Search results for: Turkish nurses
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 924

Search results for: Turkish nurses

684 Exploring the Career Experiences of Internationally Recruited Nurses at the Royal Berkshire NHS Foundation Trust

Authors: Natalie Preville, Carlos Joel Mejia-Olivares

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In the UK, since the early 1950s when the NHS was founded, international staff in the NHS have played an important role. Currently, they represent 16% of the workforce within the NHS in the UK. Furthermore, to address the shortfalls in nursing staff, international recruitment programs have been essential to reduce the gaps in the UK nursing workforce over the last two decades. The NHS Long Term Plan (2019) aims to have a significant reduction of nursing vacancies to 5% by 2028. However, in 2021 and 2022, Workforce Race Equality Standards (WRES) reports stated that there is inequitable Career Progression (CP) among Internationally Recruited (IR) nurses as compared to British counterparts. In addition, there is sufficient literature exploring the motives and lived experiences of IR nurses, which underpins the findings. Therefore, the overall aim of this report is to conduct a scoping project to understand the experiences of the IR nurses who joined the NHS in the South East of England within the last 5 years. Methodology- This document is based on the data from a survey developed by Royal Berkshire NHS Foundation Trust using Microsoft forms and consisted of 23 questions divided into four themes, staff background, career experience, career progression and future career plans within Royal Berkshire NHS Foundation Trust. The descriptive analysis provided the initial analysis of the quantitative data. As a result, 44 responses were collected and evaluated by utilising Microsoft excel. Key findings: Career experiences; 72% of respondents felt that their current role was a good fit, and in a subsequent question, the main reason cited was having “relevant skills”. This indicates that, for the most part, the prior experience of IR nurses is a large factor in their placement, which is viewed positively; the next step is to effectively apply similar relevance in aligning prior experience with career progression opportunities. Moreover, 67% of respondents feel valued by the department/team, which is a great reflection of the values of the Trust being demonstrated towards IR Nurses. However, further studies may be necessary to explore the reasons why the remaining 33% may not feel valued; this can include having a better understanding of cultural perceptions of value. Perceived Barriers: Although 37% of respondents had been promoted since commencing employment with the Trust, the data indicates that there is still room for CP opportunities, as it is the leading barrier reported by the respondents. Secondly, the growing mix of cultures within the nursing workforce gives the appearance of inclusion. However, this is not the experience of some IR nurses. Conclusion statemen: Survey results indicate that this NHS Trust has an excellent foundation to integrate international nurses into their workforce with scope for career progression in a reasonable timeframe. However, it would be recommendable to include fast-tracking career promotions by recognizing previous studies and professional experience. Further exploration of staff career experiences and goals may provide additional useful data for future planning.

Keywords: career progression, International nurses, perceived barriers, staff survey

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683 The Association of Excessive Work Stress with Job Satisfaction and Turnover Intention in Operating Room Nurses: A Cross-Sectional Study in a Metropolitan Teaching Hospital in Southern Taiwan

Authors: Chia Yu Chen, Shu Fen Wu, Chen-Fuh Lam, I-Ling Tsai, Shu Jiuan Chen, Yen Ling Liu

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Aim: It remains undetermined that whether increased work stress may affect the job satisfaction and career loyalty among nursing staffs in the operating room. The long-term goal of this study is to lengthen the professional life of operating room nurses by attenuating the work stress and enhancing their contentment in work. Method: This was a cross-sectional, descriptive study performed in a metropolitan teaching hospital in the southern Taiwan between May 2017 to July 2017. A structured self-administered questionnaire, modified from the Occupational Stress Indicator-2 (OSI-2) and Maslach Burnout Inventory (MBI) manual was collected from the operating room nurses. Chi-square test was used to analyze the categorical data and Pearson correlation was used to analyze the association between two numerical datasets (SPSS version 20.0). Results: The response rate was 80% (80/100) and a total of 73 (73%) completed forms were eventually proceeded for analysis. The average scores for work stress and job satisfaction of the operating room nurses were 145.96±32.91 and 47.38±6.07, respectively. The correlation coefficients of work stress versus job satisfaction and organizational identity were (r=-0.338, p=0.003 and r=-0.354, p=0.002), respectively. There were more nurses who took rotating shift quitted works from the operating room than those who took only dayshift (2=5.176, p<0.05). Nurses who reported of having lower job satisfaction were associated with significantly higher turnover intention (t=3.714, p< 0.01). Following multivariate regression analysis, rotating shift and low job satisfaction were identified as the two independent predictors of intention to quit from working in the operating room. Conclusion: Our study clearly demonstrates that increased work stress significantly attenuates job satisfaction and organizational identity. Rotating shift is associated with higher work stress, lower job satisfaction, and higher turnover intention, which is consistent with the previous surveys carried out in the department of medical technology. Therefore, improvement of working quality in the operating rooms is essential to increase the retain intention of the well-trained nursing staffs. Further investigation into types of work shifts and other strategies of attenuating stress in workplace is currently undertaken in order to improve the job satisfaction and to decrease turnover intention in the operating room.

Keywords: rotating shift, work stress, job satisfaction, turnover intention

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682 Mediation in Turkish Health Law for Healthcare Disputes

Authors: V. Durmus, M. Uydaci

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In order to prevent overburdened courts, rising costs of litigation, and lengthy trial resolutions, the Law on Mediation for Civil Disputes was enacted, which was aimed at defining the procedure and guiding principles for dispute resolutions under Civil Law, in 2012. This “Mediation Code” also applies for civil healthcare disputes in Turkey. Aside from mediation, reconciliation, governed by Articles 253-255 of Criminal Procedure Law, has emerged as an alternative way to resolve criminal medical disputes, but the difference between mediation and conciliation is mostly procedural. This article deals with mediation in Turkish health law and aspect of medical malpractice mediation in Turkey. In addition, this study examines the issue of mediation in health law from both a legal and normative point of view, including codes of mediation which regulate both the structural and professional practice of mediation providers. As a result, although there is not official record about success rate of medical malpractice litigations and malpractice mediation in Turkey, it is widely accepted that the success rate for medical malpractice cases is relatively low compared to other personal injury cases even if it is generally considered that medical malpractice case filings have gradually increased recently. According to the Justice Ministry’s Department of Mediation in Turkey, 719 civil disputes have referred to mediators since 2013 (when the first mediation law came into force) with a 98% success rate.

