Asociación entre dependencia funcional y calidad de vida en pacientes adultos mayores oncológicos / Association between functional dependence and quality of life in older adult oncology patients

RESUMEN Introducción: La presencia de comorbilidades modula el proceso de envejecimiento, el diagnóstico de cáncer puede comprometer de manera importante la salud del adulto mayor, lo cual repercute en su calidad de vida. Objetivo: Determinar la asociación entre la dependencia funcional y la calidad de vida en pacientes oncológicos adultos mayores tratados con radioterapia. Métodos: Estudio analítico retrospectivo, realizado en 181 pacientes ambulatorios del Centro Médico Naval del Callao, Perú, varones, mayores de 60 años. Se valoró la dependencia funcional mediante los índices de Barthel y el de Lawton; y la calidad de vida mediante la escala de calidad de vida en adultos mayores de la Organización Mundial de la Salud (WHOQoL-Old). Resultados: Se encontró asociación estadísticamente significativa entre dependencia funcional y calidad de vida, tanto para las actividades básicas de la vida diaria (PR= 1,04 [IC 95 %; 1,01-1,07]) como para las actividades instrumentales de la vida diaria (PR= 1,08 (IC 95 %: 1,01 - 1,13). Conclusiones: En los pacientes adultos mayores oncológicos tratados con radioterapia, se encuentra asociación significativa entre dependencia funcional y una pobre calidad de vida.

ABSTRACT Introduction: The presence of comorbidities modulates the aging process, the diagnosis of cancer can significantly compromise the health of the elderly, which affects their quality of life. Objective: Determine the association between the functional dependence and the quality of life in elderly oncology patients treated with radiotherapy. Methods: Retrospective analytical study, carried out in 181 outpatients of Centro Médico Naval del Callao, Perú, male, older than 60 years. The functional dependence was assessed with Barthel index and Lawton scale; and the quality of life was assessed with World Health Organization Quality of Life-Older Adults Module (WHOQoL-Old). Results: A statistically significant association was found between functional dependence and quality of life, for both the basic activities of daily living (PR= 1.04 [IC 95 %: 1.01-1.07]), and the instrumental activities of daily living (PR= 1.08 [IC 95 %: 1.01 - 1.13]). Conclusion: There was significant association between the functional dependence and the poor quality of life in the elderly oncology patients treated with radiotherapy.

Buenas prácticas en la visita domiciliaria integral en atención primaria chilena / Good practices in the integral home care visits in Chilean primary care

La atención del paciente en el domicilio, constituye una excelente alternativa de salud, con múltiples beneficios demostrados, en especial para un grupo de pacientes con dificultades de acceso. El objetivo principal de una visita domiciliaria integral (VDI) es favorecer el autocuidado en salud, ofreciendo una atención de salud centrada en la persona y su familia, considerando las variables biopsicosociales, facilitando el acceso a la atención y redes de apoyo, mejorando así su calidad de vida y potenciando su recuperación y rehabilitación. Una VDI, consta de tres etapas: planificación previa de la visita en base a los motivos de consulta principales; la ejecución de la visita en sí, en la cual se busca generar el vínculo, observar el ambiente familiar y priorizar los problemas biopsicosociales para lograr cambios e intentar mejorar la situación; y por último, realizar un monitoreo y evaluación del caso. El objetivo de este artículo es brindar una breve sistematización al equipo de salud de atención primaria de salud, para que puedan comprender la relevancia y el proceso del desarrollo de una VDI, sumado a síntesis de buenas prácticas para el trabajo eficiente en equipo

Home care visits are an excellent chance of health attention, with multiple proven benefits, specially, for a group of patients with access difficulties. The main objective of an integral home care visit is to promote self-care in health, offering a person and family centered care, taking in consideration biopsychosocial variables, facilitating the access to healthcare systems and support networks, improving their quality of life and enhancing their recovery and rehabilitation. An integral home care visit, has mainly three stages: planification of the visit with anticipation according to the main complaints; the execution of the visit itself, which seeks to create an initial bond, observe the family and domestic environment, prioritize biopsychosocial problems to achieve changes and try to improve the situation; and at last, to monitor and evaluate the case. The objective of this article is to provide a brief systematization to the primary health care team, so that they can understand the relevance and the process of developing an integral home care visit, added to a synthesis of good practices to achieve an efficient interdisciplinary team work.

