Yaşlı bireylerde otago egzersizlerinin fiziksel performans, denge, düşme, kırılganlık ve güçlendirme üzerindeki etkisinin incelenmesi

Amaç: Araştırmanın temel amacı; yaşlı bireylerde uygulanan otago egzersizlerin fiziksel performans, denge, düşme, kırılganlık ve güçlendirme üzerindeki etkisinin incelenmesidir. Yöntem: Bu araştırma randomize kontrollü deneysel olarak Narlıdere Huzurevi Yaşlı Bakım ve Rehabilitasyon Merkezinde Eylül 2016-Haziran 2017 tarihleri arasında yapılmıştır. Araştırmanın evrenini; veri toplama süresi boyunca Narlıdere Huzurevi Yaşlı Bakım ve Rehabilitasyon Merkezinde kalan 65 yaş üstü bireyler oluşturmuştur. G-Power istatistik analizine göre %95 güvenirlikte %80 teorik power ile her bir grupta 36 olmak üzere toplam 72 hasta ile çalışılması hedeflenmiştir. Ancak otago grubundaki bir hastanın ameliyat nedeni ile çalışmadan ayrılması sonucu 71 hasta ile çalışma tamamlanmıştır. Bu araştırmada örneklem kapsamına alınacak bireylerin egzersiz uygulamasını etkileyebileceği düşünülerek tabakalı randomizasyon için yaş ve cinsiyet ölçüt olarak kullanılmıştır. Otago egzersizleri eğitiminde hastalara eğitim süresince; araştırmacı öncülüğünde gösterip yaptırma tekniği kullanılarak Otago egzersizleri uygulanmış ve el kitapçığı verilmiştir. Araştırmada plasebo etkisini dışlamak ve etik sorun oluşmasını engellemek için yürüyüş grubuna yürüme programı uygulanmıştır. Yürüyüş grubundaki yaşlılara yürüme programı araştırmacı tarafından bir kere gösterilmiş olup bireylere eğitim ve takip kitapçığı verilmiştir. Çalışmada veri toplama formları olarak; Hasta Tanılama Formu, Edmonton Kırılganlık Ölçeği, Berg Denge Ölçeği, 30 saniye Otur-Kalk Testi, Altı dakika yürüme testi, Yaşlılar için Düşme Davranışları (FaB) Ölçeği, Güçlendirme Ölçeği kullanılmıştır. Bulgular: Otago grubunun yaş ortalaması 74,6±5,9 iken yürüyüş grubunun yaş ortalaması 75,8 ±4,5 dir. Otago grubundaki bireylerin %74,3'ü kadın, %25,7'si erkek ve yürüyüş grubunun %75'i kadın ve %25'i erkektir (p=0,576). Her bir gruptaki tekrarlı ölçüm değerleri için değişim yüzdeleri hesaplanarak gruplar arasında anlamlı fark olup olmadığı araştırılmıştır. Kırılganlık ölçeği için gruplar arasında değişim yüzde değerleri farkı araştırıldığında, %95 önem düzeyinde 0 ölçüm ile 3. ay ölçüm değerleri arasında anlamlı farklılık bulunmuştur (p0,001). Yürüyüş grubu medyanı 0 (%) olarak bulunurken otago grubunun medyanı -50(%) olarak bulunmuştur. Berg denge ölçeği için ise %95 önem düzeyinde 0 ölçüm ile 3. ay ölçüm değerleri arasında anlamlı farklılık bulunmuştur (p0,001). Yürüyüş grubu medyanı 0 (%) iken otago grubu medyanı 13,6 (%) olarak bulunmuştur. Otur-kalk testi için ise %95 önem düzeyinde 0 Ölçüm ile 3. ay ölçüm değerleri arasında anlamlı farklılık bulunmuştur (p=0,023). Yürüyüş grubu medyanı 22,2 (%) iken otago grubu medyanı 33,3 (%) olarak bulunmuştur. Yürüme testi için ise %95 önem düzeyinde hiçbir grup için anlamlı farklılık bulunamamıştır (p>0,05). 0 ölçüm ile 3. ay ölçüm değerleri değişim yüzdesinde; yürüyüş grubu medyanı 15,8 (%) iken otago grubu medyanı 17,5 (%) olarak bulunmuştur. Düşme davranışları ölçeği için ise %95 önem düzeyinde 0 ölçüm ile 3. ay ölçüm değerleri arasında anlamlı farklılık bulunmuştur (p=0,003). Yürüyüş grubu medyanı 19,6 (%) iken otago grubu medyanı 15,4 (%) olarak bulunmuştur. Güçlendirme ölçeği için ise %95 önem düzeyinde 0 Ölçüm ile 3. ay ölçüm değerleri arasında anlamlı farklılık bulunmuştur (p0,001). Yürüyüş grubu medyanı -16,7 (%) iken Otago grubu medyanı -27,8 (%) olarak bulunmuştur. Sonuç: Çalışmadan elde edilen sonuçlar ve bulgular doğrultusunda, otago egzersizlerin fiziksel performans, denge, düşme, kırılganlık ve güçlendirme üzerinde olumlu etkisinin olduğu saptanmıştır.Objective: The main purpose of the