Text in Afrikaans / Hierdie navorsing handel oor selfaktualisering as voorspeller van bestuursukses. In die literatuuroorsig is bestuursukses as afhanklike veranderlike en selfaktualisering as onafhanklike veranderlike binne die humanistiese paradigma gekonseptualiseer en geoperasionaliseer. Die persoonlikheidskenmerke verwant aan die veranderlikes is bepaal en geintegreer. Die empiriese ondersoek is binne die funksionalistiese paradigma aangebied. Die gekose meetinstrumente, naamlik die Bestuursvaardigheidsinventaris vir die meet van bestuursukses en die Persoonlike Orientasie-inventaris vir die meet van selfaktualisering is op 'n ewekansige steekproef van 51 middelvlakbestuurders afgeneem. Die betroubaarheid van die Bestuursvaardigheids- inventaris is met behulp van die "Cronbach Alpha Coeffisient"- metode bepaal. Om te bepaal of selfaktualisering 'n voorspeller van bestuursukses is, is stapsgewyse regressieontledings gedoen. Die resultate dui daarop dat die ondersteuningsratio (innerlike orientasie) bestuursukses beduidend voorspel, sowel as 12 van die 18 kenmerke eie aan bestuursukses onderskeidelik. / This research deals with self-actualization as predictor of management success. In the literature review, management success as the dependent variable and self-actualization as independent variable, is conceptualized and operationalized within the humanistic paradigm. The personality chracteristics inhirent in the variables were determined and integrated. The empirical investigation is presented within the functionalistic paradigm. The chosen measuring instruments, namely the Management Skills Inventory for the measurement of management success and the Personal Orientation Inventory for the measurement of self-actualization were administrated by means of random sampling to 51 middle level managers. The reliability qf the Management Skills Inventory was determined by means of the "Cronbach Alpha CoEHfisient"- method. To determine if selfactualization is a predictor of Management Success, stepwise regression analysis was done. The results indicate that the support ratio (inner directedness) predicts management success significantly, as well as 12 of the 18 personality characteristics inherent in management success, respectively. / Psychology / M.A. (Industrial Psychology)

La prise optimale d’un traitement antirétroviral est la clé du succès de ces traitements. Cette prise devrait être d’au moins 95 % des médicaments antirétroviraux prescrits afin de supprimer à long terme la réplication virale et donc de restaurer et de préserver la fonction immunologique. Cependant, les personnes vivant avec le virus de l’immunodéficience humaine (PVVIH) éprouvent des difficultés à adopter et à maintenir ce niveau de prise dans le temps. Bien que certaines interventions aient démontré leur capacité à faciliter ce comportement, au Québec il n’y a pas d’intervention systématique pour soutenir ces personnes dans la prise quotidienne de ces traitements. Le but de cette étude était donc de développer et d’évaluer une intervention pour faciliter le comportement de prise optimale d’un traitement antirétroviral chez des personnes vivant avec le VIH. Pour guider le développement de l’intervention, la démarche appelée « intervention mapping » a été suivie. Le cadre théorique proposé par Godin et ses collègues (2005) qui inclut le sentiment d’efficacité personnelle et les attitudes positives face à la prise optimale d’un traitement antirétroviral a été ainsi utilisé non seulement pour prédire et expliquer le comportement de prise, mais aussi pour élaborer l’intervention. Selon ce modèle, le soutien social, la satisfaction envers les professionnels et le fait de ne pas ressentir d’effets indésirables sont autant de facteurs modifiables associés au sentiment d’efficacité personnelle et aux attitudes positives. L’intervention développée visait l’acquisition et la mobilisation des habiletés nécessaires pour influencer ces facteurs en vue de rehausser le sentiment d’efficacité personnelle et les attitudes positives ainsi que pour faciliter ce comportement. Cette intervention comportait quatre rencontres d’une durée de 45 à 75 minutes, s’échelonnant sur 12 semaines, avec une infirmière iii possédant une expertise en VIH. L’évaluation de l’effet de cette intervention sur le comportement et les variables explicatives a été effectuée à l’aide d’un essai clinique avec répartition aléatoire. La principale