Knee extension strength and handgrip strength are important predictors of Timed Up and Go test performance among community-dwelling elderly women: a cross-sectional study

ABSTRACT BACKGROUND: Handgrip and knee extension strengths have each been used to characterize disability. However, it has been reported that the association between handgrip and knee extension strengths is weak. OBJECTIVE: To evaluate the influence of knee extensor and handgrip muscle strength on Timed Up and Go (TUG) test results among elderly women with worse (≥ 10 seconds) and better (< 10 seconds) performance, after controlling for confounders. DATA AND SETTING: Cross-sectional study on a sample selected according to convenience, carried out in a federal public institution of higher education. METHODS: Assessment of handgrip was carried out using the Jamar dynamometer (Lafayette Instrument Company, Inc., Lafayette, United States). Knee extensor muscle performance was measured using an isokinetic dynamometer (Biodex System 3 Pro; Biodex Medical Systems, Inc., United States), The confounding factors were education, age, comorbidities, body mass index and Geriatric Depression Scale and Human Activity Profile scores. Functional performance was assessed through the TUG test. A backward linear regression model was used. RESULTS: 127 elderly women performed the TUG test in more than 10 seconds and 93 in less than 10 seconds. However, regardless of test performance, handgrip strength and knee extension strength comprised the reduced final model. CONCLUSIONS: Knee extension strength and handgrip strength might be particularly useful indicators for measuring disability.

Criterios de valoración geriátrica integral en adultos mayores con dependencia moderada y severa en Centros de Atención Primaria en Chile / Functional geriatric assessment in primary health care

The functional assessment of moderately or severely dependent older people encompasses social, psychological and biological aspects that may influence their quality of life and their degree of independence. This paper reviews the global geriatric assessment that should be performed in primary health care (PHC) for moderately or severely dependent older people. Since 2012 in PHC in Chile, the norm establishes that the degree of independence of older people should be assessed using the Barthel scale and caregiver stress should be evaluated using Zarit scale. People with severe disability should receive home care. We recommend to evaluate also cognitive aspects using the minimental state examination (MMSE) to Barthel Index or using the Functional Independence Measure (FIM), since they are closely associated with functional capacity.

Influência da circunferência abdominal sobre o desempenho funcional de idosas / Infuence of waist circumference on elderly women’s functional performance

O objetivo do estudo foi comparar o desempenho funcional de idosas segundo a medida de suas circunfêrencias abdominais (CA). Foram avaliadas 48 idosas, divididas nos grupos 1, com CA>88 cm, e grupo 2, de CA<88 cm. A funcionalidade foi avaliada pelo teste de caminhada de seis minutos (TC6') e pelo teste de desempenho físico modificado (TDFM), não-dependente de condicionamento cardiovascular. O grupo 1, cujos valores de peso e índice de massa corporal foram estatisticamente superiores (p<0,05) aos do grupo 2, percorreu distância média menor, quando comparado ao grupo 2 (p<0,05), e obteve escores médios inferiores no TDFM (p<0,05). Os dados mostram que mulheres idosas com circunferência abdominal superior a 88 cm tiveram pior desempenho nos testes funcionais, sugerindo que a obesidade abdominal pode contribuir para o declínio funcional precoce e conseqüente incapacidade nessa população.

The purpose of this study was to compare physical performance of elderly women according to their waist circumference (WC). Forty-eight elderly women were divided into group 1, with WC>88 cm, and group 2, with WC<88 cm. Physical function was assessed by means of the six-minute walk test (6MWT) and by the modified physical performance test (MPPT), non-dependent on physical fitness. Group 1 mean body mass and body mass index measures were statistically higher (p<0.05) than group 2's; group 1 also walked significantly shorter mean distances than group 2 (p<0.05), and scored lower at the MPPT (p<0.05). Data thus show that elderly women with over 88 cm waist circumference had poor performance at physical function tests, suggesting that the presence of visceral obesity may contribute to functional decline and further impairment among elderly women.

A Survey on Functional Status among Low-Income Older Adults Living at Home / 간호학회지

PURPOSE: The purpose of the study was to analyze the functional status of low income elderly living at home according to their socio-economic factors, sensory function, health status, medical service utilization, commodity and types of chronic disease. METHOD: Functional status was defined by the level of mobility, ADL and IADL categorized as independently functional, mildly impaired, moderately disabled, and severely disabled. The data was collected by home-visit interviews with 567 community dwelling adults who were 65 years of age or more with low a income status subsidized by government in ChonAn. RESULTS: 9.9% of community dwelling older adults were severely disabled, and 44.4% were moderately disabled in their functional status. There were significant differences in the functional status by age, education, religion, and types of family structure. The older adults with hearing impairment or dental problems had a significantly higher rate of severe disability. Self-rated health status and medical service utilization were also significant factors to the differences in functional status. The functional status of older adults was also significantly related to the presence of chronic health problems such as chronic back pain, stroke, and Alzheimer-dementia. CONCLUSION: The results confirmed that community dwelling older adults with low income status were more functionally disabled in comparison to general older adults at national level, while the relating factors to their functional status seemed similar to other studies on older adults. Further studies were suggested to look into functional status longitudinally and focus on the changes of functional status by managing modifiable influencing factors.