O rápido envelhecimento populacional faz com que a saúde mental da população geriátrica venha tomando uma importância cada vez maior na saúde pública. Os objetivos deste estudo foram:(1) investigar a prevalência de transtornos mentais ao longo da vida, analisando possíveis fatores sócio-demográficos associados (2) pesquisar a possível relação entre prevalência de transtorno mental ao longo da vida e desempenho cognitivo. Foram estudados 82 sujeitos acima de 60 anos da área de captação do Hospital das Clínicas da cidade de São Paulo. O instrumento utilizado para investigação diagnóstica foi o Composite International Diagnostic Interview (CIDI), sendo a avaliação do desempenho cognitivo obtida através do Mini Exame do Estado Mental (MEEM) e do Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE). Os resultados mostraram que os transtornos mentais de maior prevalência ao longo da vida foram Depressão (16%), Transtorno de Humor Recorrente (10%) e Transtorno de Ansiedade Generalizada (8,5%). Os demais transtornos observados foram Distimia (6%), Transtorno Doloroso Persistente (5%), Uso Nocivo de Álcool (5%) e Transtorno Dissociativo (2,4%). Não foram identificados casos de Transtorno Afetivo Bipolar, Esquizofrenia e outras psicoses, assim como dependência de Álcool ou de psicotrópicos. Apesar de haver uma maior prevalência nas mulheres dos quadros de Depressão (18,5%), Transtorno de Humor Recorrente (12%), Distimia (6%), Transtorno Doloroso Persistente (7%) e Transtorno Dissociativo (3,5%), e por outro lado uma maior prevalência de Abuso de Álcool (9%) e Transtorno de Ansiedade Generalizada (9%) nos homens, não houve correlação estatisticamente significativa entre gênero e transtornos mentais. Na amostra, os sujeitos de maior escolaridade demonstraram maior associação com prevalência de distimia (p=0,01) e transtorno de ansiedade generalizada (p=0,03). Houve maior associação entre baixa escolaridade (p=0,000) e idade mais avançada (p=0,007) com pior desempenho cognitivo pelo MEEM. A presença de disfunção cognitiva pelo MEEM foi de 11% e pelo IQCODE 16%. Não foi identificada asssociação entre prevalência de transtornos mentais ao longo a vida e pior desempenho cognitivo. Os resultados da prevalência de transtornos mentais ao longo da vida desta amostra foi similar aos achados de outros estudos que utilizaram o CIDI, exceto pela maior prevalência de Transtorno do Humor Recorrente no presente estudo que nos demais. Maior atenção deve se dar a associação entre maior escolaridade e prevalência de distimia e transtornos de ansiedade generalizada ao longo da vida em populações idosas de regiões urbanas / With a rapidly aging society, geriatric mental health is emerging as important public health concern.The study objectives were: (1) investigate the lifetime prevalence of psychiatric illnesses and the association between sociodemografic characteristics (2) investigate the possible relationship between the prevalence of mental disorder throughout life and cognitive performance. We studied 82 subjects over 60 years older from the catchment area of Hospital das Clínicas de São Paulo. The instrument used for diagnostic investigation was the Composite International Diagnostic Interview (CIDI), and the assessment of cognitive performance achieved by the Mini Mental State Examination (MMSE) and Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE). The results showed that the most prevalent lifetime ICD-10/CIDI disorders were major depression (16%), followed by recurrent mood disorder (10%), and generalized anxiety disorder (8,5%). Other disorders were observed such as dysthymia (6%), persistent pain disorder (5%), alcohol abuse (5%) and dissociative disorders (2.4%). There were no identified cases of bipolar affective disorder, schizophrenia and other psychoses, as well as dependence on alcohol or psychotropic substances. Women had higher prevalence of depression (18.5%), recurrent mood disorders (12%), dysthymia (6%), persistent pain disorder (7%) and dissociative disorder (3.5%). On the other hand, men have higher prevalence alcohol (9%) and generalized anxiety disorder (9%). However, these differences were not statistically significant. In this sample, subjects