Search results for: nurse profession
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 664

Search results for: nurse profession

214 Prostitution in Colonial Bengal: Autobiographical Articulations and Fictional Representations

Authors: Aparna Bandyopadhyay

Abstract:

The proposed paper will examine how prostitution produced a vast corpus of literature in colonial Bengal. This corpus included autobiographical accounts by prostitutes themselves. While the authenticity of some of these has, at times, been doubted by contemporary observers, the sheer magnitude of such narrative prose demands critical attention. Many of these autobiographical narratives focused on the prostitute’s early life within respectable society and then proceeded to delineate the transgressions and the inescapable chain of circumstances that eventually rendered her a prostitute. Significantly, these serve to corroborate the findings of official investigations regarding the circumstances that led upper-caste Hindu women in Bengal to embrace prostitution in this period. The literary corpus that dwelt on prostitution also included a vast volume of fiction penned by celebrated writers. These foregrounded a prostitute as the central protagonist, telling the life-stories of prostitutes and the circumstances that made them what they were. Novels and short stories often represented the prostitute as an affective being – an individual capable of deep emotions despite her profession. She was seldom a person who had voluntarily embraced prostitution. She was always a figure of helplessness and suffering, a woman whose desire to love and be loved transcended the carnality of her livelihood. She was an outcast, but she experienced the entire repertoire of emotions experienced by her respectable counterparts. The proposed paper will examine the trends and characteristics of the available repertoire of prostitute-oriented literature in late colonial Bengal. It will begin by focusing on the existing perspectives on the origins of prostitution in late colonial Bengal. It will proceed to discuss the literary corpus supposedly penned by prostitutes themselves and then focus on the manner in which some of the stalwarts of high literature represented the prostitute in their literary creations.

Keywords: emotions, literature, prostitution, transgression

Procedia PDF Downloads 90
213 Implementing Teacher Students’ Coaching in Practical Periods of University Teacher Education: The Significance of Training Cultures

Authors: Rahm Sibylle

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The core element in most European teacher training concepts consists in practical periods where teacher students may review the chosen profession before going on to their theoretical studies. In Germany, teacher students learn in practical studies about everyday teaching and learning in schools. Teacher students appreciate opportunities to explore school practice and to feel responsible for students’ learning. In practical studies, teacher students often idealize their teacher mentors (and consequently tend to imitate their teaching style) or contrarily feel disappointed about school practice. Concepts of empowerment through practical experience in school-based academic teacher training have to be developed. Our Swiss-German research project COPRA (Coaching in practical periods; funded by the Swiss National Science Foundation (SNF) and the German Research Foundation (DFG), aims at gaining resilient results about the effectiveness of (peer) coaching in practical school periods. To explore innovative ways of accompanying novice teachers in practical periods we consider different cultures of teacher training institutions. School cultures, including teachers’ beliefs and teaching traditions involve different training cultures as starting positions for our intervention study. In our qualitative study, we describe typologies of teacher training institutions by analyzing group discussions with teacher students, mentor teachers and university lecturers concerning participation, cooperation, and relationships. In our paper, we present the design of our intervention study, our coaching concept as well as typologies of teacher training cultures. We discuss opportunities for teacher students to learn through domain-specific (peer) coaching on the background of these typologies.

Keywords: teacher training (practical periods), teacher students' coaching, training cultures (typologies), COPRA (coaching in practical periods)

Procedia PDF Downloads 217
212 The Transition from National Policy to Institutional Practice of Vietnamese English Language Teacher Education

Authors: Thi Phuong Lan Nguyen

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The English Language Teacher Education (ELTE) in Vietnam is rapidly changing to address the new requirements of the globalization and socialization era. Although there has been a range of investments and innovation in policy and curriculum, tertiary educators and learners do not engage in the enactment. It is vital to understand the practices at the tertiary education level. The study is to understand the higher education curriculum development policy, both in theory and in practice across four representatives of ELTE institutions in the North of Vietnam. The lecturers’ perceptions about the extent to which the enacted curriculum is aligned with national standards will be explored. Nineteen policy documents, seventy surveys, and twelve interviews with lecturers and instructional leaders across these four Vietnamese Northern ELTE institutions have been analyzed to investigate how the policy shape the practice. The two most significant findings are (i) a low level of alignment between curriculum and soft-skills standards of the graduates required by the Vietnamese Ministry of Education and Training (MOET) and (ii) incoherence between current national policy and these institutions’ implementation. In order to address these gaps, it is strongly recommended that curriculum needs to be further developed, focusing more on the institutional outcomes, MOET’s standards, and the social demands in times of globalization. More importantly, professional development in ELTE is vital for a range of curriculum and educational policy stakeholders. The study helps to develop the English teaching profession in Vietnam in a systematic way, from policymakers to implementers, and from instructors to learners. Its significance lies in its relevance to English teaching careers, particularly within the researcher’s specific context, yet also remains relevant to ELTE in other parts of Vietnam and in other EFL (English as a Foreign Language) countries.

Keywords: curriculum, English language teaching education, policy implementation, standard, teaching practice

Procedia PDF Downloads 212
211 Effects of an Educative Model in Socially Responsible Behavior and Other Psychological Variables

Authors: Gracia V. Navarro, Maria V. Gonzalez, Carlos G. Reed

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The eudaimonic perspective in philosophy and psychology suggests that a good life is closely related to developing oneself in order to contribute to the well-being and happiness of other people and of the world as a whole. Educational psychology can help to achieve this through the design and validation of educative models. Since 2004, the University of Concepcion and other Chilean universities apply an educative model to train socially responsible professionals, people that in the exercise of their profession contribute to generate equity for the development and assess the impacts of their decisions, opting for those that serve the common good. The main aim is to identify if a relationship exists between achieved learning, attitudes toward social responsibility, self-attribution of socially responsible behavior, value type, professional behavior observed and, participation in a specific model to train socially responsible (SR) professionals. The Achieved Learning and Attitudes Toward Social Responsibility Questionnaire, interview with employers and Values Questionnaire and Self-attribution of SR Behavior Questionnaire is applied to 394 students and graduates, divided into experimental and control groups (trained and not trained under the educative model), in order to identify the professional behavior of the graduates. The results show that students and graduates perceive cognitive, affective and behavioral learning, with significant differences in attitudes toward social responsibility and self-attribution of SR behavior, between experimental and control. There are also differences in employers' perceptions about the professional practice of those who were trained under the model and those who were not. It is concluded that the educative model has an impact on the learning of social responsibility and educates for a full life. It is also concluded that it is necessary to identify mediating variables of the model effect.

