Submitted by Jamile Barbosa da Cruz (jamile.cruz@ucsal.br) on 2017-01-16T11:57:51Z No. of bitstreams: 1 2014.1 - SANDRA MOREIRA COSTA DE CARVALHO.pdf: 1498054 bytes, checksum: df6bf133731bc981f31b234e3af675dd (MD5) / Approved for entry into archive by Rosemary Magalhães (rosemary.magalhaes@ucsal.br) on 2017-01-16T16:48:02Z (GMT) No. of bitstreams: 1 2014.1 - SANDRA MOREIRA COSTA DE CARVALHO.pdf: 1498054 bytes, checksum: df6bf133731bc981f31b234e3af675dd (MD5) / Made available in DSpace on 2017-01-16T16:48:02Z (GMT). No. of bitstreams: 1 2014.1 - SANDRA MOREIRA COSTA DE CARVALHO.pdf: 1498054 bytes, checksum: df6bf133731bc981f31b234e3af675dd (MD5) Previous issue date: 2014-04-24 / Este trabalho se propõe a analisar o paradoxo existente desde 1988 entre a conquista de direitos sociais universais, tais como a saúde, e a falta de mecanismos para sua concretização na prática, analisando o acesso às políticas de saúde por parte das pessoas em situação de rua, percebido na restrição encontrada por essas pessoas na área da saúde, processo vivenciado no trabalho direto da autora, há mais de doze anos, com esse público nessas áreas. O método utilizado será o dialético crítico, com a realização de um estudo teórico empírico de abordagem qualitativa, realizado através de revisão bibliográfica, com consulta a autores que discutem a questão social, capitalismo, trabalho, pobreza extrema, políticas sociais e a situação de rua, além dos últimos censos realizados em Salvador e em âmbito nacional sobre a situação de pessoas nessas condições. Analisam-se a realidade de duas unidades de saúde, de atenção básica, do Centro Histórico de Salvador e as contradições no processo social, político e econômico de negação de direitos que permeia essa questão. O contexto brasileiro, mais especificamente do Centro Histórico de Salvador, demonstra a falta de dispositivos para acesso desses sujeitos a políticas fundamentais como a saúde. Entender essa situação implica considerar que a situação de rua precisa ser analisada na construção e reconstrução de políticas sociais que, ao mesmo tempo em que respondem formalmente às demandas apresentadas por esses sujeitos, contraditoriamente reforçam sua condição de despossuídos de direitos, por não se operacionalizarem na prática. Neste estudo, considera-se importante fundamentar brevemente a situação de rua atrelada à criação, configuração e reconfiguração histórica da pobreza extrema como expressão da questão social no sistema capitalista de produção, entender, na história e na atualidade brasileira e no Centro Histórico de Salvador, e o que se tem construído para a efetivação de direitos sociais dessas pessoas, e os entraves que impedem esse avanço. / This study aims to analyze the paradox since 1988 between the conquest of universal social rights, such as health and lack of mechanisms for their implementation in practice, analyzing access health policies for people living on the street, perceived the restriction found by these people in healthcare, process experienced in the direct work of the author, there are more than twelve years with this audience in these areas. The method used will be critical dialectic, where a theoretical study will be conducted through literature review in consultation with the authors argue that the social question, capitalism, labor, extreme poverty, social policy and the homeless and the last census conducted in Salvador and nationally on the situation of people in these conditions. We sought to analyze the social contradictions in the economic process, and denial of political rights that permeates this question. The Brazilian and more specifically Salvador context demonstrates the lack of access to these devices subject to fundamental policies such as health. Understand it means considering that the homeless need to be analyzed in the construction and reconstruction of social policy, which while formally respond to the demands presented by these subjects, paradoxically reinforce their status as dispossessed of rights, not operationalize in practice. In this study, it is considered important to briefly justify the situation of street tied to the creation, configuration and reconfiguration of historical extreme poverty as an expression of the social question in the capitalist system of production. We seek to understand the history and current Brazilian and Salvador, which has advanced in attaining social rights of these people, and what barriers hinder this progress.

