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1.
Emergencias (Sant Vicenç dels Horts) ; 32(1): 49-56, feb. 2020. tab, graf
Artigo em Espanhol | IBECS-Express | ID: ibc-ET2-3437

RESUMO

Objetivo. Evaluar la efectividad, en relación al retorno a circulación espontánea, la supervivencia al alta y la supervivencia al alta con buen estado neurológico, del acceso intraóseo frente al acceso venoso en la resucitación en parada cardiaca extrahospitalaria. Método. Se realiza una revisión sistemática y metanálisis en las bases de datos Medline (PubMed), Embase, Web of Science y Cochrane Library. Se incluyeron estudios observacionales y ensayos clínicos registrados en las bases de datos mencionadas desde el 1 de enero de 1950 hasta el 31 de mayo de 2019, en los que la población incluida fueran pacientes adultos en situación de parada cardiaca extrahospitalaria y que tuvieran canalizado un acceso intraóseo o intravenoso. La evaluación del riesgo de sesgo se realizó mediante la herramienta de evaluación de sesgo de Cochrane y la herramienta GRADE. Resultado. Se identificaron 434 referencias de las que 5 se incluyen en la síntesis cualitativa y cuantitativa. El acceso intraóseo se relaciona con una peor tasa de retorno a circulación espontánea [OR 0,69 (IC 95%: 0,57-0,83), p = 0,02, I2 = 65%] y una peor supervivencia al alta hospitalaria [OR 0,65 (IC 95%: 0,51-0,83); p < 0,01, I2 = 30%] en comparación con el acceso venoso. Conclusiones. El acceso intraóseo en pacientes en situación de parada cardiaca extrahospitalaria se relaciona con peores resultados en términos de retorno a circulación espontánea y supervivencia al alta hospitalaria


Objective. To evaluate the efficacy of intraosseous access versus venous access in out-of-hospital cardiac arrest in terms of return of spontaneous circulation (ROSC) and survival to hospital discharge with or without favorable neurologic status. Methods. Systematic review and meta-analysis of articles indexed in MEDLINE (PubMed), Embase, the Web of Science, and the Cochrane Library. Other terms adapted to the language of each index were also used. We included observational studies and clinical trials published from January 1, 1950, to May 31, 2019, if the study population included adult patients in cardiac arrest outside the hospital and in whom an intraosseous or intravenous catheter was inserted. Risk of bias was evaluated with the Cochrane and GRADE (Grading of Recommendations Assessment, Development and Evaluation) tools. Results. We identified 434 papers to include in the qualitative review and 5 studies for meta-analysis. Intraosseous access was related to a lower rate of ROSC (odds ratio [OR], 0.69; 95% CI, 0.57-0.83; P = .02; I2 = 65%) and worse survival to discharge (OR, 0.65; 95% CI, 0.51-0.83); P<.01, I2 = 30%). Conclusion. Intraosseous access in out-of-hospital cardiac arrest is related to poorer outcomes in terms of ROSC and survival at hospital discharge

4.
Emergencias ; 32(1): 49-56, 2020 Feb.
Artigo em Espanhol, Inglês | MEDLINE | ID: mdl-31909913

RESUMO

OBJECTIVES: To evaluate the efficacy of intraosseous access versus venous access in out-of-hospital cardiac arrest in terms of return of spontaneous circulation (ROSC) and survival to hospital discharge with or without favorable neurologic status. MATERIAL AND METHODS: Systematic review and meta-analysis of articles indexed in MEDLINE (PubMed), Embase, the Web of Science, and the Cochrane Library. Other terms adapted to the language of each index were also used. We included observational studies and clinical trials published from January 1, 1950, to May 31, 2019, if the study population included adult patients in cardiac arrest outside the hospital and in whom an intraosseous or intravenous catheter was inserted. Risk of bias was evaluated with the Cochrane and GRADE (Grading of Recommendations Assessment, Development and Evaluation) tools. RESULTS: We identified 434 papers to include in the qualitative review and 5 studies for meta-analysis. Intraosseous access was related to a lower rate of ROSC (odds ratio [OR], 0.69; 95% CI, 0.57-0.83; P=.02; I2=65%) and worse survival to discharge (OR, 0.65; 95% CI, 0.51-0.83); P<.01, I2=30%). CONCLUSION: Intraosseous access in out-of-hospital cardiac arrest is related to poorer outcomes in terms of ROSC and survival at hospital discharge.

