Objective: To examine the perception of patient safety culture amongst health care workers in Libyan Hospitals. Study Design: The study adopted a mixed methods approach with 2 phases. Phase 1 was conducted prior to the Libyan revolution. This was a quantitative research study, which used the Survey of Hospital Patient Safety Culture (HSOPSC) that was developed by the US Agency for Health Care Research and Quality (AHRQ, 2004). Phase 2 was conducted post revolution and it was a qualitative research study, which used semi-structured interviews. Setting: The three largest hospitals which were located in the Northeast of Libya were involved in the study. Participants and sampling: Phase 1 of the study included a stratified sample of 346 health care workers who were working as Doctors, Nurses, Technicians, Pharmacists and Managers. Phase 2 of the study used a purposeful sample which involved 27 health care workers from those took part in the survey study. Main Outcome Measures: The survey measured twelve Patient Safety Culture dimensions. It indicated that ten of the twelve dimensions were weak and need to be improved. The interview findings also showed that the 12 patient safety culture dimensions were very weak and shed light on some of the reasons for this sub-optimal practice. Findings: The respondents who took part in the study were from different departments in the three hospitals. The survey showed the dimensions with acceptable positive ratings were teamwork within hospitals and organizational learning and continuous improvement, while those with lowest ratings included frequency of reporting errors, non-punitive response to error and communication and openness. Approximately 60% of health care workers perceived patient safety culture practice in Libya negatively. Twenty respondents (5.8%) who gave an excellent grade for patient safety in their hospitals. Furthermore, the interviews results revealed that patient safety culture dimensions were very weak. The interview explored further factors and issues of poor safety culture in the 3 hospitals; which had not been identified in the survey. These were related to results of the political changes, administrative factors, environmental issues, organisational system issues, and health care workers matters. Conclusions: The study identified that the current state of patient safety culture in Libyan hospitals is very weak and there is a need for improvement to safety practice and for promotion of this important issue amongst those health care workers and health managers working at the frontline of health care delivery. Furthermore, the study found that the level of patient safety in the 3 hospitals was below an unacceptable level according to the perceptions of the health care staff. It was noted that there was no effective patient safety system in any of the 3 hospitals to deal with patient safety issues and there were no proactive patient safety measures in place to reduce the level of risk to patients. Furthermore, the study revealed other significant aspects that represent a serious threat to patient safety in the 3 hospitals, which were mainly due to poor hospital management, ineffective emergency services and a lack of training programmes. Moreover, poor organisation of monitoring systems for the licensing of medical practice of health care workers was shown to have a significant impact on patient safety culture. Lastly, the study showed the political change in Libya had affected patients’ safety sharply as result of the military conflict and the lack of hospitals’ preparedness to cope with such emergency events.

