On laughter and loss. Children's experiences of shared time, parenting and security post-separation

Among the research, practice and socio-legal commentary on the substantial sharing of parenting time after separation, children’s voices about their experiences remain overwhelmingly silent. This article draws on findings of a descriptive phenomenological study which investigated Australian school-aged (8- to 12-year-old) children’s descriptions of two binary phenomena: security and contentment in shared time arrangements, and the absence of security and contentment in shared time parenting. Specifically, this article focuses on exploring parental behaviours and interactions recognised by children as sources of security in shared time lifestyles, through happy and needy times. Central to this is the juxtaposition of the child’s experience of security and shared enjoyment with the present parent, against the absence of security emanating from unresolved longing for the ‘absent’ parent. The article provides an empirically derived formulation of children’s advice to parents about shared time parenting, with relevance for family law related parent education forums.

Implementation of the diabetes and hypertension guideline lifestyle recommendations in urban Mongolia: A qualitative study of primary care providers

Abstract
Background: Hypertension and diabetes, key risk factors for cardiovascular disease, are significant health problems globally. As cardiovascular disease is one of the leading causes of mortality in Mongolia since 2000, clinical guidelines on arterial hypertension and diabetes were developed and implemented in 2011. This paper explores the barriers and enablers influencing the implementation of these guidelines in the primary care setting.
Methods: A phenomenological qualitative study with semi-structured interviews was conducted to explore the implementation of the diabetes and hypertension guidelines at the primary care level, as well as to gain insight into how practitioners view the usability and practicality of the guidelines. Ten family health centres were randomly chosen from a list of all the family health centres (n = 136) located in Ulaanbaatar City. In each centre, a focus group discussion with nurses (n = 20) and individual interviews with practice doctors (n =10) and practice managers (n= 10) were conducted. Data was analysed using a thematic approach utilising the Theoretical Domains Framework.
Results: The majority of the study participants reported being aware of the guidelines and that they had incorporated them into their daily practice. They also reported having attended guideline training sessions which were focused on practice skill development. The majority of participants expressed satisfaction with the wide range of resources that had been supplied to them by the Mongolian Government to assist with the implementation of the guidelines. The resources, supplied from 2011 onwards, included screening devices, equipment for blood tests, medications and educational materials. Other enablers were the participants’ commitment and passion for guideline implementation and their belief in the simplicity and practicality of the guidelines. Primary care providers reported a number of challenges in implementing the guidelines, including frustration caused by increased workload and long waiting times, time constraints, difficulties with conflicting tasks and low patient health literacy.
Conclusions: This study provides evidence that comprehensive and rigorous dissemination and implementation strategies increase the likelihood of successful implementation of new guidelines in low resource primary care settings. It also offers some key lessons that might be carefully considered when other evidence-based clinical guidelines are to be put into effect in low resource settings and elsewhere.

Core components of communication of clinical reasoning: a qualitative study with experienced Australian physiotherapists

Communication is an important area in health professional education curricula, however it has been dealt with as discrete skills that can be learned and taught separate to the underlying thinking. Communication of clinical reasoning is a phenomenon that has largely been ignored in the literature. This research sought to examine how experienced physiotherapists communicate their clinical reasoning and to identify the core processes of this communication. A hermeneutic phenomenological research study was conducted using multiple methods of text construction including repeated semi-structured interviews, observation and written exercises. Hermeneutic analysis of texts involved iterative reading and interpretation of texts with the development of themes and sub-themes. Communication of clinical reasoning was perceived to be complex, dynamic and largely automatic. A key finding was that articulating reasoning (particularly during research) does not completely represent actual reasoning processes but represents a (re)construction of the more complex, rapid and multi-layered processes that operate in practice. These communications are constructed in ways that are perceived as being most relevant to the audience, context and purpose of the communication. Five core components of communicating clinical reasoning were identified: active listening, framing and presenting the message, matching the co-communicator, metacognitive aspects of communication and clinical reasoning abilities. We propose that communication of clinical reasoning is both an inherent part of reasoning as well as an essential and complementary skill based on the contextual demands of the task and situation. In this way clinical reasoning and its communication are intertwined, providing evidence for the argument that they should be learned (and explicitly taught) in synergy and in context.

