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Ces 15 dernières années, la recherche sur l'empathie clinique dans le contexte de la médecine somatique s'est développée de manière significative. Cette empathie clinique est donc de mieux en mieux cernée : élaboration de différentes modélisations et identification de ses bénéfices. Aujourd'hui, il reste certains challenges à relever, et notamment celui d'améliorer et de préserver l'empathie clinique au fil de la formation et de la pratique médicales tout en protégeant le bien-être des médecins. Ce travail de thèse a pour objectif de définir l'empathie clinique dans le cadre des maladies chroniques graves : son processus, ses déterminants, ses conséquences et les ressources nécessaires. Ce travail propose trois études successives portant sur des patients (N=15) et des médecins hospitaliers (N=235) selon un design mixte, recueils de données quantitatifs et qualitatifs associés à des analyses de données quantitatives. Ces études cherchent à définir l'empathie, identifier et tester ses antécédents et conséquences, en explorant les vécus des médecins et des patients. Par ailleurs, une quatrième étude longitudinale dite pilote a été mise en place. Les résultats ont mis en évidence la spécificité de l'empathie à une clinique spécifique, ont souligné sa nature majoritairement cognitive et comportementale et son rôle primordial dans la clinique et le bien-être des patients et des médecins. Ce travail propose ainsi une définition empirique qui concilie et enrichit les précédentes tout en développant la connaissance des déterminants de cette compétence clinique dans le cas spécifique des maladies chroniques graves. L'empathie clinique résulte de nombreux éléments tant individuels que situationnels ou encore interindividuels. Alors le développement de l'empathie des médecins auprès des personnes atteintes de maladies chroniques graves ne peut être considéré sans développer des recommandations à destination des institutions, des programmes de formation, et des dispositifs de soutien individuel et collectif. / Over the last 15 years, research on clinical empathy in somatic medicine has increased significantly. This clinical empathy is therefore becoming better understood, which shows by the appearance of various models and benefits on patients and physicians. Today, the challenge is to improve and to maintain clinical empathy through medical training and practice while protecting the well-being of physicians. This thesis' aim is to define clinical empathy in the context of serious chronic diseases: its process, its determinants, its consequences and the resources it needs. This work proposes three sequential studies involving patients (N = 15) and hospital doctors (N = 233). The design is mixed between qualitative and quantitative data and methods. These studies seek to define empathy, identify and test its antecedents and its consequences, exploring both the experiences of physicians and patients. Furthermore, a fourth study, a pilot one, has been conducted. Empathy appears as specific to a clinic. The results emphasize its cognitive and behavioral facets. Clinical empathy has a key role in patients' care and wellbeing but also in physicians' wellbeing. This work proposes an empirical definition that reconciles and enriches the preceding ones. It gives the opportunity to develop knowledge of empathy's determinants in the specific case of serious chronic diseases. Clinical empathy is the result of many individual, situational and inter-individual elements. Therefore, the development of doctors' empathy with patients with severe chronic diseases cannot be considered without developing recommendations to institutions, training programs, and individual and collective supports.

Bakgrund: Ökade rörligheten i samhället, snabb teknisk och industriell utveckling, ökat våld och terrorhot till följd av samhällsutvecklingen tyder på ökning av sjukvård. Mortalitet samt morbiditet orsakade av trauma kan reduceras med snabbt och effektivt insatta åtgärder.  Syfte: Syftet med denna studie var att studera specialistsjuksköterskors upplevelser av nyckelfaktorer till patientsäker omvårdnad vid traumalarm nivå 1.  Deltagare och datainsamling: Åtta specialistsjuksköterskor med intensivvård- eller anestesiutbildning intervjuades med semistrukturerade intervjuer.  Metod: Kritiskt incident teknik med kvalitativ ansats användes vid analys under studien vilket resulterade i 7 kategorier.  Resultat: Resultatet av studien visar bland annat vikten av att känna sig förberedd, både genom utbildning samt träning inom teamet men även att känna till de lokaler och den utrustning som används i traumarummet. Stor vikt läggs även på att få möjlighet att reflektera och följa upp traumalarm som varit, för teamsamverkan, större förståelse mellan klinikerna, känslomässig avlastning men även för patientsäkerheten under framtida traumalarm.  Slutsats: Studien visar på svårigheter som uppkommer vid omhändertagande av patienter som drabbats av trauma men även de nyckelfaktorer som specialistsjuksköterskorna menar kan förbättra och effektivisera vården för patienterna. / Background: Increased mobility in society, rapid technical and industrial development, increased violence and terrorist threats as a result of societal developments indicate an increase in healthcare. Mortality and morbidity caused by trauma can be reduced with quick and effective measures.  Aim: The aim of this study was to study specialist nurses' experiences of key factors for patient-safe nursing at level 1 trauma alarm. Participants and data collection: Eight specialist nurses with intensive- or anesthesia care were interviewed with semi-structured interviews. Method: Critical incident technique with qualitative approach was used in analysis during the study which resulted in 7 categories. Results: The results of the study show, among other things, the importance of feeling prepared, both through education and training within the team, but also to know the premises and the equipment used in the trauma room. Great emphasis is also placed on having the opportunity to reflect and follow up on trauma alarms that have been, for team collaboration, greater understanding between the clinics, emotional relief but also for patient safety during future trauma alarms. Conclusion: The study shows difficulties that arise in the care of patients affected by trauma, but also the key factors that the specialist nurses believe can improve and streamline care for patients.

