Bakgrund: Sverige tar emot många asylsökande vilket har medfört att arbetsbelastningen för distriktssköterskor inom primärvården har ökat. Några av de svårigheter som distriktssköterskan ställs inför när det gäller omvårdnaden och omhändertagandet kring asylsökande är bland annat, att bemöta dem med vänlighet och respekt och att försöka lindra deras lidande. Syfte: Syftet med studien var att beskriva asylsökandes upplevelser av bemötande från distriktssköterskor och övrig vårdpersonal på en flyktinghälsa och vårdcentral. Metod:Kvalitativ design med en induktiv ansats valdes till denna studie. Semistrukturerade intervjuer utfördes med hjälp av professionell telefontolk med 12 asylsökande. Materialet analyserades med kvalitativ innehållsanalys med fokus på det latenta innehållet. Resultat: Bemötande har många dimensioner som kan ge upphov till många olika känslor. Asylsökande har i vårdmötet upplevt bemötande som orsakat dem otrygghet och vårdlidande men även bemötande som har gett dem trygghet och känslan av att vara betydelsefulla som människor. Slutsats: Upplevelser kring varje vårdmöte är individuella och unika. Vårdlidande kan uppstå genom att asylsökande upplever otrygghet i det vårdande mötet. Om asylsökande däremot upplever trygghet i vårdmötet kan deras lidande lindras. / Background: Sweden receives many asylum seekers which implies that the workload of district nurses in primary care has increased. Some of the difficulties that the district nurse face when it comes to the nursing care and the specific care of asylum seekers is, among other things, to treat them with kindness and respect and to try to lessen their suffering. Purpose: The purpose of this study was to describe the asylum seekers' experiences of nurse-patient encounters with the district nurses and other health professionals at a refugee health clinic and health center. Method: Qualitative design with an inductive approach was chosen for this study. Semi-structured interviews were conducted with the help of professional telephone interpreters’ with 12 asylum seekers. The material was analyzed using qualitative content analysis focusing the latent content. Results: Treatment (nurse-patient encounters) have many dimensions that can cause many different feelings. Asylum seekers have in the health care encounter experienced treatment that caused them a sence of insecurity and suffering due to care but also the nursing staffs’ attitude has given them increased confidence and a feeling of being an important person. Conclusion: Experiences of each nurse-patient encounter is individual and unique. Care suffering can be caused by that asylum seekers are experiencing a sence of insecurity in the encounter with health care. But if they experience security in the encounter with health care staff, their suffering lessened.

Bakgrund: En människa som saknar uppehållstillstånd, saknar ofta vissa rättigheter till vård. Vårdpersonal möter papperslösa patienter i olika sammanhang vilket skapar en stor variation av inställningar och uppfattningar om deras rätt till vård. För att uppnå en rättvis och fungerande vård för denna utsatta grupp krävs bland annat tydliga riktlinjer och flexibilitet av sjuksköterskan. Syfte: Att skildra vårdpersonalens, med inriktning mot sjuksköterskans, upplevelser och etiska argument i vårdandet av papperslösa. Metod: Litteraturöversikt baserad på elva vetenskapliga artiklar hämtade i databaserna SwePub, CINAHL with Full Text och Academic Search Premier. Artiklarna har analyserats enligt Fribergs (2012a) modell. Resultat: Resultatet presenteras i fem huvudkategorier och två underkategorier. Första huvudkategorin är Vårdpersonalens inställning till att vårda papperslösa vilket visar att åsikter går isär kring papperslösas rätt till vård. Andra huvudkategorin är Upplevelser kring regelverk och riktlinjer där det framkommer att det råder oklarheter kring dessa. I den tredje kategorin Vårdrelation framkommer det att flexibilitet krävs av sjuksköterskan i mötet med papperslösa. Den fjärde huvudkategorin är Vårdpersonalens upplevda barriärer i vården som har två underkategorier. Den femte och sista huvudkategorin är Organisationer och deras samarbete och visar på ett behov av samarbete mellan vårdinstanser, myndigheter och frivilligorganisationer.   Diskussion: Resultatet analyseras utifrån Beauchamp och Childress (2013) vårdetiska teori om de fyra principerna om autonomi, att inte skada, att göra gott samt rättviseprincipen. Diskussionen visar att konflikter uppstår mellan principer och att lagar och restriktioner leder till etisk stress och etiska kostnader. / Background: A person without a residence permit, often lacks certain rights to care. Health professionals encounter undocumented patients in different contexts which generates a large variety of perceptions of their right to health care. Clear guidelines and flexibility is required by the nurse in order to achieve a fair and effective care for this vulnerable group.   Aim: To describe the experiences and ethical arguments of health professionals and nurses in particular in the care of undocumented migrants.  