Pessoas com deficiência: qualidade de vida e condições de saúde e nutrição - Estudo BRAZUCA Natal

Abstract

People with Disabilities (PwD) are more vulnerable and tend to have more unfavorable health outcomes due to the barriers they face, resulting in unequal access to education, employment, health care, quality of life (QoL) and, consequently, food insecurity. (AI). Objective: To understand the dimension of AI, QoL and the health conditions of PwD. Methodology: A hybrid study based on the BRAZUCA Natal Study, comprising a cross-sectional study and a case control. For the cross-sectional study, 39 PwD were evaluated, who were also part of the case group (16 adults and 23 elderly people). For the control case, 78 people without disabilities were included (46 adults and 32 elderly people). Data collection was carried out in person between August 2019 and March 2020. Participants were interviewed regarding demographic, socioeconomic, lifestyle, anthropometric nutritional status and health conditions. The Brazilian Food Insecurity Scale (EBIA), the World Health Organization's Quality of Life questionnaires – WHOQOL-BREF and WHOQOL-OLD were applied, and anthropometric measurements were evaluated. Results: Physical disability was the most frequent (48.7%). Among the PWD, 81.6% did not have paid work, 86.8% reported not drinking and 78.6% did not smoke and 44% were overweight. Regarding the difficulty in buying food, 63.2% (CI 47.4% - 78.9%) reported high/extreme difficulty for processed foods and 57.9% (CI 42.1% - 73.7%) fresh. A large part had difficulties eating in restaurants (47.4%; CI 31.6% – 63.2%); to store food (52.6%; CI 36.8% – 68.4%); and to prepare food (60.5%; CI 44.7% – 76.3%). While no or low difficulty was found to identify foods that were unsuitable for consumption (63.2%; CI 47.4 – 78.9); putting food on the plate (50%; CI 34.2 – 65.8); eating solid foods (55.3%; CI 39.5 – 71.1); soft foods (97.4%; CI 92.1 – 100); using a knife and fork (62.2%; CI 47.4 – 78.9) and filling glasses and bottles (47.4%; CI 31.6 – 63.2). Most reported the need for caregivers or family members to buy food (86.8%). When comparing cases and controls, the multimorbidity variable was much higher in the case group (69.2%), as well as in the occurrence of AI (56.8%). The QOL domains were smaller for PwD. Conclusion: PwD have low autonomy to buy and prepare their own food, which can impact food choices and unhealthy habits, as well as AI. PwD had higher proportions of AI and multimorbidities in relation to non-PwD in the evaluated population. The QoL domains were lower for PwD, and it was observed that the physical domain was the one with the highest mean difference, putting PwD in worse conditions in terms of quality of life.