Validation of Nursing Outcome Indicators in Patients with Postsurgical Delirium / Validación de indicadores de resultados enfermeros en pacientes con delirium postquirúrgico / Validação de indicadores de resultados de enfermagem em pacientes com delirium pós-cirúrgico

Objective. To validate the content of the indicators proposed from the Nursing Outcome Classification in a care plan for delirium management in older adults. Methods. Content validity study, conducted under the expert judgment technique. The procedure was developed in five moments: organization of indicators that respond to the nursing outcome classification for delirium management, support with literature of the indicators that responds to the result, selection of experts, establishment of agreements, and discussion. Quality criteria evaluated: pertinence and relevance, the Content Validity Coefficient and average scores assigned by the experts were calculated. Results. The study had the participation of 14 experts. The indicators, according to criteria of pertinence and relevance evaluated by experts showed a global average content index value of 0.93; 97.05% (66) of the indicators had Content Validity Coefficient > 0.75. Conclusion. The quantitative findings of the indicator validation process showed high relevance and pertinence index, which favors their being applied to measure care changes in patients with delirium.

Objetivo. Validar el contenido de los indicadores propuestos a partir de Nursing Outcome Classification en un plan de cuidados para el manejo de delirium en los adultos mayores. Métodos. Estudio de validación de contenido realizado bajo la técnica de juicio de expertos. El procedimiento se desarrolló en cinco momentos: organización de los indicadores que responden a la clasificación de resultados de enfermería para manejo de delirium, soporte con literatura de los indicadores que responde al resultado, selección de expertos, establecimiento de acuerdos y discusión. Criterios de calidad evaluados: pertinencia y relevancia. Se calculó el Coeficiente de Validez de Contenido, así como los promedios de los puntajes asignados por los expertos. Resultados. Se contó con la participación de 14 expertos. Los indicadores según los criterios de pertinencia y relevancia evaluados por expertos mostraron un valor global promedio de índice de contenido de 0.93. El 97.05% (66) de los indicadores presentaron Coeficiente de Validez de Contenido mayor a 0.75. Conclusión. Los hallazgos cuantitativos del proceso de validación de los indicadores mostraron alto índice de relevancia y pertinencia lo que favorece que puedan ser aplicados para medir cambios de cuidado en los pacientes con delirium.

Objetivo. Validar o conteúdo dos indicadores propostos pela Classificação dos Resultados de Enfermagem em um plano de cuidados para o manejo do delirium em idosos. Métodos. Estudo de validação de conteúdo, realizado através da técnica de julgamento de especialistas. O procedimento foi desenvolvido em 5 momentos: organização dos indicadores que respondem à classificação dos resultados de enfermagem para manejo do delirium, suporte com literatura dos indicadores que respondem ao resultado, seleção de especialistas, estabelecimento de acordos e discussão. Foram calculados os critérios de qualidade avaliados: relevância e pertinência, o Coeficiente de Validade de Conteúdo e as médias das notas atribuídas pelos especialistas. Resultados. Participaram 14 especialistas. Os indicadores segundo os critérios de relevância e pertinência avaliados por especialistas apresentaram valor médio do índice de conteúdo global de 0.93. O 97.05% (66) dos indicadores apresentaram Coeficiente de Validade de Conteúdo superior a 0.75. Conclusão. Os achados quantitativos do processo de validação dos indicadores apresentaram alto índice de relevância e pertinência, o que favorece sua aplicação para mensurar mudanças no cuidado de pacientes com delirium.

Validation of Nursing Outcome Indicators in Patients with Postsurgical Delirium.

Objective: To validate the content of the indicators proposed from the Nursing Outcome Classification in a care plan for delirium management in older adults. Methods: Content validity study, conducted under the expert judgment technique. The procedure was developed in five moments: organization of indicators that respond to the nursing outcome classification for delirium management, support with literature of the indicators that responds to the result, selection of experts, establishment of agreements, and discussion. Quality criteria evaluated: pertinence and relevance, the Content Validity Coefficient and average scores assigned by the experts were calculated. Results: The study had the participation of 14 experts. The indicators, according to criteria of pertinence and relevance evaluated by experts showed a global average content index value of 0.93; 97.05% (66) of the indicators had Content Validity Coefficient > 0.75. Conclusion: The quantitative findings of the indicator validation process showed high relevance and pertinence index, which favors their being applied to measure care changes in patients with delirium.

Validation and reliability of the Care Vulnerability Index: A study by interrater agreement and test-retest method.

AIM: The aim of this study is to determine the validity and reliability of the Care Vulnerability Index (CVI) as a tool to estimate the need and competence of care. DESIGN: A cross-sectional survey including a longitudinal component. METHODS: Content validity ratio (CVR) was calculated by interrater agreement of a group of 11 experts in two rounds. The test-retest analysis was measured in an urban population of Colombia with 96 participants through two statistical tests: Pearson's correlation coefficient and the difference in means. RESULTS: Care Vulnerability Index turned out to be valid with a CVR of 0.879. Reliability by Pearson correlation between test-retest was 0.912 (CI95: 0.872-0.941; p-value <.01) and there was no significant mean difference between test and retest in global score and in clustered groups of variables. Validating CVI will make it possible to prioritize healthcare resources in the population and identify people susceptible to care problems.

The Design and validation of a Nursing Plan for Elderly Patients with Postoperative Delirium.

