Aplicativo multimídia para cuidados domiciliares de pacientes pós-cirúrgicos: protótipo de tecnologia cuidativo-educacional* / Aplicación multimedia para el cuidado domiciliario de pacientes posquirúrgicos: prototipo de tecnología asistencial-educativa / Multimedia application for home care of post-surgery patients: care-educational technology prototype*

Objetivo: desenvolver um protótipo de Tecnologia Cuidativo-Educacional em forma de aplicativo multimídia, voltado aos cuidados domiciliares de pacientes pós-cirúrgicos com dispositivos invasivos. Método: pesquisa metodológica, desenvolvida entre março de 2021 e abril de 2022, norteada pelo modelo ADDIE (Analize, Design, Develop, Implement e Evaluate). Realizou-se a prototipagem com auxílio do software Adobe Experience Design, sendo aplicados plugins para a animação dos ícones e a inclusão dos vídeos educacionais. Resultados: o protótipo "Home Self-Care" contém logomarca, menu principal com descrição dos dispositivos invasivos, informações sobre o procedimento, cuidados e dúvidas frequentes dos pacientes, bem como imagens e vídeos educacionais para conduzir a construção do conhecimento. Ressalta-se que futuramente o aplicativo será hospedado em loja virtual. Conclusão: o uso desta ferramenta visa a continuidade do cuidado, estimulando a autonomia e empoderamento dos usuários em domicílio. Acredita-se que a tecnologia facilitará a recuperação do paciente e reduzirá as (re)internações.

Objective: to develop a care-educational technology prototype, in the form of a multimedia application, aimed at home care of post-surgical patients with invasive devices. Method: this is methodological research, developed between March 2021 and April 2022, guided by the ADDIE model (Analyze, Design, Develop, Implement and Evaluate). Prototyping was carried out with the help of Adobe Experience Design software, applying plugins for icon animation and inclusion of educational videos. Results: the "Home Self-Care" prototype contains a logo, main menu with description of invasive devices, information about the procedure, care and frequently asked questions by patients as well as images and educational videos to guide the construction of knowledge. It should be noted that in the future the application will be hosted in a virtual store. Conclusion: using this tool aims at continuity of care, encouraging users' autonomy and empowerment at home. It is believed that the technology will facilitate patient recovery and reduce (re)admissions.

Objetivo: desarrollar un prototipo de tecnología asistencial-educativa en forma de aplicación multimedia, dirigida a la atención domiciliaria de pacientes posquirúrgicos con dispositivos invasivos. Método: investigación metodológica, desarrollada entre marzo de 2021 y abril de 2022, guiada por el modelo ADDIE (Analyze, Design, Develop, Implement y Evaluate). El prototipado se realizó con la ayuda del software Adobe Experience Design, aplicando plugins para la animación de íconos y la inclusión de videos educativos. Resultados: el prototipo "Home Self-Care" contiene un logo, un menú principal con descripción de los dispositivos invasivos, información sobre el procedimiento, cuidados y preguntas frecuentes de los pacientes, además de imágenes y videos educativos para orientar la construcción del conocimiento. Cabe señalar que en el futuro la aplicación estará alojada en una tienda virtual. Conclusión: el uso de esta herramienta tiene como objetivo la continuidad de la atención, estimulando la autonomía y el empoderamiento de los usuarios en el hogar. Se cree que la tecnología facilitará la recuperación del paciente y reducirá las (re)hospitalizaciones.

Long-term care facilities for older people and the COVID-19 pandemic: epidemiological data and preventive measures / Instituições de longa permanência para idosos e a pandemia de COVID-19: dados epidemiológicos e medidas preventiva

Objectives: The COVID-19 pandemic has challenged society, especially residents of long-term care facilities (LTCF). This study investigated rates of infection, hospitalization, and death due to COVID-19 among LTCF residents and staff in Minas Gerais, Brazil and identified strategies to control the spread of the disease.Methods: This cross-sectional study collected data from 164 LTCF (6017 older adults). The owners or managers were invited to answer an electronic questionnaire. The questionnaire included 55 items, divided into 3 sections.Results: Of the participating LTCF, 48.7%, 39.6%, and 32.3% reported COVID-19 infections, hospitalizations, and deaths, respectively, among residents, while 68.9%, 7.3%, and 1.2% reported COVID-19 infections, hospitalizations, and deaths, respectively, among staff. Preventive measures were identified and classified as organizational, infrastructural, hygiene items/personal protective equipment, and staff training.Conclusion: The strategies used in the daily routines of LTCF during the pandemic were classified. The challenges experienced in Brazilian facilities were similar to those observed worldwide. The results highlight the importance of continuity and the need to improve protective measures for LTCF residents, especially in low- and middle-income countries

