ABSTRACT BACKGROUND: The Positive Aspects of Caregiving (PAC) scale is used to assess psychosocial benefits provided to caregivers by the task of caring. The PAC scale consists of nine items, assessed using a five-point Likert scale, with higher values indicating greater positive perceptions and gains from the caregiving experience. OBJECTIVE: To translate and culturally adapt the PAC scale for informal Brazilian caregivers of people with dementia. DESIGN AND SETTING: A methodological study was conducted at the Federal University of São Carlos. METHODS: The following stages were carried out: Translation; Synthesis of the translations; Back-translation; Evaluation by an experts’ committee; and Pre-test. RESULTS: Two independent professionals translated the PAC scale. The consensus version was obtained by merging both translations, which were back-translated into English by a third translator. The expert committee comprised three specialists in the area and project researchers. All scale items presented a Content Validity Index of 1 (CVI = 1.0), and thus remained in the pre-final version of the instrument. The instrument was pre-tested with seven caregivers of people with dementia, the majority of whom were women (57.1%), with a degree of kinship corresponding to sons/daughters (57.1%) and an average age of 55.2 (± 4.1) years. The caregivers considered it clear and understandable and made no suggestions for changes. CONCLUSION: The PAC scale was translated and culturally adapted for use by informal caregivers of people with dementia in Brazil. However, a psychometric analysis of the instrument is necessary to provide normative data for this population group. BACKGROUND (PAC caring fivepoint five point experience OBJECTIVE SETTING Carlos METHODS out Translation translations Backtranslation Back translation Back-translation experts Pretest. Pretest Pre test. test Pre-test RESULTS backtranslated back translator researchers CVI 1.0, 10 1.0 , 0 1.0) prefinal pre final pretested tested 57.1%, 571 57.1% 57 sonsdaughters sons daughters (57.1% 552 55 2 55. ± ( 4.1 41 4 years changes CONCLUSION Brazil However group 1. 57.1 5 (57.1 4. 57. (57. (57 (5

ABSTRACT The sense of mastery is conceptualized as a positive aspect of care targeted at people living with dementia, a coping mechanism to reduce burden, and may represent a protective factor for caregivers’ mental and physical health. Objective: To translate and culturally adapt the Pearlin Mastery Scale for Brazil. Methods: A methodological study was conducted at the Federal University of São Carlos in which the initial translation stages were followed; synthesis; back-translation; review by the committee of judges by analyzing the Content Validity Index (CVI); and test of the pre-final version. Results: Two specialists translated the scale into Brazilian Portuguese and defined a consensus version with the researchers. Subsequently, another two specialists back-translated the consensus version, which was reviewed by three judges who are PhDs in the area, considering all scale items as very equivalent (CVI=1.0), and maintaining them in the pre-final version of the instrument. This was tested in a first group of caregivers for them to point out adjustments. The suggestions were accepted by modifying three items and, afterward, the scale was tested in a second group, which did not present difficulties answering the instrument. Conclusion: The Pearlin Mastery Scale was translated and culturally adapted for Brazil, showing equivalence. However, future psychometric analyses of the instrument are required to make it available for use in this population. dementia burden health Objective Brazil Methods followed synthesis backtranslation back back-translation CVI (CVI) prefinal pre final Results researchers Subsequently backtranslated area CVI=1.0, CVI10 CVI=1.0 , 1 0 (CVI=1.0) adjustments afterward Conclusion equivalence However population (CVI CVI1 CVI=1. (CVI=1.0 CVI=1 (CVI=1. CVI= (CVI=1 (CVI=

RESUMO O senso de domínio é conceituado como um aspecto positivo do cuidado voltado às pessoas que vivem com demência, um mecanismo de enfrentamento para reduzir a sobrecarga e que pode representar um fator protetor para a saúde mental e física do cuidador. Objetivo: Traduzir e adaptar culturalmente a Pearlin Mastery Scale para o Brasil. Métodos: Estudo metodológico conduzido na Universidade Federal de São Carlos, em que foram seguidas as etapas de tradução inicial; síntese; retrotradução; revisão pelo comitê de juízes pela análise do Índice de Validade de Conteúdo (IVC); e teste da versão pré-final. Resultados: Dois especialistas traduziram a escala para o português brasileiro e definiram uma versão consensual com os pesquisadores. Posteriormente, outros dois especialistas retrotraduziram a versão consensual, que foi revisada por três juízes doutores na área, considerando todos os itens da escala como muito equivalentes (IVC=1,0), mantendo-os na versão pré-final do instrumento. Esta foi testada em um primeiro grupo de cuidadores, a fim de se apontarem adequações. As sugestões foram acatadas mediante a modificação de três itens e, depois, a escala foi testada em um segundo grupo, o qual não apresentou dificuldades em responder ao instrumento. Conclusão: A Pearlin Mastery Scale foi traduzida e adaptada culturalmente para o Brasil, demonstrando equivalência. Entretanto, análises psicométricas futuras do instrumento são necessárias para disponibilizá-lo para uso entre essa população. demência cuidador Objetivo Brasil Métodos Carlos inicial síntese retrotradução IVC (IVC) préfinal. préfinal pré final. final Resultados pesquisadores Posteriormente área IVC=1,0, IVC10 IVC=1,0 , 1 0 (IVC=1,0) mantendoos mantendo cuidadores adequações depois Conclusão equivalência Entretanto disponibilizálo disponibilizá lo população (IVC IVC1 IVC=1, (IVC=1,0 IVC=1 (IVC=1, IVC= (IVC=1 (IVC=

