De longue date, l’hôpital public a voulu faire fonctionner un service public autonome avec ses propres moyens et ses personnels.Cependant, il s’est trouvé dans l’obligation d’ouvrir ses portes à des opérateurs privés (l’intervention des médecins libéraux l’illustre) pour répondre à ses besoins de fonctionnement et d’organisation, dont les voies ont été ouvertes par la dernière loi hospitalière. Ainsi, la loi HPST a créé des dispositifs contractuels via notamment le « contrat d’exercice libéral » et le contrat de « clinicien hospitalier » pour que l’hôpital public propose des conditions statutaires plus attractives à l’attention de ces nouveaux opérateurs.Ce besoin nouveau qui s’impose, sans être véritablement souhaité, entraîne le recours à des solutions juridiques trop diversifiées.De ce fait, une cohabitation et un foisonnement de statuts s’est créé au sein de l’hôpital public. Cette situation apporte une vraie contradiction de règles statutaires, un véritable fatras qui met à mal sa cohérence.Un rapprochement des statuts des praticiens hospitaliers et des praticiens libéraux paraît inévitable pour clarifier et donner une lisibilité à l’hôpital public avec le souci unique d’apporter des soins de qualité aux usagers du service public. / The public hospital has long been willing to operate an independent public service with its own means and own staff.However, it was forced to open its doors to some private operators (the intervention of private doctors illustrates it) to satisfy its needs for operating and organization, the path of which has been opened by the last Hopsital Act. Thus, the HPST Law has created some contractual arrangements mainly with the “private practice contract”and the contract of “hospital clinical practitioner” in order that the public hospital offers more attractive statutory conditions to these new operators.This new major need, not being really desired, requires legal solutions which are too diverse.Consecuently, a coexistence and a lot of statuses have emerged within the public hospital. This situation causes a real contradiction of the statutory rules, a real hackneyed nonsense which undermines its consistency.An harmonization of the hospital and private practitioners statuses seems to be inevitable in order to clarify and make the public hospital more transparent with the sole concern to improve the quality of the health care provided to the public service users.

Orientador: Carmen Maria Bueno Neme / Resumo: A Psicologia está cada vez mais presente no contexto da saúde e a inserção do psicólogo em instituições hospitalares vêm crescendo nos últimos anos, em diferentes clínicas e especialidades médicas, demandando aperfeiçoamento e solidificação da prática deste profissional junto às equipes de saúde. Neste estudo, de caráter qualitativo, entrevistou-se 10 profissionais de saúde, sendo dois médicos; duas enfermeiras; duas fisioterapeutas; uma fonoaudióloga; uma nutricionista; uma assistente social e uma terapeuta ocupacional, pertencentes a equipes interdisciplinares de um hospital geral público, referência em urgências e emergências em trauma, neurologia e neurocirurgia, localizado na região centro-oeste do estado de São Paulo. Visou compreender como os profissionais identificam e concebem as diferentes possibilidades de atuação do psicólogo no hospital. As entrevistas semiestruturadas individuais foram gravadas em áudio e analisadas por meio da técnica da análise de conteúdo. Identificou-se 10 categorias que indicam a visão que os profissionais da equipe interdisciplinar possuem acerca do trabalho do psicólogo hospitalar e 2 categorias referentes à formação dos profissionais de saúde, revelando que os entrevistados reconhecem e valorizam o trabalho do psicólogo no hospital junto a pacientes, familiares e à própria equipe. Cada profissional identifica a necessidade de interconsultas e da intervenção psicológica, com base em sua própria prática profissional e experiências pessoais... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Psychology is increasingly present in the health context and the insertion of the psychologist in hospital institutions has been growing in recent years, in different clinics and medical specialties, demanding improvement and solidification of the practice of this professional with the health teams. In this qualitative study, 10 health professionals were interviewed: two physicians, two nurses, two physiotherapists, a speech therapist, a nutritionist, a social worker and an occupational therapist, belonging to interdisciplinary teams of a public general hospital, reference in emergencies and emergencies in trauma, neurology and neurosurgery, located in the Midwest region of the state of São Paulo. It aimed to understand how the professionals identify and conceive the different acting possibilities of the psychologist in the hospital. Individual semi-structured interviews were audio recorded and analyzed using the content analysis technique. We identified 10 categories that indicate the view that professionals of the interdisciplinary team have about the work of the hospital psychologist and two categories referring to the training of health professionals, revealing that respondents recognize and value the work of the psychologist in the hospital with patients, family members and the team itself. Each professional identifies the need for interconsultation and psychological intervention, based on his or her own professional practice and personal experiences, resulting in genera... (Complete abstract click electronic access below) / Mestre

