The study examined the sexual and reproductive health needs of adolescents infected with HIV and AIDS. This was a qualitative study that involved semi-structured interviews and observation. The sampling method used was purposive and it entailed 10 adolescents (4 boys and 6 girls) who are living with HIV at Chiedza Child Care Centre in Zimbabwe. This study revealed that adolescents’ sexual and reproductive health needs are the desire to have sex, desire to have children, the need for prevention of unwanted pregnancy and care and treatment support. However, their knowledge of HIV and AIDS was inadequate. Adolescents also revealed their lack of proper information regarding their health care and treatment needs. However, adolescents illustrated an adequate knowledge of the services available for them for their health, treatment and care needs. The study recommended that there is need to strengthen the provision of information and services on adolescents’ sexual and reproductive health issues. The study also recommended that counsellors should improve their counselling skills so that they can empower adolescents living with HIV to be able to negotiate condom usage, matters of dating and handling relationships. / Sociology / M. A. (Social Behaviour Studies in HIV and AIDS)

Substance abuse and suicidal behaviour are major challenges to public health. These phenomena are mainly studied by quantitative designs. This qualitative thesis aims at gaining a deeper understanding of substance abuse and suicidal behaviour, as experienced by young men in different types of treatment. By describing, exploring and interpreting lived experiences, in this thesis I try to give a more nuanced language of both substance abuse and suicidal behaviour, also in young migrating men. I also focus on the system of services related to the prevention and follow-up of life-threatening overdoses by describing and exploring how this phenomenon is experienced by individuals and professionals in Oslo. By researching the lived experiences of substance abuse and suicidal behaviour, combined with researching the phenomenon of life-threatening overdoses, a deeper insight is gained and this can be an important source to both prevention and health promotion for the group in question. The first three papers are based on descriptive, explorative and interpretative studies. How meaning is constructed is the core research question. In the fourth study I describe and explore life-threatening overdoses as a contemporary phenomenon in its context. The research questions are on a descriptive level. In the first three papers, the research object is the personal narratives from in-depth interviews, which are analysed using a phenomenological hermeneutic method. The case study is composed of data collected from different sources, and analysed by triangulation. The main finding in the first paper is that substance abuse and suicidal behaviour can be understood as goal-oriented, communicative and meaning-making activities about the individuals’ balance between death as an escape from pain and the hope of a life. In the second study, metaphorical expressions about a shifting sense of self is understood as balancing being an agent or a victim. In migrating young men these phenomena are interpreted as goal-oriented, communicative and meanig-making activities about existing in a maze that is perceived as closed. The findings of the case study show that different forms of life-threatening overdoses in Oslo are experienced in a state of existential and material stress. A wish of follow-up might not be expressed by the individual. Due to structural problems, such as lack of goals, professionals do not prevent such events in a planned way, nor do they cooperate between different levels. Professionals decide what is good quality in prevention and follow-up of life-threatening overdoses / Rusavhengighet og selvmordsadferd representerer store folkehelseproblemer. Disse fenomenene er hovedsakelig studert med kvantitative design. Målet med denne kvalitative avhandlingen er å få dypere kunnskap om rusavhengighet og selvmordsadferd slik fenomenene er opplevd av yngre menn i ulike typer behandling. Gjennom å beskrive, undersøke og tolke levde opplevelser forsøker avhandlingen å få fram en mer nyansert forståelse av, og språk om, både rusavhengighet og selvmordsadferd, også hos yngre menn med migrasjonserfaring. Avhandlingen fokuserer systemnivået gjennom å beskrive og undersøke hvordan livstruende overdoser oppleves og erfares som levde erfaringer og som yrkesutfordring i Oslo. Et omverdensperspektiv, kombinert med en dypere forståelse og et rikere språk kan være viktige bidrag til forebyggende og helsefremmende tiltak. Det første, andre og tredje arbeidet i avhandlingen er beskrivende, undersøkende og tolkende studier som fokuser yngre menns levde erfaringer med rusavhengighet og selvmordsadferd. Hvordan mening konstrueres er det sentrale forskningsspørsmålet. Det fjerde arbeidet, case