Clinical Outcomes of Bipolar Hemiarthroplasty with a Conjoined Tendon-Preserving Posterior Approach for Femoral Neck Fractures.

Background and Objectives: The conventional posterior approach in the lateral decubitus position is widely used for femoral neck fractures in femoral hemiarthroplasty. Postoperative dislocation is the major problem with this approach. The conjoined tendon-preserving posterior (CPP) approach is a less invasive surgical approach than the conventional posterior approach to the hip, maintains posterior stability, and preserves short external rotators and joint capsules. However, the mention was required to avoid muscle damage and whether muscle damage affects postoperative dislocation or not. The current study aimed to evaluate the clinical results of the CPP approach in hemiarthroplasty for femoral neck fractures and identify muscle damage risk factors. Materials and Methods: This study was a retrospective cohort study and included 170 hips in 168 patients. The mean age at the operation was 81.2 years. The preservation rate of the internal obturator muscle and gemellus inferior muscle and factors related to intraoperative short rotator muscle injury were investigated retrospectively. The postoperative complications and the relation between muscle damage and postoperative dislocation were investigated. Results: In the four hips (2.3%) with the obturator internus muscle damage, thirty-eight hips (22.4%) with gemellus inferior muscle damage were detected; in the muscle-damaged cases, the high body mass index (BMI) was significantly higher. The complication occurred in four hips (2.3%), including postoperative posterior dislocation in one hip without muscle damage (0.6%). Postoperative infection occurred in one hip (0.6%), and peroneal or sciatic nerve paralysis was suspected in two hips (1.1%). Conclusions: Compared to the conventional posterior approach in previous reports, the CPP approach reduces postoperative dislocation. A higher BMI is a risk factor for muscle damage, and the gemellus inferior muscle damage has no effect on postoperative dislocation. The CPP approach for BHA appeared to be an effective treatment method.

Intervención participativa comunitaria: necesidades de salud de las personas mayores durante el período de la pandemia por COVID-19 / Community participatory intervention: health needs of older people during the COVID-19 pandemic period

Objetivo. Proponer una intervención participativa comunitaria según las necesidades de salud percibida por las personas mayores del Programa de Salud Cardiovascular de un centro de salud familiar y comunitaria de una comuna de Santiago de Chile durante el período de la pandemia de la COVID-19. Métodos. Se utilizó una metodología participativa de la comunidad, la cual se desarrolló en dos fases: diagnóstico participativo comunitario y desarrollo de la propuesta participativa de una intervención en salud comunitaria. Resultados. Desde el diagnóstico participativo comunitario, los participantes eligieron el desarrollo de un programa educativo fundamentado en las necesidades de salud, además de la entrega de material educativo sobre estilos de vida saludable y recomendaciones para tener un buen control de sus enfermedades. Conclusión. Desde el diagnóstico y planificación participativa, es posible intervenir en pro de las necesidades de las personas, familias y comunidades y capacitarlas en el manejo de su propia salud. (AU)

Aim. To propose a community participatory intervention according to the health needs perceived by elderly people in the Family and Community Health Centre Cardiovascular Health programme of a Santiago de Chile commune during the COVID-19 pandemic. Methods. A community participatory methodology was used, which was developed over two phases: community participatory diagnosis and development of a participatory proposal for a community health intervention. Results. From the community participatory diagnosis, participants opted for development of an educational programme based on health needs, in addition to the delivery of educational material related to healthy lifestyles and recommendations for robust control of their diseases. Conclusion. From diagnosis and participatory planning, it is possible to intervene in favour of the needs of individuals, families and communities and train them in managing their own health. (AU)

Condiciones de salud bucodental en personas adultas mayores con enfermedad de Alzheimer: Scoping Review

