O presente estudo examina as relações entre autocuidado e envelhecimento, nas narrativas de idosos favelados da cidade de São Paulo. Trata-se de estudo qualitativo no qual se investigou as formas de autocuidado adotadas pelos entrevistados, com ênfase na relação com os serviços de saúde. Defende-se que o autocuidado não pode ser compreendido como simples adoção de saberes técnicos para a promoção da saúde, mas como uma atitude prática, relacionada à experiência de envelhecer, às condições de vida e às interações familiar e comunitária. Propõe-se a necessidade de resistir à tendência de responsabilização individual do idoso pela sua saúde, freqüentemente associada às propostas de autocuidado. / This study examines, in narratives, the relationships between self-care and aging for elderly who live in a slum of Sao Paulo city. It is a qualitative research which analysis self-care strategies, undertaken by the interviewed, emphasizing the ir relationship with health care services. The analysis supports that self-care can not be understood as a plain adoption of technical skills in order to promote health but as a practical behavior related to aging experience, life conditions, family and community interactions. The study proposes that it?s necessary to avoid take elderly as the main responsible in other to promote their own health, what is often related to self-care strategies.

Made available in DSpace on 2017-06-01T18:08:20Z (GMT). No. of bitstreams: 1 erica_patricia_borba_lira_uchoa.pdf: 4523264 bytes, checksum: d4dd5f77d0353ad601698587c24fda01 (MD5) Previous issue date: 2016-11-10 / This thesis deals with the osteoarthritis (OA) of the knee in the elderly, the burden of the caregiver, the quality of life (QOL) and the relationship between the old-family caregiver dyad. That way, your goal was to study the population profile and the QOL of elderly people with OA and their family caregivers. The study was conducted in two phases, on the first were elaborated two articles of literature review. And on the second, three practical articles were developed, which were quantitative type, observational, descriptive and cross-sectional. The sample consisted of 15 older diagnosed with knee OA and their family caregivers. For the elderly have been applied the demographic questionnaire and clinical, the Visual analogue scale (EVA), Algofuncional survey of Lequesne, the World Health Organization Questionnaire for Quality of Life-Form Bref (WHOQOL-Bref) and the old relationship quiz-caregiver. For caregivers have been applied the demographic questionnaire and clinical, Zarit Burden Interview, scale the WHOQOL-Bref questionnaire and the relative caregiver-aged. The elderly showed an average age of 74 ± 6.4 years, with body mass index (BMI) 26.91 average ± 8.85 Kg/m2, out of which 53.33% (n = 8) were married and lived with their husbands, 66.6% (n = 10) were retired, 60% (n = 8) did not practice physical activity and 93.3% (n = 14) used some type of medication. In relation to caregivers, 53.3% were men (n = 8), with an average age of 58.53 ± 17.54 years, with average BMI 25.16 ± 4.80 Kg/m2, of which 73.33% (n = 11) were married, 60% (n = 8) did not practice physical activity and 93.3% (n = 14) were smokers. In general, it is observed that the elderly patients with OA of knee, point out the pain as a symptom more identifiable and the QOL is decreased, being the worst physical domain. In relation to family caregivers, realized an increase of burden and the QOL is diminished. When comparing the QOL of the elderly carer dyad, the results show that the elderly are the most committed to the caregiver QV, except in the field social relations. And, the relationship between the pair, shows signs of being harmonious. With this thesis, the design of a health support program, for individuals with OA and their caregivers seeking to minimize the impact of OA in the lives of the elderly and minimize overhead suffered by caregivers. / Esta tese versa sobre a osteoartrose (OA) de joelho no idoso, a sobrecarga do cuidador, a qualidade de vida (QV) de ambos e a relação entre a díade idoso-cuidador familiar. Dessa forma, seu objetivo foi de estudar o perfil populacional e a QV de idosos com OA e de seus cuidadores familiares. O estudo foi realizado em duas fases; na primeira foram elaborados dois artigos de revisão de literatura. E, na segunda, foram elaborados três artigos empíricos, que foram do tipo quantitativo, observacional, descritivo e de corte transversal. A amostra foi constituída por 15 idosas diagnosticadas com OA de joelho e seus cuidadores familiares. Para as idosas foram aplicados o questionário sociodemográfico e clínico, a Escala Visual Analógica (EVA), o