Orientador: Monica Rodrigues Perracini, Anita Liberalesso Neri / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-19T08:29:17Z (GMT). No. of bitstreams: 1 Tomomitsu_MonicaReginaScandiuzziValente_M.pdf: 125208194 bytes, checksum: f704327f18ecc0c04405aa6020e70e90 (MD5) Previous issue date: 2011 / Resumo: Objetivo: Explorar as relações entre prestar cuidado e as condições socioeconômicas, de saúde e de bem estar em fase da velhice. Idosos que prestam cuidado no contexto familiar foram comparados com idosos não cuidadores, quanto às condições socioeconômicas (idade, gênero e renda familiar), de saúde (número de doenças, fadiga, insônia), psicossocial (sintomas depressivos, suporte social percebido), funcionalidade (envolvimento em atividades avançadas de vida diária, desempenho de atividades instrumentais de vida diária) e sua relação com satisfação com a vida. Métodos: Estudo multicêntrico, de corte transversal, desenvolvido a partir de dados provenientes do banco de dados do Estudo FIBRA das cidades de Campinas-SP, Ivoti-RS e Parnaíba-PI. Integraram a amostra para este estudo 676 idosos, dentre os quais 338 cuidadores e 338 não-cuidadores, emparelhados aos cuidadores conforme critérios de cidade de origem, gênero, idade e renda familiar. A base de dados completa continha 1581 idosos que compuseram a amostra probabilística dos selecionados por pontuação superior à nota de corte no Mini Exame do Estado Mental. Os cuidadores foram identificados por responder afirmativamente a questão sobre cuidado contida no Elders Life Stress Inventory (ELSI), enquanto os não-cuidadores foram identificados por responder negativamente a esta questão. Os instrumentos utilizados foram: versões brasileiras da Geriatric Depression Scale, do ELSI, da Interpersonal Support Evaluation List e a escala de Lawton para atividades instrumentais de vida diária, e mais 13 itens de atividades avançadas de vida diária. A escala de satisfação com a vida continha dois itens de satisfação global e seis referenciados a domínios específicos. Foram aplicadas questões de autorrelato sobre idade, gênero, renda familiar, número de doenças e fadiga. Resultados: Os cuidadores compuseram 29.7% da amostra, sendo que a tarefa de cuidar era mais frequente entre as mulheres, entre os idosos de 65 a 74 anos e entre os de menor renda familiar. A grande maioria dos idosos (95,5% dos cuidadores e 96,4% dos não cuidadores) avaliaram a satisfação com a vida global hoje como moderada ou alta. Para ambos os grupos, as mulheres eram as mais doentes e os homens eram mais isolados socialmente. Ser mais pobre estava associado com ter mais problemas de insônia, assim como relacionou-se com maior número de sintomas depressivos entre os cuidadores e com maior comprometimento em AIVD entre os não cuidadores. Os cuidadores de idade avançada reportaram maior frequência de dependência em AIVD. Nas análises de regressão multivariada, sentir-se fatigado e depressivo associaram-se com menor satisfação com a vida, para ambos os grupos, bem como, nível baixo de satisfação com a vida correlacionouse com queixas de insônia entre cuidadores e baixo suporte social percebido entre não cuidadores. O grupo de cuidadores com nível mais alto de estresse relataram mais sintomas de insônia e maior necessidade de auxílio no desempenho de AIVD do que os cuidadores com baixo nível de estresse e os não cuidadores, enquanto que, cuidadores com menor estresse e não cuidadores não diferiram significativamente quanto à frequência das variáveis investigadas. Conclusões: Circunstâncias socioeconômicas contribuem para desfechos negativos sobre as condições de saúde e psicológica, de envolvimento social e de desempenho independente em AIVD, especialmente entre os cuidadores e entre os homens. Para ambos os grupos, a satisfação com a vida é afetada por condições de saúde e psicológica. Idosos cuidadores não são mais vulneráveis do que não cuidadores, exceto os cuidadores mais estressados quanto à qualidade do sono e a independência em AIVD / Abstract: Objective: To investigate the relationships among caregiving and the socioeconomic, health and well-being conditions at aging. Older caregivers were compared with older noncaregivers regarding socioeconomics status (age, sex, income familiar), health status (comorbidities, fatigue, insomnia), psychosocial conditions (depressive symptoms, perceived social support), functionality (engagement social in advanced activities of daily living, performance in instrumental of activities of daily living) and life satisfaction. Method: The data for this study were obtained using a database of a multicenter, crosssectional study know as the FIBRA Study, using information collected in the three cities Campinas-SP, Ivoti-RS and Parnaíba-PI. The sample, used in this study, consisted of 676 elderly individuals, including 338 caregivers and 338 non-caregivers. The latter were randomly drawn from the database to match to the caregivers according to city of origin, gender, age and family income. The original database included 1,581 elderly individuals selected using representative sampling methods, and all participants had results above cutoff score on the Mini-Mental State Examination. The caregivers were identified on the basis of their responses to question about caregiving in the Elders Life Stress Inventory (ELSI). The instruments used for datacollection included: the Brazilian versions of the Geriatric Depression Scale, the Elders Life Stress Inventory, the Interpersonal Support Evaluation List, and Lawton's Scale of Instrumental activities of Daily Living and 13 items related to Advanced Activities of Daily Living. Life satisfaction was measured using two items regarding global satisfaction and six items regarding specific domains. Respondents answered self-report questions about age, gender, family income, number of illness and fatigue. Results: Caregivers constituted 29% of the sample. Providing care was more common among women, among people aged 65 to 74 years and among those with lower family incomes. The majority of the elderly individuals evaluated their life satisfaction as being moderate or high (95,5% of caregivers and 96,4% of non-caregivers) In both groups, women had a higher number of diseases while men were more socially isolated. Low income was related with a greater likehood of reporting insomnia and with a higher number of depressive symptoms among caregivers and greater impairment in IADL among noncaregivers. The older caregivers reported a higher frequency of dependency for IADL. In the multivariate logistic regression, feeling fatigued and depressed were associated with lower life satisfaction among both caregivers and non-caregivers. Lower life satisfaction was correlated with insomnia among caregivers and with lower perceived social support and among non-caregivers. The perception of a higher stress levels among caregivers was related to greater insomnia and greater needs for assistance in IADL than caregivers with lower stress levels and non-caregivers. No significant differences were observed between caregivers with lower stress levels and non-caregivers in terms of health status, psychosocial conditions and functionality. Conclusions: Socioeconomic status was associated with negative conditions in terms of health status, psychological well-being, social disengagement and independence in the performance of IADL, particularly among elderly caregivers and men. For both groups, life satisfaction levels seems to be related to health and psychology conditions. In conclusion, the elderly caregivers were not more vulnerable than the non-caregivers, except for caregivers with a higher stress levels, who had more frequent problems with insomnia and a greater level of difficulty with IADL / Mestrado / Mestre em Gerontologia

Orientador: Maria José D'Elboux / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-21T07:08:39Z (GMT). No. of bitstreams: 1 Oliveira_DeborahCristinade_M.pdf: 2408872 bytes, checksum: 31c303898ae88f90a0f0de819a259b4d (MD5) Previous issue date: 2012 / Resumo: A expectativa de suporte para o cuidado é a crença que o idoso tem de que pessoas próximas proverão a assistência futura a ele caso haja necessidade, aliviando o estresse em situação de crise, podendo inibir o desenvolvimento de doenças e exercer um papel positivo em sua recuperação. Esta pesquisa teve por objetivos comparar a expectativa de suporte para o cuidado, arranjo de moradia e variáveis relacionadas à saúde, em função de gênero e faixa etária de idosos da comunidade e identificar as variáveis associadas à ausência de expectativa de suporte para o cuidado em idosos da comunidade. Foi realizada a partir dos dados da Rede de Pesquisa sobre Fragilidade em Idosos Brasileiros (Rede FIBRA), utilizando dados da cidade de Campinas-SP (n=671). Foram selecionadas variáveis sociodemográficas (gênero, idade e arranjo de moradia), variáveis relacionadas à saúde (doenças auto-relatadas, independência funcional, saúde percebida e fragilidade) e expectativa de suporte para o cuidado para a realização de ABVD's e AIVD's. Foi realizada análise descritiva e, por meio dos testes Qui- Quadrado ou exato de Fisher, análise de comparação das principais variáveis categóricas entre gênero, faixa etária e expectativa suporte para o cuidado. Para estudar os fatores associados com a ausência de expectativa de suporte para o cuidado foi utilizada a análise de regressão logística univariada e multivariada, com critério Stepwise de seleção de variáveis. O Estudo FIBRA e o presente estudo foram aprovados pelo Comitê de Ética em