Effective mental workload measurement is critical because mental workload significantly affects human performance. A non-invasive and objective workload measurement tool is needed to overcome limitations of current mental workload measures. Further, training/learning increases mental workload during skill or knowledge acquisition, followed by a decreased mental workload, though sufficient training times are unknown. The objectives of this study were to: (1) investigate the efficacy of using thermography as a non-contact physiological measure to quantify mental workload, (2) quantify and describe the relationship between mental workload and learning/training, and, (3) introduce a method to determine a sufficient training time and an optimal human performance level for a novel task by using thermography. Three studies were conducted to address these objectives. The first study investigated the efficacy of using thermography to quantity the relationship between mental workload and facial temperature changes while learning an alpha-numeric task. Thermography measured and quantified the mental workload level successfully. Strong and significant correlations were found among thermography, performance, and subjective workload measures (MCH and SWAT ratings). The second study investigated the utility of using a psychophysical approach to determine workload levels that maximize performance on a cognitive task. The second study consisted of an adjustment session (participants adjusted their own workload levels) and work session (participants worked at the chosen workload level). Participants were found to fall into two performance groups (low and high performers by accuracy rate) and results were significantly different. Thermography demonstrated whether both group found their optimal workload level. The last study investigated efficacy of using thermography to quantify mental workload level in a complex training/learning environment. Experienced drivers’ performance data was used as criteria to indicate whether novice drivers mastered the driving skills. Strong and significant correlations were found among thermography, subjective workload measures, and performance measures in novice drivers. This study verified that thermography is a reliable and valid way to measure workload as a non-invasive and objective method. Also, thermography provided more practical results than subjective workload measures for simple and complex cognitive tasks. Thermography showed the capability to identify a sufficient training time for simple or complex cognitive tasks.

The concept of home care nursing workload has not been widely studied and no evidence was found that an analysis of the concept had been undertaken. Consequently, there was a knowledge gap regarding the definition and attributes for the concept of home care nursing workload as it is currently experienced. To address that gap, a descriptive, three-phase, mixed methods (quantitative and qualitative) study was conducted. In Phase One, Rodgers’ (2000) evolutionary method was used to analyze the concept of home care nursing workload based on the empirical literature. Phase Two was situated within the naturalistic inquiry paradigm and involved observation of ten home care registered nurses during their visits to 61 patients. In Phase three a questionnaire was administered to validate the draft definition and attributes for the concept of home care nursing workload. It was completed by 88 home care nursing experts from clinical practice, education, management and research. Qualitative findings were analyzed using inductive content analysis. Quantitative data were analyzed descriptively using SPSS. Data triangulation was used extensively within and between the study phases. Of 14 attributes in the phase three draft concept definition, respondents assigned the highest level of relevance to the attribute of cognitive effort and the lowest to physical effort. The final definition contained 20 attributes and includes the following excerpt: “Home care nursing workload is the totality of the cognitive, emotional and physical effort home care nurses expend to meet the expectations of all stakeholders in providing holistic, outcome directed and patient/family focused care within the context of a short or long-term therapeutic relationship.” Respondents reported high levels of agreement with the accuracy and completeness of the definition and the majority indicated the definition would be useful or very useful in their day-to-day work. The comprehensive concept exemplar that emerged from the study includes each of the identified attributes. The study findings provided evidence of the complexity and challenge inherent in quantitatively measuring home care nursing workload. Accordingly, implications of the findings are shared for the management and monitoring of workload and associated outcomes, as well as for nursing practice, education and research.

The concept of home care nursing workload has not been widely studied and no evidence was found that an analysis of the concept had been undertaken. Consequently, there was a knowledge gap regarding the definition and attributes for the concept of home care nursing workload as it is currently experienced. To address that gap, a descriptive, three-phase, mixed methods (quantitative and qualitative) study was conducted. In Phase One, Rodgers’ (2000) evolutionary method was used to analyze the concept of home care nursing workload based on the empirical literature. Phase Two was situated within the naturalistic inquiry paradigm and involved observation of ten home care registered nurses during their visits to 61 patients. In Phase three a questionnaire was administered to validate the draft definition and attributes for the concept of home care nursing workload. It was completed by 88 home care nursing experts from clinical practice, education, management and research. Qualitative findings were analyzed using inductive content analysis. Quantitative data were analyzed descriptively using SPSS. Data triangulation was used extensively within and between the study phases. Of 14 attributes in the phase three draft concept definition, respondents assigned the highest level of relevance to the attribute of cognitive effort and the lowest to physical effort. The final definition contained 20 attributes and includes the following excerpt: “Home care nursing workload is the totality of the cognitive, emotional and physical effort home care nurses expend to meet the expectations of all stakeholders in providing holistic, outcome directed and patient/family focused care within the context of a short or long-term therapeutic relationship.” Respondents reported high levels of agreement with the accuracy and completeness of the definition and the majority indicated the definition would be useful or very useful in their day-to-day work. The comprehensive concept exemplar that emerged from the study includes each of the identified attributes. The study findings provided evidence of the complexity and challenge inherent in quantitatively measuring home care nursing workload. Accordingly, implications of the findings are shared for the management and monitoring of workload and associated outcomes, as well as for nursing practice, education and research.

In a research series carried out between 1984 and 1988 in the county of Västerbotten in northern Sweden, various aspects of the professional role and work of physiotherapists were studied. A variety of research methods were used: questionnaires (n = 163), a time budget study (n = 149), and a qualitative interview (n = 24). Physiotherapy was considered varied and creative, but not well defined or very specific in its objectives. Physiotherapy is still a predominantly female profession, though the proportion of male physiotherapists was increasing. The proportion entering full-time employment in physiotherapy increased due both to the greater number of male graduates and the increasing number of women working full-time. A partial internal division of work between the sexes has arisen. More women than men are employed in in-patient care, while proportionately more men worked outside institutions. Most respondents were firmly in control of their treatment methods, but were somewhat restricted in their freedom to decide whom to treat, and when to terminate treatment. Few had carried out any research concerning treatment and results. The time budget study showed that the treatment of patients took up on average 33% of the physiotherapists’ gross working hours and was the largest single task. Continuing education accounted for 5%, development work for 1% and the remaining occupational tasks for 38%. Occupational area was the most important factor in explaining the distribution of working hours, when other factors were kept constant. Neither sex nor gender markedly affects the carrying out of tasks other than treatment. Nor does professional post particularly affect time utilization other than for administrative tasks. This profession has a double objective: care and service more generally and to provide physiotherapy in particular—both equally important. In order to improve the quality of physiotherapy, and at the same time to extend their own specific, theoretical body of knowledge, a number of physiotherapists have reappraised and extended their concept of the profession to include management and research in their everyday work. Conclusion: The fact that occupational area exercises such a profound influence on the work of physiotherapists, taken together with the slight influence that professional post has, reveals that the individual physiotherapist must be prepared to play a broadly defined professional role. There seems to be a wealth of skill and expertise available within the profession, which could, however, be more efficiently used if the management and organization of physiotherapy service were better adapted to serve its objectives, and if these were better delineated and communicated. / digitalisering@umu.se