A dissertation submitted to the Faculty of Arts, University of the Witwatersrand, in partial fulfilment of the requirements of the degree of Masters of Arts, Johannesburg, 1990. / The prevailing understanding of burnout is firmly entrenched in, and has been fundamentally influenced by, the three component definition of the burnout concept proposed by Maslach and Jackson (1981), as evidenced in its almost exclusive application in the burnout research and theoretical developments (Maslach & Jackson, 1986; Shirorn, 1989). Although the construct validity of the three factor burnout structure is well established, no research could be found which has investigated the discriminant validny of this construct. Thus the aim of tha present study was to determine how emotional exhaustion, depersonalisation, and low feelings of personal accomplishment may relate differentially to conceptually related variables. [Abbreviated Abstract. Open document to view full version] / MT2017

The Healthcare Quality Strategy for NHS Scotland, relates its overall vision of healthcare quality to six dimensions of care as: Safe, Efficient, Effective, Equitable, Timely and Patient Centred. Patient Centred Care also underpins many subsequent policies such as the management of Long Term Conditions (Scottish Government, 2008) and the Chief Medical Officers Realistic Medicine report (Barlow, et al., 2015) Leadership styles and associated policies and procedures are often assumed to inhibit or encourage the delivery of quality Patient Centred Care and the NHS invests millions of pounds per year in Leadership training. At a clinical team and management level there are behaviours and initiatives that can arguably have positive and negative impacts on the ability of individual practitioners to provide quality Patient Centred Care. However there have been no attempts to empirically test the association between (good) Leadership and quality Patient Centred Care. Without any evidence of such a relationship, NHS investment of substantial resources may be misguided. Additionally, much of the focus of research in both Leadership and Patient Centred Care has focused on medical practitioners and nurses. There is little research that focuses on the impact of allied health professionals' (a term describing 12 differing health care professional groups representing over 130,000 clinicians throughout the United Kingdom) practice on the quality of person centred care and how this is affected by Leadership structures and styles. This study aimed to explore whether there is a direct or indirect link between (transformational) Leadership and achieving the delivery of high quality Patient Centred Care (PCC) in allied health professional (AHP) practice. Aim The aim of this thesis was to explore whether it was possible to empirically demonstrate a relationship between Leadership (good or bad) and Patient Centred Care, and to do this in relation to Allied Health Professional practice. Research questions I. Is there a relationship between Transformational Leadership and Patient Centred Care in AHP practice? II. How do AHP’s conceptualise Leadership and its impact on their ability to deliver PCC? III. Do local contexts influence the ability of leaders to support Patient Centred Care? Study one Study one was designed to answer research question one: exploring the relationship between transformational Leadership and Patient Centred Care using survey design. Two groups of Allied Health Professionals were selected to take part in the study: Podiatrists and Dieticians. Clinical team leaders from across 12 Podiatry teams and 12 Dietetic teams completed a survey composed of measures of transformational Leadership and self-monitoring. Clinicians from these teams were also be asked to complete questionnaires on their perception of their clinical leaders’ transformational Leadership skills. This allowed comparison of self-assessed Leadership and team assessed Leadership. Clinicians were also asked to collect patient experience measures from 30 of their patients. Study Two Study Two was designed to answer research questions 2 and 3: how do AHPs conceptualise Leadership and how do they view the link between Leadership and their ability to deliver Patient Centred Care; and how might local context impact on professional Leadership and therefore its potential to enable or inhibit Patient Centred Care. In depth interviews were conducted with clinicians and clinical team leaders to explore the barriers and facilitators to effective Leadership, teamwork and the provision of quality care. Interviews were conducted with 21 Podiatrists and 12 Dieticians and analysed using a framework analysis approach. Results I. Is there a relationship between Patient Centred Care and transformational Leadership in AHP practice? The theory that there is a link between transformational Leadership and Patient Centred Care was confirmed. A significant relationship was discovered for the dietetics group linking Transformational Leadership with patient centred quality of care measures. There was also a relationship in the podiatry group that was suggestive of a relationship. II. How do AHP’s conceptualise Leadership and its impact on their ability to deliver PCC? AHP’s in both groups had broadly similar conceptualisations of Leadership and both groups played down the role of Leadership in the delivery of Patient Centred Care. A far more salient factor in achieving the delivery of high quality Patient Centred Care for the AHP’s interviewed was professional autonomy. III. Do local contexts influence the ability of leaders to support Patient Centred Care? A number of contextual issues related to both Patient Centred Care and Leadership were identified from the qualitative analysis. These were centred on systemic factors, relating to management and bureaucracy, and individual factors, such as relationships within teams. In Podiatry a major shift in the context of care was ongoing during the study, namely a greater emphasis on encouraging patients to self-care. This affected the relationships between patients and Podiatrists, and Podiatrists and managers, in a way that Podiatrists felt it negatively impacted on their ability to provide quality Patient Centred Care. Conclusion A weak relationship was observed between Transformational Leadership styles and the delivery of Patient Centred Care in two Allied Health Professional groups. Professional autonomy was identified as being more likely to facilitate delivery of person centred care. Organisational issues and intervening policy directives can impact on the delivery of Patient Centred Care, regardless of Leadership. Recommendations Further work exploring the link between Leadership and Patient Centred Care is required. The concept of professional autonomy should be fostered within Leadership programs to enhance delivery of Patient Centred Care. The impact of individual policies, such as moves towards more self-care, on quality criteria need to be more fully considered. Whilst such policies may make care more efficient, there may be negative consequences for other quality care criteria, such as Patient Centred Care.

