The relationship between parents’ self-efficacy beliefs, outcome expectations, child behaviour, and management of atopic dermatitis

Atopic dermatitis (AD) is a chronic inflammatory skin condition, characterized by intense pruritis, with a complex aetiology comprising multiple genetic and environmental factors. It is a common chronic health problem among children, and along with other allergic conditions, is increasing in prevalence within Australia and in many countries worldwide. Successful management of childhood AD poses a significant and ongoing challenge to parents of affected children. Episodic and unpredictable, AD can have profound effects on children’s physical and psychosocial wellbeing and quality of life, and that of their caregivers and families. Where concurrent child behavioural problems and parenting difficulties exist, parents may have particular difficulty achieving adequate and consistent performance of the routine management tasks that promote the child’s health and wellbeing. Despite frequent reports of behaviour problems in children with AD, past research has neglected the importance of child behaviour to parenting confidence and competence with treatment. Parents of children with AD are also at risk of experiencing depression, anxiety, parenting stress, and parenting difficulties. Although these factors have been associated with difficulty in managing other childhood chronic health conditions, the nature of these relationships in the context of child AD management has not been reported. This study therefore examined relationships between child, parent, and family variables, and parents’ management of child AD and difficult child behaviour, using social cognitive and self-efficacy theory as a guiding framework. The study was conducted in three phases. It employed a quantitative, cross-sectional study design, accessing a community sample of 120 parents of children with AD, and a sample of 64 child-parent dyads recruited from a metropolitan paediatric tertiary referral centre. In Phase One, instruments designed to measure parents’ self-reported performance of AD management tasks (Parents’ Eczema Management Scale – PEMS) and parents’ outcome expectations of task performance (Parents’ Outcome Expectations of Eczema Management Scale – POEEMS) were adapted from the Parental Self-Efficacy with Eczema Care Index (PASECI). In Phase Two, these instruments were used to examine relationships between child, parent, and family variables, and parents’ self-efficacy, outcome expectations, and self-reported performance of AD management tasks. Relationships between child, parent, and family variables, parents’ self-efficacy for managing problem behaviours, and reported parenting practices, were also examined. This latter focus was explored further in Phase Three, in which relationships between observed child and parent behaviour, and parent-reported self-efficacy for managing both child AD and problem behaviours, were explored. Phase One demonstrated the reliability of both PEMS and POEEMS, and confirmed that PASECI was reliable and valid with modification as detailed. Factor analyses revealed two-factor structures for PEMS and PASECI alike, with both scales containing factors related to performing routine management tasks, and managing the child’s symptoms and behaviour. Factor analysis was also applied to POEEMS resulting in a three-factor structure. Factors relating to independent management of AD by the parent, involving healthcare professionals in management, and involving the child in management of AD were found. Parents’ self-efficacy and outcome expectations had a significant influence on self-reported task performance. In Phase Two, relationships emerged between parents’ self-efficacy and self-reported performance of AD management tasks, and AD severity, child behaviour difficulties, parent depression and stress, conflict over parenting issues, and parents’ relationship satisfaction. Using multiple linear regressions, significant proportions of variation in parents’ self-efficacy and self-reported performance of AD management tasks were explained by child behaviour difficulties and parents’ formal education, and self-efficacy emerged as a likely mediator for the relationships between both child behaviour and parents’ education, and performance of AD management tasks. Relationships were also found between parents’ self-efficacy for managing difficult child behaviour and use of dysfunctional parenting strategies, and child behaviour difficulties, parents’ depression and stress, conflict over parenting issues, and relationship satisfaction. While significant proportions of variation in self-efficacy for managing child behaviour were explained by both child behaviour and family income, family income was the only variable to explain a significant proportion of variation in parent-reported use of dysfunctional parenting strategies. Greater use of dysfunctional parenting strategies (both lax and authoritarian parenting) was associated with more severe AD. Parents reporting lower self-efficacy for managing AD also reported lower self-efficacy for managing difficult child behaviour; likewise, less successful self-reported performance of AD management tasks was associated with greater use of dysfunctional parenting strategies. When child and parent behaviour was directly observed in Phase Three, more aversive child behaviour was associated with lower self-efficacy, less positive outcome expectations, and poorer self-reported performance of AD management tasks by parents. Importantly, there were strong positive relationships between these variables (self-efficacy, outcome expectations, and self-reported task performance) and parents’ observed competence when providing treatment to their child. Less competent performance was also associated with greater parent-reported child behaviour difficulties, parent depression and stress, parenting conflict, and relationship dissatisfaction. Overall, this study revealed the importance of child behaviour to parents’ confidence and practices in the contexts of child AD and child behaviour management. Parents of children with concurrent AD and behavioural problems are at particular risk of having low self-efficacy for managing their child’s AD and difficult behaviour. Children with more severe AD are also at higher risk of behaviour problems, and thus represent a high-risk group of children whose parents may struggle to manage the disease successfully. As one of the first studies to examine the role and correlates of parents’ self-efficacy in child AD management, this study identified a number of potentially modifiable factors that can be targeted to enhance parents’ self-efficacy, and improve parent management of child AD. In particular, interventions should focus on child behaviour and parenting issues to support parents caring for children with AD and improve child health outcomes. In future, findings from this research will assist healthcare teams to identify parents most in need of support and intervention, and inform the development and testing of targeted multidisciplinary strategies to support parents caring for children with AD.

