The relationship between quality of work life and turnover intention of primary health care nurses in Saudi Arabia

Background Quality of work life (QWL) has been found to influence the commitment of health professionals including nurses. However, reliable information on the QWL and turnover intention of primary health care (PHC) nurses is limited. The aim of this study was to examine the relationship between QWL and turnover intention of PHC nurses in Saudi Arabia. Methods A cross-sectional survey was used in this study. Data were collected using Brooks’ survey of Quality of Nursing Work life (QNWL), the Anticipated Turnover Scale and demographic data questions. A total of 508 PHC nurses in the Jazan region, Saudi Arabia completed the questionnaire (RR = 87%). Descriptive statistics, t-test, ANOVA, General Linear Model (GLM) univariate analysis, standard multiple regression (SMR), and hierarchical multiple regression (HMR) were applied for analysis using SPSS v17 for Windows. Results Findings suggested that the respondents were dissatisfied with their work life, with almost 40% indicating a turnover intention from their current PHC centres. Turnover intention was significantly related to QWL. Using SMR, 26% of the variance in turnover intention was explained by the QWL, p < 0.001, with R² = .263. Further analysis using HMR found that the total variance explained by the model as a whole (demographics and QWL) was 32.1%, p < 0.001. QWL explained an additional 19% of the variance in turnover intention, after controlling for demographic variables. Conclusions Creating and maintaining a healthy work life for PHC nurses is very important to improve their work satisfaction, reduce turnover, enhance productivity and improve nursing care outcomes.

Examining the health related quality of life of people with end stage kidney disease living in Hanoi, Vietnam

Background: The prevalence of end-stage kidney disease (ESKD) patients is increasing in Vietnam; however, the impact of ESKD and its treatment on a person’s quality of life (QOL) is not well understood. Objective: This research sought to examine the association between monthly income, comorbidity, length of time on dialysis, social support and health-related quality of life (HRQOL) among Vietnamese ESKD patients. Method: Using a descriptive design, 95 patients who were receiving haemodialysis (HD) and peritoneal dialysis (PD) from one hospital in Hanoi, were conveniently sampled. Results: ESKD patients reported having a moderate level of HRQOL. Factors associated with QOL were social support (r= .268, p<.05), comorbid health conditions (r= –.185, p<.05), and length of time on dialysis (r= .182, p<.05). However, monthly income was not significantly related to HRQOL (p>.05). Conclusion: The results seem to indicate that ESKD patients in Vietnam have a high level of support from family members, friends and significant others. There was also a negative impact of comorbid conditions on the QOL of these patients. Based on the results of this study, nurses ought to develop nursing interventions which will lead to a better QOL for patients, and further research into the QOL for ESKD patients in Vietnam is warranted.

A longitudinal study of health-related quality of life, fatigue and physical activity in chronic kidney disease patients

This study assessed the health-related quality of life (HRQoL), fatigue and physical activity levels of 28 persons with chronic kidney disease (CKD) on initial administration of an erythropoietin stimulating agent, and at 3 months, 6 months and 12 months. The sample comprised of 15 females and 13 males whose ages ranged from 31 to 84 years. Physical activity was measured using the Human Activity Profile (HAP): Self-care, Personal/Household work, Entertainment/Social, Independent exercise. Quality of life was measured using the SF-36 which gives scores on physical health (physical functioning, role-physical, bodily pain and general health) and mental health (vitality, social functioning, role-emotional and emotional well-being). Fatigue was measured by the Fatigue Severity Scale (FSS). Across all time points the renal sample engaged in considerably less HAP personal/household work activities and entertainment/social activities compared to healthy adults. The normative sample engaged in three times more independent/exercise activities compared to renal patients. One-way Repeated measures ANOVAs indicated a significant change over time for SF-36 scales of role physical, vitality, emotional well-being and overall mental health. There was a significant difference in fatigue levels over time [F(3,11) = 3.78, p<.05]. Fatigue was highest at baseline and lowest at 6 months. The more breathlessness the CKD patient reported, the fewer activities undertaken and the greater the reported level of fatigue. There were no significant age differences over time for fatigue or physical activity. Age differences were only found for SF-36 mental health at 3 months (t=-2.41, df=14, p<.05). Those younger than 65 years had lower emotional well-being compared to those aged over 65. Males had poorer physical health compared to females at 12 months. There were no significant gender differences on mental health at any time point. In the management of chronic kidney disease, early detection of a person’s inability to engage in routine activities due to fatigue is necessary. Early detection would enable timely interventions to optimise HRQoL and independent exercise.

