Submitted by Filipe dos Santos (fsantos@pucsp.br) on 2017-09-21T12:28:44Z No. of bitstreams: 1 Cristiane Tenani Pomeranz.pdf: 4211902 bytes, checksum: 0b7dcfbb031038106d44f262f87d9076 (MD5) / Made available in DSpace on 2017-09-21T12:28:44Z (GMT). No. of bitstreams: 1 Cristiane Tenani Pomeranz.pdf: 4211902 bytes, checksum: 0b7dcfbb031038106d44f262f87d9076 (MD5) Previous issue date: 2017-09-16 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / To approach Art and Old Age, with the interdisciplinary view of Gerontology, is the working method used in this documental research The research is also retrospective, descriptive and qualitative in character and has its main axis in the story of a ballerina named Elisa, whose stage name was Zuzima. After the stroke, and during rehabilitation, she is exposed to Art Therapy, where she finds ways to rescue the potential of life that was lost to the pathology. This research is based on authors from various fields of knowledge, such as Geertz, Tótora, Ciornai, Francisquetti, Carrière, Messy, Beauvoir, Foucault, Nietzsche among others, and features a method of art-therapeutic intervention named PREAMAR. The method consists of seven steps -perception, recognition, strategy, affection, hands-on, result analysis and refinement, and was developed during the professional involvement with Elisa. More than a methodology, Elisa revealed the imminent human frailty, as a condition that is able to stifle the potency of existing life in the elderly, and became what the sociologist Max Weber termed an “ideal type”, an instrument for researching sociological knowledge, a mental construction of the researcher which emphasizes the aspects to analyze in the object of study. Elisa allowed the selection of a series of interventions, building in this manner an “ideal type” that can be perceived in the practical cases of Art Therapy. These interventions were made with elderly people in a large institution of Long-permanence in the city of São Paulo, with elders from the Atelier of Art & Inclusion and Dementia of the project Make Memories, with socially vulnerable elders who attended a public day-Center, and other elders that were attended individually by the researcher, pointing towards an internal movement that was developed in favor of those elders who perceive the possibilities of living the old age. It was observed that Art Therapy is a facilitating tool for the understanding of elderliness, as well as a practice favoring conducts of meaning–of-life for the elderly. By being involved in this method, the elderly can find ways of interpreting the world, to exist inserted in the present time, in which the understanding of facts, of life and of elderliness can be clarified in the midst of the current scenario. The PREAMAR method, learned and replicated, shows to be effective in the transformation of landscapes that, in many old-ages, are devoid of enchantments. For the fragile old-ages , this study proposes an Art Therapy that seeks, in the force of Art and in the PREAMAR method, the conditions to rescue the Zuzimas oppressed by the nihilism that is found in the most diverse forms of growing old / Aproximar a Arte da velhice, com o olhar interdisciplinar da Gerontologia é o método de trabalho utilizado nesta pesquisa documental. A pesquisa também tem um caráter retrospectivo, descritivo e qualitativo que tem como eixo principal a história de uma bailarina chamada Elisa, cujo nome artístico era Zuzima. Após o derrame, ao fazer reabilitação, ela é exposta à Arteterapia, onde encontra maneiras de resgatar a potência de vida perdida em meio à patologia. A pesquisa está fundamentada em autores de diversas áreas do saber, como Geertz, Tótora, Ciornai, Francisquetti, Carrière, Messy, Beauvoir, Foucault, Nietzsche entre outros, e apresenta um método de intervenção arteterapêutica nomeado PREAMAR. O método é composto de sete passos - percepção, reconhecimento, estratégia, afeto, mão na massa, análise de resultado e refinamento foi desenvolvido durante o envolvimento profissional com Elisa. Mais do que uma metodologia, Elisa revelou a fragilidade humana eminente, como condição, capaz de abafar a potência de vida existente nos velhos, e tornou-se o que o sociólogo Max Weber chamou de “tipo ideal”, instrumento de pesquisa do saber sociológico, uma construção mental do pesquisador, que enfatiza aspectos que deseja