RESUMO

Older adults face a decline in the quality of their diet, which affects their health. The prevalence of DM2 is increasing, as are the associated complications. Effective nutrition education and mobile health (mHealth) interventions offer a viable solution in the scenario of the widespread use of mobile devices. This study aimed to develop and validate messages for a mobile application aimed at older adult Brazilians with DM2 who receive care at the Brazilian Unified Health System (SUS). The educational messages on healthy eating for older adults with DM2 were created from 189 excerpts selected from Brazilian official documents. A total of 37 messages were created, categorized into 20 educational, 12 motivational, and 5 congratulatory, all up to 120 characters. Twenty-one experts validated the messages for clarity and relevance, and 11 messages had to be revised to meet the criteria. Subsequently, the 36 messages approved by the experts were tested on a sample of 57 older adults, guaranteeing clarity rates of over 80%. This study developed and validated 36 messages for a mobile health app aimed at older adults with type 2 diabetes mellitus in Brazil. Expert evaluation ensured clarity and relevance, confirmed by older adult participants who evaluated clarity. This research highlights the potential of mHealth to overcome barriers to accessing healthcare in the SUS, emphasizing personalized interventions for the effective management of older adults' health.

Assuntos

RESUMO

OBJECTIVE: Build and validate a terminological subset of ICNP® for the prevention of falls in the elderly in the context of primary health care, in light of the Self-Care Deficit Theory. METHOD: Methodological study developed in accordance with ICN recommendations and the Brazilian method for constructing terminological subsets, in two stages: 1) construction of ICNP® statements of nursing diagnoses, outcomes, and interventions; 2) content validation of statements by specialist nurses. RESULTS: A total of 182 diagnoses/outcomes and 321 nursing interventions were constructed, which were subjected to content validation by 28 experts, being validated with a Content Validity Index ≥ 0.80. After validation, the statements were organized according to self-care requirements and the majority of diagnoses/outcomes (51.6%) and interventions (52.7%) were classified under health deviation requirements. CONCLUSION: It was possible to construct and validate a terminological subset of ICNP® with a predominance of statements related to health deviation requirements, standing out for being the first terminological subset for the prevention of falls in the elderly in the context of primary care.

Assuntos

RESUMO

Purpose: To propose predictive models for absolute muscle strength (AMS) of elderly people with type 2 Diabetes Mellitus (DM2) in primary health care. Patients and Methods: The cross-sectional study was conducted with 138 elderly diabetics. The AMS was measured by a JAMAR® hydraulic handgrip dynamometer, determined by the sum of both hands. The following indices were evaluated: waist-to-height ratio (WHtR), body mass index (BMI), Lipid Accumulation Product (LAP), Triglyceride/High Density Lipoprotein (TG/HDL) ratio and platelet/lymphocyte ratio (PLR). Multiple linear regression was used in the statistical analysis. Results: The final regression model indicated 66.4% (R²=0.66) of the variation in AMS. WHtR decreased AMS by 41.1% (ß = -0.19; t = -3.70; p < 0.001), while PLR by 11.3% (ß = -0.12; t = -2.36; p = 0.020). Male sex increased AMS by 10.6% (ß = 0.32; t = 4.16; p < 0.001), and lean mass (LM) by 0.89% (ß = 0.46; t = 6.03; p < 0.001). Conclusion: WHtR and PLR predicted a decrease, while male sex and LM predicted an increase in AMS. It is suggested that these markers be used as screening measures for variation in AMS in older adults with DM2. These results have relevant practical application in primary health care since the markers are easy to use.

