Targeting belongingness among older people through engagement in senior centres: intervention development study in Denmark.

Adults often experience a loss of social relations and sense of belonging in later life, leading to the risk of social isolation. Municipal senior centres offer a potential site for intervention, as they provide social communities targeting older people. However, not all older people find it easy to access these social communities due to experiencing physical and/or psychosocial frailties and could therefore continue to experience a decline in social relations and sense of belonging, which potentiates poor physical and psychosocial health and well-being. To date, there are limited evidence-based interventions in Denmark. The present article describes the development of an intervention to increase belongingness and decrease social isolation among older people with frailties who attend Danish municipal senior centres. The development process was conducted with reference to the INDEX (IdentifyiNg and assessing different approaches to DEveloping compleX intervention) guidance. The development process resulted in a 6-month supportive intervention, consisting of four elements: skills development workshops for all staff members; a start conversation including frailty screening; allocation of a 'buddy' among existing service users; and monthly follow-up conversations with staff members. This theory-informed approach can progress to feasibility testing and outcome evaluation in order to generate an evidence base. Concurrently, the article reflects on current guidance for intervention development and how it may be used and optimized to strengthen developmental processes in the future.

Life-Space Mobility, Transportation, and the Companionship Network of Members of a Hispanic Senior Center.

OBJECTIVES: Companions (i.e., friends who spend time together) are important for the well-being of older adults. Senior centers in the United States are places for older adults to participate in group activities and form and maintain companionships. However, differences in mobility and transportation may affect the ability of older adults to leverage senior center activities into actual companionships. METHODS: This social network analysis was conducted to characterize the companionship network among members of a senior center in relation to their life-space mobility and transportation resources. An exponential random graph model was estimated to identify mobility- and transportation-related correlates of the likelihood of a companionship tie among senior center members (N = 42). RESULTS: Members had an average of 2 companionships with one another (M = 2.2, SD = 2.7). Companionships were more likely for members with greater life-space mobility (p = .009), who attended the senior center more frequently (p = .004), with automobile ownership in their households (p = .034), and who were not transportation cost-burdened (i.e., spent less than 15% of their income on transportation, p = .005). Demographic characteristics, limitations on instrumental activities of daily living, and being at risk for depression were not significantly associated with the likelihood of companionships. DISCUSSION: These findings extend previous knowledge of the role of life-space mobility and transportation in supporting general social participation for older adults to include the importance of transportation and mobility for having companions within a senior center.

The impact of older adult care policy mixes on the construction of senior centers.

The problem of an aging population is becoming increasingly serious, and the establishment of senior centers helps to promote the physical health and mental health of the older adult, a key factor in achieving the high-quality development of the old-age security industry. The government has issued a number of policies to promote the establishment and development of senior centers. However, more and more older adult care policy mixes have gradually shown the phenomenon of poor policy connection, confusing standards, and even mutually exclusive content, resulting in many problems in the construction of policy-driven senior centers. Therefore, based on the overall perspective of the older adult care policy mix, this paper uses the GMM method to explore the impact of the comprehensiveness, balance, and consistency of older adult care policy tool portfolios issued by Chinese government agencies on the construction of senior centers in China. The empirical analysis results show that a comprehensive and consistent policy mix can promote the establishment of senior centers, while the balance of the policy mix will inhibit the establishment of senior centers. This paper analyzes the impact of older adult care policy on the construction of senior centers from the perspective of the policy mix, which helps to clarify the different policy effects produced by different policy mix characteristics and provides feasible policy suggestions for the government to formulate more reasonable and effective policies.

Occupation's Role in Inclusion of Spanish-Speaking Older Adults in a Senior Center.

