Predictive ability of both the healthy aging index and the frailty index for all-cause mortality.

AIM: We aimed to develop and assess a modified healthy aging index (HAI) among Chileans aged 60 years and older and compare its predictive ability for all-cause mortality risk with the frailty index (FI). METHODS: This prospective study analyzed data from the Chilean National Health Survey (CNHS) conducted in 2009-2010. We included 847 adults with complete data to construct the HAI and FI. The HAI comprised five indicators (lung function, systolic blood pressure, fasting glucose, cognitive status, and glomerular filtration rate), while the FI assessed frailty using a 36-item scale. HAI scores were calculated by summing the indicator scores, ranging from 0 to 10, with higher scores indicating poorer health. Receiver operating curves (ROC) and area under the curve (AUC) were used to assess predictive validity. Associations with all-cause mortality were assessed using Cox proportional hazard models adjusted by confounders. RESULTS: The mean HAI score was 4.06, while the FI score was 0.24. The AUC for mortality was higher for the HAI than the FI (0.640, 95% confidence interval (CI) 0.601 to 0.679 vs. 0.586, 95% CI 0.545 to 0.627). After adjusting for confounders, the FI showed a higher mortality risk compared to the HAI (2.63, 95% CI 1.76 to 3.51 vs. 1.16, 95% CI 1.08 to 1.26). CONCLUSION: The FI and HAI were valid predictors for all-cause mortality in the Chilean population. Integrating these indices into research and clinical practice can significantly enhance our capacity to identify at-risk individuals.

Walking to Prevent Fear of Falling Among Community-Dwelling Older Adults: A Scoping Review.

The current review sought to identify and synthesize the evidence on available interventions that include walking and their impact on fear of falling (FOF) among community-dwelling older adults without cognitive impairment. A 10-year search was conducted (January 2012 to January 2022) in two peer-reviewed databases. A total of 116 articles were identified, and 22 articles were reviewed. Most studies included multicomponent walking interventions, such as walking and another type of intervention or exercise. Among the different questionnaires to assess FOF, the Falls Efficacy Scale-International was the most used in 77.3% (n = 17) of studies. In addition to walking, interventions to reduce FOF mainly included balance training, lower extremity strengthening, cardio or aerobic exercises, or a combination of these exercises. Further research is needed to evaluate the impact of unidimensional walking interventions, as well as those that incorporate psychological and technological elements targeted to FOF prevention and management. [Journal of Gerontological Nursing, 50(1), 15-21.].

Factors Related to the Need for Informal Care Among Community-Dwelling Older Adults in Chile.

PURPOSE: To identify factors contributing to the need for informal care among community-dwelling older adults with functional impairment in Chile. METHOD: A secondary data analysis was conducted using cross-sectional data from 540 Chilean older adults aged ≥60 years (mean age = 72.2 years, SD = 6.22 years). RESULTS: Informal care need was reported by 24.3% (n = 131) of participants. Among the variables that most influenced the need for informal care among older adults were hospitalization in the past 1 year, functionality, comorbidities, and multidimensional frailty (all p < 0.05). CONCLUSION: This study identified factors that clinicians and nurses should be aware of when caring for this population to prevent or manage the need for informal care. [Journal of Gerontological Nursing, 50(2), 43-52.].

Internet use by informal caregivers in Chile: An analysis including age and gender perspectives.

OBJECTIVES: This study explored the relationship between Internet use and informal caregivers' characteristics. METHODS: We used the Chilean Sociodemographic Characterization Survey. A total of 86,172 informal caregivers were identified. We conducted a weighted χ2 to test differences in 10 types of Internet use and weighted logistic regressions with caregivers' characteristics as predictors of Internet use. RESULTS: Younger caregivers engaged in more types of use than the older ones. Education level was positively associated with all types of use, such as searching for information (OR = 3.52, CI 95% [2.34, 5.29]). Age was negatively related to Internet use. Women used the Internet more to communicate via social networks. Being single reduced the likelihood of performing certain types of use, such as information seeking. The number of people living in households has increased entertainment. CONCLUSIONS: Older caregivers with lower education levels are at greater risk of digital exclusion. The same occurred in some types of use with single caregivers, where fewer people lived in the household. CLINICAL IMPLICATIONS: The Internet can be a tool for coping with caregiving tasks and their negative consequences. Interventions should consider these characteristics when promoting online tools and performing online interventions to reach the broadest possible audience.