variable résultat a été mesurée à l’aide d’un questionnaire autoadministré, de la charge virale et du nombre de CD4. Autant la variable résultat principale que les variables explicatives ont été mesurées avant l’intervention et après celle-ci, soit à 12 et 24 semaines. L’échantillon était constitué de 51, personnes vivant avec le VIH et suivies dans une clinique à Montréal : 23 dans le groupe contrôle et 28 dans le groupe expérimental. Des analyses de variance (ANOVA) à mesures répétées ont été réalisées afin d’analyser l’effet de l’intervention sur la prise optimale d’un traitement antirétroviral et les autres variables intermédiaires dans le temps. Les résultats montrent une tendance positive (p = 0,056) quant à l’obtention d’une charge virale indétectable dans le groupe intervention. Ainsi, 43,8 % plus de personnes du groupe expérimental comparativement au groupe contrôle (78,6 % versus 34,8 %) avaient une charge virale indétectable à 12 semaines et 32,8 % de plus à 24 semaines (89,3 % versus 56,5 %). Bien qu’aucun effet significatif ait été trouvé en regard des variables explicatives, probablement à cause d’un manque de puissance statistique, les légères augmentations observées dans le groupe expérimental sont cohérentes avec le modèle théorique utilisé (Godin & al., 2005). Cette étude contribue à l’avancement des connaissances en proposant une intervention pour faciliter la prise optimale d’un traitement antirétroviral chez des personnes vivant avec le VIH. / The key to the success of antiretroviral treatment is optimal treatment taking. At least 95% of prescribed antiretroviral treatments (ARV) have to be taken to achieve long-term suppression of viral replication and so restore and preserve immunologic functioning. However, people living with acquired immunodeficiency virus (PLHIV) have problems adopting and sustaining this level of medication taking over time. Although some interventions have demonstrated they can facilitate this behaviour, in Quebec there are no systematic interventions to support PLHIV in daily treatment taking. The goal of this study was to develop and evaluate an intervention to facilitate optimal antiretroviral-treatment-taking behaviour among people living with HIV. Development of the intervention was guided by an approach known as “intervention mapping.” Accordingly, the theoretical framework put forward by Godin and his colleagues (2005), which includes the factors of self-efficacy and attitudes, was used not only to predict and explain treatment-taking behaviour but also to develop the intervention. In the model, self-efficacy and attitudes are associated with a number of modifiable factors: social support, satisfaction with health professionals and not feeling adverse effects. The goal of the intervention was therefore the acquisition and mobilization of skills in order to affect these factors and, consequently, enhance self-efficacy and positive attitudes towards taking one’s ARV treatment, thus facilitating the desired behaviour. The individualized intervention was structured as four 45- to 75-minute meetings held over a 12-week period with a nurse who had expertise in HIV. A randomized trial was conducted to evaluate the effect of the intervention on behaviour and on the explanatory variables. A self-administered questionnaire, viral load and CD4 count were used to measure the principal outcome variable. vi Measurements of the principal outcome and the explanatory variables were made before the intervention and at 12 weeks and at 24 weeks post-intervention. The sample comprised 51 people living with HIV who were being followed at a clinic in Montreal: 23 in the control group and 28 in the experimental group. Data were subjected to repeated measures analysis of variance (ANOVA). The intervention was found to have a positively trend (p = 0.056) in terms of achieving an undetectable viral load : 43.8 % more persons of the experimental group compared with the group control (78.6 % versus 34.8 %) had an undetectable viral load at 12 weeks and 32.8 % more at 24 weeks (89.3 % versus 56.5 %). Probably the lack of statistical power meant no significant effect was found on the explanatory variables, but the small increases observed in the experimental group are consistent with the theoretical model (Godin et al., 2005). This study contributes to knowledge by proposing an intervention to facilitate optimal antiretroviral-treatment taking among PLHIV.

