Thesis (M.N.M.)--Regis University, Denver, Colo., 2005. / Title from PDF title page (viewed on Nov. 16, 2005). Includes bibliographical references.

No / The journey for people with Alzheimer’s disease or another dementia involves the need for increasing levels of support, with transitions across care settings. Although transitional care has received increasing attention in the health care arena, no widely accepted transitions typology exists for the dementia journey. At the same time, national dementia strategies are proliferating. We developed a typology containing six transitions that cover the dementia journey from symptom recognition to end-of-life care. We then critically evaluated whether and how the national dementia strategies of Australia, England, France, the Netherlands, Norway, Scotland, and the United States addressed each transition. Adopting a person-centered perspective, we found that most or all of the national strategies adequately address earlier transitions in the journey, but fewer strategies address the later transitions. We recommend that next-generation national dementia strategies focus on later transitions, specify how care coordination and workforce training should make transitions more person centered, and use person-centered outcomes in evaluating the success of the strategies’ implementation and dissemination.

La littérature décrit l'organisation hospitalière comme complexe et cloisonnée. Elle identifie le cadre de santé (CdS) comme un pivot pour traduire et articuler les différentes logiques professionnelles. Sa fonction est habituellement décrite par son travail quotidien de coordination opérationnel au détriment d'un travail destiné à structurer et améliorer l'organisation.En s'intéressant à la gestion de projet, l'objectif de la thèse est d'identifier le travail de coordination organisationnelle porté par les CdS.Elle s'appuie sur un dispositif pédagogique qui met des étudiants cadres en position de tiers pour explorer un problème organisationnel délégué par un CdS. Suite à la restitution au CdS du travail produit par le tiers, la recherche intervention a suivi la mise en œuvre de 17 projets sur une année.La thèse est organisée autour de quatre articles publiés. Le premier qualifie les bénéfices et limites de l'intervention du tiers. Le second présente les deux manières d'utiliser la production du tiers, révélatrices de la relation entre le projet, le CdS et l'équipe. Le troisième article explore les conditions de la conduite du projet porté par le CdS dans trois dimensions relationnelles : en proximité avec l'équipe soignante, en transversal avec d'autres unités de soins et au niveau institutionnel avec les acteurs administratifs et hiérarchiques. Le quatrième définit, parmi 12 variables, les facteurs qui influencent le résultat du plan d'action mis en œuvre.Les résultats montrent que l'acteur-tiers a permis de reconfigurer les relations collectives dans l'unité de soins et a relancé le CdS dans son pouvoir d'agir. Le succès du projet a été plus fréquent quand il a été présenté à l'équipe et discuté en réunion, c'est-à-dire quand le CdS a été un régulateur des débats et un arbitre. A l'inverse, lorsque le CdS a attendu un soutien institutionnel, ou que la conduite de projet a été prescriptive, sans communication formelle avec les soignants, l'échec a été plus fréquent. Au final 71% des actions ont produit une amélioration opérationnelle.La recherche montre que les attributs de méthodes et sociaux, ne sont pas tous identifiés dans la conduite de projet portée par les CdS. Les résultats permettent de qualifier le travail de coordination produit par le CdS de « Projet ordinaire ».Des préconisations sont formulées. Au niveau institutionnel, il est proposé d'identifier une unité de soutien managérial. Il est souligné l'importance de donner de la visibilité au projet ordinaire et de développer des espaces de discussions. Des activités de formation initiale et continue sont identifiées pour accompagner les futurs CdS et les CdS dans leurs pratiques managériales. / Literature describes hospital organisation as complex and compartmentalised. It identifies the head nurse (HN) as a pivot to translate and articulate various professional logics. Her function is usually described by their daily operational work of coordination to the detriment of a job destined to structure and improve organisation.By focusing on project management, the aim of this thesis is to identify the work of organisational coordination carried by the HN.It leans on an educational device which puts student executives in the position of a third party to explore an organisational problem delegated by a HN. After the restitution to the HN produced by a third party, research intervention has followed the implantation of 17 projects over one year.The thesis is organised around four published articles: the first one prones the benefits and limits of the third party intervention. The second presents two methods to use the third party production, revealing the link between the project, the HN and the team. The third article explores the conditions of project management carried by the HN in three relational dimensions: in relation to the medical team, in cross section with other units of care, and at institutional level with the administrative and hierarchical actors. The fourth defines, among 12 variables, the factors which influence the result of the implemented action plan.The results show that the third party allowed to re-configure the collective relations in the unit of care and relaunched the HN in his power to act. The success of the project was more frequent when it was presented to the team and discussed in meetings, that is, when the HN helped regulate debates and be referee. On the contrary, when the HN waited for institutional support, or when the project management was prescriptive, without formal communication with the nursing staff, failure was more frequent. In summary, 71 % of the actions encountered resulted in an operational improvement.The research shows that the attributes of methods and social are not all identified in the project management carried by the HN. The results permit to consider the work of coordination produced by the HN as « ordinary Project ».Recommendations are formulated. At an institutional level, it is suggested to identify a unit managerial support. The proposals underline the importance of giving visibility to the ordinary project and necessity to develop spaces of discussion. Activities of initial and continuous training are identified to accompany the future HN and the HN in their managerial practices.

