Evaluating the effect of a patient education brochure on patients’ expectations and satisfaction with emergency department service

Introduction: The purpose of this study was to assess the capacity of a written intervention, in this case a patient information brochure, to improve patient satisfaction during an Emergency Department (ED) visit. For the purpose of measuring the effect of the intervention the ED journey was conceptualised as a series of distinct areas of service comprising waiting time, service by the triage nurse, care from doctors and nurses and information giving Background of study: Research into patient satisfaction has become a widespread activity endorsed by both governments and hospital administrations. The literature on ED patient satisfaction has consistently indicated three primary areas of patient dissatisfaction: waiting time, nursing care and communication. Recent developments in the literature on patient satisfaction studies however have highlighted the relationship between patients. expectations of a service encounter and their consequent assessment of the experience as dissatisfying or satisfying. Disconfirmation theory posits that the degree to which expectations are confirmed will affect subsequent levels of satisfaction. The conceptual framework utilised in this study is Coye.s (2004) model of disconfirmation. Coye while reiterating satisfaction is a consequence of the degree expectations are either confirmed or disconfirmed also posits that expectations can be modified by interventions. Coye.s work conceptualises these interventions as intra encounter experiences (cues) which function to adjust expectations. Coye suggests some cues are unintended and may have a negative impact which also reinforces the value of planned cues intended to meet or exceed consumer expectations. Consequently the brochure can be characterized as a potentially positive cue, encouraging the patient to understand processes and to orient them in what can be a confronting environment. Only a limited number of studies have examined the effect of written interventions within an ED. No studies could be located which have tested the effect of ED interventions using a conceptual framework which relates the effect of the degree to which expectations are confirmed or disconfirmed in terms of satisfaction with services. Method: Two studies were conducted. Study One used qualitative methods to explore patients. expectations of the ED from the perspective of both patients and health care professionals. Study One was used in part to direct the development of the intervention (brochure) in Study Two. The brochure was an intervention designed to modify patients. expectations thus increasing their satisfaction with the provision of ED service. As there was no existing tools to measure ED patients. expectations and satisfaction a new tool was also developed based on the findings and the literature of Study One. Study Two used a non-randomised, quasi-experimental approach using a non-equivalent post-test only comparison group design used to investigate the effect of the patient education brochure (Stommel and Wills, 2004). The brochure was disseminated to one of two study groups (the intervention group). The effect of the brochure was assessed by comparing the data obtained from both the intervention and control group. These two groups consisted of 150 participants each. It was expected that any differences in the relevant domains selected for examination would indicate the effect of the brochure both on expectation and potentially satisfaction. Results: Study One revealed several areas of common ground between patients and nurses in terms of relevant content for the written intervention, including the need for information on the triage system and waiting times. Areas of difference were also found with patients emphasizing communication issues, whereas focus group members expressed concern that patients were often unable to assimilate verbal information. The findings suggested the potential utility of written material to reinforce verbal communication particularly in terms of the triage process and other ED protocols. This material was synthesized within the final version of the written intervention. Overall the results of Study Two indicated no significant differences between the two groups. The intervention group did indicate a significant number of participants who viewed the brochure of having changed their expectations. The effect of the brochure may have been obscured by a lack of parity between the two groups as the control group presented with statistically significantly higher levels of acuity and experienced significantly shorter waiting times. In terms of disconfirmation theory this would suggest expectations that had been met or exceeded. The results confirmed the correlation of expectations with satisfaction. Several domains also indicated age as a significant predictor with older patients tending to score higher satisfaction results. Other significant predictors of satisfaction established were waiting time and care from nurses, reinforcing the combination of efficient service and positive interpersonal experiences as being valued by patients. Conclusions: Information presented in written form appears to benefit a significant number of ED users in terms of orientation and explaining systems and procedures. The degree to which these effects may interact with other dimensions of satisfaction however is likely to be limited. Waiting time and interpersonal behaviours from staff also provide influential cues in determining satisfaction. Written material is likely to be one element in a series of coordinated strategies to improve patient satisfaction during periods of peak demand.

