The healthcare strike action that rocked South Africa in 2007 and 2010 highlighted the trend of professional nurses towards exercising their rights as employees to embark on strike actions, often also in solidarity with other categories of employees. This study aimed to highlight the problem brought about by the lack of proactive strategies to maintain a balance between human and professional rights and responsibilities of nurses within the legal framework of South Africa. The theoretical grounding of the study included both organisational change models and transformational leadership models. A descriptive and analytic design was followed, using both qualitative and quantitative non-probability sampling approaches to meet the research objectives of determining factors for nurses‘ involvement in strikes and their impact. Eighty professional nurses were included as the total sample of the study with 53 that did not participate in strike action and 27 that participated in strike action. A sample of eleven nurse managers was also included in the study to determine their views on strikes by nurses and their understanding of the changing work environment. To determine the overall impact of the nurses‘ strike, 40 healthcare consumers were included. The sample was selected from four provinces: Eastern Cape, KwaZulu-Natal; Western Cape and Gauteng. The study was limited to professional nurses, nurse managers within the public-health sector and healthcare consumers using public-health facilities. The findings and the relevant literature referred to in this study indicate that though there are different reasons for strike action in the public-health sector by area or by country, remuneration is undoubtedly the most mentioned reason. Important to note is that salary per se is not the most critical actor but it is a tangible measure of the value that the employer places on people. In the absence of other incentives in the nursing environment, it becomes the focal point. However, addressing salary issues alone will not prevent strike action in the public-health sector / Health Studies / D. Litt. et Phil. (Health Studies)

In the study, I explored how to achieve sustained road-traffic accidents reduction in Zimbabwe. Road traffic accidents are indiscriminant and each year hundreds of people lose their lives in road traffic accidents in Zimbabwe. A mixed methods research approach was used to conduct the study. The study was therefore done in two phases. Phase 1 was a quantitative survey using questionnaires, and phase 2 was a qualitative case study using semi-structured interviews. A sample of 500 road-users drawn at random from internet databases formed the respondents for the quantitative phase of the inquiry. A further 20 snowball selected participants, formed the qualitative inquiry group. The key findings from the study were that effective intervention planning, timely measurement, adequate resourcing, and inclusive organization development interventions were the key drivers of successful road safety programmes. Additionally, critical interventions for sustainable road traffic safety in Zimbabwe included; community consultation and involvement in road traffic safety strategy formulation and implementation, mainstreaming road traffic safety education in the schools’ curricula, behavioral changes, financial, and engineering interventions. / Business Management / M. Com. (Business Management)

The intention of this study was theory creation in the field of organisational change, directed towards the creation of a conceptual change framework. A qualitative research approach was followed and a grounded theory methodology adopted. This study involved a theoretical investigation of organisational change and leadership within South African organisations, although insights gained could be transferred across contexts or settings. The primary aim was to create a practical change framework to ensure sustainable organisational change. Secondly, to determine the impact of leadership on successful organisational change. Thirdly, to establish whether any fundamental elements can be identified as essential for inclusion in such a change framework. Fourthly, to identify non-negotiable success factors that can ensure successful change. Fifthly, to determine the human elements that should be included in order to minimise negative outcomes such as resistance and noncompliance. The final aim was to ascertain what meta-insights can be gained from organisational change and leadership. The research findings concluded that the first perception when speaking about change is fear, anxiety and increased stress, resulting in impaired functioning. Organisations struggle to handle increased stress levels during periods of change and require improved methods of dealing with stress to ensure optimal individual functioning. Only through reduced stress