Satisfaction with pregnancy and delivery services: The quality of maternity care services as experienced by women

Objective: The objective of this study was to investigate the opinions of women regarding the satisfaction about the quality of maternity care received. We hope to establish whether health care technology increases satisfaction or whether it actually interferes with the construction of personal satisfaction in the process of care. Design and setting: Information was gathered using the focus group technique. The area of study comprised the post-natal groups run as part of the Sexual and Reproductive Health Programme of the Catalan Health Authority. (Spain) Participants: Five focus groups were held between May 2006 and July 2007. Findings: Quality of care is a complex concept in which a number of independent core features can be identified. We have grouped these core features into three basic categories. Safety: the hospital and its technological facilities, and the technical expertise of health professionals. The other two main pillars of quality of care are the human dimension of the relationship between the carers and the patient, and finally the structural aspects that determine the context in which the heath care is provided. Key conclusions and implications for practice: The mothers of our study feel satisfied with healthcare technology and view it as a source of security; technology become indispensable features in order to reduce the anxiety provoked by the perceived lack of confidence in their ability as mothers. In this study, women, both during pregnancy and especially when giving birth, believe their feelings and values should be understood by professionals, from whom they seek empathy and a personal commitment, and not just information.

Satisfaction with pregnancy and delivery services: The quality of maternity care services as experienced by women

Objective: The objective of this study was to investigate the opinions of women regarding the satisfaction about the quality of maternity care received. We hope to establish whether health care technology increases satisfaction or whether it actually interferes with the construction of personal satisfaction in the process of care. Design and setting: Information was gathered using the focus group technique. The area of study comprised the post-natal groups run as part of the Sexual and Reproductive Health Programme of the Catalan Health Authority. (Spain) Participants: Five focus groups were held between May 2006 and July 2007. Findings: Quality of care is a complex concept in which a number of independent core features can be identified. We have grouped these core features into three basic categories. Safety: the hospital and its technological facilities, and the technical expertise of health professionals. The other two main pillars of quality of care are the human dimension of the relationship between the carers and the patient, and finally the structural aspects that determine the context in which the heath care is provided. Key conclusions and implications for practice: The mothers of our study feel satisfied with healthcare technology and view it as a source of security; technology become indispensable features in order to reduce the anxiety provoked by the perceived lack of confidence in their ability as mothers. In this study, women, both during pregnancy and especially when giving birth, believe their feelings and values should be understood by professionals, from whom they seek empathy and a personal commitment, and not just information.

Estrés del terapeuta ocupacional

Desde que inicié el grado en Terapia Ocupacional, he vivido en primera persona situaciones de estrés seguramente causadas por diferentes factores: viajes diarios incómodos, comidas fuera de casa, horas frente al ordenador, falta de descanso y poca vida social. El estrés ha influenciado de forma negativa en mi salud, provocando en algunas épocas, no rendir al 100% en los estudios. Me interesa saber si los terapeutas ocupacionales que ejercen en Cataluña trabajan bajo condiciones de estrés. Otro objetivo de este estudio es comprender, si es el caso, experiencias reales de terapeutas ocupacionales acerca del estrés del terapeuta. Discutir sobre si impacta de forma negativa en la práctica profesional y determinar de qué forma, redefinir los factores desencadenantes y describir qué tipo de estrategias ponen en uso para afrontar el estrés. La metodología utilizada, debido a la naturaleza de la pregunta de investigación, tiene un enfoque cualitativo con un paradigma hermenéutico. Como técnicas de recolección de información se utiliza el grupo de discusión y el cuestionario. La escasa investigación acerca de la temática, ha llevado a tener que crear el formato de las técnicas a partir de documentos relevantes encontrados tras la búsqueda bibliográfica en diferentes bases de datos y revistas de terapia ocupacional. Los resultados del estudio, podrían ser útiles para llegar a crear una guía para combatir el estrés, incluso para prevenirlo en estudiantes de Terapia Ocupacional.

