Text in Afrikaans, abstract in Afrikaans and English / Wanneer psigometriese toetsing op groepe uit verskillende sosio-ekonomiese agtergronde toegepas word, presteer individue uit agtergeblewe omgewings swakker as bulle ewekniee uit meer ontwikkelde omgewings. Hierdie individue se toegang tot hoofstroom loopbaangeleenthede word dikwels bemoeilik as gevolg van die beperking. Die leerpotensiaal benadering word aangebied as belowende alternatief om die probleem, wat 'n sosio-ekonomiese oorsprong het, te oorbrug. Die resultate van die studie bewys die stelling gedeeltelik waar, maar met buitengewone inspanning. In die finale ontleding van die resultate is dit duidelik dat die verbeterde voorspelling eerder toegeskryf kan word aan die optimale vlak van ontwikkeling wat die individu bereik net voor die toetsing, en nie soseer sy/haar leerpotensiaal nie. / Applying psychometric tests to groups from different socio-economical backgrounds, inevitably result in the individuals from deprived backgrounds performing noteably poorer than their counterparts from more developed backgrounds. These individuals also find enterance to the mainstream careers difficult because of this restriction. The learning potential approach to assessment is presented as a promising alternative to overcome the problem that is related to the socio-economic background of the individual. The results of this study partly confirm the value of the learning potential approach, but only with extra-ordinary effort. In the final analysis of the results it is clear that the improved predictive accuracy was rather due to the optimal level of development the individuals reached just before the testing, and not so much their learning potential. / Psychology / M. Sc. (Sielkunde)

Thesis (PhD)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: Due to a lack of research, which, in turn, resulted in a shortage of applicable literature that focused on the experiences and socio-emotional needs of family members as carers of AIDS-patients, the researcher decided to undertake this research project. The aim of this was to investigate the experiences and socio-emotional needs of family members as AIDS care givers. To lead the research, the researcher made use of a qualitative research approach. Attention was also given to the description of HIV/AIDS, as well as the prevention and treatment of HIV/AIDS. The impact of HIV/AIDS was also given attention, and it was done from an ecological perspective. Within the qualitative research paradigm a phenomenological, explorative, descriptive and contextual research design was utilised. The boundaries for data collection were delineated to the George area. Semi-structured interviews were conducted with family members who acted as primary care givers of AIDS-patients who were recruited by means of purposive sampling and the snowball sampling technique. The data collected were analysed according to the steps for qualitative data analysis as proposed by Tesch (in Cresswell, 1994). To ensure the trustworthiness of the research findings, data verification was executed according to Guba’s model (in Krefting, 1991). The following twelve themes emanated from the process of data analysis: - Knowledge of the disease - Caring for people with AIDS - Risky behaviour - Other people’s reactions - Care givers’ feelings and reactions - Support that was received with the care giving - Effect of the care giving on the relationship between the care giver and the patient - Changes in the care givers’ life because of the care giving of AIDS patients - Experiences regarding the dying process - Needs regarding the caring of the patient - Services that are needed - Advice from the participants to other family members as AIDS care givers. The following recommendations were made based on the conclusions derived from the research findings: Information sessions by Social Workers in collaboration with the different clinics on certain days; a community based project to recruit volunteers to support family care givers on a regular basis; look at facilities, like old age homes and hospices, that can give respite for a week to three weeks; connect family care givers to support groups in the community; make use of the media to give information regarding HIV/AIDS to the broader community; a centralized food and clothes bank from which care givers can draw affordable food and clothes. An application for funding can be done at the Department of Social Development or the Department of Health. Another recommendation that is made is to investigate the possibility of a community based project that provides cleaning and washing services to family members as care givers, as well as the patients. This can even become a job creation project. Other recommendations are: to investigate an alternative form of transport that is wheelchair accessible and patient friendly; to train home based carers to help family members as AIDS care givers; to train home based carers to be of assistance with counseling of patients with regard to their medication; to train home based carers as AIDS care givers to help family members to reach out to other support services or groups; that care givers should be careful about expectations of other people and that they should be confident enough to verbalize their expectations; that