Thesis (Ph.D.)--The University of Manitoba (Canada), 2002. / Adviser: Ron Norton.

Thesis (M.A.)--Eastern Illinois University, 2009. / Includes bibliographical references (leaves 27-33).

Thesis (Ph. D.)--University of Sydney, 2008. / Title from title screen (viewed Jan. 19, 2009) Includes tables and questionnaires in English and Farsi. Submitted in fulfilment of the requirements for the degree of Doctor of Philosophy to the School of Behavioural and Community Health Sciences, Faculty of Health Sciences. Includes bibliography. Also available in print form.

Research suggests that for many older people with dementia living in residential care, communication with staff often provides the most significant element of their day. It seems likely that the quality of the interactions provided by staff during their care of people with dementia will be an essential factor in affecting the person's quality of life. Research also suggests that the attitudes of nursing and care staff towards people with dementia is a central component in the quality of care they deliver, however, to date, there has been no empirically established evidence that staff attitudes have a direct effect on the quality of life of the people cared for. This study aims to examine the impact of staff attitudes on both the quality of care delivered and on the quality of life of residents and to examine whether there are any changes in any of these areas as a result of training and development interventions. The research includes a review of existing attitude measurements and the development of a new attitude scale for use with dementia care professionals, offering evidence for its reliability and validity. In order to evaluate quality of care, a new observational technique is developed, which draws on previous observational methodologies, with a focus on the behaviour of staff during their care of people with dementia. Results suggest that staff with more 'hopeful' attitudes about people with dementia are more likely to engage in social interactions and activities with residents and use more quality indicators (such as giving choice and information) during physical care tasks. The study also showed improvements in staff attitudes, the quality of care provided and in resident well-being following a number of training and development inputs. The implications of the results are discussed in relation to the limitations of the research.

The indirect influence of prior experience on a subsequent task is termed Implicit memory (IM). This study examined the status of pictorial and verbal IM in four groups of 20 subjects each: normal young (M age = 27.2), young-old (M age = 66.7), old-old (M age = 76.6), and Alzheimer's disease (AD) patients (M age = 75.4, M Mini-Mental State Examination score = 17.3). Study conditions involved reading words, naming pictures, and generating best-fit endings for high-cloze sentence frames (e.g., Ron swept the floor with a ____ .). Implicit memory was subsequently assessed by word-stem completion (WSC), in which subjects were instructed to complete three-letter stems with the first word that came to mind (e.g., bro____), and picture-fragment identification (PFI), in which subjects attempted to identify perceptually degraded pictures. Among the control groups, WSC priming was greatest following word study, and PFI priming was greatest following picture study, thereby establishing that crossover priming effects recently found among young subjects are fully retained in healthy aging, In contrast to previous studies suggesting that WSC priming may be preserved for deeply encoded material in AD patients, the present results showed that WSC priming was impaired in the AD group regardless of study condition, Nevertheless, AD patients demonstrated normal perceptual priming on the PFI task following picture study, These findings support a dissociation between perceptual and conceptual priming in AD. Explicit yes/no recognition testing revealed standard picture superiority and generation effects among controls. AD patients, in contrast, were impaired on all recognition items. Results are discussed in terms of transfer-appropriate processing theory, which states that level of retention Is a function of the degree to which processes invoked at study are recapitulated at test. Essentially, the similarity between word reading and WSC and between picture naming and PFI is a crucial determinant of priming effects In healthy young and elderly subjects. AD patients' WSC impairment may be due to a lexical-semantic processing deficit, whereas their preserved PFI priming may be supported by intact perceptual processes. Similarly, their uniformly depressed recognition memory may be explained by impaired conceptual processing. / Graduate

