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Dermatite associada à incontinência em idosos hospitalizadosFerreira, Mariana da Costa. January 2016 (has links)
Orientador: Luciana Patrícia Fernandes Abbade / Coorientador: Silvia Cristina Mangini Bocchi / Banca: Magda Cristina Queiroz Dell / Banca: Heloísa Quatrini Carvalho Passos Guimarães / Resumo: Introdução: A Dermatite Associada à Incontinência (DAI) no idoso apresenta implicações significativas na qualidade de vida e reflete a qualidade da assistência e cuidados ofertados. Sua prevenção e tratamento precoces requerem dos profissionais de enfermagem, intensificação dos cuidados por meio de Sistematização da Assistência de Enfermagem, aliada a protocolos baseados em evidências cientificas, bem como, somar esforços junto aos cuidadores, a fim de que o cuidado contínuo, mesmo após hospitalização, possa ser atingido. Objetivo: Determinar a prevalência e características clínicas da DAI, em idosos hospitalizados e propor um guia para sua prevenção e manejo direcionado aos cuidadores dos idosos. Método: Estudo transversal, exploratório em dois hospitais públicos do interior de São Paulo, com pacientes idosos incontinentes, em enfermarias clínica (41 leitos), cirúrgica (41 leitos) e de longa permanência (25 leitos). Todos os aspectos éticos foram preservados. Os dados foram coletados por meio de um instrumento elaborado para esse fim, composto por dados sociodemográficos, clínicos e referentes a cuidados com a pele e por meio de consulta de prontuário eletrônico e exame físico da região de fraldas. Os dados de prevalência de DAI e suas associações foram obtidos por meio do cálculo da razão, variáveis categóricas e ordinais foram representadas por percentuais e comparadas entre os grupos pelos testes do qui-quadrado, exato de Fisher e qui-quadrado de tendência. A dimensão do ... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Elderlies Incontinence associated dermatitis (IAD) implicates into their quality of lives and reflects the care offered. Its early treatment and prevention require care intensification from nursing professionals through the Systemization of Nursing Care, combined with protocols based on scientific evidences, such as add efforts along with caregivers, so that continuous care can be reached even after the hospitalization. Objective: To determinate the clinical characteristics and prevalence of IAD in elderly hospitalized patients and suggest guide to their prevention in a way it is focused on elderly caregivers. Method: A cross-sectional, exploratory study in two public hospitals from the countryside of Sao Paulo, with elderly incontinent patients, in clinical (41 beds), surgical (41 beds) and long-stay (25 beds) wards. All ethical aspects have been preserved. The data was compiled from an instrument developed for this purpose. It is composed of sociodemographic, clinical and skin care data, electronic medical records, and also physical examination in the diaper region. The most important data from IAD and its associations are resulted through by calculating the ratio, categorical and ordinary variations were represented by percentages and compared between the groups by chi-square, Fisher exact and chi-square test. The effect size was estimated by Odds Ratio and its 95% confidence interval. Data were tabulated and analyzed in the IBM SPSS 22 software. Statistical significance was defined as p values <0.05. RESULTS: A total of 138 participants, mean age of 77.2 years (± 9.3), 75 (54.3%) female, 92 (66.7%) whites and urinary fecal incontinence were included in 69 (50%) participants. The prevalence of IAD was 36.2% (50), 28% (14) of the patients with IAD were associated with pressure injury and 14% (7) presented with candidiasis. There was an association of IAD with contact... (Complete abstract click electronic access below) / Mestre
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Patient satisfaction regarding service delivery at a hospital in BotswanaKhuwa, Zibo Kitso January 2021 (has links)
Thesis (MPH.) -- University of Limpopo, 2021 / Background:Patient satisfaction is an important means of measuring the effectiveness of
health care delivery and medical care. Patient satisfaction provides a picture of the extent to
which the general health care needs of the patient provided by health care professionals are
met to the satisfaction of the patient. Administration of patient satisfaction surveys provide
an opportunity to identify and resolve potential problems before they become serious.