Keywords: educative model, good life, professional social responsibility, values

Procedia PDF Downloads 240
210 Low Pertussis Vaccine Coverage Rates among Polish Nurses

Authors: Aneta Nitsch-Osuch, Sylwia Dyk, Izabela Gołebiak

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Background. Since 2014 the pertussis vaccine is recommended to Polish health care workers who have close contacts with infants. Although this recommendation is implemented into the National Immunization Programme, its realization has remained unknown. The Purpose: The aim of the study, conducted at the department of Social Medicine and Public Health (Medical University of Warsaw, Poland), was to describe a perception, knowledge and coverage rates regarding pertussis vaccination among nursing staff. According to the authors' knowledge, it was the first study related to this topic in our country. Material and Methods: A total number of 543 nurses who work at pediatric or neonatal wards was included into the study (501 women and 42 men), average age was 47 years. All nurses were asked to fulfill the anonymous survey, previously validated. Results: 1. Coverage rates: The analysis of results revealed that only 4% of responders reported they were vaccinated with Tdpa within past 10 years, while 8% declared they would plan the vaccine in the future. 35% of responders would consider the Tdpa vaccine whether there is some kind of the reimbursement. 2. Perception and knowledge of the disease and vaccination: The majority (82%) of nurses did not recognize pertussis as a re-emerging infectious disease. 54% of them believed that obligatory vaccinations in the childhood protect against the disease and the protection is a life-long one. Only 15% of nurses considered pertussis as a possible nosocomial infection. The current epidemiology of the disease was known to 6% of responders, while 24% of them were familiar with pertussis vaccination schedules for infants, children and adolescents, but only 9% of responders knew that adults older than 19 years are recommended to be vaccinated with Tdpa every 10 years. Many nurses (82%) would expect more educational activities related to pertussis and methods of its prophylaxis. Conclusions: The pertussis vaccine coverage rate among Polish nurses is extremely low. This is a result of not enough knowledge about the disease and its prevention. Educational activities addressed to health care workers and reimbursement of the pertussis vaccine are required to improve awareness and increase of vaccine coverage rates in the future.

Keywords: coverage, nurse, pertussis, vaccine

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209 Effect of Summer Training Volunteering Practices in Healthcare on Self-Confidence of Nursing Students in Riyadh

Authors: Alyaa Farouk Abdelfattah Ibrahim, Samah Mohamed, Huda Jrady, Mashail Alrashidi, Alaa Mohammad, Fatimah Alotaibi, Maram Almutiri

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Participation in volunteering was associated with better mental and physical health, self-esteem, and life satisfaction. The main motivator for students in particular is the chance to gain work-related experiences, improve skills, and build on qualifications that may help them achieve their educational goals and further their careers. This study aimed to assess the effect of summer training volunteering practices in healthcare on self-confidence of nursing students in Riyadh. In a crossectional study design, 150 nursing students at King Saud bin Abdul-Aziz University for health sciences in Riyadh were included in the study. Bio-socio-demographic, self-confidence, patients’ care and skills questionnaires were used for data collection. Results: Participants’ age ranged between 20 and 26 years. The majority were from the educational level seven (80%). 40.7 % of them reported volunteering in summer training programs; 70.37% of them volunteered at least once and for a duration of at least one month. Nursing students from level 6 were less likely to have self-confidence in their patients’ care skills than those in level 7. Students who volunteered were more likely to be more interested in becoming social, professional, and independent healthcare workers. There was no difference regarding experience in clinical skills and education by volunteering status. Clinical skills improved by a level of education in this group. Conclusion: Professional self-confidence and clinical performance are related in this group of nursing students. Monitoring, arranging, and encouraging volunteering activities for nursing students are important to help them broaden their interests, their self-confidence in their capabilities, and advancement in their chosen profession. Mostly, volunteering enhanced knowledge in patient safety and quality of care and attempts to secure volunteering opportunities should be a priority on the nursing education agenda.

Keywords: volunteering, health care volunteering, nursing students, summer training

Procedia PDF Downloads 177
208 The Influences of Nurses’ Satisfaction on the Patient Satisfaction with and Loyalty to Korean University Hospitals

Authors: Sung Hee Ahn, Ju Rang Han

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Background: With increasing importance in healthcare organization on patient satisfaction and nurses’ job satisfaction, many studies have been conducted. But no research has been administered how nurses’ satisfaction with healthcare organization influence patient satisfaction and loyalty. Purpose: This study aims to conceptualize nurses‘ satisfaction, patient satisfaction with and patient loyalty to hospitals using a hypothetical linear structural equation model, and to identify the significance of path coefficients and goodness of fit index of the structural equation model as well. Method: A total of 2,079 nurses and 6,776 patients recruited from 5 university hospitals in South Korea participated in this study. The data on nurses, including ward nurses and outpatient nurses, were collected from June 24th to July 12th, at the 204 departments of the 5 hospitals through an on-line survey. The data on the patients, including both inpatients and outpatients, were collected from September 30th to October 24th, 2013 at the 5 hospitals using a structured questionnaire. The variable of nurses’ satisfaction was measured using a scale evaluating internal client satisfaction, which is used in SSM Health Care System in the US. Patient satisfaction with the hospital and nurses and patient loyalty were measured by assessing the patient’s intention to revisit and to recommending the hospital to others using a visual analogue scale. The data were analyzed using SPSS version 21.0 and AMOS version 21.0. Result: The hypothetical model was fairly good in terms of goodness of fit (χ2= 64.897 (df=24, p <. 001), GFI=. 906, AGFI=.823, CFI=.921, NFI=.951, NNFI=.952. RMSEA=.114). The significance of path coefficients includes followings 1)The nurses’ satisfaction has significant influence on the patient satisfaction with nurses. 2)The patient satisfaction with nurses has significant influence on the patient satisfaction with the hospital. 3)The patient satisfaction with the hospital has significant influence on the patients’ revisit intention. 4)The patient satisfaction with the hospital has significant influence on the patients’ intention to the recommendations of the hospital. Conclusion: These results provide several practical implications to hospital administrators, who should incorporate ways of improving nurses' and patients' satisfaction with the hospital into their health care marketing strategies.

Keywords: linear structural equation model, loyalty, nurse, patient satisfaction

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207 Analysis of Relationship between Social Media Conversation and Mainstream Coverage to Mobilize Social Movement

Authors: Sakulsri Srisaracam

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Social media has become an important source of information for the public and the media profession. Some social issues raised on social media are picked up by journalists to report on other platforms. This relationship between social media and mainstream media can sometimes drive public debate or stimulate social movements. The question to examine is in what situations can social media conversations raise awareness and stimulate change on public issues. This study addresses the communication patterns of social media conversations driving covert issues into mainstream media and leading to social advocacy movements. In methodological terms, the study findings are based on a content analysis of Facebook, Twitter, news websites and television media reports on three different case studies – saving Bryde’s whale, protests against a government proposal to downsize the Office of Knowledge Management and Development in Thailand, and a dengue fever campaign. These case studies were chosen because they represent issues that most members of the public do not pay much attention to but social media conversations stimulated public debate and calls to action. This study found: 1) Collective social media conversations can stimulate public debate and encourage change at three levels – awareness, public debate, and action of policy and social change. The level depends on the communication patterns of online users and media coverage. 2) Patterns of communication have to be designed to combine social media conversations, online opinion leaders, mainstream media coverage and call to both online and offline action to motivate social change. Thus, this result suggests that social media is a powerful platform for collective communication and setting the agenda on public issues for mainstream media. However, for social change to succeed, social media should be used to mobilize online movements to move offline too.

