La conscience de l’environnement d’affaires est définie comme l’ensemble des savoirs détenus par les employés non-cadres par rapport à l’environnement d’affaires interne et externe de leur organisation. Elle se manifeste lorsque l’employé est impliqué dans la prise de décision ou résolution de problème affectant l’entreprise. Ce travail a comme objectifs la validation d’une échelle de mesure du concept à l’étude, ainsi que la vérification de sa validité de construit et nomologique. L’ensemble initial d’items de l’échelle de mesure a été déterminé suite à des entrevues avec les employés d’organisations participantes (Gauvreau-Jean, 2008). L’ensemble initial de 40 items a été testé avec un échantillon de 508 employés d’une manufacture. Suite à des ajustements, l’échelle modifiée couvre quatre dimensions du construit. L’adéquation de son contenu a ensuite été mise à l’épreuve par deux groupes cibles et deux évaluations expertes (Lessard, 2014). Finalement, dans le cadre de notre étude, la validité du contenu et nomologique de l’échelle modifiée (contenant 24 items) a été testée avec 330 employés de première ligne de quatre entreprises. Les quatre dimensions du construit furent supportées, la fiabilité de l’échelle était haute, puis les hypothèses reliant la conscience de l’environnement avec les caractéristiques au travail, l’évaluation de la performance par un superviseur et l’engagement affectif furent supportées également. Un autre sondage complété par les gestionnaires (n=43) avait comme but une évaluation de la performance contextuelle des employés supervisés. Le développement de l’échelle à 24 items sur la conscience de l’environnement d’affaires pourrait répondre aux questions portant sur la participation de l’employé et l’efficacité organisationnelle. / Employee business awareness is defined as individual nonmanagerial employee realization, perception or knowledge of the employing organization’s business environment as demonstrated when involved in decision making or problem solving that affects the business. This study delineates the context of this construct, applies accepted scale development procedures, and provides construct and nomological validity evidence supporting the developed measure. The initial set of items for the measurement scale was generated from interviews conducted with employees in participatory work settings (Gauvreau-Jean, 2008). The initial 40-item scale was then tested with a sample of 508 workers within a manufacturing company. Scale reduction resulted in a scale covering four dimensions of the construct. Its content adequacy was then challenged by two focus groups and two expert assessments (Lessard, 2014). Finally, the construct and nomological validity of the modified scale (which included 24 items) was tested with 330 front-line employees from four companies. The initial four-dimensional structure was supported, scale and factor reliabilities were high, and hypotheses relating employee business awareness to work characteristics, supervisor-rated contextual performance and affective organizational commitment were supported. The development of the 24-item employee business awareness scales may illuminate questions relating to employee participation and organizational effectiveness. Another survey completed by supervisors (n=43) tested the extra role performance of the frontline employees.

SUMMARY CONSTRUCTING AND VALIDATING A MEASURING INSTRUMENT FOR COPING WITH OCCUPATIONAL STRESS by Melissa du Plessis Supervisor: Prof N. Martins Department: Industrial and Organisational Psychology Degree: Doctor of Philosophy in Psychology Orientation: Occupational stress is still a concern for both individuals and organisations, and academia is no exception. Employees’ ability to cope with occupational stressors depend on the regulatory strategies they adopt in response to the stressor. However, there is no clear consensus on how the coping construct should be measured. Existing literature further outlines various conceptual and methodological concerns regarding the measurement of coping. Van Wyk (2010) advocates that currently, no coping instrument has been developed and very few instruments have been validated in a South African and African context. Research purpose: The primary objective of this research was to construct a valid and reliable instrument for determining which coping strategies academics adopt in response to occupational stress. Research methodology: A combination of steps, suggested by scale development authors, was followed to develop the instrument. The process was broken down into three phases, namely: (1) theoretical investigation, (2) instrument purification, and (3) instrument optimisation. The construction of the questionnaire was based on a sample of 305 university employees who were permanently employed in a higher education institution in the Gauteng Province of South Africa. Main findings: The study resulted in a psychometrically sound 33-item measuring instrument. Nine empirically validated coping strategies emerged, namely (1) social coping, (2) religious coping, (3) cognitive coping, (4) active leisure coping, (5) avoidant coping, (6) social disengagement, (7) vacation time, (8) rumination, and (9) emotional coping. These strategies were further classified as adaptive or maladaptive coping strategies. CFA confirmed the nine-factor model. Empirical support for construct and content validity, internal consistency reliability v and composite reliability was available. The instrument further demonstrated convergent and discriminant validity. Contribution/value-add: The key contribution of this study was the development of a psychometrically sound instrument for determining which coping strategies academics adopt in response to occupational stress. This study further contributed to constructing and empirically testing a model for coping with occupational stress. Lastly, the study provided support for measurement invariance across different demographical groups, and the findings revealed that individuals from different demographical backgrounds differ significantly in the coping strategies they adopt in response to occupational stress. / DIE ONTWIKKELING EN VALIDASIE VAN ’N MEETINSTRUMENT VIR DIE HANTERING VAN BEROEPSTRES deur Melissa du Plessis Promotor: Prof N Martins Departement: Bedryfs- en Organisasiesielkunde Graad: DPhil in Sielkunde Oriëntasie: Beroepstres is steeds ’n bron van kommer vir individue sowel as organisasies, en die akademiese omgewing is geen uitsondering nie. Werknemers se vermoë om beroepstres te hanteer, word bepaal deur die regulatoriese strategieë wat hulle aanneem in reaksie tot die stressor. Daar is egter geen duidelike konsensus oor hoe die hanteringskonstruk gemeet behoort te word nie. Voorts dui bestaande literatuur op verskeie konseptuele en metodologiese probleme met betrekking tot die meet van streshantering. Van Wyk (2010) beweer dat daar tot dusver geen hanteringsinstrument ontwikkel is nie en baie min instrumente is in ’n Suid-Afrikaanse en Afrika-konteks gevalideer. Doel van die navorsing: Die primêre doel van hierdie navorsing was om ’n geldige en betroubare instrument te ontwikkel waarmee daar bepaal kan word watter hanteringstrategieë akademici aanneem om beroepstres te hanteer. Navorsingsmetodologie: Die instrument is ontwikkel deur die kombinasie van verskeie stappe wat deur skrywers oor skaalontwikkeling voorgestel is. Die proses is in die volgende drie fases verdeel: (1) ’n teoretiese ondersoek; (2) die suiwering van die instrument; en (3) die optimalisering van die instrument. Die vraelys is ontwerp met die oog op die steekproef bestaande uit 305 werknemers met permanente aanstellings by ’n hoëronderwysinstelling in die Gauteng provinsie in Suid-Afrika. Hoofbevindinge: Die studie het gelei tot die ontwerp van ’n psigometries betroubare meetinstrument bestaande uit 33 items. Nege empiries gestaafde hanteringstrategieë het na vore gekom: (1) sosiale hantering; (2) religieuse hantering; (3) kognitiewe hantering; (4) aktieweontspanningshantering; (5) vermydende hantering; (6) sosiale ontkoppeling; (7) vakansietyd; (8) ruminering; en (9) emosionele hantering. Hierdie strategieë is verder vii geklassifiseer as adaptiewe of wanadaptiewe hanteringstrategieë. Dié nege-faktormodel is deur BFA bevestig. Empiriese steun vir konstruk- en inhoudsgeldigheid, interne konsekwentheidsbetroubaarheid en saamgestelde betroubaarheid was beskikbaar. Voorts het die instrument ook konvergente en diskriminantgeldigheid gedemonstreer. Bydrae / waardetoevoeging: Die belangrikste bydrae van hierdie studie was die ontwikkeling van ’n psigometries betroubare instrument wat gebruik kan word om te bepaal watter strategieë akademici volg om beroepstres te hanteer. Die studie het ook bygedra tot die ontwerp en empiriese toetsing van ’n model vir die hantering van beroepstres. Ten slotte het die studie metingsinvariansies oor verskillende demografiese groepe heen bevestig en die bevindinge het getoon dat individue uit verskillende demografiese groepe se hanteringstrategieë vir beroepstres merkbaar verskil. / IQOQO LOKUBAKULEKILE UKWAKHA NOKUQINISEKISA ITHULUZI LOKULINGANISA UKUKWAZI UKUMELA UKUKHATHAZEKA NGENXA YEZIMO ZASEMSEBENZINI ngu Melissa du Plessis UMhloli Olulekayo: USolwazi N Martins Umnyango: Izifundo Mayelana Nokusebenza Kwengqondo Nomthelela Walokho Ekuziphatheni Kwabantu Emsebenzini Iziqu: UDokotela Wezifundo Zefilosofi Maqondana Nokusebenza Kwengqondo Nomthelela Walokho Ekuziphatheni Okumaqondana nakho:Ukukhathazeka okumaqondana nezimo zasemsebenzini kusayinto ehlupha