ABSTRACT Denna uppsats var en undersökning av motivationsarbetet på ett hälsoföretag i Sverige. Syftet med undersökningen var att beskriva vad hälsoföretaget använder sig av för teorier och metoder för att motivera sina klienter. Uppsatsen baserades på fyra intervjuer och två observationer. Personerna som ingick i undersökningen var alla anställda på företaget. Ledarna använder sig av olika teorier och modeller för att motivera sina deltagare. Några av dessa var motiverande samtal, kroppsspråk och motivationskorset. En viktig del av Hälsoföretagets arbete var att sprida glädje bland sina deltagare. De vill få alla att känna sig sedda och detta gjorde de genom uppmuntrande kommentarer och blickar. Trots det så upplevde vi att ingen av dem har reflekterat särskilt över hur de gör när de ska motivera sina klienter. Ett annat resultat vi fann var att inte alla använder sig av någon vetenskapligt baserad motivationsmodell. För att öka chansen för bättre resultat kan det vara en fördel att ta stöd från forskningen.

Prior to 1994, the South African Health Department was characterised by a fragmented health care system, which was largely curative and hospital based, with services planned and managed without community involvement and participation. The government, through the establishment of a district health system, integrated the health services with the aim of overcoming the fragmentation, and providing integrated comprehensive health care services that are equitable, accessible, efficient and effective. The integration of health services in Gauteng, meant the devolution of primary health care services from the provincial health department to the local authority health department, because the local authority services are nearer and accountable to the community. The process of integration of health services also meant the closing down of provincial clinics and transferring of provincial authority nurses to the local authority clinics. The transfer process impacted negatively on staff morale and on the resources available for health care delivery to the communities. It is against this background that the researcher decided to investigate the integration process. The researcher then conducted focus group interviews with the local authority nurses, provincial authority nurses and the district management team as these nurses's immediate supervisors. The results revealed that the local and provincial authority nurses were integrated without proper consultation and as a result integration was rejected. The following themes emerged from the results as negative perceptions and obstacles towards integration: lack of consultation, disparities in conditions of service and resistance to change. Positive perceptions also emerged from the results as strategies to improve the integration, and these strategies were used to develop guidelines to operationalise the model. It is envisaged that the proposed model will serve as a theoretical framework for nurse managers from both spheres of government, local and provincial to improve the integration of nurses through proper consultation, and involvement of nurses in the process affecting them. It is further envisaged that the model will serve as guideline to introduce changes within the district health system with more understanding and acceptance by nurses affected. Health care managers will find the model useful to overcome disparities in conditions of service among nurses and, in turn this may boost the moral of nurses and lead to successful integration of provincial and local authority nurses. / Health Studies / D.Litt. et Phil (Health Studies)

Failure accompanies most organizational change efforts. Change agents' efforts focus on employee resistance or readiness to change without considering employee ambivalence. Motivational interviewing (MI) may reduce ambivalence and improve the success rate of organizational change initiatives. The purpose of this experimental research was to evaluate the effectiveness of MI to increase readiness to organizational change, to assess the influence of MI on change-related beliefs, and to investigate the relationship between beliefs and readiness to change. The theoretical framework was the transtheoretical model of change, the theory of planned behavior, and social cognitive theory. Through random assignment, 56 employees of a company undergoing change and located in the Midwest region of the United States populated the experimental and control groups. Members of the experimental group participated in 3 motivational interviewing sessions over a 30-day period. Participants indicated their readiness and underlying change-related beliefs by completing the Job Change Ladder and the Organizational Change Recipients' Belief Scale. Within and between group differences from a mixed ANOVA revealed that MI significantly increased readiness to change. There was not a significant difference between the beliefs of both groups as indicated by the results of the MANOVA test. Participants' beliefs explained readiness to change as evidenced by the results from the use of multiple regression. The findings indicate that leaders of organizational and societal change initiatives could incorporate MI to prepare individuals and groups to embrace the change process, thereby improving the chances that the change initiative will be successful.

