Fabrício-Wehbe SCC, Schiaveto FV, Vendrusculo TRP, Haas VJ, Dantas RAS, Rodrigues RAP. Cross-cultural adaptation and validity of the "Edmonton Frail Scale -EFS" in a brazilian elderly sample. Rev Latino-am Enfermagem 2009 novembro-dezembro; 17(6):1043-9. (-0,60, p<0,01 This study aimed to assess the cross-cultural adaptation of the Edmonton Frail Scale (EFS) and its validity in a

OBJECTIVE: to verify the inter and intra-rater reproducibility of the Brazilian adapted version of the Edmonton Frail Scale (EFS) in an elderly group of residents. METHOD: in order to test the inter-rater reproducibility, two assessments were independently conducted by two researchers on the same day but at different times, in a sample of 103 elderly. Concerning the intra-rater reproducibility, the instrument was administered to 83 elderly (80.6% of the initial sample) by the same researcher in a time gap of 15 days between the two assessments. RESULTS AND DISCUSSION: in relation to the inter-rater test, the Kappa was 0.81 (CI 0.61-1.00) and the Intraclass Correlation Coefficient (ICC) corresponded to 0.87 (CI 0.82-0.91, p<0.001). In relation to the intra-rater test, the Kappa was 0.83 (CI 0.72-0.94) and the ICC 0.87 (CI 0.81-1.00, p<0.001). CONCLUSION: the results show that the EFS is reliable and can be used as a tool to improve geriatric nursing care in Brazil.

OBJECTIVE:To identify demographic and socioeconomic differentials associated with the health status of oldest-old individuals living in two cities of different Brazilian regions. METHODS:A comparative and cross-sectional epidemiological study was conducted with the oldest-old (≥ 80 years), living in the cities of Ribeirão Preto (RP, Southeastern Brazil) and Caxias do Sul (CS, Southern). The probabilistic sample included 117 individuals in CS and 155 in RP, and data were collected between 2007 and 2008. The instrument included demographic and socioeconomic data, Mini-Mental State Examination, Functional Independence Measure, number of self-reported comorbidities and Geriatric Depression Scale. RESULTS:Mean age was similar, with predominance of women (~70%) and widowed individuals (~60%) in both cities. Mean level of education did no differ statistically, although mean income was higher in RP than in CS (p = 0.05). RP showed a higher concentration of individuals in the extreme levels of education and income than that of CS. Mean score of the Mini-Mental State Examination was similar in both groups and higher among men, individuals aged between 80 and 84 years, married and with a higher level of education. Better functional performance was observed in elderly individuals aged between 80 and 84 years in both cities, in those with higher level of education in RP; and in males and married individuals in CS. Elderly individuals in CS showed higher number of comorbidities than those in RP (p < 0.001). Male elderly individuals, married and with -higher income level showed fewer depressive symptoms in both groups; and those in RP showed higher Geriatric Depression Scale score than the others in CS (p < 0.001). CONCLUSIONS:Although the oldest old in CS showed lower socioeconomic inequality and fewer depressive symptoms, they also had a higher mean number of comorbidities and lower level of functional independence, when compared to those in RP.DESCRIPTORS: Aged, 80 and over. Depressive Disorder. Comorbidity. Socioeconomic Factors. Cross-Sectional Studies.