studien, undersøker livstruende overdoser i en nå-tidig kontekst, og forskningsspørsmålene er beskrivende. I de første tre arbeidene er forskningsobjektet personlige narrativer samlet gjennom åpne dybdeintervjuer, og som er tolket ved bruk av en fenomenologisk hermeneutisk analyse. I case studien er data fra ulike kilder analysert ved hjelp av triangulering. Hovedfunnet i den første studien er at rusavhengighet og selvmordsadferd kan forstås som måltettede, kommunikative og meningsfulle handlinger om personens balanse mellom døden som befrielse fra smerte og håpet om et bedre liv. I den andre studien kommer metaforiske beskrivelser av en skiftende opplevelse av seg selv i prosessene knyttet til både rusavhengighet og selvmordsadferd tydelig fram. Dette kan forstås som å balansere en selvopplevelse mellom aktør og offer. I den tredje studien kan rusavhengighet og selvmordsadferd hos migrerte menn forstås som målrettede, kommunikative og meningsfulle handlinger om personens opplevelse av å eksistere i en stengt labyrint. Funnene i case studien tyder på at livstruende overdoser i Oslo erfares i eksistensielt stressfulle omstendigheter. Et personlig ønske om oppfølging gis ikke alltid eksplisitt. Strukturelle problemer medfører at profesjonelle arbeider med livstruende overdoser uten overordnete mål og uten samordnet planlegging. Profesjonelle bestemmer derfor selv hva som er god kvalitet når det gjelder forebygging og oppfølging av livstruende overdoser

Résumé indisponible. / A healthcare network or health system consists of all organizations, actions and people who participate to promote, restore or maintain people’s health. The health care systems in many developed countries are facing increasing costs. The major reason is the changing age distribution of the population with more elderly people in need of support. Increasing healthcare costs has created new alternatives to traditional hospitalization in which one is Home Health Care (HHC). Home health care or domiciliary care is the provision of health care and assistance to people in their own homes, according to a formal assessment of their needs. HHC has attained a specific place in healthcare network. HHC programs have now been successfully implemented in many countries. The purpose of HHC is to provide the care and support needed to assist patients to live independently in their own homes. HHC is primarily performed by means of personal visitations of healthcare workers to patients in their homes, where they provide care assistance according to patients’ needs. In this thesis we have considered different aspects of planning problems for home health care services. The efficient use of resources is necessary in continuous healthcare services. To meet the increased demand of HHC, operation research specialist can play an important role by solving the various combinatorial optimization problems arising in HHC. These problems can be tactical, strategic or operational with respect to planning horizon. Strategic problems are those which help in attaining long term goals or objectives, e.g. higher level of quality for HHC patients and efficient use of resources. These strategic objectives can be achieved through tactical i.e. medium term panning and operational planning i.e. short term planning. The main purpose of our thesis is to identify these potential optimization problems and solve them via recent metaheuristics. HHC is an alternative to traditional hospitalization and has got a significant share in the organization of healthcare in developed countries. The change in aging demographics, recent development in technology and the increase in the demand of healthcare services are major reasons for this rapid growth. Some studies show HHC as a tool to reduce costs of care, which is a major preoccupation in developed countries. Some others reveal that it leads to the improvement of patients’ satisfaction without increasing the resources. Home health care, i.e. visiting and nursing patients in their homes, is a flourishing realm in the medical industry. The number of companies has grown largely both in public and private sectors. The staffing needs for HHC companies have been expanded as well. Also they face the problem of assigning geographically dispersed patients to home healthcare workers and preparing daily schedules for these workers. The challenge of this problem is to combine aspects of vehicle routing and staff rostering. Both of them are well known NP- hard combinatorial optimization problems, it means the amount of computational time required to find solution increases exponentially with problem size. Home healthcare workers scheduling problem is difficult to solve optimally due to presence of large number of constraints. These are two types of constraints: hard constraints and soft constraints. The hard constraints are the restrictions to be fulfilled for the schedules to be applicable and soft constraints are preferences to improve the quality of these schedules. (...)

