As an effect of increased living standards and improved health care, life expectancy has risen in many parts of the world. At the same time, welfare diseases such as diabetes and obesity increases. As the number of elderly and long-term sick rises, so will the medical care needs. E-health applications are often presented as a way to meet future medical and doing so within the scope of existing resources. By facilitating health communication and widen access to health services by offering them online, e-health applications encourages people to become more engaged in their own health, thus working proactively towards a healthier population. However, e-health applications often fail to reach their full potential. The purpose of this study is to explore how health care providers and health care recipients perceives e-health applications and their usefulness and thus being able to identify factors significant for successful introduction and use of e-health services. Two e-health applications have been analysed and six important aspects have been identified and discussed. In order to be successful, an e-health application must facilitate behaviour change and be integrated in the everyday life of the user. Substantial and adequate evaluation is essential to make sure that the application meet the requirements from both health care providers and health care recipients. An understanding of the possibilities technology has to offer is needed in order to fully exploit the potential of e-health applications in health care. Instructions for health care providers on how to use the applications are essential not only to ensure their proper usage but also to make sure that applications are being presented to recipients in a satisfactory way and that care providers can offer the support and help recipients may need. Finally, when discussing e-health applications it is important to remember that there are people who does not want to get involved and that there is still a demand for face-to-face interaction in health care. Therefore, e-health services must be complemented with alternatives providing different types of interaction opportunities.

This research, based on literature discussion related to issues on intraorganizational power, aims to discover the critical factors affecting the power of HR department within a firm and measure their causal relation as well as correlation through questionnaires. The questionnaires, being sent to any possible representative firms within each industry on our lists, were distributed in a convenient way. They mainly contain two sets of items, one for the HR department manager, another three for the line department manager. In the HR manager one, the questionnaires has 10 questions on HR departmental power index as dependent variable in our study; in the line manager one, it has 15, 5 and 5 questions on HR effectiveness, Top Management Support and HR Innovativeness respectively as independent variable. Based on our findings after statistical analysis, we conclude the followings: 1. As the HR effectiveness increases, the power of HR department does in the same. 2. As the Top Management Support increases, the power of HR department does in the same. 3. As the HR Innovativeness increases, the power of HR department does in the same.

Globally, there are great efforts made by organisations to improve effectiveness and systems to remain competitive in ever-changing business markets. Total quality management (TOM) has become a philosophy that most companies adopt once they reach a state where it would like to have a system where all efforts are made to satisfy customers or add value to customer experiences. An investigation was done at a South African chemical company to ascertain if important philosophies (continuous improvement, customer focus and winning with people) of TOM, which are found to be related to some of the company values, are taken seriously at all levels of the company. The company received a number of complaints from customers about the quality of service and goods supplied and it is of utmost importance to investigate if the concept of TOM is practiced effectively by this company since the implementation of the TOM programme. The study conducted has shown that the company understands the concept of quality and the impact of quality on customer satisfaction. TOM is useful when it is implemented at all levels in a company and was indeed found to be implemented on all company levels in this company. Management support, employee improvement, employee empowerment, process improvement, training and development, cleanliness and organisation, teamwork as well as customer focus are the TOM practices that were found to be highly rated within the company. Responses showed that management communication should be improved to ensure that everyone in the organisation is fully informed about all developments. From the results, it was concluded that the foundation of effective TOM is being practiced by the company except in a few minor cases and, therefore, more focus should be placed on those cases. / Thesis (M.B.A.)--North-West University, Vaal Triangle Campus, 2010

Globally, there are great efforts made by organisations to improve effectiveness and systems to remain competitive in ever-changing business markets. Total quality management (TOM) has become a philosophy that most companies adopt once they reach a state where it would like to have a system where all efforts are made to satisfy customers or add value to customer experiences. An investigation was done at a South African chemical company to ascertain if important philosophies (continuous improvement, customer focus and winning with people) of TOM, which are found to be related to some of the company values, are taken seriously at all levels of the company. The company received a number of complaints from customers about the quality of service and goods supplied and it is of utmost importance to investigate if the concept of TOM is practiced effectively by this company since the implementation of the TOM programme. The study conducted has shown that the company understands the concept of quality and the impact of quality on customer satisfaction. TOM is useful when it is implemented at all levels in a company and was indeed found to be implemented on all company levels in this company. Management support, employee improvement, employee empowerment, process improvement, training and development, cleanliness and organisation, teamwork as well as customer focus are the TOM practices that were found to be highly rated within the company. Responses showed that management communication should be improved to ensure that everyone in the organisation is fully informed about all developments. From the results, it was concluded that the foundation of effective TOM is being practiced by the company except in a few minor cases and, therefore, more focus should be placed on those cases. / Thesis (M.B.A.)--North-West University, Vaal Triangle Campus, 2010