5.
Issues Ment Health Nurs ; 41(1): 59-65, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31868551

RESUMO

Young adults have a significant prevalence of mental disorders, which could lead to dysfunctional quality of life. Records of 1,645 Spanish adolescents were examined and multiple logistic regressions were performed. Being a woman, being older and having a sedentary life were all associated with a higher psychological vulnerability, whereas a low frequency of fresh fruit and bread/cereals consumption, as well as regular intense physical activity, were considered protective against such susceptibility. Regular physical activity and a diet with a high consumption of fruit and cereals may help reduce depressive symptoms, but sociodemographic features are as much as important as lifestyle habits.

6.
Artigo em Inglês | MEDLINE | ID: mdl-31640279

RESUMO

The objective of this study was to analyze the temporal trend of physical activity and bodymass index in young adults aged 18-30 in Spain and to ascertain their relationship withsociodemographic and psychosocial variables in the period of 2009-2017. METHODS: A descriptivestudy with a sample of 10,061 young adults aged 18-30 years was performed. The data wereobtained from the European Health Survey in Spain in 2009 and 2014 and the National HealthSurvey in 2011/2012 and 2017. The chi-square test was used for qualitative variables, and multiplelinear regression analysis was performed for physical activity. RESULTS: Sedentary levels haddecreased in 2017 as compared to 2011/2012 (p < 0.001); smokers were more sedentary than nonsmokers(p < 0.001); men were more active than women (p < 0.001); and the year with the highestphysical activity was 2014. Body mass index in the total sample increased from 2009 to 2017 (p <0.01), showing a significant increase in obesity in women (p < 0.05) and no difference in men (p ≥0.05). CONCLUSIONS: In the period 2011/2012-2017, the sedentary lifestyle of young adults wasreduced and physical activity was increased, with men being more active than women.

7.
J Clin Med ; 8(9)2019 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-31500156

RESUMO

Restless leg syndrome (RLS) disrupts sleep, affecting the quality of life of patients with various chronic diseases. We assessed the prevalence of RLS in peripheral artery disease (PAD) patients and the effects of a pain-free exercise program. A total of 286 patients with claudication were enrolled in a home-based low-intensity exercise program prescribed at the hospital. RLS was determined through standardized questions. Hemodynamics, degree of calf deoxygenation, and mobility were assessed using the ankle-brachial-index, a treadmill test assisted by near-infrared spectroscopy and the 6-min walk test, respectively. During hospital visits, persistence of RLS, adherence to exercise, hemodynamics, and mobility were assessed. At the enrollment, 101 patients (35%) presented RLS, with higher prevalence among females (p = 0.032). Compared to RLS-free patients, they showed similar hemodynamics but more severe calf deoxygenation (p < 0.001) and lower mobility (p = 0.040). Eighty-seven RLS patients (83%) reported the disappearance of symptoms after 39 (36-70) days of exercise. This subgroup, compared to nonresponders, showed higher adherence (p < 0.001), hemodynamic (p = 0.041), and mobility improvements (p = 0.003). RLS symptoms were frequent in PAD but were reduced by a pain-free walking exercise aimed at inducing peripheral aerobic adaptations. The concomitant recovery of sleep and mobility may represent a synergistic action against the cardiovascular risk in PAD.

8.
Intern Emerg Med ; 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31435898

RESUMO

We retrospectively studied the association between changes in exercise capacity at discharge from a home-based exercise program and the risk of all-cause mortality among patients with peripheral artery disease (PAD) and claudication. The records of 1076 consecutive PAD patients were assessed between 2003 and 2013. The exercise program was prescribed during a few visits and executed at home at symptom-free walking speed. Ankle-Brachial Index (ABI) and maximal speed (Smax) on an incremental treadmill test were recorded at baseline and discharge. The number and date of deaths and hospitalizations for a 10-year period were collected from the regional registry. A total of 865 PAD patients completed the program (completers), while 221 left the program for health reasons (n = 128, diseased) or for nonhealth reasons (n = 83, quitters). Among the completers, the mortality rate (27%) was significantly lower (p < 0.001) than that of both the diseased (49 deaths, 38%) and the quitters (45 deaths, 54%). The completers (71 ± 9 years; 88% exercise sessions completed) showed significant improvements in the lowest ABI (from 0.62 ± 0.18 to 0.67 ± 0.19) and Smax (from 3.3 ± 1.1 to 3.8 ± 1.1 km h-1) at discharge. The completers who reached the clinically important difference of Smax ≥ 0.4 km h-1 at follow-up showed a significantly lower mortality risk (25% vs. 30%; HR 0.72; 95% CI 0.55-0.93) as well a lower rate of hospitalizations (p < 0.001). In conclusion, in PAD patients, active participation in a home-based exercise program was associated with a lower rate of death and better long-term clinical outcomes, particularly for those who attained a moderate increase in exercise capacity.

