Vicarious traumatisation (VT) has been defined as an experience of change in several domains of personhood including worldview, identity, and beliefs related to major psychological needs. Self-care practice is widely considered essential in sustaining personal and professional well-being, and a lack of appropriate practice can enhance the risk of VT in trainee and newly qualified therapeutic practitioners. Both quantitative and qualitative research suggests that mindfulness practice can have a protective role in the risk of VT for trainees. This study examined the relationship between VT, self-care and mindfulness in a sample of 238 trainee therapists from the UK, Australia, Canada and Ireland. Structural equation modelling was used to test a mediation model with good fit with self-care as predictor variable, mindfulness as mediator, and VT as outcome variable. The hypothesis that when controlling for the effects of mindfulness on VT the effect of self-care on VT is no longer significant could not be confirmed as no mediational effect was present. The hypothesis that predicted a negative association between self-care practice and VT was confirmed with a significant total effect although the direct effect of self-care on VT was not significant. Findings are discussed in relation to previous research involving mindfulness in trainee cohorts. Links are made with neuroscience research to consider underlying mechanisms of mindfulness within the context of VT.

This thesis offers a rethinking of the role for education as critical workplace pedagogy in complex problems of health care. Taking the case of paediatric diabetes, the study explored how health-care professionals learn the work of supporting children, and their parents, to self-manage the condition. By reconceptualising work problems as sociomaterial learning struggles, this research contributes new understandings of informal professional learning in everyday health-care provision. Data were generated through fieldwork in an outpatient clinic. Particular challenges of supporting self-management in this case were the difficulties of balancing policy aspirations for empowerment with biomedical knowledge about risks to immediate and long-term health. Tracing the materialisation of learning as it unfolded in moments of health-care practice showed professionals handling multiple and contradictory flows of information. Particular challenges were posed by insulin-pump technologies, which have specific implications for professional roles and responsibilities, and introduce new risks. A key insight is that professionals were concerned primarily with the highly complicated perpetual discernment of safe parameters within which children and their parents might reasonably be allowed to contribute to self-management. Such discernment does not readily correspond to the notion of empowerment circulating in the policies and guidelines intended to enable professionals to accomplish this work. As a result, this thesis argues that the work of discernment is obscured. Learning strategies evolve, but could be supported and extended by explicit recognition of the important work of learning as it unfolds in everyday practices of supporting self-management in paediatric diabetes. Most importantly, workplace pedagogies could be developed in ways that attune to the profound challenges and uncertainties that are at stake in these practices.

Bakgrund: Cystisk fibros (CF) är inte längre en barnsjukdom eftersom 95% lever upp i vuxen ålder. Sjukdomen har stor påverkan på kroppens organ där lungorna och mag-och tarmkanalen är främst utsatta. Behandlingen är krävande och består till stor del av egenvård. Syfte: Syftet var att belysa personers erfarenheter av att leva med CF. Metod: Studien är utformad som allmän litteraturstudie med induktiv ansats. Sökningar genomfördes i tre databaser och genererade i elva artiklar. Resultat: Fyra kategorier skapades: Oro över att vara annorlunda, Symtomens påverkan på livet, Hopp och lidande samt Vårderfarenheter. Konklusion: Personer med CF upplever en bristande normalitet, önskan om ett normalt liv och en relation med döden. Att vara delaktig i vården är en förutsättning för personer med CF och bidrar till självständighet. Fortsatt forskning inom sjukdomen behövs för att lindra lidandet hos personer med CF. / Background: Cystic fibrosis (CF) is no longer a pediatric disease since 95% live up to adulthood. The disease has a great impact on the organs especially the lungs and the gastrointestinal tract. The treatment is very demanding and consists mainly of selfcare. Aim: The aim of this study was to illustrate persons´ experience of living with CF. Method: The study was constructed as a general literature study with an inductive approach. The searches were conducted in three different databases and resulted in eleven articles. Result: These eleven articles resulted in four categories: The worry of being different, The symptoms effect on life, Hope and suffering and Health care experience. Conclusion: People with CF experience a lack of normality, a wish for a normal life and they have a relationship with death. Being involved in the care is a prerequisite for people with CF and it contributes to independence. Continued research within the disease is necessary to relieve the suffering of people with CF.

