ABSTRACT BACKGROUND: We aimed to develop and validate a practical instrument to assess older adults’ satisfaction with their social participation (SP). DESIGN AND SETTING: This methodological validation study was conducted at a public higher education institution. METHODS: A two-phase study was designed, developed, and validated to assess older adults’ satisfaction with their SP. In the first phase, we conceptualized SP and developed an “instrument to assess older adults’ satisfaction with their SP (IAPSI),” as approved by a committee of specialists, pre-tested, and partially validated. Second, we determined the IAPSI’s reproducibility using Cronbach’s alpha to measure internal consistency, Pearson’s and Spearman’s coefficients to measure correlations, the Bland-Altman plot and intraclass correlation coefficient (ICC) to measure reproducibility. We also generated a receiver operating characteristic (ROC) curve. RESULTS: 102 older adults (mean age, 87.29) participated in the first phase. Moderate internal consistency (Cronbach’s alpha 0.7) and significant moderate correlations with quality of life by World Health Organization Quality of Life (WHOQOL)-bref and by WHOQOL-old social domains (Pearson’s coefficients 0.54 and 0.64, respectively; P < 0.001) were found. The ROC curve indicated an IAPSI score of 17 as the threshold for the impact of pain on satisfaction with SP (83.3% sensitivity and 88.9% specificity, P < 0.001). In the second phase, 56 older adults (between 81 and 90 years old) participated. We found adequate intra- and inter-observer reproducibility for the IAPSI (ICC 0.96 and 0.78, respectively). CONCLUSION: We have developed a practical instrument with appropriate psychometric properties to assess older adults’ satisfaction with their SP.

OBJETIVO: Avaliar a qualidade de vida de idosos em assistência domiciliária. MÉTODO: estudo transversal analítico. Foram avaliados idosos de um programa de assistência domiciliária quanto aos dados sociodemográficos, clínicos, funcionais e de qualidade devida pelo instrumento WHOQOL-Bref. Foram excluídos idosos com déficit cognitivo e/ou déficit auditivo grave. Utilizou-se o teste de Mann Whitney, Kruskal-Wallis e correlação de Spearman para verificar a associação do WHOQOL-Bref com as variáveis (α=0,05). RESULTADO: a amostra foi constituída por 23 idosos, com média etária de 84,22±7,89 anos, maioria feminina (69,6%). O número de comorbidades encontrado foi de 7,13±2,32. O tempo médio de dependência funcional foi de 3,48±2,5 anos. As variáveis que se aproximaram dos domínios do WHOQOL-Bref foram: sintomas depressivos (p<0,001), número de comorbidades (p=0,037) e capacidade funcional (p=0,019) com o domínio físico; idade (p=0,015), capacidade funcional (p=0,004), número de medicamentos (p=0,037) e sintomas depressivos (p=0,002) com o psicológico; idade (p=0,002), sintomas depressivos (p=0,002), número de comorbidades (p=0,010) com o meio-ambiente; afecções psiquiátricas (p=0,016) e capacidade funcional (p=0,001) com o domínio relações sociais; e queixa de dor (p=0,002), escala visual analógica de dor (p=0,021), número de medicamentos (p=0,002) e sintomas depressivos (p=0,050) com o domínio geral (overall). CONCLUSÃO: os fatores que influenciam negativamente a QV de idosos em AD são: idosos mais jovens, queixa de dor em maior intensidade, polifarmacoterapia, maior número comorbidades, presença de sintomas depressivos e outras afecções psiquiátricas e comprometimento funcional.

OBJECTIVE: To evaluate the quality of life of elderly patients in home care. METHOD: Analytical cross-sectional study. Elderly patients of a home care program were assessed regarding socio-demographic, clinical, functional data and quality of life by the WHOQOL-Bref. Elderly people with cognitive and/or severe hearing deficits were excluded from the study. The T-Student, ANOVA and Pearson's Correlation tests were used to investigate the association between the WHOQOL-Bref and the variables (α=0.05). RESULTS: The sample comprised 23 elderly patients, mostly female (69.6%), with mean age of 84.22±7.89 years. The number of comorbidities found was 7.13±2.32. The mean time of functional dependence was 3.48±2.5 years. The variables that presented significant association with the WHOQOL-Bref domains were: depressive symptoms (p<0.001), number of illnesses (p=0.037) and functional capacity (p=0.019) with the physical domain; age (p=0.015), functional capacity (p=0.004), number of drugs (p=0.037) and depressive symptoms (p=0.002) with the psychological domain; age (p=0.002), depressive symptoms (p=0.002), number of illnesses (p=0.010) with the environment domain; psychiatric affections (p=0.016) and functional capacity (p=0.001) with the social relationships domain; and pain complaint (p=0.002), analogical visual scale of pain (p=0.021), number of drugs (p=0.002) and depressive symptoms (p=0.050) with the overall domain ("overall"). CONCLUSION: Factors that negatively influence the QoL of elderly patients in HC are: young elderly, high intensity pain complaint, poly-pharmacotherapy, high number of illnesses, presence of depressive symptoms and other psychiatric affections, and functional deficit.