Pesquisa da Faculdade de Ciências Médicas da Unicamp (208/2007). Mais mulheres moram sozinhas (20,52%), tem maior número de doenças (49,02%), incapacidades em ABVD's (12,42%), pior avaliação da própria saúde (7,39%) e esperam receber cuidado de apenas uma pessoa caso haja necessidade (46,84%). Grande percentual de homens mantém a realização de suas AAVD's (95,59%), tem expectativa de suporte para o cuidado (93,33%) e esperam serem cuidados por um maior número de pessoas caso precisem (55,34%). Maior número de idosos mais longevos vivem sozinhos (22,55%) e tem incapacidade para realização das AIVD's (35,96%). As respostas afirmativas referentes à expectativa de suporte para o cuidado estiveram mais presentes para os homens, sujeitos que residem acompanhados, que deixaram de realizar uma ou mais AAVD e que referem saúde percebida boa e muito boa. Grande percentual de idosos que avaliaram sua saúde como ruim ou muito ruim (25,64%) e idosos que residem sozinhos (22,42%) não têm expectativa de suporte para o cuidado. Os idosos que avaliaram a própria saúde como ruim ou muito ruim têm três vezes mais chance de não ter expectativa. As mulheres têm duas vezes mais chance de não ter expectativa de suporte para o cuidado, e, se residirem sozinhas, tem três vezes mais chance de ausência de expectativa. Esta pesquisa evidencia que a expectativa de suporte para o cuidado dos idosos da cidade de Campinas - SP está diretamente relacionada ao gênero, é independente da idade e que os idosos estão em situação vulnerável para a falta de expectativa de suporte para o cuidado e percepção de saúde, podendo estar mais suceptíveis ao declínio funcional, morbidades e à falta de suporte para o cuidado / Abstract: The anticipated support for care is the belief that the elderly have people around that will provide future assistance to him should the need arise, relieving stress in a stressful situation, can inhibit the development of diseases and exerting a positive role in their recovery. This research aimed to compare the anticipated support for care, arranging housing and health related outcomes, by gender and age group of older adults and identify the variables associated with lack of anticipated support for care in dwelling elderly. It was performed from the data of the Research Network on Frailty in Elderly Brazilian Network (FIBRA), using data from the city of Campinas- SP (n = 671). There were selected sociodemographic variables (gender, age and arrangement of housing), health-related variables (self-reported illnesses, functional capacity, perceived health and frailty) and expectation of support for care to perform BADL's and IADL's. A descriptive analysis and by using the chi-square or Fisher exact test, comparison analysis of the main categorical variables of gender, age and anticipated support for care. To explore the factors associated with the absence of expected support for the careful analysis was used for univariate and multivariate analysis with stepwise criterion for variable selection. FIBRA Study and the present study were approved by the Ethics Committee in Research of the Faculty of Medical Sciences of Unicamp (208/2007). More women live alone (20.52%), has more diseases (49.02%), disabilities in BADL's (12.42%), worse assessment of their health (7.39%) and expect to receive care only a person should the need arise (46.84%). Large percentage of men have to carry out their AAVD's (95.59%) is expected to support care (93.33%) and expect to be cared for by a greater number of people if they need it (55.34%). Increased number of oldest-old elderly living alone (22.55%) and has inability to perform IADL's (35.96%). The affirmative answers regarding the anticipated support support for care were more positive for men, guys who live together, who failed to perform one or more AAVD and perceived health good and very good. Large percentage of seniors who rated their health as poor or very poor and elderly who live alone have negative anticipated support for care. Elderly people who assess their health as poor or very poor are three times more likely to have no expectations. Women are twice as likely to have no anticipated support for care and, if they reside alone has three times more likely to lack of expectation. This research shows that the anticipated support for elderly care in the city of Campinas - SP is directly related to gender, is independent of age and who are vulnerable in relation to the expectation of support for the care and health perception, with more susceptible to functional decline and lack of expected support / Mestrado / Enfermagem e Trabalho / Mestra em Ciências da Saúde