Soledad y fragilidad en personas mayores que viven en comunidad: Una revisión integrativa / Loneliness and frailty in community-dwelling older adults: An integrative review

CONTEXTO: Se proyecta un aumento del 6% en la población mundial de personas mayores para el 2050, generando desafíos sociales significativos, especialmente el crecimiento de la soledad en la vejez. Este fenómeno está estrechamente vinculado a problemas de salud notables, incluido el síndrome de fragilidad. OBJETIVO: Esta revisión de literatura tiene como objetivo proporcionar una comprensión actualizada de la relación entre fragilidad y soledad en adultos mayores que residen en la comunidad. METODOLOGÍA: Utilizando una revisión integradora, se recopilaron sistemáticamente artículos originales de las bases de datos de PubMed, Web of Science y CINAHL. RESULTADOS: Una revisión de 475 artículos publicados entre 2018 y 2022 identificó 17 estudios que cumplían con los criterios de inclusión y exclusión especificados. CONCLUSIÓN: Los hallazgos revelan sólida evidencia científica que respalda una asociación sustancial entre la soledad y la fragilidad en adultos mayores que viven en la comunidad. A pesar de la consistencia en la evidencia, persisten variaciones en los enfoques conceptuales y las metodologías de medición en los estudios revisados.

CONTEXT: The global elderly population is projected to increase 6% by 2050, posing significant social challenges, particularly the escalating prevalence of loneliness in old age. This phenomenon is closely linked to notable health issues, including the frailty syndrome. OBJECTIVE: This literature review aims to provide an updated understanding of the relationship between frailty and loneliness among older adults residing in the community. Methodology: Employing an integrative review, original articles were systematically gathered from PubMed, Web of Science, and CINAHL databases. RESULTS: A review of 475 articles published between 2018 and 2022 identified 17 studies meeting specified inclusion and exclusion criteria. CONCLUSION: Findings reveal robust scientific evidence supporting a substantial association between loneliness and frailty among older adults in community settings. Despite consistent evidence, variations persist in conceptual approaches and measurement methodologies across reviewed studies.

Cuidados domiciliarios para personas mayores dependientes: Una revisión de alcance / Home care for dependent older people: A scoping review

INTRODUCCIÓN: Existe escasa evidencia que indague en los aspectos psicosociales del cuidado, considerando la perspectiva de quienes cuidan a personas mayores (PM) dependientes para diseñar intervenciones idóneas para los cuidadores informales y las PM. OBJETIVO: Sintetizar la evidencia disponible en torno a los cuidados domiciliarios disponibles para PM dependientes con un fuerte énfasis en los cuidadores informales. MATERIALES Y MÉTODOS: Se realizó una búsqueda de artículos publicados en los últimos 10 años (enero 2012 hasta enero 2022) en dos bases de datos revisadas por pares. Se identificaron un total de 116 artículos y 42 artículos fueron revisados. RESULTADOS: Los resultados identificados fueron agrupados en: (1) factores que influyen en la sobrecarga o calidad de vida del cuidador, (2) necesidades de cuidado en la diada, (3) intervenciones o recomendaciones de cuidados para la diada, (4) uso de redes de apoyo al cuidado (informal y formal). CONCLUSIONES: Las implicancias para la práctica clínica de esta revisión implican profundizar en las necesidades sentidas de los cuidadores y conexión con la red de estatal y territorial. Lo anterior impacta directamente en los factores que influyen en la percepción de sobrecarga del cuidador, así como también en su calidad de vida. Investigar el rol del cuidador a través de la generación de evidencia robusta es aún una tarea pendiente.

