No description available.

No description available.

Dans le cadre des systèmes de santé, la réalité de la crise est très largement admise. Les solutions proposées prennent alors forme au travers d’initiatives spécifiques des pouvoirs publics. L’ensemble des réformes véhiculées par les différents gouvernements ont une influence sur les acteurs de santé. Cette thèse a pour objectif de mettre en évidence les discours des différents acteurs des centres hospitaliers. La question centrale est ainsi formulée : quelles sont les représentations des différents acteurs face à la mise en oeuvre du nouveau management public à l’hôpital ? Le cadre théorique proposé pour cette analyse prend appui sur le lien entre contrôle et discours dans les organisations, d’une part. Et, d’autre part, il fait appel au nouveau management public et au développement de l’obligation de rendre compte pour les acteurs. Cette étude se base sur une démarche méthodologique qualitative centrée sur des données textuelles issues d’entretiens réalisés en France et en Italie. Pour cela, elle mobilise des outils d’analyse de discours. Les résultats de l’étude montre que de représentations communes existent entre les acteurs de la même catégorie professionnelle (médical, infirmière et administrative). Ces représentations sont toutefois divergentes lorsque celles-ci sont mises en parallèle. Deux catégories d’acteurs, les responsables de pôle et les cadres de santé, émergent de l’étude pour leur capacité à gérer deux dimensions fondamentales : le management et le soin. / Within the framework of the health care systems, the reality of the crisis is widely admitted. The solutions are shaped through specific initiatives of public authorities. The health care reforms conveyed by the various governments have an influence upon the actors of the health care sector. The goal of this thesis is to bring to light the discourses of the various actors of medium hospitals. The central question is : what are the representations of the various actors during theimplementation of the new public management in the hospital ? The theoretical framework for this analysis lies on the link between control and discourses in organizations, on one hand. And, on the other hand, it highlights the new public management and to the development of the accountability for the actors. This study is based on a qualitative methodological approach focused on textual data stemming from interviews in France and in Italy. For that purpose, we choose tools for the analysis of discourse. The results of the study show that common representations remain between the actors of the same professional category (medical, nursing and administrative). These representations are however different from one category to another. Two categories of actors, responsible of pole and nursing managers, are revealed by the study for their ability to manage two fundamental dimensions : management and care.

The research method of this thesis is Archival Analysis method. First of all, according to accreditation of the hospital, we selected 104 hospitals, 73 hospitals organization charts in total, for the research objects. Secondly, we categorized organization charts based on the ownership of hospital and its statues. Finally, we deduced the types of hospitals administration department from their history and hospital administration management developed history. According to the result, there are three types of hospitals administration department that include: the Model of National Taiwan University Hospital, the Model of Chang Gung Memorial Hospital, and the Model of China Medical University Hospital. Most of Taiwan hospitals are belonged to the Model of National Taiwan University Hospital and the Model of Chang Gung Memorial Hospital. These two types existed before the National Health Insurance practiced. However, the Model of China Medical University Hospital occurred and developed into a staff system after the National Health Insurance practiced. By the configuration theory of Henry Mintzberg, the National Taiwan University Hospital Model is a professional organization, and its administration department is acting as assistance in managing, the medical unit leads the control over all. On contrast with the National Taiwan University Hospital Model, The Chang Gung Memorial Hospital Model tended to be a machine organization, administration is a core management which had a powerful authority. The China Medical University Hospital Model is a combination of those two models but slightly tends to machine organization; therefore its administration department has the authority. By understanding the role of management and it¡¦s important in hospital system, administrator has to rethink about the mission statement, the prospect and the impact from the changing of hospital system based on macro viewpoint in order to manage its Human Resource Management resources efficiently.

Diploma thesis deals with problems realization of primary prevention of socially pathological phenomena at elementary schools. Presents basic characteristics of the socially pathological phenomena, organisations engaged in the implementation of preventive programs, including recommended methods and procedures. Also proposes a methodology of prevention, the filling of his work. The key part is the custom implementation of the short-prevention program with the use of the materials issued by the Civil association Call hope. Part of the work is also a proposal of variants of the job of the leaves, which is possible in the framework of the implementation of the primary prevention use. In the framework of the master thesis was carried out research whose aim was to obtain the opinion of the on the issue of prevention and the current situation at the primary school from the perspective of the methodology of prevention, to further obtain feedback from pupils who have completed the preventive programs.