O trabalho buscou conhecer os motivos que levaram mulheres do município de Piraí, estado do Rio de Janeiro, agendadas para realizar o exame de mamografia, a não comparecer ao mesmo / The study sougth to know the reasons why women Piraí

This study uses secondary survey data collected from a sample population of clients from JPS Health Network in Tarrant County, Texas from July-August, 2000. Respondents for this study represents a group of working-age Hispanic immigrant adults, N=379. Andersen's "Behavioral Model for Vulnerable Populations" is used to as the theoretical framework. Bivariate crosstabulation revealed significant relationships for dependent variables: problems getting needed healthcare, doctor visits, emergency room visits, overnight in the hospital, and obtaining prescription medication. Findings confirm that lack of coverage, competing needs, and difficulties in the health care system are significant in access health care. Subsequent implications and policy recommendations suggests the inevitability of short and long term health consequences unless changes are made to policies and programs.

Despite the availability of the human papillomavirus (HPV) vaccine, African American women are still at risk for contracting HPV. This is significant because HPV is one of the main risk factors for cervical cancer. The purpose of this quantitative study was to explore the relationship between the use of HPV vaccination for cervical cancer prevention and personal history of HPV, reduced access to healthcare, and risky sexual behaviors in African American women. The theoretical framework used for this study was the health belief model (HBM). Two hundred twenty-nine (n=229) African American women living in the United States, ages 18-49, who participated in the 2013-2014 National Health and Nutrition Examination Survey (NHANES) were the sample under study. A univariate analysis was performed to describe the population and obtain frequencies and percentages for all covariates. A bivariate analysis was conducted to determine whether there was an association between any of the independent variables and the dependent variable. A multivariable logistic regression was conducted to build a predictor model for use of HPV vaccination. Women between the ages of 18 and 34 were 7.22 times as likely to receive the HPV vaccine as women aged 35-49 years, and this was statistically significant (OR: 7.22; 95% CI: 2.36 - 22.13). This study can contribute to positive social change within the community and public health profession through an increased awareness and knowledge of HPV and cervical cancer, especially for African American women.

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Mothers typically act as gatekeepers to health care for their children, yet many Indigenous mothers report poor access to health services. Inadequate access to health services may contribute to the poor health outcomes experienced by Indigenous infants. Understanding how urban-dwelling Indigenous mothers experience selecting and using health services to meet the health needs of their infants is important to informing how health services can best support the needs of these families. This study employs qualitative interpretive description methodology guided by the Two-Eyed Seeing framework and Andersen’s Behavioural Model of Health Services Use. Interviews facilitated by ecomaps and a discussion group were conducted with 19 Indigenous mothers living in Hamilton with infants under the age of 2 years. Additional interviews with 12 health providers added further context to the mothers’ experiences. Results relate to three domains of health service use: primary care, acute care and early childhood health promotion services. Findings suggest that health providers can improve the access and use of health services by Indigenous mothers and infants through integrating three approaches to care: culturally safe care, trauma and violence-informed care and family centred care. While Indigenous-led supports may be better suited to meet the needs of Indigenous families, mainstream services can improve access and promote health service use through integrating these approaches to care. The findings have numerous implications for nursing education, practice and research as well as for health policy. Application of this evidence may result in equitable access to care, improved use of health services and better health outcomes for Indigenous infants and their families. / Thesis / Doctor of Philosophy (PhD) / Access and use of health care are important to health and wellness. Indigenous infants are known to have poorer health outcomes than non-Indigenous infants in Canada, yet little is understood of how their parents access health care to meet their health needs. This thesis uses qualitative methods, including interviews and a discussion group, to ask Indigenous mothers living in a city about their experiences selecting and using health services to meet their infant’s health needs. Interviews with health providers assist with understanding how health care is delivered to these families. The results provide important strategies for nurses and other health providers to improve how they provide care. This may then improve access to health services for Indigenous parents and ultimately lead to improved health outcomes for Indigenous infants and their families.

