Comme n’importe quel acteur social, les personnes âgées mettent en oeuvre diverses sortes de tactiques (on ne préjuge pas que leurs pratiques sont le fruit d’une élaboration consciente ou l’adaptation de routines) pour affronter les difficultés de la vie quotidienne. La diversité et la dispersion de ces pratiques s’expliquent en partie par la nature des problèmes auxquels elles sont confrontées aux différents moments de leur trajectoire. Trois sortes de problèmes importants structurent ces itinéraires : le changement provoqué par la fin de l’activité professionnelle ou familiale; la restriction des activités imposée par les déficiences ou handicaps; la dépendance physique ou morale. Autour des stratégies d’affrontement de ces problèmes, on peut élaborer un modèle simplifié des processus de vieillissement, à trois épisodes.
L'usage de la ville ne disparaît pas à la vieillesse, mais les changements dans les pratiques urbaines dépendent autant de la place laissée aux personnes âgées dans l'espace public que de leurs difficultés de déplacement. Une sélection des lieux fréquentés s'opère dans une logique d'économie des forces et selon des stratégies d'évitement : fuir la foule, la confrontation physique aux autres et à leur regard tend à valoriser le chez soi. Mais ce dernier n'est pas aussi coupé de la ville qu'il y paraît, et l'investissement dans les lieux est très lié aux possibilités de maintenir les liens affectifs essentiels à la santé.
The objectives were to ascertain the sociodemographic background of bladder cancer survivors acting on their participation behavior to a medical follow-up survey. This population-based quality of life (QOL) survey was realized by mail with 201 survivors (M:F = 171:30, median age = 74 years, range 33-99) randomly selected from the 1731 patients diagnosed between 1990 and 1994 in two regions of France. Response rate was 47.3%. Female and younger survivors were more receptive to the survey than were males and older survivors. Furthermore, survivors who had experienced a cystectomy were more responsive than those who did not. Similarly, the length of time since a major treatment was significant, with a shorter interval associated with a better response. The missing item rate in the QOL questionnaire was 13.8%. Other variables were not significantly associated with acceptance of the survey. Missing items among the responders were found more often in the sub-scale of social/familial well-being (15.6%). The older and male subjects left more questions blank. The reason for this low response rate can be categorized to the following three points: (1) Physically and psychologically not motivated to answer, (2) sensitive and private content of the question, and (3) methodological problem. Clearer concepts of the research would have helped the participants understand the objectives and better relate to the survey. Subsequently, these three issues should be given more attention in organizing questionnaire survey for improved participation rates in future studies.
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