In attempting to give more years of life to cancer patients, their Quality of Life (QoL) during this time has frequently been compromised. Assessment of patients’ QoL provide nurses with an opportunity to know about the whole range of patients’ needs and desires. These information would be potentially very useful for health care professionals particularly nurses for planning, conducting and evaluating the nursing care of cancer patients. Questionnaire survey research carried out in countries other than Australia identified a varied amount of agreement between cancer patients and nurses about cancer patients’ QoL. However, based on the literature review, no research study has been found in Australia that provides a detailed understanding of how nurses and cancer patients are similar or different in their perceptions of cancer patients’ QoL. A research study, therefore, was conducted to answer the following key questions: (a) what differences and/or similarities are there between patients’ and nurses’ perceptions of cancer patients’ QoL; (b) why do these differences and/or similarities exist? A research study with a mixed approach was undertaken to answer the research questions. In the first phase, a survey by questionnaire was conducted. The main aims were to identify: (a) the level of agreement between cancer patients’ and nurses’ scores on the World Health Organisation’s Quality of Life Brief questionnaire (WHOQoL-BREF); and (b) variables that may influence the level of agreement between them. Each patient and nurse was invited to complete the WHOQoL-BREF questionnaire, which was considered as an appropriate tool for evaluating cancer patients’ QoL. This questionnaire considers QoL across four domains or dimensions: physical, psychological, social relationship and environmental. In the first phase of the study, 166 cancer patients and 95 nurses were recruited from three major hospitals in Adelaide, South Australia. The patients had a range of cancer diagnoses with breast cancer being the most prevalent. Most patients were being treated as inpatients with chemotherapy being their primary treatment. The mean age of nurses was approximately 37 years and their clinical experience with cancer patients averaged approximately eight years. Intraclass Correlation Coefficient (ICC) between patients’ and nurses’ scores ranged from ‘poor’ in the social relationship and psychological domains up to ‘moderate’ in the physical domain indicating that generally nurses were different in their perceptions from those of cancer patients. Another major finding of this phase was that nurses underestimated cancer patients’ QoL in the social relationship and environmental aspects, which consisted of more personal and private issues. Having finished the first phase, the second phase was conducted based on the principles of a classical version or mode of grounded theory. The aim here was to include an interpretive perspective and explore the reasons why nurses may differ in their perceptions about cancer patients’ QoL in comparison to cancer patients. In this phase, three cancer patients and 10 nurses took part in semi-structured interviews. Participants were selected from different inpatient and outpatient oncology services and a palliative setting. Differences in patients’ and nurses’ perceptions about cancer patients’ QoL and their implications for nursing clinical practice were discussed further in the light of six important categories found in the second phase including: QoL meanings, QoL aspects, Cues-based QoL assessment; Purpose-based QoL assessment; Facilitators of QoL assessment; and Barriers to QoL assessment. It emerged that QoL has individualised meanings and nurses generally have difficulties understanding their patients’ personal perspective or definition of QoL. Another interpretive outcome that may explain why nurses differed in their perceptions when compared with cancer patients is that nurses’ assessment of cancer patients’ QoL in oncology wards is mainly made during their interaction with patients when providing care. Such an assessment has a focus on physical cues and may not facilitate nurses developing a more holistic picture of cancer patients’ QoL. Participants in the interpretive phase indicated that time limitations, focus on care tasks, and discontinuity of care, all work against nurses developing a more accurate understanding of cancer patients’ QoL. Conversely, it was found that building a relationship and stronger rapport with patients is the main facilitator in improving nurses’ understanding of cancer patients’ QoL.

This research explores the identity reconstruction of graduate students in additional language (AL) contexts. It addresses not only the issue of language proficiency in self-representation, but also more complicated factors that influence self-positioning and perceived social positioning in an additional culture, as well as ways of establishing the self in academic writing. The research is grounded in language learning theories in second language education and identity theories in linguistics, sociology, and cultural studies. Eleven graduate students participated in the study, among whom five were international students at a Chinese university and six were Chinese students at a Canadian university. Data were drawn from a questionnaire, writing samples, interviews, and email correspondence. Commonalities and divergences were found between groups and within groups. I developed a framework of writer identity for AL graduate students prior to the study and modified it in the discussion. Based on the data, I elaborated on the connections of personal identity and writer identity, and conceptualized for AL speakers a mediated space incorporating home culture and host culture but going beyond the overlap of the two, as well as a mediated self that is achieved through negotiation with the available options in their respective social context. / Thesis (Ph.D, Education) -- Queen's University, 2008-04-24 23:24:36.208

This thesis is concerned with a research project conducted with a Swedish company to provide recommendations for developing a prototypical information system for the company. The system’s goal was to consolidate data regarding the company’s supply chain and packaging conditions in order to find improvements in packaging development. The thesis employed the use of Soft Systems Methodology to aid with the system development process. A qualitative explorative study was designed for this purpose. Soft Systems Methodology was used after exploring alternative methodologies. This was chosen as the researchers found it important to engage the case company in the system development process. Four semi-structured interviews and two workshops with the relevant officials were the main methods of collecting data. Models such as a rich picture, CATWOE and PQR formula were utilized during the research to visualize important aspects of the system development process. As a result of the research, the researchers were able to provide the company with recommendations for how to further proceed with the development process. Another result of the study was that Soft Systems Methodology was able to unlock tacit information. The methodology also allowed for a consideration of the implementation of an iterative process to support the development. The results of this research suggest that introducing and making use of Soft Systems Methodology is very stimulating in an environment not already using it. The research provided insights needed for progress towards a successful implementation of a new information system, and contributes a real-world SSM case in a corporate environment. The researchers also suggest future opportunities for research that could further build on the work presented in the thesis.

