published_or_final_version / Social Work / Master / Master of Social Sciences

This project explored the values considered by elderly people, their younger relatives, and health professionals in decisions about residential long - term care, aiming to contribute to the literature on prospectively held values. The mixed methods design utilised a medical record review of 60 frail elderly hospital patients, a stratified survey of 3,015 adults in the South Australian community, and interviews with 36 stakeholders ( 10 elderly people, 10 younger relatives, and 18 health professionals ). The medical record review confirmed that the hospital patients and their outcomes resembled those described internationally. It was used to develop a hypothetical vignette, used in the later studies. Survey responses suggested that when considering a hypothetical long - term care decision, community members put the elderly person ' s physical health and safety first. Situational variables ( the elderly person ' s autonomy, environmental adaptation, and caregiver burden ) appeared secondary, albeit less so with increasing age of the respondent. Thematic analysis of the interviews demonstrated that elderly stakeholders considering a hypothetical decision were more likely to mention autonomy values, and less likely to mention safety values, than were relatives or health professionals. However, elderly stakeholders were also more likely to suggest restrictive solutions, such as residential placement and proxy decision - making. This finding raised methodological issues concerning ' third person ' vignettes, in that respondents might be responding as proxy decision - makers, rather than as if the hypothetical decision applied to themselves. The project confirmed that, in this context, prospectively held values resembled the retrospectively described values identified by McCullough, Wilson, Teasdale, Kolpakchi and Shelly ( 1993 ). Hence, the retrospective literature could be applied. The project supported the importance and complexity of psychosocial predisposing factors when applying the Andersen Behavioral Model ( Andersen, 1995 ) to long - term care decisions. Additionally, the Ecological Theory of Aging ( Nahemow, 2000 ) and the MacArthur Model of Successful Aging ( Andrews, Clark, & Luszcz, 2002 ) were found to be relevant to long - term care decisions for individuals and populations. It was concluded that both clinically, and at a policy level, discussions of long - term care could be more effective if they focussed on maintenance of elderly people ' s autonomy and control, rather than on their physical health and safety. / Thesis (Ph.D.) -- University of Adelaide, School of Psychology, 2006.

Thesis (M. Soc. Sc.)--University of Hong Kong, 1997. / Includes bibliographical references.

Thesis (M.S.)--University of Missouri--Columbia, 2004. / Typescript. Includes bibliographical references (leaves 27-30). Also available on the Internet.

Thesis (M.Sc.)--Memorial University of Newfoundland, 2004. / Includes bibliographical references.

Thesis (M.Soc.Sc.)--University of Hong Kong, 1997. / Includes bibliographical references. Also available in print.

Nursing documentation is currently still very hot topic. Perhaps because they are still many health workers (physicians and non-physicians) sufficiently understand the importance and seriousness of this document. The documentation not only provides valid information about the client and his health, but also ensures continuous flow its nursing care and ultimately became a piece of evidence in case of litigation. Documentation can also be used for education and research purposes. Home care is a field that has recently rapidly growing and gaining in popularity. As part of primary and community care nursing provides clients in its natural, familiar and domestic environment, which is a big advantage for him, he does not spend his days in hospital, which is economically difficult anyway. Home Care provides health care services indicated by the treating physician or practitioner and are paid for by health insurance. This thesis deals with the nursing documentation in home care agencies, which aims to describe the demographic impacts on the use of nursing documentation, check the attitude of nurses from selected agencies of home care to nursing documentation and analyze the nursing documentation in selected home care agencies. The thesis is composed of two parts, theoretical and empirical. The theoretical part deals with the history of home care, statistical data shows the growth of agencies, their employees and clients, providing comprehensive home care and medical documentation. The empirical part was realized in the form of qualitative research. The information was gathered in-depth interview technique, which was compiled from 1 identification questions and 11 open-ended questions that formed the framework for the entire interview. In fact, respondents to individually comment on the issue to the extent that they saw fit. The research group consisted of seven sisters of different age, education and length of experience, currently working from home care. Due to fears nurses were promised total anonymity, so you can just tell that they were sisters from ADP capital city of Prague and Central Bohemia. Complementary research was conducted in seven home care agencies for the same regions, but any of nurses does not belong to the Agency from the second survey. In the first phase of the research we examined the influence of nurses' demographic factors such as age, education or length of experience in the management of nursing documentation and own attitudes of nurses from selected agencies in the management of nursing documentation. The research sample consisted of seven nurses working in home care agencies that were selected purposefully and were willing to cooperate in research. In the second phase of the research we tried to analyze individual nursing documentation of selected home care agencies. For this part, we chose seven agencies, which have been their leadership under the promise of anonymity willing to cooperate. The research investigation set up three goals and three research questions. The first objective was to describe the demographic impacts on the use of nursing documentation. The second objective was to determine the attitude of nurses from selected agencies of home care to nursing documentation. The third objective was to analyze the nursing documentation in selected home care agencies. At the outset of the investigation, we asked the following questions: they influence the management of the nursing documentation demographic factors such as age, education or length of practice nurses? What attitudes toward nursing documentation occupy the sisters from selected home care agencies? Correspond to different parts of the nursing documentation with the phases of the nursing process? Results of the research can be an inspiration not only for the nursing management ADP, but also for the nurses working in home care agencies throughout the Czech Republic, only selected agencies.

