Factores asociados a las competencias del cuidador informal en la atención domiciliaria de salud

Santos, Fernanda Gatez Trevisan dos; Zulin, Aline; Cardoso, Luana Cristina Bellini; Sanches, Rafaely de Cassia Nogueira; Rêgo, Anderson da Silva; Girardon-Perlini, Nara Marilene Oliveira; Radovanovic, Cremilde Aparecida Trindade

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Revista Brasileira de Enfermagem

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ORIGINAL ARTICLE • Rev. Bras. Enferm. 75 (04) • 2022 • https://doi.org/10.1590/0034-7167-2021-0744 copiar

Factores asociados a las competencias del cuidador informal en la atención domiciliaria de salud

Autoría SCIMAGO INSTITUTIONS RANKINGS

RESUMEN

Objetivo:

Identificar factores asociados a competencias cognitivas, emocionales, psicomotrices y relacionales del cuidador informal en la atención domiciliaria.

Métodos:

Estudio transversal, realizado con 216 cuidadores informales, residentes en municipio del estado de Paraná. Recolecta de datos ocurrió entre febrero y julio de 2019, con instrumento desarrollado y validado para evaluación de las competencias del cuidador informal. Utilizado análisis descriptivo e inferencial para tratamiento de las variables.

Resultados:

Los factores asociados a mayor competencia del cuidador informal fueron sexo femenino, tener capacitación y más de cinco años en atención domiciliaria. La menor competencia fue observada en cuidadores que presentaban problema de salud y pertenecían a menores extractos del poder de compra familiar. Los participantes tuvieron menores índices en la competencia psicomotora y obtuvieron mejores resultados en la cognitiva.

Conclusión:

Identificado que mujeres con experiencia en el cuidado tuvieron mayores niveles de competencia para realizar una atención domiciliaria de salud de calidad.

Descriptores:
Cuidadores; Familia; Atención Domiciliaria de Salud; Competencia Clínica; Estado Funcional

	n	%
Age
18-29	7	3.2
30-39	17	7.9
40-49	29	13.4
50-59	62	28.7
≥ 60	101	46.8
Gender
Female	181	83.8
Male	35	16.2
Marital status
With partner	119	55.1
Without partner	97	44.9
Educational level
Without education	16	7.4
Elemental school I (< 5 years)	81	37.5
Elemental school II (5 to 9 years)	32	14.8
High School (10 to 12 years)	73	33.8
College (>12 years)	14	6.5
Socioeconomic class
AB	55	25.5
C	128	59.3
DE	33	15.3
Family income**
Up to 2 Minimum ages	134	62.1
3 to 5	75	34.7
6 to 9	5	2.3
10 or more	2	0.9
Family relation
Partner	49	22.7
Children	96	44.4
Sisters/Brothers	17	7.9
Parent	24	11.1
Others	30	13.9
Health problem
No	82	38.0
Yes	134	62.0
Time caring for the patient
Up to 5 years	89	41.2
More than 5 years	127	58.8
Training
No	202	93.5
Yes	14	6.5
Cares for more than one dependent person
No	182	84.3
Yes	34	15.7

