Análise da validade da Morse Fall Scale - versão brasileira para idosos institucionalizados

• Autor(a) principal: Rosa, Vitor Pena Prazido
• Data de Publicação: 2020
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações da PUC_RS
• Texto Completo: http://tede2.pucrs.br/tede2/handle/tede/9293
• topic: Idoso; Instituição de Longa Permanência; Acidente por Queda; Segurança do Paciente; Estudos de Validação; Elderly; Long Term Institution; Fall Accident; Patient Safety; Validation Studies; CIENCIAS DA SAUDE::MEDICINA

Ojectives: To analyze the validity of the Morse Fall Scale - Brazilian version (MFS-B) in institutionalized elderly. Method: It is characterized as a methodological study. The research was carried out in two long-term institutions for the elderly. In the Porto-Alegrense Society of Aid to the Needy (SPAAN) and Asilo Padre Cacique. The study population will consist of 127 institutionalized elderly in SPAAN and 98 institutionalized elderly in Asilo Padre Cacique, totaling 255 elderly. The sample of this study was composed of 172 elderly people who agreed to participate in the study and met the inclusion and exclusion criteria. Data were collected from October 2018 to September 2019. Data collection was performed by a trained team and was carried out through direct assessment of the elderly and their medical records. Using an instrument composed of four parts, which evaluated sociodemographic data, screening for cognitive decline, clinical data and risk factors for falls, in addition to investigating the occurrence of falls. Each elderly person was assessed only once if there was no fall. Surveillance was maintained regarding the occurrence of falls by the researcher and the health care team and a new assessment was carried out with each new fall. For data analysis, descriptive and inferential statistics techniques were used. The research project approved by the Research Ethics Committee of the Pontifical Catholic University of Rio Grande do Sul (CEPPUCRS), under opinion 2,877,992 and all participants or their guardians signed the Participant's Free and Informed Consent Form. Results: Institutionalized elderly people were at least 61 years old and 99 years old; as for the institutionalization time, a median of 4 years (<1 year and maximum of 29 years) was observed, with a number of medical diagnoses with a minimum of zero and a maximum of 11 pathologies; used 4 and 22 drugs a day. The frequency of items MFS-B from the first assessment without a fall (MFS-B / Initial) and from the first assessment and a fall (MFS-B / Fall) for institutionalized elderly when compared, was associated (p <0.0001). Of the 60 elderly people who fell, 56.7% fell only once. Almost half of the elderly fell again after this first fall, ranging from two to nineteen new falls. The fall was associated with the classification of MFS-B (p <0.001). The classification of the risk of falls by the MFS-B was associated (p <0.022) with education, with Katz index ((p <0.013), with RDC 283/05 (p <0.055). The best estimate to predict the drop was at the cutoff point 45 points of MFS-B in institutionalized elderly, with a sensitivity of 93.3% and specificity of 58.9%. When analyzing the reliability of MFS-B with the exclusion of item 4 “therapy endovenous ”there was an improvement in reliability (α≥0,700) and this exclusion was also confirmed in the Confirmatory Factor Analysis. Conclusions: The results point to a good ability to predict fall by MFSB in institutionalized elderly when the item“ intravenous therapy and suggest the possibility of adapting the MFS-B to five assessment items, called MFS-B / ILPI.