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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
181

Arbetslösa småbarnsföräldrars psykiska hälsa och öppna förskolans betydelse för den

Löfgren, Sofia January 2010 (has links)
<p>Arbetslöshet är ett omfattande ämne med fokus på psykisk hälsa på grund av försämrad ekonomi. Psykisk ohälsa är ett svårdefinierat begrepp som bland annat innefattar sömnsvårigheter, ängslan och ångest. Under perioden 2004 till 2005 rapporterade arbetslösa individer i Sverige psykisk ohälsa i större utsträckning än arbetande individer. Att vara arbetslös och förälder till barn i förskoleåldern kan vara påfrestande. Studier som undersökt förskolans betydelse för arbetslösa föräldrar har påvisat positiva upplevelser av förskolan under självupplevd psykisk ohälsa.</p><p>Syftet med denna studie var att undersöka arbetslösa småbarnsföräldrars psykiska hälsa och deras upplevelser av hur öppna förskolan i Västerås påverkar den. Studiens metod var kvalitativ och totalt intervjuades fem föräldrar genom halvstrukturerad intervjuform. Intervjuerna analyserades genom innehållsanalys och studien visade att förändringen från arbete till arbetslöshet påverkade föräldrarnas psykiska hälsa negativt på grund av försämrad ekonomi. Barnen var en skyddande faktor för föräldrarnas psykiska hälsa trots den försämrade ekonomin. Föräldrarnas självkänsla försämrades under arbetslöshet och öppna förskolans betydelse upplevdes endast positiv, mestadels tack vare stödjande personal. Mer forskning om ämnet arbetslösa småbarnsföräldrars psykiska hälsa och öppna förskolans betydelse för dem är av stor vikt.</p> / <p>Unemployment is a huge subject with a focus on the change in mental health caused by a worsened economic situation. Poor mental health is a complex concept to define, for instance it include insomnia, nervousness and anxiety. During the period 2004 to 2005 it were reported that the amount of unemployed individuals in Sweden with poor mental health were greater than the amount of employed individuals with poor mental health. Being unemployed and the parent of a preschool child can be stressful. Studies that examined the importance of preschool for unemployed parents with poor mental health have shown positive experiences.</p><p>The aim of this study was to examine unemployed parents’ mental health and the open preschools impact on it.  This study focus on parents with small children. The method of this study was qualitative and a total of five parents were interviewed by a semi-structured interview form. The interviews were analyzed with content analysis and the study showed that unemployed individuals got worse mental health caused by a worsened economic situation. In the worsened economic situation the children had a good impact on the parent’s mental health. The parents self-esteem was decreased during unemployment but the open preschool helped, most because the helpful personnel. More research on the subject of unemployed parents’ mental health and the impact of open preschool is of great importance.</p>
182

Opening the Black Box of Community-Based Injury Prevention Programmes : Towards Improved Understanding of Factors that Influence Programme Effectiveness

Nilsen, Per January 2006 (has links)
Despite wide application of community-based programmes to prevent injuries and promote health over the last 25 years, there is a paucity of evaluations from which to obtain evidence regarding the effectiveness and critical factors contributing to achieving effectiveness of these programmes. Research on community-based injury prevention programmes thus far has been driven by the question “does it work?” However, merely establishing whether a programme works or not provides insufficient information to generate new knowledge about these programmes. Many programme evaluations have been characterised as “black box” evaluations, with inadequate information about the intervening and contextual factors that mediate the relationship between the programme and its effects. Opening the black box is essential to developing the best evidence in relation to community-based programmes. Keeping the question “does it work?” in mind as a departure point, the seven studies of this thesis address different aspects of the questions “why does it work?” and “how does it work?” The aim is to aid in the understanding of factors that influence the operation and effectiveness of community-based injury prevention programmes. The findings from the studies support a number of conclusions with regard to the three research questions posed. There is limited evidence for the effectiveness of communitybased injury prevention programmes. Some of the problems of providing convincing evidence are due to the methodological difficulties of evaluating these programs. Contextual conditions and the amount of financial resources available to a programme are key factors associated with the effectiveness of community-based injury prevention programmes. There is inconclusive evidence regarding the importance of some of the socalled success factors described in the scientific literature for achieving effectiveness. While many programmes have access to locally collected injury data, they devote limited time to the analysis of this ssembled data. When selecting interventions, many programmes rely upon tuitive and subjective methods, e.g. discussions in networks, feedback from the general public, and experiences gained in their own work. This style of decision making is “experience-based” rather than evidence-based. The theoretical underpinning of the community-based approach has certain shortcomings, which could explain some of the difficulties in demonstrating effectiveness seen with many of these programmes. Programmes overwhelmingly define geographical units as communities. However, these entities can be highly heterogeneous and characterised by a weak sense of community, which can yield insufficient community member participation and intersectoral collaboration, as well as inadequate reach for many programmes. At the same time, none of the most plausible assumptions of the community-based approach appears to be fully or widely applied in programme practice. The implication is that many community-based programmes do not function at an optimum level.
183

