Thesis advisor: Brinton Lykes / In the 20th century, conflicts in Latin America between government armies and guerrilla groups escalated into devastating civil wars. During these wars, the armed forces frequently classified children as enemy targets. This paper will discuss the civil wars waged in Guatemala from the 1960s to 1996, and in El Salvador, between the years of 1979 to 1992. Similarities and differences between the conflicts in these two nations will be examined to explore the use of violence against children in Latin America, including how they were tortured, killed and forced to join guerrilla or government forces. An analysis of these two wars reveals the government and army’s intention to destroy community, trust, culture, and every aspect of normal life. / Thesis (BA) — Boston College, 2011. / Submitted to: Boston College. College of Arts and Sciences. / Discipline: College Honors Program.

This study focused on the psychosocial effects of parental loss on children orphaned by HIV/AIDS. The primary aim of the research was to explore the psychosocial effects of parental loss on children orphaned by HIV/AIDS through the eyes of the caregivers. Five participants were selected for this study using convenience sampling. The data was collected using face-to-face semi-structured interviews. The interviews were analysed using thematic content analysis and themes were extracted and presented. The results of this study indicate that children orphaned by HIV/AIDS living in the children’s home experience many psychosocial problems. Further research on the psychosocial issues specific to orphaned children raised in children’s homes in rural areas is recommended / Psychology / M. A. (Clinical Psychology)

Mental illness is often associated with social isolation, unemployment and limited community participation. Mental health rehabilitation services aim to decrease these psychosocial effects of illness and encourage better community integration for mental health consumers. Volunteer work is one avenue in which consumers can become actively involved with their local communities. However whilst often supported clinically, limited empirical evidence exists which supports the use of volunteer work as a potential mode of rehabilitation for consumers. The overall aim of this study was to document consumer perceptions and experiences with volunteer work and to identify if participation in volunteer work has a positive impact on their mental health. Phase one of this study involved in-depth interviews with nine consumers currently volunteering. Themes identified from these interviews supported the notion that volunteer work is a meaningful occupation for consumers and one which promotes community integration and supports consumer recovery. Findings from the interviews also guided the development of a volunteer scale for later use within the study. Phase two involved the development and pilot testing of a volunteering questionnaire which measured consumer attitudes and experiences with volunteer work. This scale was combined with other standardised tests which measured the mental health variables of personal empowerment and quality of life. Phase three involved the administration of the questionnaire battery developed in phase two. The battery was distributed and completed by thirty consumers, including both those who were and were not volunteering. Analysis conducted identified that overall consumers held a positive view of volunteer work, believing it was a way of developing work skills, friendships and promoting positive mental health. / Analysis comparing the volunteering to the non volunteering group indicated that those volunteering experienced better quality of life, specifically within the psychological health, social relationships and personal environment domains. This provides support for the hypothesis that participation in volunteer work promotes consumer recovery. However, age was identified as a potential confounding variable and so the significant results should be viewed with caution. Cost, stigma and becoming unwell during volunteering were identified as barriers to consumer participation. It is argued that mental health services are in a good position to support consumers not only to access but also to maintain ongoing volunteer participation. To date minimal evidence has existed that supported this intervention. This study has begun to fill this research void, however, small study numbers and the cross-sectional, descriptive design make establishing a cause and effect relationship impossible. It would thus be beneficial to conduct a larger study investigating the impact further, including measuring the influence of any interventions that promote consumer participation in volunteer work, such as supported volunteering.