Objetivos: A pandemia da COVID-19 tem sido desafiadora para a sociedade, principalmente para aqueles que residem em Instituições de Longa Permanência (ILPI). Este estudo teve como objetivo descrever as taxas de infecção, hospitalização e óbito por COVID-19 entre idosos e funcionários de ILPI de Minas Gerais/Brasil e identificar estratégias de prevenção e controle da disseminação da doença.Metodologia: Este estudo transversal foi realizado com 164 ILPI (6.017 idosos). Os gestores ou proprietários foram convidados a responder ao questionário eletrônico. O questionário incluiu 55 itens, divididos em três seções.Resultados: Entre as ILPI estudadas, 48,7% confirmaram a infecção por COVID-19 em idosos, resultando em 39,6% de internação e 32,3% de óbito entre os infectados. Além disso, 68,9% das ILPI confirmaram infecção por COVID-19 na equipe, com 7,3% de internação e 1,2% de óbito. As medidas preventivas foram identificadas e classificadas como organizacionais, infraestrutura, itens de higiene e equipamentos de proteção individual e treinamento de pessoal contra a COVID-19.Conclusão: Essas medidas revelaram estratégias e barreiras vivenciadas no cotidiano das ILPI durante a pandemia. As ILPI no Brasil passaram por desafios semelhantes aos observados mundialmente. Os resultados destacaram a importância da continuidade e melhoria das medidas de proteção para idosos em ILPI, especialmente em países de baixa e média renda

Asociación entre la condición oral y sistémica con la calidad de vida en salud bucal de adultos mayores institucionalizados en Recoleta. Estudio piloto

Objetivo: Evaluar la asociación entre la condición oral y sistémica con la calidad de vida relacionada a salud bucal de adultos mayores institucionalizados en un hogar en Recoleta, Santiago. Material y método: En el presente estudio piloto de corte transversal, se realizó un examen intraoral y se aplicó la encuesta OHIP-7Sp a adultos mayores internados en la residencia Mi Hogar. Además, se revisaron las fichas médicas de los participantes para el registro de sus enfermedades y fármacos. Los datos fueron analizados a través del test t, test de Mann-Whitney y regresión logística considerando un valor p < a 0.05 como estadísticamente significativo. Resultados: 20 adultos mayores cumplieron los criterios de inclusión, 11 hombres y 9 mujeres, con un rango de edad entre 65 y 88 años. Se encontró asociación clínica entre la condición oral (p=0.06), salud general (p=0.2) y calidad de vida asociada a salud bucal en los adultos mayores. Conclusión: La condición oral, salud general y calidad de vida asociada a salud bucal de los adultos mayores se consideró deficiente. Se requieren estudios posteriores con una mayor muestra para lograr establecer una significancia estadística de las variables y así, proponer intervenciones para mejorar las condiciones de salud de los adultos mayores institucionalizados.

Aim: To evaluate the association between the oral and systemic condition and the oral health-related quality of life of institutionalized older people in a retirement home in Recoleta, Santiago. Material and method: In the present pilot, non-experimental, cross-sectional and descriptive study, an oral examination was performed, alongside with the OHIP-7Sp survey to the individuals that meets the inclusion criteria. In addition, the medical history of the participants was reviewed to record the diseases under treatment and the drugs in use. Results: 20 individuals met the inclusion criteria, 11 men and 9 women with ages ranging between 65 and 88 years. There was a clinical association between oral condition, general health and oral health-related quality of life related to oral health in the oelder people of thefrom the residence retirement home of in Recoleta. A statistical significance was not established. Conclusion: The oral condition, general health and quality of life related to oral health was were deficient. Subsequent studies with a larger sample are required to establish a statistically significant relationship of between the variables in order to propose different solutions.

Função e atuação do serviço de atendimento domiciliar na perspectiva de profissionais da Atenção Primária à Saúde / Function and performance of the Home care service from the perspective of Primary Health Care professionals / Función y desempeño del Servicio de atención domiciliaria desde la perspectiva de los profesionales de Atención Primaria de Salud

Introdução: O Serviço de Atenção Domiciliar (SAD) é um serviço complementar aos cuidados realizados na atenção básica e urgência e visa fortalecer a integralidade da atenção à saúde, pois assume papel importante na formação de novas estratégias de cuidado na modalidade de atenção complementar e substitutiva. Objetivo: Caracterizar a função e atuação do SAD na perspectiva dos profissionais da Atenção Primária à Saúde (APS) em um município do extremo sul catarinense. Método: Trata-se de uma pesquisa de abordagem qualitativa, do tipo descritivo-exploratório, realizada com 14 profissionais que atuaram antes da implantação do SAD e continuam trabalhando em equipes de Saúde da Família do município de Araranguá/SC. O processo de análise ocorreu pela técnica de análise de conteúdo, com auxílio do software para análise de dados qualitativos Atlas.ti. Resultados: A atuação do SAD restringe-se à prestação do cuidado no domicílio; à realização de trabalho multiprofissional; a pacientes acamados como foco da assistência; à equipe de referência para prestação do cuidado. Com relação à função do SAD, ela associa-se ao apoio às equipes de Saúde da Família; ao auxílio para a efetivação da integralidade do cuidado; ao incentivo à desospitalização; à melhoria na qualidade de vida; e à ampliação do acesso ao serviço de saúde. Conclusão: A atuação do SAD representa um serviço mais próximo da população acamada e é realizado por equipe de referência multiprofissional. Sua função vincula-se à melhoria da assistência e à ampliação da garantia do direito à saúde.

