Title: Perceptions of Central Gauteng occupational health nurses of their traditional and expanded roles Background: The majority of the published literature alludes to the evolution of the occupational health nursing practitioner (OHNP) role from a traditional to an expanded role yet there are comparatively few notable studies that have attempted to explore the significance that OHNPs place on both these roles, the extent to which they enact these roles in the workplace and the amount of time they dedicate to these roles. Purpose: The overall purpose of the research was to investigate the perceptions that OHNPs have of their traditional and expanded roles in their current occupational health nursing (OHN) practice. Methodology: Using a survey method, occupational health nursing practitioners (n = 150 ) who practiced and are members of a professional society of occupational health practitioners in the Central Gauteng district were invited to complete a self-administered, structured questionnaire about their perceptions of their traditional and expanded roles. The questionnaire composed of 27 specific task items that reflect OHN practice role activities divided into eight major areas of OHN practice. The items were measured on a 5-point Likert scale ranging from 1 (not significant) to 5 (extremely significant) and participants were also required to estimate in hours, in any given week, the time they believed they dedicated o each of the eight major areas. Main outcome measures: The main outcome measures of the research were perceptions of the OHNPs of their traditional and expanded roles and the time devoted to these roles in their current practice. Findings: A total of 102 questionnaires were completed, yielding a response rate of 68%. The majority of the OHNPs generally regarded their traditional and expanded roles as moderately significant indicating that the roles were at least performed to some extent in their practice. Nevertheless, OHNPs regarded the roles in the traditional domain highly (mean rating = 3.29) than those in the expanded domain (mean = 2.84). Managing an occupational health service (mean= 3.60) and assessment of workers health (mean = 3.61) activities received the highest rankings whereas research-related activities had the lowest (mean = 2.39). On average OHNPs spend 35 hours per week in OHN practice of which 39.7% is spent in management of occupational health services, 33.1% in worker health assessments, 27.1% in rendering curative services, 16% in health promotion activities, 14% in health education activities, 14% in rehabilitation services, 12% in workplace assessments and 9.7% in research-related activities. The perception of the significance of core areas appeared to be mainly dependent on availability of occupational health and safety personnel and the OHNPs job title. Also comparisons made between perception of roles and time devoted to those roles revealed that there were gaps between what they perceived as significant and amount of time dedicated to roles. Conclusions: OHNPs regard both traditional and expanded roles as moderately significant in their current practice. However gaps existed between perception of individual roles and amount of time spent in those roles. In this instance data revealed higher perception of expanded roles yet time devoted to these roles was less than that devoted to traditional roles where the perception of the roles were relatively lower. Implications for OHN practice: Knowledge of what entails significant practice from the OHNPs’ perspective is a good needs assessment technique as it indicates where training and continuing education should be targeted. Also, acknowledgement of the gap that exists between perception of a role and the actual time spent in that role indicates where strategies to reduce role ambiguity, role conflict and resulting occupational stress have to be directed. Key words: occupational health nursing, nurses’ perceptions, role, Role Theory, traditional and expanded role, self-administered questionnaire