9.
Emergencias (Sant Vicenç dels Horts) ; 31(4): 261-269, ago. 2019. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-182768

RESUMO

Objetivo: Evaluar, en términos de mortalidad y estado funcional, la eficacia y seguridad de la administración de ácido tranexámico (TXA) en los pacientes que sufren un traumatismo grave en los servicios de urgencias y emergencias. Metodo: Revisión sistemática y metaanálisis. Las bases de datos consultadas fueron Medline, Embase, The Cochrane Library, Web of Science y TheClinicalTrials.gov. Se incluyeron ensayos clínicos publicados entre el 1 de enero de 2008 y el 1 de agosto de 2018 en los que participaran pacientes que sufrían un traumatismo y a los que se les administró TXA en las primeras 8 horas tras este. Se extrajeron variables clínicas relacionadas con los pacientes y con la intervención. Las variables de resultado principales fueron la mortalidad y el estado funcional. Resultados: Se incluyeron 5 ensayos clínicos para la revisión sistemática y 4 para el metanálisis (20.697 pacientes). Se detectó una disminución de la mortalidad (OR 0,89 [IC 95% 0,83-0,96]; p = 0,004; I2 = 0%) y un mejor estado funcional (OR 0,60 [IC 95% 0,39-0,94]; p = 0,02; I2 = 0%) tras la administración de TXA en estos pacientes en comparación con placebo. Por el contrario, se encontró una estancia en la unidad de cuidados intensivos más larga (diferencia de medias 2,55 días [IC 95% 0,04-5,06]; p = 0,05; I2 = 0%). Conclusiones: La administración de TXA disminuye la mortalidad de los pacientes con traumatismo grave y mejora su estado funcional


Objective: The aim of this systematic review and meta-analysis was to evaluate the efficacy (mortality and functional status) and safety of emergency department (ED) use of tranexamic acid (TXA) in patients with severe trauma. Methods: MEDLINE, Embase, the Cochrane Library, the Web of Science, and ClinicalTrials.gov were searched to find relevant clinical trials published between January 1, 2008, and 1 August, 2018. The selected trials included trauma patients who received infusions of TXA within 8 hours. We extracted patient-related clinical variables and treatment variables. The main outcomes were mortality and functional status. Results: Five clinical trials were included in the systematic review. Four of them (20 697 patients) were included in the metaanalysis. We found that TXA versus placebo was associated with lower mortality (OR, 0.89 [95% CI, 0.83-0.96]; P = .004; I2 = 0%) and better functional status (OR, 0.60 [95% CI, 0.39-0.94]; P = .02; I2 = 0%). However, intensive care unit stays were longer in patients administered TXA (mean difference, 2.55 days [95% CI, 0.04-5.06 days]; P = .05; I2 = 0%). Conclusions: ED infusion of TXA decreases mortality after severe trauma and improves patients' functional status


Assuntos
Humanos , Ácido Tranexâmico/administração & dosagem , Ferimentos e Lesões/tratamento farmacológico , Serviços Médicos de Emergência , Resultado do Tratamento , Ácido Tranexâmico/uso terapêutico , Indicadores de Morbimortalidade , Hospitalização/tendências , Tempo de Internação/estatística & dados numéricos , Escala de Resultado de Glasgow
10.
Emergencias ; 31(4): 261-269, 2019.
Artigo em Espanhol, Inglês | MEDLINE | ID: mdl-31347807

