Bakgrund: Risken att insjukna i depression vid något tillfälle i Sverige, ligger på cirka 23 procent för män och cirka 31 procent för kvinnor. Efter första episoden av depression, ligger risken för att återinsjukna på cirka 50 procent. När en förälder har drabbats av depression, kan det påverka övriga familjemedlemmar, då det oftast är någon av föräldrarna som har det största ansvaret inom familjen och för ekonomin.Syfte: Syftet var att beskriva barns upplevelser av att leva med en förälder som har depression.Metod: En systematisk litteraturstudie med induktiv ansats har använts. Både kvalitativa och kvantitativa artiklar inkluderades och kvalitativ innehållsanalys beskriven av Lundman & Hällgren Graneheim användes vid analysen.Resultat: Analysen resulterade i fyra kategorier: Behov av copingstrategier, Olika insikter, En förändrad tillvaro och Behov av hjälp. Barn som distanserade sig från sin förälder, upplevde det som ett sätt att skydda sig själva. En del barn hade dålig insikt om förälderns depression, de berättade att de inte märkte att något annorlunda eller fel. Barn anpassade sig efter situationen och utvärderade effekten av sin anpassning, de justerade sina handlingar efter det. Familjen samtalade sällan om förälderns depression och barnen fick inte någon information.Slutsats: Barn distanserade sig i både positiv och negativ bemärkelse. Vissa barn hade insikt i förälderns depression och anpassade sig utefter den, medan andra förnekade dess existens eller inte förstod sjukdomen. Barnen fick ett ökat ansvar i hemmet vilket resulterade i ett försämrat mående. En positiv aspekt var att vissa barn hävdade att de hade blivit starkare som person och fått mer empati för andra människor. Den allmänna sjukvården hade otillräcklig kunskap och resurser vid bemötande av barn som anhörig, vilket kan åtgärdas med mer utbildning och vidare forskning av problemområdet.

Flertalet vårdpersonal inom hälso- och sjukvården kommer på något sätt i kontakt med IT- systemen dagligen, främst genom journalskrivning men även läkemedelshantering och kommunikation med andra yrkesgrupper. Enligt tidigare forskning väntas IT bli starkare i framtiden, det vill säga att det förväntas användas mer i det dagliga arbetet, emellertid uppger vårdpersonal att de upplever svårigheter när de använder systemen i sitt arbete. Systemen saknar lämpliga funktioner som stödjer kliniska uppgifter, vidare kräver systemet att läkare utför samma steg upprepande gånger med alla patienter vilket gör dokumentationen negativt laddat. Vidare får vårdpersonal ont i rörelseapparaten samt svårigheter med stress och trötthet. Syftet med studien är att få svar på om det finns ett samband mellan IT- systemen som används inom hälso- och sjukvården och sjuksköterskors hälsa. Studien har en kvantitativ inriktning, med fokus på enkätutskick på vårdcentraler, mottagningar samt barnavårdcentral runt om i Skåne. Undersökningsgruppen bestod av 93 stycken män och kvinnor i åldrarna 18 år upp till över 55 år som arbetar som sjuksköterskor i skåneregionen. Majoriteten av undersökningsdeltagarna arbetade inom offentlig sektor, vidare använde övervägande antal IT- systemet fler än 16 gånger per dag. Enkäterna fylldes i på plats i verksamheten, även internetenkäter tillämpades som ett alternativ på grund av lättillgängligheten. För att analysera enkätformuläret använde vi oss av en regressionsanalys samt Pearsons korrelationstest. I resultaten kunde vi se att det finns ett samband mellan sjuksköterskors hälsa och användandet av IT- systemen inom hälso – och sjukvården i skåneregionen. Avslutningsvis är studien ett intressant tillägg till den i övrig sparsamma forskningen som använts och finns sedan tidigare, och som visar att IT- miljön måste förbättras för att vårdpersonalen ska bibehålla sin hälsa.

