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A relação entre autopercepção de saúde e a mortalidade em idosos, tem sido encontrada e descrita em estudos realizados em todo o mundo. O objetivo do presente estudo é descrever a autopercepção de saúde e analisar sua relação com a mortalidade dos idosos de Alcobaça, Bahia, bem como sua associação com variáveis sociodemográficas e o número de doenças autorrelatadas. Este estudo faz parte do Estudo Longitudinal de Saúde do Idoso de Alcobaça (ELSIA), e a investigação é caracterizada como estudo de coorte prospectivo de base populacional.Na análise de regressão logística, verificou-se que o número de morbidades e a renda em salários mínimos permaneceram associados à autopercepção de saúde, sendo que idosos com cinco ou mais morbidades apresentaram (RCP=3,46;IC 2,36-5,18) mais chances de relatar autopercepção de saúde negativa, bem como àqueles que vivem com 0 à 3 salários mínimos apresentaram (RCP=1,61; IC 1,06-2,46) mais chances de autopercepção ruim. Segundo a Regressão de Cox, somente a idade, ou seja, ter 80 anos ou mais (RR=4,62; IC 2,75- 7,75) consolidou-se como variável preditora para o óbito. Neste estudo, entre os idosos de Alcobaça, não foi encontrada associação estatisticamente relevante entre a autopercepção de saúde e a mortalidade. Existem fatores que levam o idoso a ter uma autopercepção ruim de saúde que podem ser modificados. Desta forma, estes idosos podem viver mais e com maior qualidade, desde que estes recebam informações e acolhimento necessário para um envelhecimento saudável. The relationship between self-perception of health and mortality in the elderly has been found and described in studies carried out around the world. The objective of the present study is to describe self-perception of health and analyze its relationship with mortality among the elderly in Alcobaça, Bahia, as well as its association with sociodemographic variables and the number of self-reported diseases. This study is part of the Longitudinal Study of Elderly Health in Alcobaça (ELSIA), and the investigation is characterized as a population-based prospective cohort study. In the logistic regression analysis, it was found that the number of morbidities and income in minimum wages remained associated with self-perception of health, with elderly people with five or more morbidities being 3.46 times more likely to report negative self-perception of health, as well as those who live with 0 to 3 minimum wages were 1.61 times more likely to have a poor self-perception. According to the Cox regression, only age, that is, being 80 years of age or older (HR=4.62; CI 2.75-7.75) was consolidated as a predictor variable for death. In this study, among the elderly in Alcobaça, no statistically significant association was found between self-perception of health and mortality. There are factors that lead the elderly to have a poor self-perception of health that can be modified. In this way, these elderly people can live longer and with higher quality, as long as they receive the information and care necessary for healthy aging.

Introduction: Self-assessment of health status can be considered a good predictor of population morbidity and mortality. Sociodemographic, environmental and health conditions can influence health self-perception. However, in rural areas, the identification of morbidities that affect workers' health and their general health condition is unknown. This study aims to evaluate the relationship between health self-perception and the occurrence of morbidities according to type of work. Methods: This was a cross-sectional, population-based study of a rural area of Brazil. Health self-perception outcomes were classified as good (very good or good) or not good (fair, poor or very poor). Rural work, classified as yes or no, was considered to be the exposure. Crude and adjusted Poisson regression analyses were performed, obtaining prevalence ratio (PR) estimates and the respective confidence intervals (95%CI). All analyses were stratified by sex and adjusted for confounding factors. Results: The sample comprised 893 individuals. The not good health self-perception prevalence was 27.6%, with a significant difference between the sexes (24.2% of men v 32.5% of women, p=0.014). Although associated with rural work in the crude model, self-perception was not associated with type of work after adjustment (PR: 1.02, 95%CI: 0.83-1.27). The risk of developing obesity (PR: 0.65, 95%CI: 0.47-0.91) and cardiovascular diseases (PR: 0.32, 95%CI: 0.12-0.87) was lower in men who developed rural activities. Also, women who reported doing rural work presented a lower risk for respiratory diseases (PR: 0.47; 95%CI: 0.22-0.97). Conclusion: The association between rural work and not good health self-perception, cardiovascular disease and obesity in women, and respiratory diseases in men seems to be highly dependent on sociodemographic context.

