Previous research has investigated the effects of daycare on infants, though little attention has been given to the emotional impact of this work on their caregivers. Attachment theory has influenced the approach to infant daycare, leading many programs to adopt a primary caregiving system in order to respond effectively to the needs of the infant. Babies become attached to caregivers and in turn caregivers become attached to the babies. This study explored the implications of such attachments. Naturalistic inquiry made the web of relationships surrounding infant/toddler caregivers apparent. In conversational interviews, caregivers spoke deeply of the complexities and demands of their work with babies and their families. Their voices were eloquent, thoughtful and reflective. The data consist of lengthy initial interviews, follow-up conversations, and observations. The researcher's own education and experience informed the data gathering and interpretation. Seven caregivers in four different centres were interviewed. Each had her Under Age Three Certificate and worked in a licensed centre. Each of these centres used some degree of primary caregiving. The interviews were informal, based on a list of questions used to encourage conversation and narrative. Observations offered an opportunity to understand the context of each caregiver and prompt further conversation. Analysis was a process of analyzing the interviews for themes and ideas in light of the observations. The picture that emerged illustrates the complexity inherent in the work of caring for babies. Caregivers spoke of their relationships as sources of satisfaction and frustration. In a dynamic, ongoing process of engaging with babies, families, co-workers, and selves, caregivers must negotiate these multiple relationships using skills of empathy and thoughtfulness. The Early Childhood Education and Care literature discusses toddlers' struggle with separation anxieties. Not well articulated in the literature, but evident in the data, is the grief of the caregivers. Each woman spoke of her own sadness at the loss of her relationship with a baby or toddler when that child left the centre. Relationship with all its intensity and tensions was central to the professional experience of these women. Each of the four most experienced caregivers accented a different aspect of caregiving: a) the sensual aspects of caring for babies, b) the intellectual possibilities of caregiving, c) caring as a spiritual practice, and d) the need for attentive care for one's self. The particular centre and context of each caregiver influenced the care she provided; without a supportive environment it is difficult to provide respectful and responsive care. The participants discussed the need for adequate time to establish and maintain relationships; time was also necessary to meet and discuss concerns. Caregivers needed time for reflection to keep multiple perspectives in mind. Time is an important and often scarce resource for caregivers. Caregiving is a web of relationships. This research was reflective of and ethically responsive to the caregiving relationship. Paying attention to the multiple pulls experienced as an insider, I used trust, respect, responsiveness, and responsibility to guide the research process. Two women, whom I called peer reviewers and who had both worked in the field, but were now a step removed, discussed with me general topics raised by the interviews and listened for the "ring of truth". Listening to the seldom heard voices of the caregivers and their emphasis on the process of building and maintaining relationships suggests possible directions for supervision of centres, guidelines for Early Childhood Education and Care education, and development of licensing policies. The caregivers' focus on relationship challenges the centrality of child development in the organization of practice. Supporting, honouring, and building on caregivers' connections with the babies in their care, the families, the staff, and with themselves will enhance the practice of infant and toddler care. / Graduate

Following the availability of antiretrovirals (ARVs) for the treatment of HIV in the public sector from 2004 to 2008, thousands of multidisciplinary health care workers were trained by RHRU on HIV care and ARVs on behalf of the South African Department of Health. To ascertain if, and to what extent, transfer of learning had occurred, a case study approach was used involving a sample of seventy alumni. Data was collected via questionnaire, interview and observation tools. Data collected suggests that transfer of learning took place at some level for most alumni but was weakest with non clinical staff in ARV sites and ward based staff, many of whom did not feel that they treated HIV patients. The study concludes that the ‘one size fits all’ approach preferred by the Department of Health did not support effective transfer of learning for all alumni mainly due to the subsequent inappropriate training design for many participants and the impact of this on motivation and connection to a less enabling transfer climate. To optimize the possibility of transfer, therefore, HIV training should be specifically designed for the learning needs of each cadre of health care worker with clear expected changes to practice for participants, linked to supporting transfer environments post training.