levels will individuals be able to engage with organisational change initiatives. Alternative intervention technologies were suggested which could assist the individual change journey through reduced stress and/or increased consciousness. These alternative intervention technologies were suggested because of the paucity of current literature. It practically aids organisations on how to deal with the stress dilemma. This research introduced the concepts of anti-leader and anti-manager. These concepts depict the negative characteristics of leadership and management which invariably increases individual stress levels. Emotions elicited by the anti-leader and/or anti-manager could potentially split, divide and fragment a workforce. The ideal organisational approach should be designed by the people, be inclusive of all, involve, empower and allow individuals to make the required decisions. As organisational change can only be effected through individual change, this thesis places the individual in the centre. Without individual change, vicissitude and sustainable organisational change become highly unlikely. / Business Management / DBL

Thesis (MMil)--University of Stellenbosch, 2007. / ENGLISH ABSTRACT: The initial conceptual framework for transformation proposes the context (why), the content (what), and the process (how) as three dimensions of transformation that are always present. A distinction is made between external and internal triggers of transformation, and information is provided on the challenges posed by, among others, the knowledge society, globalisation, and changing market conditions that require companies to become learning organisations staffed by empowered knowledge workers. Literature study on transformation clearly shows that transformation brings about change. There are different models on transformation and this shows that there are different approaches to transformation. Ubuntu should be introduced as a way forward for the South African Military Academy (SAMA) to deal with transformation issues. Ubuntu is more concern about the wellbeing of the people and their morale during and after transformation has been implemented. Subsequently, a conceptual model for transformation is proposed in which generic elements of the “why”, “what”, and “how” dimensions are included. The SAMA model is developed to fit the scope of a conceptual model, and to be in line with what is generally proposed in the literature for organisations that want to transform in order to become market leaders and enhance long-term goals. Conclusions drawn from the ongoing SAMA transformation process are that its aims and principles are not in line with what appears to be required in creating an innovative learning organisation. With regard to the “how” of transformation, it is found that improvement is still needed to the processes to change attitudes, mindsets, and styles on the part of managers as well as employees that might inhibit empowerment and stifle creativity and innovation. / AFRIKAANSE OPSOMMING: Die aanvanklike konseptuele raamwerk vir transformasie stel die konteks (waarom), die inhoud (wat) en die proses (hoe) voor as drie dimensies van transformasie wat altyd teenwoordig is. Daar word ‘n onderskeid getref tussen eksterne en interne aanleidende oorsake van transformasie, en inligting word voorsien oor die uitdagings wat voortspruit uit, onder andere, die kennissamelewing, globalisering, en veranderende marktoestande wat vereis dat maatskappye leerorganisasies word met ‘n personeel van bemagtigde kenniswerkers. Uit ‘n literatuurstudie oor transformasie is dit duidelik dat transformasie verandering teweegbring. Daar is verskillende modelle van transformasie en dit toon dat daar uiteenlopende benaderings tot transformasie bestaan. Ubuntu moet ingestel word as ‘n manier waarop die Suid-Afrikaanse Militêre Akademie (SAMA) voortaan transformasie kan hanteer. Ubuntu is meer besorg oor die welstand van die mense en hulle moreel terwyl en nadat transformasie geïmplementeer is. Daar word dus ‘n transformasiemodel voorgestel waarin generiese elemente van die “waarom”-, “wat”- en “hoe”-dimensie ingesluit word. Die SAMA-model word ontwikkel om dieselfde omvang te hê as ‘n konseptuele model, en om ooreen te stem met wat algemeen in die literatuur voorgestel word vir organisasies wat wil transformeer om sodoende markleiers te word en langtermyndoelwitte te bevorder. Gevolgtrekkings wat voortspruit uit die voortgesette SAMA-transformasieproses is dat die doelwitte en beginsels nie ooreenstem met wat skynbaar vereis word om ‘n vernuwende leerorganisasie te skep nie. Ten opsigte van die “hoe” van transformasie, word bevind dat verbetering nodig is voor die prosesse verandering gaan meebring aan houdings, ingesteldhede en styl, by bestuurders sowel as werknemers, wat tans nog bemagtiging beperk en kreatiwiteit en vernuwing onderdruk.

