Submitted by isabela.moljf@hotmail.com (isabela.moljf@hotmail.com) on 2017-08-31T11:18:33Z No. of bitstreams: 0 / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2017-08-31T12:26:12Z (GMT) No. of bitstreams: 0 / Made available in DSpace on 2017-08-31T12:26:12Z (GMT). No. of bitstreams: 0 Previous issue date: 2016-03-30 / CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / O mundo do trabalho tem sofrido diversas modificações decorrentes do capitalismo e da modernização, exigindo do trabalhador flexibilidade. A incapacidade de adaptação às mudanças gera estresse ocupacional, repercutindo no desgaste físico e emocional à saúde do trabalhador. A Síndrome de Burnout (SB), é um tipo específico de estresse ocupacional no qual o trabalhador expõe-se cronicamente a estressores laborais. Caracteriza-se pelas dimensões exaustão emocional (EE), despersonalização (DE) e baixa realização profissional (RP). Profissionais de saúde são propensos à SB por lidarem diretamente com pessoas, sofrimento e morte. A Atenção Primária à Saúde (APS) é o nível assistencial mais aproximado da comunidade, expondo os profissionais às realidades e dificuldades desta. Entretanto, nota-se a escassez de estudos sobre SB na APS. Objetivo: identificar a prevalência da SB nos profissionais da APS de Juiz de Fora e fatores associados. Métodos: estudo transversal com uma amostra de 153 profissionais da APS. A variável dependente SB foi medida pelo questionário MBI (Maslach Burnout Inventory). Resultados: a prevalência da SB foi de 0,7% segundo critérios de Maslach e Jackson e de 51% conforme Grunfeld et al. Seguindo critérios de Grunfeld et al. a equipe de enfermagem apresentou maior prevalência da SB (56,6%) em relação as demais categorias profissionais. As variáveis autoavaliação do estado de saúde ruim (p<0,001) e insatisfação laboral (p<0,001) associaram-se à SB. 13,1% e 0,7% apresentaram altos níveis de EE e DE, respectivamente, e 48,4% baixa RP. Tempo de serviço, autopercepção da saúde, apoio social e satisfação laboral relacionaram-se significativamente com as dimensões. Conclusão: o trabalho na APS possui peculiaridades revelando-se complexo devido à proximidade existente entre profissional e comunidade, pela atribuição em cuidar integralmente e continuadamente do usuário, exigindo a utilização das tecnologias leves, além de comprometer-se prioritariamente em promover a saúde e prevenir a doença. Somados a estes desafios, destaca-se a desvalorização do nível primário de atenção e a insuficiência dos recursos a ele destinados. A APS constitui-se como lócus importante a ser estudado no sentido de promover boas condições laborais, visando diminuir o risco de desenvolvimento do burnout, resguardar o bem estar destes profissionais e garantir a produção de um cuidado de qualidade à sociedade. / The world of work has undergone several changes resulting from capitalism and modernization, requiring flexibility worker. The inability to adapt to changes generates occupational stress, reflecting the physical and emotional toll on workers' health. The Burnout Syndrome (BS) is a specific type of occupational stress in which the worker is exposed to chronic labor stressors. It is characterized by emotional exhaustion dimensions (EE), depersonalization (DE) and low personal accomplishment (RP). Health professionals are likely to BS by dealing directly with people, suffering and death. The Primary Health Care (PHC) is the closest level of care in the community, exposing professionals to the realities and difficulties of this. However, there is a lack of studies of BS on PHC. Objective: to identify the prevalence of BS in professional Juiz de Fora from PHC and associated factors. Methods: cross-sectional study with a sample of 153 professionals of the APS. The dependent variable BS was measured by questionnaire MBI (Maslach Burnout Inventory). Results: the prevalence of BS was 0.7% according to criteria of Maslach and Jackson and 51% as Grunfeld et al. following criteria Grunfeld et al. The nursing team showed a higher prevalence of BS (56.6%) than the other professional categories. The self-assessment variables of poor health status (p <0.001) and job dissatisfaction (p <0.001) were associated with the BS. 13.1% and 0.7% had high levels and EE, respectively, and 48.4% low RP. Length of service, self-perceived health, social support and job satisfaction correlated significantly with the dimensions. Conclusion: work in APS has peculiarities revealing complex due to the proximity between professional and community, the assignment to care fully and continuously user, requiring the use of lightweight technologies, and commit priority to promote health and prevent disease. Added to these challenges, there is the devaluation of the primary care level and the lack of resources allocated to it. The APS constitutes an important locus to be studied in order to promote good working conditions in order to reduce the risk of developing burnout, protect the welfare of workers and ensure the production of quality care to society.