with higher education showed an association with prevalence of dysthymia (p = 0.01) and generalized anxiety disorder (p = 0.03). There was a higher association between low education (p = 0.000) and older age (p = 0.007) with worse cognitive performance by the MMSE. The presence of cognitive impairment evaluated by the MMSE was 11% and the result based on the IQCODE was 16%. There was not a relationship between lifetime prevalence of mental disorders and impaired cognitive performance. The results of lifetime prevalence of mental disorders in this sample were similar to the findings of other studies using the CIDI, except for a higher prevalence of recurrent mood disorder in this study than the others. Close attention are required to address the relationships between higher educational level and dysthymia and generalized anxiety disorder in urban elderly population

Introdução: O envelhecimento populacional acelerado reafirma a necessidade da prestação de cuidados de longa duração e a instituição de longa permanência para idosos (ILPI) é uma das modalidades disponíveis. Pela demanda de cuidado, os enfermeiros estão inseridos na maioria dessas residências. Objetivo: compreender a vivência de enfermeiros no cuidado ao idoso que reside em instituição de longa permanência. Método: trata-se de pesquisa qualitativa, com abordagem fenomenológica, realizada com 11 enfermeiros que trabalham em ILPI. Os dados foram coletados por meio de entrevistas individuais, gravadas em áudio, com as seguintes questões norteadoras: Fale sobre sua vivência no cuidado ao idoso que reside em instituição de longa permanência e O que você espera com a sua atuação em ILPI? Os conteúdos foram transcritos e analisados individualmente, segundo o referencial da fenomenologia social de Alfred Schütz. Resultados: a partir da análise dos discursos foi possível identificar sete categorias concretas do vivido: dificuldades no trabalho, desvalorização profissional, vínculo, valorização do trabalho, oferecer assistência de boa qualidade, ser reconhecido e valorizar o idoso. A vivência do enfermeiro nesse mundo vida é permeada pela escassez de recursos financeiros, materiais e humanos, alta rotatividade de profissionais e qualificação insuficiente para o trabalho, gerando sentimento de insegurança. Também é marcado pela falta de autonomia, baixos salários, preconceitos e desrespeito nas relações interpessoais. Apesar das dificuldades vivenciadas, a formação de vínculos afetivos significativos com os idosos leva o enfermeiro a refletir sobre o processo de envelhecimento e promover uma assistência mais humanizada. A partir da percepção do valor social do trabalho, projeta melhorar a qualidade da assistência oferecida, por meio de qualificação adequada dos profissionais que atuam em ILPI, adequação do quantitativo de recursos humanos e a eliminação da sobrecarga de trabalho. Dessa forma, busca reconhecimento profissional, financeiro e social. Por fim, da vivência desse contexto emerge, no grupo social estudado, a consciência sobre a importância e a premência da mudança do valor do idoso em nossa sociedade. Espera-se que isso aconteça por meio de intervenções educacionais, com enfoque na redução do preconceito, na difusão do envelhecimento saudável e pela ampliação e efetividade de políticas públicas que priorizem a população idosa. Considerações finais: o presente estudo possibilitou a compreensão da ação de cuidar de idosos residentes em ILPI, sob a perspectiva de enfermeiros, evidenciando a vivência desse grupo social, marcada pela dificuldade no trabalho, pela aproximação afetiva com os idosos e pelas expectativas de transformar a realidade do cuidado ao idoso, vislumbrando um envelhecimento digno a todos. / Introduction: Accelerated populational aging reaffirms the need for long-term care, and long-term care institutions for the elderly (LTCI) is one of the available modalities. Given the care demands, nurses are inserted in the majority of these residences. Objective: to understand nurses experience in the care for elderly living in a long-term institution. Method: this is a qualitative research of phenomenological approach, conducted with 11 nurses working in LTCI. Data were