Neste estudo foi verificada a satisfação dos usuários com os serviços de atenção básica de saúde, pertencentes ao Distrito de Saúde Sul, da cidade de Campinas, São Paulo, no ano de 2011. Trata-se de um inquérito domiciliar, com abordagem quantitativa, realizado através de um questionário semi-estruturado. As avaliações da satisfação deram-se através do prisma da humanização dos serviços, da integralidade do sistema, da participação do controle social, da resolutividade dos serviços, das atividades de promoção da saúde e da atenção à saúde bucal. Verificou-se uma alta utilização dos serviços pelos usuários, com absoluto predomínio do sexo feminino, com média de idade de 48,7 anos. Constatou-se que a busca pelos serviços de saúde deveu-se a procura por consultas médicas e a medicamentos. Os usuários em sua maioria estão satisfeitos com o atendimento recebido. Os resultados encontrados demonstram o alto nível de humanização dos serviços de saúde, ratificados pelos índices de aprovação do tempo de espera pelas consultas e exames, pela condição das estruturas física das unidades, pela aprovação do atendimento da recepção, pelo horário de funcionamento das unidades, pelo acolhimento destinado aos usuários e pelos meios de informação destinados aos usuários. Verificou-se um alto índice de encaminhamentos para outros níveis de atenção, denotando-se baixa resolutividade dos serviços. Porém, o estudo encontrou uma rede de serviços estruturada e integrada entre si e com os demais níveis do sistema. Os resultados mostram que as ações de promoção de saúde foram muito bem avaliadas pela população, através das práticas integrativas e complementares de saúde, das atividades de grupo e de vivências nas unidades e das atividades de educação em saúde. Porém, estas ações ainda estão voltadas para uma pequena parcela da população. Os resultados da pesquisa mostrou um controle social desarticulado e inoperante, sendo incapaz de executar o seu papel fiscalizador e propositor de políticas públicas de saúde. Como decorrência desta pesquisa, verificou-se que a saúde bucal foi muito bem avaliada pela população. Porém, o estudo mostrou dificuldade no acesso às consultas e que este estava se dando através das urgências odontológicas, indicando a grande necessidade de saúde bucal acumulada. O estudo mostrou que a saúde bucal é pouco referida pelos outros profissionais de saúde. É fundamental que se incorpore no cotidiano das equipes de saúde, mecanismos de avaliação permanente, a fim de identificar os fatores facilitadores e dificultadores para o bom relacionamento entre usuário e serviço, visando à melhoria da assistência e consequentemente a satisfação do usuário. / In this research, an evaluation of satisfaction of users with services of primary health care, belonging to the South Health District, in the city of Campinas, São Paulo, was carried out in the year 2011. This is a household inquiry with quantitative approach performed through a semi-structured questionnaire. The evaluation of satisfaction levels were developed through an angle of humanization of services, health system comprehensiveness, participation in decision making instances of the public health system, solvability potential of the services for health needs, activities of health promotion and oral health care. There was a high frequency in health services by users with absolute predominance of females and mean age of 48.7 years. It was found that the main reason for searching health services was the demand for medical consultations and medicines. The majority of users are satisfied with the health care received. The results demonstrate a high level of humanization of health services, ratified by the approval ratings of waiting time for appointments and examinations, the physical condition of the structures of the units, the approval of the reception attendants approach, by the hours of operation of the units, the humanitarian approach given to users and by means of information for them. There was a high rate of referrals to other levels of care, showing up poor solvability of the service. However, this research found structured and a good level of integration between primary care units and with upper care levels of the system. The results show that health promotion activities were very well evaluated by the population through integrative and complementary health practices, group activities and activities of health education. However, these actions are focused on a small portion of the population. The results of the research showed a disjointed and ineffective level of participation of the community in local health councils, being unable to perform its oversight role and proponent of public health policies. As a result of this research, it was found that oral health care was well evaluated by population. However, the study showed difficulty in access to dental consultations and that oral care was most provided through emergencies, indicating an accumulated great need for oral health. The study showed that oral health is rarely reported by other health professionals. Thus, oral health must be incorporated into the daily health teams and into ongoing assessment mechanisms in order to identify the facilities and difficulties to the good relationship between user and health care service, aiming a significant improvement of health care quality and consequently user satisfaction.