Delirium is the sudden alteration of the state of consciousness and perception, fluctuating over hours or days. It predominates in older adults and is associated with the aging process. The incidence of delirium increases between 10% and 15% in surgical interventions. The objective of this study was the design and validation of a nursing care plan for elderly patients with postoperative delirium. This study was based on the Delphi method and applied to nursing professionals at the Hospital Universitario del Caribe, Cartagena. The sample consisted of 36 nurses with knowledge of the taxonomy of nursing diagnoses. The care plan was applied in two rounds. For the analysis, measures of central tendency and dispersion were used, as well as frequency and percentages. The participants were women (90.9%) from the hospitalization service (51.5%), with training in Nursing Diagnosis (NANDA), Nursing interventions classification (NIC) and Nursing Outcome Classifications (NOC) (78.8%). The validated care plan has eight diagnostic features. Highlights include "Risk for Ineffective Cerebral Tissue Perfusion" and "Disturbed Sleep Pattern" (in 98.1%; 11 results), with the highest score in the first round being "Vital Signs" (with 100%) and "Sleep" (100%) and "Mobility" (100%) in the second round. Forty-four interventions and 18 suggested activities were identified. This care plan offers the nursing professionals reliable and pertinent tools in clinical practice for the management of patients with postoperative delirium.

The Dimensions of Care: Big Data Analysis in Health Information Systems.

The axioms of care postulate energy and time as underlying entities that allow us to study the dimensions of the person as care: the sorge. Logic allows to formalize the deductive study of sorge knowledge in order to determine what are the dimensions of care. These dimensions will be the guiding framework in the analysis of big data contained in health information systems.

Cognitive Stimulation of Elderly Residents in Social Protection Centers in Cartagena, 2014 / Estimulación cognitiva de los adultos mayores residentes en centros de protección social. Cartagena, 2014

Abstract Objective: To determine the effectiveness of a program of cognitive stimulation of the elderly residents in Social Protection Centers in Cartagena, 2014. Methods: Quasi-experimental study with pre and post tests in control and experimental groups. A sample of 37 elderly residents in Social Protection Centers participated: 23 in the experimental group and 14 in the control group. A survey and a mental evaluation test (Pfeiffer) were applied. The experimental group participated in10 sessions of cognitive stimulation. Results: The paired t-test showed statistically significant differences in the Pfeiffer test, pre and post intervention, compared to the experimental group (P=.0005). The unpaired t-test showed statistically significant differences in Pfeiffer test results to the experimental and control groups (P=.0450). The analysis of the main components showed that more interrelated variables were: age, diseases, number of errors and test results; which were grouped around the disease variable, with a negative association. Conclusions: The intervention demonstrated a statistically significant improvement in cognitive functionality of the elderly. Nursing can lead this type of intervention. It should be studied further to strengthen and clarify these results.

Resumen Objetivo: Determinar la efectividad de un programa de estimulación cognitiva de los adultos mayores residentes en Centros de Protección Social de Cartagena en 2014. Métodos: Estudio cuasi-experimental, con pre y post-test en grupos control y experimental. Participó una muestra de 37 adultos mayores residentes en Centros de Protección Social: 23 en el grupo experimental y 14 en el grupo control. Se aplicaron una encuesta y el test de valoración mental de Pfeiffer. El grupo experimental participó en 10 sesiones de estimulación cognitiva. Se tuvieron en cuenta las consideraciones éticas. Resultados: La prueba de la t apareada mostró diferencias estadísticamente significativas en el test de Pfeiffer antes y después de la intervención en el grupo experimental (p=0,0005). La prueba de la t no apareada mostró diferencias estadísticamente significativas en los resultados del test de Pfeiffer entre los grupos (p = 0,0450). El análisis de componentes principales mostró que las variables más relacionadas entre sí fueron: edad, enfermedades, número de errores cometidos y resultado de la prueba, las cuales se agruparon en torno a la variable enfermedad con una asociación negativa. Conclusiones: La intervención demostró una mejoría estadísticamente significativa en la funcionalidad cognitiva de los adultos mayores. Enfermería puede liderar este tipo de intervenciones. Se debe continuar investigando para fortalecer y aclarar estos resultados.

Cognitive Stimulation of Elderly Residents in Social Protection Centers in Cartagena, 2014.

OBJECTIVE: To determine the effectiveness of a program of cognitive stimulation of the elderly residents in Social Protection Centers in Cartagena, 2014. METHODS: Quasi-experimental study with pre and post tests in control and experimental groups. A sample of 37 elderly residents in Social Protection Centers participated: 23 in the experimental group and 14 in the control group. A survey and a mental evaluation test (Pfeiffer) were applied. The experimental group participated in 10 sessions of cognitive stimulation. RESULTS: The paired t-test showed statistically significant differences in the Pfeiffer test, pre and post intervention, compared to the experimental group (P=.0005). The unpaired t-test showed statistically significant differences in Pfeiffer test results to the experimental and control groups (P=.0450). The analysis of the main components showed that more interrelated variables were: age, diseases, number of errors and test results; which were grouped around the disease variable, with a negative association. CONCLUSIONS: The intervention demonstrated a statistically significant improvement in cognitive functionality of the elderly. Nursing can lead this type of intervention. It should be studied further to strengthen and clarify these results.

Calidad de vida en adultos mayores en Cartagena, Colombia / Quality of life in the senior population of Cartagena, Colombia

RESUMEN Objetivo Determinar factores asociados a la calidad de vida de los adultos mayores en Cartagena, 2015. Método Estudio transversal, con una población de 107 604 adultos mayores y se estimó una muestra de 660 personas. Se adelantó un muestreo bietapico. Se tomó como referente la teoría de calidad de vida relacionada con salud y para medir los conceptos planteados por esta teoría se emplearon los test de Pfeiffer, encuesta socio-demográfica, escala de depresión de Yesavage, cuestionario de salud auto percibida, escala de Barthel, Lawton y Brody, Índice Multicultural de Calidad de Vida, cuestionario Duke- UNC-11. Se usó la estadística descriptiva y un modelo de regresión logística multivariada. Se consideraron los aspectos éticos de estudios con humanos. Resultados Participaron 657 personas, edad promedio de 71 años, predominó el sexo femenino (55,7 %), tener pareja estable (62,6 %), escolaridad primaria (49,6 %), ocupación hogar (52,8%), residir en estratos 2 y 3 (66,7 %) y vivir con 4 personas, promedio, en el hogar. Se observó alta prevalencia de apoyo social adecuado (89,5 %), no presentar síntomas depresivos con significancia clínica (86.9 %), independencia para realizar actividades básicas (86,3 %) e instrumentales de la vida diaria (60,8 %), percibir su salud como buena (51,4 %), percibir la calidad de vida relacionada con salud como excelente (87,4 %). Las patologías más frecuentes fueron las cardiovasculares (26,1 %). Conclusiones La calidad de vida se asoció positivamente a percibir apoyo social adecuado y a la independencia para realizar actividades instrumentales de la vida diaria y neg(AU)

