Made available in DSpace on 2016-08-10T10:55:57Z (GMT). No. of bitstreams: 1 Landia Fernandes de Paiva Soares.pdf: 483046 bytes, checksum: f24a51c0d461e46cb58c2b77fe0c9589 (MD5) Previous issue date: 2005-01-03 / Over the last two decades, the ethical problems of Medicine and Biological Sciences blew up in our society with great intensity, which constituted a challenge to contemporary ethics to provide a common moral standard for solving controversial issues coming from biomedical sciences and high technologies applied to health with the lack of care by life-care workers. Facing such matters, the Health Ministry has developed the Hospital Humanization National Program which is based upon a change of behavior between workers and the health system users, as a change in the service given to the user, aiming at rescuing the care which is the essence of human being. Based on this, our study investigates the impact of the humanization program in the everyday life of health workers in the city of Goiânia. 218 questionnaires were given to higher educated workers who work in the unities implementing the humanization process. Correlations among satisfaction with performed activities, workplace, working time, workload, earnings and religion with the humanized care were analised. We have also investigated the information workers have concerning the health humanization program and their participation as actors in this process. We have noted that they are in favor of the humanization process, but their adherence was not significant, in spite of all effort shown in the implementation of such process. We have discussed that humanizing theory is being assimilated only as a model of service, without the understanding of social changes proposed by this program. / Nas duas últimas décadas, os problemas éticos da medicina e das ciências biológicas explodiram em nossa sociedade com grande intensidade, constituindo um desafio para a ética contemporânea providenciar um padrão moral comum para a solução das controvérsias provenientes das ciências biomédicas e das altas tecnologias aplicadas à saúde com a falta de cuidado por parte de profissionais que lidam com a vida. Mediante tais problemas o Ministério da Saúde desenvolveu um Programa Nacional de Humanização Hospitalar que se baseia em uma mudança de postura entre profissionais e usuários do Sistema Ú nico de Saúde, como mudança no acolhimento e atendimento ao usuário, buscando resgatar o cuidar que é essência do ser humano. Com base nesse quadro, este estudo investiga o impacto do Programa de Humanização no cotidiano dos profissionais de saúde do Município de Goiânia. Os participantes foram 218 profissionais de nível superior que trabalham nas unidades piloto de implantação do processo de humanização. Foram analisadas as correlações entre satisfação com as atividades desempenhadas, local de trabalho, tempo de serviço, carga horária trabalhada, remuneração e religião com o cuidar humanizado. Investigou-se, também, as informações que os trabalhadores tem a respeito do programa de humanização da saúde e a sua participação como atores deste processo. Constatou-se que eles são favoráveis ao processo de humanização, mas a adesão dos trabalhadores não foi significativa, apesar de todo o empenho realizado na implantação de tal processo. Discute-se que a teoria da humanização está sendo assimilada apenas como modelo de atendimento, sem a compreensão acerca das mudanças sociais que são propostas por este programa.

Thesis (M.A. (Nursing Science)) --University of Limpopo, 2018 / Introduction and background The shortage of human resources in rural areas remains a crisis, especially in subSaharan Africa, affecting rural primary health centres. The purpose of this study was to identify and describe factors influencing the retention of health care workers in rural clinics, in order to develop strategies to improve retention in rural clinics. Methodology A quantitative research method and descriptive design was used in this study. The population was professional nurses and operational managers in rural clinics. Simple random sampling was used to select the clinics, the professional nurses and operational managers. The sample size were 210 professional nurses and operational managers. Only 170 professional nurses and operational managers participated in the study. Data were collected using a questionnaire, and all ethical principles were adhered to. The data was analysed using SPSS version 22.0. Results The study revealed that there are complex interconnecting factors that affect retention. It was further revealed that age is the core factor affecting retention (P= 0.001) with 19 (100%) of those aged < 30 years intending to leave rural practice. Furthermore, more than half of the respondents 118 (87.06%) were dissatisfied with the salary they earned. Only 1 (0.6%) of the respondents had a masters’ degree. Conclusion It is therefore concluded that both financial and non-financial incentives such as education, improving working conditions and relationship with colleagues needs to be incorporated in order to improve nurse retention. Key words: Retention, migration, rural health care workers, job satisfaction

No description available.

