Anotações cronológicas sobre a trajetória do Serviço Social no sistema de saúde em Portugal

O presente artigo sistematiza em breves notas cronológicas alguns passos do caminho de alargamento e consolidação do espaço profissional do Serviço Social no sistema de saúde em Portugal. As anotações aqui apresentadas pretendem contribuir para organizar os principais marcos históricos e legislativos, do período que decorre entre 1924 e 2010, atravessando um percurso que centramos no Serviço Social em articulação com o contexto sociopolítico nacional e global em que se insere

Types of Personal Social Networks of Older Adults in Portugal

This study presents and discusses a three-dimensional typology for personal social networks of Portuguese older adults. We used a K-means cluster analysis of structural, functional and relational-contextual variables of the networks of 612 participants aged 65 + (M = 76 ± 7.6), mostly women (63%). Four types of networks emerged: family networks, friendship networks, neighbourhood networks and institutional networks. The most frequent are family networks (61.8%), constituted by 94.6% of family ties, on average, attesting the familistic nature of the older persons’ networks in Portugal, followed by friendship networks (23.5%) and neighbourhood networks (11.9%). The less frequent type is the institutional network (2.8%), dominated by formal ties (M = 59.3%). Sociographic profiles reveal that family networks are more likely to be held by middle-old focal subjects, married or widowed, and with children. Friendship and neighbourhood networks are held by young-old subjects with different marital status, many of them living alone, with a higher proportion of men with friendship networks. Institutional networks are held by old–old, widowed or single with no children. The presented typology contributes to understand social support needs and social isolation. The conclusions allow to anticipate social services’ demand trajectories and to propose intervention plans and social policy measures to promote the well-being of the older population

Redes de suporte social e (in)acesso a direitos em famílias monoparentais femininas

O estudo caracteriza as redes de suporte social e o (in)acesso a direitos de famílias monoparentais femininas em situação de vulnerabilidade social. A amostra de 29 mulheres beneficiárias de um banco de recursos da zona centro de Portugal, é constituída na maioria por mães divorciadas, com idades entre os 18 e os 61 anos, com baixos níveis de escolaridade e predominantemente desempregadas. Os resultados revelam desproteção familiar, sendo que a maioria não beneficia de direitos consagrados, experienciando privação material. As redes de suporte informal são pequenas e coesas, centradas nas relações familiares, verificando-se uma forte reciprocidade mas níveis moderados de apoio emocional e baixos de apoio material/instrumental e informativo, não representando um apoio compensatório da situação de vulnerabilidade social. Urgem políticas públicas que potenciem uma efetiva proteção social das mulheres e crianças desta configuração familiar e estratégias de intervenção emancipadoras que ultrapassem a iliteracia em direitos e favoreçam a cidadania.The study characterizes social support networks and the access to social rights of socially vulnerable female single-parent families. A sample of 29 women beneficiaries of a social service of central Portugal, consists mostly of divorced mothers, aged 18 to 61 years old, with low levels of education and predominantly unemployed. The results reveal family unprotected, who are not benefiting from recognized rights, experiencing material deprivation. The informal support networks are small and cohesive, focused on family relationships, with a strong reciprocity but moderate levels of emotional support and low material/instrumental and informative support, and does not represent a compensatory support of the vulnerability. Urge public policies that foster effective social protection of women and children in this family configuration and emancipatory intervention strategies beyond illiteracy on rights that promote citizenship

Anotações cronológicas sobre a trajetória do serviço social no sistema de saúde em Portugal

O presente artigo sistematiza em breves notas cronológicas alguns passos do caminho de alargamento e consolidação do espaço profissional do Serviço Social no sistema de saúde em Portugal. As anotações aqui apresentadas pretendem contribuir para organizar os principais marcos históricos e legislativos, do período que decorre entre 1924 e 2010, atravessando um percurso que centramos no Serviço Social em articulação com o contexto sociopolítico nacional e global em que se insere

Expectations associated with the informal care of older generations

The informal care between generations deal with the important challenge of reconciling family life with the demands of professional life, and reveals how important it is to acknowledge the expectations of adults facing the eventual need of caring of older generations, by understanding and analyzing the differences in phratries, comparing single sons/daughters and sons/daughters in phratries. This paper presents a prospective, transversal and quantitative study, using an inquiry to data collecting by indirect administration. The sample of this study is constituted by Portuguese adults aged between 25 and 65, no caregivers, having unless one of the parents alive. We had 186 participants with an average age of 32 years old, the majority of this inquires where women (88%), with high level education (91%). The results indicate that all pointed love and tenderness as the most important motive for caring. The only sons/daughters previously see an economic difficulty and ponder a major source for external resources in opposite to the members of phratries that prefer a strategy of exclusivity. The domestic routines, the leisure routines and productivity at work are the main problems in their lives that they imagine that could be affected. We understand that the option for caring can’t penalize families. To anticipate eventual difficulties during the live cycle, the families should be stimulated of thinking how to conciliate their lives with the eventual needs of informal caring for the oldest. Social Work should promote the responsibility that the public politics presented about this subject, such as for the definition, amplification of programs that give an effective response to the needs of the dependents, the caregivers and families