INTRODUCTION: There is little evidence that investigates the psychosocial aspects of care, considering the perspective of those who care for dependent older people (OP) to design suitable interventions for informal caregivers and OP. OBJECTIVE: To synthesize the available evidence around home care available for dependent older people with a strong emphasis on informal caregivers. MATERIALS AND METHODS: A search of articles published in the last 10 years (January 2012 to January 2022) was conducted in two peer-reviewed databases. A total of 116 articles were identified and 42 articles were reviewed. RESULTS: The identified results were grouped into: (1) factors that influence the burden or quality of life of the caregiver, (2) care needs in the dyad, (3) interventions or recommendations for care for the dyad, (4) use of care support networks (informal and formal). CONCLUSIONS: The implications for clinical practice of this review involve delving into the felt needs of caregivers and connection with the state and territorial network. This directly impacts the factors that influence the caregiver's perception of overload, as well as her quality of life. Investigating the role of the caregiver through the generation of robust evidence is still a pending task.

Acceptability of HPV Vaccines: A Qualitative Systematic Review and Meta-Summary.

In 2006, the human papillomavirus (HPV) vaccine was approved for use as an effective intervention for reducing the risk of developing cervical cancer; however, its successful implementation is dependent on acceptability. This study aims to provide a comprehensive understanding of the reasons that favor or do not favor the acceptability of HPV vaccines. METHODS: We conducted a systematic review and meta-summary of qualitative research on 16 databases. A total of 32 articles that considered the perspectives of vaccine users, their parents, and the professionals who care for them were reviewed. Synthesis was conducted as described by Sandelowski and Barroso. RESULTS: We used inductive and deductive methods to obtain a total of 22 dimensions, out of which three issues stood out that should be considered to improve acceptability and are formed by three groups of study, namely, information about the vaccine, fears and side effects, and sexuality associated with the vaccine. CONCLUSIONS: Acceptability, as well as adherence to HPV vaccination, is a complex concept. This review highlights the perspectives of the three sets of actors involved in the process (i.e., users, parents, and professionals) and views these factors in relation to acceptability as a guide for new interventions.

Providing Care During the COVID-19 Pandemic: The Experience of Formal Caregivers in Long-Term Care Facilities in Chile.

The current study aimed to identify the main challenges to formal caregivers from different long-term care facilities (LTCFs) that care for older adults (aged ≥60 years) in Chile during the coronavirus disease 2019 pandemic. Chile's national LTCF governing body (SENAMA) sent a survey to 1,190 LTCFs, receiving 996 responses. LTCF characteristics were number of residents, certification with SENAMA, licensure, geographic zone, and poverty level. Four dimensions were assessed: (a) concerns, (b) challenges, (c) needs, and (d) opportunities for improvement. The majority of respondents replied negatively to these four dimensions. Among those who responded positively, the fear of infecting a loved one, staff shortages and overwork, the need for access to psychological support, and improving payments were among formal caregivers' primary concerns. Targeting supportive interventions for formal caregivers, clinically and psychologically, is essential to preserve caregivers' health. [Journal of Gerontological Nursing, 49(5), 39-44.].

Factors Related to Multidimensional Frailty Among Hispanic People Living With HIV Aged 50 Years and Above: A Cross-sectional Study.

ABSTRACT: Among Hispanics, frailty has been extensively studied as a physical syndrome associated with an increased risk for adverse outcomes. Because of additional barriers to accessing care, the impact of frailty may be even more significant for people living with HIV (PLWH). Multidimensional frailty among Hispanic PLWH has not been studied. This study aimed to examine the factors related to multidimensional frailty among Hispanic PLWH aged 50 years and above. A cross-sectional design with 120 participants was used. Hypothesized factors related to multidimensional frailty were sociodemographic and psychosocial variables. Multidimensional frailty was measured with the Tilburg Frailty Indicator. We found that 45.83% of the participants were frail ( n = 55), and multidimensional frailty was significantly associated with higher depressive symptoms ( b = .26, p < .001) and a higher number of comorbidities ( b = .71, p < .001). This study identified factors that clinicians should be aware of when caring for Hispanic PLWH to prevent or manage frailty-related complications.

