Evaluation of functionality and disability of older elderly outpatients using the WHODAS 2. 0 / Avaliação de funcionalidade e incapacidade de idosos longevos em acompanhamento ambulatorial utilizando a WHODAS 2. 0

Abstract Objectives: To analyze the level of functionality and disability of older elderly persons receiving care at a university hospital in Curitiba, Paraná, and identify functional differences between men and women. Method: A descriptive, cross-sectional study with a quantitative approach, based on a convenience sample of elderly persons receiving outpatient care, was undertaken. The Brazilian version of the World Health Organization Disability Assessment Schedule (WHODAS 2.0). Results: A total of 28 people with a mean age of 86.21 (±4.17) were evaluated. Of these 50.0 % were male, 46.4 % were widowed, and 57.1 % performed the evaluated activities independently. There were no significant differences between genders in terms of age (p≤0.635) or years of study (p≤0.329), although women showed a higher level of disability than men in general (p≤0.16). Conclusion: The WHODAS 2.0 proved to be a sensitive tool for the analysis and comparison of the level of functionality of the older elderly. However, it is important to develop prospective studies, with non-convenience samples, for a better reflection on the disability and functionality of older elderly persons. AU

Resumo Objetivos: Analisar o nível de funcionalidade e incapacidade de idosos longevos em acompanhamento ambulatorial, em um hospital universitário na cidade de Curitiba, Paraná e identificar diferenças funcionais entre os sexos e as enfermidades mais frequentes. Método: Estudo descritivo, transversal, de abordagem quantitativa e amostra por conveniência, junto a sujeitos acompanhados ambulatoriamente. Foi aplicada a versão brasileira da Escala de Incapacidades da Organização Mundial de Saúde (WHODAS 2.0). Resultados: A amostra foi composta por 28 sujeitos, com média de idade de 86,21 (±4,17) anos, 50,0% eram do sexo masculino, 46,4% viúvos, e 57,1% desempenhavam as atividades avaliadas de forma independente. Na comparação entre sexos, não houve diferenças significativas dos grupos em relação à idade (p≤0,635) e anos de estudo (p≤0,329), contudo, as mulheres apresentaram maior nível de incapacidade que os homens em geral (p≤0,16). Conclusão: O instrumento WHODAS 2.0 mostrou-se sensível para analisar e comparar o nível de funcionalidade de idosos longevos. No entanto, mostra-se importante desenvolver pesquisas prospectivas, com amostras não convenientes, para uma melhor reflexão sobre a incapacidade e a funcionalidade de idosos longevos. AU

Frecuencia de sintomatología ansiosa y sus factores relacionados en mujeres con artritis reumatoide en un hospital general de Lima / Frequency of anxious symptomatology and related factors in female patients with rheumatoid arthritis in a general hospital in Lima.

Objetivo: Estudiar la frecuencia de sintomatología ansiosa y los factores relacionados a ésta en mujeres con artritis reumatoide (AR) que acuden a un hospital general de Lima. Métodos: Se incluyeron pacientes mujeres con AR a quienes se les aplicó una ficha con las variables sociodemográficas, la escala visual analógica (EVA) para medir intensidad de dolor, el Modified Health Assessment Questionnaire (M-HAQ)para evaluar discapacidad funcional y una escala de ansiedad (EA-72) construida y validada en el Perú para determinar presencia o ausencia de ansiedad clínicamente significativa. Resultados: Se encontraron 68 pacientes con ansiedad clínicamente significativa (46,57%) entre las 146 pacientes evaluadas. El análisis multivariado mostró que la discapacidad funcional con puntaje de M-HAQ > 2(OR = 6,89) y el dolor > 5cm según la EVA (OR = 3,27) fueron factores relacionados a ansiedad clínicamente significativa en las pacientes con AR mientras que el grado de instrucción superior (OR = 0,25) fue un factor protector. Conclusiones: Este estudio muestra que una alta proporción de pacientes con AR presenta ansiedad clínicamente significativa y que ésta se relaciona con la discapacidad funcional, el dolor y un menor grado de instrucción.

Objectives: To study the frequency of anxiety symptomatology and related factors in female patients with rheumatoid arthritis (RA) in a general hospital in Lima. Methods: Female patients with RA were included. We administered a questionnaire to evaluate socio-demographic data, the visual analogue scale (VAS) to measure pain intensity, the Modified Health Assessment Questionnaire (M-HAQ) to study functional disability and an anxietyscale (EA-72) constructed and validated in Peru to determine the presence or absence of clinically significant anxiety. Results: 68 subjects with clinically significant anxiety (46.57%) were found among 146 RA patients. Multivariate analysis showed that functional disability with a score of M-HAQ > 2 (OR = 6.89) and pain > 5 cm according to VAS (OR = 3.27) were factors related to anxiety in patients with RA while the high educational level (OR=0.25) was a protective factor. Conclusions: This study shows that a high percentage of RA patients had clinically significant anxiety and that it was related tofunctional disability, pain and a lower educational level.

