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Vickerman, Shelley Ann. "The experiences of transgender female sex workers within their families, occupation and the health care system." University of the Western Cape, 2018. http://hdl.handle.net/11394/6868.
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Magister Artium (Psychology) - MA(Psych)There is a dearth of scholarly literature surrounding transgender female sex workers (TFSW) within South Africa. Their voices are often marginalised and not adequately heard in the literature and in a society that generally views gender as a fundamental element of the self, determining their subject positions against binaried heteronormative gender ideals. This process of the ‘othering’ of TFSW, is exacerbated by the moralistic judging of their occupation of sex work. This has left many TFSWs vulnerable to emotional abuse such as being socially stigmatised, discriminated against and socially isolated. The literature further echoes vulnerability to physical violence, such as hate crimes, rape, heightened HIV infection, homelessness, police brutality and murder. The current study aimed to explore the subjective experiences of TFSW within their families, occupations and the healthcare system within the Cape Town metropole, South Africa. The study was framed within an intersectional feminist epistemological position, highlighting intersecting identities that marginalise groups of people. Informant driven sampling was used in the case of this study where a total of eleven participants were individually interviewed using a semi-structed approach – interviews ranged from 35-90 minutes. The data collected was subsequently analysed using thematic analysis and the three themes that emerged were: transgender female (TGF), Sex work and HIV. Family rejection and abuse based on participants non-conforming gender identity was expressed by participants. Repressive home circumstances led to many opting to live on the street. Participants described being introduced to sex work through a network of other homeless TFSW, also described as ‘Sisters’ (who fulfil the role of family) as a means of survival. Sex work for TGFs is a particularly dangerous job, as sex workers run the risk of being exposed as TGFs, often resulting in severe physical harm for some. To cope with their severe realities of violence and homelessness, many reported turning to substances, such as alcohol and methamphetamine. A total of ten participants described being HIV positive and adherence was very poor among the group. This could be attributed to stigmatisation from health workers, substance use and homelessness. This group of women, though vulnerable and structurally oppressed, displayed exceptional resilience. It is suggested that further research should be conducted on this group in the South African context for a clearer understanding of their needs and improved policy, as well as interventions for TFSW.
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Cox, Julia R. "Training Future Mental Health Professionals in an Evidence-Informed System of Care." VCU Scholars Compass, 2019. https://scholarscompass.vcu.edu/etd/5964.
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High quality mental health services do not reach the youth who need them, leading to efforts to implement effective treatments more broadly. One focus of these efforts concerns training the mental health workforce, of which master’s-level social workers represent a large proportion. However, the curricula of master’s in social work (MSW) programs do not often emphasize evidence-based approaches. One possible solution is Managing and Adapting Practice (MAP; PracticeWise, LLC), a system that allows clinicians to (1) identify clinically indicated evidence-based programs by searching a growing evidence-base of randomized controlled trials (RCTs) and (2) build individualized evidence-informed treatment plans by focusing on common practice elements. MAP may also address the concerns about manual-based programs (e.g., inflexibility). Although some MSW programs have integrated MAP, the benefits of MAP training within MSW education have not yet been evaluated. This project evaluated multiple mechanisms of training in a semester-long MSW-focused MAP course relative to curriculum-as-usual control at a large public university.
Participants were advanced MSW students (mean age = 27, SD = 5.8; 92.3% women; 59% white) either enrolled in the MAP course (n = 17) or enrolled in curriculum-as-usual (n = 22). The MAP course was co-taught by an expert MAP trainer and a MAP-trained social worker. Pre- and post-semester, participants completed a battery that included: (1) role-plays with standardized patients that were videotaped and coded using the Therapy Observational Coding System of Child Psychotherapy – Revised Strategies scale; (2) a written task that was subsequently coded to assess participants’ clinical decision-making skills during different phases of a standardized case; and (3) attitudinal factors that may be predictive of future MAP usage, such as attitudes toward evidence-based practice and the acceptability and feasibility of MAP. Results indicate significant uptake of cognitive and behavioral therapeutic strategies in the MAP condition. Overall, participants endorsed positive attitudes toward evidence-based practice broadly and MAP specifically. Findings may be used to inform the development of more effective evidence-informed curriculum for master’s-level clinical programs and future workforce training initiatives. Methodological considerations may inform advances in instrumentation to measure multidimensional training outcomes
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Flad, Jennifer. "Advocating work an institutional ethnography of patients' and their families' experiences within a managed care health system /." Related electronic resource: Current Research at SU : database of SU dissertations, recent titles available full text, 2009. http://wwwlib.umi.com/cr/syr/main.
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Kim, Wonhee. "Association of Youth Mental Health Status with Caregiver Strain: The Moderating Role of Youth Mental Health Service Use in System of Care Research." Case Western Reserve University School of Graduate Studies / OhioLINK, 2021. http://rave.ohiolink.edu/etdc/view?acc_num=case1606841849946494.
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Jaghoory, Mahnaz. "Challenges of collaborative activities within emergency health care. : A study of the limitations of IT in supporting current medical practices within emergency health care in Vaasa and Umeå." Thesis, Umeå universitet, Institutionen för informatik, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-121522.
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Emergency Health Care (EHC) is an extended and multi-professional protocol designed to make communication easier in the event of a health-care emergency. Information and communication technologies (ICTs) play a vital role within EHC by coordinating emergency responses across involved departments as well as to health-care providers in the pre-hospital and hospital settings. Despite advances in ICT, there are still a variety of challenges regarding ICT usage in emergencies. To identify these challenges, a semi-structured interview was conducted with pre-hospital and hospital staff at the Emergency Departments of Vaasa Central Hospital, Finland, and Umeå University Hospital, Sweden. The findings indicate that workflow practices and the applying of medical knowledge in a pre-hospital setting is more challenging in Vaasa due to limited accessibility to the patient electronic record system. In the hospital setting, the clinical workflow and application of medical knowledge is easier in Umeå than in Vaasa as a result of there being an integrated information system in the Umeå region compared to a disintegrated system in the Vaasa region. It was discovered that the lack of a national record system in Sweden is a challenge for practitioners in the hospital setting in Umeå. In addition, badly structured information in the Finnish national record system has made collaborative activities between departments and hospitals difficult within EHC. The results reveal that the capacity of IT tools to provide on-time accessibility to patient information is fundamental for safe decision making and collaborative activities across departments and hospitals within EHC.