collected through individual audio-recorded interviews with the following guiding questions: Talk about your experience in the care of the elderly living in a long-term institution and What do you expect from your performance at the LTCI?. The contents were transcribed and analyzed individually according to Alfred Schützs social phenomenology framework. Results: from the analysis of discourses, it was possible to identify seven concrete categories of the experience: work difficulties, professional devaluation, bonding, valorization of work, provision of good quality care, being recognized and valuing the elderly. Nurses experience in this world is permeated by the scarcity of financial, material and human resources, high turnover of professionals and insufficient qualification for the work, generating a feeling of insecurity. It is also marked by lack of autonomy, low salaries, prejudices and disrespect in interpersonal relationships. Despite the difficulties experienced, the formation of significant affective bonding with the elderly leads nurses to reflect on the aging process and promote a more humanized care. Based on the perception of the social value of work, nurses plan to improve the quality of care provided by means of adequate qualification of professionals working in LTCI, adequate human resources quantitatively, and the elimination of work overload. This way, they seek professional, financial and social recognition. Finally, from the experience in this context, in the studied social group emerges the awareness about the importance and urgency of changing the elderlys value in our society. This is expected to happen through educational interventions focused on reducing prejudice, disseminating healthy aging, and by the expansion and effectiveness of public policies that prioritize the elderly population. Final considerations: the present study enabled an understanding about the action of caring for elderly people living in LTCI from the nurses perspective. It showed the experience of this social group is marked by work difficulties, affective approximation to the elderly and expectations of transforming the reality of care for the elderly, with the view of aging with dignity for all.

Orientadores: Maria da Luz Rosario de Sousa, Fernando Neves Hugo / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-26T05:56:27Z (GMT). No. of bitstreams: 1 Torres_LuisaHelenadoNascimento_D.pdf: 1911467 bytes, checksum: 2b830f3462b85c1e0e821da1c3c949c2 (MD5) Previous issue date: 2014 / Resumo: O objetivo deste estudo foi avaliar determinantes de agravos à saúde geral e bucal em uma coorte de idosos independentes residentes em Carlos Barbosa, RS. No capítulo 1 foi realizada uma revisão sistemática para verificar os fatores de saúde bucal associados com fragilidade. Para os demais capítulos, utilizou-se dados do estudo longitudinal em idosos de Carlos Barbosa, RS (2004). Foram coletadas informações sócio-demográficas, comportamentais, de acesso aos serviços, de história médica, depressão, atividade física e exame bucal, antropométrico e fragilidade. No capítulo 2, em estudo exploratório transversal aninhado em uma coorte, o objetivo foi investigar se saúde bucal precária age como fator associado para a fragilidade. No capítulo 3, o objetivo foi verificar se saúde bucal precária contribui para o desenvolvimento de obesidade geral (BMI) e central (WC). No capítulo 4, o objetivo foi determinar incidência de perda dentária após 8 anos e seus preditores. Análise descritiva e bivariadas foram realizadas. Associações com os desfechos foram realizadas por meio de regressão logística binária, regressão logística multivariada e análise longitudinal multinível e regressão de Poisson ajustando para variáveis de confundimento. No capítulo 1, de 12 estudos incluídos, 07 eram transversais e 05 longitudinais. Foram considerados de boa qualidade 41,7% (n=5) dos artigos selecionados e 8,3% (n=1) de baixa. No capítulo 2, dos 389 idosos estudados, após controle da idade, renda familiar e estado civil, aqueles que precisavam de prótese dentária apresentaram duas vezes mais chance de ser pré-frágil/ frágil do que aqueles que não precisavam (OR = 2,0, IC95% 1,1-3,7); assim