Method: A literature review based on eleven scientific articles were used and selected from the databases SwePub, CINAHL plus with Full Text and Academic Search Premier. The articles have been reviewed and analyzed by the Friberg model (2012a). Results: The results are presented in five main categories and two subcategories. The first main category Health professionals’ attitudes towards caring for undocumented migrants indicates that opinions differ about their rights and access to health care. Ambiguities towards the regulations are shown in the second main category Experiences surrounding regulations. The third category Caring relationship shows that flexibility is required by the nurse when caring for undocumented migrants. The fourth category presents Barriers perceived by health care professionals. The fifth and final category Organizations and cooperation demonstrates a need for health care institutions, government agencies and NGO’s to collaborate. Discussions: The result is analysed according to Beauchamp and Childress (2013) care ethical theory concerning the four principles: respect for autonomy, non-maleficence, beneficence and justice. The discussion shows that conflicts occur between the principles. Laws and limits lead to ethical stress and costs.

Background: To care for someone with a mental illness can be strenuous both mentally, socially and economically. Those close to the patient are often there as support before mental health care can intervene, and they are often there when the patient is discharged from the hospital. A good relationship between mental health care personnel and those close to the patient is of most importance for creating a feeling of participation in the care of the patient. This requires that the mental health care personnel are aware of the needs of those close and have knowledge of how to meet these. Aim: To describe how those close to someone - usually a relative or loved one - with a mental illness experience the treatment from mental health personnel Method: Literature review based on 17 articles with a qualitative perspective. Analyzed using a descriptive data analysis technique. Results: Results show that those close to someone with a mental illness often feel excluded in the care of their loved ones, and mental health personnel fail to satisfy the relative or loved one’s basic needs - especially in the area of providing them with information and showing them respect. This exclusion can be felt when the care provider shows the loved one / family member an authoritarian attitude rather than appreciating or acknowledging the importance of the knowledge that these loved one possess regarding the patient’s mental illness. The results show that in cases when mental health personnel have been accommodating to the needs of the next of kin by making them feel respected, heard and taken seriously the loved one have feelings of inclusion and participation in the caring process. Discussions: The foundation of the relationship between mental health personnel and those close to the patient is often established within the first meeting. It is therefore of utterly importance that the mental health professionals are aware of how their demeanor and attitude are affecting the next of kins perception of participation. The needs of those close to the patient can, in most cases, be satisfied with relatively small means. Keywords: Relative, relatives of the mentally ill, treatment by mental health care professionals, participation, professional-family relations / Bakgrund: Att vara anhörig till en närstående med psykisk ohälsa kan vara påfrestande såväl ekonomiskt som psykiskt och socialt. Anhöriga är oftast de som är där och stöttar och hjälper till både innan och efter sjukhusvistelsen. Ett gott bemötande från vårdpersonalen är ytterst viktigt för att känna delaktighet i vårdandet, detta förutsätter att personalen är väl medveten om anhörigas behov och kan tillgodose dessa. Syfte: Att beskriva anhörigas erfarenheter av bemötandet från psykiatrisk vårdpersonal Metod: Kvalitativ litteraturstudie inkluderat 17 artiklar med kvalitativt perspektiv. Data har analyserats med tolkande dataanalys. Resultat: Resultatet visar på att anhöriga till stor del känner sig exkluderade i vårdandet av deras närstående, vårdpersonalen misslyckas ofta med att tillgodose anhörigas behov, genom att visa upp en auktoritär attityd, inte erbjuda adekvat information och uppmärksamma anhöriga som den tillgång de faktiskt är. Resultatet visar även på tillfällen då vårdpersonalens agerande får anhöriga att känna sig inkluderade och respekterade genom att skapa en känsla av delaktighet i vårdandet. Diskussion: Mötet mellan vårdpersonal och anhöriga tenderar att fallera redan på ett tidigt stadium, då innerbörden av ett gott bemötande samt vikten av att etablera en fungerade kontakt många gånger glöms bort eller inte uppmärksammas. Delaktighet i vårdandet förutsätter att vårdpersonalen är uppmärksam på anhörigas behov, genom relativt enkla medel kan dessa i de flesta fall tillgodoses.