questionário Algofuncional de Lequesne, o World Health Organization Questionnaire for Quality of Life Bref Form (WHOQOL-Bref) e o questionário da relação idoso-cuidador. Para os cuidadores foram aplicados o questionário sociodemográfico e clínico, a escala Zarit Burden Interview, o WHOQOL-Bref e o questionário da relação cuidador-idoso. As idosas apresentaram média de idade de 74±6,4 anos, com Índice de Massa Corporal (IMC) médio de 26,91 ± 8,85 Kg/m2, das quais 53,33% (n=8) eram casadas e moravam com os maridos, 66,6% (n=10) eram aposentadas, 60% (n=8) não praticavam atividade física e 93,3% (n=14) utilizava algum tipo de medicação. Em relação aos cuidadores, 53,3% eram homens (n=8), com média de idade de 58,53±17,54 anos, com IMC médio de 25,16±4,80 Kg/m2, dos quais 73,33% (n=11) eram casados, 60% (n=8) não praticavam atividade física e 93,3% (n=14) eram fumantes. De forma geral, observou-se que as idosas portadoras de OA de joelho, apontaram a dor como sintoma mais identificável e que a QV está diminuída, sendo o físico o pior domínio. Em relação aos cuidadores familiares, percebeu-se presença de sobrecarga e a que a QV está diminuída. Ao comparar a QV da díade idoso-cuidador, os resultados mostraram que as idosas têm a QV mais comprometida que o cuidador, exceto no domínio relações sociais. E a relação entre o par, demonstra indícios de ser harmoniosa. Com esta tese, gerou o projeto de um programa de apoio a saúde, para indivíduos com OA e seus cuidadores buscando minimizar as repercussões da OA na vida dos idosos e minimizar a sobrecarga sofrida pelos cuidadores.

Made available in DSpace on 2017-06-01T18:09:02Z (GMT). No. of bitstreams: 1 erica_maria_tenorio_wanderley.pdf: 326510 bytes, checksum: c4bd0641d9d8874ef90e8f2ecd9cc66e (MD5) Previous issue date: 2016-09-01 / In Brazil, the expectation of the people's living 60 years or more has increased, from this reality, we highlight the amount of homes formed by older who are single and living alone. Starting from the perspective that the support of a relational system is of great importance as it provides exchanges, support and protection, it must be recognized that the more the subject age, tends to have limitations which cause them to depend on others, are family, friends or paid professionals. Against this background, it appears that the reality of elderly who do not have children and spouses, and inhabiting a one-person household, is little known, especially in the state of Pernambuco. Based on these, the general objective of this research was to describe as the elderly, who are not married and have no children, build their networks in order to support and care. The specific objectives were to identify the sociodemographic profile of them; analyze how they perceive their aging process; and identify their needs and feelings about the fact of living alone and their expectations for the future and the reasons that led them to live alone. It is a qualitative research, which was attended by eight elderly women with chronological age of 60, unmarried and living alone. The instrument used was an interview consists of questions that met the research objectives and also to the socio-demographic data of the participants. The interviews were analyzed according to the technique of thematic content analysis. The main results showed: 1) the heterogeneity of aging, since older emphasized the importance of having a proper lifestyle that provides autonomy and satisfaction with life; 2) the construction of social networking, support and care in the family has the primary source (especially brothers and nephews), followed by spirituality / religiosity and friendships; 3) income, combined with a good education, appeared as providing security and independence; 4) the experience of living alone, in general, was viewed positively because the elderly live to old age soon, satisfactory health and occupations. It is hoped that the research contributes to knowledge about the reality of these older, as can also support the work of the professionals that they meet or are interested in aging theme. / No Brasil, a expectativa de vida da população com 60 anos ou mais vem aumentando, dentre essa realidade, destacamos a quantidade de lares formados por idosas que são solteiras e que moram sozinhas. Partindo-se da perspectiva que o suporte de um sistema relacional é de grande importância, pois proporciona trocas, apoio e proteção, deve-se reconhecer que quanto mais o sujeito envelhece, tende a apresentar limitações que o levam a depender de outras pessoas, sejam familiares, amigos ou profissionais pagos. Diante desse panorama, constata-se que a realidade de idosas que não possuem filhos e cônjuges, e que habitam um domicílio