RESUMO Objetivo Verificar a associação entre a restrição à participação decorrente de perda auditiva e a autopercepção da saúde, do suporte social e da qualidade de vida em pessoas idosas. Método Estudo com delineamento transversal, observacional, descritivo e com abordagem quantitativa dos dados. Foi utilizado um banco de dados com informações coletadas em um município brasileiro de médio porte, sendo incluídas no estudo 235 pessoas cadastradas em cinco unidades de Estratégia de Saúde da Família. Utilizou-se informações sociodemográficas, de saúde e os resultados dos questionários: avaliação à restrição à participação (Hearing Handicap Inventory for the Elderly Screening Version - HHIE-S), Suporte Social (Escala de Apoio Social do MOS), Avaliação Subjetiva de Saúde e a Qualidade de Vida (Short-Form 6 dimensions- SF-6D). Comparou-se os grupos com restrição e sem restrição à participação segundo as variáveis sociodemográficas, de saúde, suporte social e qualidade de vida. Um método de regressão logística binária multivariado foi utilizado para avaliar as associações entre as variáveis independentes e a restrição à participação. Resultados O grupo com restrição à participação é mais velho, possui menor qualidade de vida e pior autopercepção de saúde. Esta se mostrou ser o único preditor da restrição à participação relacionada à perda auditiva. Conclusão A restrição à participação está associada a uma pior autopercepção de saúde. O estudo revela a importância de avaliar a autopercepção dos indivíduos quanto às questões biopsicossociais, além de considerar o contexto ambiental para a compreensão dos impactos sociais e emocionais da perda auditiva. idosas transversal observacional porte 23 Família Utilizouse Utilizou sociodemográficas questionários Hearing HHIES, HHIES HHIE S , HHIE-S) Escala MOS, MOS MOS) ShortForm Short Form dimensions SF6D. SF6D SFD SF 6D . D SF-6D) Comparouse Comparou velho biopsicossociais 2 HHIE-S SF-6D

ABSTRACT Purpose To verify the association between participation restriction due to hearing loss and self-perception of health, social support, and quality of life in elderly people. Methods This is a cross-sectional, observational, and descriptive study with a quantitative data approach. A database with information collected in a medium-sized Brazilian municipality was used. The study was conducted with 235 elderly people registered in five Family Health Strategy Units. Sociodemographic and health information and the results of the following questionnaires were used: Hearing Handicap Inventory for the Elderly – Screening Version (HHIE-S), Medical Outcomes Study (MOS) Social Support Survey, Subjective Health Assessment, and Short-Form 6-Dimension (SF-6D) Health and Quality of Life Index. Groups with and without participation restriction were compared according to sociodemographic, health, social support, and quality of life variables. A multivariate binary logistic regression method was employed to evaluate the associations between the independent variables and participation restriction. Results The group with participation restriction is composed of older individuals with lower quality of life and poorer self-perception of health. Poorer self-perception of health was the only predictor of participation restriction related to hearing loss. Conclusion Participation restriction is associated with poorer self-perception of health. The study highlights the importance of assessing individuals’ self-perception regarding biopsychosocial issues, in addition to considering the environmental context to understand the social and emotional impacts caused by hearing loss. selfperception self perception support crosssectional, crosssectional cross sectional, sectional cross-sectional observational approach mediumsized medium sized used 23 Units HHIES, HHIES HHIE S , (HHIE-S) MOS (MOS Survey Assessment ShortForm Short Form 6Dimension Dimension 6 SF6D SFD SF 6D D (SF-6D Index sociodemographic issues 2 (HHIE-S

ABSTRACT The World Health Organization developed the "iSupport for Dementia" program for family caregivers of people with dementia. Objective: To explore studies on adaptation, randomized clinical trial protocols, and preliminary results of iSupport by unpaid caregivers of people living with dementia in different countries. Methods: Systematic review. Results: Ten cultural adaptation studies, eight randomized clinical trial protocols, and two preliminary results were included. Adaptation studies showed adjustments in terminology, design, and additional resources. Clinical trial protocols included burden as the primary outcome, and baseline, three months of intervention, and follow-up after six months. Studies with preliminary results found positive effects on the mental health and well-being of caregivers after using the program. Conclusion: iSupport is an online program of the World Health Organization in response to dementia in implementation in different countries. Dementia Objective countries Methods review Results terminology design resources outcome baseline intervention followup follow up wellbeing well being Conclusion

