Fragilidade física e incontinência urinária de idosos em assistência ambulatorial / Fragilidad física e incontinencia urinaria de adultos mayores en atención ambulatoria / Physical frailty and urinary incontinence of elderly in ambulatory care

RESUMO Objetivo: analisar a associação dos marcadores e da condição de fragilidade física à incontinência urinária em assistência ambulatorial de geriatria e gerontologia. Método: estudo transversal, desenvolvido na atenção secundária à saúde de ambulatório do Paraná, com 384 idosos. Coletaram-se dados entre setembro de 2016 a março de 2017 mediante fenótipo de fragilidade e questionário International Consultation on Incontinence Questionnaire - Short Form. Resultados: dos idosos 118 (30,7%) foram considerados não frágeis, 212 (55,2%) pré-frágeis, 54 (14,1%) frágeis, 106 (27,6%) com incontinência urinária, 50 (47,2%) com impacto muito grave na rotina diária, 18 (17,0%) grave, 16 (15,0%) moderado, 11 (10,4%) leve a nenhum impacto. Associaram-se à incontinência urinária a condição de fragilidade (p=0,011), os marcadores força de preensão manual diminuída (p=0,027), fadiga e exaustão (p=0,002) e velocidade da marcha reduzida (p=0,000). Conclusão: os resultados contribuem com o desenvolvimento crítico da enfermagem no momento de avaliar as necessidades de cuidado gerontológico.

RESUMEN Objetivo: analizar la asociación de los marcadores y la condición de fragilidad física a la incontinencia urinaria en la atención ambulatoria en geriatría y gerontología. Método: estudio transversal, desarrollado en atención secundaria ambulatoria de salud del estado de Paraná (Brasil), con 384 ancianos. La recolección de datos se realizó entre septiembre de 2016 y marzo de 2017, mediante fenotipo de fragilidad y cuestionario International Consultation on Incontinence Questionnaire - Short Form. Resultados: 118 (30,7%) ancianos se consideraron no débiles, 212 (55,2%) pre débiles, 54 (14,1%) débiles, 106 (27,6%) con incontinencia urinaria, 50 (47,2%) con impacto muy grave en la rutina diaria, 18 (17,0%) con impacto grave, 16 (15,0%) con impacto moderado, 11 (10,4%) con leve o ningún impacto. Se asociaron a la incontinencia la condición de fragilidad (p=0,011), los marcadores fuerza de sujeción manual disminuida (p=0,027), fatiga y agotamiento (p=0,002) y velocidad da marcha reducida (p=0,000). Conclusión: los resultados contribuyen al desarrollo crítico de la enfermería al momento de evaluar las necesidades de cuidado gerontológico.

ABSTRACT Objective: To analyze the association of markers and physical frailty condition with urinary incontinence in outpatient geriatric and gerontological care. Method: A cross-sectional study, developed in the secondary health care of an outpatient clinic of Paraná, with 384 elderly. Data were collected between September 2016 and March 2017 through frailty phenotype and the questionnaire International Consultation on Incontinence Questionnaire - Short Form. Results: of the elderly 118 (30.7%) were considered non-frail, 212 (55.2%) pre-frail, 54 (14.1%) frail, 106 (27.6%) with urinary incontinence, 50 (47.2 %) with very severe impact on daily routine, 18 (17.0%) severe, 16 (15.0%) moderate, 11 (10.4%) mild to no impact. Urinary incontinence was associated with the condition of frailty (p=0.011), the markers for decreased handgrip strength (p=0.027), fatigue and exhaustion (p=0.002) and reduced gait speed (p=0.000). Conclusion: The results contribute to the critical development of nursing when assessing the needs of gerontological care.