Orientador: Maria José D'Elboux / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-21T21:57:37Z (GMT). No. of bitstreams: 1 Cruz_KeilaCristianneTrindadeda_D.pdf: 1556961 bytes, checksum: 94953ff52f751da3d348450f9fbc5715 (MD5) Previous issue date: 2012 / Resumo: A qualidade de vida relacionada à saúde (QVRS) é uma forma utilizada para avaliar a saúde das pessoas bem como detalhes subjetivos de suas vidas. Esta pesquisa teve por objetivo avaliar a QVRS dos idosos do Estudo SABE por meio do SF-12 e de variáveis que contemplem as características peculiares dessa faixa etária. O presente estudo foi realizado a partir dos dados do Estudo Longitudinal Saúde, Bem-estar e Envelhecimento (SABE) coletados em 2006, com uma amostra representativa de 1031 idosos residentes no município de São Paulo, sem sintomas depressivos que responderam o "The Medical Outcomes Study 12-item Short-Form Health Survey" (SF-12). Os escores do SF-12 são resumidos em dois grandes componentes, o escore do componente físico (ECF) e o escore do componente mental (ECM). Foi realizada uma busca na literatura sobre os significados atribuídos por idosos brasileiros sobre QV e agrupados em quatro categorias de informações contidas no questionário do Estudo SABE 2006: a categoria sociodemográfica, relacionada à saúde, de relacionamento/apoio e de bem-estar subjetivo. Os ECF e ECM do SF-12 foram categorizados em tercis sendo o primeiro constituído pelos escores mais baixos dos componentes e os demais pelos escores intermediários e mais altos, respectivamente. Foi realizada a Regressão Logística Multinomial para modelar a chance de um idoso pertencer a um dos tercis de cada componente de QVRS. Os componentes físicos e mentais apresentaram médias e amplitudes de variação maiores para os homens, com exceção do ECF cuja variação foi maior para as mulheres. No ECF, o maior número de idosos apresentou piores valores desse componente. Houve associação significativa entre o componente físico e sexo, faixa etária, ter casa própria, escolaridade, morbidades, número de medicamentos, dificuldade para ABVDs e AIVDs, paz/tranquilidade e religião. Em relação ao componente mental, houve associação significativa com ter dinheiro suficiente, escolaridade, morbidade, número de medicamentos, sentir-se nutrido, sentir-se amado pela família, APGAR de Família, paz/tranquilidade e satisfação com a vida. No componente físico houve influência das categorias sociodemográfica e relacionadas à saúde e no componente mental, de variáveis pertencentes às categorias dados sociodemográficos, relacionados à saúde e bem estar subjetivo. Espera-se com esse trabalho subsidiar o planejamento e implantação de intervenções que visem favorecer a QV do idoso / Abstract: The Health related quality of life (HRQoL) is a kind of health assessment as well as an evaluation of subjective details of people lives. This research aimed to evaluate HRQOL of no depressed elderly people, that were subjects of a Longitudinal Study on Health, Wellbeing and Aging (SABE Study), using "The Medical Outcomes Study 12-item Short- Form Health Survey "(SF-12) and variables that cover specific characteristics of this age group. The present study have used SABE Study data that were collected in 2006 on a sample of 1031 older adults that were living in São Paulo, without depressive symptoms, those who responded SF-12. The scores of SF-12 are summarized into two major components: the physical component score (PCS) and the mental component score (MCS). It were done a literature review on the meanings attributed by Brazilian elderly on Quality of Life(QOL) and these meanings were grouped into four categories of information in the survey of SABE Study: sociodemographic category, health-related category, relationship / support and subjective well-being. The PCS, MCS and the SF-12 were categorized as terciles. The first of these have consisted of the lowest scores of the components. The others have presented intermediate and highest scores, respectively. It were performed a Multinomial Logistic Regression to investigate the chance of an elderly to belong to one of terciles of each component of HRQOL. The physical and mental components showed averages and amplitudes of variation greater for men, except for PCS which variation was greater for women. In the PCS, largest number of elderly has the worst scores of this component. There was a significant association between physical component and some variables as: sex, age group, homeownership, education, comorbidities, number of medications in use, difficulty for Basic Activities of Daily Living (BADL) and Instrumental Activities of Daily Living (IADL), peace / tranquility and religion. Regarding the mental component, there was significant association with having enough money, education, comorbidity, number of medications in use, to feel nurtured, feeling of being loved by family, Family APGAR, peace / tranquility and life satisfaction. The physical components were influenced by sociodemographic and health related categories. The mental component received influence by variables of the following categories: sociodemographic, health-related and subjective well-being. It is expected that this work supports the planning and implementation of interventions designed to improve the QOL of the elderly / Doutorado / Enfermagem / Doutora em Enfermagem