Text in Afrikaans / Hierdie navorsing handel oor selfaktualisering as voorspeller van bestuursukses. In die literatuuroorsig is bestuursukses as afhanklike veranderlike en selfaktualisering as onafhanklike veranderlike binne die humanistiese paradigma gekonseptualiseer en geoperasionaliseer. Die persoonlikheidskenmerke verwant aan die veranderlikes is bepaal en geintegreer. Die empiriese ondersoek is binne die funksionalistiese paradigma aangebied. Die gekose meetinstrumente, naamlik die Bestuursvaardigheidsinventaris vir die meet van bestuursukses en die Persoonlike Orientasie-inventaris vir die meet van selfaktualisering is op 'n ewekansige steekproef van 51 middelvlakbestuurders afgeneem. Die betroubaarheid van die Bestuursvaardigheids- inventaris is met behulp van die "Cronbach Alpha Coeffisient"- metode bepaal. Om te bepaal of selfaktualisering 'n voorspeller van bestuursukses is, is stapsgewyse regressieontledings gedoen. Die resultate dui daarop dat die ondersteuningsratio (innerlike orientasie) bestuursukses beduidend voorspel, sowel as 12 van die 18 kenmerke eie aan bestuursukses onderskeidelik. / This research deals with self-actualization as predictor of management success. In the literature review, management success as the dependent variable and self-actualization as independent variable, is conceptualized and operationalized within the humanistic paradigm. The personality chracteristics inhirent in the variables were determined and integrated. The empirical investigation is presented within the functionalistic paradigm. The chosen measuring instruments, namely the Management Skills Inventory for the measurement of management success and the Personal Orientation Inventory for the measurement of self-actualization were administrated by means of random sampling to 51 middle level managers. The reliability qf the Management Skills Inventory was determined by means of the "Cronbach Alpha CoEHfisient"- method. To determine if selfactualization is a predictor of Management Success, stepwise regression analysis was done. The results indicate that the support ratio (inner directedness) predicts management success significantly, as well as 12 of the 18 personality characteristics inherent in management success, respectively. / Psychology / M.A. (Industrial Psychology)

The study was undertaken to investigate the effectiveness of the interventions made by the Mogale City Plato mentorship programme to promote growth and sustainability of SMMEs. Though there have been interventions through the Plato mentorship programme to help develop SMMEs, there is still a high failure rate of small businesses in MCLM. The study will therefore evaluate if the Plato mentorship programme achieved its envisaged aim. A structured research instrument (questionnaire) was used to collect data through a self-administered survey. Questionnaires were distributed to the respondents by the researcher, and 100% of the questionnaires were returned for analysis. The results of the study showed that Mogale Plato mentorship programme adds value and advances small businesses and entrepreneurship. The study concluded that owners that took part in the MCLM Plato mentorship programme acknowledged that the programme was effective and increased business performance. The study showed that owners are faced with different challenges in running their businesses, which spoke volumes regarding the effectiveness of the mentorship programme. The findings also revealed that a majority of business owners benefited from the assistance received from MCLM Plato mentorship programme. The study recommends that MCLM sets up an office for mentoring individuals/groups in the municipality. This means that within MCLM, there should be a mentoring office and training twice a month that is aimed at helping business people know how to improve their businesses and manage challenges and take advantage of opportunities around them. The study also recommends that the municipality to create an incubating site for new owners/managers. The new owners/managers could share common services such as secretarial services, bookkeeping, and boardrooms / Business Management / M. Tech. (Business Administration)

Caminhos da formação de gestores de sistemas e serviços de saúde: uma análise da adequação entre teoria e a prática?. O cotidiano da gestão dos sistemas serviços de saúde é constituído de questões que perpassam o contexto das políticas econômicas, interagem com as faces das incorporações tecnológicas, estando intimamente relacionado ao componente regional e social. Nesse ambiente de alta labilidade torna-se importante a utilização de mecanismos que reforcem a interação entre educação e trabalho. A responsabilidade da formação profissional deve relacionar-se aos resultados das necessidades da assistência à saúde, guiadas pelos resultados de avaliações sistemáticas. O objetivo principal desta tese consistiu em analisar a adequação do conteúdo teórico representado nas dimensões de competências do Curso de Especialização em Gestão em Saúde do IMS/UERJ face às reais necessidades de aplicação