RESUMO

OBJECTIVES: The aim of this systematic review and meta-analysis was to evaluate the efficacy (mortality and functional status) and safety of emergency department (ED) use of tranexamic acid (TXA) in patients with severe trauma. MATERIAL AND METHODS: MEDLINE, Embase, the Cochrane Library, the Web of Science, and ClinicalTrials.gov were searched to find relevant clinical trials published between January 1, 2008, and 1 August, 2018. The selected trials included trauma patients who received infusions of TXA within 8 hours. We extracted patient-related clinical variables and treatment variables. The main outcomes were mortality and functional status. RESULTS: Five clinical trials were included in the systematic review. Four of them (20 697 patients) were included in the metaanalysis. We found that TXA versus placebo was associated with lower mortality (OR, 0.89 [95% CI, 0.83-0.96]; P = .004; 2 = 0%) and better functional status (OR, 0.60 [95% CI, 0.39-0.94]; P = .02; I2 = 0%). However, intensive care unit stays were longer in patients administered TXA (mean difference, 2.55 days [95% CI, 0.04-5.06 days]; P = .05; I2 = 0%). CONCLUSION: ED infusion of TXA decreases mortality after severe trauma and improves patients' functional status.

11.
PLoS One ; 14(7): e0220157, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31348797

RESUMO

AIMS: To know the prevalence, associated factors and temporal trends of disabilities for basic and instrumental activities of daily living in older people in Spain from 2009 to 2017. BACKGROUND: Disability in older people is associated with health problems, increased health costs and low quality of life. There are no updated data in Spain with a representative sample about disability. METHODS: Cross-sectional study with 25,465 non-institutionalized older people who participated in the European Health Survey in 2009 and 2014 and the National Health Survey in 2011/12 and 2017 in Spain. The prevalence rates of disability were evaluated using the Katz Scale and Lawton and Brody Scale. Logistic regression was used to determine if there was an association between basic and instrumental activities of daily living and sociodemographic characteristics. RESULTS: More individuals had disability for instrumental activities of daily living (31.9%) than disability for basic activities of daily living (11.1%). The most predominant disability for instrumental activities of daily living was performing severe housework (34%). The prevalence of disabilities decreased from 2009 to 2017. In general, disability was associated with female gender, advanced age, lower education, restricted daily activity, being bedridden and higher pain levels. CONCLUSION: There is a considerable prevalence of disabilities for basic and instrumental activities of daily living in older people in Spain. Although the disability prevalence has decreased slowly from 2009 to 2017, it continues to remain a health problem. Gender may influence the disabilities for basic and instrumental activities of daily living. Health policymakers should establish prevention strategies and effective interventions (e.g., physical exercise) for prevention and reduction of the disabilities for basic and instrumental activities of daily living, particularly in older females.

12.
J Forensic Nurs ; 15(1): 9-17, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30789465

RESUMO

OBJECTIVE: The purpose of this study was to know who are the people who assist women, who work as a health professional in the Spanish Public Health System, when they suffer intimate partner violence (IPV). METHODS: A descriptive, cross-sectional, multicenter study was conducted. The participants were female health professionals (N = 794) working within the Spanish Public Health System. The instrument used was Delgado, Aguar, Castellano, and Luna del Castillo's (2006) scale to measure ill-treatment of women. RESULTS: Two hundred seventy women suffered IPV (34%). Of the female health professionals who suffered IPV, 25.9% had spoken with someone about the violence, most commonly talking to trusted people (24.3%), a psychologist (24.3%), health professionals (20%), and others (20%). Married female health professionals living with their current or last partner/husband, residing in an urban area, and with their own salary were least likely to speak about their problem. CONCLUSION: Female health professionals who suffer IPV usually speak about this problem with trusted people instead of consulting a health professional, which may leave the problem in the private sphere. This can be because of victims not wanting to report the violence for fear of their intimate partner or wanting it to remain private. This may deprive the victims of the help they need. For this reason, the health services should establish screening for IPV not only for their patients but also for their workers.


Assuntos
Pessoal de Saúde/estatística & dados numéricos , Violência por Parceiro Íntimo/estatística & dados numéricos , Comunicação , Estudos Transversais , Feminino , Humanos , Relações Interpessoais , Estado Civil , Espanha/epidemiologia , População Urbana
13.
J Clin Med ; 8(2)2019 Feb 07.
Artigo em Inglês | MEDLINE | ID: mdl-30736443

