This research explores the meaning that older persons ascribe to the friendships in which they engage. Previous research mostly focuses on the strain that the older population places on the self-reliant community. The older person is faced by many challenges, such as sickness, loss of social and emotional support and death. Friendships serve as a support for physical and emotional needs which could not always be addressed by the family. The aim of this research is to explore the type of friendships in which older persons prefer to engage and the meanings they assign to it. A qualitative study was identified as the most appropriate method and focus groups and personal interviews were used as methods of data collection. Data was analysed by means of thematic content analysis. Findings indicated that different types of friendships exist and that different meanings were attached to friendships. Meaning in friendships is promoted by trustworthy friends who are able to form a deepened level of connection through the support and the compassion they are able to give each other. The experience of connection in friendships is furthermore enhanced through mobility, proximity and technology that facilitate better emotional as well as physical support for the older individual. Informal friendships with younger people ensure that older people are more mobile and are able to maintain their friendships. It is also a great source of support in cases where family members are not able to provide support, due to whatever reason. Further exploration of the value of friendships is recommended, so as to plan more specific intervention strategies. Some insights have already been gathered in this study concerning the way in which mobility, proximity and modern technology can make it possible to sustain a friendship. Further studies could explore ways to empower older people through providing better mobility, proximity and the use of modem technology. Such studies may also explore the needs which an old age home fulfils, such as improving the residents' access to one another, for mutual support. Proximity might be a solution for the immobility experienced in the older community, and when older people are taught to use modern technology they will be enabled to maintain their friendships better. / Thesis (M.A. (Psychology))--North-West University, Potchefstroom Campus, 2007.

Thesis (M.A. (Psychology))--North-West University, Potchefstroom Campus, 2007.

This research explores the meaning that older persons ascribe to the friendships in which they engage. Previous research mostly focuses on the strain that the older population places on the self-reliant community. The older person is faced by many challenges, such as sickness, loss of social and emotional support and death. Friendships serve as a support for physical and emotional needs which could not always be addressed by the family. The aim of this research is to explore the type of friendships in which older persons prefer to engage and the meanings they assign to it. A qualitative study was identified as the most appropriate method and focus groups and personal interviews were used as methods of data collection. Data was analysed by means of thematic content analysis. Findings indicated that different types of friendships exist and that different meanings were attached to friendships. Meaning in friendships is promoted by trustworthy friends who are able to form a deepened level of connection through the support and the compassion they are able to give each other. The experience of connection in friendships is furthermore enhanced through mobility, proximity and technology that facilitate better emotional as well as physical support for the older individual. Informal friendships with younger people ensure that older people are more mobile and are able to maintain their friendships. It is also a great source of support in cases where family members are not able to provide support, due to whatever reason. Further exploration of the value of friendships is recommended, so as to plan more specific intervention strategies. Some insights have already been gathered in this study concerning the way in which mobility, proximity and modern technology can make it possible to sustain a friendship. Further studies could explore ways to empower older people through providing better mobility, proximity and the use of modem technology. Such studies may also explore the needs which an old age home fulfils, such as improving the residents' access to one another, for mutual support. Proximity might be a solution for the immobility experienced in the older community, and when older people are taught to use modern technology they will be enabled to maintain their friendships better. / Thesis (M.A. (Psychology))--North-West University, Potchefstroom Campus, 2007.