ABSTRACT Objective To determine factors associated with the quality of life of the elderly in Cartagena in 2015. Method Cross-sectional study on a population of 107 604 senior adults, with a sample of 660 people. Two-stage sampling was carried out using the Pfeiffer test, socio-demographic survey, Yesavage depression scale, self-perceived health questionnaire, Barthel Lawton and Brody scale, Multicultural Quality of Life Index, and Duke Questionnaire. Descriptive statistics and a multivariate logistic regression model were used. The ethical aspects of human studies were considered. Results 657 people participated, with an average age of 71 years, predominantly female (55.7 %), with a stable partner (62.6 %), primary schooling (49.6 %), household occupation (52.8 %), residing in strata 2 and 3 (66.7 %), and living with an average of 4 people in the same household. Findings include high prevalence of adequate social support (89.5 %), no depressive symptoms of clinical significance (86.9 %), independence to perform basic activities (86.3 %) and instrumental activities of daily living (60.8%). Additionally, their health was perceived as good (51.4 %), and the quality of life related to health as excellent (87.4 %). The most frequent pathologies were cardiovascular (26.1 %). Conclusions Quality of life was positively associated to the perception of adequate social support and independence to perform instrumental activities of daily living, and negatively to working or having a pension.(AU)

Significado de salud: la vivencia del adulto mayor / Meaning of Health: The Experience of the Elderly / Significado de saúde: a vivência do idoso

RESUMEN Durante la vejez, el significado de salud se basa en alcanzar un estado de bienestar; por ello, es importante comprender los factores que benefician o afectan el logro de este propósito. Objetivo: analizar los significados de salud que los adultos mayores construyen a partir de sus vivencias y experiencias. Materiales y métodos: investigación cualitativa con técnica de análisis de contenido y entrevista semiestructurada. Participaron veinte adultos mayores, que acudieron a un centro de atención geriátrica, seleccionados de manera intencionada y determinada por índice de saturación. Resultados: el significado de salud se manifiesta en la capacidad de poder hacer cosas; así, la salud se concibe como un medio útil para obtener un beneficio, ya sea material, moral o físico. Los vínculos familiares son importantes, incluso los comparan con la salud; también, identifican la salud con la ausencia de dolor y enfermedad. Conclusión: la salud del adulto mayor es vivida en contexto familiar; el bienestar es percibido como la capacidad de hacer cosas, aunque el dolor y la enfermedad estén presentes.

ABSTRACT The meaning of health during old age is based on achieving a state of well-being. Therefore, it is important to understand the factors that benefit or affect accomplishing that goal. Objective: Analyze what health means to older adults, based on their experiences. Materials and methods: This is a qualitative study based on content analysis and semi-structured interviews. Twenty elderly adults who frequented a geriatric care center were selected intentionally and determined by means of a saturation index. Results: The meaning of health is manifest in the ability to do things. Accordingly, health is conceived as a useful means to obtain a benefit, be it material, moral or physical. Family ties are important and were even compared to health. The participants also equated health with the absence of pain and disease. Conclusion: Health is experienced by the elderly in a family context. Well-being is perceived as the ability to do things, even if pain and illness are present.

RESUMO Durante a velhice, o significado de saúde está baseado em atingir um estado de bem-estar; por isso, é importante compreender os fatores que beneficiam ou afetam conquistar esse propósito. Objetivo: analisar os significados de saúde que os idosos constroem a partir de suas vivências e experiências. Materiais e método: pesquisa qualitativa com técnica de análise de conteúdo e entrevista semiestruturada. Participaram vinte idosos que foram a um centro de atenção geriátrica, selecionados de maneira intencionada e determinada por índice de saturação. Resultados: o significado de saúde se manifesta na capacidade de poder fazer coisas; assim, a saúde é concebida como um meio útil para obter um benefício - material, moral ou físico. Os vínculos familiares são importantes, inclusive os comparam com a saúde; também identificam a saúde com a ausência de dor e doença. Conclusões: a saúde do idoso é vivida em contexto familiar; o bem-estar é percebido como a capacidade de fazer coisas, embora a dor e a doença estejam presentes.

[Quality of life in the senior population of Cartagena, Colombia]. / Calidad de vida en adultos mayores en Cartagena, Colombia.

OBJECTIVE: To determine factors associated with the quality of life of the elderly in Cartagena in 2015. METHOD: Cross-sectional study on a population of 107 604 senior adults, with a sample of 660 people. Two-stage sampling was carried out using the Pfeiffer test, socio-demographic survey, Yesavage depression scale, self-perceived health questionnaire, Barthel Lawton and Brody scale, Multicultural Quality of Life Index, and Duke Questionnaire. Descriptive statistics and a multivariate logistic regression model were used. The ethical aspects of human studies were considered. RESULTS: 657 people participated, with an average age of 71 years, predominantly female (55.7 %), with a stable partner (62.6 %), primary schooling (49.6 %), household occupation (52.8 %), residing in strata 2 and 3 (66.7 %), and living with an average of 4 people in the same household. Findings include high prevalence of adequate social support (89.5 %), no depressive symptoms of clinical significance (86.9 %), independence to perform basic activities (86.3 %) and instrumental activities of daily living (60.8%). Additionally, their health was perceived as good (51.4 %), and the quality of life related to health as excellent (87.4 %). The most frequent pathologies were cardiovascular (26.1 %). CONCLUSIONS: Quality of life was positively associated to the perception of adequate social support and independence to perform instrumental activities of daily living, and negatively to working or having a pension.