No

A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the degree of Master of Science in Nursing Johannesburg, 2014 / Background: Job satisfaction is one determinant of employees’ health and an important component in the retention of employees. It is evident from literature that job satisfaction is a factor in the retention of nurses and the prevention of a high turnover. Literature also revealed that job satisfaction is seen as an important component that can have an impact on several areas such as patient safety, quality care and performance as well as commitment to the organisation and dedication to the profession. However, limited literature is available on job satisfaction of occupational health nursing practitioners internationally or nationally. Purpose: The overall purpose of this study is to determine the factors which contribute to the levels of job satisfaction and dissatisfaction among occupational health nursing practitioners working for a private occupational health service provider in South Africa. Methodology: A cross sectional survey design, using a structured self-administered questionnaire with close-ended questions and items relating to demographic date, professional status, doctor-nurse relationships, administration, autonomy, task requirements and interaction, was used in this research. Data was collected in this research by means of a structured questionnaire namely, the Index of Work Satisfaction, part B (IWS-Part B), developed by Stamps to measure American hospital based nurses level of job satisfaction.A total sample of 183 participants, all occupational health-nursing practitioners employed by the private occupational health service provider in three regions, was used, namely Gauteng, Mpumalanga and Pretoria Northern region Data Analysis: Data analysis was done through descriptive statistics using statistical assistance from a statistician from the University of the Witwatersrand Postgraduate Research Support Services. Setting: The setting for this study was in three regions namely Mpumalanga, Pretoria North and Gauteng, in which the private occupational health service provider operates. Findings: A total of a 180 questionnaires were completed and analysed, yielding a response rate of 97%. The findings relating to age distribution revealed that majority response presented an age group of 63% (n=114) between 30 and 49 years and predominantly female 88%, (n=159). The majority of the nurses, (78.3%: n=141) had one to four years occupational health nursing experience; 74.5% (n=134) of the participants were in possession of a general nursing qualification and 78.3% (n=41) had an additional diploma in occupational health nursing. The findings revealed that nurses who held a diploma in occupational health nursing were more likely to have a higher level of work satisfaction than nurses with a general diploma in nursing. The level of work satisfaction was higher for nurses holding a degree in occupational health nursing than either the diploma or certificate in occupational health nursing. The level of work satisfaction was higher for nurses who held a Master’s degree than a degree, diploma or certificate in occupational health nursing. The second part of the research instrument intended to attain the level of job satisfaction. The questionnaire consisted of forty items divided into six main components. The findings are reflected based on the majority responses from the different categories. vi Remuneration was found to be a major area of dissatisfaction as 72% (n=130) of the participants indicated being less satisfied with remuneration and 89% (n=160) agreed a remuneration upgrade was required. Based on the overall findings, it was apparent the participants were more dissatisfied with their remuneration. Professional status revealed 86% (155) of the participants were proud of their work and 88% (n=159) considered the profession to be important. From the general findings on professional status it was obvious OHN’s have a strong satisfied view with their professional status. The findings related to nurse-doctor relationship indicated occupational health nurses are more likely to be satisfied than dissatisfied with their doctor/nurse relations as validated by the response of 76% (n=136), who agreed occupational health doctors understand and appreciate OHNs and 70% (n=127) agreed that in general, the doctors cooperate with the nursing staff. Another section which indicated more dissatisfaction than satisfaction, was on administrative work as 87% (n=157) of nurses agreed there was too much administrative work required from them. The component on autonomy indicated the majority of nurses (74%; n=133) agreed that a great deal of independence was permitted, if not required of them, as well as 70% (n=125) agreeing to having freedom at work to make important decisions. The final element of the questionnaire on task interaction and relationships reflected that 82% (n=148) agreed that nurses in their specialty help one another when things are uncertain and 72% (n=128) agreed they were satisfied with the different types of work activities. Based on the findings, it was evident that the OHNPs appeared to be more satisfied that dissatisfied with their task interaction and relationships. Conclusion: The ideal work environment consists of staff satisfaction and continuity. Evident from literature, job satisfaction plays an important role in the preservation of workforce numbers, as well as a reduction in staff turn-over. This paper revealed that overall there are more areas of job satisfaction in comparison to job dissatisfaction. The findings of the present study increases the understanding of what contributes to satisfaction of occupational health nursing practitioners. Aspects such as nurse-doctor relationships, task interaction and relationships, professional status and autonomy contributed to OHN job satisfaction levels, whereas remuneration and administrative work created more job dissatisfaction. Recommendations: It is the aspiration of the researcher that this study of job satisfaction levels of OHNP’s contributes to a frame of information and that the data will create awareness of what contributes to the satisfaction and dissatisfaction levels within the profession of an occupational health nurse in South Africa. Within this study the researchers was able to present recommendation relating to nursing practice, management education as well as further research. It is the researcher’s opinion that the information on job satisfaction of nursing staff must be disseminated to interested parties throughout the field of occupational health. Key words: Job satisfaction, occupational health nurses, occupational health service provider, South-Africa

Thesis (M.S.)--University of Michigan, 2000. / Includes bibliographical references.

Thesis (M.S.)--University of Michigan, 2000. / Includes bibliographical references.