	M±SD	CI 95%	Competency Level
How do you rate your knowledge to:
Identify the physical limitations of the person you care for (C)	4.03±0.91	3.91-4.16	BC
Identify signs and symptoms of the worsening of the health of the person you care for (P)	3.13±1.16	2.96-3.32	CR
Identify the feeding needs of the person you care for (P)	3.68±1.13	3.51-3.83	CR
Identify signs and symptoms of dehydration in the person you care for (P)	2.42±1.42	2.20-2.59	CR
Identify the medications that the person you care for uses (C)	3.76±1.21	3.60-3.91	CR
Identify facial expressions that the person you care for may show (R)	4.22±1.00	4.06-4.36	BC
Recognize signs of changes in the person you care for regarding evacuations (P)	2.85±1.36	2.67-3.00	CR
Composite index - Knowledge	3.44±0.72	3.34-3.54	CR
How adapted do you feel:
To the daily care routine (E)	3.74±1.18	3.58-3.89	CR
To exercise the role of caregiver (E)	3.76±1.17	3.59-3.91	CR
Composite index - Adaptation	3.75±1.07	3.62-3.89	CR
How do you feel about your preparation for:
Administering/Offering medication (C)	4.21±1.12	4.07-4.36	BC
Assessing the body temperature of the person you care for (P)	3.41±1.37	3.23-3.61	CR
Changing the clothes of the person you care for (C)	3.93±1.26	3.76-4.12	BC
Communicating with the person you care for (R)	4.07±1.05	3.93-4.22	BC
Encouraging the autonomy of the person you care for (R)	3.44±1.41	3.25-3.61	CR
Composite index - Preparation	3.81±0.76	3.71-3.93	BC
Cognitive skills	3.98±0.80	3.87-4.11	BC
Psychomotor skills	3.26±0.80	3.14-3.39	CR
Relational skills	3.91±0.80	3.78-4.01	BC
Emotional competences	3.75±1.07	3.59-3.90	CR