OBJETIVO: Determinar factores asociados a la calidad de vida de los adultos mayores en Cartagena, 2015. MÉTODO: Estudio transversal, con una población de 107 604 adultos mayores y se estimó una muestra de 660 personas. Se adelantó un muestreo bietapico. Se tomó como referente la teoría de calidad de vida relacionada con salud y para medir los conceptos planteados por esta teoría se emplearon los test de Pfeiffer, encuesta socio-demográfica, escala de depresión de Yesavage, cuestionario de salud auto percibida, escala de Barthel, Lawton y Brody, Índice Multicultural de Calidad de Vida, cuestionario Duke- UNC-11. Se usó la estadística descriptiva y un modelo de regresión logística multivariada. Se consideraron los aspectos éticos de estudios con humanos. RESULTADOS: Participaron 657 personas, edad promedio de 71 años, predominó el sexo femenino (55,7 %), tener pareja estable (62,6 %), escolaridad primaria (49,6 %), ocupación hogar (52,8%), residir en estratos 2 y 3 (66,7 %) y vivir con 4 personas, promedio, en el hogar. Se observó alta prevalencia de apoyo social adecuado (89,5 %), no presentar síntomas depresivos con significancia clínica (86.9 %), independencia para realizar actividades básicas (86,3 %) e instrumentales de la vida diaria (60,8 %), percibir su salud como buena (51,4 %), percibir la calidad de vida relacionada con salud como excelente (87,4 %). Las patologías más frecuentes fueron las cardiovasculares (26,1 %). CONCLUSIONES: La calidad de vida se asoció positivamente a percibir apoyo social adecuado y a la independencia para realizar actividades instrumentales de la vida diaria y negativamente al hecho de trabajar o tener pensión.

[Validity and Reliability of the Attitudes Toward Sexuality in the Elderly Questionnaire in Cartagena, Colombia]. / Validez y confiabilidad del cuestionario de actitudes hacia la sexualidad en la vejez en adultos mayores en Cartagena, Colombia.

BACKGROUND: There are many stereotypes and prejudices about the sexual lives of the elderly. However, there are no validated and reliable tools for measuring these in the Latin-American context. OBJECTIVE: To determine the internal consistency, dimensionality, differential item functioning (DIF) by gender and stability of the Attitudes towards Sexuality in the Elderly Questionnaire (ASEQ) in adults over 60 years-old in Cartagena, Colombia. METHOD: A validation study was designed that included a sample of 130 participants without cognitive impairment attending a Life Center. The ages ranged between 60 and 90 years (mean, 73.7±8.0), and there were 61.5% females. Internal consistency was calculated using Cronbach alpha and McDonald omega, exploratory factor analysis (EFA) (dimensionality), DIF by gender (item response theory) with Kendall correlation, and stability (reproducibility) with Pearson correlation and intraclass correlation coefficient (ICC). RESULTS: The ASEQ showed high internal consistency on the first application (α=.83 and ω=.87) and in the second one (α=.85 and ω=.89). AFE showed two salient factors (prejudices and limitations) that explained 42.6% of the total variance. The IDF presented appropriate coefficients, with the exception of item 14 that showed a high value (τ=.37). ASEQ showed high stability (r=.82 and ICC=.89; 95% confidence interval, 0.83- 0.92; P<.001). CONCLUSIONS: ASEQ is a two-dimensional and reliable scale in older adults attending a Life Center in Cartagena, Colombia. New studies are required to evaluate the performance in a representative sample.

Validez y confiabilidad del cuestionario de actitudes hacia la sexualidad en la vejez en adultos mayores en Cartagena, Colombia / Validity and Reliability of the Attitudes Toward Sexuality in the Elderly Questionnaire in Cartagena, Colombia

Introducción: Existen estereotipos y prejuicios alrededor de la vida sexual de los adultos mayores; no obstante, no se cuenta con instrumentos válidos y confiables para la medición en el contexto latinoamericano. Objetivo: Conocer consistencia interna, dimensionalidad, funcionamiento diferencial de los ítems (FDI) según sexo y estabilidad del Cuestionario de Actitudes hacia la Sexualidad en la Vejez (CASV) en adultos mayores de 60 años en Cartagena, Colombia. Método: Se diseñó un estudio de validación. Participaron 130 adultos mayores sin deterioro cognitivo asistentes a Centros de Vida. Las edades observadas estaban entre 60 y 90 (media, 73,7 ± 8,0) años; el 61,5% eran mujeres. Se calculó la consistencia interna con alfa de Cronbach y omega de McDonald, análisis factorial exploratorio (AFE) (dimensionalidad), FDI por sexo (teoría de respuesta al ítem) con la correlación de Kendall y la estabilidad (reproducibilidad) con la correlación de Pearson y el coeficiente de correlación intraclase (CCI). Resultados: La consistencia interna del CASV fue alta en la primera aplicación (α = 0,83 y ω = 0,87) y en la segunda (α = 0,85 y ω = 0,89). El AFE mostró dos factores relevantes (prejuicios y limitaciones) que explicaron el 42,6% de la varianza. El FDI mostró coeficientes adecuados, con excepción del ítem 14, que presentó valor alto (τ = 0,37). El CASV presento alta estabilidad (r = 0,82 y CCI = 0,89; intervalo de confianza del 95% [IC95%], 0,83-0,92; p < 0,001). Conclusiones: El CASV es una escala bidimensional y confiable en adultos mayores que asisten a Centros de Vida en Cartagena, Colombia. Se necesitan nuevas investigaciones que evalúen el funcionamiento en una muestra representativa.

