Quality of work life and turnover intention in primary healthcare organisations : a cross-sectional study of registered nurses in Saudi Arabia

Purpose: The purpose of this study was to improve the retention of primary healthcare (PHC) nurses through exploring and assessing their quality of work life (QWL) and turnover intention. Design and methods: A cross-sectional survey design was used in this study. Data were collected using a questionnaire comprising four sections (Brooks’ survey of Quality of Nursing Work Life [QNWL], Anticipated Turnover Intention, open-ended questions and demographic characteristics). A convenience sample was recruited from 143 PHC centres in Jazan, Saudi Arabia. A response rate of 87% (n = 508/585) was achieved. The SPSS v17 for Windows and NVivo 8 were used for analysis purposes. Procedures and tests used in this study to analyse the quantitative data were descriptive statistics, t-test, ANOVA, General Linear Model (GLM) univariate analysis, standard multiple regression, and hierarchical multiple regression. Qualitative data obtained from responses to the open-ended questions were analysed using the NVivo 8. Findings: Quantitative findings suggested that PHC nurses were dissatisfied with their work life. Respondents’ scores ranged between 45 and 218 (mean = 139.45), which is lower than the average total score on Brooks’ Survey (147). Major influencing factors were classified under four dimensions. First, work life/home life factors: unsuitable working hours, lack of facilities for nurses, inability to balance work with family needs and inadequacy of vacations’ policy. Second, work design factors: high workload, insufficient workforce numbers, lack of autonomy and undertaking many non-nursing tasks. Third, work context factors: management practices, lack of development opportunities, and inappropriate working environment in terms of the level of security, patient care supplies and unavailability of recreation room. Finally, work world factors: negative public image of nursing, and inadequate payment. More positively, nurses were notably satisfied with their co-workers. Conversely, 40.4% (n = 205) of the respondents indicated that they intended to leave their current employment. The relationships between QWL and demographic variables of gender, age, marital status, dependent children, dependent adults, nationality, ethnicity, nursing tenure, organisational tenure, positional tenure, and payment per month were significant (p < .05). The eta squared test for these demographics indicates a small to medium effect size of the variation in QWL scores. Using the GLM univariate analysis, education level was also significantly related to the QWL (p < .05). The relationships between turnover intention and demographic variables including gender, age, marital status, dependent children, education level, nursing tenure, organisational tenure, positional tenure, and payment per month were significant (p < .05). The eta squared test for these demographics indicates a small to moderate effect size of the variation in the turnover intention scores. Using the GLM univariate analysis, the dependent adults’ variable was also significantly related to turnover intention (p < .05). Turnover intention was significantly related to QWL. Using standard multiple regression, 26% of the variance in turnover intention was explained by the QWL F (4,491), 43.71, p < .001, with R² = .263. Further analysis using hierarchical multiple regression found that the total variance explained by the model as a whole (demographics and QWL) was 32.1%, F (17.433) = 12.04, p < .001. QWL explained an additional 19% of the variance in turnover intention, after controlling for demographic variables, R squared change =.19, F change (4, 433) = 30.190, p < .001. The work context variable makes the strongest unique contribution (-.387) to explain the turnover intention, followed by the work design dimension (-.112). The qualitative findings reaffirmed the quantitative findings in terms of QWL and turnover intention. However, the home life/work life and work world dimensions were of great important to both QWL and turnover intention. The qualitative findings revealed a number of new factors that were not included in the survey questionnaire. These included being away from family, lack of family support, social and cultural aspects, accommodation facilities, transportation, building and infrastructure of PHC, nature of work, job instability, privacy at work, patients and community, and distance between home and workplace. Conclusion: Creating and maintaining a healthy work life for PHC nurses is very important to improve their work satisfaction, reduce turnover, enhance productivity and improve nursing care outcomes. Improving these factors could lead to a higher QWL and increase retention rates and therefore reinforcing the stabilisation of the nursing workforce. Significance of the research: Many countries are examining strategies to attract and retain the health care workforce, particularly nurses. This study identified factors that influence the QWL of PHC nurses as well as their turnover intention. It also determined the significant relationship between QWL and turnover intention. In addition, the present study tested Brooks’ survey of QNWL on PHC nurses for the first time. The qualitative findings of this study revealed a number of new variables regarding QWL and turnover intention of PHC nurses. These variables could be used to improve current survey instruments or to develop new research surveys. The study findings could be also used to develop and appropriately implement plans to improve QWL. This may help to enhance the home and work environments of PHC nurses, improve individual and organisational performance, and increase nurses’ commitment. This study contributes to the existing body of research knowledge by presenting new data and findings from a different country and healthcare system. It is the first of its kind in Saudi Arabia, especially in the field of PHC. It has examined the relationship between QWL and turnover intention of PHC nurses for the first time using nursing instruments. The study also offers a fresh explanation (new framework) of the relationship between QWL and turnover intention among PHC nurses, which could be used or tested by researchers in other settings. Implications for further research: Review of the extant literature reveals little in-depth research on the PHC workforce, especially in terms of QWL and organisational turnover in developing countries. Further research is required to develop a QWL tool for PHC nurses, taking into consideration the findings of the current study along with the local culture. Moreover, the revised theoretical framework of the current study could be tested in further research in other regions, countries or healthcare systems in order to identify its ability to predict the level of PHC nurses’ QWL and their intention to leave. There is a need to conduct longitudinal research on PHC organisations to gain an in-depth understanding of the determents of and changes in QWL and turnover intention of PHC nurses at various points of time. An intervention study is required to improve QWL and retention among PHC nurses using the findings of the current study. This would help to assess the impact of such strategies on reducing turnover of PHC nurses. Focusing on the location of the current study, it would be valuable to conduct another study in five years’ time to examine the percentage of actual turnover among PHC nurses compared with the reported turnover intention in the current study. Further in-depth research would also be useful to assess the impact of the local culture on the perception of expatriate nurses towards their QWL and their turnover intention. A comparative study is required between PHC centres and hospitals as well as the public and private health sector agencies in terms of QWL and turnover intention of nursing personnel. Findings may differ from sector to sector according to variations in health systems, working environments and the case mix of patients.

