Validação do instrumento dos indicadores observáveis da qualidade do cuidado em instituições de longa permanência para idosos

The Nursing Homes are an important alternative care in the world, but Brazil still has no valid instrument to monitor the quality these institutions. In the United States, the Observable Indicators of Nursing Home Care Quality Instrument (OIQ) is used to assess the quality of Nursing Home care using 30 indicators of structure (2 dimensions) and process (5 dimensions) related to quality person-centered care. The present study aimed at cross-culturally adapting the OIQ in order to evaluate the quality of Nursing Home care in Brazil. Conceptual and item equivalence were determined to assess the relevance and viability of OIQ in the Brazilian context, using the Content Validity Index (CVI) and a group of specialists composed of 10 participants directly involved in the object of study. Next, operational, idiomatic and semantic equivalence were carried out concurrently. This consisted of 5 phases: (1) two translations and (2) their respective back translations; (3) formal appraisal of referential and general meaning; (4) review by a second group of specialists; (5) application of the pretest at three Nursing Homes by different social entities: health professionals, sanitary surveillance regulators and potential consumers. Measurement equivalence was evaluated by the Cronbach’s alpha test to verify the internal consistency of the instrument. To measure inter-evaluator agreement, the General Agreement Index (ICG) and Kappa coefficient were used. Timely compliance and 95% Confidence Interval of indicators, dimensions and total construct were estimated. The CVI obtained high results for both relevance (95.3%) and viability (94.3%) in the Brazilian context. With respect to referential meaning, similarity was observed, ranging between 90-100% for the first back translation and 70-100% for the second. In relation to general meaning, version 1 was better, classified as “unchanged” in 80% of the items, whereas in version 2 it was only 47%. In the pretest, the OIQ was easy to understand and apply. The following outcomes were obtained: a high Cronbach’s alpha (0.93), satisfactory ICG (75%) and substantial agreement between the pairs of evaluators (health professionals, regulators from the Superintendency of Sanitary Surveillance –SUVISA-, and potential consumers), according to the Kappa coefficient (0.65). It´s possible take the operational equivalence held since it preserved the original layout in the Brazilian version from the maintenance in application mode, response options, number of items, statements and scores. The performance of nursing homes obtained approximate average scores of 87, a variation 55-111 considering a range from 30 to 150 points. The worst outcomes were related to process indicators with a mean of 2.8 per item, while structure was 3.75 on a scale of 1 to 5. The lowest score was obtained for the care dimension (mean 2). The OIQ version was deemed to be a valid and reliable instrument in the Brazilian context. It is recommended that health professionals, regulators and potential consumers adopt it to access and monitor the quality of Nursing Home care and demonstrating opportunities for improvement.

The song of humpback whale and the potential effects of whale-watching in the abrolhos bank, BA, Brazil

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

The song of humpback whale and the potential effects of whale-watching in the abrolhos bank, BA, Brazil

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Formação profissional do cuidador de idosos em instituições de longa permanência

The old caretaker's work seeks to minimize suffering and morbidity resulting from physical, cognitive and emotional limitations of these individuals, being a practice permeated by the uniqueness of the subjects involved, therefore, a process in constant construction. In this notion, the caregiver's role is crucial to assist the elderly in everyday life, aiming at improving their quality of life. This study has descriptive and analytical character with quantitative and qualitative approach aimed to investigate the professional training of active caregivers in long-term stay institutions for the Elderly (ILPIs) in Natal/RN in the year 2014. For this, semi-structured interviews were conducted with 63 caregivers employed in nine ILPIs, representing 75% of the professionals performing activities in these institutions. The interviews captured data on the socioeconomic profile, the perception about the profession and training of caregivers. Data were analyzed by observation of absolute and relative measures of central tendency of the numeric variables frequencies. It was found that most caregivers had poor socioeconomic status and had no specific training course to practice caregiver role. However, among those who carried out courses, most reported that the content covered during the training gave security to perform the practice, although they have shown a contradiction when referred to the need to build capacity. The perception of care is mainly related to love and care for the other while the choice of profession is associated with care practice itself. The results also indicate the presence of a low level of formal training for the exercise of the occupation, also revealing the weaknesses ranging from the absence of a core curriculum that can guide the formation, compounded by the low educational professionals in focus.

TS/Ph-3 macrophyte plots, Taylor Slough

This material is based upon work supported by the National Science Foundation through the Florida Coastal Everglades Long-Term Ecological Research program under Cooperative Agreements #DBI-0620409 and #DEB-9910514. This image is made available for non-commercial or educational use only.

TS/Ph-3 autosampler platform and macrophyte plots, Taylor Slough

This material is based upon work supported by the National Science Foundation through the Florida Coastal Everglades Long-Term Ecological Research program under Cooperative Agreements #DBI-0620409 and #DEB-9910514. This image is made available for non-commercial or educational use only.

Macrophyte plots at TS/Ph-2, Taylor Slough

This material is based upon work supported by the National Science Foundation through the Florida Coastal Everglades Long-Term Ecological Research program under Cooperative Agreements #DBI-0620409 and #DEB-9910514. This image is made available for non-commercial or educational use only.

Macrophyte plots at TS/Ph-1b, Taylor Slough

This material is based upon work supported by the National Science Foundation through the Florida Coastal Everglades Long-Term Ecological Research program under Cooperative Agreements #DBI-0620409 and #DEB-9910514. This image is made available for non-commercial or educational use only.

TS/Ph-4 macrophyte plots, Taylor Slough

This material is based upon work supported by the National Science Foundation through the Florida Coastal Everglades Long-Term Ecological Research program under Cooperative Agreements #DBI-0620409 and #DEB-9910514. This image is made available for non-commercial or educational use only.

Macrophyte plots at TS/Ph-2, Taylor Slough

This material is based upon work supported by the National Science Foundation through the Florida Coastal Everglades Long-Term Ecological Research program under Cooperative Agreements #DBI-0620409 and #DEB-9910514. This image is made available for non-commercial or educational use only.

TS/Ph-4 iron enrichment plots, Taylor Slough

This material is based upon work supported by the National Science Foundation through the Florida Coastal Everglades Long-Term Ecological Research program under Cooperative Agreements #DBI-0620409 and #DEB-9910514. This image is made available for non-commercial or educational use only.

Measuring sawgrass in macrophyte plots at TS/Ph-1 (Gustavo Rubio, Damon Rondeau)

This material is based upon work supported by the National Science Foundation through the Florida Coastal Everglades Long-Term Ecological Research program under Cooperative Agreements #DBI-0620409 and #DEB-9910514. This image is made available for non-commercial or educational use only.

TS/Ph-4 macrophyte plots, Taylor Slough

This material is based upon work supported by the National Science Foundation through the Florida Coastal Everglades Long-Term Ecological Research program under Cooperative Agreements #DBI-0620409 and #DEB-9910514. This image is made available for non-commercial or educational use only.