In this research, it proposes an approximation of the meaning given by nurses and doctors in relation to the practice of orthothanasia. Thus, tracing out the purpose of analyzing the social representations of nurses and doctors, working in the Intensive Care Unit (ICU), in the practice of orthothanasia and how these representations influence the professional activities. This is an exploratory type of search based on a qualitative approach, which adopts as the theoretical framework of social representations Moscovici. Was developed in the adult ICU of a public hospital located in the geographic center of Rio Grande do Sul (RS) and the population were five nurses and five physicians. It was decided to semi-directed. The period of data collection occurred from January to March of 2008. Ethical issues were considered in the research as required by Resolution 196/96 of the National Health Council, for the conduct of research with human beings. After analyzing the content of Bardin, it was possible to identify some distancing and approximations of the representations. The proliferation vocabulary designating orthothanasia is pervaded by doubt and lack of concept and its applicability, and this action can easily be distorted or confused with euthanasia. The orthothanasia appears so latent in speeches, and professionals do not refer directly to your action. The term is related to the possibility of death occurs at the right time without unnecessary pain and suffering. Refer know exactly what the practice is illegal in the orthothanasia hospital. The representations of nurses in orthothanasia are directed to the alleviation of suffering, and its operation confirmed by the methods of non cardiorespiratória resuscitation (CPR) in patients deemed not investível. The representations about orthothanasia the physicians are built on the same perspective, as opposed to suffering from the patient and not the result leads RCR, however direct his attention to the fear and anguish that this decision creates the risk of legal punishment. Discuss the matter of the practice of orthothanasia was not simply consider it as something mechanical, but its performance against the context of a dynamic routine that tries to mask it, simply because there is no amparos in different areas, whether in medicine the jurisdiction. In fact, the orthothanasia, which is installed in the hospital, was perceived by practitioners as the viable option to treat the death as an inevitable and constant in order to counter any prolongation of human suffering. Thus, it is necessary to consider the context of the patient die in dignity, from the actions that aim to understand it as deadly. / Nesta pesquisa, propõe-se uma aproximação do significado atribuído por enfermeiros e médicos em relação à prática da ortotanásia. Para tanto, fora traçado o objetivo de analisar as representações sociais dos enfermeiros e médicos, atuantes na Unidade de Terapia Intensiva (UTI), diante da prática da ortotanásia e como essas representações influenciam na atuação profissional. Trata-se de uma pesquisa do tipo exploratório pautada na abordagem qualitativa, que adota como referencial teórico as Representações Sociais de Moscovici. Foi desenvolvida na UTI adulto de um Hospital público localizado no centro geográfico do Estado do Rio Grande do Sul (RS) participaram cinco enfermeiras, e cinco médicos. Optou-se pela entrevista semi-dirigida. O período de coleta dos dados ocorreu de janeiro a março de 2008. As questões éticas na pesquisa foram consideradas conforme previsto pela Resolução 196/96 do Conselho Nacional de Saúde, para a realização de pesquisa com seres humanos. Após a análise de conteúdo de Bardin, foi possível identificar alguns distanciamentos e aproximações das representações. A proliferação vocabular que designa a ortotanásia é permeada por dúvidas e indefinições de seu conceito e aplicabilidade, e a possibilidade desta ação ser facilmente deturpada ou confundida com a eutanásia. A ortotanásia aparece de maneira latente nos discursos, e os profissionais não mencionam diretamente a sua ação. O termo está relacionado com a possibilidade da morte ocorrer no momento certo sem dor e sofrimento desnecessário. Referem saber exatamente que a prática da ortotanásia é ilegal no ambiente hospitalar. As representações dos enfermeiros na ortotanásia estão direcionadas à paliação do sofrimento, sendo sua operacionalização confirmada com os métodos de não ressuscitação cardiorespiratória (RCR), no paciente considerado não investível. As representações dos médicos quanto a ortotanásia são construídas na mesma perspectiva, como contraponto ao sofrimento apresentado pelo paciente e a não RCR conduz o resultado, contudo direcionam sua atenção ao receio e as angústias que essa decisão provoca o risco da punição jurídica. Tratar sobre o assunto da prática da ortotanásia, não foi simplesmente considerá-la como algo mecanizada, mas sim contextualizar sua atuação frente à dinâmica de uma rotina que tenta mascará-la, simplesmente pelo fato de não existir amparos das diferentes áreas, seja da medicina a jurisdição. De fato, a ortotanásia, que se instala no ambiente hospitalar, foi percebida pelos profissionais como a possibilidade viável de tratar a morte como um processo irremediável e constante, de forma a contrapor qualquer tipo de prolongamento do sofrimento humano. Desta forma, é necessário pensar a contextualização de o paciente morrer de forma digna, a partir das ações que visem percebe-lo como mortal.

