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Abstract(s)
Introdução: Um dos desafios relacionados com o envelhecimento da população é o
ageism - discriminação baseada na idade, sobretudo em relação aos idosos. Existe um
consenso geral de que o ageism está presente nos sistemas e políticas de saúde. Este
estudo pretende desenvolver os primeiros estudos de validação da Escala de Perceção de
Ageism em Cuidados de Saúde, avaliar em que medida se observam determinados
comportamentos discriminatórios nos cuidados de saúde portugueses e, ainda, analisar as
variáveis que podem estar relacionadas com essa mesma perceção.
Métodos: O estudo consistiu na aplicação a médicos portugueses de diversas
especialidades, de um questionário com 28 itens acerca da existência de ageism em
contextos de saúde. Os dados foram recolhidos através de um formulário online, durante a
pandemia por COVID-19.
Resultados: Responderam 500 médicos (75,4% mulheres), de 41 especialidades
diferentes. Os estudos de validação da escala apresentaram boas propriedades
psicométricas. A análise fatorial desta escala revelou a existência de 3 fatores principais,
sendo estes relacionados com: 1. a discriminação direta, com a exclusão de pessoas idosas
de programas de elevado custo; 2. a discriminação indireta, com o adiamento de
tratamentos/exames ou a proposta de tratamentos menos completos; e 3. o tratamento
desigual dos idosos face aos mais jovens e a superproteção e tratamento paternalista com
que se trata o idoso. Em 6 situações é referida uma maior perceção de ageism por mais de
60% dos médicos. Todas estas 6 situações, em que a perceção de ageism é maior, se
relacionam com o terceiro fator identificado na escala. O total da escala correlacionou-se
positivamente com os médicos terem formação prévia em geriatria, sugerindo que esta
pode influenciar a perceção de ageism, tornando os profissionais de saúde mais atentos a
esta temática. Dos médicos, 96,6% consideram que o ageism se manteve ou agravou
durante a pandemia por COVID-19.
Conclusões: A Escala de Perceção de Ageism em Cuidados de Saúde está em condições
de ser aplicada de uma forma mais generalizada aos médicos portugueses e outros
profissionais de saúde para a avaliação da sua perceção de ageism em cuidados de saúde.
Os resultados indicam que o nível de ageism global percecionado em cuidados de saúde é
baixo. Contudo existem situações em que a perceção de ageism nos cuidados de saúde é
elevada, através de uma discriminação direta, indireta, e um tratamento desigual dos
idosos. Estes resultados alertam para a necessidade de se repensarem práticas e se implementarem medidas de modo a impedir esta forma de discriminação e violação de
direitos das pessoas mais velhas em contexto de saúde.
Introduction: One of the challenges related to the aging of the population is ageism - age-based discrimination, which mainly occurs with the elderly. There is a general agreement on ageism being present in the health service systems and policies. This study intends to develop the first validation studies of an Ageism Perception Scale for the Portuguese population, to evaluate to which extent certain discriminatory behaviors are observed in Portuguese healthcare, and also to analyze the variables that may be related to this perception. Methods: The study consisted of applying to Portuguese doctors of different specialties a questionnaire with 28 items about the existence of ageism in healthcare contexts. Data were collected with an online form during the COVID-19 pandemic. Results: 500 doctors (75.4% women), from 41 different specialties participated in this study. The scale validation studies showed good psychometric properties. The factor analysis of this scale revealed the existence of 3 main factors, which are related to: 1. direct discrimination, with the exclusion of elderly people from high-cost programs; 2. indirect discrimination, with the postponement of treatments/exams or the proposal of less complete treatments; and 3. the unequal treatment of the elderly compared to the youngest and the overprotection and paternalistic treatment of the elderly. In 6 situations, the perception of ageism is higher as mentioned by more than 60% of the doctors. All of these 6 situations, in which the perception of ageism is higher, are related to the third factor identified on the scale. The scale's total correlated positively with physicians having previous training in geriatrics, suggesting that it may influence the perception of ageism, making health professionals more attentive to this theme. 96.6% of the doctors consider that ageism was maintained or worsened during the COVID-19 pandemic. Conclusions: The Ageism Perception in Healthcare Systems Scale can be applied in the future to Portuguese doctors and other health professionals to assess their perception of ageism in healthcare systems and policies. The results indicate that there is a small global level of perceived ageism. However, in some situations, there is a high perception of ageism in Portuguese healthcare systems, through direct, indirect discrimination, and unequal treatment of the elderly. These results alert to the need to rethink practices and implement measures in order to prevent this form of discrimination and violation of the rights of older people in healthcare.
Introduction: One of the challenges related to the aging of the population is ageism - age-based discrimination, which mainly occurs with the elderly. There is a general agreement on ageism being present in the health service systems and policies. This study intends to develop the first validation studies of an Ageism Perception Scale for the Portuguese population, to evaluate to which extent certain discriminatory behaviors are observed in Portuguese healthcare, and also to analyze the variables that may be related to this perception. Methods: The study consisted of applying to Portuguese doctors of different specialties a questionnaire with 28 items about the existence of ageism in healthcare contexts. Data were collected with an online form during the COVID-19 pandemic. Results: 500 doctors (75.4% women), from 41 different specialties participated in this study. The scale validation studies showed good psychometric properties. The factor analysis of this scale revealed the existence of 3 main factors, which are related to: 1. direct discrimination, with the exclusion of elderly people from high-cost programs; 2. indirect discrimination, with the postponement of treatments/exams or the proposal of less complete treatments; and 3. the unequal treatment of the elderly compared to the youngest and the overprotection and paternalistic treatment of the elderly. In 6 situations, the perception of ageism is higher as mentioned by more than 60% of the doctors. All of these 6 situations, in which the perception of ageism is higher, are related to the third factor identified on the scale. The scale's total correlated positively with physicians having previous training in geriatrics, suggesting that it may influence the perception of ageism, making health professionals more attentive to this theme. 96.6% of the doctors consider that ageism was maintained or worsened during the COVID-19 pandemic. Conclusions: The Ageism Perception in Healthcare Systems Scale can be applied in the future to Portuguese doctors and other health professionals to assess their perception of ageism in healthcare systems and policies. The results indicate that there is a small global level of perceived ageism. However, in some situations, there is a high perception of ageism in Portuguese healthcare systems, through direct, indirect discrimination, and unequal treatment of the elderly. These results alert to the need to rethink practices and implement measures in order to prevent this form of discrimination and violation of the rights of older people in healthcare.
Description
Keywords
Ageism Covid-19 Cuidados de Saúde Discriminação Idosos