Aggression in Sexually Abused Trafficked Girls and Efficacy of Intervention

The broad objective of this study was to understand the incidence and severity of aggression among sexually abused girls who were trafficked and who were then further used for commercial sexual exploitation (referred to subsequently as sexually abused trafficked girls). In addition, the impact of counseling for minimizing aggression in these girls was investigated. A group of 120 sexually abused trafficked Indian girls and a group of 120 nonsexually abused Indian girls, aged 13 to 18, participated in the study. The sexually abused trafficked girls were purposively selected from four shelters located in and around Kolkata, India. The nonsexually abused girls were selected randomly from four schools situated near the shelters, and these girls were matched by age with the sexually abused trafficked girls. Data were collected using a Background Information Schedule and a standardized psychological test, that is, The Aggression Scale. Results revealed that 16.7% of the girls were first sexually abused between 6 and 9 years of age, 37.5% between 10 and 13 years of age, and 45.8% between 14 and 17 years of age. Findings further revealed that 4.2% of the sexually abused trafficked girls demonstrated saturated aggression, and 26.7% were highly aggressive, that is, extremely frustrated and rebellious. Across age groups, the sexually abused trafficked girls suffered from more aggression (p < .05), compared with the nonvictimized girls. Psychological interventions, such as individual and group counseling, were found to have a positive impact on the sexually abused trafficked girls. These findings should motivate counselors to deal with sexually abused children. It is also hoped that authorities in welfare homes will understand the importance of counseling for sexually abused trafficked children, and will appoint more counselors for this purpose.

Understanding the optimal learning environment in palliative care

The learning experiences of student nurses undertaking clinical placement are reported widely, however little is known about the learning experiences of health professionals undertaking continuing professional development (CPD) in a clinical setting, especially in palliative care. The aim of this study, which was conducted as part of the national evaluation of a professional development program involving clinical attachments with palliative care services (The Program of Experience in the Palliative Approach [PEPA]), was to explore factors influencing the learning experiences of participants over time. Thirteen semi-structured, one-to-one telephone interviews were conducted with five participants throughout their PEPA experience. The analysis was informed by the traditions of adult, social and psychological learning theories and relevant literature. The participants' learning was enhanced by engaging interactively with host site staff and patients, and by the validation of their personal and professional life experiences together with the reciprocation of their knowledge with host site staff. Self-directed learning strategies maximised the participants' learning outcomes. Inclusion in team activities aided the participants to feel accepted within the host site. Personal interactions with host site staff and patients shaped this social/cultural environment of the host site. Optimal learning was promoted when participants were actively engaged, felt accepted and supported by, and experienced positive interpersonal interactions with, the host site staff.

The utilisation of skilled immigrants and skilled Refugees in countries of destination

about 82 million immigrants in the OECD area; and worldwide, there are about 191 million immigrants and displaced persons, and some 30-40 million unauthorised immigrants. Also according to recent OECD report, little in-depth research has been carried out to-date to help decision makers in government, business, and society at large, to better understand the complexities and wider consequences of future migration flows. Literatures have also indicated that the lack of a skilled population in muchneeded occupations in countries of destination have contributed to the need to bring in skilled foreign workers. Furthermore, despite current global financial crisis, some areas of occupation are in need of skilled workers such that in a job-scarce environment jobs become fewer and employers are more likely to demand skilled workers from both natives and immigrants. Global competition for labour is expected to intensify, especially for top talent, highly qualified and semi-skilled individuals. This exacerbate the problems faced by current skilled immigrants and skilled refugees, particularly those from non-main English speaking countries who are not employed at optimal skill level in countries of destination. The research study investigates whether skilled immigrants are being effectively utilised in their countries of destination, in the context of employment. In addition to skilled immigrants, data sampling will also include skilled refugees who, although arriving under the humanitarian program, possess formal qualifications from their country of origin. Underlying variables will be explored such as the strength of social capital or interpersonal ties; and human capital in terms of educational attainment and proficiency in the English Language. The aim of the study is to explain the relationship between the variables; and whether the variables influence the employment outcomes. A broad-ranging preliminary literature review has been undertaken to explore the substantial bodies of knowledge on skilled immigrants worldwide, including skilled refugees; and to investigate whether the utilisation issues are universal or specific to a country. In addition, preliminary empirical research and analysis has been undertaken, to set the research focus and to identify the problems beyond literature. Preliminary findings have indicated that immigrants and refugees from non-main English speaking countries are particularly impacted by employment issues regardless of their skills and qualifications acquired in their country of origins; compared with immigrants from main-English speaking countries. Preliminary findings from the literature review also indicate that gaps in knowledge still exist. Although the past two decades have witnessed a virtual explosion of theory and research on international migration, no in-depth research has been located that specifically links immigrants and refugees social and human capitals in terms of employment outcomes. This research study aims to fill these gaps in research; and subsequently contribute to contemporary body of knowledge in literatures on the utilisation of skilled immigrants and skilled refugees, specifically those from non-main English speaking countries. A mixed methods design will be used, which incorporates techniques from both quantitative and qualitative research traditions that will be triangulated at the end of the data collection stage.