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Thompson, Guy. "A Phenomenological Study: Foster Care Youth Aging Out of the System." Thesis, NSUWorks, 2016. https://nsuworks.nova.edu/fse_etd/73.
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The purpose of this applied dissertation was to explore the lived experiences of teens aging out of foster care, in an effort to better understand their needs. While the child welfare system is geared towards family preservation, reunification, and adoption, most young adults transitioning from the foster care system are not reunited with family members or are only reunited as a last resort. Unfortunately, every year, thousands are leaving the support of the foster care system, unprepared. Youth departing the child welfare system are not gradually transitioned into becoming self-sufficient. They do not have an effective support system available if they fail or need help. Instead, when they leave foster care, they are simply released from the system they have become accustomed to and most struggle during this transition. The researcher conducted three 60-minute interviews with nine former foster youth. Questions were based on a set of interview questions (Appendix C), developed and used by Dr. Lee (2010), to assist in understanding the lived experiences of former foster youth. From an analysis of the data gathered from the young adults’ interviews and the researcher’s observations, four prevalent themes emerged: 1) Looking for the ‘care’ in foster care, 2) the threat of mental disability, 3) pick of the draw, and 4) navigating emotionally alone. This study will allow the state and foster care system to examine the highlighted issues and to consider appropriate corrections. Gaps have been identified in the system, as it currently operates, and there is a need to examine the current practices with internal and external lenses, in order to recommend possible changes.
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Grahn, Robert. "Treatment repeaters : re-entry in care for clients with substance use disorder within the Swedish addiction treatment system." Doctoral thesis, Umeå universitet, Institutionen för socialt arbete, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-141601.
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According to the regulations contained in the Social Services Act (SFS 2001:453), Swedish social services have a legal responsibility to provide support, care, and treatment for individuals with substance use problems. This law mandate those who are responsible to provide treatment to motivate drug users to actively seek treatment on a voluntary basis, ensuring an end to their dependence on drugs. Studies have shown that although the treatment system largely focuses on promoting abstinence, about two-thirds of client’s relapse into substance use within one year after completing treatment. This dissertation focuses broadly on clients who repeatedly enter and use treatment for substance use disorders in the Swedish addiction treatment system. The aim of this thesis is to examine and identify the population groups who are repeated treatment users of the Swedish treatment system for substance use disorder, including both the voluntary treatment and compulsory care. This thesis was based on three national level databases. The results showed that clients with a higher degree of problems and problems in different areas of life also had an increased risk of having treatment for substance use disorder repeatedly. Clients who were older, men, reported more years of polydrug and alcohol use to intoxication, reported more compulsory care episodes for substance use, had ever been charged with crime, had ever been in inpatient mental health treatment, and had a higher ASI mental health symptom composite score, were significantly more likely to report more voluntary addiction treatment episodes. The strongest significant association with the number of treatment episodes was the number of compulsory treatment episodes for alcohol and drugs. Individuals who experienced prior compulsory care including mandatory treatment through LVU (law (1990:52)), been in prison, and had children mandated to out-of-home care, were more likely to have two or more entries in the compulsory care system for substance use disorder. In addition, this analysis showed that 59% of clients mandated to compulsory care dropped-out during their compulsory care episode, and that younger clients were significantly more likely to drop-out. Those who drop-out were significantly more likely to experience negative outcomes, i.e. additional sentence to compulsory care and higher risk of mortality. A hierarchal logistic regression model also identified that individuals with riskier childhood conditions were more likely to have had repeated entries to compulsory care for substance use disorder. The indirect effects showed that a family history of substance use disorder and psychiatric problems are both associated with higher probability of institutional care as a child i.e. LVU, and that in turn, mandated childhood institutional care is related to repeated compulsory care intakes as an adult. Individuals who use treatment for substance use disorder repeatedly have a higher degree of problems i.e. an exposed and problematic group of individuals characterized by problem in several different areas of life. Growing up in a home environment with unfavorable conditions, mandated care before the age of 18 (LVU), compulsory care for substance use disorder as an adult, children taken into out-of-home care, and crime are the factors that are primarily associated with repeated treatment for substance use. A change in the view of treatment for clients in need of repeated use of treatment seems important, and access to adapted continuous care efforts are crucial to counteract the risk of relapse after a treatment episode of voluntary or compulsory care. Further, it seems important to motivate the client to complete the compulsory care without any deviation, since this seems to have positive effects on their substance use disorder.
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Wollard, Marissa R., and Monique N. Bettencourt. "OLDER LESBIAN AND BISEXUAL WOMEN’S ACCESS TO SERVICES AND RELATED HEALTH OUTCOMES." CSUSB ScholarWorks, 2017. https://scholarworks.lib.csusb.edu/etd/509.
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This exploratory research utilized a qualitative focus group of seven participants to see what insights older lesbian women provide toward impacting understanding of their perceived isolation, perceived invisibility, health needs and access to social services that are congruent with LGBTQ+ culture. The participants were recruited through snowball sampling. After the completion of the data collection, data were thematically analyzed and color coded. The significance of this study was to gain greater insight into the specific needs and areas of concerns of a vulnerable population. This greater insight may lead to social workers’ being able to provide better services for lesbian women. The major themes derived from the data were separated by access, homophobia, invisibility, social support, and health. Sub-themes included: quality of healthcare, support system, community involvement, political climate, coming out, need for LGBTQ+ specific services, discrimination (sexism/homophobia), finances, relationship status, health issues and social limitations, quality of life, planning, invisibility.