Enhancing quality of service delivery in public health facilities is a prerequisite for the
increased utilisation and sustainability of health care services to the population. The aim of
the study was to investigate the level of patient satisfaction regarding service delivery
provided by the doctors and nurses at a hospital in Botswana.
Purpose:The study’s aim was to investigate the level of patient satisfaction regarding
service delivery at a hospital in Botswana.
Methods:Aquantitative approach using a self-administered structured questionnaire to
collect data regarding patient satisfaction regarding service delivery at hospital was used.A
consecutive sampling technique was used to select patients who fulfilled the study’s
inclusion criteria. A sample size of 360 patients was required for the study, which was
calculated based on the Taro Yamane formula. Data was analysed using SPSS version V.21.0.
Results:The mean age of the outpatients was 38.5(SD ±15.6) years while,for the
inpatients, the mean agewas 33.3(SD±12.4) years. The greater proportion of respondents
in both groups was females. Nearly half (47%) of the outpatients were employed, whereas
more than half (53%) of the inpatients were unemployed. The majority of the participants
had a low level of education. The mean satisfaction level was 58.9 (SD±7.9)for outpatients,
while for in patients, the mean satisfaction level was 70.3 (SD±12.5). A large proportion
(65%) of the outpatients were satisfied compared to the inpatients (54%), however, the
results were not statistically significant (p>0.05). There was no statistically significant
relationship between the age, gender, employment status, level of education of the
outpatients and their level of satisfaction. For inpatient variables, age, gender, and level of
education were not associated with level of satisfaction (p>0.05).
Conclusion: Inconclusion, regardless of the fact that certain aspects of care provided a t this
hospital were unsatisfactory, the results of the present study revealed that, overall,more
than half of the patients were satisfied with the inpatients and outpatient aspects of the
xiv
care they were provided.
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Experiences and practises of professional nurses caring for terminally ill cancer patients in Pietersburg Provincial Hospital, Capricorn District of the Limpopo ProvinceKgosana, Androulla Isabella January 2017 (has links)
Thesis (M. (Nursing)) -- University of Limpopo, 2022 / Caring for terminally ill cancer patients is considered stressful and heartbreaking. Oncology nurses often consider leaving the nursing profession because of the high levels of stress experienced by these health care professionals.
The aim of this study was to investigate the experiences and the practices of nurses who care for terminally ill cancer patients in the Pietersburg Provincial Hospital in the Capricorn District of the Limpopo Province. The objectives of this study were to explore and describe the experiences and practices of nurses who care for terminally ill cancer patients and further to describe the relationship between certain demographic variables and nurses’ experiences of death. An additional objective was to develop recommendations and strategies that might assist management of the Pietersburg Provincial Hospital with the development of appropriate skills and the implementation of emotional support that could assist nurses who care for dying cancer patients in the oncology wards.
The study followed a phenomenological, descriptive, exploratory and contextual research design, which assisted the researcher to describe and explore the experience and practices of nurses caring for terminally ill cancer patients. Semi-structured interview method was used to collect data, making use of an interview guide, was used because it is a more free-flowing approach, with its structure being limited only by focusing on the research. Field notes were captured during the data collection session by the researcher. A voice recorder was used to capture all the interview sessions. The initial data analysis started with the researcher listening to the recordings and transcribing verbatim all statements made by the participants. Tesch’s open coding data analysis method was used by following the proposed eight steps to analyse qualitative data as outlined in Creswell (2013). Ethical standards as set in Babbie (2013) were adhered to by the researcher. The researcher requested permission to conduct the study from the Limpopo Department of Health Ethics Research Committee and informed consent was obtained from the participants before collecting data. Privacy of the participants was ensured as participants were never called by their names. In the study participants shared different views with respect to caring for dying cancer patients. Some participants regarded caring for cancer patients as stressful and heartbreaking. Other oncology nurses blamed the management for not providing them with courses to assist them with caring for dying cancer patient, nor providing debriefing sessions for them. On the other hand, some oncology nurses believed that relocating to other wards was a better solution. The participants suggested the following improvements for caring for dying cancer patients; oncology nurses should be offered short courses to assist them with the challenges that they come across with regard to caring for dying cancer patients. Oncology nurses need support from the management and colleagues in order to cope with the workload. Oncology nurses need psychological assistance to help them with the psychological stressors they experience. Family members and patients need health education on how to deal anticipatory grief. / University of Limpopo
