Submitted by Fabíola Silva (fabiola.silva@famerp.br) on 2017-02-21T18:00:50Z No. of bitstreams: 1 camilaalinelazaro_dissert.pdf: 832681 bytes, checksum: ec140f633900c014aa6ef9576469ca45 (MD5) / Made available in DSpace on 2017-02-21T18:00:50Z (GMT). No. of bitstreams: 1 camilaalinelazaro_dissert.pdf: 832681 bytes, checksum: ec140f633900c014aa6ef9576469ca45 (MD5) Previous issue date: 2016-10-27 / INTROTUCTION: Leprosy is an infectious disease, which presents a slow evolution and signs on the skin and peripheral nerves are manifested. It represents a public health problem that can lead to deficiencies, which generate the limiting activities of the affected people and can bring drastic changes and result in several difficulties. OBJECTIVE: The aim of this study is to verify the presence and degree of activity limitations assessed by the scale Screening of Activity Limitation and Safety Awareness (SALSA) drug after discharge of patients who had leprosy. METHODOLOGY: This is a cross-sectional descriptive study, which was conducted a survey of activity limitation data, through semi-structured interviews and the use of screening scale of Activity Limitation & Safety Awareness (SALSA), applied in 59 patients who were in High drug treated from 2001 to 2013 in the counties of Jaci and Mirassol in the state of São Paulo. RESULTS: 98 people treated in the period, 59 (60.20%) were interviewed, 30 (50.80%) males, 29 (49.20) women and the age ranged from 21 to 88 years, with dp (12.56), average (58.83), medium (61). Thus, it was verified that of the 59 patients the greatest difficulty is the movement of upper limbs and the risks although underreported appeared in self-care and movement of the upper limbs. CONCLUSION. It was concluded that was possible to realize that the individuals still face difficulties in their daily lives to perform some functions, requiring some means of intervention and / or orientation to base and enable the improvement of their quality of life. / INTRODUÇÃO: A hanseníase é uma doença infectocontagiosa, que apresenta uma evolução lenta e se manifesta por sinais na pele e nervos periféricos. Representa um problema de saúde pública que pode levar a deficiências que gera a limitação de atividades dos acometidos, podendo trazer mudanças drásticas e acarretar diversas dificuldades. OBJETIVO: O objetivo deste estudo é verificar a presença e o grau da limitação de atividades avaliada pela escala Screening of Activity Limitation and Safety Awareness (SALSA) pós-alta medicamentosa de pacientes que tiveram hanseníase. CASUÍSTICA E MÉTODO: Trata-se de um estudo descritivo transversal, no qual foi realizado um levantamento de dados de limitação de atividades, por meio de entrevistas semiestruturadas e uso da escala Screening of Activity Limitation & Safety Awareness (SALSA), aplicadas em 59 portadores que se encontravam em alta medicamentosa tratados no período de 2001 a 2013 nos municípios de Jaci e Mirassol no interior do Estado de São Paulo. RESULTADOS: De 98 pessoas tratadas no período, 59(60,2%) foram entrevistadas, sendo 30(50,8%) homens, 29 (49,20) mulheres e a idade variou de 21 a 88 anos, apresentando dp (12,5), média (58,8), mediana (61,0). Verificou que dos 59 pacientes a maior dificuldade é a movimentação de membros Superiores e que os riscos apesar de pouco relatados apareceram no autocuidado e movimentação de membros superiores. CONCLUSÃO. Concluiu-se que foi possível perceber que os indivíduos ainda se deparam com dificuldades na sua vida cotidiana para desempenhar algumas funções, necessitando de algum meio de intervenção e/ou orientação para poderem se embasar e possibilitar a melhoria da sua qualidade de vida.

