<p>There seems to be a gap in previous literature where economists and social scientists do not focus on factors driving emigration of health professionals between developed coun-tries. Although, there is a lot of literature that discusses emigration of health profession-als from developing towards developed countries, there are few previous studies of health professional emigration between developed to developed countries. This paper examines and analyzes factors which might be of importance in determining the direc-tion of emigration of health professionals between developed countries. The concept of health professionals in our study contains people with more than 3 years of education within the health and social welfare sector, not referring to any particular occupation such as nurses, doctors, dentist etc; or whether they are specialized in any area. This pa-per analyses factors that affect emigration of Swedish health professionals, using eco-nomic and social variables in a structured regression model. The results indicate that the percentage of Swedish health professionals is directly affected by factors of destination countries such as geographical proximity, GDP(PPP) per capita, income tax rate and co-workers encouraging development.</p>

Background: During the 1980s, the fear of HIV spread over the world. Health professionals'attitudes to patients with HIV, was negatively impacted because of their fear to be infected.Patients with HIV have therefore,during disease history's first two decades, experienced stigma and discrimination in the response from health professionals. Because of the increasing knowledge of HIV it is of interest to study patients' contemporary experiences of the encounter with health professionals. Aim:To explore how patients with HIV experiencing the meeting with health professionals. Method:Literature study with seven qualitative and three quantitative articles. Results:Two themes were found; to be discriminated and to be powerless and extradited. To be discriminated describes that patients in several cases been treated differently than others, by health professionals.To be powerless and extradited describes that patients are not allowed tobe involved in their care and they have distrust to health care providers.Conclusion:Patients with HIV experience discrimination, excessive precautions and ignorance which cause a care suffering. It is important that the nurse is aware of the deficiencies in the treatment to work towards a good care relationship.There is a great need for further research regarding to explore how patients with HIV experiencing the treatment from health professionals.

No description available.

Research report (MMed) -- Interdisciplinary Health Sciences, Stellenbosch, 2010. / ENGLISH ABSTRACT: Background The referral system is an important component of the health care system. In public health facilities, a high number of patients’ attendance has lead to a huge burden on the secondary and tertiary level of the care system in terms of manpower, equipments and resources. Public health in South Africa consumes around 11% of the government's total budget. The state contributes about 40% of all expenditure on health; the public health sector is under pressure to deliver services to about 80% of the population. Despite the huge spending on health care in most developing countries, health outcomes and services remain poor. Few studies are available to give insights into reasons for this disparity. Therefore the findings of this may help to explain some of the reasons for this overburden of public health facilities and further to make recommendations on how health service delivery may be improve on. The results of this study can be useful in future planning; this may lead to a reduction in huge health expenditure incurred by most developing countries. Methods A cross sectional survey of three different groups of people which comprises of 273 patients, 28 referral centre participants and 19 referring centre participants was carried out. All patients referred from Motherwell community health centre to Dora Nginza hospital were eligible for the study. Questionnaires were interview administered to patients after they had finished consultations in Dora Nginza Hospital. Health professionals from both facilities were also interviewed with the use of self administered questionnaires. Results Three out of every four patients interviewed were of the opinion that their referral to hospital was appropriate which is consistent with the results from referring health professionals, eighteen of nineteen respondents. However, only one-quarter (7) of the referral centre health professionals felt the referrals from referring centre to hospital were appropriate p<0.01.The majority of the patients were satisfied with the level of service received at the referral centre. 77% (210) reported that the staff at the referral centre was friendly and 84% (230) were happy with the explanation given for their illness. However, a source of concern is that, in most of the referred patients 58% (215), there was no formal response back to their primary care. In the referring centre, participants identified transportation of patients to referral centre as the major problem encountered when referring patients 68 % (13), whereas 32 % (6) felt it is communication. In addition, 73 % (14) were of the opinion that transportation was inadequate and 89 % (17) reported the response rate of transport was unsatisfactory. In the referral centre, results showed participants were more concerned about the adequacy of information provided in the referral letters with 78% (22) reporting they were often not adequate information on the referral letters. However, half of the respondents agreed that they do not have clear referral guidelines. Conclusion Primary care health professionals and patients in this study view the referrals to higher levels of care as appropriate. However, the referral centres health professionals were of the opinion that most referrals were inappropriate. The opinion of the referral centre can be attributed to their negative attitudes towards referrals. The referral centres needs to provide more support to primary care for a more efficient referral system .They also need to improve on the continuity of care by providing feedback to referrals. On the other hand, the primary health care needs to be strengthened in terms of resource allocation in order to gain more confidence from both patients and referral centres. / AFRIKAANSE OPSOMMING: geen opsomming