Aquesta tesis presenta un estudi interpretativista sobre els processos d'estandardització i integració relacionats amb la implementació d'un sistema d'informació inter-organitzatiu (SIIO) sectorial en el Port de Barcelona. Aquest treball adopta una perspectiva de conjunt sobre els SIIO. Per un costat, des d'aquesta perspectiva un SIIO està en constant en moviment durant la implementació i el seu posterior ús. Per tant, la implementació del SIIO ve condicionada per configuracions prèvies, ja que els sistemes existents influencien en les opcions i trajectòries que pot prendre la implementació. Per altre costat, de la mateixa manera la implementació ve determinada tant per aspectes materials i/o tecnològics com per aspectes socials. És a dir, la implementació es pot veure com un procés de canvi socio-tecnològic que evoluciona al llarg de la implementació del SIIO sectorial.L'objectiu d'aquesta tesis és investigar la naturalesa socio-tecnològica del procés de implementació d'un SIIO i identificar aspectes teòrics i pràctics que puguin explicar les dinàmiques que es produeixin al llarg de la implementació. En base a un estudi de cas intepretativista i en profunditat, el qual combina l'ús de grounded theory i actor-network theory, realitzo un anàlisi del procés d'implementació, i formalitzo una sèrie de contribucions teòriques i pràctiques. El primer gran tema d'estudi d'aquest treball ha estat l'estandardització que ha tingut lloc abans i durant la implementació del SIIO sectorial. El segon tema ha estat la integració dels sistemes de informació prèviament existents amb el SIIO sectorial.Les contribucions d'aquest treball tenen implicacions per la recerca. En primer lloc, aquest treball amplia el limitat, tot i que creixent, nombre de investigacions que s'han centrat en la naturalesa processual i socio-tecnològica dels SIIO. Igualment aquest treball complementa la literatura existent en SIIO, que ha proposat models de factors, ja que explica com i perquè alguns d'aquests factors són importants. En segon lloc, aquest treball contribueix a la recerca que ha fet estudis longitudinals en l'àrea de sistemes d'informació ja que proporciona una interpretació contextual i en profunditat sobre els processos d'adaptació i canvi que tenen lloc durant la implementació d'un SIIO. Finalment, aquesta tesis contribueix a la literatura sobre estandardització de SIIO mitjançant l'establiment de lligams entre els estudis que proposen models de procés i els que es centren en l'anàlisi dels grups d'interès que participen en l'estandardització.Per altre costat, aquesta tesis té legitimitat pragmàtica ja que pot servir d'ajuda per millorar la pràctica. En primer lloc, aquest treball confirma el dinamisme dels interessos dels actors que participen en els processos d'estandardització, i posa de relleu que aquests actors tenen un ampli ventall d'interessos que varia en funció de la naturalesa dels propis actors i que condiciona la seva actitud al llarg del procés. És, per tant, molt important realitzar una constant identificació dels interessos dels actors. En segon lloc, aquesta tesis mostra que la gestió de SIIO ha de posar èmfasi i dedicar recursos no solament al disseny, a preveure escenaris futurs, i a desenvolupar estratègies i accions per fer front a aquestes previsions. La gestió també ha de prestar atenció i comprendre els esdeveniments no previstos i els canvis emergents que succeeixen durant l'ús del SIIO. Finalment, la implementació de SIIO requereix que els directius donin resposta per tal de reforçar o atenuar aquests canvis emergents. És a dir, la gestió de SIIO no es pot concebre únicament com una intervenció que es pot predefinir i planificar, sinó també com una forma de reacció i resposta al context i el comportament dels altres. Aquesta tesis també suggereix una sèrie de maniobres que poden ésser d'ajut als directius i professionals involucrats en projectes d'implementació de SIIO. / Esta tesis presenta un estudio interpretativista sobre los procesos de estandarización e integración relacionados con la implementación de un sistema de información inter-organizativo (SIIO) sectorial en el Puerto de Barcelona. Este trabajo adopta una perspectiva de conjunto sobre los SIIO. Por un lado, desde esta perspectiva un SIIO está en constante movimiento durante su implementación y posterior uso. Por lo tanto, la implementación del SIIO viene condicionada por configuraciones previas, ya que los sistemas existentes influyen en las opciones y trayectorias que puede tomar la implementación. Por otro lado, igualmente la implementación viene determinada tanto por aspectos materiales y/o tecnológicos como por aspectos sociales. Es decir, la implementación puede verse como un proceso de cambio socio-tecnológico que evoluciona a lo largo de la implementación de SIIO sectorial.El objetivo de esta tesis es investigar la naturaleza socio-tecnológica del proceso de implementación de un SIIO e identificar aspectos teóricos y prácticos que puedan explicar las dinámicas que se producen durante la implementación. En base a un estudio de caso en profundidad e interpretativista, el cual combina el uso de grounded theory y actor-network theory, realizo un análisis del proceso de implementación, y formalizo una serie de contribuciones teóricas y prácticas. El primer gran tema de estudio de este trabajo ha sido la estandarización que ha tenido lugar antes y durante la implementación del SIIO sectorial. El segundo tema ha sido la integración de los sistemas de información que ya existían previamente con el SIIO sectorial.Las contribuciones de este trabajo tienen implicaciones para la investigación. En primer lugar, este trabajo