como, aqueles com um maior número de dentes perdidos (OR = 1,0, IC95% 1,0-1,1), aqueles que fumaram pelo menos cem cigarros na vida (OR = 2,5, IC95% 1,4-4,7) e aqueles que estavam deprimidos (OR = 2,8, IC95% 1,2-6,9). No capítulo 3 participaram 633 idosos independentes. As pessoas que nunca visitaram um dentista eram mais propensas a serem obesas (OR = 3,02 IC 95% 1,25-7,26), de acordo com o IMC e a necessidade de prótese inferior total aumentou o risco de ser obeso de acordo com a CC (OR = 4,38, 95% CI 1,34-14,32). Em relação ao IMC, os indivíduos edêntulos com próteses totais em ambos os arcos (OR = 0,23, 95% CI 0,06-0,84) e aqueles que percebiam sua saúde bucal como insatisfatória, de acordo com a CC (OR = 0,43 IC 95% 0,19-0,88 ), apresentaram uma menor chance de serem obesos. No capítulo 4 o número médio de dentes no baseline foi 10,50 (±7,09) e a média de dentes presentes ao final foi 9,06 (±7,3). Dados completos estavam disponíveis para 193 participantes. Ser do sexo feminino (RR = 0,65, 95% CI 0,49-0,86), não usar uma prótese parcial removível (RR = 0,73, 95% CI 0,56-0,97) foram associados com menor risco de perda dentária. Ter mais sítios de sangramento foi associado com maior risco de perda dentária (RR = 1,008, IC 95% 1,003-1,01). Saúde bucal precária apresenta relação com fragilidade e é fator de risco para obesidade central e geral e também para perda dentária / Abstract: The aim of this study is to evaluate determinants of general and oral health among a cohort of independently living older adults residents in Carlos Barbosa, Brazil. In chapter 1 it was performed a systematic review to assess the oral health measures that were related to frailty. To the other chapters it was used data from the study about the elderly population of Carlos Barbosa held in 2004. The measures comprised a questionnaire with information about socio-demographic, behavioral, access to services, medical history, depression, physical activity and oral examination, also anthropometric and frailty assessments. In chapter 2, a cross-sectional exploratory study nested in a major cohort, the aim was to investigate if poor oral health acts as a associate factor for the presence of frailty. In chapter 3, the aim was to investigate if poor oral health status contributes to the development of general (BMI) and central obesity (WC). In chapter 4 the aim was to determine tooth loss incidence after 8 years and its predictors among community-living older adults in a southern Brazilian city. Descriptive and bivariate analysis were performed Associations with the outcomes will be assessed using binary logistic regression, multinomial logistic regression, longitudinal multilevel regression and negative binomial regression adjusting for confounding variables. Twelve studies met the inclusion criteria, 07 of them were cross-sectional and 05 were cohort studies. From the 12 papers, 41.7% (n=5) were rated as GOOD and 8.3% (n=1) as POOR. In chapter 2, 389 elders participated and after controlling for age, family income and marital status the analysis found that those who needed dental prosthesis were 2 times more likely to be prefrail/frail when compared to those who did not need (OR=2.0, CI95% 1.1-3.7) as well as those with a higher number of missing teeth (OR=1.0, CI95% 1.0-1.1), those who smoked at least a hundred cigarettes in (OR=2.5, CI95% 1.4-4.7) and those who were depressed (OR=2.8, CI95% 1.2-6.9). For chapter 3 a total of 633 independently-living elders participated. Individuals who never visited a dentist were more likely to be obese (OR=3.02, 95%CI:1.25-7.26) according to the BMI and the need for a full mandibular denture increased the risk for being obese according to their waist-circumference ratio-WC (OR=4.38, 95%CI:1.34-14.32). Regarding BMI, edentulous subjects with full dentures in both arches (OR=0.23, 95%CI:0.06-0.84) and those who perceived their oral health as unsatisfactory, according to the WC (OR=0.43, 95%CI:0.19-0.88), had a lower likelihood of being obese. In chapter 4 the mean number of teeth in risk (baseline mean number of teeth) was 10.50±7.09 and mean teeth present at 8-years follow-up was 9.06±7.3. Complete data was available for 193 participants. Being female (RR=0.65, 95%CI 0.49-0.86), not using a partial removable prosthesis (RR=0.73, 95%CI 0.56-0.97) were associated with lower risk of tooth loss. Having more bleeding sites was associated with higher risk of tooth loss (RR=1.008, 95%CI 1.003-1.01). Poor oral health is associated with frailty and it is a risk factor for central and general obesity and also for tooth loss / Doutorado / Saude Coletiva / Doutora em Odontologia