Social Workers should investigate if the family member, as AIDS care giver, as well as the patient, gets the necessary support on all levels of the ecological perspective, and if not, he/she must look at ancillary sources and mobilize it to give support to the family care giver as well as to the patient; that professionals need to keep in mind the advice the participants was given to other family members as care givers when they are working with these families. A recommendation was also made to do a follow-up research on the same topic in the White, Indian and Black communities and especially that further emphasis should be placed on their needs, as participation by this population groups were scarce or could not be obtained at all. / AFRIKAANSE OPSOMMING: Weens ‘n gebrek aan navorsing, en gevolglik ook aan literatuur rakende die belewenisse en sosio-emosionele behoeftes van familielede as primêre VIGS-versorgers, het die navorser besluit om hierdie navorsingsprojek te onderneem. Die doel hiermee was om die belewenisse en sosio-emosionele behoeftes van familielede as primêre VIGS-versorgers te verken en te beskryf. Om die navorsing te rig, is ‘n kwalitatiewe navorsingsbenadering vir die doel gebruik. Aandag is ook gegee aan die beskrywing en voorkoms van MIV/VIGS, asook die voorkoming en behandeling van MIV/VIGS. Die impak van MIV/VIGS is ook breedvoerig bespreek en is dit vanuit ‘n ekologiese perspektief gedoen. Binne die kwalitatiewe navorsingsbenadering is daar van ‘n fenomenologiese, verkennende, beskrywende en kontekstuele navorsingsontwerp gebruik gemaak. Die grense vir data-insameling het binne die George-area geval. Semi-gestruktureerde onderhoude is gevoer met familielede wat as primêre VIGS-versorgers optree, en wat deur middel van ‘n doelgerigte steekproeftrekking en die sneeubaltegniek vir deelname aan die navorsing gewerf is. Die ingesamelde data is ontleed aan die hand van die agt stappe van kwalitatiewe data-ontleding van Tesch soos uiteengesit in Creswell (1994). Guba se model soos dit in Krefting (1991:214-221) uiteengesit is, is gebruik om die vertrouenswaardigheid van die navorsingsdata te verifieer. Twaalf temas het na aanleiding van die prosesse van data-ontleding na vore gekom, naamlik: - Kennis van die siektetoestand - Versorging van VIGS-lyers - Risiko-gedrag - Ander mense se reaksie - Versorger se gevoelens en reaksies - Ondersteuning wat ontvang is met die versorging - Effek van pasiënt se versorging op die verhouding tussen versorger en pasiënt - Verandering van versorger se lewe as gevolg van die versorging van die VIGS-lyer - Belewenisse ten op sigte van die sterwensproses - Behoeftes ten opsigte van die versorging van die pasiënt - Dienste wat benodig word - Raad deur deelnemers aan ander familielede as VIGS-versorgers. Voortspruitend uit die navorsingsbevindinge, is tot sekere gevolgtrekkings gekom waaruit die volgende aanbevelings gemaak is: dat inligtingsessies deur maatskaplike werkers in samewerking met die verskillende klinieke op sekere dae gehou sal word; dat ‘n gemeenskapsprojek van stapel gestuur word om vrywilligers te werf wat op ‘n gereelde basis aan VIGS-versorgers ondersteuning bied; dat daar gekyk word na respite by ouetehuise of ‘n hospice vir ‘n tydperk van ongeveer drie weke om aan versorgers ‘n ruskans te gee; dat versorgers betrek word by ondersteuningsgroepe in die gemeenskap; dat die media gebruik word om inligting oor VIGS aan die breë gemeenskap deur te gee; dat aandag gegee word aan ‘n gesentraliseerde voedsel- en klerebank waarvandaan versorgers voorraad kan onttrek. Aansoek vir befondsing kan gedoen word by Departement Maatskaplike Ontwikkeling of Departement Gesondheid. Verdere aanbevelings wat gemaak kan word, is: dat ‘n gemeenskapsprojek van stapel gestuur word om skoonmaakdienste en hulp met wasgoed was tot die beskikking van die VIGS-versorger te stel wat selfs as ‘n werkskeppingsprojek begin kan word; dat ‘n alternatiewe vorm van vervoer wat deur die familielid en pasiënt benut kan word, en wat geskik is vir pasiënt vervoer, ondersoek sal word; dat opleiding van tuisversorgers as hulp vir familielede as VIGS-versorgers aandag sal kry; dat opleiding van tuisversorgers om behulpsaam te wees met berading van pasiënte rakende hulle medikasie dringende aandag sal geniet; dat familielede as VIGS-versorgers uitreik na ander ondersteuningsbronne vir hulp; dat versorgers versigtig sal wees ten opsigte van verwagtinge van ander, maar dat hulle ook vrymoedigheid sal neem om hulle verwagtinge te verbaliseer; dat die maatskaplike werker sal ondersoek instel of die familielid as primêre VIGS-versorger, sowel as die pasiënt, vanuit al die vlakke van die ekologiese perspektief die nodige ondersteuning geniet, en indien nie, moet daar gekyk word na hulpbronne en dit moet gemobiliseer word ten einde hierdie noodsaaklike ondersteuning te bied; dat die raad wat deur die deelnemers aan die navorsing aan ander familielede as VIGS-versorgers voorsien is, in gedagte gehou sal word wanneer met hierdie families gewerk word. ‘n Aanbeveling is ook gemaak dat opvolg navorsing oor dieselfde onderwerp gedoen word onder die Wit, Indiër en Swart gemeenskappe, en dat veral klem gelê word op hulle behoeftes, aangesien deelname vanuit hierdie bevolkingsgroepe skraal was, of glad nie bekom kon word nie.

The history of the mining industry indicates a lack of understanding among the decision-makers of the impact the closure of mines has on the industry and the associated effects on the society and surrounding environment. The policies of the mining industry do make provision for a planned mine closure, but not for an unexpected closure. This detrimental aspect of closures in the mining industry is highlighted in the present study. The present study investigates how mineworkers’ dependency on their employment at a mine affects their ability to sustain their livelihoods. Vulnerable livelihoods leave the community at a greater risk to be affected by a disaster, than the livelihoods of a community that is resilient and has sustainable resources. Even though mineworkers are not considered as poor at the time of their employment, a mine closure could render them into a status called ‘transitional poverty’. This study also highlights that mineworkers who are skilled for mining operations only do not overcome the status of ‘transitional poverty’ and hence enter a phase called ‘chronic poverty’. This stage constitutes their inability to negotiate livelihood strategies and livelihood outcomes that could sustain a household. Thus humanitarian assistance would be needed from outside sources. Planning for unexpected mine closures should also be on the agenda of the mining industry due to the extreme consequences such an event holds for the mining community experiencing the event. In the case under investigation, the unexpected mine closures occurred in the Grootvlei mine in Springs and the Orkney mine owned by the Aurora Empowerment Systems Ltd. at the time of this study. These closures left the surrounding communities in need of food, shelter and clean water. The inhabitants gradually lost their livelihood assets. A contingency planning model is proposed at the end of this study to address the short-term and long-term consequences of an unexpected mine closure. / M Development and Management, North-West University, Potchefstroom Campus, 2014

The objective of this study is to conduct a critical evaluation of the Namibian law and policy framework that currently regulates small-scale mining in Namibia. The discussion begins with an introduction to small-scale mining in Namibia which deals with the practice of small-scale mining, inter alia, as far as it is defined and the possible affects thereof. Small-scale mining affects various second generation rights of persons directly involved therein as well as the community as a whole. These rights include child labour; unemployment; gender issues; public health care; occupational health and safety; access to finance; poverty alleviation; and access to mining tools, machinery, markets and buyers. The law and policy framework applicable to small-scale mining in Namibia is accordingly critically discussed in terms of the strengths and weaknesses of the current framework. It is found that small-scale mining is quite well regulated in Namibia, but the current law and policy framework is not without its problems. Some of the main weaknesses identified are the centralised nature of the application for and pegging of claims, the lack of formal provision and regulation of the off-set markets, and the lack of access to finance for smallscale miners. Recommendations are made, such as that regulatory measures should be put in place to make provision for and to regulate the off-set markets for the minerals being mined by the artisanal miners. At the end of the study further research topics which relate directly to the regulation of small-scale mining in Namibia are identified. / LLM (Environmental Law and Governance), North-West University, Potchefstroom Campus, 2014

The history of the mining industry indicates a lack of understanding among the decision-makers of the impact the closure of mines has on the industry and the associated effects on the society and surrounding environment. The policies of the mining industry do make provision for a planned mine closure, but not for an unexpected closure. This detrimental aspect of closures in the mining industry is highlighted in the present study. The present study investigates how mineworkers’ dependency on their employment at a mine affects their ability to sustain their livelihoods. Vulnerable livelihoods leave the community at a greater risk to be affected by a disaster, than the livelihoods of a community that is resilient and has sustainable resources. Even though mineworkers are not considered as poor at the time of their employment, a mine closure could render them into a status called ‘transitional poverty’. This study also highlights that mineworkers who are skilled for mining operations only do not overcome the status of ‘transitional poverty’ and hence enter a phase called ‘chronic poverty’. This stage constitutes their inability to negotiate livelihood strategies and livelihood outcomes that could sustain a household. Thus humanitarian assistance would be needed from outside sources. Planning for unexpected mine closures should also be on the agenda of the mining industry due to the extreme consequences such an event holds for the mining community experiencing the event. In the case under investigation, the unexpected mine closures occurred in the Grootvlei mine in Springs and the Orkney mine owned by the Aurora Empowerment Systems Ltd. at the time of this study. These closures left the surrounding communities in need of food, shelter and clean water. The inhabitants gradually lost their livelihood assets. A contingency planning model is proposed at the end of this study to address the short-term and long-term consequences of an unexpected mine closure. / M Development and Management, North-West University, Potchefstroom Campus, 2014

The objective of this study is to conduct a critical evaluation of the Namibian law and policy framework that currently regulates small-scale mining in Namibia. The discussion begins with an introduction to small-scale mining in Namibia which deals with the practice of small-scale mining, inter alia, as far as it is defined and the possible affects thereof. Small-scale mining affects various second generation rights of persons directly involved therein as well as the community as a whole. These rights include child labour; unemployment; gender issues; public health care; occupational health and safety; access to finance; poverty alleviation; and access to mining tools, machinery, markets and buyers. The law and policy framework applicable to small-scale mining in Namibia is accordingly critically discussed in terms of the strengths and weaknesses of the current framework. It is found that small-scale mining is quite well regulated in Namibia, but the current law and policy framework is not without its problems. Some of the main weaknesses identified are the centralised nature of the application for and pegging of claims, the lack of formal provision and regulation of the off-set markets, and the lack of access to finance for smallscale miners. Recommendations are made, such as that regulatory measures should be put in place to make provision for and to regulate the off-set markets for the minerals being mined by the artisanal miners. At the end of the study further research topics which relate directly to the regulation of small-scale mining in Namibia are identified. / LLM (Environmental Law and Governance), North-West University, Potchefstroom Campus, 2014

Workplace bullying is creating negative physical and psychological effects on employees and has a serious impact on the organisations’ bottom line. Workplace bullying has been related to excessive absenteeism, high employee turnover and hostile work environments. However, no recent studies on the prevalence of workplace bullying in the South African context are available. This is important because of the multicultural, multiracial composition of the South African workforce, and socio–demographic factors such as race, gender, age, education level and type of industry should be investigated to determine if differences exist with regard to the experience of workplace bullying. The personality resource, sense of coherence, should add an important element to this study, as the results could offer an important indicator for managers to change the employee’s environment in order to render the stimuli to which they are exposed more understandable, significant and manageable. In South Africa, diversity, multiculturalism, affirmative action and equal employment opportunity are words in common currency in a newly democratic country. Literature suggests that if diversity within African organisations is positively experienced, it could enhance harmony and effectiveness within that organisation. The objectives of this study were to 1) determine the relationship between workplace bullying, socio–demographic characteristics, sense of coherence and diversity experiences according to the literature; 2) to determine how frequently employees in South Africa experience acts of workplace bullying; 3) to determine if there are significant differences between socio–demographic groups (including race, gender, age, education and industry) with regards to workplace bullying; 4) to determine if there are significant differences between the different types of bullying (direct, indirect, supervisor and colleague bullying) with regards to sense of coherence; and 5) to determine if there are significant differences between the different types of bullying (direct, indirect, supervisor and colleague bullying) with regard to diversity experiences. An availability sample (N = 13 911) was utilised to determine the prevalence of workplace bullying in a sample of South African employees. Frequencies were used to determine the prevalence of workplace bullying for the total sample and MANOVA was used to determine differences between the groups. The results indicated that workplace bullying is a prevalent problem in South Africa, as people experience frequent overall bullying (4% reported being often bullied; 31,1% reported being always bullied). On the socio–demographic characteristics, Blacks experienced a higher level of workplace bullying in comparison with the other race groups, and men and women experience statistically significant differences with regards to workplace bullying. It was evident that older employees experience statistically significantly lower levels of bullying, and a statistically significant difference between those employees with a secondary and tertiary education was found. It seems that the highest levels of direct bullying by supervisors occurred in the government industry, followed by the mining industry. Individuals with a higher SOC experienced lower levels of bullying compared to individuals with a lower SOC. Statistically significant differences were found on all bullying dimensions with regards to diversity experiences. Recommendations were made for future research and organisations. / Thesis (M.Com. (Industrial Psychology))--North-West University, Potchefstroom Campus, 2012.

