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Relação entre queixa de memória, alterações cognitivas, autopercepção da saúde e ADAM10, em idososAlmeida, Mariana Luciano de 15 February 2016 (has links)
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Previous issue date: 2016-02-15 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / There is a wide divergence of results in the literature on the clinical
relevance and the etiology of memory complaints (MC). Currently QM is being studied
as pre-clinical symptom of Alzheimer's disease before a possible CCL setting. Our
hypothesis is that MC may be associated with lower performance on cognitive tests or a
low self-rated health. Objective. To investigate the relationship among MC in elderly
patients with objective cognitive impairment and self-rated health. Method. This was a
cross-sectional, correlational and quantitative study. The instruments used were the
Memory Complaint Scale (MCS) - forms A and B, Addenbrooke’s Cognitive
Examination – Revised (CEA-R), Mini-Mental State Examination (MMSE), Clock
Drawing Test (CDT), Medical Outcomes Study 8-item Short-Form Heath Survey,
Geriatric Depression Scale and a sociodemographic questionnaire. Results. Participated
in this study 83 subjects, divided between the two forms of MCS evaluation scale.
Sociodemographic groups were very similar, with no significant differences with MC.
According to MCS-A, there was a significant association only with the CDT. MCS-B
was associated with ACE-R and its domains memory, fluency and visual spatial
orientation?. A ROC curve was drawn from the results of MCS-B in relation to the
ACE-R and MMSE, demonstrating the high specificity of the instrument. Conclusion.
In this study it was not found robust results with MC reported by the elderly and
changes in cognitive screening tests. However, when the informant reported the
complaint, the analysis with cognitive performance levels were more consolidated. This
results highligh the need to include and empower perception of someone who knows
enough the elderly to assess the MC globally. / Introdução. Existe uma grande divergência de resultados na literatura quanto à
relevância clínica e à etiologia da queixa de memória (QM). Atualmente a QM vem
sendo estudada como sintoma pré-clínico da doença de Alzheimer, antes de se instalar
um possível quadro de CCL. A hipótese deste estudo é que a QM pode estar associada a
um desempenho inferior nos testes cognitivos ou a uma baixa autopercepção de saúde.
Objetivo. Investigar a relação da QM em idosos com alterações cognitivas objetivas e
autopercepção da saúde. Método. Tratou-se de um estudo transversal, correlacional e de
caráter quantitativo. Os instrumentos aplicados foram a Escala de Queixa de Memória –
formas A e B, Exame Cognitivo de Addenbrooke – Revisado, Mini-Exame do Estado
Mental, Teste do Desenho do Relógio, Medical Outcomes Study 8-item Short-Form
Heath Survey, Escala de Depressão Geriátrica e um questionário sociodemográfico.
Resultados. Participaram da pesquisa 83 sujeitos, divididos entre as formas de
avaliação da EQM para as análises. Com relação às variáveis sociodemográficas os
grupos foram muito semelhantes, não havendo diferenças significativas com a QM. De
acordo com a EQM-A, houve associação significativa apenas com o TDR. A EQM-B
apresentou associação com a ACE-R total e os domínios memória, fluência e visual
espacial. Foi elaborada uma curva ROC a partir dos resultados da EQM-B em relação à
ACE-R e ao MEEM, demonstrando alta especificidade do instrumento. Conclusão.
Neste estudo não foram encontrados resultados tão robustos com a QM relatada pelo
idoso e alterações nos testes de rastreio cognitivo. Contudo, quando o informante
relatou a queixa, as análises com os níveis de desempenho cognitivo mostraram-se mais
consolidadas, evidenciando a necessidade da inclusão e valorização da percepção de
alguém que conheça suficientemente o idoso para avaliar a QM de forma global.