O atual Curr(culo M(nimo do Curso de Especialização para Enfermeiros do Trabalho - CEET, está em vigor desde 1978, sendo seu conteúdo estabelecido pela Fundação Jorge Duprat Figueiredo de Segurança e Medicina do Trabalho - FUNDACENTRO. Desde essa época o currículo não foi alterado e se acumulam nos CEETs as insatisfações e preocupações quanto a real adequação da formação às necessidades da prática profissional e da assistência à saúde dos trabalhadores. Diante disso, decidiu-se desenvolver uma pesquisa com a finalidade de avaliar o currículo vigente e de propor alterações curriculares. Esta pesquisa foi realizada entre as categorias diretamente envolvidas no ensino e na assistência de enfermagem do trabalho, a saber: coordenadores, professores e alunos de tris CEETs do Brasil, e enfermeiros do trabalho do Estado de São Paulo no ano de 1984. Os objetivos desta pesquisa foram: - verificar o ajuizamento e sugestões das categorias supra referidas, sobre o CEET, tomando por base o Currículo Mínimo estabelecido pela FUNDACENTRO para esse Curso, avaliando-o nos aspectos relativos a: filosofia e objetivos, organização curricular, processo ensino-aprendizagem e organização administrativa; - elaborar uma proposta de reestruturação curricular para o CEET, com base na análise crítica dos dados coletados. A coleta de dados se desenvolveu por meio de questionários, onde os participantes expressaram o ajuizamento e sugestões de modificações do currículo em questão. A análise crítica desses dados foi fundamentada em experiências curriculares que estão sendo desenvolvidas em outros países, e na experiência pessoal da autora no desenvolvimento de currículos para diferentes níveis de ensino de enfermagem. Os resultados obtidos demonstraram que inexistem no currículo do CEET, a adoção explícita de uma linha filosófica norteadora, e a definição de objetivos para o Curso, sendo tais aspectos considerados necessários por todas as categorias pesquisadas. No que diz respeito a organizaçio curricular, ficou evidenciada a inadequaçio do elenco de disciplinas que compõem o currículo. A carga horária foi considerada insuficiente, e mal distribuída em termos teórico-práticos. O conteúdo curricular foi considerado repetitivo em algumas disciplinas e com falhas em outras; o estágio prático previsto, apresentou-se qualitativa e quantitativamente insuficiente. Foram propostas pelos participantes, diversas alterações nessa organizaçio curricular. Com relação ao processo ensino-aprendizagem, ficou demonstrado que: não existe qualquer definição do modo de condução desse processo nos cursos pesquisados: os métodos de ensino e avaliação adotados nem sempre facilitaram ou avaliaram totalmente a aprendizagem dos alunos; os enfermeiros de campo julgaram que os cursos frequentados supriram parcialmente as necessidades requeridas na prática profissional, sendo que muitos consideraram insuficiente o ensino prático que tiveram em seus cursos. Quanto à organização administrativa dos CEETs, sentiu-se necessidade de se estabelecer requisitos prévios para matrícula dos alunos; a maioria dos pesquisados aponta o profissional enfermeiro do trabalho como aquele que deve assumir a coordenação do CEET, devendo ele ter experiência na área de administração de ensino e prática de campo na área de enfermagem do trabalho. Frente a estes resultados, sentiu-se então necessidade de uma ampla e profunda reestruturação curricular, sendo elaborada uma nova proposta curricular para o CEET. Essa proposta foi sub-dividida em: marco conceitual, onde foram definidas as linhas norteadoras do currículo; marco metodológico, em que se assentaram as diretrizes condutoras do processo ensino-aprendizagem; marco estrutural, onde foram estabelecidas as áreas de ensino, bem como o elenco e o conteúdo das disciplinas e a distribuição horária teórico-prática. Antes da implantação desta proposta curricular, ela deverá ser validada pelas categorias diretamente envolvidas no ensino e na assistência de enfermagem do trabalho, e ao mesmo tempo, os professores e coordenadores dos CEETs deverão ter acesso a cursos específicos que os capacitem a conduzir o trabalho dentro da nova filosofia curricular. / In 1978 a curriculum for the Specialization Course on Occupational Health for Nurses was established by FUNDACENTRO - Fundaço Jorge Duprat Figueiredo de Segurança e Medicina do Trabalho and has not been changed since then. Throughout the years, it became clear that the present curriculum does not cover adequately all aspects of protection of worker\'s health and, therefore, it was thought advisable to carry out a research aimimg the evaluation of the present curriculuru and its eventual changes. To carry out such research, a questionnaire was answered by all categories of people directly involved with the ministration of such courses: coordinators, teachers and students of three Brazil ian CEET; besides, occupational health nurses of the state of São Paulo also answered a questionnaire. The main objectives of this studw were to verify how the present curriculum was judged by the people involved from the point of view of its: philosophy and objectives; curricular organization; teaching-learning process and administrative organization. The final objective was to propose a curricular restructuration of the courses based on the critical analysis of the points above outlined. Data collection was dane through the use of special questionnaires, different for each group of people, who expressed their opinion on the present curriculum and presented suggestions as to its modification. On the basis of similar courses existing in developed countries, and also on the basis of the author´s experience, an analysis was carried out and it was possible to demonstrated that presently inexists either a philosophic guideline or a definition of objectives, these two points being considerer as essential by all categories of people who participated of this study. Concerning the curricular organization, it became evident the inadequacy of the curricular contents of each discipline which composes the whole curriculum. The number of hours of teaching was considered as insufficient and not well distributed among theoretical and practical teaching. The curricular content was considered repetitive in some disciplines and insufficient in others. In the whole, it was considered that the curriculum is not adequate both in quantity and in quality and several changes were proposed. As to the teaching-learning process, it was evident that there is no definition regarding the way of conducting it. The adopted teaching techniques and methods of evaluation of the students\' learning results, were not considered as satisfactory. The already practicing occupational health nurses informed that the courses attended have only partially supplied the needed knowledge needed for professional practice and many others considered as insufficient the practical learning they had in their courses. Concerning the administrative organization of the courses, it was considered as very important to establish previous requirements for the selection of students. The majority of the people consulted considered that the courses\' coordinators must be occupational health nurses having a good experience in the field of teaching administration and also a very good practice in the occupational health nursing field. Due to these results, it was felt that there is an urgent need of a wide and deep curricular re-structuration and, a new curriculum for the courses is proposed. The proposed curriculum was sub-divided in conceptual framework, in which the curriculum guidelines were defined; methodological framework, in which were founded the directives te conduct the teaching-learning process; structural framework, where were established the areas of teaching, as well as the set and content of disciplines, and the theoretical-practical classes distribution. Before this curricular proposal is implemented, it shall be validated by the categories directly involved with occupational health nursing teaching and assistance, and, at the same time, the teachers and coordinators of the CEET\'s shall have access to specific courses with capacitale them to conduct the work within the new curricular philosophy.

