The diploma thesis consists of two parts: Theoretical and Empirical. The Theoretical Part explains the basic meaning of the expression Intensive Care, the types of Intensive Care, its history and provides a description of an intensive care workplace and the health personnel working in Intensive Care (their education and competence). The thesis also deals with patients in Intensive Care and their needs. The objective of the Empirical Part was to ascertain the Czech general public knowledge and attitudes towards Intensive Care, their experience with Intensive Care as a patient or a person close to the patient. The methodology of the Empirical Part consists in a survey using questionnaires among Czech general public. The questionnaire was answered by 259 respondents. On the basis of statistical evaluation of respondents' data made by a statistics computer program, we found out the Czech general public is able to define the notion of Intensive Care and those who had their own experience with an intensive care workplace described the setting of the place as positive, which was a surprising finding. However, we also found out the respondents of our survey still lack information, and they would, therefore, appreciate to receive an information leaflet whenever entering into contact with an intensive care...

Thailand has faced under-nutrition and yet, paradoxically, the prevalence of diseases of over-nutrition, such as obesity and diabetes, has escalated. Since access to diabetes prevention programs is limited in Thailand, especially in rural areas, it becomes critical to develop a health information delivery system that is relevant, cost-effective and sustainable. Therefore, the main objective of this program is to build capacity for chronic disease prevention in Thailand through application of learning technologies in the education, support and accreditation of community health care workers (CHCWs). This program stems from established partnerships among: The University of Waterloo (UW), Department of Health Studies and Gerontology; Institute of Nutrition, Mahidol University (INMU); The Office of Disease Prevention and Control 10 Chiang Mai province; Ministry of Public Health (MOPH), Thailand and UW, Centre for Teaching Excellence (CTE) . The development of the community-based diabetes prevention education program in Chiang Mai, Thailand was informed by in-depth interviews with health care professionals (n=12) and interviews (n=8) and focus groups (n = 4 groups, 23 participants) with community volunteers, screened as at-risk for diabetes. Coded transcripts from audio-taped interviews or focus groups underwent qualitative analysis by hand and using NVivo software. Health care professionals identified opportunities to integrate health promotion/ disease prevention into CHCWs’ duties. However, they also identified potential barriers to program success as motivation for regular participation, and lack of health policy support for program sustainability. Health care professionals supported an education program for CHCWs and recommended small-group workshops, hands-on learning activities, case studies and video presentations that bring knowledge to practice within their cultural context; CHCWs should receive a credit for continuing study. Community volunteers lacked knowledge of nutrition, diabetes risk factors and resources to access health information. They desired two-way communication with CHCWs. A tailored diabetes prevention education program was designed based on this formative research. Learning modules were delivered over eight group classes (n=5/class) and eight self-directed E-learning sessions (www.FitThai.org). The program incorporated problem-based learning, discussion, reflection, community-based application, self-evaluation and on-line support. The frequency that students accessed on-line materials, including video-taped lectures, readings, monthly newsletters, and community resources, was documented. Participant satisfaction was assessed through three questionnaires. Knowledge was assessed through pre-post testing based on an exam that was pilot tested with 32 CHCWs from a district outside of the 5 districts in semi-urban Chiang Mai province from which the 69 participating CHCWs (35 intervention, 34 control) were randomly selected. The program was implemented over four months. Three quarters of participants attended all eight classes and no participant attended fewer than six. Online support and materials were accessed 3 – 38 times (median 13). Participants reported that program information and activities were fun, useful, culturally relevant, and applicable to diabetes prevention in their specific communities. Participants also appreciated the innovative technology support for their work. Comfort with E-learning varied among participants. Scores on pre-post knowledge test increased from a mean (SD) of 56.5% (6.26) to 75.5% (6.01) (P < .001). The effect of the program on knowledge of CHCWs was compared between intervention and control communities at baseline and the end of the program. Overall, the knowledge at baseline of both groups was not significantly different (56.5% (6.26) intervention versus 54.9% (6.98) control) and all CHCWs scored lower than 70%. The lowest scores were found in the “understanding of nutritional recommendations” section (mean score = 28% in intervention and 30% in control CHCWs). After 4 months, CHCWs in the intervention group demonstrated improvement relative to the control group (75.5% (6.01) versus 57.4% (5.59), respectively, p <.001, n=69). The percent of CHCWs achieving a total score of 70% was 77% (27/35) in intervention and 0% in control groups. The diabetes prevention education program was effective in improving CHCWs’ health knowledge relevant diabetes prevention. The innovative learning model has potential to expand chronic disease prevention training of CHCWs to other parts of Thailand. Ultimately, prevention of chronic diseases and associated risk factors should be enhanced.

