This thesis focuses on the topic: ?The Physical activity of persons with a focus on physician?. In the theoretical part of my thesis, I focus eg. on area history of kinesiology, motor skills and development, factors influencing physical activity or diseases caused by physical inactivity. The practical part of this work is to monitor physical activity among physicians from different sectors.To determine the level of physical activity was chosen IPAQ long for 100 doctors who participated in the monitoring. I selected 30 doctors, who for a week had individually set pedometer and write down your daily physical activity.

This study was designed to evaluate the quality of informed consent practiced by healthcare professionals in South Africa using an empirical quantitative methodology combined with medicolegal analysis to produce an interdisciplinary thesis on bioethics and medical law. Informed consent is an ethical and legal doctrine derived from the principle of respect for autonomy, whereas the rights to bodily integrity, privacy and human dignity are constitutionally protected in South Africa. The National Health Act 61 of 2003 codified requirements for informed consent by stipulating that healthcare providers must inform healthcare users about diagnosis, risks, benefits, treatment options, and the right of refusal, while taking into consideration users language and literacy levels. However, African communities are inherently challenged by problems of poverty, poor education, power asymmetry, and unfamiliarity with libertarian rights-based autonomy, which could affect informed consent practice. An empirical study was conducted at randomly selected public hospitals in EThekwini metropolitan municipality involving 927 participants; comprising 168 medical doctors, 355 professional nurses, and 404 patients. The study showed that healthcare professionals had limited knowledge regarding ethical and legal requirements for informed consent, and were partially compliant with current informed consent regulations. Barriers to informed consent identified were language, poor education, workload, and lack of interpreters. Most patients attending public hospitals were indigent, but preferred full information disclosure, and a shift from informed to shared-healthcare decision-making. The study recommends that a corps of trained interpreters should be introduced at public hospitals. This will improve providerpatient communications and minimize workloads, increase job satisfaction, and the overall quality of healthcare service delivery. Analysis of recent South African case law on informed consent revealed vacillations between the “reasonable doctor” and “prudent patient” standards of information disclosure which are inconsistent with the jurisprudence from comparative foreign common law jurisdictions. Therefore, South African court judgments on informed consent ought to be re-evaluated to establish a uniform standard of information disclosure consistent with international jurisprudence, current legislation, and constitutional protections relating to human dignity and security of the person. / Jurisprudence / LL. D.

This study examined Angolan culture as an influence to accessing modern scientific health care with the aim to develop health information brochures to inform the population of the advantages of scientific medicine. The quantitative approach with an exploratory and descriptive design was applied in this study, using a questionnaire to collect data from 100 respondents by means of a convenience sample. The findings indicated that most of the respondents were aware of what caused disease and illness in terms of modern knowledge, preferred to access government hospitals and also that government health care services were more affordable than some of the other alternatives. However, the study also found that a small section of the respondents believed in the powers and advantages of witch doctors, thus confirming that certain cultural issues still influenced the selection of assistance when health care and treatment is required. Recommendations were made through which health education could be distributed. / HEALTH STUDIES / Chemistry / MA (HEALTH STUDIES) / MSC (Chemistry)

This study was carried out as part of efforts to better understand the factors that impinge on childbirth service delivery and to develop guidelines to help improve the quality and safety of childbirth services in Ghana. The objectives were to: assess the factors that influence client-centredness; explore women’s and health professional’s views of and experiences with client-centred childbirth services; and develop guidelines to assist improve client-centred childbirth services in hospitals. The fixed mixed methods design comprising both quantitative and qualitative methods was employed. Structured questionnaire and exit interviews were used to gather data from 754 women who delivered in the hospitals. Furthermore, in-depth interviews were used to examine the experiences of women, doctors and midwives. STATA MP Version 13 was used to analyse the data by generating frequencies, chi-square and binary logistic regression results. Qualitative data analysis was analysed through data reduction, data display and generation of themes and categories. The process of developing the guidelines comprised: drafting based on the findings of the study and additional literature review, and a number of reviews by senior health professionls to build consesnsus on the content. With a response rate of 97.8%, the results indicated average performance. A number of the items examined under demographic characteristics, ante-natal, labour and postnatal care were significantly associated with the experience of excellent client-centred care. These included: number of weeks pregnant before delivery; health professional who assisted with delivery; mode of delivery; labour pain management; and length of stay after delivery. On the whole, the findings of the quantitative study were support by that of the structured interviews. Most of the themes from in-depth interviews with women were had to do with the relationship between health care provider and clients. Issues of support during childbirth; decision-making and informed choice; and continuity were raised. Themes deduced from the doctors’ and midwives’ interviews demonstrated a fair understanding of principles of client-centred care and delineated relational as well as client, health care worker and organisational factors that facilitate or limit effective implementation of client-centred care. The findings of the studies were used to develop guidelines to help improve services. It is recommended that the Ministry of Health, Ghana adopt the guidelines and provide the enabling environment for its effective implementation. / Health Studies / D. Litt. et Phil. (Health Studies)

