published_or_final_version / Community Medicine / Doctoral / Doctor of Philosophy

Stress hör till vårdpersonalens vardag och talangen att hantera stress är en lämplig egenskap för ett bra vårdarbete. Undersökningens syfte var att beskriva hur utländska läkare upplever stress på arbetsplasten i sammanhang med språkbarriärer, kommunikationssvårigheter och kulturskillnader samt hur dessa svårigheter påverkade deras arbetsförande och privatlivet. Via sju intervjuer granskades läkares tankar, kunskaper och upplevelser och resultatet visade att dålig kommunikation och okunskap från patienter och kollegor hade en negativ påverkan på stressnivån i arbetet. Medan otillräckliga språkkunskaper i svenska uppfattades som ett stort hinder av informanterna. Resultatet visade även att socialt stöd och hjälp från kollegor och ansvariga chefer saknades vilket påverkade informanternas privatliv i form av försämrat självförtroende och minskad energi under ledig tid. Ett par förslag på förbättring för att minska stressnivån på informanternas arbetsplatser ges i slutet.

Research on stress factors among General Practitioners in relation to burnout is limited. In view of the clinical impression that stress is becoming more prevalent amongst Indian General Practitioners in urban areas, a study was planned to investigate the demographic variables, stress factors in practice and burnout among Indian General Practitioners in the Greater Durban Area. The research design involved the analysis of data on demographic variables, stress factors in practice and burnout. This data was obtained from a sample of 106 Indian General Practitioners in the Greater Durban Area. Informed consent was obtained by a letter that was sent to the General Practitioners. A Demographic Inventory, a 4 item Stress of Practice Questionnaire and the Maslach Burnout Inventory was administered by a postal questionnaire. The analysis of the scores obtained from the Stress of Practice Questionnaire and the Maslach Burnout Inventory provided the following findings: 1. The stress of practice - 6 factors were identified of which 3 were related to demands of the job, work: home interface and workload. 2. The Indian General Practitioners experienced a low to moderate degree of burnout. 3. The correlation of stress factors and Maslach Burnout Inventory subscales were weak. 4. For emotional exhaustion - dimensions of frequency and intensity, some of the stress related factors explained a fair amount of variation but the relationship was not strong. These findings lend themselves to further research in this field and have significant therapeutic implications for both practitioner and their patients. / Thesis (M.Med.)-University of Natal, Durban, 1991.

This study seeks to investigate perceptions of medical doctors towards psychologists. The study focuses on exploring whether race and gender have any influence on medical doctors’ perceptions of psychology. In exploring these perceptions, the study focuses on medical doctors’ knowledge of the psychology profession. Secondly, it focuses on medical doctors’ experiences in working with psychologists. Thirdly, it examines medical doctors’ referral patterns towards psychologists. Finally, it focuses on the kinds of problems that medical doctors are likely to refer to psychologists. This was a quantitative study. The population of this study was medical doctors from both public and private sectors in the Pietermaritzburg region. The sampling method used in this study was convenience sampling. The study was conducted on sixty-two medical doctors. Thirty-four males and twenty-eight females participated in this study. Thirty-two Whites, twenty Indians, seven Blacks, two Coloureds and one Chinese participated in this study. Questionnaires were used as data gathering instruments. In analyzing data, a chi-square test was used. Chi-square analysis was performed at 0.05 percent level of significant association. The findings indicated that medical doctors hold positive views towards psychologists and the psychology profession. The participants seemed to have a good understanding of what the psychology profession entails. The findings also seemed to suggest that medical doctors understand the overall scope of psychologists. Overall findings suggest that there were no significant associations between medical doctors’ responses and their race and gender. This seems to be an area that has not been researched and it therefore serves as a pilot study. / Thesis (M.Soc.Sc.)-University of KwaZulu-Natal, Pietermaritzburg, 2009.