This study focused on the psychosocial effects of parental loss on children orphaned by HIV/AIDS. The primary aim of the research was to explore the psychosocial effects of parental loss on children orphaned by HIV/AIDS through the eyes of the caregivers. Five participants were selected for this study using convenience sampling. The data was collected using face-to-face semi-structured interviews. The interviews were analysed using thematic content analysis and themes were extracted and presented. The results of this study indicate that children orphaned by HIV/AIDS living in the children’s home experience many psychosocial problems. Further research on the psychosocial issues specific to orphaned children raised in children’s homes in rural areas is recommended / Psychology / M. A. (Clinical Psychology)

Made available in DSpace on 2016-06-02T19:48:20Z (GMT). No. of bitstreams: 1 4530.pdf: 821086 bytes, checksum: 9e78b099e4b89c5af27cfaaaf7357aae (MD5) Previous issue date: 2012-12-16 / Financiadora de Estudos e Projetos / Tuberculosis (TB) is a curable disease, however, is still a stigmatized disease. People with TB suffer from the disease, not only by clinical manifestations, but also with prejudice, embarrassing situations and even a self-discrimination that contribute to social isolation. This study aimed to analyze the psychosocial experiences of patients who were treated for TB in São Carlos - SP. A clinical-qualitative methodology was used as it seeks the meanings assigned by subject. 15 people who had completed TB treatment were studied as participants, the definition of the sample is given by the criteria of saturation. A data collection method, semi-directed interviews recorded on digital media were and were later transcribed and analyzed. Data analysis was based on the method of thematic content analysis as proposed by Bardin. Two thematic units were determined: Obstacles to cure TB and Psychosocial Experiences from the treatment. In the first thematic unit sub-categories that were listed: difficulties in diagnosis and supervised treatment. In the second thematic unity sub-categories that were listed: suffering in the face of disease, the impact on family and social context, the support of the health service and its effects after treatment. There is the thematic unity "obstacles to cure TB" that patients have difficulties in identifying the disease and health services sojourn until this diagnosis, patients suffer from adverse drug reactions; supervised treatment was identified as a facilitator for the completion of treatment, because they feel taken care of by the team and also as an obstacle to change the daily routine due to frequent displacement of health facilities. In the unit "Living resulting psychosocial treatment" found that the disease still causes distress to patients for fear of transmission, they are also victims of prejudice and fear of death. Suffering is also caused by stigmatizing, prejudicial actions in society. Family and health team offer support to patients and were essential to the completion of treatment. However, friends and colleagues keep away from them because of the fear of contagion and / or prejudice. The lack of knowledge about the disease and its mode of transmission are present in the statements of interviewees, which can still reproduce the stigma of the disease. The absence from work during treatment may be due to health conditions and also to minimize the constraints. It is concluded that health professionals should be aware of the repercussions that the treatment of TB leads the patient to minimize the obstacles that the disease causes in the patient's life. For this to happen the professional should allow sharing moments of anguish, suffering, psychosocial and biological changes so that the treatment is completed with fewer obstacles. / A tuberculose (TB) é uma enfermidade curável, entretanto, ainda é uma doença estigmatizada. Os indivíduos com TB sofrem com a doença, não apenas pelas manifestações clínicas, mas também pelo preconceito, situações constrangedoras e até por uma auto-discriminação. Tais fatores contribuem para o isolamento social do paciente. Este estudo teve como objetivo analisar as vivências psicossociais de pacientes que foram tratados de TB no município de São Carlos - SP. Utilizou-se a metodologia clínicoqualitativa, uma vez que se buscam os significados atribuídos pelos sujeitos. Fizeram parte do estudo 15 pessoas que haviam concluído o tratamento de TB. A definição da amostra se deu pelos critérios de saturação. Como método para coleta de dados, ou foram utilizadas entrevistas semi-dirigidas, gravadas em mídia digital as quais foram posteriormente transcritas e analisadas. O tratamento dos dados baseou-se no método de análise de conteúdo - modalidade