Relationship between Falls and the Use of Medications and Diseases in an Otago Exercise Programme in Old People Living in the Community in Spain.

(1) Background: Falls are a significant health problem among older adults, and can result in severe injuries, disability, and even death. In Spain, the prevalence of falls is lower if the person lives in the community than if they are institutionalized. Research has shown that exercise is an effective strategy for reducing the risk of falls among older adults. The objective of this study was to study the influence of a multicomponent exercise intervention on falls in people between 65 and 80 years of age despite the presence of diseases and drug use that are risk factors for falls; (2) Methods: This is a quasi-experimental study that focuses on people aged 65-80 who attended 21 primary healthcare centres. Target: Inclusion criteria were people between 65 and 80 years of age, living in the community with independent ambulation, and who were served by the healthcare centre of their region. Variables analysed: The number and characteristics of falls, sociodemographic, drug use, and previous diseases; (3) Results: The drugs associated with falls are benzodiazepines (OR 2.58), vasodilators (OR = 2.51), and psychotropics (OR = 1.61). For one of the years, a relationship was found between the consumption of antidepressants and falls (OR = 1.83). The associated diseases were mental and behavioural (OR = 2.53); (4) Discussion: The intervention has been related to the reduction in falls in people who consumed benzodiazepines, vasodilators, and psychotropics and in people with mental disorders; (5) Conclusion: This research concludes the importance of the implementation of the Otago Exercise Programme in the prevention of falls in the elderly.

Efecto del Programa de Ejercicios de Otago en la fragilidad de personas entre 65 y 80 años / Effect of the Otago Exercise Programme on the frailty of people between 65 and 80 years old

Objetivo: Evaluar el efecto del Programa de Ejercicios de Otago en la fragilidad de personas entre 65 y 80 años no institucionalizadas y estudiar factores asociados a la fragilidad. Método: Estudio pre-post test (basal y tras 12 meses) sin grupo control en personas de entre 65-80 años (que viven en la comunidad y con deambulación independiente) tras formarles en el Programa de Ejercicios de Otago en 5 sesiones: semanas 1, 2, 4 y 8, y una sesión de refuerzo a los 6 meses. Los pacientes se seleccionaron en 3 áreas de salud (n=200). La fragilidad se evaluó con la escala FRAIL. Resultados: Las personas que comenzaron el estudio fueron 198 y terminaron el seguimiento de 12 meses 161. La edad promedio de la muestra fue de 72,28 años; predominio del sexo femenino: 64,65%; nivel de estudios bajo 76,50%; personas viviendo solas 24,50%; sobrepeso en el 42% y obesidad grado i en el 32,32%. Se observan diferencias significativas con p=0,023 en el nivel de fragilidad entre el momento basal y a los 12 meses. El análisis exploratorio permitió identificar diferencias significativas antes y después de la intervención por sexo (ser mujer) (p=0,018) y condición de vivir solo (p=0,0468). Conclusiones: El Programa de Ejercicios de Otago presenta resultados positivos en la fragilidad en personas de 65 a 80 años y puede ayudar a mantener la funcionalidad y evitar su deterioro.(AU)

Aim: To evaluate the effect of the Otago Exercise Programme on the frailty of non-institutionalized people between 65 and 80 years of age and study factors associated with frailty. Method: Pre-post test study (baseline and after 12 months) without control group in people aged 65-80 years (living in the community and with independent ambulation) after being trained in the Otago Exercise Programme in 5 sessions: weeks 1, 2, 4 and 8, and a reinforcement session at 6 months. Patients were recruited from 3 health areas (n=200). Frailty was assessed with the FRAIL scale. Results: There were 198 people who started the study and 161 completed the 12-month follow-up. The average age of the sample was 72.28 years; predominance of female sex: 64.65%; low educational level 76.50%; people living alone 24.50%; overweight in 42%, and grade i obesity in 32.32%. Significant differences were observed with a P=.023 in the level of frailty between baseline and 12 months. The exploratory analysis identified significant differences before and after the intervention by sex (being a woman) (P=.018) and condition of living alone (P=.0468). Conclusions: The Otago Exercise Programme shows positive results in frailty in people 65 to 80 years of age and can help maintain function and prevent deterioration.(AU)

Effect of the Otago Exercise Programme on the frailty of people between 65 and 80 years old.

