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Bu, Yi-Qin, and Jieyu Wang. "Overview of Care Coordination Within Specialized Home Care in Stockholm County." Thesis, KTH, Skolan för teknik och hälsa (STH), 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-183441.
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The ageing population of Sweden is expected to increase throughout the future decades. Changing life-style trends and smaller families in the modern society has decreased the population’s access to informal care. This is expected to entail an increase in the services provided by specialized home care. This thesis studies the work performed by nurses within the department of specialized home care (ASIH) in Stockholm County. The nurses represent the majority of all professions active at ASIH in Stockholm County, which puts their work in particular interest for this thesis. The thesis focuses on the ways the nurses’ work procedures may influence continuity of care and patient safety. Continuity of care is an essential component in qualitative care and is characterized by well-executed coordination and minimization of broken patient appointments. A high level of continuity of care consequently entails a high level of patient safety. Descriptions of continuity of care at ASIH in Stockholm County can therefore provide indications on current care quality and areas of improvement. The thesis consists of two parts – a literature review containing international research on continuity within home care and an empirical study containing a retrospective analysis based on the Functional Resonance Analysis Method (FRAM). The empirical study creates an overview of work tasks related to nursing performed at three units of ASIH in Stockholm County. The interdependencies between work tasks are identified and important chain reactions are analyzed. The findings from this thesis indicate that extended training programs for nurses in the initial phase of employment is likely to decrease the number of disruptions in the nurses’ work. Furthermore, well-developed routines could facilitate work task procedures which would decrease the number of delays and disruptions in the nurses’ work. It was found that these findings together with information continuity between all parties involved represent significant factors for attaining continuity of care and patient safety at ASIH in Stockholm County.Den äldre befolkningen i Sverige förväntas öka under de kommande årtiondena. Det moderna samhället har dessutom medfört förändrade livsstilar och allt mindre familjekonstellationer, vilket har resulterat i en minskad tillgång till anhörigvård. Detta förväntas medföra en ökad efterfrågan av tjänster som tillhandahålls av specialiserad hemsjukvård. Den specialiserade hemsjukvården ansvaras av Avancerad Sjukvård I Hemmet (ASIH) i Stockholms län. Sjuksköterskor utgör den största andelen anställda av de yrken som är verksamma vid ASIH. Denna rapport undersöker sjuksköterskornas arbetsflöden vid tre ASIH-enheter i Stockholms län. Rapporten fokuserar på att undersöka på vilka sätt sjuksköterskornas arbetsprocesser kan påverka vårdens kontinuitet och patientsäkerhet. Vårdkontinuitet är ett centralt begrepp i kvalitativ hemsjukvård och kännetecknas av välkoordinerad vård och lågt antal otillfredsställande patientbesök. God vårdkontinuitet förväntas medföra hög patientsäkerhet. Återgivningar av den nuvarande vårdkontinuiteten på ASIH i Stockholms län tros därför kunna skapa en uppfattning om den nuvarande vårdkvaliteten samt eventuella förbättringsområden. Denna rapport utgörs av två delar – en litteraturstudie som innehåller internationell forskning om vårdkontinuitet i hemsjukvård samt en empirisk studie som innehåller en retrospektiv analys baserad på Functional Resonance Analysis Method (FRAM). Den empiriska studien skapar en översikt över sjuksköterskors huvudsakliga arbetsuppgifter vid de tre undersökta ASIH-enheterna belägna i Stockholms län. Arbetsuppgifternas korrelationer samt ömsesidiga påverkan kartläggs och signifikanta kedjereaktioner analyseras. Resultaten i denna rapport påvisar att utökad undervisning för sjuksköterskor i anställningens inledande skede kan troligen minska antalet störningar i sjuksköterskornas dagliga arbete. Dessutom påvisar resultaten att fler tydliga rutiner skulle kunna underlätta sjuksköterskornas arbetsprocesser, vilket skulle kunna minska antal förseningar och störningar i deras dagliga arbete ytterligare. Dessa fynd i kombination med välfungerande kommunikationer mellan alla berörda parter utgör de huvudsakliga åtgärderna för att erhålla vårdkontinuitet och patientsäkerhet hos ASIH i Stockholms län.
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Mütze, Ulrike, Alena Gerlinde Thiele, Christoph Baerwald, Uta Ceglarek, Wieland Kiess, and Skadi Beblo. "Ten years of specialized adult care for phenylketonuria." Universitätsbibliothek Leipzig, 2016. http://nbn-resolving.de/urn:nbn:de:bsz:15-qucosa-205208.
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Background: Specialized adult care of phenylketonuria (PKU) patients is of increasing importance. Adult outpatient clinics for inherited errors of metabolism can help to achieve this task, but experience is limited. Ten years after establishment of a coordinated transition process and specialised adult care for inherited metabolic diseases, adult PKU care was evaluated with respect to metabolic control, therapy satisfaction, life satisfaction, sociodemographic data, economical welfare as well as pregnancy outcome. Methods: All PKU patients transferred from paediatric to adult care between 2005 and 2015 were identified. A
retrospective data analysis and a cross-sectional survey in a sub-cohort of 30 patients including a questionnaire for assessing quality of life (FLZm) were performed as a single-centre investigation at the metabolic department of the University Hospital Leipzig, Germany. For statistical analysis, Mann-Whitney-U-test, t-test for independent samples, ANOVA and chi square test were used as appropriate. Results: 96 PKU patients (56 females/40 males; median age 32 years, range 18–62) were included. In the last 3-year period, 81 % of the transferred patients still kept contact to the adult care centre. Metabolic control was stable over the evaluation period and dried blood phenylalanine concentrations mostly remained within the therapeutic range (median 673.0 μmol/l, range 213.0–1381.1). Sociodemographic data, economical welfare and life satisfaction data were comparable to data from the general population. However, differences could be revealed when splitting the cohort according to time of diagnosis and to management during childhood. 83 % of the PKU adults were satisfied
with the transition process and current adult care. 25 completed pregnancies were supervised; three newborns, born after unplanned pregnancy, showed characteristic symptoms of maternal PKU syndrome. Conclusions: Continuous care for adult PKU patients in a specialized outpatient clinic is successful, leading to good to satisfactory metabolic control and social outcomes. Uninterrupted good metabolic treatment throughout childhood and adolescence positively influences educational, professional and economic success in later life. Further effort in specialized paediatric and adult metabolic care is needed to prevent loss of follow-up and to support the recommended life-long treatment and/or care.
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Huguet, Marius. "Volume-outcome relationship in health, inequalities in access to care and referral of patients for specialized care." Thesis, Lyon, 2020. http://www.theses.fr/2020LYSE2012.
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Cette thèse de doctorat étudie la question de la centralisation des soins pour le traitement du cancer, et apporte des preuves empiriques sur de nombreux aspects liés à cette problématique. Le chapitre 1 explore la relation entre le volume d’activité des hôpitaux et la qualité des soins pour le traitement du cancer de l’ovaire. L’exploitation d’une base de données comprenant des informations très détaillées sur le degré de sévérité du cancer nous a permis de mettre en évidence de très fortes disparités de survie en fonction du volume d’activité de l’établissement de prise en charge. Le deuxième chapitre de cette thèse vise à identifier les mécanismes soutenant cette relation, et plus particulièrement la contribution du choix du traitement par les cliniciens dans l’effet causal du volume d’activité sur la qualité des soins. Les résultats confirment la contribution du processus de sélection du traitement par les cliniciens dans l’effet causal du volume d’activité sur la qualité des soins, et apportent ainsi de nouveaux éléments permettant caractériser l’effet d’apprentissage induit par le volume d’activité. Le chapitre 3 a pour objectif d’évaluer l'impact d'une centralisation des soins pour le traitement du cancer du sein et de l’ovaire sur les inégalités spatiales et socioéconomiques d'accès aux soins spécialisés. En exploitant une base de données administrative nationale, nos résultats indiquent une forte détérioration de l’accès aux soins spécialisés si une telle réforme était appliquée, ainsi qu’une répartition territoriale et socioéconomique très inégale du fardeau de la centralisation. Dans une perspective plus large, il est primordial de mieux comprendre les mécanismes liés à l’adressage des patients vers les hôpitaux, afin de mieux saisir la nécessité - ou non - de centraliser les soins. L’objectif du quatrième chapitre de cette thèse est d’identifier les préférences des patients dans le choix de leur établissement de prise en charge pour le traitement du cancer, en tenant compte du rôle du médecin traitant dans l’adressage. Nos résultats soulignent le rôle central du médecin traitant dans le processus de d’adressage, et mettent en évidence des facteurs limitant le libre choix de l’établissement de prise en chargeThis PhD dissertation provides empirical evidence on many aspects of the volume-outcome relationship with regard to cancer care. In the first chapter, we explore the relationship between hospital volume activities and patient outcomes for ovarian cancer care. Using a wide-ranging set of clinical characteristics depicting patients’ degree of illness, we identified a strong volume-outcome relationship, with substantial differences in survival between patients treated in high volume and in low volume hospitals. In the second chapter, we look in more depth into what underlies the observed hospital volume-outcome relationship. More specifically, we provide evidence on the contribution of clinician decisions (i.e., which drive patient care pathways) to the causal impact of hospital volume on patient outcomes. Our findings substantiate the contribution of clinician decisions regarding the treatment option to the causal impact of hospital volume on patient outcomes, thereby offering a better understanding of this complex relationship. In chapter 3, we use a nationwide administrative dataset to evaluate the impact that centralization of care for breast cancer and ovarian cancer treatment has on spatial and socioeconomic inequalities in access to specialized care. Our findings indicate a strong and highly unequally distributed deterioration in patient access to specialized care, which highlights a major adverse consequence of such a policy. From a broader perspective, there is a need to understand the mechanisms of patient referral to hospitals to better understand the potential necessity of centralized care. The fourth chapter of this thesis provides evidence of patient preferences for cancer care using a revealed preferences framework, taking into account that patient choice sets are actually unobserved. Our findings highlight the importance of the choice set preselection, which could be related to the role of general practitioners in the referral process and substantiate several barriers to patient choice
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Araya, Elsa Semere. "An assessment of kangaroo mother care among staff in a specialized neonatal intensive care unit, Asmara, Eritrea." Master's thesis, University of Cape Town, 2018. http://hdl.handle.net/11427/29346.
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Introduction: Preterm delivery remains the major cause of newborn infants’ morbidity and mortality globally and more so in low-income countries like Eritrea. Research has shown that the provision of Kangaroo mother care (KMC) can contribute to a reduction in morbidity and mortality among newborn infants. However, there is limited research on the practice of KMC in Eritrea. Methods: A mixed methods approach was adopted in a phenomenographic study to collect the data. Eleven participants with work experience of at least two years were recruited from the Specialised Neonatal Intensive Care Unit (SNICU) at Orotta Paediatric Hospital (OPH), Asmara, Eritrea. Data were collected via individual interviews and observations. Results: The results showed that participants had no prior KMC training and education. In addition, staff had limited knowledge and mixed attitudes about KMC practice. There were also no KMC guidelines and protocols. Furthermore, space was not adequate for full KMC practice except for implementation of the kangaroo position. The researcher’s observation confirmed similar evidence of a lack of availability of a KMC ward and lack of protocols and guidelines. Limited interaction and communication about KMC between participants and parents was also observed. Some of the most common hindrances to KMC practice were the perception that KMC increased staff work load and that it was time consuming. In addition, lack of regular KMC training for staff, lack of a convenient setup and too few staff members were among the hindrances. One staff members also perceived that KMC practice was not culturally accepted. 15 Conclusion: The results of this study showed that there were no proper KMC guidelines and protocols in the ward. In addition, only the kangaroo position was practiced, not the full KMC protocol. Furthermore, staff had limited knowledge and mixed attitudes. The observation component of the research highlighted the lack of space and KMC protocols and guidelines as key limitations for delivering KMC. Therefore, it is recommended that a programme to improve staff knowledge be implemented, that evidence-based KMC guidelines and polices be made available, that the KMC ward be expanded, and that health education about KMC practice be brought to the population through mass media
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Boisvert, Joanne. "The effects of a specialized day care program on people with Alzheimer's disease /." Thesis, McGill University, 1993. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=68155.
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A specialized day care program was developed for community-residing individuals diagnosed with Senile Dementia of the Alzheimer Type (SDAT). Eighteen subjects with SDAT who were categorized at stages 3 and 4 of the Global Deterioration Scale participated in the day care program once a week for 12 weeks. Activities for the program were selected so as to stimulate cognitive processes as well as promote independence in activities of daily living (ADL) and instrumental activities of daily living (IADL). Emphasis was placed on habilitation. The Mini-Mental State Examination, the Hierarchic Dementia Scale, and the Rapid Disability Rating Scale-2 were used to assess the performance of the subjects. Cognitive and functional performances were measured before the program began, throughout the 12 weeks of intervention, at completion, and one-month post-intervention. The Burden Interview was used to measure the burden expressed by the family caregivers. There were no significant changes in the group's functional and cognitive performance as measured on the three tests, but performance did remain stable over the 16-week period and did not deteriorate. Scores on the Burden Interview also remained stable.
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Rivera, Mara Liz. "The gift of diakonia, the caring ministry of the whole church in specialized care cells." Chicago, IL : McCormick Theological Seminary, 2000. http://dx.doi.org/10.2986/tren.102-0004.
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Spencer, Patricia L. "The influence of specialized cancer hospitals in Florida on mortality, length of stay, and charges of care." [Tampa, Fla] : University of South Florida, 2008. http://purl.fcla.edu/usf/dc/et/SFE0002725.
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Matthews, Sara L. "Maternal care, male-male aggression, and the use of a specialized appendage in the Caprellid amphipod, Caprella mutica /." Connect to title online (Scholars' Bank), 2008. http://hdl.handle.net/1794/7984.
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Matthews, Sara L. 1984. "Maternal care, male-male aggression, and the use of a specialized appendage in the Caprellid amphipod, Caprella mutica." Thesis, University of Oregon, 2008. http://hdl.handle.net/1794/7984.
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ix, 55 p. : ill., maps. A print copy of this thesis is available through the UO Libraries. Search the library catalog for the location and call number.Aggressive behaviors in many animals increase juvenile survival and reproductive success. I explored the role of aggressive behavior in maternal care and male-male competition in caprellid amphipods. Attacks of females in three reproductive states toward male and female conspecific and congeneric caprellids were quantified. Parental females showed greatest aggression toward males of both species, suggesting these caprellids may pose threats to juveniles. Paired males were exposed to females in three reproductive states and other males and fought most often in the presence of nonbrooding females. This finding suggests that males recognize and fight over receptive females. Males fight with the second gnathopods and "poison tooth," which may cause fatalities in conflicts. Mortality rates of males with and without (removed) poison teeth were not significantly different, but the highest observed mortality rate was no-tooth caprellids when paired with toothed males, suggesting presence of the teeth may impact the outcome of male-male conflicts.
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González, Robles Vicente Alberto. "Effectiveness of a transdiagnostic Internet-based protocol for the treatment of emotional disorders in public specialized mental health care." Doctoral thesis, Universitat Jaume I, 2019. http://hdl.handle.net/10803/666585.
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The principal objective of the current doctoral thesis was to test the effectiveness of a transdiagnostic Internet-based cognitive-behavioral protocol for emotional disorders (depression and anxiety disorders), compared to treatment as usual in Spanish public specialized mental health care. Overall, the results showed that the transdiagnostic Internet-based protocol was more effective than treatment as usual in measures of anxiety, depression, and quality of life. Additionally, a number of secondary studies were conducted: a systematic review to summarize the state-of-the-art about transdiagnostic treatments for emotional disorders, two validation studies focused on brief measures for the assessment of anxiety and depression, and a randomized pilot study testing the feasibility of a transdiagnostic protocol that includes a component for the regulation of positive affectivity. The findings of the current doctoral thesis contribute to the field of transdiagnostic treatments, showing that a transdiagnostic Internet-based protocol can be effectivily delivered in public specialized mental health care.La presente tesis doctoral se centró fundamentalmente en estudiar la efectividad de un protocolo de tratamiento transdiagnóstico cognitivo-comportamental online para trastornos emocionales (ansiedad y depresión), en comparación al tratamiento habitual proporcionado por el sistema público español de salud mental. Globalmente, se encontró una mayor efectividad del protocolo de tratamiento transdiagnóstico online en comparación al tratamiento habitual en medidas de ansiedad, depresión y calidad de vida. Además, se realizaron distintos estudios secundarios: una revisión sistemática sobre protocolos de tratamiento transdiagnósticos, la validación de dos instrumentos breves para la evaluación de la ansiedad y la depresión, y un estudio piloto aleatorizado para probar la viabilidad de un protocolo de tratamiento transdiagnóstico con un componente de regulación del afecto positivo. Los resultados de esta tesis contribuyen al campo de los tratamientos transdiagnósticos, mostrando que un protocolo de tratamiento transdiagnóstico online puede ser administrado de manera efectiva en el sistema público de salud mental.