Med ett mål att förbättra ledarskapet använder ett stort antal verksamheter diverse ledarskapsutbildningar. Målet med ledarskapsutbildningarna var att förbättra chefers hälsofrämjande ledarskap. Kan chefer verka hälsofrämjande och då skapa en bättre arbetsmiljö kan detta bland annat ge gynnsamma effekter på minskat behov av nyrekrytering. Autentiskt ledarskap har tidigare visat sig ha positiva effekter på medarbetares hälsa och kan ses som en typ av hälsofrämjande ledarskap. Syftet med denna interventionsstudie är att studera om det hälsofrämjande ledarskapsprogrammet främjar ett autentiskt ledarskap. Metoden har varit att analysera en interventionsgrupps självskattade effekter på sitt autentiska ledarskap i förhållande till en kontrollgrupp. Detta har skett i områdena självmedvetenhet, relationell transparens, balanserad processhantering och internaliserat moraliskt perspektiv med det beprövade instrumentet Authentic Leadership Questionnaire (ALQ). Analysen har genomförts med den statistiska metoden ANCOVA. Studiens deltagare var chefer inom vård och omsorg som studerat vid en hälsofrämjande ledarskapsutbildning. Av de 86 deltagarna ingick 42 i interventionsgruppen och 44 i icke-lika kontrollgruppen. Inget av de analyserade områdena visade på någon signifikant förbättring efter genomgången intervention även om resultatet får relateras till problemet med reliabiliteten. En bidragande orsak till avsaknaden av ett signifikant resultat kan vara bristande reliabilitet i instrumentet som användes. Slutsatsen är att det inte har kunnat identifierats någon signifikant inverkan på deltagarnas förmåga att utöva ett autentiskt ledarskap.

In Sweden, turnover among healthcare professionals is a significant problem in hospital settings. Efficient leadership of healthcare professionals is vital for enhancing the quality and integration of healthcare. Authentic leadership (AL) is a relational leadership style instigated from the field of positive organizational conduct and is asserted to advocate healthy work environments that impact healthcare professional’s efficiency and positive organizational outcomes. This master’s thesis aims to describe the impact of AL on the work environment and patient outcomes in hospital settings. The method is a literature study. Peer-reviewed English or Swedish articles that examined the impact of AL on the work environment and patient outcomes in hospital settings were selected from seven databases. Quality appraisal, data extraction, and analysis were accomplished on the included studies. A total of 26 articles (n=24 quantitative, n=1 qualitative and n=1 mixed method) satisfied the inclusion criteria. Results were evaluated according to the literature review content analysis. Findings support positive relationships between AL and increased optimism and trust among healthcare professionals, job satisfaction and turnover, patient care quality, structural empowerment, and work engagement. Findings were, therefore, consistent with AL theory. Future studies using more diversity in research themes, settings, study populations, organizations, job areas, geographic origins, and theory context are merited. People in positions of influence in healthcare settings and healthcare practitioners can use the findings of this study as a guide to increase awareness of the processes by which AL promotes positive outcomes in the workplace.

No description available.

Bakgrund. Patientbesöken på svenska akutmottagningar ökar. Med ett ökat inflöde av patienter ökar även kraven på vårdpersonalen som arbetar på akutmottagningen. Vid obalans mellan in-, genom- och utflöde skapas risker för crowding, med konsekvenser som ökade väntetider för patienterna, ökade patientsäkerhetsrisker och lidande som följd. Akutsjuksköterskans ansvarsområden innefattar kunskap om patientflöden, patientsäkerhet och att lindra lidande. Ändå finns mycket lite nationell forskning om patientflöden till akutmottagningar. Syfte. Syftet med studien var att studera inflödet av patienter till akutmottagningarna vid ett länssjukhus och ett länsdelssjukhus. Metod. Studiens genomfördes som en kvantitativ punktprevalensstudie med en induktiv ansats. Studien innefattar analys av data från två akutmottagningar inom Region Dalarna, n=201. Resultat. Över 70 procent av patienterna som sökte till akutmottagningarna hade haft en tidigare vårdkontakt. Det var vanligast att yngre patienter hade sökvägen eget initiativ och att äldre hade sökvägen ambulans. Det var fler män än kvinnor som kom från vårdcentralen med remiss. Patienter som hade en annan vårdkontakt före besöket hade en högre medicinsk prioritet eller högre risk för inläggning än de patienter som kom på eget initiativ. Slutsats. Ett fysiskt möte med annan vårdpersonal kan ha stor betydelse för att minska inflödet av patienter till akutmottagningen. Att en stor del av patienterna blir hänvisade till akutmottagningen kan vara ett tecken på att det saknas kapacitet inom hälso- och sjukvården för att behandla patienter med icke akuta besvär. / Background. Patient flows to Swedish emergency departments are increasing. With an increased inflow of patients, the demands on the healthcare staff at the emergency department increase. With a discrepancy between in-, through- and outflow, risks of crowding are created, with consequences such as increased waiting times for patients, increased patient safety risks and suffering as a result. The emergency nurse's responsibility includes knowledge of patient flows, patient safety and alleviation of suffering. Nevertheless, there is little research about patient flows to the emergency department nationally. Purpose. The purpose of the study was to study the inflow of patients to the emergency departments at two regional hospitals. Method. The study was conducted as a quantitative point-prevalence study with an inductive approach. The analysis includes an analysis of data from two emergency departments in Region Dalarna, n = 201. Results. Over 70 percent of the patients that presented to the emergency departments had a previous healthcare contact. It was most common that younger patients used their own initiative and that elderly presented by ambulance. There were more men than women who came from community health centres with referral. Patients who had another healthcare contact before the visit had a higher medical priority or risk of admittance to the hospital than the patients who came on their own initiative. Conclusion. A physical meeting with healthcare staff can be of great importance for reducing the inflow of patients to the emergency department. It may be that there is a low capacity in the health care system to treat low-acuity patients.

