Jack Roberto Silva Fhon

Sobrecarga dos cuidadores de idosos com acidente vascular cerebral.

The aim was to assess the burden on caregivers of elderly victims of cerebrovascular accident (CVA) and to correlate it with care hours, the elderly peoples age and functional independence. This cross-sectional study counted the participation of 62 elderly individuals with CVA and their caregivers. The instrument used contained socio-demographic and economic variables, the Mini-Mental Status Examination, the Functional Independence Measure (FIM) and the Zarit Scale. The possible correlations between the Zarit scale scores and the other variables were assessed using Pearsons Correlation Coefficient. Most caregivers were adults, children of the victims, married, and female. The mean Zarit score was 34.92(15.8). The FIM showed a negative correlation with caregiver burden, but no correlation with age and number of care hours. The burden on most of the caregivers ranged from moderate to severe and seems to be related to the level of functional independency of the elderly.The aim was to assess the burden on caregivers of elderly victims of cerebrovascular accident (CVA) and to correlate it with care hours, the elderly peoples age and functional independence. This cross-sectional study counted the participation of 62 elderly individuals with CVA and their caregivers. The instrument used contained socio-demographic and economic variables, the Mini-Mental Status Examination, the Functional Independence Measure (FIM) and the Zarit Scale. The possible correlations between the Zarit scale scores and the other variables were assessed using Pearsons Correlation Coefficient. Most caregivers were adults, children of the victims, married, and female. The mean Zarit score was 34.92(15.8). The FIM showed a negative correlation with caregiver burden, but no correlation with age and number of care hours. The burden on most of the caregivers ranged from moderate to severe and seems to be related to the level of functional independency of the elderly.

Accidental falls in the elderly and their relation with functional capacity

AIM This study aimed to determinate the prevalence of falls in the elderly and its relationship with the functional capacity. METHOD This is an epidemiological and cross-sectional study; a two-stage cluster sample of 240 male and female subjects aged over 60 years was used. Data were collected from November 2010 to February 2011. The following questionnaires were used: socio-demographic profile, assessment of falls, Functional Independence Measure, Lawton and Brody Scale. Significance was set at 0.05. To identify the occurrence of falls and their relation with functional capacity, the prevalence ratio and prevalence odds ratios were used, as well as multiple logistic regression. RESULTS Average age was 73.5 years (±8.4); 25% 80 years or more, with preponderance of female gender; 48.8% attended school between 1-4 years. The average was 1.33 falls (±0.472), with prevalence in women and elderly between 60 and 79 years old; the most frequently sites were the backyard and bathroom. Strong correlation between the level of functional independence and instrumental activities and age was found, but no relation between elderly victims of falls and the gender and age variables. CONCLUSION Women who suffered falls related to functional independence were predominant, which can be prevented through elderly health promotion strategies, a policy that serves to offer living conditions to people in the aging process.OBJETIVO: determinar a prevalencia de quedas em idosos e sua relacao com a capacidade funcional. METODO: trata-se de estudo epidemiologico transversal de base populacional, com uma amostra por conglomerado de duplo estagio de 240 sujeitos, com idade acima de 60 anos, de ambos os sexos, residentes em Ribeirao Preto, SP. Os dados foram coletados entre novembro de 2010 e fevereiro de 2011 e utilizaram-se os questionarios: perfil social, avaliacao de quedas, Medida de Independencia Funcional e Escala de Lawton e Brody. Foi adotado o nivel de significância de 0,05. Para a identificacao da ocorrencia das quedas e sua relacao com a capacidade funcional, foram utilizadas razao de prevalencia e de chances de prevalencia e regressao logistica multipla. RESULTADOS: a media de idade foi de 73,5 anos (±8,4), 25% com 80 anos ou mais, predominio do sexo feminino; 48,8% estudaram de 1 a 4 anos. Media de 1,33 quedas (±0,472); com maior prevalencia em mulheres e idosos mais jovens; o local mais frequente foi o quintal e o banheiro. Houve forte correlacao entre o nivel de independencia funcional e as atividades instrumentais com a idade, e nao houve relacao entre os idosos que sofreram queda e as variaveis sexo e idade. CONCLUSAO: houve predominio de mulheres que sofreram quedas relacionadas a independencia funcional, podendo-se prevenir com estrategias de promocao a saude ao idoso, politica essa para oferecer condicao de vida a pessoa no processo de envelhecer.