Smoked cocaine in socially-depressed areas

Background: The main objectives of this study are to describe the smoked cocaine user's profile in socially-depressed areas and their needs from a harm-reduction perspective, to investigate their use of smoking crack and compare the acute effects between injecting and smoking consumption. Methods: The study took place in SAPS, Barcelona, Spain. Two focus group sessions were undertaken with a total of 8 drug users. Secondly, the 8 participants answered a structured questionnaire and in the course of the sessions, as a snowball activity, were trained to survey 6 other crack smokers. Results: We obtained 56 questionnaires. The majority of participants were from non-European Community countries (62.69%), 70.2% of participants referred to sharing the smoking equipment. The most frequent symptoms reported during smoked cocaine were mydriasis (83.33%)), perspiration (72.92%) and compulsive object search (70.83%) During the group sessions, participants said that smoked cocaine is much more addictive than injected cocaine and causes more anxiety. Participants also reported the difficulty of changing from injected use to smoked use, due to the larger amount of cocaine needed to reach the same effects as when having injected. Conclusions We can conclude that the research, focused on achieving greater knowledge of the smoked cocaine user's profile, their usage of smoking crack, consumption patterns and acute effects, should be incorporated into substance misuse interventions.

Supporting older people’s independent living at home through social and health care collaboration

Tässä tutkimuksessa tarkasteltiin ikäihmisten kotona asumista sosiaali- ja terveydenhuollon yhteistyön näkökulmasta. Tutkimuksen tarkoituksena oli lisätä ymmärrystä iäkkäiden kotihoidon asiakkaiden voimavaroista arjesta selviytymisen näkökulmasta, ja tutkia miten asiakkaiden hoito sosiaali- ja terveydenhuollon yhteistyönä toteutuu. Tutkimus oli poikkileikkaustutkimus, jossa sovellettiin kuvailevaa ja vertailevaa tutkimusasetelmaa. Tutkimusaineisto kerättiin yhden länsisuomalaisen kunnan kotihoidon asiakkailta (≥65 v.) ja heitä hoitavilta ammattihenkilöiltä. Kotihoidon 21 iäkästä asiakasta kuvasivat omia voimavarojaan arjesta selviytymisen näkökulmasta sekä kokemuksiaan hoidon toteutumisesta ammattihenkilöiden yhteistyönä. Aineisto kerättiin avoimella haastattelulla ja analysoitiin sisällön analyysillä. Lisäksi 25 kotihoidon ammattihenkilöä: 13 kotipalvelun työntekijää, 11 kotisairaanhoitajaa ja lääkäri kuvasivat kokemuksiaan iäkkään asiakkaan hoidon toteutumisesta ammattihenkilöiden yhteistyönä. Aineisto kerättiin fokusryhmähaastattelulla ja analysoitiin sisällön analyysillä. Näiden tulosten sekä aikaisemman kirjallisuuden perusteella laadittiin strukturoitu kyselylomake, jolla analysoitiin ja vertailtiin asiakkaiden ja ammattihenkilöiden näkemyksiä siitä, miten asiakkaiden hoito sosiaali- ja terveydenhuollon yhteistyönä toteutui. Esitestausten jälkeen kyselylomake lähetettiin 200 kotihoidon asiakkaalle ja 570 heitä hoitavalle kotihoidon työntekijälle: 485 kotipalvelun työntekijälle, 81 kotisairaanhoitajalle ja 4 lääkärille. Kyselyyn vastasi 120 asiakasta (60 %) ja 370 ammattihenkilöä (65 %). Ryhmien välisten erojen tarkastelussa käytettiin ristiintaulukointia, Pearsonin khin neliötestiä ja Fisherin tarkan todennäköisyyden testiä. Iäkkäiden asiakkaiden kuvauksissa voimavarat muodostuivat elämänhallinnan tunteesta ja toimintatahdon säilymisestä. Asiakkaat ammensivat arkeen voimaa harrastuksista ja sosiaalisesta verkostosta, mutta ulkopuolisten asettamat elämisen ehdot, terveydentilan heikkeneminen sekä yksinäisyys asettivat ikäihmisen ja hänen voimavaransa suurten haasteiden eteen. Tulokset osoittivat, että ammattihenkilöiden toiminta oli osittain ristiriidassa ikäihmisten omien odotusten kanssa, eikä se kaikilta osin tukenut asiakkaiden omia voimavaroja. Ammattihenkilöt tekivät hoitoon liittyviä päätöksiä ja toimintoja asiakkaiden puolesta, vaikka asiakkaille itselleen oli tärkeää elämänhallinnan tunne ja toimintatahdon säilyminen. Asiakkaiden voimavarojen tukemista moniammatillisena yhteistyönä vaikeuttivat ammattihenkilöiden vaikeus tunnistaa asiakkaiden omia voimavaroja sekä niitä uhkaavia tekijöitä, tiedon kulun ongelmat, tavoitteeton ja epäyhtenäinen tapa toimia sekä ammattihenkilöiden vastakkain asettuvat näkemyserot ja toimintatavat. Asiakkaiden ja ammattihenkilöiden näkemykset toteutetusta hoidosta erosivat toisistaan tilastollisesti merkitsevästi (p<0.05). Asiakkaat arvioivat sekä itsenäiseen toimintaan tukemisen että fyysisen, psyykkisen ja sosiaalisen tuen toteutuneen työntekijöitä huonommin. Yhteistyön kehittämishaasteita kotihoidossa ovat asiakkaan oman elämänsä asiantuntijuuden vahvistaminen, toimintakulttuurin muuttaminen asiakaslähtöiseksi tavoitteelliseksi toiminnaksi, ammattihenkilöiden roolien ja vastuun selkiyttäminen sekä tiedon kulun menetelmien kehittäminen. Tutkimus vahvistaa gerontologisen hoitotieteen tietoperustaa ja tuottaa uutta tietoa, jota voidaan soveltaa sosiaali- ja terveysalan koulutuksessa ja johtamisessa