Dado o acelerado processo de envelhecimento populacional vivenciado no Brasil e no mundo, é importante identificar quais as melhores maneiras de avaliar a saúde da pessoa idosa inserida na comunidade ou institucionalizada. Neste sentido, a Organização Mundial de Saúde preconiza a avaliação desta população por meio da condição funcional. Diferentes instrumentos se propõem a este fim, seja evidenciando o desempenho de atividades ou capacidade funcional, por métodos aferido ou referido. No entanto, existe grande diferença entre estas possíveis maneiras de avaliação da pessoa idosa e poucos estudos que abordem este tema. Objetivo: comparar a avaliação de atividades básicas de vida diária (ABVD) por meio do desempenho referido e aferido em pessoas idosas residentes na comunidade. Método: Estudo transversal que avaliou 40 idosos que realizavam tratamento ou acompanhamento médico em dois ambulatórios (clínica médica e ortopedia) no município de Londrina (PR). Esta amostra foi avaliada frente desempenho funcional por meio da Medida de Independência Funcional (MIF) e o desempenho referido foi verificado a partir da utilização de um questionário padronizado. Ao todo, 12 atividades básicas de vida diária foram avaliadas por ambos os métodos. Para possibilitar a comparação entre as respostas obtidas em cada instrumento, houve um processo de categorização no qual cada idoso era classificado como independente; tendo dificuldade ou utilizando adaptação para realizar a atividade; ou necessitando de ajuda. Foi utilizado o teste do coeficiente de Kappa e teste de correlação de Spearman para comparar a concordância entre os métodos de avaliação da condição funcional. Resultados: Os idosos residentes na comunidade apresentavam média etária de 71,6 anos (IC 95% 72,8;79,4) e maior proporção de mulheres (52,5) e a maioria dos participantes não apresenta comprometimento da função cognitiva. Dentre as atividades avaliadas, aquelas relacionadas ao uso e acesso ao vaso sanitário foram as que a presentaram menor concordância. Já locomoção, alimentação, controle de fezes, banho e vestir-se são aquelas mais comparáveis. Pela comparação entre os métodos de avaliação foi possível observar que a avaliação de modo aferido evidencia indivíduos com menor nível funcional frente a avaliação autorreferida das mesmas atividades. As dificuldades aferidas e referidas estiveram relacionadas com a condição de saúde do idoso avaliado, sendo que idosos provindos do ambulatório ortopédico apresentavam maior comprometimento de atividades que comprometiam membros superiores ou inferiores. Foi possível concluir que a avaliação de ABVD utilizando desempenho referido ou aferido apresenta respostas similares para maioria das atividades avaliadas, com grau de concordância substancial. No entanto, as respostas obtidas pelo método de avaliação autorreferido devem ser interpretadas com cautela, principalmente quando da avaliação do uso e acesso ao vaso sanitário. Os métodos de avaliação avaliados são complementares e quando possível ambos devem ser aplicados para avaliação funcional de pessoas idosas. / About the accelerated ageing process experienced in Brazil and the world, it is important to identify the best ways to check the health of the older persons inserted in the community. In this sense, the World Health Organization indicates the assessment of functional condition as good option to evaluate this population. Different instruments are proposed and it can be done by the assessment of capacity or performance, by measured or (self) reported methods. However, these methods are different and there are few studies that address this issue. Objective: To compare the evaluation of activities of daily living (ADL) by reported or measured performance in older adults living in community. Methods: Cross-sectional study that evaluated 40 subjects who were undergoing treatment or medical care at two clinics (generical medicine and orthopedics) in Londrina (PR). This sample was evaluated from the functional performance through the Functional Independence Measure (FIM) and reported performance was observed from the use of a standardized questionnaire. Twelve ADL were assessed by both methods. To enable a comparison of obtained responses with each instrument, the subjects were classified as independent; with difficulty or using adaptation to perform the activity; or who needing help. We used the Kappa coefficient test to compare the agreement among the methods to assess functional condition. Results: community-dwelling older adults had a mean age of 71.6 years (95% CI 72.8; 79.4) and higher proportion of women (52.5) and most of the participants does not have impaired cognitive function. Among the activities evaluated, those related to the use and access to the toilet showed the least agreement. Already locomotion, feeding, control stool, bathing and dressing are those more comparable. In the comparison process, it was observed that the older adults had lower functional level when the assessment is made by measured performance against reported assessment of the same activities. The measured and reported difficulties were related to the health condition of the evaluated elderly, and older persons in treatment of orthopedic clinic had greater commitment in activities involving the arms or legs, structures in rehabilitation process. When we evaluated community-dwelling elderly, there was a higher level of agreement between measured functional condition and reported performance. We concluded that the evaluation of ABVD using measured or reported performance shows similar responses to most of the activities evaluated, with substantial degree of agreement. However, the responses obtained by self-reported assessment method should be interpreted with caution, especially when assessing the use of and access to toilet. The methods of this evaluation are complementary and it is a better option when both can be applied for functional assessment of elderly.