Assuntos

RESUMO

Introduction: Neuromodulation is a non-invasive technique that allows for the modulation of cortical excitability and can produce changes in neuronal plasticity. Its application has recently been associated with the improvement of the motor pattern in older adults individuals with sequelae from neurological conditions. Objective: To highlight the effects of non-invasive neuromodulation on the risk of falls and fear of falling in community-dwelling older adults. Methods: Systematic review conducted in accordance with the items of the Cochrane Handbook for Systematic Reviews of Interventions. Searches were carried out in electronic databases: CENTRAL, Clinical Trials, LILACS, PEDro, PubMed, Web of Science, between 13/06/2020 and 20/09/2023, including all indexed texts without language and publication date restrictions, randomized controlled clinical trials, which presented as their main outcome non-invasive neuromodulation for reducing the fear of falling and risk of falls in the older adults, regardless of gender. Results: An extensive search identified 9 eligible studies for qualitative synthesis from 8,168 potential articles. Rigorous filtering through automated tools, title/abstract screening, and full-text evaluation ensured a focused and relevant selection for further analysis. Most studies (80%) used transcranial direct current electrical stimulation as an intervention, over the motor cortex or cerebellum area, with anodal current and monopolar electrode placement. The intensity ranged from 1.2 mA to 2 mA, with a duration of 20 min (80%). The profile of the research participants was predominantly individuals over 65 years old (80%), with a high risk of falls (60%) and a minority reporting a fear of falling (40%). The outcomes were favorable for the use of neuromodulation for the risk of falls in the older adults, through improvements in static and dynamic balance. Conclusion: The results may have limited applicability to direct outcomes related to the risk of falls, in addition to evidence regarding the difference or lack thereof in applicability between genders, fallers and non-fallers, as well as older adults individuals with low and high fear of falling. Systematic review registration: The protocol for this review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) to obtain the identification of ongoing research (ID: 222429).

RESUMO

Objetivo: avaliar a prevalência de síndrome metabólica e sua associação com variáveis sociodemográficas, clínicas, antropométricas e estilo de vida em idosos atendidos na atenção primária. Método: estudo transversal realizado com 344 idosos em uma Unidade Básica de Saúde do Distrito Federal. Realizaram-se análises do perfil lipídico, glicemia de jejum e hemoglobina glicada. Foram avaliados dados sociodemográficos, hábitos de vida, pressão arterial, antropometria e percentual de gordura. Realizou-se regressão de Poisson para cálculo da razão de prevalência bruta e ajustada. Resultados: a prevalência de síndrome metabólica foi de 62,2%. A hipertensão arterial (RPajustada=1,31; IC95%=1,02-1,67), cintura aumentada (RPajustada=1,46; IC95%=1,21-1,76), hipertrigliceridemia (RPajustada=1,98; IC95%=1,67-2,34) e HDL diminuído (RPajustada=1,19; IC95%=1,03-1,37) foram significativamente associados à síndrome metabólica. Conclusão: a elevada prevalência de síndrome metabólica e sua associação com fatores modificáveis apontam para a necessidade de identificar e controlar precocemente os fatores de risco em idosos

Objective: to evaluate the prevalence of metabolic syndrome and association with sociodemographic, clinical, anthropometric and lifestyle variables in elderly people attended in primary care. Method: cross-sectional study carried out with 344 elderly in a Basic Health Unit in the Federal District. Analyzes of lipid profile, fasting glucose and glycated hemoglobin were performed. Sociodemographic data, lifestyle habits, blood pressure, anthropometry and fat percentage were evaluated. Poisson regression was performed to calculate the crude and adjusted prevalence ratio. Results: the prevalence of metabolic syndrome was 62.2%. The arterial hypertension (PRadjusted =1.31; 95%CI=1.02-1.67), increased waistline (PRadjusted=1.46; 95%CI=1.21-1.76), hypertriglyceridemia (PRadjusted=1.98; 95%CI=1.67-2.34) and decreased HDL (PRadjusted=1.19; 95%CI=1.03-1.37) were significantly associated with metabolic syndrome. Conclusion: the high prevalence of metabolic syndrome and association with modifiable factors point to the need to early identify and control risk factors in the elderly