Introduction: The Home Care Service (HCS) is a complementary service to the care provided in basic and basic care and aims to intensify the integrality of training, as it plays an important role in the prevention of new care in the form of complementary and substitutive care. Objective: To identify how the HCS work process occurs from the perspective of primary health care professionals in a municipality in the extreme south of Santa Catarina. Methods: This is a qualitative research, of the descriptive-exploratory type, carried out with 14 professionals who work before the implementation of HCS and continue to work in Family Health teams in the municipality. The analysis process emerged through the content analysis technique, with the help of Atlas.ti qualitative data analysis software. Results: HCS's role is restricted to providing care at home; carrying out multi-professional work; bedridden patients as the focus of care; reference team to provide care. In relation to the role of the HCS, the Family Health teams are associated with support; in helping to carry out comprehensive care; encouraging no hospitalization; improvement in quality of life; and access to health services. Conclusions: HCS's performance represents a service closer to the bedridden population, performed by a multiprofessional reference team. And its function linked the improvement of care and guarantee of the right to health.

Introducción: El Servicio de Atención Domiciliaria (SAC) es un servicio complementario a la atención prestada en la atención básica y básica y tiene como objetivo intensificar la integralidad de la formación, ya que juega un papel importante en la prevención de nuevos cuidados en forma de complementos y sustitutivos. cuidado. Objetivo: Analizar cómo ocurre el proceso de trabajo del SAC en la perspectiva de los profesionales de la atención primaria de salud en un municipio del extremo sur de Santa Catarina. Métodos: Se trata de una investigación cualitativa, de tipo descriptiva-exploratoria, realizada con 14 profesionales que actúan antes de la implantación del SAC y continúan actuando en los equipos de Salud de la Familia del municipio. El proceso de análisis surgió a través de la técnica de análisis de contenido, con la ayuda del software de análisis de datos cualitativos Atlas.ti. Resultados: El papel de SAC se restringe a brindar atención en el hogar; realización de trabajos multiprofesionales; pacientes encamados como foco de atención; equipo de referencia para brindar atención. En relación al papel de la SAC, los equipos de Salud de la Familia están asociados al apoyo; en ayudar a llevar a cabo una atención integral; alentar la no hospitalización; mejora en la calidad de vida; y el acceso a los servicios de salud. Conclusiones: La actuación de SAC representa un servicio más cercano a la población encamada, realizado por un equipo de referencia multiprofesional. Y su función vinculada a la mejora de la atención y garantía del derecho a la salud.

Poor physical fitness is associated with impaired memory, executive function, and depression in institutionalized older adults: a cross-sectional study

Objective: To analyze the association between physical fitness, cognitive function, and depressive symptoms among older adults in long-term care facilities (LTCFs). Methods: Seventy-six institutionalized male and female elderly individuals (65 years and older) living in LTCFs participated of this study. Physical fitness (aerobic capacity and strength), cognitive functions (global cognition, short-term and working and semantic memories, and executive function), and depressive symptoms were assessed. Linear regression and contingency analyses were performed. Significance was accepted at p-values ≤ 0.05. Results: Aerobic capacity predicted 32% of variance in global cognition (p < 0.01) and 25% of variance in semantic fluency/executive function (p < 0.01). Low levels of upper limb strength, lower limb strength, and aerobic capacity were associated with semantic fluency/executive function (OR = 1.38, p = 0.01, OR = 1.26, p = 0.03, and OR = 1.07, p = 0.01, respectively) and depressive symptoms (OR = 1.06, p < 0.01). Conclusion: Poor physical fitness is associated with cognition and depressive symptoms in institutionalized older adults. Low levels of strength and aerobic fitness increase the odds of presenting with impaired semantic fluency and executive function, possibly denoting an increased risk of developing dementia.

Resistência microbiana a medicamentos em uma Instituição de Longa Permanência para Idosos / Resistencia microbiana a medicamentos en una institución de larga estadía para adultos mayores / Microbial drug resistance in a Nursing Home

Resumo Objetivo Caracterizar os microrganismos e sua suscetibilidade antimicrobiana em uroculturas de idosos residentes de uma instituição de longa permanência. Métodos Estudo observacional transversal com 116 indivíduos de uma Instituição de Longa Permanência para Idosos de um município do sul da Bahia. O estudo foi aprovado por Comitê de Ética em Pesquisa e utilizou-se Termo de Consentimento Livre e Esclarecido. Foram realizadas coleta e análise laboratorial de urina tipo I e urocultura. Realizaram-se testes de sensibilidade a antimicrobianos conforme os critérios do European Committee on Antimicrobial Susceptibility Testing. Para o diagnóstico de infecção do trato urinário, foram utilizados os critérios de McGeer. A análise de dados se deu por estatística descritiva, com frequências absolutas e relativas. Resultados A prevalência de infecção do trato urinário foi de 33,62%, com predominância no sexo feminino e idade acima de 80 anos. Os uropatógenos foram: 69,2% Escherichia coli, 20,6% Klebsiella pneumoniae e 5,1% Providencia stuartii e Acinetobacter baumannii. As cepas de E. coli apresentaram suscetibilidade para a maior parte dos antimicrobianos; já nas de K. pneumoniae, a suscetibilidade foi variável. P. stuartii e A. baumannii não apresentaram resistência a carbapenêmicos e aos betalactâmicos aztreonam e piperacilina associados a tazobactam. Conclusão As cepas mais prevalentes e o perfil de suscetibilidade seguiram padrão próximo ao hospitalar, o que implica a necessidade de a instituição promover melhores estratégias de controle de infecção e envolver a equipe de enfermagem no gerenciamento dos casos e na qualificação da prescrição antimicrobiana, para reduzir a resistência bacteriana e efeitos adversos nos idosos.