Syftet med denna studie var att undersöka kunskap och uppfattningar om papperslösas tillgång och rätt till vård hos personal inom öppen hälso- och sjukvård i Landstinget i Uppsala län. Ett ytterligare syfte var att undersöka om information kring handhavandet av papperslösa finns på arbetsplatserna, vad personal i så fall anser om detta, samt vad de önskar för information.   Studien är av en deskriptiv design med kvantitativ ansats. 86 anställda vid vårdcentraler i Uppsala län besvarade enkäter med frågor angående kunskap och uppfattningar om lagstiftning samt tillgång till och önskan om information gällande papperslösa. Insamlad data har sammanställts i Microsoft Excel och presenterats i tabeller och diagram.   Resultatet av studien tyder på att det finns en kunskapsbrist bland personal inom öppen hälso- och sjukvård angående lagstiftningen om papperslösas tillgång till sjukvård. Enligt de medverkandes vetskap finns ingen information tillgänglig på arbetsplatsen gällande papperslösa, och så gott som alla önskar information av något slag. Majoriteten av de tillfrågade anser att papperslösa ska ha samma rätt till vård som svenska medborgare.   Slutsatsen av denna studie är att det finns ett behov av information och riktlinjer gällande handläggning av papperslösa i Landstinget i Uppsala län. / The aim of this study was to investigate knowledge and opinions concerning undocumented migrants’ access and right to health care among employees within the primary health care sector in the county council of Uppsala. An additional aim was to investigate whether there is information available about management of undocumented migrants at the workplaces, and if so what the employees think about it and what kind of information they wish to receive.   The study is quantitative with a descriptive design. 86 employees at primary health care centres within the county of Uppsala answered questionnaires concerning knowledge and opinions about legislation as well as access to and demand for information concerning undocumented migrants. Collected data was compiled using Microsoft Excel and was then presented in tables and diagrams.   The result of the study indicates that there is a lack of knowledge among employees within the primary health care sector concerning legislation on undocumented migrants’ access to health care. According to the employees’ knowledge there is no information available at the workplace concerning undocumented migrants, and nearly everyone requested information of some kind. The majority of the employees are of the opinion that undocumented migrants should have the same right to health care as Swedish citizens.   The conclusion of this study is that there is a need for information and guidelines concerning management of undocumented migrants in the county council of Uppsala.

Darbo tikslas. Įvertinti pacientų pasitenkinimą terapinio profilio (neurologo, kardiologo, endokrinologo) ambulatoriškai teikiamomis paslaugomis apskrities ligoninės Konsultacinėje poliklinikoje. Tyrimo metodai. 2008-01-21 – 01-31 apskrities ligoninės Konsultacinėje poliklinikoje atlikta pacientų besikreipiančių neurologo, kardiologo ir endokrinologo konsultacijai anoniminė anketinė apklausa. Išdalinta 400 anketų. Užpildytos 387 anketos (atsako dažnis 96,75%). Statistinė duomenų analizė buvo atlikta personaliniu kompiuteriu, naudojant statistinės analizės SPSS 10.03 programinį paketą. Įvairūs pasitenkinimo aspektai įvertinti pagal Licherto skalę 5 balų sistemoje. Rezultatai. 89,2% respondentų buvo patenkinti arba labai patenkinti paslaugos kokybe. Labiausiai respondentus tenkino neurologo konsultacijos kokybė ir jų pasitenkinimas, išreikštas balų vidurkiu buvo 4,44 iš 5 galimų. 93,7% apklaustųjų buvo patenkinti gydytojų bendravimu. Gydytojų bendravimas labiausiai tenkino neurologo pacientus ir išreikštas balų vidurkiu buvo 4,52. 40,9% respondentų pateko pas gydytojus konsultacijai tą pačią ar kitą dieną, 20,7% - per 3-10 dienų nuo registravimosi. 10,6% respondentų laukė 11-14 dienų, 23,3% pateko po 2-4 savaičių, 4,5% laukė ilgiau nei mėnesį. Laukimo laikas tenkino 65,2% respondentų. Aukštesnio išsilavinimo ar jaunesnio amžiaus respondentai buvo mažiau patenkinti laukimu. Pasitenkinimas kardiologo konsultacijos laukimu buvo didžiausias (4,21 balo). 89,4%... [toliau žr. visą tekstą] / Aim of the study: to evaluate the patients satisfaction with out-patient care services in therapeutic care (neurology, cardiology, and endocrinology) at consultation clinics of county hospital. Material and methods. The anonymous survey was conducted in January 2008 at consultation clinics of county hospital. The sample comprised of patients seeking consultation of neurology, cardiology or endocrinology specialists. Altogether, 400 questionnaires were distributed, out of which 387 counted as properly fulfilled (response rate 96.75%). Statistical data analysis was performed using statistical package „SPSS for Windows 10.03“. The satisfaction items were evaluated using Likert scale (scoring 1 to 5). Results. Altogether, 89.2% of responders were satisfied with the quality of care. Mostly, they were satisfied with neurology consultations (average Likert score 4.44). The communication with physician was also evaluated highly – 93.7% of responders were satisfied with it. Again, this was mostly expressed in neurology (average Likert score 4.52). Access to consultation was different: 40.9% of patients got consultation the same or following day after registration, 20.7% following 3–10 days, 10.6% following 11–14 days, 23.3% following 2–4 weeks, and 4.5% waited for longer than one month. The duration of waiting time was evaluated as satisfactory by 65.2% of responders, with the highest scores in cardiology (average Likert score 4.21). Higher education and younger age was related with... [to full text]

