電子零件通路商在電子零件產業中扮演協調的角色，需要調解上游供應商與下游顧客，減少市場供給與需求間的差距。ABC公司，為亞洲市場數一數二的電子零件通路商，負責企業間的配銷工作，在整體供應鏈中具有緩衝的作用。 ABC公司有兩個主要的銷售模式：非直販與直販模式。兩者差異在於負責訂單管理流程中的角色不同。非直販模式有兩個主要角色：銷售員Sales與產品經理PM (Product Managers)。Sales需負責將產品售出，而PM則負責訂單的達交、履行。而直販模式則只需PM來處理所有訂單或銷售相關的業務。在非直販模式下，Sales的訂單需要經由PM審核通過才算成立。而在訂單要求被拒絕的同時可能造成兩者間的衝突產生。Sales傾向盡可能的銷售較多的產品來達到預期的目標，而PM則需顧慮相應訂單產生的剩餘產品所造成的庫存水準提升的風險。這種情況在訂單履行的問題中非常常見。一般來說，公司會考量訂單達交的預算，包含為了完成此筆訂單的其他成本，如額外的附加運送成本，而Sales通常會被鼓勵採用“Sell what you have”的銷售策略來販售產品以避免額外的庫存產生。 為此，本研究想得知電子零件通路商如何在非直販模式下作訂單決策，釐清它的訂單流程並進一步瞭解影響訂單決策的重要因素。本研究採用訪談作為主要研究方法，透過與與個案公司的Sales與PM的訪談，整理了在非直販模式下的訂單流程與不同的訂單履行策略。本研究成果可幫助企業瞭解非直販模式的接單流程，以及決策所需考量的變數與其影響，有助於提升企業的知識管理功能。

Problématique : Le rôle des paramédics se transforme partout dans le monde. Les besoins des aînés et des malades chroniques entraînent une forte proportion d’interventions préhospitalières non urgentes. La confrontation entre la perception et l’expérience du rôle peut entraîner un conflit correspondant à un stress organisationnel modéré et chronique chez ces travailleurs. Pour y faire face, différentes stratégies d’adaptation peuvent être adoptées. Objectifs : Cette étude vise à dépeindre la réalité des interventions préhospitalières non urgentes des paramédics québécois et à explorer son influence sur leur perception du rôle et les manifestations de cynisme et de désengagement. Méthode : Les données qualitatives obtenues en entrevues semi-structurées ont été codifiées et analysées à partir d’un modèle adapté des théories en psychosociologie du travail et d’administration de la santé (n=13, 3 régions, intervenants de - de 3 à + de 20 ans de carrière). Résultats : Les paramédics reconnaissent vivre un conflit de rôle alors que la formation et la définition de leur pratique se rapportent exclusivement à l’urgence, au contraire de leur expérience. Ils manifestent des attitudes de cynisme et de désengagement affectant la qualité des services, précisant qu’il s’agit d’une réalité inhérente à leur expérience professionnelle intimement reliée à l’épuisement professionnel, plus qu’à un manque fondamental de professionnalisme. Conclusion : Les paramédics décrivent différents mécanismes à instaurer qui visent à reconnaître la dualité conflictuelle de leur pratique dont, la mise en valeur de leur aptitude clinique à intervenir en première ligne dans un cadre préhospitalier non urgent ainsi que l’ajustement et le rehaussement des programmes de formation. / Problem: The paramedic’s role has been steadily evolving internationally. Elderly and chronically ill user’s demands have lead to an increase in prehospital non urgent interventions. Confronting the conflict between the perceived role of a paramedic and the shifting reality toward non urgent care may result in a role conflict that manifests as chronic-moderate organizational stress. Mechanisms of coping related to this stress may be adopted. Objectives: The objectives of this study are to depict the Quebec paramedic’s experience related to non urgent interventions and explore their role perception and resulting attitudes of cynicism and disengagement. Method: Qualitative data from semi-structured interviews have been codified and analyzed based on a model adapted from the literature on works in socio-psychology and health administration theories. (n=13, 3 administrative regions, less than 3 years to more than 20 years of career) Results: Paramedics acknowledge experiencing role conflict as they explain the formation of their work and field of practice as being exclusively oriented toward emergency response, contrary to their pervasive work reality. They demonstrate cynicism and disengagement, and specify it as being inherent to the professional experience and intimately linked with burnout, affecting quality of care despite fundamental professional intentions. Conclusion: Paramedics described different professional coping mechanisms aimed at acknowledging the conflicting duality of their practice, amongst them, showcasing their clinical capability to play an active role in primary health care in the prehospital, non urgent setting and adjusting and enhancing the training programs.