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Alzheimerova demence a zátěž pečovatele. Vliv Alzheimerovy demence na psychosociální zdraví pečující osoby. / Alzheimer's Disease and Family Caregiver Burden. Impact of Alzheimer's Disease on Family Caregiver Psychosocial Health.Zvěřová, Martina January 2013 (has links)
Alzheimer's Disease is a progressive, irreversible neurodegenerative illness and the most common of the dementing disorders. Only few diseases disrupt patients and their relatives so completely or for so long a period of time as Alzheimer 's. Caring is held to be very demanding and emotionally involving. Caregiver burden has been defined as a multidimensional response to emotional, social, physical, psychological, and financial stressors associated with the caregiving experience. The objective of the 1st study was to assess the degree of burden and its possible change in family caregivers of the long-term sick family member with progressive Alzheimer's disease during eight-month monitoring. In addition to the common psychiatric examination the Mini- Mental State Examination (MMSE) was administered in patients to indicate the severity of the dementia and the Zarit Burden Interview was administered in caregivers to assessed degree of burden. The total of 60 people have been examined - 30 patients with AD and 30 their caregivers (24 females, 6 males) were recruited from the Department of Psychiatry, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague. At the beginning of the study there were 18 patients with mild stage of AD (60%), 11 patients suffered...
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Självupplevd hälsa bland närstående till individer med demenssjukdom / Self – perceived health among related parties to individuals with dementiaEllow, Ebba, Rydén, Lydia January 2021 (has links)
Bakgrund: Demenssjukdom skiljer sig från naturligt åldrande och är ständigt föränderligt i sin manifestation. För varje demenssjuk individ finns det ofta åtminstone en närstående som lever en förändrad och även ibland försvårad vardag i det tysta. Närstående löper en ökad risk att drabbas av psykisk ohälsa då flera blir informella vårdgivare till den demenssjuke individen, vilket ökar den närståendes psykiska, fysiska och ekonomiska belastning. Syfte: Syftet var att belysa självupplevd hälsa bland närstående som är informella vårdgivare till individer med demenssjukdom. Metod: Denna icke-systematiska litteraturöversikt inkluderade 19 vetenskapliga originalartiklar av kvalitativ och kvantitativ design. Datainsamlingen av artiklar skedde i februari år 2021 från databaserna PubMed och CINAHL med hjälp av olika kombinationer av söktermer samt manuell sökning, vilket genererade flera artiklar. Utifrån Sophiahemmet högskolas bedömningsinstrument kvalitetsgranskades artiklarna och artiklar med låg kvalitet exkluderades. Därefter utfördes en integrerad dataanalys där resultatartiklarnas innehåll kategoriseras i två teman med tillhörande underteman. Resultat: Litteraturöversikten resulterade i att två teman och sex underteman identifierades. De två teman som urskildes var psykiska och sociala faktorer som belyste självupplevd hälsa bland närstående. Underteman som framkom var närståendes depression, stress, sorg, isolering, kommunikationsproblematik samt processen att gå från att vara närstående till att bli informell vårdgivare. Slutsats: Resultatet visade att självupplevd hälsa för närstående till individer med demenssjukdom påverkas av olika faktorer. Den självupplevda hälsan förändrades när närstående känner psykologisk och social belastning. I resultatet framkom att närstående upplevde att det var en omvälvande process att gå från att vara partner till att bli informell vårdgivare. / Background: Dementia differs from natural aging and is constantly changing in its manifestation. For every individual with dementia, there is often at least one close relative who lives an alternated and even sometimes strenuous everyday life in silence. Relatives of individuals with dementia run an increased risk of suffering from mental illness as many become informal caregivers for them, which increases the relative's mental, physical and financial burden. Aim: The aim was to portray self-perceived health among related parties to individuals with dementia. Method: A non-systematic literature review compiled with 19 original scientific articles of qualitative and quantitative design. The data collection of articles took place in February 2021 and was obtained from the databases PubMed and CINAHL using various combinations of search terms as well as manual search, which generated several articles. Based on Sophiahemmet University's assessment instruments, the articles were quality-reviewed, and then an integrated data analysis was executed, lastly the result articles were organized in two themes with associated sub-themes. Results: The literature review resulted in the identification of two themes and six sub-themes. The two distinguished themes were psychological and social factors, which described self-perceived health among related parties. Sub-themes that emerged were relatives' depression, stress, grief, isolation, communication problems and the process of going from being a partner to becoming an informal caregiver. Conclusions: The results illustrated self-perceived health of relatives of individuals with dementia to be affected by various factors. Self-perceived health shifts when a close relative feels a psychological and social strain. The results demonstrate that close relatives felt that it was a transformative process to go from being a partner to becoming an informal caregiver.
