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The implementation of planned organizational change is ultimately a communication-related phenomenon, and as such, it is imperative that organizational communication scholars examine the interactions surrounding EHR implementation and understand how users (e.g. healthcare practitioners) utilize, evaluate, and deliberate this new technological innovation. Previous research on planned organizational change has called for researchers to adopt a more dynamic perspective that emphasizes the active agency of organizational members throughout implementation processes and focuses on informal implementers and change reinvention (work-arounds) as individuals actively reinterpret and personalize their work roles during implementation socialization. This dissertation seeks to fill this gap in research by demonstrating how communication between doctors, nurses, and other health professionals affects the adoption, maintenance, alternation, modification, or rejection of EHR systems within health care organizations. To delve into these inquiries and examine the intersecting domains of medical informatics and organizational communication research, this dissertation proceeds in the following manner: First, a literature review, capitalizing on Laurie Lewis’s work in planned organizational change and social constructionist views of technology use in organizations, outlines the assumptions that undergird this research. Next, this dissertation builds a model that predicts the communicative and structural antecedents of the study outcome variables, which include 1) organizational resistance to EHR implementation, 2) employees’ perception of EHR implementation success, 3) levels of change reinvention—or work-arounds—due to change initiatives and activities, and 4) employees’ perceptions of the quality of the organizational communication surrounding the change. Hypotheses guiding the model specification are provided and are followed by a description of the empirical methods and procedures that were utilized to explore the variable relationships. Results of the SEM model suggest that work-arounds could play a mediating role governing the relationship between informal social influence and the outcome variables in the study. In addition, one-way ANOVAs and multiple regression analyses reveal that physicians are the most resistant to EHR implementation and perceived change communication quality positively predicts perceived EHR implementation success and perceived relative advantage of EHR and negatively predicts employee resistance. A discussion of the expected and unexpected results is offered in addition to study limitation and future directions. / text

Few interpersonal and organizational communication studies examine the professional and organizational aspects of career satisfaction among minority physicians. Due to the underrepresenation of minority physicians, most studies resort to comparing aggregate groups of minority physicians in juxtaposition to non-minority physicians. These studies fail to uncover possible communication differences, which originate from cultural dissimilarities between disaggregate racial/ethnic groups. Even fewer studies examine physicians' written communication to open-ended survey questions about career satisfaction/dissatisfaction between disaggregate racial/ethnic minority groups and non-minorities. This study specifically examines written responses to two open-ended survey questions about professional and organizational dissatisfaction and compares responses from disaggregate minority physician and non-minority physicians. Participants were divided into five response-driven categories of race/ethnicity as follows: Asian/Pacific Islander, Black/African American, Indian/Pakistani, Hispanic, and White/Non-Hispanic. The population consists of 1849 members of the medical staff roster of a Southeastern, U.S., not-for-profit hospital group. Primary findings indicate the presence of recurrent themes among disaggregate minority physician racial/ethnic groups' responses. Significant variation exists between responses from disaggregate minority physician racial/ethnic groups and non-minority physicians. Results imply that open-ended methods of data collection are essential to gaining knowledge about ways cultural dissimilarities between disaggregate minority racial/ethnic groups affect communication and satisfaction. Understanding more about cultural dissimilarities is necessary for: improving data collection quality; recruiting and retaining minority physicians; and reducing healthcare disparities among minorities.

This thesis focuses on the role of communication from healthcare professionals to patients, their relatives, and colleagues and its impact on patient care outcomes. We demonstrate the importance of appropriate communication style and strong communication skills to these outcomes (i.e. higher adherence, overall satisfaction, and social support). We also illustrate various situations requiring difficult communication that healthcare professionals commonly encounter in practice. The aim is to capture the most common communication demanding situations from the practice of healthcare professionals and provide a "reference" for their successful completion. The outcome of the practical part of this work is to map the difficult communication situations of Czech healthcare professionals (doctors, nurses and others) through questionnaire survey , and to design a mobile application that will serve as a form of aid for healthcare professionals or medics in individual communication situations with adult patients, their relatives, and colleagues. Keywords: Communication in healthcare, communication-demanding situations, patient care, health professionals