RESUMO A Organização Mundial da Saúde desenvolveu o programa "iSupport for Dementia" para cuidadores familiares de pessoas com demência. Objetivo: Explorar estudos sobre adaptação, protocolos de ensaio clínico randomizado e resultados preliminares do "iSupport" por cuidadores não remunerados de pessoas que vivem com demência em diferentes países. Métodos: Revisão sistemática. Resultados: Foram incluídos dez estudos de adaptação cultural, oito protocolos de Ensaio Clínico Randomizado e dois resultados preliminares. Os estudos de adaptação apresentaram os ajustes nas terminologias, design e recursos adicionais. Os protocolos de ensaio clínico incluíram a sobrecarga como desfecho primário, e com linha de base, três meses de intervenção e acompanhamento após seis meses. Os estudos com resultados preliminares encontraram efeitos positivos na saúde mental e bem-estar dos cuidadores após o uso do programa. Conclusão: O iSupport é um programa online da Organização Mundial da Saúde em resposta à demência na implantação em diferentes países. Dementia Objetivo países Métodos sistemática Resultados cultural terminologias adicionais primário base bemestar bem estar Conclusão

ABSTRACT BACKGROUND: Frailty comprises three dimensions: physical, psychological, and social. It is established that social frailty is correlated with several variables, such as quality of life, depression, and loneliness. These findings reinforce the need to investigate and define predictors of social frailty. OBJECTIVE: To translate, culturally adapt, and assess the reliability of the HALFT scale for Brazil. DESIGN AND SETTING: Methodological study conducted at Universidade Federal de São Carlos. METHODS: This study aimed to translate and culturally adapt the HALFT scale from English to Brazilian Portuguese, for which the steps of translation, synthesis of translations, back translation, evaluation by an expert committee, pre-test, and test-retest were followed. RESULTS: Two independent translators translated the HALFT. The consensual version was established by merging the translations, which were back translated into English by a third translator. The expert committee comprised seven health professionals working in frailty and/or social fields of study. Only one item on the scale had a content validity index of less than one (0.85). The instrument was pre-tested with 35 older adults who considered it clear and understandable, with no suggestion of changes. The reliability analysis (reproducibility) of the adapted version of the HALFT with test-retest of the scale with 23 participants showed a Kappa index of 0.62, showing good agreement. CONCLUSION: The HALFT scale is translated and adapted for Brazil, and shows good reliability. However, it is necessary to conduct psychometric analysis of the instrument to provide normative data for this population.

ABSTRACT BACKGROUND: Sarcopenia is defined as a slow, progressive, and apparently inevitable process of involuntary loss of muscle mass, strength, and quality, which occurs with advancing age. It is widely accepted that sarcopenia can directly affect quality of life. OBJECTIVE: Translate, adapt and validate the “Sarcopenia and Quality of Life” instrument (SarQoL) to the Brazilian context. DESIGN AND SETTINGS: Translation, cross-cultural adaptation, and validation study carried out at the Federal University of São Carlos, São Carlos, São Paulo, Brazil. METHODS: The population consisted of 221 older adult participants. The steps recommended by the guidelines from the authors of the original instrument were followed sequentially: initial translation, synthesis of translations, backward translation, evaluation by a panel of judges, pre-test, and analysis of psychometric properties. The translation and adaptation process was conducted as recommended. RESULTS: Two hundred and twenty-one participants took part in the step analysis of the psychometric properties of SarQoL, in which 55 presented sarcopenia. Cronbach's alpha coefficient of the total SarQoL questionnaire was 0.976, indicating excellent internal consistency. Excellent agreements between the test and retest with an Interclass Correlation Coefficient (ICC) of 0.983 (95% confidence interval: 0.901–0.996) were observed in the SarQoL domains. The domains of Short-Form 36 and EuroQoL 5-dimension showed significant correlation, from moderate to strong magnitude, with SarQoL total score, indicating convergent validity. CONCLUSION: The Brazilian version of SarQoL presented evidence of reliability and validity.

Abstract Objective This study aimed to translate and culturally adapt the COVID-19 Anxiety Scale for the Brazilian context. Method Cross-sectional and methodological study that encompassed the following stages: initial translation, synthesis of translations, back-translation, expert committee review, and pre-testing. Results The COVID-19 Anxiety Scale was initially translated into Portuguese by two translators. A consensus version was established and then back-translated into English by a different translator. Eight experts reviewed these versions, resulting in modifications to two of the seven scale items. This led to the creation of the pre-final version of the COVID-19 Anxiety Scale. Finally, the pre-testing of this version was conducted with 47 individuals, who found the scale to be clear and understandable. Conclusion In conclusion, the COVID-19 Anxiety Scale was adequately translated and culturally adapted for the Brazilian context, and further research is intended to verify evidence of the scale’s validity. COVID19 COVID 19 COVID-1 context Crosssectional Cross sectional stages translation translations backtranslation, backtranslation back back-translation review pretesting. pretesting pre testing. testing translators backtranslated translator versions items prefinal final Finally 4 individuals understandable conclusion scales s validity COVID1 1 COVID-