Submitted by Maike Costa (maiksebas@gmail.com) on 2016-08-17T14:09:53Z No. of bitstreams: 1 arquivo total.pdf: 1591212 bytes, checksum: a944c32fd7a97d6e7d63f53ea5b74dd8 (MD5) / Made available in DSpace on 2016-08-17T14:09:53Z (GMT). No. of bitstreams: 1 arquivo total.pdf: 1591212 bytes, checksum: a944c32fd7a97d6e7d63f53ea5b74dd8 (MD5) Previous issue date: 2016-03-18 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / Obstetrics is a prominent area for Medicine because it represents one of the basic needs of the population. It is responsible for a very important social, cultural and historical event that is the realization of a childbirth. This submits the professionals who work in this area to a constant pressure for good results, in addition to the variability and dilemmas that are inherent in the profession. Thereby, the present dissertation has as the main objective to understand the work of Obstetricians engaged in a public maternity. In order to do that, the theoretical contribution of this study is based on the contributions from Psychodynamics of Work through reflections brought by Christophe Dejours. Regarding the method, this research presents a field study of a qualitative nature. The techniques used here were semi-structured interviews and observations of the work. The perspective adopted for data analysis was the thematic content analysis. In this research, 13 obstetricians working in a maternity unit located within the Northeast region participated, being 10 female and 3 male. Their ages ranged between 31 and 61 years old. Regarding the time of practice as an obstetrician, it ranged from one year up to 40 years of experience in the job. As a result, it is highlighted the presence of collective work in the activity of an obstetrician. Working together is present in the professional performance and as a professional training. The development of practical intelligence, subjective mobilization and, above all, cooperation, are presented as necessary to ensure that the obstetrician performs his or her job and win the hurdles imposed by the real. In addition to the health risks inherent in this professional category, obstetricians deal daily with violence from the doctor-patient relationship, in which they suffer threats from the recipients of their service, in an ambiguous relationship, sometimes made of difficulty and brainstorm, and in other times made of pleasure, satisfaction, and recognition. Furthermore, another highlight is the presence of subjecting activity in the work of an obstetrician; in order to work, the obstetrician needs to incorporate the world. In addition, the use of time away from duty is permeated by work, giving little room for family relationship, leisure activities and health care. Finally, despite the difficulties, obstetricians are fulfilled and they show that the profession makes gains for their identity and self-realization. / A obstetrícia é uma área de destaque para a medicina, pois representa uma das necessidades básicas da população. É responsável por um evento social, cultural e histórico muito importante que é a realização de um parto. Tal situação submete os profissionais que atuam nessa área a uma pressão constante por bons resultados, além das variabilidades e dilemas que são inerentes a este ofício. Desse modo, a presente dissertação tem como objetivo principal compreender o trabalhar de médicos obstetras que atuam em uma maternidade pública. Para tanto, o aporte teórico desse estudo se baseia nas contribuições oriundas da Ergonomia da atividade e em especial da Psicodinâmica do Trabalho através das reflexões trazidas por Christophe Dejours. No que se refere ao método, esta pesquisa apresenta-se como um estudo de campo de caráter qualitativo. As técnicas utilizadas foram entrevistas semiestruturadas e observações do trabalho. A perspectiva adotada para análise dos dados foi a análise de conteúdo temática. Participaram desta pesquisa 13 médicos obstetras que atuam em uma maternidade pública situada no interior do Nordeste, 10 são do sexo feminino e três são do sexo masculino. As idades variaram entre 31 e 61 anos. Quanto ao tempo de atuação como obstetra, este variou de um ano até 40 anos de profissão. Como resultados, destaca-se a presença do trabalho coletivo na atividade do médico obstetra. O trabalhar junto estar presente na atuação profissional e como uma via de formação profissional. O desenvolvimento da inteligência prática, da mobilização subjetiva e, sobretudo, da cooperação se apresentam como necessárias para que o obstetra realize seu trabalho e vença os obstáculos impostos pelo real. Além dos riscos à saúde inerentes a categoria profissional, os obstetras lidam cotidianamente com a violência na relação médico-paciente, na qual sofrem ameaças por parte dos beneficiários de seu serviço, em uma relação ambígua, ora de dificuldade e impasses, ora de prazer, satisfação e reconhecimento. Destaca-se, ainda, a presença da atividade subjetivante no trabalho do médico obstetra; para trabalhar, o obstetra necessita corpopriar o mundo. Além disso, verifica-se que o uso do tempo fora do trabalho é permeado pelo trabalho, dando pouco espaço para relação familiar, o lazer e os cuidados com a saúde. Por fim, apesar das dificuldades, os obstetras sentem-se realizados e demonstram que a profissão possibilita ganhos para a identidade e realização de si.

