Comparação entre idosos que sofreram quedas segundo desempenho físico e número de ocorrências / Physical performance and number of falls in older adult fallers

Objetivos: Analisar, entre idosos com ocorrência de quedas, a relação entre as variáveis sociodemográficas, clínicas, físicas e funcionais segundo as variáveis critério desempenho físico e número de quedas. MÉTODOS: Estudo transversal com 72 idosos (76,3±8,3 anos) que sofreram quedas no último ano, sendo 65,3 por cento mulheres, atendidos no ambulatório de geriatria de um hospital universitário de Campinas, SP. Os idosos foram divididos em grupo com pior (PDF) e grupo com melhor desempenho físico (MDF), e em grupo com uma queda (1Q) e grupo com duas quedas ou mais (2Q). As características sociodemográficas, clínicas, físicas e funcionais foram as variáveis independentes do estudo. Foi realizada análise de comparação entre os grupos. RESULTADOS: Os idosos do grupo PDF tiveram maior faixa etária, maior número de doenças e menor independência na maior parte das tarefas da dimensão motora em relação ao grupo MDF. Os idosos do grupo 2Q apresentaram maior número de doenças, menor força de preensão manual e menor independência na tarefa "controle das fezes" na dimensão motora da medida de independência funcional (MIF) em relação ao grupo 1Q. CONCLUSÕES: Entre idosos que já caíram, piores níveis de desempenho físico relacionam-se com maior faixa etária, mais doenças e menos independência funcional. Além disso, ter sofrido quedas recorrentes relaciona-se com mais doenças, menos força muscular e menos independência funcional na tarefa de controle de fezes.

Objectives: The aim of this study was to determine the relationship between sociodemographic, clinical, physical and functional data according to physical performance and number of falls among older fallers. METHODS: Cross-sectional study carried out among 72 older adults (76.3 ±8.3 years) with a history of falls in the past year, 65.3 percent of which were women. The participants received care at the geriatric outpatient clinic of a university hospital in Campinas, SP. They were divided into the following groups: worst physical performance (WPP) and best physical performance (BPP), one-time fallers (1F) and frequent fallers (2F). Sociodemographic, clinical, physical and functional characteristics were considered as independent variables. Comparison analysis between the groups was conducted. RESULTS: The WPP group was older and had a higher number of illnesses and less independence in most motor dimension tasks compared to the BPP group. The 2F group had a higher number of illnesses, less handgrip strength and less independence in the bowel management task in the motor dimension of the Functional Independence Measure (FIM) compared to the 1F group. CONCLUSIONS: Among older adults fallers, poor physical performance is associated with more advanced age, more illnesses and less functional independence. Moreover, recurrent falls are associated with more illnesses, less muscle strength and less functional independence in the bowel management task.

Psychometric properties of the Minnesota Living with Heart Failure--Brazilian version--in the elderly.

BACKGROUND: Heart failure (HF) has implications for the quality of life for any age range, more so for the elderly who simultaneously present other limitations imposed by multiple co-morbidities. Although there are several instruments to measure Health Related Quality of Life (HRQL), none is specific to the elderly with HF. Among disease-specific instruments, Minnesota Living with Heart Failure(LHFQ) has not been studied extensively among the elderly with respect to its psychometric properties. OBJECTIVE: The purpose of this study was to evaluate the convergent, divergent and discriminative validity of the Brazilian version of LHFQ applied to elderly HF patients. METHOD: One hundred and seventy (170) elderly were interviewed. LHFQ capacity to discriminate subjects among New York Heart Association (NYHA) Classes I, II and III/IV was analyzed. Convergent and divergent validity was evaluated through the correlation between the domains of LHFQ and the generic instrument, Medical Outcomes Study (MOS) 36-item Short-Form Health Survey (SF-36). RESULTS: The LHFQ total score and physical dimension sub-scale discriminated between the three sub-groups of NYHA Classes I, II and III/IV (P < .0001). The emotional dimension discriminated NYHA Classes I and III/IV (P = .0034). The physical and emotional dimensions of the LHFQ and SF-36 were significantly correlated (coefficients from .46 to .70 for physical dimension and from .31 to .65 for emotional dimension). However, contrary to expectations, the divergent validity was not totally confirmed as there was no difference in the magnitude of the correlations between the LHFQ emotional and physical dimensions and the SF-36 role physical, social functioning and role emotional. Thus, the results suggest that LHFQ seems to be a valid tool to measure HRQL in the elderly, but new studies remain necessary to gain a better understanding of its discriminative validity for more advanced NYHA functional classes and for its divergent validity.

[Stories by the elderly]. / Lo que cuentan los ancianos.

This Brazilian article bears interest for its qualitative methodology which allows us to get a feeling for the elderly of this country being able to relate the results of their lives and knowledge to our own. The lack of an educational health program for the elderly led the authors to create the Health Care Group for the Elderly (GRASI in Portuguese) in which we developed an educational program based on the social-historical perspective of L. S. Vygotsky. This current study analyzes the dynamic speeches recorded by a group of elderly in the GRASI educational program. A group of seven elderly people, from both sexes, having an age equal to or greater than 60, participated in an analysis of the content from meetings among themselves. To analyze the data obtained, in the underlying text as well as their recorded speech, the feelings and meanings of their conversations and stories were identified and separated into thematic units. The results obtained reveal that the opportunity to express their experiences regarding the transformation the elderly have lived during their lives, and to find new ways to treat health problems or how to carry out self health care, is an important resource for elderly nursing care which can lead to the development of health education programs.

