Fatalistic beliefs, self-care, and HbA1c in Mexican men with type 2 diabetes mellitus: A cross-sectional study.

The aim of this study is to examine the relationship between fatalistic beliefs, self-care, and glycemic control among Mexican men with type 2 diabetes mellitus. This is a cross-sectional study in men diagnosed with type 2 diabetes mellitus from 18 to 59 years of age from the Northeast of Mexico. Fatalistic beliefs, self-care, medication adherence, and HbA1C were evaluated. Patients were divided into glycemic control (<7% HbA1c) and without glycemic control (>7% HbA1c). Tests were performed to compare 2 independent groups, Student's t and U Mann Whitney. Correlation tests and multiple linear regression models were also performed. For statistical analysis, the SPSS v27 program was used. Forty-nine percent of the men had glycemic control (<7% HbA1c). Fatalistic beliefs were negatively correlated with self-care and medication adherence, but not with HbA1c. In multiple linear regression models, fatalistic beliefs were a negative predictor of self-care and medication adherence. In the model for HbA1c, the pessimism subdimension and self-care were the predictors. Fatalistic beliefs negatively affect self-care compliance and medication adherence, while the pessimism subdimension was related to the increase in HbA1c.

Conductas del estilo de vida y sarcopenia en personas mayores de Mexicali México: estudio transversal / Lifestyle behaviors and sarcopenia in older adults from Mexicali, Mexico: cross-sectional study

Objetivo principal: Describir la prevalencia de sarcopenia y analizar la influencia de las conductas asociadas del estilo de vida en la sarcopenia en personas mayores residentes de Mexicali, México. Metodología: Se consideró un diseño descriptivo inferencial. Participaron 105 personas mayores de 60 años o más. El muestreo fue no probabilístico. Se evaluaron los criterios diagnósticos para sarcopenia y las conductas asociadas al estilo de vida. La investigación se realizó acorde a la reglamentación ética. Resultados principales: El 24,8% y el 59% presentaron uno de los tres estadios de la sarcopenia acorde a los puntos de corte para la población mexicana y EWGSOP respectivamente. Se encontró asociación con el IMC (p <,01) y sexo (p <,05). Conclusión principal: Se identificó que la prevalencia es menor cuando se consideran los puntos de corte regionales para México. El IMC y el sexo se asociaron con la sarcopenia. (AU)

Objetive: To describe the prevalence of sarcopenia and analyze the influence of lifestyle behaviors associated with sarcopenia in older adults residents of Mexicali, Mexico. Methods: A descriptive inferential design was considered. The participants were 105 older adults. The sampling was non-probabilistic. The research considers the evaluation of the diagnostic criteria for sarcopenia and the behaviors associated with lifestyle. The research considered the current national and international ethical regulations. Results: The 24.8% and 59% presented one of the three stages of sarcopenia according with the cut-off points for the Mexican population and the EWGSOP, respectively. BMI (p <.01) and sex (p <.05) were associated sarcopenia. Conclusions: It was found that the prevalence is lower when considering the regional cut-off points for northern Mexico. Only BMI and gender were associated with sarcopenia. (AU)

Modelo de Competencia Cultural Enfermería-Persona para la Autogestión de la Enfermedad Crónica / Nursing-Person Cultural Competence Model for Self-Management of Chronic Disease

El presente artículo propone un modelo basado en competencia cultural para explicar la conducta de autogestión a través de la interacción de los profesionales de enfermería y las personas con enfermedad crónica. Se utilizó la metodología de subestructuración teórica de Dulock y Holzmer. El modelo propuesto incluye para los profesionales de enfermería la identidad (individual y social), las resistencias a la diversidad cultural, así como la competencia cultural. Para las personas con enfermedades crónicas incluye la identidad (individual y social), la percepción de cuidado culturalmente competente y la autogestión de la enfermedad crónica. La propuesta permite considerar variables que intervienen en la autogestión de las personas con enfermedad crónica a nivel individual, así como aquellas variables que involucran a los profesionales de enfermería y pueden afectar en esta conducta, lo que permite profundizar en esta problemática de salud para el futuro desarrollo de intervenciones.(AU)

This article proposes a model based on cultural competence to explain self-management behavior through the interaction of nursing professionals and people with chronic illnesses. The Dulock and Holzmer theoretical sub-structuring method was used. The proposed model includes identity (individual and social) for nursing professionals, resistances to cultural diversity, and cultural competence. For people with chronic illnesses, it supplies identity (individual and social), the perception of culturally competent care, and self-management of chronic illness. The proposal makes it possible to consider variables that intervene in the self-management of people with chronic disease at the individual level, as well as those that involve nursing professionals and can affect this behavior, allowing us to delve into this health problem for the future—development of interventions.(AU)

Adaptación de personas adultas mayores frente al deterioro cognitivo leve: teoría de rango medio / Adaptation of older adults facing mild cognitive impairment: middle range theory

Objetivo: Describir una propuesta de teoría de rango medio basada en el Modelo de Adaptación de Roy (MAR) que incorpora estrategias de compensación de memoria para la adaptación de personas adultas mayores con deterioro cognitivo leve (DCL). Metodología: Se utilizó la formalización conceptual-teórica-empírica para analizar la congruencia entre los conceptos del modelo parental (MAR) y la teoría propuesta. Resultados: Los conceptos clave retomados son: (a) nivel de adaptación compensatorio (representado por el DCL), (b) estímulos contextuales (edad, sexo, escolaridad, conciencia de problemas de memoria, depresión y ansiedad), (c) estímulo focal (la intervención), (d) subsistema cognator (el uso de compensadores de memoria) y (e) la adaptación general (actividades instrumentales de la vida diaria). Conclusión: La propuesta teórica es congruente con el MAR y capaz de orientar los conceptos de una intervención de enfermería que pretende promover la adaptación ante el DCL en adultos mayores.(AU)

Objective: To describe a middle-range theory proposal based on Roy's Adaptation Model (RAM) that incorporates memory compensation strategies for the adaptation of older adults with mild cognitive impairment (MCI). Methods: Formalization of conceptual-theoretical-empirical structure was used to analyze the congruence between the concepts of the parental model (RAM) and the proposed theory. Results: The key concepts used are: (a) compensatory adaptation level (represented by MCI), (b) contextual stimuli (age, sex, schooling, awareness of memory problems, depression and anxiety), (c) focal stimulus (the intervention), (d) cognator subsystem, represented by the use of memory compensators; and (e) general adaptation (instrumental activities of daily living). Conclusion: The theoretical proposal shows congruence with the RAM and capability to guide the concepts of a nursing intervention that pretends to promote adaptation in older adults facing cognitive decline.(AU)

