Social Representations of Violence against the Elderly

The repercussions of violence on the mental, social, and physical well-being of the elderly are some of the most challenging problems in public health today. Using a qualitative design, we conducted a study in Portugal and the United States that applied both descriptive and comparative methods in order to understand the social representations of violence against the elderly. Utilizing the Theory of Social Representations, we explored the perspectives of the elderly, their families, and healthcare professionals on the subject of violence against the elderly. The data on which the findings were based were obtained in two very different cultural contexts, yet the representations of violence against the elderly revealed no significant cross-cultural differences. However, conceptualizations regarding expectations of care and protection for the elderly proved to be distinct. We discussed concerns about the general attitudes of tolerance toward violence, including those of the elderly who self-identified as eventual victims. Violence against the elderly was portrayed as a part of old age and also somehow was justified by it. The results also indicated the need to better prepare healthcare professionals and society in general to deal with the consequences of the problem and not, as we would like to report, to prevent it from happening.

Symposium: Violence in Adults and the elderly: to investigate and intervene

This symposium aims to address some studies on violence in adults, as well as address the job done in an intervention network in domestic violence and a project on the study of violence in the elderly, in Alentejo. Communications: - PREVALÊNCE OF VIOLENCE IN ADULTS- Zangão, Maria Otília; Serra, Isaura; Gemito, Maria Laurência; Pinheiro, Felícia Tavares; Magalhães, Dulce; Marques, Maria de Fátima - SOCIAL REPRESENTATION OF DOMESTIC VIOLENCE - Gemito, Maria Laurência; Pinheiro, Felícia Tavares; Zangão, Maria Otília; Serra, Isaura; Magalhães, Dulce; Marques, Maria de Fátima - DOMESTIV VIOLENCE IN THE PERSPECTIVE OF WOMEN WHO LIVE IT - Magalhães, Dulce; Marques, Maria de Fátima; Zangão, Maria Otília; Serra, Isaura; Gemito, Maria Laurência; Pinheiro, Felícia Tavares - INTEGRATED INTERVENTION NETWORK OF DISTRICT OF ÉVORA (RIIDE): A multidisciplinary response to violence - Gemito, Maria Laurência; Pinheiro, Felícia Tavares; Lopes, Manuel - ESACA - Ageing Safely in Alentejo – Understanding for Action - Mendes, Felismina; Gemito, Maria Laurência; Zangão, Maria Otilia; Chora, Maria Antónia; Pereira, Catarina Symposium goal(s): - To present studies on violence in Alentejo. - To discuss the importance of networks in the problem of violence. - To present Project underway on how to age with security in Alentejo. Symposium moderator(s): Maria Otília Brites Zangão Project affiliation:All three studies have resulted in an intervention project against domestic violence "Love me, love me not- Why does the violence exist and why does it not choose ages?" funded by POPH. ESACA Project - Aging Safely in Alentejo - Understanding to act, co-funded by: Alentejo 2020 Portugal 2020 and the European Union.

Prevention of falls in the elderly in the home: promoting active ageing

Objective: To determine the frequency of falls and identify risk factors in the homes of the elderly under the Home Care Service of a village in Alentejo (Portugal). Method: Exploratory, descriptive study. The target group were elderly persons under the Home Care Service (23). The questionnaire consists of open and closed questions, and was based on the Jefferson Area Board for Aging Safety in the Home Assessment; Instrument to Assess the Risk of Falls and Adaptations to Prevent Falls at Home. Results: Of the 23 seniors, 13 were men; the mean age was 85; 10 widowers; 11 live alone; 12 cannot read or write; 17 have experienced falls, loss of balance being the main cause. They report changes in vision (21), hearing (14) and rheumatic diseases (14); hypertension (19); they use 4 or more drugs on a daily basis (16). Conclusion: The physiological changes associated with ageing may increase the risk of falls. Due to the consequences, it is a priority field in community intervention.