Evidence-based medicine calls for the use of current best evidence (together with individual clinical expertise). Guidelines aim to distil such evidence, yet clinical practice often fails to follow guidelines, for multiple reasons that are still not well understood. One under-researched aspect of the gap between guidelines and practice is psychology. My literature review found that the application of psychology to implementation research has been limited, and such research is not well integrated into wider implementation research. In this study, I sought to a) systematically apply psychological theory to understand the different psychological processes in the stages of adoption described in the diffusion of innovations model; b) collect and analyse data to explore and test this new, psychologically-enhanced model of guideline adoption; and c) improve and extend my model in the light of my empirical data. Having populated my proposed framework with potentially relevant psychological theories based on my literature review, I undertook a first assessment of the validity and added value of this proposed theoretical framework through a case study of the implementation of guidance on universal offering of HIV testing in hospitals serving populations meeting the criteria for high HIV prevalence in the catchment population, interviewing 20 healthcare professionals across two sites. My findings broadly supported my proposed theoretical approach, and illustrated relevant psychological theories for different stages of adoption. My findings support two provisional conclusions. First, that there is potential to improve the effectiveness of efforts to implement guidelines by augmenting the widely-used innovation adoption model with specific psychological theories. Second, that policymakers would do well to shift from viewing the health system as a complicated entity that policy can control and direct is misconceived; I recommend shifting to a perspective of the health system as a complex system, and rethinking the role of policy from that perspective.

A community coalition is a formal alliance of organisations, groups and agencies that have come together for a common goal. Collaborative partnerships between the health professionals and the communities they serve have received attention as a strategy for achieving health gain and are spreading globally. This partnership approach has a potential for a synergistic maximization of impact and has been advocated as a means to increase citizen participation and ownership among under-privileged groups. Despite the popular appeal and theoretical promise of this approach, the precise domains that need to be fostered by the stakeholders to implement this complex model remain unclear. The aim of this study was to investigate and compare the characteristics and perceptions of the CPs' stakeholders as regards the structural characteristics and operational parameters of the partnerships, as well as the correlates of effectiveness and impact for each participant group. Of particular interest was to identify the characteristics which enable partnerships to fulfill their organizational tasks and goals, regardless of the scope or complexity of purpose. The five CPs were located across South Africa and aimed at Health Professions Education reforms. Quantitative data was collected from 668 coalition members and qualitative data from 46 strategic participants. The partnerships' documents were also scrutinized and ample participant observations were undertaken. The data was then pooled and the comparison groups were constructed: the professionals, comprising of staff from the academic institutions and the health service providers, the community members and the full-time paid employees of the partnerships, the core staff. The analyses of the partner's opinions and views as well as the predictors of accomplishment of diverse stakeholders hold lessons for managers concerned with health coalitions. Generally, training and development seem to be the main thrust of the partnerships' missions. The observation is that clarity of roles, procedures and responsibilities is imperative. Clarity requires transparency to each others agendas. Although there was an under-representation of the youth, there seemed to exist a mixture of various levels of satisfaction in the partnerships, with the community members in need for more sense of ownership. The findings also point to that consultation in decision making seem to be lacking with unilateral decision making taking place. This might lead to power struggles and hidden agendas between the partners that could hamper the advancement of the partnerships. Explanation of why stakeholders are satisfied or committed or what explains their views on effectiveness and activity levels of their partnerships may inform efforts in other settings. With diverse partners, it is important to be somewhat cautious in the consideration of the stakeholders engaged in these collaborative efforts. Partners working together need not be considered homogenous entities. The groups come from different backgrounds, organizations and cultures. The attitude to be created in collaborative interventions is one of a clear understanding that embraces the different origins and aspirations of the stakeholders and recognises the mutual roles, responsibilities, resources and limits. Only by paying due attention to their individual values and weaving it into a common vision can the partnership process be taken forward.