RESUMO

The study retrospectively evaluated the association between rehabilitative outcomes and risk of peripheral revascularizations in elderly peripheral artery disease (PAD) patients with claudication. Eight-hundred thirty-five patients were enrolled. Ankle-brachial index (ABI) and maximal walking speed (Smax) were measured at baseline and at discharge from a structured home-based rehabilitation program. For the analysis, patients were divided according to a baseline ABI value (severe: ≤0.5; moderate: ≥0.5) and according to hemodynamic or functional rehabilitative response (responder: ABI ≥0.10 and/or Smax >0.5 km/h). Three-year outcomes were collected from the regional registry. According to the inclusion criteria (age 60⁻80, ABI <0.80; program completion) 457 patients, 146 severe and 311 moderate, were studied. The whole population showed significant functional and hemodynamic improvements at discharge, with 56 revascularizations and 69 deaths at follow-up. Compared to the moderate group, the severe group showed a higher rate of revascularizations (17% vs. 10%, p < 0.001) and deaths (29% and 8%, respectively; p < 0.001). However, patients with severe PAD who were ABI responders after rehabilitation showed less revascularizations than non-responders (13% vs. 21%; hazard ratio (HR): 0.52) and were not different from patients with moderate disease (9%). Superimposable rates were observed for Smax responders (13% vs. 21%; HR: 0.55; moderate 10%). In conclusion, elderly patients with severe PAD empowered by better rehabilitation outcomes showed lower rates of peripheral revascularizations and deaths that were comparable to patients with moderate PAD.

14.
J Womens Health (Larchmt) ; 28(9): 1313-1321, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30222507

RESUMO

Background: Peripheral artery disease (PAD) is a common cardiovascular pathology that affects mobility. In previous research, supervised exercise, a recommended treatment for claudication, was less effective in women. This study retrospectively investigated whether functional outcomes exhibit sex differences following a pain-free, home-based exercise program for PAD patients. Materials and Methods: Patients with PAD and claudication enrolled to a structured home-based program from 2003 to 2016 were studied. The program was prescribed at the hospital and based on two daily 10-minute pain-free walking sessions at progressively increasing speed. Outcome measures, which were assessed at baseline and discharge, were pain threshold speed (PTS) and maximal (Smax) during a treadmill test and pain-free walking distance (PFWD) and total distance walked in 6 minutes (6MWD). The ankle-brachial index (ABI), program duration, and patient adherence were determined. Results: A total of 1007 patients (women; n = 264; 26%) were enrolled. At baseline, compared to men, women exhibited similar ABI values but lower PTS and PFWD values (p < 0.001). At discharge, with similar adherence (score 3/4 ± 1 each) in both groups, superimposable improvements were observed for PTS (0.8 ± 0.8 km/h each), Smax (0.4 ± 0.5 km/h each), PFWD (women 95 ± 100; men 86 ± 104), 6MWD (women 32 ± 65; men 35 ± 58), and ABI (women 0.07 ± 0.12; men 0.06 ± 0.11) without between-group differences (confirmed after propensity analysis). Conclusion: A personalized, structured pain-free exercise program for PAD patients performed inside the home for a few minutes a day was equally effective in both sexes. Programs favoring adherence and functional outcomes in women should be tested in prospective studies.

15.
Rev Lat Am Enfermagem ; 26: e3067, 2018 Nov 14.
Artigo em Inglês, Português, Espanhol | MEDLINE | ID: mdl-30462782

RESUMO

OBJECTIVE: to evaluate the application of a noninvasive intervention consisting of a postural modification using personalized models and osteopathy in people with occipital neuralgia. METHOD: retrospective study of the intervention performed in adult population with occipital neuralgia, consisting of postural modification using personalized plantar orthoses and osteopathy, in a study period of four years. The observed variables were: persistence of headache, alignment of the axes, plantar support, center of gravity and center of mass; medical interview data, visual analogue scale, Win-Track gait analysis system and Kinovea software for video analysis (clinical assessment instruments used). RESULTS: a total of 34 records of people with occipital neuralgia were studied. A fraction of 58.8% of the patients reported improvement after the intervention. The visual analogue scale data were provided for 64.7% of the records and significant differences (p <0.001) between the means before (8.4 ± 1.7) and after the intervention (2.6 ± 2.7) were found. CONCLUSION: postural modification using personalized orthoses and osteopathy substantially improves the symptomatology of patients with occipital neuralgia.