Prevalencia de quedas de idosos em situacao de fragilidade

OBJECTIVE To measure the prevalence in frail elderly people, their consequences and associated demographic factors. METHODS This was an epidemiological and cross-sectional study with a probabilistic sample composed of 240 elderly people (≥ 60 years) living in Ribeirão Preto, Sao Paulo state. Data were collected between November 2010 and February 2011, through a questionnaire that included socio-demographic data, fall assessment and the Edmonton Frailty Scale. Uni-variate and bivariate analyses were carried out. RESULTS The mean age was 73.5 (± 8.4), with higher ages among women; 25% of the interviewees were aged 80 or older; 11.3% presented moderate frailty and 9.6% severe frailty. The prevalence of falls in frail elderly participants corresponded to 38.6%; higher levels were found among women and younger subjects (60 to 79 years old); 26.8% were victims of 1 to 2 falls, 27.1% of which occurred in the bedroom, 84.7% fell from their own height, 55.9% lost their balance, 54.2% suffered scratches and 78% were afraid of suffering a new fall. Higher fall prevalence levels were found in frail elderly 1,973 (1,094-3,556) compared to non-frail. CONCLUSIONS We highlight the importance of addressing the health of frail elderly people, especially regarding the risk of falls, as well as of increasing investment in prevention strategies of these syndromes and in the formation of train like a virgin ed human resources to better care for this population.OBJECTIVE To measure the prevalence in frail elderly people, their consequences and associated demographic factors. METHODS This was an epidemiological and cross-sectional study with a probabilistic sample composed of 240 elderly people (≥ 60 years) living in Ribeirao Preto, Sao Paulo state. Data were collected between November 2010 and February 2011, through a questionnaire that included socio-demographic data, fall assessment and the Edmonton Frailty Scale. Uni-variate and bivariate analyses were carried out. RESULTS The mean age was 73.5 (± 8.4), with higher ages among women; 25% of the interviewees were aged 80 or older; 11.3% presented moderate frailty and 9.6% severe frailty. The prevalence of falls in frail elderly participants corresponded to 38.6%; higher levels were found among women and younger subjects (60 to 79 years old); 26.8% were victims of 1 to 2 falls, 27.1% of which occurred in the bedroom, 84.7% fell from their own height, 55.9% lost their balance, 54.2% suffered scratches and 78% were afraid of suffering a new fall. Higher fall prevalence levels were found in frail elderly 1,973 (1,094-3,556) compared to non-frail. CONCLUSIONS We highlight the importance of addressing the health of frail elderly people, especially regarding the risk of falls, as well as of increasing investment in prevention strategies of these syndromes and in the formation of train like a virgin ed human resources to better care for this population.

Síndrome de fragilidade relacionada à incapacidade funcional no idoso

Objectives: To characterize the sociodemographic profile of the elderly, verify the level of fragility according to gender, functional independence and instrumental activities of daily living, and to correlate the dimensions of the Functional Independence Measure and Instrumental Activities of Daily Living with age, education, frailty and morbidities. Methods: A cross-sectional and observational study using a sample of 240 elderly living in Ribeirao Preto, Sao Paulo (Brazil). The collection period was November/2010 and February/2011. The questionnaires used were: sociodemographic, Edmonton Frail Scale, Functional Independence Measure and the Instrumental Activities of Daily Living Scale of Lawton and Brody. For analysis, we used descriptive statistics and the Student’s t-test and Pearson’s correlation. Results: Mean age was 73.5 years (± 8.4), 57.5% were married, 39.1% had some level of fraility. Among the frail elderly, 29.8% had minimal dependence/supervision, and 81.9% had partial dependence for instrumental activities of daily living. Conclusion: There was a greater dependence in activities for the frail elderly, and females had a higher prevalence of frailty.

Qualidade de vida em idosos que sofreram quedas: revisão integrativa da literatura

An Integrative Literature Review was conducted in order to evaluate the scientific knowledge produced regarding quality of life of the elderly who have suffered falls. Published articles between 1999 and 2009 were selected from the LILACS, CINAHL and MEDLINE databases, and the following search words in Portuguese, English and Spanish were used: quality of life, the elderly and accidents involving falls. Nine articles met the inclusion criteria. It was revealed that falls are frequent among the elderly, and especially the elderly with more intrinsic risk factors and who have suffered falls are those who are more afraid and more prone to fall again. They also reported physical, mental and emotional impairments, body pains and environmental problems. It was revealed that programs to prevent falling can improve the quality of life of the elderly over time. It was clear that there are knowledge gaps, especially a low level of national scientific output, especially by nurses and the predominance of descriptive studies, with low levels of data. We suggest that health professionals conduct research into interventions to prevent falls that can be used in clinical practice in improving the quality of life of the elderly.

Frailty syndrome related to disability in the elderly

Objectives: To characterize the sociodemographic profile of the elderly, verify the level of fragility according to gender, functional independence and instrumental activities of daily living, and to correlate the dimensions of the Functional Independence Measure and Instrumental Activities of Daily Living with age, education, frailty and morbidities. Methods: A cross-sectional and observational study using a sample of 240 elderly living in Ribeirao Preto, Sao Paulo (Brazil). The collection period was November/2010 and February/2011. The questionnaires used were: sociodemographic, Edmonton Frail Scale, Functional Independence Measure and the Instrumental Activities of Daily Living Scale of Lawton and Brody. For analysis, we used descriptive statistics and the Student’s t-test and Pearson’s correlation. Results: Mean age was 73.5 years (± 8.4), 57.5% were married, 39.1% had some level of fraility. Among the frail elderly, 29.8% had minimal dependence/supervision, and 81.9% had partial dependence for instrumental activities of daily living. Conclusion: There was a greater dependence in activities for the frail elderly, and females had a higher prevalence of frailty.

Sobrecarga de trabalho em cuidadores de idosos fragilizados que vivem no domicílio

Objectives: To assess the burden of caregivers of frail elders living at home; to characterize elderly that are considered frail and their caregivers; to assess the degree of dependency of the elderly according to the level of frailty and to correlate it with the burden of work of their caregivers. Methods: A transversal study with a sample of 60 caregivers and frail elderly who lived at home. Data collection was conducted in the home with frail elders and their caregivers. We used the sociodemographic profile of the elderly and the caregiver instruments, the Edmonton Frail Scale, the Functional Independence Measure for the elderly, and the Zarit Burden Interview Scale for the caregivers. Descriptive statistics and the Pearson test were employed for data analysis. Results: The majority of caregivers were female (75%), married (58.3%) and were children of the elderly (45%). Regarding the burden, 31.7% said they rarely felt burdened. However, a correlation was found between frailty and burden: the higher the level of frailty, the greater the caregiver burden. Conclusion: It was found that the majority of caregivers were female and the greater the degree of functional dependence, the greater the degree of frailty, which elevated the level of caregiver burden.Objectives: To assess the burden of caregivers of frail elders living at home; to characterize elderly that are considered frail and their caregivers; to as- sess the degree of dependency of the elderly according to the level of frailty and to correlate it with the burden of work of their caregivers. Methods: A transversal study with a sample of 60 caregivers and frail elderly who lived at home. Data collection was conducted in the home with frail elders and their caregivers. We used the sociodemographic profile of the elderly and the caregiver instruments, the Edmonton Frail Scale, the Functional Independence Measure for the elderly, and the Zarit Burden Interview Scale for the caregivers. Descriptive statistics and the Pearson test were employed for data analysis. Results: The majority of caregivers were female (75%), married (58.3%) and were children of the elderly (45%). Regarding the burden, 31.7% said they rarely felt burdened. However, a correlation was found between frailty and burden: the higher the level of frailty, the greater the caregiver burden. Conclusion: It was found that the majority of caregivers were female and the greater the degree of functional dependence, the greater the degree of frailty, which elevated the level of caregiver burden. Keywords: Caregivers; Frail elderly; Geriatric nursing ReSumo Objetivos: Avaliar a sobrecarga dos cuidadores de idosos fragilizados que residem no domicilio; caracterizar os idosos que sao considerados frageis e seus cuidadores; avaliar o grau de dependencia dos idosos de acordo com o nivel de fragilidade e correlaciona-lo com a sobrecarga de trabalho dos seus cuidadores. Metodos: Estudo transversal com amostra de 60 cuidadores e de idosos frageis, que viviam no domicilio. A coleta de dados realizada no domicilio com idosos frageis e seus cuidadores. Utilizaram-se os instrumentos de perfil sociodemografico do idoso e do cuidador, a Escala de Fragilidade de Edmonton, a Medida da Independencia Funcional para os idosos e a Escala Zarit Burden Interview, para os cuidadores. Para a analise foram empregados a estatistica descritiva e o teste de Pearson. Resultados: A maioria dos cuidadores era do sexo feminino (75%), casados (58,3%) e, 45% eram filhos. Quanto a sobrecarga, 31,7% responderam que raramente se sentiam sobrecarregados. Mas, houve correlacao entre a fragilidade e a sobrecarga, ou seja, quanto maior o nivel de fragilidade, maior a sobrecarga do cuidador. Conclusao: Evidenciou-se a maioria dos cuidadores do sexo feminino e quanto maior o grau de dependencia funcional, maior o grau de fragilidade o que eleva o nivel de sobrecarga do cuidador. Descritores: Cuidadores; Idoso fragilizado; Enfermagem geriatrica ReSumeN Objetivos: Evaluar la sobrecarga de los cuidadores de ancianos fragiles que residen en el domicilio; caracterizar a los ancianos que son considerados fragiles y sus cuidadores; evaluar el grado de dependencia de los ancianos de acuerdo con el nivel de fragilidad y correlacionarlo con la sobrecarga de trabajo de sus cuidadores. Metodos: Estudio transversal realizado con una muestra de 60 cuidadores y de ancianos fragiles, que vivian en el domicilio. La recoleccion de los datos se realizo en el domicilio con ancianos fragiles y sus cuidadores. Se utilizaron los instrumentos de perfil sociodemografico del anciano y del cuidador, la Escala de Fragilidad de Edmonton, la Medida de la Independencia Funcional para los ancianos y la Escala Zarit Burden Interview, para los cuidadores. Para el analisis fueron empleados la estadistica descriptiva y el test de Pearson. Resultados: La mayoria de los cuidadores era del sexo femenino (75%), casados (58,3%) y, 45% eran hijos. En cuanto a la sobrecarga, 31,7% respondieron que raramente se sentian sobrecargados. Sin embargo, hubo correlacion entre la fragilidad y la sobrecarga, o sea, cuanto mayor el nivel de fragilidad, mayor la sobrecarga del cuidador. Conclusion: Se evidencio que la mayoria de los cuidadores era del sexo femenino y cuanto mayor el grado de dependencia funcional, mayor el grado de fragilidad lo cual eleva el nivel de sobrecarga del cuidador. Descriptores: Cuidadores; Anciano fragil; Enfermeria geriatrica

Burden on caregivers of elderly victims of cerebrovascular accident

The aim was to assess the burden on caregivers of elderly victims of cerebrovascular accident (CVA) and to correlate it with care hours, the elderly peoples age and functional independence. This cross-sectional study counted the participation of 62 elderly individuals with CVA and their caregivers. The instrument used contained socio-demographic and economic variables, the Mini-Mental Status Examination, the Functional Independence Measure (FIM) and the Zarit Scale. The possible correlations between the Zarit scale scores and the other variables were assessed using Pearsons Correlation Coefficient. Most caregivers were adults, children of the victims, married, and female. The mean Zarit score was 34.92(15.8). The FIM showed a negative correlation with caregiver burden, but no correlation with age and number of care hours. The burden on most of the caregivers ranged from moderate to severe and seems to be related to the level of functional independency of the elderly.The aim was to assess the burden on caregivers of elderly victims of cerebrovascular accident (CVA) and to correlate it with care hours, the elderly peoples age and functional independence. This cross-sectional study counted the participation of 62 elderly individuals with CVA and their caregivers. The instrument used contained socio-demographic and economic variables, the Mini-Mental Status Examination, the Functional Independence Measure (FIM) and the Zarit Scale. The possible correlations between the Zarit scale scores and the other variables were assessed using Pearsons Correlation Coefficient. Most caregivers were adults, children of the victims, married, and female. The mean Zarit score was 34.92(15.8). The FIM showed a negative correlation with caregiver burden, but no correlation with age and number of care hours. The burden on most of the caregivers ranged from moderate to severe and seems to be related to the level of functional independency of the elderly.

