The aim of the current work was to analyze the structure of training in the four – year Olympic cycle (2001 – 2004), the achieved results and to assess the dynamics of sportsmen`s physical and functional abilities over the period. The dynamics of the physical and functional abilities over the annual cycle of training was analyzed on an example of A.Z. and E.K., the most efficient Lithuanian modern pentathlonists. We analyzed physical load in 2001 – 2004 and the results achieved in the same year, the dynamics of physical development, such as body mass, muscle and fat mass, lung volume, muscular power in different zones of energy production. The efficiency on anaerobic alactic energy production mechanisms was determined by measuring single muscle contraction power (SMCP) and anaerobic alactic muscular power (AAMP). The functional capacity of the circulatory and respiratory systems was assessed by the Roufier index (RI). By fixing the speed on a running-track, pulse rate and lactate concentration in blood we determined the intensity of bioenergetic processes at the anaerobic metabolism threshold limit. Also, aerobic capacity at the critical intensity limit and anaerobic metabolism threshold limit were determined. The physical development indices of these sportsmen changed little over the annual cycle of training. In both sportsmen, muscular power under short work remained stable at the level years and showed little change throughout the competition period up to its culmination... [to full text]

Text in Afrikaans / In this quantitative study emphasis is placed on the role of the nurse as a member of the rehabilitation team. Furthermore, the role of the nurse in patient education as well as the importance of effective patient education during the rehabilitation process after hip replacement surgery is emphasised. Various factors that impacted on the rehabilitation process are highlighted. A structured interview schedule was used to interview a group of 20 respondents. All of the respondents participated voluntarily. Orem's Selfcare Theory was used as a theoretical basis for the study. The researcher determined which information respondents regarded as important to attain functional independence during the rehabilitation process. The data gathered would serve as recommendation for a planned information brochure that could in future be given to patients at their first visit to the surgeon before surgery. The brochure could then be used as a basis for patient education in the course of the rehabilitation process. / Advanced Nursing Sciences / M.A. (Verpleegkunde)

O processo de envelhecimento acarreta um declínio no equilíbrio postural, na força muscular e no condicionamento cardiorrespiratório, influenciando diretamente a capacidade funcional do idoso. No entanto, a prática sistemática de atividade física pode reduzir esses efeitos deletérios. Os exercícios realizados em meio aquático, como a hidroginástica, são adequados e seguros para essa população, devido ao reduzido impacto sobre os membros inferiores e à diminuição da sobrecarga cardiovascular. Assim, o objetivo do presente estudo foi analisar e comparar os efeitos de três métodos de treinamento de hidroginástica no equilíbrio corporal e na aptidão física de idosos. A amostra foi composta por 44 mulheres saudáveis, com idades entre 60 e 75 anos, sedentárias há no mínimo seis meses, as quais foram divididas aleatoriamente em três grupos: Equilíbrio (GE; n=17; 66 ± 3,68 anos), Força (GF; n=13; 65,3 ± 3,68 anos) e Aeróbico (GA; n=14; 63,7 ± 4,09 anos). Os grupos realizaram o treinamento durante 12 semanas, com duas sessões semanais de 45min, e um período controle de quatro semanas. Foram mensuradas variáveis de equilíbrio corporal, neuromusculares, cardiorrespiratórias e funcionais antes e após esses períodos. Para análise estatística utilizou-se o teste T pareado para a comparação dos dados no período controle e a Generalized Estimating Equations (GEE) para a comparação entre os momentos e entre os grupos Adotou-se um nível de significância de α=0,05 e os dados foram rodados no SPSS 20.0. Após o treinamento, todos os grupos apresentaram melhora no equilíbrio estático (p<0,05), constatada pela redução da amplitude máxima de deslocamento do centro de pressão plantar nas direções ântero-posterior (COPap) e médio-lateral (COPml), durante os apoios bilateral (olhos abertos e olhos fechados) e unilateral, e da velocidade média do COPap na situação bilateral com olhos fechados. Além disso, houve incremento no equilíbrio dinâmico, avaliado através do teste de Marcha Tandem, após as três intervenções (p<0,001). Em todas as variáveis supracitadas, não se verificou diferença significativa entre os grupos, sendo esse um dos principais achados do presente estudo. Em relação às variáveis neuromusculares, houve aumento significativo na força dinâmica máxima, mensurada através do teste de uma repetição máxima dos extensores do joelho (1RM), sem diferença entre os grupos (p>0,05). Porém, ao analisar estatisticamente os percentuais de incremento do 1RM (Δ%), observaram-se valores significativamente maiores no GF comparado ao GE (31,51 ± 3,44 vs 14,85 ± 2,26%). Nas avaliações cardiorrespiratórias, observou-se incremento significativo no consumo de