Current state: The Congregation of Sisters of Mercy of St. Charles Borromeo is the largest congregation of nuns in the Czech Republic. Its charism living mercy in contemplation is still valid. Religious sisters mainly care for sick people, the aged and the needy people, as they were serving them in the beginning of their history. The topic of this paper 'Education and care of nurses Congregation of the Sisters of Mercy of St. Charles Borromeo operating in the Czech Republic' is original and has not yet been treated to such extent and with this focus. Some works have been written and published, but they cover our topic only partially. This study is a compilation of information, enriched with memories of those sisters who remember the early days. The aim of the thesis: The first aim of this thesis is to map education and care of nurses of The Congregation of Sisters of Mercy of St. Charles Borromeo in the Czech Republic in its historical development with emphasis on health care and social facilities. The second aim is to compare education, care and status of religious sisters in the health-care team in each historical period. Methodology: In this thesis qualitative research was employed. There were two procedures of data collection used: exploration of written documents and narrative interviews. The research file for narrative interviews consists of ten persons. All respondents are women, members of The Congregation of Sisters of Mercy of St. Charles Borromeo, who attained appropriate education for the profession of a nurse and carried out this job in a hospital. Respondents were segmented into three groups according to respective historical periods. The first historical period starts with the arrival of religious sisters from France to Prague in 1837 and finishes in 1948. The second historical period follows up the previous one and ends in 1989. The third historical period spans the time from 1989 till the present. The total number of recorded and assessed interviews is ten. Narrative interview were recorded on a voice recorder and consequently transcribed into the written form and further processed. To analyze the text we used open coding, performed by the paper-and-pencil tests. Findings were interpreted using 'card sorting' technique. Results: Education and care of nurses of Congregation of the Sisters of Mercy of St. Charles Borromeo have always met the requirements of concrete times. Specific aspects of care for the sick and the needy was also influenced by other factors. Among others the development od medical science and political situation of individual historical periods. The care of Sisters of Mercy of St. Charles Borromeo has always been based on their dedication and the vow of mercy. Conclusion: This is a compact work, describing education and care of nurses of Congregation of the Sisters of Mercy of St. Charles Borromeo in contexts of different historical periods and in broader connection with the history of nursing care.

This diploma thesis deals with the possibilities of further education in the agencies of domiciliary care. This is a very current topic. Like any other profession, the nursing profession requires a particular education. The development of the new methods in the medical treatment and home care demands more thorough and specialised education of the nurses employed by the domiciliary-care agencies. The aim of the thesis was to find out the present situation of the nurses´ education in the domiciliary-care agencies, the professional specialisation of nurses, the possibilities of education, the nurses´ need of further education and the employers´ willingness to enable the nurses of the agencies to take part in the further education in their field. It can be said that the aims of the research have been fulfilled.

Trata-se de uma pesquisa de cunho qualitativo que tem como objetivos desvelar as vivências de famílias de classe popular no cuidado a familiares idosos fragilizados, no domicílio, bem como obter subsídios para a sistematização do cuidado de enfermagem a essas famílias. O Referencial Teórico aborda temas relacionados à área temática do estudo: o cuidado de enfermagem domiciliar, a família de classe popular e a pessoa idosa fragilizada. Os sujeitos dessa investigação, intencionalmente escolhidos a partir de critérios previamente estabelecidos, são quatro famílias pertencentes à população adstrita a uma Unidade Sanitária do município de Porto Alegre. O Estudo de Caso do Tipo Etnográfico é a metodologia utilizada. Os instrumentos utilizados para a coleta de dados são a Observação Participante, a Entrevista, a Análise Documental e a Ficha Informativa. Do tratamento dos dados, através da análise de conteúdo, emergiram seis categorias: Características das famílias, Concepções das famílias, A (re)organização da família para o cuidado, A família no cotidiano do cuidado, Relação com as instituições sociais, O cuidado de enfermagem domiciliar. Foi possível perceber que as famílias são multigeracionais. Sobrevivem quase que exclusivamente das aposentadorias dos idosos e enfrentam constantemente o desemprego. Sua concepção de saúde está relacionada à capacidade de trabalho. Valorizam a família, na qual o idoso é reconhecido em sua experiência de vida. Ao necessitar de cuidado, este deve ser assumido, preferencialmente, pelos familiares. Uma pessoa envolve-se mais intensamente no cuidado, mas toda a família, auxiliada por uma rede apoio, constituída de amigos e vizinhos, interage. Nas atividades cotidianas, valem-se da