Objectives: Among different factors, diet patterns seem to be related to depression. The aim of this study was to evaluate the association between the consumption of fruits and/or vegetables and depressive symptoms. Methodology/Principal findings: A secondary data analysis was conducted using information from a population-based survey from 25 regions from Peru. The outcome was the presence of depressive symptoms according to the Patient Health Questionnaire (cutoff 15 to define major depressive syndrome); whereas the exposure was the self-reported consumption of fruits and/or vegetables (in tertiles and using WHO recommendation 5 servings/day). The association of interest was evaluated using Poisson regression models controlling for the complex-sample survey design and potential confounders. Data from 25,901 participants were analyzed, mean age 44.2 (SD: 17.7) and 13,944 (54.0%) women. Only 910 (3.8%; 95%CI: 3.5%–4.2%) individuals reported consuming 5 servings of fruits and/or vegetables/day; whereas 819 (2.8%; 95%CI: 2.5%–3.1%) had depressive symptoms. Those in the lowest tertile of fruits and/or vegetables consumption had greater prevalence of depressive symptoms (PR = 1.88; 95% CI: 1.39–2.55) than those in the highest tertile. This association was stronger with fruits (PR = 1.92; 95%CI: 1.46–2.53) than vegetables (PR = 1.42; 95%CI: 1.05–1.93) alone. Conclusions: An inverse relationship between consumption of fruits and/or vegetables and depressive symptoms is reported. Less than 5% of subjects reported consuming the amount of fruits and vegetables recommended by the WHO. There is a need to implement strategies to promote better diet patterns with potential impact on mental health. © 2017 Wolniczak et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract The purpose of this study was to describe and understand the evolution of the content and characteristics of Finnish geriatric nursing from the 1930s till the 2000s. The research approach was based on three underlying assumptions: historicity, multi-level analysis and the dimensions of goals and actual practice. Historicity implied both a long-term analysis of the phenomenon and the use of historical methodology. Multi-level analysis implied that the phenomenon was analyzed at both a macro-level and a micro-level. The macrolevel consisted of the societal geriatric policies (level I). The micro-level was divided into functional environments comprising the municipal context (level II) and nursing organizations (level III) as well as the nursing practice (level IV). The focal aim in the multi-level analysis was to compare the goals (at levels I-III) to the actual practice (level IV). The underlying theoretical premises of the multi-level analysis consisted of system-oriented thinking, and the data were organized in terms of the guidance model. The evolution of geriatric nursing was analyzed on the basis of official documents at the level I, the municipal documents of three municipalities in northern Finland at the level II, the documents of geriatric nursing organizations in selected municipalities at the level III, and retrospective knowledge of nursing aids and assistants and practical nurses at the level IV. In addition to this, contemporary material as well as relevant literature, magazines and research findings were used to shed light on the historico-sociocultural context. The manner of reading applied was systematic interpretation, which allowed the macro- and micro-level information of geriatric nursing in different historical periods to be integrated into a comprehensible whole. The study highlighted the basic dimensions of both goals and actual practice. Using a theoretical societal frame of analysis, they were combined into the general guidelines of geriatric