Clinical decision rules improve health care fidelity, benefit patients, physicians and healthcare systems, without reducing patient safety or satisfaction, while promoting cost-effective practice standards. It is critical to appropriately and consistently apply clinical decision rules to realize these benefits. The objective of this thesis was to understand how physicians use the Ottawa Ankle Rules to guide radiography decision-making. The study employed a clinical judgment survey targeting members of the Canadian Association of Emergency Physicians. Statistical analyses were informed by the Brunswik Lens Model and Social Judgment Analysis. Physicians’ overall agreement with the ankle rule was high, but can be improved. Physicians placed greatest value on rule-based cues, while considering non-rule-based cues as moderately important. There is room to improve physician agreement with the ankle rule and use of rule-based cues through knowledge translation interventions. Further development of this Lens Modeling technique could lend itself to a valuable cognitive behavioral intervention.

In the face of the global trend of administrative reform, to cope with changing times and enhance the competitiveness, Taiwan restructures the administrative division into five Metropolitan Cities. To improve the administrative efficiency of the Government and responding to people's need, Central and local government implement reconstruction, rebuilding the organizational culture and the core values. After the Reform, among the five new Metropolitan Cities, Kaohsiung City has the biggest transformation in size of the city and organizational changes, also in geography, culture, industry, transportation, community, and more. It becomes more challenging for the local government to face the new problems. The Household Registration Office is the front-line of customer services and their core value is ¡§to better serve people¡¨. During the general public¡¦s visit to the Household Registration Office, people can feel the changes of better customer services and efficiency. This will change public¡¦s view of the government operation. Therefore, the Kaohsiung Household Registration Office has to set a very clear organizational mission and vision. Furthermore, with the limited resources, managers must worry about how to build the public value and vision, which will be recognized and implemented by the members of the Office. At the same time, these values and vision should be also recognized by the general public. The purpose of this study is to explore public value differences among different parties within the Kaohsiung Household Registration Office. Through Public Affairs Management and literature analysis, I outline the characteristics of regional governance in Kaohsiung City. With in-depth interview of the policy-setting officials of the Kaohsiung Household Registration Office, I also focus on the public values of the Household Registration Office. This study corresponds to four structure (Organization internal process, and financial, and customer, and learning and growth) of Balanced Score Card, and to establish a goal to evaluate the organizational performance. The Social Judgment Theory questionnaires are also based on this. Test target are the entry-level Household Registration Officers of previous known as Kaohsiung City and Kaohsiung County. At the same time, I asked the general public to answer the same Balanced Score Card questionnaires. This will help the manager to understand the variation of public value differences among different parties. This will also help the managers to solve the problem in-time, change the content of public value and to achieve the goal set by the Local Government. This result of the study, for the Household Registration Office, there are no big discrepancy before and after the Reform. The main reason is that Household Registration Office utilizes the nationwide Standardized Computer Operation System. And the regulation is base on Household Registration Act. Both Computer System and regulation are put in place by the Central Government. However, from this study, after the merger of city and County, I did find that the Kaohsiung Household Registration Office need to do an overall adjustment in the allocation of financial resources and staffing, local application of the separate regulations and organizational cultural.

In a plural democratic society, the macro phenomena and policies are formed by individual cognition and choices. Thus the field of decision-making and judgment analysis based on individual cognitions has become the major analytical method in the public affairs management. The citizenship view of the republicanism requires citizens to reach consensus. The group decision-making method is so helpful for reaching consensus and overcoming the limits of individual cognition that it¡¦s necessary in forming public policies. By reviewing various group decision-making methods, the study found that there are at least Program Planning Method (PPM; Delbecq & Van de Ven, 1971), Policy Delphi (Turoff, 1970), Interactive Management(IM; Warfield & Cárdenas, 1994), and Social Judgment Theory(SJT; Hammond, 1965, 1996; Hammond et al., 1975, 1977, 1980) can be used to reach consensus in a plural society. Among them, the IM results have been proven effective for solving complicated problems and compliant with citizen participation spirit of a plural society ( Wang Min-shen & Chang Ning, 2002; Warfield & Cárdenas, 1994) . However, the accuracy of IM results can not be proven by the method and the weight between factors can not be identified, either. SJT can be used to analyze the assumption between decision criteria of different hierarchies and obtain the weights between different factors out of the same result so that SJT can examine the annotated graphics of IM. Besides, since SJT emphasizes cognitive feedback, it can facilitate reaching consensus by comparing various stakeholders¡¦ judgment principles dissolving the cognitive conflicts. Thus the study applied theoretical SJT to examine the validity of IM results. I discussed SJT procedure in a collective, hierarchic and large-scaled way. The study also adopted classic experimental design to compare the cognitive changes of participants before and after the SJT procedure to explore the performance of SJT results of group decision-making in public affairs cases in terms of consistency, individual learning effect and satisfaction. The results of this study show that SJT procedure can be operated in a large-scaled way while consensus with high satisfaction will be reached. In addition, the theoretical validity of IM results on psychological cognition provides the reason why participants accepted the results. Talking about the changes of the participants¡¦ cognition through SJT procedure, the participants using SJT have not improved their consistency, while the learning effect changes significantly towards group conclusion. In the subjective evaluations such as satisfaction, learning effect and caring degree, the participants who use SJT are better than those who don¡¦t, but not better than those who use IM procedure. In terms of policy significance, though the covert consistency between the participants who use SJT has not been improved, their overt satisfaction towards the group conclusion is better than those who don¡¦t. It shows that the conflict between participants has not disappeared yet, while they accept the consensus. Therefore, the way to wipe away the conflicts in a plural society is not to build up a single exclusive value, but to design a procedure allowing the stakeholders accept consensus.