Background: There are many stereotypes and prejudices about the sexual lives of the elderly. However, there are no validated and reliable tools for measuring these in the Latin-American context. Objective: To determine the internal consistency, dimensionality, differential item functioning (DIF) by gender and stability of the Attitudes towards Sexuality in the Elderly Questionnaire (ASEQ) in adults over 60 years-old in Cartagena, Colombia. Method: A validation study was designed that included a sample of 130 participants without cognitive impairment attending a Life Center. The ages ranged between 60 and 90 years (mean, 73.7±8.0), and there were 61.5% females. Internal consistency was calculated using Cronbach alpha and McDonald omega, exploratory factor analysis (EFA) (dimensionality), DIF by gender (item response theory) with Kendall correlation, and stability (reproducibility) with Pearson correlation and intraclass correlation coefficient (ICC). Results: The ASEQ showed high internal consistency on the first application (α=.83 and ω=.87) and in the second one (α=.85 and ω=.89). AFE showed two salient factors (prejudices and limitations) that explained 42.6% of the total variance. The IDF presented appropriate coefficients, with the exception of item 14 that showed a high value (τ=.37). ASEQ showed high stability (r=.82 and ICC=.89; 95% confidence interval, 0.83- 0.92; P<.001). Conclusions: ASEQ is a two-dimensional and reliable scale in older adults attending a Life Center in Cartagena, Colombia. New studies are required to evaluate the performance in a representative sample.

Calidad de vida de adultos mayores en centros de protección social en Cartagena (Colombia) / Quality of Life of Senior Citizens at Social Welfare Centers in Cartagena (Colombia) / Qualidade de vida de idosos em centros de proteção social em Cartagena (Colombia)

Objetivo: describir la calidad de vida relacionada con la salud de los adultos mayores residentes en centros de protección social en Cartagena (Colombia). Materiales y métodos: estudio descriptivo. La población fueron 187 adultos mayores residentes en centros de protección social en Cartagena. Se aplicó el Test de Valoración Mental (Pfeiffer), una encuesta sociodemográfica y el "Índice multicultural de calidad de vida". Se mantuvo la confidencialidad de la información, el anonimato de los participantes y se diligenció el consentimiento informado. Resultados: el promedio de edad fue de 75 años (95%), predominó el estado civil soltero (57,6%), nivel educativo primaria (45,5%), recibir medicamentos (80,3%), realizar actividades físicas (54,5%) y no realizar actividades productivas (37,9%). La autopercepción de la calidad de vida relacionada con salud tiende a valores que pueden considerarse como buenos (7,6%). Conclusiones: las dimensiones que presentaron puntajes más altos fueron la plenitud espiritual y el autocuidado, y con menor puntaje el bienestar físico y el apoyo comunitario. Esta información será útil para proponer políticas de salud y prácticas de cuidado para esta población.

Objective: Describe the quality of life related to the health of senior residents at social welfare centers in Cartagena (Colombia). Materials and Methods: This is a descriptive study. The population was comprised of 187 seniors living at welfare centers in Cartagena. The Mental Status Test (Pfeiffer), a socio-demographic survey and the Multicultural Quality of Life Index were applied. Confidentiality of information was maintained, the participants remained anonymous, and informed consent was given. Results: The mean age was 75 (95%). Most of the participants are single (57.6%). Some have a primary education (45.5%), are receiving medication (80.3%), engage in physical activity (54.5%) and carry out non-productive activities (37.9%). The self-perception of quality of life related to health tends towards values that can be considered good (7.6%). Conclusions: The aspects with the highest scores were spiritual fulfillment and self-care; the lowest scores pertained to physical well-being and community support. The information will be useful to propose health care policies and practices for this segment of the population.

Objetivo: descrever a qualidade de vida relacionada com a saúde dos idosos residentes em centros de proteção social em Cartagena (Colômbia). Materiais e métodos: estudo descritivo. A população foi constituída por 187 idosos residentes em centros de proteção social em Cartagena. Aplicou-se o Teste de Valorização Mental (Pfeiffer[RD1] ), uma enquete sociodemográfica, e o "Índice multicultural de qualidade de vida". Manteve-se a confidencialidade da informação, o anonimato dos participantes e diligenciou-se o consentimento informado. Resultados: a média de idade foi de 75 anos (95%), predominou o estado civil solteiro (57,6%), nível educativo primário (45,5%), receber medicamentos (80,3%), realizar atividades físicas (54,5%) e não realizar atividades produtivas (37,9%). A autopercepção da qualidade de vida relacionada com saúde tende a valores que podem ser considerados bons (7,6%). Conclusões: as dimensões que apresentaram pontuações mais altas foram a plenitude espiritual e o autocuidado, e com menor pontuação o bem-estar físico e o apoio comunitário. Esta informação será útil para propor políticas de saúde e práticas de cuidado para esta população.

Factores asociados a la calidad de vida de adultos mayores. Cartagena (Colombia) / Factors associated to life quality of older adults. Cartagena (Colombia)

Objetivo: Identificar los factores sociodemográficos asociados a la calidad de vida relacionada con salud de los adultos mayores de la Comuna 9 del Distrito de Cartagena. Materiales y métodos: Encuesta transversal. Población de 5020 adultos mayores, muestra de 514 personas. Muestreo en dos etapas: primero estratificado, considerando la proporción de adultos mayores en cada barrio de la Comuna 9, y luego aleatorio simple, para seleccionar las manzanas donde ubicar a los participantes. Auxiliares de investigación, previamente entrenados, recolectaron la información durante abril-mayo de 2009. Se aplicó el instrumento "Índice Multicultural de Calidad de Vida". Se realizó inicialmente un análisis descriptivo de las variables y luego un análisis logístico multivariado para establecer las posibles asociaciones. Resultados: Participaron 514 adultos mayores: 65,8% mujeres; 43% viven en unión libre o son casados; 56,6% han cursado estudios de primaria; 58% no trabaja y el 64,3% residía en estrato 1 o 2. Estar pensionado o estar trabajando aumenta 2,7 veces la posibilidad de tener un buen bienestar psicológico (OR= 2,729 IC 95%= 1,758-4,236). Conclusiones: Ser mujer, tener nivel de escolaridad secundaria o más, vivir en estrato tres o cuatro, ser pensionado o estar trabajando y vivir con menos de cuatro personas muestra asociación a la calidad de vida relacionada con salud de los adultos mayores.