Contexte : Les interventions cliniques pour les patients avec multimorbidité sont complexes et l'effet du statut socioéconomique sur ces interventions est limité. Nous avons analyser l'effet d'une intervention multidisciplinaire chez des patients avec multimorbidité et l'effet du statut socioéconomique (SSÉ) sur les résultats de l'intervention. Méthodologie : Analyse secondaire de données d'une intervention multidisciplinaire pragmatique randomisée-contrôlée de patients avec maladies chroniques. Patients recrutés dans 8 cliniques médicales de première ligne. Les patients avec trois maladies chroniques et plus ou leurs facteurs de risques ont été analysés. Issu primaire : changement substantiel dans un des huit domaines du Health Education Impact Questionnaire (heiQ). Le statut socioéconomique (SSÉ) des participants a été mesuré au début de l'intervention. Une collecte de données additionnelles a été faite pour mesurer l'autoappréciation de la situation financière des participants. Des régressions logistiques univariées et multivariées ont été utilisées. Résultats : 281 participants ont été analysés, avec une moyenne de 5,5 maladies chroniques. 13.5% avaient un revenu annuel de moins de 20,000$ et 51% avaient un diplôme d'études secondaires ou moins. En analyses univariées, l'intervention a amélioré le heiQ dans 6 domaines (RC : 1.96-2.91, p<0,05). En contrôlant pour le SSÉ, le OR de quatre domaines a augmenté incluant un domaine qui est devenu statistiquement significatif (Positive and active engagement in life). Conclusion : L'intervention a été efficace pour améliorer les résultats du heiQ chez des patients avec multimorbidité. Après avoir corrigé pour le SSÉ, quatre domaines se sont améliorés, suggérant que le SSÉ avait un effet négatif sur les résultats. / Abstract : Background : Successful interventions for patients with multimorbidity are complex and the known impact of the socioeconomic status (SES) on these interventions is limited. We analyzed the effect of a multidisciplinary intervention on patients with multimorbidity and the effect of the SES on the results of the intervention. Methods : Secondary data analysis of a pragmatic randomized controlled trial relating to a multidisciplinary intervention on patients with chronic diseases in 8 primary care practices in Quebec, Canada. Participants with three or more chronic conditions or risk factors were included in the analysis. Primary outcome: self-management improvement assessed by a substantial change in one of the eight domains of the Health Education Impact Questionnaire (heiQ). Socioeconomic Status (SES) of participants was measured at baseline. Self-perceived financial status was also collected. Univariate and multivariate logistic regression were used. Results : 281 participants were included in the analysis, with a mean 5.5 chronic conditions or risk factors. 13.5% had an annual income <20,000$ and 51% had an high school degree or less. In the univariate analysis, the intervention improved 6 domains of the heiQ (RC : 1.96-2.91, p<0,05). After controlling for SES, the OR of 4 domains improved, including a domain that became statistically significant (Positive and active engagement in life). Interpretation : The intervention was effective at improving self-management of patients with multimorbidity. After correction for SES, the OR of domains improved, suggesting the SES had a negative effect on the results.