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Waters, Leland. "Factors Associated with Access to Palliative Care in a Large Urban Public Teaching Hospital with a Formal Hospital-Based Palliative Care Program." VCU Scholars Compass, 2012. http://scholarscompass.vcu.edu/etd/2746.
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Hospital-based specialist palliative care services are designed to address the needs of critically ill patients by psychosocial and spiritual support, improving symptoms management, and offering discussions on goals of care. Integrating palliative care upstream in the care continuum for patients who eventually die in the hospital will help to address the many individualistic needs of the critically ill patient. The diffusion of specialist hospital-based palliative care services requires an understanding of patterns of utilization by patients. The purpose of this study was to examine the population characteristics of decedents who may or may not have utilized specialist palliative care services in a hospital setting in order to develop a model of predictors of access to specialist palliative care services. The basic constructs of this study are grounded in the Behavioral Model of Health Services Use. Potential access is measured in terms of population characteristics, which include predisposing characteristics, enabling resources, and evaluated need. Building on this theoretical model, the study sought to better understand equitable and inequitable access to specialized palliative care services and to define which predictors of realized access were dominant. The research question asked was: What are predictors of access to specialized palliative care within a large urban public teaching hospital? A model of access to a palliative consult and a predictor of access to a palliative care unit were explored. Findings from this study revealed that factors encouraging access to a palliative care consult include older age, White non-Hispanic ethnic membership, a diagnosis with solid cancer and insurance. Factors encouraging access to a palliative care unit include older age, gender (female), insurance, and either a solid cancer or hematologic malignancy diagnosis.
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Collinsworth, Brittney M. "Hospital to housing| A grant proposal for specialized discharge planning services for people who are homeless." Thesis, California State University, Long Beach, 2014. http://pqdtopen.proquest.com/#viewpdf?dispub=1527688.
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The purpose of this project was to identify and create a program that would meet the needs of a target population, identify potential funding sources, and write a grant to fund a program at St. Mary's Hospital in Long Beach, California. An examination of the literature expanded knowledge about the challenges homeless individuals face. Homeless individuals commonly receive inadequate medical care and often access more costly acute care services due to limited resources, discrimination, and cost. Housing and case management services after discharge from a hospital setting can help improve health care outcomes and reduce costly services.
The program was designed to provide specialized discharge planning services to homeless individuals being discharged from St. Mary's Hospital. The California Wellness Foundation was chosen for this grant based on the program areas of the funder. The actual submission and/or funding of this proposal was not a requirement for completion of this project.
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MacNamara, Tamara Brook-Linn. "Variability in current practice used in confronting trauma in the lives of the nation's children who live in foster care : a national survey of specialized foster care services /." view abstract or download file of text, 2003. http://wwwlib.umi.com/cr/uoregon/fullcit?p3095261.
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Thesis (Ph. D.)--University of Oregon, 2003.Typescript. Includes vita and abstract. Includes bibliographical references (leaves 211-224). Also available for download via the World Wide Web; free to University of Oregon users.
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Arfvidsson, Isaksson Josefin, and Zara Stiberg. "Emotionellt stöd inom palliativ slutenvård : närståendes erfarenheter." Thesis, Högskolan Kristianstad, Fakulteten för hälsovetenskap, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:hkr:diva-18014.
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Bakgrund: I Sverige avlider varje år cirka 90.000-100.000 personer. Trettiofem till fyrtio procent av svårt sjuka avlider inne på sjukhus och 40–50% på någon form av hospice. Att vara närstående till någon som är svårt sjuk medför många emotionella svårigheter såsom oro, stress och ovisshet. Sjuksköterskan har en viktig roll då hen genom emotionellt stöd kan lindra onödigt lidande hos närstående.Syfte: Syftet var att beskriva närståendes erfarenheter av emotionellt stöd från sjuksköterskan vid den sena palliativa fasen inom slutenvård samt beskriva skillnader mellan palliativ vård på sjukhus och specialiserad palliativ vård.Metod: Designen var en allmän litteraturstudie med systematisk sökning efter empiriska vetenskapliga artiklar.Resultat: Närståendes erfarenheter delades upp i sex olika kategorier: tydlig och ärlig information gav känsla av lättnad och trygghet, tillgängligheten till sjuksköterska gav känsla av närhet och minskad ensamhet, samtalet gav känsla av att vara sedd och betydelsefull, praktiskt stöd gav känsla av tacksamhet och att bli omhändertagen, egentid och tillgång till privat utrymme gav känsla av ro och bevarad integritet, skillnader mellan palliativ vård på sjukhus och specialiserad palliativ vård.Slutsats: Närståendes erfarenheter visade att sjuksköterskan gav emotionellt stöd då hen gav tydlig och ärlig information, fanns tillgänglig, samtalade med närstående, gav praktiskt stöd samt möjliggjorde egentid och privat utrymme för närstående. Det visade sig att på hospice och liknande palliativa vårdenheter var erfarenheterna övervägande positiva medan erfarenheterna från sjukhus var både positiva och negativa.
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Molin, Mattias. "Hemtjänstpersonalens upplevelse av stöd i omvårdnadsarbete från ett specialiserat palliativt team." Thesis, Sophiahemmet Högskola, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:shh:diva-2423.
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SAMMANFATTNING Syftet med denna studie har varit att beskriva hemtjänstpersonalens upplevelse av stödet i omvårdnadsarbetet från ett specialiserat palliativt team. I studien har kvalitativa semistrukturerade fokusgruppsintervjuer använts som metod. Antal folkgruppsintervjuer har varit två med sammanlagt tretton hemtjänstpersonal. En innehållsanalys av intervjuerna har därefter genomförts. Resultatet av data analyserna visade på tre huvudkategorier: Organisation, information och stöd. Hemtjänstens personal upplevde att stödet de fick av det specialiserade palliativa teamet var vägledande för dem i omvårdnadsarbetet. Det som upplevdes som särskilt viktigt i stödet var att få kunskaper om patienterna och deras omvårdnadsbehov av sjuksköterskorna i det specialiserade teamet. Även frågor som tillgänglighet och information framkom som angelägna i stödet. Synpunkter av mindre positivt slag var hur samarbetet mellan hemtjänsten och det specialiserade palliativa teamets huvudmän, kommun och landsting, fungerade i vissa omvårdnadssituationer. I denna studie dras slutsatsen att stödet till hemtjänsten från det specialiserade palliativa teamet upplevdes förbättra hemtjänstens omvårdnadsarbete i mötet med de patienter som var inskrivna hos det specialiserade palliativa teamet. Tillgängligheten och den upplevda kunskapen hos sjuksköterskorna i det palliativa teamet som hemtjänsten hade kontakt med var ett gott stöd för hemtjänsten i deras omvårdnadsarbete. I vissa fall fanns behov av ytterligare handledning och utbildning från det palliativa teamet.ABSTRACT The aim of this study was to describehome care personals` experiences of support received from a specialist palliative care team. A qualitative research approach was used to carry out this study with, semi-structured focus group interviews A total of 13 home care personal participated in two focus group interviews. Data was analyzed using a content analysis approach. The findings in this study were divided up into three main categories: Organization, Information and Support. Home help personal expressed that the support they received from a specialized palliative team strengthened them in their caring role. It was deemed of great importance that the specialized palliative care team had extensive knowledge about the persons receiving care and their needs. Having access to such information was important for the interviewed home care personal. A challenge identified was the fact that home care services and specialized palliative team, (municipal and county) were run by two separate organisations. This created problems in certain care situations. This study concludes that availability and perceived expertise of the specialist palliative care team support supported and strengthened the home care personal in their caring role. A desire for further supervision and training from the specialist palliative team was expressed.
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Cruz, Ellis Cleuza Lopes Ramos da. "WEB 2.0 sites in health care services barriers to adoption : case study at Fresenius Nephocare." Master's thesis, Instituto Superior de Economia e Gestão, 2015. http://hdl.handle.net/10400.5/11219.
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Mestrado em Gestão de Sistemas de InformaçãoAs Tecnologias de Informação são actualmente transversais a quase todos os sectores de actividade, incluindo os serviços de saúde. Relativamente aos serviços de saúde, há uma quantidade incomensurável de informações encontrada na Internet, através de redes sociais, comunidades online e sites especializados, e hoje os utilizadores criam o seu próprio conteúdo com ajuda das tecnologias web 2.0, permitindo a construção de uma enorme base de dados criada por utilizadores para os utilizadores. No entanto isto traz-nos dúvidas em relação a fraca aderência a esses sites web 2.0 relacionadas com os serviços de saúde, sobre quais os motivos ou causas por detrás dessa fraca aderência? O objectivo desta investigação é encontrar orientações que nos ajudarão a responder à questão de investigação: "Quais as barreiras de adoção aos sites Web 2.0 nos serviços de saúde", em pacientes portadores de IRC (insuficiência renal crônica). Para tal, foi escolhido o método de estudo de caso, usando uma estratégia exploratória e descritiva, resultantes do questionário aos pacientes de uma clínica de hemodiálise, bem como entrevistas, feitas à profissionais da área que trabalham em associações, hospitais e clínicas para complementar o estudo de caso. Mostrar as maiores barreiras de adoção encontradas, bem como perceber se existem novas oportunidades inerentes aos sites web 2.0 nos serviços de saúde, na perspectiva dos utilizadores e profissionais, bem como o risco-benefício associado.
Information technologies are currently transversal to almost every sectors of activity, including health care services. In health care services there is an immeasurable quantity of information over the internet, through social networks, online communities and specialized websites, and today users create their own content using web 2.0 technologies, allowing the construction of an enormous database created by users for the users. However it brings a doubt regarding the poor adherence to these web 2.0 sites health-related , so if there is a cause or reason , what it would be? So the aim of this investigation is to find guidelines that will help us to answer the question: ?What are the barriers to adoption of Web 2.0 sites in healthcare services?, within patients with CKD (Chronic Kidney Disease). For such, the case study method was chosen, using an exploratory and descriptive strategy resulting from the survey of patients attending a clinic of hemodialysis, as well as interviews, made to professionals who work in associations, hospitals and clinics to augment the case study. The goal is to show the biggest barriers of adoption encountered as well as realize new opportunities inherent to web 2.0 sites in the health system, from the perspective of users and professionals, as well as the risk-benefit associated.
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Silva, Viviane Martins da. "Characterization of nursing diagnoses in children with congenital heart disease: Study at a specialized hospital in diseases cardiopulmonary." Universidade Federal do CearÃ, 2007. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=1050.
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CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel SuperiorOs cuidados de enfermagem para crianÃas com cardiopatia congÃnita devem ser estabelecidos e executados tÃo logo se suspeite do diagnÃstico de defeito cardÃaco congÃnito, voltados sempre para a detecÃÃo precoce de sinais de descompensaÃÃo e manutenÃÃo de condiÃÃes Ãtimas para a cirurgia. Objetivou-se caracterizar o quadro de diagnÃsticos de enfermagem apresentados por crianÃas com cardiopatias congÃnitas. Estudo de natureza observacional, longitudinal desenvolvido nos meses de julho a novembro de 2004. A amostra foi composta por 45 crianÃas internadas em um hospital da rede pÃblica do municÃpio de Fortaleza-CearÃ. Para a coleta, foram utilizados entrevista e exame clÃnico de enfermagem. As crianÃas foram acompanhadas durante quinze dias de internamento desde a data de sua admissÃo. No perÃodo efetivaram-se seis avaliaÃÃes diagnÃsticas com intervalo de 48 horas. O processo de elaboraÃÃo e inferÃncia dos diagnÃsticos e problemas colaborativos seguiu as etapas de coleta, interpretaÃÃo / agrupamento das informaÃÃes e nomeaÃÃo de categorias. Foram encontrados 22 diagnÃsticos de enfermagem, 34 fatores relacionados e 13 problemas colaborativos diferentes nas 270 avaliaÃÃes realizadas. Observou-se associaÃÃo estatisticamente significante entre os diagnÃsticos Troca de gases prejudicada, PadrÃo respiratÃrio ineficaz, IntolerÃncia à atividade, Crescimento e desenvolvimento retardados e PerfusÃo tissular ineficaz. Estes diagnÃsticos apresentaram associaÃÃo com os fatores relacionados: DesequilÃbrio da ventilaÃÃo-perfusÃo, HiperventilaÃÃo, ReduÃÃo mecÃnica do fluxo sangÃÃneo, SecreÃÃes brÃnquicas e SecreÃÃes retidas. Os diagnÃsticos IntolerÃncia à atividade e Crescimento e desenvolvimento retardados mostraram associaÃÃo com o sexo feminino. Nos diagnÃsticos Troca de gases prejudicada, PadrÃo respiratÃrio ineficaz, IntolerÃncia à atividade, Crescimento e desenvolvimento retardados e DÃbito cardÃaco diminuÃdo, identificaram-se diferenÃas de mÃdia de sobrevida entre crianÃas atà 4 meses e acima de 4 meses. Os diagnÃsticos Troca de gases prejudicada, PadrÃo respiratÃrio ineficaz, IntolerÃncia à atividade e Risco para infecÃÃo ocorreram precocemente no perÃodo de internamento. Entre os diagnÃsticos, seis evidenciaram maiores oscilaÃÃes em suas trajetÃrias de ocorrÃncia no tempo: PadrÃo respiratÃrio ineficaz, IntolerÃncia à atividade, DesobstruÃÃo ineficaz das vias aÃreas, Hipertermia, PadrÃo de sono perturbado e Risco para intolerÃncia à atividade. Foram construÃdos cinco modelos paramÃtricos no domÃnio tempo, com vistas a predizer a ocorrÃncia desses diagnÃsticos de enfermagem. O ajustamento das equaÃÃes para os diagnÃsticos PadrÃo de sono perturbado e Hipertermia denotou grande dispersÃo entre os dados e a linha de tendÃncia, indicando que, alÃm do tempo, outras variÃveis determinam a proporÃÃo de crianÃas que manifestarÃo esses diagnÃsticos. Considera-se a importÃncia de se realizar pesquisas de caracterizaÃÃo do quadro de diagnÃsticos para determinaÃÃo das necessidades de assistÃncia de enfermagem à crianÃa cardiopata. O conhecimento da evoluÃÃo temporal das respostas do indivÃduo pode direcionar os cuidados de enfermagem para as reais necessidades do cliente, facilitando, assim, a escolha de intervenÃÃes mais adequadas
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Griffin, Patricia Lynne. "The potential impact of population-based funding in regional models on the planning, financing and delivery of specialized health care services, the case of paediatrics." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2000. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape4/PQDD_0021/NQ53667.pdf.
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Rosén, Ulf. "Att samtala med närstående inom specialiserad palliativ hemsjukvård : sjuksköterskans erfarenheter." Thesis, Ersta Sköndal Bräcke högskola, Institutionen för vårdvetenskap, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:esh:diva-6840.
