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- El cuidado de familiares adultos: ¿Cómo afecta a la salud y al bienestar del cuidador familiar?Publication . Araújo, F.; Peixoto, Maria José; Martins, Teresa; Lumini Landeiro, Maria José; Pinto Martins Salazar Almeida, Berta Maria; Machado, Paulo Alexandre Puga; Freire, R.M.A.Introducción. El cuidado de un miembrode la familia con dependencia para los cuidados personales es un procesocomplejo que afecta a la salud y al bienestar del cuidador familiar. Objetivos. Sistematizar la producción científica nacional sobre las implicacionesen la salud y bienestar de los que tienen a su cargo cuidar familiares com dependencia en el autocuidado. Método. Se llevó a cabo una revisión integradora, respaldada por el Repositório Científico de Acesso Aberto de Portugal entre los años 2000 y 2012, en la que se tuvieron en cuenta todos los documentos completos accesibles. Seutilizó el método PI(CO)D. Para el análisis de los datos se solicitó la intervenciónde dos revisores independientes. Se utilizaron los indicadores del Joanna Briggs Institute para analizar la calidad metodológica de los estudios. Resultados. Se seleccionaron doce estúdios principales. La mayoría de ellos se basaban en investigación observacional de tipo transversal/descriptivo, lo cual permite describir el perfil de los cuidadores familiares e identificar sus necesidades y los factores relacionados con la sobrecarga. Los resultados muestran una mayor sobrecarga/estrés en los cuidadores familiares de personas con demencia y con un nivel elevado de dependencia. La mayor sobrecarga está relacionada con una mala percepción del estado de salud, de la satisfacción y de la calidad de vida del cuidador familiar. Los niveles de sobrecarga asociada, depresión emocional y estrés son más elevados en las mujeres que en los hombres. Conclusiones. La naturaleza de los estúdios utilizados permite identificar el impacto que supone el cuidado de un familiar con dependencia para los cuidadores familiares. No obstante, es imposible analizar los resultados de manera dinámica a lo largo de un periodo de tiempo. Es importante centrarse en la investigación basándose en los mejores datos clínicos disponibles para potenciar la toma de decisiones en la práctica clínica.
- Formulário de avaliação da dependência no autocuidadoPublication . Pereira, Soraia; Martins, Teresa; Puga Machado, Paulo AlexandreIntrodução: A avaliação da capacidade de autocuidado da pessoa dependente, com recurso a instrumentos de medida e a avaliação do nível e tipo de dependência, pode possibilitar aos enfermeiros uma melhor compreensão da natureza dos problemas que afetam a dependência e o estabelecimento de um plano de ação orientado para a promoção da autonomia. O presente trabalho apresenta como objetivo o estudo das propriedades psicométricas de uma versão reduzida do Formulário da Avaliação da Dependência no Autocuidado (FADA), constituído por um total de 27 atividades de avaliação, distribuídos por 10 domínios de autocuidado. Metodologia: O método de amostragem utilizado foi o não probabilístico, do tipo acidental. Para além do formulário referido foram ainda utilizados o Índice de Barthel (IB), a Escala de Lawton e Brody (ELB) e a versão em português do instrumento Appraisal of Self-Care Agency Scale (ASA-A). Resultados: A versão reduzida do FADA apresenta relações significativas entre todos os domínios de autocuidado, e entre os instrumentos IB e ELB. Já ao nível do ASA-A não se observaram relações estatisticamente significativas. O formulário apresenta ainda uma elevada fiabilidade, com uma consistência interna traduzida pelo coeficiente de alfa de Cronbach de 0,97. Discussão: O nível de especificação do FADA permite compreender o tipo de dependência que a pessoa possui, e a sua construção feita por domínios específicos de autocuidado e de acordo com a CIPE, permite uma maior relação entre os focos de atenção de enfermagem e seus registos. A versão reduzida do FADA apresenta relações significativas entre todos os domínios de autocuidado, o que nos faz pensar na multidimensionalidade do autocuidado. A versão reduzida do FADA revela-se, pois, um instrumento válido e fiável, ao mesmo tempo que ostenta robustez e um grande poder discriminativo, auxiliando a prática da enfermagem.
