Teses / dissertações sobre o tema "Patient Advocate"
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1
Calabro, Kristin, e Whitney Shields. "Project SHAPE (Students Helping Advocate for Patient Education)". The University of Arizona, 2010. http://hdl.handle.net/10150/623898.
Resumo:
Class of 2010 AbstractOBJECTIVES: The purpose of Project SHAPE was to provide an interdisciplinary workshop for future practitioners from the Colleges of Pharmacy, Medicine and Public Health on health literacy to improve the communication between the patients and their providers. METHODS: Study participants were recruited via email from the Colleges of Pharmacy, Medicine, and Public Health at The University of Arizona. Participants attended a workshop that included a one-hour presentation by Dr. Barry Weiss followed by the development of educational materials on various health topics. A retrospective analysis of the health professional students’ knowledge of health literacy was performed. Materials were provided to El Rio Community Health Center, Colleges of Pharmacy, Medicine and Public Health to distribute to their patients in the Tucson community. RESULTS: Students’ overall knowledge on health literacy and communication with patients improved by 88% after the presentation. A total of nine different low literacy educational materials were developed by the students who attended the workshop. Copies of the educational materials were given to participating students from the other colleges to use in their patient outreach programs. The materials were also distributed to patients at a variety of brown bags, community health fairs, screenings, and El Rio Community Health Center. CONCLUSIONS: Project SHAPE has already affected many future healthcare practitioners through the interdisciplinary workshop. The educational materials will continue to be provided to patients in the Tucson community.
2
Lindeman, Sandra, e Andinsson Helena Josefsson. "Sjuksköterskan som patientens förespråkare : En litteraturstudie som beskriver faktorer som påverkar sjuksköterskan i rollen som förespråkare". Thesis, Ersta Sköndal högskola, Institutionen för vårdvetenskap, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:esh:diva-1422.
Resumo:
Bakgrund: Sjuksköterskan har enligt kompetensbeskrivningen och ICN:s etiska kod ett ansvar att förespråka patienten. Begreppet advocacy myntades i USA under 1970-talet och sedan dess har begreppet diskuterats i litteraturen. Advocacy innebär att sjuksköterskan ska kunna uttyda patientens önskemål, kommunicera med patient och närstående, försäkra sig om patientens säkerhet, respektera och beskydda patientens rättigheter och tala samt agera på uppdrag av patienten. Syfte: Syftet är att beskriva faktorer som påverkar sjuksköterskan i rollen som patientens förespråkare. Metod: En litteraturstudie baserad på 13 vetenskapliga artiklar, varav tio kvalitativa och tre kvantitativa. Resultat: Författarna fann i det analyserade materialet, fyra huvudfaktorer som på olika sätt påverkade sjuksköterskan i rollen som förespråkare. Dessa huvudfaktorer är sjuksköterskan som person, sjuksköterskeprofession, samarbetet med läkaren och arbetsmiljön. I en av de analyserande studierna återfanns även anhöriga som en faktor. Diskussion: Att sjuksköterskan själv är en faktor som är viktig för patientvården är något som Jean Watson belyser i sin omvårdnadsteori. Hon menar att omsorgen inte får det utrymme den bör ha inom vården men också i övriga samhället och att det leder till svårigheter för bevarandet av den ursprungliga mänskliga omsorgen. Att stärka professionen och se den skild från det medicinska området är därför viktigt. Författarna menar att även om sjuksköterskan själv är en viktig faktor kommer hon likväl behöva en stödjande miljö för att orka och våga agera utifrån sina värderingar som person och profession fullt ut.Background: The nurse has, according to the description of competence and the ethical code of ICN, a responsibility to advocate the patient. The idea of advocacy was coined in the USA during the 1970s and since then it has been discussed in the literature. Advocacy means that the nurse should be able to interpret the wishes of the patient, to communicate with the patient and his/hers relatives, to assure the safety of the patient, to respect and protect the rights of the patient and to speak and act on behalf of the patient. Aim: The aim is to describe factors that affect the nurse in her role as the patient’s advocate. Method: A literature review based on 13 research reports, of which ten are qualitative and three quantitative. Result: In the analyzed material the authors’ found four factors, which in different ways affected the nurse in her role as advocate. These factors are the nurse as a person, the nursing profession, the cooperation with the doctor, and the working environment. In one of the analyzed studies the family of the patient was also found as a factor. Discussion: That the nurse herself is an important factor for the care of the patient is something that Jean Watson illustrates in her nursing theory. She argued that human care do not get the space it should have in health care but also in the rest of society and that it leads to difficulties for the preservation of the original human care. To strengthen the profession and to view it as separated from the medical area is therefore important. The authors mean that even if the nurse in herself is one important factor she will, however, need a supportive environment to be able to fully sustain and dare to act according to her values as a person and profession.
3
Johnston, Sharon 1972. "Double agent dilemma : the Canadian physician: patient advocate and social agent". Thesis, McGill University, 1999. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=30308.
Resumo:
This thesis considers the rationalization of health care in Canada. It focuses on the conflicting roles modern physicians play in our system, acting as both patient advocate and social agent. It begins by tracing the origin of both of these duties. It then examines the ethical, professional, and legal issues which arise in the limited circumstances where front-line physicians must participate in the rationing of health care. It offers a framework for resolving the double agent dilemma and states five interlocking recommendations which are the building blocks of the resolution.
4
Johnston, Sharon. "Double agent dilemma, the Canadian physician : patient advocate and social agent". Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp03/MQ64284.pdf.
5
Hörnfeldt, Katarina, e Ulrica Johnsson. "Hur vårdrelationen etableras preoperativt för god personcentrerad vård : En litteraturstudie med syntes från Fundamentals of Care". Thesis, Uppsala universitet, Anestesiologi och intensivvård, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-446670.
Resumo:
Bakgrund: Vårdrelationen som etableras mellan patienten och specialistsjuksköterskan inom anestesi i det tidsbegränsade preoperativa mötet är en förutsättning för att specialist-sjuksköterskan ska kunna ge personcentrerad vård. Det har tidigare inte studerats hur vårdrelationen etableras utifrån ramverket Fundamentals of Care i den preoperativa kontexten. Syfte: Att beskriva hur vårdrelationen etableras i det tidsbegränsade preoperativa mötet mellan patienten och specialistsjuksköterskan inom anestesi utifrån Fundamentals of Care. Metod: Litteraturstudie med systematisk ansats. Deduktiv innehållsanalys enligt Elo och Kyngäs. Resultat: Studiens resultat visar hur vårdrelationen kan etableras i det preoperativa mötet, beskrivet utifrån Fundamentals of Care, vilket inte gjorts tidigare. Resultatet visade på kunskap, erfarenheter, sinnen och förmågor som anestesisjuksköterskan behövde besitta för att etablera vårdrelationen. Det som kan lyftas fram var anestesisjuksköterskans speciella kommunikationsförmåga, mentala närvaro, metoder för att lugna patienten, olika sätt att visa fysisk närvaro samt hennes simultankapacitet för att etablera vårdrelationen preoperativt. Ramverket Fundamentals of Care gjorde det möjligt att överföra tidigare forskning för att beskriva etablerandet av vårdrelationen. Fortsatt fördjupning och forskning inom detta område skulle kunna ligga till grund för praktisk vägledning för specialistsjuksköterskan inom anestesi. Slutsats: Studien visar hur det är möjligt att etablera en vårdrelation i det tidsbegränsade preoperativa mötet mellan patienten och specialistsjuksköterskan inom anestesi, för att ge personcentrerad vård. Resultatet kan ses som en introduktion eller underlag för diskussion för nyexaminerade anestesisjuksköterskor om hur hon kan etablera en vårdrelation i det preoperativa mötet med patienten.Background: The relationship established preoperatively between the patient and the nurse anesthetic specialist is a prerequisite for the nurse specialist to give person-centered care. The establishment of the caring relationship has not earlier been investigated using the Fundamentals of Care framework in the perioperative context. Aim: To describe the establishment of the relationship between the nurse anesthetic specialist and the patient within a limited period in the preoperative setting using Fundamentals of Care. Method: Literature review with a systematic approach. The collected data was analyzed with a deductive approach according to Elo and Kyngäs. Result: The result of the study shows how the establishment of the caring relationship in the preoperative setting, described from Fundamentals of Care, which have not been done before. The result brings forth knowledge, experiences, senses, and abilities that the nurse anesthetist needed to possess to establish the caring relationship. Skills worth mentioning are her specific communication skills, her mental attendance, methods of calming the patient, different ways of showing physical presence and her simultaneous capacity for establishing the perioperative relationship. The framework Fundamental of Care itself made it possible to transfer former research to describe the establishment of a caring relationship. Furthermore, in-depth research in this area could be the basis to practical guidance for the nurse anesthetist. Conclusions: The study shows how it is possible to establish a caring relationship between the patient and the nurse anesthetist within the limited period in the preoperative setting in order to deliver person-centered care. The result can be an introduction or basis for discussion for the new graduate nurse anesthetist about the establishment of a caring relationship in the preoperative meeting with the patient.
6
Sundqvist, Ann-Sofie. "Perioperative patient advocacy : having the patient's best interests at heart". Doctoral thesis, Örebro universitet, Institutionen för hälsovetenskaper, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-55998.
Resumo:
Patient advocacy implies taking action on someone else’s behalf, and has been described as a key element of nurses’ professional care. In the perioperative setting, it involves not only critical decision making, but also all the small things that the nurses do for the sake of the patients during their working day. Since previous research on the advocacy role of a registered nurse anesthetist (RNA) is sparse, and has not been conducted in a Swedish context, this thesis was intended to contribute to a greater understanding of advocacy in the perioperative context. The overall aim was therefore to explore the characteristics and consequences of perioperative patient advocacy (Study I), and to describe RNAs’ views of advocacy in anesthetic nursing through interviews (Study II), a questionnaire (Study III), and observations (Study IV). The synthesis of the characteristics and consequences of perioperative patient advocacy was interpreted in this thesis as the RNAs having the patient’s best interests at heart, in that they (1) had control of the situation, (2) preserved human values, and finally (3) were emotionally affected, as the results from the four studies suggested this as the core of perioperative patient advocacy. Perioperative patient advocacy is not always perceived as easy. In praxis, it is linked to the code of ethics outlined by the International Council of Nurses, which states that all registered nurses, regardless of their working context, shall respect human rights, promote health, prevent illness, and ensure that the individual receives accurate and sufficient information. This thesis elaborates on how this is done by describing how RNAs exert perioperative patient advocacy and how they interact in order to facilitate the best possible care for the patient. The results deepen the understanding of perioperative patient advocacy from the RNA’s perspective and contribute to a new insight in the RNA’s professional role.
7
Malkin, Lisa Sohl. "Patients' and significant others' satisfaction with nursing activities in oncology ambulatory settings". Thesis, The University of Arizona, 1988. http://hdl.handle.net/10150/558093.
8
Hamdy, R. C., J. V. Lewis, Amber Kinser, A. Depelteau, Rebecca Copeland, T. Kendall-Wilson e K. Whalen. "Too Many Choices Confuse Patients With Dementia". Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etsu-works/1231.
Resumo:
Choices are often difficult to make by patients with Alzheimer Dementia. They often become acutely confused when faced with too many options because they are not able to retain in their working memory enough information about the various individual choices available. In this case study, we describe how an essentially simple benign task (choosing a dress to wear) can rapidly escalate and result in a catastrophic outcome. We examine what went wrong in the patient/caregiver interaction and how that potentially catastrophic situation could have been avoided or defused.
9
Squires, Ruelokke Violet Doreen. "Nurses' perceptions of their empowerment to be patient advocates". Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape9/PQDD_0007/MQ42449.pdf.
