The study sought to analyse the referrals received by a psychiatric unit in a general hospital in the Western Cape by studying the referral letters and the referral responses. The study sought to determine which departments were referring patients and which patients were being referred. The completeness and appropriateness of the referrals were also studied. The major inferences drawn from this study are that health care workers have a poor concept of what information the psychiatric units needs and about the scope and function of the unit. The poor feedback from the psychiatric unit to the referral source is indicative of the poor communication amongst the health care team members. / Health Studies / M.A. (Advanced Nursing Sciences)

This thesis explores the potential of visual information and communication technologies (ICTs) for collaboration in emergency care. The thesis consists of four studies exploring future technology, 3D telepresence technology for medical consultation (3DMC), from several different methodological and analytical perspectives. Together the studies provide a broad view of the potential benefits, risks and implications of using visual technologies for collaboration in emergency care. The results show that paramedic-physician collaboration via 3DMC might have some benefits for patient care, both in the immediate patient care situation and beyond, for example, when coordinating transport and resources; improving understanding between different actors; and in developing paramedic competence and confidence in their skills. However, collaboration is heavily impacted by physicians’ and paramedics’ respective work practices which are situated in very different physical, professional and organizational contexts. Adding a visual dimension to this collaboration presents unique challenges for the overall design, development, implementation, and appropriation process. Thus, the thesis emphasizes the importance of understanding both the individual users as well as the complex overall image which, although often neglected or ignored, is crucial to understand when developing and introducing new technology that is successful and justified in the overall context while also being useful and meaningful for the individual users. / <p>Academic dissertation for the Degree of Doctor of Philosophy in Library and Information Science at the University of Gothenburg and the University of Borås to be publicly defended on Thursday 19 September 2013 at 13:15 in the auditorium at Simonsland, University of Borås, Skaraborgsvägen 3, Borås.</p>

Some innovations are termed ‘disruptive’, a designation that is normally applied to technology; examples include computers, digital cameras, and mobile phones. The term can also be applied to groups of workers, particularly if they are able to offer specific technical capabilities within a market at lower cost, but broadly equal and effective to that offered by traditional products or services. Paramedics could be described in this way and are a newly professionalised group, with distinctive capabilities in terms of responding to the needs of not just the acutely ill and injured, but increasingly those patients with undifferentiated non-life- threatening conditions, which increasingly make up the bulk of 999 call demand. The key to their transition from an artisan, skilled worker to professional status is the acquisition of certain ‘hallmarks’. Perhaps the most important of these is the completion of more prolonged education that affords the opportunity to graduate with enhanced decision-making and other clinical skills in order to meet the needs of the full spectrum of patients in the pre-hospital setting. Paramedics were surveyed to determine how they rated their ‘traditional’ preparation and to establish what their attitudes were to a more educationally based approach. Paramedics themselves proved to be realistic regarding shortcomings in established training and education systems, while also being strongly motivated to learn more within a higher education setting, particularly if this additional effort would result in being able to offer a wider range of care to their patients. During the study, major changes in the health care environment and the role of the Ambulance Service took place, leading to a requirement to undertake a second phase of research. This took the form of ‘Horizon Scanning’ in an attempt to detect ‘signals’, themes and trends in relation to newly emerging ‘competitors’ to the paramedic role. These included nursing, new practitioners and most critically, the rapidly emerging medical sub-speciality of pre-hospital care, staffed by medical personnel on a pattern found specifically in some European countries, sometimes termed the ‘Franco-German’ model/System (FGM/S). Hitherto, the model of provision in the UK had followed the ‘Anglo-American’ model/System (AAM/S), approach, with paramedics providing direct patient care in the field and medical staff largely involved in medical oversight, teaching, clinical governance and other higher level roles. As part of this research, the evidence base for change was examined and consideration given to the factors that might help clarify what the likely situation could be in 2030 in respect of ambulance services, pre-hospital care and paramedics. This future is uncertain, but factors have been identified that would militate in favour of one or other model prevailing, with close links established between educational preparation, system design, career structure and the continuance of the professionalisation process favouring paramedic progression. However, other factors, most specifically professional power, the absence of a clear evidence base and an apparent reluctance to clearly acknowledge this in some respects, lead to the conclusion that the future of pre-hospital care remains uncertain and contested, but also potentially amenable to a well-directed influencing strategy.

published_or_final_version / Social Work / Master / Master of Social Work

The problem of this study is to compare prior health care experience with satisfactory adjustment in a long-term care facility. Both quantity and quality of prior experience in a health care facility are examined in terms of the significance to successful relocation. Demographic data and perceived control of health are examined in relation to significance of the findings.