Bakgrund: Fotkomplikationer är vanligt bland personer med diabetes typ 2 och kan förebyggas genom egenvård av fötter. Diabetessjuksköterskan har en viktig uppgift i att hjälpa personen att integrera sjukdomen i vardagslivet och hitta strategier för effektiv egenvård. Syfte: Att beskriva personers erfarenheter av egenvård av fötter vid diabetes typ 2. Metod: Kvalitativ studie med induktiv ansats där 12 individuella intervjuer genomfördes och datamaterialet analyserades med kvalitativ innehållsanalys. Resultat: Studiens resultat visar på förutsättningar och hinder för egenvård av fötter hos personer med diabetes typ 2. Förutsättningarna innehöll strategier för livsstilsförändring, att ta ansvar för den egna fothälsan samt rådgivning, stöd och hjälpmedel. Hinder var begränsningar på det psykologiska, kroppsliga, fysiska och organisatoriska planet. Temat kunskap skapar kontroll och handlingskraft framträdde. Diskussion: Resultatet stämmer överens med tidigare forskning angående personer med diabetes behov för att kunna utföra egenvård. Deltagarna önskade dialog och samarbete med diabetessjuksköterska för att bli en aktiv del av vård och egenvård. När samarbetet fungerade upplevde personen kontroll över sjukdomen och kunde ta välinformerade beslut angående egenvård. Konklusion: Kunskap om samband mellan diabetes och fothälsa var avgörande för möjligheten att utföra egenvård och här blev diabetessjuksköterskan en resurs att vända sig till för information och stöd. / Background: Foot complications are common among people with type 2 diabetes and can be prevented through self-care. The diabetes specialist nurse can help the person integrate diabetes into their life world, and find strategies for self-care. Aim: Describing experiences of foot self-care among people with type 2 diabetes. Method: A qualitative method with inductive approach was used. 12 individual interviews were conducted and the data was analyzed using qualitative content analysis. Results: There were prerequisites and obstacles for self-care. Prerequisites were strategies for life-style changes, taking responsibility for foot self-care along with consultation, support and aids. Obstacles included limitations in psychological, bodily, physical and organizational factors. A theme: knowledge creates control and drive emerged. Discussion: The results support previous research about the needs of people with diabetes in regards to self-care. Dialogue and cooperation with the diabetes specialist nurse was needed for the person to become an active part in care and self-care. Working cooperation resulted in that the person felt in control and was able to take informed decisions about self-care. Conclusion: Knowledge about the connection between diabetes and foot care was crucial when it came to self-care and the diabetes specialist nurse became a resource for information and support.

Bakgrund: Diabetes typ 1 är en autoimmun kronisk sjukdom som har ökat i antal drabbade de senaste 20 åren. Kontroll av plasmaglukosvärdet är centralt för att kunna utföra behandlingsåtgärder samt minska risken för komplikationer. En del av sjuksköterskans roll är att bidra med information, stödja och ge råd. Hantering av diabetes typ 1 bygger på egenvård där sjuksköterskan genom individanpassning kan skapa motivation till förändring hos personer med diabetes typ 1. Syfte: Syftet var att beskriva hur personer med diabetes typ 1 upplever sitt dagliga liv Metod: Litteraturöversikt med induktiv ansats där 10 artiklar analyserades enligt Fribergs femstegsmodell. Resultat: Resultatet utmynnade i två huvudkategorier. Dagliga resurser, som efterföljs av underkategorierna behov av stöd från sjukvården, behov av socialt stöd och behov av kunskap. En diagnos som förändrar livet följt av underkategorierna vardagen struktureras och mental påverkan av egenvården. Resurser som stöd och kunskap beskrevs i relation till egenvård och det dagliga livet. Det framkom även att faktorer som struktur, ansvar och rädsla förändrades vid diabetes typ 1. Slutsats: Rädsla för hypoglykemi och bristande individualiserad vård var utmärkande bland deltagarna. Stöd och information kan utveckla möjligheten för sjuksköterskan att stötta personer med diabetes typ 1 i deras dagliga liv relaterat till egenvård. / Background: Diabetes type 1 is an autoimmune chronic disease wich has increased in number over the past 20 years. Control of the plasma glucose value is central to being able to perform treatment measures and reduce the risk of complications. Part of the nurse's role is to contribute information, support and advise. Management of diabetes type 1 is based on self-care where the nurse can, through individual adaptation, create motivation for change in people with type 1 diabetes. Aim: The aim was to describe how people with Type 1 Diabetes experiencing their daily life. Method: A literature review with an inductive onset, 10 articles was analyzed through Friberg’s five-step model. Results: The result culminated in two main categories. Daily resources, which are followed by the subcategories of need for healthcare support, the need for social support and the need for knowledge. A diagnosis that changes life followed by the subcategories everyday life is structured and mental impact of self-care. Resources like support and knowledge was described in relation to self-care and daily life. Factors of structure, responsibility and fear emerged to be changing in relation to diabetes type 1. Conclusion: Fear of hypoglycemia and lack of individualized care was characteristic throughout the result. Support and information can develop the opportunity for nurses to support people with type 1 diabetes in their daily lives related to self-care.

