To see the other types of publications on this topic, follow the link: Geriatric assessment.
Dissertations / Theses on the topic 'Geriatric assessment'
Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles
Consult the top 50 dissertations / theses for your research on the topic 'Geriatric assessment.'
Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.
You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.
Browse dissertations / theses on a wide variety of disciplines and organise your bibliography correctly.
1
Júnior, Carlos Montes Paixão. "Uma revisão sobre instrumentos de avaliação do estado funcional do idoso." Universidade do Estado do Rio de Janeiro, 2001. http://www.bdtd.uerj.br/tde_busca/arquivo.php?codArquivo=2253.
Full textAbstract:
Conselho Nacional de Desenvolvimento Científico e TecnológicoEste estudo visa avaliar, através de uma revisão, as qualidades conceituais e psicométricas dos instrumentos de avaliação do estado funcional do paciente idoso, e de suas adaptações para o contexto do Brasil. A dissertação está estruturada em três partes. A primeira é constituída de cinco seções que introduzem os temas do envelhecimento da população mundial e de países emergentes como o Brasil como razões de base para um estudo do atendimento do paciente idoso. Descreve-se o que se entende por estado funcional do paciente idoso no contexto da avaliação geriátrica interdisciplinar. A parte 2 se constitui no artigo da dissertação. Na seção de material e métodos descreve-se detalhadamente a revisão realizada e os bancos de dados utilizados. Nas últimas duas seções do artigo apresentam-se os resultados e a discussão, em que se verificam, em primeiro lugar, um bom número de instrumentos com propriedades psicométricas adequadas que avaliam as subdimensões do estado funcional. Dos 30 instrumentos escolhidos utilizando critérios explicitados pelos autores, apenas dois, o Multiple Outcomes Study SF-36 e o Health Assessment Questionnaire, possuem adaptação para 0 português. Entretanto, alguns dos instrumentos revisados vêm sendo utilizados em nosso meio sem adaptação formal prévia. Vários destes instrumentos possuem bons históricos em sua língua original, porém este fato ainda não despertou a preocupação da comunidade brasileira para adaptações formais dos mesmos. Também se constatam a escassez de estudos de adaptação e concepção de instrumentos desta dimensão no contexto brasileiro. Alguns aspectos deste problema são discutidos, além de possíveis caminhos para corrigi-lo. Na parte final desta dissertação são sucintamente descritos os instrumentos de cada subdimensão de estado funcional escolhidos como mais interessantes na parte 2. Em seguida, são indicadas outras dimensões consideradas pertinentes para um escrutínio semelhante. A conclusão geral sugere uma melhor utilização de medidas de saúde estruturadas no contexto da avaliação geriátrica no Brasil.
This study aims to evaluate, through a review, conceptual and psychometric qualities of the instruments to assess the functional status of elderly patients, and their adaptation to the context of Brazil. The dissertation is structured in three parts. The first consists of five sections that introduce the themes of global aging and emerging countries like Brazil reasons as the basis for a study of the care of elderly patients. Described what is meant by functional status of elderly patients in the context of interdisciplinary geriatric assessment. Part 2 constitutes the article dissertation. In the section of materials and methods are described in detail the review performed and the databases used. In the last two sections of the article presents the results and discussion, in which there are, firstly, a number of instruments with adequate psychometric properties that assess the subdimensions of functional status. Of the 30 instruments selected using the criteria described by the authors, only two, the Multiple Outcomes Study SF-36 and the Health Assessment Questionnaire, have adapted to 0 Portuguese. However, some of the reviewed instruments have been used in our midst without prior formal adaptation. Several of these instruments have good historical in its original language, but this fact has not aroused the concern of the Brazilian community for formal adaptations thereof. Also note the lack of studies of adaptation and design of instruments of this size in the Brazilian context. Some aspects of this problem are discussed, and possible ways to fix it. In the final part of this dissertation are briefly described the instruments of each sub dimension of functional status chosen as most interesting in part 2. Then, are indicated other dimensions deemed relevant to similar scrutiny. The general conclusion suggests a better use of health measures in the context of structured geriatric assessment in Brazil.
2
Rantakari, Minna-Kristiina. "Sjuksköterskans smärtidentifiering hos äldre med demenssjukdom." Thesis, Jönköping University, HHJ, Institute of Gerontology, 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-1234.
Full text
3
Estehag, Johannesson Anna. "Sjuksköterskors erfarenheter av att arbeta kliniskt med Comprehenssive Geriatric Assessment- CGA på en geriatrisk akutvårdsavdelning : En empirisk studie." Thesis, Högskolan i Gävle, Avdelningen för hälso- och vårdvetenskap, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:hig:diva-19973.
Full textAbstract:
Syftet var att granska sjuksköterskans dokumentation avseende intagningsorsak, andra identifierade problem/behov utefter CGA och vilka åtgärder det ledde till samt beskriva sjuksköterskans erfarenheter av att använda instrumentet CGA. Metod: Studien har en beskrivande design med kvantitativ och kvalitativ ansats. Totalt granskades 50 bedömningsinstrument och datajournaler. Frågeformulär utformades och 13 sjuksköterskor valde att delta. Journalgranskningarna utfördes med kvantitativ retrospektiv analys och frågeformulären analyserades enligt kvalitativ manifest innehållsanalys. Resultat: Under journalgranskningen framkom 11 olika intagningsorsaker där försämrat allmäntillstånd var den största gruppen. Totalt identifierades 205 problem/behov och 186 initierade åtgärder varav 7 åtgärder/person var högsta antal. Flest initierade åtgärder fanns inom nutrition, social bakgrund och fallrisk. Sjuksköterskornas erfarenheter av att använda CGA var att det fanns behov av tydliga arbetsrutiner gällande CGA, att CGA fungerade bra som checklista men var tidskrävande. De upplevde att CGA gav dubbelarbete men viljan fanns att använda CGA men däremot svårt att få det att fungera i arbetet samt att sjuksköterskorna identifierade problem/behov utan att använda CGA. Sjuksköterskorna upplevde inte att omhändertagandet förändrades men däremot fick teamet helhetsperspektiv på patientens livssituation. Samverkan med anhöriga och kommunen var viktigt. Slutsats: Studiens resultat visade att förutom inskrivningsorsak fanns även andra identifierade problem/behov utefter CGA som hade stor betydelse för att den äldre skulle uppleva hälsa. Sjuksköterskorna upplevde brister inom rutinen runt CGA samt erfor att sjuksköterskornas omhändertagande av den geriatriska patienten inte förändrades efter implementeringen av CGA.Aim was to examine nurses documentation regarding admission cause, other identified problems/needs by the CGA and the actions that led to and describe nurses experiences of using the instrument CGA. Method: The study has a descriptive design with quantitative and qualitative approach. Total audited 50 assessment instruments and data records. Questionnaires were designed and 13 nurses chose to participate. Journal audits performed by quantitative retrospective analysis and the questionnaires were analyzed by the inspiration of qualitative manifest content analysis. Results: In the journal audit identified 11 different admission causes which reduced general condition was the largest group. Total identified 205 problems/needs and 186 initiated measures which 7 action/person was the highest number. Most measures were initiated in nutrition, social background and risk of falling. Nurses experiences of using the CGA was that there was a need for clear work procedures regarding the CGA, the CGA worked well as a checklist but was time consuming. They felt that the CGA gave duplication but the desire was to use the CGA but hard to make it work at work and the nurses identified problems / needs without using the CGA. The nurses did not feel that the care was changed but got the team holistic view of the patients life situation. Collaboration with families and the municipality was important. Conclusion: The study results showed that in addition the cause enrollment were other identified problems/needs along the CGA that had great importance for the elderly would experience health. The nurses experienced deficiencies in routine around the CGA and required that the nurses taking care of the geriatric patient did not change after the implementation of CGA.
4
Stec, Sandra M. "Transition from Geriatric Assessment and Rehabilitation Units to home." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2001. http://www.collectionscanada.ca/obj/s4/f2/dsk3/ftp05/MQ62853.pdf.
Full text
5
Åberg, Anna Cristina. "General motor function assessment and perceptions of life satisfaction during and after geriatric rehabilitation /." Uppsala : Acta Universitatis Upsaliensis : Univ.-bibl. [distributör], 2003. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-3788.
Full text
6
Reed, J. "All dressed up and nowhere to go : Nursing assessment in geriatric care." Thesis, University of Newcastle Upon Tyne, 1989. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.234416.
Full text
7
Gordon, Adam L. "Does Comprehensive Geriatric Assessment (CGA) have a role in UK care homes?" Thesis, University of Nottingham, 2012. http://eprints.nottingham.ac.uk/12619/.
Full textAbstract:
UK care home residents are frail, dependent and multimorbid. General practitioners (GPs) provide their healthcare but there is evidence that existing provision fails to meet their needs. Comprehensive Geriatric Assessment (CGA) comprises comprehensive multidisciplinary assessment, goal setting and frequent review. This thesis considers a possible role for CGA in UK care homes through three research projects. The Care Home Literature Review (CHoLiR) was a systematic mapping review of randomized controlled trials (RCTs) in care homes. It found no evidence supporting CGA as a whole but described some CGA components supported by RCTs: advanced care planning; interventions to reduce prescribing; staff education around dementia and end-of-life; calcium/vitamin D and alendronate in preventing fractures and osteoporosis; vaccination/neuraminidase inhibitors in preventing influenza; functional incidental and bladder training for incontinence; and risperidone/olanzapine for agitation. The Care Home Outcome Study (CHOS) was a longitudinal cohort study recording dependency, cognition, behaviour, diagnoses, prescribing, nutrition and healthcare resource use in 227 residents across 11 care homes over six months. It reported high levels of dependency, cognitive impairment, malnutrition, multimorbidity and frequent behavioural disturbance. Polypharmacy and prescribing errors were common. Variability between homes and individuals was significant for most baseline and outcome measures. Staff Interviews in Care Homes (STICH) was a qualitative interview study of 32 staff working with care homes including: GPs; care home managers and nurses; NHS community nurses and specialist practitioners. It described care defined by discontinuity and lack-of-anticipation; driven by communication failure, inadequate training and expertise in frail older patients, and arbitrary boundaries between care homes and the NHS which interfered with care. Using the findings of these studies, the author proposes a model of care which is multidisciplinary, guided by comprehensive assessment, reinforced by frequent review and delivered by experts in the care of frail older patients: CGA has a role in UK care homes.
8
Kalsi, Tania. "The impact of comprehensive geriatric assessment on tolerance to chemotherapy in older people." Thesis, King's College London (University of London), 2016. https://kclpure.kcl.ac.uk/portal/en/theses/the-impact-of-comprehensive-geriatric-assessment-on-tolerance-to-chemotherapy-in-older-people(e444b47c-535b-4df7-89c4-b010e14b2d4c).html.
Full textAbstract:
Background: This thesis evaluates the impact of geriatrician-delivered comprehensive geriatric assessment (CGA) interventions on chemotherapy toxicity and tolerance for older people with cancer. While comorbidities are identified in routine oncology practice, intervention plans for the co-existing needs of older people receiving chemotherapy are rarely made and have rarely been evaluated. Methods: Comparative study of two cohorts of older patients (aged 70+) undergoing chemotherapy in a London Hospital. The observational control group (N=70, October 2010 - July 2012) received standard oncology care. The intervention group (N=65, September 2011 - February 2013) underwent risk stratification using a patient-completed screening questionnaire; high risk patients received CGA. Impact of CGA interventions on chemotherapy tolerance outcomes and grade 3+ toxicity rate were evaluated. Outcomes were adjusted for age, comorbidity, metastatic disease and initial dose reductions. Results: Intervention participants undergoing CGA received a mean of 6.2+/-2.6 (range 0-15) CGA-based interventions. They were more likely to complete cancer treatment as planned (odds ratio (OR) 4.14 (95% CI 1.50-11.42), p=0.006) and fewer required treatment modifications (OR 0.34 (95% CI 0.16-0.73), p=0.006). Overall grade 3+ toxicity rate was 43.8% in the intervention group, 52.9% in the control (p=0.292). Conclusions: Geriatrician-led CGA identified many indications for interventions. This approach was associated with improved chemotherapy tolerance. Embedding CGA interventions in oncology practice merits further evaluation.
9
Lea, Erin J. "Road map: The utility of cognitive assessments to predict the driving capacity of geriatric veterans." Case Western Reserve University School of Graduate Studies / OhioLINK, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=case1372441395.
Full text
10
Hansebo, Görel. "Assessment of patients' needs and resources as a basis in supervision for individualised nursing care in nursing home wards : evaluation of an intervention study /." Stockholm, 2000. http://diss.kib.ki.se/2000/91-628-4531-4/.
Full text
11
Karnakis, Theodora. "O uso longitudinal da avaliação geriátrica ampla em um centro oncológico no Brasil: estudo piloto em portadores de câncer de mama." Universidade de São Paulo, 2015. http://www.teses.usp.br/teses/disponiveis/5/5169/tde-12052015-083558/.
