Thesis submitted in fulfilment of the requirements for the degree Master of Technology: Sport Management in the Faculty of Business and Management Sciences at the Cape Peninsula University of Technology / Volunteer tourism, as a form of leisure and/or recreation, is one of the fastest growing forms of tourism globally. It has also become a critical human resource for many organisations in the Western Cape, South Africa who rely on the support of volunteer tourists. A review of the current literature showed that most volunteer tourism research studies is volunteer-tourist-centred and focus on the motivations for participation and the benefits of participation to the volunteer tourist. Very few studies consider the effect of volunteer tourism on the host organisation and within the South African context only two volunteer tourist profile studies exist. Both studies excluded host organisation factors that indicated how host organisations benefited from hosting volunteer tourists. This research study focussed on creating a comprehensive profile of volunteer tourists at SANCCOB (a non-profit seabird rehabilitation centre) in Table View, Western Cape, South Africa. The profile included demographic factors, motivational factors and SANCCOB specific information. Data were collected through an anonymous, self-administered, online questionnaire and from the data, five conclusions were made. Firstly, the demographic factors of volunteer tourists that participated in SANCCOB’s international volunteer programme was similar to other South African based volunteer tourism studies. Secondly, to experience something different and new was the most important motivational factor for volunteer tourists. Thirdly, volunteer tourists derived considerable benefit from volunteering at SANCCOB. Fourthly, volunteer tourists continued to support SANCCOB through social and financial activities after completing the programme, indicating that SANCCOB (as a host organisation) benefited from hosting volunteer tourists and that as a result, a mutually beneficial relationship exists between this host organisation and the volunteer tourist. Lastly, this study provided SANCCOB with valuable information for volunteer management, as well as future marketing and fundraising campaigns.