Du står nå som nummer... : En kvalitativ undersøkelse av ventelistepasienters oppfatning av informasjon og kommunikasjon med sykehuse / You are now in line as number...” : A qualitative study of how patients on a waiting list perceive the information from and communication with the hospita

Snekkenes Wik, Unni Jane January 2007 (has links)
Hensikt: Hensikten med undersøkelsen var å beskrive, og å oppnå større forståelse for, hvordan ventelistepasienter ved Klinikk for ortopedi og revmatologi og pasientrepresentanter fra Brukerutvalget ved St. Olavs Hospital i Trondheim oppfattet ventetiden og kontakten med sykehuset i påvente av undersøkelse og behandling. Kunnskapen skal brukes til å forbedre informasjonen til og kommunikasjonen med ventelistepasientene. Metode: Datainnsamling ble gjort ved 24 individuelle intervju med pasienter fra ventelistene og et gruppeintervju med pasienter i en offisiell rolle som medlemmer av sykehusets Brukerutvalg. Analysen av intervjuene ble gjort med fenomenografisk tilnærming. Resultat: To sammenhengende hovedtema fremkom, der tema om Daglig liv som ventelistepasient dominerte over tema om Informasjon og kommunikasjon i ventetiden. De to tema ble belyst med seks hovedkategorier med til sammen 20 underkategorier som viste at ventelistepasientene opplevde en hverdag med mye smerter og hindringer i forhold til tidligere funksjonsnivå. De var lite opptatt av generell informasjon og hvordan den skriftlige informasjonen så ut. Den informasjon de hadde fått ble oppfattet som grei nok, men inneholdt ikke de opplysninger de hadde behov for. Det viktige var å få personlig, lett forståelig og forklarende informasjon av legen ved den polikliniske undersøkelsen der de eventuelt ble søkt til innleggelse og operasjon; på et tidlig tidspunkt i ventetiden få en konkret operasjonsdato å forholde seg til; få målrettet informasjon om hvordan de kunne forberede seg på operasjonen og tilrettlegge for seg selv etter operasjonen; at det var noen å komme i kontakt med hvis de ønsket det. I tillegg til samsvarende oppfatninger med ventelistepasientene var deltakerne fra Brukerutvalget mer opptatt av og kritisk til informasjonens innhold og form enn pasientene i de 24 individuelle intervjuene. Konklusjon: Pasientene ønsket kontroll over livet i ventetiden ved å få konkret og personlig informasjon om operasjonsdato, hensiktsmessige forberedelser, hva og hvordan i forhold til operasjon og rekonvalesens. Først når dette var oppfylt kunne de vise en begrenset interesse for informasjonens utforming / Aim: The aim of the study was to describe and achieve a greater understanding of how patients on the waiting list for surgery at the Department of Orthopaedic Surgery and Rheumatology and the group of patient representatives (Brukerutvalget) at St. Olav’s University Hospital in Trondheim experienced the waiting time and the contact with the hospital. The knowledge shall be used to improve the information to and the communication with patients on waiting list. Method: The data collection was done through 24 individual interviews with patients on waiting lists and one group interview with four of the patients having an official role as members of the hospital’s group of user representatives. The analysis of the interviews was done by a phenomenographic approach. Results: Two related main subjects appeared of which the subject of the daily life as a waiting list patient dominated over the subject of the information and communication received during the waiting time. These two subjects were illustrated by six main categories and 20 subcategories which showed that the waiting list patients experienced a daily life with much pain and hindrances compared to their earlier level of functionality. They were to a small degree interested in any general information and how the general information was presented. The information they had received was conceived as satisfactory, but did not contain the information they needed. The important thing was to get personal, easy to understand and well explained information from the doctor during the visit at the outpatient clinic, when they were eventually sought referred to the hospital for admission and operation, to get a fixed time for the operation early in the waiting time, to get systematic information about how to prepare for the operation and how to organize themselves after the operation, and finally that there should be a person to contact if they needed to. In addition to perceptions common with the waitinglist patients the participants from the group of user representatives were more concerned with and critical to the contents and presentation of the information than the patients from the 24 individual interviews. Conclutions: Personal and relevant information was needed to cope with the daily life. Not till the patients knew about a fixed time for the operation, appropriate preparations, the surgery and convalescence they could show a limited interest for the shaping of the information / <p>ISBN 978-91-85721-15-3</p>
184