Políticas para la igualdad de género en Portugal: contribuciones a un marco para las mujeres mayores

The way people age is exceptionally heterogeneous, diverse and fraught with various asymmetries (Fernandez-Ballesteros, 1999). Empirical evidence confirms that the diversity and cultural complexity interfere in how individuals age, and recognises that there are differences in how men and women experience their ageing. This article analyses the five National Plans for the Promotion of Equality and Citizenship, implemented between 1997 and 2017. The objective is to assess policies to gender equality in the context of ageing and focusing on older women. The authors concluded that the older population is practically invisible in the documents analysed, with a higher prevalence of women. The documents show a homogenization of older people as a group, only making a distinction by gender. There are not considered identity categories of this population. Measures concerning the senior population are mainly focused on the economic dimension, in the context of combating poverty and social inclusion

Social networks of elderly with social services support living in two different areas of Portugal

Focusing social support networks of the elderly, we present a study centered on the assessment of social resources, by analyzing differences between living in a coastal urban area, or in a rural inner region of Portugal. We had 176 participants, 119 elderly users of home care services in the municipality of Penamacor in an interior region of Portugal, and 57 elderly users of day care and residential care in the municipality of Coimbra in a littoral (coastal) region of the country. Their social resources were assessed by Americans Resources and Services Program (OARS). The participants are mostly over 80 years old (72%), 70% women, 63% widowed and 71% are illiterate. The main findings indicate that the network size is much bigger in the elderly of interior region with significant differences between the samples, but the numbers of visits and telephone calls these elderly do or receive are very similar. Curiously, the elderly of Penamacor tend to express that they feel alone sometimes and the most part of the elderly of Coimbra doesn’t express loneliness, as well as the last ones feel that have someone to help when they need and the first only sometimes have someone to help them. This probably happens because the social services settings are different. Older adults from Coimbra present better levels of social resources when compared with elderly from Penamacor. These last group present mostly severe limitations and the first ones present mostly good or low limitations, on the OARS classification scale. Both activate their contacts with the social network especially with sons and daughters or other family members. These results need further study to discuss possible asymmetries, inequalities and other differences. However, Social Work must reflect on these indicators to be able to promote a more equity access to social resources, and to increase an effective social support on the elderly social networks

Health promotion and social intervention with children and youngsters with HIV: a ludic-educational program with peers and caregivers

O artigo analisa o programa “A Brincar também se Aprende” para crianças e jovens com VIH e suas famílias. Em 17 edições, teve 687 participantes: 459 crianças e jovens infetadas e afetadas pela doença e 228 cuidadores. Metodologicamente, a avaliação usou a análise de conteúdo de testemunhos dos participantes em 6 edições. Emergiram cinco categorias, sendo as três primeiras mais referidas: 1) Avaliação da iniciativa, dinâmica e programação; 2) Partilha e fator facilitador de relações interpessoais e de integração; 3) Promoção de cuidados e do bem-estar; 4) Suporte social; 5) Reforço e Valorização. A avaliação sustenta empiricamente o programa para que seja adotado noutros contextos de intervenção social com crianças e jovens com doença crónica, dado o potencial na promoção da saúde e bem-estar psicossocial.The article analyzes the program “A Brincar também se Aprende” [Learning through Playing], for children and young people with HIV and their families. There were 687 participants in 17 editions: 459 children and youth infected and affected by the diseaseand and 228 informal caregivers. Methodologically, the evaluation used the participants’ testimonies content analysis in 6 editions. Five main categories emerged, and the first three were the most mentioned: 1) Evaluation of the initiative, dynamics and planning; 2) Promotion of integration and interpersonal relationships; 3) Promotion of care and well-being; 4) Social support; 5) Strengthening and Valorization. The outcomes empirically support the program, and motivates it’s application in other social intervention contexts for children and youth affected with chronic illness, given the large potential in promoting health and psychosocial well-being.Departamento de Trabajo Social y Servicios Sociales; Facultad de Trabajo Socia

As redes de suporte social informal como fontes de provisão social em Portugal:: o caso da população idosa