As relações interpessoais são discutidas em vários campos da enfermagem; na saúde mental e na psiquiátrica elas se desenvolvem como relações terapêuticas sendo abordadas como relação de ajuda ou relacionamento interpessoal. Na Abordagem Centrada na Pessoa as atitudes de consideração positiva incondicional, atitude empática e congruência são imprescindíveis para se desenvolver relações interpessoais terapêuticas promovendo nelas um clima de facilitação do crescimento e desenvolvimento do sujeito no cuidado. Na literatura brasileira de enfermagem não foram encontradas medidas de avaliação de tais atitudes embora se acredite que serão necessárias tanto no campo do cuidado quanto da educação. Através deste estudo, buscou-se desenvolver um instrumento de avaliação das relações interpessoais, abrangendo as três atitudes facilitadoras: consideração positiva incondicional, atitude empática e congruência e realizar a análise exploratória quanto à dimensionalidade e a fidedignidade do instrumento. O polo teórico envolveu a explicação dos construtos, a elaboração dos itens e as análises empíricas; o polo empírico relacionou-se a fase de experimentação do instrumento. Trata-se da escala de observação da interação enfermeiro-cliente constituída de itens positivos e reversos, tipo likert com cinco pontos. A consideração positiva incondicional ficou com 22 itens (15 reversos); a atitude empática compôs-se de 18 itens (2 reversos) e a congruência totalizou em 8 itens (2 reversos). Tais itens expressam o componente comportamental, verbal e motor de cada construto e foram indicados para o uso em situações de observação durante o cuidado. Optou-se pela filmagem das relações interpessoais desenvolvidas por 10 enfermeiros com 92 pessoas diagnosticadas com transtornos mentais durante consultas de enfermagem realizadas nas Estratégias de Saúde da Família de uma cidade do interior de Minas Gerais. No polo analítico, utilizou-se da análise fatorial (AF) e a consistência interna (coeficiente alfa de Cronbach) segundo referencial teórico-metodológico utilizado. O instrumento foi avaliado segundo modelo teórico apresentando alfa da escala global de 0,82, do atributo um (consideração positiva incondicional) 0,68, do atributo dois (atitude empática) 0,76 e do atributo três (congruência) 0,49. Devido à baixa consistência interna do atributo três em conformidade com os resultados das cargas fatoriais, analisou-se um modelo sugerido pela AF de 36 itens, o que se mostrou frágil em relação aos conceitos constitutivos e a operacionalização. Os melhores resultados apontaram para um instrumento composto de três subescalas. A escala global de consideração positiva incondicional apresentou alfa de 0,687, a escala de atitude empática teve escore global de 0,769 e a terceira de 0,517. Itens com cargas fatorais abaixo de 0,40 foram eliminados. Todos os coeficientes foram significativos com valor-p <0,01 e correlação significativa observada pelo coeficiente de Spearman. Consideram- se necessários ajustes no construto/atributo três, devido à fragilidade dos resultados, embora estejam dentro dos parâmetros considerados aceitáveis. O instrumento construído pode ser utilizado por profissionais que desejam avaliar as relações interpessoais no cuidado de enfermagem que tenha a finalidade de pesquisa ou didática. / The interpersonal relations are discussed in many nursing fields and in mental health or psychiatric nursing they develop themselves as therapeutic relations that are approached as help relations or interpersonal relationship. In the Person-Centred Approach, unconditional positive consideration attitudes, empathetic attitudes and congruence are indispensable to develop therapeutic interpersonal relations and to promote an environment of growing and development facilitation for the subject on care. In Brazilian nursing literature, evaluation measures for these attitudes were not found although one believes that they will be necessary so far as in care and education fields. Through this study, one had as an objective to develop an interpersonal relationship evaluation instrument that enfolds the three facilitating attitudes, unconditional positive consideration attitudes, empathetic attitudes and congruence, and to perform the exploratory analysis concerning the dimensionality and reliability of such an instrument. The theoretic pole involved the explanation of the constructs, elaboration of the items and empirical analysis; the empirical pole related to the experimentation phase of the instrument. It is a matter of nurse-customer interaction observation scale constituted of positive and reverse items like a Likert-scale with five points. The unconditional positive consideration stayed with 22 items (15 reverse); the empathetic attitude was composed of 18 items (2 reverse) and the congruence counted for 8 items (2 reverse). Such items express the behavioral, oral and motor component of each construct and were indicated for using in conditions of observation during care. One chose for recording the interpersonal relations developed by 10 nurses involving 92 subjects with mental-impaired patients during nursing inquiries performed in Family Health Strategies in an inland city of Minas Gerais. In the analytical pole one made use of the factorial analysis (FA) and the internal consistency (Cronbach\'s alpha-coefficient) according the used theoretic-methodological referential. The instrument evaluated concerning to the theoretical model presented an alpha-scale global outcome of 0.82, being 0.68 for attribute one (unconditional positive consideration), 0.76 for attribute two (empathetic attitude) and 0.49 for attribute three (congruence). Due to the low internal consistency of attribute three in relation to the factorial load results, one analyzed a model of 36 items suggested by FA that showed itself fragile in relation to constitutive concepts and operationalization. The best outcomes indicate a three-subscale instrument. The unconditional positive consideration global scale presented an alpha of 0.687, the empathetic attitude scale got a global score of 0.769, and congruence featured 0.517. Items with factorial load below 0.40 were eliminated. All coefficients were significant for p<0.01 and significant correlation confirmed by Spearman coefficient. Some adjustments are necessary for the third construct/item due to the fragility of the results, although they are within acceptable parameters. The instrument so developed can be used by professionals who wish to evaluate the interpersonal relations in nursing care with research or didactic purpose.

Abstract Product development (PD) has an important role as a key competitive factor in business environments. The capacity of designers and other stakeholders to perceive and process product related information is burdened by the increasing complexity of products and the high demands of working life. Therefore, companies need new human-centred perspectives and methods of balancing and enhancing their overall PD processes in order to develop successful products. The main motive for this research arises from the fact that ergonomics design research has been scarce from the process-oriented and systemic methods perspective. It has mainly focused on the methods, such as those needed in user interface design, and the usability and safety testing of products. The purpose of this dissertation is to consider the PD work system from the macroergonomics perspective. Macroergonomics is a top-down sociotechnical systems approach that is concerned with the analysis, design and evaluation of work systems. Nowadays, the individual user context is the dominating source of product requirements, but the designers’ work system has significant influence on its outcome as well. As an open work system, PD covers the use and design contexts of a product, not only at the individual, but also at the social and system levels. In this dissertation, the use and design contexts of products are examined through six individual studies, which were carried out during a demanding PD project of a new simulation game. In this design process, from the initial state to the goal state, macroergonomics was used as the main theoretical guideline. In many companies, PD processes are considered and developed mainly from the project management or technological points of view. However, because of the increasing complexity and systemic nature of products, PD organisations, too, will have to become more participatory, more networked and more systems oriented. As the main findings, this dissertation indicates that the macroergonomic approach can enrich the PD process and its outcomes by emphasising the balance between the technical and social subsystems of PD work system. The emerging complexity of products must be controlled from the entire PD work system, not the individual context of use only. The research introduces a new PD work system model that includes both the design and use contexts of products and demonstrates their analogical sociotechnical structures. The value of this dissertation for the industry is that companies can overcome certain emerging challenges of PD by applying the introduced macroergonomic principles. The findings of the research may encompass the re-designing of the current PD process in a company. Instead of shutting their eyes to the complexity of the surrounding world, companies should consider it as the macroergonomic PD work system and be more aware about the overall product requirements.