Made available in DSpace on 2016-08-10T10:49:50Z (GMT). No. of bitstreams: 1 TATIANE OLIVEIRA SILVA.pdf: 2209275 bytes, checksum: 87ef9c00b793521642f362c0b79fffa4 (MD5) Previous issue date: 2012-03-27 / Waste management is a worldwide problem, specially the waste that comes from health services (RSS). Although it does not represent the largest quantity, it can be considered one of the most dangerous, because of its pathogenic, toxic and carcinogenic characteristics. Within this perspective this research is concerned about investigating the Public management of RSS in the municipality of Goiânia, in order to assess whether the management of this waste has been implemented in a planned, sustainable and respectful environmental legislation. It was possible to accomplish this research through literature, documents researches, some visits to the Landfill of Goiânia, public agencies and interviews with municipal managers.So we can verify that the current acts made by the federal, the state and the municipal levels are not consistent neither updated according to the National Policy on Solid Waste yet.Furthermore, the city of Goiânia is a risky society , and it happens because of RSS has not been done in a planned, efficient and legal way, which can represent a risk for the environment and public health. So it represents threats to nature and also to socio, economic, scientific and political matters, because it does not have a time deadline or space limits. Even up against the actual situation, the reality of this city can be changed through the addition of urban planning in the management of Goiânia RSS. / A gestão de resíduos é uma problemática mundial, principalmente os Resíduos de Serviços de Saúde (RSS) que apesar de não se apresentarem em grandes quantidades é o de maior periculosidade, por conta de suas características de patogenicidade, carcinogenicidade e toxidade. Dentro dessa perspectiva a presente pesquisa preocupou-se em investigar a Gestão Pública dos RSS no Município de Goiânia, de modo a avaliar se o gerenciamento desses resíduos, tem sido executado de forma planejada, sustentável e respeitando a legislação ambiental. A pesquisa foi realizada através de pesquisas bibliográfica e documental, visitas ao Aterro Sanitário de Goiânia e demais órgãos públicos e entrevistas com gestores municipais. Dessa forma, pode-se constatar que os atuais atos normativos, em âmbito federal, estadual e municipal ainda não se encontram em consonância e atualizados de acordo com a Política Nacional de Resíduos Sólidos. E ainda, que o Município de Goiânia representa uma sociedade de risco , pois a gestão de RSS não é realizada de forma planejada, eficiente e legal, colocando em risco o meio ambiente e a saúde pública, dessa forma representando ameaças à natureza que se transformam em ameaças sociais, econômicas, científicas e políticas, por não apresentarem limites temporais e espaciais. Mas mesmo diante de tal situação, essa realidade pode ser transformada por meio da inclusão do planejamento urbano na Gestão dos RSS de Goiânia.

Refugee resettlement to the United States has decreased tremendously since 2017. This study investigates whether, and how, resettlement and health organization in New York are facilitating the distribution of health resources and how they are integrating refugees into becoming self-sufficient in the United States. Refugees have a right to many resources upon arrival in the United Stated especially health resources. Through case studies, this thesis examines two organizations contribution to changing the health status of refugees and the strategies that they implement to help refugees. Findings show that both organizations examined contribute to assist refugees to improve access to the health care. Findings also reveal many strategies for the facilitation of integration, the most prominent factor being interaction between organizations and refugees upon resettlement.

