Impacto de la fractura de cadera intervenida quirúrgicamente sobre la calidad de vida, el estado funcional y el estado de ánimo del anciano / Impact of surgically operated hip fracture on the quality of life, functional status and mood of the elderly

OBJETIVO: Determinar la calidad de vida relacionada con la salud, la capacidad funcional y el estado de ánimo previo a la fractura de cadera y al mes de la intervención quirúrgica. MÉTODO: Estudio descriptivo prospectivo desarrollado desde enero de 2015 a enero de 2016 en el Hospital Campo Arañuelo (Navalmoral de la Mata, Cáceres). Se recogieron variables sociodemográficas, capacidad funcional (índice de Barthel), dependencia (escala de Lawton y Brody), calidad de vida relacionada con la salud (cuestionario Euroqol-5D) y estado de ánimo (escala de depresión geriátrica de Yesavage) con anterioridad a la fractura de cadera y al mes de la intervención. RESULTADOS: En 96 pacientes mayores de 65años se produjo un descenso significativo de la capacidad funcional: la media fue de 86,66 antes de la fractura frente a 58,72 al mes de la intervención (p < 0,001). La dependencia media fue de 4,95, y al mes, de 2,24 (p < 0,001). Las puntuaciones medias sobre calidad de vida basal y posterior a la intervención en EQ-5D fue de 72,95 vs 59,45, respectivamente (p = 0,004). Aunque antes de la fractura el 94,10% no tenían alteración del estado de ánimo, al mes de la intervención presentaban probable depresión el 20,50% y depresión establecida el 11%. CONCLUSIONES: La fractura de cadera afecta a la funcionalidad de los ancianos y provoca dependencia para las actividades básicas e instrumentales de la vida diaria. También afecta a la calidad de vida, y esta disminuye de forma significativa al mes de la intervención quirúrgica. El estado de ánimo depresivo está inversamente relacionado con la calidad de vida percibida

OBJECTIVES: To determine the quality of life related to health, functional capacity and mood to hip fracture and one month after surgery. METHOD: Prospective and descriptive study developed from January 2015 to January 2016 in Campo Arañuelo Hospital (Navalmoral de la Mata, Cáceres, Spain). Sociodemographic variables, functional capacity (Barthel Index), dependence (Lawton and Brody Scale), quality of life related to health (Questionnaire Euroqol-5D) and on mood (Yesavage geriatric depression scale GDS15) were collected, prior to the hip fracture and one month after the intervention. RESULTS: Significant decrease in functional capacity (Barthel), the mean score was 86.66 before the fracture, compared to 58.72 at the month after surgery (P<.001). Regarding the Lawton and Brody Scale, the mean was 4.95 and at 2.24months (P<.001). The mean scores on health related quality of life, baseline and post-intervention in the analog visual scale of the EQ-5D questionnaire were 72.95 vs 59.45 respectively (P=.004). Although before the fracture, 94.10% had no alteration in mood, one month after the intervention there was a possible depression of 20.50% and an established depression of 11%. CONCLUSIONS: The fracture of the head affects the functionality of the elderly, causing dependence for the basic and instrumental activities of daily life. It also affects the quality of life related to health and this decreases significantly in the month after surgery. Depressive mood is inversely related to perceived perceived quality of life

Impact of surgically operated hip fracture on the quality of life, functional status and mood of the elderly. / Impacto de la fractura de cadera intervenida quirúrgicamente sobre la calidad de vida, el estado funcional y el estado de ánimo del anciano.

OBJECTIVES: To determine the quality of life related to health, functional capacity and mood to hip fracture and one month after surgery. METHOD: Prospective and descriptive study developed from January 2015 to January 2016 in Campo Arañuelo Hospital (Navalmoral de la Mata, Cáceres, Spain). Sociodemographic variables, functional capacity (Barthel Index), dependence (Lawton and Brody Scale), quality of life related to health (Questionnaire Euroqol-5D) and on mood (Yesavage geriatric depression scale GDS15) were collected, prior to the hip fracture and one month after the intervention. RESULTS: Significant decrease in functional capacity (Barthel), the mean score was 86.66 before the fracture, compared to 58.72 at the month after surgery (P<.001). Regarding the Lawton and Brody Scale, the mean was 4.95 and at 2.24months (P<.001). The mean scores on health related quality of life, baseline and post-intervention in the analog visual scale of the EQ-5D questionnaire were 72.95 vs 59.45 respectively (P=.004). Although before the fracture, 94.10% had no alteration in mood, one month after the intervention there was a possible depression of 20.50% and an established depression of 11%. CONCLUSIONS: The fracture of the head affects the functionality of the elderly, causing dependence for the basic and instrumental activities of daily life. It also affects the quality of life related to health and this decreases significantly in the month after surgery. Depressive mood is inversely related to perceived perceived quality of life.

Critical points in the experience of spouse caregivers of patients who have suffered a stroke. A phenomenological interpretive study.