Tratase de parte do Estudo SABE Saúde, Bem Estar e Envelhecimento, de delineamento longitudinal de base populacional que entrevistou 2143 pessoas de 60 anos e mais em 2000, no município de São Paulo, e reentrevistou 1115 delas em 2006. O objetivo do presente estudo foi avaliar a atenção às condições crônicas, utilizando a Hipertensão Arterial Sistêmica e o Diabetes Mellitus como condições traçadoras. Para isso, identificouse o uso e acesso aos serviços de saúde e as práticas de controle dessas doenças. Além disso, observouse a associação do uso de serviços com a ocorrência de desfechos desfavoráveis e compararamse indicadores de atenção à saúde com relação à posse de plano de saúde ou não. Foram utilizados testes estatísticos de regressão logística múltipla. Observouse uma prevalência de Hipertensão Arterial Sistêmica de 53,1 por cento e de Diabetes Mellitus do tipo 2 de 16,8 por cento em 2000, com incidência de autorreferência acumulada no período, de 30,0 por cento e 8,0 por cento respectivamente. O uso de três ou mais consultas por idosos hipertensos e/ou diabéticos em 2006 foi de 80,0 por cento e identificouse associação com os fatores de necessidade e com posse de plano de saúde, indicando desigualdades de acordo com o modelo de Andersen. A cobertura de planos de saúde entre os hipertensos e/ou diabéticos foi de 48,9 por cento em 2006, mantido no período. Foi referida dificuldade em usar serviços de saúde por 28,6 por cento dos hipertensos e/ou diabéticos em 2006, a maior parte relacionada à qualidade percebida dos serviços. Quem tem plano de saúde mostrou menor dificuldade de acesso, menor tempo de espera para agendamento e para ser atendido no serviço e maior satisfação com o uso. No entanto, o uso de serviços para controle foi maior entre os que não referiram posse de plano de saúde. Houve ampliação do acesso medicamentoso no período para ambas as doenças, em particular no setor público, com 70,5 por cento dos diabéticos e 88,4 por cento dos hipertensos usando medicação específica em 2006. Não se encontrou associação entre uso de serviços ambulatoriais nem com AVC, nem com perda de capacidade funcional sendo que, houve associação de posse de plano de saúde apenas com dificuldades em AIVD. Por outro lado, usar serviços ambulatoriais com maior frequência, mostrouse protetor ao risco de morrer. A taxa de mortalidade foi de 48 por mil para os hipertensos e 59,2 por mil para os diabéticos. Em conclusão, as condições crônicas estudadas têm forte impacto no uso de serviços, mas estes mostram pouca influência nos desfechos e sugerem desigualdades no acesso e na qualidade da atenção / This is part of the SABE Study Health, Welfare and Aging, a longitudinal study, which interviewed 2143 people, aged 60 and older in 2000, in São Paulo, and reinterviewed 1115 people, in 2006. The aim of this study was to evaluate the care for chronic conditions using Hypertension and Diabetes Mellitus as tracer conditions. For this, use of and access to health services and control practices were identified. Furthermore, association between use of health services and the occurrence of unfavorable outcomes was observed and, indicators of health care between public health and health insurance were compared. Logistic regression was used for multivariate analysis. The prevalence of hypertension was 53.1 per cent and type 2 Diabetes Mellitus was 16.8 per cent in 2000 and the incidence of selfreference accumulated in the period was 30.0 per cent and 8.0 per cent respectively. The use of three or more visits by hypertensive and / or diabetics in 2006 was 80.0 per cent. It was possible to identify an association between health services use and the factors of need and health insurance, indicating inequalities, according to the model of Andersen. The percent of the health insurance of hypertension and / or diabetes was 48.9 per cent in 2006. Difficulty in health services use was referred by 28.6 per cent of hypertensive and / or diabetics in 2006 mostly related to quality of services. Those who have health plan haves less difficulty of access, less waiting time for scheduling and to be serviced and increased satisfaction with use. However, the services use for disease control was higher among those who did not have health insurance and the access to drugs was increased, particularly in the public sector, with 70.5 per cent of diabetics and 88.4 per cent of the patients using drugs in 2006. There was no association between health services use and the incidence of stroke and loss of functional capacity, but the last one was associated with health insurance. On the other hand, an increased use of health services is related with a lower risk of death. Mortality rate was 48 per thousand for hypertensive and 59.2 per thousand for diabetics. In conclusion, the chronic conditions studied have a strong impact on the use of services, but they showed little influence on outcomes and suggest inequalities in access and quality of care

