Darbo tikslas: Įvertinti sveikatos priežiūros paslaugas Jurbarko rajono mokyklose mokytojų ir visuomenės sveikatos specialistų požiūriu. Uždaviniai.1.Įvertinti mokytojų požiūrį į moksleivių sveikatą ir teikiamas sveikatos priežiūros paslaugas mokykloje. 2. Įvertinti mokyklų visuomenės sveikatos specialistų nuomonę apie sveikatos priežiūros paslaugų organizavimo problemas. 3. Palyginti sveikatos priežiūros paslaugų organizavimą Jurbarko rajono miesto ir kaimo vietovių bendrojo lavinimo mokyklose. Metodika. Jurbarko rajono bendrojo lavinimo mokyklose atlikta anketinė mokytojų apklausa. Išdalinta 600 anketų. Anketas grąžino 360 respondentų (60,0 proc.). Buvo vertinamas mokytojų požiūris į sveikatos priežiūros paslaugų poreikį mokykloje ir visuomenės sveikatos priežiūros specialisto veiklą. Visuomenės sveikatos priežiūros specialistų nuomonės tyrimui panaudotas kokybinis tikslinių grupių apklausos metodas. Kiekybinio tyrimo duomenys apdoroti panaudojant specializuotą duomenų tvarkymo ir statistinės analizės paketą SPSS 16.0. Rezultatai. 70,2 proc. miesto ir 47,0 proc. kaimo mokytojų mokinių sveikatą vertino patenkinamai. Atitinkamai 78,1 ir 56,9 proc. mokytojų mano, kad mokinių sveikata blogėja. Tik šiek tiek visuomenės sveikatos specialisto funkcijas žino 55,3 proc. miesto ir 65,3 proc. kaimo mokytojų. 9,0 proc. mokytojų nežino specialisto funkcijų. 42,6 proc. kaimo mokytojų vertina sveikatos priežiūros paslaugų prieinamumą mokykloje kaip nepakankamą. 89,0 proc.mokytojų visas... [toliau žr. visą tekstą] / Aim of the study: to conduct survey among teachers and medical staff of school health services and to evaluate provision of health care services in public schools of Jurbarkas district. Objectives: 1. To evaluate the attitudes of teachers on provision of health care services in schools. 2. To evaluate the opinion of schools’ public health specialists about the problems of provision of health care services at schools. 3. To compare the health care services organization between the general education schools in urban and rural areas in the Jurbarkas district. Methods. Questionnaire survey of teachers was conducted in the general schools of Jurbarkas district. 600 questionnaires were distributed. 360 respondents filled in and returned questionnaires (response rate - 60.0%). Teachers’ opinions on health care needs in school and public functions of health care specialist of school was evaluated by conducting questionnaire survey. Also qualitative research method – focus group discussion - was applied in order to get deeper insight into the issues of provision of health cares services at school. The quantitative survey data was processed through a specialized data management and statistical analysis package SPSS-16.0. Results. 70.2% urban and 47.0% rural teachers assessed the students' health satisfactory. Respectively, 78.1% and 56.9% teachers believe that students' health is deteriorating. 60.0% of teachers indicated pupils’ health care as an important problem. Only some... [to full text]

<p>The development and provision of equitable and acceptable standard of health services to all segments of the population has been the major objective of the 1993 Ethiopian National health policy. However, community based studies on satisfaction with public health care facilities reveal that the majority of the population are not satisfied with the services provided predominantly as a result of the long waiting times. Studies done on private health facilities on the contrary reveal that patients are satisfied with the service delivered within short waiting times in these clinics. Even though the speculated waiting time is thought to be long among the public health care facilities and short in private clinics, the actual waiting and service times have not been measured and compared. Aim: To determine the waiting and service times among the public and private health care facilities and measure the perceptions of &ldquo / acceptable&rdquo / waiting time among the providers and clients. Materials and methods: A cross sectional observational study using quantitative techniques was carried out amongst patients and staff at selected public and private health care facilities in Gondar District. Stratified sampling method was used to select facilities. All patients visiting the selected facilities and all staff who provided service to patients on the day of the study were included in the time-delimited sample. Data was collected by research assistants and health workers from all patients attending the health care facility by registering the arrival and departure time of each patient to the facility and to each service point on a patient flow card. Then data was cleaned and captured by a specific Waiting and Service Time database. Descriptive statistics was done on waiting and service times for each facility and this was summarized for each public and private health facility by using tables and graphs. Finally a comparison was made for private and public health facilities by using Wilcoxon-mann-whitney non parametric tests.</p>

Made available in DSpace on 2015-05-14T12:20:17Z (GMT). No. of bitstreams: 1 arquivototal.pdf: 1296467 bytes, checksum: 14410a01151daaf9525cec84628f9234 (MD5) Previous issue date: 2012-08-24 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / The brazilian society has experienced classical principles of democracy for almost thirty years however citizen involvement remains insufficient when it comes to Public Administration. In doing so, this study aimed to verify whether the Public Health Care System (SUS) Ombudsmen have in fact served as a public management tool giving room to participation and listening to users concerns. The study based itself on the concept that a democratic society is one where civil rights are created as a mean to change and enhance the state (CHAUÍ, 2011). As per Luchman (2007), a participative democracy is an open debate environment of public affairs towards collective interests based on government commitment. Health Care Ombudsman management reports from 2008 to 2011 regarding drug programs have been analyzed allowing for a comparison between the drug lists published by SUS in the same period with the purpose of verifying whether user requests are taken into account. The results showed SUS has helped socialize the state and might very well allow for participation although not yet considered a management instrument once its reports have not been taken into account in the development of drug lists. Based on this study, the SUS General Ombudsman is still in the process of establishing itself as a democratic environment and management instrument. / Há quase trinta anos, a sociedade brasileira convive com os pressupostos clássicos da democracia, todavia a participação dos cidadãos na geração de direitos é insuficiente, inclusive na gestão do aparelho do Estado. Por isso, este estudo verificou se as ouvidorias no Sistema Único de Saúde (SUS) se constituem como espaço de participação e como instrumento de gestão, tornando o aparelho estatal brasileiro mais acessível aos usuários dos serviços de saúde a partir da escuta de suas vozes. Para tanto, a pesquisa se referenciou no conceito de sociedade democrática como sendo aquela que gera direitos como uma criação social que modifica a ação do aparelho estatal (CHAUÍ, 2011); e, em Lüchmann (2007) que define um espaço de democracia participativa como um ambiente de discussão pública em torno de decisões de interesse coletivo, sustentado pelo compromisso governamental, pela tradição associativa dos cidadãos e pelo seu desenho institucional. Nesse rumo, foram analisados os relatórios gerenciais da Ouvidoria-Geral do Ministério da Saúde referentes à assistência farmacêutica no período de 2008 a 2011, que permitiu o cotejamento com as listas de medicamentos do SUS publicadas no mesmo período, a fim de verificar se as manifestações dos usuários do SUS são consideradas na elaboração dessas listas. Ao final, verificou-se que o SUS contribuiu para democratizar o aparelho estatal brasileiro; que a Ouvidoria-Geral do SUS é uma possibilidade de participação, ainda não sendo um ambiente de democracia participativa; e, que ela não é vista como instrumento de gestão, pois os seus relatórios gerenciais não foram considerados pelo Ministério da Saúde, pelo menos naquilo concernente às manifestações dos usuários sobre a elaboração da lista de medicamentos. Por este estudo, considera-se que a Ouvidoria-Geral do SUS está ainda se instituindo como ambiente de democracia participativa e instrumento de gestão.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / Some studies indicate a misbalance between the practices developed by primary health care psychologists and the specific demands of this context. Those studies point out to a mere transposition of the traditional model of clinic, without the proper contextualization that this area requests, besides some difficulties in teamwork. Thus, it is understood that psychology faces a challenge in qualifying its training in order to perform accordingly to the principles of the Brazilian Health Care System (SUS). Towards this challenge, psychology has found in the Multiprofessional Residencies in Health Care an opportunity of a training, which is diverse from that offered in undergraduate courses, that aims to qualify its practices for the work in public health care. Based on that, this research aimed to acknowledge the professional practices of psychologists who are part of a Multiprofessional Residency in Health Care Program, in the context of primary health care. Therefore, it was conducted a qualitative and exploratory research. The data collection was performed with semi-structured interviews. After the transcription of the interviews, data analysis followed the content analysis technique. The participants were eight psychology residents in the programs of Multiprofessional Residency Programs of two higher education institutes, from the city of Porto Alegre, Brazil. The results were discussed in three articles. The first article discussed the value granted to the Residency as an area of learning, which had given the psychologists the possibility of experiencing knowledge and daily situations found in SUS’ context, allowing mistakes, innovations and the construction and reformulation of ideas. There were discussed aspects related to the workload and the relationship between residents and health care team. The second article focused on the undergraduate training in psychology for working in primary health care. The results showed important movements of approximation between the psychology undergraduate courses and themes such as SUS, Community Health and Public Policies. In addition, it was pointed out to the importance of professors who are identified with the SUS’s proposals, as well as the value given to the discipline of groups as an important tool for the practice of psychologists in primary health care. The third article reported a significant change in the way that the psychology residents have conceived the psychologist’s role in primary health care. Such comprehension, not restricted to intra-individual aspects, drives to expanded and interdisciplinary practices. However, it was emphasized the charge for individual appointments and the large demand for the area of psychology. Based on the data obtained by the three articles, it was concluded that the Residency has enabled psychologists to experiment and create, which has been supporting the construction of practices more aligned to the principles of primary health care, overcoming the mere transposition of practices. / Estudos assinalam para um desequilíbrio entre as práticas desenvolvidas por psicólogos na atenção básica e as demandas específicas desse contexto. Tais estudos apontam para a simples transposição do modelo clínico tradicional sem a devida contextualização que esse cenário requer, além de dificuldades no trabalho em equipe. Assim, entende-se que a psicologia apresenta o desafio de qualificar sua formação para atuar em concordância com os princípios do SUS. Diante desse desafio, a psicologia tem encontrado nas Residências Multiprofissionais em Saúde uma oportunidade de formação diferenciada da graduação que busca qualificar sua atuação para um trabalho no sistema público. Com base nisto, o presente estudo teve por objetivo conhecer a prática profissional de psicólogos, vinculados a Programas de Residência Multiprofissional em Saúde, no contexto da atenção básica. Para tanto, se realizou uma pesquisa qualitativa de cunho exploratório, sendo que a coleta de dados se deu por meio de entrevista semiestruturada. Após a transcrição das entrevistas, a análise dos dados seguiu a técnica de análise de conteúdo. A pesquisa contou com a participação de oito psicólogos residentes vinculados a dois Programas de Residência Multiprofissional em Saúde de duas Instituições de Ensino e Pesquisa em Saúde, do município de Porto Alegre, RS. Os resultados foram apresentados em três artigos. O primeiro artigo teve como resultados a valorização da Residência como um cenário de aprendizagem, o qual possibilitou aos psicólogos experimentar conhecimentos e situações do cotidiano do SUS, permitindo erros, novas tentativas e a construção e reformulação de ideias. Foram problematizados aspectos da carga horária e a relação residente e equipe de saúde. O segundo artigo teve como foco a formação acadêmica em psicologia para um trabalho na atenção básica. Os resultados evidenciaram importantes movimentos de aproximação dos cursos de graduação em psicologia com as temáticas do SUS, Saúde Coletiva e Políticas Públicas. Do mesmo modo, apontou-se para a importância de docentes identificados com as propostas do SUS, assim como o entendimento da disciplina de grupos como um subsídio importante da atuação do psicólogo na atenção básica. O terceiro artigo apresentou uma significativa mudança no modo como os residentes da psicologia têm concebido o papel do psicólogo na atenção básica. Tal entendimento, não restrito a aspectos intra-individuais, volta-se para ações ampliadas e interdisciplinares. Porém, a cobrança por atendimentos individuais e a grande demanda para a psicologia foram destacadas como desafios presentes no desenvolvimento dessas práticas. Diante dos dados obtidos nos três artigos concluiu-se que a Residência tem possibilitado aos psicólogos espaços de experimentação e de criatividade, auxiliando na construção de práticas mais alinhadas aos pressupostos da atenção básica, superando a simples transposição de práticas.