AIMS: To explore and document the experiences and values of spouse caregivers of stroke survivors. To gain more in-depth knowledge of how the act of caring and the adaption process affects caregiving spouses. MATERIALS AND METHODS: Phenomenological, qualitative study. This study included spouses of stroke survivors who also served as primary caregivers. Individual, semi-structured, in-depth interviews were conducted, transcribed, and analysed using a thematic content analysis as proposed by Giorgi. Data was analysed and managed using Atlas-ti (version 7.0). This study was approved by our institution´s Complejo Hospitalario de Caceres Ethics and Research Committee. RESULTS: Spouse caregivers of stroke survivors undergo a process of disruption in their private lives and relationships, marked by their caregiving duties. The experiences of spouses caring for stroke survivors is condensed into topics and subtopics: "Caregiving and that´s all" summarizes the sense of having no life horizons and also caregiver impossibility of moving away from caring role. Otherwise, "Breaking the couple´s life together" enlightens the further consequences of stroke in couples shared live biography, which needs to be understood and rebuilt. Finally, "Going through the (non) loss alone" alludes to how spouses reinterpret meaning of loss, which is not appreciated by others and that refers to the balance between stroke survival and any acquired global disability. CONCLUSIONS: A comprehensive approach to the couple (family), from a psycho-socio-emotional and relational perspective, is essential for ensuring adequate quality of life for people who suffered a stroke as well as their caregivers. Spouses-caregivers must be considered as individuals living a transition process due to their unexpected disrupting change, which nurses should address through a comprehensive and integrated approach focused on transition care. Care resources must be adapted to the interpretation that the spouses have of their caregiving role and their relationship with the different components of the caregiving process.

Impacto en la calidad de vida en cuidadores de supervivientes de un ictus / Impact on quality of life in caregivers of stroke survivors

El ictus es la primera causa de discapacidad en adultos. Con frecuencia, el cuidado recae sobre la familia pudiendo afectar a su calidad de vida. OBJETIVO: Determinar la calidad de vida relacionada con la salud y el grado de sobrecarga del cuidador de un paciente tras un ictus. MÉTODO: Estudio descriptivo, transversal. Se incluyeron cuidadores que llevaban más de 6 meses y sin remuneración por cuidar. Proyecto aprobado por el Comité de Ética. Variables recogidas: variables sociodemográficas, cuestionario de calidad de vida EuroQol-5D (EQ-5D), escala de Zarit, estado de ánimo y problemas de sueño. RESULTADOS: Se incluyeron 48 cuidadores, la edad media fue de 55,63 (DS: 13,41) y la mayoría mujeres (70,8%). El tiempo medio de cuidado fue de 28,8 meses (DS: 28,68). El 58% manifestaban tener un estado de ánimo deprimido, el 31,3% presentaba sobrecarga; y el 89,6% problemas de sueño. Las dimensiones que presentaron problemas (moderados o graves) en el cuestionario EQ-5D fueron dolor/malestar (66,7%) y angustia/depresión (68,8%). La puntuación de la escala de valoración analógica de la calidad de vida del EQ-5D se asoció a un peor estado de ánimo (75,5 vs.65,32; p = 0,0028), a la presencia de dolor (81,94 vs.63,38; p < 0,001) y con la escala de Zarit (r = -0,334; p = 0,020). CONCLUSIONES: La función de cuidador del paciente con ictus recae con más frecuencia en la mujer. El ser cuidador afecta a la calidad de vida, principalmente a las dimensiones de dolor y angustia/depresión, independientemente del estado funcional del paciente. Las enfermeras, debemos detectar sus necesidades psicopatológicas y desarrollar estrategias que las aborden para prevenir el riesgo de claudicación

Stroke is the first cause of disability in adults. Often, the care falls on the family and can affect their quality of life. AIM: To determine the health-related quality of life and the level of caregiver burden of a patient after a stroke. METHOD: Descriptive and cross-sectional study. Caregivers, who had cared for a patient for more than six months and without pay, were included. This study had been approved by the Ethics Committee. Variables collected: sociodemographic, EuroQol-5D questionnaire, Zarit scale, mood and sleep problems. RESULTS: Forty-eight caregivers were included, with a mean age of 55.63 (SD: 13.48) and the majority were women (70.8%). The mean time of the care was 28.8 months (SD: 28.68), with 58% stated having a depressed mood, 31% had burden, and 89.6% had sleep problems. The dimensions that presented problems (moderate and severe) in the EQ-5D were pain-discomfort (66.7%) and anxiety-depression (68.8%). The score on the visual analog scale rating of quality of life was associated with a worse mood (75.5 vs.32, p = 0.0028), with the pain (81.94 vs.38, p < 0 .001), and Zarit scale (r: < 0.334, p = 0.020). CONCLUSIONS: The role of caregivers of stroke patients often falls on women. To be a caregiver affects the quality of life, mainly in the pain-discomfort and anxiety-depression dimensions, regardless of the functional status of the patient. Nurses must identify the psychopathological needs and develop strategies on the prevention of the risk of burnout

[Impact on quality of life in caregivers of stroke survivors]. / Impacto en la calidad de vida en cuidadores de supervivientes de un ictus.