criatividade para adaptar utensílios e o ambiente, bem como do saber popular, como recursos nos cuidados à saúde. As dificuldades destacadas estão relacionadas à condição socioeconômica precária, à moradia, ao vestuário e ao transporte. Percebem que o suporte social a famílias cuidadoras é restrito. Destacam que o acesso aos serviços de saúde é sofrível e ressaltam a urgência em solidificar o Sistema Único de Saúde, em busca da concretização dos seus princípios. Expressam a necessidade de implantação de programas de cuidado domiciliar, interdisciplinares, que assistam a família e o idoso de forma integral, continuada, participativa, contextualizada e humanizada. / This is a qualitative research, which aims to unveil the life experience of families from lower classes at caring for their frail elderly relatives at home, as well as to obtain subsides for creating a model of nursing care for such families. The theoretical model approaches issues related to the thematic area of caring: the family nursing home care, the lower classes families, and the frail elderly. The subjects of this investigation, intentionally chosen upon the criteria previously established, were four families from the Sanitation Unity of Porto Alegre. The design of this case study was an ethnographic type. Tools used for data collection were: participated observation, an interview, a documented analysis, and the informative report. From the analysis of data, through the content analysis, six categories were established: characteristics of the families, conceptions of the families, reorganisation of the family to the care, the family within the routine of the care, the relationship with social institutions, and the nursing home care. It was possible to perceive that families are multigeneration. They survive almost exclusively from the elderlies retirement and frequently they have to cope with unemployment. Their concept of health is related to their work skills. They value the family where the elderly is recognised for his or her life experience. When he or she needs to be cared of, it has to be performed preferably by the family. One is more involved in the care, but the whole family interacts, supported by a social net, composed of friends and neighbours. In the daily activities, they use creativity to adapt goods and the environment, as well as the popular knowledge as resources in the health care. The stressed difficulties are related to the poor social-economic condition, to dwelling, clothing, and transport. They perceive that the social support to caring families is restricted. They emphasise that access to health services is appalling and magnify the urgency in strengthening the "United Health System", aiming to establish their principles. They stress the need to introduce interdisciplinary home care programs, which could assist the family and the elderly in a holistic, permanent, participating, contextural, and humanised way. / Se trata de una investigación de tipo cualitativo que tiene como objetivos descubrir las vivencias de familias de clase popular en el cuidado a familiares ancianos fragilizados, en el domicilio, así como obtener subsidios para la sistematización del cuidado de enfermería a esas familias. El Referencial Teórico aborda temas relacionados al área temática del estudio: el cuidado de enfermería domiciliar, la familia de clase popular y la persona anciana fragilizada. Los sujetos de esa investigación, intencionalmente elegidos a partir de criterios previamente establecidos, son cuatro familias pertenecientes a la población perteneciente a una Unidad Sanitaria del municipio de Porto Alegre. El Estudio de Caso de Tipo Etnográfico es la metodología utilizada. Los instrumentos utilizados para la colecta de datos son la Observación Participante, la Entrevista, el Análisis Documental y la Ficha Informativa. Del tratamiento de los datos, a través del análisis de contenido, emergieron seis categorías: Características de las Familias, Concepciones de las Familias, La (re)Organización de la Familia para el Cuidado, La Familia en la Cotidianeidad del Cuidado, Las Relaciones con las Instituciones Sociales, El Cuidado de Enfermería Domiciliar. Fue posible percibir que las familias son multigeneracionales. Sobreviven casi exclusivamente de las jubilaciones de los ancianos y enfrentan constantemente el desempleo. Su concepción de salud está relacionada a la capacidad de trabajo. Valorizan la familia, en la cual el anciano es reconocido por su experiencia de vida. Al necesitar de cuidado, este debe ser asumido, preferencialmente, por los familiares. Una persona se envuelve mas intensamente en el cuidado, pero toda la familia, auxiliada por una red de apoyo, constituida de amigos y vecinos, interactúa. En las actividades cotidianas, se valen de la creatividad para adaptar los utensilios y el ambiente, tanto del saber popular, como en los recursos para el cuidado de la salud. Las dificultades destacadas están relacionadas a la condición socioeconómica precaria, a la vivienda, al vestuario y al transporte. Perciben que el soporte social a familias cuidadoras es restricto. Destacan que el acceso a los servicios de salud es sufrible y resaltan la urgencia en solidificar el Sistema Único de Saúde (Sistema Unico de Salud), en busca de la concretización de sus principios. Expresan la necesidad de implantación de programas de cuidado domiciliar, interdisciplinares, que asistan a la familia y al anciano de forma integral, continuada, participativa, contextualizada y humanizada.