Keywords: public issues, mainstream media, social media, social movement

Procedia PDF Downloads 258
206 Empathy in the Work of Physiotherapists in Slovakia

Authors: Vladimir Littva, Peter Kutis

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Based on common practice, we know that an empathic approach to a patient is one of the characteristics of a physiotherapist. Although empathy is regarded as an essential condition of the psychotherapeutic relationship, it has taken quite a while for attention to be paid to it in clinical practice. Patients who are experiencing a sense of understanding from health care providers are more willing to cooperate, and treatment within the optimistic attunes a more comfortable framework of care. Age, experience, family, education and the working environment may have an impact on the degree of empathy for paramedics. Within the KEGA project no. 003KU-4-2021, we decided to investigate the level of empathy in the work of physiotherapists in Slovakia. Research sample and Methods: The sample comprised 194 respondents – physiotherapists working on the territory of Slovakia. 112 were men and 82 women. The age of respondents was between 21 and 64 years of age. 133 were married, 51 were single and ten were divorced. 98 were living in the countryside and 96 in towns. Twenty-two grew up without siblings, 95 with one sibling and 77 with two and more siblings. In the survey, we used the Empathy Assessment Questionnaire (EAQ) with 18 questions with four possible answers: strongly disagree, disagree, agree; and strongly agree, which we validated linguistically and psychometrically. All data were statistically processed by SPSS 25. Results: We evaluated the intrinsic reliability of the questionnaire EAQ using Cronbach's Alpha and the coefficient is 0.756 in the whole set. This means that the questionnaire is a quite strong and reliable measurement tool. The mean for individual questions ranged from 2.39 to 3.74 (maximum was 4). In Pearson's correlations, we confirmed the significant differences between the groups regarding sex in 8 questions out of 18, regarding age in 5 questions, regarding family status in 4 questions and regarding siblings in 4 questions out of 18 at the level 5% (p <0.05). Conclusion: The results obtained during the research show the importance of adequate communication with the patient due to his health and well-being. Empathy in the physiotherapists’ profession is very important. It would be worthwhile if the students of physiotherapy would receive a course during their study that would deal exclusively with empathy, empathic approach, burnout, or psycho-emotional hygiene.

Keywords: empathy, approach, clinical practice, physiotherapists

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205 Accountant Strategists Challenge the Dominant Business Model: A Strategy-as-Practice Perspective

Authors: Lindie Grebe

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This paper reports on a study that explored the strategizing practices of professional accountants in the mining industry, based on Jarratt and Stiles’ dominant strategizing practice models framework. Drawing on a strategy-as-practice perspective, the paper recognises qualified professional accountants in strategic management such as Chief Executive Officers, as strategy practitioners that perform their strategizing practices and praxis within a specific context. The main findings of this paper were produced through semi-structured individual interviews with accountants that perform strategy on a business level in the South African mining industry. Qualitative data were analysed through conversation analysis over two coding-cycles. Findings describe accountant strategists as practitioners who challenge the dominant business model when a disconnect seems to exist between international corporate level strategy and business level strategy in the South African mining industry. Accountant strategy practitioners described their dominant strategizing practice model as incremental change during strategic planning and as a lived experience during strategy implementation. Findings portrayed these strategists as taking initiative as strategy leaders in a dynamic and volatile environment to combine their accounting background with strategic management and challenge the dominant business model. Understanding how accountant strategists perform strategizing offers insight into the social practice of strategic management. This understanding contributes to the body of knowledge on strategizing in the South African mining industry. In addition, knowledge on the transformation of accountants as strategists could provide valuable practice relevant insights for accounting educators and the accounting profession alike.

Keywords: accountant strategists, dominant strategizing practice models framework, mining industry, strategy-as-practice

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204 Another Justice: Litigation Masters in Chinese Legal Story

Authors: Lung-Lung Hu

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Ronald Dworkin offered a legal theory of ‘chain enterprise’ that all the judges in legal history altogether create a ‘law’ aiming a specific purpose. Those judges are like co-writers of a chain-story who not only create freely but also are constrained by the story made by the judges before them. The law created by Chinese traditional judges is another case, they, compared with the judges mentioned by Ronald Dworkin, have relatively narrower space of making a legal sentence according to their own discretions because the statutes in Chinese traditional law at the very beginning have been designed as panel code that leaves small room to judge’s discretion. Furthermore, because law is a representative of the authority of the government, i.e. the emperor, any misjudges and misuses deviated from the law will be considered as a challenge to the supreme power. However, different from judges as the defenders of law, Chinese litigation masters who want to win legal cases have to be offenders challenging the verdict that does not favor his or his client’s interest. Besides, litigation master as an illegal or non-authorized profession does not belong to any legal system, therefore, they are relatively freer to ‘create’ the law. According to Stanley Fish’s articles that question Ronald Dworkin and Owen Fiss’ ideas about law, he construes that, since law is made of language, law is open to interpretations that cannot be constrained by any rules or any particular legal purposes. Stanley Fish’s idea can also be applied on the analysis about the stories of Chinese litigation masters in traditional Chinese literature. These Chinese litigation masters’ legal opinions in the so-called chain enterprise are like an unexpected episode that tries to revise the fixed story told by law. Although they are not welcome to the officials and also to the society, their existence is still a phenomenon representing another version of justice different from the official’s and can be seen as a de-structural power to the government. Hence, in this present paper the language and strategy applied by Chinese litigation masters in Chinese legal stories will be analysed to see how they refute made legal judgments and challenge the official standard of justice.

Keywords: Chinese legal stories, interdisciplinary, litigation master, post-structuralism

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203 A Deluge of Disaster, Destruction, Death and Deception: Negative News and Empathy Fatigue in the Digital Age

Authors: B. N. Emenyeonu

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Initially identified as sensationalism in the eras of yellow journalism and tabloidization, the inclusion of news which shocks or provokes strong emotional responses among readers, viewers, and browsers has not only remained a persistent feature of journalism but has also seemingly escalated in the current climate of digital and social media. Whether in the relentless revelation of scandals in high places, profiles on people displaced by sporadic wars or natural disasters, gruesome accounts of trucks plowing into pedestrians in a city centre, or the coverage of mourners paying tributes to victims of a mass shooting, mainstream, and digital media are often awash with tragedy, tears, and trauma. While it may aim at inspiring sympathy, outrage, or even remedial reactions, it would appear that the deluge of grief and misery in the news merely generates in the audience a feeling that borders on hearing or seeing too much to care or act. This feeling also appears to be accentuated by the dizzying diffusion of social media news and views, most of whose authenticity is not easily verifiable. Through a survey of 400 regular consumers of news and an in-depth interview of 10 news managers in selected media organizations across the Middle East, this study therefore investigates public attitude to the profusion of bad news in mainstream and digital media. Among other targets, it examines whether the profusion of bad news generates empathy fatigue among the audience and, if so, whether there is any association between biographic variables (profession, age, and gender) and an inclination to empathy fatigue. It also seeks to identify which categories of bad news and media are most likely to drag the audience into indifference. In conclusion, the study discusses the implications of the findings for mass-mediated advocacies such as campaigns against conflicts, corruption, nuclear threats, terrorism, gun violence, sexual crimes, and human trafficking, among other threats to humanity.