unipessoal, é pouco conhecida, especialmente no estado de Pernambuco. Frente ao exposto, o objetivo geral desta pesquisa foi descrever como as idosas, que não são casadas e não possuem filhos, constroem suas redes de relacionamento, visando ao apoio e ao cuidado. Os objetivos específicos foram: identificar o perfil sociodemográfico delas; analisar como elas percebem seu processo de envelhecimento; identificar suas necessidades e sentimentos acerca do fato de morar sozinhas e suas expectativas para o futuro. e os motivos que as levaram a morar sozinha. Trata-se de uma pesquisa qualitativa, da qual participaram oito idosas com idade cronológica acima de 60 anos, solteiras e que moram sozinhas. O instrumento utilizado foi uma entrevista constituída de questões que atendiam aos objetivos da pesquisa e também aos dados sociodemográficos das participantes. As entrevistas foram analisadas de acordo com a técnica da análise de conteúdo temática. Os principais resultados evidenciaram: 1) a heterogeneidade do envelhecimento, uma vez que as idosas enfatizaram a importância de ter um estilo de vida próprio que proporcione autonomia e satisfação com a vida; 2) a construção da rede de relacionamento, apoio e cuidados tem na família a fonte primordial (especialmente irmãos e sobrinhos), seguida pela espiritualidade/religiosidade e amizades; 3) a renda, aliada a uma boa escolaridade, apareceu como propiciando segurança e independência; 4) a experiência de morar sozinha, em geral, foi vista de forma positiva uma vez que as idosas vivem a velhice com prazer, saúde satisfatória e ocupações. Espera-se que a pesquisa contribua com conhecimentos acerca da realidade dessas idosas, como também possa subsidiar o trabalho dos profissionais que a elas atendem ou que estão interessados na temática do envelhecimento.

Made available in DSpace on 2017-06-01T18:29:31Z (GMT). No. of bitstreams: 1 erica_patricia_borba_lira_uchoa.pdf: 4523264 bytes, checksum: d4dd5f77d0353ad601698587c24fda01 (MD5) Previous issue date: 2016-11-10 / This thesis deals with the osteoarthritis (OA) of the knee in the elderly, the burden of the caregiver, the quality of life (QOL) and the relationship between the old-family caregiver dyad. That way, your goal was to study the population profile and the QOL of elderly people with OA and their family caregivers. The study was conducted in two phases, on the first were elaborated two articles of literature review. And on the second, three practical articles were developed, which were quantitative type, observational, descriptive and cross-sectional. The sample consisted of 15 older diagnosed with knee OA and their family caregivers. For the elderly have been applied the demographic questionnaire and clinical, the Visual analogue scale (EVA), Algofuncional survey of Lequesne, the World Health Organization Questionnaire for Quality of Life-Form Bref (WHOQOL-Bref) and the old relationship quiz-caregiver. For caregivers have been applied the demographic questionnaire and clinical, Zarit Burden Interview, scale the WHOQOL-Bref questionnaire and the relative caregiver-aged. The elderly showed an average age of 74 ± 6.4 years, with body mass index (BMI) 26.91 average ± 8.85 Kg/m2, out of which 53.33% (n = 8) were married and lived with their husbands, 66.6% (n = 10) were retired, 60% (n = 8) did not practice physical activity and 93.3% (n = 14) used some type of medication. In relation to caregivers, 53.3% were men (n = 8), with an average age of 58.53 ± 17.54 years, with average BMI 25.16 ± 4.80 Kg/m2, of which 73.33% (n = 11) were married, 60% (n = 8) did not practice physical activity and 93.3% (n = 14) were smokers. In general, it is observed that the elderly patients with OA of knee, point out the pain as a symptom more identifiable and the QOL is decreased, being the worst physical domain. In relation to family caregivers, realized an increase of burden and the QOL is diminished. When comparing the QOL of the elderly carer dyad, the results show that the elderly are the most committed to the caregiver QV, except in the field social relations. And, the relationship between the pair, shows signs of being harmonious. With this thesis, the design of a health support program, for individuals with OA and their caregivers seeking to minimize the impact of OA in the lives of the elderly and minimize overhead suffered by caregivers. / Esta tese versa sobre a osteoartrose (OA) de joelho no idoso, a sobrecarga do cuidador, a qualidade de vida (QV) de ambos e a relação entre a díade idoso-cuidador familiar. Dessa forma, seu objetivo foi de estudar o perfil populacional e a QV de idosos com OA e de seus cuidadores familiares. O estudo foi realizado em duas