Déficit de autocuidado entre hombres mayores en el transcurso de la pandemia de COVID-19: implicaciones para la enfermería

analizar el déficit de autocuidado entre ancianos en el transcurso de la pandemia de COVID-19 en Brasil y discutir las implicaciones para la práctica de enfermería.

Métodos:

web survey, multicéntrica, cualitativa. Participaron un total de 120 ancianos, aplicando un formulario de abril a junio de 2020 y de abril a agosto de 2021. Se utilizó el Análisis Temático Reflexivo, interpretado por la Teoría del Déficit de Autocuidado de Orem.

Resultados:

temporalmente, el autocuidado de los ancianos se manifestó en los requerimientos de autocuidado - vínculos afectivos, autocuidado para el desarrollo - meditación y autocuidado con desviaciones de salud - consultas a distancia Los sistemas educativos/de apoyo total o parcialmente compensatorios movilizaron el autocuidado.

Consideraciones Finales:

como gestores del cuidado, los enfermeros pueden fortalecer la red de apoyo al anciano activando profesionales del equipo multidisciplinario, familiares, cuidadores y comunidad para promover el autocuidado y corregir las desviaciones de salud en tiempos de crisis.

Descriptores:
Pandemia; Autocuidado; Atención de Enfermería; Salud del Hombre; Salud del Anciano.

Autoría

Vinícius de Oliveira Muniz Corresponding author: Vinícius de Oliveira Muniz, E-mail: viniciusomuniz22@gmail.com

Instituto Ensinar Brazil. Serra, Espírito Santo, BrazilInstituto Ensinar BrazilBrazilSerra, Espírito Santo, BrazilInstituto Ensinar Brazil. Serra, Espírito Santo, Brazil

http://orcid.org/0000-0001-5605-9720

Lorena de Cerqueira Andrade Braga

Universidade Federal da Bahia. Salvador, Bahia, BrazilUniversidade Federal da BahiaBrazilSalvador, Bahia, BrazilUniversidade Federal da Bahia. Salvador, Bahia, Brazil

http://orcid.org/0000-0002-9550-0985

Pricila Oliveira de Araujo

Universidade Estadual de Feira de Santana. Feira de Santana, Bahia, BrazilUniversidade Estadual de Feira de SantanaBrazilFeira de Santana, Bahia, BrazilUniversidade Estadual de Feira de Santana. Feira de Santana, Bahia, Brazil

http://orcid.org/0000-0002-7941-9263

Pedro Paulo Corrêa Santana

Universidade Federal Fluminense. Niterói, Rio de Janeiro, BrazilUniversidade Federal FluminenseBrazilNiterói, Rio de Janeiro, BrazilUniversidade Federal Fluminense. Niterói, Rio de Janeiro, Brazil

http://orcid.org/0000-0002-4470-9746

Gildasio Souza Pereira

Universidade Federal da Bahia. Salvador, Bahia, BrazilUniversidade Federal da BahiaBrazilSalvador, Bahia, BrazilUniversidade Federal da Bahia. Salvador, Bahia, Brazil

http://orcid.org/0000-0001-8754-0998

Anderson Reis de Sousa

Universidade Federal da Bahia. Salvador, Bahia, BrazilUniversidade Federal da BahiaBrazilSalvador, Bahia, BrazilUniversidade Federal da Bahia. Salvador, Bahia, Brazil

http://orcid.org/0000-0001-8534-1960

Larissa Chaves Pedreira

Universidade Federal da Bahia. Salvador, Bahia, BrazilUniversidade Federal da BahiaBrazilSalvador, Bahia, BrazilUniversidade Federal da Bahia. Salvador, Bahia, Brazil

http://orcid.org/0000-0001-8939-324X

Evanilda Souza de Santana Carvalho

http://orcid.org/0000-0003-4564-0768

Corresponding author: Vinícius de Oliveira Muniz, E-mail: viniciusomuniz22@gmail.com

EDITOR IN CHIEF: Dulce Barbosa

ASSOCIATE EDITOR: Rafael Silva

SCIMAGO INSTITUTIONS RANKINGS

Instituto Ensinar Brazil. Serra, Espírito Santo, BrazilInstituto Ensinar BrazilBrazilSerra, Espírito Santo, BrazilInstituto Ensinar Brazil. Serra, Espírito Santo, Brazil

Universidade Federal da Bahia. Salvador, Bahia, BrazilUniversidade Federal da BahiaBrazilSalvador, Bahia, BrazilUniversidade Federal da Bahia. Salvador, Bahia, Brazil

Universidade Federal Fluminense. Niterói, Rio de Janeiro, BrazilUniversidade Federal FluminenseBrazilNiterói, Rio de Janeiro, BrazilUniversidade Federal Fluminense. Niterói, Rio de Janeiro, Brazil

Figuras | Tablas

Figuras (2)
Tablas (2)