Full textAbstract:
Introdução: O Câncer e o envelhecimento estão integralmente relacionados e evidenciam um inexorável aumento nos países desenvolvidos e em desenvolvimento. No Brasil o câncer de mama é o mais frequente nas mulheres com aumento de sua incidência e mortalidade na população idosa. A avaliação Geriátrica Ampla (AGA) é instrumento seguro e utilizado por geriatras, para estratificar os idosos entre diferentes níveis de fragilidades e tem por objetivo determinar as deficiências e incapacidades para um planejamento individual do cuidado. Objetivos : Avaliar a utilidade da AGA e sua aplicabilidade como instrumento de monitoramento longitudinal em mulheres idosas portadoras de câncer de mama no Brasil. Material e métodos: Estudo coorte, prospectivo, quasi experimental em mulheres idosas, com >= 60 anos, provindas do sistema público de saúde, recém diagnosticadas do câncer de mama e que iriam iniciar tratamento oncológico. As pacientes foram seguidas por dois anos e avaliadas pelos parâmetros da AGA: Escala de Comorbidades de Charlson; Atividades básica de vida diária (ABVD); Atividades Instrumentais de Vida Diária (AIVD); Mini Exame do Estado Mental (MEEM) ; Escala de Depressão Geriátrica (GDS-15); Mini Avaliação Nutricional (MAN) e pela Escala de Sintomas de Edmonton ao diagnóstico e a cada 4 meses no primeiro ano e após 2 anos do diagnóstico. Resultados: 20 idosas de idade média 70,2 (+ - 7.03 ), receberam um total de 97 AGAs no decorrer de 2 anos. A AGA identificou novas fragilidades em 90% das avaliações, com ampliação da conduta clinica, e 45% das pacientes tiveram o tratamento oncológico modificado após a avaliação. Como instrumento de monitoramento, houve uma tendência de diminuição do numero de novos diagnósticos após cada AGA realizada ao longo de 2 anos. Conclusão: O presente estudo valida a importância do uso da AGA na população idosa com câncer de mama no Brasil ao identificar fragilidades e sugerir mudanças no plano do tratamento oncológico. Novos estudos, em diversos tipos de câncer, com maior tempo de seguimento, são necessários para avaliar o impacto da AGA na população idosa em tratamento oncológicoIntroduction: The Cancer and aging are integrally related and show an inexorable rise in developed and developing countries . In Brazil, breast cancer is the most common in women with increased incidence and mortality in the elderly population . The Comprehensive Geriatric Assessment (CGA) is an instrument used with insurance by geriatricians to stratify elderly between different levels of weaknesses and aims to determine the disabilities for an individual plan of care. Objectives : To evaluate the usefulness of CGA and its applicability as longitudinal monitoring instrument in older women with breast cancer in Brazil. Methods: Cohort study , prospective, quasi experimental in elderly women with >= 60 years , originated from the public health system , newly diagnosed breast cancer and they would start cancer treatment . The patients were followed for two years and evaluated by the parameters of CGA : Charlson Comorbidity Index (CCI); Activities of Daily Living (ADL); Instrumental Activities of Daily (IADL); Mini Mental State Evaluation (MMSE); Geriatric Depression Scale (GDS); Mini Nutritional Assessment (MAN) and Edmonton Symptom Assessment Scale. The CGA occurred every four months in the first year and after 2 years of diagnosis . Results: 20 elderly women with average age of 70.2 ( + - 7.03 ) , received a total of 97 GA in the course of two years . CGA identified new weaknesses in 90 % of cases , with expansion of the clinical conduct, and 45% of patients had cancer treatment modified after the evaluation. As monitoring instrument , there was a downward trend in the number of new diagnoses after each AGA conducted over two years. Conclusion: This study validates the importance of using the AGA in the elderly population with breast cancer in Brazil to identify weaknesses and suggest changes in cancer treatment plan. New studies in various cancers and longer follow-up are needed to assess the impact of AGA in the elderly undergoing cancer treatment
12
Igenbergs, Elisabeth. "Untersuchung des Effektes einer Checkliste auf die Auswertungsquantität und -Genauigkeit des geriatrischen Assessments im Blockpraktikum Allgemeinmedizin." Doctoral thesis, Universitätsbibliothek Leipzig, 2014. http://nbn-resolving.de/urn:nbn:de:bsz:15-qucosa-154777.
Full textAbstract:
In Anbetracht der steigenden Zahl an älteren und multimorbiden Patienten in Deutschland und den westlichen Nationen stellt die Geriatrie eine der größten gesundheitspolitischen, ökonomischen und sozialen Herausforderungen unserer Gesellschaft dar. Die Implementie‐
rung der Geriatrie in die universitäre Lehre von Studierenden der Medizin ist daher essentiell. Dabei ist die Handhabung geeigneter geriatrischer Screeningverfahren im klinischen Alltag ein wichtiger Bestandteil, um Abläufe zu vereinfachen, Diagnostik und Therapie zu
individualisieren und Kosten zu reduzieren.
Das geriatrische Assessment in Form des STEP‐Assessments (Standardisiertes evidenzbasiertes präventives Assessment älterer Menschen in der medizinischen Primäreversorgung) ist ein solches Screeningverfahren, welches im Rahmen des Blockpraktikums Allgemeinmedizin an der Universität Leipzig von Medizinstudierenden durchgeführt wird. Es erfasst ein breites Spektrum an Bedürfnissen in vielen unterschiedlichen Lebensbereichen geriatrischer Patienten und scheint daher besonders für die Sensibilisierung von Studierenden der Medizin für die Komplexität der Geriatrie geeignet zu sein. Zur Verbesserung der Auswertungsquantität und ‐genauigkeit des geriatrischen Assessments wurde eine Checkliste als strukturierende Interpretationshilfe installiert. In dieser Studie wird der Effekt dieser Checkliste im Vergleich zweier Kohorten von Studierenden untersucht. Als weitere Indikatoren für die mögliche Verbesserung der Auswertungsquantität und ‐genauigkeit wurde die Benotung des Blockpraktikums, sowie für die Zufriedenheit der Studierenden mit dem
Blockpraktikum eine Evaluation herangezogen. Bei statistisch belegter Vergleichbarkeit der Patientenkohorten, fanden wir bei nahrzu allen
STEP‐Themen mehr Dokumentation durch die Studierenden, denen die Checkliste als Interpretationshilfe vorlag. Durch diese checklistenassoziierte Steigerung der Dokumentationsquantität und
‐genauigkeit ließ sich eine signifikante Verbesserung der Noten der Studierenden mit Checkliste gegenüber derer ohne Checkliste verbuchen. Die Analyse der Evaluation zeigte jedoch, dass die Studierenden mit Checkliste mit dem Blockpraktikum nicht signifikant zufriedener waren.
In der Gegenüberstellung der Auswertungen des geriatrischen Assessments durch die Studierenden mit der aktuellen Fachliteratur und Leitlinien stellte sich stellenweise eine Diskrepanz dar. Die von den Studierenden empfohlenen Diagnostik‐ oder Therapieansätze waren zwar stets medizinisch korrekt, entsprachen jedoch nicht immer den empfohlenen klinischen Leitlinien. Es stellt sich die Frage, ob dies bei noch nicht abgeschlossenem Studium von den Studierenden erwartet werden kann, oder ob indikationsgerechte und zielführende Vorschläge ausreichend sind.
Die Ergebnisse dieser Untersuchung zeigen, dass ein Screeninginstrument mit der Komplexität eines STEP‐Assessments erst in Kombination mit einer strukturierenden Interpretations‐
hilfe in Form einer Checkliste von den Studierenden sachgerecht gehandhabt werden kann.
Es konnte eine Steigerung der Auswertungsgenauigkeit sowie ‐quantität gesehen werden, was zu der Vermutung führt, dass dies ebenfalls zu einer Erhöhung des Lernerfolges bei den Studierenden gereichte. Eine Verbesserung der Art der Implementierung der Checkliste und deren gesonderte Evaluation wären wünschenswert, um die Zufriedenheit der Studierenden
mit der Checkliste messbar zu machen. Ein Rückschluss dieser Ergebnisse auf bereits spezialisierte Allgemeinmediziner oder Geriater liegt nahe und sollte in einer weiteren Studie eingehend untersucht werden.
13
Åberg, Anna Cristina. "General Motor Function Assessment and Perceptions of Life Satisfaction during and after Geriatric Rehabilitation." Doctoral thesis, Uppsala University, Geriatrics, 2003. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-3788.
Full textAbstract:
Two main goals of geriatric rehabilitation are to re-establish ability for physical function in order to facilitate independence in activities of daily living (ADL), and to promote an optimal degree of well-being, i.e. life satisfaction, in the individual. In this research a new scale, the General Motor Function assessment scale (GMF), was developed and evaluated. Subsequently, factors perceived as important for the life satisfaction of people undergoing geriatric rehabilitation were investigated.
The GMF includes both mobility and upper limb functions and comprises three subscales covering different aspects of functioning, namely performance-related Dependence, Pain and Insecurity. The clinical practicality of the GMF was evaluated by a field test. Its psychometric properties were analysed in both hospital and community-based settings of geriatric rehabilitation, using non-parametric statistical methods. The results indicated that the GMF is clinically adequate, possesses good reliability and is sensitive enough to demonstrate changes from pre- to post-intervention in different forms of geriatric rehabilitation.
For investigation of perceptions of life satisfaction, individual qualitative interviews were conducted with old (80+) care recipients and with their significant others, who had a helping relationship with them. The results revealed that habitual activity, independence and adaptation were generally considered to be important for the life satisfaction of the care recipients. Recalling of pleasant past memories in an effort to achieve current life satisfaction was a commonly used adaptive strategy among the care recipients. This strategy created a temporary sense of life satisfaction, with a potential for concealing dissatisfaction with conditions that might otherwise be correctable. From the perspective of the significant others, protection of the continuity of the care recipients’ self was seen as vital for the latter's life satisfaction, and was thus an underlying general purpose of the informal caregiving.
14
Dekenah, Ghabrielle Anne. "The development of a fall risk assessment and exercise intervention programme for geriatric subjects." Thesis, Stellenbosch : Stellenbosch University, 2012. http://hdl.handle.net/10019.1/71783.
Full textAbstract:
Thesis (M Sport Sc)--Stellenbosch University, 2012.ENGLISH ABSTRACT: Falling is a common occurrence and one of the most serious problems in the elderly population (65 years and older). Falls account for 70% of accidental deaths in persons aged 75 years and older. Falls can be markers/indicators of poor health and declining function, and are often associated with significant morbidity. More than 90% of hip fractures occur as a result of falls, with most of these fractures occurring in persons over 70 years of age (Fuller, 2000). About one third of people aged 65 years and older fall each year, resulting in a substantial decrease in quality of life in addition to placing a huge burden on current health care systems. The purpose of this study was to determine whether a 12-week exercise intervention programme, consisting of two 30 minute exercise sessions a week, could lower the risk of falling in a group of elderly women. Female subjects (n=22) with an average age of 79.5 years were selected from three retirement homes situated in Stellenbosch, Western Cape, South Africa, according to specific inclusion and exclusion criteria. The subjects included presented no major cardiovascular and pulmonary disease signs and symptoms as recognised by the American College of Sports Medicine (2011); had no serious illnesses or co-morbidities; were mobile with no significant musculoskeletal disorders; had no uncorrected visual or vestibular problems as well as no significant cognitive impairments or major psychological disturbances; were not taking any psychotropic medications or Benzodiazepines that could affect their progress. Subjects also had to be willing to follow the 12-week exercise intervention programme and sign an informed consent document. The selected subjects then underwent a pre- and post-intervention assessment consisting of a subjective rating of their fear of falling, the Fall Risk Assessment: Biodex Balance system, Balance Evaluations Systems Test (BESTest) and the 30-Second Chair Stand Test. Statistica 10 was used to analyse the data. Data was analysed to assess any significant improvements that the exercise intervention had on each fall risk variable tested. The main fall risk variables consisted of: fear of falling, muscular strength, balance, gait and getting up strategies. Statistically significant improvements (p<0.001) were seen in: Fear of falling, muscular strength, balance, gait and getting up strategies after the 12-week exercise intervention programme. This study suggests that exercise intervention has the potential to decrease the risk of falling among elderly women and should play an extremely important role in the prevention of falling amongst this population group.
AFRIKAANSE OPSOMMING: Om te val is ‘n alledaagse gebeurtenis en een van die mees ernstige probleme vir ons bejaarde bevolking (65 jaar en ouer). Insidente van val verklaar tot 70% van toevallige sterftes met betrekking tot persone van 75 jarige ouderdom en ouer. Om te val kan ‘n teken van swak gesondheid en/of ‘n afname in funksionele kapasiteit wees, en is gewoonlik met morbiditeitspatrone gekoppel. Meer as 90% van heupfrakture kom as gevolg van valle voor, waar die meeste van die frakture in persone bo 70 jarige ouderdom voorkom (Fuller, 2000). Minstens een derde van persone bo 65 jaar en ouer val elke jaar, so ‘n val het ‘n noemenswaardige afname in lewenskwaliteit tot gevolg asook ‘n enorme druk wat op huidige gesondheidsorg sisteme geplaas word. Die doel van die studie was om te bepaal of ‘n 12 week oefenintervensieprogram, wat uit twee oefen sessies van 30 minute elk bestaan, die risiko van val vir n groep bejaarde vroue kan verlaag. Vroulike individue (n=22) met ‘n gemiddelde ouderdom van 79.5 jaar uit drie ouetehuise/aftree oorde in Stellenbosch, Wes-Kaap, Suid-Afrika geleë; is volgens bepaalde insluitings- en uitsluitingskriteria geselekteer. Individue wie ingesluit is het geen tekens of simptome van grootskaalse kardiovaskulêre of pulmonêre siekte getoon nie, soos herken deur die “American College of Sports Medicine (2011) ; het aan geen ernstige siektes of ko-morbiditeite gely nie; kon stap met geen merkwaardige muskulo-skeletale afwykings nie; het geen nie-gekorrigeerde visie of vestibulêre probleme asook geen beduidende kognitiewe gestremdhede of ernstige sielkundige steurnisse gehad nie; het nie enige psigotropiese medikasie of Benzodiazepines geneem wat hul kon beinvloed nie. Individue moes bereid gewees het om die 12 week oefenintervensieprogram te volg en moes ook ‘n ingeligte toestemmingsvorm onderteken. Die geselekteerde individue het ‘n pre- en post-intervensie assessering ondergaan wat uit ‘n subjektiewe bepaling van hul vrees vir val bestaan het, die Val Risiko Assessering asook “Biodex Balans System Test, Balance Evaluations Systems Test (BESTest)” asook die 30 Sekonde Stoel-staan Toets. Statistica 10 is gebruik om die data te analiseer. Data was geanaliseer om enige merkwaardige verandering wat die oefenintervensie op elke val risiko veranderlike wat getoets was gehad het, te bepaal. Die belangrikste val risiko veranderlikes het uit: die vrees vir val, spier sterkte, balans, stappatroon en opstaan tegnieke bestaan. Betekenisvolle statistiese veranderinge (p<0.001) is gerapporteer in: die vrees vir val, spiersterkte, balans, stappatroon en opstaan tegnieke na die 12 week oefenintervensieprogram. Die studie bevind dat die intervensieprogram die potensiaal het om die risiko van val onder bejaarde vroue te verminder en behoort ‘n uiters belangrike rol in die voorkoming van val onder die bevolkingsgroep te speel.
15
Whaley, Mirtha Montejo. "Effect of personal and practice contexts on occupational therapists' assessment practices in geriatric rehabilitation." [Tampa, Fla.] : University of South Florida, 2007. http://purl.fcla.edu/usf/dc/et/SFE0002091.
Full text
16
Phillips, Sara. "The use of the Brief Assessment Depression Cards (BASDEC) and the nature of autobiographical memory in a group of elderly people with memory complaints." Thesis, Bangor University, 1994. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.239876.
Full text
17
Vivanti, Angela Patricia. "Screening and identification of dehydration in older people admitted to a geriatric and rehabilitation unit." Thesis, Queensland University of Technology, 2007. https://eprints.qut.edu.au/16635/1/Angela_Vivanti_Thesis.pdf.
Full textAbstract:
The diagnosis of dehydration in the older person admitted to hospital has been associated with increased morbidity and mortality. In spite of the high US hospital mortality and morbidity rates associated with dehydration (although presumably not the only contributing factor), no standardised or validated approach to assess or easily screen for dehydration in the hospital setting is reported in the international literature. Therefore, a series of studies was undertaken to assess the extent of this, and to identify other gaps in the current literature. The first study estimated the dehydration prevalence amongst older people upon admission to geriatric and rehabilitation unit in the Australian setting to estimate the morbidity burden in the Australian context. The second study assessed the application of dilution and bio-electrical impedance (BIA) techniques as alternative means to assess dehydration in the clinical setting. The third study undertook to validate against total body water the parameters required to confirm dehydration and to identify those that contribute little to discrimination. The final study integrated the information from the first two studies to identify a clinically practical, sensitive and specific screen suitable for the identification of those at risk of dehydration in a geriatric and rehabilitation unit. Older people aged 60 years or over admitted to the Geriatric and Rehabilitation Unit (GARU) of a tertiary teaching hospital in Brisbane. Australia, were eligible for participation in the study. Individuals were excluded if: involuntarily admitted, informed consent was not obtained, younger than 60 years or fitted with a pacemaker (due to contraindication with the use of BIA). Of 82 GARU participants approached, 43 fulfilled the inclusion criteria and consented, 21 declined and 18 were ineligible. Thirty-five (35) of the 43 were able to be involved in the assessment of prevalence. The studies in this thesis provide original insights into dehydration including prevalence, body water contents, useful clinical assessment and screening parameters. Results showed that dehydration prevalence amongst older people is substantially underreported in the Australian geriatric and rehabilitation unit setting (17.1%) when compared to the reported through coding from the medical record (5.3%). The presence of dehydration has frequently been measured in healthy populations by assessing total body water loss through short-term weight change. Gold standard dilution and bio-electrical impedance techniques were used to assess body water as the assessment of dehydration by weight change has practical and ethical limitations in the clinical setting for either research or assessment applications. Gold standard dilution studies and the bio-electrical impedance technique were not confirmed to be either practical or valid alternates to assess dehydration in the clinical setting. Weight and body mass index (BMI) confounded the association between body water and dehydration. Good agreement (78-87%) of global clinical dehydration assessment (clinical assessment) was confirmed between the study's medical officer and the consultants of the Geriatric and Rehabilitation Unit (GARU) and thus become the alternate dependant variable. Although the optimal combination of parameters for clinical dehydration assessment was unable to be elucidated, clinically significant changes upon mild dehydration were more apparent with physical as opposed to biochemical parameters. BMI confounded the association between dehydration and some physical measurements, such as the drop in systolic blood pressure on standing and skin turgor. Of all the clinical assessment and screening variables explored, tongue dryness was validated and represents a practical, sensitive (64%) and specific (62%) dehydration screen suitable for use with all older people in a geriatric and rehabilitation unit setting. Dehydration was established to be more prevalent amongst older Australians admitted to hospital than previously acknowledged or identified by hospitals. The finding identifies dehydration as a significant clinical issue considering the ageing Australian population, limited health resources and the association of dehydration with increased morbidity and mortality. The validation of the simple dehydration screen will contribute to the identification and treatment of dehydration. Although the highest sensitivity and specificity is always desired for screening, it is not always achieved. Moderate sensitivity results in more people being identified at risk by the screen than confirmed to be dehydrated through clinical assessment. Moderate specificity results in the screen's failure to identify those who would be clinically assessed with dehydration. Moderate sensitivity and specificity necessitates the assessment of more people than those with the condition and results in other people with the condition of interest not being identified. Each situation is reduced with increasing levels of sensitivity and specificity. A valid and simple dehydration screen provides future opportunities to confirm improved clinical (prevent adverse events, improve or stabilise disease), cost (reduce intensity of care, hospital stay) and client (death, disability) outcomes as a result of improved identification and timely and appropriate treatment. New insights are provided into individual clinical assessment measures as well as valid and reliable screening. A number of recommendations and future dehydration studies are discussed. The key recommendation for future studies is to discern between intracellular and intravascular volume depletion to enable investigation of an homogenous sample. Further studies are needed to also establish optimal dehydration prevention methods (e.g. awareness and positioning of fluids, beverage carts) and provide evidence that hydration support enhances primary (e.g. morbidity and mortality) and secondary (e.g. cognitive or functional measures, quality of life) health outcomes. Through responsive systems in health delivery, dehydration amongst older hospitalised people can be identified, better managed if present, and avoided with suitable treatment.
18
Vivanti, Angela Patricia. "Screening and identification of dehydration in older people admitted to a geriatric and rehabilitation unit." Queensland University of Technology, 2007. http://eprints.qut.edu.au/16635/.
Full textAbstract:
The diagnosis of dehydration in the older person admitted to hospital has been associated with increased morbidity and mortality. In spite of the high US hospital mortality and morbidity rates associated with dehydration (although presumably not the only contributing factor), no standardised or validated approach to assess or easily screen for dehydration in the hospital setting is reported in the international literature. Therefore, a series of studies was undertaken to assess the extent of this, and to identify other gaps in the current literature. The first study estimated the dehydration prevalence amongst older people upon admission to geriatric and rehabilitation unit in the Australian setting to estimate the morbidity burden in the Australian context. The second study assessed the application of dilution and bio-electrical impedance (BIA) techniques as alternative means to assess dehydration in the clinical setting. The third study undertook to validate against total body water the parameters required to confirm dehydration and to identify those that contribute little to discrimination. The final study integrated the information from the first two studies to identify a clinically practical, sensitive and specific screen suitable for the identification of those at risk of dehydration in a geriatric and rehabilitation unit. Older people aged 60 years or over admitted to the Geriatric and Rehabilitation Unit (GARU) of a tertiary teaching hospital in Brisbane. Australia, were eligible for participation in the study. Individuals were excluded if: involuntarily admitted, informed consent was not obtained, younger than 60 years or fitted with a pacemaker (due to contraindication with the use of BIA). Of 82 GARU participants approached, 43 fulfilled the inclusion criteria and consented, 21 declined and 18 were ineligible. Thirty-five (35) of the 43 were able to be involved in the assessment of prevalence. The studies in this thesis provide original insights into dehydration including prevalence, body water contents, useful clinical assessment and screening parameters. Results showed that dehydration prevalence amongst older people is substantially underreported in the Australian geriatric and rehabilitation unit setting (17.1%) when compared to the reported through coding from the medical record (5.3%). The presence of dehydration has frequently been measured in healthy populations by assessing total body water loss through short-term weight change. Gold standard dilution and bio-electrical impedance techniques were used to assess body water as the assessment of dehydration by weight change has practical and ethical limitations in the clinical setting for either research or assessment applications. Gold standard dilution studies and the bio-electrical impedance technique were not confirmed to be either practical or valid alternates to assess dehydration in the clinical setting. Weight and body mass index (BMI) confounded the association between body water and dehydration. Good agreement (78-87%) of global clinical dehydration assessment (clinical assessment) was confirmed between the study's medical officer and the consultants of the Geriatric and Rehabilitation Unit (GARU) and thus become the alternate dependant variable. Although the optimal combination of parameters for clinical dehydration assessment was unable to be elucidated, clinically significant changes upon mild dehydration were more apparent with physical as opposed to biochemical parameters. BMI confounded the association between dehydration and some physical measurements, such as the drop in systolic blood pressure on standing and skin turgor. Of all the clinical assessment and screening variables explored, tongue dryness was validated and represents a practical, sensitive (64%) and specific (62%) dehydration screen suitable for use with all older people in a geriatric and rehabilitation unit setting. Dehydration was established to be more prevalent amongst older Australians admitted to hospital than previously acknowledged or identified by hospitals. The finding identifies dehydration as a significant clinical issue considering the ageing Australian population, limited health resources and the association of dehydration with increased morbidity and mortality. The validation of the simple dehydration screen will contribute to the identification and treatment of dehydration. Although the highest sensitivity and specificity is always desired for screening, it is not always achieved. Moderate sensitivity results in more people being identified at risk by the screen than confirmed to be dehydrated through clinical assessment. Moderate specificity results in the screen's failure to identify those who would be clinically assessed with dehydration. Moderate sensitivity and specificity necessitates the assessment of more people than those with the condition and results in other people with the condition of interest not being identified. Each situation is reduced with increasing levels of sensitivity and specificity. A valid and simple dehydration screen provides future opportunities to confirm improved clinical (prevent adverse events, improve or stabilise disease), cost (reduce intensity of care, hospital stay) and client (death, disability) outcomes as a result of improved identification and timely and appropriate treatment. New insights are provided into individual clinical assessment measures as well as valid and reliable screening. A number of recommendations and future dehydration studies are discussed. The key recommendation for future studies is to discern between intracellular and intravascular volume depletion to enable investigation of an homogenous sample. Further studies are needed to also establish optimal dehydration prevention methods (e.g. awareness and positioning of fluids, beverage carts) and provide evidence that hydration support enhances primary (e.g. morbidity and mortality) and secondary (e.g. cognitive or functional measures, quality of life) health outcomes. Through responsive systems in health delivery, dehydration amongst older hospitalised people can be identified, better managed if present, and avoided with suitable treatment.
19
Fegas, Rebecca K. "GERIATRIC ASSESSMENT VARIABLES ADD PROGNOSTIC VALUE TO THE INTERNATIONAL PROGNOSTIC SCORING SYSTEM FOR MYELODYSPLASTIC SYNDROME." Thesis, The University of Arizona, 2015. http://hdl.handle.net/10150/528170.
Full textAbstract:
A Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine.Background: The International Prognostic Scoring System (IPSS) for myelodysplastic syndrome (MDS) is commonly used to predict survival and assign treatment. We explored whether markers of frailty add prognostic information to the IPSS in a cohort of older patients. Design, Setting, Participants: Retrospective cohort study of 114 MDS patients ≥ age 65 who presented to Dana‐Farber Cancer Institute between 2006‐2011 and completed a baseline quality of life questionnaire. Measurements: We evaluated questions corresponding to frailty and extracted clinical‐ pathologic data from medical records. We used Kaplan‐Meier and Cox proportional hazards models to estimate survival. Results: 114 patients consented and were available for analysis. The median age was 72.5 years, and the majority of patients were white ( 94.7%), male ( 74.6%), and over half had a Charlson comorbidity score < 2. Few patients ( 23.7%) had an IPSS score consistent with low‐risk disease and the majority received chemotherapy. In addition to traditional prognostic factors (IPSS score and history of prior chemotherapy or radiation), significant univariate predictors of survival included low serum albumin, Charlson score, the ability to take a long walk, and interference of physical symptoms in family life. The multivariate model that best predicted mortality included low serum albumin (HR=2.3; 95%CI: 1.06‐5.14), previous chemotherapy or radiation (HR=2.1; 95%CI: 1.16‐4.24), IPSS score (HR=1.7; 95%CI: 1.14‐2.49), and ease taking a long walk (HR=0.44; 95%CI: 0.23‐0.90). Conclusions: In this study of older adults with MDS, we found that markers of nutritional status and self‐reported physical function added important prognostic information to the IPSS score. More comprehensive risk assessment tools for older patients with MDS that include markers of function and frailty are needed.
20
Crawford, Gregory Brian, and gregory crawford@adelaide edu au. "Depression in palliative care patients in Australia: identification and assessment." Flinders University. Medicine, 2008. http://catalogue.flinders.edu.au./local/adt/public/adt-SFU20090127.133003.
Full textAbstract:
Depression is poorly recognised, under-assessed and under-treated in patients receiving palliative care for a life-limiting illness. There are barriers to assessment and diagnosis, and limited access to specialist clinicians who might assist in these complex assessments and who could provide options for treatment.
The three studies presented, using different research methodologies, and using both qualitative and quantitative analysis, seek to clarify these issues and to provide some solutions. A questionnaire was sent to all Palliative Care Services (PCS) in Australia. Questions included what part specialist psychological clinicians played in multi-disciplinary team meetings and in the treatment or coordination of patient care. Very few PCS used a valid screening instrument for psychological distress and very few had regular support from a psychiatrist or psychologist. Many did not have access to social work support.
There are two competing issues with regard to recognising and assessing depression in palliative populations. A rapid reliable screen that points to a likely problem would be useful, but also there is a need to understand something of the patient experience of depression.
In the second study, the one- and two-item screening instruments widely used in palliative care are examined and limitations that have been found in other settings are confirmed. A new novel screening tool is developed from this data and tested empirically. This algorithm is short, has good psychometric properties and is validated for an Australian palliative care population. Depending on the response pattern it is possible to identify that a particular patient has significant symptoms of depression by asking between one and four questions. Professional carer and patient acceptability of the questions is high.
The understanding of the experience and symptom profile of depression in Australian palliative care patients is addressed in the third study. Patients and family carers were recruited prospectively from palliative care and oncology ambulatory clinics of two teaching hospitals in an Australian capital city. The Geriatric Depression Scale (GDS) was administered to the patient and the Collateral Source version of this instrument was asked of the carer. A subset of this sample completed the measures twice. The results using this 30-item scale were then compared with all the known previously published short versions of this scale. Two short forms met as many psychometric criteria as the longer forms. None of the versions of the GDS showed sufficiently high correlations between carer-completed and patient-completed forms. The frequency of symptoms was also assessed. Patients more frequently reported fatigue and anhedonia than depressed affect.
