A combined, multiple-methods action research strategy is constructed and used to assess teams of personnel working in and around group homes for mentally retarded adults and young offenders in the Canadian Province of Newfoundland and Labrador between August, 1983 and January, 1987. Grounded in the practise experiences and previous research of the author, the question "what works?" is developed both as a contextual framework for the examination of teamwork as a component of professional practise and as a contextual feature of group care. The question is used to guide categorization and organization of differences amongst 51 sample teams in order to isolate valid and reliable measures of team work functioning. Drawing from four distinct theoretical traditions comprising core knowledge of human behaviour in the social environment, multiple methodologies for differentiating within and amongst teams are combined to triangulate data around the central research question. A methodology for the collection and analysis of data which are thought to represent the "lived experiences" of sample subjects is developed and used to illuminate the phenomenological alignments of team members. Qualitative themes in the reports of on- and off-the-job satisfactions and frustrations for sample subjects are examined for teams and for occupational groupings. Separate measures of Level of Organizational Change and Prevalence of Stressful working Conditions are developed and used to examine the interplay between these variables and other preselected variables. The assessment procedures and the typology of team functioning developed by Fulcher (1983) are replicated. Specific flaws and limitations in Fulcher's methodology and design are overcome through the use of a different theoretical orientation, extensions and refinements of the methodology, changes in instrumentation and by replicating his findings with a more homogeneous sample. Four of the team styles of adaptation are empirically validated and their descriptions refined. Both linear and non-linear statistical analytic methods are used to test for correlation and association between and among preselected variables. The Heimler/Fulcher Work Orientation Schedule, which serves as the basis for Fulcher's interpretative categorization of teams, is subjected to tests of reliability and validity and found to meet predetermined expectations. Through the use of an international, comparative data base, norms for team satisfaction and ratio of frustration to satisfaction for this instrument are empirically validated. Further research using Fulcher's typology along with the Work Orientation Schedule is indicated. Field observation recordings, sample subjects' personal narratives, the social policy and corporate contexts in which the study takes place, and a mythical, yet ultimately necessary, experiment which takes place in the future are all used to illuminate and ground the findings in the action research process.

The purpose of this explanatory sequential mixed methods study was threefold. First, this study compared the effects of two different simulation-based instructional strategies on athletic trainers’ clinical competence in performing cardiovascular screening with cardiac auscultations. Second, this study identified the athletic trainers’ perceptions of learning through simulation-based instructional strategies. Third, this study attempted to identify and offer instructional recommendations based on the outcomes. The quantitative phase analyzed cognitive and diagnostic reasoning knowledge and history-taking and clinical skills specific to cardiovascular screenings with cardiac auscultations as it was taught to athletic trainers (ATs) at a continuing professional education (CPE) course. The quantitative results found that high-fidelity and low-fidelity simulation-based instructional strategies significantly increased cognitive and diagnostic reasoning knowledge and history-taking and clinical skill from pre-test to post-test assessment on all dependent variables. When comparing the two fidelity types to each other, the analysis found that the participants in the high-fidelity simulation group gained significantly more skill when compared to the low-fidelity group. In the qualitative analysis of this study, three themes emerged specific to the perceptions of the athletic trainers’ experiences as they learn through simulation-based instructional strategies. The first theme that emerged was a clear indication that participants’ exhibited positive perceptions of learning through simulation-based instructional strategies. The second theme that emerged was that the high-fidelity simulation experience during the pre-assessment and post-assessment raised an awareness of the deficit of knowledge and skills in performing a comprehensive cardiovascular screening with cardiac auscultations. Lastly, the third theme that emerged was specific to the perceived limitations in the effectiveness of low-fidelity simulation and the perceived strengths in the effectiveness of high-fidelity simulation. A few instructional recommendations emerged from this dissertation study. Simulation-based instructional strategies are an ideal teaching method to utilize during continuing professional education courses with athletic trainers. Specifically, this study identified that both, high-fidelity and low-fidelity simulation, are effective in teaching cardiovascular screening with cardiac auscultations. Additionally, the participants perceived influences of a pre-test on the identification of their knowledge and skills deficit suggests that there are benefits of utilizing an authentic simulation pre-test as part of CPE courses. / Includes bibliography. / Dissertation (Ph.D.)--Florida Atlantic University, 2016. / FAU Electronic Theses and Dissertations Collection