Professional organizations offer nurses services and resources for professional growth throughout their careers; yet, membership has declined over the past 10 years. Accordingly, this study was to understand the barriers in membership and identify positive changes that will increase membership and retain members. A quantitative descriptive design was employed within a convenience sample of 150 advanced practice registered nurses (APRNs) who were past or nonmembers of a professional organization. Exchange theory was applied and the Professional Association Membership Questionnaire (PAMQ) was administered to assess the barriers to APRNs participating in a specific professional organization. Statistical analysis included mean scores for each of the PAMQ's 34 questions with groupings by benefits and barriers using a 7-point Likert-type scale. Study results indicated 71% (n = 106) of 150 participants ranked continuing education as the most important benefit when considering joining a professional organization. Although prior literature frequently reported cost as a barrier to membership in professional organizations, fewer than 50% (n = 56) of participants in this study ranked cost as a barrier to membership. Professional organizations can bring about positive social change by providing accessible continuing education to membership. To do so will improve the quality of nursing services through evidence-based practice, education, and leadership. Membership in a professional organization allows the nurse to maintain current awareness of health care changes and policies. Significant membership is necessary in order for the organization to have a major impact in the profession.

No description available.

La profession de masseur kinésithérapeute est officiellement née le 30 avril 1946. A partir de la fin du 19e siècle, le massage, la kinésithérapie, la gymnastique ayant pénétré le champ de la médecine et la loi du 30 novembre 1892 confié aux médecins le monopole de l’ensemble des techniques de soins, ceux-ci vont faire appel à des auxiliaires dont ils auront assurés la formation préalable pour mieux les contrôler. La guerre de 1914-1918 « fléau social » va assurer la promotion empirique de ces méthodes. L’absence de masseurs professionnels ayant limité le bénéfice de ces pratiques, le corps médical va accepter de les déléguer à certains auxiliaires. Il faudra attendre la Seconde Guerre mondiale pour que soient créées la profession de moniteur de gymnastique médicale et celle de masseur médical. Ces textes abrogés en 1945, la loi n° 46.857 du 30 avril 1946 tendant à réglementer l’exercice des professions de masseur gymnaste médical va créer la profession de masseur-kinésithérapeute en lui confiant le monopole légal du massage. Il lui faudra attendre près d’un quart de siècle (1969) pour voir aboutir sa principale revendication : une troisième année d’études et 60 ans pour obtenir Conseil de l’Ordre (2006). Par la suite l’évolution de la profession va être impactée par la mise en place de quotas d’accès aux études qui va inciter un grand nombre de jeunes français(e)s à entreprendre leurs études dans des pays de l’Union européenne. Subséquemment, de plus en plus de ressortissants communautaires viennent exercer en France. Les bouleversements en matière de mœurs apparus au cours des années 1960-1970, ayant aboli un certain nombre d’interdits, a bouleversé les mentalités en favorisant une recherche du bien-être. Les masseurs-kinésithérapeutes ayant abandonné le massage hygiénique et esthétique d’autres le revendiquèrent. La création d’un Ordre professionnel a été sources de graves dissensions intra professionnelles. La raison ayant fini par l’emporter la profession, majoritairement unie, vient d’obtenir une avancée significative symbolisée par l’obtention d’une quatrième année d’études précédée d’une première année d’études universitaire (PACES, STAPS, STC). / The physiotherapist profession is officially born on 30 April 1946. From the late 19th century, massage, physiotherapy, gymnastics having entered the field of medicine and the law of 30 November 1892 given doctors a monopoly all care techniques, they will appeal to auxiliary assured they will pre-service training to better control. The War of 1914-1918 "social evil" will ensure the promotion of these empirical methods. The lack of professional masseurs who limited the access to these practices the medical profession will agree to delegate certain auxiliaries. It was not until World War II that a purely authoritarian manner are created medical gymnastics instructor profession and the medical masseur. These texts repealed in 1945, Law No. 46857 of 30 April 1946 designed to regulate the exercise of the medical professions gymnast masseur will create the profession of physiotherapist by giving him the legal monopoly of the massage. Very quickly this monopoly will be challenged and just as quickly the profession will manifest a desire for emancipation in relation to medical supervision. He will have to wait almost a quarter century (1969) to see its main claim result: a third year of study and 60 years for the Council of the Order (2006). The evolution of physiotherapy was, at first, hampered by the hegemonic designs of the medical profession and in a second stage conditional on regulatory harmonization policy allied health professionals conducted by public authorities and by societal choices. Subsequently the evolution of the profession will be affected by the establishment of quotas for access to studies that will encourage a large number of French youth (s) to undertake their studies in countries of the European Union. Subsequently, more and more EU citizens come to work in France. The upheavals on morals appeared in the years 1960-1970, have abolished a number of prohibitions, has upset the mentalities by promoting research of wellbeing. The physiotherapists who discontinued hygienic and aesthetic massage others vindicated. The first were beauticians who eventually win the case (massages to aesthetic purposes) followed by self-appointed wellness massage practitioners that case law has gradually legitimized. The creation of a Professional Order was the source of serious intra professional dissension. In this case, the energy expended was not put on the professional service, but of a certain conception of the latter. The reason has finally prevailed occupation, mainly united, has obtained significant progress symbolized by obtaining a fourth year preceded by a first year of university studies (PACES, STAPS, STC )