10
Curran, Leah Jane. "The development of new instruments to assess and predict patient involvement in medical decision-making". Connect to full text, 2006. http://hdl.handle.net/2123/4014.
Resumo:
Thesis (D.C.P. / M. Sc.)--School of Psychology, Faculty of Science, University of Sydney, 2007.Title from title screen (viewed on February 3, 2009) Degree awarded 2007; thesis submitted 2006. Submitted in fulfilment of the requirements for the degree of Doctor of Clinical Psychology/Master of Science to the School of Psychology, Faculty of Science. Includes bibliographical references. Also issued in print.
11
Miller, Monica. "Leadership Challenges for Patient Advocates| A Cross Sector Alliance Perspective". Thesis, Pepperdine University, 2019. http://pqdtopen.proquest.com/#viewpdf?dispub=13811665.
Resumo:
Innovative and enduring solutions to the myriad of complex social and environmental challenges facing the world today require the shared resources and combined talents of government, nonprofit and for-profit sectors. Interactions between these sectors are called cross sector partnerships (CSPs). As an example of CSPs, nonprofit patient advocacy organizations (PAOs) are increasingly entering relationships and collaborations with for-profit pharmaceutical companies (FPPCs). Using a phenomenological approach, this study sought to contribute to the body of knowledge on PAO/FPPC partnerships, as well as the broader CSP phenomenon, by exploring how leaders in the field of PAO/FPPC alliances experience collaboration with one another. Three research questions were used as the basis of semi-structured interviews with 11 patient advocacy leaders. Five of the participants were nonprofit leaders (NPLs) and six were for-profit leaders (FPLs). Results from this study include several important new contributions that add to the body of knowledge related to PAO/FPPC cross sector alliances. First, the data describe disparities in decision-making authority between the NPLs and FPLs and the data illustrate the complex, variable and challenging decision-making context that exists in PAO/FPPC partnerships. Second, these results confirm that strategic analysis skills, marketing skills and facilitation skills are important leadership competencies that impact productive PAO/FPPC partnerships. Finally, this research describes similarities and differences in leadership competencies that are important to NPLs and FPLs. This study is significant because an increased understanding of collaborations between patient advocacy organizations and drug development companies may allow for more positive and beneficial future collaborations. In addition, this research provides insight into the general phenomena of cross sector alliances, which may prove beneficial to a wide range of social challenges.
12
Enros, Brynn Marie. "Mental health social workers : strategies for social justice advocacy in a hospital setting". Thesis, McGill University, 2005. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=99163.
Resumo:
This qualitative, quasi-phenomenological study presents strategies and methods hospital-based mental health social workers utilize to promote social justice and advocate for their clients. Three frontline mental health social workers and one mental health department head were interviewed. The findings of this research demonstrated that the participating social workers utilized a variety of creative and flexible approaches to promote social justice and successfully advocate for their clients. These approaches included: the use of appropriate language, using the system against itself, developing written standards and regulations for their tasks, and forming a network of allies.
13
Beaty-Edwards, Dawn Tanesha. "ETHICS AT THE BEDSIDE: ADVOCACY FOR THE PATIENT AND THE COST". Master's thesis, Temple University Libraries, 2019. http://cdm16002.contentdm.oclc.org/cdm/ref/collection/p245801coll10/id/563468.
Resumo:
Urban BioethicsM.A.
As a healthcare professional at the bedside, it has been very difficult to advocate for the patient while all parties involved cannot respect what the patient wants. Four out of five Americans do not have an advance directive. The history and court cases that have led the country to make patient’s right to make their own healthcare decisions has been decades in the making, yet still bring daily challenges within the healthcare system. When a patient’s wishes are not being honored, medical futility may lead to moral distress and compassion fatigue. Institutions provide multidisciplinary teams to address these issues, but if a patient’s capacity or competence is in question, their voice may not be heard. The toll on the healthcare provider and the patient can be permanently damaging, causing many nurses to leave the profession all together. I will attempt to determine the barriers to implementing the patient’s wishes, address the syndrome of moral distress among healthcare professionals, and attempt to offer solutions to promote well rounded, patient-centered care.
Temple University--Theses
14
Kleman, Carolyn Cable. "A PATH ANALYSIS OF TRUST IN NURSES, SOCIAL SUPPORT, PATIENT SELF-ADVOCACY, PSYCHOLOGICAL DISTRESS, AND PHYSICAL SYMPTOMS IN PATIENTS WITH CHRONIC HEART FAILURE". Kent State University / OhioLINK, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=kent150513325871688.
15
Jordan, Joanne Emma. "Conceptualising and measuring health literacy from the patient perspective". Connect to thesis, 2009. http://repository.unimelb.edu.au/10187/6776.
Resumo:
The current patient-centred healthcare approach encourages individuals to assume greater roles in decisions about their health. The premise is that patients who are well informed about healthcare options are more likely to adhere to prescribed treatments and achieve better health outcomes. This approach assumes that patients have an adequate level of health literacy. While a range of definitions exist, health literacy is commonly defined as an individual’s ability to seek, understand and utilise health information to make appropriate health decisions.Health literacy is increasingly recognised as a complex multi-dimensional concept which involves interactions between individual abilities and broader environmental factors. However across definitions, there has been little consultation with patients to understand what is important to effectively seek, understand and utilise health information. The lack of a consensual understanding has led to debate as to what health literacy represents and how it should be measured. A range of measures exist with the predominant approach being the testing of individual literacy abilities. However measures do not assess the range of attributes described in definitions. Thus a considerable gap exists between how health literacy is defined and how it is measured. This thesis focused on addressing this gap. The objectives were to: (i) critically appraise existing health literacy measures (ii) develop a conceptual framework from the patient perspective and (iii) use this framework to develop a comprehensive measure of health literacy.
A multi-method qualitative and quantitative approach was used:
(1) Systematic review and appraisal of the content, development and psychometric properties of health literacy measures.
(2) In-depth consultations with patients across healthcare and disease continuums to develop a conceptual framework.
(3) Development of a new health literacy measure based on the conceptual framework using a classical test theory approach.
A critical appraisal of the literature revealed that the majority of health literacy measures are not based on a conceptual framework and none appeared to adequately measure a person’s ability to seek, understand and utilise health information. Content focussed primarily on reading, comprehension and numeracy skills and scoring was poorly defined. Only five of the 19 measures had evidence of acceptable reliability.
The conceptual framework of health literacy from the patient perspective identified 17 key elements: six individual abilities and 11 broader contextual factors that are important to seek, understand and utilise health information and expanded previous conceptualisations of health literacy. This informed the development of the Health Literacy Management Scale (HeLMS) which measures six generic and potentially modifiable abilities and three specific broader social factors. Overall the HeLMS measures an individual’s ability to seek, understand and utilise health information within the healthcare setting. The HeLMS consists of 29 items across eight domains. Rigorous psychometric testing demonstrates that it possesses strong construct validity and high reliability (coefficient α >0.80 for all eight domains).
This research provides unique contributions to the conceptualisation and measurement of health literacy. Limitations in the content and psychometric properties of previously developed measures have been identified through a systematic process. A conceptual framework derived from the patient perspective identifies a range of components that provide new insight into: (i) constructs that should be incorporated to measure health literacy and (ii) areas that need to be addressed to improve health literacy. The development of the HeLMS now allows for a more comprehensive assessment of health literacy. Information from the conceptual framework and the HeLMS are likely to be useful tools to inform the development of public health initiatives to enhance patient participation in the management of their health.
16
Audet, Chantale. "La promotion de la cause des patients (patient advocacy) dans un contexte de collaboration interdisciplinaire la perspective des infirmières en milieu de soins de longue durée". Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape9/PQDD_0015/MQ56854.pdf.
17
Mulder, Anja. "Women's lived experiences of the breast cancer trajectory: the waiting period for treatment and the impacts on feminine identity". Thesis, University of Cape Town, 2012. http://hdl.handle.net/11427/2661.
Resumo:
Breast cancer, according to research, is diagnosed in approximately one in every twenty-nine women in South Africa. Differences in gender, race and class produce disparities in health care, subjecting lower class women to lengthy waiting periods between diagnosis and treatment. Present research studies on breast cancer predominantly use quantitative methods. To understand women's lived experiences of the breast cancer trajectory this study explores experiences encountered during the waiting period, as well as the impacts of breast cancer and its treatment on feminine identity. For this a qualitative method was applied. Semistructured, in-depth interviews were conducted with five black and coloured breast cancer patients residing at two of CANSA's care homes. Participants varied in age and phases of treatment, were all married or widowed, had minor dependants, and had all travelled from distant and outlying areas. Based on a thematic analysis, six themes emerged from the data collected. These included: First experiences of cancer in the body; breast cancer and waiting periods from the patient's perspective; sources of support; meanings and perceptions of being a woman; conceptualising disease, and patients' needs. The analysis illustrates the importance of researching women's lived experiences and highlights that these need to be understood within a framework of socially constructed notions of gender, race and class in order to improve breast cancer treatment and psycho-social care.
18
Bui, Long T. "The politics of AIDS advocacy for Asian Americans". Diss., Connect to a 24 p. preview or request complete full text in PDF format. Access restricted to UC campuses, 2008. http://wwwlib.umi.com/cr/ucsd/fullcit?p1454978.
Resumo:
Thesis (M.A.)--University of California, San Diego, 2008.Title from first page of PDF file (viewed June 18, 2008). Available via ProQuest Digital Dissertations. Includes bibliographical references (p. 74-81).
19
Rakowski, Sonja K. "Ethical Considerations in Access to Experimental Drugs for Treatment Use". Yale University, 2010. http://ymtdl.med.yale.edu/theses/available/etd-03252010-091403/.
Resumo:
Do dying patients have a moral claim to access experimental drugs when all else has failed? This question has been the focus of an active and evolving debate concerning the rights of terminally ill patients, the nature of the drug development process, and the scope of federal regulation, with supporters arguing that seriously ill patients should be able to decide for themselves whether and when to attempt experimental therapies and opponents arguing that the resulting state of affairs would be disastrous for patient safety and for the integrity of the drug development process. This thesis concerns the ethical considerations surrounding the provision of experimental drugs for treatmentoften termed compassionate use or expanded accessand argues that compelling ethical merits on both sides of the debate complicate the formation of satisfactory public policy. Although patient autonomy is often invoked to support liberal access to experimental drugs, the paucity of known information about investigational compounds as well as the unique vulnerability of the terminally ill patient call into question the wisdom of the unfettered exercise of autonomy in this context. Although equitable distribution of experimental drugs is often felt to be a concern, the meaning of equity in this context has not been clearly defined, and in fact several working concepts of equitable access may not be achievable or desirable. Although the financial burden on drug manufacturers is frequently recognized as a barrier to expanded access, the potential for expanded access programs to constitute a marketing strategy should be recognized, and the mixing of profit motives with altruistic ones brought to light. Parsing these and other ethical nuances points to certain ways in which policies governing expanded access can be refined to allow for access while maximizing patient protection and ensuring the generation of scientific knowledge. Physicians, as frequent mediators of requests for experimental drugs, should be knowledgeable of the ethical issues inherent and should help to ensure the judicious use of experimental therapies. Finally, general misconceptions about the benefits of experimental therapy, pervasive in our culture, heighten the contentiousness of this debate. A workable legislative solution should be accompanied by a thoughtful and deliberate effort to educate patients, their advocates, and broader society about the realistic pace of drug development and the limits of modern medicine. This thesis recognizes that individuals who seek expanded access often have valid moral claims to do so, but advocates a cautious attitude toward the dissemination of experimental drugs for treatment and maintains the importance of government and physician participation in adjudicating access.