1 ABSTRACT The diploma thesis is focused on experience with self-reflection of social workers who supporting foster families. It is divided into two parts - theoretical and empiric. Aim of the thesis was to find out what kind of experience with self-reflection has social workers of organizations supporting foster families. The theoretical part has five chapters. The first chapter shows to readers what profession of a social worker is about - at first it looks at social work in context of helping professions, then it defines expert studies, abilities, and personality of social worker, and it also mentions possible motivation for working in this field. The second chapter brings topic of foster care and a definition of supporting; it describes supporting organizations for foster families and role of social worker in it. In the third chapter there can be found definition of self-reflection (in narrow meaning it brings nearer parts of self-reflection such as self-approach, self-knowledge, or self-regulation); further there can be found consideration of what importance self-reflection has for social workers and which tools to reach it they can use. The fourth chapter is aimed at view of influence which can affect self-reflection, such as emotion of worker, projection, topic of power and powerlessness, work with...

Thesis (Ph.D.)--University of Alberta, 2009. / A thesis submitted to the Faculty of Graduate Studies and Research in partial fulfillment of the requirements for the degree of Doctor of Philosophy in Engineering Management, Department of Mechanical Engineering. Title from pdf file main screen (viewed on October 23, 2009). Includes bibliographical references.

Title: The Principles of Funding of the Public and Voluntary Formalised Solidarity in the Social Care Services in the Czech Republic Abstract: The social care services are a specific system within the social protection system. Opposed to the public benefit systems they allow the coexistence of public and voluntary solidarity. There are many welfare state models and systems of cooperation of the public and NGOs in Europe. These models offer differently formed relationships of their entities. This thesis raises the question of finding a more convenient organisation of the whole system of the social care services in the Czech Republic where the problem is currently being discussed The objective of the thesis is to find possibilities of public and voluntary solidarity in the social care services settings and to suggest ways for their cooperation. The research is mainly based on qualitative methods. Firstly, the causal links of statistical nature from the fields of demography, social relations and economics are introduced. In the next step a combination of methods of in depth interviews and expert discussions is used. They focus on public solidarity and regulation in the system. The last research step brings 3 case studies with examples of the best practice in financing of NGOs in the social care services...

