Idosos frágeis em unidades de trapia intensiva: prevalência, caracterização e carga de trabalho de enfermagem
Data
2021
Autores
Tanabe, Fabiola Mika [UNIFESP]
Orientadores
Whitaker, Iveth Yamaguchi [UNIFESP]
Tipo
Dissertação de mestrado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Introdução: A população de idosos é crescente e, consequentemente, maior é o quantitativo de idosos hospitalizados, refletindo nas admissões em Unidades de Terapia intensiva (UTIs). A prevalência e condição de fragilidade dos idosos admitidos nas UTIs, bem como os desfechos e a carga de trabalho de enfermagem dispendida para o cuidado dos idosos são pouco conhecidas. Objetivos: Identificar idosos frágeis na UTI e caracterizar sua fragilidade nos domínios físicos, sociais e psíquicos; comparar as caraterísticas sociodemográficas, da hospitalização, condições clínicas e dos aspectos físicos, sociais e psíquicos entre idosos frágeis e não frágeis e, analisar a carga de trabalho de enfermagem de idosos de acordo com a condição de fragilidade. Metodologia: Estudo transversal, prospectivo cuja amostra incluiu pacientes com idade > 60 anos e internação > 24h no Centro de Terapia Intensiva (CTI) de hospital universitário em São Paulo. A coleta de dados foi realizada de outubro/2017 a abril/2018. Tilburg Frailty Indicator (TFI) foi aplicado para identificar fragilidade no idoso e o Nursing Activities Score (NAS) para mensurar carga de trabalho de enfermagem. A análise estatística descritiva e inferencial foram realizadas aplicando-se testes conforme o tipo de variável, tendo como nível de significância o p < 0,05. Resultados: Na amostra com 204 idosos, a condição de fragilidade foi constata em 156 (76,5%). O TFI indicou que a fragilidade dos idosos associou-se à precariedade das condições físicas do idoso (p<0,05), à falta de ter pessoas ao seu lado (p<0,001), ao sentimento de tristeza, nervosismo e ansiedade (p<0,001) e dificuldade de enfrentar problemas (p<0,041). Evidenciou-se maior gravidade da doença em idosos frágeis do que não frágeis (52,1 vs 47,1, p=0,029), mas a fragilidade não foi associada ao tempo de internação na UTI e no hospital e à mortalidade dos idosos. A condição de fragilidade não elevou a carga de trabalho da equipe de enfermagem (p=0,179). Conclusão: Os idosos frágeis apresentaram maior gravidade da doença, associada à necessidade de suporte familiar e social, e apresentou alta carga de trabalho de enfermagem como os não frágeis. Novos estudos que avaliem a fragilidade de forma multidimensional são importantes para melhor atender as necessidades, evitar desfechos desfavoráveis e proporcionar melhor qualidade de vida aos idosos.
Introduction: The number of older adults is growing in the general population which reflects on higher admission rates in hospitals and consequently in the Intensive Care Units (ICU). The prevalence and frailty of old adults admitted in ICUs, the major outcomes and the nursing workload on such care are mostly unknown. Objectives: Identify frail older people hospitalized in the ICU and characterize their frailty in the physical, social and psychological domains; compare the sociodemographic and clinical conditions, the physical, social and psychological characteristics between frail and non-frail old adults and investigate the nursing workload regarding the frail condition. Method: This is a prospective cross-sectional study whose sample included patients aged > 60 years with length of stay > 24h in the ICU of a University Hospital in São Paulo. The data collection was performed from October 2017 to April 2018. The Tilburg Frailty Indicator (TFI) was applied to identify frailty in old adults and the Nursing Activities Score (NAS) to measure the nursing workload. Descriptive and inferential statistical analysis tests were performed according to the types of variables, considering p<0,05 as statistical significance. Results: Frailty was identified in 156 (76,5%) of the 204 old adults sample. The TFI indicated that frailty was associated with poor physical conditions (p<0,05), lack of supporting people (p<0,001), sadness and nervousness/anxiety (p<0,001) and difficulty or inability to cope with problems (p<0,041). Illness severity was higher in frail elderly (p=0,029), but frailty was not associated with the length of stay in the ICU, hospital, or mortality rate. The frail condition did not increase the nursing workload (p=0,179). Conclusion: Frail older people showed higher illness severity, associated with the need for family and social support, and high nursing workload similar to non-frailty. New studies that assess frailty in a multidimensional way are important to improve care, avoid negative outcomes and provide quality of life to the older adults.
Introduction: The number of older adults is growing in the general population which reflects on higher admission rates in hospitals and consequently in the Intensive Care Units (ICU). The prevalence and frailty of old adults admitted in ICUs, the major outcomes and the nursing workload on such care are mostly unknown. Objectives: Identify frail older people hospitalized in the ICU and characterize their frailty in the physical, social and psychological domains; compare the sociodemographic and clinical conditions, the physical, social and psychological characteristics between frail and non-frail old adults and investigate the nursing workload regarding the frail condition. Method: This is a prospective cross-sectional study whose sample included patients aged > 60 years with length of stay > 24h in the ICU of a University Hospital in São Paulo. The data collection was performed from October 2017 to April 2018. The Tilburg Frailty Indicator (TFI) was applied to identify frailty in old adults and the Nursing Activities Score (NAS) to measure the nursing workload. Descriptive and inferential statistical analysis tests were performed according to the types of variables, considering p<0,05 as statistical significance. Results: Frailty was identified in 156 (76,5%) of the 204 old adults sample. The TFI indicated that frailty was associated with poor physical conditions (p<0,05), lack of supporting people (p<0,001), sadness and nervousness/anxiety (p<0,001) and difficulty or inability to cope with problems (p<0,041). Illness severity was higher in frail elderly (p=0,029), but frailty was not associated with the length of stay in the ICU, hospital, or mortality rate. The frail condition did not increase the nursing workload (p=0,179). Conclusion: Frail older people showed higher illness severity, associated with the need for family and social support, and high nursing workload similar to non-frailty. New studies that assess frailty in a multidimensional way are important to improve care, avoid negative outcomes and provide quality of life to the older adults.