Keywords: malpractice mediation, medical disputes, reconciliation, health litigation, Turkish health law

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681 Impact of Forced Displacement on Place Attachment and Home Perception of Internally Displaced Turkish Cypriots

Authors: Makbule Oktay

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Home is a significant entity in people’s lives. It is a place that provides shelter to people and a place to which one feels a sense of attachment and belonging. It is an entity that people develop feelings and meaning to it. People – place bond, or in other words place attachment, and home perception might alter as a consequence of lifetime experiences. Thus, forced displacement appears as a dramatic experience for people who lose their homes, belongings and communities. It impacts people who involuntarily leave their homes and belongings behind, experience physical, social, cultural and economic disruption and are forced to settle in an unfamiliar environment. Place attachment and home perception of internally displaced people who involuntarily leave their homes might be different from those who haven’t experience forced displacement. Although place attachment, meaning of home and forced displacement are the subjects that have been broadly studied, there is a lack of studies which question the relation between the three subjects in general and on Turkish Cypriot case in particular. Considering this, it is the aim of this paper to investigate the impact of forced displacement to internally displaced people’s attachment to a particular place and home perception. To do so, the study focuses on internally displaced Turkish Cypriots who have been internally displaced as a result of conflict. Interview and questionnaire as two of the commonly used techniques in the place attachment and home perception studies have been used in this study too. The results of the study indicate that internal displacement has an apparent impact on place attachment of forcibly displaced people. As a consequence of longstanding displacement, forcibly displaced people developed multiple attachments. Compared to people who have not experienced displacement, forcibly displaced people have low attachments. Forced displacement does not strongly impact the home perception in terms of meaning of home in longstanding displacement situations even though displacement-related meanings of home exist.

Keywords: forcibly displaced people, home perception, internal displacement, place attachment, Turkish Cypriots

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680 The Factors Affecting on Promoting Productivity from Nurses' View

Authors: Mahnaz Sanjari, Sedigheh Salemi, Mohammad Mirzabeigi

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Nowadays, the world is facing a crisis of workforce and one of the most striking examples is the shortage of nurses. Nursing workforce productivity is related by various factors such as absenteeism, professional effectiveness and quality care. This cross-sectional study was conducted in 700 nurses who work in government hospitals from 35 hospitals of 9 provinces in Iran. The study was approved by the Nursing Council and was carried out with the authorization of the Research Ethics Committee. The questionnaire included 33 questions and 4 sub categories such as human resource, education and management. The reliability was evaluated by Cronbach's alpha (α=0/85). Statistical analyzes were performed, using SPSS version 16. The result showed that nurses emphasized on "respect to nurse-to-bed ratio" and less importance item was "using less experienced nurse". In addition, another important factor in clinical productivity is "Proper physical structure and amenities","good communication with colleagues" and "having good facilities". Also, "human resources at all levels of standard", "promoting on merit" and "well defined relationship in health system" are another important factors in productivity from nurse` view. The main managerial factor is "justice between employees" and the main educational component of productivity is “updating nursing knowledge”. The results show that more than half of the participants emphasized on the management and educational factors. Productivity as one of the main part of the health care quality leads to appropriate use of human and organizational resources, reduce cost services, and organizational development.

Keywords: productivity, nursing services, workforce, cost services

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679 Clinicians' and Nurses' Documentation Practices in Palliative and Hospice Care: A Mixed Methods Study Providing Evidence for Quality Improvement at Mobile Hospice Mbarara, Uganda

Authors: G. Natuhwera, M. Rabwoni, P. Ellis, A. Merriman

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Aims: Health workers are likely to document patients’ care inaccurately, especially when using new and revised case tools, and this could negatively impact patient care. This study set out to; (1) assess nurses’ and clinicians’ documentation practices when using a new patients’ continuation case sheet (PCCS) and (2) explore nurses’ and clinicians’ experiences regarding documentation of patients’ information in the new PCCS. The purpose of introducing the PCCS was to improve continuity of care for patients attending clinics at which they were unlikely to see the same clinician or nurse consistently. Methods: This was a mixed methods study. The cross-sectional inquiry retrospectively reviewed 100 case notes of active patients on hospice and palliative care program. Data was collected using a structured questionnaire with constructs formulated from the new PCCS under study. The qualitative element was face-to-face audio-recorded, open-ended interviews with a purposive sample of one palliative care clinician, and four palliative care nurse specialists. Thematic analysis was used. Results: Missing patients’ biogeographic information was prevalent at 5-10%. Spiritual and psychosocial issues were not documented in 42.6%, and vital signs in 49.2%. Poorest documentation practices were observed in past medical history part of the PCCS at 40-63%. Four themes emerged from interviews with clinicians and nurses-; (1) what remains unclear and challenges, (2) comparing the past with the present, (3) experiential thoughts, and (4) transition and adapting to change. Conclusions: The PCCS seems to be a comprehensive and simple tool to be used to document patients’ information at subsequent visits. The comprehensiveness and utility of the PCCS does paper to be limited by the failure to train staff in its use prior to introducing. The authors find the PCCS comprehensive and suitable to capture patients’ information and recommend it can be adopted and used in other palliative and hospice care settings, if suitable introductory training accompanies its introduction. Otherwise, the reliability and validity of patients’ information collected by this PCCS can be significantly reduced if some sections therein are unclear to the clinicians/nurses. The study identified clinicians- and nurses-related pitfalls in documentation of patients’ care. Clinicians and nurses need to prioritize accurate and complete documentation of patient care in the PCCS for quality care provision. This study should be extended to other sites using similar tools to ensure representative and generalizable findings.

Keywords: documentation, information case sheet, palliative care, quality improvement

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678 Multiple Institutional Logics and the Ability of Institutional Entrepreneurs: An Analysis in the Turkish Education Field

Authors: Miraç Savaş Turhan, Ali Danişman

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Recently scholars of new institutional theory have used institutional logics perspective to explain the contradictory practices in modern western societies. Accordingly, distinct institutional logics are embedded in central institutions such as the market, state, democracy, family, and religion. They guide individual and organizational actors and constraint their behaviors in a particular organizational field. Through this perspective, actors are assumed to have a situated, embedded, boundedly intentional, and adaptive role against the structure in social, cultural and political context. On the other hand, over a decade, there is an emerging attempt focusing on the role of actors on creating, maintaining, and changing the institutions. Such attempts brought out the concept of institutional entrepreneurs to explain the role of individual actors in relation to institutions. Institutional entrepreneurs are individuals, groups of individuals, organizations or groups of organizations that are able to initiate some actions to build, maintain or change institutions. While recent studies on institutional logics perspective have attempted to explain roles of entrepreneurial actors who have resources and skills, little is known about the effects of multiple institutional logics on the ability of institutional entrepreneurs. In this study, we aim to find out that how multiple institutional logics affect the ability of institutional entrepreneurs during the process of institutional change. We examine this issue in the Turkish Education Field. While institutional logics were identified based on the previous studies in the education field, the actions taken by Turkish National Education Ministry from 2003 to 2013 was examined through content analysis The early results indicate that there are remarkable shift and contradictions in the ability of institutional entrepreneur in taking actions to change the field in relationship to balance of power shift among the carriers of institutional logics.