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The effect of pre-operative therapeutic play on post-operative outcomes of Hong Kong Chinese children and their parents having surgery in a day surgery unit. / CUHK electronic theses & dissertations collectionJanuary 2005 (has links)
*This dissertation is a compound document (contains both a paper copy and a CD as part of the dissertation). The CD requires the following system requirements: Windows MediaPlayer or RealPlayer. / Aim. The aim of this study was to examine the effects of preoperative therapeutic play on the immediate preoperative and postoperative outcomes of Hong Kong Chinese children undergoing surgery, and their parents in a day surgery unit. / An intervention study was conducted in the second phase of the study. A randomized controlled trial, two-group pretest and repeated posttest, between subjects design was employed. Hong Kong Chinese children (7-12 years of age; N = 203) admitted for elective surgery in a day surgery unit during a 13-month period, were invited to participate in the study along with their parents. By using a simple complete randomisation method, 97 children with their parents were assigned to the experimental group receiving therapeutic play intervention, and 106 children with their parents were assigned to the control group receiving routine information preparation. / Background. Surgery causes considerable stress and anxiety that can have a profound effect on both children and their parents. Therefore, they need to be well prepared before surgery to minimize their anxiety, enhance their feeling of control, and promote positive post-operative outcomes. With the increasing number and complexity of paediatric surgery being performed in day surgery units, there is a compelling need for nurses to develop and evaluate appropriate interventions tailored to the needs of children and parents so as to enhance their ability to cope with surgery. / Conclusion. The first phase of this study confirmed the psychometric properties of the Chinese version of the State and Trait Anxiety Scales for Children, and the Children's Emotional Manifestation Scale. The results also support the appropriateness of these instruments as clinical research tools in evaluating the effectiveness of preoperative nursing interventions. / Methods. The study was conducted in two phases. The first phase consisted of developing and testing the psychometric properties of three instruments that were used in the second phase of the study. These instruments included the Chinese version of the State Anxiety Scale for Children, the Chinese version of the Trait Anxiety Scale for Children, and the Children's Emotional Manifestation Scale. / Results. The results showed that both children and parents in the experimental group reported statistically significant lower state anxiety scores than the control group in both pre- and post-operative periods. Children in the experimental group also exhibited statistically significant fewer instances of negative emotional behaviours, displayed lower heart rates and mean arterial blood pressures. Additionally, parents in the experimental group reported significantly higher level of satisfaction with the preoperative nursing preparation given. The results, however, did not find statistically significant differences in children's postoperative pain scores and post-hospital adjustment between the two groups. / Significance of the study. It is anticipated that this study could increase nurses' understanding of the emotional responses of children undergoing surgery and enrich their experience in using child-sensitive research tools in evaluating the effectiveness of preoperative nursing interventions. Most importantly, this research provides empirical evidence of the benefits of incorporating therapeutic play in the preoperative preparation of children and parents thus charting a path towards promoting holistic and quality care.* / The second phase of this study had addressed a gap in the literature by empirically testing the effectiveness of the therapeutic play intervention in preparing children for surgery, and their parents, which had been under-researched. It also provides empirical evidence that therapeutic play, using preoperative tour visit to the operating theatre, doll demonstration and return demonstration on the procedure of anaesthesia, is more effective in improving immediately pre- and post-operative outcomes of children and their parents than information-based preparation alone. / Therapeutic play has been used as a psychological preparation for helping children cope with the stress of hospitalisation. However, the majority of previous studies into the effect of therapeutic play were based only on theories and clinical observations. The lack of empirical evidence makes it difficult to determine precisely the effectiveness of therapeutic play. Therefore, there is vital need for more rigorous empirical scrutiny. / Li Ho Cheung William. / "July 2005." / Advisers: Violeta Lopez; Chung Kwong Yeung. / Includes supplementary digital materials. / Source: Dissertation Abstracts International, Volume: 67-11, Section: B, page: 6309. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2005. / Includes bibliographical references (p. 335-354). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts in English and Chinese. / School code: 1307.
