Med risk för långvarig stress bland anställda inom socialtjänsten, ställs höga krav på chefer i ett psykosocialt arbete. Då socialtjänst är ramstyrt, söker bistånd samt har svårigheter i prioritering av arbetet ställer detta frågan hur chefer upplever förutsättningen till det psykosociala arbetsmiljöarbetet. Sex chefer inom en socialförvaltning har intervjuats. Intervjuerna analyserades genom en innehållsanalys med ett manifest fokus. Resultaten visar en homogen upplevelse att med rätt inställning finns förutsättningar för ett arbete som gynnar den psykosociala arbetsmiljön. Det finns möjligheter som medvetenhet, interventioner för stress och visioner samt att den psykosociala arbetsmiljön diskuteras i olika forum och har kontinuerlig uppföljning.  Dock fanns hinder som sociala aktiviteter, arbetsbelastning, rekrytering och lokaler. Bristande resurser och bristande stöd från kommunalt styre motverkar interventioner på organisationsnivå för att förebygga stress och ohälsa på arbetsplatserna.  Resultaten tyder på att det behövs mer forskning för bättre vägledning och prioritering av den psykosociala arbetsmiljön inom socialtjänsten.

<p>Lack of knowledge about stroke in general and specific knowledge of the risk factors, signs, and symptoms of stroke results in the late presentation of patients at hospital. The aim of this study was to determine the knowledge of stroke among hypertensive patients in the Tanga region of Tanzania. To investigate this, a cross-sectional survey using a quantitative research design was used.</p>

Thesis (D.P.H.)--University of Michigan.

Thesis (D.P.H.)--University of Michigan.

Thesis (D.P.H.)--University of Michigan.

Thesis (D.P.H.)--University of Michigan.

Como dirigentes e gestores de Secretarias Municipais e Estaduais de SaÃde avaliam e monitoram a prÃpria gestÃo governamental? A presente dissertaÃÃo teve como objetivo analisar informaÃÃes, opiniÃes e discursos acerca de processos e prÃticas de avaliaÃÃo e monitoramento da gestÃo governamental em Secretarias Municipais e Estaduais de SaÃde. Trata-se de um estudo de casos mÃltiplos, de nÃveis analÃticos imbricados e carÃter exploratÃrio, com abordagem quanti-qualitativa. Foram aplicados questionÃrios semiestruturados a dirigentes governamentais de 577 Secretarias Municipais (amostra sistemÃtica e estratificada de 10,4% do total) e 24 Secretarias Estaduais de SaÃde (amostra estatÃstica, simples e aleatÃria de 88,8% do total). No estudo qualitativo, foi realizada a tÃcnica de Grupo focal com a participaÃÃo de dirigentes governamentais de 7 (sete) Secretarias Estaduais de SaÃde, selecionados a partir de um amostra intencional, que contemplou todas as grandes regiÃes brasileiras e estados de distintos portes populacionais. Procedeu-se uma anÃlise de sÃntese por meio da triangulaÃÃo de evidÃncias, utilizando-se como escopo de anÃlise o referencial normativo dos Sistemas de DireÃÃo EstratÃgica (SDE). Na maior parte dos casos analisados, os usuÃrios das informaÃÃes produzidas ainda estÃo pouco definidos e dispersos. A massa de informaÃÃo à mais diversificada e menos seletiva, veiculada em tempo ineficaz, com uma produÃÃo tendente a centralizaÃÃo e uso mais generalizado do que especifico. SÃo poucos os indicadores e sinalizadores mais especÃficos e apropriados para a gestÃo governamental em SaÃde. Hà lacunas especÃficas e significativas no gerenciamento financeiro, de pessoal e de situaÃÃes de crise. Apesar da reconhecida incipiÃncia observada nos processos e prÃticas de Monitoramento e AvaliaÃÃo da gestÃo governamental no Ãmbito de Secretarias Estaduais e Municipais de SaÃde, denota-se a conformaÃÃo e instituiÃÃo de comunidades de prÃticas vocacionadas e implicadas nesta perspectiva de atuaÃÃo (inter) institucional, com demandas e iniciativas que indicam uma gradual consolidaÃÃo desta (sub) Ãrea. / How leaders and managers of Municipal and State Health Department evaluate and monitor their own government management? This thesis aimed to analyze information, opinions and speeches about processes and practices for evaluating and monitoring government management in Municipal and State Health Department. It is a study of multiple cases, with intertwined analytical levels and exploratory nature and with quantitative and qualitative approach. Semi-structured questionnaires were administered to 577 government leaders of Municipal Health Department (stratified systematic sample of 10.4% of the total) and to 24 leaders of State Health Departments (statistical sample, simple random and 88.8% of the total). In the qualitative study, was applied the technique of focus group with the participation of government officials from seven (7) State Health Departments, selected from a purposive sample, which included all Brazilian biggest regions and states with different population sizes. Proceeded then a synthetic analysis through triangulation of evidences, using as scope analysis the reference standard of Strategic Management Systems (SMS). In most of the cases, users of the produced information are still poorly defined and dispersed. The mass of information is more diverse and less selective, with inefficient broadcast time, a production tending to centralization and more widespread usage than specific. Few are the more specific and appropriate indicators and flags for the Health government management. There are specific and significant gaps in financial management, personnel and crisis situations. Despite the recognized incipience observed in the processes and practices of monitoring and evaluation of government management in the context of State and Municipal Health Departments, denoted conformation and establishment of communities of practice dedicated and implicated in this (inter) institutional acting perspective, with demands and initiatives that indicate a gradual consolidation of this (sub) area.

