Even though a plethora of research is devoted to explicating caregivers' experiences, comparatively there is a dearth of information about care recipients. The purpose of this study was to further theoretical and empirical understanding of care recipients' experiences within care relationships. Specifically, this study was concerned with identifying the strategies elders use to seek care and how the processes and characteristics of individual, interpersonal, and structural levels interact to affect elders' care seeking. A synthesized symbolic interactionist and life span developmental framework informed the research. Multiple qualitative field work methods (semi-structured interviews, participant observation, focus group) were utilized to collect information about care recipients who were representative of the variety of care relationships within a life care retirement community. The care seeking process emerged as a sequence of activities engaged in as elders elicited care from others and negotiated care with others. Of most conceptual interest, however, was elders' dependency work: The work elders engaged in as they not only sought care for a specific need but also situated each care occasion within past experiences of care and future possibilities for care. Dependency work was agency in action, serving to define the everyday lives of elders involved in care relationships. The findings of this study suggest the need for viewing care recipients as agents, actively being with others in their delicate dance of dependency.

Conforme os anos se passam, maior é o número de idosos e maiores são suas perspectivas de vida, evidencia-se a importância de garantir aos idosos não só uma sobrevida maior, mas também uma boa qualidade de vida. À medida que um indivíduo envelhece, sua qualidade de vida é fortemente determinada por sua habilidade de manter autonomia e independência. O objetivo deste trabalho foi caracterizar a qualidade de vida em idosos institucionalizados e não institucionalizados do município de Agudos (SP) e a sua relação com os fatores associados. A amostra foi composta por 30 idosos, sendo 15 institucionalizados e 15 idosos não institucionalizados do município de Agudos (SP), de ambos os sexos e idade mínima de 60 anos. Os sujeitos foram pareados quanto ao gênero e idade. Os instrumentos utilizados foram: Questionário de análise socioeconômica (Critério de Classificação Econômica Brasil CCEB); Questionário sobre os aspectos de saúde geral; Protocolo para avaliar capacidade funcional Índice de Katz; Inventário de Depressão de Beck; e o Protocolo de Qualidade de Vida para Idosos WHOQOLOLD. Como resultados pode-se observar escores inferiores para os idosos institucionalizados frente aos não institucionalizados para todos os fatores investigados: saúde geral principalmente hipertensão, uso de medicamentos e queixas de memória - , capacidade funcional, depressão e qualidade de vida. Para qualidade de vida, a faceta que obteve melhor escore foi Morte e Morrer, com 80,84 para os institucionalizados e 78,33 para não institucionalizados, e a de pior escore foi Autonomia, com 57,92 e 58,75 para o primeiro e segundo grupo. Considerando a análise estatística, os sintomas depressivos são os que interferem de maneira significativa (p=0,0211) na qualidade de vida dos idosos institucionalizados. Tendo em vista os princípios da Política Nacional de Saúde da Pessoa Idosa, faz-se necessária uma reestruturação e implementação de novos programas de promoção e prevenção de agravos que acometem a velhice, como a hipertensão e depressão, visando uma melhor qualidade de vida para esta população. / As the years pass, the greater the number of older and larger are their life prospects in Brazil and the world, before this fact it´s very important to ensure the elderly not only increased survival but also good quality life. As an indi vidual ages,their quality of life is largely determined by its ability to maintain autonomy and independence. The objective of this study was to characterize the quality of life in institutionalized and non-institutionalized elderly in Agudos, state of São Paulo and its relation with associated factors. The sample consisted of 30 elderly, 15 institutionalized and 15 noninstitutionalized elderly in Agudos (SP) for both sexes and more than 60 years. The individuals were matched for gender and age. The instruments used were: Questionnaire of socioeconomic analysis (Economic Classification Criterion Brazil - CCEB); Questionnaire of aspects of general health; Katz Index; Beck Depression Inventory; and the Quality of Life Protocol for Seniors WHOQOL-OLD. The results show lower scores for institutionalized elderly compared to non-institutionalized for all investigated factors: general health especially hypertension, medication use and memory complaints - , functional capacity, depression and quality of life. For quality of life, the domain that had the best score was \"Death and Dying\", with 80,84 for institutionalized and 78,33 for noninstitutionalized, and the worst score was \"Autonomy\" with 57,92 and 58,75 for the first and second group. Considering the statistical analysis, depressive symptoms are interfering in a significant way (p=0,0211) in the quality of life of institutionalized elderly. In view of the principles of the National Health Policy for Older Persons, it is necessary restructuring and to implement new programs of health promotion and prevention of diseases that affect the elderly, such as hypertension and depression, to improve the quality of life for this population.

Conforme os anos se passam, maior é o número de idosos e maiores são suas perspectivas de vida, evidencia-se a importância de garantir aos idosos não só uma sobrevida maior, mas também uma boa qualidade de vida. À medida que um indivíduo envelhece, sua qualidade de vida é fortemente determinada por sua habilidade de manter autonomia e independência. O objetivo deste trabalho foi caracterizar a qualidade de vida em idosos institucionalizados e não institucionalizados do município de Agudos (SP) e a sua relação com os fatores associados. A amostra foi composta por 30 idosos, sendo 15 institucionalizados e 15 idosos não institucionalizados do município de Agudos (SP), de ambos os sexos e idade mínima de 60 anos. Os sujeitos foram pareados quanto ao gênero e idade. Os instrumentos utilizados foram: Questionário de análise socioeconômica (Critério de Classificação Econômica Brasil CCEB); Questionário sobre os aspectos de saúde geral; Protocolo para avaliar capacidade funcional Índice de Katz; Inventário de Depressão de Beck; e o Protocolo de Qualidade de Vida para Idosos WHOQOLOLD. Como resultados pode-se observar escores inferiores para os idosos institucionalizados frente aos não institucionalizados para todos os fatores investigados: saúde geral principalmente hipertensão, uso de medicamentos e queixas de memória - , capacidade funcional, depressão e qualidade de vida. Para qualidade de vida, a faceta que obteve melhor escore foi Morte e Morrer, com 80,84 para os institucionalizados e 78,33 para não institucionalizados, e a de pior escore foi Autonomia, com 57,92 e 58,75 para o primeiro e segundo grupo. Considerando a análise estatística, os sintomas depressivos são os que interferem de maneira significativa (p=0,0211) na qualidade de vida dos idosos institucionalizados. Tendo em vista os princípios da Política Nacional de Saúde da Pessoa Idosa, faz-se necessária uma reestruturação e implementação de novos programas de promoção e prevenção de agravos que acometem a velhice, como a hipertensão e depressão, visando uma melhor qualidade de vida para esta população. / As the years pass, the greater the number of older and larger are their life prospects in Brazil and the world, before this fact it´s very important to ensure the elderly not only increased survival but also good quality life. As an indi vidual ages,their quality of life is largely determined by its ability to maintain autonomy and independence. The objective of this study was to characterize the quality of life in institutionalized and non-institutionalized elderly in Agudos, state of São Paulo and its relation with associated factors. The sample consisted of 30 elderly, 15 institutionalized and 15 noninstitutionalized elderly in Agudos (SP) for both sexes and more than 60 years. The individuals were matched for gender and age. The instruments used were: Questionnaire of socioeconomic analysis (Economic Classification Criterion Brazil - CCEB); Questionnaire of aspects of general health; Katz Index; Beck Depression Inventory; and the Quality of Life Protocol for Seniors WHOQOL-OLD. The results show lower scores for institutionalized elderly compared to non-institutionalized for all investigated factors: general health especially hypertension, medication use and memory complaints - , functional capacity, depression and quality of life. For quality of life, the domain that had the best score was \"Death and Dying\", with 80,84 for institutionalized and 78,33 for noninstitutionalized, and the worst score was \"Autonomy\" with 57,92 and 58,75 for the first and second group. Considering the statistical analysis, depressive symptoms are interfering in a significant way (p=0,0211) in the quality of life of institutionalized elderly. In view of the principles of the National Health Policy for Older Persons, it is necessary restructuring and to implement new programs of health promotion and prevention of diseases that affect the elderly, such as hypertension and depression, to improve the quality of life for this population.

本研究是一項關於北京中年抑鬱症患者主觀經驗的敘事分析。研究的目的在於探尋患者對於自身患病歷程的主觀詮釋，他們的服務需求以及對於中國大陸精神衛生社會工作進行反思。研究的參與對象為目的性抽樣所得到的來自北京的一個抑鬱癥自助團體的八名中年抑鬱癥患者。 / 患者回顧了他們不同階段的經歷：發病期、住院期以及康復期。然後他們對於這些經歷做了詮釋。基於不同領域的社會服務需求，對於醫院、社區、大眾傳媒以及政府，他們都給出了寶貴的意見。 / 研究發現，既有的理論觀點對於關著對自身經歷的詮釋有著重要的影響，尤其是生物醫學模型。認知觀點和性別觀點也可以在患者們的敘事中找到蹤跡。精神科醫生在患者的整個經歷中都處於重要的地位，他們的觀點和行為對患者也產生了重要的影響。 / 患者還受到社會和歷史因素的影響。他們的詮釋會受到社會觀念和文化價值的影響，比如命運、面子、孝順以及性別角色等等。而歷史事件諸如文化大革命以及天安門事件也會對他們的人生經歷以及他們的主觀詮釋造成影響。而中國目前的社會情境也是另一項重要的影響因素。 / 從他們的故事中，我們可以看到，最重要的主題就是他們在患病過程中認知模式的轉變，包括對待抑鬱癥本身，所接受的服務以及自身的看法。在他們的敘述中，另外兩個主題也是非常值得注意的，那就是和抑鬱症有關的“喪失以及醫院裡非人道的治療方式。 / 他們的故事為我們對於北京中年抑鬱症患者經歷的理解提供了非常豐富詳實的材料。這些發現對於知識理論的發展、政策的制定以及針對抑鬱症患者的臨床社會工作實踐都有著很大的啟示。整個社會以及不同領域的精神衛生專業人士都應該攜起手來幫助他們，共同去創造一個更加包容和諧的社會。 / This research was a narrative analysis of the subjective experiences of the depressed middle-aged adults in Beijing, China. The purposes of the research were to explore the clients’ subjective interpretation of their lived experience of depression, their service needs and reflect on the improvement of mental health social work in Mainland China. A purposive sample of eight depressed clients from a self-help group in a mental health hospital in Beijing participated in this study. / The clients talked about their experiences at different stages: the onset, in the hospital and the rehabilitation, and interpreted their experiences. They also gave some advice to the hospital, the community, the mass media and the government based on their social service needs. / The theoretical perspectives influenced the clients’ interpretations of their experiences, especially the biomedical model. The cognitive perspective and the gender perspective could also be found in the client’s narratives. The psychiatrists were very important in the whole process of the clients’ experiences. Their perspectives and behaviors also influenced the clients. / It is found that the clients were also influenced by social and historical factors. Their interpretations were affected by social beliefs and cultural values such as fate, face, filial piety and gender roles. The historical events such as Cultural Revolution and June.4th Movement also affected their experiences and interpretations. The current social context in China was another important factor affecting them. / From their stories, we could see that the main theme was change of their cognitive styles, including view of depression, service and themselves. Another two themes were highlighted in their narratives as well: the linkage of their losses with depression and the dehumanized treatment in the hospital. / Their stories have provided comprehensive materials for an in-depth understanding of depressed middle-aged adults in Beijing. Based on the findings, recommendations are made to knowledge development, policymakers and clinical social workers in helping the depressed clients. It is necessary for our society and mental health professionals in different areas to work together to help them and build an inclusive society. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Shi, Song. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2012. / Includes bibliographical references (leaves 228-245). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts and appendixes also in Chinese. / Chapter Chapter 1 --- Introduction --- p.1 / Chapter 1.1 --- Rationale of the study --- p.1 / Chapter 1.2 --- Background of the study --- p.2 / Chapter 1.3 --- Research Questions --- p.3 / Chapter 1.4 --- Purposes and significance of the research --- p.4 / Chapter Chapter 2 --- Literature Review --- p.7 / Chapter 2.1 --- Adult depression --- p.7 / Chapter 2.1.1 --- Definition of adults’ depression --- p.7 / Chapter 2.1.2 --- Different perspectives on “depression“ --- p.9 / Chapter 2.1.3 --- Social factors associated with adult depression --- p.24 / Chapter 2.1.4 --- Cultural influences in Chinese society --- p.32 / Chapter 2.2 --- Treatment of depressed adults --- p.36 / Chapter 2.2.1 --- Psychotherapy --- p.36 / Chapter 2.2.2 --- Medication --- p.38 / Chapter 2.3 --- Research on subjective experiences of people with mental disorders --- p.39 / Chapter 2.4 --- Research on depression in Mainland China --- p.48 / Chapter 2.5 --- The roles of social work in mental health services --- p.51 / Chapter Chapter 3 --- Research Methodology --- p.58 / Chapter 3.1 --- Paradigmatic Considerations --- p.58 / Chapter 3.1.1 --- Social constructionism --- p.58 / Chapter 3.1.2 --- Social construction and mental illness --- p.61 / Chapter 3.1.3 --- Theoretical Framework --- p.63 / Chapter 3.2 --- Research Design --- p.70 / Chapter 3.2.1 --- Qualitative research strategy --- p.70 / Chapter 3.2.2 --- Sampling strategies --- p.75 / Chapter 3.2.3 --- Data collection procedures --- p.84 / Chapter 3.2.4 --- Data analysis procedures --- p.86 / Chapter 3.2.5 --- Strategies for validating findings --- p.88 / Chapter 3.3 --- Ethical issues --- p.91 / Chapter Chapter 4 --- Research findings --- p.93 / Chapter 4.1 --- The experiences of the participants --- p.93 / Chapter 4.1.1 --- The experience during the onset of depression --- p.94 / Chapter 4.1.2 --- The experience in hospital --- p.118 / Chapter 4.1.3 --- The experience in the rehabilitation period --- p.131 / Chapter 4.2 --- The interpretation of their experiences --- p.142 / Chapter 4.2.1 --- The interpretation of the process of suffering from depression --- p.143 / Chapter 4.2.2 --- The interpretation of the process of recovery --- p.148 / Chapter 4.3 --- Advice on their needs --- p.154 / Chapter 4.3.1 --- The hospital --- p.154 / Chapter 4.3.2 --- The community --- p.159 / Chapter 4.3.3 --- Mass media --- p.161 / Chapter 4.3.4 --- The government --- p.164 / Chapter 4.4 --- Summary --- p.170 / Chapter Chapter 5 --- Discussion and Recommendation --- p.171 / Chapter 5.1 --- Characteristics of the participants in this study --- p.171 / Chapter 5.2 --- Social and historical factors affecting the clients’ interpretation of suffering from depression --- p.173 / Chapter 5.2.1 --- Social beliefs and cultural values --- p.174 / Chapter 5.2.2 --- Social context --- p.183 / Chapter 5.2.3 --- Historical events --- p.184 / Chapter 5.3 --- Themes --- p.186 / Chapter 5.3.1 --- Change of Cognitive Style --- p.187 / Chapter 5.3.2 --- The linkage of loss with depression --- p.190 / Chapter 5.3.3 --- The dehumanized treatment of hospitalization --- p.193 / Chapter 5.3.4 --- The interrelationships among the themes --- p.195 / Chapter 5.4 --- Revisiting the proposed conceptual framework --- p.197 / Chapter 5.5 --- Significance and recommendations --- p.200 / Chapter 5.5.1 --- Significance and recommendations --- p.201 / Chapter 5.5.2 --- Limitations --- p.214 / Chapter Appendix A: --- Possible Probes for interview (English Version & Chinese Version) --- p.218 / Chapter Appendix B: --- Oral Consent form (English Version & Chinese version) --- p.225 / References --- p.228

IntroduÃÃo Consequente ao envelhecimento populacional, as mudanÃas no perfil sociodemogrÃfico e epidemiolÃgico constituem problema de saÃde pÃblica, ensejando a necessidade de criaÃÃo de polÃticas e prÃticas de saÃde voltadas para esta populaÃÃo. Fortaleza à uma cidade com dois milhÃes e meio de habitantes, com um percentual de 7,48% de idosos. Avaliar como a linha de cuidado do idoso ocorre nas redes assistenciais de saÃde de Fortaleza produz informaÃÃes que podem subsidiar a tomada de decisÃo por parte da gestÃo municipal. Objetivo Compreender como a linha de cuidado do idoso acontece nas cinco redes assistenciais de saÃde de Fortaleza, na percepÃÃo de gestores atuantes neste cenÃrio. Metodologia Estudo qualitativo, com abordagem descritiva, tÃcnica de grupos focais e, para organizaÃÃo dos achados, foi empregado o Discurso do Sujeito Coletivo (LEFÃVRE, LEFÃVRE, 2006). Resultados Na Rede Assistencial EstratÃgia SaÃde da FamÃlia, destacam-se as aÃÃes de promoÃÃo da saÃde e a introduÃÃo da caderneta do idoso como instrumento de trabalho. Na Rede Assistencial Especializada, foi constatada significativa demanda reprimida em razÃo da carÃncia de serviÃos especializados no cuidado com o idoso. Na Rede Assistencial Hospitalar, nÃo se observa um cuidado especÃfico para o idoso, uma vez que ele à visto como usuÃrio comum. Na Rede Assistencial de UrgÃncia e EmergÃncia, inclui-se como prioridade a remoÃÃo e, no hospital, o atendimento conforme a gravidade. Na Rede Assistencial SaÃde Mental, uma abordagem psicossocial com envolvimento da comunidade e articulaÃÃo intersetorial. ConsideraÃÃes finais Entre os principais achados deste estudo, tem-se que a linha de cuidado do idoso na cidade de Fortaleza ainda à frÃgil, onde alguns fios se desalinham, ou se rompem, comprometendo a continuidade do cuidado. Ante o estado de transiÃÃo demogrÃfica e o perfil demogrÃfico e epidemiolÃgico atual, observa-se a necessidade de melhor integraÃÃo das redes assistenciais, ancoradas na Rede Assistencial da EstratÃgia SaÃde da FamÃlia, bem como a estruturaÃÃo de novos serviÃos especializados, objetivando melhorar a assistÃncia da populaÃÃo idosa de Fortaleza. / Introduction As a result to the population aging, changes in demographic and epidemiological profile is public health problem, entailing the need to develop health policies and practices for the population. Fortaleza is a city of two and a half million inhabitants, of which 7.48% are elderly. The assessment of how the care for the elderly occurs in health assistance networks in Fortaleza produces information that can support the decision taken by the municipal government. Purpose Understanding how the way of caring for the elderly takes place in five health care networks in Fortaleza, in the perception of managers acting in this scenario. Methodology A qualitative study with descriptive approach and focus group technique. The Discourse of the Collective Subject was used to organize the findings (LEFÃVRE, LEFÃVRE, 2006). Results In the Family Health assistance network (so called EstratÃgia SaÃde da FamÃlia), the actions of health promotion and introduction of the recording book of the elderly as a working tool are highlighted. A significant unmet demand was observed due to the lack of specialized services in caring for the elderly in the Specialized assistance network. Specific care for the elderly was not observed in the Hospital assistance network, as he is seen as common user. In the Emergency assistance network, the removal is included as a priority, and in the hospital, the service applied is according to severity. In Mental Health assistance network, there is a psychosocial approach to community involvement and intersectorial coordination. Final considerations Among the main findings of this study is that the way of care for the elderly in the city of Fortaleza is still weak, where some strands are misaligned, or broken, compromising the continuity of service. Given the state of demographic transition and the demographic and epidemiological profile, there is a need for better integration of health care, anchored in the Family Health Strategy as well as the structuring of new specialized services, aiming to improve care for the elderly population of Fortaleza.

Thesis (M.S.W.)--University of Hong Kong, 1987.

Thesis (M. Soc. Sc.)--University of Hong Kong, 1987.

No description available.

No description available.

Diss. (sammanfattning) Stockholm : Karol. inst., 2004. / Härtill 4 uppsatser.