AUTOPERCEPÇÃO POSITIVA DA SAÚDE EM ADULTOS DE MEIA-IDADE E PESSOAS IDOSAS: UM ESTUDO LONGITUDINAL

Abstract

Self-perceived health is subjective data that gathers information perceived by the person about their health. It is considered a predictor of morbidity and mortality, therefore, knowing the factors that stimulate it positively is essential to promote a healthy life and aging. The objective of this study is to analyze the sociodemographic and biopsychosocial factors associated with changes in the positive self-perceived health of middle-aged and older adults at three points in time. This is a longitudinal study, developed with 300 participants aged 45 years or older registered in the Family Health Units of the municipality of Três Lagoas, Mato Grosso do Sul, Brazil. Data collection took place in the years 2018/2019 (T1), 2021 (T2) and 2023 (T3). The dependent variable was positive self-perceived health and the independent variables were: sociodemographic and health data, frailty, depressive symptoms and lifestyle habits. Data were analyzed using the Statistical Package for Social Science (SPSS) using multinomial regression models. The project met all ethical requirements. Most of the sample was female (65.7%), had a partner (56.0%), had a mean age of 60.9 years and 5.7 years of schooling, used medication (75.7%), was frail (56.3%), had depressive symptoms (56.7%) and had healthy lifestyle habits (49.3%). At T1, 51.7% of participants had a positive self-perceived health, which was associated with not using medication (OR = 2.60), being non-frail (OR = 8.73) or pre-frail (OR = 2.11) and not having depressive symptoms (OR = 1.86). At T2, the prevalence of positive self-perceived health was 52.3%, with 38.3% maintaining a positive self-perception and 14.0% evolving to positive between T1 and T2. Participants who were non-frail (OR = 9.74) or pre-frail (OR = 2.58) and who did not have depressive symptoms (OR = 3.56) were more likely to maintain a positive self-perception from T1 to T2. Male participants (OR = 2.23) and those without depressive symptoms (OR = 3.17) were more likely to have their self-perception become positive between T1 and T2. At T3, 54.0% had a positive self-perceived health, with 41.3% maintaining their self-perception as positive, and 12.7% becoming positive between T2 and T3. There was a lower chance of self-perception remaining positive (OR = 0.97) and becoming positive (OR = 0.95) between T2 and T3 in older individuals; and a higher chance of remaining positive for non-frail individuals (OR = 4.10) and pre-frail individuals (OR = 2.92). It was concluded that men, people who are not frail or pre-frail, who do not have depressive symptoms and who are younger can maintain or promote positive self-perceived health over time. The study reinforces the importance of knowing the factors that stimulate the population's positive self-perception of health to guide care actions and public policies, in order to promote health and healthy aging. Among the actions, prevention, early diagnosis and reversal/treatment of frailty and depression stand out, especially in groups of older women. The nurse, as a leader of the Primary Care health team, is an indispensable professional in this process.