Depuis plus de dix ans, l'émergence des pratiques de contrôle de gestion en environnement public ont donné lieu à de nombreuses contributions dont certaines abordent le rôle des contrôleurs dans cette dynamique de changement.L'objectif de ce travail est de comprendre les déterminants de la légitimité des contrôleurs de gestion dans cet environnement et de déterminer comment les individus qui incarnent cette fonction ont pu « survivre » jusqu'à présent dans des organisations d'ordinaires hostiles au contrôle. Nous nous appuyons pour cela sur une étude de cas que nous avons mené auprès du Commissariat à l'Energie Atomique et aux Energies Alternatives. Quatre profils-types de contrôleurs y sont étudiés : le jeune premier, le nouveau converti, le caméléon et le conseiller du roi.Ce travail de recherche contribue donc à enrichir la connaissance de la fonction de contrôleur en liant notamment les différentes composantes de l'activité des contrôleurs autour de la recherche quotidienne de légitimité. Il permet également d'approfondir le rôle du contrôleur et de resituer l'individu dans le processus d'institutionnalisation du contrôle et dans la mise en œuvre du nouveau management public. / For more than ten years, the development of management control practices inpublic sector gave rise to many researches which some, focus on role that accountants play.The aim of this paper is to understand the determinants of management accountants' legitimacy in professional bureaucracies and to define how individuals, who embody this function, had survived in this unfriendly environment. From a case study at the French Atomic Energy Commission, we highlight four profiles of management accountants: the young novice, the new convert, the chameleon and the king's advisor.The results show that the legitimacy of the controllers should not be studied through his generic definition. Instead, it must be considered as a polymorphic judgment based on manifold determinants. It also allows to replace the individual at the center of the study field of the new managerial practices in public organizations.

The purpose of this paper is to investigate how social workers, working in a management position in the health care system, perceive the encounter of the medical and social perspective. With seven qualitative interviews, the study tries to conclude whether or not social workers are accepted at managerial positions within the health care sector. The social worker is, as a manager in health care, a leader but at the same time in a professional alienation from the medical caregivers. Organizations in the health care sector are often multi professional and have their own long standing tradition, history and culture. The results show that the conditions for social workers, working in a management position in health care appear to be agreeable. Collaboration works well, there is mutual respect, and the social perspective are considered valuable. Generally, the respondents agree upon what qualities distinguish a good leader and most believe that social work training provides a good foundation for the management role. Many argue that leadership is personalized and not dependent on the educational background. The social worker in a leadership position, is received well, is accepted and respected in the medical health care. Social workers, according to this study, assume the leadership role in the same ways as other professionals in health care. The social worker brings a psychosocial holistic approach which gives attention to both patients and employees alike. To meet future needs in health care in Sweden, the social worker is a good competence contributor.