Improvement of Older Women's Sexuality Through Emancipatory Education

The purpose of this action research (AR) was to explore the ways in which sexuality is experienced daily and to improve the expression of older women's sexuality. The pedagogy of autonomy as proposed by the Brazilian educator Paulo Freire theoretically supported this AR, with the participation of six older adult women living in a rural setting in southwest Brazil. The older women's experiences regarding sexuality, their concerns, and their educational demands could be summarized through five phrases: the improvement of self-esteem as a way to promote sexuality; sexuality impaired by loneliness and lack of affection; men's sexual satisfaction seen as a woman's obligation; women's sexuality controlled by the society; and relinquishment of the companion to attend to the expectations of family members. Dialogical and participative educational approaches and continuous observation-participation strategies were performed to support the women's care and educational requirements.

Loss of interest, depressed mood and impact on the quality of life: Cross-sectional survey

Abstract Background Depressive symptoms and chronic disease have adverse effects on patients' health-related quality of life (H-RQOL). However, little is known about this effect on H-RQOL when only the two core depressive symptoms - loss of interest and depressed mood - are considered. The objective of this study is to investigate H-RQOL in the presence of loss of interest and depressed mood at a general medical outpatient unit. Methods We evaluated 553 patients at their first attendance at a general medical outpatient unit of a teaching hospital. H-RQOL was assessed with the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36). Depressed mood and loss of interest were assessed by the Primary Care Evaluation of Mental Disorders (PRIME-MD)-Patient Questionnaire. A physician performed the diagnosis of chronic diseases by clinical judgment and classified them in 13 possible pre-defined categories. We used multiple linear regression to investigate associations between each domain of H-RQOL and our two core depression symptoms. The presence of chronic diseases and demographic variables were included in the models as covariates. Results Among the 553 patients, 70.5% were women with a mean age of 41.0 years (range 18-85, SD ± 15.4). Loss of interest was reported by 54.6%, and depressed mood by 59.7% of the patients. At least one chronic disease was diagnosed in 59.5% of patients; cardiovascular disease was the most prevalent, affecting 20.6% of our patients. Loss of interest and depressed mood was significantly associated with decreased scores in all domains of H-RQOL after adjustment for possible confounders. The presence of any chronic disease was associated with a decrease in the domain of vitality. The analysis of each individual chronic disease category revealed that no category was associated with a decrease in more than one domain of H-RQOL. Conclusion Loss of interest and depressed mood were associated with significant decreases in H-RQOL. We recommend these simple tests for screening in general practice.