Keywords: digital media, empathy fatigue, media campaigns, news selection

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202 Glycemic Control on Self-Efficacy and Self-Care Behaviors among Omani Adults with Type 2 Diabetes

Authors: Melba Sheila D'Souza, Anandhi Amirtharaj, Shreedevi Balachandran

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Background: Type 2 diabetes has a significant impact on individuals’ health and well-being. Glycemic control may influence self-efficacy and self-care behaviors, and reduce the risk of complications among adults with type 2 diabetes. Type 2 diabetes has substantial morbidity and mortality and 60% of adults’ poor self-care. Glycemic control is associated with reported self-efficacy and self-care behavior. Adults with type 2 diabetes with less information were less likely to take diabetes self-care. Aim: To examine the relationship between glycemic control, demographic factors, clinical factors on self-efficacy, self-care behaviors among Omani adults with type 2 diabetes. Methods: A correlational, descriptive study was used. Omani adults with type 2 diabetes (n=140) were recruited from a public hospital in Oman. The data were collected during January-March 2015. Ethical approval was given by the college research and ethics committee, College of Nursing, and the Hospital, Sultan Qaboos University Data was collected on self-efficacy, self-care behaviors and glycemic control. The study was approved by the Institution Ethics and Research Committee. Bivariate and multivariate analyses were conducted. Results: Most adults had a fasting blood glucose >7.2mmol/L (90.7%), with the majority demonstrating ‘uncontrolled or poor HbA1c of > 8%’ (65%). Variance of self-care behavior (20.6%) and 31.3% of the variance of the self-efficacy was explained by the age, duration of diabetes, medication, HbA1c and prevention of activities of living. Adults with type 2 diabetes with poor glycemic control were more likely to have poor self-efficacy and poor self-care behaviors. Conclusion: This study confirms that self-efficacy model on outcome predicts self-efficacy and self-care behavior. Higher understanding of diabetes, prevention of normal daily activities, higher ability to fit diabetes life in a positive manner and high patient-physician communication were significant with self-efficacy and self-care behaviors. Hence, glycemic control has a high effect on improving self-care behaviors like diet, exercise, medication, foot care and self-efficacy among type 2 diabetes. Implications: Using these findings to improve self-efficacy, individualized self-care management is recommended for better self-efficacy and self-care behaviors among adults with type 2 diabetes.

Keywords: self-efficacy, self-care behaviors, self-care management, glycemic control, type 2 diabetes, nurse

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201 Inter-Communication-Management in Cases with Disabled Children (ICDC)

Authors: Dena A. Hussain

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The objective of this project is to design an Information and Communication Technologies (ICT) tool based on a standardized platform to assist the work-integrated learning process of caretakers of disabled children. The tool should assist the intercommunication between caretakers and improve the learning process through knowledge bridging between all involved caretakers. Some children are born with disabilities while others have special needs after an illness or accident. Special needs children often need help in their learning process and require tools and services in a different way. In some cases the child has multiple disabilities that affect several capabilities in different ways. These needs are to be transformed into different learning techniques that the staff or personal (called caretakers in this project) caring for the child needs to learn and adapt. The caretakers involved are also required to learn new learning or training techniques and utilities specialized for the child’s needs. In many cases the number of people caring for the child’s development is rather large; the parents, specialist pedagogues, teachers, therapists, psychologists, personal assistants, etc. Each group of specialists has different objectives and in some cases the merge between theses specifications is very unique. This makes the synchronization between different caretakers difficult, resulting often in low level cooperation. By better intercommunication between professions both the child’s development could be improved but also the caretakers’ methods and knowledge of each other’s work processes and their own profession. This introduces a unique work integrated learning environment for all personnel involve, merging learning and knowledge in the work environment and at the same time assist the children’s development process. Creating an iterative process generates a unique learning experience for all involved. Using a work integrated platform will help encourage and support the process of all the teams involved in the process.We believe that working with children who have special needs is a continues learning/working process that is always integrated to achieve one main goal, which is to make a better future for all children.

Keywords: information and communication technologies (ICT), work integrated learning (WIL), sustainable learning, special needs children

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200 The Politics and Consequences of Decentralized Vocational Education: The Modified System of Vocational Studies in Ghana

Authors: Nkrumak Micheal Atta Ofori

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The Vocational System is a decentralized Studies System implemented in Ghana as vocation studies strategy for grassroot that focuses on providing individuals with the specific skills, knowledge, and training necessary for a particular trade, craft, profession, or occupation. This article asks how devolution of vocational studies to local level authorities produces responsive and accountable representation and sustainable vocational learning under the vocational Studies System. It focuses on two case studies: Asokore Mampong and Atwima kwanwoma Municipal. Then, the paper asks how senior high school are developing new material and social practices around the vocational studies System to rebuild their livelihoods and socio-economic wellbeing. Here, the article focusses on Kumasi District, drawing lessons for the two other cases. The article shows how the creation of representative groups under the Vocational Studies System provides the democratic space necessary for effective representation of community aspirations. However, due to elite capture, the interests of privilege few people are promoted. The state vocational training fails to devolve relevant and discretionary resources to local teachers and do not follow the prescribed policy processes of the Vocational Studies System. Hence, local teachers are unable to promote responsive and accountable representation. Rural communities continue to show great interest in the Vocational Studies System, but the interest is bias towards gaining access to vocational training schools for advancing studies. There is no active engagement of the locals in vocational training, and hence, the Vocational Studies System exists only to promote individual interest of communities. This article shows how ‘failed’ interventions can gain popular support for rhetoric and individual gains.

Keywords: vocational studies system, devolution of vocational studies, local-level authorities, senior high schools and vocational learning, community aspirations and representation

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199 Listening to the Voices of Teachers Who Are Dyslexic: The Careers, Professional Development, and Strategies Used by of Teachers Who Are Dyslexic

Authors: Jane Mullen

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Little research has been undertaken on adult dyslexia and the impact it has on those who have professional careers. There are many complexities behind the career decisions people make, but for teachers who are dyslexic, it can be even more complex. Dyslexia particularly impacts on written and verbal communication, as well as planning and organisation skills which are essential skills for a teacher. As the teachers are aware of their areas of weakness many, make the conscious decision not to disclose their disability at work. In England, the reduction to three attempts to pass the compulsory English and Maths tests prior to undertaking teacher training may mean that dyslexics are now excluded from trying to enter the profession. Together with the fact that dyslexic teachers often chose to remain ‘hidden’ the situation appears to be counter to the inclusive rhetoric that dominates the current educational discourse. This paper is based on in-depth narrative research that has been undertaken with a small group of teachers who are dyslexic in England and firstly explores the strategies and resources that the teachers have found useful. The narratives of the teachers are full of difficulties as well as diversity, consequently, the paper secondly examines how life experiences have impacted on the way the teachers see their dyslexia and how it affects them professionally. Using a narrative methodology enables the teachers to tell their ‘stories’ of how they feel their dyslexia impacts on their lives professionally. The first interview centred around a limited number of semi structured questions about family background, educational experiences, career development, management roles and professional disclosure. The second interview focused on the complexities of being a teacher who is dyslexic and to ‘unlock’ some of their work based narratives visual elicitation was used. Photographs of work-based strategies, issues or concerns were sent to the researcher and these were used as the basis for discussion in the second interview. The paper concludes by discussing possible reasonable adjustments and professional development that might benefit teachers who are dyslexic.

