Aim: This thesis aimed to explore community nursing middle manager role enactment in managing change within Community Health Partnerships (CHPs) in three regions of Scotland from 2008-2011. Background: CHPs were established to play a key role in shifting care from the acute to the community setting. Within this context the community nursing workforce has been adapting roles in response to Scottish Government (SG) directives. However literature review demonstrated there has been very little research into the role of Community Nurse Middle Managers (CNMMs) in the midst of this change. This investigation sought to address this deficit in the literature. Design and Methodology: The study was conducted in four distinct phases comprising of the reflexive, foundational, recursive and expansive. A total of 42 semi-structured interviews were conducted over the period of investigation. The investigation was qualitative and phenomenological in character. A hermeneutic approach was adopted, broadly based on Heideggerian philosophy. More specifically this study drew on the Interpretative Phenomenological Analysis (IPA) approach of Jonathan Smith (1996). Main findings: In general CNMMs perceived that their jobs had become more complex, with the pace and intensity of work having increased. They held a wide range of responsibilities managing the challenges of driving change within a hierarchy and professional bureaucracy. Opportunities for education and learning were felt to have reduced. A small but significant proportion had left and some were considering leaving the NHS service. A primary motivation for CNMMs was maintaining an implicit connection with service users. They were proud to be members of the nursing profession and aligned their identity with their career history. This was perceived to influence their management and leadership style. In overcoming some of the personal challenges they faced they identified protective factors or “assets” to counteract stress. The application of a salutogenic perspective emerged as important in supporting this. Conclusion: The study has addressed a knowledge gap in literature. It contributes to understandings of NHS community nursing, middle management, role, change and Community Health Partnership literature. In particular it gives a voice to the perspectives of community nursing middle managers in Scotland. It suggests that much more attention needs to be paid to the needs, constitution and sustenance of middle managers in Scottish community nursing and that this has policy, practice, education and research implications.

Inledning/Bakgrund: Anhöriga till personer i palliativ vård tar ofta på sig rollen som anhörigvårdare och en sjuksköterska kommer med stor sannolikhet att möta dessa personer. Därför kan det vara av stor betydelse att som sjuksköterska veta hur anhörigvårdare upplever sin vardag.   Syfte: Syftet var att beskriva upplevelsen av att vara anhörigvårdare i palliativ vård.   Metod: En litteraturöversikt har genomförts med en induktiv ansats. Dataanalys har utgjorts av artiklar med kvalitativ design, samt mixad metod, då det stämde överens med examensarbetets syfte. Dataanalys har gjorts utifrån Fribergs femstegsmodell.   Resultat: Huvudfynd från 17 artiklar presenterades i tre huvudkategorier: När livet vänds upp och ner, Kommunikation och relation samt Stöd till anhörigvårdaren, med sju tillhörande subkategorier. Resultatet visade att positiva och negativa upplevelser av att vara anhörigvårdare började när personen tog rollen som anhörigvårdare. Upplevelserna fortsatte sedan genom hela sjukdomsperioden och fanns även efter att deras närstående gått bort.   Slutsats: Att vara en anhörigvårdare är en upplevelse på gott och ont. Det är viktigt att tillhandahålla nödvändig information tidigt i sjukdomsförloppet. Dock bör informationen ges i små mängder utefter anhörigvårdarens takt. Nyckelord: Anhörigvårdare, Palliativ vård, Stöd, Hanterbarhet, Rollförändring / Introduction/Background: Relatives to people in palliative care often take the role as a caregiver and a nurse will most likely encounter with these people. It could be of great significance for a nurse to know how caregivers experience their every-day life.   Aim: The aim was to describe the experience of being a caregiver in palliative care.   Method: A literature review with an inductive approach was composed. Data analysis was composed by articles with qualitative and mixed method design, as it harmonizes with the aim of this Bachelor’s thesis. Friberg’s five-step model has been used for data analysis.   Results: Main findings from 17 articles were presented in three main categories: When life turns up-side-down, Communication and relation and Support for the caregiver, with seven belonging subcategories. The results showed that positive and negative experiences of being a caregiver started when the person took the role as a caregiver. The experiences continued then throughout the whole illness trajectory and where present even after the death of their relative   Conclusion: Being a caregiver is both a good and a bad experience. It is important to provide necessary information early in the disease trajectory but the amount of information should be given in small doses in the pace of the caregiver.   Keywords: Caregivers, Palliative care, Support, Coping, Role change