Made available in DSpace on 2011-05-04T12:36:18Z (GMT). No. of bitstreams: 0 Previous issue date: 2009 / O objetivo desta dissertação consiste em investigar o processo de construção da identidade profissional de médicos que se dedicam à assistência a pacientes que apresentam doenças progressivas e ameaçadoras da continuidade existencial e que têm contribuído para o desenvolvimento dos Cuidados Paliativos no Brasil. Buscamos conhecer a trajetória profissional destes médicos desde a escolha da medicina como profissão até o encontro com a filosofia e a prática dos Cuidados Paliativos. Com este intuito, realizamos entrevistas semiestruturadas,colhidas segundo a metodologia de História Oral de Vida. Foram entrevistados seis médicos de diferentes especialidades que ocupam cargos diretivos em uma das associações profissionais voltadas para a disseminação e legitimação política e social dos Cuidados Paliativos no Brasil. Os depoentes se destacam no cenário nacional no que diz respeito às discussões sobre esta temática e mantêm contato com importantes instituições internacionais. Por esta razão, chamamos o conjunto de entrevistados de elite médica paliativista. Percebemos uma pobre interlocução entre os médicos paliativistas, o que se reflete na ausência de uma identidade integrada desse grupo profissional. Os entrevistados acentuaram as competências humanitárias necessárias ao bom exercício da Medicina Paliativa, mas, no entanto, não foram explicitadas as competências específicas a este campo profissional, que justificariam seu reconhecimento pelas entidades médicas competentes comouma nova área de atuação ou especialidade.

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Ce mémoire examine les pratiques des demandeurs d’asile dans les structures humanitaires médicales de l’île de Lesvos, en Grèce. Maintenus dans la zone-frontière que constitue l'île, les demandeurs d’asile vivent dans le camp de Moria, reconnu pour ses conditions de vie extrêmement mauvaises. Dans le cadre de leur processus d’asile, ils sont soumis à une procédure médicale, l’évaluation de vulnérabilité, dont le résultat influence leurs parcours. Dans le cadre d’un terrain ethnographique mené sur l’île à l’été 2018, j’ai effectué de la participation observante en tant qu’interprète au sein d’une clinique humanitaire, où des médecins bénévoles et des demandeurs d’asile négocient ensemble le pouvoir attribué à l’évaluation de vulnérabilité. Le mémoire analyse les pratiques des demandeurs d’asile à partir du concept d’agentivité circonscrite, une forme d'agentivité aux effets imprévisibles. Dans une première partie, je démontre que les demandeurs d’asile mettent en œuvre des stratégies pour négocier la situation inhumaine dans laquelle ils sont mis ainsi que pour obtenir une reconnaissance. Leurs stratégies se structurent autour d’une réappropriation des logiques du dispositif humanitaire, notamment des stéréotypes qui sont assignés aux réfugiés. Dans une seconde partie, j’examine en profondeur un élément de ces stratégies qui est central aux interactions de soin dans la clinique humanitaire : les documents médicaux. Je montre que ces documents sont une technologie flexible dont la fonction est détournée par les pratiques des demandeurs d’asile, qui les utilisent comme une ressource et comme une preuve. Finalement, j’analyse les différentes façons dont les médecins bénévoles réagissent à ces pratiques ainsi que leurs conséquences sur l’accès aux soins médicaux. Ces éléments établissent un portrait nuancé des effets du dispositif humanitaire établi aux frontières de l’Europe suite à la crise des réfugiés de 2015. / This study examines asylum seekers’ practices within medical humanitarian structures on Lesvos island, Greece. Maintained inside the border-zone constituted by the island, asylum seekers live in Moria camp, which is known for its extremely bad living conditions. In the context of their asylum process, they undergo a medical procedure, the vulnerability assessment, the result of which influences their trajectories. As part of an ethnographic fieldwork conducted on the island in the summer of 2018, I carried out observing participation as an interpreter in a humanitarian clinic, a space where volunteer doctors and asylum seekers negotiate the power attributed to the vulnerability assessment. This study analyses the practices of asylum seekers through the concept of circumscribed agency, which effects are unpredictable. I first show that asylum seekers set up strategies to negotiate the inhuman situation in which they find themselves, as well as to obtain recognition. Their strategies are structured around a reappropriation of the logics of the humanitarian device, notably the stereotypes assigned to refugees. The second part extensively examines an element of these strategies central to the care interactions taking place in the humanitarian clinic: the medical documents. I show that these documents act as a flexible technology and that their function is reconfigured by asylum seekers’ practices, who use them as resources and proofs. Finally, I highlight the different ways in which volunteer doctors react to these practices, along with their consequences on access to medical care. These elements provide a nuanced description of the effects of the humanitarian device established at Europe’s borders following the 2015 refugee crisis.

PhD (Advanced Nursing Science) / Department of Advanced Nursing Science / iii Abstract The Mental Health Act is the law which sets out when you can be admitted, detained, and treated in hospital against your wishes. It is also known as being “sectioned”. For this to happen, certain people must agree that you have a mental disorder that requires a stay in hospital. In South Africa, the Mental Health Act of 1973 was noted to have many gaps. Due to all the shortcomings, in 2004 the Mental Health Care Act No. 17 of 2002 came into being in order to protect human rights of the mental health care users. This study sought to determine the knowledge and explore the experiences of medical doctors regarding the implementation of Mental Health Care Act No. 17 of 2002. Secondly, based on the findings, to develop a programme to facilitate the implementation of the Mental Health Care Act No. 17 of 2002 by medical doctors in Vhembe District. The population of this study consisted of all medical doctors working in Vhembe District Hospitals with mental health units and at a specialized mental health hospital as well as all documents completed by medical doctors during admission, care and discharge of mental health care users were purposively sampled. The study was conducted in two phases. In phase 1, where quantitative and qualitative designs were followed to do situational analysis. In phase 2, the programme was developed using results from phase 1, the theoretical framework and approaches outlined by Dickoff, James and Wiedenbach (1968); Chinn and Krammer (1999); Walker and Avant (1995). Individual in-depth interviews and questionnaires checklist were used to collect data which was analysed through opened coding method and SPSS. The findings of this study indicate that medical doctors have knowledge and skills deficit regarding implementation of the Mental Health Care Act No. 17 of 2002 during the admission, care, and discharge of mental health care users. Based on these, a programme to facilitate the implementation of the Mental Health Care Act No. 17 of 2002 by medical doctors during admission, care and discharge of mental health care users was developed. The study concludes that this is a significant contributor in supporting the vision of the National Department of Health to ensure improved mental health for all in South Africa. The study recommends a longitudinal study, tracking the impact of a developed programme, the knowledge of medical doctors regarding the implementation of Mental Health Care Act No. 17 of 2002, and its contribution to the improvement of mental health for all should be conducted over a period of 5 (five) to 10 (ten) years

Introduction: The properties of human blood are so specific that it has not yet been possible to replace human blood with any other fluid than obtaining it as a blood gift from donors. In recent years, there has not been a sufficient number of new blood donors in the Czech Republic to compensate for the decrease in the number of donors due to the increasing incidence of a number of civilization diseases and age (Czech Red Cross, 2020). Blood donation and the need for blood products are constantly increasing with the development of the methods of treatment and medicine as a science. Ensuring a sufficient number of blood donors and sufficient deposition of blood obtained from donors is a permanent task of healthcare (Society for Transfusion Medicine of the Czech Medical Association JEP, 2019). Aim of the work: The main goal of the research was to map the issue of blood donation, to identify the factors by which blood donors are motivated to donate. Furthermore, what can cause stagnation in the growth of blood donors and what means doctors motivate potential blood donors. Methodology: A qualitative research method was chosen for the research survey. Data collection took place in the form of semi-structured interviews and was completed by achieving theoretical data saturation. In order to preserve...

Syfte: Syftet med detta arbete var att analysera vilka faktorer som bidrar till utbrändhet hos de som arbetar inom hälsovården. Metod: Följande arbete bestod av en litteraturstudie. Analys: Flera vetenskapliga tvärsnittsartiklar från olika länder användes med målet att undersöka vilka arbetsmiljöfaktorer ofta förekommer och orsakar utmatning hos läkare, sjuksköterskor och undersköterskor. Resultat: Under arbetets gång under resultatet redogjordes det att utbrändhet orsakas av många faktorer såsom stressiga arbetsdagar, ung ålder, brist på arbetserfarenhet, familjestatus, antal barn, tätt samarbete med många patienter, liten kontakt med arbetskamrater, höga krav och otacksamhet från patienter, problem med ekonomi, brist på vila och individens hälsoproblem. Med hjälp av Maslach Burnout Inventory och Copenhagen Burnout Inventory som användes i artiklar var utmattningssyndrom tydligt definierad, och dess faktorer noggrant analyserade. Diskussion: I diskussionsdelen var två olika Burnout Inventory - enkäter beskrivna med stöd av artiklar. Dessutom diskuterades egenskaper hos en enkät vilket stöddes av Bryman (2008), och förutom det genomfördes genomgång av artiklar, använda i analysdelen, för att säkerställa deras trovärdighet. / Purpose: The purpose of this work was to analyze the factors that contribute to burnout in those who works in health care. Method: The following work consists of literature study. Analysis: Several scientific cross-sectional articles from different countries were used with the aim of investigating which work environment factors often occur and cause the burnout among physicians, nurses and assisted nurses. Result: During the result, it was reported the burnout is caused by many factors such as stressful working days, young age, lack of work experience, family status, number of children, close cooperation with many patients, little contact med colleagues, high demands and ingratitude from the patients, problems with finances, lack of rest and individual´s health problems. Using the Maslach Burnout Inventory and Copenhagen Burnout Inventory used in articles, fatigue syndrome was clearly defined, and its factors carefully analyzed. Discussion: In the discussion two different Burnout Inventory – surveys were described with the support of articles. In addition, the characteristics of a survey were discussed, with was supported by Bryman (2008); and articles, used in the analysis, were presented to ensure their credibility.