Made available in DSpace on 2015-04-22T22:06:37Z (GMT). No. of bitstreams: 1 Dissertacao-SELMA.pdf: 1364010 bytes, checksum: 5110016b72698ae07033570a648e11f4 (MD5) Previous issue date: 2010-06-22 / FAPEAM - Fundação de Amparo à Pesquisa do Estado do Amazonas / This study had as objective the analysis of how the demands of violence against children and teenagers affect the working process of health sector professionals: in the process of assistance, in the production of registers and in the formation of a professional identity. The methodology design used involves a qualitative approach in social research, with a case study through interviews and official registers in the target institution and the municipality. The study was conducted in a public hospital in Manaus. The data analysis was based on Bardin s (1977) content analysis methodology, developing the categories: definitions of the subject by the professionals, types of violence acknowledged, strategies presented for cases identification, violence impacts on health sector professionals, the follow up to the cases in the Health Institution according to the professionals, the difficulties identified and challenged in the management of cases, the directing to other institutions and its follow up by the Health institution, the formation of professionals and their knowledge of the ECA (Child and Teenager Estatute) and repercussion in the still dreamed integral assistance. The results showed under-notification of cases, little follow up and no monitoring of the cases of violence, which could be the reflex of the lack of training of professionals, recognized by 100% of the interviewees, who recognized having non-sufficient knowledge about the ECA, no belief in a solution for the cases with the accountability of those responsible and almost non-existent public policies for social and psychological support to follow up the identified cases, adding up to the constant stress faced by these professionals. / Este estudo teve como objetivo, analisar como a demanda dos maus-tratos à criança e ao adolescente afeta o processo de trabalho dos profissionais de saúde na produção da assistência, na produção de registro e na conformação de uma identidade profissional. O desenho metodológico utilizado é de uma abordagem qualitativa em pesquisa social, um estudo de caso, por meio de entrevistas e levantamento das ocorrências dos casos registrados na instituição e no município, sendo o campo de estudo um serviço de pronto atendimento infantil num Hospital Público de Manaus. A análise dos dados foi baseada nos princípios do método de análise de conteúdo, de Bardin (1977). A partir da análise, foram desenvolvidas as categorias: definições do tema pelos profissionais, tipos de maus-tratos conhecidos, estratégias apresentadas na identificação dos casos, marcas dos maus-tratos nos profissionais da saúde, percursos dos casos na Unidade de Saúde segundo os profissionais, barreiras nomeadas e enfrentadas no manejo dos casos, encaminhamentos e monitoramentos realizados pela unidade, formação dos profissionais, conhecimento do ECA e repercussões na ainda utópica proteção integral. Os resultados analisados apontam para uma sub-notificação, pouco encaminhamento e nenhum monitoramento dos casos de maus-tratos, que podem ser reflexos de pouca capacitação dos profissionais em identificar os casos, expressa por 100% dos entrevistados que reconheceram serem insuficientes os seus conhecimentos a respeito do ECA, e apresentaram uma descrença na resolução dos casos pelas instâncias da responsabilização, bem como a quase inexistência de políticas públicas e serviços de suporte psicossocial para encaminhar os casos encontrados, contribuindo ainda mais no aumento do nível de estresse vivenciado pelos profissionais na unidade estudada.

Made available in DSpace on 2016-04-28T20:38:46Z (GMT). No. of bitstreams: 1 Mariana Sarkis Braz.pdf: 618893 bytes, checksum: 1611e2369644aad5db2f2d2aad7695b6 (MD5) Previous issue date: 2013-11-01 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Palliative care seek quality of life based primarily on prevention and relief of suffering of patients who have life threatening diseases, encompassing the areas of physical, psychosocial and spiritual. Furthermore, extending the post-mortem patient, it offers support the family support in the grieving process. The theme provides discussions of education for death and dying process for health care professionals who are educated mostly geared towards the enhancement of technical knowledge at the expense of a humanist education, which removes the theme of death as the focus of learning. This qualitative study aimed to understand and analyze the training of professionals in relation to dying patient and their perception regarding their contributions to the prevention of complicated grief care unit. The Attachment Theory grounded this research theoretically, providing support for the analysis. Health professionals who integrate palliative care teams voluntarily participated in this research . A questionnaire was used to obtain academic and professional data, besides courses taken. A semi-structured interview allowed us to understand the following topics: the choice of working in palliative care, the strategies used (by oneself and by the care unit) on a daily basis to deal with the issue of the dying process and the perception of its contribution to the prevention of complicated grief of patient and family. The results confirmed that the training of professionals in relation to the dying process is scarce. Moreover, it was observed that health professionals working in palliative care have attachment behaviors, identified as natural in this context, and that ends up to make it harder to realize that those are important contributions to prevent grief from becoming complicated in the care unit / Os cuidados paliativos buscam qualidade de vida baseada principalmente na prevenção e no alívio do sofrimento de pacientes que possuem doenças ameaçadoras de vida, englobando as esferas de ordem física, psicossocial e espiritual. Além disso, estende-se ao pós-morte do paciente, oferecendo suporte e apoio à família no processo de luto. O tema proporciona discussões acerca de educação para morte e processo de morrer para os profissionais de saúde, que têm uma formação em sua maioria voltada para a valorização do saber técnico em detrimento de uma formação humanista, o que afasta o tema da morte como foco de aprendizado. Esta pesquisa qualitativa teve como objetivo compreender e analisar a formação dos profissionais em relação ao processo de morrer do paciente e as percepções daqueles em relação às suas contribuições para a prevenção de luto complicado da unidade de cuidado. A Teoria do Apego fundamentou teoricamente esta pesquisa, oferecendo respaldo para a análise. Participaram voluntariamente desta pesquisa profissionais de saúde, que integram formalmente equipes de cuidados paliativos. Foi utilizado um questionário auto-aplicativo para obtenção de dados acadêmicos, profissionais e de cursos realizados e uma entrevista semiestruturada, que permitiu compreender os seguintes tópicos: a escolha de trabalhar em cuidados paliativos; as estratégias utilizadas (para si mesmo e para com a unidade de cuidado) no dia a dia para lidar com a questão do processo de morrer e a percepção sobre a sua contribuição para a prevenção de um luto complicado de paciente e família. Os resultados confirmaram que a formação dos profissionais em relação ao processo de morrer é escassa. Ademais, observou-se que os profissionais de saúde que trabalham em cuidados paliativos possuem comportamentos de apego, os quais são identificados como naturais nesse contexto, o que acaba por dificultar a percepção de que são importantes contribuições para a prevenção de luto complicado da unidade de cuidado

Many organizations now realize the important role of social network technology (SNT) in building social capital and hence broadening their customer base. However, observations have indicated that, while working, many knowledge workers use SNT to engage in non-job related activities, potentially leading to a decrease in productivity. The purpose of this study was to examine the relationship between the usage of SNT and productivity in the health sector. The theoretical foundation of this study emanated from Rogers's theory of diffusion of innovations and Campbell, Rodney, Scott, and Christopher's theory of performance. Collection of data involved a self-administered survey designed with tools from SurveyMonkey. Out of 123 respondents, some were team members (67%), some were independent (24%), others were team leaders (8%), and a few were administrators (2%). A multiple linear regression analysis subsequent to correlation analysis between each of the 4 variables of SNT (frequency of SNT use, duration of cellphone-based SNT use, duration of PC-based SNT use, and performance rating) and knowledge worker productivity revealed a significant relationship between productivity and performance. The findings suggest that, of the 4 SNT variables, performance rating statistically predicts productivity of the health care professional. Managers may find these results informative in their effort to boost productivity among their health care professional workers. Further investigations are recommended to explore the association between productivity and SNT among knowledge workers.