Introducción: El aumento de la longevidad de las personas ha generado en la última etapa de vida la aparición de enfermedades de tipo multifactorial y relacionadas con el estilo de vida, aumentando la prevalencia de patologías mentales y enfermedades orales. Objetivo: Identificar las condiciones de salud oral en personas adultas mayores con enfermedad de Alzheimer. Métodos: Se planteó una revisión de la literatura tipo Scoping Review, determinando una estrategia de búsqueda para tres bases de datos (Pubmed, EbscoHost y LILACS). Fueron incluidos artículos con diseño de corte transversal, cohorte y casos y controles en idioma español, inglés y portugués entre 2011 y 2021. Se realizó la extracción y evaluación del riesgo de sesgo teniendo en cuenta los criterios de elegibilidad. Resultados: Se seleccionaron 32 artículos para revisión de texto completo y síntesis cualitativa de la información. Alemania y Estados Unidos presentan mayor cantidad de publicaciones, el sexo femenino predominó como población de estudio. Se observó menor frecuencia de cepillado, mayor cantidad de ausencias dentales en pacientes con demencia por Alzheimer y consecuentemente un mayor uso de prótesis en dicha población. Conclusiones: Es importante fortalecer la relación sistémico-oral de los adultos mayores mediante un manejo interdisciplinario entre el geriatra y el odontólogo.

Introduction. The increase in the longevity of individuals has led to the emergence of multifactorial diseases related to lifestyle during the later stages of life, thereby increasing the prevalence of mental disorders and oral diseases. Objective: To identify oral health conditions in older adults with Alzheimer's disease. Methods: A Scoping Review literature review was conducted, outlining a search strategy for three databases (Pubmed, EbscoHost, and LILACS). Articles with a cross-sectional, cohort, or case-control design published in Spanish, English, or Portuguese between 2011 and 2021 were included. Extraction and bias risk assessments were performed based on eligibility criteria. Results: Thirty-two articles were selected for full-text review and qualitative synthesis of information. Germany and the United States had the highest number of publications, with females predominating as the study population. A lower frequency of brushing, a higher number of missing teeth in Alzheimer's patients, and consequently higher use of prosthetics were observed in this population. Conclusions: It is essential to strengthening the systemic-oral relationship in older adults through interdisciplinary management involving geriatricians and dentists.

Introdução: O aumento da longevidade das pessoas tem gerado na última fase da vida o aparecimento de doenças multifatoriais e relacionadas ao estilo de vida, aumentando a prevalência de patologias mentais e doenças bucais. Objetivo: identificar as condições de saúde bucal em idosos com doença de Alzheimer. Métodos: foi realizada uma revisão de escopo da literatura, determinando uma estratégia de busca em três bancos de dados (Pubmed, EbscoHost e LILACS). Foram incluídos artigos com desenho transversal, de coorte e de caso-controle em espanhol, inglês e português entre 2011 e 2021. A extração e a avaliação do risco de viés foram realizadas levando-se em conta os critérios de elegibilidade. Resultados: Trinta e dois artigos foram selecionados para revisão do texto completo e síntese qualitativa das informações. A Alemanha e os Estados Unidos tiveram o maior número de publicações, e a população do estudo era predominantemente feminina. Observou-se menor frequência de escovação, maior número de ausencias odontológicas em pacientes com demência de Alzheimer e, consequentemente, maior uso de dentaduras nessa população. Conclusões: É importante fortalecer a relação sistêmico-oral dos idosos por meio do gerenciamento interdisciplinar entre o geriatra e o dentista.

Modelo de co-construcción intergeneracional de cápsulas comunicacionales en base a comidas tradicionales

Introducción: La valoración de las comidas tradicionales resulta esencial para mantener el patrimonio gastronómico, sin embargo, su divulgación es limitada, por lo que se requiere de estrategias comunicacionales que promuevan la difusión de las culturas inmateriales. Objetivo: Elaborar un modelo de co-construcción de cápsulas comunicacionales intergeneracionales para difundir preparaciones culinarias significativas de personas mayores. Material y métodos: El estudio se enmarca en la investigación aplicada del tipo tecnológico. Se realizó una búsqueda teórica de aspectos relevantes en el uso de cápsulas comunicacionales (videos), así como el uso de TICs en personas mayores, siguiendo los lineamentos del diseño cualitativo a través de un análisis de contenido temático. Luego se construye un modelo, que es validado por profesionales del área gerontológica, para ser aplicado en un proyecto piloto que incluyó a una diada constituida por una persona mayor y un descendiente, los que guiaron y grabaron una entrevista en profundidad focalizada. Resultados: Se co-construyeron 6 videos con preparaciones culinarias tradicionales en el que participaron 5 mujeres y 1 hombre, de las Regiones del Biobío y Metropolitana. Se siguió modelo teórico que incorporó 7 pasos para su elaboración: identificación de diada intergeneracional, capacitación, realización del video, primera edición del video, presentación del video a la diada, edición final y difusión del video en redes sociales. Conclusiones: Como estrategia para un envejecimiento saludable, la realización de un video intergeneracional con una receta preferida se visualiza como una oportunidad para entrelazar cultura, patrimonio y emociones entre los participantes y la comunidad.

