ABSTRACT
La disfagia es un síndrome geriátrico por su alta prevalencia en ancianos (mayor en la población institucionalizada) que favorece la desnutrición y compromete la seguridad, debido al riesgo de aspiración de alimentos. Objetivos: Conocer el estado nutricional de los ancianos institucionalizados que presentan disfagia, residentes en instituciones sociosanitarias de carácter público de la provincia de Toledo. Metodología: Estudio descriptivo y transversal (enero-febrero 2015). Población de estudio: personas de 65 años o más, residentes en instituciones sociosanitarias públicas de Toledo con disfagia. Criterios de exclusión: nutrición enteral o parenteral y situación terminal. Variables: edad, sexo, valoración antropométrica, dieta, restricciones dietéticas, suplemento nutricional y estado nutricional con Mini Nutritional Assessment (MNA). Resultados: Un total de 33 ancianos. Media de edad: 86,73 años (DT 7,74). Mujeres: 84,84%. MNA medio: 13,85 (DT = 3,5), riesgo de desnutrición: 18,18% y desnutrición: 78,78%. IMC: bajo peso 36,36%. Un 51,51% no sabe si ha perdido peso, un 96,97% con deterioro cognitivo, un 81,82% toma 4 fármacos o más, un 39,4% toma menos de 3 comidas diarias completas, un 27,27% toma frutas o verduras menos de 2 veces al día, un 78,79% menos de 6 vasos de líquidos al día. Un 90,9% solo movilidad cama-sillón y un 78,79% necesita ayuda para alimentarse. Dieta túrmix: 90,9%, sin restricciones dietéticas: 84,84%. Sin suplementos nutricionales: 75,75%. Diferencias estadísticamente significativas: MNA-independencia en movilidad (p = 0,008), MNA-problemas neuropsicológicos (p = 0,01), MNA-independencia en alimentación (p = 0,001) y MNA-suplementos nutricionales (p = 0,028). MNA-polimedicación: tendencia a sufrir desnutrición (p = 0,903). Conclusiones: En la valoración nutricional de la población mayor institucionalizada con disfagia se concluye la existencia de una gran proporción de ancianos con un estado nutricional deficitario, asociada a demencia y mayor dependencia en movilidad y alimentación
Dysphagia is a geriatric syndrome due to its high prevalence in the elderly (higher in the institutionalized population) favoring malnutrition and compromising safety because of choking risk by food intake. Objective: To know the nutritional status of institutionalized elderly people with dysphagia, residents in public nursing homes of Toledo. Methodology: Descriptive and transversal study (January February 2015). Sample: people aged ≥ 65 years with dysphagia from Toledo, residents in public nursing homes. Exclusion criteria: enteral-parenteral nutrition and terminal illness. Variables: age, gender, anthropometric assessment, diet, dietary restrictions, nutritional supplement and nutritional status with Mini Nutritional Assessment (MNA). Results: 33 adults, aged: 86.73 years (SD 7.74). 84.84% women. MNA (average): 13.85 (SD = 3.5), risk of malnutrition: 18.18%, malnutrition: 78.78%. BMI: underweight 36.36%. 51.51% do not know if he/she has lost weight, 96.97% dementia, 81.82% ≥4 drugs, 39.4% < 3 full meals daily, 27,27% fruits or vegetables < 2 times daily, 78.79% 6 glasses daily. 90.9% mobility bed to chair and 78.79% help to feed. Turmix diet: 90.9%, without dietary restrictions: 84.84%. No nutritional supplements: 75.75%. Statistically significant differences: MNA-independent to mobilize (p=0.008), MNA-dementia (p=0.01), MNA independent to feed (p=0.001), MNA-nutritional supplements (p=0.028). MNA-polypharmacy: tend to malnutrition (p=0.903). Conclusions: In the nutritional assessment of institutionalized elderly population with dysphagia is concluded that the existence of a large proportion of elderly patients with a deficient nutritional status, associated with dementia and increased reliance on mobility and feed
Subject(s)
Humans , Aged , Aged, 80 and over , Nutritional Status , Elderly Nutrition , Nutrition Disorders/epidemiology , Malnutrition/epidemiology , Deglutition Disorders/complications , Health of Institutionalized Elderly , Nutrition Assessment , Frail Elderly/statistics & numerical data , Dementia/epidemiology , Cross-Sectional StudiesABSTRACT
