Nursing student-patient relationship and associated factors

The purpose of this study was to analyse the nursing student-patient relationship and factors associated with this relationship from the point of view of both students and patients, and to identify factors that predict the type of relationship. The ultimate goal is to improve supervised clinical practicum with a view to supporting students in their reciprocal collaborative relationships with patients, increase their preparedness to meet patients’ health needs, and thus to enhance the quality of patient care. The study was divided into two phases. In the first phase (1999-2005), a literature review concerning the student-patient relationship was conducted (n=104 articles) and semi-structured interviews carried out with nursing students (n=30) and internal medicine patients (n=30). Data analysis was by means of qualitative content analysis and Student-Patient Relationship Scales, which were specially developed for this research. In the second phase (2005-2007), the data were collected by SPR scales among nursing students (n=290) and internal medicine patients (n=242). The data were analysed statistically by SPSS 12.0 software. The results revealed three types of student-patient relationship: a mechanistic relationship focusing on the student’s learning needs; an authoritative relationship focusing on what the student assumes is in the patient’s best interest; and a facilitative relationship focusing on the common good of both student and patient. Students viewed their relationship with patients more often as facilitative and authoritative than mechanistic, while in patients’ assessments the authoritative relationship occurred most frequently and the facilitative relationship least frequently. Furthermore, students’ and patients’ views on their relationships differed significantly. A number of background factors, contextual factors and consequences of the relationship were found to be associated with the type of relationship. In the student data, factors that predicted the type of relationship were age, current year of study and support received in the relationship with patient. The higher the student’s age, the more likely the relationship with the patient was facilitative. Fourth year studies and the support of a person other than a supervisor were significantly associated with an authoritative relationship. Among patients, several factors were found to predict the type of nursing student-patient relationships. Significant factors associated with a facilitative relationship were university-level education, several previous hospitalizations, admission to hospital for a medical problem, experience of caring for an ill family member and patient’s positive perception of atmosphere during collaboration and of student’s personal and professional growth. In patients, positive perceptions of student’s personal and professional attributes and patient’s improved health and a greater commitment to self-care, on the other hand, were significantly associated with an authoritative relationship, whereas positive perceptions of one’s own attributes as a patient were significantly associated with a mechanistic relationship. It is recommended that further research on the student-patient relationship and related factors should focus on questions of content, methodology and education.

Factors Affecting Innovation Adoption in Organizations: The Case of Corporate Website Adoption

Diplomityössä tutkittiin innovaatioiden omaksumista organisaatioissa, ja tarkoituksena oli selvittää tekijät, jotka vaikuttivat omaksumisajankohtaan sekä luokitella yritykset omaksujaryhmiin. Työn empiirinen osuus tarkasteli yritysten internet-kotisivujen omaksumista. Tutkimuksen empiirinen aineisto kerättiin postikyselyn avulla, ja vastausprosentti kyselyssä oli melko hyvä (60%). Aikaisempien tutkimusten pohjalta muodostettiin eri tekijöille mittarit, jotka analyysien perusteella olivat erittäin luotettavia. Regressioanalyysia sovellettiin, kun pyrittiin selvittämään omaksumisajankohtaan vaikuttavia tekijöitä, ja klusterianalyysiä käytettiin apuna omaksujaluokkien muodostamisessa. Omaksujaluokkien väliset erot selvitettiin varianssianalyyseillä. Tutkimuksessa löydettiin kolme omaksumisajankohtaan vaikuttavaa tekijää: (1) innovaation koettu suhteellinen hyöty, (2) yritysjohdon sitoutuminen omaksumisprosessiin, sekä (3) yrityksen strategisten partnereiden määrä. Yritykset luokiteltiin neljään omaksujaluokkaan (innovaattorit, aikaiset omaksujat, aikainen enemmistö ja myöhäinen enemmistö) innovatiivisuuden perusteella. Innovatiivisuutta mitattiin kolmella indikaattorilla, jotka olivat: (1) ajankohta, jolloin yritys tuli tietoiseksi internet-sivuista, (2) ajankohta, jolloin tehtiin omaksumispäätös sekä (3) aika, joka kului internet-sivujen käyttöönottoon. Omaksujaluokkien välillä tunnistettiin lukuisia eroja eri ominaisuuksien suhteen.

Building high technology complete products for the markets of humanitarian organizations and developing countries

Tämä tutkielma käsittelee high-tech kokonaisratkaisun rakentamista kehitysmaiden ja humanitääristen organisaatioiden markkinoille. Tavoitteena on löytää ne komponentit joita case-yritys Mediburner Ltd:n polttouuni tarvitsee rinnalleen. Jotta täydentävien elementtien määritteleminen olisi mahdollista, pitää ensin selvittää keitä ovat asiakkaat, ja mitkä ovat heidän tarpeensa. Tutkimusmetodina käytetään kuvailevaa case-tutkimusta. Empiirinen materiaali kerättiin henkilökohtaisissa- ja puhelinkeskusteluissa. Niihin henkilöihin, joiden tavoittaminen oli aikaeron vuoksi hankalaa, otettiin yhteyttä sähköpostitse. Toinen tietolähde olivat dokumentit. Tutkielmassa käytettiin internetsivuja, sairaalajätehuoltoon liittyvien kansainvälisten konferenssien ja kenttätutkimusten raportteja sekä humanitääristen organisaatioiden suosituksia ja lehdistötiedotteita. Tulokseksi saatiin kymmenen tarvittavaa tukevien elementtien ryhmää: lisälaitteet, astiat jätteen keräilyyn ja tilapäiseen varastointiin, polttoaine, sähkö, logistiset ratkaisut, asennus ja käyttöönotto, huolto- ja korjauspalvelut, koulutus, help-desk –palvelu ja rahoitus. Lisäksi tarvitaan imago, joka konkretisoi tarjotun ratkaisun hyödyt. Yksi toimivan imagotyylin perusta voisi olla vastuullisuus.

Blended learning and student time-use in engineering education

Aiheen laajempi artikkeli on julkaistu konferenssi-CD:llä.

Web 2.0 technology assisted global knowledge network as an organizations key asset

Aim of the Thesis is to study and understand the theoretical concept of Metanational corporation and understand how the Web 2.0 technologies can be used to support the theory. Empiric part of the study compares the theory to the case company’s current situation Goal of theoretical framework is to show how the Web 2.0 technologies can be used in the three levels of the Metanational corporation. In order to do this, knowledge management and more accurately knowledge transferring is studied to understand what is needed from the Web 2.0 technologies in the different functions and operations of the Metanational corporation. Final synthesis of the theoretical framework is to present a model where the Web 2.0 technologies are placed on the levels of the Metanational corporation. Empirical part of the study is based on interviews made in the case company. Aim of the interviews is to understand the current state of the company related to the theoretical framework. Based on the interviews, the differences between the theoretical concept and the case company are presented and studied. Finally the study presents the found problem areas, and where the adoption of the Web 2.0 tools is seen as beneficiary, based on the interviews and theoretical framework.

Buying behavior of public organizations and its influence on export partner governance

Public organizations form a significant part of any economy, yet their buying behavior has received very little attention. Operating with complex public sector is further complicated when sales and marketing activities are done by foreign export partners. This thesis explores the buying behavior of public organizations and how partnership governance is influenced by it. The theoretical part focuses on two subjects. Firstly the strictly regulated purchase process, rigid decision making and other special characteristics of public organizations are examined. Secondly the thesis examines partnership governance forms and how coordination is arranged in the relationships. The empirical part investigates the subjects of public organization buying behavior and partnership governance using a case study of a Finnish SME and their two export partners. The findings suggest high degree of uniformity between public organizations enables the use of unilateral governance forms. By creating mutual dependence through training the possibility of adopting a purely bilateral governance form exists as well.

Use Of Systems Approach with Total Quality Management in Industrial Organizations

The objective of the work has been to study why systems thinking should be used in combination with TQM, what are the main benefits of the integration and how it could best be done. The work analyzes the development of systems thinking and TQM with time and the main differences between them. The work defines prerequisites for adopting a systems approach and the organizational factors which embody the development of an efficient learning organization. The work proposes a model based on combination of an interactive management model and redesign to be used for application of systems approach with TQM in practice. The results of the work indicate that there are clear differences between systems thinking and TQM which justify their combination. Systems approach provides an additional complementary perspective to quality management. TQM is focused on optimizing operations at the operational level while interactive management and redesign of organization are focused on optimization operations at the conceptual level providing a holistic system for value generation. The empirical study demonstrates the applicability of the proposed model in one case study company but its application is tenable and possible also beyond this particular company. System dynamic modeling and other systems based techniques like cognitive mapping are useful methods for increasing understanding and learning about the behavior of systems. The empirical study emphasizes the importance of using a proper early warning system.

