Rehabilitation counsellor competency studies : a review of praxis in a human service profession

Competency research in the rehabilitation profession and that of rehabilitation counseling in particular has an extensive pedigree. This article reviews the significant research in the field and details several of the instruments used in competency research to dat. Issues concerning the current use of competency research and the future role of such research is discussed.

Beyond the dotted drawings : the Aboriginal Health Worker and health promotion practice

Aboriginal and Torres Strait Islander health workers' roles have changed over the years as the profession has shifted far beyond the mere provision of a cultural brokerage service. Important achievements have been made in enhancing the biomedical role of the Aboriginal and Torres Strait health worker, even though this is not the only area of expertise they need to possess.

Entering the field as a sports coordinator: Negotiating the micropolitics of the profession

The work of French sociologist, anthropologist and philosopher Pierre Bourdieu has been influential across a set of cognate disciplines that can be classified as physical culture studies. Concepts such as field, capital, habitus and symbolic violence have been used as theoretical tools by scholars and students looking to understand the nature and purpose of sport, leisure, physical education and human movement within wider society. Pierre Bourdieu and Physical Culture is the first book to focus on the significance of Bourdieu’s work for, and in, physical culture. Bringing together the work of leading and emerging international researchers, it introduces the core concepts in Bourdieu’s thought and work, and presents a series of fascinating demonstrations of the application of his theory to physical culture studies. A concluding section discusses the inherent difficulties of choosing and using theory to understand the world around us. By providing an in-depth and multi-layered example of how theory can be used across the many and varied components of sport, leisure, physical education and human movement, this book should help all serious students and researchers in physical culture to better understand the importance of social theory in their work.

Sexual harassment in the medical profession: Legal and ethical responsibilities

Sexual harassment of women in medicine in the Australian medical profession is a serious problem which presents substantial legal, ethical and cultural questions for the medical profession. Women have enforceable legal rights to gender equality and freedom from sexual harassment in the workplace. Both individual offenders and their employers face significant legal consequences for sexual harassment. Individual medical practitioners and employers need to understand their legal and ethical responsibilities in this context. This article analyses four areas of legal liability in every State and Territory which apply to individual offenders and employers: criminal law, discrimination law, civil law, and contract law. It also analyses ethical duties owed by doctors towards their colleagues under professional regulatory schemes. The analysis shows that individual doctors and their employers have clear legal and ethical obligations to prevent sexual harassment. On legal and ethical grounds, medical employers, professional colleges and associations, and regulators need to improve gender equality and professional culture in medicine. A five-step model for cultural change is proposed.

Workplace acceptance and experiences of LGBTIQ health professionals: A systematic literature review

Background The purpose of this study was to explore the workplace acceptance and experiences of lesbian, gay, bisexual, transgender, intersex and queer (LGBTIQ) paramedics. Methods A systematic search of academic databases and reference lists from selected papers were the sources of the data. Inclusion criteria were research papers published in English, which focused on workplace acceptance and experiences of LGBTIQ health personnel. Results The initial focus of this systematic review was the workplace acceptance and experiences of LGBTIQ paramedics. However due to no published research specific to the paramedic profession the scope of the review was broadened to include of all LGBTIQ health personnel. Thirty-three papers were included in this review. Evidence indicated that LGBTIQ health professionals experienced discrimination from their patients, heterosexual colleagues and ‘closeted’ LGBTIQ peers. Positive contribution of LGBTIQ health professionals include improved patient care and role models for LGBTIQ peers. Inclusive policy is required for LGBTIQ health professional workforce retention. Conclusions The paramedic workforce is known to be a high risk occupational group for post-traumatic stress disorder and depression. Theoretically, LGBTIQ paramedics working in a heteronormative culture experience increased level of stress. While LGBTIQ health professionals receive legislative protection against discrimination, discrimination still exists in practice through lack of visibility. Effective and efficient integration of LGBTIQ health professionals could improve workplace satisfaction, workforce retention, and equity of access by marginalised groups. An inclusive workplace policy of LGBTIQ embraces and celebrates the value of diversity.

