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INTRODUCTION: Colorectal cancer (CRC) is the second cause of cancer-related deaths worldwide. Five-year survival rate in Spain is 57%. The most important prognostic factor is the stage of the tumor at the diagnosis. CRC can be early diagnosed, but the adherence to screening programs is low (<50%). This study aims to ascertain the influence of social support and stressful life events on the adherence to the population screening of CRC with fecal occult blood test in Spanish average risk population. METHODS: Multicenter case-control study. We conducted a simple random sampling among individuals invited to participate in the colorectal cancer screening program. We analyzed epidemiological and social variables associated with lifestyle and behavioral factors. We performed a descriptive and a bivariant analyses and a logistic regression analysis. RESULTS: Four hundred and eight patients (237 cases and 171 controls) were included. Multivariant analyses showed independent association between higher adherence to the screening program and older age (OR: 1.06; 95% CI: 1.01-1.10), stable partner (OR: 1.77, 95% CI: 1.08-2.89) and wide social network (OR: 1.68; 95% CI: 1.07-2.66). Otherwise, lower adherence was associated to perceiving barriers to participate in the program (OR: 0.92; 95% CI: 0.88-0.96). We find a statistically significant association between lower adherence and high impact stressful life events in the bivariant analyses, and the tendency was maintained (OR: 0.63, 95% CI: 0.37-1.08) in the multivariant. CONCLUSION: Social variables decisively influence the adherence to colorectal cancer screening. The implementation of social interventions that improve social support, reduce impact of stressful life events and the design of screening programs that decrease the perceived barriers, will contribute to increase the participation on these programs. Secondary, the colorectal cancer diagnosis will be made in early-stages with the consequent mortality reduction.
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Neoplasias Colorretais , Sangue Oculto , Humanos , Estudos de Casos e Controles , Detecção Precoce de Câncer , Neoplasias Colorretais/epidemiologia , Apoio SocialRESUMO
INTRODUCTION: Patients with liver cirrhosis who are candidates for liver transplantation must be evaluated both clinically and socially in order to obtain the optimal outcomes and avoid futile therapeutic measures. For the evaluation of the social aspects in these patients, no validated scale in Spanish is available. The SIPAT (Stanford Integrated Psychosocial Assessment for Transplantation) scale is an instrument that measures the social, family and psychological aspects in candidates for solid organ transplantation. The objective of this study is to adapt and validate an abbreviated version of the SIPAT scale in Spanish for patients with liver cirrhosis. MATERIAL AND METHODS: Prospective observational study carried out in the Hepatology Unit of the La Fe Unversity Hospital in Valencia, by questionnaire validation methodology. To analyze the reliability of the questionnaire, the internal consistency of all variables was calculated, for variability an exploratory factor analysis, and for stability the test-retest test was carried out. RESULTS: 96 patients who were admitted for decompensated cirrhosis to the Hepatology Unit of the La Fe Hospital in Valencia between November 1, 2017 and January 31, 2017 were selected. 84% were men, the mean age was 60.01 (SD 10.12) years. In 73.2% of those admitted, the etiology of cirrhosis was alcoholic. 14.4% had a Child's stage A, 57.7% B and 27.8% C. The internal consistency of all variables reached a Cronbach's Alpha of 0.766. In the exploratory factor analysis, 6 dimensions of the questionnaire were identified that explain 84.27% of the total variability. To see the stability of the instrument, the measurement was repeated at 2 and 6 months of follow-up, obtaining in the test-retest a kappa agreement of 0.612 and 0.565 respectively. CONCLUSION: The SIPAT-11 questionnaire has good psychometric characteristics in cirrhotic patients who are candidates for liver transplantation. It is easy to complete and can be administered by professionals who are not specialists in the area of Mental Health.
