This study aims to explore the experiences of traditional healers who work in a hospital environment in a different capacity. A secondary aim of this inquiry is to look at how participants' perceptions of the interface between traditional and modern medicine in a hospital context influences their practices as both traditional healers and hospital employees. A snowball sampling strategy was employed and five suitable participants were identified through referral and post-interview selection. Participants were selected from a sample of South African-born women who have experienced an ancestral calling and initiation into African traditional healing, have been initiated as an Inyanga/iSangoma (diviner), and are presently working in a different vocational capacity in a hospital environment. All participants work and reside in Gauteng. Data was collected through two semi-structured interviews per participant. Interviews were based on an interview guide. In looking at participants' experience as traditional healers who work in a hospital and how their perceptions on the interface between traditional and modern medicine influence their traditional healing practices, four research questions have been identified: 1. How do participants perceive themselves as a traditional healer? 2. How do participants perceive and experience their work in the hospital? 3. How do participants perceive the interface between traditional and modern approaches to healing in a hospital context? 4. How do participants experience the perceptions of others at work? A qualitative approach was adopted in order to gain an in-depth understanding of participants' experiences. Data analysis was guided by narrative and thematic approaches. Thus results are presented in accordance with principles of narrative and thematic content analysis. Interpretation of data focused on the ways in which these women relate to their role as traditional healer in a different vocational capacity and how their perceptions reflect a broader dialogue on the relationship between traditional and modern healing modalities in a modern health care context. Participants felt empowered by some colleagues who consulted them on traditional healing skills and applied them to patients without constraint upon their working duties. All felt they needed their jobs to support a decent living as full-time work as traditional healers would not provide for all their needs. Implications for future research and collaboration between western and traditional healing systems are considered.

Thesis (Ph.D.)--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. / This study was concerned with examining some of the perceptions which female volunteers and female employees have of their respective work situations. It also compared some of the satisfactions which both groups derived from their work. A review of the literature on volunteers revealed that they come from varying backgrounds and that their specific motives for doing volunteer work were likely to be highly diversified. It was noted that little information was available describing the extent to which they differed from a comparable population of non-volunteers. It was suggested that there were some similarities between paid employees and volunteers. For example: 1) volunteers and employees work for another individual; 2) volunteers and employees work in the context of a total setting; 3) volunteers and employees expect some form of payment, be it tangible or intangible, for their services. An assumption was made based upon these similarities, namely, that many of the same psychological needs can be met through either volunteer work or paid employment. Important differences between the two groups were also identified. Some of these were the fallowing: 1. Volunteers are supplementary to the paid personnel. 2. Volunteers have less responsibility than the paid employees. 3. Volunteers receive a different kind of supervision than do employees. 4. Volunteers seek more personal gratifications from their work than do paid employees. It was suggested that the major factor contributing to these differences was that of monetary reward although it was also recognized that economic gain was not necessarily the primary benefit which a worker sought or obtained from employment. Nevertheless, financial remuneration or some tangible equivalent is a basic part of the contract between the employer and the paid employee. Its absence is what distinguishes the volunteer contract from that of the paid employee and determines the individual's role with respect to each. It defines what is expected of the worker and what the worker may expect from participating in the work situation. A second assumption was made on the basis of the differences outlined above, namely, that being a volunteer was different from being a paid employee. A theory of volunteer behavior was presented which was based upon the two assumptions that had been made. It was suggested that volunteers are freer to select a work situation on the basis of personal needs than are paid employees. The absence of monetary remuneration in the volunteer contract caused the volunteer and the volunteer supervisor to place more emphasis upon the psychological rewards which are to be gained from the work. failure to satisfy personal needs often results in termination of the volunteer activity. In the paid employment situation recognition is given to the importance for the person to meet various personal needs through her activity; however, the fact that she is being given wages and other tangible benefits tends to curtail the extent to which either she or the employer may be concerned with such needs being met. It was therefore suggested that volunteers and paid employees within the same work situation might view it differently because of the fact that there were differences in the extent to which their personal needs could influence their subsequent involvement in the setting. The first set of hypotheses offered for testing were: Hyp. 1. The perception of tbe work situation of women volunteers and paid employees within a given setting will differ. Hyp. 1a. There will be differences between volunteers and paid employees in terms of these needs which they perceive the setting as being most able to satisfy. It was noted that work situations differ from one another in terms of the kinds of satisfactions which they made available to the individual. It was then suggested that when an individual selects a setting predominantly on the basis of her personal needs that she chooses one in which she thinks those needs can be most easily met. Thus given a setting conducive to gratifying certain needs, volunteers should therefore be more homogeneous as a group than paid employees in terms of the kinds of satisfactions which they derive from their work. [TRUNCATED] / 2999-01-01

