Arbeidsplassen som læringsarena : en kvalitativ studie av 5 sykehjem i Kristiansand kommune

Denne masteroppgaven har vært gjennomført som en del av studiet ” Erfaringsbasert Master i ledelse, med spesialisering innen personalledelse og kompetanseutvikling” på Universitet i Agder høsten 2008. Temaet vi har valgt er læring blant ansatte på sykehjemmene i Kristiansand kommune og bygger på to tidligere prosjekter vi har gjennomført i løpet av studiet. Dette er et aktuelt tema for sykehjemmene i dag både i forhold til å tilfredsstille dagens kvalitetskrav til tjenestene og ikke minst for å være rustet mot kommende utfordringer i omsorgstjenesten. I oppgaven har vi belyst sentrale forhold knyttet til følgende problemstilling; ”Hvordan utnyttes læringsrommets elastisitet lokalt på sykehjemmene i Kristiansand kommune?” For å kunne gi svar på denne problemstillingen har vi valgt en kvalitativ og deduktiv tilnærming. Metodene som ble benyttet for datainnsamling er dokumentanalyse og individuelle delvis strukturerte intervjuer. Hovedtyngden av funn i undersøkelsen fikk vi gjennom intervju av enhetsledere og avdelingsledere ved fem sykehjem i kommunen og ved intervju av representanter fra staben i Helse- og sosialsektoren. Vi har også benyttet oss av enkelte resultater fra de to tidligere prosjektene som før nevnt. Det teoretiske fundamentet for oppgaven er basert på modellen ”læring i arbeidslivet ” som er utarbeidet av Illeris. Modellen består av tre dynamiske hovedprosesser eller samspill linjer. Den ene prosessen er den sentrale samspillprosessen mellom individuelt og sosialt nivå, den andre prosessen er den individuelle tilegnelsesprosessen, mens den tredje prosessen er samspillet mellom det teknisk - organisatoriske og sosialt - kulturelle læringsmiljø. Elementene i denne modellen ble utgangspunkt for både valg av relevant teori, utarbeidelse av intervjuguide og drøfting av funnene i undersøkelsen. Basert på våre resultater ser vi at sykehjemmene som arbeidsplass er den viktigste læringsarena for de ansatte, både gjennom utføring av daglige oppgaver sammen med andre i praksisfellesskap og gjennom andre mer formelle interne læringstiltak. Videre ser vi at læringsrommet formes og utnyttes forskjellig fra sykehjem til sykehjem. Dette til tross for at sykehjemmene har de samme utfordringene både med hensyn til stramme økonomiske rammer og døgnkontinuerlig drift med høyt arbeidstempo og intensitet. Vi konkluderer med at dette henger hovedsakelig sammen med ledelsens holdning og evne til å utnytte læringsrommets elastiske vegger. Ved å se og utnytte mulighetene og samspillet mellom læringsrommets uformelle og formelle sider og medarbeidernes læringsforløp, kan forholdene legges godt til rette for å få til gode læringssituasjoner på arbeidsplassen. Vi konkluderer videre med at det potensialet sykehjemmene har som læringsarena, kan utnyttes bedre enn det gjøres i dag. Dette kan gjøres både med interne grep, men også ved at Helse- og sosialsektoren i kommunen i større grad bidrar til å fremme interne læringstiltak gjennom økte midler, bedre koordinering og erfaringsutveksling mellom sykehjemmene og ikke minst utvikle og støtte ledere som har vilje og evne til å utnytte elastikken i læringsrommet

Hardiness and optimism in women with breast cancer

Background: Hardiness and optimism are two general health promoting factors, which enable the individuals to remain both psychologically and physically healthy despite encountering negative life events. But there is lack of knowledge about the current state of these constructs and their relationship in breast cancer patients in an Iranian context. Materials and Methods: This was a descriptive study which was completed in Sayyed-AL-Shohda Hospital affiliated to Isfahan University of Medical Sciences, Iran, in 2015. Two hundred and ten women with breast cancer were conveniently selected to complete the personal/demographic/illness questionnaire, Hardiness Scale, and Life Orientation Test. Data were analyzed by t-test, analysis of variance, and Pearson correlation with a significance level of p < 0.05. Results: The mean (SD) age and duration of illness were 46.73 (10.12) years and 29.48 (19.70) months, respectively. Most patients were married (86.23%), without university education (92.61%) and unemployed (85.69%). Most patients received chemotherapy as their main treatment (39.43%). Also, 61.42 and 58.10% of patients had high hardiness and optimism, respectively. There was a significant positive correlation between the score of hardiness and optimism (r = 0.22, p ≤ 0.01). Conclusions: The results showed that most of the breast cancer patients had moderate to high hardiness and optimism, so healthcare providers can use these personality properties in their care planning to improve coping strategies. Also, the findings of this study can assist healthcare team in order to pay more attention to coping strategies in cancer patients during their treatment and also considering the relationship of these issues in their evaluations

Evaluating and prioritizing the healthcare waste disposal center locations using a hybrid multi-criteria decision-making method

