Thesis (M.S.)--Yale. / eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references.

Thesis--Columbia University. / eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references.

Thesis--Columbia University. / Includes bibliographical references.

Thesis (M.S.)--Yale. / Includes bibliographical references.

Thesis (M.S.)--Catholic University of America. / Includes bibliographical references.

Thesis (M.S.)--Catholic University of America. / eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references.

Esta pesquisa teve por finalidade apreender os processos de construção, instalação e banalização do poder, da violência e da dominação simbólicos dentro de um serviço público hospitalar que atende mulheres em situação de gestação, parto e puerpério. Seus objetivos foram a compreensão desses mesmos processos nas vivências das mulheres pacientes e nas experiências das trabalhadoras da saúde, bem como a apreensão da sua constituição nos aspectos relacionados à organização do espaço físico e burocrático no contexto hospitalar estudado. O referencial teóricometodológico utilizado foi inspirado na teorização de Pierre Bourdieu, sobre poder, violência e dominação simbólicos, cujas noções foram, neste trabalho, adaptadas para o estudo das relações que ocorrem entre os(as) trabalhadores(as) e as mulheres usuárias de serviços públicos de saúde. Foram incorporados à teorização de Bourdieu as referências conceituais de gênero e etologia, todas muito imbricadas no processo de análise. A análise temática foi a técnica que orientou o tratamento do material empírico. Com base na análise do material coletado através de entrevistas com as usuárias e profissionais de saúde, observação, participante, análise de prontuários e filmagem do espaço hospitalar, defini três unidades de significado. As duas primeiras unidades se concentraram na análise do poder, da violência e da dominação simbólicos nas ações e práticas de saúde da medicina e da enfermagem. A terceira foi reservada ao estudo desses elementos na forma como eles estão impressos no ambiente físico e organizacional do serviço estudado. O quadro analítico da pesquisa apontou inicialmente, para os processos de construção, banalização e naturalização do poder, da violência e da dominação simbólicos nas práticas de saúde e no espaço físico do serviço estudado. Em sincronia com esses processos, emergiram as diferenças impressas pela aprendizagem de gênero entre as práticas médica e de enfermagem, no que diz respeito ao processo de assistir e se relacionar no hospital. Junto à análise das duas primeiras unidades, evidenciou-se a aguda consciência das mulheres sobre a fragilidade da sua condição de pacientes nos serviços públicos, indicando também as resistências e a rejeição dessas à já naturalizada objetificação de suas pessoas pelas práticas de saúde dentro do serviço estudado. Os dados também revelaram, na análise etológica, as muitas adaptações, concessões e mesmo os arranjos feitos pelas mulheres clientes dos serviços públicos para ajustar-se ao ambiente hospitalar e a quase inexistente contrapartida do serviço neste mesmo sentido. Portanto, pude concluir que a dominação simbólica, por ser sempre ratificada a partir do olhar dominante, por evidências que podem ser atestadas pela precariedade tanto de seu espaço físico quanto simbólico nos serviços de saúde e por já estar inscrita nas disposições corporais dos indivíduos, bem traduz o valor e a importância da clientela feminina para o serviço estudado / The objective of the present study was learn about the processes of construction, installation and banalization of symbolic power, violence and domination inside a public hospital service that provides care to women during pregnancy, delivery, and the postpartum period. The objectives were to understand these processes as experienced by the patients and by the health workers and in terms of their constitution in aspects related to the organization of the physical and bureaucratic space within the hospital context studied. The theoretical-methodological framework used was inspired on Pierre Bourdieu\'s theories about symbolic power, violence and domination were adapted in the present study to the investigation of the relations between workers and the women using the public health services. The conceptual references of gender and etology were incorporated into the concepts of Bourdieu, all of them deeply intertwined with the process of analysis. Thematic analysis was the technique used to guide the treatment of empirical material. On the basis of the analysis of the material collected by interviewing the clients and the health professionals, by participant observation, by analysis of the medical records and by filming the hospital space, I defined three units of meaning. The first two inits were concentrated on the analysis of symbolic power, violence and dominance in the health actions and practices of medicine and nursing and the third was devoted to the study of these elements in the form in which they are imprinted on the physical and organizational environment of the health service studied. The analytical picture of the research first pointed at the processes of contruction, banalization and naturalization of the symbolic power, violence and dominancein the health pratices and in the physical space of the service studied and, in synchrony with these processes, there was the emergence of differences imprinted by gender learning between medical and nursing practice with respect to the process of providing care and of relating in the hospital. The analysis of the first two categories demonstrated the acute awareness of women of the fragility of their condition as patients of public services, also indicating their resistance to and rejection of the objectification of their persons already naturalized by the health practices followed within the service studied. The data obtained by etologic analysis also revealed the many adaptations, concessions and even the arrangements made by the female clients of public health services in order to adapt to the hospital environment, and the almost nonexistant reciprocal contribution by the service in this respect. Thus, I concluded that the symbolic domination, by being always ratified from the dominant view through evidence shown by the precarious nature of both its physical and symbolic space in health services and by being inscribed in the body attitudes of the individuals, clearly the value and importance of the female clientele for the service studied, evidence provided by the importance of the female clientele for the service studied