Resumo Objetivo Este estudo objetivou traduzir e adaptar culturalmente a COVID-19 Anxiety Scale para o contexto brasileiro. Método Trata-se de um estudo transversal e metodológico, que seguiu as seguintes etapas: tradução inicial, síntese das traduções, retrotradução, revisão por um comitê de especialistas e pré-teste. Resultados Inicialmente dois tradutores fizeram uma primeira tradução da COVID-19 Anxiety Scale para o português. Depois, estabeleceu-se a versão consensual, que foi retrotraduzida para o idioma inglês por outro tradutor. Posteriormente, as versões da COVID-19 Anxiety Scale foram revistas por oito especialistas. Após a análise, dois dos sete itens da escala foram modificados, obtendo--se a versão pré-final da COVID-19 Anxiety Scale. Por fim, essa última versão do instrumento foi pré-testada com 47 pessoas, que consideraram a escala clara e compreensível. Conclusão Conclui-se, portanto, que a COVID-19 Anxiety Scale foi adequadamente traduzida e adaptada para o contexto brasileiro e almeja-se dar seguimento à pesquisa para verificar evidências de validade da escala. COVID19 COVID 19 COVID-1 Tratase Trata se metodológico etapas inicial traduções retrotradução préteste. préteste pré teste. teste pré-teste português Depois estabeleceuse estabeleceu consensual tradutor Posteriormente análise modificados obtendose obtendo préfinal final fim prétestada testada 4 pessoas compreensível Concluise, Concluise Conclui se, Conclui-se portanto almejase almeja COVID1 1 COVID-

ABSTRACT. Unpaid caregivers of people living with dementia tend to suffer mental health problems as a result of the negative effects associated with the care tasks. Thus, psychosocial interventions for this population group are necessary. iSupport is an online support program for caregivers that was created by the World Health Organization. Objective: To describe the design of a randomized clinical trial to measure the efficacy of the iSupport-Brasil version on caregivers’ mental health and well-being. Methods: The participants will be randomized into Intervention Group (IG) (n=195) and Control Group (CG) (n=195). For three months, the IG will access the iSupport-Brasil platform, the CG will enter the electronic page of the Brazilian Alzheimer’s Association, and both groups will be emailed the preliminary version of the “Guia de cuidados para a pessoa idosa” e-book (a guide to providing care to the elderly) from the Ministry of Health. The data will be collected at three moments: baseline, and three and six months after the beginning of the intervention. Results: It is expected that it will be possible to provide diverse validity evidence about iSupport-Brasil as an online and free intervention alternative, as a preventive means and as a way to promote mental health among caregivers of people living with dementia. Conclusion: Through the evaluation protocol of this randomized clinical trial on the effects of the iSupport-Brasil program, it may become a reference for countries that plan to adapt and improve the iSupport program using digital health solutions. ABSTRACT tasks Thus necessary Organization Objective iSupportBrasil Brasil wellbeing. wellbeing well being. being well-being Methods (IG n=195 n195 n 195 (n=195 (CG n=195. . platform Alzheimers Alzheimer s Association Guia idosa ebook e book elderly moments baseline Results alternative Conclusion solutions n=19 n19 19 (n=19 n=1 n1 1 (n=1 n= (n= (n

RESUMO. Cuidadores informais de pessoas que vivem com demência tendem a sofrer problemas de saúde mental como resultado dos efeitos negativos associados às tarefas de cuidado. Assim, intervenções psicossociais para essa população são necessárias. O iSupport é um programa de apoio online para cuidadores criado pela Organização Mundial da Saúde. Objetivo: Descrever o desenho de um ensaio clínico randomizado para medir a eficácia da versão iSupport-Brasil na saúde mental e no bem-estar de cuidadores. Métodos: Os participantes serão randomizados em Grupo Intervenção (GI) (n=195) e Grupo Controle (GC) (n=195). Durante três meses, o GI acessará a plataforma iSupport-Brasil, o CG entrará na página eletrônica da Associação Brasileira de Alzheimer e ambos os grupos receberão por e-mail a versão preliminar do e-book Guia de cuidados para a pessoa idosa, do Ministério da Saúde. Os dados serão coletados em três momentos: linha de base, três e seis meses após o início da intervenção. Resultados: Espera-se que seja possível fornecer diversas evidências sobre os efeitos do iSupport-Brasil como alternativa de intervenção online e gratuita, de forma a promover a saúde mental entre os cuidadores de pessoas que vivem com demência. Conclusão: O protocolo de avaliação deste ensaio clínico randomizado sobre os efeitos do programa iSupport-Brasil pode se tornar uma referência para os países que planejam adaptar e melhorar esta intervenção, usando soluções digitais de saúde. RESUMO cuidado Assim necessárias Saúde Objetivo iSupportBrasil Brasil bemestar bem estar Métodos (GI n=195 n195 n 195 (n=195 GC (GC n=195. . iSupportBrasil, Brasil, email mail ebook book idosa momentos base Resultados Esperase Espera gratuita Conclusão n=19 n19 19 (n=19 n=1 n1 1 (n=1 n= (n= (n