Trata-se de uma pesquisa de cunho qualitativo que tem como objetivos desvelar as vivências de famílias de classe popular no cuidado a familiares idosos fragilizados, no domicílio, bem como obter subsídios para a sistematização do cuidado de enfermagem a essas famílias. O Referencial Teórico aborda temas relacionados à área temática do estudo: o cuidado de enfermagem domiciliar, a família de classe popular e a pessoa idosa fragilizada. Os sujeitos dessa investigação, intencionalmente escolhidos a partir de critérios previamente estabelecidos, são quatro famílias pertencentes à população adstrita a uma Unidade Sanitária do município de Porto Alegre. O Estudo de Caso do Tipo Etnográfico é a metodologia utilizada. Os instrumentos utilizados para a coleta de dados são a Observação Participante, a Entrevista, a Análise Documental e a Ficha Informativa. Do tratamento dos dados, através da análise de conteúdo, emergiram seis categorias: Características das famílias, Concepções das famílias, A (re)organização da família para o cuidado, A família no cotidiano do cuidado, Relação com as instituições sociais, O cuidado de enfermagem domiciliar. Foi possível perceber que as famílias são multigeracionais. Sobrevivem quase que exclusivamente das aposentadorias dos idosos e enfrentam constantemente o desemprego. Sua concepção de saúde está relacionada à capacidade de trabalho. Valorizam a família, na qual o idoso é reconhecido em sua experiência de vida. Ao necessitar de cuidado, este deve ser assumido, preferencialmente, pelos familiares. Uma pessoa envolve-se mais intensamente no cuidado, mas toda a família, auxiliada por uma rede apoio, constituída de amigos e vizinhos, interage. Nas atividades cotidianas, valem-se da criatividade para adaptar utensílios e o ambiente, bem como do saber popular, como recursos nos cuidados à saúde. As dificuldades destacadas estão relacionadas à condição socioeconômica precária, à moradia, ao vestuário e ao transporte. Percebem que o suporte social a famílias cuidadoras é restrito. Destacam que o acesso aos serviços de saúde é sofrível e ressaltam a urgência em solidificar o Sistema Único de Saúde, em busca da concretização dos seus princípios. Expressam a necessidade de implantação de programas de cuidado domiciliar, interdisciplinares, que assistam a família e o idoso de forma integral, continuada, participativa, contextualizada e humanizada. / This is a qualitative research, which aims to unveil the life experience of families from lower classes at caring for their frail elderly relatives at home, as well as to obtain subsides for creating a model of nursing care for such families. The theoretical model approaches issues related to the thematic area of caring: the family nursing home care, the lower classes families, and the frail elderly. The subjects of this investigation, intentionally chosen upon the criteria previously established, were four families from the Sanitation Unity of Porto Alegre. The design of this case study was an ethnographic type. Tools used for data collection were: participated observation, an interview, a documented analysis, and the informative report. From the analysis of data, through the content analysis, six categories were established: characteristics of the families, conceptions of the families, reorganisation of the family to the care, the family within the routine of the care, the relationship with social institutions, and the nursing home care. It was possible to perceive that families are multigeneration. They survive almost exclusively from the elderlies retirement and frequently they have to cope with unemployment. Their