Orientador: Rosana de Fátima Possobon / Dissertação (mestrado profissional) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-25T21:56:58Z (GMT). No. of bitstreams: 1 Pereira_LuizetedeSousaAlexandre_M.pdf: 3174824 bytes, checksum: ecd53e664a1c9e6a71a57c37f3ebfdab (MD5) Previous issue date: 2014 / Resumo: A expectativa de vida aumentou no mundo e no Brasil e a mudança na pirâmide etária, decorrente desse processo, implica a necessidade de se repensar as políticas sociais, especialmente as da área de saúde. Este estudo teve como objetivo avaliar a associação entre a qualidade de vida do idoso e do cuidador e sua relação com o grau de sobrecarga do cuidador e grau de dependência do idoso no município de Santa Cruz do Rio Pardo/SP. Trata-se de um estudo transversal analítico, realizado com 203 idosos e 164 cuidadores, cadastrados nas unidades de saúde do município de Santa Cruz do Rio Pardo, interior do estado de São Paulo. Foram utilizados os instrumentos de avaliação: Escala MIF para avaliação do grau de dependência do idoso; Escala Zarit para avaliação do grau de sobrecarga do cuidador; Questionário Socioeconômico e Questionário WHOQOL-bref para avaliação da qualidade de vida do idoso e do cuidador; avaliação das condições da saúde bucal dos idosos; questionário de dados relacionados aos medicamentos consumidos, com ou sem prescrição médica, para mensurar a prevalência da automedicação dos idosos. Entre os 203 idosos entrevistados, a maioria era do sexo feminino (68%), na faixa etária entre 60 a 100 anos, de baixa renda, não alfabetizados e arranjo domiciliar com até 3 pessoas na família. Constatou- se a presença de 453 agravos de saúde, ou seja, tipos diferentes de doenças, sendo que 72,4% dos idosos apresentavam mais do que uma patologia. A maior prevalência estava relacionada ao aparelho circulatório (37,5%), sendo que os agravos que mais acometem esse grupo eram a hipertensão arterial essencial (19,2%), seguida de acidente vascular cerebral. Os idosos faziam uso, em média, de 5,5 medicamentos por dia, havendo uma minoria que se automedicava. A média do índice CPO-D foi de 29,3, sendo que 68,4% eram entulhos, 32% usavam prótese total e apenas 5,91% apresentaram alterações em tecido mole, porém sem suspeita de malignidade. Em relação ao grau de dependência, mensurado pela Escala MIF, os resultados mostraram que mais da metade da amostra (53,7%) apresentava dependência moderada ou severa, ou seja, necessitavam de assistência de outra pessoa ou recurso de adaptação para desenvolver suas tarefas básicas diárias. No geral, os idosos apresentaram boa qualidade de vida. Houve associação significativa (p=0,000) entre o grau de dependência do idoso e a sua qualidade de vida. Com relação aos 164 cuidadores entrevistados, observou-se a predominância de mulheres (81,1 %), com idade entre 18 e 89 anos, sendo a maioria de baixa renda, baixa escolaridade e vivendo em arranjos domiciliares com até 3 pessoas na família. A maioria (81,4%) dos cuidadores era informal, sem curso especifico para cuidar de idosos, 85,7% dos cuidadores apresentavam grau de parentesco com os idosos e à responsabilidade de cuidar concentraram-se nos familiares mais próximos, tais como filhos e cônjuges. Mais da metade dos cuidadores (57,4%) relatou ter problemas de saúde, constatando-se 134 agravos. Em relação à sobrecarga de trabalho, mensurada pela Escala Zarit, a maioria dos cuidadores apresentava-se com baixo nível, sendo que não houve associação significativa entre o grau de sobrecarga do cuidador e o grau de dependência do idoso. No geral, os cuidadores apresentaram boa qualidade de vida, havendo associação significativa (p=0,000) entre qualidade de vida e sobrecarga do cuidador. Porém, não houve associação significativa entre o grau de dependência do idoso e a qualidade de vida do cuidador e também entre o grau de dependência do idoso e a sobrecarga do cuidador. Pode-se concluir que a sobrecarga do cuidador influencia sua qualidade de vida. Entretanto, o grau de dependência do idoso não exerce influencia sobre a qualidade de vida do cuidador, o que pode indicar que a sobrecarga do cuidador pode estar relacionada com a responsabilidade do ato de cuidar de uma pessoa de idade, sem importar o seu grau de dependência. Palavras-chaves: Envelhecimento; Idoso e Sobrecarga do Cuidador / Abstract: Life expectancy has increased worldwide and in Brazil and the change in the age structure, resulting from this process implies the need to rethink social policies, especially health care. This study aimed to evaluate the association between quality of life of the elderly and the caregiver and their relation to the degree of caregiver burden and degree of dependency of the elderly in the municipality of Santa Cruz do Rio Pardo / SP. This is an analytical cross-sectional study with 203 elderly and 164 caregivers, registered in health facilities in the municipality of Santa Cruz do Rio Pardo, in the state of São Paulo. Assessment instruments were used: MIF Scale for assessment of the degree of dependency of the elderly; Zarit scale for assessing the degree of caregiver burden; Socioeconomic questionnaire and the WHOQOL-Bref questionnaire for assessing quality of life of the elderly and the caregiver; assessment of the conditions of the oral health of the elderly; questionnaire related to the medications used, with or without medical prescription, to measure the prevalence of self-medication of older data. Among the 203 subjects interviewed, the majority were female (68%), aged between 60 to 100 years, low-income, illiterate and living arrangement with up to 3 people in the family. It was found the presence of health problems 453, or different kinds of diseases, and 72.4% of subjects had more than one pathology. The highest prevalence was related to the circulatory system (37.5%), and the hardships that most affect this group were essential hypertension (19.2%), followed by stroke. The elderly were using, on average, 5.5 medications per day, there is a minority who self-medicated. The average CPO-D index was 29.3, and 68.4% were rubble, 32% wore dentures and only 5.91% had alterations in soft tissue, but without suspicion of malignancy. Regarding the degree of dependence, measured by the MIF scale, the results showed that more than half of the sample (53.7%) had moderate or severe dependence, ie, needed assistance from another person or resource adaptation for development tasks basic daily. Overall, the elderly showed good quality of life. There was a significant association (p = 0.000) between the degree of dependency of the elderly and their quality of life. Regarding the 164 caregivers interviewed, there was a predominance of women (81.1%), aged between 18 and 89 years, mostly low-income, low education and living in household arrangements with up to 3 people in the family. The majority (81.4%) of caregivers were informal, without a specific course to take care of elderly, 85.7% of caregivers had kinship with the elderly and the responsibility of caring focused on close relatives, such as children and spouses. More than half of caregivers (57.4%) reported having health problems, noting were 134 injuries. Regarding workload, measured by the Zarit Scale, most caregivers presented with low level, and there was no significant association between the degree of caregiver burden and the degree of dependence of the elderly. Overall, caregivers showed good quality of life, no significant association (p = 0.000) between quality of life and caregiver burden. However, there was no significant association between the degree of dependency of the elderly and the quality of life of the caregiver and also between the degree of dependency of the elderly and caregiver burden. It can be concluded that caregiver burden affects their quality of life. However, the degree of dependency of the elderly does not exert influence on the quality of life of the caregiver, which may indicate that caregiver burden may be related to the responsibility of the act of caring for an elderly person, regardless of their degree of dependence. Keywords: Aging; Elderly and Caregiver burden / Mestrado / Odontologia em Saude Coletiva / Mestra em Odontologia em Saúde Coletiva