temática - conforme proposto por Bardin. Foram nomeadas duas unidades temáticas: Obstáculos para a Cura da TB e Vivências Psicossociais Decorrentes do Tratamento. Na primeira unidade temática, foram elencadas as sub-categorias: as dificuldades para o diagnóstico e o tratamento supervisionado. Já na segunda unidade temática, foram consideradas as sub-categorias: o sofrimento frente a doença; as repercussões no contexto familiar e social; o apoio do serviço de saúde e repercussões após o tratamento. Verifica-se, na unidade temática, Obstáculos para a cura da TB , que os doentes enfrentam dificuldades na identificação da doença e peregrinam pelos serviços de saúde até obterem esse diagnóstico. Os pacientes sofrem com as reações adversas dos medicamentos. O tratamento supervisionado foi apontado ora como um facilitador para a conclusão do tratamento, em decorrência de os pacientes se sentirem cuidados pela equipe, ora como obstáculo por alterar a rotina diária devido ao deslocamento freqüente às unidades de saúde. Na unidade, Vivências psicossociais decorrentes do tratamento , constatou-se que a doença ainda provoca sofrimento nos doentes pelo medo da transmissão, do preconceito e, também, da morte. O sofrimento também é decorrente de ações preconceituosas e estigmatizantes presentes na sociedade. Os familiares e a equipe de saúde oferecem suporte para os pacientes e são imprescindíveis para a conclusão do tratamento. No entanto, amigos e colegas de trabalho se afastam por medo do contágio e/ou por preconceito. A falta de conhecimento sobre a doença e sobre sua forma de transmissão estão presentes nas falas dos entrevistados, os quais ainda reproduzem o estigma da doença. O afastamento do trabalho, durante o tratamento, pode ser em decorrência das condições de saúde ou também para minimizar os constrangimentos. Conclui-se que os profissionais de saúde devem conhecer as repercussões que o tratamento da TB tem na vida do doente para minimizar os obstáculos que a doença acarreta. Para isso, deve-se possibilitar momentos de compartilhamento das angústias, sofrimentos, alterações psicossociais e biológicas para que o tratamento seja concluído com menos obstáculos.

The effects of implementing Lean has been widely studied within the context of discrete manufacturing, where it originated, but much less so within the process industry. Within discrete manufacturing there are major benefits to implementing Lean with a focus on respect for people and human aspects, particularly on employee health and organisational culture, but does the same hold true in the process industry? The purpose of this thesis is to look into this question. In order to do so, a case company within the process industry, which was working with a consultant firm to implement Lean, was contacted. The primary method of gathering data was through semi-structured interviews, further backed by KPIs provided by the case company. The data from the case company has been analysed and compared with theories and ideas gathered from literature, and then discussed. The results indicated that there had not been enough time to see the full extent of benefits or issues on employee health or organisational culture in relation to implementing Lean, only minor effects could be observed. However, better contact between employees, increased motivation, but also increased stress could be seen. In order to gain a broader understanding of the human aspects within the context of process industry while implementing Lean, future research could look at more long-term effects, or the generalisability through a quantitative approach.

O cuidado diário de um idoso com incapacidade funcional demanda recursos econômicos, planejamento, organização familiar e pessoal. Esse cuidar, sem uma rede e apoio social, pode ocasionar sobrecarga de tarefas, desgaste físico e emocional para quem cuida, principalmente quando é assumido por tempo prolongado e por uma única pessoa, desencadeando limitações na vida diária do cuidador e interferindo na sua qualidade de vida. Assim, o objetivo deste estudo foi avaliar a qualidade de vida do cuidador familiar de idosos dependentes e associar com a rede social, o apoio social, a sobrecarga do cuidador e o grau de dependência do idoso. Trata-se de um estudo descritivo quantitativo realizado no município de Arapongas-Pr, com uma amostra de 178 cuidadores familiares de idosos com incapacidade funcional. A coleta de dados foi realizada por pesquisadores de campo devidamente treinados, mediante entrevista domiciliar, utilizando os instrumentos: questionário contendo variáveis sociodemográficas do cuidador, o Medical Outcomes Study - MOS e o Social Network Index para avaliação da rede e apoio social, The Zarit Burden Interview -ZBI para avaliação da sobrecarga