Esta Pesquisa tem como objetivo investigar os sentidos construídos acerca da assistência prestada e recebida em Hospital Psiquiátrico e em Centro de Atenção Psicossocial, sob a ótica de usuários e profissionais de saúde deste último. Para tanto, adota a Estratégia Qualitativa de Pesquisa, dentro das perspectivas teóricas da pós-modernidade, do social construcionismo e da desinstitucionalização. Seus resultados foram ordenados sob dois eixos temáticos e respectivas categorias que emergiram da fala dos sujeitos. Seguindo a trajetória histórica da assistência em saúde mental, o primeiro eixo temático diz respeito à assistência em Hospital Psiquiátrico e, o segundo em serviço substitutivo do tipo CAPS. Em relação ao primeiro, na ótica dos usuários, este espaço assistencial é tido como aprisionamento, onde vêem perdida a sua autonomia e obrigados a seguir normas rígidas e repetitivas; espaço pobre em relações, afeto e escuta, mas rico em produção de violência. Para estes mesmos sujeitos, o CAPS surge como uma porta que se abre às relações, aos contratos, à convivência mais estreita e respeitosa, com possibilidades que podem ser ativadas para a maior compreensão da pessoa que vivencia o sofrimento psíquico e melhoria da assistência recebida. Entre os profissionais, apesar das experiências negativas no processo de formação em Hospital Psiquiátrico, há a defesa da sua manutenção para o atendimento do usuário em crise. Por outro lado, o CAPS, para a maioria destes profissionais, é uma nova e criativa experiência, com aprendizados e faltas sentidas que se traduzem ainda num processo incipiente, porém, em construção de uma nova prática em saúde mental. Ao final, é realizada uma análise das dimensões políticas, históricas e culturais locais que condicionam os sentidos produzidos acerca da assistência em saúde no serviço substitutivo em questão e, são apontados desafios a serem superados; responsabilidades a serem compartilhadas e, caminhos possíveis e necessários para a mudança paradigmática. / This research has the objective of investigating the senses constructed by users and professionals of health about the assistance given and received both in the Psychiatric Hospital and in a Center for Psycho-Social Attention (CAPS). It adopts the Qualitative Strategy of Research, under the theoretical perspectives of Postmodernity; Social-Constructionism and Des - institutionalization guidelines. Its results were organized in two themes and respective categories that emerged from the interviews. Following the historical trajectory of assistance in Mental Health, the first theme refers to the assistance in the Psychiatric Hospital and the second to the CAPS. In the perspective of the users, the Hospital is like a prision, where they lose their autonomy and follow rigid and repetitive norms; it is a space poor in relationships, affection and listening, but rich in violence. For the same subjects, the CAPS appears as a door that opens to relationships, contracts, and respectful acquaintanceship, with the possibility of better understanding of the person who suffers and improvement of the assistance. The professionals, in spite of negative experiences during their formation in the Hospital environment, defend its maintenance for the attendance of the user in crisis. On the other hand, the CAPS, for the majority of these professionals, is a new and creative experience. Although the learning and the achievements are still in an incipient process, they point to the construction of a new practice in Mental Health. The analysis of the categories covers political, historical and cultural aspects that condition the produced meanings concerning Mental Health assistance in open services. It also detects the challenges to be surpassed; responsibilities to be shared and the possible and necessary ways for a change of paradigm.

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The diploma thesis focuses on the possibilities of a psychologist in the process of psychoprophylactic care of the mother, or both expectant parents. The theoretical part is trying to define the term psychoprophylactic antenatal care and map the situation in terms of the important personalities in the field of antenatal psychoprophylactic care and in terms of its historical context. Furthermore, it attempts to define the tasks of antenatal psychoprophylactic care, introduce the structure of courses, and map the current situation in this field in the Czech Republic. The research project conducted examines the importance of the psychologist's role during the pregnancy of an expectant mother and in the field of the antenatal care for the foetus in a qualitative manner. It investigates both the needs and attitudes of pregnant women, especially in the third trimester, and experienced psychologists, concerned in the area by the selected method of the semi-structured interview.

Poor health care delivery in rural communities is a major problem facing the health sector in Namibia. Patients who visit rural communities often wait on queues for several hours every day before they can be examined by a medical practitioner. This is detrimental to the health care process and impacts negatively on the efficiency and effectiveness of the sector. Mobile phones can however be employed as tools to improve work processes in such hospitals and as a result improve health care delivery in rural communities. The purpose of this study was to investigate the health care services provided to patients at Outpatient Departments (OPDs) in rural hospitals through the use of data collection instruments such as interviews, questionnaires, document analysis, expert validation and photographs in order to compile a Mobile Health Service Framework (MHSF) to improve healthcare delivery processes in OPDs. From an interpretive paradigm perspective, the qualitative design was used together with a case study approach. Three hospitals in rural communities were used as case studies. These were Okuryangava Hospital, Katutura Hospital and Khomasdal Hospital. Interviews were conducted and questionnaires distributed to the participants. The findings revealed that there is a high concentration of mobile phone usage in rural communities and there is a high usage of the SMS feature on such mobile phones. / Computing / M. Sc. (Computing)

Poor health care delivery in rural communities is a major problem facing the health sector in Namibia. Patients who visit rural communities often wait on queues for several hours every day before they can be examined by a medical practitioner. This is detrimental to the health care process and impacts negatively on the efficiency and effectiveness of the sector. Mobile phones can however be employed as tools to improve work processes in such hospitals and as a result improve health care delivery in rural communities. The purpose of this study was to investigate the health care services provided to patients at Outpatient Departments (OPDs) in rural hospitals through the use of data collection instruments such as interviews, questionnaires, document analysis, expert validation and photographs in order to compile a Mobile Health Service Framework (MHSF) to improve healthcare delivery processes in OPDs. From an interpretive paradigm perspective, the qualitative design was used together with a case study approach. Three hospitals in rural communities were used as case studies. These were Okuryangava Hospital, Katutura Hospital and Khomasdal Hospital. Interviews were conducted and questionnaires distributed to the participants. The findings revealed that there is a high concentration of mobile phone usage in rural communities and there is a high usage of the SMS feature on such mobile phones. / Computing / M. Sc. (Computing)

