Changes to the feet of institutionalized elderly persons

Abstract Objective: The present study aimed to identify the most frequent changes to the feet of institutionalized elderly persons. Method: A descriptive study was conducted with elderly persons living in long-term care facilities in the city of Passo Fundo, Rio Grande do Sul, Brazil. A total of 174 people aged 60 years and over of both genders were surveyed regardless of health conditions. Those with amputations, burns or who were undergoing surgery of the lower limbs were excluded. Data were collected through the application of a structured questionnaire containing sociodemographic variables (age, gender, ethnicity, marital status, schooling, main occupation) and variables related to alterations of the feet (nail, dermatological and bone deformities). The Manchester Scale was subsequently applied to evaluate the degree of hallux deformity. Results: The most frequent nail deformities were onychomycosis, onychogryphosis, onycholysis, onychosclerosis; the dermatological findings were callosities, especially interdigital and bromhidrosis; the most prevalent bone deformities were pes cavus and transverse arches. In the assessment of hallux valgus, according to the Manchester Scale, painful feet (38.5%), mild deformities (35.6%) and no deformities (25.3%) were identified. Conclusion: The results suggest signs of neglect of the health of the feet of institutionalized elderly persons. There should be more investment in the training of teams responsible for care.

摘要
研究目的：本研究旨在明确机构养老老年人足部最常见的病变类型。
研究方法：本研究为描述性研究，研究对象为巴西南里奥格兰德州（Rio Grande do Sul）帕苏丰杜市（Passo Fundo）长期护理机构内的老年人。最终纳入174名年龄≥60岁的男女受试者，纳入不受健康状况限制，但排除存在下肢截肢、烧伤或正接受下肢手术者。数据收集采用结构化问卷，问卷内容涵盖社会人口学变量（年龄、性别、种族、婚姻状况、受教育程度、主要职业）以及与足部病变相关的变量（指甲、皮肤及骨骼畸形）。随后采用曼彻斯特量表（Manchester Scale）评估拇趾畸形程度。
研究结果：最常见的指甲畸形依次为甲真菌病（onychomycosis）、甲弯曲（onychogryphosis）、甲剥离（onycholysis）及甲硬化（onychosclerosis）；皮肤病变以胼胝（尤以趾间胼胝）及臭汗症（bromhidrosis）最为多见；患病率最高的骨骼畸形为高弓足（pes cavus）与足部横弓异常。采用曼彻斯特量表评估拇外翻（hallux valgus）情况时，共发现足部疼痛者占38.5%、轻度畸形者占35.6%、无畸形者占25.3%。
研究结论：本研究结果提示，机构养老老年人的足部健康存在被忽视的迹象，应进一步加大对护理团队的培训投入。