Bedre Mad Til Syge, Implementering Af Ernæringsscreening På Sygehus / Proper Nutrition To Patients, Implementation Of Nutritional Screening In Hospitals

Sandahl Sørense, Ellen January 2007 (has links)
Sammanfattning: 20 – 50 % af patienter indlagt på sygehuse er underernæret eller i risiko for underernæring. 40 % af alle indlagte patienter får ikke dækket det daglige behov for energi og protein og der er evidens for, at sundhedsprofessionelles viden om ernæring til småtspisende patienter er begrænset. 2oo2 blev der udviklet et ernæringsscreeningsredskab, der kan vurderer ernæringstilstanden hos alle patienter indlagt på Sygehus Sønderjylland. Det er således muligt at vurdere patientens ernæringstilstanden og iværksætte en forebyggende ernæringsindsats. Dette vil forårsage en bedring i patientens levevilkår og konsekvenser af underernæring mindskes. Studiets teoretiske kontekst indeholder elementer fra et sundhedsfremmende perspektiv, kvalitets- og implementeringsprocesser og postmodernisme. Formål: Udvikling og afprøvning af et redskab, der kan vurdere kvaliteten af den sundhedsprofessionelle ernæringsindsats til de småtspisende patienter. Metode: Der er gennemført en kvantitativ spørgeskemaundersøgelse, survey. Resultat: Det ses ikke, at sundhedsprofessionelle under implementeringsprocessen har fået øget faglig viden på ernæringsområdet til de småtspisende patienter. Der er sket en mindre vidensudvikling i forhold til ernæringsscreeningsredskabet. Fortsat er der usikkerhed i de sundhedsfaglige arbejdsrutiner på ernæringsområdet og det tværfaglige og tværsektorielle samarbejde er nærmest usynligt. Der ses ikke effekt af ernæringsindsatsen til patienten i denne undersøgelse. Konklusion: En implementeringsproces af et ernæringsscreeningsredskab tager mere end et år og det er nødvendigt at fortsætte kvalitets- og forbedringsarbejde på ernæringsområdet.Kvalitetsudviklingsarbejde synliggør et sundhedsfagligt indsatsområde. Ønskes derimod at skabe en forankring af den sundhedsfaglige indsats er udfordringen at anvende redskaber fra systemtænkning og forbedringsarbejde. Når sundhedsprofessionelle får mulighed for at udvikle ejerskab og ansvar for implementeringsprocessen, får kvalitetsarbejdet større effekt og bliver attraktivt. Nøglebegreber i fremtidige implementeringsprocesser er kvalitetsudvikling og forandrings arbejde, såvel som fokus på værdibaseret faglig ledelse og igangsættelse af læreprocesser / Abstract: 20 – 50 % of patients are in nutritional risk on admission to hospital. 40 % of the patients do not receive an adequate amount of energy and protein to cover the daily need for nutrition and health professionals knowledge about nutritional needs to underweight patients are limited. In 2002 a nutritional screening tool, which can be used to estimate the nutritional status in all patients admitted to Sygehus Sønderjylland was developed. It is now possible to estimate nutritional status at an early stage and start nutritional treatment with the purpose to avoid under nutrition. This leads to improved life skills for the patient and consequences of under nutrition are limited. The theoretical context of this study contains elements from a health promotion perspective, system thinking, quality- and implementation processes and postmodernism. Purpose: Developing and testing of a tool that can determine the quality of nutritional treatment and care given by health professionals to undernourished patients. Method: A quantitative questionnaire, survey, has been carried out.Result: The result of the survey does not provethat health professionals under the implementation process have increased their knowledge about the undernourished patients. In relation to the nutritional screening tool only minimum of improvement in knowledge has been detected as a result of increased documentation. Still the working routines in the nutritional area among health professionals are unclear and the cross-sectional and interdisciplinary co-operation is invisible. The result of this survey does not show any improvement related to the nutritional effect of the undernourished patient. Conclusion: An implementation process of a nutritional screening tool takes more than one year and it is necessary to continue the quality and improvements in the nutritional area. Quality and managing change will high light a health promoting area. If change in working routines and values among health professionals is wanted, the challenge is to use tools from system thinking and improvement strategies. When health professionals get the opportunity to create ownership and responsibility for an implementation process in a health promoting area, the effect of quality management will become larger and more attractive. Keywords in future implementation processes are quality and managing change as well as focus on value-based management and to start learning processes / <p>ISBN 978-91-85721-03-0</p>
185