SAMMANFATTNING Bakgrund: I en åldrande befolkning ökar prevalensen av hjärtsvikt. När det kommer till behandling av sjukdomen läggs mycket ansvar på patienten när det gäller symtomlindring. Strategier för att kunna kontrollera symtomen kan innebära en omfattande livsstilsförändring, vilket i sin tur kan skapa en mängd olika känslor för patienten.  Syfte: Syftet med denna studie var att beskriva patienters upplevelser av att leva med hjärtsvikt. Metod: En deskriptiv, systematisk litteraturstudie genomfördes. Tolv kvalitativa artiklar användes, och materialet analyserades genom kodning och teman. Databasen som användes var PubMed. Den teoretiska referensramen som tillämpades var livsvärldsperspektivet.    Resultat: Tre kategorier med tolv underkategorier identifierades. Patienter upplevde olika typer av begränsningar i det dagliga livet, både fysiska och emotionella. Andnöd och trötthet var en central fysisk upplevelse. Ensamhet, isolering och förändrade roller inom familjen rapporterades. Upplevelser av skuld, skam och känslan av att utgöra en börda gentemot familjen framkom. Vidare rapporterades olika former av anpassning till ett nytt liv, som till exempel förändringar i kost, alkoholkonsumtion och fysisk aktivitet. Positiv attityd och spiritualitet visades vara strategier för att hantera sitt tillstånd. Sjukhuset upplevdes vara den säkraste platsen för rehabilitering och hantering av symtom. Vidare framkom dock upplevelser av brister inom sjukvården gällande empati, kontinuitet och förmedlande av information. Familj och vänner upplevdes vara en viktig resurs gällande fysiskt och emotionellt stöd samt motivation.  Slutsats: Patienter med hjärtsvikt upplevde olika typer av begränsningar i det dagliga livet relaterat till sjukdomen, brister inom sjukvården samt behov av stöd. Sjukvården behöver ta dessa upplevelser i beaktande i mötet med patienten för att kunna individanpassa omvårdnad och egenvårdsrekommendationer. Vidare kan detta ge ett ökat oberoende och därmed en ökad livskvalitet för patienten. / ABSTRACT Background: In an ageing population the prevalence of heart failure is rising. When it comes to treating the disease, a lot of responsibility lies with the patient in terms of symptom management. Strategies to control symptoms may mean a significant change of life style which in turn can cause a range of emotions.  Objective: The objective for this study was to describe the experience of patients living with heart failure.  Methods: A descriptive systematic literature review was conducted. Twelve qualitative studies were used, and the material was analyzed by making codes and themes. The database that was used was PubMed. The theoretical framework that guided this study was theperspective of life world. Results: Three categories with twelve subcategories were identified. Patients experienced different types of limitations in their daily life, both physical and emotional. Central physical experiences were breathlessness and fatigue. Loneliness, isolation and changing roles within the family was also reported. Experiences of guilt, shame and a sense of being a burden towards the family emerged. Furthermore, various forms of adaptation were reported, such as changes in diet, alcohol consumption and physical activity. Positive attitude and spirituality proved to be strategies used to cope with the condition. The hospital was considered the safest place for rehabilitation and management of symptoms. Moreover, the hospital environment proved to lack in empathy, continuity and in conveying information. Family and friends were important resources regarding both physical and emotional support and motivation. Conclusions: Heart failure patients experience different types of limitations related to the disease in their daily life, shortcomings in health care, and need of support. The health care system needs to take these experiences into consideration when meeting the patient in order to personalize the care and self-care recommendations to increase independency and with that increase overall life quality for the patient.