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Cohen, Deborah A. "Obtaining Genuine Family Involvement: Unpacking the System of Care Values and Principles." UKnowledge, 2014. http://uknowledge.uky.edu/csw_etds/9.
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Despite the federal government’s $1.5 billion investment between 1993 and 2010 to fund 164 separate community-based systems of care, there has been an extremely limited attempt to measure the impact of system of care. The impetus for this research is the struggle for how the value based concept of system of care is communicated within a community. While child mental health services researchers have published a number of randomized control trials to explore individual level supports for youth served in a system of care community, researchers have struggled to devise a way to measure system of care philosophy diffusion.
While system of care is a system level intervention, this study explored the role of the system of care value: family voice as it pertains to direct practice for children and families. The goal was to assess whether specific direct practices regularly associated with system of care (i.e., wraparound or home-based services) lead to greater family voice or if the mere presence of a high-functioning system of care community leads to equal family voice for all receiving community-based services.
The primary finding was a relationship between the perception of family functioning and perceived empowerment/self-efficacy. This finding suggests that as functioning improves, so does a caregiver’s perception of their personal empowerment/ self-efficacy. While the framing of this study was to “unpack” the system of care value of family voice, the findings do not support any clear cut explanation for how family voice is promoted or communicated to families. Based on the findings, it appears as if families feel more empowered as their child improves. Additional research needs to be done on the application of family voice within the practice setting to better understand how to best instruct staff to infuse family voice in their daily practice.
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Swanepoel, Monique (Marais). "The psychosocial influences on the family of a child diagnosed with cancer." Diss., University of Pretoria, 2014. http://hdl.handle.net/2263/46181.
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Cancer affects everyone; it does not distinguish between age, race, gender or social background. When a child is diagnosed with cancer, it does not only affect the child, but also the family system as a whole. The focus of this study was on the psychosocial aspects that are affected in the family system once a child diagnosed with cancer. These psychosocial aspects included the emotional impact, the spousal impact, the role changes that occur in the family system, the financial impact, the impact on siblings as well as the impact on religion and spirituality. These aspects were investigated by the researcher during the applied study.
This applied study used a qualitative approach with a collective case study research design. The research population of this study included families who have a child diagnosed with cancer, who was treated at Nicus Lodge Cancer Treatment Centre in Pretoria which is a CANSA affiliate. The staff at Nicus Lodge selected participants who met the criteria based on purposive sampling, on behalf of the researcher. The researcher used semi-structured interviews and an interview schedule in order to obtain the participants’ experiences of their child diagnosed with cancer and the psychosocial effects it had on them as a family system. Nine participants participated in the study. The interviews were recorded with the permission of the participants and then later transcribed. Creswell’s steps for qualitative data analysis were implemented. By utilizing these measures and tools, the researcher was able to formulate findings from which conclusions and recommendations could be made. From the findings, the following themes and sub-themes were identified, demonstrating the psychosocial effect that a child diagnosed with cancer has on the family system and answering the research question: Theme 1: Protective measures with the sub-themes of religion, support structures and personality. Theme 2: Restrictive measures with the sub-themes of role changes, single parent, multiple children and date of diagnosis. Theme 3: Financial related aspects with the sub-themes of employment/unemployment, supportive employer, transport and medical aid. The findings demonstrated that many different aspects of a family system are affected when a child is diagnosed with cancer. It also demonstrated that a family system that had the necessary protective measures, were able to cope more effectively and maintain their quality of life when their child was diagnosed with cancer. The findings furthermore showed specific focus areas that a social worker in the health care setting, specifically in the oncology field, should focus on which hinder family systems from coping effectively. These focus areas enable the social workers to provide adequate supportive services to the families of a child diagnosed with cancer.
Supportive services are imperative when dealing with a family of a child diagnosed with cancer, and this is one of the recommendations of the study and a focus area for future studies. Recommendations from this study can be used by social workers in the health care field to better understand the challenges that families of a child diagnosed with cancer experience and how to effectively address their needs. Social workers can also utilize the recommendations to find ways to make their services known to the communities and improve their intervention and supportive services to these families. It is important for social workers to improve awareness in the community and to provide them with the necessary resources to cope better with the situation. To better understand this paper, certain key terms were used by the researcher.Dissertation (MSW)--University of Pretoria, 2014.
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Sader, Débora. "A contra-reforma do Estado e o financiamento da seguridade social: 1995 a 2002." Universidade Federal do Espírito Santo, 2006. http://repositorio.ufes.br/handle/10/6484.
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Previous issue date: 2006-10-30Trata do financiamento da Seguridade Social no Brasil no contexto da contra-reforma do Estado na década de 1990 e início dos anos 2000, focando o período do governo Fernando Henrique Cardoso (1995 2002). A Seguridade é uma das formas da intervenção pública do governo, com o objetivo de promover sua legitimação. A partir de uma problematização teórico-histórica sobre a teoria do Estado, base para os estudos, é discutida a construção do conceito de Seguridade no país e a regulamentação das políticas que a compõem Previdência, Assistência e Saúde , além da contra-reforma do Estado no Brasil e seus efeitos sobre essa política. Apresenta considerações sobre as alterações nas políticas componentes da Seguridade, discorrendo sobre a contra-reforma da Previdência Social com a incorporação da lógica atuarial à concessão dos benefícios; sobre a assistencialização das políticas sociais e o aumento dos gastos com a Assistência Social, ainda que em nível insuficiente para lidar com as mazelas sociais do país; e sobre o processo de implantação do Sistema Único de Saúde, que trouxe uma valorização da atenção básica à saúde e dos mecanismos de descentralização dos recursos, ficando os municípios responsáveis por boa parte da operacionalização e financiamento da política. A partir da discussão sobre o financiamento público, é ressaltada a predominância da valorização financeira do capital com a destinação de parcela crescente dos recursos arrecadados pelo governo para garantir a acumulação. Os principais mecanismos nesse sentido são os instrumentos de desvinculação das receitas, agora comprometidas com o pagamento dos juros da dívida, e as metas de resultado primário positivo. A intervenção pública dos anos 90 pautou-se pela busca da estabilização da economia, sobre-valorizando a importância de uma política econômica de cunho contracionista e conduzindo a cortes nos gastos públicos para a área social com a finalidade de pagar parte dos juros da dívida pública, ou seja, remunerar o capital especulativo e manter calmos, ou melhor, satisfeitos, os ditos mercados . Na medida em que avançou a penetração da ideologia neoliberal na sociedade e a utilização dos recursos arrecadados em nome da Seguridade para os gastos específicos foi reduzida, as possibilidades para a efetivação dessa política enquanto intervenção pública consolidada pioraram, dependendo cada vez mais de uma mobilização social nesse sentido.
