Organizational factors impacting on patient satisfaction : a cross sectional examination of service climate and linkages to nurses' effort and performance

Background Patient satisfaction is influenced by the setting in which patients are treated and the employees providing care. However, to date, limited research has explained how health care organizations or nurses influence patient satisfaction. Objectives The purpose of this study was to test the model that service climate would increase the effort and performance of nursing groups and, in turn, increase patient satisfaction. Method This study incorporated data from 156 nurses, 28 supervisors, and 171 patients. A cross-sectional design was utilized to examine the relationship between service climate, nurse effort, nurse performance and patient satisfaction. Structural equation modeling was conducted to test the proposed relationships. Results Service climate was associated with the effort that nurses directed towards technical care and extra-role behaviors. In turn, the effort that nurses exerted predicted their performance, as rated by their supervisors. Finally, task performance was a significant predictor of patient satisfaction. Conclusions This study suggests that both hospital management and nurses play a role in promoting patient satisfaction. By focusing on creating a climate for service, health care managers can improve nursing performance and patient satisfaction with care.

The first year experience : looking back to inform the future

The importance of the first year experience (FYE) to success at university has been a focus of attention in the Australian higher education sector since the 1990s. For students a successful transition into university during their first year is now regarded as crucial for student engagement, success and retention. In this review we summarise a decade of research into FYE in the Australasian context. We draw on the findings arising from this comprehensive review of FYE programs and practices to describe FYE trends through the dual lenses of the first year curriculum principles and the generational approach to FYE initiatives. We contend that the generational approach to conceptualising the FYE and first year student engagement has made a useful but limited contribution to our understanding of the first year experience. Acknowledging the criticality of student engagement in a successful FYE, we propose an alternative— the Student Engagement Success and Retention Maturity Model (SESR-MM)— as a sophisticated vehicle for achieving whole-of-institution approaches to the FYE. The SESR-MM embodies the aspirations and characteristics of the transition pedagogy, highlights the need for institutional level evaluation of the FYE, focuses attention on the capacity of institutions to mobilise for first year student engagement, and importantly builds on the generational approach to allow an assessment of institutional capacity to initiate, plan, manage, evaluate and review institutional FYE practices.

Reflexivity and aesthetic inquiry : building dialogues between the arts and literacy

Reflection can form the basis for powerful dialogue between the arts and literacy as we seek interpretive and expressive fluency across modes. Through deep, cumulative reflection we make aspects of our world and experiences more perceivable, and open them up for artistic expression and aesthetic inquiry. Such reflections are also the catalysts for self-awareness and identity building. Theories of reflexivity offer a useful lens with which to understand our relationship with the world and the people, texts and things within it. The reflexive process can prompt us to challenge our understandings and change our representations of self and others through text. This paper offers a discussion of reflexivity and the ways in which it can be expressed and performed in discursive and non-discursive ways to develop literacies through and in the arts.

Triumphs and tribulations in the psychotherapy of schizophrenia : reflections on a pilot study of metacognitive narrative psychotherapy

Schizophrenia results in a profound disruption of one’s capacity to make sense of mental states, coherently narrate self-experiences, and meaningfully relate to others. While current treatment options for people with schizophrenia tend to be symptom-focused, experience in designing and implementing a study focusing on enhancing sense of self demonstrates the feasibility of developing and implementing models of treatment that prioritize the subjective distress and self-experience of people with schizophrenia. There is emerging research evidence, based upon dialogical theory of self, that posits the potential of people with deficits of self to engage in meaningful therapeutic relationships and work toward greater integrity of self and degrees of recovery. The challenge is to translate these ideas into a research methodology that can be successfully applied within therapeutic contexts with people who meet the diagnostic criteria for schizophrenia. Based upon dialogical theory, we developed a principle-based manual for metacognitive narrative psychotherapy: a psychological approach to the treatment of people with schizophrenia, which aims to enhance metacognitive capacity and ability to narrate self-experiences. Five phases of treatment were identified: (1) developing a therapeutic relationship, (2) eliciting narratives, (3) enhancing metacognitive capacity, (4) enriching narratives, and (5) living enriched stories. Proscribed practices were also identified. We then implemented the manual within a university clinic context. Six therapists were trained to implement the model and, in turn, provided therapy to 11 patients who completed 12 to 24 months of treatment. Participants were assessed on metacognitive capacity, narrative coherence, narrative richness, self-reported recovery, and symptomatology at three points in time over the course of therapy. Contrary to expectations, participants were highly engaged in the therapeutic process, with minimal dropout. Overall, over 75% of participants evidenced improvement in their level of recovery over the course of therapy. The manualization and outcome findings demonstrate the feasibility of applying such interventions to a broader clinical population.