Increased physical activity and fitness above the 50th percentile prevents the institutionalization of elderly people: a cross-sectional pilot study.

Introduction Institutionalization in a nursing home restricts autonomy, most notably free will, free choice, and free action. Decreased physical activity and fitness are predictive of disability and dependence (Rikli & Jones, 2013; Tak, Kuiper, Chorus, & Hopman-Rock, 2014); however little is known about the impact of these factors on institutionalization. Thus, this study aimed to analyze the impact of physical activity and fitness and on the risk of elderly people without cognitive impairment become institutionalized. Methods This cross-sectional study involved 195 non-institutionalized (80.14.4yrs) and 186 institutionalized (83.85.2yrs) participants. Cognitive impairment was assessed using Mini-Mental State Examination, physical activity was assessed using the International Physical Activity Questionnaire, and measures of physical fitness were determined by the Senior Fitness Test. Results: Multivariate binary logistic analysis selected 4 main predictors of institutionalization in both genders. The likelihood of becoming institutionalized increased by +18.6% for each additional year of age, while it decreased by -24.8% by each fewer kg/m2 in BMI, by -0.9% for each additional meter performed in the aerobic endurance test and by -2.0% for each additional 100MET-min/wk of physical activity expenditure (p<0.05). Values ≤50th percentile (age ≥81yrs, BMI≥26.7kg/m2, aerobic endurance ≤367.6m, and physical activity ≤693MET-min/wk) were computed using Receiver Operating Characteristics analysis as cut-offs discriminating institutionalized from non-institutionalized elderly people. Conclusion The performance of physical activity, allied to an improvement in physical fitness (mainly BMI and aerobic endurance) may prevent the institutionalization of elderly people without cognitive impairment only if they are above the 50th percentile; the following is highly recommend: expending ≥693MET-min/wk on physical activity, being ≤26.7kg/m2 on BMI, and being able to walk ≥367.6m in the aerobic endurance test, especially above the age of 80 years. The discovery of this trigger justifies the development of physical activity programs targeting the pointed cut-offs in old, and very old people. References Rikli, R., & Jones, C. (2013). Development and validation of criterion-referenced clinically relevant fitness standards for maintaining physical independence in later years. Gerontologist, 53, 255-267. Tak, E., Kuiper, R., Chorus, A., & Hopman-Rock, M. (2014). Prevention of onset and progression of basic ADL disability by physical activity in community dwelling older adults: a meta-analysis. Ageing Res Rev, 12, 329-338.

Prevention of falls in the elderly in the home: promoting active ageing

To determine the frequency of falls and identify risk factors in the homes of the elderly under the Home Care Service of a village in Alentejo (Portugal). Method: Exploratory, descriptive study. The target group were elderly persons under the Home Care Service (23). The questionnaire consists of open and closed questions, and was based on the Jefferson Area Board for Aging Safety in the Home Assessment; Instrument to Assess the Risk of Falls and Adaptations to Prevent Falls at Home. Results: Of the 23 seniors, 13 were men; the mean age was 85; 10 widowers; 11 live alone; 12 cannot read or write; 17 have experienced falls, loss of balance being the main cause. They report changes in vision (21), hearing (14) and rheumatic diseases (14); hypertension (19); they use 4 or more drugs on a daily basis (16). Conclusion: The physiological changes associated with ageing may increase the risk of falls. Due to the consequences, it is a priority field in community intervention.

The daily life of informal caregivers of elderly

Objectives: To identify the reasons why the informal caregivers to take care of the elderly; to identify enjoyed support and the problems/needs senses. Methods: A descriptive, exploratory and cross study. The sample was 366 informal caregivers of the elderly residents in the District of Évora (Alentejo). Applied a questionnaire, which identified the reasons that led to cohabitation, the difficulties experienced by caregivers, experienced changes in their health and support they receive. Results: Most caregivers are women, with a mean age of 54 years. The main reason of care was elderly disease. These caregivers have changed in relaxation and leisure activities, on the organization of day-to-day and on economic aspects. They receive support from health institutions, social security and firemen’s. Conclusions: Family is the support in the disease, despite the difficulties, particularly in relaxation and leisure activities, organization of day-to-day and economic matters. They requested support in healthcare, transportation and economic aid.

