Vulnerabilidades ao sofrimento psíquico e à ideação suicida de idosos do Sertão Paraibano

Abstract

This study aimed to analyze the vulnerabilities of elderly people in the Sertão of Paraíba in relation to psychological suffering and suicidal ideation. For this purpose, the study was carried out based on two surveys, according to the respective specific objectives: 1) To analyze the suicide mortality rates, in Paraíba, of elderly people living in the Paraiba Hinterland. 2) Analyze the vulnerabilities to psychological distress and suicidal ideation based on reports from elderly people living in the countryside of the state. The first research was characterized as being exploratory, descriptive and documentary. Data were collected in the Mortality Information System (SIM) of the Informatics Department of the Unified Health System (DATASUS). The available data were analyzed during the entire period available in SIM / DATASUS, from 1979 to 2018. It was found that the country population presented the highest risk of deaths by suicides in comparison with other mesoregions of the state. The highest suicide rates occurred among the elderly. The highest frequencies were seen in the following groups: male, non-white, group aged 60 to 69, little schooling, married elderly men, widowed and single elderly women. The results pointed to the growing trend of suicide mortality in the elderly over the years. The second research is characterized as being exploratory, descriptive, transversal, with a qualitative approach. Data collection was done in cities located in the micro-regions belonging to the Sertão of Paraíba mesoregion. Thirty-one elderly people, who presented symptoms of Common Mental Disorders (CMD) participated, the majority being female (20 people). The following instruments were used: Self-Reporting Questionnaire [SRQ-20] to identify CMD; Sociodemographic questionnaire; Semi structured interview. The data resulting from closed and objective questions were analyzed using descriptive statistics. The interview data were analyzed using Content Analysis, thematic categorical type. Among the 31 participants with CMD, nine (29%) had suicidal ideation. Among the elderly with mental suffering, the group of people with the following characteristics prevailed: female (64.5%); non-white (64.5%); little schooling time (83.9%); monthly income of up to 2 minimum wages (80.5%); retirement as the main source of income (90.3%); widows, single and divorced (51.7%). The content analysis showed four thematic categories and twenty-one subcategories. The reports showed that the participants experience sadness, malaise, worry and anxiety, resulting from physical illness, loneliness, violence, family conflicts, living conditions, emotional losses, depressive and anxious symptoms. Suicidal thoughts and plans are recurrent and appear as an alternative to deal with suffering. Spirituality and informal social support network were the only protective factors against thoughts of self-destruction mentioned by the elderly. The expressive number of suicides among the elderly indicates the importance of improving care within the scope of public policies aimed at the needs of the elderly population that ages in the hinterland. The experiences and living conditions reported denote the need for actions that involve family, society and the public sector to effectively meet the needs of the elderly population