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- A Technological-Based Platform for Risk Assessment, Detection, and Prevention of Falls Among Home-Dwelling Older Adults: Protocol for a Quasi-Experimental StudyPublication . AraĂșjo, F.; Nilza Caldevilla, Maria; Silva, Joana; Rego, SĂlviaBackground: According to the United Nations, it is estimated that by 2050, the number of people aged 80 years and older will have increased by 3 times. Increased longevity is often accompanied by structural and functional changes that occur throughout an individualâs lifespan. These changes are often aggravated by chronic comorbidities, adopted behaviors or lifestyles, and environmental exposure, among other factors. Some of the related outcomes are loss of muscle strength, decreased balance control, and mobility impairments, which are strongly associated with the occurrence of falls in the elderly. Despite the continued undervaluation of the importance of knowledge on fall prevention among the elderly population by primary care health professionals, several evidence-based (single or multifaceted) fall prevention programs such as the Otago Exercise Program (OEP) have demonstrated a significant reduction in the risk of falls and fall-related injuries in the elderly within community settings. Recent studies have strived to integrate technology into physical exercise programs, which is effective for adherence and overcoming barriers to exercise, as well as improving physical functioning. Objective: This study aims to assess the impact of the OEP on the functionality of home-dwelling elderly using a common technological platform. Particularly, the impact on muscle strength, balance, mobility, risk of falling, the perception of fear of falling, and the perception of the elderly regarding the ease of use of technology are being examined in this study. Methods: A quasi-experimental study (before and after; single group) will be conducted with male and female participants aged 65 years or older living at home in the district of Porto. Participants will be recruited through the network COLABORAR, with a minimum of 30 participants meeting the study inclusion and exclusion criteria. All participants will sign informed consent forms. The data collection instrument consists of sociodemographic and clinical variables (self-reported), functional evaluation variables, and environmental risk variables. The data collection tool integrates primary and secondary outcome variables. The primary outcome is gait (timed-up and go test; normal step). The secondary outcome variables are lower limb strength and muscle resistance (30-second chair stand test), balance (4-stage balance test), frequency of falls, functional capacity (Lawton and Brody - Portuguese version), fear of falling (Falls Efficacy Scale International - Portuguese version), usability of the technology (System Usability Scale - Portuguese version), and environmental risk variables (home fall prevention checklist for older adults). Technological solutions, such as the FallSensing Home application and Kallisto wearable device, will be used, which will allow the detection and prevention of falls. The intervention is characterized by conducting the OEP through a common technological platform 3 times a week for 8 weeks. Throughout these weeks, the participants will be followed up in person or by telephone contact by the rehabilitation nurse. Considering the COVID-19 outbreak, all guidelines from the National Health Service will be followed. The project was funded by InnoStars, in collaboration with the Local EIT Health Regional Innovation Scheme Hub of the University of Porto. Results: This study was approved on October 9, 2020 by the Ethics Committee of Escola Superior de Enfermagem do Porto (ESEP). The recruitment process was meant to start in October, but due to the COVID-19 pandemic, it was suspended. We expect to restart the study by the beginning of the third quarter of 2021. Conclusions: The findings of this study protocol will contribute to the design and development of future robust studies for technological tests in a clinical context.