Tidigare studier visar att sjuksköterskor lägger allt mer tid på omvårdnadsdokumentation.Forskningen tyder på två rationella förklaringar till detta fenomen. Den ena förklaringenbehandlar den ökade dokumentationen som en effekt av sjuksköterskors professionalisering.Samtidigt som lagkravet på sjukvårdsdokumentation trädde i kraft startade enprofessionaliseringssträvan för sjuksköterskor. Vikten låg på att som sjuksköterska ständigtsöka större skicklighet inom sitt yrke för att kunna erbjuda patienter bästa möjliga vård. Dettagjorde dokumentationen till en del i ett kollegialt kommunikationsverktyg för att säkrapatientsäkerheten.Den andra förklaringen till ökad dokumentation kan se fenomenet som en effekt avgranskningssamhället. New Public Management och konkurrensbaserad sjukvård har drivitsjuksköterskor att dokumentera om patienters vård och omvårdnad för att kunna styrka att rätthandlingar ä gjorda och därmed klara en granskning.Tidigare studier visar att både professionalisering och granskningssamhället har uppvisateffekter som kan förklara den ökade dokumentationen i sjukvården. Denna kvantitativa studiehar därför låtit sjuksköterskor från fyra avdelningar på Södra Älvsborgs Sjukhus (SÄS) svarapå en enkät om varför de dokumenterar. Detta för att vi studerat vilken av de två förklarandesom gjort sig gällande och därmed dominerar. Studien har även lagt fokus på vilken påverkanålder, erfarenhet och avdelningsform (planerad och akut) har på sjuksköterskors uppfattningom dokumentation och tid som läggs på den.Resultatet visar att båda förklaringarna är av betydelse för de tillfrågade sjuksköterskorna,men med något större värdering på professionaliseringsförklaringen. Bakgrundsvariablernaålder, erfarenhet och avdelning har även visat sig vara av betydelse för tiden som läggs pådokumentation där dokumentationsomfattningen tycks öka med högre ålder och erfarenhet.Resultatet visar även ett samband där sjuksköterskor från planerade avdelningar lägger mertid på dokumentation än sjuksköterskor verksamma på akuta avdelningar gör. Det är utifråndessa resultat vi kan dra slutsatsen om att dokumentation framförallt kan verka som ettredskap för kollegial kommunikation och samarbete, där skicklighet och erfarenhet förmedlas.

「馬上關懷急難救助」開辦以來，已成為了我國社會救助政策中一項重要措施，也為社會救助政策注入了異於傳統的複雜性與動態性。福利輸送體系的規畫與執行為社會政策的重要一環，當福利輸送體系出現了轉變，其中的參與者，不論是政府部門、執行單位、甚至是接受福利服務的案主，其角色與功能也因此異於以往。 據此，本研究從福利輸送觀點來檢視馬上關懷此項方案，針對其福利輸送體系作一步的探討與分析。透過本研究期待可瞭解：一、瞭解馬上關懷急難救助的福利輸送體系之運作過程與組成結構；二、探討馬上關懷急難救助的福利輸送體系對於福利接受者的影響；三、探討馬上關懷急難救助的福利輸送體系在實務上的相關問題，以提供政策制定者為參考。 依據研究問題與目的，本研究採質性研究方法，邀請台北市文山區九位執行人員與五位福利接受者進行深度訪談，研究結果茲分述如下： 一、 馬上關懷急難救助福利輸送體系之改革 首先，就其運作過程而言，在輸入階段有多元且深入社區的入口管道、具包容性的申請門檻、仰賴通報人員等特色；在轉化階段有僵化的書面審查、實地訪視、明文化的裁量空間、政治壓力的介入等特色；在輸出階段有可及性的協助、尚未能整合社區資源、福利銀行機器等特色。 其次，就其組成結構而言，在重新建構福利輸送體系的面向，有聯邦模式的協調方式、公民參與等特色；在重新分配福利輸送體系任務分工的面向，有多元化的執行者、專業的撤離等特色；重新建構福利輸送體系組成的面向，有多元且即時的求助管道、補充性的福利措施等特色。 二、 對於福利接受者的影響 馬上關懷急難救助對於福利接受者的正面影響主要有提升可近性與可及性，而負面影響為整合性、連續性、公平性、可責性等方面的不足，有待改善。 / Ever since the start of Emergency assistance, it has become an indispensable assistance policy in our society and it helps our social assistance policies with new mobility and elaborateness. The program and the execution of the service delivery system are considered the most important links for the social policies; when service delivery system shifts, every part of its participator, such as the government, the executive board, or the clients functions differently. According to the fact mentioned above, this research attempts to scrutinize the Implementing Urgent Caring System with a service delivery system perspective, especially focusing on the further analysis of its service delivery system. The paper would be divided into three parts: 1. Understanding the operational process and the structure of the service delivery system of the Implementing Urgent Caring System. 2. Discussing the influence of the welfare receivers’ of the emergency assistance of the service delivery system. 3. Discussing the problems regarding the emergency assistance of the service delivery system and offering suggestions for the policy makers for reference. This research adopts qualitative research methods to invite nine executive social workers of Wenshan District, Taipei City and five welfare receivers (clients) to do the depth interviews, and the research results are as follows: 1. The reformation of the emergency assistance of the service delivery system of the Implementing Urgent Caring System: Foremost, in the preliminary process of the reformation, the diverse entrance, the loose application restrictions, and the evaluation system of professional informers play very significant roles. Second, on the middle of the reformation, the ossified application form examination and inquiry, the transparent measurement of evaluation, and politic interference are the evident conditions in executing the emergency assistance. In the last phase of the emergency assistance, there we can find the accessible assistance ,the disorganization of community resources, and welfare bank apparatus are the main characteristics of this part. Moreover, when it comes to the structure of the emergency assistance,we can find its features sit on the modes of federation and the citizen participation. Next, in distributing the whole project, the executives and the professional evacuators take charge of the service delivery system. In the final process of the emergency assistance, immediate and diverse assistance, supplementary welfare measures make the emergency assistance more beneficial. 2. The Influence on the Clients: The positive influences of emergency assistance of the Implementing Urgent Caring System toward the clients are uprising the accessibility and availability while the negative influences are the lack of integration, continuity, equality, and accountability.