Keywords: institutional theory, institutional logics, institutional entrepreneurs, Turkish national education

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677 The Impact of Hospital Strikes on Patient Care: Evidence from 135 Strikes in the Portuguese National Health System

Authors: Eduardo Costa

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Hospital strikes in the Portuguese National Health Service (NHS) are becoming increasingly frequent, raising concerns in what respects patient safety. In fact, data shows that mortality rates for patients admitted during strikes are up to 30% higher than for patients admitted in other days. This paper analyses the effects of hospital strikes on patients’ outcomes. Specifically, it analyzes the impact of different strikes (physicians, nurses and other health professionals), on in-hospital mortality rates, readmission rates and length of stay. The paper uses patient-level data containing all NHS hospital admissions in mainland Portugal from 2012 to 2017, together with a comprehensive strike dataset comprising over 250 strike days (19 physicians-strike days, 150 nurses-strike days and 50 other health professionals-strike days) from 135 different strikes. The paper uses a linear probability model and controls for hospital and regional characteristics, time trends, and changes in patients’ composition and diagnoses. Preliminary results suggest a 6-7% increase in in-hospital mortality rates for patients exposed to physicians’ strikes. The effect is smaller for patients exposed to nurses’ strikes (2-5%). Patients exposed to nurses strikes during their stay have, on average, higher 30-days urgent readmission rates (4%). Length of stay also seems to increase for patients exposed to any strike. Results – conditional on further testing, namely on non-linear models - suggest that hospital operations and service levels are partially disrupted during strikes.

Keywords: health sector strikes, in-hospital mortality rate, length of stay, readmission rate

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676 Nursing-Related Barriers to Children’s Pain Management at Selected Hospitals in Ghana: A Descriptive Qualitative Study

Authors: Abigail Kusi Amponsah, Evans Frimpong Kyei, John Bright Agyemang, Hanson Boakye, Joana Kyei-Dompim, Collins Kwadwo Ahoto, Evans Oduro

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Staff shortages, deficient knowledge, inappropriate attitudes, demanding workloads, analgesic shortages, and low prioritization of pain management have been identified in earlier studies as the nursing-related barriers to optimal children’s pain management. These studies have mainly been undertaken in developed countries, which have different healthcare dynamics than those in developing countries. The current study, therefore, sought to identify and understand the nursing-related barriers to children’s pain management in the Ghanaian context. A descriptive qualitative study was conducted among 28 purposively sampled nurses working in the pediatric units of five hospitals in the Ashanti region of Ghana. Over the course of three months, participants were interviewed on the barriers which prevented them from optimally managing children’s pain in practice. Recorded interviews were transcribed verbatim and deductively analysed based on a conceptual interest in pain assessment and management-related barriers. NVivo 12 plus software guided data management and analyses. The mean age of participating nurses was 30 years, with majority being females (n =24). Participants had worked in the nursing profession for an average of five years and in the pediatric care settings for an average of two years. The nursing-related barriers identified in the present study included communication difficulties in assessing and evaluating pain management interventions with children who have nonfunctional speech, insufficient training, misconceptions on the experience of pain in children, lack of assessment tools, and insufficient number of nurses to manage the workload and nurses’ inability to prescribe analgesics. The present study revealed some barriers which prevented Ghanaian nurses from optimally managing children’s pain. Nurses should be educated, empowered, and supported with the requisite material resources to effectively manage children’s pain and improve outcomes for families, healthcare systems, and the nation. Future studies should explore the facilitators and barriers from other stakeholders involved in pediatric pain management

Keywords: Nursing-Related Barriers, Children, Pain Management, Ghana

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675 The Impact of Trade Liberalization on Current Account Deficit: The Turkish Case

Authors: E. Selçuk, Z. Karaçor, P. Yardımcı

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Trade liberalization and its effects on the economies of developing countries have been investigated by many different studies, and some of them have focused on its impact on the current account balance. Turkey, as being one of the countries, which has liberalized its foreign trade in the 1980s, also needs to be studied in terms of the impact of liberalization on current account deficits. Therefore, the aim of this study is to find out whether trade liberalization has affected Turkey’s trade and current account balances. In order to determine this, yearly data of Turkey from 1980 to 2013 is used. As liberalization dummy, the year 1989, which was set for Turkey, is selected. Structural break test and model estimation results show that trade liberalization has a negative impact on trade balance but do not have a significant impact on the current account balance.

Keywords: budget deficit, liberalization, Turkish economy, current account

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674 Demotivation-Reducing Strategies Employed by Turkish EFL Learners in L2 Writing

Authors: kaveh Jalilzadeh, Maryam Rastgari

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Motivation for learning a foreign language is needed for learners of any foreign language to effectively learn language skills. However, there are some factors that lead to the learners’ demotivation. Therefore, teachers of foreign languages, most notably English language which turned out to be an international language for academic and business purposes, need to be well aware of the demotivation sources and know how to reduce learners’ demotivation. This study is an attempt to explore demotivation-reducing strategies employed by Turkish EFL learners in L2 writing. The researchers used a qualitative case study and employed semi-structured interviews to collect data. The informants recruited in this study were 20 English writing lecturers who were selected through purposive sampling among university lecturers/instructors at the state and non-state universities in Istanbul and Ankara. Interviews were transcribed verbatim, and MAXQDA software (version 2022) was used for performing coding and thematic analysis of the data. Findings revealed that Turkish EFL teachers use 18 strategies to reduce language learners’ demotivation. The most frequently reported strategies were: writing in a group, writing about interesting topics, writing about new topics, writing about familiar topics, writing about simple topics, and writing about relevant topics. The findings have practical implications for writing teachers and learners of the English language.