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Redução do uso e do consumo de açúcar por merendeiras de escolas públicas : ensaio randomizado por conglomerado / Reducing the use and consumption of sugar by school lunch cooks in public schools: a cluster randomized trialRita Adriana Gomes de Souza 06 August 2010 (has links)
Conselho Nacional de Desenvolvimento Científico e Tecnológico / O Brasil é um dos maiores consumidores per capita de açúcar e estudos têm mostrado um papel específico do consumo excessivo de açúcar no ganho de peso. Com o aumento do ganho de peso observado em vários países, e também no Brasil, é importante testar quais mensagens, estratégias e propostas de intervenção seriam eficazes na prevenção dessa epidemia. Os dados reportados são referentes a um ensaio randomizado por conglomerado, controlado, conduzido em 20 escolas municipais na cidade metropolitana de Niterói no Estado de Rio de Janeiro, de março a dezembro de 2007, que testou a eficácia de orientações para merendeiras objetivando reduzir a disponibilidade de açúcar e de alimentos fontes de açúcar na alimentação escolar e no consumo delas. A intervenção consistiu em um programa de educação nutricional nas escolas usando mensagens, atividades e material educativo que encorajassem a redução da adição de açúcar na alimentação escolar pelas merendeiras e no consumo delas. A redução da disponibilidade per capita de açúcar pelas escolas foi analisada através de planilhas com dados da utilização dos itens do estoque. O consumo individual das merendeiras foi avaliado através de questionário de freqüência de consumo alimentar. As medidas antropométricas e bioquímicas foram realizadas de acordo com técnicas padronizadas. As escolas de intervenção apresentaram maior redução da disponibilidade per capita de açúcar quando comparadas às escolas controle (-6,0 kg vs. 3,4 kg), mas sem diferença estatisticamente significante. Houve redução no consumo de doces e bebidas açucaradas nas merendeiras dos dois grupos, mas o consumo de açúcar não apresentou diferenças estatisticamente significativas entre eles. Houve redução do consumo de energia total nos dois grupos, mas sem diferença entre eles, e sem modificação dos percentuais de adequação dos macronutrientes em relação ao consumo de energia. Ao final do estudo somente as merendeiras do grupo de intervenção conseguiram manter a perda de peso, porém sem diferença estatisticamente significante. A estratégia de redução da disponibilidade e do consumo de açúcar por merendeiras de escolas públicas não atingiu o principal objetivo de redução de adição de açúcar. Uma análise secundária dos dados avaliou a associação entre a auto-percepção da saúde e da qualidade da alimentação com o excesso de peso e concentração elevada de colesterol sérico das merendeiras na linha de base. As perguntas de auto-percepção foram coletadas por entrevista. Dentre as que consideraram a sua alimentação como saudável, 40% apresentavam colesterol elevado e 61% apresentavam excesso de peso vs. 68% e 74%, respectivamente, para as que consideraram a sua alimentação como não-saudável. Dentre as que consideraram a sua saúde como boa, 41% apresentavam colesterol elevado e 59% apresentavam excesso de peso vs. 71% e 81%, respectivamente, para as que consideraram a sua saúde como ruim. A maioria das mulheres que relatou ter alimentação saudável apresentou maior frequência de consumo de frutas, verduras e legumes, feijão, leite e derivados e menor freqüência de consumo de refrigerante. Conclui-se que perguntas únicas e simples como as utilizadas para a auto-avaliação da saúde podem também ter importância na avaliação da alimentação. / Brazil is one of the largest per capita consumers of sugar and several studies have shown a specific role of excessive consumption of sugar on weight gain. With the increased weight gain observed in several countries, including Brazil, it is important to test which messages, strategies and proposals for intervention would be effective in preventing this epidemic. The data reported are for an intervention study that tested the efficacy of guidelines for school lunch cooks aiming to reduce the added sugar in schools meals and their sugar intake. A cluster randomized controlled trial was carried out in twenty public schools in the metropolitan city of Niterói in Rio de Janeiro, Brazil, from March to December 2007, to assess the change in the availability and consumption of sugar. The intervention consisted of a nutrition educational program in schools using messages, activities and printed educational