Orientador: Solange L'Abbate / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-25T09:31:16Z (GMT). No. of bitstreams: 1 Vivot_ClaudiaCristiane_M.pdf: 1742438 bytes, checksum: a6d24f89393f18ab5da4a51e74d5fc9a (MD5) Previous issue date: 2014 / Resumo: A Secretaria Municipal de Saúde de Sorocaba/SP, por meio da Diretoria de Área da Assistência e Educação em Saúde, responsável pelo direcionamento do modelo de atenção à saúde e gestão das Unidades Básicas de Saúde, vem adotando diferentes estratégias de trabalho para o fortalecimento da Atenção Básica em Saúde em seu território. Em 2010, foram criados seis Colegiados de Gestão, compostos por cinco Unidades Básicas de Saúde cada. Foram constituídos também três Núcleos Técnicos, compostos por profissionais do nível central designados para apoiar a gestão das Unidades Básicas de Saúde. Nesse novo formato, houve uma revisão do papel dos apoiadores técnicos e a implementação de reuniões com coordenadores das Unidades Básicas de Saúde. A adesão dos técnicos da Diretoria de Área da Educação em Saúde a este modelo organizacional não ocorreu de modo homogêneo em todos os Colegiados. Nos Colegiados Leste e Centro Sul, as diferentes estratégias de trabalho foram discutidas em reuniões periódicas orientadas pelos princípios da Política Nacional de Educação Permanente em Saúde. Assumiu-se a premissa de que o desenvolvimento técnico-científico e ético dos coordenadores das Unidades Básicas de Saúde favoreceria o fortalecimento da Política Nacional de Atenção Básica. O objetivo geral dessa investigação de caráter qualitativo foi analisar essas reuniões, ocorridas de junho de 2010 a dezembro de 2012, como espaços de discussão de práticas relativas à qualificação da gestão e seus possíveis desdobramentos em relação aos coordenadores das Unidades Básicas de Saúde. As informações foram obtidas a partir da leitura das Atas das reuniões, dos relatos da autora que atuou como uma das apoiadoras dos referidos colegiados, complementadas por entrevistas semiestruturadas com os coordenadores das Unidades Básicas de Saúde e com os diretores da Diretoria de Área da Assistência e Educação em Saúde, que atuaram de 1998 a 2012. A análise das informações levou em conta os pressupostos da Educação Permanente, baseou-se no referencial teórico-metodológico da Análise Institucional, sobretudo os conceitos de instituição, implicação e analisador. Os resultados da investigação apontaram que nestes Colegiados de Gestão Leste e Centro Sul houve um expressivo avanço na construção coletiva de conhecimentos e ações voltadas ao enfrentamento dos problemas do cotidiano do trabalho, resultando numa maior aproximação entre a gestão e a assistência. Evidenciou-se também um aumento do vínculo entre os próprios coordenadores e entre estes e os apoiadores, construindo uma nova intersubjetividade. Esta investigação pretende contribuir para a institucionalização e difusão dessa estratégia de caráter inovador e estimular movimentos semelhantes em outros equipamentos das Secretarias Municipais de Saúde, buscando sempre o aprimoramento do Sistema Único de Saúde / Abstract: The Municipal Health Department of Sorocaba, SP, Brazil, through its Division for Health Treatment and Education, is responsible for managing the model of treatment dispensed at basic health units. In effect, the department has adopted different working strategies for strengthening primary health care in the municipality. In 2010, six management teams were set up, each one responsible for five basic health units. Three technical groups were also implemented, comprised of middle-level professionals assigned to back up the management of basic health units. With this new format the role of technical backers was revised and meetings were held with coordinators of basic health units. Acceptance of this model by technicians in the Division for Health Treatment and Education was far from homogeneous among the teams. In the eastern and south-central teams the different working strategies were discussed at periodic meetings, based on the principles found in the Brazilian National Policy for Continuing Education in Health. The premise was accepted that the technical, scientific and ethical training of the coordinators of basic health units favored the strengthening of the National Primary Care Policy. The overall objective of this qualitative investigation was to