Thailand has faced under-nutrition and yet, paradoxically, the prevalence of diseases of over-nutrition, such as obesity and diabetes, has escalated. Since access to diabetes prevention programs is limited in Thailand, especially in rural areas, it becomes critical to develop a health information delivery system that is relevant, cost-effective and sustainable. Therefore, the main objective of this program is to build capacity for chronic disease prevention in Thailand through application of learning technologies in the education, support and accreditation of community health care workers (CHCWs). This program stems from established partnerships among: The University of Waterloo (UW), Department of Health Studies and Gerontology; Institute of Nutrition, Mahidol University (INMU); The Office of Disease Prevention and Control 10 Chiang Mai province; Ministry of Public Health (MOPH), Thailand and UW, Centre for Teaching Excellence (CTE) . The development of the community-based diabetes prevention education program in Chiang Mai, Thailand was informed by in-depth interviews with health care professionals (n=12) and interviews (n=8) and focus groups (n = 4 groups, 23 participants) with community volunteers, screened as at-risk for diabetes. Coded transcripts from audio-taped interviews or focus groups underwent qualitative analysis by hand and using NVivo software. Health care professionals identified opportunities to integrate health promotion/ disease prevention into CHCWs’ duties. However, they also identified potential barriers to program success as motivation for regular participation, and lack of health policy support for program sustainability. Health care professionals supported an education program for CHCWs and recommended small-group workshops, hands-on learning activities, case studies and video presentations that bring knowledge to practice within their cultural context; CHCWs should receive a credit for continuing study. Community volunteers lacked knowledge of nutrition, diabetes risk factors and resources to access health information. They desired two-way communication with CHCWs. A tailored diabetes prevention education program was designed based on this formative research. Learning modules were delivered over eight group classes (n=5/class) and eight self-directed E-learning sessions (www.FitThai.org). The program incorporated problem-based learning, discussion, reflection, community-based application, self-evaluation and on-line support. The frequency that students accessed on-line materials, including video-taped lectures, readings, monthly newsletters, and community resources, was documented. Participant satisfaction was assessed through three questionnaires. Knowledge was assessed through pre-post testing based on an exam that was pilot tested with 32 CHCWs from a district outside of the 5 districts in semi-urban Chiang Mai province from which the 69 participating CHCWs (35 intervention, 34 control) were randomly selected. The program was implemented over four months. Three quarters of participants attended all eight classes and no participant attended fewer than six. Online support and materials were accessed 3 – 38 times (median 13). Participants reported that program information and activities were fun, useful, culturally relevant, and applicable to diabetes prevention in their specific communities. Participants also appreciated the innovative technology support for their work. Comfort with E-learning varied among participants. Scores on pre-post knowledge test increased from a mean (SD) of 56.5% (6.26) to 75.5% (6.01) (P < .001). The effect of the program on knowledge of CHCWs was compared between intervention and control communities at baseline and the end of the program. Overall, the knowledge at baseline of both groups was not significantly different (56.5% (6.26) intervention versus 54.9% (6.98) control) and all CHCWs scored lower than 70%. The lowest scores were found in the “understanding of nutritional recommendations” section (mean score = 28% in intervention and 30% in control CHCWs). After 4 months, CHCWs in the intervention group demonstrated improvement relative to the control group (75.5% (6.01) versus 57.4% (5.59), respectively, p <.001, n=69). The percent of CHCWs achieving a total score of 70% was 77% (27/35) in intervention and 0% in control groups. The diabetes prevention education program was effective in improving CHCWs’ health knowledge relevant diabetes prevention. The innovative learning model has potential to expand chronic disease prevention training of CHCWs to other parts of Thailand. Ultimately, prevention of chronic diseases and associated risk factors should be enhanced.