As the cost for health care delivery increases, so does the demand for access to care. However, individuals in a rural community often do not have access to the care they need. Shortages of rural health care professionals are an ever-increasing problem. The Affordable Care Act of 2010 sought to increase health care access by focusing on team-based care delivery. Thus, the need to educate health care students in the fundamentals of team-based practice has led to an increased emphasis on Interprofessional Education (IPE). While past research focused on urban IPE, a literature gap exists for the effects of a rural team-based educational experience on practice location decisions. This study examined how rural IPE influenced health profession students' perspectives of what it means to be a member of a rural health care team and explored what factors go into making decisions of where to live and provide care. Motivational Theory provided the framework for a mixed methods approach with data from student reflective journaling and a post-experience Q sort. Analysis yielded important understandings about the impact of rural IPE. Accordingly, having a rural IPE experience provided positive motivation for returning after graduation. Further, the time spent in rural IPE generated understandings of what it means to live and provide care to a rural community. One important new discovery gained is the clinical setting is not where most IPE took place. As a result, social interactions with fellow students and community members achieved the goals of rural IPE. Despite these influential findings, noted barriers to genuine rural IPE persisted. In the end, students, educators, and rural health care professionals need to be aware of the multiple factors that guide decisions of where to live and provide care.

Thesis (Dr.P.H.)--University of Texas Health Science Center at Houston, School of Public Health, 2006. / Includes bibliographical references (leaves 114-126).

Cotherapy has been advocated as an effective treatment mode, especially with groups, couples, and families. The relationship between the cotherapists has been identified as an important determinant in the success of this method. This relationship has been compared to the marital relationship between spouses, and the marriages of therapists have been viewed as offering advantages for cotherapy. Since not all therapists who are married to each other work as cotherapists, the purpose of this study was to investigate whether or not spouse cotherapists differ from other therapists who are also married to each other but who do not work together on a regular basis as cotherapists. The five dimensions measured for all subject couples include frequency of differing theoretical orientation, similarity of self-reported behavior in therapy, compatibility of needs for inclusion, compatibility of needs for control, and compatibility of needs for affection. Subjects for this study were 6 5 married couples in which both spouses were psychotherapists. The couples were divided into two groups according to whether or not they worked together as cotherapists on a regular basis. The group of spouse cotherapists included 29 couples who reported regular cotherapy together. The group of therapist couples included 37 couples who reported no regular cotherapy with their spouses. All subject couples were provided a packet of materials which included a letter explaining the general purpose of the study, two copies of the Therapist Personal Data Form, two copies of the Self-Description of Therapist's Behavior, two copies of the Fundamental Interpersonal Relations Orientation-Behavior, and a stamped envelope addressed to the experimenter for the return of the materials.

Thesis (MPH.) -- University of Limpopo, 2016 / Background: The purpose of the study was to find out if hand hygiene was being done according to World Health Organization hand hygiene Guideline. It was hoped that the study would benefit all health care workers through making recommendations aimed at improving hand hygiene compliance. Purpose: The aim of the study was to assess hand hygiene practices among healthcare workers in Nyangabgwe Hospital, Francistown, Botswana Methods: Quantitative, Cross-sectional study, using a self-administered Questionnaire to collect data on 280 participants. The questionnaire consisted of three (3) sections: socio-demographic profile; attitudes of HCWs and practice of healthcare on hand hygiene. For attitude questions Three (3) point Likert scale was used. The sampled Healthcare workers were stratified. The results were analysed using SPSS version 24.0. The descriptive statistical method was used to analyse frequencies, correlations and means. The chi-squared was used to analyse cross tabulation between variables and association with significance level at (p < = 0.05). Results: The results shows that 260 participants aged between 20- 60years responded to the questionnaire. The majority of participants had good knowledge of hand hygiene and younger participants practiced hand hygiene more than older ones (p<.05). Barriers to hand hygiene were significant and included lack of time, negative attitude, but not lack of knowledge. Conclusion: The study highlighted the practices of hand hygiene among health care workers and the status of hand hygiene resources in the hospital which have a negative impact on hand hygiene practices demonstrated that compliance with hand hygiene compliance among health care workers remains unacceptably low, despite xiv the irrefutable scientific evidence that hands are the most common vehicle for transmission of pathogens Keywords: Hand hygiene, Health care workers, Hand hygiene practices, Health care associated infection, Resources.

