Drawing from the rich records of Protestant British women’s missionary societies, this dissertation explores the motivations, goals, efforts, and experiences of British women who pursued careers as missionary doctors and nurses dedicated to serving Indian women in the decades before Indian independence in 1947. While most scholarship on women missionaries focuses on the imperial heyday of the Victorian and Edwardian eras, this study highlights women medical missionaries in the late colonial period and argues for the significance of this transitional moment, a time of deepening change in medical science and clinical practice, imperial rule and nationalist politics, gender relations, and the nature of the missionary enterprise in both India and Britain. Analysis of the relationship between missionaries in India and their managers in Britain reveals the tensions among women who shared a common commitment, yet brought different perspectives and priorities to women’s missionary work. A life-cycle approach to work and career allows examination of individual women’s development as healthcare professionals and as missionaries. Telling the stories of missionaries’ everyday experiences shows that a sense of purpose, preparation, professionalism, and positive role models sustained those women who were able to meet the great demands of medical missionary work. These missionaries often overcame obstacles and challenges through negotiation and collaboration with patients and their families as well as reflection and learning from experience. Many came to believe they had achieved measurable progress and made a positive difference in the quality of Indian women’s lives. The missionaries’ commitment to Christian medical service for Indian women reached beyond the colonial era and eventually embraced a transfer of leadership to Indian Christians. [WU1] [WU1]Your abstract will not be accepted if it exceeds the limit by even one word.

Thesis (Ph.D.)--University of Adelaide, Dept. of Social Inquiry, 2004. / "January 2004" Includes bibliographical references (leaves 252-273).

Made available in DSpace on 2015-05-08T14:53:40Z (GMT). No. of bitstreams: 1 arquivototal.pdf: 692581 bytes, checksum: 4c44cf423c5dfa82aed85e3ae4dabde1 (MD5) Previous issue date: 2008-11-28 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / This research aimed at developing a management model of stress for doctors in hospitals based on guidelines proposed by the OHSAS 18001:2007. With the advent of globalization and competitiveness, the work became more stressful and diseases resulting from stress were more present. Stress is a physiological reaction of the body, therefore, necessary for life. The stress on its balance brings benefits to the individual and is called eustress, on the contrary it is called distress. The medical work puts into context a number of stressors, such as: dealing with illness and death, extended days, night work, work overload, teams conflict, among others, and therefore are affected by various problems of stress at work. To change this scenario, a way to control the stress in the hospital and in the medical work is to create ways for its management, keeping it at a healthy level. Thus, with the guidelines of a model for management of the Health and Safety at Work, the OHSAS 18001:2007, a model to manage the stress in hospitals and for the medical profession was built. The research carried out was mainly exploratory and on literature, with elements of methodology and documentation. The development of the system was based on studies of the literature on stress, stress on doctors and a careful study in all the sections and subsections of the OHSAS18001. During the study, strong points of the instrument which are key points to the success of how to manage stress were observed. As for the hospital, its organizational culture must be turned to the stress experienced by doctors and it is the starting point so that the management can happen. As to the structure of OHSAS18001, the policy should be constructed in a well defined way with clear objectives; the involvement of the medical professionals should be done through participation, awareness and training; there must be cooperation among all sectors of the hospital related to the medical work; capable and responsible people should be in charge of the system implementation; the existence of controls must be effective; and the proposal for continuous improvement means that the system should be constantly reassessed, it gives credibility to the system and preventive character and attention to medical work. It follows therefore that it was possible to adapt the OSHAS 18001:2007 to the management of stress for doctors in hospitals. The validation was not performed, but it is expected that by proving its efficiency, this proposed system could be another instrument of prevention and quality of life at work. / Esta pesquisa teve por objetivo o desenvolvimento de um modelo de gestão de estresse para médicos em hospitais baseado nas diretrizes propostas pela OHSAS 18001:2007. Com o advento da globalização e da competitividade, o trabalho tornouse mais estressante e