At least two studies have been found conducted in the area of audiological in-services and their impact on the people to whom they were presented. In 1981, Dancer and Keiser studied the effects of empathy training on geriatric-care nurses and in 1985, Dampier, Dancer, and Keiser studied changing attitudes of college students toward older persons with hearing loss. Both of the studies investigated the effect of in-service training on empathy, rather than using the traditional academicallyoriented in-service program approach. Both studies found statistical results indicating a significant positive change in the subjects' feelings toward hearing impaired geriatrics. Additionally, Dancer et al. (1981) found a positive significant change in the subjects' perceptions of hearing impaired elderly persons. This study investigated the effect of an in-service training program on nursing home personnel. The in-service that was developed included both empathy training and factual information. It was hypothesized that both elements are important and the inclusion of both could result in a greater change in people's attitude. The empathy portion of this in-service included a taped interview with a hearing impaired older person, a tape dramatizing interactions between hearing impaired and normal hearing individuals, simulated high frequency hearing loss, an "unfair listening test" and suggestions for interacting with hearing impaired people. The factual information included anatomy and physiology of the ear, types of hearing loss, common characteristics of hearing loss among older people, and the impact of hearing loss on speech understanding.

This thesis endeavours to explore, describe and portray the author's attempt to work with the people of Vanuatu, a small island nation in the South Pacific, establishing a preventative eye care project. The goal of this study is to offer a contribution to the understanding of cross-cultural health work in Vanuatu. / thesis (PhD)--University of South Australia, [2000]

Thesis (Ph. D.)--Ohio State University, 2006. / Title from first page of PDF file. Includes bibliographical references (p. 64-67).

Thesis (D.Clin.Psych) - University of Queensland, 2006. / Includes bibliography.