concept of health is related to their work skills. They value the family where the elderly is recognised for his or her life experience. When he or she needs to be cared of, it has to be performed preferably by the family. One is more involved in the care, but the whole family interacts, supported by a social net, composed of friends and neighbours. In the daily activities, they use creativity to adapt goods and the environment, as well as the popular knowledge as resources in the health care. The stressed difficulties are related to the poor social-economic condition, to dwelling, clothing, and transport. They perceive that the social support to caring families is restricted. They emphasise that access to health services is appalling and magnify the urgency in strengthening the "United Health System", aiming to establish their principles. They stress the need to introduce interdisciplinary home care programs, which could assist the family and the elderly in a holistic, permanent, participating, contextural, and humanised way. / Se trata de una investigación de tipo cualitativo que tiene como objetivos descubrir las vivencias de familias de clase popular en el cuidado a familiares ancianos fragilizados, en el domicilio, así como obtener subsidios para la sistematización del cuidado de enfermería a esas familias. El Referencial Teórico aborda temas relacionados al área temática del estudio: el cuidado de enfermería domiciliar, la familia de clase popular y la persona anciana fragilizada. Los sujetos de esa investigación, intencionalmente elegidos a partir de criterios previamente establecidos, son cuatro familias pertenecientes a la población perteneciente a una Unidad Sanitaria del municipio de Porto Alegre. El Estudio de Caso de Tipo Etnográfico es la metodología utilizada. Los instrumentos utilizados para la colecta de datos son la Observación Participante, la Entrevista, el Análisis Documental y la Ficha Informativa. Del tratamiento de los datos, a través del análisis de contenido, emergieron seis categorías: Características de las Familias, Concepciones de las Familias, La (re)Organización de la Familia para el Cuidado, La Familia en la Cotidianeidad del Cuidado, Las Relaciones con las Instituciones Sociales, El Cuidado de Enfermería Domiciliar. Fue posible percibir que las familias son multigeneracionales. Sobreviven casi exclusivamente de las jubilaciones de los ancianos y enfrentan constantemente el desempleo. Su concepción de salud está relacionada a la capacidad de trabajo. Valorizan la familia, en la cual el anciano es reconocido por su experiencia de vida. Al necesitar de cuidado, este debe ser asumido, preferencialmente, por los familiares. Una persona se envuelve mas intensamente en el cuidado, pero toda la familia, auxiliada por una red de apoyo, constituida de amigos y vecinos, interactúa. En las actividades cotidianas, se valen de la creatividad para adaptar los utensilios y el ambiente, tanto del saber popular, como en los recursos para el cuidado de la salud. Las dificultades destacadas están relacionadas a la condición socioeconómica precaria, a la vivienda, al vestuario y al transporte. Perciben que el soporte social a familias cuidadoras es restricto. Destacan que el acceso a los servicios de salud es sufrible y resaltan la urgencia en solidificar el Sistema Único de Saúde (Sistema Unico de Salud), en busca de la concretización de sus principios. Expresan la necesidad de implantación de programas de cuidado domiciliar, interdisciplinares, que asistan a la familia y al anciano de forma integral, continuada, participativa, contextualizada y humanizada.