Submitted by Suellen Rodrigues (suellen_rodrigues18@yahoo.com.br) on 2017-09-28T18:38:45Z No. of bitstreams: 1 Versão final..pdf: 2027194 bytes, checksum: b1abe06e18e019c92d79b3c3bd5fb7b1 (MD5) / Approved for entry into archive by Monique Sasaki (sayumi_sasaki@hotmail.com) on 2017-09-29T17:28:50Z (GMT) No. of bitstreams: 1 rodrigues_ss_me_arafcl.pdf: 2027194 bytes, checksum: b1abe06e18e019c92d79b3c3bd5fb7b1 (MD5) / Made available in DSpace on 2017-09-29T17:28:50Z (GMT). No. of bitstreams: 1 rodrigues_ss_me_arafcl.pdf: 2027194 bytes, checksum: b1abe06e18e019c92d79b3c3bd5fb7b1 (MD5) Previous issue date: 2017-08-17 / A formação do professor é fundamental para assegurar um trabalho sistemático, contínuo e formal de educação sexual na escola, assim como, nos distintos ambientes de saúde. Há a necessidade de formação inicial e continuada deste profissional, considerando que os cursos de graduação geralmente não apresentam em seus currículos temas relacionados a gênero, sexualidade e, diversidade sexual. Aliado a isso, é imprescindível se ter professores aptos e que possam ser sensibilizados à necessidade de se discutir temas relacionados à sexualidade humana levando em consideração a necessidade de serem abordados no contexto escolar. O mesmo pode ser dito acerca dos profissionais da saúde. A formação acerca deste tema é incipiente diante das demandas que apresentam de abordar este assunto. Diante disso, a presente pesquisa teve por o objetivo geral averiguar as demandas dos profissionais da educação e saúde relativas à sexualidade e educação sexual, para a partir disso e neste contexto, elaborar e implementar propostas interventivas em sexualidade e educação sexual direcionado aos mesmos, acompanhando-os e assessorando-os no desenvolvimento de projetos de educação sexual. A abordagem metodológica utilizada na presente pesquisa é qualitativa, mediado pela pesquisa-ação. A pesquisa foi realizada no município de Abaetetuba-PA. E os participantes da pesquisa foram profissionais da educação (pedagogos e professor de matemática) e da saúde (psicóloga). Quanto aos instrumentos de pesquisa para a coleta de dados foi utilizado um questionário com perguntas abertas. A partir dos dados deste instrumento foram implementadas propostas interventivas para assessorar os profissionais nas efetivações de ações em sexualidade. Em linhas gerais, a elaboração de propostas interventivas visou dar legitimidade para uma formação articulada, fornecendo oficinas sobre as seguintes temáticas (história da sexualidade, diferença sexualidade e sexo, relação de gênero, gravidez na adolescência, prevenção as IST-HIV-AIDS, diversidade sexual, direitos sexuais e reprodutivos e violência sexual), assim como, sensibilizando ante à necessidade de implementação destas propostas. Contudo, por meio da implementação das propostas interventivas direcionadas aos profissionais de educação e saúde, foi notório verificar as contribuições que a formação propiciou nas concepções destes e, principalmente, no manejo para abordar o tema na prática profissional. Desse modo, percebemos que por meio dos resultados obtidos os profissionais da educação e saúde do citado município necessitam de formação e informação para desenvolver trabalhos interventivo de sexualidade, o que salienta a urgência do acréscimo de cursos contínuos para a efetivação das ações em ambas áreas. / The aim of this paper was to enhance the proper preparation concerning to teachers specialization in matters of systematical, continuous and formal-standardized sexual education, which has to be assured preparing teachers to deal with this topics in schools, as well as in all health institutions. It is extremely necessary to emphasize the urge of this initial and continuous preparation of this professional, considering that undergraduation courses at the university