O atual Curr(culo M(nimo do Curso de Especialização para Enfermeiros do Trabalho - CEET, está em vigor desde 1978, sendo seu conteúdo estabelecido pela Fundação Jorge Duprat Figueiredo de Segurança e Medicina do Trabalho - FUNDACENTRO. Desde essa época o currículo não foi alterado e se acumulam nos CEETs as insatisfações e preocupações quanto a real adequação da formação às necessidades da prática profissional e da assistência à saúde dos trabalhadores. Diante disso, decidiu-se desenvolver uma pesquisa com a finalidade de avaliar o currículo vigente e de propor alterações curriculares. Esta pesquisa foi realizada entre as categorias diretamente envolvidas no ensino e na assistência de enfermagem do trabalho, a saber: coordenadores, professores e alunos de tris CEETs do Brasil, e enfermeiros do trabalho do Estado de São Paulo no ano de 1984. Os objetivos desta pesquisa foram: - verificar o ajuizamento e sugestões das categorias supra referidas, sobre o CEET, tomando por base o Currículo Mínimo estabelecido pela FUNDACENTRO para esse Curso, avaliando-o nos aspectos relativos a: filosofia e objetivos, organização curricular, processo ensino-aprendizagem e organização administrativa; - elaborar uma proposta de reestruturação curricular para o CEET, com base na análise crítica dos dados coletados. A coleta de dados se desenvolveu por meio de questionários, onde os participantes expressaram o ajuizamento e sugestões de modificações do currículo em questão. A análise crítica desses dados foi fundamentada em experiências curriculares que estão sendo desenvolvidas em outros países, e na experiência pessoal da autora no desenvolvimento de currículos para diferentes níveis de ensino de enfermagem. Os resultados obtidos demonstraram que inexistem no currículo do CEET, a adoção explícita de uma linha filosófica norteadora, e a definição de objetivos para o Curso, sendo tais aspectos considerados necessários por todas as categorias pesquisadas. No que diz respeito a organizaçio curricular, ficou evidenciada a inadequaçio do elenco de disciplinas que compõem o currículo. A carga horária foi considerada insuficiente, e mal distribuída em termos teórico-práticos. O conteúdo curricular foi considerado repetitivo em algumas disciplinas e com falhas em outras; o estágio prático previsto, apresentou-se qualitativa e quantitativamente insuficiente. Foram propostas pelos participantes, diversas alterações nessa organizaçio curricular. Com relação ao processo ensino-aprendizagem, ficou demonstrado que: não existe qualquer definição do modo de condução desse processo nos cursos pesquisados: os métodos de ensino e avaliação adotados nem sempre facilitaram ou avaliaram totalmente a aprendizagem dos alunos; os enfermeiros de campo julgaram que os cursos frequentados supriram parcialmente as necessidades requeridas na prática profissional, sendo que muitos consideraram insuficiente o ensino prático que tiveram em seus cursos. Quanto à organização administrativa dos CEETs, sentiu-se necessidade de se estabelecer requisitos prévios para matrícula dos alunos; a maioria dos pesquisados aponta o profissional enfermeiro do trabalho como aquele que deve assumir a coordenação do CEET, devendo ele ter experiência na área de administração de ensino e prática de campo na área de enfermagem do trabalho. Frente a estes resultados, sentiu-se então necessidade de uma ampla e profunda reestruturação curricular, sendo elaborada uma nova proposta curricular para o CEET. Essa proposta foi sub-dividida em: marco conceitual, onde foram definidas as linhas norteadoras do currículo; marco metodológico, em que se assentaram as diretrizes condutoras do processo ensino-aprendizagem; marco estrutural, onde foram estabelecidas as áreas de ensino, bem como o elenco e o conteúdo das disciplinas e a distribuição horária teórico-prática. Antes da implantação desta proposta curricular, ela deverá ser validada pelas categorias diretamente envolvidas no ensino e na assistência de enfermagem do trabalho, e ao mesmo tempo, os professores e coordenadores dos CEETs deverão ter acesso a cursos específicos que os capacitem a conduzir o trabalho dentro da nova filosofia curricular. / In 1978 a curriculum for the Specialization Course on Occupational Health for