The problem with which this study is concerned is the delineation of current practices in therapeutic recreation in psychiatric treatment centers in Texas, The programs of the forty-two hospitals responding to the survey questionnaire were evaluated in terms of the National Therapeutic Recreation Society's "Standards for Therapeutic Recreation in Psychiatric Facilities." It was determined that, while the use of recreation in psychiatric rehabilitation is widespread, many programs are not administratively independent., A close association between recreation and occupational therapy was found. Extensive recreation facilities and activities were reported. Use of community resources was widespread, but follow-up and leisure counseling services were rare. Most personnel had no recreation training. The evaluation showed limited compliance with the standards.

"The purpose of this study is to examine the impact of the medicare law on a particular hospital: Flow Memorial Hospital, Denton, Texas. The scope of this study is limited to an analysis of changes in hospital car at Flow Memorial Hospital resulting from medicare. These changes are examined on the basis of 1. number of patients and days of care; 2. hospital services by department; 3. the means of payment; and 4. social characteristics of the aged patient group. A detailed examination of aged patient care was made for the fiscal years 1966 and 1967. The 1966 year was the year immediately preceding medicare. The 1967 year was the first year of medicare. Longer time periods were used where the data were available and pertinent."-- leaf 1.

WORK The aim of this work is to explore and describe the problem of nicotine clients of residential facilities voluntarily hospitalized for alcohol dependence. Learn whether it is on their side for such treatment if they are interested or might acquire in the course of his treatment of alcoholism motivation to quit smoking if they were offered such treatment if they were on a method of treating at least generally aware and if you know the benefits of such léčby.První stage research will consist of obtaining the basic sample. To obtain the respondents will choose the method of choice through deliberate purpose institutions. The population intended for actual research facility which clients will be allowed to participate in such research and who will be able to participate in research. Through the simple purpose a selection, Fagerström test for all survey respondents. Based on the results of this test determine how many people hospitalized for alcohol dependence with the diagnosis F10.2 simultaneously diagnoses F17.2-behavioral disorders due to use of tobacco. This finding generates the sample with which I will continue to work. To work with a sample of clients will be the main data collection method used questionnaire method. The questionnaire will be represented in both open and closed questions...