<p> The purpose of this paper is to examine how lay perceptions of risk influence individual behaviour. The study focuses on health care practitioners who are daily exposed to low levels of ionizing radiation. By using qualitative research methods, the goal was to understand how individuals attach meaning to the environment they work in, when there is a risk involved. It points out that people must go through a risk assessing procedure, in order· to be able to deal with the daily risks to their health. People will develop different mechanism to cope with this daily risk. A model of risk perception was developed from this qualitative data. It is hoped that this model will contribute to the existing literature on risk perception models. </p> / Thesis / Bachelor of Arts (BA)

Antalet människor som har diagnostiserats med ADHD respektive med ätstörning har ökat i jämförelse med tidigare år. Det har påvisats en koppling mellan dessa, en samsjuklighet mellan ADHD och ätstörning. Syftet med denna studie var att undersöka ätstörningsbehandlares erfarenhet och reflektioner kring samsjukligheten mellan ADHD och ätstörning. Det genomfördes åtta semistrukturerade intervjuer med verksamma ätstörningsbehandlare. Utifrån tematiseringen av intervjuerna framkom fyra teman. De identifierade temana var: likartade symtom vid ADHD som vid ätstörning, ADHD som en (bort)förklaring, ADHD påverkar behandlingen och Behandlarnas utbildningsbehov. Resultatet visade bland annat att behandlarna upplevde svårigheter att identifiera samsjukligheten mellan ätstörning och ADHD. I linje med tidigare forskning kan denna svårighet resultera i utmaningar vid bedömning av omvårdnadsdiagnostik vilket är ett hinder för att upprätta en korrekt individuell vårdplan. Ätstörningsbehandlarna uppmärksammade även ett behov av utbildning av samsjukligheten mellan ADHD och ätstörning i syfte att underlätta arbetet med den typen av patientgrupp.

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The purpose of this study was twofold. First, the relationship between organizational climate and job satisfaction was examined to determine if they are redundant constructs. Second, the validity of aggregate scores on the organizational climate scale was tested. Paula Jorde-Bloom’s Early Childhood Work Environment Survey (ECWES) was sent to child care workers in Virginia to assess their perceptions of the organizational climate of their centers. An aggregate center score was derived by taking a mean of all the respondents from a particular center. The Early Childhood Job Satisfaction Survey (ECJSS) was used to assess workers’ feelings of satisfaction with their jobs. Results of correlations and factor analysis indicated that the two scales do represent distinct constructs. Results of T-tests, analysis of variance, and correlations provided partial support for acceptance of the validity of aggregate scores on the ECWES. Directions for future research included replicating the study with a larger sample size and more respondents per center, attempting to validate aggregate scores on the ECWES with existing objective rating scales, examining the relationships between center attributes and climate dimensions, and between these attributes and turnover. Implications for practice include ways child care center directors can enhance the climate of their centers. For example, directors should examine their supervisory behavior to see if they are being supportive of their staff and fostering group decision-making. / Master of Science

Yes / Person-centered care (PCC) has been the subject of several intervention studies, reporting positive effects on people with dementia. However, its impact on staff’s outcomes remains unclear. The purpose of this systematic review was to assess the impact of PCC approaches on stress, burnout and job satisfaction of staff caring for people with dementia in care homes. The databases PubMed, Web of Knowledge, Scopus and EBSCO and reference lists from relevant publications, were searched between December 2012 and March 2013. The review was limited to experimental and quasi-experimental studies, published in English and involving direct care workers (DCWs). Seven studies were included, addressing different PCC approaches: dementia care mapping (n=1); stimulation-oriented approaches (n=2); emotion-oriented approaches (n=2) and behavioral-oriented approaches (n=2). Five studies reported benefits on DCWs, suggesting a tendency towards the effectiveness of PCC on staff. However, methodological weaknesses and heterogeneity among studies make it difficult to draw firm conclusions. / Portuguese Foundation for Science and Technology

