This thesis deals with health of nurses and nursing students. The World Health Organization defines health as follows: "Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity." This definition includes three components - physical, mental and social. In case that it comes to disharmony in one of the three components, it means a disorder of human health, what is subsequently blending into the other components. By this reason it is important for people to be concerned about their health properly. However, health care should not only be the task of health service. Everyone should realize the value of health and should have a big share of its sustaining. The thesis includes two parts. The theoretical part focuses on the prevention of health, personality of nurses and their health care. There is also described how can employers take care of nurses´ health and what lifestyle do the nursing students keep. The conclusion of the theoretical part deals with healthy lifestyle and proper observance of wholesome principles. The second part of this thesis presents an empirical part. The research has been realized in the form of quantitative survey. There were used electronic questionnaires within the research addressed to two groups of respondents, i.e. nurses and nursing students. The questions in the questionnaires have been focused on health and compliance being in accordance with the wholesome principles of respondents. The first research group has been formed of nurses who pursue their profession in various medical facilities in the Czech Republic.There have been provided five goals For the purpose of this research work. The purpose of the first goal has been to compare how the nurses and students keep their own health. The results showed that in the context of compliance with health wholesome activities are not striking differences between the nurses and students. Both groups (nurses, students) take care about their health almost to the same degree. There are no significant differences even in case of doing harmful activities (smoking, alcohol consumption, taking drugs). The second goal of this work has been to determine what health problems start the students their studies with. By the research there was found out that the most students have been gone on their studies with chronic health problems such as asthma and allergies (26%), diseases and musculoskeletal pains (17%) and diseases of gastrointestinal tract (11%). The third aim should determine whether their health - from the perspective of students - was changed during their studies. The results of that survey have showed that 17% of students really changed the state of their health during their studies. The fourth aim has been to find out which health problems take nurses to their jobs with. The nurses commence with more diseases and musculoskeletal pains (23%) following by asthma and allergy (14%) unlike the students. The last aim has been set in order to find out if the health status of nurses is changing during the pursuit of their professions. The results have been pointed out that 46% of nurses changed their health status during their careers.The thesis has been conceived very widely because of the extensive concept of health and healthcare. Moreover, the both experimental groups represent a large part of the population and include various differences. In this work have been outlined various issues that could definitely be a good basis for further research. In case that anyone would be able to deal with this issue, it could be good to split the two groups and focus on the specific problems of selected groups only. Definitely it is necessary to start dealing with the health status of nursing students.

O Programa de Saúde da Família (PSF) incorpora e reafirma os princípios do SUS e está estruturado a partir da Unidade de Saúde da Família, que se propõe a organizar suas ações sob os princípios da integralidade e hierarquização, territorialidade e cadastramento da clientela, a partir de uma equipe multiprofissional. O objetivo do estudo foi avaliar através de gráficos de tendências, se a expansão do PSF foi acompanhada por melhoras na saúde infantil nos municípios do estado do Rio de Janeiro, entre 1998 e 2010. A análise foi feita relacionando graficamente a utilização de serviços hospitalares como internações por pneumonias e desidratação na infância, procedimentos pediátricos, como taxas de aleitamento materno, utilização da terapia de reidratação oral e consultas de puericultura, com a taxa de cobertura do programa. A expansão do PSF pareceu estar relativamente pouco associada com aumento no número de consultas de puericultura, nas taxas de aleitamento materno e na utilização da terapia de reidratação oral e com diminuição nas internações por pneumonia e desidratação. Essas associações aparentemente fracas sugerem que o PSF pode não estar gerando os resultados desejáveis. Evidentemente, estudos adicionais são necessários a fim de analisar essas associações. / The family health program (PSF) incorporates and reaffirms the principles of the SUS and is structured from the family health unit, which aims to organize their actions under the principles of comprehensiveness and tiering, territoriality and customer registration, from a multidisciplinary team. The objective of this study was to evaluate through trend charts, whether the PSF expansion was accompanied by improvements in child health in municipalities of the State of Rio de Janeiro, between 1998 and 2010. The analysis was done by relating graphically using hospital services such as hospitalizations for pneumonia and dehydration in children, Pediatric procedures such as breastfeeding rates, use of oral rehydration therapy and childcare queries, with the coverage rate of the program. The PSF expansion seemed to be relatively little associated with increase in number of childcare queries in breastfeeding rates and the use of oral rehydration therapy and reduction in hospitalizations for pneumonia and dehydration property. These seemingly poor associations suggest that the PSF may not be generating the desired results. Of course, additional studies are needed to examine these associations.