Keywords: phenomenological study, emotional vulnerability, motivation, digital Settings

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673 Integration of an Innovative Complementary Approach Inspired by Clinical Hypnosis into Oncology Care: Nurses’ Perception of Comfort Talk

Authors: Danny Hjeij, Karine Bilodeau, Caroline Arbour

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Background: Chemotherapy infusions often lead to a cluster of co-occurring and difficult-to-treat symptoms (nausea, tingling, etc.), which may negatively impact the treatment experience at the outpatient clinic. Although several complementary approaches have shown beneficial effects for chemotherapy-induced symptom management, they are not easily implementable during chemotherapy infusion. In response to this limitation, comfort talk (CT), a simple, fast conversational method inspired by the language principles of clinical hypnosis, is known to optimize the management of symptoms related to antineoplastic treatments. However, the perception of nurses who have had to integrate this practice into their care has never been documented. Study design: A qualitative descriptive study with iterative content analysis was conducted among oncology nurses working in a chemotherapy outpatient clinic who had previous experience with CT. Semi-structured interviews were conducted by phone, using a pre-tested interview guide and a sociodemographic survey to document their perception of CT. The conceptual framework. Results: A total of six nurses (4 women, 2 men) took part in the interviews (N=6). The average age of participants was 49 years (36-61 years). Participants had an average of 24 years of experience (10-38 years) as a nurse, including 14.5 years in oncology (5-32 years). Data saturation (i.e., redundancy of words) was observed around the fifth interview. A sixth interview was conducted as confirmation. Six themes emerged: two addressing contextual and organizational obstacles at the chemotherapy outpatient clinic, and three addressing the added value of CT for oncology nursing care. Specific themes included: 1) the outpatient oncology clinic, a saturated care setting, 2) the keystones that support the integration of CT into care, 3) added value for patients, 4) a positive and rewarding experience for nurses, 5) collateral benefits, and 6) CT an approach to consider during the COVID-19 pandemic. Conclusion: For the first time, this study describes nurses' perception of the integration of CT into the care surrounding the administration of chemotherapy at the outpatient oncology clinic. In summary, contextual and organizational difficulties, as well as the lack of training, are among the main obstacles that could hinder the integration of CT in oncology. Still, the experience was reported mostly as positive. Indeed, nurses saw HC as an added value to patient care and meeting their need for holistic care. HC also appears to be beneficial for patients on several levels (for pain management in particular). Results will be used to inform future knowledge transfer activities related to CT in oncology nursing.

Keywords: cancer, chemotherapy, comfort talk, oncology nursing role

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672 Transformation in Palliative Care Delivery in Surgery

Authors: W. L. Tsang, H. Y. Li, S. L. Wong, T. Y. Kwok, S. C. Yuen, S. S. Kwok, P. S. Ko, S. Y. Lau

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Introduction: Palliative care is no doubt necessary in surgery. When one looks at studies of what patients with life-threatening illness want and compares to what they experience in surgical units, the gap is huge. Surgical nurses, being patient advocates, should engage with patients and families sooner rather than later in their illness trajectories to consider how to manage the illness, not just their capacity to survive. Objective: This clinical practice guide aims to fill the service gap of palliative care in surgery by producing a quality-driven, evidence-based yet straightforward clinical practice guide based on a focus strategy. Methodology: In line with Guide to Good Nursing Practice: End-of-Life Care recommended by Nursing Council of Hong Kong and the strategic goal of improving quality of palliative care proposed in HA Strategic Plan 2017-2022, multiple phases of work were undertaken from July 2015 to December 2017. A pragmatic clinical practice guide for surgical patients facing life-threatening conditions was developed based on assessments on knowledge of and attitudes towards end-of-life care of surgical nurses. Key domains, including preparation for bereavement, nursing care for imminently dying patients and at the dying scene were crystallized according to the results of the assessments and the palliative care checklist formulated by UCH Palliative Care Team. After a year of rollout, its content was refined through analyses of implementation in routine practice and consensus opinions from frontline nurses. Results and Outcomes: This clinical practice guide inspires surgical nurses with the art of care to provide for patients’ comfort, function, and longevity. It provides practical directions and assists nurses to master the skills on advance care planning and learn how to be clear with patients, families and themselves about the realities of the disease pictures. Through the implementation, patients and families are included in the decision process, and their wishes are honored. The delivery of explicit and high-quality palliative care maintains good nurse-to-patient relations and enhances satisfaction of hospital care of patients and families. Conclusion: Surgical nursing has always been up to the unique challenges of the era. This clinical practice guide has become an island of credibility for our nurses as they traverse the often stormy waters of life-limiting illness.

Keywords: palliative care delivery, palliative care in surgery, hospice care, end-of-life care

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671 Analysis of the Interventions Performed in Pediatric Cardiology Unit Based on Nursing Interventions Classification (NIC-6th): A Pilot Study

Authors: Ji Wen Sun, Nan Ping Shen, Yi Bei Wu

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This study used Nursing Interventions Classification (NIC-6th) to identify the interventions performed in a pediatric cardiology unit, and then to analysis its frequency, time and difficulty, so as to give a brief review on what our nurses have done. The research team selected a 35 beds pediatric cardiology unit, and drawn all the nursing interventions in the nursing record from our hospital information system (HIS) from 1 October 2015 to 30 November 2015, using NIC-6th to do the matching and then counting their frequencies. Then giving each intervention its own time and difficulty code according to NIC-6th. The results showed that nurses in pediatric cardiology unit performed totally 43 interventions from 5394 statements, and most of them were in RN(basic) education level needed and less than 15 minutes time needed. There still had some interventions just needed by a nursing assistant but done by nurses, which should call for nurse managers to think about the suitable staffing. Thus, counting the summary of the product of frequency, time and difficulty for each intervention of each nurse can know one's performance. Acknowledgement Clinical Management Optimization Project of Shanghai Shen Kang Hospital Development Center (SHDC2014615); Hundred-Talent Program of Construction of Nursing Plateau Discipline (hlgy16073qnhb).

Keywords: nursing interventions, nursing interventions classification, nursing record, pediatric cardiology

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670 Regulating the Ottomans on Turkish Television and the Making of Good Citizens