The use of multimodal technologies to enhance reflective writing in teacher education

For preservice teachers new to the teaching profession, reflective practice can be a difficult process. Yet reflective writing, once mastered, has the capacity to support preservice teachers to make connections between teaching theory and professional practice, and to start to take control of their own professional learning journey. The reflective practice described in this chapter was scaffolded through a framework for writing, the use of annotated work samples and explicit teaching. This approach was enhanced through multimodal resources including written peer assessment, audio teacher feedback and a video recording of the class presentation. The video footage assisted the preservice teachers to reconcile the feedback that they received from multiple sources. This chapter describes and analyses the implementation of the PRT Pattern (Prompting Reflection using Technology). Results of this practice revealed that the multiple forms of feedback assisted the preservice teachers to analyse their performance in terms of their developing professional identity and practice.

Introduction: Reflective and Reflexive Approaches in Higher Education : A Warrant for Lifelong Learning?

In our complex and incongruous world, where variety produces more variety, and there is no blueprint for dealing with unprecedented change, it is imperative that individuals develop reflexive approaches to life and learning. Higher education has a role to play in guiding students to be self-analysts, with the ability to examine and mediate self and context for improved outcomes. This chapter elucidates the catchphrase of lifelong learning and its enactment in higher education. Theories of reflexivity and personal epistemology are utilised to provide the conceptual tools to understand the ways in which individuals manage competing influences and deliberate about action in their learning journey. The case is made for the integral role of higher education teachers in developing students’ capacities for reflective thinking and reflexive approaches to learning as a life project.

Beyond the hospital door : a retrospective, cohort study of associations between birthing in the public or private sector and women’s postpartum care

Background In Australia, maternity care is available through universal coverage and a parallel, competitive private health insurance system. Differences between sectors in antenatal and intrapartum care and associated outcomes are well documented but few studies have investigated differences in postpartum care following hospital discharge and their impact on maternal satisfaction and confidence. Methods Women who birthed in Queensland, Australia from February to May 2010 were mailed a self-report survey 4 months postpartum. Regression analysis was used to determine associations between sector of birth and postpartum care, and whether postpartum care experiences explained sector differences in postpartum well-being (satisfaction, parenting confidence and feeling depressed). Results Women who birthed in the public sector had higher odds of health professional contact in the first 10 days post-discharge and satisfaction with the amount of postpartum care. After adjusting for demographic and postpartum contact variables, sector of birth no longer had an impact on satisfaction (AOR 0.95, 99% CI 0.78-1.31), but any form of health professional contact did. Women who had a care provider’s 24 hour contact details had higher odds of being satisfied (AOR 3.64, 95% CI 3.00-4.42) and confident (AOR 1.34, 95% CI 1.08- 1.65). Conclusion Women who birthed in the public sector appeared more satisfied because they had higher odds of receiving contact from a health professional within 10 days post-discharge. All women should have an opportunity to speak to and/or see a doctor, midwife or nurse in the first 10 days at home, and the details of a person they can contact 24 hours a day.