Sammanfattning Att ha rätt kompetens ses som viktigt för organisationers omvärldsanpassning och konkurrenskraft. Stora summor läggs på kompetensutveckling där personalutbildning är en sätt att sprida kunskap. Men många organisationer lyckas inte med att producera ihållande och heltäckande överföring av kunskap eftersom det kan uppstå problem i att överföra lärandet från utbildningsmiljön till att faktiskt använda nya kunskaper i arbetsmiljön. Detta benämns transferproblemet. Forskningen visar att transfer påverkas av faktorer som härrör individens förmåga och motivation, utbildningens utformning och relevans, arbetsklimatet, samt stöd från ledningen och kollegor. Ledningen bör ta hänsyn till forskningen för att skapa förutsättningar för utbildningsdeltagaren att tillämpa ny kompetens, men trots detta verkar det som att organisationer har svårt att identifiera vilka faktorer som är mest kritiska för transfer. I centrum för denna studie står ledningspersoners upplevelser av hur de arbetar med att stödja och ta tillvara anställdas kompetens i samband med personalutbildning. För att få en förståelse för ledningspersonernas upplevelse av att arbeta med transfer genomfördes åtta semistrukturerade intervjuer med fyra verksamhetschefer, tre arbetsledare och en HR-medarbetare i en tandvårdsorganisation som måste möta många förändringar och har ett omfattande utbildningsprogram. Det insamlade materialet har sedan tematiserats och analyserats mot tidigare forskning om transfer och med hjälp av ett organisationspedagogiskt perspektiv. Det framträdande i resultatet var att cheferna anpassade stöd och resurser för transfer både till utbildningen och till individen. Ett proaktivt arbetssätt användes främst för att anpassa insatser för transfer till utbildningen genom att det i vissa utbildningar ingick efter-utbildnings-insatser, en efter-utbildnings-aktivitet på kliniken, samt att planera för att individen ska komma igång med nya arbetsuppgifter. Ett reaktivt förhållningssätt var dock vanligare för att kunna göra de individuella anpassningarna av insatserna. Cheferna var också mer benägna att ge stöd och resurser för transfer i samband med yrkesutbildning än vid relationsinriktad utbildning. Något som också var framträdande var den kollektiva kompetensens betydelse. Det ansågs viktigt att arbetsteamet och ibland hela gruppen på arbetsplatsen behövde kunskap inom det aktuella området för att bidra till den kollektiva kompetensen att utföra en uppgift och för att kunna stötta en utbildningsdeltagare. Något som också var utmärkande var det kollegiala stödets betydelse både på arbetsplatsen och i organisationen, samt hur organisationen och cheferna aktivt arbetar med att skapa interaktionsutrymme mellan olika medlemmar i organisationen för stöd och kunskapsutbyte. / Abstract Having the right skills is considered important for organizations' adaption to changes and competitiveness. Large sums are being spent on skills development, where staff training is a way of spreading knowledge. However, many organizations fail to produce sustained and comprehensive transfer of knowledge, as problems may arise in transferring learning from the educational environment to actually using new skills in the work environment. This is called the transfer problem. Research shows that transfer is influenced by factors that derived from the individual's ability and motivation, the design and relevance of the staff training, work environment, and support from management and colleagues. Management should take into account the research to create the conditions for the training participant to apply new skills, but despite this, organizations seem to have difficulties identifying which factors are the most critical of transfer. At the heart of this study, management's experience is how they work to support and utilize employee skills in staff training. In order to gain understanding of executives' experience of working with transfer, eight semi- structured interviews were conducted with four business executives, three supervisors and a HR employee in a dental organization that has to face many changes and has a comprehensive education program. The collected material has since been thematized and analyzed against previous research on transfer, using an organizational pedagogical perspective. The prominent outcome was that the managers had adapted support and resources for transfer both to the education and to the individual. A proactive approach was used primarily to adapt efforts for transfer to education through the inclusion of post-education activities, post-training activities in the clinic, and planning for the individual to get started with new tasks. However, a reactive approach was more common in order to make individual adjustments of the efforts. The managers were also more likely to provide support and resources for transfers in vocational education than in relational education. Something that was also prominent was the importance of collective competence. It was considered important that the work team and sometimes the entire group at the workplace needed knowledge in the field in question to contribute to the collective competence to perform a task and to support a training participant. Something that was also significant was the importance of collegial support both in the workplace and in the organization, as well as how the organization and managers actively work to create interaction space between different members of the organization for support and knowledge sharing.