Submitted by Sara Ribeiro (sara.ribeiro@ucb.br) on 2019-05-16T12:42:40Z No. of bitstreams: 1 MonicaPalermodeSouzaBarbosaDissertacao2019.pdf: 1135309 bytes, checksum: 249982f52830143842c952d184efdca1 (MD5) Approved for entry into archive by Sara Ribeiro (sara.ribeiro@ucb.br) on 2019-05-16T12:42:51Z (GMT) No. of bitstreams: 1 MonicaPalermodeSouzaBarbosaDissertacao2019.pdf: 1135309 bytes, checksum: 249982f52830143842c952d184efdca1 (MD5) Made available in DSpace on 2019-05-16T12:42:51Z (GMT). No. of bitstreams: 1 MonicaPalermodeSouzaBarbosaDissertacao2019.pdf: 1135309 bytes, checksum: 249982f52830143842c952d184efdca1 (MD5) Previous issue date: 2019-02-26 In oldest-old people, a positive self-perception of health can be associated with a self-perceived successful aging. Aim: To investigate if multimorbidity (???2 chronic diseases) and polypharmacy (???5 drugs) influence the health self-perception in oldest-old people (???80 years). Methodology: A sample of 190 outpatients was submitted to a medical consult and application of questionnaires, to assess clinical and sociodemographic characteristics, self-reported diseases and medication use. We also measured the self-perception of current health (good/very good, regular, or poor/very poor), and the relative self-perception of health compared to the previous year and to age-matched individuals (better, equal or worse). Chi-square test was used for comparison, p-value of ???0.05 was considered significant. Results: Self-perception of health was reported as positive by 42%, regular by 51% and poor/very poor by 7% of the participants. When compared to others of the same age, 66% considered their health to be better. A decreased positive self-perception of health was observed when own health and was compared to the prior year. The presence of multimorbidity or polypharmacy did not influence the self-perception of health. Conclusions: The use of health self-perception should be considered in the elaboration of strategies for a more positive self-rated of aging, even in the presence of multimorbidity and polypharmacy. Em idosos longevos, uma autoavalia????o positiva da sa??de pode estar associada ?? autopercep????o de um envelhecimento bem-sucedido. Objetivo: Investigar se a multimorbidade (???2 doen??as cr??nicas) e a polifarm??cia (???5 medicamentos) influenciam na autopercep????o da sa??de em idosos longevos (idade ???80 anos). M??todos: Uma amostra de 190 idosos, em contexto ambulatorial, foram submetidos ?? consulta m??dica e aplica????o de question??rios para avaliar caracter??sticas cl??nicas e sociodemogr??ficas, doen??as autorrelatadas e uso de medicamentos. Tamb??m foi medida a autopercep????o da sa??de no momento atual (muito boa/boa, regular, ruim/muito ruim), em compara????o com outros da mesma idade e a pr??pria sa??de com um ano atr??s (melhor, igual ou pior). Foi usado o teste Qui-quadrado para compara????o e p???0,05 foi considerado significativo. Resultados: A autopercep????o da sa??de foi relatada como muito boa/boa para 42%, regular para 51% e ruim/muito ruim para 7% dos participantes. Quando compararam com outros da mesma idade, 66% considerou sua sa??de melhor. Uma queda da autopercep????o positiva da sa??de foi observada quando a pr??pria sa??de foi comparada ao ano anterior. A presen??a de multimorbidade ou polifarm??cia n??o influenciou a autopercep????o da sa??de. Conclus??es: O uso da autopercep????o da sa??de deve ser considerado na elabora????o de estrat??gias para uma autoavalia????o mais positiva do envelhecimento, mesmo na presen??a de multimorbidade e polifarm??cia.

Addictive disorders are a significant complaint for referral to consultation-liaison (C-L) psychiatry services, as the C-L psychiatrist is specialized in consulting patients with general health conditions, as well as with psychosomatic disorders. Among addictive disorders, gambling disorder is likely to become an emerging issue in C-L psychiatry. The present systematic review aimed to examine the correlation between gambling disorder and general health, particularly focusing on health self-perception. A systematic review of English-language papers was performed. The articles included in the present study reported general health or health self-perception data, as well as a measure of problem gambling severity. Nine studies were included in the present review. The main result we yielded is that disordered gamblers appear to show a somewhat worse somatic health self- perception than the non-gambling population and that they were more likely to utilize medical services. All studies concerning the relation between gambling and general health used self-report measures and were cross-sectional in their design. The literature seems to show a certain correlation between gambling and a worse self-perception of general health, although the effect size was limited. We hypothesize that at least a part of that patients presenting disordered gambling might be relatively often referred to C-L psychiatry due to their comorbidities. The clinical implications of the present work would point out that the consultation-liaison psychiatrist might play a pivotal role in detection and treatment of gambling disorder.