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BACKGROUND: Colorectal cancer is the second cancer-related cause of death in the world. Tumour stage at diagnosis is the principal prognosis factor of survival. However, the participation in the programme is around 50%. The aim of the study was to identify the benefits and barriers perceived by the population when participating in a colorectal cancer screening programme with faecal occult blood test. METHODS: We carried out a cases-controls study with 408 participants. We analyzed epidemiological and social variables associated with lifestyle and behavioural factors based in the Health Belief Model. We conducted a descriptive analysis, and identified variables associated to adherence by a logistic regression. RESULTS: Variables independently associated with the participation in a colorectal cancer screening programme were age (OR 1.06; 95% CI: 1.01-1.11), having a stable partner (OR 1.96; 95% CI: 1.20-3.18), the level of education (OR 1.59; 95% CI: 1.02-2.47) and two of the barriers to participate in the faecal occult blood test screening: "you don't know how to do one" (OR=0.46; 95% CI: 0.23-0.93) and "it is not that important right now" (OR=0.43; 95% CI: 0.24-0.78). CONCLUSION: The existing barriers for screening with faecal occult blood test are the best factor predicting. This is relevant when designing the intervention programmes, as they should focus on reducing perceived barriers to increase the participation in colorectal cancer screening, thereby reducing colorectal cancer mortality.
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Neoplasias Colorretais , Sangue Oculto , Humanos , Detecção Precoce de Câncer , Programas de Rastreamento , Neoplasias Colorretais/epidemiologiaRESUMO
INTRODUCTION: Inadequate social support is associated with higher mortality both in the general population and in patients with chronic diseases. There are no studies that have described social support in liver cirrhosis and its impact on prognosis. OBJECTIVES: To analyze the impact social support has in the survival of patients with decompensated cirrhosis. METHODS: Prospective multicentric cohort study (2016-2019). Patients with decompensated liver cirrhosis were included. Epidemiological, clinical and social variables were collected, using the validated Medical Outcomes Study Social Support Survey, with a 12-month follow-up. RESULTS: A total of 127 patients were included, of which 79.5% were men. The most common etiology of cirrhosis was alcohol (74.8%), mean age was 60 years (SD 10.29), mean MELD was 15.6 (SD 6.3) and most of the patients had a Child-Pugh B (53.5%) or C (35.4%). In the assessment of social support, we observed that most of the patients (92.2%) had adequate global support. At the end of the follow-up (median 314 days), 70.1% of the patients survived. The 1-year survival rate in patients with inadequate global social support was 30%, compared to 73.5% in the presence of social support. In multivariate Cox regression analysis, inadequate social support predicted survival with an adjusted HR of 5.5 (95% CI 2,3-13,4) independently of MELD (HR 1.1, 95% CI 1-1.2), age (HR 1, 95% CI 1-1.1) and hepatocarcinoma (HR 10.6, 95% CI 4.1-27.4). CONCLUSION: Adequate social support improves survival in liver cirrhosis, independently of clinical variables. Social intervention strategies should be considered for their management.
Assuntos
Cirrose Hepática , Neoplasias Hepáticas , Masculino , Humanos , Pessoa de Meia-Idade , Feminino , Estudos de Coortes , Estudos Prospectivos , Cirrose Hepática/complicações , Prognóstico , Neoplasias Hepáticas/complicações , Índice de Gravidade de DoençaRESUMO
INTRODUCTION: Colorectal cancer 5-years-survival is 57%, partway due to a low rate of participation in screening programmes. Instruments analyzing causes of low adherence are needed. OBJECTIVE: To evaluate the validity and internal consistency of the Spanish version of Rawl's Questionnaire for the screening of colorectal cancer by faecal occult blood testing. TYPE OF STUDY: Questionnaire validation methodology. LOCATION: Three Primary Care Centres in Valencia. VARIABLES: Age, sex, civil status, educational level, social class, smoking, alcohol consumption, body mass index, personal and family history of cancer. RESULTS: We analyzed 408 individuals (237 cases and 171 controls). Mean age was 59.45 years (SD 5.17). Internal consistency of all variables reached a Cronbach's alfa of 0.796. The Cronbach's alfa benefit dimension of the screening was 0.871 and for the barrier dimension of the screening it was 0.817. Intraclass correlation coefficients of the test-retest for the benefit dimension of the screening was 0.809 (CI 95% 0.606-0.913) and 0.499 (CI 95% 0.126-0.750) for the barrier dimension. CONCLUSION: The Spanish version of Rawl's Questionnaire is valid, reliable and reproducible, so we have this validated instrument with which to identify barriers and benefits in a colorectal screening programme in Spain.