nursing: the retaining nursing of the activation stage (1930-1950), the collective nursing of the preliminary stage (1950-1970), the individual nursing of the revitalizing stage (1970-1990) and the balancing nursing of the renovative stage (1990-). The findings indicated that the evolution of geriatric nursing was shaped by the goal-oriented dimensions of the geriatric policies, the municipal organizations and the functional contexts of the nursing organizations as well as the nurses' role in the actual practice. The findings also indicated that the goals defined in geriatric policies were implemented in the actual nursing practice with some delay. The purpose of the study was to produce synthesizing basic nursing research. It thus opened up a new perspective into the research questions motivated by nursing science. The findings can also be utilized in efforts to understand the value and knowledge base of geriatric nursing and in nurse education. In order to be able to develop nursing further, it is important not to approach nursing as a separate phenomenon, but to integrate it into a wider historico-sociocultural analysis. The methodological solutions made here can also be applied to other nursing research. / Tiivistelmä Tutkimuksen tarkoituksena oli kuvailla ja ymmärtää suomalaisen vanhusten hoitotyön sisällön ja luonteen muotoutumista 1930-luvulta 2000-luvulle. Tutkimuksen tarkastelunäkökulmana oli kolme perusolettamusta: historiallisuus, monitasoisuus sekä tavoitteiden ja tosiasiallisen toiminnan ulottuvuudet. Historiallisuus viittasi sekä ilmiön tarkasteluun pitkällä aikavälillä että historialliseen tutkimusmenetelmään. Monitasoisuus liitti ilmiön tarkastelun makro- ja mikrotasoille. Makrotason muodosti yhteiskunnallinen vanhuspolitiikka (I-taso). Mikrotaso jakaantui kunnalliseen (II-taso) ja hoito-organisaatioiden (III-taso) muodostamiin toimintaympäristöihin sekä käytännön hoitotyöhön (IV-taso). Monitasotarkastelun lävistävänä näkökulmana oli heijastaa tavoitteellisia ulottuvuuksia (I-III-taso) käytännön tosiasialliseen toimintaan (IV-taso). Tutkimuksen väljänä monitasotarkastelua ohjaavana teoreettisena lähtökohtana oli systeemiajattelu ja jäsennyksenä toimi ohjausmalli. Vanhusten hoitotyön muotoutumista haettiin I-tasolla virallisten dokumenttien, II-tasolla kolmen pohjoissuomalaisen kunnan kunnallisten asiakirjojen, III-tasolla valittujen kuntien vanhusten hoito-organisaatioiden dokumenttien sekä IV-tasolla apu-, perus- ja lähihoitajien muistitiedon avulla. Tämän lisäksi ajan historiallis-sosiokulttuurisen kontekstin ymmärtämiseksi hyödynnettiin aikalaisaineiston ohella myös ilmiötä koskevaa kirjallisuutta, aikakauslehdistöä ja tutkimustietoa. Tutkimuksen luentatapana oli systematisoiva tulkinta, jonka avulla integroitiin makro- ja mikrotason tiedot vanhusten hoidosta eri aikakausilta yhteen ymmärrettäväksi kokonaisuudeksi. Tutkimus tuotti sekä tavoitteellisten että tosiasiallisen toiminnan ulottuvuuksien peruslinjat. Näistä muodostettiin teoreettista yhteiskunnallista jäsennyskehystä hyödyntäen hoitotyön yleiset kehityslinjat: aktivointivaiheen säilyttävä hoitotyö (1930-1950), luonnosteluvaiheen kollektisoiva hoitotyö (1950-1970), elävöittämisvaiheen yksilöllinen hoitotyö (1970-1990) sekä uudentamisvaiheen tasapainoileva hoitotyö (1990-). Tutkimus osoitti, että hoitotyön muotoutumiseen vaikuttivat vanhuspolitiikan, kunnallisen ja hoito-organisaatioiden toimintaympäristöjen tavoitteelliset ulottuvuudet sekä hoitajan rooli tosiasiallisessa toiminnassa. Tuloksista kävi ilmi, että vanhuspolitiikan tavoitteet heijastuivat hoitotyön tosiasialliseen toimintaan viiveellä. Tutkimuksen ideana oli tuottaa kokoavaa hoitotieteellistä perustutkimusta. Tutkimus avasi siten uutta näkökulmaa hoitotieteen tieteenalasta nouseviin tutkimuskysymyksiin. Tuloksia voidaan hyödyntää myös vanhusten hoitotyön arvo- ja tietoperustan ymmärtämiseen sekä hoitotyön opetukseen. Hoitotyön edelleen kehittämisen kannalta on tärkeää, että hoitotyötä ei tarkastella vain yksittäisenä ilmiönä, vaan se liitetään laajempaan ajan historiallis-sosiokulttuuriseen tarkasteluun. Tutkimuksen menetelmällisiä ratkaisuja voidaan soveltaa myös muissa hoitotieteellisissä tutkimuksissa.

