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  • Multimorbidity daily life activities and socio-economic classification in the Central Portugal primary health care setting: an observational study
    Publication . Santiago, Luiz Miguel de Mendonça Soares; Prazeres, José Filipe Chaves Pereira; Boto, Tânia; Mauricio, Katia; Rosendo, Inês; Simões, José Augusto Rodrigues
    Background. Multimorbidity (MM) is associated with decreased quality of life, mainly due to decreased functional capacity and increased use of health care. Objectives. Evaluate the prevalence of MM in older people of Central Portugal and understand the impact of MM on daily life activities (DLA) and how socioeconomic level influenced prevalence of MM. Material and methods. Observational study of data on age, sex, number of ICPC2 codes and Barthel (Bt) and Graffar (Gr) Indexes in clinical records of all aged between 65 to 99 years enrolled in the Health Centers of the Central Region of Portugal. The Bt was used to assess the dependence on DLA and the Gr the socioeconomic level. Results. Population of 190025, mean age of 80.16± 8.03 years. MM prevalence of 80% out of which, 52.9% were female and the majority was aged between 76-85 years (39.1%). Average number of health problems of 8.7 problems for males and 9.5 for females. The Bt and Gr Indexes filling for the studied sample were of, Barthel 7.4% and Graffar 4,9%. Older people without MM have higher dependency rates than those with MM (total dependence 7.4% vs 6.2% and severe dependence 20.1% vs 9.6%). MM in older people are mainly in the middle (55.3% vs 27.5%) and low (31.8% vs 19.6%) Graffar class, while the older people without MM are mainly at middle to upper (35.3%) and upper (17.6%) Graffar classes. Conclusions. Multimorbidity is mainly associated with lower social classes. Dependence for DLA appears unrelated to MM. Multimorbidity persons need special attention, based on socio-economic contexts.
  • Cross-cultural adaptation and validation of the PRISMA-7 scale for European Portuguese
    Publication . Santiago, Luiz Miguel de Mendonça Soares; Silva, Raquel; Velho, Denise Alexandra Cunha; Rosendo, Inês; Simões, José Augusto Rodrigues
    Background. Frailty is an age-associated biological syndrome and a predictor of multimorbidity outcomes, whose early recognition allows for the identification of those older patients at risk. The PRISMA-7 scale allows for the identification of frail older people. Objectives. To make a cross-cultural adaptation and validation of the PRISMA-7 to the European spoken Portuguese language. Material and methods. Cross-cultural adaptation by translation of the PRISMA-7 scale into European Portuguese, debriefing and back-translation to English. Application for intra-observer reliability assessment and validation by simultaneous and concurrent application of the Katz scale. Results. Cronbach’s alpha coefficient was of 0.420 and 0.409 after a re-test. Spearman’s Rank Order Correlation of 0.969 in the re-test operation in a sample of 64 older people (35 female). More than 3 affirmative answers were found for older people (p < 0.001), for a higher number of self-reported drugs taken, (p = 0.001), self-reported years of education (p = 0.001), higher values for those with less years of studies were found in the validation of the translated PRISMA-7 scale, in a purposive sample of 127 older people, 72 (56.7%) female. No differences were found between gender (p = 0.414) and for number of self-reported diseases (p = 0.258). A Spearman correlation of ρ = 0.477 (p < 0.001) between the total of the two scales was found. Discussion. This comprehensive tool enables health care providers to discuss and architect more effective and efficient measures for these patients’ care, regardless of gender, socio-demographic factors, number of self-reported drugs taken and diseases. Conclusions. The PRISMA-7 scale is now recommended to identify frail older people in the Portuguese community.