Background: In Utah, all major hospital facilities have employee vaccination policies. However, the presence of health care worker vaccination policies in the Utah outpatient oncology setting was unknown. Objectives: The objectives were to identify Utah oncology outpatient employee vaccination policies and to identify what consequences, if any, were present for unvaccinated employees. Methods: This was a cross-sectional, descriptive study design in which clinic managers from outpatient oncology clinics in Utah were asked, via questionnaire, to describe the clinic's employee vaccination policy and the consequences for refusing the policy. Findings: Most vaccination policies applied to employees primarily assigned to work in the back office area. Most commonly, influenza and Hepatitis B vaccines were required as part of the vaccination policy. Most managers offered free vaccinations to employees, although most managers also allowed employees to refuse to follow the vaccination policy for medical, religious, or personal reasons.

Medicinos darbuotojai dėl kasdieninio kontakto su žmogaus organizmo skysčiais priskiriami didžiausios biologinių veiksnių rizikos grupei. Incidentų – mikrotraumų ir ekspozicijos krauju, rizika yra susijusi su kraujo keliu plintančiomis infekcijomis (HBV, HCV, ŽIV). Darbo tikslas: Nustatyti medicinos darbuotojų profesinių biologinių veiksnių riziką ir paplitimą Kauno medicinos universiteto klinikų chirurgijos profilio skyriuose. Tyrimo metodika. Vykdytas retrospektyvinis tyrimas 2006 m. 1-6 mėnesių, duomenys rinkti Kauno medicinos universiteto klinikų chirurgijos profilio skyriuose. Atlikta anketinė apklausa. Išdalintos 347 anoniminės anketos, atsako dažnis 89,6 % (311). Statistiniam duomenų apdorojimui naudotas SPSS 11.0 programinis paketas. Rezultatai. 64,5% respondentų patyrė mikrotraumą, 71,1 % – ekspoziciją biologiniais skysčiais, mikrotraumą, ir ekspoziciją patyrė 39,6% darbuotojų. Visais mikrotraumų atvejais buvo sužeistos rankos, ekspozicijų metu 63% respondentų apsitaškė sveiką odą, 20% – akis. Dažniausiai darbuotojai apsitaškė krauju (60%). Gydytojai mikrotraum��� dažniausiai patyrė operacijų metu (79,3%), slaugytojos – apruošdamos instrumentus (35,1%), pagalbiniai darbuotojai – tvarkydami atliekas (75,8%). Gydytojai dažniausiai susižeidė chirurgine adata (72,4%), slaugytojos – injekcine adata (72,4%), pagalbiniai darbuotojai – stiklu (60,6%). 86% respondentų nebuvo pasiskiepiję HB vakcina. Mikrotraumų metu 14,5%, ekspozicijų metu 5% respondentų asmeninių apsaugos... [toliau žr. visą tekstą] / The health care workers are attributed to the highest biological factors risk group, as they daily come into contact with fluids of human body. Risk of incidents – sharps injuries and blood exposure – is related to the infections, spread by blood (HBV, HCV, HIV). Aim of the study. Determine the professional biological risk factors for health care workers and their incidence in the surgical departments of Kaunas Medical University Hospital. Methods. Retrospective study of 1-6 months of year 2006 was performed; data was collected in the surgical departments of Kaunas Medical University Hospital. Anonymous questionnaire survey was performed. 347 questionnaires were distributed; rate of response was 89.6% (311). SPSS 11.0 software was used for statistical data processing. Results. 64.5% of respondents had experienced sharps injury, 71.1% were exposed to the biological fluids, and 39.6% of workers had experienced the injury and the exposure. The hands were injured during all the sharps injury cases; 63% of respondents were drabbled by blood on the healthy skin and 20 % were drabbled into the eyes during the blood exposure. In most cases worker were drabbled by blood (60%). Physicians mostly experience the sharps injury during the surgery (79.3%), nurses – during the preparation of instruments (35.1%), supporting staff – disposing the waste (75.8%). Commonly physicians were injured by the surgical needle (72.4%), nurses – by needlestick (72.4%), and the supporting staff – by glass... [to full text]