Academics’ work and the concept of “profession” : an Australian case study

Universities in Australia and elsewhere have changed considerably in recent years. Inevitably, this has meant that the work of academics has also changed. Academics’ work is of importance because they are key players in universities and universities matter to the nation economically and intellectually in advancing knowledge and its practical application. Through the changes and challenges that have characterised academia in recent years, there is an assumption that academics’ work is representative of a profession. This research study investigates how academics construct their own perspectives regarding the academic "profession". The study is theoretically informed by Freidson’s theory that conceptualises professions as occupations if they are in control of their work rather than it being under the control of either the market or of their employing institutions. Two research questions guide this study. The first question investigates how academics might construct their work in ideal terms and the second one investigates the extent to which such constructions might constitute a "profession". A qualitative case study was conducted within two Australian universities. In all, twenty academics from ten disciplines took part in the study that consisted of a focus group and fifteen individual interviews. The study was conducted in three phases during which a conceptual framework of academics’ work was developed across three versions. This framework acted both a prompt to discussion and as a potential expression of academics’ work. The first version of the framework was developed from the literature during the first phase of the study. This early framework was used during the second phase of the study when five academics took part in a focus group. After the focus group, the second version of the framework was developed and used with fifteen academics in individual interviews during phase three of the study. The third version of the framework was the outcome of a synthesis of the themes that were identified in the data. The discussion data from the focus group and the individual interviews were analysed through a content analysis approach that identified four major themes. The first theme was that academics reported that their work would ideally be located within universities committed to using their expert knowledge to serve the world. The second theme was that academics reported that they wanted sufficient thinking time and reasonable workloads to undertake the intellectual work that they regard as their core responsibility, particularly in relation to undertaking research. They argued against heavy routine administrative workloads and sought a continuation of current flexible working arrangements. The third theme was that teaching qualifications should not be mandated but that there should be a continuation of the present practice of universities offering academics the opportunity to undertake formal teaching qualifications if they wish to. Finally, academics reported that they wanted values that have traditionally mattered to academia to continue to be respected and practised: autonomy, collegiality and collaborative relationships, altruism and service, and intellectual integrity. These themes are sympathetic to Freidson’s theory of professions in all but one matter: the non-mandatory nature of formal qualifications which he regards as absolutely essential for the performance of the complex intellectual work that characterises occupations that are professions. The study places the issue of academic professionalism on the policy agenda for universities wishing to identify academics’ work as a profession. The study contributes a theory-based and data-informed conceptual framework for academics’ work that can be considered in negotiating the nature and extent of their work. The framework provides a means of analysing what "academic professionalism" might mean; it adds specificity to such discussions by exploring a particular definition of profession, namely Freidson’s theory of professions as occupations that are in control of their own work. The study contributes to the development of theories around higher education concepts of academic professionalism and, in so doing, links that theoretical contribution to the wider professions field.

