No abstract

No abstract

BackgroundThe aging process promotes a progressive increase in chronic-degenerative diseases. The effect of these diseases on the functional capacity has been well recognized. Another health parameter concerns “quality of life related to health”. Among the elderly population, cardiovascular diseases stand out due to the epidemiological and clinical impact. Usually, these diseases have been associated with others. This set of problems may compromise both independence and quality of life in elderly patients who seek cardiologic treatment. These health parameters have not been well contemplated by cardiologists.ObjectiveEvaluating, among the elderly population with cardiovascular disease, which are the most relevant clinical determinants regarding dependence and quality of life.MethodsThis group was randomly and consecutively selected and four questionnaires were applied: HAQ, SF-36, PRIME-MD e Mini Mental State.ResultsThe study included 1,020 elderly patients, 63.3% women. The group had been between 60 and 97 years-old (mean: 75.56 ± 6.62 years-old). 61.4% were independent or mild dependence. The quality of life total score was high (HAQ: 88.66 ± 2.68). 87.8% of patients had a SF-36 total score > 66. In the multivariate analysis, the association between diagnoses and high degrees of dependence was significant only for previous stroke (p = 0.014), obesity (p < 0.001), lack of physical activity (p = 0.016), osteoarthritis (p < 0.001), cognitive impairment (p < 0.001), and major depression (p < 0.001). Analyzing the quality of life, major depression and physical illness for depression was significantly associated with all domains of the SF-36.ConclusionAmong an elderly outpatient cardiology population, dependence and quality of life clinical determinants are not cardiovascular comorbidities, especially the depression.

OBJECTIVES:Though elderly persons with chronic atrial fibrillation have more comorbidities that could limit indications for the chronic use of anticoagulants, few studies have focused on the risk of falls within this particular group. To evaluate the predictors of the risk of falls among elderly with chronic atrial fibrillation, a cross-sectional, observational study was performed.METHODS:From 295 consecutive patients aged 60 years or older with a history of atrial fibrillation who were enrolled within the last 2 years in the cardiogeriatrics outpatient clinic of the Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, 107 took part in this study. Their age was 77.9±6.4 years, and 62 were female. They were divided into two groups: a) no history of falls in the previous year and b) a history of one or more falls in the previous year. Data regarding the history of falls and social, demographic, anthropometric, and clinical information were collected. Multidimensional assessment instruments and questionnaires were applied.RESULTS:At least one fall was reported in 55 patients (51.4%). Among them, 27 (49.1%) presented recurrent falls, with body lesions in 90.4% and fractures in 9.1% of the cases. Multivariate logistic regression showed that self-reported difficulty maintaining balance, use of amiodarone, and diabetes were independent variables associated with the risk of falls, with a sensitivity of 92.9% and a specificity of 44.9%.CONCLUSION:In a group of elderly patients with chronic atrial fibrillation who were relatively independent and able to attend an outpatient clinic, the occurrence of falls with recurrence and clinical consequences was high. Difficulty maintaining balance, the use of amiodarone and a diagnosis of diabetes mellitus were independent predictors of the risk for falls. Thus, simple clinical data predicted falls better than objective functional tests.

Purpose: To examine knowledge, behaviours, and beliefs related to ischaemic heart disease (IHD) of Indo-Canadians (ICs), thereby helping target health education strategies. Methods: In a cross-sectional descriptive/comparative study, 102 Indian-born Indo-Canadians (ICs) and 102 Canadian-born EuroCanadians (ECs) completed a standardized questionnaire on IHD knowledge and lifestyle-related behaviours and beliefs. Results: Compared with ECs, ICs were less aware of IHD-risk factors. ICs' lifestyle practices and beliefs were consistent with having less perceived control over health than ECs. ICs reported more stress from various sources and resorted less to exercise for stress relief and more to religious/spiritual activities. Conclusions: In accordance with health belief theory, approaches to educating immigrants from collectivistic cultures such as India to assume responsibility for their personal health may need to be different from those used with ECs, which stress self-management. Such programmes may need to emphasize lifestyle-related health knowledge and beliefs as bases for health behaviour change.Key Words: health education; health promotion; socioeconomic factors; myocardial ischemia; attitude. RÉ SUMÉObjectif : É tudier les connaissances, les comportements et les croyances qui ont trait à la cardiopathie isché mique (CPI) chez les Indo-Canadiens (IC) pour aider ainsi à cibler des straté gies d'é ducation en santé . Conclusions : Conformé ment à la thé orie des croyances en santé , il faudra peut-ê tre aborder l'é ducation des immigrants de cultures collectivistes comme l'Inde, qui vise à les amener à assumer la responsabilite´de leur santé personnelle de fac¸on distincte de celle des EC, qui met l'accent sur l'autoprise en charge. Ces programmes devront peut-ê tre mettre l'accent sur les connaissances et les croyances relatives aux habitudes de vie dans le domaine de la santé comme base des changements de comportement en santé .The Health Belief Model, a leading social cognition model of health services use, advocates that predicting a person's health-related behaviour should precede the goal of actually changing that behaviour. 1 Culture contributes significantly to people's lifestyle behaviours and health beliefs, particularly with respect to non-communicable conditions such as ischaemic heart disease (IHD) and the likelihood of making positive risk-reducing choices. 2 Health behaviour change strategies that fail to consider factors such as social and cultural dimensions may be less effective.Physical therapists are well positioned, as knowledge translators, to translate lifestyle-related health knowledge into action. 3 To support inclusive health care in Canada, 4 physical therapists need to devise effective health education and intervention strategies to address chronic 208From the: