Avaliação do alfabetismo funcional em saúde em cuidadores de idosos
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2017-12-20
Autores
Almeida, Kaoana Maria Vieira de
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Universidade Estadual Paulista (Unesp)
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Introdução: Indivíduos com baixos níveis de alfabetismo em saúde têm menor conhecimento das suas próprias condições de saúde, pior manejo de doenças crônicas e aumentam os custos dos serviços. Os cuidadores desenvolvem papel fundamental na vida dos idosos, pois os auxiliam em atividades no dia a dia, como higiene pessoal, uso de medicações e até mesmo na tomada de decisão em saúde. Existem poucos estudos que avaliam os níveis de alfabetismo em saúde em cuidadores de idosos. Objetivos: Avaliar o desempenho de cuidadores de idosos no instrumento S-TOFHLA (Short Test of Functional Health Literacy in Adults) que é uma ferramenta validada no Brasil para este objetivo. Métodos: Estudo transversal em que foram aplicados a 80 cuidadores de idosos atendidos rotineiramente por médicos de duas unidades da rede básica de saúde do município de Botucatu-SP os seguintes instrumentos: S-TOFHLA, questionário sociodemográfico, o Mini Exame do Estado Mental e o “The Patient Health Questionnaire (PHQ) 2”. A análise estatística das variáveis categorizadas foi realizada por meio do teste do qui-quadrado e as variáveis contínuas por meio do teste t de student. A análise multivariada utilizou modelo de regressão logística ordinal tendo como variável dependente os escores do teste S-TOFHLA. O nível de significância estatística adotado foi de 0,05. Resultados: Os indivíduos apresentaram idade média de 54,6(±11,7) anos sendo 87,5% do sexo feminino; 27% dos cuidadores avaliados apresentaram índices de não adequação em alfabetismo em saúde. Houve diferença estatisticamente significante (p<0,001) na distribuição dos níveis de escolaridade entre os grupos classificados como “inadequado”, “limítrofe” e “adequado” de acordo com o desempenho no S-TOFHLA, sendo que uma maior proporção de indivíduos com baixa escolaridade apresentou alfabetismo em saúde inadequado e limítrofe. De acordo com o modelo da regressão logística ordinal, para indivíduos da mesma faixa etária, o grupo de cuidadores com 5 a 8 anos de escolaridade teve 18 vezes mais chances do que o grupo de 1 a 4 anos de migrar de um nível menos adequado para um mais adequado (OR:18.0; IC95%: 3,0-107,0); O grupo de cuidadores com 9 a 11 anos de escolaridade teve 11 vezes mais chances (OR:11.0; IC95%: 2,0-57,0) e o grupo com escolaridade maior ou igual a 12 anos teve 38 vezes mais chances (OR:38,0; IC95%: 6,4-228,0). Conclusão: No presente estudo identificamos aproximadamente 1/3 dos indivíduos em níveis marginais e inadequados de alfabetismo em saúde, que se relacionam com baixa escolaridade dos cuidadores, mas não com a idade dos mesmos. Esses resultados mostram as dificuldades dos cuidadores no entendimento de informações em saúde, deixando clara a necessidade de criar estratégias para promover a melhor compreensão destas informações e assim prevenir erros e melhorar os cuidados prestados aos idosos. Sugere se que estudos prospectivos sejam feitos a fim de avaliar os impactos do analfabetismo dos cuidadores no curso de vida dos idosos.
Introduction: Individuals with low health literacy have less knowledge of their own health condition, poor self-management of chronic diseases, delayer on diagnosis and increases the costs of the services. Caregivers have a key role in elderly's daily living activities, assisting them on the daily activities such as personal hygiene, use of medication and health decision-making. There are few studies on health literacy among elderly’s caregivers. Aims: To evaluate the performance of elderly's caregivers on S-TOFHLA (Short Test of Functional Health Literacy in Adults), which is a validated tool in Brazil for that purpose. Methods: Cross-sectional study. The S-TOFHLA, a sociodemographic instrument, the Mini Mental State Exam and the Patient Health Questionnaire-2 were applied to 80 elderly’s caregivers. The elders were routinely followed by doctors from the Primary Health Care Sector of the City of Botucatu, SP. Statistical analysis of categorized variables was performed using the chi-square test and the continuous variables using the t-student test. The multivariate analysis used ordinal logistic regression model with the tests scores as the dependent variable. The level of statistical significance adopted was 0,05. Results: The individuals had a mean age of 54,6 (±11,7) years and 87,5% were female; 27% of the caregivers evaluated had no adequate levels in health literacy. There was a statistically significant difference (p<0,001) in the distribution of schooling levels among the groups classified as “inadequate”, “marginal” and “adequate” according to S-TOFHLA performance, and a higher proportion of individuals with low schooling presented inadequate and marginal health literacy. According to the ordinal logistic regression model, with the variable age, the group of caregivers with 5 to 8 years of schooling was 18 times more likely than the group of 1 to 4 years to migrate from a less adequate level to one more adequate (OR:18.0; IC95%: 3,0-107,0); The group of caregivers with 9 to 11 years of schooling was 11 times more likely (OR:11.0; IC95%: 2,0-57,0) and the group with schooling greater than or equal to 12 years had 38 times more chances (OR:38,0; IC95%: 6,4-228,0). Conclusion: In the present study we identified approximately 1/3 of the individuals at marginal and inadequate levels in health literacy among elderly’s caregivers, which are related to the individuals' low level of schooling, but not to their age. These results evidence the difficulties of caregivers in the understanding of health information emphasizing the need to create strategies to promote better understanding of this information and thus prevent errors and improve the care provided to the elderly. It is suggested that prospective studies need be done to assess the impacts of illiteracy among caregivers on the life of the elders.
Introduction: Individuals with low health literacy have less knowledge of their own health condition, poor self-management of chronic diseases, delayer on diagnosis and increases the costs of the services. Caregivers have a key role in elderly's daily living activities, assisting them on the daily activities such as personal hygiene, use of medication and health decision-making. There are few studies on health literacy among elderly’s caregivers. Aims: To evaluate the performance of elderly's caregivers on S-TOFHLA (Short Test of Functional Health Literacy in Adults), which is a validated tool in Brazil for that purpose. Methods: Cross-sectional study. The S-TOFHLA, a sociodemographic instrument, the Mini Mental State Exam and the Patient Health Questionnaire-2 were applied to 80 elderly’s caregivers. The elders were routinely followed by doctors from the Primary Health Care Sector of the City of Botucatu, SP. Statistical analysis of categorized variables was performed using the chi-square test and the continuous variables using the t-student test. The multivariate analysis used ordinal logistic regression model with the tests scores as the dependent variable. The level of statistical significance adopted was 0,05. Results: The individuals had a mean age of 54,6 (±11,7) years and 87,5% were female; 27% of the caregivers evaluated had no adequate levels in health literacy. There was a statistically significant difference (p<0,001) in the distribution of schooling levels among the groups classified as “inadequate”, “marginal” and “adequate” according to S-TOFHLA performance, and a higher proportion of individuals with low schooling presented inadequate and marginal health literacy. According to the ordinal logistic regression model, with the variable age, the group of caregivers with 5 to 8 years of schooling was 18 times more likely than the group of 1 to 4 years to migrate from a less adequate level to one more adequate (OR:18.0; IC95%: 3,0-107,0); The group of caregivers with 9 to 11 years of schooling was 11 times more likely (OR:11.0; IC95%: 2,0-57,0) and the group with schooling greater than or equal to 12 years had 38 times more chances (OR:38,0; IC95%: 6,4-228,0). Conclusion: In the present study we identified approximately 1/3 of the individuals at marginal and inadequate levels in health literacy among elderly’s caregivers, which are related to the individuals' low level of schooling, but not to their age. These results evidence the difficulties of caregivers in the understanding of health information emphasizing the need to create strategies to promote better understanding of this information and thus prevent errors and improve the care provided to the elderly. It is suggested that prospective studies need be done to assess the impacts of illiteracy among caregivers on the life of the elders.
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escolaridade, educação em saúde, alfabetismo em saúde, idosos, cuidadores, educational status, health education, health literacy, aged, caregivers