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Neoplasias Colorretais/diagnóstico , Idioma , Sangue Oculto , Traduções , Fatores Etários , Idoso , Estudos de Casos e Controles , Escolaridade , Humanos , Pessoa de Meia-Idade , Fatores SexuaisRESUMO
We aimed to assess the risk of cancer in patients with abdominal symptoms after a complete colonoscopy without colorectal cancer (CRC), according to the carcinoembryonic antigen (CEA) concentration, as well as its diagnostic accuracy. For this purpose, we performed a post-hoc analysis within a cohort of 1431 patients from the COLONPREDICT study, prospectively designed to assess the fecal immunochemical test accuracy in detecting CRC. Over 36.5 ± 8.4 months, cancer was detected in 115 (8%) patients. Patients with CEA values higher than 3 ng/mL revealed an increased risk of cancer (HR 2.0, 95% CI 1.3-3.1), CRC (HR 4.4, 95% CI 1.1-17.7) and non-gastrointestinal cancer (HR 1.7, 95% CI 1.0-2.8). A new malignancy was detected in 51 (3.6%) patients during the first year and three variables were independently associated: anemia (OR 2.8, 95% CI 1.3-5.8), rectal bleeding (OR 0.3, 95% CI 0.1-0.7) and CEA level >3 ng/mL (OR 3.4, 95% CI 1.7-7.1). However, CEA was increased only in 31.8% (95% CI, 16.4-52.7%) and 50% (95% CI, 25.4-74.6%) of patients with and without anemia, respectively, who would be diagnosed with cancer during the first year of follow-up. On the basis of this information, CEA should not be used to assist in the triage of patients presenting with lower bowel symptoms who have recently been ruled out a CRC.
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Introducción: La supervivencia del cáncer colorrectal es del 57% a los 5 años, en parte debido a un diagnóstico tardío por una baja participación en los programas de cribado. Son necesarios instrumentos que analicen las causas de participación.Objetivo: Comprobar la validez y consistencia interna de la versión en castellano del cuestionario de Rawl para el cribado de cáncer colorrectal con sangre oculta en heces.Tipo de estudio: Metodología de validación de cuestionarios.Localización: Tres centros de salud de Valencia.Variables: Edad, sexo, estado civil, nivel de estudios, clase social, consumo de tabaco, alcohol, índice de masa corporal, antecedentes personales y familiares de cáncer.Resultados: Se estudiaron 408 individuos (237 casos y 171 controles). La edad media fue de 59,45 (DE 5,17) años. La consistencia interna de todas las variables alcanzó una alfa de Cronbach de 0,796. El alfa de Cronbach de la dimensión beneficios del cribado fue de de 0,871 y para la dimensión barreras al cribado fue de 0,817. Los coeficientes de correlación intraclase del test-retest para la dimensión de los beneficios del cribado fue de 0,809 (IC 95% 0,606-0,913) y de 0,499 (IC 95% 0,126-0,750) para las barreras.Conclusión: La versión en castellano del cuestionario Rawl es válido, fiable y reproducible. Con lo que disponemos de un elemento validado en España con el que objetivar barreras y beneficios percibidos en un programa de cribado poblacional.
Introduction: Colorectal cancer 5-years-survival is 57%, partway due to a low rate of participation in screening programmes. Instruments analyzing causes of low adherence are needed.Objective: To evaluate the validity and internal consistency of the Spanish version of Rawl's Questionnaire for the screening of colorectal cancer by faecal occult blood testing.Type of study: Questionnaire validation methodology.Location: Three Primary Care Centres in Valencia.Variables: Age, sex, civil status, educational level, social class, smoking, alcohol consumption, body mass index, personal and family history of cancer.Results: We analyzed 408 individuals (237 cases and 171 controls). Mean age was 59.45 years (SD 5.17). Internal consistency of all variables reached a Cronbach's alfa of 0.796. The Cronbach's alfa benefit dimension of the screening was 0.871 and for the barrier dimension of the screening it was 0.817. Intraclass correlation coefficients of the test-retest for the benefit dimension of the screening was 0.809 (CI 95% 0.606-0.913) and 0.499 (CI 95% 0.126-0.750) for the barrier dimension.Conclusion: The Spanish version of Rawl's Questionnaire is valid, reliable and reproducible, so we have this validated instrument with which to identify barriers and benefits in a colorectal screening programme in Spain.
