Change is a common feature of nursing, influenced by prevailing governments as part of their political agendas. These changes have impacted both on the context within which nursing takes place as well as on the actual role of the nurse. For change agents who are implementing these changes, it is imperative that they are aware of how nurses respond to change in order that they can plan the most effective strategies. This thesis investigated how nurses understand their own practice changes, the process that they undergo, how resistance to change manifests and if nursing rituals have an impact on the process. Finally the thesis made recommendations based on the findings to facilitate effective practice change and development. The study was conducted in two parts. In-depth interviews with eight nurses from one acute NHS Trust made up the first part of the study. A further two interviews were conducted with eleven mental health nurses from an early intervention team in one NHS Mental Health Partnership Trust, and this constituted the second part of the study. Constructivist grounded theory was the research method employed in the design of the study. An underpinning theoretical framework of structural anthropology with specific reference to the work of Levi-Strauss was used to present the final grounded theory. The study found that nurses understood the process of practice change as a spiral with the most significant aspects of practice change at the bottom. These were the day-to-day changes that may or may not lead to permanent change. At the top of the hierarchy and of least significance were the changes imposed by their employing organisations or nationally. The overall personal process of practice change and development was identified from the study as a process that centres on the experiences that participants have in their workplace, a process of sense making, learning and intuition. A Practice Change Model in the form of a continuum was developed that described how nurses respond to practice change and development. The significance of this study is that the thesis was able to identify strategies for promoting effective practice change and development, aimed at nurses in practice, change agents at an organisational and national level, and the clinical link role within higher education.

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M.Comm. / The people who make waves in today's business world aren't playing by yesterday's rules. They've jettisoned tradition. They've turned the old cosy business of being in business upside down and inside out. Towering corporate structures are crumbling. Middle managers are a dying breed. Successful â bosses now lead their troops from the front. People are becoming multiskilled. Enlightened businesses make this happen. Whatever it takes. Our society, facing momentous challenges in the closing years of the twentieth century, needs visions of the future so attractive, inspiring, and compelling that people will shift from their current mind-set of focusing on immediate crises to one of eagerly anticipating the future - a future where the health and well-being of the earth and its inhabitants is secure. As we round the corner of the millennium, questions about our future loom ever larger on the horizon. The decade ahead is sure to bring more radical changes in everything from marketing to enterpreneuring, resources, demographics, lifstyles and more. Success in 2000 and beyond will mean riding the crest of this wave of change- but if we are to catch the wave before it catches us, we must see it coming. This study have adopted Alvin Toffler's concept of waves of change, to serve as the framework for the vision of business in the twenty-first century. The First Wave of change, the agricultural revolution, has essentially ended. The Second Wave, co-incidental with industrialisation, has covered much of the earth and continues to spread, while a new, postindustrial Third Wave is gathering force in the modern industrial nations. A Fourth Wave is following close upon the Third

The purpose of this thesis is to develop a model of the role of a senior management services officer in one part of the National Health Service. It puts forward and discusses the deficiencies of other models of this role in order to identify parts of the role which a new model must seek to describe more adequately. The main parts of the role explored can be described as political and the expertise required to carry them out is usually said to be based on experience. The model put forward in the thesis is a two part model. The first part consists of a set of categories which describe the events which make up all the various aspects of the activities of a management services officer. The general properties and characteristics of these event categories are developed. The second part of the model is concerned with how such events fit together into projects. The main theme of this fitting together of events is the negotiation of order in large complex organisations. The model is based on a record of the change agent activities of one management services officer over a long period of time. Because of the present lack of understanding of this role and in order to include a wide variety of events in the analysis, an unstructured data collection method was used. Qualitative data is used in this study and appropriate grounded theory data analysis methods are used in the analysis. The generality of this model outside the context in which it has been developed is discussed.

Zugl.: Kassel, Univ., Diss., 2008

Zugl.: Kassel, Univ., Diss., 2008

Zugl.: München, Univ., Diss., 2006

Zugl.: Passau, Universiẗat, Diss., 2007.

Zugl.: Leipzig, Universiẗat, Magisterarbeit, 2007.