Estilo de vida del adulto mayor de acuerdo con el nivel socioeconómico, ocupación y vecindario / Elder adult´s lifestyle according to socioeconomic status, occupation and neighborhood

Resumen Objetivo: Conocer si el estilo de vida es determinado por el nivel socioeconómico, ocupación y vecindario de adultos mayores. Materiales y métodos: El estudio fue transversal, correlacional, con muestreo no probabilístico por conveniencia usando medios digitales de grupos conocidos. Se contactaron 101 adultos mayores por correo electrónico, WhatsApp o a través de conocidos. Los datos fueron recolectados mediante la herramienta digital QuestionPro. Se usaron las subescalas del instrumento FANTASTIC: actividad física, nutrición, toxicidad (tabaco), alcohol, sueño, estrés y control de la salud; Neighborhood Environment Walkability Survey; el AMAI para valorar estilos de vida, caminabilidad del vecindario y nivel socioeconómico, respectivamente. así como preguntas abiertas sobre ocupación. Las medidas de tendencia central, dispersión, frecuencias y porcentajes describen las variables continuas y nominales, el Alpha de Cronbach la consistencia interna de los instrumentos y prueba de Kolmogorov Smirnov con corrección de Lilliefors para la distribución de variables. Se usaron coeficientes de correlación de Spearman y modelos de regresión lineal múltiple para responder los objetivos. Resultados: A medida que el nivel socioeconómico mejora las medias de caminabilidad del vecindario aumentan (p < 0.001). El modelo de regresión lineal múltiple fue significativo (p < 0.001), el nivel socioeconómico (p = 0.006) y vecindario (p = 0.005), explican el 28% de la variación de estilos de vida. Conclusiones. El estudio permitió confirmar las teorizaciones en el sentido de que el estatus social y las oportunidades de vida, entendidas como el entorno inmediato juegan un papel importante en la elección del estilo de vida, en este caso representado por nivel socioeconómico y la caminabilidad del vecindario de los adultos mayores. Sin embargo, ello evidencia la desigualdad de oportunidades para mantener un estilo de vida saludable por parte de los adultos mayores, y es a la vez un reto para los profesionales de la salud.

Abstract Objective: To learn if elder adults lifestyle is determined by socioeconomic status, occupation, and neighborhood. Materials and methods: The design was cross sectional, correlational and a convenience non probabilistic sampling through digital social networks of known groups was used. One hundred and one older adults were contacted through e-mail, WhatsApp or by known groups (friends, classmates, professors). Data were collected through the QuestionPro digital tool. Lifestyle was measure using the following subscales: physical activity, nutrition, toxicity (tobacco), alcohol, sleep, stress and health control of the FANTASTIC instrument. Neighborhood's walkability was measured by short version of the Neighborhood Environment Walkability Survey, the AMAI index was used to determine the socioeconomic status, and the type of past or present occupation, activities performed and number of people under their command. Descriptive statistics, Cronbach's Alpha, Kolmogorov Smirnov test with Lilliefors correction, and nonparametric statistics were used. Results: As socioeconomic status went up medians of neighborhood walkability increased (p < 0.001). The linear multiple regression model was significant (p < 0.001); socioeconomic status (p = 0.006), and neighborhood (p = 0.005), explained 28% of the lifestyle variance. Conclusions. The study allowed some theoretical confirmation, in that social status, and life opportunities like environment, play an important role on lifestyle choices, in this study represented by socioeconomic status and neighborhood's walkability of elder adults. But results evidence social inequalities of opportunities to keep a healthy lifestyle by elder adults and at the same time it is a challenge for health professionals.

Feasibility of a Physical Training Intervention With Music in Community-Dwelling Older Women: A Quasi-Experimental Study.

Physical activity performed with music activates important brain areas associated with cognition, emotions, and motor skills. Limited information is available on the feasibility and acceptability of physical activity and music interventions. The current study aimed to (a) determine the feasibility of a physical training intervention with music in older women, and (b) describe the differences between pretest and posttest variables (i.e., cognitive state, immediate memory, executive function, gait parameters [cadence and gait speed], muscle strength, flexibility, and symptoms of depression). Results suggest that the intervention with physical training and music was feasible, given the high acceptability and retention rates, high level of attendance at the sessions, and absence of adverse events. Significant improvements were observed in immediate memory (p ≤ 0.01), executive function (p ≤ 0.05), cadence (p ≤ 0.01), leg strength (p ≤ 0.01), right arm strength (p ≤ 0.01), left arm strength (p ≤ 0.05), symptoms of depression (p ≤ 0.01), and left lower body flexibility (p ≤ 0.05). Therefore, a randomized clinical trial with a larger sample could confirm the effects of this intervention on memory, executive function, cadence, leg strength, arm strength, symptoms of depression, and left lower body flexibility. [Journal of Gerontological Nursing, 48(11), 37-43.].

Estado cognitivo y estrategias de compensación de memoria en personas adultas mayores / Cognitive state and memory compensation stategies in older adults

Resumen Objetivo: Explorar la relación entre el estado cognitivo y las estrategias de compensación de memoria en personas adultas mayores que asisten a un centro de actividades diarias. Materiales y métodos: Se empleó un diseño descriptivo correlacional en 110 adultos mayores asistentes a un centro público de actividades recreativas. Se aplicó una cédula de datos personales, la Evaluación Cognitiva de Montreal y el Cuestionario de Estrategias de Compensación de Memoria. La investigación se realizó bajo la reglamentación vigente en México para la investigación en materia de salud. Resultados: El 54.5% de los participantes presentaron un estado cognitivo adecuado, 29.1% obtuvieron puntajes indicativos de probable demencia y 16.4% de deterioro cognitivo leve. La estrategia de compensación más empleada fue la del tiempo, seguido de las estrategias externas, esfuerzo, interna y confianza. El estado cognitivo se relacionó con las estrategias de confianza (p= 0.002) y esfuerzo (p= 0.013). El grupo con deterioro cognitivo leve uso mayormente la estrategia tiempo (p= 0.026) en comparación con los otros dos grupos. En cambio, el grupo de probable demencia, empleo mayormente la estrategia confianza (p= 0.013). Conclusiones: Ante el declive cognitivo, mayor será la necesidad de apoyarse en otra persona, así como el esfuerzo que realicen para recordar información. Además, las personas adultas mayores con deterioro cognitivo leve emplean más tiempo para lograr recordar, mientras que aquellas con probable demencia, compensan el declive apoyándose en otra persona para recordar. Este conocimiento podría apoyar en un futuro el desarrollo de intervenciones centradas en compensar el daño cognitivo y con ello favorecer a retrasar el declive cognitivo.