A presente pesquisa tem como objetivo verificar se a legislação pós Segunda Guerra Mundial foi apta a inibir o comportamento maleficente de médicos no auxílio em especializar, dissimular e acobertar a tortura. Nesse sentido, pretende-se demonstrar o envolvimento médico com experimentos em seres humanos durante a Segunda Guerra Mundial e corroborar que a maleficência médica, todavia, ainda nos dias de hoje é empregada na sociedade contemporânea, permitindo aos profissionais de saúde, desde o período da Guerra Fria, o envolvimento com a tortura e a consequente violação dos princípios da Bioética, especialmente, na conjuntura atualíssima da guerra norte-americana contra o terrorismo. Em um segundo momento, o intuito é propor soluções, caso se verifique que a legislação e os demais esforços se demonstrem contraproducentes, tendo em vista as noções de Bioética, as normas de Direito Internacional e os Direitos Humanos. / The present research aims to verify if legislation created after World War II was able to inhibit maleficent behavior from medical doctors in the improvement and cover-up of torture. This study aims to demonstrate the medical involvement in experiments with human beings during World War II and confirm that medical maleficence was and still is part of our reality, allowing doctors to involve with torture since the Cold War until current days, especially in the United States war on terrorism, violating the basic principles of Bioethics. Secondly, if legislation and overall efforts prove to be inoperative and inefficient, the objective is to propose solutions, in light of notions of Bioethics, rules of International Law and Human Rights.

Orientador: Thomas Patrick Dwyer / Tese (doutorado) - Universidade Estadual de Campinas, Instituto de Filosofia e Ciências Humanas / Made available in DSpace on 2018-08-17T03:36:02Z (GMT). No. of bitstreams: 1 Moliani_MariaMarce_D.pdf: 2474438 bytes, checksum: 21f53ff10257b2a7c6a4b32eebec64f0 (MD5) Previous issue date: 2010 / Resumo: O objetivo desta tese é analisar as causas de erros médicos junto aos profissionais de saúde e os pacientes, vitimas de erros médicos a fim de compreender os condicionantes sociais dos erros e efeitos adversos do processo de tratamento medico, verificando a influência de fatores tais como: os condicionantes profissionais, através da identidade do sujeito social com a profissão e com os papéis sociais desempenhados; formação medica e condições de trabalho. Esse trabalho utilizou como referencial Teórico-metodológico aportes da fenomenologia de Alfred Schutz, a fim de compreender os critérios de relevância mobilizados pelo sujeito social no curso de sua ação. A pesquisa foi elaborada utilizando metodologia qualitativa, através de entrevistas e apreensão dos condicionantes da ação / Abstract: The aim of this thesis is to analyze the causes of medical errors, involving health professionals and patients, the victims of medical errors, in order to understand the social conditions of the errors, as well as the adverse effects of the medical treatment process, checking the influence of factors such as: professional conditions, through the social subject's identity in the profession and the social roles played, as well as medical training and work conditions. This work was based on the theoretical and methodological contributions of Alfred Schutz's phenomenology, in order to understand the relevance criteria raised by the social subject in the course of action. The methodology used in the research was qualitative, through interviews and by understanding the action determinants / Doutorado / Doutor em Ciências Sociais

O evento do câncer de mama pode ser traumático para a mulher que o vivencia, impactando e alterando sua qualidade de vida, principalmente em termos da organização da vida cotidiana, familiar e social, o que implica na necessidade de se adaptar às novas condições de existência e às transformações que podem resultar em uma nova identidade pessoal e social. No momento do diagnóstico de câncer de mama, diversos sentimentos são vivenciados, dentre os quais se destacam a desesperança, angústia e medo do desconhecido, sendo o impacto do diagnóstico muitas vezes considerado como uma vivência extremamente significativa, que influencia todo o processo até a reabilitação da pessoa adoentada. Além disso, os profissionais da saúde são considerados