Aims: Exercise and physical activity have been found to be beneficial in managing disabilities caused by multiple sclerosis (MS). Despite the known benefits, people with MS (pwMS) are inactive. Research has focused on structured exercise programmes, rarely considering a broader range of activities, which pwMS integrate into everyday life. The aims of this study were to gain in-depth understanding of the priorities and meanings of exercise and physical activity from the perspective of pwMS and to explore how these might inform clinical practice. Methods: a mixed methods approach using three interconnected studies was adopted: Study 1: A four-round Delphi questionnaire scoped and determined consensus of priorities for exercise and physical activity and the reasons why pwMS (n=101) engaged in these activities. Content and statistical analyses were utilised. Study 2: Sixteen face-to-face, semi-structured interviews were conducted with pwMS to explore the meanings ascribed to exercise and physical activity in relation to the Delphi study. Study 3: Three focus groups involving 14 physiotherapists explored perceptions about exercise and physical activity. Data were analysed for studies 2 and 3 using Framework Analysis and themes developed. Results: outcome from each phase 1. Study 1 revealed that the prioritised exercise and physical activity practices and the reasons why pwMS (n=70) undertook these activities were diverse. Consensus was found for the exercise and physical activity practices (W=0.744, p < 0.0001) and the reasons why pwMS engaged in these activities (W=0.723, p < 0.0001). 2. Study 2 demonstrated that the meanings pwMS ascribed to exercise and physical activity was beyond ‘movement’ reflecting how they lived with a variable and progressive condition. Contextual factors, specifically personal factors were dominant influences. 3. Study 3 highlighted that physiotherapists shared similar views in some aspects to pwMS, however physiotherapists perceptions of exercise and physical activity were predominately influenced by their theoretical knowledge. Conclusion: The priorities and meanings ascribed to exercise and physical activity were ‘a matter of perspective’ and context driven. Understanding the strategies used by pwMS for prioritisation might help clinicians support pwMS more effectively in their decision making about exercise and physical activity. Taking this approach creates the opportunity to deliver a more focused patient-centred approach in the management of MS. Recommendations for clinical practice and further research were identified.

This study is a case study for a mobile app for fishing enthusiasts, Fishbrain with the purpose of presenting personas based on user-research. This assignment was carried out upon request of Fishbrain as the company finds that they lack qualitative data. One main reason for this is that the majority of the users are located in the US. Fishbrain has 4.83 million users mainly across the United States, Australia, Sweden and Brazil (14th of December 2017). This study intends to determine whether our chosen methods for user-research can apply when the interviewers and the responders are located at different geographical locations, and to evaluate if our chosen method for deriving personas can be applied on a large user base. This study is based on quantitative data collected through surveys. Subsequently, interviews were conducted as a method for collecting more qualitative data. Based on this empirical foundation, interesting insights and recurring factors were categorized. Two primary personas and two secondary personas were developed from this analysis. This study finds that our chosen methods for user-research are valid when users and researchers are located in different places, but that there are certain limitations that the researchers should take into consideration, for example the time difference. This may require a longer research timeframe  than if the research is conducted in a lab environment. / Denna undersökning är en fallstudie för Fishbrain med syfte att presentera personas framtagna utifrån användarundersökningar. På önskan av Fishbrain genomfördes detta uppdrag då företaget upplever att de saknar kvalitativ data, eftersom majoriteten av användarna befinner sig i USA. Fishbrain har 4,83 miljoner användare fördelat över främst USA, Australien, Sverige och Brasilien (2017-12-14). Med denna studie hoppas vi kunna svara på huruvida våra valda metoder för användarundersökningar är lämpliga då undersökare och deltagare befinner sig på olika geografiska platser, samt att utvärdera huruvida vår valda metod för framtagande av personas kan appliceras på en stor användarbas. Undersökningen utgår från kvantitativt insamlad data från enkätundersökningar. Därefter används intervju som metod för att komma åt mer kvalitativa aspekter. Utifrån denna empiriska grund kategoriseras olika intressanta insikter och återkommande faktorer. Vid analys av datainsamlingen utvecklas två primära samt två sekundära personas. Undersökningens slutsats är att det är applicerbart att genomföra användarundersökningar när användarna och undersökarna befinner sig på olika platser, men att det finns vissa begränsningar som undersökarna bör ta hänsyn till, såsom tidsskillnad. Dessa begränsningar medför att den tidsram som sätts för projektet bör beräknas längre än om undersökningarna genomförs i laboratoriemiljö.