Abstract Extensive applications of information technologies actually brings with much convenience for daily life and work of people. However, every thing acts just like a double-edged sword combined with both advantages and disadvantages together. Despite much convenience for people, it makes lots of people miserably bothered and trapped by considerable volumes of quickly-updating novel technologies. Technical stress is a concept firstly proposed by Craig in 1984. Thereafter, there are numerous scholars starting to conduct theoretical and empirical researches on the technical stress of information technologies happening to work environment. This article focuses on the technical stress of information technologies exploring the influence on people¡¦s work roles caused by technical stress. Furthermore, there are some researches indicating that organizational support perception can be served as a kind of buffer mechanism to the negative correlation between crossing-border role stress and work performance. Therefore, based on exploring technical stress, this research aims to explore the influence on the correlation between the technical stress of information technologies and role stress caused by organizational support perception. In this research, there are totally 50 valid questionnaire replies received. The regression analysis is meant to explore the influence on role stress caused by both the technical stress of information technologies and organizational support perception. From research results, it is found the technical stress of information technologies exerts positive influence role stress. Organizational support perception exerts negative influence on role stress. Additionally, organizational support perception exerts negative influence on the technical stress of some information technologies. It is also found organizational support perception can really exert some effect on the technical stress of information technologies and role stress. In this research, it indicates organizational support perception can reduce the effect on role stress caused by the technical stress of information technologies. The main contribution of this research is meant to find out the influence for organizational support perception to reduce the difficulties when members are learning novel techniques, the burden of information confidentiality and the influence on organizational members when changing their roles. From research results, the importance of organizational support perception to reduce the technical stress of information technologies and role stress is resultantly found. Finally, the theoretical and managerial implications are proposed herein with the suggestions available for upcoming research effort. Keyword: the technical stress of information technologies, life invasion of information technologies, the stress of role change, organizational support perception, organizational assistance perception, work stress

This exploratory synthesis of research was the product of three years of dissertation research efforts that systematically reviewed 23 years of empirical articles between 1983 (or its inception) and 2006 from three of the most highly regarded educational administration journals. Specifically designed to collect investigative data and information from primary research contained within Educational Administration Quarterly, the Journal of School Leadership, and the Journal of Educational Administration; this research synthesis drew upon various research methods to propose pragmatic insights and proffer an empirically founded response to: What has the educational administration profession learned from the research efforts that were independently conducted, presented, and published about the overall connections between school superintendents and education's technical core -teaching and learning in schools? Results from employing meta-analysis, descriptive synthesis, and thematic synthesis techniques to appropriately collect and analyze relevant data indicate that school superintendents remain directly connected to the technical core; however, these connections have evolved from the traditional connections presently maintained by campus administrators and to new connections that meet the increased responsibilities and complexities of the superintendents' role. The thematic synthesis, reinforced by descriptive syntheses, indicated 15 separate superintendent - technical core constructs that promote new areas for investigation; however, the extent and strength of these constructs have yet to be determined. The impact from the next step suggestions for future research indicate that effects could range from educational administration knowledge base contributions to refining in-practice standards and professional development programs. The possible knowledge base contributions, coupled with specific in-practice elements that demonstrate superintendents' direct impact on the technical core, may be the necessary raw materials from which a foundational framework that clearly redefines the superintendent - technical core connections may be forged by scholars and implemented by district leaders to improve teaching and learning in schools.

This study aims to show how mid-level managers experience a role change while in a bigger organizational change. Semi-structured interviews were undertaken with ten mid-level managers in a wholesale company with approximately 650 employees. The study is about roles and role change and how a middle manager experience a change in roles. It aims to give a new contribution to management- and organization studies and to contribute with action-advices to practitioner in work life. The theoretical starting points are Helen Rose Fuchs Ebaughs (1988) theory about role exit. The result from the interviews was analyzed with this theory and the main conclusions are: A forced change of roles for a mid-level manager can show the same steps in role exiting as the examples in Ebaughs (1988) study. Throughout the change, the manager’s experiences doubt, seeking alternatives, the turning point and creating an Ex-role. The time it took, the managers to go through all these steps varied. The company’s actions created a bigger doubt than necessary. The fact that the company waited for up to two months to declare the new roles for the middle managers created most doubt. A clearer purpose, more information about the coming roles and more information about why the change was necessary could have shortened the time it took for the managers to get through all the role-exiting steps and some role-uncertainty could have been avoided.

Den somaliskfödda gruppen beskrivs ofta som den mest svårintegrerade i Sverige med en stor underrepresentation på den svenska arbetsmarknaden. De beskrivs ha traditionella värderingar och könsroller som ofta dikterar arbetsfördelning och funktioner i familjen. Den aktuella studien ämnar undersöka effekten av ett förvärvsarbete för somaliska familjeroller i ett migrationsperspektiv. Genom att jämföra lönearbetande och arbetslösa somaliskfödda kvinnors upplevelser avser studien även belysa förvärvsarbetets betydelse för kvinnans vardagsliv. Uppsatsen bygger på tidigare forskning om de historiska, sociala och transnationella dimensionerna i somaliskt familjeliv och kultur samt teoretiska begrepp såsom rollkonflikt, rollförändring och rollförhandling. En kvalitativ jämförande fallstudie har genomförts, där resultatet baseras på data från semistrukturerade intervjuer. Åtta respondenter deltog i undersökningen, varav fyra var förvärvsarbetande och fyra arbetslösa somaliskfödda kvinnor. Med utgångspunkt från tidigare forskning och samhällsvetenskapens rollteori har resultatet analyserats för att kunna besvara forskningsfrågorna. I resultatet framkommer det att det finns vissa skillnader mellan de båda grupperna. De somaliska familjerna där kvinnorna inte befinner sig i ett förvärvsarbete har en distinkt uppdelning av hushållsarbetet, där kvinnan står för majoriteten av sysslorna. Det är även tydligt att de traditionella somaliska familjerollerna fortfarande vidmakthålls. I de familjer där de somaliskfödda kvinnorna lönearbetar däremot, har de traditionella familjerollerna uppluckrats och lett till en mer jämlik fördelning av hushållsarbetet. Där delar mannen, kvinnan och barnen på ansvaret. Fortsättningsvis framkommer det att de arbetslösa somaliskfödda kvinnorna är mycket angelägna om att ha ett arbete då självständighet från stat och myndigheter är drivkraften. För de lönearbetande kvinnorna framkommer istället ett tydligare fokus på att vara självständig från mannen och kunna bestämma mer i familjeangelägenheter. Resultatet visar även hur samhällets förväntningar på kvinnorna har påverkat deras drivkrafter till att arbeta och sätt att tänka om sin funktion i familjen. / Somali-born immigrants are often described as the most difficult group to integrate into Swedish society with an extensive underrepresentation on the Swedish labour market as well as traditional values and gender roles that often dictate the division of labour and functions in the family. This study aims to examine the effects of a job on Somali family roles from a migration perspective. By comparing wage-earning and unemployed Somali-born women's experiences, the study also aspires to elucidate the importance of a job in their everyday life. The essay is based on previous research on the historical, social and transnational dimensions of Somali family life and culture, as well as theoretical concepts such as role conflict, role change and role negotiation. A qualitative comparative case study has been conducted, based on data from semi-structured interviews. Eight respondents participated in the survey – four employed and four unemployed women born in Somalia. The results were then analyzed in the light of previous research and the theoretical concepts. The result shows that there are some interesting differences between the two groups. The Somali families in which the women are unemployed have a distinct division of the household work, where the woman assumes the majority of the workload. Here it is also clear that traditional Somali family roles are still of importance. However, in the families where the Somali-born women have employment, traditional family roles have changed and led to a more even distribution of household work, where the men, women and children share the responsibility. Furthermore, it appears that the unemployed Somali-born women are very keen to have a job, as independence from the state and government is a main driving force. For the wage-earners on the other hand, there is a clearer focus on being independent from the man and being able to be a decision-maker in family matters. The result also illustrates how society's expectations on women influence their driving forces to work and the way they think about their role in the family.

