Thesis (M.S.)--University of Michigan, 1987.

This study was designed to examine the status of public health nursing in British Columbia's Provincial Health Service during the period from 1939 to 1959. Based on the social history approach, the focus of the study was public health nursing and influences on its evolution during the selected period. The historical method was used to collect and analyze data from various primary and secondary sources; these included annual reports of provincial health units, annual reports of the Division of Public Health Nursing, journal articles, and oral histories. Data were subjected to content analysis to reveal themes relevant to the topic. Several important factors were identified that had affected the development of public health nursing during the selected period. Data were categorized according to the various influences and research notes were written as a basis for the historical account. The presentation of findings included descriptions of the organization of public health services in the province and the role of the public health nurse. This was followed by a discussion of the forces and their impact on public health nursing. The study's conclusions were drawn from the analysis of the historical data within the social context of the time. During the 1939 to 1959 period, some of the major influences on provincial public health nursing were basic education for public health nurses, staff development on the job, the demand for services, and the supply of qualified personnel. Other factors were the social and political forces of the time, the health care system, and the role of voluntary agencies in public health care. Although public health nursing faced a number of problems, these were overcome to a large extent through creative strategies that promoted collegiality among staff and enhanced job satisfaction. Public health nurses had a strong sense of identity and were respected because their work contributed to improving the health of the communities they served. / Applied Science, Faculty of / Nursing, School of / Graduate

In this study, systematic reflection in professional practice is seen as a dynamic process towards socio-political action, negating a navel-gazing critique. Positioned within nursing, the pioneering narrative inquiry approach will be highly valuable in medicine, education and other health fields. When I embarked on this study, research to guide me in homeless health care was limited and there is, even yet, insufficient evidence to demonstrate the effectiveness of advanced nursing practice in England particularly with homeless people. Through its reflexive narrative nature that research gap is addressed in a profound journey that illuminates my transformation over a three year period of being and becoming a Specialist Public Health Nurse (homelessness). The methodology draws dynamically on an eclectic, philosophical framework which includes reflective practice/guidance, narrative inquiry, hermeneutics, aesthetics, critical social science theory, storytelling, performance-ethnography and ancient wisdom. The Six Dialogical Movements (Johns, 2009) provides coherence to the twenty-one practice experiences that adequately marked my transformation towards my practice vision. I used the Being Available Template (Johns, 2009) as a reflexive framework which became the metaphoric net of my practice, showing where and how homeless people fall through the net of care, and my role in weaving a stronger net. I also drew on the work of Belenky et al's (1986) voice perspectives to show empowerment in my specialist role. Within the narrative, each story illuminates complexity and brings new knowledge about homeless health care. The study tangibly links childhood trauma to adult homelessness; it illuminates suffering in homelessness, showing where and how mainstream health professionals contribute to suffering when they do not grasp their role within the net, perpetuating homelessness. Appreciating precarious engagement in four quadrants: health services, homeless services, the homeless person and my SPHN role, is a concept that illuminates the precariousness of the net. The study concludes with a SPHN Homeless Health Care Model. Towards an ensuing social action through dialogue, I use the term 'audiencing' rather than transferability of findings. Hearing stories from 'street to boardroom' - making the invisible visible - has been profound in health services as evidenced in the narrative.