Bakgrund: En vårdande relation är inte detsamma som en vänskapsrelation, men förutsätter ändå närhet och engagemang. Personligt engagemang är också nödvändigt för att utvecklas som vårdare. Sorg är en naturlig reaktion vid förlust av relationer, men det är inte självklart att vårdare vet om de får eller bör känna och uttrycka sorg när patienter dör. Det saknas en samlad bild av vårdares sorg över döende och avlidna patienter. Syfte: Syftet var att beskriva hur vårdares egen sorg över döende och avlidna patienter gestaltar sig. Metod: Beskrivande litteraturöversikt av elva artiklar som analyserades med en form av kvalitativ innehållsanalys. Resultat: Vårdarens sorg gestaltar sig i form av inre känslor som att känna smärta och tyngande känslor samt skuld och ilska. Sorgen kan även visa sig i form av yttre uttryck där vårdaren exempelvis gråter eller känner sig rastlös. Den kan också yttra sig i ett tidsperspektiv där vårdarens sorg över en specifik patient förändras med tiden samt ett längre perspektiv där vårdarens tidigare erfarenheter påverkar hur han eller hon upplever sorgen. Klinisk betydelse: Denna studie kan vara ett stöd för vårdare som undrar om de får eller bör känna och uttrycka sorg över döende och avlidna patienter. Den kan också användas av vårdare som nått expertstadiet och som fungerar som handledare. Vid denna nivå av expertis bör enligt denna studies resultat uppmuntran och stöd ges till mindre erfarna vårdare, för att hjälpa dem att våga känna och uttrycka sin sorg. / Background: A caring relationship is not the same as a friendship relationship, but still requires intimacy and commitment. Personal commitment is also necessary to develop as a health care worker. Grief is a natural reaction to loss of relationships, but caregivers do not necessarily know if they are allowed to or should feel and express grief when patients die. There is no complete picture of health care workers’ grief over dying and deceased patients. Objective: The objective was to describe how health care workers’ own grief for the dying or deceased patients manifests itself. Method: A descriptive literature review of eleven articles, analyzed with a form of qualitative content analysis. Findings: Health care workers’ grief manifests itself as inner feelings such as pain, burdensome feelings, and guilt and anger. Grief can also manifest itself as an outward expression where the caregiver for example cries or feels restless. It can also manifest itself through time, when the health care worker’s grief for a particular patient is changing over time, but also in a life-time perspective, when the health care worker’s past experiences affect how he or she experiences the grief. Clinical significance: This study may provide support to health care workers who are wondering if they are allowed to or should feel and express grief for dying and deceased patients. It can also be used by health care workers who have reached the expert stage and are supervisors themselves. At this level of expertise, according to the results of this study, encouragement and support should be given to less experienced health care workers, to help them gain the courage to feel and express their grief.

Master of Public Health - MPH / Gay men and other men who have sex with men (MSM) and a subset within this group who are people who inject drugs (PWID) face difficulties when trying to access humanimmune deficiency virus (HIV)/ anti-retroviral treatment (ART) services and adhere to ART, due to the intersecting forms of oppression they face. Current interventions to address adherence to ART are mostly bio-medical in nature, and support the presumption that individual-level factors are the most pertinent barriers to adherence to ART. This mini-thesis presents findings from a qualitative study that explored individual, health systems and structural factors that shape experiences of adherence to ART amongst gay men and other MSM and a subset within this group who are PWID