Desafíos éticos en la investigación en cuidados con comunidades rurales / Ethical challenges in care research with rural communities

Introducción: Los contextos rurales presentan desafíos significativos en la investigación en cuidados debido a su diversidad y visiones culturales únicas, lo que requiere una sólida formación ética. Objetivo: Sintetizar recomendaciones éticas para la investigación en cuidados en comunidades rurales, basándose en experiencias publicadas entre 2000 y 2023. Metodología: Se llevó a cabo una revisión integrativa de artículos originales indexados en cuatro bases de datos. Resultados: Fueron seleccionados 26 artículos, cuyas recomendaciones éticas se sintetizaron siguiendo los criterios de Emanuel. Discusión: La ética en la investigación en cuidados en contextos rurales promueve el diálogo colaborativo y el respeto mutuo. Los desafíos surgen de las diferencias culturales, percepciones negativas y dinámicas de poder. Se sugiere la implementación de enfoques participativos, aunque enfrentan dificultades en términos de tiempo, costos y manejo de poder. Los investigadores deben ser sensibles a las normas culturales y respetar el contexto de las comunidades rurales.(AU)

Introduction: Rural contexts present significant challenges in care research due to their unique cultural diversity and perspectives, demanding a strong ethical foundation. Objective: To synthesize ethical recommendations for care research in rural communities based on experiences published between 2000 and 2023. Methodology: An integrative review of original articles indexed in four databases. Results: 26 articles were selected, and their ethical recommendations were synthesized following Emanuel's criteria. Discussion: Ethical considerations in care research in rural settings promote collaborative dialogue and mutual respect. Challenges arise from cultural differences, negative perceptions, and power dynamics. Implementing participatory approaches is suggested, though it faces difficulties in terms of time, costs, and power management. Researchers should be sensitive to cultural norms and respect the context of rural communities.(AU)

Diferencias entre mujeres menores y mayores de 75 años relacionadas con fragilidad multidimensional y calidad de vida / Differences between women younger and older than 75 years related to multidimensional frailty and quality of life

Objetivo: Analizar la diferencia entre mujeres menores y mayores de 75 años en relación con la fragilidad multidimensional y la calidad de vida, controlando por variables determinantes del curso de la vida, aspectos de salud, valoración geriátrica integral y comorbilidad. Metodología: Estudio descriptivo, analítico y transversal en 356 mujeres mayores que se atienden en los centros de salud familiar de las comunas de la Pintana y Puente Alto en Santiago de Chile. La recolección de datos se llevó a cabo por los asistentes de investigación capacitados previamente. Se recolectaron los siguientes datos: determinantes del curso de la vida, aspectos de salud, valoración geriátrica integral, comorbilidad, fragilidad multidimensional y calidad de vida. El análisis de datos fue descriptivo, correlacional y de regresión lineal. Resultados: Ser mayor de 75 años implica que a un intervalo de confianza del 95% se tiene una calidad de vida de 17,09 puntos más alta con relación a las mujeres adultas menores de 75 años. Conclusiones: La fragilidad multidimensional, en lo físico, incide en las mujeres menores de 75 años en sentirse físicamente saludables, mientras que lo social influye en las mujeres mayores de 75 años y la psicológica en ambos grupos. Por otra parte, la calidad de vida incide de manera positiva en las mujeres mayores de 75 años (AU)

Objective: To analyze the difference between women under and over 75 years of age, in relation to multidimensional frailty and quality of life, controlling for variables determining the life course, health aspects, comprehensive geriatric assessment and comorbidity. Methodology: Descriptive, analytical and cross-sectional study in 356 elderly women treated at the family health centers of the Pintana and Puente Alto communes in Santiago de Chile. Data collection was performed by previously trained research assistants. The following data were collected: life course determinants, health aspects, comprehensive geriatric assessment, comorbidity, multidimensional frailty, and quality of life. The data analysis was descriptive, correlational and linear regression. Results: Being over 75 years of age implies that, at 95% confidence, there is a quality of life 17.09 points higher in relation to adult women under 75 years of age. Conclusions: The multidimensional fragility, physically, affects women under 75 years of age in feeling physically healthy, while the social influences women over 75 years of age and the psychological in both groups. On the other hand, the quality of life has a positive impact on women over 75 years of age (AU)

Evaluación del modelo de calidad de Donabedian en base a los criterios de Chinn y Kramer / Evaluation of the Donabedian quality model based on the Chinn and Kramer criteria