Introduction: Population is demographically aging and proportion of older adults in the society increases. Also the number of sick persons raises, and the high consumption of drugs and polypharmacotherapy in old age are global problems. The definition of polypharmacotherapy is not uniform. Most commonly it is defined as the use of 5 or more drugs simultaneously. In the scientific literature we also see the term "excessive polypharmacotherapy". This is defined as the use of 10 or more drugs simultaneously. Polymorbidity, irrational indications, wrong diagnostics of drug-related problems, but also changes in pharmacokinetics and pharmacodynamics common in the old age contribute to polypharmacotherapy. It is important that pharmacotherapy in the old age must be simple, effective and safe. Methods: Using the electronic database PubMed, all studies on the subject "Polypharmacotherapy in Old Age" published in 2005-2015 were reviewed. The data were summarized in tables. Studies that included causal factors (predictors) of polypharmacotherapy were also evaluated. The most frequently prescribed drugs in geriatric patients with polypharmacotherapy were recorded in a separate table. Results: In this diploma thesis, the prevalence of polypharmacotherapy was compared from 81 studies. We found that the...

D.Cur. (Community Nursing Science) / The purpose of the study was to develop a strategy to assist community nurses facilitate the mobilization of resources for meeting the basic needs of the elderly in the peri-urban and rural communities within the Hhohho region in Swaziland. Qualitative, exploratory, descriptive and contextual research designs were used to explore and describe the basic needs and the resources for meeting the needs of the elderly. In order to achieve the study objectives and be logical, this study was organized into two phases namely: phase one and two. Phase one focused on the first objective namely: to explore and describe the basic needs and resources of the elderly in the peri-urban and rural communities in the Hhohho region in Swaziland. The second phase focused on the second objective namely: to develop and describe the strategy for mobilizing the resources meeting the basic needs of the elderly. Purposive sampling was utilized to select participants who met the inclusion criteria. Data were collected using focus groups and individual indepth face-toface interviews. Tesch method of qualitative data analysis was utilized to identify themes. From the study findings the researcher and the independent coder identified the following themes from the focus groups and individual indepth face-to-face interviews with the elderly and the key informants in the peri-urban and rural communities in the Hhohho region: • Theme 1: Need for resources because of poverty • Theme 2: Need for support because of burden for caring for others • Theme 3: Need for health care because of health challenges • Theme 4: Need for company because of loneliness • Theme 5: Need for protection because of abuse of the elderly persons The study highlighted a lack of resources including food security, housing accommodation, clothing, water supply and basic sanitation, electricity supply and lack of financial resource. The burden of caring for grandchildren who were orphans due to HIV/AIDS related illnesses and others as well as chronic illnesses were also reported...

Magister Curationis - MCur / The international concern about human rights, gender equality, domestic violence and the increase in the aging populations has brought elder abuse into the public focus. Elder abuse is a complex, multi-faceted health, social, criminal justice, international public health and human rights issue. The widely divergent and varying definitions is a controversial problem to understanding elder abuse. The elderly have been excluded from national gender-based programs on domestic violence and the abuse of women and children. In South Africa victims of elder abuse are often physically and or cognitively unable to speak for themselves which necessitates that the public be empowered and trained to become advocates for the aged. Lachs & Pillemer ( 2004 : 1265 ) states that "the physical and psychological impairement of elder persons could be predisposing factors for elder abuse ". Statistical evidence on the incidence and prevalence rates of elder abuse is lacking as elderly persons are reluctant to identify care givers for fear of abandonment, retaliation and being left destitute ( Lachs & Pillemer, 2004 : 1265 ). Despite the Bill of Rights as set out in the South African Constitution and the Older Persons Act, No. 13 of 2006 which was developed to deal with the empowerment and protection of elder persons and promote and maintain their status, rights, safety, security and well being the abuse of elder person continues to occur ( Older Persons Act, No. 13 of 2006 ). This qualitative research study is allied with the phenomenological approach in an