elementos importantes no enfrentamento do câncer, principalmente quando informam sobre a doença e sua evolução, bem como quando confortam e encorajam a mulher durante o diagnóstico e tratamento. O objetivo deste estudo é compreender a vivência do processo de comunicação do diagnóstico de câncer de mama na perspectiva da mulher e do médico informante. Trata-se de um estudo de caráter descritivo, exploratório, prospectivo e apoiado na metodologia qualitativa de pesquisa. Colaboraram com o estudo seis mulheres que se encontravam em processo de investigação diagnóstica e que receberam, posteriormente, a confirmação do câncer de mama, e seis médicos oncologistas que são responsáveis pela comunicação do diagnóstico. Os colaboradores foram recrutados no Serviço de Mastologia e Oncologia Ginecológica da Unidade de Ginecologia e Obstetrícia do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto. Os instrumentos utilizados foram: Formulário de Dados Sociodemográficos do LEPPS; entrevista aberta, desenvolvida a partir de questão norteadora; e diário de campo. A análise dos dados foi pautada no referencial teórico-metodológico da Fenomenologia. Os resultados mostram que a comunicação do diagnóstico de câncer de mama é vivenciada como uma experiência complexa, tanto para as pacientes quanto para os/as médicos/as. Ao mesmo tempo em que se vê como transmissor da má notícia, o/a médico/a compreende seu papel como aquele/a que também oferece possibilidades de vida para a pessoa adoecida. Quanto às mulheres, é possível apontar que a vivência desse processo é uma experiência liminar, não linear e passível de significação singular, pela qual perpassam diversos sentimentos paradoxais, como medo, incerteza, angústia, tristeza, tranquilidade, esperança e indiferença, que suscitam diferentes modos (negação, enfrentamento, aceitação), de lidar com as facticidades do adoecimento. Conclui-se que, tanto para as pacientes quanto para os/as médicos/as, é importante que se valorizem as singularidades em seus modos de existência, buscando oferecer espaço para manifestação de subjetividades, a fim de alcançar um cuidado integral tanto na perspectiva de quem cuida como na de quem é cuidado / The event of breast cancer can be traumatic for who experiences it, impacting and changing these womens quality of life, mainly in terms of the organization of daily family and social life, implying the need to adapt to new conditions of existence and to the transformations that may result in a new personal and social identity. At the time of the diagnosis, several feelings are experienced, among which despair, anguish and fear of the unknown stand out, being the impact of the diagnosis often considered as an extremely significant experience that influences the entire process until the rehabilitation of the patient. In addition, health professionals are considered important elements in coping with cancer, especially when they inform about the disease and its evolution, as well as when they comfort and encourage women during the diagnosis and treatment. The objective of this study is to understand the experience of the communication process of the breast cancer diagnosis from the perspective of the woman and the physician diagnosing the condition. This is a descriptive, exploratory and prospective qualitative research. Six women who underwent diagnostic investigation and who subsequently received confirmation of breast cancer and six oncologists who are responsible for communicating the diagnosis collaborated with the study. The collaborators were recruited at the Department of Mastology and Gynecological Oncology of the Gynecology and Obstetrics Service at the Hospital das Clínicas of the Ribeirão Preto Medical School. The instruments used were: Sociodemographic Data Form of the LEPPS, open interview, developed based on a guiding question; and a field diary. The data analysis was based on the theoretical and methodological framework of Phenomenology. The results show that both patients and physicians go through the communication of the breast cancer diagnosis as a complex experience. At the same time as the physicians see themselves as transmitters of the bad news, they understand their role as the people who also offer possibilities of life for the sick person. As for the women, it can be appointed that the experience of this process is liminal, nonlinear and of singular significance, through which they go through different paradoxical feelings, such as fear, uncertainty, anguish, sadness, tranquility, hope and indifference, which arouse different ways (denial, coping and acceptance) of dealing with the particularities of the illness. It is concluded that, for both patients and physicians, it is important to value the singularities in their modes of existence, aiming to provide space for the manifestation of subjectivities, in order to achieve integral care from the perspectives of those who care and those who receive care

