Most of the training programmes received by the health advisers in the Gauteng health promotion directorate, are delivered in a lecture form, whereby trainers prepare their presentations according to themes chosen by management, without the involvement of trainees. After training, the health advisers adopt the same attitude with the individuals they educate. This study describes how participatory research was carried out to investigate how health advisers in the Gauteng Province experience and utilise these training programmes. It articulates the roles of the researcher and participants in the research process. The study showed that while it is true that trainees must receive theoretical information, it is equally true that they must be able to relate that information to their practical situations. The study indicates that this can occur by introducing a form of training in which the focus is on both the trainer and trainees as co-learners in the learning situation. / Social Work / M.A. Soc. Sc. (Mental Health)

Submitted by Mario Mesquita (mbarroso@fiocruz.br) on 2014-11-06T11:00:43Z No. of bitstreams: 1 Ray_Muller_EPSJV_Mestrado_2012.pdf: 858304 bytes, checksum: f5e74c295a80032f8b09e111f13f034c (MD5) / Approved for entry into archive by Mario Mesquita (mbarroso@fiocruz.br) on 2014-11-06T12:07:56Z (GMT) No. of bitstreams: 1 Ray_Muller_EPSJV_Mestrado_2012.pdf: 858304 bytes, checksum: f5e74c295a80032f8b09e111f13f034c (MD5) / Made available in DSpace on 2014-11-06T12:07:56Z (GMT). No. of bitstreams: 1 Ray_Muller_EPSJV_Mestrado_2012.pdf: 858304 bytes, checksum: f5e74c295a80032f8b09e111f13f034c (MD5) Previous issue date: 2012 / Fundação Oswaldo Cruz. Escola Politécnica de Saúde Joaquim Venâncio. Laboratório de Formação Geral na Educação Profissional em Saúde / Este trabalho busca analisar a trajetória do Movimento de Promoção da Saúde a nível internacional, em termos de reconfiguração da atenção em saúde, através da inclusão dos determinantes sociais em sua abordagem. Esta reconfiguração também ocorreu no Brasil, tendo a Promoção da Saúde se materializado enquanto política social no documento do Ministério da Saúde: Política Nacional de Promoção da Saúde, no ano de 2006. Através de levantamento bibliográfico e análise de documentos, busca traçar um paralelo entre o modo como a Promoção da Saúde é implementada no Brasil, em um cenário de reformulação do neoliberalismo, e a instauração de consenso em torno de um projeto societário que atende aos interesses do capital e mobiliza a sociedade civil, por meio da pedagogia da hegemonia. Busca também ressaltar a importância do Movimento de Promoção da Saúde na medida em que rompe com o paradigma biomédico do cuidado em saúde, e a possibilidade deste projeto ser utilizado visando conquistar apoio para um projeto político que mantém as relações de exploração intocadas. / This study analyses the path of the Health Promotion Movement, in the world, through the reconfiguration of health care, by including the social determiners in its approach. This reconfiguration also happened in Brazil, and Health Promotion could take form as a social policy in the Health Ministry document: The National Policy of Health Promotion, in 2006. It also draws a parallel between the way Health Promotion establishes in Brazil, during the neoliberalism reformulation; and the consensus establishment around a society project that serves the capital interests, while mobilizes civil society by the hegemony pedagogy. It seeks to emphasize the relevance of Health Promotion Movement as a biomedical paradigm of health care break up, and its possible application as a mean to gather support to a political project that keeps untouched the exploitation relationships. It will be done from literature and documents review.

A partir de 2008, com a implementação da Política de Atenção à Saúde e Segurança no Trabalho do Servidor Público Federal Pass, intensifica-se o debate nas diferentes organizações da Administração Pública Federal quanto ao cuidado com seus servidores, com especial preocupação com a promoção da saúde. A concretização da política se dá por meio da implantação de unidades de saúde conduzidas por equipe multiprofissional, na qual o psicólogo tem papel fundamental. A experiência profissional da pesquisadora como psicóloga de uma das unidades sediadas no INSS fomentou o desejo de compreender como vem sendo desenvolvidas as práticas psicológicas promotoras de saúde voltadas ao servidor nesta organização, tendo em vista os desafios percebidos quanto ao desenvolvimento de ações de promoção de saúde do trabalhador no espaço organizacional e quanto ao delineamento do papel do psicólogo nas políticas públicas. Foram entrevistados 06 (seis) psicólogos do INSS, utilizando-se a narrativa como instrumento de pesquisa qualitativa. Partindo da perspectiva hermenêutica filosófica de Gadamer, o encontro entre a pesquisadora e os narradores propiciou a fusão de horizontes compreensivos e construção de sentidos sobre o fenômeno investigado. As compreensões tecidas apontam para um importante momento de questionamento de ações de promoção de saúde pontuais e focadas nos estilos de vida dos indivíduos e para o despontar de movimentos moleculares na forma de estratégias mais efetivas, comprometidas com o empoderamento dos trabalhadores para a transformação da dinâmica organizacional, articuladas à perspectiva de uma psicologia clínica transversalizada em saúde do trabalhador na organização.

A trend toward non-institutionalization of the elderly, in conjunction with the increasing size of the elderly population has resulted in the development of a variety of community programs and services to help meet their complex and diverse health care needs in the community setting. Although there is substantial documentation pertaining to the needs of the elderly in the community and the available services (Lifton, 1989; Padula, 1983; Starrett, 1986; Wallace, 1987), this documentation has been generated primarily by health care professionals and agencies, rather than from the perspectives of the elderly themselves. Adult Day Care [ADC] programs were established in the late 1960s as one means of attempting to meet the needs of the frail elderly in the community (Padula, 1983). On the surface, these programs appear to be effective in meeting the needs of clients through the provision of nursing services and a wide variety of therapeutic programs and social activities. This exploratory descriptive study was based on the premise that there exists a need to gain insight into the clients' perspectives regarding the ways in which ADC services are instrumental in meeting their perceived needs. Data were collected and analyzed to identify the self-perceived needs of ADC clients and their perceptions of how the ADC nursing services were instrumental in assisting them to meet these needs. Two interviews were conducted with each of the 11 ADC participants comprising the sample, using a semi-structured interview guide developed by the researcher. The two needs most commonly identified by participants included the need to cope with a range of concurrent and/or successive losses, and the need to establish new support systems. Participants identified the most significant components of the nursing role as those of the provision of emotional support through counselling, and the provision of health monitoring services. Participants viewed the overall ADC program as important in assisting them to meet their needs by providing access to social outings, individualized care, emotional support, and the opportunity to enhance their self-esteem, confidence, and feelings of belongingness. / Applied Science, Faculty of / Nursing, School of / Graduate

MPH / Department of Public Health / Workplaces are important settings for health promotion and disease prevention. Participation in sport and recreation can lead to improved health of individuals and increased productivity levels at work places. Despite the health benefits of sports and recreation and the approval of the workplace sports and recreation policy in the Limpopo Department of Health, many employees still do not participate, even when invited for games. The aim of the study was to determine the perceived factors influencing participation of non-medical staff members in workplace sports and recreation at Elim Hospital using the constructs of the Health Belief Model. A quantitative descriptive cross-sectional study was conducted. The population were all non-medical staff members of Elim Hospital. A total sample of 222 non-medical staff members of Elim Hospital were used for the study. Participants were divided into three categories, depending on the type of their work. A researcher-administered structured questionnaire based on the construct of the Health Belief Model was used to collect data. The Statistical Package for Social Sciences (SPSS) version 23 and Microsoft Excel was used to analyse the data. A descriptive statistical method was used to analyse frequencies and Chi-square test was used to determine the level of significance of correlations between the different variables. A probability level of 0.05 or less was used to indicate statistical significance. The study revealed that the rate / level of participation in workplace sports and recreation among non-medical staff members at Elim Hospital was low (30%). Participants perceived themselves mainly as less susceptible and not susceptible to NCDs. The major barriers to participation that were identified include lack of awareness of the sports and recreation policy as well as busy work schedule. There was a significant relationship between participation and age of respondents, as well as between participation and occupation category. Educational programme geared towards increasing awareness of employees on the policy as well as on benefits of sports and recreation can significantly improve participation in workplace sports and recreation.

Cardiovascular disease (CVD) is responsible for approximately 600,000 deaths in the United States each year, with African Americans (AAs) disproportionately affected. Individual-level approaches to reducing CVD remain ineffective, mobilizing a movement that advocates for population-based solutions. Workplace wellness programs (WWPs) have gained considerable traction as a viable strategy for ameliorating CVD burden among workers in general. However, no studies have looked at the efficacy of WWPs in ameliorating CVD specifically among AA employees--a knowledge gap that this investigation aimed to close. Based on the health belief model and the social cognitive theory, this retrospective cohort study used de-identified secondary data to evaluate the racial differences in the mean change in CVD biomarkers between 163 AAs and 228 Caucasians civilian workers participating in a U.S. Marine Corp self-directed WWP. The 4 CVD biomarkers evaluated were systolic blood pressure (SBP), diastolic blood pressure (DBP), and waist-to-hip ratio. Repeated measures MANCOVA analysis was used to establish the contribution of the independent variable (race) to SBP, DBP, LDL cholesterol, and waist-to-hip ratio. Results showed an overall significant main effect of time for changes in SBP and DBP even after controlling for race, sex, age, and days from baseline. However, there was no overall main effect of time for changes in LDL cholesterol or waist-to-hip ratio. Further research using randomization, a comprehensive health risk appraisal, and a larger sample size may yield additional benefits to AAs. Implications for positive social change include reduction of the extraordinarily high CVD disease burden and disparity among AAs.

Because half of age-related physical losses result from inactivity and disuse, and loss frequently antecedes depression and decreased self-esteem; exercise intervention offers potential physiological and psychological benefits. Self-efficacy and personal control is additionally promoted in a wellness concept program. The effect of twelve weeks of wellness-oriented exercise upon depression, self-esteem, and locus of control orientation is studied in an exercise and non-exercise control group of community residing women 65 and older. Statistically significant post-exercise changes result from reductions in two self-report measures of depression in the exercise group, and increased self-esteem scores in the control group. A non-representative sample may account for high pre-exercise scores in all three dependent variables. A replication with a larger, random, representative sample of older people and domain-specific measures is recommended to improve the study of hypothesized psychological benefits associated with exercise.

Submitted in full compliance with the requirements for a Master’s Degree in Technology: Nursing, Department of Community Health Studies at the Durban University of Technology, 2009. / Purpose: Breastfeeding is a key child survival strategy important for the long-term health of both the mother and child. The number of women in paid employment has increased exponentially, yet very few of these women continue breastfeeding as recommended by the World Health Organisation. The purpose of this qualitative study was to identify the factors affecting breastfeeding practices in the workplace. Objectives of the study are to: 1: Describe managers’ attitudes to and knowledge about providing breastfeeding support. 2: Identify mothers’ attitudes towards breastfeeding and the workplace environment. 3: Describe the practices of the breastfeeding mothers in the workplace. 4: Identify factors that influence breastfeeding practices within the workplace environment Method The theoretical frameworks adopted were the Situation- Specific Theory of Breastfeeding and the BASNEF model. The frameworks together with the literature review provided the background which informed this study. The research was a case study of two multi -national companies in Durban, KwaZulu Natal; participants were mothers and managers in the companies. Purposive sampling was used for selecting eight women who participated in the focus groups, two follow up interviews were conducted and five managers were interviewed. Data collection techniques also included a reflexive journal and field observation. After a thorough review of the data, the main themes which emerged were used to guide the discussion and answer the objectives of the study. Results The two companies reflected a scenario of pressures in the workplace environment affecting women’s choices regarding combining work and breastfeeding; societal pressures were dictating acceptable behaviour. Breastfeeding was not a priority for employers, no breastfeeding policy existed. Breastfeeding mothers were isolated and employers and employees were not engaging on the issue. Conclusions and Recommendations Simple enabling factors within the workplace would allow mothers, their infants and employers to enjoy the benefits of supporting breastfeeding in the workplace; this would be a win-win situation. Government, non-governmental organisations and society have a responsibility to overtly protect, support and promote breastfeeding in society and in the workplace.

Fysisk aktivitet är viktigt för att främja hälsa och förebygga ohälsa och bör även rekommenderas till kvinnor under graviditeten. Barnmorskan har en central roll i det hälsofrämjande arbetet då hon ibland är den enda hälso- och sjukvårdspersonal som träffar kvinnan under graviditeten. Det finns rekommendationer för hur mycket den gravida kvinnan bör träna men studier visar att det är få som följer dessa. Barnmorskan upplever det svårt att ge råd och det finns ett behov av att hitta strategier som kan användas i arbetet med att främja fysisk aktivitet. Syftet med denna studie var att beskriva barnmorskors strategier för att främja fysisk aktivitet under graviditeten. Studien utfördes enligt kvalitativ metod där semistrukturerade intervjuer användes för insamling av data som sedan analyserades utifrån tematisk analys. I studien framkom ett flertal olika strategier som barnmorskorna använde för att främja fysisk aktivitet under graviditeten; Att ge råd, Att motivera, Att söka stöd i omgivningen, Att individualisera, Att vårda relationen och Att utveckla. Studien visade också att barnmorskorna upplevde arbetet med att främja fysisk aktivitet som viktigt men svårt. Författarna anser att strategierna är användbara, inte bara av barnmorskan utan även av annan personal inom hälso- och sjukvården som arbetar med att främja fysisk aktivitet under graviditeten. / Physical activity should be recommended to all women during pregnancy. Midwives have an important role in the health promotion practice. There are recommendations about physical activity during pregnancy, although studies show that few pregnant women actually follow them. The midwife experience difficulties in counselling and there is a need to find strategies that can be used to promote physical activity. The aim of this study was to describe the midwives strategies to promote physical activity during pregnancy. The study was conducted by qualitative method and semistructured interviews were used to collect data. The data was analysed by thematic analysis. Several strategies emerged that the midwives used to promote physical activity during pregnancy; To advice, To motivate, To seek support in the surroundings, To individualize, To take care of the relationship and To elaborate. Another finding in the study was that promotion of physical activity was perceived as important but difficult by the midwives. These strategies can be used by midwives and other healthcare providers to promote physical activity during pregnancy.

The purpose of this study was to examine in what way a strong employer branding of health promotion can have an effect on the ways individuals can experience isolation and stress. In this survey we have used the theories of health promotion, organizational culture, isolation and stress in an analysis of the possible situation caused by strong employer branding of health promotion. We have used these theories in analysis with the purpose to answer the following questions: How does a strong employer branding of health promotion influence those employees who, for some reasons, don’t take advantage of organizations’ health promotion programs and activities? Could those, who don’t take advantage of health activities, become isolated in a company? The method of research that was used in this study is a qualitative analysis; we used semi structured interviews and open e-mail correspondences. The material was collected from nine different organizations as the response from ten interviews. The result of the analysis show that is possible for an individual to experience isolation and stress as a result of an organization’s employer branding on health promotion. At the same time these individuals can experience that they are indirectly obligated to consider their everyday actions from the health promotion perspective, which we have assumed to be a result of the possible punishments and rewards from their leaders. The conclusion is consequently that a strong employer branding can affect an individual’s social situation within an organization, but it is problematic to see in which scale. The result has revealed that employer branding of health promotion is a possible cause for isolation and stress.