Authors: Chien Yang Erdem

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This paper takes up the proliferating historical dramas and children’s programs featuring the Ottoman-Islamic legacy on Turkish television as a locus where the processes of subjectification take place. A critical analysis of this emergent cultural phenomenon reveals an alliance of neoliberal and neoconservative political rationalities based on which the Turkish media is restructured to transform society. The existing debates have focused on how the Ottoman historical dramas manifest the Justice and Development Party’s (Adalet ve Kalkınma Partisi) neo-Ottomanist ideology and foreign policy. However, this approach tends to overlook the more complex relationship between the media, government, and society. Employing Michel Foucault’s notion of 'technologies of the self,' this paper aims to examine the governing practices that are deployed to regulate the media and to transform individual citizens into governable subjects in contemporary Turkey. First, through a brief discussion of recent development of the Turkish media towards an authoritarian model, the paper suggests that the relation between the Ottoman television drama and the political subject in question cannot be adequately examined without taking into account the force of the market. Second, by focusing on the managerial restructuring of the Turkish Television and Radio Corporation (Türkiye Radyo ve Televizyon Kurumu), the paper aims to illustrate the rationale and process through which the Turkish media sector is transformed into an integral part of the free market where the government becomes a key actor. The paper contends that this new sphere of free market is organized in a way that enables direct interference of the government and divides media practitioners and consumers into opposing categories through their own participation in the media market. On the one hand, a 'free subject' is constituted based on the premise that the market is a sphere where individuals are obliged to exercise their right to freedom (of choice, lifestyle, and expression). On the other hand, this 'free subject' is increasingly subjugated to such disciplinary practices as censorship for being on the wrong side of the government. Finally, the paper examines the relation between the restructured Turkish media market and the proliferation of Ottoman television drama in the 2010s. The study maintains that the reorganization of the media market has produced a condition where private sector is encouraged to take an active role in reviving Turkey’s Ottoman-Islamic cultural heritage and promulgating moral-religious values. Paying specific attention to the controversial case of Magnificent Century (Muhteşem Yüzyıl) in contrast with TRT’s Ottoman historical drama and children’s programs, the paper aims to identify the ways in which individual citizens are directed to conduct themselves as a virtuous citizenry. It is through the double movement between the governing practices associated with the media market and those concerning the making of a 'conservative generation' that a subject of citizenry of new Turkey is constituted.

Keywords: neoconservatism, neoliberalism, ottoman historical drama, technologies of the self, Turkish television

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669 The Determinants of the Operational Performance in Airline Industry: A Case of a Turkish Airline Company

Authors: Mustafa K. Yilmaz, Ahmet Kaplan, Murat Guven, Vildan Kesici

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Aviation industry influences the social and economic growth across the countries. Further, airline companies are highly affected by social, political, and financial crises and show a high degree of cyclicity in operational performance. Hence, this paper investigates the effects of available seat kilometers (ASK), revenue per kilometer (RPK), passenger load factor (PLF) as well as socio-political crisis on the number of passengers carried (PC) by Turkish Airlines company over the period of 2010M1-2018M12. To conduct the analysis, we employ fully modified ordinary least squares (FMOLS), dynamic ordinary least squares (DOLS), and canonical cointegration regression (CCR) techniques using monthly data. We use ASK, RPK, PLF as independent variables to identify the determinants of the PC, as a dependent variable. We also test the effect of the socio-political crisis. The results reveal that there is a significant and negative relationship between ASK and PC, while the relationship between RPK and PC is positive and significant. We also find that there is an insignificant relationship between PLF and PC. Further, we also find a negative effect of the crisis on the PC. These findings show although the crisis had an immediate effect on the operational performance of Turkish Airlines, the company recovered from the crisis and cope with the situation very promptly. Thus, this proves the resilience and agile management ability of the company.

Keywords: airline industry, operational performance, air traffic, socio-political crisis

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668 Meiji Centennial as a Media Event: Ideas for Upcoming Turkish Republic Centennial

Authors: Hasan Topacoglu

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The Meiji Restoration was a chain of events that restored Japan in 1868 and considered as the beginning of Japanese Modernization by many scholars. In 1968, to honor its modern incarnation, Japan celebrated Meiji Centennial as one of the biggest Media Events in the country after the World War II. It was celebrated all around the country throughout the year following with a central event in Tokyo. Meanwhile, Japanese scholars started an opposition movement and claimed that Government was using this event to raise nationalism, pointing at Government’s statement on the meaning of Meiji. Most of the scholars, unfortunately, were hooked into the ideological problem of the Government’s way of planning and evaluated it as a failure. However, scholars missed out an important point that apart from the central event in Tokyo, each city planned its own event and celebrated it on a different date, also with a different theme. For example, Kyoto showed a regional characteristic and focused on Kyoto’s own culture, tradition etc., and highlighted a further past than 100 years. This was mainly because some areas/cities had a different ‘memory’ for Meiji Restoration than Tokyo which was reflected through the way they celebrated Meiji Centennial. On the other hand, 2023 will be the year of Turkish Republic Centennial. A year which will be marked by national and maybe even international events. Although an official committee has not been announced yet, The 2023 Vision, a list of goals has been released by the Government to coincide with the centenary of the Republic of Turkey in 2023 and there are some ongoing projects that are planned to be completed by then. By looking at the content of these projects, it is possible to say that Government is aiming to focus on Modernization through the Centennial. However, some of the projects are already showing some interesting characteristics such as the Istanbul New Airport whose design is inspired by Selimiye Mosque’s Islamic-Ottoman figure. It is true that Turkey and Japan have different historical backgrounds and the timeline of the Meiji Restoration and Foundation of Turkish Republic are different. Therefore, a particular comparison between these two events is not justified. However, they may have more in common than we are up to think because, each country marked the start of a new nation conceived on modern principles. For that reason, it is important to understand the similarities or differences between Meiji Centennial and Turkish Republic Centennial as a media event. This study introduces Meiji Centennial as a media event and analyses opposition movement along with the meaning of Meiji Centennial. Additionally, it explains regional characteristic differences and gives Kyoto as an example. Moreover, it introduces some of the ongoing Centennial projects in Turkey and analyses the meaning of the Turkish Republic Centennial through these projects. Without comparing Japan and Turkey, it explains the case of Japan but the discussion centers on deepening our understanding of Centennial as a Media Event and remarks some important aspects for Turkey’s upcoming Centennial events.

Keywords: media events, Meiji centennial, the 2023 vision, Turkish republic centennial

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667 Assessing the Usability and Accessibility of Turkey E-Government Websites

Authors: Yakup Akgül, Kemal Vatansever

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E-Government services offer citizens an easy way to accomplish their work anytime and anywhere. Ensuring the accessibility and usability of such services is crucial to citizens to allow smooth online transaction. In this paper, an empirical study to investigate the accessibility and usability of a representative sample of Turkish e-government services presented. The study evaluated sixty one Turkish government websites according to four perspectives.The accessibility will be based on the compliance to WCAG 2.0 recommendations, and the usability will be based on a heuristics-based content, HTML and CSS validity and current use of HTML 5 and ARIA. The evaluation results show that the examined e-Government services have one or more accessibility issues. On the other hand, in terms of usability, most services were usable and well designed, thus little work is recommended to make them more user-friendly and attractive to citizen.

