Fatigue secondary to chronic illness (FSCI) is a common experience in individuals with chronic conditions, with fatigue impacting on performance of daily activities and health-related quality of life (HRQoL). Due to the higher prevalence of FSCI in women, they may experience even greater disruption to roles and activity engagement. The literature consistently points to three main aspects when defining fatigue regardless of diagnoses; a physical aspect, a psychological aspect, and the impact on activity and participation. Research into the first two aspects has demonstrated relationships between fatigue, pain, depression, and social support. However, examination of the third aspect has been largely overlooked with respect its relationship to, and impact on, fatigue. Leisure theorists have hypothesized that engagement in leisure activities makes a positive contribution to physical and mental health. Previous research has measured leisure activities based on frequency of, or satisfaction with, participation. While some research has shown that physical and social activities have positive health benefits, gaps still exist in understanding the relative contribution of different types of leisure participation to fatigue and HRQoL.For example, little research has examined the contributions of leisure participation and leisure satisfaction to HRQoL and fatigue in women with chronic conditions. One explanation for the lack of research may be the absence of measurement tools developed to classify and quantify participation in different types of leisure activities for women with FSCI. Without a measurement tool, the relative contribution of participation in different activities (by frequency and/or satisfaction) to fatigue and HRQoL cannot be examined. / This PhD research aimed to fill the current gaps in understanding different types of leisure participation in related to fatigue and HRQoL. It sought to address two component parts: development and testing of the Classification of Leisure Participation (CLP) Scale; and an examination of the contribution of leisure participation to fatigue and HRQoL in women with FSCI.

Thesis (Ph.D.)--University of Tulsa, 1993. / Includes bibliographical references (leaves 73-78).

Diss. (sammanfattning) Linköping : Linköpings universitet, 2007. / Härtill 4 uppsatser.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2006. / Härtill 4 uppsatser.

Thesis (M.S.)--University of Wisconsin--Madison, 1990. / Typescript. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 102-104).

Este trabalho traz algumas considerações e problematizações das políticas sobre drogas, transcorrendo pela história da Redução de Danos em seu percurso clínicopolítico desde o campo da AIDS e sua transição como diretriz de trabalho para o cuidado a pessoas que usam álcool e outras drogas no campo da saúde mental. Para isso, utilizamo-nos do Método da Roda, que serviu também para pensar o papel do apoiador institucional e a cogestão de coletivos, para nos aproximamos de um município em que foi possível acompanhar os modos de andar a redução de danos também no campo micropolítico e, assim, pensar nessa transição e nas perspectivas de trabalho para a atenção básica. Com isso, apresentamos a Redução de Danos como tecnologia leve de cuidado, que circula pelo território e acompanha os diferentes modos de andar a vida, que está atravessada pelos impasses da Reforma Psiquiátrica e pela precarização do trabalho, que acompanha o trabalho da redução de danos desde o seu início e que se atualiza neste campo de pesquisa. / This essay brings some consideration and render problematily of the politics about drugs, elapsing between harm reduction in its political clinical course since Aids field and its transition as guideline of working to care to people that use alcohol and other drugs in the mental health field. For this, we use the wheel method, that fit also to think about the institucional supportes role and the co-management of collective to approach to a county that was possible to follow the way of the harm damage goes and also in the micropolitical field and, so, think about this transition and in the work perspectives to the basic attention. Therewith, we show the harm reduction as light care technology, that moves within the territory and follows the different ways of livong life, that is crossed by impasses of the psychiatric reform and by Precariously of the work, that follows the harm reduction work since its updates in this research field.

The dementias are illnesses which have significant cultural prominence and feature in a wide range of contemporary writing, often as a trope for old age. This thesis examines how stories of dementia are told in fiction and in the clinic. To do this, the work uses Arthur Frank's socio-narratology to examine twelve selected texts in which a key protagonist has dementia. Three of the selected texts have been written by authors with direct experience of dementia within their family and form a subset of texts, memoir fiction. How stories of dementia are told is considered by examining the clinic as a storytelling venue, the creation of faux medical notes from information in the texts and a Triple Analysis of the memoir fiction using three reading templates. The templates have been created from clinical practice, using the questions posed by Frank's socio-narratological practice of Dialogical Narrative Analysis, and using the parameters of Rita Charon's version of Close Reading drill in Narrative Medicine. The work is informed by autoethnography which uses my position as a clinician and reader to examine how fiction has been used in my clinical practice and how it informs my reading of the selected texts.