Made available in DSpace on 2014-06-11T19:28:19Z (GMT). No. of bitstreams: 0 Previous issue date: 2008-11-13Bitstream added on 2014-06-13T18:57:20Z : No. of bitstreams: 1 torralbo_fap_me_botfm.pdf: 841128 bytes, checksum: 1051049ae02ad0a1f1564b88b23d7662 (MD5) / Secretaria de Saúde do Estado de São Paulo / Enquanto Supervisora Técnica da área da saúde da Fundação CASA, o interesse pela temática surgiu em decorrência da preocupação com o direito à saúde, garantido por lei. O objetivo da pesquisa foi compreender a percepção da equipe de saúde da Fundação CASA (médicos, enfermeiros e auxiliares de enfermagem) sobre o funcionamento do sistema de referência e contra referência da rede pública de saúde, quando se faz necessário o encaminhamento do adolescente. A metodologia, de caráter qualitativo, utilizou a fenomenologia. As entrevistas áudio-gravadas foram realizadas entre maio e agosto de 2007, após assinatura do termo de consentimento livre e esclarecido. Após as etapas de transcrição, redução e compreensão fenomenológica foram evidenciadas os temas e as categorias e. As categorias são: o acesso ao atendimento à saúde pelo SUS, a condição de ser adolescente em conflito com a lei, o direito à saúde e a organização dos serviços de saúde. Os achados mostram a importância do desenvolvimento de pactuações com os municípios, exigindo maiores responsabilidades dos serviços na formulação de políticas de saúde vinculadas ao adolescente, assim como deve ocorrer para qualquer cidadão. Isto implica, na necessidade de propostas de gestão e melhoria da organização conforme diretrizes e princípios do Sistema Único de Saúde. / As a health care Technical Supervisor for CASA Foundation, the interest in this topic arose from the concern about the right to health care, which is warranted by law. This study aimed at understanding the perception of the health care team working for CASA Foundation (physicians, nurses and nursing auxiliaries) as regards the functioning of the referral and contra referral system of the public health care network when adolescents’ referral is required. The qualitative methodology was used based on phenomenology. The audio-taped interviews were conducted from May to August, 2007 after a free and informed consent document was signed by the participants. Following the transcription, reduction and phenomenological comprehension phases, the topics and categories were shown. The categories are: access to health care through the Unified Health Care System (SUS), the condition of being an adolescent in conflict with the law, the right to health care and the organization of health care services. The findings show the importance of developing agreements among municipalities, requiring greater liability from services in the formulation of health care policies for adolescents, similarly to what should occur for any other citizen. This implies the need for management proposals and organization improvement according to guidelines and principles of the Unified Health Care System.