Background: Many health care facilities enforce strict dress code policies prohibiting visible body modifications, including tattoos, piercings, and vibrant hair colors. As popularity of body modifications among young adults surges, facilities may be forced to adapt policies as these workers enter the workforce. While some evidence exists related to patient perceptions of health care workers with body modifications, there is little about how nursing students perceive them. This study aimed to describe undergraduate, pre-licensure nursing students’ perceptions of health care worker appearance on compassion, skill, knowledge, and trustworthiness. Methods: Using cross-sectional design, an on-line Likert-type survey was used to collect data from 137 undergraduate, pre-licensure nursing students in Northeast Tennessee. Participants viewed photos of male and female workers with various body modifications. Data were analyzed using descriptive and inferential statistics. Results: There were statistically significant differences between groups across all four variables. Male and female health care workers without body modifications were rated highest on all four variables. Male and female with tattoos were rated the second highest. Male and female with facial piercings were rated lowest. The female health care worker color, irrespective of body modification type, was rated higher than the male counterpart across all variables. Conclusion: Results suggest that nursing students may perceive health care workers without body modifications to be the most compassionate, skilled, knowledgeable, and trustworthy. Students may perceive tattoos as more acceptable in the workplace than facial piercings or vibrant hair colors. Students may perceive body modifications as more acceptable for females than males.

Detta är en uppsats där normer och värderingar om vårdbiträdet i hemtjänst undersöks genom kritisk diskursanalys. Datamaterial omfattar SOU-rapporten I den äldres tjänst. Äldreassistenten – ett framtidsyrke samt två fokusgruppsintervjuer med omsorgspersonal från en hemtjänstenhet. Diskursanalysen utförs i förhållande till och i samspel med sekundärlitteraturen. Utöver den språkliga analysen tas även kulturella och sociala dimensioner med i studien. För att ringa in rådande diskurser studeras centrala termer och formuleringar genom att undersöka hur ofta och upprepat de förekommer, samt vilken inkludering och exkludering som görs. I spänningsfältet som uppträder mellan den statliga diskursen och den praktiknära diskursen framträder stridigheter om de brister som äldreomsorgen tillskrivs. På politisk statlig nivå framträder en normerande bild av vårdbiträdet som den bristande länken i lagarbetet kring den äldre. På praktiknära nivå framhålls en förklaringsmodell där organisering och ledning är centrala bristkomponenter. Praktiker-diskursens faktorer bemötande och lön konkurrerar med de överordnade faktorerna som återges i SOU-diskursen; utbildning och validering. / This study is a discourse analytical study of norms and values in the Swedish public home health care sector. The discourse is studied at two different levels in Swedish society: the political and the practical. Information is collected through focus-group interviews at the practical level and at the political level from a report in the Swedish Government Official Reports Series (SOU 2008:126), appointed by the Ministry of Health and Social Affairs.   Government-sponsored publications and reports are used as a basis for executive and legislative decision-making in the parliament and the government. The governmental study is an important template for the formation and maintenance of norms and valuations. Elder care workers constitute Sweden's largest labor force and a majority of them are employed by municipalities. The SOU report motivates competence-reform in light of pending waves of retirements within the elder care work force, increased demand for elder care, and decreasing high-school enrollment in care and service programs. The discourse analysis is executed in relation to and in concert with the secondary literature.   The theoretical and methodological perspective in this study takes its starting point in Fairclough's critical discourse analytical theory and method. This provides dialectic of structures and practices, where discourse has an influence on and is influenced by social structures. In Fairclough's view, discourse practices are an important form of social practice that contributes to the forming of identities and relationships. The study investigates discursive practices in the report in order to uncover their role in the perpetuation of an unequal balance of power, so called ideological effects.  The study reveals contradictions within the SOU report and discordance between the report and home health care workers. Despite a societal eagerness to professionalize the home health aide, the political discourse relegates the aide to the bottom of the care hierarchy, by excluding issues such as compensation and subordinating questions concerning the organization and management. Discourses and action-space for workers in the home health care environment can be investigated in light of current deficiencies in top-down guidance and limited opportunities for peer-group meetings, especially since an increasing number of home health care workers have Swedish as a second language. Interactive research with both workers and management could be investigated and developed with pedagogical tools as a part of process of reform. Because Swedish society places such a high value on government reports, it is of continuing importance to scrutinize through critical-discourse analysis the entity of governmental research.

