Introdução: Na velhice podem ocorrer mais situações de vulnerabilidades (biológica, funcional, familiar, social e emocional), prejudicando o autocuidado e a provisão suficiente de recursos. Emerge então a necessidade da prestação de cuidados de longa duração. Dentre as modalidades deste tipo de cuidado, encontra-se a Instituição de Longa Permanência para Idosos (ILPI). Considerando a escassez de recursos das ILPI privadas sem fins lucrativos, são adotados diversos mecanismos de ajuda, às vezes estabelecidos informalmente pela rede de apoio destas instituições. Objetivos: mapear a rede de apoio de uma ILPI privada sem fins lucrativos, identificando seus membros, atributos, a configuração dos laços relacionais e do comportamento da rede, e os motivos da prestação de apoio. Métodos: Trata-se de estudo transversal, de abordagem quanti-qualitativa, de natureza exploratória e descritiva, utilizando-se a Análise de Rede Social (ARS). A rede de apoio da ILPI foi mapeada a partir de seus dirigentes pelo método Snowball, e as entrevistas proporcionaram a coleta de dados sobre os tipos de apoio, os atributos dos atores e as relações sociais entre eles, analisados com os softwares UCINET® 6 e NETDRAW®. Resultados: Observou-se que os dirigentes da ILPI não tinham conhecimento da amplitude da rede e dos tipos de apoio prestado. O estudo mostrou uma rede composta por 86 parceiros, sendo 50 pessoas físicas (58,13 por cento ), 17 empresas privadas (19,77 por cento ), 11 organizações não governamentais (12,80 por cento ) e 8 órgãos públicos (9,30 por cento ), que proveem apoio material, instrumental, trabalho voluntário, divulgação da ILPI, organização de eventos para captação de recursos, além de entretenimento, apoio emocional e espiritual às moradoras. A natureza filantrópica da instituição e o público assistido revelaram-se fatores motivadores para a prestação de ajuda. Constatou-se que a rede de apoio da ILPI é também um dos componentes da rede pessoal de apoio das moradoras, além de contribuir com ações que impactam positivamente o bem estar das idosas. A ARS mostrou uma rede mais centralizada, com potencial capacidade para aumentar a densidade e a reciprocidade dos laços. Os membros dirigentes ocupam papéis centrais na rede, detendo os maiores índices de centralidade de grau (Degree), de proximidade (Closeness) e de intermediação 7 (Betweenness). No entanto, membros não dirigentes com medidas de centralidade elevadas podem exercer influência sobre os outros atores, como pontes entre atores desconectados. Houve correlação linear positiva muito forte entre as medidas de centralidade de grau e proximidade da rede. Analisando separadamente o grupo de pessoas físicas, houve forte correlação linear entre as medidas de centralidade de grau, de proximidade e de intermediação. Este é o grupo que apresenta maior potencial para ampliar a rede de apoio e intensificar a frequência e a quantidade de apoios, detendo a maior parte da reciprocidade das relações, o que pode aumentar a confiança entre os membros. Conclusão: O mapeamento da rede de apoio da ILPI mostrou-se potencial ferramenta gerencial. Os motivos que levam os membros a colaborarem podem influenciar a intensidade da ajuda, e os membros dirigentes podem adotar estratégias para contemplar os elementos motivacionais dos diferentes tipos de parceiros. A rede de apoio da ILPI é importante para a sobrevivência econômica da entidade, devendo ser continuamente fortalecida e ampliada, dada a necessidade de fidelizar os membros e de potencializar conexões e captação de recursos. / Introduction: Old age is a typical life stage in which many people are likely to be vulnerable whether for biological reasons or functional, familiar, social and emotional ones which may cause not only functional impairment but also lack of both self-care conditions and enough resources for their own survival, which gives rise to exist a long-term care. Long-term care institutions for the elderly (LTCI) are sought to provide this care. Taking into account for the usual scarcity of LTCI resources, notably those non-profit organizations, several aiding mechanisms are adopted, sometimes informally established by the institutions social network. Objectives: the aims of the present work were to map a support social network of a non-profit LTCI by identifying their members, attributes, quantify the presence of social network clicks and examine their influence on the provision of support. Methods: the present investigation is descriptive and exploratory with both quantitative and qualitative approaches. The Social Network Analysis (SNA) is used to measure and visualize its indicators and sociograms, followed interpreting qualitative analysis of the results taken from the interviews with managers and collaborators of the LTCI as well as partners appointed by them, data categorization, content analysis and discussion with national and international papers. The Snowball method was used to find out its partners and collaborators from all types of support (voluntary service activities, food, clothes and money donations, leisure activities, hand-made products for funding, and publicity of events). Both UCINET® and NETDRAW® were used to characterize network indices and their attributes. Results: it was found that the LTCI directors were neither aware of its supportive network amplitude nor their types. The study showed that its network has 86 partners: 50 ordinary people (58,13 per cent ), 17 private companies (19,77 per cent ), 11 nongovernmental organizations (12,80 per cent ) and 8 public organizations (9,30 per cent ). They all provide material and instrumental means, do voluntary work, promote the LTCI, 9 organize events for gathering resources besides entertainment, and both emotional and spiritual support for the elderly people. The non-profit nature of the LTCI and the public attended were motivating factors for the delivery of aid. It was verified that the support network of the LTCI is also one of the components of the personal support network of the dwellers, besides contributing with actions that positively impact the well-being of the elderly. The SNA showed a more centralized network, with potential capacity to increase the density and the reciprocity of the ties. The directors play a major role in the network so they have high degree, closeness and betweenness centralities. However, non-directing actors with high centrality indices were found to have influence on other actors acting as bridges or link among nonconnected members. There was a very strong positive linear correlation between the measures of degree and closeness centralities network. Analyzing separately the group of ordinary people, there was a strong linear correlation between the measures of degree centrality, closeness and betweenness. Ordinary people represent a high potential to both amplify social network and the frequency of support by having most part of relationship reciprocity, which may improve trust among their members. Conclusions: mapping of LTCI support network has proved to be a potential management tool. The reasons that make members to collaborate may influence the intensity of help so that director may adopt strategies to increase motivation for different types of partners. LTCI support network is important for economical sustainability of the enterprise and must therefore be continuously strengthened and ample besides the necessity for member fidelity, more connections and resource gathering.

