Global ETD Search

41	Examining sexual and reproductive health needs of adolescents infected with HIV at Chiedza Child Care Centre, Harare, Zimbabwe Murimba, Lynnette 01 1900 (has links) The study examined the sexual and reproductive health needs of adolescents infected with HIV and AIDS. This was a qualitative study that involved semi-structured interviews and observation. The sampling method used was purposive and it entailed 10 adolescents (4 boys and 6 girls) who are living with HIV at Chiedza Child Care Centre in Zimbabwe. This study revealed that adolescents’ sexual and reproductive health needs are the desire to have sex, desire to have children, the need for prevention of unwanted pregnancy and care and treatment support. However, their knowledge of HIV and AIDS was inadequate. Adolescents also revealed their lack of proper information regarding their health care and treatment needs. However, adolescents illustrated an adequate knowledge of the services available for them for their health, treatment and care needs. The study recommended that there is need to strengthen the provision of information and services on adolescents’ sexual and reproductive health issues. The study also recommended that counsellors should improve their counselling skills so that they can empower adolescents living with HIV to be able to negotiate condom usage, matters of dating and handling relationships. / Sociology / M. A. (Social Behaviour Studies in HIV and AIDS) Adolescents living with HIV and AIDS Sexual needs Reproductive health needs Health care and treatment needs Youth friendly services Health care services 362.196979205081096891 Teenagers -- Sexual behavior -- Zimbabwe Chiedza Child Care Centre
42	Die medizinische Versorgung erwachsener Patienten mit Muskelerkrankungen Kuschel, Franziska 15 May 2006 (has links) Im Frühjahr/Sommer 2002 wurde eine Befragung von 51 erwachsenen Patienten im Raum Berlin-Brandenburg mit seltenen Muskelerkrankungen bzw. neuromuskulären Erkrankungen zu verschiedenen Aspekten der medizinischen Versorgung durchgeführt. Angewandte Methoden waren ein standardisierter Fragebogen sowie ein Leitfadeninterview. Vom ersten Arztbesuch bis zur in 59% der Fälle im Krankenhaus erfolgten Diagnosestellung einer Muskelerkrankung vergingen durchschnittlich 4,1 Jahre (Median: 1 Jahr). Es fanden sich eine unzureichende Anamneseerhebung und körperliche Untersuchung sowie eine mangelnde Überweisungsbereitschaft an Neurologen. Eine signifikante Verzögerung erlitten Patienten, die anstelle eines Hausarztes zunächst einen anderen Facharzt als den Neurologen aufgesucht hatten. 43% der Patienten hatten Schwierigkeiten, im Anschluss einen kompetenten Arzt für die Langzeitbetreuung zu finden. Fragen der Vererbbarkeit sowie der respiratorischen und kardialen Komplikationen wurden unzu! reichend besprochen. Im Verlauf erfolgte eine mangelnde Überwachung der respiratorischen sowie kardialen Funktion. Die Verordnung von Physiotherapie und Hilfsmitteln wurde dagegen gut bewertet. Bei 51% der Patienten kam es auch nach der Diagnosestellung zu Krankenhausaufenthalten. 22% der Patienten mussten wegen Komplikationen stationär behandelt werden. Insgesamt zeigten sich Defizite in der medizinischen Versorgung, wie sie z.T. bereits in Expertenstellungnahmen bzw. wenigen anderen Studien berichtet wurden. Für den Bereich der seltenen Erkrankungen gilt eine Spezialambulanz als geeignetes Versorgungsmodell, welches die spezialisierte, multidisziplinäre Betreuung der Patienten sichern soll. Solche Einrichtungen existieren mittlerweile in Deutschland, Outcome-Studien fehlen jedoch bisher. / In spring/summer 2002 a group of 51 adult patients in Berlin-Brandenburg suffering from a muscle or a neuromuscular disease were questioned concerning various aspects of their medical care. The applied methods were a standardized questionnaire and a qualitative interview. The average time between the first consultation of a physician and the establishment of the diagnosis of a muscle disease was 4,1 years (median: 1 year). 59% of the patients received their diagnosis at a hospital. An insufficient history-taking, lacks in the physical examination and a reluctance to refer the patient to a neurologist could be identified. There was a significant delay for those patients who initially consulted a non-neurological specialist instead of a general physician. 43% of the patients had difficulties in finding a qualified physician for the long-time care. The patients were insufficiently informed about the heredity of their disease and about possible respiratory and cardiac complicati! ons. There was a lack in following up the respiratory and cardiac functions of the patients. The prescription of physiotherapy and aids was rated positively by the patients. 51% of the patients had hospital stays also after having their diagnosis. 