Occupation-based literature has not explored the specific community-level occupational processes that support inclusion or exclusion of Latine older adults in senior centers. This study examined occupation at the community level and its role in the inclusion or exclusion of older adult Spanish speakers in a senior center community. In addition, it sought to examine potential roles for occupational therapy practice in this realm. A 6-month ethnographic study used interviews, observations, document review, group mapping activities, and collaborative analysis to explore occupation of a senior center as the community and staff welcomed older adult Spanish speakers. Being culturally proactive, considering values and interests, offering regular activities, and cross-group doing together encouraged cohesion and communal habits of inclusion. These tailored modes of community occupation benefit Spanish-speaking older adults. Occupational therapy practitioners have opportunities to utilize tailored community occupations to support community inclusion and cohesion for this population.

Relación entre el apoyo social percibido y la depresión en adultos mayores con asistencia en centro gerontológico / Relationship between perceived social support and depression in older people with attendance in a gerontological center

Objetivo: Evaluar la asociación entre el apoyo social percibido y el nivel de depresión en adultos mayores que asisten y participan en actividades de un centro gerontológico en el estado de Hidalgo, México. Metodología: Estudio no experimental cuantitativo, transversal y correlacional. Muestra de 71 adultos mayores que asisten a centros gerontológicos. Las variables de estudio fueron el apoyo social percibido y la depresión. Para la medición y obtención de datos se utilizaron los cuestionarios DUKE-UNC11, con una confiabilidad de 0,66 y una validez de 0,88, que evalúa cómo el adulto mayor percibe el apoyo social y la escala geriátrica de Yesavage, con una confiabilidad de 0,84 y una validez de 0,78, que identifica el grado de depresión del adulto mayor. Resultados: De los 71 adultos mayores, el 72,8% fueron mujeres y el 28,2% hombres. En la escolaridad, el 29,6% concluyeron la primaria, el 80,3% eran de religión católica, el 38% de los participantes están casados y el 62% de ellos se dedican al hogar. La edad que más prevaleció fue 75 años. El 42,3% de los adultos mayores presentan depresión leve, el 49,3 depresión moderada y el 8,5% depresión grave. Asimismo, un 67,6% tenía apoyo social normal y un 32,4% un apoyo social bajo. Se obtuvo una correlación inversa significativa entre el apoyo social y el nivel de depresión (r = –0,336; p < 0,01) Conclusión: A mayor apoyo social que reciban los adultos mayores menor será su grado de depresión (AU)

Objective: To evaluate the association between perceived social support and the depression level in older adults who attend and participate in activities at a gerontological center from Hidalgo state, Mexico. Methodology: Quantitative, descriptive, correlational non-experimental study. A sample of 71 older adults who attend gerontology centers. The study variables were perceived social support and depression. For the measurement and data collection, the questionnaires were used, DUKE-UNC11 with a reliability of 0.66 and validity of 0.88, which assesses how the older adults perceive social support and the Yesavage geriatric scale with a reliability of 0.84 and validity of 0.78 that identifies the degree of depression in the elderly. Results: Of the 71 older adults, 72.8% were female and 28.2% male. In schooling, 29.6% finished primary school, on the other hand, 80.3% are of the catholic religion, 38% of the participants are married and most of them dedicate themselves to the home, 62%. The age that most prevailed was 75 years. 42.3% of older adults are observed with mild depression, 49.3% moderate depression 8.5% severe depression. Likewise, 67.6% with normal social support and 32.4% low social support. A significant inverse correlation was obtained between social support and the level of depression (r = –0.336, p < 0.01). Conclusion:The more social support older adults receive, the lower their degree of depression (AU)

Evaluating a theory-based intervention for improving eHealth literacy in older adults: a single group, pretest-posttest design.

BACKGROUND: The Internet is considered an important channel for providing health information to older adults. We developed an intervention to improve eHealth literacy in older adults according to the information-motivation-behavioral skills (IMB) theory and Intervention Mapping. This study aimed to analyze the effect of a developed intervention on information, motivation, behavioral skills, and behaviors related to eHealth information in older adults. METHODS: Forty-six older adults over the age of 65 were recruited from two senior welfare centers in a city in South Korea. We divided the participants into four groups and conducted one intervention per group from March to December 2019. One intervention consisted of 5 sessions and was performed once a week (2 h/1 time) for 5 weeks, culminating in a total lecture time of 10 h. One lecture instructor and two assistant instructors supported the participants in the computer practices. RESULTS: Participants' computer/web knowledge, perceived ease of use, perceived enjoyment, and attitude toward eHealth information showed statistically significant increases. The eHealth literacy efficacy score, searching performance score, and understanding score were also significantly increased. However, there was no significant difference in perceived usefulness. CONCLUSION: The application of the current theory-based methodology can improve the quality of research in eHealth literacy. Additionally, various interventions should be developed and continuously applied to improve eHealth literacy among older adults.

Centro de Convivência Virtual: potencialidades e desafios para a promoção da saúde e redes de afeto em tempos de pandemia / Virtual Coexistence Center: potentialities and challenges for health promotion and networks of affection in times of pandemic / Centro de Convivencia Virtual: potencialidades y desafíos para la promoción de la salud y las redes de afecto en tiempos de pandemia

A pesquisa apresentada neste artigo foi realizada com o objetivo de estudar as potencialidades e os desafios encontrados na convivência virtual para a continuidade do trabalho dos Centros de Convivência e Cultura (CECOs), que são pontos da rede de atenção psicossocial do SUS. O estudo se caracteriza como uma pesquisa-intervenção por meio da qual se investigou como a Agenda ConViver, através das 28 oficinas por ela ofertadas, pôde servir como uma ferramenta para promoção da saúde e o fortalecimento das redes de afeto no período da pandemia de covid-19 estudado. O método usado foi o grupo focal online com gestores, usuários e usuárias, oficineiros e a equipe de comunicação. Os resultados apontaram que a convivência virtual não substitui a convivência presencial, mas que, quando balizados por uma ética afetiva e relacional, é possível reduzir os danos do isolamento social e promover saúde por meio do uso da tecnologia da informação e comunicação (TIC)

The research presented in this article was carried out with the aim of studying the potentialities and challenges encountered in virtual coexistence for the continuity of the work developed by the Centros de Convivência e Cultura (CECOs), which are points of the Unified Health System (SUS) psychosocial care networking. The study is characterized as an intervention-research by means of which it was examined how the ConViver Agenda through the 28 workshops produced by it could serve as a tool for health promotion and strengthening of affection networks during the studied period of the covid-19 pandemic. The method used was the online focus group with managers, users, participants in workshops and the communication team. The results showed that the virtual coexistence cannot replace the face-to-face coexistence but that when it is guided by an affective and relational ethic it is possible to reduce the damage of social isolation and promoting health through the use of information and communication technology (ICT).

La investigación presentada en este artículo ha sido realizada con el objetivo de estudiar las potencialidades y los desafíos encontrados en la convivencia virtual para la continuidad del trabajo de los Centros de Convivência e Cultura (CECOs), que son puntos de la red de atención psicosocial del Sistema Único de Salud (SUS). El estudio se caracteriza como unainvestigación-intervención por medio de la cual se ha examinado como la Agenda ConViver a través de los 28 grupos de actividadesproducidos por ella ha podido servir como herramienta para la promoción de la salud y el fortalecimiento de las redes de afecto durante el periodo de la pandemia de covid-19 estudiado. El método utilizado fue un grupo focal online con gestores, usuarios y usuarias, participantes de los grupos de actividades, y el equipo de comunicación. Los resultados mostraron que la convivencia virtual no puede reemplazar la convivencia presencial, pero que cuando se guía por una ética afectiva y relacional es posible reducir los daños del aislamiento social y promover la salud mediante el uso de las tecnologías de la información y la comunicación (TIC)

Health service challenges at senior centres in an urban South Korean community: A mixed-method approach focusing on nurses' roles.