INTRODUCCIÓN: La evaluación de teorías es un proceso crucial para el desarrollo del conocimiento enfermero, permite seleccionar y utilizar la teoría en función de los problemas y fenómenos del cuidado, sin embargo, es escasamente realizada, especialmente en teorías de otras disciplinas. OBJETIVO: Analizar críticamente el modelo de calidad de la atención de salud de Donabedian, a través de la propuesta metodológica de Chinn y Kramer. DESARROLLO: Se realizó un estudio descriptivo-reflexivo del componente teórico y conceptual del modelo de Donabedian, se explica el propósito, conceptos, relaciones, estructura y supuestos. Se continua con la evaluación crítica del modelo, analizada bajo los criterios de claridad, sencillez, generalidad, accesibilidad e importancia, a través de una revisión narrativa de la literatura. CONCLUSIÓN: el modelo es útil para la gestión, los procesos de mejora, evaluación de estrategias y programas. Con valor para enfermería, puesto que coinciden en el significado e importancia otorgada a la calidad de la atención, reconociendo su contribución en la implementación, desarrollo de intervenciones y mejoramiento de la salud.

NTRODUCTION: The evaluation of theories is a crucial process for the development of nursing knowledge, as it allows the selection and use of such theories to address the problems of patient care. However, it is scarcely performed, especially with theoriesfrom disciplines other than nursing. OBJECTIVE: To critically analyze the Donabedian model of health care quality, through the methodological approach of Chinn and Kramer (1999). METHODOLOGY: A descriptive-reflexive study of the theoretical and conceptualcomponent of the Donabedian model was carried out, explaining its purpose, concepts, relationships, structure, and assumptions. A critical evaluation of the model was then conducted, using the criteria of clarity, simplicity, generality, accessibility, and importance, through a narrative review of the literature. CONCLUSIONS: The model is useful for management, improvement processes, and the evaluation of strategies and programs. It is especially valuable for nursing, since it coincides with the meaning and importance given to the quality of nursing care, recognizing its contribution in the development and implementation of interventions and improvement of health.

Beneficios y barreras para hacer ejercicio percibidas por personas mayores que viven con el VIH / Benefits and barriers to do exercise perceived by older people living with HIV

Objetivos: Conocer los beneficios percibidos y las barreras pararealizar actividad física que refieren las personas mayores que vivencon el VIH. Metodología: Estudio cualitativo exploratorio. Serealizó entrevista en profundidad a 30 personas mayores de 50 años,atendidos en un policlínico de especialidad de un hospital público delsector suroriente, Santiago, Chile. Se realizó un análisis de contenidocualitativo inductivo según la metodología descrita por Krippendorff.Para asegurar la validez de los hallazgos, se utilizaron los criterios deGuba y Lincoln. Se contó con la aprobación del Comité de Ética delServicio de Salud Sur Oriente de la Región Metropolitana. Resultados:En relación con los beneficios percibidos de realizar actividad física,se identificaron las siguientes subcategorías: reactivarse, socializar enpareja o con otros y sentirse mejor. Con respecto a las barreras parahacer ejercicios se encontraron: cansancio, mi propia enfermedad(VIH) y opción personal de no hacer ejercicio. Conclusiones: Losresultados de este estudio permiten orientar al equipo de salud quetrabaja con personas mayores que viven con VIH para aconsejarpromover la actividad física en este grupo etario. (AU)

Introduction. There is few scientific evidence about the benefits andbarriers experienced by older people living with HIV (OPLWHIV) toperform physical activity. Objective: To know the perceived benefitsand the barriers that the PMVIH refer to perform physical activity.Methodology: Qualitative exploratory study. An in-depth interviewwas carried out with 30 people of 50 years of age, treated in a specialtypolyclinic of a public hospital in the southeastern sector, Santiago,Chile. An analysis of qualitative inductive content was performedaccording to the methodology described by Krippendorff. To ensurethe validity of the findings, the Guba and Lincoln Criteria were used.This protocol was approved by the Ethics Committee of the SouthEast Health Service of the Metropolitan Region. Results: In relation tothe perceived benefits of physical activity, the following subcategorieswere identified: Reactivate, socialize with a partner or with others, andfeel better. Regarding the barriers to exercise were found: Tiredness,my own illness (HIV) and personal choice not to exercise. Discussion:The results of this study allow HIV providers to guide the counselingin order to promote physical activity in this age group (AU)

Evaluación de la calidad de vida de personas mayores participantes de un centro diurno / Evaluation of quality of life of older people participating in an adult day care center

