Avaliação da saúde bucal de idosos por enfermeiros: validade e confiabilidade do instrumentO ASBTO

Abstract

36 RESUMOO objetivo do estudo foi aplicar o Instrumento "Avaliação da Saúde Bucal para Triagem Odontológica" (ASBTO) em idosos institucionalizados para determinação dos índices de validade e confiabilidade, quando da aplicação por Enfermeiros. Os exames foram executados por um Enfermeiro e por um Cirurgião-Dentista (CD) em 50 idosos de uma instituição de longa permanência. A determinação da consistência interna foi verificada por meio do Coeficiente Alfa de Cronbach e ANOVA. Para determinação da estabilidade e confiabilidade foram considerados os percentuais de concordância e teste Kappa. Não houve diferença estatística significante entre as médias finais obtidas pelo CD e pelo Enfermeiro (p=0,41). Houve maior consistência interna nos exames procedidos pelo CD. Os percentuais de concordância variaram de 60%, na categoria Lábio, até 90%, na categoria "Dentes naturais". O Kappa total do instrumento alcançou 0,46. A utilização do ASBTO é passível por Enfermeiros. Faz-se necessária adequada capacitação e treinamento prático para padronização de critérios.Descritores: Idoso. Saúde Bucal. Instituição de Longa Permanência para Idosos. RESUMEN Se objetivó aplicar el Instrumento Evaluación de la Salud Bucal (IESB) para la determinación de la fiabilidad y validez, cuando de la aplicación por enfermeros. Los exámenes fueron ejecutados por un Enfermero y por un

Evaluation of the factors that make eating of hospitalized elderly difficult

“…The instrument presents an initial part for the characterization of the subjects followed by 26 questions regarding the specific situations on the difficulties of eating of the elderly. The elaboration of the questions of the scale occurred through a revision of the literature (3,(4)(5)(6)(7) . The scale aimed at verifying the factors which provide eating of the hospitalized elderly, being operated through a Likert scale of five points: (1) It does not interfere;…”

“…Even though the population of elderly is growing, little attention has been directed to eating during old age (5) , so the precarious nutritional condition of this population shows the need to understand the singularities which contribute to malnutrition. So, the justification of this study is centered on the need that the evaluation of the factors which render the feeding of hospitalized elderly occurs effectively during the period of hospitalization, qualifying the nursing care and bringing direct benefits to the elderly patients (5) .…”

Inter-examiner agreement in the application of an oral health assessment instrument in hospitalized elderly

“…For the maintenance of oral health in elderly individuals, there are three guiding factors: oral assessment, regular oral hygiene and dental treatment. However, when they are hospitalized, these patients represent a risk group, with respect to highly complex oral changes, resulting from inadequate care, which may occur due to lack of self-perception of oral health; limitations in maintaining adequate oral hygiene; the nonexistence of a daily care routine spent by the nursing professional; the absence of a dental surgeon (DS) expert in hospital units; due to lack of resources for care provided; and the absence of trained and qualified personnel to assess oral health, since nursing professionals, in addition to not having complete training to substantiate the care practices with the oral hygiene of the elderly in a scientifically technical way, , there is lack of protocols for assessments that could be used by the nursing team (13,(18)(19)(20)(21) .…”

“…However, it is common for hospitalized elderly people to find it difficult to routinely and appropriately maintain all care with their hygiene, either because they do not perform cleaning and are not encouraged to take such action, or because they are dependent on others for the action of self-care and, thus, commitment to their autonomy. These elderly people, who need help from other people, are inclined to have worse oral conditions (7,(18)(19)(20) .…”

“…In hospital wards, it is quite rare to find protocols and instruments that can both assist in the care and screening of oral health and be used by the nursing staff in adequate monitoring and in the formulation of essential procedures according to individual needs. This aspect hinders more specialized care and, even, the adoption of educational and preventive strategies for patients (18)(19)(20) .…”