<p>Low back pain (LBP) is a common musculoskeletal condition that can lead to pain, functional limitations and disability. Due to the prevalence of LBP, multiple self-reported outcome measures have been developed, which have resulted in redundancy in the literature. Two frequently used outcome measures are the Roland Morris Questionnaire (RMQ) and the Oswestry Disability Index (ODI). Few authors have performed head-to-head comparison studies to determine which of these outcome measures are the most successful at measuring sensitivity to change. The purpose of this thesis was to answer the question: Is there a difference in the sensitivity to change between the RMQ and the ODI in their ability to measure pain-related functional status in persons with low back pain?</p> <p>The first part of this thesis involves a systematic review of head-to-head comparison studies to determine the difference in the sensitivity to change of the RMQ and the ODI. Five databases were searched and nine articles were located. The second part of this thesis entails the development of a quality criteria form to evaluate head-to-head comparison studies.</p> <p>The third aspect of this research was to perform a head-to-head comparison study of the RMQ and the ODI using data from the nine studies. A small but significant difference was noted in favour of the RMQ in terms of the Spearman rank correlation coefficient between its change scores and the reference standard (Z = 2.36, p = 0.018; Z = 3.28, p = 0.001) and also in the Receiver Operating Characteristic curve area (<em>X</em>²₁ = 8.58, p = 0.003).</p> / Master of Science Rehabilitation Science (MSc)

This research project investigates individuals' resistance to change brought about by new information technology implementation in the Architecture, Engineering, and Construction (AEC) industry. By understanding how individual participants resist and adapt to change, their resistance can be better accommodated by the organization in the adoption of new information technology within the AEC industry. This enables researchers and practitioners to understand how new technologies should be introduced within organizations. A social architecture factor model associated with impeding/promoting use of information technologies was created based on a literature review of change management theory on resistance to change and attitude-behavior connections. In Phase I of the research, the personality traits and behavioral characteristics individuals included in the original model were reduced to a smaller number of variables indicative of resistance to information technology change. A revised social architecture factor model was created after this reduction. The variable reduction and revised model were based on data collected from a 50-person sample of the AEC population. At the conclusion of Phase I, a Resistance to Change Index (RTCI) was created, enabling estimations of the intensity of resistance an individual is likely to exhibit using the personality traits and behavioral characteristics kept in the revised social architecture factor model. Phase II of the research investigated relationships between the RTCI and demographics of the individual using a 156-person sample of the AEC population. This phase of the research determined whether different demographic groups within the AEC population exhibited differences in their RTCI. The data analysis found several demographic groups that were different in their likelihood of resistance, including profession, gender, computer understanding and experience, and awareness of past or future changes occurring in their company. Age and education level were expected to have relationships with RTCI, based on industry stereotypes. The data analysis found that these stereotypes have no scientific basis. Two other stereotypes, gender and computer understanding and experience, were supported by the data analysis, however. / Ph. D.

Despite the well-established effectiveness of couple therapy for reducing distress and improving relationship satisfaction (Cohen, 1988; Christensen and Heavey, 1999), less than a fourth of couples seek couple therapy prior to divorce (Albrecht, Bahr, and Goodman, 1983; Wolcott, 1986). Rather, the majority of couples wait over 5 years before seeking therapy (Johnson et al., 2002). Barriers to seeking individual therapy are well established and are associated with decreased rates of therapy attendance and the negative consequences of untreated distress and mental health problems (Corrigan, 2004; Killaspy, Banerjee, King, and Lloyd, 2000; Vogel, Wade and Hackler, 2007). It is unclear as to whether the same barriers exist for individuals who are seeking couple therapy. This study examined the applicability of the Health Belief Model (HBM; Rosenstock, 1966), with the addition of demographic characteristics (gender, income, education, and religion) and contextualizing individual factors (relational distress and perceived stigma), to predict an individual in a committed relationship's (N =158) motivation to seek couple therapy. When controlling for demographic variables and contextualizing factors, the Health Belief Model factors of lower barriers and lower benefits were predictive of higher motivation to seek couple therapy. Throughout all iterations of the model, lower income and lower relational distress were also associated with higher rates of motivation to seek couple therapy. This research indicates that barriers, including high levels of relational distress, impact an individual's motivation to seek couple therapy. Further investigation of the application of the HBM factors to mental health, including research into more systemic measurements of these factors, is needed. Future research should also identify other potentially contextualizing factors, as the overall model accounted for a relatively small amount of variation in the individual's motivation to seek couple therapy. / Ph. D. / Couple therapy has been shown to provide relief for relationship distress and individual mental health problems (Cohen, 1988; Christensen & Heavey, 1999). Despite this, the majority of couples choose to either live with relationship distress prior to seeking couple therapy or never seek treatment prior to getting divorced (Albrecht, Bahr, & Goodman, 1983; Gottman & Gottman, 2013; Johnson et al., 2002; Wolcott, 1986). Unfortunately, very little is known about the reasons couples avoid couple therapy; therefore, this research is based on the established barriers found in the literature on why individuals do not seek mental health treatment. Because of the inclusion of an established help-seeking theory, known as the Health Belief Model (HBM; Rosenstock, 1966), the results of this study can more broadly inform individuals, couples, therapists, and policy makers about the reasons individuals may not seek couple therapy. An online survey of 158 couples indicated that higher levels of relationship satisfaction, lower income levels, lower perceived benefits to couple therapy, and lower perceived barriers to accessing treatment were associated with higher motivation to seek couple therapy. Overall, research should continue to examine the application of the Health Belief Model constructs (perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and cues to action) to mental health seeking behavior, especially couple and family therapy. Research should also identify other potential constructs, beyond those used in this study (gender, income, education, religion, self-stigma, and relational distress), that impact an individual’s motivation to seek couple therapy.