Keywords: dyslexia, life history, narrative, professional, professional development, strategies, teachers

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198 Improving Graduate Student Writing Skills: Best Practices and Outcomes

Authors: Jamie Sundvall, Lisa Jennings

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A decline in writing skills and abilities of students entering graduate school has become a focus for university systems within the United States. This decline has become a national trend that requires reflection on the intervention strategies used to address the deficit and unintended consequences as outcomes in the profession. Social work faculty is challenged to increase written scholarship within the academic setting. However, when a large number of students in each course have writing deficits, there is a shift from focus on content, ability to demonstrate competency, and application of core social work concepts. This qualitative study focuses on the experiences of online faculty who support increasing scholarship through writing and are following best practices preparing students academically to see improvements in written presentation in classroom work. This study outlines best practices to improve written academic presentation, especially in an online setting. The research also highlights how a student’s ability to show competency and application of concepts may be overlooked in the online setting. This can lead to new social workers who are prepared academically, but may unable to effectively advocate and document thought presentation in their writing. The intended progression of writing across all levels of higher education moves from summary, to application, and into abstract problem solving. Initial findings indicate that it is important to reflect on practices used to address writing deficits in terms of academic writing, competency, and application. It is equally important to reflect on how these methods of intervention impact a student post-graduation. Specifically, for faculty, it is valuable to assess a social worker’s ability to engage in continuity of documentation and advocacy at micro, mezzo, macro, and international levels of practice.

Keywords: intervention, professional impact, scholarship, writing

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197 Concept Analysis of Professionalism in Teachers and Faculty Members

Authors: Taiebe Shokri, Shahram Yazdani, Leila Afshar, Soleiman Ahmadi

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Introduction: The importance of professionalism in higher education not only determines the appropriate and inappropriate behaviors and guides faculty members in the implementation of professional responsibilities, but also guarantees faculty members' adherence to professional principles and values, ensures the quality of teaching and facilitator will be the teaching-learning process in universities and will increase the commitment to meet the needs of students as well as the development of an ethical culture based on ethics. Therefore, considering the important role of medical education teachers to prepare teachers and students in the future, the need to determine the concept of professional teacher and teacher, and the characteristics of teacher professionalism, we have explained the concept of professionalism in teachers in this study. Methods: The concept analysis method used in this study was Walker and Avant method which has eight steps. Walker and Avant state the purpose of concept analysis as follows: The process of distinguishing between the defining features of a concept and its unrelated features. The process of concept analysis includes selecting a concept, determining the purpose of the analysis, identifying the uses of the concept, determining the defining features of the concept, identifying a model, identifying boundary and adversarial items, identifying the precedents and consequences of the concept, and defining empirical references. is. Results: Professionalism in its general sense, requires deep knowledge, insight, creating a healthy and safe environment, honesty and trust, impartiality, commitment to the profession and continuous improvement, punctuality, criticism, professional competence, responsibility, and Individual accountability, especially in social interactions, is an effort for continuous improvement, the acquisition of these characteristics is not easily possible and requires education, especially continuous learning. Professionalism is a set of values, behaviors, and relationships that underpin public trust in teachers.

Keywords: concept analysis, medical education, professionalism, faculty members

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196 Emerging Social Media Presence of International Organisations - Challenges and Opportunities

Authors: Laura Hervai

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One of the most significant phenomena of the 2000s was the emergence of social media sites and web 2.0 that revolutionized communication processes. Social networking platforms have fundamentally changed social and political participation of the public, which require organisations in the public and non-profit sector not only to adapt to these new trends but also to actively engage their audiences. Opportunity for interaction, freer expression of opinion and the proliferation of user generated content are major changes brought by web 2.0 technologies. Furthermore, due to the wide penetration of mobile technologies, social media sites are capable of connecting underdeveloped regions to the global flow of information. Taking advantage of these characteristics, organisations have the opportunity to engage much wider audiences, exploit new ways to raise awareness or reach out to regions that are difficult to access. The early adopters of these new communication tools soon recognized the need of developing social media guidelines for their organisations as well as the increased workload that they require. While ten years ago communication officers could handle their organisation’s social media presence, today it is a separate profession. International organisations face several challenges related to their social media presence. Early adopters have contributed to the development of best practices among which the ethics of social media usage still remained problematic. Another challenge for international organisations is to adapt to country-specific social media trends while they have to comply with the requirements of their parent organisation as well. However in the 21st century social media presence can be crucial to the successful operation of international organisations, their importance is still not taken seriously enough. The measurement of the effects and influence of social networking on the organisations’ productivity is an unsolved problem thus further research should focus on this matter. Research methods included primary research of major IGOs’ and NGOs’ social media presence and guidelines along with secondary research of social media statistics and scientific articles in the topic.

Keywords: international organisations, non-profit sector, NGO, social media, social network

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195 The Relationship between Functional Movement Screening Test and Prevalence of Musculoskeletal Disorders in Emergency Nurse and Emergency Medical Services Staff Shiraz, Iran, 2017

Authors: Akram Sadat Jafari Roodbandi, Alireza Choobineh, Nazanin Hosseini, Vafa Feyzi

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Introduction: Physical fitness and optimum functional movement are essential for efficiently performing job tasks without fatigue and injury. Functional Movement Screening (FMS) tests are used in screening of athletes and military forces. Nurses and emergency medical staff are obliged to perform many physical activities such as transporting patients, CPR operations, etc. due to the nature of their jobs. This study aimed to assess relationship between FMS test score and the prevalence of musculoskeletal disorders (MSDs) in emergency nurses and emergency medical services (EMS) staff. Methods: 134 male and female emergency nurses and EMS technicians participated in this cross-sectional, descriptive-analytical study. After video tutorial and practical training of how to do FMS test, the participants carried out the test while they were wearing comfortable clothes. The final score of the FMS test ranges from 0 to 21. The score of 14 is considered weak in the functional movement base on FMS test protocol. In addition to the demographic data questionnaire, the Nordic musculoskeletal questionnaire was also completed for each participant. SPSS software was used for statistical analysis with a significance level of 0.05. Results: Totally, 49.3% (n=66) of the subjects were female. The mean age and work experience of the subjects were 35.3 ± 8.7 and 11.4 ± 7.7, respectively. The highest prevalence of MSDs was observed at the knee and lower back with 32.8% (n=44) and 23.1% (n=31), respectively. 26 (19.4%) health worker had FMS test score of 14 and less. The results of the Spearman correlation test showed that the FMS test score was significantly associated with MSDs (r=-0.419, p < 0.0001). It meant that MSDs increased with the decrease of the FMS test score. Age, sex, and MSDs were the remaining significant factors in linear regression logistic model with dependent variable of FMS test score. Conclusion: FMS test seems to be a usable screening tool in pre-employment and periodic medical tests for occupations that require physical fitness and optimum functional movements.

Keywords: functional movement, musculoskeletal disorders, health care worker, screening test

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194 Patient Safety Culture in Brazilian Hospitals from Nurse's Team Perspective

Authors: Carmen Silvia Gabriel, Dsniele Bernardi da Costa, Andrea Bernardes, Sabrina Elias Mikael, Daniele da Silva Ramos

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The goal of this quantitative study is to investigate patient safety culture from the perspective of professional from the hospital nursing team.It was conducted in two Brazilian hospitals,.The sample included 282 nurses Data collection occurred in 2013, through the questionnaire Hospital Survey on Patient Safety Culture.Based on the assessment of the dimensions is stressed that, in the dimension teamwork across hospital units, 69.4% of professionals agree that when a lot of work needs to be done quickly, they work together as a team; about the dimension supervisor/ manager expectations and actions promoting safety, 70.2% agree that their supervisor overlooks patient safety problems.Related to organizational learning and continuous improvement, 56.5% agree that there is evaluation of the effectiveness of the changes after its implementation.On hospital management support for patient safety, 52.8% refer that the actions of hospital management show that patient safety is a top priority.On the overall perception of patient safety, 57.2% disagree that patient safety is never compromised due to higher amount of work to be completed.In what refers to feedback and communication about error, 57.7% refer that always and usually receive such information. Relative to communication openness, 42.9% said they never or rarely feel free to question the decisions / actions of their superiors.On frequency of event reporting, 64.7% said often and always notify events with no damages to patients..About teamwork across hospital units is noted similarity between the percentages of agreement and disagreement, as on the item there is a good cooperation among hospital units that need to work together, that indicates 41.4% and 40.5% respectively.Related to adequacy of professionals, 77.8 % disagree on the existence of sufficient amount of employees to do the job, 52.4% agree that shift changes are problematic for patients. On nonpunitive response to errors, 71.7% indicate that when an event is reported it seems that the focus is on the person.On the patient safety grade of the institution, 41.6 % classified it as very good. it is concluded that there are positive points in the safety culture, and some weaknesses as a punitive culture and impaired patient safety due to work overload .

Keywords: quality of health care, health services evaluation, safety culture, patient safety, nursing team

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193 Political Economy on the Recent Labor Condition in the Philippines: A Literature Review

Authors: Lloyd B. Ranises

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The Philippine labor force has been affected by the pandemic recently. The situation was added by the high inflation rate, which makes matter worse. Since the Philippines has a new government after the 2022 national election, the labor condition under the previous government has been passed on to the new one. To understand the labor challenges the present government faces, this study revisits the labor conditions and responses of the previous government from 2016 to 2022. Thus, this study reviews the labor force of the Philippines within the time frame. It explores the challenges in the labor market and examines government policy. This study uses secondary sources in tracing the labor conditions and government actions that addressed them. The Literatures are consolidated to see its relevance to the new government’s labor policy. This study found that the labor force had a sluggish growth earlier until 2018 and thrived on but was affected by the pandemic. By 2020, the National Capital Region’s labor force dropped, although, after which, it begins to thrive again, showing recovery. However, its composition is much more complex. Cognitive skill is high in demand that requires tertiary education. But the production of goods and services is low in the scientific workforce in addition to the mismatch between position and profession. Moreover, Philippine labor has poor female participation. In addition to these complexities, the agricultural rural areas have high underemployment, which implies surplus labor of low skill. Overseas employment, on the other, is significant to the decrease in domestic production. The major responses of the previous government, by far, have been focused on the minimum wage increase and the social services and health insurance, which are appropriate to the post-pandemic needs. Yet still, some issues are unattended. This study concludes that the previous government’s policy needs to be fleshed out substantially. It necessitates that the new administration shall consider encompassing all aspects of the Philippine labor force to sustain and strengthen the economy of the country.

Keywords: cognitive skills, minimum wage, national capital region, underemployment

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192 The Influence of the Normative Gender Binary in Diversity Management: A Multi-Method Study on Gender Diversity of Diversity Management

Authors: Robin C. Ladwig

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Diversity Management, as a substantial element of Human Resource Management, aims to secure the economic benefit that assumingly comes with a diverse workforce. Consequently, diversity managers focus on the protection of employees and securing equality measurements to assure organisational gender diversity. Gender diversity as one aspect of Diversity Management seems to adhere to gender binarism and cis-normativity. Workplaces are gendered spaces which are echoing the binary gender-normativity presented in Diversity Management, sold under the label of gender diversity. While the expectation of Diversity Management implies the inclusion of a multiplicity of marginalised groups, such as trans and gender diverse people, in current literature and practice, the reality is curated by gender binarism and cis-normativity. The qualitative multi-method research showed a lack of knowledge about trans and gender diverse matters within the profession of Diversity Management and Human Resources. The semi-structured interviews with trans and gender diverse individuals from various backgrounds and occupations in Australia exposed missing considerations of trans and gender diverse experiences in the inclusivity and gender equity of various workplaces. Even if practitioners consider trans and gender diverse matters under gender diversity, the practical execution is limited to gender binary structures and cis-normative actions as the photo-elicit questionnaire with diversity managers, human resource officers, and personnel management demonstrates. Diversity Management should approach a broader source of informed practice by extending their business focus to the knowledge of humanity studies. Humanity studies could include diversity, queer, or gender studies to increase the inclusivity of marginalised groups such as trans and gender diverse employees and people. Furthermore, the definition of gender diversity should be extended beyond the gender binary and cis-normative experience. People may lose trust in Diversity Management as a supportive ally of marginalised employees if the understanding of inclusivity is limited to a gender binary and cis-normativity value system that misrepresents the richness of gender diversity.