Thesis (MPH.) --University of Limpopo, 2019. / Background: The purpose of this study was to investigate the extent of adherence to Infection Prevention and Control (IP&C) practices and programs amongst healthcare workers (HCWs) in the neonatal ward at Charlotte Maxeke Central Hospital (CMCH). Methods: Quantitative research was conducted on 57 Clinicians directly providing care to the patients and 5 Health Care Workers indirectly providing care to the patients by means of supporting the environment and logistics where patients are being taken care. Data collection was done using structured questionnaires. Because the population was so small, all available HCWs, who were willing to participate in the study were selected to participate in the study. Furthermore, the SAS statistical software was used to describe and analyse data received from the data collection tools. Results: Two groups of respondents participated in the study which were (n=57) who in the neonatal ward at CMCH and Health Care Workers (n=5), most of the clinicians were having 1 – 4 years’ experience working in the neonatal unit at 54.6% followed by 5 – 9 years at 21.8%. Participants were in the age group ≤ 30 years at 39.3% followed by 31 – 40 years (32.1%) and least being at ≥ 51 years (5.4%). Clinicians included 46% of professional nurses, 28.6% Auxiliary Nursing Assistant, 16.1% student nurses and 8.9% medical doctors. The findings revealed that there are some areas where there’s inconsistent in using gloves when anticipating exposure to blood or body fluids, drying of hands after washing and removing jewellery during clinical care among clinicians particularly doctors, professional nurses and student nurses about IPC practices during clinical care. In Conclusion: There was inadequate compliance with IPC standards and there’s a need for regular trainings to improve the knowledge about IPCs and awareness of its importance among clinicians and health care workers in the neonatal unit. The IPC committee need to be revitalized by the hospital management to be able to undertake its mandate. Furthermore, the Hospital administration should provide copies of IPPC policy Guidelines in all wards/units and ensure effective implementation through vi constant supervision and adequate supplies and conduct regular audits to enhance compliance and implementation of IPPC policy. The study concluded that there was inadequate compliance with IPC and there’s a need for regular trainings to improve the knowledge about IPCs and awareness of its importance among clinicians and health care workers in the neonatal unit.

Le patient acteur dans la prise en charge du cancer: attentes normatives et travail du malade. Dans un contexte d’humanisation des soins valorisant la figure de l’individu acteur de sa santé, la présente thèse interroge les positionnements des malades touchés par le cancer et des accompagnants dans la prise en charge et le vécu de cette pathologie (professionnels soignants et proches) sur ce « devenir acteur » de la maladie. Elle met en évidence le travail de gestion de la maladie réalisé par les individus touchés, en analysant notamment comment ils composent avec les dimensions incertaines de l’expérience du cancer. Elle montre également que les considérations éthiques de « droit à l’information », de patient « associé aux décisions » ou encore « au cœur de la prise en charge » et la politique de lutte contre le cancer axée sur une « éducation sanitaire » contribuent à faire émerger des attentes normatives qui pèsent sur les malades. Au travers de quatre temps de la maladie – la découverte et l’annonce du cancer, la période des traitements, le vécu de la rémission et les trajectoires de fin de vie -, elle interroge plus spécifiquement les écarts entre les rôles attendus ou prescrits et les rôles effectivement endossés, les stratégies de coopération, de négociation ou de résistance entre les acteurs et les éléments qui fondent les prises de décision des malades et leur engagement dans les actions qu’ils mènent pour faire face au cancer au quotidien. Le questionnement sous-jacent porte ainsi sur les actions et stratégies entreprises par les acteurs touchés pour tenter de maitriser une trajectoire de maladie marquée par l’incertitude et sur la manière dont ces dernières s’intègrent – ou non – dans les attentes portées sur « l’individu acteur de sa santé et de sa maladie ». / The patient actor in the management of cancer : normative expectations and patient workIn the context of a humanisation of care that enhances the figure of the individual as an actor in his or her health, this thesis questions the positioning of patients affected by cancer and their caregivers and close relatives in the care and experience of this pathology from the point of view of their "becoming actor". It highlights the disease management work done by the affected individuals, notably by analyzing how they deal with the uncertain dimensions of the experience of cancer. It also shows how the ethical considerations of the "right to information", the patient "associated with decisions" or even "at the heart of care" and the fight against cancer policy centered on "health education" contribute to bring to the foreground normative expectations that weigh on the sick. Through four stages of the disease - the discovery and announcement of cancer, the treatment period, the experience of remission and end-of-life trajectories - it more specifically examines the differences between the expected and prescribed roles and the roles effectively endorsed, the strategies of cooperation, negotiation or resistance between the actors and the elements that underpin the decision-making of the patients and their commitment to the actions they take to face cancer on a daily basis. The underlying questioning thus focuses on the actions and strategies undertaken by the actors affected in an attempt to control a trajectory of illness marked by uncertainty and how the latter integrate - or not the expectations of " the individual actor of his health and his disease ".