20
Zhang, Yiyun Arayan Trangarn. "An economic evaluation on the new cooperative medical scheme (NCMS) financing : a case study of Meedu county, Yunnan province, China /". Abstract, 2008. http://mulinet3.li.mahidol.ac.th/thesis/2551/cd415/4938053.pdf.
21
Gallo, Maria L. "Nursing advocacy and the accuracy of intravenous to oral opioid conversion at discharge in the cancer patient". [Tampa, Fla] : University of South Florida, 2009. http://purl.fcla.edu/usf/dc/et/SFE0003235.
22
Gallo, Maria L. R. N. O. C. N. "Nursing Advocacy and the Accuracy of Intravenous to Oral Opioid Conversion at Discharge in the Cancer Patient". Scholar Commons, 2009. https://scholarcommons.usf.edu/etd/1978.
Resumo:
Pain is a common problem for cancer patients at home and when hospitalized. Pain interferes with all aspects of a patient's life including sleep, appetite, sexual desire, emotion and productivity. The under-prescribing of opioids can lead to uncontrolled pain in cancer patients. This study examined nursing advocacy related to pain management and the accuracy of the intravenous (IV) to oral (PO) opioid conversion at discharge in cancer patients.
Retrospective chart audits were done on 50 cancer patients. The physicians in the charts surveyed who prescribed the discharge medications consisted of a mix of hematologist/oncologists, surgeons and internists/hospitalists in a southwest Florida community. Fifty nurses were also surveyed and asked how comfortable they are in advocating for their patient's pain control and how often they actually advocate for proper pain management. This was done in the same southwest Florida hospital.
The most common cancer diagnoses of the patient subjects were colorectal cancer and esophageal/lung cancer. The results of this study show that an overwhelming majority of cancer patients (47 of 50), received doses that were not accurately converted from intravenous to oral opioids at the time of discharge from the hospital. This conversion was based on the Johns Hopkins Opioid Conversion Tool. Nurses in general reported that they are comfortable in advocating for their patients' pain control, but more so in more autonomous areas of practice such as intensive care.
The results were overwhelming in the direction of poor control of patient pain. This study leads to the need for further research in the important area of pain control for cancer patients. It also indicates the need for additional education for physicians and nurses about pain control and opioid conversion.
23
Eklund, Anna Josse. "Sjuksköterskor som patienters företrädare : Med huvudsakligt fokus på företrädarskap för äldre patienter i kommunal hälso- och sjukvård". Doctoral thesis, Karlstads universitet, Institutionen för hälsovetenskaper, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:kau:diva-16127.
Resumo:
The overall aim was to study nurses’ and managers’ attitudes towards micro social patient advocacy (I) and factors related to patient advocacy (II, III) with the main focus being on advocacy in the care of older patients in community health care together with psychometric testing of the instrument 'Attitudes toward Patient Advocacy Scale-Attitudes toward MIcrosocial Advocacy' (IV). Methods: A quantiative cross-sectional study and a qualitative study were carried out. Nurses (n=207) and managers (n=23) in community health care responded to a questionnaire about patient advocacy, nursing competence, personal traits, quality of care and organisational climate (I, II, IV). Nurses' (n=18) perceptions of influencers of patient advocacy was studied in a phenomenographic study (III). The results showed that nurses and managers reported positive attitudes to patient advocacy (I, II), especially for patients unable to speak for themselves (I). Two areas of nursing competence (Performing the nursing process, Supervision and cooperation) and a dimension of quality of care of older patients were positively associated with attitudes towards patient advocacy (II). Two organisational dimensions were, negatively (dynamism) respectively positively (playfulness), associated with attitudes towards patient advocacy. The nurses' perceptions of influencers of patient advocacy consist of three hierarchically related levels: The nurse's character traits, The nurse’s bond with the patient and The organisational conditions (III). The Swedish version of APAS-AMIA consists of 33 items in a four-factor structure (APAS-AMIA/SE): Support patients’ beliefs and decision-making, Safeguard patients' health care, Support patients to communicate their wishes and Respect patients’ wishes not to participate in decisions regarding care (IV). Conclusions: Maintaining the continuing professional competence of nurses is important, and is ensuring the organisational prerequisites to enable nurses' advocacy for patients.Det övergripande syftet var att studera sjuksköterskors och chefers attityder till mikrosocialt företrädarskap för patienter (I), faktorer relaterade med företrädarskap (II, III) med huvudsakligt fokus på företrädarskap för äldre patienter inom kommunal hälso- och sjukvård samt psykometriskt testa instrumentet Attitudes toward Patient Advocacy Scale-Attitudes toward MIcrosocial Advocacy (IV). Metod: En kvantitativ tvärsnittstudie och en kvalitativ studie genomfördes. Sjuksköterskor och chefer (n=230) i kommunal hälso-och sjukvård besvarade frågor om företrädarskap, yrkeskompetens, personlighet, vårdkvalitet och organisationsklimat (I, II, III). Sjuksköterskors (n=18) uppfattningar av vad som påverkar företrädarskap studerades i en fenomenografisk studie (III). Resultat: Sjuksköterskor och chefer rapporterade positiva attityder till företrädarskap (I, II), framför allt för oförmögna patienter (I). Två områden av yrkeskompetens (Att utföra omvårdnadsprocessen, Arbetsledning och samarbete) liksom en dimension av kvalitet i vården av äldre var positivt associerade med attityder till företrädarskap (II). Två organisatoriska dimensioner var negativt (livfullhet) respektive positivt (lekfullhet) associerade med attityder till företrädarskap. Sjuksköterskors uppfattningar av vad som påverkar företrädarskap omfattar tre hierarkiskt relaterade nivåer: Sjuksköterskans karaktärsdrag, Sjuksköterskans förhållande till patienten och Arbetsplatsens beskaffenhet (III). Den svenska versionen av APAS-AMIA omfattar 33 påståenden i en fyrfaktorstruktur (APAS-AMIA/SE): Stödja patienternas önskemål och beslutsfattande, Värna om patienternas vård, Stödja patienterna att kommunicera sina önskemål och Respektera patienternas önskemål om att inte delta i beslut (IV). Konklusioner: Sjuksköterskors yrkeskompetens bör upprätthållas för att de ska ha förutsättningar att företräda patienter. Det är viktigt att skapa organisatoriska förutsättningar för att sjuksköterskor ska kunna etablera en relation till patienten som underlag till företrädarskap.
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McCormick, Laura J. "Women and Thyroid Disease: Treatment Experiences and the Doctor-Patient Relationship". ScholarWorks, 2015. https://scholarworks.waldenu.edu/dissertations/1362.
Resumo:
Thyroid disease, a chronic illness, affects nearly 200 million people worldwide and is more common among women than in men. Numerous factors make diagnosing and treating thyroid disease in women challenging. The standard blood test for diagnosing thyroid disease and determining treatment effectiveness is inconsistent in its accuracy. Many women with thyroid disease are misdiagnosed or struggle with symptoms even once receiving treatment. Although thyroid disease is highly prevalent among women and the doctor-patient relationship is known to influence treatment outcomes, there is a gap in the literature regarding the treatment experiences of women with thyroid disease and the doctor-patient relationship. The purpose of this phenomenological study was to explore female thyroid patients' experiences of treatment and the doctor-patient relationship. Sixteen female thyroid patients, ages 18 and older and members of an international online support group, were individually interviewed via online chat. Data interpretation was guided by social constructionism and feminist theory and was accomplished via Moustakas's analytic method. Themes related to the doctor-patient relationship were identified, including the culture of the medical profession, diagnostic bias, and gender differences in communication. Emergent themes included patient education level, patient self-advocacy behaviors, and the use of natural thyroid medication. The results of this study may contribute to positive social change by enhancing doctors' understanding of thyroid disease in women and the influence of the doctor-patient relationship in determining positive treatment outcomes, thus equipping doctors with enriched knowledge for providing their female thyroid patients with the highest quality of care.
25
Hällkvist, Ylva, e Torbjörn Lundblad. "Att vårda med fingertoppskänsla : Anestesisjuksköterskors erfarenheter av att möta patienter inför och under anestesi". Thesis, Mälardalens högskola, Akademin för hälsa, vård och välfärd, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:mdh:diva-43523.
Resumo:
Bakgrund: Alla patienter är oroliga inför anestesi då de förlorar kontrollen över sin kropp. De önskar ha en bra kontakt med anestesisjuksköterskan för att kunna förmedla sina behov. Informationsbehovet är dock olika för alla patienter, vissa vill veta allt medan andra vill få sparsamt med information. Syfte: Syftet är att beskriva anestesisjuksköterskors erfarenheter av att möta patienter inför och under anestesi. Metod: Kvalitativ systematisk litteraturstudie av bearbetat material. Resultat: Anestesisjuksköterskorna ansåg att det var viktigt att se patientens behov för att kunna skapa trygghet, likväl som att ha en bra kommunikation. Tidsbrist var dock vanligt förekommande vilket skapade hinder i mötet med patienten. Slutsats: Anestesisjuksköterskorna vill utföra ett bra arbete, men då patienterna och verksamheten ofta ställer motstridiga krav krävs en ständig avvägning för att avgöra vad som är bäst här och nu.Background: All the patients are apprehensive prior to anesthesia, due to the fact that they lose control of their bodies. The patients desire good contact with the nurse anesthetist, in order to convey their needs. The need for information vairy for all the patients. Some require detailed information, while others only sparingly need information. Aim: The aim of the study is to describe nurse anesthetists experience in meeting the patients prior and during anesthesia. Method: A systematic qualitative literature study of published materials was conducted. Results: The nurse anesthetists believe that it is important to see the patients needs, in order to be able to build a sense of security, in addition to good communication. The common obstacle is shortage of time, which affects contact with the patient. Conclusion: The nurse anesthetists feel a need to perform good work. But the patienten och the administration often make conflicting demands, which means that a constant consideration is needed to decide what’s best here and now.
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Soares, Ana Claudia Camargo [UNESP]. "Avaliação da prática não humanizada em um hospital universitário, segundo demandas registradas pela ouvidoria". Universidade Estadual Paulista (UNESP), 2017. http://hdl.handle.net/11449/151101.
Resumo:
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O termo “Humanização” tem sido constantemente empregado no âmbito da saúde e visa recuperar a dimensão essencial do cuidado e a relação entre humanos. Para viabilizar a implantação desse cuidado nos serviços de saúde foi criada pelo Sistema Único de Saúde – SUS - a Política Nacional de Humanização - PNH. A maneira como as atividades de um hospital são desenvolvidas, bem como a forma como os recursos humanos e materiais disponíveis são geridos e aplicados à prestação dos serviços influencia diretamente no atendimento à referida política, tornando-se extremamente relevante para a qualidade dos serviços prestados. Considerando a relevância do assunto e com anseio de avaliar se as práticas de um hospital atendem ao preconizado pela PNH foi desenvolvido o presente trabalho. Trata-se de um estudo quanti-qualitativo que aborda uma avaliação das atividades desenvolvidas pelo Hospital das Clínicas da Faculdade de Medicina de Botucatu (HCFMB) sob a perspectiva dos usuários que registraram demandas na ouvidoria do HCFMB, tendo a PNH como referencial conceitual. Por meio de análise quantitativa das demandas registradas, complementada com a análise subjetiva do sentimento expressado pelos usuários através da descrição do ocorrido, foi realizado um diagnóstico situacional dessas demandas, identificando os principais motivos que caracterizam as práticas não humanizadas reportadas à ouvidoria, bem como os locais onde essas práticas ocorrem com maior frequência. A análise dos dados permitiu que fossem identificadas as principais causas das intercorrências, bem como o nível de governabilidade dos atores envolvidos sob elas, segundo proposto por MATUS; o grupo ao qual são atribuídos os problemas identificados, baseando-se na tríade de avaliação em saúde de DONABEDIAN; além das diretrizes da PNH que estão sendo violadas pela ausência da prática humanizada em determinadas atividades do HCFMB. Constatou-se que as demandas registradas na ouvidoria representam práticas desenvolvidas pelo HCFMB de maneira não humanizadas, provenientes de questões atreladas principalmente à gestão, causadas em sua maioria por acumulações sob as quais o ator envolvido possui influência, representando problemas atribuídos à estrutura da instituição, constituída pelos recursos humanos e materiais disponíveis, bem como pela sua organização administrativa; e tendo o acolhimento como a principal diretriz violada. Diante deste contexto, torna-se necessária a reorganização de determinadas atividades e desenvolvimento de programas de educação continuada aos profissionais, visando intensificar o desenvolvimento de práticas que atendam ao preconizado pela PNH.
