Thesis (MBA (Business Management))--University of Stellenbosch, 1999. / ENGLISH ABSTRACT: As part of South Africa's transformation, legislative changes have been introduced to support the Constitutional rights of the people, including the right of access to health care. In restructuring the health services, the redistribution of resources between the private and public sector is addressed through a long-term vision which includes a Social Health Insurance scheme. The focus has been shifted to primary health and prevention, with community based services at the centre. Various Acts and regulations have been introduced to give substance to the transformation, including the Acts affecting medical schemes and the pharmaceutical services, labour legislation, education and training. The Bargaining Councils and Occupational health services have been extended to include primary health care, and in many cases this is extended to the dependents of the workers, bringing them into the ambit of the private sector. The proposed redistribution of resources into the public sector has placed the low-wage earner at risk as the cost of private health care increases. The legislation controlling medical schemes and pharmaceutical services are a threat to the viability of the Health Care Funds, particularly in the short-term until the Social Health Insurance has been established. The restrictions placed on dispensing and the measures which are intended to make drugs more affordable also provide a challenge to the low-cost medical funds. The relevant legislation is being subjected to judicial challenges, and the replacement legislation promulgated prematurely, resulting in confusion and uncertainty. It is within this context that the Funds must prepare for the changes ahead. A management consulting case study is presented using the Clothing Industry Bargaining Council of the Western Cape with the Clothing Industry Health Care Fund which provides comprehensive primary health services in Fund owned clinics, factories and through panel doctors. Because of the complexity of the organisation and the issues surrounding the implementation of changes to the pharmaceutical services, Yolles' viable approach to management systems has been used as a framework for the consultancy intervention. This is a newly published approach grounded in chaos theory, which directs the nature of inquiry according to form and the behaviour of the situation, aiming to maintain viability and adaptability. This case study examines the impact of the legislative changes on the health services which are accessed through the workplace, and tests the applicability of the viable approach to management systems. / AFRIKAANSE OPSOMMING: As deel van Suid-Afrika se transformasie is veranderings aangebring aan die wetgewing om die Konstitusionele regte van die mense te ondersteun, insluitend die reg van toegang tot gesondheidsorg. Met die herstrukturering van die gesondheidsdienste, word die verdeling van bronne tussen die privaat en publieke sektor aangespreek deur middel van 'n lang-tenmyn visie wat 'n gemeenskapsgesondheidsversekering insluit. Die lokus het herskuil na primêre gesondheid en voorkoming, met gemeenskapsdienste as sentrum. Verskeie wette en regulasies is voorgestel om as kern van die verandering te dien, insluitende wette wat die mediese skemas en farmaseutiese dienste, asook die werknemer, opleiding en opvoeding beinvloed. Die gesondheidsdienste van die Onderhandelingsrade en die Beroepsgesondheiddienste is uitgebrei om primêre sorg in te sluit. Dit sal ook die afhanklikes van die werkers dek en hulle sodoende binne die privaatsektor betrek. Die voorgestelde herverdeling van bronne in die publieke sekdor veroorsaak dat daar 'n risiko is vir die werker met 'n lae inkomste as gevolg van die stygende koste van gesondheidsorg. Die wetgewing wat mediese skemas en farmaseutiese dienste beheer veroorsaak ook dat die Siekefonds se lewensvatbaarheid bedreig word, veral in die korttenmyn tot tyd en wyl die gemeenskapsgesondheidsversekering gestig word. Die beperkings wat op reseptering geplaas word en die metodes wat beplan word om medisyne meer bekostigbaar te maak, veroorsaak ook 'n uitdaging vir die inkomste mediese fondse. Die relevante wetgewing word tans in die hof betwis, en die plaasvervangende wetgewing is voortydig gepromulgeer, wat verwarring en onsekerheid veroorsaak. Die siekefondse moet hulle binne die konteks voorberei vir die veranderinge wat voorlê. 'n Bestuurskonsultasie gevallestudie is voorgelê, met die hulp van die Klerasienywerheid Gesondheidsorgfonds (Weskaap), wie se siekefonds omvattende primêre gesondheidsdienste lewer binne klinieke, fabrieke en deur gemeenskapsgeneeskundiges. Omdat die organisasie en die omstandighede rondom die veranderings aan die farmaseutiese dienste kompleks is, word Yolles se lewensvatbare benadering (viable approach) as 'n raamwerk gebruik vir die konsultasie. Die model is nuut gepubliseer, en is gebaseer op chaos teorie, wat rigting gee aan die aard van die ondersoek volgens die vorm en die gedrag wat die situasie aanneem. Dit is daarop gemik om lewensvatbaarheid en aanpassingsvermoë te ondersteun. Daar word 'n studie gemaak van die impak wat die veranderings tot wetgewing op gesondheidsdienste wat deur middel van die werksplek bereik word mag hê, en toets die toepaslikheid van Yolles se model in die konteks van bestuurskonsultasie.