generally do not contemplate these issues on its course curriculum, those themes are related to gender, sexuality and sexual diversity. Still attached to this idea, it is also demanding from teachers to be prepared and cope with this sexual education themes adequately, taking into consideration the compromise of approaching those issues accordingly. Providing the same know how and preparation as the health professionals receive on their specialized courses giving thus, the important implementation and reinforcement due to the necessity to convey this sexual matters approach. To this view, the present research had its general objective to assure the demands of education and health professionals regarding to sexuality and sex education, to start from this point and in this especific context to elaborate and implement interventional proposals on sexuality and sexual education advising them on the development of sex education projects. The methodological approach, on this research was qualitative, verified via action research. The research was applied in the city of Abaetetuba-PA. And the research participants were education professionals (pedagogy professionals), (mathematics teachers) and in the health area (psychologists). In terms of tools applied, in order to, collect data, it has been used a survey-questionnaire. Based on the data collected, there were implemented inventive proposals to assist those professionals on effective actions related to sexuality issues. In general terms, the concept of elaborating an inventive proposal intended to assure authenticity in articulated preparation, providing workshops on the following themes (history of sexuality, sexuality and sex difference, gender relations, teenage pregnancy, STI-HIV-AIDS prevention, sexual diversity, sexual and reproductive rights, and sexual violence), as well as, the awareness of the massive needs on implementing these proposals. Nevertheless, through implementing those inventive proposals directed to these professionals of education and health fields respectively, there has been noticed the necessity of verifying the contributions that this preparation provided on this professionals’ conceptions, especially on how the theme has been approached in real life scenarios. In this way, we realize that through the results obtained, the education and health professionals who participated of the research need an appropriate training and information about the issue discussed in order to develop interventional sexuality educational effective work, which highlights the urgency of adding continuous courses for the implementation of actions in both areas.

Conselho Nacional de Desenvolvimento CientÃfico e TecnolÃgico / Nas Ãltimas dÃcadas, a AtenÃÃo BÃsica à SaÃde (ABS) tornou-se um tema especialmente relevante, resultando na reformulaÃÃo do Sistema Nacional de SaÃde. Assim, a rede bÃsica no Brasil tornou-se um espaÃo de prÃtica potencial e necessÃria, na qual os vÃrios cursos de formaÃÃo de profissionais de saÃde deverÃo inserir seus estudantes. Neste contexto, o programa interministerial PET-SaÃde (Programa de EducaÃÃo pelo Trabalho para SaÃde) tem contribuÃdo para a integraÃÃo universidade-serviÃo. O preceptor à a figura inserida no PET-SaÃde que surge no cenÃrio de prÃtica, como o profissional de saÃde-educador que oferece ao aluno ambiente que lhe permita construir e descontruir conhecimentos e experimentar vivÃncias prÃticas de um atendimento humanizado. O presente estudo buscou analisar a preceptoria do PET-SaÃde na EstratÃgia SaÃde da FamÃlia nos MunicÃpios de Fortaleza, Pacatuba e MaracanaÃ, tendo como pÃblico-alvo 82 preceptores da EstratÃgia de SaÃde da FamÃlia (ESF) do MunicÃpio de Fortaleza, 12 de Maracanaà e 06 de Pacatuba. Em relaÃÃo aos alunos bolsistas, foi pesquisada uma amostra de 113 alunos de Fortaleza, 24 de