Reverse immigration

This book (256 pages, written in Korean) is a critical essay that reviews, questions, and criticises Korean and Eastern immigrants’ thinking and behaviour styles in Australia from their cultural perspectives, and discuss and proposes a creative cultural dimension for their better life in a multicultural context. Multiculturalism is not supportive of Eastern cultures because of individualistic collection of cultures, while transculturalism facilitates nurture of their culture in a community-oriented way within multicultural circumstances. Korean and Eastern immigrants, sharing oriental cultural systems and values, should approach to the Australian multicultural context with transculturalism which allows creating new cultural values in collaboration with and by participation into local communities. ------------------------------------------------------------ Many Eastern immigrants live in their own ethnic communities without or less interacting with Australian (communities). The author defines this phenomenon as “reverse immigration”. Reverse immigration refers to re-immigrating to their ethnic community in Australia or to their birth country despite they did not anticipate that this would happen to them before immigration to Australia. The author argues that Easterners’ collectivistic culture often devalues individuality and vice versa. Cultural clash between West and East often forces the immigrants to choose reverse immigration because of their lack of understanding of Western culture and their cultural characteristics such as low individuality, high power distance, and high uncertainty avoidance. For example, a vague boundary between individualist and collectivist in a collectivistic context (within their ethnic group) often leads to maladjustment to local communities and enhancement of cultural conservatism. The author proposes that the cultural clash can be overcome by cross-cultural activities named “transculturalism”. To Eastern immigrants, transculturalism can be achieved by acculturation of their two predominant cultures, the third-person perspective and generalised others. In a multicultural context, the former refers to the ability to share another person's feelings and emotions as if they were your own, and the latter does the ability to manage community and public expectations. When both cultural values are used for quality interactions between East and West, they allow Eastern immigrants to be more creative and critical and Australian to be more socially inclusive and culturally tolerant. With these discussions, the author discusses cultural differences throughout the book with four topics (chapters) and proposes transculturalism as a solution to the reverse immigration. ------------------------------------------------------------ Chapter 1 criticises Koreans’ attitudes and methods towards learning English that is less pragmatic and practical, but more likely to be a scholarly study. The author explains that Koreans’ non-pragmatic towards learning English has been firmly built based on their traditional systems and values that Koreans view English as a discipline and an aim of academic achievements rather than a means of communication. Within their cultural context, English can be perceived as more than a language, but something like vastly superior to their language and culture. Their collectivistic culture regards English as an unreachable and heterogeneous one that may threaten their cultural identity, so that “scholarly studying” is only the way to achieve (not learn) it. This discourages the immigrants to engage and involve in daily dialogues by “using” English as a second language. The author further advises the readers to be aware of Eastern collectivistic culture in communication and interaction that sometimes completely reverses private and public topics in a Western context. This leads them to feel that they have no content to talk to natives. ------------------------------------------------------------ Chapter 2 compares between Korea and Australia in terms of their educational systems and values, and proposes how Eastern overseas students can achieve critical and creative thinking within a Western educational setting. Interestingly, this chapter includes an explanation of why Eastern overseas students easily fail assessments including essay writing, oral presentations and discussions. One of the reasons the author explains is that Eastern students are not familiar to criticise others and think creatively, especially when they recognise that their words and ideas may harm the collectivistic harmony. Western educational systems focuses on enhancement of individuality such as self-confidence, self-esteem, and self-expression, while Eastern educational systems foster group-oriented values such as interpersonal relationship, and strong moral and spiritual values. Yet, the author argues that the collectivistic approach to criticism and creativity is often more critical and creative than Western individuals when they know what they are supposed to do for a group (or a community). Therefore, Eastern students need to think their cultural merits and demerits by using an individual perspective rather than generalised others’ perspective. The latter often discourages individual participation in a community, and the generalised others in a Western culture is weaker than Eastern. Furthermore, Western educational systems do not educate students to transform (loose) their individuality to fit into a group or a community. Rather they cultivate individuality for community prosperity. ------------------------------------------------------------ Chapter 3 introduces various cases of reverse immigration in workplaces that many immigrants return to their country or their ethnic community after many trials for acculturation. Reverse immigration is unexpected and not planned before immigration, so that its emotional embarrassment increases such severe social loneliness. Most Eastern immigrant workers have tried to adjust themselves in this new cultural environment at the early stages of immigration. However, their cultural features of collectivism, high power distance, high uncertainty avoidance, and long-term oriented cultures suppress individual initiative and eliminate the space for experiments in ways of acculturation. The author argues that returning to their ethnic community (physically and psychologically) leads to two significant problems: their distorted parenting and becoming more conservatives. The former leads the first generation of immigrants to pressure their children to pursue extrinsic or materialist values, such as financial success, fame and physical appearance, rather than on intrinsic values, while the latter refers to their isolated conservative characters because of their remoteness from the changes of their own country. The author also warns that their ethnic and religious groups actively strengthens immigrants’ social loneliness and systematically discourages immigrants’ interests and desire to be involving into local communities. The ethnic communities and leaders have not been interacting with Australian local communities and, as a result, are eager to conserve outdated cultural systems values. Even they have a tendency to weed out those people who wish to settle down within Australian local communities. They believe that those people can threaten their community’s survival and continuity. ------------------------------------------------------------ Chapter 4 titled multiculturalism argues that Korean and Eastern immigrants should more precisely understand Australia as a multicultural society in a way of collaboratively creating new cultural values. The author introduces multiculturalism with its definitions and history in Australia and argues the limitations of multiculturalism from an Easterner’s perspective. With well known tragedies of the second generations of U.S. immigrants, Cho Seung-Hui, a university student, massacred 32 people on the Virginia Tech before committing suicide and Hidal Hassan, an Army psychiatrist, killed 13 people at Fort Hood and the responses of ethnic community, the author explains that their mental illness may be derived from their parents’ (or ethnic group) culturally isolated attitude and socially static viewpoint of U.S. (Western system and values). The author insists that multiculturalism may restrict Eastern immigrants’ engagement and involvement in local communities. Multiculturalism has been systematically and historically developed based on Western systems and cultural values. In other words, multiculturalism requires high self-confidence and self-esteem that Eastern immigrants less prioritise them. It has been generally known that Easterners put more weight on human relationship than Westerners, but the author claims that this is not true. Within an individualistic culture, Westerners are more interested in building person-to-person connections and relationships. While Easterners are more interested in how individuals can achieve a sense of belonging within a group and a community. Therefore, multiculturalism is an ideology which forces Eastern immigrants to discard their strong desire to be part of a group and does not give a sense of belonging. In a consequence, the author advises that Eastern immigrants should aim towards “transculturalism” which allows them to actively participate in and contribute to their multicultural community. Transculturalism does not ask Easterners to discard their cultural values, but enables them to be a collectivistic individualist (a community leader) who is capable of developing new cultural values in a more creative and productive way. Furthermore, transculturalism encourages Western Australians in a multicultural context to collaborate with ethnic minorities to build a better community.