analyze these meetings, which were held between June 2010 and December 2012, as spaces for discussing practices related to training in management and the possible results for coordinators of basic health units. The information was obtained from the minutes of these meetings and from reports by the author, who served as one of the backers of the above-mentioned teams. The information was completed with semi-structured interviews with coordinators of basic health units and with persons who had served as supervisors of the Division for Health Treatment and Education between 1998 and 2012. The analysis of the information took into account the premises of continuing education and the theoretical and methodological framework of institutional analysis, especially the concepts of institution, implication, and analyzer. Research results showed that there was a significant advance in the collective construction of knowledge and actions in the eastern and south-central teams, aimed at addressing everyday problems of work. This resulted in a closer relationship between management and treatment. Closer ties also resulted among the members themselves and between them and the backers, which led to new intersubjectivity. This study is intended as a contribution to the institutionalization and dissemination of this innovative strategy. The authors also hope that it will encourage similar movements in other areas of municipal health departments in the improvement of the Brazilian Federal Health System / Mestrado / Ciências Sociais em Saúde / Mestra em Saúde Coletiva

Orientador: Eliete Maria Silva / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Enfermagem / Made available in DSpace on 2018-08-25T15:28:42Z (GMT). No. of bitstreams: 1 Santos_DanielaValentimdos_M.pdf: 7290095 bytes, checksum: b019946b07ea6d0efe9b37e5ac47bee4 (MD5) Previous issue date: 2014 / Resumo: A temática da violência contra a mulher está contemplada em diversas políticas públicas, conferindo visibilidade a este agravo. Entretanto, a efetivação dessas políticas passa por uma ampla rede de serviços, que para dar suporte à mulher deve ser integrada. Entre os pontos de atenção desta rede está a Atenção Primária à Saúde, que é a porta de entrada preferencial do Sistema Único de Saúde e principal estratégia para oferecer acesso, atenção integral e impactar na situação de saúde das pessoas, como é o caso da violência. O objetivo deste estudo foi caracterizar a força de trabalho da enfermagem na Atenção Primária à Saúde, em município de grande porte do interior paulista, e descrever as práticas dessa equipe no cuidado com mulheres em situação de violência. Constitui-se em pesquisa quantitativa, descritiva, transversal, com amostra aleatória, realizada com auxiliares e técnicos(as) de enfermagem e enfermeiros(as) de todas as unidades básicas de Sorocaba. Foi utilizado formulário com questões semiestruturadas, com informações sociodemográficas e sobre detecção de situações de violência. A coleta de dados ocorreu no mês de fevereiro de 2014. O software SAS, versão 9.2, foi utilizado para realizar os testes estatísticos Mann-Whitney, Kruskal-Wallis e Qui-quadrado. Foram considerados significantes os valores de p menor que 0,05. Para as respostas textuais, procedeu-se a análise de conteúdo. Os resultados referem-se a 236 profissionais de enfermagem, sendo 54(22,88%) auxiliares de enfermagem, 48(20,34%) enfermeiros(as) e 134(56,77%) técnicos(as) de enfermagem. A distribuição entre os sexos foi semelhante entre as categorias, e todas apresentaram predomínio do sexo feminino, 210 (88,98%). Quanto ao quesito raça/cor, predomínio de pessoas que se autodeclararam brancas 188 (88,98%). As diferenças entre as categorias da enfermagem foram significantes; os auxiliares de enfermagem apresentaram maior média de idade (49 anos), tempo de serviço público (21 anos) e tempo de unidade básica (12 anos) que enfermeiros(as) e técnicos(as) de enfermagem. A respeito do atendimento às mulheres, entre os profissionais de enfermagem da APS, 133(56,33%) já suspeitaram que alguma mulher tivesse sofrido violência. As principais dificuldades relatadas pelos profissionais para investigar suspeitas de violência foram: medo da mulher falar sobre o assunto, falta de treinamento e capacitação e receio de sofrer represálias do agressor. Dessa forma, concluímos que a força de trabalho na atenção primária é