Fusion of worlds : consumers’ self-narrative in a hybrid physical/digital world

As the Internet becomes deeply embedded into consumers’ daily life, the digital virtual world brings significant influence to consumers’ self and narrative. Prior studies look at consumer self from either from a certain online space or comparing consumers’ physical and digital virtual selves but not the integration of the physical/digital world. This paper aims to explore the meanings of the digital virtual space on consumers’ narrative as a whole (their interests, dreams, or subjectivity). We utilise a postmodern concept of the cyborg to understand the cultural complexity, subjective meanings of, and the extent to which the digital virtual space plays a role in consumers’ self-narrative. We conducted in-depth interviews and gathered three consumer narratives. Our findings indicate that consumers’ narrative contains important fragments from both physical and digital virtual worlds and their physical and digital virtual selves form a feedback loop that strengthen their overall narrative.

Psychological well-being status among medical and dental students in Makkah, Saudi Arabia: A cross-sectional study

Objectives Medical and dental students experience poor psychological well-being relative to their peers. This study aimed to assess the psychological well-being among medical and dental students in Saudi Arabia, identify the high-risk groups and assess the association between the psychological well-being and the academic performance. Methods In this cross-sectional study, 422 preclinical medical and dental students at Umm Al-Qura University, Saudi Arabia, were recruited to assess their depression, anxiety, stress, self-efficacy and satisfaction with life levels using 21-items Depression Anxiety Stress Scale (DASS-21), General Self-Efficacy (GSE) scale and Satisfaction With Life Scale (SWLS). Students’ academic weighted grades were obtained later. Descriptive statistics and univariate general linear model were used to analyse data. Results High levels of depression (69.9%), anxiety (66.4%) and stress (70.9%) were indicated, whereas self-efficacy (mean = 27.22, sd = 4.85) and life satisfaction (mean = 23.60, sd = 6.37) were within the normal range. Female medical students had higher psychological distress in contrast to dental students. In general, third-year students were more depressed and stressed in comparison with second-year students, except for stress among dental students. Moreover, all females had higher self-efficacy than males. Life satisfaction was higher within the second-year and high family income students. Depression was the only psychological variable correlated with the academic performance. Conclusion High levels of psychological distress were found. Female medical students had higher psychological distress than males, whereas male dental students had higher distress than female. Medical students at third year were more depressed and stressed. Dental students were more depressed in the third year, but more stressed in the second year. Attention should be directed towards reducing the alarming levels of depression, anxiety and stress among medical and dental students.

Using strengths-based approaches in early years practice and research

Strengths-based approaches draw upon frameworks and perspectives from social work and psychology but have not necessarily been consistently defined or well articulated across disciplines. Internationally, there are increasing calls for professionals in early years settings to work in strengths-based ways to support the access and participation of all children and families, especially those with complex needs. The purpose of this paper is to examine a potential promise of innovative uses of strengths-based approaches in early years practice and research in Australia, and to consider implications for application in other national contexts. In this paper, we present three cases (summarised from larger studies) depicting different applications of the Strengths Approach, under pinned by collaborative inquiry at the interface between practice and research. Analysis revealed three key themes across the cases: (i) enactment of strengths-based principles, (ii) the bi-directional and transformational influences of the Strengths Approach (research into practice/practice into research), and (iii) heightened practitioner and researcher awareness of, and responsiveness to, the operation of power. The findings highlight synergies and challenges to constructing and actualising strengths-based approaches in early years childhood research and practice. The case studies demonstrate that although constructions of what constitutes strengths-based research and practice requires ongoing critical engagement, redefining, and operationalising, using strengths-based approaches in early years settings can be generative and worthwhile.

"Unruly women and semiotic spaces": Jay Verney's a mortality tale

Written at a time of significant changes for women and for women writers in Queensland, Australia, Jay Verney's A Mortality Tale (1994), privileges women's experiences of place and seeks to redeem the feminine from its entrapment in masculine stories/discourses of self and place. This chapter draws on Julia Kristeva's conceptualisation of the semiotic as a way of reading Verney's witty and reflective re-articulation of phallocentric orderings of spatiality and gender.