The term "Humanization" has been used systematically in aims of health and the goal is to recover an essential dimension of care and a relationship between human beings. To enable the implementation of care with health services for the Sistema Único de Saúde – SUS - the Política Nacional de Humanização - PNH. The way a hospital's activities are developed, as well as how the available human and material resources are managed and applied to the provision of services directly influence on accomplishment to these standards, it has become very important for the quality of services provided. Considering the relevance of the subject and with the wish to evaluate if the practices of a hospital attend to recommended by the PNH, the present work was developed. This is a quantitative-qualitative study that addresses an evaluation of the activities developed by the Hospital das Clínicas da Faculdade de Medicina de Botucatu (HCFMB) from the perspective of users who registered demands in the ombudsman's office of HCFMB, having a PNH as a conceptual reference. Through a quantitative analysis of the recorded demands, complemented with a subjective analysis of the feeling expressed by users through of a description of the occurrence, a situational diagnosis of these demands was carried out, identifying the main reasons that characterize the non-humanized practices reported to the ombudsman's office as well as the places where these practices occur more frequently. The analysis of the data allowed them to be identified as the main causes of the intercurrences, as well as the level of governability of the actors involved in these, according to MATUS proposal; the group to which are attributed the identified problems, Based on the on triad of health evaluation of the DONABEDIAN; besides the guidelines of the HNP that are being violated by the absence of the humanized practice in certain activities of the HCFMB. It was found that the demands registered in the ombudsman's office represent practices developed by HCFMB in a non-humanized way, arising from the questions related to management, caused mostly by accumulations under which the actor involved has influence, representing problems attributed to the structure of the institution, made up of available human and material resources, as well as its administrative organization; And having the host as the main guideline violated. Against this context, it is necessary to reorganize certain activities and develop continuing education programs for professionals, aiming to intensify the development of practices that meet the requirements by PNH.
27
Soares, Ana Claudia Camargo. "Avaliação da prática não humanizada em um hospital universitário, segundo demandas registradas pela ouvidoria". Botucatu, 2017. http://hdl.handle.net/11449/151101.
Resumo:
Orientador: Antonio Luis Caldas JuniorResumo: O termo “Humanização” tem sido constantemente empregado no âmbito da saúde e visa recuperar a dimensão essencial do cuidado e a relação entre humanos. Para viabilizar a implantação desse cuidado nos serviços de saúde foi criada pelo Sistema Único de Saúde – SUS - a Política Nacional de Humanização - PNH. A maneira como as atividades de um hospital são desenvolvidas, bem como a forma como os recursos humanos e materiais disponíveis são geridos e aplicados à prestação dos serviços influencia diretamente no atendimento à referida política, tornando-se extremamente relevante para a qualidade dos serviços prestados. Considerando a relevância do assunto e com anseio de avaliar se as práticas de um hospital atendem ao preconizado pela PNH foi desenvolvido o presente trabalho. Trata-se de um estudo quanti-qualitativo que aborda uma avaliação das atividades desenvolvidas pelo Hospital das Clínicas da Faculdade de Medicina de Botucatu (HCFMB) sob a perspectiva dos usuários que registraram demandas na ouvidoria do HCFMB, tendo a PNH como referencial conceitual. Por meio de análise quantitativa das demandas registradas, complementada com a análise subjetiva do sentimento expressado pelos usuários através da descrição do ocorrido, foi realizado um diagnóstico situacional dessas demandas, identificando os principais motivos que caracterizam as práticas não humanizadas reportadas à ouvidoria, bem como os locais onde essas práticas ocorrem com maior frequência. A análise dos dados permitiu q... (Resumo completo, clicar acesso eletrônico abaixo)
Abstract: The term "Humanization" has been used systematically in aims of health and the goal is to recover an essential dimension of care and a relationship between human beings. To enable the implementation of care with health services for the Sistema Único de Saúde – SUS - the Política Nacional de Humanização - PNH. The way a hospital's activities are developed, as well as how the available human and material resources are managed and applied to the provision of services directly influence on accomplishment to these standards, it has become very important for the quality of services provided. Considering the relevance of the subject and with the wish to evaluate if the practices of a hospital attend to recommended by the PNH, the present work was developed. This is a quantitative-qualitative study that addresses an evaluation of the activities developed by the Hospital das Clínicas da Faculdade de Medicina de Botucatu (HCFMB) from the perspective of users who registered demands in the ombudsman's office of HCFMB, having a PNH as a conceptual reference. Through a quantitative analysis of the recorded demands, complemented with a subjective analysis of the feeling expressed by users through of a description of the occurrence, a situational diagnosis of these demands was carried out, identifying the main reasons that characterize the non-humanized practices reported to the ombudsman's office as well as the places where these practices occur more frequently. The analysis of the data all... (Complete abstract click electronic access below)
Mestre
28
Trujillo, Enio. "Seleção de pacientes e recrutamento dos sujeitos da pesquisa: implicações éticas e jurídicas no âmbito das Instituições de Ensino Superior públicas - uma visão sob a ótica do Código de Defesa do Consumidor". Universidade de São Paulo, 2016. http://www.teses.usp.br/teses/disponiveis/25/25144/tde-07112016-090749/.
Resumo:
Os sujeitos da pesquisa, em razão de seu estado de vulnerabilidade, reclamam por cuidados éticos e jurídicos. Esta tutela deve anteceder ao status em que o sujeito da pesquisa ainda não está caracterizado como tal, ou seja, quando, como paciente, participa de seleções para integrar experimentos, no caso, promovidos por Instituições de Ensino Superior públicas (IES). No aspecto jurídico, pacientes, sujeitos da pesquisa e comunidade científica foram colocados sob a égide do Código de Defesa do Consumidor a fim de se apurar a tutela desse diploma legal sobre referidas figuras. Em face dessa abordagem ética e jurídica, este estudo teve como objetivo, por meio de uma revista da literatura, desenvolver uma análise crítica sobre a formatação atual utilizada pelas IES pública para recrutamento de sujeitos da pesquisa, através de seus pacientes pré-concebidos; mensurar a importância da formalização de edital pela IES pública nesse contexto de recrutamento. Analisar, ainda, a dicotomia jurídica desenvolvida em torno do Código de Defesa do Consumidor pertinente ao paciente atendido pela IES Pública, por intermédio do SUS e o paciente atendido pela IES privada não submetido ao SUS. Por fim, conferir sob a ótica do Código de Defesa do Consumidor a responsabilidade civil da comunidade científica em decorrência de danos causados ao sujeito da pesquisa. Trata-se de um estudo exploratório e descritivo, com abordagem qualitativa desenvolvida a partir de pesquisas em material existente na literatura nacional e internacional, pertinente à pesquisa envolvendo seres humanos, a sua forma de recrutamento e a responsabilidade civil suscitada em face dos sistemas de saúde público e privado e, não menos, sobre a relação jurídica desenvolvida entre sujeito da pesquisa e comunidade científica. Especificamente, a fundamentação teórica se deu sobre a doutrina da bioética, do biodireito e da ordem jurisdicional, com fomento da legislação brasileira. Foram utilizadas as bases de dados Pubmed, Scielo, Lilacs, Google Acadêmico, Google e Tribunais de Justiça, com a combinação dos seguintes descritores: seleção de pacientes, sujeitos da pesquisa, defesa do consumidor, ética em pesquisa e academia e institutos. Considera-se, ao final, que na IES pública o recrutamento de sujeitos da pesquisa não deve configurar coerção tácita, sendo superlativa a valoração de conceitos éticos intrínsecos à dignidade humana, restando-lhe, ainda a observância de princípios constitucionais referente à administração pública. Nesse âmbito público, a necessidade de edital é requisito formalístico, imperioso para recrutamento de sujeito da pesquisa. Tanto o sistema público de saúde, promovido pela IES pública, como o sistema privado de saúde, promovido pela IES privada, estão sob a tutela do Código de Defesa do Consumidor; ainda devendo ficar sob o pálio deste diploma legal a relação jurídica desenvolvida entre sujeito da pesquisa e comunidade científica.Human research subjects, due to their vulnerability status, claim to ethical and legal care. This protection must precede the status in which the research subject is not characterized as such, that is when, as a patient, attends selections to integrate experiments in the case, promoted by Public Higher Education Institutions (HEI). In the legal aspect, patients, research subjects and scientific community were placed under the aegis of the Consumer Protection Code in order to establish the tutelage of this statute on those figures. Faced with this ethical and legal approach, this study aimed, through a literature review, develop a critical analysis of the current format used by public HEIs to the recruitment of research subjects, through their predesigned patients; measure the importance of the announcement of the formal public HEIs in this recruitment context. Also, analyze the legal dichotomy developed around the Consumer Protection Code relevant to patients attended by public HEIs, through the Brazilian Public System of Health (BSH) and the patient treated by the private institution not subjected to the BSH. Finally, check, from the perspective of the Consumer Protection Code, the liability of the scientific community due to damages caused to the research subject. This is an exploratory and descriptive study with qualitative approach, developed from research into existing material in national and international literature, relevant to researches involving human beings, their form of recruitment and liability raised in the face of public and private system of health and, not least, on the legal relationship developed between the research subject and the scientific community. Specifically, the theoretical foundation took over the doctrine of bioethics, the bio law and court order, fostering by the Brazilian law. Databases used were Pubmed, Scielo, Lilacs, Google Scholar, Google and Courts of Justice, with the combination of the following descriptors: Patient Selection, Research Subjects, Consumer Advocacy, Ethics, Research and Academies and Institutes. In the end, is considered that in the public HEI, the research subject recruitment should not configure tacit coercion, being superlative the valuation of intrinsic ethical concepts of human dignity, leaving him, yet compliance with constitutional principles relating to public administration. In this public sphere, the need for notice is formalistic requirement imperative for the recruitment of research subjects. Both systems of health, as public promoted by public HEIs, as the private promoted by the private HEIs are under the authority of the Consumer Protection Code; should still be under the canopy of this instrument the legal status developed between the research subject and the scientific community.
29
Karlsbakk, A. "Patents versus patients : global governance and the role of civil society in South Africa's quest for affordable drugs". Thesis, Stellenbosch : Stellenbosch University, 2005. http://hdl.handle.net/10019.1/50414.
