Factors associated with healthcare professionals' intent to stay in hospital: a comparison across five occupational categories.

OBJECTIVE: To identify factors associated with intent to stay in hospital among five different categories of healthcare professionals using an adapted version of the conceptual model of intent to stay (CMIS). DESIGN: A cross-sectional survey targeting Lausanne University Hospital employees performed in the fall of 2011. Multigroup structural equation modeling was used to test the adapted CMIS model among professional groups. Measures Satisfaction, self-fulfillment, workload, working conditions, burnout, overall job satisfaction, institutional identification and intent to stay. PARTICIPANTS: Surveys of 3364 respondents: 494 physicians, 1228 nurses, 509 laboratory technicians, 935 administrative staff and 198 psycho-social workers. RESULTS: For all professional categories, self-fulfillment increased intent to stay (all β > 0.14, P < 0.05). Burnout decreased intent to stay by weakening job satisfaction (β < -0.23 and β > 0.22, P < 0.05). Some factors were associated with specific professional categories: workload was associated with nurses' intent to stay (β = -0.15), and physicians' institutional identification mitigated the effect of burnout on intent to stay (β = -0.15 and β = 0.19). CONCLUSION: Respondents' intent to stay in a position depended both on global and profession-specific factors. The identification of these factors may help in mapping interventions and retention plans at both a hospital level and professional groups' level.

The baby and the couple : understanding and treating young families

The Baby and the Couple provides an insider's view on how infant communication develops in the context of the family and how parents either work together as a team or struggle in the process. The authors present vignettes from everyday life as well as case studies from a longitudinal research project of infants and their parents interacting together in the Lausanne Trilogue Play (LTP), an assessment tool for very young families. Divided into three parts, the book focuses not only on the parents, but also on the infant's contribution to the family. Part 1 presents a case study of Lucas and his family, from infancy to age 5. With each chapter we see how, in the context of their families, infants learn to communicate with more than one person at a time. Part 2 explores how infants cope when their parents struggle to work together - excluding, competing or only connecting through their child. The authors follow several case examples from infancy through to early childhood to illustrate various forms of problematic co-parenting, along with the infant's derailed trajectory at different ages and stages. In Part 3, prevention and intervention models based on the LTP are presented. In addition to an overview of these programs, chapters are devoted to the Developmental Systems Consultation, which combines use of the LTP and video feedback, and a new model, Reflective Family Play, which allows whole families to engage in treatment. The Baby and the Couple is a vital resource for professionals working in the fields of infant and preschool mental health including psychiatrists, psychologists, social workers, family therapists and educators, as well as researchers.

Quelle organisation des soins pour le patient polymorbide? [How should we organize health care for multimorbidity patients?].

Polymorbidity affects an increasing number of patients of all ages as demonstrated by a recent epidemiological study and represents a real challenge for the organization of health care. Appropriate management of polymorbid patients requires an interdisciplinary approach associating generalist and specialist physicians, but also nurses, other health professionals and social workers. An improvement in transition care between the community and the hospital is necessary in both directions. Prioritizing the treatment objectives is essential to allow patient adherence and avoid cumulative drug interactions and adverse effects. Those objectives are difficult to attain in the context of our present health care organization. This paper attempts to identify the difficulties involved in caring for polymorbid patients and propose ways to improve it.

Soins intégrés: comment accompagner un changement de culture [Integrated care: how to support a culture change?].

The primary care center at Lausanne University Hospital trains residents to new models of integrated care. The future GPs discover new forms of collaboration with nurses, pharmacists or social workers. The collaboration model includes seeing patients together or delegating care to other providers, with the aim of improving the efficiency of a patient-centered care approach. The article includes examples of integrated care in consultation for travelers, victims of violence, pharmacist medication adherence counseling, medicosocial team work for alcohol use disorders and nurse practitioners' primary care for asylum seekers.