Objetivos: Evaluar los cambios en la calidad de vida de un grupo de personas mayores participantes de un centro de adultos mayores en Santiago, Chile. Metodología: Estudio longitudinal prospectivo con 2 aplicaciones, una al ingreso y otra al término de la participación en un centro de adultos mayores con 35 personas mayores de 60 años. La calidad de vida se midió con el instrumento de la Organización Mundial de la Salud en su versión abreviada. Para el análisis de los datos se utilizaron estadísticas descriptivas y el test de la t de Student. Resultados: Al alta, la calidad de vida mostró un aumento significativo (p < 0,05), es decir, las personas mayores reportan mejores puntuaciones de calidad de vida después de haber participado en las intervenciones que tiene el centro de adultos mayores. Conclusiones: La calidad de vida se debe considerar una medida clave para evaluar los resultados de las intervenciones realizadas en los centros de adultos mayores (AU)

Objectives: To examine the changes in the quality of life of a group of older people participating in an adult day care center in Santiago, Chile. Methodology: Longitudinal study with two applications, one at admission and the other at the end of participation in the adult day care center, among 35 older people over 60 years belonging to the adult day care centers in Santiago, Chile. Quality of life was measured with the World Health Organization BREF instrument. Descriptive and analytical statistics were used for data analysis (t Student test). Results: This study showed a significant increase in quality of life (p < 0.05); older people reported better scores for quality of life after having participated in the interventions that the adult day care center has. Conclusions: Quality of life should be considered a key outcome when evaluating the results of interventions in adult day care center (AU)

Correlación entre miedo a caer y factores sociodemográficos, biomédicos y de la valoración geriátrica integral de las personas mayores que viven en la comunidad / Correlation between worry about falling and sociodemographic, biomedical factors and the comprehensive geriatric assessment of a group of older people living in the community

ntroducción: El miedo a las caídas se presenta en el 30% de las personas mayores sin historia de caída previa, porcentaje que se duplica en aquellos que han tenido antecedentes de caída, con mayor prevalencia en personas mayores de edad más avanzada, lo que genera consecuencias negativas como pérdida de autonomía y aislamiento. Objetivo: Analizar la correlación entre el miedo a caer y los factores sociodemográficos, biomédicos y de la valoración geriátrica integral de un grupo de personas mayores que viven en la comunidad. Metodología: Estudio descriptivo, analítico, realizado en 113 personas mayores de 60 años que asistieron a control médico ambulatorio. Se midieron las siguientes variables: demográficas, biomédicas, funcionales, estado cognitivo y estado afectivo. El miedo a caer se midió mediante la versión acortada Short Scale International. Para estos análisis se usó estadística descriptiva y análisis bivariado, medidas de correlación de Pearson y Spearman, y se consideró una significación ≤ 0,05. Esta investigación contó con la aprobación del comité de ética. Resultados: La mayoría de las personas mayores presentó un grado moderado de miedo a caer. El miedo a caer tuvo una correlación negativa entre nivel educacional, índice de Barthel y escala de depresión geriátrica de Yesavage, y una correlación positiva con satisfacción con su vida y autopercepción de salud. Conclusiones: Nivel educacional, funcionalidad, ánimo, satisfacción con la vida y autopercepción de salud fueron las variables correlacionadas con el miedo a caer que tienen las personas mayores que viven en la comunidad. Es importante reconocer este fenómeno a nivel de la atención primaria de salud y la forma de abordarlo oportunamente para incentivar el envejecimiento positivo (AU)

Introduction: Concern about falling occurs in 30% of older people with no history of previous fall, a percentage that doubles in those who have had a history of falling, with a higher prevalence in older people of older age, generating negative consequences such as loss of autonomy and isolation. Objective: To analyze the correlation between worry about falling and sociodemographic, biomedical factors and the comprehensive geriatric assessment of a group of older people living in the community. Methodology: Descriptive, analytical study carried out on 113 people over 60 years of age who attended an outpatient medical check-up. The following variables were measured: demographic, biomedical, functional, cognitive and affective status. Concern about falling was measured by the shortened version Short Scale International. For these analyzes, descriptive statistics and bivariate analysis were used, Pearson and Spearman correlation measures considering a significance ≤ 0.05. This investigation had the approval of the ethics committee. Results:Most of the PM presented a moderate degree of concern about falling. Concern about falling had a negative correlation between educational level, Barthel index, Yesavage geriatric depression scale; and a positive correlation with satisfaction with her life and self perception of health. Conclusions: Educational level, functionality, encouragement, life satisfaction and self-perception of health were the variables correlated with the concern to fall that have the PM that live in the community. It is important to recognize this phenomenon at the level of primary health care in a timely manner to encourage positive aging (AU)

