ABSTRACT
OBJETIVO: Conocer las características y las diferencias clínicas entre pacientes institucionalizados y los de programas de atención domiciliaria. DISEÑO: Estudio observacional descriptivo transversal multicéntrico. EMPLAZAMIENTO; Sevilla, 2016. PARTICIPANTES: Un total de 1.857 pacientes ancianos (1.441 institucionalizados y 416 en domicilio). MEDICIONES: Las variables estudiadas fueron: sexo, edad, estado civil, apoyo familiar, patologías, criterios de pluripatología y fármacos. Se valoraron el estado funcional y el cognitivo mediante las escalas de Barthel, Lawton-Brody y Pfeiffer. RESULTADOS: Un 71,40% fueron mujeres. Estadísticamente el hecho de estar institucionalizados o vivir en el domicilio se relaciona con las siguientes patologías y categorías: esquizofrenia (p < 0,001), HTA (p = 0,012), DM (p = 0,001), FA (p < 0,001) y neoplasias (p = 0, 012), A1 (p = 0,012), A2 (p < 0,001), B1 (p < 0,001), B2 (p = 0,002), C (p < 0,001), E1 (p < 0,001), E3 (p = 0,01), F2 (p < 0,01), G2 (p = 0,024) y H (p = 0,005). El promedio del índice de Barthel de la muestra fue de 49,1 ± 34,45 (IC 95%: 47,49-50,7), el de Lawton-Brody en domicilio fue de 2,33 ± 2,49 y en institucionalizados, de 1,59 ± 2,12. La media de la escala de Pfeiffer fue de 4,93 ± 3,53. CONCLUSIONES: Se asocia con la institucionalización el deterioro cognitivo, consecuencia de posibles patologías neurológicas (categoría E3) y psiquiátricas. Por el contrario, no se asocia con la comorbilidad del paciente, puesto que es muy elevada en pacientes en situación de atención domiciliaria con mejores estados de independencia funcional y cognitivo
OBJECTIVES: To describe the characteristics and clinical differences between institutionalised patients and those included in a home care program. DESIGN: A descriptive, observational, cross-sectional, and multicentre study. Site Seville, 2016. STUDY SUBJECTS: A total 1857 elderly patients of similar characteristics (1441 institutionalised and 416 at home) in Seville in 2016. MEASUREMENTS: The variables studied included gender, age, civil status, family support, pathologies, multiple pathology criteria, and medication prescriptions. Functional and cognitive status was evaluated using the Barthel index, and the Lawton-Brody and Pfeiffer scales. RESULTS: The majority of patients (71.40%) were women. The fact of being institutionalised or being included in a home care program were statistically related to the following pathologies and categories: schizophrenia (p < .001), arterial hypertension (p = .012), diabetes mellitus (p = .001), atrial fibrillation (p < .001), and neoplasia (p = .012), A1 (p = .012), A2 (p < .001), B1 (p < .001), B2 (p = .002), C (p < .001), E1 (p < .001), E3 (p = .01), F2 (p < .01), G2 (p = .024), and H (p = .005). The mean Barthel index of the sample was 49.1 ± 34.45 (95% confidence interval: 47.49-50.7). The mean Lawton-Brody scale in the case of patients included the home care program was 2.33 ± 2.49 and in those institutionalised 1.59 ± 2.12. The mean Pfeiffer scale was 4.93 ± 3.53. CONCLUSIONS: Cognitive impairment was related to institutionalisation, being a result of possible neurological (E3 category) and psychiatric diseases. On the other hand, patient comorbidity was not related to it, because it is very high in patients included in a home care program, in whom functional and cognitive independency status is better
Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Home Care Services , Chronic Disease/epidemiology , Institutionalization , Cognitive Dysfunction , Chronic Disease/classification , Chronic Disease/drug therapy , Cross-Sectional Studies , Socioeconomic Factors , Disabled Persons , SpainABSTRACT
OBJECTIVES: To describe the characteristics and clinical differences between institutionalised patients and those included in a home care program. DESIGN: A descriptive, observational, cross-sectional, and multicentre study. Site Seville, 2016. STUDY SUBJECTS: A total 1857 elderly patients of similar characteristics (1441 institutionalised and 416 at home) in Seville in 2016. MEASUREMENTS: The variables studied included gender, age, civil status, family support, pathologies, multiple pathology criteria, and medication prescriptions. Functional and cognitive status was evaluated using the Barthel index, and the Lawton-Brody and Pfeiffer scales. RESULTS: The majority of patients (71.40%) were women. The fact of being institutionalised or being included in a home care program were statistically related to the following pathologies and categories: schizophrenia (p<.001), arterial hypertension (p=.012), diabetes mellitus (p=.001), atrial fibrillation (p<.001), and neoplasia (p=.012), A1 (p=.012), A2 (p<.001), B1 (p<.001), B2 (p=.002), C (p<.001), E1 (p<.001), E3 (p=.01), F2 (p<.01), G2 (p=.024), and H (p=.005). The mean Barthel index of the sample was 49.1±34.45 (95% confidence interval: 47.49-50.7). The mean Lawton-Brody scale in the case of patients included the home care program was 2.33±2.49 and in those institutionalised 1.59±2.12. The mean Pfeiffer scale was 4.93±3.53. CONCLUSIONS: Cognitive impairment was related to institutionalisation, being a result of possible neurological (E3 category) and psychiatric diseases. On the other hand, patient comorbidity was not related to it, because it is very high in patients included in a home care program, in whom functional and cognitive independency status is better.
Subject(s)
Home Care Services , Institutionalization , Activities of Daily Living , Aged , Comorbidity , Cross-Sectional Studies , Female , Humans , MaleABSTRACT
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