"At present, the actual placing of a child in the home is the only real test of whether this home has use for the agency. This seems to social workers to be a risky method. Through analysis of factors involved in success and failure, we may be able to further eliminate some of the element of chance which we now face. There has been comparatively little work done in this area. Through this study it is hoped that caseworkers will become more familiar with some of the factors which seem to operate in success and failures. It is also hoped that by pointing out some of the dynamics behind failure, caseworkers will be aided in the home study process. The tentative conclusions reached in this paper may provide basis for further study"--Introduction. / Typescript. / "May, 1950." / "Submitted to the Graduate Council of Florida State University in partial fulfillment of the requirements for the degree of Master of Arts under Plan II." / Advisor: Margaret B. Bailey, Professor Directing Paper. / Includes bibliographical references (leaf 54).

À medida que o ser humano envelhece as doenças crônicas tornam-se mais frequentes, o que faz com que os idosos necessitem de mais atenção à saúde. Paralelo a este cenário, a estrutura familiar brasileira vem passando por modificações e, atualmente, fica cada vez mais difícil que o cuidado fornecido ao idoso venha de membros da família. Muitas empresas privadas já contam com a oferta de cuidadores de idosos para atendimento domiciliar, outras poucas estão utilizando um novo formato de assistência à saúde do idoso, com a inclusão de gerontólogos na gestão do cuidado. Objetivo: compreender o significado do gerontólogo bacharel como gestor do cuidado formal domiciliar, através da perspectiva dos gerontólogos e cuidadores formais envolvidos diretamente no cuidado ao idoso. Método: A pesquisa foi qualitativa e teve como referencial metodológico a fenomenologia social. Foram entrevistados 20 participantes, que trabalhavam em empresas de atendimento domiciliar localizadas na cidade de São Paulo, sendo 15 cuidadores formais e cinco gerontólogos. Os depoimentos foram coletados por meio de perguntas norteadoras, gravados e transcritos. Para análise dos dados foi realizada a categorização dos significados a partir da redução fenomenológica. Resultados: a partir dos depoimentos foi possível verificar que os gerontólogos zelam pelo cuidado à saúde do idoso; capacitam e orientam os cuidadores de idosos; dão suporte integral e eficaz aos cuidadores; administram as informações; dão orientação e suporte aos familiares; unem a equipe interprofissional, familiares e cuidadores; gerenciam os conflitos familiares; auxiliam o cuidador no processo de adaptação com o paciente; entre outras categorias. Conclusão: A compreensão dos significados do gerontólogo como gestor do cuidado formal domiciliar mostra que este profissional, com sua formação generalista e interdisciplinar sobre o envelhecimento e a velhice, consegue desenvolver uma visão integral do idoso, compreender e atender suas necessidades biopsicossociais, trabalhar em equipe e atuar ativamente na assistência. Todos os cuidadores entrevistados apresentam uma visão definida e positiva em relação à atuação do gerontólogo. Enfatizaram que a falta de uma gestão gerontológica afeta diretamente na qualidade do cuidado prestado ao idoso / As the human being ages, chronic diseases become more frequent, which makes the elderly need more attention to health. In parallel to this scenario, the Brazilian family structure has been undergoing changes and, at present, it is increasingly difficult for the family members to provide the care needed by the elderly. Many private companies already have the supply of caregivers of elderly people for home care, others are using a new form of health care for the elderly, with the inclusion of gerontologists in the management of care. Objective: to understand the meaning of the bachelor gerontologist as manager of the formal home care, from the perspective of gerontologists and formal caregivers directly involved in care for the elderly. Method: The research is qualitative and had as methodological reference the social phenomenology. Twenty participants were interviewed, who work in home care companies located in the city of São Paulo, 15 formal caregivers and five gerontologists. The testimonies were collected through guiding questions, recorded and transcribed. For the analysis of the data the categorization of the meanings was carried out from the phenomenological reduction. Results: from the testimony it was possible to verify that the gerontologists: care for the health care of the elderly; train and mentor caregivers of the elderly; provide comprehensive and effective support to caregivers; manage the information; give guidance and support to family members; unite interprofessional staff, family members and caregivers; manage family conflicts; assist the caregiver in the process of adaptation with the patient; among other categories. Conclusion: The understanding of the gerontologist\'s meanings as a manager of formal home care shows that this professional, with his general and interdisciplinary training on aging and old age, is able to develop an integral view of the elderly, understand and respond to their biopsychosocial needs, work as a team and act actively in the care. All caregivers interviewed present a definite and positive view regarding the performance of the gerontologist. They emphasized that the lack of gerontological management directly affects the quality of care provided to the elderly

Submitted by Sara Ribeiro (sara.ribeiro@ucb.br) on 2018-04-18T16:59:11Z No. of bitstreams: 1 AngelitaGiovanaCaldeiraDissertacao2017.pdf: 2000891 bytes, checksum: b54fc8fc1c7bd3e7df44fce2dbeb0a25 (MD5) / Approved for entry into archive by Sara Ribeiro (sara.ribeiro@ucb.br) on 2018-04-18T16:59:27Z (GMT) No. of bitstreams: 1 AngelitaGiovanaCaldeiraDissertacao2017.pdf: 2000891 bytes, checksum: b54fc8fc1c7bd3e7df44fce2dbeb0a25 (MD5) / Made available in DSpace on 2018-04-18T16:59:27Z (GMT). No. of bitstreams: 1 AngelitaGiovanaCaldeiraDissertacao2017.pdf: 2000891 bytes, checksum: b54fc8fc1c7bd3e7df44fce2dbeb0a25 (MD5) Previous issue date: 2017-12-11 / Home care of the population in the Federal District (DF) is carried out nowadays by the Regional Centers for Home Care (NRAD's), located in the seven health regions of the Federal District, which provide care for all age groups, including the population in study - the elderly. The care takes place through a multiprofessional team, having the nurse important role in the program. The objective of this research was to describe the profile of the elderly assisted by the Home Care Program (PID) of the Regional Nucleus of Home Care (NRAD) of the South - Gama - DF health region from 2006 to 2016. This is a longitudinal study, descriptive, exploratory, quantitative approach with data from the medical records of the elderly patients admitted to the program. As a result, it was found that the female population (50.6%), married (52.5%), retired (68.8%), brown (57.5%), and the most prevalent age group is elderly people, that is, between 80 and 89 years (31.2%). The Catholic religion was the most dominant (56.9%), as well as the naturalness of the northeastern region (62.5%). The knowledge of the program was through the hospital (78.8%). The most evident reasons for hospitalization were neoplasias (43.7%), followed by Stroke (22.5) with prevalence longer than 180 days (44.3%). As diseases associated with Systemic Arterial Hypertension (SAH) and Diabetes Mellitus (DM) were the most frequent (56.2% and 25.0%). The most developed procedures were the verification of vital signs (99.3%), oximetry (88.1%), monitoring of capillary glycemia (65.6%), followed by dressing (37.5%), venous puncture (36.8%) and nasoenteric catheter, bladder of relief and delay (15.0%, 13.1% and 8.1%). At the time of admission, the main drug class in use was antihypertensive (51.8%) and 81 patients (50.6%) used 5 or more drugs. In conclusion, home hospitalization is of utmost importance to the elderly person affected by pathologies, where knowing the patient attended assists in their better follow-up, in addition to performing care that seeks to achieve the well-being of the patient in question. / O atendimento domiciliar da popula????o no Distrito Federal (DF) ?? realizado nos dias atuais pelos N??cleos Regionais de Aten????o Domiciliar (NRAD???s), situados nas sete regi??es de sa??de do DF, os quais realizam a assist??ncia de todas as faixas et??rias, incluindo a popula????o em estudo ??? os idosos. O atendimento ocorre atrav??s de uma equipe multiprofissional, tendo o enfermeiro papel importante no programa. O objetivo desta pesquisa foi descrever o perfil dos idosos atendidos pelo Programa de Interna????o Domiciliar (PID) do N??cleo Regional de Aten????o Domiciliar (NRAD) da regi??o de sa??de sul - Gama -DF, de 2006 a 2016. Trata-se de um estudo longitudinal, descritivo, explorat??rio, de abordagem quantitativa com dados dos prontu??rios dos pacientes idosos admitidos/atendidos no programa. Como resultado encontrou-se que a popula????o usu??ria deste servi??o, ?? em sua maioria do sexo feminino (50,6%), casada (52,5%), aposentada (68,8%), cor parda (57,5%) e a faixa et??ria mais prevalente ?? a de idosos com idade mais avan??ada, ou seja, entre 80 a 89 anos (31,2%). A religi??o cat??lica foi a mais dominante (56,9%), assim como, a naturalidade proveniente da regi??o nordeste (62,5%). O conhecimento do programa foi atrav??s do hospital (78,8%). Os motivos da interna????o mais evidentes no programa foram as neoplasias (43,7%), seguidas do Acidente Vascular Encef??lico ??? AVE (22,5%), com tempo de interna????o prevalente maior que 180 dias (44,3%). Como doen??as associadas ?? Hipertens??o Arterial Sist??mica (HAS) e Diabetes Mellitus (DM) foram as mais encontradas (56,2% e 25,0%). Os procedimentos mais desenvolvidos pela Enfermagem foram a verifica????o dos sinais vitais (99,3%), oximetria (88,1%), monitoriza????o da glicemia capilar (65,6%), seguidos de curativo (37,5%), pun????o venosa (36,8%) e sonda nasoent??rica, vesical de al??vio e demora ( 15,0%, 13,1% e 8,1%). No momento da admiss??o, a principal classe medicamentosa em utiliza????o foi a de anti-hipertensivos (51,8%) e 81 pacientes (50,6%) faziam uso de 5 ou mais medicamentos. Concluindo, a interna????o domiciliar ?? de suma import??ncia ao idoso acometido por patologias, onde conhecer o paciente atendido auxilia no seu melhor acompanhamento, al??m da realiza????o de cuidados que buscam alcan??ar o bem estar do paciente em quest??o.

This dissertation focuses on how perceptions of ethnicity and culture become meaningful in relation to the transition from care into independent living, studied from unaccompanied youths’, professionals’, and a methodological perspective. The findings from interviews with unaccompanied youth with experience of leaving care showed that thoughts about their ethnic minority background are constantly present in the young men’s lives. Their stories about preparing to leave care show a continuous attempt to make adjustments in order to fit into the Swedish society (Study I). The results based on interviews with professionals and observations at two residential care units indicated that ‘home’ is sometimes used as a metaphor when describing the residential care units. The home metaphor affected the staff in ways that it sometimes became difficult to separate private and professional matters. The clash between the residential care unit and the desire to create a home environment highlights the issue that programs executed in Sweden for unaccompanied young people were originally not made for them (Study II). Study III emphasised how transnational relationships form the unaccompanied youths view of past, present, and future time. This study highlighted the importance of how the professionals need to understand the unaccompanied children and youth and their situation as flexible (Study III). Finally, methodological reflections about research concerning ethnicity indicated the importance of reflecting on one’s own perceptions, the role as a researcher, and the benefits and limitations these different roles may have in the research process (Study IV). The research was conducted using qualitative methods. The data collection methods entailed interviews with the youth (Study I), individual interviews, focus-groups, and observations with professionals (Study II and III), and discussions based on the data collected for study I-III (Study IV). Altogether, 11 youths (18-22 years) and about 20 professionals at the residential care units participated in the studies. Qualitative content analysis was used to analyse the individual interviews and the focus-groups. All interviews were transcribed verbatim for analysis. The empirical data from observations consisted of notes taken during everyday situations, as well as from short conversations with the professionals. The notes were analysed using qualitative content analysis. The combined results of study I-III were used as empirical data for the analysis in study IV. This dissertation shows that (re)constructing a home is a central part of the care-leaving process for a migrant about to resettle in a new country. The greatest challenge the unaccompanied youth have to conquer during the transition from care to independent living is to fight against exclusion. The main purpose in (re)constructing a home appears to be the same for the youth and the professionals, namely, to reach a sense of safety and belonging. However, different conditions and points of departure may make it hard to agree on details such as what the meaning of belonging actually is, and if it is possible to develop a tailor-made solution. Researching issues of ethnicity comes with the responsibility to avoid reinforcing an ‘us’ versus ‘them’ and, in so doing, reinforce stereotypes.

Autism is a life-long neurological disease that manifests differently in every autistic person. Children with autism have difficulties with four developmental areas, namely: language and communication, social interaction, imagination, and sensory issues. These behaviours make it extremely difficult to care for, or teach, autistic children as these children often present with behaviours that are psychologically, cognitively and physically challenging. As there is only one government subsidised school with the expertise and support structures to teach and care for autistic children in the Eastern Cape, parents often have no option, but to place such children in residential care in order for the children to receive the expert teaching they need. As a result, hostel housemothers are often placed in parental roles as they provide much of the parenting on a daily basis. Many of these caregivers have their own families that also need support and care. This may place additional burdens on these employees that could lead to a variety of psychological and physical conditions, depending on their resilience, and ability to handle frequent stressful situations. It is for this reason that this study is imperative, as it will uncover the stressors experienced by the hostel housemothers who play such a pivotal role in the lives of autistic children. The results of the study will serve to inform possible future interventions. This is a qualitative study. Participants were obtained through purposive sampling, and data was analysed through a thematic analysis approach. The Salutogenesis theory of Antonovsky was used, which particularly looks at stressors, tension, breakdown, and Salutogenesis. The study has generated, in the researcher, an understanding of how hostel housemothers cope with the stressors of caring for autistic children, and intends to do the same for readers.