Maracanaà e 12 de Pacatuba. Trata-se de um estudo quantitativo, descritivo, observacional e transversal. A coleta de dados foi realizada atravÃs de um questionÃrio semiestruturado direcionado aos alunos e preceptores. As informaÃÃes foram analisadas no programa estatÃstico SPSS versÃo 17.0. A pesquisa foi aprovada pelo Comità de Ãtica em Pesquisa, com o parecer n 751292. Buscou-se identificar e correlacionar as percepÃÃes dos preceptores e alunos sobre as competÃncias exigidas na preceptoria, as principais dificuldades para o seu exercÃcio e quais resultados prÃticos foram alcanÃados com a realizaÃÃo da preceptoria em relaÃÃo preceptor/serviÃo. A pesquisa mostrou que 54,43% dos preceptores realizaram curso de pÃs-graduaÃÃo apÃs inÃcio da preceptoria e 65,82% afirmaram que a preceptoria influenciou na escolha desse curso. Os resultados apontaram as seguintes dificuldades na preceptoria: despreparo pedagÃgico dos preceptores, infraestrutura deficiente e pouca valorizaÃÃo da preceptoria pelo serviÃo. Com os resultados alcanÃados, pode-se concluir que o exercÃcio da preceptoria do PET-SaÃde à uma experiÃncia que apresenta possibilidades de crescimento para o profissional e desafios em relaÃÃo ao melhor preparo dos preceptores e serviÃos que devem ser superados com uma maior interaÃÃo entre gestores, preceptores, profissionais do serviÃo, instituiÃÃes de ensino e comunidade. / In recent decades, the Primary Health Care (ABS) has become a particularly important issue, resulting in the reformulation of different national health systems. The basic field has become a potential and necessary practice space, in which the various health professionals training courses shall insert its students. In this context, the inter-ministerial program PET-Health (Education Program for Working for Health) greatly contributes to the university-service integration. The Preceptor is the figure inserted into the Pet-health that arises in practical scenario, such as health educator professional who provides the student environments that allow them to build and deconstruct knowledge and experiment practical experiences of humanized care. This study investigated the PET-health preceptorship in Family Health Strategy in the municipalities of Fortaleza, Pacatuba and MaracanaÃ, having as target 82 preceptors professionals of the Family Health Strategy (FHS) in the city of Fortaleza, 12 from Maracanaà and 06 from Pacatuba. Regarding the scholarship students will be surveyed a sample of 113 students from Fortaleza, 24 students and 12 students from Maracanaà and Pacatuba. It is a quantitative and qualitative, descriptive, observational and cross-sectional study. Data collection wasconducted through semi-structured questionnaire directed to students and preceptors. The study was approved by the Research Ethics Committee opinion n 751 292. It sought to identify and correlate perceptions of competence required on preceptorship according to the preceptors and students, the main difficulties for exercise and what practical results preceptorship in Strategy Family Health brought to preceptors, students and service. Research has shown that 54.43% of the preceptors made a graduate course after the initiation of preceptorship and 65.82% said preceptorship influenced in the choice of course. The results showed the following difficulties in preceptorship: the pedagogical unpreparedness of preceptors, poor infrastructure and little appreciation of preceptorship by the service. With the results it can be concluded that the exercise of PET-health preceptorship is an experience that offers growth possibilities for professional and challenges relative to better preparation of preceptors and services that must be overcome with greater interaction among managers, preceptors, service professionals, educational institutions and community.