Objective: to examine the transition of care in families caring for elderly persons who suffered the first episode of a cerebrovascular accident. Methodology: an instrumental ethnographic case study was used. The sample comprised 20 subjects: 10 caregivers and 10 elderly persons aged 65 or over, of both sexes, with diagnoses of first episode of cerebrovascular accident, capable of communicating, and requiring care from a main carer in their family. The data was collected through interviews, observation, existing documentation and field notes. Qualitative analysis techniques were used to codify and classify the data and to formulate significant categories, which generated typologies of care. Results and Discussion: The central idea was the Transition of Care and showed the context in three typologies: The care process for the dependent elderly person, Strategies for the care process and Impact and acceptance of the limitations. Conclusion: The data indicates that caring for an elderly person after a cerebrovascular accident is a challenge for the family. The data permitted it possible to elaborate a proposal for a model for the organization of the work, with a view to holistic care delivery in the health services, forming a care network, which constitutes an advance for the area of nursing.Descriptors: Aged; Stroke; Family; Caregivers; Geriatric Nursing. Os dados possibilitaram elaborar uma proposta de modelo para a organização do trabalho, visando a integralidade do cuidado nos serviços de saúde, formando uma rede de cuidado, o que constitui avanço para a área da enfermagem.Descritores: Idoso; Acidente Vascular Cerebral; Família; Cuidadores; Enfermagem Geriátrica. Transición del cuidado del adulto mayor despues del accidente cerebral vascular del hospital para casaObjetivo: examinar la transición del cuidado en familias que cuidan de adultos mayores que sufrieron el primer episodio de accidente cerebral vascular. Metodología: Fue utilizado el estudio de caso etnográfico instrumental. La muestra fue constituida de 20 sujetos, siendo 10 cuidadores y 10 adultos con 65 años y más, de ambos sexos, con diagnóstico de primer episodio de accidente cerebral vascular, capaces de comunicarse, demandando cuidado de un cuidador principal en la familia. Los datos fueron colectados por medio de entrevistas, observaciones, documentos existentes y notas de campo. Fueron utilizadas las técnicas de análisis cualitativo para codificar, clasificar los datos y formular categorías significativas, lo que generó tipologías de cuidado. Resultados y Discusión: La idea central fue la transición del cuidado y mostró el contexto en tres tipologías: El proceso de cuidar del adulto mayor dependiente, Estrategias para el proceso de cuidar e Impacto y aceptación de las limitaciones. Conclusión: Los datos nos indicaron que el cuidado para el adulto mayor, después del accidente cerebral vascular es un desafío para la familia. Los datos posibilitaron elaborar una propuesta de modelo para la organización del trabajo, visando la integralidad del cuid...

Aim: This study aimed to determinate the prevalence of falls in the elderly and its relationship with the functional capacity. Method: This is an epidemiological and cross-sectional study; a two-stage cluster sample of 240 male and female subjects aged over 60 years was used. Data were collected from November 2010 to February 2011. The following questionnaires were used: socio-demographic profile, assessment of falls, Functional Independence Measure, Lawton and Brody Scale. Significance was set at 0.05. To identify the occurrence of falls and their relation with functional capacity, the prevalence ratio and prevalence odds ratios were used, as well as multiple logistic regression. Results: Average age was 73.5 years (±8.4); 25% 80 years or more, with preponderance of female gender; 48.8% attended school between 1-4 years. The average was 1.33 falls (±0.472), with prevalence in women and elderly between 60 and 79 years old; the most frequently sites were the backyard and bathroom. Strong correlation between the level of functional independence and instrumental activities and age was found, but no relation between elderly victims of falls and the gender and age variables. Conclusion: Women who suffered falls related to functional independence were predominant, which can be prevented through elderly health promotion strategies, a policy that serves to offer living conditions to people in the aging process.Descriptors: Aged; Accidental Falls; Activities of Daily Living; Cross Sectional Study. quedas relacionadas à independência funcional, podendo-se prevenir com estratégias de promoção à saúde ao idoso, política essa para oferecer condição de vida à pessoa no processo de envelhecer.Descritores: Idoso; Acidentes por Quedas; Atividades Cotidianas; Estudos Transversais. Caídas en mayores y su relación con la capacidad funcionalObjetivo: Determinar la superioridad de caídas en los mayores y su relación con la capacidad funcional. Método: Estudio epidemiológico transversal de base de la población, con una muestra por conglomerado de doble cursillo de 240 sujetos, con edad arriba de 60 años, de ambos los sexos, residentes en Ribeirão Preto. Los datos fueron colectados entre noviembre de 2010 y febrero de 2011 y se utilizaron los cuestionarios: perfil social, evaluación de caídas; Medida de Independencia Funcional y Escala de Lawton y Brody. Fue adoptado el nivel de significancia de 0,05. Para la identificación de la ocurrencia de las caídas y su relación con la capacidad funcional fueron utilizadas razón de superioridad y de chances de superioridad y regresión logística múltiple. Resultados: La media mayores fue de 73,5 años (±8,4), 25% con 80 años o más, predominio del sexo femenino; 48,8% estudiaron durante 1 a 4 años. Media 1,33 caídas (±0,472); con mayor superioridad en mujeres y mayores más jóvenes; el local más frecuente fue el patio y el baño. Hubo fuerte correlación entre nivel de independencia funcional y las actividades instrumentales con la edad y no hubo relación entre los mayores que sufrieron caída y las var...

The aging context of the elder elderly needs to be taken into account, due to the redefinition of family as a social institution. This is an epidemiological, cross-sectional study that characterized the household arrangements of 147 elder elderly living in Ribeirão Preto, SP, through home interviews. The age range between 80 and 84 years predominated. The majority receives a retirement benefit ranging from one to three minimum wages, and owns their house. On the average, they have 4.08 children and live with 2.8 people. Most men live with their partners, while women live by themselves. The elderly head a large part of households. The most frequent arrangements are families with two and three generations. Regarding the household arrangement, there was equivalence in the results between the ones that moved into the house of the elderly and cases when the elderly moved into the family's house, reinforcing the family as a protector and caregiver of the elderly.