In the South African public health care system, HIV Counselling and Testing (HCT) has become a function that is routinely entrusted to lay counsellors. These counsellors are expected to educate clients about HIV and AIDS, encourage them to be tested and convince them to change risky behavioural practices. They have to convey the clients’ test results and assist those who test HIV-positive and their families to cope with the psychological challenges associated with the diagnosis. The counsellors occupy the front line of HIV and AIDS service delivery, even though they are not formally employed in the health care system. They only have basic training and are not adequately remunerated. The counsellors are confronted with psychological and structural stressors in their work. Psychological stressors include the impact of emotionally challenging work, the lack of appropriate training, debriefing and supervision. Because they are not formally employed in the health care system, there is a lack of formal supervision or channels to discuss their frustrations. This research focuses on the stressors which HIV counsellors experience, how they cope, and the impact it has on their psychological well-being. As part of the mixed methods approach 50 HCT counsellors working at the City of Tshwane clinics completed the Bar-On Emotional Quotient Inventory, the Maslach Burnout Inventory for Human Services Survey (MBI- HSS), the Centre for Epidemiologic Studies Depression scale (CES-D), and the Brief COPE scale to assess their psychological well-being. In addition, they participated in focus group discussions. EQ-i scores indicated that counsellors reported below average emotional skills, with the overall group score of (88.76). Scores that indicated average emotional skills were Self-Regard (101), Interpersonal Relationships (100.12), and Impulse Control (102.66). Scores that indicated low emotional skills were Independence (86.66), Self-Actualization (88.28), and Reality Testing (83.94). Although they reported high levels of Emotional Exhaustion (27.66), they also have a sense of high Personal Accomplishment (38.64) (MBI-HSS). Counsellors reported an overall CES-D score which was indicative of mild depression (26.08). Counsellors used mostly positive coping skills that included religion, planning, and direct action in coping with stressors in their lives. In a regression analysis with depression as the dependent variable, there was a positive relationship between depression and depersonalization and a negative relationship with positive or active coping and assertiveness. It was concluded that counsellors experienced some depression, emotional exhaustion, and lower than average levels of emotional well-being. Despite that, they reported positive ways of coping and high levels of personal accomplishment. Counsellors were motivated by their sense of altruism, compassion towards their clients, the positive changes they see in client’s lives as well as the reciprocal relationships they have formed with their clients. Counsellors thus have strengths to cope with the high level of stressors and challenges related to their work. It can be concluded that their state of mental health is in line with Keyes’ proposal that mental health forms a continuum. They fluctuate between mental well-being and mental ill-being. However, it is necessary to assist HCT counsellors to develop their emotional capacities to enable them to enhance their ability to counsel their clients effectively. / Dissertation (MA)--University of Pretoria, 2013. / gm2014 / Psychology / unrestricted

Magister Public Health - MPH / The development and provision of equitable and acceptable standard of health services to all segments of the population has been the major objective of the 1993 Ethiopian National health policy. However, community based studies on satisfaction with public health care facilities reveal that the majority of the population are not satisfied with the services provided predominantly as a result of the long waiting times. Studies done on private health facilities on the contrary reveal that patients are satisfied with the service delivered within short waiting times in these clinics. Even though the speculated waiting time is thought to be long among the public health care facilities and short in private clinics, the actual waiting and service times have not been measured and compared. Aim: To determine the waiting and service times among the public and private health care facilities and measure the perceptions of 'acceptable' waiting time among the providers and clients. Materials and methods: A cross sectional observational study using quantitative techniques was carried out amongst patients and staff at selected public and private health care facilities in Gondar District. Stratified sampling method was used to select facilities. All patients visiting the selected facilities and all staff who provided service to patients on the day of the study were included in the time-delimited sample. Data was collected by research assistants and health workers from all patients attending the health care facility by registering the arrival and departure time of each patient to the facility and to each service point on a patient flow card. Then data was cleaned and captured by a specific Waiting and Service Time database. Descriptive statistics was done on waiting and service times for each facility and this was summarized for each public and private health facility by using tables and graphs. Finally a comparison was made for private and public health facilities by using Wilcoxon-mann-whitney non parametric tests. / South Africa

Magister Public Health - MPH / Aim: To determine the waiting and service times among the public and private health care facilities and measure the perceptions of “acceptable” waiting time among the providers and clients.

