RESUMEN
OBJECTIVE: To report the experience of offering the Quality End of Life Care for All (QELCA) Programme, highlighting the distinct methodology for the training of health professionals. DEVELOPMENT: The QELCA Programme, intellectual property of St Christopher's Hospice, was offered to seven health professionals working in the hospital palliative care unit at the National Cancer Institute, between June and December 2022, with the support of Premier Institute. The programme, which originates in the UK, has been evaluated there and is currently being evaluated in Hong Kong, and is delivered in two phases: (1) a 5-day immersion programme; (2) monthly sessions of Action Learning for 6 months. Participants realised that communication between members of the multidisciplinary team, as well as between health professionals and patients/loved ones, was one of the key challenges for achieving quality of death in the hospital palliative care unit. This insight empowered them to drive forward significant changes in practice that promise to improve quality of care. CONCLUSION: The QELCA Programme enabled participants to engage in active problem-solving to promote the relief of suffering of patients and their families in end-of-life care.
Asunto(s)
Cuidados Paliativos al Final de la Vida , Hospitales para Enfermos Terminales , Cuidado Terminal , Humanos , Cuidados Paliativos/métodos , Cuidado Terminal/métodos , Personal de Salud/educaciónRESUMEN
PURPOSE: To trace the socio-functional and clinical profiles of elders with moderate levels of movement functionality as determined by the Performance-Oriented Mobility Assessment (POMA Ia), and to compare the groups having high and moderate levels of functionality regarding the frequency of falls and identifiable risk factors. METHODS: The research involved 49 elders (with an average age of 71.24, SD 5.47) who were seeking medical care in the geriatric unit of a tertiary care hospital. Study participants were evaluated regarding their balance and gait (POMA Ia assessment), muscle strength (chair-stand test), gait velocity (timed up and go test), incidence of falls, and other clinical risk factors. RESULTS: The moderate functionality group reported significantly more falls (14) compared with the high functionality group (3). Of the risk factors evaluated, the presence of depression or of a psychiatric record was significantly more frequent in the moderate-functionality group but was not correlated with an increase in falls., Muscle weakness was found significantly more frequently in the moderate-functionality group and was significantly correlated with an increased frequency of falls. CONCLUSIONS: These findings suggest that the POMA Ia assessment can identify individuals with an increased risk of falling, and the treatment of risk factors such as depression or a psychiatric record, and muscle weakness could help prevent the occurrence of falls in elders with moderate functionality as determined by the POMA Ia assessment.
Asunto(s)
Accidentes por Caídas/prevención & control , Evaluación Geriátrica , Movimiento/fisiología , Actividades Cotidianas , Anciano , Anciano de 80 o más Años , Envejecimiento/fisiología , Distribución de Chi-Cuadrado , Femenino , Marcha/fisiología , Humanos , Masculino , Persona de Mediana Edad , Factores de Riesgo , Factores SocioeconómicosRESUMEN
OBJETIVO: Traçar o perfil sócio-funcional e clínico de idosos com risco moderado de quedas e compará-lo com idosos de baixo risco, identificando os fatores avaliados que correlacionassem com o risco e o relato de queda. MÉTODOS: O estudo avaliou 49 idosos (com média de idade de 71,24 anos, DP 5,47) que procuraram atendimento num ambulatório de triagem geriátrica de um hospital de nível terciário. Foram avaliados: equilíbrio, marcha (avaliados pelo teste POMA Ia), força muscular (30's chair stand), velocidade da marcha (timed up and go), incidência de quedas e outros riscos clínicos. RESULTADOS: O grupo de risco moderado relatou mais quedas (14 idosos) do que o baixo risco (3), atingindo a significância estatística (x sobre 2 = 0,0052). Dentre os fatores de risco avaliados a presença de depressão ou antecedentes psiquiátricos foi mais freqüente no risco moderado (x sobre 2 = 0,0016), porém, não apresentou diferença quando a variável era o relato prévio de quedas. A presença de fraqueza muscular apresentou associação estatística tanto em relação ao risco (x sobre ç2 =0,0284) quanto à queda (x sobre 2 =0,0013). CONCLUSÃO: Estes dados sugerem que o POMA Ia é um instrumento para a identificação de pacientes com risco de quedas e que fatores como depressão ou antecedentes e fraqueza muscular estão associados a ocorrência de quedas em idosos de risco moderado.
Asunto(s)
Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano de 80 o más Años , Accidentes por Caídas/prevención & control , Evaluación Geriátrica , Movimiento/fisiología , Actividades Cotidianas , Envejecimiento/fisiología , Distribución de Chi-Cuadrado , Marcha/fisiología , Factores de Riesgo , Factores SocioeconómicosRESUMEN
Exercícios físicos têm sido prescritos como prevenção de quedas na terceira idade. Nesse ensaio clínico controlado, a prática de tai chi chuan conseguiu melhorar o equilíbrio de mulheres idosas fisicamente independentes, em avaliações de mobilidade funcional (avaliação de equilíbrio e marcha de Tinetti).Em relação a avaliações pela posturografia dinâmica computadorizada sobre organização sensorial e controle motor, não houve alterações. O grupo controle, submetido somente a programa educacional, evoluiu com piora do desempenho na mobilidade funcional, demonstrado provavelmente como conseqüência da falta de atividade física programada / Physical exercises have been prescribed for elderly people in order to delay the incidence of falls. In this controlled clinical trial, tai chi chuan training group improved balance scores assessed by functional mobility test (Performance Oriented Mobility Assessment) in independent elderly women. Sensory organization and motor control test results did not change after intervention (computerized dynamic posturography protocols). Otherwise, subjects in the control group that had attended educational meetings, decreased their mobility performance, probably due to lack of engagement in a fitness program...