This study explored community-based Palliative Care nurses’ experiences of their work. The aim of this study was to explore the positive aspects of working in palliative care, as well as the challenges that community-based nurses experience in their work. The coping strategies that are employed by these nurses to deal with the difficulties of their work were understood, and the participants provided recommendations to their organisations to improve their working experiences. The research was conducted in two research settings, St Luke’s Combined Hospices and Tygerberg Hospice, which are both non-profit organisations providing Palliative Care in the community. Permission was gained to conduct research by the St Luke’s Combined Hospices Research Ethics Committee, and the Palliative Care Manager at Tygerberg Hospice. A qualitative research design was used to conduct this study, and purposive sampling was used to select the sample. Fourteen nurses were interviewed using a semi-structured interview schedule, and a digital recorder was used so that interviews could be recorded accurately. Qualitative data analysis was used to arrange the data into themes, categories and subcategories. Findings from the study indicate that there is a great sense of satisfaction from working in Palliative Care and positive aspects include feelings of honour and privilege, making a difference, appreciation from patients and families, life lessons learnt, having a role in the community and working in a team. The perceived challenges were emotional challenges such as persistent rumination about work, feelings of helplessness and dealing with challenging families. Organisational challenges pertained to demanding workloads and a lack of organisational support. Personal challenges were seen as having a negative impact on the physical health and family lives of participants. Lastly, environmental challenges included issues around safety and driving to communities. Coping strategies were the support from family and friends, avoidance coping and self-care as well as group support and debriefing and support from colleagues. Lastly, recommendations include an open-door policy within the organisation, improved training and education, a better understanding of community Palliative Care, improved interaction with staff and staff reward and recognition.

Includes abstract. / Includes bibliographical references (leaves 64-69). / This study explored Cotlands Hospice staff's perceptions of challenges and stressors which they experience in the workplace, in caring for HIV infants. This aim of this study was to highlight some of the key struggles that healthcare workers are faced with in the HIV workplace in caring for HIV positive infants. The study also explored the participants' current coping strategies used to cope with stressors from within the workplace and supportive resources available to aid the participants were identified. Lastly unmet needs identified by participants were explored and discussed.

Includes bibliographical references (leaves 70-75). / The research investigated the perceptions of the challenges faced by grandmothers caring for AIDS orphans in Khayelitsha, a township on the outskirts of Cape Town. The aim of this study was to make a contribution to an understanding of the challenges faced by grandmothers who are performing a surrogate parent role. The research focused on the grandmothers? perceptions of the types of challenges they faced in caring for AIDS orphans as well as their perceptions of the causes of these challenges. Lastly the research aimed to investigate the strategies employed by the grandmothers in dealing with these challenges and to ascertain whether or not grandmothers are aware of existing resources that are available to assist them with their challenges.

Includes abstract. / Includes bibliographical references (leaves 82-86). / In this study the researcher aims to explore the child right violations and psychosocial risks experienced by children orphaned primarily as a result of HIV/AIDS in Lesotho. Lesotho ranks in at number three in the world of countries most ravaged by the HIV/AIDS pandemic. Of its 2.2million citizens, 17% are orphans, and half of them have been orphaned as a result of HIV/AIDS (United Nations Program on HIV/AIDS, 2004) (UNAIDS). According to the Non-Governmental Coalition on the Rights of the child, (2000), the number of orphans in Lesotho continues to increase on daily basis resulting in the country being under enormous strain and these vulnerable children at increased risk. The research design used in this study is the qualitative research design and research was conducted using face to face in depth interviews. A semi structured interview schedule was constructed and the researcher also used a tape recorder. Purposive sampling technique was used to obtain a sample size of 12 adolescent orphans at a High School in Maseru Lesotho. Data analysis is done according to Tesche’s steps of interview analysis, in which the main themes and categories are drawn from the interviews and discussed. The main findings were that most of the orphans who participated in the study had a poor quality of life but maintained a positive outlook in terms of the future. Most of the orphans were living in child headed households that had no electricity. There was no evidence of physical abuse amongst the respondents. In terms of psycho social risks, most orphans did not suffer from depression or severe anxiety. A small percentage of orphans did experience suicidal ideation in response to the death of their parents and their current circumstances. The main conclusions were that orphans in Lesotho are experiencing child right violations especially poor quality of life and that orphans in this study did not experience severe psycho social risks. From these findings, it is recommended that there is a need for more non-profit organizations that address the child right violations and psycho social risks experienced by orphans in Lesotho as well as a need for awareness campaigns on the plight of orphans to be generated. It is also recommended that the Lesotho government continue to fund the education costs of orphans as well as offer transportation to school.

It has been recognised that there is a need to get a better understanding of the user of technology in work as information technology progressively saturates users' everyday working environments. One motivating force has been a perceived need to link the design of new technology with the work actually being done. One way to do this has been to turn to ethnography as an analytic approach when studying work, and then try to relate the results to design in different ways. The main question in this thesis is precisely how technology is being used in everyday work activity. The individual papers include discussions about what the resulting analyses can do for design. The contributions from the analyses do nog guide design in any 'linear' way but can be brought to the 'design table' and serve as points of departures for design considerations.