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Thesis (M.A. (Nursing Science)) -- University of Limpopo, 2016 / The purpose of the study was to develop a protocol to enhance patient satisfaction with regard to nursing care at Health Centres and to determine factors leading to patient dissatisfaction. A quantitative, descriptive and cross-sectional research design was used for this study. The population of the study for the two Health Centres was: Agincourt Health Centre= 5697 while Thulamahashe Health Centres= 5696. Systemic random sampling method was used to select 400 respondents from each Health Centre. Data were collected through self-developed questionnaire. The questionnaire was pre-tested at Cunningmoore clinic. Reliability was ensured through conducting of a pre-test. Validity was ensured through undertaking extensive literature review. The questionnaire was also given to the supervisor for content validity. Data analysis was done through descriptive and inferential statistics using SPSS version 22 programme of data analysis. The findings indicated that factors leading to patient dissatisfaction with regard to nursing are: long waiting time, poor communication and information between nurses and patients, shortage of nurses, poor service and environmental condition and shortage of treatment (medication). The study recommends that waiting time should be reduced to less than 3 hours, shortage of nurses should be addressed, workshops and inservice training should be implemented and treatment should be monitored.

La presente investigación es de naturaleza cualitativa, con abordaje de estudio de caso, cuyo objetivo fue identificar y analizar los conflictos éticos que afrontan los internos de enfermería en un hospital del distrito de Chiclayo, 2014. Los sujetos de estudios fueron 8 internas de enfermería, según criterio de inclusión: se consideraron internos hombres o mujeres, que cursen el internado desde el primer mes, después de haber ingresado al hospital, determinados por técnica de saturación y redundancia. Para la recolección de datos se utilizó la entrevista semiestructurada a profundidad. Los datos obtenidos fueron por análisis de contenido. Se tuvo en cuenta los criterios bioéticos según Sgreccia y los criterios de rigor científico planteados por Hernández. Los resultados emergentes fueron categorías y subcategorías:1) Conflictividad ética: Poder vs Autoridad frente a la vulnerabilidad de la Interna de enfermería: Sumisiones de la interna ante carácter autoritarismo de la enfermera, Comunicación ineficaz entre interna y enfermera, Rutina laboral frente a la formación profesional y exigencias de la universidad, Improcedente utilización de materiales y medicamentos. 2) Internas de enfermería con autonomía profesional limitada para enfrentar conflictos éticos. 3) Solicitando prácticas innovadoras durante el internado de Enfermería. Como consideración final los conflictos éticos que afrontan los internos de enfermería, emergen por escasa comunicación, rutina laboral y el carácter de las enfermeras asistenciales.

Published Article / The aim of this research was to identify the design aspects necessary to create an aesthetically appealing playroom environment to aid the well-being of hospitalised oncology children at a public hospital in Bloemfontein, South Africa. The methodology design is overall qualitative within the interpretivist paradigm with a triangulation methodology design with explanatory components. These components consisted of a literature review which was further explored by means of a qualitative questionnaire. The playroom was created as part of a community project according to the literature review and questionnaire after which semi-structured individual interviews were conducted with the children themselves.

This thesis explores the collaborative practice between psychiatrists and chaplains within three mental healthcare facilities in south central Ontario, Canada. From an overview of the current literature, there has been a renewed interest by psychiatrists in the healing qualities of religion and spirituality. However, the literature also reveals that psychiatrists have a tendency not to be interested in spiritual matters. So, despite the renewed interest in the effects of spirituality on persons with mental illness and the positive outcomes that the research reveals, many psychiatrists remain unconvinced about the use of spirituality in their practice. In the light of this, I undertook this research into the lived experiences of twelve psychiatrists and ten chaplains within three mental healthcare facilities within south central Ontario. From an overview of the literature, I noted the lack of engagement by chaplains in performing research and the lack of a theological focus on the collaborative practice between these two disciplines. This study is located within the discipline of practical theology using a transversal model of praxis. Through the use of hermeneutic phenomenology as both methodology and method within a qualitative framework, I engaged some of the fundamentals of the concepts within the work of the philosopher Hans Georg Gadamer,1 in order to gain access into the collaborative practices between psychiatrists and chaplains. Using the transversal model of cross-disciplinary dialogue, I come to an understanding of the array of collaborative or non-collaborative practices between psychiatrists and chaplains. I then come to the understanding that in many instances, it is up to the chaplain to lead the way in collaborative practice. Drawing on the Christian notion of hospitality, the persuasive communication techniques used by Jesus and current organization theories within healthcare, I bring about a more robust collaborative practice with psychiatrists.