Systematic assessment of the training needs of health library staff

Urquhart, C., Spink, S., Thomas, R. & Durbin, J. (2005). Systematic assessment of the training needs of health library staff. Library and Information Research, 29(93), 35-42. Sponsorship: National Library for Health (NLH)

Challenge of culture, conscience, and contract to general practitioners' care of their own health: qualitative study

Objective: To explore general practitioners' perceptions of the effects of their profession and training on their attitudes to illness in themselves and colleagues. Design: Qualitative study using focus groups and indepth interviews. Setting: Primary care in Northern Ireland. Participants: 27 general practitioners, including six recently appointed principals and six who also practised occupational medicine part time. Main outcome measures: Participants' views about their own and colleagues' health. Results: Participants were concerned about the current level of illness within the profession. They described their need to portray a healthy image to both patients and colleagues. This hindered acknowledgement of personal illness and engaging in health screening. Embarrassment in adopting the role of a patient and concerns about confidentiality also influenced their reactions to personal illness. Doctors' attitudes can impede their access to appropriate health care for themselves, their families, and their colleagues. A sense of conscience towards patients and colleagues and the working arrangements of the practice were cited as reasons for working through illness and expecting colleagues to do likewise. Conclusions: General practitioners perceive that their professional position and training adversely influence their attitudes to illness in themselves and their colleagues. Organisational changes within general practice, including revalidation, must take account of barriers experienced by general practitioners in accessing health care. Medical education and culture should strive to promote appropriate self care among doctors.

Mental Health Social Work and the Troubles in Northern Ireland: A Study of Practitioner Experiences

• Summary: During the last decade increasing attention has been paid to the impact of the Troubles1 on social work in Northern Ireland. In this paper, the authors describe the first survey used to test some of the assumptions which exist in the literature. An 87-item questionnaire was applied to a range of social work staff currently working in, or associated with, mental health settings. One hundred and one questionnaires were returned: it is estimated that this represented over 70 per cent of mental health social workers in Northern Ireland. • Findings: The design of the questionnaire elicited both qualitative and quantitative data. The findings reveal a workforce with complex religious and national identities and many of the respondents have experienced relatively high levels of Troubles-related incidents whilst carrying out their duties in a variety of organizational and geographical settings. High proportions of respondents received minimal agency support and training to equip them to deal with Troubles-related problems faced by them during this period. • Applications: The authors conclude that the profession and employing agencies should pay greater attention to past and present effects of the Troubles on social work practice and develop appropriate strategies for supporting, training and resourcing staff in this neglected area.

Recent policy initiatives in early childhood and the challenges for the social work profession

The Labour Government in the UK has announced, as part of its launch of The Children's Plan, that it 'wants to make this country the best place in the world for children and young people to grow up' in. This latest Plan is further evidence of the surge of interest that there has been in children (and, in particular, early childhood) over the last ten years in the UK and indeed elsewhere. Many of the recent policy and practice initiatives have implications for social workers working with young children. Yet, social work as a profession, in comparison with education, has remained relatively silent on these initiatives and it is hard to find any critical analysis of these developments in terms of either their underlying discourses or their implications for social workers. This article sets out to address these gaps by providing a critical analysis of: what types of knowledge regarding the early years have gained political currency; why and how this is the case; and what the implications are for the role and practices of social workers. The article proposes that discourses of 'need' and 'provision' mask more powerful discourses of economics, social control and risk avoidance, and it concludes by advocating more critically reflexive social work practice with young children and their families.

Mental Health nurses' attitudes towards personality disorder

The importance of the impact of nurses views towards personality disorder and their place in acute mental health environments are surveyed.A total of 49 registrants were surveyed all with at least one years experience and all on part one of the active register. Overall 66% of respondents did not feel that patients with a personality disorder should be treated in an acute inpatient setting, with only 36% reporting feeling confident in their abilities when working with this patient group. Almost all respondents 98% called for more training which the authors feel is a positive reflection on the profession.

The Association of Distress and Sleeping Problems With Physicians' Intentions To Change Profession: The Moderating Effect of Job Control

The present study examined whether job control moderated the association between stress indicators (distress and sleeping problems) and intentions to change profession among 2,650 Finnish physicians. Ordinal logistic regression analysis was applied. The authors found that high levels of distress and sleeping problems were associated with higher levels of intentions to change profession, whereas high job control was associated with lower levels of intentions to change profession even after adjusting for the effects of gender, age, and employment sector. In addition, high job control was able to mitigate the positive association that distress and sleeping problems had with intentions to change profession. Our findings highlight the importance of offering more job control to physicians to prevent unnecessary physician turnover.