amplia el limitado, aunque creciente, número de investigaciones que se han centrado en la naturaleza procesual i socio-tecnológica de los SIIO. Igualmente este trabajo complementa la literatura previa en SIIO, la cual ha propuesto modelos de factores, ya que explica cómo y por qué algunos de estos factores son relevantes. En segundo lugar, este trabajo contribuye a la investigación que ha realizado estudios longitudinales en el área de los sistemas de información ya que proporciona una interpretación contextual y en profundidad sobre los procesos de adaptación y cambio que tienen lugar durante la implementación de un SIIO. Finalmente, esta tesis contribuye a la literatura sobre estandarización ya que establece vínculos entre los estudios que han propuesto modelos de proceso y los que se centran en el análisis de los grupos de interés que participan en la estandarización.Por otro lado, esta tesis tiene legitimidad pragmática ya que puede servir de ayuda para mejorar la práctica. En primer lugar, este trabajo confirma el dinamismo de los intereses de los actores que participan en procesos de estandarización, y pone de relieve que los diferentes actores tienen una amplia gama de intereses que varía en función de la naturaleza de los propios actores y que condiciona su actitud a lo largo del proceso. Es, por lo tanto, muy importante realizar una constante identificación de los intereses de los actores durante la implementación. En segundo lugar, esta tesis muestra que los directivos encargados de la implementación de SIIO han de poner énfasis y dedicar recursos no sólo a diseñar, prever escenarios de futuro, y desarrollar estrategias y acciones para cumplir con estas previsiones. La gestión también ha de prestar atención y comprender los acontecimientos no previstos y los cambios emergentes que se sucedan durante el uso del SIIO. Finalmente, la implementación de SIIO requiere que los directivos den respuesta con el fin de reforzar o atenuar estos cambios emergentes. Es decir, la gestión de SIIO no se puede concebir únicamente como una intervención que puede ser predefinida y planificada, sino también como una forma de reacción y respuesta al contexto y al comportamiento de otros. Esta tesis también sugiere una serie de maniobras que pueden ser de ayuda para los directivos y profesionales involucrados en proyectos de implementación de SIIO. / This dissertation presents an interpretive study of standardization and integration processes related to the implementation of an industry inter-organizational information system (IOIS) in the Seaport of Barcelona. This thesis adopts an ensemble view of the IOIS. First, from this perspective an IOIS is in constant flux as it is implemented and used in practice. Thus implementation becomes path dependent in the sense that existing systems influence the implementation choices and paths. Second, the implementation is being partly materially determined and partly socially constructed. That is, implementation may be viewed as socio-technical change processes that evolved around the implementation of the industry IOIS.The objective of this thesis is to inquire into the socio-technical nature of IOIS implementation process and identify theoretical and practical issues that can provide a relevant explanation of the implementation dynamics. Based on an in-depth interpretive case study, which is combined with actor-network theory and grounded theory, I conduct an analysis of the implementation process and formalize a set of theoretical and practical implications. The first main theme of this work has been the standardization effort that has taken place before and during the implementation of the industry IOIS. The second main theme is related with the integration of the adopters' pre-existing systems with the industry IOIS.The contributions that arise from this research have implications for research. Firstly, it adds to the limited but growing group of researchers that have focused on the processual and socio-technical nature of IOISs, as well as adds to the factor-based IOIS literature by detailing how and why some of these factors become important. Secondly, it contributes to longitudinal IS research by providing a deeper contextual understanding of the processes of adaptation and change that underlie IOIS implementation. Finally, it contributes to IOIS standardization literature by establishing links between the process and stakeholder models. On the other hand, this thesis has pragmatic legitimacy as it may serve as a helpful guide from which to improve practice. Firstly, this work confirms the dynamism of the stakes during the standardization process and highlights that the stakeholders that participate in the standardization have a range of stakes that vary among their nature and drive their attitude towards the process. Thus a continuous identification of participants' stakes appears to be very important. Secondly, this thesis shows that IOIS management has to place emphasis and devote resources not only to design, predict future conditions, and develop strategies and actions to meet those predictions, but also to pay attention and understand the unexpected events and emergent changes that arise during the use of the IOIS. Finally, IOIS implementation requires management to respond in order to reinforce or attenuate the emergent changes. That is, the IOIS management cannot only be conceived as predefined planned intervention, but also as a form of reaction and response to situational demands and others' behavior. In addition, this thesis provides a set of maneuvers that may guide managers and practitioners involved in the implementation of IOISs.