Uso de artigos científicos em uma disciplina de Físico-Química

This paper describes the use of primary chemistry literature in a fifth-semester physical chemistry course for undergraduate chemistry students. The main goal is to expose students to the primary literature of physical chemistry, demonstrating how they can benefit from using it. The assignment addresses issues in chemical education such as scientific writing, relating lecture material to the real world, and conducting literature searches. The student evaluation of this assignment, consisting of two surveys and one focus group, showed its usefulness. The details of the evaluation instruments and their results are provided. Out of 45 students enrolled in the course, 30 (67%) students completed the assignment.

Customer consciousness in the production process of a steel factory

The purpose of this thesis is to examine the level of customer consciousness of the production process employees in a steel factory and to investigate the methods of internal marketing in order to propose development practices to enhance the customer consciousness of the case company employees. The significance of the level of customer consciousness is discussed and practices already implemented affecting the level of customer consciousness in the company are examined. The literature review gives an insight to the role of customer consciousness in the CRM philosophy of a manufacturing company and examines the means of internal marketing in enhancing customer consciousness. In the empirical part of the study, the level and significance of customer consciousness is determined by conducting individual and focus group interviews. The interviews are also used to examine the practices that could function in enhancing the customer consciousness of the employees. Development suggestions to improve the level of customer consciousness in the production process are given based on the results. The level of customer consciousness is at a poor level in the production process and influences above all on work motivation and job satisfaction, but possibly on customer satisfaction as well. The enhancement of customer consciousness in the production process should be done e.g. by ensuring the distribution of right knowledge coherently to all of the employees, gathering large customer reference database to exploit in work and in training, using visual illustration in presenting the customer information, training proactively and letting the employees to participate in the customer oriented development activities. Customer satisfaction focused reward system can be considered.