materials that encouraged the reduction of added sugar in the schools meals by the school lunch cooks and in their consumption. The reduction in per capita sugar availability by the schools was examined through spreadsheets with data from the use of inventory items. Individual food intake of the school lunch cooks was evaluated by a Food Frequency Questionnaire. Anthropometric and biochemical measurements were performed according to standard techniques and the variation in weight change was measured throughout the study. Per capita sugar availability reduced most markedly in the intervention schools compared to the control schools (-6,0 kg vs. 3,4 kg), however this difference was not statistically significant. Both groups of school lunch cooks showed a reduction in the consumption of sweets and sweetened beverages, but the difference in sugar intake was not statistically significant. A reduction in total energy consumption was observed in both groups, but there was no difference between them. Also, there was no difference in the percentage of adequacy of nutrients in relation to energy consumption. Sweetened beverages presented the most important consumption reduction. At the end of the study, only school lunch cooks in the intervention group were able to maintain weight loss, but not statistically significant. The strategy of reducing the availability and consumption of sugar by the school lunch cooks from public schools did not achieve the main goal of reducing added sugar. A secondary analysis examined the association between self-perceived health status and diet quality with overweight and high serum cholesterol concentration of the school lunch cooks at baseline. The self-perception questions were collected by interview. Among women who reported healthy diet, 40% presented high serum cholesterol and 61% were overweight. Among women who reported unhealthy diet, 68% presented high serum cholesterol and 74% presented overweight. Most women who reported healthy diet showed a higher frequency of consumption of sweets, fruits, vegetables, beans, dairy products and lower frequency of consumption of soft drink. In conclusion, single and simple questions, such as those used for self-perceived health status may also be important in assessing the diet.
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Redução do uso e do consumo de açúcar por merendeiras de escolas públicas : ensaio randomizado por conglomerado / Reducing the use and consumption of sugar by school lunch cooks in public schools: a cluster randomized trialRita Adriana Gomes de Souza 06 August 2010 (has links)
Conselho Nacional de Desenvolvimento Científico e Tecnológico / O Brasil é um dos maiores consumidores per capita de açúcar e estudos têm mostrado um papel específico do consumo excessivo de açúcar no ganho de peso. Com o aumento do ganho de peso observado em vários países, e também no Brasil, é importante testar quais mensagens, estratégias e propostas de intervenção seriam eficazes na prevenção dessa epidemia. Os dados reportados são referentes a um ensaio randomizado por conglomerado, controlado, conduzido em 20 escolas municipais na cidade metropolitana de Niterói no Estado de Rio de Janeiro, de março a dezembro de 2007, que testou a eficácia de orientações para merendeiras objetivando reduzir a disponibilidade de açúcar e de alimentos fontes de açúcar na alimentação escolar e no consumo delas. A intervenção consistiu em um programa de educação nutricional nas escolas usando mensagens, atividades e material educativo que encorajassem a redução da adição de açúcar na alimentação escolar pelas merendeiras e no consumo delas. A redução da disponibilidade per capita de açúcar pelas escolas foi analisada através de planilhas com dados da utilização dos itens do estoque. O consumo individual das merendeiras foi avaliado através de questionário de freqüência de consumo alimentar. As medidas antropométricas e bioquímicas foram realizadas de acordo com técnicas padronizadas. As escolas de intervenção apresentaram maior redução da disponibilidade per capita de açúcar quando comparadas às escolas controle (-6,0 kg vs. 3,4 kg), mas sem diferença estatisticamente significante. Houve redução no consumo de doces e bebidas açucaradas nas merendeiras dos dois grupos, mas o consumo de açúcar não apresentou diferenças estatisticamente significativas entre eles. Houve redução do consumo de energia total nos dois grupos, mas sem diferença entre eles, e sem modificação dos percentuais de adequação dos macronutrientes em relação ao consumo de