Lo que cuentan los ancianos. Su discurso como base de la educación para la salud / Stories by the elderly

Artículo brasileño, interesante por su metodología cualitativa que nos acerca al sentir de los ancianos en este país, pudiendo extrapolar sus resultados al nuestro. La inexistencia de un programa de educación para la salud de ancianos nos llevó a crear el Grupo de Atención de Salud del Anciano (GRASI), en el cual desarrollamos un programa de educación planteado en la perspectiva socio-histórica de L.S.Vygotsky. El presente estudio analiza la dinámica discursiva de un grupo de ancianos del programa de educación del GRASI. Un grupo de siete ancianos, de ambos sexos, con edad igual o mayor que 60 años, participó en el análisis del contenido de los encuentros entre ellos. Para analizar los datos fueron identificados, en el subtexto e intertexto, los sentidos y significados de los discursos, agrupándolos en unidades temáticas. Los resultados revelan que la oportunidad para expresarse al respecto de las transformaciones vividas, y para encontrar nuevas formas de atención para la salud y para el autocuidado, representa un recurso importante para la enfermería gerontológico a fin de desarrollar programas de educación para la salud

This Brazilian article bears interest for its qualitative methodology which allows us to get a feeling for the elderly of this country, being able to relate the results of their lives and knowledge to our own. The lack of an educational health program for the elderly led the authors to create the Health Care Group for the Elderly (GRASI in Portuguese) in which we developed and educational program based on the social-historical perspective of L. S. Vygotsky. This current study analyzes the dynamic speeches recorded by a group of seven elderly people, from both sexes, having an age equal to or greater than 60, participated in an analysis of the content form meetings among themselves. To analyze the data obtained, in the underlying text as well as their recorded speech, the feelings and meanings of their conversations and stories were identified and separated into thematic units. The results obtained reveal that the opportunity to express their experiences regarding the transformation the elderly have lived during their lives, and to find new ways of treat health problems or how to carry out self health care, is an important resource for elderly nursing care which can lead to the development of health education programs

Avaliaçäo de programa educativo para portadores de glaucoma / Evaluation of an educational program for patients with glaucoma

Avaliar o resultado da implementaçäo de um programa de educaçäo à saúde a glaucomatosos; fornecer subsídios para a implantaçäo de um programa de educaçäo à saúde dos portadores de glaucoma atendidos em um serviço universitário. Foi realizada entrevista com 50 portadores de glaucoma, através de questionário, seguida de reuniäo na qual se aplicou o programa de educaçäo à saúde. Após um intervalo médio de 2,7 meses, realizou-se nova entrevista onde os portadores de glaucoma foram submetidos ao mesmo questionário, com o acréscimo de questöes sobre a importância atribuída às orientaçöes recebidas e sobre as modificaçäoes no autocuidado. Näo houve melhora significativa no conhecimento sobre a identificaçäo da doença ocular, os efeitos colaterais, o significado do glaucoma, a importância do tratamento, a finalidade da terapêutica e o valor normal da pressäo intra-ocular. Houve melhora significativa na técnica de instilaçäo dos colírios e em relaçäo ao conhecimento sobre a importância da hereditariedade e a finalidade da campimetria. Os autores concluem que o programa foi insuficiente para a apreensäo de todo o seu conteúdo cognitivo. Os resultados podem ser conseqüentes ao tipo de processo ensino-aprendizagem, desenvolvido de forma vertical, que näo atende à necessidade de informaçäo dos glaucomatosos e à sua dificuldade de compreensäo, decorrente do baixo nível cultural, de escolaridade e de fatores psicossociais relacionados à doença e condiçöes de vida

Orientaçäo pré-operatória a pacientes com catarata e indicaçäo de cirurgia ambulatorial: relato de experiência / Preoperative care of patients with cataract before they are submitted to ambulatory surgery

O pacientes com indicaçäo de cirurgia ambulatorial necessitam de orientaçäo pré-operatória. O estudo descreve um programa de orientaçäo pré-operatória a pacientes com catarata e indicaçäo de cirurgia ambulatorial em um hospital de ensino. Utiliza como método a orientaçäo sistematizada, por meio de reuniöes com 15 pacientes cada e seus acompanhantes. Tem como objetivos, propiciar aos pacientes uma compreensäo sobre a catarata, orientá-los sobre os cuidados peri-operatórios, possibilitar uma avaliaçäo de enfermagem e contribuir para a reduçäo do número de abstençöes e suspensäo de cirurgias. As autoras analisam as preocupaçöes expressas pelos pacientes em relaçäo à catarata, procedimento cirúrgico e cuidados pós-operatórios. Apontam as limitaçöes encontradas e concluem que o programa é relevante para a participaçäo mais efetiva do paciente e sua adesäo ao tratamento.