The aim of this study was to explore the role of feedback in managing resistance to organisational change. A general systems theoretical model of individual resistance to change was developed. It describes the origin, function and outcomes of individual resistance to planned organisational change. The role of feedback within this process was identified as a central one and feedback was therefore identified as an important point of leverage in managing resistance to change. The survey feedback approach was adopted in a retail organisation undergoing significant change. Staff were asked to respond to a survey on their experience of the change. Results were analysed and then fed back to them during group discussions. The process was repeated. It was concluded that the survey feedback approach significantly contributed to a reduction in resistance to change and that both survey feedback approach and the model of individual resistance to change merit further investigation. / Industrial Psychology / M.A. (Industrial Psychology)

The aim of this study was to explore the role of feedback in managing resistance to organisational change. A general systems theoretical model of individual resistance to change was developed. It describes the origin, function and outcomes of individual resistance to planned organisational change. The role of feedback within this process was identified as a central one and feedback was therefore identified as an important point of leverage in managing resistance to change. The survey feedback approach was adopted in a retail organisation undergoing significant change. Staff were asked to respond to a survey on their experience of the change. Results were analysed and then fed back to them during group discussions. The process was repeated. It was concluded that the survey feedback approach significantly contributed to a reduction in resistance to change and that both survey feedback approach and the model of individual resistance to change merit further investigation. / Industrial Psychology / M.A. (Industrial Psychology)