Sosiaalityö ja maahanmuuttajat. Lastensuojelun ammattilaisten ja asiakkaiden vuorovaikutus ja tulkinnat

Tutkimuksen tavoitteena oli tuottaa tietoa siitä, mitä maahanmuuttajia koskevat erityiskysymykset suomalaisessa lastensuojelun sosiaalityössä ovat ja miten näitä kysymyksiä lastensuojelussa käsitellään. Teoreettismetodologisena viitekehyksenä on sosiaalinen konstruktionismi. Etnisten suhteiden tutkimusperinteessä työ paikantuu keskusteluun, jossa kulttuuri ja etnisyys nähdään sosiaalisesti rakentuvina ja muuntuvina. Analyysissä sovelletaan diskurssianalyyttistä metodologiaa. Tutkimus rakentuu yhteenveto-osiosta ja neljästä artikkelista. Maahanmuuttajasosiaalityötä ja lastensuojelua tarkastellaan sosiaalityöntekijöiden, muiden ammattilaisten ja asiakkaiden kielenkäytön kautta. Aineisto koostuu 11 lastensuojelun asiakaskeskustelusta ja niiden jälkeen keskustelun osapuolille tehdyistä haastatteluista, joita on yhteensä 35. Tutkimuksessa analysoidaan seuraavia kysymyksiä: Miten sosiaalityöntekijät tulkitsevat maahanmuuttajasosiaalityön erityisyyttä oman ammatillisen tehtävänsä näkökulmasta? Minkälaisia ominaisuuksia sosiaalityöntekijät rakentavat maahanmuuttaja-asiakkaille? Miten lastensuojelun keskusteluissa puhutaan monikulttuurisuuteen liittyvistä teemoista, kuten erilaisuudesta ja samanlaisuudesta sekä kulttuuri- ja rasismikysymyksistä? Miten maahanmuuttajalasten ja -nuorten osallisuus lastensuojelun asiakaskeskusteluissa rakentuu aikuisten ja lasten itsensä tuottamana? Mitä ja miten maahanmuuttajalapset ja -nuoret puhuvat kokemuksistaan lastensuojelussa ja suomalaisessa yhteiskunnassa? Maahanmuuttajien erityiskysymyksiä ovat kieleen, kulttuuriin ja valtayhteiskunnan toimintaan liittyvät ymmärtämisvaikeudet, kokemukset arkipäivän rasismista sekä perheen ja yhteisön merkittävä, osin ristiriitainen rooli. Lapsilla ja nuorilla kulttuuri on muuntuvaa ja jatkuvien neuvottelujen kohteena. Aineiston lastensuojelutilanteiden taustalla on usein kouluympäristöön liittyviä vaikeuksia. Haastatteluissa lapset kertovat kokemuksistaan ja toimijuudestaan perheeseen, yhteisöön ja kouluun paikantuvissa tilanteissa. Asiakaskeskusteluissa lasten puhuja-asema on usein heikko, jos aikuiset eivät aktiivisesti vahvista sitä. Jotkut lapset ottavat itse vahvan puhuja-aseman. Asiakaskeskusteluissa maahanmuuttajien erityiskysymyksistä puhutaan harvoin eksplisiittisesti. Haastatteluissa sosiaalityöntekijät enemmän tai vähemmän tietoisesti paikantavat maahanmuuttajasosiaalityötä vieraannuttavaan, sopeuttavaan, tasa-arvoistavaan, kulttuuritietoiseen, rasismitietoiseen ja osallistavaan kehykseen. Kehykset nostavat sosiaalityön tavoitteista, menetelmistä ja asiakkaasta keskeisiksi erilaisia asioita. Tulkinnat ovat muuntuvia, vaikka osoittavat myös tiettyä säännönmukaisuutta. Kulttuuri on keskeinen käsite erilaisuuden ja samanlaisuuden ymmärtämiseksi. Sekä työntekijät että asiakkaat perustelevat toivottavia elämäntapoja "omalla kulttuurillaan" ja selittävät ongelmia ”erilaisella kulttuurilla”. Kulttuurin käsitettä voidaan myös käyttää työvälineenä asiakaskeskusteluissa avattaessa asiakkaan omaa näkökulmaa korostavaa dialogia. Perheen ja kulttuurisen yhteisön merkitys on tärkeää arvioida lapsen ja nuoren hyvinvoinnin ja kulttuurisen identiteetin kehittymisen näkökulmasta. Sosiaalityöntekijöillä on merkittävä välittäjän rooli yhtäältä valtayhteiskunnan ja maahanmuuttaja-asiakkaiden, toisaalta vanhempien, yhteisöjen sekä lasten ja nuorten välillä. Lastensuojelussa haasteena on arkipäivän rasismin tiedostaminen sekä siihen pureutuvien työmenetelmien kehittäminen.