research is to evaluate the effect of Otago exercises on physical performance, balance, falls, frailty and empowerment in elderly individuals. Method: This randomized controlled trial included subjects over 65 years of age in the Narlıdere Nursing Home Care and Rehabilitation Center in Turkey between September 2016 and June 2017. The universe of research; During the data collection period provided the elderly people over 65 years old at the Narlıdere Nursing Home Geriatric Care and Rehabilitation Center. According to G-Power statistical analysis, it is aimed to study 72 patients with 36% in each group with 95% confidence and 80% theoretical power. However, the study was completed with 71 patients who leave otago group without working for the reason of surgery. Age and gender were used as the criteria for stratified randomization in this study, considering that the subjects to be included in the sample may affect the exercise application. In Otago exercises training, Otago exercises were applied using a demonstration technique and a handbook was given in front of the researcher. In the study, a walking program was implemented to exclude the placebo effect and prevent ethical problems. The walking program for the elderly was shown once by the researcher and the individual was provided with a training and follow-up booklet. As data collection forms in the study; The Patient Identification Form, the Berg Balance Scale, the 30-second Sit to Stand test, the 6-minute walking test, the Falls Behavioural (FaB) Scale for the Older Person, the Edmonton Frail Scale and the Empowerment Scale were used. Results: The average age of the Otago group is 74.6 ± 5.9, while the average age of the walking group is 75.8 ± 4.5. 74.3% of the individuals in the Otago group were female, 25.7% were male and 75% of the marching group were female and 25% were male (p = 0.576). Change percentages were calculated for repeated measurement values in each group to investigate whether there was a significant difference between the groups. A significant difference was found between 0 measurement and 3 month measurement values at 95% significance level (p 0.001) when the difference percentage values between groups were investigated for Frail scale. The median of the walking group was 0 (%), while the median of the otago group was -50 (%). For the Berg balance scale, there was a significant difference between the measurements at 0% and 95% significance level (p 0.001). The median of the walking group was 0 (%) while the median of the otago group was 13.6 (%). For the 30-second Sit to Stand test, a significant difference was found between the 0 measurement and the 3 month measurement values at 95% significance level (p = 0.023). The walking group's median was 22.2% while the otago group's median was 33.3%. No significant difference was found for any group with a 95% significance level for the the 6-minute walking test (p> 0,05). 0 measurement and 3 month measurement values change percentage; while the walking group's median was 15.8%, while the otago group's median was 17.5%. For the Falls Behavioural (FaB) Scale, there was a significant difference between the measurements at 0, 95% significance level and 3 month (p = 0.003). The walking group's median was 19.6% while the otago group's median was 15.4%. For the empowerment scale, a significant difference was found between 0 measurement and 3 month measurement values at 95% significance level (p 0.001). The walking group's median was -16.7 (%) while the Otago group median was -27.8 (%). Conclusion: It has been determined that otago exercises have a positive effect on physical performance, balance, drop, fragility and empowerment in the results and findings obtained from the study