Bakgrund och problemområde: Organisationer påverkas i stor utsträckning av globaliseringen och den tekniska utvecklingen, något som inte är ett undantag för tillverkningsindustrisektorn. Detta kräver att organisationer ständigt behöver utvecklas för att hålla sig konkurrenskraftiga på marknaden. Men något som också kan skapas i och med de ständiga förändringarna är ett växande förändringsmotstånd. Medarbetares förändringsmotstånd kan ha förödande konsekvenser. Men är det verkligen själva motståndet som är problemet, kan det inte vara så att det orsakas av något annat? För att förstå förändringsmotståndet och att det i sig kanske inte är det verkliga problemet skapas kunskap om orsaken till att förändringsmotståndet uppstår. Även vilket stöd organisationen kan bidra med vid förändringsarbeten.. Förändringsmotstånd kan yttra sig på olika sätt och det finns olika orsaker till dess uppkomst. Syfte: Syftet med rapporten är att öka kunskapen om orsakerna till medarbetares förändringsmotstånd och hur motståndet ser ut på ett av Sveriges största tillverkningsföretag. En ökad kunskap kring förändringsmotstånd i olika kontexter kan bidra till att förstå hur oönskat motstånd kan förebyggas.  Problemformulering:● Vilka former av förändringsmotstånd upplevde medarbetarna vid enorganisationsförändring och vad var orsaken till motståndet? o Vilken möjlighet för stöttning av organisationen finns för medarbetaren vid förändringsarbeten? Metod: I studien har det använts en kvalitativ metod för att öka kunskapen kring medarbetarnas perspektiv på förändringsmotstånd. Det har genomförts tio semistrukturerade intervjuer med medarbetare som är mellanchefer på Företag X i tillverkningsindustrisektorn. Slutsats: Bland de olika reaktionerna är det känslomässigt motstånd som varit starkast. I de flesta fallen har motståndet varit passivt eller ambivalent, det vill säga att det handlat om negativa tankar och känslor. Samtidigt är en majoritet av motståndet omedvetet, det vill säga att de som har ett motstånd själva inte vet om det eller antar sig ha det. Hur förändringsmotståndet yttrar sig antas bero på vad orsaken till motståndet bottnar sig i. Psykologiska orsaker till motstånd var det som visat sig tydligast. Att vara mellanchef verkar till viss del påverka hur motståndet uttrycker sig då de har mer insyn och inflytande i organisationen. Undersökningen kom fram till att medarbetarna inte upplevde sig behöva något ytterligare stöd vid förändringsprocessen då de redan kände sig tillfreds med den stöttning de hade i form av en god kommunikation och relation till sin närmsta chef. / Problem background: Organizations are greatly affected by globalization and technological development, which is not an exception for the manufacturing industry sector. This requires that organizations constantly need to develop in order to remain competitive in the market. A phenomenon that can be created as an impact of constant changes within an organization is a growing resistance to change. Employee resistance to change can have devastating consequences. But is it really the resistance itself that is the problem, couldn't it be caused by something else? In order to understand the resistance to change and that it may not in itself be the real problem, knowledge is created about the reason why the resistance to change arises. Also, what support the organization can contribute to when changes in the workplace are taking place. Resistance to change can manifest itself in different ways and there are different reasons for its emergence. Purpose: The purpose of the report is to increase knowledge about the reasons for employee resistance to change and what the resistance looks like at one of Sweden's largest manufacturing companies. An increased knowledge of resistance to change in different contexts can contribute to understanding how unwanted resistance can be prevented. Research question:● What forms of resistance to change did the employees experience during an organizational change and what was the reason for the resistance?o What opportunity for support from the organization is there for the employee during organizational change? Method: In this study, a qualitative method was used to increase knowledge about the employees' perspective on resistance to change. Ten semi-structured interviews have been conducted with employees who are middle managers at Company X in the manufacturing industry sector. Conclusion: Among the different reactions, it is the emotional resistance that has been the strongest. In most cases, the resistance has been passive or ambivalent, that is to say, it has been about negative thoughts and feelings. At the same time, a majority of the resistance is unconscious, that is, those who themselves have a resistance do not know about it or assume that they have it. How the resistance to change manifests itself is assumed to depend on what the cause of the resistance is rooted in. Psychological reasons for resistance were the most clearly demonstrated. Being a middle manager seems to some extent to influence how the resistance expresses itself as they have more visibility and influence in the organization. The survey concluded that the employees did not feel they needed any additional support during the change process as they already felt satisfied with the support they had in the form of good communication and a good relationship with their immediate supervisor. / <p>Externt samarbete med ett anonymt tillverkningsföretag.</p>

Syfte: Komplexa, offentliga organisationer genomgår ständigt organisationsförändring och det enda som är bestående är just förändring. Vi har valt att studera hur ledare hanterar medarbetare som inte tycker om att, eller vill, förändras då det är en vanlig situation enligt våra egna erfarenheter. Studien har genomförts för att utveckla forskningen inom området för hur ledare kan hantera sina medarbetares förändringsmotstånd inför en organisationsförändring. Syftet är att skapa förståelse för hur ett individanpassat stöd kan hjälpa ledaren att reducera medarbetarens kognitiva, känslomässiga samt medvetna förändringsmotstånd inför en organisationsförändring. Metod: Vi har använt en kvalitativ metod med semistrukturerade intervjuer för att samla in data. Den empiriska informationen analyserades därefter genom tematiska nätverk och presenterades som ett gemensamt empiriskt och analytiskt kapitel. Resultat &amp; slutsats: De resultat vi funnit tyder starkt på att individanpassat stöd från ledarens sida har en inverkan på medarbetares förändringsmotstånd samt att de allra flesta medarbetarna har någon form av motstånd. Vidare fann vi inga belägg för att individanpassat stöd endast tillhör det transformella ledarskapet, utan vi påstår att detta stöd finns inom flera ledarskapsstilar. Förslag till fortsatt forskning: Vi anser att vår studie bör göras om i samma kontext, men med fler respondenter, för att på så sätt se om samma resultat framkommer samt att ha möjlighet att öka tillförlitligheten av våra resultat. Uppsatsens bidrag: Vårt teoretiska bidrag består av en djupare förståelse i hur ledare använder sig av individanpassat stöd samt hur det påverkar medarbetare med förändringsmotstånd. Vårt praktiska bidrag ger våra respondenter och andra chefer inom Gävle Kommun en tankeställare i hur förändring bör hanteras samt råd som kan användas vid framtida organisationsförändringar. / Aim: Complex, public sectors go through constant organizational change and nothing endures but change. We have chosen to investigate how leaders deal with followers’ who do not like or want to change though this is common according to our own experiences. The study has been completed to contribute to science within the subject of how leaders reduce their followers’ resistance to change in the initial stage of an organizational change. The aim is to create an understanding in how an individualized support can help the leader to reduce followers’ cognitive, emotional and intentional RTC in the initial stage of an organizational change. Method: We have used a qualitative method and semi-structured interviews to gather our data. The empirical information was analyzed through theme networks and was presented as an empirical and analyzing chapter all together. Result &amp; Conclusions: The results we found do confirm the most of our research questions including that individualized support used by the leader does have an effect on followers’ resistance to change as well as that most employees have some kind of resistance to change. Although we did not find any proof of individualized support only being a part of the transformational leadership. Instead, we think that this kind of support will be found in several leadership styles. Suggestions for future research: We believe that our study shall be done all over again within the same context but with more respondents and in that way see if there result will be the same. This would according to us also increase the reliability. Contribution of the thesis: Our theoretical contribution includes a deeper understanding of how leaders use individualized support together with the effect on employees with RTC. Our hands-on contribution gives our interviewees and other leaders within the public sector an eye-opener of how change should be handled in future coming organizational change.

Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal.

Preference for one stimulus context over another and resistance to disruption within those contexts are a function of the conditions of reinforcement arranged within those contexts. According to behavioral momentum theory, these measures are converging expressions of the concept of response strength. Most studies have found that preference in concurrent chains and resistance to change are greater in contexts presenting higher rates or larger magnitudes of reinforcement. The present series of experiments attempted to extend behavioral momentum theory by examining whether differences in reinforcer type affect relative response strength with rats lever pressing for different types of food. In Experiment 1 of Chapter 2, several nonuniform disrupter types were examined that provided free access to a food type that was the same as one reinforcer type. Responding decreased more in the context presenting the same type of reinforcer as the disrupter, suggesting that many traditional disrupters (e.g., satiation) are inappropriate for examining how reinforcer type impacts response strength. Therefore, extinction was used throughout the remainder of the experiments to more uniformly disrupt responding across contexts. In Experiment 2 of Chapter 2, resistance to extinction was assessed when food pellets and a sucrose solution maintained responding across contexts. Moreover, relative reinforcer type was manipulated by changing the sucrose concentration across conditions. Relative response rates were systematically affected by changing sucrose concentration, but relative resistance to extinction was not. In Experiment 3 of Chapter 2, qualitative difference between reinforcers was enhanced and preference also was assessed to provide a converging measure of response strength. Preference and relative response rates were systematically affected, but relative resistance to extinction again was not. Finally, in Chapter 3, relative reinforcer rate and type were manipulated while assessing preference and resistance to extinction using the matching law. Preference, but not resistance to extinction, consistently was affected by changes in reinforcer rate and type. Systematic deviations in sensitivity and bias, however, suggested that different reinforcer types interacted with reinforcer rate. Overall, these findings suggest that the overall context of reinforcement, including interactions between different reinforcer types, should be considered when assessing preference and relative resistance to change.

The present experiment was conducted to investigate the effects of reinforcer magnitude on resistance to disruption of remembering and response rates. Pigeons were exposed to a variable-interval (VI), delayed-matching-to-sample procedure (DMTS) with two components (rich and lean). Specifically, completion of a VI 20 second (s) multiple schedule resulted in DMTS trials in both components. In a DMTS trial, a choice of one of two comparison stimuli (e.g., blue key) results in reinforcement if the choice matches some property of the sample stimulus presented previously. Sample and comparison stimuli are separated by a delay. Four delays (0.1, 4, 8, and 16 s) were used between the sample and comparison stimuli in the study. The difference between rich and lean components was the length of hopper duration following a correct response. The probability of reinforcement following a correct response in both components was .5. Each pigeon was exposed to 50 sessions of initial baseline and then 30 sessions of baseline between each disruptive condition (extinction, intercomponent interval [ICI] food, lighting the houselight during delays, and prefeeding). Separable aspects of the forgetting functions (initial discriminability and rate of forgetting) were examined by determining accuracy at each delay. During baseline, response rates were higher in the rich component relative to the lean. Accuracy decreased as delay increased in both rich and lean components, and accuracy was consistently higher in the rich relative to the lean component. During disruptive conditions, extinction, ICI food, and prefeeding disrupted response rates, but lighting the houselight during the delays had little effect. During the DMTS portion of the procedure, extinction and prefeeding decreased initial discriminability and lighting the houselight during the delay increased rate of forgetting. Intercomponent food had little effect on accuracy. Accuracy in the rich component was more resistant to disruption relative to the lean component during extinction. These results indicate that certain disruptors do not have the same disruptive effect across response rates and accuracy (e.g., ICI food). These data also suggest that when systematic differences in accuracy between rich and lean components are revealed, performance in the rich component tends to be more resistant to disruption.