Clinical validation of the nursing diagnosis Fall risk in adults (00303) in elderly people in the community-dwelling

Resumo

PurposeTo identify the risk factors for the nursing diagnosis of fall risk in adults (00303) in elderly people in the community-dwelling.MethodThis is a methodological study, with a quantitative approach, carried out with elderly people living in the city of Ribeir & atilde;o Preto, SP, Brazil, from February to December 2018. For data collection, the demographic profile, Mini-Mental State Examination, diseases self-reported, functional independence measure, Lawton and Brody scale, geriatric depression scale, and self-perception of gait instruments were used. Tests of accuracy and association of risk factors with p <= 0.05 were performed.FindingsA total of 262 elderly people, aged over 80 years (55.7%), 71% of which were female and 42.7% were widowed, were included in the sample. A total of 82.1% had vascular diseases, 72.1% had diabetes, and 20.6% had depression. The predominant risk factors were difficulty performing instrumental activities of daily living (58.8%), cognitive dysfunction (43.5%), and depressive symptoms (26.3%). Difficulty performing instrumental activities of daily living had a sensitivity greater than 60%. The positive and negative predictive values were mostly greater than 50%. In the regression analysis, it was found that the elderly have a higher risk of suffering a fall if they present anxiety (p = 0.05), impaired physical mobility (p = 0.02), and difficulty to perform instrumental activities of daily living as risk factors (p = 0.03).ConclusionIt was possible to identify the presence of risk factors for the diagnosis fall risk in adults (00303) in the clinical context of the elderly in home settings and contribute to the clinical validation of the taxonomy, increase the evidence and importance of the diagnosis, and generate new knowledge for gerontological nursing.Implications for nursing practiceTo help nurses identify risk factors that lead elderly people to suffer falls at home and to implement preventive actions in their community with the support of their families. ObjetivoIdentificar os fatores de risco para o diagn & oacute;stico de enfermagem Risco de Quedas em adultos (00303) em idosos do domic & iacute;lio.M & eacute;todoTrata-se de um estudo metodol & oacute;gico, com abordagem quantitativa, realizado com idosos residentes na cidade de Ribeir & atilde;o Preto, SP, Brasil, no per & iacute;odo de fevereiro a dezembro de 2018. Para coleta de dados foram utilizados instrumentos de perfil sociodemogr & aacute;fico, Mini exame do Estado Mental, doen & ccedil;as autorreferidas, Medida de Independ & ecirc;ncia Funcional, Escala de Lawton e Brody, Escala de Depress & atilde;o Geri & aacute;trica e autopercep & ccedil;& atilde;o da marcha. Foram realizados testes de acur & aacute;cia e associa & ccedil;& atilde;o de fatores de risco com p <= 0,05.ResultadosParticiparam 262 idosos, com idade superior a 80 anos (55,7%), sendo 71% do sexo feminino e 42,7% vi & uacute;vos. Um total de 82,1% tinha doen & ccedil;as vasculares, 72,1% tinham diabetes e 20,6% tinham depress & atilde;o. Os fatores de risco predominantes foram dificuldade para realizar atividades instrumentais de vida di & aacute;ria (58,8%), d & eacute;ficit cognitivo (43,5%) e sintomas depressivos (26,3%). A dificuldade para realizar atividades instrumentais da vida di & aacute;ria apresentou sensibilidade superior a 60%. Os valores preditivos positivos e negativos foram em sua maioria superiores a 50%. Na an & aacute;lise de regress & atilde;o constatou-se que os idosos apresentam maior risco de sofrer queda se apresentarem Ansiedade (p = 0,05), Mobilidade f & iacute;sica prejudicada (p = 0,02) e Dificuldade para realizar atividades instrumentais de vida di & aacute;ria (p = 0,03).Conclus & atilde;oFoi poss & iacute;vel identificar a presen & ccedil;a de fatores de risco para o diagn & oacute;stico Risco de queda em adultos (00303) no contexto cl & iacute;nico do idoso em ambiente domiciliar e contribuir para a valida & ccedil;& atilde;o cl & iacute;nica da taxonomia, aumentar a evid & ecirc;ncia e a import & acirc;ncia do diagn & oacute;stico e gerar novos conhecimentos para a enfermagem gerontol & oacute;gica.Implica & ccedil;& otilde;es para a pr & aacute;tica de enfermagemAjudar os enfermeiros a identificar os fatores de risco que levam os idosos a sofrer quedas no domic & iacute;lio e a implementar a & ccedil;& otilde;es preventivas na sua comunidade com o apoio dos seus familiares.