oxigênio no segundo limiar ventilatório (VO2LV2) e de pico (VO2pico) somente em GA e GE, sem diferença entre os grupos, enquanto a frequência cardíaca no segundo limiar ventilatório (FCLV2) reduziu significativamente apenas no GF No entanto, o desempenho no teste “caminhada de seis minutos” melhorou significativamente nos três grupos, sem diferença entre os mesmos. Todas as variáveis funcionais avaliadas melhoraram significativamente após o treinamento, com diferença estatística somente entre GE e GA nos testes “flexão de cotovelo” e “levantar e sentar”, com maiores valores no GA no pós-treinamento. Todavia, constataram-se valores significativamente maiores no Δ% do teste “flexão de cotovelo” do GA e do GF comparados ao do GE (GA: 52,35 ± 9,63%; GF: 53,39 ± 6,82%; GE: 22,65 ± 5,09%) e diferença significativa no Δ% do teste “levantar e sentar” entre GA e GE (42,04 ± 4,58% vs 23,68 ± 4,75%), sendo ambos similares ao GF (37,41 ± 4,23%). Concluiu-se que o treinamento na hidroginástica foi efetivo para melhora de diversos parâmetros do equilíbrio corporal e da aptidão física de mulheres idosas, independente do método empregado. Porém, alguns resultados sugerem que as maiores adaptações na força muscular (1RM e resistência) tenham sido provocadas pelos treinamentos de força e aeróbico, enquanto as alterações cardiorrespiratórias mais relevantes ocasionadas pelos treinamentos de equilíbrio e aeróbico. / The aging process leads to a decline in postural balance, muscle strength and cardiorespiratory system, affecting directly the functional capacity of the elderly. However, the systematic practice of physical activity may reduce these deleterious effects. The exercises performed in water environment, such as water-based, are appropriate and safe for this population, especially by offering a reduced impact on the lower limbs and a decrease in cardiovascular overload. Thus, the aim of this study was to analyze and compare the effects of three different water-based exercises programs on body balance and physical fitness in the elderly. The sample was composed of 44 healthy women, aged between 60 and 75 years, sedentary for at least six months, randomly into three groups: Balance (GE; n = 17; 66 ± 3.68 years), Strength (GF; n = 13; 65.3 ± 3.68 years) and Endurance (GA; n = 14; 63.7 ± 4.09 years). The groups had trained for 12 weeks, with two 45 minutes weekly sessions, and maintained a control period during four weeks. Balance, neuromuscular, cardiorespiratory and functional responses were measured before and after these periods. The statistical analysis was performed using paired T test for comparisons in the control period, and Generalized Estimating Equations (GEE) to comparisons between moments and between groups. The significance level was α = 0.05 (SPSS 20.0) After the training period, all groups showed improvement in the static balance (p<0.05), verified by the reduction of the maximum displacement amplitude of center of pressure (COP) in the anteroposterior (COPap) and mid-lateral (COPml) directions, during the bilateral (eyes open and closed) and unilateral support bases, and the average COPap velocity in the bilateral situation with eyes closed. In addition, there was an increase in the dynamic balance, evaluated by the Tandem test, after the three interventions (p<0.001). In all variables previously mentioned, there was no significant difference between groups, being one of the main findings of the present study. In adition, there was a significant increase in maximal dynamic strength, measured by one maximal repetition test of knee extensors (1RM), with no difference between groups (p>0.05). However, the statistical analysis with percentages of 1RM incrementes (Δ%) showed higher values in the GF compared to the GE (31.51 ± 3.44 vs. 14.85 ± 2.26%; p<0.05). The cardiorespiratory measurements analysis showed a significant increase in the peak oxygen uptake (VO2pico) and in the oxygen uptake corresponding to the second ventilatory threshold (VO2LV2) only in GA and GE, with no difference between groups, while heart rate corresponding to the second ventilatory threshold (FCLV2) decreased significantly only in GF However, the “six-minute walk test” performance improved significantly in all groups, with no difference between them. All functional variables improved significantly after training, with statistical difference between GA and GE only in the "arm curl test" and "chair stand test", with higher values in GA at posttraining moment. On the other hand, significantly higher values were found in the Δ% of "arm curl test" in GA and GF compared to GE (GA: 52.35 ± 9.63%; GF: 53.39 ± 6.82%; GE: 22.65 ± 5.09%) and significant difference in the Δ% of "chair stand test" between GA and GE (42.04 ± 4.58% vs 23.68 ± 4.75%), being both similar to GF (37.41 ± 4.23%). It was concluded that the water-based exercise training was effective to improve several body balance and physical fitness parameters of elderly women, regardless of the method used. However, some results suggest that the greatest adaptations in muscular strength (1RM and resistance) were provoked by strength training and aerobic training, while the most relevant cardiorespiratory changes were caused by aerobic training and balance training.