Estudo observacional quantitativo longitudinal prospectivo em idosos e seus cuidadores, de ambos os sexos, internados na enfermaria de geriatria de um hospital-escola, com coleta de dados no período de agosto de 2013 a março de 2014. Objetivo: Avaliar a condição funcional subjetiva e objetiva de idosos internados em uma enfermaria geriátrica; entre os relatos de desempenho no autocuidado e suas necessidades de ajuda. Método: avaliações subjetivas e objetiva, usando o instrumento Performance test of Activities of Daily Living (PADL), com 16 tarefas associado a três itens da Escala de Atividades Instrumentais de Vida Diária (AIVD). Resultados: o sexo feminino predominou dentre os idosos (32 - 58,2%) e os cuidadores (46 - 83,6%); a idade dos clientes variou entre 64 e 99 (x=80) anos, e dos cuidadores entre 37 e 84 anos (x=58,7a); a escolaridade básica foi mais frequente entre os idosos (36 - 65,4%) e a superior (18 - 32,7%) para os cuidadores; quanto ao parentesco dos cuidadores, 30 (54,4%) eram filhas e 12 (21,5%) esposas. Para comparar as funcionalidades subjetivas e objetiva no desempenho do autocuidado, calculou-se o Índice de Concordância (Ind.Con%), que variou de 62 a 93%, com Kappa oscilando entre 0,20 e 0,59. Tanto os idosos como os cuidadores referiram desempenhar as tarefas sem ou com ajuda, porém, na avaliação objetiva, detectou-se maior necessidade de ajuda ou a incapacidade da realização da tarefa. Saliente-se que os idosos se autoavaliaram um pouco melhor que os seus cuidadores. Discussão: Nas avaliações subjetivas idosos e subjetivas cuidadores, em comparação com a objetiva, as respostas dos idosos para o autocuidado foram confirmadas na avaliação objetiva e com os relatos reportados subjetivamente pelos cuidadores. Verificou que o Nível de funcionalidade nos idosos, na maioria foi o nível 3 (fazer sem ajuda) para as atividades de vida diária PADL e atividades instrumentais AIVD. Os relatos subjetivos idosos em comparação com a avaliação objetiva podem apresentar que alguns idosos fazem as atividades sem ajuda, outros com ajuda e aqueles que não fazem as tarefas sozinhos, e, assim, necessitaram de algum tipo de ajuda. As informações subjetivas reportadas pelos cuidadores foram discordantes em comparações com a avaliação objetiva em alguns itens das escalas. Os idosos tendem a se avaliar melhor que seus cuidadores. Os cuidadores reportam que os idosos conseguem realizar a tarefa, mas, na avaliação objetiva, alguns não fazem. Conclusões: Há importantes diferenças entre as capacidades funcionais relatadas pelo próprio idoso e seus cuidadores quando comparadas com a observação direta destas tarefas pelo enfermeiro, o que indica a necessidade de basear as ações e os cuidados muito mais na avaliação direta do que exclusivamente nos relatos dos clientes e de seus cuidadores / Prospective, longitudinal quantitative study in elderly people and their proxies, of both genders, admitted at a geriatric ward of a school hospital, whose data collection was August 2013 to March 2014. Objective: to evaluate subjective and objective functional condition of elderly people admitted at a geriatric ward; among the reports of self care performance and their needs for help. Method: subjective and objective evaluations using the instrument Performance test of Activities of Daily Living (PADL), with 16 tasks associated to 3 items of Instrumental Activities of Daily Living (IADL). Results: Female gender was predominant among the elderly (32 - 58.2%) and the proxies (46 - 83.6%); clients´ age varied between 64 and 99 (x=80) years old and their proxies between 37 and 84 years old (x=58.7y); basic education was more frequent among the elderly (36 - 65.4%) and higher (18 - 32.7%) for their proxies. Regarding the family connection of proxies, 30 (54.4%) were daughters and 12 (21.5%) wives. In order to compare the subjective and objective functionalities to perform self care, it was calculated the Concordance Index (CI), which varied from 62 to 93%, whose Kappa was between 0.20 and 0.59. Both elderly people and their proxies referred performing tasks with or without help. However, on the objective evaluation it was detected greater need for help or incapability to perform a task. It must be highlighted that elderly people evaluated themselves a little better than their proxies. Discussion: elderly subjective and proxy subjective evaluations in comparison to objective ones, elderly responses for self care were confirmed in objective evaluation and the reports provided subjectively by their proxies. It was verified that the functionality level of elderly people in majority was level 3 (do it without help) for PADL daily life activities and IADL instrumental activities. Elderly subjective reports in comparison to objective