Loading...
14 results
Search Results
Now showing 1 - 10 of 14
- 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.
- 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.
- 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.
- A pandemia por covid-19 numa comunidade escolar do ensino superiorPublication . Freire, R.M.A.; Bastos, Fernanda; Nilza Caldevilla, Maria; Sousa, Maria Rui; Teixeira, Manuela; Abreu, MargaridaIntrodução: Na sequĂȘncia do aparecimento do SARS-COV-2, a escola desenvolveu um conjunto de açÔes para prevenir e controlar a transmissĂŁo deste agente. Seguindo as orientaçÔes da Direção-Geral da SaĂșde (2020), o Plano de ContingĂȘncia Covid-19, entretanto criado, teve como objetivo, nomeadamente, a monitorização epidemiolĂłgica da comunidade escolar. Objetivos: Descrever as variĂĄveis sociodemogrĂĄficas e clĂnicas dos indivĂduos que estiveram em isolamento profilĂĄtico ou quarentena, por Covid-19, determinado pelos serviços de saĂșde e analisar a incidĂȘncia da infeção e do nĂșmero de indivĂduos em isolamento profilĂĄtico na comunidade escolar. Metodologia: Estudo descritivo, de natureza epidemiolĂłgica, cuja população incluiu todos os indivĂduos que voluntariamente notificaram Ă equipa do plano de contingĂȘncia (EPC) a sua situação. Estas notificaçÔes reportaram-se aos casos de isolamentos profilĂĄticos ou quarentena por Covid-19 que ocorreram num perĂodo de 12 meses. Os dados colhidos tiveram por base a informação facultada pelos indivĂduos. As variĂĄveis foram analisadas recorrendo-se Ă anĂĄlise estatĂstica descritiva e inferencial. Atendeu-se aos aspetos Ă©ticos inerentes Ă pesquisa com seres humanos. Resultados: Dos 331 indivĂduos que contactaram a EPC, 69,8% estiveram em isolamento profilĂĄtico e 30,2% em quarentena. A maioria Ă© do sexo feminino (84,9%) e aproximadamente 90% da amostra sĂŁo estudantes do curso de licenciatura em enfermagem. Quanto ao local de contacto de risco, maioritariamente ocorreram na comunidade (44,7%), 6% na escola e 38,7% no ensino clĂnico (EC). Destes, 48,3 % ocorreram em EC hospitalar, verificando-se uma maior incidĂȘncia de casos positivos neste contexto (p â€0,005). Verificou-se que estes indivĂduos residem maioritariamente nos concelhos de Gondomar (27,7% e 8% dos estudantes em isolamento profilĂĄtico e quarentena, respetivamente), Matosinhos (33,3% e 7%, dos estudantes em isolamento profilĂĄtico e quarentena, respetivamente) e Porto (22,6% e 7% dos estudantes em isolamento profilĂĄtico e quarentena, respetivamente). ConclusĂ”es: Verificou-se que o local de contacto de risco foi predominantemente externo Ă instituição. Os estudantes em EC hospitalar estiveram mais expostos ao contĂĄgio do que os que frequentaram o EC na comunidade. TambĂ©m nĂŁo se exclui a possibilidade de uma maior exposição dos estudantes com atividades presenciais, resultante da deslocação para os contextos de EC ou para o edifĂcio da escola. Acresce referir a existĂȘncia de estudantes trabalhadores, nomeadamente dos cursos pĂłs-graduados, que sĂŁo enfermeiros.
- Non-pharmacological interventions in the control of urinary incontinence and the instruments that allow the diagnosis: integrative reviewPublication . Nilza Caldevilla, Maria; Carvalho Pinto, Cristina; Cerqueira, Carla; Ramos, JosĂ©; Teixeira, Leonor OlĂmpiaIntroduction: Urinary incontinence is a major health problem resulting in physical, psychological and social changes with economic repercussions on the health system. Is a multifactorial condition associated with age-related changes and disorders of the genitourinary system, which corroborates the fact that it is the most often recurring geriatric syndrome. Aims: To identify non-pharmacological interventions for adults with urinary incontinence and to identify tools for urinary incontinence diagnosis in adults. Method: An integrative review study design was completed. Two electronic databases was search (MEDLINE and Web of Science). Three independent reviewers searched databases according to a predetermine inclusion and exclusion criteria. Results: Twelve articles were included in the review. Eleven articles mentioned non-pharmacological interventions, such as physical therapies, lifestyle strategies, behavioural therapies and alternative conservative management options. These interventions should be targeted and individualized to the type of incontinence to result in health gains for the population. One article mentioned an assessment tool for urinary incontinence - The Gaudenz-Fragebogen tool. The evaluation tools can help to systematize the diagnostic activity and consequently improve the clinical practice in the field of urinary incontinence. Conclusion: In care conception, nurses should target their interventions to personal data to address individual symptoms and use assessment tools that can help in the differential diagnosis of UI. Then, to advancing the quality and rigor of nursing care, we advocate that providing nurses with skills in attaining a differential diagnosis of UI presents an added value to the improvement of quality of care in a multidisciplinary context.