O tema da humanização dos serviços e práticas de saúde vem sendo objeto atualmente de várias elaborações e pesquisas no campo da saúde coletiva em razão de sua importância para constituição de práticas e serviços centrados no cuidado e na integralidade da atenção. Esse estudo teve como objetivo a análise das transformações contemporâneas do trabalho médico e suas implicações para os processos de humanização/desumanização do trabalho em saúde. Optou-se pela metodologia de vertente qualitativa, sendo que a coleta de dados baseou-se na triangulação das técnicas de entrevista em profundidade sob a forma de seis histórias de vida profissional de médicos e de análise documental. A fim de analisar como as transformações em andamento nas práticas médicas e de saúde afetam a relação entre profissional de saúde e usuário de forma a caracterizá-la como desumanizante, nos valemos do substrato filosófico da dialética humanização-alienação. O estudo das transformações pelas quais passam o trabalho médico e em saúde demonstrou a conformação de dinâmicas potencializadoras de relações simultaneamente humanizadoras e alienantes entre seus sujeitos constituintes e destes com os demais elementos componentes dos processos assistenciais em saúde. Por um lado, o movimento permanente de desenvolvimento de teorias, métodos e práticas cada vez mais eficientes na abordagem das condições de sofrimento dos sujeitos, principalmente em sua dimensão orgânica, representa uma dimensão humanizadora inegável do trabalho em saúde, expressando aqui um elemento constituidor do gênero humano como cada vez mais rico e complexo. Por outro lado, a repercussão desse acúmulo genérico no plano dos sujeitos e coletivos concretos tende a produzir implicações contraditórias, expressas, por exemplo, na (re)produção de graus significativos de desumanização e sofrimento. Exemplo disso é como os movimentos contemporâneos de socialização do trabalho médico e em saúde sob referenciais centrados na heteronomia, na racionalidade de base empresarial, na divisão técnica reificada e no papel determinante exercido pelo capital no interior do setor saúde contribuem para a conformação de processos de trabalho progressivamente subordinadores do agir autodeterminado, reflexivo e criativo dos agentes a dinâmicas fetichizadas e instrumentalizadoras, tanto para eles quanto para usuários dos serviços. Também em função dessa ampla gama de transformações, evidencia-se um aprofundamento do estranhamento dos médicos em relação às determinações sociais de sua prática, dos demais sujeitos e de seus sofrimentos. Analisou-se como esses agentes podem estabelecer relações reificantes com seus instrumentos de trabalho, seja na forma de equipamentos, seja na forma de tecnologias não-materiais, como as várias formas de rotinas e protocolos, contribuindo para um descentramento dos sujeitos no interior das práticas de saúde. O trabalho em saúde, destarte, constitui-se como cenário-processo onde o desenvolvimento da dialética humanização-alienação expressa a tensão permanente entre, por um lado, a busca do devir consciente e autodeterminado pelos sujeitos e, por outro, sua subordinação por dinâmicas reprodutoras de relações sociais desumanizantes / The subject of humanization of health services and health practices has been the object of several researches in the field of collective health due to its importance for the constitution of practices and services focused on the care and completeness of attention. The present study aimed to analyse the contemporary changes in medical work and their inplications on the humanization/dehumanization processes in the health practice. The qualitative approach to research was chosen, and the data collection was based on the triangulation of in-depth interview technique under the form of stories of the