Workplace bullying is creating negative physical and psychological effects on employees and has a serious impact on the organisations’ bottom line. Workplace bullying has been related to excessive absenteeism, high employee turnover and hostile work environments. However, no recent studies on the prevalence of workplace bullying in the South African context are available. This is important because of the multicultural, multiracial composition of the South African workforce, and socio–demographic factors such as race, gender, age, education level and type of industry should be investigated to determine if differences exist with regard to the experience of workplace bullying. The personality resource, sense of coherence, should add an important element to this study, as the results could offer an important indicator for managers to change the employee’s environment in order to render the stimuli to which they are exposed more understandable, significant and manageable. In South Africa, diversity, multiculturalism, affirmative action and equal employment opportunity are words in common currency in a newly democratic country. Literature suggests that if diversity within African organisations is positively experienced, it could enhance harmony and effectiveness within that organisation. The objectives of this study were to 1) determine the relationship between workplace bullying, socio–demographic characteristics, sense of coherence and diversity experiences according to the literature; 2) to determine how frequently employees in South Africa experience acts of workplace bullying; 3) to determine if there are significant differences between socio–demographic groups (including race, gender, age, education and industry) with regards to workplace bullying; 4) to determine if there are significant differences between the different types of bullying (direct, indirect, supervisor and colleague bullying) with regards to sense of coherence; and 5) to determine if there are significant differences between the different types of bullying (direct, indirect, supervisor and colleague bullying) with regard to diversity experiences. An availability sample (N = 13 911) was utilised to determine the prevalence of workplace bullying in a sample of South African employees. Frequencies were used to determine the prevalence of workplace bullying for the total sample and MANOVA was used to determine differences between the groups. The results indicated that workplace bullying is a prevalent problem in South Africa, as people experience frequent overall bullying (4% reported being often bullied; 31,1% reported being always bullied). On the socio–demographic characteristics, Blacks experienced a higher level of workplace bullying in comparison with the other race groups, and men and women experience statistically significant differences with regards to workplace bullying. It was evident that older employees experience statistically significantly lower levels of bullying, and a statistically significant difference between those employees with a secondary and tertiary education was found. It seems that the highest levels of direct bullying by supervisors occurred in the government industry, followed by the mining industry. Individuals with a higher SOC experienced lower levels of bullying compared to individuals with a lower SOC. Statistically significant differences were found on all bullying dimensions with regards to diversity experiences. Recommendations were made for future research and organisations. / Thesis (M.Com. (Industrial Psychology))--North-West University, Potchefstroom Campus, 2012.

Text in Afrikaans, abstract in Afrikaans and English / Wanneer psigometriese toetsing op groepe uit verskillende sosio-ekonomiese agtergronde toegepas word, presteer individue uit agtergeblewe omgewings swakker as bulle ewekniee uit meer ontwikkelde omgewings. Hierdie individue se toegang tot hoofstroom loopbaangeleenthede word dikwels bemoeilik as gevolg van die beperking. Die leerpotensiaal benadering word aangebied as belowende alternatief om die probleem, wat 'n sosio-ekonomiese oorsprong het, te oorbrug. Die resultate van die studie bewys die stelling gedeeltelik waar, maar met buitengewone inspanning. In die finale ontleding van die resultate is dit duidelik dat die verbeterde voorspelling eerder toegeskryf kan word aan die optimale vlak van ontwikkeling wat die individu bereik net voor die toetsing, en nie soseer sy/haar leerpotensiaal nie. / Applying psychometric tests to groups from different socio-economical backgrounds, inevitably result in the individuals from deprived backgrounds performing noteably poorer than their counterparts from more developed backgrounds. These individuals also find enterance to the mainstream careers difficult because of this restriction. The learning potential approach to assessment is presented as a promising alternative to overcome the problem that is related to the socio-economic background of the individual. The results of this study partly confirm the value of the learning potential approach, but only with extra-ordinary effort. In the final analysis of the results it is clear that the improved predictive accuracy was rather due to the optimal level of development the individuals reached just before the testing, and not so much their learning potential. / Psychology / M. Sc. (Sielkunde)

