RESUMO

The ageing in place (AIP) model enjoys widespread recognition in gerontology and has been strongly encouraged through social policy. However, progress remains to be made in terms of analysing AIP for minority groups and groups with diverse life pathways in old age. This systematic review aims to identify studies that address the AIP model in indigenous communities, answering the following questions: In which geographical contexts and for which Indigenous Peoples have AIP been researched? Which physical dimensions are considered in the assessment of AIP? Which social dimensions are considered in the assessment of AIP? This systematic review applied the SALSA (Search, Appraisal, Synthesis and Analysis) method to AIP among Indigenous older adults on the Web of Science, PsycINFO, MEDLINE and Scopus digital platforms for publications from 2011 to 2021. We identified 12 studies conducted in five countries in North and South America and Oceania. The results show that the following elements of the physical environment are assessed: household, neighbourhood, local surroundings or reserve and native territories. Meanwhile, assessed elements of the social environment are as follows: personal characteristics, attachment to place, social networks, social participation and social policies. There is discussion of the need to develop AIP in order to promote successful ageing among Indigenous older adults.

RESUMO

This study examined the incidence of loneliness among Chilean indigenous older adult women (106 Aymara and 180 Mapuche) and how family, community and socio-cultural integration are associated with lower levels of loneliness. A cross-sectional study involving 800 older adults living in a rural context in Chile, of whom 35.8% were indigenous women. The De Jong Gierveld Loneliness Scale (DJGLS-6) were used to assess loneliness and a questionnaire about the maintenance of certain indigenous cultural practices was created. The descriptive findings indicate more loneliness among Mapuche women. Moreover, hierarchical regression models confirmed that women who did not live alone, who participated in social groups and who maintained cultural practices reported lower levels of loneliness, with notable transmission of indigenous knowledge to their children. While, taking part in the indigenous New Year, leading or organizing a ceremony and receiving attention with a health cultural agent were associated with more loneliness. These seemingly contradictory findings are discussed and may be explained by religious changes in indigenous communities; however, this study would confirm that social integration in different dimensions is a protective factor against loneliness.

Assuntos

RESUMO

(1) Background: loneliness is a problem that becomes increasingly acute in old age, with greater repercussions among socially disadvantaged groups such as indigenous and Afro-descendant older adults. The aim of this research is to analyze the psychosocial variables related to loneliness in old age. (2) Methods: a multi-ethnic sample was involved, with the participation of eight indigenous peoples and Afro-descendant tribal people (n = 1.348). Various gerontological scales previously validated among the Chilean population (De Jong Gierveld Loneliness Scale, Brief Resilient Coping Scale, Health Problems Questionnaire, and Family APGAR questionnaire) and a model are contrasted, establishing the relationship between psychosocial variables and loneliness. (3) Results: Structural equation modeling (SEM) showed the existence of indirect relationships between health problems, via family functioning and resilience, and loneliness. Resilience and family functioning were directly related to loneliness (WLSMV-χ2 (df = 345) = 875.106, p < 0.001; CFI = 0.992; TLI = 0.991; RMSEA = 0.034 [C.I. 90% = 0.031-0.037]). (4) Conclusions: loneliness has cross-culturally affected older Chilean people living in rural areas and it appears that the COVID-19 pandemic has had a negative effect on well-being. This study proves that loneliness is related to several psychosocial variables that can be intervened.

Assuntos

RESUMO

Chile recientemente ha reconocido al pueblo tribal afrodescendiente, se trata de un colectivo poco estudiado y con severas desventajas sociales y sanitarias. Este estudio tiene como objetivo describir el perfil de salud y el acceso a servicios sanitarios, junto con analizar la asociación entre las variables sociodemográficas, de salud y los síntomas depresivos en personas mayores afrodescendientes. Estudio piloto que contó con la participación de 60 personas mayores afrodescendientes, se aplicaron diversas escalas de valoración geriátrica. Los antecedentes de salud indicarían que el 78% es hipertenso, 57% tiene síntomas depresivos, el 30% es independiente en actividades de la vida diaria (AVD), y un 61% tiene riesgo leve de caídas. Respecto al acceso a salud: 84% está inscrito en un centro de salud, el 68% es beneficiario del programa de salud cardiovascular y un 71% está al día con la vacuna preventiva de la influenza. Las variables predictivas de depresión son ser beneficiario del programa de alimentación complementaria y la dependencia en AVD. Este estudio ratifica la relevancia de la inclusión de patologías específicas concorde al perfil epidemiológico de los grupos étnicos-raciales y seguir avanzando en estudios sanitarios específicos en minorías étnicas.