AIM: To evaluate the effect of the Otago Exercise Programme on the frailty of non-institutionalized people between 65 and 80 years of age and study factors associated with frailty. METHOD: Pre-post test study (baseline and after 12 months) without control group in people aged 65-80 years (living in the community and with independent ambulation) after being trained in the Otago Exercise Programme in 5 sessions: weeks 1, 2, 4 and 8, and a reinforcement session at 6 months. Patients were recruited from 3 health areas (n = 200). Frailty was assessed with the FRAIL scale. RESULTS: There were 198 people who started the study and 161 completed the 12-month follow-up. The average age of the sample was 72.28 years; predominance of female sex 64.65%; low educational level 76.50%; people living alone 24.50%; overweight in 42%, and grade I obesity in 32.32%. Significant differences were observed with a P = .023 in the level of frailty between baseline and 12 months. The exploratory analysis identified significant differences before and after the intervention by sex (being a woman) (P = .018) and condition of living alone (P = .0468). CONCLUSIONS: The Otago Exercise Programme prevents positive results in frailty in people 65 to 80 years of age and can help maintain function and prevent deterioration.

The effect that the Otago Exercise Programme had on fear of falling in community dwellers aged 65-80 and associated factors.

BACKGROUND: Falls are a major public health problem. Fear of falling is highly prevalent amongst community-dwelling older adults who have already fallen and it is also a risk factor for recurrent falls. There has been limited research about the impact that exercises programs have on the fear of falling. The aim of this study was to evaluate whether the Otago Exercise Programme (OEP) reduced the fear of falling in non-institutionalised people aged 65-80 years in Spain. It also evaluated the factors associated with the fear of falling. METHODS: This was a quasi-experimental study that focused on people aged 65-80 who attended 21 primary healthcare centres, lived in the community, were able to walk independently and provided written, informed consent. They were recruited from September 2017 to December 2019. The OEP sessions took place at the primary healthcare centres and were provided on an individual or group basis by trained OEP instructors. The participants attended five weekly sessions, where they were given exercises to develop their strength, balance and endurance. They then continued the programme at home. The subjects were followed up 12 months after baseline and the analyses included a bivariate analysis and a multivariate analysis with logistic regression. RESULTS: We enroled 498 patients (67.07% female) with an average age of 71.81 years. More than two-thirds (65.06%) lived with a partner and 42.37% were overweight. Significant reductions were observed in the mean level of fear of falling between baseline and 12 months (p = 0.000). A number of factors associated with fear of falling also showed significant differences. These were: age (p = 0.033), sex (p = 0.000), living alone (p = 0.000), body mass index (p = 0.003) and whether psychotropic drugs were used (p = 0.000). The multivariate analysis showed a moderate to high fear of falling amongst participants who were female (p = 0.000), 72-80 years of age (p = 0.017), obese (p = 0.045) and used psychotropic drugs (p = 0.021). CONCLUSIONS: Taking part in the OEP reduced the overall fear of falling. There were significant associations between fear of falling and being female, taking psychotic drugs and having a history of falls. This study is a quasi-experimental sign nested an experimental study (randomized controlled trial previously published and registered on ClinicalTrials.org (NCT03320668)). Retrospectively registered on 25/10/2017.

The Relation between Functional Performance, Falls and Previous Falls Among Participants in the Otago Programme: A Secondary Data Analysis.

Fall prevention is a key priority in healthcare policies. Multicomponent exercises reduce the risk of falls. The purpose of this study is to describe the relationship between functional performance and falls after following the Otago multicomponent exercise programme and previous falls. A prospective multi-centre intervention study was performed on 498 patients aged over 65 in primary care, with or without a history of previous falls. Sociodemographic, anthropometric and functionality data were collected. The primary outcome was the occurrence of falls; functional performance was measured using the Tinetti, Short Physical Performance Battery and Timed Up and Go tests. Among the patients, 29.7% referred to previous falls. There was a statistically significant (p < 0.001) increase in falls at 6 months (10.1%) and at 12 months (7.6%) among participants with previous falls in the baseline assessment compared to those without. In addition, the existence of previous falls could be considered a risk factor at 6 and 12 months (OR =2.37, p = 0.002, and OR = 1.76, p = 0.046, respectively). With regard to balance and gait, differences between the groups were observed at 6 months in the Tinetti score (p < 0.001) and in the baseline assessment Timed Up and Go score (p < 0.044). Multicomponent exercises improve the fall rate, balance and gait in older people, although this improvement is less in people with previous falls. Earlier intervention and tailoring of exercises in patients with previous falls could help improve outcomes.