Made available in DSpace on 2014-12-17T15:24:27Z (GMT). No. of bitstreams: 1 FrancenildoDR_DISSERT.pdf: 1441958 bytes, checksum: 084daa6b15b408dd79e5f9d215bf8101 (MD5) Previous issue date: 2013-12-19 / This dissertation try to understand how management actions implemented by Monsenhor Walfredo Gurgel Hospital in the city of Natal promote effectively the benefits of Home Care Services / Programa Melhor em Casa . The research is exploratory and descriptive, qualitative approach. Data were collected through document analysis and the interviews with the managers of the Program in Health Department and Hospital beyond the questionnaires with the home care teams and technical management unit of Hospital Jobs. The information were treatment trough categories that analyzed to implemented actions and program objectives. The results show that: the practices carried out by the host teams produce the humanization of care by seeking to ensure access to health services and solving human form; networks of health care are not yet finalized hindering the referral of patients to other units, the networks allow support from other institutions to minimize the problems encountered, the management unit vacancies allows the reduction of costs, mainly by regulating beds and record of health initiatives in home care assists in the monitoring and evaluation process of the Services Home Care / Programa Melhor em Casa primarily the epidemiological profile and patients individual treatment plan. Concludes that most of the actions implemented by the Hospital contribute to the effectiveness of the goals of Programa Melhor em Casa / Esta disserta??o busca compreender como as a??es gerenciais implementadas pelo Hospital Monsenhor Walfredo Gurgel no munic?pio do Natal promovem de forma eficaz os benef?cios do Servi?o de Aten??o Domiciliar/ Programa Melhor em Casa. A pesquisa tem natureza explorat?ria e descritiva, com abordagem qualitativa. Os dados foram coletados atrav?s da an?lise documental e com a realiza??o de entrevistas com os gestores do Programa na Secretaria Estadual de Sa?de e no Hospital al?m da aplica??o de question?rios com as equipes de aten??o domiciliar e com os t?cnicos da unidade de gerenciamento de vagas do Hospital. No tratamento das informa??es foram analisadas categorias vinculadas ?s a??es implementadas e aos objetivos do programa. Os resultados mostram que: as praticas de acolhimento realizadas pelas equipes produzem a humaniza??o do atendimento por buscar garantir o acesso ao servi?o de sa?de de forma humana e resolutiva; as redes de aten??o em sa?de ainda n?o est?o conclu?das dificultando o referenciamento dos pacientes para outras unidades; as redes possibilitam buscar apoio de outras institui??es para minimizar os problemas encontrados; a unidade de gerenciamento de vagas possibilita a redu??o dos custos, principalmente por regular os leitos de interna??o e o registro ambulatorial das a??es em sa?de em aten??o domiciliar auxilia no processo de monitoramento e avalia??o do Servi?o de Aten??o Domiciliar/Programa Melhor em Casa principalmente por conhecer o perfil epidemiol?gico e o plano terap?utico individual dos pacientes. Conclui assim que a maioria das a??es implementadas pelo Hospital contribuem para a efic?cia dos objetivos do Programa Melhor em Casa

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