Estudou-se a relação do exercício das masculinidades com o cuidado em saúde para homens na atenção primária, para se compreender como são percebidas e apreendidas as necessidades de saúde masculina nas interações entre homens e profissionais de saúde, tomando como referência a identidade masculina. Partiu-se do pressuposto de que o exercício das masculinidades pode representar riscos para a saúde dos homens e que os serviços de saúde não incorporam os referenciais culturais de masculinidades nas práticas de saúde efetivadas. Foram estudados dois serviços de atenção primária à saúde por meio de observação direta das atividades assistenciais e de entrevistas com homens usuários e profissionais de saúde. Encontrou-se uma diversidade de modelos de masculinidade que definem diferentes formas para pensar o cuidado de saúde dos homens. O estudo aponta que a identidade masculina de gênero passa por diferentes dimensões, as quais devem ser consideradas na apreensão das necessidades e nas práticas de cuidados de saúde empreendidas aos homens. No entanto, os padrões hegemônicos de gênero socialmente construídos criam dificuldades para o bom cuidado da saúde masculina. Não obstante, a população masculina procura as unidades básicas de saúde. Embora presente, percebe-se barreiras no uso desses serviços, relacionadas à invisibilidade e à não identificação dos homens com os serviços de atenção primária. Observou-se que as necessidades de saúde dos homens estão pautadas por questões como o trabalho, a sexualidade, a estrutura corporal, a vida comunitária e as relações familiares. Discute-se que as necessidades de saúde das masculinidades e suas particularidades não são acolhidas integralmente nas práticas de cuidado dos serviços de atenção primária à saúde. / This thesis studied the relation between the exercise of masculinities and health care of men in primary health care services. It consists of an attempt to comprehend how male health needs are apprehended in the interactions between men and health professionals. It was presumed that the exercise of masculinities could represent a risk to mens health and that health care services do not incorporate masculinities cultural references in effectuating health practices. Two primary health care services were studied by means of direct observation of assistential activities and interviews with men utilizing the services and health professionals. A diversity of models of masculinity that define different forms of reflecting upon mens health care was encountered. The interviews indicate that gendered masculine identity permeates different dimensions and that these dimensions should be taken into consideration when apprehending the needs and practices with respect to health care undertaken by men. The socially constructed hegemonic patterns of gender create difficulties for men to attain good health care. Nonetheless, the masculine population seeks the primary health care services for care. Although they are present, barriers related to invisibility or to the lack of identification of men with the primary health care services were perceived. This study indicates that mens health needs are regulated by issues such as work, sexuality, corporal structure, community life and family relationships. Masculinities and their needs are not entirely taken into account, as discussed, within the health care practices undertaken by the health services wherein this research was conducted.

Objetivos: Este estudo é parte do Projeto Saúde, Bem-estar e Envelhecimento (SABE), com o objetivo de identificar as desigualdades no acesso e uso de serviços de saúde entre idosos no município de São Paulo, Brasil. Métodos: Em 2000, foram entrevistados, 2143 indivíduos com 60 anos ou mais, utilizando-se o questionário padronizado do SABE. A amostra foi obtida em dois estágios, utilizando-se setores censitários com reposição, probabilidade proporcional à população e complementação da amostra de pessoas de 75 anos. Os dados finais foram ponderados, de forma a serem expandidos. Foi mensurado o uso de serviços hospitalares (internações) e ambulatoriais (consultas médicas) nos últimos quatro meses e o não uso de serviços de saúde (mesmo precisando), relacionando-os com fatores de capacidade, necessidade e predisposição (renda total, escolaridade, seguro saúde, morbidade referida, auto-percepção, sexo e idade). Resultados: A proporção dos entrevistados que referiu ter utilizado algum serviço de saúde, nos últimos quatro meses, foi de 4,7 por cento com relação à internação hospitalar e 64, 4 por cento com referência ao atendimento