The purpose with this thesis was to study user activities in a business system, MediusFlow. The overall objective was to identify user related problems and to analyse which of the usability data gathering methods to use in the future development process of the company Medius. The outcome of this study indicated that a cognitive related user problem was the most important problem to solve. A Star Life Cycle method was preferred. Two low-fidelity prototypes were developed to exemplify an alternative design solution to the identified cognitive user problem. Furthermore, the two best methods to use when gathering user related requirements were heuristic evaluation and expert review. In addition a company specific Style Guide was created with generic guidelines as a foundation for development of future applications within Medius.

Bakgrund I arbetet möter sjuksköterskan många olika individer. En grupp individer som har ett stort behov av personcentrerad vård är intellektuellt funktionsnedsatta. Bemötandet och personcentrerad omvårdnad av denna individgrupp upplevs variera allt efter sjuksköterskans erfarenhet och kunskap. Syfte Studiens syfte var att undersöka personcentrerad omvårdnad utifrån sjuksköterskans upplevelse till individer med intellektuell funktionsnedsättning. Metod Litteraturstudien består av 13 kvalitativa och två kvantitativa artiklar och är från olika länder. Artiklarna har publicerats mellan år 2007-2017. Sökningar har gjorts i databaserna Cinahl och PubMed. Resultat Resultatet presenteras i fem kategorier med respektive underrubriker; Individanpassat bemötande (bemötande i vården, utåtagerande beteende, vikten av informationsutbyte); Kommunikation i vården (faktorer som kan påverka kommunikationen, anpassad kommunikation); Samarbete med anhöriga; Behov av kunskap och utbildning; Stöd och samarbete. Konklusion Personcentrerad omvårdnad som möter individens behov framkommer i studien som viktiga beståndsdelar i mötet med individer med intellektuell funktionsnedsättning. För att arbeta personcentrerat och med utgångspunkt från individens behov behöver sjuksköterskan ha förståelse för individgruppen, kunskap och praktisk utbildning för att bli mer trygg i sitt bemötande. / Background At work, the nurse meets many different individuals. A group of individuals with a high need for person-centered care is intellectually impaired. The perception and person-centered care of this individual group is experienced varies according to the nurse's experience and knowledge. Aim The purpose of the study was to investigate the person-centered nursing based on the nurse's experience with individuals with intellectual impairment. Method The literature study consists of 13 qualitative and two quantitative articles and is from different countries. The articles have been published between 2007-2017. Searches have been made in the databases Cinahl and PubMed . Results The result is presented in five categories with respective subheadings; Individualized treatment (treatment in care, outpatient behavior, importance of information exchange); Communication in healthcare (factors that may affect communication, custom communication); Collaboration with relatives; Need for knowledge and education; Support and cooperation. Conclusion Person-centered nursing that meets the needs of the individual appears in the study as important elements in the meeting with individuals with intellectual disabilities. To work personally and based on the needs of the individual, the nurse needs an understanding of the individual group, knowledge and practical training to be more confident in their treatment.