das competências gerenciais dos egressos no desempenho de suas funções no dia a dia de trabalho. O estudo a adequação dos conteúdos educacionais ás necessidades contextuais dos processos de trabalho, importa na leitura das condições de enfrentamento dos problemas cotidianos, as dificuldades ou facilidades de soluções podem variar em função do nível de apropriação dos saberes trabalhados no processo aprendizagem. Ainda que as dificuldades da gestão no ambiente da saúde não resultem apenas de fatores ligados á formação profissional, essa vertente precisar ser monitorada visando contribuir com as reais necessidades de desempenho dos gerentes. Tais necessidades podem ser facilitadas pelo aumento da capacidade de análise contextuais e pelo domínio de manuseio de ferramentas técnicas que se configurem como instrumentos de resolução de problemas na realidade cotidianas. A partir do problema pesquisado, e dos resultados encontrados foi possível concluir, respondendo às questões de partida: (i) O curso de Especialização em gestão de saúde do IMS/UERJ atende as necessidades de desempenho profissional de seus egressos em suas funções cotidianas gerenciais considerando as respostas destes, classificando em mais 80% das dimensões de competência componentes do conteúdo programático como muito importante e indispensável no desempenho pratico de suas funções cotidianas. (ii) Os ajustes á serem inseridos ao conteúdo programático do Curso de Especialização em Gestão de Saúde, segundo seus egressos, e demais entrevistados para o atendimento das reais necessidades de capacitação dos gerentes de sistemas e serviços de saúde, está configurado nas considerações finais desta tese. Os resultados dessa tese oferecem subsídios para formulação de conteúdo programático que fomentem as necessidades de profissionalização da gestão na saúde. O estudo dessas situações, no campo prático, aponta perspectivas positivas com a busca de aperfeiçoamento de programa de capacitação de gestão de saúde e, por conseguinte representa um investimento importante para a melhoria da assistência à saúde da população.

Caminhos da formação de gestores de sistemas e serviços de saúde: uma análise da adequação entre teoria e a prática?. O cotidiano da gestão dos sistemas serviços de saúde é constituído de questões que perpassam o contexto das políticas econômicas, interagem com as faces das incorporações tecnológicas, estando intimamente relacionado ao componente regional e social. Nesse ambiente de alta labilidade torna-se importante a utilização de mecanismos que reforcem a interação entre educação e trabalho. A responsabilidade da formação profissional deve relacionar-se aos resultados das necessidades da assistência à saúde, guiadas pelos resultados de avaliações sistemáticas. O objetivo principal desta tese consistiu em analisar a adequação do conteúdo teórico representado nas dimensões de competências do Curso de Especialização em Gestão em Saúde do IMS/UERJ face às reais necessidades de aplicação das competências gerenciais dos egressos no desempenho de suas funções no dia a dia de trabalho. O estudo a adequação dos conteúdos educacionais ás necessidades contextuais dos processos de trabalho, importa na leitura das condições de enfrentamento dos problemas cotidianos, as dificuldades ou facilidades de soluções podem variar em função do nível de apropriação dos saberes trabalhados no processo aprendizagem. Ainda que as dificuldades da gestão no ambiente da saúde não resultem apenas de fatores ligados á formação profissional, essa vertente precisar ser monitorada visando contribuir com as reais necessidades de desempenho dos gerentes. Tais necessidades podem ser facilitadas pelo aumento da capacidade de análise contextuais e pelo domínio de manuseio de ferramentas técnicas que se configurem como instrumentos de resolução de problemas na realidade cotidianas. A partir do problema pesquisado, e dos resultados encontrados foi possível concluir, respondendo às questões de partida: (i) O curso de Especialização em gestão de saúde do IMS/UERJ atende as necessidades de desempenho profissional de seus egressos em suas funções cotidianas gerenciais considerando as respostas destes, classificando em mais 80% das dimensões de competência componentes do conteúdo programático como muito importante e indispensável no desempenho pratico de suas funções cotidianas. (ii) Os ajustes á serem inseridos ao conteúdo programático do Curso de Especialização em Gestão de Saúde, segundo seus egressos, e demais entrevistados para o atendimento das reais necessidades de capacitação dos gerentes de sistemas e serviços de saúde, está configurado nas considerações finais desta tese. Os resultados dessa tese oferecem subsídios para formulação de conteúdo programático que fomentem as necessidades de profissionalização da gestão na saúde. O estudo dessas situações, no campo prático, aponta perspectivas positivas com a busca de aperfeiçoamento de programa de capacitação de gestão de saúde e, por conseguinte representa um investimento importante para a melhoria da assistência à saúde da população.