Caring for a demented family member has been associated with burden. Studies concerning health self-perception of family caregivers are still scarce. OBJECTIVE: To investigate caregivers perceived health and to look into relationships with patients and caregivers' sociodemographic and clinical data. METHOD: Dyads of dementia outpatients and family caregivers (n=137) were assessed with Mini Mental State Examination, Functional Activities Questionnaire, Neuropsychiatric Inventory and Clinical Dementia Rating. Caregivers answered Sociodemographic Questionnaire, Beck Depression and Anxiety Inventories, Zarit Burden Interview and Maslach Burnout Inventory. RESULTS: Caregivers poor perceived health was associated with emotional exhaustion, burden, depression and anxiety. Logistic regression analyses revealed caregivers' age, anxiety and physical problem as the main predictors of health self-perception. CONCLUSION: Aged family caregivers with anxiety who also report physical problem characterize a group at risk for poor self-perceived health. Evaluation of health self-perception may be useful for designing interventions to improve anxiety and physical health.

CONTEXTO: A autopercepção de saúde contempla vários aspectos da saúde física, cognição e capacidade funcional. OBJETIVO: Comparar idosos com e sem evidência de declínio cognitivo/demência quanto a autopercepção de saúde e variáveis sociodemográficas, destacando as variáveis associadas à autopercepção de saúde positiva e negativa dentro destes grupos. MÉTODOS: Noventa e oito idosos residentes na comunidade foram avaliados em visitas domiciliares para este trabalho. A avaliação cognitiva e funcional foi feita por meio da aplicação do Mini-Exame do Estado Mental (MEEM), do Teste do Desenho do Relógio (TDR), da Escala de Demência de Blessed (EDB) e do Questionário do Informante de Declínio Cognitivo em Idosos (IQCODE). A autopercepção da saúde foi avaliada por intermédio de um questionário adaptado do Brazil Old Age Schedule. RESULTADOS: Vinte e seis idosos (26%) apresentaram quadro de declínio cognitivo. Autopercepção de saúde negativa e menor participação em atividades físicas e recreativas se associaram significativamente a declínio cognitivo nesta amostra (p = 0,006, p = 0,05, p = 0,03, respectivamente). No grupo de sujeitos sem evidência de declínio cognitivo, a história prévia de eventos cerebrovasculares se relacionou à maior frequência de autopercepção negativa da saúde. CONCLUSÃO: A autopercepção negativa da saúde está relacionada ao provável diagnóstico de demência. Nos idosos com declínio cognitivo, a autopercepção positiva de saúde associa-se a quadros mais graves, refletindo possivelmente menor insight quanto ao estado mórbido.BACKGROUND: The self-perception of health can approach several aspects of physical health, cognition and functional abilities. OBJECTIVE: To compare elderly subjects wit and without evidence of cognitive decline in relation to health self-perception and socio-demographic variables, highlighting the variables associated with positive or negative health self-perception in these groups. METHODS: Ninety eight community-dwelling subjects were assessed in this study. Cognitive and functional abilities were tested using the Mini-Mental State Examination (MMSE), the Clock Drawing Test (CDT), the Blessed Dementia Scale (BDS), and the Informant Questionnaire of Cognitive Decline in the Elderly (IQCODE). Self-perception of health evaluation was performed with the use of an adapted questionnaire of the Brazil Old Age Schedule. RESULTS: Twenty-six subjects (26%) had evidence of cognitive decline in this sample. Negative health self-perception and lower levels of physical and leisure activity were significantly associated with cognitive decline in this sample (p = 0.006, p = 0.05, p = 0.03, respectively). In the group of subjects without evidence of dementia, history of cerebrovascular disease was associated with negative health perception. DISCUSSION: Dementia was associated with worse health self-perception evaluation. In addition, elders with evidence of dementia and good health self-perception evaluation had higher IQCODE scores, suggesting lack of judgment regarding health status.