Problem Statement: The burden of musculoskeletal injuries among workers is very high, particularly so in direct care workers involved in patient handling. Efforts to reduce injuries have shown mixed results. Strong evidence for intervention effectiveness is lacking.<p> Specific Aims: The goal of this study was to evaluate the effectiveness of a patient handling injury prevention program implemented in the Saskatoon Health Region (SHR) comparing it with a non-randomized control group, Regina QuAppelle Health Region (RQHR), in a pre-post design. Injury rates, lost-time days, and claim costs were the outcomes of interest.<p> Intervention: A Transfer, Lifting and Repositioning (TLR) program, consisting of engineering and administrative ergonomic controls, was implemented in SHR hospitals from 2002-2005.<p> Methods: Data on time loss and non-time loss injuries, lost time days, and claims costs were collected from the SHR and RQHR for corresponding time periods one year pre and one year post-intervention. Age, length of service, profession, and sex were selected as covariates. Full Time Equivalents (FTE) data were collected for each time period. Univariate and multivariate Poisson regression were performed.<p> Results: Rates for all injuries (number of injuries/100 FTE) dropped from 14.68 pre-intervention to 8.1 post-intervention. Control group all injury rates, while overall lower in absolute value, dropped to a lesser degree, from 9.29 to 8.4. Time loss injury rates decreased from 5.3 to 2.51 in the SHR, while they actually increased from 5.87 to 6.46 in the RQHR, for the same intervention periods. Poisson regression showed the greatest reduction in injury rate, both time loss (Rate ratio=0.48, 95% C.I: 0.34-0.68) and non-time loss (Rate Ratio=0.25, 95% C.I: 0.15-0.41) in the smaller long term care facility controlling for hospital size. Analysis of injury rates, incidence rate ratios, and incidence rate differences showed significant differences between the intervention and comparison group for all injuries and time loss injuries. Mean claim cost/injury decreased from $3906.20 to $2200.80 and mean time loss days/claim decreased from 35.87 days to 16.23 days for the SHR.<p> Conclusions: The study provides evidence for the effectiveness of a multi-factor TLR program for direct-care health workers, and emphasizes their implementation, especially in smaller hospitals.

Sammanfattning  För att förhålla sig till en modern och föränderlig omgivning genomgår idag många offentliga  verksamheter stora förändringar i sina sätt att styra organisationen. En av de största förändringar  som skett är möjligheten för privata aktörer att köpa upp och bedriva verksamheter, något som  tidigare bedrivits i kommunal regi. Äldreomsorgen är en av de sektorer som idag står inför stora  organisatoriska utmaningar där omsorg ska kombineras med strategier som tidigare främst tillhörde  marknaden.  Den forskning som har gjorts på området är tvetydig och ger inga klara besked om de effekter som  privatiseringen har för varesig personal eller vårdtagare. Vi ville därför undersöka ett privatiserat  äldreboende för att studera vilka marknadsmässiga tendenser det kan uppvisa samt hur personalen  upplever sin arbetssituation.  Uppsatsens resultat visar att äldreboendet har flera marknadsmässiga inslag och att personalen i det  stora hela verkar mycket nöjda med sin arbetssituation. Vidare framgår de fördelar en privatisering  kan innebära för både anställda och vårdtagare beträffande kvalitet och utbud, men även de  svårigheter som uppstår i omsorgsarbetet då omsorg som en relativt oförutsägbar verksamhet inte  tillfullo kan anpassas till företagsmässiga visioner och strategier.  Nyckelord: Äldreomsorg, privatiseringens effekter, standardisering, individuell omsorg,  omsorgspersonal. / Abstract  To respond to a changing and contemporary environment many organisations in the public sector  changes in their way of controlling the organisation. One of the biggest changes is the ability of  private actors to buy and practice care, which were previously conducted by the municipality.  Elderly care is one of the sectors which are currently facing major organisational challenges where  care will be combined with strategies that previously belonged to the market sector.  The research that has been done in this area is ambiguous and gives no clear answer about the  effects that privatisation has. Therefore we wanted to investigate a privatised home for the elderly to  study the market trends that can exhibit and how staff perceives their work situation.  The result shows that the home for the elderly has market elements and their staff seems very  pleased with their work situation. The study shows that there are benefits of privatisation for both  employees and patients regarding quality and supplies, but the study also shows the difficulties that  occur in the care work when care, which is an unpredictable activity, not fully can be adapted to  market visions and strategies.  Keywords: Elderly care, effects of privatisation, standardisation, individual care, care workers.

Personality, ways of coping and occupational burnout were examined within the context of child care work, using a number of self-report questionnaires. Subjects included 70 full-time child care workers from children's homes in the Natal-KwaZulu area. The subject sample was treated as one group, as environmental sources of stress were perceived more or less consistently across the population. Stepwise multiple regression was used to assess the relationships between personality (neuroticism, extraversion) and ways of coping and the three facets of burnout (emotional exhaustion, depersonalisation and personal accomplishment). Demographic variables such as age and experience were also explored. Varying degrees of burnout were found, with particularly high levels of diminished personal accomplishment. Both emotion- and problem-focused coping strategies contributed significantly to the burnout response, with emotion-focused coping being the most frequently reported coping strategy. Significant relationships were found between personality and burnout. Neuroticism contributed a significant proportion of the variance in all three dimensions of burnout, particularly emotional exhaustion and depersonalisation. Extraversion and psychoticism contributed significantly to higher levels of personal accomplishment. A significant relationship was found between personality and ways of coping. Neuroticism contributed significantly to the prediction of emotion-focused coping strategies, particularly wishful thinking and self-blame. Extraversion was found to contribute significantly to problem-focused coping and growth-oriented coping. Demographic variables, particularly age and experience, were found to influence both burnout and coping responses. Ethnic identity was found to influence the coping strategies used. The results were discussed primarily in terms of their function as defenses, or as efforts to adapt (successfully or unsuccessfully) to the stress being experienced, and as vulnerability factors. The importance of contextual factors in the stress and burnout process, particularly within the current South African context, was highlighted. Recommendations for future research were made. / Thesis (M.Soc.Sc.)-University of Natal, Pietermaritzburg, 1997.