22% were admitted to hospital due to complications of their disease. In general, deficits in the medical care for these patients were shown, similar to those described in expert opinions or few preview studies. A specialized hospital-based outpatient centre that should ensure the specialized multidisciplinary care for the patients is regarded as the model for the medical care in the area of rare diseases. Similar centres exist in Germany by now, but there are no outcome-studies yet. Therapie medizinische Versorgung Muskelkrankheiten Neuromuskuläre Erkrankungen seltene Erkrankungen Patientenbefragung Interview Diagnosestellung Spezialambulanz medical care diagnosis myopathies muscle diseases neuromuscular diseases rare diseases patient survey interview treatment tertiary medical centre comprehensive care centre 610 Medizin 33 Medizin XG 7904 XG 7913 XG 7926 XG 7928 ddc:610
43	Assessment of patient's satisfaction with the health care services provided by the Crossroads Community Health Care Centre Van Niekerk, Pearl Christine 10 1900 (has links) The study aimed to explore and described the assessment of patient’s satisfaction with the quality of health care services rendered by the Crossroads Community Health Centre (CHCC). The target population comprised of adult male and female patients who have attended the clinic more than once. One hundred and twenty patients participated in the study. The convenience sampling method was used to select the respondents. A questionnaire was used to collect data. Validity and reliability were ensured. The Chronbach’s alpha reliability test was used to measure the internal consistency of the likert scale questionnaire items and was less than 0.4 for sections B-F, and 0.675 for section E. Descriptive and inferential data analysis was conducted using the Statistical Package for the Social Sciences 16.0 for Windows, release 16.0.1 with the assistance of a statistician. The findings indicated a positive perception of the quality of health care services rendered by the Crossroads CHCC. It was concluded that despite a positive perception of the health care services, there was a percentage of the respondents that rated the quality of the service as poor in relation to environmental cleanliness, staff attitudes, long waiting times, medications shortage, the complaints system reporting and health care service drainage to other CHCC where patient’s resided. The issue of quality improvement in these aspects was noted to be crucial and recommendations were made to improve the quality of the health care service at Crossroads CHCC. / Healh Studies / M.A. (Health Studies) Primary health care Patient satisfaction Community health care centre Assessment Quality health care and perception 610.734309687355 Clinics -- South Africa -- Cape Town
44	Literární dílna pedagoga volného času - vybraná tvorba Markéty Zinnerové / Literary workshop by leisure time educators - selected works by children´s book author Markéta Zinnerová JAŠKOVÁ, Eva January 2014 (has links) Abstract This dissertation is aimed at exploring the utilization of select works by children's book author Markéta Zinnerová in literary education. The selected texts all feature a child protagonist in a difficult life situation with regards to their immediate or wider family circle. The vantage point was primarily the ouvre of M. Zinnerová, particularly the titles Indiáni z Větrova ('The Indians from Větrov'), Tajemství proutěného košíku ('The Secret of the Woven Basket'), and Kde padají hvězdy ('Where Stars Fall'). The dissertation is divided into a theoretical and a practical part. The theoretical part contains first a description of the general characteristics of narrative prose from the life of children with an emphasis on the issues of personal and social education. Furthermore, it focuses in detail on the utilisation of prose in literary education in primary schools, the methodology and different types of literary analysis and the insertion of all these activities into the relevant curriculum. The practical part deals with concrete classical and activising methods of application with regards to select texts from M. Zinnerová's works. The aim of the dissertation was to create work sheets based on excerpts from the prose of this author and to test them in practice in the environment of an after-school care centre where primary school children were to engage with them. This part of the dissertation describes said work sheets as well as the procedural methodology and the reasoning behind their creation. The work sheets were used when working with 3rd -grade school children in an after-school care centre. The ways in which they cooperated with us and were captivated by the texts, as well as the precise way in which the activities involved in working with the proposed sheets proceeded are described in the following chapter of the practical part. The concluding reflection upon the utilisation of the work sheets proposes certain possible corrections, expansions or other possible uses of these work sheets.
