Cuidados familiares prestados por los ancianos del ámbito rural a distintas generaciones / Family care provided by the elders of a rural area to different generations

Objetivos: Describir el perfil del cuidador mayor del ámbito rural, analizar las diferencias sociodemográficas, de salud, relaciones sociales y necesidades de servicios no cubiertas entre cuidadores familiares y no cuidadores. Metodología: Se encuestaron 787 mayores de 64 años no institucionalizados pertenecientes a una Zona Básica de Salud de Zaragoza. Las variables recogidas mediante el cuestionario OARS-MAFQ (OARS) fueron: sociodemográficas, necesidad de servicios, recursos sociales, económicos y salud física. Otras variables: capacidad funcional para las actividades de la vida diaria, básicas e instrumentales, índice de masa corporal y realización de actividad física. Resultados: Los cuidadores de hijos/nietos fueron independientes para las actividades de la vida diaria, realizaron más actividad física, presentaron buena salud física y así lo percibieron. Los no cuidadores tuvieron mayor dependencia y depresión. Los tres grupos mostraron buenos recursos sociales y económicos, aunque significativamente mejores los cuidadores de hijos/nietos, cuyas necesidades fueron: transporte público y viajar. Los no cuidadores refirieron mayor necesidad de ayuda para bañarse, vestirse, realizar tareas de casa y preparar comidas. Los cuidadores de cónyuges/padres necesitaron más tratamientos por problemas familiares y personales. Todos precisaron cuidados de enfermería. Conclusiones: El perfil, características y necesidades del cuidador y no cuidador fueron diferentes, coincidiendo en la elevada necesidad de cuidados de enfermería

Objectives: To describe the profile of caregivers higher in rural areas, to analyze sociodemographic differences in health and social relations between family caregivers and non-caregivers, and service needs unmet. Methodology: We surveyed 787 people over 64 noninstitutionalized belonging to the Basic Health Area of Zaragoza. Variables were collected through the questionnaire OARS-MAFQ (OARS): sociodemographic, need for services, assessment of social, economic and physical health. Other variables were: functional capacity for activities of daily living, basic and instrumental, body mass index and physical activity undertaken. Results: All caregivers of children/grandchildren were independent for activities of daily living, performed more physically active, had good physical and so perceived. Noncaregivers had the highest proportion of dependence and depression. The three groups had good social and economic resources, although significantly higher in those who care for children/grandchildren in which needs were perceived as more public transport and travel more. Non-caregivers reported more need for help with bathing, dressing, household chores and meal preparation. Caregivers of spouses/parents needed more treatment to personal or family problems. There was a great need for nursing care in the three groups. Conclusions: The profile, characteristics and needs of caregiver and no-caregiver were different, coinciding only in high need for nursing care

Depressive symptoms and associated factors in an older Spanish population positively screened for disability.

OBJECTIVES: To measure the prevalence of depressive symptoms and its association with a comprehensive set of variables and to study the potential modifying effects of sex and age. METHODS: In a cross-sectional study, subjects who tested positive to the 12-item World Health Organization disability screening tool were selected from a probabilistic sample of persons aged 65 years or older in a rural area of Spain. Measurements included EURO-D depression scale, socio-demographics, habits, anthropometrics, medical history, cognition, disability, functional dependence, self-rated health and pain. Logistic regression models were used to obtain adjusted odds ratios (aORs) and 95% confidence intervals (95% CIs) for the association between depression and variables. The modifying effects of age and sex were assessed. RESULTS: Prevalence (95% CI) of current depressive symptoms among the 438 participants was 35.8% (31.3-40.3%). Depressive symptomatology was higher among women (aOR = 2.98). An inverse association was observed with alcohol (aORs of 0.52 and 0.27 for consumption of 1-2 and >2 standard units/day, respectively, versus abstainers). Depressive symptomatology was associated with heart failure (aOR = 4.24), urinary incontinence (aOR = 2.68), ischemic heart disease (aOR = 1.87), poor self-rated health and pain. Sex and age modified the effect of several variables. CONCLUSION: Prevalence of depressive symptoms, albeit high, was less than expected. The consistently strong negative association between depressive symptoms and alcohol consumption warrants further in-depth research. Awareness of effect modification by key variables, such as sex and age, may enable the probability of suffering depression to be more accurately assessed, with a view to performing a potential diagnostic work-up.

Mental health and social relations in older rural population.

OBJECTIVES: To describe and analyze the influence of social relations in the elderly in the rural setting with depression. DESIGN: A cross-sectional study. SAMPLE: Patients (N=787) over 64 years, non-institutionalized who belong to the Basic Health Zone Substations (Zaragoza), a representative rural area of Aragon. The following variables were evaluated: diagnosis of depression, comorbidity, taking antidepressants, sociodemographic variables and use of social resources (OARS questionnaire), instrumental activities of daily living (Lawton-Brody test) and basics daily living activities (Barthel test). RESULTS: According to multivariate analysis, the risk of suffering depression is higher in women (OR=5.6 CI=3.0- 10.5), patients with comorbidity (OR=12.2 CI=5.1-29.2), people who speak by phone with other at least 5 times a week (OR=3.1 CI=1.7-5.5), who have no one to confide in (OR=3.9 CI=1.8-8.5), sometimes feeling alone (OR=2.7 CI=1.0-4.8), they do not see their family as much as they want to (OR=2.1 CI=1.3-4.4) and who are dependent on others for daily living activities (OR= 2.6 CI=1.5-4.6). CONCLUSIONS: These results confirm the findings in other studies and provide clues to guide interventions aimed at improving the quality of life of the elderly.

Salud mental y relaciones sociales en población mayor rural / Mental health and social relations in older rural population

Objetivos. Describir y analizar la influencia de las relaciones sociales en la depresión en personas mayores. Métodos. Diseño: Estudio transversal. Muestra: Mayores de 64 años (N=787), incluidos en la Zona Básica de Salud de Casetas (Zaragoza), un entorno rural representativo de Aragón. Variables evaluadas: Diagnóstico de depresión, consumo de antidepresivos, variables sociodemográficas y de recursos sociales (cuestionario OARS), así como actividades de la vida diaria instrumentales (test de Lawton-Brody) y básicas (test de Barthel). Resultados. En el análisis multivariante el riesgo de padecer depresión es mayor entre las mujeres (OR=5,6 IC=3,0-10,5), los que presentan comorbilidad (OR=12,2 IC=5,1-29,2), hablan por teléfono con otras personas 5 o más veces/semana (OR=3,1 IC=1,7-5,5) no tienen a nadie en quien confiar (OR=3,9 IC=1,8-8,5), alguna vez se encuentran solos(OR=2,7 IC=1,0-4,8) no ve a su familia/amigos tanto como le gustaría (OR=2,1 IC=1,3-4,4) y es dependiente para las actividades de la vida diaria (OR=2,6 IC=1,5-4,6).Conclusiones. Estos resultados confirman los hallazgos obtenidos en otros estudios y proporcionan claves para orientar las intervenciones dirigidas a mejorar la calidad de vida de los mayores (AU)

Objectives. To describe and analyze the influence of social relations in the elderly in the rural setting with depression. Methods. Design: A cross-sectional study. Sample: Patients (N=787) over 64 years, non-institutionalized who belong to the Basic Health Zone Substations (Zaragoza), a representative rural area of Aragon. The following variables were evaluated: diagnosis of depression, comorbidity, taking antidepressants, sociodemographic variables and use of social resources (OARS questionnaire), instrumental activities of daily living (Lawton-Brody test) and basics daily living activities (Barthel test).Results. According to multivariate analysis, the risk of suffering depression is higher in women (OR=5.6 CI=3.0-10.5), patients with comorbidity (OR=12.2 CI=5.1-29.2),people who speak by phone with other at least 5 times aweek (OR=3.1 CI=1.7-5.5), who have no one to confide in(OR=3.9 CI=1.8-8.5), sometimes feeling alone (OR=2.7CI=1.0-4.8), they do not see their family as much as they want to (OR=2.1 CI=1.3-4.4) and who are dependent on others for daily living activities (OR= 2.6 CI=1.5-4.6). Conclusions. These results confirm the findings in other studies and provide clues to guide interventions aimed at improving the quality of life of the elderly (AU)

Producción científico-profesional española sobre discapacidad según el modelo CIF. Revisión de la literatura, 2001-2011 / Scientific-professional production on the ICF disability model in Spain. A literature review (2001-2010)