- Self‐Care Dependency Evaluation Form: Psychometric properties of the revised version with 27 itemsPublication . Parente, Paulo; Costa, Andreia; Pereira, Soraia; Puga Machado, Paulo Alexandre; Martins, Teresa; Pereira, Filipe Miguel Soares; Silva, AbelAbstract Introduction: The Self-Care Dependency Evaluation Form assesses dependency in performing self-care activities, but its original version is extensive and provides redundant information. The present study aims to scrutinise the items of the scale with the purpose of creating a revised version and to evaluate its psychometric properties. Methods: The study was conducted in two phases. In the first phase, an exploratory and correctional analysis of the items of the original form was performed from a database with 282 participants, followed by a review by a panel of experts who analysed the discriminatory ability and the contribution and relevance of each item, which resulted in the revised version. In the second phase, a new study with a sample comprising 150 participants was conducted to test the psychometric properties of the revised version. All ethical aspects and matters of confidentiality and privacy were assured. Results: The scale with 27 items shows good internal consistency, ranging from 0.67 (taking medication) to 0.96 (walking). It was moderately correlated with the Barthel Index and the Lawton and Brody Scale, proven to be a discriminatory measurement instrument. Discussion/Conclusion: This measure will enable health professionals to better evaluate self-care activities and provide more efficient, simple and effective prescriptions.
- Avaliação da dependência no autocuidado: estudo exploratório do fenómeno em contexto comunitárioPublication . Pereira, Soraia; Martins, Teresa; Machado, Paulo Alexandre PugaThe assessment of the dependent person’s self-care ability, through measurement instruments, and the assessment of the level and kind of dependency, may provide nurses a more assertive method for understand the nature of the problems that affect dependency and for establish an action plan tailored to the development of new practices centered on the dependent person, looking forward to promote autonomy. Within this context, and in order to develop nursing practice in self-care dependency context, this paper serves the goal of the characterization of dependent people in self-care in a community context and the analysis of the different domains of self-care according to sociodemographic and clinical variables. It was used the non-probabilistic sampling method, of the accidental type and for data collection was used the reduced version of the Self-Care Dependency Assessment Form. The results found show that women and the elderly are more dependent, and that the dependence settles mainly gradually. Regarding the level of dependence by self-care domain, the one that registered the highest level of dependence was self-care “taking medication”, followed by “dressing and undressing” and self-care “taking a bath”. The “global level of dependence” has an average of 2.64 and a standard deviation of 0.83, which reveals high degrees of dependence on self-care. With current demographic changes and consequent health needs and their implications for health policy preparation and planning, the measurement and evaluation of the dependent person and their caregiver is becoming increasingly essential, enabling a holistic and adjusted approach.
- Functional capacity and self‐care profiles of older people in senior care homesPublication . Imaginário, Cristina; Rocha, Magda; Machado, Paulo Alexandre Puga; Antunes, Cristina; Martins, TeresaThe reduction of the functional capacity in older people is the result of physical, psychological and functional changes related to the ageing process, compromising the performance of daily life activities. Assessing their functional capacity and their self-care profile can facilitate the planning of targeted strategies related to stimulation, as well as cognitive and motor rehabilitation. This study aims to evaluate and analyse the functional capacity, as well as the level of dependence in self-care of older people in senior care centres. This is a transversal exploratory study, quantitative in nature. The sample was comprised of 313 participants, randomly selected from a set of senior care centres, with an average age of 83.41 (SD=7.14) years, recruited from the interior North of Portugal. The data collection instruments included the Barthel Index, the Lawton and Brody Scale, the Evaluation Form of Dependence in Self-care, the Self-care of Home Dwelling Elderly (self-care subscale profiles) and a questionnaire on demographic data. The elderly showed several levels of dependence on different self-care items. It was possible to observe that the staff often replaces the elderly in many of the tasks that could still be performed by them, and thus aggravates their levels of dependence. The link observed between functional capacity and self-care profiles highlights the need to focus on the notion of a healthy and active ageing process, especially in some profiles. The monitoring of the functional capacity and the self-care profile can provide knowledge concerning the potential for autonomy and individual needs, thus enabling targeted and more responsive interventions for the individual and the real needs of older people.
