Thesis (LLM (Public Administration)) --University of Limpopo, 2013 / Turnover of health care professionals is a global challenge and has severely affected developing countries. South Africa as a developing country is not exceptional on the problem of turnover rate of health care professionals. The high vacancy rate became evident in the recent years. The health institutions depend on the health professionals in providing quality health care services. The challenges that are facing the health institutions include lack of a clear understanding by managers of the factors that are contributing to high turnover rate of health care professionals as well as the formulation of effective recruitment and retention strategies. The prevailing of the rapid changes in the internal and external environment make it difficult for the health institutions to develop and implement recruitment and retention strategies in an effort to minimise high turnover of healthcare professionals. The purpose of this study is to analyse the factors that are contributing to turnover of health care professionals at Polokwane and Mankweng Tertiary Hospital in Limpopo Province. The study also provides recruitment and retention strategies that the management may apply them to minimise the high turnover of health care professionals. The population sample was randomly selected from Polokwane and Mankweng Tertiary Hospital. Data was collected and analysed from a total number of 150 respondents. A structured questionnaire was used as an instrument for the collection of primary data. In this regard, factors such as lack of medical equipment, poor management style, poor working conditions and high workload are found to be critical factors that are affecting quality health care service and eventually the morale of employees, and resulting into turnover of health care professionals

Three groups of health care professionals were canvassed for their views on euthanasia - student nurses, practising nurses and doctors. The aim of the research was to make a possible contribution to a formalised health policy on this issue for the ACT. The following forms of euthanasia were covered by the research: (i) voluntary active euthanasia: (ii) voluntary passive euthanasia: (iii) involuntary active euthanasia: (iv) involuntary passive euthanasia. Passive forms of euthanasia were found to be the most acceptable. Voluntary forms of euthanasia were not found, in general, to be more approved of than involuntary forms of euthanasia. However, active forms of euthanasia were much less acceptable than passive forms. In order to adapt the research findings to a methodology for policy use. Allison's models (1971) of public policy development were modified into a single model. This provided an application of the research results in such a way as to allow for the development of a possible formalised policy on euthanasia, and practical applications. The conclusions drawn from the research findings and the subsequent recommendations are supportive of law reform and the implementation of a new policy on the issue of euthanasia.

<p><strong>Bakgrund: </strong>Övervikt är ett folkhälsoproblem i västvärlden. Att leva med övervikt kan innebära ett stort lidande. Sjuksköterskan är ofta den som har mest regelbundna kontakter med överviktiga patienter. Sjuksköterskans uppgift är att bemöta patienter på ett värdigt sätt oavsett ålder, utseende, funktion eller prestationsförmåga.<strong> Syfte:</strong> Syftet med litteraturstudien var att belysa bemötandet av patienter med övervikt i hälso- och sjukvården. <strong>Metod: </strong>Studien genomfördes som en litteraturstudie baserat på nio vetenskapliga artiklar. <strong>Resultat: </strong>Resultatet presenteras ur två perspektiv, ett patientperspektiv och ett sjukvårdspersonalsperspektiv. Studien visade att bemötandet till överviktiga patienter upplevdes både positivt och negativt. Patienterna upplevde att de fick en god relation med sjukvårdspersonalen. Andra tyckte att de blev dömda direkt utifrån sin övervikt. Sjukvårdspersonal upplevde att övervikt var ett känsligt område att arbete inom. <strong>Slutsats: </strong>För en lyckad vårdrelation där bemötandet upplevs positivt bör sjukvårdspersonalen vara medveten om sina attityder och se hela människan.</p><p> </p> / <p><strong>Background</strong>: Overweight is a public health problem in the Western world, and the disease can cause severe suffering. Usually, the nurse has the most contact on a frequent basis with overweight patients. The nurse’s task is to treat patients in a dignified manner regardless of age, appearance, function or capacity. <strong>Aim: </strong>The aim with this literature study was to enlighten the encountering with<strong> </strong>overweight patients in the health care system. <strong>Method:</strong> This study was carried out as a literature study based on nine scientific articles. <strong>Result: </strong>The result is presented from the patient’s perspective as well as from the health care professionals’ perspective. The study shows that the encountering with overweight patients is experienced both negatively and positively. The patients could feel that they established a good relationship to the health care professionals. Other patients experienced that they were judged directly by their overweight. The health care professionals experienced that overweight were a sensitive area to work within. <strong>Conclusion:</strong> For a caring relation where the encountering is experienced as positive, the health care professionals should be aware of their attitudes in the caring relation and consider the different aspects of the human they treat.</p><p> </p>