This exploratory study focused on identifying the stuctural indicators of high quality childcare that are associated with high levels of caregiver sensitivity. The participants in the study were 318 caregivers employed in 234 Canadian childcare centres. Caregivers were observed in their centres and their sensitivity was rated using the Caregiver Interaction Scale (Arnett, 1989). Structural indicators of quality were identified through a Centre Questionnaire and a Staff Questionnaire developed for the You Bet I Care! study (Goelman et al. 2000) sent to centres prior to the observations. Using a median split, the caregivers' scores were divided into high and low scores and the structural indicators of the two groups were compared. The results were analysed first considering the scores of all observed caregivers together and then as two separate groups: caregivers of infants and toddlers and caregivers of children aged 3 to 6 years. The analysis revealed that certain features of the centre and characteristics of the caregiver were associated with higher levels of caregiver sensitivity. The features of the centre that were associated with caregiver sensitivity included financial issues (eg. wages), staff development, centre administration, and characteristics of the children in the centre. Characteristics of the caregivers that were associated with sensitivity were caregiver attitudes and beliefs, caregiver feelings about their work, and level of education. The results of this study suggest that caregiver sensitivity which is related to positive developmental outcomes for children may be enhanced through the active support of the larger community.

Background and Research Problem: It is well-known that nurses around the world are exposed to various forms of violence at their workplaces. In psychiatric facilities, many of these incidents are perpetrated by patients against nurses. There is a perception that the current legislation and regulations in the country do not adequately protect psychiatric nurses (health care workers in general) against workplace violence. The preliminary literature suggested that most quantitative studies on workplace violence in psychiatric facilities have concentrated on secondary and tertiary psychiatric hospitals looking at the prevalence, the association between demographic factors and violence behaviour, nurses‟ therapeutic responses, and the impacts on the quality of care. Studies on workplace violence in a psychiatric facility for adults with intellectual disability in the country are limited. Secondly, it appeared from the preliminary literature review that similar studies have not looked at this phenomenon from the individual resilience perspective.Therefore, this study will seek to determine the factors associated with the psychological response of nurses‟ victims of inpatient violence in a psychiatric facility for adults with intellectual disability in Cape Town.Aim: To determine factors associated with the psychological response of nurses‟ victims of in-patient violence in a psychiatric facility for adults with intellectual disability in Cape Town. Objectives: To describe the (1) individual resilience of nurses working at a psychiatric facility for adults with intellectual disability; (2) psychological response of nurses‟ victims of in-patients‟ violence at a psychiatric facility for adults with intellectual disability; and (3) association between the individual resilience characteristics and the psychological responses of nurses victims of in-patients‟ violence in a psychiatric facility for adults with intellectual disability.Methodology: Descriptive-exploratory design using a quantitative approach was used.All categories of nurses (professional nurse, enrolled nurse and enrolled nursing assistance) working at the psychiatric facility for adults with intellectual disability were eligible for the study. Convenient sampling was conducted to select 127 participants who met the inclusion criteria. Self-administered questionnaire was used to collect data. Data was analysed using the SAS V9.3 computer programme. Ethical clearance was obtained from University as well as approval from the management of the psychiatric facility prior to approaching the study participants. Results: The results of the study showed high level of resilience among nurses on Assessment of Resilience Scale (82.9%, n=104); nurses psychological responses to violence were equally distributed between avoidance (mean =4.65 and SD=1.36), intrusion (mean= 4.55 and SD=1.50), hyper arousal (mean=4.46 and SD=1.60) resulting in total mean of 13.67 (SD=4.14) on the revised Impact of Event Scale (IES-R). Measure of association between resilience and the impact of violence on the psychological wellbeing of nurses showed that nurses with high resilience score (82.9%, n=104) fitted the symptoms of PTSD on the IES-R. Spearman Rank correlations (r) analysis showed the total scores of IES-R (r=0.04, p=0.68), avoidance (r=0.01, p= 0.34), intrusion (r=0.08,p=0.34), and hyper-arousal (r= -0.002, p=0.97). Further research looking at the nurses‟ reliance and their responses using resilience theory is needed. / Magister Curationis - MCur