abantu ngabodwana nezinkampani, kanti nezazi zezemfundo ephakeme nazo ngeke zashiywa ngaphandle. Ukukwazi kwabasebenzi ukubhekana nezimbangela zokukhathazeka ngenxa yezimo zomsebenzi kuya ngamasu okulawula asetshenziswayo ukubhekana nalokho okudala ukukhathazeka. Nakuba kunjalo, akukho ukuvumelana okucacile ekutheni lokho okwakhiwe kokubhekana nokukhathazeka kungalinganiswa kanjani. Imibhalo ekhona ibeka kabanzi okukhathazayo okwahlukahlukene okuqondene nokuqanjwa nendlela yokwenza maqondana nokulinganiswa kokukwazi ukubhekana nokukhathazeka. UVan Wyk (2010) ulwela ukuthi, njengamanje, akunathuluzi elakhelwe ukuqonda ngokukhathazeka eselike lakhiwa kanti ambalwa amathuluzi aseke aqinisekiswa eNingizimu Afrika nase-Afrika. Injongo yocwaningo:Okuyiyona njongo eqavile yalolu cwaningo ngukwakha ithuluzi elifanele nelikholakalayo ukuveza ukuthi yimaphi amasu okubhekana nezimo asetshenziswa yizazi kwezemfundo ephakeme ezimweni zokukhathazeka ngenxa yomsebenzi. Indlela ezolandelwa ekwenzeni ucwaningo:Ukuze kusungulwe leli thuluzi, kulandelwe inhlanganisela yamagxathu ahlongozwe ngababhala mayelana nokwakhiwa kwezikali. Indlela elandelwayo yahlukaniswa izigaba ezintathu, okuyilezi: (1) ukuhlolwa kwesichasiselo esibonwa ngokucabanga kwengqondo, (2) ukuhlanjululwa kwethuluzi, kanye (3) nokusetshenziswa kwangcono kwethuluzi. Ukuhlanganiswa kohlu lwemibuzo kwakuncike esampuleni lwabasebenzi basenyuvesi abangama-305 ababeqashwe ngokugcwele esikhungweni semfundo ephakeme esifundazweni saseGauteng eNingizimu Afrika. ix Imiphumela yocwaningo eqavile: Lolu cwaningo lwadala ukuba kube khona ithuluzi lokulinganisa elisebenza kahle maqondana nokukala okuphathelene nengqondo okunezinhla ezingama-33. Kwavela amasu ayisishiyagalolunye aqinisekiswe ngokubhekwa, nokuyilawa (1) ukubhekana nesimo ngokokuhlalisana nabantu, (2) ukubhekana nesimo ngokwezenkolo, (3) ukubhekana nesimo ngokokuqonda, (4) ukubhekana nesimo ngokuzibandakanya nezikaqedisizungu, (5) ukubhekana nesimo ngokuzila okuthile, (6) ukungazibandakanyi nezimo ezihlanganisana nabantu, (7) ukungcebeleka, (8) ukuzindla, kanye (9) nokubhekana nesimo ngokuba nomunyu. La masu abuye afakwa ngaphansi kohlu lwamasu okubhekana nesimo alandelekayo nangalandeleki. I-CFA yaziqinisekisa lezi zindlela ezihlukene kasishiyagalolunye. Ukwesekelwa kokubonakele ukuqinisekisa okwakhiwe nokuqukethwe, indlela yokubheka ukuthi ithuluzi elisetshenziswayo likulinganisa ngendlela efanele kangakanani lokho okubhekwayo kanye nokusebenza ngokukholakala ngokuphelele kwamaqoqo asetshenzisiwe. Ithuluzi labuye laveza ukuqinisekiseka kokufanayo nokwahlukayo. Okusebenzile/ okuhambisana nenzuzo: Okuyiyona nto emqoka kakhulu maqondana nalolu cwaningo kwaba ngukusungulwa kwethuluzi lokulinganisa elisebenza kahle maqondana nokulinganisa okuphathelene nengqondo ukubona ukuthi yimaphi amasu okubhekana nezimo asetshenziswa yizazi kwezemfundo ephakeme ezimweni zokukhathazeka ngenxa yomsebenzi. Ucwaningo luphinde lwadlala indima ekwakheni nasekuhloleni ngokubheka okwenzekayo ngethuluzi elingasetshenziselwa ukubhekana nesimo sokukhathazeka emsebenzini. Okokugcina, ucwaningo luhlinzeke ukwesekelwa kokungaguquki kwezilinganiso emaqoqweni ahlukahlukene ngokwezigaba, kanti imiphumela yaveza ukuthi abantu abaqhamuka emaqoqweni ahlukahlukene ngokwezigaba ahluka kakhulu uma kufikwa emaswini abakhetha ukuwasebenzisa maqondana nokukhathazeka ngenxa yezimo zomsebenzi. / Psychology / D. Phil.(Psychology)

Dans cette thèse, nous décrivons les résultats d’un projet de recherche visant à mesurer et évaluer la qualité des soins obstétricaux des hôpitaux de référence au Mali et au Sénégal. Dans ces pays, la mortalité maternelle hospitalière est élevée et est liée en partie à la pratique médicale inadéquate. Cette recherche a été réalisée dans le cadre de l’étude QUARITE, un essai randomisé en grappe évaluant l’efficacité du programme GESTA International visant à réduire la mortalité maternelle hospitalière. GESTA a été mis en œuvre entre 2008 et 2010 et consistait en la formation des professionnels de santé et en la revue des cas de décès maternels. En parallèle de QUARITE, les programmes de prévention de la transmission du VIH de la mère à l’enfant (PTME) ont été mis à l’échelle à travers les pays. Ces derniers ayant également la capacité d’augmenter la qualité des soins obstétricaux, nous avons donc évalué les effets des deux programmes (GESTA et PTME) sur la qualité des soins. Dans un premier temps, à l’aide d’une recension des écrits nous avons évalué la capacité d’un audit clinique basé sur des critères à mesurer la qualité des soins obstétricaux. Cet audit vérifiait si l’offre des soins avait respecté les critères cliniques définissant la meilleure prise en charge selon l’évidence scientifique et l’avis des experts. Nous avons démontré que cet