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Bakgrund: Palliativ vård ska tillgodose behoven hos patienter med livshotande (icke botbara) sjukdomar på alla vårdnivåer i Sverige. Studier har visat att närstående till patienter i specialiserad palliativ hemsjukvård inte alltid har bemötts korrekt eller tagits på allvar vilket har resulterat i att de har slitit hårt ofta i skymundan. Att inte få rätt stöd har visat sig kunna leda till både fysiska, psykiska och psykosociala påfrestningar. Det har till exempel rapporterats om nedstämdhet, koncentrationssvårigheter och fatigue. Centralt i arbetet som sjuksköterska i specialiserad palliativ hemsjukvård är stöd till närstående då de ofta är en förutsättning för att patienten ska kunna vistas den sista tiden i livet i hemmet. Stödet bestod till stor del av samtal. Genom att bekräfta och ta närståendes oro och funderingar på allvar ökade deras välbefinnande. Syfte: Att beskriva sjuksköterskornas erfarenheter av att stödja närstående genom samtal inom specialiserad palliativ hemsjukvård. Metod: Designen var en empirisk studie med induktiv beskrivande ansats. Datainsamling skedde genom kvalitativa forskningsintervjuer. Resultat: Efter analysen framträdde svaret på de två frågeställningarna: Hur gjorde sjuksköteskorna för att etablera en god kontakt med närstående? Hur kunde sjuksköterskorna stötta närstående? Det framkom fyra subkategorier till varje fråga. Resultatet visade att samtalet i specialiserad palliativ hemsjukvård var en stor del av det befintliga arbetet men att det inte alltid skedde under strukturerade och medvetna former. Erfarenheter av strukturerade närståendesamtal var uteslutande positiva. Diskussion: Resultatet diskuterades mot valda delar av Watson´s tio karitativa faktorer. Känslighet gentemot självet och andra, Mänsklig omsorgsrelation, Att ge uttryck för positiva och negativa känslor, Kreativ, problemlösande omsorgsprocess.Background: Palliative care is intended to cater for the needs of patients with life threatening, non-curable, diseases at all levels of medical care in Sweden. Studies have shown that family and loved ones of patients receiving specialized palliative care in the home have not always been taken seriously or otherwise considered appropriately. This has led to them struggling under the pressure, often without acknowledgment. Not receiving the appropriate support has been shown to be a factor causing physical, psychological as well as psychosocial distresses. For example, depression, difficulties to concentrate and fatigue have been reported. Central to the work as a nurse in specialized palliative home care is to provide support to family and loved ones as it is often a necessity enabling the patient to be at home towards the end of life. The support in this case consisted largely of dialogue. By acknowledging and considering the thoughts and worries of the family, their wellbeing was increased. Aim: Describing the experiences of nurses supporting family and loved ones through dialogue within specialized palliative home care. Method: The study was by design inductive and data were collected via qualitative research interviews. Results: Following the analysis, the answer to the two questions emerged: How did nurses do to establish a good relationship with family and loved ones? How could nurses support family and loved ones? There were four subcategories for each question. The result showed that the conversation in specialized palliative home care was a major part of the existing work, but it did not always happen in structured and conscious forms. The experience of structured conversations with relatives was exclusively positive. Discussion: The result was discussed against selected parts of Watson's ten carative factors. Sensitivity to self and others, Human care relationship, To express positive and negative feelings, Creative, problem-solving care process.
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Wittchen, Hans-Ulrich, Sabine M. Apelt, Michael Soyka, Markus Gastpar, Markus Backmund, Jörg Gölz, Michael R. Kraus, et al. "Feasibility and outcome of substitution treatment of heroin-dependent patients in specialized substitution centers and primary care facilities in Germany: A naturalistic study in 2694 patients." Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2013. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-110756.
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Background: In many countries, buprenorphine and methadone are licensed for the maintenance treatment (MT) of opioid dependence. Despite many short-term studies, little is known about the long-term (12-month) effects of these treatments in different settings, i.e. primary care-based (PMC) and specialized substitution centers (SSCs).
Objectives: To describe over a period of 12 months: (1) mortality, retention and abstinence rates; (2) changes in concomitant drug use, somatic and mental health; and (3) to explore differences between different types of provider settings.
Methods: 12-Month prospective-longitudinal naturalistic study with four waves of assessment in a prevalence sample of N= 2694 maintenance patients, recruited from a nationally representative sample of N= 223 substitution physicians.
Results: The 12-month retention rate was 75%; the mortality rate 1.1%. 4.1% of patients became “abstinent” during follow-up. 7% were referred to drug-free addiction treatment. Concomitant drug use decreased and somatic health status improved. No significant improvements were observed for mental health and quality of life. When controlling for initial severity, small PMC settings revealed better retention, abstinence and concomitant drug use rates.
Conclusion: The study underlines the overall 12-month effectiveness of various forms of agonist MT. Findings reveal relatively high retention rates, low mortality rates, and improvements in most 12-month outcome domains, except for mental health and quality of life. PMC settings appear to be a good additional option to improve access to MTs.
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Wittchen, Hans-Ulrich, Sabine M. Apelt, Michael Soyka, Markus Gastpar, Markus Backmund, Jörg Gölz, Michael R. Kraus, et al. "Feasibility and outcome of substitution treatment of heroin-dependent patients in specialized substitution centers and primary care facilities in Germany: A naturalistic study in 2694 patients." Technische Universität Dresden, 2008. https://tud.qucosa.de/id/qucosa%3A26834.
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Background: In many countries, buprenorphine and methadone are licensed for the maintenance treatment (MT) of opioid dependence. Despite many short-term studies, little is known about the long-term (12-month) effects of these treatments in different settings, i.e. primary care-based (PMC) and specialized substitution centers (SSCs).
Objectives: To describe over a period of 12 months: (1) mortality, retention and abstinence rates; (2) changes in concomitant drug use, somatic and mental health; and (3) to explore differences between different types of provider settings.
Methods: 12-Month prospective-longitudinal naturalistic study with four waves of assessment in a prevalence sample of N= 2694 maintenance patients, recruited from a nationally representative sample of N= 223 substitution physicians.
Results: The 12-month retention rate was 75%; the mortality rate 1.1%. 4.1% of patients became “abstinent” during follow-up. 7% were referred to drug-free addiction treatment. Concomitant drug use decreased and somatic health status improved. No significant improvements were observed for mental health and quality of life. When controlling for initial severity, small PMC settings revealed better retention, abstinence and concomitant drug use rates.
Conclusion: The study underlines the overall 12-month effectiveness of various forms of agonist MT. Findings reveal relatively high retention rates, low mortality rates, and improvements in most 12-month outcome domains, except for mental health and quality of life. PMC settings appear to be a good additional option to improve access to MTs.
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Edsäker, Persdotter Johanna, and Elin Johansson. "STATISTISKT SAMBAND MELLAN INTENSIVVÅRDSSJUKSKÖTERSKANS ARBETSBELASTNING OCH PATIENTSÄKERHET : En nationell studie." Thesis, Linnéuniversitetet, Institutionen för hälso- och vårdvetenskap (HV), 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-60675.
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Bakgrund: Under de senaste åren har det blivit allt mer uppmärksammat i media om patienters rättigheter i vården och att patientsäkerheten hotas på grund av bristen på sjuksköterskor. Det framhävs att det är särskilt stor brist på specialistutbildade sjuksköterskor och att arbetsbelastningen på intensivvårdsavdelningarna ökar, vilket kan leda till allvarliga konsekvenser för bedrivandet av intensivvård och för att upprätthålla en god patientsäkerhet. Syfte: Syftet med studien var att undersöka statistiskt samband mellan intensivvårdssjuksköterskans arbetsbelastning och patientsäkerhet. Metod: Studien genomfördes med en kvantitativ metod med deduktiv ansats och en tvärsnittsstudie gjordes med hjälp av webbenkäter. Alla allmänna intensivvårdsavdelningar i Sverige inkluderades och intensivvårdssjuksköterskorna var tvungna att ha arbetat minst två år. Sammanlagt distribuerades 372 enkäter och 258 svar erhölls vilket gav en svarsprocent på 69.4 procent. Dataanalys utfördes med deskriptiv statistik och korstabulering. Med hjälp av en bivariat analys kunde vi jämföra om det fanns statistiskt samband mellan patientsäkerhet och arbetsbelastning. Resultat: Resultatet visar att det finns statistiskt samband mellan patientsäkerhet och arbetsbelastning. Patientsäkerheten påverkas negativt av en högre arbetsbelastning. Intensivvårdssjuksköterskorna uppger att de tvingas utföra ett sämre jobb relaterat till tidspressen och att arbetsbelastning är för hög. Resultatet visar att intensivvårdssjuksköterskorna anser att det finns välfungerande system för rutiner och avvikelser men på grund av en hög arbetsbelastning kan inte systemen och rutinerna följas vilket påverkar patientsäkerheten negativt. Slutsats:Den här studien ger belägg att lyfta intensivvårdssjuksköterskornasarbetsbelastning i förhållande till patientsäkerhet och underlag för att vidta åtgärder inom berörda verksamheter. Åtgärder i form av en attraktivare, hälsosammare och patientsäkrare arbetsplats. Exempelvis arbetstidsförkortning som ger möjlighet till återhämtning mellan arbetspassen.Det är nödvändigt att se över arbetsbelastningen på intensivvårdsavdelningar nationellt för att inte mer omfattande patientsäkerhetsbrister ska ske.Background: In recent years there has been increasing attention in the media about the right of patients in health care and that the safety of a patient is threatened because of the shortage of nurses. In particular, the current lack of specialized nurses and the increased workload in the intensive care units could lead to serious consequences regarding the provision of intensive care and maintaining high patient safety. Objective: The objective of this study was to investigate the statistical connection between the workload of an intensive care nurse and the patient safety. Method: The study was performed by a quantitative method with a deductive approach and a cross-sectional study was done using surveys on the web. All general intensive care units in Sweden were included and the intensive care nurses needed to have worked for at least two years. A total of 372 surveys were distributed and 258 responses were received giving a response rate of 69.4 percent. Data analysis was performed by descriptive statistics and cross tabulation. Using a two-dimensional analysis, the authors could compare whether there was a link between the patient safety and the workload. Result: The result indicates that there is a statistical connection between patient safety and workload. Patient safety is negatively affected by a higher workload. The intensive care nurses state that they are forced to do a worse job related to time pressure and because of that the workload is too high. The result shows that today it is felt that there is a well functioning system of procedures and divergences but because of a high workload, the system and the procedures cannot be followed which affect patient safety negatively. Conclusion: This study demonstrates proof to highlight critical care nurses' workload in relation to patient safety and evidence to take action within the relevant business. Arrangements such as an attractive, healthier and safer workplace for the patient. For an example, shorter working hours that allows recovery between shifts. It is a necessity to revise the workload in the intensive care units nationwide for not more extensive patient safety defects to occur.
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Silva, Gilda Pereira da. "Tecnologia Assistiva como apoio à ação docente." Universidade do Oeste Paulista, 2012. http://bdtd.unoeste.br:8080/tede/handle/tede/125.
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Previous issue date: 2012-08-30This study aimed to analyze the use of Assistive Technology in education of children with special educational needs. The method used was case study with a qualitative approach, the participants were a student with special educational needs (cerebral palsy), Professor of educanda specialist area and eight special education teachers working in the classroom regular education. The data was collected through observation of 16 sessions in the classroom Itinerant Support Specialist for a public school and a questionnaire with open questions, the regular classroom teachers teaching in specific areas of the curriculum of the State of São Paulo. The results indicated that in specialized care, assistive technology enables accessibility to children with special needs, with good use, the different educational activities; regular teachers showed determined resistance to inclusion by the absence of extensive ongoing training for teachers not experts; the assistive technologies are not well known by teachers working in the classroom regular education.
A presente pesquisa teve por objetivo analisar a utilização de Tecnologia Assistiva na escolarização de crianças com Necessidades Educacionais Especiais (NEE). O método utilizado foi estudo de caso com abordagem qualitativa, cujos participantes foram uma aluna com NEE (paralisia cerebral), a professora da educanda, especialista da área de educação especial e oito professores que atuam na sala de aula do ensino regular. A coleta de dados ocorreu mediante a observação de 16 sessões na sala de aula do Apoio Especializado Itinerante (AEI) de uma escola pública e aplicação de questionário, com questões abertas, a professores da sala regular de ensino nas áreas específicas do Currículo do Estado de São Paulo. Os resultados indicaram que em atendimento especializado, a Tecnologia Assistiva permite a acessibilidade das crianças com necessidades especiais, com bom aproveitamento, a diferentes atividades educacionais; professores do ensino regular revelaram determinada resistência à inclusão, pela ausência de formação continuada extensiva aos docentes não especialistas; as Tecnologias Assistivas são pouco conhecidas pelos professores que atuam na sala de aula do ensino regular.
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Kuodienė, Audronė. "Pacientų pasitenkinimas specializuota medicinos pagalba apskrities ligoninės Konsultacinėje poliklinikoje." Master's thesis, Lithuanian Academic Libraries Network (LABT), 2008. http://vddb.library.lt/obj/LT-eLABa-0001:E.02~2008~D_20080618_153015-12287.
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Darbo tikslas. Įvertinti pacientų pasitenkinimą terapinio profilio (neurologo, kardiologo, endokrinologo) ambulatoriškai teikiamomis paslaugomis apskrities ligoninės Konsultacinėje poliklinikoje.
Tyrimo metodai. 2008-01-21 – 01-31 apskrities ligoninės Konsultacinėje poliklinikoje atlikta pacientų besikreipiančių neurologo, kardiologo ir endokrinologo konsultacijai anoniminė anketinė apklausa. Išdalinta 400 anketų. Užpildytos 387 anketos (atsako dažnis 96,75%). Statistinė duomenų analizė buvo atlikta personaliniu kompiuteriu, naudojant statistinės analizės SPSS 10.03 programinį paketą. Įvairūs pasitenkinimo aspektai įvertinti pagal Licherto skalę 5 balų sistemoje.
Rezultatai. 89,2% respondentų buvo patenkinti arba labai patenkinti paslaugos kokybe. Labiausiai respondentus tenkino neurologo konsultacijos kokybė ir jų pasitenkinimas, išreikštas balų vidurkiu buvo 4,44 iš 5 galimų. 93,7% apklaustųjų buvo patenkinti gydytojų bendravimu. Gydytojų bendravimas labiausiai tenkino neurologo pacientus ir išreikštas balų vidurkiu buvo 4,52. 40,9% respondentų pateko pas gydytojus konsultacijai tą pačią ar kitą dieną, 20,7% - per 3-10 dienų nuo registravimosi. 10,6% respondentų laukė 11-14 dienų, 23,3% pateko po 2-4 savaičių, 4,5% laukė ilgiau nei mėnesį. Laukimo laikas tenkino 65,2% respondentų. Aukštesnio išsilavinimo ar jaunesnio amžiaus respondentai buvo mažiau patenkinti laukimu. Pasitenkinimas kardiologo konsultacijos laukimu buvo didžiausias (4,21 balo). 89,4%... [toliau žr. visą tekstą]Aim of the study: to evaluate the patients satisfaction with out-patient care services in therapeutic care (neurology, cardiology, and endocrinology) at consultation clinics of county hospital. Material and methods. The anonymous survey was conducted in January 2008 at consultation clinics of county hospital. The sample comprised of patients seeking consultation of neurology, cardiology or endocrinology specialists. Altogether, 400 questionnaires were distributed, out of which 387 counted as properly fulfilled (response rate 96.75%). Statistical data analysis was performed using statistical package „SPSS for Windows 10.03“. The satisfaction items were evaluated using Likert scale (scoring 1 to 5). Results. Altogether, 89.2% of responders were satisfied with the quality of care. Mostly, they were satisfied with neurology consultations (average Likert score 4.44). The communication with physician was also evaluated highly – 93.7% of responders were satisfied with it. Again, this was mostly expressed in neurology (average Likert score 4.52). Access to consultation was different: 40.9% of patients got consultation the same or following day after registration, 20.7% following 3–10 days, 10.6% following 11–14 days, 23.3% following 2–4 weeks, and 4.5% waited for longer than one month. The duration of waiting time was evaluated as satisfactory by 65.2% of responders, with the highest scores in cardiology (average Likert score 4.21). Higher education and younger age was related with... [to full text]
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Karmann, Alexander, Markus Schneider, Andreas Werblow, and Uwe Hofmann. "Hospizstudie: Standorte und demographische Rahmenbedingungen von Hospizangeboten in Sachsen." Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2014. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-150582.
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Ziel dieser Studie ist, einen aktuellen Statusbericht zu Standortdichte, räumlicher Bedarfsabdeckung und demografischen Rahmenbedingungen für die ambulante und stationäre hos-pizliche und palliative Versorgung in Sachsen zu erstellen. Dabei sollen aktuelle Versorgungslücken identifiziert und der künftige Bedarf (2020–2030–2050) an Angeboten auf Ebene der Landkreise und Kreisfreien Städte herausgearbeitet werden.
Für die Ableitung der Normwerte zeigt sich, dass angesichts der hohen Sterblichkeitsunterschiede zwischen den Bundesländern eine Bedarfsermittlung auf der Basis bundesdurchschnittlicher Normwerte je Bevölkerung nicht zufriedenstellend ist. Deshalb empfiehlt die Studie, in der regionalen Planung der Hospiz- und Palliativversorgung auf die erwarteten Sterbefälle abzustellen, die sich unter Berücksichtigung der Altersstruktur ergeben. Dieses bedeutet, dass die Normwerte der DGP zur Berechnung der Sollwerte um Bevölkerungsstruktur und Sterblichkeit korrigiert werden.
