evaluar hasta que punto los usuarios del servicio de ayuda a domicilio (SAD) cumplen criterios de fragilidad y la relacion de los diferentes problemas geriatricos detectados con la dependencia funcional, con el fin de alertar a los servicios sociales y sanitarios sobre la necesidad de priorizar la atencion en esas areas.
Material y métodoel estudio se llevo a cabo mediante cuestionario postal, enviado a los usuarios del SAD de un distrito de Madrid, y con una posterior entrevista directa con enfermeria. Ademas de otras preguntas de interes, se utilizaron diversas escalas de uso comun en geriatria (Barber, National Screening Initiative, Pfeiffer, Barthel y Lawton). El analisis estadistico se realizo con el programa SPSS y se utilizaron los tests de la t de Student, de la χ2 y de correlacion bivariable. Se utilizaron los registros de las 153 personas con una edad media de 81± 7,2 anos que respondieron.
Resultadossegun el cuestionario de Barber, todos los usuarios cumplen criterios de fragilidad. De ellos, el 13,7% era independiente para las actividades instrumentales de la vida diaria y el 18,5%, para las basicas. Hubo una correlacion negativa entre las escalas de Barthel y Lawton y entre las puntuaciones de Barber, NSI y Pfeiffer. Se detectaron numerosos problemas geriatricos. Las caidas, el dolor y las quejas respecto a la memoria fueron los mas frecuentes para los dependientes en las actividades de la vida diaria, tanto basicas como instrumentales. Entre los dependientes para las actividades instrumentales destacaban el animo triste y los problemas de vision. La edad, el riesgo vascular o los problemas de audicion no guardaron una relacion estadisticamente significativa con la dependencia. En ambos casos, la soledad se comporto como un factor protector.
Conclusionesla poblacion estudiada cumple criterios de fragilidad y es altamente dependiente. Los problemas geriatricos detectados precisan de un estrecho control para evitar un mayor deterioro.
to evaluate the extent to which users of the home help service meet frailty criteria and the relationship between the various geriatric problems detected and functional dependence, in order to alert social and health services to the need to prioritise these areas.
Material and methodthe study was carried out by postal questionnaires to users of the home help service in a district of Madrid with follow-up interviews by nursing staff. In addition to other questions, several commonly used geriatric assessment tools were used (National Screening Initiative, Barber, Pfeiffer, Barthel and Lawton scales). Statistical analysis was carried out with SPSS using t-test, Chisquare test and bivariate correlation. The data were compiled from 153 respondents with a mean age of 81 (7.2) years.
Resultsaccording to the Barber questionnaire, all the users of the home help service met fragility criteria. Of these, 13.7% were independent for instrumental activities of daily living (ADL) and 18.5% for basic ADL. There was a significant negative correlation between Barthel and Lawton scores and those for the Barber, National Screening Initiative and Pfeiffer scales. Numerous geriatric problems were detected. The most frequent in the population classified as dependent for both basic and instrumental ADL were falls, pain, and memory complaints. The most frequent complaints in elderly individuals classified as dependent for instrumental ADL were low mood and poor vision. Neither age, vascular risk nor hearing impairments were statistically significantly associated with dependence. In both cases, solitude was a reinforcing factor.
Conclusionsthe target population met fragility criteria and was highly dependent. The geriatric problems detected should be closely monitored to prevent further deterioration.