Abstract Healthcare waste disposal center location (HCWDCL) impacts the environment and the health of living beings. Different and sometimes contradictory criteria in determining the appropriate site location for disposing of healthcare waste (HCW) complicate the decision-making process. This research presents a hybrid multi-criteria decision-making (MCDM) method, named PROMSIS, to determine the appropriate HCWDCL in a real case. The PROMSIS is the combination of two well-known MCDM methods, namely TOPSIS and PROMETHEE. Moreover, fuzzy theory is used to describe the uncertainties of the problem parameters. To provide a reliable decision on selecting the best HCWDCL, a comprehensive list of criteria is identified through a literature review and experts’ opinions obtained from the case study. In total, 40 criteria are identified and classified into five major criteria, namely economic, environmental, social, technical, and geological. The weight of the considered criteria is determined by the Analytical Hierarchy Process (AHP) method. Then, the score of the alternative HCWDCLs in each considered criterion is obtained. Finally, the candidate locations for disposing of HCWs are ranked by the proposed fuzzy PROMSIS method. The results show that the most important criteria in ranking the alternatives in the studied case are economic, environmental, and social, respectively. Moreover, the sub-criteria of operating cost, transportation cost, and pollution are identified as the most important sub-criteria, respectively

Investigation of eating disorders in cancer patients and its relevance with body image

Background: Eating disorder is one of the most common health problems with clinical and psychological consequences, which can affect body image in cancer patients. Similar studies in this area for checking the status of this disorder and its relevance with body image in patients with cancer are limited. Therefore, this study was designed with the aim of determination of eating disorders in patients with cancer and their relevance with body image. Materials and Methods: The research was a cross-correlation study. It was carried out in Sayed-Al-Shohada Hospital affiliated to the Isfahan University of Medical Sciences in 2013. Two hundred and ten patients with cancer were selected and were asked tocomplete the demographic and disease characteristics questionnaire, the Multidimensional Body-Self Relations Questionnaire (MBSRQ), and eating disorders questionnaire. SPSS statistical software, version 14 was used for statistical analysis′-Test, analysis of variance (ANOVA), and Pearson correlation coefficient were used for analyzing the obtained data. Results: The mean values of age, body mass index (BMI), and duration of illness were 48.2 ± 13.20 years, 24.6 ± 4.6kg/m 2 , and 25.64 ± 21.24months, respectively. Most patients were married (87%), without university education (96%), unemployed (67%), and with incomes below their requirement (52%). Most patients were diagnosed with breast cancer (36.5%). They received chemotherapy as the main treatment (56.2%). In addition, mean ± SD of eating disorders and body image were 12.84 ± 4.7 and184.40 ± 43.68, respectively. Also, 49.7% of patients with cancer had an eating disorder. Among these, 29% had experiences of anorexia and 20.7% had bulimia. There was a significant negative correlation between the score of body image and eating disorders (r = −0.47, P = 0.01). Conclusions: Findings of this study showed that most patients with cancer had experienced symptoms of eating disorders. This may lead to a negative impact on the body image in these patients and may be the cause of further psychological and physical changes in these patients. The findings of this study can assist the healthcare team to pay more attention to eating disorders and body image in patients with cancer and also in considering the relationship of these issues in their evaluations

Prevalence of diabetes in women with preeclampsia referred to Imam Hossein and Fatemieh Hospitals in Shahroud

Introduction and objective: Preeclampsia, characterised by hypertension and proteinuria occurring after 20 gestational weeks, is a leading cause of maternal and foetal morbidity and mortality . The pathophysiology of preeclampsia remains elusive, and &nbsp;the incidence of diabetes during pregnancy in patients with preeclampsia is still a mather of study. Therefore, the objective of this study was to investigate the prevalence of diabetes in women with preeclampsia referred to Imam Hossein and Fatemieh hospitals in Shahroud. Methodology: This descriptive cross-sectional study was conducted on 108 women with preeclampsia (based on clinical symptoms, gynecological tests, and diagnoses) referred to Fatemieh and Imam Hossein hospitals in Shahroud for delivery or termination of pregnancy in 2014. A questionnaire, which included demographic information such as age, number of pregnancies, birth rank, pregnancy conditions, type of delivery, history of hypertension and diabetes in the patient and their first-degree relatives, was used in this study. Data were expressed as percentage, frequency, standard deviation, mean, and were analyzed by Student's t test and chi-square, using SPSS software. A value of p&lt;0.05 was considered significant. Results: The incidence of preeclampsia was associated with maternal diabetes (p&le;0.05), maternal age (p&le;0.04), birth rank (p&le;0.04), multiple pregnancies (p&le;0.03), history of maternal diabetes, history of maternal hypertension (p&le;0.03), history of preeclampsia at previous delivery (p&lt;0.02) and age of termination of pregnancy (p&le;0.01). There was no significant difference with regard to other variables. Conclusion: The results revealed that about 25% of preeclampsia patients had gestational diabetes, which increased the risk in pregnant women and neonates. Therefore, by preventing and controlling blood pressure and diabetes, we can reduce the maternal and fetal complications of these disorders, and thus, reduce the rate of mortality