The Decent Work Questionnaire (DWQ): Development and validation in two samples of knowledge workers

This research aimed to develop a questionnaire measure of workers’ perceptions of decent work. The initial pool of 72 items covered the substantive elements used by the International Labour Organization to characterize decent work. It was administered to workers from Portugal (N = 636) and Brazil (N = 1039) and submitted to exploratory and confirmatory factor analysis. The final 31-item version yields seven factor scores in addition to the global decent work score. With good reliability, convergent and discriminant validity indices, the DWQ could open new avenues for empirical studies of the decent work concept.

Health Problems of Institutionalized Elderly

Introduction: human aging is marked by a decrease in the performance of some daily tasks, some even considered banal and imperceptibly when this limitation is followed by chronic diseases, the elderly becomes a source of concern for the family. Objective: identifying the health problems of the elderly living in long-stay institutions from self-reported diseases. This is a descriptive and quantitative study, conducted in northeastern Brazil capital, involving 138 elderly. For data collection we used a questionnaire containing demographic variables, institutional and related to self-reported health problems. Data were evaluated using bivariate analysis and association chi-square. Results: predominance of women was found (61.6%), aged 60-69 years old (39.1%), coming from the state capital (51.4%), and institutional permanence time between 1-5 years (77.5%). The most frequent diseases were related to the cardiovascular system (15.9%) and endocrine, nutritional and metabolic diseases (9.4%). It showed a significant association between self-reported diseases and the age of the elderly (p=0.047). Conclusion: it is expected to raise awareness among health professionals to provide a better assistance to the institutionalized elderly focusing on the real needs of these persons.

THE TEACHING ABOUT THE CARE OF THE ELDERLY IN NURSING TRAINING: THE SITUATION IN PORTUGAL

This paper aims to look at the teaching situation of the nursing undergraduate degree’s courses about eldercare in Portugal. A documentary research on the teaching programs in 39 nursing schools, 26 schools presented syllabus units related to the topic ‘eldercare’ and in eight of these schools the contents of the units were identified. Using textual analysis and from the categories we concluded that the teaching regarding eldercare for the nurse training in Portugal is focused on hospital care; it is directed to the adult/elderly/family; it explores the definitions related to the aging process; it explores community issues, legislation and research. People responsible for the design/monitoring of teaching programs should include teaching regarding eldercare in the nurse training, considering that the elder population is increasing in Portugal.

Medication regimen complexity in institutionalized elderly people in an aging society

Background Complex medication regimens may adversely affect compliance and treatment outcomes. Complexity can be assessed with the medication regimen complexity index (MRCI), which has proved to be a valid, reliable tool, with potential uses in both practice and research. Objective To use the MRCI to assess medication regimen complexity in institutionalized elderly people. Setting Five nursing homes in mainland Portugal. Methods A descriptive, cross-sectional study of institutionalized elderly people (n = 415) was performed from March to June 2009, including all inpatients aged 65 and over taking at least one medication per day. Main outcome measure Medication regimen complexity index. Results The mean age of the sample was 83.9 years (±6.6 years), and 60.2 % were women. The elderly patients were taking a large number of drugs, with 76.6 % taking more than five medications per day. The average medication regimen complexity was 18.2 (±SD = 9.6), and was higher in the females (p < 0.001). The most decisive factors contributing to the complexity were the number of drugs and dosage frequency. In regimens with the same number of medications, schedule was the most relevant factor in the final score (r = 0.922), followed by pharmaceutical forms (r = 0.768) and additional instructions (r = 0.742). Conclusion Medication regimen complexity proved to be high. There is certainly potential for the pharmacist’s intervention to reduce it as part as the medication review routine in all the patients.