	Total		Cognitive Competence			Psychomotor competence			Cognitive Competence			Cognitive Competence
	n	%	M±SD	Ranks	p	M±SD	Ranks	p	M±SD	Ranks	p	M±SD	Ranks	p
Age
18-29 years	7	3.2	4.26±0.75	89.9	0.017	3.43±0.91	88.2	0.007	4.06±0.90	105.6	0.073	3.63±1.30	143.1	0.252
30-39 years	17	7.9	3.71±0.92	96.2		3.00±0.59	126.5		3.80±1.06	121.3		4.35±0.62	92.0
40-49 years	29	13.4	3.77±1.00	132.8		3.52±0.90	119.4		4.11±0.63	123.8		3.50±1.08	105.4
50-59 years	62	28.7	4.17±0.65	121.7		3.52±0.84	125.9		4.04±0.75	119.0		3.93±0.92	117.5
> 60 years	101	46.8	3.83±0.82	96.8		3.03±0.95	93.0		3.75±0.80	95.7		3.67±1.10	104.2
Gender
Female	181	83.8	4.08±0.73	115.2	0.000	3.37±0.88	114.3	0.002	3.98±0.77	114.6	0.001	3.77±1.06	109.0	0.790
Male	35	16.2	3.45±0.96	73.7	0.000	2.80±0.99	78.4	0.002	3.47±0.87	77.0	0.001	3.68±1.10	106.0	0.790
Marital status
With companion	119	55.1	3.95±0.82	107.4	0.762	3.26±0.95	108.6	0.963	3.80±0.79	100.6	0.039	3.81±1.10	112.5	0.281
Without companion	97	44.9	4.00±0.79	109.7	0.762	3.30±0.90	108.2	0.963	4.02±0.82	118.1	0.039	3.68±1.02	103.5	0.281
Educational level
Without education	16	7.4	3.71±0.87	88.4	0.069	2.62±0.74	65.8	0.001	3.81±0.67	96.5	0.315	3.37±1.27	89.7	0.361
Elementary school I	81	37.5	3.89±0.78	101.1		3.09±1.00	96.3		3.76±0.85	99.9		3.81±1.08	113.7
Elementary school II	32	14.8	4.09±0.87	120.0		3.45±0.80	120.7		4.11±0.74	124.1		3.59±1.18	100.8
High school	73	33.8	3.99±0.79	109.1		3.45±0.86	118.7		3.95±0.78	112.1		3.78±0.97	106.2
College	14	6.5	4.38±0.62	144.8		3.90±0.68	146.9		4.07±0.98	117.9		4.15±0.85	129.6
Family income^ Categorization of monthly household income estimates for socioeconomic strata based on the purchasing power of the household head: AB (good conditions), C (regular conditions), and DE (low conditions).
Up to 2 minimum wages	134	62.0	3.92±0.78	103.9	0.489	3.18±0.91	102.3	0.261	3.93±0.82	111.2	0.738	3.67±1.09	104.2	0.622
3 to 5	75	34.7	4.04±0.87	116.1		3.42±0.95	117.1		3.86±0.76	104.0		3.88±1.01	115.7
6 to 9	5	2.3	4.25±0.55	126.0		3.60±0.80	129.5		3.93±1.14	116.7		3.90±1.14	115.8
10 or more	2	0.9	3.87±0.17	90.8		3.75±0.35	145.0		3.50±1.17	76.8		3.75±1.76	110.5
Occupation
Employee	44	20.4	4.03±0.92	114.4		3.46±0.92	120.3		4.00±0.85	117.1		3.81±1.09	111.3	0.522
Unemployed	101	46.8	4.02±0.76	112.5	0.302	3.42±0.89	117.7	0.003	3.98±0.75	114.0	0.092	3.85±0.98	112.1
Retired	71	32.9	3.88±0.89	99.2	0.302	2.97±0.91	88.2	0.003	3.71±0.85	95.5	0.092	3.59±1.16	101.7
Purchasing power^ Categorization of monthly household income estimates for socioeconomic strata based on the purchasing power of the household head: AB (good conditions), C (regular conditions), and DE (low conditions).
AB	55	25.5	4.12±0.62	115.8	0.019	3.54±0.85	126.1	0.003	3.94±0.78	111.7	0.305	4.09±0.87	123.8	0.023
C	128	59.2	4.00±0.85	112.6		3.28±0.96	108.6		3.92±0.84	111.1		3.73±1.03	107.5
DE	33	15.3	3.63±0.81	80.7		2.84±0.77	78.7		3.73±0.73	93.2		3.28±1.29	86.9
Family ties
Parent	24	11.1	3.80±1.02	98.2	0.002	3.47±0.95	120.4	0.018	4.21±0.76	136.0	0.012	3.56±1.35	98.9	0.934
Children	96	44.4	4.22±0.71	127.9		3.48±0.88	120.8		3.98±0.84	116.4		3.80±0.99	109.7
Sisters/Brothers	17	7.9	3.92±0.61	93.2		3.28±0.65	109.0		3.75±0.80	94.9		3.71±1.12	105.2
Companion	49	22.7	3.82±0.72	93.3		3.00±1.03	91.6		3.67±0.71	87.9		3.75±0.10	109.3
Others	30	13.9	3.58±0.92	88.2		2.93±0.80	86.8		3.86±0.82	102.7		3.78±1.06	112.8
Capacitation
No	202	93.5	3.97±0.79	105.0	0.002	3.27±0.94	103.7	0.000	3.88±0.83	105.9	0.020	3.74±1.11	104.6	0.000
Yes	14	6.5	3.97±0.83	158.8	0.002	3.29±0.91	178.5	0.000	3.93±0.78	145.9	0.020	3.77±1.01	165.4	0.000
Health problems
Yes	134	62.0	3.95±0.75	105.0	0.285	3.22±0.90	104.8	0.266	3.86±0.82	106.3	0.505	3.62±1.08	101.6	0.035
No	82	38.0	4.00±0.88	114.3	0.285	3.37±0.96	114.5	0.266	3.97±0.78	112.1	0.505	3.97±1.02	119.8	0.035
Takes care of someone else
No	182	84.3	3.94±.079	105.9	0.164	3.21±0.93	104.7	0.038	3.84±0.82	104.1	0.016	3.68±1.09	105.3	0.077
Yes	34	15.7	4.14±0.87	122.1	0.164	3.62±0.84	128.8	0.038	4.21±0.66	132.0	0.016	4.13±0.84	125.5	0.077
Time caring for someone
Up to 5 years	89	41.2	3.83±0.80	95.7	0.012	3.07±0.95	95.6	0.011	3.80±0.84	101.4	0.164	3.61±1.00	99.1	0.060
More than 5 years	127	58.8	4.08±0.79	117.4	0.012	3.40±0.89	117.5	0.011	3.98±0.78	113.4	0.164	3.85±	115.0	0.060

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[1] Corresponding author: Fernanda Gatez Trevisan dos Santos E-mail: fer.gatez@gmail.com