Problématique : Le rôle des paramédics se transforme partout dans le monde. Les besoins des aînés et des malades chroniques entraînent une forte proportion d’interventions préhospitalières non urgentes. La confrontation entre la perception et l’expérience du rôle peut entraîner un conflit correspondant à un stress organisationnel modéré et chronique chez ces travailleurs. Pour y faire face, différentes stratégies d’adaptation peuvent être adoptées. Objectifs : Cette étude vise à dépeindre la réalité des interventions préhospitalières non urgentes des paramédics québécois et à explorer son influence sur leur perception du rôle et les manifestations de cynisme et de désengagement. Méthode : Les données qualitatives obtenues en entrevues semi-structurées ont été codifiées et analysées à partir d’un modèle adapté des théories en psychosociologie du travail et d’administration de la santé (n=13, 3 régions, intervenants de - de 3 à + de 20 ans de carrière). Résultats : Les paramédics reconnaissent vivre un conflit de rôle alors que la formation et la définition de leur pratique se rapportent exclusivement à l’urgence, au contraire de leur expérience. Ils manifestent des attitudes de cynisme et de désengagement affectant la qualité des services, précisant qu’il s’agit d’une réalité inhérente à leur expérience professionnelle intimement reliée à l’épuisement professionnel, plus qu’à un manque fondamental de professionnalisme. Conclusion : Les paramédics décrivent différents mécanismes à instaurer qui visent à reconnaître la dualité conflictuelle de leur pratique dont, la mise en valeur de leur aptitude clinique à intervenir en première ligne dans un cadre préhospitalier non urgent ainsi que l’ajustement et le rehaussement des programmes de formation. / Problem: The paramedic’s role has been steadily evolving internationally. Elderly and chronically ill user’s demands have lead to an increase in prehospital non urgent interventions. Confronting the conflict between the perceived role of a paramedic and the shifting reality toward non urgent care may result in a role conflict that manifests as chronic-moderate organizational stress. Mechanisms of coping related to this stress may be adopted. Objectives: The objectives of this study are to depict the Quebec paramedic’s experience related to non urgent interventions and explore their role perception and resulting attitudes of cynicism and disengagement. Method: Qualitative data from semi-structured interviews have been codified and analyzed based on a model adapted from the literature on works in socio-psychology and health administration theories. (n=13, 3 administrative regions, less than 3 years to more than 20 years of career) Results: Paramedics acknowledge experiencing role conflict as they explain the formation of their work and field of practice as being exclusively oriented toward emergency response, contrary to their pervasive work reality. They demonstrate cynicism and disengagement, and specify it as being inherent to the professional experience and intimately linked with burnout, affecting quality of care despite fundamental professional intentions. Conclusion: Paramedics described different professional coping mechanisms aimed at acknowledging the conflicting duality of their practice, amongst them, showcasing their clinical capability to play an active role in primary health care in the prehospital, non urgent setting and adjusting and enhancing the training programs.

現階段的兒童少年保護工作中，社會工作專業的介入都與法令的執行及公權力角色息息相關，強制性的工作乃是依據兒童及少年保護的相關立法規定而進行強制性的介入。在兒童及少年保護工作中，以緊急安置對兒童及少年的家庭、親子關係及相關權益有最直接的影響，而事實上，在強制性的介入中，家庭弁鄋熊�估及處遇工作是一項整合修復兒童及少年個人與家庭的重要過程，並確保兒童少年及其家庭二方的權益皆能受到保障。本研究係針對屏東縣91年至94年間處理的78件兒童少年緊急安置案件，採量化的文件分析法及質性的深度訪談蒐集研究資料，希望透過本研究檢視過去緊急安置的處遇方式，並提出未來在兒童及少年保護過程中緊急安置發展方向的建議。研究者以家庭處遇的觀點來探討兒童及少年在經過緊急安置及提供受虐者與施虐者必要的輔導後，家庭維繫或家庭重整對兒童及少年權益的影響。研究者透過個案處遇記錄及與執行兒少保護實務的工作人員訪談，針對屏東縣在執行兒童及少年保護工作的緊急安置處遇提出下列研究成果與建議：1.目前兒童及少年保護的工作模式，大致仍以提供兒童及少年最佳安全環境為主要目的，緊急安置對案主權益的維護，與後續的家庭評估與處遇有重要的相關，是以加強專業網絡的建構及提昇專業人員知能才能有效執行法令對兒童及少年的保護；2.治本的辦法則為加強社會教育強化父母對子女的責任觀念；3.若評估家庭弁鄐w無法重建，?維護兒童及少年的權益，替代性的服務是必要的處遇觀念，讓兒童及少年有機會重新出發建立新的生活能力。 / Presently, the involvement of professional social work is related closely with the execution of laws and the gov ern ment when we talk about the protection of children and teenagers. Forceful modes are based on the laws of children and teenagers protection. However, what influences the relati on and rights of children and teenagers is crisis interven tion and placement. In fact, the evaluation of family fu nction and family treat ment is an important processof int egrating th econnection of individual and family in forceful mode. It can also guarantee the rights of both child ren and family. This research is based on 78 cases of teenagers’ crisis i ntervention and pl acement in Pintung County fro m 2002 to 2005. It is a quantified document analysis and a qualified deep interview as well . The purpose of this article is to discuss the way o f the urgent ensconced treatment in the past, and give advices to improve the quality of children and teenage protection in the future. This article uses the view of family treat ment approach to discuss the in fluence of victims, offenders, and fa mily in children and teenagers urgent ensconced treatment. Based on the individual reco rds and interview with workers who work with children and teenagers, there are some conclusions and suggestions to urgent ensconced treat ment of children and teenagers protection in Pintung county as following: 1. At present , the main goal o f the children and teenagers protection is still providing the safest circu mstances. The way o f crisis int ervention and placement has strong connection with guarantee of client s’ rights and family evaluation in the future. To improve the function of child ren andteenagers protection more efficiently, we should strengthen the professional netwo rk and elevate the knowledge of professional workers. 2. The best way to solve the problem is to enhance parent s’ responsibility to their children. 3. If fami ly function could not be rebuilt, alternative service would b e a necessary to ensure children and teenagers’ rights. It can give them a chance to develop their social ability as well. / 目錄 中文摘要……………………………………………………………………i 英文摘要…………………………………………………………………ii 誌謝………………………………………………………………………iii 目錄………………………………………………………………………iv 表目錄 ………………………………………………………………… viii 圖目錄……………………………………………………………………x 第 一 章 緒 論 …………………………………………………………1 第一節 研究背景………………………………………………… 2 第二節 研究動機 ……………………………………………3 第三節 研究目的 ……………………………………………4 第四節 名詞界定 ……………………………………………5 第 二 章 文獻探討 ………………………………………………… 8 第一節 兒童及少年保護緊急安置的概念 ……………………8 第二節 兒童及少年保護、福利相關法規 ……………………9 第三節 受虐類型……………………………………………… 9 第四節 兒童及少年保護服務處遇模式 ……………………11 第五節 家庭維繫與家庭重整 ………………………………11 第六節 過去相關研究 ………………………………………13 第 三 章 研究方法 …………………………………………………… 15 第一節 研究架構…………………………………………… 15 第二節 研究假設…………………………………………… 16 第三節 研究變項定義……………………………………… 17 第四節 研究流程…………………………………………… 21 第五節 資料蒐集…………………………………………… 21 第六節 信度與效度………………………………………… 22 第七節 資料分析方法……………………………………… 23 第 四 章 兒少保護緊急安置的個案紀錄分析 …………………… 25 第一節 受虐者與施虐者…………………………………… 25 第二節 受虐類型…………………………………………… 31 第三節 緊急安置…………………………………………… 32 第四節 受虐者與施虐者處遇……………………………… 32 第五節 家庭處遇… …………………………………………33 第六節 受虐者基本特質與受虐原因交叉分析…………… 34 第七節 討論…………………………………………………… 49 第 五 章 緊急安置處遇社工員的質性訪談分析………………… 51 第一節 緊急安置的處遇及意義 ……………………………… 51 第二節 安置資源及公、私部門合作機制………………… 54 第三節 年幼及特殊需求的兒少安置……………………… 56 第四節 處遇計畫的評估與擬定…………………………… 58 第五節 緊急安置的期限…………………………………… 59 第六節 緊急安置的法令完善性…………………………… 60 第七節 緊急安置處遇司法處遇的探討…………………… 61 第八節 研究結果討論……………………………………… 63 第 六 章 結論與研究建議…………………………………………… 69 第一節 結論…………………………………………………… 69 第二節 研究的建議…………………………………………… 70 第三節 研究的限制…………………………………………… 71 參考書目………………………………………………………………… 72 附錄一 臺閩地區兒童及少年保護執行概況表………………… 75 附錄二 兒童及少年福利法……………………………………… 76 附錄三 兒童及少年福利法施行細則…………………………… 89 附錄四 屏東縣兒童及少年虐待暨被疏忽研判指標…………… 92 附錄五 屏東縣強制性親職教育處遇評估表…………………… 100 附錄六 家庭暴力與兒童少年保護事件通報表…………………… 103 附錄七 訪談同意書……………………………………………… 105 附錄八 訪談大綱…………………………………………………… 106 附錄九 訪談人員基本資料……………………………………… 107 圖表目錄 圖 1 兒少保護緊急安置處遇研究架構…………………………… 16 表 1 1990-2005年有關兒少保護處遇博碩士論文篇數…………… 14 表 1.1 1990-2005年相關重要兒少保護處遇的研究者及研究項目…… 14 表 2 受虐原因分析…………………………………………………… 28 表 2.1 受虐主基本資料分析…………………………………………… 29 表 2.2 施虐者身份與施虐原因分析…………………………………… 30 表 3 受虐類型分析………………………………………………… 31 表 4 緊急安置方式分析…………………………………………… 32 表 5 受虐者與施虐者處遇分析………………………………… 33 表 6 家庭處遇分析……………………………………………… 34 表 7 受虐者基本資料與受虐原因交叉分析表………………… 36 表 7.1 受虐者基本資料與受虐原因交叉分析表(續)………………… 36 表 8 通報來源及受虐原因交叉分析…………………………… 37 表 8.1 通報來源及受虐原因交叉分析(續)…………………………… 38 表 9 家庭類型與受虐原因交叉分析…………………………… 39 表 9.1 家庭類型與受虐原因交叉分析(續)………………………… 39 表 10 受虐者基本資料與受虐原因交叉分析………………………… 40 表 10.1 受虐者基本資料與受虐原因交叉分析(續)……………… 41 表 11 施虐者教育程度與受虐原因交叉分析………………………… 42 表 12 施虐者年齡與受虐原因交叉分析……………………………… 43 表 12.1 施虐者年齡與受虐原因交叉分析(續)…………………… 43 表 13 施虐者身份與受虐原因交叉分析…………………………… 44 表 13.1 施虐者身份與受虐原因交叉分析(續)……………………… 45 表 14 施虐者教育程度與受虐類型交叉分析表…………………… 46 表 15 施虐者年齡與受虐類型交叉分析表……………………… 47 表 15.1 施虐者年齡與受虐類型交叉分析表(續)…………………… 47 表 16 施虐者身份與受虐類型交叉分析………………………… 48 表 16.1 施虐者身份與受虐類型交叉分析(續)……………………… 48