For too many of us, the implications of a worldwide pandemic unfolded in graduated stages of understanding that seemed too sluggish for the opponent we faced. For too many of us, even those of us in health care, the unfolding was terrifying; we felt blindsided and unprepared. If coronavirus disease 2019 (COVID-19) were a bully picking a fight, they got the first punch in before we even raised a fist. Now, many rounds in, health care teams will have an opportunity to deploy a new weapon against COVID-19. Vaccines are coming. We do not know when, who will pay for them, or the logistical aspects (e.g., storage and administration). We do not even know how effective they will be. Moreover, we must plan for mass vaccination in a chaotic and politically charged context that bears little resemblance to the ones with which we have experience. Nevertheless, in this fight, vaccines could be our winning blow. We are getting better at working with unknowns and in disrupted environments during COVID-19. We have some time to prepare, and we have some extant knowledge and experience in vaccine distribution and uptake. Health care teams can use these to best their adversary, and we can and should begin now. The aim of this article is to discuss how to mobilize interprofessional teams within systems of care to engage best practices in vaccine dissemination and uptake in the unique COVID-19 context. We begin by discussing challenges to dissemination and uptake and then provide solutions using our experiences in the primary care system.

Thesis (PhD)--University of Stellenbosch, 2006 / ENGLISH ABSTRACT: Zambia is reported to have high levels of maternal morbidity and mortality due to low contraceptive prevalence rates, over 50% of births not being attended to by skilled persons, and teenage pregnancies. A number of organisations (stakeholders) have invested in the training of adolescent reproductive health peer educators with the aim of empowering them to be role models to their peers in reproductive health, but Zambia does not have a generic and locally developed training programme for peer educators. The purpose of this study was to develop a training programme that would produce competent and more effective peer educators for Zambia. The objectives were to determine the characteristics of the ideal peer educator. Further objectives were to ascertain the factors that contribute to or impair the development of the ideal peer educator, and to determine whether training programmes that were being used were producing ideal peer educators and enhancing healthy lifestyle behaviours. Key stakeholders participated in group interviews were they presented and critiqued their training programmes. Emerging out of this process was a draft training programme, developed by the stakeholders. Focus Group Discussions (FGDs) were held with adolescent peer educators from Lusaka, Kafue, Livingstone and Maheba refugee camp. Data were analysed by triangulating the outcomes of the group interviews (with the stakeholders) with the outcomes of the FGDs and reviewed literature. The FGDs highlighted the characteristics of an ideal peer educator as well as factors that contribute towards his/her competence development. Numerous factors were reported that had a negative impact on the development of an ideal peer educator. The peer educators reported that their training had had a positive effect on their lifestyle behaviours. While they had gained more knowledge on HIV and AIDS, they recommended more training on other health issues. The study found that at community level, peer educators were not being given adequate respect because the concept of voluntary work was not readily accepted and they were regarded as failures in life. Major demotivating factors were the lack of payment of incentives and the fact that peer educators were not certified. Peer educators did not receive sufficient support from programme managers/coordinators to enable them to become more effective at community level. Weaknesses in the way the training programmes were conducted were also discerned. Based on the findings of this study, it is recommended that more life skills’ development be promoted for peer educators. Training should be contextualised for the communities in which the peer educators work. The developed training programme, which should be used as a guide, should be repackaged to suit the profiles (e.g. values) of the different communities. Adolescents and various social sectors (inclusive of indicated stakeholders) ought to be involved in diagnosing community needs so as to influence both peers and communities in a way that would promote adolescent reproductive health. This study also recommends a more informal way of practising peer education, which would produce trainees who would be peer educators and role models in any given setting. / AFRIKAANSE OPSOMMING: Na berig word is die hoë siekte- en sterftesyfers onder moeders in Zambië daaraan te wyte dat voorbehoedmiddels nie algemeen gebruik word nie, dat meer as 50% van geboortes plaasvind sonder die bystand van bekwame persone, en dat daar ‘n hoë voorkoms van tienerswangerskappe is. ‘n Aantal organisasies (belanghebbers) het in die opleiding van adolessent- portuurgroep-opvoeders in reproduktiewe gesondheid belê ten einde hierdie portuurgroep-opvoeders te bemagtig om as rolmodelle in reproduktiewe gesondheid op te tree. Zambië het egter nie ‘n eie generiese, plaaslik-ontwikkelde opleidingsprogram vir portuurgroep-opvoeders nie. Die doel van hierdie studie was om ‘n opleidingsmodel en opleidingsprogram te ontwikkel wat bekwame en meer effektiewe portuurgroep-opvoeders vir Zambië sou kon oplewer. Die doelstellings was om die kenmerke van ‘n ideale portuurgroep-opvoeder te bepaal en om die faktore te identifiseer wat óf tot die ontwikkeling van ‘n ideale portuurgroep-opvoeder bydra óf sy/haar ontwikkeling strem. Daar moes ook vasgestel word of bestaande opleidingsprogramme ideale portuurgroep-opvoeders oplewer en gevolglik gesonde leefstylgedrag bevorder. Die navorser het groeponderhoude gebruik en betekenisvolle belanghebbers genooi om hulle opleidingsprogramme aan te bied, te beoordeel en krities te bespreek. ‘n Konsepopleidingsprogram wat deur die belanghebbers ontwikkel is, het uit hierdie proses ontstaan. Fokusgroepbesprekings (Engels: Focus Group Discussions of FGDs) is met adolessente portuurgroep-opvoeders van Lusaka, Kafue, Livingstone en die Maheba-vlugtelingekamp gehou. Data is ontleed deur die uitkomste van die groeponderhoude (met die deelhebbers) met die uitkomste van die fokusgroepbesprekings en die bespreekte literatuur te trianguleer. Die fokusgroepbesprekings het die soeklig op die kenmerke van die ideale portuurgroepopvoeder asook op die faktore wat tot sy/haar bekwaamheidsontwikkeling bydra, laat val. Talle faktore wat ‘n negatiewe uitwerking op die ontwikkeling van ‘n ideale portuurgroep-opvoeder het, is ook vasgestel. Die portuurgroep-opvoeders het bevestig dat hul opleiding ‘n positiewe invloed op hul lewenstylgedrag gehad het. Terwyl hulle genoem het dat hulle meer kennis oor MIV en VIGS opgedoen het, het hulle aanbeveel dat daar ook meer klem op ander gesondheidskwessies behoort te wees. In hierdie studie is daar bevind dat portuurgroepopvoeders op gemeenskapsvlak nie met voldoende respek behandel word nie. Die begrip van vrywillige werk word nie geredelik aanvaar nie, en die opvoeders word as mislukkings beskou. Faktore wat besonder ontmoedigend inwerk is die gebrek aan ‘n aansporingsloon en die feit dat portuurgroep-opvoeders nie sertifikate ontvang nie. Portuurgroep-opvoeders het ook nie voldoende ondersteuning van programbestuurders/- koördineerders ontvang om hulle in staat te stel om meer effektief op gemeenskapsvlak op te tree nie. Daar is voorts swakhede opgemerk in die wyse waarop die opleidingsprogramme uitgevoer is. Gegrond op die bevindinge van hierdie studie, word daar aanbeveel dat die ontwikkeling van lewensvaardighede tot ‘n groter mate bevorder word. Opleiding behoort gekontekstualiseer te word vir die gemeenskappe waarbinne die opvoeders werk. Die bestaande opleidingsprogram, wat as ‘n riglyn gebruik behoort te word, behoort herstruktureer te word om by die profiele (bv. die waardes) van die verskillende gemeenskappe in te pas. Adolessente en verskillende sosiale sektore (insluitend die aangeduide belanghebbers) behoort betrokke te wees by die bepaling van die gemeenskap se behoeftes ten einde beide portuurgroepe en gemeenskappe so te beïnvloed dat adolessente- reproduktiewe gesondheid bevoordeel sal word. Hierdie studie beveel ook aan dat portuurgroep-opvoeding op ‘n informeler grondslag beoefen behoort te word sodat die kwekelinge uiteindelik in enige gegewe omgewing suksesvolle portuurgroepopvoeders en rolmodelle sal kan wees.

