RESUMO
Resumen Los significados sobre la sexualidad en la adultez mayor se encuentran sobre la base de una compleja interrelación entre factores sociales, culturales y personales. La presente investigación tuvo como objetivo explorar los significados psicológicos que personas adultas mayores de la Ciudad de México le confieren a la sexualidad, al placer sexual y al deseo sexual, mediante el empleo de las redes semánticas naturales (modificadas). La muestra estuvo constituida por 204 personas: 162 mujeres y 40 hombres, entre los 60 y 100 años, asistentes a centros de educación continua para personas adultas mayores en la Ciudad de México. El estudio fue mixto, descriptivo, no experimental, con muestreo no probabilístico y por conveniencia. Los resultados muestran que los significados psicológicos que las personas adultas mayores estudiadas refieren sobre la sexualidad, el deseo y el placer sexual son predominantemente positivos, y abarcan sentimientos, comportamientos y sensaciones. Se identifican diferencias por género tal como se planteó en la hipótesis de investigación, pero también se encontraron similitudes dentro de dichos significados. En las adultas mayores predomina la interrelación entre significados afectivos y contacto físico, mientras que en los hombres predominan las sensaciones. En general la muestra describe la sexualidad, el deseo y el placer sexual de manera muy similar, lo cual lleva a comprender que las fronteras entre los términos son sensibles, de tal manera que los significados y referentes de las propias personas llegan a permearse.
Abstract The meanings of sexuality in seniorhood are found at the base of a complex interrelation between social, cultural and personal factors. The present research aimed to explore the psychological meanings that senior adults in Mexico City confer on sexuality, sexual pleasure and sexual desire; through the use of modified natural semantic networks. The sample consisted of 204 people: 162 senior women and 40 senior men, between 60 and 100 years old, attending a continuing education centers for senior adults in Mexico City. The study was mixed, descriptive, non-experimental, with non-probability and convenience sampling. The results show how the psychological meanings that the studied senior adults have related to sexuality, desire and sexual pleasure are predominantly positive, encompassing feelings, behaviors and sensations. Differences by gender are identified as proposed in the research hypothesis, but similarities within these meanings were also found. The senior women studied define sexuality from the interrelation between affective meanings and physical contact; the word "love" was the most referenced. In addition, they mentioned "pleasure", "desire", "caresses", "satisfaction", "kisses", "joy", "hugs", "health", "attraction", and "knowledge". Senior men, for their part, consider sexuality mainly as an attraction and include others such as: "satisfaction", "pleasure", "respect", "life", "fidelity", "complete", "unique", "woman", "touch", "important", "love", "knowledge", "passion", "desire", "need", and "affection". Women and men in the sample describe sexual desire and pleasure in a very similar way to their sexuality referents, which leads us to understand that the boundaries between the two terms are sensitive. Regarding sexual desire, senior women cite defining words such as: "caresses", "kisses", "love", "hugs", "pleasure", "desire", "necessary", "satisfaction", "natural", "attraction", "partner", "happiness", and "respect". In relation to sexual pleasure, they include the words: "enjoyment", "tenderness", "affection", "friendship", "joy", "it is the maximum", and "relaxing". For their part, senior men defined sexual desire as: "attraction", "love", "caresses", "satisfaction", "looks", "necessary", "natural", "woman", "kisses", "being alive", "respect", "passion", "libido", "important", "moving", "pleasure", "hug", "energy", "games", "excitement", "communication", "masturbation", "eroticism", and "taste". Sexual pleasure includes: "important", "fullness", "enjoyment", "respect", "pleasure", "joy", and "naturalness". The results show that the stage of sexuality in seniorhood is diverse and it is influenced by gender and social beliefs, which evidences the psychological complexity of this sphere of life.
RESUMO
In this study, we aimed to estimate the association between social support and healthcare utilization among older Mexican adults. We conducted a prospective study with 4027 older adults aged 65-74 in rural areas in seven Mexican states. Data were collected at baseline (2007) and 14 months later (2009). Healthcare utilization was defined as number of visits to a physician for preventive or curative purposes in the last 6 months. Multidimensional social support was operationalized into two components: structural (living arrangements, marital status and network size) and functional (perceived availability of support; and perceived support across emotional, instrumental, economic and information domains). Mixed-effects regression models were used to estimate the probability of healthcare use and to examine the association between social support and the number of visits to a physician. Results showed that perceived availability of social support was associated with the probability of visits to a physician (OR 1.44; p < .01). Meanwhile, the following domains of functional component of social support were associated with the probability of visits to a physician: instrumental (OR 1.55; p < .01), economic (OR 1.19; p = .03) and informational (OR 1.39; p < .01); and also with the number of visits to a physician: instrumental (e ß = 1.27; p < .01), economic (e ß = 1.14; p = .01) and informational (e ß = 1.12; p < .10). Our findings suggest that a significant association exists between social support, measured from a multidimensional viewpoint, and healthcare utilization, in which greater social support was related to a greater extent of use of health services.