Yes / An experimental study using a pre-posttest control group design was conducted to assess the effects of a person-centred care based psycho-educational intervention on direct care workers’ stress, burnout and job satisfaction. The intervention aimed to develop person-centred care competences and tools for stress management. Four aged care facilities were randomly assigned to a psycho-educational or an education-only intervention (control). Data were collected from fifty-six direct care workers (female, mean age 44.72±9.02) through measurements of burnout (Maslach Burnout Inventory), job satisfaction (Minnesota Satisfaction Questionnaire-short form) and stress (Perceived Stress Scale) and focus-group interviews. Results showed significant positive effects in emotional exhaustion (p=0.029) and positive but no significant effects in stress and job satisfaction. According to qualitative data, the experimental group perceived enhanced group cohesion, emotional management and self-care awareness. Psycho-educational interventions may contribute to reduce direct care workers’ burnout. Further work is needed to determine the extent of its benefits. / Portuguese Foundation for Science and Technology

Yes / This study assessed the effects of a psycho-educational intervention on direct care workers' person-centredness during morning care to residents with dementia. A controlled pretest–posttest study was conducted in four aged-care facilities with 56 direct care workers (female, mean age 44.72 ± 9.02). Two experimental facilities received a psycho-educational intervention comprising person-centred care competences and stress management skills; control facilities received an education-only intervention, without stress support. In total, 112 video-recorded morning care sessions were coded using the Global Behaviour Scale. Both groups reported significantly higher scores on eight of 11 items of the Global Behaviour Scale and on the Global Behaviour Scale total score at posttest (F=10.59; p=0.02). Global Behaviour Scale total score improvements were higher for the experimental group, with values close to significance (F=3.90; p=0.054). The findings suggest that a psycho-educational intervention may increase care workers' person-centredness. Further research is needed to explore the long-term sustainability and extent of its benefits on workers and residents. / Foundation for Science and Technology

Yes / Early booking or registration into Antenatal Care (ANC) can be defined as initiation of ANC before 12 weeks of gestation and is important for the best health outcome of the mother and the baby. Delayed initiation of ANC has been linked to increased rate of maternal and fetal mortality. There is international consensus that ANC should begin within first trimester yet pregnant women delay initiation of ANC. Health Care Workers (HCWs) understanding of reasons for this can improve patient provider relationship. Objectives: This study aims to explore the perception of the HCWs in Fiji towards early antenatal booking. Methods: A qualitative study was employed using four Focus-Group Discussions (FGDs)with the HCWs who provide health care service for pregnant women in Ba Mission Hospital (BMH) in 2020. Each group comprised of medical officers, mid-wives and registered nurse who were chosen purposively. A semi-structured open ended questionnaire was used to guide the discussion. Data was transcribed and analyzed manually using thematic content analysis using the following process: familiarization, coding, identifying themes, reviewing and refining, integration and interpretation. Results: There was a total of 18 HCWs for the FGDs. The mean age of the participants was 37.4±11.8years. The three themes identified were: knowledge of HCWs on early booking, their perceived barriers and perceived enabling factors to early antenatal booking. The FGDs identified that the HCWs had adequate knowledge on early initiation of ANC and that there were a range of barriers to early initiation of ANC. The HCWs also suggested factors that could enable women to book early. Conclusion: Based on the study it can be concluded that the HCWs have a positive perception of early antenatal booking, however, there are various factors that contribute to delayed antenatal booking. The barriers to early ANC are both an opportunity and a challenge to strengthen and review the maternal services offered. The enabling factors should be reinforced from an individual level to the health system and the general context. The implications of the barriers and enabling factors identified in this study is to implement evidence-based policies to improve early antenatal booking in Ba, Fiji.