Keywords: accessibility, e-government, usability, Turkey

Procedia PDF Downloads 528
666 Distributed Listening in Intensive Care: Nurses’ Collective Alarm Responses Unravelled through Auditory Spatiotemporal Trajectories

Authors: Michael Sonne Kristensen, Frank Loesche, James Foster, Elif Ozcan, Judy Edworthy

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Auditory alarms play an integral role in intensive care nurses’ daily work. Most medical devices in the intensive care unit (ICU) are designed to produce alarm sounds in order to make nurses aware of immediate or prospective safety risks. The utilisation of sound as a carrier of crucial patient information is highly dependent on nurses’ presence - both physically and mentally. For ICU nurses, especially the ones who work with stationary alarm devices at the patient bed space, it is a challenge to display ‘appropriate’ alarm responses at all times as they have to navigate with great flexibility in a complex work environment. While being primarily responsible for a small number of allocated patients they are often required to engage with other nurses’ patients, relatives, and colleagues at different locations inside and outside the unit. This work explores the social strategies used by a team of nurses to comprehend and react to the information conveyed by the alarms in the ICU. Two main research questions guide the study: To what extent do alarms from a patient bed space reach the relevant responsible nurse by direct auditory exposure? By which means do responsible nurses get informed about their patients’ alarms when not directly exposed to the alarms? A comprehensive video-ethnographic field study was carried out to capture and evaluate alarm-related events in an ICU. The study involved close collaboration with four nurses who wore eye-level cameras and ear-level binaural audio recorders during several work shifts. At all time the entire unit was monitored by multiple video and audio recorders. From a data set of hundreds of hours of recorded material information about the nurses’ location, social interaction, and alarm exposure at any point in time was coded in a multi-channel replay-interface. The data shows that responsible nurses’ direct exposure and awareness of the alarms of their allocated patients vary significantly depending on work load, social relationships, and the location of the patient’s bed space. Distributed listening is deliberately employed by the nursing team as a social strategy to respond adequately to alarms, but the patterns of information flow prompted by alarm-related events are not uniform. Auditory Spatiotemporal Trajectory (AST) is proposed as a methodological label to designate the integration of temporal, spatial and auditory load information. As a mixed-method metrics it provides tangible evidence of how nurses’ individual alarm-related experiences differ from one another and from stationary points in the ICU. Furthermore, it is used to demonstrate how alarm-related information reaches the individual nurse through principles of social and distributed cognition, and how that information relates to the actual alarm event. Thereby it bridges a long-standing gap in the literature on medical alarm utilisation between, on the one hand, initiatives to measure objective data of the medical sound environment without consideration for any human experience, and, on the other hand, initiatives to study subjective experiences of the medical sound environment without detailed evidence of the objective characteristics of the environment.

Keywords: auditory spatiotemporal trajectory, medical alarms, social cognition, video-ethography

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665 Naturalization of Aliens in Consideration of Turkish Constitutional Law: Recent Governmental Practices

Authors: Zeynep Ozkan, Cigdem Serra Uzunpinar

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Citizenship is a legal bond that binds a person to a certain state. How constitutions define ‘the citizen’ and how they regulate the elements of citizenship have great importance in terms of individuals’ duties before the state as well as the rights they own. Especially in multi-segmented societies that contain foreign elements, it becomes necessary to examinate the institution of naturalization in terms of individuals’ duty of constitutional citizenship. The meaning of citizenship in Turkey has transformed due to the changes in practices of naturalization, in parallel to receiving huge amount of immagrants with the recent Syrian Crisis, the change in the governmental system and facing economic crisis. This transformation took place in the way of a diversion from the states’ initial motive of building the bond of citizenship with the aim of founding/sustaining political unity. Hence, rising of the economic and political motives in naturalization practices are in question, instead of objective and subjective criterias, that are traditionally used on defining the notion of nation. In this study, firstly the regime of citizenship and the legal regime of aliens in Turkish legislation will be given place. Then, the transformation, that the notion of constitutional citizenship underwent, will be studied, especially on the basis of governmental practices of naturalization. The assessment will be made in the context of legal institutions brought with the new governmental system as a result of recent constitutional amendment.

Keywords: constitutional citizenship, naturalization, naturalization practices in Turkish legal system, transformation of the notion of constitutional citizenship

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664 A Resolution on Ideal University Teachers Perspective of Turkish Students

Authors: Metin Özkan

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In the last decade, Turkish higher education has been expanded dramatically. With this expansion, Turkey has come a long way in establishing an efficient system of higher education which is moving into a ‘mass’ system with institutions spanning the whole country. This expansion as a quantitative target leads to questioning the quality of higher education services. Especially, the qualities of higher education services depend on mainly quality of educators. Qualities of educators are most important in Turkish higher education system due to rapid rise in the number of universities and students. Therefore, it is seen important that reveals the portrait of ideal university teacher from the point of view student enrolled in Turkish higher education system. The purpose of this current study is to determine the portrait of ideal university teacher according to the views of Turkish Students. This research is carried out with descriptive scanning method and combined and mixed of qualitative and quantitative methodologies. Research data of qualitative section were collected at Gaziantep University with the participation of 45 students enrolled in 15 different faculties. Quantitative section was performed on 217 students. The data were obtained through semi-structured interview and “Ideal University Teacher Assessment” form developed by the researcher. The interview form consists of basically two parts. The first part of the interview was about personal information, the second part included questions about the characteristic of ideal university teacher. The questions which constitute the second part of the interview are; "what is a good university teacher like?” and “What human qualities and professional skills should a university teacher have? ". Assessment form which was created from the qualitative data obtained from interviews was used to attain scaling values for pairwise comparison and ranking judgment. According to study results, it has been found that ideal university teacher characteristics include the features like patient, tolerant, comprehensive and tolerant. Ideal university teacher, besides, implement the teaching methods like encouraging the students’ critical thinking, accepting the students’ recommendations on how to conduct the lesson and making use of the new technologies etc. Motivating and respecting the students, adopting a participative style, adopting a sincere way of manner also constitute the ideal university features relationships with students.

Keywords: faculty, higher education, ideal university teacher, teacher behavior

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663 The Making of a Male: Narrative Analysis of the Protagonist in Cholera District

Authors: Behre O. Ozalp

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Cinema is a reflection of the society, as much as it captures the social codes. These codes are learned within the society; and through movies these practices of the gender order are reproduced as well. One of the best examples engendering these codes is a modern classic of Turkish cinema, Cholera District (1997), originally Ağır Roman in Turkish. It is a coming of age movie of a teenage boy in an old neighborhood of Istanbul, where he learns to be a 'man' through the hegemonic masculinity codes of the society. The corporal and verbal practices that are used in the representation of the male protagonist's portrayal is based on his performativity. This paper, through narrative analysis of the aforementioned movie, reviews how gender and narrative are intertwined within the context of queer theory. The methodology follows the protagonist's object of desire while evaluating his heterosexuality which requires affirmative performances. The framework of the study firstly focuses on the protagonist's own life and his interactions with the males of his kinship. Later, the focus gravitates towards his interactions with the female object of desire while evaluating how this relationship shapes his status in society. Lastly, the study focuses on the relationship between the protagonist and non-relative males of the neighborhood. The journey of a young male becoming a man by copying the other males delivers a clear representation of how heterosexuality is favored in terms of gender order.