O Programa de Saúde da Família (PSF) incorpora e reafirma os princípios do SUS e está estruturado a partir da Unidade de Saúde da Família, que se propõe a organizar suas ações sob os princípios da integralidade e hierarquização, territorialidade e cadastramento da clientela, a partir de uma equipe multiprofissional. O objetivo do estudo foi avaliar através de gráficos de tendências, se a expansão do PSF foi acompanhada por melhoras na saúde infantil nos municípios do estado do Rio de Janeiro, entre 1998 e 2010. A análise foi feita relacionando graficamente a utilização de serviços hospitalares como internações por pneumonias e desidratação na infância, procedimentos pediátricos, como taxas de aleitamento materno, utilização da terapia de reidratação oral e consultas de puericultura, com a taxa de cobertura do programa. A expansão do PSF pareceu estar relativamente pouco associada com aumento no número de consultas de puericultura, nas taxas de aleitamento materno e na utilização da terapia de reidratação oral e com diminuição nas internações por pneumonia e desidratação. Essas associações aparentemente fracas sugerem que o PSF pode não estar gerando os resultados desejáveis. Evidentemente, estudos adicionais são necessários a fim de analisar essas associações. / The family health program (PSF) incorporates and reaffirms the principles of the SUS and is structured from the family health unit, which aims to organize their actions under the principles of comprehensiveness and tiering, territoriality and customer registration, from a multidisciplinary team. The objective of this study was to evaluate through trend charts, whether the PSF expansion was accompanied by improvements in child health in municipalities of the State of Rio de Janeiro, between 1998 and 2010. The analysis was done by relating graphically using hospital services such as hospitalizations for pneumonia and dehydration in children, Pediatric procedures such as breastfeeding rates, use of oral rehydration therapy and childcare queries, with the coverage rate of the program. The PSF expansion seemed to be relatively little associated with increase in number of childcare queries in breastfeeding rates and the use of oral rehydration therapy and reduction in hospitalizations for pneumonia and dehydration property. These seemingly poor associations suggest that the PSF may not be generating the desired results. Of course, additional studies are needed to examine these associations.