Made available in DSpace on 2014-06-11T19:29:36Z (GMT). No. of bitstreams: 0 Previous issue date: 2007-04-20Bitstream added on 2014-06-13T19:59:24Z : No. of bitstreams: 1 braga_lc_me_botfm_prot.pdf: 1494494 bytes, checksum: d6f4463b7f3357dd599df502be0fa068 (MD5) / Vários estudos revelam que os transtornos mentais comuns (TMC) apresentam elevada prevalência em populações comuns e de trabalhadores, dentre os quais, os profissionais de saúde. Trata-se de transtornos com conseqüências individuais e sociais importantes. Os objetivos deste estudo consistiram em estimar a prevalência de TMC em trabalhadores da saúde e investigar possíveis associações com variáveis sócio-demográficas, satisfação no trabalho e situação demanda / controle / suporte. Trata-se de estudo transversal, descritivo, efetuado junto à população de servidores da rede básica de saúde de Botucatu - SP. A coleta de informações, executada de abril a outubro de 2006, foi efetuada por meio de questionário auto-aplicável, não identificado, composto por 92 questões. Dentre estas, havia sub-conjuntos de perguntas, com destaque para itens abordando satisfação no trabalho, demanda / controle / suporte e presença de sintomas de transtorno mental comum (Self Reporling Questionnaire, SRQ-20). As informações foram inseridas em banco de dados construído com o programa Excel / Office XP 2003 e as análises estatísticas foram efetuadas por meio do pacote estatístico SAS. Constatou-se que 42,6% dos servidores apresentavam transtorno mental comum. Encontrou-se associação entre TMC e: (a) atividade profissional com escolaridade média e com escolaridade superior; (b) unidades a que pertenciam os servidores; (c) situação relativa à demanda / controle; (d) as pontuações relativas às demandas psicológicas no trabalho discriminaram melhor a ocorrência de TMC (método da árvore de classificação e de regressão para análise de relações entre variáveis). No tocante à satisfação no trabalho, 71,2% dos servidores tiveram pontuações que os enquadraram em muito satisfeitos e satisfeitos com o trabalho... / Many studies have shown that common mental disorders (CMD) have high prevalence among general population and workers, especially health care workers. These are mental disorders which have important individual and social consequences. The objectives of the present study were estimate the prevalence of CMD among primary health care workers, and investigate possible associations with social-demographic variables, job satisfaction, and demand ! control! support situation. This transversal and descriptive study was carried out on Primary Care workers of Botucatu - SP. The data were collected, from April to October of 2006, using one anonymous autoaplicable questionnaire composed of 92 questions. Among these questions there were a sub-group of questions related to job satisfaction, demand ! control! support situation, and presence of CMD symptoms (Self Reporling Questionnaire, SRQ-20). The data were stored using the software Excel! Office XP 2003, and the statistical analyses were performed in SAS system. It was observed that 42,6% of the health care workers presented CMD symptoms. It was also noticed an association among CMD and: (a) activities of secondary and graduation; (b) Heath care unit of work; (c) Demand ! control situation; (d) Psychological requirements at work Date-related points best discriminated the occurrence of CMD (c1assification and regression tree method to analyze the relationship among the variables). For job satisfaction 71,2% of the workers considered to be content or very content with their work. Job satisfaction was related to: (a) the work period is the most important period of the day; (b) possibility to continue working with the same job during next years; (c) degree of work interference with personal and family life. The lack of respect and verbal aggressions, lack of comprehension from patients/users of the Service, and...( Complete abstract click eletronic access below)