Abstract Objective: To explore the relationship between cognitive status and memory compensation strategies in older adults attending a daily activity center. Materials and methods: A descriptive and correlational design was applied in 110 older adults who attended a public recreational activities center. A personal data questionnaire, Montreal Cognitive Assessment, and Memory Compensation Strategies Questionnaire were applied. The research was conducted under the ethical current regulations for health research in Mexico. Results: 54.5% of participants had adequate cognitive status, 29.1% obtained scores indicative of probable dementia, and 16.4% of mild cognitive impairment. The most frequently used compensation strategy was time, followed by external, effort, internal, and reliance strategies. Cognitive status was related to the strategies of confidence (p= .002) and effort (p= .013). The mild cognitive impairment group used more time strategy (p= .026) compared to the other two groups. In contrast, the probable dementia group used more the reliance strategy (p= .013). Conclusions: The greater the cognitive decline, the greater the need to rely on another person, as well as the effort made to remember information. In addition, older adults with mild cognitive impairment spent more time to remember, while those with probable dementia compensated for the decline by relying on another person to remember. This knowledge could support in the future the development of interventions focused on compensating for cognitive impairment and thus help to delay cognitive decline.

Sensory and cognitive functions, gait ability and functionality of older adults.

OBJECTIVE: to know the relationship between the sensory function, gait ability, and cognitive function with dependency in older adults. METHOD: a descriptive cross-sectional design, 146 older adults took part. MEASUREMENTS: Snellen chart, Audiometer, Stereognosia tests, Semmes-Weinstein monofilament, basic aromas and flavors, GAITRite system, Montreal Cognitive Assessment Test, the Barthel Index, and the Lawton and Brody Index. RESULTS: sensory function, cognitive function and gait explain 25% dependence on basic activities of daily life and 21% dependence on instrumental activities of daily life. The variables that influence dependence on basic activities were taste (p=.029), gait speed (p=.009), cadence (p=.002) and step length (p=.001) and, in instrumental activities, gait speed (p=.049), cadence (p=.028) and step length (p=.010). CONCLUSION: gait speed, cadence and stride length are variables that influence both dependence on basic and instrumental activities of daily life.

Sensory and cognitive functions, gait ability and functionality of older adults / Função sensorial, cognitiva, capacidade de caminhar e funcionalidade de idosos / Función sensorial, cognitiva, capacidad de marcha y funcionalidad de adultos mayores

Objective: to know the relationship between the sensory function, gait ability, and cognitive function with dependency in older adults. Method: a descriptive cross-sectional design, 146 older adults took part. Measurements: Snellen chart, Audiometer, Stereognosia tests, Semmes-Weinstein monofilament, basic aromas and flavors, GAITRite system, Montreal Cognitive Assessment Test, the Barthel Index, and the Lawton and Brody Index. Results: sensory function, cognitive function and gait explain 25% dependence on basic activities of daily life and 21% dependence on instrumental activities of daily life. The variables that influence dependence on basic activities were taste (p=.029), gait speed (p=.009), cadence (p=.002) and step length (p=.001) and, in instrumental activities, gait speed (p=.049), cadence (p=.028) and step length (p=.010). Conclusion: gait speed, cadence and stride length are variables that influence both dependence on basic and instrumental activities of daily life.

Objetivo: conhecer a relação entre a função sensorial, capacidade de caminhar e função cognitiva com dependência em idosos. Método: estudo transversal descritivo, com a participação de 146 idosos. Medições: Carta de Snellen, audiômetro, testes de estereognosia, monofilamento de Semmes-Weinstein, aromas e sabores básicos, sistema GAITRite, Montreal Cognitive Assessment Test e índice de Barthel e Lawton e Brody. Resultados: função sensorial, função cognitiva e caminhar explicam 25% de dependência de atividades básicas da vida diária e 21% de dependência de atividades instrumentais da vida diária. As variáveis que influenciam a dependência de atividades básicas foram: paladar (p=0,029), velocidade de caminhar (p=0,009), cadência (p=0,002) e comprimento do passo (p=0,001), e nas atividades instrumentais, velocidade de caminhar (p=0,049), cadência (p=0,028) e comprimento do passo (p=0,010). Conclusão: velocidade de caminhar, cadência e comprimento do passo são variáveis que influenciam a dependência de atividades básicas e instrumentais da vida cotidiana.

Objetivo: conocer la relación entre la función sensorial, capacidad de marcha y función cognitiva con la dependencia en adultos mayores. Método: diseño descriptivo transversal, en que participaron 146 adultos mayores. Mediciones: Carta Snellen, Audiómetro, pruebas de Estereognosia, Monofilamento de Semmes-Weinstein, aromas y sabores básicos, sistema GAITRite, Montreal Cognitive Assessment Test e Índice de Barthel y de Lawton y Brody. Resultados: la función sensorial, función cognitiva y marcha explican el 25% de la dependencia en las actividades básicas de la vida diaria y 21% de la dependencia en actividades instrumentales de la vida diaria. Las variables que influyen sobre la dependencia en actividades básicas fueron gusto (p=0,029), velocidad de marcha (p=0,009), cadencia (p=0,002) y longitud del paso (p=0,001); y en actividades instrumentales, velocidad de marcha (p=0,049), cadencia (p=0,028) y longitud del paso (p=0,010). Conclusión: velocidad de marcha, cadencia y longitud del paso son variables que influyen en la dependencia en actividades básicas e instrumentales de la vida diaria.