Engaging nursing students in a bioscience unit using a web-based response system, GoSoapBox

Nursing students used GoSoapBox, a web-based student response system to poll responses to multiple choice questions (MCQs) presented during bioscience lectures. Participation in GoSoapBox appears to have facilitated student engagement, interaction and learning. The majority of students surveyed appreciated the immediate feedback to the student responses and being able to participate anonymously. The use of this tool facilitated collaborative group and class discussion and clarification around any misconceptions or challenging concepts. Information collected using GoSoapBox provided the academic with feedback allowing for reflection, adjustment and improvement in framing of formative and summative MCQs.

Engaging nursing students in a bioscience unit using a web-based response system, GoSoapBox

Nursing students used GoSoapBox, a web-based student response system to poll responses to multiple choice questions (MCQs) presented during bioscience lectures. Participation in GoSoapBox appears to have facilitated student engagement, interaction and learning. The majority of students surveyed appreciated the immediate feedback to the student responses and being able to participate anonymously. The use of this tool facilitated collaborative group and class discussion and clarification around any misconceptions or challenging concepts. Information collected using GoSoapBox provided the academic with feedback allowing for reflection, adjustment and improvement in framing of formative and summative MCQs.

Experiences of male patients and wife-caregivers in the first year post-discharge following minor stroke: A descriptive qualitative study

Background Most patients with minor stroke are discharged directly home from acute care, under the assumption that little will be required in the way of adaptation and adjustment because informal caregivers will manage the stroke recovery process. We explored male patients with minor stroke and their wife-caregivers' perceptions of factors affecting quality of life and caregiver strain encountered during the first year post-discharge. Methods Data were obtained from responses to two open-ended questions, part of quality of life and caregiver strain scales administered to participants in a larger descriptive study. Conventional content analysis was used to assess narrative accounts of living with minor stroke provided by 26 male patients and their wife-caregivers over a period of 1-year post-discharge. Results Two major themes that emerged from these data were 'being vulnerable' and 'realization'. Subthemes that arose within the vulnerability theme included changes to patients' masculine image and wife-caregivers' assumption of a hyper-vigilance role. In terms of 'realization' patients and their wife-caregivers shared 'loss' as well as 'changing self and relationships'. Patients in this study focused primarily on their physical recovery and their perceptions of necessary changes. Wife-caregivers were actively involved in managing the day-to-day demands that stroke placed on individual, family and social roles. Conclusions We conclude that patients and wife-caregivers expend considerable time and energy reestablishing control of their lives following minor stroke in an attempt to incorporate changes to self and their relationship into the fabric of their lives.

Implementing a holistic process for embedding sustainability: A case study in first year engineering, Monash University, Australia

While there is clear recognition of the need to incorporate sustainable development into university curricula, there is limited research that examines how to achieve that integration or evaluates its impacts on student learning. This paper responds to these knowledge gaps through a case study of curriculum renewal that involved embedding sustainability into a first year engineering curriculum. The initiative was guided by a deliberative and dynamic model for curriculum renewal that brought together internal and external stakeholders through a structured sequence of facilitated workshops and meetings. That process identified sustainability-related knowledge and skills relevant for first year engineering, and faculty members teaching in the first year program were guided through a process of curriculum renewal to meet those needs. The process through which the whole of curriculum renewal was undertaken is innovative and provides a case study of precedent in the field of education for sustainability. The study demonstrates the contribution that can be made by a web-based sustainability portal in supporting curriculum renewal. Learning and teaching outcomes were evaluated through ‘before and after surveys’ of the first year engineering students. Statistically significant increases in student's self-reported knowledge of sustainability were measured as a result of exposure to the renewed first year curriculum and this confirmed the value of the initiative in terms of enhancing student learning. While applied in this case to engineering, the process to achieve integration of sustainability into the curriculum approach is likely to have value for other academic disciplines. Considering student performance on assignments and exam questions relating to sustainability would provide a stronger basis for future research to understand the impact of initiatives like this on student learning.