Objetivo: evaluar la prevalencia del síndrome metabólico y su asociación con variables sociodemográficas, clínicas, antropométricas y de estilo de vida en ancianos atendidos en atención primaria. Método: estudio transversal realizado con 344 ancianos en una Unidad Básica de Salud del Distrito Federal. Se realizaron análisis del perfil lipídico, glucosa en ayunas y hemoglobina glucosilada. Se evaluaron datos sociodemográficos, hábitos de vida, presión arterial, antropometría y porcentaje de grasa. Se realizó regresión de Poisson para calcular la razón de prevalencia cruda y ajustada. Resultados: la prevalencia de síndrome metabólico fue del 62,2%. Hipertensión arterial (RPajustada=1,31; IC95%=1,02-1,67), aumento de cintura (RPajustada=1,46; IC95%=1,21-1,76), hipertrigliceridemia (RPajustada=1,98; IC95%=1,67-2,34) y la disminución de HDL (RPajustada= 1,19; IC del 95 % = 1,03-1,37) se asoció significativamente con el síndrome metabólico. Conclusión: la alta prevalencia del síndrome metabólico y su asociación con factores modificables apuntan a la necesidad de identificar y controlar precozmente los factores de riesgo en los ancianos

Assuntos

RESUMO

Objetivo: Relacionar a dor crônica a depressão e ansiedade de pacientes com Diabetes Mellitus. Método: Estudo transversal, amostra n=50, avaliou a dor crônica pela escala numérica de dor, identificou o Diagnóstico de Enfermagem Dor crônica da Taxonomia da NANDA,e Ansiedade e Depressão foi avaliada pela Hospital Anxiety and Depression Scale (Escala Hospitalar de Ansiedade e Depressão). Resultados:A prevalência de ansiedade foi de 36,0% e 32,0% dedepressão, acometeu mulheres entre 60 e 69 anos. A relação entre intensidade de dor foi moderada, em ambos que tinham ansiedade ou depressão. Identificou as características definidoras do Diagnósticos de Enfermagem Dor Crônica: Alteração da capacidade em continuar atividades prévias, 61,1% tinham ansiedade e 56,3% apresentaram depressão; Alteração no padrão de sono, 72,2% com ansiedade e 56,3% com depressão; Autorrelato usando escala padronizada de dor, 98,0% tinham ansiedade e depressão respectivamente. Os Fatores Relacionados do Diagnósticos de Enfermagem 88,9% com Aumento de IMC tinham ansiedade e 93,8% com depressão; Alteração no padrão de sono 72,2% com ansiedade e 56,3% depressão; 92% com Idade ≥50 anos 93,8% com ansiedade e 88,9% com depressão. Conclusão:As mulheres tinham dor crônica de intensidade moderada e foi relacionado a ansiedade e a depressão.

Method:Cross-sectional study, sample n=50, assessed chronic pain using the numerical pain scale, identified the Nursing Diagnoses Chronic pain from the NANDA Taxonomy, Anxiety and Depression was assessed using the Hospital Anxiety and Depression Scale. Results:The prevalence of anxiety was 36.0% and 32.0% of depression, affecting women between 60 and 69 years old. The relationship between pain intensity was moderate, in both those who had anxiety or depression. Identified the defining characteristics of the Chronic Pain Nursing Diagnosis: Change in the ability to continue previous activities, 61.1% had anxiety and 56.3% had depression; Change in sleep pattern, 72.2% with anxiety and 56.3% with depression; Self-reported using a standardized pain scale, 98.0% had anxiety and depression respectively. Related Factors of Nursing Diagnoses 88.9% with increased BMI had anxiety and 93.8% with depression; Change in sleep pattern 72.2% with anxiety and 56.3% depression; 92% aged ≥50 years, 93.8% with anxiety and 88.9% with depression. Conclusion: Women had chronic pain of moderate intensity and it was related to anxiety and depression.

