The dilemma for service managers: which degree programme for their staff?

Background: Moral distress has been described as a major problem for the nursing profession, and in recent years, a considerable amount of research has been undertaken to examine its causes and effects. However, few research projects have been performed that examined the moral distress of an entire nation’s nurses, as this particular study does. Aim/objective: The purpose of this study was to determine the frequency and intensity of moral distress experienced by registered nurses in New Zealand. Research design: The research involved the use of a mainly quantitative approach supported by a slightly modified version of a survey based on the Moral Distress Scale–Revised. Participants and research context: In total, 1500 questionnaires were sent out at random to nurses working in general areas around New Zealand and 412 were returned, giving an adequate response rate of 27%. Ethical considerations: The project was evaluated and judged to be low risk and recorded as such on 22 February 2011 via the auspices of the Massey University Human Ethics Committee. Findings: Results indicate that the most frequent situations to cause nursing distress were (a) having to provide less than optimal care due to management decisions, (b) seeing patient care suffer due to lack of provider continuity and (c) working with others who are less than competent. The most distressing experiences resulted from (a) working with others who are unsafe or incompetent, (b) witnessing diminished care due to poor communication and (c) watching patients suffer due to a lack of provider continuity. Of the respondents, 48% reported having considered leaving their position due to the moral distress. Conclusion: The results imply that moral distress in nursing remains a highly significant and pertinent issue that requires greater consideration by health service managers, policymakers and nurse educators.

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SIGNIFICANCE OF ART AND SCIENCE OF URBAN DESIGN IN THE STUDY PROGRAMME OF ARCHITECTURE / URBANISTIKOS MENO IR MOKSLO REIKŠMĖ ARCHITEKTŪROS STUDIJŲ PROGRAMOJE

Journal of Architecture and Urbanism ◽

10.3846/20297955.2013.866822 ◽

2013 ◽

Vol 37 (4) ◽

pp. 268-278 ◽

Cited By ~ 2

Author(s):

Dalia Dijokienė

Keyword(s):

European Union ◽

Urban Design ◽

Professional Training ◽

The European Union ◽

Art And Science ◽

Degree Programme ◽

Study Programme ◽

Technical University ◽

Common Understanding ◽

Scientific Classification

Urban design is a component of art and science of architecture and an indispensable field of architectural activity. Subsequent to restoration of independence, Lithuania started travelling down the path of democratic urban design of towns and districts, which resulted in an inevitable evolution of concepts as well as mindset. Two decades of independence have passed, yet one could hardly say that everything is clearly and uniformly perceived by all players involved in activities of urban design. There is still a clear lack of common understanding of the object of art and science of urban design. As a branch of science, urban design is still somewhat misplaced in the scientific classification. This article discusses definitions of urban design used in Lithuania and abroad, gives summarised information on the formal position of urban design in documents regulating professional training, and assesses (within the context of the European Union requirements for professional qualifications) the courses on urban design basics taught under the BA degree programme of architecture at the Faculty of Architecture, Vilnius Gediminas Technical University. Santrauka Urbanistika yra sudėtinė architektūros meno ir mokslo dalis bei neatsiejama architektūrinės veiklos sritis. Lietuvai atgavus nepriklausomybę ir einant demokratinio miestų bei rajonų planavimo ir urbanistinio projektavimo keliu, neišvengiamai buvo susidurta su vartojamų sąvokų ir net mąstysenos kaita. Nors prabėgo jau antrasis nepriklausomybės dešimtmetis, tačiau negalime teigti, kad viskas tapo aišku ir vienodai suprantama urbanistikos veiklos srityje. Lietuvoje vis dar yra gilus nesusikalbėjimas dėl urbanistikos meno ir mokslo objekto. Urbanistika kaip mokslo šaka vis dar neturi vietos mokslo klasifikatoriuje. Šiame straipsnyje yra aptariamos Lietuvoje ir užsienyje vartojamos urbanistikos definicijos, apibendrinama formalioji urbanistikos padėtis studijas reglamentuojančiuose dokumentuose, Europos Sąjungos reikalavimų profesinėms kvalifikacijoms kontekste įvertinami dėstomi urbanistinio projektavimo pagrindai VGTU AF architektūros bakalauro studijose.

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Action research: a way of researching or a way of managing?

Journal of Health Services Research & Policy ◽

10.1258/135581903321466076 ◽

2003 ◽

Vol 8 (2) ◽

pp. 100-104 ◽

Cited By ~ 18

Author(s):

Richard Lilford ◽

Rachel Warren ◽

David Braunholtz

Keyword(s):

Action Research ◽

Change Process ◽

Research Finding ◽

Organisational Change ◽

Total Quality ◽

Discrete Form ◽

Effect Change ◽

Managerial Action ◽

Service Managers ◽

Change Monitoring

Scrutinising recent systematic reviews both on action research and on the management of change in organisations, we have made two observations which, we believe, clarify a rather amorphous literature. First, by comparing formal descriptions of each, action research cannot be clearly distinguished from many other change methodologies. This applies particularly to total quality management (TQM). Both action research and TQM are cyclical activities involving examination of existing processes, change, monitoring the apparent effects of the change and further change. Both emphasise active participation of stakeholders. The examples used to illustrate action research would serve equally well as examples of TQM and vice versa. Second, the methods used in action research are neither specific to action research nor are they of any particular kind. It therefore follows that action research, in so far as it purports to describe a unique or discrete form of research rather than a change process, is a misnomer. Based on these observations, we make two suggestions. Organisational change should be described in terms of the steps actually taken to effect change rather than in 'terms of art' which, like the various brands of post-Freudian psychotherapy, obscure what they have in common rather than illuminate substantive differences. And the research embedded in any cyclical managerial process can have two broad (non-exclusive) aims: to help local service managers to take the next step or to assist managers in other places and in future years to make decisions. These can be described as limited (formative) and general (summative) aims. Whether, or to what extent, a research finding is generalisable across place and time is a matter of judgement and turns on the form of the research and on its context; it is completely independent of whether or not the research was carried out within a cycle of managerial action currently described by terms such as action research or TQM.