AIMS: We aim to identify challenges and recommendations for senior centre health services focusing on nurses' roles in an urban South Korean community. BACKGROUND: Senior centres can potentially provide easily accessible and cost-effective health services to older adults. It is essential to identify current challenges to improve health services. METHOD: This study used an explanatory sequential mixed-methods design. Quantitative descriptive data were obtained from a survey of all nurses at senior centres in Seoul (n = 30). For the qualitative data, focus group interviews were conducted with various senior centre stakeholders (n = 15). RESULTS: Two main themes, discrepancy between services and needs and reform senior centres, were identified with six subthemes. CONCLUSIONS: Challenges identified included insufficient availability to meet health service needs, overlapping health services, and no legal clarification of nurses' roles. Recommendations to improve the senior centre health services include to focus on the centres' main goals, function as health and welfare hubs, establish legal guidelines, and provide adequate nurse staffing. IMPLICATION FOR NURSING MANAGEMENT: The senior centres need to hire more nurses and define nurses' occupational roles legally for the centres to serve as a hub connecting medical care and welfare.

Protocol for a collaborative randomised effectiveness trial of lay-delivered versus clinician-delivered behavioural activation in senior centres.

INTRODUCTION: Depression is common among community-dwelling older adults who make use of senior centre services yet remains undertreated due to a lack of acceptable and available treatments. Emerging evidence suggests that lay health providers can offer psychosocial interventions for mental health disorders experienced by older adults. We developed a streamlined Behavioural Activation intervention (called 'Do More, Feel Better'; DMFB) to be delivered by older adult volunteers and propose to compare its effectiveness to that of clinician-delivered behavioural activation (BA). METHODS AND ANALYSIS: This study is a type I collaborative randomised effectiveness trial testing the effect of DMFB in comparison to BA among 288 senior centre clients (aged 60+). Participant clients will be recruited from 6 Seattle, 6 New York City and 6 Tampa area senior centres serving economically and ethnically diverse communities. Primary outcomes will be increased activity level (target) and decreased depressive symptoms. Secondary outcomes will be functioning and client satisfaction, and an exploratory outcome will be treatment fidelity. ETHICS AND DISSEMINATION: The study received ethics approval from the University of Washington Institutional Review Board (STUDY00011434). Client, volunteer and clinician participants will all provide informed consent for study procedures through in-person or remote contact with investigators. Results of this study will be presented in peer-reviewed journals and at professional conferences. TRIAL REGISTRATION NUMBER: NCT04621877; ClinicalTrials.gov.

[Effectiveness of a multidimensional therapeutic program for aged people attending senior centers]. / Efectividad a mediano plazo de un programa multidimensional en personas mayores en centros diurnos en Chile.

BACKGROUND: It is imperative to have effective programs to improve or maintain the health of aged people. AIM: To evaluate the effectiveness of an intervention based on a multidimensional program in Senior centers in Chile five months after its implementation, in the domains of physical and mental health, functionality and quality of life in aged people. MATERIAL AND METHODS: Sixty participants older than 60 years completed a multidimensional program for one month that included interventions of guided physical exercises, in addition to educational and social activities. They were evaluated at baseline and one and five months after the intervention. RESULTS: After the first and fifth months, significant improvements were observed in the five times sit to stand test (5TSTS) and gait speed (WST), in addition, significant improvements were observed in literacy measured by the Short Assessment of Health Literacy for Spanish-speaking Adults (SAHLSA). At the fifth month, slight improvements were observed in the Yesavage and short Falls efficacy scales, Barthel index, Unipodal Station and EuroQol five-dimensional quality of life tests. CONCLUSIONS: A multidimensional program for aged people lasting one month, improved the physical health dimension and literacy by the fifth month of evaluation.

"Do More, Feel Better": Pilot RCT of Lay-Delivered Behavioral Activation for Depressed Senior Center Clients.

