A Nursing Care Intervention Model for Elderly People to Ascertain General Profiles of Functionality and Self Care Needs

Abstract

A core set of International Classification of Functioning, Disability and Health codes was used to ascertain general profiles of functionality as a function of biological and sociodemographic characteristics and to develop structured nursing interventions in accordance with self care deficits identified by studying self care behavior for elderly people living in both extensively and sparsely populated rural areas. Data were collected by health professionals in the participants' houses. An exploratory factor analysis enabled reduced data dimensions, and factorial validity was assessed by a confirmatory factor analysis. An ordinal regression model was built to identify general profiles of functionality as a function of age. A bar graph was used as a measurement tool for nursing care needs as a function of self care behavior and functional profile level. No functional problems were expected among people under the age of 74 years, while mild functionality problems were expected among people older than 74 years. Regarding nursing care needs, the results of the constructed model suggested that the functional concept "Support and Relationships" is associated with higher levels of functional problems and thus a greater need for self care interventions and that people aged 85 years and older always show therapeutic self care deficits.

Functioning in Institutionalized and Noninstitutionalized Older Adults: A Comparative Study

“…Women showed, on average, higher functional profile scores than men, which indicates greater functional dependence. This results are in line with another studies 22,24 . Other study concluded that women had higher rates of functional dependence, cognitive deficit and depression and worse family functioning 38 .…”

“…With regard to education, the participants who did not attend school and did not know how to read or write had worse general profile of functionality and in the domains "SC-ADL(a)", "MF" and "COM" than those who had attended school but did not pursue higher education. This results are similar with another Portuguese study 22 . A Brazil study, illiterate individuals were more dependent for instrumental activities of daily living 23 .…”

“…The "SR" is the domain with the highest score, followed by the domains Self-Care - The older adults functional profile is interrelated with sociodemographic context and with the biological, cultural and environmental characteristics, which was generally observed in the present study and is in line with the findings of other authors 22,25,26 . The sample included a greater number of women than men, a phenomenon that was called the "feminization of old age" 27 and was reported by the World Health Organization 28 .…”

“…Assuming the functional domains developed by Goes et al (2020) 22 (Table 2, left column), the results of the initial CFA (first-order model), without correlating the error of any item, showed a poor model goodness-of-fit ( Table 1). The fitting was determined in two stages: started with the removal of the items presenting factor weights lower than 0.4;…”

“…Of particular note is the International Classification of Functioning, Disability and Health (ICF) (21), which is used to evaluate the results of health interventions. In addition, as an internationally applicable instrument, it allows national and international comparisons (22). The ICF includes biological, psychological, social and environmental factors because it classifies the functioning, disability and health of the person and interrelates those factors with the individual's health status; body functions and structures; activity, which includes the execution of individual tasks or actions; participation, that is, involvement in real-life situations; and context, i.e., environmental and personal factors that can act as barriers or facilitators (23)(24)(25).…”