Hand grip strength (HGS) is recognized as an important health indicator, but validated reference values that can be applied to the evaluation of individuals in different populations are still lacking. This work aimed to identify correlations between HGS and anthropometric variables and to establish HGS reference values for adult and elderly populations. This is a population-based cross-sectional study considering the subsets of individuals with healthy right or left upper limbs from a sample of 1,609 adults and elderly residents in Rio Branco, Acre, Brazil. Descriptive statistics of anthropometric measures and HGS values at maximum performance based on three measurements of the two hands were obtained, and Pearson correlations between these variables were applied. Percentile distributions were estimated for right and left HGS by sex and age group. Men presented, in general, a maximum HGS 57% higher than women (43.4 kg vs. 27.6 kg), and also higher HGS levels in the different age groups. In both sexes, the highest HGS values were observed in the age group of 30 to 39 years (men, 46.9 kg; women, 29.4 kg), with a subsequent decline. HGS presented a negative correlation with age and a weak to moderate positive correlation with anthropometric variables, among men and women. The median HGS of men was reduced by about 46% between the ages of 30 and 39 years and 80 years and over (right hand, 46.4 to 23.7 kg; left hand, 42.2 to 23.5 kg) and by about 44% in women (right hand, 29.0 to 16.4 kg, left hand, 27.3 to 15.2 kg). The values identified are a reference for HGS behavior among healthy adults and seniors, although they do not discriminate individuals with specific health conditions. They can be used in rehabilitation programs and subsidize future studies aimed at exploring their potential application in the evaluation of the health condition of adults and elderly individuals.
OBJECTIVE: To verify the prevalence of chronic kidney disease and the factors associated to it in older adults (≥ 60 years). METHODS: This is a population-based research conducted in 2014, involving 1,016 older adults living in urban and rural areas of the municipality of Rio Branco, Acre. Chronic kidney disease was defined by glomerular filtration rate < 60 ml/min/1.73 m², estimated by the equations of the Chronic Kidney Disease Epidemiology Collaboration, and the presence of albuminuria > 29 mg/g. Association measure were estimated by gross and adjusted odds ratio (OR), with a confidence level of 95% (95%CI). RESULTS: The overall prevalence of chronic kidney disease was 21.4% in older adults, with the associated factors age, diabetes (OR = 3.39; 95%CI 2.13–5.40), metabolic syndrome (OR = 2.49; 95%CI 1.71–3.63), self-assessment of poor health (OR = 1.79; 95%CI 1.10–2.91), arterial hypertension (OR = 1.82; 95%CI 1.04–3.19) and obesity (OR = 1.69; 95%CI 1.02–2.80). CONCLUSIONS: The prevalence of chronic kidney disease was high in older adults, being associated with age, self-assessment of health as bad or very bad, obesity, diabetes and metabolic syndrome.
Resumo Este estudo objetivou analisar a associação entre multimorbidade e depressão e qualidade de vida em idosos da Estratégia de Saúde da Família (ESF), por meio de estudo transversal com cadastrados na ESF de Senador Guiomard, Acre. Utilizou-se a Escala de Depressão Geriátrica (EDG-15) e o Questionário de Qualidade de Vida (WHOQOL-Bref). As diferenças das variáveis descritivas por idosos com e sem multimorbidade foram estimadas pelo teste qui-quadrado de Pearson e as associações entre multimorbidade e depressão e qualidade de vida foram estimadas com técnica de regressão logística. Observou-se que idosos com depressão representaram 27% da amostra, sendo essa doença em maior proporção entre os com multimorbidade em comparação àqueles sem. Os idosos com multimorbidade tiveram duas vezes mais chance de apresentar depressão. Similarmente, os indivíduos com multimorbidade tiveram maior chance de pior qualidade de vida total e nos domínios físico, psicológicos, social (todos com p ≤ 0,010), exceto no domínio ambiental (p = 0,493). Assim, a multimorbidade em idosos está associada à presença de depressão e pior qualidade de vida, impondo à ESF o desafio de garantir a essa população viver a senescência sem sofrimento e redução da qualidade de vida.
RESUMO:Objetivo: construir e validar o conteúdo de um instrumento para registro da assistência de Enfermagem Perioperatória para um Hospital de Clínicas, visando a atender as exigências da Organização Mundial da Saúde propostas no 2.º Desafio Global e reafirmadas no Manual Cirurgias Seguras Salvam Vidas do Ministério da Saúde Brasileiro. Método: trata-se de um relato de experiência. A construção do instrumento fundamentou-se na Teoria das Necessidades Humanas Básicas e na revisão bibliográfica sobre o tema. Para a validação de conteúdo, foram realizadas aulas expositivas para treinamento da Equipe de Enfermagem. Resultados: o instrumento foi analisado como satisfatório pelas avaliadoras por ser de fácil interpretação e preenchimento. Conclusão: ressalta-se a importância da parceria entre a academia e o serviço de saúde. Sugere-se que o desenvolvimento de instrumentos com esta finalidade seja realizado em conjunto, no intuito de auxiliar os profissionais nos campos de estágio, envolver alunos estagiários e valorizar a assistência de Enfermagem. PALAVRAS-CHAVE:Enfermagem perioperatória. Diagnósticos de enfermagem. Segurança.ABSTRACT: Objective: The purpose of this study is to develop and validate an instrument of perioperative nursing for a university hospital aiming to meet the requirements proposed at the 2nd Global Challenge of the World Health Organization (WHO) and reiterated in the "Safe Surgeries Save Lives" Manual from the Brazilian Ministry of Health. Method: It is an experience report of descriptive approach. The construction of the instrument was based on the Basic Human Needs Theory and on literature review. Training lectures were conducted with the nursing staff to validate the instrument contents. Results: The instrument was assessed as satisfactory by evaluators because it can be easily filled in. Conclusion: We realized how important the partnership between the academy and the health service is. We suggest that more studies such as this one be undertaken in order to assist the field of training, engage trainee students, and enable the recovery of our profession.KEYWORDS: Perioperative nursing. Nursing diagnosis. Safety. RESUMEN:Objetivo: construir y validar el contenido de un instrumento para registro de la asistencia de enfermería perioperatoria en un Hospital de Clínicas, con el objetivo de atender las exigencias de la Organización Mundial de Salud, propuestas en el 2º Desafío Global y reafirmadas en el Manual "Cirugías Seguras Salvan Vidas" del Ministerio de Salud. Método: se trata de un relato de experiencia. La construcción del instrumento se fundamentó en la teoría de las Necesidades Humanas Básicas y en la revisión bibliográfica sobre el tema. Para la validación del contenido se realizaron clases expositivas, con el fin de entrenar al equipo de enfermería. Resultados: el instrumento fue evaluado como satisfactorio al ser de fácil interpretación y cumplimentación. Conclusión: se resalta la importancia de que haya colaboración entre el mundo académico y el servicio de salud. Se sugiere que el ...
Objetive:to identify risk factors for death in patients who have suffered non-infectious adverse events. Method:a retrospective cohort study with patients who had non-infectious Adverse Events (AE) in an Intensive Care Unit. The Kaplan Meier method was used to estimate the conditional probability of death (log-rank test 95%) and the risk factors associated with death through the Cox regression. Results:patients over 50 years old presented a risk 1.57 times higher for death; individuals affected by infection/sepsis presented almost 3 times the risk. Patients with a Simplified Acute Physiology Score III (SAPS3) greater than 60 points had four times higher risk for death, while those with a Charlson scale greater than 1 point had approximately two times higher risk. The variable number of adverse events was shown as a protection factor reducing the risk of death by up to 78%.Conclusion:patients who had suffered an adverse event and who were more than 50 years of age, with infection/sepsis, greater severity, i.e., SAPS 3>30 and Charlson>1, presented higher risk of death. However, the greater number of AEs did not contributed to the increased risk of death.
Background: Handgrip strength (HGS) is an important health biomarker whose low scores have been shown to be associated with the morbimortality. This study aimed to analyze the factors associated with low HGS in older people in Rio Branco, Acre, Brazil. Methods: The study was carried out with data from the Study of Chronic Diseases (EDOC-I)-Older People, a crosssectional household PAPI probability sample survey performed with 1016 people aged over 60 residing in Rio Branco in 2014. The low HGS was defined by the 20th percentile of the maximum HGS by sex and age group. Associations between variables of health status (psychological and physical) and low HGS, by sex, were estimated using logistic regression, expressed by adjusted ORs (aOR). Results: Older individuals had lower median HGS than younger individuals (− 6.0 kg among men and − 2.6 kg among women). Women aged over 80 had, on average, the lower quintile of HGS compared to women of the previous age groups. Factors independently associated with low HGS in men and women, respectively, were low weigh in body mass index [(aOR = 2.80; 95%CI: 1.19, 6.61) and (aOR = 2.61; 95%CI: 1.46, 4.66)], anemia [(aOR = 4.15; 95%CI: 2.09, 8.21) and (aOR = 1.80; 95%CI: 1.06, 3.06)] and diabetes as a risk factor in men (aOR 1.95; 95%CI: 1.00, 3.81). There was a higher chance of low HGS in men with partners (aOR = 2.44; 95%CI: 1.32, 4.51), smokers or former smokers (aOR = 3.25; 95%CI: 1.25, 8.44), with current self-assessment of health worse than the 12 previous months (aOR = 2.21; 95%CI: 1.14, 4.30) and dependence in activities of daily living (aOR = 2.92; 95%CI: 1.35, 6.30). Only among women, there was an increased chance of low HGS associated with altered waist-to-hip ratio (aOR = 1.79; 95%CI: 1.02, 3.12), insomnia (aOR = 1.83; 95%CI: 1.10, 3.03) and physical activity from displacement/occupation (aOR = 1.75; 95%CI: 1.08, 2.84). Conclusion: Factors associated with low HGS are not the same between sexes, and the inclusion of HGS as a component of health assessment seems to be a promising strategy for disease prevention and health promotion.
Resumo Objetivo: Analisar fatores de risco para óbito em indivíduos com síndrome respiratória aguda grave por COVID-19. Métodos: Coorte retrospectiva, constituída de indivíduos adultos com COVID-19, de março a setembro de 2020, notificados pelo sistema de vigilância epidemiológica do estado do Acre, Brasil. Empregou-se regressão de Cox. Resultados: Entre 57.700 indivíduos analisados, a incidência foi de 2.765,4/100 mil habitantes, e a mortalidade, de 61,8/100 mil hab. Os fatores de risco para o óbito foram ser do sexo masculino (HR=1,48 - IC95% 1,25;1,76), ter idade ≥60 anos (HR=10,64 - IC95% 8,84;12,81), sintoma de dispneia (HR=4,20 - IC95% 3,44;5,12) e apresentar multimorbidade (HR=2,23 - IC95% 1,77;2,81), com destaque para cardiopatas e diabetes mellitus. Os sintomas ‘dor de garganta’ e ‘cefaleia’ estavam presentes nos casos leves da doença. Conclusão: Ser homem, idoso, apresentar cardiopatia, diabetes mellitus e dispneia foram características associadas ao óbito pela COVID-19.
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