[The significance of menopause for Chilean women attending primary health care centers]. / El significado de la menopausia para un grupo de mujeres chilenas atendidas en el sistema público de salud.

BACKGROUND: Menopause connects a biological event with social representations related to aging Aim: To assess the meaning of menopause in a group of Chilean women attending primary health care. MATERIAL AND METHODS: Secondary analysis of a descriptive qualitative study of in-depth interviews to explore the meaning of menopause in fifteen women aged 55 to 71 years who experienced menopause between 2 and 29 years before. Data were collected using the method proposed by the Grounded Theory. Guba's criteria of scientific rigor were used. RESULTS: Relational analysis shows that menopause divides the life cycle of women into two stages related with the possibility of having children, which is heavily influenced by the cultural significance of menopause. CONCLUSIONS: Women perceive that menopause is a natural stage and that it is the end of a period focused on tasks related to reproduction and motherhood. However, that "normality" includes a suffering process, loaded with negative cultural beliefs about menopause passed down for generations.

El significado de la menopausia para un grupo de mujeres chilenas atendidas en el sistema público de salud / The significance of menopause for Chilean women attending primary health care centers

BACKGROUND: Menopause connects a biological event with social representations related to aging AIM: To assess the meaning of menopause in a group of Chilean women attending primary health care. MATERIALS AND METHODS: Secondary analysis of a descriptive qualitative study of in-depth interviews to explore the meaning of menopause in fifteen women aged 55 to 71 years who experienced menopause between 2 and 29 years before. Data were collected using the method proposed by the Grounded Theory. Guba's criteria of scientific rigor were used. RESULTS: Relational analysis shows that menopause divides the life cycle of women into two stages related with the possibility of having children, which is heavily influenced by the cultural significance of menopause. CONCLUSIONS: Women perceive that menopause is a natural stage and that it is the end of a period focused on tasks related to reproduction and motherhood. However, that "normality" includes a suffering process, loaded with negative cultural beliefs about menopause passed down for generations.

[Educational needs of parents of hemophiliac children: An approach to comprehensive care]. / Necesidades educativas de padres de niños hemofílicos: Una aproximación hacia el cuidado integral.

INTRODUCTION: In Chile, hemophilia was incorporated into the System of Explicit Health Guarantees (GES), which ensures access to treatment and financial protection for these patients. To support patients and their families, educational programs have been proposed that focus on managing possible complications of the pathology, first aid, and prophylaxis, however, there are no educational instances focused on the needs of the patients. OBJECTIVE: To know the educational needs of parents with hemophilic chil dren and adolescents regarding contents, people, place, methodology, and stage of the illness. Sub jects and Method: Descriptive qualitative study of 15 parents with hemophilic children in outpatient care. For the data collection, we used a semi-structured interview with five open questions, aimed at the search for educational needs such as what (contents), how (methodology), when (moment), who (person), and where (place) is education needed. For data analysis, were used the Berelson's content analysis technique. To guarantee the scientific validity of the qualitative results, the methodological rigor criteria of Guba and Lincoln were used. RESULTS: The most frequent educational needs reported by parents include content such as venipuncture training, injury prevention, pathophysiological as pects of the disease, among others; with methodology developed in group workshops and guided by a peer; in a comfortable and familiar place; in three stages of the disease's development (diagnosis, blee ding events, and development of autonomous activities), and provided by professionals and peers. CONCLUSION: Knowledge of educational needs is the basis for the creation of an educational program that guides the comprehensive care of hemophilic children and their parents.