Thesis (Ph.D.)--Mississippi State University. School of Human Sciences. / Title from title screen. Includes bibliographical references.

Made available in DSpace on 2014-12-17T14:46:52Z (GMT). No. of bitstreams: 1 ReginaCD_DISSERT.pdf: 4065706 bytes, checksum: 3728d95ddfb6dc0370f79da6d3a87956 (MD5) Previous issue date: 2011-12-19 / This research, which appears in the form of a dissertation, entitled: Integrative Therapy Community: construction of a listening space to health care workers in primary care, addresses the Integrative Community Therapy (ICT) as a tool to create meeting spaces between health professionals where they can be receptive among one another. With the completion of this study aimed to analyze the ICT as a therapeutic approach and space of listening and speaking for health professionals cited here in order to identify their anxieties, doubts, worries and uncertainties arising from the context of labor relations and the impact of therapeutic experiences under the view of the participants. It was developed as an action-science research, involving several steps. The field of research was the ICT meetings of workers from the units under the Family Health Strategy of Northern Health Districts I and II of the city of Natal, using a qualitative approach. The interpretation of data collected was based on content analysis proposed by Bardin. Finally, this study showed the ICT as a space for dialogue and sharing, with repercussions on labor relations and expansions beyond the ICT meetings, reaching out to family and social relationships, contributing to creating bonds and solidarity networks. Under the view of the participants it was recognized as an experience that optimized the socialization, promoting the alleviation of suffering and increasing the well-being. Based on the study findings, it is inferred that ICT can be considered a viable tool for the receptiveness and humanized care of health care workers. / Esta pesquisa, que se apresenta no formato de uma disserta??o de mestrado, cujo t?tulo ?: TERAPIA COMUNIT?RIA INTEGRATIVA: constru??o de um espa?o de escuta para os trabalhadores da aten??o b?sica da sa?de, aborda a Terapia Comunit?ria Integrativa (TCI) como ferramenta para a cria??o de lugares de encontros entre os profissionais da sa?de, nos quais cada componente pode acolher o outro e ser acolhido tamb?m. Com a realiza??o desse estudo, objetivou-se analisar a referida terapia como abordagem terap?utica e espa?o de escuta dos depoimentos dos profissionais aqui citados, visando identificar suas ang?stias, d?vidas, inquietudes e incertezas decorrentes do contexto das rela??es de trabalho, bem como a repercuss?o das viv?ncias terap?uticas na vis?o dos participantes. O mesmo foi desenvolvido como uma pesquisa-a??o que envolveu v?rias etapas. Seu campo de investiga??o foram as rodas de TCI com trabalhadores das Unidades da Estrat?gia Sa?de da Fam?lia dos Distritos Sanit?rios Norte I e II do munic?pio de Natal-RN, utilizando-se uma abordagem qualitativa. A interpreta??o dos dados obtidos foi fundamentada na an?lise de conte?do proposta por Bardin. Por fim, este trabalho evidenciou a TCI como um espa?o de di?logo e de partilha, com repercuss?es nas rela??es de trabalho e expans?es para al?m das rodas, alcan?ando as rela??es familiares e sociais e contribuindo para a cria??o de v?nculos e a forma??o de redes solid?rias. Na vis?o dos participantes, este estudo foi reconhecido como uma experi?ncia que aperfei?oou a socializa??o, promoveu a atenua??o de sofrimentos e potencializou o bem-estar. Diante das conclus?es, infere-se que a TCI pode ser considerada uma ferramenta vi?vel para o acolhimento e cuidado humanizado dos trabalhadores da sa?de.