outil est largement utilisé dans les pays à faibles et moyens revenus, malgré le peu d’évidence sur sa validité (article 1). Dans un deuxième temps, nous avons développé un audit clinique basé sur des critères qui s’applique au contexte ouest-africain et qui a été approuvé par des experts-obstétriciens nationaux et internationaux. À partir des dossiers obstétricaux, les actes médicaux posés pendant le travail et l’accouchement ont été évalués à l‘aide de cet instrument. La qualité des soins a été estimée sous forme de pourcentage de critères atteints. Appliqué dans différents contextes et par différents auditeurs, nous avons démontré que notre instrument est fiable et valide (article 3). Néanmoins, l’expérience de l’audit nous a amenés à nous questionner sur le mauvais remplissage des dossiers médicaux et ses conséquences sur la qualité des soins (article 2). Dans un troisième temps, l’outil a été appliqué à large échelle pour évaluer les effets de l’intervention GESTA (article 4). Nous avons mené une révision de plus de 800 dossiers obstétricaux dans 32 hôpitaux de référence (16 bénéficiaires de l’intervention et 16 non-bénéficiaires). Grâce à cet audit clinique, nous avons démontré que le programme GESTA contribue à l’amélioration de la qualité des soins, spécifiquement l’examen clinique lors de l’admission et le suivi après l’accouchement. Dernièrement, nous avons utilisé cet instrument afin d’évaluer les effets des programmes de PTME sur la qualité des soins obstétricaux (article 5). Notre travail a documenté que seulement certaines composantes du programme de PTME améliorent la qualité des soins telles que la formation des professionnels et les services complémentaires en nutrition. En conclusion, cette recherche a identifié plusieurs pistes d’intervention pour améliorer la qualité des soins obstétricaux en Afrique de l’Ouest. / In this thesis, we describe the results of a research project that aimed to measure and evaluate quality of care in referral hospitals in Mali and Senegal. In these countries, hospital maternal mortality is high and linked, in part, to inadequate medical practice. This research was conducted as part of the QUARITE cluster randomized trial that assessed whether the program, ALARM International, could reduce facility maternal mortality. ALARM was implemented from 2008 to 2010 and consisted of the training of local health professionals and the use of maternal death reviews. At the same time as QUARITE was ongoing, programs for the prevention of maternal to child transmission of HIV (PMTCT) were scaled- up; these can also improve obstetrical quality of care. Thus, we evaluated the effects of both programs (ALARM and PMTCT) on quality of care. We began with a systematic review of the literature to evaluate the capacity of a criterion-based clinical audit to measure the quality of obstetrical care (article 1). This type of audit verifies if the care provided meets criteria indicative of best clinical practices, according to the literature and expert opinion. Our review demonstrates that this tool has been used in a variety of low- and middle-income settings, but the way it has previously been employed leaves doubts as to its validity (article 1). We thus developed a criterion based clinical audit specific to the West African context and approved by national and international expert obstetricians. Using patient medical records, with this instrument we evaluated obstetrical care provided during labour and delivery. Quality of care was calculated based on the percentage of care criteria met. Applied to different sites and by different auditors, our instrument demonstrated concordant results and provided a valid image of the quality of obstetrical care provided at hospitals in the region (article 3). Nonetheless, the audit experience raised concerns about the implications of poor medical recordkeeping and archiving on quality of care (article 2). We used the criterion-based clinical audit to review over 800 medical records at 32 QUARITE hospitals (16 intervention and 16 control hospitals) in order to evaluate the effects of the ALARM intervention. We demonstrated that the ALARM program contributes to better obstetrical quality of care, especially during the first clinical examination and postpartum monitoring of women treated at intervention hospitals (article 4). Finally, we used this instrument to evaluate the effects of PMTCT programs on obstetrical quality of care (article 5). Our work demonstrated that certain components of a PMTCT program, specifically training of healthcare professionals and supplementary nutritional services, are associated with better obstetrical care. In all, this research identified several mechanisms that can be targeted by quality improvement interventions in West Africa.