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Kjellström, Madelaine. "Ledningssystem som planeringsverktyg i vård- och omsorgssektorn : - En studie av ledningssystemet för systematiskt kvalitetsarbete i tre värmländska kommuner: Karlstad, Sunne och Storfors -." Thesis, Karlstads universitet, Institutionen för samhälls- och kulturvetenskap, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:kau:diva-63960.
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Thesis in Healt Care Administration, C-level. Author: Madelaine Kjellström. Supervisor: Alf Sundin. Autumn semester 2017. Title: Management system as a Planning Instrument in Health Care Services - A Study of Management System for Systematic Quality Work in three swedish municipalities in Värmland; Karlstad, Sunne and Storfors – In the year 2011 the Swedish authority Socialstyrelsen published a prescription (SOSFS 2011:9) and also a recommendation who where adressed to the municipalities, who are responsible for the public servises in Sweden, to implement a Management System for Quality Work within Health and Social Care Services. The aim of this study is to examine how municiapilities in Sweden is planning for implementation and evaluation of the Management system for Quality Work within Health and Social Care Services. The question for approaching the thesis choice of subject are: Is the Management System for Quality Work Work within Health and Social Care Services more likely to succed in the municipality of Karlstad which is a bigger municipality comparing to Sunne and Storfors municipalities, which is smaller municipalities comparing to the size of budget and population? Is there any similarities and/or differences between the different municipalities capacity to planning for implementation and evaluation of the Management System for Quality Work within Health ans Social Care Services? As mentioned above there are three municipalities that has been selected as cases in this comparative case-study. All three municipalities is located in the region of Värmland, Sweden. The main findings and the result of this comparative case-study is that; all of the three municipalities independent of their respective sixe have capacities to fullfill the prescription and recommendation according to the authority Socialstyrelsen intentions concerning the planning of implementation and evaluation of the Management System. Keywords: Planning, implementation, evaluation, Mangagement system, quality work, health and social care service.
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Mateo, Rowena. "The efficacy of the augmented board and care (ABC) system in reducing rehospitalization of identified "high end user" residents of San Bernardino County." CSUSB ScholarWorks, 1996. https://scholarworks.lib.csusb.edu/etd-project/1210.
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Cunningham, Brian Stewart. "Treatment outcomes of the augmented board and care system for the mentally ill: Focus on post-placement and diagnosis." CSUSB ScholarWorks, 1999. https://scholarworks.lib.csusb.edu/etd-project/1807.
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Palmnert, Marie. "Vilka möjligheter finns för att implementera en god arbetsmiljö? En kvalitativ undersökning av arbetsledare inom äldreomsorgen." Thesis, Malmö högskola, Fakulteten för hälsa och samhälle (HS), 2005. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-25694.
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Den demografiska förändringen över ålderstrukturen står inför en förändring, där antalet äldre förväntas öka markant. För att äldreomsorgen ska ges möjlighet att tillhanda hålla en god omvårdnad, bör behovet av kompetent personal och en god arbetsmiljö tillgodoses. Syftet med denna undersökning var att skaffa kunskap om vilka möjligheter samt vilka resurser arbetsledare inom äldreomsorgen har för att implementera en god arbetsmiljö. Metoden som använts för denna kvalitativa undersökning var hermeneutisk metod, för att erfara och tolka arbetsledarnas arbetsmiljöarbete. I resultatet av undersökningen framkom att en majoritet av arbetsledarna ansåg att de hade en god arbetsmiljö och resurserna var adekvata, men utifrån intervjuerna kunde det tolkas att arbetsledningen och medarbetarna arbetade mot olika mål. En möjlighet för att implementera en god arbetsmiljö enligt studien, var att skapa en värdegrund som utgår ifrån hälsans bestämningsfaktorer. Ytterligare något som framkom ur undersökningen var att kompetensen borde ökas inom äldreomsorgen för att möt den framtida förändringen.The demographic over the age structure stand before a change, when the elderly people expect to increase considerably. For making it possible for care of the elderly and to provide a good form of health care should the need for competent staff and work environment be satisfactory. The purpose of this study was to examine which possibility and which facilities work leaders have to implement a healthy work environment. The method that was used in this qualitative research was hermeneutic method, to examine and interpret work leaders work environments work. In the results of this study it emerged that a majority of the work leaders meant that they had a good work environment and adequate facilities, but from the interviews could it be interpreted that the management and coworkers worked towards different goals. In the study it emerged that the foundation of values should be from the determinants of health, and these values can be a possibility to implement a healthy work environment within the care of the elderly. Another finding in the study was that the competence within care of elderly should increase, to encounter the future changed demands on care of elderly.
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Andersson, Réka. "Gränsdragningar i Vårdens Vardag : Hanteringen av arbetsrelaterad psykisk ohälsa i det svenska välfärdssystemet." Doctoral thesis, Linköpings universitet, Tema teknik och social förändring, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-139866.