The aim of this qualitative interpretive research was to explore the experiences of HIV counsellors and how these experiences influence the counsellors' psychological wellbeing. The complexities of the context within which HIV pre and post test counselling occurs form the day-to-day real ity of barely trained volunteer counsellors whose task it is to counsel, inform and educate people at grass roots concerning HIV. The guiding question of the current research pertained to the experience of HIV counselors regarding the influence of their work on their own well-being. A case study design was used. In depth interviews were conducted with nine Sotho speaking HIV counselors working in primary healthcare clinics in the Sedibeng region of Gauteng. Additional data was collected through observation. Data was initially coded, using axial coding; this was followed by thematic analysis. The focus was .on the psychological well-being of the volunteer HIV counsellors. The data indicated that the participants were not overwhelmed by the many stressors of their challenging occupations. They succeeded in developing their own ways of stress relief especially through practising their spiritual beliefs and other means like participating in community activities and meaningful relationships of significant other. They experienced personal growth and empowerment in general, but especially in the field of health and sexuality. The female participants were increasingly able to negotiate safer sex. Participants' lives were enriched through amongst others the regard they received from their communities, and being in a position to give information and advice that they gained from the training and exposure to information. The participants experienced feelings of self-worth in that they were able to contribute to their communities and thereby adding meaning to their own existence. It became clear that their character strengths such as wisdom, courage, humanity, justice and transcendence enabled them to function and grow in their difficult situation. The research highlighted that the inner strengths and virtues of the volunteer counsellors enable them to persist, in challenging work conditions and socio-economic circumstances. Difficulties facing volunteer HIV counsellors that became clear are the lack of support and recognition they have to contend with. It is therefore recommended that more attention should be given by the relevant stakeholders to strengthen the support and to make more resources available to them. / Thesis (M.A. (Psychology))--North-West University, Vaal Triangle Campus, 2010.

The aim of this qualitative interpretive research was to explore the experiences of HIV counsellors and how these experiences influence the counsellors' psychological wellbeing. The complexities of the context within which HIV pre and post test counselling occurs form the day-to-day real ity of barely trained volunteer counsellors whose task it is to counsel, inform and educate people at grass roots concerning HIV. The guiding question of the current research pertained to the experience of HIV counselors regarding the influence of their work on their own well-being. A case study design was used. In depth interviews were conducted with nine Sotho speaking HIV counselors working in primary healthcare clinics in the Sedibeng region of Gauteng. Additional data was collected through observation. Data was initially coded, using axial coding; this was followed by thematic analysis. The focus was .on the psychological well-being of the volunteer HIV counsellors. The data indicated that the participants were not overwhelmed by the many stressors of their challenging occupations. They succeeded in developing their own ways of stress relief especially through practising their spiritual beliefs and other means like participating in community activities and meaningful relationships of significant other. They experienced personal growth and empowerment in general, but especially in the field of health and sexuality. The female participants were increasingly able to negotiate safer sex. Participants' lives were enriched through amongst others the regard they received from their communities, and being in a position to give information and advice that they gained from the training and exposure to information. The participants experienced feelings of self-worth in that they were able to contribute to their communities and thereby adding meaning to their own existence. It became clear that their character strengths such as wisdom, courage, humanity, justice and transcendence enabled them to function and grow in their difficult situation. The research highlighted that the inner strengths and virtues of the volunteer counsellors enable them to persist, in challenging work conditions and socio-economic circumstances. Difficulties facing volunteer HIV counsellors that became clear are the lack of support and recognition they have to contend with. It is therefore recommended that more attention should be given by the relevant stakeholders to strengthen the support and to make more resources available to them. / Thesis (M.A. (Psychology))--North-West University, Vaal Triangle Campus, 2010.