<p>Syftet med detta arbete var att beskriva vilka metoder för stresshantering personal på olika företagshälsovårder upplever att de använder sig av för att hjälpa kunder med stressrelaterade problem, samt vad deras egen uppfattning av anledningen är till den/de valda metoderna.</p><p> </p><p>Genom kvalitativa intervjuer med fem personer med olika professioner på olika företagshälsovårder i Mellansverige undersöktes stresshantering. Det som frågades i intervjuerna var informanternas upplevelser av vilka stresshanteringsmetoder som används, anledningarna till användandet och anpassningar efter kunder. Någonting annat som undersöktes i studien var likheter och skillnader mellan de olika professionerna.</p><p> </p><p>Resultatet visade att avslappning var den vanligaste angivna metoden, strax före kroppskännedom, qigong, motion, medicin, mindfulness och massage. Andra verktyg informanterna uppgav att de använde sig av var samtal, förklaringar av kroppens reaktioner på stress, kartläggningssamtal, snabb tillbakagång till arbete samt positiva tankar och känslor. De beskrivna anledningarna till användandet av metoderna var främst upplevelsen av att de fungerade. Andra anledningar var vetenskapliga bevis på att de fungerar, utbildning i metoden, enkla att implementera samt tydliggörande för kunden.</p> / <p>The aim of this study was to describe what methods for stress management staff on occupational health services perceive they use to help clients with stress related problems, and what there appreciation of reason is on choosing these methods.</p><p> </p><p>Through qualitative interviews with five people with different professions in different occupational health services of Central Sweden stress management was investigated. The things that were questioned in the interviews were the interviewees experience in which stress management methods they use, the reasons of the using and the adaption after clients. One other thing that was investigated was similarities and differences between the different professions. </p><p> </p><p>The result showed that relaxation were the most common method used, right before body awareness, qigong, physical exercise, medicine, mindfulness and massage. Other tools the interviewees informed they were using was conversation, explanations of the body reaction on stress, conversation to map the clients situation, a quick way back to work and positive thoughts and feelings. The interviewees described reasons to use the methods were mainly the experience that they work. Other reasons were scientific evidence that the methods work, education in the method, simplicity in implement them and clarification for clients.</p>

Syftet med detta arbete var att beskriva vilka metoder för stresshantering personal på olika företagshälsovårder upplever att de använder sig av för att hjälpa kunder med stressrelaterade problem, samt vad deras egen uppfattning av anledningen är till den/de valda metoderna.   Genom kvalitativa intervjuer med fem personer med olika professioner på olika företagshälsovårder i Mellansverige undersöktes stresshantering. Det som frågades i intervjuerna var informanternas upplevelser av vilka stresshanteringsmetoder som används, anledningarna till användandet och anpassningar efter kunder. Någonting annat som undersöktes i studien var likheter och skillnader mellan de olika professionerna.   Resultatet visade att avslappning var den vanligaste angivna metoden, strax före kroppskännedom, qigong, motion, medicin, mindfulness och massage. Andra verktyg informanterna uppgav att de använde sig av var samtal, förklaringar av kroppens reaktioner på stress, kartläggningssamtal, snabb tillbakagång till arbete samt positiva tankar och känslor. De beskrivna anledningarna till användandet av metoderna var främst upplevelsen av att de fungerade. Andra anledningar var vetenskapliga bevis på att de fungerar, utbildning i metoden, enkla att implementera samt tydliggörande för kunden. / The aim of this study was to describe what methods for stress management staff on occupational health services perceive they use to help clients with stress related problems, and what there appreciation of reason is on choosing these methods.   Through qualitative interviews with five people with different professions in different occupational health services of Central Sweden stress management was investigated. The things that were questioned in the interviews were the interviewees experience in which stress management methods they use, the reasons of the using and the adaption after clients. One other thing that was investigated was similarities and differences between the different professions.    The result showed that relaxation were the most common method used, right before body awareness, qigong, physical exercise, medicine, mindfulness and massage. Other tools the interviewees informed they were using was conversation, explanations of the body reaction on stress, conversation to map the clients situation, a quick way back to work and positive thoughts and feelings. The interviewees described reasons to use the methods were mainly the experience that they work. Other reasons were scientific evidence that the methods work, education in the method, simplicity in implement them and clarification for clients.