La síndrome de Burnout en els treballadors socials a Catalunya

Aquest treball de fi de grau constitueix una proposta d’investigació sobre el fenomen del burnout o síndrome d’esgotament professional que pateixen molts treballadors socials. Concretament, es pretenen analitzar els factors causants d’aquesta síndrome així com les seves conseqüències en termes estructurals i organitzatius, de qualitat en l’atenció a les persones i personals per part dels professionals del treball social. La necessitat i interès d'abordar el tema es deu a les evidències científiques, realitzades en d’altres països, que confirmen que l'exposició als factors de risc psicosocials afecten la salut del professional i a tota l'organització. Més encara en un moment de crisi econòmica en la qual els treballadors socials han d’atendre a una major quantitat d’usuaris amb diversitat de dificultats i en situacions més complexes. En el nostre país, la investigació sobre la síndrome del burnout en l’àmbit dels treballadors socials és pràcticament inexistent, raó per la qual es fa més necessari potenciar recerques que es focalitzin en aquesta realitat.Aquest document és el resultat d’un treball continuat que comprèn tant la cerca i lectura de la bibliografia existent i rellevant sobre el fenomen del esgotament professional, com una primera fase exploratòria per contrastar el marc teòric amb la realitat catalana, concretament la de la comarca del Gironès. Posteriorment, i a partir dels resultats obtinguts, es presenta el disseny d’una investigació que ha de cobrir tot l’àmbit català. En aquest cas, s’ha optat per fer una recerca amb una metodologia qualitativa (entrevistes i grups de discussió), ja que l’objectiu és copsar les vivències, percepcions i opinions dels treballadors socials sobre les causes del burnout i les seves conseqüències. Els resultats d'aquesta investigació són considerats una oportunitat per identificar àrees de millora en l'organització de la feina i altres aspectes rellevants com el disseny del lloc de treball, les relacions interpersonals i a nivell personal

La metodologia d'intervenció dels treballadors socials en el sistema de les cures pal·liatives

L’atenció a l’etapa final de la vida de les persones és un dels pilars fonamentals de les cures pal·liatives i és des de la professió del treball social que es pot promoure aquesta atenció en concepte de qualitat, tranquil·litat i preservació dels valors de les persones en situació terminal. És per aquesta raó que s’ha elaborat el present document d’investigació, el qual compta inicialment amb un recull bibliogràfic que abraçarà la metodologia d’intervenció dels treballadors socials en el sistema de les cures pal·liatives de l’Estat espanyol i del Regne Unit, país pioner en la creació de les unitats de cures pal·liatives. En aquest recull s’emmarcaran detalladament les diferències existents en termes d’intervenció i de desenvolupament d’aquest àmbit en els dos territoris. La descripció detallada dels dos models d’intervenció pretén donar la resposta a l’interrogant sobre quina és la metodologia d’intervenció que realitzen els treballadors socials en el sistema de cures pal·liatives. Per assolir aquesta resposta, s’adrecen qüestions com els objectius que lideren el treball d’aquests professionals, les funcions que realitzen en la seva pràctica professional diària i les habilitats de les que han de disposar per tal d’aconseguir que la seva intervenció sigui òptima, tant per als mateixos professionals com per a les persones amb les quals intervenen. Posteriorment a la revisió bibliogràfica, es realitzaran tres entrevistes exploratòries a tres treballadors socials de diferents nivells sanitaris que promoguin les cures pal·liatives a Catalunya. S’analitzaran les qüestions treballades en el recull bibliogràfic (objectius, funcions i habilitats dels treballadors socials), les quals permetran comparar la perspectiva teòrica cercada amb la informació primària obtinguda. Finalment, es planteja una proposta de projecte que permetrà aprofundir en la intervenció dels treballadors socials de Catalunya i del Regne Unit, realitzant una comparació entre els dos models a través de la realització de quaranta-vuit entrevistes repartides homogèniament per els dos territoris. D’aquesta manera, s’especificaran totes aquelles accions que es puguin millorar i les intervencions que siguin més òptimes per la tipologia d’atenció que es requereix en els sistemes de les cures pal·liatives d’avui en dia.

Challenges to patient-centred care in a general internal medicine context: findings from an exploratory study