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Contribution à la réduction de la mortalité intrahospitalière des enfants en Afrique centrale, Nord Kivu - RD CongoBitwe Mihanda, Richard 26 March 2009 (has links)
Introduction<p>Dans le monde, presque 10,6 millions d’enfants meurent chaque année avant d’avoir atteint leur cinquième anniversaire. En dépit de l’existence théorique d’interventions curatives efficaces, on constate que la mortalité intrahospitalière peut demeurer très élevée dans les services de pédiatrie de nombreux pays à faible revenu notamment en Afrique. Pour améliorer la prise en charge des enfants dans ces hôpitaux et par conséquent la survie des enfants, il est nécessaire avant tout de faire le constat de la situation et de la reconnaître, d’en analyser les causes, de s’attaquer aux déterminants vulnérables et de se doter d’outils d’évaluation de la qualité de soins dans les hôpitaux. En tant que pédiatre oeuvrant à l’HPG, j’ai constaté que la mortalité intrahospitalière était élevée. Fruit d’une démarche personnelle, ce travail avait pour objectif global la réduction de cette mortalité.<p>Pour y arriver, les objectifs spécifiques étaient les suivants :<p>1) Décrire et évaluer la qualité des soins intrahospitaliers chez les enfants à l’HPG.<p>2)Préciser la mortalité intrahospitalière globale ainsi que les mortalités spécifiques.<p>3)Etudier l’importance des facteurs associés à la surmortalité des enfants à l’Hôpital Provincial de Goma.<p>4)Construire un modèle de prédiction de la mortalité globale intrahospitalière ainsi qu’un score pronostique adapté au contexte.<p>5)Mettre en place un programme de formation et de supervision du personnel médical et paramédical.<p>6)Etudier l’impact de ce programme sur la mortalité intrahospitalière. <p><p>Méthodologie<p>Les analyses ont porté sur les données des études qui se sont déroulés dans le service de pédiatrie de l’hôpital provincial de Goma (HPG), il s’agit des études suivantes: une étude descriptive d’observation d’évaluation de la qualité des soins intrahospitaliers des enfants en décembre 2004 (étude qualitative utilisant la méthode de Nolan), une étude de cohorte prospective intrahospitalière portant sur les indicateurs prédictifs de la mortalité (du 1er avril 2003 au 31 mars 2004) (« avant ») ,suivi d’une intervention dont l’impact avait été évalué de nouveau par une étude de cohorte prospective intrahospitalière (du 1er janvier 2005 au 31 décembre 2005) (« après ») (étude d’intervention quasi-expérimentale). <p><p>Résultats<p>Les résultats du travail étaient les suivants :<p>A) -Les facteurs qui augmentent le risque de décès étaient la référence tardive et la sévérité de la maladie à l’admission. <p>-Les facteurs limitant la qualité de la prise en charge et qui contribuaient probablement au mauvais pronostic étaient :<p>1)A l’admission, le triage n’était pas toujours correctement fait, les soins d’urgences étaient retardés l’après-midi et la nuit et 12% des admissions étaient différés. Il n’y avait pas de grille d’évaluation initiale, ni des guides pratiques de l’OMS, ni les guides standardisés de prise en charge, ni de kit d’urgence.<p>2)En hospitalisation, il y avait une insuffisance en nombre du staff (surtout l’après-midi et la nuit), le monitoring de base et les soins infirmiers étaient insuffisants surtout la nuit, les cliniciens notaient les signes cliniques, mais ne les documentaient pas toujours, le délai pour avoir le diagnostic était trop long et l’indisponibilité des médicaments prescrits.