Comparing the availability, price, variety and quality of fruits and vegetables across retail outlets and by area level socioeconomic position

Abstract Objective: To explore whether area-level socioeconomic position or the form of retail stream (conventional versus farmers’ market) are associated with differences in the price, availability, variety and quality of a range of fresh fruit and vegetables. Design: A multi-site cross-sectional pilot study of farmers’ markets, supermarkets and independent fruit and vegetable retailers. Each was surveyed to assess the price, availability, variety and quality of 15 fruit and 18 vegetable items. Setting: Retail outlets were located in South-East Queensland. Subjects: Fifteen retail outlets were surveyed (five of each retail stream). Results: Average basket prices were not significantly different across the socioeconomic spectrum however prices in low socioeconomic areas were cheapest. Availability, variety, and quality did not differ across levels of socioeconomic position however the areas with the most socioeconomic disadvantage scored poorest for quality and variety. Supermarkets had significantly better fruit and vegetable availability than farmers’ markets however price, variety and quality scores were not different across retail streams. Results demonstrate a trend to fruit and vegetable prices being more expensive at farmers’ markets, with the price of the Fruit basket being significantly greater at the organic farmer’s market compared with the non-organic farmers’ markets. Conclusions: Neither area-level socioeconomic position nor the form of retail stream was significantly associated with differences in the availability, price, variety and quality of fruit and vegetables, except for availability which was higher in supermarkets than farmers’ markets. Further research is needed to determine what role farmers’ markets can play in affecting fruit and vegetable intake.

Will the application of spatial multi criteria evaluation technique enhance the quality of decision-making to resolve boundary conflicts in the Philippines?

Systematic studies that evaluate the quality of decision-making processes are relatively rare. Using the literature on decision quality, this research develops a framework to assess the quality of decision-making processes for resolving boundary conflicts in the Philippines. The evaluation framework breaks down the decision-making process into three components (the decision procedure, the decision method, and the decision unit) and is applied to two ex-post (one resolved and one unresolved) and one ex-ante cases. The evaluation results from the resolved and the unresolved cases show that the choice of decision method plays a minor role in resolving boundary conflicts whereas the choice of decision procedure is more influential. In the end, a decision unit can choose a simple method to resolve the conflict. The ex-ante case presents a follow-up intended to resolve the unresolved case for a changing decision-making process in which the associated decision unit plans to apply the spatial multi criteria evaluation (SMCE) tool as a decision method. The evaluation results from the ex-ante case confirm that the SMCE has the potential to enhance the decision quality because: a) it provides high quality as a decision method in this changing process, and b) the weaknesses associated with the decision unit and the decision procedure of the unresolved case were found to be eliminated in this process.

The effect of Tai Chi on health related quality of life in people with elevated blood glucose or diabetes : a randomized controlled trial

Purpose The aim was to assess the effects of a Tai Chi based program on health related quality of life (HR-QOL) in people with elevated blood glucose or diabetes who were not on medication for glucose control. Method 41 participants were randomly allocated to either a Tai Chi intervention group (N = 20) or a usual medical care control group (N = 21). The Tai Chi group involved 3 x 1.5 hour supervised and group-based training sessions per week for 12 weeks. Indicators of HR-QOL were assessed by self-report survey immediately prior to and after the intervention. Results There were significant improvements in favour of the Tai Chi group for the SF36 subscales of physical functioning (mean difference = 5.46, 95% CI = 1.35-9.57, P < 0.05), role physical (mean difference = 18.60, 95% CI = 2.16-35.05, P < 0.05), bodily pain (mean difference = 9.88, 95%CI = 2.06-17.69, P < 0.05) and vitality (mean difference = 9.96, 95% CI = 0.77-19.15, P < 0.05). Conclusions The findings show that this Tai Chi program improved indicators of HR-QOL including physical functioning, role physical, bodily pain and vitality in people with elevated blood glucose or diabetes who were not on diabetes medication.