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Figure 1
Comparative-temporal line of experiences and behaviors of older men in the face of self-care and self-care deficit in the pandemic context of COVID-19

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Figure 2
Representative pictogram of the explanatory model of Dorothea Elizabeth Orem’s Self-Care Deficit Theory, adapted to the results found in the research

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Chart 1
Thematic category 1 on self-care, therapeutic self-care demand and its requirements

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Chart 2
Thematic category 2 on self-care deficit and its totally compensatory, partially compensatory and educational/support systems

Figure 1 Comparative-temporal line of experiences and behaviors of older men in the face of self-care and self-care deficit in the pandemic context of COVID-19

Figure 2 Representative pictogram of the explanatory model of Dorothea Elizabeth Orem’s Self-Care Deficit Theory, adapted to the results found in the research

Chart 1 Thematic category 1 on self-care, therapeutic self-care demand and its requirements

Thematic category 1 - Self-care and therapeutic demand for self-care

Group 01-2020
Self-care requirements:

[...] I tried to be closer to my family members and strengthen affective bonds. (M01); [...] I improved my diet, started cooking at home and sunbathing. (M93); [...] I am complying with quarantine, social distancing, washing and sanitizing of hands and food and the domestic environment. (M99); [...] I started to access content on the internet and stayed connected on social networks and participate in WhatsApp groups to be involved with friends and reduce the impact of social isolation. (M100)

Self-care requirements for development:

[...] I kept myself informed. (M76); [...] meditated, I paid more attention to my interior and to the interaction with the other. (M90); [...]I tried to start activities that would preserve my health, especially mental, such as resting my mind, keeping calm, exercising faith in God. (M105); [...] I learned to give more value to others. (M105)

Self-care requirements with health deviation:

[...] I started to prevent myself against COVID-19, but maintained other health care such as periodic medical consultations, carried out by phone call and video call. (M112); [...] I needed to maintain a health treatment, visits to services for evaluation and to the pharmacy to purchase medicines. (M117); [...] the pandemic prevented me from performing health care as I did before. I stopped attending the health unit and the social group that I was part of. (M120); [...] I had a health problem and needed to be hospitalized amid the pandemic. (M121)

Group 02-2021
Self-care requirements:

[...] I tried to reduce the sedentary lifestyle, the consumption of sugar and carbohydrates, I consumed vitamins and minerals and healthier foods, I started a diet, and started to practice exercises, which led me to lose weight. (M01); [...] I have been going to the gym and doing weight training. (M02; M29); [...] physical activities done at home. (M30); [...] to walk and cycle. (M39)

Self-care requirements for development:

[...] gardening and started to take more care of pets. (M04); [...] reduce stress. (M08); good readings and more virtual cultural activities. My stance was not to ignore the reality and significance of the pandemic at any time, but also to face and fight it with proactive actions, without being subject to neurosis and fighting fake news. I maintained activities with plants and vegetation, logical and scientific readings on the subject [...] I distanced myself from neurotic and frightened people. (M30)

Self-care requirements with health deviation:

[...] I started to seek and follow medical guidelines. (M01); cardiology and gastroenterology and increased care. (M23); [...] I started to do preventive care. (M50)

Chart 2 Thematic category 2 on self-care deficit and its totally compensatory, partially compensatory and educational/support systems

Thematic category 2 - Self-care deficit

Group 01-2020
Totally compensatory system:

Physical health damage: [...] my blood pressure got out of control after the pandemic, malaise. (M09); [...] health problems, especially in circulation and motor strength. (M19)
Mental health damage: [...] changes in sleep and a lot of muscle tension [...] anxiety, apprehension, insecurity, restlessness and fear. (M01); [...] to consume alcoholic beverages and cigarettes, much more than before, which I did in a social way, and in the pandemic, I started to consume almost every day. (M08)
Affective-marital relationship damage: [...] marital relationship was affected by the pandemic. We started to have more conflicts, withdrawal and changes in sexual practice. (M11); [...] the affective relationship with friends, who became more distant. (M18)
Social interaction damage: [...] the distance from contact with the people in my social life greatly harmed my health and well-being. (M13); [...] I felt alone and trapped inside the house. (M14); [...] I was removed from work for being an older adult and for being considered a risk group for COVID-19. My relationship with my co-workers has diminished and it has made me lonely. (M15); [...] the impossibility of accessing the street and having public mobility, made it difficult for me to get used to the new routine. (M17)

Partially compensatory system

Sanitary control for prevention and protection against COVID-19: [...] I quarantined, social distanced, hand washed and sanitized [...] of the domestic environment and food. (M02)
Health management: [...] I needed to go to the doctor, who increased the dose of my medication for high blood pressure. (M09)
Psychosocial and spiritual well-being promotion:
[...] I tried to reduce the stress and anxiety generated by isolation, seeking to access news on the internet, watch movies and series, television programs, listen to music, take care of domestic and work activities, in addition to having sex. (M03); [...] I tried to distract myself, communicate with people, even if virtually, through social networks. (M05); [...] I tried not to think too much about the pandemic and for that I paid more attention to my pets. I took care of plants and started listening to music. (M06); [...] to fix furniture and do physical activity. (M07); [...] I tried to get involved with the production of text and art. (M21)