The health and fitness status of Canadian children has been declining over the past several decades. Children’s health and fitness impacts future health status as many health and fitness indicators track from youth into adulthood and are associated with serious illnesses such as cardiovascular disease (CVD). One potential determining factor of health and fitness may be the level of proficiency exhibited in performing fundamental movement skills (FMS). Failure to master FMS in childhood may decrease the physical activity options available in adulthood because FMS provide a foundation for all forms of physical activity pursuits necessary for health and fitness benefits. Todate, the relationship between health, fitness and proficiency of FMS has not been examined in Canadian children. Therefore, the purpose of the present investigation was to examine the current state of movement skill proficiency in relation to health and fitness in Canadian elementary-aged children. Boys (n = 71) and girls (n = 91 girls) ages 8 to 11 years were recruited from schools participating in the evaluation component of the Action Schools! BC program. Measures of fundamental movement skill proficiency (i.e., running, horizontal jumping, vertical jumping, jumping from a height, hopping, and skipping) and indicators of health and fitness (i.e., blood pressure, arterial compliance, weight status, musculoskeletal and cardiovascular fitness) were assessed. Results indicated low levels of FMS proficiency for both boys and girls. Analysis also revealed significant relationships between EMS and indicators of health and fitness. Correlation analyses found running and hopping to be significantly (p < .01) related to musculoskeletal and cardiorespiratory fitness tests. Significant (p < .01) relationships between vertical jumping and weight status, musculoskeletal and cardiorespiratory fitness were also found by the correlation analyses. Regression analyses were performed to determine the independent relationship between health and fitness indicators. Vertical jump was significantly (p < .01) related to blood pressure (BP) independent of confounding health and fitness variables. Finding significant relationships between FMS proficiencies and health and fitness indicators coupled with the low proficiencies demonstrated by our sample of children suggest the need for a greater emphasis on the development of FMS. / Education, Faculty of / Kinesiology, School of / Graduate

Magister Artium - MA / This minithesis provides an ethnographic account of the life world of older people in the community of Belhar in the Cape Peninsula, which was historically categorised as a 'coloured' community during the implementation of the Group Areas Act. By content analysing newspaper articles published in the early 1980s and specifically during the implementation of the Group Areas Act I found that many of the residents reported that they lived in fear of their lives, in what was once known as a 'prestige suburb'. At the present time the community of Belhar is an intensely gang-infested area. From preliminary research done by myself at a senior citizen centre in Belhar, the high incidence of violence was a recurring theme throughout discussions with older people. In fact when I posed the question Why do you come to the centre five days a week? to a group of older people they answered without hesitation It is unsafe for an older person to be alone during the day. Answers like these to many of the questions that I posed would almost always be followed with Things were better then. It also was apparent that the older people in this community remember (or perhaps reconstruct) the past in the context of their present living situation. This became the leading theme in my study and is also the background against which I had formulated my research questions. However this study not only focused on the impact of the high incidence of violence on the community of older people but also essentially looked at elderly residents; everyday lived experiences in Belhar. The research sample consisted of twenty elderly residents and four key informants. The latter provided mainly infrastructural data on the community. Primary data was collected by using ethnographic techniques of inquiry which included participant observation and unstructured interviews. Results revealed that older people occupy a liminal space both in the community and in their households. I also found that the elderly stroke victim is twice silenced and marginalized due to the constraints brought on by their chronic illness and their status as an older person in the community. / South Africa

Please read the abstract in the 00front part of this document / Thesis (DPhil (Social Work))--University of Pretoria, 2007. / Social Work and Criminology / unrestricted

Background: There is little information on how the quality of oral health services in long-term care (LTC) facilities is conceptualized or assessed. Objectives: This study aims to develop a model for assessing the quality of oral healthcare services in LTC facilities. Methods: This study is divided into four main steps. Firstly, I examined literature for existing concepts relating to program evaluation and quality assessment in healthcare to build a theoretical framework appropriate to dental geriatrics. Secondly, I explored as an ethnographic case study a comprehensive oral healthcare program within a single administrative group of 5 LTC facilities in a large metropolis by interviewing 33 participants, including residents and their families, nursing staff, administrators and dental personnel. I also examined policy documents and made site visits to identify other attributes influencing the quality of the program. Thirdly, I drafted the assessment model combining a theoretical framework with empirical information from the case study. And lastly, I tested the feasibility and usability of the model in another dental geriatric program in northern British Columbia. I applied the assessment model by conducting 15 interviews with participants in the program, made site-visits to the 5 facilities, and reviewed documents on the development and operation of the program. Results: A combination of theory-based evaluation and quality assurance provided six sequential and iterative steps for quality assessment of oral health services in LTC. The empirical information supported the theoretical framework that a program of oral healthcare in a LTC context should be assessed for quality from multiple perspectives; it should be comprehensive; and it should include the three main attributes of quality - capacity, performance, and outcomes. Participants revealed 20 quality indicators along with suggested program objectives which encompass eight quality dimensions such as effectiveness, efficiency, and patient-centered. Conclusion: The model provides a unique system for assessing the quality of dental services in LTC facilities that seems to meet the needs of dental and non-dental personnel in LTC. / Dentistry, Faculty of / Graduate

[no abstract included] / Arts, Faculty of / Social Work, School of / Graduate

[no abstract included] / Arts, Faculty of / Social Work, School of / Graduate

This investigation, comprising two studies, examined the number of barriers to physical activity (Study 1) and barrier strength (Study 2) reported by middle-aged and older adults using a social ecological framework (McLeroy et al., 1988). Researchers were interested in assessing age group (45-54; 55-64; 65-74 yrs) by physical activity group (active, less active) effects for barrier responses using analyses of variance. In Study 1, 180 participants completed a physical activity level survey (Godin & Shephard, 1985) and answered open-ended questions about barriers. Results indicated that 45-54 yr-olds reported more barriers overall, and more intrapersonal barriers than older groups. Less active 45-54 yr-olds reported more organizational-interpersonal barriers than the other groups. Descriptive analyses of coded themes demonstrated that common intrapersonal barrier sub-themes cited by younger adults related to family commitments, while sub-themes reported by middle-aged and older adults related to having a health problem or an injury. In the organizational-interpersonal category, the most common barrier sub-theme related to the workplace. In Study 2, 116 participants completed a survey assessing weekly physical activity and barrier strength for items pertaining to ecological categories and barrier sub-factors. Results showed that less active adults reported each of intrapersonal, interpersonal, and physical environment barriers more strongly than active adults, irrespective of age; the intrapersonal category was relatively the most constraining for our participants. In terms of barrier sub-factors, results showed that significantly higher barrier strength scores are most often associated with physical activity level (i.e., less active), and only occasionally associated with age group. The overall investigation can provide valuable information for improving physical activity interventions for middle-aged and older adults.