Enfermería Familiar y Comunitaria: claves de presente, retos de futuro / Community and family nurse: Present keys, future challenges

El/la enfermero/a de familia y comunitaria es el profesional que a través de una mirada integral y holística asume la misión de acompañar a las personas desde su nacimiento hasta la muerte para desarrollar su potencial de salud, promocionando los diferentes entornos familiares, laborales y sociales para facilitar dicho desarrollo. A lo largo de la historia, diversos organismos de ámbito internacional, europeo y nacional, han ido regulando la figura de estos profesionales de enfermería de familia y comunitaria, hasta la fecha actual, donde existe normativa que regula de pleno derecho sus funciones, atribuciones y desempeño profesional. El personal de enfermería de familia y comunitaria puede dar respuestas a las necesidades de una población cambiante, y que asume nuevas responsabilidades en la gestión y la investigación. Sus amplias competencias básicas y avanzadas recogidas en un riguroso programa formativo suponen una mejora para el sistema sanitario, la profesión enfermera y la ciudadanía y la comunidad en la que vive. Aún existen muchos retos para que cada Consejería de Salud de cada comunidad haga posible que esta especialidad desarrolle todo su potencial de mejora de los cuidados

It is the mission of the Community and Family Nurse through an integral and holistic approach to accompany people from cradle to death in developing their health potential, and promote different family, work and social environments to facilitate this development. Throughout history, various international, European and national organizations have regulated the figure of the Community and Family Nurse, and now their functions, powers and professional performance are fully regulated. The Community and Family Nurse can respond to the needs of a changing population and take on new responsibilities in management and research. Their extensive basic and advanced skills gathered under a rigorous training programme, benefit the health system, the nursing profession, citizenry and its communities. Many challenges remain for the Health Departments of each Autonomous Region to make it possible for this specialty to develop its full potential for improving care

Community and family nurse: Present keys, future challenges. / Enfermería Familiar y Comunitaria: claves de presente, retos de futuro.

It is the mission of the Community and Family Nurse through an integral and holistic approach to accompany people from cradle to death in developing their health potential, and promote different family, work and social environments to facilitate this development. Throughout history, various international, European and national organizations have regulated the figure of the Community and Family Nurse, and now their functions, powers and professional performance are fully regulated. The Community and Family Nurse can respond to the needs of a changing population and take on new responsibilities in management and research. Their extensive basic and advanced skills gathered under a rigorous training programme, benefit the health system, the nursing profession, citizenry and its communities. Many challenges remain for the Health Departments of each Autonomous Region to make it possible for this specialty to develop its full potential for improving care.

La modificación de los hábitos y la adherencia terapéutica, clave para el control de la enfermedad crónica / Modifying habits and treatment adherence, essential for controlling the chronic disease

La adherencia terapéutica es el grado en que el comportamiento de una persona (tomar medicación, seguir un régimen alimentario y ejecutar cambios del modo de vida) se corresponde con las recomendaciones sanitarias. Es, pues, un fenómeno múltiple, complejo y cambiante: se puede ser adherente total o parcialmente al tratamiento, así como en unos momentos o circunstancias sí y en otros no. La falta de adherencia es un problema inquietante por su gran magnitud y por su complejidad (con más de doscientos factores relacionados), responsable del aumento de la morbimortalidad, complicaciones, ingresos hospitalarios, costes sanitarios e insatisfacción del usuario y de los sanitarios. El objetivo de este artículo es presentar y desarrollar algunas de las intervenciones eficaces en la modificación de hábitos y la mejora de la adherencia tanto cognitivas (educación y mejora de la comunicación) como conductuales (comportamiento y motivación). Las áreas de intervención abarcan el tratamiento farmacológico, los hábitos y estilos de vida y el apoyo social y familiar. De los modelos que se proponen el más eficaz enfatiza el autocuidado y la autoresponsabilidad del usuario para gestionar su enfermedad y aumentar la adherencia terapéutica