Made available in DSpace on 2016-03-22T17:26:08Z (GMT). No. of bitstreams: 1 Liege.pdf: 201664 bytes, checksum: 3ce8f45216b1185b5c097de0ede5de72 (MD5) Previous issue date: 2007-12-22 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / This study aimed at describing the occurrence of falls and related factors by the elderly living in long-term care institutions for elderly people (LCIE) in Pelotas, RS. A structured questionnaire with questions on demographic characteristics, morbidity, use of psychotropics, and occurrence of falls was used. In December 2006 all the 21 (LCIE) registered in the city. Of these, 19 agreed to take part in the study. A total of 377 elderly people were identified, but 96 were not able to answer the questionnaire and 38 refused to do it. Most of the 243 elderly included in the study were women (72.8%) and were, one average, 77.7 (dp=8.9) years old. About one third of the elderly (32.5%) had at least one fall in the previous year. The occurrence of falls was two times higher by women, by the elderly with rheumatism or spinal cord disease, and in those making use of psychotropics. It is intended that the information obtained make it possible further discussions on the health of the elderly people living in long-term care institutions / O objetivo deste estudo foi descrever a ocorrência de quedas e fatores associados em idosos residentes em Instituições de Longa Permanência para Idosos (ILPI) em Pelotas, RS. Foi utilizado um questionário estruturado com perguntas sobre características demográficas, morbidade, uso de psicotrópicos e ocorrência de quedas. Em dezembro de 2006 foram visitadas todas as 21 (ILPI) registradas na cidade. Destas, 19 consentiram participar do estudo. Foram identificados 377 idosos, sendo que, 96 não tinham condições de responder o questionário e 38 foram recusas. Dos 243 idosos incluídos no estudo, a maioria eram mulheres (72,8%) e tinham, em média, 77,7 (dp=8,9) anos. Cerca de um terço dos idosos (32,5%) sofreram pelo menos uma queda no último ano. A ocorrência de quedas foi duas vezes maior nas mulheres, nos idosos com reumatismo ou doença da coluna e naqueles que utilizavam medicação psicotrópica. Pretende-se que as informações obtidas possibilitem discussões sobre a saúde dos idosos residentes em ILPI

Made available in DSpace on 2016-08-10T10:54:35Z (GMT). No. of bitstreams: 1 ANA PAULA FELIX ARANTES.pdf: 4596015 bytes, checksum: 09a2cbf24925d26838c2dbbd4773ce5e (MD5) Previous issue date: 2015-03-04 / The functionality of institutionalized elderly has been researched and recognized as an important indicator of the demands of care in long-stay institutions. A crosssectional study was conducted in order to determine the prevalence of functional dependence and its associated factors in institutionalized elderly. Data were collected in the only long-term establishment of a city of the Southwest of the State of Goiás, Midwest region of Brazil. In order to collect the data a structured form was used consisting of three sections: identification, socio-demographic and economic profile, general health condition and the functional independence measure (FIM). Its statistical analysis was performed using multivariate logistic regression. 75 elderly participated in the study, whom most were men 72.0%, among 60 and 79 years 69.3%, did not live in marital union 85.3%, had no schooling degree 69.3% and 76% lived in the facility for less than 10 years. The mean age was 76.3 ± 8.0 years and the mean residence time in long-term care institution was 6.68 ± 6.80 years. The prevalence of dependence was in 68% of the elderly. The average of the total scores of the FIM (77.0 ± 36.8), its motor (53.0 ± 29.6) and cognitive domains (24.0 ± 9.6) and categories, ranked the institutionalized elderly as moderate dependent people level. There was observed association between the variables female sex (p = 0.043; OR = 6.09) and presence of cognitive impairment (p = 0.001; OR = 20.26) and the functional dependency. The functional dependence in institutionalized elderly is multifactorial and the knowledge of these factors contribute to the development of targeted policy interventions to minimize this process. / A funcionalidade de idosos institucionalizados tem sido pesquisada e reconhecida como um importante indicador das demandas de cuidados em instituições de longa permanência. Estudo transversal analítico desenvolvido com objetivo de determinar a prevalência da dependência funcional e os fatores associados em idosos institucionalizados. Os dados foram coletados na única instituição de longa permanência de um município do Sudoeste do Estado de Goiás, região Centro- Oeste do Brasil. Para a coleta de dados foram utilizados um formulário estruturado composto de três seções: dados de identificação, perfil sociodemográfico e econômico, condições de saúde geral e avaliação da medida da independência funcional (MIF). Para a análise de associação foi utilizada a regressão logística multivariada. Participaram do estudo 75 idosos, a maioria eram homens 72,0%, tinham entre 60 e 79 anos 69,3%, não viviam em união conjugal 85,3%, não possuíam instrução escolar 69,3% e 76% residiam na ILPI em estudo há menos de 10 anos. A média de idade foi 76,3±8,0 anos e o tempo médio de residência na instituição de longa permanência foi de 6,68±6,80 anos. Foi verificada uma prevalência de dependência em 68% dos idosos. A média dos escores total da MIF (77,0±36,8), dos domínios motor (53,0±29,6) e cognitivo (24,0±9,6) e de suas categorias, classifica os idosos institucionalizados em estudo como pessoas com nível de dependência moderada. Verificou-se associação das variáveis sexo feminino (p=0,043; OR=6,09) e presença de déficit cognitivo (p=0,001; OR=20,26) com a dependência funcional. A dependência funcional em idosos institucionalizados é multifatorial e o conhecimento desses fatores contribuem para o desenvolvimento de políticas de intervenção direcionados à minimização desse processo.