Made available in DSpace on 2014-07-29T15:30:39Z (GMT). No. of bitstreams: 1 Dissertacao Michelle Cristina Guerreiro dos Reis.pdf: 617682 bytes, checksum: a9f91c7541dba56bdf16a1188367288a (MD5) Previous issue date: 2007-12-12 / Tuberculosis (TB), one of the oldest disease in the world, is until our days a public health concern. It s believed that one third of the world s population is latently infected. Brazil is an endemic area for TB and its incidence in 2005 was about 60 cases per 100.000 inhabitants. One of the most important challenge in TB control is the identification of individuals who are latent infected. Health Care Workers (HCW) are at high risk of getting infected with Mycobacterium tuberculosis and because of that they had increased chances to became ill. The aim of this work was to elucidate the sorological profile of latent infected HCW through the antibody response against proteic recombinant antigens from Mycobacterium tuberculosis, GLcB, Hspx and MPT51. It was observed that almost 70% of HCW presented antibodies (IgM and IgG) against these antigens. When IgM was measured, the negative TST HCW showed higher antibodies s levels than the positive TST HCW. When IgG was measured, negative and positive TST HCW showed similar antibodies´s levels. Men and women also showed similar antibodies´s levels against those antigens. The antibodies s levels were also similar between BCG-vaccinated and BCG non-vaccinated HCW, the same occurs among the different professional categories. There isn t any relation between the antibody responses (humoral response) and TST results (cellular response). These results showed that the majority of the HCW presented antibodies against the proteic recombinant antigens GLcB, Hspx e MPT51 of Mycobacterium tuberculosis independent of the TST response. / A tuberculose (TB) é uma das doenças mais antigas do mundo e permanece até os dias atuais como um problema de saúde pública. Estima-se que um terço da população mundial está infectada. O Brasil é considerado área endêmica da TB e em 2005 apresentou taxe de incidência de 60 casos a cada 100.000 habitantes. Atualmente um dos principais desafios no controle da tuberculose é a identificação dos portadores latentes. Trabalhadores da área da saúde são expostos a um alto risco de infecção e por isso têm aumentadas as chances de se tornarem portadores latentes. Com intuito de elucidar o perfil sorológico de portadores latentes, avaliamos a resposta imune humoral de trabalhadores da área da saúde frente a antígenos recombinantes do Mycobacterium tuberculosis, GLcB, Hspx e MPT51, utilizando a técnica do ensaio imunoenzimático (ELISA). Constatou-se que quase 70% dos trabalhadores da saúde apresentaram anticorpos contra tais antígenos. Nas dosagens de IgM apenas naquela contra o Hspx os trabalhadores da saúde prova tuberculínica (PT) negativa apresentaram níveis de anticorpos superiores aos dos trabalhadores PT positiva. Nas dosagens de IgG trabalhadores PT negativa ou positiva apresentaram níveis semelhantes de anticorpos. Homens e mulheres apresentaram níveis similares de anticorpos (IgM ou IgG) contra os antígenos recombinantes. Os níveis de anticorpos de indivíduos BCGvacinados e BCG-não-vacinados também foram semelhantes, bem como entre indivíduos de diferentes categorias profissionais, independentemente da classe da imunoglobulina testada. Não houve correlação entre nível de anticorpo (resposta humoral) e o resultado da prova tuberculínica dos trabalhadores da saúde (resposta celular). Os resultados deste trabalho permitem concluir que os trabalhadores da área da saúde reconhecem os antígenos protéicos recombinantes GLcB, Hspx e MPT51 do Mycobacterium tuberculosis independentemente de reação à prova tuberculínica.

Child and youth care workers in residential care provide support and intervention to young people who are experiencing difficulties in their lives. Caring for these young people can be complex and demanding and many child and youth care practitioners struggle to meet the challenges associated with their roles. Practice problems include volatile and punitive environments, inability of practitioners to safely manage young people’s threatening and aggressive behaviours, and staff turnover and burnout. These problems are often attributed to job stress, personal characteristics of practitioners, and lack of education, training, and professional development. To reconceptualise the aforementioned practice problems, Robert Kegan’s (1982) constructive-developmental theory was used as a theoretical framework to explore the experiences of child and youth care workers in residential care. The research was guided by 2 main questions: 1. How do different meaning-making systems influence how practitioners cope with and experience the demands of the job? 2. What role does the organizational environment play, if any, in mediating or exacerbating the demands of the job for practitioners with different meaning-making systems? An exploratory study was conducted using a mixed methods design. The study was conducted in two stages. First, 99 participants completed the Professional Quality of Life Scale (ProQOL), Work Environment Scale (WES), and Leadership Development Profile (LDP). Linear regression was conducted to explore the relationships between the ProQOL, LDP, and WES and most results were not significant. From the initial pool, 18 participants were selected for in-depth, qualitative interviews to assess their constructive-developmental orders – the ways in which they make meaning - and explore their experiences in residential care in the areas of job satisfaction and success, challenge, and coping with the demands of the job. The ways in which participants at different constructive-developmental orders experience and cope with the challenges of their jobs are described and themes are identified. There was internal coherence among participants of the same epistemological order and across organizations. This dissertation examines implications of the findings for child and youth care practice, education, training, supervision, research, and organizational management in residential care. / Graduate