ambulatorial. Dos atendimentos ambulatoriais, 24,7 por cento ocorreu em hospital público e 24,1 por cento em serviço ambulatorial público sendo que nos serviços privados, 14,5 por cento ocorreu em hospital e 33,7 por cento em clínicas. A não utilização foi relacionada à pouca gravidade da doença, qualidade e distância dos serviços e custo. Na regressão logística multivariada, observou-se associação entre a utilização de serviços e sexo, presença de doenças, auto-percepção de saúde, interação da renda e escolaridade e posse de seguro saúde, sendo que a escolaridade isoladamente apresentou efeito inverso. Conclusão: Foram observadas desigualdades no uso e acesso aos serviços de saúde e inadequação do modelo de atenção, indicando necessidade de políticas públicas que levem em conta as especificidades dessa população, facilitem o acesso e possam reduzir essas desigualdades / Objectives: This research is part of a project called Health, Well-being and Aging in Latin America and the Caribbean, “SABE study", and aims to study the inequalities in use and access to health care services among the elderly persons in the Municipality of São Paulo, Brazil. Methods: In 2000, 2.143 individuals aged 60 or older, dwelling in the urban area of São Paulo, were interviewed using census sectors with replacement and probability proportional to population. To achieve the desired number of respondents 75 or older, additional homes close to the selected census sector were used, with weighting of the final results. The use and access to health services were measured for outpatient medical services and hospital admission in the context of the personal characteristics of the subjects, context and need for health care. Results: Considering the elderly who needed healthcare assistance in the four months prior to the interview, 4,7% were hospitalized and 64,4% needed ambulatory care, being 24,7% in public hospitals and 24,1% in public ambulatory health services. As for the private services, this number was 14, 5% for hospitals and 33, 7% for medical clinics. In the multivariate analysis, there is an association between use of health services, sex, diseases, wealth quintiles and health insurance. However, the opposite effect was found for the variable “educational level". Conclusions: The results demonstrate inequalities in use and access to health services and a problematic health care system. Public policies should take into account the different needs of this older population, in order to facilitate access to health care services and reduce inequalities.

Thesis (LLM. (Labour Law)) -- University of Limpopo, 2013 / The South African government gazzetted the Green Paper introducing the NHI on 12 August 2012. This policy seeks to progressively realize the right of access to quality health care services for everyone. Those who cannot provide for themselves will be assisted by government at the expense of the elite. The NHI was first recommended by the Taylor Commission and it has been under the discussion since then. Since this announcement, there has been growing pressure for mandatory health insurance to be included in the development of a comprehensive social security system, as was envisaged by the Taylor Committee of Inquiry. This discussion was further debated at the 52nd conference of the African National Congress (ANC) in Polokwane in December 2007 where numerous resolutions were taken with regard to the NHI. The Freedom Charter of 1955 and also section 27 and 28 also provided some guidance.

Vertinant sveikatos priežiūros paslaugų kokybę, svarbu yra įvertinti kaip patys pacientai vertina įvairius sveikatos priežiūros paslaugų elementus – nuo sveikatos priežiūros organizavimo, prieinamumo iki pačių sveikatos priežiūros paslaugų, gydytojo ar slaugytojo vertinimo. Nemažiau svarbi ir mediko nuomonė, nes pacientas vertina daugiau subjektyviai, per savo lūkesčius, o medikas vertina daugiau objektyviai, geriau žinodamas sveikatos priežiūros sistemos ar naujų technologijų galimybes. Habilitacijos procedūrai teikiamų mokslo darbų apžvalgoje nagrinėta 21 mokslinė publikacija. Pacientų nuomonė apie sveikatos priežiūros paslaugas nagrinėta pagal respondentų socialines – demografines chrakteristikas, jų gyvenamąją vietą. Nagrinėta vyresnio amžiaus žmonių nuomonė apie sveikatos priežiūros paslaugas. Sveikatos priežiūros paslaugos įvertintos ir medikų požiūriu pagal darbo vietos chrakteristiką ir pagal sveikatos priežiūros įstaigos geografinę padėtį. Apžvalgoje nagrinėtas vairuotojų sveikatos tikrinimo tvarkos efektyvumas, informacinių technologijų poreikis Lietuvos asmens sveikatos priežiūros įstaigose. Pacientų įtraukimas į sveikatos priežiūros paslaugų vertinimą pateikia vertingą informaciją apie sveikatos priežiūros sistemos silpnąsias ir stipriąsias