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Satisfação e mudança percebida por familiares de usuários de centros de atenção psicossocial em álcool e outras drogas / Satisfaction and Perceived Change of family users from Psychosocial Care Centers Alcohol and other DrugsRojas, Thaís Fernandes 17 June 2016 (has links)
Apesar das substâncias psicoativas serem consumidas há milhares de anos, nas últimas décadas a questão de seu consumo abusivo e dependência tem se configurado como uma demanda de saúde pública, diante de um cenário marcado pela acelerada transição socioeconômica que está ocorrendo em vários países. Este estudo tem como objetivo a avaliação das práticas oferecidas nos Centros de Atenção Psicossocial para Usuários de Álcool e Outras Drogas (CAPSad) do ponto de vista dos familiares dos usuários. Métodos: pesquisa avaliativa transversal, com análise quantitativa de dados coletados em CAPSad do município de São Paulo, utilizando a Escala de Satisfação (Satis-BR) e a Escala de Mudança Percebida (EMP), já validadas e utilizadas anteriormente em estudos avaliativos. Além das escalas, dados acerca da estrutura do serviço, dados sociodemográficos, de acesso, e de caracterização da participação do familiar no tratamento do usuário, foram analisados, com condução de modelo de regressão linear múltipla, no qual evidenciou-se a mudança percebida como variável preditiva de melhor nível de satisfação com os serviços, bem como a correlação negativa das seguintes variáveis com índices de mudança percebida: residir nas zonas leste e norte da cidade e ter renda familiar mensal entre 2 e 4 salários mínimos. O fato de ter parentesco não nuclear, como ser tio ou sobrinho, com o usuário, já teve associação positiva com a mudança percebida. São necessários mais estudos com este tipo de serviço para melhor explorar essas dimensões relacionadas à qualidade da atenção nesta temática, contribuindo para avaliar o impacto das novas políticas e da Rede de Atenção Psicossocial. / Despite psychoactive substances have been consumed for thousands of years, in recent decades, the issue of their abuse and dependence has been configured as a public health demand, against a backdrop marked by rapid socioeconomic transition that has been occurring in several countries. The object of this study is the evaluation of practices offered at Psychosocial Care Centers for Users of Alcohol and Other Drugs (CAPSad) based on the point of view of the families of their users. Methods: evaluative research, by quantitative method, to analyze data collected at CAPSad located in the city of São Paulo, using the Satisfaction Scale (Satis-BR) and the Perceived Change Scale (EMP), already validated and previously used in evaluation studies, will guide the focus of analysis. In addition to the scales, data on the service structure, sociodemographic data, access, and characterization of the family\'s participation in the user´s treatment, were analyzed, with the lead of the multiple linear regression model, in which it revealed a change perceived as a predictive variable higher level of satisfaction with the services and the negative correlation of these variables with perceived change in rates: living in the eastern and northern areas of the city and considering a monthly income between 2 and 4 minimum salaries. The fact that no nuclear kinship, as being an uncle or nephew, with the user, has had a positive association with the perceived change. Further studies are needed with this type of service to better explore these dimensions related to quality of care in this theme, helping to assess the impact of new policies and Psychosocial Care Network.
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Estratégia Saúde da Família e Internações por Condições Sensíveis à Atenção Primária (CSAP): revisão sistemática da literatura / Family Health Strategy and Hospitalizations by Ambulatory Care-Sensitive Conditions (ACSC): systematic review of the literature.Fontenelle, Leonardo Ferreira 11 March 2011 (has links)
OBJETIVO: Verificar se a adoção da estratégia Saúde da Família (ESF; antigo Programa Saúde da Família, PSF) está ou não associada a menores taxas, chances ou risco de internação por condições sensíveis à atenção primária (CSAP), quando comparada à atenção básica tradicional. MATERIAIS E MÉTODOS: Estudo de revisão sistemática da literatura científica, usando os termos \'saúde da família\' e (\'programa\' ou \'estratégia\') e (\'internações sensíveis\' ou \'condições sensíveis\'), bem como seus correspondentes em inglês. A busca não foi limitada por ano de publicação, mas abrangeu apenas pesquisas originais que tenham testado a associação entre o modelo de atenção básica e as internações por CSAP na população geral. As fontes de dados utilizadas foram os índices MEDLINE, LILACS e IBECS, através da Biblioteca Virtual em Saúde (BVS) e do PubMed. A qualidade metodológica não foi usada como critério de exclusão, mas sim para explorar as eventuais divergências dos resultados. O instrumento de avaliação foi uma lista com 10 itens a serem verificados, proposta por Downs & Black e adaptada por Nedel et al. RESULTADOS: Foram localizadas 82 citações únicas, das quais apenas 4 atenderam aos critérios de inclusão. Os estudos tinham variadas abordagens metodológicas, mas todos encontraram alguma associação inversa entre a ESF e as internações por CSAP. Essa associação variou de acordo com a faixa etária, o sexo, o grupo de CSAP, e o tamanho do município. DISCUSSÃO: A Saúde da Família se mostrou associada a um menor número de internações por CSAP, especialmente no sexo feminino, nos idosos, e para as condições cardiovasculares, as condições respiratórias e o diabetes mellitus. Sugere-se a necessidade de que as análises sejam conduzidas separadamente para cada combinação de sexo, faixa etária e CSAP, e que o controle ou não da análise por aspectos de qualidade da atenção básica seja explicitamente decidido com base num marco conceitual. / OBJECTIVE: To verify if the adoption of the Family Health strategy (ESF; formerly named Family Health Program, PSF) is associated with lower rates, odds or risk of hospitalization by ambulatory care sensitive conditions (ACSC), compared to the traditional Brazilian primary health care (PHC) model. MATERIALS & METHODS: A systematic review of the scientific literature using the terms (\'family health program\' or \'familial health strategy\') and (\'sensitive conditions\' or \'sensitive hospitalizations\'), as well as the corresponding terms in Portuguese. The was no publication date limit, but the search was restricted to original research testing whether if there\'s an association between the PHC model and hospitalizations by ACSC in the general population. The data sources included MEDLINE, LILACS and IBECS, through PubMed and Biblioteca Virtual em Saúde (BVS). The methodological quality was not used as an exclusion criterion, but to explore eventual divergences in the results. The assessment instrument was a checklist with 10 items, proposed by Downs & Black and adapted by Nedel et al. RESULTS: 82 unique citations were found, but only 4 of them matched the inclusion criteria. The studies have variable methodological approaches, but all of them found some association between ESF and hospitalizations by ACSC. This association changed with age, sex, ACSC group, and municipality size. DISCUSSION: Family Health was associated with less hospitalizations by ACSC, specially in the female sex, in the elderly, and for cardiovascular conditions, respiratory conditions and diabetes mellitus. It may be necessary to run the analysis separately for each combination of age group, sex and ACSC group. Controlling or not the analysis for PHC quality should be explicitly decided on basis of a conceptual framework.
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The rights-based approach to development :|baccess to health care services at Ratshaatsha Community Health Centre in Blouberg Municipality of LimpopoRammutla, Chuene William Thabisa January 2013 (has links)
Thesis (M. Dev) -- University of Limpopo, 2013 / Refer to document
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Costs of illness, demand for medical care, and the prospect of community health insurance schemes in the rural areas of Ethiopia /Asfaw, Abay. January 2003 (has links)
Thesis (doctoral)--Universität, Bonn, 2002. / Includes bibliographical references (p. 207-218).
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Professional development of dietitians completing compulsory community service in South Africa with special focus on KwaZulu-Natal.Paterson, Marie. January 2006 (has links)
Introduction:
The aim of this research was to establish the attitudes, knowledge, job satisfaction and
professional development of community service dietitians because negative attitudes,
poor knowledge, low levels of job satisfaction and poor professional development would
be detrimental to the process of community service and ultimately to the provision of
health services.