Resumo:
Thesis (MA)--Stellenbosch University, 2005.ENGLISH ABSTRACT: This thesis is an explanatory study into civil society's increased influence in global governance. More specifically this situation is examined by looking at the generic medicine debate that came in the wake of the passing of the Medicines and Related Substances Act by the South African government in 1997. This debate gained worldwide attention and touched some of the prevailing inequalities between the developed world and the developing world in our globalised society. The research question that is addressed here is to what extent did civil society influence the signing of the Doha Declaration of the TRIPS Agreement and Public Health by the members of the World Trade Organisation (WTO) in 2001? In doing so, this thesis looks at the role of the US government, the South African government, the pharmaceutical industry, the WTO's TRIPS Agreement and civil society in the form of nongovernmental organisations like Treatment Action Campaign (TAC), Oxfam and Medecines Sans Frontieres (MSF). The study applies a constructivist approach in order to analyse how civil society used global advocacy networks to inform and communicate the normative concerns regarding South Africa and developing countries' lack of access to HIVand AIDS drugs. Moreover, it examines how civil society's use of moral authority challenged the regulative power of the WTO. The study concludes that civil society played a vital role in influencing the WTO member states' decision to sign the Doha Declaration on the TRIPS Agreement and Public Health. However, it was not only civil society's ability to set the agenda concerning the HIV/AIDS pandemic, but also the content of the normative concerns themselves that help explain its success. Consequently, the study further concludes that civil society's success in this specific case must be seen in light of its growing influence in challenging global governance.
AFRIKAANSE OPSOMMING: Hierdie tesis is 'n verduidelikende studie van die burgerlike samelewing se groeiende invloed in globale regering. Hierdie situasie word meer spesifiek ondersoek deur te kyk na die generiese medisyne debat wat gevoer is na die Suid-Afrikaanse Regering die Medisyne en Verwante Stowwe Wet van 1997 goedgekeur het. Hierdie debat het wêreldwye aandag geniet en het geraak aan sommige van die bestaande ongelykhede wat daar heers tussen die ontwikkelde en ontwikkelende wêreld in die geglobaliseerde samelewing. Die navorsingsvraag wat hier aangespreek word is tot watter mate die burgerlike samelewing die ondertekening van die Doha Verklaring van die TRIPS Ooreenkoms en Publieke Gesondheid deur lede van die Wêreld Handelsorganisasie (WHO) in 2001 beïnvloed het. Deur dit te doen, sal hierdie tesis kyk na die rol van die Amerikaanse regering, die Suid- Afrikaanse regering, die farmaseutiese bedryf, die WHO se TRIPS Ooreenkoms en die burgerlike samelewing in die vorm van nie-regerings organisasies soos die Treatment Action Campaign (TAC), Oxfam en Medecines Sans Frontieres (MSF). Die studie maak gebruik van 'n konstruktiwistiese benadering om 'n analise te doen van hoe die burgerlike samelewing globale ondersteunings netwerke gebruik het om die normatiewe besorgdhede wat heers oor die tekorte in Suid-Afrika en die ontwikkelende lande ten opsigte van toegang tot MIV en VIGS medisyne, toe te lig en te verkondig. Verder ondersoek die studie hoe die gebruik deur die burgerlike samelewing van morele gesag die regulerende mag van die WHO uitgedaag het. Die studie kom tot die gevolgtrekking dat die bugerlike samelewing 'n uiters belangrike rol gespeel het in die WHO lidlande se besluit om die Doha Verklaring van die TRIPS Ooreenkoms en Publieke Gesondheid te onderteken. Dit was egter nie net die burgerlike samelewing se vermoë om die agenda daar te stel ten opsigte van die MIV/VIGS pandemie nie, maar ook die inhoud van die normatiewe besorgdhede self wat bygedra het om hierdie sukses te verduidelik. Gevolglik kom die studie tot die verdere gevolgtrekking dat die burgerlike samelewing se sukses in hierdie spesifieke geval gesien kan word in die lig van sy groeiende invloed in die uitdaging van globale mag en gesag.
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Ferreira, Carla Marília Medeiros. "Factores sociais no tratamento oncológico: um estudo na população dos Açores". Master's thesis, Instituto Superior de Ciências Sociais e Políticas, 2010. http://hdl.handle.net/10400.5/3025.
Resumo:
Dissertação de Mestrado em Política Socialpresente tema de Mestrado em Política Social surge da ligação de duas áreas de intervenção da Mestranda. O apoio psicossocial aos doentes oncológicos do Hospital Divino Espírito Santo de Ponta Delgada EPE, e o apoio social ao Serviço de Deslocação de Doentes do mesmo hospital. Pelo contacto estabelecido com os doentes oncológicos, a mestranda, acabou por desenvolver uma grande empatia por estes, atendendo a que, na generalidade, são muito receptivos à intervenção social. Com efeito, o surgimento de uma doença oncológica vem perturbar toda a dinâmica interna do doente e do seu capital social, actuando o Trabalhador Social neste âmbito. Para além da questão oncológica e das consequências que tais doenças acabam por inferir nos doentes e seus capitais sociais, pretende a mestranda, estudar os impactos dos tratamentos oncológicos nos doentes açorianos, neste caso concreto abordando a questão das Deslocações Hospitalares para o Continente para a realização de Radioterapia. Do mesmo modo, a autora está intencionada a avaliar as condições do Hospital Divino Espírito Santo de Ponta Delgada EPE, para se tornar no receptáculo de todos os doentes oncológicos açorianos propostos para radioterapia aquando da criação do Centro de Radioterapia em São Miguel.
The present subject of Master Degree in Social Policy appears of the linking of two areas of intervention of the author: the advocacy empowerment support to the oncology patients of the Hospital of Divino Espirito Santo de Ponta Delgada EPE, as well as the Social Support given to the Service of Displacement of Illness People of the same hospital. For the contact established with the oncology population, the author, developed an enormous affection for these patients, that, in generaly, are very receptive to the social intervention. The diagnosis of an oncology illness, comes to disturb all the internal dynamics of the illness person and its social relathionship, inferring consequencies at all levels. Also, the author is intended, to study the impacts of the oncology treatments in the azores population, in this concrete case, of accomplishment to displacement for the Continent’s Hospitals to procede with radiotherapy treatments. Similarly, the author is intended, to evaluate the terms of the Hospital Divino Espirito Santo of Ponta Delgada EPE, to become the receptacle for all azorian cancer patients, proposed for treatments of radiotherapy, on the occasion of establishment of the Radiotherapy Center in San Miguel.
31
Alexander, Kathy. "Promoting health at the local level : a management and planning model for primary health care services /". Title page, contents and introduction only, 1994. http://web4.library.adelaide.edu.au/theses/09PH/09pha376.pdf.
32
de, Andrade Marisa. "Pharmaffiliation : a model of intra-elite communication in pharmaceutical regulation". Thesis, University of Stirling, 2011. http://hdl.handle.net/1893/6500.
Resumo:
In 2005, the House of Commons (HoC) Health Committee produced a report on The Influence of the Pharmaceutical Industry – the first of its kind since 1914. The inquiry concluded that there were ‘over-riding concerns about the volume, extent and intensity of the industry’s influence, not only on clinical medicine and research but also on patients, regulators, the media, civil servants and politicians’, and stressed the need ‘to examine critically the industry’s impact on health to guard against excessive and damaging dependencies’ (HoC 2005, p. 97). It also noted that it is important to comprehensively analyse pharmaceutical regulation in order to ascertain whether there are systemic problems: In some circumstances, one particular item of influence may be of relatively little importance. Only when it is viewed as part of a larger package of influences is the true effect of the company’s activity recognised and the potential for distortion seen. The possibility that certain components of any such campaign are covert and their source undeclared is particularly worrying. (HoC 2005, p. 97) This study addresses this recommendation and was primarily conducted to examine whether recognised concerns are merely ad hoc or as a result of systemic flaws in the current system of pharmaceutical regulation. The work addresses a gap in the academic literature by drawing on the fragmented criticisms of the pharmaceutical industry in order to produce a model to illustrate how various stakeholders collaborate with drug companies to promote licensed products, and to explore the nature of the relationships between these elite stakeholders. The thesis begins with a literature review which determines who is involved in pharmaceutical regulation; how the regulatory system works; and explores the key role of communication in this process (Chapters 1 to 3). The recurrent theme is the neglect or exclusion of the patient/consumer, which leads to the development a model of intra-elite communication in drug regulation called Pharmaffiliation (Chapter 3). The thesis then looks for evidence to support or refute this model, using multiple methods (Chapter 4). Four case studies (with specific selection criteria) are chosen to test the model’s constructs and indicators (Chapters 5 to 8). The research uncovers systemic problems in the current system of pharmaceutical regulation which can ultimately harm the patient/consumer, and the implications of these findings are discussed (Chapter 9). Solutions on a micro-level include consumer involvement in decision making processes, which can be enhanced through public education and awareness campaigns and the instigation of public inquiries whenever drugs are withdrawn from the market (HoC 2005, p. 105). On a macro-level, however, this will involve critically exploring neoliberal capitalism and the empowerment of the citizenry (Street 2001).
33
Fonte, Valéria Hartt Pereira e. Lopes da. "Sociedade e conhecimento leigo: o desafio da equidade em saúde na experiência da International Myeloma Foundation no Brasil". Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, 2013. https://www.arca.fiocruz.br/handle/icict/7096.
Resumo:
Submitted by Gentil Jeorgina (jeorgina@icict.fiocruz.br) on 2013-10-09T16:15:12Z
No. of bitstreams: 1
Valéria Hartt.pdf: 1919843 bytes, checksum: 68a6cd38069d53b02f4eb969f570af19 (MD5)Made available in DSpace on 2013-10-09T16:15:12Z (GMT). No. of bitstreams: 1 Valéria Hartt.pdf: 1919843 bytes, checksum: 68a6cd38069d53b02f4eb969f570af19 (MD5) Previous issue date: 2013
Fundação Oswaldo Cruz. Instituto de Comunicação e Informação Científica e Tecnológica em Saúde. Rio de Janeiro, RJ, Brasil
Nesse recorte de pesquisa, o conceito de conhecimento leigo é ponto de partida e fio condutor para compreender as práticas de participação e ativismo de uma organização de pacientes de câncer, aqui na experiência da International Myeloma Foundation no Brasil (IMF). É a perspectiva informacional que ancora a meta de identificar os contornos do conhecimento leigo da representação brasileira da IMF para dar relevo aos sentidos de equidade em saúde na atenção oncológica. Os resultados apontam para uma forma de mobilização cidadã capaz de abrigar a produção social do conhecimento científico, mas mostram que a prática de advocacia em saúde ainda precisa avançar no Brasil como reflexo dessa nova forma de construção do conhecimento.
In this research outline, the concept of lay knowledge is a starting point and guideline for understanding the practices of participation and activism of a cancer patients organization, here through the experience of the International Myeloma Foundation (IMF) in Brazil. It is the informational perspective that anchors the goal of identifying the contours of lay knowledge of Brazilian representation of the IMF to emphasize the senses of equity in health in cancer care. The results point to a form of citizen mobilization able to shelter the social production of scientific knowledge, but show that the practice of health advocacy still needs to advance in Brazil as a result of this new form of knowledge construction.
34
Baker, Christine Ann. "The lived experience of nurse advocates a Heideggerian hermeneutical analysis /". 1993. http://catalog.hathitrust.org/api/volumes/oclc/31095493.html.
Resumo:
Thesis (M.S.)--University of Wisconsin-Madison, 1993.Typescript. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 140-153).
35
Oliveira, Joana Filipa Pinto São Martinho. "Patient Advocacy na Medicina Centrada no Doente". Master's thesis, 2017. http://hdl.handle.net/10316/82380.