Resumen Objetivo Caracterizar los microorganismos y su susceptibilidad antimicrobiana en urocultivos de adultos mayores residentes en una institución de larga estadía. Métodos Estudio observacional transversal con 116 individuos de una institución de larga estadía para adultos mayores de un municipio del sur del estado de Bahia. El estudio fue aprobado por el Comité de Ética de Investigación y se utilizó Consentimiento Informado. Se obtuvieron muestras de orina, con las cuales se realizó análisis de laboratorio tipo I y urocultivo. Se realizaron pruebas de sensibilidad a antimicrobianos según los criterios del European Committee on Antimicrobial Susceptibility Testing. Para el diagnóstico de infección del tracto urinario, se utilizaron los criterios de McGeer. El análisis de datos se obtuvo mediante estadística descriptiva, con frecuencias absolutas y relativas. Resultados La prevalencia de infección del tracto urinario fue del 33,62 %, con predominancia del sexo femenino y edad superior a 80 años. Los uropatógenos fueron: 69,2 % Escherichia coli, 20,6 % Klebsiella pneumoniae y 5,1 % Providencia stuartii y Acinetobacter baumannii. Las cepas de E. coli presentaron susceptibilidad en la mayor parte de los antimicrobianos, en las de K. pneumoniae, la susceptibilidad fue variable. P. stuartii y A. baumannii no presentaron resistencia a carbapenémicos ni a los betalactámicos aztreonam y piperacilina asociados a tazobactam. Conclusión Las cepas más prevalentes y el perfil de susceptibilidad presentaron un patrón parecido al hospitalario, lo que implica la necesidad de que la institución promueva mejores estrategias de control de infecciones e involucre al equipo de enfermería en la gestión de los casos y en la cualificación de la prescripción antimicrobiana para reducir la resistencia bacteriana y los efectos adversos en los adultos mayores.

Resumo Objetivo Caracterizar os microrganismos e sua suscetibilidade antimicrobiana em uroculturas de idosos residentes de uma instituição de longa permanência. Métodos Estudo observacional transversal com 116 indivíduos de uma Instituição de Longa Permanência para Idosos de um município do sul da Bahia. O estudo foi aprovado por Comitê de Ética em Pesquisa e utilizou-se Termo de Consentimento Livre e Esclarecido. Foram realizadas coleta e análise laboratorial de urina tipo I e urocultura. Realizaram-se testes de sensibilidade a antimicrobianos conforme os critérios do European Committee on Antimicrobial Susceptibility Testing. Para o diagnóstico de infecção do trato urinário, foram utilizados os critérios de McGeer. A análise de dados se deu por estatística descritiva, com frequências absolutas e relativas. Resultados A prevalência de infecção do trato urinário foi de 33,62%, com predominância no sexo feminino e idade acima de 80 anos. Os uropatógenos foram: 69,2% Escherichia coli, 20,6% Klebsiella pneumoniae e 5,1% Providencia stuartii e Acinetobacter baumannii. As cepas de E. coli apresentaram suscetibilidade para a maior parte dos antimicrobianos; já nas de K. pneumoniae, a suscetibilidade foi variável. P. stuartii e A. baumannii não apresentaram resistência a carbapenêmicos e aos betalactâmicos aztreonam e piperacilina associados a tazobactam. Conclusão As cepas mais prevalentes e o perfil de suscetibilidade seguiram padrão próximo ao hospitalar, o que implica a necessidade de a instituição promover melhores estratégias de controle de infecção e envolver a equipe de enfermagem no gerenciamento dos casos e na qualificação da prescrição antimicrobiana, para reduzir a resistência bacteriana e efeitos adversos nos idosos.

Relationship between frailty and orthostatic hypotension in the elderly in nursing homes / 中国实用护理杂志

Objective:To understand the predictive effect of orthostatic hypotension on frailty in nursing homes, and the effect of frailty on heart rate and blood pressure in supine positionand orthostatic position.Methods:A total of 214 elderly cases in three nursing homes (the Golden Years of Jinjialing Retirement Life Center, Hangzhou Boyang Pension Service Co., Ltd, Hangzhou Langhe International Medical Care Center) were interviewed by the general information questionnaire, the Frail Scale and Barthel Index. Systolic blood pressure, diastolic blood pressure, and heart rate were measured by electronic sphygmomanometer in supine position and orthostatic position of 1 and 3 minutes.Results:The incidence of frailty combined with orthostatic hypotension was 26.64%(57/214) in the elderly in nursing homes. The incidence of orthostatic hypotension in the robust elderly, pre-frailty and frailty gradually increased, 14.29%(5/35), 20.00%(12/60), 47.90%(57/119). The differences of heart rate and systolic blood pressure in supine position between the elderly with and without frailty were significant ( t=2.16, 3.25, P<0.05), the differences of systolic pressure difference in orthostatic position of 1 and 3 minutes between the elderly with and without frailty were significant ( H=3.16, 4.08, P<0.01). There was significant difference in systolic pressure between the prefrail elderly and the elderly without frailty in lying position ( t=2.02, P<0.05). The differences of systolic and diastolic pressure differences in orthostatic position of 3 minutes between the frail elderly and pre-frail elderly were significant ( H=3.13,2.44, P<0.05). Ordered Logistic regression analysis showed that orthostatic hypotension was a risk factor for frailty ( OR=2.425, 95% CI were 1.133-4.988, P<0.05). Conclusions:Elderly adults with orthostatic hypotension in nursing homes have a higher prevalence of frailty. Frailty also impairs blood pressure regulation during postural changes. Nurses should attach importance to the assessment, education and intervention of frailty and orthostatic hypotension.