This pilot randomized control trial (RCT) tested "Do More, Feel Better" (DMFB), a lay-delivered Behavioral Activation intervention for depressed senior center clients. The study examined: (1) the feasibility of training older lay volunteers to fidelity; and (2) the acceptability, safety, and impact of the intervention. Twenty-one lay volunteers at four senior centers were trained in DMFB. Fifty-six depressed clients were randomized to receive 9 sessions of DMFB or Behavioral Activation delivered by social workers (MSW BA). Research assessments of overall client activity level (BADS) and depression severity (HAM-D) were conducted at baseline and Weeks 3, 6, and 9. Eighty-one percent of lay volunteers who underwent training were formally certified in DMFB. Depressed clients receiving each intervention reported high levels of satisfaction and showed large and clinically significant changes in 9-week activity level (d ≥ 1.35) and depression severity (d ≥ 3.34). Differences between treatment groups were very small for both activity level (dMSW = 0.16; 95% CI, -0.70 to 1.02) and depression (dMSW = 0.14; 95% CI, -0.63 to 0.91). Increases in activity level were associated with decreases in depression (ß = -0.42; 95% CI, -0.55 to -0.30). Both interventions appeared to work as intended by increasing activity level and reducing depression severity. "Do More, Feel Better" shows the potential of evidence-based behavioral interventions delivered by supervised lay volunteers, and can help address the insufficient workforce available to meet the mental health needs of community-dwelling older adults.

Description of frequent and persistent symptoms of COVID-19 among older adults who attend senior centers. / Descripción de síntomas frecuentes y persistentes de COVID-19 en asistentes a centros del adulto mayor.

INTRODUCTION: COVID-19 not only acutely compromises peoples health but can also generate symptoms that remain weeks after the infection. Moreover, older adults may have different symptomatologic patterns than other age groups. OBJECTIVE: To describe the acute and persistent symptoms of COVID-19 in older adult users of Social Security senior centers. METHODS: A retrospective descriptive study was carried out by telephone call to older adults from five Peruvian senior centers, from July to September 2020, who reported being positive for COVID-19 in the last three months. Older adults were asked about associated symptoms, with a follow-up of up to four months. RESULTS: The most frequent acute symptoms were cough, fever, headache, and myalgia. The mean num- ber of symptoms per person was one to three. We also found that 4.4% of COVID-19 cases had symptoms that persisted over three weeks. CONCLUSIONS: Older persons in senior centers have a low frequency of persistent COVID-19 symptoms.

INTRODUCCIÓN: COVID-19 no sólo compromete agudamente la salud de las personas, sino que puede generar síntomas que permanecen luego de la infección aguda, incluso por más de tres semanas. Más aún, las personas adultas mayores podrían tener patrones sintomatológicos diferentes a otros grupos etarios. OBJETIVO: Describir los síntomas agudos y persistentes de COVID-19 en personas adultas mayores usuarias de centros del adulto mayor de la Seguridad Social. MÉTODO: Se realizó un estudio descriptivo retrospectivo por llamada telefónica a adultos mayores de cinco centros del adulto mayor peruanos, de julio a septiembre de 2020, quienes habían reportado ser positivos a COVID-19 en el monitoreo telefónico de los últimos tres meses. En las llamadas se les pregunto por los síntomas asociados, con un seguimiento de hasta cuatro meses. RESULTADOS: Los síntomas agudos más frecuentes fueron tos, fiebre, cefalea y mialgia. La media de síntomas por persona fue de uno a tres. Un 4,4% de los casos tuvo COVID-19 prolongado. CONCLUSIONES: Las personas mayores de los centros del adulto mayor presentan una baja frecuencia de síntomas post COVID-19 agudo.

Efectividad a mediano plazo de un programa multidimensional en personas mayores en centros diurnos en Chile / Effectiveness of a multidimensional therapeutic program for aged people attending senior centers

BACKGROUND: It is imperative to have effective programs to improve or maintain the health of aged people. AIM: To evaluate the effectiveness of an intervention based on a multidimensional program in Senior centers in Chile five months after its implementation, in the domains of physical and mental health, functionality and quality of life in aged people. MATERIAL AND METHODS: Sixty participants older than 60 years completed a multidimensional program for one month that included interventions of guided physical exercises, in addition to educational and social activities. They were evaluated at baseline and one and five months after the intervention. RESULTS: After the first and fifth months, significant improvements were observed in the five times sit to stand test (5TSTS) and gait speed (WST), in addition, significant improvements were observed in literacy measured by the Short Assessment of Health Literacy for Spanish-speaking Adults (SAHLSA). At the fifth month, slight improvements were observed in the Yesavage and short Falls efficacy scales, Barthel index, Unipodal Station and EuroQol five-dimensional quality of life tests. CONCLUSIONS: A multidimensional program for aged people lasting one month, improved the physical health dimension and literacy by the fifth month of evaluation.