Knowledge translation describes the process of getting knowledge into practice, leading to a healthy workforce and economy. Knowledge translation is particularly challenging at the primary healthcare level, which manifests as a research to practice gap. This research aimed to explore and describe knowledge translation from both a knowledge translation organisation’s and knowledge user’s point of view at the South African primary healthcare level. A qualitative dominant, mixed methods approach was used. Twelve semi-structured interviews were conducted with nine organisations to evaluate their knowledge translation strategies. An online survey collected responses from primary healthcare workers to assess their knowledge needs and preferences. Lastly, the Thinking Processes of Theory of Constraints were applied to the public sector to identify ways in which knowledge translation can be optimised within the Department of Health system. This research found that the organisations’ strategies were inextricably linked to the knowledge translation context. Barriers to knowledge translation in the public and private sector as well as urban and rural areas differed in many respects. Organisations were successful in overcoming many of these barriers, but barriers that reside at the Department of Health (DOH) policy level, remain difficult to address. The 82 survey respondents were mostly doctors from the urban private sector. They represented a distinct subset of practitioners who preferred using the internet to access knowledge and identified no significant barriers to staying up to date. The Thinking Processes identified possible solutions to getting new DOH guidelines into practice in a fast, reliable and coordinated manner. This requires increased collaboration between knowledge translation organisations and the DOH as well as the design of a system for updating the DOH guidelines on an annual basis. / Dissertation (MBA)--University of Pretoria, 2013. / ccgibs2014 / Gordon Institute of Business Science (GIBS) / MBA / Unrestricted

Magister Scientiae Dentium - MSc(Dent) / Tuberculosis is the world’s leading cause of death from a single infective agent. The World Health Organisation has declared the disease a “global emergency”. Extrapulmonary presentations form a major proportion of new cases, especially since the advent of the acquired immunodeficiency syndrome epidemic. Therefore, it is important that oral health care workers are aware of tuberculosis in the head and neck region and its varied manifestations. This study reports on one hundred and four patients diagnosed with tuberculosis and with head and neck tuberculosis lesions.The aim of the study was to determine the extent to which tuberculosis presents in the head and neck region. It was a descriptive, retrospective, record-based study on a cohort of tuberculosis patients that presented with head and neck tuberculosis at private practices in the Durban area over a fourteen month period. A structured data capture sheet was the method chosen for recording the data.The majority of the sample (89.4%) had tuberculosis of the head and neck lymph nodes, five (4.8%) had tuberculosis of the tonsil, two (1.9%) had tuberculosis of the larynx, two (1.9%) had tuberculosis of the ear, one (1%) had parotid gland tuberculosis and one (1%) had tuberculosis of the nose. The records indicate that excision biopsy and histopathological examinations were used to make a diagnosis. A third (33.7%) of the patients were confirmed with human immunodeficiency virus infection.A high index of suspicion of tuberculosis is important in the differential diagnosis of neck swellings, hoarseness and otorrhoea and in human immunodeficiency virus positive patients with an enlarging neck mass. A biopsy is usually necessary for diagnosis. Successful outcome depends upon appropriate chemotherapy and timely surgical intervention when necessary. Oral health care workers need to be fully cognizant of all the various presentations of head and neck tuberculosis to allow early diagnosis and quick commencement of appropriate treatment.

Magister Artium (Social Work) - MA(SW) / Primary Health Care (PHC) is the cornerstone of health care globally, nationally and locally and, therefore, should be regarded as the foundation of health care provision. In South Africa, Community Day Clinics (CDCs) are part of the bouquet of services that is being offered at a PHC level. There are various factors that generate inconsistency in the provision of care to people accessing these CDCs. The purpose of this study was to identify and explore how these factors impact on the care practices that health care professional’s provide. Research suggests that the majority of health care workers are women, who play a double role as carers in their professional and private lives. Therefore, the political ethics of care, a feminist theoretical approach, was utilized to understand care practices in these health settings. The aim of the study was to develop an in-depth understanding of the care practices of health care workers at two CDC facilities on the Cape Flats. A qualitative research methodology was used to explore and identify the phenomenon under study. The research project followed an explorative and descriptive research design, as the researcher sought to understand the care practices of health care workers and how their values and ethics further influenced care practices at these two CDC settings. The data was gathered using semi-structured one-on-one interviews, and later analysed using qualitative thematic analysis. The research findings were grouped in terms of the values entrenched in the political ethics ofcare, which are attentiveness, responsibility, competence, responsiveness and trust. The research findings identified various aspects that, either negatively or positively, impact on these values. Finally, recommendations were made to management, as well as care workers. These recommendations were in terms of implementing care services that are attentive to service-users and care-workers; providing a service that takes into consideration the value of responsibility; the provision of competent services; and finally creating trusting relationships within the CDC.