Although the Ministry of Health, Indonesia, has achieved some successful occupational health interventions, published literature on such interventions in Indonesia remains scarce. This study utilized mixed methods of qualitative and quantitative research for the years 2010 and 2011. The qualitative study covered respondents in West, Central, and East Java Provinces to gather stakeholders' perspectives on the impact, effectiveness, adoption, implementation, maintenance, and barriers of occupational health services for informal sectors in Indonesia. The quantitative portion measured the impact of occupational health training for community health officers using Reach, Efficacy, Adoption, Implementation and Maintenance (RE-AIM) dimensions. West Java, as a province with a center for occupational health referral services (Balai Kesehatan Kerja Masyarakat/BKKM), was compared to Central Java as a province without BKKM. The qualitative study showed that interventions improved knowledge of and engagement in occupational health among workers and health officers. Among other improvements, occupational health training resulted in some owners of food processing home industries switching from non-food to food-based coloring. The advocacy program improved local governments' political commitment to funding the occupational health program. The BKKM played important roles in delivering occupational health in West Java Province. The quantitative study showed the efficacy variable to have the lowest p-value (p:<.0001). Meanwhile, the reach variable showed on the second lowest p-value among RE-AIM components (p: <.0190). Moreover, education (p-value: 0.0001), job type (p-value: 0.0015), and job duration (p-value: 0.0289) were considered individual variables that could have contributed to the differences in RE-AIM scores between Central and West Java. The qualitative study confirmed that occupational health interventions in Indonesia resulted in some positive impacts related to safe and healthy work-related behaviors. The quantitative study found that West Java, a province with BKKM, had a better RE-AIM score as compared to Central Java, a province without BKKM. Some individual variables such as education, job type, and job duration could have contributed to the differences in RE-AIM scores between Central and West Java. The future direction of the occupational health-training program should consider the participants' diversity in their education, job type, and job duration.

Occupational health is concerned with health in its relation to work and the working environment. This study was undertaken to present an overview of occupational health in South Africa, with national and international perspectives on the discipline, in the light of : (a) the recent commissions of enquiry into aspects of occupational health in South Africa (b) the development of the national and self-governing states (c) new strategies by the authorities in the form of decentralization and deregulation. Information on the health profile of its workers, current legislative and service provisions and on policies for economic development and urbanization is vital for health administrators, occupational health and safety practitioners and policy makers. Data was collected through the use of literature surveys and postal questionnaires to the various interested persons and groups involved with occupational health. The findings reveal that (a) an inadequate occupational health policy exists in that the responsibilities of government(s), employers, workers and health professionals are not defined (b) there is an absence of an organizational and service framework for an occupational health system in South Africa although the morbidity and mortality data are significant (with their concomitant economic and social consequences) (c) there is a lack of financial and human resources for the practice of occupational health in South Africa. Recommendations are made taking into account the developed and developing components of South Africa. / Thesis (M.Med.)-University of Natal, Durban, 1987.

The primary purpose for this study was to investigate small businesses organizational support and interest in health promotion. The research question for this study was, "Are small businesses actively involved with the organizational support of health promotion programs?"A survey was distributed via mail to small businesses in the Lynchburg, Virginia area, with a follow up three weeks later because an appropriate number of surveys had not been returned. The results of this study have provided insight into the current status of worksite wellness programs of businesses with fewer than 250 employees.Small businesses do actively support healthy food and smoking policies at the worksite. Some small businesses provided activities to measure employee health risks. The main issue small businesses deal with are safety/accident prevention. Other health topics are not prevalent in small businesses. Small businesses that had a health promotion program in place offered more programs and awareness materials than those who did not and are actively involved in the organizational support of health promotion programs. / Fisher Institute for Wellness

The purpose of this study was to identify the satisfaction from services received by businesses as members of Wellness Councils. All 105 members of the Wellness Council of Northwest Indiana were invited to participate in the survey. Fifty four (51%) participants completed and returned the survey on satisfaction levels.The instrument was developed to measure member satisfaction with the services provided by the Wellness Council of Northwest Indiana. The member organizations rated the council on a 5 point scale, with 5 being the highest possible score.A two way analysis of variance was conducted to identify differences in satisfaction by size and organization purpose; profit and nonprofit.The least satisfied group was the large for profit, while the most satisfied group was the large nonprofit group. Small for profit member organizations were slightly more satisfied than small not for profit organizations.Satisfaction did vary by size and organization, but in general, members were mostly satisfied with their participation in the Wellness Council of Northwest Indiana.Also, four open ended questions were asked, to allow the members to elaborate on other areas of interests or concerns. These results showed that members were interested in the following 2 areas: 1. education, 2. networking.Future research should include quantitative methodology that examines the meanings behind many of the narrative comments from the study. Future instruments should also include specific areas of satisfaction mentioned in the narrative responses. / Institute for Wellness

