Intervenção educativa na adesão dos idosos às medidas preventivas de quedas e nas crenças em saúde : estudo quase experimental

• Autor(a) principal: Cardoso, Joana Darc Chaves
• Data de Publicação: 2020
• Tipo de documento: Tese
• Idioma: por
• Título da fonte: Repositório Institucional da UFMT
• Texto Completo: http://ri.ufmt.br/handle/1/3649
• topic: Saúde do idoso; Acidentes por quedas; Educação em saúde; Prevenção e controle; Cooperação e adesão ao tratamento; CNPQ::CIENCIAS DA SAUDE::ENFERMAGEM; Health of the elderly; Accidental falls; Health education; Prevention and control; Treatment adherence and compliance

ABSTRACT: The adoption of preventive measures (PM) is the best way for the elderly to prevent falls, however they find it difficult to adopt these measures in their daily lives. Objective: to evaluate the effect of an educational intervention on the elderly's adherence to preventive measures against falls and beliefs in health. Materials and Method: quasiexperimental study, with a time-series design, carried out at the Community Center for Seniors in Cuiabá, from June to October 2019. The sample was determined considering error type I = 5%, error type II = 20%, proportion of adherence to falls MP = 64.36%, minimum difference before and after intervention = 4%, resulting in a minimum sample of 66 elderly people. 30% were added to the sample, predicting losses, and ended with 97 elderly people. Included: people aged 60 and over and who performed at least one of the physical activities. Excluded: people who had cognitive and mental difficulties. 109 elderly people were recruited (baseline), of whom 68 completed an intervention protocol. The educational intervention was based on the Health Belief Model (HBM) and carried out in six stages (T0 to T5). Validated instruments were applied for pre and post-intervention assessments: sociodemographic characteristics and health conditions, health beliefs and adherence to falls PM. Simple (unadjusted) and adjusted multiple linear regression analyzes and paired t and Wilcoxon tests for paired samples were used. Results: the majority of the elderly recruited is a woman (86.24%), a widow (37.61%), had 1 to 4 years of study, average age of 69.73 years, with health problems (93.58 %) and 46.79% fell in the last year. In simple linear regression, dimensions 3 (perception of the benefits of adhering to falls PM), 4 (perception of barriers to adhering to PM falls) and the total score of health beliefs was positively and significantly associated with the elderly's adherence to falls PM (p 0.002, p <0.001, p <0.001, respectively). In multiple linear regression, dimensions 3, 4 and the total score of beliefs in health remained positively associated with the adherence of the elderly. In the pre and postintervention comparison, there was a statistically significant increase in the mean scores of the constructs perception of susceptibility, perception of severity, perception of benefits, perception of barriers and in the total score of beliefs (p <0.0001, 0.0019, <0.0001, <0.0001 and <0.0001, respectively). The indicators of total adherence increased (p <0.0001) and partial adherence decreased (p <0.0001) significantly. When adding the total adherence to the partial, there was a significant increase in the adherence of the elderly to the preventive measures for falls after the educational intervention (p <0.0001). Conclusion: there was a positive association between the adherence of the elderly to the PM of falls with beliefs in health and that educational intervention based on the HBM was able to improve these beliefs and their adherence. It is recommended that nurses consider the health beliefs of the elderly about falls and their prevention in health care for these people and that educational interventions based on this model are used.