Avaliação funcional de idosos com estomias e fatores associados.

Abstract

Introduction: The necessity of intestinal ostomy in the elderly entails consequences for both the elderly individual and their family members, with physiological impacts on digestive changes that affect psychosocial aspects. Adaptations in lifestyle range from acceptance to the need to adapt to new materials and knowledge, requiring skills and competencies for self-care. Objective: To evaluate the functional capacity of elderly individuals with ostomies and associated factors. Methods: This was an exploratory, descriptive, cross-sectional study with a quantitative approach. The research was conducted at the Amélio Marques Outpatient Clinic in the Stomatherapy Sector of the Clinical Hospital of the Federal University of Uberlândia, involving elderly users of colostomy, ileostomy, or transversostomy bags. Data were collected through face-to-face interviews, analyzed inductively, and discussed under the proposed theoretical framework. Data collection instruments included sociodemographic and clinical data collection tools, Katz Index of Independence in Activities of Daily Living, Lawton Instrumental Activities of Daily Living Scale, Mini-Mental State Examination, Geriatric Depression Scale, and Family A.P.G.A.R. Data were entered into Microsoft Excel and imported into the Statistical Package for the Social Sciences, version 23.0, for analysis. The Kolmogorov-Smirnov test was conducted to verify quantitative variables. Results: The study involved 139 elderly participants of both sexes, with an average age of 70 years old for men and 71 for women, predominantly with primary education. Statistical analysis showed an association between the female gender and higher incidences of hypertension (p = 0.017), depression diagnosis (p = 0.006), urinary incontinence (p = 0.002), and immunosuppression state (p = 0.007). Women notably faced more difficulties in removing the ostomy bag (p = 0.045) and the device that seals the bag (p = 0.022). Furthermore, there was a predominance of discomfort due to fecal leakage under the bag barrier in public among females (p = 0.027) and insecurity about the bag detaching (p = 0.001). Regarding functional capacity, half of the elderly showed impaired cognition and mild to moderate dependence in performing instrumental activities of daily living, especially among women. However, most were independent in performing basic daily activities and showed no signs of depression. Most reported good family functionality, although women had more family support compared to men (p = 0.021). Conclusion: Most elderly ostomy users reported low educational levels, cognitive impairment, and difficulties in performing instrumental daily activities. Despite these challenges, they managed to take responsibility for their ostomy care. Women experienced greater difficulties in removing the bag, the sealing device, and more frequent discomfort and insecurity. However, they exhibited better functionality and family support.