Hábitos alimentarios y actividad física en adultos mayores con enfermedad crónica

RESUMEN Objetivo: Determinar los factores relacionados con hábitos alimentarios y actividad física en adultos mayores con enfermedad crónica. Material y Método. Estudio correlacional de corte transversal en 200 adultos mayores de Matamoros, Tamaulipas, México. El trabajo de campo se realizó en el primer semestre de 2019 y mediante un cuestionario ex profeso, se midieron los hábitos alimentarios y actividad física. Se usaron medidas de tendencia central y dispersión para variables continuas; frecuencias y porcentajes para variables cualitativas; prueba de Kolmogorov-Smirnov con corrección de Lilliefors para determinar distribución de variables numéricas; coeficientes de correlación de Spearman para relaciones entre las variables sociodemográficas, enfermedad crónica, hábitos alimenticios y actividad física. El estudio fue aprobado por los comités de ética e investigación (FAEN-D-912). Resultados: El consumo de refrescos (p= ,039), legumbres (p= ,001) y pescado (p= ,005) se relacionó con la escolaridad; la ingesta de agua (p= ,007), legumbres (p< ,001) y escolaridad (p< ,001) se relacionó con la edad; la caminata por semana (p< ,001) y minutos que dedican a caminar (p< ,001) se relacionó con el consumo de agua. Conclusiones. La alimentación y la actividad física en los adultos mayores son importantes para la prevención y control de las enfermedades crónicas y otro tipo de enfermedades. Los resultados de este estudio reflejan la urgencia de intervenir en etapas tempranas para enfatizar hábitos de una alimentación balanceada y la práctica regular de actividad física asociada a la salud.

ABSTRACT Objective: To determine the factors related to eating habits and physical activity in older adults with chronic disease. Material and Method: Cross-sectional correlational study, carried out with 200 older adults from Matamoros, Tamaulipas State, Mexico. The field work was conducted in the first semester of 2019 and eating habits as well as physical activity were measured using an ex profeso questionnaire. Different measures were used: central tendency and dispersion for continuous variables; frequencies and percentages for qualitative variables; Kolmogorov-Smirnov test with Lilliefors correction to determine distribution of numerical variables; Spearman's correlation coefficients for relationships among sociodemographic variables, chronic disease, eating habits and physical activity. The study was approved by the ethics and research committees FAEN-D-912. Results: The consumption of soft drinks (p= .039), legumes (p= .001) and fish (p= .005) were related to schooling; water intake (p= .007), legumes (p< 001) and schooling (p< .001) were related to age; walking per week (p< .001) and walking minutes (p< .001) were related to water consumption. Conclusions: Diet and physical activity in older adults are important for the prevention and control of chronic diseases and other diseases. The results of this study reflect the urgency of early intervention to emphasize balanced eating habits and the regular practice of health-related physical activity.

RESUMO Objetivo. Determinar os fatores relacionados aos hábitos alimentares e atividade física em idosos com doença crónica. Material e Método: Estudo correlacional transversal em 200 idosos de Matamoros, Tamaulipas, México. O trabalho de campo foi realizado no primeiro semestre de 2019 e por meio de um questionário deliberado foram mensurados os hábitos alimentares e a atividade física. Medidas de tendência central e dispersão foram utilizadas para variáveis contínuas; frequências e percentuais para variáveis qualitativas; teste de Kolmogorov-Smirnov com correção de Lilliefors para determinar a distribuição das variáveis numéricas; coeficientes de correlação de Spearman para relações entre variáveis sociodemográficas, doença crónica, hábitos alimentares e atividade física. O estudo foi aprovado pelos comitês de ética e pesquisa (FAEN-D-912). Resultados: O consumo de refrigerantes (p= .039), legumes (p= .001) e peixe (p= .005) foram relacionados à escolaridade; a ingestão de água (p = .007), leguminosas (p= .001) e escolaridade (p= .001) foram relacionadas à idade; a caminhada por semana (p< .001) e os minutos dedicados à caminhada (p< .001) estavam relacionados ao consumo de água. Conclusões: A alimentação e a atividade física em idosos são importantes para a prevenção e o controle de doenças crónicas e outros tipos de doenças. Os resultados deste estudo refletem a urgência de intervir nas fases iniciais para enfatizar os hábitos de uma alimentação equilibrada e a prática regular de atividade física associada à saúde.

Riesgo ecológico para desarrollar Diabetes Mellitus tipo 2: derivación de una teoría de rango medio / Ecological risk to develop Diabetes Mellitus type 2: derivation of a mid-range theory

OBJETIVO: Describir la teoría de rango medio (TRM) "Riesgo ecológico para desarrollar Diabetes Mellitus Tipo 2". METODOLOGÍA: Se aplicó la estrategia "derivación teórica" por Walker y Avant a partir del Modelo Ecológico para la Promoción de la Salud. RESULTADOS: La teoría explica los factores individuales y del entorno involucrados en el riesgo de desarrollar Diabetes Mellitus tipo 2 (DMT2). CONCLUSIÓN: Existen en la literatura factores más allá del ámbito individual que influyen en las conductas de riesgo para desarrollar DMT2. Estos factores se pueden estructurar por medio del desarrollo de una TRM para facilitar la comprensión teórica del fenómeno. En este caso, la TRM se derivó del Modelo Ecológico para la Promoción de la Salud y permitió abordar el riesgo de desarrollar DMT2 desde una perspectiva ecológica

AIM: To describe the theory of mid-range (TRM) "Ecological risk to develop Type 2 Diabetes Mellitus". METHODOLOGY: The "theoretical derivation" strategy proposed by Walker y Avant was applied starting from the Ecological Model for the Promotion of Health. RESULTS: The theory explains the individual and environmental factors involved in the risk of developing Type 2 Diabetes Mellitus (DMT2). CONCLUSION: There are factors in the literature beyond the individual scope that influence risk behaviors to develop DMT2. These factors can be structured through the development of a TRM to facilitate the theoretical understanding of the phenomenon. In this case, the TRM was derived from the Ecological Model for Health Promotion and allowed addressing the risk of developing DMT2 from an ecological perspective

Music therapy intervention in community-dwelling older adults with mild cognitive impairment: A pilot study.

The purpose of the pilot study was twofold, seeking to investigate both the feasibility and preliminary effects of a music therapy intervention on the global cognitive state (attention, immediate and delayed memory, and executive function) and gait parameters (gait velocity, cadence, and right and left stride length) in older adults with mild cognitive impairment (MCI). Sixteen participants attended the one-hour music therapy sessions three times a week for 12 weeks. The intervention was feasible, achieving a retention rate of 84%. Significant effects were found in global cognitive state (p = .001), attention (p = .007), immediate memory (p < .001), delayed memory (p = .001), executive function (p = .002), gait velocity (p = .021), right stride length (p = .007), and left stride length (p = .014). These results suggest that music therapy intervention is a potentially innovative strategy for improving cognition and gait parameters in older adults with MCI.