In einer abschließenden Bewertung werden – vor dem Hintergrund einer Stärken- und Schwächenanalyse aus Experteninterviews – weitere Handlungsempfehlungen abgeleitet, die auch die Dimensionen von Qualität der Leistungserbringung, Ausbildung, Finanzierung und deren Anreizwirkung sowie Integration einbeziehen.
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Emma, Tegel. "“I am not so sure of that we are very good at working actively, and are doing this, when we lack any form of suspiciousness” : An implementation evaluation of region skåne’s care program to prevent intimate partner violence in three care settings specialized in youth." Thesis, Malmö universitet, Institutionen för kriminologi (KR), 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-44477.
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The present study constitutes the qualitative part of a project with aim to evaluate the implementation of Region Skåne’s care program to prevent intimate partner violence. Due to the increasing awareness of youth intimate partner violence in Sweden, the study aim was to evaluate the extent to which the care program has been implemented, as well as what the perceptions of the care program were, in three care settings specialized in young patients. A qualitative focus group study with an inductive approach was chosen. Four focus groups with 12 participants recruited from three care settings specialized in young patients within the region of Skåne county were held. Three of the participants were not explicitly governed by regional guidelines due to working in units which constituted a partnership between the region and the municipality. The data was analysed by using thematic analysis. Two main themes appeared in the findings, with the first being organizational leadership. Factors associated was that the care program had not been fully communicated and/or implemented in any regional unit. Further, the extent to which the professionals had obtained extensive training and/or perceived themselves as supported from the management varied. The second main theme, the clinical practice, reflected the clinical experiences of various types of violence, tasks that could appear challenging such as documenting IPV, screening for IPV online and making reports of concern. The main conclusion is that there are gaps between policy and practice in all contexts where the program is to be used. Recommendations are that organizational leaders should ensure the program to be sufficiently communicated to all professionals, and be responsive to requests for local adjustments and/or insecurities in relation to following the program, in order for neither screenings, nor documentation, nor making reports to fall between the cracks.Den ingår i en ännu pågående utvärdering av Region Skånes vårdprogram mot våld i nära relationer. Projektet är finansierat av BRÅ.
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Dorneles, Marciele Vieira. "EM CENA: A CONSTITUIÇÃO DO PROFESSOR DO ATENDIMENTO EDUCACIONAL ESPECIALIZADO." Universidade Federal de Santa Maria, 2013. http://repositorio.ufsm.br/handle/1/7102.
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This study aims to problematize how the discursive productions of care Specialized Education (ESA) have produced modes of being Special Education teacher in inclusive education and what are the effects of these discourses in their teaching practices. For this, we use a range of analysis tools extracted from the writings of authors who share their thinking and research using poststructuralist thoughts, like as: the notion of modes of subjectivity, for thinking about the discourses and practices that are in a network of power and knowledge defining, a certain way, teachers of Special Education and regulating their conduct, as well as the notion of experience and narratives of self, de Jorge Larrosa. The research involved the collaboration of six teachers of Special Education working in ESA, which made reports on their experiences in educational practice and how they constituted themselves as professionals in the currently prevailing neoliberal rationality. Thus, it was observed that the Special Education teachers are experiencing conflicts with regard to working in Resource Room Multifunctional and an uncertainty of their role in school. Given the problematization presented, noted that the Special Education teacher are feeling a "emptying professional" , that is , at the same time that you are given numerous assignments - perhaps more focused on the use of technologies and management - leave behind the pedagogical actions.Este estudo tem como objetivo problematizar como as produções discursivas do Atendimento Educacional Especializado (AEE) vêm produzindo modos de ser professor de Educação Especial na educação inclusiva e quais são os efeitos desses discursos em suas práticas pedagógicas. Para isso, é utilizado um conjunto de ferramentas de análise extraído de escritos de autores que compartilham um modo de pensar e pesquisar utilizando a vertente pós-estruturalista, como: a noção de modos de subjetivação, para pensar a respeito dos discursos e das práticas que estão em uma rede de poder e saber produzindo/marcando de determinada maneira os professores de Educação Especial e regulando suas condutas; assim como a noção de experiência e narrativas de si, de Jorge Larrosa. A pesquisa contou com a colaboração de seis professoras de Educação Especial que atuam no AEE, das quais fizeram relatos sobre suas experiências na prática educativa e como foram constituindo-se enquanto profissionais em tempos em que impera a racionalidade neoliberal. Para tanto, foi observado que as professoras de Educação Especial estão vivenciando conflitos no que diz respeito ao trabalho na Sala de Recursos Multifuncional e a indefinição de seu papel na escola. Assim, com a problematização empreendida, visualizou-se que o professor de Educação Especial está com a sensação de esvaziamento profissional , ou seja, ao mesmo tempo em que lhe são dadas inúmeras atribuições talvez mais voltadas para o uso de tecnologias e gestão deixa-se marginalizada as ações pedagógicas.
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Deitos, Alexandre Raphael. "Avaliação na atenção especializada em saúde bucal." Universidade de São Paulo, 2009. http://www.teses.usp.br/teses/disponiveis/23/23148/tde-26022010-085252/.
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O objetivo do estudo foi avaliar os Centros de Especialidades Odontológicas (CEO), com vistas ao monitoramento e avaliação da atenção especializada em saúde bucal no Sistema Único de Saúde. Trata-se de um estudo transversal piloto, que utilizou parte do banco de dados de do estudo descritivo realizado pela Coordenação Nacional de Saúde Bucal entre 2008 e 2009. A pesquisa foi aprovada pelo Comitê de Ética em Pesquisa da FOUSP. Os dados foram organizados e analisados no programa STATA 10.0. Participaram da análise 56 CEO localizados em 6 estados: 30,36% de CEO tipo I, 62,5% de CEO tipo II e 7,14% de CEO tipo III; possuem em média 9,07 cirurgiões-dentistas (CDs), 5,5 auxiliares de saúde bucal (ASB) e 0,9 técnicos em saúde bucal (TSB); em 64,29% dos CEO existem cirurgiões-dentistas concursados em seus quadros; existe atendimento noturno e em horário flexibilizado em, respectivamente, 14,29% e 44,64% dos centros; atendem predominantemente pacientes oriundos da classe baixa (92,73%); em sua grande maioria os profissionais não recebem gratificação por estarem trabalhando com especialidades: apenas 16,07% dos centros a encaminham para os CDs; 35,71% dos CDs também trabalham em equipe de Saúde Bucal da estratégia Saúde da Família. Em relação à média de pacientes atendidos, os do tipo I (64,71%) atendem até 20 pacientes por turno de 4 horas; os de tipo II atendem até 30 pacientes em 65,71% dos casos; e os da modalidade III de 31 a 70 pacientes. Das especialidades mínimas obrigatórias exigidas por portaria a maior parte da carga horária observada por CEO foi a seguinte: endodontia: entre 21-40h (47,92%); periodontia: entre 8-20h (63,83%); cirurgia oral menor: 20h (51,06%); estomatologia: 20h (50,00%) e pacientes especiais: 20h (45,24%). Em 57,14% dos centros existem gerentes que não exercem atividades clínicas e realizam apenas trabalho de gestão, e apenas 30,19% de pessoas que trabalham com gestão em saúde bucal participaram de algum curso sobre gerência de CEO. Em relação ao financiamento, apenas 4,40% dos CEO recebem uma contrapartida financeira encaminhada pelo gestor estadual. Considerando-se a referência intermunicipal, 52,73% não a realizam, enquanto 39,28% dos ambulatórios são referência para urgência e emergência odontológica. A forma em que a referência é realizada segue, em sua maioria (78,57%), a demanda de toda a rede de atenção básica. As ações especializadas em saúde bucal não eram executadas em 68.52% dos municípios até a implantação do CEO. A maioria atende os usuários em uma média de tempo de até 30 dias: endodontia (59,62%), periodontia (82,35%), cirurgia (92,16%), estomatologia (84,21%) e pacientes especiais (91,67%). Conclui-se que após uma primeira fase de sucesso da implantação da Política Nacional de Saúde Bucal na reorganização da atenção em saúde bucal no país, mais especificamente neste caso a atenção especializada em saúde bucal, é necessário, nesta segunda fase, um maior desenvolvimento e profissionalização da gestão em saúde bucal, tendo como instrumentos o monitoramento e avaliação dos serviços, para que a cada dia haja uma melhora das condições de saúde bucal da população brasileira.The aim of this study was to evaluate the specialized dental clinics (CEO), with a view to the institutionalization of monitoring and evaluation of specialized care in oral public health. This is a cross-sectional pilot study, which used part of the database of the descriptive study conducted by the Ministry of Health between 2008 and 2009. The study was approved by the Ethics in Research FOUSP. The data were organized and analyzed using STATA 10.0. Participated in the analysis 56 CEO located in 6 states: 30.36% of CEO type I, 62.5% of CEO type II and 7.14% of CEO type III; have an average of 9.07 dentists (CDs), 5.5 auxiliary oral health (ASB) and 0.9 technical oral health (TSB); in 64.29% of the CEO there are gazetted dentists; in their management is nighttime and flexible hours, respectively, in 14 29% and 44.64% of the centers; serving patients from predominantly low grade (92.73%); mostly professionals receive no bonus because they are working with expertise: only 16.07% of the centers to refer to CDs; 35.71% of the CDs also work in teams of Oral Health of the Family Health Strategy. In the average of patients treated, the type I (64.71%) attend to 20 patients per shift (4 hours), the type II serve 30 patients in 65.71% of the cases, and the mode III 31 to 70 patients. About the Specialties minimum required by ordinance, the majority of the workload observed by CEO was as follows: endodontics: between 21-40h (47.92%); periodontics: between 8-20h (63.83%); minor oral surgery: 20h (51.06%); dentistry: 20h (50.00%) and special patients: 20h (45.24%). In 57.14% of the centers managers are not engaged in clinical practice and perform only administrative work, and only 30.19% of people who work with management in oral health attended a course on management of CEO. In relation to funding, only 4.40% of the CEO receive a financial contribution referred by the state manager. Considering the inter-reference, 52.73% do not realize it, while 39.28% of the clinics are a reference to urgent and emergency dental care. The way in which reference is made attends, the majority (78.57%), the demand of the entire network of primary care. Shares expertise in oral health were not performed in 68.52% of the municipalities until the implementation of the CEO. Most serves users in an average time of 30 days: endodontics (59.62%), periodontics (82.35%), surgery (92.16%), dentistry (84.21%) and special patients ( 91.67%). We conclude that after an initial phase of successful implementation of the National Oral Health Policy in the reorganization of oral health care in Brazil, specifically in this case the specialized attention to oral health, is necessary in this second phase, the further development and \"professionalization\" of management in oral health, and the use of tools for monitoring and evaluation of services, so that each day might improve the oral health of the population.
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Cruz, Jene Greyce Oliveira da. "O acolhimento na assistência especializada no estado do Acre: micropolítica e produção do cuidado em saúde." Universidade de São Paulo, 2017. http://www.teses.usp.br/teses/disponiveis/6/6135/tde-27062017-110416/.
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Introdução:A implantação e implementação da diretriz do acolhimento nos serviços de assistência especializada representam desafios à Política Nacional de Humanização (PNH) do SUS pela complexidade de gerenciamento e de estrutura, diversidade de atores sociais e pelas relações que se estabelecem entre os trabalhadores-gestores-usuários, e destes, com o sistema de saúde pública. Objetivos:Identificar aspectos relacionados ao trabalho e à produção do cuidado em saúde que interferem no acolhimento e na humanização da assistência especializada; Interpretar a relação entre as diferentes práticas profissionais envolvidas no trabalho e na produção do cuidado especializado com as possibilidades elimites da implementação da PNH; Compreender a percepção dos trabalhadores usuários sobre a humanização em saúde e o acolhimento como diretriz da PNH. Percurso Metodológico: Estudo de natureza qualitativa, realizado no ambulatório de especialidades médicas do Hospital das Clínicas do Acre (HCAC), entre setembro de 2015 e janeiro de 2016. Foram realizados quatro grupos focais (usuário, trabalhadores de apoio, médicos e outros profissionais de saúde) e três entrevistas semiestruturadas (gerência do serviço e ouvidora). Com base na diretriz do acolhimento, na PNH e a na micropolítica, a análise temática do conteúdo das mensagens permitiu formar quatro categorias temáticas. Resultados:A Atenção Primária em Saúde(APS), o complexo regulador e o atendimento médico na APS,representam pontos sensíveis na Rede de Atenção em Saúde (RAS)que dificultam a resolubilidade, e contribuem para a grande demanda da assistência especializada interferindo no acolhimento e na humanização dos serviços. Na assistência especializada, o modeloburocrático de gestãoe os fatores relacionados à ambiência dificultam a implementação do acolhimento. A micropolítica pode interferir tanto positivamente quanto negativamente para a produção do cuidado humanizado no serviço especializado. A humanização e acolhimento para os usuáriosrefletem o respeito, a educação e o bom atendimento realizado pelo trabalhador; para os trabalhadores a humanização e acolhimento representam a escuta de suas necessidades, informação adequada ao usuário, vínculo e resolubilidade. O apoio institucional e a ouvidoria no HCAC representaram avanços na implementação da PNH e da diretriz do acolhimento. Considerações finais: A diretriz do acolhimento mostrou-secomo estratégia de humanização possível de ser implementadano serviço especializado apesar de todos os problemas e desafios relacionados ao ambulatório no HCACe à RAS. Neste sentido, a gestão deve considerar a introdução de dispositivos tecnológicos de acolhimento e espaços coletivos de escuta do trabalhador.Introduction: The introduction and implementation of the user embracement directive in specialized assistance services represent challenges to the National Humanization Policy (PNH) of the Brazilian Health System (SUS) due to the complexity of management and structure, the diversity of social actors and the relationships established between workers-managers-users and the public health system.Objectives: To identify aspects related to work and to production of health care that interfere with the user embracement and humanization of specialized care; To interpret the relationship among the different professional practices involved in work and production of specialized care and the possibilities and challenges related to the implementation of PNH; To comprehend the perception of the workers and users about humanization in health and the user embracement as guideline of PNH.Methods: A qualitative study was held in the ambulatory medical care of the Hospital das Clínicas do Acre (HCAC), between September 2015 and January 2016. We conducted four focus groups (users; support workers; physicians and other health professionals) and three semi-structured interviews (manager and ombudsman). Based on the user embracement directive, the PNH and the micropolitics field, the thematic analysis of the content allowed distributing the messages in four thematic categories.Results: The Primary Health Care (APS), the regulatory service and the medical care in APS represent sensitive points of the health care system that hamper resolubility and contribute to the high demand of specialized care interfering in the user embracement and humanization of services. In specialized health care, the bureaucratic model of management and the factors related to the ambience make the user embracement difficult to implement. Micropolitics can interfere both positively and negatively to the production of humanized care in the specialized service. For the users, the humanization and the user embracement reflect the respect, the education and the good service promoted by the worker; for the workers, humanization and user embracement represent the attention of their needs, adequate information to the user, bond and resolubility. The institutional support and the ombudsman service in HCAC represented advances in the implementation of the PNH and the user embracement directive.Final considerations: In this study, the user embracement directive proved to be a viable strategy of humanization in the specialized health caredespite all the problems and challenges identified and related to the medical ambulatory of HCAC and the health care system. In this sense, management should consider the introduction of technological devices of user embracement and collective spaces for listening to the workers.
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SILVA, Juliana de Cássia Gomes da. "Representações Sociais do ensino de matemática por professores de salas regulares e professores que atuam na Sala de Atendimento Educacional Especializado (SAEE) no Estado de Pernambuco." Universidade Federal de Pernambuco, 2016. https://repositorio.ufpe.br/handle/123456789/18685.
