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1.
Heliyon ; 10(15): e35120, 2024 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-39161834

RESUMO

Background: Digital inclusion of older people is an important agenda for the future and well-being of the older population, as it represents a form of social inclusion with significant gains for healthy aging. The present study aimed to understand the experiences of Brazilian older adults who use smartphones and the implications in their daily lives. Method: A qualitative study was developed using a constructivist grounded approach. Older people (≥60 years) with prior access to a smartphone were invited to participate in the study. Participation took place through semi-structured, audio-recorded interviews. Data collection and analysis occurred simultaneously using a constant comparative approach. Data management and analysis used the Atlas.ti® software. Results: Overall, 37 older people participated, with an average age of 70.60 ± 6.95 years, predominantly female (n = 33), white (n = 25), married (n = 26) and retired (n = 27). The first sample group included 27 older people with family support and the second group included 10 older people without family support (who lived alone in their homes). A core category emerged from the data analysis-"Expanding the personal and social development of older adults through smartphone communication"-around which three main categories emerged: 1) The smartphone as "a window to the world"; 2) The problem of misinformation and fake news on virtual networks; 3) Technological paradoxes in the use of smartphones. Conclusions: The digital transition associated with smartphone use brings unimaginable benefits to older adults who adopt positive habits to improve their well-being and expand their social connections, following efforts proposed by the Decade of Healthy Aging. However, older adults still face disparities and experience a significant digital divide, which represents a major challenge. Barriers to access are further aggravated in developing countries. We hope this study contributes to public health policies on digital inclusion and healthy aging.

2.
Healthcare (Basel) ; 12(14)2024 Jul 19.
Artigo em Inglês | MEDLINE | ID: mdl-39057586

RESUMO

The persistence of symptoms for more than three months following infection with severe acute respiratory syndrome coronavirus 2 is referred to as "Long COVID". To gain a deeper understanding of the etiology and long-term progression of symptoms, this study aims to analyze the prevalence of Long COVID and its associated factors in a cohort of Brazilian adults and elders, twelve months after hospital discharge. An observational, prospective, and follow-up study was performed with a cohort of adults and older adults diagnosed with COVID-19 in 2020 in the State of Paraná, Brazil. Twelve months after hospital discharge, patients answered a phone questionnaire about the persistence of symptoms after three levels of exposure to COVID-19's acute phase (ambulatory, medical ward, and intensive care unit). According to the characteristics of participants, the prevalence of Long COVID-19 was calculated, and logistic regression analyses were conducted. We analyzed data from 1822 participants (980 adults [≥18-<60 years] and 842 older people [≥60 years]) across three exposure levels. The overall Long COVID prevalence was 64.2%. Long COVID was observed in 646 adults (55%; of which 326 were women) and 523 older people (45%; of which 284 were women). Females had a higher prevalence of long-term symptoms (52%) compared with men. The most common post-COVID-19 conditions in the 12-month follow-up were neurological (49.8%), followed by musculoskeletal (35.1%) and persistent respiratory symptoms (26.5%). Male individuals were less likely to develop Long COVID (aOR = 0.50). Other determinants were also considered risky, such as the presence of comorbidities (aOR = 1.41). Being an adult and having been hospitalized was associated with the development of Long COVID. The risk of developing Long COVID was twice as high for ward patients (aOR = 2.53) and three times as high for ICU patients (aOR = 3.56) when compared to non-hospitalized patients. Presenting clinical manifestations of digestive (aOR = 1.56), endocrine (aOR = 2.14), cutaneous (aOR = 2.51), musculoskeletal (aOR = 2.76) and psychological systems (aOR = 1.66) made adults more likely to develop Long COVID. Long COVID was present in a large proportion of people affected by the SARS-CoV-2 infection. Presence of Long COVID symptoms displayed a dose-response relationship with the level of disease exposure, with a greater prevalence of symptoms associated with the severe form in the acute period.