Factibilidad y aceptabilidad de una intervención multicomponente en adultos mayores frágiles residentes de asilos / Feasibility and acceptability of a multicomponent intervention in frail elderly residents of nursing homes / Viabilidade e aceitabilidade de uma intervenção multicomponente em idosos idosos frágeis de lares de idosos

Objetivo: describir la factibilidad y aceptabilidad de una intervención de ejercicio físico y estrategias de memoria en adultos mayores frágiles viviendo en asilos. Método: estudio de factibilidad realizado en 20 adultos mayores frágiles residentes de dos asilos del área metropolitana de la ciudad de Monterrey, Nuevo León, México. La factibilidad se describe considerando el acceso a los participantes, barreras, procesos y esfuerzo percibido. La aceptabilidad se midió mediante una encuesta con 20 preguntas, aplicada en 12 ocasiones. Resultados: el 90% completó el total de las sesiones programadas. Los participantes evaluaron como aceptables todos los componentes de la intervención (ejercicios, series y repeticiones) y estuvieron satisfechos con el programa. Se observó que a los adultos mayores les llevó más tiempo realizar algunos ejercicios de las estrategias de memoria. Conclusión: la intervención es factible en adultos mayores con fragilidad, residentes en asilos que cuenten con espacio para entregar la intervención. Se recomienda realizar un estudio a mayor escala para evaluar la efectividad de la intervención alargando el tiempo planeado de las estrategias de memoria, continuar utilizando la escala de Borg y monitorear el estado de salud físico y emocional de los adultos mayores.(AU)

Objective: to describe the feasibility and acceptability of a physical exercise and memory strategies intervention in frail elders living in nursing homes. Method: the feasibility study was conducted in 20 frail elders living in two nursing homes in the metropolitan area of the city of Monterrey, Nuevo León, Mexico. Feasibility is described considering the access to participants, barriers, processes and perceived effort. Acceptability was measured using a survey with 20 questions, which was applied 12 times. Results: 90% completed the total of the planned sessions. Participants evaluated as aceptable all the components of the intervention (exercise, sets, and repetitions), and were satisfied with the program. It was observed that older adults took more time to perform some of the memory strategies exercises. Conclusion: the intervention is feasible in frail older adults living in nursing homes that have enough space to deliver the intervention. It is recommended to conduct a study at a larger scale to evaluate the effectiveness of the intervention, planning more time for the memory strategies, continue using the Borg scale, and monitoring the physical and emotional health status of the elderly.(AU)

Objetivo: descrever a factibilidade e aceitabilidade de uma intervenção baseada no exercício físico e estratégias de memória em idosos frágeis de instituições asilares. Método: estudo de factibilidade. Participaram 20 idosos que moravam em duas instituições asilares da região metropolitana da cidade de Monterrey, Nuevo León, México. A factibilidade foi descrita considerando o acesso, barreiras, processo e esforço percebido. A aceitabilidade foi medida com um questionário estruturado com 20 perguntas. O questionário foi aplicado 12 vezes. Resultados: 90% completaram o total de sessões agendadas. Os participantes avaliaram todos os componentes da intervenção como aceitáveis (exercícios, séries e repetições) e ficaram satisfeitos com o programa. Observou-se que levou mais tempo para os idosos realizarem alguns exercícios de estratégias de memória. Conclusão: a intervenção é viável em idosos frágeis que residem em casas de repouso que têm espaço para realizar a intervenção. Recomenda-se a realização de um estudo em maior escala para avaliar a eficácia da intervenção, alongando o tempo planejado das estratégias de memória, continuar usando a escala de Borg e monitorar o estado de saúde física e emocional dos idosos.(AU)

Use of Music Therapy to Improve Cognition in Older Adults With Dementia: An Integrative Review.

BACKGROUND AND PURPOSE: Dementia is considered a public health priority due to physical, psychological, economic, and social repercussions in older adults, their families, and caregivers. To address this issue, healthcare providers can use music therapy as a complementary therapy. This manuscript was elaborated to analyze and synthesize the current evidence of the use of music therapy to improve cognition in older adults with dementia. METHODS: Using the Whittemore and Knafl (2005) method, databases searched were PubMed, CINAHL, Ovid, EBSCO, ProQuest, and PsycINFO, using the terms such as "Music Therapy," "Acoustic Stimulation," "Music," "Cognition," "Memory," "Attention," "Aged," and "Dementia." Studies that met the eligibility criteria were screened by title, abstract and full text. Quality of the studies were evaluated using critical appraisal tools and Cochrane "Risk of Bias" tool. RESULTS: A total of 211 articles were screened by title and abstract, but only 28 articles met the inclusion criteria and were full text screened. Of the 28 articles, only five studies were analyzed and synthesized as they focused specifically on music therapy and cognition. Three of the studies showed that active and active-passive approaches of music therapy produce significant effect on cognition in older adults with dementia. The common characteristic was the participation of music therapists or music teachers who delivered the music therapy sessions that resulted in improved cognition. IMPLICATIONS FOR PRACTICE: As a safe, inexpensive intervention, it should be considered as a complementary therapy to positively impact cognition in older adults with different types of dementia and levels of severity.

Mild cognitive impairment: A concept analysis.

AIM: To clarify the concept of mild cognitive impairment (MCI) and identify its attributes to enhance understanding of its implications for nursing practice and research. BACKGROUND: MCI is a concept that has evolved, thus clarification of this concept is essential for the advancement of nursing science. DESIGN: Walker and Avant's eight steps of concept analysis strategy was used. DATA SOURCE: Manuals of mental disorders and databases such as PubMed, Springer, PsychINFO, Cumulative Index to Nursing and Allied Health Literature, and Education Resources Information Center (ERIC) from 1982 to 2018. REVIEW METHODS: A literature search was conducted using keywords such as "mild," "cognitive," "impairment," and "deterioration." RESULTS: The concept of MCI is defined as the transitional state between cognitive state normal for age and the early manifestation of dementia states. It is characterized by the presence of objective and subjective evidence of impairment in one or multiple cognitive domains, independence in daily activities, can be reversible, and is a risk factor for dementia. CONCLUSIONS: Clarification of MCI serves as a framework for identification, treatment, and interventions that may support healthy aging in older adults.