Risk-informed thinking in airports: the application of business continuity management in airport infrastructure

Airports worldwide represent key forms of critical infrastructure in addition to serving as nodes in the international aviation network. While the continued operation of airports is critical to the functioning of reliable air passenger and freight transportation, these infrastructure systems face a number of sources of disturbance that threaten their operational viability. Recent examples of high magnitude events include the eruption of Iceland’s Eyjafjallajokull volcano eruption (Folattau and Schofield 2010), the failure of multiple systems at the opening of Heathrow’s Terminal 5 (Brady and Davies 2010) and the Glasgow airport 2007 terrorist attack (Crichton 2008). While these newsworthy events do occur, a multitude of lower-level more common disturbances also have the potential to cause significant discontinuity to airport operations. Regional airports face a unique set of challenges, particularly in a nation like Australia where they serve to link otherwise remote and isolated communities to metropolitan hubs (Wheeler 2005), often without the resources and political attention received by larger capital city airports. This paper discusses conceptual relationships between Business Continuity Management (BCM) and High Reliability Theory, and proposes BCM as an appropriate risk-based management process to ensure continued airport operation in the face of uncertainty. In addition, it argues that that correctly implemented BCM can lead to highly reliable organisations. This is framed within the broader context of critical infrastructures and the need for adequate crisis management approaches suited to their unique requirements (Boin and McConnell 2007).

Monitoring identity of past, current and future : a performance management system perspective

This paper seeks to explore how organisations can effectively use performance management systems (PMS) to monitor collective identities. The monitoring of relationships between identity and an influential PMS—the balanced scorecard (BSC)—are explored. Drawing from identity and management accounting literature, this paper argues that identity products, patternings and processes are commonly positioned, monitored and interpreted through the multiple perspectives and levels of the BSC. Specifically, human, technical and organisational capital under the Learning and Growth perspective of the BSC can incorporate various identity measures that sustain the relative, distinctive and fluid nature of identities. The value of this research is to strengthen the theoretical grounds which position identity as an important dimension of organisational capital in PMS.

X-Aware Business Process Management

In my last Column this year, I want to draw your attention to some current efforts in the space of BPM research and education that try to move BPM thinking forward into new areas of application. I am subsuming these efforts under the notion of x-aware BPM.

Management characteristics and the decision to internationalize : Exploration of exporters vs. non-exporters within the Chilean wine industry

The objective of this exploratory study was to identify the key factors that enhance and inhibit the export activities of wineries and identify differences between exporters and non-exporters. Based on data collected from Chilean wineries, the findings of this study suggest that the major constraints for non-exporters are the lack of financial resources, limited quantities of stocks for market expansion, management’s lack of knowledge and experience, and the high cost of travelling and participating in trade shows. In addition, the main international markets for Chilean wineries were not psychically close markets as has been found for Australian or other wine industries. For domestic market oriented wineries cellar door sales were an important source of revenue. Finally, the results show that managers have educational levels and international experience exceeding those of other comparable New World wineries.

Organization and management of police

To understand the nature of police organisations and their management in an Australian context it is necessary to appreciate the recent history of policing at least in the last 30 years. In doing so an overall perspective is gained on the various reform efforts and organisational changes that have taken place in Australian policing. With this police reform perspective clearly in mind it then becomes possible to appreciate that the organization and management of the institution of policing in Australia is nested within the larger framework of ‘governance’. Hence, this notion of governance will be used as the key focal point around which to understand how police organizations manage their mission in the Australian context. Finally, the chapter discusses the inevitable ‘tension spaces’ that arise in policing and the need for police organizations to better manage such complexities.

