Orientador: Tania Ruiz / Banca: Paulo José Fortes Villas Boas / Banca: Gilberto Luppi dos Santos / Resumo: A população mundial está envelhecendo e o Brasil segue essa tendência. A queda dos índices de fecundidade associada a outros fatores como a melhoria dos investimentos e do acesso a serviços públicos de saúde têm contribuído para explicar o aumento da expectativa de vida da população. Essa situação demanda organização da sociedade para o cuidado desses idosos, principalmente levando-se em conta a perda de autonomia como uma das características desta faixa etária e a associação dos graus de dependência com a qualidade de vida. Observa-se também a vinculação destas morbidades com outras doenças crônico-degenerativas relatadas na literatura. Neste estudo, objetivou-se estimar a prevalência de sintomas depressivos e de déficits cognitivos na população de 60 anos e mais do município de Botucatu e sua eventual relação com outras doenças crônico-degenerativas desta população. Foi um estudo epidemiológico, de corte transversal, onde foram avaliados 364 idosos. Os instrumentos utilizados foram: questionários sócio-demográficos e de morbidade, o Mini-Exame do Estado Mental, a Escala de Depressão Geriátrica de Yesavage, a Escala de Atividades de Vida Diária (Índice de Katz) e a Escala de Atividades Instrumentais de Vida Diária (The Physical Self-Maintenance Scale). Foi estudada uma população com predominância do sexo feminino (59,1%) e maioria entre 60 e 79 anos (83,3%). Aproximadamente 75% dos idosos, com suspeita de depressão ou déficit cognitivo, eram portadores de, pelo menos, mais uma patologia crônica. A suspeita de depressão foi encontrada em 44% (160), sendo que 3,3% (12) apresentaram suspeita de depressão grave e 40,7% (148) suspeita de depressão leve a moderada. O déficit cognitivo foi identificado em 38,7% (141) dos idosos. A dependência para AVD em 17% (62) e para AIVD em 14% (51). Foi possível estabelecer associações estatisticamente... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: The world population is aging and Brazil follows this trend. The fall in fertility rates associated with other factors such as improving investment and access to public health services have contributed to explain the increase in life expectancy of the population. It requires the organization of society for the care of elderly people, especially taking into account the loss of autonomy as a characteristic of this age and the association of the degree of dependence on the quality of life. It is also observed the association of these diseases with other chronic diseases reported in the literature. This study aimed to estimate the prevalence of depressive symptoms and cognitive deficits in the population 60 years and over in Botucatu and its possible association with other chronic diseases in this population. It was an epidemiological cross-sectional study were evaluated 364 elderly. The instruments used were questionnaires socio-demographic and morbidity, the Mini-Mental State Examination, the Geriatric Depression Scale of Yesavage, Scale of Activities of Daily Living (Katz Index) and the Scale of Instrumental Activities of Daily Living (The Physical Self-Maintenance Scale). We found the population was predominantly female (59.1%) and mostly between 60 and 79 years (83.3%). Approximately 75% of elderly patients with suspected depression or cognitive impairment patients had at least one chronic disease. The suspicion of depression was found in 44% (160), and 3.3% (12) of suspected severe depression and 40.7% (148) suspected of mild to moderate depression. Cognitive impairment was identified in 38.7% (141) of the elderly. Dependence for ADL in 17% (62) and IADL in 14% (51). It was possible to establish statistically significant associations with chronic diseases, "suspected of depression" and "IADL" (p <0.0001, OR 7.59, CI 3.361 to 7.139) and "cognitive impairment"... (Complete abstract click electronic access below) / Mestre