as doenças decorrentes do estresse se fizeram mais presentes. O estresse é uma reação fisiológica do corpo, portanto, necessária à vida. O estresse quando em equilíbrio traz benefícios para o indivíduo e é chamado de eustress, ao contrário fala-se de distress. O trabalho médico insere no seu contexto uma série de estressores, tais como: lidar com a doença e com a morte, jornadas prolongadas, trabalho noturno, sobrecarga de trabalho, conflitos em equipe, entre outros, e, por conseguinte, são acometidos de diversos problemas derivados do estresse no trabalho. Para mudar esse cenário, uma maneira se controlar o estresse no ambiente hospitalar e no trabalho médico, é criar caminhos para seu gerenciamento, mantendo-o num nível saudável. Desse modo, com as diretrizes de um modelo de gerenciamento da Saúde e Segurança no Trabalho, a OHSAS 18001:2007, foi construído um modelo para gerenciar o estresse em hospitais e para a classe médica. A pesquisa realizada foi essencialmente exploratória e bibliográfica, com elementos metodológicos e documentais. A elaboração do sistema foi realizada com base nos estudos da literatura sobre estresse, estresse em médicos e um estudo cuidadoso em todas as seções e subseções da OHSAS18001. Observou-se durante o estudo pontos fortes do instrumento base e que são peças chaves para o sucesso da forma de gerenciar o estresse. Quanto ao hospital, sua cultura organizacional deve estar voltada para o estresse vivenciado pelos médicos. Quanto à estrutura da OHSAS18001, a política deve ser construída de forma bem definida com objetivos claros; o envolvimento da classe médica deverá ser feito através da participação, conscientização, e treinamento; deve existir a colaboração de todos os setores do hospital; a implementação do sistema deve acontecer sob responsabilidade de pessoas capazes e responsáveis; a existência de controles deve ser eficaz; e a proposta de melhoria contínua faz com que o sistema seja reavaliado de forma constante. Tudo isso, dá ao sistema credibilidade e caráter preventivo e de atenção ao trabalho médico. A validação não foi realizada, porém espera-se que ao se comprovar a sua eficiência, esse sistema proposto possa ser mais um instrumento de prevenção e de qualidade de vida no trabalho.

Submitted by Adriano Leite Soares (dr.asoares@uol.com.br) on 2012-03-27T00:28:30Z No. of bitstreams: 1 TESE REVISADA FINALCOM FICHA E CAPA.pdf: 2461287 bytes, checksum: 04852765664e2f8eeecb1e2688c53bfc (MD5) / Approved for entry into archive by Gisele Isaura Hannickel (gisele.hannickel@fgv.br) on 2012-03-27T12:37:14Z (GMT) No. of bitstreams: 1 TESE REVISADA FINALCOM FICHA E CAPA.pdf: 2461287 bytes, checksum: 04852765664e2f8eeecb1e2688c53bfc (MD5) / Made available in DSpace on 2012-03-27T13:01:21Z (GMT). No. of bitstreams: 1 TESE REVISADA FINALCOM FICHA E CAPA.pdf: 2461287 bytes, checksum: 04852765664e2f8eeecb1e2688c53bfc (MD5) Previous issue date: 2012-02-27 / Os prestadores de serviços de saúde e, para este estudo, principalmente o médico, cuja atuação interfere diretamente tanto nos resultados da terapêutica instituída, como também na determinação dos custos dos diversos sistemas de saúde, têm a remuneração profissional como prioridade na agenda dos diversos participantes do setor, quer seja no Sistema Único de Saúde, quer principalmente no setor de saúde suplementar. Devido ao ritmo inflacionário do setor e às exigências estabelecidas pela regulamentação dos planos de saúde, os valores de remuneração dos prestadores de serviços têm crescimento menor que os índices inflacionários gerais. Os modelos de remuneração existentes, de forma isolada, não suprem as expectativas de todos os recursos credenciados, e, mesmo em um único sistema de saúde, os diferentes mecanismos de pagamento podem combinar-se, não sendo obrigatória a existência de somente um método de remuneração para cada sistema, pois mesmo na remuneração do médico, por esta remuneração não atender às expectativas das diversas especialidades, poderá levar a um desequilíbrio entre oferta e demanda de profissionais de certas áreas da Medicina. O objetivo deste trabalho é elencar, dentre os diversos modelos de pagamento, os pressupostos básicos para a remuneração do médico-cirurgião, levando-se em consideração os recursos empregados no tratamento, bem como o risco inerente de cada paciente tratado, tentando traduzir tais pontos em uma fórmula de cálculo padrão e comparar este novo valor com os valores atuais de remuneração. O modelo de remuneração deve fomentar a eficiência do tratamento instituído e a equidade do pagamento, além de ser de fácil implantação e compreensão pelos players do setor, bem como ter neutralidade financeira entre o principal e o agente, mantendo a qualidade e a acessibilidade aos serviços, a fim de que os médicos sejam incentivados a promover um tratamento eficiente aos beneficiários. Deve ser baseado no tratamento de doenças em si e não na realização de procedimentos, bem como estar atrelado a índices de desempenho e ao risco assumido pelo profissional. Enfim, o trabalho médico deve ser remunerado de forma diretamente proporcional à quantidade de horas trabalhadas, por profissionais