Pessoas idosas e incontinência urinária: trajetória da proposição de um modelo de sistematização da assistência especializada em enfermagem

Abstract

Delineated in mixed method research aimed to analyze the occurrence of urinary incontinence for people ≥ 65 years of age and understand their social representations in the light of the determinants of the aging process in order to propose a model for systematization of specialized nursing care. Performed in six micro area a Unit Primary Health Care (UAPS) having traditional care model. Sampling design selection to complete the quantitative approach (survey, n = 110) and qualitative approach (Theory of Social Representations procedural approach, n = 104 and structural, n = 102). The participants were people aged ≥ 65 years of age lucid and not bedridden. Performed household approach with four to six visits per participant. Data collected in the octuber /2013 until June/2014. Used: previously validated questionnaire; scales for urinary incontinence and quality of life; recall from pictures, and interviews from leading questions. Quantitative data consolidated into SPSS for descriptive and correlational and qualitative analysis in Nvivo consolidated with content analysis and EVOC. Met legal and ethical requirements for research involving humans. 110 people participated in survey, and ≥ 65 years, 62.7% women; mean age 73 (variability 65-96 years); 47.3% were married or living with a partner; 88.2% had less than 7 years of study; 53.6% were delivered vaginally; 76.4% had a cardiovascular disease; 29.1% had DM, 28.2% were taking a diuretic; 21.8% were smokers; 12.7% consumed alcoholic beverage; 37.3% had urinary incontinence; 73.5% of the emergency type; 70.7% said losing small amount of urine; 41.1% said that urine leakage affected your life (daily activities). Step Social Representation (RS) Structural included 102 people with negative evaluative character and the "terrible" cognema higher frequency and lower average order of evocation. 104 subjects participated in the procedural RS, no difference in the form of construction of the representation even though its content has been consensual and corroborated the RS Estructural. Historic built, diagnoses, nursing interventions and outcomes based on philosophical references (Betty Neuman), taxonomic (diagnosis, nursing interventions and outcomes, legal (law 358/2009) and theoretical (Brazilian Association of Stomatherapy and International Continence Society) on theme the results allowed the development of a situational diagnosis of a region with vulnerabilities and brought evidence on the negative impact of incontinence on quality of life for seniors the relevance of incontinence as a component of geriatric syndromes in the context investigated allowed to suggest: 1) their inclusion or resizing between the content covered in the academic training of general nurses; 2) resize policies, programs and actions of local emergency basis when it prioritizes a process of active aging and 3) validation of the model developed to evaluate their impact before and after therapeutic interventions in the approaches of urinary incontinence.