Brief Anti-Ageism Messaging Effects on Physical Activity Motivation Among Older Adults.

When people have more negative perceptions about aging or attribute health decline to old age, they engage in less health promotion behavior. We tested whether an intervention of brief anti-ageism messages addressing views of aging could motivate engagement in physical activities at senior centers. Attendees aged 50 and older (n = 349; Mage = 72, SD = 9) at seven centers were randomly assigned to read one of three intervention messages (different approaches addressing views of aging) or to not read a message before rating their likelihood of attending a variety of center programs, including physical activities. Multilevel regression models indicated the intervention increased motivation to attend physical activities compared with the control group among participants aged 72 and older. The three anti-ageism messages were similarly effective suggesting some flexibility in framing. The results indicate anti-ageism messages may be a scalable, low-cost approach to promoting physical activity in older adults.

Tuberculosis Contact Investigations Conducted in New York City Adult Day Care and Senior Centers, 2011-2018.

OBJECTIVES: Multiple tuberculosis (TB) exposures have been reported in New York City (NYC) adult day care and senior centers. Strategies to identify TB transmission at such locations are needed. METHOD: Review of the NYC TB Registry identified 12 contact investigations (CIs) at adult day care or senior centers (2011-2018). RESULTS: Median age of the 12 index patients was 81 years. Of 148 contacts identified who had no history of TB infection or disease, 141 (95%) were tested for TB, primarily with interferon gamma release assays; 46 (33%) tested positive. Transmission was probable (n = 3) or possible (n = 1) at 4 (33%) centers; at all of these, the index patient had an acid-fast bacilli-positive sputum smear. Transmission was not found from index patients with negative sputum smears. DISCUSSION: We found evidence of transmission of smear-positive respiratory TB disease to contacts in adult day care or senior centers, underscoring the importance of CI.

Detect, trace and react: Danish senior centre staffs' awareness of and response to signs of deteriorating health or well-being among senior centre users - An ethnographic field study.

Senior centre staff members seemingly have an important organisational and administrative role, as well as engage in outreach activities, referral and follow-up in relation to health issues among senior centre users. However, their role in health promotion and illness prevention is easily overlooked and under researched. This study aimed to explore municipal senior centre staffs' awareness of and response to signs of deteriorating health or well-being among users. A multisite ethnographic field study was conducted at seven municipal senior centres in Denmark from November 2019 to February 2020. Data were obtained from participant observation and semi-structured individual interviews with 16 staff members. A thematic analysis strategy helped identify themes of importance. Senior centre staff followed a process of three steps when remaining aware of and responding to signs of deteriorating health and well-being among users: detecting, tracing and reacting. Three themes with corresponding subthemes were identified: Establishing close and trusting relationships, facilitating a community feeling and utilising joint collaboration. Each subtheme was linked to some or all of the three steps in the process. The municipal senior centre staff had a strong and explicit focus on detecting, tracing and reacting to signs of deteriorating health and well-being among senior centre users. This makes the senior centres a promising arena for illness prevention and health promotion.

Senior Center Service Utilization: Do Social Ties Affect Participation Patterns?

PURPOSE: A better understanding of service utilization patterns at senior service centers can improve program development and constituent usage. THEORY: This research examines whether participation in senior center activities is a function of senior socialization that reinforces and supports existing social ties by selecting specific activities in senior centers. METHODS: A total of 924 participants of senior centers in a municipality in the Southwest were surveyed. RESULTS: We find that having closer friends influences participation in certain senior center services. We also find that gender, race, ethnicity, and income also explain different usage rates beyond age. CONCLUSION: Opportunities to foster social interaction to grow and reduce barriers to participation and market to a broader range of current and potential participants are discussed.