Introduction: The appreciation of traditional foods is essential in the maintenance of gastronomic heritage; however, its dissemination is limited, which is why communication strategies are required to promote the dissemination of intangible cultures. Objective: To develop a model for the co-construction of intergenerational communication capsules that allow the dissemination of significant culinary preparations for the elderly. Material and methods: The study is part of an applied technological research. In order to consolidate knowledge and use it for educational purposes, a theoretical search of relevant aspects in the use of communication capsules (videos) was carried out, following the guidelines of qualitative design through thematic content analysis. Then, a model is constructed and validated by professionals from the gerontological area to be applied to a pilot project that included a dyad made up of an elderly person and a descendant, who guided and recorded an in-depth focused interview. Results: A total of 6 videos about traditional culinary preparations made by 5 women and 1 man from the Biobío and Metropolitana Regions were co-constructed. A theoretical model that incorporated 7 steps for its elaboration was followed: identification of intergenerational dyad, training, making of the video, first edition of the video, presentation of the video to the dyad, final edition, and dissemination of the video on social networks. Conclusions: As a strategy for healthy aging, making an intergenerational video with a favorite recipe is seen as an opportunity to intertwine culture, heritage and emotions between participants and the community.

[Technology at the heart of vulnerability]. / La "techné" au cœur de la vulnérabilité.

The ubiquitous presence of the elderly in care services raises questions about the evolution and limits of new techniques and technologies in the care relationship. We carried out a cross-sectional study in a geriatric ward, using parallel patient and carer questionnaires to assess how each felt about innovations, analyze their opportunities and evaluate their dangers in care provision.

Impact of influenza, herpes zoster, and pneumococcal vaccinations on the incidence of cardiovascular events in subjects aged over 65 years: a systematic review.

This systematic review aims to summarize the impact of vaccination against influenza, shingles, and pneumococcus on the incidence on the risk of cardiovascular events in the elderly. This protocol was developed in accordance with PRISMA guidelines. We conducted a literature search and identified all relevant articles published regarding the matter up to September 2022. We retrieved 38 studies (influenza vaccine = 33, pneumococcal vaccine = 5, and zoster vaccine = 2). A total of 28 and 2 studies have shown that influenza and pneumococcal vaccines significantly lower the risk of cardiovascular disease in the elderly. Also, repeated influenza vaccination shows a consistent and dose-dependent protective effect against acute coronary syndromes and stroke. Moreover, dual influenza and pneumococcal vaccination was associated with lower risks of some cardiovascular events (stroke, congestive heart failure, ischemic heart disease, and myocardial infarction). However, the impact of PCV13 on cardiovascular events has not been studied, nor has the currently recommended vaccination schedule (PCV13 + PPV23). As for herpes zoster vaccination, only the protective effect against stroke has been studied with the live attenuated herpes zoster vaccine, but no studies have been conducted with the recombinant subunit herpes zoster vaccine. This review outlines the benefits of the vaccines mentioned above beyond their preventive action on infectious diseases. It is intended for health professionals who wish to inform and advise their elderly patients.

["Assure" program, to improve the management of emergency situations in Ehpad]. / Programme Assure, pour améliorer la prise en charge des situations d'urgence en Ehpad.

The Assure approach (improvement of emergency care) is a project designed to improve emergency care for the 63,000 residents of homes for the dependent elderly (Ehpad) in the Ile-de-France region. By reinforcing the skills of caregivers in emergency situations and facilitating collaboration between care providers, the Assure approach is mobilizing, alongside all the Ehpad in the Ile-de-France region over a period of two years, the emergency medical assistance services, emergency physicians, mobile geriatric teams and nursing and care assistant training institutes.

[The ethical charter for the elderly in the daily life of GHSIF care providers]. / La charte éthique du grand âge dans le quotidien des acteurs de soin du GHSIF.