The aim of this thesis is to investigate attitudes to functional foods (here defined as foods with health claims) among Swedish consumers and health-care professionals. The aim is also to survey demographics and health interests associated with the consumption of functional foods among Swedish consumers. Finally, the aim is to investigate health-care professionals’ knowledge of and willingness to recommend functional foods to patients. Examples of functional foods used in the studies are probiotic fruit-drinks, probiotic milk-products, cholesterol-lowering spreads and fibre-rich bread with omega-3 fatty acids. Ten focus groups of consumers and three of health-care professionals were conducted. Two questionnaires were also used, one for consumers aged 17-75 years (n=2000) and one for health-care professionals (dieticians, n=100; registered nurses, n=200; physicians, n=200). Almost half of the consumers (48%) and exactly half (50%) of the health-care professionals responded. The consumers wondered whether the functional foods were normal foods or medicines. They considered functional foods unnecessary, unless you suffer from incurable diet-related problems. The consumers were worried that the foods could be used as a compensation for an unhealthy lifestyle. While the consumers in the focus groups were mainly sceptical towards functional foods, these foods are being consumed by those who perceive them as necessary, the health-conscious, the well-educated and people who have noticed effect of the foods. The registered nurses and physicians, in contrast to the dieticians, expressed doubts regarding the claimed effects of the functional foods. The dieticians rated higher knowledge and were more willing to recommend functional foods to patients than were the physicians and, to some extent, the registered nurses. The interviews with the health-care professionals revealed that the dieticians were more positive towards functional foods than the registered nurses and, primarily, the physicians. This was confirmed through the questionnaire. Those, who consumed functional foods, reported high knowledge, and perceived benefits of functional foods, were most likely to recommend these foods to patients.

According to the Crohn’s and Colitis Foundation of Canada, there is approximately 1 in every 200 individuals who is living with inflammatory bowel disease (IBD). Many of those living with IBD also need to have an ostomy. The literature on the effects IBD and an ostomy has on adolescents and young adults lacks consensus. Therefore, the purpose of this phenomenological study was to try to understand the lived experiences of adolescents and young adults (N=6) living with IBD and an ostomy. Sociodemographic information was collected, and the participants were interviewed in person using a semi-structured interview guide. The work of van Manen (1990) was used as a guide for data collection, analysis and interpretation of this study. Analysis revealed the essence of the adolescents’ and young adults’ lived experience as being “Concealing and Revealing the Self”. Three themes communicate the essence of their lived experience: (a) Uneasy feelings, (b) “It’s hard…”, and (c) A renewed sense of self. The needs of the adolescents and young adults, along with their recommendations to health care providers, are addressed. The study findings inform nurses in the areas of practice, education and research. Practice recommendations include being cognizant that these individuals need holistic care that addresses their psychological, psychosocial and physical needs. This study forms the basis for future research to explore some of the themes in greater detail, as well as a recommendation for a longitudinal study. / February 2008

Bakgrund: Övervikt är ett folkhälsoproblem i västvärlden. Att leva med övervikt kan innebära ett stort lidande. Sjuksköterskan är ofta den som har mest regelbundna kontakter med överviktiga patienter. Sjuksköterskans uppgift är att bemöta patienter på ett värdigt sätt oavsett ålder, utseende, funktion eller prestationsförmåga. Syfte: Syftet med litteraturstudien var att belysa bemötandet av patienter med övervikt i hälso- och sjukvården. Metod: Studien genomfördes som en litteraturstudie baserat på nio vetenskapliga artiklar. Resultat: Resultatet presenteras ur två perspektiv, ett patientperspektiv och ett sjukvårdspersonalsperspektiv. Studien visade att bemötandet till överviktiga patienter upplevdes både positivt och negativt. Patienterna upplevde att de fick en god relation med sjukvårdspersonalen. Andra tyckte att de blev dömda direkt utifrån sin övervikt. Sjukvårdspersonal upplevde att övervikt var ett känsligt område att arbete inom. Slutsats: För en lyckad vårdrelation där bemötandet upplevs positivt bör sjukvårdspersonalen vara medveten om sina attityder och se hela människan. / Background: Overweight is a public health problem in the Western world, and the disease can cause severe suffering. Usually, the nurse has the most contact on a frequent basis with overweight patients. The nurse’s task is to treat patients in a dignified manner regardless of age, appearance, function or capacity. Aim: The aim with this literature study was to enlighten the encountering with overweight patients in the health care system. Method: This study was carried out as a literature study based on nine scientific articles. Result: The result is presented from the patient’s perspective as well as from the health care professionals’ perspective. The study shows that the encountering with overweight patients is experienced both negatively and positively. The patients could feel that they established a good relationship to the health care professionals. Other patients experienced that they were judged directly by their overweight. The health care professionals experienced that overweight were a sensitive area to work within. Conclusion: For a caring relation where the encountering is experienced as positive, the health care professionals should be aware of their attitudes in the caring relation and consider the different aspects of the human they treat.

Bakgrund: Antalet människor som lider av fetma ökar ständigt, och har globalt sett mer än fördubblats sedan år 1980. Då fetma ofta leder till flera följdsjukdomar innebär det att denna patientgrupp blir allt vanligare inom hälso- och sjukvården. Detta ställer i sin tur krav på hälso- och sjukvårdspersonlens attityder gentemot personer med fetma.   Syfte: att belysa hälso- och sjukvårdspersonals attityder gentemot personer med fetma och den vård som erbjuds den här patientgruppen.   Metod: En systematisk litteraturstudie som i första hand baserades på Kristenssons (2014) metodbeskrivning.   Resultat: Litteraturstudien identifierade två kategorier; attityder till personer med fetma samt attityder gällande vård av personer med fetma. Både positiva och negativa attityder påvisades hos hälso- och sjukvårdspersonal, bland annat beskrevs personer med fetma i negativa ordalag, med ord som lata, själviska och oattraktiva. Även attityder om att personen har låg motivation och viljestyrka syntes. Exempel på positiva attityder som syntes var att empati för personerna med fetma fanns.   Slutsats: För att motverka negativa attityder hos hälso- och sjukvårdspersonal är det viktigt att vara medveten om sina egna och andras attityder, för att kunna reflektera och bearbeta dem. På så vis kan en förändringsprocess ta sin början. De negativa attityderna framstod som barriärer för en effektiv viktnedgång för personen med fetma. / Background: People suffering from obesity are constantly increasing and have globally more than doubled since 1980. Since obesity often leads to comorbidity, this patient group is getting more common in health care settings. This means higher demands on health care professionals´ attitudes towards obese individuals.   Purpose: To enlight health care professionals´ attitudes towards obese individuals and to the care they are offered.   Method: A systematic literature review, that was primarily based on Kristenssons (2014) description of its methodology.   Results: This literature review identified two categories; attitudes towards obese individuals and attitudes concerning obese individuals´ care. Both positive and negative attitudes were found among health care professionals, e.g. obese individuals were described with negative attributes as lazy, selfish and unattractive. Attitudes that the obese individuals had low motivation and low willpower were seen as well. An example of positive attitudes were that empathy for obese individuals occurred.   Conclusion: To encounter negative attitudes among health care professionals, it is important to be aware of  one´s own and others´ attitudes. This enables a process of reflection that might lead to changed attitudes. Negative attitudes workes as barriers for an effective weight loss.

Bakgrund: Dagens forskning visar på att det finns en oengihet om orsaken bakom fibromyalgi. Ålder, etnicitet eller social status spelar ingen roll, alla kan drabbas, dock finns det forskning som visar att kvinnor drabbas oftare än män.. De mest framträdanden symtomen är värk, stelhet och trötthet. Den behandling som erbjuds denna patientgrupp är oftas symtomlindrande behandling. Syfte: Att beskriva upplevelsen av mötet med vården för patienter med fibromyalgi. Metod: Författarna har valt att göra en litteraturöversikt av åtta vetenskapliga artiklar som har fokus på patienters upplevelse av att leva med fibromyalgi och mötet med vården. Författarna valde Joyce Travelbees omvårdnadsteori med fokus på kommunikation och mellanmänskliga relationer. Resultat: Resultatet visar att patienter med fibromyalgi upplever att sjukvårdspersonal ifrågasätter deras trovärdighet och inte tar deras problem på allvar. Vidare visar resultatet att sjukvårdspersonalen kategoriserar dessa patienter efter stereotypa rolluppfattningar och möter dem utifrån deras förförståelse om vad fibromyalgi är eller inte är. Diskussion: Denna studie visar att sjukvårdspersonal utgår från sin egen eller andras objektiva bedömning av patientens situation istället för patientens unika upplevelse i mötet med dessa. Författarna gör då tolkningen utifrån resultatet och utifrån Joyce Travelbees omvårdnadsteori att sjukvården brister i deras förmåga att lära känna och kartlägga patientens behov. / Background: The cause for fibromyalgia is not known. Age, ethnicity and social status doesn´t matter. The most prominent symptoms are pain, stiffness and fatigue. The treatment for fibromyalgia is limited, it is often a combination of pain relief, physical activity and lifestyle changes. Nurses working with fibromyalgia patients have an important role in education and informing patients about their disease. Aim: The aim of this study is to describe patient with fibromyalgia and their experience of the encounter with the health care. Method: A literature review of eight scientific articles, with the focus on patients’ experience of living with fibromyalgia and the encounter with the health care. The authors chose Joyce Travelbees theoretical framework for their literature review. Result: The result shows that patient with fibromyalgia experience that health care professionals question their credibility and that they don’t take their problems seriously. Furthermore the result showed that health care professionals categorized these patients by stereotypical role perceptions, and encounters these patients by their pre-understanding about what fibromyalgia is or is no. Discussion: This study shows that health care professionals meets these patients, based of their own and others objective assessment of the situation, instead of being based on the patient´s unique perception of their situation. The authors make the interpretation based on the result and Travelbees nursing theory that health care professionals lack in their ability to know and to identify the patient´s needs.

Bakgrund: Flyktingar lider ofta i hög utsträckning av ohälsa. Arbetet med denna patientgrupp ställer krav på sjukvårdspersonal, vilka bör besitta en djupare förståelse för de individuella behov som kan förekomma hos flyktingar. Syfte: Syftet med föreliggande arbete var att beskriva personalens erfarenheter av arbetet och mötet med patienterna på en vårdmottagning för flyktingar. Metod: Studien är av deskriptiv kvalitativ design med intervjuer som datainsamlingsmetod. Urvalsgruppen var samtlig verksam sjukvårdspersonal vid utvald vårdmottagning. Data insamlades med hjälp av semistrukturerade intervjuer. Intervjuerna transkriberades och analyserades enligt Graneheim och Lundmans innehållsanalys. Resultat: Personalen upplevde arbetet på vårdmottagningen som tidskrävande och oförutsägbart. Särskild kompetens som personalen gav uttryck för att de själva besatt var bland annat ett intresse för asylfrågor och transkulturella relationer, erfarenhet av att arbeta med flyktingar samt vana av att samarbeta med tolk. Känslomässiga svårigheter i arbetet som identifierades var bland annat att ta del av patienternas traumatiska bakgrund, samt känslan av otillräcklighet då patienterna många gånger var i behov av mer än bara sjukvård. Patienternas behov av stödsamtal var större än resurserna räckte till. En önskan om utökade personaltjänster och lokaler uttrycktes, dock betonades vikten av att verksamheten skulle förbli en samlad enhet. Slutsats: En medvetenhet om hur kulturella kontexter påverkar människor samt en medvetenhet om sin egen förförståelse och eventuella fördomar, visades vara eftersträvansvärt hos sjukvårdspersonal som vårdar flyktingar. Egenskaper som visade sig vara viktiga hos sjukvårdspersonal, som vårdar flyktingar, var att ha ett öppet förhållningssätt, ett holistiskt synsätt på individen samt en övertygelse om människors lika värde. / Background: Refugees often suffer from a high degree of illness. The work of this group of patients requires that health care professionals should possess a deeper understanding of the individual needs that may affect refugees. Objective: The aim of this study was to describe the staff’s experiences of the work and the meeting with patients at a health clinic for refugees. Method: A descriptive qualitative study using interviews as data collection method. The selection group were all the active health care staff who worked at the clinic. Data were collected using semi-structured interviews. The interviews were transcribed and analyzed according to Graneheim and Lundman’s content analysis. Findings: The staff experienced work at the medical clinic as time consuming and unpredictable. Special skills that the staff expressed that they themselves possessed included an interest in asylum issues and transcultural relationships, experience of working with refugees and accustomed to working with an interpreter. Identified emotional difficulties in the care of refugees was to take part of the patients’ traumatic background, and the feeling of inadequacy when the patients often were in need of more than medical care. Patients’ needs for counseling were greater than available resources. A need for increased staff services and working space were expressed, however the importance of the care unit as one single unit was emphasized. Conclusion: Awareness of how cultural contexts influence people and awareness of her own preconceived ideas and possible prejudices, was found to be desirable of clinicians who care for refugees. Characteristics that proved to be important for health care professionals, caring for refugees, was to have an open approach, a holistic approach to the individual and a conviction of human equality.

According to the Crohn’s and Colitis Foundation of Canada, there is approximately 1 in every 200 individuals who is living with inflammatory bowel disease (IBD). Many of those living with IBD also need to have an ostomy. The literature on the effects IBD and an ostomy has on adolescents and young adults lacks consensus. Therefore, the purpose of this phenomenological study was to try to understand the lived experiences of adolescents and young adults (N=6) living with IBD and an ostomy. Sociodemographic information was collected, and the participants were interviewed in person using a semi-structured interview guide. The work of van Manen (1990) was used as a guide for data collection, analysis and interpretation of this study. Analysis revealed the essence of the adolescents’ and young adults’ lived experience as being “Concealing and Revealing the Self”. Three themes communicate the essence of their lived experience: (a) Uneasy feelings, (b) “It’s hard…”, and (c) A renewed sense of self. The needs of the adolescents and young adults, along with their recommendations to health care providers, are addressed. The study findings inform nurses in the areas of practice, education and research. Practice recommendations include being cognizant that these individuals need holistic care that addresses their psychological, psychosocial and physical needs. This study forms the basis for future research to explore some of the themes in greater detail, as well as a recommendation for a longitudinal study.