Relatório do Projeto de Investigação apresentado para cumprimento dos requisitos necessários à obtenção do grau de Mestre em Fisioterapia, área de especialização em Fisioterapia em Condições Músculo- Esqueléticas A população idosa tem vindo a aumentar em Portugal, sendo este período de vida associado a maior incapacidade e dependência. Torna-se relevante desenvolver uma "estratégia de envelhecimento bem-sucedido", com o objetivo de promover a independência e autonomia, focando-se nos preditores para um envelhecimento saudável, tais como a atividade física e a diminuição dos períodos em atividade sedentária. Os programas de atividade no domicílio são viáveis e mais eficazes na redução da incapacidade aumentando também a taxa de adesão e de cumprimento dos programas através da motivação e autoperceção de saúde. O programa LIFE original é definido como um programa de atividade física no domicílio para pessoas idosas, reduzindo o tempo em atividade sedentária e contribuindo para a manutenção da independência nas AVD’s (Clemson, et al. 2012). Objetivo: Contribuir para o desenvolvimento de um modelo de intervenção no domicílio para a população idosa portuguesa com mais de 75 anos, que pretende diminuir o tempo em atividade sedentária, analisando a sua influência na velocidade da marcha realizada com tarefa cognitiva, e a autoperceção de saúde. Metodologia: Série de estudos de caso, com dois sujeitos (76 e 77 anos). Foi implementado uma adaptação do programa LIFE (Clemson, et al. 2012) e estudado o seu efeito no tempo em atividade sedentária, através do pedómetro e diário de atividade física, a autoperceção de saúde com o SF12v2 e a velocidade de marcha com tarefa cognitiva avaliada através de uma prova de 10 metros com associação de uma tarefa executiva e de memória. Resultados: A implementação do programa adaptado sugere que, o tempo em atividade sedentária dos sujeitos diminuiu em ambos os sujeitos, aumentou a velocidade de marcha (13% no caso A e de 32% no caso B) e uma evolução positiva nas questões da escala de autoperceção de saúde (SF12 v2), mudando a sua perspectiva de saúde de “razoável” para “boa”. Conclusões: O modelo implementado fornece uma estrutura interventiva para a população portuguesa no domicilio que ainda não tinha sido abordada. É importante a manutenção dos resultados obtidos e das tarefas implementadas, sendo necessário maior investigação na área para adequar este programas a grupos diferentes, averiguando se a longo prazo este tipo de programas promove a continuidade do exercício. Abstract: Introduction: The Elderly Population has been increased in Portugal, being this life period associated with increased of dependence and inability. It is relevant to develop a "successful aging" strategy, aiming to promote independence in the elderly, focusing on predictors of healthy aging , such as physical activity and fewer periods of sedentary activity. The home programs activity are feasible and more effective, obtaining superior results in reducing inability among the elderly, also increasing the membership fee and compliance programs through motivation and health self-perception. The original LIFE program is defined as a program of physical activity at home for the old-aged people, reducing time in sedentary activity and contributing to the maintenance of independence in AVD’s (Clemson, et al. 2012). Objective: To contribute to the development of the home intervention model for the Portuguese elderly population over 75 years , we want to decrease the time in sedentary activity, analyzing their influence on the speed of the march held with cognitive task , and health self-perception. Methodology: Case studies series, with two subjects ( 76 to 77 years old) . It has been implemented the LIFE program ( Clemson, et al . 2012) and studied their time effect in sedentary activity through pedometer and daily physical activity, the health self-perception with SF12v2 and running speed with cognitive task assessed by a test of 10 meters with membership of an executive task and memory. Results: The implementation of this adapted program, suggested that the time at sedentary activity of the subjects decreased in both subjects, has increased thewalking speed (13 % for A and 32 % for B ) and had a positive trend in the range of health self-perception ( SF12 v2) , changing its health perspective "fair" to "good". Conclusions: The implemented model provides an interventional framework for the Portuguese population in the household that had not yet been addressed. It is important to maintain the results achieved and implemented tasks, being necessary research in order to adapt this program to different groups, examining whether long term this type of program promotes the continuity of the exercise.