Despite many screening instruments being available for depression, their use is limited in Palliative Care Services. Although these studies have validated several options for Australian palliative care patients, the issues behind the low uptake rates for screening have not been resolved. The final chapter of this thesis constructs known and potential barriers into a logical structure and then offers some solutions to improve access to mental health professionals by considering service models and applying this theory to the problem of depression and its assessment in palliative care populations.
21
Subki, Manal. "Assessment of the nutritional status of frail elderly persons participating in geriatric day hospital rehabilitation program." Thesis, McGill University, 2001. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=33847.
Full textAbstract:
We assessed the nutritional status and physical function of 121 women (79.4 +/- 6.6 y, 26.8 +/- 5.6 kg/m2) and 61 men (78.6 +/- 8.3 y, 26.6 +/- 4.7 kg/m2) participating in the Geriatric Day Hospital. According to a composite index of malnutrition, 19% of them were found malnourished whereas the Mini-Nutritional Assessment, a validated nutritional screening tool, found that 56% of the elderly were malnourished or at risk for malnutrition. Malnourished persons, as determined by the composite index, had a lower lean body mass (LBM) by bioelectrical impedance analysis compared with the well-nourished group (40.5 +/- 9.7 vs. 42.0 +/- 8.7 kg, p = 0.0001). LBM correlated significantly with handgrip strength (r = 0.34, p = 0.0001) but not with gait speed (r = 0.04, p = 0.27). There were no significant differences between nutritional states for any of the two tests of physical function. The score of the MNA, correlated with gait speed (r = 0.24, p = 0.02) but the performance at the physical tests was not different according to the nutritional status defined by this tool. We conclude that malnutrition is relatively prevalent among frail persons participating in the Geriatric Day Hospital and that malnutrition is one among many other factors that contribute to their low level of physical performance. As such, a nutritional intervention may be of benefit in improving the physical function of frail elderly persons who are malnourished.
22
Söderhamn, Ulrika. "Nutritional screening of older patients : developing, testing and using the Nutritional form for the elderly (NUFFE) /." Linköping : Linköping University, 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-7335.
Full text
23
Morin, Diane. "The comparison of the impact two comprehensive geriatric assessment procedures on quality of life and service use." Thesis, London School of Hygiene and Tropical Medicine (University of London), 1998. http://researchonline.lshtm.ac.uk/901043/.
Full textAbstract:
Home care of the elderly is of increasing concern not only to purchasers and providers of health care but also to the public and to those responsible for providing social care. As with any service, the aim must be to provide care that is appropriate for each individual. To achieve that, valid and reliable measures of a person's needs are required and resources are to be used as efficiently as possible. A considerable amount of work has been carried out to develop such normative-based measures for assessing the home care needs of the elderly in the form of comprehensive geriatric assessment (CGA). CGA is a commonly used technology which has been shown to be associated with improved health status and lower service use. Despite widespread use, however, the effectiveness of different CGAs has not yet been fully investigated. In the Province of Quebec, Canada, two CGAs which differ in comprehensiveness and resource requirements are being used to assess needs at entry to home care. The aim of this study is to compare the differential impact of these two CGA procedures on patient outcomes: the Systdme de mesure de l'autonomie fonctionnelle, the longer, more comprehensive and resourceintensive CGA, and the Admission au maintien d domicile which is a shorter and less resource-intensive form of CGA. In a prospective cohort study, 158 elderly patients aged 65 years or over were assessed at admission to home care using one or the other CGA and changes in health-related quality of life as well as service use were monitored and compared at the end of a 12-week follow-up. Costs related to the use of a long or a shortform CGA were also explored. These comparisons were made while controlling for patient (age, gender, living alone, quality of life at entry, depression), process (type and intensity of care received) and structural variables (budget and staff mix). Results from comparative and multivariate analyses are in favour of not rejecting the null hypothesis that both forms of CGAs are similarly associated with outcomes. Depression was the strongest predictor of changes in quality of life and high intensity of care and a low proportion of nurses on the home care teams were the strongest predictors of service use outside HC. These results lead us to discuss whether long or shortform CGAs were developed on a comparative rather than a normative definition of needs. The implications of these findings for home care policy and practice are discussed and suggestions for future research are presented.
24
Duim, Etienne Larissa. "Comparação entre capacidade aferida e desempenho referido para avaliação de atividades básicas em idosos." Universidade de São Paulo, 2016. http://www.teses.usp.br/teses/disponiveis/7/7139/tde-12052017-154013/.
Full textAbstract:
Dado o acelerado processo de envelhecimento populacional vivenciado no Brasil e no mundo, é importante identificar quais as melhores maneiras de avaliar a saúde da pessoa idosa inserida na comunidade ou institucionalizada. Neste sentido, a Organização Mundial de Saúde preconiza a avaliação desta população por meio da condição funcional. Diferentes instrumentos se propõem a este fim, seja evidenciando o desempenho de atividades ou capacidade funcional, por métodos aferido ou referido. No entanto, existe grande diferença entre estas possíveis maneiras de avaliação da pessoa idosa e poucos estudos que abordem este tema. Objetivo: comparar a avaliação de atividades básicas de vida diária (ABVD) por meio do desempenho referido e aferido em pessoas idosas residentes na comunidade. Método: Estudo transversal que avaliou 40 idosos que realizavam tratamento ou acompanhamento médico em dois ambulatórios (clínica médica e ortopedia) no município de Londrina (PR). Esta amostra foi avaliada frente desempenho funcional por meio da Medida de Independência Funcional (MIF) e o desempenho referido foi verificado a partir da utilização de um questionário padronizado. Ao todo, 12 atividades básicas de vida diária foram avaliadas por ambos os métodos. Para possibilitar a comparação entre as respostas obtidas em cada instrumento, houve um processo de categorização no qual cada idoso era classificado como independente; tendo dificuldade ou utilizando adaptação para realizar a atividade; ou necessitando de ajuda. Foi utilizado o teste do coeficiente de Kappa e teste de correlação de Spearman para comparar a concordância entre os métodos de avaliação da condição funcional. Resultados: Os idosos residentes na comunidade apresentavam média etária de 71,6 anos (IC 95% 72,8;79,4) e maior proporção de mulheres (52,5) e a maioria dos participantes não apresenta comprometimento da função cognitiva. Dentre as atividades avaliadas, aquelas relacionadas ao uso e acesso ao vaso sanitário foram as que a presentaram menor concordância. Já locomoção, alimentação, controle de fezes, banho e vestir-se são aquelas mais comparáveis. Pela comparação entre os métodos de avaliação foi possível observar que a avaliação de modo aferido evidencia indivíduos com menor nível funcional frente a avaliação autorreferida das mesmas atividades. As dificuldades aferidas e referidas estiveram relacionadas com a condição de saúde do idoso avaliado, sendo que idosos provindos do ambulatório ortopédico apresentavam maior comprometimento de atividades que comprometiam membros superiores ou inferiores. Foi possível concluir que a avaliação de ABVD utilizando desempenho referido ou aferido apresenta respostas similares para maioria das atividades avaliadas, com grau de concordância substancial. No entanto, as respostas obtidas pelo método de avaliação autorreferido devem ser interpretadas com cautela, principalmente quando da avaliação do uso e acesso ao vaso sanitário. Os métodos de avaliação avaliados são complementares e quando possível ambos devem ser aplicados para avaliação funcional de pessoas idosas.About the accelerated ageing process experienced in Brazil and the world, it is important to identify the best ways to check the health of the older persons inserted in the community. In this sense, the World Health Organization indicates the assessment of functional condition as good option to evaluate this population. Different instruments are proposed and it can be done by the assessment of capacity or performance, by measured or (self) reported methods. However, these methods are different and there are few studies that address this issue. Objective: To compare the evaluation of activities of daily living (ADL) by reported or measured performance in older adults living in community. Methods: Cross-sectional study that evaluated 40 subjects who were undergoing treatment or medical care at two clinics (generical medicine and orthopedics) in Londrina (PR). This sample was evaluated from the functional performance through the Functional Independence Measure (FIM) and reported performance was observed from the use of a standardized questionnaire. Twelve ADL were assessed by both methods. To enable a comparison of obtained responses with each instrument, the subjects were classified as independent; with difficulty or using adaptation to perform the activity; or who needing help. We used the Kappa coefficient test to compare the agreement among the methods to assess functional condition. Results: community-dwelling older adults had a mean age of 71.6 years (95% CI 72.8; 79.4) and higher proportion of women (52.5) and most of the participants does not have impaired cognitive function. Among the activities evaluated, those related to the use and access to the toilet showed the least agreement. Already locomotion, feeding, control stool, bathing and dressing are those more comparable. In the comparison process, it was observed that the older adults had lower functional level when the assessment is made by measured performance against reported assessment of the same activities. The measured and reported difficulties were related to the health condition of the evaluated elderly, and older persons in treatment of orthopedic clinic had greater commitment in activities involving the arms or legs, structures in rehabilitation process. When we evaluated community-dwelling elderly, there was a higher level of agreement between measured functional condition and reported performance. We concluded that the evaluation of ABVD using measured or reported performance shows similar responses to most of the activities evaluated, with substantial degree of agreement. However, the responses obtained by self-reported assessment method should be interpreted with caution, especially when assessing the use of and access to toilet. The methods of this evaluation are complementary and it is a better option when both can be applied for functional assessment of elderly.
25
Maalouf, Elizabeth W. "Assessment of the knowledge and attitudes of nurses caring for patients with Alzheimer's disease / by Elizabeth W. Maalouf." Access Digital Full Text version, 1995. http://pocketknowledge.tc.columbia.edu/home.php/bybib/11751095.
Full textAbstract:
Thesis (Ed.D.)--Teachers College, Columbia University, 1995.Includes tables. Typescript; issued also on microfilm. Sponsor: Barbara Wallace. Dissertation Committee: Marie O'Toole. Includes bibliographical references (leaves 95-103).
26
Serova, Svetlana. "Factor Structure of the Neurocognitive Battery in a Geriatric Sample with Cognitive Impairments." Thesis, University of North Texas, 2007. https://digital.library.unt.edu/ark:/67531/metadc3615/.
Full textAbstract:
The present study was designed to empirically validate six theoretically derived cognitive domains (verbal memory, visual memory, working memory, attention-concentration, executive functions, and visuospatial abilities) assessed by a comprehensive battery of neuropsychological tests used in the Geriatric Memory Clinic at the University of North Texas Health Science Center in Fort Worth, Texas. The study examined the extent to which various cognitive dimensions are tapped by this battery in a heterogeneous geriatric sample of 114 patients with cognitive impairments. The proposed six-factor model of cognitive functioning has not been supported. Further exploratory factor analysis arrived at a five-factor solution. Factor pattern of the 23 tests supported the following five dimensions: memory, executive control, attention, visuospatial abilities, and cognitive flexibility.
27
Mamhidir, Anna-Greta. "Meeting ethical and nutritional challenges in elder care : the life world and system world of staff and high level decision-makers /." Stockholm, 2006. http://diss.kib.ki.se/2006/91-7140-943-2/.
Full text
28
Janlöv, Ann-Christin. "Participation in needs assessment of older people prior to public home help : older persons', their family members', and assessing home help officers' experiences /." Lund : Lund University, 2006. http://theses.lub.lu.se/postgrad/search.tkl?field_query1=pubid&query1=med_1352&recordformat=display.
Full text
29
Francis, Charmine 1978. "The discriminative validity of the McGill Ingestive Skills Assessment (MISA) /." Thesis, McGill University, 2009. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=111570.
Full textAbstract:
Introduction: Stroke is associated with a high prevalence of dysphagia in the elderly population. Hence, dysphagia evaluation and management are key issues in stroke rehabilitation. The McGill Ingestive Skills Assessment (MISA) is a recently developed mealtime observational tool aimed at evaluating the functional aspects of the oral phase of ingestion. Objective: To determine the discriminative validity of the MISA by assessing known/extreme groups of elderly individuals presenting with stroke, who have been admitted to an acute-care-hospital or a rehabilitation center. Participants were allocated to one of two groups: 1) individuals with stroke and no dysphagia, who are on a regular diet and 2) individuals with stroke and dysphagia, who are permitted only purees. Methods: Participants were evaluated with the MISA and a comprehensive chart review was conducted. Analysis: Groups were compared on socio-demographic and clinical characteristics. Univariate tests were performed to test the significance of between-group differences. Conclusion and significance: The results of the study are satisfactory, and enhance the clinical usefulness of the tool for dysphagia management. These results also support future studies addressing the responsiveness of the MISA.
30
Weierbach, Florence M. "Who Provides Care in the Home for the Tri-State Area Elderly: Sn Assessment of Informal Family Caregiver’s Perception of Health?" Digital Commons @ East Tennessee State University, 2013. https://dc.etsu.edu/etsu-works/7401.
Full text
31
Monroe, Diaz Francisco Javier, Del Mar Solania Tello, and Bueno María Fernanda Torres. "Prevalencia y asociación entre la dependencia funcional y síntomas depresivos en el adulto mayor de un centro público de atención residencial geronto-geriátrico de Lima-Perú." Bachelor's thesis, Universidad Peruana de Ciencias Aplicadas (UPC), 2015. http://hdl.handle.net/10757/621622.