Resumo:
Trabalho de Projeto do Mestrado Integrado em Medicina apresentado à Faculdade de MedicinaIntrodução: A Medicina Centrada no Doente (MCD) ou Cuidados Centrados no Doente (CCD) é um modelo amplamente utilizado no sistema de saúde moderno. Contudo, ainda existem lacunas e dificuldades no uso e na definição desta abordagem na prática médica. O termo “Patient Advocacy” surgiu na prática clínica com o objetivo de melhorar a qualidade e o acesso aos cuidados de saúde, particularmente no que diz respeito aos cuidados centrados no doente; a intervenção do doente nas decisões relativas à sua saúde e a sua proteção em relação ao erro médico, utilizando ao longo do processo a perspetiva do doente.Objetivo: Realçar e entender a importância do cuidado centrado no doente como fator fundamental para uma relação médico – doente otimizada, bem como identificar em que é que a utilização do “Patient Advocacy” pode ou não ser profícuo no decorrer dessa otimização.Metodologia: Foi efetuada uma seleção de artigos através plataforma de pesquisa Pubmed sobre a literatura recente acerca do cuidado centrado no doente, da relação médico – doente, do termo “patient advocacy”, da adesão, da intervenção ativa do doente e da tomada de decisão partilhada para a elaboração deste artigo de revisão. Focados os modelos e atitudes adjacentes aos cuidados centrados no doente e os mecanismos existentes de patient advocacy, o artigo propõem apurar se tal abordagem conduz a um maior potencial de eficácia na relação entre o clínico e o doente.Discussão e Conclusões: A Medicina requer uma visão global e dinâmica do doente, atendendo à sua personalidade, expectativas demonstradas, crenças em que acredita sem esquecer as vicissitudes do tratamento. Os doentes chegam cada vez mais às consultas armados com informação obtida dos media, publicidade e internet. Partilhar com os doentes, a arma que ajude a fazer sentido o ataque de informação, é um desafio para os clínicos. Sendo assim, uma forma de reduzir erros e aumentar a eficiência e qualidade de cuidados é encaminhar os doentes para fontes de informação fidedignas e creditadas. Os grupos de patient advocacy estão unicamente posicionados para providenciar serviços quer para os doentes quer para os membros de família e para os clínicos inclusive para outros profissionais de cuidados de saúde. Advocacy é alegadamente uma forma de salvaguardar um bom cuidado ao doente. Verifica-se que, apesar de existirem algumas oposições quanto à utilidade de “patient advocacy” em alguns países onde este já vigora, ele é visto como um processo ou estratégia que consiste numa série de ações específicas para preservar, representar e/ou salvaguardar os direitos dos doentes, os melhores interesses e valores no serviço de cuidados de saúde. Todavia, não existindo estudos sobre esta temática em Portugal, torna-se imprescindível que estes sejam iniciados, de modo a conhecer-se de que forma o uso do patient advocacy seria proveitoso ou não prática hospitalar. O artigo visa também alertar para a importância do papel do doente como um interveniente ativo na consulta sendo necessário que os direitos e interesses dos mesmos sejam preservados, representados e/ou salvaguardados na identificação, monitorização e planeamento de estratégias médicas.
Background: Patient Centred Care (PCC) is a widely used attitude on the modern healthcare system. In spite of, there are many deficiencies not only in its use but as well in its definition for the medical practice.The term “Patient Advocacy” emerged from medical practice with the intention of improving quality and access to healthcare, specially regarding patient centred care; patient intervention in the decisions regarding its health and protection from medical error, by considering patient’s perspective.Objective: Enhance and acknowledge PCC significance as a fundamental key to a well-established and optimized patient-doctor partnership, as well as highlight when a PCC approach may or may not be advantageous to achieve aforesaid optimized partnership.Methodology: A selection of articles was made, via the search platform Pubmed, between the recent available literature on Patient Centred Care, Patient-Doctor Partnership, the term “Patient Advocacy”, patient’s support and intervention and shared decision making for the elaboration of this review article.With the mentioned models and its subsequent attitudes to PCC and the existing patient advocacy mechanisms highlighted, this paper proposes to determine if said approach leads to greater potential for effectiveness in the relationship between clinician and patient.Discussion and Final Inferences: Medicine requires a global and dynamic vision of the patient, regarding its personality, the demonstrated expectations, its beliefs without disregard to the vicissitudes of the treatment. Patients come to the consultations armed with more and more information, seldom incorrect, obtained from the media, advertisements and internet. Sharing with the patients, the defense weapon that helps keeping the sense to this attack of information, is a challenge to clinics. Furthermore, a manner of reducing errors and increase efficiency and quality in care is to provide the patients with reliable and certified information sources. Patient Advocacy groups are uniquely positioned to provide services, not only to the patients and family members but to clinics and other healthcare providers. Advocacy is, allegedly, a form of safeguarding good patient care.Albeit there are contrary opinions on the usefulness of Patient Advocacy in some countries where it is already being put into effect, the term is seen as a process or strategy consisting of a series of specific actions to preserve and/or safeguard patients’ rights, their best interests and values in the health care service. Although, given that there are no studies on this subject in Portugal, it is imperative that these are initiated, so that it is perceived how the use of Patient Advocacy is beneficial or not to hospital practice. This article also aims to alert to the significance of the patient as an active intervenient on the consultation while their rights and interests are preserved, represented and/or safeguarded during the identification, monitoring and planning of medical strategies.
36
Ferreira, Marta Maria Horta e. Costa Ravara Bello Seabra. "Promoção da vertente do Cancer Patient Advocacy nos cuidados de enfermagem". Master's thesis, 2017. http://hdl.handle.net/10400.26/19104.
Resumo:
O Cancer Patient Advocacy (CPA) relaciona-se com a defesa da pessoa com doença oncológica, abrangendo conceitos como apoiar e suportar a pessoa, informar e promover a sua autonomia na tomada de decisão, prestar cuidados centrados na pessoa (CCP). A nível europeu defende-se que o CPA, como meio para reduzir o impacto negativo da doença oncológica, deve ser promovido pelas organizações de saúde. O Hospital de Dia do Centro Clínico Champalimaud não possui uma estratégia nem objetivos para a prática do CPA nos cuidados de enfermagem, o que se pode constituir como um obstáculo na melhoria da qualidade dos cuidados. Assim, estabeleci como finalidade para este trabalho desenvolver competências na promoção de uma cultura organizacional impulsionadora do CPA, através de um relatório de avaliação da prática do mesmo nos cuidados de enfermagem deste serviço. Foi utilizada a metodologia de projeto, desenvolvida em dois locais de estágio que assumem na sua missão defender e a apoiar a pessoa com doença oncológica e um terceiro que revelou o propósito de promover o CPA, na equipa de enfermagem. A scoping review permitiu mapear a literatura existente acerca da operacionalização do conceito em enfermagem, sustentando a aplicação de um questionário à equipa acerca do significado que lhe atribuem e discussão dos resultados. A realização do relatório de análise concretizou-se com base no Guia da UICC. Conclui-se que a promoção do CPA numa equipa de enfermagem deve passar pela formação acerca do conceito e de uma estrutura que impulsione a sua operacionalização, monitorização e avaliação, com base nos CCP. Nos cuidados de enfermagem em que se entreviu como um CPAe, para fazer face às reais necessidades de saúde da pessoa, identificou-se a importância de possuir conhecimento técnico-científico adequado, de considerar os valores, ideais e projeto de vida da pessoa, de refletir sobre a prática entre pares e ainda de ter em conta as competências de cada enfermeiro na gestão dos cuidados diários.
37
Bu, Xiaoyan. "Development and psychometric evaluation of an instrument Attitudes toward patient advocacy /". 2005. http://proquest.umi.com/pqdweb?did=982833241&sid=8&Fmt=2&clientId=39334&RQT=309&VName=PQD.
Resumo:
Thesis (Ph.D.)--State University of New York at Buffalo, 2005.Title from PDF title page (viewed on Mar. 21, 2006) Available through UMI ProQuest Digital Dissertations. Thesis adviser: Includes bibliographical references.
38
Gage, Elizabeth Ann. "Strong advocates and compliant patients socioeconomic status and parental adaptation to pediatric cancer /". 2008. http://proquest.umi.com/pqdweb?did=1629571921&sid=59&Fmt=2&clientId=39334&RQT=309&VName=PQD.
Resumo:
Thesis (Ph.D.)--State University of New York at Buffalo, 2008.Title from PDF title page (viewed on April 08, 2009) Available through UMI ProQuest Digital Dissertations. Thesis adviser: Farrell, Michael Includes bibliographical references.
39
Cardoso, Ana Lucia Vitorino. "Participation of civil society in European Union (EU) decision-making and agenda-setting: role of patient organisations on EU health policy". Master's thesis, 2017. http://hdl.handle.net/10451/27611.
Resumo:
Civil society organisations (CSOs) play a prominent role in influencing national, regional and international policies. They are a key player in democratic societies, have shown to complement (and even replace) governments when it comes to health delivery and provision of services, and have gradually become global players as a result of globalisation. The focus of this study is the policy work of European CSOs representing (directly or indirectly) patients, and which normally act on behalf of national CSOs. The study aims to assess how successful civil society is in representing patients at the EU level and whether this representation has led to policy change. The dissertation explores factors that may influence the success of CSOs when advocating for EU health policies.
A two-fold method has been adopted. The first element includes a review of scientific (28 articles were fully read and others consulted). The second element includes 14 semi-structured interviews conducted with high level stakeholders, 12 with representatives from CSOs working at the European policy level and two with officials working for institutions that develop and implement policies (i.e. policy-makers).