Thesis (M.S.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / 2031-01-01

The impulse to develop an effective method of intervention for conduct disorder arose through practice experience. As a social worker based in a special school for children with severe emotional and behavioural problems between 1986 and 1995, I had responsibility for working with the child in the famiIy context. My clinical impression was that behavioural gains in the school setting were not transferred to the home setting, where parents of conduct-problem children reported that they continued to find the child’s behaviour unmanageable. This was confirmed by Fitzgerald, Butler, and Kinsella (1990) who found that parents having a child who was placed in a special school reported with frustration that they were not taught how to manage their child in the home setting. I shared their frustration, because it was evident that these children were usually manageable in the school setting. Generic social work training and post-qualifying training in family therapy did not however, provide the means to intervene effectively with the child’s behaviour in the home setting. I hope that this research will encourage the introduction of behavioural social work practice in Ireland, and that by doing so, it will broaden the practice options which are currently available to social workers. I also hope that the introduction of behavioural methods will lead, not to further paradigm wars, but to the necessary respect for diversity which emerges when social work is considered in a European context: The diversity of social work approaches which, despite all efforts at international harmonisation has not been levelled to one standard norm, might turn out to be one of the professions greatest assets in facing up to the diversity of the newly emerging welfare scenario (Lorenz, 1994, p. 181).

The aim of the thesis is to study the role of instruction in the interconnection of instruction-learning-development. The thesis consists of six empirical papers and a summing-up and perspectivizing introductory paper. Five of the empirical studies concern so called heart conferences, clinical diagnostic meetings, which at the time of my study, 1995-1996, were arranged as telemediated conferences between a sub-team of surgeons and radiologists in a university clinic, and a sub-team of cardiologists and radiologists in a regional hospital. The outcome of the coronary diagnostic work in the heart conferences was patient diagnoses and decided-upon treatment (surgery, balloon dilatation, or conservative treatment). The sixth empirical study, conducted in the autumn 2000, investigates the design and redesign of a central artifact used in the heart conference, ?the angio film,? produced in the angio lab. A recurrent theme in the empirical papers is whether artifacts might be instructive and, if so, in what ways. The introductory paper is a hybrid between an ordinary summing-up paper of the findings in the empirical studies, and a perspectivizing presentation of activity-theoretical approaches to instruction, learning and development, elaborating on three basic aspects (learning as a collaborative phenomenon, the instructiveness of artifacts, and the relation between learning and development on an individual level, but primarily on an activity level). In conclusion, my study outlines an approach to learning based on new perspectives on instruction. / Studier av läkares co-coaching av varandra som ett led i deras samarbete rörande kranskärlsdiagnostiskt arbete. Artefaktanvändning, lärande och versamhetsutveckling.

The ability to interoperate between systems, people, and organizations is considered an important issue within eHealth in order to deliver patient centered care. The achieving and improving of interoperability is a complex undertaking involving the evolution of an information infrastructure, sharing of knowledge and resources, governance of the interoperation between organizations, people and work practices, and handling of economic and legal matters. This thesis contributes with practical knowledge on improving interoperability, based on active participation in and empirical studies of improving interoperability in ePrescribing. A case study describes and analyzes the evolution of ePrescribing in Sweden since the early pioneering years in 1980s, its growth and consolidation before the reregulation of the pharmacy market in 2009. Apractical theory on ePrescribing is presented. A unique field experimental study measuring improvement of interoperability in ePrescribing, before and after a major intervention to improve the quality of ePrescriptions between 2004 and 2009 is presented. Furthermore, a practical theory on interoperation and interoperability is presented. Interoperability is seen as the exercised capability of organizations through their agents to interoperate in a shared work practice in an effective, efficient, and satisfactory manner based on a common ground in a mediated, prescriptive, and non-personal communicative setting using an information infrastructure for mediating interoperation.

When employee turnover rate in a company is too high, not only it will result in the increase of cost, affecting employee morale, making negative impression on customers, but also impacting corporate performance in the long run. This research uses one of the qualitative research techniques to study the human resource management practices of the four interviewed companies, trying to identify the best practices they have in common that contribute to the decline of employee turnover rate or maintain it within acceptable level. After interviewing the four companies, two in service industry and the other two in high-tech manufacture industry, this research analyzed their human resource management practices, and found five best practices they have in common that help these four companies successfully keep employee turnover rate in control. Therefore this research concluded that a company, whether it is in service industry or high-tech manufacture industry, or whether its organizational culture is more performance-oriented or rather paternalistic, by recruiting employees through diversified approaches and selecting them by their personalities, and strongly linking performance appraisal system, reward system, promotion system and training and development system together, the synergy of the best practices all together will contribute to the decline or maintain of employee turnover rate.