Full textAbstract:
Introducción: Los adultos mayores institucionalizados (AMI), constituyen una población vulnerable porque pierden autonomía al adaptarse a un nuevo ambiente lo cual predispone la aparición de síntomas depresivos y dependencia funcional. El objetivo del estudio es determinar la asociación entre síntomas depresivos y funcionalidad en esta población. Materiales y Métodos: Estudio transversal analítico con la aplicación de instrumentos estandarizados para evaluar síntomas depresivos (Escala de depresión geriátrica de Yesavage) y dependencia funcional para actividades básicas de la vida diaria (Índice de Barthel) y la extracción de datos de historias clínicas en un Centro Geronto-Geriátrico en Lima- Perú durante Febrero- Abril del 2013. Resultados: 153 AMI fueron enrolados con una media de 80,8 ±7,3 años a predominio masculino, solteros, y de bajo nivel educativo. El 47,1% tenía algún grado dependencia funcional y el 62,1% algún síntoma depresivo. El coeficiente de Spearman entre los puntajes de Yesavage y Barthel mostró con una correlación negativa no significativa (-0,14, p=0,08). En el análisis de regresión lineal multivariado las covariables educación secundaria (p<0,01), hipertensión arterial (p<0,01), y dependencia funcional escasa (p=0,01) estuvieron asociadas a un mayor puntaje de sintomatología depresiva. Conclusiones: Existe asociación significativa entre los síntomas depresivos y dependencia funcional. Por ello, la identificación precoz de la dependencia funcional escasa en los AMI debe ser considerada como un indicador evitar la aparición de síntomas depresivos.Introduction: Institutionalized Elderly (IE) constitute a vulnerable population because they lose their autonomy to adapt to a new environment which predisposes the onset of depressive symptoms and functional dependency. The aim of the study is determine the relationship between depressive symptoms and functional dependency in public old age homes. Materials and Methods: Analytical cross- sectional study using standardized scales to evaluate depressive symptoms (Yesavague’s Geriatric Depression Scale) and functional dependency on activities of daily living (Barthel Scale) and extracting data manually from medical records in a Gerontological- Geriatric Center in Lima Peru from February to April, 2013. Results: 153 IE were enrolled in the study with a mean age of 80.8, +/- 7.3 years. They were predominantly men, single and with low educational level, 47.1% had some degree of functional dependency and 62.09% some symptom of depression. The Spearman coefficient between Yesavage and Barthel illustrated non-significant negative correlation (-0.14, p=0.08). In the multivariate linear regression analysis, the covariates secondary education (<0.01), arterial hypertension (p<0.01) and functional dependency (p=0.01) were associated with a higher score of depressive symptoms. Conclusions: There is a significant association between depressive symptoms and functional dependency. Thus, the early identification of low functional dependency in IE should be considered as an early indicator to avoid depressive symptoms.
32
Fadayevatan, Reza. "Inpatient hospital care for older people : relationship between comprehensive geriatric assessment (CGA), frailty and outcomes in eldery hospitalized patients." Thesis, University of Sheffield, 2007. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.443880.
Full text
33
Knight, Adriene Jean. "Nutritional Assessment of Individuals who Utilize Services Available Through the Wood County Committee on Aging." Bowling Green State University / OhioLINK, 2009. http://rave.ohiolink.edu/etdc/view?acc_num=bgsu1245692500.
Full text
34
Palmieri, Jean Carlo. "Avaliação Geriátrica Ampla de Idosos Acompanhados em Centro Dia de Botucatu." Botucatu, 2019. http://hdl.handle.net/11449/183472.
Full textAbstract:
Orientador: Paulo José Fortes Villas BoasResumo: Introdução: Atualmente a expectativa de vida mundial está aumentando significativamente. Avaliar a população assistida em centros de convivência permitirá ampliar a discussão acerca das atividades realizadas e propostas nesses locais, com ênfase na qualidade de vida dos idosos. Objetivo: Avaliar os idosos do Centro de Convivência do Idoso “Aconchego” em Botucatu quanto às síndromes geriátricas, capacidade funcional e uso de medicamentos. Métodos: Estudo observacional transversal, realizado entre o mês de janeiro de 2018 e abril de 2019, no Centro de Convivência do Idoso Aconchego, em Botucatu (SP). Foi realizada avaliação geriátrica amola quanto aos domínios capacidade funcional (escala de Katz, Pfeffer, escala de Lawton), cognição (Mini Exame do Estado Mental - MEEM), humor (escala de depressão geriátricade Yesavage), deficit sensorial dos idosos (teste da voz sussurrada e déficit visual), nutrição (índice de massa corpo- ral), fragilidade (índice Study of osteoporotic fracture e índice fenotípico de Linda Fried), continência urinária e questão social e familiar. Os idosos portadores de demência foram classificados quanto a gravidade pelo Clinical Dementia Ratio (CDR). Foi realizada análise descritiva, testes de associação (QuiQuadrado, T-stu- dent), sendo estatisticamente significativo quando o nível alfa foi < 0,05. Resultados: A amostra avaliada foi de 76 idosos, que tiveram a média de idade de 80,6 + 8,0 anos, sendo que 72,4% (55) eram do sexo feminino. 94,2% apresentava... (Resumo completo, clicar acesso eletrônico abaixo)
Abstract: Introduction: The current world life expectancy is increasing significantly. Assessing the population assisted in social centers will allow a broader discussion about the activities carried out and proposed in these places, with emphasis on the quality of life of the elderly. Objective: To evaluate the elderly of the Center for the Cohabitation of the Elderly "Aconchego" in Botucatu regarding geriatric syndromes, functional capacity and medication use. Methods: Cross-sectional observational study, conducted between January 2018 and April 2019, at the Aconchego Shelter Center in Botucatu (SP). A geriatric evaluation was carried out in relation to functional capacity domains (Katz scale, Pfeffer, Lawton scale), cognition (Mental State Mini Examination), humor (Yesavage geriatric depression scale), sensorial deficit of the elderly (Index of osteoporotic fracture and Linda Fried's phenotype index), urinary continence, and social and family issues. Elderly people with dementia were classified as severity by the Clinical Dementia Ratio (CDR). A descriptive analysis, association tests (Chi-Square, T-student) was performed, being statistically significant when the alpha level was <0.05. Results: The sample evaluated was 76 elderly, who had a mean age of 80.6 + 8.0 years, and 72.4% (55) were female. 94.2% had cognitive impairment by MMSE, and 47.4% had a previous diagnosis of dementia. 55.3% were classified as overweight / obese. 41.7% of the elderly were classified as mild dementia a... (Complete abstract click electronic access below)
Mestre
35
Yu, Jie. "The significance of walking speed in physical function among a group of community dwelling older adults." Diss., Columbia, Mo. : University of Missouri-Columbia, 2008. http://hdl.handle.net/10355/6049.
Full textAbstract:
Thesis (Ph. D.)--University of Missouri-Columbia, 2008.The entire dissertation/thesis text is included in the research.pdf file; the official abstract appears in the short.pdf file (which also appears in the research.pdf); a non-technical general description, or public abstract, appears in the public.pdf file. Vita. "May 2008" Includes bibliographical references.
36
Hein, Susanne. "Praktikabilität, Verständlichkeit, Nützlichkeit und Akzeptanz der Selbstausfüller-Version eines hausärztlichen geriatrischen Assessments (STEP)- Ergebnisse einer Querschnittsstudie." Doctoral thesis, Universitätsbibliothek Leipzig, 2013. http://nbn-resolving.de/urn:nbn:de:bsz:15-qucosa-130539.
Full textAbstract:
Mit der vorliegenden Arbeit sollte untersucht werden, ob die Selbstausfüller-Version des STEP (Standardised assessment of elderly people in primary care in Europe) praktikabel und verständlich ist, ob sie von Patienten und Ärzten akzeptiert wird und ob sie nützlich ist, bisher unbekannte gesundheitliche Probleme der Patienten zu entdecken. 1007 von 1540 Patienten über 65 Jahren, die in 28 sächsische Hausarzt-praxen kamen, beantworteten die Selbstausfüller-Version des STEP. Ermittelt wurde, dass 95,8% der teilnehmenden Patienten den Fragebogen ohne Hilfe ausfüllen konnten. Die durchschnittliche Zeit zum Beantworten des Fragebogens nahm, abhängig vom Alter der Patienten, von 17 bis 25 Minuten zu. Vierzehn der 75 Fragen der Selbstausfüller-Version wurden von mehr als 9% der Patienten nicht beantwortet. Die Patienten gaben bei acht der 14 häufig nicht beantworteten Fragen Verständnisprobleme an. Bei einer Stichprobe von 257 zufällig ausgewählten Patienten wurden 281 gesundheitliche Probleme (1,1 pro Patient) entdeckt, die den Hausärzten noch nicht bekannt gewesen waren. Die Hausärzte gaben an, dass 16,4% dieser neuen Probleme eine Konsequenz hatten, vordergründig die physischen Probleme. Bemerkenswert war, dass die neu entdeckten psycho-sozialen Probleme keinerlei Konsequenzen hatten. Die Selbstausfüller-Version war praktikabel, nützlich und wurde von den meisten Patienten gut akzeptiert. Einige Fragen sollten hinsichtlich der Verständlichkeit überprüft werden. Weitere Studien müssen zeigen, warum einige neu entdeckte Probleme keine Konsequenzen hatten, ob diese Probleme gebessert werden können und ob es nötig ist, diese Probleme zu ermittelnThe study was designed to evaluate the acceptance of the self-rated version of the Standardized Assessment of Elderly People in primary care in Europe (STEP) by patients and general practitioners, as well as the feasibility, comprehensibility, and usefulness in gaining new information. In all, 1007 of 1540 patients aged 65 and above, from 28 different Saxon general practices took part. We recognized that 96% of the patients were able to fill in the questionnaire by themselves. It took them an average of approximately 20 minutes to do so. Further analysis of 257 randomly selected patients identified 281 previously unknown problems (1.1 per patient). In the practitioners’ opinion, 16% of these problems, particularly physiological and mental ones, could lead to immediate consequences. Remarkably, newly identified psychosocial problems were not followed by any consequences. Fourteen of the 75 questionnaire items were not answered by more than 9% of the participants. Eight of the 14 frequently unanswered items were marked as difficult to understand by the patients. Altogether the self-rating version of the STEP was found to be feasible and useful. It was well accepted among patients; however, some questions need further review to improve their comprehensibility. Furthermore, it should be investigated why some identified problems do not have consequences and whether there is a need to record these issues at all
37
Minhage, Margareta. "The Swedish Version of the Philadelphia Geriatric Center Multilevel Assessment Instrument (PGCMAI) : Development and testing in an old-age population with locomotor disability." Licentiate thesis, Linköping University, Linköping University, Nursing Science, 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-9582.
Full textAbstract:
The general aim was to examine the Swedish version of the Philadelphia Geriatric Center Multilevel Assessment Instrument, PGCMAI, in a population of old people with locomotor disability in Sweden. Specific aims were to examine whether the Swedish version of the PGCMAI meets the criteria of reliability and validity when assessing the life situation of Swedish old people with locomotor disability and to explore the pattern of the Swedish version of the instrument in respect of age and gender.
Home visits were made to 199 people aged 60 years and older in two counties in Sweden. They were interviewed using the Swedish version of the PGCMAI and tested with the Standardized Practical Equipment test, SPE. The data collected were tested for reliability and validity. Cronbach’s alpha varied from 0.27 to 0.86 among the eight domains of the PGCMAI, which concurred with other studies in the field. Validity was analyzed by explorative factor analysis. The eight new factors showed construct validity with a logical relation to the eight original domain distributions. There were also significant relationships between both the original domains of the PGCMAI and the SPE and the new factors of the PGCMAI and the SPE. Both the original Mobility domain index and the new factor correlated well with the ‘Balance and mobility’ factor in the SPE. The Cognitive domain index and the corresponding new factor show a high correlation with the ‘Cognitive functions’ factor in the SPE. The Swedish version of the PGCMAI and SPE presented a functional pattern among old men and women whereby women had deteriorated most with age, which is in agreement with other studies.
In conclusion the reliability and validity testing of the Swedish version of the PGCMAI has given satisfactory results when used with old people with locomotor disability. The Swedish version of the PGCMAI can be considered a valuable tool for measuring function in old people with locomotor disability.
Befolkningen åldras mer och mer, både i Europa och Sverige, som en följd av längre livslängd och låga födelsetal. Det ställer krav på samhällets resurser i form av vård och omsorg för äldre. I en tid när resurserna inte ökar blir det allt viktigare att samhällets stöd fördelas efter behov.
I den här studien utvecklades och prövades den svenska versionen av the Philadelphia Geriatric Center Multilevel Assessment Instrument, PGCMAI, på personer 60 år och äldre med rörelsehinder. Instrumentet omfattar åtta huvudsakliga funktionsområden eller domäner, Activities of Daily Living, ADL, Personal Adjustment, PADI, Physical Health, PHDI, Social, SDI, Environmental, EDSI, Time Use, Mobility, MOBI and Cognitive, CDI. Varje område består av frågor som ställs till den enskilde vid en intervju. Originalversionen av instrumentet, på amerikanska, finns i tre varianter eller längder, ’short-length’, ’mid-length’ och ’full-length’. Den svenska versionen av PGCMAI är en översättning och bearbetning av ’mid-length’ varianten.
Studiens målgrupp har varit äldre med rörelsehinder. Den har genomförts i tre steg. I det första steget skickades ett frågeformulär till 3469 personer, 60 år och äldre i två geografiska områden i Jönköpings och Värmlands län, där de tillfrågades om de hade något rörelsehinder. Det andra steget innebar att de som rapporterat rörelsehinder, 566 personer, erhöll ett nytt frågeformulär där de bl.a. tillfrågades om svårigheter att förflytta sig och ADL. Det tredje steget innebar att de som besvarade det andra frågeformuläret och accepterade besök i det egna hemmet, 199 personer, intervjuades med PGCMAI och testades med det praktiska testet, Standardized Practical Equipment test, SPE.
Det första delarbetet syftade till att utreda om den svenska versionen av PGCMAI fyllde kriterierna för reliabilitet och validitet vid bedömning av livssituationen hos äldre med rörelsehinder i Sverige.
Reliabilitet testades med Cronbach’s alpha och visade högre värde för det ursprungliga PGCMAI än för den svenska versionen, med undantag av domänerna EDSI och Time Use. Jämförelse av Cronbach´s alpha mellan äldre med rörelsehinder i den egna studien (n=199) och studie från 1982 av Lawton et al (n=590) visade likheter med högst värde för ursprungsinstrumentets domäner ADL, PADI och CDI, och lägst värde för domän SDI. Den svenska versionen av PGCMAI testades på validitet med exploratorisk faktoranalys av de 40 variabler i PGCMAI som ingick i de ursprungliga domänerna. Faktoranalysen identifierade åtta faktorer som förklarade 47% av variansen. Dessa åtta faktorer visade betydande överensstämmelse med det ursprungliga instrumentets åtta domäner. Högst korrelation med de nya faktorerna visade domänerna EDSI, SDI och ADL. MOBI i originalversionen och motsvarande faktor i den nya versionen visade högst korrelation med ’Balance and mobility’ i SPE, på motsvarande sätt erhölls samband mellan CDI och ’Cognitive functions’ i SPE.