Background: The aim of palliative care is to keep the quality of life by integrating a person-centered care at the end of life. Palliative care and hospice care do not focus only on symptoms and medication. Self-esteem, dignity and support were major components for the patient at the end of life. Aim: The aim of this study was to describe how palliative care is given at a hospice in a developing country. Method: The used method was a qualitative participant observation study. The participants were health care staff at a hospice, they were chosen before the study began. The observation took place three times per week for six weeks. The researcher intertwined volunteering and observing at the same time. The data was analyzed with a qualitative content analysis. Result: The study resulted in six categories: environment, nursing records, nursing care, infection control and meals. Conclusion: The conclusion was that nature and safety had a big impact on the environment. The health care staff worked as a team to fulfill their goals. / Bakgrund: Syftet med palliativ vård är att hålla välbefinnandet genom att integrera en personcentrerad vård i livets slutskede. Palliativ vård och hospicevård fokuserar inte bara på symptom och medicinering. Självkänsla, värdighet och stöd är viktiga komponenter för patienten i livets slutskede. Syfte: Syftet med denna studie var att beskriva hur palliativ vård ges på ett hospice i ett utvecklingsland. Metod: Den använda metoden var en kvalitativ deltagande observationsstudie. Deltagarna var vårdpersonal på ett hospice, de valdes innan studien började. Observationen ägde rum tre gånger per vecka i sex veckor. Forskarna sammanflätade volontärarbetet och observationen samtidigt. Uppgifterna analyserades med en kvalitativ innehållsanalys. Resultat: Studien resulterade i sex kategorier: miljö, omvårdnads register, omvårdnad, infektionskontroll och måltider. Slutsats: Slutsatsen var att natur och säkerhet hade stor inverkan på miljön. Vårdpersonalen arbetade som ett team för att uppfylla sina mål.

The aim of this study was to create an understanding of how unit managers and care workers work with user influence in connection with elderly moving to nursing homes. This study was delimited to analyze two nursing homes in a medium-sized municipality in southern Sweden. The study was based on qualitative semi-structured interviews from two unit managers and six care workers in nursing homes. To analyze the data, Michael Foucault’s theory about power, Pierre Bourdieus's concept of doxa and symbolic power have been used as well as client construction. The result of this study indicates that elderly are given the opportunity to influence through implementation plans, welcome talks, being listened to, relationship-building, feeling homelike, resignation and reluctance, adaption to the conditions that are available and rethinking. The results of the study also shows that elderly were transformed and adapted according to the nursing homes guidelines and routines when moving in. Therefore, there were opinions taken for granted and not questioned within the organizations. With this basis, situations that caused limited influence of the elderly were excused and justified according to the organizations´ implied logic, which was deeply rooted in the workplace structure including the unit managers and care workers.

Text in Afrikaans / Die huisouermodel word tans internasionaal in kinderhuise gevolg. ’n Huisouer of huisouerpaar tree as surrogaatouer(s) op en woon saam met die kinders in ’n huis in ’n gewone woonbuurt, weg van die hoofkampus van die kinderhuis. Direkte waarneming van die daaglikse funksionering van huisouers binne die huisouermodel het die navorser bewus gemaak van die kompleksiteit van die huisouer(s) se take. Die doel van hierdie navorsing was gevolglik om ’n verkennende studie te onderneem, ten einde te bepaal watter bydrae kernrolspelers kan lewer om huisouers binne die huisouermodel van ’n kinderhuis in die uitvoering van hulle take te ondersteun. Om hierdie doel te bereik is ’n kwalitatiewe navorsingstudie uitgevoer waartydens semi-gestruktureerde onderhoude met huisouers en kernrolspelers van drie satelliethuise van ’n kinderhuis, as data-insamelingsmetode benut is. Die kwalitatiewe data is geanaliseer en die bydrae wat kernrolspelers kan lewer om huisouers in die uitvoering van hulle take te ondersteun, is beskryf. / Internationally, children’s homes follow the houseparent model. A houseparent or houseparent couple act as surrogate parent(s) and live with children in a home, away from the main campus of the children’s home. Direct observation of the functioning of houseparents within the houseparent model brought awareness with regards to the complexity of houseparents’ tasks. The goal of this research was to conduct an exploratory study to determine what contribution key role players can make to support houseparents within the houseparent model with the fulfilment of their tasks. To achieve this goal, data was gathered through the application of a qualitative research study, utilising semi-structured interviews that were conducted with houseparents and key role players within three satellite homes. The qualitative data was analysed and the contribution that key role players can make to support houseparents in the fulfilment of their duties was described. / Social Work / M. Diac. (Spelterapie-rigting)

Made available in DSpace on 2014-07-29T15:30:43Z (GMT). No. of bitstreams: 1 DISSERTACAO DE MESTRADO JULIANA ROSA.pdf: 303226 bytes, checksum: 9585889e11363ca2d5297656fdeae6e5 (MD5) Previous issue date: 2008-04-17 / Coagulase negative staphylococci (CNS) is in human and animal microbiota, but may cause with infections with significant morbidity and mortality rates. Healthy care workers may be carriers of many microorganisms and spread resistant ECN in the hospital. This study aimed to identify the CNS species isolated from healthy care workers saliva, establishe the oxacillin resistance pattern and detect the mecA gene in resistant isolates. We evaluated 100 ECN, isolated from the saliva of an institution of professional health of large Riberão Preto in Sao Paulo state. The ECN identification was based on biochemical tests, and 41 were identified as S. epidermidis, 25 S. saprophyticus, 18 S. haemolyticus, 8 S. cohnii, 4 S. lugdunenses, 3 S. capitis, and 1 S. simulans. Thirty-two percent were nonsusseptible to oxacillin, 84.4% to mupirocin, 43.7% to cefoxitin, but all were vancomycin susceptible. The oxacillin nonsusseptible ECN, detected by disk diffusion test were grown in agar screening oxacillin (6 &#956; g) supplemented with sodium chloride (4.0%) and submited to mecA detection by the PCR. Of the 32 nonsusseptible oxacillin CNS,, 93.7% developed in the oxacillin agar and the mecA gene was detected in 75.0%. This is the first report of mecA gene presence in CNS isolated from the saliva of healthy care workers. Attention must be given to CNS species identification, as well as the characterization of the nonsusceptible microorganisms, since healthy care workers may represent a reservoir of CNS / Estafilococos coagulase negativa (ECN) fazem parte da microbiota autóctone humana e animal, embora possam causar infecções. Profissionais da saúde podem ser portadores de inúmeros microrganismos virulentos entre eles os ECN resistentes a oxacilina que podem ser disseminados por esses profissionais. O estudo teve como objetivo identificar espécies de ECN isolados da saliva de profissionais da saúde, de uma instituição de saúde de grande porte em Riberão Preto no estado de São Paulo, determinar o perfil de resistência à oxacilina e detectar o gene mecA. Foram avaliados 100 ECN, e através de testes bioquímicos 41 estafilococos foram identificados como S. epidermidis, 25 S. saprophyticus, 18 S. haemolyticus, 8 S. cohnii, 4 S. lugdunenses, 3 S. capitis e um S. simulans. Trinta e dois por cento apresentaram resistência in vitro a oxacilina, 84,4% a mupirocina, 43,7% a cefoxitina, e todos suscetíveis a vancomicina. Os ECN resistentes a oxacilina, detectados pelo teste de disco difusão, foram cultivados no agar triagem oxacilina (6µg) suplementado com cloreto de sódio e a detecção do gene mecA foi realizada pela técnica de PCR. Dos 32 ECN resistentes a oxacilina, 93,7% desenvolveram no agar oxacilina e o gene mecA foi detectado em 75,0% das amostras analisadas. Vale ressaltar que este estudo é pioneiro em mostrar a presença do gene mecA em ECN isolados da saliva de profissionais da saúde saudáveis. Uma maior atenção deve ser dada na identificação das espécies de ECN, e na caracterização da resistência desse grupo de microrganismos, uma vez que os profissionais da saúde podem representar um reservatório de ECN resistentes

This investigation was concerned with the problem that the staff development needs of child-care personnel in juvenile detention facilities in the State of Texas have not been identified and described. The study utilizes the Delphi technique in determining juvenile detention administrators' perceptions of the skills/knowledge required to be a competent detention child-care worker. The assumption was made that detention administrators can supply relevant input to study.