企業大型商用套裝軟體(企業系統)的導入迫使系統使用者在許多方面必須進行改變，包含了工作的內容、人際間的關係、決策的過程以及工作的現狀。變革管理在企業系統建置能否成功的議題上扮演了非常關鍵性的角色。全面性地瞭解不同型態的使用者為什麼會抗拒企業系統建置的原因將有益於管理策略的執行並且產生更加符合期望的建置成果。本研究應用Delphi方法，針對十二位專案管理人進行深入的訪談，從他們的背後代表的上百個專案的經驗中，發現主管階層的使用者和基層操作階層的使用者對企業系統的抗拒原因不同，所需使用的管理策略亦不相同。管理階級的使用者本身抗拒系統最主要的原因為相信自己決策的能力比電腦來得強，同時對於系統能帶來的效益較持懷疑的態度。他們最常表現出來的抗拒行為是在會議當中和高階主管或是顧問們顯現負面的感覺或是抱怨。主管階層的使用者需要的是參與式的管理策略，給予協助並且確認他們對整個系統所能帶來的效益有所瞭解。而對於基層操作階層的使用者來說，因為導入系統所帶來的工作量增加、受到監視的感覺增加以及對於系統的不熟悉、認知不足，是他們抗拒企業系統的主要原因。這些使用者傾向於將錯誤推諉給其他員工以及直接抱怨系統的不易使用。本研究建議針對基層操作員工進行整體流程的訓練、加上適當的獎勵制度以及由他們的直屬主管來和他們進行更明確的溝通，協助他們解決問題。 / Enterprise systems (ES) impose changes on users in many areas: job content, interpersonal relationships, decision-making approaches, and work status. Change management is critical to successful ES implementation. A complete understanding of reasons and behaviors of different types of user resistance can lead to better management strategies and desired outcomes. Applying Delphi techniques with in-depth interviews with 12 project managers of more than one hundred ES projects, the study found that managerial and operational users resist enterprise systems in different ways and require different management strategies. Managerial users resisted using enterprise systems mainly due to confidence in their own way of making decisions and low perceived value of the system. They tended to express their doubts and negative feelings in meetings with top managers and consultants, and required more participative strategies to clarify their understanding of ES benefits. Resistance from operational users came mainly from excessive workloads, increased monitoring, and insufficient knowledge of ES. These users tended to blame others for errors as well as complaining the difficulties of using the system. It is suggested that users receive process training with proper rewards and clear communication from direct managers.

對台灣的企業而言，全球貿易從來不是新鮮的事。台灣企業早已面對全球市場、參與全球競爭。但是在這些行業中的台商能否稱為全球化的公司或是具有全球化組織架構的跨國公司呢？這恐怕是有爭議的。對許多西方多國公司而言，它們的業務範圍早已分佈於世界各地。他們所思考的是如何強化現有的組織架構、善用全球搜尋能力，進而擴大規模經濟效益、增強全球競爭能力使企業轉型為全球化的組織。這個議題是從20世紀末期一直到今天都不曾停止的。 多國公司所關注的問題已經不再是如何由本土市場進軍國際市場，或是如何面對國際競爭的問題。它們關注的問題是如何在全球據點對價值鏈中的各項價值活動做合理的配置，使得企業的效益能夠充分發揮，同時藉著部門間的協調和整合來提升組織的效率和效能而成為真正全球化的企業組織，進而掌握全球市場。 在這些多國公司全球化的過程中，不但要整合所有的價值活動，更要適當的配置這些價值活動，將它們佈置在最適合的地點，以發揮全球組織架構的優勢。而這個全球組織架構的建立與運作不但是前所未見的企業行為，更是多國公司全球化的創舉。因此，吾人希望藉著其中某大石化公司全球化的過程與經驗，了解他們是如何進行全球化的組織轉型，找出其中的關鍵成功因素及達成全球化組織轉型的作法，以供國內企業之借鏡與參考。同時吾人亦將以整合─回應架構理論針對價值鏈中國際行銷管理因公司組織全球化而做的改變加以探討。此外，亦希望藉此案例瞭解多國公司除了改造作業流程、進行組織轉型、以降低成本及提高組織效率之外，也盼望能了解多國公司如何進行全球組織的知識管理來累積經驗曲線,增進創新能力。 吾人希望藉此研究了解： <1>多國公司是如何由區域型組織(以亞洲為例)轉型為全球化的組織？ <2>多國公司(MNCs)在轉型為全球化組織時，國際行銷之“整合-回應”架構的差異為何？ 本研究共計分為五章，第一章敘述研究背景與動機、研究問題與目的和研究流程；第二章則探討多國公司之改革與發展、多國公司之策略與類型、 多國公司整合─回應架構之應用和多國公司子公司之策略性角色；第三章提出初步研究架構、個案研究法和研究限制。第四章為個案背景與分析、第一節將先描述個案所面臨的全球環境、然後針對個案A1事業部所處的產業環境和顧客加以分析、並運用Porter五力分析了解A1事業部的產業競爭優勢。第二節將探討全球策略下的組織轉型及全球化的組織架構。接著在第三節詳述如何由國際區域型組織轉型為全球化組織，並以個案的全球化專案小組為例，說明如何成立專案小組、選擇成員、建立新的資訊平台與作業系統、和相關部門溝通到系統建構完成與測試計劃的擬定。第四節則以A1事業部為例，比較原有的組織架構和全球化組織架構的差異，同時將論及全球化企業中最重要組織控管原則，然後聚焦於國際行銷管理的4P、新產品開發及知識管理，最後希望能歸納出多國公司全球化的主要步驟和關鍵成功因素。第五章為結論與建議。 由本個案可歸納出，多國公司由區域型組織轉型為全球化的組織時，其主要作法如下： 1. 由全球最高管理階層召集高階主管組成全球組織轉型專案小組 2. 根據企業所處全球競爭環境擬訂全球策略並設計全球組織架構 3. 依據全球策略及組織架構擬訂作業流程並選擇全球資訊平台與作業系統 4. 由全球最高管理階層發佈並說明企業面對之環境及公司未來目標和願景 5. 選擇適當人員組成區域專案小組，負責推動組織轉型 6. 訓練區域專案小組成員熟習全球資訊平台與作業系統，並依照此系統設計業務準則 7. 建構全球資訊平台與作業系統、進行數據轉換 8. 全球資訊平台與作業系統之测試與評估 9. 定期向全公司溝通“全球化”之進度 10. 定義全球企業組織之職務及權責(Role & Responsibilities) 11. 進行組織轉型、人事調整，區域型組織轉型為全球化組織 12. 發佈全球化組織的業務準則及作業流程 13. 定期追蹤組織績效，蒐集客戶和基層人員反映，以供修正業務準則及作業流程參考 同時吾人亦可由本個案的知多國公司(MNCs)達成全球化的關鍵成功因素為： 1. 企業最高級主管的願景(Vision)及意志力； 2. 足夠的財力以建立、維護並更新全球作業系統； 3. 具跨文化管理經驗及能力的管理團隊； 4. 良好的業務準則及管理系統； 5. 遵守業務準則的企業文化； 6. 全球一致的企業語言及價值觀； 7. 跨業務單位的協調機制； 8. 定期反饋市場情況的能力； 9. 與時俱進的國際人力資源管理制度。 以本個案而言，全球化組織架構可以幫助提升多國公司的知識管理能力，但是卻對企業創新能力的助益不大，甚至因為全球作業系統的標準化、流程的簡單化、決策的極權化以至於對地區客戶的反應能力降低進而導致創新能力的減弱。然而，一旦全球企業觀察到世界各地市場對產品的共同需求並且決定投入資源去掌握此機會時，則其所發揮的能力和速度將會遠勝過區域型的多國公司。同時因為具有全球資源、網絡和市場，使得全球企業能夠有足夠的經濟規模從事較耗費資源的、革命性的產品創新工作。 另一方面，由於全球企業的資訊網路連結和跨區域的事業部組織架構，使得某地區的最佳典範能夠快速的轉移、複製到全球各地，領先競爭者、取得市場先機，更能夠因此快速的建立全球企業的經驗曲線。因此，以同一企業而言，全球化的知識管理能力將優於區域型組織。此知識管理能力可能較偏向於既有產品開發的成功經驗轉移而非新產品的創新，或是有關改進生產及組織管理效率的作法。 根據本個案的研究，吾人對台灣的企業建議如下： 1. 企業全球化之前必須了解各子公司所在地的法律以確保子公司及全球總公司所做的任何交易和投資都符合當地法律，避免誤蹈法網。同時對各地的法律的瞭解亦可保護公司資產、取得較佳稅率以增進獲利能力。 2. 全球化的第一個步驟就是企業管理的制度化、標準化、透明化和正式化。而企業控管能力的強化更是不可或缺的條件。台灣企業雖然已逐步邁向國際化但是除了少數大型企業以良好的制度管理公司以外，大部分的企業依舊有較大的改善空間。 3. 全球企業管理系統的建立可以提供全球子公司共同的作業平台和全球連結的管理系統，然而如何在此龐大的系統中注入適當的彈性以滿足地區市場和客戶的需求是組織全球化之前必須仔細考量的問題。 4. MEGA 公司對知識管理的重視和如何建立一個有效的全球知識管理系統足以作為台灣企業的借鏡。企業領導人必須重視知識管理並且全力推動。全球知識經驗的累積和分享將可協助企業成為學習型的組織。 5. 企業全球化需要及早儲備國際化的人才、培養多國公司語言〈英語〉,並加強書面溝通的能力。台灣企業在本身人才不足的情形下可考慮引進外國人才以加速國際化的腳步。 對後續研究的建議： 1. 本研究並未取得MEGA化學公司轉型前後之財務報告及進行全球化轉型所投入之經費，故無法以量化呈現研究結果。日後相關研究若能取得量化資料，將可從另一角度分析全球化的效益以供業界參考。 2. MEGA化學公司全球化之後，並未對跨全球事業部的業務進行探討，如何處理這些業務是全球化企業的另一挑戰，爾後應可針對此議題加以研究。 3. 支援性的價值活動(Support Activities)在全球化企業中扮演著非常重要的角色，幕僚單位(FunctionalGroups)如何在全球化組織中運作及發揮功能、其效能在組織轉型前後之比較是可研究的另一題目。 4. 本研究並未對組織全球化的缺點詳細探討，日後或可針對全球化的缺點及改善的對策深入研究。 5. 本研究以MEGA 公司的亞洲分公司為研究對象，歐、美分公司對組織全球化反應及變革管理的作法可能不同，此題目可為日後研究的方向之一。 / Globalization is a term widely used by almost all the enterprises in the world. It is also a challenge to most of companies and even individuals in the 21st century. How to transform from regional structure to global organization is a common challenge for all the multinational companies (MNCs) nowadays as they already have affiliates doing business in different part of the worlds and can access all kinds of resources easily. MNCs major concern is how to allocate their value activities in appropriate locations so that its maximum efficiency can be achieved, in the mean time its effectiveness can also be improved through delicate coordination and integration among the value activities. They are thinking how to strengthen existing organization through globalization, and capitalize their global accessibility to further expand scales of economy in order to become an organization with global competitiveness in the world market. This study is to understand how a MNC transformed from regional structure to global organization through observation of the real case of a major American petrochemical company. Hopefully it can help identify key success factors, provide major procedures and share the learning of global organization transformation to parties interested. Apart from the above mentioned, the study used the Integration- -Responsiveness Framework to evaluate the efficiency and effectiveness of the value activity of International Marketing and Sales before and after organization change. Knowledge Management in the two different organization structures is another subject will also be briefly discussed in this study. The study once again confirms that globalization will help company increase competitiveness and achieve better financial results in the short term, but it will also become less responsive to local customers and markets due to centralized decision making process, which may hurt long term growth opportunity for certain industries. However, for a petrochemical company, the drawbacks of globalization may not really affect them as they have stronger bargaining power in the world where natural resource is getting less every day. Another issue really concerns the company is the reduced communication among different business units , it becomes a silo for almost every business unit as people only care and focus on things really matter to them. How to improve and enhance communication among business units and assign workforce to manage things not belong to a single business unit is anther challenge to be tackled. Since the study focused mainly on the organization transformation in Asia, it would be good if people can do further study based on the observation in other regions, across the business units, or focus on the drawbacks of globalization.