feminina, com predomínio de profissionais de nível médio. Nossa pesquisa corrobora com pesquisas, que evidenciam que as situações de violência contra a mulher permeiam as práticas de enfermagem na Atenção Primária à Saúde. Consideramos que o enfoque das políticas públicas de enfrentamento da violência contra a mulher deve abranger a capacitação e o suporte para os profissionais da Atenção Primária à Saúde para que estes serviços não se reduzam a pontos de triagem e encaminhamento / Abstract: The theme of violence against women is addressed in various public policies, giving visibility to this damage. However, the effectiveness of these policies goes through an extensive network of services, which should be integrated to support the woman. Among important aspects of this network is the Primary Health Care, which is the preferred gateway of the Unified Health System and principal strategy to provide access, comprehensive health, and impact on people's health situation, as in the case of violence. The objective of this study was to characterize the workforce of nursing in the Primary Health Care, in large inland municipality of São Paulo, and describe the practices of that team in the care of women in situations of violence. Consists of quantitative, descriptive, and transversal research, with random sample. Held with the nursing assistants, nurses and nursing technicians from all the basic health units of Sorocaba. It was used a form with semi-structured questions, demographic information and about detection of violence situations. Data collection occurred in February, 2014. The SAS software, version 9.2, was used to make statistical tests Mann-Whitney, Kruskal-Wallis and Qui-quadrado. P values less than 0.05 were considered significant. For textual responses, content analysis was conducted. The results refer to 236 nursing professionals, being 54 (22.88%) nursing assistants, 48 (20.34%) nurses, and 134 (56.77) nursing technicians. The gender distribution was similar between the categories, and all showed female predominance, 210 (88.98%). As for the item race/color, there was the predominance of people who declare themselves white, 188 (88.98%). The differences between the categories of nursing were significant; the nursing assistants presented a higher median age (49 years old), public service time (21 years) and basic unit time (12 years) than nurses and nursing technicians. Regarding the attendance to women, among the nursing professionals of APS, 133 (56.33%) had already suspected that a woman had suffered violence. The main difficulties reported by professionals to investigate suspicions of violence were: fear of women speaking about the subject, lack of training, and qualification and fear of suffering reprisals of the assailant. Thus, we conclude that the workforce in primary care is female, with a predominance of middle-level professionals. Our research corroborates with researches showing that the situations of violence against women permeate nursing practices in the Primary Health Care. We consider that the focus of public policies for combating violence against women should include training and support for professionals in the Primary Health Care so that these services do not reduce the points of sorting and routing within the basic unit / Mestrado / Enfermagem e Trabalho / Mestra em Ciências da Saúde

Submitted by Fabiana Gonçalves Pinto (benf@ndc.uff.br) on 2017-03-13T19:38:59Z No. of bitstreams: 1 Suellen Gomes Barbosa Assad.pdf: 2196562 bytes, checksum: 3e8473124e293e8c4ab3e9d502052fa7 (MD5) / Made available in DSpace on 2017-03-13T19:38:59Z (GMT). No. of bitstreams: 1 Suellen Gomes Barbosa Assad.pdf: 2196562 bytes, checksum: 3e8473124e293e8c4ab3e9d502052fa7 (MD5) Previous issue date: 2015 / Mestrado Profissional em Ensino na Saúde / A vacinação é uma das ações primordiais da Atenção Básica, entretanto a ocorrência de Oportunidades Perdidas de Vacinação (OPV) aponta para a necessidade de se instituir estratégias de Educação Permanente em Vacinação, direcionadas aos profissionais de saúde, especialmente àqueles responsáveis pelo atendimento nas Unidades de Saúde da Família (USF). O objeto deste estudo foi a Educação Permanente em Saúde (EPS) sobre OPV na USF, e como objetivo geral o estudo visou: Propor uma experiência de EPS sobre OPV no contexto do Programa Nacional de Imunizações (PNI) em uma USF da