Efectos de la intervención Alfa-Salud en la alfabetización sanitaria de los ancianos en la atención primaria de salud

Serbim, Andreivna Kharenine; Santos, Naiana Oliveira dos; Paskulin, Lisiane Manganelli Girardi

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Revista Brasileira de Enfermagem

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Sumário

ORIGINAL ARTICLE • Rev. Bras. Enferm. 75 (Suppl 4) • 2022 • https://doi.org/10.1590/0034-7167-2020-0978 copiar

Efectos de la intervención Alfa-Salud en la alfabetización sanitaria de los ancianos en la atención primaria de salud

Autoría SCIMAGO INSTITUTIONS RANKINGS

RESUMEN

Objetivo:

evaluar los efectos de la intervención Alfa-Salud sobre la alfabetización sanitaria y los hábitos de salud de los ancianos vinculados a la atención primaria, en comparación con la atención sanitaria habitual.

Métodos:

investigación cuasiexperimental, con métodos mixtos, con 21 ancianos en cada grupo. El Alfa-Salud fue realizado por una enfermera durante cinco meses. Los instrumentos utilizados fueron la Short Assessment of Health Literacy for Portuguese Speaking Adults, Health Literacy y preguntas sobre hábitos de salud. En el análisis cuantitativo se utilizó el Modelo GEE y en el análisis cualitativo temático.

Resultados:

hubo un efecto de interacción en los puntajes de alfabetización en salud. Los hábitos de salud como la vacunación, las tres comidas al día y el consumo de carne mostraron un efecto de interacción estadísticamente significativo. En la etapa cualitativa, hubo un desarrollo en las habilidades para acceder, comunicar y evaluar la información, y estabilidad en la capacidad de comprensión.

Conclusiones:

el Alfa-Salud es un dispositivo importante para el desarrollo de la alfabetización en salud para las personas mayores.

Descriptores:
Alfabetización en Salud; Salud; Anciano; Educación en Salud; Atención Primaria de Salud

	*CG (n=21)	†IG (n=21)	p
Age
60-69	81%	71.4%	0.726
70-79	19%	23.8%
80 and older	-	4.8%
Sex
Female	76.2%	66.7%	0.734
Marital status
Without a partner	61.9%	47.6%	0.501
With whom does the elderly live?^‡
Spouse	11 (36.7)	8 (22.9)
Grandchild	7 (23.3)	9 (25.7)
Child	6 (20)	8 (22.9)
Alone	5 (16.7)	5 (14.3)
Others	1 (3.3)	5 (14.3)
Cognitive assessment	7 [6; 8]	7 [6; 8]	0.517
Study years	4 [1; 5]	4 [2; 5]	0.899
Number of minimum wages^§	1 [1; 1]	1 [1; 2]	0.680

Category: Ability to seeking/accessing health information
CG^* * CG= Comparison Group; †IG= Intervention Group. baseline themes	CG^* * CG= Comparison Group; †IG= Intervention Group. follow-up themes	IG† baseline themes	IG† follow-up themes
1 - Doubts about the chosen health situation: reported having doubts about whether the chosen health situation was serious; about what was the health situation; others reported that they had no doubts or were not concerned about the chosen health situation. 2 -Predominant sources of information: doctor; health unit; emergency service; television programs.	1 - Doubts about the chosen health situation: similar to the baseline 2 -Predominant sources of information: similar to the baseline, but the emergency service and television programs were not mentioned.	1 - Doubts about the chosen health situation: similar to the CG baseline, but some IG participants were unable to answer this question. 2 -Predominant sources of information: doctor; emergency service; people with the same problem.	1 - Doubts about the chosen health situation: reported having doubts about food; about what the health situation was; about the complexity of the health situation; others reported that they had no doubts or were not concerned about the chosen health situation; some reported concern in solving the health situation; worry about being dependent. 2 -Predominant sources of information: doctor; health unit; Alpha-Health nurse; people with the same problem.
Examples of participants’ speeches
1 - Doubts I didn’t have any that I didn’t even know what it was. (Participant 20, female, 60 years old) 2 - No, the doctor doesn’t guide me, she just gives me the medicine. (Participant 15, female, 61 years old)	1 - The doubt I had was because I felt many things, but I didn’t know it was diabetes. (Participant 4, female, 74 years old) 2 - At the health center they give information about medication and pressure. (Participant 4, female, 74 years old)	1 - I didn’t know and didn’t even know what the word diabetes was. (Participant 19, female, 61 years old) 2 - The neighbor had surgery and almost died. I always visited him and he told me how the illness started. (Participant 16, male, 64 years old)	1 - I thought it was a simpler disease, right, that this little pain in the legs was normal, the doctor said you could have a stroke. (Participant 3, female, 68 years old) 2 - In the health unit, the information was clear and this has been arousing, because illness is not a joke. (Participant 5, female, 61 years old)