Nurses was established by FUNDACENTRO - Fundaço Jorge Duprat Figueiredo de Segurança e Medicina do Trabalho and has not been changed since then. Throughout the years, it became clear that the present curriculum does not cover adequately all aspects of protection of worker\'s health and, therefore, it was thought advisable to carry out a research aimimg the evaluation of the present curriculuru and its eventual changes. To carry out such research, a questionnaire was answered by all categories of people directly involved with the ministration of such courses: coordinators, teachers and students of three Brazil ian CEET; besides, occupational health nurses of the state of São Paulo also answered a questionnaire. The main objectives of this studw were to verify how the present curriculum was judged by the people involved from the point of view of its: philosophy and objectives; curricular organization; teaching-learning process and administrative organization. The final objective was to propose a curricular restructuration of the courses based on the critical analysis of the points above outlined. Data collection was dane through the use of special questionnaires, different for each group of people, who expressed their opinion on the present curriculum and presented suggestions as to its modification. On the basis of similar courses existing in developed countries, and also on the basis of the author´s experience, an analysis was carried out and it was possible to demonstrated that presently inexists either a philosophic guideline or a definition of objectives, these two points being considerer as essential by all categories of people who participated of this study. Concerning the curricular organization, it became evident the inadequacy of the curricular contents of each discipline which composes the whole curriculum. The number of hours of teaching was considered as insufficient and not well distributed among theoretical and practical teaching. The curricular content was considered repetitive in some disciplines and insufficient in others. In the whole, it was considered that the curriculum is not adequate both in quantity and in quality and several changes were proposed. As to the teaching-learning process, it was evident that there is no definition regarding the way of conducting it. The adopted teaching techniques and methods of evaluation of the students\' learning results, were not considered as satisfactory. The already practicing occupational health nurses informed that the courses attended have only partially supplied the needed knowledge needed for professional practice and many others considered as insufficient the practical learning they had in their courses. Concerning the administrative organization of the courses, it was considered as very important to establish previous requirements for the selection of students. The majority of the people consulted considered that the courses\' coordinators must be occupational health nurses having a good experience in the field of teaching administration and also a very good practice in the occupational health nursing field. Due to these results, it was felt that there is an urgent need of a wide and deep curricular re-structuration and, a new curriculum for the courses is proposed. The proposed curriculum was sub-divided in conceptual framework, in which the curriculum guidelines were defined; methodological framework, in which were founded the directives te conduct the teaching-learning process; structural framework, where were established the areas of teaching, as well as the set and content of disciplines, and the theoretical-practical classes distribution. Before this curricular proposal is implemented, it shall be validated by the categories directly involved with occupational health nursing teaching and assistance, and, at the same time, the teachers and coordinators of the CEET\'s shall have access to specific courses with capacitale them to conduct the work within the new curricular philosophy.

Thesis (M.S.)--University of Michigan, 1992.

Thesis (M.S.)--University of Wisconsin, School of Nursing. / eContent provider-neutral record in process. Description based on print version record.

Thesis (M.S.)--University of Michigan, 1992.