<p>-Le staff du service avait des connaissances théoriques et pratiques insuffisantes et une motivation insuffisante<p>B)-Durant la première étude de cohorte, une mortalité globale de 15,9% et des mortalités spécifiques anormalement élevées ont été observés. Les enfants les plus à risque de décès avaient, à l’admission, les caractéristiques suivantes :un âge < 1 an, un périmètre brachial < 115 mm ou un retard de croissance pondérale (-3< Z-PPA ≤ -2 et Z-PPA ≤ -3), une altération de la conscience, une raideur de la nuque, un tirage intercostal et une infection.<p>C)-Ces premières données avaient permis de construire le modèle Goma1 basé essentiellement sur les indicateurs suivants :l’âge,le périmètre brachial, l’état de conscience et le type d’infection. Grâce au score pronostique, il était destiné à la sélection à l’admission des enfants à risque élevé de décès pour une admission en soins intensifs et à la standardisation de la mortalité en vue de l’évaluation de la qualité de prise en charge. <p>D)-Une intervention a été menée, en décembre 2004 portant essentiellement sur la formation et la supervision du personnel de santé œuvrant à l’HPG. Grâce à une évaluation avant-après, on a pu déterminer l’impact probable de cette intervention :la mortalité globale a diminué de 15,9% (avant l’intervention) à 4,6% (après l’intervention) et restait toujours plus basse après l’intervention et après ajustement à l’aide du modèle. <p><p>Conclusions<p>La mortalité pédiatrique intrahospitalière est généralement beaucoup trop élevée et c’était le cas à l’HPG.<p>Notre démarche après ce constat et l’évaluation de la qualité des soins donnés aux enfants sur base d’un questionnaire qualitatif a été d’intervenir sur un des points mis en exergue par cette évaluation (formation et supervision du personnel insuffisante) et d’évaluer l’impact de ce programme sur la mortalité globale.<p>Les résultats ont suggéré un impact positif de ce programme (mortalité globale de 15,9% avant l’intervention et de 4,6% après l’intervention).<p>Si de nombreuses critiques liées à la méthodologie (évaluation uniquement qualitative, étude quasi-expérimentale avant-après, intervention limitée, etc) doivent être épinglées et limitent la portée de ce travail, la démarche entreprise a cependant permis de mobiliser le personnel de santé œuvrant dans des conditions difficiles, autour d’un projet commun et améliorer ainsi la prise en charge des enfants hospitalisés à l’HPG. / Doctorat en Sciences médicales / info:eu-repo/semantics/nonPublished
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The need for social work intervention for the elderly patients and their family membersAbo, Yasuyo 01 January 2005 (has links)
Contends that poor discharge planning for elderly patients in American hospitals is the result of reduced lengths of stay which do not give medical social workers adequate time to assess patients' needs. A survey methodology was used to assess social service and community resource needs of hospitalized elderly patients and their family members at Riverside Community Hospital in California. Argues that the results of the survey can be used to improve discharge planning and lead to a more client-centered practice in hospitals.
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Ontwerp van 'n ouerleidingsprogram vir moeders in 'n kangaroemoedersorg-program : 'n opvoedkundig sielkundige benaderingSnyman, Amelia 06 1900 (has links)
Die doel van hierdie studie is die ontwikkeling van 'n ouerleidingsprogram vir
moeders wat hul premature babas in 'n kangaroemoedersorgprogram versorg. Die
program het ten doel om die moeders in die onmiddelikke versorging, sowel as die
toekomstige begeleiding van hut kinders, toe te rus. 'n Literatuuroorsig word gegee
van prematuriteit as fenomeen en van kangaroemoedersorg (KMS) as
versorgingswyse, met spesifieke verwysing na die toepassing daarvan in Kalafonghospitaal.