energia. Ao final do estudo somente as merendeiras do grupo de intervenção conseguiram manter a perda de peso, porém sem diferença estatisticamente significante. A estratégia de redução da disponibilidade e do consumo de açúcar por merendeiras de escolas públicas não atingiu o principal objetivo de redução de adição de açúcar. Uma análise secundária dos dados avaliou a associação entre a auto-percepção da saúde e da qualidade da alimentação com o excesso de peso e concentração elevada de colesterol sérico das merendeiras na linha de base. As perguntas de auto-percepção foram coletadas por entrevista. Dentre as que consideraram a sua alimentação como saudável, 40% apresentavam colesterol elevado e 61% apresentavam excesso de peso vs. 68% e 74%, respectivamente, para as que consideraram a sua alimentação como não-saudável. Dentre as que consideraram a sua saúde como boa, 41% apresentavam colesterol elevado e 59% apresentavam excesso de peso vs. 71% e 81%, respectivamente, para as que consideraram a sua saúde como ruim. A maioria das mulheres que relatou ter alimentação saudável apresentou maior frequência de consumo de frutas, verduras e legumes, feijão, leite e derivados e menor freqüência de consumo de refrigerante. Conclui-se que perguntas únicas e simples como as utilizadas para a auto-avaliação da saúde podem também ter importância na avaliação da alimentação. / Brazil is one of the largest per capita consumers of sugar and several studies have shown a specific role of excessive consumption of sugar on weight gain. With the increased weight gain observed in several countries, including Brazil, it is important to test which messages, strategies and proposals for intervention would be effective in preventing this epidemic. The data reported are for an intervention study that tested the efficacy of guidelines for school lunch cooks aiming to reduce the added sugar in schools meals and their sugar intake. A cluster randomized controlled trial was carried out in twenty public schools in the metropolitan city of Niterói in Rio de Janeiro, Brazil, from March to December 2007, to assess the change in the availability and consumption of sugar. The intervention consisted of a nutrition educational program in schools using messages, activities and printed educational materials that encouraged the reduction of added sugar in the schools meals by the school lunch cooks and in their consumption. The reduction in per capita sugar availability by the schools was examined through spreadsheets with data from the use of inventory items. Individual food intake of the school lunch cooks was evaluated by a Food Frequency Questionnaire. Anthropometric and biochemical measurements were performed according to standard techniques and the variation in weight change was measured throughout the study. Per capita sugar availability reduced most markedly in the intervention schools compared to the control schools (-6,0 kg vs. 3,4 kg), however this difference was not statistically significant. Both groups of school lunch cooks showed a reduction in the consumption of sweets and sweetened beverages, but the difference in sugar intake was not statistically significant. A reduction in total energy consumption was observed in both groups, but there was no difference between them. Also, there was no difference in the percentage of adequacy of nutrients in relation to energy consumption. Sweetened beverages presented the most important consumption reduction. At the end of the study, only school lunch cooks in the intervention group were able to maintain weight loss, but not statistically significant. The strategy of reducing the availability and consumption of sugar by the school lunch cooks from public schools did not achieve the main goal of reducing added sugar. A secondary analysis examined the association between self-perceived health status and diet quality with overweight and high serum cholesterol concentration of the school lunch cooks at baseline. The self-perception questions were collected by interview. Among women who reported healthy diet, 40% presented high serum cholesterol and 61% were overweight. Among women who reported unhealthy diet, 68% presented high serum cholesterol and 74% presented overweight. Most women who reported healthy diet showed a higher frequency of consumption of sweets, fruits, vegetables, beans, dairy products and lower frequency of consumption of soft drink. In conclusion, single and simple questions, such as those used for self-perceived health status may also be important in assessing the diet.
