Background: In Utah, all major hospital facilities have employee vaccination policies. However, the presence of health care worker vaccination policies in the Utah outpatient oncology setting was unknown. Objectives: The objectives were to identify Utah oncology outpatient employee vaccination policies and to identify what consequences, if any, were present for unvaccinated employees. Methods: This was a cross-sectional, descriptive study design in which clinic managers from outpatient oncology clinics in Utah were asked, via questionnaire, to describe the clinic's employee vaccination policy and the consequences for refusing the policy. Findings: Most vaccination policies applied to employees primarily assigned to work in the back office area. Most commonly, influenza and Hepatitis B vaccines were required as part of the vaccination policy. Most managers offered free vaccinations to employees, although most managers also allowed employees to refuse to follow the vaccination policy for medical, religious, or personal reasons.

Magister Curationis - MCur / Caring for people with intellectual disability is stressful as they have a reduced ability to cope independently. The stress may be exacerbated by the challenging behaviours intellectually disabled people display and by the lack of social support that care workers may experience. The aim of this study is to explore and describe care workers’ experience of stress and social support whilst caring for intellectually disabled residents with challenging behaviour. A qualitative, exploratory, descriptive phenomenology study was utilised to answer the research question: “What are the experiences of stress and social support of care workers caring for intellectually disabled residents with challenging behaviour at a residential facility in the Western Cape?” A purposive sampling technique was utilised to select ten care workers working at a residential facility for intellectually disabled residents with challenging behaviour in the Western Cape. Lazarus and Folkman’s transactional model of stress and coping has been used to guide the study. Data were collected by means of semi-structured interviews. Colaizzi’s method of data analysis was used to analyse the data. The four main themes that emerged are: (1) acceptance of abuse as a working condition, (2) interpersonal relationships with colleagues, residents and residents’ families, (3) the selfimpacted by an array of emotions and (4) social support and coping strategies used to deal with the stress experienced. The study concluded that care workers’ training does not prepare them to understand and manage residents with challenging behaviour adequately. Formalised training as well as interpersonal skills building is necessary for them to cope with the stress they experience while working with intellectually disabled residents.

The study seeks to explore the experiences of care workers participating in laughter therapy. Community care workers play a vital role in the support of the HIV/AIDS infected and affected members of the community. However, the nature of this type of work contributes to high levels of emotional distress such as depression, anxiety and stress. The purpose of the study is 1) to explore the effects of working with orphans and vulnerable children (OVC) on the care workers and their experiences of participating in laughter therapy; and 2) the effects of laughter therapy on care workers’ levels of depression and stress. Given that laughter has been found to have several positive effects, many variations of this intervention have been developed. For the purpose of this study, a specific type of laughter therapy was used, namely that of Aerobic Laughter Therapy (ALT). The study was part of a project run by InHappiness Institution and was conducted at Nanga Vhutshilo in Soweto. The care workers at the centre provide care services for orphans and vulnerable children (OVC) affected by the HIV/AIDS epidemic. Purposive sampling was utilised to recruit seven care workers from the centre who participated in a laughter intervention. The study was phenomenological in nature and utilized both qualitative and quantitative methodology. Quantitative data was collected through two questionnaires administered before and after the laughter therapy intervention: The Hospital Anxiety and Depression Scale (HADS) and the Perceived Stress Scale (PSS). The Wilcoxon Signed-Rank Test was used to compare pre- and post- results of the scale scores for each participant. Results showed a significant difference between the pre- and post-intervention assessment scores for both Anxiety and Depression (-2.226 (p<0.05) and -1.876 (p<0.05) respectively). In addition, the Wilcoxon signed rank test showed that the post-intervention total scores for PSS were significantly lower than the pre-intervention assessment total scores (-1.863). The significantly lower post-intervention assessment scores show that the laughter therapy intervention produced a positive change with regards to anxiety, depression and stress in the participants. Qualitative data was collected through pre and post –intervention face- to- face semi-structured interviews and were analysed using Interpretative Phenomenological Analysis (IPA). The three themes that emerged from data analysis of the pre-intervention interviews were: motivation to become a care worker, work stresses and coping mechanisms. The five themes that emerged from the post-intervention interviews were: Initial reactions and expectations, effects on interpersonal relationships, improved effective coping ability, collective participation and laughter as a change agent. The study revealed that care workers experience high levels of stress, and anxiety. These emotions manifested in emotional distress in the form of frustrations, exhaustion and feelings of being overwhelmed. Emotional distress was found to be related to care workers’ personal involvement with their clients and high levels of emotional investment in them. Furthermore the study revealed the cyclic link that identification not only contributed to employment in such contexts, but it served to increase levels of personal involvement. Such personal involvement subsequently caused care workers to experience high levels of emotional distress when unable to meet the needs of the community in this respect. Findings from this study support laughter, with specific reference to Aerobic Laughter Therapy (ALT), as a positive therapeutic intervention that can possibly improve behaviour with regards to coping with difficult situations and providing a buffer against the negative effects of stress. However, the sample used in this study was not sufficient to conclusively make a generalised finding. / Dissertation (MA)--University of Pretoria, 2013. / Psychology / unrestricted