Learning to reason: a journey of professional socialisation

One of the key attributes that health professional students and new graduates develop during professional socialisation is clinical reasoning ability. Clinical reasoning is a complex skill that is essential for professional practice. There is limited research specifically addressing how physiotherapists learn to reason in the workplace. The research reported in this paper addressed this gap by investigating how experienced physiotherapists learned to reason in daily practice. This learning journey was examined in the context of professional socialisation. A hermeneutic phenomenological research study was conducted using multiple methods of data collection including observation, written reflective exercises and repeated, semi-structured interviews. Data were analysed using phenomenological and hermeneutic strategies involving in-depth, iterative reading and interpretation to identify themes in the data. Twelve physiotherapists with clinical and supervisory experience were recruited from the areas of cardiopulmonary, musculoskeletal and neurological physiotherapy to participate in this study. Participants' learning journeys were diverse, although certain episodes of learning were common or similar. Role models, mentors and colleagues were found to be influential in the development of reasoning. An important implication for the professional socialisation of physiotherapists and other health professionals and for those involved in practice development is the need to recognise and enhance the role of practice communities in the explicit learning of clinical reasoning skills.

Implementation of clinical guidelines on diabetes and hypertension in urban Mongolia: a qualitative study of primary care providers' perspectives and experiences

BACKGROUND: Hypertension and diabetes, key risk factors for cardiovascular disease, are significant health problems globally. As cardiovascular disease is one of the leading causes of mortality in Mongolia since 2000, clinical guidelines on arterial hypertension and diabetes were developed and implemented in 2011. This paper explores the barriers and enablers influencing the implementation of these guidelines in the primary care setting.

METHODS: A phenomenological qualitative study with semi-structured interviews was conducted to explore the implementation of the diabetes and hypertension guidelines at the primary care level, as well as to gain insight into how practitioners view the usability and practicality of the guidelines. Ten family health centres were randomly chosen from a list of all the family health centres (n = 136) located in Ulaanbaatar City. In each centre, a focus group discussion with nurses (n = 20) and individual interviews with practice doctors (n = 10) and practice managers (n = 10) were conducted. Data was analysed using a thematic approach utilising the Theoretical Domains Framework.

RESULTS: The majority of the study participants reported being aware of the guidelines and that they had incorporated them into their daily practice. They also reported having attended guideline training sessions which were focused on practice skill development. The majority of participants expressed satisfaction with the wide range of resources that had been supplied to them by the Mongolian Government to assist with the implementation of the guidelines. The resources, supplied from 2011 onwards, included screening devices, equipment for blood tests, medications and educational materials. Other enablers were the participants' commitment and passion for guideline implementation and their belief in the simplicity and practicality of the guidelines. Primary care providers reported a number of challenges in implementing the guidelines, including frustration caused by increased workload and long waiting times, time constraints, difficulties with conflicting tasks and low patient health literacy.

CONCLUSIONS: This study provides evidence that comprehensive and rigorous dissemination and implementation strategies increase the likelihood of successful implementation of new guidelines in low resource primary care settings. It also offers some key lessons that might be carefully considered when other evidence-based clinical guidelines are to be put into effect in low resource settings and elsewhere.

Feeling it: understanding Korean adoptees' experiences of embodied identity

This paper examines the ways in which transnational Korean adoptees experience identity as an embodied subjective process that is simultaneously contested and objectified by social perceptions of their bodies in their adoptive countries and South Korea. To analyse these lived experiences, I draw primarily on embodiment theories such as Budgeon’s (2003) sociological concept of ‘body as event’ and Csordas’ (2002) cultural phenomenological view of the body not as an object but as a ‘subject of culture’. To analyse processes of (re)embodiment, I draw on Ahmed’s (2007) concepts of ‘space’ and ‘whiteness’. Based on ethnographic data in South Korea and semi-structured interviews with 22 adult Korean adoptees, this paper demonstrates how Korean adoptees’ embodied identities are lived in relation to racialised experiences of belonging and Otherness.