Objective: To identify socio-demographic factors associated with quality of life related to health of the elderly in the Community 9 District of Cartagena. Materials and methods: Cross-sectional survey. 5,020 elderly population, sample size of 514 people. Sampling in two stages: first stratified by considering the proportion of elderly people in every district of the Commune 9 and then simple random blocks to select where to place the participants. Previously trained research assistants collected information during the months of April-May 2009. The instrument was administered Index Multicultural Quality of Life. Was initially a descriptive analysis of the variables and then a multivariate logistic analysis to establish potential partnerships. Results: Participants were 514 older adults: 65.8% female, 43% cohabiting or were married, 56.6% have completed primary education, 58% not working and 64.3% resided in stratum 1 or 2. Be retired or be working increases 2.7 times more like-ly to have a good psychological well-being (OR = 2.729 95% CI = 1.758 to 4.236). Conclusions: Being female, having secondary school level or older, live in stratum three or four, be retired or be working and living on less than four people, showed an association with the quality of life related to health of older adults.

Factores asociados al uso de servicios de atención primaria por adultos mayores de Cartagena, Colombia / Factors associated with senior citizens using primary healthcare services in Cartagena, Colombia

RESUMEN Objetivo Establecer los factores asociados al uso de los servicios de salud por los adultos mayores de Cartagena-Colombia. Métodos Estudio transversal. Con una población de 66 795 adultos mayores, se estimó una muestra de 656. Muestreo estratificado. Se aplicó el cuestionario "uso de los servicios de salud". Se utilizó estadística descriptiva y regresión logística para modelar la probabilidad de ser usuario del servicio. Resultados Participaron del estudio 656 adultos mayores, con un promedio de edad de 67,9 años. Consultaron por enfermedad, en el último mes, 407 participantes (62,0 %) de los cuales 376 (92,4 %) consultó 1 o 2 veces. Residir en estrato socio-económico 4, 5 y 6) (chi² 4,14 p=0,043), tener una enfermedad diagnosticada (chi² 3,82 p=0,051), enfermedad crónica (chi² 7,0 p=0,008) o esperar 30 minutos o menos para ser atendidos (chi² 3,17 p=0,075), son factores asociados al uso de los servicios de atención primaria en salud por parte de los adultos mayores en Cartagena. En el modelo de regresión las variables tener enfermedad diagnosticada (chi²3, 59 p=0,0581) y esperar 30 minutos o menos para ser atendido (chi² 3,02 p=0,0818), fueron variables explicativas del uso de los servicios. Conclusión El uso de los servicios de atención primaria por parte de los adultos mayores en Cartagena está influido por múltiples dimensiones como residir en estrato socio-económico medio, tener enfermedad diagnosticada, padecer enfermedad crónica y esperar 30 minutos o menos para ser atendidos.

Objective Establishing the factors associated with using healthcare services for the aged in Cartagena, Colombia. Methods This was a cross-sectional study. A 656 sample-size was estimated for a population of 66,795 senior citizens; stratified sampling was used. A questionnaire entitled "Using healthcare services" (Uso de los servicios de salud) was used; descriptive statistics and logistical regression were then used for modeling the probability of being a healthcare service user. Results 656 senior citizens participated in the study; average age was 67.9 years old. 407 of the participants had consulted for disease during the last month (62.0 %); 376 of them (92.4 %) had consulted once or twice. Living in socio-economicstrata4, 5 and/or 6 (Chi² 4.14; p=0.043), having a diagnosed disease (Chi² 3.82 p=0,051), suffering from a chronic disease (Chi² 7.0; p=0.008) or waiting for 30 minutes or less to be seen (Chi² 3.17; p=0.075) were factors associated with using primary healthcare services by senior citizens in Cartagena. Having a diagnosed disease (Chi² 3.59; p=0.0581) and waiting for 30 minutes or less to be seen (Chi² 3.02; p=0.0818) were the regression model variables explaining healthcare service use. Conclusion A senior citizen using primary healthcare services in Cartagena was influenced by variables such as residing in mid-level socio-economic strata, having a diagnosed disease, suffering from a chronic disease and waiting for 30 minutes or less to be seen.

[Factors associated with senior citizens using primary healthcare services in Cartagena, Colombia]. / Factores asociados al uso de servicios de atención primaria por adultos mayores de Cartagena, Colombia.

OBJECTIVE: Establishing the factors associated with using healthcare services for the aged in Cartagena, Colombia. METHODS: This was a cross-sectional study. A 656 sample-size was estimated for a population of 66,795 senior citizens; stratified sampling was used. A questionnaire entitled "Using healthcare services" (Uso de los servicios de salud) was used; descriptive statistics and logistical regression were then used for modeling the probability of being a healthcare service user. RESULTS: 656 senior citizens participated in the study; average age was 67.9 years old. 407 of the participants had consulted for disease during the last month (62.0 %); 376 of them (92.4 %) had consulted once or twice. Living in socio-economic strata 4, 5 and/or 6 (Chi² 4.14; p=0.043), having a diagnosed disease (Chi² 3.82 p=0,051), suffering from a chronic disease (Chi² 7.0; p=0.008) or waiting for 30 minutes or less to be seen (Chi² 3.17; p=0.075) were factors associated with using primary healthcare services by senior citizens in Cartagena. Having a diagnosed disease (Chi² 3.59; p=0.0581) and waiting for 30 minutes or less to be seen (Chi² 3.02; p=0.0818) were the regression model variables explaining healthcare service use. CONCLUSION: A senior citizen using primary healthcare services in Cartagena was influenced by variables such as residing in mid-level socio-economic strata, having a diagnosed disease, suffering from a chronic disease and waiting for 30 minutes or less to be seen.