The Community Policing should not take only the policing viewpoint into consideration, but be carried out by taking the community as the core network functioning conformity. Strategic formulation of Community Policing cannot be self-lauded as police professionalism, but be understood in the context of solving policing problems connected with other topics that depend on widespread opinion consultation, research questionnaires and public verification. Community Policing is precisely what police and people share in mutual governance; it is a witnessing of public affairs participation that carries out democracy at the grassroots level. However, its foundation is established on effective communication, mutual understanding and confidence between the police and citizens. It also depends on environmental social capital to develop gradually. Therefore, it is the key to learn how to respect and yet contain different societies and individuals with cognition of their roles in such societies. Accordingly, we can try to seek collective mutual recognition. This research puts emphasis on the operation pattern of the ¡§partnership spirit¡¨ and the ¡§network governance¡¨ from the ¡§acts as circumstances permit¡¨ characteristic of Community Policing. In addition, it discusses the problem of lack of people-participation in Community Policing in the Penghu area by literature discussion (including area background material analysis), expert interview, interactive management (IM), questionnaire survey of society judgment theory (SJT), cross-territory analysis and so on. Through question analysis and interactive conference, 12 items of the first plan and enhancement drawings are obtained. It belongs to the fourth level according to the IM success rank, i.e. it can discover a suitable plan that promotes the participation of the populace, and thus can be recommended to the policing governance and relevant administration agencies. This research takes Penghu as the background and the IM as the interface. The community populace and the performers of Community Policing network (including government institution, private enterprise and Non-governmental organizations) are the main participants. Then, the collective consensus containing multi-dimensional individual cognition was delivered. Furthermore, the endorsement of the local policing decision-making group was investigated through the V-C-S strategic triangle analysis and the SJT questionnaire. Overall, the twelve plans of top priority can be categorized into three essential strategies: ¡§strengthen the policing management to respond to the populace¡¨, ¡§enhance community empowerment to form a policing network¡¨ and ¡§specialization community policing¡¨, separately presenting the viewpoint of three main participants: the experts, the populace, and the basic unit police. Moreover, ¡§specialization of Community Policing¡¨ was considered to be the top priority. However, taking the above essential strategies as the judgment cues to perform the SJT questionnaire to the local policing decision-making group demonstrates that the policing decision-making commanding officer most take seriously the notion of ¡§strengthen the policing management to respond to the populace¡¨, but the ground-roots staff most take seriously the ¡§enhance community empowerment to form policing network¡¨ strategy. Through the investigation, the IM model is proven to be effective in enhancing public participation in Community Policing affairs and reaching a consensus; through SJT questionnaires, the local policing decision-making group gave high approval to the key strategies from interactive deliberation. The result of the survey also shows that people in different positions could have various considerations and judgments. Thus, this research suggests that enforcement authorities can actualize their policies by adopting IM and reach consensus through public participation and mutual understanding.