Dépendance des personnes âgées et devise républicaine : quelles articulations ? Cette thèse examine l'accompagnement professionnel de la dépendance, sujet d'intérêt public, au regard des principes républicains de liberté, d'égalité dont procède l'équité territoriale et de fraternité, dont découle la solidarité. La démarche géographique, innovante sur cet objet, analyse l'offre professionnelle en France métropolitaine de manière transversale, selon des méthodes quantitatives et qualitatives, et à plusieurs échelles territoriales. Il s'agit d'étudier la territorialisation de l'accompagnement des personnes âgées, c'est-à-dire son appréhension à partir de réalités spatiales et des processus afférents. Trois axes sont retenus. D’abord, les termes majeurs de l'étude, tels vieillissement ou dépendance, outre des chiffres-clés nationaux, sont éclairés par des réalités historiques et des témoignages d'acteurs, dans des perspectives nationales et locales. Une analyse de l'organisation actuelle de l'offre à destination des personnes âgées dépendantes est réalisée, incluant aides à domicile et auxiliaires de vie sociale, services de soins infirmiers à domicile et infirmiers libéraux, établissements d'hébergement pour personnes âgées dépendantes, ainsi que les structures de coordination. La seconde partie de la thèse se polarise sur les ancrages territoriaux de l'offre professionnelle. Certes, les offres étudiées sont de proximité, en témoigne leur comparaison avec d'autres types d'équipements. Leur présence dans les départements n'est cependant pas homogène, les infirmiers libéraux sont par exemple davantage présents dans les départements du littoral méditerranéen, quand les aides à domicile et auxiliaires de vie sociale interviennent davantage dans les départements du Nord de la France. Entre complémentarités et substitutions, cette recherche étudie les enjeux économiques, sociaux et politiques découlant d'une répartition spatiale différenciée. Dans la dernière partie de thèse, deux thèmes révélateurs sont approfondis. Le non-recours à l'Allocation personnalisée d'autonomie à domicile, prestation solidaire de compensation de la dépendance attribuée par les Conseils départementaux sur demande de la personne est d’abord étudié. Ensuite, les déterminants des migrations des personnes lors de leur entrée en EHPAD. La difficulté est induite par le fait que de mêmes comportements, de non-recours ou de migrations, peuvent à la fois refléter les choix des personnes, et une défaillance des pouvoirs publics à proposer une offre adaptée et disponibles sur les territoires. Une analyse des déterminants individuels, appuyée sur des bases de données détaillées et sur les témoignages d'acteurs locaux permet de distinguer la limite entre liberté individuelle et responsabilité des pouvoirs publics. Cette étude produit des diagnostics territorialisés, outils potentiels d'aide à la décision, pour la Drees qui en est le financeur et les quatre Conseils départementaux partenaires / This thesis is based upon the French republican principles of Freedom, Equality which proceeds the territorial Equity of and Fraternity, fromwhich ensues Solidarity. Their application is studied on a matter of public interest: the professional care of the elderly dependence of inmainland France. The geographical approach implemented is innovative on this object. It analyzes the professional offer in a transverse way, thanks to quantitative and qualitative methods, and on several territorial scales.This paper seeks to study the territorialisation of elderly care, that is to say its apprehension from spatial realities and relative processes. Mythesis is composed of three themed chapters. The first section of this paper will examine, the major terms of the study, such as ageing ordependence, in addition national key figures, are highlighted by historical realities and actors' testimonies, in national and local perspectives.An analysis of the current organization of the offer aimed at dependent elderly persons is realized, including at home caregiver and at homesocial workers, at home nursing services and private nurses, nursing homes, as well as the coordinating structures.The second part of this study focuses on the territorial anchoring of the professional offer. Although, the offers studied are mainly locals, asevidenced by their comparison with other types of organizations, their presence in departments (The term department in this case refers toFrench administrative divisions) is not however homogeneous. Indeed private nurses are more present for instance in the departments of theFrench Mediterranean coast, whereas at home caregivers and at home social workers intervene more in northern departments of France.Between complementarities and substitutions, this research investigates the economic, social and political stakes ensuing from adifferentiated territorial