Keywords: cis-normativity, diversity management, gender binarism, trans and gender diversity

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191 The Implications of Instrumental Animal Protection for the Legal and Moral Status of Animals

Authors: Ankita Shanker, Angus Nurse

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The notion of animal rights is an emerging trend in various spaces, including judicial and societal discourse. But one of the key purposes of recognizing the fundamental rights of anyone is their de-objectification. Animals are a prime example of a group that has rights that are neither recognized nor protected in any meaningful way, and anything that purports differently fails to ameliorate this because it still objectifies animals. Animals are currently treated by law and society as commodities with primarily (though not exclusively) instrumental value to some other rights-holder, such as humans or nature. So most protections that are afforded to them are done so in furtherance of the interests that they allegedly further, be it social morality or environmental protection. Animal rights are thus often seen as an application or extension of the rights of humans or, more commonly, the rights of nature. What this means is that animal rights are not always protected or even recognized in their own regard, but as stemming from some other reason, or worse, instrumentally as means to some other ends. This has two identifiable effects from a legal perspective: animal rights are not seen as inherently justified and are not seen as inherently valuable. Which in turn means that there can be no fundamental protection of animal rights. In other words, judicial protection does not always entail protection of animal ‘rights’ qua animal rights, which is needed for any meaningful protections to be afforded to animals. But the effects of this legal paradigm do not end at the legal status of animals. Because this status, in turn, affects how persons and the societies of which they form part see animals as a part of the rights of others, such as humans or nature, or as valuable only insofar as they further these rights, as opposed to as individuals with inherent worth and value deserving of protection regardless of their instrumental usefulness to these other objectives. This does nothing to truly de-objectify animals. Because even though most people would agree that animals are not objects, they continue to treat them as such wherever it serves them. For individuals and society to resolve, this inconsistency between stance and actions is for them to believe that animals are more than objects on a psychological and societal level. In this paper, we examine the implications of this perception of animals and their rights on the legal protections afforded to them and on the minds of individuals and civil society. We also argue that a change in the legal and societal status of animals can be brought about only through judicial, psychological, and sociological acknowledgment that animals have inherent value and deserve protection on this basis. Animal rights derived in such a way would not need to place reliance on other justifications and would not be subject to subjugation to other rights should a conflict arise.

Keywords: animal rights law, animal protection laws, psycho-socio-legal studies, animal rights, human rights, rights of nature

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190 Comparative Analysis of Decentralized Financial Education Systems: Lessons From Global Implementations

Authors: Flex Anim

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The financial system is a decentralized studies system that was put into place in Ghana as a grassroots financial studies approach. Its main goal is to give people the precise knowledge, abilities, and training required for a given trade, business, profession, or occupation. In this essay, the question of how the financial studies system's devolution to local businesses results in responsible and responsive representation as well as long-term company learning is raised. It centers on two case studies, Asekwa Municipal and Oforikrom. The next question posed by the study is how senior high school students are rebuilding their livelihoods and socioeconomic well-being by creating new curriculum and social practices related to the finance and business studies system. The paper here concentrates on Kumasi District and makes inferences for the other two examples. The paper demonstrates how the financial studies system's establishment of representative groups creates the democratic space required for the successful representation of community goals. Nonetheless, the interests of a privileged few are advanced as a result of elite capture. The state's financial and business training programs do not adhere to the financial studies system's established policy procedures and do not transfer pertinent and discretionary resources to local educators. As a result, local educators are unable to encourage representation that is accountable and responsive. The financial studies system continues to pique the interest of rural areas, but this desire is skewed toward getting access to financial or business training institutions for higher education. Since the locals are not actively involved in financial education, the financial studies system serves just to advance the interests of specific populations. This article explains how rhetoric and personal benefits can be supported by the public even in the case of "failed" interventions.

Keywords: financial studies system, financial studies' devolution, local government, senior high schools and financial education, as well as community goals and representation

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189 Identifying, Reporting and Preventing Medical Errors Among Nurses Working in Critical Care Units At Kenyatta National Hospital, Kenya: Closing the Gap Between Attitude and Practice

Authors: Jared Abuga, Wesley Too

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Medical error is the third leading cause of death in US, with approximately 98,000 deaths occurring every year as a result of medical errors. The world financial burden of medication errors is roughly USD 42 billion. Medication errors may lead to at least one death daily and injure roughly 1.3 million people every year. Medical error reporting is essential in creating a culture of accountability in our healthcare system. Studies have shown that attitudes and practice of healthcare workers in reporting medical errors showed that the major factors in under-reporting of errors included work stress and fear of medico-legal consequences due to the disclosure of error. Further, the majority believed that increase in reporting medical errors would contribute to a better system. Most hospitals depend on nurses to discover medication errors because they are considered to be the sources of these errors, as contributors or mere observers, consequently, the nurse’s perception of medication errors and what needs to be done is a vital feature to reducing incidences of medication errors. We sought to explore knowledge among nurses on medical errors and factors affecting or hindering reporting of medical errors among nurses working at the emergency unit, KNH. Critical care nurses are faced with many barriers to completing incident reports on medication errors. One of these barriers which contribute to underreporting is a lack of education and/or knowledge regarding medication errors and the reporting process. This study, therefore, sought to determine the availability and the use of reporting systems for medical errors in critical care unity. It also sought to establish nurses’ perception regarding medical errors and reporting and document factors facilitating timely identification and reporting of medical errors in critical care settings. Methods: The study used cross-section study design to collect data from 76 critical care nurses from Kenyatta Teaching & Research National Referral Hospital, Kenya. Data analysis and results is ongoing. By October 2022, we will have analysis, results, discussions, and recommendations of the study for purposes of the conference in 2023

Keywords: errors, medical, kenya, nurses, safety

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188 The Effect of Values on Social Innovativeness in Nursing and Medical Faculty Students

Authors: Betül sönmez, Fatma Azizoğlu, S. Bilge Hapçıoğlu, Aytolan Yıldırım

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Background: Social innovativeness contains the procurement of a sustainable benefit for a number of problems from working conditions to education, social development, health, and from environmental control to climate change, as well as the development of new social productions and services. Objectives: This study was conducted to determine the correlation between the social innovation tendency of nursing and medical faculty students and value types. Methods and participants: The population of this correlational study consisted of third-year students studying at a medical faculty and a nursing faculty in a public university in Istanbul. Ethics committee approval and permission from the school administrations were obtained in order to conduct the study and voluntary participation of the students in the study was ensured. 524 questionnaires were obtained with a total return rate of 57.1% (65.0% in nurse student and 52.1% in physic students). The data of the study were collected by using the Portrait Values Questionnaire and a questionnaire containing the Social Innovativeness Scale. Results: The effect of the subscale scores of Portrait Values Questionnaire on the total score of Social Innovativeness Scale was 26.6%. In the model where a significance was determined (F=37.566; p<0.01), the highest effect was observed in the subscale of universalism. The effect of subscale scores obtained from the Portrait Values Questionnaire, as well as age, gender and number of siblings was 25% on the Social Innovativeness in nursing students and 30.8% in medical faculty students. In both models where a significance was determined (p<0.01), the nursing students had the values of power, universalism and kindness, whereas the medical faculty students had the values of self-direction, stimulation, hedonism and universalism showed the highest effect in both models. Conclusions: Universalism is the value with the highest effect upon the social innovativeness in both groups, which is an expected result by the nature of professions. The effect of the values of independent thinking and self-direction, as well as openness to change involving quest for innovation (stimulation), which are observed in medical faculty students, also supports the literature of innovative behavior. These results are thought to guide educators and administrators in terms of developing socially innovative behaviors.