Occupational stress in the chef profession

Purpose – The purpose of this paper is to consider the occupational stress experienced by chefs and the moderating influence of coping behaviour and locus of control on stress outcomes. Design/methodology/approach – A total of 40 working chefs were surveyed. They were asked to complete an occupational stress questionnaire, the General Health Questionnaire. Differences were
sought between gender and locus of control and stress measures, and correlations were carried out between key variables. Findings – The reported stress was markedly higher than in previous research. Excessive workload,
feeling undervalued and communication issues were common and bullying and threats of violence were present for some. Unexpectedly, locus of control was unable to predict stress experiences. Explanations were offered, such as the possibility that those who perceive they have a strong sense of control may believe that this, paradoxically, affords them the opportunity to engage in unhealthy behaviours. Research limitations/implications – Limitations of the research include the influence of the wider environment, specifically the history of political violence in the province, and its possible effect on stress outcomes. However, this may be negated by the many positive effects peace has brought over the last decade. In drawing conclusions it is important to note the limitations of the sample size and the self-reporting nature of survey responses. Further research could usefully incorporate well-being as well as stress measures, including physiological ones. It would be worth exploring further how one’s sense of control affects perceptions of stress and, in turn, the coping behaviours engaged in. Practical implications – Practical implications include the need for managers and head chefs to provide more feedback to employees, to validate their good work and to foster a supportive working environment. Norms in the working environment endorsing aggressive behaviour must be challenged.
Staff appraisals should consider the need to have work that involves variety and challenge, especially where changes involve increases in workload. Originality/value – This paper identifies some important ingredients to reduce distress and it will be of value to chefs and other kitchen staff and, more broadly, to those involved in people management.

Measuring horizontal integration among health care providers in the community: An examination of a collaborative process within a palliative care network

In many countries formal or informal palliative care networks (PCNs) have evolved to better integrate community-based services for individuals with a life-limiting illness. We conducted a cross-sectional survey using a customized tool to determine the perceptions of the processes of palliative care delivery reflective of horizontal integration from the perspective of nurses, physicians and allied health professionals working in a PCN, as well as to assess the utility of this tool. The process elements examined were part of a conceptual framework for evaluating integration of a system of care and centred on interprofessional collaboration. We used the Index of Interdisciplinary Collaboration (IIC) as a basis of measurement. The 86 respondents (85% response rate) placed high value on working collaboratively and most reported being part of an interprofessional team. The survey tool showed utility in identifying strengths and gaps in integration across the network and in detecting variability in some factors according to respondent agency affiliation and profession. Specifically, support for interprofessional communication and evaluative activities were viewed as insufficient. Impediments to these aspects of horizontal integration may be reflective of workload constraints, differences in agency operations or an absence of key structural features.

Workplace accommodation for older teachers in Japan and Germany: The role of the institutional context in supporting late career options for teachers with ill-health

Due to population ageing, Japan and Germany have to extend individuals´ working lives. However, disability increases with old-age. Workplace accommodation is a means to enable disabled individuals to remain productively employed. Drawing on qualitative interview data, this paper explores how School Authorities in these countries use workplace accommodation to support ill teachers, a white-collar profession strongly affected by (mental) ill-health. It furthermore explores how such measures influence older teachers´ career expectations and outcomes. It finds that even though the institutional contexts are similar, career options and expectations vary, though with similar (negative) outcomes for national strategies to extend working lives.

Street Medicine – Assessment Work Strategies of Paramedics on the Front lines of Emergency Health Services

This article is based on an institutional ethnographic inquiry into the work of paramedics and the institutional setting that organizes and coordinates their work processes in a major City in Canada. Drawing on over 200 hours of observations and over 100 interviews with paramedics (average length of 18 minutes) and other emergency medical personnel, this article explores the standard and not so standard work of paramedics as they assess and care for their patients on the front lines of emergency health services. The multiplicity of interfacing social, demographic, locational, and situational factors that shape and organize the work of paramedics are analyzed. In doing so, this article provides insights into the complex work of an understudied yet ever-important profession in healthcare.