O estudo tem por objetivos analisar a organização tecnológica do trabalho dos enfermeiros na produção do cuidado em Unidades de Pronto Atendimento, analisar as atividades dos enfermeiros, descrevendo a constituição da dimensão assistencial e gerencial no seu processo de trabalho; identificar o objeto do cuidado e a finalidade do trabalho dos enfermeiros e identificar os saberes tecnológicos e o conjunto de instrumentos utilizados pelos enfermeiros na produção de cuidados em Unidades de Pronto Atendimento (UPA). A estratégia de investigação foi à pesquisa de métodos mistos, do tipo explanatório sequencial. Na etapa quantitativa foi utilizado um questionário para a coleta de dados com 47 enfermeiros e, na etapa qualitativa, foi utilizada a técnica de observação por amostragem de eventos, referente às atividades dos enfermeiros em uma unidade de pronto atendimento selecionada. Os dados quantitativos foram analisados com o auxílio do Programa Statistical Package for the Social Sciences (SPSS), pela utilização de técnicas da estatística descritiva. Os dados qualitativos foram analisados pela técnica de Análise Temática de Conteúdo, contemplando os núcleos de sentido que compõem a comunicação e interpretação dos seus significados. O agrupamento dos dados quantitativos e qualitativos originou quatro núcleos de análise: trabalho dos enfermeiros, finalidade do trabalho dos enfermeiros, instrumentos de trabalho dos enfermeiros e os desafios e perspectivas do trabalho dos enfermeiros nos serviços de pronto atendimento. Na dimensão assistencial do trabalho destacaram-se as atividades de acolhimento com avaliação e classificação de risco e o registro dos dados clínicos em prontuários, caracterizados pelo atendimento partindo da queixa, com aprofundamento, enriquecendo a conduta, contudo as intervenções de enfermagem não extrapolaram seu caráter instrumental. Na dimensão gerencial do trabalho as atividades de distribuição de tarefas entre a equipe de enfermagem, o dimensionamento de pessoal da enfermagem, a organização de escalas de trabalho da enfermagem e o preenchimento de relatórios referentes ao seu trabalho são as práticas desenvolvidas com muita frequência pelos enfermeiros nessa realidade de trabalho. As ações de gerência do cuidado visam à previsão e provisão de recursos para produção do cuidado, por meio da organização e divisão do trabalho da equipe de enfermagem. O encaminhamento dos usuários a níveis adequados de assistência foi apontado pelos enfermeiros como a principal finalidade do seu trabalho nas unidades de pronto atendimento, seguido das finalidades de prestar o atendimento clínico ao usuário, prestar a assistência ao usuário em situação de urgência e de recuperar a saúde, tratando doenças e agravos. Os instrumentos mais utilizados pelos enfermeiros foram o julgamento e tomada de decisão clínica, a escuta, vínculo e acolhimento, os equipamentos para realização de procedimentos, o conhecimento clínico e o protocolo que orienta a classificação de risco. A resolução de problemas que não são de sua responsabilidade e o volume de atendimento da unidade são as principais dificuldades para o desenvolvimento do trabalho. As variáveis referentes à prática clínica foram identificadas como um potencial para a instrumentalização na tomada de decisão, colaborando para a produção de cuidados. / This study aims at analyzing the technological organization of nurses’ work, focusing on the production of health care in Emergency Units, as well as the activities performed by nurses. This research also aims at describing how the aid and management dimensions of nurses’ work are developed, with the goal of identifying the object of care and the purpose of nurses’ work, pointing out the technological knowledge and the instruments used by nurses to produce health care in Emergency Units. The investigation strategy was based on the Mixed Methods of Research, such as sequential explanatory. During the quantitative part of the research, a questionnaire was given to 47 nurses as a means of collecting data. During the qualitative part, the technique of sample rate events observation was used to follow nurses’ activities in an Emergency Unit previously selected. The quantitative data was analyzed by the Statistical Package for the Social Sciences (SPSS) program, using techniques from descriptive statistics. The qualitative data was analyzed by the technique of theme content analysis, prioritizing the meaning cells which compose the communication and interpretation of their meanings. The grouping of quantitative and qualitative data gave origin to four analysis cells: Nurses’ Work, the Objective of Nurses’ Work, Instruments of Nurses’ Work and Challenges and Perspectives of Nurses’ Work at Emergency Units. In the aid dimension of nurses’ work, activities of admission and rating of life risk and the registration of clinical data on patients’ charts stand out, characterized by the service performed from patient’s complain, making the process of admission more reliable. However, the nurses’ interventions do not go beyond its instrumental character. In the management dimension of nurses’ work, the activities of chores distribution among the team of