Structured software development with the IPIDDDT method - A lean method for small agile organizations

A software development process is a predetermined sequence of steps to create a piece of software. A software development process is used, so that an implementing organization could gain significant benefits. The benefits for software development companies, that can be attributed to software process improvement efforts, are improved predictability in the development effort and improved quality software products. The implementation, maintenance, and management of a software process as well as the software process improvement efforts are expensive. Especially the implementation phase is expensive with a best case scenario of a slow return on investment. Software processes are rare in very small software development companies because of the cost of implementation and an improbable return on investment. This study presents a new method to enable benefits that are usually related to software process improvement to small companies with a low cost. The study presents reasons for the development of the method, a description of the method, and an implementation process for the method, as well as a theoretical case study of a method implementation. The study's focus is on describing the method. The theoretical use case is used to illustrate the theory of the method and the implementation process of the method. The study ends with a few conclusions on the method and on the method's implementation process. The main conclusion is that the method requires further study as well as implementation experiments to asses the value of the method.

Delay reduction in courts of justice – possibilities and challenges of process improvement in professional public organizations

Delays in the justice system have been undermining the functioning and performance of the court system all over the world for decades. Despite the widespread concern about delays, the solutions have not kept up with the growth of the problem. The delay problem existing in the justice courts processes is a good example of the growing need and pressure in professional public organizations to start improving their business process performance.This study analyses the possibilities and challenges of process improvement in professional public organizations. The study is based on experiences gained in two longitudinal action research improvement projects conducted in two separate Finnish law instances; in the Helsinki Court of Appeal and in the Insurance Court. The thesis has two objectives. First objective is to study what kinds of factors in court system operations cause delays and unmanageable backlogs and how to reduce and prevent delays. Based on the lessons learned from the case projects the objective is to give new insights on the critical factors of process improvement conducted in professional public organizations. Four main areas and factors behind the delay problem is identified: 1) goal setting and performance measurement practices, 2) the process control system, 3) production and capacity planning procedures, and 4) process roles and responsibilities. The appropriate improvement solutions include tools to enhance project planning and scheduling and monitoring the agreed time-frames for different phases of the handling process and pending inventory. The study introduces the identified critical factors in different phases of process improvement work carried out in professional public organizations, the ways the critical factors can be incorporated to the different stages of the projects, and discusses the role of external facilitator in assisting process improvement work and in enhancing ownership towards the solutions and improvement. The study highlights the need to concentrate on the critical factors aiming to get the employees to challenge their existing ways of conducting work, analyze their own processes, and create procedures for diffusing the process improvement culture instead of merely concentrating of finding tools, techniques, and solutions appropriate for applications from the manufacturing sector

Animal Lovers, Bridge-Builders, and Supervising Watchdogs: Framing and Civil Society Construction by Japanese Pro-Animal Organizations in the Kansai and Tokyo Areas

Unlike their counterparts in Europe and America, the citizen organizations acting for the well-being of animals in Japan have not received scholarly attention. In this research, I explore the activities of twelve Japanese pro-animal organizations in Tokyo and Kansai area from the perspective of social movement and civil society studies. The concept of a ‘pro-animal organization’ is used to refer generally to the collectives promoting animal well-being. By using the collective action frame analysis and the three core framing tasks – diagnostic, prognostic, and motivational – as the primarily analytical tools, I explore the grievances, tactics, motivational means, constructions of agency and identity as well as framing of civil society articulated in the newsletters and the interviews of the twelve organizations I interviewed in Japan in 2010. As the frame construction is always done in relation to the social and political context, I study how the organizations construct their roles as civil society actors in relation to other actors, such as the state, and the idea of citizen activism. The deficiencies in the animal welfare law and lack of knowledge among the public are identified as the main grievances. The primary tactic to overcome these problems was to educate and inform the citizens and authorities, because most organizations lack the channels to influence politically. The audiences were mostly portrayed as either ignorant bystanders or potential adherents. In order to motivate people to join their cause and to enforce the motivation within the organization, the organizations emphasized their uniqueness, proved their efficiency, claimed credit and celebrated even small improvements. The organizations tended to create three different roles for citizen pro-organizations in civil society: reactive, apolitical and emphatic animal lovers concentrating on saving individual animals, proactive, educative bridge-builders seeking to establish equal collaborative relations with authorities, and corrective, supervising watchdogs demanding change in delinquencies offending animal rights. Based on the results of this research, I suggest that by studying how and why the different relations between civil society and the governing actors of the state are constructed, a more versatile approach to citizens’ activism in its context can be achieved.