Objetivo: describir la epidemiología de los pacientes llevados a cirugía cardiaca en el periodo entre 2004 y 2008, y valorar la funcionalidad y la calidad de vida postoperatoria en un subgrupo. Material y métodos: estudio descriptivo de corte transversal. Análisis estadístico se realizó en epiinfo 2000 versión 3.5.3 de 2011 y una p < 0.05 se consideró estadísticamente significativa. La calidad de vida se evaluó con SF-12v2 y se aplicaron la escala de Barthel y de Lawton para la valoración de la funcionalidad. Resultados: el promedio de edad fue 68.6 años, 2.4% ≥ 80 años. La mortalidad global hospitalaria fue 10.3% (9.2% para revascularización, 11.1% para cambio valvular y del 16.7% para cirugía mixta). El promedio del componente de salud física fue 43.7 vs 49.6 (población de referencia), y el del componente de salud mental fue 53.2 vs 49.3. 79.4% mejoran la autopercepción en salud posterior a la cirugía, 94.1% eran independientes en su ABC físico y 85.3% requerían alguna ayuda en sus actividades instrumentales. Conclusiones: es el primer estudio en nuestro medio que describe la epidemiología de un grupo de pacientes ancianos llevados a cirugía cardiaca y que evalúa calidad de vida y funcionalidad; se evidenció una repercusión positiva en la calidad de vida, funcionalidad y en la autopercepción de salud. A nivel instrumental se evidenció mayor compromiso de las actividades que requieren movilidad y participación social, siendo el sexo femenino y la edad avanzada los factores de mayor impacto negativo. (Acta Med Colomb 2014; 39: 118-123). Objective: to describe the epidemiology of patients undergoing cardiac surgery in the period 2004 to 2008 and evaluate the functionality and postoperative quality of life in a subgroup. Material and methods: a descriptive cross-sectional study . Statistical analysis was performed in Epi Info 2000 version 3.5.3 2011 and p < 0.05 was considered statistically significant. Quality of life was assessed by SF-12v2 and Barthel and Lawton scale for assessing the functionality was applied. Results: mean age was 68.6 years, 2.4% ≥ 80 years. The overall hospital mortality was 10.3 % (9.2 % for revascularization, valve replacement 11.1% and 16.7% for joint surgery). The average physical health component was 43.7 vs 49.6 ( reference population) and the mental health component was 53.2 vs 49.3. 79.4% improve health self-perception after surgery, 94.1% were independent in their physical ABC and 85.3% required some help in their instrumental activities. Conclusions: this is the first study in our environment describing the epidemiology of a group of elderly patients undergoing cardiac surgery that evaluates quality of life and functionality. A positive impact on quality of life, functionality and health self-perception was evidenced . At instrumental level, greater commitment of activities requiring mobility and social participation was evident. Female sex and advanced age were factors with greater negative impact. (Acta Med Colomb 2014; 39: 118-123).

Caring for a demented family member has been associated with burden. Studies concerning health self-perception of family caregivers are still scarce. OBJECTIVE: To investigate caregivers perceived health and to look into relationships with patients and caregivers' sociodemographic and clinical data. METHOD: Dyads of dementia outpatients and family caregivers (n=137) were assessed with Mini Mental State Examination, Functional Activities Questionnaire, Neuropsychiatric Inventory and Clinical Dementia Rating. Caregivers answered Sociodemographic Questionnaire, Beck Depression and Anxiety Inventories, Zarit Burden Interview and Maslach Burnout Inventory. RESULTS: Caregivers poor perceived health was associated with emotional exhaustion, burden, depression and anxiety. Logistic regression analyses revealed caregivers' age, anxiety and physical problem as the main predictors of health self-perception. CONCLUSION: Aged family caregivers with anxiety who also report physical problem characterize a group at risk for poor self-perceived health. Evaluation of health self-perception may be useful for designing interventions to improve anxiety and physical health. Cuidar de familiar com demência tem sido associado a sobrecarga. Estudos sobre autopercepção de saúde em cuidadores ainda são escassos. OBJETIVO: Investigar autopercepção de saúde em cuidadores e relação entre dados sociodemográficos e clínicos de cuidadores e pacientes. MÉTODO: Díades de pacientes demenciados e cuidadores familiares (n=137) foram avaliados pelo Mini Exame do Estado Mental, Questionário de Atividades Funcionais, Inventário Neuropsiquiátrico e Escala de Avaliação Clínica da Demência. Cuidadores responderam ao Questionário Sociodemográfico, Inventários Beck de Depressão e Ansiedade, de Sobrecarga Zarit e de Burnout Maslach. RESULTADOS: Pior percepção de saúde associou-se a exaustão emocional, sobrecarga, depressão e ansiedade. Análise de regressão logística revelou idade, ansiedade e problema físico como principais preditores da percepção de saúde. CONCLUSÃO: Cuidadores familiares idosos, com ansiedade e problema físico, constituem grupo de risco para pior percepção de saúde. Avaliação da percepção de saúde pode ser útil em intervenções para melhorar ansiedade e saúde física.

