FROM ORGANIZATIONAL WELFARE TO BUSINESS SUCCESS: HIGHER PERFORMANCE IN HEALTHY ORGANIZATIONAL ENVIRONMENTS

This e-book provides insight into the link between employee health and productivity/performance, with a focus on how individuals, groups, or organizations can intervene in this relationship to improve both well-being and performance-related outcomes. Given the continuous changes that organizations and employees face, such as the aging workforce and continued economic turbulence, it is not surprising that studies are increasingly finding that employee health is related to job conditions. The papers in this e-book emphasize that organizations make a critical difference when it comes to employees' health and well-being. In turn, healthy employees help their organizations to flourish. Such findings are in line with the recent emphasis by both the International Labour Organization (ILO) and the United Nations (UN) on the importance of work for individual well-being and the importance of individual well-being for productive and sustainable economic growth (see e.g., ILO, 1985; World Health Organisation, 2007; UN, 2015). Overall, the papers report findings from a cumulative sample of nearly 19,000 workers and perspectives from 68 authors. They suggest that performance cannot be successfully achieved at the cost of health and well-being, and provide various perspectives and tools to guide future research and practice

A programme to facilitate quality client-centred care in Primary Health Care clinics of the rural West Coast District

Philosophiae Doctor - PhDIntroduction: The overall aim of this study was to develop a programme to facilitate quality client-centred care in Primary Health Care clinics of the rural West Coast District. Research design and -method: Both quantitative and qualitative methods were applied for this study . Phase 1, a situational analysis collected and analysed quantitative data from the perspective of clients and clinical nurse practitioners via structured questionnaires. The population included all clients 18 years and older (N=137 991) of the fixed clinics (N=25) in the five subdistricts of the West Coast District. According to the Cochran formula a sample of (n=383) should be adequate to represent the population. Non-proportional sampling was applied to estimate the number of participants per clinic. An all-inclusive sample of (n=64) clinical nurse practitioners participated in the study. Phase 2, the qualitative part of the situational analysis, applied five focus group discussions to explore and describe the managers and allied health professionals’ perceptions about quality client-centred care. A semi-structured interview schedule was compiled to guide the focus group discussions. An all-inclusive sample was utilised to include all the managers and allied health professionals of the five subdistricts (N=43). Phase 3 included the development of the programme based on the study findings and literature. Quantitative results: The analysis revealed the following quality client-centred care challenges, namely: Patient Rights (Domain 1) were not always respected and adhered to as these were characterised by: language (statistical p<0.001 and practical significant with a large effect size d=0.74); Satisfaction and Safety (statistical p<0.001 and practical significant with a medium effect size d=0.55); Referral Procedures (statistical significant p<0.001); Waiting Times (statistical p<0.001 and practical significant with a medium effect size d=0.47) and Confidentiality difficulties (statistical p<0.001 and practical significant with a medium effect size d=0.68). The Domain 2, Clinical Governance, Care and Safety showed shortcomings as highlighted by the Client and his/her Family (statistical p<0.001 and practical significant with a large effect size d=0.77). Clinical Support Services, Domain 3, revealed inadequacies regarding the continuous availability of medication (statistical significant p<0.008) and the reporting of side-effects (statistical significant p<0.001). Furthermore, Public Health Domain 4, showed that clients identified community health promotion and disease prevention events (statistical p<0.01 and practical significant with a large effect size d=0.79), and home visits by the community healthcare workers (statistical p<0.001 and practical significant with a large effect size d=1.09) as both a “problem” and a “gap”. Leadership and Corporate Governance, Domain 5 was characterised by the lack of: visible organograms (clients mean 2.40), community communication (clients mean 2.12 & clinical nurse practitioners mean 2.36), visibility of goals, values and future plans of the Western Cape Department of Health (statistical p<0.001 and practical significant with a medium effect size d=0.59) and role and function of the clinic committees (statistical significant p<0.008). Moreover, Domain 6, Operational Management was challenged by inadequate staffing levels (statistical significant p<0.003). Lastly, Domain 7: Infrastructure was characterised by the lack of drinking water in the waiting areas (clients mean 2.08 & clinical nurse practitioners mean 2.02), inadequate clinic space (clients mean 2.10 & clinical nurse practitioners 2.23); maintenance not up-to-date (statistical significant p<0.002); physical appearance of the clinic (statistically significant p<0.001) did not have a positive effect on staff morale and evacuation plans (statistical p<0.001 and practical significant with a medium effect size d=0.54) were not visible. In addition, correlations between the domains showed that the domains are not in silos, but are interdependent on another. Qualitative results The qualitative, thematic data analysis revealed various inadequacies regarding quality client-centred care. Theme One about the Patient Rights revealed that patients were not always treated with the necessary respect and dignity. Theme Two concerning Patient Care, revealed that focus group participants were well-informed on what the concept client-centred care entailed. However, patients and or clients did not always experience their care as client-centred. Theme Three about the Clinical Support Services, indicated shortages of medication and medical equipment; long waiting time for specialists and rehabilitation referral appointments. Theme Four, referring to the Public Health confirmed that health promotion and prevention activities are limited, due to various organizational factors and community healthcare workers’ activities which are limited to home-based care activities. Theme Five, Corporate Governance and Leadership matters were characterised by too many processes or “red tape” resulting in inefficient procurement processes, inadequate staffing and inactive health committees. Theme Six, Operational Management highlighted the severe pressure under which the operational managers have to work, resulting from their twofold role of being the clinic manager and at the same time operate as a clinical nurse practitioner. Theme Seven refers to Infrastructure and Facilities and is characterised by inadequate maintenance and lack of space according to the number of clients and package of care. To summarise: The situational analysis revealed 81 problems. These problems form the evidence base for the development of the programme to facilitate quality client-centred care in primary helth care clinics of the rural West Coast District

The hidden truth: A sociological history of lie detection.

Drawing on Foucault and the sociology of science and technology, this thesis traces the curious attempt that has been made over the last century to capture one of the most elusive social acts - the lie. This endeavour was made possible by the emergence of the human sciences, whose guiding belief was that the subject's inner life could be made apparent by means of physiological measurements and therefore be controlled. My thesis follows the development of the 'embodiment' of the lie within early and recent psychology as a means of detecting the subject's guilt. It examines the disconnection of lie detection from its academic origins and its re-positioning within criminal investigation which engenders the development of polygraphy as a separate profession. In this, it elaborates on the special roles played by instruments in lie detection practices - the 'lie detector' and the 'polygraph' - and analyses changing epistemological aims and models of 'scientific' expertise. In accounting for its contested status, the latter analysis is connected to an evaluation of the continuous exclusion of lie detection as scientific evidence from the courts. The thesis examines the changing functions of the polygraph examination in systems of social control as their logic moves from reform to increased containment and control: from a confessional technique mediating the efficient processing of a delinquent population from the 1920s, to a disciplinary technique controlling employee behaviour from the 1930s. In recent years it has become a 'truth facilitator' in the management and containment of the monstrous individual: the sex offender. In a broader consideration of the power/knowledge mechanism of lie detection, the thesis applies Foucault's notion of grotesque knowledge, arguing that the ensemble of the lie detector/polygraph and psychological expert/interrogator is Ubuesque as it implements an absolute power in the 'diagnosis' of the lie, which is disqualified at the moment of its verification through confession. The thesis demonstrates how Foucauldian analyses and the sociology of science can be fruitfully combined to comprehensively explain both the dynamics of contested expert knowledges and the ways in which psychological techniques operate in shaping the subject. Having traced the emergence of the lie as an object of knowledge and intervention, the thesis concludes by providing directions in an historically informed sociology of the lie