Susanne Elero Betiolli

Prevalence of pre-frailty for the component of gait speed in older adults

Objetivo: investigar la prefragilidad y los factores asociados a esa condicion, considerando medidas de velocidad de la marcha de los ancianos. Metodo: la seleccion de los participantes ocurrio por medio de criterios de inclusion/exclusion y prueba de rastreo cognitivo. La muestra fue calculada con base en la estimativa de la proporcion poblacional y fue constituida por 195 ancianos usuarios de una Unidad Basica de Salud de Curitiba, PR. Los datos fueron recolectados mediante cuestionario sociodemografico/clinico y prueba de velocidad de la marcha. Resultados: la prefragilidad para la velocidad de la marcha posee moderada prevalencia (27,3%) y se asocio al intervalo de edad entre 60 y 69 anos, baja escolaridad, no sentirse solitario, utilizar antihipertensivos, presentar enfermedad cardiovascular y sobrepeso. Conclusion: se considera relevante identificar a los ancianos en la condicion de prefragilidad, ya que de esa manera existe la posibilidad de intervenir inmediata con la finalidad de estacionar el cuadro. Es significativo el deficit de estudios sobre el sindrome de la fragilidad en ancianos brasilenos, principalmente aquellos que se refieren a un componente aislado. Considerando que la enfermeria gerontologica se encuentra en los primeros pasos en lo que se refiere a la tematica, se entiende que la identificacion de la prevalencia debe ser el punto primordial de las investigaciones sobre el tema.

Significado atribuído pelos idosos à vivência em uma instituição de longa permanência: contribuições para o cuidado de enfermagem

RESUMO: Trata-se de estudo etnografico com o objetivo de interpretar o significado atribuido pelos idosos a vivencia em uma Instituicao de Longa Permanencia para Idosos, do municipio de Curitiba, Parana. As informacoes foram coletadas por meio de observacao participante e entrevista etnografica, em uma instituicao de carater privado com fins lucrativos, no periodo de janeiro a agosto de 2010, e analisadas em dominios, taxonomias e tema cultural. Os informantes-chave foram idosos residentes, selecionados mediante criterios de inclusao. Emergiram os dominios culturais: motivos que levaram a viver na instituicao; maneiras de viver: atividades do cotidiano; atividades promovidas pela instituicao; sentimentos atribuidos a vivencia; atributos da instituicao; e atributos das pessoas residentes; e o tema cultural: em busca do nectar da vida. Essa vivencia significou para os idosos a possibilidade de ser cuidado, compreendido de forma abrangente, como manutencao da vida e otimizacao do bem-estar, implicando em acoes de cuidado de enfermagem. DESCRITORES: Idoso. Instituicao de longa permanencia para idosos. Pesquisa. Enfermagem. Antropologia cultural. MEANING ASSIGNED BY THE ELDERLY TO THE EXPERIENCE AT A LONG STAY INSTITUTION: CONTRIBUTIONS FOR THE NURSING CARE

Força de preensão manual e atividade física em idosos fragilizados

OBJECTIVE To investigate the association between handgrip strength (HS) and physical activity in physical frailty elderly. METHOD Cross-sectional quantitative study with a sample of 203 elderly calculated based on the population estimated proportion. Tests were applied to detect cognitive impairment and assessment of physical frailty. Descriptive statistics and multivariate analysis by binary logistic regression were used, and also Students t-test and Fishers exact test. RESULTS A total of 99 (64.3%) elderly showed decreased handgrip strength and 90 (58.4%) elderly presented decrease in physical activity levels. There was a statistically significant difference between these two components (p=0.019), in which elderly who have decreased HS have lower levels of physical activity. For low levels of physical activity and decreased HS, there was no evidence of significant difference in the probability of the classification as frail elderly (p<0.001). CONCLUSION The components handgrip strength and physical activity are associated with the frail elderly. The joint presence of low levels of physical activity and decreased handgrip strength leads to a significantly higher probability of the elderly to be categorized as frailty.OBJETIVO Investigar a associacao entre forca de preensao manual e atividade fisica em idosos na condicao de fragilidade fisica. METODO Estudo quantitativo transversal realizado com amostra de 203 idosos, calculada com base na estimativa da proporcao populacional. Foram aplicados testes para rastreio da alteracao cognitiva e avaliacao da fragilidade fisica. Foram empregados: estatistica descritiva e analise multivariada por regressao logistica binaria, teste t de Student e teste exato de Fisher. RESULTADOS 99 (64,3%) idosos apresentaram forca de preensao diminuida e 90 (58,4%) diminuicao do nivel de atividade fisica. Houve diferenca estatisticamente significativa entre essas duas componentes ( p=0,019), na qual idosos que apresentam FPM diminuida possuem menores niveis de atividade fisica. Para os baixos niveis de atividade fisica e diminuida FPM houve evidencia de diferenca significativa em relacao a probabilidade de classificacao do idoso como fragil ( p<0,001). CONCLUSAO As componentes forca de preensao manual e atividade fisica estao associadas em idosos na condicao de fragilidade. A presenca conjunta de baixos niveis de atividade fisica e diminuida forca de preensao manual leva a uma probabilidade significativamente maior de o idoso ser categorizado como fragil.

Handgrip strength and physical activity in frail elderly

OBJECTIVE To investigate the association between handgrip strength (HS) and physical activity in physical frailty elderly. METHOD Cross-sectional quantitative study with a sample of 203 elderly calculated based on the population estimated proportion. Tests were applied to detect cognitive impairment and assessment of physical frailty. Descriptive statistics and multivariate analysis by binary logistic regression were used, and also Students t-test and Fishers exact test. RESULTS A total of 99 (64.3%) elderly showed decreased handgrip strength and 90 (58.4%) elderly presented decrease in physical activity levels. There was a statistically significant difference between these two components (p=0.019), in which elderly who have decreased HS have lower levels of physical activity. For low levels of physical activity and decreased HS, there was no evidence of significant difference in the probability of the classification as frail elderly (p<0.001). CONCLUSION The components handgrip strength and physical activity are associated with the frail elderly. The joint presence of low levels of physical activity and decreased handgrip strength leads to a significantly higher probability of the elderly to be categorized as frailty.OBJETIVO Investigar a associacao entre forca de preensao manual e atividade fisica em idosos na condicao de fragilidade fisica. METODO Estudo quantitativo transversal realizado com amostra de 203 idosos, calculada com base na estimativa da proporcao populacional. Foram aplicados testes para rastreio da alteracao cognitiva e avaliacao da fragilidade fisica. Foram empregados: estatistica descritiva e analise multivariada por regressao logistica binaria, teste t de Student e teste exato de Fisher. RESULTADOS 99 (64,3%) idosos apresentaram forca de preensao diminuida e 90 (58,4%) diminuicao do nivel de atividade fisica. Houve diferenca estatisticamente significativa entre essas duas componentes ( p=0,019), na qual idosos que apresentam FPM diminuida possuem menores niveis de atividade fisica. Para os baixos niveis de atividade fisica e diminuida FPM houve evidencia de diferenca significativa em relacao a probabilidade de classificacao do idoso como fragil ( p<0,001). CONCLUSAO As componentes forca de preensao manual e atividade fisica estao associadas em idosos na condicao de fragilidade. A presenca conjunta de baixos niveis de atividade fisica e diminuida forca de preensao manual leva a uma probabilidade significativamente maior de o idoso ser categorizado como fragil.

Factors associated with loss of handgrip strength in long-lived elderly

OBJECTIVE To investigate the prevalence of reduced grip strength and associated factors in long-lived elderly, who are users of primary health care. METHOD Cross-sectional quantitative study, data were collected during the period of January to December of 2013, by applying tests and questionnaires. The convenience sampling was comprised of 157 seniors. RESULTS The findings indicate that the reduction in grip strength presents a moderate prevalence (25.5%), predominantly among females (19.1%), in the age group of 80-89 years (18.5%) and in those with lower educational levels (15.9%). The association between reduced grip strength and the variables of age and body mass index showed a statistical significance. CONCLUSION Investigations about the handgrip strength are essential for identifying clinical conditions of Brazilian long-lived elderly, and contribute to the development of plans towards the management of frailty.Objetivo Investigar la prevalencia de la reduccion de la fuerza de agarre manual y los factores asociados en ancianos longevos, usuarios de la atencion basica a la salud. Metodo Estudio cuantitativo transversal, cuyos datos fueron recogidos en el periodo de enero a diciembre de 2013, por medio de pruebas y aplicacion de cuestionarios. La muestra por conveniencia comprendio a 157 ancianos. Resultados Senalan que la reduccion de la fuerza de agarre manual tiene prevalencia moderada (25,5%), con predominio del sexo femenino (19,1%), del rango de edad de 80 a 89 anos (18,5%) y baja escolaridad (15,9%). La asociacion entre la disminucion de la fuerza de agarre manual y las variables de edad e indice de masa corporea mostro significacion estadistica. Conclusion Las investigaciones acerca del componente de la fuerza de agarre manual son fundamentales para la identificacion de las condiciones clinicas de los ancianos longevos brasilenos y contribuyen para la construccion de planes dirigidos a la gestion de la fragilidad.

Meaning assigned by the elderly to the experience at a long stay institution: contributions for the nursing care

RESUMO: Trata-se de estudo etnografico com o objetivo de interpretar o significado atribuido pelos idosos a vivencia em uma Instituicao de Longa Permanencia para Idosos, do municipio de Curitiba, Parana. As informacoes foram coletadas por meio de observacao participante e entrevista etnografica, em uma instituicao de carater privado com fins lucrativos, no periodo de janeiro a agosto de 2010, e analisadas em dominios, taxonomias e tema cultural. Os informantes-chave foram idosos residentes, selecionados mediante criterios de inclusao. Emergiram os dominios culturais: motivos que levaram a viver na instituicao; maneiras de viver: atividades do cotidiano; atividades promovidas pela instituicao; sentimentos atribuidos a vivencia; atributos da instituicao; e atributos das pessoas residentes; e o tema cultural: em busca do nectar da vida. Essa vivencia significou para os idosos a possibilidade de ser cuidado, compreendido de forma abrangente, como manutencao da vida e otimizacao do bem-estar, implicando em acoes de cuidado de enfermagem. DESCRITORES: Idoso. Instituicao de longa permanencia para idosos. Pesquisa. Enfermagem. Antropologia cultural. MEANING ASSIGNED BY THE ELDERLY TO THE EXPERIENCE AT A LONG STAY INSTITUTION: CONTRIBUTIONS FOR THE NURSING CARE

Fatores de risco para mortalidade de idosos com infecção do sítio cirúrgico

PURPOSE: to relate risk factors for mortality in elderly patients undergoing abdominal surgery with surgical site infection. METHOD: it is a descriptive quantitative cross-sectional retrospective study, performed in teaching hospital in Curitiba-PR. The sample period was from January 1999 to December 2008. Data were collected through structured instrument in secondary sources: Registration Service Infection Control and the patients chart. A sample consisted of records of 114 elderly patients with surgical site infection. Variables were investigated classified into three categories: clinical, surgical hospitalization and surgical procedures among the elderly. Data were analyzed using Epi Info version 6.04 and were considered statistically significant when p <0,05. RESULTS: life habits and preexisting conditions were not significantly associated with mortality. It is inferred that the longer hospitalization, surgical site infection in the cavity, the combination of two or more surgeries and emergency surgery were significantly related to mortality risk. The readmission of elderly related the significant values for discharge. CONCLUSION: knowing the factors that influence the progression to death of these patients allows nurses to extend the possibilities of managing the geriatric care and intervene in risk factors for mortality.

Physical frailty prediction model for the oldest old

ABSTRACT Objective: to present a physical frailty prediction model for oldest old users of primary health care, according to clinical variables. Method: cross-sectional study with proportional stratified sample of 243 oldest old subjects. Data were collected through a structured clinical questionnaire, handgrip strength test, walking speed, weight loss, fatigue/exhaustion, and physical activity level. For the analysis of the data, univariate and multivariate analysis by logistic regression were used (p<0.05), which resulted in prediction models. The odds ratios (95% Confidence Interval) of the models were calculated. Each model was evaluated by deviance analysis, likelihood ratios, specificity and sensitivity, considering the most adequate. All ethical and legal precepts were followed. Results: the prediction model elected was composed of metabolic diseases, dyslipidemias and hospitalization in the last 12 months. Conclusion: clinical variables interfere in the development of the physical frailty syndrome in oldest old users of basic health unit. The choice of a physical frailty regression model is the first step in the elaboration of clinical methods to evaluate the oldest old in primary care.

