Manutenção da autonomia e independência: o cuidado de si de idosos com úlcera venosa

Abstract

Venous ulcer is a health public problem;itis an important chronic health problem and negative biopsychosocial impact on the lives of the elderly people. Human aging is accompanied by functional and cognitive decline, which can be enhanced in presence of disease situations.The health care for the elderly should appreciate the early identification of factors that may interfere in their independence and autonomy, through multidimensional assessment in order to plan actions that contribute to the self-care. In this context, elderly that living with venous ulcer are include. The question of this research was: how the elderly with venous ulcers in outpatient follow-uphave developed the self-care? This had the general aim:to understand the self-care of elderly patients with venous ulcer in outpatientfollow-up, from a teaching hospital, in the active aging perspective. The specific objectives were: to identify the functional and cognitive capacity and social support of elderly patients with venous ulcers in outpatient follow-up; and to describe how elderly who have venous ulcers, with outpatient follow-up, take care of themselves. This is a field research, exploratory and descriptive, with a qualitative approach. Ten elderly patients with venous ulcers, who were in outpatient follow-up at a University Hospital, participated. Data collection occurred from February to April 2015 through semi-structured interview. Katz and Lawton s scale and Brody s scalewere applied to assess the functional aspects; Mini Mental State Examinationwas used to assess the cognitive aspects; Inventory of Social Support Networkwas applied to evaluate social support. The data of the interview, after transcripts, were submitted to thematic content analysis. In assessing the functionality of the elderly, it was observed that they have independence for most of their daily activities, but have partial dependence for some. By analyzing the cognitive capacity, it was obtained predominance of elderly people without cognitive impairment and through social support, low number of components in the social networkwas observed, but with good quality in their relations. The family was considered the main source of support for the elderly, it helps in achieving the injury and health care, but there were times that the elderly had to demonstrate their capacity to autonomy, rejecting family interference. Self-care is evidenced in the care practice for the body, concern with cognitive capacity, leisure activities and care of venous ulcer. This causes several limitations in their daily routines, among them stood out the restriction to keep work and social relations, dependence for daily activities, body care and the psychological and emotional impact. It considers that this study allows us to support nursing care to recognize the self-care as acare object, which means favoring independence, autonomy and freedom of the individual, encouraging their participation and expression of the health needs and decision making about care practices.