O estudo teve como objetivo analisar as vulnerabilidades e os enfrentamentos dos idosos vivendo com HIV/Aids na atenção básica de saúde. Para realização da pesquisa, utilizou-se a abordagem qualitativa, tendo como referencial teórico a abordagem psicossocial e emancipatória, segundo o conceito de vulnerabilidade baseada nos direitos humanos. O estudo foi realizado no município de Botucatu, em todas as unidades de saúde que adotam a Estratégia Saúde da Família e no Hospital-dia HIV/Aids, da Faculdade de Medicina de Botucatu da Universidade Estadual Paulista. Participaram do estudo 11 idosos vivendo com HIV que descobriram a doença após os 60 anos, 12 médicos e 11 enfermeiros que atuam na Estratégia Saúde da Família. Os dados foram obtidos por meio de entrevistas semiestruturadas analisadas de acordo com o referencial da Análise de Conteúdo de Bardin, mais especificamente, a Análise Temática. Buscando entender as razões que levaram os idosos a estarem em situação vulnerável à infecção pelo HIV, foram adotadas para análise as seguintes categorias: vulnerabilidade individual, vulnerabilidade social e vulnerabilidade programática. Foram encontradas como categorias empíricas: - Infecção e formas de contágio do HIV; - Enfrentando a soro positividade: o cotidiano dos idosos vivendo com HIV; - Acesso do idoso aos serviços de saúde x solicitação da sorologia para HIV; - Marcos da relação entre o profissional de saúde e o idoso; - Planejamento, compromisso e responsabilidade dos profissionais para com os idosos. A articulação das subcategorias que emergiram das categorias empíricas permitiu identificar duas categorias centrais: O viver com HIV/Aids e Diagnóstico Tardio. O conceito de vulnerabilidade no quadro dos direitos humanos possibilitou visualizar aspectos que podem contribuir para a emancipação psicossocial do idoso. Para isso, é necessário reconhecer o idoso como um sujeito cidadão, sujeito sexual e sujeito de direito, abordando esse idoso e compreendendo-o como sujeito do seu cotidiano e de direitos. Conclui-se que, enquanto os serviços de saúde não englobarem os idosos como sujeitos coautores das ações direcionadas à prevenção das DST/Aids, poucos serão os avanços na luta contra a epidemia. São necessários, portanto, esforços dos organismos de saúde, por meio de programas específicos, e dos profissionais de saúde, que devem buscar o olhar sobre o idoso, incluindo sua sexualidade, para que possam contribuir para uma melhor qualidade de vida deste segmento populacional. / The aim of this study was to analyze the vulnerability and challenges of the elderly living with HIV/Aids in primary health care. In order to conduct the research, we followed the qualitative approach, having as a theoretical reference the psychosocial and emancipatory approach according to the concept of vulnerability based on human rights. The study was performed in Botucatu at all health units that adopt the Family Health Strategy and at the partial hospitalization for HIV/Aids of São Paulo State University Medical School in Botucatu. 11 elderly people who were diagnosed with HIV after their 60th birthday, 12 physicians, and 11 nurses working at Family Health Strategy took part in the study. The data were obtained with semistructured interviews analyzed according to Bardins Content Analysis, more specifically Thematic Analysis. Seeking to understand the reasons that have made the elderly vulnerable to the HIV infection, we adopted for analysis the following categories: individual, social and programmatic vulnerability. We established as empirical categories: - HIV infection and forms of contagion; - Facing seropositivity: the daily life of the elderly living with HIV; - Access of the elderly to health services vs. request for HIV serology; - Milestones in the relationship between health professionals and the elderly; - Planning, commitment and responsibility of professionals towards the elderly. The articulation of the subcategories arising from the empirical categories enabled us to identify two central categories: Living with HIV/Aids and late diagnosis. The concept of vulnerability in the context of human rights enabled us to view aspects that can contribute to the psychosocial emancipation of the elderly. To that purpose, it is necessary to recognize the elderly as social, sexual, and rightful individuals, as actors of their lives and rights. In conclusion, unless health services engage the elderly in actions geared at the prevention of STD/AIDS, there will be few advances in the struggle against the epidemic. Therefore, health organizations, by means of specific programs, and health professionals, who have to take the elderly into consideration, including their sexuality, should strive to contribute to a better quality of life for this demographic.