The Effect of Orem's Self-care Education on Interdialytic Weight and Blood Pressure Changes in Hemodialysis Patients

WOS: 000384546600047Chronic renal disease is known as progressive and irreversible loss of renal function. These diseases cover a wide range from proteinuria to increase in serum creatinine which is a clear sign of weak glomerular filtration rate and complete failure of kidney in final stages of kidney disease. Sodium retention in kidney patients accumulate liquids in their body, followed by the overweight and hypertension. The present study aimed to investigate the effect of Orem's self-care education on overweight between two dialysis sessions and blood pressure in patients suffering chronic kidney failure under treatment in Ayatollah Taleghani Hospital at Urmia. The present study is a quasi-experimental one conducted in a group with pretest and posttest in the hemodialysis ward of Ayatollah Taleghani Hospital of Urmia. 50 patients suffering chronic kidney failure were selected according to the purpose of the study and characteristics of the units under study. The data for the study were collected through interviews and the questionnaire for identifying needs, demographic information and the checklist. In the pretest, the patients were asked to fill out the questionnaire for needs, demographic information and checklist and their average overweight between two dialysis sessions were recorded along with their blood pressure. Then, an educational plan was commenced based on problems identified and Orem's self-care theory and was taught to the patients in three thirty-minute sessions in five groups of ten subjects. Supplementary resources like videos, booklets etc. were also utilized. Two months later, average overweight and blood pressure for two months after training were measured. The data collected were analyzed through SPSS (version 18) computer application and coupled T test. The study revealed that the patients overweight decreased significantly between two dialysis sessions (P0.05). Conducting self-care teaching programs on patients under hemodialysis treatment could reduce their problems especially in case of overweight between two hemodialysis sessions. Therefore, the use of this model in hemodialysis patients is recommended

The Impact of the Otago Exercise Program on Frailty and Empowerment in Older Nursing Home Residents: A Randomized Controlled Trial

Background: This study assessed the impact of Otago exercises on frailty and empowerment in older nursing home residents. Methods: This randomized controlled trial included 72 individuals aged over 65 years residing in a single nursing home in Izmir, Turkey. The participants were randomly assigned to the Otago exercise group (OEG) or control group (CG). The OEG performed Otago exercises for 45 minutes, 3 days per week for 12 weeks plus a walking program the 3 other days of the week. In addition to Otago exercise training, the OEG received training based on empowerment consisting of 10 sessions lasting 30 minutes each. The CG received no intervention except routine care in the nursing home. The data collected were sociodemographic characteristics, Edmonton Frail Scale (EFS) scores, and Elderly Empowerment Scale (EES) scores before and 3 months after the intervention. Results: We observed significant differences between the mean EFS (p=0.0001) and mean EES (p=0.0001) before and 3 months after the intervention in the OEG compared to the CG. We also observed a significant difference between the OEG and CG in mean EFS (p=0.018) and EES (p=0.0001) 3 months after the intervention. Conclusion: The results of the present study demonstrated the positive impact of the Otago exercise program on preventing/delaying frailty and enhancing empowerment in older people

Adaptation of Diabetic Empowerment Scale-Short Form to Older Individuals and to Turkish Language: Validity and Reliability Study

WOS: 000542299000005PubMed: 32612417Objective: the empowerment of old people is important in order for them to gain control over their own lives and to raise their quality of life. the purpose of this study was to adapt the Diabetes Empowerment Scale-Short Form (DES-SF) to old people and to the Turkish language, and to determine its validity and reliability. Materials and Methods: This methodological type study was conducted between 1 January and 30 March 2017 with 106 old people fitting the criteria of acceptance in the study who attended the geriatrics clinic of a university hospital. in determining validity, language equivalence, content, and predictive validity were used, while reliability was tested with temporal invariance, Cronbach's alpha coefficient, and item total correlation. We examined its reliability and validity via item analyses, content validity (expert panel), confirmatory factor analyses, and construct validity (exploratory factor analyses). Results: the Cronbach's alpha of the scale was 0.883. the scale items were grouped under a single factor in accordance with the original. Confirmatory and exploratory factor analysis showed good fit signs. Conclusion: After conducting validity and reliability testing on the adaptation of the Diabetic Empowerment Scale-Short Form to old people and the Turkish language, it is was concluded that it is a reliable scale to determine the empowerment levels of old people. Based on the statistical analyses applied to evaluate the validity and reliability of the scale obtained by adapting the DES-SF to old people, it was inferred that it is an instrument with high validity and reliability. the scale is a short and practical instrument to evaluate the empowerment levels of old people. the new name of the scale is the elderly empowerment scale