Influencia de la comorbilidad y la fragilidad en la calidad de vida de las mujeres con edad igual o mayor a 65 años / Influence of comorbidity and frailty in the quality of life of women aged 65 years or older

Objetivo: describir la influencia de la comorbilidad y la fragilidad en la calidad de vida de mujeres con edad igual o mayor a 65 años.Método: se realizó una revisión narrativa. Se llevaron a cabo búsquedas bibliográficas en las bases de datos CINAHL y PubMed desde enero de 2010 hasta noviembre de 2020. Se emplearon las palabras claves “frail elderly”, “comorbidity” y “quality of life”. En PubMed se hizo la combinación (“Frail Elderly”[Mesh] AND “Comorbidity”[Mesh]) AND “Quality of Life”[Mesh]. EnCINAHL se aplicaron los descriptores “quality of life” and “comorbidity” and “frail elderly”. Filtros: idioma inglés y español; mujeres, principalmente; mayores de 64 años; temática de estudio.Resultados: se encontraron 116 artículos de CINAHL y 80 artículos de PubMed, de los cuales se seleccionaron 37, que enfatizan la fragilidad y la comorbilidad como incidencia en la calidad de vida. La fragilidad es multidimensional y puede ser detectada mediante la evaluación geriátrica integral. La fragilidad afecta a la calidad de vida por lo que es necesario potenciar dicha calidad de vida, mediante la prevención y tratamientos oportunos. A menor comorbilidad mayor calidad de vida. La fragilidad y la comorbilidad en mujeres de edad avanzada son predictores que se asocian con mayor riesgo de muerte.Discusión: la calidad de vida está influenciada por la comorbilidad y la fragilidad. Las mujeres de 65 años o mayores son población que necesita mayor atención, cuidados, recursos sanitarios y sociales, factores que son imprescindibles para llevar una buena calidad de vida a un coste razonable.(AU)

Objective: to describe the influence of comorbidity and frailty in the quality of life of women aged 65 years or older.Method: a narrative review was conducted. Bibliographic search was conducted in the CINAHL and PubMed databases from January, 2010 until November, 2020. The key words used were: “frail elderly”, “comorbidity” and “quality of life”. The combination (“Frail Elderly”[Mesh] AND “Comorbidity”[Mesh]) AND “Quality of Life”[Mesh] was used at PubMed. The key words “quality of life” and “comorbidity” and “frail elderly” were used at CINAHL”. Criteria: English and Spanish languages; women, primarily; >64-year-old; subject of the study.Results: in total, 116 articles were found in CINAHL and 80 articles in PubMed; 37 were selected out of these, highlighting frailty and comorbidity as an incidence in quality of life. Frailty is multidimensional, and can be detected through comprehensive geriatric evaluation. Frailty has impact on quality of life; therefore, it is necessary to enhance the quality of life through prevention and adequate treatments. The lower the comorbidity, the higher the quality of life. Frailty and comorbidity in women of advanced age are predictors associated with higher risk of death.Discussion: comorbidity and frailty have impact on quality of life. Women aged 65 years or older are a population requiring higher care, and more healthcare and social resources; these factors are essential to lead a good quality of life at a reasonable cost.(AU)

Fear of Falling among Community-dwelling Sedentary and Active Older People.

OBJECTIVES: The study sought to compare community-dwelling older people with respect to their level of physical activity and to the fear of falls between a group of sedentary elderly and a group of active elderly. METHODS: Cross-sectional descriptive study carried out with 113 community-dwelling older people (45 sedentary and 48 active), users of an outpatient care center of the private health system with a geriatric program in Santiago, Chile. The study measured socio-demographic variables, state of health, comprehensive geriatric assessment, exercise, depression with the Yesavage scale, and fear of falling with the Short Falls Efficacy Scale - International (Short FES-I). RESULTS: Sedentary older people have significantly higher scores in the Yesavage depression scale compared with active older people (4.2 versus 0.8). No statistically significant differences were found when comparing both groups of sedentary and active participants in terms of socio-demographic variables along with health, and functional and cognitive capacity. Regarding the fear of falling, the sedentary had a slightly higher score than the active (12 versus 11), although not significant. CONCLUSIONS: This study showed that fear of falling was equal in sedentary and active older people who live in the community, although it was found that sedentary individuals had a higher risk of having a positive screening for geriatric depression in those participants who do not perform physical activity.