RESUMO - O presente projecto enquadra-se no paradigma salutogénico e visa apurar alguns dos factores que determinam que algumas pessoas se apresentem mais saudáveis que a população em geral. Foi seleccionado um estudo, quantitativo, analítico tipo caso-controlo (1 caso para 3 controlos), em que os casos são constituídos por indivíduos integrando a Função Pública que se encontram acima do percentil 95 de assiduidade ao trabalho nos últimos dois anos e com uma auto-percepção de Saúde classificada como muito boa, os controlos são indivíduos que não obedecem à definição de caso. Os indivíduos serão emparelhados por idade, género, estado civil, carreira, categoria profissional e unidade funcional que integram. A assiduidade será calculada com recurso aos certificados de incapacidade temporária entregues nos respectivos serviços. Os factores a estudar são os mais citados na literatura como factores salutogénicos ou factores de protecção, são eles: - Sentido de Coerência de Antonowsky - Locus de controlo - Auto conceito -Auto Eficácia - Aptidão física nas três vertentes clássicas: Capacidade aeróbia, Composição corporal, Aptidão muscular. Todos estes factores serão estudados com recurso a questionários auto preenchidos devidamente testados e validados para o português de Portugal sendo a aptidão física apurada com recurso á bateria de testes "Fitness Gram" adoptada para Portugal pelo Instituto do Desporto de Portugal e pelo Ministério da Educação. Os resultados serão apurados com recurso ao software de análise epidemiológica EPIDAT. 3.1. ---------------- ABSTRACT - The present project follows the salutogénic paradigm and intends to identify some of the factors that determine why some people are healthier than the general population. It was selected a quantitative, analytic, case-control study type (1 case to 3 controls), in which the cases are constituted by individuals who are integrated in Public Services and find themselves above 95 percentile of assiduity in work in the last two years, and with a self-perception of Health classified as very good, the controls are individuals who don’t obey to the case definition. The individuals will be matched by age, gender, civil state, career, professional category and Functional Unity in the Health services. The assiduity will be calculated with the help of temporary incapacity certificates delivered in the respective services. The currently studying factors are the most cited in literature, like salutogenic factors or protection factors, are those: - Antonowsky’s Sense of Coherence - Locus Control - Self-concept - Self-Efficacy - The three classic strands of Physical Fitness: Aerobic Capacity, Corporal Composition, Muscular Fitness. All these factors will be studied with the resource of properly tested and validated self-filled questionnaires for Portugal Portuguese (language), with the Physical Fitness being determined with the resource of “Fitness Gram” test battery, adopted for Portugal by the Portuguese Sports Institute and the Education Ministry. The results will be determined with the resource of the epidemiologic analysis software EPIDAT. 3.1.

Objective: The aim of this study was to analyze substance abuse and health self-perception in children and adolescents from the province of Cádiz (Spain). Methodology: Participants were 738 students, 50.9 boys and 49.1% girls, from elementary school to high school (1st to 12th grade, mean age 12.2. years), who responded a Spanish adaptation of the Health Behavior in School-aged Children Inventory. Results: No difference was observed in percentage of boys and girls reporting to smoke or drink alcohol. Smoking and drinking habits increased with age, being higher in 11th and 12th grade students. Significant differences were observed among the percentage of smokers and non smokers recognizing to have parents, older brothers or friends who smoke. Rates of drug abuse were generally low, being cannabis the most frequently consumed illicit drug. Most respondents had a perception of excellent or good health, with no significant gender differences. About half of subjects considered that health exclusively depends on self behavior, but an important percentage also gave a relevant role to luck. Stomach-ache was the most frequent physical complaint, followed by headache. Psychological complaints mainly corresponded to nervousness and bad temper. Only a small percentage of subjects declared the use of medicines or tablets without prescription. No significant difference in the percentage of respondent who perceived an excellent or good health was observed among substance users and non users. Conclusions: Substance abuse and health self-perception in children and adolescents are the result of the interaction of a complex series of individual and social factors. Activities aimed to improve health focusing on partial aspects of adolescents' lifestyle most probably will have limited results, and global programs are required.