Syfte: Syftet med denna studie är att analysera vilket bemötande arbetstagare inom privat tjänstesektor i Sverige önskar av arbetsledningen inför en kommande organisationsförändring. Följande forskningsfrågor bevaras: Vilka psykologiska bakomliggande faktorer indikerar motstånd mot förändring bland arbetstagare inom privat tjänstesektor i Sverige Vad anser dessa arbetstagare vara ett bra bemötande av företagsledningen inför en kommande organisationsförändring Metod: Denna studie har en kvantitativ ansats genom en enkätundersökning där resultatet av undersökningen analyserats med hjälp av explorativ faktoranalys. Undersökningen genomfördes med 171 arbetstagare inom privat tjänstesektor i Sverige. I ett led att skapa en nyans till studien förekommer det kvalitativa inslag som grundar sig i en innehållsanalys av kommentarer skapade via en fritext-fråga i enkäten. Resultat och slutsats: Resultatet av denna studie visar att de psykologiskt bakomliggande faktorerna som indikerar förändringsmotstånd är: Känslorna styr inför en förändring, Konsekvent och principfast, Rutiner är av godo samt Nuet är viktigare än framtiden. Resultatet visar även att inför en förändring önskar arbetstagare följande bemötande av arbetsledningen: En tydlig och transparent kommunikation, Förberedelse med information i god tid, En öppen dialog och delaktighet i förändringsprocessen samt En socialt stödjande miljö som främjar trygghet och framtidstro. Examensarbetets bidrag: Denna studie har bidragit till att validera användandet av modellen “The Resistance to Change-scale". Resultatet av studien visar på att modellen kan användas som ett verktyg för att utreda hur arbetstagare inom privat tjänstesektor i Sverige kommer reagera på olika sätt inför en kommande organisationsförändring. Ytterligare ett bidrag är att resultatet av studien visar på att en tydlig, inbjudande och transparant kommunikation är av vikt för att förebygga uppkomsten av negativt förändringsmotstånd. Ledningen bör beakta de fyra kommunikationsstrategierna för att skapa ett informationsutbyte som passar alla individer i en organisation. Förslag till fortsatt forskning: Förståelsen för fenomenet förändringsmotstånd är långt från färdigutvecklat och vi ser att det finns olika inriktningar framtida forskning kan ta för att utveckla förståelsen för ämnet. RTC-skalan behöver användas som ett verktyg i andra populationer för att testa skalans tillförlitlighet. Vi ser även att framtida forskning kan beröra hur en arbetstagares mående utanför arbetet påverkar dennes benägenhet att mer eller mindre uppvisa organisatoriskt förändringsmotstånd. Ett sista förslag är att koppla samman RTC-skalan med förändringskurvan (Five Stages of Grief). / Aim: The purpose of this study is to analyze what kind of treatment employees within the private service sector in Sweden seek from management before an upcoming organizational change. The research questions to be answered are: Which psychological underlying factors indicate resistance to change among employees in the private service sector in Sweden? What do these employees consider to be a good treatment from the management in the face of an upcoming organizational change? Method: This study has a quantitative approach through a survey where the results of the survey were analyzed using exploratory factor analysis. The survey was conducted with 171 employees in the private service sector in Sweden. In order to provide nuance to the study, there is a qualitative element based on a content analysis of comments created via a free-text question in the survey. Results and conclusions: The results of this study show that the psychological underlying factors that indicate resistance to change are: Emotions rule before a change, Consistent and principled, Routines are good and The present is more important than the future. The results also show that before an organizational change, employees want the following treatment from management: Clear and transparent communication, Preparation with information in good time, An open dialogue and participation in the change process and A socially supportive environment that promotes security and belief in the future. Contribution of the thesis: This study has contributed to validating the use of the model "The Resistance to Change-scale" as a tool to investigate how employees in the private service sector in Sweden will react in different ways to an upcoming organizational change. A further contribution is that the results of the study show that clear, inviting and transparent communication is important to prevent the emergence of negative resistance to change. Management should consider the four communication strategies to create an information exchange that suits all individuals in an organization. Suggestions for future research: The understanding of the phenomenon of resistance to change is far from fully developed, and we see that there are therefore different directions that future research can take to continue developing the understanding of the subject. The RTC scale needs to be used as a tool in other populations to test the reliability of the scale. We also see that future research can refer to how an employee's mood outside of work affects their tendency to show more or less resistance to organizational change. A final suggestion is to connect the RTC scale with the change curve (Five Stages of Grief).

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I syfte att undersöka vad som påverkar medarbetarattityder till en intervention, genomfördes en enkätstudie med 23 frågor inom två kommunala verksamhetsprocesser. Bland 137 besvarade enkäter och en svarsfrekvens på 77 procent var deltagarna mellan 22 och 64 år med olika utbildningsnivåer och omfattning på chefskontakt. Frågeställningen var: Hur påverkas medarbetarnas attityder av 1) chefens engagemang, 2) yrkes- och arbetsplatsfaktorer och 3) arbetsbelastning. Genom varians-, korrelations- och regressionsanalyser undersöktes de oberoende variablernas förhållande till medarbetarnas attityder till interventionen. Resultatet visade att medarbetarattityderna till interventionen var mer positiva när chefens engagemang uppfattades som högt. En negativ inställning till interventionen bland kollegorna på arbetsplatsen visade samband med en mer negativ medarbetarattityd. Studien gav inte stöd för något samband mellan arbetsbelastning och medarbetarattityd. Ett klusterurval hade eventuellt ökat validiteten och förbättrat könsfördelningen. Förslag till vidare forskning är att undersöka påverkan av upplevd nytta på sambandet mellan arbetsbelastning och attityd till förändring.

This study focuses on four common factors believed to affect resistance to change in public organizations. It contributes to existing literature by examining the effect of higher education and trust on the police officer's level of resistance to change and the effects of participation and communication on trust. 286 police officers from two north Texas towns responded to the survey. Regression analysis and bivariate correlations were used to determine the relationship between, resistance to change, and participation, trust, communication, information, and education and the relationship between trust and the other independent variable. The analysis failed to support previous research, which listed participation as the most important factor, but did support the concept that participation and communication improved trust.

Experimentos têm mostrado que ratos criados isolados consumem mais álcool durante a idade adulta que ratos criados em condições de interação social; no entanto, poucos experimentos têm explorado os efeitos do isolamento sobre a persistência na procura de álcool. A presente serie de estudos avaliou os efeitos do isolamento em etapas iniciais do desenvolvimento sobre a persistência na procura de álcool em contextos associados à sua entrega. Nos estudos, ratos foram distribuídos imediatamente depois do desmame em duas condições alojamento: isolamento (ISO) e interação (INT). Na idade adulta, os ratos foram treinados em esquemas múltiplos nos quais diferentes contextos de estímulos foram associados a diferentes taxas de entrega de álcool -magnitudes ou a reforçadores diferentes-. A persistência na procura de álcool foi avaliada como resistência à mudança em sessões de extinção. No Capítulo I foi avaliada a persistência em contextos associados a diferentes frequências de entrega de álcool. Foi achado que ratos ISO mostraram maior persistência que ratos INT em contextos associado a frequências altas e baixas de entrega de álcool. No Capítulo II foi estudado o efeito da concentração (5% ou 15%) de álcool sobre a persistência do comportamento de procura. Os resultados mostraram que concentrações altas de álcool geram maior persistência do comportamento de procura, embora gerem taxas baixas de resposta na linha de base. No capítulo III foram realizados dois estudos nos quais foi achado que ratos criados em isolamento persistem mais em contextos associados a concentrações altas de álcool (Experimento 3) e que o isolamento afeta particularmente a procura em contextos associados ao álcool quando comparados com contextos associados a outros reforçadores (Experimento 4). Os achados gerais demonstram que o isolamento em etapas inicias do desenvolvimento incrementa tanto o consumo quanto a persistência na procura por álcool, o que sugere que o estresse social em etapas iniciais do desenvolvimento é um fator de risco para o desenvolvimento de dependência ao álcool / Several experiments have shown increased alcohol consumption in rats reared in social isolation compared to rats reared in group conditions; however, few experiments had explored the effects of social isolation on persistence of alcohol seeking. The studies presented here assessed the effects of social isolation on persistence of seeking in alcoholrelated contexts. For the studies, rats were assigned to on of two conditions after weaning: Social Isolation (ISO) or social Interaction (INT). During adulthood, rats were trained within a multiple schedule of reinforcement, in which different contextual stimuli were related to differential frequencies, magnitudes or qualities of alcohol. Persistence was assessed as resistance to extinction in extinction sessions. Chapter I measured persistence by ISO and INT rats in contexts related to high and low rates of alcohol reinforcement. It was found that ISO rats persisted more than INT rats regardless of the frequency of reinforcement. In Chapter II was studied the effect of alcohol concentration (5% and 15%) on persistence of alcohol seeking. Results showed that high alcohol concentrations are related to higher persistence during extinction. Chapter III presented two studies that found that ISO rats are more persistent in contexts related to high alcohol concentrations (Experiment 3), also that isolation differentially increased persistence in contexts related to alcohol compared to contexts related to other reinforcers (Experiment 4). General findings show that social isolation increase both consumption and persistence in alcohol related contexts, suggesting that social stress early in the development could be a considered a risk factor for alcohol use disorders

