Promoção da saúde de idosas com osteoporose: uma abordagem a partir do modelo de promoção da saúde de Nola Pender

Abstract

This master's thesis has the general objective of analyzing the health-promoting behaviors adopted by elderly women with osteoporosis. Being a qualitative study, content analysis with pre-established categories was used as a method of evaluating the information gathered from the script based on Nola Pender's Model of Health Promotion (MPS). Twenty-five interviews were conducted between December 2019 and February 2020 at the rheumatology outpatient clinic of the Piquet Carneiro Polyclinic of the Rio de Janeiro State University (UERJ). All study participants were women, their average age was 74.04 years, and the average time of knowledge of the diagnosis of osteoporosis was 17 years. It was verified that 40% of the elderly women were widows, 48% lived alone, and 72% were retired. Regarding education, it was observed that most of them had completed primary school (28%). As for family income, the majority (60%) had between 1 and 2 minimum wages. Predominated as results the fear of falling (64%), the occurrence of at least one fall in the last 2 years (60%), the use of medicines with risk grade II for falls (68%), low consumption of the minimum recommended daily amount of calcium (92%). It was also found that 72% of the elderly women presented with 3 or more secondary clinical conditions. A significant percentage of the elderly women were overweight (40%), and the average BMI value among the elderly women was 26.51. Regarding the menopausal status, the average age of occurrence of menopause was 45.12 years. Through the analysis of the speeches coming from the interviews, it was also noted a deficit of knowledge about the care related to the disease, although they recognized the need to improve habits such as regular physical activity, sun exposure and increased consumption of foods rich in calcium. The discussion highlighted the individual characteristics of the participants as well as the specific behaviors, cognitions, and affect that can influence the adoption of healthy behaviors. The relevance of gerontological nursing and Primary Care (Atenção Básica - AB) in promoting the health of elderly women with osteoporosis was highlighted. As it is configured as a priority entrance door that coordinates and manages the care of the population, it is important that individual goals are established in the PC for the improvement of health behaviors and thus the prevention of fractures. The research showed the lack of understanding by the elderly about osteoporosis and its main consequence, fractures, also enabling to verify the multiplicity of factors that affect the health of the elderly and that sometimes limit access to important resources for self-care. It was possible to understand what health promotion actions the elderly women with osteoporosis have been adopting and need to improve in their daily lives, the main ones being: the search for relevant information about osteoporosis, spirituality, physical activity, sun exposure, and increasing the daily consumption of foods high in calcium. This knowledge is important not only for the nurse, but for the entire multidisciplinary team involved in supporting actions aimed at promoting the health of these people.