Clinical decision rules improve health care fidelity, benefit patients, physicians and healthcare systems, without reducing patient safety or satisfaction, while promoting cost-effective practice standards. It is critical to appropriately and consistently apply clinical decision rules to realize these benefits. The objective of this thesis was to understand how physicians use the Ottawa Ankle Rules to guide radiography decision-making. The study employed a clinical judgment survey targeting members of the Canadian Association of Emergency Physicians. Statistical analyses were informed by the Brunswik Lens Model and Social Judgment Analysis. Physicians’ overall agreement with the ankle rule was high, but can be improved. Physicians placed greatest value on rule-based cues, while considering non-rule-based cues as moderately important. There is room to improve physician agreement with the ankle rule and use of rule-based cues through knowledge translation interventions. Further development of this Lens Modeling technique could lend itself to a valuable cognitive behavioral intervention.

It has been postulated that occupational therapists when choosing an appropriate intervention method, use theoretical and practical knowledge (factors), based upon identifying client's goals to guide their clinical reasoning. The overall aim of this study was to identify factors and their relative contributions to the decisions occupational therapists make in the management of upper limb (UL) hypertonicity of children and adolescents with cerebral palsy (CP). Studies about general factors which influence occupational therapists' decision making have been addressed widely in the literature. However, studying influential factors in specific areas such as in the management of UL hypertonicity of clients with CP is limited. The information obtained from studies of decision making with other client groups can not readily be generalised as it has been demonstrated that specific task characteristics induce different types of cognitive thinking. For example, working with clients with orthopaedic problems may induce logical thinking, while practicing with clients with neurological problems promotes intuitive thinking. The management of UL hypertonicity of clients with CP was chosen as the focus of this study for two main reasons. First, the incidence of CP is high, manifesting in between 1.4 and 2.4 of 1000 live births. Second, people with CP are one of the major client groups referred to occupational therapy (OT) clinics as outpatients. The literature reviewed highlighted a lack of evidence about what therapists attend to when making decisions about the management of UL hypertonicity for clients with CP. To identify and evaluate these factors, the current research employed Social Judgment Theory (SJT). This methodology was selected because it had the capacity to access intuitive thought or tacit knowledge that is very difficult for experienced therapists to explain. Furthermore, SJT is most relevant in situations where there is no optimal decision. The current study proceeded in five phases. Phases One to Three were conducted to identify the most relevant factors to be used in the case vignettes necessary for the application of SJT. This process involved a review of the literature, consultation with clinical experts and then involved twelve experienced therapists in a process of identifying, refining, and ranking the relevant factors in order of priority. As a result of the processes in Phases One to Three 37 factors and their ranked importance were identified. The identified factors were reduced from 37 to 12 on the basis of ranking, cluster analysis and consultation with experts and appropriate scales identified for their measurement. These factors formed the basis of Phase Four of this study. In Phase Four 10 sample case vignettes as well as an administration manual were developed and four therapists were asked to make decisions for these cases. On the basis of therapists' comments, some changes were made in case vignettes and administration manual. Finally, 110 case vignettes were generated randomly (20 were repeated to examine consistency) for Phase Five of the study. In Phase Five, eighteen occupational therapists (16 females and 2 males), mean age of 36.7 years (SD = 7.6 years) who had worked with people with CP for a mean of 10.4 years (SD = 6.0 years) made decisions for the generated case vignettes. The findings of Phase Five revealed that therapists used three factors mainly in their decisions including severity of spasticity, wrist and finger posture, and client and family background. They had poor insight into their decision making (r = 0.36) and demonstrated only moderate consistency (r = 0.46). When therapists were divided into two groups based on their level of performance in respect to therapists' consistency and their ability to discriminate between cases, both groups used severity of spasticity and wrist and finger posture in their decision making. However, the higher performing group used limitation in passive range of movement and previous intervention in their decision making, and the low performing group used client and family background.

Il y a consensus sur la structure bidimensionnelle du jugement social. Cette thèse avait pour but de montrer que les concepts d'agentisme et de compétence sont deux registres distincts au sein de la dimension verticale du jugement. L'agentisme ferait référence à l'avancement du soi alors que la compétence ferait référence à un ensemble de ressources instrumentales. Une première implication concerne la relation entre les deux dimensions du jugement. Nous observons que la sociabilité est liée négativement à l'agentisme alors qu'elle reste indépendante de la compétence.Une autre implication concerne la perception du statut social. Nos données montrent l'agentisme est spécifiquement associé aux personnes de haut statut alors que la compétence peut être associée à des personnes de haut ou de bas statut. Les registres d'agentisme et de compétence ne jouent donc pas le même rôle dans le jugement social. / There is a consensus about the bidimensionnal structure of social judgment. The aim of this thesis was to show that the concepts of agency and competence are two distinct registers within the vertical dimension of social judgment. Agency reflects a motive to advance the self where as competence refers to a set of instrumental resources. The first implication of this distinction deals with the relationship between the two dimensions of social judgment. We found that sociability and agency were negatively correlated while sociability and competence were orthogonal. Another implication deals with social status perception. Results showed that agency is specifically associated with high status individuals whereas competence can be associated with high status individuals and relatively low status individuals. These findings suggest that these two registers do not play the same role in social judgment.