Objetivo. Valorar cambios en la presión arterial (PA) de los profesionales de Atención Primaria (AP) durante la realización de Atención Continuada (AC) y su relación con el rol profesional, nivel de ansiedad y apoyo social. Método. Estudio descriptivo, transversal, multicéntrico y prospectivo. Población: sanitarios de AP del Área de Salud de Toledo que realicen AC. Criterios de exclusión: hipertensión arterial diagnosticada, raza negra, enfermedad cardiovascular o tratamientos crónicos. Muestreo voluntario. Variables: sociodemográficas; laborales; cuestionario STAI (ansiedad estado/rasgo); cuestionario ISTAS21 (riesgos psicosociales laborales), y monitorización ambulatoria de la PA con holter durante 2 jornadas de 24h: una de AC y otra de descanso laboral no saliente de guardia. Resultados. El MAPA mostró diferencias significativas en la PA sistólica diurna: descanso 115,9±8,3mmHg/guardia 120,2±8,1 (t=4,319; p<0,001); diastólica diurna: descanso 73,3±5,9mmHg/guardia 77,9±6,1 (t=6,555; p<0,001); sistólica nocturna: descanso 106,8±8,3mmHg/guardia 111,6±9,5 (t=3,4; p<0,001); diastólica nocturna: descanso 65,1±5,6mmHg/guardia 69,1±6,9 (t=4,14; p<0,001). No encontramos relación entre las variaciones en la PA, la categoría o el rol. Las dimensiones del ISTAS (situación desfavorable-intermedia para la salud) y el nivel de ansiedad (media de 5/10 durante la guardia) tampoco se relacionaban con la PA. Conclusiones. Existen cambios significativos en la PA de los profesionales durante la realización de guardias, independientemente del rol profesional, nivel de ansiedad o riesgo psicosocial. Demostrada la variación de la PA durante la AC, será necesario realizar estudios para valorar su repercusión en la salud (AU)
Objective. To assess blood pressure (BP) in Primary Care (PC) professionals while working extra shifts and its relationship with the professional role, anxiety level and social support. Method. Descriptive, cross-sectional, multicentre and prospective study. Population: PC health workers from Toledo Health Area who work on-call shifts. Exclusion criteria: diagnosed hypertension, African origin, cardiovascular disease or chronic treatment. Voluntary sampling. Variables: sociodemographic, occupational and STAI questionnaire (anxiety state/feature); ISTAS21 questionnaire (psychosocial risks at work), and Ambulatory BP Monitoring with a Holter for two days, 48h: one of them during the shift and the other one during a day without being on-call. Results. The BP monitor showed significant differences in daytime systolic BP: rest day115.9±8,3mmHg/ Shift mean: 120.2±8,1 (t=4.319; P<0.001); daytime diastolic: rest day 73.3±5.9mmHg/Shift 77.9±6.1 (t=6.555; P<0.001); night systolic: rest day 106.8±8.3mmHg/shift 111.6±9.5 (t=3.4; P<0.001); night diastolic: rest day 65.1±5.6mmHg/Shift 69.1±6.9 (t=4.14; P<0.0001). We found no relationship between variations in the BP, the category or role. The ISTAS dimensions (health situation status) and the anxiety level (average of 5/10 during the shift) are not related with the BP either. Conclusions. There are significant changes in the BP of the professional during the extra shifts, independently of professional role, anxiety level or psychosocial risk. Studies need to be conducted on the demonstrated variation in BP working extra shifts to assess its impact on health (AU)
Subject(s)
Humans , Male , Female , Adult , Blood Pressure , Health Personnel , Cardiovascular Diseases/epidemiology , Occupational Diseases/epidemiology , Anxiety/epidemiology , Cross-Sectional Studies , Prospective Studies , Risk FactorsABSTRACT
OBJECTIVE: To assess blood pressure (BP) in Primary Care (PC) professionals while working extra shifts and its relationship with the professional role, anxiety level and social support. METHOD: Descriptive,, cross-sectional, multicentre and prospective study. POPULATION: PC health workers from Toledo Health Area who work on-call shifts. EXCLUSION CRITERIA: diagnosed hypertension, African origin, cardiovascular disease or chronic treatment. Voluntary sampling. VARIABLES: sociodemographic, occupational and STAI questionnaire (anxiety state/feature); ISTAS21 questionnaire (psychosocial risks at work), and Ambulatory BP Monitoring with a Holter for two days, 48h: one of them during the shift and the other one during a day without being on-call. RESULTS: The BP monitor showed significant differences in daytime systolic BP: rest day115.9±8,3mmHg/ Shift mean: 120.2±8,1 (t=4.319; P<0.001); daytime diastolic: rest day 73.3±5.9mmHg/Shift 77.9±6.1 (t=6.555; P<0.001); night systolic: rest day 106.8±8.3mmHg/shift 111.6±9.5 (t=3.4; P<0.001); night diastolic: rest day 65.1±5.6mmHg/Shift 69.1±6.9 (t=4.14; P<0.0001). We found no relationship between variations in the BP, the category or role. The ISTAS dimensions (health situation status) and the anxiety level (average of 5/10 during the shift) are not related with the BP either. CONCLUSIONS: There are significant changes in the BP of the professional during the extra shifts, independently of professional role, anxiety level or psychosocial risk. Studies need to be conducted on the demonstrated variation in BP working extra shifts to assess its impact on health.