The elaboration of a charter of ethics and support for the elderly, drawn up by Fabrice Gzil, places different notions of care at the center of the care of the elderly for those working in the field at the Groupe hospitalier sud Île-de-France (GHSIF). The 10 points presented are implemented on a daily basis. By highlighting these actions, the charter can be appropriated and brought to life in order to provide support adapted to the collective and individual needs of the elderly patients and residents.

[Geriatric restraints as a last resort]. / Contentions en gériatrie, dernier recours.

Relying on the remaining abilities of elderly people at home, in hospital or in residential care facilities for the dependent elderly, allows them to maintain their autonomy and avoid restraints. If geriatric caregivers observe an elderly person who is agitated, at risk of falling, or putting themselves in danger, they suggest strategies to calm the person. As a last resort, physicians may prescribe an appropriate restraint. This is a deprivation of liberty. The multidisciplinary evaluation every twenty-four hours of this care is based on the principle of beneficence by re-evaluating the prescribed device.

[Screening for frailty in the elderly subject]. / Dépister la fragilité chez le sujet âgé.

The identification of frailty can be done by any health professional. This assessment allows corrective measures to be taken in order to act early on reversible elements.

Being an Elderly Person Living in Metropolitan Cities of Northwestern Ethiopia: A Descriptive Phenomenological Study.

Background: As people grow old, they pass through various life courses. Thus, it is important to realize aging in the context of each of these stages, as aging is not only physiological and psychological processes. To understand the lifeworld experiences of the phenomenon "being an elderly person" from the individual perspective was important, in this study, within day-to-day life in Metropolitan cities of northwestern Ethiopia. Objective: The aim of this study was to describe the lifeworld of elderly persons living in Bahir Dar and Gondar Cities, Northwest Ethiopia. Methods: A community based qualitative study conducted from October 29, 2021 to November 6, 2021. A purposive sampling technique and in-depth interviews were used for sampling and data collection, respectively. To explore the life experience /life-world/ of the elderly, a descriptive phenomenological study was conducted among 15 elderly persons. The audio records were transcribed and the field notes incorporated. Transcribed texts were translated into the English language, and a descriptive phenomenological analysis was done. Results: In this study, the essence of the phenomenon, being an elderly person, means, in an ebb and flow motion, balancing a life change characterized by changing perspective, ambiguity to body functions, and preparing for being released. The elderly experienced physical, mental, and psychosocial changes. They had encountered positive and negative situations throughout their life span. They also expressed that their time was over and wished to prepare for God's Kingdom. Conclusion: The use of phenomenology for this research provided an opportunity for a deeper understanding of the experiences of elderly persons. With knowledge from this study, nurses and other health professionals can understand and support the elderly from an individual point of view.

[Inappropriate admissions of Ehpad residents to emergency departments]. / Admissions inappropriées des résidents d'Ehpad aux urgences.

After a review of inappropriate admissions of residents of residential care facilities for the dependent elderly (Ehpad) to the emergency room, we propose ways to reduce them. They include giving the coordinating physician a clinical role, organizing continuity and permanence of care in all Ehpad, signing agreements between Ehpad and hospital for direct hospitalization and collaboration with mobile teams and geriatric hotlines, generalizing the level of medical intervention in Ehpad, and deepening the training of Ehpad caregivers in geriatrics.

Vivencias de las personas mayores de una residencia durante el confinamiento por la COVID-19: un estudio cualitativo / Vivencias de las personas mayores de una residencia durante el confinamiento por la COVID-19: un estudio cualitativo

Objetivos: Conocer y explorar las preocupaciones y experiencias que genera el confinamiento por la COVID-19 en las personas mayores. Metodología: Estudio cualitativo de tipo fenomenológico basado en entrevistas semiestructuradas. La información se analizó mediante análisis de contenido y se verificó con la triangulación de los resultados. Resultados: Emergieron 8 categorías coincidentes: sentimientos durante el confinamiento, inquietudes por la salud, cambios en la propia salud, cambios en los hábitos de vida, apoyo profesionales de la salud, estrategias de afrontamiento, información sobre la COVID-19 y preocupaciones sobre el futuro. Conclusiones: Identificar las vivencias de los mayores durante el confinamiento por la COVID-19 ha mostrado, en esta población, las dificultades surgidas del día a día y las capacidades que han tenido que llevar a cabo para soportar y superar este difícil período de la pandemia (AU)