This paper addresses the question of whether Russia’s role conception changed after the annexation of Crimea. Research on role conceptions has a solid standing within foreign policy analysis, but information on role change and what it is that affects it has not been given the necessary attention. The paper’s theoretical framework contains earlier theoretical definitions of role conceptions and role change. In conjunction with the theoretical approach, process tracing and systematic text analysis with a focus on narratives are used as methodological tools. Relevant findings are then generated through the study of elite-expressions of the Russian master role from, firstly, the period between 2012 and late 2013, and, secondly, 2014. In brief, the results indicate that no major change occurred. Rather the role conception remained stable throughout both sequences. This suggests that the ramifications of the annexation of Crimea did not challenge the Russian master role and that it was not perceived as a crisis by Putin and his colleagues. Moreover, it is possible that role change more likely occurs when exceptional circumstances arise unexpectedly and when they fundamentally challenge ingrained role conceptions.

Denna uppsats syftar till att undersöka hur ett införande av Self-Service Business Intelligence och SSBI-verktyg kan påverka organisationsstruktur samt anställdas roll inom organisationen. Self-Service Business Intelligence kan definieras som ett verktyg som möjliggör decentralisering av Business Intelligence vilket innebär att BI-användaren i en verksamhet kan utföra diverse uppgifter på egen hand utan att vara beroende av IT-avdelningen (Sarkar 2017). För att konkretisera arbetet undersöks fyra organisationer. Fem intervjuer som bestod av fyra semistrukturerade intervjuer och en strukturerad intervju genomfördes för att erhålla kunskap om hur dessa företag använder Self-Service Business Intelligence i praktiken. Därtill erhålls kunskap om innebörden för organisationen och dess anställda när verktyget tillgängliggjordes. I studien har bland annat TOE-ramverk använts för att analysera vilka faktorer som har en betydelse vid införande av en ny teknologi. Teorin om Organisatorisk IT mognadsnivå (OITM) användes för att analysera organisationens beredskap för att skapa värde ur informationsteknologi. Andra teorier om olika roller av BI-användare, utbildning och organisationsförändring användes för att få en djupare inblick kring de faktorer som påverkar organisationsstrukturen och anställdas roller.  Resultatet av studien visade att de anställdas roller och organisationsstrukturen påverkades av Self-Service Business Intelligence i olika grader. Det noterades en tydlig indelning av användarroller, avancerade BI-användare och vanliga BI-användare, inom samtliga organisationer. Konkreta förändringar inom organisationerna var bättre beslutfattningsprocess, avlastning hos IT-avdelningen och effektivare arbetsflöde. Bland de organisationer där Self-Service Business Intelligence har fått stor spridning noterades det en större påverkan på organisationsstruktur och anställdas roller medan de organisationerna med en mindre spridning av verktyget hade en mindre inverkan på deras verksamhet. Detta förutsätter dock att organisationerna utbildar sina anställda genom ett strukturellt träningsprogram och motiverar syftet med Self-Service Business Intelligence för en större spridning av verktyget och således en större inverkan på organisationen och de anställdas roller. / In this essay we have chosen to investigate how an implementation of Self-Service Business Intelligence can affect organizational change and the role of users within the organization. Self-Service BI is a tool that enables decentralization of BI which means that the user in a business can perform various tasks themselves without being dependent on the IT department. To concretize the work, we have chosen to examine four companies. The survey was conducted via five interviews (four semi-structured and one structured interviews) to gather insight on how these companies use Self-Service Business Intelligence and the result for their organization and employees when the tool was applied in the organization. In the study, TOE-framework has been used to analyze which factors play a role in the implementation of a new technology. The theory of Organizational IT maturity (OITM) was used to analyze the organizations and its employees' different attitudes towards IT while other theories of different roles of users, training and organizational change were used to gain a deeper insight into the factors that affect organizational structure, employee roles and factors which causes the changes. The results of the study showed that the roles of the employees and the organizational structure were affected by Self-Service Business Intelligence to varying degrees. There was a clear division of user roles, power users and casual users, within all organizations. Concrete changes in the organizations were better decision-making processes, relieves in the IT department and more efficient workflow. Among the organizations where Self-Service Business Intelligence has become widespread, a greater impact on organizational structure and employee roles has been noted, while it has been noted that those organizations with a smaller spread of the tool have seen a smaller impact on their operations. However, this presupposes that the organizations train their employees through a structural training program and justifies the purpose of Self-Service Business Intelligence for a greater spread of the tool and thus a greater impact on the organization and the employees' roles.

Implementeringen av ERTMS/ETCS har haft betydande inverkan på lokförarnas roll och arbetssituation. Denna studie undersöker konsekvenserna av ERTMS/ETCS gällande lokförarnas ansvar, grad av kontroll och den viktiga balansen mellan automation och mänsklig kompetens. Intervjuer med lokförare och branschexperter visade på en tydlig förändring från aktivt beslutsfattande och operativ kontroll till en mer passiv roll där lokförarna följer systemets instruktioner. Med ERTMS/ETCS har lokförarnas självständighet minskat, eftersom systemet kan ta över kontrollen om förarna avviker från systemets rekommendationer. Därmed förskjuts maktbalansen mot systemets fördel och minskar lokförarnas inflytande. För att upprätthålla en balans mellan bevarandet av lokförarnas kompetens och användningen av avancerade system övervägs en strategi där lokförarna utbildas som "Säkerhetsoperatörer". Faktorer såsom ljuskänslig display och dess positionering är tydliga tecken på att ERTMS/ETCS inte beaktat den sociala aspekten ur ett sociotekniskt perspektiv. / The implementation of ERTMS/ETCS has had a significant impact on the role and work situation of train drivers. This study examines the consequences of ERTMS/ETCS in terms of train drivers' responsibilities, level of control, and the crucial balance between automation and human competence. Interviews with train drivers and industry experts revealed a clear shift from active decision-making and operational control to a more passive role where train drivers follow the system's instructions. With ERTMS/ETCS, train drivers' autonomy has decreased as the system can take control if the drivers deviate from its recommendations. Consequently, the power dynamics shift in favor of the system, diminishing train drivers' influence. To maintain a balance between preserving train drivers' competence and utilizing advanced systems, a strategy is being considered to train train drivers as "Safety Operators." Factors such as the light-sensitive display and its positioning indicate that ERTMS/ETCS has not considered the social aspect from a socio-technical perspective.

Dans le cadre d’une stratégie nationale visant les objectifs du Millénaire pour le développement 4 et 5 au Maroc - réduire la mortalité maternelle et infantile -, un plan d’action a été développé au sein des trois systèmes (socioculturel, éducationnel, disciplinaire) dans lesquels évolue un rôle professionnel de la santé et ce, pour renforcer le rôle professionnel de la sage-femme. La présente thèse vise à évaluer le niveau d’implantation du plan d’action et à comprendre les facteurs contextuels ayant affecté son implantation et susceptibles d’empêcher l’atteinte de ses effets. Le cadre conceptuel adopté dérive du modèle de Hatem-Asmar (1997) concernant l’interaction entre les systèmes éducationnel, disciplinaire et socioculturel pour changer un rôle professionnel de la santé; et le cadre de Damschroder et al. (2009) pour l’analyse de l’implantation d’une intervention en santé. Le devis est une étude de cas unique à trois niveaux d’analyse. Les données sont recueillies à partir de multiples sources de données : 11 entrevues individuelles semi-structurées, 20 groupes de discussion, observations d’activités de formation, analyse de documents. Les résultats ont montré des déficits notables au niveau de l’implantation. Seize barrières et sept facilitateurs ont été catégorisés sous les construits du cadre de Damschroder et al. (2009) et sous les dimensions des trois systèmes. Un alignement inadéquat entre les dimensions (valeurs, méthodes, acteurs et finalités) du système socioculturel et celles (valeurs, méthodes, acteurs) des systèmes éducationnel et disciplinaire d’une part, avec le plan d’action d’autre part empêche son implantation globale. La structure bureaucratique et le manque de préparation du système socioculturel ont constitué les barrières les plus influentes sur: la diffusion de l’information; l’implication des acteurs du terrain dans le processus; et l’état de préparation du système éducationnel. Les principaux facilitateurs étaient : les valeurs promues à l’égard des droits humains et le mouvement politique pour renforcer le rôle professionnel de la sage-femme et réduire la mortalité maternelle. Quant au plan, il a été perçu comme étant bénéfique mais complexe et émanant d’une source