The home should represent safety and security for the person who lives there, and this is an important factor for independence and autonomy in very old age. With aging populations, the needs for long-term care increase, care provided by spouses and/or from the growing home care sector. Injuries among these groups are common. In this study, an ergonomics perspective was applied in the analysis of some basic daily activities performed by old persons and by home care workers, assisting. The postures and movements of home care staff assisting at toilet visits, and transferring persons from wheelchair to toilet, were measured and analysed. Some daily activities related to making food and washing clothes, performed by a group of persons between the age of 75 and 100, were measured and analysed. The task of getting up from the floor – on your own and with the help of a walker equipped with a lifting device – was analysed with the help of older persons and nursing staff. The design was built on the knowledge gained from analysing how older people get up from floor. Requirements for access with a four-wheeled walker in the local built environment were investigated. Observations were made with the help of video recording. Postures were recorded with the CUELA measurement system. The VIDAR ergonomics evaluation instrument was used to register the participants’ experiences of discomfort and pain during getting up from the floor with or without the walker with a lifting device. Structured interviews were used to find out about older peoples’ experience of using the four-wheel walker. It is concluded that ageing at home requires improved architectural and technical bathroom design and improved access in the local built environment. / <p>QC 20140124</p>

Medicinos darbuotojai dėl kasdieninio kontakto su žmogaus organizmo skysčiais priskiriami didžiausios biologinių veiksnių rizikos grupei. Incidentų – mikrotraumų ir ekspozicijos krauju, rizika yra susijusi su kraujo keliu plintančiomis infekcijomis (HBV, HCV, ŽIV). Darbo tikslas: Nustatyti medicinos darbuotojų profesinių biologinių veiksnių riziką ir paplitimą Kauno medicinos universiteto klinikų chirurgijos profilio skyriuose. Tyrimo metodika. Vykdytas retrospektyvinis tyrimas 2006 m. 1-6 mėnesių, duomenys rinkti Kauno medicinos universiteto klinikų chirurgijos profilio skyriuose. Atlikta anketinė apklausa. Išdalintos 347 anoniminės anketos, atsako dažnis 89,6 % (311). Statistiniam duomenų apdorojimui naudotas SPSS 11.0 programinis paketas. Rezultatai. 64,5% respondentų patyrė mikrotraumą, 71,1 % – ekspoziciją biologiniais skysčiais, mikrotraumą, ir ekspoziciją patyrė 39,6% darbuotojų. Visais mikrotraumų atvejais buvo sužeistos rankos, ekspozicijų metu 63% respondentų apsitaškė sveiką odą, 20% – akis. Dažniausiai darbuotojai apsitaškė krauju (60%). Gydytojai mikrotraum��� dažniausiai patyrė operacijų metu (79,3%), slaugytojos – apruošdamos instrumentus (35,1%), pagalbiniai darbuotojai – tvarkydami atliekas (75,8%). Gydytojai dažniausiai susižeidė chirurgine adata (72,4%), slaugytojos – injekcine adata (72,4%), pagalbiniai darbuotojai – stiklu (60,6%). 86% respondentų nebuvo pasiskiepiję HB vakcina. Mikrotraumų metu 14,5%, ekspozicijų metu 5% respondentų asmeninių apsaugos... [toliau žr. visą tekstą] / The health care workers are attributed to the highest biological factors risk group, as they daily come into contact with fluids of human body. Risk of incidents – sharps injuries and blood exposure – is related to the infections, spread by blood (HBV, HCV, HIV). Aim of the study. Determine the professional biological risk factors for health care workers and their incidence in the surgical departments of Kaunas Medical University Hospital. Methods. Retrospective study of 1-6 months of year 2006 was performed; data was collected in the surgical departments of Kaunas Medical University Hospital. Anonymous questionnaire survey was performed. 347 questionnaires were distributed; rate of response was 89.6% (311). SPSS 11.0 software was used for statistical data processing. Results. 64.5% of respondents had experienced sharps injury, 71.1% were exposed to the biological fluids, and 39.6% of workers had experienced the injury and the exposure. The hands were injured during all the sharps injury cases; 63% of respondents were drabbled by blood on the healthy skin and 20 % were drabbled into the eyes during the blood exposure. In most cases worker were drabbled by blood (60%). Physicians mostly experience the sharps injury during the surgery (79.3%), nurses – during the preparation of instruments (35.1%), supporting staff – disposing the waste (75.8%). Commonly physicians were injured by the surgical needle (72.4%), nurses – by needlestick (72.4%), and the supporting staff – by glass... [to full text]

Bakgrund: En vårdande relation är inte detsamma som en vänskapsrelation, men förutsätter ändå närhet och engagemang. Personligt engagemang är också nödvändigt för att utvecklas som vårdare. Sorg är en naturlig reaktion vid förlust av relationer, men det är inte självklart att vårdare vet om de får eller bör känna och uttrycka sorg när patienter dör. Det saknas en samlad bild av vårdares sorg över döende och avlidna patienter. Syfte: Syftet var att beskriva hur vårdares egen sorg över döende och avlidna patienter gestaltar sig. Metod: Beskrivande litteraturöversikt av elva artiklar som analyserades med en form av kvalitativ innehållsanalys. Resultat: Vårdarens sorg gestaltar sig i form av inre känslor som att känna smärta och tyngande känslor samt skuld och ilska. Sorgen kan även visa sig i form av yttre uttryck där vårdaren exempelvis gråter eller känner sig rastlös. Den kan också yttra sig i ett tidsperspektiv där vårdarens sorg över en specifik patient förändras med tiden samt ett längre perspektiv där vårdarens tidigare erfarenheter påverkar hur han eller hon upplever sorgen. Klinisk betydelse: Denna studie kan vara ett stöd för vårdare som undrar om de får eller bör känna och uttrycka sorg över döende och avlidna patienter. Den kan också användas av vårdare som nått expertstadiet och som fungerar som handledare. Vid denna nivå av expertis bör enligt denna studies resultat uppmuntran och stöd ges till mindre erfarna vårdare, för att hjälpa dem att våga känna och uttrycka sin sorg. / Background: A caring relationship is not the same as a friendship relationship, but still requires intimacy and commitment. Personal commitment is also necessary to develop as a health care worker. Grief is a natural reaction to loss of relationships, but caregivers do not necessarily know if they are allowed to or should feel and express grief when patients die. There is no complete picture of health care workers’ grief over dying and deceased patients. Objective: The objective was to describe how health care workers’ own grief for the dying or deceased patients manifests itself. Method: A descriptive literature review of eleven articles, analyzed with a form of qualitative content analysis. Findings: Health care workers’ grief manifests itself as inner feelings such as pain, burdensome feelings, and guilt and anger. Grief can also manifest itself as an outward expression where the caregiver for example cries or feels restless. It can also manifest itself through time, when the health care worker’s grief for a particular patient is changing over time, but also in a life-time perspective, when the health care worker’s past experiences affect how he or she experiences the grief. Clinical significance: This study may provide support to health care workers who are wondering if they are allowed to or should feel and express grief for dying and deceased patients. It can also be used by health care workers who have reached the expert stage and are supervisors themselves. At this level of expertise, according to the results of this study, encouragement and support should be given to less experienced health care workers, to help them gain the courage to feel and express their grief.

国立情報学研究所で電子化したコンテンツを使用している。

Master of Public Health - MPH / Gay men and other men who have sex with men (MSM) and a subset within this group who are people who inject drugs (PWID) face difficulties when trying to access humanimmune deficiency virus (HIV)/ anti-retroviral treatment (ART) services and adhere to ART, due to the intersecting forms of oppression they face. Current interventions to address adherence to ART are mostly bio-medical in nature, and support the presumption that individual-level factors are the most pertinent barriers to adherence to ART. This mini-thesis presents findings from a qualitative study that explored individual, health systems and structural factors that shape experiences of adherence to ART amongst gay men and other MSM and a subset within this group who are PWID