Findings suggest that it is difficult to measure the influence of CSOs in EU health due to the abstract nature of policy work and the policy process, which is not linear. Moreover, the number of interactions and collaborations that exist are complex in nature hence difficult to map and analyse. Although there are challenges that both CSOs and policy-makers face in relation to patient participation in the development and implementation of policy, a number of success stories were provided showing that CSOs play an instrumental role in EU and national health policy. Although the complexity of EU advocacy makes generalisations difficult, patterns were found in interviews such as the way partnerships and coalitions are built, the way challenges are addressed and the way CSOs adapt to policy change. Future research is needed to explore in-depth formal and informal relationships and confounding factors to provide a clearer link between CSO advocacy work and policy outcomes.As Organizações da Sociedade Civil (OSC) desempenham um papel importante na sociedade e no contributo para a saúde global. A proliferação e os esforços das OSC na área das políticas de saúde europeias e globais são fenómenos recentes que se devem em grande parte à dimensão global da saúde e à necessidade de respostas internacionais coordenadas face a questões de políticas de saúde. A globalização aproximou as pessoas, mas as populações tornaram-se mais vulneráveis à propagação de doenças. Questões e decisões relacionadas com políticas de saúde tornaram-se rapidamente um assunto global, de onde emergiram, em grande número, novos atores e instituições. Sendo este um fenómeno recente, há necessidade de aprofundar o conhecimento nesta área. Este estudo tem como objetivo compreender se as OSC europeias que representam pacientes (direta ou indiretamente) contribuem e influenciam a formulação e implementação de políticas de saúde da União Europeia (UE). De forma a responder a esta questão tornou-se necessário analisar fatores que possam influenciar o sucesso das OSC no seu trabalho de advocacia junto das instituições da UE. Analisaram-se também as relações entre as OSC e as instituições Europeias e, mais especificamente, o funcionamento de mecanismos, muitas vezes coordenados por instituições da UE, que permitem o diálogo entre a sociedade civil e decisores políticos sobre políticas de saúde. Considerou-se também fundamental explorar como é que o envolvimento e participação da sociedade civil em questões de política europeia acontece na prática e quais as estratégias utilizadas para influenciar políticas de saúde europeias, tendo em conta o princípio da subsidiariedade e a competência dos Estados-Membros na área da saúde pública. A metodologia envolveu principalmente duas fases do trabalho. Na primeira, realizou-se uma revisão de literatura científica (28 referências) e na segunda efetuaram-se entrevistas semi-estruturadas a 12 representantes da sociedade civil que trabalham na área de advocacia e políticas de saúde junto das instituições europeias, bem como a dois decisores políticos, um que trabalha na Comissão Europeia e outro na Organização Mundial de Saúde. Foi então desenvolvida uma análise com base nos dados recolhidos durante a revisão bibliográfica e entrevistas. Num primeiro capítulo descreve-se o processo de tomada de decisão na UE e o papel das diferentes instituições Europeias no processo de formulação e implementação de políticas de saúde. Um exemplo de como um ato legislativo da União Europeia em matéria de saúde é debatido e aprovado demonstra as várias fases do processo político, nas quais a sociedade civil participa de diversas formas, nem sempre documentadas. Neste capítulo também se problematiza a estratégia da UE ‘Juntos para a saúde’ que se apoia na estratégia de crescimento ‘Europa 2020’, e se apresenta os principais programas europeus de saúde de modo a demonstrar a forma como a UE apoia projetos focados na saúde e o papel da sociedade civil. O segundo capítulo analisa conceitos essenciais de saúde pública, nomeadamente as desigualdades na saúde e os seus determinantes sociais, um dos maiores focos de políticas de saúde Europeias, e como tal um importante indicador da coerência de políticas de saúde. A revisão bibliográfica demonstrou que a compreensão da participação pública na área da saúde aparece cada vez mais em discussões teóricas, onde se defende a participação como elemento fundamental da sociedade democrática, e o acesso à saúde e a redução de desigualdades como um direito de cidadania. Apesar de se terem encontrado definições de sociedade civil diversas, parece existir consenso de que a sociedade civil é diferente do Estado e da economia, e de que se relaciona com princípios de democracia e liberdade. Em linhas gerais, a revisão bibliográfica mostra que a investigação nesta área debruça-se sobre: os diferentes papéis e mandatos das OSC; diferenças entre as OSC nacionais, europeias, internacionais e globais; diferenças entre países desenvolvidos e países em desenvolvimento; a importância de recursos que permitam uma advocacia eficaz e planeada da parte das OSC; e a necessidade de indicadores de avaliação que permitam avaliar a influência política das OSC. A noção de ‘governança global para a saúde’ foi também encontrada na literatura. Processos políticos ocorrem normalmente num ambiente onde existem regras (Estado), mas quando se trata de governança global as ‘regras do jogo’ não são fáceis de definir, e surgem, portanto, questões relacionadas com legitimidade, transparência ou responsabilização. Representantes de OSC entrevistados destacaram assuntos relacionados, e muitas das vezes semelhantes, aos principais temas de investigação que se encontraram durante a revisão bibliográfica. Os temas mais salientes relevaram a importância de parcerias entre OSC; de recursos que permitam o desenvolvimento de capacidades, o acesso a competências, o acesso a decisores políticos; e a necessidade de mecanismos que assegurem a transparência do processo político. Obstáculos para a participação da sociedade civil foram também encontrados e são apresentados em quatro grupos: 1) obstáculos relacionados com a falta de recursos humanos e financeiros, onde se inclui a necessidade de desenvolvimento de capacidades, a barreira da língua, a falta de recursos financeiros que possibilitem representação perto das instituições Europeias (em Bruxelas) e a impossibilidade de participação devido aos sintomas da doença; 2) obstáculos relacionados com questões de legitimidade e responsabilidade, incluindo a necessidade de boa governança e de uma representação de interesses mais transparente, incluindo no seio das OSC, assim como o problema da dependência financeira e das relações com a indústria farmacêutica; 3) obstáculos relacionados com a falta de coordenação e alinhamento, e a importância de desenvolvimento de estratégias conjuntas; 4) obstáculos relacionados com mudanças nas agendas e interesses políticos que requerem uma rápida adaptação por parte das OSC. Demonstrou-se, através das entrevistas, que ultrapassar os obstáculos requer o recurso a parcerias e a proatividade da parte da sociedade civil, e que a adaptação de estratégias de advocacia é necessária face a mudanças políticas, o que pode resultar em novas oportunidades para as OSC. A noção de ‘participação significativa’ também foi destacada, e estudos de caso e histórias de sucesso foram partilhadas pelos representantes das OSC e das instituições Europeias e internacionais. A maior parte das OSC consideram desempenhar um papel fundamental, não apenas na adoção de políticas e iniciativas de saúde da UE, mas na avaliação da implementação de políticas nos Estados-membros, mesmo que seja quase impossível estabelecer uma relação entre ações específicas por parte das OSC e resultados políticos.
40
Hultén, Tua, e Osobi Malin Andersson. ""Man blir behandlad som en andra klassens medborgare, eller inte ens det” : En intervjustudie om vårdpersonals bemötande – upplevelser från personer med missbruksproblematik". Thesis, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:rkh:diva-2586.
Resumo:
Bakgrund: Individer med narkotikamissbruk tillhör en stigmatiserad grupp som löper stor risk att drabbas av ohälsa och därför kan förväntas ha mycket kontakt med hälso- och sjukvården. Studier har visat att sjuksköterskor har negativa attityder och försämrat bemötande gentemot denna grupp. Syfte: Syftet var att beskriva vilka upplevelser personer med aktivt eller tidigare narkotikamissbruk haft av bemötande från sjuksköterskor och annan vårdpersonal samt deras inställning till hälso- och sjukvård. Metod: En intervjustudie med kvalitativ ansats genomfördes. Resultat: Analysen av intervjuerna resulterade i fyra teman: Stigmatiserande bemötande, Motarbetande bemötande, Attityder till hälso- och sjukvården och Mänskligt bemötande är gott bemötande. Slutsatser: Deltagarna i den här studien har inom hälso- och sjukvården upplevt negativt bemötande kopplat till deras aktiva eller tidigare missbruksproblematik. Negativt bemötande mot en utsatt grupp kan leda till förstärkt utanförskap, känslor av maktlöshet och ökad risk för ohälsa. Med ökad kunskap kan sjuksköterskan ge bättre bemötande vilket skulle kunna ha hälsofrämjande effekt. Implikationer: Mer specifikt utbildningsinnehåll om beroende och narkotikamissbruk behövs både på grundutbildningen och som fortbildning för redan verksamma sjuksköterskor för att denna patientgrupp ska få ett bättre bemötande.Background: Individuals with drug abuse belong to a stigmatized group at high risk of ill-health and can therefore be expected to be in much contact with health care. Studies have shown that nurses have negative attitudes and deficient encounter towards this group. Aim: The aim was to describe what experiences persons with present or former drug abuse has had regarding encounters with nurses and other health care personnel and also their attitude regarding health care. Method: An interview study with a qualitative approach was conducted. Result: The analysis of the interviews resulted in four themes: Stigmatizing encounters, Opposing encounters, Attitudes regarding health care and Humanly encounters are good encounters. Conclusions: The participants in this study have experienced negative encounters in health care related to their present or former drug abuse. Negative encounters towards an exposed group can lead to strengthened exclusion, feelings of powerlessness and increased risk of illness. With enhanced knowledge, the nurse can provide better encounters which could have a health promoting effect. Implications: More specific education about addiction and drug abuse is needed both in the undergraduate program and as further training for practicing nurses in order to give this patient group a better encounter.
41
Tomas, Nestor Petrus Namulo. "Factors contributing to the negative behaviours of nurses in a specific public health care facility in Namibia". Diss., 2017. http://hdl.handle.net/10500/24427.
Resumo:
It is important for nurses to show acceptable behaviour when interacting with the patients. The purpose of this study was to explore and describe the factors that contribute to nurses’ negative behaviour when rendering patient care and to determine the effects of nurses’ behaviour on patient outcomes.
The study used a non-experimental explorative and descriptive quantitative design. Data collection was done using a structured questionnaire. The sample comprised of 64 respondents which consisted of 25 registered nurses and 39 enrolled nurses.
The study found that besides the known contributing factor, that is, the shortage of nurses, further identified contributing factors to nurses’ negative behaviour when rendering patient care are failure to retrain nurses identified with negative behaviours, poor condition of employment and patients’ behaviours and cultural beliefs. These results suggested a need to train more nurses, improve conditions of employment, as well as support and retrain nurses identified with negative behaviours.Health Studies
M.A. (Public Health)
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O'Hara, Kathleen. "“My work belies my mental illness”: The motivations for and impacts of mental health advocacy among individuals with psychiatric disabilities". Thesis, 2019. https://doi.org/10.7916/d8-4ryp-6r08.
Resumo:
This study explores mental health advocacy among individuals with psychiatric disabilities in the New York State (NYS) adult home system. This system has garnered longstanding public concern over the unsafe and unjust conditions in which its residents live. In New York City (NYC) a unique organization, Adult Home Advocates (AHA), supports a group of residents (called peer advocates) to advocate for their rights. I integrate literature on health and mental health advocacy and movements with the concept of mental health recovery to consider how AHA participation may impact recovery for peer advocates and others living in the adult home system.
I use Brown et al.'s (2010) policy ethnography approach to study sociolegal, organizational, and individual contexts in which peer advocates work and live. From May 2013 to August 2017 I conducted peer advocate (n=36) interviews and member checks, participant observations (n=154), archival document research, and initiated policy advocacy work. This study is guided by four research questions:
1) How may the sociolegal and organizational environments - - including an unfolding shift in the sociolegal environment - - influence mental health advocacy among individuals with psychiatric disabilities? (Chapter 3, p.41)
2) How may individual characteristics - - specifically, mental health recovery characteristics - - influence mental health advocacy among individuals with psychiatric disabilities? (Chapter 4, p.90)
3) What are the motivations for mental health advocacy among individuals with psychiatric disabilities? (Chapter 5, p.134)
4) What are the impacts of mental health advocacy among individuals with psychiatric disabilities? (Chapter 6, p.182)
I use conventional content analysis (Hsieh & Shannon, 2005), with mental health recovery as a sensitizing concept, to organize and analyze data. I report on findings from the sociolegal to individual levels. First, the sociolegal environment includes patterns of unsafe, unhealthy, and socially isolating conditions within adult homes; even as a legal settlement (O’Toole v. Cuomo) helps residents move out, troubling implementation practices perpetuate these unjust conditions. AHA enters this environment with a commitment to help adult home residents advocate for themselves, though it is a small organization in terms of budget, staffing, and scope. Its size is both a key strength and limitation, as it furthers its mission-driven work, yet impedes training and support for peer advocates.
I also report on findings specific to peer advocate participants (n=36). I use six mental health recovery domains - - including a sociolegal domain I develop to explore justice and rights issues - - to describe recovery as heterogeneous and dynamic across both individual domains and individual participants. Participants’ motivations for advocacy are also heterogeneous, with three types salient: 1) self-advocacy, 2) purpose, and 3) identity. Further, these motivations lead to four types of advocacy activities: 1) self-advocacy, 2) self-help, 3) advocate leader, and 4) advocate activist. Finally, I find that advocacy involvement does impact participants, both positively and negatively. I return to the six recovery domains used above to discuss how mental health advocacy brings into relief potential means of furthering mental health recovery for individuals with psychiatric disabilities.
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Bossewitch, Jonah S. "Dangerous Gifts: Towards a New Wave of Mad Resistance". Thesis, 2016. https://doi.org/10.7916/D8RJ4JFB.
Resumo:
This dissertation examines significant shifts in the politics of psychiatric resistance and mental health activism that have appeared in the past decade. This new wave of resistance has emerged against the backdrop of an increasingly expansive diagnostic/treatment paradigm, and within the context of activist ideologies that can be traced through the veins of broader trends in social movements.
