Prevalência e fatores associados à alteração vocal em idosos institucionalizados com capacidade cognitiva preservada

Voice disorders (VD) in the elderly can interfere negatively in communication, emotional well-being and quality of life, conditions that correspond to greater exposure to illness and social isolation bringing consequent economic impact for the health system. It is assumed that institutionalized confinement, weakness and morbidity associated to nursing home (NH) contribute to transform VD an especially prevalent condition in institutionalized elderly, including those without cognitive impairment. Thus, the aim of this study was to determine the prevalence and associated factors of VD in NH elderly residents without cognitive impairment. There is no epidemiological diagnostic instruments of VD for elderly populations, so the first step of this study was dedicated to prepare and analyze the psychometric properties of a short, inexpensive and easy to use questionnaire named Screening for Voice Disorders in Older Adults (Rastreamento de Alterações Vocais em Idosos—RAVI). The methodological procedures of this step followed the guidelines of the Standards for Educational and Psychological Testing and contemplated validity evidence based on test content, based on response processes, based on internal structure and based on relations with other variables, as well as reliability analysis and clinical consistency. The result of the validation process showed that the RAVI final score generate valid and reliable interpretations for the epidemiological diagnosis of VD in the elderly, which endorsed the use of the questionnaire in the second stage of the study, performed in ten NH located in the city of Natal, Rio Grande do Norte. At this stage, data from socioeconomic and demographic variables, lifestyle, general health conditions and characterization of the institution were collected. It was performed a bivariate analysis and it was calculated the prevalence ratio as a magnitude association measure, with a confidence interval of 95%. The variables with p-value less than 0.20 were included in the multiple logistic regression model that followed the Forward selection method. The odds ratio found in the multivariate model was converted into prevalence ratio and the level of significance was 5%. The sample consisted of 117 subjects with predominance of females and average of 79.68 (± 7.92) years old. The prevalence of VD was 39.3% (95% CI: 30.4-48.1%). The multivariate model showed statistically significant association between VD and depressive symptoms, smoking for a year or more and selfreported hearing loss. In conclusion, VD is a prevalent health condition in NH elderly residents without cognitive impairment and is associated with factors involving psychosocial, lifestyle and communicative disability that require attention of managers and professionals involved with NH environment. Strategies to encourage communication and social integration, actions to combat smoking and minimizing the effects of hearing loss could stimulate the physical well-being, emotional and mental health of institutionalized elderly population, contributing to the vocal and communicative maintenance, a more effective social inclusion and better overall health condition.

Aprendizagem criativa na aula de piano em grupo

The central focus of this thesis was to investigate creative learning in music at piano group lessons. Thus, the theoretical framework adopted was guided by two main principles: (1) creativity in the field of music education and (2) Piano teaching and learning. As a methodological procedure we used a research-action with students of the disciplines Prática de Instrumento Harmônico I e II, at the Music Education Undergraduate Course of Federal University of Rio Grande do Norte (UFRN). This research-action was structured in four phases: 1) the identification of the starting points and the theme of creativity matters in piano group lessons, considering the context of a teacher training course in music; 2) the projection of actions, the definition of the objectives and the organization of instruments of data collection and analysis; 3) the realization of the planned actions; and 4) the evaluation of the results, the transcription, organization and analysis of the data collected through observation and interviews. Given the Creative Learning Cycle in Music, represented by the activities of composing, performing and criticizing Music, defended by Beineke (2009, 2013, 2015), we propose in this thesis a creative cycle of formation in music to promote creative learning in piano group lessons, in which teachers and students teach and learn creatively, expanding training opportunities in the field of Music Education. This was possible due to the joint experience of creative practices related to improvisation, elaboration of arrangements and musical compositions - elements that contributed positively to the learning process of the participants. But for this to occur, the planning, implementation and evaluation of the creative and pedagogical musical procedures adopted were decisive, considering the perspectives of students, their conceptions, musical creations, processes and collaborative exchange.

Aprendizagem criativa na aula de piano em grupo

The central focus of this thesis was to investigate creative learning in music at piano group lessons. Thus, the theoretical framework adopted was guided by two main principles: (1) creativity in the field of music education and (2) Piano teaching and learning. As a methodological procedure we used a research-action with students of the disciplines Prática de Instrumento Harmônico I e II, at the Music Education Undergraduate Course of Federal University of Rio Grande do Norte (UFRN). This research-action was structured in four phases: 1) the identification of the starting points and the theme of creativity matters in piano group lessons, considering the context of a teacher training course in music; 2) the projection of actions, the definition of the objectives and the organization of instruments of data collection and analysis; 3) the realization of the planned actions; and 4) the evaluation of the results, the transcription, organization and analysis of the data collected through observation and interviews. Given the Creative Learning Cycle in Music, represented by the activities of composing, performing and criticizing Music, defended by Beineke (2009, 2013, 2015), we propose in this thesis a creative cycle of formation in music to promote creative learning in piano group lessons, in which teachers and students teach and learn creatively, expanding training opportunities in the field of Music Education. This was possible due to the joint experience of creative practices related to improvisation, elaboration of arrangements and musical compositions - elements that contributed positively to the learning process of the participants. But for this to occur, the planning, implementation and evaluation of the creative and pedagogical musical procedures adopted were decisive, considering the perspectives of students, their conceptions, musical creations, processes and collaborative exchange.