The purpose of this study was to investigate the impact of three factors, the expectation of events, situational control and situational anxiety, on the coping effort of parents of acutely ill hospitalized children. A secondary purpose was to determine the influence of the parents' locus of control orientation on the parents' coping effort. Coping effort was defined as the amount of behavior, both action oriented and intrapsychic, employed by parents to master, tolerate, reduce or minimize stressful events encountered during their child's hospitalization. The study utilized a mathematical correlational design with a causal modeling approach to assess a four-stage theory. The convenience sample selected for the study was 45 Anglo mothers of acutely ill hospitalized children between the ages of one and 24 months. A four-scale instrument based on magnitude estimation measurement strategy was constructed to index the theoretical concepts. Reliability, validity and cross modality matching were conducted to estimate the psychometric properties of the instrument. The theory was estimated using correlational and multiple regression statistical techniques. Residual analysis was conducted to estimate violations of the causal model and statistical assumptions. Expectation of events showed a direct effect on situational anxiety (R² = .35) and thus, an indirect impact on parental coping effort. Situational anxiety had a strong, direct, positive influence on coping effort (R² = .97). Situational control did not significantly influence the parents' coping effort directly nor indirectly and was not influenced by the expectation of events. The impact of the parents' locus of control orientation on their coping effort could not be determined since the locus of control index was found to be psychometrically inadequate for this sample. Parents who knew what events to expect experienced less anxiety and, as a result, expended less effort to cope with the stresses of their child's hospital experience. By knowing what factors influence the parents' coping effort, the pediatric nurse is able to manipulate the parents' hospital experience to provide as therapeutic an environment for the child and the parents as possible.

Thesis (M.S.)--University of Michigan, 1989.

Thesis (M.S.)--University of Michigan, 1989.

No description available.

<p><strong>Background:</strong> Coronary heart disease kills more than 7 million people worldwide each year. High levels of blood fat, cholesterol, contributes significantly to coronary heart disease. Lifestyle changes combined with lipid-lowering drugs, statins, is an effective treatment. But adherence to statins is low, not even a myocardial infarction always contributes to adherence. Adherence requires patient education and good communication between patient and physician. There is no deeper knowledge of why coronary heart patients stops with statin treatment. <strong>Objective:</strong> To describe how coronary heart patients experience the disease and the statin treatment, and furthermore, opportunities and difficulties to adhere with statin therapy. <strong>Design:</strong> An exploratory qualitative study. <strong>Method:</strong> 10 male coronary heart patients, 55-78 years were strategically selected from a cardiology clinic in a larger Swedish hospital. Patients were interviewed individually in a semi-structured form, 2009/2010. Data processing was done according to content analysis and yielded four themes: <em>empowerment, effects, decision basis, </em>and<em> trust.</em> <strong>Results:</strong> The patients did not mentioned heredity among the factors they could not affect in association with the disease. Several patients saw the medication as a limitation, doubted its efficacy, but mostly took it anyway, at least for a limited time. Medication and illness were associated with each other. Information requirements were in most patients. Many patients wanted to discontinue the statin therapy. <strong>Conclusion:</strong> Retention of power over the own body, good reference base for decision about adherence, and trust in health care. These are crucial components of patients’ adherence to statin therapy, in connection with coronary heart disease.</p> / <p><strong>Bakgrund:</strong><strong> Kranskärlssjukdom dödar drygt 7 miljoner människor i världen per år.</strong></p><p><strong>För höga halter av blodfettet kolesterol i blodet bidrar kraftigt till kranskärlssjukdom.</strong> <strong>Livsstilsförändringar kombinerat med blodfettssänkande läkemedel, statiner, är en effektiv behandling. Följsamheten till statiner är dock låg, inte ens genomgången hjärtinfarkt ökar följsamhet. Följsamhet kräver patientutbildning och god kommunikation mellan patient och läkare. Det saknas djupare kunskap om varför kranskärlspatienter slutar med statiner. Syfte: </strong><strong>att </strong><strong>beskriva hur kranskärlspatienter upplever sjukdomen och statinbehandlingen, samt möjligheter och svårigheter att följa statinbehandlingen. Design: </strong><strong>explorativ kvalitativ studie. Metod: </strong><strong>10 manliga kranskärlspatienter, 55-78 år valdes strategiskt via en kardiologklinik på ett större svenskt sjukhus. Patienterna intervjuades personligen i semistrukturerad form, 2009/2010. Databearbetning skedde enligt innehållsanalys och gav fyra teman:</strong><em> egenmakt, effekter</em><strong>, </strong><em>beslutsgrund, tilltro. </em><strong>Resultat:</strong><strong> Patienterna nämnde inte ärftlighet bland faktorer som ansågs opåverkbara i samband med kranskärlssjukdomen.</strong> Flera patienter såg medicinen som en begränsning och tvivlade på effekten, men tog den oftast ändå, åtminstone under en begränsad tid. Likhetstecken sattes mellan medicinering och sjukdom. Informationsbehov fanns hos flertalet patienter. Många patienter ville sluta med statinbehandlingen. <strong>Slutsats: </strong>Bibehållen makt över sin egen kropp, god referensgrund för beslut om följsamhet samt förtroende för sjukvården, är avgörande förutsättningar för kranskärlspatienters följsamhet till statinbehandling.<strong></strong></p>

