The selected aspects of geriatric patients’ functioning evaluation

Introduction. As time passes by and the aging proceeds, the state of one’s health also changes. Chronic, progressive illnesses appear and limit one’s self-reliance. The aim of this study was to evaluate chosen functional fitness factors in geriatric patients and to analyze problems in caring. Material and methods. The study was conducted in 2010 among 109 patients from the Department and Clinic of Geriatrics. Research tools included: the Care Dependency Scale questionnaire (the CDS); Polish version, Katz Activities of Daily Living Scale (ADL) questionnaire, Lawton Instrumental Activities of Daily Living (IADL) Scale questionnaire. Results. Everyday and instrumental activities in the surveyed group were estimated at medium to high level. The majority of the patients surveyed were found to be at medium to low level of care dependency in CDS scale. The correlation between values tested for in ADL scale and the dependency on care tested for with CDS scale has been confirmed. Conclusions. Among the patients surveyed, the most prominent problems included the difficulties in adjusting the proper body position, mobility limitations and limitations in participating in recreational activities outside without help. The remaining needs were met at a medium level. The general assessment of functional capability was estimated at a medium to high level.Wstęp. Wraz z upływem czasu oraz postępem procesu starzenia zmienia się stan zdrowia, pojawiają się schorzenia o charakterze przewlekłym i postępującym, które ograniczają samodzielne funkcjonowanie. Celem badań było ocena wybranych parametrów sprawności funkcjonalnej pacjentów geriatrycznych oraz analiza problemów pielęgnacyjnych. Materiał i metody. Badania przeprowadzono w 2010 roku wśród pacjentów Katedry i Kliniki Geriatrii w liczbie 109 osób. Narzędziami badawczymi były: kwestionariusz (CDS) Care Dependency Scale - wersja polska; kwestionariusz oceny sprawności codziennej (ADL) na podstawie skali Katza, kwestionariusz oceny złożonych czynności życia codziennego (IADL) na podstawie skali Lawtona. Wyniki. Czynności dnia codziennego oraz czynności instrumentalne w badanej grupie kształtowały się na średnim i wysokim poziomie. Większość badanych pacjentów znajdowała się na średnim i niskim poziomie zależności od opieki w skali CDS. Potwierdzono istnienie korelacji między wartościami badanymi w skali sprawności funkcjonalnej ADL a zależnością od opieki badaną skalą CDS. Wnioski. U badanych pacjentów najważniejszymi problemami były trudności w realizacji potrzeb przyjęcia odpowiedniej pozycji ciała, ograniczenia w poruszaniu się oraz ograniczenia w uczestniczeniu w zajęciach rekreacyjnych poza domem bez niczyjej pomocy. Pozostałe potrzeby były zaspokajane na średnim poziomie. Ogólna sprawność funkcjonalna była oceniona na średnim i wysokim poziomie

Wybrane aspekty oceny funkcjonowania pacjentów geriatrycznych

Introduction. As time passes by and the aging proceeds, the state of one’s health also changes. Chronic, progressive illnesses appear and limit one’s self-reliance. The aim of this study was to evaluate chosen functional fitness factors in geriatric patients and to analyze problems in caring.Material and methods. The study was conducted in 2010 among 109 patients from the Department and Clinic of Geriatrics. Research tools included: the Care Dependency Scale questionnaire (the CDS); Polish version, Katz Activities of Daily Living Scale (ADL) questionnaire, Lawton Instrumental Activities of Daily Living (IADL) Scale questionnaire.Results. Everyday and instrumental activities in the surveyed group were estimated at medium to high level. The majority of the patients surveyed were found to be at medium to low level of care dependency in CDS scale. The correlation between values tested for in ADL scale and the dependency on care tested for with CDS scale has been confirmed.Conclusions. Among the patients surveyed, the most prominent problems included the difficulties in adjusting the proper body position, mobility limitations and limitations in participating in recreational activities outside without help. The remaining needs were met at a medium level. The general assessment of functional capability was estimated at a medium to high level.Wstęp. Wraz z upływem czasu oraz postępem procesu starzenia zmienia się stan zdrowia, pojawiają się schorzenia o charakterze przewlekłym i postępującym, które ograniczają samodzielne funkcjonowanie.Celem badań było ocena wybranych parametrów sprawności funkcjonalnej pacjentów geriatrycznych oraz analiza problemów pielęgnacyjnych.Materiał i metody. Badania przeprowadzono w 2010 roku wśród pacjentów Katedry i Kliniki Geriatrii w liczbie 109 osób. Narzędziami badawczymi były: kwestionariusz (CDS) Care Dependency Scale - wersja polska; kwestionariusz oceny sprawności codziennej (ADL) na podstawie skali Katza, kwestionariusz oceny złożonych czynności życia codziennego (IADL) na podstawie skali Lawtona.Wyniki. Czynności dnia codziennego oraz czynności instrumentalne w badanej grupie kształtowały się na średnim i wysokim poziomie. Większość badanych pacjentów znajdowała się na średnim i niskim poziomie zależności od opieki w skali CDS. Potwierdzono istnienie korelacji między wartościami badanymi w skali sprawności funkcjonalnej ADL a zależnością od opieki badaną skalą CDS.Wnioski. U badanych pacjentów najważniejszymi problemami były trudności w realizacji potrzeb przyjęcia odpowiedniej pozycji ciała, ograniczenia w poruszaniu się oraz ograniczenia w uczestniczeniu w zajęciach rekreacyjnych poza domem bez niczyjej pomocy. Pozostałe potrzeby były zaspokajane na średnim poziomie. Ogólna sprawność funkcjonalna była oceniona na średnim i wysokim poziomie