Objetivo: Relacionar el dolor crónica con la depresión y la ansiedad de pacientes con Diabetes Mellitus. Método:Estudio transversal, muestra n=50, se evaluó el dolor crónico mediante la escala numérica de dolor, se identificaron los Diagnósticos de Enfermería El dolor crónico de la Taxonomía NANDA, la Ansiedad y Depresión se evaluó mediante la Escala Hospitalaria de Ansiedad y Depresión. Resultados:La prevalencia de ansiedad fue de 36,0% y de depresión de 32,0%, afectando a mujeres entre 60 y 69 años. La relación entre la intensidad del dolor fue moderada, tanto en los que presentaban ansiedad como en los que presentaban depresión. Se identificaron las características definitorias del Diagnóstico de Enfermería del Dolor Crónico: Cambio en la capacidad de continuar actividades anteriores, el 61,1% presentó ansiedad y el 56,3% presentó depresión; Cambio en el patrón de sueño, 72,2% con ansiedad y 56,3% con depresión; Autoinformados mediante una escala de dolor estandarizada, el 98,0% tenía ansiedad y depresión respectivamente. Factores Relacionados con el Diagnóstico de Enfermería el 88,9% con IMC elevado presentó ansiedad y el 93,8% depresión; Cambio en el patrón de sueño 72,2% con ansiedad y 56,3% depresión; 92% con edad ≥50 años, 93,8% con ansiedad y 88,9% con depresión. Conclusión:Las mujeres presentaron dolor crónico de intensidad moderada y se relacionó con ansiedad y depresión.

Assuntos

RESUMO

ABSTRACT Objective: Build and validate a terminological subset of ICNP® for the prevention of falls in the elderly in the context of primary health care, in light of the Self-Care Deficit Theory. Method: Methodological study developed in accordance with ICN recommendations and the Brazilian method for constructing terminological subsets, in two stages: 1) construction of ICNP® statements of nursing diagnoses, outcomes, and interventions; 2) content validation of statements by specialist nurses. Results: A total of 182 diagnoses/outcomes and 321 nursing interventions were constructed, which were subjected to content validation by 28 experts, being validated with a Content Validity Index ≥ 0.80. After validation, the statements were organized according to self-care requirements and the majority of diagnoses/outcomes (51.6%) and interventions (52.7%) were classified under health deviation requirements. Conclusion: It was possible to construct and validate a terminological subset of ICNP® with a predominance of statements related to health deviation requirements, standing out for being the first terminological subset for the prevention of falls in the elderly in the context of primary care.

RESUMEN Objetivo: Construir y validar un subconjunto terminológico de la CIPE® para la prevención de caídas en ancianos en el contexto de la atención primaria de salud, a la luz de la Teoría del Déficit de Autocuidado. Método: Estudio metodológico desarrollado de acuerdo con las recomendaciones del CIE y el método brasileño de construcción de subconjuntos terminológicos, en dos etapas: 1) construcción de declaraciones de diagnóstico, resultados e intervenciones de enfermería de la CIPE®; 2) validación de contenido de declaraciones de enfermeros especialistas. Resultados: Se construyeron 182 diagnósticos/resultados y 321 intervenciones de enfermería, los cuales fueron sometidos a validación de contenido por 28 expertos, siendo validados con un Índice de Validez de Contenido ≥ 0,80. Después de la validación, los enunciados fueron organizados según los requisitos de autocuidado y la mayoría de los diagnósticos/resultados (51,6%) y las intervenciones (52,7%) fueron clasificados bajo requisitos de desviación de salud. Conclusión: Fue posible construir y validar un subconjunto terminológico de la CIPE® con predominio de enunciados relacionados a requerimientos de desviación de salud, destacándose por ser el primer subconjunto terminológico para la prevención de caídas en el anciano en el contexto de la atención primaria.