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O objetivo desse estudo foi analisar os sentidos da inclusão/exclusão no ensino de matemática construídos por professores da sala regular e professores da Sala de Atendimento Educacional Especializado (SAEE) no estado de Pernambuco. A partir da Teoria das Representações Sociais (TRS) de Serge Moscovici buscou-se compreender os sentidos do ensino de matemática para os professores que atuam na SAEE e nas salas regulares e identificar os significados inclusivos/excludentes nos processos de ensino de matemática destinado a alunos com deficiência e/ou aqueles com dificuldades de aprendizagem. Nesta pesquisa, tivemos como objeto o ensino de matemática, uma vez que a disciplina tem sentidos polêmicos e polissêmicos, construídos no senso comum, através dos aspectos históricos que delineiam a sua inserção nas modalidades educacionais. A inclusão educacional das pessoas com deficiência é permeada por questões de ordem social, econômica e histórica, bem como compreendida por um leque de valores, conceitos e concepções que embasam e ditam ações e políticas. Historicamente, a deficiência foi marginalizada a partir de uma visão de inabilidade, o que favoreceu neste estudo, o objeto de representação social (ensino de matemática), por suscitar diferentes valores e práticas educacionais frente à diversidade que tais diferenças apresentam para os professores. Moscovici propõe uma teoria que abrange contextos sociais e o pensamento social – este com suas crenças, ideologias, superstições e cultura - enquanto construtos da realidade social e da comunicação de valores e crenças. A Representação Social tem como função tornar familiar aquilo que não está familiarizado para determinado grupo, utilizando dois processos importantes: a ancoragem e a objetivação. Na metodologia, aplicamos Testes de Associação Livre com a participação de 70 sujeitos de diversas cidades do estado de Pernambuco. Realizamos 2 sessões de grupo focal presencial com professores da SAEE e professores de sala regular o que permitiu, na fase de análise, a definição do núcleo central com ajuda do software EVOC a partir da perspectiva temática de Bardin. Encontramos sentidos ancorados culturalmente na matemática, disciplina considerada difícil de aprender, fragilidades na formação do professor, nas dicotomias entre a prática e o discurso sobre a inclusão, na busca de uma realidade concreta no ensino de matemática abstrata e em sua ancoragem no sucesso didático através de práticas de ensino afetivas. O sentido de exclusão ainda é predominante, mesmo entre professores especializados que atuam na SAEE.
This study aim was to analyze the inclusion/exclusion significance of mathematical teaching built by teachers in both a typical and in Specialized Care Educational classroom (Sala de Atendimento Educacional Especializado – SAEE) in the state of Pernambuco. From the Social Representation Theory (Teoria das Representações Sociais- TRS) of Serge Moscovici, soughtto comprehend the meaning Math teaching has for those teachers who teach on SAEE. In this research, we had the mathematical teaching as the objective, since the discipline has polemic and polysomic stands, built on common sense, through historic aspects that trace its insertion on educational modality. The educational inclusion for disable people is permeated by issues of social, economic, and historical orders which is comprehended by a fan of values, concepts and conceptions that bases and dictate actions and politics. Historically, the disabilities were marginalized with a disabled view, which gave favor on this study, the object of social representation (Math teaching), to evoke different educational values and practices front the diversity this differences show to teachers. Moscovici proposed a theory that embraces social contexts and social thought with a belief, ideology, superstition and culture, constructs of a social reality, and communication between values and beliefs. The Social Representation has as function to make familiar that is not familiarized with a specific group, using two important processes, the anchorage and objectification. For methodology, we applied Free Association Tests, with participation of 70 subjects from different cities within the state of Pernambuco, which allowed the analysis of the definition of the central core with software EVOC’ help; we did it in two face to face focal groups attendance sections with from SAEE and typical classrooms and the records were analyzed according to Bardin’s thematic perspective. We found cultural meanings anchored on Math, as a hard subject matter to learn, fragile on teachers’ formation, dichotomy between practice and speech about inclusion, searching for a concrete teaching reality in an abstract Math teaching and the didactical success anchorage through affective teaching practices. The sense of exclusion is still predominant, even among teachers with specialization that teaches in a SAEE.
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Granlund, Marie, and Cynthia Kjerr. "Att främja en hälsosam vikt hos överviktiga barn : Barnhälsovårdsjuksköterskans förebyggande och hälsofrämjande insatser." Thesis, Hälsohögskolan, Högskolan i Jönköping, HHJ, Avd. för omvårdnad, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-44163.
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Bakgrund: Inom barnhälsovården (BHV) arbetar specialistsjuksköterskor hälsofrämjande och förebyggande. Tidig uppmärksammad ohälsosam tillväxt kan åtgärdertidigtimplementeras för att förebygga följdsjukdomar som hjärt- och kärlsjukdomar och diabetes. Syftet: Att beskriva hur specialistsjuksköterskor på barnhälsovården arbetar hälsofrämjande, förebyggande och evidensbaserat med familjer där barnet har en övervikt. Metod: En kvalitativ forskningsdesign med induktiv ansats har använts. Individuella intervjuer har genomförts och analyserats med hjälp av en kvalitativ innehållsanalys. Resultat: BHV-sjuksköterskorna upplevde att en längre och regelbunden kontakt med familjen ökar samarbetet och förbättrar relationen. I kontakten med familjen är det viktigt med ett empatiskt bemötande. Det är viktigt att erbjuda familjen kunskap inom kost, rörelse och begränsning av skärmtid för att främja en sund viktutveckling hos barnet. Olika informationsblad om övervikt användes. Fortbildning inom ämnet övervikt och fetma ökar BHV-sjuksköterskans trovärdighet och den evidensbaserad vården. Samverkan med olika instanser och professioner är helt nödvändigt för att kunna erbjuda familjen rätt hjälp. Slutsats:BHV-sjuksköterskans förhållningssätt och kunskap i ämnet ökade familjens motivation. I ett nära samarbete kunde de tillsammans hitta rutiner och verktyg förtillfredsställande tillväxt.Background: In the Child Health Care (CHC), specialist nurses work on health promotion and prevention. Early identification of unhealthy growth can be implemented early to prevent sequelae such as cardiovascular diseases and diabetes. The purpose: To describe how the specialist nurses in the child health care work to promote health and prevention with families whose children are overweight and how the evidence is based on the care they provide. Method:A qualitative research design with an inductive approach has been used. Individual interview has been carried out and analyzed using a qualitative analysis. Result:The CHC-nurse’s experienced that a regular contact with the family improved the cooperation and relationship. In contact with the family, an empathetic approach is important. It is important to offer the family knowledge in diet, physical activity and limited screen-time to promote healthy weight-development. Various information sheets were used. Continuing education in the subject of overweight and obesity increases the CHC-nurse's credibility and evidence-based care. Collaboration with various departments and professions is necessary to offer the family the right help Conclusion: The CHC-nurse's approach and knowledge increased the parents' awareness and motivation. In a close collaboration between the CHC-nurse and the family, they could find good routines that could lead to a satisfactory growth.
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Rios, Grasiela Maria Silva. "AVALIAÇÃO EM EDUCAÇÃO ESPECIAL: TECNOLOGIA DE GOVERNAMENTO NO ATENDIMENTO EDUCACIONAL ESPECIALIZADO." Universidade Federal de Santa Maria, 2013. http://repositorio.ufsm.br/handle/1/7069.
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This study is part of the Research Line Special Education Program Graduate Education. Its guiding question to understand what effects the discourse on assessment are brought into service by Care Specialized Education - AEE, in the conduct of conduct of teachers AEE in Florianópolis - SC. This undertaking investigative inserts into a post-structuralism approach, in which I use the lens Foucault, specifically addressing the concept of governmentality tool. The corpus of empirical research is composed of two groups of materials: documents related to legislation and evaluation reports of students served and followed the AEE, prepared by the teachers care. After the analysis of the laws, I could understand that the evaluation is produced as a possibility for identification, investigation and diagnostic categorization of the subjects of the deviation and as a mechanism of control and regulation of the conduct of the student by the teacher AEE, making students and ways of teaching performance. Then to understand how the assessment is operating driving conduct faculty, through the analysis of 194 evaluation reports produced by the teachers of the AEE in Florianopolis. Recurrences discursive found, indicate three analytical categories: "Need to diagnose / schedule and meet: Strategy driven to lead as a teacher of the AEE", "Need to standardize: teaching practices in front of the student AEE" and "Need convincing: The search for the family as a partner for the state government and learner control deviation in inclusive schools ". It was possible to show that the search for the diagnosis turns on the need for standardization as a strategy to regulate the discipline and control of risk on these subjects deviating from the norm. Finally, we have the embodiment of a relationship 'more government under government' for everyone to be and remain in school, in an order consistent with the neoliberal rationality and security policies related to education, brokered with the discourses of human rights in order to convince everyone in mobilizing for inclusion to happen.Este estudo insere-se na Linha de Pesquisa de Educação Especial do Programa de Pós-Graduação em Educação. Tem como questão norteadora compreender quais efeitos dos discursos sobre avaliação são colocados em funcionamento pelo Atendimento Educacional Especializado - AEE, na condução das condutas dos professores do AEE no município de Florianópolis - SC. Tal empreendimento investigativo insere-se em uma abordagem pós-estruturalista, na qual faço uso das lentes foucaultianas, especificamente abordando o conceito ferramenta da governamentalidade. O corpus empírico da pesquisa está composto por dois grupos de materiais: documentos referentes à legislação e relatórios avaliativos dos alunos atendidos e acompanhados no AEE, elaborados pelas professoras do atendimento. Após a análise das legislações, pude compreender que a avaliação é produzida como possibilidade de identificação, investigação e categorização diagnóstica dos sujeitos do desvio e como um mecanismo de controle e regulação da conduta discente pelo professor do AEE, inventando alunos e modos de atuação docente. Em seguida, intentei compreender o modo como a avaliação está operando a condução da conduta docente, por meio da análise de 194 relatórios avaliativos produzidos pelos professores do AEE em Florianópolis. As recorrências discursivas encontradas, indicam três categorias analíticas: Necessidade de diagnosticar/marcar e conhecer: estratégia acionada para se conduzir como docente do AEE , Necessidade de normalizar: as práticas docentes frente ao aluno no AEE e Necessidade de convencimento: A busca pela família como parceira do Estado para o governamento e controle do aluno do desvio na escola inclusiva . Foi possível inferir que a busca pelo diagnóstico coloca em funcionamento a necessidade de normalização como estratégia para a regulação, o disciplinamento e o controle do risco sobre esses sujeitos desviantes da norma. Por fim, temos a materialização de uma relação de mais governo com menos governo‟ para que todos possam estar e permanecer na escola, numa ordem condizente com a racionalidade neoliberal e de seguridade das políticas voltadas à educação, agenciadas com os discursos dos direitos humanos de forma a convencer a todos na mobilização para que a inclusão aconteça.
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Zeeman, Celeste. "Exploring the barriers and facilitators of access to care as experienced by caregivers of children who were admitted to a specialised tuberculosis hospital." University of the Western Cape, 2020. http://hdl.handle.net/11394/7269.
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Master of Public Health - MPHTuberculosis (TB) continues to be a major cause of ill health and the leading cause of death from a single infectious agent worldwide. Furthermore, young children, especially those under five years old and infants, are at risk of developing more severe forms of TB. TB cases continue to cluster among disadvantaged groups such as the poor whose lives are characterised by adverse living conditions. Defaulting from treatment poses a severe threat to children’s health because untreated TB or breaks in treatment could lead to a child developing more severe forms of TB, or worse, could result in mortality. Currently, long-term hospitalisation has the most successful TB treatment outcomes. Therefore, to ensure compliance, children are taken out of their social environment and admitted to hospital. However, being separated from one’s family, especially at a crucial stage of development, could have long-terms effects on the child’s development. The study explored, factors influencing access to care that caregivers of children; who are five years and younger, who received prolonged treatment at a specialised TB hospital in the Western Cape, South Africa experienced. A qualitative approach allowed the researcher to use personal interactions as a focus for studies and was suitable when aiming to understand health behaviour in its everyday context as experienced by the participant. The study results indicated the factors that enable caregiver visitation, is largely dependent on availability of finances. Furthermore, the hospital itself was identified as being accommodating with regards to visiting hours, telephonic calls and served as important mediator between health service provider, the children, their caregivers and the rest of the staff. Visitation depended on availability of finances, and this was the main barrier that was identified by caregivers. The challenges that hampered visitation were unemployment, lack of access to private and public transport and challenges related to farm-workers. A large number of caregivers work on farms in the Cape Winelands and many of them are dependent on seasonal work which results in inconsistent income. This limited availability of finances for visitation. Furthermore, the working conditions, long shifts and lack of employment benefits which were associated with farming, prevented caregivers from visiting. This study revealed that there are a series of factors which influence access to care of caregivers; this is especially the case in children hospitalised for TB. These factors need to be considered by policy makers as well as the Specialised Tuberculosis facility when dealing with children under five as the best way to ensure that treatment is completed through hospitalisation. Therefore, the strategies to assist families of children with TB need to be explored to assist in the continuity of care as well as the child’s development.
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Pousette, Angelica, and Mathilda Ekberg. "Distriktssköterskans upplevelse av att ge hälsofrämjande rådgivning till patienter med hypertoni : En kvalitativ intervjustudie." Thesis, Högskolan Dalarna, Vårdvetenskap, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:du-35876.
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Bakgrund. Hypertoni är en av Sveriges vanligaste folkhälsosjukdomar. De flestadistriktssköterskor möter patienter med hypertoni dagligen och det är distriktssköterskansansvar att främja hälsa hos dessa patienter. En livsstilsförändring har visat sig ha en god effektpå hälsan för patienter med hypertoni och distriktssköterskan kan hjälpa patienten att takontroll över sin situation och känna tillit till sin egen förmåga att genomföra enlivsstilsförändring.Syfte. Syftet med studien är att beskriva distriktssköterskans erfarenheter av att arbetahälsofrämjande med patienter med hypertoni.Metod. En kvalitativ intervjustudie med beskrivande design. Åtta distriktssköterskorintervjuades och materialet har analyserats med kvalitativ innehållsanalys.Resultat. Att arbeta med hälsofrämjande rådgivning utgör en viktig del avdistriktssköterskans uppdrag. Det är en ansvarsfull uppgift som kräver stor kompetens,kunskap och framförallt lyhördhet i samtalet med patienten. Det kan vara utmanande att stöttapatienten till att hitta sin egen motivation och förmåga att främja sin hälsa utan att påtvinga enlivsstilsförändring, inte minst då arbetsmiljön för distriktssköterskor kan vara krävande.Slutsats. Det hälsofrämjande arbetet beskrivs som en viktig del av professionen. Samtidigtär det en kompetens som inte utnyttjas av verksamheterna då det ofta råder både brist på båderesurser och tid som gör att det hälsofrämjande arbetet blir åsidosatt. Då livsstilsrelateradesjukdomar såsom hypertoni ökar i alla åldrar är det viktigt att verksamheter har rutiner ochriktlinjer som gör att dessa patienter erbjuds en jämlik och bra vård utifrån aktuell forskningoch evidens.Background. Hypertension is one of Sweden's most common peoples´ health issues. Mostnurses specialized in primary health care see patients with hypertension on a daily basis and itis their responsibility to promote health to these patients. Lifestyle change has proven to havea good effect on the health of patients with hypertension and the nurses specialized in primaryhealth care can help the patient to take control and trust their own ability to make a lifechange.Aim. The aim of the study is to describe the nurse specialized in primary health careexperiences of working to promote health in patients with hypertension.Method. Qualitative study with descriptive design. Eight nurses specialized in primary healthcare were interviewed and the material was analyzed using qualitative content analysis.Results. Working with health-promoting counseling is an important part of the assignmentof nurses specialized in primary health care. It is a responsible task that requires greatcompetence, knowledge and above all empathy in the conversation with the patient. It can bechallenging to support the patient in finding their own motivation and ability to promote theirhealth without forcing a lifestyle change, not least as the work environment for nursesspecialized in primary health care can be demanding.Conclusion. The health promotion work is described as an important part of the profession.At the same time, it is a competence that is not utilized by the activities as there is often a lackof both resources and time which means that the health-promoting work is neglected. Aslifestyle-related diseases such as hypertension increase at all ages, it is important that thebusiness has routines and guidelines that enable these patients to offer an equal based oncurrent research.
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Carmo, Débora do. "Atenção especializada no SUS: da máquina de produção de procedimentos a uma rede de produção de cuidados." Universidade de São Paulo, 2017. http://www.teses.usp.br/teses/disponiveis/6/6135/tde-30082017-142904/.