nurses, the distribution of people in the Emergency Units, the organization of shifts and turns and the filling of reports concerning the work are very popular practices among nurses in the Emergency Units. The actions of managing the health care try to predict and provide resources to produce this care by organizing and dividing the work. The actions to analyze the patient’s situation and provide follow up medical procedures was pointed by nurses as being the main objective of their work in Emergency Units, followed by the objective of providing clinic care to patients, proving medical attention to patients in emergency and recovery situations, by treating illnesses and injuries. The most used instruments by nurses were clinic judgment and decision-making, listening, bonding and acceptance, procedure equipments, clinic knowledge and the protocol which guides the risk rating. The solution to problems which do not concern nurses’ work and the amount of patients in Emergency Units were mentioned as the main difficulties to develop their work. The variables referring to clinical practice were identified as a potential to provide instruments during decision-making moments, collaborating to produce health care. / El estudio tiene por objetivos analizar la organización tecnológica del trabajo de los enfermeros en la producción del cuidado en unidades de pronto atendimiento (urgencias), analizar las actividades de los enfermeros, describiendo la constitución de la dimensión asistencial y gerencial en su proceso de trabajo; identificar los saberes tecnológicos y el conjunto de instrumentos utilizados por los enfermeros en la producción de cuidados en las unidades de pronto atendimiento (urgencias). La estrategia de investigación fue por métodos mistos, del tipo explanatorio sequencial. En la etapa cuantitativa fue realizado el cuestionario como técnica de colecta de datos con 47 enfermeros y en la etapa cualitativa, fue realizada la técnica de observación por amostraje de eventos relacionados a las actividades de los enfermeros en una unidad de pronto atendimiento (urgencia) selecionada. Los datos cuantitativos fueron analizados en el programa Programa Statistical Package for the Social Sciences (SPSS), por la utilización de técnicas de estatística descriptiva. Los datos cualitativos fueron analizados por la técnica del análisis de conteúdo temático, contemplando los núcleos de sentido que componen la comunicación e interpretación de sus significados. El agrupamiento de los datos cuantitativos y cualitativos originó cuatro núcleos de análisis: trabajo de los enfermeros, finalidad del trabajo de los enfermeros, instrumentos de trabajo de los enfermeros y los desafíos y perspectivas del Trabajo de los Enfermeros en los servicios de Pronto Atendimiento (urgencias). En la dimensión asistencial del trabajo se destacan las actividades de acogida con evaluación y clasificación de riesgo y el registro de datos clínicos en prontuarios, caracterizados por el atendimiento partiendo de la queja, con aprofundación, enriqueciendo la conducta, sin embargo las intervenciones de enfermería no extrapolaron su carácter instrumental. En la dimensión gerencial del trabajo las actividades de distribución de tarefas entre el equipo de enfermeros, el dimensionamiento de personal de enfermería, la organización de escalas de trabajo de enfermería y el relleno de relatorios referentes a su trabajo son prácticas desarrolladas con mucha frecuencia por los enfermeros en el pronto atendimiento (urgencias). Las acciones de gerencia del cuidado visan la provisión de recursos para la producción del cuidado, por medio de la organización y división del trabajo de equipo de enfermeros. El encaminamiento de los usuários a los locales adecuados de asistencia fue apuntado por los enfermeros como la principal finalidad de su trabajo en las unidades de pronto atendimiento (urgencia), acompañado de las finalidades de prestar el atendimiento clínico ao usuario, prestar asistencia al usuario en situación de urgencia y de recuperar la salud, tratando las enfermedades y agravios. Los instrumentos más utilizados por los enfermeros fueron el juicio y la tomada de decisión clínica, la escucha, vínculo y acogida, los equipamientos para la realización de los procedimientos, el conocimiento clínico y el protocolo que orienta la Classificacíón de Riesgo. La resolución de problemas sin relación a su trabajo y el volumen de atendimiento de la unidad aparecen como las principales dificultades para el desarrollo del trabajo. Las variables referentes a la práctica clínica fueron identificándose como un potencial para la instrumentalización en las tomadas de decisión, colaborando en la producción de los cuidados.

