This degree work concerns the role of sisters and ward sisters and their share in the nursing care quality. The theoretical part of the work is divided into three sections. Section one presents sisters and ward sisters as active members of the nursing management. Section two deals with the managements functions of the sister staff and their impact on the nursing care quality. Section three reviews the basic issues of the nursing care quality. The purpose of section one was to review the scope of activities of sisters and ward sisters with respect to the nursing care quality. The purpose of section two was to identify the key difficulties preventing sisters and wards sisters from increasing the nursing care quality. The purpose of section three was to analyse the working relationships between sisters and ward sisters with respect to the nursing care quality. While mapping out the situation in the selected hospital (the Faculty Hospital in Plzeň), we asked the following six research questions: 1. What are the areas where the hospital sisters may affect the nursing care quality? 2. What obstacles the sisters can see preventing them from taking part in continuous improvements in the nursing care quality? 3. How do the hospital sisters co-operate with the respective ward sisters concerning the nursing care quality? 4. What are the areas where the ward sisters may affect the nursing care quality? 5. Are there any obstacles preventing the ward sisters from taking part in continuous improvements in the nursing care quality? 5. How do the ward sisters co-operate with the respective sisters concerning the nursing care quality? The questions were asked during informal discussions with ten sisters and ten wards sisters at the Faculty Hospital in Plzeň. The information and data collected were processed using the framework analysis method whereby the answers to the research questions were derived. The research identified the following main problems preventing the hospital sisters and ward sisters from increasing the nursing care quality: inefficient time management on the side of ward sisters, insufficient competencies of ward sisters regarding staff remuneration, insufficient application of the existing nursing-care quality improvement tools by both sisters and ward sisters, limited engagement of the hospital sisters and ward sisters in creation of internal standard procedures, and reluctant attitudes of the hospital staff to changes. Based on the shortcomings identified through our research we have worked out proposals on practical improvements.

O presente estudo aplicou o Método Bick, para fins de pesquisa, com o objetivo de desvendar e conhecer a vivência emocional da mulher sobre o parto. Foram realizadas observações sistemáticas em um Centro Obstétrico durante dezenove meses. As observações foram relatadas, supervisionadas e posteriormente analisadas. Os dados apontam o parto como um momento potencialmente desorganizador que, somado à condição regressiva das parturientes, foi capaz de produzir sobrecarga emocional e desencadear um estado de vulnerabilidade psíquica nas mulheres, mas que produziu impacto emocional também no observador e na equipe. Foi constatado o uso de mecanismos defensivos na equipe, que prejudicava a interação profissional-paciente. O Método Bick possibilitou a aproximação da vivência emocional do parto através da disponibilidade psíquica e da postura não-intrusiva do observador. O estudo sugere a necessidade de revisão das práticas relacionadas ao manejo dos aspectos emocionais das parturientes. Implicações clínicas e para a pesquisa também são abordadas. / The present study consisted of an application of the Bick method to research aiming to reveal and investigate women's emotional experience of delivery. Observations were carried out in an Obstetric Ward during nineteen months. They were written up, supervised and later analyzed. The results revealed that delivery is a potentially disorganizing moment. Due to women's regressive condition, it may produce emotional overload and trigger a state of psychic vulnerability in women, which had an emotional impact on the observer and the professionals. The use of defensive mechanisms in the professionals was observed which interfered in the professional-patient interaction. The observer's psychic availability and non intrusive position which characterize the Bick method enabled to get in contact with the emotional experience of delivery. The study suggests the need for revising professional practices related to the handling of the emotional aspects of delivery. Both clinical and research implications of the findings are also discussed.

[pt] O presente trabalho tem como objetivo analisar os acontecimentos transcorridos nos postos indígenas do estado de Minas Gerais – o Posto Indígena Guido Marlière (PIGM) e o Posto Indígena Mariano de Oliveira (PIMO) – durante a ditadura civil-militar, sobretudo entre os anos de 1967 e 1973, período no qual a Ajudância Minas-Bahia (AJMB), responsável pela administração desses postos, ficou sob o comando da Polícia Militar de Minas Gerais (PMMG). Nesse período, foi construído um reformatório para índios considerados delinquentes transferidos de várias regiões do país para o território demarcado ao povo indígena Krenak; foi formada uma tropa militarizada de policiais-indígenas conhecida como Guarda Rural Indígena (GRIN); e, finalmente, foi realizada a transferência forçada dos Krenak e dos confinados no reformatório para uma propriedade da PMMG chamada Fazenda Guarani. Esses acontecimentos atingiram diretamente a cultura política Krenak, levando o Ministério Público Federal (MPF) a pleitear uma inédita anistia política coletiva em prol do povo indígena Krenak junto ao Ministério da Justiça no ano de 2015. Essa dissertação procura descrever esses processos à luz de um conjunto de documentos colhidos em pesquisas no acervo do Museu do Índio e do Centro de Referência Indígena do portal Armazém Memória, sobretudo aqueles que permitem conhecer o funcionamento do órgão tutelar (primeiro o Serviço de Proteção ao Índio – SPI – e posteriormente a Fundação Nacional do Índio – FUNAI) naquela região, onde ocorriam frequentes conflitos fundiários. / [en] This text aims to analyse the main facts which happened at Indigenous posts of Minas Gerais State- The Indigenous Post Guido Marliere (PIGM) and the Indigenous Post Mariano de Oliveira (PIMO)- during the civil-military dictatorship, mainly between 1967 and 1973, time in which the Ajudância Minas-Bahia (AJMB), responsible for administrating the mentioned posts, was under Military Police of Minas Gerais State s control (PMMG). During this time one reformatory was built for said offenders indians be transferred from several regions of the Country to the defined territory of Krenak indians. A militarised troop was organised with police Indians known as Rural Indigenous Guard (GRIN). All the Krenaks and the ones confined in the reformatory were forced to move to a PMMG s property know as Guarani Farm. These facts directly hit Krenak s political culture, leading the Ministério Público Federal (MPF) pleading an unique collective political amnesty to benefit the Krenak indigenous people. This litigation was submitted to Minister of Justice in 2015. This text describes all these processes under the lights of researched documents stored at Indian s Museum and Indigenous Centre of Reference collections both part of Armazem Memoria portal, mainly the ones which allow knowing how tutelary institutions such as initially SPI (Serviço de Proteção ao Índio) and later FNI (Fundação Nacional do Índio) worked in that region, where several conflicts over land had happened.

BAKGRUND: Sjuksköterskors arbetsmiljö är enligt tidigare forskning ansträngd. Hög arbetsbelastning och stress påverkar patientsäkerheten och leder till ohälsa och sjukskrivningar hos personal. Stress definieras som ett tillstånd där människor reagerar på någon aktivitet, händelse eller liknande. Ofta beror stressreaktionen på att en uppgift upplevs inneha höga krav utan tillräckliga tillgångar för att klara uppgiften. SYFTE: Är att belysa sjuksköterskors upplevelser av möjliga arbetsrelaterade stressfaktorer på vårdavdelningar på sjukhus. METOD: Litteraturöversikt baserad på 15 artiklar från Cinahl, PubMed och Psycinfo varav 13 var kvalitativa, en var kvantitativ och en var mixad metod. RESULTAT: Resultatet visade åtta faktorer i arbetsmiljön som orsakade stress hos sjuksköterskor. Dessa var: hög arbetsbelastning, etisk stress, bristande samarbete och hierarki i arbetslaget, patienter och anhöriga, våld och trakasserier, förväntningar på sjuksköterskor, låg lön, parkeringsplatser och personalrum. SLUTSATS: Sjuksköterskor på vårdavdelningar på sjukhus upplever många olika faktorer till stress. Stress hos sjuksköterskor orsakar lidande både för sjuksköterskor, patienter och anhöriga. För att sjuksköterskor ska uppleva mindre stress krävs en god relation och ömsesidig respekt i samarbetet med arbetsledning och kollegor, en hanterbar arbetsbelastning, en trygg arbetsmiljö och en rimlig lön. / BACKGROUND: Nurses work environment is strained according to earlier studies. High workload and stress affect the patient safety and causes sickness and sick leaves among the nurse staff. Stress is defined as a condition where people reacts for some activity, experience or suchlike. The stress reaction often occur when a certain assignment has a lot of demands without an adequate amount of resources to perform the assignment. AIM: To describe possible nurses stress related factors in the work environment at wards in a hospital. METHOD: Literature review based on 15 articles from Cinahl, PubMed and Psycinfo, which of 13 was qualitative articles, one was a quantitative and one was a mixed method. RESULTS: The result showed eight factors in the work environment that caused stress among nurses. The factors were high workload, ethical stress, lack of collaboration between the staff and hierarki, patients and relatives, violence and harassment, expectations on nurses, low income, parking lots and staffroom. CONCLUSION: Nurses in hospital wards experience many different factors that contributes to stress. Stress in nurses contributes to suffering for nurses, patients and relatives. In order to lower nurses stress there need to be a good relationship and mutual respect in the cooperation between nurse, colleagues and supervision, a manageable workload, a safe work environment and a reasonable salary.