The play's the thing? : Hamlet, Slings & Arrows, and the authority of theatrical consumption

This paper reads season 1 of the critically-acclaimed Canadian television series “Slings & Arrows” (2003). This six-episode series is set in a fictionalised version of the Stratford Festival, and tells the story of a plagued production of Shakespeare’s Hamlet. It follows the play’s rehearsal after the death of the festival’s artistic director; Geoffrey Tennant (himself a plagued Hamlet) takes over the role of director, and must face his past in order to produce a Hamlet that will save the festival, redeem his reputation, and repair his interpersonal relationships. Drawing on popular and theatrical understandings of Shakespeare’s play, the series negotiates tropes of metatheatre, filiality, cultural production and consumption, in order to demonstrate the ongoing relevance and legitimacy of “Shakespeare” in the twenty-first century. The “Slings & Arrows” narrative revolves around the doubled-plot of Hamlet and the experiences of the company mounting Hamlet. In quite obvious ways, the show thus thematises ways in which Shakespeare can be used to read one’s own life and world. In the broader sense, however, the show also offers theatre/performance as a catalyst for affect. In doing so, the show functions as a relatively straight adaptation of Hamlet, and a metatheatrical/metafictional commentary on the functions of Hamlet within contemporary culture. In Shakespeare’s play, the production of “The Mouse-Trap” proves, both to Hamlet and the audience, the legitimacy of the ghost’s claims. Similarly, in “Slings & Arrows”, the successful performance of Hamlet legitimises Geoffrey’s position as artistic director of the festival, and affirms for the viewer the value of Shakespearean production in contemporary culture. In each text, theatre/performance enables and legitimises a son carrying out a dead father’s wishes in order to restore or reproduce socio-cultural order. The metatheatrics of these gestures engage the reader/viewer in a self-reflexive process whereby the ‘value’ of theatre is thematised and performed, and the consumer is positioned as the arbiter and agent of that value: complicit in its production even as they are the site of its consumption.

