This diploma thesis deals with co-ordinated rehabilitation and its use in retirement home specifically in the Center of social services Staroměstská in České Budějovice. It is important to use a co-ordinated rehabilitation concept for achievement of high service quality which means better life quality for pensioners. Co-operation within multidisciplinary team is essential during comprehensive rehabilitation for all persons. The goal of this diploma thesis was to found out how retirement home uses individual components of co-ordinated rehabilitation concept. The principal research question was: How much are employees of retirement home informed about co-ordinated rehabilitation concept? For research was chosen retirement home in the Center of social services Staroměstská in České Budějovice. There were eight employees of this institution participated in the research. It was used method of questioning and half-structured interview technique. Retirement home in the Center of social services Staroměstská uses all aspects of co-ordinated rehabilitation concept. Particularly they utilize medical rehabilitation and social rehabilitation. Most of workers is well-informed about co-ordinated rehabilitation concept. Some of them do not know certain terms. However after explaining of these terms they prove good knowledge of this issue. The employees have satisfactory overview not only about rehabilitation which is directly their scope of working activity but also about other components of co-ordinated rehabilitation. The workers are perfectly informed about medical rehabilitation. They are also mostly satisfied with co-operation in multidisciplinary team. This kind of co-operation takes place at any time of a need or during the meetings or at individual scheduling. The results of this diploma thesis may help to retirement home in the Center of social services Staroměstská in České Budějovice to evaluate the usage of co-ordinated rehabilitation during elderly care. It might also show the measure of co-operation of multidisciplinary team members. This diploma thesis may help to anybody who is interested in specific retirement home or in co-ordinated rehabilitation in general.

The aim of this diploma thesis is to identify options of how to use the systém of coordinated rehabilitation in a home with a special regime. To obtain information I used qualitative research methodology. Semi-standardized interviews served as the research tool. These interviews were carried out with 10 employees of a home with a special regime run by the City Institute of Social Services in Strakonice. The thesis is divided into a theoretical and a practical part. The theoretical part of the diploma thesis focuses on coordinated rehabilitation as a whole, further, it discusses the individual parts of coordinated rehabilitation. Other chapters describe the most frequent client diagnoses within the Home with a special regime, and finally the standards of social service quality are mentioned. The main research question: What are the options of using coordinated rehabilitation in a home with a special regime? Partial research question: Are employees informed about the options of coordinated rehabilitation? For the purposes of the interview I used questions focused on general identification data, questions focusing on the importance of coordinated rehabilitation, multidisciplinary team. Further, I asked about the individual components of coordinated rehabilitation, and finally, how individual planning is carried out. The result of this diploma thesis is a finding that individual components of coordinated rehabilitation are not fully mutually connected. It would be useful to provide employees with suitable courses to complete their missing knowledge. This diploma thesis might serve as a tool for improving care in the Home with a special regime, it might contribute to the Home with a special regime´s employer awareness of coordnated rehabilitiation, and connect it with practice.