Though turnover researchers have called for a deeper understanding of the temporal and contextualized process of individual voluntary turnover, little empirical progress in this direction has been made. Adopting Price's (1977) dynamic conceptualization of turnover as moving from one social system to another, and drawing upon knowledge across organizational, social psychological and psychological domains, this exploratory thesis uses in-depth topical life histories to examine individual experiences with stay/leave decision processes in their construed context. / Findings challenge longstanding assumptions of linearity and continuity in turnover decision processes, as well as the conventional wisdom that utility-maximizing logic underlies these decisions. The data suggest that the pursuit of context-self congruence is a driving force in stay/leave decision processes, and that self-concept, emotions and psychological states may be under-studied influencers of these decisions. Results further uncover decision process characteristics previously rendered inaccessible to researchers, due to the predominant use of correlational studies in turnover research. These characteristics include: a) pivotal points of transition; b) the story lines that underlie influencing factors; c) the nature and role of context; and d) the consequences of engaging in these decision processes, for participants and for their workplaces, regardless of the outcome. / This idiographic study, using a purposive sample from a single population of Quebec physicians, is intended to provide turnover researchers with a starting point for cross-group retrospective and longitudinal comparisons. It also aims to stimulate hypothesis generation that accounts for time and the contextual conditions under which particular factors are likely to affect the turnover decision. From a practical viewpoint, this thesis begins to answer the call from Canadian and Quebec Health Care Human Resource specialists for a deeper understanding of the psychosocial aspects of Canadian healthcare worker turnover and retention (British Columbia Office of the Auditor General, 2004; Dubois & Dussault, 2002).

Darbo tikslas - įvertinti Kauno apskrities ligoninės gydytojų pasitenkinimą darbu. Uždaviniai 1. Atskleisti gydytojų požiūrį į profesiją ir bendrą profesinį pasitenkinimą. 2. Nustatyti bendrą gydytojų pasitenkinimo darbu lygį. 3. Išskirti gydytojų pasitenkinimą darbe lemiančius veiksnius. 4. Numatyti gydytojų pasitenkinimo darbu gerinimo galimybes. Tyrimo metodika Planuota, jog tiriamųjų populiaciją sudarys visi Kauno apskrities ligoninėje dirbantys gydytojai (301). Gydytojų apklausai vykdyti nedavė leidimo vieno Kauno apskrities ligoninės padalinio vadovas (padalinyje dirba 43 gydytojai). Todėl tyrimo metu buvo išdalintos 258 anketos, gauti 203 atsakymai (78,6 proc.). Klausimyno pagrįstumui įvertinti atlikta klausimyno psichometrinių savybių statistinė analizė. Anketiniai duomenys buvo apdoroti ir analizuojami naudojant statistinį duomenų analizės paketą SPSS 11,5. Rezultatai Absoliuti dauguma gydytojų (95,4 proc.) yra patenkinti savo profesija. Nepatenkinti gydytojai dažniau nei patenkinti nepasirinktų gydytojo specialybės ir patenkinti gydytojai dažniau nei nepatenkinti rekomenduotų savo vaikams rinktis gydytojo profesiją. Didžioji dalis gydytojų yra patenkinti savo darbu (85,7 proc.). Pusė arba daugiau kaip pusė apklausoje dalyvavusių gydytojų yra nepatenkinti tyrimo metu analizuotais pasitenkinimo darbu veiksniais. Nustatytas vidutinio stiprumo statistiškai reikšmingas koreliacinis ryšys tarp gydytojų pasitenkinimo darbu ir gydytojų ryšio su organizacija (r=0,26, p≤0,00... [toliau žr. visą tekstą] / Aim of the thesis – to evaluate the satisfaction with the work of the physicians in Kaunas county hospital. Targets: 1. To reveal the attitude of the physicians towards the profession and general professional satisfaction. 2. To identify the general level of satisfaction of the physicians with the work. 3. To define the factors determining the satisfaction of the physicians in the workplace. 4. To draw the possibilities about the improvement of satisfaction of the physicians with the work. Methods of the research It was planned at the beginning that the study population will consist of all the physicians employed in Kaunas county hospital (301 total). The permission for the research wasn‘t obtained from one of the head of department in the hospital (there are 43 physicians employed in it). Totally, 258 questionnaires were distributed and 203 received (the response rate was 78.6 percent). For evaluation of the validation of questionnaire the statistical analysis of psychometric characteristics of the questionnaire was performed. The data of the survey was analysed using SPSS 11.5. Results The total majority of the respondents (95.4 percent) were satisfied with their profession. Nonsatisfied ones more often then the satisfied said they would never choose the specialty of physicians and satisfied respondents more then the nonsatisfied claimed they would recommend to choose the profession of physician for their children. Majority of the respondents were satisfied with the work (8... [to full text]