Assuntos
Humanos , Adulto , Neoplasias Colorretais , Fezes , Programas de Triagem Diagnóstica , Neoplasias Colorretais/diagnóstico , Análise Multivariada , Interpretação Estatística de Dados , Estudos de Casos e Controles , Gastroenterologia , Fatores Etários , EspanhaRESUMO
Introduction Colorectal cancer (CRC) is the second cause of cancer-related deaths worldwide. Five-year survival rate in Spain is 57%. The most important prognostic factor is the stage of the tumor at the diagnosis. CRC can be early diagnosed, but the adherence to screening programs is low (<50%). This study aims to ascertain the influence of social support and stressful life events on the adherence to the population screening of CRC with fecal occult blood test in Spanish average risk population. Methods Multicenter casecontrol study. We conducted a simple random sampling among individuals invited to participate in the colorectal cancer screening program. We analyzed epidemiological and social variables associated with lifestyle and behavioral factors. We performed a descriptive and a bivariant analyses and a logistic regression analysis. Results Four hundred and eight patients (237 cases and 171 controls) were included. Multivariant analyses showed independent association between higher adherence to the screening program and older age (OR: 1.06; 95% CI: 1.011.10), stable partner (OR: 1.77, 95% CI: 1.082.89) and wide social network (OR: 1.68; 95% CI: 1.072.66). Otherwise, lower adherence was associated to perceiving barriers to participate in the program (OR: 0.92; 95% CI: 0.880.96). We find a statistically significant association between lower adherence and high impact stressful life events in the bivariant analyses, and the tendency was maintained (OR: 0.63, 95% CI: 0.371.08) in the multivariant. Conclusion Social variables decisively influence the adherence to colorectal cancer screening. The implementation of social interventions that improve social support, reduce impact of stressful life events and the design of screening programs that decrease the perceived barriers, will contribute to increase the participation on these programs. Secondary, the colorectal cancer diagnosis will be made in early-stages with the consequent mortality reduction (AU)
Introducción El cáncer colorrectal (CCR) es la segunda causa de muerte por cáncer en el mundo. La tasa de supervivencia a cinco años en España es de 57%. El factor pronóstico más importante es el estadio del tumor en el momento del diagnóstico. El CCR se puede diagnosticar precozmente, pero la adherencia a los programas de cribado es baja (< 50%). Este estudio pretende conocer la influencia del apoyo social y los acontecimientos vitales estresantes en la adherencia al cribado poblacional de CCR con sangre oculta en heces en población española de riesgo medio. Métodos Estudio multicéntrico de casos y controles. Realizamos un muestreo aleatorio simple entre los individuos invitados a participar en un programa de cribado de CCR. Analizamos variables epidemiológicas y sociales asociadas al estilo de vida y factores conductuales. Realizamos un análisis descriptivo, un análisis bivariante y una regresión logística. Resultados Se incluyeron 408 pacientes (237 casos y 171 controles). El análisis multivariante demostró una asociación independiente entre una mayor adherencia al programa de cribado y mayor edad (OR: 1,06; IC 95%: 1,01-1,10), tener pareja estable (OR: 1,77, IC 95%: 1,08-2,89) y disponer de una amplia red social (OR: 1,68; IC 95%: 1,07-2,66). Por el contrario, la menor adherencia se asoció a la percepción de barreras para participar en el cribado (OR: 0,92; IC 95%: 0,88-0,96). Encontramos una asociación estadísticamente significativa entre menor adherencia y acontecimientos vitales estresantes de alto impacto en el análisis bivariante. La tendencia se mantuvo (OR: 0,63, IC 95%: 0,37-1,08) en el análisis multivariante (AU)
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Neoplasias Colorretais/mortalidade , Apoio Social , Estudos de Casos e Controles , Detecção Precoce de CâncerRESUMO
Background: Colorectal cancer is the second cancer-related cause of death in the world. Tumour stage at diagnosis is the principal prognosis factor of survival. However, the participation in the programme is around 50%. The aim of the study was to identify the benefits and barriers perceived by the population when participating in a colorectal cancer screening programme with faecal occult blood test. Methods: We carried out a casescontrols study with 408 participants. We analyzed epidemiological and social variables associated with lifestyle and behavioural factors based in the Health Belief Model. We conducted a descriptive analysis, and identified variables associated to adherence by a logistic regression. Results: Variables independently