Submitted by Aline Batista (alinehb.ufpel@gmail.com) on 2018-04-13T19:08:15Z No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Dissertacao_Juliana_Damasceno_Nunes.pdf: 1942944 bytes, checksum: 1f03bd1b7ccfa0362c99fc4113463a4c (MD5) / Made available in DSpace on 2018-04-13T19:59:28Z (GMT). No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Dissertacao_Juliana_Damasceno_Nunes.pdf: 1942944 bytes, checksum: 1f03bd1b7ccfa0362c99fc4113463a4c (MD5) Previous issue date: 2016-08-12 / Sem bolsa / O envelhecimento populacional é um fenômeno universal, onde a busca da melhoria na qualidade de vida, independência e autonomia na sociedade vêm sendo amplamente discutida. Uma vez que as mudanças fisiológicas neste período da vida são inevitáveis e podem gerar perdas da capacidade física, cognitiva e sensorial que comprometerão a funcionalidade diária dos idosos. Neste sentido, este trabalho tem como objetivo descrever a prevalência e os fatores associados à incapacidade funcional em idosos de Bagé, Rio Grande do Sul (RS). Os dados utilizados para a realização deste estudo são provenientes do banco de dados da pesquisa intitulada “Saúde do idoso: situação epidemiológica e utilização de serviços de saúde em Bagé, RS”. Trata-se de uma pesquisa de base populacional que investigou idosos com 60 anos ou mais de idade, residentes na área urbana e de abrangência dos serviços de atenção básica à saúde de Bagé, RS. A variável dependente foi a incapacidade funcional, com enfoque nas atividades básicas e instrumentais da vida diária, sendo definida pela necessidade de ajuda ou dependência total para pelo menos uma atividade básica, por meio do Índice de Katz e para pelo menos uma atividade instrumental da vida diária por meio da Escala de Lawton e Brody. As variáveis independentes avaliadas foram: as condições sociodemográficas, comportamentais, as condições de saúde e a utilização dos serviços de saúde pelos indivíduos. A prevalência de incapacidade funcional para as atividades básicas da vida diária foi de 10,6% (IC95% 9,1–12,1) e para as instrumentais de 34,2% (IC95% 31,9–36,6), associando-se a idosos mais velhos, com baixa escolaridade, viúvos, consumistas de bebida alcoólica, portadores de doenças crônicas, que estiveram hospitalizados no último ano e que receberam atendimento domiciliar nos últimos 03 meses. Os resultados da pesquisa reforçam a condição multifatorial da incapacidade funcional, indicando a necessidade de sua investigação na rotina dos serviços de saúde para identificação prévia das funções perdidas, tornando possível o desenvolvimento de ações de promoção e prevenção focadas na necessidade funcional de cada idoso visando prevenir maiores problemas, como quedas, fraturas, e imobilidade. / The aging of the population is a universal phenomenon characterized by the quest for improved quality of life, independence and autonomy within society. On the other hand, physiological changes at this time of life are inevitable and can cause loss of physical, cognitive and sensorial capacity that compromise the daily functionality of the elderly. As such, the purpose of this paper is to describe the prevalence of disability and associated factors among elderly people in the city of Bagé, Rio Grande do Sul (RS), Brazil. The data used to carry out this study were taken from the database of the research initiative entitled “The health of the elderly: epidemiological status and use of health services in Bagé, RS”. This is a population-based study with elderly people aged 60 or over living in the urban area of Bagé, RS, and falling within the catchment area of the city’s primary healthcare services. The dependent variable was disability, defined by the need for help or total dependence in order to perform at least one basic activity according to the Katz Index and at least one instrumental activity of daily living as per the Lawton and Brody Scale. The independent variables involved the evaluation of the sociodemographic, behavioral and health conditions of the elderly, as well as their use of health services. The prevalence of disability to perform basic daily living activities was 10.6% (95%CI 9.1–12.1), whilst for instrumental activities it was 34.2% (95%CI 31.9–36.6). Associated factors were being older within the elderly age group, low level of schooling, being widows/widowers, consuming alcoholic beverages, having chronic diseases, having been hospitalized in the last year and having had care at home in the last three months. The results of the study emphasize the multifactorial nature of disability, indicating the need for it to be investigated as part of the health service routine for early identification of elderly people with loss of functionality, as well as the need to develop prevention and health promotion actions in this area.

Abnormalities in lumbopelvic rhythm (LPR) play a role in occurrence/recurrence of low back pain (LBP). The LPR before spinal fusion surgery and its changes following the surgery are not understood. A repeated measure study was designed to investigate timing and magnitude aspects of LPR in a group of patients (n = 5) with LBP before and after a spinal fusion surgery. Participants completed a forward bending and backward return task at their preferred pace in the sagittal plane. The ranges of thoracic and pelvic rotations and lumbar flexion (as the magnitude aspects of LPR) as well as the mean absolute relative phase (MARP) and deviation phase (DP) between thoracic and pelvic rotations (as the timing aspects) were calculated. Thoracic, pelvic, and lumbar rotations/flexion were respectively 2.19° smaller, 17.69° larger, and 19.85° smaller after the surgery. Also, MARP and DP were smaller during both bending (MARP: 0.0159; DP 0.009) and return (MARP: 0.041; DP: 0.015) phases of the motion after surgery. The alterations in LPR after surgery can be the result of changes in lumbar spine structure due to vertebral fusion and/or new neuromuscular adaptations in response to the changes of lumbar spine structure. The effects of altered LPR on load sharing between passive and active components of lower back tissues and the resultant spinal loads should be further investigated in patients with spinal fusion surgery.

Individuals with autism spectrum disorder (ASD) experience difficulties with learning age-appropriate daily living skills (DLS) at their homes, schools, and in the community. Such skills are significant for independent life, post-school education, employment, and overall quality of life. Video prompting (VP) is a teaching practice that has demonstrated positive outcomes in teaching a variety of DLS to individuals with ASD. The overarching purpose of this collected papers dissertation was to investigate the effects of VP interventions on improving DLS of individuals with ASD. This dissertation included two separate papers. The first paper was a meta-analysis that examined the overall effect of VP when teaching DLS to individuals with ASD across single-case research design (SCRD) studies. An analysis of potential moderators was also examined: VP intervention types, participants’ ages, and participants’ disabilities. There were 54 participantsacross17 studies meeting the study’s inclusion criteria. The results demonstrated a high-moderate effect size (ES) for VP on the acquisition of DLS across 17 studies including 54 participants. The analysis of potential moderators showed no significant differences across all moderator variables. Limitations and implications for research and practices are provided in Chapter II. The second paper was a SCRD study comparing the effects of VP alone to least-to-most prompting alone on improving three office-related tasks to secondary-aged children with developmental disabilities. An adapted alternating treatment design (AATD), including baseline, comparison, best treatment, and final treatment phases was used to examine the interventions. Data related to the effects, efficiency, and social validity of both interventions were collected to address the research questions. Video prompting was effective for all participants, while least-to-most promoting was effective for two participants. Also, VP was more efficient than least-to-most prompting in terms of sessions-to-criterion and percent of errors for all participants. Least-to-most prompting was more efficient than VP in terms of the total duration of teaching time for all participants. Finally, all participants and their teachers reported positive perspectives regarding the study’s procedures and outcomes. Limitations, future research, and implications for practices are discussed in Chapter III. Lastly, the summary of the entire dissertation and extended discussions of both papers are presented in Chapter IV.

Currently a lack of guidelines for Criterion B of the DSM-IV-TR (American Psychiatric Association, 2000) hampers diagnosis of children with developmental coordination disorder (DCD). The Performance of Activities of Daily Living Questionnaire (PADL-Q; Dewey, Larkin & Summers, 2004) is a new parent-reported instrument developed to quantify the level of interference in activities of daily living (ADL) experienced by children with DCD and was tested for its efficacy in addressing Criterion B. Thirty-two children aged between 5 and 10 years comprising two matched groups, 16 with DCD (8 boys and 8 girls) and 16 without DCD (8 boys and 8 girls) participated in the study. The aim of the research was to investigate the ability of the PADL-Q to identify differences between children with and without DCD. A further 5 children, in the same age range, who did not have DCD added data that was used to ascertain relationships between the constituent assessments. All children were tested using the MAND (McCarron, 1982) whilst their parents completed the PADL-Q. A set of Tests of Activities of Daily Living (TADL) tasks were devised for the children to perform that further validated parents ratings of children?s ADL performance. A Group x Gender MANCOVA, controlled for age, of the PADL-Q total scores demonstrated that there was a significant difference between the children with and without DCD (F(3,25) = 9.44, p < .001; Wilks' lambda = 0.47). Follow-up univariate tests showed a Group x Gender interaction and simple main effects of this interaction indicated that the PADL-Q did not discriminate between the DCD and non-DCD boys. The ability of the PADL-Q to identify DCD was explored in the concurrent validity against the MAND when using a diagnostic cut-off point. The PADL-Q demonstrated 100% specificity and positive predictive values but only 19% sensitivity and 62% negative predictive values. There was a moderately strong relationship (r = .71), between the PADL-Q total score, considered a measure of Criterion B, and the MAND, a measure of Criterion A (DSMIV- TR, 2000). A two factor (Group x Gender) ANCOVA, controlled for age, of the TADL items revealed a statistically significant effect for DCD only (F(1,19) = 34.65, p < .001). There was a moderate correlation (r = -.64) between the PADL-Q total score and the TADL tasks, indicating that parent-reports are supported by their child?s performance. The PADL-Q appears to have potential as part of the DCD diagnostic process; however, further refinement on a larger sample is necessary before it can be used as an easily-administered guide to ADL performance levels in children.