Les maladies chroniques regroupent un ensemble de problèmes de santé tels que le diabète, l’hypertension, les maladies pulmonaires obstructives chroniques (MPOC) et le cancer. Elles requièrent une prise en charge continue, durant plusieurs années et évoluent généralement lentement. Ce projet de recherche vise à comprendre et à analyser les dynamiques associées à la mise en place d’un modèle organisationnel qui permet une meilleure prise en charge des patients atteints de maladies chroniques et à porter une attention particulière aux mécanismes professionnels et organisationnels qui favorisent la mise en place de ce modèle de soin dans un contexte pluraliste des organisations et du système de santé. Il vise aussi à explorer si le modèle mis en place permet d’atteindre les objectifs et les résultats de soins escomptés par le modèle. Le contexte de notre étude s’inscrit dans le réseau de l’écosystème des maladies chroniques et des relations inter-organisationnelles lors de l’implantation et de la mise en œuvre du Centre d’accompagnement interdisciplinaire en maladies chroniques CAIMC du CSSS du Haut-Richelieu-Rouville à Saint-Jean-sur-Richelieu. Les données récoltées proviennent d’entrevues individuelles représentatives de l’ensemble des acteurs professionnels du terrain, se fondent sur des documents et rapports, notamment ceux de divers comités de travail ainsi que de protocoles de soins. Notre recherche s’appuie sur le cadre conceptuel de l’analyse stratégique de Crozier et Friedberg (1977) ainsi que sur le système des professions d’Abbott (1988). Elle met en évidence une complexité organisationnelle et structurelle qui rend difficile la gestion du changement dans les organisations pluralistes, surtout lors de l’implantation d’un modèle de soin dans un long horizon temporel. Cette implantation résulte de la gestion d’un processus d’apprentissage continu au sein de l’organisation. Le modèle que nous proposons constitue un cadre d’analyse qui permet une synthèse de diverses approches qui favorisent la compréhension de phénomènes complexes et leur gestion. Il contribue ainsi à raffiner et approfondir la compréhension des dynamiques organisationnelles et professionnelles associées à la mise en place d’un modèle organisationnel. Il peut valablement être utilisé pour l’étude de divers modèles de soins, outre celui des maladies chroniques. Il serait d’ailleurs judicieux de considérer un tel cadre d’analyse avant toute expérimentation ou implantation de modèles de soins dans des organisations pluralistes de santé. Cette étude permet de formuler des recommandations à l’attention des décideurs publics. Elle soutient, notamment, que la mobilisation d’un intrapreneur, ayant l’étoffe d’un leader transformationnel dans un cadre organisationnel agile, favoriserait la création et l’acquisition de connaissances permettant d’accélérer les processus et d’améliorer l’autogestion des patients. / Chronic diseases include a range of health problems such as diabetes, hypertension, chronic obstructive pulmonary disease (COPD) and cancer. They require continuous management over several years and generally evolve slowly. On the one hand, this research project aims to understand and analyze the dynamics associated with the implementation of an organizational model that allows for better management of patients with chronic diseases. On the other hand, it sheds light on the professional and organizational mechanisms that promote this chronic care model's implementation in a pluralistic context of organizations and the health system. Finally, it explores whether the model implemented makes it possible to achieve the model's objectives and results of care. The context of our study is part of the network of the chronic disease ecosystem and inter-organizational relations during the implementation and operation of the Centre d'accompagnement interdisciplinaire en maladies chroniques CAIMC of the CSSS du Haut-Richelieu-Rouville in Saint-Jean-sur-Richelieu. The data collected came from individual interviews representative of all professional actors in the field, documents and reports, particularly those of various working committees and care protocols. Our research is based on the conceptual framework of Crozier and Friedberg's (1977) strategic analysis and Abbott's (1988) system of professions. It highlights an organizational and structural complexity that makes it difficult to manage change in pluralistic organizations, especially when implementing a chronic care model over a long period of time. Implementation results from the management of a continuous learning process within the organization. The model we propose constitutes an analytical framework that allows a synthesis of various approaches that contribute to the understanding of complex phenomena and their management. It thus helps to refine and deepen the understanding of the organizational and professional dynamics associated with the implementation of an organizational model. It could be used for the study of other care models, in addition to chronic diseases. It would be appropriate to consider the use of such an analytical framework before experimentation or implementation of care models in pluralistic health organizations. This study makes several recommendations to public decision-makers. In particular, it argues that the mobilization of an intrapreneur, with the makings of a transformational leader in an agile organizational framework, would promote the creation and acquisition of knowledge to accelerate processes and improve patient self-management.

This diploma thesis is called "Relations of Medical Staff and Their Patients." The first part of this diploma thesis deals with patients' rights, their genesis, and the legislative base. It also includes disordered patients, whose patient's rights should not be forgotten during their hospitalization. A large part of my thesis consists of psychological, economic, legal and organizational system limits of the realization of these rights. This means relationship between a doctor and his patient, the source of health care funding, above standard medical care and the privatization of hospitals. The final part of this thesis focuses on the interaction between health professionals in social work and the patients. This thesis is enriched by an interview with the leader of social workers of a hospital in Prague, discussing new patients' right: right on a social worker.