Actualmente los servicios de emergencia de los diferentes hospitales del Perú, se ven muy congestionados por pacientes, quienes presentan innumerables problemas de salud lo que en muchas circunstancias hace que peligre su vida. Debido a la inestabilidad hemodinámica de las personas afectadas, la enfermera centra su atención en el cuidado, pasando a un segundo plano la familia; originándoles una percepción de amenaza y experimentando una gran incertidumbre. Ante esta preocupación las investigadoras se formularon ¿Cuáles son los niveles de incertidumbre en el familiar frente a la enfermedad en la Unidad de Shock Trauma del Hospital Nacional Almanzor Aguinaga Asenjo?, para lo cual se tuvo como objetivo determinar el nivel de incertidumbre en el familiar; con el fin de contribuir a la reflexión profesional de las enfermeras, comprender las diferentes situaciones que el familiar enfrenta y el grado de incertidumbre que afrontan durante este periodo. Esta investigación utilizó el enfoque cuantitativo, descriptivo y de corte transversal. Se tuvo una población de 634 y una muestra de 239 personas. En la investigación se utilizó como instrumento de recolección de datos una encuesta que toma como referencia la Escala de Incertidumbre de Mishel, y se utilizó la técnica de muestreo no probabilístico consecutivo. Se obtuvieron como resultados que el 68% tenía un nivel regular de incertidumbre, el 26% de población tenía un nivel bajo de incertidumbre, y el 6% un nivel alto de incertidumbre.

This thesis reports on a study which investigated the impact of the decisionmaking process under the remit of the Education Act 1996 s. 19, on local education authority (LEA) arrangements for educating children out of school by reason of illness in order to contribute to policy development in the area of parental involvement. A multiple site case study of the administration of exceptional provision in English LEAs was conducted. Fifteen contrasting LEAs were contacted. Seven LEAs volunteered (two shire counties; one metropolitan district; one unitary and three London). Twenty one LEA professionals who were responsible for hospital and home tuition services, and 35 parents of 35 children (24 children residing in case study LEAs; 11 children residing in non case study LEAs) volunteered to participate in the study. In-depth qualitative data were collected between March 1998 and March 1999 by means of semi-structured interviews and document collation. Overall, the dataf rom parentss uggestedth at diversity existedi n the type and quality of provision, but less diversity existed in the quantity of provision that pupils received.C onsistencye xistedi n the pragmaticn ature of factors related to the outcomes described by parents, and the data from LEA documentsa ndp rofessionals'p erceptionsE. nabling legislation and inconsistentl evels of accountabilitya llowed LEA professionalss ubstantial discretion in decisions about the type of provision that pupils received and the quality of the arrangementsT. he diversity of family provision contributed to the diversity of the outcomes for pupils also. The dataf rom LEA professionalss uggestedth at the main effectso f professionald ecision-makingin the administrationo f provision were rationing and displacement of responsibility to the school and parents. Given the pragmatic nature of factors responsible for the diversity in the type and quality of LEA provision that pupils received, together with evidenceo f rationing the quantity of resourcesa llocated,t he study concluded that the determining factor influencing professional decisionmaking was inadequater esourcesto fund LEA provision. The dataf rom LEA documents,p rofessionalsa ndp arentss uggestedth at the main effects of the informal involvement of parents in professional decision making was parental influence on the type and quality of provision, but not the quantity of LEA provision. Given the limiting factor of inadequate resources and the lack of influence of parents on the quantity of LEA resources allocated, it was likely that financial pressure within the LEA caused the displacement of responsibility for provision to schools. The discourse of participants suggested that professionals were in control of the decision-making process and parents accepted responsibility to liaise between stakeholders. The diversity of parents' needs was related to the effectiveness of the parent to influence decisions or situations that impinged on the type of provision and quality of the arrangements that pupils received. The implicationso f the findings for decision-makersa nd possiblea reasf or policy development are discussed.

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