Objective: This paper aims to understand and explore the concerns and experiences generated by confinement by COVID-19 in the elderly. Methodology: Qualitative study of a phenomenological type based on semi-structured interviews. The information was analysed by content analysis and verified by the triangulation approach. Results: Eight coinciding categories emerged: feelings during confinement, health concerns, changes in one’s health, lifestyle changes, health professional support, coping strategies, information about COVID- 19, and concerns about the future. Conclusions: Identifying the experiences of the elderly during confinement by Covid-19 has shown in this population the difficulties that arise from day to day and the capacities that they have had to carry out to withstand and overcome this difficult period of the pandemic (AU)

Vulnerabilidade e envelhecimento humano, conceitos e contextos: uma revisão / Vulnerability and human aging, concepts and contexts: a review

O presente artigo trata-se de uma revisão integrativa de literatura, cujo objetivo central é discutir o conceito de vulnerabilidade e descrever os estudos acerca da temática vulnerabilidade e envelhecimento humano. Foram realizadas buscas nas plataformas CAPES, BVS e PUBMED, utilizando os descritores, vulnerability study, aged, older person, older people, durante o período de janeiro a março de 2019. Utilizou-se 27 publicações para a confecção do presente artigo, organizadas em cinco temáticas distintas: conceito de vulnerabilidade; estudos sobre percepção/significado de vulnerabilidade; estudos teóricos sobre vulnerabilidade; ferramentas e índices de vulnerabilidade; estudos empíricos de prevalência e fatores associados à vulnerabilidade. A literatura dispõe diferentes conceitos para os diferentes contextos aplicáveis à vulnerabilidade. Para o idoso, quase sempre vulnerabilidade está relacionada a incapacidades físicas e dependência. Existem diversas publicações destinadas a adaptar e validar instrumentos. Foram levantados diversos fatores associados à vulnerabilidade, dentre os quais destacaram-se a incapacidade funcional, as doenças crônicas e a depressão.(AU)

This article is an integrative literature review, whose central objective is to discuss the concept of vulnerability and describe studies on the theme of vulnerability and human aging. Searches were carried out on the CAPES, BVS, and PUBMED platforms, using the descriptors, "vulnerability study", "aged", "older person", "older people", from January to March 2019. 27 publications were used for the making of this article, organized into five different themes: the concept of vulner- ability; studies on the perception/meaning of vulnerability; theoretical studies on vulnerability; tools and vulnerability indexes; and empirical studies of prevalence and factors associated with vulnerability. Th literature provides different concepts for the different application contexts of vulnerability. For the elderly, vulnerability is almost always related to physical disabilities and dependence. There are several publications aimed at adapting and validating instruments. Several factors associated with vulnerability were raised, among which, functional disability, chronic diseases, and depression stood out.(AU)

Factores predictores del consumo problemático de sustancias psicoactivas en un grupo de personas adultas mayores: un hábito aprendido / Predictive factors of problematic consumption of psychoactive substances in a group of older adults: a learned habit

Objetivo: Identificar los factores predictores del consumoproblemático de sustancias psicoactivas en un grupo de personas adultasmayores. Metodología: Abordaje cualitativo, diseño hermenéuticointerpretativo. Resultados: Se identifica que los factores predictoresque inciden en instaurar el consumo problemático de sustanciaspsicoactivas como un hábito aprendido en las personas adultas mayoresparticipantes en el presente estudio son: la edad y el lugar de iniciación,el consumo visto y vivenciado como fenómeno sociocultural reforzadoen la familia, generalmente conocidas como familias disfuncionalesadictogénicas, prosustancias psicoactivas-dependientes, además de lascondiciones precarias de existencia, entre ellas: el desempleo, los bajosingresos, el maltrato familiar y social, las relaciones familiares inestables,la exposición al abuso físico y/o sexual, y la presencia de figurasmasculinas identificadas como modelos a seguir que consumen alcohol,tanto en el ámbito familiar como laboral. (AU)