Calidad de vida de persona con heridas complejas en Cartagena, Colombia / The quality of life for people suffering from complex wounds in Cartagena, Colombia

Objetivo Estimar la Calidad de Vida Relacionada con Salud-CVRS- de personas con heridas complejas que reciben cuidados en una Institución Prestadora de Servicios de Salud Extramural en Cartagena, durante mayo-junio de 2010. Materiales y métodos Estudio cuantitativo, descriptivo, cuya población y muestra fueron 93 personas adultas que reciben cuidados en el programa de heridas complejas de una Institución Prestadora de Servicios de Salud Extramural de la ciudad de Cartagena. Se aplicó un cuestionario sobre características socio demográfico, una guía de observación sobre las características de las heridas y el "Índice Multicultural de Calidad de Vida". Para el análisis estadístico se empleó el software SPSS 12. Resultados El promedio de edad fue de 59,3 años; predominó género femenino, 61,3 %; estado civil casado, 43,0 %; ocupación hogar, 38,7 %; escolaridad primaria, 38,7 %; y estratos socio-económicos 2 y 3, 68,8 %. El 93,5 % de los participantes tienen afiliación a la seguridad social en salud. Las heridas complejas se caracterizaron por presentar mayor porcentaje en la fase proliferativa de la cicatrización, 80,6 %; medir de seis a diez centímetros, 63,4 %; no reportar infecciones, 85 %; no presentar amputación, 90,3 %; ni dolor relacionado con la herida, 52,7 % y presentar limitación física relacionada con la herida, 66,7 %. Conclusiones Las personas perciben su CVRS como mala, resaltando con baja puntuación las dimensiones de plenitud personal, funcionamiento ocupacional y bienestar físico y psicológico.

Objective Estimating the health-related quality of life (HRQOL) of people suffering complex wounds who were receiving care in an extramural health service provider institution in Cartagena during May-June 2010. Materials and methods This was a quantitative, descriptive study where the population/sample consisted of 93 adults receiving care in an extramural health service provider institution's complex wounds program in the city of Cartagena. A questionnaire regarding socio-demographic characteristics, an observational guide on the characteristics of injuries and the Multicultural Quality of Life Index were used. SPSS 12.0 software was used for the statistical analysis. Results Mean age was 59.3 years, females predominated (61.3 %), 43.0 % were married, 38.7 % were housewives, 38.7 % had finished primary education, 68.8 % came from socioeconomic levels 2 and 3 and 93.5 % of the participants had health social security affiliation. Complex wounds were characterised by a greater percentage being in the proliferative phase of healing (80.6 %), measuring six to ten inches (63.4 %) no infection being reported (85%), no amputation (90.3 %) or wound-related pain (52.7 %) and presenting physical limitations related to the wound (66.7 %). Conclusions People perceived their HRQOL as poor, their low scores highlighting low personal fulfillment, occupational functioning and physical and psychological wellbeing.

[The quality of life for people suffering from complex wounds in Cartagena, Colombia]. / Calidad de vida de persona con heridas complejas en Cartagena, Colombia.

OBJECTIVE: Estimating the health-related quality of life (HRQOL) of people suffering complex wounds who were receiving care in an extramural health service provider institution in Cartagena during May-June 2010. MATERIALS AND METHODS: This was a quantitative, descriptive study where the population/sample consisted of 93 adults receiving care in an extramural health service provider institution's complex wounds program in the city of Cartagena. A questionnaire regarding socio-demographic characteristics, an observational guide on the characteristics of injuries and the Multicultural Quality of Life Index were used. SPSS 12.0 software was used for the statistical analysis. RESULTS: Mean age was 59.3 years, females predominated (61.3%), 43.0% were married, 38.7% were housewives, 38.7% had finished primary education, 68.8% came from socioeconomic levels 2 and 3 and 93.5% of the participants had health social security affiliation. Complex wounds were characterised by a greater percentage being in the proliferative phase of healing (80.6%), measuring six to ten inches (63.4%) no infection being reported (85%), no amputation (90.3%) or wound-related pain (52.7%) and presenting physical limitations related to the wound (66.7%). CONCLUSIONS: People perceived their HRQOL as poor, their low scores highlighting low personal fulfillment, occupational functioning and physical and psychological wellbeing.

Creencias y prácticas de cuidado de la salud de ancianos / Beliefs and practices of health care for the elderly / Crenças e práticas de cuidado da saúde de idosos

Introducción: las creencias y prácticas de cuidado de la salud son expresiones de la cultura del cuidado de los grupos sociales. Objetivos: -Analizar el contexto sociocultural de la Comuna 9 de Cartagena y su influencia en el cuidado de la salud de sus ancianos.-Analizar las creencias y prácticas de cuidado de la salud de los ancianos en situación de discapacidad y pobreza en la Comuna 9. -Aproximarse a la comprensión de los conceptos de salud, vejez, discapacidad y pobreza de estos ancianos. Metodología: estudio cualitativo, etnografía descriptiva; se utilizó observación participante y entrevista a profundidad. Participaron ocho personas de 60 años y más, en situación de discapacidad y pobreza, en la Comuna 9. Se tomó como referente la propuesta de Leininger para el análisis de datos cualitativos. Se cumplieron criterios de credibilidad, confirmabilidad, significado en el contexto y saturación. Se obtuvo el consentimiento informado.Hallazgos: la relación entre el contexto sociocultural y el cuidado de la salud es dinámica y refleja la idiosincrasia cartagenera. Existen creencias sobre cosas que “sostienen la salud”, “cuidan la salud o causan enfermedad” y cosas que “enferman y matan”; y prácticas de cuidado que se mueven en un continuo entre hacer y no hacer nada para cuidar la salud. Conclusión: las creencias y prácticas de cuidado de la salud develan cómo la cultura permea todas las áreas de la vida de las personas y cambia con el desarrollo de las mismas.