Baixada Fluminense. E especificamente: 1) Identificar o conhecimento dos profissionais de saúde atuantes nesta USF sobre OPV; 2) Descrever os motivos que levam à ocorrência de OPV relacionadas a estes profissionais; 3) Sensibilizar a equipe multiprofissional desta unidade de saúde sobre a importância da vacinação através da elaboração de um plano de intervenção para o problema. Tratou-se de uma pesquisa descritiva de abordagem qualitativa, pesquisa-ação, através de trabalho de campo com elaboração de um Plano de Intervenção baseado numa simplificação do método Planejamento Estratégico Situacional (PES). A amostra constituiu-se por 13 trabalhadores da equipe multiprofissional atuantes nesta unidade. Os dados foram coletados através de questionário misto e submetidos à Análise de Conteúdo segundo Bardin. Foram realizados encontros de EPS, onde foi feita a análise das causas do problema em questão, definidos os Nós Críticos (NC) e criadas operações específicas para cada nó, culminando no Plano de Intervenção. A prática de vacinação pode expandir as atitudes profissionais buscando a compreensão das diferentes situações e desdobrando novas possibilidades com a consequente redução das oportunidades perdidas em imunização. Para tanto, a educação permanente em saúde deve ser adotada, visando principalmente à reflexão crítica profissional ante temas referentes à imunização, acompanhamento adequado das coberturas vacinais, busca ativa dos faltosos e demais estratégias de ação contando com o envolvimento de toda a equipe multiprofissional / Vaccination is one of the main actions of the basic attention however the occurrence of missed opportunities for vaccination (MOV) points to the need to establish permanent education in Vaccination strategies, directed at health professionals, especially those responsible for servicing in family health units (FHU). The object of this study was the permanent education in health (PEH) about missed opportunities for vaccination in FHU, and as a general objective the study aimed to: To propose an experience of PEH on MOV in the context of the NationalProgramme of Immunizations (NPI) in a FHU of the Baixada Fluminense’s region. And specifically: 1) Identify the knowledge of health professionals acting in this FHU about MOV; 2) Describe the reasons that lead to the occurrence of MOV related to these professionals; 3) Sensitize the multidisciplinary team of this health unit about the importance of vaccination through the preparation of a contingency plan for the problem. It is descriptive research of qualitative approach, through field work, aimed at drawing up a contingency plan based on a simplification of the Situational strategic planning (SSP) method. The sample was created by 13 workers of the multiprofessional team working on this unit. The data were collected through questionnaire and joint subjected to content Analysis according to Bardin. PEH meetings were held, where the analysis of the causes of the problem in question, definided critical nodes (CN) and created specific operations for each node, culminating in the contingency plan.The practice of vaccination may expand the professional attitudes seeking the understanding of the different situations and deploying new possibilities with the consequent reduction of missed opportunities in immunization. To that end, the permanent education in health should be adopted, aiming mainly to critical reflection themes relating to immunization against professional, appropriate follow-up of vaccine coverage, active search of absentees and other action strategies with the involvement of the entire multidisciplinary team

Bakgrund: Personalen är den viktigaste tillgången inom vården och därför är det viktigt att de får det stöd som de behöver för att undvika stress och psykisk utmattning. Personal som arbetar i arbetsmiljöer där kritiska och traumatiska händelser uppstår löper en större risk att drabbas av psykisk ohälsa i form av utbrändhet, depressioner samt stress och även posttraumatisk stressyndrom (PTSD). Personalstöd har visat sig leda till såväl lägre sjukfrånvaro som mindre personalomsättning. Det finns olika former av personalstöd, ute i verksamheterna används oftast kamratstöd, avlastningssamtal och debriefing. Syfte: Syftet med denna studie var att undersöka förekomst av riktlinjer samt att beskriva dess innehåll för personalstöd efter kritiska