Chile has recently recognized the Afrodescendant tribal people, a little studied group with severe social and health disadvantages. This study aims to describe the health profile and access to health services, and to analyze the association between sociodemographic and health variables and depressive symptoms in older people of African descent. Pilot study with the participation of 60 elderly people of African descent, with the application of several geriatric assessment scales. Health history indicated that 78% are hypertensive, 57% have depressive symptoms, 59% are independent in activities of daily living (ADL), and 61% have a slight risk of falling. Regarding access to health care: 84% are enrolled in a health center, 68% are beneficiaries of the cardiovascular health program and 71% are up to date with the preventive influenza vaccine. The variables predictive of depression are being a beneficiary of the complementary feeding program and dependence in ADLs. Conclusion: This study ratifies the relevance of including specific pathologies according to the epidemiological profile of ethnic-racial groups and to continue advancing in specific health studies in ethnic minorities.

Assuntos

RESUMO

OBJECTIVE: To analyse the psychometric properties of the De Jong Gierveld Loneliness Scale, 6-item version (DJGLS-6), in a multiethnic sample of older Chilean adults. METHODS: A cross-sectional study was designed using a sample of 800 older people, and 71% were self-declared indigenous. Data quality and acceptability, internal consistency, and construct and structural validity of DJGLS-6 were analysed. The scale was also analysed according to the Rasch model. RESULTS: The DJGLS-6 scored higher for the non-indigenous group than for Aymara and Mapuche (P < .001). KR-20 coefficients (internal consistency) for emotional loneliness subscale reached 0.44 for Aymara and Mapuche and 0.62 for non-indigenous, and from 0.73 (non-indigenous) to 0.86 (Aymara) for social loneliness subscale. The confirmatory factor analysis identified one dimension. None of the two subscales fit the Rasch model. CONCLUSION: The results indicate that DJGLS-6 is a reliable and adequate scale for non-indigenous Chilean older people. However, it should be culturally adapted to indigenous ethnic minorities.

Assuntos

RESUMO

Objectives: To compare differences in depression, loneliness and personal well-being in a sample made up of indigenous (Aymara and Mapuche) and non-indigenous older people resident in original rural territories. Methods: A cross-sectional study involving 800 older adults living in a rural context in Chile, of whom 201 were Aymara, 368 Mapuche and 231 non-indigenous. Validated instruments were included for depression, loneliness and personal well-being (outcome variables). Ordinary least squares regression analyses were performed. Results: Membership of an indigenous group was significantly associated with lower scores for depression and loneliness and higher scores for personal well-being. The interactions of severe deprivation and housing deprivation with indigenous group membership were significantly associated with lower loneliness scores and higher personal well-being scores for Aymara and Mapuche participants. Discussion: Native rural settings and territories may offer a degree of protection to indigenous peoples. Cultural continuity enhanced by rural areas would produce a culturally constructed resilience against deprivation.