Healthcare in the United States is a system that, organizationally speaking, is fragmented. Each hospital facility is independently operated and is responsible for the hiring of its own employees. However, corrupt individuals can take advantage of this fragmentation and move from hospital to hospital, gaining employment while hiding previous employment history. Traditionally, hospitals have been reluctant to share information on their previous employees, even with other hospitals, for fear of issues surrounding defamation, negligent hiring, and violation of the employee's privacy. However, growth in healthcare services is expected to rise exponentially in the near future, increasing the demand for employees. The need, therefore, to exchange pertinent information regarding employees will become necessary as hospitals seek qualified employees to fill positions throughout their organizations. One way to promote this information exchange is to develop trusted information sharing networks among hospital units. This study examined the problems surrounding organizational information sharing as well as the current level of employee information sharing being conducted by hospitals nationwide. Utilizing a survey of hospital administrators, this study drew upon the theoretical foundations of the Diffusion of Innovation Theory, the Knowledge Management Theory, the Social Exchange Theory and the earlier organizational information sharing frameworks established by Dawes (1996) and Landsbergen and Wolken (1998; 2001) in order to examine the variables that contribute to propensity of hospital administrators to engage in the sharing of employee information with other organizations.

PurposeThis research takes Nigeria and the healthcare prevention sector as a case study to describe the manner in which the non-profit sector is presently dealing with the challenge of communicating in a multilingual/multicultural environment. The intention is to identify the linguistic factors that affect the design of healthcare prevention interventions, indicate language strategies that are being used and potentially single out opportunities for improvement.Design/Methodology/ApproachTwo data sets were employed: the main one representing phone interviews with Communication for Development practitioners in the healthcare domain in Nigeria and a secondary one including online testimonials from the Here I Am campaign conducted by the Global Fund. The data collected was analysed following the Critical Discourse Analysis three-level framework. In addition to this, the micro level stage incorporated Grounded Theory Method to elicit thematic relations, and Semiotic Analysis and Discursive Analysis to determine the stance of the speakers.FindingsParticipants to this research perceived language and culture as two entwined concepts. Communication in the community’s local language was said to enhance message acceptance. The thematic analysis revealed that the strategy to be used, mainly translation or a combination of community interpreting and cultural mediation, depends largely on the level of literacy of the community. Of the proposed language strategies, training of bilingual individuals and a combination of community interpreting and cultural mediation appeared to be the two pivotal modes of interlingual message transposition. Pictorials are used in extreme situations.Despite the dissimilarity of the two data sets used in this research, the discursive analysis suggested the existence of an aid beneficiaries/non-profit staff binary. The way of expression of aid beneficiaries and individuals working at grassroots level exhibited traits of dependency on other players (in this case donors and non-profit staff). Similarly, the discursive analysis of the interviews put forward that the non-profit staff interviewed tended to distinguish between themselves and Others (in this case, the aid beneficiaries).This research found furthermore that translation and interpreting activities within the non-profit sphere are not always undertaken according to strict professional ethics and praxis.

Includes bibliographical references (leaves 185-194) / Underpinned by the premise that any text can be studied as a translation provided it is identified as such, this study theoretically uses Descriptive Translation Studies (DTS) to investigate English-Swahili healthcare texts. The aim of the study was to: identify, describe and analyse linguistic and cultural aspects in the texts; identify, describe, and analyse translation strategies used in the texts; and describe and analyse the use of illustrations in the texts. The study made use of Kruger and Wallmach’s (1997) analytical framework. The Tertium Comparationis of the study was descriptive terms, cohesive devices, translation strategies, division of texts, illustrations, text titles, and taboo words. On the linguistic aspects, the study’s main findings were: that the English texts use more descriptive terms than the Swahili texts; Swahili texts have a higher frequency use of references because it contains a number of derivational and inflectional morphemes; substitution is sparingly used whereas ellipsis is almost non-existent in Swahili texts in spite of its presence in the source texts; additive and causal conjunctions were the most prevalent in the texts; and inasmuch as there were no significant differences in the use of lexical cohesion in the ST and TT, Swahili texts were found to be more cohesive due to the slightly higher number of lexical items. Regarding the cultural aspects, it was found that translators use euphemism in the translation of words considered taboo and this informed the conclusion that there reigns the euphemism norm in Swahili texts. It equally emerged that strategies used to overcome non-lexicalisation include: use of pure loan words, use of pure loan words preceded by explanation, use of indigenised loan words, use of omission and translation by a more general word. On the other hand, translators used strategies of substitution, use of general words, paraphrasing and cultural substitution to translate words considered taboo. In addition, the study found that illustrations are used in more less the same way both in the ST and TT save for some slight modifications that are done in order to align them with the target culture expectations. Furthermore, the study theoretically effectuated four norms: explicitation norm, explicitness norm, euphemism norm, and illustration norm / Linguistics and Modern Languages / D. Litt.et Phil. (Linguistics)