evaluation, it can be seen that some elderly people perform their activities without help, others with help and the ones who don´t perform tasks by themselves required some kind of help. Subjective information reported by proxies was discordant in comparison to objective evaluation in some items of the instruments. Elderly people are more prone to evaluate themselves better than their proxies. Proxies reported that elderly people can perform their tasks, but in the objective evaluation it was not observed. Conclusions: there are important differences between the functional capacities reported by elderly themselves and their proxies when compared to the direct observation of these tasks by the nurse, which points to the need of actions and care more focused on the direct evaluation rather than reports by clients and their proxies

Objetivos: Utilizando-se o referencial Teórico do autocuidado de Dorothea Orem o estudo tem como objetivo: avaliar a capacidade de autocuidado do agente de autocuidado (AAC) de lactentes com Seqüência de Robin isolada (SRI), quanto à manipulação e o tempo que o AAC levou para adquirir a capacidade de cuidados com a intubação nasofaríngea (INF); sonda nasogastrica (SNG) e técnicas facilitadoras da alimentação (TFA). Modelo: Estudo prospectivo. Método: A pesquisa foi desenvolvida na Seção de Terapia Semi-Intensiva denominada Unidade de Cuidados Especiais (UCE) do Hospital de Reabilitação de Anomalias Craniofaciais da Universidade de São Paulo USP/Bauru. A amostra constituiu-se de 31 agentes de autocuidado (mães) com seus lactentes com SRI internados na UCE. Após elaboração e validação de um instrumento de coleta de dados, baseado na Teoria de Autocuidado de Dorothea Orem, o instrumento foi aplicado ao agente de autocuidado (AAC), em dois momentos distintos. O primeiro durante o período de internação após treinamento oferecido pelo enfermeiro quanto às ações de cuidados com o lactente e, o segundo, antes do lactente receber alta hospitalar a fim de verificar a capacidade do AAC para realizar os cuidados em seu domicilio. Resultados: Com relação às variáveis básicas do agente de autocuidado tais como: idade do agente de autocuidado obtivemos um total de (70,95%) de adultos jovens entre 15 a 30 anos; predominou que (77,41%) dos AAC mantinham um estado civil sem união consensual; baixo nível de escolaridade (58%); (56,11%) dos AAC possuíam mais de 1 filho; apresentavam classe social baixa (87,09%) e a maioria dos lactentes tinham menos de 30 dias (67,72%). Os AAC sem união consensual apresentaram escores mais elevados para o autocuidado. Pudemos evidenciar que os AAC com menos de 21 anos apresentavam um melhor desempenho para as habilidades de autocuidado para manipulação da INF e SNG. Assim como os AAC com classificação sócio-econômica mais elevada (classe baixa superior e média inferior) apresentaram uma pontuação maior para as habilidades do cuidar quando comparadas ao AAC de classe baixa inferior (p = 0,006). A maioria dos AAC (53%) adquiriu a capacidade para o autocuidado com INF e SNG em menos de 3 dias, enquanto que o tempo para adquirir o autocuidado com as TFA foi mais demorado. Os agentes de autocuidado que apresentaram os maiores escores na avaliação geral para o autocuidado apresentaram menos tempo para adquisição do autocuidado com a manipulação da INF. O nível sócio-econômico, escolaridade, no. de filhos, estado civil e o tempo de internação não interferiram na aquisição da capacidade de autocuidado pelo AAC, para os 3 procedimentos ensinados pelo enfermeiro: INF, SNG e TFA. Conclusão: O referencial Teórico do Autocuidado de Dorothea Orem permitiu a avaliação das capacidades de autocuidado dos agentes de autocuidado por meio do ensinoaprendizagem, preparando-os para a alta hospitalar contribuindo para uma melhor assistência do cuidar, favorecendo a melhora da vida desses lactentes com SRI. / Objectives: Using Dorothea Orem\'s theoretical reference for self-care, the objective of this study is to: assess self-care agents self-care capacity (AAC) for infants with isolated Robin Sequence (SRI), with regard to manipulation and the time the AAC needed to acquire the capacity to handle nasopharyngeal intubation (NPI); nasogastric probes (NG) and feedingfacilitating techniques (FFT). Model: Prospective study. Method: The study was carried out at the Semi-intensive Care Unit called the Special Care Unit (UCE) at the Hospital de Reabilitação de Anomalias Craniofaciais of the University of São Paulo USP/Bauru. The sample was comprised of 31 self-care agents (mothers) with their infants with SRI admitted in the UCE. A data collection instrument was elaborated and validated based on Dorothea Odems Self-Care Theory. The instrument was applied to the self-care agent (AAC) at