In the shift to a globalised creative economy where innovation and creativity are increasingly prized, many studies have documented direct and indirect social and economic benefits of the arts. In addition, arts workers have been argued to possess capabilities which are of great benefit both within and outside the arts, including (in addition to creativity) problem solving abilities, emotional intelligence, and team working skills (ARC Centre of Excellence for Creative Industries and Innovation, 2007). However, the labour force characteristics of professional artists in Australia and elsewhere belie their importance. The average earnings of workers in the arts sector are consistently less than other workers with similar educational backgrounds, and their rates of unemployment and underemployment are much higher (Australian Bureau of Statistics, 2005; Caves, 2000; Throsby & Hollister, 2003). Graduating students in the arts appear to experience similar employment challenges and exhibit similar patterns of work to artists in general. Many eventually obtain work unrelated to the arts or go back to university to complete further tertiary study in fields unrelated to arts (Graduate Careers Council of Australia, 2005a). Recent developments in career development theory have involved discussion of the rise of boundaryless careers amongst knowledge workers. Boundaryless careers are characterised by non-linear career progression occurring outside the bounds of a single organisation or field (Arthur & Rousseau, 1996a, 1996b). The protean career is an extreme form of the boundaryless career, where the careerist also possesses strong internal career motivations and criteria for success (Baruch, 2004; Hall, 2004; Hall & Mirvis, 1996). It involves a psychological contract with one's self rather than an organisation or organisations. The boundaryless and protean career literature suggests competencies and dispositions for career self-management and career success, but to date there has been minimal empirical work investigating the predictive value of these competencies and dispositions to career success in the boundaryless or protean career. This program of research employed competencies and dispositions from boundaryless and protean career theory to predict career success in professional artists and tertiary arts graduates. These competencies and dispositions were placed into context using individual and contextual career development influences suggested by the Systems Theory Framework of career development (McMahon & Patton, 1995; Patton & McMahon, 1999, 2006a). Four substantive studies were conducted, using online surveys with professional artists and tertiary arts students / graduates, which were preceded by a pilot study for measure development. A largely quantitative approach to the program of research was preferred, in the interests of generalisability of findings. However, at the time of data collection, there were no quantitative measures available which addressed the constructs of interest. Brief scales of Career Management Competence based on the Australian Blueprint for Career Development (Haines, Scott, & Lincoln, 2003), Protean Career Success Orientation based on the underlying dispositions for career success suggested by protean career theory, and Career Development Influences based on the Systems Theory Framework of career development (McMahon & Patton, 1995; Patton & McMahon, 1999, 2006a) were constructed and validated via a process of pilot testing and exploratory factor analyses. This process was followed by confirmatory factor analyses with data collected from two samples: 310 professional artists, and 218 graduating arts students who participated at time 1 (i.e., at the point of undergraduate course completion in October, 2005). Confirmatory factor analyses via Structural Equation Modelling conducted in Study 1 revealed that the scales would benefit from some respecification, and so modifications were made to the measures to enhance their validity and reliability. The three scales modified and validated in Study 1 were then used in Studies 3 and 4 as potential predictors of career success for the two groups of artists under investigation, along with relevant sociodemographic variables. The aim of the Study 2 was to explore the construct of career success in the two groups of artists studied. Each participant responded to an open-ended question asking them to define career success. The responses for professional artists were content analysed using emergent coding with two coders. The codebook was later applied to the arts students' definitions. The majority of the themes could be grouped into four main categories: internal definitions; financial recognition definitions; contribution definitions; and non-financial recognition definitions. Only one third of the definition themes in the professional artists' and arts graduates' definitions of career success were categorised as relating to financial recognition. Responses within the financial recognition category also indicated that many of the artists aspired only to a regular subsistence level of arts income (although a small number of the arts graduates did aspire to fame and fortune). The second section of the study investigated the statistical relationships between the five different measures of career success for each career success definitional category and overall. The professional artists' and arts graduates' surveys contained several measures of career success, including total earnings over the previous 12 months, arts earnings over the previous 12 months, 1-6 self-rated total employability, 1-6 self-rated arts employability, and 1-6 self-rated self-defined career success. All of the measures were found to be statistically related to one another, but a very strong statistical relationship was identified between each employability measure and its corresponding earnings measure for both of the samples. Consequently, it was decided to include only the earnings measures (earnings from arts, and earnings overall) and the self-defined career success rating measure in the later studies. Study 3 used the career development constructs validated in Study 1, sociodemographic variables, and the career success measures explored in Study 2 via Classification and Regression Tree (CART - Breiman, Friedman, Olshen, & Stone, 1984) style decision trees with v-fold crossvalidation pruning using the 1 SE rule. CART decision trees are a nonparametric analysis technique which can be used as an alternative to OLS or hierarchical regression in the case of data which violates parametric statistical assumptions. The three optimal decision trees for total earnings, arts earnings and self defined career success ratings explained a large proportion of the variance in their respective target variables (R2 between 0.49 and 0.68). The Career building subscale of the Career Management Competence scale, pertaining to the ability to manage the external aspects of a career, was the most consistent predictor of all three career success measures (and was the strongest predictor for two of the three trees), indicating the importance of the artists' abilities to secure work and build the external aspects of a career. Other important predictors included the Self management subscale of the Career Management Competence scale, Protean Career Success Orientation, length of time working in the arts, and the positive role of interpersonal influences, skills and abilities, and interests and beliefs from the Career Development Influences scale. Slightly different patterns of predictors were found for the three different career success measures. Study 4 also involved the career development constructs validated in Study 1, sociodemographic variables, and the career success measures explored in Study 2 via CART style decision trees. This study used a prospective repeated measures design where the data for the attribute variables were gathered at the point of undergraduate course completion, and the target variables were measured one year later. Data from a total of 122 arts students were used, as 122 of the 218 students who responded to the survey at time 1 (October 2005) also responded at time 2 (October 2006). The resulting optimal decision trees had R2 values of between 0.33 and 0.46. The values were lower than those for the professional artists' decision trees, and the trees themselves were smaller, but the R2 values nonetheless indicated that the arts students' trees possessed satisfactory explanatory power. The arts graduates' Career building scores at time 1 were strongly predictive of all three career success measures at time 2, a similar finding to the professional artists' trees. A further similarity between the trees for the two samples was the strong statistical relationship between Career building, Self management, and Protean Career Success Orientation. However, the most important variable in the total earnings tree was arts discipline category. Technical / design arts graduates consistently earned more overall than arts graduates from other disciplines. Other key predictors in the arts graduates' trees were work experience in arts prior to course completion, positive interpersonal influences, and the positive influence of skills and abilities and interests and beliefs on career development. The research program findings represent significant contributions to existing knowledge about artists' career development and success, and also the transition from higher education to the world of work, with specific reference to arts and creative industries programs. It also has implications for theory relating to career success and protean / boundaryless careers.