och traumatiska händelser på ett antal anestesiavdelningar i Sverige. Metod: Metoden som användes var av kvantitativ och kvalitativ ansats och analysen genomfördes med manifest innehållsanalys. Resultat: 28 frågeformulär skickades ut, av dessa erhölls fjorton svar och sju utav dessa hade avdelningsspecifika riktlinjer för personalstöd. Riktlinjerna granskades och tre kategorier urskiljdes; syfte och mål med riktlinjerna, förebygga och stödja samt arbetsmiljö. De stödåtgärder som framkom var avlastningssamtal, debriefing, krisstöd, enskilt krisstöd, ceremonier samt emotionellt stöd och eftersnack. Avlastningssamtal var den vanligaste stödåtgärden. Slutsats: Ungefär hälften av de anestesiavdelningarna som erhöll frågeformulär valde att inte medverka i studien. Endast sju anestesiavdelningar av de som medverkade hade riktlinjer trots att lagar och föreskrifter säger att arbetsgivaren ska tillhandahålla riktlinjer för personalstöd. Klinisk betydelse: Förhoppningen är att denna studie ska vara ett stöd för verksamheter vid utformning av riktlinjer samt vid uppdatering av befintliga riktlinjer för personalstöd efter kritiska och traumatiska händelser. / Background: The personnel are the most important asset in health care and it is therefore important that they receive the support they need to avoid stress and mental fatigue. Personnel which works in environments where critical and traumatic events occur is at a higher risk of mental illness in form of burnout, depression, stress and also post-traumatic stress disorder (PTSD). Support to personnel has been found to contribute both to lower absenteeism as well as a lower personnel turnover. There are various forms of personnel support, the most commonly used types within operations are co-worker support, relief conversations and debriefing. Aim: The aim of this survey was to investigate the presence of guidelines and its contents for personnel support after critical and traumatic events in a number of anesthesia departments in Sweden Method: The method used was quantitative and qualitative approach, and the analysis was performed with manifest content analyze. Result: 28 questionnaires were sent out, of these were fourteen responses received and seven of these had guidelines for personnel support. The guidelines were reviewed and three categories were distinguished; purpose and goals of the guidelines, prevention and support, and work environment. Support methods that emerged was relief conversations, debriefing, crisis support, individual crisis support, ceremonies, emotional support and after talk. Relief conversations were found to be the most common method. Conclusion: Approximately half of the anesthesia departments that received questionnaires decided to don’t participate in the study. Only seven anesthesia departments of those who participated had guidelines, despite the fact that laws and regulations say that the employer shall provide guidelines for personnel support. Clinical significance: It is wished that this study will provide support for activities when developing guidelines, and also when updating already existing guidelines for personnel support after critical and traumatic events.

This research study investigated the impact of staff education levels in ensuring implementation of effective health programmes: A comparative study of NPOs in City of Tshwane Metropolitan Municipality. The literature that was consulted explains the current level of education, worldwide and South Africa, challenges and reasons for lack of critical skills among health professionals and social workers. An exploratory approach was used in the study; by conducting a case study on two selected Non Profit Orgaisations (NPOs) namely, Hope for Life and Bophelong Life Community Hospice, both receiving funding from the Department of Health and Social Development and from the National Lotteries Distribution Trust (NLDTF) through the National Lotteries Board (NLB). Three methods of data collection were used to triangulate data, i.e. questionnaires, interviews and documentation reviews. Data was collected from staff members, NPO management and documentation from NPOs and Grant Funding System of the NLB. At the end of the study and using acquired information, a number of recommendations are made for the effective implementation of programmes for both NPOs and funding organisations such as NLB.