distribution.In the last part of this paper, two revealing themes are explored in-depth. Firstly the non take-of an important allowance to pay forprofessional care, attributed by the departmental Councils, at the request of the dependent elderly person is studied. Then, the determinants ofthe migrations of people during their entering to nursing homes are analyzed. The difficulty is due to the fact that the same behaviours, nontake-up of allowances or migrations, can reflect at the same time the choices of the people, and a failure of public authorities to propose asuitable offer available throughout the territory. An analysis of the individual determinants, based on detailed databases and on testimonies oflocal actors allows to distinguish the limit between personal freedom and responsibility of public authorities.This study produces diagnoses by territories, it is a potential decision-making tool, for D.R.E.E.S (which stands for French NationalDepartment for Research, Studies, Evaluation and Statistics, Ministry of Health) and four departmental Councils partners

Bakgrund: Depression är en vanlig sjukdom i världen, och äldre människor är särskilt utsatta. Den förväntas vara den näst vanligast funktionsnedsättning i världen efter hjärtsjukdom inom ett par årtionden. På grund av atypiska symtom är den inte alltid identifierad och därför underdiagnostiserad och underbehandlad, särskilt hos äldre. Syfte: Syftet med denna litteraturstudie var att beskriva äldres upplevelse av att leva med depression Metod: En beskrivande litteraturstudie som sammanfattar och analyserar resultatet av tretton kvalitativa studier. Huvudresultat: Identifierade teman var Känslolivets påverkan, Upplevelse avskamkänsla och stigmatisering, Syn på behandling och återhämtning, Samhörighet ochmeningsfullhet och Familjens roll i återhämtning.Flera studier visade på att de äldre inte förstod hur sjukdomen påverkade deras känsloroch tankar. De medgav att fördomar om sjukdomen var utbredd inom åldersgruppen ochbekände att deras egna tidigare obekantskap med depression hade lett till en saknadförståelse. De menade att det var en ledande faktor till att stigmatisering av sjukdomentillsammans med en rädsla för att associeras med galenskap. Att kunna dela erfarenhetermed vänner och familj ansågs viktigt för att bekämpa upplevelsen av ensamhet somvanligtvis är sammankopplad med depression. Slutsats: Denna litteraturstudie visade att upplevelsen av stigmatisering och känslor avensamhet var central i den äldres upplevelse av depression. För att förbättrabehandlingen och lindra upplevelsen var det av vikt att skingra fördomar ochförutfattade meningar om sjukdomen samt att inkludera familjen när relationen var godoch berikande. / Background: Depression is a common disorder in the world, especially elderly are particularly exposed. It is expected to become the second most common disability after heart disease within a couple of decades. Because of atypical symptoms it is not always identified and thus underdiagnosed and undertreated, particularly in the elderly community. Aim: The aim of this litterature-review was to describe the experiences of depressionthe elderly. Method: A descriptive litterature-review compiling and analyzing the results of thirteenqualitative studies. Main Result: Themes identified were Impact on emotional life, Experience of shameand stigmatization, Views on treatment and recovery, Togetherness and meaningfulnessand The family’s role in recovery. Several studies have shown that the elderly did not understand the impact of thedisorder on their thoughts and feelings. They recognized that misconceptions about thedisorder were widespread within their age group and acknowledged that their ownprevious unfamiliarity with depression lead to a lack of understanding. They sourced this to be a leading factor in the stigmatization of the disorder alongside with a fear ofbeing associated with lunacy. To be able to share experiences with friends and familywere key to combat feelings of loneliness commonly associated with depression. Conclusion: The litterature-review revealed that the experience of stigmatization and feelings of loneliness were central to the elderly’s experience of depression. To improve treatment and ease the experience, it was useful to dispel false beliefs and misconceptions about the disorder and to include family when family-relations were deemed good and nurturing.

Tittle: Physical Activity Level of Individuals Attending the University of Third Age at Charles University, Faculty of Physical Education and Sport Objectives: The aim of this diploma thesis was to describe physical activity level of the individuals attending the University of the Third Age at Charles University, Faculty of Physical Education and Sport. Methods: The theoretical part of the thesis has been achieved by using the method of search enquiry of both Czech and foreign literature. Its practical part has been created by using a survey at 226 respondents (of whom 83 % were women) who attended first year of the University of the Third Age at Charles Univeristy, Faculty of Physical Education and Sport. The average age of the respondents was 65 years, the average BMI was 25,1 kg/mš. A short version of the IPAQ questionnaire has been used, complemented with demographic questions. Results: The findings have shown that an average given volume of physical activity in one week at the tested group of seniors was 5 841,0 MET minutes. 76 % of the respondents can be thus placed into the HEPA High Active category. By the survey, hiking can be considered as the most frequent physical activity. Interestingly, older respondents have achieved a higher level of motoric activity. The results of the survey have...

Syftet med studien var att beskriva arbetsterapeuters resonemang kring preventiva och hälsofrämjande insatser för äldre och deras erfarenheter av hur dessa insatser uppmärksammas och kommuniceras inom och mellan olika vårdnivåer. För att besvara syftet har fokusgruppmetod använts för datainsamling. Fem olika fokusgrupper har genomförts med fyra arbetsterapeuter i respektive grupp som representerade olika vårdnivåer. Data har analyserats enligt analysprocess för fokusgrupper vilken resulterade i två centrala teman. Det första temat Ge arbetsterapiinsatser i rätt tid innehöll underkategorierna Vikten av att etablera kontakt tidigt och Att vara en del i en process över tid. Det andra temat Betydelsen av kollegial och teambaserad samverkan innehöll underkategorierna Vikten av ett fungerande team, Att handleda och kommunicera insatser till andra professioner och Olika kommunikationsvägars betydelse. Resultatet visar att tidig kontakt med de äldre där en personcentrerad relation etableras är en förutsättning för preventiva och hälsofrämjande arbetsterapiinsatser. En god kommunikation och etablerade relationer inom multiprofessionella team inom och mellan vårdnivåerna skapar förutsättningar för fånga upp den äldre tidigt samt för att preventiva och hälsofrämjande arbetsterapiinsatser skall erbjudas i rätt tid. Studies resultat visar att det finns behov av ytterligare forskning som kan generera kunskapsutveckling kring preventiva och hälsofrämjande arbetsterapiinsatser för äldre som är samhällsbaserade. / The purpose of the study was to describe occupational therapists´reasoning about preventive and health-promoting interventions for elderly and their experiences of how these interventions are noticed and communicated within and between different levels of care. To answer the purpose a focus group design has been used for data collection. Five different focus groups were conducted with four occupational therapists´ representing different levels of care. Data have been analyzed accordning to the analysis process for focus groups, which resulted in two central themes. The first theme Giving occupational theraphist interventions in the right time contained the subcategories The importance of establishing contact early and Being part of a process over time. The second theme The importance om collegial and team-based collaboration contained the subcategories The importance of a functioning team, Tutoring ang communicating interventions to other professions and The importance of different communication channels.  The results shows that early contact with the elderly where a person-centered relationship is established is a prerequisite for preventive and health-promoting occupational therapy interventions. Good communication and established relationships witin multi-professional teams within and between the care-levels create conditions for engaging the elderly early and for preventive and health-promoting occupational therapy initiatives to be offered at the right time. The results of the present study indicates that there is a need for further research that can generate knowledge development about preventive and health-promoting occupational therapy interventions for the elderly who are community-based.

Bakgrund: Upplevelsen av ensamhet ökar med en stigande ålder. Det finns ett samband mellan ensamhet och psykisk eller fysisk ohälsa, och detta samtidigt som medellivslängden förväntas öka i Sverige och i andra delar av världen. Situationen medför ett ökat behov av att vårdpersonal ska kunna se lidandet ensamhet skapar och för att kunna ge adekvat vård. Syfte: Att beskriva äldre personers erfarenheter och upplevelse av ensamhet. Metod: Litteraturstudie med 10 vetenskapliga artiklar från databaserna PubMed och Cinahl. Analysen av artiklarna genomfördes med hjälp av Fribergs femstegsmodell och SBUS granskningsmall. Resultat: Analysen resulterade i tre huvudkategorier med sju underkategorier: Ensamhetens konsekvenser, Saknad av betydelsefulla relationer och Att skapa meningsfullhet. Konklusion: Resultatet av litteraturstudien visade på att äldre personer erfarenheter och upplevelser påverkar det psykiska måendet. Ensamhet kan vara kopplat till känslan av utanförskap från samhället. Genom att lyfta fram äldres upplevelse av ensamhet kan sjuksköterskan bidra till en förbättrad vård och ge en djupare förståelse för den ensamma individen. / Background: The feeling of loneliness or exclusion increases with age. And there is a connection between perceived loneliness and mental or physical ill health. At the same time, the average life expectancy is expected to increase in Sweden and other parts of the world. The situation means that there is an increased need for healthcare professionals to see the suffering created by loneliness, to provide adequate care. Aim: To describe older people's experience of loneliness. Methods: Literature review conducted with 10 qualitative articles found in PubMed and Cinahl. Analysis was conducted with help from Friberg's five steps model and SBUS review template. Result: The analysis resulted in three main categories with 7 subcategories: The consequences of loneliness, The lost of meaningful relationships and To create meaningfulness. Conclusion: The result of this literature study showed that elderly peoples experiences of loneliness affects their mental health. Loneliness could be related to feelings of alienation from the society. By highlight elderly peoples experience of loneliness is it possible for the nurse to enable and contribute with a better care and to give a deeper understanding for the lonely individual.

Bakgrund: Ensamhet är ett växande problem i samhället och särskilt bland den äldrebefolkningen. Ensamhet symboliseras som en upplevelse och kan vara ett frivilligt eller ofrivilligt val. Tidigare forskning har visat att ofrivillig ensamhet kan medföra negativa hälsoeffekter. Syfte: Att beskriva äldres upplevelser av ensamhet. Metod: En litteraturstudie med deskriptiv design. Resultatet baseras på 12 vetenskapliga artiklar med kvalitativ ansats. Artiklarna söktes i databasen Medline via PubMed.Huvudresultat: De äldre beskrev upplevelsen av ensamhet ur olika perspektiv.Ensamheten beskrevs främst som något negativt, men det framkom även positivaupplevelser. De äldre skildrade de negativa upplevelserna som smärtsamma samt isolerande medan de positiva upplevelserna förknippades med frihet och beskrevs som ett frivilligt val. Slutsats En del äldre tycker att ensamheten är något av det värsta som finns, medan vissa inte påverkas av det eller till och med ser det som något positivt. Sjuksköterskan har en viktig roll i att uppmärksamma och minska de negativa upplevelserna som de äldre kan känna. Genom att stödja den äldre i dennes livsvärldkan sjuksköterskan lindra lidande och bidra till bibehållen hälsa och därmed minska möjliga negativa hälsoeffekter av den upplevda ensamheten. / Background: Loneliness is a growing problem in society and especially among the elderly population. Loneliness is symbolized as an experience and can be a voluntary orinvoluntary choice. Previous research has shown that involuntary loneliness can have negative health effects. Aim: To describe elderly peoples experiences of loneliness.Method: A literature study with descriptive design. The results are based on 12scientific articles with a qualitative approach. The articles were searched in the Medline database via PubMed. Main Result: The elderly descibed the experience of lonelinessfrom different perspectives. Loneliness was mainly described as something negative, but there were also positive experiences. The elderly portrayed the negative experiences as painful and isolating while the positive experiences were partly associated withfreedom. Conclusion: Some elderly think that loneliness is one of the worst things there is, while some don´t suffer from it at all or even see it as something positive. The nurse has an important role in paying attention to and reducing the negative experiences that the elderly may feel. By supporting the elderly in their life situation, the nurse can relieve suffering and contribute to the elderly`s maintained health and thereby reduce possible negative health effects caused by the perceived loneliness.

Bakgrund: Hög biologisk ålder medför nya utmaningar på individ och samhällsnivå. Brist på personal i hälso- och sjukvården ökar behovet av nya digitala lösningar. I Sverige finns hälsorobotar som fungerar på olika sätt och de blir allt fler. Syfte: Syftet var att belysa äldre personers erfarenhet av hälsorobotar. Metod: En litteraturstudie med systematiskt tillvägagångssätt, baserad på 11 kvalitativa empiriska studier, publicerade tidigast januari 2019. Litteratursökning gjordes i databaserna CINAHL, PubMed, PsycINFO och Google Scholar. Kvalitetsgranskning genomfördes enligt Hkr:s mall för kvalitativa studier. Analysen genomfördes stegvis enligt Fribergs modell. Resultat: Erfarenheten av hälsorobotar varierade men mönster kunde urskiljas. Hälsorobotar kunde hjälpa äldre personer att klara sig självständigt. Estetiskt önskade äldre personer främst en hälsorobot vars form upplevdes igenkännande. Funktionellt föredrogs att hälsoroboten kunde hjälpa till fysiskt. De äldre personerna önskade en hälsorobot vars funktioner var lätta att förstå. En del äldre personer ville inte interagera med hälsorobotar, andra upplevde att en hälsorobot kunde skänka trygghet, lindrade smärta och minskade känslan av ensamhet. Diskussion: Tidigare studier bekräftar att hälsorobotar kan ha ett socialt värde för äldre personer och bidra till olika positiva känslor och minska ensamhetskänslor. De kan bidra till att motivera äldre personer på olika sätt och stärka relationer samt sociala kompetenser. Att introducera hälsorobotar för äldre personer kräver lyhördhet och öppenhet för vem den äldre personen är och vad denne finner stödjande eller belastande. Sjuksköterskan bör ha relevant kompetens och fungera som en guidande mellanhand och stötta samt förklara då en hälsorobot skall introduceras för en äldre person.

Thesis (M.S.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / 2031-01-01

Research problemThe world is currently undergoing one of the most substantial crises of the past century, causing disruption both socially and economically. The effect on the Swedish inhabitants has been impactful, especially for elders, who are crippled in the ability to complete necessary tasks including private banking. Many elderlies are struggling with online banking and similar fintech services, so when the rest of the population resort to digital means of conducting bank errands, what are banks doing to smoothen the transition for elders? Research purpose The research purpose is to explore how commercial banks are bridging the digital divide between information technology and the senior customers and further how the immediate crisis complicates this. The thesis will explore the practical efforts toward smoothening the transition between an increasingly more digitalized bank sector and the older generations. Additionally, to provide insight to how the covid-19 pandemic influences commercial banking and what trends are following. Theoretical framework The theoretical framework has been modeled around five concepts relating to digitalization: Digital divide, the bell doctrine, E-banking, The profitability of traditional vs. modern banking and E-CRM. The theoretical framework is presented in full extent in its own section. Methodology A qualitative method is applied with emphasis on narrative inquiries collected through semiconstructed interviews. Empirical findings The findings are presented as thematic extracts from the interviews, anchored in the theoretical framework, consisting of primary data from five participants from four separate banks in the Umeå region, Sweden. Conclusion The local banks have been very successful in providing their non-digital customers with their services by being flexible and offering a broad range of channels through which the customer can interact with the bank. For the most part, the banks themselves remain largely unaffected by the crisis. Naturally, there are a few customers who still resist, or do not possess the ability to utilize the digital tools that has become the primary way banking matters are conducted at this time. Additionally, it is possible that the outcome of the crisis will have resulted in an increasingly higher rate of adaptation of digital banking, hence making the traditional business model more difficult to operate post-crisis.