A violência contra idosos é uma questão social cada vez mais presente em todas as sociedades, até nos países em desenvolvimento. Uma das formas de violência menos conhecidas e denunciadas é a negligência doméstica, especialmente contra idosos que apresentam comprometimento funcional. Este artigo apresenta resultados de um estudo transversal descritivo/analítico realizado com cuidadores familiares de idosos comprometidos atendidos pelo Programa de Assistência Domiciliar a Idosos, da disciplina de geriatria da Escola Paulista de Medicina (Unifesp), com o objetivo de identificar a existência de fatores potencialmente associados à negligência doméstica na situação de cuidados domésticos prestados por familiares. Foram entrevistados quarenta cuidadores, sendo aplicados os questionários de identificação de perfil de idoso e cuidador e o instrumento Caregiver Burden Scale. Os resultados encontrados mostraram a existência de fatores potencialmente associados à negligência doméstica no perfil de idosos e cuidadores e nas correlações significativas entre as variáveis comprometimento funcional do idoso, ações de cuidados e depressão do cuidador, nas dimensões tensão geral e isolamento.

The cases of abuse against elderly people have been growing significantly throughout the entire world. Among the various forms of abuse, one of the less known and denounced is the domestic negligence. As it occurs mostly inside family and nursing homes, it is hardly identified. This article presents the results of a cross-sectional descriptive/analytical study that pointed out the existing factors potentially associated to domestic negligence towards elderly patients attended by the Elderly Home Care Program as part of the discipline of Geriatrics of the Paulista Medical School, Federal University of São Paulo, Brazil. Interviews were made with 40 familiar caregivers of these patients who had functional disability. The profiles of those patients and their caregivers were identified by questionnaires and the impact on those familiars by the Caregiver Burden Scale. The results revealed the existence of the following factors potentially associated with domestic negligence among elderly people, in the study population: the dimensions general tension and isolation, as well as depression and stress on the caregiver's side, and the elder's functional ability, are the causes that impact the most on caregivers.

A violência contra idosos é uma questão social cada vez mais presente em todas as sociedades, até nos países em desenvolvimento. Uma das formas de violência menos conhecidas e denunciadas é a negligência doméstica, especialmente contra idosos que apresentam comprometimento funcional. Este artigo apresenta resultados de um estudo transversal descritivo/analítico realizado com cuidadores familiares de idosos comprometidos atendidos pelo Programa de Assistência Domiciliar a Idosos, da disciplina de geriatria da Escola Paulista de Medicina (Unifesp), com o objetivo de identificar a existência de fatores potencialmente associados à negligência doméstica na situação de cuidados domésticos prestados por familiares. Foram entrevistados quarenta cuidadores, sendo aplicados os questionários de identificação de perfil de idoso e cuidador e o instrumento Caregiver Burden Scale. Os resultados encontrados mostraram a existência de fatores potencialmente associados à negligência doméstica no perfil de idosos e cuidadores e nas correlações significativas entre as variáveis comprometimento funcional do idoso, ações de cuidados e depressão do cuidador, nas dimensões tensão geral e isolamento.

The cases of abuse against elderly people have been growing significantly throughout the entire world. Among the various forms of abuse, one of the less known and denounced is the domestic negligence. As it occurs mostly inside family and nursing homes, it is hardly identified. This article presents the results of a cross-sectional descriptive/analytical study that pointed out the existing factors potentially associated to domestic negligence towards elderly patients attended by the Elderly Home Care Program as part of the discipline of Geriatrics of the Paulista Medical School, Federal University of São Paulo, Brazil. Interviews were made with 40 familiar caregivers of these patients who had functional disability. The profiles of those patients and their caregivers were identified by questionnaires and the impact on those familiars by the Caregiver Burden Scale. The results revealed the existence of the following factors potentially associated with domestic negligence among elderly people, in the study population: the dimensions general tension and isolation, as well as depression and stress on the caregiver's side, and the elder's functional ability, are the causes that impact the most on caregivers.