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. / Education, Faculty of / Curriculum and Pedagogy (EDCP), Department of / Graduate

No description available.

Thesis (MPH.) -- University of Limpopo (Medunsa Campus), 2011 / INTRODUCTION: The human immune deficiency virus (HIV) leads to the acquired immune deficiency syndrome (AIDS). AIDS was first identified in the 1980’s and since then has spread globally causing one of the most dreaded pandemics of modern time. The issue of stigma is very important in the battle against HIV/AIDS as it affects attendance at health centres for obtaining ARV and regular medical check-ups, adherence of patients to ARV treatment. The fear of stigma further helps to fuel a culture of secrecy, silence, ignorance, blame, shame and fear of victimization. AIM: The aim of this study was to determine if there was any external stigmatization of HIV positive patients by health care workers (HCWs) at King Edward VIII Hospital. OBJECTIVES: To determine if the knowledge of HCWs regarding HIV/AIDS and its transmission affect the way they supply a service towards HIV positive patients at King Edward VIII Hospital and to determine the comfort level and the attitude of the HCWs in rendering care to a HIV positive patient. METHODOLOGY: This was a cross sectional survey where data was collected using an anonymous selfadministered structured questionnaire with closed ended questions on personal and professional characteristics, disease knowledge, and discriminatory practices such as attitudes and comfort levels towards people living with HIV/AIDS (PLWHA). A total of three hundred and thirty four HCWs from different units at the King Edward VIII hospital participated in this study. FINDINGS Overall the HCWs have an above average knowledge about HIV/AIDS and its transmission with only 1.8% scoring below average in the knowledge questions regarding HIV and its transmission, although some knowledge gaps were identified regarding occupational exposure risks. Evidently from the results is that HCW with higher levels of education are more knowledgeable on issues relating to HIV/AIDS. The implication is that a HCW with a better education is better equipped with the cognitive knowledge to deal with HIV/AIDS, highlighting the importance of education related to external stigmatization. Even though HCWs were knowledgeable about HIV/AIDS most still felt uncomfortable in performing some occupational duties on PLWHA like assisting a woman in labour and performing invasive surgical operations. Most of the HCWs showed a positive attitude towards PLWHA believing that they are not to be blamed for their condition but that individuals in the community who are perceived to be promiscuous men or women are the ones responsible for the spread of HIV/AIDS. Procedures like patients being tested without their consent and patients required to do a HIV/AIDS test before surgery that could be perceived as stigmatization have been observed in King Edward VII hospital. Patient confidentiality is also compromised in that gossiping by HCWs about the HIV/AIDS results of patients has been noted. Fortunately a significant number of HCWs are willing to report their colleagues to a higher authority if any form of stigmatization or discrimination towards PLWHA is seen at King Edward VIII Hospital. CONCLUSION Although the knowledge, attitude and comfort of the HCWs at King Edward VIII Hospital was above average continuing medical education and continuing professional development should be mandatory in the management of HIV/AIDS so that HCWs can have the needed knowledge to keep up with the changing world of HIV/AIDS medicine and also about universal precautions to take so as to reduce occupational exposures. Psychological support to the HCW is needed in dealing with PLWHA so that patients can be provided with quality and compassionate care irrespective of their HIV/AIDS status as this will eventually help in the reduction of stigma.