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- Flebite e infiltração: traumas vasculares associados ao cateter venoso periféricoPublication . Braga, Luciene Muniz; Parreira, Pedro Miguel; Oliveira, Anabela de Sousa Salgueiro; Mónico, Lisete dos Santos Mendes; Arreguy-Sena, Cristina; Henriques, Maria AdrianaObjetivo: determinar a taxa de incidência e os fatores de risco para os indicadores sensíveis aos cuidados de Enfermagem, flebite e infiltração, em pacientes portadores de cateteres venosos periféricos (CVPs). Método: estudo de coorte com 110 pacientes. Utilizou-se escalas para avaliar e documentar flebite e infiltração. Recolheram-se variáveis sociodemográficas, clínicas, relativas ao CVP, à medicação e à internação, bem como efetuou-se análise descritiva e inferencial, e modelação logística multivariada. Resultados: a taxa de incidência de flebite e infiltração foi de 43,2 e 59,7 por mil cateteres-dia, respectivamente. A maioria dos CVPs foi removida nas primeiras 24h devido a esses traumas vasculares. Foram fatores de risco para flebite o tempo de internação (p=0,042) e o número de cateteres inseridos (p<0,001), sendo para infiltração a piperacilina/tazobactan (p=0,024) e o número de cateteres inseridos (p<0,001). Conclusão: a investigação documentou a incidência de indicadores sensíveis aos cuidados de Enfermagem (flebite e infiltração) e evidenciou novos fatores de risco relacionados à infiltração. Possibilitou, também, uma reflexão sobre os cuidados de Enfermagem para prevenir esses traumas vasculares, as indicações e as contraindicações do CVP, tendo subsidiada a implementação do PICC nas práticas de Enfermagem como alternativa ao CVP.
- 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.
- Prevention of falls - interventions in the home visits to the elderly: scoping reviewPublication . Oliveira, Teresa; Baixinho, Cristina; Henriques, Maria AdrianaBackground: The prevalence of falls in the elderly population is high, causing mortality, morbidity, and loss of functionality, contributing to an increase in the elderly’s dependence, loss of quality of life and decrease in the average life expectancy. This study aims to identify the interventions performed during the home visit that may have an impact on the reduction of risk, on the prevention of falls, on their recurrence and / or on secondary injuries. Methods and Findings: Scoping review, with the inclusion of primary studies to answer the research question: Which nursing interventions during the home visit prevent the (C) fall in the home (Co) of the Elderly Person? Research conducted in the databases available on the search engines of EBSCO, B-On, ISI; SCOPUS and JBI, inclusion and exclusion criteria were defined. The search time limit has been restricted to the last 5 years. The 10 studies that integrate the sample are heterogeneous, evaluated a total of 32,308 elderly. The use of cognitive-behavioral strategies has a positive effect on reducing mortality, institutionalization, falls and functional decline. The results of our investigation are not conclusive as to the effect of physical exercise performed at home in the prevention of falls. The elderly positively evaluate the performance of home visits to prevent falls. Conclusions: Evidence on the effectiveness of home visits for falls prevention is low. Future studies should explore the effectiveness of different programs to promote physical activity and social participation in reducing the risk and prevalence of falls.
- Evaluation of the effectiveness of an intervention in a health team to prevent falls in hospitalized elderly peoplePublication . Cunha, Luís Filipe Correia da; Baixinho, Cristina Lavareda; Henriques, Maria Adriana; Sousa, Luís Manuel Mota; Dixe, Maria dos AnjosTo evaluate the effectiveness of an intervention program in practices and behaviors of a health team to prevent falls in hos pitalized elderly people. Method: This was an action, mixed-methods, and longitudinal study that applied an intervention based on TeamSTEPPS® , and organized into five domains: team training, communication, leadership, monitoring, and mutual support. The population was nurses and nursing aides who worked at the medical service of a Portuguese hospital center. Data were obtained by consulting process records and interviews, and by applying the Scale of Practices and Behaviors of Teams for Fall Prevention. Results: There was improvement in all indicators of the scale, with evident progress in discussion of risk factors and preventive measures to be implemented. Conclusion: This intervention promoted decision-making regarding the preventive measures to be applied to each elderly person and improved communication and the interest in identifying the causes of falls to prevent their recurrence.
- The fear of falls in the caregivers of institutionalized eldersPublication . Baixinho, Cristina; Dixe, Maria dos Anjos; Henriques, Maria Adriana; Marques-Vieira, Cristina; Sousa, LuisAims To understand how the fear of falls emerges and manifests itself in caregivers of institutionalized elders. Method It is a qualitative study, based on the Grounded Theory and carried out with 24 informal caregivers, 5 nurses, 2 physicians and 2 directors of two Portuguese nursing homes. Data collection took place through interviews, participant observation, and documentation analysis, between October 2016 and January 2018. Data was collected and analyzed simultaneously, following the stages of open, axial, and selective coding. Results The comparative analysis of the findings identified the conceptual category "Fear of falls in the caregivers of institutionalized elders". The main category is associated with the categories: maintaining safety, hidden fear of falls, the perceived self-efficacy in the prevention of falls, falls and interpersonal relations, previous experiences, and team support. Conclusions The fear has an influence on the self-efficacy perceived in the prevention of falls; the quality of the teamwork, in turn, is affected by previous negative experiences and by the support of the team.
- 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
- Risco multidimensional de queda em idososPublication . Oliveira, Teresa; Baixinho, Cristina; Henriques, Maria AdrianaObjetivo: Identificar fatores de risco de queda presente numa amostra de idosos residentes na comunidade. Métodos: Trata-se de estudo descritivo, transversal e exploratório, com amostra de 31 idosos de uma Unidade de Cuidados na Comunidade, da região de Lisboa e Vale do Tejo, Portugal, entre outubro de 2016 e fevereiro de 2017. Aplicaram-se escalas e instrumentos de avaliação funcional para mensurar fatores de risco. Utilizou-se estatística descritiva. Resultados: A maioria da amostra tem idade igual ou superior a 75 anos (67,7%, n=21) e apresenta mais de um fator de risco de queda em cada dimensão. Salientam-se diminuição da velocidade da marcha, com 58,1% (n=18) dos idosos a demorar mais de 12,6 segundos para realizar o Timed Up and Go Test; 54,8% (n=17) é dependente em grau moderado ou severo; 48,3% (n=15) sem ou com pouca confiança na realização das atividades; 38,7% (n=12) consome benzodiazepinas e média de 4,6 medicamentos diários. Na avaliação ambiental do domicílio, os investigadores observam iluminação adequada apenas nas cozinhas. Na totalidade, tem pelo menos um tapete em casa; 38,7% (n=12) tem animal doméstico no interior da habitação e 61,3% (n=19) possui, pelo menos, uma peça de mobília instável. Os comportamentos de segurança são baixos: 98,6% (n=30) nunca foi alertado para os riscos de queda, 61,3% (n=19) refere não ser perseverante na escolha das medidas preventivas. Conclusão: Os fatores de risco de queda são multidimensionais. Salientam-se diminuição da velocidade de marcha, pouca confiança na realização das atividades, polimedicação e não adoção de comportamentos de segurança pelos idosos.
- 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.