Objetivo: Caracterizar as redes sociais dos idosos e identificar o impacto das mesmas no óbito e na funcionalidade. Método: Estudo longitudinal de base populacional que utilizou as coortes de 2006 (n=1413) e 2010 (n=990) do Estudo SABE. Para caracterização das redes sociais utilizou-se as seguintes variáveis: número de integrantes da rede; arranjo domiciliar; sexo e idade dos integrantes; co-residência com criança ou apenas com idosos; satisfação com a relação; recebimento e oferecimento de apoio social (financeiro, material, emocional, realização de tarefas dentro e fora de casa, companhia e cuidados pessoais). Utilizou-se regressão logística e modelo de riscos proporcionais de Cox para a análise dos dados. Todos os cuidados éticos foram observados. Resultados: As redes sociais dos idosos possuem, em média, 8,15 integrantes e são constituídas predominantemente por familiares com idade entre 15 e 59 anos. A maior proporção de idosos não recebe ou não oferece apoio social aos integrantes de sua rede. Tanto na rede formada por residentes no domicílio, quanto na formada por filhos que moram fora da casa, observou-se que os idosos mais dependentes recebem mais apoio material, para realização de tarefas domésticas, fora de casa e cuidados pessoais, enquanto os idosos independentes recebem mais apoio emocional e companheirismo. Já na rede composta por outros familiares e amigos, os idosos mais dependentes recebem e oferecem mais companhia. Os idosos que diminuíram o nível de dependência de 2006 para 2010 e que mantiveram a mesma condição de 2006 em 2010 recebiam e ofereciam mais apoio em 2006. Já os que aumentaram o nível de dependência passaram a receber mais cuidado pessoal e apoio para realização de tarefas domésticas em 2010. Oferecer apoio social (HR=0,66; IC95%=0,48-0,91), possuir de 9 a 11 integrantes na rede (HR=0,67; IC95%=0,46-0,97) e 12 ou mais integrantes (HR=0,58; IC95%=0,35-0,96) diminuiu o risco de óbito, independente de condições sociodemográficas e de saúde. Oferecer apoio social (OR=0,32; IC95%=0,14-0,71) diminuiu as chances de desenvolver dependência, independente de condições sociodemográficas e de saúde. Conclusão: O fortalecimento das redes sociais na velhice deve ser implementado como um hábito a ser desenvolvido e perpetuado. Os profissionais de saúde devem estimular a formação de redes sociais onde o idoso possa, efetivamente, trocar apoio. A confiança no cuidado informal, oferecido, principalmente pelas redes domiciliares, pode não ser a melhor opção para lidar com a demanda de cuidado crescente que acompanha o envelhecimento da população brasileira / Objective: To characterize the social networks of the elderly and identify their impact on death and functionality. Methods: A longitudinal population-based study, using the 2006 (n = 1413) and 2010 (n = 990) cohorts from the SABE study. To characterize the social networks the following variables were used: number of members in the network; living arrangements; sex and age of the members; co-residence with children or only elderly individuals; satisfaction with the relationships; receiving and offering social support (financial, material, emotional, performing tasks inside and outside the home, providing companionship and personal care). Logistic regression and Cox proportional hazards model were used for data analysis. All ethical guidelines were followed. Results: The social networks of elderly individuals contain an average of 8.15 members and consist predominantly of family members aged between 15 and 59 years. The highest proportion of elderly people do not receive or offer social support to members of their network. Both in networks formed by people living in the household and those formed by children living outside the home, it was observed that the most dependent elderly received more material support, help in performing household tasks, tasks outside the home and personal care, while the independent elderly received more emotional support and companionship. In the networks composed of other family members and friends, the more dependent elderly received and provided more companionship. The elderly who decreased in level of dependency from 2006 to 2010 and who maintained the same level from 2006 to 2010 received and offered more support in 2006. Those who increased in dependency received more personal care and support for domestic tasks in 2010. The offer of social support (OR=0.66; CI95%=0.48-0.91), having 9 to 11 members in the network (OR=0.67; CI95%=0.46-0.97) and 12 or more members (OR=0.58; CI95%=0.35-0.96) decreased the risk of death, regardless of sociodemographic and health conditions. The offer of social support (OR=0.32; CI95%=0.14-0.71) decreased the chances of developing dependence, regardless of sociodemographic and health conditions. Conclusion: The strengthening of social networks in old age should be implemented as a habitual practice to develop and perpetuate. Health professionals should encourage the formation of social networks where the elderly can, effectively, exchange support. Confidence in informal care, offered primarily by home networks, may not be the best option for dealing with the growing care demand that accompanies the aging Brazilian population