This study addresses the effectiveness of communication between the team (doctors, sisters and social workers) and patients at the Breast Cancer Clinic of the Johannesburg Hospital. Tue needs of patients were highlighted, as well as the role of care-giver, both as a group and in their separate disciplines, in attempting to meet these needs. Tue empirical survey was carried out through the use of questionnaires as well as interview schedules. Patients, doctors, nurses and social workers were used as respondents. Results indicated that the majority of patients' needs for information and support were met by the team in general; however, a need for further social work intervention seemed to be apparent. In addition, several barriers were found to inhibit both team-patient and inter-team communication. Tue researcher used the information gathered in this study to make recommendations that will facilitate improved communication in the clinic, with specific reference to the role of the social worker. / Social Work / M.A.(Social Science: Mental Health)

This study addresses the effectiveness of communication between the team (doctors, sisters and social workers) and patients at the Breast Cancer Clinic of the Johannesburg Hospital. Tue needs of patients were highlighted, as well as the role of care-giver, both as a group and in their separate disciplines, in attempting to meet these needs. Tue empirical survey was carried out through the use of questionnaires as well as interview schedules. Patients, doctors, nurses and social workers were used as respondents. Results indicated that the majority of patients' needs for information and support were met by the team in general; however, a need for further social work intervention seemed to be apparent. In addition, several barriers were found to inhibit both team-patient and inter-team communication. Tue researcher used the information gathered in this study to make recommendations that will facilitate improved communication in the clinic, with specific reference to the role of the social worker. / Social Work / M.A.(Social Science: Mental Health)