Submitted by Irene Nascimento (irene.kessia@ufpe.br) on 2016-09-14T19:08:00Z No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) AlexcianePrisciladaSilva_MestradoIntegradoemSaúdeColetiva_2015.pdf: 3399629 bytes, checksum: 414d46d802901292ede4f3078b0102f9 (MD5) / Made available in DSpace on 2016-09-14T19:08:00Z (GMT). No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) AlexcianePrisciladaSilva_MestradoIntegradoemSaúdeColetiva_2015.pdf: 3399629 bytes, checksum: 414d46d802901292ede4f3078b0102f9 (MD5) Previous issue date: 2015-08-31 / Introdução – O redirecionamento da atenção às pessoas em sofrimento psíquico, da lógica hospitalocêntrica para o cuidado em rede, convive com a fragmentação do cuidado e a insuficiência de serviços extra-hospitalares. Diante disto, em 2011 o Ministério da Saúde instituiu a Rede de Atenção Psicossocial (RAPS) com objetivo de ampliar o acesso à atenção psicossocial e garantir a articulação e integração entre os serviços. Nesse contexto de integração e articulação, a regulação em saúde desponta como mecanismo capaz de organizar fluxos assistenciais que promovam o acesso equânime e o cuidado integral. Objetivo: analisar a organização da RAPS na cidade do Recife e o processo de regulação que incide sob a mesma. Metodologia: trata-se de um estudo qualitativo realizado em Recife – PE. Foram entrevistados 10 sujeitos vinculados à Gerência de Saúde Mental e à Secretaria Executiva de Regulação em Saúde. Para análise das entrevistas, utilizou-se a análise de conteúdo, a partir da técnica de condensação de significado. Documentos oficiais da gestão e dados extraídos dos sistemas de informações em saúde de base nacional complementaram a análise. Resultados: A RAPS Recife para adultos em sofrimento psíquico encontra-se em reorganização. Avançou na expansão de serviços, como a implantação dos leitos integrais de saúde mental em hospitais gerais e o aumento no número dos serviços residenciais terapêuticos e se adequa à formatação ministerial. Mas, a ausência de emergência psiquiátrica municipal e o insuficiente número de CAPS III são seus principais pontos de estrangulamento. A respeito da interface da regulação com a saúde mental, três aspectos se destacam, o processo de regulação que prevê a transformação do CAPS em uma unidade solicitante, com autonomia para marcação de consultas e exames; o processo de regulação dos fluxos de acesso às consultas psiquiátricas e psicológicas; e a supervisão nos serviços de saúde mental. Conclusão: A RAPS Recife encontra-se incompleta e insuficiente e apresenta lacunas que se expressam ora na ausência de pontos de atenção, como é o caso da emergência psiquiátrica municipal ou inexistência de centros de convivência, ora através da fragilidade de alguns de seus componentes, a exemplo a atenção psicossocial estratégica na qual o quantitativo de CAPS III apresenta-se insuficiente. Observa-se também que o estreitamento da relação entre a saúde mental e a regulação consiste em ganho ímpar para o funcionamento da RAPS, para a desconstrução do modelo de medicalização arraigado à prática ambulatorial e para a qualificação dos serviços através da supervisão. / Introduction - The redirection of attention to people in psychological distress, the hospitalcentered logic for network care, live with the fragmentation of care and lack of outpatient services. In 2011, the Ministry of Health established the RAPS in order to expand access to psychosocial care and ensure the coordination and integration between services. In this context of integration and coordination, health regulation emerges as a mechanism capable of organizing assistance flows that promote equitable access and comprehensive care. Objective: To analyze the organization of RAPS in Recife and the regulation process that focuses on the same. Methodology: This is a qualitative study conducted in Recife - PE. They interviewed 10 subjects linked to Mental Health Management and the Executive Secretariat of Health regulation. For analysis of the interviews, we used the content analysis, from the meaning of condensation technique. Official documents management and data extracted from information systems in national primary health complemented the analysis. Results: The RAPS Recife for adults in psychological distress is in reorganization. Made progress in expanding services such as implementation of the whole mental health beds in general hospitals and the increase in the number of residential care and to suit ministerial formatting. But the absence of municipal psychiatric emergency and the insufficient number of CAPS III are its main bottlenecks. Regarding the regulation interface with mental health, three aspects stand out, the process of regulation which provides for the transformation of CAPS in a requesting unit, with autonomy for appointments and tests; the process of regulation of flows access to psychiatric and psychological consultations; and supervision in mental health services. Conclusion: RAPS Recife is incomplete and inadequate and has gaps that now express themselves in the absence of points of attention, such as the municipal psychiatric emergency or lack of community centers, sometimes through the fragility of some of its components, example strategic psychosocial care in which the amount of CAPS III presents insufficient. It also notes that the strengthening of the relationship between mental health and regulation consists of odd gain for the operation of the RAPS, to the deconstruction of the medicalization model rooted in clinical practice and for the qualification of services over the supervision.

This thesis is an exploration of the perspectives of recipients and providers of health and criminal justice services about the transitional support needs of arrestees and remand prisoners, leaving short-term custody. The study implements Constructive Grounded Theory Methods, underpinned by the Network Theory of Social Capital as the theoretical framework. Forty-two semi-structured interviews were conducted, with five participant groups; service users (arrestees/remand prisoners), family/carers, mental health staff (criminal justice liaison and mental health in-reach, community mental health teams), criminal justice staff (police/prison officers) and mental health commissioners. Participants provided unique perspectives about the health and social support, available at the transitional points of leaving short-term custody. This was supported by the construction of 11 sociograms for service users, in both arrest (n=5) and remand (n=6) situations, to highlight the availability and functionality of support networks. Transitions are particularly problematic in relation to linking offenders with appropriate community-based mental health services. The over-arching constructed grounded theory is a need for a culture shift within health policy and practice to refocus on transitional care planning to optimise continuous care pathways. Associated themes include ‘lack of practical assistance’, ‘lack of crisis support’, ‘returning to the security of prison’ and ‘poor transition planning’. Critical Time Intervention, a variant of case management has demonstrated benefits when applied to mental health and offender populations, transiting from hospital and prison settings. The programme contains all the components of service that service users, carers and staff identified as important to effectively support transitions from short-term custody to the community.

This dissertation considers the issue of equivalence and the related matter of solidarity in the health insurance sector. The used methodology is an analysis on the basis of which the specific causes of the current state of the healthcare system are investigated. The initial chapters focus on the theoretical basis and insurance principles in general, and then health insurance in more detail. The individual systems (models) of healthcare, which are compared with the aim of finding the optimum method of financing the healthcare sector, are then described. The analytical section looks at the current state of healthcare in the Czech Republic and the main problems it faces: an ageing population and constantly rising healthcare costs, which are slowly becoming uncontrollable. Healthcare reform, which began on 1 January 2008 with the introduction of regulation fees, is also evaluated. A great deal of attention is paid to fees because the legality of their introduction is being settled by the Constitutional Court of the Czech Republic. In conclusion, the author outlines a healthcare system that would be, in his opinion, more financially manageable, and just more equitable and fair.