Background: Coronary heart disease kills more than 7 million people worldwide each year. High levels of blood fat, cholesterol, contributes significantly to coronary heart disease. Lifestyle changes combined with lipid-lowering drugs, statins, is an effective treatment. But adherence to statins is low, not even a myocardial infarction always contributes to adherence. Adherence requires patient education and good communication between patient and physician. There is no deeper knowledge of why coronary heart patients stops with statin treatment. Objective: To describe how coronary heart patients experience the disease and the statin treatment, and furthermore, opportunities and difficulties to adhere with statin therapy. Design: An exploratory qualitative study. Method: 10 male coronary heart patients, 55-78 years were strategically selected from a cardiology clinic in a larger Swedish hospital. Patients were interviewed individually in a semi-structured form, 2009/2010. Data processing was done according to content analysis and yielded four themes: empowerment, effects, decision basis, and trust. Results: The patients did not mentioned heredity among the factors they could not affect in association with the disease. Several patients saw the medication as a limitation, doubted its efficacy, but mostly took it anyway, at least for a limited time. Medication and illness were associated with each other. Information requirements were in most patients. Many patients wanted to discontinue the statin therapy. Conclusion: Retention of power over the own body, good reference base for decision about adherence, and trust in health care. These are crucial components of patients’ adherence to statin therapy, in connection with coronary heart disease. / Bakgrund: Kranskärlssjukdom dödar drygt 7 miljoner människor i världen per år. För höga halter av blodfettet kolesterol i blodet bidrar kraftigt till kranskärlssjukdom. Livsstilsförändringar kombinerat med blodfettssänkande läkemedel, statiner, är en effektiv behandling. Följsamheten till statiner är dock låg, inte ens genomgången hjärtinfarkt ökar följsamhet. Följsamhet kräver patientutbildning och god kommunikation mellan patient och läkare. Det saknas djupare kunskap om varför kranskärlspatienter slutar med statiner. Syfte: att beskriva hur kranskärlspatienter upplever sjukdomen och statinbehandlingen, samt möjligheter och svårigheter att följa statinbehandlingen. Design: explorativ kvalitativ studie. Metod: 10 manliga kranskärlspatienter, 55-78 år valdes strategiskt via en kardiologklinik på ett större svenskt sjukhus. Patienterna intervjuades personligen i semistrukturerad form, 2009/2010. Databearbetning skedde enligt innehållsanalys och gav fyra teman: egenmakt, effekter, beslutsgrund, tilltro. Resultat: Patienterna nämnde inte ärftlighet bland faktorer som ansågs opåverkbara i samband med kranskärlssjukdomen. Flera patienter såg medicinen som en begränsning och tvivlade på effekten, men tog den oftast ändå, åtminstone under en begränsad tid. Likhetstecken sattes mellan medicinering och sjukdom. Informationsbehov fanns hos flertalet patienter. Många patienter ville sluta med statinbehandlingen. Slutsats: Bibehållen makt över sin egen kropp, god referensgrund för beslut om följsamhet samt förtroende för sjukvården, är avgörande förutsättningar för kranskärlspatienters följsamhet till statinbehandling.

Diss. (sammanfattning) Umeå : Umeå universitet, 2008. / Härtill 3 uppsatser.

Thesis (M.S.)--University of Michigan, 1993.