Dans cette thèse, nous décrivons les résultats d’un projet de recherche visant à mesurer et évaluer la qualité des soins obstétricaux des hôpitaux de référence au Mali et au Sénégal. Dans ces pays, la mortalité maternelle hospitalière est élevée et est liée en partie à la pratique médicale inadéquate. Cette recherche a été réalisée dans le cadre de l’étude QUARITE, un essai randomisé en grappe évaluant l’efficacité du programme GESTA International visant à réduire la mortalité maternelle hospitalière. GESTA a été mis en œuvre entre 2008 et 2010 et consistait en la formation des professionnels de santé et en la revue des cas de décès maternels. En parallèle de QUARITE, les programmes de prévention de la transmission du VIH de la mère à l’enfant (PTME) ont été mis à l’échelle à travers les pays. Ces derniers ayant également la capacité d’augmenter la qualité des soins obstétricaux, nous avons donc évalué les effets des deux programmes (GESTA et PTME) sur la qualité des soins. Dans un premier temps, à l’aide d’une recension des écrits nous avons évalué la capacité d’un audit clinique basé sur des critères à mesurer la qualité des soins obstétricaux. Cet audit vérifiait si l’offre des soins avait respecté les critères cliniques définissant la meilleure prise en charge selon l’évidence scientifique et l’avis des experts. Nous avons démontré que cet outil est largement utilisé dans les pays à faibles et moyens revenus, malgré le peu d’évidence sur sa validité (article 1). Dans un deuxième temps, nous avons développé un audit clinique basé sur des critères qui s’applique au contexte ouest-africain et qui a été approuvé par des experts-obstétriciens nationaux et internationaux. À partir des dossiers obstétricaux, les actes médicaux posés pendant le travail et l’accouchement ont été évalués à l‘aide de cet instrument. La qualité des soins a été estimée sous forme de pourcentage de critères atteints. Appliqué dans différents contextes et par différents auditeurs, nous avons démontré que notre instrument est fiable et valide (article 3). Néanmoins, l’expérience de l’audit nous a amenés à nous questionner sur le mauvais remplissage des dossiers médicaux et ses conséquences sur la qualité des soins (article 2). Dans un troisième temps, l’outil a été appliqué à large échelle pour évaluer les effets de l’intervention GESTA (article 4). Nous avons mené une révision de plus de 800 dossiers obstétricaux dans 32 hôpitaux de référence (16 bénéficiaires de l’intervention et 16 non-bénéficiaires). Grâce à cet audit clinique, nous avons démontré que le programme GESTA contribue à l’amélioration de la qualité des soins, spécifiquement l’examen clinique lors de l’admission et le suivi après l’accouchement. Dernièrement, nous avons utilisé cet instrument afin d’évaluer les effets des programmes de PTME sur la qualité des soins obstétricaux (article 5). Notre travail a documenté que seulement certaines composantes du programme de PTME améliorent la qualité des soins telles que la formation des professionnels et les services complémentaires en nutrition. En conclusion, cette recherche a identifié plusieurs pistes d’intervention pour améliorer la qualité des soins obstétricaux en Afrique de l’Ouest. / In this thesis, we describe the results of a research project that aimed to measure and evaluate quality of care in referral hospitals in Mali and Senegal. In these countries, hospital maternal mortality is high and linked, in part, to inadequate medical practice. This research was conducted as part of the QUARITE cluster randomized trial that assessed whether the program, ALARM International, could reduce facility maternal mortality. ALARM was implemented from 2008 to 2010 and consisted of the training of local health professionals and the use of maternal death reviews. At the same time as QUARITE was ongoing, programs for the prevention of maternal to child transmission of HIV (PMTCT) were scaled- up; these can also improve obstetrical quality of care. Thus, we evaluated the effects of both programs (ALARM and PMTCT) on quality of care. We began with a systematic review of the literature to evaluate the capacity of a criterion-based clinical audit to measure the quality of obstetrical care (article 1). This type of audit verifies if the care provided meets criteria indicative of best clinical practices, according to the literature and expert opinion. Our review demonstrates that this tool has been used in a variety of low- and middle-income settings, but the way it has previously been employed leaves doubts as to its validity (article 1). We thus developed a criterion based clinical audit specific to the West African context and approved by national and international expert obstetricians. Using patient medical records, with this instrument we evaluated obstetrical care provided during labour and delivery. Quality of care was calculated based on the percentage of care criteria met. Applied to different sites and by different auditors, our instrument demonstrated concordant results and provided a valid image of the quality of obstetrical care provided at hospitals in the region (article 3). Nonetheless, the audit experience raised concerns about the implications of poor medical recordkeeping and archiving on quality of care (article 2). We used the criterion-based clinical audit to review over 800 medical records at 32 QUARITE hospitals (16 intervention and 16 control hospitals) in order to evaluate the effects of the ALARM intervention. We demonstrated that the ALARM program contributes to better obstetrical quality of care, especially during the first clinical examination and postpartum monitoring of women treated at intervention hospitals (article 4). Finally, we used this instrument to evaluate the effects of PMTCT programs on obstetrical quality of care (article 5). Our work demonstrated that certain components of a PMTCT program, specifically training of healthcare professionals and supplementary nutritional services, are associated with better obstetrical care. In all, this research identified several mechanisms that can be targeted by quality improvement interventions in West Africa.