BACKGROUND: The self-perception of health can approach several aspects of physical health, cognition and functional abilities. OBJECTIVE: To compare elderly subjects wit and without evidence of cognitive decline in relation to health self-perception and socio-demographic variables, highlighting the variables associated with positive or negative health self-perception in these groups. METHODS: Ninety eight community-dwelling subjects were assessed in this study. Cognitive and functional abilities were tested using the Mini-Mental State Examination (MMSE), the Clock Drawing Test (CDT), the Blessed Dementia Scale (BDS), and the Informant Questionnaire of Cognitive Decline in the Elderly (IQCODE). Self-perception of health evaluation was performed with the use of an adapted questionnaire of the Brazil Old Age Schedule. RESULTS: Twenty-six subjects (26%) had evidence of cognitive decline in this sample. Negative health self-perception and lower levels of physical and leisure activity were significantly associated with cognitive decline in this sample (p = 0.006, p = 0.05, p = 0.03, respectively). In the group of subjects without evidence of dementia, history of cerebrovascular disease was associated with negative health perception. DISCUSSION: Dementia was associated with worse health self-perception evaluation. In addition, elders with evidence of dementia and good health self-perception evaluation had higher IQCODE scores, suggesting lack of judgment regarding health status. CONTEXTO: A autopercepção de saúde contempla vários aspectos da saúde física, cognição e capacidade funcional. OBJETIVO: Comparar idosos com e sem evidência de declínio cognitivo/demência quanto a autopercepção de saúde e variáveis sociodemográficas, destacando as variáveis associadas à autopercepção de saúde positiva e negativa dentro destes grupos. MÉTODOS: Noventa e oito idosos residentes na comunidade foram avaliados em visitas domiciliares para este trabalho. A avaliação cognitiva e funcional foi feita por meio da aplicação do Mini-Exame do Estado Mental (MEEM), do Teste do Desenho do Relógio (TDR), da Escala de Demência de Blessed (EDB) e do Questionário do Informante de Declínio Cognitivo em Idosos (IQCODE). A autopercepção da saúde foi avaliada por intermédio de um questionário adaptado do Brazil Old Age Schedule. RESULTADOS: Vinte e seis idosos (26%) apresentaram quadro de declínio cognitivo. Autopercepção de saúde negativa e menor participação em atividades físicas e recreativas se associaram significativamente a declínio cognitivo nesta amostra (p = 0,006, p = 0,05, p = 0,03, respectivamente). No grupo de sujeitos sem evidência de declínio cognitivo, a história prévia de eventos cerebrovasculares se relacionou à maior frequência de autopercepção negativa da saúde. CONCLUSÃO: A autopercepção negativa da saúde está relacionada ao provável diagnóstico de demência. Nos idosos com declínio cognitivo, a autopercepção positiva de saúde associa-se a quadros mais graves, refletindo possivelmente menor insight quanto ao estado mórbido.