The global risk of pressure ulcers among elderly patients: initial diagnosis

Background. Prevention is the most effective method of reducing the risk of pressure ulcers. Prophylaxisinvolves several actions and procedures that can decrease the risk and aid implementation of rapidtreatment if pressure ulcers develop.Aim. To evaluate the risk of pressure ulcers in elderly patients.Material and methods. The study group involved patients hospitalized at the Department and Clinic ofGeriatric Medicine in Bydgoszcz: 82 females and 34 males (116 in total). The study used a diagnostic pollmethod with the application of an ADL (Activities of Daily Living) questionnaire to assess daily efficiencyon the basis of the Katz Scale, CDS (Care Dependency Scale) questionnaire to measure the level of caredependency and human needs, and a risk scale for pressure ulcer development devised by D. Norton.Results. The risk of pressure ulcers was observed in approximately one third of the study subjects (30.2%).Almost a half of the patient group had multiple morbidities. Problems concerning the care of patientswith a high risk of pressure ulcers were usually connected with a lack of independence in changing bodyposition, movement, dressing, and sphincter dysfunction.Conclusion. There is a correlation between the level of functional capability and the risk of pressureulcers. The accumulation of problems related to the lack of independence in fulfilling the patients’ ownneeds significantly increased the risk of pressure ulcers in the study group.Background. Prevention is the most effective method of reducing the risk of pressure ulcers. Prophylaxisinvolves several actions and procedures that can decrease the risk and aid implementation of rapidtreatment if pressure ulcers develop.Aim. To evaluate the risk of pressure ulcers in elderly patients.Material and methods. The study group involved patients hospitalized at the Department and Clinic ofGeriatric Medicine in Bydgoszcz: 82 females and 34 males (116 in total). The study used a diagnostic pollmethod with the application of an ADL (Activities of Daily Living) questionnaire to assess daily efficiencyon the basis of the Katz Scale, CDS (Care Dependency Scale) questionnaire to measure the level of caredependency and human needs, and a risk scale for pressure ulcer development devised by D. Norton.Results. The risk of pressure ulcers was observed in approximately one third of the study subjects (30.2%).Almost a half of the patient group had multiple morbidities. Problems concerning the care of patientswith a high risk of pressure ulcers were usually connected with a lack of independence in changing bodyposition, movement, dressing, and sphincter dysfunction.Conclusion. There is a correlation between the level of functional capability and the risk of pressureulcers. The accumulation of problems related to the lack of independence in fulfilling the patients’ ownneeds significantly increased the risk of pressure ulcers in the study group

Sociodemographic factors affecting older people’s care dependency in their daily living environment according to Care Dependency Scale (CDS)

The aim of the research was to determine the influence of sociodemographic factors on older people’s care dependency in their living environment according to the Care Dependency Scale (CDS). Methods: The research was conducted in a group of 151 older people staying in their own homes. The methods applied in the research included a sociodemographic questionnaire and scales including the Abbreviated Mental Test Score (AMTS), CDS, Katz Index of Independence in Activities of Daily Living (ADL), Lawton’s Instrumental Activities of Daily Living (I-ADL), Mini Nutritional Assessment (MNA), and Geriatric Depression Scale (GDS). Results: Gender had a significant impact on the level of care dependency. The surveyed females obtained the medium or high level of dependency more often than males (22.4% vs. 6.1%), and the low level of dependency was significantly more frequent among men than women (p = 0.006). Moreover, the age of the respondents determined their level of care dependency. The subjects with a medium or high level of care dependency were significantly older (p = 0.001). The subjects with a low level of care dependency were more likely to be married than people with a medium/high level (p < 0.001). The level of education had a significant impact on care dependency. A higher level of education correlated with a medium/high level of dependency (p = 0.003). Conclusions: The survey results confirmed that sociodemographic factors have a significant impact on the level of care dependency. When planning care in the home environment, special attention should be paid to older women, who are more likely to lose their independence than men. These women should be given additional support

Reliability and practical aspects of the disease impact measure on hypertensive patients