Die grondslae van ouerteiding word uit die literatuur opgesom en riglyne
word ook gestef vir die samestelling van 'n ouerfeidingprogram. Die kwalitatiewe
navorsingsmetode word gebruik om die inhoud van die ouerfeidingsprogram te
bepaal en om ondersoek in te stel na die mees geskikte aanbiedingswyses. Die
verslag word afgesluit met riglyne vir die samestelling van 'n prakties-toepasbare
ouerleidingsprogram waarin inhoudsmoontlikhede, idees vir aanbieding en wyses vir
die bepaling van gestelde uitkomste uiteengesit word. / The aim of this study is the development of parental guidance for mothers who take care of
their premature babies in a programme of Kangaroo Mother Care. The programme aims to
equip mothers for immediate and future care of their children. A literature review of
prematurity as phenomenon and of kangaroo mother care as care method is presented with
specifK: reference to the way it is applied in Kalafong-hospital. The basics of parental care
are summated from literature and guidelines are set to design a parental guidance
programme. The qualitative research method is put into operation to determine the content
of the parental guidance programme and to investigate the most appropriate method of
presentation. The report is concluded with guidelines for setting up a practical and
applicable parental guidance programme in which subject possibilities, ideas for presentation
and means for determining set outcomes are explained. / Educational Studies / M.Ed.(Spesialisering in voorligting)
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A fully human spirituality : a gendered response to the HIV/AIDS pandemic for the South African churchSnyman, Desiree 30 November 2006 (has links)
The HIV/AIDS pandemic is a crisis for the South African government, society and Church. About sixty percent of the HIV population are in Sub Saharan Africa with women being three times more likely to be infected with HIV than their male counterparts. Governmental, societal and Church responses seem to have had little effect in reducing the pandemic as can be seen from the rising prevalence rates. Responses to the HIV/AIDS pandemic lack a gender focus. Some churches have not responded to the HIV/AIDS pandemic. Other Church-based responses have been isolated and simplistic in that they have concentrated on one aspect of the HIV illness. The HIV/AIDS pandemic is a growing crisis to which the Church should respond.
The hermeneutical point of departure in this thesis is to express a preferential option for the poor by standing in solidarity with a group of women living on the margins of society. To this end the perspectives of black people, who are materially poor, HIV positive and part of support groups are articulated in the study. The research project suggests that the preferential option for the poor has the potential to contribute to the personal and social transformation of society.
Focussing on the deep-seated longing many desire for fullness of life, this thesis explores and describes a gendered Christian response to the HIV/AIDS pandemic that could contribute to the full humanity of people. Full humanity is understood as transformation to wholeness and incorporates unity with God, others, creation and within oneself. A multifaceted, integrated and gendered response to the HIV/AIDS pandemic is suggested by way of a model of full humanity.
The South African context of HIV/AIDS, patriarchy and poverty pose a challenge to the way that Christians develop their spirituality. This thesis aims to explore and describe aspects of a fully human spirituality emerging from the South African situation. The study suggests that a clearly integrative and holistic approach that embodies the gender perspective is necessary for churches to adopt in responding to the HIV/AIDS pandemic. / Christian Spirituality, Church History and Missiology / D.Th.(Christian Spirituality)
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Clients' perspectives of quality emergency obstetric care in public health facilities in EthiopiaAnteneh Zewdie Helelo 11 1900 (has links)
The contribution of Emergency Obstetric Care (EmOC) in reducing maternal mortality in Ethiopia is very minimal as evidenced by poor provision and low utilization of EmOC. Client centred EmOC provision improves the provision and utilization of EmOC; leading to the treatment of the majority of obstetric complications which are the main causes of maternal mortality. This study describes clients’ views and perspectives concerning the quality of EmOC provision in Ethiopian public health facilities. An explorative and descriptive phenomenological qualitative study design was used in the study in order to explore and describe the lived experiences of clients with EmOC services. Key informant interviews with women who had direct obstetric complications and received EmOC at three public health facilities in Addis Ababa generated rich data on their lived experiences. Content analysis was used to analyze the data as it complies with the phenomenological data analysis and Atlas ti version 6.2 qualitative data analysis software was employed. The findings revealed that quality EmOC is a welcoming, life-saving timely care given in a clean environment with humility, respect, equal treatment and encouragement. It is care that is safe for the client, technically sound, responsive and meets clients’ needs and expectations. Accessibility of life saving care at all time and collaborative and coordinated care created good experiences for the clients. The causes of clients’ disappointment with the provision of EmOC were higher expectations from female providers, underestimation by providers, non responsive providers, and ethical misconduct by providers such as mocking, insulting, yelling, advantage taking providers, undelivered promises by providers, expectation with place of delivery, expectation with newborn care and a limited number of health workers attending delivery. Discrimination, high cost of care and asking client to buy drugs and supplies and referrals from centres, are some of the barriers on r the use of EmOC at public health facilities. The provision of EmOC is constrained by overloaded staffs, shortage of space to accommodate clients and inadequate number of beds. In conclusion, clients have expectations and experiences of provision of EmOC that influence their future decision to seek care. Finally, a client centred guideline for the provision of client centred EmOC provision was developed. / Health Studies / D. Litt. et Phil. (Health Studies)
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"Acts of disclosing" : an enthnographic investigation of HIV/AIDS disclosure grounded in the experiences of those living with HIV/AIDS accessing Paarl Hospice House seeking treatmentLe Roux, Rhonddie 10 1900 (has links)
Thesis (MPhil)--University of Stellenbosch, 2005. / ENGLISH ABSTRACT: Paarl, in the Western Cape, has been identified as one of the 15 national sites where
antiretroviral treatment (ARVs) would be made available to people living with
HIV/AIDS. Paarl Hospice initiated a support group for people to deal with this
disease in 2003.