fases; na primeira foram elaborados dois artigos de revisão de literatura. E, na segunda, foram elaborados três artigos empíricos, que foram do tipo quantitativo, observacional, descritivo e de corte transversal. A amostra foi constituída por 15 idosas diagnosticadas com OA de joelho e seus cuidadores familiares. Para as idosas foram aplicados o questionário sociodemográfico e clínico, a Escala Visual Analógica (EVA), o questionário Algofuncional de Lequesne, o World Health Organization Questionnaire for Quality of Life Bref Form (WHOQOL-Bref) e o questionário da relação idoso-cuidador. Para os cuidadores foram aplicados o questionário sociodemográfico e clínico, a escala Zarit Burden Interview, o WHOQOL-Bref e o questionário da relação cuidador-idoso. As idosas apresentaram média de idade de 74±6,4 anos, com Índice de Massa Corporal (IMC) médio de 26,91 ± 8,85 Kg/m2, das quais 53,33% (n=8) eram casadas e moravam com os maridos, 66,6% (n=10) eram aposentadas, 60% (n=8) não praticavam atividade física e 93,3% (n=14) utilizava algum tipo de medicação. Em relação aos cuidadores, 53,3% eram homens (n=8), com média de idade de 58,53±17,54 anos, com IMC médio de 25,16±4,80 Kg/m2, dos quais 73,33% (n=11) eram casados, 60% (n=8) não praticavam atividade física e 93,3% (n=14) eram fumantes. De forma geral, observou-se que as idosas portadoras de OA de joelho, apontaram a dor como sintoma mais identificável e que a QV está diminuída, sendo o físico o pior domínio. Em relação aos cuidadores familiares, percebeu-se presença de sobrecarga e a que a QV está diminuída. Ao comparar a QV da díade idoso-cuidador, os resultados mostraram que as idosas têm a QV mais comprometida que o cuidador, exceto no domínio relações sociais. E a relação entre o par, demonstra indícios de ser harmoniosa. Com esta tese, gerou o projeto de um programa de apoio a saúde, para indivíduos com OA e seus cuidadores buscando minimizar as repercussões da OA na vida dos idosos e minimizar a sobrecarga sofrida pelos cuidadores.

Text in English / An increasingly recognised prevention approach for substance use entails reduction in risk factors and enhancement of promotive or protective factors in individuals and the environment surrounding them during their growth and development. However, in order to enhance the effectiveness of this approach, continuous study of risk aspects targeting different cultures, social groups and mixture of society has been recommended. This study evaluated the impact of potential risk and protective factors associated with family management and relations on adolescent substance abuse in South Africa. Exploratory analysis and cumulative odds ordinal logistic regression modelling was performed on the data while controlling for demographic and socio-economic characteristics on adolescent substance use. The most intensely used substances were tobacco, cannabis, cocaine, heroin and alcohol in decreasing order of use intensity. The specific protective or risk impact of family management or relations factors varied from substance to substance. Risk factors associated with demographic and socio-economic factors included being male, younger age, being in lower education grades, coloured ethnicity, adolescents from divorced parents and unemployed or fully employed mothers. Significant family relations risk and protective factors against substance use were classified as either family functioning and conflict or family bonding and support. Several family management factors, categorised as parental monitoring, discipline, behavioural control and rewards, demonstrated either risk or protective effect on adolescent substance use. Some factors had either interactive risk or protective impact on substance use or lost significance when analysed jointly with other factors such as controlled variables. Interaction amongst risk or protective factors as well as the type of substance should be considered when further considering interventions based on these risk or protective factors. Studies in other geographical regions, institutions and with better gender balance are recommended to improve upon the representativeness of the results. Several other considerations to be made when formulating interventions, the shortcomings of this study and possible improvements as well as future studies are also suggested. / Psychology / M. A. (Psychology)