UNLABELLED: Stroke is the first cause of disability in adults. Often, the care falls on the family and can affect their quality of life. AIM: To determine the health-related quality of life and the level of caregiver burden of a patient after a stroke. METHOD: Descriptive and cross-sectional study. Caregivers, who had cared for a patient for more than six months and without pay, were included. This study had been approved by the Ethics Committee. Variables collected: sociodemographic, EuroQol-5D questionnaire, Zarit scale, mood and sleep problems. RESULTS: Forty-eight caregivers were included, with a mean age of 55.63 (SD: 13.48) and the majority were women (70.8%). The mean time of the care was 28.8 months (SD: 28.68), with 58% stated having a depressed mood, 31% had burden, and 89.6% had sleep problems. The dimensions that presented problems (moderate and severe) in the EQ-5D were pain-discomfort (66.7%) and anxiety-depression (68.8%). The score on the visual analog scale rating of quality of life was associated with a worse mood (75.5 vs. 32, p=0.0028), with the pain (81.94 vs. 38, p<0.001), and Zarit scale (r:<0.334, p=0.020). CONCLUSIONS: The role of caregivers of stroke patients often falls on women. To be a caregiver affects the quality of life, mainly in the pain-discomfort and anxiety-depression dimensions, regardless of the functional status of the patient. Nurses must identify the psychopathological needs and develop strategies on the prevention of the risk of burnout.

[Rehabilitation in stroke]. / Rehabilitación en el ICTUS.

Stroke is one of the most common causes of death and disability in adults, it causes disability and participation restriction, depending on the location and size of the affected territory and cerebral vascular sequel, and the deficits will be different. Our objective is to improve the disability of patients to enable them to reintegrate fully into his personal life, work and social, and provide care and support to patients and their family. Therefore, it's important to establish a comprehensive care plan, individualized, and established early with a specific rehabilitation program continued, and with an intensity, duration and frequency adapted to the patient, to achieve functional goals raised. The rehabilitative treatment offers a variety of methods and approached from different points of view by the multidisciplinary team that deals with management. The patient and their caregivers are the most important piece of the equipment, so they should receive ongoing information, counseling and psychological support. On the other hand, the discharge should not result in an interruption of the rehabilitation program; we must adequately establish phases and areas for this healthcare. Patients who have suffered a stroke, as well as receiving the best care in the acute phase, should benefit from specific rehabilitation programs in chronic phase, we need to ensure continuity and appropriateness of care for patients and their caregivers, not in a situation of helplessness.

Rehabilitación en el ICTUS / Rehabilitation in stroke

El ictus representa una de las causas más frecuentes de muerte e invalidez en los adultos, produce discapacidad y restricción de la participación; dependiendo de la localización y tamaño del territorio vascular y cerebral afectado las secuelas y los déficits serán diferentes. Nuestro objetivo consistirá en mejorar la discapacidad de los pacientes para que puedan reintegrarse plenamente en su vida personal, laboral y social; y prestar atención y apoyo al paciente y su familia. Por ello, es importante establecer un plan de cuidados integral e individualizado e instaurar de forma precoz un programa específico de rehabilitación continuo, con una intensidad, duración y frecuencia adaptadas al propio paciente para conseguir los objetivos funcionales planteados. El tratamiento rehabilitador ofrece una gran diversidad de métodos y técnicas abordadas desde diferentes puntos de vista por el equipo multidisciplinar que se ocupa de su manejo. El propio paciente y sus cuidadores son la pieza más importante del equipo, por lo que deben recibir continua información, asesoramiento y apoyo psicológico. Por otro lado, el alta hospitalaria no debe suponer una interrupción del programa de rehabilitación, por lo que debemos establecer adecuadamente las fases y los ámbitos de esta asistencia sanitaria. Los pacientes que han sufrido un ictus, además de recibir la mejor atención en la fase aguda, deben beneficiarse de programas de rehabilitación específicos en su fase crónica, por lo que tenemos que asegurar la continuidad y adecuación de los cuidados, para que los pacientes y sus cuidadores no se encuentren en una situación de desamparo(AU)

Stroke is one of the most common causes of death and disability in adults, it causes disability and participation restriction, depending on the location and size of the affected territory and cerebral vascular sequel, and the deficits will be different. Our objective is to improve the disability of patients to enable them to reintegrate fully into his personal life, work and social, and provide care and support to patients and their family. Therefore, it’s important to establish a comprehensive care plan, individualized, and established early with a specific rehabilitation program continued, and with an intensity, duration and frequency adapted to the patient, to achieve functional goals raised. The rehabilitative treatment offers a variety of methods and approached from different points of view by the multidisciplinary team that deals with management. The patient and their caregivers are the most important piece of the equipment, so they should receive ongoing information, counseling and psychological support. On the other hand, the discharge should not result in an interruption of the rehabilitation program; we must adequately establish phases and areas for this healthcare. Patients who have suffered a stroke, as well as receiving the best care in the acute phase, should benefit from specific rehabilitation programs in chronic phase, we need to ensure continuity and appropriateness of care for patients and their caregivers, not in a situation of helplessness(AU)