Meningsdannelse som copingstrategi ved livstruende sykdom. : En oversikt over nyere forskning på meningsdannelse i livet med cancer. / Meaningfulness as a coping strategy in life threatening illness. : A review of the literature on meaningfulness in cancer patients

Stensen, Merete January 2006 (has links)
Bakrunn: det å få en cancerdiagnose er en kraftig konfrontasjon med tilværelsens grunnvilkår. En slik grenseopplevelse kan utløse enten oppgivelse, fornektelse eller en refleksjonsprosess som ofte vil ha spørsmålet om meningen med livet som omdreiningspunkt. Det har generelt vært satt lite fokus på den eksistensielle dimensjon som inngår i det å bli konfrontert med en potensielt livstruende sykdom. Meningsdannelse er et viktig element av både coping og generell livskvalitet. Hensikt: Å undersøke hvordan mennesker skaper mening når de blir konfrontert med en alvorlig sykdom som cancer. Ønsket var å foreta en litteraturoversikt for bedre å kunne forstå de faktorer som bidrar til, og inngår i meningsdannelse. Metode: Det ble foretatt en litteraturstudie, med referanse til systematiske oversikter. Ni artikler ble inkludert etter ekstensivt søk og predefinerte kvalitetsvurderingskriterier. Deretter ble det foretatt en innholdsanalyse, og temaene som fremkom ble syntetisert etter prinsipper for meta etnografi. Resultat: en søken etter mening vokste spontant frem som følge av å bli konfrontert med cancer og en mulig prematur død. Temaene i meningsdannelse dreier seg om engasjement i viktige relasjoner, oppdagelsen av egen indre styrke, engasjement i et åndelig innhold, intensivering av livsglede og optimering av tidsutnyttelse. Konklusjon: Meningsdannelse fremstår som en betydelig orientering og ressurs i bestrebelsene på å cope med en kritisk hendelse og situasjon. For deltakerne i studiene var konfrontasjonen med egen dødelighet et insitament til å bli mer bevisst om de verdifulle aspekt av livet, og ansporet til reevaluering av verdier og en søken etter mening. / Background: To obtain a diagnosis of cancer represents a powerful confrontation with the core of existence. A borderline experience such as this may result in giving up, denial or a process of reflection that often will circle around questions about the meaning of life. Generally, there has been little focus on the existential dimension that is part of being confronted with a potentially lethal illness. Meaningfulness is an important element of both coping and general quality of life. Aim: To investigate and explore how people manage to create meaningfulness when they are confronted with a serious illness like cancer. This study intends to review the literature, to highlight and reach an understanding of the factors that contributes to, and is part of the creation of meaningfulness. Method: A literature review was undertaken, with reference to systematic reviews. After an extensive search and predefined criteria for assessing quality, nine articles were included. A content analysis was undertaken, and the themes that emerged during this process was then synthesised following the principles of meta-ethnography. Result: A search for meaning grew spontaneously as a consequence of being confronted with cancer and possible premature death. Meaningfulness included themes such as an engagement in important relations, discovery of inner strength, engagement in spiritual contents, intensified joy of everyday life and optimised use of time. Conclusion: the creation of meaning stands out as a prominent orientation and resource in the efforts of coping with a critical situation. For the interviewees, the confrontation with their own mortality acted as an inspiration to become more aware of the valuable aspects of life, and led to a re-evaluation of values and a search for meaning. / <p>ISBN 91-7997-134-2</p>
186