Cuidados domiciliares de parteiras tradicionais na assistência ao parto / Home care by traditional midwives in childbirth care / Cuidados domiciliarios de parteras tradicionales en la atención del parto

Objetivo: descrever os cuidados domiciliares prestados por parteiras tradicionais durante a assistência ao parto. Método: estudo qualitativo conduzido por meio do método da História Oral Temática, realizado com 16 parteiras em nove municípios do Cariri cearense. A coleta de dados ocorreu entre julho e dezembro de 2015 por meio de entrevista semiestruturada, os relatos foram transcritos, textualizados e transcriados. Resultados: as parteiras prestavam cuidados familiares, assistência ao parto vaginal, cuidados com o recém-nascido e no puerpério imediato. Usavam chás e orações como adjuvantes do seu ofício. Conclusão: o cuidado das parteiras na assistência ao parto centralizava-se nas necessidades da mulher e da família, sendo, em alguns casos, extensivo à casa. As parteiras conheciam os sinais e sintomas do trabalho de parto e agiam nas possíveis intercorrências.

Objective: to describe home care provided by traditional midwives during childbirth care. Method: this qualitative study, using the Thematic Oral History method, was conducted with 16 midwives from nine municipalities in Cariri, Ceará. Data were collected from July to December 2015 through semi-structured interviews, the reports were transcribed, textualized and transcreated. Results: midwives provided family care, vaginal delivery care, newborn care and immediate postpartum care. They used teas and prayers as an adjuncts to their craft. Conclusion: childbirth care by midwives centered on the women's and families' needs and, in some cases, extended to the home. Midwives knew the signs and symptoms of labor and acted on possible complications.

Objetivo: describir los cuidados domiciliarios brindados por parteras tradicionales durante la atención al parto. Método: estudio cualitativo conducido mediante el método de Historia Oral Temática, realizado con 16 parteras en nueve municipios de Cariri en Ceará. La recolección de datos se realizó entre julio y diciembre de 2015 a través de entrevistas semiestructuradas; los relatos fueron transcritos, textualizados y transcreados. Resultados: las parteras brindaron atención familiar, asistencia en el parto vaginal, cuidados al recién nacido y en el puerperio inmediato. Usaban tés y oraciones como complemento de su oficio. Conclusión: el cuidado de las parteras en la atención al parto se centraba en las necesidades de la mujer y de la familia, extendiéndose, en algunos casos, al hogar. Las parteras conocían los signos y síntomas del trabajo de parto y actuaban sobre las posibles complicaciones.

Investigation of self-acceptance status and its influencing factors of elderly people in nursing home / 中国实用护理杂志

Objective:To understand the present situation of self-acceptance of elderly in nursing home and explore its influencing factors, so as to provide basis for improving self-acceptance level of elderly in nursing home.Methods:Totally 415 elderly people in 3 Medical and nursing homes in Fuyang city of Anhui province were selected by Self-Acceptance Scale, and influencing factors were analyzed.Results:The total score of Self-Acceptance Scale of the elderly in nursing home was (44.11±7.25) points, the score rate was 67.86% (44.11/65), in the middle level; the results of multiple linear stepwise regression showed that the relationship with children, hobbies, number of children, length of stay in nursing home, frequency of visits and age were the main influencing factors ( F value was 48.228, P<0.001). Conclusion:The self-acceptance of the elderly in nursing home is in the middle level. The nursing home or social should pay attention to the higher age group and the newly admitted elderly in nursing home, give such people timely psychological guidance, help them to plan their later life, cultivate their interests and hobbies through recreational activities, and take corresponding measures to harmonize their relationship with their children in order to improve their self-acceptance level and promote mental health.

Oral health status in elderly residents in Songjiang District of Shanghai / 上海预防医学

Objective To understand oral health of the elderly in nursing home in Songjiang District, Shanghai, and to provide references for improving their oral health. Methods A total of 375 elderly people in 15 nursing homes in Songjiang District were investigated by questionnaires and oral examination.Tooth loss, denture repair, periodontal condition and oral hygiene habit were analyzed. Results The rate of the tooth loss reached 94.13%.The tooth loss rate in females (96.09%) was significantly higher than that in males (91.03%) (P < 0.01).The rate of complete edentulous jaws was 28.27%.There was a significant difference between the rate of complete edentulous jaws in females (34.35%) and in males (18.62%)(P < 0.05).The rate of denture restoration was 91.51% (97/106).The number of existing teeth per capita was 11.54, and the number of teeth per capita in males (14.48 per person) was significantly higher than that in females (9.70 per person) (P < 0.05).Both the rate of the tooth loss of upper and lower posterior teeth were significantly higher than that of upper and lower anterior teeth (P < 0.01).Thirty-three percent (33.33%) of the elderly brushed their teeth more than twice a day, and almost 20.53% of them didn′t brush their teeth. Conclusion The oral health of the elderly in the nursing homes in Songjiang District is not satisfactory at present.It is necessary to strengthen the publicity and education of oral health care for the elderly in nursing homes in cooperation with multiple departments to improve their awareness of oral health care including appropriate tooth repair for the quality of life.