Using voice to make musical and social connections

Community music is a rich and ongoing activity-taking place in formal and informal settings around Australia. This small-scale phenomenological qualitative case study is part of my wider study Spirituality and Wellbeing: Music in the Community that began in 2013. This paper demonstrates that community music making in a regional district in Victoria (Australia) makes it possible for choirs to use their voice to make musical and social connections to self and community that enhances both personal and community wellbeing. In May 2014, I visited three choirs for a week in the city of Warnnambool. Drawing on observation, questionnaires and focus group semi-structured interviews, I analysed the data using Interpretative Phenomenological Analysis. The findings include why people join choirs in regional towns, what they enjoyed that contributed to their wellbeing and why they want to sing about issues that make connections to social justice and sustainability. Though generalisations cannot be made to other towns or choirs, the findings show the need, importance and benefits of connecting to each other and the wider community. Using voice can serve as an effective platform to promote issues in the community such as social justice and the environment. It is hoped that the findings may provide a vehicle for further dialogue where choirs in other settings may experience similar connections to their community.

Gestão de pessoas em organizações em processo de transformação: a experiência da Rede Ferroviária Federal em liquidação

This study apprehends the living experiences of the RFFSA employees who still remain in the organization until its final moments of existence. In order to comprehend and analyze these experiences to generate knowledge related to personnel relationships in critical management realities as it is the case in a process of organizational liquidation. Due to the fact that the case study focus on a railroad enterprise, the presence of which is inherent to the history of the nation, social implications related to that liquidation process were investigated under cultural concepts, new organization context, added to a phenomenological approach. Through the consideration of that philosophical dimension of the relationships which constituted the object of this study, the railroader being could be more broadly understood. The employed methods include bibliographic and documental research to describe the organization and to reinforce sources for a deeper study of the railroad employee¿s culture and values. The posture assumed in that investigation was participation with the subjects including the researcher. Some characteristics were extracted out of questionnaires and interviews as a means of answering questions which would not come out trough numbers. What emerges as a fundamental learning in the conclusions can be summarized as follows: the understanding of an organization as a slice detached from society, is a deviation from human relevance paths, since implications of human actions in leabenswelt are ignored and their impacts are not considered concrete. That especial learning which the case study helped to clarify and which is an alert to liquidators and employees, independently of hierarchy, is not limited to liquidation processes. The phenomenon which shows itself in that strategic category of management is that its deviation from human relevance appears in higher dramaticism.

La interculturalidade como estratégia competitiva de las organizaciones brasilenãs frente a la globalización

Este estudo aborda o emprego de estratégias interculturais para conseguir competitividade organizacional em diferentes situações, tais como fusões alianças para negócios internacionais, servIços a clientes internacionais e comércio exterior. Em busca desse objetivo, a pesquisa de campo foi realizada em cinco diferentes organizações, entre as quaIs duas são instituições de ensmo, nas quaIs estudantes em comércio e negócios internacional foram entrevistados individualmente e em grupos. Nessa busca por fundamentos para postura educacional e habilidades interculturais, Simón Bolívar foi considerado urna inspiração, em especial devido à sua preocupação com o mútuo entendimento entre as nações latino-americanas, uma questão que está nas raízes de qualquer possibilidade de superar desafios interculturais. Além disso, os ideais daquele reconhecido líder emergem fortemente, quando essas nações estão decididas a estabelecer o MERCOSUL. As conclusões deste estudo não simplesmente mostram que esforços interculturais estão atualmente presentes nas estratégias de gestão e de negócios nas organizações e grupos enfocados, mas também encontra uma orientação, o que em termos fenomenológicos é um sentido voltado á compreensão intercultural, a qual é vista como uma atitude básica para fusões e negócios internacionais serem bem sucedidos.

Impactos dos valores pessoais no trabalho em equipe em organizações do terceiro setor

This study had the main purpose to answer to the following issue: How far the social projects experts's values contribute to a specific manner of working as a team? Searchin g for this answer, bibliography and field researches, with deep interviews and the picture construction technique were accomplieshed. The data analysis was carried out under a phenomenological view. This research report is structured in two pivots: The understanding of the individual, and of his relationship within the group. Firstly, I dealed with the formation of the Individual and his values; secondly, I focused the relations of the Individual with the group and more specifically, the team concept and the main characteristics and conditions that guarantee an efficient teamwork. Both chapters were developed through interpaticipating analysis this is by showing transcriptions of the most relevant parts of the interviews and of the works produced by the groups to as well as data from the bibliographic research. I concluded that, in the case of the researched sample, personal values really act on the way the Third Sector experts work in team, and that these experts are cooperative and committed to their respec tive projects.

