Vulnerabilidade em saúde e qualidade de vida de idosos assistidos na atenção primária à saúde de uma região administrativa do Distrito Federal

Abstract

Introduction: The health vulnerabilities of the elderly, chronic non-communicable diseases have put at risk the quality of life (QoL) of this segment of the population. Hence the need to evaluate health vulnerability and QoL of the elderly attending Primary Health Care (PHC).Objectives: To determine the cutoff point in VES-13 and whoqol-bref that determines quality of life in the elderly assisted in primary health care (PHC); as well as elaborate booklet for the elderly on aspects related to quality of life quality.Method: This is a cross-sectional study with a quantitative approach. Data collection was performed at the basic health units of the Samambaia administrative region. The sample consisted of 466 elderly people attending the PHC, based on the calculation of 13259 elderly people in Samambaia, 95% power, 5% margin of error, and 20% of possible losses. The participants in the study were elderly people who spontaneously sought some service in one of the basic health units. Older subjects with a mini mental status examination with score <= 9, or who did not agree to participate in the study were excluded. A questionnaire was applied, with closed questions, on sociodemographic aspects and health conditions of the elderly, WHOQOL-bref and VES-13, on the quality of life and vulnerability in health. Three groups were created based on the responses on quality of life and health satisfaction: QVboa, QVruim and undetermined QoL. A ROC curve was applied to determine the cutoff point of VES-13 and WHOQOL-bref to detect QVruim. Then, using this cutoff point, sensitivity, specificity, positive predictive value and negative predictive value were evaluated for QVruim.Results: 475 elderly were approached, and 8 were excluded because they did not accept to participate in the study, and 1 because they were minimally <= 9. Thus, 466 elderly people were included in the study, being 68.2 ± 71 years old, 60.3% female, 30.5% white; average schooling of 4.6 years. Cut-off point to detect QVruim was> = 2 on VES-13 and <60 on WHOQOL-bref, with area under the ROC curve of 0.741 and 0.934, respectively. Regarding this cut-off point, to detect QVruim, VES-13 showed sensitivity of 84% and negative predictive value of 98.2%, and the WHOQOL-bref had sensitivity of 88% and negative predictive value of 99%. Finally, in relation to the product 'primer', it has been developed in an appropriate way. This paper was based on a scientific article titled: Validation of VES-13 and WHOQOL-BREF cutoff point to predict quality of life in elderly people in PHC, approved for publication in the Revista de Saúde Pública of the University of São Paulo and elaboration of a booklet destined to the elderly users of the fern PH with title "Quality of Life in the Elderly. "Conclusion: the cut-off point ≥2 in VES-13 and <60 in the WHOQOL-bref is proposed to indicate the detection of the elderly with QVruim and thus require a special follow-up by the ESF for a possible matriciamento with or reference to the geriatrics-gerontology team. However, more studies are suggested, preferably by longitudinal methods, to better discuss and compare these cut-off values of the instruments used to determine the quality of life and vulnerability of these populations.