Vulnerabilidade clínico funcional masculina entre idosos institucionalizados / Male functional clinical vulnerability among institutionalized elderly

Resumo Objetivo: Analisar a vulnerabilidade clínico funcional masculina entre idosos institucionalizados em duas unidades de longa permanência por meio do instrumento Índice de Vulnerabilidade Clínico Funcional (IVCF-20). Metodologia: Trata-se de um estudo transversal e comparativo, no qual se utilizou uma amostra por conveniência em que participaram 31 homens idosos institucionalizados em duas Instituições de Longa Permanência localizadas no município de Marabá-PA, no período de janeiro a maio de 2019. Para a vulnerabilidade, utilizou-se o instrumento IVCF-20 e para a análise estatística foi aplicado o Teste G considerando o nível de significância de p≤0,05. Todos os preceitos éticos em pesquisa foram assegurados. Resultados: Nos grupos predominaram a faixa etária entre 60-74 anos, solteiros, aposentados e com grau de escolaridade baixo. Os idosos institucionalizados apresentavam algumas doenças prévias como Hipertensão Arterial Sistêmica (50%) seguido de Hiperplasia da Próstata (36,8%). Quanto a vulnerabilidade, os grupos apresentaram comprometimento nas atividades de vida diária básicas e instrumentais; na cognição; no humor; na mobilidade no que tange ao alcance e/ou preensão de objetos, na capacidade aeróbica e muscular, durante a marcha e na perda urinária e fecal. Os idosos pertencentes a instituição A apresentaram vulnerabilidade clínica funcional mais comprometida do que idosos pertencentes a instituição B. Conclusão: Os resultados evidenciam alto grau de vulnerabilidade dos idosos institucionalizados ampliando discussões sobre as políticas públicas direcionadas à população idosa masculina.

Resumen Objetivo: Analizar la vulnerabilidad clínica funcional masculina entre adultos mayores institucionalizados en dos unidades de cuidados de largo plazo utilizando el Índice de Vulnerabilidad Clínica Funcional (IVCF-20). Método: Se trata de un estudio transversal y comparativo, se utilizó una muestra de conveniencia, participaron 31 adultos mayores institucionalizados en dos Instituciones de Larga Duración ubicadas en el municipio de Marabá-PA, de enero a mayo de 2019. Para la vulnerabilidad se utilizó el instrumento IVCF-20 y se aplicó la prueba G para el análisis estadístico, considerando el nivel de significancia de p≤0.05. Todos los preceptos éticos en la investigación estaban garantizados. Resultados: Predominó el grupo de edad entre 60-74 años, solteros, jubilados y con bajo nivel educativo. Los adultos mayores institucionalizados tenían algunas enfermedades previas, como la hipertensión arterial sistémica (50 %), seguida de la hiperplasia prostática (36,8%). En cuanto a la vulnerabilidad, los grupos mostraron deterioro en las actividades básicas e instrumentales de la vida diaria, en cognición, de humor, movilidad en términos de alcanzar o agarrar objetos, capacidad aeróbica y muscular durante la marcha y pérdida urinaria y fecal. Los adultos mayores pertenecientes a la institución A tenían una vulnerabilidad clínica funcional más comprometida que los pertenecientes a la institución B. Conclusión: Los resultados muestran un alto grado de vulnerabilidad de los adultos mayores institucionalizados, ampliando las discusiones sobre políticas públicas dirigidas a la población masculina adulta mayor.