Before the main study commenced, empirical work was conducted to establish and validate the Chinese version of the Satisfaction with the Nursing Home Instrument (SNHI-C), which was an instrument used to measure resident satisfaction in the main study. Testing was conducted on a cluster sample of 330 residents from 16 elderly residential care homes in Hong Kong. Findings demonstrated that the SNHI-C had good content validity with an index of .93. It also demonstrated high construct validity by having significant correlation with depression (r = -.42, p < .001), the physical component of health-related quality of life (r = .16, p < .05), the mental component of health-related quality of life (r = .41, p < .001), and global quality of care (r = .49, p < .001). The SNHI-C also demonstrated satisfactory internal consistency and good stability by having a Cronbach's alpha of .79 and intra-class correlation coefficient of .94, respectively. / Current study adds new knowledge to the psychosocial health benefits of Tai Chi for the residents living in elderly residential care homes. Findings were discussed in relation to previous research findings and in the context of elderly residential care setting. The present study has the strength of evaluating the health benefit of Tai Chi using a more stringent research design, in comparing with the previous studies. Limitations of this study included the use of convenience sampling, without random assigning participants into groups, and inadequacy in quantifying Tai Chi learning. The implications of the findings support incorporating Tai Chi training in routine elderly residential care. Based on the study experience, recommendations for a successful implementation of a Tai Chi program were provided. Future research is advised to further explore the most beneficial mode of a Tai Chi program particularly for the elderly residential care home residents. Evaluation of its effect over a longer period of time and using various approaches are also suggested for obtaining a more comprehensive picture of the health benefit of Tai Chi. Finally, it is also worthwhile to investigate the experience of practicing Tai Chi through a qualitative approach to complement present findings. / Like many areas in the world, Hong Kong is facing an aging population. To accommodate the increasing elderly population, particularly those who are frail and have limited family support, elderly residential care homes are growing in size and number. Despite of the escalating demand, it has been documented repeatedly that the nature of residential living can predispose the residents to a number of psychosocial challenges. Study findings highlight consistently that residents are prone to experience lowered self-esteem, poor social support, and poor health-related quality of life. Providing psychosocial support to the residents is an important dimension in elderly residential care. It is because older residents, despite of their deteriorating physical functions that cannot be cured, can still have the potential to live with optimum psychosocial well-being. Even though a number of interventions have been considered in the past to address the residents' psychosocial needs, evaluation on the effectiveness of these interventions is inconclusive. There is still a paucity of evidence suggesting a promising intervention that can promote psychosocial health for the residents. Given the general consensus that exercise is beneficial for the psychosocial health, and considering that the characteristics of Tai Chi are particularly suitable for the elderly population, Tai Chi is considered as a possible means to promote psychosocial health for the residents. This study aimed to examine the psychosocial effects of a Tai Chi program on the residents of the elderly residential care homes. / The main study adopted a non-equivalent pretest-posttest control group design to examine the psychosocial effect of Tai Chi on residents of elderly residential care homes. Residents were recruited from six elderly residential care homes in Hong Kong by convenience sampling. The experimental group (n = 66) joined a 26-week Tai Chi program three times per week with each session lasted for one hour. The control group (n = 73) continued their daily activities as usual. Outcome variables encompassing state self-esteem, the physical component of health-related quality of life, the mental component of health-related quality of life, social support network, and social support satisfaction were assessed at baseline, the 13th and 26th week of the intervention period. Doubly multivariate analysis of covariance was performed to examine the effect of the Tai Chi program. / With the confounding effect of resident satisfaction controlled, findings demonstrated that participants in the experimental group experienced greater improvement in the psychological composite outcome of state self-esteem, the physical component of health-related quality of life, and the mental component of health-related quality of life (p < .05). No significant changes were detected in any of the three individual psychological outcome variables. Non-significant result was also found regarding the social effect of Tai Chi program on the participants. / Lee Yin King. / "May 2006." / Advisers: Diana Lee; Jean Woo. / Source: Dissertation Abstracts International, Volume: 68-03, Section: B, page: 1558. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2006. / Includes bibliographical references (p. 249-269). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts in English and Chinese. / School code: 1307.