3.
Artigo em Inglês | MEDLINE | ID: mdl-38928994

RESUMO

Previous studies on health in prison facilities have determined that imprisonment has adverse effects on both physical and emotional well-being. Therefore, the introduction of public health measures is encouraged. This study aimed to (a) evaluate the levels of physical activity and the health condition of a sample of Brazilian prisoners and (b) determine the predictors of low physical activity. An observational and cross-sectional study was developed following the STROBE checklist. Data collection took place between June and November 2019 in a maximum-security Brazilian prison institution. This study's final sample included 220 people selected through convenience sampling, of which 115 (53.2%) were aged 18 to 29 years, followed by 79 (36.6%) aged 30 to 44 years and 22 (10.2%) aged 45 to 59 years old. Overall, 64.3% of participants failed to meet the World Health Organization (WHO) recommendation for physical activity [at least 150-300 min of moderate-intensity or 75 min of vigorous-intensity aerobic physical activity per week]. The majority reported unhealthy food consumption (116; 53.7%). Regarding body mass index (BMI), 50.2% of individuals were classified as eutrophic, 38.1% were overweight and 11.6% were obese. Older age (AOR: 0.95; CI95%: 0.92-0.99; p = 0.01) and sitting time (AOR: 0.74; CI95%: 0.65-0.85; p < 0.01) were associated with low adherence to physical activity. Our results highlight the importance of practicing physical activity within the prison context and the need for institutional programs that promote regular physical activity.


Assuntos
Exercício Físico , Prisioneiros , Humanos , Estudos Transversais , Brasil , Adulto , Pessoa de Meia-Idade , Masculino , Prisioneiros/estatística & dados numéricos , Prisioneiros/psicologia , Adulto Jovem , Adolescente , Feminino , Índice de Massa Corporal
4.
Heliyon ; 10(7): e28369, 2024 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-38571660

RESUMO

Background: The worldwide community has shown significant interest in researching the management of Long COVID. However, there is scarce evidence about the daily experiences of people living with Long COVID and their insights into the healthcare services provided to them. Aims: This study aims to understand the experience of Long COVID sufferers with their symptoms and in accessing health services. Method: We employed Charmaz's grounded theory methodology, informed by constructivism, and applied the COREQ guidelines for qualitative research. Sixty-six Brazilians living with Long COVID participated in the study. The data was collected using semi-structured telephone interviews and analyzed using a constant comparative process. Findings: The findings refer firstly to the consequences of persistent Long COVID symptoms. Secondly, they describe how the disease trajectory required Long COVID sufferers to reorganize their routines and develop adaptive strategies. Lastly, they reflect a diverse array of both positive and negative interactions inside the healthcare system conveyed by individuals suffering from Long COVID. These elements converge towards the core category of the study: "The limbo of Long COVID sufferers: between the persistence of symptoms and access to health services". Conclusions: Long COVID is characterized by its varied nature, including a range of physical and emotional repercussions experienced by individuals. There is a need for enhanced comprehension and discourse about Long COVID across several domains, including the general public, policy-making entities, and healthcare professionals. In this sense, the development of specialized services or the reinforcement of existing services to support long COVID sufferers is imperative.

5.
J Clin Nurs ; 33(1): 178-191, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36680417

RESUMO

AIMS AND OBJECTIVES: This paper aims to: (a) determine the personal, sociodemographic, clinical, behavioural, and social characteristics of older Brazilians with clinical evidence of long COVID; (b) evaluate perceived quality of life and determine its association with personal, sociodemographic, behavioural, clinical and social variables; and (c) assess significant predictors of high perceived QoL. BACKGROUND: Given the inherent vulnerabilities of the ageing process, the older people are an at-risk group for both contagion of SARS-CoV-2 and the perpetuation of residual symptoms after infection, the so-called long COVID or post-COVID syndrome. DESIGN: A cross-sectional survey design using the STROBE checklist. METHODS: Brazilian older people with long COVID syndrome (n = 403) completed a phone survey measuring personal, sociodemographic, behavioural, clinical, and social characteristics, and perceived Quality of Life (QoL). Data were collected from June 2021-March 2022. A multiple linear regression model was performed to identify salient variables associated with high perceived QoL. RESULTS: The mean age of participants was 67.7 ± 6.6 years old. The results of the multivariate regression model showed that race, home ownership, daily screen time, musculoskeletal and anxiety symptoms, and work situation were the significant predictors of QoL among COVID-19 survivors. CONCLUSIONS: Knowledge about the persistence of physical, emotional, and social symptoms of COVID-19 can help nurses and other healthcare providers to improve the management of survivors, bringing benefits to the whole society. RELEVANCE TO CLINICAL PRACTICE: Given the novelty of long-COVID and its heterogeneous trajectory, interventions focusing on the repercussions and requirements unique to more vulnerable older persons should be developed and these aspects should be included in public health recommendations and policymakers' concerns. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution was required to design, to outcome measures or undertake this research. Patients/members of the public contributed only to the data collection.


Assuntos
COVID-19 , Síndrome de COVID-19 Pós-Aguda , Qualidade de Vida , Idoso , Humanos , Pessoa de Meia-Idade , Brasil/epidemiologia , COVID-19/epidemiologia , Estudos Transversais , Síndrome de COVID-19 Pós-Aguda/epidemiologia
6.
Healthcare (Basel) ; 11(17)2023 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-37685485

RESUMO

The COVID-19 pandemic had several repercussions on prison staff, but the currently available evidence has mainly ignored these effects. This qualitative study aimed to understand the impact of COVID-19 on the prison system through the narratives of health and security professionals, using the methodological framework of the constructivist grounded theory proposed by Charmaz. The sample included 10 healthcare workers and 10 security professionals. Data collection took place between October and November 2022 through individual in-depth interviews. The data were analyzed using the MaxQDA software. Three categories of interrelated data emerged: (1) "Confrontation and disruption" caused by the COVID-19 pandemic in the prison system; (2) "Between disinfodemic and solicitude" referring to the tension between information management and the practice of care centered on the needs of inmates; and, finally, (3) "Reorganization and mitigation strategies during the fight against COVID-19". Continuous education and the development of specific skills are essential to enable professionals to face the challenges and complex demands that arise in prison contexts. The daily routines professionals had previously taken for granted were disrupted by COVID-19. Thus, investing in adequate training and emotional support programs is crucial to promote the resilience and well-being of these professionals, ensuring an efficient and quality response to critical events.

7.
Artigo em Inglês | MEDLINE | ID: mdl-37569028

RESUMO

Worldwide, the COVID-19 pandemic represented a health emergency for prisons. This study sought to understand the meanings and experiences through the narratives of prisoners and family members affected by the COVID-19 pandemic in the context of a maximum-security state penitentiary complex in southern Brazil. For this purpose, a qualitative study was developed based on the methodological framework of constructivist grounded theory. Data were collected between February and August 2022 through individual in-depth interviews and field notes. The sample consisted of 41 participants: 28 male prisoners, and 13 family members. Guided by the Charmaz method of grounded theory analysis, the study afforded the core category "Feeling trapped in prison during the COVID-19 pandemic" with three interrelated phases: "Triggering", "Escalating", and "Readjustment". The "Triggering" phase refers to COVID-19-related elements or events that triggered certain reactions, processes, or changes in prison. During the "Escalating" phase, participants became overwhelmed by the suffering caused by incarceration and the pandemic crisis. The "Readjustment" phase involved adapting, reorienting, or reformulating previous approaches or strategies for dealing with a specific situation. Prisons faced complex challenges during the pandemic and were forced to prioritize protecting public health. However, the measures adopted must be carefully evaluated, ensuring their needs and that they are based on scientific evidence. The punitive approach can undermine inmate trust in prison authorities, making it difficult to report symptoms and adhere to preventive measures.