Introduction. If we are to promote more patient-centred approaches in care delivery, we have to better characterize the situations in which being patient-centred is difficult to achieve. Data from professionals in health and social care are important because they are the people charged with operationalizing patient-centred care (PCC) in their daily practice. However, empirical accounts from frontline care providers are still lacking, and it is important to gather experiences not only from doctors but also from the other care providers. Indeed, experiences from different professions can help inform our understanding of patient care, which is expected to be both patient-centred and collaborative. Methods. This study was based on the following research question: What factors make the provision of PCC difficult to achieve? Sample and setting. A purposeful sampling technique was used, allowing for a series of choices about the participants and their professional affiliation. Because patient-centredness is the focus, 3 professions appeared to be of special interest: general internists, nurses and social workers. The study was undertaken in the General Internal Medicine Division of a teaching hospital located in a North American context. Data Collection. To answer the research question, a methodological approach based on a theory called phenomenology was chosen. Accordingly, semi-structured interviews were used since they generate understanding of the meanings different individuals have of their lived world. Interviews with 8 physicians, 10 nurses and 10 social workers were eventually conducted. Data analysis. An inductive thematic analysis was employed to make sense of the interview data. Results. The thematic analysis allowed identifying various types of challenges to PCC. Although most of the challenges were perceived by all three groups of professionals, they were perceived to a different degree across the professions, which likely reflected the scope of practice of each profession. The challenges and their distribution across the professions are illustrated in Table 1. Examples of challenges are provided in Table 2. Discussion. There is a tension between what is supposed to be done - what stands in the philosophy of patient -centredness - and what is currently done - the real life with all the challenges to PCC. According to some participants' accounts, PCC clearly risks becoming a mere illusion for health care professionals on which too great pressures are imposed.

Expertise and decision making among clinicians in investigations of alleged child sexual abuse

The purpose of the present thesis was to explore different aspects of decision making and expertise in investigations of child sexual abuse (CSA) and subsequently shed some light on the reasons for shortcomings in the investigation processes. Clinicians’ subjective attitudes as well as scientifically based knowledge concerning CSA, CSA investigation and interviewing were explored. Furthermore the clinicians’ own view on their expertise and what enhances this expertise was investigated. Also, the effects of scientific knowledge, experience and attitudes on the decision making in a case of CSA were explored. Finally, the effects of different kinds of feedback as well as experience on the ability to evaluate CSA in the light of children’s behavior and base rates were investigated. Both explorative and experimental methods were used. The purpose of Study I was to investigate whether clinicians investigating child sexual abuse (CSA) rely more on scientific knowledge or on clinical experience when evaluating their own expertise. Another goal was to check what kind of beliefs the clinicians held. The connections between these different factors were investigated. A questionnaire covering items concerning demographic data, experience, knowledge about CSA, selfevaluated expertise and beliefs about CSA was given to social workers, child psychiatrists and psychologists working with children. The results showed that the clinicians relied more on their clinical experience than on scientific knowledge when evaluating their expertise as investigators of CSA. Furthermore, social workers possessed stronger attitudes in favor of children than the other groups, while child psychiatrists had more negative attitudes towards the criminal justice system. Male participants held less strong beliefs than female participants. The findings indicate that the education of CSA investigators should focus more on theoretical knowledge and decision making processes as well as the role of beliefs In Study II school and family counseling psychologists completed a Child Sexual Abuse Attitude and Belief Scale. Four CSA related attitude and belief subscales were identified: 1. The Disclosure subscale reflecting favoring a disclosure at any cost, 2. The Pro-Child subscale reflecting unconditional belief in children's reports, 3. The Intuition subscale reflecting favoring an intuitive approach to CSA investigations, and 4. The Anti Criminal Justice System subscale reflecting negative attitudes towards the legal system. Beliefs that were erroneous according to empirical research were analyzed separately. The results suggest that some psychologists hold extreme attitudes and many erroneous beliefs related to CSA. Some misconceptions are common. Female participants tended to hold stronger attitudes than male participants. The more training in interviewing children the participants have, the more erroneous beliefs and stronger attitudes they hold. Experience did not affect attitudes and beliefs. In Study III mental health professionals’ sensitivity to suggestive interviewing in CSA cases was explored. Furthermore, the effects of attitudes and beliefs related to CSA and experience with CSA investigations on the sensitivity to suggestive influences in the interview were investigated. Also, the effect of base rate estimates of CSA on decisions was examined. A questionnaire covering items concerning demographic data, different aspects of clinical experience, self-evaluated expertise, beliefs and knowledge about CSA and a set of ambiguous material based on real trial documents concerning an alleged CSA case was given to child mental health professionals. The experiment was based on a 2 x 2 x 2 x 2 (leading questions: yes vs no) x (stereotype induction: yes vs no) x (emotional tone: pressure to respond vs no pressure to respond) x (threats and rewards: yes vs no) between-subjects factorial design, in which the suggestiveness of the methods with which the responses of the child were obtained were varied. There was an additional condition in which the material did not contain any interview transcripts. The results showed that clinicians are sensitive only to the presence of leading questions but not to the presence of other suggestive techniques. Furthermore, the clinicians were not sensitive to the possibility that suggestive techniques could have been used when no interview transcripts had been included in the trial material. Experience had an effect on the sensitivity of the clinicians only regarding leading questions. Strong beliefs related to CSA lessened the sensitivity to leading questions. Those showing strong beliefs on the belief scales used in this study were even more prone to prosecute than other participants when other suggestive influences than leading questions were present. Controversy exists regarding effects of experience and feedback on clinical decision making. In Study IV the impact of the number of handled cases and of feedback on the decisions in cases of alleged CSA was investigated. One-hundred vignettes describing cases of suspected CSA were given to students with no experience with investigating CSA. The vignettes were based on statistical data about symptoms and prevalence of CSA. According to the theoretical likelihood of CSA the children described were categorized as abused or not abused. The participants were asked to decide whether abuse had occurred. They were divided into 4 groups: one received feedback on whether their decision was right or wrong, one received information about cognitive processes involved in decision making, one received both, and one did not receive feedback at all. The results showed that participants who received feedback on their performance made more correct positive decisions and participants who got information about decision making processes made more correct negative decisions. Feedback and information combined decreased the number of correct positive decisions but increased the number of correct negative decisions. The number of read cases had in itself a positive effect on correct positive decision.

