For many years, great attention has been devoted to the care of the elderly due to global aging of population. Almost all people want to spend their old age at home in their environment. This idea is supported by many experts who deal with the issue of old age and point to the advantages that it entails for both the senior and for the society. Therefore, it is paradox that many old people are placed in various health and social care facilities despite a wide range of various external services that enable seniors to stay in their home environment. That is why this master thesis aims to compare the nursing care provided to elderly people in their home environment with the care provided in institutions, both from perspective of a nurse who provides the care and from perspective of the elderly person or members of their family. The thesis is divided into two main parts. The theoretical part focuses on explaining the old age and the changes that come along with the old age. It also points out how old age is perceived in contemporary society. Further, it deals with different types of senior care that is most frequently divided into family, health and social care. The practical part is focused directly on individual families of seniors who live at home supported with home care, and to families who have a member in the department for the chronically ill (DCI). In the practical part I also focused on nursing staff, particularly nurses who come into contact with the seniors every day. A qualitative research method was used for the research survey. The technique of in-depth interview was used for data collection. The first part of the research group consisted of nurses working in DCI and nurses working in home care. The second part of the group consisted of seniors who reside in DCI and their families and the elderly who use home care services and their families. Interviews with the nurses, seniors and their families are divided into individual categories: awareness, reason for placement to DCI, satisfaction with the care provided, the advantages and disadvantages of home care/DCI, differences in care in DCI and at home, in foods and drinks, positioning and incidence of pressure sores, hygiene, administering medicines, re-bandaging, in bowel habits, behavior of staff/family, facilities for a senior. The investigation shows that families consider hospital care and home care to be very good, but it can be seen that home care nurses enjoy greater trust of the family and have much closer relationship than those in a hospital. Both groups of nurses think that the care they provide is of high quality and professional, but point to the lack of funding that a hospital and a home care agency have. A very surprising fact emerged that families that have an elderly person in institutional care are eager for the placement since they believe that they would not be able to care of them properly themselves. The investigation cannot clearly assess which type of care is best because both methods have their positives and downsides for every party involved and there are different variables, such as the health condition of the elderly, their family or social background. Quantitative research over a longer period of time would be required for thorough mapping of the entire situation which could monitor the provided care in the long run and also take into account the above variables that may change over time.

Three generations of registered nurses make up the current nursing workforce: Baby boomers, Gen X, and Gen Y. Each generation brings its own values, behaviors, and beliefs to the workplace. The generational diversity among nurses needs to be assessed along with other factors, such as social values of the elderly, anxiety toward aging, and practice settings, to examine how each factor impacts registered nurses' attitudes toward caring for the elderly. An exploration of these factors is significant to nurse leaders, since nurses have been known to display negative attitudes toward the elderly. The theoretical foundation for this study was based upon Rosenberg's three-component view of attitudes. The bias scores from Palmore's Facts on Aging Quiz (FAQ I) was used to indirectly measure the dependent variable, registered nurses' attitudes toward caring for the elderly. The independent variables were anxiety toward aging, social values of the elderly, generations, and practice settings. Kafer's Aging Opinion Survey was used to measure anxiety toward aging, and social values of the elderly. Practice settings and generations were identified by a demographic profile. The survey data were collected from 265 registered nurses. An Analysis of Variance (ANOVA) was used to compare mean attitude scores between each generation and practice setting. Pearson's correlation coefficient examined the relationship between nurses' attitudes toward caring for the elderly, social value of the age, and anxiety toward aging. A multiple linear regression analyzed each independent variables prediction of nurses' attitude scores. Findings indicated a statistically significant association between the dependent and independent variables. Findings suggest the need to evaluate these variables prior to job placement to ensure quality healthcare provision to the elderly. Such action positively impact social change because nursing practices may be inspired to develop programs that encourage more favorable attitudes toward the elderly.