Made available in DSpace on 2016-06-02T19:22:07Z (GMT). No. of bitstreams: 1 4079.pdf: 1017196 bytes, checksum: 7d8f430d21921869f401e648a5e75162 (MD5) Previous issue date: 2011-12-19 / Financiadora de Estudos e Projetos / Proposed in the middle 80's from the concepts of "classic" periodization sports training, the periodization of resistance training (PER) has become popular in recent years. The concept of the PER refers as planned and systematic variation of the volume and intensity of strength training (ST), although other acute variables of manipulated. The model consists of 3-4 phases of adaptation during a training program. Initially, the PER was developed to meet the need for enhancement of athlete performance. However, the PER has been used in different populations with very different goals than originally proposed. Thus, this is critical review of a literature, the challenge of understanding the PER not only as a variant or a component epistemological sports training, but as a strategy to affect the physiology as whole, with special attention in the elderly people. A total of 20 manuscripts were included this review. Six publications met the inclusion criteria. Altogether 179 subjects, men and women above 60 years were investigated. It was observed that the PER in the models linear (LP) or non-linear (UP) result in significant improvement in muscular strength capacity. The elderly of both genders were benefited to preservation of functional capacity, improvements in muscular function, and activities of daily living. However, it is not possible to determine which model of periodization is more efficient. Despite of increasing popularization of the PER, few studies have examined the effects of periodized training in the older adult. It takes more information about the comparative efficiency of different intensity and at different volumes in the periodization training approaches. / Proposta em meados dos anos 80 a partir dos conceitos da periodização clássica do treinamento desportivo, a periodização do treinamento resistido (PER) tem se popularizado nos últimos anos. Conceitualmente entende-se a PER como a variação sistemática e planejada do volume e da intensidade do treinamento de força (RT) em 3-4 fases com objetivos bem definidos, embora outras variáveis agudas do RT possam ser periodizadas. Inicialmente a PER foi desenvolvida para atender a necessidade de potencialização do desempenho dos atletas. Contudo, mais recentemente a PRT tem sido empregada em diferentes populações com objetivos bem distintos dos inicialmente propostos. Assim esta revisão crítica buscou refletir, por meio de um levantamento bibliográfico, sobre o desafio de compreender a PER não apenas como uma variante ou um componente epistemológico do treinamento desportivo, mas como uma estratégia capaz de afetar sensivelmente o aparato fisiológico como um todo, com especial atenção aos adultos idosos. Ao todo, 179 indivíduos, homens e mulheres acima de 60 anos foram investigados. Observou-se que o PER, no modelo linear (LP) ou não-linear (UP), resultam em melhoras significativas na força muscular. Os idosos de ambos os gêneros foram beneficiados com a preservação da capacidade funcional, melhora da função muscular e nas atividades da vida diária. No entanto, não é possível determinar qual o modelo de periodização é mais eficiente. Apesar da crescente popularização do PER, poucos estudos examinaram os efeitos do treinamento periodizado na população. É preciso mais informações sobre a eficiência comparativa de diferentes intensidades e em diferentes volumes nas abordagens de treinamento periodização.

O processo de envelhecimento acarreta um declínio no equilíbrio postural, na força muscular e no condicionamento cardiorrespiratório, influenciando diretamente a capacidade funcional do idoso. No entanto, a prática sistemática de atividade física pode reduzir esses efeitos deletérios. Os exercícios realizados em meio aquático, como a hidroginástica, são adequados e seguros para essa população, devido ao reduzido impacto sobre os membros inferiores e à diminuição da sobrecarga cardiovascular. Assim, o objetivo do presente estudo foi analisar e comparar os efeitos de três métodos de treinamento de hidroginástica no equilíbrio corporal e na aptidão física de idosos. A amostra foi composta por 44 mulheres saudáveis, com idades entre 60 e 75 anos, sedentárias há no mínimo seis meses, as quais foram divididas aleatoriamente em três grupos: Equilíbrio (GE; n=17; 66 ± 3,68 anos), Força (GF; n=13; 65,3 ± 3,68 anos) e Aeróbico (GA; n=14; 63,7 ± 4,09 anos). Os grupos realizaram o treinamento durante 12 semanas, com duas sessões semanais de 45min, e um período controle de quatro semanas. Foram mensuradas variáveis de equilíbrio corporal, neuromusculares, cardiorrespiratórias e funcionais antes e após esses períodos. Para análise estatística utilizou-se o teste T pareado para a comparação dos dados no período controle e a Generalized Estimating Equations (GEE) para a comparação entre os momentos e entre os grupos Adotou-se um nível de significância de α=0,05 e os dados foram rodados no SPSS 20.0. Após o treinamento, todos os grupos apresentaram melhora no equilíbrio estático (p<0,05), constatada pela redução da amplitude máxima de deslocamento do centro de pressão plantar nas direções ântero-posterior (COPap) e médio-lateral (COPml), durante os apoios bilateral (olhos abertos e olhos fechados) e unilateral, e da velocidade média do COPap na situação bilateral com olhos fechados. Além disso, houve incremento no equilíbrio dinâmico, avaliado através do teste de Marcha Tandem, após as três intervenções (p<0,001). Em todas as variáveis supracitadas, não se verificou diferença significativa entre os grupos, sendo esse um dos principais