Abstract The subject of the present study is the changes to the operation processes of organisations in the field of health care that are based on the application of information and communication technology (ICT). The purpose of this dissertation is to supplement the present discussion in information system study’ research forums with regard to the role of ICT as an enabler of change in the health care work processes. The starting point for the study was to inquire about the qualitative and, to some extent, financial impact of operational changes by means of a socio-technical-economic process study. Using qualitative as well as statistical indicators, changes were mainly investigated from the perspective of health care professionals, but in part from that of customers. The cases described were used as a basis for discovering a new operational model for performing organisational tasks. By comparing the cases, the intention was to synthesise those similarities and differences that can be used when constructing a new framework. The present study makes a contribution by broadening, deepening and synthesising the understanding of health care processes in the process of a reflective description of individual cases. Services are produced through interactions between the service production process and end user process, and in this, the end user plays an important role. The purpose of process descriptions and analyses in coordination with health service professionals is to proactively develop services and support rational decision-making. The models and methods created as a result of this process can be seen to have a potential financial impact by lowering health service costs as well as an enhancing the effect of on-the-job satisfaction among health care professionals as they are enabled to plan their own work processes. Due to the rapid changes in the infrastructure, societal structures and the age of the population in Finland, the future holds great challenges for decision-makers in the field of health care. From the perspective of securing the resources for adequate, balanced and high-quality health services, investments in information technology seem lucrative. However, in order to avoid a productivity paradox, it must be noted that, in addition to new information technology, a gradual change in working habits, attitudes and sometimes even organisational culture is needed. In addition, it must be remembered that new technology does not erase these aspects of health care work – unless we want it to do so – but rather provides new forms and tools. / Tiivistelmä Tutkimukseni aiheena oli tieto- ja viestintätekniikan (ICT) soveltamiseen perustuvat organisaatioiden toimintaprosessien uudistukset terveydenhuollossa. Väitöskirjassani halusin osaltani täydentää keskustelua, jota tietojärjestelmätieteiden tutkimusfoorumeilla on käyty ICT:n roolista terveydenhuollon työprosessien muutosten mahdollistajana. Tutkimukseni lähtökohtana oli sosioteknisen prosessitutkimuksen keinoin selvittää toimintauudistusten laadullista ja osin taloudellistakin vaikuttavuutta. Muutoksia arvioitiin pääasiassa henkilöstön, mutta myös osin asiakkaiden lähtökohdista, lähinnä laadullisten, mutta myös tilastollisten mittareiden avulla. Kuvaamieni tapausten lähtökohtana on ollut löytää uusi toimintamalli organisaation tehtävien suorittamiseksi. Vertaamalla tutkittavia tapauksia keskenään olen pyrkinyt syntetisoimaan ne yhteneväisyydet ja eroavaisuudet, joiden avulla on mahdollista rakentaa uusi viitekehys. Tutkimukseni kontribuoi sen ymmärryksen kautta, joka tapauskohtaisesti, reflektiivisesti muutoksia kuvaillen, tutkimuksen kuluessa avautuu, syventyy ja syntetisoituu. Palvelut tuotetaan palveluntuotantoprosessin ja käyttäjän prosessin vuorovaikutuksessa, ja siinä käyttäjän roolilla on merkittävä osuus. Prosessien kuvaamisella ja analysoinnilla yhdessä henkilökunnan kanssa on ollut tarkoituksena pyrkiä palveluiden proaktiiviseen kehittämiseen ja rationaalisten päätösten tukemiseen. Syntyneillä malleilla ja menetelmillä voidaankin katsoa olevan paitsi potentiaalinen taloudellinen merkitys terveydenhuollon palveluiden kustannusten alentamiseksi, myös vaikutusta henkilöstön työtyytyväisyyteen sen osallistuessaan oman työnsä suunniteluun. Infrastruktuurin, yhteiskuntarakenteiden samoin kuin väestömme ikärakenteen nopea muutos ja samalla kroonisten sairauksien lisääntyminen asettavat terveydenhuollon päättäjille tulevaisuudessa suuria haasteita. Riittävän, tasapuolisen ja laadukkaan hoidon resurssien turvaamiseksi investoinnit tietotekniikkaan kuulostavat houkuttelevilta. Jotta tuottavuusparadoksilta vältyttäisiin, on kuitenkin huomioitava, että uuden tietotekniikan lisäksi tarvitaan myös työtapojen, asenteiden, joskus jopa organisaatiokulttuurinkin asteittaista muutosta. On myös syytä muistaa, että uusi tekniikka antaessaan edellä mainituille ilmiöille uusia ilmenemismuotoja ja välineitä, ei kuitenkaan hävitä niitä, ellemme itse sitä halua.