Therapeutic adherence is defined as the extent to which a person’s behavior (taking medications, following a diet and changes in lifestyle) coincides with health recommendations(WHO, 2004). We can deduce that is a multiple, complex and changing phenomenon, that there can be total or partial adherence to a treatment, and depending on timing and circumstances. Lack of adherence is a worrying problem; due to its great magnitude and complexity (over two hundred factors) it is responsible for the increased morbid-mortality, complications, hospital admissions, health costs, and dissatisfaction of the user and health professionals. In this paper we develop effective interventions in changing habits and improving adherence: cognitive (education and improved communication), behavior and motivation. Interventions areas include pharmacological treatments, habits and life style, as well as social and family support. The most effective model emphasizes self-care and self-responsibility of the user to manage their disease and increase adherence

[Modifying habits and treatment adherence, essential for controlling the chronic disease]. / La modificación de los hábitos y la adherencia terapéutica, clave para el control de la enfermedad crónica.

Therapeutic adherence is defined as the extent to which a person's behavior (taking medications, following a diet and changes in lifestyle) coincides with health recommendations (WHO, 2004). We can deduce that is a multiple, complex and changing phenomenon, that there can be total or partial adherence to a treatment, and depending on timing and circumstances. Lack of adherence is a worrying problem; due to its great magnitude and complexity (over two hundred factors) it is responsible for the increased morbid-mortality, complications, hospital admissions, health costs, and dissatisfaction of the user and health professionals. In this paper we develop effective interventions in changing habits and improving adherence: cognitive (education and improved communication), behavior and motivation. Interventions areas include pharmacological treatments, habits and life style, as well as social and family support. The most effective model emphasizes self-care and self-responsibility of the user to manage their disease and increase adherence.

Calidad percibida sobre el Trabajo Fin de Gradopor estudiantes del curso de Adaptación al Grado para Diplomados en Enfermería / Perceived quality of the End of Course Project by students in the Course of Adaptation to the Degree for Registered Nurses

Objetivos: conocer las características socio-profesionales del grupo de estudiantes del Curso de Adaptación al Grado (CAG) y la satisfacción percibida por ellos respecto al Trabajo Fin de Grado (TFG).Método: estudio descriptivo transversal, en la Escuela de Enfermería del SESPA (Gijón), durante el curso 2010-2011. La población estudiada fueron los alumnos del CAG de la primera promoción de dicha escuela. La información sobre las características socio-profesionales se obtuvieron de los currículum vítae que los estudiantes habían proporcionado. Se diseñó, pilotó y distribuyó una encuesta para explorar la calidad percibida respecto a: desarrollo del TFG, tutorización y método de evaluación, medida mediante una escala tipo Liker en la que el valor mínimo era uno y el máximo seis. Resultados: el perfil medio de la población estudiada es una enfermera proveniente de la práctica clínica, con edad inferior a 40 años y experiencia laboral media de 11, que ha realizado una importante cantidad de cursos “comerciales” y menos de cursos con garantías de calidad, con limitado bagaje de aportaciones científicas en eventos, publicaciones e investigaciones. La calidad percibida es alta respecto a la asignatura, la tutorización y la evaluación. Conclusiones: todas estas características deben tenerse en cuenta en la planificación de la docencia del CAG y en concreto del TFG (AU)

Objectives: to learn about the socio-professional characteristics of the group of students in the Course of Adaptation to the Degree (CAE), and the satisfaction perceived by them regarding the End of Course Project(ECP).Method: transversal descriptive study, in the SESPA School of Nursing (Gijón) during the 2010-2011 term. The population studied was the CAE students in the first class of said school. Information about the socio-professional characteristics was obtained from curriculum vitae provided by students. A survey was designed, tested and distributed, in order to explore the quality perceived in terms of: ECP development, tutoring and method of assessment, measured through a Liker-type scale, in which the minimum value was one and the maximum was six. Results: the average profile of the studied population is that of a nurse coming from clinical practice, under 40-year-old, and with a median work experience of 11 years, who has completed a major number of “commercial” courses, and a lower number of courses with quality guarantee, and with a limited background regarding scientific contributions in events, publications and research. There is a perception of high quality regarding the course subject, tutoring and assessment. Conclusions: all these characteristics must be taken into account in the CAD teaching plan, and specifically for the ECP (AU)