professional lives of six doctors and documental analysis. In order to analyse how the on going transformations on the medical and health practices affect the relation between health workers and users characterizing it as dehumanizing, the phylosofical basis of the dialectic relation of humanization/alienation was employed. The study of the changes the medical and health work go through has shown the construction of dynamics which potencialize relations simultaneously humanizing and alienating between their constituting subjects and their relation with the other elements that compose the health care processes. On the one hand, the permanent movement of development of theories, practices and methods increasingly efficient in approaching the patient\'s distress, mainly on their organic aspect, represents an undeniably humanizing dimension of the health care, expressing an element increasingly rich and complex constitutive of the human genre. On the other hand, the repercussion resultant of this generic accumulation in the sphere of concrete subjects and collectives tends to produce contraditory implications expressed, for example, in the (re)production of significative levels of dehumanization and distress. This may be exemplified by the manner the contemporary movements of medical and health work socialization under frameworks centered on heteronomy, business based racionality, reified technical division and the main role played by the capital inside the health sector contribute to the conformation of work processes which progressively subordinate the self determined, reflexive and creative actions of its agents to fetishized and instrumentalizing dynamics, both for agents and users of the services. Also due to this wide spectrum of transformations, it becomes evident the deepening of the estrangement between doctors and the social determinations on their practice, the other subjects and their distress. It was analysed how these agents may stablish reificating relations with their instruments of work, either as equipment, or as non-material technologies, like the various forms of routines and protocols, contributing to a decenterment of the subjects internal to the health practices. The work in health, thus, constitutes a process-scenario in which the development of the dialectic relation humanization-alienation expresses the permanent tention between, on the one hand, the search for the conscient and self determined future of the subjects and, on the other hand, their subordination to dynamics which reproduce dehumanizing social relations

[pt] Para a indústria farmacêutica, novas práticas de marketing via internet têm implicações muito relevantes, pois permitem não apenas criar vínculos diretos com seus consumidores finais(antes quase inexistentes), mas também, criar novas formas de interação com a classe médica, antes restritas basicamente às visitas de seus representantes de vendas aos consultórios e a eventos promocionais (e.g. divulgação de produtos via congressos, seminários e publicações especializadas). Esta dissertação pretende avaliar o padrão de utilização da internet por um grupo de médicos brasileiros, bem como suas reais necessidades no que diz respeito aos serviços disponíveis através da internet. Esta avaliação de seus usos e demandas é realizada de modo a pensar suas possíveis implicações sobre o marketing de relacionamento praticado pela indústria farmacêutica e demais provedores de serviços (baseados na internet) direcionados para a classe médica. / [en] For the pharmaceutical industry, the new marketing practice via internet has much relevant implications since it allows the establishment of direct bonds not only with their final customers (almost non existent before, in the Brazilian marketplace), but also with the medical community, which has been historically approached through restricted ways such as sales representatives and promotional events, such as congresses, seminars and specialized publishing on medical research. This dissertation evaluates the standards of internet use by a group of doctors, as well as their needs with respect to internet services. This evaluation of habits and demands allows us to think about some possible implications to the relationship marketing practiced by pharmaceutical industry and others internet based service providers whose main focus is thr medical community.

