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Bakgrund: Den äldre befolkningen ökar och fler drabbas av sjukdomen diabetestyp 2, detta påverkar deras hälsa och välbefinnande. Tidigare forskning visar attdiabetes påverkar äldres liv psykiskt och fysiskt. Personcentrerad vård ärbetydelsefullt för att uppnå bättre behandlingsresultat. Forskning om äldresupplevelser av livet med diabetes kan ge en ökad förståelse hos vårdgivaren vilketkan skapa bättre möjligheter till personcentrerad vård.Syfte: Att belysa äldres upplevelser av att leva med diabetes mellitus typ 2.Metod: Litteraturstudie som baseras på 11 kvalitativa studier. Datainsamling hargenomförts via databaserna PubMed och CINAHL. Inspiration har tagits frånGraneheim och Lundmans metod för innehållsanalysen.Resultat: Dataanalysen resulterade i tre teman och varje tema delades in i tvåsubteman; Känslomässig upplevelse (rädsla och frustration), upplevelse avständigt kämpande (mål och hälsa, motivation till behandling) och upplevelse avstöd från omgivning (mötet med sjukvårdspersonal, mötet med familj och vänner).Konklusion: Litteraturstudien har visat att äldres upplevelser av att leva medsjukdomen är negativa men positiva upplevelser framkommer också. Dessaupplevelser är individuella men likheter finns också och detta beror på olikafaktorer. Det finns få studier om äldres upplevelser av att leva med diabetesmellitus typ 2, därför anses personcentrerad vård viktig i behandlingen samt merforskning för ökad kunskap. / Background: The elderly population is increasing and more people suffer from thedisease type 2 diabetes, this affects their health and wellbeing. Previous researchshows that diabetes affects older people's life mentally and physically. Personcenteredcare is important for achieving better treatment results. Research onelderly people's experiences of life with diabetes could provide a betterunderstanding of the healthcare providers, which can create better opportunitiesfor person-centered care.Objective: To highlight elderly people's experiences of living with diabetesmellitus type 2.Method: A literature review based on 11 qualitative studies. Data collection wasconducted via PubMed and CINAHL. Inspiration has been taken from Granheimand Lundman's method for content analysis.Results: Data analysis resulted in three themes and each theme was divided intotwo subthemes; emotional experience (fear and frustration), experience ofconstantly struggling (goals and health, motivation for treatment) and theexperience of support from the surroundings (the meeting with the medical staff,meeting with family and friends).Conclusion: The literature has shown that older people's experiences of livingwith the disease are negative but positive experiences also emerged. Theseexperiences are individual but there are also similarities and this is due to variousfactors. There are few studies on elderly people's experiences of living with type 2diabetes mellitus, therefore person-centered care is vital in treatment and moreresearch for greater knowledge

Introduction : Les personnes âgées originaires de l’Asie de l’Est (PAAE) font partie intégrante de la population québécoise sujette à utiliser des services de réadaptation. Toutefois, elles peuvent avoir des difficultés à en bénéficier, notamment en raison des écarts culturels et sociétaux entre leur pays d’origine et d’accueil, ce qui pourrait les désavantager par rapport à la population générale. Objectif : Comprendre les expériences d’utilisation des services de réadaptation chez les PAAE, du point de vue des professionnelles et professionnels de la réadaptation et des personnes proches aidantes. Méthodologie : Une recherche qualitative descriptive a été menée. Neuf cliniciennes (huit ergothérapeutes et une physiothérapeute) et trois personnes proches aidantes ont participé au projet. Les données ont été collectées via quatre groupes de discussion focalisée et une analyse thématique a été effectuée. Résultats : Selon les cliniciennes et les personnes prochaines aidantes, les expériences d’utilisation des services de réadaptation chez les PAAE sont influencées par quatre facteurs : 1) les défis de la communication relatifs à la barrière linguistique et la réticence des PAAE à exprimer leurs besoins ; 2) la forte implication de la famille afin de soutenir la récupération et d’assurer le maintien à domicile ; 3) les croyances et perceptions en santé reliées à la définition de l’autonomie et aux décisions de santé ; et 4) les défis dans l’alliance thérapeutique. Conclusion : Ces facteurs sont à considérer tant au niveau de l’évaluation que de l’intervention en réadaptation auprès des PAAE. Ils peuvent constituer de pistes d’amélioration afin que les services rendus soient mieux adaptés à leurs besoins tout en tenant compte de leurs réalités culturelles. / Introduction: East Asian origin older adults (EAOA) form an important part of the population in Quebec who are likely to use rehabilitation services. However, they may face difficulties in benefiting from these services, partly due to cultural and societal differences between their countries of origin and their host countries, which could disadvantage them compared to the general population. Objective: To understand EAOAs’ experiences in using rehabilitation services from the perspective of rehabilitation professionals and caregivers. Methodology: A descriptive qualitative research study was conducted. Nine clinicians (eight occupational therapists and one physical therapist) and three caregivers participated in the project. Data were collected through four focus groups and a thematic analysis was conducted. Results: According to the rehabilitation professionals and caregivers of this study, EAOAs' experiences of rehabilitation services utilization are shaped by four factors: 1) communication challenges related to language barriers and EAOAs' reluctance to express their needs; 2) the strong involvement of family in supporting the recovery and in ensuring that elderly people to remain at home; 3) health beliefs and perceptions regarding the definition of autonomy and health-related decisions; and 4) challenges in the therapeutic alliance. Conclusion: These factors should be taken into consideration in rehabilitation care with EAOA both in terms of assessment and intervention. They may constitute avenues for improvement to better adapt the services provided to the needs of these individuals while also considering their cultural realities.

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Thesis(Ph.D. (Communication Studies)) -- University of Limpopo, 2022 / Digital technologies are increasingly revolutionising music consumption patterns globally. Consequently, there is an emerging culture in which online tools have become primary platforms for music consumption. In this postmodern era, digital technologies make music easily accessed, consumed and shared, thereby providing a seemingly global recognition to artistes beyond their immediate geographical market. As a result, artistes sometimes distribute their music for free with the intention to reach potential consumers. Equally, these technologies also allow consumers to illegally access and share music freely without financial compensation to the artistes. At the same time artistes also sell their music through different online stores to generate revenue. Alongside these developments, there are challenges with access to the Internet in South Africa with older adults and those in rural areas being disadvantaged, and the cost of Internet curtailing what youths can afford to do online. This then prompts critical questions: How do older adults and youth listen to music? Where and how do they access music? How does the new digitalised music affect their music consumption? What are the implications of all these to the social capital and social lifestyles of youth and older South African adults? Also, how has the digitalisation of music impacted on the political economy of the music industry in South Africa? In what ways do the illegal and legal downloads of music benefit or disadvantage local artistes? From a critical theorisation of an emerging ‘download culture’ and a discussion of the postmodern technological turn, this study examined a case study of South African youth and older adults’ music consumption pattern. Through a survey of 202 university students in a rural South African university and 100 older adults from semi rural areas of Limpopo Province in South Africa, the study examined the ways youth and older adults access and consume music. It explored music sharing habits and opinions about piracy in a culture where music has become instantaneously shareable. Apart from findings from this study, new knowledge and a contribution to communication scholarship is presented here with a proposal of new theory of ‘download culture’. Fundamental to this study is the implications of download culture for the creative industry, predominantly, its impact on the South African music industry. The data show that this cohort of South African youth are not different from youths globally, where music is accessed through mobile cell phones. This study also reflects that many older adults do not access digitalised music due to socio economic conditions and challenges of technology access. Nevertheless, the social cultural impact of this has repercussions on the cultural well-being of this vital group in society. Although internet access challenges persist, a critical concern is the blurring distinctions about the legal and illegal download of music. / National Institute for the Humanities and Social Sciences (NIHSS), in collaboration with the South African Humanities Deans Association (SAHUDA)