Actividade física e autonomia instrumental das pessoas idosas

Pretende-se perceber se existe uma relação entre o nível regular de actividade física praticado pelas pessoas idosas e a sua autonomia instrumental. Desenvolveu-se um estudo descritivo, correlacional e transversal, no ano 2010, com amostra intencional constituída por 100 indivíduos com idade igual ou superior a 60 anos, de ambos sexos. A colheita de dados foi efectuada em dois ginásios e dois centros de dia localizados na cidade de Lisboa, e foram utilizados como instrumentos a Escala de Actividades Instrumentais de Vida Diária de Lawton e Brody e o International Physical Activity Questionnaire. Obteve-se uma média de idades de 76 anos, sendo 78% dos inquiridos do sexo feminino. Inseriram-se 30% na categoria de actividade física “ligeira”, 45% na “moderada” e 25% na “vigorosa”. Relativamente à autonomia instrumental, a maioria era moderadamente dependente. Verificou-se que o grau de autonomia instrumental dos idosos aumenta com o incremento da actividade física praticada (ρS=0.815; p-value<0.001); Abstract: This work seeks to realize if there is a relationship between the level of regular physical activity practiced by elderly persons and its instrumental autonomy. A descriptive, related and transversal study was developed in the year 2010, with an intentional sample consisting of 100 individuals, aged 60 years or above, of both genders. The data collection was carried out in two gymnasiums and two day care centers located in the city of Lisbon, and were used the Lawton and Brody’s Instrumental Activities of Daily Living Scale and the International Physical Activity Questionnaire. A mean age of 76 years was obtained and 78% of the respondents were female. 30% were classified as having a "low" physical activity level, 45% as "moderate" and 25% as "high". Regarding instrumental autonomy, most were moderately dependent. It was verified that the degree of instrumental autonomy of the elderly increases with increased physical activity (ρS=0.815; p-value<0.001).

A violência contra idosos e suas representações sociais

O trabalho de investigação documentado nesta dissertação insere-se no estudo das representações sociais da violência contra idosos. Para tanto, recorreu-se à Teoria das Representações Sociais de Serge Moscovici com o objetivo de conhecer as representações acerca da violência contra o idoso, identificando as perspectivas distintas de três grupos participantes de dois países, Portugal e EUA Realizou-se um estudo qualitativo do tipo descritivo, explorando as representações sociais acerca da violência contra idosos mas, também, de carácter comparativo já que oferece a perspectivas de três grupos distintos. Buscou-se saber dos pensamentos acerca da violência sobre o idoso nas perspectivas do próprio idoso, de famílias de idosos e profissionais da área de saúde que prestam assistência à pessoas idosas. O estudo propiciou uma discussão do fenômeno como comportamento social refletindo sobre questões epidemiológicas e psico-sociais que o caracterizam como um dos mais graves na esfera da saúde pública. As questões sócio-demográficas foram processadas através do programa estatístico SPSS e, a produção discursiva das 240 entrevistas, analisada através dos programas estatísticos ALCESTE e, IRAMUTEQ.Apesar das diferenças socio-culturais, os participantes construíram representações sociais da violência contra idosos similares, associadas à identidade social do idoso que os coloca como vítima iminente de violência. As divergências encontram-se nas expectativas de intervenção e prevenção do fenômeno; Violence against the elderly and its social representation Abstract: The research documented in this dissertation is part of a study about elderly violence, considered to be one of the most serious issues in the sphere of public health and examined here through the lens of the Theory of Social Representations. The main objective is to know the perspectives of the elderly, families and health professionals from two countries: Portugal and United States of America, on the subject of elderly violence. Using a qualitative design, this study applied both, descriptive and comparative methods interviewing 240 individuals. The demographic data were analyzed through SPSS and the lexical analysis which were performed by two software programs, ALCESTE and IRAMUTEQ. The social representations of elderly violence had similarities associating violence to the social identity of the elderly as an eventual victim despite cultural differences. Variations are identified in the expectations regarding strategies of intervention and prevention of the phenomena.