The thesis deals with the topic of palliative care of child patients/clients. The theoretical part explains the terms palliative, respite and hospice care of both, adult and particularly child clients and their families. The work shows the development of palliative care in our country as well as in the world and highlights the present modern elements of the palliative care approach to a child and his/her family. The practical part is based on a qualitative research that followed two goals and tried to answer two research questions. A research method of content analysis of a document containing data obtained from the Czech Statistical Office was applied on the first goal, aimed at mapping the possible need of palliative care of children in the CR. The number of children that might require palliative care in the CR was estimated upon the data. The second goal was to map the possibilities of palliative care services for children at the territory of the CR. A quantitative method of deep interview was used for implementation of the goal. The research sample consisted of 6 respondents from 6 workplaces. Only general and paediatric nurses from wards and facilities chosen upon the fact that nurses may more often meet an incurably ill child and his/her family were asked.This thesis and its conclusions are mainly aimed at professionals, but also to the general public. The research results inform on the possibilities of providing palliative care to children and their families at the specific departments. The work may be used for study purposes as well as for nurses working at hospices, children oncology wards, home care agencies etc. Paediatric nurses may make use of it as well.

Submitted by MARCIA ROVADOSCHI (marciar@unifra.br) on 2018-08-22T17:08:22Z No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Dissertacao_GuilhermeDosSantosLopes.pdf: 2594684 bytes, checksum: f5a66caaf40be17d99b190749e683537 (MD5) / Made available in DSpace on 2018-08-22T17:08:22Z (GMT). No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Dissertacao_GuilhermeDosSantosLopes.pdf: 2594684 bytes, checksum: f5a66caaf40be17d99b190749e683537 (MD5) Previous issue date: 2017-12-20 / Introduction: The systematization of nursing assistance (SAE), from specific knowledge and critical reflection on the organization, management and philosophy of nursing, constitutes an instrument of fundamental importance to the management, optimization and qualification of nursing care. Although nurses have already science and the perceived need of the implementation of SAE, as recommended by Resolution COFEN 358/2009, the methodological process and the choice of an appropriate theoretical framework also constitutes challenge for most professionals. Based on this rationale, this study had as Objectives: general: Create and validate a plan systematized nursing interventions to pediatric intensive care units; specific: Knowing the perception of nurses on the systematization of nursing care in pediatric intensive care units, and describe the stages of construction and validation of a plan of nursing interventions to pediatric intensive care units, in view of the Theory of Basic Human Needs Wanda Aguiar Horta. Methodology: To answer the first specific objective was held one exploratory and descriptive, qualitative, between March and July 2017, with 15 nurses working in a pediatric intensive care unit of a medium-sized hospital in the eastern region of the State of Rio Grande do Sul from individual interviews with guiding questions. The second specific objective was met from the methodological research, descriptive, conducted with ten experts in the field, between the months of July and September 2017, in which we used the Psychometric Theory as the validation process measurement technique. The object concordance rate was at least 80% for validation of the material. Results: From the research data organized and coded by content analysis resulted in two thematic areas, namely: SAE: legal and private process Nurse and SAE: from conception to care practice. Methodological research has yielded a return of ten instruments evaluated by experts in the first and second round of the Delphi cycle. In the first round it was suggested pertinent changes in relation to items and nursing interventions. O instrument was considered valid both in content and appearance and can help to support the implementation of the SAE in pediatric intensive care units at local and national level. Final considerations: It follows that the perception of nurses on the systematization of nursing care in pediatric intensive care units does not differ from other units of professional performance. Nurses, in general, have superficial theoretical knowledge on the theoretical and methodological approach of SAE. Their understanding is limited, in part, in compliance with legal requirements and implementation of the stages of diagnosis and nursing interventions. In this sense, the systematic and validated plan interventions will serve to equip the Nurses