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A experiência de construção do Sistema Único de Saúde vem possibilitando reflexões e inovações conceituais tanto em relação ao processo de gestão quanto à organização do cuidado. Proposições aparentemente quase inquestionáveis, como a hierarquização dos serviços de saúde e sistema de referência e contrarreferência, tendo a atenção básica como base da pirâmide, vêm sendo alvo de ressignificações importantes. A Atenção Especializada configura-se como um lugar crítico na atenção à saúde, tradicionalmente construído como um espaço de produção de consultas e procedimentos, principalmente médicos, descolado da discussão de gestão do cuidado e da constituição de uma rede cuidadora. Esse espaço também é marcado por uma pobreza de formulações e debates a respeito de apostas, conceitos e possibilidades. As poucas publicações sobre o assunto têm como marcadores principais a regulação burocrática e a gestão de filas. Assim, dispositivos que aproximem os trabalhadores da atenção especializada aos diferentes lugares da atenção, rompendo com as lógicas fragmentadas, configuram experiências que devem ser, mais do que compartilhadas, cartografadas e analisadas, melhor ainda se a partir da experiência, da vivencia e da implicação dos diversos atores. A proposta desta dissertação foi fazer um estudo cartográfico da experiência de São Bernardo do Campo/SP na organização do cuidado especializado dentro da rede de atenção, com destaque para os dispositivos que possibilitaram aproximação, constituição de espaços de conversa e troca entre os trabalhadores para construção de novos sentidos aos enunciados de integralidade, responsabilização, cuidado compartilhado e solidariedade.The experience of building the Brazilian Public Health System has allowed reflections and changes of concept both in relation to the management process and the organization of care. Seemingly almost unquestionable propositions, such as the hierarchization of health services and the reference and counter-reference system, with Primary Attention Care as the basis of the pyramid, have been the subject of important resignifications. The specialized care is set up as a critical place in health care, traditionally built as a production space of consultations and procedures, detached from the discussion of care management and the constitution of a care network. This space is also marked by a lack of formulations and debates about bets, concepts and possibilities. The few publications on the subject have as main markers the regulation and management of queues. Thus, devices that approach workers from the specialized attention to the different places of care, breaking with the fragmented logics, configure experiences that must be more than shared, mapped and analyzed, better still if from experience, living experience and implication of various actors. The purpose of this dissertation was to make a cartographic study of the experience of São Bernardo do Campo/SP in the organization of specialized care within the care network, highlighting the devices that allowed the approach,constitution of spaces of conversation and exchange among workers to build new meanings to the integrality statements, accountability, shared care and solidarity.
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Hallberg, Anne-Sofie, and Annelie Sjöberg. "Sjuksköterskors erfarenheter av att vårda patienter med beroendediagnos inom specialiserad beroendevård - En intervjustudie." Thesis, Umeå universitet, Institutionen för omvårdnad, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-119874.
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Bakgrund: Sjuksköterskor som vårdar patienter med en beroendediagnos upplever att det är en balansgång mellan frustration och förståelse över patientens situation. Sjuksköterskor upplever även att de behövde en ökad förståelse för sina egna reaktioner. Syfte: Syftet med denna studie var att beskriva sjuksköterskors erfarenheter av att vårda personer med beroendediagnos inom specialiserad beroendevård. Metod: En kvalitativ studie där nio sjuksköterskor intervjuades under december 2015 och januari 2016. Intervjuerna analyserades med hjälp av kvalitativ innehållsanalys. Resultat: Det framkommer två huvudkategorier i denna studie, relationen mellan sjuksköterskan och patienten samt rollen som sjuksköterska. Deltagarna i studien berättar om att en individanpassad vård är det bästa för patienten. Det framkommer att drogen enbart är en del av patientens problem och att dessa patienter blir felbehandlade i icke specialiserad beroendevård. De tar även upp att det pågår en ständig diskussion kring mediciner samt att det finns en maktutövning inom vården. Deltagarna i studien berättar även om hot och våld samt påfrestningar. Deltagarna framhåller att det är viktigt att vara trygg i sin profession samt att kunna samarbeta med andra Slutsats: En individanpassas vård ger bäst resultat av den omvårdnad som ges. En annan slutsats är att tydliga rutiner och riktlinjer gör att man känner sig trygg i sitt arbete. Vidare slutsatser är att det skulle vara av intresse att forska vidare på samma frågeställning men ur ett genusperspektiv.Background: Earlier studies regarding nurses experiences shows that nurses fell that there is a balance between frustration and understanding of the patient's situation when they care for patients whit a substance use disorder. Nurses also experience that they needed a better understanding regarding their own reactions. Aim: The aim of this study was to describe nurses' experiences when caring of persons with a substance use disorders in specialized addiction care units. Method: A qualitative study was performed during December 2015 and January 2016, nine nurses were interviewed. The interviews were subjected to qualitative content analysis. Results: Two main categories appeared in this study, the relationship between the nurse and the patient, as well as the role of the nurse. Participants in the study tells us that individualized care is the best for the patient. It appears that the drug is only a part of the patient's problem, and that these patients are mistreated in nonspecialized care. The participants also talk about the fact that there is a continual discussion of medications between the patient and the nurse. It further shows that the power over the care is divided. Participants in this study also mentions threats, violence and stress. Participants emphasize that it is important to be confident in their own profession and to be able to cooperate with others. Conclusion: An individualized care gives the best results for the patient. It is important that the nurse is confident in their professional capacity and has support from their colleagues. Another conclusion is that guidelines makes the nurse feel safer during work. Further conclusions are that it would be of interest to further research in the same issue but from a gender perspective.
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Newton, Jenni. "Descriptions of the therapeutics of specialist and specialised palliative care nursing." Thesis, Anglia Ruskin University, 2007. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.478883.
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Marquezano, Viviane Laperuta. "O cuidar na ação do formador de professores." Pontifícia Universidade Católica de São Paulo, 2008. https://tede2.pucsp.br/handle/handle/16373.
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The main purpose of this investigation was to identify what is the point of view that the pedagogical analysts have about caring in its all dimensions: to care, care of the pupil, care of the teacher, being cared and to take care of yourself. These analysts are the responsible for teacher s professional development at SESI s education System, placed in Sao Paulo. The aim of this research was to broaden this vision of caring, that permit us to amplify the dimensions of specialized care in the Analysts action, moreover, reflect on its importance. Data have been collected from individual interviews with ten volunteers analysts at their workplace. The interviewers are responsible for the sixth to ninth grade, when considering nine years education. The data analysis was supported by Henri Wallon s theory of development. According to Wallon care about somebody is to be aware of they well being, taking the responsibility of this action. Caring involves the other and me relationship and keeps changing while the stage of child s development progress. The surroundings must ensure a developmental environment. The specialized care of the analysts should be intentional, planned and shared. This research pinpoints the directress for both pedagogical analysts and managers of SESI s education system with the intention to improve the quality of development of the analysts and, consequently the teachers professional performance
Esta investigação teve por objetivo levantar a visão que os analistas pedagógicos (responsáveis pela formação de professores) da rede de ensino SESI de São Paulo possuem sobre o cuidar nas suas várias dimensões: cuidar, cuidar do aluno, cuidar do professor, ser cuidado e cuidar-se, com a intenção de ampliar essa visão sobre o cuidar para podermos ampliar a dimensão do cuidar especializado na ação do formador e refletir sobre a sua importância. Os dados foram coletados no local de trabalho e estudo dos analistas - SEDE do SESI/SP- mediante uma entrevista individual com dez Analistas Pedagógicos voluntários do Ensino Fundamental ciclos III e IV que corresponde aos quatros últimos anos do ensino de 9 anos. A teoria de desenvolvimento de Henri Wallon ofereceu suporte para análise dos dados. Cuidar de outra pessoa para Wallon é estar atento ao seu bem-estar, tomando sobre si a responsabilidade desta ação. Cuidar envolve a relação eu/outro, estando presente desde o nascimento do bebê e vai se transformando na medida em que avançam as etapas de desenvolvimento das crianças. O meio é um espaço importante que deve ser pensado, para que ofereça condições para o outro se desenvolver. O cuidar do formador de professores é um cuidar especializado que deve ser intencional, planejado, compartilhado, envolvendo um sentimento de responsabilidade para que o outro possa se desenvolver. A pesquisa aponta diretrizes tanto para os Analistas Pedagógicos como para os gestores da rede de ensino SESI/SP com a finalidade de melhorar a formação do formador e a formação dos professores
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Lubenow, Juliana Almeida Marques. "Avaliação do atendimento nos serviços de saúde à pessoa idosa." Universidade Federal da Paraíba, 2016. http://tede.biblioteca.ufpb.br:8080/handle/tede/9538.
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Introduction: The elderly are the most frequent users in health institutions and with increasing rate of life expectancy, the demand for these services tends to increase. Faced with this problem, health services need to be ready to offer care that meets the elderly needs. Objectives: discussing on access of older persons to primary health care services from an integrative review; evaluate the care for the elderly in healthy services (primary and specialized care services); and, identify the social representations of the elderly on the care in health services. Method: Exploratory research with mixed approach, supported by the Social Representations Theory, carried on with 266 elderly attended in Family Health Units and in the Integral Care for Elderly Health Center located in João Pessoa, Paraíba/Brasil. For data collection, an in-depth interview and an instrument with questions related to the care provided in the health services and socioeconomic and health data of respondents were used. Data were analysed with the SPSS package and IRaMuTeQ software and interpreted using the Social Representations Theory. Data collection took place between January and July 2015 after approval by the CEP/HULW Protocol 261/09 and CAAE: 0182.0.126.000-09. Results: Three articles were originated from this research: Access for the elderly to primary health care services: an integrative review; Health services care evaluation by the elderly; What elderly think about health services care. The elderly respondents mostly had between 60 and 69 years old, were female, with elementary school, married, family income of the two minimum wages, retired, lived with someone, they considered their health reasonable and showed a high prevalence of chronic diseases. In the Basic Health Units, access to health care is easier and the waiting time for care and transportation to the service was less than in the Specialized Care Center. In both services, elderly is always attended by the same physician, and in UBS they are also assisted by the same nurse. Most seniors considered organization, health professionals and staff punctuality, comfort and cleanliness excellent. About the social representations apprehended, the elderly associated good care to be treated with respect, care and education. For them, health professionals should talk, explain, show interest in their health problem and personal life. At the same time, they linked good care to medications and tests prescription, as well as referrals to specialists, strengthening the biomedical model of health care. Conclusion: The positive assessment of the services was represented by the elderly associated with well attended, despite the delay to be attended and to set appointments. It is recommended that elderly care in health services be centred in embracement practices in a humanized and qualified way, that meet their real needs, in which health professionals and managers need to consider the different characteristics of the elderly in their approach both in primary care and in the other levels of care.
Introducción: Los ancianos son los usuarios más frecuentes en las instituciones de salud y con el aumento de la tasa de esperanza de vida, la demanda de estos servicios tiende a aumentar. Frente a esse problema, los servicios de salud deben estar preparados para proporcionar una atención que satisfaga las necesidades de los ancianos. Objetivos: Discutir el acceso de los ancianos a los servicios de atención primaria de salud a través de una revisión integradora; evaluar la atención a los ancianos en los servicios de salud (atención primaria y especializada); identificar las representaciones sociales de las personas mayores en la atención en los servicios de salud. Método: investigación exploratoria con enfoque mixto, apoyó la teoría de las representaciones sociales, desarrollado con 266 pacientes de edad avanzada a partir de Unidades de Salud Familiar y el Centro de Atención Integral para personas mayores situados en João Pessoa, Paraíba/Brasil. Se utilizó para recolección de datos una entrevista en profundidad y uno formulario de con preguntas objetivas relacionadas con el cuidar en los servicios de salud, datos socio economicos y de salud. Los datos fueron analizados con la ayuda del software SPSS y IRaMuTeQ e interpretados con la Teoría de las Representaciones Sociales. La recolección de datos se llevó a cabo entre enero y julio de 2015, después de aprobación por el CEP / HULW Protocolo 261/09 y CAAE: 0182.0.126.000-09. Resultados: En essa investigación, se originaron tres artículos: Access for the elderly to primary health care services: an integrative review; Evaluación del cuidado em los servicios de salud para las personas de edad avanzada; ¿Qué opinas los ancianos sobre el cuidado en los servicios de salud. Los encuestados en su mayoría tenían entre 60 y 69 años de edad, del sexo femenino, con la escuela primaria, casada, el ingreso familiar de dos salarios mínimos, retirado, vivía con alguien, consideraban su salud razonable y mostraron una alta prevalencia de enfermedades crónicas. En las Unidades Básicas de Salud, el acceso a la asistencia sanitaria es más fácil y el tiempo de espera para la atención y el transporte hasta el servicio era menos que en el Centro de Atención Especializada. En los dos servicios los ancianos están siempre atendidos por el mismo médico, y en UBS también son servidos por la misma enfermera. La mayoría de las personas mayores considera excelente la organización, puntualidad de los profesionales de la salud y del personal, comodidad y limpieza. Los ancianos asociaran un buen cuidado con ser tratado con respeto, cuidado y educación. Para ellos, los profesionales sanitarios deben hablar, explicar, mostrar interés en su problema de salud y su vida personal. Al mismo tiempo, ellos vincularan buena atención a la prescripción de los medicamentos y exámenes, así como referencias a los especialistas, fortaleciendo el modelo biomédico de atención de la salud. Conclusión: La evaluación positiva de los servicios fue representada por los ancianos sentirse bien atendidos, a pesar de la demora en el servicio y concierto de la consulta. Se recomienda que la atención de alto nivel en los servicios de salud se centra en la práctica de anfitrión de una manera humana y calificado, que se adapte a sus necesidades en que los profesionales sanitarios y los gestores deben tener en cuenta las diferentes características de las personas mayores en su enfoque tanto en atención primaria como en los otros niveles de atención.
Introdução: O idoso é o usuário mais frequente nas instituições de saúde e, com a elevação da taxa de expectativa de vida, a procura por esses serviços tende a aumentar. Diante dessa problemática, os serviços de saúde precisam estar preparados para oferecer uma assistência que atenda às necessidades da pessoa idosa. Objetivos: Discutir sobre o acesso de idosos aos serviços de Atenção Primária em Saúde, por meio de uma revisão integrativa; avaliar o atendimento à pessoa idosa em serviços de saúde (atenção primária e especializada); identificar as representações sociais da pessoa idosa sobre o atendimento em serviços de saúde. Método: Pesquisa exploratória com abordagem mista, subsidiada na Teoria das Representações Sociais, desenvolvida com 266 idosos atendidos em Unidades de Saúde da Família e no Centro de Atenção Integral à Saúde do Idoso, localizados na cidade de João Pessoa, Paraíba/Brasil. Para a coleta dos dados, foram utilizados uma entrevista em profundidade e um formulário com questões relacionadas ao atendimento realizado nos serviços de saúde, dados socioeconômicos e de saúde. Os dados foram analisados com o auxílio do pacote SPSS e do software IRaMuTeQ, interpretados e subsidiados na Teoria das Representações Sociais. Os dados foram coletados entre janeiro e julho de 2015, depois da aprovação pelo CEP/HULW, protocolo nº 261/09 e CAAE: 0182.0.126.000-09. Resultados: Desta pesquisa, foram originados três artigos: Access for the elderly to primary health care services: an integrative review; Avaliação do atendimento em serviços de saúde para pessoa idosa; e O que pensam os idosos sobre o atendimento nos serviços de saúde. O estudo mostrou que a maioria dos idosos entrevistados tinha entre 60 e 69 anos de idade, era do sexo feminino, com ensino fundamental, casadas, com renda familiar de dois salários mínimos, aposentados, moravam acompanhados, consideraram sua saúde razoável e apresentaram alta prevalência de doenças crônicas. Nas Unidades de Saúde da Família, o acesso ao atendimento médico é mais fácil, e o tempo de espera para atendimento e de deslocamento até o serviço foi menor do que no Centro de Atenção Especializada. Em ambos os serviços, os idosos são sempre atendidos pelo mesmo médico, e nas USF, são atendidos pelo mesmo enfermeiro. A maioria dos idosos considerou excelente a organização, a pontualidade dos profissionais de saúde e dos funcionários, o conforto e a limpeza. Os idosos associaram um bom atendimento a ser tratado com respeito, atenção e educação. Para eles, os profissionais de saúde devem conversar, explicar, mostrar interesse por seu problema de saúde e sua vida pessoal. Ao mesmo tempo, vincularam um bom atendimento à prescrição de medicamentos e exames, bem como a encaminhamentos a especialistas, reforçando o modelo biomédico de atendimento de saúde. Conclusão: A avaliação positiva dos serviços foi representada pelos idosos associada a sentimentos bem atendidos, mesmo com a demora para atendimento e marcação de consultas. Recomenda-se que o atendimento ao idoso, nos serviços de saúde, seja centrado na prática do acolhimento de forma humanizada e qualificada, que atenda às suas reais necessidades e que os profissionais de saúde e os gestores considerem as especificidades distintas da pessoa idosa em sua abordagem, tanto na atenção primária quanto nos demais níveis de atenção.
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Engvall, Charlotte. "Förbättrade förutsättningar för resiliens inom specialiserad barnsjukvård : tillämplighet av ”Resilience Assessment Grid”." Thesis, Hälsohögskolan, Högskolan i Jönköping, The Jönköping Academy for Improvement of Health and Welfare, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-36618.
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Inom specialiserad barnsjukvård finns behov av säkerhetsstrategier utvecklade för komplexa adaptiva system. Tillvägagångssätt från ”Resilience Engineering” kan användas när säkerhetsstrategier utvecklas, men erfarenheten av detta är begränsad inom sjukvården. Masterarbetet genomfördes för att utforska hur ett förbättringsarbete kring att utveckla och använda instrumentet ”Resilient Assessment Grid”, RAG, kunde stödja medarbetarnas förutsättningar att arbeta på ett resilient sätt. Förbättringsarbetet genomfördes enligt Nolans förbättringsmodell. Studien var en fallstudie med kvalitativ ansats på en vårdavdelning inom specialiserad barnsjukvård. Studieresultatet visade att arbetet med att utveckla och använda RAG kunde stödja medarbetarnas förutsättningar att arbeta på ett resilient sätt genom att de fick tillgång till ett sätt att mäta förutsättningar för resiliens och genomföra strategiska förbättringsinterventioner. Medvetenheten och kunskapen om patientsäkerhet och resiliens ökade, vilket har lett till en ökad förståelse för verksamheten, och för vad som är viktigt för god patientsäkerhet. Vi har hittills inte kunnat påvisa förbättrade förutsättningar för resiliens genom att använda instrumentet RAG. Innan längre tid förflutit och ytterligare RAG-mätningar gjorts kan vi varken påvisa eller utesluta att förutsättningarna kommer förbättras. Erfarenheterna från masterarbetet kan nyttjas i kommande initiativ, inom komplexa adaptiva system i hälso- och sjukvården, som syftar till att förbättra förutsättningarna för resiliens.This master´s thesis explores how an improvement work of developing and using the “Resilience Assessment Grid”, RAG, can support the potential for resilient performance on a paediatric ward, in light of the need for new safety strategies developed for complex adaptive systems. A qualitative case study of the improvement work was conducted. The improvement work was done according to the Model for Improvement. The work of developing and using RAG for measuring and managing resilient performance, supported the employees' potential for resilient performance by helping them in implementing strategic improvement interventions. The awareness and knowledge of patient safety and resilience increased, which led to increased understanding of the system and the needs of the system in terms of patient safety. We have not been able to show that the potential for resilient performance has improved by using RAG for measurement. We can neither demonstrate nor exclude that the potential will improve before further measurements have been made. Experience from the present study can be used in future interventions of improving the potential for resilient performance and patient safety in a complex adaptive system in the health care setting.
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Fontenele, Lissa Mara Saraiva. "O novo contexto da educaÃÃo especial: uma pesquisa etnogrÃfico-discursiva sobre identidades profissionais e maternas." Universidade Federal do CearÃ, 2014. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=11572.
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CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel SuperiorA implantaÃÃo dos Centros de Atendimento Educacional Especializado (AEEs) pelo governo ocasionou mudanÃas nas identidades profissionais da equipe multiprofissional, e reconfigurou as identidades maternas. Os profissionais e as profissionais das diversas Ãreas que antes prestavam atendimento de forma isolada tiveram que desenvolver um trabalho conjunto. Nesse contexto, as identidades profissionais foram sendo reconstruÃdas e influenciadas, em grande parte, pelas prÃticas de letramento das diversas Ãreas profissionais presentes nos centros. Quanto Ãs mÃes, viram diante de si o desafio de terem que matricular seus filhos e filhas na escola regular a fim de continuarem a ter direito aos atendimentos da equipe multidisciplinar. Isso foi fonte de grande ansiedade e inseguranÃa, visto nÃo considerarem o modelo da escola regular atual apropriado Ãs suas crianÃas. Para pesquisar sobre identidades, adoto nesta tese a Teoria Social do Letramento (BARTON; HAMILTON, 1998; BARTON, 2009), que entende o letramento como um conjunto de prÃticas sociais que tÃm relaÃÃo direta com valores e crenÃas existentes nas diversas comunidades e grupos sociais e que estÃo, assim, intimamente relacionadas Ãs identidades das pessoas. Adoto tambÃm a proposta teÃrico/metodolÃgica de Gee (2000 â 2001, 2003) de anÃlise das identidades em contextos educacionais. AlÃm disso, a abordagem teÃrico-metodolÃgica da AnÃlise de Discurso CrÃtica (CHOULIARAKI; FAIRCLOUGH, 1999; FAIRCLOUGH, 2003), fornece subsÃdios para o estudo das identidades a partir de duas categorias, a saber: o Significado Representacional (Discursos) e o Significado Identificacional (Estilos). Por meio da pesquisa etnogrÃfica reflexiva, os dados indicam a existÃncia de uma assimetria de poder nas relaÃÃes entre os profissionais e as profissionais oriunda, em sua maioria, da predominÃncia dos letramentos da Ãrea da saÃde em detrimento aos letramentos relativos à Ãrea educacional, o que acaba por afetar, de forma negativa, os atendimentos. Ao considerar as concepÃÃes e representaÃÃes das mÃes em torno do letramento, foi possÃvel perceber como esses aspectos foram importantes na formaÃÃo de suas identidades maternas no sentido de serem parÃmetros que pautam suas escolhas em relaÃÃo a que atendimentos sÃo apropriados ou nÃo para seus filhos e filhas.
The implementation of Specialized Educational Care (SEC) Centers by the Central government brought about changes in the multidisciplinary team practitioner identities, and reshaped maternal identities. Practitioners from diverse fields that used to provide treatment in isolation had to develop joint work. In this context, professional identities were rebuilt, influenced largely by the literacy practices of the various professional fields present in the centers. In relation to the mothers, they had to face the challenge of having to enroll their children in mainstream schools in order to continue to be entitled to the multidisciplinary team care. This was a source of great anxiety and insecurity, as they do not consider current mainstream schools as appropriate to their children. To research about identities, I adopted in this thesis the Social Theory of Literacy (BARTON and HAMILTON, 1998; BARTON, 2009), which considers literacy as a set of social practices that are directly related to existing values and beliefs in different communities and social groups who are thus closely related to the membersâ identities. I also adopted Geeâs (2000 - 2001, 2003) theoretical and methodological proposal on identities in educational contexts. In addition, theoretical and methodological approach of Critical Discourse Analysis (CHOULIARAKI; FAIRCLOUGH, 1999; FAIRCLOUGH, 2003) provides support for the study of identities with two categories, namely: Representational Meaning (Discourses) and Identificational Meaning (Styles). Through the reflexive ethnographic research, the data indicated the existence of power asymmetry in the relations among the practitioners originated, mostly, from the predominance of literacies related to the health area over the literacies in the educational area, which ultimately affect in a negative way the educational care. By taking into account the motherâs views and representations around literacy, it was possible to see how these aspects were important in the construction of their maternal identities in relation to their choices regarding the appropriate care to their children.
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Prest, C. B. (Colin B. ). "The institutionalisation of the aged : the importance of visitation, and the role of the specialised visitor." Thesis, Stellenbosch : Stellenbosch University, 2003. http://hdl.handle.net/10019.1/49798.
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Thesis (MA)--Stellenbosch University, 2003ENGLISH ABSTRACT: Ageing is a fact of life. It often gives rise to unfortunate consequences. Physical infirmities; senile dementia; emotional disturbance. Indeed, the effects of the ageing process can be such as to render a person incapable of performing the ordinary and normal functions of life. In such a case, institutionalisation presents itself as a prospect to enable an aged person to cope with the ordinary day-to-day activities of living. The purpose of institutionalisation is to improve the quality of life of the elderly. In considering the process, a number of important facets need to be borne in mind. Firstly, the process must be seen in relation to the condition of the person being institutionalised. Secondly, the process must be seen as a matter of extraordinary change in the life of the aged person. This implies a detailed explanation and full disclosure of the process envisaged, and, if needs be, appropriate counselling of the person concerned. Thirdly, there must be sympathetic and sensitive assistance given to the aged person in adapting to a new situation. Fourthly, a continuing and intimate interest in, and concern for, the aged person on the part of the family must be accentuated and impressed. This gives rise to the importance of visitation on the part of the family. Its meaning and purpose must be understood. The need for meaningful visitation must be stressed, and the status of a respected member of the family must be emphasised. The aged person must never be cut-off, separated or neglected. Visits must not be a coincidental, haphazard and aimless occurrence. Visitation must always be directed at improving the quality of life of the aged person. The aged person, despite her advanced years and debilitated condition, remains a person with thoughts, feelings, emotions, difficulties and problems. She needs time and attention. The normal or regular pattern of visitation does not, by and large, accomplish these ends. Something more is required. Specialised visitation. This is something different from ordinary, normal, social visitation. It is more intense, more concentrated and more regular. It embodies consistent and continuous contract. It is directed at effectiveness. It is never haphazard or aimless and always has as its objective an improved quality of life for the aged. The specialised visitor and the resident come to know each other well; they come to trust each other, and they come to realise that the object of the visit is more than an exchange of frivolities. Specialised visitation manifests a concern for the aged; it offers them support, stability, certainty and security. This is so because the specialised visitor responds to an inner conviction, an infinite calling, and an earnest urging. It is not a task but a vocation. Many factors contribute to the enhancement of the quality of life of the elderly : three may be mentioned. Institutionalisation, visitation and the role undertaken by the specialised visitor.
AFRIKAANSE OPSOMMING: Veroudering is 'n gegewe feit wat dikwels tot ongelukkige toestande soos fisiese swakhede, seniliteit en emosionele versteuring lei. Die gevolge van veroudering kan inderdaad 'n persoon verhinder om die alledaagse en normale funksies van lewe uit te voer. In sulke gevalle bied institusionalisering die moontlikheid dat 'n bejaarde persoon wel kan handel met die gewone dag-tot-dag aktiwiteite van die lewe. Die doel van institusionalisering is die verbetering van die kwaliteit van lewe van die bejaarde. In die beskouing van hierdie proses moet 'n aantal fasette in aanmerking geneem word. Eerstens, moet die proses in verhouding tot die toestand waarm die persoon wat geïnstitusionaliseeer word verkeer, gesien word. Tweedens, die proses verteenwoordig 'n buitengewone verandering in die lewe van die bejaarde persoon. Om dit te vergemaklik moet 'n gedetaileerde verduideliking en volle openbaarmaking van die proses wat voorlê aan die persoon gegee word en, indien nodig, toepaslike berading aan die persoon verskaf word. Derdens, die persoon moet simpatieke en sensitiewe bystand in die proses van aanpassing tot die nuwe situasie verleen word. Vierdens,die gesin van die persoon moet baie duidelik onder die indruk gebring word van die belang van voortgesette en intieme belangstelling in die persoon deur hulself Hierdie aspek bring die belangrikheid van besoek deur die gesin na vore. Die betekenis en doel van besoek moet deeglik verstaan word. Die behoefte van betekenisvolle besoek moet benadruk word en die status van die persoon as gerespekteerde lid van die gesin beklemtoon word. Die bejaarde mag nooit afgesny, afgesonder of verwaarloos word nie. Besoeke mag nie toevallig, planloos en doelloos geskied nie. Besoeke moet altyd gerig wees op die verbetering van die kwaliteit van die lewe van die bejaarde. Ten spyte van haar gevorderde jare en afgetakelde toestand bly die bejaarde persoon iemand met eie denke, gevoelens, emosies, moeilikhede en probleme. Sy benodig tyd en aandag. Die gewone of gereelde patroon van besoek bereik oor die algemeen nie hierdie doeleindes nie. Iets meer word vereis, naamlik gespesialiseerde besoek. Dit is duidelik verskillend van die gewone, normale sosiale besoek. Dit is meer intensief, meer gekonsentreerd en meer gereeld. Dit beliggaam bestendige en deurlopende kontak. Dit is gerig op doelbereiking. Dit is nooit planloos of doelloos nie en het altyd as oogmerk om die kwaliteit van lewe van die bejaarde te verbeter. Die gespesialiseerde besoeker en die inwoner leer mekaar goed ken sodat hulle mekaar vertrou, en besef dat die oogmerk van die besoeke meer behels as 'n uitruil van beuselagtighede. Gespesialiseerde besoek druk 'n besorgdheid VIT die bejaarde uit. Dit gee aan hulle ondersteuning, stabiliteit, sekerheid en sekuriteit. Dit is so omdat die gespesialiseerde besoeker vanuit 'n innerlike oortuiging, 'n onbegrensde roeping en 'n ernstige lewensdrang optree. Dit is nie 'n taak nie maar 'n roeping. Baie faktore dra by tot die verhoging van die kwaliteit van lewe van bejaardes. Drie hiervan is institusionalisering, besoek en die rol wat die gespesialiseerde besoeker onderneem.
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Andrews, Samantha Lee. "The general development and cognitive ability of a sample of children in specialized education." Thesis, Nelson Mandela Metropolitan University, 2011. http://hdl.handle.net/10948/d1015714.
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The main aim of this study was to explore and describe the development and cognitive ability of a sample of children aged six to eight enrolled in specialised education, in the category of specific learning disability (SLD). This was achieved through the utilization of the Griffiths-Mental Development Scales – Extended Revised, the Wechsler Intelligence Scales for Children – Fourth Edition and input from the trans-disciplinary team. A non-probability, purposive sampling method was employed and the sample consisted of eight participants. The multiple case study method was used in order to achieve the aim of the study. Both qualitative and quantitative data were incorporated to provide a holistic description of the participants. Quantitative data was obtained from the Griffiths-Mental Development Scales – Extended Revised, the Wechsler Intelligence Scales for Children – Fourth Edition while qualitative data was obtained from the Biographical Questionnaire, input from members of the trans-disciplinary team, data from the participants‟ archives as well as clinical observations made during the assessment process. The data was analysed according to the domains of childhood development.The results obtained revealed that the general development of the sample as measured by the Griffiths-Mental Development Scales – Extended Revised was average. The Eye and Hand Co-ordination Subscale was the most problematic for the participants. The majority of the sample obtained below average scores on the Wechsler Intelligence Scales for Children – Fourth Edition‟s full scale IQ (FSIQ). The Verbal Reasoning Index and the Working Memory Index yielded the lowest scores amongst the sample. The results indicated that the majority of the participants are stronger with non-verbal as opposed to verbal reasoning. The study revealed that the two measures, the Griffiths-Mental Development Scales – Extended Revised, the Wechsler Intelligence Scales for Children – Fourth Edition complement one another. The developmental and intellectual nature of the measures allow for gaps left by the one measure to be filled by the other. The study highlighted the importance of gaining information from the trans-disciplinary team and not relying purely on psychometric measures. It was made clear through the study that deficits often exist that are not picked up by assessment measures alone. In order to gain a comprehensive, holistic picture of a child, one needs to consult a variety of sources. Questions regarding the classification system of high needs learners as well as the current system of specialised education were raised.
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Maymone, Duarte. "Infecção associada aos cuidados de saúde no utente admitido numa unidade de cuidados intensivos cardiológicos a aguardar implante de pace-maker definitivo/cardioversor-disfibrilhador implantável." Master's thesis, Instituto Politécnico de Setúbal. Escola Superior de Saúde, 2017. http://hdl.handle.net/10400.26/17614.
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Relatório de Trabalho de Projeto apresentado
para cumprimento dos requisitos necessários à
obtenção do grau de Mestre em Enfermagem
Médico-CirúrgicaO presente relatório é o resultado de um percurso académico realizado com o intuito de adquirir competências comuns e específicas do Enfermeiro Especialista em Enfermagem Médico-Cirúrgica, bem como as competências inerentes ao grau de Mestre em Enfermagem Médico-Cirúrgica, através da frequência do 4º Mestrado em Enfermagem Médico-Cirúrgica da Escola Superior de Saúde do Instituto Politécnico de Setúbal. Apresentamos uma apreciação crítica e reflexiva do caminho percorrido, sendo que a sua génese teve como base o trabalho realizado utilizando a metodologia de trabalho de projeto, durante os Estágios I, II e III, inseridos no plano de estudos. Todos os estágios foram realizados numa Unidade de Cuidados Intensivos Cardiológicos e a temática abordada é a Infeção Associada aos Cuidados de Saúde (IACS) em Utentes a aguardar Implante de Pacemaker Definitivo/Cardiodisfibrilhador Implantável. Foi realizado um Projeto de Intervenção em Serviço (PIS) visando a temática acima referida de modo a possibilitar a aquisição das competências de Enfermeiro Especialista em Enfermagem Médico-Cirúrgica e as competências de Mestre em Enfermagem Médico-Cirúrgica, bem como a operacionalização das mesmas. Durante a elaboração deste foi possível identificar práticas incorretas relacionadas com a higienização das mãos e utilização de equipamentos de proteção individual tendo sido elaboradas sessões de formação de modo a reciclar conhecimentos sobre estas temáticas. Foi também realizado um Projeto de Aquisição de Competências (PAC) de modo a realizar uma reflexão crítica acerca das competências adquiridas, à luz do Modelo de Sinergia da American Association of Critical Care Nurses (AACN).
This report is the result of an academic path made with the objective of securing common and specific Medical- Surgical Specialized competences as well as competences in Medical-Surgical Masters, by attending the 4th Masters in Medical- Surgical Nursing in Escola Superior de Saúde of the Instituto Politécnico de Setúbal. In this report we can find a critic and reflexive appreciation of the path taken which was based on the work done using the Work Project methodology during the Internships I, II and III, part of the study plan. All the internships were developed in a Cardiac Intensive Care Unit and the theme was Health Care Related Infections in Clients Waiting for Pacemaker Device Implantation. An Intervention Project was created about the thematic referred above to make it possible for the student to acquire all the Medical-Surgical Specialized Nursing competences as well as the Masters competences in Medical-Surgical Nursing and their application. While building this project it was possible to identify incorrect practices related to hand hygiene and individual protection equipment. Training sessions were held to review concepts about these themes. For the critic reflexion about the acquired competences a Competence Acquiring Project was produced in the light of the American Association of Critical Care Nurses Synergy Model.
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Czapski, Alessandra Ruita Santos. "GÊNERO E CONQUISTAS: LEI MARIA DA PENHA E O ATENDIMENTO ÁS VÍTIMAS DE VIOLÊNCIA EM PALMAS TO NO ANO DE 2008." Pontifícia Universidade Católica de Goiás, 2010. http://localhost:8080/tede/handle/tede/2220.
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Previous issue date: 2010-08-16Gender and Achievements: Maria da Penha Law and care for victims of violence in Palmas - T0 in 2008, aims to analyze the phenomenon of domestic violence against women, the gender conflicts, the feminist movement, their struggle, and their achievements to the enactment of a specific law to combat domestic violence against women, and the importance of professional practice of Social Work in this expression of social issues affecting women around the world. The gender violence is a serious social problem that demands effective solutions. The Maria da Penha Law, Number 11.340/06, sanctioned by the President on August 7, 2006, is a legal instrument of great importance in the combat of domestic violence against women. This law presents innovations and advancements that contribute to the accountability of offenders and ensuring protection of the rights of women. This study chose as unit of analysis the applicability of the Maria da Penha Law on assistance to women victims of domestic violence in the city of Palmas in the Reference Center Flor de Liz, Institute of Forensic Medicine and Police Specialized Care for Women in the year of 2008. The study revealed the socioeconomic profile of the victims attended, the number of calls made in the institutions mentioned above, the lack of qualified service in the IML and DEAM Palmas, and the necessity of forming a multidisciplinary team trained on the Maria da Penha Law to attend to victims of Domestic Violence, was possible to detect that in the applicability of Law the protective measures that determine the spacing of the aggressor from the victim under penalty of imprisonment, are most used by DEAM to break the cycle of violence in Palmas, and still the absence of specific campaigns that disseminate information about the institutions that perform the service for victims of domestic violence in this city, and also the importance of overcoming the challenge of strengthening the network that make up the integrated service to victims of domestic violence, integrating the functional framework institutions that are part of this network of professional social work and psychology in order to improve customer service. The data collected in this study aims to help provide visibility into the care provided in Palmas to the domestic violence victims in the sense of ensure the applicability of the Maria da Penha Law effectively protecting women's rights to protection and a life without violence in order to build a culture where romantic relationships between men and women are more equal and horizontal.
Gênero e Conquistas: Lei Maria da Penha e o atendimento às vítimas de violência em Palmas T0 no ano de 2008 tem por objetivo a análise da aplicabilidade da lei Maria da Penha nº 11..340/06, e sua contribuição para o atendimento e amparo das vítimas de violência doméstica na cidade de Palmas. A Lei Maria da Penha sancionada pelo Presidente da República em 7 de agosto de 2006, é um instrumento jurídico importante no combate a violência doméstica praticada contra mulheres. Essa lei apresenta inovações e avanços que contribuem para a responsabilização dos agressores e a garantia de proteção aos direitos das mulheres. Este estudo elegeu como unidade de análise a aplicabilidade da Lei Maria da Penha no atendimento às mulheres vítimas de violência doméstica no município de Palmas no Centro de Referência Flor de Liz, Instituto Médico Legal e Delegacia Especializada de Atendimento à Mulheres no ano de 2008. O estudo revelou o perfil sócio econômico das vítimas atendidas, o número de atendimentos realizados nas instituições acima referidas, a precariedade das equipes de atendimento na DEAM e no IML de Palmas e, a necessidade de formação de uma equipe multidisciplinar capacitada sobre a Lei Maria da Penha para o atendimento às vítimas de violência doméstica. Durante a pesquisa detectou-se que na aplicabilidade da Lei as medidas protetivas que determinam o afastamento do agressor da vítima sob pena de prisão, são as mais utilizadas pela DEAM para romper o ciclo de violência em Palmas, e ainda, a ausência de campanhas específicas que divulguem informações sobre as instituições que realizam o atendimento às vítimas de violência doméstica nesse município, bem como, a importância de vencer o desafio de fortalecer a rede que compõem o atendimento às vítimas de violência doméstica, integrando ao quadro funcional das instituições que fazem parte dessa rede, profissionais do Serviço Social e da Psicologia a fim de aprimorar os atendimentos prestados às vítimas neste município. Os dados coletados nesse estudo têm como objetivo, contribuir para dar visibilidade ao atendimento às vítimas de violência doméstica, garantir a aplicabilidade da Lei Maria da Penha de maneira efetiva, resguardar o direito das mulheres à proteção e uma vida sem violência, no intuito de construir uma cultura onde as relações amorosas entre homens e mulheres sejam mais iguais e horizontais.
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Humphrey-Leclaire, Heather J. "Therapists Who Specialize in Addiction: A Grounded Situational Analysis of a Stigmatized Profession." Antioch University / OhioLINK, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=antioch1580920838098363.
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Jain, Julija. "The therapists' perspective on the impacts and coping strategies of counselling adult survivors of sexual abuse within specialised agencies." Thesis, University of Manchester, 2019. https://www.research.manchester.ac.uk/portal/en/theses/the-therapists-perspective-on-the-impacts-and-coping-strategies-of-counselling-adult-survivors-of-sexual-abuse-within-specialised-agencies(1409c7cd-1aa4-4016-b127-90e30d97bb89).html.
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Background: Sexual abuse is a highly distressing traumatic experience that negatively affects the lives of sexual abuse survivors. The number of individuals who reported sexual abuse has increased, which makes it a public and global concern. As a result, survivors of sexual abuse turn to counselling to cope with the traumatic impacts. Counsellors, psychotherapists, and psychologists engage in deep and meaningful explorations of the sexual abuse in order to support survivors. However, very little is known about the impacts and coping strategies involved in this type of work. Objectives: The objective of this study, therefore, was to explore the experiences of UK-based counselling professionals who counsel survivors of sexual abuse. The research questions were as follows: 1. What is the impact of counselling survivors of sexual abuse? and 2. What self-care strategies and coping techniques have been beneficial when counselling survivors of sexual abuse? Method: An inductive qualitative design was used for the purposes of this study. Semi-structured interviews were conducted with twelve UK-based counselling professionals who provided counselling to individuals who had experienced sexual abuse. The collected data were then analysed using thematic analysis. Findings: The themes developed from the first research question revealed a number of ways in which counselling survivors of sexual abuse affected counselling professionals. Three main themes emerged from the data analysis: work-related impacts, impacts on personal wellbeing and relationship impacts. These themes encompassed a total of fourteen sub-themes. Another two main themes were developed when exploring participants' self-care techniques and coping strategies: holistic self-care and work environment selfcare. Both of these main themes incorporated twelve more sub-themes. These are introduced and outlined in depth in turn. Conclusions: This research has provided a unique insight into the impacts and coping strategies of UK-based counselling professionals working with survivors of sexual abuse. The findings suggest that the counsellors experienced a number of negative impacts, some of which were perceived as traumatic in nature. Further, the impacts were not limited to the counsellors themselves; partners, children, extended family, and friends were also affected by the work. Such far-reaching impacts of sexual trauma have not been sufficiently explored previously. Contrary to the negative tendencies expressed in the research literature, some of the findings indicate positive aspects, such as high job satisfaction and evolved personal growth. The findings of this study provide a rare insight into the useful self-care techniques and copings strategies specific for counselling survivors of sexual abuse. Although the strategies are similar to those used in other areas of counselling, they emphasize organisational and educational responsibilities to support counsellors' wellbeing. Suggestions are proposed for research, educational, organisational, and ethical developments.
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Conran, Joseph. "Determining the process of rehabilitation and the outcomes of patients at a specialised in-patient centre in the Western Cape." Thesis, University of the Western Cape, 2012. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_4429_1371739260.
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The World Health Organisation estimates that the majority of the disabled population resides in the developing world, but most of the research on outcomes of patients originates from the developed world. In the light of the differences in healthcare structures and function, especially rehabilitation between settings and countries, it is imperative to have an understanding of the
functioning of patients at discharge with the objective of measuring the level at which outcomes are met. The aim of this study was therefore to determine the process of rehabilitation and the
outcome of patients following in-patient rehabilitation at a facility in the Western Cape. A quantitative research design was employed to address the objectives. Self-administered
questionnaires were developed to collate information pertaining to the demographic-, socioeconomic- and medical profile of patients and data extraction sheets collected information relating
to the process of rehabilitation and the impairment status of patients on admission. With regards to activity and participation, a longitudinal study design was used, which utilised standardised
outcomes measures. The sample consisted of all patients with stroke and spinal cord injury admitted within a three-month period, and all ethical principles relating to research on human
subjects, as stipulated in the Helsinki Declaration were adhered to during data collection, with ethical clearance obtained from relevant authorities. The SAS and the Microsoft Excel Package
2007 were used to analyse the quantitative data elements. Descriptive statistics using frequencies, percentages, ranges, means, and standard deviations and inferential statistics using
chi-square, student T-tests and correlation tests, for determining the predictors of functional outcome, were calculated. There were 175 patients, whereof 82 were patients with stroke and 93
with spinal cord injury, with 143 (76 presenting with spinal cord injury and 67 with stroke) meeting the inclusion criteria on admission. The mean age of those with spinal cord injury and stroke
was 34.14 and 52.95 years. Most of the patients with spinal cord injuries were single (73.68%), whereas the majority (53.73%) of patients with strokes were married at the time of injury. All
patients were managed by the doctor and the nurse, with most of the patients receiving physiotherapy, occupational therapy and social assistance from the social worker. With regards to recreational activities, 46.87% of patients with spinal cord injury and 39.39% of those with stroke attended the learn to swim programme, and 29.68% of patients with spinal cord injury attended the wheelchair basketball sessions. The mean length of hospital stay for patients with spinal cord injury and stroke was 73.11 and 51. 62 days, with most of the spinal cord injured patients
(80.26%) and stroke patients (82.08%) discharged home without follow-up rehabilitation. The most prevalent impairments on admission of the spinal cord injury cohort were muscle
weakness (75.0%), bladder incontinence (71.1%) and reduced sensation (69.7%), whereas patients with stroke presented mostly with muscle paralysis (80.6%), abnormal tone (76.1%) and aphasia (50.8%). Functional limitations experienced by the participants included, mobility, stair climbing and transfers. The participants experienced participation restrictions in the following
domains, leisure activities and employment. A clinical significant improvement was noted in execution of functional task of patients with spinal cord injury (p<
0.0001) and stroke (p<
0.0001)
between admission and discharge. A significant statistical change was also detected for the participation elements of both stroke and spinal cord injury cohorts. Functional ability on
admission was found to be a predictor of functional outcome of the stroke diagnostic group at discharge, whereas the multiple
redictor model of functional outcome of the spinal cord injured cohort at discharge was significant with remaining variables of functional outcome score on admission (p<
0.0001) and bladder -and bowel impairment(s) (p=0.0247). The study findings suggest that despite the significant change in activity and participation, most of the patients were discharged home without further follow-up for rehabilitation, irrespective of the activity
limitations and participation restrictions still experienced at the time of discharge. The latter finding
questions the duration of the length of hospital stay, which does not allow patients to be independent in all meaningful activities and participatory actions and roles by the end of inpatient rehabilitation. The study findings could assist authorities to adapt the existing rehabilitation
programme and referral process .
49
Gallo, Marianna. "AUTOMOTIVE TERMINOLOGY IN ENGLISH AND SLOVAK: creating terminological entries in the domain of green cars for IATE." Master's thesis, Alma Mater Studiorum - Università di Bologna, 2020. http://amslaurea.unibo.it/20334/.
Full textAbstract:
The aim of this dissertation is the creation of a terminology project of 50 entries in Slovak language. The domain of the project is green cars. The terminology resource was created as part of a project with the Terminology Coordination unit of the European Parliament (TermCoord), which is responsible for the managing of the IATE (InterActive Terminology for Europe) terminology database. The final result of the terminology project was presented to the TermCoord to be implemented into IATE. Apart from creating the resource, the results of the work conducted for this dissertation has lead to a deep analysis of the IATE database, putting the focus on the managing strategy of the resource and highlighting strong points and criticisms for the users of the database. The dissertation is composed of four chapters. The first chapter is dedicated to a theoretical overview of special languages and terminology, with a brief section dedicated to the building of corpora for terminology purposes. The second chapter presents the translation and terminology services at the EU institutions, which it was possible to analyse during the internship at the DGTranslation of the European Commission in Brussels. In the third chapter, the process for the extraction of the Slovak terms to input into the termbase is described, starting from the retrievement of terms in English and then analysisng the process to extract the Slovak equivalent to build the termbase. The fourth chapter analyses the results of the terminology research and illustrates the structure of the final monolingual termbase.
50
Geduškaitė, Laima. "K.Griniaus slaugos ir palaikomojo gydymo ligoninės veiklos optimizavimas, pritaikant demencija sergančių pacientų slaugai." Master's thesis, Lithuanian Academic Libraries Network (LABT), 2005. http://vddb.library.lt/obj/LT-eLABa-0001:E.02~2005~D_20050614_140159-70344.
Full textAbstract:
SUMMARY
The aim of this study was to investigate the requirements for patients with dementia and optimization of activities for nursing.
Methods of study – primary data were obtained from the databases of the K.Grinius nursing and supportive treatment hospital activities in 2002-2004, and using of nurses and patients relative’s interview data collected by the specific questionnaire. During 2002-2004 years all data was enrolled to the information database. Statistical analysis was performed using MS EXCEL 2000 standard statistical programming packets.
Results. During 2002-2004, the part of patients with dementia among all patients statistically significantly increased, so significantly increased the part of bed-days. The duration of nursing and supportive treatment was without significant changes, but hospital lethality have tendency to increase in average by 2.3 % /yrs, while the number of patients have tendency to decrease during this years. During the investigated period, the expenses for one bed-day were without significant changes and in averaged per year accounted 50.61 Lt. The expenses of state for one bed-day during 2002-2004 accounted 41.54 Lt. The expenses of Lithuanian state for nutrition and drugs was without significant changes and respectively accounted 8.69 and 11.90 Lt. Detecting nursing personnel, working with dementive patients, occupational peculiarities evaluated, that majority of nursing respondents were in middle-age, majority of them working in night... [to full text]