As transformações no modelo de assistência ao parto e nascimento e a criação de Centros de Parto Normal (CPN) no âmbito do Sistema Único de Saúde (SUS) remetem à importância de explorar a assistência ao parto neste contexto. O presente estudo teve o objetivo de compreender e descrever as crenças e os valores que norteiam as práticas dos profissionais em um CPN. Foi utilizada a abordagem qualitativa de pesquisa e o método etnográfico em um CPN de uma maternidade pública localizada na cidade de Osasco, Estado de São Paulo, Brasil. Os dados foram coletados por meio do processo de observação participante e de entrevistas etnográficas. Foram entrevistados todos os membros da equipe profissional, composta por enfermeiro obstetra, técnico de enfermagem, médico obstetra e médico neonatologista, que estavam diretamente envolvidos na assistência ao parto, e os gestores da instituição. A análise indutiva e interpretativa dos dados resultou em quatro subtemas culturais, que correspondem a cada uma das categorias profissionais: Enfermeira obstetra: Este CPN não é como deveria ser: inúmeros obstáculos dificultam a prestação da assistência humanizada ao parto; Técnicas de enfermagem: Fazendo o que é possível: satisfação com a assistência que é prestada mediante superação de muitas dificuldades; Médico obstetra: Um árduo cotidiano que impede o desenvolvimento da assistência desejada; Médico neonatologista: Dificuldades existem porque são comuns no serviço público, mas há satisfação em relação à assistência prestada no CPN. Destes subtemas culturais emergiu o tema cultural Entre o idealizado e o possível: os limites na assistência humanizada ao parto, que representa o cotidiano da assistência ao parto no CPN que foi foco desta pesquisa. As limitações para o desenvolvimento da assistência humanizada ao parto estavam relacionadas, não somente aos problemas relativos à precariedade da estrutura física e de recursos humanos ou aos déficits provocados pelo financiamento insuficiente da assistência ao parto. Estavam envolvidos também as crenças e os valores dos profissionais e o seu grau de envolvimento com a filosofia de humanização da assistência ao parto. Contatou-se que a efetivação da assistência humanizada ao parto, como preconizada pelos organismos nacionais e internacionais, depende da superação das inúmeras dificuldades descritas neste estudo. Um grande desafio deste âmbito está representado pela necessidade de articulação entre a grade curricular dos cursos da área da saúde com os fundamentos da Medicina Baseada em Evidências Científicas. Portanto, é de fundamental importância a existência de serviços exemplares, que prestam assistência humanizada ao parto, para os estudantes de graduação e para os profissionais. / The transformation in the model of childbirth assistance and the creation of Birth Centers within the Brazilian Unified Health System referred to the importance of exploring the delivery assistance. This study aimed to understand and describe the beliefs and values that guide the practice of professionals in a Birth Center. We used a qualitative research approach and ethnographic method was developed in a Birth Center in a public hospital at the city of Osasco, São Paulo, Brazil. Data were obtained through the process of participant observation and ethnographic interviews. We interviewed all members of the professional team consisting of nurse midwife, technical nurse assistant, obstetrician and neonatologist physician, who were directly involved in delivery care and management of the institution. The inductive analysis and interpretation of data resulted in four sub-cultural themes, which correspond to each of the professions: nurse midwife: \"The Birth Center is not as it should be, many obstacles interfere on a humanized assistance of a childbirth; Technical nurse assistant: \"Doing what is possible: satisfaction with the giving assistance throught overcoming many difficulties\"; Obstetrician Doctor: \"A hard routine restrains the development of a good assistance; Medical neonatologist:\" Difficulties exist because they are common in the public service, but there is a satisfaction in relation to the assistance provided at the Birth Center. \" From sub-cultural themes emerged a cultural theme \"Between the idealized and the possible: the limits in the humanized delivery care\", which represents the everyday care delivery in the Birth Center that was the focus of this research. The limitations for the development of humanized childbirth were related not only to problems related to the precarious physical infrastructure and human resources or deficits caused by insufficient funding of childbirth care. They were also involved in the beliefs and values of professionals and their degree of involvement with the philosophy of humanization of childbirth care. It was noted that the effectiveness of humanized delivery care, as recommended by national and international organizations, depends on overcoming the several difficulties described in this study. A major challenge in this context is represented by the need to articulate the courses academic subjects in the health field with the fundamentals of Scientific Evidence-Based Medicine. Therefore it is very importante to the existence of exemplary service to the graduate students and professionals.

The present study was developed with a professional team that works with HIV/Aids patients in a public hospital of Fortaleza. It aimed to identify, comprehend and analyze the meanings these health professionals give to their practice at this main reference public hospital for in- fectious-contagious diseases. Qualitative approach was applied, the data research being collected through interviews and focal group based on psychodramatic theory. Ten professionals from Specialized Assistance Service â SAE, also known, at the hospital, by ambulatory, were interviewed to identify their technical core competences; know the nature of human relations at work; study their links to the institution; research how these professionals are seen by society as well as the difficulties and/or facilities in what concerns their professional practice; investigate the links between strategic management vision and crew practices. The interview contents was analyzed based upon the BardinÂs (2004) methodological principles, which commend a treatment of the information of the messages that can be made through a analysis of the meanings (thematic) or a analysis of the significance (lexical, of proceedings). It was noticed a heterogenic perception in the community of these professionals on their necessary knowledge, abilities and attitudes to the efficient work, and how these professionals experi- ment different and contradictory feelings in consequence of their practices and believe that society have stereotypes about them. Based upon the results of theses analyzes it was suggested the planning of a local team work development with the different kinds of professionals that lead with these patients, once it was noticed a necessity of interprofessional attitudes and practices; the implementation of human research administration by competences and a possible change in the way of administration of this specialized work in linking it with the strategic management of human researches and the proceeding of psychological and managerial nature with the health team from the HSJ SAE, once it was identified the necessity of this kind of intervention in this professional group. / Trata-se de um estudo realizado com uma equipe de profissionais que assistem pacientes com HIV/Aids num hospital pÃblico especializado de Fortaleza. Buscou-se identificar, compreender e analisar os significados que esses profissionais de saÃde atribuem a seu trabalho nesse hospital referÃncia em doenÃas infecto-contagiosas no CearÃ. Utilizou-se metodologia de cunho qualitativo, sendo instrumentos de coleta de dados a âentrevista semi-estruturadaâ e o âgrupo focalâ conduzido à luz da teoria psicodramÃtica. Dez profissionais da equipe de saÃde do ServiÃo de AssistÃncia Especializada - SAE, tambÃm chamado, no Hospital, de AmbulatÃrio, foram entrevistados com o objetivo de identificar as competÃncias tÃcnicas especÃficas; conhecer a natureza das relaÃÃes humanas no trabalho; estudar os nexos com a instituiÃÃo; pesquisar como esses profissionais eram vistos pela sociedade e inquirir sobre dificuldades e facilidades concernentes à sua prÃtica profissional; investigar as conexÃes entre a visÃo de gestÃo estratÃgica e as prÃticas da equipe. Para anÃlise do conteÃdo das entrevistas elegeu-se o referencial metodolÃgico de Bardin (2004). O mÃtodo preconizado pelo autor caracteriza-se como um tratamento da informaÃÃo contida nas mensagens e pode ser uma anÃlise de significados (temÃtica) ou uma anÃlise de significantes (lÃxica, de procedimentos). Observou-se a existÃncia de uma visÃo heterogÃnea desses cuidadores quanto aos conhecimentos, habilidades e atitudes necessÃrias à prÃtica do seu trabalho; bem como que esses profissionais experimentam e vivenciam sentimentos e afetos diferenciados e contraditÃrios em conseqÃÃncia de suas prÃticas e acreditam que sÃo vistos pela sociedade de forma estigmatizada. Recomendouse, a partir das anÃlises efetuadas, a necessidade da realizaÃÃo de um trabalho de desenvolvimento de equipe, face aos seus anseios pela interdisciplinaridade; implantaÃÃo da administraÃÃo de recursos humanos por competÃncias; uma eventual mudanÃa na organizaÃÃo do trabalho desses profissionais, no sentido de alinhÃ-la à gestÃo estratÃgica de pessoas e, por fim, a realizaÃÃo de terapÃuticas psicolÃgicas e de gestÃo com a equipe de saÃde que atua no SAE do HSJ, por se ter identificado a importÃncia de cuidar desses cuidadores.

O objeto deste estudo é a concepção Redução de Danos, optou-se pelo estudo qualitativo, exploratório e de campo. O objetivo principal é identificar e analisar as concepções dos profissionais de um Centro de Atenção Psicossocial Álcool e outras Drogas da cidade de São Paulo acerca da Redução de Danos. Foi desenvolvido com profissionais da equipe técnica de saúde mental e o coordenador do serviço. O marco conceitual teórico deste estudo é a Reforma Psiquiátrica e os pressupostos da Redução de Danos. Para a obtenção do material empírico a técnica empregada foi à entrevista semi-estruturada. Os instrumentos para coleta de dados contemplam a caracterização sociodemográfica dos colaboradores e um roteiro para entrevista que foi gravada. Os dados foram transcritos e analisados sob a luz do método Hermenêutico Dialético. Na análise emergiram quatro categorias: dificuldade em classificar a gravidade do consumo; a droga para encobrir as necessidades de grupos sociais desfavorecidos; a droga como necessidade de todas as classes nos tempos atuais e formas da RD de trabalhar com o consumo. O resultado aponta que para os sujeitos deste estudo a RD se posiciona como uma abordagem que se opõe ao modelo hegemônico de guerra as drogas e não parte do ponto único e exclusivo do uso de drogas como doença. Afirmam que a RD não é contra a abstinência e visa diminuir riscos e danos a saúde considerando todo o contexto, o desejo e as possibilidades de cada pessoa. Nesse sentido, amplia a oferta e as possibilidades de cuidados para as pessoas que fazem uso prejudicial dos diversos psicoativos. / The object of this study is the concept of Harm Reduction. It was opted to use a field research, with exploratory and qualitative approach. The main objective was to identify and analyze the views about Harm Reduction of professionals from a Psychosocial Care Center for Alcohol and Other Drugs in São Paulo. The study as developed throughout all of the professional categories, e.g. higher-level, technical and coordinators of the staff. The theoretical framework of this study is the Psychiatric Reform and the assumptions of Harm Reduction. To obtain the empirical data, it were used semi-structured interviews as technique. The instruments for data collection include the sociodemographic characteristics of the members of the staff and a guide for the interviews, which were recorded. Data was transcribed and analyzed under the view of the Hermeneutic Dialectic method. In the analysis, four categories emerged: e.g. difficulties in classifying the severity of consumption; drugs as a way to cover the needs of disadvantaged groups; drugs as a need for all classes in the current times and ways of working with Harm Reduction and the consumption. The result shows that for the subjects in this study the Harm Reduction stands as an approach that opposes the hegemonic model of the war on drugs and not part of the one and only point of drug use as a disease. Claim that the Harm Reduction is not against abstinence and aims to reduce health risks and damage considering the entire context, the desire and the possibilities of each person. In this sense, extends the offer and the possibilities of care for people who make use of the various harmful psychoactive.

A loucura teve sua representação elaborada historicamente e significada no contexto científico enquanto doença mental, possibilitando uma semiótica médica do diagnóstico, prognóstico e plano de tratamento. Diante disso, nesta pesquisa colocou-se o discurso sobre a doença mental no centro das investigações sobre os processos de interpretação e subjetivação, de sujeitos profissionais que lidam cotidianamente com o fenômeno. Nesse sentido, este trabalho objetivou investigar as representações sociais de profissionais de um serviço público de saúde mental sobre a doença mental, fundamentada no método de análise das representações sociais, segundo Moscovici (1978, 2004), Jodelet (2005a) e Jovchelovitch (1998). O contexto estudado foi um Centro de Atenção Psicossocial III no município de Ribeirão Preto, Brasil. É sabido que as representações de saúde e doença influenciam os paradigmas envolvidos nas práticas de diagnóstico e tratamento. Os procedimentos de coleta de dados contemplaram a observação participante e, a realização de entrevistas em profundidade, com roteiro temático. A escolha dos sujeitos (n=10) procurou contemplar a heterogeneidade do grupo estudado. As entrevistas foram analisadas de acordo com a técnica da análise de conteúdo (Bardin, 1979) e organizadas em categorias temáticas. Os resultados apontaram que as representações sociais dos profissionais foram construídas através da relação com os pares e a incorporação de novos conhecimentos. A doença mental permaneceu romantizada até o contato profissional com pacientes. A etiologia da doença mais aceita pelos profissionais foi a interacionista biopsicossocial. O discurso destes se diferencia dos leigos quanto às causas e melhores formas de tratamento, sendo que estas são idealizadas. As representações sociais dos profissionais compreendem a doença mental como algo imprevisível, incapacitante e permanente, sendo objetivada na imagem do deficiente como incapaz. Observou-se também que o paradigma psicossocial alimenta o discurso dos profissionais de saúde, mas ainda é um desafio para estes na prática. / The madness had its representation developed historically and signified in a scientific context as a mental illness, enabling medical semiotics of diagnosis, prognosis and treatment. Therefore, this research put this speech on mental illness at the center of investigations into the processes of interpretation and subjectivity of subject professionals who labor daily with the phenomenon. Therefore, this study aimed to investigate the social representations of professionals from a public mental health service about mental illness, based on the method of analysis of social representations, according to Moscovici (1978, 2004), Jodelet (2005a) and Jovchelovitch (1998). The context studied was a Centro de Atenção Psicossocial III in Ribeirão Preto, Brazil. It is well known that health and ilness influence paradigms involved in diagnosis and treatment practices. Data acquisition was made by observations and in-depth interviews. The subjects (n=10) were chosen in order to guarantee the heterogeneity of the group The interviews were analyzed according to the technique of content analysis (Bardin, 1979) and organized into thematic categories. Data analysis pointed that professional´s social representations were built by relationship with their peers and incorporation of new knowledges. Mental illness remained romanticized to the professional until it´s contact with patients. The etiology of the disease more accepted by professionals was the biopsychosocial interactional. Their vision regarding the causes and treatment of mental illness are different from ordinary people, but it remains idealized. The social representation of professionals comprehends mental illness as something unpredictable, disabling and permanent, objectified in the image of the poor and helpless. It was also observed that the psychosocial paradigm feeds the speech of health professionals, but it is still a challenge for these in practice.

The Integrative and Complementary Health Practices propose an effective model of health integral care that privileges the basic health and adopts the promotion of health as its structural axis. The use of integrative practices has increased over the past few years. The study is justified in the lack of knowledge shown by the health teams about the theme and in the importance that it can bring about to the Basic Health Care. The present study intends to answer the question: What‟s the conception about the Integrative and Complementary Health Practices to the professionals that work in Basic Health Units? As bibliographic references were used mainly Pierre Bourdieu, François Laplantine, Madel T. Luz, Nelson Filice de Barros and Charles Tesser, among others. The methodology was a qualitative approach, using semi-structured interviews and participant observation. To analyze the results, it was used the content analysis of Laurence Bardin. The proposal is inserted in the Gender, Body and Health Line of Research, of the UFSM Postgraduate Social Science Program, in the theme Health. / As Práticas Integrativas e Complementares em Saúde propõem um modelo efetivo de atenção integral à saúde, que passe a privilegiar a atenção básica e adote a promoção da saúde como seu eixo estruturante. O uso das práticas integrativas tem aumentado nos últimos anos. O estudo se justifica em função do desconhecimento apresentado pelas equipes de saúde sobre o tema e da importância que poderá acarretar para a Atenção Básica de Saúde. O presente estudo pretende responder à questão: Qual é a concepção das Práticas Integrativas e Complementares em Saúde para os profissionais que atuam em Unidades Básicas de Saúde? Como aporte teórico referencial, foram utilizados principalmente Pierre Bourdieu, François Laplantine, Madel Luz, Nelson Filice de Barros e Charles Tesser, entre outros. A metodologia foi uma abordagem qualitativa, utilizando entrevistas semiestruturadas e observação participante. Para análise dos resultados, foi utilizada a análise de conteúdo de Laurence Bardin. A proposta se insere na linha de pesquisa Gênero, Corpo e Saúde, do Programa de Pós-Graduação em Ciências Sociais da UFSM, no tema Saúde.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / This research aimed to know as the physicians of the Neonatal and Pediatric Intensive Care Units (ICU) mean the dysthanasia. The specific objectives sought to identify the impact of the children's death to the physician; to understand like they live the difficulty of a child's cure; and to understand as the physician of the Neonatal and Pediatric Intensive Care Units identify their preparation to work with situations of life end in children. For so much, it was used an exploratory/descriptive study, of qualitative approach. Participated in the research 6 physicians and 5 residents, belonging to the Neonatal and Pediatric Intensive Care Units. As instrument for the data collection it was used a semi-structured interview. The information of the interviews was transcribed and analyzed starting from the content analysis. The ethical principles were respected, so that the participants rights were preserved, and an Informed Consent Document was signed as a condition to participate in the research. Among the results, it was observed that the physicians mean the dysthanasia in Neonatal and Pediatric Intensive Care Units under influence of multiples factors, leaving of the absence of the teaching and preparation to work with the death in the hospital daily during the graduation; the complexity of the daily coexistence with the death and the process of dying, together with the feelings and defense mechanisms; the statements that the dysthanasia really happens; the obstinate requests of the terminal patient's family interned in ICU, are going to have doubts in relation to the investment, or no, in the same and in the criteria used to know if they apply investing; the divergences of the team in the sockets of decision; the enormous fear of the ethical and legal repercussions in relation to the taken decisions, in what refers to the codes of practice and the Brazilian Penal code. It was ended, in this study, that improvement needs exist with respect to multiple aspects regarding the death: their approach, in the graduation and residence; appropriate communication among the professionals during decision making process and during the work in ICU; the consideration between the desires of the family and the real possibilities of survival of the patient. / Esta pesquisa objetivou conhecer como os médicos das UTIs neonatal e pediátrica significam a distanásia. Os objetivos específicos visaram identificar o impacto emocional da morte de crianças nos médicos; entender como eles vivenciam a dificuldade de cura de uma criança; e compreender como os médicos das UTIs neonatal e pediátrica identificam o seu preparo para lidar com situações de final de vida em crianças. Para tanto, utilizou-se de um estudo exploratório/descritivo, de abordagem qualitativa. Participaram da pesquisa 6 médicos e 5 residentes, pertencentes às UTIs neonatal e pediátrica. Como instrumento para a coleta de dados, utilizou-se de uma entrevista semiestruturada. As informações das entrevistas foram transcritas e analisadas a partir da análise de conteúdo. Os princípios éticos foram respeitados, de forma a proteger todos os direitos dos participantes, com formalização da participação por meio de Termo de Consentimento Livre e Esclarecido. Dentre os resultados, observou-se que os médicos significam a distanásia em UTI pediátrica e neonatal sob influência de múltiplos fatores, partindo da ausência do ensino e preparação para lidar com a morte no cotidiano hospitalar durante a graduação; a complexidade da convivência cotidiana com a morte e o processo de morrer, juntamente com os sentimentos e mecanismos de defesa; as afirmações de que a distanásia realmente acontece; os pedidos obstinados da família do paciente terminal internado na UTI, passando pelas dúvidas em relação ao investimento, ou não, no mesmo e nos critérios utilizados para se saber até onde investir; as divergências da equipe nas tomadas de decisão; o enorme receio das repercussões éticas e legais em relação às decisões tomadas, no que se refere aos códigos de ética profissional e o Código Penal brasileiro. Concluiu-se, neste estudo, que existem necessidades de aperfeiçoamento no que tange a múltiplos aspectos referentes à morte: sua abordagem, na graduação e residência; comunicação adequada entre os profissionais durante os processos decisórios e durante o trabalho na UTI; a ponderação entre os desejos da família e as reais possibilidades de sobrevivência do doente.

Magister Public Health - MPH / Job satisfaction is important for the delivery of quality health care and health worker retention. This study aimed to identify the extent of job satisfaction among University Teaching Hospital of Kigali (UTHK) health workers and to describe the variables related to job satisfaction. These included working conditions, remuneration, patient care, development opportunities, supervision, time pressure and staff relations. A cross- sectional survey of UTHK health workers was conducted using a standardized instrument to identify health worker job satisfaction with related key work factors. A self-administered questionnaire was used to collect data from 274 health workers selected using a proportional stratified random sampling method and which included 21 medical doctors, 159 nurses, 19 midwives, 37 paramedic and 37 administrative staff. Respondents provided written consent to participate in the study. Analysis consisted of both descriptive statistics of overall satisfaction and various satisfactionrelated factors. For determining whether there is a significant relationship between job satisfaction and its independent variables, data were categorized and Chi-square or Fisher Exact test performed. Results showed a moderate overall job satisfaction level with 79.1% of respondents rating their satisfaction between 6 and 8 (mean: 6.7) on a scale of 1-10. A majority of respondents (82.6%) reported being dissatisfied with work income and 85.6% believed that their pay was not comparable to the work done. Over four fifths of the respondents (83.3%) reported feeling overwhelmed by responsibilities at work while a big percentage (96.5%) reported their job to be demanding physically, emotionally as well as mentally. However, respondents reported strong satisfaction (between 80% and 95%) with respect to work meaning, professionalization, training and orientation variables. Factors significantly associated with job satisfaction were adequate training to fulfill responsibilities (p value<0.001), feeling unvalued by the hospital (p=0.037) and dissatisfaction with supervisor care for patients and employees (p=0.034). In conclusion, improvement of remuneration, working conditions and hospital management in Kigali University Teaching Hospital would be expected to increase the level of job satisfaction of hospital health workforce.