Introdução: Na velhice podem ocorrer mais situações de vulnerabilidades (biológica, funcional, familiar, social e emocional), prejudicando o autocuidado e a provisão suficiente de recursos. Emerge então a necessidade da prestação de cuidados de longa duração. Dentre as modalidades deste tipo de cuidado, encontra-se a Instituição de Longa Permanência para Idosos (ILPI). Considerando a escassez de recursos das ILPI privadas sem fins lucrativos, são adotados diversos mecanismos de ajuda, às vezes estabelecidos informalmente pela rede de apoio destas instituições. Objetivos: mapear a rede de apoio de uma ILPI privada sem fins lucrativos, identificando seus membros, atributos, a configuração dos laços relacionais e do comportamento da rede, e os motivos da prestação de apoio. Métodos: Trata-se de estudo transversal, de abordagem quanti-qualitativa, de natureza exploratória e descritiva, utilizando-se a Análise de Rede Social (ARS). A rede de apoio da ILPI foi mapeada a partir de seus dirigentes pelo método Snowball, e as entrevistas proporcionaram a coleta de dados sobre os tipos de apoio, os atributos dos atores e as relações sociais entre eles, analisados com os softwares UCINET® 6 e NETDRAW®. Resultados: Observou-se que os dirigentes da ILPI não tinham conhecimento da amplitude da rede e dos tipos de apoio prestado. O estudo mostrou uma rede composta por 86 parceiros, sendo 50 pessoas físicas (58,13 por cento ), 17 empresas privadas (19,77 por cento ), 11 organizações não governamentais (12,80 por cento ) e 8 órgãos públicos (9,30 por cento ), que proveem apoio material, instrumental, trabalho voluntário, divulgação da ILPI, organização de eventos para captação de recursos, além de entretenimento, apoio emocional e espiritual às moradoras. A natureza filantrópica da instituição e o público assistido revelaram-se fatores motivadores para a prestação de ajuda. Constatou-se que a rede de apoio da ILPI é também um dos componentes da rede pessoal de apoio das moradoras, além de contribuir com ações que impactam positivamente o bem estar das idosas. A ARS mostrou uma rede mais centralizada, com potencial capacidade para aumentar a densidade e a reciprocidade dos laços. Os membros dirigentes ocupam papéis centrais na rede, detendo os maiores índices de centralidade de grau (Degree), de proximidade (Closeness) e de intermediação 7 (Betweenness). No entanto, membros não dirigentes com medidas de centralidade elevadas podem exercer influência sobre os outros atores, como pontes entre atores desconectados. Houve correlação linear positiva muito forte entre as medidas de centralidade de grau e proximidade da rede. Analisando separadamente o grupo de pessoas físicas, houve forte correlação linear entre as medidas de centralidade de grau, de proximidade e de intermediação. Este é o grupo que apresenta maior potencial para ampliar a rede de apoio e intensificar a frequência e a quantidade de apoios, detendo a maior parte da reciprocidade das relações, o que pode aumentar a confiança entre os membros. Conclusão: O mapeamento da rede de apoio da ILPI mostrou-se potencial ferramenta gerencial. Os motivos que levam os membros a colaborarem podem influenciar a intensidade da ajuda, e os membros dirigentes podem adotar estratégias para contemplar os elementos motivacionais dos diferentes tipos de parceiros. A rede de apoio da ILPI é importante para a sobrevivência econômica da entidade, devendo ser continuamente fortalecida e ampliada, dada a necessidade de fidelizar os membros e de potencializar conexões e captação de recursos. / Introduction: Old age is a typical life stage in which many people are likely to be vulnerable whether for biological reasons or functional, familiar, social and emotional ones which may cause not only functional impairment but also lack of both self-care conditions and enough resources for their own survival, which gives rise to exist a long-term care. Long-term care institutions for the elderly (LTCI) are sought to provide this care. Taking into account for the usual scarcity of LTCI resources, notably those non-profit organizations, several aiding mechanisms are adopted, sometimes informally established by the institutions social network. Objectives: the aims of the present work were to map a support social network of a non-profit LTCI by identifying their members, attributes, quantify the presence of social network clicks and examine their influence on the provision of support. Methods: the present investigation is descriptive and exploratory with both quantitative and qualitative approaches. The Social Network Analysis (SNA) is used to measure and visualize its indicators and sociograms, followed interpreting qualitative analysis of the results taken from the interviews with managers and collaborators of the LTCI as well as partners appointed by them, data categorization, content analysis and discussion with national and international papers. The Snowball method was used to find out its partners and collaborators from all types of support (voluntary service activities, food, clothes and money donations, leisure activities, hand-made products for funding, and publicity of events). Both UCINET® and NETDRAW® were used to characterize network indices and their attributes. Results: it was found that the LTCI directors were neither aware of its supportive network amplitude nor their types. The study showed that its network has 86 partners: 50 ordinary people (58,13 per cent ), 17 private companies (19,77 per cent ), 11 nongovernmental organizations (12,80 per cent ) and 8 public organizations (9,30 per cent ). They all provide material and instrumental means, do voluntary work, promote the LTCI, 9 organize events for gathering resources besides entertainment, and both emotional and spiritual support for the elderly people. The non-profit nature of the LTCI and the public attended were motivating factors for the delivery of aid. It was verified that the support network of the LTCI is also one of the components of the personal support network of the dwellers, besides contributing with actions that positively impact the well-being of the elderly. The SNA showed a more centralized network, with potential capacity to increase the density and the reciprocity of the ties. The directors play a major role in the network so they have high degree, closeness and betweenness centralities. However, non-directing actors with high centrality indices were found to have influence on other actors acting as bridges or link among nonconnected members. There was a very strong positive linear correlation between the measures of degree and closeness centralities network. Analyzing separately the group of ordinary people, there was a strong linear correlation between the measures of degree centrality, closeness and betweenness. Ordinary people represent a high potential to both amplify social network and the frequency of support by having most part of relationship reciprocity, which may improve trust among their members. Conclusions: mapping of LTCI support network has proved to be a potential management tool. The reasons that make members to collaborate may influence the intensity of help so that director may adopt strategies to increase motivation for different types of partners. LTCI support network is important for economical sustainability of the enterprise and must therefore be continuously strengthened and ample besides the necessity for member fidelity, more connections and resource gathering.

