Submitted by Fabiana Gonçalves Pinto (benf@ndc.uff.br) on 2016-10-11T18:33:53Z No. of bitstreams: 1 Marina Gomes dos Santos.pdf: 4451935 bytes, checksum: 2777cc14dcb4f83b13ede8fbb0ba9899 (MD5) / Made available in DSpace on 2016-10-11T18:33:53Z (GMT). No. of bitstreams: 1 Marina Gomes dos Santos.pdf: 4451935 bytes, checksum: 2777cc14dcb4f83b13ede8fbb0ba9899 (MD5) Previous issue date: 2015 / Mestrado Acadêmico em Ciências do Cuidado em Saúde / Os agravos decorrentes de DCNT têm sido as principais causas de óbito em idosos, seguindo uma tendência mundial. Nesta população algumas doenças crônicas não transmissíveis, tem apresentado um crescimento alarmante, em especial a hipertensão arterial sistêmica (HAS) e os seus agravos, têm recebido atenção especial dos serviços de saúde. O Sistema de Informação em Saúde (SIS) - HIPERDIA, é uma importante tecnologia que, juntamente com a técnica de mapeamento em saúde, permite a coleta, processamento e análise dos serviços de saúde, bem como processos de vigilância e planejamento do cuidado. Nesta perspectiva, as ações de gerência do cuidado realizadas pelo enfermeiro na atenção básica têm caráter expressivo e instrumental de cuidado direto e indireto voltadas à promoção da saúde e prevenção de agravos. Para o desenvolvimento do estudo utilizou-se como questão de pesquisa: O mapeamento em saúde é uma ferramenta do gerenciamento do cuidado que possibilita determinar a relação entre o perfil epidemiológico e os determinantes sociais em saúde na prevalência dos fatores de risco relacionados à hipertensão arterial sistêmica? Hipótese: Existe correlação entre os determinantes sociais de saúde (DSS) e o perfil epidemiológico dos idosos no aumento da prevalência dos fatores de risco relacionados à hipertensão arterial sistêmica (HAS). Objetivos: Caracterizar o perfil epidemiológico da população cadastrada no Hiperdia; Mapear a distribuição dos fatores de risco relacionados aos agravos a saúde dos clientes cadastrados no programa Hiperdia da PRLB; e correlacionar os DSS e o perfil epidemiológico na prevalência dos fatores de risco da HAS. Quanto aos aspectos metodológicos foi desenvolvido um estudo do tipo epidemiológico descritivo, seccional, de abordagem quantitativa, aplicando-se o método de mapeamento em saúde. O cenário de pesquisa foi a PRLB; como fontes de dados foram utilizados os SIS: Hiperdia e Gil com corte temporal de 2009 à 2013; além de dados do IBGE, Censo Demográfico de 2000 e 2010, e do Plano Urbanístico da Região de Pendotiba, 2015, realizado pela Secretaria de Urbanismo e Mobilidade, da Prefeitura Municipal de Niterói. Após análises e com o objetivo de processar as informações obtidas de modo a simplificá-las e sintetizá-las, houve o cruzamento de múltiplas informações e dados, ou variáveis, no modelo de tabulação cruzada (cross - tables). Tendo como critérios de inclusão/exclusão: pacientes com idade superior ou igual a 60 anos, de ambos os sexos, cadastrados no período compreendido entre 2009 e 2013, moradores do bairro do Largo da Batalha, com diagnóstico de hipertensão arterial sistêmica. Foram excluídos do estudo os idosos portadores de Diabetes Mellitus, tipo 1 ou tipo 2. Resultados/Discussão: foram cadastrados 725 pacientes no programa Hiperdia da PRLB, sendo 93 selecionados para o estudo. Predominância do sexo feminino; da cor branca; e da idade entre 66 e 71 anos; 40,9% dos sujeitos informaram ter antecedentes familiares; o tabagismo foi um fator de risco confirmado por 59,1%; já o sedentarismo foi negado por 40,9%. Nesta população, a baixa escolaridade, associada à baixa renda mensal, são aspectos sociodemográficos relevantes, existindo correlação direta entre os DSS e o perfil epidemiológico dos idosos no aumento da prevalência dos fatores de risco relacionados à HAS. Neste cenário o desenvolvimento do mapeamento em saúde na atenção básica, torna-se uma ferramenta capaz de fornecer juntamente com as informações do perfil sociodemográfico e epidemiológico de sua população, subsídios para a construção de um plano de ações e de cuidado de enfermagem, mais próximo a realidade e as necessidades de seu público, devendo este ser compreendido pelo enfermeiro como uma estratégia da gerência do cuidado. O estudo encontra-se inserido em um projeto de pesquisa maior aprovado pelo Comitê de Ética em Pesquisa da Faculdade de Medicina da Universidade Federal Fluminense encontra-se sob nº CAAE: 2866.0.000.258-10. / Disorders resulting from NCDs have been the main causes of death in the elderly, following a worldwide trend. In this population some chronic diseases have shown an alarming increase, particularly systemic arterial hypertension (SAH) and its subsequent conditions which have received special attention of health services. The Health Information System (SIS) - HIPERDIA is an important technology that, with the health mapping technique, allows the collection, processing and analysis of health services, monitoring procedures and care measures planning. In this perspective, the care management actions carried out by nurses in primary care services have expressive and instrumental character of direct and indirect care, aimed at health promotion and disease prevention. For the development of this study we used as the research question: Is the health mapping a care management tool that lets us determine the relationship between the epidemiology and social determinants of health in the prevalence of risk factors related to hypertension? Hypothesis: There is a correlation between social determinants of health (SDH) and the epidemiological profile of the elderly in the increased prevalence of risk factors related to high blood pressure (hypertension). Objectives: To characterize the epidemiological profile of the population registered in HIPERDIA; to map the distribution of risk factors related to health harms of patients registered in HIPERDIA program of PRLB; and to correlate the SDH and epidemiological profile of the population in the prevalence of risk factors of hypertension. In the methodological aspects we developed a descriptive epidemiological sectional study, with quantitative approach, applying the health mapping method. The research scenario was the PRLB, and the data sources used were HIPERDIA and Gil from period between 2009 and 2013, both from SIS; in addition to data from IBGE, Census 2000 and 2010, and the Urban Plan of Pendotiba Region, from 2015, developed by the Department of Urban Planning and Mobility, of the City of Niterói. After analysis and in order to process the information obtained to simplify and synthesize them, we performed the crossing of multiple information and data and/or variables in the cross-table model. The following inclusion/exclusion criteria were used: patients aged 60 years or older, of both genders, registered in the period between 2009 and 2013, residents in the neighborhood of Largoda Batalha, with a diagnosis of hypertension. The elderly with diabetes mellitus, type 1 or type 2 were excluded from the study. Results / Discussion: Of the 725 patients registered in the HIPERDIA PRLB program, 93 were selected for the study. Of these, we could verify a predominance of women, of white color, aged between 66 and 71 years. 40.9% of the subjects reported having a family history of the disease; smoking was a risk factor confirmed by 59.1% of the patients; 40.9% of the sample denied having a sedentary lifestyle. In this population, a low education level, associated with a low monthly income, are relevant sociodemographic characteristics demonstrating direct correlation between the SDH and the epidemiological profile of the elderly in the increased prevalence of risk factors related to hypertension. In this scenario, the development of health mapping in primary care, as a tool able to provide information about the socio-demographic and epidemiological profile of the population, subsidizing the construction of an action plan as well as a nursing health care plan, closer to the reality and the needs of their targets, and which must be understood by the nursing teams as a care management strategy. This study is part of a larger research project approved by the Ethics Research Committee of the Medical College of Fluminense Federal University, under CAAE register number: 2866.0.000.258-10.

According to the Ministry of Health (1996:26), the most common chronic/terminal illnesses were cardiovascular disorders, diabetes, cancer, mental disorders, HIV/AIDS, tuberculosis and asthma. Long term treatment and care and the growing incidence of these conditions necessitated the introduction of home-based care (HBC). Consequently, family care givers play a major role in the provision of care to chronically/terminally ill patients and professional health care providers adopt a supervisory role. This study examined the quality of home care services provided in Botswana. The availability and accessibility of home-based care services and resources have a direct bearing on the quality of home-based care delivery system. The researcher used systems theory was used as the conceptual framework for this study. The study aimed to • determine the accessibility and availability of home-based care services in Molepolole East • investigate what the perspectives and experiences of family care givers, patients and professional health care providers of Botswana home-based care are • determine the roles of professionals health care providers, patients, and family care givers and their relationships in the context of home- based care • identify the needs of chronically/terminally ill patents and family care givers • determine the type of support given to family care givers and patients by professional health care providers and make recommendations for the improvement of home-based care • develop a model to prepare family care givers The research design combined quantitative and qualitative research methods. A sample of convenience was used to obtain information from patients' family care givers and professional health care providers. Interviews and questionnaires were used. A proposed care giving preparedness model is presented to meet needs of the family care givers. The study found that family care givers needs are neither known nor catered for by the professional health care provider. The family care givers were not adequately prepared before adopting the care-giving role. It is recommended that • The proposed preparedness care giving training model is considered for training of patients and family care givers before discharge and during HBC. • Increase patients and family care givers decision-making / Health Studies / D.Litt. et Phil. (Health Studies)

It is important for nurses to show acceptable behaviour when interacting with the patients. The purpose of this study was to explore and describe the factors that contribute to nurses’ negative behaviour when rendering patient care and to determine the effects of nurses’ behaviour on patient outcomes. The study used a non-experimental explorative and descriptive quantitative design. Data collection was done using a structured questionnaire. The sample comprised of 64 respondents which consisted of 25 registered nurses and 39 enrolled nurses. The study found that besides the known contributing factor, that is, the shortage of nurses, further identified contributing factors to nurses’ negative behaviour when rendering patient care are failure to retrain nurses identified with negative behaviours, poor condition of employment and patients’ behaviours and cultural beliefs. These results suggested a need to train more nurses, improve conditions of employment, as well as support and retrain nurses identified with negative behaviours. / Health Studies / M.A. (Public Health)

A proposta deste estudo é entender o fenômeno da adolescente em situação de rua através da Teoria das Representações Sociais, buscando a imbricação de relações, funções, tensões, saberes, valores que constroem e transformam as práticas cotidianas familiares para produzir o afastamento do convívio familiar ou prevenir a desafiliação. O objetivo principal é analisar o processo de desafiliação vivido na família e a possibilidade de sua prevenção a partir das representações sociais sobre a adolescente em situação de rua na perspectiva da própria adolescente. Trata-se de pesquisa qualitativa, na qual 21 adolescentes com experiência de viver na rua foram acessadas em um abrigo da rede municipal. Os dados foram produzidos através da entrevista semi-estruturada e analisados à luz da análise temático-categorial de conteúdo com auxílio do software NVivo. Os resultados indicam que a representação social da adolescente em situação de rua para a própria adolescente envolve um circuito que compreende a tradicional imagem do menor carente e abandonado, por suas perdas e ausências que constituem verdadeiros desafios de sobrevivência, para os quais encontram formas de enfrentamento em sua maioria consideradas desviantes, acrescentando a imagem da delinquência e criminalidade. Contudo, as práticas, relações, valores e lógicas estabelecidas, que tornam possível esse modo de viver, dão contorno a uma imagem da adolescente ancorada em atributos positivos como força, alegria, inteligência, afetividade, sagacidade/habilidade/capacidade de aprendizado, sinalizando uma ruptura (ainda que parcial) na tradicional representação da mulher como sexo frágil e submisso. O processo de desafiliação, por sua vez, é gradualmente constituído, de um lado pelos diversos fatores de esgarçamento dos laços familiares, e, de outro lado, pela aproximação e socialização com a rua, sendo fortemente influenciado pelas representações sociais acerca da adolescente em situação de rua (pela familiaridade com as práticas relacionadas com este modo de viver, mas, principalmente, pelos atributos positivos relativos à ideia de liberdade, força, diversão, facilidade, enfrentamento). Conhecer e valorizar a trajetória, crenças e representações de cada família e a estrutura de práticas e relações, situando-a num contexto histórico e cultural parece fundamental para a atuação junto às famílias e às adolescentes. A lógica das políticas públicas voltadas para a família deve considerar a instrumentalização que viabilize a atuação com base nesses parâmetros. / The purpose of this study was to understand the phenomenon of homeless adolescent girls via the social representations theory. We also aimed to investigate the interconnection of relationships, conflict, knowledge and values that compose and transform daily family practices that can either lead one to be estranged from family or help prevent disaffiliation. The main objective was to analyze the disaffiliation process experienced within the family and the possibility of preventing this situation based on the social representations of homeless adolescent girls as held by adolescent girls themselves. This was a qualitative study, in which 21 adolescents with a history of living on the street were contacted at a municipal shelter. The data were gathered through a semi-structured interview and analyzed using thematic categorical content analysis with the help of NVivo software. The results showed that the social representation of the homeless adolescent girls as held by the interviewees consists of a circuit containing the traditional image of the deprived and abandoned minor who makes use of coping mechanisms often considered deviant, coupled with the image of delinquency and criminality. Nonetheless, the established relationships, values and logic that make this way of living possible draw a positive picture of these adolescents based on attributes such as strength, joy, intelligence, affection, sagacity/skillfulness/ability to learn. This represents a rupture (although partial) with the traditional representation of women as the fragile and submissive sex. In turn, the disaffiliation is gradually constituted by several factors that sever family bonds on the one hand, and by the approximation and socialization with the street on the other. The latter is strongly influenced by social representations of homeless adolescent girls (due to familiarity with practices related to this way of life, but mainly because of positive attributes regarding the ideas of freedom, strength, fun, ease and coping). In order to work with these adolescent girls and their families, it is essential to be familiar with and value their trajectory, beliefs and representations. In addition, professionals must also understand the framework of practices and relationships permeating these families, considering their historical and cultural context. Public policies directed at families must consider how to provide professionals with the necessary tools so that they can act based on these parameters.

A proposta deste estudo é entender o fenômeno da adolescente em situação de rua através da Teoria das Representações Sociais, buscando a imbricação de relações, funções, tensões, saberes, valores que constroem e transformam as práticas cotidianas familiares para produzir o afastamento do convívio familiar ou prevenir a desafiliação. O objetivo principal é analisar o processo de desafiliação vivido na família e a possibilidade de sua prevenção a partir das representações sociais sobre a adolescente em situação de rua na perspectiva da própria adolescente. Trata-se de pesquisa qualitativa, na qual 21 adolescentes com experiência de viver na rua foram acessadas em um abrigo da rede municipal. Os dados foram produzidos através da entrevista semi-estruturada e analisados à luz da análise temático-categorial de conteúdo com auxílio do software NVivo. Os resultados indicam que a representação social da adolescente em situação de rua para a própria adolescente envolve um circuito que compreende a tradicional imagem do menor carente e abandonado, por suas perdas e ausências que constituem verdadeiros desafios de sobrevivência, para os quais encontram formas de enfrentamento em sua maioria consideradas desviantes, acrescentando a imagem da delinquência e criminalidade. Contudo, as práticas, relações, valores e lógicas estabelecidas, que tornam possível esse modo