e o WHOQOL-Bref para avaliação da qualidade de vida. Os dados evidenciaram que os cuidadores eram em sua maioria mulheres (90,4%), filhas (48,8%), casadas (76,4%), com média de idade de 56,7 anos, pertencentes à classe econômica C (33,1%).Os cuidadores avaliaram a sua saúde como regular (45,5%), apresentaram sobrecarga moderada (57,3%), rede social menos de três parentes (60,1%) e menos de três amigos (71,4%) e a interação social foi a dimensão de apoio social mais afetada (50,4). Na avaliação da qualidade de vida, o domínio meio ambiente (56,1) e psicológico (57,3) foram os mais comprometidos. A análise multivariada revelou que as chances de o cuidador apresentar melhor qualidade de vida no domínio físico foram associadas a pouca/nenhuma sobrecarga (OR=6,52), ausência de doença referida (OR=27,06) e estar na condição de solteiro (OR=8,47). No domínio psicológico, as chances para melhor qualidade de vida associaram-se com pouca/nenhuma sobrecarga (OR=5,61), presença de apoio de interação social (OR=3,21), ausência de doença relatada (OR=7,47) e estar na condição de solteiro (OR=6,0). No domínio de relações sociais, as chances de melhor qualidade de vida foram aumentadas quando o cuidador apresentou apoio de informação (OR=3,73) e recebeu orientação para o cuidado (OR=4,54). No domínio meio ambiente, as chances de melhor qualidade de vida associaram-se ao fato do cuidador pertencer à classe social A/B (OR=53,6), apresentar uma rede social de quatro ou mais parentes (OR=3,07), não apresentar doença diagnosticada (OR=4,51) e encontrar-se na condição de solteiro (OR=8,28). Diante dos dados encontrados, faz-se necessário pensar e refletir sobre a temática que levanta a necessidade da implantação de programas que incluam a saúde do cuidador, contribuindo, desta forma, para melhorar a sua qualidade de vida e, consequentemente, prover um cuidado adequado ao idoso dependente. / Daily care for elderlies with functional disability requires economic resources, planning, family and social organization. Without a social and support network, this care can lead to task overload, physical and emotional exhaustion of the caregiver, particularly when done for an extended period of time and by a single person, unleashing limitations in the caretaker\'s daily life and interfering with his/her quality of life. Thus, the objective of this study was to evaluate the quality of life of family caretakers of dependent elderlies, and link it to social networks, social support, caregiver overload and the elderly\'s level of dependence. It is a descriptive quantitative study performed in the city of Arapongas-PR, Brazil, with a sample of 178 family caretakers of elderlies with functional disability. Data collection was carried out by trained field researchers, through home interviews, using the following instruments: a questionnaire containing socio-demographic variables of the caregiver, the Medical Outcomes Study - MOS and Social Network Index to evaluate the social network and support, the Zarit Burden Interview -ZBI to assess overload, and the WHOQOL-Bref to evaluate quality of life. The data showed that caregivers were mostly women (90.4%), daughters (48.8%), married (76.4%), averaging 56.7 years of age, belonging to income class C (33.1%). Caretakers evaluated their own health as regular (45.5%), showed moderate overload (57.3%), social net of fewer than three relatives (60.1%) and fewer than three friends (71.4%), and social interaction was the most affected dimension of social support (50.4%). In the evaluation of quality of life, the environment (56.1%) and psychological (57.3%) domains were most compromised. Multivariate analysis revealed that the chances of the caregiver having a better quality of life in the physical domain were linked to little/no overload (OR=6.52), absence of reported illness (OR=27.06) and being single (OR=8.47). In the psychological domain, the chances of a better quality of life was linked to little/no overload (OR=5.61), presence of social interaction support (OR=3.21), absence of reported illness (OR=7.47) and being single (OR=6.0). In the realm of social relations, the chances for a better quality of life increased when the caretaker had information support (OR=3.73) and received care guidance (OR=4.54). In the environment realm, chances for a better quality of life was linked to whether the caregiver belonged to income class A/B (OR=53.6), having a social network of four more relatives (OR=3.07), not having a diagnosed illness (OR=4.51) and being single (OR=8.28). Based on the reported data, it is necessary to think and reflect on the need to implement programs that include caregiver health, thus contributing to improve their quality of life and consequently provide adequate care for the dependent elderly.