Age brings about that physical strength diminishes and in many cases there is also a loss of social contact. Older people possess years of knowledge based on experience which can be applied effectively in a service centre to the advantage of other older people. Amongst others, Section A contains the problem statement, research objectives and procedures that were undertaken. The overarching aim of this investigation was to establish the role of the retired volunteer in the functioning of Potchefstroom Service Centre for Older People. To reach the aim, the following objectives were aimed at: Obiective 1. To establish what the reasons are for retired people to become involved in Potchefstroom Service Centre of Older People as volunteers. Obiective 2. To establish in what area of the service centre retired people are involved as volunteers. Obiective 3. To establish the psychosocial functioning, self-perception, work values and profile of the retired volunteer involved in Potchefstroom Service Centre for Older People. Obiective 4. To determine what volunteers of the service centre for older people expect of the staff regarding, for instance, acknowledgement, responsibilities and remuneration. Section B contains the two articles in which the outcomes of the research were reported. Article 1 pertains to the reasons why older people become involved in service centres as volunteers and in which areas. Article 2 enters into the psychosocial functioning, self-perception, work values, profile and expectations of the retired volunteer. In Section C a synopsis of the most important findings and conclusions regarding the investigation was presented in its entirety. Additionally, recommendations were made and the contribution of the investigation was highlighted. Section D contains addendums to the research report such as the self-compiled questionnaire and the standardised questionnaire. The dissertation was concluded in Section E with a comprehensive reference list. / Thesis (M.A. (MW))--North-West University, Potchefstroom Campus, 2009.

Age brings about that physical strength diminishes and in many cases there is also a loss of social contact. Older people possess years of knowledge based on experience which can be applied effectively in a service centre to the advantage of other older people. Amongst others, Section A contains the problem statement, research objectives and procedures that were undertaken. The overarching aim of this investigation was to establish the role of the retired volunteer in the functioning of Potchefstroom Service Centre for Older People. To reach the aim, the following objectives were aimed at: Obiective 1. To establish what the reasons are for retired people to become involved in Potchefstroom Service Centre of Older People as volunteers. Obiective 2. To establish in what area of the service centre retired people are involved as volunteers. Obiective 3. To establish the psychosocial functioning, self-perception, work values and profile of the retired volunteer involved in Potchefstroom Service Centre for Older People. Obiective 4. To determine what volunteers of the service centre for older people expect of the staff regarding, for instance, acknowledgement, responsibilities and remuneration. Section B contains the two articles in which the outcomes of the research were reported. Article 1 pertains to the reasons why older people become involved in service centres as volunteers and in which areas. Article 2 enters into the psychosocial functioning, self-perception, work values, profile and expectations of the retired volunteer. In Section C a synopsis of the most important findings and conclusions regarding the investigation was presented in its entirety. Additionally, recommendations were made and the contribution of the investigation was highlighted. Section D contains addendums to the research report such as the self-compiled questionnaire and the standardised questionnaire. The dissertation was concluded in Section E with a comprehensive reference list. / Thesis (M.A. (MW))--North-West University, Potchefstroom Campus, 2009.