Neste estudo, minha proposta foi dirigir-me às pessoas portadoras de neoplasias em seu domicílio, buscando em um primeiro momento apreender o significado para os doentes de seu sendo-no-mundo com câncer, e a partir dessa compreensão, projetar novas possibilidades de cuidado a esses seres. A fenomenologia existencial de Martin Heidegger permitiu-me uma aproximação da existencialidade do doente, contemplando suas vivências com a doença. Para tal, realizei várias visitas aos sujeitos, antes e após a entrevista. A partir dos discursos e de minhas observações feitas durante as visitas, conduzi-me a uma compreensão das percepções dos pacientes sobre o estar-no-mundo com câncer. Da análise compreensiva emergiram duas categorias: A temporalidade do existir com câncer e o Ser-com-ooutro inautêntico no convívio com o câncer, as quais interpretei apropriando-me de algumas idéias de Martin Heidegger. E, finalmente, retomando o caminho percorrido, reflito sobre a assistência dispensada aos doentes e a importância de buscar novos caminhos para contemplar as reais necessidades de cuidados da pessoa com neoplasia. / In this study, my proposal was to direct myself to people who carry neoplasia at their dwellings, aiming, in the first instance, to understand the meaning of the being in world with cancer to the ill, and from this comprehension, to project new care possibilities to these beings. Martin Heidegger’s existential phenomenology allowed me to approximate myself to the ill person’s existentiality, contemplating his experience with the disease. For that, I accomplished several visits to individuals, before and after the interview. From the speeches and my observations fulfilled during the visits, I conducted myself to A comprehension of the ill perceptions of being in the world with cancer. From the comprehensive analysis, two categories emerged: The temporality of being with cancer and the inauthentic being-with the other in living together with cancer, which I interpreted adopting some Martin Heidegger’s ideas. Finally, recapturing the coursed path, I reflect on the exempt assistance to the ill and the importance of searching new to contemplate the real care necessities of the person with neoplasia.

To stay competitive in today’s business environments companies have to adapt to the fast-changing business conditions. Hereby change management plays an important role; companies and consultants often apply certain change models to plan and implement change projects. The two change models by John Kotter, published in 1996 and 2014 are one of the most famous and most often applied ones. Within this thesis, the authors developed a modified change management model where they developed Kotter’s ideas further and enlarged them with new perspectives that were not included before. Resistance to change is considered in the new approach from a positive perspective, which means that it is seen as an opportunity instead of being an obstacle. Besides that, the modified change model includes several leadership aspects that were neglected in Kotter’s change models. New leadership aspects are reflection, a concrete leadership style, sensemaking, as well as the different leadership characters between female and male leader. Out of these new insights, the authors developed a modified change model, which allows to plan and manage the change project better than before.