Submitted by Jordan (jordanbiblio@gmail.com) on 2017-05-26T14:53:04Z No. of bitstreams: 1 DISS_2014_Elisangela Cerencovich.pdf: 1424941 bytes, checksum: a51d5201c06ebb2530e78683e48d02c0 (MD5) / Approved for entry into archive by Jordan (jordanbiblio@gmail.com) on 2017-05-26T16:48:18Z (GMT) No. of bitstreams: 1 DISS_2014_Elisangela Cerencovich.pdf: 1424941 bytes, checksum: a51d5201c06ebb2530e78683e48d02c0 (MD5) / Made available in DSpace on 2017-05-26T16:48:18Z (GMT). No. of bitstreams: 1 DISS_2014_Elisangela Cerencovich.pdf: 1424941 bytes, checksum: a51d5201c06ebb2530e78683e48d02c0 (MD5) Previous issue date: 2014-02-10 / O familiar cuidador é o principal provedor de cuidados, mobilizador de ações e mediador de relações interpessoais da pessoa com estomia, seja em sua própria família ou nos órgãos e serviços. Este estudo teve como objetivo compreender o contexto do familiar cuidador na condição crônica estomia. O referencial teórico adotado foi a sociocultura. O contexto do estudo foi um ambulatório de enfermagem que cuida de pessoas com estomas, localizado em Cuiabá, Mato Grosso. A coleta de dados foi realizada no período entre abril de 2012 a maio de 2013 e ocorreu em duas etapas distintas com diferentes estratégias. A primeira se deu com rodas de terapia comunitária, em que participaram oito familiares; e a segunda ocorreu com a realização de seis entrevistas semiestruturadas. Os dados foram submetidos à análise temática. Cada etapa permitiu identificar um tema, sendo a primeira intitulada O familiar cuidador no contexto da pessoa com estoma. Nesta etapa, o familiar cuida nas esferas domiciliar, que se relaciona com o ambiente doméstico, suas relações familiares e as demandas de alimentação, higiene e conforto; e a pública, que se refere às relações em busca de atenção profissional, apoio social institucional necessário à continuidade do cuidado. Ao narrarem sobrecargas, requerem cuidados pelas instituições. A TCI como estratégia de coleta de dados se mostrou potente em evidenciar o contexto sociocultural do familiar cuidador. A segunda, Significados da experiência em ser familiar cuidador na condição crônica estoma, evidenciou que os significados da experiência do familiar se relacionam ao processo do adoecimento marcado pela trajetória inicial nas instituições de saúde, passando por internações, apropriação de termos médicos, manifestações corporais, risco de morte, impacto da realização do estoma, cujas implicações são expressivas pela percepção sensorial, requerendo cuidados. Das repercussões biológicas, sociais e culturais descrevem como marcantes o preconceito, a desinformação, os espaços comuns, em especial o banheiro público e os deslocamentos em busca dos dispositivos. Embora expressem sofrimento, dão sentido positivo à experiência. Portanto, os temas evidenciaram que o familiar cuidador provê cuidados mobilizando ações mediadas por movimentos, identidade e alteridade, responsabilidade, plasticidade, projetos e preocupação com o outro. / The family caregiver is the primary care provider, mobilizing action and mediator of interpersonal relationships of people with ostomy, whether in your own family or in the agencies and services. This study aimed to understand the context of family caregivers in chronic condition ostomy. The theoretical framework adopted was sociocultural. The context of the study was a clinic nurse who takes care of a people with stomas located in Cuiaba , Mato Grosso. Data collection was conducted from April 2012 to May 2013 and has occurred in two distinct steps with different strategies. The first occurred with circle community therapy, attended by eight families, and the second consisted of six semi-structured interviews. The data were subjected to thematic analysis. Each step allowed to identify a theme, the first titled The family caregiver in the context of the person being stoma. In this step, the family takes care in home context,, which is related to the domestic environment, family relations and the demands of feeding, hygiene and comfort, and in public context which refers to relations seeking professional attention, governmental social support needed to continuity of care. As they told overloads require care institutions. The CIT ( Community Integrative Therapy) as a data collection strategy proved powerful in highlighting the sociocultural context of family caregivers. The second, Meanings of experience in being a family caregiver in chronic condition stoma showed that the meanings of the experience of the family relate to the illness marked by initial path in health institutions through admissions, ownership of medical terms, physical manifestations process, risk death impact the completion of the stoma, the implications are significant for the perception requiring care. Biological, social and cultural repercussions describe how remarkable prejudice, misinformation, common spaces, especially public toilet and offsets in search of devices. While expressing grief give positive meaning to the experience. Therefore, the subjects showed that the family caregiver provides care mobilizing actions mediated movements, identity and otherness, responsibility, plasticity, projects and concern for each other.