externe. Les résultats mettent l’accent sur la nécessité de contourner les barrières identifiées dans les trois systèmes afin d’obtenir des contextes propices à la production des effets. Par ailleurs, les résultats ont soulevé aussi sept barrières qui risquent de compromettre l’atteinte des effets désirés. Elles concernent: le cadre légal, les représentations sociales et le support médiatique au niveau du système socioculturel; le réseautage et les mécanismes de communication, les caractéristiques liées au rôle, à l’environnement de pratique, et le niveau de préparation du système disciplinaire. Notre recherche confirme qu’un changement visant le système éducationnel isolément représente une vision réductrice pour le renforcement du rôle des sages-femmes. Une combinaison des conditions contextuelles favorables au niveau des dimensions des trois systèmes est requise pour atteindre le but de la stratégie gouvernementale, soit fournir des sages-femmes qualifiées selon les normes globales de la Confédération Internationale des sages-femmes, capables d’offrir des soins de qualité en santé de la reproduction qui permettront de contribuer à réduire la mortalité maternelle et néonatale. / As part of a national strategy for reaching the Millennium Development Goals 4 and 5 in Morocco – to reduce maternal and infant mortality - an action plan covering the three systems (socio-cultural, educational, disciplinary) in which evolves a health professional role was developed in order to strengthen the midwifery professional role. This thesis aims to assess the level of implementation of the action plan and to understand the contextual factors affecting its implementation and that may prevent reaching the targeted outcomes. We used a conceptual framework that builds on Hatem-Asmar’s model regarding the interaction between the socio-cultural, educational and disciplinary systems to change a health professional role; and on the Consolidated Framework for Implementation Research (CFIR) for the implementation analysis of a health intervention. A single case study design with three levels of analysis was chosen for this thesis. The data were collected through multiple data sources: 11 individual semi-structured interviews, 20 focus groups, observations of training activities, analysis of documents. The results showed a significant deficit in the implementation. Sixteen barriers and seven facilitators encountered during the implementation were categorized into the four system’s dimensions. Misalignment between the dimensions (values, methods, actors and targets) of the socio-cultural system and those (values, methods, actors) of the educational and disciplinary systems on the one hand, and with the action plan on the other hand, prevent its global implementation. The bureaucratic structure and lack of readiness of the socio-cultural system were among the most influential barriers on: diffusion of information; involvement of key actors in the process, readiness of the educational system. The main facilitators were the values promoted with respect to human rights, and the political movement to strengthen midwives’ professional role and to reduce maternal mortality. The plan was perceived as beneficial but complex and externally driven. The results emphasize the need to overcome the barriers identified in the three systems in order to obtain contextual conditions favorable to achieve outcomes. In addition, seven barriers were identified in the analysis that may compromise the achievement of the targeted outcomes. They relate to the: legal framework, social representations and media support at the socio-cultural system; and the practice environment, networks and communication mechanisms, characteristics related to the role and the readiness of the disciplinary system. Our research confirms that conducting a change in the educational system represents a partially focused view for strengthening the midwives’ role. A combination of favorable contextual conditions at the dimensions of the three systems is required to achieve the goal of the government's strategy which is to provide qualified midwives according to the International Confederation of Midwives global standards for midwifery, able to provide quality reproductive health care, and to contribute to reducing maternal and neonatal mortality.