Teoría de rango medio: procesos familiares que predicen el descontrol glucémico en diabetes mellitus 2 / Middle range theory: family processes predicting glycemic uncontrolled in diabetes mellitus 2 / Teoria de médio alcance: processos familiares que predizem o descontrole glicêmico no diabetes mellitus 2

Objetivo: describir el desarrollo de una teoría de rango medio que contribuya en el abordaje de las perspectivas tanto del individuo como de los integrantes de la familia considerando las relaciones e interacciones que surgen en la dinámica de la vida diaria al experimentar una situación de cronicidad. Método: la teoría fue desarrollada deductivamente del modelo de la organización sistémica, un modelo empleado en la investigación y en la disciplina de enfermería para el abordaje del sistema familiar e individual. Los vínculos entre los conceptos de la teoría se desarrollan bajo los niveles de abstracción planteados por Smith y Liehr. Resultados: el desarrollo de la teoría procesos familiares e individuales y descontrol glucémico en adultos con diabetes mellitus 2 sirve para construir la ciencia de enfermería mediante la integración de la teoría de enfermería existente y el conocimiento empírico. Conclusión: esta teoría ayuda a comprender de mejor forma como se percibe y otorga el apoyo al interior de la familia y la influencia con el automanejo del integrante con diabetes mellitus 2 reflejado en el control glucémico.(AU)

Objective: to describe the development of a mid-range theory that contributes to the approach of the perspectives of both the individual and the members of the family considering the relationships and interactions that arise in the dynamics of daily life when experiencing a situation of chronicity. Method: the theory was developed deductively from the model of the systemic organization, a model used in research and in the discipline of nursing for the approach of the family and individual system. The links between the concepts of the theory are developed under the levels of abstraction proposed by Smith and Liehr. Results: the development of the theory: Family and Individual Processes and Glycemic Decontrol in adults with diabetes mellitus 2 serves to build nursing science through the integration of existing nursing theory and empirical knowledge. Conclusion: this theory helps to better understand how it is perceived and gives support to the interior of the family and the influence with the self-management of the member with diabetes mellitus 2 reflected in glycemic control.(AU)

Objetivo: descrever o desenvolvimento de uma teoria de médio alcance que contribua para abordagem das perspectivas tanto do indivíduo quanto dos membros da familia, considerando as relações e interações que surgem na dinâmica da vida diária ao experimentar uma situação de cronicidade. Método: teoria desenvolvida dedutivamente a partir do modelo de organização sistêmica, um modelo usado na investigação e disciplina de enfermagem para abordar a família e sistema individual. As ligações entre os conceitos da teoria são desenvolvidas sob os níveis de abstração levantados por Smith e Liehr. Resultados: o desenvolvimento da teoria processos familiares e individuais, e descontrole glicémico em adultos com diabetes mellitus 2 serve para construir a ciência de enfermagem mediante a integração da teoría de enfermagem existente e o conhecimento empírico. Conclusão: esta teoria ajuda a compreender de melhor forma como se percebe e fornece o apoio no interior da familia e a influência com o automanejo do integrante com diabetes mellitus 2 refletido no controle glicémico.(AU)

Social Factors Contributing to the Development of Allostatic Load in Older Adults: A Correlational-Predictive Study / Factores sociales que contribuyen al desarrollo de la carga alostática en adultos mayores: un estudio correlacional-predictivo / Fatores sociais que contribuem para o desenvolvimento da carga alostática em idosos: um estudo preditivo correlacional

ABSTRACT Objective: To determine if social factors, such as housing conditions, satisfaction with one's house, neighborhood characteristics, social support, family relations and church attendance affect allostatic load in older adults. Materials and method: A correlational-predictive, cross-sectional study was conducted. The instruments used were sociodemographic data, the perceived family relationships instrument, the Medical Outcomes Study-Social Support Survey and the abbreviated version of the Neighborhood Environment Walkability Scale. The allostatic load biomarkers used were: systolic and diastolic blood pressure, body mass index, waist circumference, waist-hip ratio, total cholesterol, high density lipoprotein, glycated hemoglobin, fibrinogen, and C-reactive protein. Sample size was estimated to contrast the no relation (R2= 0) hypotheis in a multiple lineal regression model with 11 covariables, with a significance level of .05, power of 90% (.90), when coefficient of determination (R2) is .15, resulting in a sample of 131 older adults. The statistical analysis included descriptive measures and generalized linear models. Results: The participants had either medium- or high-risk allostatic load. Multivariate linear regression model analysis showed that better housing conditions, satisfaction with own house, presence of dead-end streets, and church attendance reduce allostatic load, while dangerous traffic increases allostatic load. Conclusions: There are several social factors contributing to the development of allostatic load in older adults. It is necessary to create nursing care strategies toward the social environment to decrease allostatic load in older adults.

RESUMEN Objetivo: determinar si factores sociales como las condiciones de vivienda, la satisfacción con la casa, las características del vecindario, el apoyo social, las relaciones familiares y la asistencia a la iglesia contribuyen al desarrollo de la carga alostática en los adultos mayores. Materiales y método: se realizó un estudio correlacional y predictivo de corte transversal. Los instrumentos utilizados fueron una hoja de datos sociodemográficos, el instrumento de relaciones familiares percibidas, el cuestionario de Apoyo Social y la Escala de Movilidad Activa en el Entorno Comunitario, versión corta. Los biomarcadores de carga alostática utilizados fueron: presión arterial sistólica y diastólica, índice de masa corporal, circunferencia de la cintura, relación cintura-cadera, colesterol total, lipoproteína de alta densidad, hemoglobina glicosilada, fibrinógeno y proteína C-Reactiva. La muestra se calculó para para el contraste de la hipótesis de no relación (R2= 0), en un modelo de regresión lineal múltiple con 11 covariables, con un nivel de significancia del .05 y una potencia del 90 % (.90), cuando el coeficinete de determinación poblacional (R2) es .15, tamaño de muestra que resultó en 131 adultos mayores. El análisis estadístico incluyó medidas descriptivas y modelos lineales generalizados. Resultados: los participantes tenían un riesgo medio o alto de carga alostática. El análisis del modelo de regresión lineal multivariante mostró que las mejores condiciones de vivienda, la satisfacción con la propia casa, la presencia de calles sin salida y la asistencia a la iglesia reducen la carga alostática y que el tráfico peligroso aumenta la carga alostática. Conclusiones: existen varios factores sociales que contribuyen al desarrollo de la carga alostática en adultos mayores. Es necesario crear estrategias de cuidado de enfermería hacia el entorno social para disminuir la carga alostática en el adulto mayor.