Objective: Identify the predictors of problematic consumptionof psychoactive substances in a group o older adults.Methodology: Qualitative approach, interpretive hermeneuticdesign. Results: It is identified that the predictive factors thataffect establishing the problematic consumption of psychoactivesubstances as a learned habit, in the older adults participating inthe present study are: age and place of initiation, consumptionseen and experienced as a sociocultural phenomenon, reinforcedin the family, generally known as addictogenic dysfunctionalfamilies, pro-psychoactive-dependent substances, in additionto precarious living conditions, including: unemployment, lowincome, family and social abuse, unstable family relationships,exposure to physical and/or sexual abuse, and the presence ofmale figures identified as role models who with consume alcohol,both in the family and at work. (AU)

Conocimiento de profesionales de la atención primaria de salud sobre demencias en personas mayores, Frutillar Chile / Knowledge of primary health care professionals about dementias in the elderly, Frutillar Chile

Objetivos: Analizar aspectos relacionados con el conocimiento enprofesionales de la atención primaria de salud respecto de las demenciasen personas mayores. Metodología: Se desarrolló una investigacióncuantitativa, no experimental de corte transversal y diseño descriptivocorrelacional con una muestra de 32 profesionales de un centro desalud familiar. Resultados: Los conocimientos generales y específicosrespecto de las demencias en personas mayores se encontraron enniveles insuficientes (62,4 y 62,5%, respectivamente), misma situaciónque ocurrió respecto de la autopercepción que los profesionales teníande sus conocimientos (78,1%). Se encontró correlación entre laautopercepción con los conocimientos (coeficiente general Rho: 0,484,p = 0,005; coeficiente específico Rho: 0,642, p = 0,001), con un nivelde confianza del 99%). Además, el estudio reveló que a mayor edady años de profesión, más alto es el nivel de conocimientos respectode las demencias por parte de los profesionales (Waldt 6,43 y 5,854,respectivamente, significación 0,011 y 0,016), y que las capacitaciones alos profesionales de la salud favorecerían a poseer conocimientos mediosen la mima área (Waldt 4,272, significación 0,039). Conclusiones:La incorporación de educación sobre las demencias a nivel depregrado, posgrado y capacitaciones permanentes al personal de losestablecimientos de salud primaria favorecen a unos mayoesr y mejoresreconocimiento, atención, diagnóstico y derivación oportuna depersonas mayores en estadios iniciales de demencias. (AU)

Objectives: To analyze aspects related to the knowledge ofprimary health care professionals regarding dementia in theelderly. Methodology: A quantitative, non-experimental crosssectional research and descriptive-correlational design wasconducted with a sample of 32 professionals from a familyhealth center. Results: General and specific knowledge aboutdementia in older people was found to be insufficient (62.4%and 62.5%, respectively), the same situation happenedwith regard to the self-perception that professionals had oftheir knowledge (78.1%). A correlation was found betweenself-perception and knowledge (general C. Rho: 0.484, p =0.005; specific C. Rho: 0.642, p = 0.001), with a confidencelevel of 99%). In addition, the study revealed that, the higherthe age and years of the profession, the higher the level ofknowledge about dementia on the part of professionals (Waldt6.43 and 5.854, respectively, sig. 0.011 and 0.016), and thatthe training of health professionals would favour havingaverage knowledge in the same area (Waldt 4.272 sig. 0.039).Conclusions: The incorporation of dementia education at theundergraduate and postgraduate levels and ongoing trainingfor staff of primary health care facilities favours greater andbetter recognition, care, diagnosis and timely referral of olderpeople in early stages of dementia. (AU)

[Psychological characteristics of working and non-working elderly people.]

A comparative analysis of the psychological characteristics of the working and non-working population in the context of personal employment, demand and quality life. The study was conducted with the participation of 51 women and 58 men, age 65,35±5,25 years. Randomization into two groups: the 1st group - 59 people of those continuing to work in the field of higher and vocational education; the 2nd group (50 people) consisted of non-working pensioners whose labor activity was related to teaching, taking care of their families, children and grandchildren, the circle of their social contacts is limited by the connections necessary to ensure life. An assessment was made of the orientation of the personality, the level of prevailing needs, the formation and strength of motives, the degree of adequacy of one's own attitude to various life situations, and the psycho-emotional state. It is shown that working pensioners have a higher indicator of the personality's orientation to the task and a low indicator of the personality's orientation to oneself. In the 1st group a stable psycho-emotional state was revealed for a number of functional indicators of a physical, role, social nature, significantly higher indicators of vitality and the physical component of health, they strive to maintain professionalism, financial freedom, and independence. In the 2nd group the desire to overcome social isolation, the desire to develop creativity in oneself prevails. In the 1st and 2nd groups, there were no differences in the levels of the motivational-need sphere. To expand the possibilities of the life potential of an elderly person, it is necessary to study the psychological characteristics older working and non-working population.