A exequibilidade das atribuições dos enfermeiros de Saúde Pública da Secretaria de Estado da Saúde de São Paulo foi avaliada mediante um questionário em que se solicitava aos respondentes que traduzissem seu julgamento quanto a esse grau de exequibilidade, consignando notas com o seguinte significado: O - totalmente inexequível, 1 - exequível com dificuldades, 2 - plenamente exequível. Também se solicitava que fossem indicadas as atribuições consideradas mais importantes, em cada função, e que fosse avaliada a importância relativa das funções. Foram incluídas 35 atribuições, distribuídas por cinco funções: administrativa (19); educativa (7); de pesquisa (2); assistencial (4) e de assessoria (3). Foram obtidas 122 respostas, sendo 59 (48 por cento ) provenientes de Centros de Saúde da Grande São Paulo e 63 (52 por cento ) do Interior. A plena exequibilidade das atribuições foi admitida, em 15 das 35, por menos de 50 por cento dos enfermeiros; em duas delas, essa percentagem não alcançou 30 por cento . Nas diferentes funções observou-se marcada discrepância entre o índice de exequibilidade de atribuições e o grau de importância que lhes foi conferido pelos enfermeiros. Fatores relacionados com caracteristicas dos Centros de Saúde (localização e tipo) e pessoais dos enfermeiros (idade, tempo de exercicio na Secretaria, formação profissional, especialização em Enfermagem de Saúde Pública e existência de obrigações familiares), mostraram-se capazes de influir, em graus variáveis, no julgamento, pelos enfermeiros, da exequibilidade das atribuições. Na avaliação pelos enfermeiros, a função assistencial foi considerada a mais importante, seguindo-se, na ordem, a educativa, a administrativa, a de pesquisa e a de assessoria. Foram examinadas as dificuldades arroladas pelos enfermeiros para a execução das atribuições, destacando-se a falta de recursos humanos e materiais, insuficiência de enfermeiros, despreparo de pessoal auxiliar, excesso de demanda e de reuniões, grande número de atribuições para a enfermeira e a pouca organização da comunidade. / The assignments of Public Health Nurses belonging to the State Health Department were estimated as to their feasibility through a questionnaire where the respondents were asked to give their judgment on the degree of this feasibility, consigning scores according to the following criteria: O - totally unfeasible; 1 - feasible with some difficulties; 2 - completely feasible. The respondents were also asked to indicate, in each function, the assignments they considered more important as well as to evaluate the relative importance of their functions. Thirty five assignments were included, distributed among five functions: administrative (19); educative (7); researching (2); assistential (4) and of assessorship (3). A hundred and twenty two answers were achieved, being 59(48 per cent ) from Health Centers belonging to the Great São Paulo and 63(52 per cent ) from the Inland. The assignment \"complete feasibility\" was admitted in 15 of the 35 answers by less than 50 per cent of the nurses; in two of them, this percentage did not reach 30 per cent . Marked discrepancies were observed between the rates of feasibility of assignements and the degree to importance attributed by the nurses regarding the different functions. Factors related to the Health Centers characteristics (Localization and type) and those personal ones related to the nurses (age, time of practice along the Department, professional background, specialization in Public Health Nursing, and the existence of family responsibilities), showed themselves able to exercise influence, in variable degrees, upon the nurses\' judgment on the assignments feasibility. According to the nurses\' evaluation, the assistential function was considered the most important one, following, in a decreasing order, the educative, the administrative and those related to research and assessorship. The difficulties rolled up by the nurses for the feasibility of the assignments were examined, deserving being emphasized the following ones: lack on human and material resources; insufficience of nurses; inadequate preparation of the auxiliary personnel; excessive demand and number of meetings; an overload of assignments upon the nurse; and little community organization.

Thesis (M.S.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / 2031-01-01

A identificação do enfermeiro na força de trabalho de Enfermagem de Saúde Pública, no Departamento Regional de Saúde 6 de Ribeirão Preto da Secretaria de Estado da Saúde, destacando e analisando alguns aspectos que o caracterizam, constituiu o objetivo geral deste trabalho. Util izou-se, como fonte primária e direta de coleta de dados um questionário, cujo conteúdo incluía: dados de identificação, nível de formação, progressão funcional, funções, expectativas futuras, quanto ao exercício profissional e filiação à órgãos de classe. A totalidade do grupo estudado (35) era do sexo feminino, predominado: o grupo etário de 20 a 30 anos (40,0 por cento ), as casadas (51,5 por cento ), e com tempo de serviço entre zero a 15 anos (77,2 por cento ). Com referência à sua interproporcionalidade com as demais categorias, as enfermeiras se dtstribuiam nas seguintes relações: 1 enfermeira/13,5 pessoal auxiliar e 1 enfermeira/8,1 médicos. Quanto à formação profissional, 68,5 por cento realizaram habilitação em Enfermagem de Saúde Pública e 8,6 por cento , Especialização em Saúde Pública. Não havia para as enfermeiras carreira nem quadro e seus vencimentos estavam entre 2 e 7 salários mínimos e apenas uma com 10. Todas (100 por cento ) rejeitaram o processo de avaliação de desempenho. A função administrativa é exercida por todas as enfermeiras com predomínio de freqüência entre as inspetoras e de CS, 68,5 por cento . A de assistência de enfermagem, teve sua maior freqüência (73,3 por cento ) entre as chefes e/ou com encarregatura. Há indícios de desvios de funções e o grupo identificou como fator preponderante que as impede de cumprí-las, a própria estrutura técnico-administrativa, que indicou como sendo a área mais carente de reformulação. As enfermeiras sentem-se preparadas paraa participarem dos programas de assistência primária e 84,3 por cento delas pretendem permanecer em exercício até a aposentadoria. Estavam associadas às entidades de classe nas seguintes freqüências: Associação Brasileira de Enfermagem 29,4 por cento , Associação Profissional dos Enfermeiros do Estado de São Paulo, 23,5 por cento e Conselho Regional de Enfermagem, 100,0 por cento . / The general purpose of this study was the identification of the nurse withim the work force of public health nursing in the regional Health Department of Ribeirão Preto of the State Health Secretariat. A questionaire, the options of which include: identification, level of training, progress in carreer, function, future professional expectations and membership of professional associations, was the chief data source. Of the group studied (35) were female of which 40 per cent were between 20 and 30 years old; 51.5 per cent were married and 77.2 per cent had been in service for zero up to fifteen years. Regarding the other categories, the distribution was as follows: 1 nurse per 13.5 assistants; 1 nurse per 8. I doctors. Concerning progessional training, 68.5 per cent were qualified In Public Health Nursing and 8.6 per cent specialized in public health. No carreer opportunities were available in the nursing profession and their salaries ranged from 2 to seven minimum salaries, only one receiving l0 All (100 per cent ) condemned the system of performance assessment. All nurses performed largely administrative services, the inspectors some 65 per cent of their time. Among nursin assistants this percentage rase to 73.3 per cent for those in charge. There was evidence of inapproprate task allocation, the chief factor being the technical/administrative infrastructure itself, this being the area most in need of reform. The nurses were prepared to participate in primary care programmes and 84.3 per cent intended to remain in service until retirement. They were members of various professional associations,the most frequent being: Brazilian Nursing Association (Associação Brasileira de Enfermagem) 29,4 per cent , Professional Nurses Association or the State of São Paulo (Associação Profissional de Enfermeiros do Estado de São Paulo) 23.5 per cent and Regional Nursin Council (Conselho Regional de Enfermagem) 100 per cent .