The data for this research were taken from Utah's contribution to the regional research project "An Interstate Comparison of Urban/Ruxal Families' Time Use." Data were collected between May 1977 and August 1978 from 210 two-parent/ two-child families. Tlus thesis research studied the rel3.tionsbip between olVners lup and use of nine selected household appliances and time spent on the related housekeeping tasks for 208 of the families studied. Statistical analysis was done using t-tests for comparisons of time spent on the related task by owners and non-owners of each appliance. Analysis of variance was used to compare time spent on combined activities with ownerslup of differing numbers of appliances . The relationship between frequency of use and time spent on tasks was measured us ing the Pearson Product Moment correlation. The hypotheses tested werc: 1. Ownership of home care equipment is not related to the amollnt of time spent in home care tasks . 2. Heported llse of home care eqllipment is not related to the amollfit of time spent in home care tasks . Hypothesis Number 1 was accepted for all rela tionships tested with the exception of the dishwasher and time spent in dishwashing and the sewing machine and time spent in construction of clothing and household linens . The results indicated that the homemal(ers Wl10 owned a dishwasher spent less time in clishwashing than did non-owners. This was not true of the spouses , who spent very little time in dishwashing under either circumstance . The homemalmrs who owned a sewing machine spent conSiderably more time in construction of clothing and household linens than non-owners . When families were grouped by the number of appliances oÄÄ~led , no statistically significant relationships were found to exist between the nwnber of appliances owned and the total time spent in home care tasks . Generally, thoso who owned many or few of the appliances spent more time in home care activities than did owners of four or five of tbe appliances Jlypothesis Number 2 was rejected for the relationships between dishwasher llse and spouse time spent in dishwashing , sewing machine use and hornemal

No description available.

Complications due to stroke account for a significant proportion of admissions to medical wards in Thailand. Unlike western countries where community rehabilitation programs have been established to provide services following the acute stage of stroke recovery, there is no stroke rehabilitation team in the community and family care givers are the primary source of ongoing care and support. This research was a comparative study with concurrent controls, using a two-group pre-test and post test design. The aims of this study were to develop and implement a nurse led supportive educative learning program for care givers of stroke survivors, and to evaluate outcomes for patients and their carers. The study demonstrated that providing education and support to the family caregiver of stroke survivors does benefit both the survivors and caregiver by empower carers to make decisions about the care they provide which has a follow on effect of reducing care stress and burden. It is recommended that programs to provide carers with skills and knowledge to assume an active and therapeutic role in the management of family members who suffer a stroke be established and appropriately supported. Furthermore, implementing this research in other regions of Thailand is recommended. / Doctor of Philosophy (PhD)

China is currently facing what I expect to be its most significant challenge to date - a crisis in the care of its rapidly ageing population. The causes of this crisis are complex and multi-faceted and its implications far-reaching from the social, economic and political perspectives. This thesis examines the causes and consequences of the impending aged care crisis in China, with a particular focus on the urban elderly. In addition to extensive interviews with government officials, a sample of 2,000 retires and their children were surveyed in Shanghai as part of my research. My findings from the Research Survey and Questionnaire, together with my observations from site visits to numerous aged care crisis and the associated problems. Of primary concern is the fact that the Chinese government does not have in place an appropriate aged care structure nor a strategy to implement systems to cope with the impending crisis. I conclude that it is imperative the Chinese government recognises both the immediacy and scale of the crisis and acts accordingly. Failure to do so may result in both significant social unrest and severe economic consequences. Recommendations are offered for consideration by the Chinese government in an effort to manage the impending aged care crisis in China. / Doctor of Philosophy (PhD)

An individual with advanced cancer moves through his or her illness trajectory engaged in an ongoing process of negotiation with the health care system, caregivers, and family members. The ability to maintain control is a key principle upheld in western society, but it may be difficult to do so if cognitive or physical decline occurs during the palliative phase of advanced cancer. Cognitive decline in progressive dementias such as Alzheimers disease or AIDS Dementia Complex is often gradual, allowing such individuals and their family members time to reassign responsibilities for illness management that protect the sense of control of the ill family member. When the onset of cognitive decline occurs more quickly, as is often the case in advanced cancer, ill individuals and their family members may not have the luxury of time to incorporate a transition in responsibilities for illness management into their collective decision-making process, leading to a sense on the part of the person with advanced cancer that he or she has lost control. Current understanding of this transition is limited, and thus the qualitative, grounded theory study, Decision-Making in Family Dyads in the Context of Advanced Cancer was conducted. Advanced cancer patients (n = 5), family caregivers (n = 3), and bereaved caregivers (n = 9) from palliative home care settings in Ontario were recruited for the study. Purposive and theoretical sampling of participants occurred until saturation was reached. Data collection, coding, and analysis occurred simultaneously. Results indicated that family caregivers who tried to fulfill their dying family members wishes often did so at the expense of their own health or finances. The core category Covering captured the strategies caregivers used to enable their family members to die in the manner of his or her choosing. The basic social process Dancing on the Stairs chronicled the stages of the patient-caregiver relationship as they navigated through the grey areas of decision-making in their final months together. The findings may assist health care personnel striving to help individuals with advanced cancer and their family caregivers maintain a sense of control during the palliative phase of an illness.