<p>The appeal of Allport&rsquo / s Contact Hypothesis lies in the simplicity of its core principle, which holds that contact between different groups may serve to reduce prejudices. Contact needs to meet key conditions, i.e. equal power, cooperation towards a common goal and institutional support. Support has been found for the Contact Hypothesis in its original form and for those contacts which fail to meet the specified conditions. This study sought to explore whether contact, in forms different to those traditionally defined by the Contact Hypothesis, i.e. exposure, had any bearing on group prejudice. The prejudice and its underlying negative attitudes of interest, were those informed by HIV and AIDS stigma. HIV and AIDS stigma, defined as a discrediting quality and informed by social processes, is of particular concern as it impedes prevention, treatment and care efforts in South Africa&rsquo / s response to the HIV and AIDS epidemic. The health care context is often an area where Persons Living with HIV (PLHIV) are confronted with HIV and AIDS stigma. The research aims were thus to explore the extent of HIV and AIDS stigma amongst health care workers, the forms of exposure to PLHIV and the relationship between exposure and HIV and AIDS stigma. A quantitative, survey design was employed to accomplish these aims and to test formulated hypotheses, which were based on current literature and the core principle of the Contact Hypothesis. The sample consisted of 202 health care workers in the Cape Town metropole. Data analyses revealed the existence of low to moderate levels of HIV and AIDS stigma and also found that most of the sample had exposure to PLHIV in either its individual forms or overall form. Bivariate correlations revealed negative relationships between forms of exposure, overall exposure and stigma.</p>

<p>The appeal of Allport&rsquo / s Contact Hypothesis lies in the simplicity of its core principle, which holds that contact between different groups may serve to reduce prejudices. Contact needs to meet key conditions, i.e. equal power, cooperation towards a common goal and institutional support. Support has been found for the Contact Hypothesis in its original form and for those contacts which fail to meet the specified conditions. This study sought to explore whether contact, in forms different to those traditionally defined by the Contact Hypothesis, i.e. exposure, had any bearing on group prejudice. The prejudice and its underlying negative attitudes of interest, were those informed by HIV and AIDS stigma. HIV and AIDS stigma, defined as a discrediting quality and informed by social processes, is of particular concern as it impedes prevention, treatment and care efforts in South Africa&rsquo / s response to the HIV and AIDS epidemic. The health care context is often an area where Persons Living with HIV (PLHIV) are confronted with HIV and AIDS stigma. The research aims were thus to explore the extent of HIV and AIDS stigma amongst health care workers, the forms of exposure to PLHIV and the relationship between exposure and HIV and AIDS stigma. A quantitative, survey design was employed to accomplish these aims and to test formulated hypotheses, which were based on current literature and the core principle of the Contact Hypothesis. The sample consisted of 202 health care workers in the Cape Town metropole. Data analyses revealed the existence of low to moderate levels of HIV and AIDS stigma and also found that most of the sample had exposure to PLHIV in either its individual forms or overall form. Bivariate correlations revealed negative relationships between forms of exposure, overall exposure and stigma.</p>