External knowledge transfer mechanisms in service business acquisition

In knowledge-intensive economy an effective knowledge transfer is a part of the firm’s strategy to achieve a competitive advantage in the market. Knowledge transfer related to a variety of mechanisms depends on the nature of knowledge and context. The topic is, however, very little empirical studied and there is a research gap in scientific literature. This study examined and analyzed external knowledge transfer mechanisms in service business and especially in the context of acquisitions. The aim was to find out what kind of mechanisms was used when the buyer began to transfer data e.g. their own agendas and practices to the purchased units. Another major research goal was to identify the critical factors which contributed to knowledge transfer through different mechanisms. The study was conducted as a multiple-case study in a consultative service business company, in its four business units acquired by acquisition, in various parts of the country. The empirical part of the study was carried out as focus group interviews in each unit, and the data were analyzed using qualitative methods. The main findings of this study were firstly the nine different knowledge transfer mechanisms in service business acquisition: acquisition management team as an initiator, unit manager as a translator, formal training, self-directed learning, rooming-in, IT systems implementation, customer relationship management, codified database and ecommunication. The used mechanisms brought up several aspects as giving the face to changing, security of receiving right knowledge and correctly interpreted we-ness atmosphere, and orientation to use more consultative touch with customers. The study pointed out seven critical factors contributed to different mechanisms: absorption, motivation, organizational learning, social interaction, trust, interpretation and time resource. The two last mentioned were new findings compared to previous studies. Each of the mechanisms and the related critical factors contributed in different ways to the activity in different units after the acquisition. The role of knowledge management strategy was the most significant managerial contribution of the study. Phenomenon is not recognized enough although it is strongly linked in knowledge based companies. The recognition would help to develop a better understanding of the business through acquisitions, especially in situations such as where two different knowledge strategies combines in new common company.

Det pedagogiska övervägandet : en uppmärksamhetsriktande studie i och genom humanvetenskaplig handlingsteori

Det övergripande syftet med avhandlingen är att bidra till en handlingsinriktad diskurs. Ambitionen är att rikta uppmärksamheten mot den pedagogiska övervägande handlingen genom att pröva konkreta exempel från en pedagogisk praktik mot en begreppsapparat inspirerad av den humanvetenskapliga handlingsteorin. Forskningsfrågorna lyder: Vad är en övervägande handling? Hur byggs den upp och vad förutsätter den? Bakgrunden till intresset att belysa den övervägande handlingen är en önskan att överbrygga klyftan mellan teori och praktik och att hitta ett sätt att samtala om ”tyst kunskap” och den konkreta pedagogiska verkligheten så att denna kan utvecklas på ett meningsfullt sätt. Förhållandet mellan intentionalitet och instrumentella handlingar är av särskilt intresse. Den aristoteliska begreppsapparaten som avser att belysa den mänskliga handlingen används i studien som både utgångspunkt och analysredskap. Retoriken ses som den vetenskap som kan beskriva och förklara hur vi skapar mening med hjälp av språket. Fyra fokussamtal med sammanlagt fem studerande på musikanimatörutbildningen genomfördes under vårterminen 2006. Referaten från samtalen bearbetades till en berättelse. I konstruktionen av berättelsen användes dels en fenomenologisk analys, dels narrativ bearbetning. De aristoteliska begreppen poíesis, praxis och theoria tillämpades och prövades på berättelsen varefter en retorisk analys genomfördes. Berättelsen visar två konkurrerande praxis. Utbildningen framstår i berättelsen dels som en horisontell ”alla kan”-utbildning, dels som en vertikal och lärarstyrd verksamhet. Berättelsen ger inte så många exempel på pedagogiska överväganden men tydliggör ändå den övervägande handlingen. Det pedagogiska övervägandet innebär ett väljande utifrån teoretiskt tänkbara och med praxis förenliga handlingsalternativ. Reflektion ingår i övervägandet men är inte detsamma som övervägande. Övervägandet är inte enbart en rationellt kalkylerande aktivitet. Holistiska och intuitiva procedurer är en viktig del i processen. Övervägande förutsätter dessutom ansvar.

Innovatiivisuus johtoryhmätyöskentelyssä

Tutkimus tarkastelee innovatiivisuutta johtoryhmätyöskentelyssä. Tutkimuksen tavoitteena on selvittää innovatiivisen tiimityön prosessiin liittyviä tekijöitä johtoryhmätyöskentelyssä ja kuinka näitä tekijöitä voidaan kehittää. Tässä tutkimuksessa innovatiivisen tiimityön prosessiin liittyvät seuraavat tekijät: tiimin innovoinnin säännöt, refleksiivisyys, johtajuus, ristiriitojen johtaminen, eri tiimien yhteistyö, tiimin ulkopuoliset suhteet sekä vähemmistön ja enemmistön näkökulmat. Tutkimus toteutettiin laadullisena tapaustutkimuksena ja aineistonkeruumenetelmänä oli teemahaastattelu. Tutkimuksessa haastateltiin kymmentä johtoryhmän jäsentä. Kohderyhmänä oli Kymenlaakson ammattikorkeakoulun johtoryhmä. Tutkimuksen tulokset tukevat teoriassa esitettyjä määritelmiä ja luovat pohjan johtoryhmätyöskentelyn innovatiivisuuden kehittämiseen. Innovatiivisuus johtoryhmätyöskentelyssä perustuu johtoryhmätyöskentelyn erityispiirteiden huomioon ottamiseen, joita ovat johtoryhmän toiminnan reunaehdot ja johtoryhmän rooli toimia toimitusjohtajan avustajana päätöksenteossa. Johtajan rooli innovointiin ja avoimuuteen rohkaisevan läpinäkyvyyden kulttuurin luomisessa on merkittävä.

Customer-related skills and capabilities in knowledge-intensive business services

The roles of knowledge and customer involvement form distinct features in providing knowledge-intensive business services. The objective of this study was to investigate the customer-related skills and capabilities of knowledge-intensive business services. The research was carried out as case study, involving two polar cases. The other case represented customized services, and the other standardized services. The research method was qualitative, and included focus group workshops, individual interviews and a survey. The capabilities of business services have been mainly studied on organizational level. This study provides valuable insight into the role of individual skills as a part of capabilities of knowledge-intensive business services. According to this study, the most important capabilities are related to acquiring and integrating of knowledge, resource management, managing the customer’s role as a co-producer of the service, and active and effective communication. The study indicates that the level of tacit knowledge is high in the needed individual skills. Based on the study, the needed capabilities and skills are affected by the level of customization of the service, the demand for customer knowledge, the demand for consultation and the stage of the service providing.

Induction practices : experiences of newly qualified teachers

The thesis consists of four studies (articles I–IV) and a comprehensive summary. The aim is to deepen understanding and knowledge of newly qualified teachers’ experiences of their induction practices. The research interest thus reflects the ambition to strengthen the research-based platform for support measures. The aim can be specified in the following four sub-areas: to scrutinise NQTs’ experiences of the profession in the transition from education to work (study I), to describe and analyse NQTs’ experiences of their first encounters with school and classroom (study II), to explore NQTs’ experiences of their relationships within the school community (study III), to view NQTs’ experiences of support through peer-group mentoring as part of the wider aim of collaboration and assessment (study IV). The overall theoretical perspective constitutes teachers’ professional development. Induction forms an essential part of this continuum and can primarily be seen as a socialisation process into the profession and the social working environment of schools, as a unique phase of teachers’ development contributing to certain experiences, and as a formal programme designed to support new teachers. These lines of research are initiated in the separate studies (I–IV) and deepened in the theoretical part of the comprehensive summary. In order to appropriately understand induction as a specific practice the lines of research are in the end united and discussed with help of practice theory. More precisely the theory of practice architectures, including semantic space, physical space-time and social space, are used. The methodological approach to integrating the four studies is above all represented by abduction and meta-synthesis. Data has been collected through a questionnaire survey, with mainly open-ended questions, and altogether ten focus group meetings with newly qualified primary school teachers in 2007–2008. The teachers (n=88 in questionnaire, n=17 in focus groups), had between one and three years of teaching experience. Qualitative content analysis and narrative analysis were used when analysing the data. What is then the collected picture of induction or the first years in the profession if scrutinising the results presented in the articles? Four dimensions seem especially to permeate the studies and emerge when they are put together. The first dimension, the relational ˗ emotional, captures the social nature of induction and teacher’s work and the emotional character intimately intertwined. The second dimension, the tensional ˗ mutable, illustrates the intense pace of induction, together with the diffuse and unclear character of a teacher’s job. The third dimension, the instructive ˗ developmental, depicts induction as a unique and intensive phase of learning, maturity and professional development. Finally, the fourth dimension, the reciprocal ˗ professional, stresses the importance of reciprocity and collaboration in induction, both formally and informally. The outlined four dimensions, or integration of results, describing induction from the experiences of new teachers, constitute part of a new synthesis, induction practice. This synthesis was generated from viewing the integrated results through the theoretical lens of practice architecture and the three spaces, semantic space, physical space-time and social space. In this way, a more comprehensive, refined and partially new architecture of teachers’ induction practices are presented and discussed.

