Protective factors against problem gambling are important to study, and this thesis focuses on religious affiliation and family solidarity. In this study, 100 Métis Ontarians aged 46-88 completed a cross-sectional survey. The relationships of problem gambling risk with alcohol misuse, age, gender, religious affiliation, and family solidarity were explored. Intergenerational religious concordance (passing down religious affiliation through generations) was examined in the context of healthy family functioning. A qualitative research question asked participants about the potential relationship between religious beliefs and gambling behaviour. Participants at moderate or high risk of problem gambling (score of two or more on the Problem Gambling Severity Index) were more likely than those at no or low risk to say that they perceive a relationship between their gambling behaviour and their religious beliefs. / Canadian Institutes of Health Research, Ontario Problem Gambling Research Centre

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Submitted by Daniele Amaral (daniee_ni@hotmail.com) on 2016-09-30T20:01:57Z No. of bitstreams: 1 DissAGB.pdf: 5457544 bytes, checksum: 990a9b49aed6e9edda6eb4ff1c898f94 (MD5) / Approved for entry into archive by Marina Freitas (marinapf@ufscar.br) on 2016-10-10T17:39:25Z (GMT) No. of bitstreams: 1 DissAGB.pdf: 5457544 bytes, checksum: 990a9b49aed6e9edda6eb4ff1c898f94 (MD5) / Approved for entry into archive by Marina Freitas (marinapf@ufscar.br) on 2016-10-10T17:39:35Z (GMT) No. of bitstreams: 1 DissAGB.pdf: 5457544 bytes, checksum: 990a9b49aed6e9edda6eb4ff1c898f94 (MD5) / Made available in DSpace on 2016-10-10T17:39:44Z (GMT). No. of bitstreams: 1 DissAGB.pdf: 5457544 bytes, checksum: 990a9b49aed6e9edda6eb4ff1c898f94 (MD5) Previous issue date: 2016-02-24 / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / This study aimed to analyze the relationship between cognition, frailty, urden and depressive symptoms in older caregivers from rural communities of Sao Carlos, Brazil. The study was exploratory and analytical. Approved by the Ethics Committee of the interviews were conducted in homes with two or more elderly. We used scales for basic activities (BADL) and instrumental (IADL) of daily living evaluation(Katz and Lawton), sociodemographic and care information forms, the Addenbrooke’s Cognitive Examination - Revised (ACE-R), that includes the Mini Mental State Examination (MMSE) for global cognitive assessment and domains (Attention/Orientation, Memory, Verbal Fluency, Language and Visospatial Skills), frailty evaluation according to Fried’s phenotype (weight loss, fatigue, weakness, slowness and low levels of physical activity), Zarit Burden interviw for assessment of caregiver burden and, in addition, the Geriatric Depression Scale (GDS). We interviewed in homes 85 pairs of elderly (85 elderly care recipients and their older caregivers 85). The elderly who were receiving care, most were male (n = 60; 70.5%), mean age of 72 years and 3.78 years of education, pre-frail (42.8%) and with significant frequency cognitive impairment (CI) (45.9%). The elderly caregivers were mostly women (76.7%). The average age was 69 years and 4.35 years of education. Regarding the context of care, 89.4% were taking care of their spouses, an average of 145.68 months (about 12 years), and received help for care (76.5%). The average score for ACE-R was 68.78 points and 24.44 points for the MMSE. 15.3% of caregivers showed evidence for CI, 9.4% were classified as frail, 52.9% were pre-frails and 37.6% non-frails/robusts, 67.1% were classified with a small burden, 24.7% had a moderate burden, 8.2% had severe burden and 84.7% showed no depressive symptoms. Comparison analysis showed that groups with higher levels of burden and frailty had worse cognitive performance and more depressive symptoms compared to those non frails and less burdened. Regression analysis showed that being pre frail represents a decrease of almost 12 points in the ACE-R, in the univariate model, and 8.6 points in the multiple model, interestingly being frail decreased 28 points in the cognitive battery if it is analyzed in the univariate model. In both models, theburden is associated with poor cognitive performance, This association is more intense in the univariate model (β = -7.83; p = 0.02). Being a burdened caregivers decreased nearly 8 points in cognitive battery (p = 0.04), as evidenced in the multiple model. This shows that not only the frail condition, but also burden condition represent a negative relationship with the cognitive performance in older caregivers in rural context. The older caregiver in this context certainly experiences working within the available resources. Longitudinal studies may be ways for in-depth knowledge on the subject. It is recommended the study of variable stress and its relationship to cognitive frailty in caregivers and seek to understand the differences between rural and urban. / O objetivo principal deste estudo foi analisar a relação entre cognição, fragilidade, sobrecarga e sintomas depressivos em idosos cuidadores em comunidades rurais de São Carlos-SP. O estudo foi exploratório e analítico. Aprovado pelo Comitê de Ética da Universidade Federal de São Carlos (Processo no. 517.182/14). Para identificação dos possíveis cuidadores foi realizado inquérito domiciliar em residências com dois e mais idosos e aplicados critérios para identificação. Foram utilizados para a coleta de dados Escalas de Atividade Básica (ABVD) e Instrumentais (AIVD) da Vida Diária (Katz e Lawton), instrumentos de caracterização sociodemográfica e do cuidado, o Exame Cognitivo de Addenbrooke – Revisado (ACE-R), que contempla o Mini Exame do Estado Mental (MEEM) para avaliação cognitiva global e de domínios (Atenção/Orientação, Memória, Fluência Verbal, Linguagem e Habilidades Visuespaciais), avaliação da fragilidade segundo os critérios de Fried et al. (perda de peso, fadiga, fraqueza, lentidão e baixo nível de atividade física), Inventário de Sobrecarga de Zarit para avaliação da sobrecarga do cuidador e, adicionalmente, a Escala de Depressão Geriátrica (EDG). Foram entrevistados no domicilio 85 pares de idosos (85 idosos receptores de cuidado e seus 85 idosos cuidadores). Dos idosos que eram receptores de cuidado, a maioria era homem (n=60; 70,5%), idade média de 72 anos e 3,78 anos de escolaridade, pré-frágil (42,8%) e com importante frequência de alterações cognitivas (AC) (45,9%). Os idosos cuidadores eram em sua maioria mulher (76,7%). As médias de idade delas era de 69 anos e 4,35 anos de escolaridade. Com relação ao contexto do cuidado, 89,4% estavam cuidando de seus cônjuges, numa média de 145,68 meses (mais ou menos 12 anos), e recebiam ajuda para o cuidado (76,5%). A média de pontos para o ACE-R foi de 68,78 pontos e de 24,44 pontos para o MEEM. Dos cuidadores, 15,3% apresentaram indício de AC, 9,4% foram classificados como frágeis, 52,9% pré frágeis e 37,6% robustos, 67,1% foram classificados com uma pequena sobrecarga, 24,7% com uma moderada sobrecarga, 8,2% com uma sobrecarga severa e 84,7% da amostra não apresentaram sintomas depressivos. Análises de comparação mostraram que os grupos com maiores níveis de sobrecarga e fragilidade apresentam pior desempenho cognitivo e mais sintomas depressivos comparados aqueles não frágeis e menos sobrecarregados. As análises de regressão mostraram que ser pré frágil representa a diminuição de quase 12 pontos no ACE-R, no modelo univariado, e 8,6 pontos no modelo múltiplo, interessantemente ser frágil representa uma queda de até 28 pontos na bateria se esta for analisada no modelo univariado. Em ambos os modelos, a sobrecarga está associada ao pior desempenho cognitivo, sendo que a associação mais intensa é no modelo univariado (β=- 7,83; p=0,02). Fazer parte da porção de cuidadores acima da mediana de sobrecarga (>16), ou consistir em grupo mais sobrecarregado, representa uma queda de quase 8 pontos na bateria (p=0,04), evidenciado no modelo múltiplo. Isso mostra que não só a condição de fragilidade, mas também a condição de sobrecarga representam uma relação negativa com o desempenho cognitivo de idosos cuidadores em contexto rural. O cuidador que é idoso nesse contexto certamente vivencia e trabalha suas experiências em função dos recursos disponíveis ao seu alcance. Estudos longitudinais podem ser caminhos para o conhecimento aprofundado no tema. Recomenda-se o estudo da variável estresse, e sua relação com a Fragilidade Cognitiva nos cuidadores, bem como buscar compreender as divergências entre o rural e urbano.