Made available in DSpace on 2016-06-02T19:00:23Z (GMT). No. of bitstreams: 1 3824.pdf: 2658470 bytes, checksum: 5e7861897a19147035f7c37972ec6fa0 (MD5) Previous issue date: 2011-02-18 / Universidade Federal de Minas Gerais / The purpose of this research was originally the anthropological study of multidisciplinary teams of Family Health Program (PSF), realized from ethnography in a city of São Paulo, in which I intend to observe the interaction between different discursive fields and professional practices. It was noted, however, that the multidisciplinary teams studied could be divided into two types of teams: a hierarchical, formed by all legitimate health professionals (doctors, nurses and nursing assistants), and a more egalitarian, just conformed by Community Health Agents (ACS). Moreover, by exploring the theme through ethnographic research, was also shown that knowledge and health practices in the field were crossed by the paradigm of health promotion, which not only sought to reorient the demand of users of public health, but sought to transform them, through educational processes, in subjects of citizenship. For this, an analysis of this process was made, focusing particularly on the role and training of ACS, since they emerged not only as mediators between biomedical knowledge and popular knowledge, but also showed themselves capable of switching between these two roles: the interventionist state and the interlocutor of the community. Thus, if the ambiguity of the ACS reveal, on hand, the normative character of the strategy, on the other hand, showed an opening for the emergence of citizenship, which allowed the problematization of the health citizention project implicit in public health politics, as the coexistence of contradictory models within the same program and the same health equipment. Then we saw that the Family Health Strategy presents paradoxes and inconsistencies in the operationalization of the program, some of which may bind that it consolidates as a guideline of SUS and must be object of reflection, in order that the program does not become just a model manager without the effective care counterparty expected of a health care service in public health. / O objetivo desta pesquisa foi, originalmente, o estudo antropológico das equipes multiprofissionais do Programa de Saúde da Família (PSF), realizado a partir da etnografia em um município do Estado de São Paulo, na qual se procurou observar a interação entre diferentes campos discursivos e práticas profissionais. Constatou-se, entretanto, que as equipes multiprofissionais estudadas podiam ser divididas em dois tipos de equipe: uma hierárquica, conformada por todos os profissionais de saúde legitimados (médicos, enfermeiros, técnicos e auxiliares de enfermagem), e outra, mais igualitária, conformada apenas pelos Agentes Comunitários de Saúde (ACS). Além disso, ao explorar o tema por meio da pesquisa etnográfica, foi também evidenciado que os saberes e as práticas de saúde em campo eram atravessados pelo paradigma da promoção da saúde, a qual não só buscava reorientar a demanda dos usuários da saúde pública, mas visava a transformá-los, por meio de processos pedagógicos, em sujeitos de cidadania. Para tanto, foi feita uma análise desse processo, focando-se, particularmente, na atuação e formação dos ACS, dado que eles surgiam não só como mediadores entre o saber biomédico e o saber popular, mas também se mostravam capazes de transitar entre estes dois papéis: o de interventor do Estado e o de interlocutor da comunidade. Assim, se por um lado a ambigüidade do ACS revelava o caráter normatizador da estratégia, por outro, mostrava uma brecha para a emergência da cidadania, o que permitiu tanto a problematização do projeto de cidadanização na saúde implícito nas políticas públicas de saúde, quanto da coexistência de modelos contraditórios dentro de um mesmo programa e de um mesmo equipamento de saúde. Vimos, então, que a Estratégia de Saúde da Família apresenta paradoxos e incongruências na operacionalização do programa, algumas das quais podem comprometer sua consolidação como eixo norteador do SUS e devem ser objeto de reflexão, a fim de que o programa não se transforme apenas em um modelo gestor sem a contraparte assistencial efetiva que se espera de um serviço de atenção em saúde pública.

The purpose of this study was to explore the life experiences of multiparous teenage mothers at selected communities in the Eastern Cape Province. The population for this study was pregnant teenage mothers aged 12-18 years having at least one previous pregnancy, living in the catchment areas of the provincial hospital of Bizana in the Alfred Nzo District of the Eastern Cape Province. Data were collected through 12 semi-structured individual interviews using a selfdeveloped interview schedule. The transcribed interviews were analysed by means of thematic analysis, using the five stages according to Terre Blanche, et al. (2006), namely familiarisation, inducing themes, coding, elaboration, and checking. Subcategories were grouped into 12 categories and five main themes. Findings on the life experiences of the multiparous teenage mothers are described according to the main themes, namely the everyday life of the teenage mothers, cultural practices leading to pregnancies, factors contributing to pregnancies, challenges experienced by teenage mothers, and messages from the teenage mothers. Recommendations focus on the role of social services to engage the multidisciplinary team and the community to assist in the empowerment of young mothers to break the cycle of multiparous teenage pregnancies and the negative impact thereof on the lives of young mothers. / Health Studies / M. P. H.

The diploma thesis aims to describe the process of family strengthening of two services provided by Regional Caritas Jičín. It also compares the services using a good practice approach, which is defined by multidisciplinary cooperation and a network of activities of various organizations. The theoretical part of the thesis describes the process of family strengthening and explains terms such as family and its functions, multi-problem family, the vulnerability of contemporary family, family typology, or various socio-pathological phenomena. In this part, the objectives, principles, and legal framework of family strengthening are described. Two researched social activation services providing family strengthening are introduced. The setting of the system of care in Czechia is outlined, including its current issues and the ongoing transformation. Moreover, the innovative concepts of cooperation and methods of social work are introduced, i.e. multidisciplinary teams, child protection conferences, family conferences, or the Cochem model. The practical part of the thesis sets out three research objectives and describes the approach to the research, including its ethics, the researchers' position, and the method used for data collection - the semi-structured interview. Furthermore, the research analysis is...