A epidemia da aids é um dos mais graves problemas mundiais de Saúde Pública da atualidade. No Brasil, com o avanço da disseminação epidêmica, observou-se recentemente incremento no número de casos notificados na faixa etária de 60 anos e mais, as pessoas na terceira idade. Neste estudo investigou-se o viver com HIV na perspectiva de homens e mulheres idosos acompanhados na Casa da Aids- HC/FMUSP. Foram entrevistados 75 pacientes, buscando-se: dados sóciodemográficos e relatos sobre vida sexual; percepção de risco de aquisição da infecção por HIV; circunstâncias em que se deu a revelação do diagnóstico e o impacto deste sobre sua vida; relatos de vivência de estigma/discriminação e a percepção do idoso sobre o cuidado recebido no serviço de saúde e as dificuldades por eles enfrentadas. A população foi composta predominantemente por homens (64%), brancos (65,3%), com escolaridade de até 4 anos e renda mediana de 600 reais. O tempo de diagnóstico variou entre 18 meses e 17 anos. Em relação às condições de vida, verificou-se que 28% residia sozinho e 52% responsabilizavase pelo cuidado de outros. Embora 66,7% estivesse aposentado, a participação do idoso na renda familiar foi expressiva. Dentre os 47 pacientes com atividade sexual, apenas 30 possuíam parceria fixa, e destes, 70% informou parceiro sorodiscordante. A grande maioria dos entrevistados relatou uso de condom após o diagnóstico. A percepção de risco de aquisição da infecção foi baixa e a maioria dos pacientes (74,7%) acreditava ter-se infectado em relação sexual desprotegida. O teste diagnóstico foi mais freqüentemente realizado por solicitação médica (73,3%) do que por iniciativa do idoso (26,7%), na maior parte das vezes em hospital (66,7%) e sem aconselhamento pré-teste (85,1%). Onze idosos relataram indiferença ou discriminação por parte do profissional envolvido na revelação do diagnóstico. O reconhecimento da soropositividade afetou principalmente o relacionamento com o parceiro sexual. Vivências de estigma e discriminação foram informadas por 18,7%. Em relação ao acesso e a percepção do cuidado prestado no serviço de saúde, constatou-se que embora os idosos possuissem facilidade para chegar ao local e acesso aos insumos necessários para seu cuidado (medicamentos, exames laboratoriais, condons), faltavam-lhes canais de comunicação para diálogo mais efetivo com os profissionais. Exceto pela maior freqüência de homens, não se observaram diferenças significativas, quando se compararam os idosos diagnosticados com 60 anos e mais àqueles diagnosticados em idades inferiores. As dificuldades apontadas pelos idosos no viver com HIV não se restringiram a limitações físicas, necessidade de acompanhamento clínico ou uso contínuo de medicamentos e suas eventuais conseqüências. Apontaram também para sentimentos de solidão, isolamento e receio de discriminação na família e no serviço de saúde. A identificação de particularidades nos aspectos psicossociais do viver com HIV/aids na terceira idade pode ser útil para subsidiar políticas públicas de cuidado a essa população nos serviços especializados, além de permitir a inclusão de abordagens preventivas nas ações que integram a atenção à saúde do idoso. / The AIDS epidemic is one of the most serious Public Health problems of our time. With the spread of the Brazilian epidemic, the number of reported cases among the elderly has recently increased. In the present study living with HIV was investigated, from the perspective of elderly men and women under follow-up at the AIDS Clinic-HC/FMUSP. Seventy-five patients were interviewed in search of socio-demographic data, information on their sexual lives, risk perception of HIV exposure, circumstances involving disclosure of diagnosis and how it impacted on their lives, reported episodes of stigma and discrimination, as well as their perception of provided care, the difficulties they had to face, and their plans for the future. The study cohort comprised mainly white men (65.3% and 64%, respectively), with less than 5-year schooling and a median income of 600 reais. Time since HIV diagnosis ranged from 18 months to 17 years. As far as their living conditions were concerned, 28% reported to live alone and 52% to be caregivers. Though 66.7% were retired, elderly patients significantly contributed for the family income. Out of 47 sexually active patients, 30 informed having a steady partner, more likely, serodiscordant (70%). Most patients reported consistent condom use after HIV diagnosis. Risk perception of HIV exposure was low and most (74.7%) patients believed having acquired the infection in unsafe sex. Serodiagnosis was carried out more often after healthcare professionals recommendation (73.3%), as compared to patients own initiative (26.7%), in a hospital setting and without pre-test counselling (85.1%). Eleven patients reported having received the diagnosis from an indifferent healthcare worker or, alternatively, felt discriminated against at the time of disclosure. Diagnosis affected their relationships with sexual partners, mainly. Episodes of stigma and discrimination were experienced by 18.7%. As for their perception of provided care, even though patients reported easy access to the clinic and to necessary care tools (medication, laboratory tests and condoms), they lacked efficient communication with the healthcare team. Except for a higher proportion of men, no significant difference was seen, when patients diagnosed aged 60 or more were compared to those tested younger. Among their difficulties in living with HIV, elderly patients not only reported physical handicap, or the need for continuous clinical follow-up and medication and its adverse effects, but highlighted feeling lonely and isolated, and feared being discriminated against by relatives and healthcare workers. Identifying particular psychosocial features of living with HIV/AIDS in elderly life may help establish public care policies for this population at specialised centres. In addition, it may allow integrating prophylactic strategies in a comprehensive care approach to elderly men and women.