Made available in DSpace on 2015-03-05T20:05:12Z (GMT). No. of bitstreams: 0 Previous issue date: 24 / Nenhuma / Objetivo de conhecer a percepção dos profissionais de equipes do PSF a respeito das configurações familiares e a compreensão de família saudável. Metodos de pesquisa de abordagem qualitativa, empregando a técnica de grupo focal com profissionais do PSF do município de Campo Bom – RS. A amostra foi composta por 12 profissionais: médicos, enfermeiras, técnicas de enfermagem e agentes comunitárias de saúde. O instrumental metodológico utilizado foi a análise de conteúdo.Resultados: Os profissionais identificam e respeitam as diferentes configurações familiares, e adaptam o tratamento ao modelo de família que se apresenta. Conclusões: Disposição dos profissionais em lidar com os múltiplos arranjos familiares presentes no seu cotidiano / Objective this work aims to know the perception of a health care group professionals towards the families structures and their comprehension of a healthy family. Method it consists of a quality approach research, using the focal technical group with professionals of a health family program from Campo Bom – RS. The sample was composed by 12 professionals: physicians, nurses, nursing technician and health community agents. The methodological tool used was the content analysis. Results the professionals identify and respect the different family configurations, and adapt the medical treatment to the family that presents. Conclusion: The professional’s disposition to deal with the various families arrangements that are present in their quotidian

This thesis is focusing on families at risk of social failure in the Region of Karlovy Vary. The aims of this work are outlining social situation in the Region of Karlovy Vary, mapping network of social service for families at risk of social failure and finding out the most frequent problems these families are struggle with. Outputs are the recommendations for SOS Children's Villages in Doubí in Karlovy Vary based on above presented findings that tells which services for families at risk would be advisable to set up. In theoretical part of final thesis is defined the concept of family at risk and then based on foreign experiences are cited the principles of how to work with these families. Practical part is build on study of feasibility realizes by SOS Children's Villages Association, which was finding out neediness of social services for families at risk and children in the Region of Karlovy Vary, where this organization is considering realization of programs for family support.