RESUMO Objetivo: determinar se fatores sociais, como as condições de moradia, a satisfação com a casa, as características do bairro, o apoio social, as relações familiares e a freqüência à igreja afetam a carga alostática em idosos. Materiais e método: um estudo de correlação transversal e preditivo foi realizado. Os instrumentos utilizados foram dados sociodemográficos, o instrumento de relações familiares percebido, o Medical Outcomes Study-Social Support Survey e a Abbreviated Neighborhood Environment Walkability Scale. Os biomarcadores de carga alostática utilizados foram: pressão arterial sistólica e diastólica, índice de massa corporal, circunferência da cintura, relação cintura-quadril, colesterol total, lipoproteína de alta densidade, hemoglobina glicada, fibrinogênio e proteína C-reativa. A amostra foi calculada para o contraste do hipóseo de nenhuma relação (R2 = 0), em um modelo de regresión múltiple linear con 11 covariáveis, com um nível de significância de 0.05 e uma potencia de 90% (0.90), quando o coeficiente de determinação populacional (R2) es .15, o tamanho da amostra resultou em 131 idosos. A análise estatística incluiu medidas descritivas e modelos lineares generalizados. Resultados: os participantes tinham risco médio ou alto de carga alostática. A análise multivariada do modelo de regressão linear mostrou que melhores condições de moradia, satisfação com a casa própria, presença de ruas sem saída e freqüência à igreja reduzem a carga alostática e o tráfego perigoso aumenta a carga alostática. Conclusões: existem vários fatores sociais que contribuem para o desenvolvimento da carga alostática em idosos. É necessário criar estratégias de cuidados de enfermagem em direção ao ambiente social para diminuir a carga alostática no idoso.

Factors Contributing to Active Aging in Older Adults, from the Framework of Roy's Adaptation Model.

OBJECTIVES: To determine the variables contributing to the explanation of active aging according to Roy's adaptation model. METHODS: Descriptive correlational study, with convenience and snowball sampling. Two hundred older adults with chronic disease, were included. The instruments used were: a) Yesavage's Geriatric depression scale, b) Pheiffer's mental state questionnaire, c) basic activities of daily living, d) instrumental activities of daily living, e) Hope scale, f) coping mechanism items from the Successful Aging Inventory (coping with aging), g) hours of volunteer work, and h) The Duke-UNC Functional Social Support Questionnaire. Coping with aging was composed of independence in basic and instrumental activities of daily living, free from symptoms of depression, good mental state, and perception of health as good. Data were analyzed by using descriptive and inferential statistics, and simple and multiple linear regression models. RESULTS: Fifty one percent of the participants showed active aging (42% men, and 56% women). Of the proposed variables, the variables showing effect on the variables of active aging, in the generalized linear model, were years of suffering the disease (Λ=0.922; p=0.008), coping with aging (Λ=0.582; p=0.001), and perceived social support (Λ=0.885; p=0.001). These three variables explained 5% of basic activities of daily living, 41% of the instrumental activities, 12.5% of health perception, 26% of mental state, and 21% of depression. Hope, and volunteer work were not significant. When the variables of active aging were dichotomized, age showed negative effect on global active aging and coping with aging positive effect. CONCLUSIONS: Although, proposed variables explained individually active aging, only coping with aging explained global active aging.

Salud, enfermedad y cuidado de adultos mayores inmigrantes / Health, illness and care of immigrant older adults / Saúde, doença e cuidado de idosos imigrantes

Objetivo: describir el significado de salud, enfermedad y cuidado del adulto mayor inmigrante de la comunidad El Mezquital ubicada al nordeste de la costa mexicana del golfo de México en relación a su cosmovisión y el entorno donde viven. Método: una investigación etnográfica fue realizada con estadías largas en el sitio de estudio, observación participante y entrevista abierta a 15 participantes, durante enero de 2016 a abril de 2017. La validación de datos se realiza mediante una técnica de triangulación de la información. Resultados: patrones recurrentes de significado de salud fueron: sentirse bien, tener familia, tener dinero, el lugar donde viven; de enfermedad: conocimiento personal, alimentación, actividad física y tener fe; y en el cuidado se identificaron la medicación, estudios diagnósticos, cirugías. Conclusión: conocer el significado de salud, enfermedad y cuidado de adultos mayores permitió identificar patrones recurrentes que inciden culturalmente sobre lo que ayuda a la persona a estar bien y lo que la enferma o le hace mal, expresando el cuidado desde el entorno del hogar. La investigación desde perspectiva cultural, potencia un campo natural de cuidado basado en el entendimiento y comprensión cultural para brindar cuidado culturalmente congruente.

Objective: it was to describe the health, disease and care of immigrant older adults living in the Mezquital in Northeastern Mexican coast of the Gulf of Mexico. Method: an ethnographic research was conducted with long stays in the study site, participant observation and open interviews to 15 participants, during january 2016 through february 2017. Data obtained was validated through a triangulation technique. Results: recurring patterns of meaning of health were: feel good, have a family, have money, where they live; of disease were personal knowledge, physical activity, food and faith; in care were identified: medication, diagnostic tests and surgeries. Conclusions: to know the meaning of health, illness and care of major adults allowed identifying patterns appellants who affect culturally on what helps the person it is to be well and what the sick person or it harms him, reflecting the care from the environment of the hearth. The investigation from cultural perspective, promotes a natural field of care established in the understanding and cultural comprehension to offer culturally coherent care.

Objetivo: descrever o significado de saúde, doença e cuidado do idoso imigrante da comunidade El Mezquital localizada no nordeste da costa mexicana do Golfo do México em relação à sua cosmovisão e o entorno de onde vivem. Método: uma investigação etnográfica foi realizada com estadias longas no local do estudo, observação participante e entrevistas abertas a 15 participantes, durante janeiro de 2016 a fevereiro de 2017. A validação dos dados se realizou mediante uma técnica de triangulação de informações. Resultados: padrões recorrentes de significância em saúde foram: sentir-se bem, ter uma família, ter dinheiro, o lugar onde vivem; de doença: conhecimento pessoal, comida, atividade física e ter fé; e no cuidado se identificaram a medicação, estudos diagnósticos e cirurgias. Conclusão: conhecer o significado de saúde, doença e cuidado de idosos permitiu identificar padrões recorrentes que incidem culturalmente sobre o que ajuda a pessoa a estar bem e o que a torna doente ou que faz mal, expressando o cuidado desde o entorno do lar. A investigação a partir da perspectiva cultural potencializa um campo natural de cuidado baseado no entendimento e compreensão cultural para fornecer cuidado culturalmente congruente.