Bakgrund: Antalet patienter med kroniska sjukdomar ökar i världen, vilket ställer krav på sjuksköterskans stödjande roll i form av patientundervisning. Sjuksköterskan kan vägleda patienten till ett hälsosamt samt reflektivt förhållningssätt som ger utrymme för dennes lärande och egenvård. En del av egenvård är att hitta en vardag som bringar känsla av kontroll och hälsa. Syfte: Belysa sjuksköterskors erfarenheter av patientundervisning vid kroniska sjukdomar. Metod: En litteraturöversikt över vetenskapliga artiklar. Resultat: Resultatet visar att förståelse och att se patientens livsvärld upplevs som betydelsefullt. Stöd och vägledning möjliggör både en god hälsa samt egenvårdsförmåga. Faktorer som begränsar eller försvårar patientundervisningen kan vara bristande följsamhet, patientens ekonomiska situation, anhöriga samt tidsbrist i arbetet. Konklusion: Patientundervisning för att stärka patientens egenvårdsförmåga visar sig vara ett omfattande område. Sjuksköterskor belyser flera aspekter i patientundervisningen som bidrar till en god egenvårdsförmåga hos patienten. En personcentrerad vård skapar ett samarbete mellan sjuksköterska och patient där fokus ligger på gemensamma mål och förståelse för patientens livsvärld. Sjuksköterskan behöver i arbetet med patientundervisning vara medveten om eventuella barriärer som kan förekomma där ett lösningsorienterat och inlyssnande arbetssätt måste beaktas. / Background: The number of patients with chronic diseases is increasing worldwide, which increases the demand for the nurse's supportive role in the form of patient education. The nurse can guide the patient to a healthy and reflective approach that provides space for the patient's learning and self-management. A part of self-care is to find an everyday life that brings a sense of control and health. Aim: Explore nurse’s experience of patient education in case of chronic disease. Method: The study is a literature review of scientific articles. Findings: The results show that understanding and seeing the patient's world as important. Support and guidance enable good health and self-management ability. Factors that limit or complicate patient education can be lack of compliance, the patient's financial situation, relatives and lack of time at work. Conclusion: Patient education to strengthen the patient's self-management ability turns out to be an extensive area. Nurses highlight several aspects that help the patient's self-management. A person-centered care creates a collaboration between nurse and patient where the focus is on common goal and understanding of the patient's world. Nurse’s need to be aware of barriers, where a solution-oriented and listening approach must be considered.

The phenomenal feminisation of the South African labour force since the first democratic elections in 1994 is a result of the new democratic government’s efforts to transform South African society into a just, non-discriminatory and non-sexist society. This has, however, heightened several serious psychosocial problems facing working women, especially single working mothers, as they struggle to balance work and home responsibilities. The study was undertaken, firstly, to develop a valid and reliable measuring instrument to survey the problems and pressures experienced by single mothers in management and professional occupations in South Africa and, secondly, to obtain data on single working mothers’ perceptions about the resources they believe would assist them to mitigate the negative effects of the work-home conflict. To achieve these objectives, an exploratory, sequential, mixed method design was employed within a feminist perspective: First, based on the information obtained from theoretical and empirical data about the problems and perceived support of working mothers, semistructured interviews were held with 17 women in management and professional occupations (ten women in dual-career families and seven single working mothers). Then, on the basis of the interviews, a questionnaire was developed that was piloted among 30 experts and developed according to Lawshe’s principles. This questionnaire was called the Work-Family Pressure and Support Questionnaire (W-FPSQ). It was used in conjunction with the Overall Stress Index (OSI) and the Coping Behaviour Index (CBI) to determine the relationship and effect of supportive resources and coping behaviour on the work-family pressure and stress experienced by a purposive convenience sample of 104 single and 101 dual-career mothers (n=205). For the purposes of this study, descriptive, comparative, associational and inferential statistics were used to analyse the data, using SPSS for Windows, Release 17. Exploratory factor analysis (EFA), with varimax rotation, was employed to explore the internal structure and validity of the W-FPSQ, the OSI, and the CBI. The reliability of the questionnaires was determined by calculating Cronbach’s alpha coefficient for each scale of the measures. The results indicated that the three questionnaires were sufficiently reliable and valid to capture the present sample of working mothers’ experience of work-family pressures and stress and to discover the resources they perceived as supporting them in coping with work and family demands. The comparison of the 104 single working mothers with the 101 married working mothers showed that the single mothers’ mean rank scores were significantly lower than those of their married counterparts on the five support scales and on the coping behaviour scale, and significantly higher on the workfamily pressure and stress scales. The computed logistic regression model indicated that management support, organisational flexibility, time for family interaction, work-family pressure and stress were a set of variables that distinguished reliably between the single and married mothers in the sample. The study has clearly confirmed Gill and Davidson’s (2001:397) proposition that single working mothers are a ‘distinct group facing unique problems and pressures, and deserve to be recognized as such’. The problems they face as captured in this study demand a multi-pronged approach requiring organisations to provide management support, opportunities for personal growth and career development, work flexibility, time for family interaction and childcare facilities. These resources and a work-family-friendly environment will improve their work attitudes, job performance and well-being. Considering the proportion of single mothers in the society and the impact of their status on their children’s development, the issue of single working mothers and their needs deserves urgent attention. / Thesis (PhD)--University of Pretoria, 2010. / Human Resource Management / unrestricted

