Applicability of the instrument “Screening of Activity Limitation and Safety Awareness” in elderly with leprosy

Nogueira, Paula Sacha Frota; Barbosa, Rachel Gabriel Bastos; Almeida, Paulo César de; Florêncio, Caroline Mary Gurgel Dias; Marques, Marília Braga; Teles, Liana Mara Rocha

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Sumário

Research • Esc. Anna. Nery 24 (2) • 2020 • https://doi.org/10.1590/2177-9465-EAN-2019-0251 copy

Applicability of the instrument “Screening of Activity Limitation and Safety Awareness” in elderly with leprosy^a a Article extracted from the Doctoral Thesis Análise da capacidade funcional de idosos com hanseníase através de três instrumentos (“Analysis of the functional capacity of older people with leprosy through three instruments”, in free translation), written by Paula Sacha Frota Nogueira, tutored by Maria Josefina da Silva, defended in the Post-Graduate Program in Nursing, of the Faculty of Pharmacy, Dentistry and Nursing, of the Universidade Federal do Ceará, in 2015.

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ABSTRACT

Objective

To analyze the applicability of Screening of Activity Limitation and Safety Awareness (SALSA) for the evaluation of the functional capacity of the elderly with leprosy.

Method

Descriptive and transversal research, developed with 77 elderly people with Hansen’s disease accompanied at the Reference Center in Dermatology, in Fortaleza, Ceará, from June to August 2015, through the application of SALSA and two other scales already validated for use in elderly. For the analysis, descriptive and inferential statistics were used.

Results

There was convergence between the scales (p=0.0000) on the evaluation of functional capacity. The variables age and gender showed a larger number of associations with the activities evaluated, whereas, in the clinical variables related to leprosy, just the grade of disability presented a relationship with more than two activities.

Conclusion and Implications for practice

The SALSA has contributed to the effective evaluation of functional capacity in the population studied, being more influenced by age than by leprosy. SALSA’s application is recommended in the initial consultations as a tool for screening of the functional capacity of older people with leprosy.

Keywords:
Leprosy; Geriatric Assessment; Personal Autonomy

Variables	N	%
Age
60 - 64	25	32.5
65 - 70	28	36.4
71 - 83	24	31.2
Gender
Male	49	63.6
Female	28	36.4
City of residence
Fortaleza	46	59.7
Other cities	31	40.3
No. of people in the household
One or two people	19	24.7
Three or four people	35	45.5
Five or more people	23	29.9
Education
No schooling	22	28.6
One to three years of study	18	23.4
Four to eight years of study	23	29.9
Nine to 15 years of study	14	18.2
Monthly household income
Up to a Minimum Wage (MW)	27	35.1
Two MW	37	48.0
Three to Four MW	10	13.0
Five or more MW	03	3.9

Variables	N	%
Grade Disability (GD) at diagnosis
Zero	46	59.7
1	15	19.5
2	16	20.8
Bacilloscopic index
Positive	40	51.9
Negative	37	48.1
Clinical form of leprosy
Undetermined	03	3.9
Tuberculoid	15	19.5
Borderline	40	51.9
Lepromatous	19	24.7
Regimen of treatment
Paucibacillary	18	23.4
Multibacillary	53	68.8
Alternative	06	7.8
Has/d leprosy reaction
Yes	15	19.5
No	62	80.5
Type of leprosy reaction (n=15)
Reverse Reaction (Type I)	13	86.6
Erythema Nodosum Leprosum (Type II)	02	13.4