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A multidimensional assessment of health and functional status in older Aboriginal Australians from Katherine and Lajamanu, Northern TerritorySevo, Goran, sevo1984@yubc.net January 2003 (has links)
Human health is multidimensional: apart from physical, mental, and social aspects, it also
incorporates subjective perceptions of health, and functional status (FS). Given that elderly
persons have very distinctive health and social needs, multidimensional assessment (MA)
of health proves particularly useful in this age group.¶
Aboriginal populations suffer poor health, and there are relatively few studies addressing
the health problems of older Aboriginal Australians, mainly because of their distinctive
demographic structure, and the low proportion of their elderly. Also, there is no prior
information available on MA of health in this Australian population group.¶
This thesis offers a MA of health in older Aboriginal persons from two, urban and
rural/isolated, locations in the NT, Katherine and Lajamanu (the NT survey).¶
This thesis specifically addresses the following questions:
- what is the physical health, FS, subjective perception of health, and social
functioning amongst the NT survey participants?
- what are the possible similarities and differences in various dimensions of health
between the two major survey locations, what age and gender patterns are
observed, and what are the reasons for these patterns, similarities and
differences?
- how do various dimensions of health relate to each other, and why?
- how do current findings relate to broader Aboriginal and non-Aboriginal
populations, and why?
- what can MA add to a better understanding of various aspects of morbidity and
health care use?
- what are its possible implications for health planning?¶
Findings from this work indicate poor physical health amongst participants in almost all
investigated aspects, comparable to information available from other Aboriginal
populations. These are accompanied by low levels of ability for physical functioning. Despite this, subjective perception of health is rather optimistic amongst participants, and
levels of social functioning high. Use of health services is mainly related to available health
infrastructure. Important health differences exist between Katherine and Lajamanu, and
they became particularly visible when all dimensions of health are considered together.¶
The Main conclusions from the current work are that 1) poor physical health is not
necessarily accompanied by similar level of deterioration in other dimensions of health:
even though participants from the isolated community of Lajamanu experience most
chronic diseases, their ability for physical functioning is better, self-perceived health (SPH)
more optimistic and levels of social functioning highest 2) institutionalised participants from
Katherine suffer by far the worst health of all sample segments in this study; at least some
of the poor health outcomes are potentially avoidable, and could be improved by more
appropriate residential choices for Aboriginal elderly 3) better health infrastructure does
not necessarily bring better health in all its dimensions, suggesting that other factors
(primarily socio-economic and cultural) should be addressed in conjunction with this in
solving complex health problems of Aboriginal Australians, and 4) it provides strong
support that MA can become a useful tool in comprehensive health assessment of older
Aboriginals.