Dado o acelerado processo de envelhecimento populacional vivenciado no Brasil e no mundo, é importante identificar quais as melhores maneiras de avaliar a saúde da pessoa idosa inserida na comunidade ou institucionalizada. Neste sentido, a Organização Mundial de Saúde preconiza a avaliação desta população por meio da condição funcional. Diferentes instrumentos se propõem a este fim, seja evidenciando o desempenho de atividades ou capacidade funcional, por métodos aferido ou referido. No entanto, existe grande diferença entre estas possíveis maneiras de avaliação da pessoa idosa e poucos estudos que abordem este tema. Objetivo: comparar a avaliação de atividades básicas de vida diária (ABVD) por meio do desempenho referido e aferido em pessoas idosas residentes na comunidade. Método: Estudo transversal que avaliou 40 idosos que realizavam tratamento ou acompanhamento médico em dois ambulatórios (clínica médica e ortopedia) no município de Londrina (PR). Esta amostra foi avaliada frente desempenho funcional por meio da Medida de Independência Funcional (MIF) e o desempenho referido foi verificado a partir da utilização de um questionário padronizado. Ao todo, 12 atividades básicas de vida diária foram avaliadas por ambos os métodos. Para possibilitar a comparação entre as respostas obtidas em cada instrumento, houve um processo de categorização no qual cada idoso era classificado como independente; tendo dificuldade ou utilizando adaptação para realizar a atividade; ou necessitando de ajuda. Foi utilizado o teste do coeficiente de Kappa e teste de correlação de Spearman para comparar a concordância entre os métodos de avaliação da condição funcional. Resultados: Os idosos residentes na comunidade apresentavam média etária de 71,6 anos (IC 95% 72,8;79,4) e maior proporção de mulheres (52,5) e a maioria dos participantes não apresenta comprometimento da função cognitiva. Dentre as atividades avaliadas, aquelas relacionadas ao uso e acesso ao vaso sanitário foram as que a presentaram menor concordância. Já locomoção, alimentação, controle de fezes, banho e vestir-se são aquelas mais comparáveis. Pela comparação entre os métodos de avaliação foi possível observar que a avaliação de modo aferido evidencia indivíduos com menor nível funcional frente a avaliação autorreferida das mesmas atividades. As dificuldades aferidas e referidas estiveram relacionadas com a condição de saúde do idoso avaliado, sendo que idosos provindos do ambulatório ortopédico apresentavam maior comprometimento de atividades que comprometiam membros superiores ou inferiores. Foi possível concluir que a avaliação de ABVD utilizando desempenho referido ou aferido apresenta respostas similares para maioria das atividades avaliadas, com grau de concordância substancial. No entanto, as respostas obtidas pelo método de avaliação autorreferido devem ser interpretadas com cautela, principalmente quando da avaliação do uso e acesso ao vaso sanitário. Os métodos de avaliação avaliados são complementares e quando possível ambos devem ser aplicados para avaliação funcional de pessoas idosas. / About the accelerated ageing process experienced in Brazil and the world, it is important to identify the best ways to check the health of the older persons inserted in the community. In this sense, the World Health Organization indicates the assessment of functional condition as good option to evaluate this population. Different instruments are proposed and it can be done by the assessment of capacity or performance, by measured or (self) reported methods. However, these methods are different and there are few studies that address this issue. Objective: To compare the evaluation of activities of daily living (ADL) by reported or measured performance in older adults living in community. Methods: Cross-sectional study that evaluated 40 subjects who were undergoing treatment or medical care at two clinics (generical medicine and orthopedics) in Londrina (PR). This sample was evaluated from the functional performance through the Functional Independence Measure (FIM) and reported performance was observed from the use of a standardized questionnaire. Twelve ADL were assessed by both methods. To enable a comparison of obtained responses with each instrument, the subjects were classified as independent; with difficulty or using adaptation to perform the activity; or who needing help. We used the Kappa coefficient test to compare the agreement among the methods to assess functional condition. Results: community-dwelling older adults had a mean age of 71.6 years (95% CI 72.8; 79.4) and higher proportion of women (52.5) and most of the participants does not have impaired cognitive function. Among the activities evaluated, those related to the use and access to the toilet showed the least agreement. Already locomotion, feeding, control stool, bathing and dressing are those more comparable. In the comparison process, it was observed that the older adults had lower functional level when the assessment is made by measured performance against reported assessment of the same activities. The measured and reported difficulties were related to the health condition of the evaluated elderly, and older persons in treatment of orthopedic clinic had greater commitment in activities involving the arms or legs, structures in rehabilitation process. When we evaluated community-dwelling elderly, there was a higher level of agreement between measured functional condition and reported performance. We concluded that the evaluation of ABVD using measured or reported performance shows similar responses to most of the activities evaluated, with substantial degree of agreement. However, the responses obtained by self-reported assessment method should be interpreted with caution, especially when assessing the use of and access to toilet. The methods of this evaluation are complementary and it is a better option when both can be applied for functional assessment of elderly.

