Concept of family insufficiency in the aged: critical literature analysis

"Readiness for enhanced healthy aging" nursing diagnosis: Content validation by experts

PURPOSE

To validate the content nursing diagnosis "Readiness for enhanced healthy aging."

METHODS

Descriptive, methodological study of diagnostic content validation, using the Fehring model. The sample consisted of 74 nurses experts in gerontology, with knowledge in NANDA-I nursing diagnoses.

FINDINGS

The title, one definition, and the three defining characteristics proposed for the diagnosis were validated, as well as the suggestion of domain and location class in NANDA-I Taxonomy II. The Diagnostic Content Validity Index was 0.81.

CONCLUSIONS

The validation of the diagnostic content by experts was fundamental for adequacy of the elements of the proposed diagnosis, which supported the elaboration of the diagnostic framework for submission to the NANDA-I taxonomy.

IMPLICATION FOR NURSING PRACTICE

The diagnosis "Readiness for enhanced healthy aging" can help nurses understand the phenomenon of "Healthy Aging" and, consequently, will support the planning and implementation of interventions aimed at promoting the health of the elderly population and those in the aging process. In addition, this diagnosis will offer nurses the opportunity to rethink health promotion strategies in their care plan, making a commitment to the population regarding the promotion of healthy aging, as recommended by the Word Health Organization.

Feasibility of smartphone-supported, combined physical and cognitive activities in the Neighbourhood for stimulating social participation of the elderly

BACKGROUND

Combining smartphone-assisted group activities in the neighbourhood and training in physical and cognitive skills may offer the potential to promote social participation and connectedness of older adults. This non-controlled proof-of-concept, retrospectively registered study aimed to determine the feasibility of such an intervention approach, including its evaluation.

METHODS

In two consecutive six-month intervention cycles, 39 community-dwelling adults were provided with weekly smartphone, physical and cognitive training by two tutors. Using a specifically designed app, the participants were also encouraged to join and later self-organise physically and cognitively stimulating activities related to hot spots in their Bochum neighbourhood. Indicators of feasibility were documented.

RESULTS

The recruitment and assessments took 3 hours per participant. Excluding smartphone support, the preparation and the implementation of the intervention amounted to nine person-hours per week. Six participants dropped out, and 13 did not complete one or more assessments. The participants attended 76 ± 15% of the weekly training sessions. The instructors deemed the programme feasible, but familiarisation with the smartphone and the app was very time-consuming. Twenty-seven of 29 participants reported high overall satisfaction, and 22 agreed that the programme helped them to establish social contacts. The smartphones attracted substantial interest and were used frequently, despite mixed satisfaction with the project-specific app. From baseline to follow-up, the six-minute walking distance, lower extremity strength and moderate to vigorous physical activity, as well as quality of life, were preserved at a high level, while balance performance was significantly improved. Of the 11 tests related to cognitive functioning, 4 tests (a memory test, the Stroop test and 2 tests of verbal fluency) indicated significant improvement. No moderate or serious adverse events occurred in relation to the assessments or the intervention.

CONCLUSIONS

The multimodal approach seems safe and feasible and offers the potential to promote social connectedness, bonds in the residential neighbourhood and smartphone competency, as well as to preserve or improve physical and cognitive functions. Adaptations of the intervention and of the outcome assessments may contribute to better assessment and exploitation of the potential of this approach in a future study involving socially, physically and cognitively less active elderly persons.

Health care strategies in long-term care facilities in Bahia State, Brazil

OBJECTIVE: To describe health care strategies for older people living in long-term care facilities (LTCFs) in Bahia state, Brazil. METHODS: This is an ecological study involving LTCFs identified in Bahia state, which were invited to participate in a survey conducted between April and June 2021. The variables of interest were LTCF characteristics, health care strategies, visits received from national public health system (SUS, in Portuguese) teams, and health care actions taken by SUS. A comparative analysis was performed between LTCFs located in the East macro-region and other parts of the state, in general and also stratified by funding type (private and non-private). RESULTS: The sample consisted of 177 LTCFs, more than half of them were located in the East macro-region, seat of the state capital. Most facilities declared themselves as non-private (68%). Less than one-third of the LTCFs had their own health teams. Although 67% of LTCFs reported some health care provided by SUS, only 49% reported clinical consultations, with even lower percentages for other SUS actions, except for vaccination (91%). The East macro-region had a lower percentage of LTCFs accompanied by a SUS team, and the highest percentage of LTCFs with supplementary health insurance. CONCLUSIONS: This study shows the limited access of LTCF residents to essential health services, due to a general neglect of this population by public health care providers. The inadequacy of public policies to support LTCFs has important consequences for the quality of care offered to residents.

Relation between family functionality and the household arrangements of the elderly

Abstract Objective :to verify the association between family functionality and the household arrangements of the elderly in an urban area of Minas Gerais. Method: a quantitative, household survey type study that was analytical, cross-sectional and observational in nature was carried out with 637 elderly persons. The Mini Mental State Examination, a characterization of sociodemographic and economic data and the Family Apgar test were used. Descriptive analysis was performed by absolute and relative frequencies for the categorical variables. The Chi-squared test (p <0.05) was used to identify relationships between household arrangements and family functionality. Results: elderly women (66.6%), aged 60 to 70 years (42.1%), who were married (42.7%), and received the minimum wage (45.1%), with up to four years of education (51%) predominated. It was found that the majority of the elderly persons interviewed (87.8%) considered their family as a unit of care with good functionality. There was a significant association between poor family functionality and elderly individuals who lived alone (p = 0.007). Conclusion: it is important to understand the family dynamics of the elderly so that multidisciplinary teams can promote actions and interventions aimed at the needs of each family, helping to strengthen family relationships.