Ce mémoire traite de l’intégration d’une offre de soins surspécialisés, la gérontopsychiatrie, au sein du système de soins aux personnes âgées souffrant de troubles mentaux du Québec. L’objectif général de cette étude consiste à faire une analyse en profondeur des facteurs favorisant l’émergence de la pratique surspécialisée de gérontopsychiatrie et son implantation, afin d’en déduire des recommandations pour son développement. Dans un premier temps, nous avons analysé les forces porteuses qui ont soutenu l’implantation de cette nouvelle pratique clinique il y a trente années, dans la région de l’Estrie. Ensuite, nous avons identifié la dynamique conjuguée des facteurs cliniques, organisationnels et symboliques ayant soutenu l’institutionnalisation de cette nouvelle pratique. De cette analyse, nous avons tiré des recommandations pour le développement d’une telle pratique dans le réseau local de santé de Drummondville, puis en région Mauricie-Centre-du-Québec. Ces recommandations prennent en compte les particularités de ce nouveau contexte d’implantation. Notre cueillette de données s’appuie sur des entretiens individuels et de groupe, des observations non participantes et l’analyse de documents. L’information est présentée sous la forme d’études de cas permettant de rendre vivants les apports d’auteurs ayant éclairé la dynamique d’intégration d’une nouvelle discipline (Abbott, 1995; Abbott, 2003; Mintzberg, 1985, 1998; Nonaka, 1994). Quatorze recommandations émergent de cette étude. Les quatre premières traitent de la définition de l’objet gérontopsychiatrie, ainsi que de sa diffusion dans les espaces professionnels et organisationnels. Les cinq suivantes portent sur la construction de la dynamique de soutien qui se résume ainsi : tisser des liens dans l’environnement clinique et organisationnel. Quatre recommandations cherchent à faciliter l’institutionnalisation de cette nouvelle pratique dans une dynamique organisationnelle. Il s’agit d’investir la fonction de « champion » (Mintzberg, 1998), à partir d’un noyau où le leadership est partagé, de solliciter des espaces de création et d’alignement des logiques cliniques et organisationnelles. Enfin, la dernière recommandation encourage le soutien du processus de reconnaissance de la gérontopsychiatrie dans la province de Québec. Cette étude permet de générer certains apprentissages. Le premier est de mettre en lumière que des modèles universels pour améliorer l’organisation des services n’existent pas. Seuls des repères contextualisés à travers une analyse en profondeur permettent d’identifier les forces porteuses de l’environnement. Ensuite, il est possible de les utiliser pour identifier les dynamiques cliniques, organisationnelles et symboliques en présence. La réponse sera ainsi toujours adaptée. Le second apprentissage est venu de la mise à l’épreuve de notre modèle conceptuel. Ceci nous a permis de comprendre que nous ne devions pas considérer les facteurs d’intégration symboliques, organisationnels et cliniques comme séparées, tel que présentés dans notre modèle théorique initial. C’est plutôt en utilisant une représentation d’imbrication en spirale, tel que proposé par Nonaka (1994) comme un système « hypertexte », que nous avons pu trouver les repères utiles à une conceptualisation globale de l’interférence des facteurs entre eux. Nous considérons donc que les recommandations formulées pour l’émergence et le développement de la gérontopsychiatrie à Drummondville pourront avoir une pertinence dans une autre région, à la condition expresse de reposer sur une analyse du contexte local et de son environnement. / This memoir discusses the integration of a subspecialized offer of care: geriatric psychiatry in the healthcare system for older people with mental disorders in Quebec. The general objective of this study is to do a in-depth analysis of factors favoring the emergence of subspecialized geriatric psychiatry practice and its implementation, to deduce recommendations for its development. First, we analyzed the supporting strengths enabling the establishment of this new clinical practice, thirty years ago, in the Eastern Townships. Next, we identified the