Assuntos

RESUMO

RESUMEN Objetivo: Analizar las diferencias entre hombres y mujeres en los diversos dominios de la calidad de vida (CdV) en personas mayores que residen en zonas rurales del extremo norte de Chile. Material y Método: Estudio cuantitativo, descriptivo, transversal realizado entre noviembre 2019 y febrero 2020 en diversas zonas rurales de la Región de Arica y Parinacota. Contó con un universo de 100 personas mayores de 60 años y sin deterioro cognitivo. Se aplicó el Cuestionario Breve de Calidad de Vida (CUBRECAVI). La investigación fue aprobada por la Escuela de Trabajo Social de la Universidad de Tarapacá. Resultados: 69% mujeres, 63% entre 60 y 69 años, 67% casado o en pareja y 58% indígena. Se confirman diferencias estadísticamente significativas en el dominio salud objetiva: tobillos hinchados, cansancio, dificultad para dormir, escape de orina y hormigueos; en el dominio salud psíquica: llorar con facilidad, sentimientos depresivos y problemas de memoria. Lo mismo se observa en integración social, en el nivel de satisfacción con la relación del cónyuge o pareja, con los familiares y con las amistades. Igualmente los hallazgos confirman diferencias en el dominio actividades, nivel de actividades, frecuencia camina y frecuencia hace manualidades. Por último, en el dominio calidad ambiental, en la satisfacción con la temperatura del hogar. Los resultados indican que las mujeres tienen peor CdV y las personas mayores perciben que el dominio salud es el más importante para valorar su CdV. Conclusión: Se confirma riesgo biopsicosocial para mujeres mayores que residen en zonas rurales del extremo norte de Chile. Enfermería y otras disciplinas de trato directo con las personas mayores deben conocer las distintas maneras de envejecer, diferenciando por sexo y especificidades del entorno rural.

ABSTRACT Objective: To analyze the differences between men and women in the different domains of quality of life (QoL) among elderly people living in rural areas of the north of Chile. Material and Method: Quantitative, descriptive, cross-sectional study conducted between November 2019 and February 2020 in various rural areas of the Region of Arica and Parinacota. The sample consisted of 100 people over 60 years old and without cognitive impairment. The Brief Quality of Life Questionnaire (CUBRECAVI) was applied. The research was approved by the School of Social Work of the Universidad de Tarapacá. Results: 69% were women, 63% were between 60 and 69 years old, 67% were married or had a relationship and 58% had indigenous origin. Statistically significant differences were confirmed in the objective health domain: swollen ankles, tiredness, sleep problems, urinary incontinence and tingling; in the psychic health domain: crying easily, depressive feelings and memory problems. This was similar in the field of social integration, in the level of satisfaction concerning the relationship with the spouse or partner, with family members and with friends. Moreover, the findings corroborate differences in the domain of activities, level of activities, frequency of walking and frequency of doing crafts. Finally, in the environmental quality domain, there are differences in satisfaction with room temperature. The results show that women have worse QoL and the elderly perceive that the health domain is the most important when assessing their QoL. Conclusion: There is a biopsychosocial risk for older women living in rural areas in the north of Chile. It is clear that nursing and other areas dealing directly with the elderly have to familiar with the different ways of aging, taking into account gender and specific rural setting.

RESUMO Objetivo: Analisar as diferenças entre homens e mulheres nos diversos domínios da qualidade de vida (QV) em idosos residentes em áreas rurais do norte do Chile. Material e Método: Estudo quantitativo, descritivo, transversal realizado entre novembro de 2019 e fevereiro de 2020 em diversas áreas rurais da Região de Arica e Parinacota. A amostra consistiu em 100 pessoas com mais de 60 anos e sem déficit cognitivo. Foi aplicado o Questionário Breve de Qualidade de Vida (CUBRECAVI). A pesquisa foi aprovada pela Escola de Serviço Social da Universidade de Tarapacá. Resultados: 69% eran mulheres, 63% tinham entre 60 e 69 anos, 67% estavam casadas ou tinham um relacionamento e 58% tinham origem indígena. Foram confirmadas diferenças estatisticamente significativas no dominio da saúde objetiva: tornozelos inchados, fadiga, dificuldade para dormir, perda de urina e formigamento; no domínio da saúde psíquica: choro com facilidade, sentimentos depressivos e problemas de memória. O mesmo foi observado na integração social, no nível de satisfação na relação com o cônjuge ou companheiro, com os familiares e com os amigos. Da mesma forma, os achados confirmam diferenças no domínio das atividades, nível de atividades, frequência de caminhadas e frequência de artesanato. Finalmente, no domínio da qualidade ambiental há diferenças no grau de satisfação com a temperatura da casa. Os resultados indicam que as mulheres apresentam pior QV e os idosos percebem que o domínio saúde é o mais importante para avaliar sua QV. Conclusão: O risco biopsicossocial é confirmado para mulheres idosas residentes em áreas rurais do extremo norte do Chile. A enfermagem e as demais disciplinas que lidam diretamente com o idoso devem conhecer as diferentes formas de envelhecer, diferenciando entre os sexos e as especificidades do meio rural.