Summaries in Afrikaans and English / Text in Afrikaans / In hierdie proefskrif word daar gekonsentreer op die bewyslas in die nywerheidshof omdat die nywerheidshof se benadering met betrekking tot die bewyslas verskil van geval tot gevaL afhangende van die aard van die regshulp waarvoor die party je die nywerheidshof nader. In die tweede plek volg 'n bespreking van hoe en deur wie die voorlegging van getuienis aan die nywerheidshof mag geskied, hetsy by wyse van dokumente of getuies en daarbenewens oak 'n bespreking van watter soort getuienis aan die nywerheidshof voorgele mag word met spesifieke verwysing na inter alia, klankopnames, videobande en die resultate van leuenverklikkertoetse. / In this thesis there will be concentrated on the burden of proof in the industrial court because the industrial court's approach in regard to the burden of proof differs from case to case, depending on the nature of the legal aid for which the party /ies approaches the industrial court. In the second place a discussion will follow of how and by whom the presenting of evidence can be done, whether by documents or by witnesses, and in addition thereto also a discussion on which sort of evidence can be presented to the industrial court with specific reference to, inter alia, taperecordings, video tapes and the results of lie-detector tests. / Private Law / LL.M. (Handelsreg)

The theme for this thesis is based on the European Resuscitation Council's guidelines for cardiopulmonary resuscitation of 2015. One of the important points of these procedures is the use of an automatic external defibrillator (AED). These devices were developed for informed responders without the knowledge of cardiac rhythm diagnostics and allow to perform an early defibrillation of the heart, before the arrival of emergency services. AED is a sophisticated device that is a part of the equipment of I - firefighters and policemen. Training of these so-called first aid responders performs the local emergency service team. Over the years 2015 and 2016, the majority of the professionally active firefighters and police officers in one selected Czech district who have the automatic external defibrillator in their equipment attended a training in how to use this device. The aim of this thesis is to determine whether the concept of the training courses is sufficient. If the theoretical part is well understandable for the respondents, and whether the practical training is sufficient - not only the actual compressions and ventilation, but also the use of an automatic external defibrillator, or whether it would be appropriate to extend this training. In this research I used a quantitative method - an...

O estudo tem por objetivos analisar a organização tecnológica do trabalho dos enfermeiros na produção do cuidado em Unidades de Pronto Atendimento, analisar as atividades dos enfermeiros, descrevendo a constituição da dimensão assistencial e gerencial no seu processo de trabalho; identificar o objeto do cuidado e a finalidade do trabalho dos enfermeiros e identificar os saberes tecnológicos e o conjunto de instrumentos utilizados pelos enfermeiros na produção de cuidados em Unidades de Pronto Atendimento (UPA). A estratégia de investigação foi à pesquisa de métodos mistos, do tipo explanatório sequencial. Na etapa quantitativa foi utilizado um questionário para a coleta de dados com 47 enfermeiros e, na etapa qualitativa, foi utilizada a técnica de observação por amostragem de eventos, referente às atividades dos enfermeiros em uma unidade de pronto atendimento selecionada. Os dados quantitativos foram analisados com o auxílio do Programa Statistical Package for the Social Sciences (SPSS), pela utilização de técnicas da estatística descritiva. Os dados qualitativos foram analisados pela técnica de Análise Temática de Conteúdo, contemplando os núcleos de sentido que compõem a comunicação e interpretação dos seus significados. O agrupamento dos dados quantitativos e qualitativos originou quatro núcleos de análise: trabalho dos enfermeiros, finalidade do trabalho dos enfermeiros, instrumentos de trabalho dos enfermeiros e os desafios e perspectivas do trabalho dos enfermeiros nos serviços de pronto atendimento. Na dimensão assistencial do trabalho destacaram-se as atividades de acolhimento com avaliação e classificação de risco e o registro dos dados clínicos em prontuários, caracterizados pelo atendimento partindo da queixa, com aprofundamento, enriquecendo a conduta, contudo as intervenções de enfermagem não extrapolaram seu caráter instrumental. Na dimensão gerencial do trabalho as atividades de distribuição de tarefas entre a equipe de enfermagem, o dimensionamento de pessoal da enfermagem, a organização de escalas de trabalho da enfermagem e o preenchimento de relatórios referentes ao seu trabalho são as práticas desenvolvidas com muita frequência pelos enfermeiros nessa realidade de trabalho. As ações de gerência do cuidado visam à previsão e provisão de recursos para produção do cuidado, por meio da organização e divisão do trabalho da equipe de enfermagem. O encaminhamento dos usuários a níveis adequados de assistência foi apontado pelos enfermeiros como a principal finalidade do seu trabalho nas unidades de pronto atendimento, seguido das finalidades de prestar o atendimento clínico ao usuário, prestar a assistência ao usuário em situação de urgência e de recuperar a saúde, tratando doenças e agravos. Os instrumentos mais utilizados pelos enfermeiros foram o julgamento e tomada de decisão clínica, a escuta, vínculo e acolhimento, os equipamentos para realização de procedimentos, o conhecimento clínico e o protocolo que orienta a classificação de risco. A resolução de problemas que não são de sua responsabilidade e o volume de atendimento da unidade são as principais dificuldades para o desenvolvimento do trabalho. As variáveis referentes à prática clínica foram identificadas como um potencial para a instrumentalização na tomada de decisão, colaborando para a produção de cuidados. / This study aims at analyzing the technological organization of nurses’ work, focusing on the production of health care in Emergency Units, as well as the activities performed by nurses. This research also aims at describing how the aid and management dimensions of nurses’ work