RESUMO
BACKGROUND: There are few data reporting the needs and priorities of older adults in Brazil. This hampers the development and/or implementation of policies aimed at older adults to help them age well. The aim of this study was to understand areas of importance, priorities, enablers and obstacles to healthy ageing as identified by older adults and key stakeholders in both urban and rural environments. METHODS: Two locations were selected, one urban and one rural in the municipality of Santo André, in the metropolitan region of São Paulo (SP). Workshops for older adults (>60 y) and stakeholders were conducted separately in each location. The workshops incorporated an iterative process of discussion, prioritisation and ranking of responses, in roundtable groups and in plenary. Areas of commonality and differences between older adult and stakeholder responses were identified by comparing responses between groups as well as mapping obstacles and enablers to healthy ageing identified by older adults, to the priorities identified by stakeholder groups. The socio-ecologic model was used to categorise responses. RESULTS: There were few shared responses between stakeholders and older adults and little overlap between the top ranked responses of urban and rural groups. With respect to areas of importance, both stakeholder groups ranked policies for older people within their top five reponses. Both older adult groups ranked keeping physically and mentally active, and nurturing spirituality. There was a marked lack of congruence between older adults' obstacles and enablers to healthy ageing and stakeholder priorities, in both urban and rural settings. Most responses were located within the Society domain of the socio-ecologic model, although older adults also responded within the Individual/ Relationships domains, particularly in ranking areas of most importance for healthy ageing. CONCLUSIONS: Our results highlight substantial differences between older adults and stakeholders with respect to areas of importance, priorities, enablers and obstacles to healthy ageing, and point to the need for more engagement between those in advocacy and policymaking roles and the older people whose needs they serve.
Assuntos
População Rural , População Urbana , Humanos , Brasil , Idoso , Masculino , Feminino , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , Participação dos Interessados , Prioridades em Saúde , Envelhecimento Saudável , Necessidades e Demandas de Serviços de SaúdeRESUMO
The objective of this study was to systematically investigate and review studies on the concept of vulnerability associated with the health of the older population. Articles were selected, filtered, and analyzed following the steps recommended by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Screening and data extraction were performed independently by 2 reviewers using templates developed by the authors. Data extracted included specific details about population, interest, and context. Studies were eligible for inclusion if they: 1) were cross-sectional or prospective, 2) involved community-dwellers aged ≥ 60 years, 3) were published in the last 10 years, and 4) had as a concept vulnerability associated with the health of the older population. A total of 833 studies were identified and screened, 26 of which were included. Most included studies addressed vulnerability in older adults as an individual aspect, whether biological or psychological. The remaining studies reported vulnerability as affecting socio-environmental, health care system, and multifactorial aspects. Therefore, the concept of "vulnerability in older people" was not properly defined in the biomedical scientific community. When we return to the guiding question of this review, we can conclude that the conditions of vulnerability of older people are being treated broadly and diversely, producing different methodological strategies. The systematic review was conducted in the United States National Library of Medicine (PubMed), Latin American and Caribbean Health Sciences Literature (LILACS), and Scientific Electronic Library Online (SciELO) databases between August and December 2020 and updated in September 2022, with registration number CRD42022361649
O objetivo da pesquisa é investigar e revisar sistematicamente estudos sobre o conceito de vulnerabilidade associado à saúde da população idosa. Os trabalhos foram selecionados, filtrados e analisados seguindo as etapas recomendadas pela The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. A triagem e a extração de dados foram realizadas por dois revisores independentes usando modelos desenvolvidos pelos autores. A extração de dados incluiu detalhes específicos da população; interesse; contexto. Consideraram-se artigos que: 1) fossem estudos transversais ou prospectivos, 2) envolvessem idosos da comunidade (≥ 60 anos), 3) fossem dos últimos dez anos; tivessem como conceito a vulnerabilidade associada à saúde da população idosa. O total de 833 estudos foi identificado e triado, e 26 deles foram incluídos. A maioria dos estudos incluídos verificou a vulnerabilidade do idoso no aspecto individual, seja biológico, seja psicológico. Em contrapartida, o restante dos estudos acredita que a vulnerabilidade atinja o aspecto socioambiental, sistema de saúde e multifatorial. Sendo assim, conceito de "vulnerabilidade do idoso" não está devidamente definido na comunidade científica biomédica. Neste caso, retornando à questão norteadora desta revisão, conclui-se que as condições de vulnerabilidade do idoso estão sendo tratadas de maneira ampla e diversa, produzindo diferentes estratégias metodológicas. A revisão sistemática foi realizada nas bases de dados United States National Library of Medicine (PubMed), Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs) e Scientific Electronic Library Online (SciELO), entre agosto e dezembro de 2020, com atualização em setembro de 2022, sob código CRD42022361649