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      Functional independence in patients with chronic kidney disease being treated with haemodialysis¹ Translated title: Independencia funcional en pacientes con enfermedad renal crónica en tratamiento de hemodiálisis Translated title: Independência funcional em pacientes com doença renal crônica em tratamento hemodialítico

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          Abstract

          PURPOSE: This study has described and analysed the functional independence of the patients served in the haemodialysis services of a countryside town in the State of São Paulo, Brazil, using the Functional Independence Measure (FIM). METHOD: The population considered was that of 214 patients being treated with haemodialysis, assessed in 2011, by means of a social, demographic and clinical report, a Mini-Mental State Examination (MMSE) and also the FIM. RESULTS: The mean age of the population under study was 58.01 years, while the mean FIM point score was 118.38 points, showing a level of complete or modified independence within this population. Even though the level of dependence found has been low, this can be highlighted, within the locomotion domain, in the activity of going up and down stairs (10.28%). Age, complications arising from haemodialysis, and comorbidities show a negative correlation with FIM. CONCLUSION: Awareness of the level of functional independence of the patients being subjected to treatment with haemodialysis is essential in order to back up intervention for the improvement of nursing assistance provided to this population.

          Translated abstract

          OBJETIVO: este estudio describió y analizó la independencia funcional de los pacientes atendidos en los servicios de hemodiálisis de una ciudad del interior paulista, según la Medida de Independencia Funcional (MIF). MÉTODO: la población fue de 214 pacientes en tratamiento de hemodiálisis, evaluados en 2011, por medio de un cuestionario sociodemográfico y clínico, Mini examen del Estado Mental y MIF. RESULTADOS: la edad Media de la población del estudio fue de 58,01 años y la media de la MIF fue de 118,38 puntos, evidenciando un nivel de independencia completa o modificada de esa población. Mismo habiendo sido bajo el nivel de dependencia encontrado, se destacó en el dominio locomoción, en la actividad ascender y bajar escaleras (10,28%). La edad, complicaciones relacionadas a la hemodiálisis y mortalidades presentaron correlación negativa con la MIF. CONCLUSIÓN: conocer el nivel de independencia funcional de los pacientes en tratamiento hemodiálisis es primordial para subvencionar intervenciones para la mejoría de la asistencia de enfermería prestada la esa población.

          Translated abstract

          OBJETIVO: este estudo teve como objetivo descrever e analisar a independência funcional dos pacientes atendidos nos serviços de hemodiálise, de uma cidade do interior paulista, segundo a Medida de Independência Funcional (MIF). MÉTODO: a população foi de 214 pacientes em tratamento hemodialítico, avaliados em 2011, por meio de um questionário sociodemográfico e clínico, Miniexame do Estado Mental e MIF. RESULTADOS: a idade média da população do estudo foi de 58,01 anos e a média da MIF foi de 118,38 pontos, evidenciando nível de independência completa ou modificada dessa população. Mesmo tendo sido baixo o nível de dependência encontrado, essa dependência destacou-se no domínio locomoção, na atividade subir e descer escadas (10,28%). A idade, complicações relacionadas à hemodiálise e comorbidades apresentaram correlação negativa com a MIF. CONCLUSÃO: conhecer o nível de independência funcional dos pacientes em tratamento hemodialítico é primordial para subsidiar intervenções para a melhoria da assistência de enfermagem prestada a essa população.

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          Increased risk of mortality associated with hip fracture in the dialysis population.

          Patients with end-stage renal disease (ESRD) are at increased risk of bone loss and hip fracture. Although it is well known that hip fracture in the general population is associated with increased mortality, this relationship is not well elucidated in the ESRD population. The authors studied the association between hip fracture and mortality in dialysis patients. The authors used data from the United States Renal Data System to identify patients initiating dialysis between May 1, 1995, and December 31, 2000. Patients with hip fractures were identified using Medicare claims data. Each patient who experienced a hip fracture was matched to 3 nonfracture controls by age, history of cardiovascular disease (CVD), and dialysis duration. Proportional hazards models were used to estimate the risk of all-cause and cardiovascular mortality associated with hip fracture stratified by CVD history. A total of 7,636 patients with a hip fracture and 22,896 matched controls were identified. Median survival time for patients with hip fracture was 289 days (95% confidence interval [CI]: 275, 302) compared with 714 days (95% CI: 697, 732) for those without a hip fracture. The average relative risk of mortality associated with hip fracture was 1.99 (95% CI: 1.91, 2.07; P < 0.001). Hip fracture is associated with an increased risk of all-cause mortality in the dialysis population.
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            Population aging today: demands, challenges and innovations.

            The paper discusses the social and, particularly, the health consequences resulting from the expansion of the numbers of elderly people in Brazil over a short period. The data used were from the 1998 and 2003 Pesquisa Nacional por Amostra de Domicílios (PNAD, the national household sampling survey), and they express an improvement in elderly people's health conditions and similar distribution of chronic diseases across all income groups. If, on the one hand, elderly people present greater disease burden and incapacities and they use healthcare services more, on the other hand, the current models for healthcare for the elderly are shown to be inefficient and high-cost. Creative and innovative structures are required, such as social centers with health assessments and treatment. Foremost on the agenda for Brazilian public policy, priority should be given to maintaining elderly people's functional capacity, with monitoring of their health conditions; preventive and differentiated actions relating to health and education; and qualified care and multidimensional comprehensive attendance.
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              Caderno de Atenção Básica. Envelhecimento e saúde da pessoa idosa

              (2007)
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                rlae
                Revista Latino-Americana de Enfermagem
                Rev. Latino-Am. Enfermagem
                Escola de Enfermagem de Ribeirão Preto / Universidade de São Paulo (Ribeirão Preto )
                1518-8345
                December 2012
                : 20
                : 6
                : 1033-1040
                Affiliations
                [1 ] Universidade Paulista Brazil
                [2 ] Faculdade de Medicina de São José do Rio Preto Brazil
                [3 ] Universidade de São Paulo Brazil
                Article
                S0104-11692012000600004
                10.1590/S0104-11692012000600004
                ddb46eb6-3fcf-42b6-b7f4-9f69fba8d4cf

                http://creativecommons.org/licenses/by/4.0/

                History
                Product

                SciELO Brazil

                Self URI (journal page): http://www.scielo.br/scielo.php?script=sci_serial&pid=0104-1169&lng=en
                Categories
                NURSING

                Nursing
                Renal Dialysis,Activities of Daily Living,Nursing,Diálisis Renal,Actividades Cotidianas,Enfermería,Diálise Renal,Atividades Cotidianas,Enfermagem

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