Towards an orchestration theory in business transformation management (research in progress)

Business transformations are large-scale organisational change projects that, evidence suggests, are often unsuccessful. This study aims to develop a conceptual model that explains how management services that are required for a business transformation are orchestrated during such a initiative. We classify management services such as (but not limited to) change management, risk management, IT management, financial management, program management and so forth as bearing transformational and/or transactional capabilities in a transformation initiative. We then draw upon three principles of musical composition, namely melody, harmony and rhythm, and illustrate how they apply to the orchestration of management services in the management of business transformations. In order to illustrate our emerging model, we examine the case of Malaysia Airlines, who have managed to successfully turnaround the near-bankrupt organisation beyond survival. We demonstrate how the notions of melody, harmony and rhythm can be used to describe their endeavour. We conclude by discussing next steps of our research.

Supply chain sustainability : a relationship management approach moderated by culture and commitment

This paper explores the nature of relationship management on construction projects in Australia and examines the effects of culture, by means of Schwarz’s value survey, on relationships under different contract strategies. The research was based on the view that the development of a sustainable supply chain depends on the transfer of knowledge and capabilities from the larger players in the supply chain through collaboration brought about by relationship management. The research adopted a triangulated approach in which quantitative data were collected by questionnaire, interviews were conducted to explore and enrich the quantitative data and case studies were undertaken in order to illustrate and validate the fi ndings. The aim was to investigate how values and attitudes enhance or reduce the incorporation of the supply chain into the project. From the research it was found that the degree of match and mismatch between values and contract strategy impacts commitment and the engagement and empowerment of the supply chain.

Making it creatively : building sustainable careers in the arts and creative industries

Many people aspire to careers in the arts and creative industries. However, it has long been known that it can be challenging to navigate a creative career: that competition for work can be intense, particularly for entry-level positions, and that success requires advanced skill sets in addition to a high degree of artistic talent and proficiency. In this article, Dr Ruth Bridgstock draws upon her doctoral and post-doctoral research to explore the challenges involved in building a creative career in Australia and suggest ways to support emerging creatives to build satisfying and sustainable careers.

Quality management in construction projects

[Quality Management in Construction Projects by Abdul Razzak Rumane, CRC Press, Boca Raton, FL, 2011, 434 pp, ISBN 9781439838716] Issues of quality management, quality control and performance against specification have long been the focus of various business sectors. Recently there has been an additional drive to achieve the continuous improvement and customer satisfaction promised by the 20th-century ‘gurus’ some six or seven decades ago. The engineering and construction industries have generally taken somewhat longer than their counterparts in the manufacturing, service and production sectors to achieve these espoused levels of quality. The construction and engineering sectors stand to realize major rewards from better managing quality in projects. More effort is being put into instructing future participants in the industry as well as assisting existing professionals. This book comes at an opportune time.

Design and design thinking in business and management education and development

Design and design thinking have been identified as making valuable contributions to business and management and the numbers of higher education programs that teach design thinking to business students, managers and executives are growing. However multiple definitions of design thinking and the range of perspectives have created some confusion about potential pathways. This paper examines notions of design and design thinking and uses these definitions to identify themes in higher educational programs. We present the findings from an initial exploratory investigation of design and design thinking in higher education business programs and define four distinct educational approaches around human centred innovation, integrative thinking, design management and design as strategy. Potential directions for management education programs are presented.

A multi-level model of leadership in complex project management

Management (or perceived mismanagement) of large-scale, complex projects poses special problems and often results in spectacular failures, cost overruns, time blowouts and stakeholder dissatisfaction. While traditional project management responds with increasingly administrative constraints, we argue that leaders of such projects also need to display adaptive and enabling behaviours to foster adaptive processes, such as opportunity recognition, which requires an interaction of cognitive and affective processes of individual, project, and team leader attributes and behaviours. At the core of this model we propose is an interaction of cognitive flexibility, affect and emotional intelligence. The result of this interaction is enhanced leader opportunity recognition that, in turn, facilitates multilevel outcomes.

Introduction to the First International Workshop on Empirical Research in Business Process Management (ER-BPM 2009)

Providing effective IT support for business processes has become crucial for enterprises to stay competitive. In response to this need numerous process support paradigms (e.g., workflow management, service flow management, case handling), process specification standards (e.g., WS-BPEL, BPML, BPMN), process tools (e.g., ARIS Toolset, Tibco Staffware, FLOWer), and supporting methods have emerged in recent years. Summarized under the term “Business Process Management” (BPM), these paradigms, standards, tools, and methods have become a success-critical instrument for improving process performance.