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      Analysis of risk factors for falls among institutionalized elderly persons Translated title: Análise dos fatores de risco para queda em idosos institucionalizados

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          Abstract

          Abstract Objectives: to identify the demographic and clinical profile, context of risk and the occurrence of falls among institutionalized elderly persons; analyze the association between the classification of risk of falling using the Brazilian version of the Morse Fall Scale and the occurrence of falls in such individuals. Method: A cohort study was performed in two long-stay institutions in the city of Porto Alegre, Brazil. The sample consisted of 193 elderly persons. Descriptive and inferential statistics (Chi-squared and Fisher tests) were used for analysis. Results: The occurrence of falls was associated with hearing impairment, hand grip strength, Katz Index score, degree of dependence according to Collegial Board Resolution 283/2005 and risk of falls according to the MFS-B. Conclusion: Falls have multifactorial causes, which makes it important to identify the agents that contribute to their occurrence, as it is known that institutionalization significantly increases the risk of falling. Multidisciplinary actions are important for reducing the risk of falls, together with the use of instruments that can predict such risk among institutionalized elderly people.

          Translated abstract

          Resumo Objetivos: Identificar o perfil demográfico, clínico, o contexto de risco e da ocorrência de queda em idosos institucionalizados; analisar a associação da classificação de risco de cair de Morse Fall Scale na versão brasileira (MFS-B) e a ocorrência de quedas em idosos institucionalizados. Método: Estudo de coorte, em duas instituições de longa permanência para idosos no município de Porto Alegre-RS, Brasil. A amostra foi composta por 193 idosos. Para a análise foi utilizada a estatística descritiva e inferencial (testes Qui-quadrado e exato de Fisher). Resultados: A ocorrência de quedas esteve associada ao deficit auditivo (p=0,004), força de preensão palmar (p=0,004), Escore Índex Katz (p<0,001), grau de dependência, conforme Resolução da Diretoria Colegiada (RDC) nº 283/2005 (p<0,001) e risco de quedas pela MFS-B (p=0,012). Conclusão: A queda tem causas multifatoriais, fazendo-se necessário conhecer os agentes que contribuem para a ocorrência de quedas, pois se sabe que a institucionalização aumenta significativamente o risco de cair. Ações multidisciplinares são importantes para a diminuição do risco de cair, bem como a utilização de instrumentos que sejam capazes de predizer o risco de quedas em idosos institucionalizados.

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          Inpatient fall prevention programs as a patient safety strategy: a systematic review.

          Falls are common among inpatients. Several reviews, including 4 meta-analyses involving 19 studies, show that multicomponent programs to prevent falls among inpatients reduce relative risk for falls by as much as 30%. The purpose of this updated review is to reassess the benefits and harms of fall prevention programs in acute care settings and to identify factors associated with successful implementation of these programs. We searched for new evidence using PubMed from 2005 to September 2012. Two new, large, randomized, controlled trials supported the conclusions of the existing meta-analyses. An optimal bundle of components was not identified. Harms were not systematically examined, but potential harms included increased use of restraints and sedating drugs and decreased efforts to mobilize patients. Eleven studies showed that the following themes were associated with successful implementation: leadership support, engagement of front-line staff in program design, guidance of the prevention program by a multidisciplinary committee, pilot-testing interventions, use of information technology systems to provide data about falls, staff education and training, and changes in nihilistic attitudes about fall prevention. Future research would advance knowledge by identifying optimal bundles of component interventions for particular patients and by determining whether effectiveness relies more on the mix of the components or use of certain implementation strategies.
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            Assessment of risk of falls in elderly living at home 1

            ABSTRACT Objective: to assess the risk of falls in elderly, by comparing the sociodemographic and cognitive factors, history of falls and self-reported comorbidities. Method: cross-sectional and quantitative study with 240 elderly. Data were collected based on the social profile, through the instrument of risk of falls and assessment of falls, by univariate analysis, bivariate and multiple logistic regression. The Statistical Package for the Social Sciences (SPSS) version 19 was used for statistical analysis. Results: there was a significant association of the risk of falls, as measured by the Fall Risk Score, with sex (<0.001), age (0.054), cognitive status (<0.001) and history of falls (<0.001). All variables were statistically significant and contributed to the occurrence of falls. In logistic regression, the variables that showed association with risk of falls were: fall, with whom they live, hypertension and visual impairment. Conclusion: female gender, older elderly (over 80 years old), with low cognitive status and occurrence of previous falls in the last six months are factors that increase the prevalence of falls. In logistic regression, the variables that were associated with risk of falls were: fall, with whom they live, visual impairment and rheumatologic diseases.
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              Quedas de idosos institucionalizados: ocorrência e fatores associados

              Quedas entre pessoas idosas constituem importante problema de saúde pública, devido à sua incidência, às complicações para a saúde e aos altos custos assistenciais. Estudos realizados no Brasil e em outros países referem que as quedas são mais frequentes em idosos institucionalizados e apresentam causa multifatorial. Com o objetivo de verificar a ocorrência de quedas em idosos institucionalizados e identificar seus fatores associados, foi realizado um levantamento de dados de 105 indivíduos com idade igual ou superior a 60 anos, residentes em quatro instituições asilares do município de Catanduva, São Paulo. O método utilizado para a coleta dos dados foi entrevista. Foram utilizados os instrumentos: Escala de Depressão Geriátrica e Mini-Exame do Estado Mental, instrumentos estes destinados à avaliação dos estados de humor e cognitivo, respectivamente. Os achados mostraram que 40% dos idosos relataram quedas nos últimos seis meses, e os fatores de risco considerados significativos foram: sexo feminino (p=0,035), uso de medicamentos (p=0,047), visão deficiente (p=0,029), ausência de atividade física (p=0,035), presença de osteoartrose (p=0,000), depressão (p=0,034), déficit de força de preensão palmar (p=0,0165) e distúrbios no equilíbrio e marcha (p=0,038). Os resultados apontam para a necessidade da implementação de programas de prevenções de quedas em instituições asilares, através de intervenção multidisciplinar buscando, portanto, uma melhoria na qualidade de vida dessa população.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Journal
                rbgg
                Revista Brasileira de Geriatria e Gerontologia
                Rev. bras. geriatr. gerontol.
                Universidade do Estado do Rio Janeiro (Rio de Janeiro, RJ, Brazil )
                1809-9823
                1981-2256
                2019
                : 22
                : 1
                : e180138
                Affiliations
                [2] Porto Alegre Rio Grande do Sul orgnamePontifícia Universidade Católica do Rio Grande do Sul orgdiv1Escola de Ciências da Saúde Brazil
                [1] Porto Alegre Rio Grande do Sul orgnamePontifícia Universidade Católica do Rio Grande do Sul orgdiv1Escola de Medicina orgdiv2Programa de Pós-graduação em Gerontologia Biomédica Brazil
                Article
                S1809-98232019000100208
                10.1590/1981-22562019022.180138
                046d8541-2618-4816-aeef-e65f0ef1e310

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 14 March 2019
                : 02 August 2018
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 26, Pages: 0
                Product

                SciELO Brazil

                Categories
                Original Articles

                Patient Safety,Accidental Falls,Risk Factors,Elderly,Homes for the Aged,Segurança do Paciente,Acidentes por Quedas,Fatores de Risco,Instituição de Longa Permanência para Idosos,Idoso

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