Scaling up malaria interventions. : Integrating free distribution of long lasting insecticide treated mosquito nets during vaccination campaigns. A new strategy to meet the millennium development goal

Monclair, Marianne January 2008 (has links)
Objective: To look at the Red Cross and the Red Crescent societies integrated campaigns between 2002 and 2006 with free distribution of insecticide treated nets (ITN)that have taken place and its contribution to the Millennium Development Goals(MDG) and the Abuja target.  Method: Review of surveys, evaluations and reports from the International Federation of Red Cross and Red Crescent integrated campaigns. Published articles up to 2007 have been accessed from electronic databases Medline, PubMed, the Cochrane Library and website`s from WHO, UNICEF, GFATM , and related articles available from international organisations web sites in addition to informal discussions and meetings with key stakeholders. Results: The integrated vaccination and free distribution of long lasting insecticidal nets (LLINs) achieved a rapid, high and equal LLIN coverage among all wealth quintiles. The MDG and Abuja target for ITN coverage at household level were reached within a week giving a unique opportunity for a significant reduction in malaria incidences, morbidity and mortality. The ITN possession remained higher than utilisation, but utilisation increased if a follow up visit, ensuring nets being hung and properly used, had taken place at household level post campaign. Conclusion: Large scale free distribution of LLINs  bridge the equity gap between poor and rich and increased the use rate among children under five and pregnant women. The low utilisation versus possession remains a challenge and thus a “minimum standard” of a two phased strategy is recommend to reach maximum impact and the MDG; Phase one preparing for pre campaign data, logistical planning and distribution while phase two should focus on a post campaign Keep Up program providing health education at household level to ensure proper net hanging and use. / <p>ISBN 978-91-85721-42-9</p>
187

Krenket jeg deg? : Den økede sårbarheten hos personer med begynnende demens og omsorgspersoners mulighet til å respektere deres integritet / Did you feel offended? : The increased vulnerability in an early stage of dementia and caretakers possibility to respect their integrity

