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Previous issue date: 2016-06-13 / A queda ? uma s?ndrome geri?trica associada ? alta morbimortalidade nos idosos. Este trabalho tem como objetivo determinar a incid?ncia e os fatores de risco relacionados a quedas em idosos institucionalizados na cidade do Natal-RN. Para esse fim, foi realizado um estudo longitudinal tipo coorte com per?odo de dura??o de um ano. Foram avaliados idosos residentes nas 10 Institui??es de longa perman?ncia para idosos (ILPI) do munic?pio do Natal-RN, que deambulassem e possu?ssem capacidade cognitiva preservada, avaliada a partir do question?rio de Pfeiffer. Do total de 364 idosos residentes nas ILPI, 130 foram inclu?dos de acordo com os crit?rios estabelecidos para inclus?o e exclus?o. Foi questionado ocorr?ncia de quedas no ?ltimo ano. Vari?veis referentes ? institui??o, condi??es s?cio-demogr?ficas e sa?de do idoso foram coletadas por meio de question?rio aplicados aos idosos ou cuidadores, ou ainda pela coleta nos prontu?rios. Foram utilizados os question?rios Escala de depress?o geri?trica, Escala de depress?o CES-D, Escala de sonol?ncia de Epworth e o ?ndice de Barthel. Dados ambientais, antropom?tricos e de exame f?sico (Timed up and go - TUG, Escala de Equil?brio de Berg - EEB, Velocidade de marcha - VM, For?a de preens?o palmar - FPP e Teste do sentar e levantar - TSL) foram obtidos a partir de dados secund?rios. As an?lises estat?sticas foram realizadas por meio dos testes de Qui-quadrado ou Exato de Fisher e Regress?o Log?stica, considerando o n?vel de signific?ncia de 5%. Como resultados, na an?lise ambiental nenhuma institui??o cumpriu todas as normas da ANVISA. Pela avalia??o f?sico-funcional, h? infer?ncia para risco de quedas. Sessenta e dois idosos ca?ram ao final dos doze meses de avalia??o, com incid?ncia de 47,7% (IC95%=39,59-55,81) e uma taxa de quedas por pessoa/ano de 1,65 (+ 8,43). Para quedas recorrentes, a incid?ncia foi de 26,92% (IC= 22,38 - 31,46), representando 56,45% dos idosos que ca?ram. A maioria das quedas ocorreu no quarto e foram encontrados como fatores de risco o uso de antiepil?pticos e fadiga e como fatores de prote??o o decl?nio de mobilidade e uso de medicamentos antitromb?ticos, ajustados pela terap?utica tireoidiana, funcionalidade, sexo e hospitaliza??o. Para duas ou mais quedas, foram identificados fadiga como fator de risco e uso de betabloqueadores como fator de prote??o, ajustados pelo uso de medicamento antitromb?tico, antiepil?ptico, funcionalidade, sexo e idade. Conclui-se que queda ? um evento bastante incidente nas ILPI e que a fadiga foi identificada como fator de risco para queda ?nica ou recorrente, devendo a condi??o f?sica do idoso e o cansa?o serem levados em considera??o no momento de sua avalia??o. / Falls are a common geriatric syndrome and are related to high morbidity and mortality among this age group. The risk of falls among institutionalized elderly persons is higher due to their poor health, impaired mobility, increased frailty and functional dependence. This study aims to determine the incidence and risk factors related to falls among institutionalized elderly. To this purpose, a one-year longitudinal cohort study was carried out. Residents of ten Homes for the Aged (HA) in the city of Natal, Rio Grande do Norte, who has both the ability to walking (with or without assistance) and preserved cognitive function were assessed. Following the application of the inclusion and exclusion criteria, 130 of a total of 364 elderly residents of the HA were included in this study. The occurrence of falls over the last twelve months was asked to the elderly residents, caregivers and a research strategy was performed through the nursing records. Variables regarding to the institutions, socio-demographic conditions, use of daily medications, chronic diseases, hospitalization and fractures were collected from medical records The elderly residents were asked regarding to depression, fatigue, cognition status, dizziness and somnolence while caregivers were asked about the functional capacity of the elderly residents. Environmental, anthropometric and functional capacity data was obtained from secondary sources. Statistical analysis was performed using the Chi-squared or Fisher's exact tests and stepwise forward Logistic Regression, considering a statistical significance level of 5%. The environmental analysis results found that no institution met all the necessary Health Surveillance guidelines. Physical and functional assessment revealed implications for the risk of falls. A total of 62 elderly persons had fallen at the end of the twelve-month evaluation, with an incidence of 47.7% (CI 95% = 39.59 to 55.81) and a rate of falls per person/year of 1.65 (+ 8.43). The incidence of recurrent falls was 26.92% (CI95% = 22.38 to 31.46), equivalent to 56.45% of the elderly individuals who had fallen. Most falls occurred in the rooms of the elderly individuals. The use of antiepileptic drugs and fatigue, were found to be risk factors, while reduced mobility and use of antithrombotic drugs were identified as protective factors, adjusted by thyroid therapy, functionality and sex. It was concluded that falls are a high incident events in HA and fatigue and antiepileptic drugs were identified as risk factor for falling. Therefore the physical condition of the elderly should be assessed as well drugs with nervous central system action should be discontinued or replaced whenever possible.
| Identifer | oai:union.ndltd.org:IBICT/oai:repositorio.ufrn.br:123456789/21840 |
| Date | 13 June 2016 |
| Creators | Ferreira, Lidiane Maria de Brito Macedo |
| Contributors | 50337157472, Ribeiro, Karyna Myrelly Oliveira Bezerra de Figueiredo, 67300448453, Pernambuco, Leandro de Ara?jo, 02862922463, Ferreira, Maria Angela Fernandes, 39817270459, Perracini, M?nica Rodrigues, 12614123897, Lima, Kenio Costa de |
| Publisher | PROGRAMA DE P?S-GRADUA??O EM SA?DE COLETIVA, UFRN, Brasil |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/doctoralThesis |
| Source | reponame:Repositório Institucional da UFRN, instname:Universidade Federal do Rio Grande do Norte, instacron:UFRN |
| Rights | info:eu-repo/semantics/openAccess |
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