Bakgrund: Kommunikation är utbyte av betydelsefull information mellan individer och kan förmedlas via verbalt och icke-verbalt språk. Genom att vårdpersonal skapar en mellanmänsklig relation till patienten uppnås ömsesidig förståelse som är grunden för att bedriva personcentrerad vård. I interkulturell kommunikation kan det däremot vara svårt att nå full förståelse på grund av otillräckliga språkkunskaper och kulturella skillnader. Syfte: Syfte med studien var att beskriva betydelsen av språklig och kulturell förståelse i kommunikationen mellan patient och hälso- och sjukvårdspersonal.  Metod: En allmän litteraturstudie med systematisk ansats baserad på kvalitativa vetenskapliga artiklar genomfördes. Artikelsökningar gjordes i PubMed och Cinahl. Följande sökord användes i sökningar: communication, communication barriers, experience, health care, health personal, immigrant, interpreter, language, migrant, nurse-patient relations. Resultat: Ömsesidig förståelse, språklig och kulturell, är nyckeln för att vårdpersonal ska kunna förstå patienten och bedriva god vård. Resultatet baserades på 15 artiklar och består av tre tema: Kommunikation och relation, Invandrare i vården och Tolkning. Konklusion: Otillräckliga språkkunskaper är ett hinder för invandrare att komma i kontakt med vården, förmedla sina behov och nå full förståelse för given information. För vårdpersonal är språkbarriären ett hinder för att kunna bedriva patientsäker och personcentrerad vård. Båda parter är beroende av en tolk för att uppnå ömsesidig förståelse. / Background: Communication is an exchange of significant information between individuals and can be conveyed through verbal and non-verbal communication. When health personnel establish interpersonal relationships with the patient, mutual understanding will be obtained which is the basis for person-centered care. However, in intercultural communication it can be difficult to achieve full understanding due to insufficient language knowledge and cultural differences. Aim: The aim of this study was to describe the importance of linguistic and cultural understanding in communication between patient and health personnel. Method: A literature study with a systematic approach based on qualitative articles was conducted. Article searches were made in PubMed and Cinahl. The following keywords were used in search process: communication, communication barriers, experience, health care, health personnel, immigrant, interpreter, language, migrant, nurse-patient relations. Results: Mutual understanding, linguistic and cultural, is the key for healthcare professionals to understand the patient and provide good care. The result was based on 15 articles and consists of three topics: Communication and relationship, Immigrants in healthcare and Interpreting. Conclusion: Insufficient language knowledge is an obstacle for immigrants to come into contact with healthcare, communicate their needs and gain full understanding of given information. Language barrier is an interference fpr healthcare professionals to be able to deliver patient-safe and person-centered care. Both parties are dependent on an interpreter to achieve mutual understanding.