Keywords: social innovativeness, portrait values questionnaire, nursing students, medical faculty students

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187 Maternal Perception of Using Epidural Anesthesia and the Childbirth Outcomes

Authors: Jiyoung Kim, Chae Weon Chung

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Labor pain is one of the most common concerns of pregnant women, thus women are in need of possible options they could take to control the pain. So, this study aimed to explore maternal perception of epidural anesthesia and to compare the childbirth outcomes according to the use of epidural anesthesia. For this descriptive study, women who were over 36 weeks of pregnancy were recruited from an out-patient obstetric clinic in a public hospital in Seoul. Women were included in the study if agreed to participate, were pregnant singleton, without pregnancy complication, and expecting a natural birth. Data collection was done twice, the first one at the prenatal care visit and the second one at an in-patient ward on 2nd day postpartum. The instrument of the beliefs about epidural anesthesia, one item of asking intention to use epidural anesthesia, demographics, and obstetrical characteristics were incorporated into a questionnaire. One nurse researcher performed data collection with the structured questionnaire after the approval of the institutional review board. At the initial data collection 133 women were included, while 117 were retained at the second point after excluded 13 women due to the occurrence of complications. Analyses were done by chi-square, t-test, and ANOVA using the SPSS program. Women were aged 32.5 years old, 22.2% were over 35 years old. The average gestational age was 38.5 weeks, and 67.5% were nulliparous. Out of 38 multiparous women, 20 women (52.6%) had received epidural anesthesia in the previous delivery. At the initial interview, 62.6% (n=73) of women wanted to receive epidural anesthesia while 22.4% answered not decided and 15.4% did not want to take the procedure. However, there were changes in proportions between women’s intention to take it and actual procedures done, particularly, two-thirds of women (n=26) who had been undecided were found to receive epidural anesthesia during labor. There was a significant difference in the perception of epidural anesthesia measured before delivery between women who received and not received it (t=3.68, p < .001). Delivery outcomes were statistically different between the two groups in delivery mode (chi-square=8.64, p=.01), O₂ supply during labor (chi-square =5.01, p=.03), duration of 2nd stage of labor (t=3.70, p < .001), and arterial cord blood pH (t=2.64, p=.01). Interestingly, there was no difference in labor pain perceived between women with and without epidural anesthesia. Considering the preference and use of epidural anesthesia, health professionals need to assess coping ability of women undergoing delivery and to provide accurate information about pain control to support their decision making and eventually to enhance delivery outcomes for mothers and neonates.

Keywords: epidural anesthesia, delivery outcomes, labor pain, perception

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186 The Communicational Behaviors of the Nurses Towards 'Crying Patient'

Authors: Hacer Kobya Bulut, Kıymet Yeşilçiçek Çalık, Birsel Canan Demirbağ, Hacer Erdöl, Songül Aktaş

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Introduction: As an expression of an emotion which always exists in life, crying is regarded as one of the problematic behaviors of patients by nurses. Towards such patients, nurses may exhibit emotional and behavioral reactions such as feeling helpless, anger, indifferent, defense, and opposition. However crying either meets a need, reduces the tension to cope with problems or helps patient to gain strength. Therefore, nurses must accept that crying is a normal mechanism that reduces emotional tension and should approach a crying patient accordingly. Objective: This study was carried out to evaluate the communicational behaviors of the nurses towards ‘crying patient’. Methods: This descriptive study was conducted with the nurses working at a university hospital in a city in the Eastern Black Sea in June-September 2015. The entire universe was tried to be reached without sampling. 90% of the population was reached and the study was completed with 309 nurses who volunteered to participate in the study. Data were collected through a questionnaire which was prepared reviewing the literature by researchers. Data were evaluated in SPSS analysis program using percentages, numbers and chi-square test with the 95% confidence interval and p <0.05significance level. Findings: The findings showed that the average age of nurses was 31.52 ± 7.96, work experience was 10:09 ± 7.69 and only 22.7% had training about ‘approach to crying patient’ during their education. 97.1% of the nurses often faced with crying patients in their professional lives, 62.8% stated that they faced crying women patients. When they see crying patients, 84.8% of the nurses ‘do not want the patient to cry’, 80.9% wonder ‘why they are crying’, % 79.6 ‘feel uneasiness’,% 79.3 ‘feel sorry’ and 41.4% ‘ feel helpless’. The question ‘Why do you think the patient is crying?’ was answered by 93.5% nurses as ‘they are suffering’, by 86.1% ‘they are helpless’, 80.9% ‘they are sad’, 79.6% ‘they need help’, 54.4% ‘because they feel inadequate,’ and 44.7% ‘they fail to control their crying behavior. ‘How do you approach to your patient when she/he is crying?’ question was answered by 82.5% of nurses as ‘I would console’, 77.3% as ‘I would ask the reason’, 63.1% as ‘I would try to stop her from crying’ all of which are actually inappropriate nursing approaches. However, 92.2% of the nurses stated that ‘I do not judge the crying patient’, ‘87.1% said ‘I allocate time to crying patients’ and 85.8% said ‘ I ask patient whether they want to cry alone’. The study showed that educational background and work experience of the nurses affected the appropriate approach to crying patients (P <0.05). Conclusion: As a result of the study, it was found out that nurses do not want patients to cry, so they exhibit inappropriate approach such as consoling the patients and they have difficulty in approaching crying patients.

Keywords: approach to patient, communication, crying patient, nurse, Turkey

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185 Challenges of Outreach Team Leaders in Managing Ward Based Primary Health Care Outreach Teams in National Health Insurance Pilot Districts in Kwazulu-Natal

Authors: E. M. Mhlongo, E. Lutge

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In 2010, South Africa’s National Department of Health (NDoH) launched national primary health care (PHC) initiative to strengthen health promotion, disease prevention, and early disease detection. The strategy, called Re-engineering Primary Health Care (rPHC), aims to support a preventive and health-promoting community-based PHC model by using community-based outreach teams (known in South Africa as Ward-based Primary Health Care Outreach teams or WBPHCOTs). These teams provide health education, promote healthy behaviors, assess community health needs, manage minor health problems, and support linkages to health services and health facilities. Ward based primary health care outreach teams are supervised by a professional nurse who is the outreach team leader. In South Africa, the WBPHCOTs have been established, registered, and are reporting their activities in the District Health Information System (DHIS). This study explored and described the challenges faced by outreach team leaders in supporting and supervising the WBPHCOTs. Qualitative data were obtained through interviews conducted with the outreach team leaders at a sub-district level. Thematic analysis of data was done. Findings revealed some challenges faced by team leaders in day to day execution of their duties. Issues such as staff shortages, inadequate resources to carry out health promotion activities, and lack of co-operation from team members may undermine the capacity of team leaders to support and supervise the WBPHCOTs. Many community members are under the impression that the outreach team is responsible for bringing the clinic to the community while the outreach teams do not carry any medication/treatment with them when doing home visits. The study further highlights issues around the challenges of WBPHCOTs at a household level. In conclusion, the WBPHCOTs are an important component of National Health Insurance (NHI), and in order for NHI to be optimally implemented, the issues raised in this research should be addressed with some urgency.

Keywords: community health worker, national health insurance, primary health care, ward-based primary health care outreach teams

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