Privatização da Vale do Rio Doce: valores, manifestações e implicações

Este estudo investigou, na Companhia Vale do Rio Doce (CVRD), como os funcionários perceberam as mudanças ocorridas na empresa, as ações da alta administração e o que ocorreu com os valores na organização após o processo de privatização. O objetivo final da pesquisa foi verificar que valores norteiam as propostas administrativas da Vale após a privatização, e como se manifestam nas ações e na postura dos agentes na sede da empresa. O referencial teórico incluiu mudança organizacional, teoria dos valores e responsabilidade das ações administrativas, para compreender o contexto atual da empresa após a privatização. A pesquisa de campo foi concebida sob o paradigma do construtivismo, em busca de percepções e sentimentos subjacentes e manifestos em entrevistas e questionários a fim de explicitar os valores passados e presentes na organização e possibilidades de uma nova realidade. Uma abordagem fenomenológica complementar favoreceu a inserção da autora no mundo da vida dessa organização, facilitando a fluência do diálogo para a apreensão de manifestações e implicações dos valores das pessoas no processo de transição. As reflexões finais indicam a necessidade de um trabalho organizacional que envolva funcionários e alta administração com o propósito comum de redescoberta do significado próprio da organização. O Programa Vale Viver surge como uma tentativa nessa direção. Os valores "vestir a camisa", "valorizar a prata da casa" e "vencer desafios" acompanham o tempo de vida da cultura da Vale. O valor "vestir a camisa," cujo significado é compartilhamento autêntico, na atualidade é mais uma expectativa a ser retomada do que uma vivência. O valor "vencer desafios" está mais presente na área operacional e o valor "valorizar a prata da casa" aparece mais relacionado a programas como o Banco de OpOliunidades, reavivado pelo Vale Viver. Não significa que o Vale Viver seja a única saída para a retomada da confiança, da elevação da auto-estima e de uma articulação empregados e nova administração na construção de uma base comum de valores, mas é a possibilidade mais visível no momento em que a retomada do espírito da V ALE é fundamental para essa nova etapa de sua vida.

Um caso de aprendizagem organizacional: exame conceitual e de aplicabilidade no contexto público

This research has a practice-oriented focus on the concept of Organizational Learning. The basic approach is a learning organization perspective, and some references to the concepts and concerns of organizational learning were included whenever necessary and proper. Organizational Learning is researched mainly from a management techniques and strategy point of view, with a smaller emphasis on the innovation and accumulation of technological capabilities and theoretical research points of view. A broad approach has been used, based mainly on the study of a successful case using action research in a private telecommunication company operating nationwide in Brazil. This study involved a small group, as it is common with pilot groups for learning organizations. The main purpose of this research is to provide a broad and updated survey about the idea of Organizational Learning. Results presented in the related literature are compared with findings from the field, and that literature is cited throughout the text. The interactions of Organizational Learning with the Brazilian context and with the public administration context are analyzed; important data, ranging from the historical origins and bases of the concept, to details of the activities in a real life learning organization, are shown. Some essential aspects, that should be considered or used when applying this type of management, are analyzed. The action research has shown a close proximity between Organizational Learning and a phenomenological perspective, servant leadership, and managerial model, respectively in the fields of philosophical approach, leadership, and management models.