Methodology:
Three distinct annual intakes of qualified dietitians completing compulsory community
service were the subjects of an analytical cross sectional survey conducted biannually for
the period 2003-2005. Data collection methods included telephone interviews, mail, emailed
questionnaires and focus group discussions. Individual factors: sex, population
group, language, university attended; institutional factors: organisation of community
service, mentorship rating, hospital manager support type of facility, rural allowance,
hospital location, access to resources, working and living conditions and personal safety
and other factors: attitude, community nutrition knowledge, job satisfaction and
professional development were included in the data set.
Management of data:
Data were divided into 2003 cohort (n=20) and 2004-2005 cohorts (n=26). Analysis of
the demographic details for 2003 and 2004-2005 cohorts were, respectively: mean ages
23.6 (±0.99) and 24.05(±4.96) years, 60 percent and 73 percent white, 90 percent and 96
percent female, 35 percent and 73 percent University of KwaZulu-Natal graduates and 65
percent of both cohorts were placed in rural facilities.
Results:
Community nutrition knowledge of the 2003 cohort was unacceptable but improved in
the 2004-2005 cohort. Subjects had a generally positive attitude towards community
service. Community nutrition levels of knowledge of the 2003 ranged between 60 percent
at entry and 67 percent at exit and for the 2004-2005 between 72.8 percent and 78.42
percent. The job satisfaction level of the 2003 cohort at exit was 13.65 (±3.573). In the
2004-2005 cohort job satisfaction was 15.75(±3.360) at entry and 15.75 (±3.360) at exit.
85 percent of the 2003 cohort rated their professional development positively whereas 65
percent of the 2004-2005 cohort rated theirs' positively. This decline and associated
problems were to some extent shown in the interview responses. The 2004-2005 cohort
did however show a tendency for improvement in the professional practitioner ranking
(p=0.088). The majority (95%) of the 2004-2005 cohort rated the dietetic services
positively.
Focus group discussions highlighted problems that the community service dietitian
(CSD) encountered such as lack of supervision and support, lack of basic facilities, poor
hospital administration, problems with transport, work overload and problem with their
professional role in the community and health facility.
A model showing the results of the research indicated that the objectives of the
Department of Health for improved service in rural areas were obtained but the retention
of health professionals and capacity was lost due to annual rotation of subjects.
Community service as a strategy to overcome service delivery has merit provided
identified problems are addressed. / Thesis (Ph.D.)-University of KwaZulu-Natal, Pietermaritzburg, 2006.
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The effect of distance from clinics on maternal and child health (MCH) service utilization and MCH status.Tsoka, Joyce Mahlako. January 2004 (has links)
There is strong evidence from developing countries to support the hypothesis that physical accessibility of health services, particularly absolute distance from clinics, is a major determinant of health service utilization and health status. In South Africa, such evidence is very limited and as a result the relationship between absolute distance and health service utilization and health status is not fully understood. As an attempt to understand this relationship, a household survey of mothers with children aged 12-23 months was conducted in a rural district of KwaZulu-Natal province, South Africa. Maternal and child health (MCH) service utilisation and MCH status patterns were then compared at different absolute distances from PHC clinics. The find ings reveal that the study population is characterised by impoverished living conditions (86%), high functional illiteracy (67%), high fertility and unemployment rates . In comparison with other studies conducted previously in the same population, MCH service utilization rates are high. Based on mean distances of homesteads from PHC clinics in the entire study area before the Clinic Upgrading and Building Programme it has been concluded that the physical accessibility of fixed PHC clinics, when compared with the WHO recommendations, was suboptimal. When this assessment is based on clinic usage patterns, it is found that clinic usage decreased from 86.4% at 0-5 km to 79% at 6-10 km with a dramatic decrease to 37.8% at distances beyond 10 km. This decrease in usage at distances above 5 km translates into a considerable reduction in effective coverage of the target population by PHC clin ic services if it is considered that above 50% of the population live greater than 5 km from these clinics. An assessment of the effect of distance of homesteads from PHC clinics on specific MCH service utilization and MCH status has found very few or no significant differences between mothers and children living at 0-5 km, 6-10 km or > 10 km from these clinics. This observation is consistent even after adjustment for the effects of potential confounding. The fact that distance from clin ics has little or no effect on the indicators of MCH service utilization and MCH status is counter-intuitive. A few explanations can be provided. These include the fact that only 50% of the population, even in one of the most rural parts of South Africa access clinics on foot. Since the traditional assumption has been that this distance effect is a function of straight-line walking distances between homesteads and clinics, Euclidian distances alone may be a poor explanatory variable for health service utilization. Furthermore, if the hypothesis is valid that health status is a function of service utilization, it may also be a poor explanatory variable for health status of community members who are reliant on these services. Secondly, based on data from other sources, there is evidence that there have been steady declines in both mortality and fertility rates in the study population over the past 10-20 years suggesting that client communities are already benefiting quite substantially from health services in general and from MCH services in particular in spite of residual distance barriers. In other words, this distance effect on service utilization and health status may be more evident in populations with much higher background infant, child and maternal mortality rates. Thirdly, it is also possible that distance effect still exists, but that methodological limitations prevented this study from showing this effect. For instance, the fact that people use mobile clinics for some MCH services may have confounded the effect of distance from fixed clinics. It is also possible that people use different facilities for different services even though they are further away, and the assumption that all facilities have equal attraction for clients and that the only determinant of use is distance may be flawed. For example, it is evident from this and from other studies in South Africa that whereas most clients use fixed clinics for vaccinations, deliveries are now increasingly conducted at hospitals. Other methodological issues include the fact that certain health outcomes such as stunting are not an exclusive reflection of health service inputs, but are a function of social and economic determinants. Based on these findings, a number of recommendations are made. / Thesis (Ph.D.)-University of Natal, Durban, 2004.
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Cutting into perceptions : investigating men's understanding of protection - through medical male circumcision for HIV prevention, in Durban, KwaZulu-Natal.Mathew, Wesley. January 2012 (has links)
Three recent Randomised Controlled Trials (RCTs) have been able to deduce that Medical
Male Circumcision (MMC) can reduce a heterosexual man’s chances of acquiring HIV
through vaginal sexual intercourse by approximately 60% (Auvert et al. 2005; Gray et al.
2007; Bailey et al. 2007). In 2010, based on WHO recommendations, South Africa
commenced a nationwide roll-out of MMC services. However, in the wake of these findings
have come concerns that decreases in men’s perceived risk of contracting HIV could spark
increases in risky sexual behaviour (risk compensation), in turn, driving up HIV incidence as
opposed to abating it (Cassell et al. 2006). Accordingly, the World Health Organisation has
identified social change communication as one of the ten key elements critical to the success
of a wide scale MMC roll out (WHO & UNAIDS, 2010). Aside from creating demand, the
role of MMC health communication efforts in crafting messages delineating the scope of
MMC’s protective ability is paramount; especially in South Africa, a country hamstrung by a
weak public health sector that can ill afford any regression in the fight against HIV and
AIDS.
This thesis provides a small-scale qualitative study that investigates both the motivating and
discouraging factors impacting on men’s choices to undergo MMC, as well as exploring how
and what ‘key messages’ of Medical Male Circumcision media and information initiatives are
being received. In this way, my study hopes to bring insight into not only risk compensation
associated with MMC, but also to provide a glimpse into the condition of health
communication for MMC in the South African context. / Thesis (M.Soc.Sc.)-University of KwaZulu-Natal, Durban, 2012.
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The implementation of the rehabilitation service package in the Metropole Health District, Western Cape Province, South AfricaMisbach, Sadia January 2004 (has links)
This research investigated the availability and nature of the rehabilitation service at primary health care level rendered by rehabilitation staff in the Metropole district health services. The aim of the study was to determine the extent to which selected elements of the rehabilitation components of the primary health care service package are currently being implemented. In doing so, the study aimed to identify obstacles within the district management as perceived by rehabilitation therapists that hinder the implementation of the rehabilitation programme, so as to make recommendations for future planning.
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Die geskiedenis van die Stellenbosch Hospitaal (1942-2001)Baderoen, Tougeda 03 1900 (has links)
Die Queen Victoria Gedenkhospitaal van Stellenbosch, wat sedert 1904 die
Stellenbosse gemeenskap bedien het, het as gevolg van 'n groeien~e
inwonergetal geleidelik 'n gebrek aan ruimte ondervind. Daarom is daar
gedurende die 1930's pogings aangewend vir die oprigting van 'n groter
hospitaal. Hierdie pogings is uiteindelik met sukses bekroon en in 1944 het
die Stellenbosch Hospitaal sy deure geopen.
Spoedig na die opening van die hospitaal is verskeie probleme, soos
byvoorbeeld 'n tekort aan beddens en 'n behoefte aan meer moderne
mediese toerusting, ondervind. Die Hospitaalraad het deur voortdurende
verto~ tot die Kaapse Provinsiale Administrasie en met die finansi~le steun
van die Stellenbosse gemeenskap daarin geslaag om belangrike moderne
algemene en mediese toerusting aan te koop.
Die Stellenbosch Hospitaal, in samewerking met die Cloetesville
Gemeenskaps Gesondheidsentrum, wat onder die beheer van die hospitaal
staan, se belangrikste doelwit was, en is, om die beste moontlike diens aan
die gemeenskap te lewer. Daarom het die Hospitaalraad met verloop van tyd
'n omvattende gemeenskaps gesondheidsprogram ontwikkel.
Sedert die dae van die Queen Victoria Gedenkhospitaal het die Stellenbosse
gemeenskap 'n aktiewe rol in die lewering van noodsaaklike hospitaaldienste
gespee!. As gevolg van die betrokkenheid en die finansi~le bydraes van die
gemeenskap kon die Hospitaalraad noodsaaklike uitbreidings, soos 'n
kraamsaal en 'n verpleegsterstehuis finansier. Omdat die gemeenskap besef
het dat dit nie net die staat se verantwoordelikheid was om
gesondheidsdienste te lewer nie, is die Aksie Stellenbosch Hospitaal, die
gemeenskapsarm van die hospitaal, in 1988 gestig. Hierdie Aksie
Stellenbosch Hospitaal speel dus in 'n tydperk waar staatsfondse beperk is, 'n
belangrike rol om die Stellenbosch Hospitaal doeltreffend te laat funksioneer
en om steeds hoe standaarde met betrekking tot gesondheidsorg te
handhaaf.
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The role of spirituality in the wellbeing of community health care workers at Temba Community Development ServicesRoberson, Peter 01 1900 (has links)
The research focused on employee wellness and explored and described the role of spirituality
in the wellbeing of CHCWs of HIV/AIDS patients. It was important to determine how CHCWs
dealt with the stress of caregiving, due to the increasing number of HIV infections and burden
on government resources. The approach was a phenomenological qualitative study using faceto-
face interviews to collect data from a purposive sample of eight CHCWs from a population
of 250 at Temba. The audio-recorded interviews were transcribed verbatim and analysed for
emerging themes using thematic analyses. The research findings provided evidence that
spirituality impacted positively on the wellbeing of the CHCWs by providing the coping
mechanism to deal with stress. The conclusions drawn were that personal and organisational
wellbeing operated at an optimal level due to the influence of spirituality.
Recommendations were that formalised spiritual programmes were offered as a tool to equip
CHCWs in their duties. / Industrial and Organisational Psychology / M. Com.
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