A epidemia da aids é um dos mais graves problemas mundiais de Saúde Pública da atualidade. No Brasil, com o avanço da disseminação epidêmica, observou-se recentemente incremento no número de casos notificados na faixa etária de 60 anos e mais, as pessoas na terceira idade. Neste estudo investigou-se o viver com HIV na perspectiva de homens e mulheres idosos acompanhados na Casa da Aids- HC/FMUSP. Foram entrevistados 75 pacientes, buscando-se: dados sóciodemográficos e relatos sobre vida sexual; percepção de risco de aquisição da infecção por HIV; circunstâncias em que se deu a revelação do diagnóstico e o impacto deste sobre sua vida; relatos de vivência de estigma/discriminação e a percepção do idoso sobre o cuidado recebido no serviço de saúde e as dificuldades por eles enfrentadas. A população foi composta predominantemente por homens (64%), brancos (65,3%), com escolaridade de até 4 anos e renda mediana de 600 reais. O tempo de diagnóstico variou entre 18 meses e 17 anos. Em relação às condições de vida, verificou-se que 28% residia sozinho e 52% responsabilizavase pelo cuidado de outros. Embora 66,7% estivesse aposentado, a participação do idoso na renda familiar foi expressiva. Dentre os 47 pacientes com atividade sexual, apenas 30 possuíam parceria fixa, e destes, 70% informou parceiro sorodiscordante. A grande maioria dos entrevistados relatou uso de condom após o diagnóstico. A percepção de risco de aquisição da infecção foi baixa e a maioria dos pacientes (74,7%) acreditava ter-se infectado em relação sexual desprotegida. O teste diagnóstico foi mais freqüentemente realizado por solicitação médica (73,3%) do que por iniciativa do idoso (26,7%), na maior parte das vezes em hospital (66,7%) e sem aconselhamento pré-teste (85,1%). Onze idosos relataram indiferença ou discriminação por parte do profissional envolvido na revelação do diagnóstico. O reconhecimento da soropositividade afetou principalmente o relacionamento com o parceiro sexual. Vivências de estigma e discriminação foram informadas por 18,7%. Em relação ao acesso e a percepção do cuidado prestado no serviço de saúde, constatou-se que embora os idosos possuissem facilidade para chegar ao local e acesso aos insumos necessários para seu cuidado (medicamentos, exames laboratoriais, condons), faltavam-lhes canais de comunicação para diálogo mais efetivo com os profissionais. Exceto pela maior freqüência de homens, não se observaram diferenças significativas, quando se compararam os idosos diagnosticados com 60 anos e mais àqueles diagnosticados em idades inferiores. As dificuldades apontadas pelos idosos no viver com HIV não se restringiram a limitações físicas, necessidade de acompanhamento clínico ou uso contínuo de medicamentos e suas eventuais conseqüências. Apontaram também para sentimentos de solidão, isolamento e receio de discriminação na família e no serviço de saúde. A identificação de particularidades nos aspectos psicossociais do viver com HIV/aids na terceira idade pode ser útil para subsidiar políticas públicas de cuidado a essa população nos serviços especializados, além de permitir a inclusão de abordagens preventivas nas ações que integram a atenção à saúde do idoso. / The AIDS epidemic is one of the most serious Public Health problems of our time. With the spread of the Brazilian epidemic, the number of reported cases among the elderly has recently increased. In the present study living with HIV was investigated, from the perspective of elderly men and women under follow-up at the AIDS Clinic-HC/FMUSP. Seventy-five patients were interviewed in search of socio-demographic data, information on their sexual lives, risk perception of HIV exposure, circumstances involving disclosure of diagnosis and how it impacted on their lives, reported episodes of stigma and discrimination, as well as their perception of provided care, the difficulties they had to face, and their plans for the future. The study cohort comprised mainly white men (65.3% and 64%, respectively), with less than 