La literatura científica sitúa la autonomía del paciente en la toma de decisiones en el ámbito clínico, en una encrucijada entre dos posiciones éticas; el paternalismo y la elección informada. Analizar los textos de los registros de las historias clínicas y los discursos de las enfermeras, mediante una metodología cualitativa y desde la perspectiva de la ética foucaultiana, permite conocer los factores que determinan el poder de decisión de los pacientes. Este estudio revela que el paciente no es autónomo en la toma de decisiones sobre sus cuidados debido; a una determinada institucionalización de la atención, que marca los ritmos de las decisiones, a las características de las relaciones interprofesionales y a las dinámicas relacionales que se establecen entre los profesionales, en particular, de la enfermera con el paciente y la familia. Se debe liberar al paciente de las reglas impuestas, promoviendo su propia conducta, su propio estilo de vida. / The scientific literature places the patient autonomy in decision-making in the clinical setting, at a crossroads between two ethical positions, paternalism and informed choice. Analyze records of clinical histories and nurses discourses, using a qualitative methodology and from the perspective of foucauldian ethics, allows knowing the factors that determine the power of patient decision. This study reveals that the patient is not autonomous in making decisions about your care because, to a certain institutionalization of care, which marks the rhythms of the decisions, the characteristics of the interprofessional-relationships and relational dynamics that exist between professionals, in particular, of the nurse with the patient and family. It should free the patient from the rules imposed by promoting their own behavior, their own lifestyle. / La literatura científica situa l'autonomia del pacient en la presa de decisions en l'àmbit clínic, en una cruïlla entre dues posicions ètiques, el paternalisme i l'elecció informada. Analitzar els textos dels registres de les històries clíniques i els discursos de les infermeres, mitjançant una metodologia qualitativa i des de la perspectiva de l'ètica foucaultiana, permet conèixer els factors que determinen el poder de decisió dels pacients. Aquest estudi revela que el pacient no és autònom en la presa de decisions sobre les seves cures a causa, a una determinada institucionalització de l'atenció, que marca els ritmes de les decisions, a les característiques de les relacions interprofessionals i les dinàmiques relacionals que s'estableixen entre els professionals, en particular, de la infermera amb el pacient i la família. Cal alliberar el pacient de les regles imposades, promovent la seva pròpia conducta, el seu propi estil de vida.

Text in English / An increasingly recognised prevention approach for substance use entails reduction in risk factors and enhancement of promotive or protective factors in individuals and the environment surrounding them during their growth and development. However, in order to enhance the effectiveness of this approach, continuous study of risk aspects targeting different cultures, social groups and mixture of society has been recommended. This study evaluated the impact of potential risk and protective factors associated with family management and relations on adolescent substance abuse in South Africa. Exploratory analysis and cumulative odds ordinal logistic regression modelling was performed on the data while controlling for demographic and socio-economic characteristics on adolescent substance use. The most intensely used substances were tobacco, cannabis, cocaine, heroin and alcohol in decreasing order of use intensity. The specific protective or risk impact of family management or relations factors varied from substance to substance. Risk factors associated with demographic and socio-economic factors included being male, younger age, being in lower education grades, coloured ethnicity, adolescents from divorced parents and unemployed or fully employed mothers. Significant family relations risk and protective factors against substance use were classified as either family functioning and conflict or family bonding and support. Several family management factors, categorised as parental monitoring, discipline, behavioural control and rewards, demonstrated either risk or protective effect on adolescent substance use. Some factors had either interactive risk or protective impact on substance use or lost significance when analysed jointly with other factors such as controlled variables. Interaction amongst risk or protective factors as well as the type of substance should be considered when further considering interventions based on these risk or protective factors. Studies in other geographical regions, institutions and with better gender balance are recommended to improve upon the representativeness of the results. Several other considerations to be made when formulating interventions, the shortcomings of this study and possible improvements as well as future studies are also suggested. / Psychology / M. A. (Psychology)

