RESUMO
OBJECTIVE: To analyse the informal system of caring for people with neuro-degenerative disease: what it consists of and the characteristics of main carers, the type of care given, and the consequences for the main carer of assuming these functions. DESIGN: Descriptive cross-sectional study conducted by means of a home-filled questionnaire. SETTING: Autonomous Community of Andalusia. PARTICIPANTS: 72 main carers of someone with neuro-degenerative disease, chosen from a sub-sample of 1000 homes in which at least one dependent person lives and receives care from a member of his/her family or social network with whom he/she resides. This sub-sample was based on a random sample of 3160 Andalusian homes stratified proportionately according to province and size of dwelling. MAIN RESULTS: In 86.1% of the 72 homes polled, health care was provided only by the informal system network. In over half the homes, care was provided by just one person, the main carer. The main carer was usually a woman (87.4%), with an average age of 54.52, house-wife and close family member of the sick person. In our study the beneficiaries of care had an average age of 77.63, a low level of autonomy in daily activities, and had had a neuro-degenerative disease for an average of 8.16 years. The main kinds of care provided in the home for people with neuro-degenerative disease were help in instrumental activities, care related to daily activities, observation/company and supervision of medicines. Main carers believed that undertaking this work had seriously affected their health (72.2%), the use they made of their time (84.7%), their social life (83.3%) and their economic position (44.4%). CONCLUSIONS: People with neuro-degenerative disease make considerable demands on health care provision, which is mainly covered at home by the immediate family network. In most cases this network consists of just one person, the main carer, on whom falls the entire burden of care. The assumption of this role directly affects the health of a large number of carers, as well as other areas of their lives, in particular the possibility of conducting a social life and using their time for themselves or for activities other than caring.
Assuntos
Cuidadores , Doenças Neurodegenerativas/terapia , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
BACKGROUND: The objective of this study was to estimate the relationship between the levels of air pollution and the daily mortality in the city of Huelva for the 1993-1996 period using the EMECAM methodology. METHODS: The number of daily deaths for all causes except external ones, the death rate of those over age 69, due to diseases of the circulatory system and for respiratory diseases were used as rate indicators. Four pollutants--SO2, PM10, NO2 and CO--were analyzed, the daily levels of which were furnished by the air pollution monitoring network in Huelva. Autoregressive Poisson regression models were constructed controlling by tendency, seasonality, temperature, humidity, flue and events out of the ordinary. RESULTS: For the mortality rate for all causes, a significant association impact was found to exist for the NO2 for the entire period (RR10 microgram/m3: 1.0414; CI95%: 1.0047-1.0794) and for the particles (PM10) for the cold half of the year (RR10 microgram/m3: 1.0358; CI95%: 1.007-1.0722). For the mortality in people over age 69, a significant relationship was found to exist for SO2 throughout the entire period (RR10 microgram/m3: 1.0606; CI95%: 1.0020-1.1227). A significant relationship to the mortality from respiratory disease particles (PM10) was found to exist for the cold half of the year (RR10 microgram/m3: 1.1412; IC95%: 1.0300-1.2644). There was no association of contaminants with cardiovascular mortality; also there was no association between levels of CO and mortality indicators. CONCLUSIONS: In Huelva, significant relationships have been found to exist between the current levels of air pollution resulting from particles, SO2 and NO2 and the daily mortality. The impact of these pollutants on the mortality is coherent with scientific literature, although in the case of Huelva, the extremely small number of daily deaths due to its small population and other factors limit the consistency thereof.
Assuntos
Poluição do Ar/efeitos adversos , Mortalidade/tendências , População Urbana/estatística & dados numéricos , Idoso , Poluentes Atmosféricos/efeitos adversos , Poluentes Atmosféricos/análise , Poluição do Ar/estatística & dados numéricos , Causas de Morte , Humanos , Distribuição de Poisson , Análise de Regressão , Risco , Estações do Ano , Espanha/epidemiologia , Fatores de TempoRESUMO
BACKGROUND: As part of the EMECAM Project, the objective of this study is that of assessing the impact of air pollution on the daily mortality in Seville throughout the 1992-1996 period. METHODS: During the 1992-1996 period, readings were taken daily of the amounts of SO2, particles in suspension (PM10) and NO2 present in the air in the city of Seville, in addition to the number of deaths daily due to different causes. For analyzing this data, a multivariable Poisson regression model was used for modeling each one of the causes of death in terms of the air immission readings, controlling other confusion-causing variables. RESULTS: A relationship was found to exist between the rises in the NO2 levels and the daily death rate throughout the months of May to October. For each 10 micrograms/m3 rise, the risk of death or all causes showed a 2% rise, the same rise in the NO2 levels leading to a 3% rise in the risk of death resulting from cardiovascular diseases. CONCLUSIONS: A relationship exists between the levels of NO2 air pollution and the daily death rate in Seville. The findings provide scientific knowledge and information which can be of use for preventing the impact of air pollution on human health.