Advanced search
Start date

The impact of care on families of patients with disabilities and dependence in different contexts of vulnerability

Full text
Cintia Hitomi Yamashita
Total Authors: 1
Document type: Doctoral Thesis
Press: São Paulo.
Institution: Universidade de São Paulo (USP). Escola de Enfermagem (EE/SBD)
Defense date:
Examining board members:
Maria Amelia de Campos Oliveira; Marcia Regina Martins Alvarenga; Suely Itsuko Ciosak; Yeda Aparecida de Oliveira Duarte; Sofia Cristina Iost Pavarini
Advisor: Maria Amelia de Campos Oliveira

Introduction and justification: The family is an important support resource in case of illness of one of its members. However, when care is provided at home, there is a great impact on the family environment, which can change the dynamics and strengthen or weaken family relationships. Objective: To evaluate the impact of care on families of patients with disabilities and dependence in different contexts of vulnerability. Method: longitudinal survey using data from the SABE Study (Health, Welfare and Aging), 2010 and 2015. The elderly included in the study were grouped into three categories, according to the difficulty reported in performing basic activities of daily living (BADL): Incidence, Decline and Permanence. For each context of social vulnerability (low and medium/high), an analysis was made of the elderlys profile, health condition, difficulty in performing BADL, family characteristics, social network and support, caregivers\' profile, difficulties faced and aspects positive of care. Descriptive data analysis and hierarchical multiple logistic regression were performed for each group of functional disability in each context of vulnerability, considering the sample weight. Data were analyzed using the Stata software version 15.1 and the results were considered statistically significant when p <0.05. Results: in the context of low social vulnerability, 61.06% of the elderly were classified in the Incidence group, 19.41% in the Decline group and 19.53% in the Permanence group. In the medium to high vulnerability context, 54.58% was included in the Incidence group, 30.93% in the Decline group and 14.49% in the Permanence group. In both contexts and in all disability groups, elderly people who lived with their children predominated, shared the household with one to two people, had a good perception of family functionality, and were assisted with household tasks. The Decline group had the highest proportion of elderly people with a caregiver in both contexts: 37.83% of the elderly in low vulnerability context and 53.47% in medium to high vulnerability context. The Incidence and Permanence groups, in the medium to high vulnerability context, presented a higher proportion of caregivers who reported high difficulty in caring for the elderly. In contexts of low vulnerability, predominated caregivers who reported low difficulty in the Incidence and Decline groups. Satisfaction with the care provided was high for the Incidence (low vulnerability) and Permanence (medium to high vulnerability) groups. Only the Permanence group (low vulnerability) showed a predominance of caregivers who reported low satisfaction with the care provided. In low vulnerability context, in 2010, caregivers\' perception of family functionality was good in all groups of functional disability; In 2015, most caregivers rated families as dysfunctional. In contexts of medium to high vulnerability, in both years, good family functionality predominated. Variables associated with functional disability varied between groups; however, family dysfunction and the absence of caregivers stand out, which influenced the functional disability of the elderly in most groups, in both contexts of vulnerability. Conclusion: the aspects that most influenced functional disability varied between disability groups and vulnerability contexts. Thus, in addition to the profile of the elderly, family and caregivers, the focus of the intervention should consider the resources available in certain contexts of social vulnerability in order to reduce the burden of care. (AU)

FAPESP's process: 14/17821-0 - Impact of caregiving in families of patients with disabilities and dependence in different contexts of vulnerability
Grantee:Cintia Hitomi Yamashita
Support type: Scholarships in Brazil - Doctorate