RESUMEN Objetivo: Comparar el apoyo social percibido por personas mayores en un contexto de vulnerabilidad social según la funcionalidad familiar. Método: Estudio transversal con abordaje cuantitativo, realizado en São Carlos-SP, con 123 personas mayores residentes en contexto de alta vulnerabilidad social. La muestra fue dividida en dos grupos: buena funcionalidad familiar y disfunción familiar moderada/severa. Se recogieron datos sobre características sociodemográficas, funcionalidad familiar (APGAR Familiar) y apoyo social (Escala de Apoyo Social del Medical Outcomes Study). Se utilizaron las pruebas estadísticas de Mann-Whitney, Chi-cuadrado y exacta de Fisher. Resultados: Hubo una diferencia estadísticamente significativa entre el apoyo social y la funcionalidad familiar (p<0,05). El grupo con buena funcionalidad familiar obtuvo puntuaciones medias de apoyo social más altas: afectivo 100,00; material 95,00; información 90,00; emocional 90,00; interacción social positiva 85,00; en comparación con el grupo con disfunción familiar moderada/grave: afectivo 86,67; material 87,50; información 70,00; emocional 65,00; interacción social positiva 65,00. Conclusión: Las personas mayores que viven en familias disfuncionales tienen menos apoyo social percibido, en comparación con los que viven en familias con buena funcionalidad familiar. Objetivo Método cuantitativo CarlosSP, CarlosSP Carlos SP, SP Carlos-SP 12 grupos moderadasevera moderada severa moderada/severa sociodemográficas APGAR Familiar Escala Study. Study . Study) MannWhitney, MannWhitney Mann Whitney, Whitney Mann-Whitney Chicuadrado Chi cuadrado Fisher Resultados p<0,05. p005 p p<0,05 0 05 (p<0,05) altas 100,00 10000 100 00 95,00 9500 95 90,00 9000 90 85,00 8500 85 moderada/grave moderadagrave grave 86,67 8667 86 67 87,50 8750 87 50 70,00 7000 70 65,00 6500 65 Conclusión 1 p00 p<0,0 (p<0,05 100,0 1000 10 95,0 950 9 90,0 900 85,0 850 8 86,6 866 6 87,5 875 5 70,0 700 7 65,0 650 p0 p<0, (p<0,0 100, 95, 90, 85, 86, 87, 70, 65, p<0 (p<0, p< (p<0 (p< (p

ABSTRACT Objective: To compare the social support as perceived by elderly persons in a context of social vulnerability according to family functionality. Method: A cross-sectional study using a quantitative approach, carried out in São Carlos-SP, with 123 elderly people living in a context of high social vulnerability. The sample was divided into two groups: good family functionality and moderate/severe family dysfunction. Data was collected on sociodemographic characteristics, family functionality (Family APGAR) and social support (Medical Outcomes Study Social Support Scale). The Mann-Whitney, Chi-square and Fisher’s exact statistical tests were used. Results: There was a statistically significant difference between social support and family functionality (p < 0.05). The group with good family functionality obtained higher median social support scores: affective 100.00; material 95.00; information 90.00; emotional 90.00; positive social interaction 85.00; when compared to the group with moderate/severe family dysfunction: affective 86.67; material 87.50; information 70.00; emotional 65.00; positive social interaction 65.00. Conclusion: Elderly persons living in dysfunctional families have less perceived social support when compared to those living in families with good family functionality. Objective Method crosssectional cross sectional approach CarlosSP, CarlosSP Carlos SP, SP Carlos-SP 12 groups moderatesevere moderate severe dysfunction characteristics Family APGAR Medical Scale. Scale . Scale) MannWhitney, MannWhitney Mann Whitney, Whitney Mann-Whitney Chisquare Chi square Fishers Fisher s used Results p 0.05. 005 0.05 0 05 0.05) scores 100.00 10000 100 00 95.00 9500 95 90.00 9000 90 85.00 8500 85 86.67 8667 86 67 87.50 8750 87 50 70.00 7000 70 65.00 6500 65 Conclusion 1 0.0 100.0 1000 10 95.0 950 9 90.0 900 85.0 850 8 86.6 866 6 87.5 875 5 70.0 700 7 65.0 650 0. 100. 95. 90. 85. 86. 87. 70. 65.

RESUMO Objetivo: Comparar o apoio social percebido por pessoas idosas em contexto de vulnerabilidade social segundo a funcionalidade familiar. Método: Estudo transversal de abordagem quantitativa, realizado em São Carlos-SP, com 123 idosos inseridos em contexto de alta vulnerabilidade social. A amostra foi dividida em dois grupos: boa funcionalidade familiar e disfunção familiar moderada/severa. Foram coletados dados de caracterização sociodemográfica, funcionalidade familiar (APGAR de Família) e apoio social (Escala de Apoio Social do Medical Outcomes Study). Foram utilizados os testes estatísticos Mann-Whitney, Qui-quadrado e Exato de Fisher. Resultados: Houve diferença estatisticamente significante entre apoio social e funcionalidade familiar (p < 0,05). O grupo com boa funcionalidade familiar obteve maiores escores medianos de apoio social: afetivo 100,00; material 95,00; informação 90,00; emocional 90,00; interação social positiva 85,00; quando comparado ao grupo com disfunção familiar moderada/severa: afetivo 86,67; material 87,50; informação 70,00; emocional 65,00; interação social positiva 65,00. Conclusão: Pessoas idosas que vivem em famílias disfuncionais têm menos apoio social percebido quando comparadas àquelas que vivem em famílias com boa funcionalidade familiar. Objetivo Método quantitativa CarlosSP, CarlosSP Carlos SP, SP Carlos-SP 12 grupos moderadasevera moderada severa moderada/severa sociodemográfica APGAR Família Escala Study. Study . Study) MannWhitney, MannWhitney Mann Whitney, Whitney Mann-Whitney Quiquadrado Qui quadrado Fisher Resultados p 0,05. 005 0,05 0 05 0,05) 100,00 10000 100 00 95,00 9500 95 90,00 9000 90 85,00 8500 85 86,67 8667 86 67 87,50 8750 87 50 70,00 7000 70 65,00 6500 65 Conclusão 1 0,0 100,0 1000 10 95,0 950 9 90,0 900 85,0 850 8 86,6 866 6 87,5 875 5 70,0 700 7 65,0 650 0, 100, 95, 90, 85, 86, 87, 70, 65,