Keywords: hegemonic masculinity, performativity, queer theory, Turkish cinema

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662 Tracing the Concept of Equivalence in Translation Theories from the Linguistics Oriented Era to Present

Authors: Fatma Ülkü Kavruk

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The comparison of the old and new approaches reveals that the concept of equivalence has been interpreted and categorized in different ways by different scholars throughout the history. The aim of this study is to trace the concept of equivalence in translation theories from the linguistics-oriented era to present, referring to various translation scholars and to provide a critical evaluation of the nature and applicability of the concept of equivalence in today’s world of translation studies. Within the study, various interpretations of equivalence proposed by international scholars in translation studies are to be presented. In order to find out the reflections of these scholars’ approaches to the Turkish scholars’ research, the interpretations of equivalence by various Turkish scholars are to be examined. At the end of the paper, the applicability of the concept of equivalence in real life is to be discussed in light of these approaches.

Keywords: translation studies, equivalence, translation theories, evaluation

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661 Moderating Effect of Different Social Supports on the Relationship between Workplace Bullying and Intention to Occupation Leave in Nurses

Authors: Chenchieh Chang

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Objectives: This study had two objectives. First, it used affective events theory to investigate the relationship between workplace bullying and the intention to resign in nurses, a topic rarely explored in previous studies. Second, according to the conservation of resource theory, individuals encountering work incidents will utilize resources that are at their disposal to strengthen or weaken the effects of the incidents on them. Such resources include social support that comes from their bosses, colleagues, family, and friends. To answer the question of whether different social supports exert distinct effects on alleviating stress experienced by nurses, this study examined the moderating effects of different social supports on the relationship between workplace bullying and nurses’ intention to resign. Method: This study was approved by an institutional review board (code number: 105070) and adopted purposive sampling to survey 911, full-time nurses. Results: Work-related bullying exerted a significant and positive effect on the intention to resign, whereas bullying pertaining to interpersonal relationships and body-related bullying nonsignificantly affected intention to resign. Support from supervisors enhanced the effect of work-related bullying on an intention to resign, whereas support from colleagues and family did not moderate said effect. Research Limitations/Implications: The self-reporting method and cross-sectional research design adopted in this study might have resulted in common method variance and limited the ability to make causal inferences. This study suggests future studies to obtain measures of predictor and criterion variables from different sources or ensure a temporal, proximal, or psychological separation between predictor and criterion in the collection of data to avoid the common method bias. Practical Implications: First, businesses should establish a friendly work environment and prevent employees from encountering workplace bullying. Second, because social support cannot diminish the effect of workplace bullying on employees’ intention to resign, businesses should offer other means of assistance. For example, business managers may introduce confidential systems for employees to report workplace bullying; or they may establish consultation centers where employees can properly express their thoughts and feelings when encountering workplace bullying.

Keywords: workplace bullying, intention to occupation leave, social supports, nurses

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660 Knowledge, Awareness and Practices Concerning of Breast Cancer among Nursing Students in Sri Lanka

Authors: Vimarshi Sandamali Godigamuwa

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Background: Breast cancer is the leading cause of cancer mortality in women worldwide. Its incidence is increasing and young women affected more than ever. Nursing students are the future nurses who will have the opportunity to encourage and influence women to be aware of breast cancers. Objectives: To determine the level of knowledge, awareness and practices concerning of breast cancer among Sri Lankan student nurses. Methods: A descriptive cross sectional study was conducted on 150 nursing students who are in their 2nd and 3rd year studies by distributing a standard self-administered questionnaire. The completed questionnaire were retrieved, graded and scored. Results: Mean age of the respondents was 24.27; (SD=1.66) years and ranged from 20-30 years. Most of the students were female which was 85%. 32% of nursing students scored below 55% for the questionnaire and only 7.3% had good overall knowledge and awareness of breast cancer. Out of 128 female students 89.9% were answered that they know how to perform Breast Self Examination (BSE), out of which 37% of them performed BSE regularly. Only 33% were aware of recommended age for BSE and 10% were knew the recommended age for mammography. 9.3% were aware of frequency for Clinical Breast Examination on 20-39 years of age group. Of the female participants, 11.7% reported positive family history of breast cancer. Conclusion: Nursing students should explore to health educational programs on regular basis on breast cancer and its screening methods. Further studies are needed to identify reasons for not practicing BSE.

Keywords: breast cancer, student nurses, knowledge, awareness, practice, BSE

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659 Antioxidant Properties, Ascorbic Acid and Total Carotenoids Values of Sweet and Hot Red Pepper Paste: A Traditional Food in Turkish Diet

Authors: Kubra Sayin, Derya Arslan

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Red pepper (Capsicum annum L.) has long been recognized as a good source of antioxidants, being rich in ascorbic acid and other phytochemicals. In Turkish cuisine red pepper is sometimes consumed raw in salads and baked as a garnish, but its most wide consumption type is red pepper paste. The processing of red pepper into pepper paste includes various thermal treatment steps such as heating and pasteurizing. There are reports demonstrating an enhancement or reduction in antioxidant activity of vegetables after thermal treatment. So this study was conducted to investigate the total phenolics, ascorbic acid and total carotenoids as well as free radical scavenging activity of raw red pepper and various red pepper pastes obtainable on the market. The samples were analyzed for radical-scavenging activity (RSA) and total polyphenol (TP) content using 1,1-diphenyl-2-picrylhydrazyl (DPPH) and Folin-Ciocalteu methods, respectively. They were also evaluated for ascorbic acid content (AsA) by HPLC. Total carotenoids content was determined spectrophotometrically. Results suggest that there is no significant (P > 0.05) difference in RSA, TP, AsA and total carotenoids content between various red pepper paste products. However, red pepper paste showed marked differences (P < 0.05) in the RSA, TP and AsA contents compared with raw red pepper. It is concluded that the red pepper paste, that has a wide range of consumption in Turkish cuisine, presents a good dose of phenolic compounds and antioxidant capacity and it should be regarded as a functional food.

