A thesis submitted in partial fulfillment for the requirement for the degree of Doctor of Philosophy in the Department of Psychology at the University of Zululand, South Africa, 2010. / This research project was undertaken to investigate workplace bullying and its effect on health service delivery. Research participants were drawn from Prince Mshiyeni Memorial and Mosvold Hospitals; the aim was to compare the experiences of public health employees in rural and urban areas of KwaZulu- Natal. The employees have a right to be treated with respect and dignity and, most importantly, to work in a harmonious and supportive environment. Bullying behaviour breaches the employer’s duty under common law to provide a safe and a secure work environment both physically and psychologically. What makes it difficult for managers to manage bullying is that it has no tangible results but it leaves the victim with psychological and emotional problems which lead to anxiety, stress and depression if not properly attended to. The results of this research project further reveal that the majority of bullied employees are reluctant to speak out or end up not reporting the incidences because when they do report problems they believe that they will not be taken seriously. The results also prove that bullying is not a once-off event but a continuous cycle aimed at humiliating and belittling the XVII victim and that it is present in both health institutions. Though many factors were indicated as contributing to bullying, the low–self-esteem and personality factors of the bully were mentioned as the main factors, followed by inadequate training for the managers. If managers are serious about combating bullying in their workplaces they need to be in touch with what their employees go through when they execute their daily duties and they need to devise some means of ensuring that the grievance procedure is adequate and that it caters for bullying problems.

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No description available.

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<p> When the HITECH Act of 2009 set mandates for the transition from paper to electronic health records (EHRs), few realized the far-reaching impact this technological change would have on the entire healthcare environment. This dissertation examines the many facets of this adoption process by exploring perceptions, responses, and reactions of physicians and patients alike as they navigate through this transformative &ldquo;medicological environment.&rdquo; Characterized by influences from legal, political, governmental, medical, social, geographical, economic, and technological factors, this multi-faceted space reveals how a new medium for communication&mdash;the electronic message within secured health portals&mdash;transforms the way in which healthcare is managed and utilized today. </p><p> Multiple methods of observation, including oral histories, surveys, critical incident reports, and content analyses of data mined messages, together reveal the many challenges faced by patients and healthcare professionals alike as they attempt to adapt to this change while still maintaining (or improving upon) primary healthcare needs. As demonstrated by the varied responses from those living in rural and urban areas, it was found that each population approached the transition process from different vantage points. The early-adopting, urban physicians provided patient online communication simply because they felt patients expected it while rural physicians tended to resist the process, arguing that patients were media illiterate, lacked Internet access, and preferred face-to-face interactions. Others cited implementation costs and personnel training issues as a deterring factor. This provides insight into how such a new medium can affect user perceptions about online healthcare, including physician availability, online relationship factors, and overall patient care. Future research suggestions include expanded content analyses of the electronic messages themselves and follow-up, longitudinal research once implementation is more widespread. </p><p> As the Institute of Medicine (2008) states, all patients have the right to varied means of communicating with their physicians, including but not limited to online interactions. Evidence of a paradigmatic shift exists in physician training as well as patient expectations. The influence of online communication within secured health portals certainly has contributed towards this shift as more personalized, patient-centered care becomes a vital part of this ever-changing medicological environment.</p>

<p> This grounded theory study describes how Nurse Practitioners (NPs) provided care to Aboriginal people in British Columbia and proposed a theoretical foundation to guide NPs interactions with Aboriginal people in providing healthcare. This study first explored NPs work with Aboriginal people. Through analysis of interview responses, insight was gained into how NPs provide care to Aboriginal people. Fourteen NPs who worked with Aboriginal people in British Columbia for at least one year during the past five years were interviewed. After each interview data were manually coded for concepts and categories from which to build theory. Memos were written for further clarity and participants were asked to verify whether or not identified concepts and categories worked, fit, and were relevant and modifiable as new data arose. The theory, Engaging Mutually, identified core categories of Initializing Engagement, Sympathetic Mutuality, and Therapeutic Enlightenment as being connected and working together to help provide effective health care. Engaging Mutually was identified as relevant to the theories of oppression, motivational expectancy, social justice, social cognitive, cultural competency, and Watson&rsquo;s caring theory. The significance of this study was to assist NPs to gain a better understanding of how to work with Aboriginal people to improve their health. This study contributes to research, theory, leadership, and nursing and NP practice. Engaging Mutually may assist NPs and other health care providers to develop appropriate health care practices when working with Aboriginal people and potentially with people from other cultures.</p>