Intervenções de enfermagem de ajuda na sobrecarga do cuidador informal que cuida da pessoa idosa no domicílio / Nursing interventions to help with the burden of the informal caregiver who takes care of the elderly person at home

Devido ao envelhecimento populacional muitas famílias experienciam ao longo do seu ciclo vital a situação de doença sendo confrontados com um novo papel: ser cuidador. A manutenção da pessoa idosa que necessita de cuidados no domicílio é cada vez mais uma estratégia fundamental que permite a promoção da autonomia e da dignidade dos idosos, no entanto a prestação destes cuidados pode ser extremamente desgastante e, normalmente, acarreta um aumento da sobrecarga por parte de quem os presta. O reconhecimento da importância social dos cuidadores informais faz-se acompanhar de uma atenção aos seus problemas e da procura de respostas para as suas necessidades, na lógica que é preciso "cuidar de quem cuida". Entende-se que são importantes as ações que visem minimizar o impacto da situação de cuidar do familiar idoso, amenizar a intensidade e a diversidade de sentimentos que surgem durante o desempenho deste complexo papel. Neste campo, os enfermeiros especialistas têm um papel fundamental no diagnóstico das diversas necessidades identificadas junto dos cuidados informais, isto é, das principais dificuldades, do nível de conhecimento assim como da sobrecarga. Com isto é possível a definição de estratégias e implementação de intervenções capazes de ajudar no bem-estar dos cuidadores informais e desta forma fomentar uma maior segurança nos cuidados prestados por estes à pessoa idosa no domicílio. Desta forma, o presente relatório apresenta, de forma crítica, reflexiva e introspetiva, o percurso de aquisição e desenvolvimento de competências de enfermeira especialista em Enfermagem Médico-Cirúrgica, conduzidos por objetivos e atividades delineadas com esse propósito. Destacam-se as intervenções realizadas junto aos cuidadores, intervenções essas individuais, dado que os cuidadores são um grupo heterogéneo com diferentes necessidades, expectativas e características. A aquisição de competências de enfermeiro especialista em Enfermagem Médico-Cirúrgica visa o desenvolvimento de conhecimentos e competências específicas, que devem ser mobilizados para a prática, permitindo o desenvolvimento de novos e atualizados comportamentos e habilidades para a prática de Enfermagem.

Due to population aging, many families experience illness throughout their life, being faced with a new role: being a caregiver. The maintenance of the elderly who need care at home is increasingly a fundamental strategy that allows the advancement of autonomy and dignity of the elderly, however, the provision of this care can be extremely exhausting and, normally, it entails an increase in the burden on the part of those who exercise them. Recognition of the social importance of informal caregivers is accompanied by attention to their problems and the search for answers to their needs, in the logic that it is necessary to "help those who help". It is understood that actions aimed at minimizing the impact of the situation of caring for the elderly family member and softening the intensity and diversity of feelings that arise during the performance of this complex role are important. In this field, specialist nurses play a fundamental role in the diagnosis of the many needs identified with informal care, i.e. the main difficulties, knowledge level as well as overload. With this, it is possible to define strategies and implement interventions capable of helping informal caregivers in regards to their well-being and thus foster greater security in the care provided by these to the elderly person at home. In this way, this report makes it possible to demonstrate, in a critical, reflective, and introspective way, the path of acquisition and development of specialist nursing skills in Medical-Surgical Nursing, driven by objectives and activities designed for that purpose. This document describes individual interventions carried out with the caregivers, given that these caregivers are a heterogeneous group with different needs, expectations and characteristics. The acquisition of skills as a specialist nurse in Medical-Surgical Nursing aims to develop specific knowledge and skills, which must be mobilized for practice, allowing the development of new and updated behaviors and skills for nursing practice.