The purpose of this study was to examine how sexual satisfaction in older marriages (marriages with at least one spouse between the ages of 55 and 75) was affected by family-of-origin distress (recent measure of recollection of childhood experiences) and marital distress (measure of current marital relationship) for husbands and wives. The hypotheses of this study were that both family-of-origin distress and marital distress would have negative effects on sexual satisfaction for older couples, with marital distress having a direct, negative effect on sexual satisfaction and with family-of-origin distress having an indirect, negative effect on sexual satisfaction through its influence on marital distress. The sample consisted of 614 older couples (approximate average age of 65 for husbands and 62 for wives) who participated in the Project Couple Retire research project which provided the data for this study. Each participant completed the Project Couple Retire questionnaire which included the Marital Satisfaction Inventory-Revised (MSI-R) (1997), the Personal Assessment of Intimacy in Relationships (PAIR) (1981), and other instruments measuring various factors relating to older marriages. A conceptual model was created consisting of three latent variables: sexual satisfaction, family-of-origin distress, and marital distress. The latent dependent variable, sexual satisfaction, was measured by the MSI-R sexual dissatisfaction (SEX) scale and the sexual intimacy scale of the PAIR inventory. One of the latent independent variables, family-of-origin distress, was originally measured by both the MSI-R family history of distress (FAM) scale and an additional instrument from the Project Couple Retire questionnaire measuring history of abuse. However, the history of abuse measure was eventually dropped from the study due to poor measurement fit. The other latent independent variable, marital distress, was measured by the affective communication (AFC) and time together (TTO) scales of the MSI-R. The data in this study was dyadic, with each variable including data from both husbands and wives. Therefore, both actor and partner effects were examined. Structural equation modeling (SEM) was used to analyze the conceptual model. Findings indicated that both family-of-origin distress and marital distress negatively affected sexual satisfaction in older marriages for both husbands and wives when considering both indirect and direct effects.

<p>  </p> <p>Polypharmacy in older adults presents several challenges, such as suboptimal therapeutic outcomes and increased adverse effects. Deprescribing, a clinically supervised process of decreasing dosage or stopping the medication when risks outweigh benefits, has emerged as one possible solution to these problems. However, the literature describing deprescribing intervention frameworks is heterogenous regarding targeted medications to deprescribe, population characteristics, clinical settings, and measured outcomes. This dissertation utilizes Linsky et al.'s deprescribing conceptual model, which details factors influencing decisions regarding initiating deprescribing interventions and their direct impact on the process. </p> <p>This dissertation utilizes a multimethod approach to investigate factors that facilitate and improve the deprescribing of anticholinergic medications for older adults, addressing gaps in this population's anticholinergic medication use. The three studies included in this dissertation provide a comprehensive understanding of deprescribing anticholinergic medications for this population, each contributing unique insights and results. </p> <p>The first study explores the feasibility of in-person and remote Home Medication Inventory Method (HMIM) approaches to evaluate over-the-counter (OTC) and prescription medication possession and use, including anticholinergics. Results demonstrate that both methods can accurately assess anticholinergic medication usage patterns, providing healthcare providers with reproducible methods and detailed medication profiles to make informed deprescribing decisions based on complete medication lists.</p> <p>The second study examined the intertwined roles of social determinants of health and health beliefs in predicting older adults' self-reported deprescribing behaviors, proposing the Deprescribing Health Belief Model (DeRx-HBM) framework that can be utilized for these efforts. These results emphasize the importance of considering these elements when creating a patient-centric and culturally sensitive intervention since they significantly shape deprescribing behaviors.</p> <p>In the third study, we explored the use of a symptom-specific scale for measuring the symptom burden in older adults during the deprescribing of anticholinergic medications prescribed for urinary incontinence, depression, and pain management. This research introduces a validated scale for assessing anticholinergic symptom burden prior to, throughout, and following the deprescribing attempt. The implementation of this scale has the potential to enhance the reproducibility and standardization of deprescribing decisions. Furthermore, it can improve communication between healthcare professionals and patients, as well as monitor the effectiveness of interventions during and after the deprescribing process.</p> <p>Collectively, these studies provide invaluable insights into factors influencing deprescribing decisions, obstacles to implementing deprescribing practices, and potential strategies to optimize medication management in older adults. The major takeaway from these studies is that addressing these factors leads to more informed decisions among healthcare professionals and patients - potentially leading to improved patient outcomes, ensure the ongoing effectiveness of deprescribing initiatives among older adults, and the promotion of health equity throughout the deprescribing process.</p>