Factores que contribuyen al Envejecimiento Activo en los adultos mayores, desde el marco del Modelo de Adaptación de Roy / Fatores que contribuem ao Envelhecimento Ativo nos adultos maiores, desde o marco do Modelo de Adaptação de Roy / Factors Contributing to Active Aging in Older Adults, from the Framework of Roy's Adaptation Model

Objective. To determine the variables contributing to the explanation of active aging according to Roy's adaptation model. Methods. Descriptive correlational study, with convenience and snowball sampling. Two hundred older adults with chronic disease, were included. The instruments used were: a) Yesavage's Geriatric depression scale, b) Pheiffer's mental state questionnaire, c) basic activities of daily living, d) instrumental activities of daily living, e) Hope scale, f) coping mechanism items from the Successful Aging Inventory (coping with aging), g) hours of volunteer work, and h) The Duke-UNC Functional Social Support Questionnaire. Coping with aging was composed of independence in basic and instrumental activities of daily living, free from symptoms of depression, good mental state, and perception of health as good. Data were analyzed by using descriptive and inferential statistics, and simple and multiple linear regression models. Results. Fifty one percent of the participants showed active aging (42% men, and 56% women). Of the proposed variables, the variables showing effect on the variables of active aging, in the generalized linear model, were years of suffering the disease (Λ=0.922; p=0.008), coping with aging (Λ=0.582; p=0.001), and perceived social support (Λ=0.885; p=0.001). These three variables explained 5% of basic activities of daily living, 41% of the instrumental activities, 12.5% of health perception, 26% of mental state, and 21% of depression. Hope, and volunteer work were not significant. When the variables of active aging were dichotomized, age showed negative effect on global active aging and coping with aging positive effect. Conclusion. Although, proposed variables explained individually active aging, only coping with aging explained global active aging. (AU)

Objetivo. Determinar las variables que contribuyen a la explicación del envejecimiento activo de acuerdo con el modelo de adaptacion de Roy. Métodos. Estudio descriptivo correlacional; se hizo muestreo por conveniencia y bola de nieve. Se incluyeron 200 adultos mayores. Se utilizaron los instrumentos: a) escala geriátrica de depresión de Yesavage, b) cuestionario de estado mental de Pfeiffer, c) Actividades básicas de la vida diaria, d) Actividades instrumentales de la vida diaria, e) escala de esperanza, f) reactivos de mecanismos de afrontamiento del inventario de Envejecimiento exitoso (afrontamiento al envejecimiento), y g) el cuestionario de apoyo social Duke-UNC-11. El envejecimiento activo se conformó por independencia en las actividades básicas e instrumentales de la vida diaria, libre de síntomas de depresión, buen estado mental y percepción de salud buena. Los datos se analizaron a partir de estadística descriptiva e inferencial, y modelos de regresión lineal y múltiple. Resultados. El 51% de los participantes mostró envejecimiento activo (42% en hombres y 56% en mujeres). De las variables propuestas, el modelo lineal generalizado mostró que los años de padecer la enfermedad, (Λ=0.922; p=0.008), el afrontamiento al envejecimiento (Λ=0.582; p=0.001), y el apoyo social percibido (Λ=0.885; p= 0.001), presentaron efecto sobre las variables que conformaron el envejecimiento activo. Estas tres variables explicaron el 5% de las actividades de la vida diaria, 41% de las instrumentales, 12.5% de la percepción de salud, 26% del estado mental y el 21% de la depresión. La esperanza y trabajo voluntario no fueron significativas. Al dicotomizar las variables del envejecimiento activo se encontraron efectos negativos de la edad y positivos del afrontamiento al envejecimiento. Conclusión. Aunque en este estudio se encontró que las variables propuestas explican en forma individual las variables del envejecimiento activo, solamente el afrontamiento al envejecimiento explicó la varianza del envejecimiento activo en forma global. (AU)

Objetivo. Determinar as variáveis que contribuem à explicação do envelhecimento ativo de acordo ao modelo de adaptação de Roy. Métodos. Estudo descritivo de correlação, se fez amostragem por conveniência e bola de neve. Se incluíram 200 adultos maiores. Se utilizaram os instrumentos: a) escala geriátrica de depressão de Yesavage, b) questionário de estado mental de Pfeiffer, c) Atividades básicas da vida diária, d) Atividades instrumentais da vida diária, e) escala de esperança, f) reativos de mecanismos de afrontamento do inventário de Envelhecimento de sucesso (afrontamento ao envelhecimento), e g) o questionário de apoio social Duke-UNC-11. O envelhecimento ativo se conformou por independência nas atividades básicas e instrumentais da vida diária, livre de sintomas de depressão, bom estado mental e percepção de boa saúde. Os dados se analisaram através de estatística descritiva e inferencial, e modelos de regressão lineal e múltipla. Resultados. 51% dos participantes mostrou envelhecimento ativo (42% em homens e 56% em mulheres). Das variáveis propostas o modelo lineal generalizado mostrou que os anos de padecer a doença, (Λ=0.922; p=0.008), o afrontamento ao envelhecimento (Λ=0.582; p=0.001), e o apoio social percebido (Λ=0.885; p=0.001), apresentaram efeito sobre as variáveis que conformaram o envelhecimento ativo. Estas três variáveis explicaram 5% das atividades da vida diária, 41% dos instrumentais, 12.5% da percepção de saúde, 26% do estado mental e 21% da depressão. A esperança, e trabalho voluntário não foram significativas. Ao classificar as variáveis do envelhecimento ativo se encontrou efeito negativo da idade e positivo do afrontamento ao envelhecimento sobre o envelhecimento ativo global. Conclusão. Embora neste estudo se encontrou que as variáveis propostas explicam em forma individual as variáveis do envelhecimento ativo, somente o afrontamento ao envelhecimento explicou a variável do envelhecimento ativo em forma global. (AU)