In contrast to earlier generations of consumer/survivor/ex-patient activists, many of whom dogmatically challenged the existence of mental illness, the emerging wave of mad activists are demanding a voice in the production of psychiatric knowledge and greater control over the narration of their own identities. After years as a participant-observer at a leading radical mental health advocacy organization, The Icarus Project, I present an ethnography of conflicts at sites including Occupy Wall Street and the DSM-5 protests at the 2012 American Psychiatric Association conference.
These studies bring this shift into focus, demonstrate how non-credentialed stakeholders continue to be silenced and marginalized, and help us understand the complex ideas these activists are expressing. This new wave of resistance emerged amidst a revolution in communication technologies, and throughout the dissertation I consider how activists are utilizing communications tools, and the ways in which their politics of resistance resonate deeply with the communicative modalities and cultural practices across the web. Finally, this project concludes with an analysis of psychiatry’s current state and probable trajectories, and provides recommendations for applying the lessons from the movement towards greater emancipation and empowerment.
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Perreault, Isabelle. "Rôle de l'infirmière oeuvrant en milieu de soins aigus dans le processus décisionnel menant à une ordonnance de non-réanimation pour un patient apte à consentir aux soins". Thesis, 2007. http://hdl.handle.net/1866/17946.
45
Guay, Martine. "La pratique infirmière en procréation médicalement assistée au sein d’un établissement de santé québécois : une étude autoethnographique". Thesis, 2019. http://hdl.handle.net/1866/24542.
Resumo:
Problématique : L’infertilité – considérée par l’Organisation mondiale de la santé (OMS) comme une maladie du système reproducteur – affecte de plus en plus d’hommes et de femmes, soit un couple sur six en âge de procréer au Canada et au Québec. Elle a un impact sur le bien-être physique et mental des patient.e.s, souvent stigmatisé.e.s et isolé.e.s socialement parce que, pour plusieurs, l’infertilité demeure un sujet tabou. L’infertilité est traitée en procréation médicalement assistée (PMA) où les patient.e.s-familles sont accompagné.e.s par des infirmières dont la pratique est complexe et diversifiée, mais méconnue. But : L’étude avait pour but d’explorer la pratique infirmière en PMA dans un établissement de santé québécois. Méthode : Le devis retenu est une autoethnographie où l’étudiante-chercheuse a mis à profit son expérience comme patiente et comme infirmière en PMA. Des entretiens semi-dirigés, une observation participante et un journal de terrain ont été employés pour la collecte des données. Une analyse thématique a été réalisée. Résultats : L’expérience des patient.e.s-familles en infertilité est au cœur de la pratique infirmière et l’une des principales dimensions de cette pratique est le soin relationnel, peu importe les sphères d’activités auxquelles les infirmières sont affectées au sein de la clinique. Les autres dimensions rapportées sont le leadership/advocacy, l’apprentissage/enseignement, la collaboration et les interventions techniques. Ces résultats correspondent à l’expérience de l’étudiante-chercheuse, tant à titre de patiente que d’infirmière en PMA. Retombées : L’étudiante-chercheuse a documenté la pratique infirmière en PMA, mettant en valeur une méthode peu usitée en sciences infirmières : l’autoethnographie.Problem: Infertility – classified by the World Health Organization (WHO) as a reproductive system disease – affects an ever-increasing number of women and men. Today, one couple out of six of reproductive age struggles with this condition in Canada and in Quebec. It has an impact on the patients’ physical and psychological well-being, often leaving both partners stigmatized and socially isolated as infertility remains a societal taboo for many. Infertility can be treated via Assisted Reproduction Technologies (ART) where the patients-families are cared for by fertility nurses, whose practice is both complex and diversified, but remains little-known. Purpose: This study explores the field of fertility nursing as it is practised in a Quebec healthcare institution. Method: The student-researcher chose to do an autoethnography in order to draw from her own experience as both a fertility nurse and a fertility patient. Semi-directed interviews, participant observation and field journal were used to collect data. A thematic analysis of data then followed. Results: The patients-families’ infertility experience is at the heart of the fertility nurse’s practice and relational care is the main dimension of that practice, regardless of which nursing activities are assigned to them in the clinic. These other dimensions were also reported : leadership/advocacy, learning/teaching, collaboration and technical interventions. These results coincide with the student-researcher’s experience, both as a fertility patient and as a fertility nurse. Impact: The student-researcher documented the practice of fertility nursing and showcased a method rarely used in nursing science: autoethnography.
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Guedes, Melissa Simone Pinto. "Direitos Individuais e Coletivos da Pessoa Portadora de Doença Crónica". Master's thesis, 2019. http://hdl.handle.net/10316/90379.
Resumo:
Dissertação de Mestrado em Ciências Jurídico-Forenses apresentada à Faculdade de DireitoA doença crónica é incurável e está cada vez mais presente nas pessoas da nossa sociedade. Por isso, esta tem que estar preparada para dar resposta às vicissitudes que vêm surgindo, não só na perspetiva da saúde, mas também no ramo jurídico. Não obstante já existir um vasto leque de direitos inerentes às pessoas com doença crónica, ainda há algumas dificuldades a resolver. Num plano individual, o direito à saúde, à reserva da intimidade da vida privada, à não discriminação são alguns dos direitos fundamentais que se irá abordar. A pessoa com doença crónica tem todo o direito à reserva da sua privacidade, por isso, deve ser rigorosamente respeitado o dever de sigilo, sendo apenas justificado o seu levantamento em casos muito restritos. Relativamente ao direito à não discriminação, embora existam cada vez mais medidas com vista ao combate de práticas discriminatórias, estas não foram ainda totalmente aniquiladas. Continua a existir discriminação no que diz respeito à contratação da pessoa com doença crónica. Por esse motivo, devem ser postas em prática as medidas de incentivo ao emprego, bem como a adaptação razoável da pessoa doente no trabalho. O Serviço Nacional de Saúde e a Entidade Reguladora de Saúde são entidades que visam, respetivamente, garantir o acesso de todos os cidadãos aos cuidados de saúde e regular a atividade dos estabelecimentos prestadores de cuidados de saúde. São essenciais para que as pessoas com doença vejam assegurado o seu direito de acesso e proteção da saúde. Numa dimensão coletiva, consagra-se o direito de associação, que é a base do reconhecimento das associações de doentes, fundamentais no apoio à pessoa doente. Ainda neste âmbito, surgem dois conceitos que têm em vista a promoção da participação ativa dos doentes nos sistemas de saúde- a patient advocacy e a democracia sanitária.
Chronic diseases are incurable and increasingly present among people of our society. Therefore, there is a need to respond to the vicissitudes that have arisen, not only in the health perspective, but also in the legal field. Although there is already a wide range of rights inherent to people with chronic diseases, there are still some difficulties to solve.At an individual level, the right to health, to the privacy, and non-discrimination are some of the fundamental rights that will be addressed.The person with chronic disease has the right to protect their privacy, therefore, the duty of confidentiality must be strictly respected, and only in very restricted cases is it justified to break this vow. Relatively to the right of non-discrimination, despite the increasing measures to combat discriminatory practices, these have not yet been completely annihilated. Discrimination continues in the moment of hiring a person with a chronic disease. For this reason, measures to encourage employment and reasonable job supporting of the sick person should be put in place.The National Health Service and the Health Regulatory Entity are entities that aim, respectively, to guarantee the access of all citizens to health care and to regulate the activity of health care establishments. They are essential for people with disease to be assured of their right of access and protection of health. In a collective dimension, the right of association is established, that is the basis for the recognition of patient associations, which are fundamental in supporting the sick person. Also in this context, two concepts emerge that aim to promote the active participation of patients in health systems - patient advocacy and health democracy.
47
Juráčková, Veronika. "Zdraví a jeho socioekonomické ukazatele - testování reliability a validity na PSAS". Master's thesis, 2018. http://www.nusl.cz/ntk/nusl-384541.
Resumo:
The diploma thesis "Health and Socio-economic Indicators - reliability and validity testing of the PSAS" deals with a theoretical concept of health and its socio-economic indicators. A substantial part of the work concentrates on the application of PSAS tools to the Czech population and determining whether the range is reliable and valid for Czech respondents. To determine the reliability, a complex test is used for the whole range through the value of Cronbach's Alpha, and then the Item Response Theory (IRT) is also tested. The IRT test is done using the 18-point Likert's range of responses, of which is the PSAS composed. The validity is tested based on confirmatory factor analysis, using the construct validity as well as analysis of cognitive interviews for face validity. The secondary data analysis is done in SPSS, MPLUS, R, and IRTPRO programs. The last two programs are used to test the lesser known Item Response Theory.
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Stránská, Markéta. "Výhody a nevýhody plynoucí organizacím z členství v České asociaci pro vzácná onemocnění (ČAVO)". Master's thesis, 2015. http://www.nusl.cz/ntk/nusl-353177.
Resumo:
In my work, I want to focus on the perceived advantages and disadvantages of membership in the umbrella organization. This topic, I will discuss from the perspectives of the member organizations. This is a specific segment associations - the patient organizations focused to patients with rare diseases. It is clear that cooperation in the umbrella organization brings advantages, but it is probable that it can also bring some disadvantages. For my work I choose the Czech Association for rare diseases. In the Czech Republic is the only organization in the civil sector, focusing exclusively on rare diseases. The goal of the master thesis is to find out the perceived advantages and disadvantages, and how it is related to the level of activity of members of the umbrella organization. Further, I want to compare the data with the theoretical literature in order that differs. Theme of umbrella in the Czech Republic is almost unexplored. There are only a few expert papers in this area. That's why I decided to focus on cooperation in civil sector (organization focus on rare diseases), which is relatively unknown. Keys words: advantages of cooperation, disadvantages of cooperation, rare disease, advocacy function, information function, umbrella organizations, patient organizations, Czech Association for Rare...
49
Maxey, Hannah L. "Understanding the Influence of State Policy Environment on Dental Service Availability, Access, and Oral Health in America's Underserved Communities". Thesis, 2014. http://hdl.handle.net/1805/5993.
Resumo:
Indiana University-Purdue University Indianapolis (IUPUI)Oral health is crucial to overall health and a focus of the U.S. Health Center program, which provides preventive dental services in medically underserved communities. Dental hygiene is an oral health profession whose practice is focused on dental disease prevention and oral health promotion. Variations in the practice and regulation of dental hygiene has been demonstrated to influence access to dental care at a state level; restrictive policies are associated lower rates of access to care. Understanding whether and to what extent policy variations affect availability and access to dental care and the oral health of medically underserved communities served by grantees of the U.S. Health Center program is the focus of this study. This longitudinal study examines dental service utilization at 1,135 health center grantees that received community health center funding from 2004 to 2011. The Dental Hygiene Professional Practice Index (DHPPI) was used as an indicator of the state policy environment. The influence of grantee and state level characteristics are also considered. Mixed effects models were used to account for correlations introduced by the multiple hierarchical structure of the data. Key findings of this study demonstrate that state policy environment is a predictor of the availability and access to dental care and the oral health status of medically underserved communities that received care at a grantee of the U.S. Health Center program. Grantees located in states with highly restrictive policy environments were 73% less likely to deliver dental services and, those that do, provided care to 7% fewer patients than those grantees located in states with the most supportive policy environments. Population’s served by grantees from the most restrictive states received less preventive care and had greater restorative and emergency dental care needs. State policy environment is a predictor of availability and access to dental care and the oral health status of medically underserved communities. This study has important implications for policy at the federal, state, and local levels. Findings demonstrate the need for policy and advocacy efforts at all levels, especially within states with restrictive policy environments.