two different moments. The first during the hospital stay period after training offered by the nurse with regard to infant care and the second after the infant had been released from the hospital in order to verify AAC capacity to perform the care at home. Results: With regard to the self-care agents basic variables, such as: the self-care agents age, we had a total of (70.95%) young adults between 15 and 30 years of age; a predominant percentage (77.41%) of the AACs marital status was without consensual union; low levels of education (58%); (56.11%) of the AAC had more than 1 child; low-income social class (87,09%) and the majority of the infants was under 30 days of age (67.72%). The AAC without consensual unions revealed higher scores for self-care. We can see that the AAC under 21 years of age had a better performance in terms of self-care skills for handling NPI and NG. The AAC with higher social-economic classifications (upper low class and low middle class) received a higher score for care skills when compared to AAC from lower low classes (p = 0.006). Most of the AAC (53%) acquired self-care capacity with NPI and NG in less than 3 days, whereas the time to acquire self-care with FFT was longer. The self-care agents that presented the highest scores in the general assessment for self-care needed less time to acquire self-care skills with INF manipulation. The social-economic level, education, number of children, marital status and hospital stay time did not interfere in selfcare capacity acquisition by the AAC for the 3 procedures taught by the nurse: NPI, NG and FFT. Conclusion: The Dorothea Orem Self-Care Theoretical Reference allows the assessment of self-care capacities for self-care agents by means of teaching-learning, preparing them for release from the hospital and contributing towards better care assistance, favoring improvement in life for these infants with SRI.

Este estudo objetivou analisar a relação entre as atividades de autocuidado com o diabetes mellitus (DM) e as variáveis sociodemográficas, de saúde, o desempenho funcional e a presença de sintomas de depressão em idosos com DM2. Trata-se de um estudo quantitativo, descritivo e transversal, realizado com 121 idosos com DM2, atendidos no Ambulatório de Diabetes, de um Hospital Geral Terciário, no interior paulista. Os dados foram coletados no período de fevereiro a junho de 2014. Para tanto, utilizaram-se o Miniexame do Estado Mental, o Índice de Katz, a Escala de Lawton, o Questionário de Atividades de Autocuidado com o Diabetes e a Escala de Depressão Geriátrica. A média de idade dos idosos foi 68,1 anos, 57,2% eram mulheres, 65,3%, casados e 32,2%, analfabetos; 29,8% moravam somente com cônjuge, e 71,9% eram aposentados. A média de diagnóstico médico foi 5,2, com maior prevalência de hipertensão arterial sistêmica (90,8%), dislipidemia (77,6%), nefropatias (32,2%) e retinopatias (42,1%); a média de complicações foi 2,6, destacando-se os problemas nos olhos (38,8%), a pressão alta (30,6%) e colesterol/triglicérides (26,5%). Quanto ao tipo de tratamento, 79,3% realizavam dieta e 55,4%, associação de antidiabético oral e insulina; 50% sempre faziam autoaplicação de insulina; 50% armazenavam a insulina na porta da geladeira; 80,2% não alteravam a dose de insulina e 85,9% realizavam o rodízio dos locais de aplicação. Para o desempenho das atividades básicas da vida diária, 93,4% eram independentes e para as atividades instrumentais de vida diária, 71,1% eram parcialmente dependentes. Quanto às atividades de autocuidado, as maiores médias de dias na semana foram para os itens: \"secar os espaços entre os dedos dos pés, depois de lavá-los\" 6,4(DP=1,8), \"tomar injeções de insulina conforme recomendado\" 6,1 (DP=2,3), \"avaliar o açúcar no sangue o número de vezes recomendado\" 5,5 (DP=2,5) e as menores médias foram para: \"realizar atividades físicas por 30 minutos\", 1,6 (DP=2,6), \"realizar exercício físico específico\" 1,6 (DP=2,5) e \"ingerir doces\" 0,8 (DP=1,5). Houve significância estatística entre a variável estado civil e a dimensão monitorização da glicemia (p=0,00), com menor média para os solteiros 3,3 (DP=3,3); e a variável renda e a dimensão alimentação específica (p=0,03), mostrando menor média 3,8 (DP=1,4) para os que possuíam renda de até R$ 1.300,00. Em relação ao tabagismo, 51,2% nunca fumaram. Os sintomas depressivos estavam presentes em 55,4% dos idosos, porém não houve diferença estatisticamente significativa entre as médias de dias na semana para as dimensões do QAD e a presença ou ausência de sintomas depressivos. Conhecer as características sociodemográficas, de saúde, o desempenho para as atividades diárias e a frequência das atividades de autocuidado de idosos com DM2 possibilita aos profissionais