- Registro das circunstancias das quedas no Ăąmbito comunitĂĄrio: perspectiva na PenĂnsula IbĂ©ricaPublication . AraĂșjo, F.; Nilza Caldevilla, Maria; Maciel, CĂąndida; Malheiro, Felicidade; RodrĂguez-Borrego, MarĂa Aurora; LĂłpez-Soto, Pablo JesĂșsObjetivo: determinar o diagnĂłstico da situação sobre a documentação das quedas e risco de queda em pessoas maiores de 75 anos em unidades bĂĄsicas de saĂșde da Espanha e Portugal. MĂ©todo: estudo exploratĂłrio misto em duas etapas: (i) descritiva quantitativa de registros de queda selecionados aleatoriamente produzidos em um ano (597 registros; 197 espanhĂłis e 400 portugueses); e (ii) qualitativa, para conhecer a percepção dos profissionais de saĂșde, utilizando entrevistas semiestruturadas (72 profissionais; 16 espanhĂłis e 56 portugueses). Os Ăąmbitos de estudo foram duas unidades bĂĄsicas de saĂșde do Sul de Espanha e do Norte de Portugal. Resultados: nos registros de queda, o nĂșmero de mulheres era maior. A presença de queda esteve associada com as variĂĄveis idade, presença de demĂȘncia, doença osteoarticular, quedas prĂ©vias e consumo de antivertiginosos. Os profissionais de saĂșde perceberam uma ausĂȘncia de instrumentos de avaliação do risco de queda, assim como carĂȘncia de programas de prevenção e falta de sensibilização sobre este acontecimento. ConclusĂŁo: as quedas sĂŁo percebidas como uma ĂĄrea de atenção prioritĂĄria para os profissionais de saĂșde. NĂŁo obstante, existe uma falta de adesĂŁo ao registro de quedas e da avaliação do risco como consequĂȘncia de problemas organizacionais, logĂsticos e motivacionais.
- Conhecimento dos enfermeiros antes e apĂłs um programa educativo, sobre prevenção de quedas na população idosa em contexto comunitĂĄrioPublication . AraĂșjo, F.; Nilza Caldevilla, Maria; Maciel, CĂąndida; Fernandes, Ana PaulaIntroduction: In good organizational practice, health professionals should be provided with training programs for fall prevention. Aims: To evaluate the impact of an educational program for nurses on the prevention of falls in the elderly population in a community context. Method: This study supports the intervention phase of an Action-Research investigation. Was implemented a training program, with two steps: sensitization (S) and formation (F) held in a group of North Health Centers of Portugal. In the S step, 154 professionals from different areas participated. In the F step, 67 nurses participated. The S step occurred between February and March of 2017. The satisfaction of the training was assesseded. The F step enrolled five sessions, performed between May and June 2017. The target group of this stage were only nurses. In addition to the assessment of training satisfaction, a questionnaire was useded (pre-test). We used descriptive analysis and comparison of means using the IBM SPSS 25.0 software. The Ethics Committee for North Health centers (nÂș 97/2014) approved the study. Results: In the S step, were represented all the professional areas, but the physicians (43.8%) were more representative. In F step, the sample of nurses is mostly female (80.6%), with an age between 32-60 years. The professional activity years of nurses vary between 8 and 36 years. In the overall assessment of training satisfaction, it was verified that the training dimension (mean 3.71 and mean 3.67), respectively in sessions 3 and 5, was the most valued. Conclusion: The program revealed improvement in nursesâ knowledge.
- Try to be a nurse. Itâs Cool! - manual de apoioPublication . Cerqueira, Carla; Reisinho, Maria Da Conceição; Carvalho Pinto, Cristina; Oliveira, Manuel Fernando; Lima, Ligia; Cruz, MĂĄrcia; Barbieri-Figueiredo, MC; Nilza Caldevilla, Maria; Marques, Paulo; Parente, Paulo; Cruz, SandraA ĂĄrea da saĂșde cativou desde sempre os jovens, pelos desafios que comporta, pela proximidade e relação com os outros, saudĂĄveis ou doentes; e a enfermagem em particular tem-se constituĂdo como uma opção de grande significado, valendo por isso conhecer por dentro a sua riqueza de conteĂșdos, o seu dinamismo, a diversidade de abordagens. Uma semana entre nĂłs, no ambiente onde tudo começa a acontecer, proporcionar-te-ĂĄ uma ideia mais concreta sobre o que Ă© ser enfermeiro na actualidade, sem esquecer o caminho que outros percorreram, mas dando-te a possibilidade de experimentar nos contextos de prĂĄtica laboratorial, prĂĄticas em domĂnios que vĂŁo das crianças aos adultos, recorrendo a simuladores, manequins e dispositivos utilizados no dia-a-dia destes profissionais. A evolução e as mudanças que jĂĄ se fazem sentir na sociedade, abrem novas perspectivas e caminhos nesta ĂĄrea do saber, que estamos dispostos a ajudar-te a descobrir.