Objetivos: Cuantificar la utilización de la Clasificación Internacional del Funcionamiento, Discapacidad y Salud (CIF) en España a partir de publicaciones, y compararla con la de otros países europeos. Métodos: Revisión de la literatura relativa a publicaciones periódicas nacionales e internacionales con participación de investigadores españoles, desde mayo de 2001 hasta junio de 2010. Resultados: Se encontraron 47 publicaciones, con un incremento anual reciente de las de lengua inglesa. Predominaron las publicaciones periódicas teóricas (53,1%) y las especialidades de revistas de salud mental, rehabilitación y discapacidad, con medio o bajo factor de impacto. El 27,6% utilizan el instrumento WHODAS-II. Son más frecuentes los estudios en adultos con enfermedad mental. En relación a otros países europeos, y por referencias Medline, España ocupa el quinto lugar. Conclusiones: Esta revisión sugiere que la aplicación efectiva de la CIF en España es limitada, aunque rápidamente creciente la de carácter científico, referida sobre todo al marco conceptual y diagnóstico en distintos contextos clínicos, de rehabilitación y poblacionales, con escasa aplicación en servicios y una considerable incardinación internacional (AU)

Objectives: To quantify the use of the International Classification of Functioning, Disability and Health (ICF) in Spain on the basis of published reports, and to compare this use with that in other European countries. Methods: We reviewed the scientific literature published by, or with the participation of, authors having Spanish institutional affiliations in Spanish or international journals between May 2001 and June 2010. Results: A total of 47 papers were identified, with a recent annual increase in those published in English. There was a predominance of theoretical journals (53.1%) and those specializing in mental health, rehabilitation and disability, with a medium or low impact factor. The World Health Organization-Disability Assessment Schedule (WHODAS-II) was used in 27.6% of publications. Most studies addressed adult populations with mental illness. Spain ranked midway in the table of European countries (fifth by Medline references). Conclusions: This review suggests that the effective application of the ICF in Spain is limited but is increasing and is internationally co-ordinated. The main fields of application are theoretical and diagnostic, in various clinical, rehabilitation and population-based contexts and, to a much lesser extent, in health services (AU)

[Scientific-professional production on the ICF disability model in Spain. A literature review (2001-2010)]. / Producción científico-profesional Española sobre discapacidad según el modelo CIF. Revisión de la literatura, 2001-2011.

OBJECTIVES: To quantify the use of the International Classification of Functioning, Disability and Health (ICF) in Spain on the basis of published reports, and to compare this use with that in other European countries. METHODS: We reviewed the scientific literature published by, or with the participation of, authors having Spanish institutional affiliations in Spanish or international journals between May 2001 and June 2010. RESULTS: A total of 47 papers were identified, with a recent annual increase in those published in English. There was a predominance of theoretical journals (53.1%) and those specializing in mental health, rehabilitation and disability, with a medium or low impact factor. The World Health Organization-Disability Assessment Schedule (WHODAS-II) was used in 27.6% of publications. Most studies addressed adult populations with mental illness. Spain ranked midway in the table of European countries (fifth by Medline references). CONCLUSIONS: This review suggests that the effective application of the ICF in Spain is limited but is increasing and is internationally co-ordinated. The main fields of application are theoretical and diagnostic, in various clinical, rehabilitation and population-based contexts and, to a much lesser extent, in health services.

ICF-based disability survey in a rural population of adults and older adults living in Cinco Villas, Northeastern Spain: design, methods and population characteristics.

BACKGROUND: This article describes the methods of a door-to-door screening survey exploring the distribution of disability and its major determinants in northeastern Spain. This study will set the basis for the development of disability-related services for the rural elderly in northeastern Spain. METHODS: The probabilistic sample was composed of 1,354 de facto residents from a population of 12,784 Social Security card holders (age: > or = 50 years). Cognitive and disability screenings were conducted (period: June 2008-June 2009). Screening instruments were the MMSE and the World Health Organization Disability Assessment Schedule. Participants screened positive for disability underwent an assessment protocol focusing on primary care diagnoses, disability, lifestyle, and social and health service usage. Participants screened positive for cognitive functioning went through in-depth neurological evaluation. RESULTS: The study sample is described. Usable data were available for 1,216 participants. A total of 625 individuals (51.4%) scored within the positive range in the disability screening, while 135 (11.1%) scored within the positive range of the cognitive screening. The proportion of positively screened individuals was higher for women and increased with age. CONCLUSIONS: Screening surveys represent a feasible design for examining the distribution of disability and its determinants among the elderly. Data quality may benefit from methodological developments tailored to rural populations with a low education level.