O emprego da medida de independência funcional em idosos

OBJECTIVES To analyze in scientific publications how the Functional Independence Measure (FIM) has been employed to evaluate the elderly. METHODS Integrative review of periodical publications between 2011 and 2015, available online in full-text in Portuguese, English and Spanish. RESULTS 129 articles were found; after the application of the criteria, they resulted in 21. The studies were categorized into two groups: A) follow or compare scores in FIM (cohort studies, case-control, clinical trials), focusing on rehabilitation, evaluation of programs and changes in the functional level after procedures/interventions; and B) measure/associate the functionality of the elderly (cross-sectional studies), focused on evaluation protocols in elderly health and associations to the caregiver burden, hospital stay, balance, satisfaction with life, cognition and clinical/socio-demographic aspects. CONCLUSION The FIM was used in several scenarios of healthcare for the elderly, particularly in rehabilitation and outpatient clinics or health centers.Objetivos : analisar em publicacoes cientificas como a Medida de Independencia Funcional (MIF) tem sido empregada para avaliar idosos. Me todos : revisao integrativa de publicacoes periodicas entre os anos de 2011 e 2015, disponiveis on-line com texto completo, escritas em portugues, ingles ou espanhol. Resultados : encontrou-se 129 artigos, apos aplicacao de criterios resultaram 21. Os estudos foram categorizados em dois grupos: A) acompanhar ou comparar escores na MIF (estudos de coorte, caso controle, ensaios clinicos), centra na reabilitacao, avaliacao de programas e alteracoes no nivel funcional apos procedimentos/intervencoes; e B) mensurar/associar a funcionalidade dos idosos (estudos transversais), foco em protocolos de avaliacao em saude do idoso, associacoes a sobrecarga do cuidador, ao tempo de internacao, ao equilibrio, a satisfacao com a vida, a cognicao, aos aspectos clinicos/sociodemograficos. Conclus ao : empregou-se a MIF em diversos cenarios de atencao a saude do idoso, com destaque para reabilitacao e ambulatorios ou centros de saude. Palavras-chave : Enfermagem geriatrica. Idoso. Saude do idoso. Atividades cotidianas.

Associação da síndrome da fragilidade física às características sociodemográficas de idosos longevos da comunidade

ABSTRACT Objective: investigating the association between frailty syndrome and sociodemographic characteristics in long-lived individuals of a community. Method: a cross-sectional study with a proportional stratified sample consisting of 243 long-lived individuals. A structured instrument, scales and tests that comprise evaluating frailty were applied for data collection. Univariate and multivariate analyzes were performed by logistic regression (p<0.05) by Statistica 10(r) software and Odds Ratio (95% Confidence Interval) were calculated for the predictive models. Results: of the 243 long-lived individuals evaluated, 36 (14.8%) were frail, 55 (63.8%) were pre-frail and 52 (21.4%) were not frail. A predominance of females (n=161; 66.3%), widows/widowers (n=158; 65%), who lived with family members (n=144; 59.3%) and in a self-reported satisfactory financial situation (n=108; 44.5%) was observed. A significant association was found between the demographic variable of age (p=0.043) and frailty syndrome. The best predictor model for the syndrome included the variables: gender, age and household companion. Conclusion: the variable of age contributed most to the fragilization process of long-lived individuals residing in the community. It is essential that gerontological nursing care contemplates early detection of this syndrome, considering age as being indicative of care needs.Objective: investigating the association between frailty syndrome and sociodemographic characteristics in long-lived individuals of a community. Method: a cross-sectional study with a proportional stratified sample consisting of 243 long-lived individuals. A structured instrument, scales and tests that comprise evaluating frailty were applied for data collection. Univariate and multivariate analyzes were performed by logistic regression (p<0.05) by Statistica 10(r) software and Odds Ratio (95% Confidence Interval) were calculated for the predictive models. Results: of the 243 long-lived individuals evaluated, 36 (14.8%) were frail, 55 (63.8%) were pre-frail and 52 (21.4%) were not frail. A predominance of females (n=161; 66.3%), widows/widowers (n=158; 65%), who lived with family members (n=144; 59.3%) and in a self-reported satisfactory financial situation (n=108; 44.5%) was observed. A significant association was found between the demographic variable of age (p=0.043) and frailty syndrome. The best predictor model for the syndrome included the variables: gender, age and household companion. Conclusion: the variable of age contributed most to the fragilization process of long-lived individuals residing in the community. It is essential that gerontological nursing care contemplates early detection of this syndrome, considering age as being indicative of care needs.