Vertailevan markkinoinnin sääntely kilpailijan näkökulmasta

Tämän tutkielman tarkoituksena on tutkia, miten vertailevaa markkinointia tulee arvioida kilpailevien elinkeinonharjoittajien välisissä riita-asioissa. Kuluttajia koskeva näkökulma rajataan siten tutkimuksen ulkopuolelle. Tutkielmassa käsitellään vertailevaa markkinointia koskevaa sääntelyä ja sen tulkintaa erityisesti markkinaoikeuden ja liiketapalautakunnan ratkaisuissa noudattaen lainopillista tutkimusmenetelmää. Tutkimustulokset osoittavat, ettei yksistään lainsäädännön nojalla voida tehdä päätelmiä siitä, millaisia vertailevaa markkinointia koskevia toimenpiteitä on pidettävä kiellettyinä. Arvioinnissa on siten otettava huomioon kaikki tapauskohtaiset seikat ja tulkittava niitä lainsäädännön, itsesääntelyn sekä oikeuskäytännön perusteella. Etenkin kohderyhmä määrittelee sen, miten vertailevan markkinoinnin sääntelyä tulee yksittäisessä tapauksessa tulkita.

Creating generation Y sources of motivation for enhanced performance

New challenges have been created in the modern work environment as the diversity of the workforce is greater than ever in terms of generations. There will become a large demand of generation Y employees as the baby boomer generation employees retire at an accelerated rate. The purpose of this study is to investigate Y generation specific characteristics and to identify motivational systems to enhance performance. The research questions are: 1. What are Y generation characteristics? 2. What motivational systems organizations can form to motivate Y generation employees and in turn, create better performance? The Y generation specific characteristics identified from the literature include; achievement oriented; confident; educated; multitasking; having a need for feedback; needing management support; sociable and tech savvy. The proposed motivational systems can be found in four areas of the organization; HRM, training and development, communication and decision making policies. Three focus groups were held to investigate what would motivate generation Y employees to achieve better performance. Two of these focus groups were Finnish natives and the third consisted of international students. The HRM systems included flexibility and a culture of fun. It was concluded that flexibility within the workplace and role was a great source of motivation. Culture of fun was not responded to as favorably although most focus group participants rated enjoyableness as one of their top motivating factors. Training and development systems include training programs and mentoring as sources of potential motivation. Training programs were viewed as a mode to gain a better position and were not necessarily seen as motivational systems. Mentoring programs were not concluded to have a significant effect on motivation. Communication systems included keeping up with technology, clarity and goals as well as feedback. Keeping up with technology was seen as an ineffective tool to motivate. Clarity and goal setting was seen as very important to be able to perform but not necessarily motivating. Feedback had a highly motivating effect on these focus groups. Decision making policies included collaboration and teamwork as well as ownership. Teams were familiar and meet the social needs of Y generation employees and are motivating. Ownership was equated with trust and responsibility and was highly valued as well as motivating to these focus group participants.