M.Cur. / Occupational health nurses are qualified registered nurses with a post-graduate qualification in occupational health nursing as a specialised discipline, and provide the basic healthcare aspect of the occupational health programme. Their most important activity is to identify and assess the health hazard risks in the workplace. Health risk assessments are conducted by occupational health nurses to determine all the stresses, e.g. hazardous chemicals, vibration, insufficient lighting, noise exposure and thermal exposure, which may affect employees‟ health and working efficiency. The researcher conducted audits and, over a period of time, observed that 85% (n=23) of occupational health nurses in different settings conduct health risk assessments only to a certain extent. The following questions were raised: To what extent do occupational health nurses conduct health risk assessments? What are the possible reasons for them conducting the health risk assessments only to a certain extent, or not at all? What can be done to improve this? The purpose of this study was thus to explore and describe the extent to which occupational health nurses conduct health risk assessments; and the possible reasons for not conducting them or conducting them only to a certain extent. Guidelines were developed to assist occupational health nurses in conducting health risk assessments. A quantitative, descriptive design was used in this study. A sampling frame was developed from a list of all the members of the South African Society of Occupational Health Nursing Practitioners (SASOHN) in Gauteng. From the target population of occupational health nurses in Gauteng, a systematic cluster sampling method was used. A developed questionnaire was distributed by mail and e-mails, and reminders were sent by the researcher to the respondents (Burns & Grove, 2006). The researcher ensured validity and reliability throughout the study by means of theoretical review, content securing and statistical assistance (Burns & Grove, 2006). Ethical standards of the right to self-determination, right to privacy, right to confidentiality and autonomy, right to fair treatment and right to protection from discomfort and harm were adhered to. The findings revealed that the occupational health nurse is a mature, predominately female experienced practitioner who operates on behalf of a disproportionably large number of employees. Four factors influencing these nurses in conducting a health risk assessment to a certain extent were identified: competence, ignorance about the role of the occupational health nurse, workload and attitude. The researcher formulated guidelines to assist practising occupational health nurses to conduct health risk assessments.

Identity is an important determinant of behavior. This paper proposed an identity model as one way of understanding those factors related to the perceived probability or willingness of a worker to participate in health promotion programming at the worksite. Part of a larger study on employee wellness, this study took place in the municipal complex of a small city in the southeastern United States. A stratified cross sectional sample of 150 employees was selected utilizing a systematic random sampling methodology. Structured interviews were conducted with 129 participants resulting in a response rate of 92% after adjusting for those people no longer employed by the city. In order to test the identity model developed by this author, descriptive analysis, simple multiple regression analysis and path analysis were utilized. The dependent variable, perceived willingness to participate in health promotion programming, was examined in relationship to commitment to one's health identity, commitment to one's organizational identity, tendency to comply with health initiatives, and the forms of supervisory power utilized to enact employee compliance. The descriptive analysis revealed that subjective health status is moderately and positively associated with commitment to one's health identity, that individuals can be strongly committed to a negative/destructive health identity, and that both the family and physician play important roles as health advice givers. The path analysis revealed that commitment to one's organizational identity, commitment to one's health identity, and tendency to comply with health initiatives are significantly and positively associated with willingness to participate in health promotion programming, accounting for 25% of the variance in the dependent variable. In contrast, the forms of supervisory power were not shown to be related to the dependent variable. In conclusion, the identity model appears to be a useful tool for the understanding of health attitudes and behaviors within a work setting.

This thesis deals with a topic of the legal significance of a medical opinion. The aim of the work is to analyse the current legal regulation of medical opinions, create a comprehensive interpretation and evaluate the sufficiency and unambiguity of their legal regulation. The topic connects two important and indispensable fields - law and medicine. In addition to the importance and practicality of the topic, the author also chose it because she had participated in a research within the project: "Medical opinions of occupational health service providers and their importance for ensuring safety and health at work of employees", identification sheet No. V11- S4. At the end of the work there is a brief summary of the information obtained in the research. The work is divided into four chapters, which follow each other in both content and logic. The introductory chapter introduces the legal framework of the issue of medical opinions. It does so by mentioning relevant national, international and European legislation. Chapter two marginally describes occupational health services, health care providers, occupational health examinations and a contract for the provision of occupational health services. The main subject of the medical opinions is comprised I chapters there and four. First of all, there is a...