Made available in DSpace on 2014-07-29T15:04:45Z (GMT). No. of bitstreams: 1 Dissertacao Selma Rodrigues Alves.pdf: 314407 bytes, checksum: fb77a8af968a927e5bbfa460c32ff114 (MD5) Previous issue date: 2006-12-19 / Family is a natural group that, through the times, has developed interaction standards, that they constitute the familiar structure, that, in turn, governs the functioning of its members, delineating its gamma of behaviors and facilitating its interaction. In accordance with Wright; Leahey (2002) the nursing has the commitment to include the families in the cares of health. Many evidences exist that the family assumes one meaning special for well-being and the health of its members, thus the nurses must consider the family of the patients as integrant part of the unit of care. Front to the displayed one, immerges the necessity to evaluate and to intervine together to the family of the people during the process of hospitalization, independent of which is its alteration of health. We know that an evaluation model does not exist that contemplates all the phenomena of the family. However, the Wrights; Leahey (2002) cite the necessity of the adoption of a clear conceptual structure, or map of the family. This encourages the synthesis of data, in order to be identified to the forces and the problems of the family, constituting a plan of useful and systemize treatment. The Calgary model involves evaluation (MCAF) and Intervention (MCIF) in the Family and constitutes the multidimensional one structure that possesss three main categories: structural, of development and functionary. These subcategories allow that the evaluation of each family is differentiated. Nor all the subcategories need to be evaluated in a first meeting with the family and some never will need to be evaluated. This study the June of 2006 through descriptive study has the objective to analyze the disgnostic profile of nursing identified in families of patients interned in the medical clinic of a hospital school during the period of January. They had been enclosed families who were following patient in the period for collection of data that had agreed to participating by means of signature of the term of free and clarified assent. The patient and its familiar ones had been taken as participant unit of the research. The findings had been argued focusing the disgnostic headings, related factors and characteristic defining to the light of the Model Calgary de Evaluation and Intervention 12 disgnostic of nursing,being 75% Reals and 25% of risk had been found. They had not been detected disgnostic of well-being the disgnostic average for family was of four, being that we had a family with 07 (seven) disgnostic ones and one with 02 (two). The ones that had gotten greater frequency had been: Tension Due to the Paper of Cuidador, gift in 100% of the families; in second, Harmed, present Verbal Communication in 75%, and together in third, Interrupted Maintenance of the Harmed Home and Familiar Processes, gifts in 66% of the families. The nurses need to be intent to the families who are on its cares, fitting to them to develop strategies shared with all the team to multidiscipline to protect the families in relation to these occurrences, to prevent that the adoecimento of a familiar one has taken the abalos greaters in the structure and functioning of the families. To make the evaluation of the families allows to identify to the difficulties for which these families passes, allowing a acurada intervention more on the part of the professionals. / A família assume um significado especial para o bem-estar e a saúde de seus membros, desta forma, os enfermeiros devem considerar a família dos pacientes como parte integrante da unidade de cuidado. No contexto da internação hospitalar de adultos este aspecto tem sido pouco valorizado. Frente ao exposto, emerge a necessidade de avaliar e intervir junto à família das pessoas durante o processo de hospitalização, independente de qual seja sua alteração de saúde. Este estudo tem o objetivo de analisar o perfil de diagnósticos de enfermagem identificados junto a famílias em situação de acompanhamento de pessoas hospitalizadas para tratamento e doenças crônicas não-transmissíveis, utilizando o Modelo Calgary de Avaliação. Este estudo descritivo foi realizado na clínica médica de um hospital escola da região centro-oeste, durante o período de janeiro a junho de 2006. Foram incluídas 12 famílias que estavam acompanhando pacientes no período de coleta de dados, que concordaram em participar mediante assinatura do termo de consentimento livre e esclarecido. A pessoa internada e seus familiares foram tomados como unidade participante da pesquisa. Os mesmos foram entrevistados nas enfermarias, de uma a três vezes, conforme necessário. Os encontros foram gravados e a entrevistas transcritas. O processo diagnóstico foi realizado pelo pesquisador e validado por um perito. A declaração diagnóstica foi realizada com base na Taxonomia II da North American Nursing Diagnosis Association, versão 2005-2006. Os achados foram discutidos focalizando os títulos diagnósticos, fatores relacionados e características definidoras à luz do Modelo Calgary de Avaliação. Foram encontradas 12 categorias diagnósticas, sendo nove reais e três de risco, totalizando 49 diagnósticos de enfermagem. Não foram detectados diagnósticos de bem-estar. O número de diagnósticos variou de dois a sete, sendo a média de diagnósticos por família foi quatro. Foram identificados por ordem de freqüência com os seguintes diagnósticos: tensão devido ao papel de cuidador (100%), comunicação verbal prejudicada (75%), manutenção do lar prejudicada (66%), processos familiares interrompidos (66%), interação social prejudicada (25%), paternidade prejudicada (16,6%) e risco para interação social prejudicada (16,6%). Com ocorrência menor que 10% foram identificados: enfrentamento familiar incapacitado, paternidade e maternidade prejudicada, risco para infecção e processos familiares disfuncionais: alcoolismo. Embora não esteja incluído na Taxonomia da North American Nursing Diagnosis Association, foi identificado risco para infestação em uma família. Este perfil denota problemas de desenvolvimento e funcionamento das famílias participantes do estudo, sendo alguns deles anterior ao processo de hospitalização e outros agravados ou causados pela situação de internação. Os enfermeiros precisam estar atentos às famílias que estão sob os seus cuidados, cabendo-lhes desenvolver estratégias compartilhadas com toda a equipe multidisciplinar para proteger as famílias em relação a estas ocorrências, para evitar que o adoecimento de um familiar leve a maiores abalos na estrutura e funcionamento das famílias. Fazer a avaliação das famílias permite identificar as suas forças e fragilidades, permitindo uma intervenção mais acurada por parte dos profissionais.