Educational/support system

Seeking support from the health system: [...] I searched for readings, accessed reliable websites such as the Ministry of Health to obtain reliable information about COVID-19. (M01); [...] I counted on the Family Health Unit support in my neighborhood to perform a quick test for COVID-19 and to maintain the health care that I already performed before the pandemic. (M03)
Approach and strengthening of family and socio-affective bonds: [...] family and friends were very important to overcome the first months of social isolation to control the pandemic, due to loneliness and anxiety. (M10); [...] contact with optimistic friends helped me to face the pandemic with acceptance, confidence and strength. (M16); [...] caring for my children and contacting friends and colleagues on social media helped me to face the most critical moment of the pandemic, when I had to stay indoors for most of the day. (M20)

Group 02-2021
Totally compensatory system:

Non-physical health management: [...] tiredness increased. (M06); [...] I did not perform periodic examinations. (M07); [...] I detected a very serious prostate problem, I stopped ejaculating. (M10); [...] I didn’t go to doctors, hospitals and I didn’t do preventive exams. (M11); [...] I gained weight and reduced physical exercise [...] I had post-COVID sequel, such as decreased lung capacity, body aches and muscle weakness. (M31); [...] I did not do any exams, only two medical appointments, during all this time. (M48); [...] I neglected my appearance. I stopped shaving and cutting my hair. (M58); [...] I started to have visual fatigue. (M68); [...] my circulation problem got worse. (M80); [...] I have suffered from severe gastrointestinal disorders due to the use of Chloroquine. (M89)
Cognitive problems, grief, stress management and emotion management: [...] stress and rheumatic pain increased. (M08); [...] I have felt powerless. (M11); [...] I got more depressed. (M13); [...] postponed routine exams for fear of COVID-19. (M14); [...] I increased my alcohol intake. (M16); [...] I started having mental problems like fear and panic. (M19); [...] my immunity has dropped and I am shaken by the many losses of family, friends, colleagues and acquaintances. (M32); [...] I have felt constant sadness. (M38); generalized anxiety and grief over death [...] anger and irritability increased. (M41); [...] I lost my partner, a victim of COVID-19 and that made me lose the meaning of life. (M48); [...] I am having hand tremors and forgetfulness. (M60)
Sociopolitical crises: [...] the total absence of planning, articulation and coordination by the federal government hampered my health care in relation to the prevention and control of COVID-19. (M32); [...] I started to walk and cycle. (M39)

Partially compensatory system

Physical health restoration: [...] I started going to a gym and doing weight training. (M02); [...] use of alcohol gel, constant water and soap and use of vitamins. (M10); [...] more medical appointments and taking more medicine. (M35); [...] I went to the cardiologist. (M41); [...] I am having cardiac sequel from COVID-19 and my insulin is increasing. As a result, I started the treatment. (M43); [...] I am having a loss of appetite and with that, I increased the care. (M49); [...] daily exercises, meditation, medical consultations whenever necessary, seeking to follow all the sanitary recommendations of health agencies. (M56)
Management of mental health disorders: [...] I started taking a homeopathic medicine. (M10); [...] care with improving sleep. (M18); [...] take more care of my well-being. (M24); [...] I increased care and attention to mental health. (M37); [...] I am having bouts of depression and having to take medication. (M41); [...] my mental health has deteriorated; I have moderate depressive symptoms and I am doing virtual consultations. (M47)
Promoting harmony and functionality in family and social processes: [...] I had the need to learn to live in relative isolation with the family [wife, son and a maid who helps us with household chores and in the education of our son, as she is a retired teacher]. (M56); [...] the social restriction caused me a period of adaptation to the new of the pandemic. (M61)

Educational/support system

Seeking support from the health system: [...] I became more attentive to the recommended prevention measures, following the health protocols that were informed. (M03); [...] I changed hygiene habits and this change was due to the influence of the media. (M14)
Health management: [...] I have been practicing social distancing, medical appointments have been remote, and I have been taking food supplements more often. (M36); [...] hand hygiene, I wear a mask continuously. (M46)
Strengthening of family and socio-affective bonds: [...] I expanded contacts, by electronic means, with friends and relatives [...] I worried about the health of relatives, I strengthened communication and mutual support [...] I made the most of my time at home to apply in varied readings, with the purchase of books. (M56)

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Déficit de autocuidado entre hombres mayores en el transcurso de la pandemia de COVID-19: implicaciones para la enfermería

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[1] Corresponding author: Vinícius de Oliveira Muniz, E-mail: viniciusomuniz22@gmail.com