analisar do objeto de estudo. Elisa permitiu que selecionássemos uma série de observações construindo assim um “tipo ideal” que pode ser percebido em casos práticos de Arte-terapia. Estas intervenções foram feitas com idosos de uma Instituição de Longa Permanência e de grande porte na cidade de São Paulo, com idosos do Atelier de Arte&Inclusão e demenciados do projeto Faça Memórias, com idosos em situação de vulnerabilidade social que frequentam um Centro-dia público, e outros idosos atendidos individualmente pela pesquisadora, apontando um movimento interno desenvolvido a favor do sujeito velho que percebe possibilidades de viver a velhice.Observo u-se que a Arteterapia é uma ferramenta facilitadora para a compreensão das velhices, assim como uma prática a favor das condutas de significação da vida para os velhos. Ao serem envolvidos neste método, os idosos podem encontrar meios de interpretar o mundo, para existir inserido no tempo presente, em que a compreensão dos fatos, da vida e da velhice pode clarificar-se em meio ao cenário atual. O método PREAMAR, aprendido e replicado, mostra-se eficaz na transformação das paisagens que, em muitas velhices, são desprovidas de encantamento. Para as velhices fragilizadas, esta pesquisa propõe uma Arteterapia que busca, na força da Arte e no método PREAMAR as condições de resgatar as Zuzimas oprimidas pelo niilismo encontrado nas mais diversas maneiras de envelhecer

Bakgrund: Förmågan att utföra oral egenvård kan påverkas av skörhet hos äldre, därmed krävs fler för gruppen anpassade hjälpmedel. Syfte: Att hos sköra äldre i ordinärt boende analysera upplevelsen av att använda ett tekniskt munhälsohjälpmedel, en så kallad trigger, för påminnelse av tandborstning. Metod: Rekrytering av informanter gjordes i samverkan med folktandvården i Region Jönköpings län och institutionen för Gerontologi på HHJ. Triggern testades i egna bostaden av sju informanter i en vecka vardera. Två intervjuer utfördes om livssituation/munhygien och kring upplevelsen av användandet. En kvalitativ, induktiv innehållsanalys av materialet utfördes. Resultat: Analysen gav huvudkategorin, ”användning”, vilken kopplades till subkategorin ”förhållningssätt och vanor”. Där ansågs munhygienvanorna goda och värdet av användningen sattes istället i relation till om kapaciteten att upprätthålla munhygienen hade blivit försämrad. Behovet anpassa triggern till föränderliga vardagstider upplevdes i relation till subkategorin ”fungerande vardagstruktur”. Huvudkategorin ”Funktion”, upplevdes i stort som god, subkategorin ”otillförlitlig” syftade dock till teknik som upplevts brista. Subkategorin ”utvecklingsmöjligheter” berörde signalsystemet som upplevdes behöva kompletterande ljud/ljusintryck.              Slutsats: Informanterna upplevde sig för friska i relation till huvudkategorin ”användning”. Gentemot huvudkategorin ”funktion” kom dock detta att resultera i användbara aspekter till vidareutvecklingen av triggern, såsom uppmärksamhetsförhöjande ljudintryck. Detta bör fokus läggas på innan fortsatta studier utförs. / Background: The ability to perform oral self-care can be affected by frailty in the elderly. Aim: To analyze the experience of using assistive technology, a so called trigger, as a reminder of tooth brushing, for the home dwelling elderly. Method: The recruitment was done in collaboration with the public Dental service and the Institute of Gerontology at HHJ. Seven informants tested the trigger for a week. Two interviews regarding their life situation/oral hygiene and the experience around the trigger was performed.A qualitative inductive content analysis was performed. Result: The main category "use", was linked to the subcategory "approaches and habits", here the value of the use was linked to if the capacity to maintain oral hygiene was impaired. In "everyday structure" a need to adapt the trigger to a changing schedule was experienced.  The main category ”function” and the subcategory "unreliable" referred to the parts that malfunctioned. “Improvement opportunities” regarded the need to develop the signal system. Conclusion: The informants perceived themselves as too healthy in relation to "use". In “function” this can be perceived as a strength. It resulted in improvement suggestions, such as sound-developments for attention, that should be taken into account before further studies are performed.

Submitted by Angela Maria de Oliveira (amolivei@uepg.br) on 2019-02-07T12:23:57Z No. of bitstreams: 2 license_rdf: 811 bytes, checksum: e39d27027a6cc9cb039ad269a5db8e34 (MD5) Camila Zanesco.pdf: 957298 bytes, checksum: 44f05075b15006c339a41dfbbe86de7d (MD5) / Made available in DSpace on 2019-02-07T12:23:58Z (GMT). No. of bitstreams: 2 license_rdf: 811 bytes, checksum: e39d27027a6cc9cb039ad269a5db8e34 (MD5) Camila Zanesco.pdf: 957298 bytes, checksum: 44f05075b15006c339a41dfbbe86de7d (MD5) Previous issue date: 2018-12-14 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Envelhecer com qualidade representa um desafio atual, sendo que a exiguidade de doenças não mais confere um parâmetro exclusivo de proteção à saúde. Desta maneira, o presente estudo buscou analisar fatores com alto grau de associação com dificuldades funcionais entre idosos brasileiros. Constitui-se estudo transversal, quantitativo, com dados provenientes da Pesquisa Nacional de Saúde – 2013, considerando a amostra total de indivíduos com 60 ou mais anos (n=23.815). Para a análise foram consideradas duas variáveis dependentes que sobrevieram ao agrupamento de questões relacionadas à Dificuldade Funcional (DF): Dificuldade Funcional para Atividades Básicas de Vida Diária (DF-ABVD) e Dificuldade Funcional para Atividades Instrumentais de Vida Diária (DF-AIVD). Na fase de préexploração foram selecionadas às variáveis independentes para, posteriormente, proceder-se com duas análises: a primeira considerando condições sociodemográficas, de saúde geral, saúde bucal e utilização de serviços de saúde; e a segunda ponderarando condições gerais, padrões de cuidado e uso de serviços voltados a saúde bucal. O software Waikato Environment for Knowledge Analysis foi utilizado para realizar a análise dos dados, as etapas realizadas em seu ambiente foram: balanceamento do conjunto de dados por meio do algoritmo Resample; método de validação cruzada de 10 Fold empregado para realizar a redução de dimensionalidade; posteriormente, as variáveis relacionadas com as variáveis dependentes foram avaliadas por meio de regressão logística. Na primeira análise as variáveis que apresentaram forte relação com quadros de DF para ABVD e AIVD foram: idade, com destaque para 80 ou mais anos (DF-ABVD OR=2,25; DF-AIVD OR=2,81); percepção ruim da condição geral de saúde (DF-ABVD OR=4,77; DF-AIVD OR=2,86); necessidade de atendimento emergencial no domicílio (DF-ABVD OR=3,39; DF-AIVD OR=3,21 ); e internação hospitalar (DF-ABVD OR= 2,42; DF-AIVD OR=2,25). A segunda análise apontou associação direta entre DF de idosos e aspectos de saúde bucal, como: presença de dificuldade para se alimentar decorrente de problemas com dentes ou próteses (DF-ABVD OR= 1,73; DF-AIVD OR=1,59), não realização de consulta com cirurgião-dentista ao longo da vida (DF-ABVD OR=1,69) e ausência de dentes naturais (DF-AIVD OR=1,64). Os dados permitem o fortalecimento do planejamento e da execução de estratégias voltadas às demandas da população idosa brasileira, além da orientação de investimentos para ações voltadas a preservação e manutenção das capacidades funcionais. / Aging with quality represents a current challenge, and the scarcity of diseases no longer confers an exclusive parameter of health protection. In this way, the present study sought to analyze factors with a high degree of association with functional difficulties among Brazilian elderly. This is a cross-sectional, quantitative study with data from the National Health Survey - 2013, considering the total sample of individuals aged 60 years or older (n = 23,815). For the analysis, we considered two dependent variables that came to the grouping of questions related to Functional Difficulty (DF): Functional Difficulty for Basic Activities of Daily Living (DF-ABVD) and Functional Difficulty for Instrumental Activities of Daily Living (DF-AIVD). In the pre-exploration phase, the independent variables were selected to be followed by two analyzes: first considering socio-demographic conditions, general health, oral health and health services utilization; and the second considering general conditions, standards of care and use of oral health care services. The Waikato Environment for Knowledge Analysis software was used to perform the data analysis; the steps performed in its environment were: data set balancing through the Resample algorithm; 10-fold crossvalidation method employed to perform dimensionality reduction; later, the variables related to the dependent variables were evaluated through logistic regression. In the first analysis, the variables that presented a strong relation with DF for ABVD and AIVD were: age, with emphasis on 80 or more years (DF-ABVD OR = 2.25; DF-AIVD OR = 2.81); poor perception of the general health condition (DF-ABVD OR = 4.77; DF-AIVD OR = 2.86); need for emergency care at home (DF-ABVD OR = 3.39; DF-AIVD OR = 3.21); and hospital admission (DF-ABVD OR = 2.42; DF-AIVD OR = 2.25). The second analysis showed a direct association between the DF of the elderly and aspects of oral health, such as: presence of difficulty to feed due to problems with teeth or prostheses (DF-ABVD OR = 1.73; DFAIVD OR = 1.59) (DF-ABVD OR = 1.69) and absence of natural teeth (DF-AIVD OR = 1.64). The data allow the strengthening of planning and execution of strategies geared to the demands of the Brazilian elderly population, as well as the orientation of investments for actions aimed at the preservation and maintenance of functional capacities.

Introduktion: Multisjuka patienter är individer med många sjukdomar och komplexa vårdbehov. För denna grupp är vikten av kontinuitet för att öka känsla­n av trygghet stor. Syfte med förbättringsarbetet: : Att skapa en trygg och möjlig ASIH-vård för multisjuka äldre genom att utveckla arbetssätt som möjliggör anslutning och en trygg utskrivning för multisjuka äldre. Syftet med studie av förbättringsarbetet: Att undersöka och analysera medarbetares gemensamma erfarenheter. Metod: Förbättringsarbetet genomfördes med stöd av Nolans förbättringsmodell. Studien av förbättringsarbetet genomfördes med en fallstudie med kvalitativ innehållsanalys. Resultat: Förbättringsarbetet resulterade i ett jämnt inflöde av remisser och kortare anslutningstid till ASIH. Patientens upplevelse av trygghet skattades i en enkät till 76%.  Möjlighet till återanslutning till ASIH fick 7 patienter mellan 1-7 gånger under förbättringsprojektet. Studien av förbättringsarbetet sammanfattades i temat: ”Villkor för samverkan mot det gemensamma målet” då ett tydligt mönster framkom i fokusgruppsintervjuerna. Följande villkor sågs som betydelsefulla: kontinuitet, lärande, samarbete och kommunikation.. Diskussion: ASIH är en alternativ vårdform som kan bidra till att skapa trygghet och underlätta övergången till hemmet för gruppen multisjuka äldre. I bästa fall också minska behov av vård på akutsjukhus vid försämring. För att möjliggöra denna vård krävs återkoppling som skapar lärande genom tydliga mål och mätbara resultat. / Introduction: Patients with multiple illnesses are individuals with complex needs of care. For this group of patients, continuity of care and their sense of security is is of great importance. Improvement work objective: To create secure and accessible ASIH for elders with multiple illnesses by¨develop ways of working to enable re-admittance and secure discharges for this group of patients. Case study objective: To Investigate and analyze team members’ common experiences. Method: Implementation using Nolan’s improvement model. A case study using qualitative contents analysis. Result: The improvement work resulted in an even flow of referrals and shortened admission times to ASIH. Patients’ sense of security were rated to 76%. Seven Seven patients had the possibility towere be  re-admitted 1-7 times 1-7 times during the project. Casestudy summary: ”Conditions for cooperationfor a common goal”. A clear pattern with the following significant conditions emerged from the focusgroups interviews: continuity, learning, cooperation, and communication. Discussion: ASIH can be an option to facilitate the transition home for elderly patients with multiple illnesses. ASIH provides a sense of security and may prevent re-hospitalization. This model of cooperation requires clear, common goals and opportunities for feedback to enable learning contributes to measurable results.