Background Hospital-acquired infections are significant cause of morbidity and mortality among hospitalized patients worldwide. Healthcare workers during job are exposed to blood borne pathogens through contact with infected body parts, blood and body fluids. World health organization (WHO) estimated that globally about 2.5% of HIV and 40% of hepatitis viral infected cases are among health workers due to exposures. The most important mechanism of spread of these pathogens is through contaminated hands of the healthcare workers. Standard precautions measures are essential to prevent and control healthcare associated infection among healthcare workers and patients. In developing countries despite the development of detailed guideline for infection control the knowledge of standard precautions is low and not properly applied. The aim of this study is to assess the knowledge and practice of health care workers regarding standard precautions and hand hygiene to infectious disease control.  Aim The aim of this study was to assess the knowledge and practice of health care workers regarding hand wash and standard precautions to control infectious diseases in BMCH. In addition create awareness among participants and encourage them to practice regularly hand hygiene and standard precautions to control or reduce nosocomial infections in health care facilities Methods The study design is cross-sectional evaluation of healthcare worker knowledge and practices about standard precautions and hand hygiene for infectious disease control. A questionnaire administered to health care workers (doctors and nurses). The questionnaire was divided in two parts and the first part concerns demographic information, asking knowledge and practice. The second part asked opinions about risk and prevention of HAIs. The questionnaire was developed with consultation of other studies of the same kind. It has been pre tested and is finalized for survey. The ethical approval was given by hospital superintendent and informs consent from all study participants. Statistic analysis was done on Excel and statistical software SPSS version 20. Data was described in numbers, percentages and Chi Square test done for association among categorical variables, significant level was considered P= &lt;0.05. Results Two hundred questionnaires were distributed to HCWs in BMCH and 169 completely fill questionnaire were returned. The male gender respondents were 42% and female respondents were 58%. The basic questions about knowledge of hand hygiene and standard precautions were answered well in both categories; about 73% were with sufficient knowledge. The practice of hand hygiene and standard precautions was not satisfactory among both categories; about 47% found with good practice. Differences found in sub groups, young age none trained doctors and nurses answered wrong and shown lack of knowledge. This study found an association of age, profession and job experience with knowledge and practice regarding hand hygiene and standard precautions. Open handed questions described well the major issue regarding HAIs and participants emphasized on risk and prevention methods.  Conclusions The respondents were HCWs (doctors and nurses) of both sex and this study found that majority of HCWs have good knowledge and practice about control of HAIs but difference were found in age groups, sex and profession. Above half of the HCWs were not trained for infection control in health facilities, thus getting training of infection control is important but more important is implementation of it during practice.

The purpose of this study was a comparative analysis of the perceptions of parents and caregivers concerning appropriate discipline of young children enrolled in child care. A questionnaire, the Parent and Caregiver Perceptions Concerning Appropriate Discipline for Young Children Enrolled in Child Care Questionnaire (PCPQ), was designed by the researcher. Through the use of a Likert scale, respondents indicated their agreement or disagreement with statements derived from various discipline philosophies. This survey was distributed to the parents and caregivers of young children enrolled in 17 licensed child care facilities throughout the state of Indiana. Of the total sample, 1,963 persons, respondents included 592 parents and 312 caregivers. Diverse ages and educational levels were represented. Females represented the largest group of respondents. While most of the parents were married, the caregivers were evenly divided between single and married. The mean response for caregiver teaching experience was 4.57 years. Factor analysis resulted in three factors with reliability coefficients above .65. Of the 40 items on the survey, only four were eliminated from further analysis due to a lack of reliability. Factor I included items related to the Need for Discipline, Factor II was related to the Need for Consistency, and Factor III was related to the Need for Authority. The mean score for each factor was computed. A multivariate analysis of variance (MANOVA) was conducted at the .05 level of significance.Results1. There was a difference in the perceptions of parents and caregivers concerning appropriate discipline of young children enrolled in child care. The hypothesis, there is no difference in the perceptions of parents and caregivers concerning appropriate discipline of young children enrolled in child care, was rejected, F(3,674) _ 4.58, R = .003.2. Univariate F-tests were conducted to determine if the independent variable (parent or caregiver) differed on all three dependent variables (Factors I, II, or III) or on just one. The difference was primarily in Factor II, The Need for Consistency, F(1,676) = 5.75, p = .017. Parents and caregivers had similar perceptions regarding Factor I; they agreed with the need for discipline. Parents and caregivers did not have similar perceptions regarding Factor II; parents agreed and caregivers more strongly agreed with the need for consistency. Regarding Factor III, they had similar perceptions in that they sometimes agreed and they sometimes disagreed with the need for authority. / Department of Elementary Education