de saúde o planejamento da assistência, com intervenções específicas às necessidades dos mesmos / This study\'s aim was to analyze the relationship between self-care activities regarding diabetes mellitus (DM) and socio-demographic and health variables, functional performance, and the presence of depressive symptoms among elderly individuals with DM2. This quantitative, descriptive and cross-sectional study was conducted with 121 seniors with DM2 cared for by the endocrinology and metabolism care clinic of a tertiary general hospital in the interior of São Paulo, Brazil. Data were collected from February to June 2014. The Mini Mental State Exam, Katz Index, Lawton Scale, Summary of Diabetes Self-Care Activities Questionnaire, and Geriatric Depression Scale were used. The participants were 68.1 years old on average, 57.2% were women, 65.3% were married, 32.2% were illiterate, 29.8% lived with the spouse only, and 71.9% were retired. The individuals presented 5.2 medical diagnoses on average, the most frequent were: hypertension (90.8%), dyslipidemia (77.6%), nephropathies (32.2%), and retinopathies (42.1%); and presented 2.6 complications on average, mainly eye problems (38.8%), hypertension (30.6%), and cholesterol/triglycerides (26.5%). In regard to type of treatment, 79.3% complied with the diet and 55.4% used an association of oral anti-diabetic medication and insulin; 50% always self injected insulin; 50% stored insulin in the refrigerator\'s door; 80.2% did not change the insulin dose; and 85.9% alternated the sites where insulin was applied. In regard to basic activities of daily living, 93.4% were independent and 71.1% were partially dependent on others to perform instrumental activities of daily living. In regard to the most frequently performed self-care activities, the following items achieved the highest average of days/week: \"drying between toes after washing them\" 6.4 (SD=1.8), \"taking insulin shots as recommended\" 6.1 (SD=2.3), and \"checking blood sugar as many times as recommended\" 5.5 (SD=2.5), while the lowest averages were found for: \"exercise for 30 minutes\", 1.6 (SD=2.6), \"perform specific physical exercise\" 1.6 (SD=2.5) and \"eating sweets\" 0.8 (SD=1.5). Statistical significance was found between marital status and the blood glucose monitoring dimension (p=0.00), in which the lowest average was found among single people 3.3 (SD=3.3); and between income and the specific food dimension (p=0.03), in which the lowest average, 3.8 (DP=1.4), was found among those with income up to R$ 1,300.00. In regard to smoking, 51.2% never smoked. Depressive symptoms were experienced by 55.4% of the elderly individuals, though no significant difference was found between the average of days for the dimensions QAD and presence or absence of depressive symptoms. The identification of sociodemographic characteristics, health variables, performance of daily activities, and frequency with which self-care activities are performed by elderly individuals with DM2, enables healthcare workers to plan care delivery with interventions specifically designed to meet these patients\' needs

Introdução: A incontinência urinária (IU) acomete um grande contingente de mulheres e é considerada uma das novas epidemias do século XXI. Objetivo: elaborar um material educativo para promover o autocuidado de mulheres com IU. Os objetivos específicos foram explorar as experiências vividas por mulheres com IU; identificar as dúvidas e necessidades dessas mulheres relacionadas à IU; levantar dificuldades e potencialidades no enfrentamento dos problemas relacionados à IU. Referencial Teórico: As premissas interacionistas e dialógico-educativas de Paulo Freire alicerçaram este estudo. Metodologia: Foi desenvolvida uma pesquisa-ação (PA) com dois grupos (G1 e G2) de mulheres portadoras de IU. O G1 composto por 12 mulheres de um hospital do Sistema Único de Saúde, do Município de Macapá-AP. O G2 por dez mulheres da rede privada do mesmo município. As quatro fases da PA foram diagnóstico da realidade; planejamento e execução das ações educativas; elaboração e validação do material educativo; avaliação reflexiva. Os dados do diagnóstico da realidade foram obtidos em oito sessões de grupos focais (GFs). As ações educativas desenvolveram-se em quatro oficinas com os G1 e G2 e a avaliação reflexiva numa única sessão. A análise indutiva e interpretativa dos dados gerou seis categorias. O material educativo, ilustrado com figuras inéditas, teve por base evidências científicas atualizadas. A versão preliminar foi submetida à avaliação de peritos e à apreciação das mulheres. Resultados: Os itens principais do material educativo são: Conheça mais sobre a incontinencia urinária IU); Como descubro se tenho IU?; Conheça os três