- Prevenção das quedas dos idosos: Projecto-piloto no hospital de ValongoPublication . Nilza Caldevilla, Maria
- Quais as barreiras Ă participação de cuidadores informais de pessoas dependentes num programa psico-educacional?Publication . Abreu, Margarida; Silva, Alcione; Nilza Caldevilla, MariaIntrodução: Os programas psico-educacionais tĂȘm sido amplamente recomendados como estratĂ©gia para fornecer informaçÔes e apoio aos cuidadores informais de pessoas dependentes. No entanto, a literatura aponta para nĂveis muito baixos de participação nestes programas devido a vĂĄrias barreiras. Assim, o nosso objetivo foi analisar as barreiras para a participação dos cuidadores informais de idosos dependentes num programa psico-educacional realizado numa unidade de saĂșde na Trofa. Metodologia: Estudo qualitativo realizado com 13 cuidadores informais de pessoas idosas dependentes. Como tĂ©cnica de colheita de dados foi utilizada a entrevista semi-estruturada. Na anĂĄlise dos dados recorremos Ă tĂ©cnica de anĂĄlise de conteĂșdo de Bardin. Resultados: As barreiras âsituacionaisâ foram as mais relatadas pelos participantes (n = 9), ou seja, ter que acompanhar as pessoas dependentes a consultas mĂ©dicas, a falta de tempo devido ĂĄ prestação de cuidados. Dois participantes referiram barreiras âpsicossociaisâ, ou seja, a falta de interesse em aprender e dois apontaram barreiras âinformativasâ, ou seja, desconheciam o horĂĄrio da sessĂŁo. Os resultados deste estudo vĂŁo de encontro aos de outros estudos. ConclusĂŁo: Os resultados deste estudo podem ajudar os enfermeiros a identificar as barreiras para a participação das pessoas cuidadoras em programas psico- educacionais e a desenvolver estratĂ©gias especĂficas para eliminar essas barreiras.
- Atitudes de estudantes de Enfermagem sobre o envelhecimentoPublication . Abreu, Margarida; Nilza Caldevilla, MariaIntrodução: Em Portugal, tem aumentado o nĂșmero de pessoas idosas com necessidades de cuidados de saĂșde especĂficos. Os cuidados prestados Ă s pessoas idosas estĂĄ diretamente relacionada com as atitudes dos profissionais de saĂșde, nomeadamente os enfermeiros e estudantes de enfermagem. O nosso objetivo Ă© explorar as atitudes dos estudantes de enfermagem em relação Ă velhice. Metodologia: Estudo de natureza quantitativo, exploratĂłrio e descritivo. Cento e quarenta estudantes de enfermagem do primeiro ano, constituĂram a amostra. O instrumento de colheita de dados utilizado foi o InventĂĄrio de Atitudes em Relação Ă Velhice, originalmente desenvolvido por Sheppard (1981) e adaptado para o portuguĂȘs por Neri (1986). Na anĂĄlise dos dados recorremos a medidas de tendĂȘncia central. RESULTADOS: O estudo envolveu 14 estudantes do sexo masculino e 126 estudantes do sexo feminino, com uma idade mĂ©dia de 18,7 anos. A mĂ©dia das pontuaçÔes atribuĂdas pelos estudantes nos itens de InventĂĄrio de Sheppard foi de 2,05 (DP=0,32). Em geral, este valor indica que as respostas foram negativas. A pontuação para cada fator do InventĂĄrio de Atitudes em Relação Ă Velhice estavam abaixo do ponto mĂ©dio nas dimensĂ”es "Expectativas quanto Ă atividade" e "Expectativas em relação a satisfação" (X=1,70, DP=0,39 e X=1,66, SD=0, 56, respetivamente) e valor acima do ponto mĂ©dio da escala dimensĂŁo "A ansiedade sobre a morte" (X=2,82, DP=0,71). DISCUSSĂO: Estes resultados, espelhando atitudes negativas dos estudantes em relação Ă velhice, estĂŁo em consonĂąncia com os de Celik et al. (2010). CONCLUSĂO: Os estudantes de enfermagem do 1.Âș ano demonstram atitudes negativas, em relação Ă velhice X=2.05 (SD=0.32). Compete aos professores , do ensino superior, da ĂĄrea da saĂșde, desmistificar os estereĂłtipos que acompanham o envelhecimento.