Compulsory community service programmes have been initiated in many countries to recruit health care professionals to provide services in rural and under-served areas. However, the success or failure of the Community Service Programme depends largely on the attitudes of the professionals, their understanding of the programme's objectives, their preparedness for working in these areas and their ability to adapt to a new and challenging experience. Aim The aim ofthis study was to assess therapist's perceptions and attitudes about the compulsory Community Service Programme in KwaZulu-Natal in 2005 and to assess whether these changed during the year. Methods An observational cross sectional study with a descriptive and analytic component was conducted on commencement and after completion of community service. The therapists completed a self-administered questionnaire before and after their community service. Results A total of 126 (89% of 142) therapists responded to the initial questionnaire, 59 (42%) completed the exit questionnaire of which 47 (33%) completed both the questionnaire at commencement and completion of community service. Despite the poor response rate, similarities in perceptions and attitudes were noted with other studies conducted nationally and internationally. At onset 50% indicated that they would work in the public sector in the future and this proportion declined to 35% by exit. Even fewer (24%) said they would work in a rural area in the future. Only 16% reported that they would stay on at the same institution the year after community service. There was also no significant association between therapists collecting a rural allowance and expressing an interest to work in a rural area in the future (p=0.78) or staying at the same institution in the years after community service (p=0.32). However, therapists working in urban areas were more likely to say they would work in a rural area in the future (p=0.018). The comparisons between the occupational catergories showed that for support and supervision, the Speech Therapy and Audiology Forum was considered significantly (p=O.OOI) supportive compared to the Physiotherapy Forum. There was no significant difference within the occupational catergories in their perceptions of support, mentoring and supervision, attitude, psychological coping, personal and professional gains, safety issues and the amount of community outreach conducted. All groups were similarly resource constrained. Language was a barrier for 50% of all community service therapists and impeded their professional functioning. Discussion Despite the challenges experienced by community service therapists the majority felt that they had made a difference in the community in which they have been placed. The obligation to work in rural and under-served areas was personally and professionally rewarding. Particular concerns centred on support, supervision, training, resources and language barriers in providing better service delivery. Recommendations To achieve its objectives in relation to compulsory community service, which is to ensure an improved provision of health services to all citizens ofthe country, the Department ofHealth should consider multiple strategies including financial incentives such as rural allowances and non-financial incentives to retain health care personnel in rural and under-served areas. A long-term strategy that addresses human resources in a comprehensive manner needs to be developed to improve staffing and quality health services in these areas. / Thesis (MMed.)-University of KwaZulu-Natal, Durban, 2009.

Dissertation submitted to the Faculty of Health Sciences at The Durban University of Technology in partial compliance with the requirements for a Master's Degree in Technology: Chiropractic, 2008. / Objective: To determine the current knowledge and perceptions of biokineticists with respect to the chiropractic profession in South Africa. Design: A descriptive design was utilized in a qualitative questionnaire in order to evaluate, in a structured manner, the knowledge and perceptions of biokineticists with respect to Chiropractic. Subjects: The total population size used in the study was 657 (response rate n=78; 11.87%). Outcome Measures: These were based on a questionnaire which addressed biokineticists knowledge of Chiropractic, interaction with Chiropractic, Chiropractic terminology and scope of Chiropractic practice. Results: Of the 657 questionnaires that were mailed, only 78 questionnaires were returned and this gave a response rate of 11.87%. The most frequent view or attitude towards chiropractic was that it had a valuable role in the health care system (64%). About 50% of the respondents believed chiropractors to be greatly competent in examination and diagnosis whilst 40% felt that chiropractors were moderately competent in examination and diagnosis. Nevertheless, the rate of communication between biokineticists and chiropractors was found to be quite high, in this study. All together, 67% of biokineticists had communicated with chiropractors. Of those that had communicated, the communication was rated as positive (94.4%). Of those who had referred patients to chiropractors, 41.8% had received treatment feedback reports and of those who had received reports, 68.8% said they were concise and valuable. Conclusion: The results of this study show that the mean knowledge score was 60%. Thus the overall knowledge of chiropractic was high. The only factor that significantly affected respondents’ knowledge was their self reported knowledge of chiropractic. In congruence with this, the most common attitude towards chiropractic was that it had a valuable role to play in the health care system (64%).

There are many choices of specialists to be utilized in a sport medicine support staff. The effectiveness of any athletic training program depends on the organization and utilization of these specialists. The purpose of this investigation was to review current practices of accessibility, utilization, and compensation of sports medicine support staff at NCAA Division I, II, and III institutions. A random sample of 225 NCAA institutions equally stratified by level (Division I, II, 111) was obtained from the National Association of Collegiate Directors of Athletics (NACDA) directory. A questionnaire was sent to 75 head athletic trainers in each of three NCAA divisions levels. Of the 225 questionnaires mailed, 178 were returned representing a 79% response rate.The accessibility and utilization of support staff was equally distributed with respect to gender and sports at all division levels. When examining the support staff, Division I had consistently higher accessibility and utilization rates than Division II and Ill. This study may assist athletic trainers to evaluate or update their program by reviewing current practices of accessibility utilization, and compensation of support staff. / School of Physical Education

Typescript. / Thesis (Ed. D.)--University of Hawaii at Manoa, 1981. / Bibliography: leaves 231-243. / Photocopy. / xvii, 243 leaves, bound 29 cm