associated with the participation in a colorectal cancer screening programme were age (OR 1.06; 95% CI: 1.011.11), having a stable partner (OR 1.96; 95% CI: 1.203.18), the level of education (OR 1.59; 95% CI: 1.022.47) and two of the barriers to participate in the faecal occult blood test screening: you dont know how to do one (OR=0.46; 95% CI: 0.230.93) and it is not that important right now (OR=0.43; 95% CI: 0.240.78). Conclusion: The existing barriers for screening with faecal occult blood test are the best factor predicting. This is relevant when designing the intervention programmes, as they should focus on reducing perceived barriers to increase the participation in colorectal cancer screening, thereby reducing colorectal cancer mortality.(AU)
Antecedentes: El cáncer colorrectal constituye la segunda causa de muerte por cáncer en el mundo. El estadio del tumor al diagnóstico es el principal factor pronóstico de supervivencia. Sin embargo, la participación en el programa está en torno al 50%. El objetivo de este estudio fue identificar los beneficios y las barreras percibidos por la población al participar en un programa de cribado de cáncer de colon mediante el test de sangre oculta en heces. Métodos: Estudio de casos y controles con 408 participantes en el que analizamos variables sociodemográficas, variables asociadas al estilo de vida y factores conductuales basados en el Modelo de Creencias en Salud. Realizamos un análisis descriptivo y, para identificar las variables asociadas a la adhesión al programa de cribado de cáncer colorrectal, una regresión logística. Resultados: Las variables que se asociaron de forma independiente a la participación en el programa fueron la edad (OR 1,06; IC 95% 1,01-1,11), tener pareja estable (OR 1,96; IC 95% 1,20-3,18), el nivel de estudios (OR 1,59; IC 95% 1,02-2,47) y 2 de las barreras para participar en el cribado mediante test de sangre oculta en heces: «no sabe cómo hacerlo» (OR 0,46; IC 95% 0,23-0,93) y «no es un problema importante en el momento actual» (OR 0,3; IC 95% 0,24-0,78). Conclusión: Las barreras existentes para el cribado mediante test de sangre oculta en heces son el mejor factor predictivo de participación. Esto es importante a la hora de diseñar los programas de cribado de cáncer colorrectal, ya que la reducción de las barreras percibidas aumentará la participación en los mismos, reduciendo así la mortalidad por cáncer de colon.(AU)
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Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Fezes , Sangue Oculto , Neoplasias do Colo , Atenção Primária à Saúde , Mortalidade , Programas de Rastreamento , Estudos de Casos e ControlesRESUMO
Introduction: Inadequate social support is associated with higher mortality both in the general population and in patients with chronic diseases. There are no studies that have described social support in liver cirrhosis and its impact on prognosis. Objectives: To analyze the impact social support has in the survival of patients with decompensated cirrhosis. Methods: Prospective multicentric cohort study (20162019). Patients with decompensated liver cirrhosis were included. Epidemiological, clinical and social variables were collected, using the validated Medical Outcomes Study Social Support Survey, with a 12-month follow-up. Results: A total of 127 patients were included, of which 79.5% were men. The most common etiology of cirrhosis was alcohol (74.8%), mean age was 60 years (SD 10.29), mean MELD was 15.6 (SD 6.3) and most of the patients had a ChildPugh B (53.5%) or C (35.4%). In the assessment of social support, we observed that most of the patients (92.2%) had adequate global support. At the end of the follow-up (median 314 days), 70.1% of the patients survived. The 1-year survival rate in patients with inadequate global social support was 30%, compared to 73.5% in the presence of social support. In multivariate Cox regression analysis, inadequate social support predicted survival with an adjusted HR of 5.5 (95% CI 2,3-13,4) independently of MELD (HR 1.1, 95% CI 11.2), age (HR 1, 95% CI 11.1) and hepatocarcinoma (HR 10.6, 95% CI 4.127.4). Conclusion: Adequate social support improves survival in liver cirrhosis, independently of clinical variables. Social intervention strategies should be considered for their management.(AU)