Made available in DSpace on 2016-04-27T18:12:04Z (GMT). No. of bitstreams: 1 Bruna de Souza Diogenes.pdf: 945426 bytes, checksum: 8b78af1dcd81ea4a0fad45a7aecf9e83 (MD5) Previous issue date: 2014-07-28 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / INTRODUCTION: Speech Therapy is a new area of knowledge when compared with other scientific areas and it has expanded from clinical setting to public health care services. Studies in public health care services that purpose to relate risk indicators with speech symptoms are incipient, although they contribute, significantly, to create strategies of health promotion. Therefore, it s necessary to create specific, fast and efficient tools to evaluate the speech of children aged 0 to 6 years. OBJECTIVE: To validate risk indicators for infant speech. METHOD: It is a quantitative-qualitative research. This study included the trial of 5 experts of a record with the purposed risk indicators. A Silva (2005) and Fernandes (2005) form was applied to evaluate the record content. Three aspects were analyzed: evaluation of each indicator; evaluation of each indicator´s item and the evaluation of all. The data collected were placed in excel and analyzed by Statistical Package for the Social Sciences (SPSS). The validity index of the content (VIC) was measured with a minimum positive consensus of 75%. RESULTS: Only two of 12 indicators were under 0,75, therefore it was necessary to make a review and another evaluation of those 2 indicators. CONCLUSION: It is intended that the risk indicators evaluated for infant speech work as a practical and objective tool to evaluate speech in a larger number of children. This instrument will make possible to identify some speech disorders earlier, thus acting both in health care promotion and in therapeutic in Speech Therapy / INTRODUÇÃO: A Fonoaudiologia, área de conhecimento relativamente nova se comparada a outras ciências, têm estendido seus modos de atuação do âmbito da clínica para o da Saúde Pública. Nesse campo de conhecimento, os estudos que se propõem a articular indicadores de risco aos sintomas de linguagem são incipientes, apesar desse tipo de pesquisa contribuir significativamente para a construção de estratégias de promoção de saúde. Consequentemente, a construção de instrumentos específicos para avaliar a fala de crianças de 0 a 6 anos, que sejam rápidos e eficazes, torna-se necessária. OBJETIVO: Validar o conteúdo dos indicadores de risco para a fala infantil. MÉTODO: Trata-se de uma pesquisa de abordagem quanti-qualitativa. O estudo compreendeu o julgamento, por um grupo de 05 especialistas, do conteúdo de uma ficha com os indicadores propostos pelo presente trabalho. Para sua realização foi aplicado o formulário de validação de conteúdo de Silva (2005) e Fernandes (2005). Foram analisados 3 (três) domínios: avaliação de cada indicador; avaliação de cada item dos indicadores e avaliação do conjunto. Os dados foram colocados em uma tabela Excel e analisados pelo Pacote Estatístico para Ciências Sociais (SPSS). O Índice de Validade de Conteúdo (IVC) foi calculado sob o consenso favorável mínimo de 75%. RESULTADOS: Dos 12 indicadores submetidos à validação de conteúdo, somente dois ficaram abaixo de 0,75, sendo necessária sua revisão e posterior reavaliação. CONCLUSÃO: Pretende-se que os indicadores de risco para a fala infantil, uma vez validados, funcionem como um instrumento simplificado e objetivo para avaliar a fala de um número maior de crianças. Com sua adoção será possível identificar precocemente alguns possíveis problemas e, dessa forma, atuar tanto na promoção da saúde como na terapêutica em Fonoaudiologia

O direito à saúde abriga um feixe de atribuições, dentre elas encontra-se a assistência farmacêutica. Atualmente, as ações judiciais de medicamentos funcionam como via alternativa ao acesso pelo Sistema Único de Saúde. Este tipo de ação tem como objeto tanto os medicamentos previstos na rede pública como aqueles não incorporados ao sistema público. O presente trabalho teve como objetivo analisar a desprogramação causada pelo fornecimento de medicamentos não padronizados e consequentemente não previstos no orçamento público aprovado, sendo custeados pelos cofres públicos em razão das demandas judiciais. O trabalho aborda o tema por uma perspectiva que evidencia a lógica da Assistência Farmacêutica federal. / The right to health houses a bundle of tasks, among which is pharmaceutical care. Currently, lawsuits involving medicines work as an alternative access to the Sistema Único de Saúde. This type of legal action has as object both drugs provided in the public system and those not incorporated into the public system. This study aimed to analyze the deprogramming caused by nonstandard drug supply and therefore not included in the approved government budget, being funded by the public purse because of lawsuits. This paper addresses the issue from a perspective that emphasizes the logic of public pharmaceutical care.

Det finns en ojämlikhet i hälsan hos utsatta grupper i samhället, där nyanlända flyktingar är en växande patientgrupp. Syftet är att beskriva distriktssköterskans upplevelse av arbetet med nyanlända flyktingar inom primärvården med fokus på jämlik hälsa. Det är en kvalitativ intervjustudie med induktiv ansats där nio intervjuer genomförts på vårdcentraler i Västra Götaland och Halland. Kvalitativ innehållsanalys har gjorts enligt Elo och Kyngäs. Resultatet presenteras i kategorierna Det viktiga mötet, Den helhetstänkande distriktssköterskan och Den komplicerade organisationen. Det framkommer att distriktssköterskan har en viktig roll i att möta den nyanlända flyktingen och det är viktigt att se helheten kring patienten, att i mötet uppmärksamma hela situationen patienten befinner sig. Där är psykisk ohälsa och den sociala situationen värdefull att uppmärksamma. Lyhördhet, en god kommunikation med hög kvalité på tolk är nödvändigt, vilket även är viktiga delar för en jämlik vård. Det behövs även organisatoriska förutsättningar som tillräckligt med tid avsatt och att samverkan med andra kring patienten fungerar, där finns det ett behov av förbättringsarbete. Det finns hinder för nyanlända flyktingar med att komma i kontakt med hälso-och sjukvården och distriktssköterskan fyller en viktig funktion att informera, vägleda och lotsa rätt. Distriktssköterskorna upplever att det finns ett stort behov av hälsofrämjande åtgärder.