Objective: to investigate the association between frailty with hospitalization and institutionalization in a follow-up study of elderly residents. Method: the follow-up study was performed in 2008 and 2013 with elderly of both genders, aged 65 years and older who were living in the community-dwelling. The sampling procedure performed was probabilistic, with dual-stage clustering. In 2008, 515 elderly people were interviewed and, in 2013, 262. We used the socioeconomic and demographic data, self-reported morbidity, specifi c data of hospitalization and institutionalization. Frailty was measured by the Edmonton Frail Scale (EFS), and functional capacity through the Functional Independence Measure. Results: we found the mean gross EFS score was higher among resident elderly who were hospitalized and institutionalized and was statistically signifi cant in both investigated years. Conclusion: the confi rmation of association between frailty and hospitalization and institutionalization reinforces the importance of the subject, and highlights frailty as an important tool for risk estimates for these adverse events.

À Deus, pelas oportunidades e conquistas, pelos momentos de aprendizado.Aos meus pais, Ruth e Fabrício (in memoriam), hoje juntos. Obrigada pelo amor e exemplo de vida, pelos esforços dedicados a minha educação. Mãe, obrigada por ter estado ao meu lado nesta vida, pelo incentivo, amor e segurança, por ter me mostrado a importância da leitura, do estudo e da vida espiritual. Enquanto você esteve neste plano demonstrou força, foi a minha grande motivação para lutar. Agora que vive em nosso coração, ficou a saudade de uma mulher batalhadora que eu amo tanto e que nunca vou esquecer. Ao meu marido Afrânio, obrigada pela dedicação, carinho, amor e respeito. Por ser a minha vida, minha alegria, minha proteção. À minha irmã Aline, pela alegria, pela ajuda com meus textos, pelas discussões e sugestões que sempre melhoram este trabalho. Muito obrigada pela dedicação como irmã, pela paciência e por sempre acreditar em mim. Ao meu cunhado Giacomo, por ser tão gentil e cuidar da minha irmã quando não posso estar com ela. À minha irmã Neila, pela sabedoria, pelo exemplo de força e determinação, por me fazer sentir amada e importante. Ao meu sobrinho Rafael e cunhado Ricardo, por estarem perto de mim e me proporcionarem alegrias imensas. AGRADECIMENTOS À minha orientadora Dra. Rosalina Aparecida Partezani Rodrigues que, com paciência e sabedoria me acompanhou não apenas neste trabalho, mas em toda minha trajetória como graduanda e pós-graduanda nesta Universidade. Aos idosos, que nos receberam em sua casa com amor e respeito, proporcionando não somente aprendizado teórico, mas também aprendizado de vida. Ao professor Dr. Vanderlei José Haas, por sua paciência, dedicação e disponibilidade. Suas orientações e sugestões foram de extrema importância e foram a essência deste trabalho. À professora Dra. Rosana Aparecida Spadoti Dantas, pelo carinho com que me recebeu em sua sala e pelas orientações e sugestões para o estudo. Obrigada pela disponibilidade e generosidade em compartilhar seu conhecimento. Às professoras doutoras Claudia Benedita dos Santos, Sueli Marques, Luciana Kusumota pela ajuda no exame de qualificação e participação no "Comitê de Juízes". Ao professor Dr. Matheus Cruz, pela ajuda na tradução da escala. Ao amigo Fábio e às amigas Aline, e Edma, pela incansável ajuda, durante as entrevistas e digitações do banco de dados. À tão amada família Wehbe, que me acolheu e tornou-se minha família. A todas as colegas de trabalho do Centro Universitário Barão de Mauá pela amizade, em especial às coordenadoras Tokico Murakawa Moriya e Tânia Aparecida Cancian e à profa. Márcia Lúcia de Souza Furlan, por permitirem que eu permanecesse ao lado de minha mãe até o fim de nossa missão nesta vida. Aos acadêmicos que compartilham comigo a sala de aula, pelo aprendizado diário. Enfim, agradeço a todos que participaram e contribuíram de alguma maneira na realização deste trabalho. RESUMO FABRÍCIO-WEHBE, S.C.C. Adaptação Cultural e Validação da "Edmonton Frail Scale" (EFS) -escala de avaliação de fragilidade em idosos. 2008. 164 f. Tese...