - 44.2% and, 32.6% are unmarried without children. As for schooling and precedence, 41.9% are illiterate and 67.4% come from the rural area. The time of residency in the institution goes between 1 to 5 years for 69.8% of the elderly, 37.2% of them residing in the institution for not having another option. Most elderly informed using medicines. 51.3% said they are taking anti-hypertensive. As for the other aspects of QL: sensory aspects, autonomy, past, present and future activities, social participation, death and dying and intimacy, the WHOQOL-OLD, showed an average total score of 52.9% (scale of 0 to 100), with a tendency to neutrality, denoting that the elderly, in this study, evaluated their QL as neither satisfactory or unsatisfactory. Of all the facets of the instrument of QL, the sensory facet secured the highest average scores (68,1%), showing that the elderly are "happy" in the situation in which they find themselves, not showing significant disabilities. The facet of autonomy, which refers to the independence and the ability to make decisions on their own life, received the lowest average scores (40.7%), showing the dissatisfaction of the elderly on this aspect. The evaluation of the elderly on other facets were: social participation (48.2%); activities past, present and future (44.6%) and intimacy (50.6%), all perceived as neither unsatisfactory or satisfactory. On the item death and dying, the elderly people declared themselves satisfied, with average score of 65.5%. The analysis of the reliability of the WHOQOL-OLD by the Cronbach Alpha showed 0.57, considering the 24 items that cover the instrument, showing regular internal reliability of the instrument, in our reality. The result is probably due to differences between the regions south and east and the broader sociocultural diversity. We believe that the elderly in this study, tended to realize their QL as neutral, considering it as neither unsatisfactory or satisfactory, result likely related to the resignation with the destine, characterized, at the time, by the finitude of life, feeling very common among elderly, or perhaps, even for an accommodation, often accompanied by discouragement, present in the daily life of many of them

Prevalência e fatores associados ao risco e a desnutrição em idosos institucionalizados

One of the most important problems in the elderly is a nutritional deficiency. Several physiological changes and the use of multiple drugs interfere with appetite, food intake and absorption of nutrients, which can lead to the risk and malnutrition in the elderly, especially among institutionalized. The present study aimed to evaluate the prevalence of malnutrition and risk for malnutrition and its associated factors in institutionalized elderly. The same can be characterized by the type individual, observational and cross-sectional. Obtaining the sample was through the records of individuals of long-stay institutions for the elderly in the city of Natal, RN. The elderly were evaluated through the Mini Nutritional Assessment (MNA) and triceps skinfold (TSF) and each senior or caregiver answered a questionnaire about information like type and dietary restrictions, accessibility to food, use of alcohol and tobacco, practice physical activity and appetite. Variables such as age, gender, education, marital status, time that the elderly living in the institution, the reason for the institutionalization and comorbidities were taken from the records of each senior. The frequency of food consumption of various food groups was assessed from the questionnaire frequency of feeding study Health, Wellbeing and Aging (HWA). Data were presented as means and standard deviations, absolute and relative frequencies. To analyze the frequency of consumption, there was a factor analysis with extraction of factors from the principal components analysis with varimax rotation. A bivariate analysis was performed using the chi-square and the magnitude of the effect observed by prevalence ratio (95% CI). The Poisson regression assessed the net effect of independent variables on the two outcomes, considering a significance level of 5%. We studied twelve Homes for the Aged totaling 381 seniors eligible for the study. The prevalence of risk of malnutrition was 46.1% (45.9 to 46.2) and malnutrition was 31.4% (31.2 to 31.5). The risk of malnutrition was significantly associated with the presence of urinary incontinence (RP = 1.444, 1.113 to 1.874) was associated with malnutrition and lack of appetite (RP = 1.757, 1.246 to 2.476), the fact that the individuals do not have access to food outside the institution (RP = 0.565, 0.337 to 0.946), low water consumption (RP = 1.646, 1.101 to 2.459) and dementia (PR = 1.537, 1.072 to 2.204). The high prevalence of malnutrition and risk of malnutrition in the study suggests that we should pay attention to information related to eating habits and the presence of comorbidities, as these can influence the nutritional status of this population