Background: Within the Stockholm County Council returned in 2013 around 68 percent of the women to the antenatal clinic for a check-up after childbirth. Earlier studies show that new mothers want greater support from maternal health care and do not always know where to seek care. Aim: The aim of this work was to investigate whether the use of a standard model describing midwifery care and procedures for the postpartum check-up could affect the number of women who return to Södermalms clinic. A further aim was to compare the midwife and the patient's perspective, about what were included and discussed at this postpartum check-up. Method: This study had a descriptive quantitative research approach. How and when the woman contacted, and what topic the midwife discussed with the woman during the postpartum visit, was well described in a flowchart. 112 women were enrolled in the study and the project could be evaluated on the basis of data from the Pregnancy Registry and a control group corresponding to the intervention group was appointed. Results: Registered data showed an increased number of women who returned to Södermalms clinic postpartum, in the control group, there was no increase in the percentage of women who came to postpartum visits. There was a difference between the midwife and the woman's perception of what was discussed at the postpartum visit, particularly around the   information about the ruptures and the pelvic floor muscle, there was a discrepancy.  The midwives participating in the study preferred after completion of the study a more structured working model, where the postpartum visits were clarified. Conclusion: There may be advantages to use a standard model describing the midwifery care and procedures for the postpartum visits. The midwives preferred to book in the woman's postpartum check-up during her last pregnancy visit and were more satisfied with the new approach.

Bakgrund: Inom psykiatrisk vård är det viktigt att respektera patientens personliga förväntningar och mål för att uppnå goda behandlingsresultat och för att patienterna ska känna sig tillfreds med den vård de erhåller. Sjuksköterskan bör underlätta för patienter att kommunicera om sina besvär, stödja patienten att analysera destruktivt beteende, stödja patienten att skapa en normal daglig livsföring samt främja patientens integritet och egenvård. Trots detta upplever inte patienterna att detta uppfylls alla gånger. Syfte: Syftet med denna litteraturöversikt var att undersöka patienter med psykisk ohälsa med fokus på deras upplevelser av vården på psykiatriska vårdavdelningar.  Metod: I denna litteraturöversikt har författarna använt tio vetenskapliga artiklar för att besvara syftet. Dessa har granskats för att förstå skillnader och likheter och sedan delats in i teman. Resultat: Tre teman och tre underteman påvisades i denna litteraturöversikt. Ett tema var patienters upplevelser av att bli eller inte bli behandlad med respekt med undertemana patienters upplevelser av stigmatisering samt patienters upplevelser av vårdande miljö. Det andra temat var upplevelser av personalens förhållningssätt med undertemat patienters upplevelser av vårdande relationer. Det tredje och sista temat var patienters upplevelser av trygghet. Diskussion: I diskussionen diskuterar författarna patienters upplevelser på psykiatriska vårdavdelningar samt hur dessa påverkar dem. Författarna kom fram till fyra områden; patienters upplevelser av maktlöshet vid stigmatisering, vårdandets och miljöns påverkan på känslor av trygghet, självbestämmandets betydelse samt betydelsen av delaktighet. Dessa områden diskuterades och jämfördes med befintlig forskning och knöts an till Phil Barkers tidvattenmodell. / Background: In psychiatric care, it is important to respect the patients’ personal expectations and goals in order to achieve good treatment outcomes and to make patients feel satisfied with the care. The nurse should help patients to communicate about their inconveniences, support the patient to analyze destructive behaviors, support the patient to create a normal daily life routine and promote patients’ integrity and self-care. However, patients do not experience this in psychiatric care. Aim: The aim of this literature review was to explore patients with mental illness focusing on their experiences of care in psychiatric care units. Method: In this literature review the authors used ten scientific papers to answer the aim of the review. These articles have been examined to understand differences and similarities and then the authors performed a thematic analysis. Results: Three themes and three subthemes were identified in this literature review. The first theme was patients’ experiences of being or not being treated with respect with the associated subthemes patients’ experiences of stigmatization and patients’ experiences of the health care environment. The second theme was the experience of the staff's attitude with the associated subtheme patients’ experiences of caring relationship. The third and last theme was patients’ experiences of safety. Discussion: The authors discussed patients' experiences in psychiatric care units and how these experiences affect the patients. The discussion emphasized four areas; patients experiences of powerlessness in stigmatization, the healthcare’s and the environment's impact on feelings of safety, the importance of self-determination and the importance of participation. These areas were discussed and compared to existing research and also linked to Phil Barker's tidal model.

No description available.

Interprofessional practice and teamwork are becoming more essential in health care. Increased collaboration gives the opportunity to enable patient centred health care with high quality of outcomes. If health professional students learn together they will be better prepared for interprofessional collaboration and teamwork, such initiative can be interprofessional education (IPE) at a clinical education ward (CEW). The aim of the study is to explore how students from medicine, nursing, physiotherapy and occupational therapy programs, perceive their own and each others` profession prior to a clinical placement at a CEW. This was a qualitative study using focus groups. 18 students participate in the study. Data were analyzed using thematic analysis and a thematic network was developed. A plethora of professional perceptions emerged as the highest order category. This was derived from four organizing themes; professional expectations, relationship to the patient, leadership and relationship across professions and from the respective basic themes: different areas of professional doing and explanation of professional images, being close, being distanced, being a coordinator and being a leader, collaboration and unclear boundaries. This perceptions are needed to discuss and reflect during the CEW and allowing the student, together rather than silos, to develop professional identities as well as the knowledge, skills and attitudes.

