Browsing by Author "Madeira, Carla"
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- Análise Interobservadores das práticas e comportamentos de segurança adotados pelos idosos institucionalizados para prevenir quedasPublication . Baixinho, Cristina; Dixe, Maria dos Anjos; Madeira, Carla; Alves, Silvia; Henriques, Maria AdrianaObjetivo: determinar as propriedades psicométricas da dimensão das práticas e dos comportamentos de segurança da Escala de Práticas e Comportamentos dos Idosos Institucionalizados para Prevenir Quedas numa amostra de idosos com declínio cognitivo
- Falls and Preventive Practices among Institutionalized Older PeoplePublication . Baixinho, Cristina Lavareda; Madeira, Carla; Alves, Silvia; Henriques, Maria Adriana; Dixe, Maria dos AnjosThe present study about falls among the older adult population essentially explores biophysiological factors. In light of the complexity of the factors that cause these accidents, it is important to identify the safety and self-care practices of institutionalized older adults and their relationship with falls in order to introduce prevention measures and personalized cognitive–behavioral strategies. The objective of this study was to: (a) determine the frequency of falls and their recurrence among institutionalized older adults, and (b) to associate the occurrence of falls among institutionalized adults with or without cognitive impairment to communication and safety practices. This was a quantitative, correlational, and longitudinal study with 204 institutionalized older adults living in two long-term care facilities in Portugal. The Scale of Practices and Behaviors for Institutionalized Elderly to Prevent Falls was administered to the sample. The prevalence of falls at a 12-month follow-up was 41.6%, of which 38.3% were recurring episodes. Older adults with cognitive decline showed lower mean scores for safety practices. Further research with larger samples should explore the relationships between communication and safety practices and falls, their recurrence, and fear of new falls.
- Falls in institutionalized elderly with and without cognitive decline A study of some factorsPublication . Baixinho, Cristina Lavareda; Dixe, Maria dos Anjos; Madeira, Carla; Alves, Sílvia; Henriques, Maria AdrianaFalls in long-stay institutions for elderly people have a high prevalence, contributing to the physical and mental deterioration of institutionalized elderly.
- Gait Ability and Muscle Strength in Institutionalized Older Persons with and without Cognitive Decline and Association with FallsPublication . Dixe, Maria dos Anjos; Madeira, Carla; Alves, Silvia; Henriques, Maria Adriana; Baixinho, Cristina LavaredaFalls are a complex problem, given their multifactorial nature, the comorbidities involved, and due to the dependency of older persons living in nursing homes. Risk, fear of falling, falls themselves, and their recurrence are the main factors behind fragility fractures, lack of independence, and increases in pain prevalence, and other comorbidities in older populations. The objectives of the present quantitative and longitudinal study were: (a) to characterize the cognitive state and fall frequency of older persons living in nursing homes; (b) to analyze the relationship between cognitive status and some fall risk factors; and (c) to associate cognitive decline, gait ability, and muscle strength of the examined institutionalized older persons with fall occurrence and recurrence over 12 months. The participants were 204 older persons who lived in Portuguese nursing homes, and data were collected from January 2019 to February 2020 by consulting medical records and applying the following instruments: the Mini-Mental State Examination, Timed Up and Go Test, and Medical Research Council Manual Muscle Testing Scale. Fall prevalence, assessed in two periods, 12 months apart, was similar in both samples (with and without cognitive decline) and close to 42%, and the annual recurrence rate was 38.3%. Older persons with no cognitive decline showed an association between gait speed and occurrence of first fall and recurrent fall (p < 0.05). Muscle strength and use of gait aid devices were not related to falls and their recurrence, regardless of mental state.
- Transitional Care Management from Emergency Services to Communities: An Action Research StudyPublication . Batista, José; Pinheiro, Carla Munhoz; Madeira, Carla; Gomes, Pedro; Ferreira, Óscar Ramos; Baixinho, Cristina LavaredaIn recent years, nurses have developed projects in the area of hospital to community transition. The objective of the present study was to analyze the transitional care offered to elderly people after they used emergency services and were discharged to return to the community. The action research method was chosen. The participants were nurses, elderly people 70 years old or older, and their caregivers. The study was carried out from October 2018 to August 2019. The data were collected by means of semi-structured interviews with the nurses, analysis of medical records, participatory observation, phone calls to the elderly people and caregivers, and team meetings. The qualitative data were submitted to Bardin’s content analysis. Statistical treatment was carried out by applying SPSS version 23.0. The institution’s research ethics committee approved the research. Only 31.4% of the sample experienced care continuity after discharge, and the rate of readmission to emergency services during the first 30 days after discharge was 33.4%. The referral letters lacked data on information provided to patients or caregivers, and nurses mentioned difficulties in communication between care levels, as well as obstacles to teamwork; they also mentioned that the lack of health policies and clinical rules to formalize transitional care between the hospital and the community perpetuated non-coordination of care between the two contexts. The low level of literacy of patients and their relatives are mentioned as a cause for not understanding the information regarding seeking primary health care services and handing the discharge letter. It was concluded that there is an urgent need to mobilize health teams toward action in the patients’ process of returning home, and this factor must be taken into account in care planning.