El envejecimiento de la población constituye hoy en día uno de los problemas más acuciantes en nuestra sociedad. El incremento del colectivo de mayores de 65 años (donde destaca un fuerte incremento de la población de edad más avanzada -80 años-) está planteando nuevas demandas a los profesionales de los dispositivos de salud y/o servicios sociales, así como a los gestores e interventores que están implicados en la adopción y puesta en práctica de políticas de Bienestar. Con objeto de conocer la situación concreta de este colectivo en una zona de Huelva se plantea el presente estudio cuyo objetivo principal es valorar la calidad de vida de la población mayor. Para ello se seleccionó, a partir del censo disponible, una muestra representativa de la población de 65 años y más de una zona de salud de Huelva capital. Mediante entrevistas individualizadas en los domicilios de los mayores, llevadas a cabo por personal específicamente entrenado, se administraron una serie de escalas y cuestionarios para medir distintos aspectos (tanto objetivos como subjetivos) de la calidad de vida. Entre otros se midieron la autopercepción de salud y el bienestar subjetivo (a través de la satisfacción con la vida), las relaciones sociales y el apoyo social y el grado de autonomía del anciano, además de variables sociodemográficas. En el presente trabajo se presentan solamente los resultados referidos a la salud y el bienestar subjetivos de los mayores. Pretendemos que los resultados finales sobre los distintos aspectos medidos de la calidad de vida de los mayores puedan servir para orientar actuaciones de cara a mejorar la situación de este sector de población., The ageing of the population is nowadays one of the most pressing problems in our society. The increase of the community of people over 65 (where a strong increase of the oldest population –80 years old– is remarkable) is demanding new challenges from public health and/or social services professionals, and from managers and supervisors involved in the adoption and implementation of Welfare policies. In order to knowing the concrete situation of this group in an area of Huelva, the present study is planned. Its main aim is to assess quality of life of the older population. For this purpose, a representative sample of the population over 65 and more than one health zone of the city of Huelva were selected from the available census. By means of individual interviews at the elders’ homes made by specifically trained staff, a number of scales and questionnaires were administered in order to measure several aspects (both objective and subjective) of the quality of life. Among others, health self-perception and subjective well-being (through satisfaction with life), social relationships and support, and the degree of autonomy of the elder, as well as some socio-demographic variables, were measured. The present study shows only the results relative to the elders’ subjective health and well-being. Our aim is for the final results of the various measured aspects of the elders’ quality of life to help guiding performances in order to improve the situation of this sector of the population

ResumenObjetivoAnalizar las diferencias en la percepción del estado de salud de los varones y mujeres en las últimas etapas de la vida y explorar su relación con variables sociodemográficas y de salud.MétodosDatos procedentes de la Encuesta de Salud de Cataluña de 1994, de 1.459 varones y 1.993 mujeres de 60 y más años. Se realizó un análisis de la autovaloración del estado de salud según la edad, el sexo, la clase social, la declaración de enfermedades crónicas y la discapacidades y se aplicó un modelo de análisis multivariable de regresión logística teniendo en cuenta el diseño muestral.ResultadosEl 57,3% de las mujeres de 60 y más años declaraba no tener buena salud, frente al 43,6% de los varones. También fue superior la proporción de mujeres que padecía una o más discapacidades (41,2%) respecto a los varones (28,7%), así como la de enfermedades crónicas, el 92,2% de las mujeres y el 85,6% de los varones. En el modelo de regresión logística multivariable continúa manteniéndose una percepción de mala salud superior en las mujeres y aparecen como factores explicativos el número de enfermedades crónicas, padecer discapacidades y pertenecer a las clases sociales más desfavorecidas. La edad en interacción con las enfermedades crónicas amortigua el efecto de éstas en la valoración del estado de salud.ConclusionesEntre la población anciana, la percepción de mala salud fue superior en las mujeres incluso ajustando por otras variables explicativas significativas (clase social, edad, discapacidades y enfermedades crónicas). Padecer enfermedades crónicas y/o discapacidades constituyen los factores explicativos más importantes en la percepción del estado de salud. El impacto del padecimiento de enfermedades crónicas en relación con la percepción de mala salud disminuye a medida que los grupos son de mayor edad.SummaryObjectivesTo analyze the differences in health self-perception between men and women in the later stages of life and to assess their association with sociodemographic and health variables.MethodsData on 1,459 men and 1,993 women aged 60 or older from the 1994 Catalan Health Survey, were collected and an analysis of health self-perception according to age, gender, social class, reporting of chronic disease and handicaps was performed. Multivariate logistic regression analysis was used, taking into account the survey design.ResultsOf the women aged 60 and older, 57.3% reported poor health compared with 43.6% of men of the same age. The proportion of women with one or more handicaps was also greater (41.2%) than that of the men (28.7%), as was the case with chronic disease (92.2% inwomen and 85.6% in men). The multivariate model also revealed that health self-peerception was poorer among women than among men. Other explanatory factors were the number of chronic diseases, having handicaps, and being a member of a lower social class. Age interacted with the number of chronic diseases to mitigate the effect of chronic diseases on perceived health status.ConclusionsIn the elderly population, poor health self-perception was greater among women, even when other significant explanatory variable (social class, age, handicaps and chronic disease) were adjusted for. The most important explanatory factors in health self-perception were having chronic disease and/or handicaps. The impact of chronic disease on poor health self-perception decreased in older age groups.