Assuntos
Órtoses do Pé , Manipulação Osteopática/métodos , Neuralgia/terapia , Lobo Occipital , Postura/fisiologia , Adulto , Fenômenos Biomecânicos , Feminino , Humanos , Masculino , Neuralgia/fisiopatologia , Medição da Dor , Estudos Retrospectivos , Fatores Socioeconômicos , Resultado do Tratamento
16.
J Int Med Res ; 46(11): 4399-4406, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30178683

RESUMO

This review was performed to investigate the association between treatment with dialysis and Takotsubo syndrome in patients with end-stage renal disease. We systematically explored the PubMed database using the search terms "Takotsubo cardiomyopathy" and/or "stress-induced cardiomyopathy" and/or "Takotsubo syndrome" in combination with "dialysis" and "uremia." Of 3630 articles found, 8 articles reporting 10 cases were selected for analysis. Most patients were women, and their age ranged from 51 to 84 years. Diabetes mellitus and hypertension were diagnosed in 40% of patients, and glomerular disease was diagnosed in 30%. One only patient was treated with peritoneal dialysis; all others were treated with hemodialysis. The outcome was unfavorable in only one patient. An association between Takotsubo syndrome and dialysis is uncommon, but not negligible, and comorbidities play a major role in determining the clinical outcome.


Assuntos
Diálise Renal/efeitos adversos , Cardiomiopatia de Takotsubo/etiologia , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
17.
Rev Lat Am Enfermagem ; 26: e2977, 2018 Jul 16.
Artigo em Inglês, Português, Espanhol | MEDLINE | ID: mdl-30020332

RESUMO

OBJECTIVE: to determine the diagnosis of the situation regarding documentation of falls and risk of falls in people older than 75 years in basic health units in Spain and Portugal. METHOD: mixed exploratory study in two stages: (i) quantitative descriptive of randomly selected fall records produced in one year (597 records; 197 Spanish and 400 Portuguese); and (ii) qualitative, with the purpose of knowing the perception of health professionals employing semi-structured interviews (72 professionals, 16 Spanish and 56 Portuguese). The study areas were two basic health units in southern Spain and northern Portugal. RESULTS: in the fall records, the number of women was higher. The presence of fall was associated with the variables age, presence of dementia, osteoarticular disease, previous falls and consumption of antivertiginous medication. Health professionals perceived an absence of risk assessment instruments, as well as lack of prevention programs and lack of awareness of this event. CONCLUSION: falls are perceived as an area of ​​priority attention for health professionals. Nonetheless, there is a lack of adherence to the registration of falls and risk assessment, due to organizational, logistical and motivational problems.


Assuntos
Acidentes por Quedas/estatística & dados numéricos , Atitude do Pessoal de Saúde , Avaliação Geriátrica/estatística & dados numéricos , Pessoal de Saúde/estatística & dados numéricos , Serviços de Saúde/estatística & dados numéricos , Acidentes por Quedas/prevenção & controle , Idoso , Idoso de 80 Anos ou mais , Enfermagem em Saúde Comunitária/estatística & dados numéricos , Feminino , Humanos , Masculino , Médicos/estatística & dados numéricos , Portugal/epidemiologia , Medição de Risco , Distribuição por Sexo , Fatores Socioeconômicos , Espanha/epidemiologia
19.
J Interpers Violence ; 33(2): 339-356, 2018 01.
Artigo em Inglês | MEDLINE | ID: mdl-26442955

RESUMO

In many parts of the world, elder abuse happens almost unnoticed. Until recently, this serious social problem was hidden from public view and was regarded as an essentially private matter. However, there is growing evidence that elder abuse is an important problem of public health and in the society. The objective of this study is to determine the degree of abuse of elder and vulnerable people in the families and communities of Eastern Bolivia. With this end in mind, we conducted a cross-sectional descriptive study with a sample size of 210 60-year-old people coming from different health care areas. Elder Abuse Suspicion Index (EASI) and Yaffe's Evaluation Form of Social Work were used. An abuse rate of 39% of the older adults was identified. The most common type of abuse observed was psychological abuse (32.4% of cases), followed by neglect (21.9%). Children were identified as triggers of the abuse in 66.7% of cases of abuse. The prevalence of elder abuse was similar to the prevalence of other types of abuse that exist in Bolivia, such as the gender-based abuse. Also, this prevalence is comparable to other developing countries and European countries. The profile of abused older adult is as follows: woman, widow, 70 years old, incomplete primary education, without an occupation, and an average of 4.59 children. The information obtained shows that dysfunctional families have a higher percentage of elder abuse.