puses. Dauguma respondentų sveikatos priežiūros įstaigų darbą vertina teigiamai. Blogai sveikatos priežiūros įstaigų darbą vertina tik 5,1 % respondentų. Visų socialinių – demografinių grupių atstovai nurodo, kad... [toliau žr. visą tekstą] / Evaluation of the quality of health care services is important from the viewpoint of both providers as well as receivers of those services. Patient’s perspective includes the evaluation of all the parts of the process- from accessibility and other organizational issues to personal collaboration with physicians and nurses. On the other hand, the health care professionals evaluate the same services from inside the system, with better understanding the health care delivery process and possibilities of the system. 21 scientific publications have been included into the Habilitation thesis. Patients’ opinion concerning the health care services has been evaluated according to the patient’s social and demographic characteristics, their place of living and other variables. This also included evaluation of opinions of elderly patients concerning the services they receive. Evaluation of opinions of health care professionals has been made according to the characteristics of the institutions, their locality and specialty of respondents. Part of the materials is evaluation of efficiency of professional health checks of drivers, which is a common procedure in health care institutions. Evaluation of patient opinions about health care services provides important information for improvement of the quality of health care services. Majority of respondents evaluate health care services positively. 5,1% of respondents evaluate health care services as unsatisfactory. Respondents of all social... [to full text]

Darbo tikslas – ištirti senyvo amžiaus asmenų, gyvenančių namuose, integruotų sveikatos priežiūros ir socialinių paslaugų poreikį bei teikimo organizavimą. Tyrimo klausimai: Koks yra integruotų sveikatos priežiūros ir socialinių paslaugų poreikis senyvo amžiaus asmenims namuose? Kaip organizuojamos integruotos sveikatos priežiūros ir socialinės paslaugos senyvo amžiaus asmenims namuose? Su kokiais iššūkiais susiduriama teikiant integruotos sveikatos priežiūros ir socialines paslaugas senyvo amžiaus asmenims namuose? Tyrimo metodika: Tyrimo tikslui pasiekti buvo atliktas kokybinis atvejo analizės tyrimas. Tyrime duomenys rinkti vadovaujantis metodų trianguliacija: duomenų rinkimo, giluminio pusiau struktūruoto interviu, stebėjimo ir dokumentų analizės. Apklausti 12 trijų komandų skirtingus lygmenis ir sritis atstovaujantys specialistai: socialinė darbuotoja – projekto administratorė, kineziterapeutė, 4 socialinio darbuotojo padėjėjos, 4 slaugytojo padėjėjos, 2 bendrosios praktikos slaugytojos. Tyrimo objektas: integruotų sveikatos priežiūros ir socialinių paslaugų poreikis bei teikimo organizavimas senyvo amžiaus asmenų namuose. Rezultatai: Integruotų paslaugų poreikis bei teikimo organizavimas senyvo amžiaus asmenims, gyvenantiems namuose, atsiskleidė per apklaustųjų patirtis ir požiūrį, per socialinių aplinkybių, kuriose gyvena senyvi asmenys, analizę, pastebima su kokiais sunkumais ir iššūkiais susiduria paslaugų gavėjai ir teikėjai. Pažymima, kaip yra identifikuojami ir... [toliau žr. visą tekstą] / Aim of the study – to explore the need and provision of integrated health and social home care services for elderly. Research questions. What is the need for integrated social and health home care services for elderly? How is organised provision of integrated social and health home care services for elderly? What kind of challenges face the provision of integrated social and health home care services for elderly? Methods. Conducted qualitative case study. For validity of findings used data triangulation, semi structured in depth interviews, observation and document analyses. Interviewed 12 mobile team members: project administrator - social worker, direct service providers professionals from all three mobile teams of integrated care: 2 nurses, 4 assistant nurses, physiotherapist, 4 assistant social workers. Research object: the need and organization of integrated social and health home care services for elderly provision. Results: The need for integrated services organization of the provision of elderly people living at home, revealed through the experiences and attitudes of the respondents, through the social circumstances in which they live in elderly subjects, analysis, noted the difficulties and challenges faced by users and providers. It is noted, as is the identification and assessment of the needs of elderly persons and who does it. During the course of the study, an integral - mobile teams, as innovations in the creation process, the way in which communication... [to full text]