Background: Many health care facilities enforce strict dress code policies prohibiting visible body modifications, including tattoos, piercings, and vibrant hair colors. As popularity of body modifications among young adults surges, facilities may be forced to adapt policies as these workers enter the workforce. While some evidence exists related to patient perceptions of health care workers with body modifications, there is little about how nursing students perceive them. This study aimed to describe undergraduate, pre-licensure nursing students’ perceptions of health care worker appearance on compassion, skill, knowledge, and trustworthiness. Methods: Using cross-sectional design, an on-line Likert-type survey was used to collect data from 137 undergraduate, pre-licensure nursing students in Northeast Tennessee. Participants viewed photos of male and female workers with various body modifications. Data were analyzed using descriptive and inferential statistics. Results: There were statistically significant differences between groups across all four variables. Male and female health care workers without body modifications were rated highest on all four variables. Male and female with tattoos were rated the second highest. Male and female with facial piercings were rated lowest. The female health care worker color, irrespective of body modification type, was rated higher than the male counterpart across all variables. Conclusion: Results suggest that nursing students may perceive health care workers without body modifications to be the most compassionate, skilled, knowledgeable, and trustworthy. Students may perceive tattoos as more acceptable in the workplace than facial piercings or vibrant hair colors. Students may perceive body modifications as more acceptable for females than males.

Detta är en uppsats där normer och värderingar om vårdbiträdet i hemtjänst undersöks genom kritisk diskursanalys. Datamaterial omfattar SOU-rapporten I den äldres tjänst. Äldreassistenten – ett framtidsyrke samt två fokusgruppsintervjuer med omsorgspersonal från en hemtjänstenhet. Diskursanalysen utförs i förhållande till och i samspel med sekundärlitteraturen. Utöver den språkliga analysen tas även kulturella och sociala dimensioner med i studien. För att ringa in rådande diskurser studeras centrala termer och formuleringar genom att undersöka hur ofta och upprepat de förekommer, samt vilken inkludering och exkludering som görs. I spänningsfältet som uppträder mellan den statliga diskursen och den praktiknära diskursen framträder stridigheter om de brister som äldreomsorgen tillskrivs. På politisk statlig nivå framträder en normerande bild av vårdbiträdet som den bristande länken i lagarbetet kring den äldre. På praktiknära nivå framhålls en förklaringsmodell där organisering och ledning är centrala bristkomponenter. Praktiker-diskursens faktorer bemötande och lön konkurrerar med de överordnade faktorerna som återges i SOU-diskursen; utbildning och validering. / This study is a discourse analytical study of norms and values in the Swedish public home health care sector. The discourse is studied at two different levels in Swedish society: the political and the practical. Information is collected through focus-group interviews at the practical level and at the political level from a report in the Swedish Government Official Reports Series (SOU 2008:126), appointed by the Ministry of Health and Social Affairs.   Government-sponsored publications and reports are used as a basis for executive and legislative decision-making in the parliament and the government. The governmental study is an important template for the formation and maintenance of norms and valuations. Elder care workers constitute Sweden's largest labor force and a majority of them are employed by municipalities. The SOU report motivates competence-reform in light of pending waves of retirements within the elder care work force, increased demand for elder care, and decreasing high-school enrollment in care and service programs. The discourse analysis is executed in relation to and in concert with the secondary literature.   The theoretical and methodological perspective in this study takes its starting point in Fairclough's critical discourse analytical theory and method. This provides dialectic of structures and practices, where discourse has an influence on and is influenced by social structures. In Fairclough's view, discourse practices are an important form of social practice that contributes to the forming of identities and relationships. The study investigates discursive practices in the report in order to uncover their role in the perpetuation of an unequal balance of power, so called ideological effects.  The study reveals contradictions within the SOU report and discordance between the report and home health care workers. Despite a societal eagerness to professionalize the home health aide, the political discourse relegates the aide to the bottom of the care hierarchy, by excluding issues such as compensation and subordinating questions concerning the organization and management. Discourses and action-space for workers in the home health care environment can be investigated in light of current deficiencies in top-down guidance and limited opportunities for peer-group meetings, especially since an increasing number of home health care workers have Swedish as a second language. Interactive research with both workers and management could be investigated and developed with pedagogical tools as a part of process of reform. Because Swedish society places such a high value on government reports, it is of continuing importance to scrutinize through critical-discourse analysis the entity of governmental research.