Expectations, obligations or promises? A conceptual review and revision of the beliefs comprising the psychological contract

The psychological contract is a frequently deployed construct to examine the dynamics of the employee-employer exchange relationship. While there is consensus that the contract comprises employee and employer beliefs regarding this relationship, the various belief types are not conceptually well-defined and understood. Over time, the contract has been conceptualised as comprising expectations, obligations, promises or some combination therein. While most contemporary researchers focus solely upon promises, the justifications for this position are unpersuasive. This paper theoretically describes the various belief types, identifies their interrelationships and proposes a reconceptualisation of the beliefs constituting the contract. Specifically, it is demonstrated that the extant promise-based belief framework provides too restrictive a theoretical base for a comprehensive understanding of individuals’ psychological contracts.

Issues and challenges in higher education leadership : engaging for change

It is proposed from this study that engaging productively with others to achieve change has never been more critical in educational environments, such as universities. Via semi-structured interviews with a cohort of senior leaders from one Australian university, this paper explores their perceptions of the key issues and challenges facing them in their work. The study found that the most significant challenges centred around the need for strategic leadership, flexibility, creativity and change-capability; responding to competing tensions and remaining relevant; maintaining academic quality; and managing fiscal and people resources. Sound interpersonal engagement, particularly in terms of change leadership capability, was found to be critical to meeting the key challenges identified by most participants. In light of the findings from the sample studied some tentative implications for leadership and leadership development in university environments are proposed, along with suggestions for further empirical exploration.

Communication and control : case studies in Australian telecommuting

This paper discusses the results of in-depth semi-structured interviews with 39 telecommuters from 12 Australian organisations. The paper serves two broad aims: firstly, it identifies current trends in telecommuting and offers a perspective on Australian developments. Secondly, it provides a focus on significant communication aspects of the Australian telecommuting experience. Findings are that the majority of interviewees reported overall satisfaction with telecommuting as an important contributor to their improved work and lifestyle outcomes. Overall, telecommuters appear to cope with communication aspects of their work environments. They also were not overreliant on advanced communications media when telecommuting. Difficulties as reported by telecommuter interviewees included: perceived discomfort over lack of management support for their telecommuting; reduced levels of interpersonal communication suggesting the likely need to adopt a ‘media mix’ approach to servicing their communication needs; problems of information access; and telecommuters’ reported levels of difficulty with their uses of some computer and communication technologies. Problems relating to telecommuters’ perceived professional and social isolation, were also identified. Finally, the paper underscores where organisational communication theorists and practitioners need to more energetically embrace the concepts of virtual work and telecommuting

Cultivating Innovation through Social Relationships: A Qualitative Study of Outstanding Australian Innovators in Science, Technology and the Creative Industries

In this chapter, we describe and explore social relationship patterns associated with outstanding innovation. In doing so, we draw upon the findings of 16 in-depth interviews with award-winning Australian innovators from science & technology and the creative industries. The interviews covered topics relating to various influences on individual innovation capacity and career development. We found that for all of the participants, innovation was a highly social process. Although each had been recognised individually for their innovative success, none worked in isolation. The ability to generate innovative outcomes was grounded in certain types of interaction and collaboration. We outline the distinctive features of the social relationships which seem to be important to innovation, and ask which ‘social network capabilities’ might underlie the ability to create an optimal pattern of interpersonal relationships. We discuss the implications of these findings for universities, which we argue play a key role in the development of nascent innovators.