Dans le contexte de l’augmentation de l’espérance de vie et de l’obésité ainsi qu’avec les changements environnementaux et culturels, la prévalence du diabète est à la hausse ainsi que ses complications inhérentes tels l’ulcération plantaire diabétique (UPD), l’amputation au membre inférieur (AMI) et les risques d’infection associés. Une façon efficiente de gérer ces complications est la prise en charge en équipe multidisciplinaire (ÉMD) et les soins de pieds intégrés en incluant plusieurs professionnels, dont le podiatre. Dans l’optique d’améliorer les résultats pour la santé de cette population, cette thèse a pour objectifs de développer de nouvelles connaissances pour la compréhension du rôle du podiatre et de ses interventions, réalisées en contexte seul ou en ÉMD, dans la prise en charge de l’UPD et de l’AMI ainsi que d’explorer spécifiquement une nouvelle possibilité de matériel pour la prévention de la colonisation bactérienne des UPDs principalement associée à Staphylococcus aureus. Les travaux de recherche s’insèrent dans une approche intégrative faisant appel aux domaines théorique, pratique et expérimental utilisant différentes approches méthodologiques telles la revue systématique avec méta-analyse, l’étude cohorte comparative et l’étude expérimentale in vitro. Cela a conduit à trois articles scientifiques; les deux premiers traitent spécifiquement des effets des interventions du podiatre en approche d’ÉMD sur les résultats pour la santé (données sur l’UPD, l’AMI et l’utilisation des ressources dans le système de la santé) et le dernier concerne l’effet antibactérien d’un produit potentiel pour la gestion locale des infections des UPDs. Une analyse intégrée des travaux de recherche a permis une perspective des résultats à l’aide du cadre de référence pour la prévention et gestion des maladies chroniques et du cadre d’analyse pour les résultats pour la santé, en relation avec les connaissances actuelles sur la problématique. Cette thèse a contribué à l’avancement des connaissances pour la gestion des UPDs en ÉMD incluant le podiatre et a démontré que cette pratique clinique peut avoir des répercussions sur l’UPD et l’AMI. Elle démontre également l’importance d’optimiser la prise en charge ii en ÉMD incluant le podiatre. Elle a proposé l’aspect novateur d’un matériel biomédical, la cellulose phosphorylée avec l’argent ionisé, ayant le potentiel d’être impliqué dans la prise en charge de l’infection locale de l’UPD puisque les résultats préliminaires sur ses capacités antibactériennes, dans les conditions de laboratoire, ont un effet comparable à des produits de même nature actuellement proposés par l’industrie. Somme toute, que ce soit une UPD qui résulte en une AMI ou non, avec ou sans infection, ce qui importe concrètement, c’est d’en diminuer le nombre et de contribuer à la qualité de vie de ces personnes atteinte de diabète. Les professionnels de la santé, dont les podiatres, doivent donc agir selon les meilleurs pratiques en ÉMD et les décideurs doivent mobiliser les ressources nécessaires. / In the context of increasing life expectancy and obesity rates as well as environmental and cultural changes, the prevalence of diabetes is on the rise, as are its inherent complications such as diabetic foot ulceration (DFU), lower extremity amputation (LEA) and higher infection risks. An efficient way to manage these complications is a multidisciplinary team (MDT) approach along with integrated foot care involving several professionals, including the podiatrist. In order to improve health-related outcomes for these persons, the objectives of this thesis are, first, to develop new knowledge to further understand the role of the podiatrist and his interventions, performed alone or in MDT context, in the management of DFU and LEA, and second, to specifically explore the possibility of new material for the prevention of bacterial colonization of UPDs, mainly associated with Staphylococcus aureus. These research projects adopt an integrated approach involving theoretical, practical and experimental domains and uses different methodological approaches such as systematic review with meta-analysis, comparative cohort study and in vitro experimental study. It has led to three scientific articles; the first two specifically address the effects of podiatrist interventions in the MDT approach on health-related outcomes (data on DFUs, LEAs and the usage of healthcare resources) and the last concerns the antibacterial efficacy of a potential material for local infection management. An integrated analysis of the research projects provides perspective on the results through the use of the framework for prevention and management of chronic diseases and the analytical framework for health-related outcomes, in relation with the latest scientific evidences on this issue. This thesis contributes to the advancement of knowledge for the management of DFUs in MDT approach including podiatrists and demonstrates that this type of clinical management can have significant impacts on LEAs, including decreasing rates of major and total LEAs and improvement of healing time and rate of DFUs. It also establishes the importance of optimizing MDT with the podiatrist. Furthermore, it puts forward the potential of an innovative biomedical material, phosphate cellulose fibers with ionic silver, to be involved in the management of local DFU infection, due to its antibacterial properties which, under laboratory conditions, have an effect comparable to similar products currently offered by the industry. In sum, what truly matters is that whether or not a DFU, with or without infection, results in LEA, the aim is to reduce the number of its occurrences and to contribute to the quality of life of the people it affects. Health professionals including podiatrists must therefore act according to best practices in MDT approach and decision-makers must mobilize the necessary resources.

