As características da rede de apoio social estão associadas à hospitalização? Achados de um estudo de coorte com pessoas idosas da comunidade

Abstract

Introduction: Aging is characterized by physiological changes that can exacerbate chronic conditions, making older people more susceptible to hospitalization. In this context, the social support network can help mitigate the detrimental effects of stress on the body and consequently be an important ally in the care process of older people, by reducing the chances of adverse outcomes. Objective: To verify if the characteristics of the social support network are associated with the time to hospitalization of older people. Method: This is a prospective cohort study that used baseline data from the research entitled "Association between low level of social support and telomere length in older people" conducted in 2019 in Alfenas, MG. Follow-up data were collected in May 2023. The characteristics of the social support network were assessed using the Medical Outcomes Study Social Support Survey. Hospitalization dates were obtained from the municipality's information systems records. Association analyses were performed using the Cox proportional hazards model. Hazard Ratios (HR) and 95% confidence intervals were calculated. The log-rank test was used to analyze the statistical difference between survival curves constructed by the Kaplan-Meier method. Results: Of the 413 older people followed, it was observed that 72.9% of the sample were women, 46.3% were between 60 and 69 years old, and 44.1% reported a monthly income between 1 to 2 minimum wages. Regarding health, 68.7% of the participants reported two or more chronic diseases, 40.1% were in polypharmacy, and the majority did not report depressive symptoms (65.9%) or cognitive decline (71.9%). Regarding the characteristics of the social support network, 72.1% of the older people had more than five members in their social network. Most participants reported a high/medium level of all types of support. The presence of cognitive decline (HR=1.69; 95%CI=1.10-2.58) and low levels of positive social interaction (HR=1.76; 95%CI=1.07-2.90) increase the chances of hospitalization, regardless of the size of the network, material support, affective support, and emotional/informational support. Conclusion: Low levels of positive social interaction increase the chances of hospitalization of the evaluated older people, indicating that nursing care should consider interventions that stimulate the creation, maintenance, and expansion of older people's social support networks to prevent or postpone hospitalizations.