tipos de IU mais frequentes; A IU e o parto; A IU tem cura?; Tratamentos que existem para a mulher que tem IU; Como a IU pode afetar a vida sexual e amorosa?; As leis brasileiras para a saúde da mulher; Sugestões de mulheres para melhoria da assistência e tratamento da IU. As categorias que descrevem a experiência da IU são: 1. A urina sai sem querer: o processo de descoberta da doença; 2.Variados motivos levam a esta doença: as percepções das mulheres sobre as causas da IU; 3. Uma doença estigmatizante: significados negativos atribuídos à IU; 4. Uma doença que causa reflexos negativos na vida cotidiana: consequências sobre a vida social e a saúde; 5. Sexualidade e vida sexual afetadas: consequências da IU na vida íntima; 6. Desconhecida das mulheres e desconsiderada pelos profissionais: motivos da busca tardia pelo tratamento da IU. Discussão: As categorias reafirmaram resultados de outros estudos. As mulheres com IU sofrem danos físicos e psicológicos, com impactos negativos em sua qualidade de vida, entre outros, a vida sexual e social. Mesmo sendo patologia relevante, a IU está silenciada nas políticas públicas de saúde, por diversas deficiências, impedindo a prevenção e promoção da saúde das mulheres. As deficiências incluem falhas na infraestrutura assistencial, na escuta e tratamento humanizados pelos profissionais de saúde. Considerações finais: Espaços específicos de educação em saúde gerariam o empoderamento das mulheres na busca de estratégias de promoção da sua saúde. Pretende-se que o material educativo auxilie a educação e promoção da saúde das mulheres portadoras de IU. / Introduction: Urinary incontinence (UI) affects a large contingent of women and is considered one of the new epidemics of the 21st century. Objective: to elaborate an educational material to promote the self-care of women with UI. The specific objectives were to explore the experiences of women with UI; Identify the doubts and needs of these women related to UI; Difficulties and potentialities in facing UI-related problems. Theoretical Framework: The interactionist and dialogical-educational premises of Paulo Freire supported this study. Methodology: An action research (AR) was developed with two groups (G1 and G2) of women with UI. The G1 was composed of 12 women from a hospital of the Unified Health System of the city of Macapá-AP. The G2 by ten women from the private network of the same municipality. The four phases of AR were diagnostic of reality; planning and execution of educational actions; rreparation and validation of educational material, and reflective evaluation. Data related to the diagnosis of reality was obtained through eight focus group sessions (FGs). The educative activities were developed through four workshops with the G1 and G2 and the reflexive evaluation in a single session. The inductive and interpretive analysis of the data generated six categories. The educational material, illustrated with original figures, was based on updated scientific evidence. The draft was submitted to expert assessment and to the appreciation of women. Results: The main items of educational material are: Learn more about UI); How do I find out if I have UI?; Know the three most common types of UI; UI and childbirth; Does UI have a cure? ; Treatments that exist for the woman who has UI; How can UI affect sexual and loving life? Brazilian laws for the health of women; Suggestions from women to improve UI care and treatment. The categories that describe the UI experience are: 1. The urine leaves unintentionally: the process of finding the disease; 2. Various reasons lead to this disease: women\'s perceptions about the causes of UI; 3. A stigmatizing disease: negative meanings attributed to UI; 4. A disease that causes negative reflexes in daily life: consequences on social life and health; 5. Sexuality and sexual life affected: consequences of UI on the intimate life; 6. Unknown to women and disregarded by professionals: reasons for the late search for UI treatment. Discussion: These categories reaffirmed results from other studies. Women with UI suffer physical and psychological damages, with negative impacts on their quality of life, among others, sexual and social life. Although it is a relevant pathology, the UI is silenced in public health policies, due to several deficiencies, hindering the prevention and promotion of women\'s health. The deficiencies include failures in healthcare infrastructure, humanized listening and treatment by health professionals. Final considerations: Specific spaces of health education would generate the empowerment of women in search of strategies to promote their health. It is intended that the educational material contributes to the education and health promotion of women with UI.