Det andra delarbetet hade syftet att undersöka mönstret i den svenska versionen av PGCMAI utifrån ålder och kön samt i jämförelse med andra studier inom området.
Materialet analyserades i två och fyra åldersgrupper och indelat i män (n=67) och kvinnor (n=132). Analysen visade att rörelsehinder ökar med ålder både för män och kvinnor. Jämförelse mellan åldersgrupperna 60-79 år, 80-99 år, visa att rörligheten försämrades med ålder enligt domänen MOBI. För kvinnor försämrades förmågan enligt domänerna ADL, Time Use, MOBI, SDI och i alla SPE faktorerna, med ålder. Slutsatsen är att PGCMAI kunde särskilja ett funktionellt mönster bland äldre män och kvinnor med rörelsehinder och en försämring med ålder. SPE visade ett motsvarande resultat.
Slutsatsen av studien är att testningen av validitet och reliabilitet på den svenska versionen av PGCMAI har givit tillfredställande resultat när det används på gruppen 60 år och äldre med rörelsehinder. PGCMAI kunde särskilja funktionella mönster hos äldre män och kvinnor och visade att kvinnor med rörelsehinder hade försämrats mest med ålder. SPE visade liknande resultat. Den svenska versionen av PGCMAI bedöms vara ett värdefullt instrument för att mäta funktionen hos äldre med rörelsehinder och kan bli ett viktigt hjälpmedel för att ge rätt insats och i rätt omfattning.
38
Voos, Mariana Callil. "A influência da idade e da escolaridade na execução e no aprendizado de uma tarefa cognitivo-motora." Universidade de São Paulo, 2010. http://www.teses.usp.br/teses/disponiveis/47/47135/tde-09032010-090822/.
Full textAbstract:
Função executiva é a habilidade necessária para planejar, iniciar, realizar e monitorar comportamentos intencionais, relacionados a um objetivo ou a demandas ambientais, com base na experiência prévia. Tanto indivíduos idosos, quanto indivíduos com escolaridade baixa apresentam dificuldade em tarefas que requerem função executiva, como o Trail Making Test (TMT), que consiste em traçar retas em uma folha de papel, conectando uma seqüência de números (parte A, TMTA) e de números e letras, alternados (parte B, TMTB), o mais rápido possível. O presente estudo teve como objetivo geral desenvolver uma nova versão do TMT, o Teste de Deambulação Funcional (TDF), que poderia ser mais familiar a indivíduos com escolaridade baixa e favorecer sua compreensão e execução. Os objetivos específicos foram: testar se haveria diferenças de idade e/ou escolaridade (1) na execução das partes A e B do TDF (TDFA e TDFB) e das partes A e B do TMT (TMTA e TMTB); (2) nos deltas cognitivos do TMT (dcTMT=TMTBTMTA) e do TDF (dcTDF=TDFBTDFA); (3) nos deltas motores da parte A (dmA=TDFATMTA) e da parte B (dmB=TDFBTMTB) e (4) no aprendizado do TDF. Participaram 70 voluntários, (24 jovens, 26 adultos maduros, e 20 idosos). Na primeira sessão os voluntários realizaram (I) o TDF, (II) o TMT, (III) sete repetições do TDFA, (IV) sete repetições do TDFB. Metade dos voluntários de cada faixa etária realizou a ordem (I) e (II) e metade, (II) e (I). Depois de uma semana, realizaram (V) quatro repetições do TDFA e (VI) quatro do TDFB. Foi adotado nível de significância de p=0,05. ANOVAs mostraram que (1) os idosos, principalmente aqueles com escolaridade baixa, foram mais lentos que os adultos jovens e maduros no TMT e no TDF, sobretudo na parte B e os idosos com escolaridade alta foram mais lentos no TDFB do que no TMTB; (2) os deltas cognitivos do TMT e do TDF foram mais altos para indivíduos com maior idade e menor escolaridade e o dcTMT foi maior que o dcTDF para idosos com escolaridade baixa; (3) o dmB de idosos com escolaridade baixa foi menor que o de idosos com escolaridade alta; (4) os idosos com escolaridade baixa foram mais lentos que aqueles com escolaridade alta na avaliação 1 da TDFA e em todas as avaliações da TDFB, mas não foram observadas diferenças de escolaridade no desempenho de adultos jovens e maduros. O TDF mostrou-se uma ferramenta complementar eficaz para avaliar indivíduos com diferentes idades e escolaridades. Indivíduos mais idosos e com escolaridade mais baixa apresentaram tempos mais altos, tanto no TMT, quanto no TDF. O dcTDF não parece ter sido equivalente ao dcTMT em indivíduos com escolaridade baixa, já que eles apresentaram menor dificuldade em resolver cognitivamente o TDF. Idosos com alta e baixa escolaridade apresentaram resultados antagônicos no dmB: idosos com escolaridade baixa apresentaram menor dificuldade no TDFB, com relação ao TMTB e o contrário ocorreu para idosos com escolaridade alta. A escolaridade baixa prejudicou o aprendizado da tarefa, principalmente em idosos. Idosos apresentaram estabilização mais lenta no desempenho do que adultos maduros, que por sua vez apresentaram estabilização mais lenta que jovens.Executive function is the ability of planning, initiating, performing and monitoring intentional behaviors, related to an objective or environmental demands, based on previous experience. Older adults and individuals with a low educational status have difficulty in performing executive function tasks, such as the Trail Making Test (TMT), which consists on linking a sequence of numbers on a sheet of paper (part A, TMTA) and alternated numbers and letters (part B, TMTB) as fast as possible. The present study had as a general aim to develop a new version of the TMT, the Functional Gait Test (FGT), which could be more familiar to individuals with a low educational status and favor their comprehension and performance. The specific aims were: to investigate possible differences due to age and/or educational status (1) in the performance of parts A and B of FGT (FGTA e FGTB) and of parts A and B of TMT (TMTA and TMTB); (2) in the cognitive deltas of TMT (cdTMT=TMTBTMTA) and of FGT (cdFGT=FGTBFGTA); (3) in the motor deltas of part A (mdA=FGTATMTA) and part B (mdB=FGTBTMTB) and (4) in the learning process of FGT. Seventy volunteers participated (24 young adults, 26 mature adults and 20 older adults). At the first session, volunteers performed (I) the FGT, (II) the TMT, (III) seven repetitions of the FGTA, (IV) seven repetitions of the FGTB. Half of the sample of each age group performed the order (I) and (II) and the other half, (II) and (I). After one week, they performed (V) four repetitions of the FGTA and (VI) four of the FGTB. Significance level was p=0,05. ANOVAs showed that (1) older adults, mainly the ones with a low educational status, were slower than young and mature adults on the TMT and on the FGT, principally on part B and older adults with a high educational status were slower on the FGTB than on the TMTB; (2) the cognitive deltas of TMT and FGT were higher for individuals with higher age and lower level of education and the cdTMT was higher than cdFGT for older adults with a low educational status; (3) the mdB of older adults with a low educational level was lower that the mdB of older adults with more years of formal education; (4) older adults with a low educational status were slower than the ones with a high level of education on assessment 1 of the FGTA and in all assessments of the FGTB, but no educational status differences were observed in the performance of young and mature adults. The FGT is an useful complementary tool to evaluate individuals with different ages and educational levels. Older adults and individuals with a lower educational level showed higher times, both in the TMT and in the FGT. The cdFGT did not seem equivalent to the cdTMT in individuals with a low educational status, since they had less difficulty in solving the cognitive part of the FGT. Older adults with a high and a low educational level had antagonistic results on mdB: older adults with a low educational status had less difficulty on the FGTB, compared to the TMTB and the opposite occurred for the ones with a high educational status. The low educational level impaired the learning process, mainly for older adults. Older adults showed slower stabilization on performance than mature adults and mature adults showed slower stabilization than young adults.
39
Wang, Ying. "Living Arrangements, Intergenerational Dynamics, and Psychological Well-being of Elders: An Examination of Predictors of Elder Depression in Retired Persons in Yancheng, Jiangsu, China." Yale University, 2009. http://ymtdl.med.yale.edu/theses/available/etd-05032009-135833/.
Full textAbstract:
This study explores the relationship between living arrangement and psychological wellbeing in retired elderly individuals living in Yancheng, Jiangsu (PR China). Data on mode of residence, socio-economic background, daily activities, and intergenerational dynamics were collected from 200 subjects, and their potential correlations with depression (assessed via the Geriatric Depression Scale Short Version) were analyzed. Univariate as well as logistic regression confirmed mode of residence as a significant predictor of depression in this group. The following depression odds ratios associated with each mode of residence were derived via logistic regression: 1) nuclear household, i.e. living with a spouse only ¨C 1 [reference category], 2) multigenerational households in which a spouse is not present ¨C 4.341, 3) multigenerational households in which a spouse is present ¨C 0.781, and 4) living alone ¨C 3.018. Based on these ratios, we conclude that the traditional model of intergenerational coresidence is not, in itself, associated with less depression. Rather, it is the presence of a sharing spousal in a household (whether single or multigenerational) that protects against elderly depression. Other predictors of depression identified in backward logistic regression included presence of a chronic illness and self assessed wealth status. Additionally, a number of psychosocial variables were identified as independently correlated with depression, but were subsequently selected out by multivariate analysis. These included: educational background, religious affiliation, membership in an organization, attitude toward aging, and family status. Based on this study, we believe that efforts to promote mental wellbeing among today¡¯s Chinese elders should be directed toward psychosocial factors that are modifiable (education, building supportive social networks etc.) rather than insisting on the traditional ideal of multigenerational living and dependence on filial piety.
40
Silva, Thiago Junqueira Avelino da. "Delirium em idosos hospitalizados: análise de características clínicas e prognóstico." Universidade de São Paulo, 2016. http://www.teses.usp.br/teses/disponiveis/5/5169/tde-20042016-143404/.
Full textAbstract:
INTRODUÇÃO: Delirium é um problema médico frequente em idosos e está potencialmente associado a desfechos desfavoráveis, como prolongamento da hospitalização, declínio funcional e cognitivo, e maior mortalidade. Contudo, considerando que, geralmente, ocorre em situações de grande complexidade clínica, o efeito ajustado de delirium e seus subtipos motores sobre o prognóstico de pacientes acometidos ainda não foi suficientemente explorado. OBJETIVOS: Investigar em idosos agudamente enfermos hospitalizados: (1) a associação independente entre ocorrência de delirium e tempo para óbito intra-hospitalar, e em 12 meses de seguimento; (2) a associação independente entre subtipos motores de delirium e tempo para óbito intra-hospitalar, e em 12 meses de seguimento. MÉTODOS: Estudo de coorte prospectivo realizado em uma enfermaria de geriatria de um hospital universitário terciário, em São Paulo, Brasil. Foram incluídas internações de pacientes agudamente enfermos, com idade igual ou superior a 60 anos, hospitalizados entre junho de 2009 e maio de 2014. Delirium foi detectado pelo Confusion Assessment Method e classificado de acordo com o subtipo motor em hipoativo, hiperativo, ou misto. Os desfechos primários foram tempo para óbito intra-hospitalar, e tempo para óbito em 12 meses (para a amostra que recebeu alta). Os pacientes foram avaliados na admissão seguindo modelo de avaliação geriátrica ampla que incluiu variáveis sociodemográficas, clínicas, funcionais, cognitivas, e laboratoriais. Informações adicionais sobre a hospitalização foram registradas na alta ou no óbito. As análises multivariadas foram realizadas por meio de modelos de riscos proporcionais de Cox. Foi examinada a presença de modificação do efeito de delirium sobre os desfechos por análises de interação com outros fatores clínicos. RESULTADOS: Incluímos 1.034 hospitalizações, com uma média de idade de 80 anos. Na amostra geral, 61% eram mulheres, e 35% tinham demência. A mortalidade intra-hospitalar foi de 22%, com uma mortalidade cumulativa de 44% em 12 meses. Delirium ocorreu em 52% das internações, e o subtipo motor predominante foi o hipoativo (53%). Nas hospitalizações com delirium, 32% dos idosos faleceram no hospital, com uma taxa de óbitos cumulativa de 59% em 12 meses. Verificamos que delirium teve associação independente com tempo até óbito intra-hospitalar (HR=1,63 IC95%=1,11-2,40), porém não encontramos associação estatisticamente significante com sobrevida em 12 meses após ajuste para as covariáveis selecionadas. Constatamos, ainda, que os subtipos hipoativo e misto se associaram independentemente com o desfecho intra-hospitalar (HR=1,87 IC95%=1,24-2,83; HR=1,65 IC95%=1,022,67), mas não houve associação estatisticamente significante com o desfecho em 12 meses. O efeito de delirium sobre o tempo até óbito intrahospitalar não foi modificado de modo significativo por sua interação com idade, câncer, desnutrição, ou valores de albumina sérica. CONCLUSÕES: Um terço dos idosos agudamente enfermos internados que tiveram delirium faleceu ainda no hospital. Delirium se associou a menor tempo de sobrevida intra-hospitalar, mesmo após ajuste para características clínicas coexistentes. Além disso, profissionais da saúde devem ter especial atenção com os subtipos hipoativo e misto de delirium, que também se associaram independentemente com maior mortalidade intra-hospitalar em idososBACKGROUND: Delirium in older adults is common and potentially associated with unfavorable outcomes, such as longer hospital stay, functional and cognitive decline, and higher mortality. However, given that it usually occurs in a context of great clinical complexity, the adjusted effect of delirium and its motor subtypes on the prognosis of affected patients has not been sufficiently explored. OBJECTIVES: To investigate in acutely ill hospitalized older adults: (1) the independent association between delirium and time to death in the hospital, and in a 12-month follow-up; (2) the independent association between delirium motor subtype and time to death in the hospital, and in a 12-month follow-up. METHODS: Prospective cohort study completed in a geriatric ward of a tertiary university hospital, in Sao Paulo, Brazil. We included admissions of acutely ill patients aged 60 years and over, who were hospitalized from June 2009 to May 2014. Delirium was detected using the Confusion Assessment Method and classified according to its motor subtype in hypoactive, hyperactive, or mixed. Primary outcomes were time to death in the hospital, and time to death in 12 months (for the discharged sample). Patients were evaluated at admission according to a comprehensive geriatric assessment model that included socio-demographic, clinical, functional, cognitive, and laboratory variables. Further clinical data were documented upon death or discharge. Multivariate analyses were performed using Cox proportional hazards models. We investigated the potential modification of the effect of delirium on outcomes including an interaction term between delirium and other clinical variables. RESULTS: We included 1,034 hospitalizations, with a mean age of 80 years. Overall, 61% were women, and 35% had dementia. The proportion of in-hospital deaths was of 22%, with a cumulative mortality of 44% in 12 months. Delirium ensued in 52% of the admissions, and the predominant motor subtype was hypoactive (53%). In-hospital death occurred in 32% of the cases with delirium, while cumulative 12-month mortality reached 59% in this group. We verified that delirium was independently associated with time to in-hospital death (HR=1.63 95%CI=1.11-2.40), but did not find statistically significant association with 12month survival after adjusting for selected covariates. We additionally found that hypoactive and mixed motor subtypes were independently associated with in-hospital death (HR=1.87 95%CI=1.24-2.83; HR=1.65 95%CI=1.02-2.67), but there were no significant associations with 12-month mortality. The effect of delirium on time to in-hospital death was not significantly modified by its interaction with age, cancer, malnutrition, or serum albumin levels. CONCLUSIONS: One third of acutely ill hospitalized older adults who suffered delirium died in the hospital. Delirium was associated with decreased survival in the hospital, even after adjusting for coexistent clinical characteristics. In addition, health care providers should be attentive for the hypoactive and mixed subtypes of delirium, as they were also independently associated with poorer in-hospital outcomes in older adults
41
Söderqvist, Anita. "Bedömning av kognitiv förmåga hos äldre patienter med höftfraktur : assessment of cognitive function in elderly patients with hip fractures /." Stockholm, 2007. http://diss.kib.ki.se/2007/978-91-7357-065-7/.