professionals working in pediatric intensive units and thus contribute to the improvement and consolidation of the nursing process in health services. As resultant product of the research process will be available a systematic plan and validated to support nursing interventions in pediatric intensive care units. It is recognized that the problems of care practice must be part of the academic discussions, as well as scientific theories need to contribute to the gradual transformation of practices. Integrating and strengthening these realities will result in addition best care practices in commitment to the consolidation of nursing science. It should be noted, finally, the need for further studies in the area, to expand clinical interventions and enable new theoretical insights into the relevance of the systematization of nursing care in different areas of nurse's performance. / Introdução: A Sistematização da Assistência de Enfermagem (SAE), a partir de conhecimento específico e de reflexão crítica acerca da organização, da gestão e da filosofia do trabalho de enfermagem, se constitui em um instrumento de fundamental importância para o gerenciamento, a otimização e a qualificação da assistência de Enfermagem. Embora os Enfermeiros já tenham ciência e a percepção da necessidade da implementação da SAE, conforme preconizado pela Resolução COFEN 358/2009, o processo metodológico, assim como a escolha de um referencial teórico apropriado, ainda, se constitui em desafio para a maioria dos profissionais. Com base nesta justificativa, o presente estudo teve como Objetivos: geral: Criar e validar um plano sistematizado de intervenções de enfermagem para unidades intensivas pediátricas; específicos: Conhecer a percepção de Enfermeiros sobre a Sistematização da Assistência de Enfermagem em unidades intensivas pediátricas, e, Descrever as etapas de construção e de validação de um plano de intervenções de enfermagem para unidades intensivas pediátricas, na perspectiva da Teoria das Necessidades Humanas Básicas de Wanda de Aguiar Horta. Metodologia: Para atender o primeiro objetivo específico foi realizada uma pesquisa exploratório-descritiva, de caráter qualitativo, entre março e julho de 2017, com 15 enfermeiros que atuam em uma unidade intensiva pediátrica de um hospital de médio porte da região leste do Estado do Rio Grande do Sul, a partir de entrevistas individuais com questões norteadoras. O segundo objetivo específico foi atendido a partir da pesquisa metodológica, de caráter descritivo, realizada com dez especialistas da área, entre os meses de julho e setembro de 2017, na qual utilizou-se a Teoria da Psicometria como técnica de medida do processo de validação. O índice de concordância considerado foi de, no mínimo, 80% para a validação do material. Resultados: Dos dados de pesquisa organizados e codificados pela análise de conteúdo resultaram dois eixos temáticos, quais sejam: SAE: processo legal e privativo do Enfermeiro e SAE: da concepção à prática assistencial. Da pesquisa metodológica se obteve-se um retorno de dez instrumentos avaliados por especialistas na primeira e na segunda rodada do Ciclo de Delphi. Na primeira rodada foram sugeridas mudanças pertinentes em relação aos itens e às intervenções de enfermagem. O instrumento foi considerado válido tanto em conteúdo quanto em aparência e poderá contribuir para subsidiar a implementação da SAE em unidades intensivas pediátricas em âmbito local e nacional. Considerações finais: Conclui-se, que a percepção dos Enfermeiros sobre a Sistematização da Assistência de Enfermagem em unidades intensivas pediátricas não se difere das demais unidades de atuação profissional. Os Enfermeiros, de modo geral, possuem conhecimento teórico superficial sobre a proposta teórico-metodológica da SAE. A sua compreensão limita-se, em parte, no cumprimento dos preceitos legais e na execução das etapas do diagnóstico e das intervenções de enfermagem. Nessa direção, o plano sistematizado e validado de intervenções servirá para instrumentalizar os profissionais Enfermeiros que atuam em unidades intensivas pediátricas e, assim, contribuir para a qualificação e a consolidação do processo de enfermagem nos serviços de saúde. Como produto resultante do processo de investigação será disponibilizado um plano sistematizado e validado para subsidiar as intervenções de enfermagem em unidades intensivas pediátricas. Reconhece-se que os problemas da prática assistencial precisam fazer parte das discussões acadêmicas, assim como as teorias científicas precisam contribuir para a transformação gradativa das práticas. A integração e o fortalecimento destas realidades resultarão em melhores práticas de cuidado, além de compromisso com a consolidação da ciência de enfermagem. Salienta-se, por fim, a necessidade da realização de novos estudos na área, no sentido de ampliar as intervenções clínicas e possibilitar novas compreensões teóricas sobre a relevância da Sistematização da Assistência de Enfermagem nos diferentes espaços de atuação do Enfermeiro.