RESUMO Objetivo: Construir e validar um subconjunto terminológico da CIPE® para a prevenção de quedas em idosos no contexto da atenção primária à saúde, à luz da Teoria do Déficit do Autocuidado. Método: Estudo metodológico desenvolvido conforme recomendações do ICN e do método brasileiro para construção de subconjuntos terminológicos, em duas etapas: 1) construção de enunciados de diagnósticos, resultados e intervenções de enfermagem da CIPE®; 2) validação de conteúdo dos enunciados por enfermeiros especialistas. Resultados: Foram construídos 182 diagnósticos/resultados e 321 intervenções de enfermagem, os quais foram submetidos a validação de conteúdo por 28 especialistas, sendo validados com Índice de Validade de Conteúdo ≥ 0,80. Após a validação, os enunciados foram organizados conforme os requisitos de autocuidado e a maioria dos diagnósticos/resultados (51,6%) e das intervenções (52,7%) foi classificada nos requisitos de desvio de saúde. Conclusão: Foi possível construir e validar um subconjunto terminológico da CIPE® com predomínio de enunciados relacionados aos requisitos de desvio de saúde, destacando-se por ser o primeiro subconjunto terminológico para a prevenção de quedas em idosos no contexto da atenção primária.

Assuntos

RESUMO

This study aimed to evaluate the time course and responsiveness of plasma interleukin-6 (IL-6) and creatine kinase (CK) levels following acute eccentric resistance exercise in sedentary obese older women with a different muscle quality index (MQI). Eighty-eight participants (69.4 ± 6.06 years) completed an acute eccentric resistance exercise (7 sets of 10 repetitions at 110% of 10-repetition maximum with 3 min rest interval). Participants were divided into two groups: high or low MQI according to 50th percentile cut-off. The responsiveness was based on minimal clinical important difference. There were no differences between groups and time on IL-6 and CK levels (p > 0.05). However, the high MQI group displayed a lower proportion of low responders (1 for laboratory and 2 for field-based vs. 5 and 4) and a higher proportion of high responders for IL-6 (7 for laboratory and 6 for field-based vs. 4 and 5) compared to low MQI group. In addition, the high MQI group showed a higher proportion of high responders for CK (11 for laboratory and 9 for field-based vs. 6 and 6) compared to low MQI. A prior MQI screening can provide feedback to understand the magnitude response. Individual responsiveness should be taken into consideration for maximizing eccentric exercise prescription.

RESUMO

BACKGROUND: Vaccination is a fundamental part of all levels-local to worldwide-of public health, and it can be considered one of humanity's greatest achievements in the control and elimination of infectious diseases. Teaching immunization and vaccination can be monotonous and tiring. It is necessary to develop new approaches for teaching these themes in nursing school. OBJECTIVE: We aimed to develop and validate a serious game about immunization and vaccination for Brazilian nursing students. METHODS: We developed a quiz-type game, Immunitates, using design and educational theoretical models and Brazilian National Health Guidelines. The game's heuristics and content were evaluated with 2 different instruments by a team of experts. A sample of nursing students evaluated the validity of the game's heuristics only. We calculated the content validity index (CVI) for each evaluation. RESULTS: The study included 49 experts and 15 nursing students. All evaluations demonstrated high internal consistency (Cronbach α≥.86). The game's heuristics (experts: CVI 0.75-1.0; students: CVI 0.67-1.0) and the game's contents demonstrated validity (experts: CVI 0.73-1.0). Participants identified some specific areas for improvement in the next version. CONCLUSIONS: The serious game appears to be valid. It is intended as a support tool for nursing students in the teaching-learning process and as a tool for continuing education for nurses.