Intervenção especializada de enfermagem na prevenção, avaliação e tratamento da dermatite associada à incontinência na pessoa idosa / Specialized nursing intervention in the prevention, evaluation and treatment of dermatitis associated with incontinence in the elderly

A dimensão das dermatites associadas à incontinência é desconhecida em diversos contextos de prestação de cuidados, principalmente em Portugal. Contudo sabe-se que afeta uma elevada percentagem de pessoas idosas, não só pelo processo de envelhecimento da pele, mas também por ser comum apresentarem incontinência urinária e fecal. Um dos principais focos da enfermagem é a integridade da pele, e por isso é importante atentar nos principais fatores de risco para o desenvolvimento de lesões na mesma, e consequentemente desenvolvimento de dermatite associada à incontinência. O presente relatório, concretiza a implementação de um projeto sustentado na metodologia de projeto, realizado na prática clínica do Curso de Mestrado em Enfermagem na Área de Especialização Enfermagem Médico-Cirúrgica na Área de Intervenção à Pessoa Idosa, em dois contextos distintos, uma unidade de cuidados na comunidade e um serviço de internamento hospitalar. A realização do estágio e implementação do projeto permitiu-nos desenvolver competências ao nível de atividades centradas numa prática baseada na evidência, tendo por base os resultados de uma revisão integrativa da literatura; nomeadamente no envolvimento da pessoa idosa e sua família no plano de cuidados, centrado na prevenção da dermatite associada à incontinência; sensibilizamos ainda as equipas de cuidados para a temática; implementamos intervenções e estratégias para a prevenção da dermatite associada à incontinência e desenvolvemos um guia orientador para a prática de cuidados. Percebemos também que um plano de cuidados de enfermagem individualizado permite a implementação de intervenções adequadas, através da realização de um diagnóstico diferencial eficaz, incluindo procedimentos preventivos e tratamentos apropriados em pessoas idosas com situações de dermatite. Este percurso possibilitou a aquisição e desenvolvimento de competências inerentes ao grau de mestre e enfermeiro especialista em enfermagem médico-cirúrgica, no cuidado à pessoa idosa e família.

The dimension of incontinence-associated dermatitis is unknown in several contexts of care provision, mainly in Portugal. However, it is known that it affects a high percentage of elderly-people, not only because of the skin aging process but also because it is common to have both urinary and fecal incontinence. One of the main focuses in nursing is skin integrity. Hence the importance to be aware of the main risk factors for developing skin damage and, consequently, the development of incontinence-associated dermatitis. Therefore, an evidence-based practical approach, supported by the literature review, centered on the prevention of incontinence-associated dermatitis and sensitization of health teams in the subject achieved by implementing strategies for preventing incontinence-associated dermatitis and developing guidelines for the care practice. Furthermore, we also realized that an individualized nursing care plan allows for the implementation of adequate interventions, by performing an effective differential diagnosis, including preventive procedures and appropriate treatments in elderly people with situations of dermatitis. The path taken led to the acquisition and further development of skills inherent to the master's degree and specialized nurse in medical-surgical nursing, in elderly care and family.

Correlation Between Skin Autofluorescence and Muscle Activities of Lower Limb in Aging Without Disease and Disability.

Skin autofluorescence is a useful index to estimate the accumulation of advanced glycation end-products in human tissues. Elderly persons with higher skin autofluorescence have lower muscle mass, muscle strength and muscle power, however, little is known about the relationship between the skin autofluorescence level and each muscle activity. We measured the values of skin autofluorescence from five places on a lower limb, and the signals of surface electromyogram during isometric contractions from five muscles on that, simultaneously. The waveforms of surface electromyogram were analyzed by Daubechies-4 wavelet transformation. The value of skin autofluorescence was increased in the proximal part of the lower limb compared with the value of the distal part. The principal component of surface electromyogram activity in a time-frequency domain was lower in the proximal part compared with that of the distal part. There was a weak negative correlation between the value of skin autofluorescence on the gluteal region and the value of the mean wavelet coefficient of the surface electromyogram signals within the gluteus maximus muscle. The higher accumulation of advanced glycation end-products on the gluteal region might suggest the lower muscle activity in aging without disease and disability.