Philosophiae Doctor - PhD / Background: Satisfaction with the care mothers receive during child-birth is known to have a very strong influence on their future use of facility-based care during child-birth. Women and children continue to die from complications associated with pregnancy and child-birth and the majority of the causes that lead to mortality are related to labour and delivery. For this reason it is imperative for mothers to access facility-based child-birth care to receive skilled birth care. Mothers report dissatisfaction with facility-based child-birth care as one of the reasons for home births without skilled attendants. The presence of the skilled birth attendants is known to reduce maternal and neonatal mortality rates because of their ability to diagnose any early complications, and to intervene appropriately. Aim: The aim of the current study was to develop an in-service training programme for midwives to provide patient-centred child-birth care that would increase client satisfaction with child-birth care. Method and findings: The intervention research model by Rothman and Thomas (1994) – Design and development (D & D) – was used as the research framework. Only the first four of the six phases of the D & D model were applied in this study. In the first phase, a situational analysis was done using a qualitative study. The expectations, experiences, and satisfaction with child-birth care of antenatal and postnatal mothers, were explored. The research was conducted in four health institutions within the Kumasi Metropolis. Between 12 and 15 participants were purposively sampled in each hospital. Data were collected by means of individual in-depth interviews using an interview guide and data were analysed using content analysis. The study found that mothers expected to receive respectful care and safe care. Mothers had encouraging experiences and discouraging experiences during their child-birth care. The discouraging experiences did not align with their expectations of care, leading to dissatisfaction with child-birth care. In the second phase of the study an integrative literature review was conducted to identify evidence-based best practices to deal with client dissatisfaction with health care. The integrative literature review indicated that in-service training was commonly used as best-practice to improve health professionals' knowledge, skills and attitudes towards work and consequently to improve health outcomes for patients, including client satisfaction. In the third phase of the study, the in-service training programme to enhance patient-centred care was developed using Chinn and Kramer (2005) guidelines for programme development and steps to programme development by Management Sciences for Health (2012). The fourth phase entailed an assessment of feasibility and usability of the in-service training programme using 6 midwives in a district Hospital. The procedure was guided by the I-Tech Technical Implementation guide (2010). The outcomes of the assessment was used to refine and revise the developed in-service training programme. Conclusion: This study sought to develop an intervention to increase client satisfaction with child-birth care service by engaging the following processes in phases: • Assessing the expectations and experiences of mothers about child-birth care services. • An integrative literature review for evidence-based best practice to tackle client dissatisfaction with health care. • Designing a patient-centred care in-service training programme together with experts in the field of maternal and child health. • As assessment of feasibility and usability of the in-service training programme by means of a pilot test to refine the programme. Recommendations: It was recommended among others that, the study is carried out on a national scale to cover all administrative regions of Ghana. It is further recommended that the study findings and the programme developed form part of the continuous professional assessment course requirement for nurses and midwives.

Sexual assault is a global public health and human rights challenge which cuts across all social classes. According to a literature review based on 50 studies from around the world, between 10% and 50% of women have experienced some act of physical violence while one in every four women experience sexual violence by an intimate partner at some point in their lives. In an emergency unit in the North West, South Africa there are policies, guidelines and procedures in place with regard to the management of the rape survivors after the incident which focus on a medical orientated approach. The views of female rape survivors on their management are neglected; therefore management is not patient-centred. The main objective of the study was to explore and describe the views of the female rape survivors regarding the management they received in emergency unit to enable the health care professionals to move towards a more patient-centred approach in the management these patients. Appreciative Inquiry was used a research methodology. A qualitative design using purposive sampling was used to select the participants. Unstructured interviews were conducted with 10 female rape survivors and Tesch steps were used to analyse the data. Three main themes were identified, namely 1) therapeutic environment, 2) optimal healthcare received and 3) excellence in service delivery. With regard to the disease orientated management received the female rape survivors found it to be good. The participants voiced that it is important that female rape survivors should have an opportunity to attend group therapy following the rape incident so that they are able to support each other. / Dissertation (MCur)--University of Pretoria, 2014. / lk2014 / Nursing Science / MCur / Unrestricted

Introduction: Patient-centred communication is vital to ensure a good patient experience in the emergency department. Visits to the emergency department leave patients disillusioned regarding the communication experienced and this increases patient dissatisfaction. There is a need to put the "patient" back in communication in order to make it more patient-centred and provide the patient the opportunity to voice their individual needs pertaining to patient-centred communication. The aim of the study was to co-design patient-centred communication in an emergency department. In order to reach the aim of the study the following objectives were set: To explore current communication in an emergency department as experienced by patients and healthcare professionals. To collaboratively co-design strategies to enhance patient-centred communication in an emergency department. Research design and methods: An Experience-based Co-design has been used. Unstructured observation was done to observe existing communication in the emergency department. Patients have told their stories through narrative-based film interviews and healthcare professionals have been interviewed to share their experiences regarding communication in the emergency department. The observation notes and interviews have been shared during a Co-design event. Patients and healthcare professionals have collaboratively analysed the data to identify key touch points and co-design strategies to enhance patient-centred communication in the emergency department. Results: Three (3) key touch points were identified namely; professionalism, communication and daily focus. The patients and healthcare professionals were equal partners to change the communication culture in the emergency department to be more patient-centred. This may lead to positive patients' experiences with an increase in patient satisfaction. Conclusion: The ultimate goal of this study was to raise awareness relating existing communication in the emergency department and collaboratively plan strategies to work towards patient-centred communication. / Dissertation (MCur)--University of Pretoria, 2017. / Nursing Science / MCur / Unrestricted