The study was to investigate the effectiveness of Sociocultural Competency Training (SCCT) as an intervention in enhancing self-efficacy among trainees in the health care profession. The purposes of the study were threefold: (a) to evaluate the effectiveness of the training in enhancing the trainees' self-efficacy and behavioural performance; (b) to examine their personal experiences in the learning ofthe sociocultural competencies, and (c) to identify the factors that contribute to effective outcomes. A sample of 84 participants in the Health Sciences program at the Vancouver Community College was recruited. There were 26 local born Canadians and 32 immigrants in the experimental group, whereas 11 local born Canadians and 15 immigrants were in the control group. Experimental group participants took part in an 18- hour training over a 6-week period as part of their regular Human Relations Skills course curriculum. The control group also took the same training course after post-test data collection. This study used both quantitative and qualitative methods. Self-efficacy and behavioural performance were assessed quantitatively by the results from the General Self-Efficacy Scale (GSE), Situational Social Avoidance Scale (SSA), Social Self-Efficacy Scale (SSE), and Interpersonal Skills Checklist (ISC-33). Qualitative data was collected through written feedback from 28 participants and semi-structured interviewing with 24 volunteer interviewees in the experimental group. The results of this study supported the hypotheses that the Sociocultural Competency Training was effective in improving the interpersonal skills and lowering the social avoidance tendency among participants in the experimental group when compared to individuals in the control group. The hypothesis that there would be more significant change in participants' social self-efficacy was also supported. The Sociocultural Competency Training offered effective ways of helping people develop positive self-efficacy and behavioural competencies. Participants reported the training enabled them to have the sociocultural competencies to conduct their professional career in a multicultural community. In the future, the training can be used with high school students, college and university students, international students, professionals, business people, and expatriates who need to learn the sociocultural competencies for career success. / Education, Faculty of / Educational and Counselling Psychology, and Special Education (ECPS), Department of / Graduate

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Bakgrund: Självreflektion innebär att kunna iaktta sig själv, sina reaktioner och att kunnasamtala med sig själv om sina handlingar och om sina upplevelser. Det är ett medvetetsökande efter förståelse. Reflektion ger möjlighet att utveckla yrkesmässig medvetenhet omsitt eget sätt att fungera och reagera. Genom systematisk reflektion kan individen utvecklasoch koppla teori till praktik. Individen måste medvetet utvärdera sina erfarenheter för attkunna dra lärdom av dem. Syfte: Syftet var att belysa sjuksköterskors möjligheter till självreflektion inom psykiatriskvård. Metod: En integrativ litteraturstudie användes som metod. Data inhämtades från databasernaCinahl plus, PubMed och PsycINFO.Sammanlagt sex artiklar ligger till grund för resultat. Material har analyserats medWhittemore och Knafls (2005) analysmetod. Resultat: Sjuksköterskor behövde skapa utrymme för självreflektion. Studier visade attarbetsgivare behövde möjliggöra att självreflektion kunde utövas på arbetsplatsen ochmedarbetare måste värdesätta att självreflektion kunde fungera som ett hjälpmedel i denpsykiatriska omvårdnaden. Det var också viktigt att lärare och utbildare, i enutbildningssituation, var intresserade av individens lärande och hade kunskap om hur man lärut självreflektion. Slutsats: Möjligheter till självreflektion är tid, kunskap och en tillåtande miljö därsjuksköterskan eller sjuksköterskestudenten kan och vågar ställa frågor och där det finns engemensam norm som värdesätter självreflektion på arbetsplatsen. / Backgound: Self-reflection means being able to observe oneself, their reactions and beingable to talk to themselves about their actions and their experiences. It is a conscious search forunderstanding. Reflection provides the opportunity to develop professional awareness ofone ́s own way of functioning and reacting. Through systematic reflection, the individual candevelop and link theory to practice. The individual must consciously evaluate theirexperiences in order to learn from them. Aim: The purpose of this study is to elucidate nurses ́ opportunities for self-reflection inpsychiatric careMethod: An integrative literature study was used as a method. Data were obtained from thedatabases Cinahl Plus, PubMed and PSYCinfo. A total of six articles form the basis for theresult. The material has been analyzed using the Whittemore and Knafls (2005) method. Results: Nurses need to create space for self-reflection. The study showed that employersneeded to enable self-reflection to be exercised in the workplace and employees needed toappreciate that self-reflection could serve as an aid in psychiatric nursing. It was alsoeducators, in an educational situation, were interested in the individual ́s learning and hadknowledge of how to teach self-reflection. Conclusion: Opportunities for self-reflection are time, knowledge and a permissiveenvironment where the nurse or nurse student can and dare to ask questions and where there isa common norm that values self-reflection in the workplace.