Die Krise der Hochschulen scheint seit den frühen 90er Jahren nicht mehr abzureißen. Die angestrebte Strukturreform, die Gesetzesänderungen im Hochschulrahmengesetz und die in der Öffentlichkeit diskutierten Reformansätze machen das sehr deutlich. In dieser Arbeit werden bereits erkannte kritische Erfolgsfaktoren der universitären Anpassung an die Umweltbedingungen aufgegriffen und ausgehend von der gegenwärtigen Situation der Hochschulen ein Ansatz zur Unterstützung der Reformbemühungen vorgeschlagen. Dazu werden Konzepte zur Strukturierung von Handlungsebenen an Universitäten und deren Versorgung mit Entscheidungsrelevanten Informationen mittels adäquater Informations- und Kommunikationstechnologien in Form eines Management-Support-Systems (MSS) vorgestellt. Insbesondere wird die Konzeption eines Online-Lehrevaluationsinstrumentes für die Universität Osnabrück als Teilsystem eines Hochschul-MSS bearbeitet und die Eingliederung des Systems in die IT-Infrastruktur der Hochschule verdeutlicht. Die Erweiterung des Typenspektrums des MSS durch die mittels der Evaluation gewonnenen qualitativen Daten, deren Integration in die MSS-Datenbasis, die Funktionsweise des Evaluationsinstrumentes und der verbundenen Komponenten wird anhand einer prototypischen Implementierung erläutert. Abschließend wird ein Ausblick auf Erweiterungsmöglichkeiten gegeben, die Nutzenpotentiale der vorgeschlagenen technisch-organisatorischen Infrastruktur identifiziert und kritische Erfolgsfaktoren bei deren Einführung respektive Übertragung auf andere Bereiche der Hochschule betrachtet.

Dem Management stehen heute zur Problemlösung häufig mehrere unterschiedliche Management Support Systeme (MSS) zur Verfügung. Je MSS-Werkzeug wird ein breites Spektrum an Funktionen angeboten. Da die Problemlösung zumeist den kombinierten Einsatz unterschiedlicher MSS-Werkzeuge und -Funktionen erfordert, stellt der Umgang mit diesen Systemen immer höhere Anforderungen an das Management. Die von den MSS-Werkzeugen bereitgestellten Online-Hilfen bieten nur für die Anwendung einzelner Funktionen eine Unterstützung. Direkte, auf die konkrete Problemsituation/den (konkreten) Problemlösungsprozess bezogene Hilfen fehlen jedoch bisher.Ziel dieser Arbeit war es ein Konzept einer MSS-Assistenz zu entwickeln, bei der die Anwender für den gesamten Problemlösungsprozess eine Unterstützung erhalten. Als Lösungsansatz für die Implementierung der einzelnen Assistenzfunktionen wurde das Agentenparadigma eingesetzt, mit dem Nebenziel, die Anwendbarkeit der agentenbasierten Konzepte zu untersuchen.Im ersten Teil der Arbeit wird auf die Definitionen und Funktionsumfänge von MSS eingegangen, sowie die Universität Osnabrück als Untersuchungsobjekt für den MSS-Einsatz eingeführt. Anhand eines universitären Beispiel-Szenarios werden der potenzielle Assistenzbedarf von MSS bestimmt und die Charakteristika für eine MSS-Assistenz ermittelt.Im zweiten Teil der Arbeit wird auf die Gestaltungspotenziale des agentenbasierten Paradigmas eingegangen. Es wird ein Gesamtkonzept der agentenbasierten MSS-Assistenz entwickelt, bestehend aus den Agenten Assistant Agent, Vermittlungsagent, den Funktionsagenten und der MSS-Metadatenbasis. Deren Aufbau und Funktionsumfang werden dokumentiert und deren Zusammenspiel anhand eines Anwendungsszenarios erläutert.Im dritten Teil der Arbeit werden die einzelnen Architekturkomponenten des agentenbasierten Prototyps beschrieben. Zusätzlich werden die Einsatzmöglichkeiten des implementierten MSS-Assistenzsystems anhand dreier Anwendungsfälle aufgezeigt und bewertet.