RESUMO

BACKGROUND: There has been scant research published regarding the assessment of depression in ethnic groups, and few studies have addressed the validation of scales for standardized assessment of depressive symptoms among indigenous minorities. OBJECTIVE: The aim of this study was to analyze the psychometric properties of the 15-item Geriatric Depression Scale (GDS-15) for a multi-ethnic sample of older Chilean adults. METHODS: Cross-sectional study with a sample of 800 older people, 71% of whom were self-declared indigenous (Aymara/Mapuche). RESULTS: The non-indigenous group had a higher total GDS-15 score and lower quality of life and wellbeing scores than the indigenous groups (p < 0.001). The GDS-15 had a KR-20 coefficient of 0.90 for the non-indigenous group, 0.80 for Aymara, and 0.85 for Mapuche. The homogeneity index was 0.38 for non-indigenous, 0.24 for Aymara, and 0.29 for Mapuche. DISCUSSION: The GDS-15 showed satisfactory psychometric characteristics for the samples studied. However, the better results observed for the non-indigenous group suggest that some characteristics and content of the rating scale are not fully appropriate for the indigenous older population. CONCLUSIONS: There is a need to develop the transcultural validation of scales such as GDS-15, which are applied in a standardized manner in geriatric evaluations as part of primary healthcare.

RESUMO

Abstract Background: There has been scant research published regarding the assessment of depression in ethnic groups, and few studies have addressed the validation of scales for standardized assessment of depressive symptoms among indigenous minorities. Objective: The aim of this study was to analyze the psychometric properties of the 15-item Geriatric Depression Scale (GDS-15) for a multi-ethnic sample of older Chilean adults.Methods: Cross-sectional study with a sample of 800 older people, 71% of whom were self-declared indigenous (Aymara/Mapuche).Results: The non-indigenous group had a higher total GDS-15 score and lower quality of life and wellbeing scores than the indigenous groups (p< 0.001). The GDS-15 had a KR-20 coefficient of 0.90 for the non-indigenous group, 0.80 for Aymara, and 0.85 for Mapuche. The homogeneity index was 0.38 for non-indigenous, 0.24 for Aymara, and 0.29 for Mapuche.Discussion: The GDS-15 showed satisfactory psychometric characteristics for the samples studied. However, the better results observed for the non-indigenous group suggest that some characteristics and content of the rating scale are not fully appropriate for the indigenous older population. Conclusions:There is a need to develop the transcultural validation of scales such as GDS-15, which are applied in a standardized manner in geriatric evaluations as part of primary healthcare.

Assuntos

Assuntos

RESUMO

Family and community social networks act as social resources that promote well-being at advanced ages. In this study, we analyze the association between social support received from personal social networks (social support from various family members and friends) and community social networks (social support from neighbors and the neighborhood, age, ethnic, or religious group peers and formal social support networks) and quality of life (QoL) for a sample of older Chilean persons (n = 777). The results confirm that social support from family (partner, children, and extended family) and friends, integration in the community (neighbors) and social support from informal systems (social groups) are associated with QoL. Moreover, the model including both types of support explains 25.8% of variance in QoL. The results and their possible implications are discussed.

Assuntos

RESUMO

Recent evidence regarding the relationship between social support and depression in elderly people shows the important role of ethnicity. This research describes the characteristics of social support in a sample of elderly people aged 60 and above living in northern Chile (n = 493), and analyzes the differences in the relationship between social support and depression between an indigenous group (Aymara population, n = 147) and a nonindigenous group (white, Caucasian, mestizo, n = 346). Various dimensions of social support were considered: structural elements, functional social support according to source, and community participation. The results show the existence of significant differences in the characteristics and dimensions of social support depending on sex, ethnicity, and marital status. Further, the central role of the family group is observed for both Aymara and nonindigenous elderly people. The hierarchical regression models obtained result in notable differences in the role of the structural, functional, and community elements of support in explaining depression for the ethnic groups considered.

Assuntos