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OBJECTIVES: The objective of the study was to evaluate the factors associated with symptoms of posttraumatic stress in mothers during the COVID-19 pandemic. METHODS: Cross-sectional study conducted with mothers of children and adolescents living in Brazil, who answered an online questionnaire containing sociodemographic variables and the Impact of Events Scale-Revised. The Poisson regression model with robust variance was used to identify the factors associated with posttraumatic stress. RESULTS: A percentage of 83.82% of mothers reported an overload in caring for their children during the pandemic. The prevalence of posttraumatic stress symptoms was 39.05%, and this condition was associated with younger age, living in the northern region of the country, using medications, presenting neuropsychiatric comorbidities and being little/more or less satisfied with life. CONCLUSIONS FOR PRACTICE: The mental health situation of mothers during and after the pandemic must be monitored, in order to guarantee public policies capable of optimizing the coping with the situation.

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The prevalence of chronic diseases, especially depression, has been increasing worldwide. Health professionals have an important role in screening and early detection of the disorder, to prevent possible damage such as disability and dependence. With aging, sensory impairments can occur, such as visual and hearing losses, which can lead to isolation contributing to the development of depressive symptoms. The objective of this study was to analyze the relationship between depressive symptoms, social isolation, and self-perception of visual complaints and hearing loss in middle-aged and older adults. It was a cross-sectional quantitative study, in Três Lagoas, state of Mato Grosso do Sul, Brazil, with 300 participants of both sexes, aged 45 years and over, registered in the Primary Health Care network. Data were collected using a structured questionnaire with sociodemographic data and the questions "Do you consider yourself socially isolated?", "Do you have a vision and/or a hearing problem capable of stopping you from performing a daily life activity?" and "If yes, do you use a hearing aid and/or glasses or contact lenses?". Depressive symptoms were assessed using the Center for Epidemiological Studies - Depression (CES-D) scale with a cut-off score adapted for age. Data were analyzed with binary logistic regression, with the presence of depressive symptoms being the dependent variable. Values of p≤0.05 were considered significant. The majority of the sample were women (65.7%), with an average age of 60.9 years, 56.7% were classified with depressive symptoms, 27.0% considered themselves socially isolated, 84.7% reported visual acuity loss (70.7% used glasses) and 17.3% reported hearing loss (2.3% used hearing aids). Social isolation (OR = 6.0), visual complaints (OR = 3.85), and hearing loss (OR = 4.67) were related to the presence of depressive symptoms. Moreover, being married (OR = 0.51) was a protective factor in these participants. The results showed the importance of early diagnosis of depressive symptoms. The correction of visual and hearing deficits is highlighted, as these may be related to symptoms of depression. Health professionals in Primary Health Care should be able to monitor depressive symptoms, visual and hearing complaints, and to promote social interaction.

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OBJECTIVE: To identify the factors related to clinical-functional vulnerability in older people. METHODS: This cross-sectional quantitative study was conducted in 2018/2019 with 492 older adults registered in Family Health Strategy units in the city of Três Lagoas, MS, Brazil. Sociodemographic data were collected and the Clinical-Functional Vulnerability Index (CFVI-20) was applied (possible score 0-40; higher scores indicate greater vulnerability). A multinomial logistic regression was performed to identify the risk factors for clinical-functional vulnerability. RESULTS: The sample's mean age was 70.80 years (SD, 7.82) and the mean CFVI-20 score was 9.25 (SD, 7.09), with 17.07% at high risk of clinical-functional vulnerability, 38.82% at moderate risk, and 44.11% at low risk. Low education, social isolation, difficulty sleeping, and being female were risk factors for moderate vulnerability. On the other hand, low education, social isolation, difficulty sleeping, physical inactivity, being female, not using alcohol, and not participating in social groups were risk factors for high vulnerability. CONCLUSIONS: The CFVI-20 is convenient for primary health care contexts, since it is fast and easy to apply. By recognizing factors related to vulnerability, specific preventive actions can be planned.