Full text
42
Nilsson, Jan. "Understanding health-related quality of life in old age : a cross-sectional study of elderly people in rural Bangladesh /." Stockholm : Division of Geriatric Epidemiology, Department of Neurotec, Karolinska institutet ; Stockholm Gerontology Research Center, 2005. http://diss.kib.ki.se/2005/91-7140-477-5/.
Full text
43
Dutra, Michelinne Oliveira Machado. "Perfil sociodemográfico e capacidade funcional de idosos com plegias por acidente vascular encefálico." Universidade Estadual da Paraíba, 2015. http://tede.bc.uepb.edu.br/jspui/handle/tede/2908.
Full textAbstract:
Submitted by Jean Medeiros (jeanletras@uepb.edu.br) on 2017-11-21T13:07:34Z
No. of bitstreams: 1
PDF - Michelinne Oliveira Machado Dutra.pdf: 14643451 bytes, checksum: 00d044272ac0ee88364381aeee5c9705 (MD5)Approved for entry into archive by Secta BC (secta.csu.bc@uepb.edu.br) on 2017-12-06T18:40:05Z (GMT) No. of bitstreams: 1 PDF - Michelinne Oliveira Machado Dutra.pdf: 14643451 bytes, checksum: 00d044272ac0ee88364381aeee5c9705 (MD5)
Made available in DSpace on 2017-12-06T18:40:05Z (GMT). No. of bitstreams: 1 PDF - Michelinne Oliveira Machado Dutra.pdf: 14643451 bytes, checksum: 00d044272ac0ee88364381aeee5c9705 (MD5) Previous issue date: 2015-07-28
Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES
Conselho Nacional de Desenvolvimento Científico e Tecnológico - CNPq
By introducing the latest technological innovations of the preventive and curative medicine, there was an increase in life expectancy and reduction of mortality rate, which in conjunction with the decline in the fertility rate shows the process of population aging. Consequence, diseases proper of the old age have shown increased expression in society. Among them, we highlight the cerebrovascular accident that among seniors, presents high incidence. It aimed to verify the associations between socio-demographic factors and the functional capacity of the elderly with plegias by cerebrovascular accident. This is a cross-sectional study, descriptive, of a quantitative approach. It was performed in the homes of the elderly with plegias for stroke attached to Family Health Units of the municipality of Campina Grande/PB, Brazil, in the period September 2014 and March 2015. Eligibility criteria: people aged 60 or older, of both genders, with some kind of palsy diagnosed by specialist, due to cerebrovascular accident, cognitive function that makes it possible to answer the questions and be attached in any family Health Unit municipality campinense. Two questionnaires were used: the questionnaire I, for the investigation of socio-demographic variables, and the questionnaire II, called Barthel Index for the evaluation of the functional capacity of the subjects for the activities of daily life. The data collected were deployed (in double-entry) into an electronic database and analyzed through the statistical program Statistical Package for the Social Sciences, 20.0 version for Windows, and presented through tables. The associations investigated considered the 95% confidence intervals (p < 0,05). For demographic data analysis and IB scores there was used the descriptive statistics. To check the level of significance between associations of socio-demographic aspects and functional capacity for activities of daily living there was used dichotomization of the Barthel Index variables. This research was developed according to the parameters of the resolution 466/12 of the National Health Council and Ministry of Health, which feature on research involving humans. The results were presented by means of a scientific article derived from the research. There has been a predominance of women, widowed, without schooling and with household income of up to one minimum wage. The average age was of 65 years old. Found satisfactory reliability of Barthel Index, with Cronbach's alpha total = 0,917. The activities in which there was greater difficulty of urination (73,8%) and evacuate (66,9%) were carrying out. Regarding the functional capacity for activities of daily living, there was verified the level of capacity ranging from moderate to total dependence, and degree of mild dependence. It was found association between the functional capacity and the race (p = 0,027), age group (p = 0,001) and schooling (p = 0,041). It was noted that the socio-demographic factors may interfere with the functional capacity of the elderly with plegias by cerebrovascular accident. In this sense, through the provision of research results, it is believed to have contributed to the reflection on this issue, as well as provided by other studies of the reproduction methods used.
Ao introduzir as mais recentes inovações tecnológicas da medicina preventiva e curativa, houve aumento da expectativa de vida e redução da taxa de mortalidade que conjuntamente com o declínio da fecundidade evidencia o processo de envelhecimento populacional. Conseguinte, doenças próprias da velhice têm apresentado crescente expressão na sociedade. Dentre elas, destaca-se o acidente vascular encefálico que entre os idosos, apresenta elevada incidência. Objetivou-se verificar as associações entre os fatores sociodemográficos e a capacidade funcional de idosos com plegias por acidente vascular encefálico. Trata-se de um estudo transversal, descritivo, com abordagem quantitativa. Foi realizado no domicílio dos idosos com plegias por acidente vascular encefálico adscritos às Unidades de Saúde da Família do município de Campina Grande/PB, Brasil, no período de setembro de 2014 a março de 2015. Os critérios de elegibilidade: pessoas com idade igual ou superior a 60 anos, de ambos os sexos, com algum tipo de plegia diagnosticada por especialista, decorrente de acidente vascular encefálico, função cognitiva que possibilite responder os questionamentos e estar adstrito em alguma Unidade Saúde Família do município campinense. Foram utilizados dois questionários: o Questionário I, destinado à investigação das variáveis sociodemográficas e o Questionário II, denominado Índice de Barthel destinado à avaliação da capacidade funcional dos sujeitos para as Atividades de Vida Diária. Os dados coletados foram implantados (em dupla entrada) em um banco de dados eletrônico e analisados por meio do programa estatístico Statistical Package for the Social Sciences , versão 20.0 para Windows, e apresentados por meio de tabelas. As associações investigadas consideraram os intervalos de confiança em 95% (p<0,05). Para análise dos dados sociodemográficos e dos escores do IB, foi utilizada a estatística descritiva. Para verificar o nível de significância entre associações dos aspectos sociodemográficos e capacidade funcional para as atividades de vida diária, foi utilizada a dicotomização das variáveis do Índice de Barthel. Esta pesquisa foi desenvolvida de acordo com os parâmetros da Resolução 466/12 do Conselho Nacional de Saúde e Ministério da Saúde, que dispõem sobre pesquisa envolvendo seres humanos. Os resultados foram apresentados por meio de um artigo científico derivado da pesquisa. Verificou-se predomínio de indivíduos do sexo feminino, viúvos, sem escolaridade e com renda familiar de até um salário mínimo. A média de idade foi de 65 anos. Constatou-se satisfatória confiabilidade do Índice de Brathel, com Alfa de Cronbach total = 0,917. As atividades nas quais se verificou maior dificuldade de realização foram micção (73,8%) e evacuar (66,9%). Com relação à capacidade funcional para as atividades de vida diária, verificou-se grau de capacidade variando de moderado para total dependência, independente e grau de leve dependência. Verificou-se associação entre a capacidade funcional e a raça (p= 0,027), faixa etária (p= 0,001) e escolaridade (p= 0,041). Constatou-se que os fatores sociodemográficos podem interferir na capacidade funcional de idosos com plegias por acidente vascular encefálico. Nesse sentido, por meio da disponibilização dos resultados da pesquisa, acredita- se ter contribuído para a reflexão sobre essa problemática, bem como proporcionado reprodutibilidade por outros estudos dos métodos utilizados.
44
Berglund, Lars. "Measurement Variability Related to Insulin Secretion and Sensitivity : Assessment and Implications in Epidemiological Studies." Doctoral thesis, Uppsala : Acta Universitatis Upsaliensis : Univ.-bibl. [distributör], 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-99636.
Full text
45
Silva, Valquíria Carvalho. "Capacidade funcional do idoso hospitalizado: subsídios para elaboração de um protocolo de enfermagem." Universidade Federal Fluminense, 2016. https://app.uff.br/riuff/handle/1/3166.