O trabalho em equipe representa estratégia para superação da frágil articulação entre profissionais, sendo potencializado pela prática colaborativa entre agentes e gestão participativa. Entretanto, os arranjos organizacionais não favorecem a interação entre os profissionais e dificultam o trabalho em equipe. A magnitude dos agravos cardiovasculares por serviços regulados e estruturados, pautados num enfoque multiprofissional em saúde, a carência de publicações científicas sobre trabalho em equipe na atenção hospitalar, a potência do trabalho em equipe para responder às demandas reais de saúde justificam investigações a respeito do trabalho em equipe de saúde em Unidade Coronariana, particularizando a compreensão de aspectos que dificultam e facilitam esse trabalho. Assim, esta pesquisa teve como objetivo analisar o trabalho em equipe, desenvolvido em unidade hospitalar de alta densidade tecnológica, segundo a perspectiva da equipe de saúde. É um estudo descritivo, utilizando dados qualitativos e quantitativos, realizado em Unidade Coronariana de um Hospital público, de ensino, de nível terciário, referência para atendimento de alta densidade tecnológica. A população constituiu-se de profissionais da equipe multiprofissional que atuavam na referida unidade há, pelo menos, um ano, sendo excluídos aqueles que se encontravam afastados do trabalho à época da coleta dos dados e os não localizados após três tentativas para agendamento da entrevista. Utilizou-se a Técnica do Incidente Crítico, e os dados primários foram coletados por meio de entrevista semiestruturada. A análise dos dados fundamentou-se em análise de conteúdo. Participaram do estudo 45 profissionais da equipe de saúde, sendo 20 técnicos/auxiliares de enfermagem; 11 médicos; nove enfermeiros; quatro fisioterapeutas e um psicólogo. Das entrevistas, emergiram 49 situações, das quais 38 (77,6%) receberam referências negativas e 11 (22,4%), positivas; 385 comportamentos, sendo 209 (54,2%) positivos e 176 (45,8%) negativos; além de 182 consequências que receberam 131 (71,9%) referências negativas e 51 (28,1%) positivas. As referências positivas indicam aspectos que facilitam o trabalho em equipe e as negativas, aqueles que dificultam. Foram considerados facilitadores do trabalho em equipe colaborar/relacionar-se com os outros profissionais, desenvolver assistência ao paciente conforme a competência profissional, relacionamento entre agentes pautado na prática colaborativa e comunicação. Aspectos como baixa colaboração entre profissionais, gerenciamento inadequado de agentes, despreparo profissional no atendimento à parada cardiorrespiratória/emergência, divergências nas condutas terapêuticas, limitação de recursos materiais e agir de maneira descomprometida com o trabalho dificultam o trabalho em equipe. Conclui-se que, apesar do predomínio de situações e consequências negativas relativas à dinâmica do trabalho em equipe nessa Unidade Coronariana, a ênfase em comportamentos positivos, favoráveis ao trabalho em equipe, evidencia investimento e esforço para superar dificuldades, na perspectiva da potência do trabalho em equipe para atingir a finalidade do trabalho em saúde. A partir dos resultados, acredita-se que aspectos relativos à formação/capacitação profissional e à organização do serviço precisam favorecer o trabalho em equipe, estando a centralidade do processo de trabalho dessa equipe nas relações entre agentes / Teamwork is a strategy for overcoming the fragile link between professionals, enhanced by collaborative practices between agents and participatory management. However, the organizational arrangements do not favor the interaction between professionals, hindering teamwork. The magnitude of cardiovascular diseases, worsened by regulated and structured services, guided by a multi-professional approach to health, and the lack of scientific publications on teamwork in hospital care and its potential to meet real health needs justify studying the teamwork of a health team in a Coronary Care Unit, individualizing the understanding of aspects that hinder and facilitate this work. Thus, the aim of this study was to analyze the teamwork developed in hospital of high technological density, from the perspective of the health team. It is a descriptive study using qualitative and quantitative data, held in a teaching, tertiary, reference Coronary Care Unit for a high technological density service. The population consisted of professionals from the multidisciplinary team who worked in that unit for at least one year, excluding those who were out of work at the time of data collection or who were not located after three attempts to schedule the interview. The Critical Incident Technique was used, and primary data were collected through semi- structured interviews. Data analysis was based on content analysis. Study participants were 45 health team professionals, 20 nursing technicians/aides; 11 physicians; 9 nurses; 4 physical therapists and 1 psychologist. The interviews revealed 49 situations, of which 38 (77.6%) were negative references and 11 (22.4%) positive; 385 behaviors, where 209 (54.2%) were positive and 176 (45.8%) negative; in addition to receiving 182 consequences of which 131 (71.9%) were negative and 51 (28.1%) were positive references. Positive references indicate aspects that facilitate teamwork and negative aspects that hinder it. The characteristics among staff such as collaboration/relationship with other professionals, development of patient care according to professional competence, relationship between guided agents in collaborative and communication practice were considered teamwork facilitators. Aspects such as low collaboration among professionals, inadequate agent management, lack of professional preparation to assist heart arrests/emergencies, differences in therapeutic approaches, limitation of material resources and lack of commitment to work hinder teamwork. In conclusion, despite the predominance of negative situations and consequences related to the dynamics of teamwork in this Coronary Care Unit, the emphasis on positive behavior, favorable to teamwork, shows investment and effort to overcome difficulties in view of the teamwork potential to achieve the purpose of health work. Analyzing these results, it is believed that aspects of the professional education/training and service organization must promote teamwork, with the centrality of the working process of this team focused on the relationships among agents

