O medo de quedas pode influenciar a participação social de idosos com doença pulmonar obstrutiva crônica após um mês de alta hospitalar?

Abstract

Introduction: Chronic Obstructive Pulmonary Disease (COPD) is a highly complex condition with respiratory, systemic, and social repercussions. Individuals with COPD often experience balance deficits, reduced muscle strength, activity limitations, and consequently, fear of falling. These impairments may be exacerbated due to disease exacerbations. The combination of fear of falling and the impacts of COPD may affect the social participation of older adults. However, there is no clear evidence on whether fear of falling in hospitalized older adults is associated with reduced social participation. Objective: To analyze whether there is a relationship between fear of falling and reduced social participation in older adults with COPD after hospitalization. Materials and methods: This is a longitudinal observational study with a one-month follow-up of individuals diagnosed with COPD who were hospitalized for various causes. Participants were identified through a review of hospital medical records. Eligible individuals were assessed within 72 hours prior to hospital discharge through clinical data collection and the administration of standardized instruments: the Activities-Specific Balance Confidence Scale (ABC), to assess confidence in avoiding falls, and the Falls Efficacy Scale – International (FES-I), both short and long versions, to assess fear of falls. One month after hospital discharge, social participation was assessed via telephone using the Late Life Function and Disability Instrument (LLDI). An association analysis was conducted between the frequency and limitation domains of the LLDI and the ABC and FES-I scales (short and long versions). Results: Data from 23 participants with COPD were included, with a mean age of 72 years. 71.4% were male, with an average smoking history of 57 packs/year, 47.6% were classified as moderate according to GOLD criteria, and 23.8% had a history of falls in the past 12 months. A significant correlation was found between the frequency and social role domains of the LLDI and the ABC scale (r=-0,512; p=0,013); FES-I 7- item version (r=0,483; p= 0,020) and FES-I 16 item version (r=0,511; p=0,013), with a negative correlation for the ABC scale. No association was observed between the other LLDI domains and the fall- related scales. Conclusion: The results of the study indicate that greater confidence in avoiding falls and lower fear of falling are associated with reduced social participation. This highlights the complexity of the relationship between functional self-confidence and social engagement in older adults with COPD, suggesting the need for further research on the factors influencing this participation.