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老年人寂寞之相關因素的模式探討林千立 Unknown Date (has links)
本研究旨在探討老年人寂寞及其相關因素模式。主要目的為:一、編擬老年人寂寞量表,以測量老年人寂寞。二、瞭解我國老年人的寂寞現況並比較不同背景變項之老年人在寂寞上的差異情形。三、建立人格特質(神經質與外向性)、自覺健康狀況、社會關係數量、社會供應(情緒共同感、價值肯定、社會共同感)與寂寞(情緒性寂寞與社會性寂寞)之間的結構方程模式,以瞭解變項之間的路徑關係。
為逹以上目的,本研究採用問卷調查法,以702位老年人為研究對象,施以「人格特質量表」、「社會關係量表」、「自覺健康狀況量表」,修訂之「社會供應量表」、自編之「老年人寂寞量表」等量表,並以描述性統計分析、t考驗、單因子變異數分析、結構方程模式進行統計分析。研究發現:1.老年人寂寞量表經因素分析,可區分為情緒性寂寞與社會性寂寞。2.我國老年人的寂寞程度為中度偏低,社會性寂寞顯著高於情緒性寂寞。3.不同年齡、性別、婚姻狀況、參與社團與居住狀況的老年人在寂寞上有顯著差異。4.去除解釋力低的自覺健康狀況,人格特質、社會關係數量、社會供應與寂寞所建構之結構方程模式的適配度獲得支持,可以有效解釋相關變項間的關聯性。
最後本研究根據研究結果進行討論,並對諮商實務及未來研究提出建議。 / The purpose of this study was to develop a 「Loneliness Scale for the Elderly」 and to explore loneliness and related factors in the elderly. Moreover, this study created the structural equation model of personality traits(neuroticis / extraversion)、quantity of social relationship、self-perceived health status、social provision(emotional togetherness / reassurance of worth / social togetherness)and loneliness(emotional loneliness / social loneliness)in the elderly, which served the purpose of illustrating the linear structural relationships among the relevant variables.
The participants in this study were 702 elderly people in Taiwan. Research instruments included Personality Traits Scale、Quantity of Social Relationship Scale、Self-perceived Health Status Scale、Social Provision Scale, and Loneliness Scale for the Elderly. The collected data was analyzed by descriptive statistics, t-test, ANOVA, and structural equation model.
The findings were as follows: 1. Two factors were extracted from the Loneliness Scale for the Elderly by factor analysis, they were emotional loneliness and social loneliness. 2. The level of loneliness among elderly was moderate and social loneliness is significantly higher than emotional loneliness. 3. There were significant differences in loneliness among different age groups, gender, marital status, group participations, and living arrangements. 4. The structural equation model of personality traits、quantity of social relationship、social provision and loneliness in the elderly could explain the relationship among main variables.
Based on these findings, some suggestions were made for practice and future research.
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Health literacy among newly arrived refugees in Sweden and implications for health and healthcareWångdahl, Josefin January 2017 (has links)
The overall aim of this thesis was to examine the distribution of health literacy (HL) levels in newly arrived Arabic-, Dari-, or Somali-speaking refugees in Sweden. Further aims were to investigate sociodemographic characteristics associated with inadequate HL in this group, and to investigate whether HL levels are associated with experiences of the health examination for asylum seekers (HEA), health seeking behaviour and health. Three quantitative cross-sectional studies, using data from two different surveys, were conducted among Arabic-, Dari-, and Somali-speaking, newly arrived refugees taking part in courses in Swedish for immigrants or civic orientation. In addition, an explorative qualitative study, based on focus group discussions, was performed on Arabic- and Somali-speaking newly arrived refugees who had taken part in an HEA. All data were collected 2013-2016. The quantitative data were analysed using different statistical methods, foremost descriptive statistics and univariate and multivariate binary logistic regression analyses. The qualitative data were analysed using Graneheim and Lundman’s method for latent content analysis. The main findings were that the majority of Arabic-, Dari-, or Somali-speaking refugees in Sweden have limited functional health literacy (FHL) and/or limited comprehensive health literacy (CHL). Having a low education level and/or being born in Somalia were associated with having inadequate FHL, but not with having inadequate CHL. Limited FHL was associated with inadequate CHL. Experiences of poor quality of communication and having benefited little from the HEA were more common among those with limited CHL, as compared to those with higher CHL. Experiences of communication problems and a lack of information related to the HEA were found in the qualitative studies as well. In addition, it was more common that those with limited CHL reported poor general health and impaired psychological well-being, and that they had refrained from seeking healthcare. In conclusion: limited HL is common among newly arrived refugees in Sweden and seems to be of importance for the experience of the HEA, health-seeking behaviour and health. HL needs to be taken into consideration in the work with refugees in order to increase equity in healthcare and health.
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