5-year schooling and a median income of 600 reais. Time since HIV diagnosis ranged from 18 months to 17 years. As far as their living conditions were concerned, 28% reported to live alone and 52% to be caregivers. Though 66.7% were retired, elderly patients significantly contributed for the family income. Out of 47 sexually active patients, 30 informed having a steady partner, more likely, serodiscordant (70%). Most patients reported consistent condom use after HIV diagnosis. Risk perception of HIV exposure was low and most (74.7%) patients believed having acquired the infection in unsafe sex. Serodiagnosis was carried out more often after healthcare professionals recommendation (73.3%), as compared to patients own initiative (26.7%), in a hospital setting and without pre-test counselling (85.1%). Eleven patients reported having received the diagnosis from an indifferent healthcare worker or, alternatively, felt discriminated against at the time of disclosure. Diagnosis affected their relationships with sexual partners, mainly. Episodes of stigma and discrimination were experienced by 18.7%. As for their perception of provided care, even though patients reported easy access to the clinic and to necessary care tools (medication, laboratory tests and condoms), they lacked efficient communication with the healthcare team. Except for a higher proportion of men, no significant difference was seen, when patients diagnosed aged 60 or more were compared to those tested younger. Among their difficulties in living with HIV, elderly patients not only reported physical handicap, or the need for continuous clinical follow-up and medication and its adverse effects, but highlighted feeling lonely and isolated, and feared being discriminated against by relatives and healthcare workers. Identifying particular psychosocial features of living with HIV/AIDS in elderly life may help establish public care policies for this population at specialised centres. In addition, it may allow integrating prophylactic strategies in a comprehensive care approach to elderly men and women.

O cuidado diário de um idoso com incapacidade funcional demanda recursos econômicos, planejamento, organização familiar e pessoal. Esse cuidar, sem uma rede e apoio social, pode ocasionar sobrecarga de tarefas, desgaste físico e emocional para quem cuida, principalmente quando é assumido por tempo prolongado e por uma única pessoa, desencadeando limitações na vida diária do cuidador e interferindo na sua qualidade de vida. Assim, o objetivo deste estudo foi avaliar a qualidade de vida do cuidador familiar de idosos dependentes e associar com a rede social, o apoio social, a sobrecarga do cuidador e o grau de dependência do idoso. Trata-se de um estudo descritivo quantitativo realizado no município de Arapongas-Pr, com uma amostra de 178 cuidadores familiares de idosos com incapacidade funcional. A coleta de dados foi realizada por pesquisadores de campo devidamente treinados, mediante entrevista domiciliar, utilizando os instrumentos: questionário contendo variáveis sociodemográficas do cuidador, o Medical Outcomes Study - MOS e o Social Network Index para avaliação da rede e apoio social, The Zarit Burden Interview -ZBI para avaliação da sobrecarga e o WHOQOL-Bref para avaliação da qualidade de vida. Os dados evidenciaram que os cuidadores eram em sua maioria mulheres (90,4%), filhas (48,8%), casadas (76,4%), com média de idade de 56,7 anos, pertencentes à classe econômica C (33,1%).Os cuidadores avaliaram a sua saúde como regular (45,5%), apresentaram sobrecarga moderada (57,3%), rede social menos de três parentes (60,1%) e menos de três amigos (71,4%) e a interação social foi a dimensão de apoio social mais afetada (50,4). Na avaliação da qualidade de vida, o domínio meio ambiente (56,1) e psicológico (57,3) foram os mais comprometidos. A análise multivariada revelou que as chances de o cuidador apresentar melhor qualidade de vida no domínio físico foram associadas a pouca/nenhuma sobrecarga (OR=6,52), ausência