Category: Ability to understanding health information
CG^* * CG= Comparison Group; †IG= Intervention Group. baseline themes	CG^* * CG= Comparison Group; †IG= Intervention Group. follow-up themes	IG† baseline themes	IG† follow-up themes
What they did when they did not understand a medical term: 1 - most reported doing nothing when they do not understand the information; 2 - some mentioned asking family and friends; 3 - the others mentioned asking the doctor.	What they did when they did not understand a medical term: similar to the baseline (except item 2, which was not mentioned)	What they did when they did not understand a medical term: 1 - reported doing nothing when they do not understand the information; 2 - some reported trying to understand on their own	What they did when they did not understand a medical term: 1 - reported doing nothing when they do not understand the information; 2 - related the lack of understanding to aspects of aging.
Examples of participants’ speeches
1 - I didn’t ask why I was embarrassed, because the person would think I was stupid. (Participant 10, male, 73 years old) 2 - I asked my wife. (Participant 11, male, 63 years old) 3 - I asked again. (Participant 14, female, 62 years old)	1 - I don’t ask or ask the person to explain again. (Participant 2, male, 67 years old) 3 - Occasionally he said a word I didn’t understand, I asked again to clear up the doubt. (Participant 7, female, 61 years old)	1 - I stay quiet not understanding, not to disturb. (Participant 3, female, 68 years old) 2 - There are things that I go after and want to know. (Participant 8, female 61 years old)	1 - I don’t ask again, I keep thinking to myself. (Participant 10, female, 63 years old) 2 - Lately I even have vision problems, I don’t hear well and I don’t understand. (Participant 3, female, 68 years old)

Category: Ability to communicating/sharing health information
CG^* * CG= Comparison Group; †IG= Intervention Group. baseline themes	CG^* * CG= Comparison Group; †IG= Intervention Group. follow-up themes	IG† baseline themes	IG† follow-up themes
Information that would be shared with other elderly: 1 - search for a doctor; 2 - have healthy habits; 3 - pray and have faith; 4 - be careful with the disease; 5 - seek complementary practices.	Information that would be shared with other elderly: similar to the baseline (except item 3, which was not mentioned)	Information that would be shared with other elderly: 1 - take care not to worsen the health situation; 2 - have healthy habits; 3 - look for a specialist doctor; 4 - some did not know what to suggest.	Information that would be shared with other elderly: 1 - seek health information; 2 - look for a doctor; 3 - have a healthy diet; 4 - follow drug treatment.
Examples of participants’ statements
1 - See a doctor for treatment. (Participant 3, male, 68 years old) 2 - Do not eat too much salt or fatty foods. (Participant 4, female, 74 years old) 3 - Wait for God, have faith. (Participant 9, female, 62 years old) 4 - I would say that he should take care of himself, because he is getting old. (Participant 2, male, 67 years old) 5 - I give advice and the herbs I have, such as Mororó, Aroeira, Jatobá… (Participant 10, male, 73 years old)	1 - So you try to go to the doctor first, because we have to go, right? (Participant 6, female, 61 years old) 2 - To do the regimens and exercises you need. (Participant 14, female, 62 years old) 3 - I think they should take care of themselves and measure the pressure. (Participant 5, female, 69 years old) 4 - Herbal tea and natural remedy is very good. (Participant 10, male, 73 years old)	1 - You have to move, do some physical activity, not to get worse. (Participant 13, female, 81 years old) 2 - If you follow the diet hard and take the drugs, you can control it, but no one can control it. (Participant 7, male, 62 years old) 3 - Going to a specialist doctor, which is very difficult for those who don’t have a lot of money. (Participant 6, female, 73 years old) 4 - I don’t know, because I didn’t receive any information. (Participant 15, male, 78 years old).	1 - Look for the health center, ask the right people for information. (Participant 1, female 65 years old) 2 - The doctor will give the solution for this type of problem. (Participant 20, male, 76 years old) 3 - Be careful with food, be careful with salt. Which is what I’m doing after the group. (Participant 6, female, 73 years old) 4 - Each organism works differently and what works for one doesn’t work for another. You cannot stop taking the medicine. (Participant 8, female, 61 years old)

Category: Ability to assess health information
CG baseline themes	CG follow-up themes	IG baseline themes	IG follow-up themes
Impact of health information on participants’ lives: 1 - they reported changes in the care for the disease; 2 - some reported not making a difference in life; 3 - for others, it made a difference	Impact of health information on participants’ lives: similar to the baseline	Impact of health information on participants’ lives: 1 - they reported changes in care for the disease; 2 - some reported not making a difference in life; 3 - changes in food.	Impact of health information on participants’ lives: 1 - they reported changes to healthy habits; 2 - increased knowledge about the chosen health situation; 3 - changes in disease care
Examples of participants’ statements
1 - Because it’s a reason for me to be more careful with my health. (Participant 8, female, 69 years old) 2 - I didn’t improve anything, it didn’t solve my health problem. (Participant 7, female, 61 years old) 3 - They made a difference for the better, right? (Participant 3, male, 68 years old)	1 - Mainly taking care of your food, going for a walk. (Participant 12, female, 63 years old) 2 - Very little. Because I don’t do physical activity, right? (Participant 7, female, 61 years old) 3 - Relieved a little worry about the disease. (CG Participant 6, female, 61 years old)	1 - The guidelines on how to carry out the treatment made a difference. (Participant 14, female, 60 years old) 2 - No, I’m used to not receiving information. Life goes on with its problems. (Participant 3, female, 68 years old) 3 - I can no longer eat everything I could eat. (Participant 19, female, 61 years old)	1 - I started to eat differently, every day I make salad and I try to exercise. (Participant 5, female, 61 years old) 2 - Before I had the problem and didn’t know what it was, now I know how to deal with my disease. (Participant 10, female, 63 years old) 3 - When the information is good, it makes a difference, in the medication, I didn’t stop anymore. (Participant 8, female, 61 years old)

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[1] Corresponding author: Andreivna Kharenine Serbim E-mail: andreivna.serbim@arapiraca.ufal.br