Domains	SALSA Scale Activities	If so, how easy is that for you?			If not, why not?
Domains	SALSA Scale Activities	Easy	A little difficult	Very difficult	I don’t need to do this	I physically can’t	I avoid it because of the risk
	Visual acuity	30(38.9%)	25(32.5%)	14(18.2%)		08(10.4%)
Mobility (feet)	Sit / squat on the floor	21(27.3%)	23(29.8%)	17(22.1%)	01(1.3%)	13(16.8%)	02(2.6%)
	Walk barefoot	17(22.1%)	05(6.5%)	03(3.9%)	21(27.3%)	13(16.8%)	18(23.4%)
	Walking on uneven ground	30(38.9%)	19(24.7%)	11(14.3%)	09(11.6%)	06(7.8%)	02(2.6%)
	Walking longer distances	35(45.5%)	15(19.5%)	15(19.5%)	03(3.9%)	07(9.1%)	02(2.6%)
Self-care	Wash the whole body	69(89.6%)	03(3.9%)	04(5.2%)	-	01(1.3%)	-
	Cut one´s nails	26(33.7%)	21(27.3%)	06(7.8%)	05(6.5%)	18(23.4%)	01(1.3%)
	Hold hot cup / bowl	60(77.9%)	09(11.6%)	02(2.6%)	02(2.6%)	03(3.9%)	01(1.3%)
Work (hands)	Work with tools	46(59.7%)	07(9.1%)	02(2.6%)	15(19.5%)	06(7.8%)	01(1.3%)
	Carry heavy objects	33(42.8%)	15(19.5%)	13(16.8%)	04(5.2%)	12(15.6%)	-
	Lifting objects above head	57(74.0%)	07(9.1%)	04(5.2%)	05(6.5%)	04(5.2%)	-
	To cook	42(54.5%)	09(11.6%)	07(9.1%)	16(20.8%)	03(3.9%)	-
	Serve hot liquids	52(67.5%)	06(7.8%)	04(5.2%)	11(14.3%)	04(5.2%)	-
	Open / close bottles with screw cap	58(75.3%)	08(10.4%)	06(7.8%)	-	05(6.5%)	-
	Opening glass with screw cap	56(72.7%)	08(10.4%)	06(7.8%)	01(1.3%)	06(7.8%)	-
Dexterity (hands)	Handle small objects	64(83.2%)	04(5.2%)	05(6.5%)	03(3.9%)	01(1.3%)	-
	Use buttons	65(84.4%)	04(5.2%)	05(6.5%)	02(2.6%)	01(1.3%)	-
	Thread a needle	25(32.5%)	16(20.8%)	15(19.5%)	07(9.1%)	14(18.2%)	-
	Handle pieces of paper	58(75.3%)	06(7.8%)	03(3.9%)	05(6.5%)	05(6.5%)	-
	Picking up objects on the floor	40(51.9%)	12(15.6%)	14(18.2%)	01(1.3%)	09(11.6%)	01(1.3%)

Variables	Limitation Classification (SALSA)				Value p*
Variables	None	Mild	Moderate	Severe	Value p*
Lawton Scale	N(%)	N(%)	N(%)	N(%)
Independent (n=45)	20(44.4%)	25(55.5%)	-	-	0.000
Semi-dependent (n=27)	02(7.4%)	12(44.4%)	10(37.0%)	03(11.2%)
Dependent (n=05)	-	01(20.0%)	02(40.0%)	02(40.0%)
Katz Scale
Total independence (n=67)	22(32.8%)	35(52.2%)	10(15.0%)	-	0.000
Partial dependency (n=07)	-	03(42.8%)	02(28.6%)	02(28.6%)
Important dependency (n=03)	-	-	-	03(100.0%)

SALSA scale	Value p*
Visual acuity
Blood glucose	0.000
Use of adaptation and/or orthotics	0.037
Domain Mobility (Feet)
To sit / squat on the floor
Grade of disability	0.020
Walk barefoot
City of residence	0.011
Grade of disability	0.034
Walking on uneven ground
Other comorbidities	0.039
Walking longer distances
Age	0.020
Grade of disability	0.016
Leprosy reaction	0.016
Domain Work (hands)
To carry heavy objects
Body mass index	0.050
To cook
Gender	0.014
Serve hot liquids
Gender	0.000
To open / close bottles with screw cap
Age	0.017
Gender	0.018
Opening glass with screw cap
Age	0.023
Gender	0.015
Domain Dexterity (hands)
Handle small objects
Age	0.006
Thread a needle
Age	0.050
Grade of disability	0.028
Handle pieces of paper
Age	0.006
Gender	0.038
Picking up objects on the floor
Age	0.037

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[1] Corresponding Author: Paula Sacha Frota Nogueira E-mail: sachanogueira@yahoo.com.br