ABSTRACT BACKGROUND: Frailty is consensually understood to be a clinical syndrome in which minimal stressors can lead to negative outcomes such as hospitalization, early institutionalization, falls, functional loss and death. Frailty is more prevalent among patients with chronic kidney disease (CKD), and those on dialysis are the frailest. Depression contributes towards putting patients with CKD into the frailty cycle. OBJECTIVE: To assess frailty and its relationship with depression among patients with CKD undergoing hemodialysis. DESIGN AND SETTING: Observational and quantitative cross-sectional study conducted in a renal therapy unit, located in the interior of the state of São Paulo, Brazil. METHODS: This investigation took place in 2019, among 80 patients. The following instruments were applied: a sociodemographic, economic and health condition characterization and the Subjective Frailty Assessment (SFA) and Patient Health Questionnaire-9 (PHQ-9). RESULTS: Among the patients, there was higher prevalence of females, individuals with a steady partner and retirees, and their mean age was 59.63 (± 15.14) years. There was high prevalence of physical frailty (73.8%) and depression (93.7%). Depression was associated with frailty, such that patients with depression were 9.8 times more likely to be frail than were patients without depression (odds ratio, OR = 9.80; 95% confidence interval, CI, 1.93-49.79). CONCLUSION: Based on the proposed objective and the results achieved, it can be concluded that depression was associated with the presence of frailty among patients with CKD on hemodialysis.

RESUMO Objetivo Verificar a associação entre o bom desempenho de linguagem e o reconhecimento de expressões faciais de emoções em idosos. Método Estudo transversal realizado com 118 idosos dos serviços de atenção primária à saúde de um município paulista. Foram coletados dados sociodemográficos, de desempenho da linguagem pelo domínio do Exame Cognitivo de Addenbrooke - Revisado e de Reconhecimento de Expressões Faciais de Emoções. A amostra foi dividida em tercis de acordo com o desempenho na linguagem: T1 = melhor, T2 = mediano e T3 = pior. Os grupos T1xT3 foram comparados em relação ao desempenho no reconhecimento de expressões faciais de raiva, nojo, medo, alegria, tristeza e surpresa e para as intensidades 40%, 60%, 80% e 100%. A associação das variáveis independentes sobre o desempenho de linguagem foi analisada por meio de regressão logística. O modelo multivariado foi construído a partir dos resultados das análises univariadas e incluiu as variáveis contínuas por emoção e por intensidade. Idade e escolaridade, associadas ao desempenho de linguagem no modelo univariado, foram incluídas no modelo multivariado para ajustar as análises de associação. Resultados A amostra era predominantemente feminina (84,7%), com idade média de 70,5 anos e 3,5 anos de escolaridade. As variáveis associadas ao melhor desempenho de linguagem na análise comparativa de T1 e T3 foram: surpresa (OR= 1,485, IC 95% 1,194 – 1,846) e nojo (OR= 1,143, IC 95% 1,005 – 1,300). Conclusão O reconhecimento de expressões faciais das emoções surpresa e nojo mostraram-se importantes fatores associados ao bom desempenho da linguagem.

ABSTRACT Purpose To check the association between a good performance of language and the recognition of facial emotional expressions in elderly individuals. Methods Transversal study performed with 118 elderly individuals from the primary care services of health of a city in the state of São Paulo. Sociodemographic data were collected, regarding the performance of language through the domain of Addenbrooke Cognitive Examination – Revised and Recognition of Facial Emotional Expressions. The sample was divided in thirds according to the performance of language: T1 = the best, T2 = average, and T3 = the worst. The groups T1xT3 were compared regarding the performance of recognition of facial expressions of anger, disgust, fear, happiness, sadness, and surprise, and for the intensities of 40%, 60%, 80%, and 100%. The association of independent variables over the performance of language was analyzed through logistic regression. The multivariate model was built from the results of the univariate analyses and has included the continuous variables by emotion and by intensity. Age and schooling associated to the performance of language in the univariate model were included in the multivariate model in order to adjust association analyses. Results The sample was mainly female (84.7%), with an average age of 70.5 years old, and 3.5 schooling years. The variables associated to the best performance of language in comparative analysis of T1 and T3 were: surprise (OR = 1.485, IC 95% 1.194 – 1.846), and disgust (OR = 1.143, IC 95% 1.005 – 1.300). Conclusion The recognition of facial emotional expressions of surprise and disgust were shown as important factors associated to the good performance of language.

RESUMO Objetivo: identificar fatores psicossociais e funcionais associados ao desempenho de idosos em linguagem e fluência verbal. Métodos: estudo realizado com 149 idosos cadastrados no serviço de atenção primária à saúde de uma cidade do interior de São Paulo. Foram utilizados um questionário de caracterização sociodemográfica, Exame Cognitivo de Addenbrooke - Revisado (domínios de fluência verbal e de linguagem), Escala de Depressão Geriátrica, Escala de Estresse Percebido, Medical Outcomes Study, WHOQOL-OLD e Escala de Atividades Instrumentais da Vida Diária. Os participantes foram divididos em tercis de acordo com o desempenho em linguagem e fluência verbal: T1 = melhor desempenho, T2 = desempenho mediano e T3 = pior desempenho. Foram comparados os grupos T1 e T3 e realizada uma regressão binária para analisar os fatores associados ao melhor desempenho em linguagem e fluência verbal. Resultados: as variáveis associadas ao melhor desempenho de linguagem comparando T1 e T3 foram: maior escolaridade, maior renda e melhor funcionalidade. Para a melhor fluência verbal, os fatores associados foram: maior escolaridade e melhor funcionalidade. Conclusão: a escolaridade e a funcionalidade mostraram-se importantes fatores associados ao bom desempenho da linguagem e da fluência verbal, enquanto a renda mostrou-se associada apenas ao bom desempenho de linguagem.

ABSTRACT Purpose: to identify psychosocial and functional factors associated with language and verbal fluency performance in older adults. Methods: a study conducted with 149 older adults registered in a primary health care service in a city in inland São Paulo. Instruments such as a sociodemographic questionnaire, the Addenbrooke Cognitive Examination-Revised (verbal fluency and language domains), Geriatric Depression Scale, Perceived Stress Scale, Medical Outcomes Study, WHOQOL-OLD, and Instrumental Activities of Daily Living Scale, were used. Participants were divided into tertiles, according to their language and verbal fluency performance: T1 = best performance, T2 = median performance, and T3 = worst performance. Groups T1 and T3 were compared, and a binary regression was conducted to analyze the factors associated with the best language and verbal fluency performance. Results: higher educational attainment, higher income, and better functioning were the factors associated with the best language performance comparing T1 and T3, while higher educational attainment and better functioning were associated with the best verbal fluency. Conclusion: educational attainment and functioning proved to be important factors associated with good language and verbal fluency performance, while income was associated only with good language performance.

RESUMO Objetivo Verificar a relação entre o handicap auditivo e fragilidade em idosos residentes da comunidade. Método Estudo transversal realizado com 238 idosos (idade ≥ 60 anos), no ano de 2018. O questionário Hearing Handicap Inventory for the Elderly - Screening version - HHIE-S, foi aplicado para quantificar o handicap auditivo. A fragilidade foi avaliada segundo o Fenótipo de Fragilidade proposto por Fried e colaboradores, utilizando os 5 critérios: perda de peso não intencional, fadiga relatada, redução da força de preensão, redução da velocidade de caminhada e baixa atividade física. A relação entre o handicap auditivo e a fragilidade foi realizada por meio dos Testes Kruskal-Wallis e Spermann. Resultados Maior percepção do handicap auditivo foi verificado nos indivíduos pré-frágeis e frágeis, comparados aos não frágeis. O handicap auditivo apresentou correlação positiva e estatisticamente significante com maiores níveis de fragilidade. Conclusão O handicap auditivo está relacionado a fragilidade em idosos da comunidade.

ABSTRACT Purpose To verify the relationship between hearing handicap and frailty in community-dwelling older adults. Methods A cross-sectional study was carried out with 238 older adults (aged ≥ 60 years) in 2018. The Hearing Handicap Inventory for the Elderly – Screening version – HHIE-S was applied to assess the hearing handicap. To assess frailty, the Frailty Phenotype proposed for Fried and co-workers was adopted, objectively evaluating 5 criteria: unintentional weight loss, reported fatigue, reduced grip strength, reduced walking speed and low physical activity. It was investigated whether the hearing handicap were related with frailty using Kruskal-Wallis and Spearman test. Results Worse perception of the hearing handicap was found in pre-frail and frail individuals, compared to non-frail individuals. In addition, hearing handicap showed a positive and statistically significant correlation with frailty. Conclusion Hearing handicap is related to frailty in community-dwelling older adults.

RESUMO Objetivo analisar, ao longo do tempo, a constituição dos arranjos familiares de idosos e a relação destes com o apoio social, a fragilidade, qualidade de vida e cognição. Também, verificar, na perspectiva destes sujeitos, tensões existentes no contexto familiar. Método estudo longitudinal, com métodos mistos e triangulação concomitante. Aplicaram-se entrevista sociodemográfica, Escala de Fragilidade de Edmonton, WHOQOL-BREF e OLD, The Montreal Cognitive Assessment, Genograma e Ecomapa. Os dados quantitativos utilizaram teste de comparação de Wilcoxon e Mann Whitney; e os de abordagem qualitativa, a análise de conteúdo de Bardin, com o materialismo dialético como referencial teórico. Resultados dos 84 idosos no período do estudo (2012/2016-2019), a maioria tinha mais de 70 anos e era do sexo feminino (83,3%). A fragilidade e cognição não apresentaram relação estatística significativa com o tipo de arranjo familiar. Idosos que moravam sozinhos apresentaram pior qualidade de vida nos domínios físico (p=0,044) e psicológico (p=0,031). Idosos que moravam com netos apresentaram piora no domínio relação social (p=0,047) e melhora no domínio morte e morrer (p<0,001). Encontraram-se três categorias e nove subcategorias, as quais evidenciaram a importância das relações de interdependência e apoio na família. A integração dos dados demonstrou que o tamanho do arranjo familiar e os tipos de membros não determinam a existência de apoio, mas os vínculos formados com a família e comunidade. Conclusão a fragilidade e cognição não apresentaram diferença estatística com o tipo de arranjo familiar, porém essa relação foi encontrada em alguns domínios da qualidade de vida.