Introducción: El apoyo social se asocia a mortalidad en población general y en pacientes con enfermedades crónicas. No hay estudios que hayan descrito el apoyo social en cirrosis hepática y su impacto sobre el pronóstico. Objetivo: Analizar el impacto del apoyo social en la supervivencia en cirrosis hepática descompensada. Material y métodos: Estudio multicéntrico prospectivo de cohortes (20162019). Se incluyeron pacientes con cirrosis hepática descompensada. Se recogieron variables epidemiológicas, clínicas y sociales mediante la escala validada Medical Outcomes Study Social Support Survey (MOS), realizando un seguimiento de 12 meses. Resultados: Se incluyeron 127 pacientes, el 79,5% eran hombres. La causa más común de la cirrosis hepática fue alcohol (74,8%), la edad media 60 años (DE: 10,29), la media de MELD 15,6 (DE: 6,3) y la mayoría tenían Child-Pugh B (53,5%) o C (35,4%). Se observó que la mayoría de pacientes (92,2%) tenían un apoyo social adecuado (MOS global>56). Al finalizar el seguimiento (mediana 314 días), el 70,1% de los pacientes sobrevivieron. La supervivencia al año en falta de apoyo social fue del 30%, comparado con el 73,5% en los que el apoyo social era adecuado. En el análisis de regresión multivariante el apoyo social predijo la supervivencia con un HR ajustado de 5,5 (IC 95%: 2,3-13,4) independientemente del MELD (HR: 1,1; IC 95%: 1-1,2), edad (HR: 1; IC 95%: 1-1,1) y hepatocarcinoma (HR: 10,6; IC 95%: 4,1-27,4). Conclusión: El apoyo social inadecuado en pacientes con CH disminuye la supervivencia, independientemente de las variables clínicas. Se deberían plantear estrategias de intervención social para su manejo.(AU)
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Humanos , Masculino , Feminino , Apoio Social , Sobrevivência , Cirrose Hepática , Doença Crônica , Mortalidade , Estudos Prospectivos , Estudos de CoortesRESUMO
UNLABELLED: Determine the prevalence of malnutrition in valid adults older than 75 years old in Xinzo (Spain), and study institutionalization as a possible risk factor of malnutrition. METHODS: This is a cross-sectional study of prevalence. SAMPLE: 311 people over 75 years. VARIABLES STUDIED: Age, gender, marital status, education level, institutionalization or not, nutritional status (MNA and anthropometric parameters), social support (Duke- Unc scale), Quality of life (Euro- Quol scale); associated diseases, swallowing problems, type of diet and medications. RESULTS: The median age was 82.55 years (SD: 4.83), 51.8% were women. The 52.7% were married, regarding the educational level, 76.8% had completed the primary education. The 17.4% were institutionalized. The median of pathologies was 3 (SD:1.42 and the number of drugs for individual was 4 (SD:2.44). The 54.70% lived with another family or partner. The median of quality of life was 6.84. According to the results of the MNA did not find any case of malnutrition, but a 20.3% of patients present values of risk. Multivariate analysis found relationship between the presence or not of malnutrition and the institutionalization OR = 0.403 (95% CI: 0.186-0.872), the number of pathologies OR = 1.301 (95% CI: 1.032-1.641), quality of life OR = 1.401 (95% CI: 1.145-1.716). CONCLUSION: Our valid elders are well nourished. The age, a good quality of life and a good support are protective factors. The risk of malnutrition is associated to a higher age, to institutionalization and to higher number of pathologies.
Determinar el estado nutricional de los ancianos de un área de salud rural y ver si la institucionalización es un factor de riesgo. Diseño del estudio: Estudio observacional descriptivo en SAP de Xinzo de Limia 3. Sujetos: El tamaño muestral fue de 311 pacientes mayores de 75 años, seleccionados por muestreo aleatorio simple. Mediciones: Edad, sexo, estado civil, nivel de estudios, institucionalización o no, estado nutricional: valorado mediante el cuestionario MNA y parámetros antropométricos; apoyo social: medido mediante la escala de Duke- Unc; Calidad de vida: con la escala Euro-Quol; patologías asociadas; trastornos de la deglución; tratamiento habitual: tipo de dieta, fármacos. Resultados principales: La mediana de edad era de 82,55 años (DT 4,83 años) y el 51,8% eran mujeres, el 52,7% estaba casado y el 76,8% referían estudios primarios. La mediana de patologías por individuo era del 3 (DT: 1,42) y del número de fármacos usados era de 4 (DT 2,44). El 54,70% vivía acompañado por su pareja u otro familiar. Estaban institucionalizados el 17,4%. La mediana de calidad de vida era de 6,84. Según los resultados del MNA no encontramos ningún caso de desnutrición, pero un 20.3% de los pacientes presentan valores de riesgo. En el análisis multivariante encontramos relación entre la presencia o no de desnutrición y la institucionalización OR = 0,40 (IC 95%, 0,18- 0,87), con el nº de patologías OR = 1,30 (IC 95%, 1,03-1,64), calidad de vida OR = 1,40 (IC 95%, 1,14-1,71). Conclusiones: Los pacientes ancianos validos estudiados presentan un buen estado nutricional. Los pacientes con riesgo de presentar desnutrición son un 20,3%, siendo la institucionalización, los mayores de 85 años con mayor número de patologías los que presentan mayor riesgo de desnutrición. La peor calidad de vida y el menor apoyo social influyen negativamente.