8.
Geriatrics (Basel) ; 8(3)2023 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-37367097

RESUMO

Abuse against elders is acknowledged as a severe and pervasive problem in society. If support services are not tailored to the victims' knowledge or perceived needs, the intervention is likely to be unsuccessful. This study aimed to explore the experience of institutionalisation of abused older people from the perspective of the victims and their formal carers in a Brazilian social shelter. A qualitative descriptive study was performed with 18 participants, including formal carers and older abused persons admitted to a long-term care institution in the south of Brazil. Qualitative thematic analysis was used to analyse the transcripts of semi-structured qualitative interviews. Three themes were identified: (1) personal, relational, and social bonds: broken or weakened; (2) denial of the violence suffered; and (3) from imposed protection to compassionate care. Our findings provide insights for effective prevention and intervention measures in elder abuse. From a socio-ecological standpoint, vulnerability and abuse might be averted at the community and societal levels (e.g., education and awareness of elder abuse) by creating a minimum standard for the care of older individuals (e.g., law or economic incentives). Further study is needed to facilitate recognition and raise awareness among individuals in need and those offering assistance and support.

9.
Behav Sci (Basel) ; 14(1)2023 Dec 23.
Artigo em Inglês | MEDLINE | ID: mdl-38247666

RESUMO

Long COVID is a multisystem condition that has multiple consequences for the physical, mental, and social health of COVID-19 survivors. The impact of the long COVID condition remains unclear, particularly among middle-aged and older adults, who are at greater risk than younger people of persisting symptoms associated with COVID-19. Therefore, we aimed to understand the experiences of middle-aged and older people who had been hospitalized for COVID-19 and the repercussions of long-term COVID symptoms in their daily lives. A qualitative study was carried out, adopting the framework of the constructivist grounded theory (CGT) proposed by Kathy Charmaz. Fifty-six middle-aged and older adult participants from the southern region of Brazil were recruited. Data were gathered from semi-structured telephone interviews. Concomitantly a comparative analysis was performed to identify categories and codes using the MaxQDA® software (version 2022). Three subcategories were identified: (1) experiencing COVID-19 in the acute phase; (2) oscillating between 'good days' and 'bad days' in long COVID; and (3) (re)constructing identity. These concepts interact with each other and converge upon the central category of this study: recasting oneself to the uniqueness of the illness experience of long COVID. Our findings provided insights related to the disruption in the lives of long COVID-19 sufferers who still live with persistent symptoms of the disease, including physical, social, family, emotional and spiritual repercussions. Likewise, this study may aid in developing friendly and welcoming social environments, lowering stigma and prejudice towards patients with long COVID, and fostering prompt and suitable policy support and mental health care for these individuals.

10.
Artigo em Inglês | MEDLINE | ID: mdl-36293568

RESUMO

This study explored the meanings and experiences of patients with terminal chronic diseases and their caregivers, who face the imminence of death in the home environment after hospital discharge. The qualitative study used constructivist grounded theory. The participants were individuals with a terminal chronic illness, discharged to home, and their family caregivers. Data were gathered from in-depth interviews and field notes, and a comparative analysis was conducted to identify categories and codes, according to Charmaz's theory. The sample consisted of 21 participants. Three inter-related data categories emerged: "Floating between acceptance and resistance: Perceiving the proximity of death", "Analysing the end from other perspectives: it is in the encounter with death that life is understood" and "Accepting the path: between the love of letting go and the love of wanting to stay". The categories translate the reconstruction of those facing end-of-life occurring in the home environment. It is amid the imminence of death that life gains intensity and talking about the finitude of life configures an opportunity to see life from other perspectives. Giving voice to individuals facing the mishaps of a terminal illness fosters the path to a comfortable death. For health professionals, it is an opportunity to provide structured and humanized care with an ethical attitude, in defence of human dignity.


Assuntos
Cuidadores , Cuidado Transicional , Humanos , Teoria Fundamentada , Pesquisa Qualitativa , Hospitais
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