OBJETIVO: Identificar os fatores relacionados à vulnerabilidade clínico-funcional em idosos. METODOLOGIA: Trata-se de um estudo transversal e quantitativo, realizado em 2018/2019 com 492 idosos cadastrados em unidades com estratégia Saúde da Família (eSF) no município de Três Lagoas-MS. Foram coletados dados de caracterização sociodemográfica e se aplicou o IVCF-20 (pontuação possível de 0-40; quanto maior a pontuação, maior o risco de vulnerabilidade). Realizou-se uma regressão logística multinomial para identificar os fatores de risco para vulnerabilidade clínico-funcional. RESULTADOS: A média de idade é 70,80 ± 7,82 anos e a média de pontuação no IVCF-20 é 9,25 ± 7,09, sendo que 17,07% apresentam alto risco de vulnerabilidade clínico-funcional, 38,82% risco moderado e 44,11%, baixo risco. Baixa escolaridade, isolamento social, dificuldade para dormir e sexo feminino foram fatores de risco para o risco moderado de vulnerabilidade. Já a baixa escolaridade, isolamento social, dificuldade para dormir, inatividade física, sexo feminino, não fazer uso de álcool e não participar de grupos sociais foram fatores de risco para o alto risco de vulnerabilidade. CONCLUSÕES: O IVCF-20 se mostra oportuno no contexto da atenção primária à saúde, visto que possui rápida e fácil aplicação. Com o reconhecimento dos fatores relacionados é possível planejar ações de prevenção específicas.

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Introdução: Verifica-se, no contexto global, a modificação do perfil da morbimortalidade em decorrência das transições demográfica e epidemiológica, relacionadas ao aumento do número de idosos e de doenças crônicas não-transmissíveis. Nesse cenário, a polimedicação tem se tornado frequente e, por conseguinte, seus danos são visualizados. O uso de múltiplos medicamentos amplia o risco de prescrições potencialmente inapropriadas, o que propicia interações farmacológicas, eventos adversos a medicamentos e hospitalizações. Soma-se a isso o ônus ao sistema de saúde e à assistência médica. Objetivo: Identificar os fatores associados à polimedicação em adultos mais velhos e idosos. Métodos: Trata-se de um estudo transversal e quantitativo, realizado em 2018 e 2019, com n=147 adultos (45-59 anos) e n=153 idosos (≥60 anos), cadastrados na Estratégia Saúde da Família (ESF) no município de Três Lagoas/MS. Foram coletados dados de caracterização sociodemográfica, estilo de vida, rede de apoio social e informações sobre saúde. Questionou-se o número de fármacos de uso contínuo tomados por dia, sendo considerada polifarmácia a utilização de cinco ou mais medicamentos. Foi conduzida uma regressão logística binomial para identificar os fatores associados à polifarmácia. Resultados: A prevalência de polifarmácia foi 10,2% (IC95% = [6,3%-16,2%]) para os adultos e 17,0% (IC95% = [11,9%-23,7%]) para os idosos. Estiveram associados à polifarmácia para o grupo de adultos o aumento da idade (OR=1,32; IC95%=1,10-1,59) e não possuir companheiro (OR=6,52; IC95%=1,59-26,81). Já para o grupo de idosos, os fatores associados foram ter sofrido pelo menos uma queda no último ano (OR=3,33; IC95%=1,13-9,85), ser tabagista (OR=5,04; IC95%=1,30-19,62), avaliar a saúde como regular (OR=4,10; IC95%=1,16-14,54) ou ruim/muito ruim (OR=6,59; IC95%=1,31-33,08). O consumo de álcool foi inversamente associado à polifarmácia (OR=0,15; IC95%=0,02-0,98) nos idosos. Conclusões: Diante dos potenciais riscos oferecidos pela polimedicação, torna-se imprescindível a distinção dos grupos em condição de maior vulnerabilidade ao uso de múltiplos medicamentos e um acompanhamento mais cauteloso, a fim de assegurar maior segurança na prescrição de fármacos na atenção primária e o aprimoramento do cuidado.