The purpose of this grounded theory study was to better understand the differences in the way older, male workers perceived themselves as they aged, particularly with reference to work and aspects of the work environment. Career theorists have, for the most part, paid scant attention to this population. Research efforts that have focused on the “older worker” implicitly assume that they are homogeneous, that aging itself has a uniform impact, and that aging is a process of inevitable loss. A grounded theory approach was chosen because it was deemed most suitable to explore the phenomena because the basic variables were not readily identifiable, the field was rather ill-defined, and the research questions were best asked from within the “lived experience” of the participants. A sample of older, male workers, who were actively employed, were interviewed using a semi-structured interview format. A number of major categories and subcategories emerged through the research analysis including attitudes toward aging, the meaning of work, and the value of interpersonal relationships. The content of these categories were observed to change over the lives of the respondents, and these changes were neither uniform nor necessarily predictable. The differences that were observed among, and within, the respondents were attributable to the interaction of the level of cognitive development, locus of control, self-knowledge, interpersonal orientation, adaptive competence, spiritual courage, and the emotional viability of one's life story. The results of the study suggest that “older workers” do not constitute a unique population within the general workforce and that, in the future, researchers must attend to their individual differences. The findings of the study provide strong support for the notion that adult development is not the result of the passage of time alone, but rather is the result of an interaction among a diversity of factors. The results also affirm that, for many older workers, aging is a time of ongoing growth and renewal, and further that personal development is inseparable from career development. Older workers have the potential to not only contribute to the postmodern workplace, but also markedly enhance the quality of working life for all. / Graduate