combined dynamic of clinical, organizational and symbolic factors which supported the institutionalization of this new practice. Then, we have identified the combined dynamic of the clinic, organizational and symbolic factors having supported the institutionalization of this new practice. From this analysis, we have deducted recommendations for the development of this practice in the Drummondville local healthcare network, then in Mauricie-Centre-du-Québec. Our data gathering is based on individual and group meetings, non-participating observations, and the analysis of documents. The information is presented in the form of case studies, permitting to bring alive contributions from leading authors who enlightened the dynamic integration of this new discipline (Abbott, 1995, 1999; Mintzberg, 1985, 1998; Nonaka, 1994). Fourteen recommendations emerge from this study. The first four dealt with the definition of geriatric psychiatry entity as well as its dissemination in professional and organizational spaces. The next five dealt with the support of the dynamic construction which can be summarized by the following: building links within the clinical and organizational environment. Four recommendations aim to facilitate the institutionalization of this new practice in an organizational dynamic. It is a question of fully engaging oneself as a "champion" (Mintzberg, 1998), from a core where the leadership is shared, to request spaces for the creation and the alignment of the clinical and organizational logics. The final recommendation is to support the geriatric psychiatry recognition process in the province of Quebec. This study permits the generation of some learning. The first one is to highlight that universal models to improve organization do not exist. Only contextualized benchmarks, through an in-depth analysis, will allow us to identify and use promising environmental strengths. Afterwards, we will be able to use them for the identification of clinical, organizational and symbolic dynamics involved. The answer provided then will always be adapted. The second learning emerged from testing our conceptual model. This enabled us to realize that we could not use clinical, organizational and symbolic factors of integration in separate boxes, as presented in our initial theoretical model. It is rather in using a spiral nesting representation, such as the one proposed by Nonaka (1994), called an «hypertext» system, that we were able to find the needed benchmarks, within the global conceptualization of the interference of factors between them. We therefore consider that the results, expressed in the recommendations supporting the emergence and the development of geriatric psychiatry in Drummondville, may be of relevance in another region, with the express condition that the local and environmental contexts be analyzed.

6 Abstract This thesis aims to offer a comprehensive view of corporate communication while emphasizing its importance for everyday life of corporations and achievement of their strategic targets. The thesis introduces potential interpretations of corporate communication with the main focus on key moments of corporate communication as well as on consequences non-effective communication has on employee satisfaction and their life in the corporation. In the thesis I opted for the method of compilation and comparison of professional literature along with expert interviews which reveal the quality of internal communication in two selected corporations and prove one-sided view of communication inside corporations. The first part of the thesis provides a detailed look at characteristics of individual communication forms, knowledge of these characteristics being the cornerstone of further research in corporate communication. Besides, this part also describes the principles of active listening, a skill which is frequently omitted from the communication skill list. The second part deals with potential interpretations and divisions of corporate communication in professional literature and offers a thorough account of internal communication and its individual aspects. The following part looks at communication between...