The final thesis follows up the quality of health care. This topic has been nowadays much discussed and is very current. The aim of this work was to bring the issue of health care quality and analyze the quality of health care in the facility Dr. Pírko Clinic by using a questionnaire to research the satisfaction of it's patients.

The thesis analyses the healthcare system in Germeny after the 1990s. The aim is to analyse the changes in the positions of insured persons within the system, as well as both internal and external factors which resulted in these changes. The role of insured persons is different than in the 1990s. Reforms and their impacts with regard to key players, especially patients are described in each chapter. The analysis is devided into four chapters, which are dedicated to the systém of insurance as such, the health care providers and the role of informations for the insured persons, subsequently. At the end, the influence of reunification is analysed. The thesis formulates conditions on which more responsibility and more decision-making opportunities are given to insured persons or taken away from them. Moreover, the role of external factors is described (e. g. the pharmaceutical industry, the development of media or macroeconomic development). Information sources used for the analysis derive from sickness funds, sickness fund unions, expert recommendations, legislation or programmes of political parties. The thesis concludes that the role of sickness funds has been strengthened, but the utilization is not as rational as it seems and is inhibited by some other factors. In a broader context, the conclusions...

In dieser Arbeit wurde das Konzept der Gesundheitszirkel auf das Arbeitsfeld der Kinderbetreuung in Kindertagesstätten adaptiert und in sieben Einrichtungen mit insgesamt 73 Erzieherinnen und Leiterinnen evaluiert. Die gesamte Intervention "Gesundheitszirkel in Kindertagesstätten" bestand aus der Entwicklung eines Manuals, der Konzeption und Umsetzung einer Qualifizierungsmaßnahme für die Moderatoren der Zirkel und der von zwei Moderatorinnen realisierten fünf bis sechs Sitzungen umfassenden Gesundheitszirkel. Die betrieblichen Gesundheitszirkel wurden nach der wissenschaftlich evaluierten Basis des Düsseldorfer Modells ausgerichtet. Das Ziel dieser Studie war zu überprüfen, ob das Manual und das Qualifizierungsseminar als praxisorientierte Anleitung für die Umsetzung der Gesundheitszirkel dienen und ob sich das adaptierte Konzept für die Problemerkennung und ?bearbeitung in Kindertagesstätten eignet. Um diese Fragen zu beantworten, wurde eine Struktur-, Prozess- und Ergebnisevaluation durchgeführt. Insgesamt wurden die Teilnehmerinnen viermal befragt: dreimal während der Intervention und einmal zwei Monate nach Abschluss der Zirkel. Die Moderatorinnen beurteilten die Qualifizierung und das Manual als hilfreich für die Umsetzung des Gesundheitszirkels und gestalteten die Sitzungen entsprechend den Vorgaben aus dem Leitfaden. Von der Mehrheit der Teilnehmerinnen wurde sowohl die Moderation als auch die Moderationsmethode positiv und strukturierend über die Messzeitpunkte hinweg gleich bleibend beurteilt. Den Erwartungen, dass im Gesundheitszirkel Problembereiche benannt, eigene Vorschläge geäußert und über gesundheitliche Auswirkungen der Arbeit gesprochen werden können, stimmten die Befragten in hoher Ausprägung zu. Die Beschäftigten waren mit den Rahmenbedingungen des Gesundheitszirkels während der gesamten Intervention sehr zufrieden. Die Auswertung der Intervention lässt sich in die Ergebnisse anderer Evaluationsstudien von Gesundheitszirkeln einordnen. Ebenso entsprechen die erhobenen Informationen zur Arbeitsbelastung den in der Literatur erhobenen Faktoren. Somit ist das Verfahren auch in andere Einrichtungen übertragbar und eignet sich als Verfahren betrieblicher Gesundheitsförderung in Kindertagesstätten.

Das Ziel dieser Studie war es, die mundgesundheitsbezogene Lebensqualität (MLQ) bei Patienten mit rheumatoider Arthritis (RA) unter Berücksichtigung krank- heitsspezifischer Parameter zu bewerten. Dabei sollte eine Analyse der verschiedenen Dimensionen der MLQ, wie Funktionseinschränkungen des Kausystems, psychosozialer Einfluss, orofaziale Schmerzen sowie dentofaziale Ästhetik, durchgeführt werden.