Aging indicators in the Portuguese population, places Portugal as one of the most aged countries in the world, being the elderly a socially vulnerable group. The vulnerability, resulting from lifelong trajectories of progressive accumulation of disadvantages, has as determinants the strong levels of loss of autonomy with advancing age, the risk of social isolation and the high risk of social exclusion and poverty, compensated by the strong impact of social transfers on income, together with the changes in Portuguese society, particularly in the morphology of families and in labor. This vulnerability framework has been adressed with the expansion of welfare public policies, but also trough informal provision, especially by families. In more recent times, we witnessed a reversal in the providencial trajectory by the Portuguese state, increasingly retreated, accentuating the family responsibility. The article presents a reflection on the relevance of informal social support in social welfare in Portugal regarding the elderly population, particularly problematizing the providential role of families in an austerity context, based on documentation and literature produced in and about the Portuguese social context.Os indicadores de envelhecimento na população portuguesa colocam Portugal como um dos países mais envelhecidos do mundo, sendo os idosos um grupo populacional socialmente vulnerável. A vulnerabilidade, resultante de trajetórias ao longo da vida com acúmulo progressivo de desvantagens, tem como determinantes os fortes níveis de perda de autonomia com o avançar da idade, o risco de isolamento social, o elevado risco de exclusão e de pobreza, colmatado pelo forte impacte das transferências sociais no rendimento, a par das transformações na sociedade portuguesa, particularmente na morfologia das famílias e na relação com o trabalho. Este quadro de vulnerabilidade tem encontrado resposta na expansão de políticas de bem-estar no contexto do desenvolvimento do Estado-providência, mas também na provisão informal, sobretudo das famílias. Em tempos recentes, assistimos a uma inversão na trajetória providencial por parte do Estado português, cada vez mais recuado, agudizando-se a responsabilidade familiar. O artigo apresenta uma reflexão sobre a relevância do suporte social informal na proteção social em Portugal no que concerne à população idosa, problematizando particularmente o papel providencial das famílias num contexto de austeridade, a partir de documentação e literatura produzida no e sobre o contexto social português

Propriedades psicométricas da versão portuguesa do Inventário de Ansiedade Geriátrica numa amostra de idosos utentes de estruturas residenciais

Contexto: O progressivo aumento na prevalência, tanto de sintomatologia como de perturbações de ansiedade nas idades avançadas, aconselha a utilização extensiva de inventários no rastreio nesta população que, em todos os lugares do mundo, se tem tornado cada vez mais numericamente expressiva. Objetivos: O objetivo deste artigo é apresentar os resultados dos estudos de validação e de fidedignidade da versão portuguesa do Inventário Geriátrico de Ansiedade (GAI) numa amostra de idosos institucionalizados. Métodos: Depois da tradução e retroversão do GAI, a versão portuguesa foi administrada a 805 idosos institucionalizados. A fidedignidade da escala foi avaliada através do coeficiente alfa de Cronbach e a validade fatorial através do método de extração de componentes principais. O estudo da validade convergente foi efetuado com a Escala Geriátrica de Depressão e com a Lista de Afetos Negativos, enquanto a validade descriminante foi efetuada com a Lista de Afetos Positivos e a Escala de Satisfação com a Vida. Utilizámos a análise fatorial confirmatória com recurso aos modelos de equações estruturais. Usámos a área sob a curva ROC (AUC) para prever a presença de perturbação de ansiedade generalizada. Resultados: A escala apresenta boa consistência interna (α = 0,94) e bons indicadores de validade convergente e divergente, todos significativos. O modelo revelou uma boa qualidade de ajustamento aos dados (χ2/gl = 2,81; TLI = 0,96; CFI = 0,96; RMSEA = 0,05), apoiando uma solução de um fator único. A análise ROC revelou uma sensibilidade de 100% e especificidade de 84,7% na deteção de perturbação de ansiedade generalizada com um ponto de corte de 13 (AUC = 0,92). Finalmente, verificou-se que as mulheres apresentam pontuações médias mais altas do que os homens. Conclusões: O GAI apresenta boas qualidades psicométricas e fatorial para medir sintomas de ansiedade em rastreios epidemiológicos e em contextos de institucionalização geriátrica.Background: The progressive increase in the prevalence of anxiety disorders in advanced ages advises the extensive use of screening inventories in this population that, everywhere in the world, has become increasingly numerically significant. Goals: The aim of this study is to present the results of validation and reliability studies of the Portuguese version of Geriatric Anxiety Inventory (GAI). Methods: After, translation and back-translation of GAI, the Portuguese version was administered to 805 institutionalized elderly. The reliability of the scale was assessed by Cronbach's alpha coefficient and factorial validity using the extraction method of Principal Components Analysis. The convergent validity study was conducted with the Geriatric Depression Scale and the Negative Affects Schedule while discriminant validity was performed with the Positive Affects Schedule and the Satisfaction With Life Scale. We used confirmatory factor analysis, by means of structural equation modeling, to test the fit of the model with 20 items. We used the area under the ROC curve (AUC) to predict the group of elderly patients with generalized anxiety disorder and the group of healthy elderly. Results: The scale has good internal consistency (α = 0.94), indicators of good convergent and discriminant validity, were all significant. The model showed a good quality of fit to the data (χ2/df = 2.805; TLI = 0.959; CFI = 0.964; RMSEA = 0.047). The ROC analysis revealed a sensitivity of 100% and specificity of 84.7% in the detection of generalized anxiety disorder with a cutoff score of 13 (AUC = 0.92). Finally, women showed higher scores than men. Conclusions: The GAI has good psychometric and factorial qualities to measure anxiety symptoms in epidemiological surveys and in geriatric institutionalized settings