Clinical decision rules improve health care fidelity, benefit patients, physicians and healthcare systems, without reducing patient safety or satisfaction, while promoting cost-effective practice standards. It is critical to appropriately and consistently apply clinical decision rules to realize these benefits. The objective of this thesis was to understand how physicians use the Ottawa Ankle Rules to guide radiography decision-making. The study employed a clinical judgment survey targeting members of the Canadian Association of Emergency Physicians. Statistical analyses were informed by the Brunswik Lens Model and Social Judgment Analysis. Physicians’ overall agreement with the ankle rule was high, but can be improved. Physicians placed greatest value on rule-based cues, while considering non-rule-based cues as moderately important. There is room to improve physician agreement with the ankle rule and use of rule-based cues through knowledge translation interventions. Further development of this Lens Modeling technique could lend itself to a valuable cognitive behavioral intervention.

本研究使用敘說研究方法，探討未婚成年女性多重戀情的心理歷程。從文獻與實務經驗中理解到，有些多重戀情者在其中有許多負向感受（女性尤其強烈），因此希望關注在歷程中時有負向感受的女性當事人身上，給予敘說的空間。採用立意取樣由熟識的人介紹受訪者小黛，訪談與分析詮釋後發現，在說出來的故事底下，還有許多難以被說出來的故事主軸。小黛雖然本著開朗釋懷的態度，看似不受外界影響與壓迫，但其實渴望被接納，也擔心被社會評價所批判，因此說得小心翼翼，不斷地解釋與抗辯污名，並且在多重戀情歷程中持續進行自我形象的整飾。社會的負向評價不僅在訪談當時影響著故事的敘說，更在故事發生當時就扮演了舉足輕重的角色，並且已經內化為女性多重戀情者的價值觀，讓當事人被污名所壓迫，「這不是一部變心與劈腿的故事，而是一部在自我形象與感情需求的拉扯下，尋求著被允許與被接納之生存空間的故事。」 最後，本研究對多重戀情現象、質性研究者與諮商員提出反思與建議。 / The study was based on narrative research approach exploring the females’s psychological process of an unmarried adult female who had more than one lover at the same time. According to the research and practical experience, some people, especially the females who had more than one lover at the same time would experience a lot of negative feelings. The participator Diane was introduced by a friend based on purposive sampling. After interviewing and interpreting the story, there are some important stories under what she had said. Although she looked like optimistic and didn’t care about external pressure, in fact, she wanted to be accepted and worried about the social judgment. Therefore, she told about her story carefully, and explained her behavior again and again. Besides, she regulated her self-image all the time when she falling in love with two men. Not only influencing the narration in the interview, the negative social judgment also played a key person from the beginning. It was internalized by the female who had more than one lover at the same time, and oppressed her through stigmatization. “This is not a story talking about unfaith; this is a story talking about a person who seek to be accepted, be permitted to survive under the struggle between the self-image and the need of love.” Finally, there were some discussion about the phenomenon that a person had more than one lover at the same time and some suggestions to the researchers and counselors.

Understanding organizational behavior (OB) has profoundly influenced organizational performance and how people behave in organizations. Researchers have suggested various micro and macro organizational behaviors to be the impetus for high-performing organizations. Through a policy capturing approach this study builds on these findings by specifically examining the perceptions of micro and macro organizational behaviors in an organizational setting. The participants (n =181) completed a Micro and Macro Organizational Behavior Perceptions Questionnaire. Results showed perception differences exist between subordinates and supervisors. Additionally, participants perceived job satisfaction to be the most important micro organizational behavior, whereas organizational design was perceived to be the most important macro organizational behavior. However when comparing hierarchal positions in the organization, supervisors weighted leadership as the most important and subordinates weighted job satisfaction as the most important organizational behavior. While these findings only scratch the surface as to how organizational behavior is perceived, the implications challenge leaders to close the OB perception gap. Correspondingly, organizational behavior thinking may result in improving individual and organizational performance.