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Psykisk ohälsa i arbetslivet är ett stort och växande problem i välfärdssamhället. Problemet har flera bottnar och väcker många frågor om vem som har ansvar, vad det egentligen är för ett slags fenomen och hur det bör hanteras. Den här studien undersöker hur arbetsrelaterad psykisk ohälsa hanteras av yrkesverksamma inom vården, med fokus på företagshälsovård och primärvård. Intresse riktas mot hur yrkesverksamma personerna resonerar kring arbetsrelaterad psykisk ohälsa, vilka dilemman de ställs inför och de strategier de har för att hantera dessa. Den söker också svar på ansvarsfrågan kring detta komplexa problem, inte minst i ljuset av privatiseringen av företagshälsovården. I studien används ett tvärvetenskapligt perspektiv, där begrepp från teknik- och vetenskapsstudier (STS), professionssociologi och organisationsteori kombineras för att analysera olika aspekter av vårdens hantering av arbetsrelaterad psykisk ohälsa. Det empiriska materialet bygger i huvudsak på intervjuer med läkare, psykoterapeuter, kuratorer, arbetsterapeuter, psykologer, rehabiliteringskoordinatorer och beteendevetare, men inkluderar även observationer inom primärvård och företagshälsovård. Hanteringen av arbetsrelaterad psykisk ohälsa i vårdens vardag präglas av att orsaksbilden till problemet är komplext, ansvarsfördelningen otydlig och att psykosociala orsaker till sjukdom är kontroversiellt. I studien diskuteras utmaningarna och möjligheterna kring hanteringen av detta komplexa problem i bred bemärkelse. I analyserna uppmärksammas de yrkesverksammas gränsdragningar kring både ansvar och fenomenet arbetsrelaterad psykisk ohälsa. Begreppet kunskapsinfrastruktur används för att förklara och förstå den kunskapsmässiga och materiella struktur som de yrkesverksamma verkar inom. Analyserna visar att de yrkesverksamma har ett pragmatiskt förhållningssätt och använder olika strategier för att skapa sig handlingsutrymme i hur de hanterar arbetsrelaterad psykisk ohälsa.Mental ill health in working life is a major and growing problem in the welfare society. The problem is multifaceted and raises many questions about who is responsible, what kind of phenomenon it is and how it should be managed. This study examines how care professionals manage work-related mental ill health. Focusing on occupational healthcare and primary care, interest is directed towards how care professionals argue about workrelated mental illness, what dilemmas they face and the strategies they rely on in managing them. It also seeks to answer the question of responsibility regarding this complex problem, not least in the light of the privatization of occupational healthcare. The study uses a multidisciplinary perspective, combining concepts from technology and science studies (STS), sociology of professions and organizational theory in order to analyze various aspects of care management of work-related mental ill health. The empirical material is mainly based on interviews with physicians, psychotherapists, counsellors, occupational therapists, psychologists, rehabilitation coordinators and behavioral scientists, but also includes observations in primary care and occupational health care. The management of work-related mental ill health in everyday healthcare practice is characterized by the fact that the cause of the problem is complex, the division of responsibility unclear and that psychosocial causes of disease are controversial. The study discusses the challenges and possibilities of managing this complex problem in a broad sense. The analysis pays attention to the drawing of boundaries by the care professionals regarding both responsibility and the phenomenon of work-related mental illness. The concept of knowledge infrastructure is used to explain and understand the knowledge and material structures that the care professionals work within. The analysis shows that the care professionals have a pragmatic approach and use different strategies to create scope for dealing with work-related mental health.
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Garcia, Cristiane Andrade. "Um estudo sobre a AMA - Assistência Médica Ambulatorial em Vila Nova Jaguaré / São Paulo e a forma de inserção do serviço social." Pontifícia Universidade Católica de São Paulo, 2009. https://tede2.pucsp.br/handle/handle/18015.
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Previous issue date: 2009-10-23This present research was conducted on the current context of implementing AMAs Assistência Médica Ambulatorial (Ambulatory Medical Assistance) in the city of São Paulo, specifically that located in Vila Nova Jaguaré zone. This AMA is a partnership between Prefeitura Muncipal de São Paulo and Fundação Faculdade de Medicina. It is a study on this service and the insertion of Social Service on this scenario. The field research was developed at AMA-Jaguaré. This study plunged into concepts related to health care, the relationship between private organizations and public assistance, Social Service practice on health care and the professional competence, the work management in a multi-professional team. The methodology has embraced the bibliographic research on the main themes, besides the documental research (laws, manuals and reports), participative investigation and the quantitative/qualitative field research. Concerning the qualitative one, the interview and the semi-structured interview were used in users, employees and professional s approach methodological procedures. The results which were obtained have shown that the service rendered by AMA may have created a new demand within the assistance net, because it showed a search that we can consider as high. We can affirm that there was not a proper projection concerning the assistance demand volume that would be created, considering the limitation of physical space and lack of professionals. Besides, it was evidenced a trend among the users concerning the need of indispensable equipment, such as XR device, for more specific health diagnosis, resulting in a demand of such arrangement. Simultaneously, it was also raised the importance of a higher attention on the reference process, by sending the cases to specialties. In terms of a positive assessment of AMA, it was made explicit the work role from Social Service. Other professionals have recognized it as a differential on user welcome, listening, mediation and attention