attempt to understand elder person’s perception, viewpoints and perspectives from their lived experiences and personal lives. Three (3) focus group discussions and eighteen (18) one-on-one interviews were conducted with elder persons living in the suburbs of Cape Town. Data from participants were audio-taped, transcribed verbatim before an inductive analysis lead to the emergence of broad themes and patterns. The main findings of the research study concluded that elderly persons were informed but not empowered about financial, emotional and verbal abuse. The abuse of the elder person in old age homes also featured prominently. The findings of the research study can be used to provide education and empower elder persons and the general public on specific aspects related to elder abuse which are : Financial, Emotional, Verbal and the abuse by staff at old age homes. These findings could be utilized by health and social welfare advocates and organisations who offer community educational and development programs to advocate against elder abuse. / South Africa

Bakgrund: Psykisk ohälsa är en av Sveriges största folksjukdomar och 20 procent av befolkningen över 65 år är drabbade. Då antalet äldre kommer att öka i och med att medellivslängden ökar kommer även antalet personer med depression följa utvecklingen. Uppkomsten av depression hos äldre kan både ha biologiska och sociala faktorer. Att sätta rätt diagnos på gruppen äldre kan vara svårt då ändrad sinnesstämning ibland misstas för tecken på åldrande. Syfte: Att beskriva äldres upplevelse av att leva med depression. Metod: I litteraturöversikten användes tio vetenskapliga studier som analyserades enligt Fribergs metod. Åtta av de utvalda artiklarna var kvalitativa studier, en artikel var med metaanalys metod och en artikel var med mixad metod. Databaser som användes för sökning av vetenskapliga artiklar var CINAHL Complete och PubMed. Resultat: Resultatet har analyserats och presenterats utifrån Katie Erikssons omvårdnadsteori. Två huvudteman utformades livslidande med underteman ensamhet, hopplöshet, skam och sjukdomslidande med undertemat kroppsligt lidande. Diskussion: De två huvudfynden ensamhet och skam har diskuterats utifrån Karin Dahlbergs teori för att få djupare förståelse av resultatet. Vikten av sjuksköterskans roll lyfts fram av författarna då ett bättre bemötande och ökad kunskap leder till snabbare tillfrisknande för äldre. / Background:Mental health is one of the Swedish largest major diseases and 20 percent of the population over 65 years are suffering. As the number of elderly will increase as well life expectancy increases, the number of people with depression will also follow the developments. The arise of depression in the elderly can have both biological and social factors. Putting the right diagnosis to the elderly group can be difficult as a change of state of mind is sometimes mistaken for signs of aging. Aim: To describe elderly's experience of living with depression.  Method: In this literature review, ten scientific studies were used and analyzed and preformed according to Friberg’s method. Eight of the selected articles were qualitative studies, one article was using meta-analysis method and one article was by mixed method. Databases used for the search of scientific articles were CINAHL Complete and PubMed. Results: The result have analyzed and presented based on Katie Eriksson's nursing theory. Two main theme were designed, the first theme life suffering with subthemes loneliness, hopelessness and shame. The second main theme is suffering from illness with subthemes the physical suffering. Discussion:The main findings loneliness and shame are discussed based on Karin Dahlberg's theory of caring, to gain a deeper understanding of the result. The importance of the nurse's role is emphasize by the authors, since better treatment and increased knowledge lead to faster recovery for the elderly.

The purpose of the current study was to investigate, and expain, the effects of an intervention known as “The Five Task Approach” (TFTA); a cognitive intervention hereby utilized within the realm of the geriatric population, as a means of taxing and strengthening cortical areas associated with memory, and visual processing. This study revealed that even short-term exposure to cognitive activities, and therapeutic cueing known to tax areas connected to visual perception, may have an effect on one’s global cognition, generalized memory, and the accuracy of one’s visual perception. It was demonstrated that even brief cognitive intervention geared at taxing cortical areas associated with memory and visual processing, in conjunction with the therapuetic cueing utilized in this study, has the potential to significantly increase participant performance in terms of global cognitive function, including skills associated with executive functioning, working memory, visual processing, visual processing speed, auditory processing, and global cognitive status.