Yeung Fai. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2000. / Includes bibliographical references (leaves 125-138). / Abstracts in English and Chinese; questionnaires also in Chinese. / Acknowledgement --- p.iii / Declaration --- p.iv / List of Tables --- p.v / List of Figures --- p.viii / Abstract --- p.ix / Abbreviation --- p.xiv / Chapter Chapter One --- Introduction / Background --- p.1 / Chapter 1.1 --- Definition / Chapter 1.2 --- Disease Prevalence / Chapter 1.3 --- Associated Disability / Chapter 1.4 --- Treatment-effectiveness / Chapter 1.5 --- Rehabilitation / Chapter Chapter Two --- Hong Kong Situation --- p.56 / Chapter 2.1 --- What is known --- Hong Kong elderly population database / Chapter 2.2 --- Service provision for the elderly in Hong Kong / Chapter Chapter Three --- Methodology --- p.68 / Chapter 3.1 --- Aims / Chapter 3.2 --- Subject and methodology / Chapter Chapter Four --- Results --- p.93 / Chapter 4.1 --- Results at baseline / Chapter 4.2 --- "Trend with time (0,12,48 weeks) between the exercise group and the control group" / Chapter 4.3 --- Results at first follow up (12 weeks) / Chapter 4.4 --- Results at second follow up (48 weeks) / Chapter 4.5 --- Results from baseline to second follow up within the exercise group or within the control group / Chapter Chapter Five --- Discussion --- p.113 / Chapter 5.1 --- Short-term efficacy of pulmonary program / Chapter 5.2 --- Long-term efficacy of pulmonary program / Chapter 5.3 --- The characteristics of pulmonary program / Chapter Chapter Six --- Conclusion --- p.124 / Reference --- p.125 / Appendix The Questionnaire Used in Interviews --- p.139

O conhecimento do paciente sobre seus medicamentos é o conjunto de informações sobre o medicamento necessárias para garantir seu uso correto. Este conhecimento é insuficiente nos idosos, que representam o segmento populacional que usa mais medicamentos e que mais cresce no Brasil. Este estudo identificou fatores relacionados ao conhecimento que pacientes muito idosos (≥80 anos), atendidos no Ambulatório de Fragilidade do Hospital Universitário da USP, possuíam sobre a medicação prescrita. As 11 perguntas do questionário espanhol \"Conocimiento del Paciente sobre su Medicamento\" foram adaptadas transculturalmente ao português brasileiro, processo que incluiu etapas de tradução, retradução, pré-teste e avaliação da confiabilidade e validade de construto da versão final. Esta foi usada para medir o conhecimento sobre todos os medicamentos prescritos pelo geriatra na última consulta médica por meio de uma entrevista face a face com o paciente ou seu cuidador. O conhecimento foi explicado por variáveis relacionadas ao entrevistado, ao atendimento médico e aos medicamentos, incluídas em um modelo misto linear. Foi construído um modelo para pacientes e outro para cuidadores. O questionário adaptado mostrou equivalência conceitual, de item, semântica, operacional, de mensuração e funcional com o original. A versão brasileira apresentou confiabilidade suficiente (α de Cronbach=0,736). Sua estrutura interna foi semelhante a do questionário espanhol e o conhecimento estimado esteve correlacionado à adesão ao tratamento anti-hipertensivo (rb=0,86), ao controle da pressão arterial (rb=0,46) e à complexidade da prescrição (r=-0,22). No grupo de pacientes, medicamentos usados de 0,1 a 6,0 meses (b=0,19, p=0,009), e a mais de 6 meses (b=0,12, p=0,025), foram mais conhecidos que medicamentos nunca usados. No grupo de cuidadores, medicamentos classificados como potencialmente perigosos em ambiente ambulatorial foram mais conhecidos que os outros medicamentos (b=0,16, p=0,004) e, quanto maior a categoria do nível de instrução, maior o conhecimento. Assim, recomenda-se o uso do instrumento adaptado para medir o conhecimento sobre medicamentos de uso crônico em qualquer paciente fluente na língua portuguesa. A equipe de saúde precisa prover programas contínuos de educação sobre medicamentos, os quais devem ser adaptados à rede de apoio do paciente, incluindo os medicamentos usados há muito tempo. Deve-se, também, estimular a participação ativa do paciente (empoderamento) no gerenciamento de seus medicamentos. / Patient drug knowledge is the set of drug information needed to guarantee correct drug use. This knowledge is poor in aged individuals, which is the most drug consuming and the fastest growing age group. Here, we identified factors related to the knowledge very old patients (≥80 years) attending the Frailty Ambulatory of the University Hospital of USP possessed on prescribed drugs. The 11 items of the Spanish questionnaire entitled \"Conocimiento del Paciente sobre su Medicamento\" were cross-culturally adapted into Brazilian Portuguese, which