Limited activity and social participation after hospital discharge from leprosy treatment in a hyperendemic area in north Brazil / Pós-alta de hanseníase: limitação de atividade e participação social em área hiperendêmica do Norte do Brasil

INTRODUCTION: Neural damages are among the main factors that contribute to physical disability in leprosy. Systematic monitoring using a broad physical, psychological and social approach is necessary. OBJECTIVE: The objective of this study was to characterize the limitation of activity and social participation and its correlation with disabilities and/or impairment in individuals after being discharged from a multidrug leprosy therapy. METHOD: A cross-sectional study conducted in Araguaína, state of Tocantins, which is a leprosy hyperendemic municipality. We included cases of patients who were discharged from treatment considered as cured from January 2004 to December 2009. We performed dermatological examination and applied the Screening Activity Limitation and Safety Awareness (SALSA) and social participation scales. RESULTS: We included 282 individuals (mean age: 45.8 years old). The paucibacillary operational classification was more common (170; 60.3%). The eye-hand-foot score ranged from 0 to 12 (mean: 0.7). A total of 84 (29.8%) individuals presented limited activity. A slight restriction in social participation occurred in 18 (6.3%) cases. There was a statistically significant correlation between activity limitation, age (r = 0.40; p < 0.0001) and degree of functional limitation (r = 0.54; p < 0.0001), as well as of restricted social participation, activity limitation (r = 0.56, p < 0.0001) and functional limitations (r = 0.54, p < 0.0001). CONCLUSION: Functional limitation due to leprosy had an impact on the conduct of activities and social participation after the discharge from a leprosy treatment. The association between Screening of Activity Limitation and Safety Awareness and participation scales will assist in designing evidence-based assistance measures. .

INTRODUÇÃO: Os danos neurais estão entre os principais fatores que contribuem para incapacidade física na hanseníase, então é necessário monitoramento sistematizado desses pacientes com abordagem ampla nos aspectos físicos, psicológicos e sociais. OBJETIVO: O objetivo deste trabalho foi caracterizar a limitação de atividade e participação social e sua correlação com incapacidades e/ou deficiências nas pessoas em pós-alta da poliquimioterapia para hanseníase. MÉTODO: Foi conduzido um estudo transversal no município de Araguaína, Tocantins, hiperendêmico para hanseníase. Avaliaram-se casos novos em alta por cura de janeiro de 2004 a dezembro de 2009, com realização de exame dermatoneurológico e análise da limitação funcional, de atividade e de restrição à participação social. RESULTADOS: Foram entrevistadas e avaliadas 282 pessoas (média de idade: 45,8 anos). As formas clínicas paucibacilares foram mais frequentes (170 pessoas; 60,3%). O escore olho, mão e pé variou de 0 a 12 (média: 0,7). Um total de 84 (29,8%) pessoas apresentou limitação de atividade. A leve restrição à participação social foi mais frequente em 18 (6,3%) casos. Houve correlação estatisticamente significante da limitação de atividade com idade mais avançada (r = 0,40; p < 0,0001) e com o grau da limitação funcional (r = 0,54; p < 0,0001), e da restrição à participação social com a limitação de atividade (r = 0,56; p < 0,0001) e com a limitação funcional (r = 0,54; p < 0,0001). CONCLUSÃO: A limitação funcional teve impacto sobre a realização de atividades e participação social das pessoas em alta ...

Structural Equation Modeling on Quality of Life in Older Adults with Osteoarthritis

PURPOSE: The aim of this study was to explore how individual factors, physiologic factors, symptoms, environmental factors, functional status and health perception predict the quality of life (QOL) for older adults with osteoarthritis and to provide guidelines for interventions and strategies to improve QOL in these patients. The conceptual model was based on the Wilson and Cleary's Model. METHODS: Data were analyzed using SPSS WIN 20.0 and AMOS 19.0 program. RESULTS: The proposed model was a good fit for the data based on the model fit indices. Based on the constructed model, individual factors, social support, functional status and health perception were founded to have direct effects on QOL. Symptom had a indirect effect on QOL. Social support had a significant effect on QOL, and this model explained 63.6% of the variance in QOL. CONCLUSION: The results of this study suggest that nursing strategies to increase QOL in this population should contain social support to promote QOL and manage functional limitations and health perception.

Relationship between restricted activity due to oral diseases and oral health behaviors among adolescents / 대한구강보건학회지

OBJECTIVES: The purpose of this study was to investigate the relationship between restricted activity due to oral diseases and oral health behaviors among adolescents. METHODS: A cross-sectional study design was used. The subjects were 238 middle school students and 231 high school students; a total of 469 students from 15 different schools located in 7 regions of Bucheon in Gyeonggi Province, Daejeon, and others. The adolescents who participated in the survey were chosen by convenience sampling. The association between restricted activities due to oral diseases and oral health behaviors was analyzed using multiple logistic regression analysis. RESULTS: The annual experience rate of oral diseases stood at 1.4 percent, while the number of days absent and early departures from school was 0.15 days per student. The rate of middle school students who were disturbed by oral disease with respect to sleep, eating, speaking, and/or schoolwork was 33.1 percent. In high school students, it was 40.6 percent. Dental pain and gingival bleeding were identified as major factors to the restriction of activities, and being disturbed while eating was related to cariogenic beverages. CONCLUSIONS: It would be of great social interest to support and promote oral health programs among adolescents. Therefore, a national survey of the status of activity restrictions due to oral diseases in adolescents should be implemented in order to make specific future plans.