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Institucionalização , Desnutrição/epidemiologia , Estado Nutricional , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Masculino , Prevalência , Fatores de Risco , Inquéritos e QuestionáriosRESUMO
No disponible
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Humanos , História do Século XX , Medicina Tradicional/história , Saúde da População Rural/história , História da MedicinaRESUMO
Determinar el estado nutricional de los ancianos de un área de salud rural y ver si la institucionalización es un factor de riesgo. Diseño del estudio: Estudio observacional descriptivo en SAP de Xinzo de Limia 3. Sujetos: El tamaño muestral fue de 311 pacientes mayores de 75 años, seleccionados por muestreo aleatorio simple. Mediciones: Edad, sexo, estado civil, nivel de estudios, institucionalización o no, estado nutricional: valorado mediante el cuestionario MNA y parámetros antropométricos; apoyo social: medido mediante la escala de Duke- Unc; Calidad de vida: con la escala Euro-Quol; patologías asociadas; trastornos de la deglución; tratamiento habitual: tipo de dieta, fármacos. Resultados principales: La mediana de edad era de 82,55 años (DT 4,83 años) y el 51,8% eran mujeres, el 52,7% estaba casado y el 76,8% referían estudios primarios. La mediana de patologías por individuo era del 3 (DT: 1,42) y del número de fármacos usados era de 4 (DT 2,44). El 54,70% vivía acompañado por su pareja u otro familiar. Estaban institucionalizados el 17,4%. La mediana de calidad de vida era de 6,84. Según los resultados del MNA no encontramos ningún caso de desnutrición, pero un 20.3% de los pacientes presentan valores de riesgo. En el análisis multivariante encontramos relación entre la presencia o no de desnutrición y la institucionalización OR = 0,40 (IC 95%, 0,180,87), con el no de patologías OR = 1,30 (IC 95%, 1,03-1,64), calidad de vida OR = 1,40 (IC 95%, 1,14-1,71). Conclusiones: Los pacientes ancianos validos estudiados presentan un buen estado nutricional. Los pacientes con riesgo de presentar desnutrición son un 20,3%, siendo la institucionalización, los mayores de 85 años con mayor número de patologías los que presentan mayor riesgo de desnutrición. La peor calidad de vida y el menor apoyo social influyen negativamente (AU)
Determine the prevalence of malnutrition in valid adults older than 75 years old in Xinzo (Spain), and study institutionalization as a possible risk factor of malnutrition. Methods: This is a cross-sectional study of prevalence. Sample: 311 people over 75 years. Variables studied: Age, gender, marital status, education level, institutionalization or not, nutritional status (MNA and anthropometric parameters), social support (Duke- Unc scale), Quality of life (Euro- Quol scale); associated diseases, swallowing problems, type of diet and medications. Results: The median age was 82.55 years (SD: 4.83), 51.8% were women. The 52.7% were married, regarding the educational level, 76.8% had completed the primary education. The 17.4% were institutionalized. The median of pathologies was 3 (SD:1.42 and the number of drugs for individual was 4 (SD:2.44). The 54.70% lived with another family or partner. The median of quality of life was 6.84. According to the results of the MNA did not find any case of malnutrition, but a 20.3% of patients present values of risk. Multivariate analysis found relationship between the presence or not of malnutrition and the institutionalization OR = 0.403 (95% CI: 0.186-0.872), the number of pathologies OR = 1.301 (95% CI: 1.032-1.641), quality of life OR = 1.401 (95% CI: 1.145-1.716). Conclusion: Our valid elders are well nourished. The age, a good quality of life and a good support are protective factors. The risk of malnutrition is associated to a higher age, to institutionalization and to higher number of pathologies (AU)