Magister Pharmaceuticae - MPharm / The effects of disability on the individual not only include physical, psychological and emotional adjustments but also negative attitudes of able bodied people towards persons with disabilities. The attitudes of healthcare professionals towards persons with disabilities could affect rehabilitation outcomes as well as the reintegration of these people into society. The aim of the study was to investigate the attitudes of health science students towards persons with disabilities at Kilimanjaro Christian Medical Centre (KCMC), in Tanzania. An explorative quantitative research design using a cross-sectional survey was used. The study sample (182) included all Physiotherapy, Occupational Therapy, Nursing, Medical and Optometry students. Data was collected using the Attitudes Towards Disabled Persons Scale,consisting of 20 items rated on a six-point Likert Type Scale. A demographic questionnaire which included questions relating to the contact of the students with persons with disabilities was also administered. Descriptive and Inferential statistical analysis was conducted using the Statistical Package for the Social Sciences version 15.0. Permission to conduct the study was obtained from the Higher Degrees Committee and the Senate Research Grant and Study Leave Committee of the University of the Western Cape. Further permission was requested from Ministry of Education, Research and Ethics Department in Tanzania and the authorities of the respective Health Sciences programmes to include students in the study. Information obtained was handled with confidentiality and anonymity, and the students had the right to withdraw from the study at anytime.The results revealed that the sample consisted of more females (58%) than males (41.2%).The majority of the participants were between the ages of 20-29 years. The highest response rate was from the medical students (29.1%) followed by the physiotherapy students (27.5%).The Optometry and physiotherapy students had more positive attitudes than the rest of the health science students who participated. The mean score on the ATDP scale was 59.01 (12.3) with scores ranging from 18 to 90. The results therefore revealed that overall the students had a neutral to negative attitude towards persons with disabilities. With regards to the contact of the students with persons with disabilities 26.9% of the participants responded that they had had a long talk with a person with a disability while only 17.6% of the students responded that persons with disabilities visited their homes. The mean contact score was 22.72 indicating that the students had a slightly above average contact with persons with disabilities. No association was found between the attitude and contact mean scores.Information obtained in this study could be used to influence the curriculum of Health Science Students at Kilimanjaro Christian Medical Centre.

>Magister Scientiae - MSc / Scientific studies have shown that chronic diseases of lifestyle (CDL) such as hypertension and diabetes mellitus are major causes of mortality and morbidity, accounting for about 60% of the disease burden globally. Available statistics for Swaziland indicate that hypertension and heart diseases are on the increase and are responsible for 33,540 and 3,146 cases per year respectively. Regular physical activity (PA) is widely recognised as a means for the primary and secondary prevention of CDL due to their multi-factorial beneficial effects on an individual‟s health. Therefore, the aim of this study was to determine PA participation among adults with hypertension in Mbabane, Swaziland and the extent to which they are encouraged to be physically active. A cross-sectional design, utilising quantitative methods was employed in the study and three validated standardised interview administered questionnaires were used to collect data from both hypertensive individuals and health professionals. A sample size of 422 hypertensive individuals and 72 health professionals was included in the study. Statistical Package for Social Sciences (SPSS) version 20 was used to analyse the data. Descriptive statistics were employed to summarise data and was expressed as means, standard deviation, frequencies and percentages. The Students‟t-test was used to compare mean age and PA. Chi-square tests were used to test for associations between categorical variables with significant levels set at 5% (p < 0.05). Blood pressure was classified into controlled (≤ 140/≤ 90 mmHg) and uncontrolled (≥ 140/≥ 90 mmHg). PA was dichotomised into active (> 600 MET-minute/week) and sedentary (< 599 METminute/ week). BMI was classified as underweight (<18.5), normal (18.5-24.9), overweight (25-29.9) and obese (>30). The findings of the current study revealed that a considerable number of individuals with hypertension (53%) were physically inactive with poorly controlled blood pressure (57%). A statistical significance was found between mean age and PA (sedentary and active) (P= 0.000 ˂ 0.05). iii The study also revealed that the perceived benefits of PA as reported by individuals with hypertension outweighed the perceived barriers. In addition, the majority of health professionals were found to be poor counsellors of PA (58%). Most health professionals informed their patients on becoming physically active but did not include important components of PA counselling such as the types of PA, intensity and duration. The common reasons for not including PA as part of the daily routine include: not my area of specialty and lack of time. These factors could significantly contribute to sedentary behaviour among hypertensive individuals in developing countries such as Swaziland. For this reason, an urgent need for PA promotion programmes which will motivate hypertensive individuals to participate in sufficient levels of PA as recommended by public health research has been established. The programmes should include educating health professionals on current trends in the promotion of PA. A combination of these approaches will help to reduce morbidity and mortality from cardio-vascular disease (CVD), in particular hypertension.