Magister Scientiae (Physiotherapy) - MSc(Physio) / Chronic diseases of lifestyle (CDL) are on a raising trend in the world regardless of age,economic class or geographical location of a population. The mortality rate associated with CDL is alarmingly among the highest globally. Tanzania is not exempted from this development.Literature indicates that physical activity is a health practice that can prevent CDL. It is recommended that medical practitioners should hold the responsibility of counselling patients on physical activity. Some studies outside Africa found an association between doctors’ physical activity patterns and their counselling practices on the same. This study therefore sought to establish whether physical inactivity among medical doctors in Tanzania significantly influenced their counselling practices on physical activity. A cross sectional quantitative survey at the Muhimbili National Hospital and Muhimbili Orthopedic Institute was conducted to derive the required information. A self administered structured questionnaire was voluntarily answered by 144 medical doctors. The Statistical Package for Social Sciences (SPSS) version 17 was used for data capturing and analysis. Descriptive statistics were employed to summarize data and was expressed as means, standard deviation, frequencies and percentages. The students’t-test was used to compare mean physical activity between different groups. Furthermore students’t-test and analysis of variance tests were used to examine association between different variables. Chisquare tests were used to test for associations between categorical variables. Alpha level was set at p< 0.05. Most of the participants in this study were sedentary in their leisure time and only active at work. When their quality of physical activity counselling was assessed, the majority of them were found to be poor physical activity counsellors. A significant association was found between physical activity and age, as well as physical activity and counselling practice (p<0.05).Participants mostly informed their patients about the intensity and duration of exercising more than any other idea of physical activity such as types of exercises, issuing of a written prescription and planning for a follow up. Lack of knowledge and experience about details of physical activity were reasons offered for failure to counsel. Participants also reported the inconvenience of physical activity facility’s schedules, fatigue and tiredness to be their barriers to physical activity participation. Doctors in Tanzania lacked personal initiative to participate in physical activity and consequently lacked the motivation to counsel. Measures around enhancing this health practice should be enhanced by all stakeholders including medical doctors,physiotherapists and patients. The need for short term and long term training in matters related to physical activity are therefore necessary among the practicing doctors and those undergoing training in medical schools. Physiotherapists who are trained in movement science can offer valuable advice/information to medical doctors to ensure that medical doctors acquire physical activity prescription and counselling knowledge. Collaboration between stakeholders in campaigning against sedentary lifestyles should be enhanced. Further reasons for failure to counsel, hindrances to physical activity participation and modern approaches to counselling should be explored.

Magister Commercii - MCom / One of the fundamental problems facing the South African public healthcare sector is motivation and retention of the healthcare practitioners. Medical doctors in particular, tend to leave the public sector for the private sector, rural settlements for the urban settlements, the Republic of South Africa for other countries or entirely leaving the healthcare industry. This study seeks to identify the factors that contribute to work satisfaction or dissatisfaction of doctors in the South African public health sector as well as bringing forth strategies that are important in retaining medical doctors in the sector. A cross-sectional survey using self-administered pre-tested questionnaires was mailed to 1000 randomly selected medical doctors in the public health sector of South Africa to get their opinions. Appropriate statistical tools were then used to interpret the findings. A total of 135 medical doctors participated in this study. The medical doctors identified lack of participation in management as the major factor hampering work satisfaction in the public sector. Pay and workload were also identified as the other leading factors to doctors’ dissatisfaction. Significant relationships with patients were found as motivators to doctors’ satisfaction. On retaining medical doctors, the respondents indicated a great need for improvement on the current working conditions and such improvements including the recognition of doctors in the workplace as well as their promotion.Discrimination and inadequate remuneration were leading factors for doctors not willing to be retained in the public sector Medical doctors are essential to the efficient delivery of health care in South Africa and an unending conflict between them and their management imposes a great risk to the future of the South African health care. It is therefore imperative for healthcare managers to address those factors that are appearing to be obstacles to job satisfaction and at the same time capitalizing on the identified retention factors in their management strategies.

ABSTRACT Patient's Informed Consent, Medicine Doctors' Responsibility, Patient's Protection This diploma thesis analysis the informed consent of patient, which is manifestation of the patient's right to decide about his own health freely. The main aim is to describe what laws is the informed consent based on, what it should contain, in which situations the doctor is allowed to act without the consent and what the consequences of acting without consent, in cases, in which the informed consent is required by law, are. Further problems, which are not adequately treated by the law, are also mentioned, and the obtaining of the informed consent in children and the informed consent in practice were described. It was found out, that registration of complaints should be kept by each medical facility separately in the Czech Republic. Except that, the complaints department is established at each regional office. Czech laws do not impose to register complaints or claims in national unified register. Number of complaints between 2008-2010 were obtained from the Czech Medical Chamber, Control Department of the Ministry of Health, Medical Department of Regional Office and from Prague City Hall. It can be stated, based on the study of all related resources and after comparing of the recquired information with the reality, that even if all regulations are abided, it is impossible for the doctor to inform patient about all risks and possible complications to avoid the complaints completely. The questionnaire survey shows, that the legal awareness of doctors in the issue of informed consent is inadequate and it is important to improve it.