included translation, back-translation, pretest, and reliability and construct validity assessment of the final version. The latter was used to measure knowledge about all geriatrician prescribed drugs in the last appointment by means of a face-to-face interview with either patient or caregiver. Drug knowledge was explained by variables related to interviewee, medical appointment, and prescribed drugs, which were included in a linear mixed model. It was obtained one model for patients and another for caregivers. The adapted questionnaire possessed conceptual, item, semantic, operational, measurement, and functional equivalence with the original. Realiability of the Brazilian version was sufficient (Cronbach´s α=.736). Internal structure was similar to the Spanish questionnaire and estimated drug knowledge was correlated to adherence to antihypertensive treatment (rb=.86), blood pressure control (rb=.46), and medication regimen complexity (r=-.22). In the patient group, drugs used from 0.1 to 6.0 months (b=0.19, p=.009), and used longer than 6 months (b=0.12, p=.025) presented more knowledge than never used ones. In the caregiver group, medications classified as high-alert in ambulatory healthcare were associated with higher knowledge than other drugs (b=0.16, p=.004) and, higher the educational level category, the bigger the caregiver drug knowledge. Thus, this work recommends the utilization of adapted instrument in order to assess chronic drug knowledge of any patient fluent in Portuguese. Healthcare team have to provide continuous drug education programs, which should be tailored to the extent of patient support and cover even long time use drugs. Patients taking active part (empowerment) in the management of their medication should also be stimulated.

Background. Habitual short (HSS) and long sleeper (HLS) were very interesting but under-research area. / Conclusion. Our study suggested that sleep duration of human being has marked inter-individual variability with existence of extreme sleepers at both ends. Throughout different phases of the study, there was a consistent negative relationship between sleep duration and socio-economic status. Our finding of unique personality profile between short and long sleepers supported the hypothesis that different personality trait (neuroticism trait) might mediate between sleep duration and socioeconomic variables. Further studies are indicated for investigating genetic as well as biological correlates between personality traits and sleep duration. / Method. Three phases were involved in this research to explore epidemiological, psychological, and PSG characteristics of HSS and HLS. / Phase three: 72 subjects (23 HSS, 41 HNS, and 8 HLS) were assessed by two nights PSG to be followed by multiple sleep latency test (MSLT). 37 subjects (6 HSS, 21 HNS, and 10 HLS) were assessed by four-day Actiwatch. In the first night of PSG assessment, HLS had lower sleep efficiency and longer sleep and REM latency than HSS and HNS. In the second night, REM density in HLS was higher than HSS and HNS. In MSLT, HSS (50.0%) was more likely to have mildly short sleep latency than HLS (0%). Multiple regression of these healthy sleepers suggested that shorter sleep duration was found in those subjects (a) attaining higher education level; (b) suffering from higher life stress; (c) having more sleepiness; and (d) having less neuroticism. / Phase two: 252 subjects attended the face-to-face clinical interview. Among them, there were 33 HSS-7 and 25 HLS-9. After controlling gender and age, HSS had more chance to earn more money, live in larger house, drank more alcohol, and lower neuroticism than HLS. / Result. Phase one: Brief sleep questionnaires with consent were administered to parents of students in 13 primary schools in 2003, and 10381 parents returned their questionnaires (response rate ≈ 67.9%). 593 subjects were excluded because of their incomplete information. Altogether, 9788 subjects were considered as eligible subjects that represented noninstitutionalized Chinese middle-age residents in Hong Kong (47.0% men vs 53.0% women, mean age: 40.9 years +/- 4.9 years [SD]). There were 322 (3.3%) HSS-7 (≤7 hours), 1415 (14.5%) HLS-9 (≥9 hours), and 481 (4.9%) HLS-10 (≥10 hours). HSS had more chance to attain higher education level, earn more money and drank more tea/coffee than HLS. / Zhang Bin. / "May 2005." / Advisers: Y. K. Wing; S. O. Chan. / Source: Dissertation Abstracts International, Volume: 67-01, Section: B, page: 0177. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2005. / Includes bibliographical references (p. 155-193). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts in English and Chinese. / School code: 1307.