<p> This business plan proposes a neurofeedback therapy clinic to treat children diagnosed with Attention-deficit/hyperactivity disorder (ADHD) and are in search of a non-pharmaceutical intervention. ADHD is the most commonly diagnosed disorder among children between the ages 4-18. By stimulating arousal in the frontal portion of the brain through neurofeedback therapy, the symptoms of ADHD can be regulated. This proposal includes a market analysis, a feasibility and SWOT analysis, a review of legal and regulatory issues, and finally, a financial analysis.</p>

<p> YouWin: Young Women&rsquo;s Mind and Body Therapy (YWMBT) is a not-for-profit case management company with the mission coordinating multi-faceted, evidence-based therapy to heal the bodies and minds of adolescent women, in order to facilitate their healthy development into tomorrow&rsquo;s women. The company&rsquo;s top three goals are to lessen the burden of obesity and depression in the local community, help individuals meet their own weight loss and recovery goals, and establish the YWMBT treatment model as the standard of treatment for comorbid obesity and depression in young women. </p><p> This business plan will present the scope of the issue to be addressed, an analysis of the target market and a relevant market strategy, an analysis of the strengths, weaknesses, opportunities and threats to YWMBT, an overview of some of the legal and regulatory concerns associated with establishing and operating the business, and finally a review of the financial viability. </p>

A Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine. / Objective: Mental health plays a central role in the well‐being of individuals. Understanding the factors that influence mental wellness is critical in order to develop effective policy that addresses the burden of mental illness in society. The objective of this study is to identify a possible relationship between healthcare access and the presence of mental distress in individuals. Methods: Logistic regression was performed using cross sectional data from a CDC developed nationwide behavioral health surveillance program (BRFSS, 2013‐4). Odds ratios were estimated using frequent mental distress as the outcome of interest while adjusting for confounding variables such as smoking, binge drinking, obesity, etc. Six models were estimated utilizing our hypothesized variables of interest. Results: The calculated adjusted odds ratios (AOR) and confidence intervals (CI) demonstrated a positive correlation between certain variables measuring access to healthcare and the reporting of frequent mental distress, agreeing with the hypothesis. Those variables were financial cost preventing access to medical care (AOR [2], CI [1.9‐2.1]) as well as a span of more than 2 years having elapsed since a routine medical checkup by a healthcare provider (AOR [1.1], CI [1.1‐ 1.2]). The opposite effect was demonstrated in individuals who had no insurance coverage (AOR [.8], CI [.7‐.9]), which was contrary to the hypothesis. Conclusion: After adjusting for confounding variables, a strong relationship exists between individuals who are not able to see a physician due to cost, and the presence of frequent mental distress. Frequent mental distress is also increased in individuals who have not had a routine medical checkup with a physician in the last 2 years.

<p>ABSTRACT Electronic medical record (EMR) use has improved significantly in health care organizations. However, many barriers and factors influence the success of EMR implementation and adoption. The purpose of the descriptive qualitative single-case study was to explore health care professionals? perceptions of the use of EMRs at a hospital division of a major medical center. The study findings highlighted the challenges in transitioning from paper records to EMR despite the many benefits and potential improvement in health care. A description of the 16 health care professionals? perceptions of EMR use emerged by adopting the unified theory of acceptance and use of technology (UTAUT) model and NVivo 10 computer software to aid with the analysis of semi-structured, recorded, and transcribed interviews. Themes emerging from the analysis were in five categories: (a) Experience of health care professionals with a subtheme of workflow, (b) Challenges in transition from paper to EMR, (c) Barriers to EMR acceptance, with a subtheme of privacy, confidentiality, and security, (d) Leadership support, and (d) Success of EMR. The findings of the case study may inform health care industry decision makers of additional social and behavioral factors needed for successful EMR strategic planning, implementation, and maintenance.