Teachers’ work in curricular markets : conditions of design and relations between the International Baccalaureate Diploma and the local curriculum

School level strategy enabled by neoliberal choice policies can produce internal curricular markets whereby branded curricula such as the International Baccalaureate are offered alongside the local government curriculum in the same school. This project investigated how such curricular markets operating in Australian schools impacted on teachers’ work. This paper reports on teachers work in three case study schools that offered both the International Baccalaureate Diploma program and the local senior schooling curriculum, then draws on an online survey of 225 teachers in 26 such schools across Australia. The analysis reveals the impact of curricular markets along two dimensions: the curriculum’s internal design; and the relational aspects of how schools manage to deliver tandem offerings within institutional constraints. Teachers working in the IBD Diploma program were shown to relish its design, despite additional demands, while teachers working in just the local curriculum reported more relational issues. The paper argues that these trends suggest that there are winners and losers emerging in the work conditions produced by curricular markets.  

Visual support for work assignment in process-aware information systems : framework formalisation and implementation

Process-aware information systems, ranging from generic workflow systems to dedicated enterprise information systems, use work-lists to offer so-called work items to users. In real scenarios, users can be confronted with a very large number of work items that stem from multiple cases of different processes. In this jungle of work items, users may find it hard to choose the right item to work on next. The system cannot autonomously decide which is the right work item, since the decision is also dependent on conditions that are somehow outside the system. For instance, what is “best” for an organisation should be mediated with what is “best” for its employees. Current work-list handlers show work items as a simple sorted list and therefore do not provide much decision support for choosing the right work item. Since the work-list handler is the dominant interface between the system and its users, it is worthwhile to provide an intuitive graphical interface that uses contextual information about work items and users to provide suggestions about prioritisation of work items. This paper uses the so-called map metaphor to visualise work items and resources (e.g., users) in a sophisticated manner. Moreover, based on distance notions, the work-list handler can suggest the next work item by considering different perspectives. For example, urgent work items of a type that suits the user may be highlighted. The underlying map and distance notions may be of a geographical nature (e.g., a map of a city or office building), but may also be based on process designs, organisational structures, social networks, due dates, calendars, etc. The framework proposed in this paper is generic and can be applied to any process-aware information system. Moreover, in order to show its practical feasibility, the paper discusses a full-fledged implementation developed in the context of the open-source workflow environment YAWL, together with two real examples stemming from two very different scenarios. The results of an initial usability evaluation of the implementation are also presented, which provide a first indication of the validity of the approach.