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Bakgrund: Att jobba i den stressfulla och komplexa miljö som tillhör intensiv- och akutsjukvårdens vardag har visat sig medföra större risker för att utveckla arbetsrelaterad stress och negativa känslomässiga reaktioner. En sjuksköterskas förmåga att hantera sina egna känslor påverkar direkt omvårdnaden och relationen till patienter och deras familjer. För att bibehålla en god psykisk hälsa och välbefinnande är det viktigt för sjuksköterskor att utveckla och använda effektiva strategier för att hantera negativa känslomässiga reaktioner efter svåra patientmöten på intensivvårdsavdelningar. Syfte: Syftet var att beskriva specialistsjuksköterskors strategier för att hantera negativa känslomässiga reaktioner efter svåra patientmöten på intensivvårdsavdelningar. Metod: Designen för arbetet gjordes som en kvalitativ studie med induktiv ansats. Sjutton specialistsjuksköterskor inom intensivvård och anestesi intervjuades med individuella semistrukturerade intervjuer. Metoden för att analysera data var kritisk incidentteknik. Resultat: Analysen av data resulterade i fem slutkategorier. Specialistsjuksköterkors strategier för att hantera negativa känslomässiga reaktioner innefattade; Att prata om händelsen med andra, Att ta stöd i varandra och hjälpas åt, Att tillåta sig att visa känslor och känna med patienten, Att strukturera upp arbetet, fokusera på vad som ska göras och lita på sin kompetens samt, Att utöva egenvård och ta hand om sig själv Slutsats: Att hantera negativa känslomässiga reaktioner efter svåra patientmöten på intensivvårdsavdelningar har visat att det är avgörande för att upprätthålla en hög nivå av arbetsprestation och professionalism. Studien ger en djupare förståelse för hur olika strategier kan användas för att sjuksköterskan ska behålla en god hälsa och kunna ge en god omvårdnad. En nyckelfaktor var att prata om händelsen och en önskan om större stöd och uppmärksamhet inom ämnet från både verksamheten och sjuksköterskeutbildningens håll.

The aim of this research was to develop a competency model for auditors by identifying those characteristics and behaviours that predict success as an auditor. The Work Profiling System (WPS), the Repertory Grid Technique (RGT) and the Critical Incident Technique (CIT) were the tools and techniques used to achieve this aim. This research was conducted in two groups: trainee accountants (year 1- 3) and chartered accountants (year 4-5+). The results of the research, which was conducted within one of the Big 5 auditing firms, indicated that the competencies required of a trainee accountant are largely consistent with those of registered chartered accountants, working in the same environment. The most noticeable difference was the change in focus from cognitive or technical skills during the earty years to a focus on managerial competencies in later years. The competencies identified in this research compare well with reported models in literature. / Industrial and Organisational Psychology / M.A. (Industrial Psychology)