Masters in Public Administration - MPA / It is often argued that public participation is the cornerstone of constitutional democracy especially in countries such as South Africa with the history of segregation which was characterised by the exclusion of the majority of citizens from the decision-making processes of the state based on race, class and gender. As such, following the introduction of the various pieces of legislation in 1994, the dominant narrative was that the progressive laws that were passed would serve as a ‘panacea’ to the challenges of participatory governance in South Africa. It was inconceivable that 25 years into democracy, South Africa would still be grappling with the concept of public participation and the extent to which citizens could influence, direct and own decisions made by and with government especially at a local level. This study assessed the state of public participation in the Western Cape focusing on Beaufort Municipality in the Central Karoo District. It argued that public participation is a prerequisite for democratic governance and that the state could be deemed illegitimate if it does not prioritize the involvement of communities in its affairs. In this context, a particular focus was placed on the effectiveness of the ward committee system (as state sponsored mechanisms of public participation) in enhancing participatory democracy in Beaufort West Municipality. It refuted assumptions on the institutional arrangements made in the legislative framework governing public participation and ward committees – identifying and outlining some of the unanticipated consequences of these pieces of legislation. The study used qualitative research methods to collect data. Primary and secondary data was gathered to assess the state of public participation in the Western Cape with specific reference on the effectiveness of the ward committee system and the role of legislative and regulatory framework governing public participation, the institutional architecture and the roles of various stakeholders involved in public participation. The primary data was gathered through structured interviews and questionnaires while the secondary data was collected the analysis of the literature on public participation and ward committees including municipal reports, guidelines on public participation, legislation and policy frameworks. The research found that it is precisely the state sanctioned ward committee system that has contributed to the collapse of public participation in South Africa. The ward committee system was identified as a ‘poisoned chalice’ - so compromised that it has become an instrument to legitimise predetermined decisions of the politically connected elite, a rubber v stamp platform to comply with the policy and legislative framework. To address this problem, the study recommended a number of measures and interventions that could be introduced which entails the reconfiguration and overhaul of the legislative framework governing public participation and ward committees including the review of the role of politicians in public participation, training and capacity building, allocation of dedicated budget for public participation etc.

Masters in Public Administration - MPA / It is often argued that public participation is the cornerstone of constitutional democracy especially in countries such as South Africa with the history of segregation which was characterised by the exclusion of the majority of citizens from the decision-making processes of the state based on race, class and gender. As such, following the introduction of the various pieces of legislation in 1994, the dominant narrative was that the progressive laws that were passed would serve as a ‘panacea’ to the challenges of participatory governance in South Africa. It was inconceivable that 25 years into democracy, South Africa would still be grappling with the concept of public participation and the extent to which citizens could influence, direct and own decisions made by and with government especially at a local level. This study assessed the state of public participation in the Western Cape focusing on Beaufort Municipality in the Central Karoo District. It argued that public participation is a prerequisite for democratic governance and that the state could be deemed illegitimate if it does not prioritize the involvement of communities in its affairs. In this context, a particular focus was placed on the effectiveness of the ward committee system (as state sponsored mechanisms of public participation) in enhancing participatory democracy in Beaufort West Municipality. It refuted assumptions on the institutional arrangements made in the legislative framework governing public participation and ward committees – identifying and outlining some of the unanticipated consequences of these pieces of legislation. The study used qualitative research methods to collect data. Primary and secondary data was gathered to assess the state of public participation in the Western Cape with specific reference on the effectiveness of the ward committee system and the role of legislative and regulatory framework governing public participation, the institutional architecture and the roles of various stakeholders involved in public participation. The primary data was gathered through structured interviews and questionnaires while the secondary data was collected the analysis of the literature on public participation and ward committees including municipal reports, guidelines on public participation, legislation and policy frameworks. The research found that it is precisely the state sanctioned ward committee system that has contributed to the collapse of public participation in South Africa. The ward committee system was identified as a ‘poisoned chalice’ - so compromised that it has become an instrument to legitimise predetermined decisions of the politically connected elite, a rubber stamp platform to comply with the policy and legislative framework. To address this problem, the study recommended a number of measures and interventions that could be introduced which entails the reconfiguration and overhaul of the legislative framework governing public participation and ward committees including the review of the role of politicians in public participation, training and capacity building, allocation of dedicated budget for public participation etc.