L’évolution du secret médical vers un secret professionnel concernant de nombreuses professions soulève la question de la transmission des données personnelles de santé. Étudiant les fondements juridiques de cette transmission et s’appuyant sur des exemples pratiques relevés au cours de l’activité des praticiens conseils au sein de l’assurance maladie, ce travail développe les droits de l’individu sur la maîtrise du secret et les possibilités de transmissions des données dans le respect du droit des autres personnes que sont les ayants droits et les employeurs comme les droits de la défense. La possibilité d’une prédominance de la société sur la personne est envisagée dans le cadre de la protection de la santé, de la justice et de la gestion économique des dépenses de santé.Des propositions d’évolution des pratiques et de la législation visent à permettre l’encadrement des transmissions des données personnelles de santé dans le respect des droits des personnes. / Medical secrecy is moving towards a professional secrecy, which concerns numerous professions, raising the question of transmission of personnel health data.This thesis, based on practical examples taken from professional activities of practitioners advisers in the Health insurance, studies legal foundations of this transmission and develops individual rights on how to control secrecy and possibilities of transmission of data according to the respect of the rights of other people such as eligible parties and employers. The fact that a society can be more prominent than a person is contemplated in the context of health protection, justice and economic management of health spending.Evolutions of practices and legislation are suggested and aim at allowing the supervision of transmission of personal health data according to people’s rights.

Background: Healthcare workers’ hand hygiene remains a key pillar because it prevents and controls healthcare associated infections. Healthcare Workers’ hand hygiene compliance is suboptimal. Aim: The study developed contextualised guidelines for Healthcare Workers’ hand hygiene and infection control in patient care. Methods: The Precede-Proceed model with Theory of Planned Behaviour guided the study. The study was conducted following the mixed methodology approach, observational survey, exploratory, descriptive and contextual in nature study with mixed thematic analyses in a research wheel process. Data were collected through direct participant observation of hand hygiene opportunities through observing (n=95 Healthcare Workers; n=570 practices). Self-administered questionnaires were used to collect data from Healthcare workers (n=189) regarding challenges they faced in achieving hand hygiene. Structured interviews were conducted with patients (n=574). Retrospective reviews of healthcare associated infections and their associated mortalities were carried out from mortality records. Data were analysed retrospectively. Partly the data were statistically and mixed thematically analysed. Guidelines were developed using intervention alignment throughout, mapping, matching, pooling, patching and validation corroborated with Precede-Proceed models’ best practices. The study was ethically reviewed and approved by University of South Africa and the Medical Research Council of Zimbabwe project numbers, 6067662 and MRCZ/B/208. Results: Hand hygiene non-compliances were mostly found in the following contexts, after touching patients’ surroundings, and before doing an aseptic procedure. A non-hand hygiene compliance of Healthcare workers 167(29.3%) and compliance 403(70.7%) in context was suboptimal with sad patients and challenges faced by Healthcare workers. Conclusion: Healthcare Workers had gaps in hand hygiene compliance and availability of required resources. Gaps were also noted in ongoing hand hygiene promotion educational strategies and guidelines to comply and prevent. Guidelines to enhance hand hygiene included, attend to hand hygiene strictly after touching patient surroundings, bed linen, lockers and curtains to prevent gastroenteritis; follow standard precautions against HCAIs from spreading to patients' environments; and comply with hand hygiene guidelines, policies and regulations for best practice with patients. The study contributes generalisable knowledge. / Health Studies / D. Litt et Phil. (Health Studies)

The study investigated knowledge, attitudes and vaccination status of registered nurses regarding prevention and control of hepatitis B (HB). An analytical, cross-sectional study was conducted, and data was collected using self-administered questionnaires. 53.0% of the respondents (n=219) had good knowledge and 96.3% had positive attitudes regarding HB prevention and control. 86.8% had received at least 1 dose of the HB vaccine, but only 54.7% had received the 3 doses for complete vaccination. A positive attitude score was a significant predictor of HB vaccination uptake (OR=1.424, p=0.003). Female registered nurses were 3.479 times (95% CI: 1.495-8.098; p=0.004) more likely to be vaccinated than male registered nurses. Registered nurses are aware that hepatitis B virus infection can be prevented by a safe and effective vaccine, however, there is need to improve awareness and encourage complete HB vaccination uptake among all registered nurses to ensure their protection against the risk of HBV infection. / Health Studies / M. P. H. (Health Studies)