Summaries in English and Afrikaans / Practical research has shown that children with learning disabilities often experience psychosocial problems. These problems not only have an influence on the parent-child relationship, but also impact negatively on the psychological development of the child. The objective of this study is to explore these psychosocial problems by investigating the personal experiences of the learning disabled child within his immediate family. The literature study on learning disabilities shows that it is a complex condition that not only manifests in learning problems, but which can also adversely affect the child in totality. The Relation theory, an educational psychological perspective, functions as a theoretical framework for exploration, and is discussed with reference to psychosocial problems of the learning disabled child. In the empirical study, the researcher has primarily employed projection techniques to investigate the child's experiences of himself and his relationships with family members, from his internal frame of reference. From these findings, recommendations are proposed for psychotherapy. / Uit die praktyk blyk dit dat leergestremdheid by kinders dikwels met psigososiale probleme gepaard gaan. Nie alleen beinvloed hlerdie problema die ouer~kindverhouding nie, maar dit het ook 'n negatiewe invloed op die psigiese ontwikkeling van die kind. Die doel van die studie is om die persoonlike belewenisse van die leergestremde kind binne die gesin te verken. Die meratuurstudie wat oor die verskynsel van leergestremdheid gedoen is, het getoon dat dit 'n kompleksa toestand is wat nie aileen met leerprobleme gepaard gaan nie, maar ook die kind in sy totallteit nadelig bei'nvloed. Die Relasieteorie, 'n opvoedkundig-sielkundige perspektief, wat as teoretiese raamwerk vir verkenning dien, is bespreek en waar toepaslik is na die psigososiale problema van die leergestremde kind verwys. In die empiriese ondersoek is hoofsaaklik van projeksietegnieke gebruik gemaak om vanuit die leergestremde kind se interne verwysingsraamwerk sy persepsies en belewenisse ten opsigte van homself en sy verhoud!ngs in die gesin te verken. Na aanleiding hiervan is aanbevelings vir terapeutiese hulpverlening gemaak. / Educational Studies / M. Ed. (Specialisation in Guidance and Counseling)

Summaries in English and Afrikaans / Practical research has shown that children with learning disabilities often experience psychosocial problems. These problems not only have an influence on the parent-child relationship, but also impact negatively on the psychological development of the child. The objective of this study is to explore these psychosocial problems by investigating the personal experiences of the learning disabled child within his immediate family. The literature study on learning disabilities shows that it is a complex condition that not only manifests in learning problems, but which can also adversely affect the child in totality. The Relation theory, an educational psychological perspective, functions as a theoretical framework for exploration, and is discussed with reference to psychosocial problems of the learning disabled child. In the empirical study, the researcher has primarily employed projection techniques to investigate the child's experiences of himself and his relationships with family members, from his internal frame of reference. From these findings, recommendations are proposed for psychotherapy. / Uit die praktyk blyk dit dat leergestremdheid by kinders dikwels met psigososiale probleme gepaard gaan. Nie alleen beinvloed hlerdie problema die ouer~kindverhouding nie, maar dit het ook 'n negatiewe invloed op die psigiese ontwikkeling van die kind. Die doel van die studie is om die persoonlike belewenisse van die leergestremde kind binne die gesin te verken. Die meratuurstudie wat oor die verskynsel van leergestremdheid gedoen is, het getoon dat dit 'n kompleksa toestand is wat nie aileen met leerprobleme gepaard gaan nie, maar ook die kind in sy totallteit nadelig bei'nvloed. Die Relasieteorie, 'n opvoedkundig-sielkundige perspektief, wat as teoretiese raamwerk vir verkenning dien, is bespreek en waar toepaslik is na die psigososiale problema van die leergestremde kind verwys. In die empiriese ondersoek is hoofsaaklik van projeksietegnieke gebruik gemaak om vanuit die leergestremde kind se interne verwysingsraamwerk sy persepsies en belewenisse ten opsigte van homself en sy verhoud!ngs in die gesin te verken. Na aanleiding hiervan is aanbevelings vir terapeutiese hulpverlening gemaak. / Educational Studies / M. Ed. (Specialisation in Guidance and Counseling)