Indiana University-Purdue University Indianapolis (IUPUI) / Safety researchers have devoted extensive attention to safety performance behaviors. However, current safety performance models have yet to differentiate between safety citizenship behaviors directed towards the organization and those directed towards individuals. This might be a potential oversight, considering that citizenship behaviors targeted at different beneficiaries might be associated with different antecedents. As such, the purpose of the present study was to develop and validate a new safety performance scale. Items from existing measures formed the item pool and those tapping into the proposed dimensions were selected. Next, items were pilot tested using an online panel of 333 employees from various safety-related industries. A 4-factor structure emerged after exploratory factor analysis and the scale was further refined using reliability analysis and item response theory analysis. Finally, confirmatory factor analysis was conducted to replicate the factor structure using data from 137 employees. Theoretically related variables were correlated with the safety performance dimensions to establish the nomological network. Results supported the 4-factor structure of the new safety performance scale and construct validation hypotheses were largely supported. Implications, study limitations, and directions for future research are discussed.

Indiana University-Purdue University Indianapolis (IUPUI) / Loneliness is a known risk factor for poor mental and physical health outcomes in the general population, and preliminary research suggests that loneliness is linked to poorer health in cancer patients as well. Various aspects of the cancer experience (e.g., heightened existential concerns) lend themselves to making patients feel alone and misunderstood. Furthermore, loneliness theory suggests that negative social expectations, which may specifically relate to the cancer experience, precipitate and sustain loneliness. Thus, loneliness interventions in cancer should be tailored to address illness-related social conditions and negative social expectations. Prior to the development of loneliness interventions for cancer populations, cancer-specific tools are needed to assess: (1) loneliness attributed to cancer (i.e., cancer-related loneliness), and (2) negative social expectations related to cancer. In the current project I developed measures of cancer-related loneliness and cancer-related negative social expectations for use in future theory-based loneliness research. A mixed-methods study design was employed. First, I developed items for the measure of cancer-related loneliness (i.e., the Cancer Loneliness Scale) based on theory, prior research, and expert feedback. Second, I conducted a clinic-based qualitative study (n=15) to: (1) obtain cancer patient feedback on the Cancer Loneliness Scale items, and (2) inform development of the item pool for the measure of negative social expectations (i.e., the Cancer-related Negative Social Expectations Scale). Interviews were audiotaped, transcribed verbatim, and then transferred to Atlas.ti for analysis. Content analysis was used to analyze data regarding patient feedback and theoretical thematic analysis was used to analyze data regarding negative social expectations. Overall, patients said they liked the Cancer Loneliness Scale and no changes were made to the items based on patient feedback. Based on results, I also created five content domains of negative social expectations that were represented in the item pool for the Cancer-related Negative Social Expectations Scale. Third, I conducted a telephone and mail-based quantitative study (n=186) to assess psychometric properties of the two new measures. Dimensionality was determined using confirmatory factor analysis. Reliability was assessed by examining internal consistency coefficients and construct validity was assessed by examining theoretical relationships between the Cancer Loneliness Scale, the Cancer-related Negative Social Expectations Scale, and existing reliable and valid measures of health and social well-being. The final products of the project included a 7-item unidimensional Cancer Loneliness Scale and 5-item unidimensional Cancer-related Negative Social Expectations Scale. Excellent evidence for reliability and validity was found for both measures. The resulting measures have both clinical and research utility.

Indiana University-Purdue University Indianapolis (IUPUI) / Chinese students are the biggest ethnic group of international students in the United States. Previous studies have identified many unique problems of Chinese students during their acculturation process and a higher level of acculturative stress than international students from other countries. A systematic review of instruments that assess acculturative stress revealed that none of the existing scales apply to Chinese students in the United States, either because of language issues or validity problems. Thus, this study aims to develop a reliable and valid scale to accurately measure the acculturative stress of Chinese students in the United States. A 72-item pool was generated by interviewing eight Chinese students and borrowing items from existing literature and scales. The item pool was sent online to 607 Chinese students and 267 of them completed the survey. Exploratory Factor Analysis was conducted to empirically derive the factor structure of the Acculturative Stress Scale for Chinese Students (ASSCS). The results produced a 32-item scale in five dimensions, which were Language Insufficiency, Social Isolation, Perceived Discrimination, Academic Pressure, and Guilt toward Family. The ASSCS demonstrated high reliability (Cronbach’s alpha = 0.939) and initial validity by predicting depression (Beta = 0.490, p<.001) and life satisfaction (Beta = -0.505, p<.001). It was the first Chinese scale of acculturative stress developed and validated among a Chinese student sample in the United States. Further studies need to be conducted to provide empirical support and confirm the validity for the scale. In the future, the scale can be used as diagnosing tool and self-assessment tool.

La présente thèse de doctorat porte sur la relation entre la perception de la justice organisationnelle, l’émission de comportements inadaptés au travail et la santé psychologique des individus au travail. En plus de développer un outil de mesure des comportements inadaptés au travail et d’entreprendre un processus de validation de celui-ci, le présent travail propose que les comportements inadaptés au travail puissent occuper un rôle soit protecteur ou explicatif dans la relation qui unit la perception de la justice organisationnelle avec la santé psychologique des individus au travail. Au sein de cette thèse, le premier article recense la documentation scientifique quant aux variables de la perception de la justice organisationnelle, de l’émission des comportements inadaptés au travail et de la santé psychologique des individus au travail, ainsi que les liens qui unissent ces variables. Aussi, les modèles conceptuels des rôles modérateur et médiateur des comportements inadaptés au travail sont proposés au sein de la relation entre la perception de la justice organisationnelle et la santé psychologique des individus au travail. Le deuxième article a pour objectif de développer un outil de mesure des comportements inadaptés au travail et de tester ses propriétés psychométriques. Ainsi, des analyses statistiques exploratoires et confirmatoires ont été effectuées. Afin d’appuyer la valeur critériée de l’outil proposé, une analyse corrélationnelle a été réalisée avec le critère de l’adaptation. Certaines valeurs psychométriques de l’outil sont validées par les résultats obtenus. Le troisième article examine empiriquement les modèles conceptuels des rôles anticipés des comportements inadaptés au travail dans la relation entre la perception de la justice organisationnelle et la santé psychologique des individus au travail. La perception de la justice organisationnelle a été vue sous les composantes distributive, procédurale, informationnelle et interpersonnelle. De son côté, la santé psychologique des individus a été observée par le biais des éléments du bien-être et de la détresse psychologique au travail. Les différentes analyses de régressions multiples hiérarchiques ont permis d’observer l’absence du rôle modérateur des comportements inadaptés au travail. Pour sa part, l’utilisation du test de Sobel a démontré la présence du rôle médiateur des comportements inadaptés au travail dans certaines relations. Plus exactement, celles-ci sont la relation entre la justice interpersonnelle et le bien-être psychologique au travail, la relation entre la justice interpersonnelle et la détresse psychologique au travail, ainsi que la relation entre la justice distributive et la détresse psychologique au travail. Finalement, la conclusion de la thèse présente une synthèse des résultats et expose les limites et pistes de recherches futures. / The present doctoral thesis treats of the relation between perception of organizational justice, emission of misbehaviours at work, and individuals’ psychological health at work. In addition to developing and undertaking a validation process for a measuring scale of misbehaviours at work, the present thesis proposes that these behaviours may occupy either a protective or an explicative role in the relationship that unites the perception of organizational justice with individuals’ psychological health at work. Within the thesis, the first article lists scientific literature concerning the perception of organizational justice, the emission of misbehaviours at work, and individuals’ psychological health at work. This article also includes a revue of links that unite the variables presently at study. Following this review, two conceptual models about possible roles played by misbehaviours at work in the relationship between perception of organizational justice and individuals’ psychological health at work are developed. More precisely, these models are conceptualisation of the moderating and mediating roles of inadequate work behaviours. The second article’s goal is the development of a measuring scale for misbehaviours at work and testing its psychometric proprieties. In this context, exploratory and confirmatory statistical analyses were made. Also, in order to support the criterion value of the proposed tool, a correlation analysis was made with the criteria of adaptation. The results showed that certain psychometric values were validated. The third article empirically examines the conceptual models developed about the possible roles played by misbehaviours at work in the relationship between perception of organizational justice and individuals’ psychological health at work. Organisational justice perception was analysed under distributive, procedural, informational and interpersonal components. As for individuals’ psychological health at work, it was observed through the psychological well-being and distress elements. The different multiple hierarchical regression analyses helped observe the absence of a moderator role for misbehaviours at work. Using the Sobel test showed the presence of a mediator role for misbehaviours at work in the relationship between the interpersonal organizational justice component and well-being, as well as psychological distress at work. This same test highlighted the mediator role of misbehaviours at work in the relationship between the distributive component of organizational justice and the psychological distress at work of individuals. Finally, the conclusion of this thesis presents a synthesis of the results and highlights the limits and future research ideas.