ABSTRACT
Objective：This study aimed to analyze the relationship between improvement in activities of daily living (ADL) and discharge to home among older stroke patients in a convalescent rehabilitation ward.Methods：The medical records of 291 stroke patients discharged from a convalescent rehabilitation ward were used to determine the association between the magnitude of ADL improvement and discharge disposition across two age groups (65-74 years and ≥ 75 years). The motor functional independence measure (FIM) motor score (FIM-M) was used to quantify ADL improvement.Results：Among the 291 patients, 213 (73.2％) were discharged home and 78 (26.8％) were institutionalized. In multivariate logistic regression analysis adjusted by functional evaluation at the time of admission, the magnitude of ADL improvement during hospitalization was significantly associated with discharge to home in each group (p＜0.01). The magnitude of ADL improvement was not associated with discharge disposition in analysis adjusted by functional evaluation at the time of discharge. But, FIM-M at discharge was significantly associated with discharge to home for individuals aged 65-74 years, and FIM cognitive score (FIM-C) at discharge was significantly associated with discharge home for individuals aged ≥ 75 years.Conclusion：Intensive rehabilitation during hospitalization in patients aged both 65-74 years and ≥ 75 years has been suggested to facilitate discharge to home. Patients aged 65-74 with low FIM-M at discharge and those aged ≥ 75 years with low FIM-C at discharge may require more effective intervention in addition to improving the ADL in order to be discharged home.
ABSTRACT
Objective：This study aimed to analyze the relationship between improvement in activities of daily living (ADL) and discharge to home among older stroke patients in a convalescent rehabilitation ward.Methods：The medical records of 291 stroke patients discharged from a convalescent rehabilitation ward were used to determine the association between the magnitude of ADL improvement and discharge disposition across two age groups (65-74 years and 75 years). The motor functional independence measure (FIM) motor score (FIM-M) was used to quantify ADL improvement.Results：Among the 291 patients, 213 (73.2％) were discharged home and 78 (26.8％) were institutionalized. In multivariate logistic regression analysis adjusted by functional evaluation at the time of admission, the magnitude of ADL improvement during hospitalization was significantly associated with discharge to home in each group (p＜0.01). The magnitude of ADL improvement was not associated with discharge disposition in analysis adjusted by functional evaluation at the time of discharge. But, FIM-M at discharge was significantly associated with discharge to home for individuals aged 65-74 years, and FIM cognitive score (FIM-C) at discharge was significantly associated with discharge home for individuals aged ≥ 75 years.Conclusion：Intensive rehabilitation during hospitalization in patients aged both 65-74 years and ≥ 75 years has been suggested to facilitate discharge to home. Patients aged 65-74 with low FIM-M at discharge and those aged ≥ 75 years with low FIM-C at discharge may require more effective intervention in addition to improving the ADL in order to be discharged home.
ABSTRACT
Introducción. Con frecuencia las personas con enfermedades crónicas requieren un cuidado especial en su hogar, siendo en este contexto fundamental la competencia de cuidado. Objetivo. Identificar las características y asociaciones del cuidado informal y de la competencia para cuidar de la díada cuidador-persona con enfermedad crónica, durante el alta hospitalaria en un hospital de alta complejidad de Bogotá 2016. Metodología. Estudio cuantitativodescriptivo, transversal-analítico; en la medición se usó la encuesta de caracterización de la díada: cuidador-persona con enfermedad crónica, y el instrumento de competencia de cuidado en el hogar, versión abreviada CUIDAR. Resultados. Participaron 97 díadas. Los cuidadores eran, en su mayoría, mujeres (79,4%) con edad promedio de 43,7 (±15,5) años, con una trayectoria como cuidadores en promedio de 4,3 años. Las personas con enfermedad crónica eran mayormente mujeres (67,0%), con edad promedio de 64,3 años, y con antecedentes patológicos de diabetes mellitus (55,7%) e hipertensión arterial (48,5%). Cuidadores perciben sentir carga (61,9%) y pacientes ser una carga (57,7%); las díadas perciben mínima satisfacción con el apoyo recibido y están más familiarizadas con el uso del teléfono y televisión. La competencia para cuidar fue valorada como alta por el cuidador (44,8 puntos promedio). Dimensiones de la competencia de cuidado se asociaron (p<0,05) con escolaridad, compromiso religioso, carga percibida, edad del paciente, entre otros aspectos. Conclusiones. Las díadas de cuidado cuentan con características relacionadas con el nivel de competencia para el cuidado, estas son de importancia en la estructuración de intervenciones para mejorar el bienestar de los cuidadores.
Introduction. People with chronic diseases often require special care in their home, being in this fun- damental context the competence of care. Objective. Identify the characteristics and associations of informal care and competition to take care of the "Caregiver-Person" dyads with chronic illness during hospital discharge in a high complexity hospital in Bogotá - 2016. Methodology. Quantitative - descriptive, analytical cross-sectional study, using the "Characterization survey of the Caregiver-Person dyad with chronic disease" and the instrument of "Home care compe- tence - abbreviated version CUIDAR-" Results. 97 days participated. Caregivers were mostly women (79,4%) with an average age of 43,7 years old and have been caregivers in average 4,3 years. The people with chronic disease were mostly women (67,0%) with an average age of 64,3 years old and with a pathological history of diabetes mellitus (55,7%) and high blood pressure (48,5%). Caregivers perceive feeling a burden (61,9%) and patients being a burden (57,7%), dyads perceive minimal satisfaction with the support received, and they are more familiar with the use of phone and television. The competence to care was rated as high by the caregiver (44,8 points average). Dimensions of care competence were associated (p <0,05) with schooling, religious commitment, perceived burden, patient age, among other aspects. Conclusions. Caregiver-Person dyads have characteristics related to the level of competence for care, these are being of importance in structuring interventions to improve the well-being of caregivers.
Introdução. As pessoas com doenças crônicas frequentemente necessitam de cuidados especiais em seu domicílio, sendo neste contexto fundamental a competência de cuidar. Objetivo. Identificar as características e associações de atenção informal e competição para cuidar das díades "Cuidador-Pessoa" com doença crônica durante a alta hospitalar em um hospital de alta complexidade em Bogotá - 2016. Metodologia. Estudo quantitativo - descritivo, analítico, transversal, utilizando o "Levantamento de caracterização da díade Cuidador-Pessoa com doença crônica" e o instrumento "Competência em assistência domiciliar - versão abreviada CUIDAR-" Resultados. 97 dias participaram. Os cuidadores eram em sua maioria mulheres (79,4%), com idade média de 43,7 anos e cuidadores em média 4,3 anos. As pessoas com doença crônica eram majorita- riamente mulheres (67,0%), com idade média de 64,3 anos e história patológica de diabetes mellitus (55,7%) e hipertensão arterial (48,5%). Os cuidadores percebem sentir um fardo (61,9%) e os pacien- tes um fardo (57,7%), as díades percebem uma satisfação mínima com o apoio recebido e estão mais familiarizados com o uso de telefone e televisão. A competência para cuidar foi classificada como alta pelo cuidador (44,8 pontos em média). As dimensões da competência assistencial foram associadas (p <0,05) à escolaridade, comprometimento religioso, carga percebida, idade do paciente, entre outros aspectos. Conclusões. os dias de atendimento têm características relacionadas ao nível de competência para o cuidado, sendo de importância na estruturação de intervenções para melhorar o bem-estar dos cuidadores.