A hierarchical evolutionary algorithmic design (HEAD) system for generating and evolving building design models

This thesis develops a detailed conceptual design method and a system software architecture defined with a parametric and generative evolutionary design system to support an integrated interdisciplinary building design approach. The research recognises the need to shift design efforts toward the earliest phases of the design process to support crucial design decisions that have a substantial cost implication on the overall project budget. The overall motivation of the research is to improve the quality of designs produced at the author's employer, the General Directorate of Major Works (GDMW) of the Saudi Arabian Armed Forces. GDMW produces many buildings that have standard requirements, across a wide range of environmental and social circumstances. A rapid means of customising designs for local circumstances would have significant benefits. The research considers the use of evolutionary genetic algorithms in the design process and the ability to generate and assess a wider range of potential design solutions than a human could manage. This wider ranging assessment, during the early stages of the design process, means that the generated solutions will be more appropriate for the defined design problem. The research work proposes a design method and system that promotes a collaborative relationship between human creativity and the computer capability. The tectonic design approach is adopted as a process oriented design that values the process of design as much as the product. The aim is to connect the evolutionary systems to performance assessment applications, which are used as prioritised fitness functions. This will produce design solutions that respond to their environmental and function requirements. This integrated, interdisciplinary approach to design will produce solutions through a design process that considers and balances the requirements of all aspects of the design. Since this thesis covers a wide area of research material, 'methodological pluralism' approach was used, incorporating both prescriptive and descriptive research methods. Multiple models of research were combined and the overall research was undertaken following three main stages, conceptualisation, developmental and evaluation. The first two stages lay the foundations for the specification of the proposed system where key aspects of the system that have not previously been proven in the literature, were implemented to test the feasibility of the system. As a result of combining the existing knowledge in the area with the newlyverified key aspects of the proposed system, this research can form the base for a future software development project. The evaluation stage, which includes building the prototype system to test and evaluate the system performance based on the criteria defined in the earlier stage, is not within the scope this thesis. The research results in a conceptual design method and a proposed system software architecture. The proposed system is called the 'Hierarchical Evolutionary Algorithmic Design (HEAD) System'. The HEAD system has shown to be feasible through the initial illustrative paper-based simulation. The HEAD system consists of the two main components - 'Design Schema' and the 'Synthesis Algorithms'. The HEAD system reflects the major research contribution in the way it is conceptualised, while secondary contributions are achieved within the system components. The design schema provides constraints on the generation of designs, thus enabling the designer to create a wide range of potential designs that can then be analysed for desirable characteristics. The design schema supports the digital representation of the human creativity of designers into a dynamic design framework that can be encoded and then executed through the use of evolutionary genetic algorithms. The design schema incorporates 2D and 3D geometry and graph theory for space layout planning and building formation using the Lowest Common Design Denominator (LCDD) of a parameterised 2D module and a 3D structural module. This provides a bridge between the standard adjacency requirements and the evolutionary system. The use of graphs as an input to the evolutionary algorithm supports the introduction of constraints in a way that is not supported by standard evolutionary techniques. The process of design synthesis is guided as a higher level description of the building that supports geometrical constraints. The Synthesis Algorithms component analyses designs at four levels, 'Room', 'Layout', 'Building' and 'Optimisation'. At each level multiple fitness functions are embedded into the genetic algorithm to target the specific requirements of the relevant decomposed part of the design problem. Decomposing the design problem to allow for the design requirements of each level to be dealt with separately and then reassembling them in a bottom up approach reduces the generation of non-viable solutions through constraining the options available at the next higher level. The iterative approach, in exploring the range of design solutions through modification of the design schema as the understanding of the design problem improves, assists in identifying conflicts in the design requirements. Additionally, the hierarchical set-up allows the embedding of multiple fitness functions into the genetic algorithm, each relevant to a specific level. This supports an integrated multi-level, multi-disciplinary approach. The HEAD system promotes a collaborative relationship between human creativity and the computer capability. The design schema component, as the input to the procedural algorithms, enables the encoding of certain aspects of the designer's subjective creativity. By focusing on finding solutions for the relevant sub-problems at the appropriate levels of detail, the hierarchical nature of the system assist in the design decision-making process.