La conception d’un produit ou d’un service en Santé est un processus complexe et risqué. Il doit intégrer dans les phases précoces de conception les normes, les contraintes réglementaires, les données de surveillance et d’évaluation de la sécurité jusqu’à l’autorisation de mise sur le marché pour les dispositifs médicaux, mais également les préférences des utilisateurs experts : professionnels de santé ou non-experts : patients. Dans le marché compétitif des nouveaux produits ou services en Santé, l’enjeu pour les ingénieurs est de faire coïncider les besoins des utilisateurs à leur contexte et usages tout en intégrant toutes les parties prenantes du système de soin. Innovation médicale, technologique et organisationnelle, la télémédecine (TM) est l’utilisation des nouvelles technologies pour délivrer des actes médicaux. L’objectif de cette thèse est la mise au point d’une méthodologie centrée sur les utilisateurs et leurs usages pour concevoir, développer, intégrer et valider une application dermatologique de la TM : la télédermatologie. L’opportunité de validation de cette méthodologie pour intégrer et déployer un service innovant dans un service de dermatologie y est également discutée. / Designing product or services for healthcare system is highly complex, costly and risky. It combines constraints such as being a multi decisional and multilevel system with specific financial model linked to the state the healthcare system organization belongs to. In the highly marketing-time sensitive context of innovative products or services, there is challenge for designers to be able to match the new design to the users’ needs, answering to their context or usages while integrating all system stakeholder components. Telemedicine (TM) is the use of ITtechnologies to provide medical care or medical advice. It is considered a care delivery transformation combining medical, technological and organizational innovation. Using the example of Teledermatology a dermatological application of TM, this PhD develops a methodology based upon users contexts and usages to design integrate and provide an assessment model to decision makers. The opportunity to implement and integrate the service in French department of dermatology is discussed.

Whether it is offering services, delivering solutions or driving innovations, team work has been a hallmark of efficiency and effectiveness in various industries. The healthcare industry is not left out as its service delivery process involves numerous interfaces, information flows and patient hand-offs among professionals with different educational training, differing knowledge levels and possibly working from different locations as well. As healthcare delivery evolves to being more patient-centered, so does the team settings as well, becoming more collaborative. Such changes also translate into a need for support systems to evolve to be able to provide support for the extent of collaboration that would be needed. A framework is needed to guide in the development of such systems. However, due to the varying needs of patients, team types and make-up would generally differ, so we explored the different types of team settings studying what they entail based on their various degrees of collaboration. We therefore present in this thesis a model of team based concepts, an ontology formalizing the model, team based scenarios designed using the ontology and then application of the scenarios to test the ability of BPMN (Business Process Modeling Notation) to model healthcare teams.

Whether it is offering services, delivering solutions or driving innovations, team work has been a hallmark of efficiency and effectiveness in various industries. The healthcare industry is not left out as its service delivery process involves numerous interfaces, information flows and patient hand-offs among professionals with different educational training, differing knowledge levels and possibly working from different locations as well. As healthcare delivery evolves to being more patient-centered, so does the team settings as well, becoming more collaborative. Such changes also translate into a need for support systems to evolve to be able to provide support for the extent of collaboration that would be needed. A framework is needed to guide in the development of such systems. However, due to the varying needs of patients, team types and make-up would generally differ, so we explored the different types of team settings studying what they entail based on their various degrees of collaboration. We therefore present in this thesis a model of team based concepts, an ontology formalizing the model, team based scenarios designed using the ontology and then application of the scenarios to test the ability of BPMN (Business Process Modeling Notation) to model healthcare teams.

Whether it is offering services, delivering solutions or driving innovations, team work has been a hallmark of efficiency and effectiveness in various industries. The healthcare industry is not left out as its service delivery process involves numerous interfaces, information flows and patient hand-offs among professionals with different educational training, differing knowledge levels and possibly working from different locations as well. As healthcare delivery evolves to being more patient-centered, so does the team settings as well, becoming more collaborative. Such changes also translate into a need for support systems to evolve to be able to provide support for the extent of collaboration that would be needed. A framework is needed to guide in the development of such systems. However, due to the varying needs of patients, team types and make-up would generally differ, so we explored the different types of team settings studying what they entail based on their various degrees of collaboration. We therefore present in this thesis a model of team based concepts, an ontology formalizing the model, team based scenarios designed using the ontology and then application of the scenarios to test the ability of BPMN (Business Process Modeling Notation) to model healthcare teams.

Whether it is offering services, delivering solutions or driving innovations, team work has been a hallmark of efficiency and effectiveness in various industries. The healthcare industry is not left out as its service delivery process involves numerous interfaces, information flows and patient hand-offs among professionals with different educational training, differing knowledge levels and possibly working from different locations as well. As healthcare delivery evolves to being more patient-centered, so does the team settings as well, becoming more collaborative. Such changes also translate into a need for support systems to evolve to be able to provide support for the extent of collaboration that would be needed. A framework is needed to guide in the development of such systems. However, due to the varying needs of patients, team types and make-up would generally differ, so we explored the different types of team settings studying what they entail based on their various degrees of collaboration. We therefore present in this thesis a model of team based concepts, an ontology formalizing the model, team based scenarios designed using the ontology and then application of the scenarios to test the ability of BPMN (Business Process Modeling Notation) to model healthcare teams.