在各個不同的產業裡，皆有研究提出構成企業「成功」和使其具有競爭力應擁有的關鍵因素。本研究以訪談資深非營利組織領導人來歸類整理出何謂「成功」的非營利組織及其發展的關鍵成功因素，以提供給向來資源有限的非營利組織在發展過程中作為檢視，以將資源優先投入這些關鍵的領域來減少無謂的摸索和失敗的可能。 為達研究目的，選擇持續運作超過十年的婦女團體，運用深度訪談法與關鍵事件分析法（Critical Incident Technique ,CIT），依五個受訪者所提其組織發展關鍵成功因素及對彼此組織發展關鍵成功因素，以「非營利組織的使命」;「非營利組織的參與者」；「非營利組織的運作」這三個構面將訪談內容歸類整理出非營利組織發展的「關鍵成功因素」如下： *非營利組織的使命：有清楚的宗旨（使命） *非營利組織的參與者： 1.參與者的特質：主動積極、對組織使命認同、有理想性格、熱忱、具行動力 2.組織的領導者：一路堅持的靈魂人物、願意不斷成長且洞見觀瞻的領導者 3.互補又分工的合作團隊 *非營利組織的運作： 1.組織文化：平等開放、學習型組織、活力型組織 2.把訴求清楚表達的能力 3.建立公信力及獲得社會認同 4.把人當做最大的資產，對參與者採「增權」方式 5.不斷檢視社會環境變遷，依社會需要調整服務或回應需求產生新服務 6.創新的靈活策略且能結合各方資源發揮影響力 一個非營利組織從成立到成為一個「成功」的非營利組織，最關鍵的因素為組織能否部份或階段性達成當初設定的使命，所以建議領導者要不斷檢視組織的使命是否有貫徹；要不斷反省與自我提升；同時要隨時注意時事以掌握社會需求脈動。非營利組織需掌握社會各種媒介的情報，促使成員相互激盪，培養出組織的共識與新行動；重視團隊合作；連結不同組織的資源網絡及凝聚共識的過程需平等公開，不採取一言堂的方式，「增權」組織成員潛能以使其盡情發揮，使組織維持最大動能。 / Research shows that there are key factors contributing to “success” that are common across industries. This study investigated the key to success of Non-Profit Organizations (NPO) and their developments through in-depth interviews with NPO leaders. These findings can serve as developmental key learnings for other, resource-limited NPO’s, allowing them to more effectively harness available resources, thus reducing wastage due to trial and error. This research paper endeavors to organize these Critical Success Factors into easily accessible best-of-practice case studies for up-and-coming NPO’s. For the purposes of this study, the author selected five Non-Profit Women’s Associations with a least ten years of successful operations. Research methodology was depth interviews combined with Critical Incident Technique (CIT). Three main constructs were used in this process including: The mission of NPOs, NPO participants and NPO operations. This study identifies and organizes “Critical Success Factors” that all successful Non-Profit Organizations should own. The Critical Success Factors of A Successful NPO Are: 1.Well defined missions. 2.Strong Personnel/Membership Structure: a.Members of the organization will have: i.self-motivated; identification to organization missions ii.A high degree of enthusiasm iii.The ability to execute the organization directives b.A successful NPO will have Leadership with the following characteristics/skill sets: i.The spiritual leader of an NPO with an unchanging sense of mission, a strong and insight. ii.The ability to continually learn and apply those learnings to the organization. iii.A mutually supporting team that divides work up equally. 3.Strong Operations: a.Organization culture: Equal, open, focused on learning and vigorous. b.Externally it will be able to: i.Clearly articulate organizational goals and objectives ii.Create sufficient exposure to create positive awareness and opinion within society c.Internally it will be able to: i.Create “esprit-de-corps” within organization ii.Empower stake-holders to leverage their strengths d.Continual review of social changes and the adjustment of old services or the introduction of new services to meet social needs. e.Creative and flexible strategies and the ability to integrate various resources to exert influence. A successful NPO needs to accomplish the initial Mission. In order to achieve this, it is recommended that the NPO leadership continually review whether or not the organization is achieving the objectives for which it was established and conduct self-evaluation and self-improvement. The NPO also needs to be in tune with developments and trends in the society it is operating in. By making the information gleaned open and available to all members of the organization, the leadership can empower its members and contribute to a common sense of purpose, helping it achieve the maximum efficiencies and success.

This qualitative study views international students as information-using learners, through an information literacy lens. Focusing on the experiences of 25 international students at two Australian universities, the study investigates how international students use online information resources to learn, and identifies associated information literacy learning needs. An expanded critical incident approach provided the methodological framework for the study. Building on critical incident technique, this approach integrated a variety of concepts and research strategies. The investigation centred on real-life critical incidents experienced by the international students whilst using online resources for assignment purposes. Data collection involved semi-structured interviews and an observed online resource-using task. Inductive data analysis and interpretation enabled the creation of a multifaceted word picture of international students using online resources and a set of critical findings about their information literacy learning needs. The study’s key findings reveal: • the complexity of the international students’ experience of using online information resources to learn, which involves an interplay of their interactions with online resources, their affective and reflective responses to using them, and the cultural and linguistic dimensions of their information use. • the array of strengths as well as challenges that the international students experience in their information use and learning. • an apparent information literacy imbalance between the international students’ more developed information skills and less developed critical and strategic approaches to using information • the need for enhanced information literacy education that responds to international students’ identified information literacy needs. Responding to the findings, the study proposes an inclusive informed learning approach to support reflective information use and inclusive information literacy learning in culturally diverse higher education environments.