de viver, dão contorno a uma imagem da adolescente ancorada em atributos positivos como força, alegria, inteligência, afetividade, sagacidade/habilidade/capacidade de aprendizado, sinalizando uma ruptura (ainda que parcial) na tradicional representação da mulher como sexo frágil e submisso. O processo de desafiliação, por sua vez, é gradualmente constituído, de um lado pelos diversos fatores de esgarçamento dos laços familiares, e, de outro lado, pela aproximação e socialização com a rua, sendo fortemente influenciado pelas representações sociais acerca da adolescente em situação de rua (pela familiaridade com as práticas relacionadas com este modo de viver, mas, principalmente, pelos atributos positivos relativos à ideia de liberdade, força, diversão, facilidade, enfrentamento). Conhecer e valorizar a trajetória, crenças e representações de cada família e a estrutura de práticas e relações, situando-a num contexto histórico e cultural parece fundamental para a atuação junto às famílias e às adolescentes. A lógica das políticas públicas voltadas para a família deve considerar a instrumentalização que viabilize a atuação com base nesses parâmetros. / The purpose of this study was to understand the phenomenon of homeless adolescent girls via the social representations theory. We also aimed to investigate the interconnection of relationships, conflict, knowledge and values that compose and transform daily family practices that can either lead one to be estranged from family or help prevent disaffiliation. The main objective was to analyze the disaffiliation process experienced within the family and the possibility of preventing this situation based on the social representations of homeless adolescent girls as held by adolescent girls themselves. This was a qualitative study, in which 21 adolescents with a history of living on the street were contacted at a municipal shelter. The data were gathered through a semi-structured interview and analyzed using thematic categorical content analysis with the help of NVivo software. The results showed that the social representation of the homeless adolescent girls as held by the interviewees consists of a circuit containing the traditional image of the deprived and abandoned minor who makes use of coping mechanisms often considered deviant, coupled with the image of delinquency and criminality. Nonetheless, the established relationships, values and logic that make this way of living possible draw a positive picture of these adolescents based on attributes such as strength, joy, intelligence, affection, sagacity/skillfulness/ability to learn. This represents a rupture (although partial) with the traditional representation of women as the fragile and submissive sex. In turn, the disaffiliation is gradually constituted by several factors that sever family bonds on the one hand, and by the approximation and socialization with the street on the other. The latter is strongly influenced by social representations of homeless adolescent girls (due to familiarity with practices related to this way of life, but mainly because of positive attributes regarding the ideas of freedom, strength, fun, ease and coping). In order to work with these adolescent girls and their families, it is essential to be familiar with and value their trajectory, beliefs and representations. In addition, professionals must also understand the framework of practices and relationships permeating these families, considering their historical and cultural context. Public policies directed at families must consider how to provide professionals with the necessary tools so that they can act based on these parameters.

Dissertação(mestrado) - Universidade Federal do Rio Grande, Programa de Pós-Graduação em Enfermagem, Escola de Enfermagem, 2009. / Submitted by eloisa silva (eloisa1_silva@yahoo.com.br) on 2012-12-07T15:14:35Z No. of bitstreams: 1 cynthiasantanna.pdf: 678748 bytes, checksum: e12aed0ddfab199186a8ebf489e42560 (MD5) / Approved for entry into archive by Bruna Vieira(bruninha_vieira@ibest.com.br) on 2012-12-09T23:21:21Z (GMT) No. of bitstreams: 1 cynthiasantanna.pdf: 678748 bytes, checksum: e12aed0ddfab199186a8ebf489e42560 (MD5) / Made available in DSpace on 2012-12-09T23:21:21Z (GMT). No. of bitstreams: 1 cynthiasantanna.pdf: 678748 bytes, checksum: e12aed0ddfab199186a8ebf489e42560 (MD5) Previous issue date: 2009 / A Estratégia Saúde da Família, estruturada na atenção básica formada por equipes multidisciplinares inseridas em um território delimitado, desenvolve seu processo de trabalho atuando com as famílias adscritas a este, tendo enfoque na compreensão do ser humano como individual e coletivo, considerando o ambiente em que vive e interage. Neste sentido, a aproximação entre trabalhador da saúde e comunidade possibilita o desenvolvimento de ações direcionadas a sua população específica, por meio do conhecimento e atuação embasada nos Determinantes Sociais