The Effect of Subjective Xerostomia and Salivary pH in Salivary Glands Stimulated by Laughter Therapy in Frail Elderly Women

PURPOSE: The purpose of this study was to identify the effect of subjective xerostomia and salivary pH in salivary glands stimulated by laughter therapy in frail elderly women. METHODS: The research used a one-group pretest-posttest design. Data were collected from July 2, 2015 to September 30, 2015. A sample of 41 frail female elderly patients was recruited at A Nursing Home in K City, Korea. We measured xerostomia and salivary pH using a questionnaire and BCP test paper (pH 5.6~7.2). Laughter therapy was given once a week for four weeks (3 items). Data were analyzed through descriptive statistics, independent t-test, ANOVA, paired t-test and Cronbach's using the SPSS 18.0 program. RESULTS: There were significant differences in salivary pH according to oral health (t=-2.06, p<.05). There were significant differences in xerostomia (t=4.41, p<.001) and salivary pH (t=-7.94, p<.001) after salivary glands stimulated by laughter therapy. CONCLUSION: Salivary glands stimulated by laughter therapy improved xerostomia and salivary pH of the frail elderly. Therefore, salivary glands stimulated by laughter therapy may be useful in promoting and maintaining oral health among the frail elderly in the rapidly increasing population of old people.

Síndrome de fragilidad en adultos mayores no institucionalizados de Emiliano Zapata, Tabasco, México / Frailty syndrome in no institutionalized older adults from Emiliano Zapata, Tabasco, Mexico

Objetivo. Determinar la prevalencia del síndrome de fragilidad y los factores asociados a este, en adultos mayores no institucionalizados de Emiliano Zapata, Tabasco, México,en el año 2008. Material y métodos. Estudio de diseño transversal, con universo de 2.375 adultos mayores. La muestra fue probabilística (p=0,9, q=0,1, Z=1,96, d=0,05), de 94 adultosmayores. El muestreo fue aleatorio simple. Los criterios de inclusión fueron cualquier sexo y sin enfermedades cognitivas de diagnóstico conocido. Se consideraron las variables sociodemográficas, enfermedades, estado nutricional, funcionalidad para actividades básicas de la vida diaria y síndrome de fragilidad. Como instrumentos seusaron cuestionario de nutrición (Nutritional Screening Initiative), escala de Katz y escala de Barber. Para el análisis se usaron estadística descriptiva, prueba exacta deFisher con 95% de confianza (p≤0,05) y el software Epi Info® versión 3,3,2.Resultados. Se incluyeron 94 adultos mayores, 63% femeninos y 37% masculinos. La edad media fue 69,4±7,1 años. La morbilidad estuvo presente en 85%. Hubo riesgonutricional elevado en 86,2%. La dependencia básica para la vida diaria fue de 9,6%. La prevalencia del síndrome de fragilidad fue 98%. Como factor asociado se encontróel riesgo nutricional (p=0,02). Conclusiones. La prevalencia del síndrome de fragilidad observada en esta serie fue mayor ala reportada por otros autores. El estado nutricional se encuentra asociado a este síndromegeriátrico...

Objective: To determine the frailty syndrome prevalence and the associated factors to it, in noinstitutionalized older adults from Emiliano Zapata, Tabasco, Mexico, in 2008. Material and methods: Design: cross-sectional. Universe: 2.375 older adults. Sample: randomized(p=0,9, q=0,1, Z=1,96, d=0,05) 94 olderadults. Sampling: randomized simple. Inclusion criterions: any sex, without cognitive diseases of known diagnosis. Variables: socio-demographics,diseases, nutritional status, functionality for basic activities of daily life, frailty syndrome.Instruments: nutrition questionnaire (Nutritional Screening Initiative), Katz scale, Barber scale. Analysis: descriptive statistic, Fisher Exact Testwith 95% of confidence (p≤0.05). Software: Epi Info® version 3.3,2.Results: 94 older adults, 63% females, 37% males; mean age, 69,4±7,1 years-old; present morbility, 85%; high nutritional risk,86,2%; basicdependence for daily life, 9,6%; frailty syndrome prevalence, 98%; associated factors: nutritionalrisk (p=0,02). Conclusions: The frailty syndrome prevalenceobserved in this series was major to report for other authors. The nutritional status it’s associatedto this geriatric syndrome....