Magister Artium - MA / Background: Healthcare workers are the human face of health systems, serving to connect knowledge and service delivery to improve patient care. The development of core competencies in the education of health professionals is fundamental for health improvement. Interprofessional collaboration amongst healthcare workers has been linked to improved patient outcomes as no single professional can address all healthcare issues. Aim: The aim of this research was to determine how UWC undergraduate physiotherapy students were being prepared for collaborative work as part of their professional development. Educational experiences of the third- and final-year physiotherapy cohort, physiotherapy educators’ perspectives on the development of competency for collaboration and a review of physiotherapy module outlines were explored. Research Method: A descriptive qualitative research design utilizing focus groups, semi-structured interviews and document analysis was employed. A pedagogical framework was used for instrument development and data analysis. The pedagogical framework was adapted from the CanMEDS physician competency framework, the core competency framework by the Medical and Dental Board of the Health Professions Council of South Africa and the Essential Competency Profile for physiotherapists in Canada. Research was conducted at the Department of Physiotherapy at the University of the Western Cape. Purposive sampling was undertaken with the sample population having consisted of six third- and six final-year physiotherapy students for the focus group discussions and seven lecturers formed the sample for the semi-structured interviews as well as sixteen physiotherapy module outlines. Data was collected and focus group discussion and interviews were transcribed verbatim. An inductive content analysis of the transcribed data was conducted and compared to the Pedagogical framework. Content analyses of module outlines were conducted drawing on Biggs work on constructive alignment and compared to the Pedagogical framework. Ethical clearance was received from the Senate Research Committee of the University of the Western Cape. Results: Participants showed a keen knowledge on the importance of collaboration in the teaching and clinical environment. It had relevance for personal development and learning as well as for interprofessional collaboration. Interprofessional education and group work were thought to be instrumental in collaborative learning but a lack of congruency of learning activities could be a barrier to learning. The clinical environment was highlighted as beneficial to developing collaboration through interprofessional observation and interaction but high patient loads and a lack of understanding of the roles and responsibilities of all healthcare professionals were identified as barriers. To a lesser degree, communication, conflict management and confidence were identifiable skills physiotherapy students should have to be effective collaborators. Conclusion: Students are well-positioned to participate within interprofessional team but have inadequately developed collaborative competencies. These include interprofessional role understanding and skills in conflict management, confidence and communication. Constructive alignment of curriculum by aligning learning outcomes and learning activities to develop collaboration including interprofessional learning activities would better prepare students for interprofessional collaboration.

Thesis advisor: Janet E. Helms / Historically, psychological theory and mental health researchers have viewed sex work as inherently harmful to sex workers and capable of producing negative mental and physical health effects (Sprankle et al., 2018). Moreover, research focused on clinicians’ expectations for sex workers in therapy has not specifically examined clinicians’ attitudes toward sex workers or sex work as separate concepts (Benoit et al., 2015; Koken, 2011; Ma et al., 2017). In addition, mental health professionals may not view sex work as legitimate work because of the virtual lack of evidence-based theoretical frameworks for guiding therapy for sex workers, and, therefore, may use prostitution stigma as a substitute for theory (Krumrei-Mancuso, 2017; Williamson & Cluse-Tolar, 2002). The present study investigated the extent to which mental health professionals’ expectations of sex work and sex workers were related to prostitution stigma and their perceptions of sex workers’ overall mental health and evaluations of sex work as decent work. In particular, the study investigated the extent to which mental health professionals stigmatized the work of sex workers. Mental health professionals (N = 201) read a clinical vignette and completed an online survey containing a demographic information sheet, the Attitudes Toward Prostitutes and Prostitution Scale (Levin & Peled, 2011); (c) the Decent Work Scale (Duffy et al., 2017), (d) the Hospital Anxiety and Depression Scale (Zigmond & Snaith, 1986), and (e) the PTSD-8 (Hansen et al., 2010). Results from multivariate multiple regression analyses supported that when mental health professionals held higher levels of stigma towards sex work and sex workers, they may diagnose the client with higher levels of PTSD symptoms. Further, the results supported that endorsement of a feminist orientation moderated the relationship between sex work stigma and diagnosis clients’ PTSD avoidance symptoms. The discussion included methodological limitations and implications for research and practice. / Thesis (PhD) — Boston College, 2020. / Submitted to: Boston College. Lynch School of Education. / Discipline: Counseling, Developmental and Educational Psychology.