Orientador: Marcelo de Castro Meneghim / Dissertação (mestrado profissional) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-24T18:44:30Z (GMT). No. of bitstreams: 1 Schmidt_CeliaRegina_M.pdf: 1028221 bytes, checksum: 75986a4864ed3f712438fccf02ab4a60 (MD5) Previous issue date: 2014 / Resumo: Os órgãos de controle interno e externo da Administração Pública estão voltados para todas as áreas de governo, porém o Sistema Único de Saúde ¿ SUS possui um sistema de controle próprio, sob sua competência e com características específicas, destinado ao acompanhamento técnico e financeiro das ações e serviços de saúde, que é o Sistema Nacional de Auditoria ¿ SNA. Entendendo a Auditoria Interna como atividade integrante do governo, com propósito construtivo e educacional, pressupõe-se que os auditores entendam a auditoria em saúde como um importante instrumento para gestão e determinante para a consolidação da Política Pública de Saúde. O objetivo deste estudo foi analisar a percepção dos auditores que realizam os controles internos e externos em relação à auditoria interna, na gestão da saúde pública, na atenção primária, no Estado de Mato Grosso. O presente estudo foi aprovado pelo CEP/FOP/UNICAMP. Nesta pesquisa foi incluída toda população de auditores do SUS do Estado de Mato Grosso e excluído o controle social, os controles de vertentes políticas e os controles específicos da gestão pública. O estudo foi qualitativo, com entrevistas, realizando-se a técnica do discurso do sujeito coletivo ¿ DSC, que resgata o sentido das opiniões coletivas, e realizada a análise descritiva dos discursos. Constatou-se que a auditoria interna existente é vista como facilitador do controle externo e interno por conhecer a complexidade das normas do SUS, acompanhar as rotinas de trabalho, detectar erros e fraudes no sistema e atuar como braço auxiliar do gestor. Há ações positivas nos controles com uso de indicadores e foco na efetividade e no funcionamento global do SUS. No entanto, a estrutura de auditoria ausente ou incompleta e problemas dos recursos humanos no setor estão entre os diversos desafios em auditar o SUS no Mato Grosso. Conclui-se que os auditores dos controles internos e externos percebem que a auditoria interna no SUS, presente em cada esfera de governo, é um relevante instrumento de apoio à gestão pública / Abstract: The organs of internal and external control of the public administration are focused on all areas of government, but the Unified Health System - SUS relies on the National Audit System - SNA, which has "self-jurisdiction," or legal authority, to determine and monitor the technical and financial aspects related to public health. Since this internal audit is an integrating strategy of the government, with constructive and educational purposes, one assumption might be that auditors understand the audit of health as an important tool for management and determining factor to the consolidation of the public health policies. The aim of this study was to assess the perceptions of auditors that monitoring internal and external controls of government in relation to the internal audit in the management of the Unified Health System in primary care, throughout the state of Mato Grosso. This study was approved by the ethics committee for human research (Piracicaba Dental School - UNICAMP). This research involved all the SUS auditors of Mato Grosso and excluded social control, politics controls and controls specific aspects of public management. The study was qualitative, with interviews, performing the technique of collective subject discourse - DSC, that rescues the sense of collective opinions, and performed a descriptive analysis of speeches. The discourse analysis revealed that the internal audit facilitates the external and internal control of activities in the SUS given his knowledge of the complexity of the rules of system, tracking the work routines, detect errors and fraud in the system and acts as an auxiliary arm of the manager. There are positive controls actions in using indicators e with a focus on effectiveness and overall functioning of the SUS. However, the missing structure or incomplete auditing structure and human resource problems in this sector are among the challenges towards auditing the SUS in Mato Grosso. In conclusion, the auditors of internal and external controls view the internal auditing in the SUS, present in every sphere of government, as a valuable aiding tool towards public health management. / Mestrado / Odontologia em Saude Coletiva / Mestra em Odontologia em Saúde Coletiva