Keywords: red pepper paste, antioxidant properties, total carotenoids, total phenolics

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658 Activity-Based Costing of Medical Intensive Care Unit 240

Authors: Suppawan Lertpongpakpoom, Anongnat Boonrat, Kunya BoontummoSuppawan

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This descriptive cost analysis aimed to analyze the unit cost of patients in medical intensive care unit. Purposive sampling was used to select 20 nurses, 6 practical nurses, 5 nurses aid and select samples 30 patients. Data were collected from both primary source (activity and average time of nursing care) and secondary source Z bill of payment and patient record). Instruments were cost recording form, activity observation form, and service recording form. Content validity of all instruments were evaluated by three experts (CVI = 0.87). Descriptive statistics was employed for data analysis. The results of the Activity-Based Costing Analysis showed that total activity cost of 4 service types for the patients was 14,776.92 Bath. The highest cost was nursing record was 5,674.78 Bath, followed direct nursing activity was 5,176.18 Bath, medical treatment was 1,976.6 Bath. The lowest cost was management activity was 1,003.64 Bath per visit. The result suggested that Activity-Base Costing Analysis could be applied to give better understanding of cost structure, enabling better consideration wasted expense and non-value-added activity, and improvement of effective utilization.

Keywords: activity-based costing, medical intensive care, nursing care, cost analysis

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657 Role of the Midwifery Trained Registered Nurse in Postnatal Units at Tertiary Care Hospitals in the Western Province of Sri Lanka: A Postal Survey

Authors: Sunethra Jayathilake, Vathsala Jayasuriya-Illesinghe, Kerstin Samarasinghe, Himani Molligoda, Rasika Perera

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In Sri Lanka, postnatal care in the state hospitals is provided by different professional categories: Midwifery trained registered nurses (MTRNs), Registered Nurses (RNs) who do not have midwifery training, doctors and midwives. Even though four professional categories provide postnatal care to mothers and newborn babies, they are not aware of their own tasks and responsibilities in postnatal care. Particularly MTRN’s role in the postnatal unit is unclear. The current study aimed to identify nurses’ (both MTRN and RNs) perception on MTRN’s tasks and responsibilities in postnatal care. This is a descriptive cross sectional study using postal survey. All nurses who were currently working in postnatal units at five selected tertiary care hospitals in the Western Province at that time were invited to participate in the study. Accordingly, the pre evaluated self-administered questionnaire was sent to 201 nurses (53 MTRNs and 148 RNs) in the study setting. The number of valid return questionnaire was 166; response rate was 83%. Respondents rated the responsibility of four professional categories: MTRN, RN, doctor and midwife whether they are 'primarily responsible', 'responsible in absence' and 'not responsible', for each of 15 postnatal (PN) tasks which were previously identified from focus group discussions with care providers during the first phase of the study. Data were analyzed using SPSS version 20; descriptive statistics were calculated. Out of the 15 PN tasks, 13 were identified as MTRNs’ primary responsibilities by 71%-93% of respondents. The respondents also considered six (6) tasks out of 15 as primary responsibility of both MTRN and RN, seven (7) tasks as primary responsibility of MTRN, RN and doctor and the remaining two (2) tasks were identified as the primary responsibility of MTRN, RN and midwife. All 15 PN tasks overlapped with other professional categories. Overlapping tasks may create role confusion leading to conflicts among professional categories which affect the quality of care they provide, eventually, threaten the safety of the client. It is recommended that an official job description for each care provider is needed to recognize their own professional boundaries for ensuring safe, quality care delivery in Sri Lanka.

Keywords: overlapping, postnatal, responsibilities, tasks

Procedia PDF Downloads 121
656 July 15 Coup Attempt and the Use of New Communication Technologies

Authors: Yasemin Gulsen Yilmaz, Suleyman Hakan Yilmaz, Muhammet Erbay

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The new communication technologies have gradually improved its efficiency in all fields of life and made its presence irreplaceable. These technologies which appear in every aspect of life differently showed itself during the failed coup attempt in Turkey too. The evening of July 15, 2016, have already taken its place in the Turkish political history. In the evening of July 15, Turkish nation confronted to a coup attempted by a group within the Turkish Armed Forces. That evening, the scene of the confrontation between the coup attempters and the resisting civilians were watched minute-by-minute by the people using the new communication technologies. Pro-coup soldiers and the resisting groups that came face to face in the streets of metropolitan cities, made their in-group communications by using new media tools very actively. New media turned into the most important weapon both for coup plotters and for those who resisted. In the morning of next day, whoever used these tools better had the upper hand. The civilians were successful in protecting democracy not only by resisting against tanks and bullets but also by following the internet, organising in social media, sharing information-photos on the net and telling large masses their experiences through these technologies. In this study, we focused on and analysed the use of new media both by coup soldiers and resisting civilians during the failed coup attempt in July 15. Within the scope of this study, coup attempt news that took place in printed media within one week were examined; the information about the use of new media tools during the night of failed coup were compiled; and it was determined how, to what extend and what for these tools were used and how effective they were.

Keywords: communication, July 15, new media, media

Procedia PDF Downloads 210
655 Management Support, Role Ambiguity and Role Ambiguity among Professional Nurses at National Health Insurance Pilot Sites in South Africa: An Interpretive Phenomenology

Authors: Nomcebo N. Mpili, Cynthia Z. Madlabana

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The South African Primary Health Care (PHC) system has undergone a number of transformations such as the introduction of National Health Insurance (NHI) to bring about easily accessible universal health coverage and to meet the health needs for all its citizens. This provides ongoing challenges to ensure that health workers are equipped with appropriate knowledge, support, and skills to meet these changes. Therefore it is crucial to understand the experiences and challenges of nurses as the backbone of PHC in providing quality healthcare services. In addition there has been a need to understand nurses’ experiences with management support, role ambiguity and role conflict amongst other challenges in light of the current reforms in healthcare. Indeed these constructs are notorious for having a detrimental impact on the outcomes of change initiatives within any organisation, this is no different in healthcare. This draws a discussion on professional nurses within the South African health care system especially since they have been labelled as the backbone of PHC, meaning any healthcare backlog falls on them. The study made use of semi-structured interviews and adopted the interpretative phenomenological approach (IPA) as the researcher aimed to explore the lived experiences of (n= 18) participants. The study discovered that professional nurses experienced a lack of management support within PHC facilities and that management mainly played an administrative and disciplinary role. Although participants mainly held positive perceptions with regards to changes happening in health care however they also expressed negative experiences in terms of how change initiatives were introduced resulting in role conflict and role ambiguity. Participants mentioned a shortage of staff, inadequate training as well as a lack of management support as some of the key challenges faced in facilities. This study offers unique findings as participants have not only experienced the various reforms within the PHC system however they have also been part of NHI pilot. The authors are not aware of any other studies published that examine management support, role conflict and role ambiguity together especially in South African PHC facilities. In conclusion understanding these challenges may provide insight and opportunities available to improve the current landscape of PHC not only in South Africa but internationally.

Keywords: management support, professional nurse, role ambiguity, role conflict

Procedia PDF Downloads 115