Assuntos
Cuidadores/estatística & dados numéricos , Maus-Tratos ao Idoso/estatística & dados numéricos , Conflito Familiar/psicologia , Problemas Sociais , Idoso , Agressão/psicologia , Bolívia , Cuidadores/psicologia , Estudos Transversais , Maus-Tratos ao Idoso/psicologia , Relações Familiares , Feminino , Humanos , Relação entre Gerações , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Distribuição por Sexo , Fatores Socioeconômicos
20.
Rev. latinoam. enferm. (Online) ; 26: e2977, 2018. tab, graf
Artigo em Inglês | LILACS | ID: biblio-961201

RESUMO

ABSTRACT Objective: to determine the diagnosis of the situation regarding documentation of falls and risk of falls in people older than 75 years in basic health units in Spain and Portugal. Method: mixed exploratory study in two stages: (i) quantitative descriptive of randomly selected fall records produced in one year (597 records; 197 Spanish and 400 Portuguese); and (ii) qualitative, with the purpose of knowing the perception of health professionals employing semi-structured interviews (72 professionals, 16 Spanish and 56 Portuguese). The study areas were two basic health units in southern Spain and northern Portugal. Results: in the fall records, the number of women was higher. The presence of fall was associated with the variables age, presence of dementia, osteoarticular disease, previous falls and consumption of antivertiginous medication. Health professionals perceived an absence of risk assessment instruments, as well as lack of prevention programs and lack of awareness of this event. Conclusion: falls are perceived as an area of ​​priority attention for health professionals. Nonetheless, there is a lack of adherence to the registration of falls and risk assessment, due to organizational, logistical and motivational problems.


RESUMO Objetivo: determinar o diagnóstico da situação sobre a documentação das quedas e risco de queda em pessoas maiores de 75 anos em unidades básicas de saúde da Espanha e Portugal. Método: estudo exploratório misto em duas etapas: (i) descritiva quantitativa de registros de queda selecionados aleatoriamente produzidos em um ano (597 registros; 197 espanhóis e 400 portugueses); e (ii) qualitativa, para conhecer a percepção dos profissionais de saúde, utilizando entrevistas semiestruturadas (72 profissionais; 16 espanhóis e 56 portugueses). Os âmbitos de estudo foram duas unidades básicas de saúde do Sul de Espanha e do Norte de Portugal. Resultados: nos registros de queda, o número de mulheres era maior. A presença de queda esteve associada com as variáveis idade, presença de demência, doença osteoarticular, quedas prévias e consumo de antivertiginosos. Os profissionais de saúde perceberam uma ausência de instrumentos de avaliação do risco de queda, assim como carência de programas de prevenção e falta de sensibilização sobre este acontecimento. Conclusão: as quedas são percebidas como uma área de atenção prioritária para os profissionais de saúde. Não obstante, existe uma falta de adesão ao registro de quedas e da avaliação do risco como consequência de problemas organizacionais, logísticos e motivacionais.


RESUMEN Objetivo: determinar el diagnóstico de la situación sobre la documentación de las caídas y riesgo de caída en personas mayores de 75 años en unidades básicas de salud de España y Portugal. Método: estudio exploratorio mixto en dos etapas: (i) descriptiva cuantitativa de registros de caída seleccionados aleatoriamente producidos en un año (597 registros; 197 españoles y 400 portugueses); y (ii) cualitativa, para conocer la percepción de los profesionales sanitarios, empleando entrevistas semiestructuras (72 profesionales; 16 españoles y 56 portugueses). Los ámbitos de estudio fueron dos unidades básicas de salud del Sur de España y Norte de Portugal. Resultados: en los registros de caída, el número de mujeres era mayor. La presencia de caída se asociaba con las variables edad, presencia de demencia, enfermedad osteoarticular, caídas previas y consumo de anti-vertiginosos. Los profesionales sanitarios percibían una ausencia de instrumentos de evaluación del riesgo de caída, así como carencia de programas de prevención y falta de sensibilización sobre este acontecimiento. Conclusión: las caídas son percibidas como un área de atención prioritaria para los profesionales sanitarios. No obstante, existe una falta de adhesión al registro de caídas y de la evaluación del riesgo como consecuencia de problemas organizacionales, logísticos y motivacionales.


Assuntos
Humanos , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , Acidentes por Quedas/prevenção & controle , Acidentes por Quedas/estatística & dados numéricos , Avaliação Geriátrica/estatística & dados numéricos , Pessoal de Saúde/estatística & dados numéricos , Enfermagem em Saúde Comunitária/estatística & dados numéricos , Portugal/epidemiologia , Espanha/epidemiologia , Atitude do Pessoal de Saúde
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