This dissertation consists of three empirical research studies that broadly pertain to the economics of collective bargaining, or the process by which employees act through labor unions to negotiate with employers over compensation, benefits, and other terms and conditions of employment; and of labor market power, which refers to the ability of economic actors to set wages and employment at levels different from those that would obtain under a theoretical ideal of perfect competition, wherein both workers and firms are atomized agents with no unilateral ability to influence a market equilibrium. The first chapter, entitled "The Effects of Union Membership on Inequality and Well-Being in Retirement," uses data from the Health and Retirement Study (HRS) and an empirical design based on comparisons of older workers who switch into or out of union employment in the years before retirement with otherwise similar peers to study the effect of union membership on various outcomes in old age, including pension income and income from other sources, wealth, consumption, time use, mortality, morbidity, and inequality. Our notable findings include a pension income premium for workers who retire as union members of approximately 10-20%, similar to estimates of the union wage premium; evidence of larger premia for retirees at lower quantiles of the pension income distribution, which mirrors existing research on how unions exert a compressive effect on the distribution of wages for current workers; and a reduction in the annual mortality rate for union retirees of around 1.25%, comparable to estimates of the mortality differential between the lowest- and highest-income individuals in the same age category. We further attempt to distill the multidimensional effects of union membership in retirement into a single measure of impact on well-being using the concept of "consumption-equivalent welfare," and estimate that the subsequent lifetime welfare of those who retire from nonunion jobs is on the order of 50-60% that of those who retire from union jobs, depending on the precise assumptions and methodology employed. The second chapter, coauthored with Leonard Goff, is entitled "Monopsony in Minnesota: Rent-Sharing and Labor Supply Consequences of a Nursing Home Reimbursement Reform." Models of static labor market monopsony predict that rent-sharing, or pass-through from firm productivity or marginal revenue shocks into workers' wages, is one consequence of labor markets being less than perfectly competitive. In this study we consider a 2016 reform to the state of Minnesota's Medicaid reimbursement scheme for residents of nursing homes that introduced so-called value-based reimbursement, and make use of data on facilities' wages, employee separations, and revenue from various sources to simultaneously estimate both rent-sharing and firm-level labor supply elasticities. In our most-preferred two-stage least squares specifications we find rent-sharing elasticities on the order of 0.10-0.25, suggesting that pass-through is substantially greater than indicated by naive OLS estimates of the same, and we confirm these results through an alternative methodology based on "seemingly unrelated regressions." With the same approach we also obtain an estimate of the average labor supply elasticity facing nursing homes of around 5, corresponding to an optimal wage markdown below marginal revenue product of roughly 15%. Furthermore, subgroup analyses by occupation, union status, and local labor market concentration show little evidence of an effect of collective bargaining on rent-sharing but more convincing indications that rent-sharing is greater in occupations or commuting zones that are characterized by lower labor supply elasticity - a fact that we show can be rationalized with a model of monopsony in which firms have isoelastic production functions. The third and final chapter, coauthored with Brendan Moore and Suresh Naidu, is entitled "Right-to-Work and Union Decline in the United States: Evidence from a Novel Dataset on County-Level Union Membership." Labor union membership and union density in the United States have fallen substantially in recent decades, in particular in the private sector. The causal contribution of state-level "right-to-work" (RTW) laws, which prohibit collective bargaining agreements from requiring union membership as a condition of employment, has been heavily debated. However, research on the role of RTW in accounting for these trends has been stymied by a paucity of data on union membership at a fine geographic level. Using a LASSO selection model and data from several different administrative and survey-based sources, we construct a novel dataset on county-level membership and density and use it to reexamine the consequences of RTW. We show that RTW has a highly significant negative effect in this regard, and we establish that the impact of these laws is felt most strongly in those counties that are the most highly-unionized at the start of our sample period. On average we find that density is reduced by about an additional 0.4 percentage points for every one percentage point increase in its initial value in 1991. However, counties at or below the median initial density see little to no change, while density declines by about 7 percentage points following the passage of RTW for those in the uppermost decile. We also present evidence from an event-study analysis which shows that the effect of RTW grows over time, with the full impact only being felt about a decade after enactment. Taken both individually and collectively, these three essays serve to advance an understanding of the determinants and consequences of union membership and monopsony power. In addition to making original contributions to the fields of applied labor economics and labor studies, it is our hope that they also offer frameworks upon which future research in these areas can build.