Conclusion. We observed a small but independent effect of soy intake and lipid lowering effect, even after taking into account the other important predicting factors - initial cholesterol, body composition, physical activity, dietary intake and age. The beneficial effect between soy protein intake and lipid profile were observed even with this relatively low level of soy protein consumption suggests that the effect of soy protein supplement use on lipid profile may be much greater than those observed here. The results of our study add to the existing evidence that soy protein may be beneficial in human lipid profile. Our data will be useful for planning effective education programs as well as providing background information for further interventional studies to prevent coronary heart disease. / Coronary Heart Disease (CHD) is the major cause of death in most developed countries and is rapidly increasing in developing countries. Recent studies showed that natural menopause confers a threefold increase in CHD risk. While many risk factors, such as hypertension, diabetes mellitus, obesity and physical inactivity contribute to the risk for CHD, lipid abnormalities are the major factor. Hyperlipidemia plays a central role in the atherosclerotic process. Recent studies showed that consuming soy, a food containing large amounts of soy protein, improves the plasma lipoprotein profile by decreasing total cholesterol, LDL cholesterol, triglycerides as well as increasing HDL level. Although soy is a main component of traditional Asian food, many of the studies on soy consumption have been conducted in Caucasian populations (table 1.2), among whom soy intake is rather low or almost nil, it was difficult to explore the association of soy protein intake and lipid profile in those populations. Soy products such as tofu and soymilk are traditional Chinese foods. With the changing dietary pattern, it gives rise to a range of intake from traditional to modern and increasing incidence of cardiovascular disease Hong Kong poses a unique opportunity for the investigation of the relation between soy protein intake and lipid profile. / For baseline age stratified subgroup analysis, our study results showed no association between soy protein intake and lipid pro file in women whose baseline age younger than 55.3 years old, but we did observe a positive association in women belonging to older subgroup. In the 12-month follow up analysis, for women whose baseline age was older than 55.3 years (mean age=58.4+/-2.1), after controlling for the potential confounders, soy protein intake was significantly associated with HDL cholesterol concentration (Linear Regression p=0.033, ANCOVA=0.011, P value for trend p=0.014), total cholesterol/HDL ratio (Linear Regression p=0.045) and LDL/HDL ratio (Linear Regression p=0.037). Similar observation was observed in the yearly change rate of HDL in 24-month follow up (Linear Regression p=0.047, P value for trend p=0.043). / For women whose initial cholesterol level was higher or equal to 200mg/dL, in our 2-year longitudinal analysis, after controlling for the potential confounders, soy protein intake was significantly associated with HDL (Linear Regression p=0.041) and cholesterol/HDL ratio (ANCOVA=0.022). We also observed a statistically significant trend for higher HDL cholesterol (p=0.038), with an increase of 11.4g in soy protein intake between the 1st and 3rd tertiles, our data showed a 3.8% increase in HDL. / In the 12-month longitudinal analyses, after controlling for the potential confounders, soy protein intake was significantly associated with HDL concentration (Linear Regression p=0.036). We also observed a statistically significant trend for higher HDL cholesterol (p=0.036), with an increase of 10.9g in soy protein intake between the 1st and 3rd tertiles, our data showed a 7.9% increase in HDL. / Methods. 307 women aged between 48 to 62 years were recruited from community subjects residing in housing estates in Shatin. Women within the first 12 years of menopause, with no history of malabsorption syndromes, chronic liver kidney diseases, parathyroid diseases, gastric operation or cancer and without currently taking lipid lowering therapy were included in the study. We estimated the dietary intake of soy foods and other key nutrients by using quantitative food frequency method. We recorded serum values of fasting cholesterol, LDL cholesterol, HDL cholesterol and triglycerides as well as other covariance measurement. Soy protein consumption was categorized as tertiles of intake and related to lipid profile. / Objectives. In order to study the relation between soy protein intake and lipid profile in the early postmenopausal Chinese women in Hong Kong, we conducted the study from February 2000 to February 2002, as a part of the population-based soy consumption and bone mineral density study. The hypothesis to be tested is that high intake of dietary soy protein has a beneficial effect on lipid profile in the early postmenopausal Chinese women in Hong Kong. / Results. In our cross-sectional analysis, our findings showed that habitual dietary soy protein intake had a weak but statistically significant correlation with triglyceride concentration (Linear Regression p=0.045, ANCOVA p=0.045 P value for trend p=0.023), and the soy protein beneficial effects were more pronounced in women whose % of total body fat were higher than 33.4%. After controlling for the potential confounders, soy protein intake was significantly associated with triglyceride concentration (Linear Regression p=0.048, P value for trend =0.021), the average decrease in triglycerides were 24.6% and 29.1 % in the 2nd and 3rd tertile compared with the 1st tertile respectively. / Lam Siu Hung. / "February 2006." / Adviser: Ho Suzanne Sutying. / Source: Dissertation Abstracts International, Volume: 67-11, Section: B, page: 6300. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2006. / Includes bibliographical references (p. 181-191). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts in English and Chinese. / School code: 1307.