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Text in Afrikaans / Summaries in Afrikaans and English / Bemagtiging van verpleegkundiges in gesondheidsdienste in Suid-Afrika bly 'n voortdurende kwessie en die mate waartoe verpleegbestuur verpleegkundiges bemagtig om outonoom op te tree, is onbekend. Wanneer verpleegkundiges bemagtig is, lei dit tot verbeterde pasientsorg deur middel van verhoogde produktiwiteit en werktevredenheid. Die wyse waarop bemagtiging van verpleegkundiges meet geskied is nog nie in SuidAfrika in diepte ondersoek nie. Die doel van hierdie studie was om daardie elemente wat vir die verpleegbestuurder noodsaaklik is om verpleegkundiges te kan bemagtig, te identifiseer. Deur middel van 'n beskrywende, ontdekkende studie wat van 'n vraelys gebruik gemaak het om inligting te bekom, is die nodige elemente gei'soleer. Verpleegbestuurders in gesondheidsdienste in die Gauteng-area het as teikengroep gedien. Definisies van bestuursbemagtiging is geanaliseer ten einde 'n konseptuele raamwerk te ken saamstel. Ses konsepte het die raamwerk vir hierdie studie gevorm, naamlik: • die bydrae van bestuurstrukture tot die bemagtiging van verpleegkundiges; • die rel van magsdeling in die bemagtiging van verpleegkundiges; • deelnemende besluitneming in die bemagtiging van verpleegkundiges; • die verpleegbestuurder se vaardighede en verantwoordelikhede in haar daaglikse taakontwerp en bestuur wat tot die bemagtiging van verpleegkundiges bydra; • motivering- en beloningstrategiee wat tot bemagtiging bydra; en • eienskappe wat kenmerkend van 'n bemagtigende verpleegbestuurder is. Uit die ontleding van die data het die volgende belangrike elemente ender andere na vore gekom: • Daar behoort gedesentraliseerde verspreiding van mag na die laagste moontlike vlak in die gesondheidsdiens plaas te vind; • Die voorstelle van verpleegkundiges behoort erken en indien aanvaarbaar, geimplementeer te word; • Gesag behoort op so n wyse gedelegeer te word dat onafhanklike besluitneming bevorder word; • Verpleegkundiges se take behoort sodanig ontwerp te word dat onafhanklike optrede in die werkplek bevorder word. Die bevindinge van hierdie studie het getoon dat verpleegbestuurders positief ingestel is betreffende die bemagtiging van verpleegkundiges. Hulle beskou dit as deel van hulle bestuursfunksie. 'n Uitdaging waarmee die bestuurder van die toekoms te kampe sal he, is die van 'n omvattende begrip vir personeellede en om van beheer deur middel van streng burokratiese reels, af te sien. / Empowerment of nurses in health services in South Africa remains an ongoing issue, but the extent to which nursing management empowers nurses to act autonomously is not known. When nurses are empowered patient care and nursing services improve through enhanced productivity and job satisfaction. The way in which nurses could be empowered by management has yet to be addressed by researchers in South Africa. The aim of the present study was to identify those essential elements through which nurse managers can empower nurses. By making use of a descriptive exploratory study, utilizing a questionnaire to acquire the necessary information, the essential elements were isolated. Nurse managers in health services in the Gauteng region formed the target group. Definitions of empowerment in management were analyzed and from this a conceptual framework regarding empowerment was formulated. Six concepts served as the basis of this study: • the contribution of management structures, towards the empowerment of nurses; • the role of power-sharing in the empowerment of nurses; • participative decision making in the empowerment of nurses; • the management skills and responsibilities of the nurse manager in her daily task design and management that contribute to the empowerment of nurses; • motivation and reward strategies that contribute towards empowerment; • attributes which characterise an empowered nurse manager. From the analysis of. the data the following important elements among others emerged: • Decentralization of the distribution of power to the lowest possible level should take place in the health services; • The suggestions of nurses should be acknowledged and if found acceptable, to be implemented; • Authority should be delegated in such a way that independent decision making by nurses is enhanced; • Nurses' tasks should be designed in a way that promote independent performance in the work place. The findings of this study revealed that nurse managers are favourably disposed towards the empowerment of nurses. They see this as part of their managerial function. A challenge which confronts the manager of the future is that of comprehensively understanding staff members, and setting aside control through bureaucratic behaviour. / Health Studies / D. Litt. et Phil.