Critical Incident Stress has the potential to affect emergency services personnel to the degree that it can change the way the responder acts and reacts in all facets of his or her life, including the job and his or her family. Research into these potential effects has produced a greater understanding of the responders experiences within a short period of time after the perceived critical incident. This study investigates the long-term effects of critical incident stress among emergency responders from two cities in the three emergency services professions were interviewed to determine what their experiences were at least six months post critical incident. A structured incident had in three areas of teh emergency responders lives: impact on job, impact on the individual responder, and perceived impact on emergency responders families. For particpants, symptoms of Critical Incident Stress lasted between 6 months and 2 years after the perceived critical incident. Analysis of the data indicatees that single responder critical incidents have the potential to negatively affect emergency responders resulting in the loss of enthusiasm and passion for their work, debilitating psychological distress, and isolation from valued support systems. Long-term effects of Critical Incident Stress change the perceptions that responders have about the job, about themselves, and the relationships with their families. The culture of emergency services, changing identities, and the lack of support from both within the system and outside of the system were seen as variables that contribute to the long-term effects of Critical Incident Stress. / xi, 181 leaves ; 29 cm.

Text in English / The purpose of this research was to investigate occupational health and safety challenges and their impact on health care workers (HCWs) in selected public hospitals from the Gauteng Province, South Africa. Method: A quantitative descriptive cross-sectional survey was conducted among HCWs in the study sites. A two-staged sampling that include purposive sampling of study sites and census sampling of 2000 HCWs was used. Self-administered questionnaires were used to obtain data from HCWs. In addition, two different checklists were used to conduct retrospective records reviews to assess occupational health and safety (OHS) policy compliance and occupational injuries and diseases occurrence. The SAS Release 9.3 was used to analyse data. The Fischer Exact test and Chi-square were also used to determine the association of variables and P-value was set at <0.05 to indicate significant association. Results: A total of eight public hospitals and 926 (46.3%) HCWs who were all females nurses participated in this survey. Major occupational health hazards reported by the participants include: needle-stick injuries 275 (54.67%), slips trips and falls 67 (13.32%) and splashes 57 (11.33%). The analysis of open-ended responses indicated increased workloads, long hours of work and shift work as the most reported psychosocial hazards among HCWs. The reviewed records indicated that back injuries 22 (4.37%), tuberculosis (TB) 17 (3.38%) and asthmatic reactions 8 (1.59%) were the commonly reported occupational injuries and diseases among the HCWs. The records review also revealed a lack in the conducting of adequate medical surveillance among participants. The results showed poor compliance with the OHS policy and a negative impact of biological and psychosocial hazards on the HCWs. Conclusion: There was a high risk of exposures to biological hazards whilst providing care to patients, thus warranting the implementation of robust preventive measures. As a result, the guidelines were developed to promote the health and safety of HCWs with a view to promoting policy compliance and preventing the occurrence of occupational injuries and diseases as well as their impact among HCWs. / Health Studies / D.Litt et Phil. (Health Studies)

The purpose of the study was to describe the determinants and practice of HIV self-testing among health care workers (HCWs) in Nyeri provincial hospital, Kenya. A descriptive cross-sectional study was conducted to determine the rate of HIV self-testing, explore the factors influencing the practice and describe access to HIV psychosocial support, care and treatment. The study was guided by the concepts of the protection motivation theory. Data was collected from 348 HCWs and analysed by means of logistic regression. Results showed that 65.8% of the HCWs had practiced HIV self-testing among themselves. Age, self efficacy and response efficacy were found to be significant predictors of HIV self-testing. Willingness to access HIV psychosocial support (71.3%) and care and treatment (73.9%) was high. Self-testing is highly practiced by HCWs. / HIV self-testing among health care workers at Nyeri Provincial Hospital in Kenya / HIV self-testing among health care workers / Public Health / M.A. (Public Health)

The purpose of the study was to describe the determinants and practice of HIV self-testing among health care workers (HCWs) in Nyeri provincial hospital, Kenya. A descriptive cross-sectional study was conducted to determine the rate of HIV self-testing, explore the factors influencing the practice and describe access to HIV psychosocial support, care and treatment. The study was guided by the concepts of the protection motivation theory. Data was collected from 348 HCWs and analysed by means of logistic regression. Results showed that 65.8% of the HCWs had practiced HIV self-testing among themselves. Age, self efficacy and response efficacy were found to be significant predictors of HIV self-testing. Willingness to access HIV psychosocial support (71.3%) and care and treatment (73.9%) was high. Self-testing is highly practiced by HCWs. / Public Health / M.A. (Public Health)