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Caracterização da funcionalidade em diferentes fases do ciclo de vida: idosos e adultos com doenças crónicas
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RESUMO - Relevância: O envelhecimento demográfico e o aumento da prevalência das doenças crónicas constituem grandes desafios para o planeamento de políticas de saúde, a nível mundial. Face a esta situação, considera-se que a caracterização da funcionalidade em diferentes fases do ciclo de vida (idosos e adultos com doenças crónicas) pode ser um contributo importante para conhecer o estado de saúde destas populações, pois facilita o planeamento e o desenho de políticas que possibilitam uma alocação de recursos mais adequada e racional para monitorizar os resultados das intervenções.
Objetivo geral do estudo: Construção e validação de instrumentos para a caracterização da funcionalidade da população em diferentes fases do ciclo de vida: população com mais de 65 anos e adultos (entre os 18 e os 64 anos) com doenças crónicas não transmissíveis. Neste âmbito, foram desenvolvidos dois estudos exploratórios: (1) caracterização da funcionalidade na população com 65 anos ou mais; (2) e caracterização da funcionalidade da população adulta com doença crónica. Apesar de objetivos genericamente semelhantes, cada estudo teve uma amostra distinta: (1) amostra aleatória e estratificada por idade, sexo e região do Alentejo; (2) amostra aleatória estratificada por patologia crónica, sexo, idade, possuir um Certificado de Incapacidade Temporária (CIT) prorrogado no último ano, sem nenhum CIT, estar registado(a) num dos dez ACES aleatorizados.
Metodologias: Foram utilizadas metodologias qualitativas e quantitativas, consoante o objetivo e a fase do estudo, nomeadamente: revisão sistemática de literatura, painel Delphi, grupo nominal, grupo de discussão, análise fatorial exploratória e confirmatória, estatísticas descritivas e diferenciais, análises correlacionais e de regressão.
Resultados: A análise dos dados revelou que receber cuidados pessoais é a variável com maior impacto na funcionalidade dos idosos em todas as dimensões e nas pessoas com doenças crónicas as maiores dificuldades relacionam-se com Mobilidade e autocuidados.
Conclusão: Os instrumentos desenhados apresentam boas características psicométricas. As pessoas depois dos 18 anos com doença crónica e os idosos em geral têm mais dificuldades na dimensão Estruturas relacionadas com o movimento e na dimensão da Mobilidade e autocuidados, e sendo estas dimensões indicadoras do estado de saúde nesta população devem ser alvo de políticas transversais a todos os setores, com o objetivo de potenciar ganhos em saúde.
ABSTRACT - Relevance: The demographic aging and increased prevalence of chronic diseases are challenges to the planning of health policies worldwide. In this context, it is considered that the characterization of the functionality in different stages of the life cycle (elderly and adults with chronic diseases) can be an important contribution to know the state of health of these populations, which it facilitates the planning and the design of policies that enable a more adequate and rational allocation of resources to monitor the results of interventions. General objective of the study: Construction and validation of instruments to characterize the functionality of the population in different phases of the life cycle-population over 65 years and adults (> 18, <65) with chronic no communicable diseases. For that purpose, two exploratory studies were developed: (1) characterization of the functionality in the population aged 65 years and over; (2) and characterization of the functionality of the adult population with chronic disease. The objectives are generically similar, but each study had a different sample: (1) random sample stratified by age, gender, and Alentejo region; (2) Randomized sample stratified by chronic pathology; sex; age; Have an certificate of temporary incapacity (CTI) extended in the last year; without any CTI; be registered in one of the ten randomized healthcare centers. Methodologies: Qualitative and quantitative methodologies were used, depending on the objective and the phase of the study, systematic literature review, Delphi panel, nominal group, discussion group, factor analysis, descriptive and differential statistics, correlation and regression analysis. Results: Data analysis revealed that receiving personal care is the variable with the greatest impact on the functionality of the elderly in all dimensions, and in people with diseases the greatest difficulties are related to Mobility and self-care. Conclusion: The instruments designed have good psychometric characteristics. People with chronic illness after the age of 18 and older people in general have more difficulties in the dimension of movement-related structures, and in the dimension of mobility and self-care, these dimensions should be the subject of policy designs that are transversal to all sectors, With the aim of promoting health gains, mobility dimensions and self-care, because they are indicators of health status in this population.
ABSTRACT - Relevance: The demographic aging and increased prevalence of chronic diseases are challenges to the planning of health policies worldwide. In this context, it is considered that the characterization of the functionality in different stages of the life cycle (elderly and adults with chronic diseases) can be an important contribution to know the state of health of these populations, which it facilitates the planning and the design of policies that enable a more adequate and rational allocation of resources to monitor the results of interventions. General objective of the study: Construction and validation of instruments to characterize the functionality of the population in different phases of the life cycle-population over 65 years and adults (> 18, <65) with chronic no communicable diseases. For that purpose, two exploratory studies were developed: (1) characterization of the functionality in the population aged 65 years and over; (2) and characterization of the functionality of the adult population with chronic disease. The objectives are generically similar, but each study had a different sample: (1) random sample stratified by age, gender, and Alentejo region; (2) Randomized sample stratified by chronic pathology; sex; age; Have an certificate of temporary incapacity (CTI) extended in the last year; without any CTI; be registered in one of the ten randomized healthcare centers. Methodologies: Qualitative and quantitative methodologies were used, depending on the objective and the phase of the study, systematic literature review, Delphi panel, nominal group, discussion group, factor analysis, descriptive and differential statistics, correlation and regression analysis. Results: Data analysis revealed that receiving personal care is the variable with the greatest impact on the functionality of the elderly in all dimensions, and in people with diseases the greatest difficulties are related to Mobility and self-care. Conclusion: The instruments designed have good psychometric characteristics. People with chronic illness after the age of 18 and older people in general have more difficulties in the dimension of movement-related structures, and in the dimension of mobility and self-care, these dimensions should be the subject of policy designs that are transversal to all sectors, With the aim of promoting health gains, mobility dimensions and self-care, because they are indicators of health status in this population.
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Funcionalidade Doenças crónicas Idosos Functionality Chronic diseases Elderly