Factors Associated with Frailty Syndrome in Older Adults.

OBJECTIVE: Frailty is a common geriatric syndrome, characterized by a decrease in energy reserve and stress resistance, resulting in an accumulated decline of multiple physiological systems and greater vulnerability. Frailty syndrome has a multifactorial etiology involving a biological basis associated with sociobehavioral factors. We verify the association of frailty syndrome with family functionality level, nutritional status and medication adherence in older adults. DESIGN: Observational and analytical study. SETTING AND PARTICIPANTS: Conducted at ambulatory the university hospital, with patients aged 60 years or older. MEASUREMENTS: Cognitive function was measured using the Mini-Mental State Examination (MMSE); nutritional status was evaluated using the Mini Nutritional Assessment (MNA) and Body Mass Index, BMI; the 5-item FRAIL scale was used for frailty screening; family functioning was assessed using the Family APGAR Index, which evaluates Adaptability, Partnership, Growth, Affection, and Resolve; Self-reported medication adherence was measured by the eight-item Morisky Medication Adherence Scale (MMAS-8). RESULTS: The study involved 308 older adults, with a mean age of 70.40 years, There was an association between frailty and highly dysfunctional family with an OR of 5.9 (95% CI 1.9-18.5)(p<0.05), nutritional risk assessed by BMI, where low weight presented an OR of 2.5 (95% CI 1.1-5.8) and obesity an OR of 2.8 (95% CI 1.1-7.0)(P <0.05) and a nutritional risk assessed by MNA with an OR 6.3(95% CI 1.9-20.4) and low medication adherence with an OR of 8.9 (95% CI, 3.6-21.6)(P = 0.01). CONCLUSION: Frailty syndrome is associated with high levels of family dysfunction, nutritional risk and poor medication adherence amongst older people.

[The qualitative research interview as a method of approach to psychiatric nurses' professional life-world in community health services]. / Det kvalitative forskningsintervju som metode for å naerme seg den psykiatriske sykepleiers profesjonelle livsverden i kommunehelsetjenesten.

In the last decade the qualitative research interview, based on hermeneutic-phenomenological understanding, has become a successfully used method in the Nordic countries, in the study of how persons experience their life-world (Ger. Lebenswelt) in social interaction and or in relation to their professions. The essential features of the qualitative research interview and its structural components have been quite well developed in these countries. Various aspects of the interpretation of interview texts have been theoretically analyzed from the hermeneutic-phenomenological viewpoint, and also its validity, reliability and fruitfullness have been carefully and constructively scrutinized. Necessary conditions to stimulate the 'right' use of qualitative research interview are, e.g., scientific articles which clearly describe how the method has been successfully applied on, inter alia, mental health and research dealing with public health. In this respect it is desireable to describe 1) how the choice of different strategies and techniques within the domain of qualitative approach are made and and illustrated, by means of concrete examples, and 2) to show how they are systematically and effectively applied in the research process. The purpose of this article should be seen against the background of 1) and 2), i.e., the article purports to show how the qualitative research interview was systematically used in studying psychiatric nurses' professional thoughts, experiences and practices in community psychiatric nursing, a study which attempted to do justice to the attainment of both goals 1) and 2).

[Delimitation of the biomedical models and its consequences for the holistic viewpoint in nursing, and for quality research]. / Den biomedicinska modellens begränsning och dess konsekvens för helhetssyn i vården och för kvalitativ forskning.

Medicine is dominated today by the so called biomedical model of sickness. This model ontologically reduces Man to biochemistry and every kind of sickness to disease, and therefore expresses an ontologically reductionistic view of Man. This view is logically incompatible with the humanistic view of Man, and a holistic concept of health. Given the distinction between disease and illness, the model is in most cases necessary and sufficient for the treatment of disease but for certain kinds of illness it might be neither necessary nor sufficient. In order to be a fruitful model it should be radically changed so that it can be supplemented by models based on a humanistic view of Man and a holistic concept of health. A complementary model would have positive effects on medical praxis, health care in general and on the Science of Health Care.

[Various necessary steps in clarification of relationships between health care science, medical science and nursing science]. / Några nödvändiga steg i precisering av relationen mellan vårdvetenskap, medicinsk vetenskap och omvårdnadsvetenskap.

The article asserts that a scientific discipline is defined by both its object of research or knowledge (domain) and its specific or adequate method. An appropriate definition should fulfill other necessary conditions implicit in certain fundamental rules of definition, e.g., a definition should not be too narrow or too broad. It should also respect well established uses of language, in which the concept to be defined may already have a given meaning. In Scandinavia there are three words used for the Science of Health Care. "Vårdvetenskap" e.g., is used both in Sweden and Finland. In Finland it is used to convey the view that care is essential to Man, and a holistic concept of Man/Health. So demarcated, Vårdvetenskapen complements Medicine which ontologically reduces Man to biochemistry and sickness to disease. To fulfill this function the Science of health Care should be humanistic and interdisciplinary, and not purely empirico-positivistic like Medicine.