The Use of Inappropriate Antibiotics in Patients Admitted to Intensive Care Units with Nursing Home–Acquired Pneumonia at a Korean Teaching Hospital / 결핵

Atitude de cuidadoras formais de idosas institucionalizadas sobre a velhice: efeito de uma intervenção educativa / Attitude of formal caregivers of institutionalized elderly women on old age: effect of an educational intervention / Actitud de los cuidadores formales de mujeres mayores institucionalizadas acerca de la vejez: efecto de una intervención educativa

O objetivo foi investigar o efeito de uma intervenção educativa sobre a atitude em relação à velhice de cinco cuidadoras de idosas institucionalizadas. A intervenção consistiu de quatro sessões em que eram exibidos vídeos abordando temáticas pertinentes à velhice, seguidos de questionamentos e reflexões. Os resultados mostram mudança positiva de atitude, especialmente naqueles aspectos relacionados à imagem social do idoso, podendo trazer benefícios no cuidado às idosas.

The objective was to investigate the effect of an educational intervention on the attitude about old age of five institutionalized elderly caregivers. The intervention consisted of four sessions where videos were presented, addressing topics pertinent to old age, followed by questions and reflections. The results show a positive attitude change, especially in those aspects related to the social image of the elderly, which can bring benefits to elderly care.

El objetivo fue investigar el efecto de una intervención educativa sobre la actitud hacia la vejez de cinco cuidadores de ancianos institucionalizados. La intervención consistió en cuatro sesiones en las que se mostraron videos que cubrían temas relevantes para la vejez, seguidos de preguntas y reflexiones. Los resultados muestran un cambio positivo de actitud, especialmente en aquellos aspectos relacionados con la imagen social de las personas mayores, que pueden traer beneficios en el cuidado de las personas mayores.

Prevalence of oral mucosal status in resident and non-resident nursing home in Isfahan city, Iran: a comparative cross-sectional study / Prevalência da condição da mucosa oral em idosos residente em casas de repouso ou não residente, na cidade de Isfahan, Irã: um estudo transversal comparativo

Objective: The aim of this study was to evaluate the oral mucosal status of residents nursing home and non-resident in Isfahan, Iran and compare them with each other. Material and Methods: This was a cross-sectional study comparing 281 elderly in two groups: 141 resident and 140 non-residents nursing homes in Isfahan, Iran. The selection of nursing home and all of elderly was randomly. The nonresidents elderly were randomly selected from the public places adjacent to the nursing home. Persons were examining and the relevant information recorded in a checklists. Data were analyzed by SPSS version 24 using t-test, chi square, MannWhitney, Fisher exact test. (α =0/05). Results: The sample of the case was 281 people, including 135 males (48%) and 146 females (52%). Of all the subjects 153 patients (54.4%) had at least one oral lesion, 78 (55.3%) in resident nursing home and 75 (53.6%) in non-resident. There was no significant difference between two groups based on Chi-Square test (P>0/05). In this study, 25 different types of lesions were recorded, the most common lesion in all participants was epulis fissuratum (12.1%). Conclusion: The results showed that the prevalence of mucosal lesions is high in the elderly living in the centers and in the non-resident. Therefore, maintaining dentures is necessary to prevent and control lesions. (AU)

Objetivos: O objetivo deste estudo foi avaliar a condição da mucosa oral de residentes em casas de repouso e não residentes em Isfahan, Irã, e compará-los entre si. Material e Métodos: Estudo transversal que comparou 281 idosos em dois grupos: 141 casas de repouso residentes e 140 não residentes em em casas de repouso na cidade de Isfahan, Irã. A seleção da casa de repouso de idosos e todos os idosos envolvidos foi aleatória. Os idosos não residentes foram selecionados aleatoriamente nos locais públicos adjacentes ao lar de idosos. As pessoas foram examinadas e as informações relevantes registradas. Os dados foram analisados pelo SPSS versão 24, utilizando o teste t, Qui-quadrado, Mann-Whitney, teste exato de Fisher (α = 0/05). Resultados: A amostra do estudo constou de 281 pessoas, incluindo 135 homens (48%) e 146 mulheres (52%). Do total geral, 153 pacientes (54,4%) apresentaram pelo menos uma lesão oral, sendo 78 (55,3%) em idosos residentes na casa de repouso e 75 (53,6%) em idosos não-residentes. Não houve diferença significativa entre os dois grupos com base no teste do Quiquadrado (p>0.05). Neste estudo, foram registrados 25 tipos diferentes de lesões, sendo que a lesão mais comum em todos os participantes foi a epulis fissuratum (12,1%). Conclusão: Os resultados mostraram que a prevalência de lesões nas mucosas é alta nos idosos residentes nas casas de repouso e também em não residentes. Portanto, a manutenção da prótese é necessária para prevenir e controlar as lesões. (AU)

Research progress of family support evaluation tools for the elderly in nursing institutions / 中国实用护理杂志

From the two aspects both at home and abroad endowment institutions the elderly family support commonly used assessment tool, this paper introduces the process of development of tools, dimensions, scoring method, and analyze the reliability and validity of the advantages and disadvantages of various assessment tools, aimed at the elderly family support for localization development of our country endowment institutions provide reference for the development and application of assessment tools.