O controle da tuberculose implica em organizar serviços de saúde para realizar ações de diagnóstico de forma integrada e colaborativa. O estudo objetivou avaliar a efetividade dos diferentes serviços de saúde no diagnóstico da tuberculose no município de Foz do Iguaçu, PR. Realizou-se uma pesquisa avaliativa com desenho epidemiológico do tipo corte transversal. Foram entrevistados 101 doentes de tuberculose diagnosticados no município com população estimada de 325.137 mil habitantes, localizado na tríplice fronteira Brasil- Paraguai-Argentinha, nos meses de janeiro a novembro de 2009. O instrumento de coleta foi baseado no \"The Primary Care Assessment Tool\" (PCAT), adaptado para a atenção à tuberculose. Os dados foram analisados por meio de técnicas de análise descritiva (frequência absoluta e relativa). A efetividade foi avaliada pela ocorrência do diagnóstico da tuberculose no primeiro serviço de saúde procurado pelo doente, e a seguir foram construídos indicadores para avaliar os tipos de serviços de saúde frente às ações de diagnóstico. Verificou-se ainda o número de vezes que o doente foi ao serviço até receber o diagnóstico da tuberculose e o tempo decorrido entre o primeiro contato com o serviço e a ocorrência do diagnóstico. Os resultados das análises foram contextualizados pelas dimensões acessibilidade e desempenho. A proporção de doentes que conseguiram consulta no mesmo dia foi superior a 70% em todos os serviços. Verificou-se que o primeiro serviço de saúde procurado pelo doente que obteve maior percentual na suspeição da tuberculose, alcançou 46%. A solicitação de exames de escarro ocorreu em 50% dos doentes nos três tipos de serviços de saúde. O percentual de exames de raios-X solicitado foi de 30% no Pronto Atendimento, sendo o melhor resultado entre os três tipos de serviços no momento da primeira consulta. O encaminhamento dos doentes para consultas e realização de exames em outras unidades foi um recurso utilizado em todos os serviços. As unidades de Atenção Básica à Saúde encaminharam 75% dos doentes para a realização de exame de raios-X, apresentando associação estatística significante (p<0,05). Na Atenção Básica à Saúde, 75% dos doentes tiveram que retornar cinco vezes ao serviço de saúde. Nos Serviços Especializados, o tempo para a realização do diagnóstico foi de sete dias (mediana). Concluiu-se que os serviços de saúde escolhidos como primeira opção pelo doente não foram efetivos na suspeita e diagnóstico da tuberculose, indicando barreiras ligadas à estrutura e ao processo de controle da doença. Existe a necessidade de organizar ações de educação permanente e incrementar a estrutura dos serviços de saúde com o intuito de melhorar a capacidade diagnóstica. O serviço com maior efetividade para oferecer o diagnóstico da tuberculose foram os Serviços Especializados. / Tuberculosis control involves organizing health services to perform diagnostic actions in an integrated and collaborative way. The study aimed to evaluate the effectiveness of different health services in the diagnosis of tuberculosis in the city of Foz do Iguaçu- PR, with an estimated population of 325,137,000 inhabitants, located in the triple border between Brazil- Paraguay-and Argentina, in the months from January to November 2009. It was carried out an epidemiological evaluation research with cross-sectional where 101 patients were diagnosed as having tuberculosis The instrument was based on \"The Primary Care Assessment Tool\" (PCAT), adapted for tuberculosis care. Data were analyzed using descriptive analysis techniques (absolute and relative frequency). Effectiveness was assessed by the finding of the tuberculosis in the first diagnosis in first health service that the patient had visited, and then were constructed indicators to evaluate the kind of health services in the face of diagnostic actions. It was also found the number of times the patient visited the health service from the first time to the diagnosis of tuberculosis and the time spent for that The test results were contextualized by the dimensions of accessibility and performance.The number of patients who had medical care the same day of the first visit in all health services was higher than 70%. It was found that the first health service visited by the patient who had the highest percentage on suspicion of tuberculosis, reached 46%. The request for sputum tests occurred in 50% of patients in three kinds of health services. The percentage of X-rays has been 30% in the Emergency Care, the best result among the three kinds of services at the first medical visit. The referral of patients for consultations and examinations in other emergency units was a resource used in all services. Primary Care Units forwarded 75% of patients to the X-rays exam, showing a statistically significant association (p <0.05). In Primary Health Care, 75% of patients had to return five times the health service. In Specialized Services, the time of the diagnosis was seven days (median). It was concluded that the health services as the first option chosen by the patient were not effective in suspicion and diagnosis of tuberculosis, indicating barriers for to the structure and process of controlling the disease. It is necessary to organize permanent education actions and improve the structure of health services in order to improve the diagnostic capacities .The most effective services to provide the diagnosis of tuberculosis were the Specialized Services. Keywords:

O controle da tuberculose implica em organizar serviços de saúde para realizar ações de diagnóstico de forma integrada e colaborativa. O estudo objetivou avaliar a efetividade dos diferentes serviços de saúde no diagnóstico da tuberculose no município de Foz do Iguaçu, PR. Realizou-se uma pesquisa avaliativa com desenho epidemiológico do tipo corte transversal. Foram entrevistados 101 doentes de tuberculose diagnosticados no município com população estimada de 325.137 mil habitantes, localizado na tríplice fronteira Brasil- Paraguai-Argentinha, nos meses de janeiro a novembro de 2009. O instrumento de coleta foi baseado no \"The Primary Care Assessment Tool\" (PCAT), adaptado para a atenção à tuberculose. Os dados foram analisados por meio de técnicas de análise descritiva (frequência absoluta e relativa). A efetividade foi avaliada pela ocorrência do diagnóstico da tuberculose no primeiro serviço de saúde procurado pelo doente, e a seguir foram construídos indicadores para avaliar os tipos de serviços de saúde frente às ações de diagnóstico. Verificou-se ainda o número de vezes que o doente foi ao serviço até receber o diagnóstico da tuberculose e o tempo decorrido entre o primeiro contato com o serviço e a ocorrência do diagnóstico. Os resultados das análises foram contextualizados pelas dimensões acessibilidade e desempenho. A proporção de doentes que conseguiram consulta no mesmo dia foi superior a 70% em todos os serviços. Verificou-se que o primeiro serviço de saúde procurado pelo doente que obteve maior percentual na suspeição da tuberculose, alcançou 46%. A solicitação de exames de escarro ocorreu em 50% dos doentes nos três tipos de serviços de saúde. O percentual de exames de raios-X solicitado foi de 30% no Pronto Atendimento, sendo o melhor resultado entre os três tipos de serviços no momento da primeira consulta. O encaminhamento dos doentes para consultas e realização de exames em outras unidades foi um recurso utilizado em todos os serviços. As unidades de Atenção Básica à Saúde encaminharam 75% dos doentes para a realização de exame de raios-X, apresentando associação estatística significante (p<0,05). Na Atenção Básica à Saúde, 75% dos doentes tiveram que retornar cinco vezes ao serviço de saúde. Nos Serviços Especializados, o tempo para a realização do diagnóstico foi de sete dias (mediana). Concluiu-se que os serviços de saúde escolhidos como primeira opção pelo doente não foram efetivos na suspeita e diagnóstico da tuberculose, indicando barreiras ligadas à estrutura e ao processo de controle da doença. Existe a necessidade de organizar ações de educação permanente e incrementar a estrutura dos serviços de saúde com o intuito de melhorar a capacidade diagnóstica. O serviço com maior efetividade para oferecer o diagnóstico da tuberculose foram os Serviços Especializados. / Tuberculosis control involves organizing health services to perform diagnostic actions in an integrated and collaborative way. The study aimed to evaluate the effectiveness of different health services in the diagnosis of tuberculosis in the city of Foz do Iguaçu- PR, with an estimated population of 325,137,000 inhabitants, located in the triple border between Brazil- Paraguay-and Argentina, in the months from January to November 2009. It was carried out an epidemiological evaluation research with cross-sectional where 101 patients were diagnosed as having tuberculosis The instrument was based on \"The Primary Care Assessment Tool\" (PCAT), adapted for tuberculosis care. Data were analyzed using descriptive analysis techniques (absolute and relative frequency). Effectiveness was assessed by the finding of the tuberculosis in the first diagnosis in first health service that the patient had visited, and then were constructed indicators to evaluate the kind of health services in the face of diagnostic actions. It was also found the number of times the patient visited the health service from the first time to the diagnosis of tuberculosis and the time spent for that The test results were contextualized by the dimensions of accessibility and performance.The number of patients who had medical care the same day of the first visit in all health services was higher than 70%. It was found that the first health service visited by the patient who had the highest percentage on suspicion of tuberculosis, reached 46%. The request for sputum tests occurred in 50% of patients in three kinds of health services. The percentage of X-rays has been 30% in the Emergency Care, the best result among the three kinds of services at the first medical visit. The referral of patients for consultations and examinations in other emergency units was a resource used in all services. Primary Care Units forwarded 75% of patients to the X-rays exam, showing a statistically significant association (p <0.05). In Primary Health Care, 75% of patients had to return five times the health service. In Specialized Services, the time of the diagnosis was seven days (median). It was concluded that the health services as the first option chosen by the patient were not effective in suspicion and diagnosis of tuberculosis, indicating barriers for to the structure and process of controlling the disease. It is necessary to organize permanent education actions and improve the structure of health services in order to improve the diagnostic capacities .The most effective services to provide the diagnosis of tuberculosis were the Specialized Services. Keywords: