Barn påverkas av föräldrars psykiska sjukdom i form av oro, rädsla och skuld samt har en förhöjd risk att själva drabbas av psykisk sjukdom. En utmaning för den psykiatriska vården är det ökande antalet av vuxna med psykiatrisk sjukdom som även är föräldrar till minderåriga barn. Sjuksköterskor inom psykiatrin har en viktig roll när det gäller att uppmärksamma dessa barn samt se till att de får adekvat hjälp och stöd. Syftet med studien var att beskriva hur barn till föräldrar med psykisk sjukdom upplever det stöd de får ifrån den psykiatriska vården samt beskriva vårdpersonals upplevelser av stöd till dessa barn. Metoden som användes var kvalitativa forskningsintervjuer som genomfördes med sex barn som har föräldrar med psykisk sjukdom och fjorton vårdpersonal som arbetar inom den psykiatriska vården. Intervjuerna analyserades med kvalitativ innehållsanalys och resultatet utmynnade i fyra kategorier. 1. Barn till föräldrar med psykisk sjukdom upplever sig bli hjälpta av stödet från den psykiatriska vården även om det bör förbättras. 2. Vårdpersonal upplever att den psykiatriska vården erbjuder olika verksamheter som ger ett gott stöd till barn även om det bör förbättras. 3. Vårdpersonal upplever att barn behöver uppmärksammas, informeras och stödjas i kontakten med sina föräldrar. 4. Vårdpersonal upplever svårigheter i form av osäkerhet kring sin egen kunskap samt föräldrars ovilja att blanda in barn i den psykiatriska vården. En slutsats av studien är att barn till föräldrar med psykisk sjukdom får ett relativt gott stöd även om det behöver förbättras. För att göra detta krävs utbildning av vårdpersonal och att verksamheten har framtagna rutiner och användbara metoder för att kunna stödja barn. / Children get affected by parents mentally illness in form of anxiety, fear and guilt and also have an enhanced risk to suffer from mentally illness themselves. A challenge to the psychiatric care is the increasing number of adults with a mental illness who also are parents to under aged children. Nurses in the psychiatric care have an important role when it comes to notice these children and make sure that they receive adequate help and support. The purpose of the study was to describe how children of mentally ill parents experience the support they receive from the psychiatric care and describe psychiatric healthcare workers experiences of these children’s support. The method that was used in this study was qualitative interviews with six children of mentally ill parents and fourteen psychiatric healthcare workers. The interviews were analysed based on qualitative content analysis and gave four categories as result. 1. Children of mentally ill parents experience help due to the support from the psychiatric care even though it should be improved. 2. Psychiatric healthcare workers experience that the psychiatric care offers a variable of activities that give a good support to children even though it should be improved. 3. Psychiatric healthcare workers experience that children need attention, be informed and supported in their relationship to their parents. 4. Psychiatric healthcare workers experience difficulties like insecurity about their own knowledge and parents’ unwillingness to involve the children in the psychiatric care. A conclusion from this study is that children of mentally ill parents receive a relatively good support even though it needs to be improved. To do that it takes education of the psychiatric healthcare workers and that the psychiatric care is given routines and useful methods to support children.

Es va determinar el risc d'asma i la seva associació amb les exposicions laborals, així com la càrrega d'asma relacionat amb el treball, entre professionals sanitaris. Després de validar un qüestionari nou, es va administrar una enquesta a 5600 metges, infermers, i tècnics en teràpia respiratòria i ocupacional a Texas (tasa de resposta-66%). S'evidencia un risc elevat d'asma desprès d'haver començat a treballar per tasques de neteja general, desinfecció d'instruments mèdics, l'ús de guants de làtex i l'administració de medicaments en aerosol. També s'evidencien associacions significatives entre símptomes de hiperreactivitat bronquial i l'ús de productes generals de neteja, l'administració de medicaments en aerosol, l'aplicació de productes adhesius/dissolvents, i en persones amb antecedents d'exposició a un vessament químic. El risc per làtex desaparegué desprès de l'any 2000. Les exposicions laborals contribueixen de manera important a l'asma en el personal sanitari, justificant tant la implementació de controls adequats com la recerca addicional. / The magnitude of asthma risk, its associations with occupational exposures, and the burden of work-related asthma was estimated in healthcare professionals. After validating a new asthma questionnaire, a cross-sectional survey was conducted among 5600 Texas physicians, nurses, respiratory therapists and occupational therapists (response rate, 66%). Elevated risks of asthma after entry into the profession were found for general cleaning tasks, medical instrument cleaning, use of powdered latex gloves, and administration of aerosolized medications. Significant associations were also found between bronchial hyperresponsiveness-related symptoms and use of general cleaning products, administration of aerosolized medications, use of adhesives or solvents as products in patient care, and with a history of acute exposure to a chemical spill. The risk associated with latex disappeared after the year 2000. Occupational exposures contribute importantly to asthma among healthcare professionals and are not trivial, meriting both further study and implementation of appropriate controls.

After the 1994 genocide and collapse of the health system, Rwanda initiated major social and health reforms in order to reduce child mortality and health inequities in accordance with the Millennium Development Goals. The aim of this thesis was to assess trends in under-five mortality (U5M) and equity in child survival, to study social barriers for improved perinatal and neonatal survival, and to evaluate Helping Babies Breathe (HBB), a newborn resuscitation program. In paper I we analysed trends and social inequities in child mortality 1990−2010, using data from national Demographic and Health Surveys conducted in 2000, 2005, and 2010. The following papers were based on hospital studies in the capital of Rwanda. In paper II we explored social inequities in perinatal mortality. Using a perinatal audit approach, paper III assessed factors related to the three delays, which preceded perinatal deaths, and estimates were made of potentially avoidable deaths. Paper IV evaluated knowledge and skills gained and retained by health workers after training in HBB. Under-five mortality declined from the peak of 238 deaths per 1000 live births (95% CI 226 to 251) in 1994 to 65 deaths per 1000 live births (95% CI 61 to 70) in 2010 and concurred with decreased social gaps in child and neonatal survival between rural and urban areas and household wealth groups. Children born to women with no education still had significantly higher under-five mortality. Neonatal mortality also decreased but at a slower rate as compared to infant and U5M. Maternal rural residence or having no health insurance were linked to increased risk of perinatal death. Neither maternal education nor household wealth was associated with perinatal mortality risks. Lack of recognition of pregnancy danger signs and intrapartum-related suboptimal care were major contributors to perinatal deaths, whereof one half was estimated to be potentially avoidable. Knowledge significantly improved after training in HBB. This knowledge was sustained for at least 3 months following training whereas practical skills had declined. These results highlight the need for strengthening coverage of lifesaving interventions giving priority to underserved groups for improved child survival at community as well as at hospital levels.

Magister Curationis - MCur / Background: Health care workers who sustain needle stick injuries are at risk of contracting blood-borne pathogens, e.g. Human Immunodeficiency Virus,Hepatitis B virus or Hepatitis C virus. Needle stick injuries are viewed as occupational hazards that can lead to health care workers developing acute or chronic diseases, which may lead to disability or death. Due to these healthrelated risks, health care workers are encouraged to adhere to universal precautions and standard operating procedures. In South Africa, the Occupational Health and Safety Act promulgated in 1993 required institutions draw up protocols in line with the regulations of the Act. However, if the health care workers do not comply with the protocols they may not be compensated for contracting a disease, e.g. Human Immunodeficiency Virus infection, following needle stick injuries. Aim: The aim of the study was to explore the health care workers’ perceptions of the needle stick injury protocol at a level 2 hospital in Cape Town. Research design: A qualitative approach was used to make sense of health care workers’ compliance to the protocols when sustaining a needle stick injury. An exploratory descriptive, contextual design was used to carry out an in-depth investigation of the phenomenon. Sample: The study was done at Mowbray Maternity Hospital, a level 2 obstetric hospital in Cape Town. The researcher made use of convenience, purposive sampling. Semi-structured interviews were used to collect the research data. Data collection: During the data collection phase, ethical considerations towards participants were ensured to include, among others, anonymity, autonomy and confidentiality of information. Data analysis: It included the following steps: reading and rereading,coding, displaying, reducing and interpreting the data. Findings: Some health care workers do not view sustaining a needle stick injury as risky enough to report the injury or even go for follow-up testing. This risky behaviour can have detrimental effects on their health. There is also a lack of knowledge about the institutional needle stick injury protocol. Recommendations: It is recommended to have educational and training sessions for all health care workers and new employees to familiarise them with the needle stick injury protocol and policies of the institution; to provide adequate management support 7 following work related injuries and to make health care workers aware of the consequences of non-compliance to institutional protocol.

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The main goal of this work is to create an idea of how an educational system for non-physician healthcare professionals in the departments of anestesiology, resuscitation, and intensive care should look like with regards to interpreting and evaluating ECG curves that would lead to a better knowledge of understanding ECG curves. This certain idea of an educational system should be another option on how to educate healthcare professionals, thus improving their competence. The theoretical part of this work compares the educational system of healthcare professionals in the Czech Republic to other foreign countries and the competence of non-physician healthcare professionals working mostly in intensive care in hospitals. It also introduces and explains the basics on how to record an ECG curve that competent workers should be able to read and interpret correctly. The empiric part is based on the quantitative method of making a survey, in which the respondents are non-physician healthcare workers working in anestesiology, resuscitation, and intensive care in Czech hospitals. The survey study focuses not just on finding out the knowledge of ECG in non-physician healthcare professionals in anestesiology, resuscitaiton, and intensive care, but also whether it's necessary to teach them more about ECG. The...

To understand the impact of recurrent pandemics such as MERS-CoV on Respiratory Therapists (RTs) behavior and commitment has become an extremely important and relevant exercise because of the unprecedented MERS-CoV occurrences in Saudi Arabia. The purpose of this study was to assess RTs knowledge, attitudes, and skills, in order to examine the differences in RTs readiness level, training status, and the association and during MERS-CoV disasters. Method used Cross-sectional survey. A web-link survey was emailed to Saudi Society for Respiratory Care (SSRC) members, (N 750). The survey consisted of two parts: knowledge, skills, and attitudes, and the readiness to come to work. Data was collected and analyzed using SPSS 23.0. Findings showed a significant difference between the different levels of work positions (p = 0.027), a gender and work position (p = 0.012). There was a significant moderate correlation between readiness to work and knowledge (r = .407, p < 0.05), a significant low correlation between readiness to work and skills (r = 0.261, p = .05). There was a significant substantial correlation between skills and knowledge (r = .521, p < 0.05). In conclusion, this study showed the importance of establishes effective disaster health bureaucracy by performs periodic health policy analysis for epidemic and pandemic influenza. It called for planning, preparedness to respond effectively using all hazard-approach for potential influenza disasters. It revealed the significance of capability building for first line responders in term of HCWs Check-list education and training programs. Moreover, it supported the establishment of independent local CDC and Disaster Management panel. It recommended flexible bureaucracy and leadership enhancement for HCWs strike teams to increase likelihood success in response for unconventional scenarios.

Made available in DSpace on 2016-06-02T20:45:42Z (GMT). No. of bitstreams: 1 6438.pdf: 2051384 bytes, checksum: 374efd43e4f0d0bfed75020a01b0d74f (MD5) Previous issue date: 2014-10-21 / The Permanent Education in Health (Educação Permanente em Saúde - EPS) is a pedagogical strategy recognized by the Pan American Health Organization in Latin America as a method to consolidate public healthcare systems around the world since regular educational activities in health alone are not capable of fulfill the needs of the population and increase the quality of the service. This study discuss the Permanent Education in Health in the city of São Carlos SP and aims to identify and problematize the limitations and potentialities pointed by the local healthcare workers and managers in other to contribute to the development of the strategy in the city. The study uses a qualitative research method through semi-structured interviews of nine actors directly related to the local EPS activities. The results show that the EPS in the city is weakened by different factors such as: fragmented actions in education; lack of knowledge or misunderstanding of the concept of EPS by the workers and mainly by the managers; and above all, rupture of project and political policies due to changes in the government political party. Despite the obstacles, the study also revels positive aspects of the EPS implementation in the city, like: good partnership between healthcare network and educational institutions; investment in activities of education in health; and involvement in governmental forums of EPS discussions and planning. The study conclude that EPS can evolve by increasing the articulation between the players involved in the public health system SUS (teaching, management, care, and social control), to guarantee the continuous consolidation the National Policy of Permanent Education in Health. / A Educação Permanente em Saúde (EPS) é uma estratégia pedagógica de educação em saúde reconhecida pela Organização Pan-Americana de Saúde (OPAS) em toda América Latina para solidificar os sistemas públicos de saúde, visto que as atividades educativas em saúde não têm sido efetivas para atender as necessidades de saúde da população e realizar mudanças na qualidade dos serviços de saúde. Este estudo busca analisar o processo da Educação Permanente em Saúde de acordo com as políticas e diretrizes no município de São Carlos, além de ponderar os impasses que dificultam o processo de Educação Permanente em Saúde e suas condições de realização e contribuir para o desenvolvimento e articulação do processo de EPS no município. A discussão está subsidiada na técnica qualitativa de pesquisa, especificamente, por meio de entrevista semiestruturada realizada com nove sujeitos que estão diretamente ligados à EPS nesse município. Os resultados demonstram que a EPS no município encontra-se fragilizada por diversos fatores como: ações de educação em saúde ocorrem de modo fragmentado, pela falta de conhecimento ou diferentes concepções dos sujeitos e principalmente pelos gestores acerca da EPS, e, sobretudo, pela ruptura de projetos e políticas devido à alternância de governos e de partidos, como ocorrido com a implementação da EPS no município de São Carlos. Apesar disso, a pesquisa evidenciou que o município possui também potenciais para a estruturação e efetivação da EPS, tal como a parceria rede-escola, recursos investidos em atividades de educação em saúde e representatividade nos colegiados de discussão e planejamento de EPS. Assim sendo, concluise que apesar de fragilizada, a EPS possui possibilidade de ascensão. Sugere-se, a partir dos resultados deste estudo, que a articulação dos atores que formam o quadrilátero do SUS (ensino, gestão, atenção e controle social) seja fortalecida de modo a garantir a continuidade e a consolidação da Política Nacional de Educação Permanente em Saúde.

Röntgenavdelningen har ett blandat flöde av patienter vilket medför att denna är en potentiell smittväg för olika sjukdomar. För att minska risken för smittspridning är det viktigt att de basala hygienrutinerna följs, dock visar studier på att följsamheten till de basala hygienrutinerna är låg. Syfte: Syftet med denna litteraturöversikt var att undersöka hur röntgensjuksköterskans följsamhet till handhygienrutiner kan förbättras. Metod: En integrativ litteraturöversikt där vetenskapliga artiklar har sökts i databaserna PubMed och CINAHL. 15 artiklar har kvalitetsgranskats, kategoriserats, analyserats och slutligen har resultatet sammanställts och en syntes skrivits. Resultat: Olika typer av interventioner, såsom utbildning, information, automatiserade observationssystem och multimodala interventioner kan vara hjälpsamma i arbetet med att förbättra följsamheten till handhygienrutinerna Slutsats: Praktisk och teoretisk utbildning, en engagerad ledning och ett klimat i kombination med god tillgång till handhygienprodukter och påminnelser om att utföra handhygien är viktiga delar i arbetet med att förbättra följsamheten till handhygienrutiner. / The radiology department has a mixed flow of patients which means that it has the potential to become a site for infection transmission. In order to reduce the risk of infection spreading it is important that the basic hand hygiene routines are followed. However, studies show that the compliance with the basic hand hygiene routines is low. Aim: The aim was to examine how the radiographer's adherence to hand hygiene practices can be improved. Method: An integrative literature review where scientific articles were searched in the PubMed and CINAHL databases. 15 articles have been quality reviewed, categorized, analyzed and finally the result has been compiled and a synthesis written. Result: Different types of interventions, such as education, information, automated observation systems and multimodal interventions, can be helpful in improving compliance with hand hygiene routines. Conclusion: Practical and theoretical education, dedicated management and a responsible climate combined with good access to hand hygiene products and reminders to perform hand hygiene are important parts of the work to improve compliance with hand hygiene routines.

L’hôpital public est une organisation qui connait de nombreuses transformations pour favoriser l’efficacité et l’efficience des soins. De nouvelles organisations du travail sont mises en place accompagnées de nouvelles règles de gestion comme la tarification à l’activité (T2A), qui vise à optimiser l’offre de soins tout en permettant un financement par les activités hospitalières. Ces évolutions ont des impacts potentiellement négatifs sur la gestion des ressources humaines. Aujourd’hui, les professionnels hospitaliers en particulier les soignants, majoritairement féminins, doivent faire face à une augmentation de l’activité hospitalière, à la pression du temps, aux contraintes horaires etc.Ces difficultés, que rencontrent les soignants au travail, débordent dans la sphère privée faisant aujourd’hui de la conciliation vie privée-vie professionnelle l’un des principaux enjeux de la qualité de vie au travail des soignants. Les difficultés à concilier vie privée-vie professionnelle peuvent être à l’origine d’une baisse de la satisfaction et de l’implication. A l’inverse, une bonne conciliation peut favoriser le développent de la satisfaction et de l’implication au travail et un enrichissement entre les sphères de vie professionnelle et personnelle. Cette recherche,sur les déterminants et les conséquences du conflit et de l’enrichissement travail-famille, repose sur une étude qualitative et quantitative. Les résultats mettent en évidence le rôle des conditions de travail (exigences de travail et autonomie au travail) et l’importance des ressources organisationnelles (soutien organisationnel, temps suffisant, horaires adaptés) et familiale (soutien familial) dans la survenance du conflit et dans le développement de l’enrichissement travail-famille. En outre, le conflit et l’enrichissement travail-famille peuvent jouer un rôle dans l’implication organisationnelle et la satisfaction des soignants. D’un point de vue managérial, notre recherche fait apparaître la nécessité pour l’hôpital, soucieux d’offrir des soins de qualité, d’améliorer le bien-être de ses professionnels et d’investir dans la qualité de vie au travail qui pourrait bien être un facteur d’attractivité des hôpitaux publics dans un contexte de nombreux de départs en retraite. / Public hospital has undertaken many transformations in order to favour the effectiveness and the efficiency of care. The implementation of new forms of work organisation has been accompanied by the introduction of new governance rules like the “tarification à l’activité” (the pricing based on activity, T2A) which aims at optimizing healthcare provision while allowing the hospital to fund its activities. These changes potentially have negative impacts on human resources management. Nowadays, healthcare workers (predominantly women) have to face an increase in hospital activities, pressure of time, schedule constraints (time restriction) etc.The difficulties that are facing healthcare workers in their job also affect their private life.Therefore, today, reconciling work and family life is one of the main issues of healthcare workers’ quality of work-life. Difficulties in achieving a balance between work and family life can lead to a decrease in the level of job satisfaction and commitment. Conversely, a good work-life balance can encourage job satisfaction, work commitment, and work-life enrichment.The purpose of this research is to study the determinants and consequences of the work-family conflict and enrichment.This research uses a qualitative and a quantitative approach.The results indicated the role of working conditions (work demands and autonomy) and the importance of organizational resources (organizational support, sufficient time, flexible schedules) and family support in the occurrence of the conflict and in the development of enrichment.Besides, work-family conflict and enrichment can play a role in healthcare workers’ satisfaction and organizational commitment.From a management perspective, our research indicated the need for the hospital that is concerned with providing quality care, to improve the well-being of its healthcare workers and invest in the quality of work life. This could be a factor that would make public hospitals attractive in a context of large number of retirements.