This thesis deals with the implementation of palliative care in hospitals and perceives the topic in context of change management in health facilities. In the Czech Republic, this type of care is still at its beginning in hospitals and its implementation is a big challenge. The aim of the thesis is to find out what factors influence the implementation of palliative care in hospitals. In the first part of the text, the theoretical bases concerning palliative care and change management are outlined. The empirical part introduces a qualitative survey identifying barriers that had to be overcome during the implementation of palliative care in hospitals and factors that were instrumental in the implementation. Within the survey, 66 interviews with members of multidisciplinary teams from 17 hospitals were made. All the hospitals participated in the Together until the end programme of the Avast Foundation. The assessment of the survey results focuses on recommendations for hospitals that decide to extend or launch the palliative attitude in their premises and on challenges for the future of palliative care in the Czech Republic. The survey was carried out under the supervision of the Center for Palliative Care and it was used as the final assessment of the Together until the end programme that mapped the...

The main goal of the Strategy for the Reform of Psychiatric Care, published in 2013 by the Ministry of Health of the Czech republic, was to improve the quality of life of people suffering from mental illness. One of the results of this strategy was the emergence of new mental health centres. These mental health centres are meant to provide individualized social and health care to people with mental illness in order to prevent or minimize their hospitalization. The service is ensured by multidisciplinary teams which include professionals such as psychiatrists, psychologists, psychiatric nurses, and social workers. Case management is supposed to be a dominant form of the service provided. The theoretical part of the thesis describes the historical context of the case management and its recent exploitation in the mental health centres in the Czech republic. The empirical part focuses on a particular multidisciplinary team applying the case management method. Through qualitative research, it aims to identify the different parts of the case management and the constraints and obstacles of its application. The analysis of the data collected brings the definition of the key problem areas the team is facing. The final part of the thesis provides recommendations for further development and proposes steps...

This thesis deals with communication process among staff in a nursing home (the facility requested not to be named). It deals as well with implementing change in the structure of multidisciplinary staff meeting in the same nursing home to improve team cooperation and to fulfill Standards for Quality in Social Services. In four chapters of the theoretical part, author follows introduction to the topic of human communication and intracompany communication to determine researched domain. For the same reason author later deals with subject of teams, it's creation, leadership and team roles. Third chapter pursues topic of meetings, their benefit, types and rules how to conduct an effective meeting. Theoretical part ends with contextualization of communication process within the Standards for Quality in Social Services. Practical part contains diagnostics of communication process among staff in a nursing home that showed the need to conduct change in the structure of multidisciplinary staff meeting. Other chapters deal with the process of the change from the stage of laying out the goal of the change, over diagnosis of the actual state of the meeting with the use of qualitative research to the phase of a creation of a new methodic directive for multidisciplinary staff meeting. Key words: communication...

CHMELÍKOVÁ, Nikola. The Hospice Care Regulation in the Czech Republic: Charles University in Prague, Faculty of Social Sciences, Institute of Sociological Studies, Department of Public and Social Policy, 2014. Thesis Supervisor Mgr. Ing. Olga Angelovská The thesis titled "The Hospice Care Regulation in the Czech Republic" is about hospice care in the Czech Republic of its development due to the following important foreign and Czech documents in health and social care. The main reason that leads me to the elaboration of this work is particularly ambiguous and rather one-sided definition of hospice palliative care in the Czech Republic in terms of health care. In the analysis and evaluation, which is the main part of the paper I will draw on already existing documents and data that relate to the topic immediately. Another integral part of the consultation and discussion with experts from the ranks of both health and social services in providing care face barriers that currently has inadequate definition of the operation itself. The aim of the thesis is the analysis of documents and data relating to the regulation of hospice care in the Czech Republic, and their subsequent reflection of professionals who care about the issue of dying deal in their working lives. Keywords hospice care, legislation,...