Doctor of philosophy (PhD) / Abstract As one of the most culturally diverse countries in the world, Australia has a high proportion of minority communities. However, its ageing population, particularly within these ethnic minorities, faces a range of barriers or difficulties in gaining access to and using health and aged care services. This study aims to identify the acculturation factors that affect the health status of Iranian-born elderly immigrants to Australia and their utilisation of health and community aged care services. The results of this study will be of value to Iranian elders, their families, and Australian aged health care service providers. The findings could also contribute towards enriched multicultural policy and improved social fairness, access to services, and equity for the aged from different ethnic backgrounds. 302 Iranian migrants aged 65 years who had lived in the Sydney Metropolitan area for at least six months were surveyed via a written questionnaire, face-to-face interviews, and telephone interviews. The results were analysed using SPSS and then compared to the findings from a 1999 survey of NSW elderly. The results indicate that Iranian migrants suffer higher levels of psychological distress and are more limited in their physical functioning than the general population of older Australians. They are in greater need of assistance with activities of daily living, have a lower sense of wellbeing, and are far less likely to utilise aged care services. Iranian migrant who do not speak English at home experience these disadvantages to an even greater extent English language proficiency was the only acculturation factor found to affect whether Iranian elderly utilised health and community aged care services, while ability to engage in activities of daily living (ADL) was the only health variable associated with their utilisation of community supportive aged care services. This variable did not predict the use of community aged care services in the broader sample of NSW respondents. Since limited proficiency in English placed elderly Iranian migrants at greater health risk and impeded their access to necessary assistance, the findings suggest that they would clearly benefit from English classes and from access to health and community care services and information regarding these services in the Farsi language.

<p>This thesis evaluates surgical correction in patients with paralytic scoliosis with emphasis on function and activity. The thesis includes four studies of 100 consecutive patients preoperatively evaluated and surgically corrected between 1992 and 1996 at Linköping University Hospital. Eighteen different diagnoses were represented. The postoperative follow-ups were at one year and in average seven years. Six patients dropped out during the first year and twelve during the long-term follow-up period. The assessments included general information, lung function, and measurements of radiographs, function and activity - seating posture, ADL, pain, care and need for rest. The patients or relatives view on the effects of surgery were evaluated in follow-up questionnaires.</p><p>The preoperative results of the 100 patients described a heterogeneous group in terms of function and activity. Even when the patients were grouped into subgroups according to the Scoliosis Research Society classification, they remained heterogeneous. In patients who could understand verbal instructions assessments that needed co-operation could be used and in those who could not understand verbal instructions, assessments relied more heavily on measures of function and level of dependence. Preoperative results of weight distribution on the seating surface were explained by thoracolumbar/lumbar spinal imbalance and pelvic obliquity R²=0.45 (n=45).</p><p>The one-year follow-up of 94 patients showed improvements in angle of scoliosis, sitting balance, weight distribution to the seating surface, seating supports in the wheelchair, time needed for rest. The results in subgroups were almost the same as in the whole group. The subjective results for patients or relatives in the follow-up questionnaire showed a positive outcome of surgery. In the comparison between the one-year follow-up and the long-term follow-up there were further improvements in sitting balance, ADL, and care given, but the angle of scoliosis was increased. These results were in line with patients’ and relatives’ assessments in the follow-up questionnaire and in the open-ended questions.</p><p>Due to the heterogeneity of patients with paralytic scoliosis, irrespective of disorder, it is important to focus on different subgroups with regards to the patients’ total situation. The surgically corrected and stabilised spine resulted in the strength to keep the body upright with improvements in function, activity and possibilities to belong in social activities. Further improvements were shown between the one-year follow-up and the long-term follow-up. It is recommended that patients who have been surgically corrected for paralytic scoliosis are followed for more than one year.</p>

<p>Bakgrund: När människor drabbas av venösa bensår kan vardagen drastiskt förändras. Ett stort antal individer drabbas av bensår och incidensen ökar med åldern. För att kunna ge en god omvårdnad behöver vårdpersonalen ökade kunskaper för att förstå bensårens inverkan på individens dagliga liv. Syfte: Syftet med studien var att beskriva hur det är att leva med venösa bensår. Metod: Studien utfördes som en allmän litteraturstudie. Fjorton empiriska studier ingick. Resultat: I samband med bensår förekommer en rad faktorer som på olika sätt påverkar det dagliga livet. Framträdande faktorer var smärta, svullna ben, lukt och läckage, rädsla och välbefinnande. Smärta var det funktionella hälsotillstånd som hade störst inverkan på det dagliga livet. Smärtan ledde till störd nattsömn, försämrad rörlighet och social isolering. Slutsats: Patienter med smärtsamma bensår har svårt att leva det liv som de önskar. Om distriktssköterskan synliggör sambandet mellan dagligt liv och funktionellt hälsotillstånd, kan specifika omvårdnadsåtgärder genomföras. Patienterna kan då uppnå ett önskvärt dagligt liv oavsett funktionellt hälsotillstånd.</p> / <p>Background: When people suffer from venous leg ulcers, their everyday life can be drastically changed. A large number of individuals suffer from leg ulcers and the incidences increase with age. In order to provide good nursing, care staff need more knowledge in order to understand the effects of the ulcers on the individual's daily life. Purpose: The purpose of this study was to describe what it is like to live with venous leg ulcers. Method: The study was carried out as a general literature review. Fourteen observational studies were included. Results: In connection with leg ulcers there are a number of factors that affect the patients’ daily lives in different ways. Important factors were pain, swollen legs, odor and leakage, fear and well-being. Pain was the functional state of health which had the greatest impact on daily life. The pain led to interrupted sleep, impaired mobility and social isolation. Conclusion: Patients with painful leg ulcers have difficulty living the life they desire. If the district nurse makes the connection between daily life and functional health status explicit, specific care measures can be implemented. Then patients can achieve a desirable everyday life regardless their functional state of health.</p>

<p>The overall aim was to improve the knowledge and understanding of eating habits of older men with somatic diseases, and the men's perceptions about managing food-related habits, such as grocery shopping and cooking. A total of 67 men between 64 and 89 years of age were visited in their homes on two occasions with 1-2 weeks in between. The participants were diagnosed with one of the three diseases Parkinson’s disease, rheumatoid arthritis, or stroke. A food survey, with repeated 24-h recall, was used to assess food intake and meal patterns. Interviews with 18 participants were conducted with open-ended questions. The interviews were further analysed with a thematic framework approach.The findings showed that eating events were distributed over a 24-h period.Further, co-living men had a significantly larger number of eating events over the day (p=0.001). No differences in daily energy intake were observed between co-living and single-living men. Co-living men’s hot eating events were compared with those of single-living men more often cooked from fresh ingredients (p=0.001), including a greater mix of vegetables/roots (p=0.003).Thematic analysis revealed three different approaches to food-related activities(FRA), namely ‘Cooking as a pleasure’, describing joy in cooking; ‘Cooking as a need’, indicating no habits or skills in cooking; and ‘Food is served’, that is, being served meals by a partner. The men's approaches to FRA were affected in particular by gender-related roles, but also by changed life circumstances, activity limitations, personal interests, and a wish to maintain continuity and independence. Further adaptive strategies were used among the men in attempts to maintain continuity and independence in FRA. In conclusion, single-living older men, especially those with activity limitations, were identified as being a vulnerable group from a nutritional perspective. Further, health care efforts in promoting FRA should preferably be individualised with respect to the older man’s approach to these activities.</p>

<p>The overall aim was to study and gain knowledge about what it means to live with muscular dystrophy and to study rehabilitation from the patient's perspective, among adults with muscular dystrophy in three Swedish counties: Örebro, Östergötland and Norrbotten. The thesis comprises two qualitative and three quantitative studies. Thirty interviews about illness experience were subjected to content analysis and 37 interviews about perceived support in rehabilitation were analysed according to phenomenological guidelines. Data were also collected by the Assessment of Problem-focused Coping (APC), the ADL Staircase, the Self-report ADL, the Mental Adjustment to Cancer Scale, the Sickness Impact Profile, the Psychosocial well-being questionnaire and the Quality of Life Profile. The APC was developed for assessment of problem-focused coping and also covers questions concerning the extent to which activities are experienced as problems and satisfaction with activities. The result shows that the experience of illness is largely similar in the three diagnostic groups (proximal MD, Myotonic muscular dystrophy, Myopathia distalis tarda hereditaria). The persons reported many restrictions of everyday activities, most often in mobility and transportation. Over half were dependent on other people in activities of daily living, and the illness was experienced mainly as having negative consequences for everyday life. A lower quality of life may be partly explained by a reduced capacity for activities. Problem-focused coping was used only to a limited extent, and 'Fighting spirit' was the dominant coping strategy. Rehabilitation was experienced as very valuable, particularly the education about the muscle disease, technical aids, grants and physical training. Over a five-year period, disability and quality of life of the study participants deteriorated significantly, and the dependence on other people increased. </p>