This study focuses on Punjabi immigrants in Bradford who immigrated in the 1960s to meet a labour shortage. While this group had initially been almost entirely men who had planned on earning money and then returning to Pakistan relatively wealthy, changes in laws in the 1970s compelled them to bring their entire families to Britain. Changes in the local economy, and younger generations putting down roots in Bradford has left this group impoverished and unable to return to Pakistan, but many have been unable or unwilling to acculturate to British society. The life expectations these Punjabi immigrants have been unmet, and there is widespread emotional distress among them. While there are statutory mental healthcare services available to them which could help manage this distress, almost none of them male voluntary use of these services, and those that use them on an involuntary or semi-voluntary basis make as little use as possible. This study investigates this issue by blending theories and concepts from the social sciences, social work and the literature on race, culture and psychiatry. It uses a qualitative methodology of narrative and semi-structured interviewing to understand why the uptake of local state-offered mental health care services is so low. Samples from three sources were used in order gain perspective on this issue: Punjabi immigrants, medical and social care personnel, and lay healers using techniques traditional in the area of Pakistan from which immigration occurred. The study found that there were radical differences between the narratives of distress offered by the Punjabis and the understanding of the professionals; this undermined trust and created barriers to communication. The statutory services, in the form in which they were provided, could not meet the culturally specific needs of the Punjabis effectively and the services of the healers were often the preferred option. There has been little previous investigation into the narratives and cultural beliefs held by Punjabi immigrants previous to this thesis, or how these beliefs inform their experience of emotional distress, their help-seeking behaviour, or their understanding and interaction with- as well as the efficacy of- statutory services. Some cultural phenomena, such as the religious belief in kismet have not been thoroughly explored in a healthcare context previously.

As medical advances make possible the increase of the individual's life span, the needs of older people become a greater concern in our society. This study is based on the assumption that home care services are a desirable alternative to prevailing methods of institutionalisation, and on the premise that the services needed to retain the elderly person in his own familiar environment can be assessed. The district chosen for the project is the West End area of Vancouver, which comprises a high proportion of persons over the age of sixty-five years. It is the primary aim of the study to develop a research interview schedule, which will enable subsequent investigators to explore the present topic more extensively. In this sense the project can be seen as a preliminary survey based on a limited sample, which has as its aim not so much the collection of data based on the design of a research instrument, but an exploration of the literature in regard to home services elsewhere and the construction of a research instrument. A critical analysis of the research methods used here is part of the research project. The thesis is an initial attempt to assess the extent of the need and to identify the types of need for home services as part of an ongoing programme in the research for such needed services which is undertaken by the School of Social Work at the University of British Columbia. / Arts, Faculty of / Social Work, School of / Graduate

Attitudes toward the elderly were examined in three generations through analysis of media use, gender, contact with elderly, age, factual knowledge about aging, and parental influence on attitude formation. The results revealed that age, factual knowledge, perceived ageism in mass media and parental influence were significantly related to attitude toward the elderly.