Text in Afrikaans / Summaries in Afrikaans and English / Bemagtiging van verpleegkundiges in gesondheidsdienste in Suid-Afrika bly 'n voortdurende kwessie en die mate waartoe verpleegbestuur verpleegkundiges bemagtig om outonoom op te tree, is onbekend. Wanneer verpleegkundiges bemagtig is, lei dit tot verbeterde pasientsorg deur middel van verhoogde produktiwiteit en werktevredenheid. Die wyse waarop bemagtiging van verpleegkundiges meet geskied is nog nie in SuidAfrika in diepte ondersoek nie. Die doel van hierdie studie was om daardie elemente wat vir die verpleegbestuurder noodsaaklik is om verpleegkundiges te kan bemagtig, te identifiseer. Deur middel van 'n beskrywende, ontdekkende studie wat van 'n vraelys gebruik gemaak het om inligting te bekom, is die nodige elemente gei'soleer. Verpleegbestuurders in gesondheidsdienste in die Gauteng-area het as teikengroep gedien. Definisies van bestuursbemagtiging is geanaliseer ten einde 'n konseptuele raamwerk te ken saamstel. Ses konsepte het die raamwerk vir hierdie studie gevorm, naamlik: • die bydrae van bestuurstrukture tot die bemagtiging van verpleegkundiges; • die rel van magsdeling in die bemagtiging van verpleegkundiges; • deelnemende besluitneming in die bemagtiging van verpleegkundiges; • die verpleegbestuurder se vaardighede en verantwoordelikhede in haar daaglikse taakontwerp en bestuur wat tot die bemagtiging van verpleegkundiges bydra; • motivering- en beloningstrategiee wat tot bemagtiging bydra; en • eienskappe wat kenmerkend van 'n bemagtigende verpleegbestuurder is. Uit die ontleding van die data het die volgende belangrike elemente ender andere na vore gekom: • Daar behoort gedesentraliseerde verspreiding van mag na die laagste moontlike vlak in die gesondheidsdiens plaas te vind; • Die voorstelle van verpleegkundiges behoort erken en indien aanvaarbaar, geimplementeer te word; • Gesag behoort op so n wyse gedelegeer te word dat onafhanklike besluitneming bevorder word; • Verpleegkundiges se take behoort sodanig ontwerp te word dat onafhanklike optrede in die werkplek bevorder word. Die bevindinge van hierdie studie het getoon dat verpleegbestuurders positief ingestel is betreffende die bemagtiging van verpleegkundiges. Hulle beskou dit as deel van hulle bestuursfunksie. 'n Uitdaging waarmee die bestuurder van die toekoms te kampe sal he, is die van 'n omvattende begrip vir personeellede en om van beheer deur middel van streng burokratiese reels, af te sien. / Empowerment of nurses in health services in South Africa remains an ongoing issue, but the extent to which nursing management empowers nurses to act autonomously is not known. When nurses are empowered patient care and nursing services improve through enhanced productivity and job satisfaction. The way in which nurses could be empowered by management has yet to be addressed by researchers in South Africa. The aim of the present study was to identify those essential elements through which nurse managers can empower nurses. By making use of a descriptive exploratory study, utilizing a questionnaire to acquire the necessary information, the essential elements were isolated. Nurse managers in health services in the Gauteng region formed the target group. Definitions of empowerment in management were analyzed and from this a conceptual framework regarding empowerment was formulated. Six concepts served as the basis of this study: • the contribution of management structures, towards the empowerment of nurses; • the role of power-sharing in the empowerment of nurses; • participative decision making in the empowerment of nurses; • the management skills and responsibilities of the nurse manager in her daily task design and management that contribute to the empowerment of nurses; • motivation and reward strategies that contribute towards empowerment; • attributes which characterise an empowered nurse manager. From the analysis of. the data the following important elements among others emerged: • Decentralization of the distribution of power to the lowest possible level should take place in the health services; • The suggestions of nurses should be acknowledged and if found acceptable, to be implemented; • Authority should be delegated in such a way that independent decision making by nurses is enhanced; • Nurses' tasks should be designed in a way that promote independent performance in the work place. The findings of this study revealed that nurse managers are favourably disposed towards the empowerment of nurses. They see this as part of their managerial function. A challenge which confronts the manager of the future is that of comprehensively understanding staff members, and setting aside control through bureaucratic behaviour. / Health Studies / D. Litt. et Phil.