The ecological dynamics of 1v1 sub-phases in association football

This paper analyzes effects of different practice task constraints on heart rate (HR) variability during 4v4 smallsided football games. Participants were sixteen football players divided into two age groups (U13, Mean age: 12.4±0.5 yrs; U15: 14.6±0.5). The task consisted of a 4v4 sub-phase without goalkeepers, on a 25x15 m field, of 15 minutes duration with an active recovery period of 6 minutes between each condition. We recorded players’ heart rates using heart rate monitors (Polar Team System, Polar Electro, Kempele, Finland) as scoring mode was manipulated (line goal: scoring by dribbling past an extended line; double goal: scoring in either of two lateral goals; and central goal: scoring only in one goal). Subsequently, %HR reserve was calculated with the Karvonen formula. We performed a time-series analysis of HR for each individual in each condition. Mean data for intra-participant variability showed that autocorrelation function was associated with more short-range dependence processes in the “line goal” condition, compared to other conditions, demonstrating that the “line goal” constraint induced more randomness in HR response. Relative to inter-individual variability, line goal constraints demonstrated lower %CV and %RMSD (U13: 9% and 19%; U15: 10% and 19%) compared with double goal (U13: 12% and 21%; U15: 12% and 21%) and central goal (U13: 14% and 24%; U15: 13% and 24%) task constraints, respectively. Results suggested that line goal constraints imposed more randomness on cardiovascular stimulation of each individual and lower inter-individual variability than double goal and central goal constraints.

DIScoveringABILITIES : creating interactive performances over the Internet

This article presents a case study that shows how a creative music educator uses the internet to enable participatory performance.

Innovation networks in the construction arena : the strategic management of mixed enterprises

The building and construction sector is one of the five largest contributors to the Australian economy and is a key performance component in the economy of many other jurisdictions. However, the ongoing viability of this sector is increasingly reliant on its ability to foster and transfer innovated products and practices. Interorganisational networks, which bring together key industry stakeholders and facilitate the flows of information, resources and trust necessary to secure innovation, have emerged as a key growth strategy within this and other arenas. The blending of organisations, resources and purposes creates new, hybrid institutional forms that draw on a mix of contract, structure and interpersonal relationship as integration processes. This paper argues that hybrid networked arrangements, because they incorporate relational elements, require management strategies and techniques that not always synonymous with conventional management approaches, including those used within the building and construction sector. It traces the emergence of the Construction Innovation Project in Australia as a hybrid institutional arrangement moulding public, private and academic stakeholders of the building and construction industry into a coherent collective force aimed at fostering innovation and its application within all levels of the industry. Specifically, the paper examines the Construction Innovation Project to ascertain the impact of relational governance and its management to harness and leverage the skills, resources and capacities of members to secure innovative outcomes. Finally, the paper offers some prospects to guide the ongoing work of this body and any other charged with a similar integrative responsibility.

The Australian Grey Nomads : are they who we think they are? Enhancing formative research through the quantitative assessment of psychological constructs

Issue addressed: Measures of 'social identity' and 'psychological sense of community' were included within a broader formative research inquiry to gain insight into the identity characteristics and level of connectedness among older recreational road travellers (commonly known as Grey Nomads). The research sought to gain insights on how best to reach or speak to this growing driver cohort. ----- ----- Method: Participants included 631 older recreational road travellers ranging in age from 50 years to over 80 years. Data were obtained through three scales which were incorporated into a larger formative research survey; an identity hierarchy, the Three Factor Model of Social Identity and the Sense of Community Index. ----- ----- Results: Older recreational road travellers see themselves principally as couples, with social group identity being secondary. Although many identified to some degree with the Grey Nomad identity, when asked to self categorise as either members of the Broad Network of Recreational Vehicle Travellers or as Grey Nomads, the majority categorised themselves as the former. Those identifying as Grey Nomads, however, reported significantly higher levels of 'social identification' and 'sense of community'. ----- ----- Conclusion: The Grey Nomad identity may not be the best identity at which to target road safety messages for this cohort. Targeting travelling 'couples' may be more efficacious. Using the 'Grey Nomad' identity is likely to reap at least some success, however, given that many identified to some degree with this group identity. Those identifying as Grey Nomads may be more open to community participation or behaviour change given their significantly higher levels of 'social identity' and 'sense of community'.

The impact of online reviews on hotel booking intentions and trust

A growing reliance on the Internet as an information source when making choices about tourism products raises the need for more research into electronic word of mouth. Within a hotel context, this study explores the role of four key factors that influence perceptions of trust and consumer choice. An experimental design is used to investigate four independent variables: the target of the review (core or interpersonal); overall valence of a set of reviews (positive or negative); framing of reviews (what comes first: negative or positive information); and whether or not a consumer generated numerical rating is provided together with the written text. Consumers seem to be more influenced by early negative information, especially when the overall set of reviews is negative. However, positively framed information together with numerical rating details increases both booking intentions and consumer trust. The results suggest that consumers tend to rely on easy-to-process information, when evaluating a hotel based upon reviews. Higher levels of trust are also evident when a positively framed set of reviews focused on interpersonal service.