Preservice teachers’ perceptions of their middle schooling teacher preparation : a sample of the Australian context

Reviews into teacher education and reform measures, such as implementing professional standards for teachers, are designed to raise the quality of education. Such reviews and reforms also target preservice teachers; hence universities examine their teacher education programs to address these issues, including developing programs that are current with the literature. Over the past fifteen years, concerns have arisen about Australian early adolescents and their disengagement from the schooling system, their “at risk” behaviour and their need for social, emotional and academic support. These concerns have prompted a middle schooling movement in Australia with the literature recognising a need for specialised middle school teachers. As a result, various universities have responded by developing courses specifically designed to graduate teachers who possess the theoretical and pedagogical knowledge for engaging early adolescent learners. This mixed-method study analysed the responses of preservice teachers from three universities across two states in Australia near the completion of their middle years teacher preparation program. The three aims of the study were to: (1) investigate final-year preservice teachers’ perceptions of their confidence to teach in the middle years of schooling; (2) analyse the experiences included in their teacher preparation course that made them feel confident; and (3) describe strategies for enhancing middle schooling teacher education preparation. Data were gathered from final-year preservice teachers (n=142) using a survey that was developed in response to middle schooling literature and the Professional Standards for Queensland Teachers (Queensland College of Teachers, 2006). A questionnaire collected extended information about the participants’ (n=142) experiences that made them feel confident. It also gathered information about strategies for enhancing middle years teacher preparation. One-to-one, 45-minute interviews (n=10) were conducted to elicit in-depth responses aligned with the research aims. Quantitative results indicated that the majority of preservice teachers (n=142) claimed confidence associated with survey items relating to creating a positive classroom environment (range: 70-97%), developing positive relationships for teaching (71-98%), pedagogical knowledge for teaching (72-95%), and implementation of teaching (70-91%). Qualitative findings suggested that the experiences that assisted them to be confident for teaching were practicum and associated field studies coursework, a positive mentor teacher, specifically designed middle years subjects, the pedagogical approaches of university staff, and other real-world experiences such as volunteering in schools and participating in professional development alongside their mentors. This study demonstrated that universities presenting middle years teacher preparation need to consider: the quality of the practicum experience; the suitability of mentor teachers; the significance and practicalities of middle years subjects; university lecturers’ modelling of pedagogical practices; and the inclusion of real-world learning experiences. Although the findings of this study provided evidence as to how preservice teacher confidence for teaching has been influenced by their middle schooling teacher preparation, further research is required to investigate how confidence translates into practice within their first years of teaching.

Towards improving public understanding of judgement practice in standards-referenced assessment : an Australian perspective

Internationally there has been a move towards standards-referenced assessment with countries such as Australia developing a National Curriculum and Achievement Standards, New Zealand adopting National Standards for literacy and numeracy that involve schools making and reporting judgements about the reading, writing and mathematics achievement of children up to Year 8 (the end of primary school) and in Canada, classroom assessment standards aimed at the improvement of assessment practice of K-12 education are being formulated. Standards-driven reform has major implications for teachers’ work. The consequences of adopting a standards-driven approach to educational change by systems are often under-estimated with the unintended effects not fully understood by either the policy writers, and the public, including parents. It is for these reasons that the contention developed in this article relates to the teacher’s role, which it is argued remains central to policy focused on the improvement of the quality of education and educational standards.

Appraisal of the quality of care of older people with cognitive impairment presenting to emergency departments

The medical records of 273 patients 75 years and older were reviewed to evaluate quality of emergency department (ED) care through the use of quality indicators. One hundred fifty records contained evidence of an attempt to carry out a cognitive assessment. Documented evidence of cognitive impairment (CI) was reported in 54 cases. Of these patients, 30 had no documented evidence of an acute change in cognitive function from baseline; of 26 patients discharged home with preexisting CI (i.e., no acute change from baseline), 15 had no documented evidence of previous consideration of this issue by a health care provider; and 12 of 21 discharged patients who screened positive for cognitive issues for the first time were not referred for outpatient evaluation. These findings suggest that the majority of older adults in the ED are not receiving a formal cognitive assessment, and more than half with CI do not receive quality of care according to the quality indicators for geriatric emergency care. Recommendations for improvement are discussed.