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Shaping (reflexive) professional identities across an undergraduate degree programme: a longitudinal case study

Teaching in Higher Education ◽

10.1080/13562517.2015.1122586 ◽

2015 ◽

Vol 21 (2) ◽

pp. 151-165 ◽

Cited By ~ 9

Author(s):

Mary Ryan ◽

Mary-Ann Carmichael

Keyword(s):

Professional Identities ◽

Longitudinal Case Study ◽

Degree Programme

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Drug costs and treatment choices: a DTB symposium

Drug and Therapeutics Bulletin ◽

10.1136/dtb.31.11.41 ◽

1993 ◽

Vol 31 (11) ◽

pp. 41-44

Keyword(s):

Cost Benefit Analysis ◽

Health Benefit ◽

Cost Benefit ◽

Drug Costs ◽

Benefit Analysis ◽

Treatment Choices ◽

The Subject ◽

The Cost ◽

The Relationship ◽

Service Managers

The relationship between drug costs and treatment choices was the subject of the first annual Drug and Therapeutics Bulletin symposium held in March 1993.* In a time of severe financial constraints for the NHS it is important that the money available is well spent. In the case of treatment that means the benefits must be worth the cost. There is, however, no agreed way of deciding when a particular health benefit to an individual is worth the cost to the NHS. Drug prices are easier to measure and more consistent than the prices of other treatments, and may be more amenable to cost-benefit analysis. Treatment choices are made primarily by doctors but with critical input from patients, pharmacists, nurses and health service managers. In this article we give an overview of the symposium at which speakers described ways in which drug costs and treatment choices were tackled in general practice (Ann McPherson, John Howie), in hospital (Dorothy Anderson), in clinical research and audit (Iain Chalmers, Alison Frater), by consumers (Anna Bradley), by health economists (Mike Drummond) and by government (Joe Collier). We also take into account points raised in discussion by the participants.

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Dissatisfaction toward O2O websites: expectation disconfirmation and justice perspective

Asia Pacific Journal of Marketing and Logistics ◽

10.1108/apjml-05-2020-0374 ◽

2021 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Tong Che ◽

Meng Ji ◽

Xiabing Zheng ◽

Bo Feng

Keyword(s):

Design Methodology ◽

Research Model ◽

Justice Theory ◽

Content Type ◽

Customer Complaints ◽

Justice Perception ◽

Consumer Dissatisfaction ◽

Expectation Disconfirmation ◽

Survey Responses ◽

Service Managers

PurposeThe online-to-offline (O2O) business is developing rapidly and is highly popular in many countries. Nevertheless, O2O suffers from a large number of customer complaints that result in consumer loss. Focusing on the O2O context, this study integrates expectation disconfirmation theory (EDT) and justice theory to investigate consumers' dissatisfaction toward O2O websites.Design/methodology/approachA research model was proposed and tested using 329 survey responses.FindingsResults show that the identified website disconfirmation and offline service disconfirmation could lead to consumer dissatisfaction. Importantly, the impacts of disconfirmation factors are contingent upon the justice perception of consumers. When a transaction is perceived as unfair, website disconfirmation arouses a higher level of dissatisfaction, and the negative emotions could transfer from O2O and damage the website's reputation.Originality/valueThis study explores the continuance intentions of customers toward O2O websites from a dissatisfaction perspective, with insights for future service studies and O2O service managers.

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A proposal for using the ratio of attempted to completed suicides across several countries worldwide

Epidemiology and Psychiatric Sciences ◽

10.1017/s2045796018000628 ◽

2018 ◽

Vol 28 (5) ◽

pp. 473-477 ◽

Cited By ~ 2

Author(s):

H. Blasco-Fontecilla ◽

P. Artieda-Urrutia ◽

J. de Leon

Keyword(s):

Regional Differences ◽

Health Resources ◽

Developed Countries ◽

Asia Pacific ◽

Lifetime Prevalence ◽

Limited Data ◽

Population Surveys ◽

Completed Suicide ◽

Annual Prevalence ◽

Service Managers

AbstractCompleted suicide (CS) is a leading cause of death worldwide and its rates are available for most developed countries. On the other hand, attempted suicide (AS) is a risk factor for CS but there are limited data on its rates in various countries. In constructing a ratio for AS/CS rates, most would agree that for CS, the denominator should be the annual suicide rate (per 100 000). As for the ratio's numerator (AS) per 100 000, there are three possible calculations: (1) annual prevalence from population surveys, (2) annual prevalence from national clinical registers or (3) lifetime prevalence from population surveys. We think that the first possibility would probably be the best choice but, unfortunately, surveys providing the annual prevalence of AS are lacking for most countries. Annual prevalence from national registers is also lacking for most countries and is contaminated by under-reporting. Therefore, in this editorial, we are left with only the last option, a ratio for lifetime prevalence of AS (per 100 000) divided by annual rate of CS (per 100 000). This ratio for AS/CS rates appears to differ substantially across countries worldwide but presents no big regional differences other than two remarkable exceptions, one per continent. In Europe, Spain and France had greater ratios (174.4 and 152.5, respectively) than Italy (64.1). In Asia/Pacific, New Zealand has a higher ratio (345.9) compared with China (75.8) and Japan (76.9). The ratio for AS/CS rates could be a good index for implementing evidence-informed decision-making regarding suicidal behaviour (SB) among health service managers, and for helping them in the allocation of health resources for the prevention of SB.

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