- Factores de riesgo de caĂda en la comunidad: basado en auto-reporte de personas mayoresPublication . Nilza Caldevilla, Maria; AraĂșjo, F.; Marques, Paulo; Cruz, Sandra; Martinho, JĂșlia; Martins, MMIntroduction: Several studies have shown independent risk factors for falling among community older people. However, there is few researches showing the importance of older personâs perception of their own fall risk. Aims: The study purpose was to identify independent risk factors for falls and to explore predictive factors related to the occurrence of falls in community-dwelling older people. Method: A cross-sectional study was conducted from January to April 2015. All data were based on self-report of older persons. An study-specific questionnaire was used. Univariate and logistic regression analyses were used. Results: The sample comprised 562 men and 760 women. Among the participants, 24.5% reported having had falls in the previous six months, scoring a total of 467 falling events. Of the individuals who had fallen, 36.8% had experienced recurrent falls. The risk of fall was nearly twice as high in women than in men (OR=1.85; 95% CI: 1.40-2.43). Being 75 years old or older was associated with an increased risk of falling compared with being 65-74 years old (OR=2.38; 95% CI:1.82-3.11). The elderly who had fallen reported injuries (48.3%) associated with falls, and 36% required health care. Conclusion: Six independent risk factors for falling into the community dwelling older people were identified, some of which are potentially modifiable.
- Physical Exercise Program on Fall Prevention Using Technological Interface: Pretest StudyPublication . Nilza Caldevilla, Maria; Silva, Joana; Nogueira, Isabel; Pacheco, Maria Neto; Lopes, Joana; AraĂșjo, F.Background: Prevention of falls among older adults has boosted the development of technological solutions, requiring testing in clinical contexts and robust studies that need prior validation of procedures and data collection tools. Objective: The objectives of our study were to test the data collection procedure, train the team, and test the usability of the FallSensing Games app by older adults in a community setting. Methods: This study was conducted as a pretest of a future pilot study. Older adults were recruited in a day care center, and several tests were applied. Physical exercise sessions were held using the interactive FallSensing Games app. Nurse training strategies was completed. Results: A total of 11 older adults participated. The mean age was 75.08 (SD 3.80) years, mostly female (10/11, 91%) and with low (3-6 years) schooling (10/11, 91%). Clinically, the results show a group of older adults with comorbidities. Cognitive evaluation of the participants through the Mini Mental State Examination showed results with an average score of 25.64 (SD 3.5). Functional capacity assessed using the Lawton Instrumental Activities of Daily Living Scale (overall score from 0-23, with lower scores reflecting worse capacity to perform activities) showed impairment in different instrumental activities of daily living (average score 14.27). The data collection tool proved to enable easy interpretation; however, its structure needed small adjustments to facilitate the data collection process. Despite the length of the questionnaire, its implementation took an average of 21 minutes. For the assessment of the prevalence of fear of falling, the need to add a question was identified. The performance of functional tests under the guidance and presence of rehabilitation nurses ensured the safety of the participants. The interactive games were well accepted by the participants, and the physical exercises allowed data collection on the functionality of the older adults, such as the number of repetitions in the tests, range of movement (angle), duration of the movements, and execution of each cycle. Concerning the training of the nurses, it was crucial that they had experience with the platform, specifically the position of the chair facing the platform, the position of the feet, the posture of participants, and the use of sensors. Conclusions: In the future pilot study, the researchers point out the need to design a study with mixed methods (quantitative and qualitative), thus enriching the study results.
- Envelhecimento demogrĂĄficoPublication . Nilza Caldevilla, Maria; AraĂșjo, F.
- A Queda: Um problema de saĂșde pĂșblicaPublication . Nilza Caldevilla, Maria; AraĂșjo, F.