«Agrega salud a tus años». Proyecto de intervención en personas mayores / No disponible

No disponible

Calidad de vida relacionada con la salud en cuidadoras de personas dependientes de dos zonas rurales de León / Quality of life related to health in caregivers of dependent people in two rural areas of León

Objetivo. Estudiar la calidad de vida relacionada con la salud y la relación con el apoyo social, la función familiar y el nivel de carga de cuidadoras de personas con un nivel medio/alto de dependencia. Método. Estudio transversal en personas de Villablino y Palacios del Sil que cursen una solicitud de dependencia en el 2007. Se administró un cuestionario para explorar las características socioeconómicas, función familiar (APGAR familiar), apoyo social (Duke-Unc), calidad de vida relacionada con la salud (láminas Coop-Wonca) y nivel de carga (Zarit) de los cuidadores. Se realizó un análisis descriptivo para cada una de las variables, y para el análisis bivariable se utilizó el coeficiente de Spearman y el coeficiente de correlación de Pearson para las cuantitativas continuas. Resultados. Contestó el 79,31% de la población diana (58 personas), edad media de 55,74 años (DE = 11,6), el 82,6% mujeres. El 45,7% (21) tiene un bajo apoyo social y el 76,1% (35) son familias normofuncionales. El 67,4% (31) presentaba una sobrecarga intensa. Se obtuvo una relación positiva, estadísticamente significativa (p<0,05), entre la calidad de vida relacionada con la salud, la función familiar, el apoyo social percibido y la negativa con la sobrecarga del cuidador. Conclusiones. La calidad de vida relacionada con la salud en las cuidadoras es mejor en las que tienen un buen apoyo familiar y social, un buen estado de salud y mantenían su nivel de actividad física y sentimientos positivos. Empeoraba cuando disminuía el apoyo social y aumentaba el nivel de carga(AU)

Objectives. To study the quality of life related to health and the relationship with the social support, family function and the level of overload for carers of people with a medium/high level of dependence have. Results. A total of 79.31% of the target population (58 people) answered the questionnaire, with an average age of 55.74 years (standard deviation=11.6), 82.6% (38) women, and 45.7% (21) have a low social support and 76.1% (35) are normal functioning families. A total of 67.4% (31) had an intense burden. There was a statistically positive significant relationship (P<0.05) between the quality of life associated with health and family function and perceived social support, and a negative significant relationship with the burden of the caregiver. Conclusions. The quality of life related to health in caregivers is better in those with a good social and family support, a good state of health, and they maintained their level of physical activity and positive feelings, but it got worse when the social support decreased and the level of overload increased(AU)

[Quality of life related to health in caregivers of dependent people in two rural areas of León]. / Calidad de vida relacionada con la salud en cuidadoras de personas dependientes de dos zonas rurales de León.

OBJECTIVES: To study the quality of life related to health and the relationship with the social support, family function and the level of overload for carers of people with a medium/high level of dependence have. METHOD: Cross-sectional study of people in Villablino Palacios del Sil making a Dependence Application in 2007. A questionnaire was administered to explore the socioeconomic characteristics, family function (Apgar Family), social support (Duke-UNC), quality of life related to health (Coop-wonca sheeting) and burden level (Zarit) of caregivers. A descriptive analysis was carried out for each one of the variables, and for the bivariate analysis the Spearman rank correlation coefficient, and Pearson's correlation coefficient were used for the continuous variables. RESULTS: A total of 79.31% of the target population (58 people) answered the questionnaire, with an average age of 55.74 years (standard deviation=11.6), 82.6% (38) women, and 45.7% (21) have a low social support and 76.1% (35) are normal functioning families. A total of 67.4% (31) had an intense burden. There was a statistically positive significant relationship (P<0.05) between the quality of life associated with health and family function and perceived social support, and a negative significant relationship with the burden of the caregiver. CONCLUSIONS: The quality of life related to health in caregivers is better in those with a good social and family support, a good state of health, and they maintained their level of physical activity and positive feelings, but it got worse when the social support decreased and the level of overload increased.