Este trabalho traz algumas considerações e problematizações das políticas sobre drogas, transcorrendo pela história da Redução de Danos em seu percurso clínicopolítico desde o campo da AIDS e sua transição como diretriz de trabalho para o cuidado a pessoas que usam álcool e outras drogas no campo da saúde mental. Para isso, utilizamo-nos do Método da Roda, que serviu também para pensar o papel do apoiador institucional e a cogestão de coletivos, para nos aproximamos de um município em que foi possível acompanhar os modos de andar a redução de danos também no campo micropolítico e, assim, pensar nessa transição e nas perspectivas de trabalho para a atenção básica. Com isso, apresentamos a Redução de Danos como tecnologia leve de cuidado, que circula pelo território e acompanha os diferentes modos de andar a vida, que está atravessada pelos impasses da Reforma Psiquiátrica e pela precarização do trabalho, que acompanha o trabalho da redução de danos desde o seu início e que se atualiza neste campo de pesquisa. / This essay brings some consideration and render problematily of the politics about drugs, elapsing between harm reduction in its political clinical course since Aids field and its transition as guideline of working to care to people that use alcohol and other drugs in the mental health field. For this, we use the wheel method, that fit also to think about the institucional supportes role and the co-management of collective to approach to a county that was possible to follow the way of the harm damage goes and also in the micropolitical field and, so, think about this transition and in the work perspectives to the basic attention. Therewith, we show the harm reduction as light care technology, that moves within the territory and follows the different ways of livong life, that is crossed by impasses of the psychiatric reform and by Precariously of the work, that follows the harm reduction work since its updates in this research field.

No description available.

O Agente Comunitário de Saúde (ACS) tem sua inserção recente nas práticas de saúde, com a profissão sendo reconhecida legalmente em 2002. Sua atuação se dá no contexto do Sistema Único de Saúde, constituindo-se em novas oportunidades no mercado de trabalho. Como pré-requisitos para o exercício da profissão, a lei estabelece: I- residir na área da comunidade que atuar; II- haver concluído com aproveitamento o curso de qualificação básica para formação de ACS; III- haver concluído o ensino fundamental. O ACS deve trabalhar com a adscrição de famílias, tendo sob sua responsabilidade no máximo 150 famílias ou 750 pessoas, em base geográfica definida. O ACS, deve ainda desenvolver atividades de prevenção das doenças e promoção da saúde, por meio de visitas domiciliares e de ações educativas individuais e coletivas, nos domicílios e na comunidade, sob supervisão e acompanhamento do enfermeiro instrutor-supervisor. A complexidade da atuação do ACS sugere que, como profissional da saúde, esteja exposto a situações que o colocam sob estresse. Este estudo propôs identificar através das percepções que os ACS têm sobre seu trabalho, eventos que provocam sobrecarga e como lidam com eles. Utilizou-se o modelo de Lazarus e Folkman de estresse e enfrentamento. Para operacionalizá-los recorreu-se à produção de conhecimento na área quanto aos dois aspectos abordados. Este é um estudo descritivo, qualitativo. Participaram do estudo 16 ACS de equipes de Saúde da Família de São José Rio Preto- SP, e os dados foram coletados por meio de entrevistas gravadas e posteriormente transcritas. A análise centrou-se na identificação das situações consideradas pelos ACS como estressoras e dos mecanismos que utilizam para lidar com eles. As situações estressoras foram agrupadas em categorias: condições de trabalho; questões salariais; gênero; interface família-trabalho e carga emocional. Os mecanismos de enfrentamento foram agrupados em categorias focalizados na emoção e no problema. Considerando as diversas atividades desenvolvidas pelos ACS e a dinâmica da realidade sanitária, acredita-se que os relatos dos sujeitos participantes desta pesquisa, discutidos à luz de outros estudos, contribuam para o planejamento de suas atividades, preparo e capacitação dos futuros profissionais de forma a fortalecê-los para o exercício de seu trabalho. / The community health agent (ACS) is a health worker recently included in health workers staff. This profession was legally created in 2002 and it is part of the Brazilian Unique Health System. This health professional is expected to live in the same community he will work; have completed a training course and the elementary school. Their activities include the register of families and having under responsibility 150 families or about 750 persons, in a limited geographic area. They also achieve activities that aim disease prevention and health promotion by means of home visits and educative actions directed to individuals and community, under supervision of a nurse. The complexity of the agents activities suggests that they are exposed to stressing situations. So the aim of this work is to indentify by ACS s perceptions of stressors at work and coping mechanisms. The theoretical model was that of Lazarus and Folkman that focuses stress and coping. To operationalize the model other works relating to this one were accessed. This is a descriptive and qualitative research. Sixteen community health agents from ESF teams in a inner city of São Paulo state were interviewed. The interviews were recorded and transcribed. The analysis focused the work events the agents perceived as stressors and also the coping mechanisms they used to face them.The stressful events were grouped into categories: work conditions; salary; gender; relationship family and work e emotional burden. The coping mechanisms were grouped into emotional oriented and problem oriented. Considering the wide range of activities the health community workers achieve, the dynamic of sanitary situation and how they understand them, it is possible that these results in comparison to others may contribute to health agents educative programs including some emotional support as well.