Transition of care for the elderly after cerebrovascular accidents - from hospital to the home

OBJECTIVE to examine the transition of care in families caring for elderly persons who suffered the first episode of a cerebrovascular accident. METHODOLOGY an instrumental ethnographic case study was used. The sample comprised 20 subjects: 10 caregivers and 10 elderly persons aged 65 or over, of both sexes, with diagnoses of first episode of cerebrovascular accident, capable of communicating, and requiring care from a main carer in their family. The data was collected through interviews, observation, existing documentation and field notes. Qualitative analysis techniques were used to codify and classify the data and to formulate significant categories, which generated typologies of care. RESULTS AND DISCUSSION The central idea was the Transition of Care and showed the context in three typologies: The care process for the dependent elderly person, Strategies for the care process and Impact and acceptance of the limitations. CONCLUSION The data indicates that caring for an elderly person after a cerebrovascular accident is a challenge for the family. The data permitted it possible to elaborate a proposal for a model for the organization of the work, with a view to holistic care delivery in the health services, forming a care network, which constitutes an advance for the area of nursing.OBJETIVO: examinar a transicao do cuidado em familias que cuidam de idosos que sofreram o primeiro episodio de acidente vascular cerebral. METODOLOGIA: foi utilizado o estudo de caso etnografico instrumental. A amostra foi constituida por 20 sujeitos, sendo 10 cuidadores e 10 idosos, com 65 anos ou mais, de ambos os sexos, com diagnostico de primeiro episodio de acidente vascular cerebral, capazes de se comunicarem, demandando cuidado de um cuidador principal na familia. Os dados foram coletados por meio de entrevistas, observacoes, documentos existentes e notas de campo. Foram utilizadas tecnicas de analises qualitativa para codificar, classificar os dados e formular categorias significativas, o que gerou tipologias de cuidado. RESULTADOS E DISCUSSAO: a ideia central foi a transicao do cuidado e mostrou o contexto em tres tipologias: o processo de cuidar do idoso dependente, estrategias para o processo de cuidar e impacto e aceitacao das limitacoes. CONCLUSAO: os dados indicaram que o cuidado com o idoso, apos o acidente vascular cerebral, e um desafio para a familia. Os dados possibilitaram elaborar uma proposta de modelo para a organizacao do trabalho, visando a integralidade do cuidado nos servicos de saude, formando uma rede de cuidado, o que constitui avanco para a area da enfermagem.