A exequibilidade das atribuições dos enfermeiros de Saúde Pública da Secretaria de Estado da Saúde de São Paulo foi avaliada mediante um questionário em que se solicitava aos respondentes que traduzissem seu julgamento quanto a esse grau de exequibilidade, consignando notas com o seguinte significado: O - totalmente inexequível, 1 - exequível com dificuldades, 2 - plenamente exequível. Também se solicitava que fossem indicadas as atribuições consideradas mais importantes, em cada função, e que fosse avaliada a importância relativa das funções. Foram incluídas 35 atribuições, distribuídas por cinco funções: administrativa (19); educativa (7); de pesquisa (2); assistencial (4) e de assessoria (3). Foram obtidas 122 respostas, sendo 59 (48 por cento ) provenientes de Centros de Saúde da Grande São Paulo e 63 (52 por cento ) do Interior. A plena exequibilidade das atribuições foi admitida, em 15 das 35, por menos de 50 por cento dos enfermeiros; em duas delas, essa percentagem não alcançou 30 por cento . Nas diferentes funções observou-se marcada discrepância entre o índice de exequibilidade de atribuições e o grau de importância que lhes foi conferido pelos enfermeiros. Fatores relacionados com caracteristicas dos Centros de Saúde (localização e tipo) e pessoais dos enfermeiros (idade, tempo de exercicio na Secretaria, formação profissional, especialização em Enfermagem de Saúde Pública e existência de obrigações familiares), mostraram-se capazes de influir, em graus variáveis, no julgamento, pelos enfermeiros, da exequibilidade das atribuições. Na avaliação pelos enfermeiros, a função assistencial foi considerada a mais importante, seguindo-se, na ordem, a educativa, a administrativa, a de pesquisa e a de assessoria. Foram examinadas as dificuldades arroladas pelos enfermeiros para a execução das atribuições, destacando-se a falta de recursos humanos e materiais, insuficiência de enfermeiros, despreparo de pessoal auxiliar, excesso de demanda e de reuniões, grande número de atribuições para a enfermeira e a pouca organização da comunidade. / The assignments of Public Health Nurses belonging to the State Health Department were estimated as to their feasibility through a questionnaire where the respondents were asked to give their judgment on the degree of this feasibility, consigning scores according to the following criteria: O - totally unfeasible; 1 - feasible with some difficulties; 2 - completely feasible. The respondents were also asked to indicate, in each function, the assignments they considered more important as well as to evaluate the relative importance of their functions. Thirty five assignments were included, distributed among five functions: administrative (19); educative (7); researching (2); assistential (4) and of assessorship (3). A hundred and twenty two answers were achieved, being 59(48 per cent ) from Health Centers belonging to the Great São Paulo and 63(52 per cent ) from the Inland. The assignment \"complete feasibility\" was admitted in 15 of the 35 answers by less than 50 per cent of the nurses; in two of them, this percentage did not reach 30 per cent . Marked discrepancies were observed between the rates of feasibility of assignements and the degree to importance attributed by the nurses regarding the different functions. Factors related to the Health Centers characteristics (Localization and type) and those personal ones related to the nurses (age, time of practice along the Department, professional background, specialization in Public Health Nursing, and the existence of family responsibilities), showed themselves able to exercise influence, in variable degrees, upon the nurses\' judgment on the assignments feasibility. According to the nurses\' evaluation, the assistential function was considered the most important one, following, in a decreasing order, the educative, the administrative and those related to research and assessorship. The difficulties rolled up by the nurses for the feasibility of the assignments were examined, deserving being emphasized the following ones: lack on human and material resources; insufficience of nurses; inadequate preparation of the auxiliary personnel; excessive demand and number of meetings; an overload of assignments upon the nurse; and little community organization.

Thesis--American University. / eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references.

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