Quality of life in chronic fatigue syndrome

Whilst the debilitating fatigue experienced in patients suffering from Chronic Fatigue Syndrome (CFS) results in a subjective marked impairment in functioning, little research has investigated the impact of this disorder on quality of life. Forty-seven subjects with a confirmed diagnosis of CFS and 30 healthy controls were compared using the Sickness Impact Profile (SIP). A subgroup of subjects were interviewed regarding the impact CFS has had on their social and family relationships, work and recreational activities. Results from both the SIP and the interview revealed that CFS subjects had significantly impaired quality of life, especially in areas of social functioning. These findings highlight the importance of addressing the social isolation and loss of role functioning experienced by CFS sufferers.

Effects of family environment on negative symptoms and quality of life of psychotic patients

This study tested the hypothesis that negative symptoms and quality of life for patients with functional psychoses are associated with family environment. Fifty-seven first-admission patients with functional psychoses were assessed at hospital admission for severity of psychopathology and premorbid adjustment. Relatives residing with patients rated the family environment at admission and one month after discharge on the Family Environment Scale. Patients made the same ratings after discharge. Six months later, patients were reassessed on severity of psychopathology, negative symptoms, and quality of life. Multiple regression analyses showed that higher levels of positive emotional expressiveness in the family predicted milder and fewer negative symptoms and better quality of life at follow-up. The prediction was statistically independent of the initial severity of psychopathology or premorbid adjustment

Reflexive professionalism : reclaiming the voice of authority in shaping the discourses of education policy

The nature and value of ‘professionalism’ has long been contested by both producers and consumers of policy. Most recently, governments have rewritten and redefined professionalism as compliance with externally imposed ‘standards’. This has been achieved by silencing the voices of those who inhabit the professional field of education. This paper uses Foucauldian archaeology to excavate the enunciative field of professionalism by digging through the academic and institutional (political) archive, and in doing so identifies two key policy documents for further analysis. The excavation shows that while the voices of (academic) authority speak of competing discourses emerging, with professional standards promulgated as the mechanism to enhance professionalism, an alternative regime of truth identifies the privileged use of (managerial) voices from outside the field of education to create a discourse of compliance. There has long been a mismatch between the voices of authority on discourses around professionalism from the academic archive and those that count in contemporary and emerging Australian educational policy. In this paper, we counter this mismatch and argue that reflexive educators’ regimes of truth are worthy of attention and should be heard and amplified.

User-driven quality of experience modelling for mobile video optimisation

The increasing demand for mobile video has attracted much attention from both industry and researchers. To satisfy users and to facilitate the usage of mobile video, providing optimal quality to the users is necessary. As a result, quality of experience (QoE) becomes an important focus in measuring the overall quality perceived by the end-users, from the aspects of both objective system performance and subjective experience. However, due to the complexity of user experience and diversity of resources (such as videos, networks and mobile devices), it is still challenging to develop QoE models for mobile video that can represent how user-perceived value varies with changing conditions. Previous QoE modelling research has two main limitations: aspects influencing QoE are insufficiently considered; and acceptability as the user value is seldom studied. Focusing on the QoE modelling issues, two aims are defined in this thesis: (i) investigating the key influencing factors of mobile video QoE; and (ii) establishing QoE prediction models based on the relationships between user acceptability and the influencing factors, in order to help provide optimal mobile video quality. To achieve the first goal, a comprehensive user study was conducted. It investigated the main impacts on user acceptance: video encoding parameters such as quantization parameter, spatial resolution, frame rate, and encoding bitrate; video content type; mobile device display resolution; and user profiles including gender, preference for video content, and prior viewing experience. Results from both quantitative and qualitative analysis revealed the significance of these factors, as well as how and why they influenced user acceptance of mobile video quality. Based on the results of the user study, statistical techniques were used to generate a set of QoE models that predict the subjective acceptability of mobile video quality by using a group of the measurable influencing factors, including encoding parameters and bitrate, content type, and mobile device display resolution. Applying the proposed QoE models into a mobile video delivery system, optimal decisions can be made for determining proper video coding parameters and for delivering most suitable quality to users. This would lead to consistent user experience on different mobile video content and efficient resource allocation. The findings in this research enhance the understanding of user experience in the field of mobile video, which will benefit mobile video design and research. This thesis presents a way of modelling QoE by emphasising user acceptability of mobile video quality, which provides a strong connection between technical parameters and user-desired quality. Managing QoE based on acceptability promises the potential for adapting to the resource limitations and achieving an optimal QoE in the provision of mobile video content.