Impactos emocionais causados pela mudança de estilo de gestão em um hospital na cidade de São Luis-MA

The objective of this study is to identify how a health institution can minimize the emotional impacts caused by the change of a style of classic management for a participative administration, that the workers and controllers can see the institution as a dynamic organization, that must be faced as an alive system, mobile and adaptable, where they is beings that have the right to react and to answer to the stimulatons. For that, the institution can handle motivator¿s instruments that develop in the people the potential to react of adequate way to the changes proposals, as well as increasing the perspective of possible technological improvements and interpersonal relationship between the internal and external customers. To change the style to manage, to hear the staff of support and user, are not part of the routine of the heads that develop classic management. This decision demands adaptation and flexibility, study, update and psychological preparation, to face common feelings to the new. It fits to the new directors, to visualize these feelings and work to minimize, avoiding future upheavals and the confrontation of situations that can harm the production of the company, as well as the quality of the communication between the diverse dimensions of the organization people. In this study case, based in phenomenological methodology, was possible to verify, through half-open interviews and comments, how was faced the feelings caused at the old direction time, composed for military who withheld the power and determined the actions of the hospital in study, was replaced by health professionals, that saw in the work team the best option to solve the problems and the potential to carry through an administration based in adequate strategies the reality of the moment, with the objective of reaching the satisfaction of the customer. Through this work, is possible to prove the theory that the changes cause impacts that affect the behavior of the people involved and cause stress, as well as conclude that despite the new direction show themselves, during the change, much made use to make right and involve all the workers, didn¿t have traced strategies to minimize the emotional impacts caused by the changes, what made all face their feelings of doubts and anxiety without no special care. Many obtained, by themselves, to face and to adapt the new proposals, but some could not assimilate the new administrative methodology and had been moved away definitively from the institution.

Responsabilidade social empresarial no mercado de seguros brasileiro: influências culturais e implicações relacionais

The Brazilian insurance market is the ambience in which this research study takes place in search for a better understanding of how cultural characteristics are related with organizational signs, practices and expectations on social responsibility. The concepts of social responsibility as well as the concept of culture are presented and discussed from different points of view, in accordance with different authors and trough several methodological approaches, in order to establish a coherent theoretical basis for qualitative data analysis. The phenomenological attitude assumed by the researcher in especial dialogues situations during the field research phase added new possibilities of apprehension or emergence of each studied organization self orientation in terms of pre-occupation with social issues intimately related with their insurance activities in the market place. Final reflections show the complexity of the insurance cultural context in the studied Brazilian segment, in which cultural and subcultural national and organizational singularities appear. However leaving space for common values and coherent orientation toward the peculiar understanding of social responsibility as inherent to any insurance company activities, themselves. Last comments point out that future research studies may give additional contribution for the continuity of the discussions initiated in this dissertation, expecting that some changes in the organizational posture and practices may happen, especially those related with risk taking and broad processes of communication with clients and society as a whole.

Racionalidade instrumental e mediação organizacional: um estudo sobre a percepção dos gestores da Caixa

o objetivo dessa dissertação é identificar e analisar a percepção dos gestores da CAIXA, frente à Empresa, tendo como referência os conceitos de Racionalidade Instrumental e Mediação Organizacional. De início, fez-se uso de um Método Fenomenológico, de forma a defmir as questões que deveriam ser respondidas, a partir das experiências práticas de gestão desta pesquisadora, decorrentes do relacionamento existente junto aos Gerentes de Mercado do Segmento de Pessoas Físicas de Média e Alta Renda da CAIXA ECONÔMICA FEDERAL. Em seguida, foi defmido o referencial teórico adequado à sustentação do objeto de pesquisa, estruturado nos conceitos de Racionalidade Instrumental, incluindo traços característicos da Síndrome Comportamentalista e os mecanismos de Mediação Organizacional. Fez-se uso de uma pesquisa descritiva, para referendar as percepções iniciais, junto ao mesmo público. Concluiu-se, sob a percepção desses gestores, que eles se vêem sujeitos aos valores de uma sociedade centrada no mercado, assumem seus códigos e são operados por ela, independente de trabalharem numa empresa pública. No nível organizacional, as mediações na dimensão ideológica respondem como o mais poderoso mecanismo de subjugação, na medida em que o tipo de atuação da CAIXA provoca em seus gestores, orgulho, senso de utilidade e de diferenciação. Em troca, os empregados seduzidos e submetidos a esse poder, se prestam a garantir o alcance dos objetivos organizacionais, de forma ampliada e recorrente, reforçando os princípios da racionalidade instrumental. Esse processo se auto-alimenta continuamente. Por fim, o questionamento que fica é: Como alterar o curso dessa história e resgatar o verdadeiro sentido das relações humanas?