Socially Competent Leadership - predictors, impacts and skilling in engineering

Earlier management studies have found a relationship between managerial qualities and subordinate impacts, but the effect of managers‘ social competence on leader perceptions has not been solidly established. To fill the related research gap, the present work embarks on a quantitative empirical effort to identify predictors of successful leadership. In particular, this study investigates relationships between perceived leader behavior and three selfreport instruments used to measure managerial capability: 1) the WOPI Work Personality Inventory, 2) Raven‘s general intelligence scale, and 3) the Emotive Communication Scale (ECS). This work complements previous research by resorting to both self-reports and other-reports: the results acquired from the managerial sample are compared to subordinate perceptions as measured through the ECS other-report and the WOPI360 multi-source appraisal. The quantitative research is comprised of a sample of 8o superiors and 354 subordinates operating in eight Finnish organizations. The strongest predictive value emerged from the ECS self- and other-reports and certain personality dimensions. In contrast, supervisors‘ logical intelligence did not correlate with leadership perceived as socially competent by subordinates. 16 of the superiors rated as most socially competent by their subordinates were selected for case analysis. Their qualitative narratives evidence the role of life history and post-traumatic growth in developing managerial skills. The results contribute to leadership theory in four ways. First, the ECS self-report devised for this research offers a reliable scale for predicting socially competent leader ability. Second, the work identifies dimensions of personality and emotive skills that can be considered predictors of managerial ability and benefited from in leader recruitment and career planning. Third, the Emotive Communication Model delineated on the basis of the empirical data allows for a systematic design and planning of communication and leadership education. Fourth, this workfurthers understanding of personal growth strategies and the role of life history in leader development and training. Finally, this research advances educational leadership by conceptualizing and operationalizing effective managerial communications. The Emotive Communication Model devised directs the pedagogic attention in engineering to assertion, emotional availability and inspiration skills. The proposed methodology addresses classroom management strategies drawing from problem-based learning, student empowerment, collaborative learning, and so-called socially competent teachership founded on teacher immediacy and perceived caring, all constituting strategies moving away from student compliance and teacher modelling. The ultimate educational objective embraces the development of individual engineers and organizational leaders that not only possess traditional analytical and technical expertise and substantive knowledge but are intelligent also creatively, practically, and socially.

Kauppatieteellisestä täydennyskoulutuksesta saatavan osaamisen hyödyntäminen organisaatioiden toiminnassa

Tässä tutkimuksessa selvitetään, kuinka Lappeenrannan teknillisen yliopiston kauppatieteiden täydennyskoulutusohjelman eli KATI-ohjelman opiskelijan osaaminen saadaan osaksi organisaation toimintaa. Lisäksi tutkitaan, kuinka osaaminen saadaan sitoutettua organisaatioon ja kuinka opinnot vaikuttavat työntekijöiden urakehitykseen. Toimeksiantajana on Lappeenrannan teknillisen yliopiston koulutus- ja kehittämiskeskus. Tutkimus on kvalitatiivinen ja tehtiin teemahaastattelun avulla haastattelemalla kahdeksaa KATI-ohjelmassa opiskellutta. Lisäksi haastateltiin kolmea esimiestä tuomaan organisaation näkökulmaa tutkimukseen. Tutkimuksessa saatiin selville, että parhaiten osaaminen saadaan organisaation hyödyksi tarjoamalla koulutusta vastaavia ja haasteellisia töitä sekä mahdollistamalla työntekijän opiskelu työn ohella esimerkiksi koulutusmaksuihin osallistumalla.