Full textAbstract:
Submitted by Fabiana Gonçalves Pinto (benf@ndc.uff.br) on 2017-03-28T17:09:53Z
No. of bitstreams: 1
Valquiria Carvalho Silva.pdf: 2683284 bytes, checksum: 233161e1b67516605f7cbfa420767f11 (MD5)Made available in DSpace on 2017-03-28T17:09:53Z (GMT). No. of bitstreams: 1 Valquiria Carvalho Silva.pdf: 2683284 bytes, checksum: 233161e1b67516605f7cbfa420767f11 (MD5) Previous issue date: 2016
Mestrado Profissional em Enfermagem Assistencial
Introdução: O número elevado de admissões hospitalares de idosos representa um indicador significativo para avaliação das condições de saúde dessa clientela. A admissão hospitalar pode ser um indicativo de fragilidade relacionada à perda de capacidade funcional, interferindo na qualidade de vida e aumentando os custos com tratamento. Durante a hospitalização cabe a Enfermagem avaliar continuamente esse idoso, identificando elementos que possam subsidiar o planejamento e implementação dos cuidados de enfermagem visando proporcionar uma assistência integral e segura, considerando as alterações inerentes ao processo de envelhecimento articuladas às decorrentes do adoecimento que repercutem diretamente na autonomia, independência e capacidade funcional dessa clientela. Objeto de estudo: Capacidade Funcional do idoso durante o processo de hospitalização. Hipótese investigativa: A capacidade funcional do idoso tende a sofrer declínio durante o processo de hospitalização. Objetivo geral: Elaborar um Protocolo de Enfermagem com foco na Capacidade Funcional do Idoso Hospitalizado; Objetivos específicos: Caracterizar o perfil socioeconômico e de saúde de idosos hospitalizados; Avaliar de modo sequencial a capacidade funcional do idoso, durante a hospitalização. Método: Estudo longitudinal, com abordagem quantitativa, envolvendo acompanhamento da capacidade funcional do idoso hospitalizado. Participaram 37 idosos, de ambos os sexos, internados nas enfermarias de clínica médica masculina e feminina de um Hospital Geral no município de Campos dos Goytacazes- RJ e de um Hospital Universitário no município de Niterói-RJ. A produção de dados ocorreu de maio à setembro de 2016, mediante análise documental inicial dos prontuários dos idosos hospitalizados, para caracterização do perfil socioeconômico e de saúde; aplicação das escalas de avaliação funcional: Escala de Katz, Escala de Lawton & Brody e Mini-Cog, para acompanhar a capacidade funcional dos idosos durante a hospitalização, semanalmente; elaboração de um protocolo de enfermagem com foco na capacidade funcional do idoso hospitalizado. Os dados foram submetidos à análise estatística descritiva e inferencial; a análise do tempo de sobrevivência até o declínio funcional foi feita pela metodologia de Kaplan-Meier; a associação entre as variáveis e o risco de declínio da capacidade funcional no tempo de internação foi investigada por Modelos de Riscos Proporcionais de Cox. Resultados: Houve maior proporção do sexo masculino, baixa escolaridade e baixa renda; A faixa etária predominante foi de 65 à 67,5 anos com período de internação de 10 à 15 dias. O principal diagnóstico medico foi doença cardiovascular e a comorbidade mais frequente hipertensão arterial sistêmica. Constatou-se maior incidência de declínio no rastreio cognitivo, seguido das Atividades Instrumentais de Vida Diária e, por último, das Atividades Básicas de Vida Diária. A incidência de quedas foi diretamente proporcional à de declínio funcional. O tempo até a ocorrência do declínio das pontuações nas escalas foi de 14 dias ou mais para homens e 21 dias ou mais para mulheres. Foram considerados alguns fatores de risco aumentado para declínio nas pontuações das escalas, dentre eles a hipertensão arterial sistêmica, acidente vascular cerebral e número de internações. O protocolo elaborado espera fornecer subsídios para sistematizar a avaliação funcional do idoso durante a hospitalização e direcionar planejamento dos cuidados de enfermagem. Conclusão: A capacidade funcional do idoso tende a sofrer declínio durante o processo de hospitalização.Cabe ao enfermeiro avaliar a capacidade funcional dessa clientela modo a implementar cuidados adequados às demandas desse grupo, evitando comprometimento funcional e dependência. Identificou-se a necessidade de um espaço destinado à assistência da população idosa. O planejamento de alta e o monitoramento dos idosos após a alta hospitalar foi sugerido. Espera-se contribuir para reduzir possíveis riscos da hospitalização de idosos, com foco na capacidade funcional, e para melhorar a qualidade da assistência de enfermagem, centrada nas especificidades do idoso. A utilização do protocolo elaborado pode implicar na redução do tempo de permanência hospitalar dos idosos, redução dos custos gerados por este evento e no aumento da qualidade dos serviços prestados pela instituição à clientela idosa
Introduction: The high number of hospital admissions for the elderly represents a significant indicator for the evaluation of the health conditions of this clientele. Hospital admission may be indicative of fragility related to loss of functional capacity, interfering with quality of life and increasing treatment costs. During hospitalization it is up to Nursing to continuously evaluate this elderly person, identifying elements that can subsidize the planning and implementation of nursing care, aiming to provide integral and safe care, considering the inherent alterations to the aging process articulated to those resulting from illness that directly affect autonomy, Independence and functional capacity of this clientele. Study object: Functional capacity of the elderly during the hospitalization process. Investigative hypothesis: The functional capacity of the elderly tends to decline during the hospitalization process. General objective: To elaborate a Nursing Protocol focusing on the Functional Capacity of Hospitalized Elderly; Specific objectives: To characterize the socioeconomic and health profile of hospitalized elderly; To evaluate sequentially the functional capacity of the elderly during hospitalization. Method: Longitudinal study, with quantitative approach, involving the monitoring of the functional capacity of the hospitalized elderly. Participants were 37 elderly men and women hospitalized in the male and female medical clinics of a General Hospital in the city of Campos dos Goytacazes, RJ, and a University Hospital in the city of Niterói, RJ. The production of data occurred from May to September 2016, through an initial documentary analysis of the medical records of the hospitalized elderly, to characterize the socioeconomic and health profile; Application of the functional assessment scales: Katz Scale, Lawton & Brody Scale and Mini-Cog, to monitor the functional capacity of the elderly during hospitalization, weekly; Elaboration of a nursing protocol focusing on the functional capacity of hospitalized elderly. Data were submitted to descriptive and inferential statistical analysis; The analysis of survival time to functional decline was done by the Kaplan-Meier methodology; The association between the variables and the risk of functional capacity decline during hospitalization time was investigated by Cox Proportional Risk Models. Results: There was a higher proportion of males, low schooling and low income; The predominant age group was from 65 to 67.5 years with hospitalization period of 10 to 15 days. The main medical diagnosis was cardiovascular disease and the most common comorbid systemic arterial hypertension. There was a higher incidence of decline in cognitive screening, followed by the Instrumental Activities of Daily Living and, finally, the Basic Activities of Daily Living. The incidence of falls was directly proportional to that of functional decline. The time until the occurrence of the decline in the scales was 14 days or more for men and 21 days or more for women. We considered some increased risk factors for a decline in scales scores, including systemic arterial hypertension, stroke and number of hospitalizations. The elaborated protocol hopes to provide subsidies to systematize the functional evaluation of the elderly during the hospitalization and to direct nursing care planning. Conclusion: The functional capacity of the elderly tends to decline during the hospitalization process. It is up to the nurse to evaluate the functional capacity of this clientele so as to implement care appropriate to the demands of this group, avoiding functional compromise and dependence. It was identified the need of a space destined to the assistance of the elderly population. Planning for discharge and monitoring of the elderly after hospital discharge was suggested. It is hoped to contribute to reduce possible risks of hospitalization of the elderly, focusing on functional capacity, and to improve the quality of nursing care, focusing on the specifics of the elderly. The use of the protocol can lead to a reduction in the length of hospital stay of the elderly, a reduction of the costs generated by this event, and an increase in the quality of services provided by the institution to elderly clients
46
Beckman, Gyllenstrand Anna. "Medication management and patient compliance in old age /." Stockholm, 2007. http://diss.kib.ki.se/2007/978-91-7357-166-1/.
Full text
47
Arroyo, Natalia Costa 1985. "Fatores associados ao desempenho funcional autorrelatado : dados do Projeto Fibra - Pólo Unicamp." [s.n.], 2013. http://repositorio.unicamp.br/jspui/handle/REPOSIP/311358.
Full textAbstract:
Orientador: Mônica Sanches YassudaDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
Made available in DSpace on 2018-08-22T00:34:44Z (GMT). No. of bitstreams: 1 Arroyo_NataliaCosta_M.pdf: 1902872 bytes, checksum: 5408a7c634beba4926a09b390cc2314a (MD5) Previous issue date: 2013
Resumo: A funcionalidade é um novo paradigma de saúde entre os idosos. As atividades instrumentais de vida diária (AIVD) representam um importante indicador de saúde, visto que são as primeiras atividades a serem comprometidas na presença de comprometimento cognitivo e são essenciais para a manutenção do idoso no seu contexto social. Assim, este trabalho tem por objetivo identificar dentre as variáveis sociodemográficas, de saúde autorrelatadas e indicadores de fragilidade, quais fatores são independente e conjuntamente associados às dificuldades observadas na realização das AIVD. Trata-se de um estudo de caráter transversal, conduzido com 2282 idosos que participaram da pesquisa "Estudo da fragilidade em idosos brasileiros", desenvolvida pela Rede FIBRA - Fragilidade em idosos brasileiros, pólo UNICAMP. As AIVDs foram avaliadas pela Escala de Lawton e a síndrome da fragilidade foi identificada pelos critérios propostos por Fried et al. (2001). Verificou-se que cerca de 38% da amostra apresentou dependência para pelo menos uma AIVD. Análises de regressão multivariada indicaram que os fatores mais fortemente associados à dificuldade nestas atividades foram ser frágil ou pré frágil, ter 80 anos ou mais, ter renda familiar de 0 a 3 salários mínimos e apresentar sintomas depressivos. Conclui-se que a melhora das condições de saúde dos idosos brasileiros está intimamente relacionada à melhora das condições socioeconômicas, à diminuição das condições associadas à fragilidade e à melhora em saúde mental. O desenvolvimento de medidas preventivas à síndrome da fragilidade e de programas terapêuticos para a prevenção de sintomatologia depressiva faz parte da atenção integral à pessoa idosa
Abstract: Functionality is a new health paradigm among the elderly. Instrumental activities of daily living (IADL) are an important indicator of health, as they are the first activities to be impaired in the presence of cognitive impairment and they are essential for the maintenance of the elderly in their social context. Thus, this study aimed to identify among sociodemographic variables, self-reported health indicators and markers of frailty, which factors are independently and jointly associated with perceived difficulties in performing IADL. This was a cross sectional study, conducted with 2282 seniors who participated in the study "Study of frailty among elderly Brazilians," developed by the FIBRA network, at UNICAMP. IADLs were assessed by the Lawton scale and the frailty syndrome was identified by the criteria proposed by Fried et al. (2001). Multivariate regression analyzes indicated that about 38% of participants showed limitations in at least one IADL. The factors most strongly associated with difficulty in these activities were being frail or pre frail, being 80 years or older, having a family income of 0 to 3 minimum wages and depressive symptoms. We concluded that the improvement of the health conditions of older Brazilians is closely related to the improvement of socioeconomic conditions, the reduction of conditions associated with frailty and improvement in the mental health of seniors. The development of preventive measures for the frailty syndrome and therapeutic programs for the prevention of depressive symptoms should be part of the comprehensive care of the elderly
Mestrado
Gerontologia
Mestra em Gerontologia
48
Hentschel, Leopold, Anke Rentsch, Felicitas Lenz, Beate Hornemann, Jochen Schmitt, Michael Baumann, Gerhard Ehninger, and Markus Schuler. "A Questionnaire Study to Assess the Value of the Vulnerable Elders Survey, G8, and Predictors of Toxicity as Screening Tools for Frailty and Toxicity in Geriatric Cancer Patients." Karger, 2016. https://tud.qucosa.de/id/qucosa%3A70600.
Full textAbstract:
Background: The aim of this study was to identify an appropriate screening instrument for the identification of frail elderly patients in a tertiary cancer center. In order to improve cancer care for older patients, the use of a geriatric assessment (GA) has been proposed to identify frail patients or those who are at a higher risk for chemotherapy-related toxicities. In busy clinical routine, an appropriate screening instrument could be used to spare time- and resource-consuming application of GA. Patients and Methods: We administered the Vulnerable Elders Survey (VES-13), G8 questionnaire, and Predictors of Toxicity (POT) as well as a GA at the first visit of 84 consecutive patients at a single Comprehensive Cancer Center. Analysis for patients’ characteristics as well as sensitivity, specificity, and positive and negative predictive value (npv) was conducted. Results: The median age of the patients was 73 years (range 63–93 years), 61.9% were male, most (63%) suffered from gastrointestinal tumors, 39.3% had a multiple cancer diagnosis, and 53.6% had metastasis. 30 (35.7%) individuals were classified as ‘frail’ by the GA. Sensitivity of G8 was 38.3%, and the npv was 63.8%. Sensitivity for VES-13 was 57.1%, and npv was 76.3%. Sensitivity of POT was 72.7%, and the npv was 80.6%. Conclusion: For the first time, the VES13, G8, and POT are compared in a sample of older German patients. The POT seems to be a sufficient screening tool to identify frail patients in a tertiary referral cancer center and helps to save time and resources compared with a complete GA.
49
Martinez, Claudia Tapia. "Évaluation de la fragilité en oncologie gériatrique : développement et validation d’une nouvelle échelle de dépistage." Thesis, Université Paris-Saclay (ComUE), 2017. http://www.theses.fr/2017SACLS368/document.
Full textAbstract:
Titre : EVALUATION DE LA FRAGILITE EN ONCOLOGIE GERIATRIQUE : DEVELOPPEMENT ET VALIDATION D’UNE NOUVELLE ECHELLE DE DEPISTAGE.Mots clés : fragilité, sujet âgée, cancer, dépistage, développement, validation, analyse de survie.Résumé : Une évaluation gériatrique (EG) est recommandée pour tous les patients âgés atteints de cancer pour identifier d’éventuels problèmes de santé et ainsi optimiser la stratégie thérapeutique. Néanmoins, elle est très consommatrice de temps et de moyens. Plusieurs outils de dépistage ont été développés mais a) aucun ne dispose de propriétés diagnostiques adéquates en pratique clinique, b) ils ont le plus souvent été développés sur la base d’opinions d’experts sans développement statistique spécifique, et c) peu de données sont disponibles pour apprécier leur robustesse au changement de gold standard pour définir le concept de « fragilité ». Par conséquent, notre objectif était 1) de construire et valider un outil de dépistage performant de la fragilité et de le comparer à l’outil de dépistage G8 actuellement utilisé en oncogériatrie, 2) d’en tester la robustesse vis-à-vis de 6 définitions de référence de la fragilité et 3) d’en évaluer la valeur pronostique pour la mortalité à 1 et 3 ans. Les données étaient issues de deux cohortes prospectives de patients âgés atteints de cancer : ELCAPA (2007–2012: n=729 [développement]), et ONCODAGE (2008–2010: n=1304 [validation externe]). L’outil G8 modifié final (aire sous la courbe ROC [AUROC] : 91,6% ; Sensibilité=89% ; Spécificité=79%) comprenait 6 items indépendants : perte de poids, problèmes neuropsychologiques, statut fonctionnel, état de santé perçu, poly-prescription et existence parmi les antécédents d’une insuffisance cardiaque ou coronaropathie. Les travaux accomplis dans le cadre de cette thèse ont de plus permis de confirmer ses bonnes propriétés diagnostiques en validation externe (AUROC : 84,6% ; Sensibilité=82% ; Spécificité=69%), sa robustesse au changement de gold standard et sa valeur pronostique forte vis-à-vis de la mortalité. L’utilisation du G8 et G8 modifié devrait être encouragée en oncologie gériatriqueTitle : ASSESSMENT OF FRAILTY IN GERIATRIC ONCOLOGY: DEVELOPMENT AND VALIDATION OF A NEW SCREENING TOOL Key words: frailty, older person, cancer, screening, development, validation, survival analysis.Abstract: The comprehensive geriatric assessment (GA) is recommended in older cancer patients to inventory health problems and tailor treatment decisions accordingly. However, GA is time- and resource-consuming. Several screening tools have been developed but a) their diagnostic performance is insufficient, b) most instruments have been developed exclusively on the basis of experts’ opinions without any specific statistical psychometric development, and c) a wide variability of criteria have been used to define “frailty” as the gold standard, with no investigations of their influence on the diagnostic properties of screening instruments. Therefore, our objective was 1) to develop and validate a new screening tool for frailty that achieves high diagnostic accuracy, and to compare it to the G8 screening tool, currently used in oncogeriatrics, 2) to evaluate its robustness to modifications on the gold standard, for which 6 reference definitions were tested, and 3) to assess its prognostic value for 1- and 3-years mortality. We used two prospective cohorts of older patients with cancer: ELCAPA (2007–2012: n=729 [development]), and ONCODAGE (2008–2010: n=1304 [external validation]). The final modified-G8 (area under the ROC curve [AUROC]: 91.6%; Sensitivity=89%; Specificity=79%) included 6 independent items: weight loss, cognition/mood, performance status, self-rated health status, polypharmacy and history of heart failure or coronary heart disease. The work carried out in this thesis has also confirmed its good diagnostic properties in external validation analyses (AUROC: 84.6%; Sensitivity=82%; Specificity=69%), its robustness to modifications of the gold standard definition and its strong prognostic value for overall survival. The use of the G8 and modified-G8 should be encouraged in geriatric oncology
50
Heideken, Wågert Petra von. "Health, physical ability, falls and morale in very old people : the Umeå 85+ study /." Umeå : Umeå universitet, 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-871.
Full text