RESUMO

RESUMO Objetivo investigar o diagnóstico de enfermagem Padrão de sexualidade ineficaz em idosos com Diabetes mellitus na atenção primária e analisar o seu perfil de sexualidade. Método estudo transversal realizado em uma Unidade Básica de Saúde com uma amostra de 134 idosos diabéticos. Entrevista foi realizada entre julho e agosto de 2019 com instrumentos estruturados, assim como foram coletados exames laboratoriais. Para investigação do diagnóstico de enfermagem Padrão de Sexualidade Ineficaz, foi utilizado um instrumento com as definições conceituais e operacionais das características definidoras e fatores relacionados de acordo com a taxonomia NANDA-I (2018-2020). Resultados predominaram mulheres, mas os homens eram mais ativos sexualmente (p<0,001). Os mais jovens eram sexualmente mais ativos (p = 0,001). Com relação aos parâmetros hormonais, idosos com maiores níveis de testosterona relataram serem ativos sexualmente (p<0,001). A maioria não utiliza preservativo durante a relação sexual. Ao analisar o diagnóstico de enfermagem Padrão de Sexualidade Ineficaz, a característica definidora mais prevalente foi "alteração no comportamento sexual", e o fator relacionado foi "déficit de habilidades sobre alternativas relacionadas à sexualidade". Conclusão e implicações para a prática o diagnóstico de enfermagem Padrão de Sexualidade Ineficaz tem sua importância na avaliação de idosos diabéticos, visto que a sexualidade tem influência em seu comportamento e sua satisfação pessoal.

RESUMEN Objetivo investigar el diagnóstico de enfermería "Patrón de sexualidad ineficaz" en ancianos con Diabetes mellitus en atención primaria y analizar su perfil de sexualidad. Método estudio transversal realizado en una Unidad Básica de Salud, con una muestra de 134 ancianos diabéticos. Las entrevistas se realizaron entre julio y agosto de 2019 con instrumentos estructurados y se recolectaron pruebas de laboratorio. Para investigar el diagnóstico de enfermería Patrón de Sexualidad Ineficaz, se utilizó un instrumento con definiciones conceptuales y operativas de las características definitorias y factores relacionados según la taxonomía NANDA-I (2018-2020). Resultados predominaron las mujeres, pero los hombres fueron más activos sexualmente (p < 0,001). Las personas más jóvenes eran más activas sexualmente (p = 0,001). En cuanto a los parámetros hormonales, las personas mayores con niveles más altos de testosterona refirieron ser sexualmente activas (p < 0,001). La mayoría no usa condones durante las relaciones sexuales. Al analizar el diagnóstico de enfermería de Patrón de Sexualidad Ineficaz, la característica definitoria más prevalente fue "cambio en la conducta sexual" y el factor relacionado "déficit de habilidades sobre alternativas relacionadas con la sexualidad". Conclusiones e implicaciones para la práctica el diagnóstico de enfermería Patrón de Sexualidad Ineficaz tiene su importancia en la evaluación de los ancianos diabéticos, ya que la sexualidad influye en su comportamiento y satisfacción personal.

ABSTRACT Objective to investigate the nursing diagnosis ineffective sexuality pattern in elderly people with Diabetes mellitus in primary care and analyze their sexuality profile. Method this is a cross-sectional study carried out in a Basic Health Unit with a sample of 134 elderly diabetics. Interviews were carried out between July and August 2019 with structured instruments and laboratory tests. An instrument was used to investigate the nursing diagnosis ineffective sexuality pattern with conceptual and operational definitions of the defining characteristics and related factors according to the NANDA-I taxonomy (2018-2020). Results women predominated, although men were more sexually active (p < 0.001). Younger people were more sexually active (p = 0.001). Regarding hormonal parameters, elderly people with higher testosterone levels reported being sexually active (p < 0.001). Most do not use condoms during sexual intercourse. When analyzing the nursing diagnosis of ineffective sexuality pattern, the most prevalent defining characteristic was "a change in sexual behavior" and the related factor was "skills deficit in sexuality-related alternatives". Conclusions and implications for practice the nursing diagnosis ineffective sexuality pattern has importance in assessing elderly diabetics, as sexuality influences their behavior and personal satisfaction.

Assuntos