Orientadores: Rosana de Fátima Possobon, Sérgio Tadeu Martins Marba / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-26T19:02:32Z (GMT). No. of bitstreams: 1 Almeida_AnaClaudiaGomesde_M.pdf: 1687313 bytes, checksum: 7f13d9f93644fa6d3554ca2c564fb984 (MD5) Previous issue date: 2015 / Resumo: Esta dissertação, em formato alternativo, com a apresentação de um capítulo, aborda a temática do desmame precoce. O desmame precoce traz inúmeras desvantagens para a criança e para a mãe, sendo associado ao aumento da morbi-mortalidade infantil. Estima-se que 1,5 milhões de lactentes vão a óbito devido à alimentação inadequada, introduzida antes do sexto mês de vida. O objetivo deste estudo foi avaliar a associação entre desmame precoce, as variáveis pré e pós-natal e o locus de controle das mães. Foi realizado um estudo retrospectivo de coorte, utilizando instrumentos que investigaram os aspectos socioeconômicos e demográficos, as variáveis pré e pós-parto, e a escala multidimensional de locus de controle de Levenson. A amostra foi composta por 410 mães de crianças com idade entre 0 a 5 anos, que estiveram presentes no dia da campanha nacional de vacinação infantil contra a Poliomielite, realizada no mês de junho de 2013, pela Secretaria de Saúde do Município de Piracicaba-SP. A análise estatística foi realizada por meio de regressão logística múltipla hierárquica, avaliando a associação entre a variável dependente, o desmame precoce e as seguintes variáveis independentes sócio-demográficas: renda familiar, número de pessoas no lar, habitação, grau de instrução materno e paterno, chefe de família e profissão dos pais. As variáveis relacionadas ao desmame precoce e ao pré e pós-parto foram: idade materna e paterna, estado civil, idade e gênero da criança, paridade, experiência em aleitar e informações sobre o início do pré-natal, tipo de parto, problemas durante o parto com a mãe e/ou com a criança, permanência em alojamento conjunto, início da amamentação, acesso à informações sobre amamentação e manejo da lactação, vontade de amamentar, gravidez planejada, intercorrências mamárias, uso de chupeta e mamadeira, retorno ao trabalho e participação da avó. A escala de Levenson, composta por três subescalas - internalidade, externalidade outros poderosos e externalidade ao acaso. Estas variáveis foram divididas em blocos, sendo o primeiro composto por características maternas, o segundo por características do nascimento do bebê e o terceiro envolvendo características do bebê e assistenciais. Desta maneira, foram testadas no modelo multinível as variáveis com p?0,20 de cada bloco, permanecendo no modelo aquelas que continuaram associadas ao desmame com p?0,05, após o ajuste, para as variáveis do mesmo bloco e finalizando com as hierarquicamente superiores. Os resultados encontrados demonstraram que a prevalência do desmame precoce foi de 40%. Encontrou-se associação estatisticamente significativa entre desmame precoce e a variável baixa escolaridade materna (IC95% = 1,18-3,22; p= 0,0131), ausência de experiência prévia em amamentar (IC95% = 3,76-9,75; p= <0,0001) e uso de chupeta (IC95% = 1,78-4,17; p= <0,0001). Não houve associação entre o tipo de locus de controle e o desmame precoce. Concluiu-se que ter maior nível de escolaridade materna, ter experiência prévia em aleitamento e não oferecer chupeta à criança são fatores de proteção ao aleitamento materno / Abstract: This dissertation, in alternate format, with the presentation of a chapter addresses the theme of early weaning. Early weaning has numerous disadvantages for the child and the mother, being associated with increased infant morbidity and mortality. It is estimated that 1.5 million infants will die due to inadequate nutrition, introduced before the sixth month of life. The objective of this study was to evaluate the association between early weaning, pre and postnatal variables and Mother's locus of control. A retrospective cohort study was performed using instruments that investigated the socioeconomic and demographic indicators, pre variables and postpartum, and the multidimensional scale of Levenson's locus of control. The sample consisted of 410 mothers of children aged 0-5 years who were present on the day of national childhood immunization campaign against polio, held in June 2013, the Health Department of the city of Piracicaba-SP . Statistical analysis was performed using hierarchical multiple logistic regression, evaluating the association between the dependent variable, early weaning and the following socio-demographic independent variables: family income, number of people in the home, housing, degree of maternal and paternal education , householder and profession of parents. The variables related to early weaning and pre and post-delivery were maternal and paternal age, marital status, age and child gender, parity, breastfeeding experience and information on the initiation of prenatal care, type of delivery, problems during childbirth with the mother and / or with the child, remained in the accommodation, initiation of breastfeeding, access to information on breastfeeding and lactation management, desire to breastfeed, unplanned pregnancy, breast complications, pacifier use and bottle, return to work and grandmother participation. The scale Levenson, composed of three subscales - internality, other powerful external and external to chance. These variables were divided into blocks, the first composed of maternal characteristics, the second by Baby Birth characteristics and the third involving baby characteristics and care. In this way, were tested in the multilevel model variables with p?0,20 of each block, remaining in the model those who remained associated with weaning with p = 0.05 after adjustment for the variables of the same block and ending with the hierarchically superior. The results showed that the prevalence of early weaning was 40%. Statistically significant association between early weaning and the variable low maternal education (95% CI = 1.18 to 3.22; p = 0.0131), no previous experience in nursing (95% CI = 3.76 to 9, 75, p = <0.0001) and pacifier use (95% CI = 1.78 to 4.17; p = <0.0001). There was no association between the type of locus of control and early weaning. It was found to have higher levels of maternal education, previous experience in breastfeeding and not offer child pacifiers are protective factors for breastfeeding / Mestrado / Saude da Criança e do Adolescente / Mestra em Saúde da Criança e do Adolescente