Introduction: In the global context, there is a change in the profile of morbidity and mortality due to demographic and epidemiological transitions, related to increase in the number of elderly people and chronic non-communicable diseases. In this scenario, polypharmacy has become frequent and, therefore, its damages are visualized. The use of multiple medications increases the risk of potentially inappropriate prescriptions, which promotes pharmacological interactions, adverse drug events and hospitalizations. There is also a burden on the health system and health care. Objective: To identify factors associated with polypharmacy in adults and older adults. Methods: This is a cross-sectional and quantitative study, carried out in 2018 and 2019, with n=147 adults (45-59 years old) and n=153 elderlies (≥60y), registered in the Family Health Strategy (ESF) in in Três Lagoas/MS/Brazil. Sociodemographic characterization, lifestyle, social support network and health information data were collected. The number of drugs of continuous use taken per day was questioned, and the use of five or more medications was considered polypharmacy. Binomial logistic regression was conducted to identify factors associated with polypharmacy. Results: The prevalence of polypharmacy was 10.2% (95% CI = [6.3% -16.2%]) for adults and 17.0% (95% CI = [11.9% -23.7%]) for the elderly. Increased age (OR = 1.32; 95% CI = 1.10-1.59) and no partner (OR = 6.52; 95% CI = 1.59-26) were associated with polypharmacy for the adult group. For the elderly group, the associated factors were having suffered at least one fall in the last year (OR = 3.33; 95% CI = 1.13-9.85), being a smoker (OR = 5.04; 95% CI = 1.30-19.62), assess health as regular (OR = 4.10; 95% CI = 1.16-14.54) or poor/very bad (OR = 6.59; 95% CI = 1.31-33.08). Alcohol consumption was inversely associated with polypharmacy (OR = 0.15; 95% CI = 0.02-0.98) in the elderly. Conclusions: In view of the potential risks offered by polypharmacy, it is essential to distinguish groups in conditions of greater vulnerability to the use of multiple medications and more careful monitoring, in order to ensure greater safety in the prescription of drugs in primary care and the improvement of attention.

Introducción: En el contexto global, hay un cambio en el perfil de morbilidad y mortalidad debido a las transiciones demográficas y epidemiológicas, en relación con el aumento en el número de personas mayores y enfermedades crónicas no transmisibles. En este escenario, la polimedicación se ha vuelto frecuente y, por lo tanto, se visualizan sus daños. El uso de múltiples medicamentos aumenta el riesgo de prescripciones potencialmente inapropiadas, lo que promueve interacciones farmacológicas, eventos adversos de medicamentos y hospitalizaciones. A esto se agrega la carga sobre el sistema de salud y la asistencia médica. Objetivo: identificar los factores asociados con la polimedicación en adultos mayores y ancianos. Métodos: Este es un estudio transversal y cuantitativo, realizado en 2018 y 2019, con n=147 adultos (45-59 años) y n = 153 ancianos (≥60 años), registrados en la Estrategia de Salud Familiar (FSE) en el municipio Três Lagoas/MS. Se recogieron datos de caracterización sociodemográfica, estilo de vida, red de apoyo social e información de salud. Se cuestionó la cantidad de medicamentos de uso continuo que se toman por día, y el uso de cinco o más medicamentos se consideró polifarmacia. La regresión logística binomial se realizó para identificar los factores asociados con la polifarmacia. Resultados: La prevalencia de polifarmacia fue del 10.2% (IC 95% = [6.3% -16.2%]) para adultos y 17.0% (IC 95% = [11.9% -23.7%]) para las personas mayores. El aumento de la edad (OR = 1.32; IC 95% = 1.10-1.59) y ninguna pareja (OR = 6.52; IC 95% = 1.59-26) se asociaron con polifarmacia para el grupo de adultos. Para el grupo de ancianos, los factores asociados fueron haber sufrido al menos una caída en el último año (OR = 3.33; IC 95% = 1.13-9.85), ser fumador (OR = 5.04; IC 95% = 1.30-19.62), evalúe la salud como regular (OR = 4.10; IC 95% = 1.16-14.54) o pobre / muy mala (OR = 6.59; IC 95% = 1, 31-33.08). El consumo de alcohol fue inversamente asociado con la polifarmacia (OR = 0.15; IC 95% = 0.02-0.98) en los ancianos. Conclusiones: En vista de los riesgos potenciales que ofrece la polimedicación, es esencial distinguir grupos en condiciones de mayor vulnerabilidad al uso de múltiples medicamentos y un monitoreo más cuidadoso, a fin de garantizar una mayor seguridad en la prescripción de medicamentos en atención primaria y la mejora cuidado.

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