Introduction: the beliefs and practices of health care are expressions of culture when caring for social groups.Objectives:To analyze the social cultural context of the Cartagena “Comuna 9” quarter and its influence when caring for the health of the elderly.To analyze the beliefs and practices in health care for the elderly with disability and in poverty, in the Cartagena’s “Comuna 9” quarter.To come closer to understanding the concepts of health, age, disability and poverty of the elderly.Methodology: a qualitative, descriptive ethnography was conducted; participant observation and in depth interviews were used. Participants were eight persons 60 years old and over, in conditions of disability and poverty in the Cartagena “Comuna 9” quarter. Leininger’s proposal for the analysis of qualitative data was taken as reference. Criteria for credibility, confirmation, meaning in the context and saturation were met. Informed consent was obtained.Findings: the relationship between the social cultural context and health care is dynamic and it reflects the idiosyncrasies of Cartagena. There are beliefs about things which “support health”, “take care of health or cause disease” and things which “sicken and kill”; and care practices that move along a continuum between doing and not doing anything about health care. Conclusion: beliefs and practices in health care reveal how culture permeates all areas of life of individuals and how it changes with their development.

Introdução: as crenças e práticas de cuidado da saúde são expressões da cultura de cuidado dos grupos sociais. Objetivos:-Analisar o contexto sociocultural da Comuna 9 de Cartagena e sua influência no cuidado da saúde destes idosos.-Analisar as crenças e práticas de cuidado da saúde dos idosos em situação de inabilidade e pobreza na Comuna 9.- Aproximar-se à compreensão dos conceitos de saúde, velhice, inabilidade e pobreza dos idosos. Metodologia: estudo qualitativo, etnografia descritiva; utilizou-se observação participante e entrevista em profundidade. Participaram oito pessoas de 60 anos e mais, em situação de inabilidade e pobreza, na Comuna 9. O referente do trabalho para a análise de dados qualitativos foi a proposta de Leininger. Observaram-se critérios de credibilidade, confirmabilidade, significado no contexto e saturação. Obteve-se o consentimento informado.Achados: a relação entre o contexto sociocultural e o cuidado da saúde é dinâmica e reflete a cultura cartageneira. Existem crenças sobre cosas que “suportam a saúde”, “cuidam a saúde ou causam doença” e coisas que “enfermam e matam”; além de práticas de cuidado que vão entre fazer e não fazer nada para cuidarem da saúde.Conclusão: as crenças e práticas de cuidado da saúde revelam como a cultura permeia todas as áreas da vida das pessoas e muda com o desenvolvimento delas.

Creencias y prácticas de cuidado de la salud de ancianos en situación de discapacidad y pobreza en la Comuna 9 de Cartagena / Beliefs and health care practices of the elderly in a situation of disability and poverty in Commune 9 of Cartagena

Introducción: Las creencias y prácticas de cuidado de la salud son expresiones de la cultura de cuidado de los grupos sociales. Objetivos: -Analizar el contexto sociocultural de la Comuna 9 de Cartagena y su influencia en el cuidado de la salud de estos ancianos. -Analizar las creencias y prácticas de cuidado de la salud de los ancianos en situación de discapacidad y pobreza, en la Comuna 9 de Cartagena. -Aproximarse a la comprensión de los conceptos de salud, vejez, discapacidad y pobreza de estos ancianos. Metodología: Estudio cualitativo, etnografía descriptiva, se utilizó observación participante y entrevista a profundidad. Participaron ocho personas de 60 años y más, en situación de discapacidad y pobreza, en la Comuna 9 de Cartagena. Se tomó como referente la propuesta de Leininger para el análisis de datos cualitativos. Se cumplieron criterios de credibilidad, auditabilidad, confirmabilidad, significado en el contexto y saturación. Se obtuvo el consentimiento informado. Hallazgos: La relación entre el contexto socio-cultural y el cuidado de la salud es dinámica y refleja la idiosincrasia cartagenera. Existen creencias sobre cosas que "sostienen la salud", "cuidan la salud o causan enfermedad" y cosas que "enferman y matan"; y prácticas de cuidado que se mueven en un continuo entre hacer y no hacer nada para cuidar la salud. Conclusiones: Las creencias y prácticas de cuidado de la salud develan como la cultura permea todas las áreas de la vida de las personas y cambia con el desarrollo de las mismas.

Introduction: The beliefs and practices of health care are expressions of culture care of social groups. Objectives: - Analyze the sociocultural context of "La Comuna 9" Cartagena and its influence on health care for the elderly. - Analyze the beliefs and practices of health care for the elderly in situations of disability and poverty in "La Comuna 9" Cartagena. - Getting closer to understanding the concepts of health, old age, disability and poverty of the elderly. Methodology: Qualitative and descriptive ethnographic research, used participant observation and depth interviews. Eight participants 60 years old or more on disability and poverty situation in "Comuna 9", Cartagena. It met the criteria of credibility, auditability, confirmability, meaning in the context and saturation. Was taken as reference Leininger's proposal for analysis of qualitative data. Informed consent was obtained. Findings: The relationship between the socio-cultural context and health care is dynamic and reflects the idiosyncrasies of Cartagena. There are beliefs about things that "health claim", "health care or cause disease" and things that "sicken and kill", and care practices that move along a continuum between doing and not doing anything for health care. Conclusions: The beliefs and practices of health care reveal how culture permeates all areas of life of individuals and change with their development.