Le changement n’est pas une chose qui peut être décidée mais plutôt quelque chose qui se fabrique. Selon un processus cadencé, de nombreuses études en gouvernance et en management stratégique placent les middle managers au cœur des analyses. Bien plus que des relais, ils conduisent le changement et contribuent à définir les compétences organisationnelles pour de meilleures performances. La conduite du changement peut être appréhendée au travers des études portant sur des aspects cognitifs ainsi qu’au travers de la Responsabilité Sociale de l’Entreprise (RSE) : celle-ci offre une occasion idéale aux middle managers de se rapprocher de la Direction Générale. Aborder ces thématiques implique un focus particulier sur le pouvoir des acteurs tout en considérant des notions de légitimité et d’urgence (Mitchell et al., 1997). Cette approche dynamique et cognitive permet de comprendre davantage les tensions partenariales quotidiennes et comment elles sont gérées. Dans ce travail, les middle managers figurent comme des instrumentalisateurs (ou manipulateurs), capables d’actionner des leviers relationnels (pouvoir, légitimité et urgence). La manière d’utiliser la politique de RSE dans leurs pratiques quotidiennes permet à ces managers d’évoluer dans le noyau stratégique organisationnel. A partir d’une étude exploratoire puis d’une étude de cas unique concernant MEDIAPOST (filiale du Groupe La Poste, spécialisée dans le courrier non-adressé), complétée par un focus partiel sur quatre grandes entreprises (Schneider Electric, Michelin, GDF Suez et Saint Gobain), ce travail étudie les systèmes de relations dans le cadre d’une transformation perpétuelle. Il propose une typologie de middle managers et un comportement type d’instrumentalisation de la RSE. Le modèle identifie différents profils : le pilote stratégique, le défendeur stratégique, le modérateur stratégique et le négociateur ou facilitateur stratégique selon trois degrés d’instrumentalisation (nulle, partielle et forte). / Change cannot be decided, it must be managed. Following a gradual process, many studies in corporate governance and strategic management give a key role to middle managers, since those actors do more than transferring organizational skills: they help to define them for better performances. This literature gets along with studies on Corporate Social Responsibility (CSR) and those related to cognitive aspects when it comes to corporate governance. In fact, CSR provides an ideal environment for middle managers to approach top management. Such question implies a particular focus on actors and their power at the same time that it considers the concepts of legitimacy and urgency (Mitchell et al. 1997).This approach allows understanding daily tensions and how they are managed through dynamic and cognitive aspects.In the present research, middle managers appear as manipulators who are able to activate relational levers (power, legitimacy and urgency). By studying how those actors guide the CSR policy in their daily practice, it is possible to understand how they progress within the core of organizational strategy. This work is based on an exploratory study and a single case study about MEDIAPOST (a subsidiary of La Poste Group specialized in non-addressed mail), which is complemented by a partial focus on four major companies (Schneider Electric, Michelin, GDF Suez and Saint Gobain). By doing so, this research examines the relations systems within a constantly changing model and proposes a typology of middle managers and their manipulation types: a strategic driver, a strategic defender, a strategic facilitator and a strategic negotiator (or facilitator) according to three degrees of manipulation (zero, partial and strong).

The healthcare strike action that rocked South Africa in 2007 and 2010 highlighted the trend of professional nurses towards exercising their rights as employees to embark on strike actions, often also in solidarity with other categories of employees. This study aimed to highlight the problem brought about by the lack of proactive strategies to maintain a balance between human and professional rights and responsibilities of nurses within the legal framework of South Africa. The theoretical grounding of the study included both organisational change models and transformational leadership models. A descriptive and analytic design was followed, using both qualitative and quantitative non-probability sampling approaches to meet the research objectives of determining factors for nurses‘ involvement in strikes and their impact. Eighty professional nurses were included as the total sample of the study with 53 that did not participate in strike action and 27 that participated in strike action. A sample of eleven nurse managers was also included in the study to determine their views on strikes by nurses and their understanding of the changing work environment. To determine the overall impact of the nurses‘ strike, 40 healthcare consumers were included. The sample was selected from four provinces: Eastern Cape, KwaZulu-Natal; Western Cape and Gauteng. The study was limited to professional nurses, nurse managers within the public-health sector and healthcare consumers using public-health facilities. The findings and the relevant literature referred to in this study indicate that though there are different reasons for strike action in the public-health sector by area or by country, remuneration is undoubtedly the most mentioned reason. Important to note is that salary per se is not the most critical actor but it is a tangible measure of the value that the employer places on people. In the absence of other incentives in the nursing environment, it becomes the focal point. However, addressing salary issues alone will not prevent strike action in the public-health sector / Health Studies / D. Litt. et Phil. (Health Studies)