A presente pesquisa contextualiza-se no momento atual, de implementação das AMAs - Assistência Médica Ambulatorial na cidade de São Paulo, especificamente daquela situada no bairro de Vila Nova Jaguaré, como parte de uma parceira entre a Prefeitura Municipal de São Paulo e a Fundação Faculdade de Medicina. Constitui um estudo sobre esse serviço e a inserção do Serviço Social nesse contexto. A pesquisa de campo foi desenvolvida na AMA Jaguaré, sendo nela aprofundados alguns conceitos relativos à saúde, à relação de organizações privadas com atendimento público, à prática do Serviço Social na saúde, à competência profissional e à gestão do trabalho em equipe multiprofissional. A metodologia abrangeu pesquisa bibliográfica sobre os temas centrais, além de pesquisa documental (leis, manuais e relatórios), observação participante e pesquisa de campo quanti-qualitativa. Quanto a esta última, foram utilizados como procedimentos metodológicos de abordagem de usuários, funcionários e profissionais, questionário e entrevista semiestruturada. A pesquisa foi norteada por algumas questões básicas, levando-se em conta principalmente a forma como foi pensada em São Paulo a questão das Organizações Sociais no âmbito da saúde, na relação público / privado. Os resultados obtidos evidenciaram que o serviço prestado pela AMA pode ter criado uma nova demanda dentro da rede de atendimento, ao ter recebido uma procura que deve ser considerada alta. Pode-se afirmar que não foi feita uma projeção adequada do volume da demanda de atendimento que seria criada, tanto se considerando a limitação do espaço físico como a insuficiência de profissionais. Além disso, constatou-se entre os usuários um consenso sobre a necessidade de equipamentos indispensáveis, tais como aparelho de RX para diagnósticos de saúde mais específicos, tendo sido reivindicada essa providência. Foi levantada também, paralelamente, a importância de maior atenção ao processo de referência, com a realização de encaminhamentos para especialidades. Em termos de avaliação positiva da AMA, explicitouse o papel do trabalho desenvolvido pelo Serviço Social, que foi reconhecido pelos outros profissionais como um diferencial na abordagem, na escuta, na mediação e no acolhimento do usuário
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Jusseaume, Anne. "Soin et société dans le Paris du XIXe siècle : les congrégations religieuses féminines et le souci des pauvres." Thesis, Paris, Institut d'études politiques, 2016. http://www.theses.fr/2016IEPP0060.
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Au XIXe siècle, les sœurs hospitalières sont au cœur du système de soin parisien. L’identité et les activités sociales de ces femmes qui partagent un engagement religieux et un apostolat soignant auprès des pauvres de la capitale sont analysées dans cette thèse. La vocation, fruit d’un choix entre les jeunes femmes et l’institution, est une voie d’émancipation dans l’espace public et le monde du travail, mais qui leur permet aussi de s’affirmer comme individu en sapant l’autorité paternelle et en légitimant l’expression d’un désir. Chevilles ouvrières du système de santé publique et figures de la charité privée, les sœurs en accompagnent la croissance. Le soin aux pauvres et leur dévouement justifient la reconnaissance de leur utilité sociale devant l’urgence d’une société confrontée à une pauvreté massive et aux effets contrastés du processus de déchristianisation. Paradoxalement, la laïcisation conforterait leur présence dans le dispositif charitable et soignant de la capitale. Les sœurs se forment à certaines exigences médicales et cherchent à maintenir un « écart chrétien » dans le monde. Le soin des sœurs participe ainsi à la médicalisation de la société mais reste une stratégie de reconquête religieuse. Leur apostolat révèlerait que la demande sociale de santé et de religion reposerait sur un souci de soi et un besoin plus vaste d’attention. Mais ce « souci de soi » est aussi, pour les sœurs, une voie fonctionnelle et harmonieuse de réconcilier les volets religieux et profane de leur mission. Dès lors, les sœurs peuvent s’adapter à la modernité en articulant les préoccupations du siècle avec une exigence spirituelleIn the nineteenth century, sisters of charity were at the core of the Parisian health system. This thesis analyses the identity and the social activities of these women who shared a religious commitment and a caring apostolate towards the poor of Paris. Vocation, which resulted from a choice by young women and the religious institution, was a way for these women to find a place in public space and in the workplace. It enabled them to assert themselves as individuals, undermining paternal authority and legitimating the expression of a desire. Cornerstones of the public health system and figures of charity, the nuns accompanied the growth of both. Their care of the poor and their devotion justified their claim to be recognised as socially useful in a context where French society was confronted by the new problem of widespread poverty and by the countervailing effects of dechristianization. Paradoxically, republican secularization would confirm their presence in the capital’s caring and charitable system. The sisters undertook training to new medical standards at the same times as they tried to maintain a ‘Christian singularity’ in the world. The care that the sisters provided played a role in the medicalization of society but nonetheless remained part of a strategy of religious reconquest. Their apostolate would reveal that society’s health and religious needs rested on a ‘care of the self’ and a need for attention. This ’care of the self’ was also a way for the nuns to reconcile the lay and religious aspects of their mission. Thus, sisters of charity could adapt themselves to modernity by articulating worldly preoccupations with a spiritual imperative
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Kašparová, Marie. "Ženy po ablaci prsu v kontextu sociální práce." Master's thesis, 2013. http://www.nusl.cz/ntk/nusl-327855.
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The thesis " Women after Mastectomy in the context of Social Work " deals with the topic of diagnosis of breast cancer, treatments and their side effects, itself, however focuses mainly on the psychological and social consequences that come along with such a serious illness. It aims to outline the possibilities that women with this diagnosis can use , and ultimately points out the great potential of social work within the health care system. Powered by TCPDF (www.tcpdf.org)
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MacLeod, Suzanne. "From the "rising tide" to solidarity: disrupting dominant crisis discourses in dementia social policy in neoliberal times." Thesis, 2014. http://hdl.handle.net/1828/5213.
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As a social worker practising in long-term residential care for people living with dementia, I am alarmed by discourses in the media and health policy that construct persons living with dementia and their health care needs as a threatening “rising tide” or crisis. I am particularly concerned about the material effects such dominant discourses, and the values they uphold, might have on the collective provision of care and support for our elderly citizens in the present neoliberal economic and political context of health care. To better understand how dominant discourses about dementia work at this time when Canada’s population is aging and the number of persons living with dementia is anticipated to increase, I have rooted my thesis in poststructural methodology. My research method is a discourse analysis, which draws on Foucault’s archaeological and genealogical concepts, to examine two contemporary health policy documents related to dementia care – one national and one provincial. I also incorporate some poetic representation – or found poetry – to write up my findings. While deconstructing and disrupting taken for granted dominant crisis discourses on dementia in health policy, my research also makes space for alternative constructions to support discursive and health policy possibilities in solidarity with persons living with dementia so that they may thrive.Graduate
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macsuz@shaw.ca
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"Uncharted Territory: Experiences of Foster Care Youth Navigating the Mental Health System as they Age Out of Care." Doctoral diss., 2015. http://hdl.handle.net/2286/R.I.29905.
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abstract: Youth who turn 18 in the foster care system often face the difficulty of transitioning to adulthood without traditional emotional and financial supports. Early experiences of trauma impact their mental health and receipt of services both while in care as well as decisions whether to continue services after leaving care.
Using the behavior analytic model, this dissertation explores the challenging and supportive situations former foster youth experience with mental health services while transitioning to adulthood. Qualitative interviews and focus groups inform the development of a quantitative instrument in a mixed methods, sequential exploratory research design. The resulting instrument identifies the most intense and frequently encountered situations former foster youth experience, related to their mental health and transitions to adulthood.
Results indicate the most challenging situations foster youth experience during the transition are related to overwhelming expectations, receiving mixed messages from professionals, feelings of isolation, and a lack of voice and choice with regard to mental health services. Young adults in this study also emphasized the importance of responsive engagement, self-efficacy, and consistency in relationships both formally and informally.
This research provides important implications for social work practice, policy, and education. Acknowledging the voice of foster youth gives them a choice in services and allows for realistic transition planning. Developing problem-solving skills and a support network beyond foster care are necessary strategies of preparation to age out. Finally, practitioners should recognize the impact of trauma and other contextual factors when conducting assessment and treatment, to promote positive outcomes.Dissertation/Thesis
Doctoral Dissertation Social Work 2015
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"The Other Consumer: Exploring Caregiver Perspectives of Child Mental Health Services in Arizona." Master's thesis, 2015. http://hdl.handle.net/2286/R.I.29928.
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abstract: The purpose of this study is to understand and explore the perspectives of caregivers of children receiving mental health services in the Southwest. The data collected examines areas of caregiver satisfaction of services including, perceived barriers and agency’s ability to effectively apply the System of Care model’s core values. Participants (N=100) were interviewed using the System of Care Practice Review, Revised. Data results include descriptive quantitative analysis, correlation and means comparisons, and thematic analysis of qualitative responses. The research indicates that as a whole, caregivers are satisfied with child mental health services. Data suggests that providers should continue to strive for improvement and excellence in several areas of service, including intervention effectiveness, family participation, cultural competence, communication and interpersonal relationships.Dissertation/Thesis
Masters Thesis Social Work 2015
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Reddy, N. G. "The viability of a national healthcare system for South Africa : a KwaZulu-Natal case study." Thesis, 2004. http://hdl.handle.net/10413/4343.
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This research is an endeavour to highlight the state of healthcare in South Africa as seen through the eyes of professional health care workers who are at the cold face of healthcare. Having worked in an environment of inequities and unjust circumstances, healthcare workers expressed their attitudes and beliefs that healthcare are in need of radical change. There appears to be insight from these professionals that the private and public healthcare sectors should forge a relationship, ultimately benefiting South African society. More research needs to be done on a major scale to determine more deeply the attitudes and beliefs of healthcare professionals. Such an endeavour will provide a stimulus for policymakers to harness this energy and direct it in a meaningful way in the transformation of healthcare in South Africa. Chapter 1 focused on several relevant perspectives and definitions on healthcare in South Africa and other countries. In Chapter 2, attention was given to socio-economic rights as per the South African Constitution and the states obligations to fulfil these rights. These rights were examined in the context of landmark Constitutional Court cases, viz. Soobramoney versus the State; TAC versus the State; and Grootboom versus the State. These cases give one the essence of interpreting rights and the constitutional obligation of the state to deliver on them. Healthcare developments in South Africa and other countries together with the RDP and GEAR considerations are outlined in Chapter 3. Research Methodology is outlined in Chapter 4, emphasizing also the limitations of this study. Chapter 5 examines the responses to the questionnaires and analyses its findings. Chapter 6 provides the conclusions and recommendations as well as a critique of healthcare in South Africa.Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2004.
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ŘÁDKOVÁ, Klára. "Léčebné konopí ve zdravotně sociální perspektivě." Master's thesis, 2016. http://www.nusl.cz/ntk/nusl-252157.