ABSTRACT Objective to analyze, over time, the constitution of the older adults' family arrangements and their relationship with social support, frailty, quality of life and cognition; in addition to verifying existing tensions in the family context from the perspective of these subjects. Method a longitudinal study, using mixed methods and concomitant triangulation. A sociodemographic interview, the Edmonton Frailty Scale, WHOQOL-BREF and OLD, The Montreal Cognitive Assessment, Genogram and Ecomap were applied. The quantitative data used the Wilcoxon and Mann Whitney comparison test; and those with a qualitative approach were treated according to Bardin's content analysis, with dialectical materialism as a theoretical framework. Results most of the 84 aged people in the study period (2012/2016-2019) were over 70 years old and female (83.3%). Frailty and cognition did not present a statistically significant relationship with the type of family arrangement. Aged people who lived alone had a worse quality of life in the physical (p=0.044) and psychological (p=0.031) domains. Older adults who lived with grandchildren showed worsening in the social relationship domain (p=0.047) and improvement in the death and dying domain (p<0.001). Three categories and nine subcategories were found, which highlighted the importance of interdependent and supportive relationships in the family. Data integration showed that the family size arrangement and the types of its members do not determine the existence of support, but the bonds formed with family and community. Conclusion frailty and cognition presented no statistical difference with the type of family arrangement, although this relationship was found in some quality of life domains.

RESUMEN Objetivo analizar a lo largo del tempo la constitución de las conformaciones familiares de los ancianos y su relación con el apoyo social, la fragilidad, la calidad de vida y la cognición; al igual que verificar, desde la perspectiva de estos sujetos, diversas tensiones existentes en el contexto familiar. Método estudio longitudinal que recurrió al uso de métodos mixtos, con triangulación concomitante. Se aplicó una entrevista sociodemográfica, la Escala de Fragilidad de Edmonton, los instrumentos WHOQOL-BREF y OLD, The Montreal Cognitive Assessment, y las técnicas de Genograma y Ecomapa. Los datos cuantitativos se sometieron a la prueba de comparación de Wilcoxon y Mann Whitney y los de enfoque cualitativo, al análisis de contenido de Bardin, con el materialismo dialéctico como referencial teórico. Resultados la mayoría de los 84 ancianos incluidos en el período del estudio (2012/2016-2019) tenía más de 70 años de edad y pertenecía al sexo femenino (83,3%). La fragilidad y la cognición no presentaron ninguna relación estadística significativa con el tipo de conformación familiar. Los ancianos que vivían solos presentaron peores niveles de calidad de vida en los dominios físico (p=0,044) y psicológico (p=0,031), mientras que los que vivían con nietos presentaron peores valores en el dominio de relaciones sociales (p=0,047) y una mejoría en el dominio relacionado con la muerte y morir (p<0,001). Surgieron tres categorías y nueve subcategorías, que hicieron evidente la importancia de las relaciones de interdependencia y apoyo en la familia. La integración de los datos demostró que el tamaño de la familia y los tipos de familiares no determinan la existencia de apoyo, pero sí los vínculos que se establecen con la familia y la comunidad. Conclusión la fragilidad y la cognición no presentaron ninguna diferencia estadística con el tipo de conformación familiar, pese a que esta relación sí se encontró en algunos dominios de la calidad de vida.

ABSTRACT BACKGROUND: The population with chronic kidney disease (CKD) is more predisposed to early development of frailty. Although the concept of frailty is well established from a physical point of view, it is not an exclusively physical syndrome. It can be characterized as an interaction of physical, psychological and social factors. OBJECTIVE: To ascertain the relationship between frailty, social support and family functionality among CKD patients undergoing hemodialysis. DESIGN AND SETTING: Correlational, cross-sectional and quantitative study conducted at a service in the interior of the state of São Paulo. METHODS: This study included 80 patients with CKD who were on hemodialysis. The participants were interviewed individually, with application of the following instruments: sociodemographic and economic characterization, Tilburg Frailty Indicator, Medical Outcomes Study and Family APGAR. Females and white ethnicity predominated among the participants, and their mean age was 59.63 ± 15.14 years. RESULTS: There was high prevalence of frailty (93.8%). Although there was a difference in scores for the dimensions of social support between the frail group and the non-frail group, only family functionality reached a statistically relevant difference. There was a significant correlation between physical frailty, social support and family functionality. CONCLUSIONS: Presence of frailty is related to the social support and family functionality of patients with CKD undergoing hemodialysis.