Sammanfattning Bakgrund: Hjärtsvikt beskrivs vara ett globalt hälsoproblem. Symtombilden är kronisk med både fysiska och psykiska symtom. Behandlingen är en kombination av farmakologisk behandling och egenvård. Syfte: Beskriva patienters upplevelser av egenvård vid hjärtsvikt. Metod: En litteraturöversikt med kvalitativ metod och induktiv ansats genomfördes. Sökningar gjordes i databaserna PsycINFO, CINAHL och PubMed, vilket resulterade i 12 vetenskapliga artiklar som analyserades utifrån Fribergs femstegsanalys. Resultat: I litteraturöversiktens resultat framkom två kategorier: olika dimensioner av symtom och deras påverkan på egenvård och möjlighet att utföra egenvård. Symtomen kan upplevas både fysiskt och psykosocialt. Kunskap och motivation var en förutsättning för följsamhet till egenvård. Kunskapen kring egenvård beskrivs vara bristfällig. Slutsats: Litteraturöversikten visar på att sjuksköterskan kan få större förståelse för patienters upplevelse av egenvård samt ett ansvar att förmedla kunskap. En god egenvård leder till förbättrad livskvalité och minskade återinläggningar. / Summary Title: A failing heart - Patients experiences of self-care in heart failure. Background: Heart failure is described as a global health problem. Heart failure is a chronic condition with both physical and mental symptoms. The treatment is a combination of pharmacological treatment and self-care. Aim: Describe patients' experiences of self-care in heart failure. Method: A literature review with a qualitative method and inductive approach was conducted. Searches were made in the databases PsycINFO, CINAHL and PubMed, which resulted in 12 scientific articles that were analyzed based on Friberg's five-step analysis. Findings: In the results of the literature review, two categories were founded: different dimensions of symptoms and their impact on self-care and the possibility of performing self-care. The symptoms can be experienced both physically and psychosocially. Knowledge and motivation were important for adherence to self-care. The knowledge about self-care is described as deficient. Conclusion: The literature review shows that the nurse can gain a greater understanding of patients' experience to self-care and a responsibility to impart knowledge. Good self-care leads to improved quality of life and reduced readmissions.

No / The use of neuroleptic drugs to mediate the behaviour of people with dementia living in care homes can lead to them being deprived of their liberty. Whilst regulation has been successful in reducing neuroleptic prescribing in the USA, policy guidance has been unsuccessful in reducing the use of these drugs in the UK. Yet the Mental capacity act 2005 aimed to protect the liberty of people lacking capacity and provided safeguards to ensure that they are not inappropriately deprived of their liberty in institutions. This article highlights the potential for using this law to identify when neuroleptic prescribing in care homes would deprive people with dementia of their liberty and, in turn, to act as a check on prescribing levels. However, the extent to which the Act can promote and protect the right to liberty of people with dementia is constrained by a lack of access to social rights.

This research provides a feminist perspective on the lowest paid sector of the United States long-term care industry, Certified Nursing Assistants. This research adds to current feminist scholarship on the modern professional caregiving industry by focusing on the perspective of the workers. As the population of older adults requiring care is expected to increase over the coming decades, the demand for paid caregivers will increase as well. Historically, care work was an expected duty done freely by the women of the family, but today much of the vital intimate caring labor is relegated to paid caregivers. I examine how alternative social, political and economic frameworks can transform United States society’s attitude towards the increasingly relevant issue of caring labor. I argue that incorporating a feminist perspective will be helpful in developing a sustainable model for caring labor that acknowledges the dignity of both patients and their caregivers. / Includes bibliography. / Thesis (M.A.)--Florida Atlantic University, 2016. / FAU Electronic Theses and Dissertations Collection