Syftet med denna studie var att undersöka kunskap och uppfattningar om papperslösas tillgång och rätt till vård hos personal inom öppen hälso- och sjukvård i Landstinget i Uppsala län. Ett ytterligare syfte var att undersöka om information kring handhavandet av papperslösa finns på arbetsplatserna, vad personal i så fall anser om detta, samt vad de önskar för information.   Studien är av en deskriptiv design med kvantitativ ansats. 86 anställda vid vårdcentraler i Uppsala län besvarade enkäter med frågor angående kunskap och uppfattningar om lagstiftning samt tillgång till och önskan om information gällande papperslösa. Insamlad data har sammanställts i Microsoft Excel och presenterats i tabeller och diagram.   Resultatet av studien tyder på att det finns en kunskapsbrist bland personal inom öppen hälso- och sjukvård angående lagstiftningen om papperslösas tillgång till sjukvård. Enligt de medverkandes vetskap finns ingen information tillgänglig på arbetsplatsen gällande papperslösa, och så gott som alla önskar information av något slag. Majoriteten av de tillfrågade anser att papperslösa ska ha samma rätt till vård som svenska medborgare.   Slutsatsen av denna studie är att det finns ett behov av information och riktlinjer gällande handläggning av papperslösa i Landstinget i Uppsala län. / The aim of this study was to investigate knowledge and opinions concerning undocumented migrants’ access and right to health care among employees within the primary health care sector in the county council of Uppsala. An additional aim was to investigate whether there is information available about management of undocumented migrants at the workplaces, and if so what the employees think about it and what kind of information they wish to receive.   The study is quantitative with a descriptive design. 86 employees at primary health care centres within the county of Uppsala answered questionnaires concerning knowledge and opinions about legislation as well as access to and demand for information concerning undocumented migrants. Collected data was compiled using Microsoft Excel and was then presented in tables and diagrams.   The result of the study indicates that there is a lack of knowledge among employees within the primary health care sector concerning legislation on undocumented migrants’ access to health care. According to the employees’ knowledge there is no information available at the workplace concerning undocumented migrants, and nearly everyone requested information of some kind. The majority of the employees are of the opinion that undocumented migrants should have the same right to health care as Swedish citizens.   The conclusion of this study is that there is a need for information and guidelines concerning management of undocumented migrants in the county council of Uppsala.

Background Considering ~9 million Canadians have one or more chronic health conditions, and >3.3 million report some level of disability, the burden of care is substantive for individuals and health system. With such conditions, self-care is essential but may pose challenges to both individuals and providers of care. As a concept, self-care is poorly understood. Further, evidence for effective self-care support is diffuse and typically studied relative to specific conditions. Objectives To investigate the concept of self-care three objectives were undertaken: 1) explore and describe the construct of self-care as understood by individuals/families, health care professionals, researchers, policy-makers; and industry; 2) produce new knowledge for health care professionals about interventions for self-care across a range of population groups; 3) develop a provisional framework to inform practice and research. Method A multi-phase enquiry was undertaken. Phase 1 Concept clarification including: 1) synthesis of qualitative evidence on the experience of self-care reported by individuals/families; 2) content analysis and definitional study of the meaning of self-care; 3) concept analysis of self-care; 4) creation of a conceptual schema encompassing these perspectives. Phase 2 Self-care Interventions: Integrative study of systematic reviews, synthesizing evidence for self-care interventions from multiple disease/impairment groupings. Results Three modes of self-care were revealed : ‘Care of self’ self-care performed on one’s own behalf; ‘care by other’ acknowledging individuals with disabilities who guide and direct care provided by another person; and ‘care of other’- care of families and others at a community level. Analysis of 30 self-care interventions across 16 conditions demonstrated that educational sessions and self-care management plans are emerging as effective strategies to support and guide self-care. Conclusion Self-care is a complex care concept that is becoming an expected element in today’s health care environment. A full understanding of how it is viewed, including the individual’s perspective, is vital for enactment and beneficial support. This comprehensive understanding of the concept along with evidence for effective interventions drawn from multiple groups will assist health care professionals to improve their assessments and provide them with strategies to support self-care needs –ultimately, contributing to enabling individuals to maintain their highest level of functioning. / Thesis (Ph.D, Rehabilitation Science) -- Queen's University, 2010-09-24 09:33:03.17

Surgical face masks have been designed to protect health care professionals from the splashes of the patients’ blood or body fluids and also to minimise the transmission of oro- and nasopharyngeal bacteria from the surgical team to the patient’s wounds, thereby decreasing the likelihood of postoperative surgical site infections during a surgical procedure. However, there are several ways in which surgical face masks could potentially contribute to contamination of the wound during a surgical procedure in the operating room. The objectives of this study were to explore and describe the effectiveness of surgical face masks as a protective barrier during a surgical procedure in the operating room in the public hospitals in the North West Province, South Africa and to formulate recommendations regarding surgical face masks worn by health care professionals during a surgical procedure in the operating rooms. A systematic review was conducted, followed by a quantitative, explorative, descriptive and contextual approach. The motivation for a systematic review was to search evidence on surgical face mask efficiency. A search strategy was conducted in February and March 2012 and the total initial search was 9,933 research articles. Screening of articles on effectiveness of surgical face masks during a surgical procedure was done. After six months the search was updated and the final sample of six relevant articles (n=6) was obtained. Studies that met the inclusion criteria were critically appraised based on the scores using standardised critical appraisal tools. The findings of this research project were synthesised and evaluated in order to come to conclusions. Conclusions were integrated and synthesised as the basis of developing a clear overview of the best quality empirical evidence about effectiveness of surgical face masks during a surgical procedure in the operating room. Recommendations were formulated for the nursing practice, education and research focussing on wearing a surgical face mask during a surgical procedure in the operating room. Reviewer’s conclusion: From the limited results it is unclear whether wearing surgical face masks during a surgical procedure in the operating room serve as a protective device for both surgical team and the patient. There is a need for further research. / Thesis (MCur)--North-West University, Potchefstroom Campus, 2013.

Surgical face masks have been designed to protect health care professionals from the splashes of the patients’ blood or body fluids and also to minimise the transmission of oro- and nasopharyngeal bacteria from the surgical team to the patient’s wounds, thereby decreasing the likelihood of postoperative surgical site infections during a surgical procedure. However, there are several ways in which surgical face masks could potentially contribute to contamination of the wound during a surgical procedure in the operating room. The objectives of this study were to explore and describe the effectiveness of surgical face masks as a protective barrier during a surgical procedure in the operating room in the public hospitals in the North West Province, South Africa and to formulate recommendations regarding surgical face masks worn by health care professionals during a surgical procedure in the operating rooms. A systematic review was conducted, followed by a quantitative, explorative, descriptive and contextual approach. The motivation for a systematic review was to search evidence on surgical face mask efficiency. A search strategy was conducted in February and March 2012 and the total initial search was 9,933 research articles. Screening of articles on effectiveness of surgical face masks during a surgical procedure was done. After six months the search was updated and the final sample of six relevant articles (n=6) was obtained. Studies that met the inclusion criteria were critically appraised based on the scores using standardised critical appraisal tools. The findings of this research project were synthesised and evaluated in order to come to conclusions. Conclusions were integrated and synthesised as the basis of developing a clear overview of the best quality empirical evidence about effectiveness of surgical face masks during a surgical procedure in the operating room. Recommendations were formulated for the nursing practice, education and research focussing on wearing a surgical face mask during a surgical procedure in the operating room. Reviewer’s conclusion: From the limited results it is unclear whether wearing surgical face masks during a surgical procedure in the operating room serve as a protective device for both surgical team and the patient. There is a need for further research. / Thesis (MCur)--North-West University, Potchefstroom Campus, 2013.