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This thesis deals with a medical and social view of taking healing hemp (cannabis). It is a theoretical thesis elaborated based on the analysis of the available Czech and foreign information sources and professional publications. The thesis target is to map the issue of taking healing hemp by means of the information from the available foreign and Czech literature. The thesis focuses on the most important issues dealt with by the professional as well as lay public and on the development of the solution of this issue. I was captured by this issue after my internship in Belgium, where I had the opportunity to travel through neighbouring Netherlands and to get to know, from the viewpoint of a foreigner, the opinions and access of the inhabitants to the hemp as healing and relaxing mean. The first chapter deals with using the healing hemp in the historical context. Hemp represents one of the oldest crops and for this reason the history of hemp in the period of antiquity, Middle Ages and modern times is described. The following chapter focuses on the individual substances contained in hemp. In this chapter, the endo-cannabinoid system and three kinds of substances contained in hemp strains are analysed canabinoids (THC), canabidiols (CBD), canabinols (CBN). The chapter presents the profile of one of the most important personalities associated with hemp, professor Raphael Mechoulam, the main icon and discoverer of THC. The chapter three devotes to toxicology and addiction when taking hemp, which occurs quite rarely among users of hemp drugs. In this chapter, influence of hemp on the memory of user is treated, as well as the influence of hemp on the occurrence of lungs diseases discussed constantly in connection with smoking and in the last part of this chapter, the addiction and influence of hemp on users psyche is analysed. The following chapter is devoted to the issue of the drug policy, especially defining the status of healing hemp in the law, research of healing hemp and legalization of hemp in the Czech Republic. This chapter is devoted in detail to the legalization of hemp in the world, especially in the states like California, Israel, Canada and Netherlands where the hemp was legalized for healing purposes many years ago. The present science brings a wide spectrum of clinical research examining the effects of hemp during the treatment of many diseases. For this reason, the chapter dealing with hemp in connection with medicine is present in the thesis. Six areas were chosen from individual medicine branches on which this chapter is focused. The reader learns about the healing effects of hemp in the area of oncological diseases, psychiatric diseases, palliation of pain, dermatological diseases, multiple sclerosis and HIV/AIDS. In the last chapter, the opinions and experiences of the professional public in connection with hemp are described. This part deals with the contribution of the newest knowledge presented at the Prague conference about healing hemp. In this part of thesis, also the international hemp Cannafest Trade Fair is mentioned held in 2015 in Prague. It follows clearly from the thesis that the health and social issues connected with healing hemp is the topic of extensive and long-lasting discussions at present. In the area of the lay public, there is interest in this form of medical treatment which is supported quite a lot. The thesis may be used as information source by medical/paramedical and social employees and organizations supporting the legal use of healing hemp. It could represent the base of a professional article for the journal dealing with this topic as e.g. professional journals "Legalization" or "Health." Last but not least, the thesis should serve as complex of information for the persons who decided to take the hemp or consider this possibility.
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Terrapon, Wendy. "Utilizing dyadic brief gestalt play therapy within an unstable adolescent foster placement." Diss., 2001. http://hdl.handle.net/10500/2889.
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In the experience of being a play therapist and social worker, the researcher became aware of the breakdown of adolescent foster placements. Although there are many causal factors of adolescent foster care breakdown, it was the treatment and sustaining of these placements that the researcher was interested in. The utilization of dyadic brief Gestalt play therapy aims to support the relationship between the carer and adolescent in order to sustain and stabilize the foster placement.
The empirical study includes data collection and analysis. The data was gathered through observations and field notes from unstructured interviews, in this case the dyadic therapeutic process with the adolescent and carer. The data was then analyzed, and eleven outcomes were discussed: the building of a therapeutic relationship, the process of dialogue, the gaining of awareness, contact, resistance, the internal working model, polarities, working in the here and now, the utilization of Gestalt experiments and Gestalt play therapeutic techniques. In addition, the implications of the brief Gestalt therapeutic model were identified. These themes are discussed fully in the final chapter encompassing conclusions and recommendations.This study found that it was possible to work effectively with the adolescent and carer in a dyadic brief Gestalt therapeutic way utilizing play therapy techniques. Recommendations regarding the conclusions were made in relation to the outcomes of this study.Social Work
M.Diac. (Play therapy)
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Coughlan, Felicity Jane. "Implementing state policy in a children's home : a transformation process." Thesis, 1998. http://hdl.handle.net/10500/17934.
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VRZALOVÁ, Monika. "Role sestry ve screeningu deprese u seniorů." Master's thesis, 2016. http://www.nusl.cz/ntk/nusl-260905.
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The diploma thesis deals with problems of depression in older people. Mainly the work is focused on identifying and analyzing the role of nurses in screening for depression in older people in primary care, acute care, long-term care and home care. This thesis was focused on theoretical direction and was used the method of design and demonstration. In this thesis was set one main goals with five research questions. The main goal was to identify and analyze the role of nurses in screening for depression in the elderly. RQ 1: What is the role of the nurse in screening for depression in the elderly? RQ 2: What is the role of the nurse in the primary care in screening for depression in the elderly? RQ 3: What is the role of the nurse in screening for depression in hospitalized patients in acute care? RQ 4: What is the role of the nurse in screening for depression in seniors in long-term and home care? RQ 5: What rating scales and methods are used in screening for depression in the elderly? The thesis introduce the concept of depression. The following are specified the causes of and the important factors that affect depression in the elderly. It also deals the differences in the clinical symptomatology of depression in old age. It explains possibilities and various barriers in the diagnosis of depression. Another chapter introduces complete geriatric examination, diagnostic classification systems, possible screening methods and scales for detection of depression in the elderly population. It also deals methods of pharmacological and non-pharmacological treatment and its possible complications associated with older age. By reason of increased suicide rate caused by depressive disorder the issue of suicidal behavior in the elderly is introduced. The next chapter deals with the nursing process, which is used by nurses in practice. It consists of the evaluation of the patient's health condition, making nursing diagnosis, creating nursing plan and subsequent implementation and evaluation. The nursing process is also needy for providing quality care. The nursing process in the stage of nursing diagnosis, introduces possible nursing diagnosis for a patient suffering from depression, which are based on the latest classification. Finally is described the role of nurses in screening for depression in the elderly in different health facilities and their contribution to the timely evaluation of depression in the elderly. This chapter introduces the role of nurses, nursing screening and collaboration with a physician. The role of nurses in screening for depression in different medical facilities is based on the first phase of the nursing process of assessment. On the basis of objective and subjective information, the nurse will assess the overall health and mental condition of the patient. Primarily, it was investigated what is the role of the nurse in screening for depression. On the basis of content analysis and synthesis it was necessary to used and processed domestic and foreign literature. A number of relevant sources are the results of various studies and Meta-analyzes, mostly from abroad, but also from the Czech Republic. The thesis can serve as a basis for nurses. The result of this thesis is to create e-learning material available for students in the Faculty of Health and Social Sciences of South Bohemia in Ceske Budejovice in the tutorial called Moodle.