de Saúde. Desta forma, este estudo objetivou identificar os Determinantes Sociais de Saúde que despontam nos depoimentos das enfermeiras, ao caracterizarem a comunidade, analisando sua relação com o trabalho desenvolvido; bem como, compreendendo a comunidade como objeto coletivo constituído por famílias e contextos socioambientais, com e nos quais as enfermeiras desenvolvem seu trabalho, objetivou-se compreender em que concerne a constituição da interação da enfermeira com a comunidade, considerando o(s) sujeito(s) e a(s) finalidade(s). A metodologia utilizada é exploratório-descritiva com análise qualitativa, utilizando entrevista semi-estruturada gravada com consentimento das 65 enfermeiras atuantes na Saúde da Família, pertencentes à 3ª Coordenadoria Regional de Saúde/RS, durante janeiro e julho de 2006. Evidenciou-se a inter e intrarrelação nos fatores determinantes da saúde, obtendo 104 citações para as características anatomofisiológicas dos indivíduos/comunidade correspondentes aos determinantes proximais e em associação predominantemente ao trabalho desenvolvido pelas enfermeiras. Para os determinantes intermediários houve 27 citações e, para os distais, 166, com predominante referência à localização territorial das comunidades em áreas rurais e periféricas. Em relação ao contato existente entre enfermeira e comunidade evidenciou-se duas abordagens desta interação: imediata relacionada às entidades coletivas da própria comunidade; e mediata por meio da relação com os demais trabalhadores da equipe. Nas finalidades acerca desta interação emergiram dois objetos de ação: a população e a equipe. A população na resolutividade e integralidade com enfoque na qualidade da ação, formação de vínculo, prevenção de doenças e promoção da saúde direcionada à autonomia com corresponsabilização; e a equipe na organização do trabalho direcionada à resolutividade da atenção. Desta forma, identificou-se que as enfermeiras relataram uma estreita relação existente entre as características proximais e o trabalho por elas desenvolvido, bem como visualizam a relação com os demais determinantes na relação com o processo de adoecimento. Enfatiza-se, no processo de trabalho na ESF, a importância da interação enfermeira-comunidade visando ações que fortaleçam potencialidades dos indivíduos/grupos e, integralidade e resolutividade da assistência pela organização do trabalho. / The Family Health Program is structured in primary care by multidisciplinary teams formed placed in a defined territory, developing their work process working with the families registered for this, with a focus on understanding the human being as individual and collective, considering the environment in which live and interact. In this sense, the approach between health workers and community allows the development of actions aimed at their specific population, through knowledge and action grounded on the Social Determinants of Health Therefore. This study aimed to identify the Social Determinants of Health Care which highlighted in the nurses’ statements, when they characterize the community, analyzing its relation to the work carried out by them; and to understand the constitution of interaction of nurses and community, considering the subject(s) and the purpose(s). The methodology is exploratory, descriptive qualitative analysis, applying semi-structured interview recorded under the permission of the 65 nurses working in the Family Health Strategy of the 3rd Regional Health Care Coordination/RS, during January and July of 2006. It has been shown the inter and intra-relation in the health determinant factors, achieving 104 citations for the anatomo-physiological features of the corresponding individuals/community to the proximal correspondents and in association, mainly, to the work carried out by the nurses. For intermediate determinants there were 27 citations and, for distals, 166, with predominant reference to the territorial localization of the communities in rural areas and peripheries. For the contact between nurse and community, it has been noticed two approaches of interaction: immediate, in the collective entities; and mediate, with the rest of the workers of the team. In the purposes, it has emerged two action objects: the population in the resolution and integration with approaches in the quality of action, bond formation, disease prevention and promotion of health aimed to autonomy with correspondence and team direction in the organization of work aimed to the resolution of attention. Thus, it was found that the nurses have stated a narrow relation between the proximal features and by the work carried out by them, besides the visualization of the relation with other determinants in the relation with the process of getting sick. Emphasis is in the process of working in the primary health care, the importance of the interaction between nurse-community aimed to actions which strengthen