Darbo tikslas. Įvertinti ligoninės gydytojų ir slaugytojų požiūrį į bendradarbiavimą ir kokybės vadybos sistemą įstaigoje. Uždaviniai. Įvertinti gydytojų ir slaugytojų požiūrį į bendradarbiavimą ir kokybės vadybos sistemą įstaigoje, palyginti gydytojų ir slaugytojų požiūrį į bendradarbiavimą ir kokybės vadybos sistemą, nustatyti gydytojų ir slaugytojų požiūrio į bendradarbiavimą įstaigoje ryšį su pasitikėjimu kitais darbuotojais ir pasitenkinimu darbu. Tyrimo metodika. Anoniminė vienos įstaigos gydytojų ir slaugytojų apklausa (n=256). Statistinei duomenų analizei taikytas hipotezės apie dviejų požymių nepriklausomumą tikrinimas susietų lentelių metodu naudojant chi kvadrato kriterijaus reikšmę. Rezultatai. Didžioji dalis medikų mano, jog partnerystė tarp sveikatos priežiūros darbuotojų gali pagerinti pacientams teikiamų paslaugų kokybę, paslaugų prieinamumą, darbuotojų pasitenkinimą darbu ir darbuotojų gyvenimo kokybę. Statistiškai reikšmingai didesnė dalis slaugytojų (50,9 proc.) nei gydytojų (35,8 proc.) nurodo, jog pasikeitimas informacija tarp gydytojų ir vadovų pakankamas, 71,7 proc. gydytojų ir 44,8 proc. slaugytojų teigia, jog informacija tarp gydytojų ir slaugytojų yra pakankama. 70,8 proc. medikų nurodo, jog jų įstaigoje yra įdiegta kokybės vadybos sistema. 50,6 proc. medikų yra patenkinti, 48,8 proc. - iš dalies patenkinti savo profesija. 63,6 proc. medikų savo pasitikėjimą kolegomis bei vadovais vertina teigiamai, 11,5 proc. – neigiamai. 54,2 proc. patenkintų... [toliau žr. visą tekstą] / Aim of the study. To investigate attitude of health care professionals towards partnership and quality management system in health care institution. Objectives. To assess attitudes of health care professionals towards partnership and quality management system, to compare attitudes of physicians and nurses towards partnership and quality management system, to evaluate associations of attitudes to partnership with trust and job satisfaction among physicians and nurses. Methods. An anonymous questionnaire survey was performed including all physicians and nurses working in one health care institution (n = 256). Statistical calculations of chi square’s test was performed. Results. The majority of health care professionals state that partnership among medical staff can improve quality of health care services provided to the patients, accessibility of the services, job satisfaction and quality of life of medical staff. The major part of nurses (50.9 percent) than physicians (35.8 percent) indicate, that information level between physicians and managers is sufficient, the major part of physicians (71.7 percent) than nurses (44.8 percent) note that information level between physicians and nurses is sufficient. 70.8 percent of respondents point that system of quality assurance is implemented in their institution. 50.6 percent of medical staff is satisfied and 48.8 percent – partly satisfied with job. 63.6 percent of respondents trust and 11.5 percent distrust in their colleagues... [to full text]

<p>Chronic diseases of lifestyle (CDL) are on a raising trend in the world regardless of age, economic class or geographical location of a population. The mortality rate associated with CDL is alarmingly among the highest globally. Tanzania is not exempted from this development. Literature indicates that physical activity is a health practice that can prevent CDL. It is recommended that medical practitioners should hold the responsibility of counselling patients on physical activity. Some studies outside Africa found an association between doctors&rsquo / physical activity patterns and their counselling practices on the same. This study therefore sought to establish whether physical inactivity among medical&nbsp / doctors in Tanzania significantly influenced their counselling practices on physical activity. A cross sectional quantitative survey at the Muhimbili National Hospital and Muhimbili Orthopedic Institute was conducted to derive the required information. A self administered structured questionnaire was voluntarily answered by 144 medical doctors. The Statistical Package for Social Sciences (SPSS) version 17 was used for data capturing and analysis. Descriptive statistics were employed to summarize data and was expressed as means, standard deviation, frequencies and percentages. The students&rsquo / t-test was used to compare mean physical activity between different groups. Furthermore students&rsquo / t-test and analysis of variance tests were used to examine association between different variables. Chisquare tests were used to test for associations between categorical variables. Alpha level was set at p&lt / 0.05. Most of the participants in this study were sedentary in their leisure time and only active at work. When their quality of&nbsp / physical activity counselling was assessed, the majority of them were found to be poor physical activity counsellors. A significant association was found between physical activity and age, as well as physical activity and counselling practice (p&lt / 0.05). Participants mostly informed their patients about the intensity and duration of exercising more than any other idea of physical activity such as types of exercises, issuing of a written prescription and planning for a follow up. Lack of knowledge and experience about details of physical activity were reasons offered for failure to counsel. Participants also reported the inconvenience of physical activity facility&rsquo / s schedules, fatigue and tiredness to be their&nbsp / barriers to physical activity participation. Doctors in Tanzania lacked personal initiative to participate in physical activity and consequently lacked the motivation to counsel.&nbsp / Measures around enhancing this health practice should be enhanced by all stakeholders including medical doctors, physiotherapists and patients. The need for short term and&nbsp / long term training in matters related to physical activity are therefore necessary among the practicing doctors and those undergoing training in medical schools. Physiotherapists who are trained in movement science can offer valuable advice/information to medical doctors to ensure that medical doctors acquire physical activity prescription and&nbsp / counselling knowledge. Collaboration between stakeholders in campaigning against sedentary lifestyles should be enhanced. Further reasons for failure to counsel, hindrances to physical activity participation and modern approaches to counselling should be explored.<br /> &nbsp / </p>