are developed, with the goal of identifying the object of care and the purpose of nurses’ work, pointing out the technological knowledge and the instruments used by nurses to produce health care in Emergency Units. The investigation strategy was based on the Mixed Methods of Research, such as sequential explanatory. During the quantitative part of the research, a questionnaire was given to 47 nurses as a means of collecting data. During the qualitative part, the technique of sample rate events observation was used to follow nurses’ activities in an Emergency Unit previously selected. The quantitative data was analyzed by the Statistical Package for the Social Sciences (SPSS) program, using techniques from descriptive statistics. The qualitative data was analyzed by the technique of theme content analysis, prioritizing the meaning cells which compose the communication and interpretation of their meanings. The grouping of quantitative and qualitative data gave origin to four analysis cells: Nurses’ Work, the Objective of Nurses’ Work, Instruments of Nurses’ Work and Challenges and Perspectives of Nurses’ Work at Emergency Units. In the aid dimension of nurses’ work, activities of admission and rating of life risk and the registration of clinical data on patients’ charts stand out, characterized by the service performed from patient’s complain, making the process of admission more reliable. However, the nurses’ interventions do not go beyond its instrumental character. In the management dimension of nurses’ work, the activities of chores distribution among the team of nurses, the distribution of people in the Emergency Units, the organization of shifts and turns and the filling of reports concerning the work are very popular practices among nurses in the Emergency Units. The actions of managing the health care try to predict and provide resources to produce this care by organizing and dividing the work. The actions to analyze the patient’s situation and provide follow up medical procedures was pointed by nurses as being the main objective of their work in Emergency Units, followed by the objective of providing clinic care to patients, proving medical attention to patients in emergency and recovery situations, by treating illnesses and injuries. The most used instruments by nurses were clinic judgment and decision-making, listening, bonding and acceptance, procedure equipments, clinic knowledge and the protocol which guides the risk rating. The solution to problems which do not concern nurses’ work and the amount of patients in Emergency Units were mentioned as the main difficulties to develop their work. The variables referring to clinical practice were identified as a potential to provide instruments during decision-making moments, collaborating to produce health care. / El estudio tiene por objetivos analizar la organización tecnológica del trabajo de los enfermeros en la producción del cuidado en unidades de pronto atendimiento (urgencias), analizar las actividades de los enfermeros, describiendo la constitución de la dimensión asistencial y gerencial en su proceso de trabajo; identificar los saberes tecnológicos y el conjunto de instrumentos utilizados por los enfermeros en la producción de cuidados en las unidades de pronto atendimiento (urgencias). La estrategia de investigación fue por métodos mistos, del tipo explanatorio sequencial. En la etapa cuantitativa fue realizado el cuestionario como técnica de colecta de datos con 47 enfermeros y en la etapa cualitativa, fue realizada la técnica de observación por amostraje de eventos relacionados a las actividades de los enfermeros en una unidad de pronto atendimiento (urgencia) selecionada. Los datos cuantitativos fueron analizados en el programa Programa Statistical Package for the Social Sciences (SPSS), por la utilización de técnicas de estatística descriptiva. Los datos cualitativos fueron analizados por la técnica del análisis de conteúdo temático, contemplando los núcleos de sentido que componen la comunicación e interpretación de sus significados. El agrupamiento de los datos cuantitativos y cualitativos originó cuatro núcleos de análisis: trabajo de los enfermeros, finalidad del trabajo de los enfermeros, instrumentos de trabajo de los enfermeros y los desafíos y perspectivas del Trabajo de los Enfermeros en los servicios de Pronto Atendimiento (urgencias). En la dimensión asistencial del trabajo se destacan las actividades de acogida con evaluación y clasificación de riesgo y el registro de datos clínicos en prontuarios, caracterizados por el atendimiento partiendo de la queja, con aprofundación, enriqueciendo la conducta, sin embargo las intervenciones de enfermería no extrapolaron su carácter instrumental. En la dimensión gerencial del trabajo las actividades de distribución de tarefas entre el equipo de enfermeros, el dimensionamiento de personal de enfermería, la organización de escalas de trabajo de enfermería y el relleno de relatorios referentes a su trabajo son prácticas desarrolladas con mucha frecuencia por los enfermeros en el pronto atendimiento (urgencias). Las acciones de gerencia del cuidado visan la provisión de recursos para la producción del cuidado, por medio de la organización y división del trabajo de equipo de enfermeros. El encaminamiento de los usuários a los locales adecuados de asistencia fue apuntado por los enfermeros como la principal finalidad de su trabajo en las unidades de pronto atendimiento (urgencia), acompañado de las finalidades de prestar el atendimiento clínico ao usuario, prestar asistencia al usuario en situación de urgencia y de recuperar la salud, tratando las enfermedades y agravios. Los instrumentos más utilizados por los enfermeros fueron el juicio y la tomada de decisión clínica, la escucha, vínculo y acogida, los equipamientos para la realización de los procedimientos, el conocimiento clínico y el protocolo que orienta la Classificacíón de Riesgo. La resolución de problemas sin relación a su trabajo y el volumen de atendimiento de la unidad aparecen como las principales dificultades para el desarrollo del trabajo. Las variables referentes a la práctica clínica fueron identificándose como un potencial para la instrumentalización en las tomadas de decisión, colaborando en la producción de los cuidados.