Orientador: Nanci Soares / Resumo: A referida pesquisa objetiva analisar as vivências de isolamento social do envelhecer e velhice da classe trabalhadora em relação à desproteção social da sociedade capitalista sob o olhar dos técnicos e usuários do Serviço de Convivência e Fortalecimento de Vínculos (SCFV) para Pessoas Idosas. O trabalho busca debater o isolamento social enquanto uma das expressões das refrações da questão social que acompanha o envelhecer e a velhice do(a) trabalhador(a), elucidar a trajetória histórica da proteção social pública da Política de Assistência Social direcionada à pessoa idosa no Brasil, em especial ao SCFV para pessoas idosas, e compreender o olhar dos usuários e técnicos de referência do referido Serviço sobre as vivências de isolamento social dos(as) velhos(as) trabalhadores(as). Compõem o universo da pesquisa os CRAS – Centro, Sul, Norte e Leste – do Município de Franca, tendo como amostra do universo os SCFVs para pessoas idosas dos respectivos territórios, sendo os técnicos de referência, assistentes sociais, e os usuários desse Serviço os sujeitos participantes. O estudo, de caráter exploratório e de abordagem qualitativa e quantitativa, fundamentou-se sob o referencial teórico-metodológico materialista histórico-dialético. O material empírico do trabalho foi apreendido por meio da técnica de entrevista individual semiestruturada realizada com os três técnicos de referência e da técnica de grupo focal realizada com usuários do SCFV para Pessoas Idosas da cidade de Franca ... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: This research aims to analyze the experiences of social isolation of aging and old age of the working class in relation to the social lack of protection of the capitalist society according to technicians and users of theServiço de Convivência e Fortalecimento de Vínculos (SCFV) para PessoasIdosas (Service of Coexistence and Strengthening of Bonds for Older People).The paper seeks to discuss social isolation as one of the expressions of the refractions of the social issue that accompanies the aging and old age of the worker,elucidate the historical trajectory of the public social protection of the Social Assistance Policy directed to older people in Brazil, in particular the SCFV for Older People, as well as to understand the view of the users and technicians of the aforementioned service on the experiences of the social isolation of old workers.The universe of the research comprises the CRAS –Downtown, South, North and East – of the Municipality of Franca, having the SCFVs for Older Peopleof each territory as samples of this universe.The research participants are the technicians, social workes, and the users of the Service. This is an exploratory research with a qualitative and quantitative approach and its theoretical-methodological framework was based on the historical-dialectical materialism.Theempirical material of the study was obtained by means of a semi-structured individual interview performed with three technicians and through the focus group technique performed with... (Complete abstract click electronic access below) / Doutor

Medication management constitutes a large part of registered nurses' (RNs) daily work in municipal elderly care. They are responsible for monitoring multimorbid older persons with extensive treatments, and they often work alone, without daily access to physicians. RNs’ drug monitoring is, in this thesis, based on the concept of pharmacovigilance. Pharmacovigilance is about the science and the activities that aim to improve patient care and safety in drug use, that is, to detect, assess, understand and prevent drug-related problems. The overall aim was to explore conditions for pharmacovigilance from a nursing perspective, focusing on implications of RNs’ competence and use of a computerized decision support system (CDSS). Both quantitative and qualitative research methods were used, including a questionnaire (I), focus group discussions (II), individual interviews (III) and an intervention study (IV). In total 216 RNs and 54 older persons participated from 13 special accommodations, located in three different regions. RNs who had completed further training in pharmacovigilance rated their medication competence higher than those who had not. However, there was no difference between groups in the number of pharmacovigilant activities they performed in clinical practice (I). The RNs appeared to act as “vigilant intermediaries” in drug treatment. They depended on the nursing staff's observations of drug-related problems. The RNs continuously controlled the work of staff and physicians, and attempted to compensate for shortcomings in competence, accessibility and continuity (II). RNs’ use of a CDSS was found to affect drug monitoring, including aspects of time, responsibility, standardization of the work, as well as access to knowledge and opportunities for evidence-based care (III). The CDSS detected significantly more drug-related problems when conducting medication reviews, than the RNs did. Nevertheless, this did not result in any significant improvement in the quality of drug use in the follow up, three and six months later (IV). This thesis contributes to the recognition of pharmacovigilance from a nursing perspective. Increased medication competence seems to be insufficient to generate pharmacovigilant activities. RNs depend on other health care professionals and organizational conditions in order to perform their work. A CDSS has the potential to support RNs, both in structured medication reviews and in daily clinical practice. Inter-professional collaboration is crucial, with or without a CDSS, and the entire team needs to be aware of and take responsibility. Other important conditions is the existence of well-functioning communication channels, competence across the team, and established procedures based on current guidelines.