OBJECTIVE: to evaluate the feasibility, acceptability, the ceiling and floor effects and the reliability of the Instrument to Measure the Impact of Coronary Disease on Patient's Daily Life (IDCV) when applied to hypertensive patients. METHOD: one hundred and thirty seven hypertensive outpatients were interviewed, using questionnaires to collect sociodemographic and clinical data, followed by the IDCV. Reliability was assessed according to the temporal stability and internal consistency criteria. RESULTS: the IDCV was applied in 8.0 (±3.0) minutes with 100% of the items answered. A ceiling effect of 31.4% was observed in the domain Adjustment to the Disease. The stability measure was observed for the total score and for all domains. There was evidence of internal consistency of the total IDCV (α=0.83) and the domains Physical Impact of the Disease - Symptoms (α=0.78) and Social and Emotional Impact of the Disease (α=0.74). CONCLUSION: the IDCV is an instrument of easy use and its reliability among hypertensive patients is evidenced. The domain Adjustment to the Disease, however, should be reviewed in further studies

Factors Correlating with Functional Capacity in Older People with Chronic Pain

Introduction: Chronic pain in older people is a global health problem not only in terms of a negative subjective feeling, but also as a social and economic factor. Deterioration of functional capacity is one of the main symptoms of chronic pain; therefore, it should be assessed as a basic parameter in the life of older people. The aim of the study was to analyze the factors which have an impact on the functional capacity of older people with chronic pain. Material and methods: The study was conducted among 181 people over 65 suffering from chronic pain lasting more than 6 months. The study used a questionnaire that included questions about demographic and social characteristics and the following scales: Abbreviated Mental Score (AMTS), Personal Activities of Daily Living (PADL) by Katz, Instrumental Activities of Daily Living (IADL) by Lawton, Geriatric Pain Measure-24 (GPM-24). Results: In the study group, a positive correlation was found between: coexisting diseases and withdrawal due to pain, pain intensity, pain resulting from walking or from the effort from other activities, and in terms of the total GPM-24 score. A positive correlation was also found between the Geriatric Depression Scale (GDS) and withdrawal due to pain, pain intensity, pain resulting from walking or from the effort from other activities, and in terms of the total GPM-24 score. A significantly negative correlation was found between: AMTS, ADL, IADL performance and: withdrawal due to pain, pain intensity, pain resulting from walking or from the effort from other activities, and in terms of total GPM-24 score. Conclusions: Chronic pain is more common in people with disabilities in basic and complex activities of daily living, with limited efficiency in cognitive functions and an increased sense of depression. The standard in everyday practice and clinical trials should be taking a history of chronic pain in every older person, monitoring the pain’s intensity and accompanying characteristics by using a multidimensional scale for assessing pain in older people

Quality of life for the chronically ill elderly

Wstęp. W ciągu ostatnich kilkunastu lat w dziedzinie medycyny, pielęgniarstwa i nauk społecznych osiągnięto znaczny postęp dotyczący badań nad jakością życia uwarunkowaną stanem zdrowia. Zainteresowanie tym zagadnieniem wiąże się z uznaniem i akceptowaniem nowego modelu medycyny holistycznej, która charakteryzuje się kompleksowym traktowaniem człowieka chorego. Celem badań było określenie wpływu czynników socjomedycznych na ocenę subiektywnego stanu zdrowia pacjentów leczonych z powodu chorób przewlekłych. W badaniach zastosowano standaryzowane narzędzie badawcze - kwestionariusz Nottingham Health Profile (NHP). Materiał i metody. Badaniem objęto 234 pacjentów przewlekle chorych (cukrzyca, choroby układu krążenia i układu ruchu, przewlekła niewydolność nerek, udar mózgu). Wyniki. Wykazano, że starsi chorzy najczęściej informowali o utracie energii życiowej, ograniczeniu sprawności ruchowej oraz dolegliwościach bólowych i zaburzeniach snu. Chorzy na cukrzycę i niewydolność serca zgłaszali najwięcej problemów dotyczących wykonywania prac domowych i prowadzenia życia towarzyskiego. Osobom przewlekle chorym często pomaga rodzina. Problemy w poszczególnych dziedzinach życia powodowane stanem zdrowia występowały istotnie częściej u mieszkańców wsi niż miast. Wnioski. Jakość życia badanych pacjentów zależała przede wszystkim od wieku oraz rodzaju i czasu trwania schorzenia. Choroby przewlekłe przede wszystkim utrudniają życie codzienne.Background. There are a lot of publications on the subject of health related quality of life in medicine, nursing, sociology and psychology during the last few years. This interest is relevant to accepting new holistic model of medicine. Characteristic of this model is comprehensive approach the ill man. Determination of influence of exogenous factor on subjective assessment of patient’s health state was the goal of this research. Understanding of the quality of life for patients with chronic diseases was the goal of this research. The standardized tool - Nottingham Health Profile (NHP) was used for this research. Material and methods. The research was conducted on 234 chronically ill patients (diabetics, circulatory system disease, rheumatic disease, chronic kidney disease or stroke victims). Results. Results revealed that the most problems declared have concerned lost live energy, restrictions of mobility, pain and slip disturbance. Diabetic and ill patients with circulatory system disease have had more problems with homework and social. Patients with diabetes had more problems with social activities than other groups of patients Family and carers aid chronically ill family members. Health related problems occurred more frequently in patients living in rural areas than in those living in cities. Conclusions. Quality of life asked patients depends mostly of age, kind of disease and its period. Chronic disease often causes difficulties and problems in different kinds of private life