From 1950 to 2000 the former Faculty of Medicine, University of Natal, Durban, pursued the traditional, didactic curriculum. The implementation of problem-based learning, Curriculum 2001, introduced many changes in the curriculum where facilitators guide instead of teach students. Based on this it is important to understand the principles of problem-based learning (PBL) more extensively and the demands that may be made on the Library and the Librarians. It is assumed that a partnership exits between the librarians and the School of Undergraduate Medical Education (SUME). The object of this study is to determine whether the introduction of Curriculum 2001 impacted on the role and functions of the library and the librarians. The 5th year students from the Traditional Curriculum and 2nd year students from Curriculum 2001 were selected to participate in this study. The methods used in this study were the analysis of the minutes of the meetings that were held to discuss and plan Curriculum 2001 of the Curriculum Development Task Force, questionnaires for the undergraduate students and semi-structured interviews with the facilitators in Curriculum 2001 and medical librarians. The minutes of the CDTF were examined to ascertain if the librarians had any input in Curriculum 2001. The interviews would determine whether PBL had an impact on the role and functions of the library and the librarians. Four librarians and 15 facilitators were interviewed. Quantitative and qualitative methods were used in this study with the assistance of the EPI Info and NVivo software to analyze the results. The results of this study indicated that there is room for greater and enhanced collaboration and faculty partnerships between SUME and the library to assist the students to improve and develop their information literacy skills that are integral part in problem solving in the PBL curriculum. / Thesis (M.Ed.)-University of KwaZulu-Natal, Pietermaritzburg, 2006.

Syfte: Syftet med litteraturstudien var att beskriva metoder som kan förbättra kommunikationen mellan sjuksköterskor och läkare för en säkrare vård. Syftet var även att beskriva kvalitén på de granskade artiklarna utifrån metodologiska aspekter gällande undersökningsgrupp och datainsamlingsmetod. Metod: En deskriptiv litteraturstudie baserad på 15 vetenskapliga artiklar. Data samlades in ifrån databaserna PubMed och Cinahl samt via manuell sökning. Artiklarna granskades samt analyserades och resultatet presenterades utifrån tre teman. Resultat: Olika metoder förbättrade kommunikationen mellan sjuksköterskor och läkare. Förbättrad kommunikation och förbättrade attityder till samarbete har visats efter att professionerna fått utbildning inom området kommunikation. Utbildning i kommunikation och kommunikationsverktyg gav struktur i kommunikationen och sjuksköterskorna upplevde att kommunikationen med läkarna förbättrades med en känsla av trygghet och mindre stress. Omstrukturering i arbetet och personalgruppen resulterade i ett starkare vårdteam med minskad hierarki och en förbättrad kommunikation. Flera metoder upplevdes av sjuksköterskorna ge en förbättrad vård för patienterna. Slutsats: Utbildning i kommunikation och kommunikationsverktyg samt omstrukturering i arbetet förbättrar kommunikationen mellan sjuksköterskor och läkare. Metoderna förbättrar samarbetet, tonar ned hierarkin och bidrar till en säkrare vård. / Aim: The aim of the literature study was to describe methods that can improve the communication between nurses and physicians for a safer care. The aim was also to describe the quality of the reviewed articles based on methodological aspects concerning the study group and the data collection method. Method: A descriptive literature study, based on 15 scientific articles. The data was collected from the databases PubMed and Cinahl and through manual search. The articles was reviewed and analyzed and the results were presented in three themes.Results: Different methods improved the communication between nurses and physicians. After studying communication and collaboration they´ve seen improved communication and attitudes towards communication. Education in communication and communication tools provided the structure of the communication and the nurses felt that communication with physicians improved with a sense of security and less stress. Restructuring of work assignments and the staff resulted in a stronger health care team with less hierarchy and improved communication. Several methods were experienced by the nurses to improved care for the patients. Conclusion: Education in communication, communications tools and reconstruction of job assignments improved communication between nurses and physicians. The methods improve the collaboration, it became less hierarchy and contribute to a safer care.