potentialities of the individuals/groups and also the integration and resolution of assistance by work organization. / La Estrategia de Salud de la Familia se estructura en atención primaria por equipos multidisciplinarios formados colocado en un territorio definido, el desarrollo de su proceso de trabajo que trabajan con las familias registradas con este, con un enfoque en la comprensión del ser humano como individuo y colectivo, teniendo en cuenta el entorno en que vivir e interactuar. En este sentido, el acercamiento entre los trabajadores de la salud y la comunidad permite el desarrollo de acciones dirigidas a la población específica, a través del conocimiento y la acción fundamentada sobre los Determinantes Sociales de la Salud. Por lo tanto, este estúdio tuvo el objetivo de identificar los Determinantes Sociales de Salud que se destacan en las declaraciones de las enfermeras, al caracterizar la comunidad, analizando su relación con el trabajo desarrollado; y comprender en que consiste la constitución de la interacción de la enfermera con la comunidad, considerando el(los) sujeto(s) y la(s) finalidad(es). Se trata de un estudio exploratorio-descriptivo con análisis cualitativa, fue utilizada la entrevista semiestructurada grabada con el consentimiento de las 65 enfermeras de la Salud de la Familia, pertenecientes a la 3ª Coordinación Regional de Salud/RS, durante el periodo de enero a julio de 2006. Fue evidenciado la inter e intrarrelación en los factores determinantes de la salud, obteniendo 104 citaciones para las características anatomofisiológicas de los individuos/comunidad correspondientes a los determinantes proximales y en asociación predominantemente al trabajo desarrollado por las enfermeras. Para los determinantes intermediarios hubo 27 citaciones y, para los distales, 166, con predominante referencia a la localización territorial de las comunidades en áreas rurales y periféricas. Para el contacto entre la enfermera y la comunidad fue evidenciado dos abordajes de la interactividad: inmediata, en las entidades colectivas; y mediata, con los demás trabajadores del equipo. En las finalidades, emergían dos objetos de acción; la población en resolución e integración con enfoques en la cualidad de acción, formación de vínculo, prevención de enfermedades y promoción de la salud dirigida a la autonomía con corresponsabilización y el direccionamiento del equipo en la organización del trabajo dirigido a la resolución de la atención. Así, se constató que las enfermeras relataron una estrecha relación entre las características proximales y el trabajo por ellas desarrollado, además de como visualizan la relación con los demás determinantes en la relación con el proceso de enfermarse. Se enfatiza la importancia de la interacción enfermera/comunidad visando las acciones que fortalezcan potencialidades de los individuos/grupos y también integración y resolución de la asistencia por la organización del trabajo.

Department of Advanced Nursing Science / MCur

MCur / Department of Advanced Nursing Science / Background: The Mother-Baby Friendly Initiative (MBFI) promotes and supports breastfeeding in environments such as clinics, community health centres and hospitals that have fully-functioning maternity units. The implementation of the Mother-Baby Friendly Initiative in hospitals is associated with significant increases in the initiation and duration of exclusive breastfeeding (EBF). The Mother-Baby Friendly Initiative also leads to improved healthcare for infants, children and provides improved maternal health to all mothers. The main aim of this study was to assess the knowledge, attitudes and practices (KAP) of nurses regarding the Mother-Baby Friendly Initiative in non-accredited primary healthcare (PHC) facilities of Makhuduthamaga Sub-district. Method: Descriptive, cross-sectional and correlational study designs were used with the quantitative method. All the 18 non-accredited primary healthcare facilities were purposively selected and a total sampling method was used to select all the nurses working in these non-accredited primary healthcare facilities. Permission to conduct the study was sought from the University of Venda Research Ethics Committee and the Limpopo Department of Health Research Committee. Data was collected using a structured self-administered questionnaire. Content and face validity were enhanced before the actual data collection process. One hundred and ninety questionnaires were distributed and 164 responded, giving a response rate of 86.3%. Cronbach’s alpha test determined the reliability and reflected 0.981, indicating high reliability. Data was analysed using the Statistical Package for Social Sciences (SPSS) 23.0 and the Pearson coefficient of correlation established the relationship between variables. The study followed ethical considerations such as privacy, autonomy, confidentiality, fair treatment and right to self-determination. Results: In this study, 50.6% were professional nurses (PNs), 6.7% were nursing managers (NMs), 15.2% were enrolled nurses (ENs) and 27.4% were enrolled nursing assistants (ENAs). This study found that 100% of NMs, 65.1% of PNs, 54.2% of ENs and 26.7% of ENAs had received formal training on lactation management. Seventy-two percent (72%) of NMs, 90.4% of PNs, 72% of ENs vii and 66.7% of ENAs were knowledgeable about the duration of exclusive breastfeeding. This analysis found that the majority of nurses agreed that MBFI increases breastfeeding rates. Results showed that 63.6% of NMs, 69.6% of PNs, 56% of ENs and 46.7% of ENAs teach and demonstrate hand-milk expression to breastfeeding mothers. Furthermore, this research revealed that there was a significant relationship between the knowledge, attitudes and practices of nurses with a p-value of (p-00.01). Recommendations and Conclusion: This study recommends that all nurses should receive formal training on MBFI implementation and this should be conducted to improve ENs and ENAs’ awareness about MBFI. MBFI should be integrated into the training curriculum for all nursing categories. This study further recommends that a support model for implementation of MBFI be developed and implemented.

According to the Ministry of Health (1996:26), the most common chronic/terminal illnesses were cardiovascular disorders, diabetes, cancer, mental disorders, HIV/AIDS, tuberculosis and asthma. Long term treatment and care and the growing incidence of these conditions necessitated the introduction of home-based care (HBC). Consequently, family care givers play a major role in the provision of care to chronically/terminally ill patients and professional health care providers adopt a supervisory role. This study examined the quality of home care services provided in Botswana. The availability and accessibility of home-based care services and resources have a direct bearing on the quality of home-based care delivery system. The researcher used systems theory was used as the conceptual framework for this study. The study aimed to • determine the accessibility and availability of home-based care services in Molepolole East • investigate what the perspectives and experiences of family care givers, patients and professional health care providers of Botswana home-based care are • determine the roles of professionals health care providers, patients, and family care givers and their relationships in the context of home- based care • identify the needs of chronically/terminally ill patents and family care givers • determine the type of support given to family care givers and patients by professional health care providers and make recommendations for the improvement of home-based care • develop a model to prepare family care givers The research design combined quantitative and qualitative research methods. A sample of convenience was used to obtain information from patients' family care givers and professional health care providers. Interviews and questionnaires were used. A proposed care giving preparedness model is presented to meet needs of the family care givers. The study found that family care givers needs are neither known nor catered for by the professional health care provider. The family care givers were not adequately prepared before adopting the care-giving role. It is recommended that • The proposed preparedness care giving training model is considered for training of patients and family care givers before discharge and during HBC. • Increase patients and family care givers decision-making / Health Studies / D.Litt. et Phil. (Health Studies)

The focused of this study is the role of capacity building in Community Home Based Care (CHBC) for HIV/AIDS patients. The study forms part of my Master's in Development Administration programme, undertaken through UNISA. The dissertation was accomplished by studying the TASO community initiative in Sseeta-Nazigo, Mukono District, Uganda. It explores the concept of capacity building and its applicability to CHBC. The primacy data was gathered by conducting Key Infonnant Interviews (KIIs) and Focus Group Discussions (FGD). The secondary data was gathered by reviewing literature to augment the primary data. In addition, data was gathered through observations within the community. The fmdings have identified seven critical components of capacity building: community mobilisation, skills development, Information, Education and Communication (IEC) Voluntary Counselling and Testing (VCT), networking and collaboration, support and supervision, Monitoring and Evaluation (M&E). The study observed that capacity built in the above areas resulted in three outcomes: skills development, improvement in procedures, and institutional development. Informed recommendations were subsequently made related to the seven componentsof capacity building in CHBC / Development Studies / M. A. (Development Studies)