- Evaluation and cross-cultural adaptation of the Hendrich II Fall Risk Model to PortuguesePublication . Nilza Caldevilla, Maria; Costa, M. Arminda M.; Teles, Paulo; Ferreira, Pedro M.Background: Several tools for the assessment of the risk of falling are used commonly by clinical nurses, but none have been validated in Portuguese. Aims: To adapt and evaluate the Hendrich II Fall Risk Model (HIIFRM) for use with elderly Portuguese inpatients. Method: We conducted a prospective study of 586 older inpatients in acute care hospitals, from November 2007 to May 2010. Results: The study involved 270 men and 316 women. The most frequent risk factor on admission and at discharge was a score âĄ3 on the âGet Up and Goâ test. The adapted HIIFRM showed a sensitivity of 93.2% and 75.7%, and a specificity of 35% and 46.7%, on admission and at discharge, respectively. A positive predictive value of 17.2% on admission and 17% at discharge and a negative predictive value of 97.3% and 93%, respectively, were estimated. Conclusions: The HIIFRM was shown to be a useful tool in predicting falls by patients. Nevertheless, the research model suggested that only four risk factors affected the occurrence of falls significantly on admission and two risk factors at discharge. Further research is required in Portuguese hospital settings.
- A fragilidade no contexto da saĂșdePublication . AraĂșjo, F.; Joana Campos, Maria; Lumini Landeiro, Maria JosĂ©; Nilza Caldevilla, Maria
- Impacte de um programa de exercĂcio fĂsico na capacidade funcional de idosos institucionalizadosPublication . Nogueira, Isabel; Caldevilla, Maria Nilza; AraĂșjo, F.Introduction: Preventive, promotion and rehabilitation actions such as physical exercise have been able to improve the functional capacity of the institutionalized elderly. Aims: To evaluate the impact of a physical exercise program on the functional capacity of institutionalized elderly. Method: Quantitative study with a quasi-experimental design, without control group, with pre and post intervention evaluation, in a convenience sample of 23 elderly. The instrument for data collection was the form with outcome and independent variables. The study was approved by the Ethics Committee of the Escola Superior de Enfermagem do Porto. Results: The majority are female (60.9%), with a mean age of 82.4 years and a high prevalence of cerebrovascular disease (91.3%). Ÿ of the sample (74%) is polymedicated. The occurrence of falls in the last 12 months was low (13%). There was a significant improvement in joint amplitude and muscular strength in all movements and joints of the upper and lower limbs. Palmar grip strength improved in both hands. A better performance was observed in the implementation of POMA I, and the number of risk-free elderly people with a high risk of falls increased. The repercussion of improvements in self-care capacity was not effective in some domains, although the mean scores obtained showed a slight improvement trend. Of the psychosocial effects, most participants (60.9%) agreed that they improved health and mood. Conclusions: The physical exercise program implemented to institutionalized elderly, without cognitive deficit, improved the functional and psychosocial capacity.