Estudi sobre el perfil de persones grans amb dependència del servei d'ajuda a domicili del Consell Comarcal d'Osona i el tipus de suport formal i informal

The aim of this study is to determine the profile of dependent elderly people users of the home care services (SAD) of the regional council in Osona (Consell Comarcal d´Osona) , and the characteristics of formal and informal types of support they use. Methodology. An observational study of a transversal format has been carried out, with retrospective and descriptive purposes. The target population is 63 people (26 men and 37 women) included in the program of the regional SAD They have a recognized dependence grade approved by the law 39 /2006, December 14th , promoting the individual autonomy and care of elderly people in a dependent situation. The data were collected by social workers of basic social services, first with a home visit and followed by handed out questionnaires, specifically designed for this study, in order to obtain information on socio-demographic characteristics, and the type of support formal and informal. The obtained results on the SAD users are women in a 58.7% and a 41.3 % are men. The 84% of the total sampling are 80 years old and more, being the average age of 85.2 years old. 45% of them are married, 41% are widows and widowers and 14% are single. 54% are rated with severe dependence (grade II), 42.8% with high dependence (grade III). 86% live accompanied. 100% have an informal caregiver and a 95% of the times, the caregiver is a relative who in 73% of the cases the dedication time is permanent. The coverage of the SAD has an average of 4.27 hours per week and per user. The formal services most used are the technical (62%), also the assessment of an occupational therapist at home (57%) and the telecare service in a (56%). Conclusions. The SAD is used primarily for women in an advanced age and severe dependence. The informal assistance structures have an informal caregiver, being a member of the family mostly, living with the dependent, and mainly in a permanent dedication basis. The SAD has a varied intensity in each case. The formal support services complementary to the SAD, are largely used in all cases.

Ètica per aixecar la Moral : Problemes ètics als serveis socials bàsics en temps de crisi

Els riscos ètics als serveis socials en temps de crisi es multipliquen i s’intensifiquen, però en essència no es tracta de riscos nous ni diferents dels que es podien produir en temps de bonança econòmica i social. No obstant, la cruesa del context dels serveis socials bàsics (freqüència de les situacions límit que s'han d'atendre, les qüestions internes i externes de la pràctica professional, el malestar i desencant dels professionals) pot suposar una oportunitat de visibilitat i prendre consciència d'aquests riscos ètics. A la vegada, l'anàlisi i l'abordatge d'aquest nou context des d'una perspectiva ètica pot suposar un antídot que permeti ressituar la pràctica professional (amb els seus límits, però també amb les seves possibilitats), millorar-ne la qualitat i la transparència, i, de retruc, trencar amb la dinàmica de cronificació de la insatisfacció i queixa professional. És a dir, la perspectiva ètica pot ajudar a aixecar la moral dels professionals. Així doncs, amb aquesta recerca pretenem assolir els següents objectius: Identificar els riscos ètics de la intervenció als serveis socials bàsics en relació als efectes i l'impacte de la crisi econòmica; analitzar els diferents riscos ètics identificats i efectuar propostes d'abordatge i minimització d'aquests riscos ètics

BLOGS NO ENSINO DE QUÍMICA: ANÁLISE DE COMENTÁRIOS PUBLICADOS EM DISCIPLINA DE COMUNICAÇÃO CIENTÍFICA

Blogs and other technology tools are commonly used in our society. Although we are familiar with the use of technology for social interaction, its application in the classroom environment is still not fully appreciated by the teaching community as a useful learning tool. This paper sheds light on this use by presenting the analysis of the comments posted on a blog used by undergraduate chemistry students for a scientific communication undergraduate course. On the course, students used the blog to ask questions and discuss assignments. All the comments were monitored by the professor and her teaching assistant, who also posted their comments. We analyzed the content of these comments using the model proposed by Henri and adapted by McKenzie and Murphy. The results show a predominance of administrative comments, followed by course content comments. The findings also indicated that this tool complements classroom discussions, supports the participation of students who would otherwise not take part, and allows a continuous learning process for all the students. We concluded that the use of blogs improved the classroom experience and supported the instructional classroom activities.

Yliopisto-opiskelijoiden sosiaalisen median käyttö, sosiaalinen verkostoitumien ja stereotypiat eri koulutusohjelmien opiskelijoista

Tämä diplomityö tutkii Lappeenrannan teknillisen yliopiston opiskelijoiden sosiaalisen median palvelujen ja sovellusten käyttöä. Se tekee myös selvyyttä tavoista, joiden avulla opiskelijat muodostavat sosiaalisen verkostonsa muihin opiskelijoihin ja muihin ihmisiin. Se tutkii myös opiskelijoiden stereotypioita ja mielikuvia eri koulutusohjelmien opiskelijoista. Työn päätarkoitus on tutkia sosiaalisen median roolia opiskelijoiden elämässä. Tutkimustyö tehtiin verkossa täytettävällä kyselylomakkeella. Tutkimuksen tulokset esitellään työn loppupuoliskolla. Alkupuolisko esittelee sosiaalisen median käsitteitä ja palveluita sekä valaisee tietotekniikan roolia sosiaalisessa mediassa. Se käsittelee myös sosiaalista verkostoitumista opiskelijan näkökulmasta ja esittelee aikaisemmin tehtyjä tutkimuksia opiskelijoiden sosiaalisen median käytöstä.

A comparison of life satisfaction, job satisfaction, and happiness using demographic variables

This study examined the interrelationships among life satisfaction, job satisfaction, and happiness and the selected demographic variables of income, age, marital status, education, sex, job tenure, job title, type of school, and location of employment. Survey data were collected from 1,993 elementary, high school, and community college teachers in the southern Ontario area, representing ten public school boards, three Roman Catholic school boards and three community colleges. Several theories were utilized in developing thirteen hypotheses and eleven experimental hypotheses. A thorough review of the literature (to January, 1980) was undertaken and major conclusions noted. Hoppock's (1935) Job Satisfaction Measure, Gurin, Veroff, and Feld's (1960) Happiness Scale, and Converse and Robinson's (1965) Life Satisfaction Scale were used as the instrument. Chi-square analysis was employed as the statistical method. Indicative of the findings: the level of education taught was significantly related to all three organizational variables, sex was unrelated to life satisfaction though positively related to job satisfaction, and income was found not to be related to either happiness or life satisfaction. A minority of findings were contrary to hypothesized relationships. Specifically, age was found to be unrelated to any of the three organizational variables, and educational achievement was not significantly related to happiness. A model was developed to illustrate the interrelationships of the organizational and demographic variables. This model was designed specifically to reflect teacher attitudes, though it may have reasonable application for other relatively homogeneous groups of employees such as nurses, engineers, or social workers.

A Foucaultian analysis of power relations in child protection case work with youth and families

This thesis takes some steps in examining the child protection system from a position that is rarely discussed. Specifically, I explore how Foucault's concept of disciplinary power can be used to demonstrate how power operates within the client/worker relationship. This relationship is shown to be quite complex with power flowing bidirectionally, rather than hierarchically. Instead of viewing power imbalances as a function of state control, I show how the client/worker relationship is constituted by the worker, the client, the organization and the social body. A postmodern auto ethnography is used to document my journey as I expose the disciplinary practices and instruments that I was subject to and used with my clients. 2 Given that the child protection system is constantly shifting and changing in order to improve its ability to safeguard children a greater emphasis is required to examine how workers operate within this complex, overwhelming and multi-dimensional world. This thesis has shown that by engaging in a reflexive examination of my position of power different approaches to making intervention beneficial to all involved become available. This is important if child protection work aims to work with clients rather than on clients.