- The link between cognitive state and general self-esteem among institutionalized elderly persons: can health condition serve as a mediating factor?Publication . Imaginário, Cristina; Rocha, Magda; Machado, Paulo Alexandre Puga; Antunes, Cristina; Martins, TeresaObjetivo: testar se a condição de saúde da pessoa idosa é mediadora na associação entre o estado cognitivo e a autoestima global de idosos institucionalizados. Método: estudo de natureza quantitativa, transversal do tipo correlacional, recorreu à análise de caminhos. Na recolha de dados utilizaram-se as versões portuguesas dos seguintes instrumentos: Mini-Mental State Examination, Tinetti Performance Oriented Mobility Assessement, Miniavaliação Nutricional e a Rosenberg Self-Esteem Scale. Resultados: a amostra foi constituída por 312 idosos de ambos os gêneros (112 homens e 200 mulheres), com média etária de 83,39 (+7,09) anos. A maioria dos idosos eram viúvos, com baixa escolaridade, institucionalizados em Equipamentos Residenciais para Pessoas Idosas em média há 54,60 (+51,69) meses. Não se confirmou a mediação da condição de saúde na associação entre estado cognitivo e autoestima nos idosos. Contudo, a análise da decomposição dos efeitos indicou a existência de um efeito significativo indireto do estado cognitivo na autoestima e na condição de saúde. O efeito total do estado cognitivo na condição de saúde dos idosos é significativo, positivo e direto. Conclusão: os resultados desse estudo permitem-nos afirmar que as alterações cognitivas podem afetar o estado nutricional e o equilíbrio corporal dos idosos institucionalizados.
- Programas de intervenção para familiares cuidadores de pessoas dependentesPublication . Freire, R.M.A.; Martins, Teresa; Peixoto, Maria José; Puga Machado, Paulo Alexandre; Vilela, Carlos
- Self-care profiles of the elderly institutionalized in Elderly Care CentresPublication . Imaginário, Cristina; Rocha, Magda; Machado, Paulo Alexandre Puga; Antunes, Cristina; Martins, TeresaThe concept of self-care in the elderly has been frequently associated with autonomy, independence and personal accountability. Self-care practices are a result of individual lifestyles and paths adapted to the circumstances and expectations of the elderly. Based on the model by Backman and Hentinen (1999), the present study attempts to categorically describe the types of self-care of the elderly. This is an exploratory study, transversal, of a quantitative nature. The sample was comprised of 313 participants, randomly selected among Elderly Care Centres in the interior North of Portugal. The Portuguese version of Self-care of Home Dwelling Elderly was used for data collection. The results call for a replication of the study, using the theoretical derivation of the four self-care profiles (responsible, formally guided, independent and abandoned).
- Risk Factors Associated with Falls among Nursing Home Residents: A Case-Control StudyPublication . Imaginário, Cristina; Martins, Teresa; Araújo, F.; Rocha, Magda; Puga Machado, Paulo AlexandreIntroduction: To identify factors predictive of falls and enable appropriate management of fall risk it is necessary to understand the behaviour and health conditions of older adults living in nursing homes. Objective: This study had two main objectives. The first was to find significant predictors for falls in older adults living in nursing homes. The second main goal was to build a predictive model to find the best predictors for falls. Methods: Out of 56 nursing homes with the same legal statute, 25 agreed to participate. The sample was randomly selected and only the independent or slight/ moderately dependent participants were included in the study (n = 325). Results: There was a mean of 1.47 ± 0.99 falls (range from 1 to 7) per resident in nursing homes. By using the t test and odds ratio analysis, ten factors related to falls were identified. Through the binary logistic regression, a model was tested identifying four robust predictors: static balance, resorting to emergency services, polypharmacy, and an independent self-care profile. Conclusions: The present study replicated the main results of contemporary research on the risk factors of falls. More importantly, it suggests that the self-care profile model should be taken into account in future studies and early interventions. It is crucial to implement preventive measures consistent with safer environments and to establish an individual plan for integrated activities according to older adults’ health needs.
- Avaliação da dependência no autocuidado da pessoa dependentePublication . Pereira, Soraia; Martins, Teresa; Puga Machado, Paulo Alexandre