Burden of work in caregivers of frail elders living at home

Objectives: To assess the burden of caregivers of frail elders living at home; to characterize elderly that are considered frail and their caregivers; to assess the degree of dependency of the elderly according to the level of frailty and to correlate it with the burden of work of their caregivers. Methods: A transversal study with a sample of 60 caregivers and frail elderly who lived at home. Data collection was conducted in the home with frail elders and their caregivers. We used the sociodemographic profile of the elderly and the caregiver instruments, the Edmonton Frail Scale, the Functional Independence Measure for the elderly, and the Zarit Burden Interview Scale for the caregivers. Descriptive statistics and the Pearson test were employed for data analysis. Results: The majority of caregivers were female (75%), married (58.3%) and were children of the elderly (45%). Regarding the burden, 31.7% said they rarely felt burdened. However, a correlation was found between frailty and burden: the higher the level of frailty, the greater the caregiver burden. Conclusion: It was found that the majority of caregivers were female and the greater the degree of functional dependence, the greater the degree of frailty, which elevated the level of caregiver burden.Objectives: To assess the burden of caregivers of frail elders living at home; to characterize elderly that are considered frail and their caregivers; to as- sess the degree of dependency of the elderly according to the level of frailty and to correlate it with the burden of work of their caregivers. Methods: A transversal study with a sample of 60 caregivers and frail elderly who lived at home. Data collection was conducted in the home with frail elders and their caregivers. We used the sociodemographic profile of the elderly and the caregiver instruments, the Edmonton Frail Scale, the Functional Independence Measure for the elderly, and the Zarit Burden Interview Scale for the caregivers. Descriptive statistics and the Pearson test were employed for data analysis. Results: The majority of caregivers were female (75%), married (58.3%) and were children of the elderly (45%). Regarding the burden, 31.7% said they rarely felt burdened. However, a correlation was found between frailty and burden: the higher the level of frailty, the greater the caregiver burden. Conclusion: It was found that the majority of caregivers were female and the greater the degree of functional dependence, the greater the degree of frailty, which elevated the level of caregiver burden. Keywords: Caregivers; Frail elderly; Geriatric nursing ReSumo Objetivos: Avaliar a sobrecarga dos cuidadores de idosos fragilizados que residem no domicilio; caracterizar os idosos que sao considerados frageis e seus cuidadores; avaliar o grau de dependencia dos idosos de acordo com o nivel de fragilidade e correlaciona-lo com a sobrecarga de trabalho dos seus cuidadores. Metodos: Estudo transversal com amostra de 60 cuidadores e de idosos frageis, que viviam no domicilio. A coleta de dados realizada no domicilio com idosos frageis e seus cuidadores. Utilizaram-se os instrumentos de perfil sociodemografico do idoso e do cuidador, a Escala de Fragilidade de Edmonton, a Medida da Independencia Funcional para os idosos e a Escala Zarit Burden Interview, para os cuidadores. Para a analise foram empregados a estatistica descritiva e o teste de Pearson. Resultados: A maioria dos cuidadores era do sexo feminino (75%), casados (58,3%) e, 45% eram filhos. Quanto a sobrecarga, 31,7% responderam que raramente se sentiam sobrecarregados. Mas, houve correlacao entre a fragilidade e a sobrecarga, ou seja, quanto maior o nivel de fragilidade, maior a sobrecarga do cuidador. Conclusao: Evidenciou-se a maioria dos cuidadores do sexo feminino e quanto maior o grau de dependencia funcional, maior o grau de fragilidade o que eleva o nivel de sobrecarga do cuidador. Descritores: Cuidadores; Idoso fragilizado; Enfermagem geriatrica ReSumeN Objetivos: Evaluar la sobrecarga de los cuidadores de ancianos fragiles que residen en el domicilio; caracterizar a los ancianos que son considerados fragiles y sus cuidadores; evaluar el grado de dependencia de los ancianos de acuerdo con el nivel de fragilidad y correlacionarlo con la sobrecarga de trabajo de sus cuidadores. Metodos: Estudio transversal realizado con una muestra de 60 cuidadores y de ancianos fragiles, que vivian en el domicilio. La recoleccion de los datos se realizo en el domicilio con ancianos fragiles y sus cuidadores. Se utilizaron los instrumentos de perfil sociodemografico del anciano y del cuidador, la Escala de Fragilidad de Edmonton, la Medida de la Independencia Funcional para los ancianos y la Escala Zarit Burden Interview, para los cuidadores. Para el analisis fueron empleados la estadistica descriptiva y el test de Pearson. Resultados: La mayoria de los cuidadores era del sexo femenino (75%), casados (58,3%) y, 45% eran hijos. En cuanto a la sobrecarga, 31,7% respondieron que raramente se sentian sobrecargados. Sin embargo, hubo correlacion entre la fragilidad y la sobrecarga, o sea, cuanto mayor el nivel de fragilidad, mayor la sobrecarga del cuidador. Conclusion: Se evidencio que la mayoria de los cuidadores era del sexo femenino y cuanto mayor el grado de dependencia funcional, mayor el grado de fragilidad lo cual eleva el nivel de sobrecarga del cuidador. Descriptores: Cuidadores; Anciano fragil; Enfermeria geriatrica