Bakgrund: Den psykiska ohälsan bland befolkningen har ökat under de senaste decennierna och medellivslängden i Sverige ökar kontinuerligt. Risken att drabbas av depression var vanligare hos personer över 65 år. Depression påverkar personens känslor, tankar och beteende negativt. Det är av vikt att upptäcka, diagnostisera och behandla depression för att minska personens lidande samt minska samhällskostnader som depression medför. Personcentrerad vård är ett etiskt förhållningssätt och syftar till att involvera den enskilda personen, samt anpassa vården efter dennes behov. Sjuksköterskor arbetar ofta självständigt i vården av den äldre personen med depression. Syfte: Syftet med studien var att belysa sjuksköterskors upplevelser av att möta och vårda den äldre personen med depression. Metod: En metasyntes (Noblit och Hare, 1988) med kvalitativ design. Resultat: Metasyntesen resulterade i fyra huvudteman; organisationens betydelse, vikten av hög kompetens, vikten av att ge tid, betydelsen av ett holistiskt förhållningssätt. Teamarbete och resurser var grundläggande för att kunna stötta den äldre personen med depression. Kunskap, erfarenhet samt normmedvetenhet underlättade identifiering av depression och bidrog till god omvårdnad. Skapandet av en relation med den äldre personen tog tid och byggdes på tillit samt kontinuitet. Att se till hela personen och relationens betydelse påverkade omvårdnaden positivt. Slutsats: Stöttning från organisationen behöver finnas, mer utbildning behöver erbjudas samt möjlighet att få tid i mötet och vården av den äldre personen med depression för att kunna förbättra omvårdnaden. Det kan inte nog betonas hur viktigt det är att sjuksköterskan får resurser som ger möjligheter att skapa en personcentrerad vård. / Background: Mental illness among the population has increased in recent decades and life expectancy in Sweden is continuously increasing. The risk of suffering from depression was generally more common for people over 65 years of age. Depression negatively affects the person's feelings, thoughts and behaviour. It is important to detect, diagnose and treat depression in order to reduce the person's suffering and reduce the societal costs that depression entails. Person-centered care is an ethical approach and aims to involve the individual, as well as adapt care to his or her needs. Nurses often work independently in the care of the elderly person with depression.Aim: The aim of the study was to describe nurses' experiences of meeting and caring for the elderly person with depression. Method: The study is a metasynthesis (Noblit and Hare, 1988) with a qualitative design. Results: The metasynthesis resulted in four main themes; the importance of the organization, the importance of high competence, the importance of giving time, the significanceof a holistic approach. Teamwork and resources were essential in order to be able to support the elderly person. Knowledge, experience and norm awareness facilitated the identification of depression and contributed to good nursing. The creating of a relationship with the older person took time and was built on trust and continuity. Looking at the whole person and the importance of the relationship had a positive impact on nursing. Conclusion: Support from the organization needs to be available, more education needs to be offered as well as the opportunity to have time in the meeting and care of the elderly person with depression in order to improve care. It cannot be emphasized enough how important it is for the nurse to receive resources that provide opportunities to create a person-centered care.