de doença referida (OR=27,06) e estar na condição de solteiro (OR=8,47). No domínio psicológico, as chances para melhor qualidade de vida associaram-se com pouca/nenhuma sobrecarga (OR=5,61), presença de apoio de interação social (OR=3,21), ausência de doença relatada (OR=7,47) e estar na condição de solteiro (OR=6,0). No domínio de relações sociais, as chances de melhor qualidade de vida foram aumentadas quando o cuidador apresentou apoio de informação (OR=3,73) e recebeu orientação para o cuidado (OR=4,54). No domínio meio ambiente, as chances de melhor qualidade de vida associaram-se ao fato do cuidador pertencer à classe social A/B (OR=53,6), apresentar uma rede social de quatro ou mais parentes (OR=3,07), não apresentar doença diagnosticada (OR=4,51) e encontrar-se na condição de solteiro (OR=8,28). Diante dos dados encontrados, faz-se necessário pensar e refletir sobre a temática que levanta a necessidade da implantação de programas que incluam a saúde do cuidador, contribuindo, desta forma, para melhorar a sua qualidade de vida e, consequentemente, prover um cuidado adequado ao idoso dependente. / Daily care for elderlies with functional disability requires economic resources, planning, family and social organization. Without a social and support network, this care can lead to task overload, physical and emotional exhaustion of the caregiver, particularly when done for an extended period of time and by a single person, unleashing limitations in the caretaker\'s daily life and interfering with his/her quality of life. Thus, the objective of this study was to evaluate the quality of life of family caretakers of dependent elderlies, and link it to social networks, social support, caregiver overload and the elderly\'s level of dependence. It is a descriptive quantitative study performed in the city of Arapongas-PR, Brazil, with a sample of 178 family caretakers of elderlies with functional disability. Data collection was carried out by trained field researchers, through home interviews, using the following instruments: a questionnaire containing socio-demographic variables of the caregiver, the Medical Outcomes Study - MOS and Social Network Index to evaluate the social network and support, the Zarit Burden Interview -ZBI to assess overload, and the WHOQOL-Bref to evaluate quality of life. The data showed that caregivers were mostly women (90.4%), daughters (48.8%), married (76.4%), averaging 56.7 years of age, belonging to income class C (33.1%). Caretakers evaluated their own health as regular (45.5%), showed moderate overload (57.3%), social net of fewer than three relatives (60.1%) and fewer than three friends (71.4%), and social interaction was the most affected dimension of social support (50.4%). In the evaluation of quality of life, the environment (56.1%) and psychological (57.3%) domains were most compromised. Multivariate analysis revealed that the chances of the caregiver having a better quality of life in the physical domain were linked to little/no overload (OR=6.52), absence of reported illness (OR=27.06) and being single (OR=8.47). In the psychological domain, the chances of a better quality of life was linked to little/no overload (OR=5.61), presence of social interaction support (OR=3.21), absence of reported illness (OR=7.47) and being single (OR=6.0). In the realm of social relations, the chances for a better quality of life increased when the caretaker had information support (OR=3.73) and received care guidance (OR=4.54). In the environment realm, chances for a better quality of life was linked to whether the caregiver belonged to income class A/B (OR=53.6), having a social network of four more relatives (OR=3.07), not having a diagnosed illness (OR=4.51) and being single (OR=8.28). Based on the reported data, it is necessary to think and reflect on the need to implement programs that include caregiver health, thus contributing to improve their quality of life and consequently provide adequate care for the dependent elderly.