achados do presente estudo. Em relação às variáveis neuromusculares, houve aumento significativo na força dinâmica máxima, mensurada através do teste de uma repetição máxima dos extensores do joelho (1RM), sem diferença entre os grupos (p>0,05). Porém, ao analisar estatisticamente os percentuais de incremento do 1RM (Δ%), observaram-se valores significativamente maiores no GF comparado ao GE (31,51 ± 3,44 vs 14,85 ± 2,26%). Nas avaliações cardiorrespiratórias, observou-se incremento significativo no consumo de oxigênio no segundo limiar ventilatório (VO2LV2) e de pico (VO2pico) somente em GA e GE, sem diferença entre os grupos, enquanto a frequência cardíaca no segundo limiar ventilatório (FCLV2) reduziu significativamente apenas no GF No entanto, o desempenho no teste “caminhada de seis minutos” melhorou significativamente nos três grupos, sem diferença entre os mesmos. Todas as variáveis funcionais avaliadas melhoraram significativamente após o treinamento, com diferença estatística somente entre GE e GA nos testes “flexão de cotovelo” e “levantar e sentar”, com maiores valores no GA no pós-treinamento. Todavia, constataram-se valores significativamente maiores no Δ% do teste “flexão de cotovelo” do GA e do GF comparados ao do GE (GA: 52,35 ± 9,63%; GF: 53,39 ± 6,82%; GE: 22,65 ± 5,09%) e diferença significativa no Δ% do teste “levantar e sentar” entre GA e GE (42,04 ± 4,58% vs 23,68 ± 4,75%), sendo ambos similares ao GF (37,41 ± 4,23%). Concluiu-se que o treinamento na hidroginástica foi efetivo para melhora de diversos parâmetros do equilíbrio corporal e da aptidão física de mulheres idosas, independente do método empregado. Porém, alguns resultados sugerem que as maiores adaptações na força muscular (1RM e resistência) tenham sido provocadas pelos treinamentos de força e aeróbico, enquanto as alterações cardiorrespiratórias mais relevantes ocasionadas pelos treinamentos de equilíbrio e aeróbico. / The aging process leads to a decline in postural balance, muscle strength and cardiorespiratory system, affecting directly the functional capacity of the elderly. However, the systematic practice of physical activity may reduce these deleterious effects. The exercises performed in water environment, such as water-based, are appropriate and safe for this population, especially by offering a reduced impact on the lower limbs and a decrease in cardiovascular overload. Thus, the aim of this study was to analyze and compare the effects of three different water-based exercises programs on body balance and physical fitness in the elderly. The sample was composed of 44 healthy women, aged between 60 and 75 years, sedentary for at least six months, randomly into three groups: Balance (GE; n = 17; 66 ± 3.68 years), Strength (GF; n = 13; 65.3 ± 3.68 years) and Endurance (GA; n = 14; 63.7 ± 4.09 years). The groups had trained for 12 weeks, with two 45 minutes weekly sessions, and maintained a control period during four weeks. Balance, neuromuscular, cardiorespiratory and functional responses were measured before and after these periods. The statistical analysis was performed using paired T test for comparisons in the control period, and Generalized Estimating Equations (GEE) to comparisons between moments and between groups. The significance level was α = 0.05 (SPSS 20.0) After the training period, all groups showed improvement in the static balance (p<0.05), verified by the reduction of the maximum displacement amplitude of center of pressure (COP) in the anteroposterior (COPap) and mid-lateral (COPml) directions, during the bilateral (eyes open and closed) and unilateral support bases, and the average COPap velocity in the bilateral situation with eyes closed. In addition, there was an increase in the dynamic balance, evaluated by the Tandem test, after the three interventions (p<0.001). In all variables previously mentioned, there was no significant difference between groups, being one of the main findings of the present study. In adition, there was a significant increase in maximal dynamic strength, measured by one maximal repetition test of knee extensors (1RM), with no difference between groups (p>0.05). However, the statistical analysis with percentages of 1RM incrementes (Δ%) showed higher values in the GF compared to the GE (31.51 ± 3.44 vs. 14.85 ± 2.26%; p<0.05). The cardiorespiratory measurements analysis showed a significant increase in the peak oxygen uptake (VO2pico) and in the oxygen uptake corresponding to the second ventilatory threshold (VO2LV2) only in GA and GE, with no difference between groups, while heart rate corresponding to the second ventilatory threshold (FCLV2) decreased significantly only in GF However, the “six-minute walk test” performance improved significantly in all groups, with no difference between them. All functional variables improved significantly after training, with statistical difference between GA and GE only in the "arm curl test" and "chair stand test", with higher values in GA at posttraining moment. On the other hand, significantly higher values were found in the Δ% of "arm curl test" in GA and GF compared to GE (GA: 52.35 ± 9.63%; GF: 53.39 ± 6.82%; GE: 22.65 ± 5.09%) and significant difference in the Δ% of "chair stand test" between GA and GE (42.04 ± 4.58% vs 23.68 ± 4.75%), being both similar to GF (37.41 ± 4.23%). It was concluded that the water-based exercise training was effective to improve several body balance and physical fitness parameters of elderly women, regardless of the method used. However, some results suggest that the greatest adaptations in muscular strength (1RM and resistance) were provoked by strength training and aerobic training, while the most relevant cardiorespiratory changes were caused by aerobic training and balance training.