Abstract Aim: To analyze functional clinical vulnerability in institutionalized elderly males in two long-term care units using the Functional Clinical Vulnerability Index (IVCF-20). Method: This is a cross-sectional and comparative study. A convenience sample was used, and as a result, 31 senior males in two institutionalized long-term institutions located in the municipality of Marabá-PA from January to May 2019 participated in the study. The IVCF-20 instrument was used to evaluate the vulnerability; a G test was applied for the statistical analysis considering a significance level of p≤0.05. All ethical requirements for research were guaranteed. Results: Among all groups, the age group between 60-74 years old, single, retired, and with a low level of education predominated. Institutionalized older people had some previous diseases such as Systemic Arterial Hypertension (50%) followed by Prostate Hyperplasia (36,8%). As for vulnerability, the groups showed an impairment in basic and instrumental activities of daily living, in cognition, in mood, mobility about reaching and / or grasping objects, aerobic and muscular capacity, gait, and urinary and fecal loss. The elderly belonging to institution A had more compromised functional clinical vulnerability than the elderly belonging to institution B. Conclusion: The results show a high degree vulnerability in institutionalized elderly citizens; discussions about public policies aimed at the elderly male population should expand.

Fortalezas y debilidades de los sistemas de gestión de la calidad implantados en los centros de personas mayores en España / Pontos fortes e fracos dos sistemas de gestão da qualidade implementados nos centros para os idosos em Espanha / Strengths and weaknesses of the quality management systems implemented in nursing homes for the elderly in Spain

El presente artículo se basa en una investigación que ha tenido como objetivo analizar lascaracterísticas de los Sistemas de Gestión de la Calidad implantados en los Centros de PersonasMayores en España. Su hipótesis principal ha sido que los Sistemas de Gestión de la Calidadimplantados en España no miden en su totalidad todos los aspectos relacionados con la atenciónde calidad. Para ello, se ha utilizado el instrumento CALCERIS001 (marca registrada M3706458)que, a través de un cuestionario de 24 variables (Alfa de Cronbach de .830), ha recogidoinformación del personal de Centros de Personas Mayores en el territorio español (N=359). Losresultados han puesto de manifiesto que la implantación de estos Sistemas de Gestión de laCalidad se ha traducido en una mejora de la calidad efectiva para estos centros y al mismo tiempose recoge que estos modelos se basan principalmente en aspectos médico-sanitarios y deorganización y gestión de los recursos humanos quedando en un segundo plano aspectos como las relaciones interpersonales y las necesidades educativas. Los autores de artículo abogarán porun sistema basado en un Modelo de Calidad Integrada, que abarque todas las dimensionesposibles.(AU)

This article is based on an investigation that has aimed to analyze the characteristics ofthe Quality Management Systems implemented in the Centers for the Elderly in Spain. Its mainhypothesis has been that the Quality Management Systems implemented in Spain do not fullymeasure all aspects related to quality care. To do this, the CALCERIS001 instrument (registeredtrademark M3706458) has been used which, through a questionnaire of 24 variables (Cronbach'sAlpha of .830), has collected information from the staff of Centers for the Elderly in Spanishterritory (N = 359). The results have shown that the implementation of these Quality ManagementSystems has resulted in an effective quality improvement for these centers and at the same timeit is stated that these models are mainly based on medical-health and organizational aspects andhuman resource management, with aspects such as interpersonal relationships and educationalneeds. The authors of the article will advocate for a system based on an Integrated Quality Model,which covers all possible dimensions.(AU)

Este artigo baseia-se numa investigação que tem como objectivo analisar ascaracterísticas dos Sistemas de Gestão da Qualidade implementados nos Centros para Idosos emEspanha. A sua principal hipótese tem sido que os Sistemas de Gestão da Qualidadeimplementados em Espanha não medem completamente todos os aspectos relacionados com oscuidados de qualidade. Para este fim, foi utilizado o instrumento CALCERIS001 (marca registadaM3706458) que, através de um questionário de 24 variáveis (Cronbach's Alpha de .830), recolheuinformações do pessoal dos Centros para Idosos em Espanha (N=359). Os resultadosdemonstraram que a implementação destes Sistemas de Gestão da Qualidade resultou numamelhoria efectiva da qualidade destes centros e, ao mesmo tempo, mostra-se que estes modelosse baseiam principalmente em aspectos médicos-saúde e organização e gestão de recursoshumanos, deixando em segundo plano aspectos como as relações interpessoais e necessidadeseducativas. Os autores do artigo defendem um sistema baseado num Modelo Integrado deQualidade, que cobre todas as dimensões possíveis.(AU)