Since February 2004 Paarl Hospice has been recruiting people from the surrounding
informal settlements for ARVs. By means of participant observation I explored how
HIV/AIDS-related disclosure experiences unfolded in places, spaces and events
associated with the support group in the context of factors enabling and preventing
people from accessing Hospice House. I did this by considering the insights drawn
from an anthropological approach. I found the meanings of disclosure in the majority
of studies to be limited and restricted. Available studies approached disclosure in a
top-down fashion by regarding the definition of disclosure as the announcement of
HIV-positivity at the time of diagnosis only. These studies have not considered social
differences relating to disclosure neither did they focus on the actual process of
disclosure.
By means of a constructivist approach to grounded theory I seek to broaden the
definition of disclosure to account for the range of ways in which disclosure practices
take place. I found that disclosure could not be separated from the situational context
in which it occurs and that it can only be understood in relation to the circumstances
and relationships in which it takes place. In this study, disclosure was an ongoing
process, situated somewhere between active, public announcement of an HIV-status
and complete secrecy and somewhere between voluntary and involuntary revealing of
the disease. / AFRIKAANSE OPSOMMING: Paarl in die Wes-Kaap is geïdentifiseer as een van die 15 nasionale areas waar
antiretrovirale medikasie beskikbaar gestel sou word aan mense wat leef met
MIV/VIGS. Paarl Hospice het gedurende 2003 ʼn ondersteuningsgroep geїnisieer om
aan MIV/VIGS aandag te gee.
Sedert Februarie 2004 is Paarl Hospice in die proses om mense te werf uit die
omliggende informele behuisingsgebiede vir antiretrovirale behandeling. Met behulp
van antropologiese insigte en deelnemende waarneming kon ek nagaan hoe
verskillende maniere van MIV/VIGS-verwante bekendmaking ontvou in plekke,
ruimtes en gebeurtenisse wat verband hou met die ondersteuningsgroep. MIV/VIGSverwante
bekendmaking is ondersoek te midde van inhiberende en fasiliterende
faktore wat mense verhoed of aanhelp om Paarl Hospice te besoek. Ek het bevind dat
die definisie van bekendmaking in die meeste navorsing gebrekkig is. Beskikbare
navorsing het bekendmaking volgens ‘n bo-na-onder-wyse benader as die openbare
bekendmaking van ‘n MIV-status na afloop van diagnose alleenlik. Met behulp van
‘n konstruktiewe benadering van die begronde teorie het ek gepoog om die definisie
van bekendmaking uit te bou om sodoende die verskeidenheid maniere waarop
bekendmaking plaasvind te akkommodeer. Ek het vasgestel dat bekendmaking
onlosmaakbaar deel is van die situasionele konteks waarin dit plaasvind en dat dit
slegs begryp kan word in verband tot die verhoudings en omstandighede waarin dit
plaasvind. In hierdie studie was bekendmaking ʼn voortdurende proses, gesitueer
tussen aktiewe openbare bekendmaking en volledige geheimhouding van ʼn MIVstatus,
asook tussen volkome vrywillige en onvrywillige bekendmaking van ʼn MIVstatus.
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