Mæhlum, Synøve January 2005 (has links)
Denne studiens hensikt er dels å belyse den økede sårbarheten hos personer med begynnende demens i forhold til omsorgspersoner, og dels å undersøke hva omsorgspersoner mener bør endres med henblikk på utvikling av kunnskap og kompetanse for integritetsstyrkende omsorg og pleie til denne pasientgruppen. Studien er en del av samarbeidsprosjektet: Helsefremmende og forebyggende psykisk helsearbeid i lokalsamfunnet, som er et samarbeidsprosjekt mellom Høgskolen i Hedmark og to kommuner, en by- og en landkommune. Dataene er skapt på grunnlag av åtte fokusgruppeintervjuer med hjemmehjelpere og pårørende og dialogbasert undervisning i de respektive kommuner i peioden okt. 2003-mars 2004. Dataene er analysert ved hjelp av kvalitativ innholdsanalyse. Resultatene viser at intervjupersonene erfarer at personer med begynnende demens har en spesiell sårbarhet og opplever både lidelse og krenkelser i sin hverdag. Hjemmehjelperne etterlyste kontinuitet i tjenesten og ”tilstrekkelig tid” i samhandligssituasjoner med personer med begynnende demens. Pårørende ønsket rutiner for oppfølging både av pasient og pårørende etter utredning og diagnostisering. I tillegg ønsket de bedre rutiner for kommunikasjon og samarbeid mellom pårørende og de hjemmebaserte tjenester.Både pårørende og hjemmehjelper ønsket et relevant faglig undervisningsopplegg for personer som har omsorgsansvar for personer med begynnende demens. / The aim of this MPH thesis is partly to show the increased vulnerability at early stages of dementia related to their caretakers, and partly to investigate what the caretakers think should be changed when it comes to development of knowledge and competence necessary for promoting a care based on the respect for the integrity of this group of patients. The study is part of a research collaboration between Hedmark University College and two municipalities, one urban and one rural municipality: Promotive and preventive mental health work in the local community. Data is created on the basis of eight focus group interviews with home care workers and family carers (spouses and children) from two municipalities during October-03 through March-04. Data was analysed by means of qualitative content analyses. The results show that the persons interviewed had experienced that persons suffering from dementia experienced vulnerability and different kinds of threats against their integrity in their daily life. The home care workers wanted continuance in the service and “time enough” in the caring situations with the patients suffering from dementia to be able to give security and confidence. The family carers wanted collaboration- and communication routines to be able to take better care of the patient. They also felt very much left alone in the care of the patient. / <p>ISBN 91-7997-118-0</p>
188

Finns en läkande vårdatmosfär? : En kvalitativ studie om betydelsen av vårdmiljö och bemötande för patienter. / Does a Healing Atmosphere in Care Settings Exist? : A Qualitative Study of the Importance of Physical Environment and Interactions between Patients and Health Professionals

Nordblad, Brita January 2012 (has links)
Bakgrund: De medicinska insatser, omvårdnad och rehabilitering som erbjuds patienter i primärvård idag är vedertagna och vanligtvisevidensbaserade. Patienter kan få diagnos, behandling och ofta bot för många åkommor. En dimension som dock mindre ofta är tillvaratagen är effekterna av en genomtänkt fysisk miljö. Ett respektfullt bemötande i kombination med en genomtänkt vårdmiljö kan beskrivas som en god vårdatmosfär. Syftet med studien är att undersöka hur patienter upplever och uppfattar vårdatmosfären vid besök på en rehabiliteringsenhet i primärvård. Metod: Kvalitativaforskningsintervjuer och kvalitativ innehållsanalys Huvudresultat: En vårdatmosfär kan delas in i tre domäner: Fysisk miljö, Bemötande och Organisation. Inom domänerna finns ett antal kategoriermed variationer: Känsla av kontroll, Fysiska förutsättningar för att bli uppmärksammad, Subjektiva upplevelser av miljön, Kunskap om miljöns effekter, Uppmärksammar och bekräftar, Kommunicerar, Helhetssyn, Patienten i fokus, Delaktighet, Empati, Jämlikt möte, Att göradet ‖lilla extra‖, Innehåll och utbud, Tillgänglighet, Kontinuitet, Vårdkedjor och samverkan, Jämlik vård, Patientens rättigheter, Bemötandeandaoch förbättrings-och utvecklingsanda.Temat som framkommit är Att bli sedd, att vara värdefull. Slutsats: Till begreppet vårdatmosfär kan förutom vårdmiljö och bemötande, organisation läggastill. Organisationen ger förutsättningar eller kan försvåra. Ett tema håller samman alla kategorier och det är betydelsen av att bli sedd som ger budskap om att vara värdeful / Background: Medical treatment, care, and rehabilitation offered to patients in primary care settings are established and mostly evidence-based. Patients can receive diagnose, treatment and, quite often, cure. A dimension that receives less attention involves the effects of a carefully planned physical environment. Combined with a carefully planned environment, respectful interaction between patients and health professionals enhancesthe atmosphere of care settings. Aim: This study aimed to investigate how patients experience the atmosphere they encounter when visiting a rehabilitation unit within a primary care unit. Method: Qualitative research interviews and qualitative content analysisResults: The atmosphere in care settings encompasses three domains: physical environment, interaction between patients and health professionals, and the organization. Within these domains, categories include sense of control, physical conditionsfor to attract attention, subjective experience, knowledge of the effects of the environment, attention to and confirmation of the patient, communication, holistic view of the patient, patient in focus, participation, empathy, equality in the meeting, To do ―the little more‖, healthcare content, accessibility, continuity, cooperation, equal care, patient rights, spirit of interaction between patient and health professional, and spirit of improvement and development. The major themes that emerged were the patient’s need to be noticed and valued. Conclusion: Our results suggest that the organization should be added to the concepts of atmosphere in care settings. The organization can create and obstruct careconditions. The overarching theme of these categories is the patient’s need to be noticed and valued / <p>ISBN 978-91-86739-27-0</p>
189