Problem Statement: The burden of musculoskeletal injuries among workers is very high, particularly so in direct care workers involved in patient handling. Efforts to reduce injuries have shown mixed results. Strong evidence for intervention effectiveness is lacking.<p> Specific Aims: The goal of this study was to evaluate the effectiveness of a patient handling injury prevention program implemented in the Saskatoon Health Region (SHR) comparing it with a non-randomized control group, Regina QuAppelle Health Region (RQHR), in a pre-post design. Injury rates, lost-time days, and claim costs were the outcomes of interest.<p> Intervention: A Transfer, Lifting and Repositioning (TLR) program, consisting of engineering and administrative ergonomic controls, was implemented in SHR hospitals from 2002-2005.<p> Methods: Data on time loss and non-time loss injuries, lost time days, and claims costs were collected from the SHR and RQHR for corresponding time periods one year pre and one year post-intervention. Age, length of service, profession, and sex were selected as covariates. Full Time Equivalents (FTE) data were collected for each time period. Univariate and multivariate Poisson regression were performed.<p> Results: Rates for all injuries (number of injuries/100 FTE) dropped from 14.68 pre-intervention to 8.1 post-intervention. Control group all injury rates, while overall lower in absolute value, dropped to a lesser degree, from 9.29 to 8.4. Time loss injury rates decreased from 5.3 to 2.51 in the SHR, while they actually increased from 5.87 to 6.46 in the RQHR, for the same intervention periods. Poisson regression showed the greatest reduction in injury rate, both time loss (Rate ratio=0.48, 95% C.I: 0.34-0.68) and non-time loss (Rate Ratio=0.25, 95% C.I: 0.15-0.41) in the smaller long term care facility controlling for hospital size. Analysis of injury rates, incidence rate ratios, and incidence rate differences showed significant differences between the intervention and comparison group for all injuries and time loss injuries. Mean claim cost/injury decreased from $3906.20 to $2200.80 and mean time loss days/claim decreased from 35.87 days to 16.23 days for the SHR.<p> Conclusions: The study provides evidence for the effectiveness of a multi-factor TLR program for direct-care health workers, and emphasizes their implementation, especially in smaller hospitals.

Individual and environmental risk factors in hand eczema have been investigated in a prospective cohort study of 2452 newly employed hospital workers with a follow-up time of 20 months. Current hand eczema was analyzed in 142 wet hospital workers from this cohort with respect to the etiologic importance of irritants, allergens and contact urticants. The density of the microflora and the effect on the microflora of topical treatment with a potent corticosteroid were studied in 20 patients with hand eczema. ’Wet’ hospital work was found to increase the odds of developing hand eczema only twice compared to 'dry' office work. Nursing children under four years old and the lack of a dish-washing machine significantly increased the risk of contracting hand eczema. Unfavourable combinations of these domestic factors increased the risk as much as wet work. A history of atopic dermatitis approximately tripled the odds both in wet as well as in dry work. Histories of earlier hand eczema (HHE), metal dermatitis (HMD) and of atopy were analyzed as risk factors for hand eczema in 1857 women in wet work. HHE increased the odds by a factor of 12.9 and created a subdivision of the population into high risk individuals and normal risk individuals. HHE was found in half of the subjects with atopic dermatitis, in one quarter of the subjects with atopic mucosal symptoms and in one fifth of the non-atopics. A HMD increased the odds by a factor of 1.8. This increase was seen as a high risk level in subjects with HHE and as a normal risk level in subjects with no HHE. A history of atopic disease as a complement to information about HHE and HMD increased the odds by another 1.3 times. The predicted probability of developing hand eczema ranged from 91 % in subjects with a combination of HHE, HMD and atopy to 24% in subjects with none of these risk factors. Subjects with AD were found to suffer a more severe form of hand eczema with significantly higher figures for medical consultation, sick- leave, termination due to hand eczema, early debut, permanent symtoms and vesicular lesions. Amongst the patients investigated for current hand eczema high risk individuals were overrepresented. It was claimed in 92.3% of the cases that trivial irritant factors had elicited the current episodes of hand eczema. In 35% of the cases the exposure to the irritant took place largely at home. Although contact sensitivity and contact urticaria were fairly common, they mostly seemed to be of minor importance in the etiology of the current hand eczema. Staphylococcus aureus colonized eczematous lesions of the hands in 18/20 patients. The density exceeded 105 colony forming units/cm2 in 15/20 patients. Only three of these patients showed signs of clinical infection. Successful topical treatment with a potent corticosteroid significantly reduced the colonization of S. aureus. / <p>Härtill 4 uppsatser</p> / digitalisering@umu