45	Health for community dwelling older people : trends, inequalities, needs and care in rural Vietnam Van Hoi, Le January 2011 (has links) Background InVietnam, the proportion of people aged 60 and above has increased rapidly in recent decades. The majority live in rural areas where socioeconomic status is more disadvantaged than in urban areas.Vietnam’s economic status is improving but disparities in income and living conditions are widening between groups and regions. A consistent and emerging danger of communicable diseases and an increase of non-communicable diseases exist concurrently. The emigration of young people and the impact of other socioeconomic changes leave more elderly on their own and with less family support. Introduction of user fees and development of a private sector improve the coverage and quality of health care but increase household health expenditures and inequalities in health care. Life expectancy at birth has increased, but not much is known about changes during old age. There is a lack of evidence, particularly in rural settings, about health-related quality of life (HRQoL) among older people within the context of socioeconomic changes and health-sector reform. Knowledge of long-term elderly care needs in the community and the relevant models are still limited. To provide evidence for developing new policies and models of care, this thesis aimed to assess general health status, health care needs, and perspectives on future health care options for community-dwelling older people. Methods An abridged life table was used to estimate cohort life expectancies at old age from longitudinal data collected by FilaBavi DSS during 1999-2006. This covered 7,668 people aged 60 and above with 43,272 person-years. A 2007 cross-sectional survey was conducted among people aged 60 and over living in 2,240 households that were randomly selected from the FilaBavi DSS. Interviews used a structured questionnaire to assess HRQoL, daily care needs, and willingness to use and to pay for models of care. Participant and household socioeconomic characteristics were extracted from the 2007 DSS re-census. Differences in life expectancy are examined by socioeconomic factors. The EQ-5D index is calculated based on the time trade-off tariff. Distributions of study subjects by study variables are described with 95% confidence intervals. Multivariate analyses are performed to identify socioeconomic determinants of HRQoL, need of support, ADL index, and willingness to use and pay for models of care. In addition, four focus group discussions with the elderly, their household members, and community association representatives were conducted to explore perspectives on the use of services by applying content analysis. Results Life expectancy at age 60 increased by approximately one year from 1999-2002 to 2003-2006, but tended to decrease in the most vulnerable groups. There is a wide gap in life expectancy by poverty status and living arrangement. The sex gap in life expectancy is consistent across all socioeconomic groups and is wider among the more disadvantaged populations. The EQ-5D index at old age is 0.876. Younger age groups, position as household head, working, literacy, and belonging to better wealth quintiles are determinants of higher HRQoL. Ageing has a primary influence on HRQoL that is mainly due to reduction in physical (rather than mental) functions. Being a household head and working at old age are advantageous for attaining better HRQoL in physical rather than psychological terms. Economic conditions affect HRQoL through sensory rather than physical functions. Long-term living conditions are more likely to affect HRQoL than short-term economic conditions. Dependence in instrumental or intellectual activities of daily living (ADLs) is more common than in basic ADLs. People who need complete help are fewer than those who need some help in almost all ADLs. Over two-fifths of people who needed help received enough support in all ADL dimensions. Children and grand-children are confirmed to be the main caregivers. Presence of chronic illness, age groups, sex, educational level, marital status, household membership, working status, household size, living arrangement, residential area, household wealth, and poverty status are determinants of the need for care. Use of mobile teams is the most requested service; the fewest respondents intend to use a nursing centre. Households expect to use services for their elderly to a greater extent than did the elderly themselves. Willingness to use services decreases when potential fees increase. The proportion of respondents who require free services is 2 to 3 times higher than those willing to pay full cost. Households are willing to pay more for day care and nursing centres than are the elderly. The elderly are more willing to pay for mobile teams than are their households. ADL index, age group, sex, literacy, marital status, living arrangement, head of household status, living area, working status, poverty and household wealth are factors related to willingness to use services. Conclusions There is a trend of increasing life expectancy at older ages in ruralVietnam. Inequalities in life expectancy exist between socioeconomic groups. HRQoL at old age is at a high level, but varies substantially according to socioeconomic factors. An unmet need of daily care for older people remains. Family is the main source of support for care. Need for care is in more demand among disadvantaged groups. Development of a social network for community-based long-term elderly care is needed. The network should focus on instrumental and intellectual ADLs rather than basic ADLs. Home-based care is more essential than institutionalized care. Community-based elderly care will be used and partly paid for if it is provided by the government or associations. The determinants of elderly health and care needs should be addressed by appropriate social and health policies with greater targeting of the poorest and most disadvantaged groups. Building capacity for health professionals and informal caregivers, as well as support for the most vulnerable elderly groups, is essential for providing and assessing the services. / Aging and Living Conditions Program / Vietnam-Sweden Collaborative Program in Health, SIDA/Sarec older people elderly health health status life expectancy health-related quality of life EQ-5D mobility self-care usual activities pain discomfort anxiety depression activity of daily living basic ADL instrumental ADL intellectual ADL non-communicable diseases need of care health service model of care mobile team day care centre nursing centre inequalities cost of care socioeconomic education marital status living arrangement household head working status living area wealth quintile poverty line community cohort study household survey focus group discussion qualitative research rural Vietnam developing country Asia người cao tuổi y tế thực trạng sức khỏe hy vọng sống chất lượng cuộc sống EQ-5D đi lại tự chăm sóc hoạt động thường xuyên đau khó chịu lo lắng trầm cảm hoạt động hàng ngày bệnh không lây nhiễm nhu cầu chăm sóc dịch vụ y tế mô hình chăm sóc đội lưu động trung tâm chăm sóc ban ngày trung tâm dưỡng lão bất bình đẳng chi phí chăm sóc kinh tế xã hội giáo dục hôn nhân sắp xếp cuộc sống chủ hộ tình trạng làm việc khu vực sống ngũ phân thịnh vượng chuẩn nghèo cộng đồng nghiên cứu theo dõi dọc điều tra hộ gia đình thảo luận nhóm tập trung nghiên cứu định tính nông thôn Việt Nam nước đang phát triển châu Á

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