Improving telemedicine onboard Norwegian ships and drilling platforms. : A study of intersectoral co-operation in Maritime Medicine

Puskeppeleit, Monika Petra January 2008 (has links)
Background: Using telemedicine to provide health services for seafarers represents a special case of intersectoral co-operation.Since 2006, several North Sea drilling platforms and internationally operating Norwegian merchant ships have usedonboard telemedicine equipment continuously. Experience gained through this new technology has improvedintersectoral co-operation regarding seafarers’ health care. Aim: This study aimed to analyze the need for intersectoral co-operation and networking in maritime medicine by usingtelemedicine equipment at sea. Various Norwegian maritime organizations and institutions participated in the study. Methods: I conducted a qualitative descriptive survey using a Web-organized interactive interview technique, a new mode ofinteraction based on a semi-structured interview guide for data collection. After conducting exploratory personalinterviews in October 2006, I developed a Web-based questionnaire comprising 53 questions. Participants receivedan e-mail invitation containing an online link to an Internet-based questionnaire. Individuals unable to use the Webbasedlink could return the completed questionnaire as an e-mail attachment. I collected data between April and June2007 and evaluated some questions according to the principles of content analysis and others with simple quantitative analysis, e.g., frequency and distribution. Results: Among 33 persons contacted, 31 (94%) agreed to participate in the study. Respondents represented 11 variousmaritime organizations and companies. Fourteen worked as maritime officers, nine as maritime managers, and eightas medical professionals. Importantly, fourteen respondents (45%) had demonstrated practical working experiencewith telemedicine at sea. According to content analysis, the following categories were developed: communicationandevidence-based telemedicine; maritime e-health standardization and knowledge management; improvingtelemedicine quality management; organizational, technical, and medical competences and intersectoral approach;technical standardization and networking; and communication and information. Four main categories illuminated theparticipants’ demands, i.e., information, communication, standardization, and centralization, and led to thedevelopment of national e-health policy and strategy to support the Norwegian maritime e-health society vianetworking and intersectoral co-operation. Conclusions: Intersectoral co-operation in maritime telemedicine requires interorganizational networking in order to introduceeffective and compatible international maritime e-health standards for seafarers’ healthcare. The Norwegian Centrefor Maritime Medicine (NCMM), a Centre of Excellence in maritime medical research, will participate importantlyin this process. The study also showed that a Web-based survey in maritime research offers an easily managedresearch tool that quickly yields a very good overview of a special situation. / <p>ISBN 978-91-85721-50-4</p>
190

Unge mødres risikooplevelse i forhold til børneulykker / Young mothers perception of risk in relation to child accidents

Rüdiger, Jane January 2006 (has links)
BAGGRUND: Ulykker er et af de alvorligste sundhedsproblemer for børn. Hvert år mister mellem 50 og 60 børn i Danmark livet ved ulykker og skadestuerne behandler omkring 160.000 børn for faldulykker, forgiftningsulykker, el-ulykker, kvælningsulykker med flere. Børn af unge mødre ser ud til at være betydeligt mere udsatte for at komme ud for ulykker end andre børn. FORMÅL: Undersøgelsen fokuserer på unge mødres risikooplevelse, holdning og adfærd i forhold til forebyggelse af børneulykker i hjemmet. METODE: Der er taget udgangspunkt i en induktiv kvalitativ undersøgelse med interview af 7 førstegangsfødende mødre i alderen 18-25 år med børn i alderen 3 måneder til 1 år. Alle mødre er af dansk oprindelse. I undersøgelsen indgik 2 mødre som havde fået piger og 5 mødre som havde fået drenge. RESULTATER: Mødrene anså ulykker som uundgåelige og vigtige for barnet, hvis de ikke havde alvorlige konsekvenser. Mindre ulykker eller skader gav barnet erfaringer, som kan anvendes, når barnet senere selv skal vurdere en eventuel risiko. Det var vigtigt for flere mødre, at deres børn bliver robuste, således at de ville kunne klare sig i det sociale fælles-skab i blandt andet daginstitutionen. Mødrene anså ikke deres egen alder som en afgørende faktor i forhold til ulykkesforebyggelse. Mødrene pegede i stedet på, at deres egne erfaringer med at udforske livet var afgørende for, hvor vigtig de anså ulykkesforebyggelse i hjemmet for at være. Undersøgelsen viste, at mødrene havde svært ved at forholde sig til hjemmet, som et sted, hvor der kan ske alvorlige ulykker til trods for, at de alle kunne udpege de farlige steder. Enkelte mødre havde indrettet hjemmet, således at barnet ikke var så udsat for at komme til skade, men flere mødre ønskede i stedet at lære børnene, hvad de må og ikke må til trods for, at mødrene ikke havde et klart billede af, hvornår disse forventninger til barnet var realistiske. KONKLUSION: Hvis mødres holdning til forebyggelse af ulykker skal påvirkes, vil det være nødvendigt sammen med moderen at drøfte, hvornår børn kan lære af erfaring, og hvornår børn bør beskyttes mod ulykker. / BACKGROUND: Accidents are one of the most serious health issues for children. Every year 50 to 60 children die in accidents and emergency departments treat approximately 160.000 children for accidents related to slips and falls, poisoning, electricity, suffocation etc. Children of young mothers appear to be significantly more exposed to accidents than other children. AIM: The survey targets the risk perception, attitude and behaviour of young mothers with regards to domestic child accidents. METHODOLOGY: The paper is based on an inductive qualitative survey with interviews of 7 first time mothers' ages 18-25 years with children ages 3 months to one year. All mothers are ethnically Danish. Of the 7 children, 2 were girls and 5 were boys. RESULTS: The mothers perceived accidents as inevitable and important for the child if they were not of a serious nature. Small accidents or injuries gave the child experiences, which could be used when the child at a later stage had to evaluate a potential risk. It was important for several mothers that their children grow up to be robust enabling them to take part in social activities, amongst others at day care institutions. The mothers did not see their own age as a factor related to accident prevention. Instead they draw attention to their own experiences as a crucial determinant of the degree of importance they attach to domestic accident prevention. The survey has shown that the mothers had trouble perceiving their home as a place where serious accidents could occur although they could all identify the potentially dangerous situations. A few mothers had arranged their home so as to lower the risk of their child having an injury but more instead desire to teach their child what it can and cannot do despite these mothers not having a clear picture of how realistic these expectations to the child were. CONCLUSION: To influence the mothers’ attitude to prevention of accidents it will be necessary to discuss with the mother which lessons children can learn from experience and when they are to be protected against accidents. / <p>ISBN 91-7997-159-8</p>

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