Submitted by Luciana Ferreira (lucgeral@gmail.com) on 2015-04-06T13:46:09Z No. of bitstreams: 2 Dissertação - Denise Pinheiro Marques Alves dos Santos - 2014.pdf: 1015766 bytes, checksum: eaa56768d23254b71b2b660ab970c18b (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2015-04-06T13:58:35Z (GMT) No. of bitstreams: 2 Dissertação - Denise Pinheiro Marques Alves dos Santos - 2014.pdf: 1015766 bytes, checksum: eaa56768d23254b71b2b660ab970c18b (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Made available in DSpace on 2015-04-06T13:58:35Z (GMT). No. of bitstreams: 2 Dissertação - Denise Pinheiro Marques Alves dos Santos - 2014.pdf: 1015766 bytes, checksum: eaa56768d23254b71b2b660ab970c18b (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Previous issue date: 2014-04-25 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / Elderly living in Long-Term Care Institutions for the Elderly (LTCI) live with chronic illnesses and pain, which start/intensify disabilities, hamper the maintenance of daily activities and generative negative perceived health conditions. The study objectives were to analyze the demographic, socioeconomic and health conditions profile of elderly living in LTCI; to estimate the prevalence of disability in basic activities of daily living (BADL) and negative self-assessed health and associated factors. Cross-sectional, analytic study, undertaken between May and August 2012, involving 159 elderly living in LTCI, in the house-home and comprehensive care modalities. The target population in this study included elderly without a severe cognitive deficit (scores ≥13 on the Folstein Mini-Mental State Examination, Folstein Mchugh (1975), who lived in the seven participating LTCI (n=246), three of which were of the house-home and four of the comprehensive care type. The outcome variables were functional disability (assessed through the Katz Index) and negative self-assessed health (bad/vary bad). Depression symptoms were assessed by means of the thirty-point Geriatric Depression Scale and pain intensity through the verbal descriptors scale. The prevalence rates were presented with the respective confidence interval (95%CI). For analysis, the Prevalence Ratio (PR) and the Poisson regression model were used, including the variables with p<0.10. Values of p<0.05 were considered significant. Most of the population was female (53.5%), with a mean age of 77.1±8.8 years, without a partner (77.2%), with children (64.2%), mean education 3.6±4.0 years; who received retirement benefits (86.0%) and lived at the institution for less than six years (61.8%). Almost 60.0% of the elderly reported that they did not receive visits. The estimated prevalence ratio of morbidities was 90.1%, with higher frequencies for arterial hypertension (52.8%), cataract (51.6%), suspected depression (44.2%) and musculoskeletal diseases (33.3%). Little more than 40% presented four or more diseases. The prevalence of disability for BADL was 35.2% (95%CI: 28.2-42.9), independently associated to living in comprehensive-care LTCI (PR=2.06:1.15-3.74), negative self-assessed health (PR=1.60:1.02-2.46), lying down due to pain in the last seven day (PR=2.54:1.60-4.07) and reporting strong pain/worst possible pain while resting (PR=1.90:1.13-3.21). Negative self-assessed health was observed in 14.5% (95%CI: 9.8-20.8) of the elderly (6.3% = bad and 8.2% = very bad). This variable was significantly associated with the comprehensive-care modality (PR=3.16:1.11-8.92), worst health comparison (PR=1.88:1.03-3.44), suspected depression (PR=6.10:1.44-25.76), lying down because of pain in the last seven days (PR=2.83:1.24-6.49), and mentioning strong pain/worst possible pain while resting (PR=2.72:1.19-6.49). The assessment of elderly from a functional and self-assessed health perspective can favor the multiprofesional approach and contribute to identify factors that predispose to the worsening of health. The need is highlighted to readapt the care practice at Long-Term Care Institutions for the Elderly. / Idosos residentes em Instituições de Longa Permanência para Idosos (ILPI) convivem com doenças crônicas e dor, que iniciam/intensificam incapacidades, prejudicam a manutenção das atividades diárias e geram percepções negativas sobre o estado de saúde. Os objetivos do estudo foram analisar o perfil demográfico, socioeconômico e de condições de saúde de idosos residentes em ILPI; estimar a prevalência de incapacidade nas atividades básicas de vida diária (ABVD) e de autoavaliação negativa de saúde e os fatores associados. Estudo transversal, analítico, realizado no período de maio a agosto de 2012, com 159 idosos residentes em ILPI, modalidades casa-lar e atendimento integral. A população alvo desse estudo constituiu-se de idosos sem déficit cognitivo grave (escores ≥13 no Mini Exame do Estado Mental de Folstein, Folstein Mchugh (1975), que residiam nas sete ILPI participantes (n=246), sendo 3 (três) tipo casa-lar e, 4 (quatro), tipo atendimento integral. As variáveis de desfecho foram incapacidade funcional (avaliada por meio do Índice de Katz), e autoavaliação negativa de saúde (ruim/péssima). Sintomas de depressão foram avaliados pela Escala de Depressão Geriátrica de 30 pontos e a intensidade de dor por meio da escala de descritores verbais. As prevalências foram apresentadas com respectivo intervalo de confiança (IC95%). Para análise utilizou-se Razão de Prevalência (RP) e o modelo de regressão de Poisson, incluindo as variáveis com p<0,10. Foram considerados significativos valores de p<0,05. A maioria da população era do sexo feminino (53,5%), com média de idade de 77,1±8,8 anos, sem companheiro (77,2%), com filhos (64,2%), média de escolaridade de 3,6±4,0 anos de estudo; que recebiam aposentadoria (86,0%) e residiam na instituição há menos de 6 (seis) anos (61,8%). Quase 60,0% dos idosos relataram não receber visitas. Estimou-se prevalência de morbidade de 90,1%, com maior frequência de hipertensão arterial (52,8%), catarata (51,6%), suspeita de depressão (44,2%) e doenças osteomusculares (33,3%). Pouco mais de 40% apresentou quatro ou mais doenças. A prevalência de incapacidade para ABVD foi de 35,2% (IC95%:28,2-42,9), associada de forma independente a residir em ILPI tipo atendimento integral (RP=2,06:1,15-3,74), avaliar negativamente a saúde (RP=1,60:1,02-2,46), ficar deitado devido a dor nos últimos sete dias (RP=2,54:1,60-4,07) e relatar dor forte/pior dor possível ao repouso (RP=1,90:1,13-3,21). Autoavaliação negativa de saúde foi observada em 14,5% (IC95%: 9,8-20,8) dos idosos (6,3% = ruim e 8,2% = péssima). Essa variável esteve associada significativamente à modalidade de atendimento integral (RP=3,16:1,11-8,92), pior comparação de saúde (RP=1,88:1,03-3,44), suspeita de depressão (RP= 6,10:1,44-25,76), ter ficado deitado por causa de dor nos últimos sete dias (RP= 2,83:1,24-6,49), e referir dor forte/pior dor possível ao repouso (RP=2,72:1,19-6,49). Avaliar os idosos sob a ótica funcional e de autoavaliação de saúde pode favorecer a abordagem multiprofissional e contribuir na identificação de fatores predisponentes à deterioração da saúde. Ressalta-se a necessidade de readequação da prática assistencial em Instituições de Longa Permanência para Idosos.

Abstract This study is focused on the self-care of home-dwelling elderly people living in Slovenia. The study has two phases. The purpose of the first phase is to describe the self-care of home-dwelling elderly people living in Slovenia and factors connected to self-care. The purpose of the second phase is to describe the experiences of the elderly people's ability to manage at home. The aim of this study was to produce new knowledge about the self-care of home-dwelling elderly people living in Slovenia and the factors connected with it. The knowledge will be used to develop elderly care and support eldery people who live at home. The knowledge can be also used to educate nurses to care for the elderly people. The study was both quantitative and qualitative. In the quantitative study the sample consisted of 302 home-dwelling elderly people who were clients in domiciliary care. The selection criteria was: aged 75 years or over and the ability to communicate, no hearing problems, no severe mental problem/cognitive disability and gave full consent for their participation. The whole instrument consists of 91 items. A instrument covers background data, types of self-care, self-care orientation, life satisfaction, self-esteem and functional ability. In the qualitative study, 20 interviews were carried out and a qualitative analysis obtained. Data collection methods included open-ended questions concerning the following topics: background data, types of self-care, self-care orientation, life satisfaction, self-esteem and functional ability. Based on factor analyses, four factors were found which described the self-care. All other factors describe elderly people's perceptions concerning either the past or the future. The elderly people who are able to manage their daily activities/routines have a good functional capacity, good family relations, live qualitatively, accept the future healthily and clearly and are satisfied with their life because they can take care of themselves, but their self-esteem is not so high. Those elderly people who do not take care of themselves are abandoned; they are not satisfied with their way of life and have low-esteem. The results are going to be the basis for planning care and nursing care for all caregivers, especially community nurses. On the basis of this result the model of nursing and social care for home - dwelling elderly people living in Slovenia could be planned. / Tiivistelmä Tutkimuksessa selvitetään Sloveniassa asuvien ikääntyneiden itsestä huolenpitoa. Tutkimus on kaksivaiheinen. Ensimmäisen vaiheen tarkoituksena oli kuvata slovenialaisten ikääntyneiden itsestä huolenpitoa ja siihen yhteydessä olevia tekijöitä. Toisen vaiheen tarkoituksena oli kuvailla ikääntyneiden kokemuksia itsestä huolenpidosta. Tutkimuksen tavoitteena oli tuottaa tietoa slovenialaisten ikääntyneiden kotona asuvien itsestä huolenpidosta. Tietoa voidaan käyttää tuettaessa ikääntyneitä asumaan kotona. Lisäksi sitä voidaan käyttää hoitotyöntekijöiden koulutuksessa. Tutkimuksessa käytettiin sekä määrällistä että laadullista lähestymistapaa. Määrällisen tutkimuksen otos oli 302 kotona asuvaa slovenialaista ikääntynyttä. Kriteerinä oli vähintään 75 vuoden ikä ja kommunikaatiokyky. Kyselylomake sisälsi 91 väittämää. Siinä oli taustatietokysymyksiä, itsestä huolenpitoon, itsestä huolenpitoon orientoitumiseen, elämään tyytyväisyyteen, itsearvostukseen ja toimintakykyyn liittyviä kysymyksiä. Laadulliseen tutkimukseen osallistui 20 henkilöä. He olivat antaneet suostumuksena haastatteluun tutkimukseen ensimmäisessä vaiheessa. Haastattelut sisälsivät avoimia kysymyksiä koskien itsestä huolenpitoa. Tulosten mukaan neljä faktoria kuvasi itsestä huolenpitoa muut faktorit kuvasivat ikääntyneiden suhdetta menneisyyteen ja tulevaisuuteen. Niillä ikääntyneillä, jotka hallitsivat päivittäiset toiminnot oli hyvä toimintakyky, hyvät perheenjäsenten väliset suhteet, he olivat elämään tyytyväisiä ja hyväksyivät tulevaisuuden. Heidän itsetuntonsa ei ollut hyvä. Ne ikääntyneet, jotka eivät pitäneet huolta itsestään olivat omapäisesti itsestä huolehtimiseen suhtautuvia. He eivät olleet elämään tyytyväisiä ja heillä oli matala itsetunto. Tutkimus tuloksia tullaan hyödyntämään kehitettäessä ikääntyneiden kotihoitoa. Tulosten perusteella tullaan kehittämään malli miten ikääntyneiden kotona asumista voidaan tukea.