The Willingness of Community Pharmacists in Collaborative Care of Frail Elderly in Nursing Homes

@#An increase in the number of residents in nursing homes has become a significant concern due to the rise in medication demand and subsequently medicationrelated issues, especially in frail elderly. Community pharmacists are the closest healthcare professionals available that can contribute to this population to allow optimal utilization of the prescribed drugs and to prevent drug-related problems. The present study aimed to investigate the awareness of community pharmacists on issues regarding frail elderly and to determine their willingness in collaborative care of frail elderly in nursing homes and the services they are willing to offer. This was a cross-sectional study utilising a set of questionnaire that was delivered to practicing community pharmacists in Peninsular Malaysia from June 2018 until December 2018. Majority of the participants agreed to the fact that aging is the primary cause of frailty (n=98, 88.3%), and that chronic disease is also a cause of frailty (n=96, 86.5%). Most of the community pharmacists were also keen to participate in the collaborative care of frail elderly, and were willing to provide their pharmacy service to the frail elderly. There was a positive correlation between the awareness of community pharmacists on issues regarding frail elderly and their willingness on collaborative care of frail elderly in nursing homes (r=0.374, n=111, p=0.01). Majority of the pharmacists were aware of the issues regarding the frail elderly, and were willing to participate in the collaborative care of frail elderly in nursing home.

Recognition of End-of-life Care by Nursing Care Staff, and Factors Impacting Their Recognition: An Exploratory Research Using Mixed Methods

Objectives: Elucidate recognition of end-of-life care by nursing care staff in elderly care facilities, and factors influencing such recognition. Methods: We conducted an internet questionnaire with 500 nursing care staff working at elderly care facilities across Japan, and an interview with 10 nursing care staff out of 500. Results: In the questionnaire, facility policies (41%) and cooperation with medical staff (38%) were selected as facilities and systems that are important for end-of-life care, and as a concern, sudden change in the condition of the patient, leading to death (53%) was selected. The interview showed that nursing care staff had a certain level of anxiety regardless of their experience with end-of-life care, with participants discussing their thoughts on how systematic learning of, and actual experience in, end-of-life care changed end-of-life care. Conclusion: Our study showed that systematic learning and experience of end-of-life care were important factors in recognition of end-of-life care by nursing care staff when providing such care in elderly care facilities.

Effects of nutrition status on activities of daily living among nursing home residents: the mediating role of physical function / 中国实用护理杂志

Objective To explore the relationship between nutrition status and activity of daily livingof elders in nursing homes and the mediating effect of physical activity. Methods From Apr to Sep in 2016,320 elders in nursing homes were selected and were surveyed using the standardized tools. The mediating effects were analyzed with PROCESS. Results The scores of elders′ nutrition status, physical function and activities of daily living were (11.88±2.27), (3.61±3.51), (79.13±26.00) points, respectively. And there were 66.9％ elders suffering from activities of living life impaired. The nutrition status were significantly positive correlated with physical function and activities of daily living of elders, and the physical function were significantly positive correlated with activities of daily living of elders. The physical function partly mediated the association between nutrition status and activities of daily living, and the effect was reached to 39.1％. Conclusions The elders′activities of daily life was poor in nursing home in China. The physical function partly mediated the association between nutrition status and activities of daily living. The related departments could combine the long time and short time plans targeting at improving of nutrition status and physical function respectively, to enhance the outcomes of elders in nursing homes.

Swallowing Dysfunction for Old People in Nursing Homes in Ningbo / 中国康复理论与实践

Objective:To investigate the prevalence of dysphagia in old people in nursing homes in Ningbo and analyze its related factors. Methods:From August, 2017 to April, 2018, 997 people aged 60 or above were selected from eight nursing homes in four districts in Ningbo. They were investigated with general questionnaire, Kubota water swallowing test, body mass index (BMI) and Quality of Life Index (QLI), and the data were analyzed with Logistic regression. Results:There were 259 (25.98%) persons with dysphagia. Age, male, hypertension, diabetes, hyperlipidemia, coronary heart disease, stroke and fracture were risk factors for dysphagia (P < 0.01). There were 19.2% with low BMI in total, and 63.3% for dysphagia. The total score of QLI decreased with age (F = 18.706, P < 0.001), more in males than in females (t = 2.516, P = 0.012), and less in those with dysphagia than with normal swallowing (t = 7.176, P < 0.001). Conclusion:Dysphagia is prevalent in the old people in nursing homes in Ningbo, which needs early intervention.

Concentrações de cortisol salivar de idosos institucionalizados e não institucionalizados / Concentraciones de cortisol salival de ancianos institucionalizados y no institucionalizados / Salivary cortisol concentrations in institutionalized and non-institutionalized elderly people

Introdução: devido às limitações inerentes do processo de envelhecimento, a institucionalização é uma realidade, podendo gerar impacto na saúde física e psicológica do individuo sênior. Objetivo: determinar as concentrações de cortisol salivar de idosos institucionalizados e não institucionalizados e verificar as condições de saúde bucal e dependência física. Métodos: estudo transversal, descritivo e analítico, com amostra composta por 80 indivíduos, sendo 45 institucionalizados e 35 não institucionalizados. Realizou-se exame clínico bucal para avaliação de uso e necessidade de prótese dentária nos arcos superior e inferior. Também foi realizada coleta salivar, para análise da concentração de cortisol, marcador biológico do nível de estresse. Resultados: a maioria dos idosos apresentou-se desdentado total, sendo 84,44 porcento no grupo institucionalizado e 71,43 porcento no grupo não institucionalizado. Os idosos institucionalizados apresentaram menor índice de uso de próteses, quando comparados ao grupo de idosos não institucionalizados (p= 0,0013). A análise das concentrações de cortisol salivar demonstrou diferenças significantes entre os grupos, com taxas mais elevadas no grupo institucionalizado (p= 0,0397). Maiores concentrações de cortisol salivar foram encontradas em indivíduos que possuíam necessidades protéticas, com diferença estatisticamente significante (p= 0,0454). Conclusão: os idosos institucionalizados apresentaram elevadas concentrações de cortisol salivar, maior necessidade de uso de próteses e apresentaram-se mais dependentes, quando comparados com o grupo não institucionalizado(AU)

Introducción: debido a las limitaciones inherentes del proceso de envejecimiento, la institucionalización es una realidad, lo que puede generar impacto en la salud física y psicológica del adulto mayor. Objetivo: determinar las concentraciones de cortisol salival de ancianos institucionalizados y no institucionalizados, y verificar variables como salud bucal y dependencia física. Métodos: estudio transversal, descriptivo y analítico, en el cual la muestra estuvo compuesta por 80 individuos, de estos 45 eran institucionalizados y 35 no institucionalizados. Se realizó examen clínico bucal para evaluar el uso y necesidad de prótesis en los arcos superior e inferior. También se realizó recolecta salivar, para análisis de la concentración de cortisol, marcador biológico del nivel de estrés. Resultados: la mayoría de los ancianos se presentaron desdentados totales, para el 84,44 por ciento en el grupo institucionalizado y 71,43 por ciento en el grupo no institucionalizado. Los ancianos institucionalizados presentaron menor índice de uso de prótesis, en comparación con el grupo de ancianos no institucionalizados (p= 0,0013). El análisis de las concentraciones de cortisol salival demostró diferencias significativas entre los grupos, con tasas más elevadas en el grupo institucionalizado (p= 0,0397). Mayores concentraciones de cortisol salivar fueron encontradas en individuos que poseían necesidades protésicas, con diferencia estadísticamente significante (p= 0,0454). Conclusiones: ancianos institucionalizados presentan elevadas concentraciones de cortisol salival, mayor necesidad de uso de prótesis y se presentan más dependientes, al ser comparados con el grupo no institucionalizado(AU)

Introduction: due to the limitations inherent to the process of aging, institutionalization is a reality which may have an impact on the physical and psychological health status of elderly people. Objectives: determine salivary cortisol concentrations in institutionalized and non-institutionalized elderly people, and verify variables such as oral health and physical dependence. Methods: a descriptive analytical cross-sectional study was conducted of a sample of 80 individuals, of whom 45 were institutionalized and 35 non-institutionalized. Oral clinical examination was performed to evaluate the use of and need for dental prostheses in the upper and lower arches. Saliva was collected to determine the concentration of cortisol, a biological marker of stress levels. Results: most of the sample were totally edentulous elderly people: 84.44 percent in the institutionalized group and 71.43 percent in the non-institutionalized group. A lower rate of prosthesis use was found in the institutionalized sample than in the non-institutionalized sample (p= 0.0013). Analysis of salivary cortisol concentrations revealed significant differences between the groups, with higher values in the institutionalized group (p= 0.0397). Higher salivary cortisol concentrations were found among individuals with prosthetic needs, the difference being statistically significant (p= 0.0454). Conclusions: institutionalized elderly people had higher salivary cortisol concentrations, greater prosthetic needs, and were more care dependent than the non-institutionalized group(AU)

Anemia in elderly residents of a long-term care institution

ABSTRACT Background: The Brazilian elderly population is growing exponentially, making prevention and treatment of chronic diseases a priority in this age group. Anemia in older adults is underdiagnosed, undervalued and associated with high morbimortality. Objective: To assess the prevalence of anemia in the elderly residents of a long-term care institution and to correlate this with individual patient history, the use of polypharmacy and mortality. Method: A retrospective study was carried out of data extracted from medical records of patients treated in 2014 at the Hospital Geriátrico e de Convalescentes Dom Pedro II under the Preventive Actions Program. Results: Data were collected from 88 female (48%) and 95 male (52%) elderly residents at a long-term care institution. Patient ages ranged from 60 to 102 years with a mean age of 76.3 years. Overall, 76 participants were diagnosed with anemia, representing 41% of the sample. Of those diagnosed, 35 were women (46%) and 41 were men (54%). Conclusion: Anemia in the elderly is a clinical condition associated with increased morbimortality. However, the disorder remains underdiagnosed, resulting in higher risks for older adults. The present study found 76 patients with anemia among the 183 residents at the long-term care institution. The patient profile of this population with anemia is non-smokers, male, aged between 70 and 79 years, with normochromic/normocytic anemia and taking multiple medications.