Maus-tratos entre iguais e percepção de suporte social: um estudo com alunos dos 2º e 3º ciclos do ensino básico

O bullying e o suporte social, apesar de conceptualmente distintos, interagem entre si. O bullying é um subgrupo do comportamento agressivo, que ocorre intencional e repetidamente, numa relação assimétrica de poder entre pares. O suporte social envolve o apoio recebido pelas fontes de suporte da rede social. O principal objetivo deste estudo é analisar a relação entre bullying e perceção de suporte social. O mesmo realizou-se numa escola básica de Évora, com 335 alunos dos 2° e 3° ciclos do ensino básico, sendo utilizados o Questionário de Violência Escolar e Isolamento Social e o Questionário de Percepção de Suporte Social. Os resultados obtidos indicam baixos níveis de incidência de comportamentos de bullying. Verificou-se que uma fraca perceção de suporte social associa-se a um maior envolvimento no bullying, o que aponta para a perceção de suporte social como um fator protetor para o envolvimento em situações de vitimação e de agressão; ABSTRACT: Bullying and social support, although conceptually distinct, interact between itself. Bullying is a sub-group of the aggressive behavior that occurs repeatedly and intentionally, in an asymmetrical power relationship between peers. Social Support involves the support received by the sources of social support networks. The aim of this study is to analise the relationship between bullying and perceived social support. The aim was done in a basic school of Évora, with 335 students of 2nd and 3th cycles of basic education. The used questionnaires had been the Questionnaire for School Violence and Social isolation and the Questionnaire for Perceived Social Support. The results indicate low levels of incidence of bullying behavior. lt was found that a low perception of social support is associated with an increased involvement in bullying, which points to the social support as a protective for involvement in situations of victimization and agression.

Comportamentos de agressão e vitimação em contexto escolar e a percepção de suporte social: um estudo com alunos do 3º e 4º anos de escolaridade

O bullying descreve-se como um abuso sistemático de poder entre pares, de carácter intencional e repetitivo. O suporte social descreve comportamentos que funcionam como um reforço na rede social. A existência de suporte social parece ser um factor protector para o envolvimento em situações de vitimação e agressão. O objectivo deste estudo é compreender a relação entre o bullying e a percepção de suporte social. Realizou-se em quatro escolas do Agrupamento de Escolas nº1 de Évora, com alunos do 3º e 4ºanos de escolaridade (262 alunos). Utilizaram-se dois questionários: o QVEIS – Questionário de Violência Escolar e Isolamento Social e o QPSP – Questionário de Percepção de Suporte Social. Os resultados deste estudo não se revelaram conclusivos, sendo reduzida a prevalência de comportamentos de vitimação e agressão. Existem correlações estatisticamente significativas entre as dimensões da vitimação e da agressão e a percepção de existência de suporte social e, a vitimação e a percepção de ausência de suporte social; ABSTRACT: Bullying is described as a systematic abuse of power among peers, intentional and repetitive. Social support describes behaviors that act as reinforcement in a social network. The existence of social support seems to be a protective factor for involvement in situations of victimization and aggression. The aim of this study is to understand the relationship between bullying and perceived social support. It was conducted in four elementary schools, with students from 3rd and 4th grade (262 students). We used two questionnaires: QVEIS – Questionnaire for School Violence and Social Isolation and QPSP - Questionnaire for Perceived Social Support. The results were inconclusive, with a fair prevalence of risk of victimization and aggression. There are statistically significant correlations between the dimensions of victimization and aggression and the perception of the existence of social support and the perception of victimization and lack of social support.