Samhället formas genom vårt språk och därför kan mänsklig kommunikation aldrig betraktas som neutral. Trots det missar den samhällsvetenskapliga forskningen ofta att belysa språkets betydelse för hur komplexa sociala fenomen framställs och förstås. Hur och i vilka sammanhang samhälleliga fenomen nämns och diskuteras i media påverkar hur människor uppfattar och förhåller sig till fenomenet i verkligheten. Det är i relationen mellan språk, kommunikation och samhälle den här studien har sitt fokus. Studien syftar till att undersöka hur diagnosen ADHD framställs i svenska dagstidningar. Studien har för avsikt att undersöka hur dagstidningstexter framställer ADHD i perspektiv som fokuserar på diagnos och funktionsförmåga. Vidare syftar studien till att belysa hur individuella erfarenheter och upplevelser skildras i dagstidningstexter. Tre svenska dagstidningar har valts ut och utifrån dessa har artiklar som berör ADHD analyserats. För att kunna uppfatta och förstå mönster och strukturer i texter som framställer ADHD är studiens utgångspunkt diskursteori. Diskurser fungerar som ett raster för vad som kan sägas, tänkas och skrivas om ett visst fenomen. Mänskliga handlingar och skeenden får genom diskurser en objektiv status vilket får effekten att de blir förgivettagna. Materialet i studien har analyserats med utgångspunkt i Norman Faircloughs kritiska diskursanalys som syftar till att belysa hur diskurser producerar och reproducerar ojämlika maktförhållanden i samhället. Resultatet tyder på att ADHD skildras ur ett antal återkommande diskurser, där främst en medicinsk diskurs dominerar. Personer som kommer till tals eller skildras i texterna upplevs ha ett motsägelsefullt förhållande till diagnosen. Det finns ett behov av att befinna sig inom diskursen för att ha rätt till samhällets stöd. Samtidigt motsätter sig personerna diagnosens stigmatiserande effekter. Studiens resultat visar att ADHD inte låter sig förklaras genom enstaka diskurser. Det krävs, precis som Fairclough hävdar, ett kritiskt ifrågasättande av intertextuella sammanhang för att förstå komplexiteten i ett fenomen som ADHD. / Society is shaped by our language and therefore human communication can never be considered neutral. Nevertheless, social science research often misses the importance of language for how complex social phenomena are produced and understood. How and in which contexts social phenomena are mentioned and discussed in the media affect how people perceive and relate to the phenomenon of reality. It is in the relationship between language, communication and society this study has its focus. The study aims at investigating how the diagnosis ADHD is presented in Swedish daily newspapers. The study intends to investigate how daily newspapers present ADHD in perspective that focuses on diagnosis and functional ability. Furthermore, the study aims at illustrating how individual experiences and events are depicted in newspaper articles. Three Swedish daily newspapers have been selected and from these, articles concerning ADHD have been analyzed. To detect and understand patterns and structures in texts that concern ADHD, the study takes origin in the discourse theory. Discourses act as a filter for what can be said, thought and written about a certain phenomenon. Human acts and occurrences are given an objective status through the discourse, which causes them to be taken for granted. The material in the study has been analyzed based on Norman Fairclough's critical discourse analysis aimed at illustrating how discourses produce and reproduce an uneven balance of power in society. The result suggests that ADHD is described by many recurring discourses, primarily dominated by a medical discourse. Persons who are spoken or portrayed in the texts are found to have a contradictory relationship to the diagnosis. There is a need to be in the discourse to be entitled to community support. At the same time, the individuals oppose to the stigmatizing effects of the diagnosis. The results of the study show that ADHD cannot be explained by single discourses. It is necessary, as Fairclough claims, to have a critical questioning of intertextual contexts to understand the complexity of a phenomenon such as ADHD.

Human health is multidimensional: apart from physical, mental, and social aspects, it also incorporates subjective perceptions of health, and functional status (FS). Given that elderly persons have very distinctive health and social needs, multidimensional assessment (MA) of health proves particularly useful in this age group.¶ Aboriginal populations suffer poor health, and there are relatively few studies addressing the health problems of older Aboriginal Australians, mainly because of their distinctive demographic structure, and the low proportion of their elderly. Also, there is no prior information available on MA of health in this Australian population group.¶ This thesis offers a MA of health in older Aboriginal persons from two, urban and rural/isolated, locations in the NT, Katherine and Lajamanu (the NT survey).¶ This thesis specifically addresses the following questions: - what is the physical health, FS, subjective perception of health, and social functioning amongst the NT survey participants? - what are the possible similarities and differences in various dimensions of health between the two major survey locations, what age and gender patterns are observed, and what are the reasons for these patterns, similarities and differences? - how do various dimensions of health relate to each other, and why? - how do current findings relate to broader Aboriginal and non-Aboriginal populations, and why? - what can MA add to a better understanding of various aspects of morbidity and health care use? - what are its possible implications for health planning?¶ Findings from this work indicate poor physical health amongst participants in almost all investigated aspects, comparable to information available from other Aboriginal populations. These are accompanied by low levels of ability for physical functioning. Despite this, subjective perception of health is rather optimistic amongst participants, and levels of social functioning high. Use of health services is mainly related to available health infrastructure. Important health differences exist between Katherine and Lajamanu, and they became particularly visible when all dimensions of health are considered together.¶ The Main conclusions from the current work are that 1) poor physical health is not necessarily accompanied by similar level of deterioration in other dimensions of health: even though participants from the isolated community of Lajamanu experience most chronic diseases, their ability for physical functioning is better, self-perceived health (SPH) more optimistic and levels of social functioning highest 2) institutionalised participants from Katherine suffer by far the worst health of all sample segments in this study; at least some of the poor health outcomes are potentially avoidable, and could be improved by more appropriate residential choices for Aboriginal elderly 3) better health infrastructure does not necessarily bring better health in all its dimensions, suggesting that other factors (primarily socio-economic and cultural) should be addressed in conjunction with this in solving complex health problems of Aboriginal Australians, and 4) it provides strong support that MA can become a useful tool in comprehensive health assessment of older Aboriginals.

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