ABSTRACT
Objective To establish a scientific and feasible evaluation index system of the quality of health education among the elderly in the community.Methods Based on the results of literature review,theory analysis,cross-sectional study and interviews,a draft evaluation index system was formulated.Then Delphi method was conducted on 28 specialists around the country,the weight of each index was determined by hierarchy analysis.Results After three rounds of Delphi procedure,the response rates of the three round consultation were all above 85％,and the authority coefficient and coordination coefficients was 0.858,0.210,respectively.An evaluation index system which covered three first-level items,7 second-level items and 35 third-level items was formulated.Conclusions Based on survey of the elderly and interviews of health education staffs in the community,and using the method of Delphi to collect experts' suggestion,a strong maneuverability and high reliability quality evaluation index system was formulated,which provided guidance for community health education of the elderly,and promoted its development towards scientization and standardization.
ABSTRACT
La Atención Primaria de Salud ocupa un lugar esencial en las Ciencias Médicas en Cuba. Una de las temáticas de mayor discusión en ésta estrategia lo constituye la relación entre las dimensiones del enfoque salubrista y el cuidado del adulto mayor hipertenso en la comunidad. Abordar este fenómeno desde la perspectiva de enfermería permite describe la sistemia que se establece entre ellas, utilizando para tal efecto los constructos: origen, estructura y funcionamiento lo que aportó la génesis, el hábitat y la articulación de elementos en la búsqueda de una propuesta atinada al problema de la insuficiencia objeto de descripción. Se concluye que la relación descrita se realiza a partir de una necesidad local concerniente con el insuficiente cuidado del adulto mayor hipertenso en la comunidad. Ésta, se nutre en su estructura del nexo enfermero-paciente-contexto, la cual funciona de forma integrada donde cada componente de este enfoque aporta a la relación el logro del objetivo propuesto(AU)
Primary Health Attention is given a lot of attention in Medical Sciences in Cuba. One of the difficulties discussed when talking about these terms has been the relationship between the dimensions of the salubrista approach and the management of hypertensive elderly in the community. This view deals with the systemic link that is established between them all, using origin, structure and functioning in the form of genesis, habitat and articulation of elements in the finding of a proposal to solve the problem already presented. It is concluded that the connection described is derived from a local need related to the insufficiencies detected in terms of management of the hypertensive elderly from the nursing point of view in the community. It is structured by using the nexus nurse-patient -context which works systemically and where each element helps to fulfil the objective proposed(AU)
Subject(s)
Humans , Aged , Aged, 80 and over , Primary Health Care/methods , Hypertension/etiology , Adult Health , Primary Care Nursing/methodsABSTRACT
<p><b>OBJECTIVES</b>We investigated the association between the fall of nocturnal blood pressure (BP) and cognitive impairment in elderly subjects.</p><p><b>METHODS</b>The study was a cross-sectional survey of 204 elderly subjects who had no cerebrovasucular episodes. Ambulatory BP monitoring and assessments of cognitive functions using the Mini-Mental State Examination (MMSE) were performed at the subjects' homes. We classified, the subjects treated with antihypertensive drugs into three groups: non-dippers (nocturnal fall<10% of the mean day diastolic BP; n=51), normal dippers (10% to less than 20%; n=58), and extreme dippers (20% or more; n=17). The subjects not treated with antihypertensive drugs were also classified as non-dippers (n=40), normal dippers (n=24), and extreme dippers (n=14).</p><p><b>RESULTS</b>The mean age of participants was 75.2±7.2 years, and 126 (61.7%) were being treated with antihypertensive drugs. In the group of antihypertensive drug users, the number with MMSE≤23 was 30 and the adjusted odds ratio for cognitive impairment in those with an extreme dip in diastolic BP (DBP) was 4.18 (95% CI, 1.07-16.40) in reference to the normal dippers. In contrast, no association was observed between cognitive function and nocturnal BP fall in the group no using antihypertensive drugs.</p><p><b>CONCLUSIONS</b>Cognitive impairment was associated with an extreme dip in DBP in the antihypertensive drug users only. It remains to be seen whether careful monitoring of nighttime BP as well as daytime BP may reduce the risk of cognitive impairment in antihypertensive drug users.</p>
ABSTRACT
Objectives: We investigated the association between the fall of nocturnal blood pressure (BP) and cognitive impairment in elderly subjects. Methods: The study was a cross-sectional survey of 204 elderly subjects who had no cerebrovasucular episodes. Ambulatory BP monitoring and assessments of cognitive functions using the Mini-Mental State Examination (MMSE) were performed at the subjects' homes. We classified the subjects treated with antihypertensive drugs into three groups: non-dippers (nocturnal fall <10% of the mean day diastolic BP; n=51), normal dippers (10% to less than 20%; n=58), and extreme dippers (20% or more; n=17). The subjects not treated with antihypertensive drugs were also classified as non-dippers (n=40), normal dippers (n=24), and extreme dippers (n=14). Results: The mean age of participants was 75.2±7.2 years, and 126 (61.7%) were being treated with antihypertensive drugs. In the group of antihypertensive drug users, the number with MMSE£23 was 30 and the adjusted odds ratio for cognitive impairment in those with an extreme dip in diastolic BP (DBP) was 4.18 (95% CI, 1.07−16.40) in reference to the normal dippers. In contrast, no association was observed between cognitive function and nocturnal BP fall in the group no using antihypertensive drugs. Conclusions: Cognitive impairment was associated with an extreme dip in DBP in the antihypertensive drug users only. It remains to be seen whether careful monitoring of nighttime BP as well as daytime BP may reduce the risk of cognitive impairment in antihypertensive drug users.