que possuam equivalente nível de graduação e qualificação, e ao risco inerente a cada paciente tratado. A fórmula encontrada leva em consideração não somente a idade do paciente a ser tratado, bem como os riscos inerentes ao tratamento deste paciente, e tem como base de remuneração a doença a ser tratada, e não os procedimentos que serão necessários, ou indicados pelos médicos para tratamento desses pacientes. Desta forma, a valorização do trabalho médico cresce com o aumento do risco de tratar o paciente, quer seja pelo risco inerente à própria idade do paciente, quer seja pelo risco inerente ao procedimento anestésico, quer seja pelo risco cardíaco, havendo, portanto, uma melhor proporcionalidade entre a remuneração hospitalar dos pacientes com mais gravidade, em que são utilizados, ou colocados à disposição, mais recursos, com a remuneração crescente, também neste caso, dos profissionais que estariam tratando tais pacientes. / Health providers services, and in this case, specially medical doctors, who's works interfere directly in outcomes and cost of the health system, has their methods of payment in the agenda of the most industry players, either in the public health system, but mainly in the supplementary health system, where because the continuous growth in cost, and the industry regulation dues, the providers gains has increments below the inflationary rates. Nowadays, the methods of payment, by itself, do not fulfill the gain goals of the health system providers, and even in a single health system, the different way of payment could be combined, and it is not obligated a unique payment method for each health system, just because the goals of remuneration moves around depending of the specialties, which contribute to keep the correct balance between demand and offer. The goals of this study is to enroll, between all of the payment methods, the basic assumptions for the surgeons payment, considering the sources applied in treatment, as well as life risk of each patient treated, trying to reproduce a standard formula to calculate the remuneration, and compare them with the present expenditure. The method of payment must encourage the treatment efficiency, and the equity of payment, and be easily understood by the industry players, and financial neutrality between principal and agency, keeping the quality and accessibility to medical services, and the doctors will be stimulate to increase the quality of the treatment to the users. Might be based on disease management, and not on procedures, and linked to performance index, and the risk owned by the patient. In conclusion, the medical labor remuneration proportionally by the total of work hours, by the same levels of the professional graduation and qualification, and the life risk of the patient treated. The new formula for calculate the medical payment consider not only the patient age, but also the risk involved on the treatment, and it is based on the disease, and not on a fee-forservice system. In this way, medical remuneration grows with the patient risk, as much as the increase of patient age, the increase of anesthetic and cardiac risks, resulting in a better correlation between hospitals costs, medical remuneration, and the resources used in the treatment.

In Natal and Zululand Swedish missions had precedence through the Church of Sweden Mission from 1876 on, the Swedish Holiness Mission from 1889 on, and the Scandinavian Independent Baptist Union from 1892 on. Between 1876 and 1902, thirty-six women were active in these South African missions. The history of all these women are explored on an individual basis in this, for the most part, empirical study. The primary goal of this dissertation is to find out who these women missionaries were, what they worked at, what positions they held toward the colonial/political situation in which they worked, and what positions they held in their respective missions. What meaning the women’s mission work had for the Zulu community in general, and for Zulu women in particular are dealt with, though the source material on it is limited. Nevertheless, through the source material from the Swedish female missionaries, Zulu women are given attention. The theoretical starting points come, above all, from historical research on women and gender and from historical mission research about missions as a part of the colonial period. Both married and unmarried women are defined as missionaries since both groups worked for the missions. In the Swedish Holiness Mission and in the Scandinavian Independent Baptist Union the first missionaries in Natal and Zululand were women. The Church of Sweden Mission was a Lutheran mission were women mostly worked in mission schools, homes for children and in a mission hospital. Women were subordinated in relationship to male missionaries. In the Swedish Holiness Mission and in the Scandinavian Independent Baptist Union women had more equal positions in their work. In these missions women could be responsible for mission stations, work as evangelists and preach the Gospel. The picture of the work of female missionaries has also been complicated and modified.