Magister Scientiae (Physiotherapy) - MSc(Physio) / Lack of knowledge about stroke in general and specific knowledge of the risk factors, signs, and symptoms of stroke results in the late presentation of patients at hospital. The aim of this study was to determine the knowledge of stroke among hypertensive patients in the Tanga region of Tanzania. To investigate this, a cross-sectional survey using a quantitative research design was used. / South Africa

Philosophiae Doctor - PhD / This research explores a poorly understood area of health systems: the nature of managerial decision-making in primary healthcare facilities, and the information that informs decision-making at this level. Located in the emerging field of Health Policy and System Research, this research draws on constructivist and participatory perspectives to understand the role of information and, more broadly, learning and knowledge in decisions that primary healthcare managers make, and the systemic factors influencing this. Using a multiple case study design with iterative cycles of in-depth data collection and analysis over a three year period, it examined the decision-making and information use in three cases of managerial responsibility in 17 primary healthcare facilities in a sub-district in Cape Town. The cases were: improving efficiency of service delivery, implementing programme priorities and managing leave of absence. Using multiple strategies for engaging primary healthcare facility managers, often as co-researchers of their own practice, the research sought to elicit both their explicit and tacit, experience-based knowledge on these phenomena. Key insights gained in the research are that firstly, operational health management at facility level is less linear and simple than policy-makers and planners often assume, and is, instead, characterised by considerable on-the-spot problem solving and people management to meet multiple agendas, which can be surprisingly complex. Secondly, contrary to prevailing views, managers do actively use information in decision-making, but require a wide range of information which is outside of the current, and indeed the globally-advocated, health information system (HIS). Thirdly, they not only use, but generate, information in their management routines and practices, and must learn from experience in order to adapt new interventions for successful implementation in their facilities and communities. This research thus makes explicit the value and use of informal information and knowledge in decision-making. It demonstrates, amongst others, a relationship of functional interdependence between the use of formal information in the HIS, and informal information and knowledge, suggesting that the latter has the potential to improve the use and utility of formal health information by making sense of it within the local context. Furthermore, building on the public policy literature on governance, this research develops a model to understand the multiple contextual influences on decision-making and information use, showing the central role of values and relationships across the health system. It proposes a causal mechanism for strengthening the use of information in decision-making. Finally, in giving priority to the informational needs of facility managers, this research offers a bottom-up perspective which argues for an integrated approach to health system strengthening which moves beyond atomised treatment of HIS strengthening. It suggests the need to re-think how to support facility managers by re-positioning the HIS relative to organisational learning, and leadership and management development.

No description available.