Submitted by Ricardo Cedraz Duque Moliterno (ricardo.moliterno@uefs.br) on 2018-01-25T23:14:34Z No. of bitstreams: 1 DISSERTA??O - MARCOS VIN?CIUS SANTOS SILVA.pdf: 1867351 bytes, checksum: def26bc9b7fc279cafbb180af8d67b58 (MD5) / Made available in DSpace on 2018-01-25T23:14:34Z (GMT). No. of bitstreams: 1 DISSERTA??O - MARCOS VIN?CIUS SANTOS SILVA.pdf: 1867351 bytes, checksum: def26bc9b7fc279cafbb180af8d67b58 (MD5) Previous issue date: 2016-04-27 / The research aims to analyze the interface between humanization and technological resources in hospitals. It was the result of an investigation under a qualitative approach, while the data were analyzed in addition to the quantifiable dimensions, but a universe embraced by signs, senses and meanings attributed to the object in focus. The empirical universe of the study was two hospital equipments linked to the Department of Health of the State of Bahia, administered under different legal and administrative systems. The choice of these hospitals met the criteria: broad flow demand of massive technological development and that were allocated near the university in which the study is linked. Empirical research showed with the application of semi-structured interviews scripts together professionals from both units. Discussions necessary researches are categorized in the debate on hospital care, specifying on its structure and the adjacent and constituent subjects in defendants processes. The results of this study reflect issues to the very interface between humanization and technological resources in health, converging on the antagonistic character attributed to technology, now seen as making it humanizes, sometimes as dehumanizing mechanism. Also, the data also indicate on the various meanings attributed to humanization, converging with its polysemous attribute. Although, all the undertaken theoretical basis points directives that establish with the ideal of restructuring hospital care, with a focus to their practice. With regard, it urges the need to safeguard the qualities inherent in the principle of ethics, as they stand up for human values in much needed. Therefore, the discussions related to the paradigm of execution of humanization in the health field by the driver of technological resources, are recurrent. Thus, it points out the need to build care environments conducive to the introduction of targeted practices and demarcated by the complementarity between categories humanization and technology. Therefore, the need to adopt and reflect on an integrative approach is argued between them, facilitating the humans values to scale on the technologic practices, proceduralists, as combated. / A pesquisa tem como objetivo analisar a interface entre a humaniza??o e a incorpora??o tecnol?gica em unidades hospitalares. Foi fruto de uma investiga??o com abordagem qualitativa, ao passo que os dados foram analisados al?m das dimens?es quantific?veis, mas num universo abarcado por signos, sentidos e significados atribu?dos ao objeto em foco. O universo emp?rico do estudo foi dois equipamentos hospitalares vinculados ? Secretaria Estadual de Sa?de do Estado da Bahia, administrados sob diferentes regimes jur?dico-administrativos. A escolha desses hospitais se deu devido aos seus amplos fluxos demandat?rios, ? maci?a incorpora??o tecnol?gica em ambos e ao fato de estarem alocados pr?ximos ? universidade em que esse estudo est? vinculado. A pesquisa emp?rica evidenciou-se com a aplica??o de roteiros semiestruturados de entrevistas junto aos profissionais de ambas as unidades. As discuss?es necess?rias ? pesquisa categorizam-se no debate sobre o cuidado hospitalar, especificando sua estrutura e os sujeitos adjacentes e constituintes nos processos demandados. Os resultados desse estudo refletem quest?es referentes ? pr?pria interface entre a humaniza??o e a incorpora??o tecnol?gica em sa?de, convergindo quanto ao car?ter antag?nico atribu?do ? tecnologia, ora vista como fazer que humaniza, ora como mecanismo desumanizador. Igualmente, os dados indicam os v?rios sentidos atribu?dos ? humaniza??o, confluindo com seu atributo poliss?mico. Conquanto, todo o aporte te?rico empreendido aponta diretivas que coligem com o ideal de reestruturar o cuidado hospitalar, com enfoque ao campo das pr?ticas. A pesquisa incita a necessidade de resguardar as qualidades inerentes ao princ?pio da ?tica, ? medida que ressalta os valores humanos, em muito carecidos. Logo, as discuss?es relacionadas ao paradigma da efetiva??o da humaniza??o no campo da sa?de, mediante o fator condicionante da incorpora??o tecnol?gica, s?o recorrentes. Assim, aponta-se para a necessidade de se construir ambientes de cuidado prop?cios ? instaura??o de pr?ticas direcionadas e demarcadas pela complementariedade entre as categorias ?humaniza??o? e ?tecnologia?. Portanto, defendeu-se a necessidade de adotar e refletir acerca de uma abordagem integradora entre ambas, possibilitando aos valores humanos dimensionarem-se sobre as pr?ticas tecnicistas, em geral, muito combatidas.