This study explored how public health nurses (PHNs) work to address health inequities. Cultural safety was used as a theoretical lens. Methods for interpretive description were relied on for data collection and analysis. Data sources included interviews with 14 staff from an urban public health unit and document review of three policies. Two themes emerged: building relationships and working within a frame. Building relationships involved: delivering the message, taking the time, being present, the right nurse and learning from communities. The public health frame influenced the capacity of PHNs to address health inequities through: culture and stereotypes, public health standards, setting priorities, inclusion of priority populations, responding to change and (re)action through reorganization. Discursive formations of priority populations, and partnership and collaboration, were revealed. Findings highlighted downstream public health approaches to addressing health inequities. Importantly, embedding cultural safety as a framework for public health practice can guide upstream action.

The EPP Project was a descriptive and inferential study designed to determine the psychosocial and medical needs of elderly post-hospital dischargees. The areas of need assessed were (1) living arrangements, (2) use of leisure time, (3) vocational adjustment, (4) financial functioning and (5) adjustment to illness. The instrument adopted for the purpose of this study was an adaptation of a scheduled in the New York Study. The New York Study, described in The Elderly Ambulatory Patient: Nursing and Psychosocial Needs by Doris Schwartz, Barbara Henley and Leonard Zeitz was a long-range study of the needs of elderly clinic patients. The schedule utilized both open-end and structured responses. Interviews were conducted in the homes of respondents. A sample of 63 patients was drawn and found from a population of elderly dischargees of the Kaiser Foundation Hospital in Portland, Oregon. The study group was composed of 20 patients adjudged by their physicians as having a high probability of need for post-hospital skilled nursing care. The control group included 43 patients systematically selected from a sample of the general hospital populace of elderly patients discharged during the same period of time as the study group and not considered to be in need of special nursing services. Findings yielded evidence to support the hypothesis that patients adjudged by the doctors as having more medical needs also had more social needs. A second hypothesis stating that medical and social needs of the study group were the same as medical and social needs of the control group was rejected. Those in the study group evidenced greater medical and related social needs. The third hypothesis sought to test the reliability of the Greenlick prediction formula, an instrument used in a previous Kaiser Hospital study to estimate the need for skilled nursing service in a population following hospital discharge. Findings indicated that the Greenlick prediction formula was effective in ascertaining need for immediate post-hospital care and was effective, with greater variance, in predicting needs over time. The final hypothesis asserted that the needs of the patients in the EPP Project were the same as those determined in the New York Study. This hypothesis was rejected when analysis of data yielded evidence that the patients in the EPP Project functioned at a higher level in all areas considered than did the patients in the New York Study. Unexpectedly, the findings disproved the stereotype emphasized in social work literature characterizing the elderly as being needy and in distress both socially and medically. On the contrary, findings indicated that such unqualified generalizations about elderly patients as a homogeneous group cannot appropriately be made. Collection and analysis of the data pointed to the need for social work services in the area of budgeting for medical expenses and utilization of appropriate community resources. A further indication was the need for volunteers to provide services such as transportation to enhance participation in social and recreational activities. The use of volunteers would also facilitate grocery shopping and obtaining medical attention. Implications for further research suggested the need for additional empirical studies of elderly post-hospital patients in a variety of settings.

Thesis (M.S.P.H.)--University of Michigan, 1948.