An exploration of the maturity model concept as a vehicle for higher education institutions to assess their capability to address student engagement : a work in progress

Gaining a competitive edge in the area of the engagement, success and retention of commencing students is a significant issue in higher education, made more so currently because of the considerable and increasing pressure on teaching and learning from the new standards framework and performance funding. This paper introduces the concept of maturity models (MMs) and their application to assessing the capability of higher education institutions (HEIs) to address student engagement, success and retention (SESR). A concise description of the features of maturity models is presented with reference to an SESR-MM currently being developed. The SESR-MM is proposed as a viable instrument for assisting HEIs in the management and improvement of their SESR activities.

Is there an inverted U-shape relationship between job demands and work engagement : the moderating role of social support

Purpose - The purpose of this paper is to examine the possibility of an inverted U-shaped relationship between job demands and work engagement, and whether social support moderates this relationship. Design/methodology/approach – This study uses 307 technical and information technology (IT) managers who responded to an online survey. Multiple regressions are employed to examine linear and curvilinear relationship among variables. Findings – Overall, results support the applicability of the quadratic effect of job demands on employee engagement. However, only supervisor support, not colleague support, moderated the relationship between job demands and work engagement. Originality/value – The paper is the first to shed light on the quadratic effect of job demands on work engagement. The findings have noteworthy implications for managers to design optimal job demands that increase employee engagement.

Mining work, family and community : a spatially-oriented approach to the impact of the Ravensthorpe nickel mine closure in remote Australia

While changes in work and employment practices in the mining sector have been profound, the literature addressing mining work is somewhat partial as it focuses primarily on the workplace as the key (or only) site of analysis, leaving the relationship between mining work and families and communities under-theorized. This article adopts a spatially oriented, case-study approach to the sudden closure of the Ravensthorpe nickel mine in the south-west of Western Australia to explore the interplay between the new scales and mobilities of labour and capital and work–family–community connections in mining. In the context of the dramatically reconfigured industrial arena of mining work, the study contributes to a theoretical engagement between employment relations and the spatial dimensions of family and community in resource-affected communities.

Vibrational spectroscopic study of the mineral creaseyite Cu2Pb2(Fe,Al)2(Si5O17)·6H2O – a zeolite mineral?

Vibrational spectroscopy has been used to characterise the mineral creaseyite Cu2Pb2(Fe,Al)2(Si5O17)·6H2O. The mineral is found in the oxidised zone of base metal deposits and interestingly is associated with copper silicate minerals including ajoite, kinoite, chrysocolla as well as wulfenite, willemite, mimetite and wickenburgite. Creaseyite is a mineral with zeolitic properties. A Raman band at 998 cm−1 is assigned to the SiO stretching vibration of SiO3 units. The Raman band at 1071 cm−1 is assigned to the SiO stretching vibrations of the Si2O5 units. Raman bands are found at 2750, 2902, 3162, 3470 and 3525 cm−1. The band at 3525 cm−1 is attributed to zeolitic water. Other bands are assigned to water coordinated to the metal cations. Vibrational spectroscopy enables aspects of the molecular structure of creaseyite to be determined.

Termination And Discipline Procedures, Disputes Procedures & Work Evaluation

This series of paper examines industrial issues from a nonprofit management perspective.

Australian Learning and Teaching Council, Learning and Teaching Academic Standards Statement for Architecture

The development of the Learning and Teaching Academic Standards Statement for Architecture (the Statement) centred on requirements for the Master of Architecture and proceeded alongside similar developments in the building and construction discipline under the guidance and support of the Australian Deans of Built Environment and Design (ADBED). Through their representation of Australian architecture programs, ADBED have provided high-level leadership for the Learning and Teaching Academic Standards Project in Architecture (LTAS Architecture). The threshold learning outcomes (TLOs), the description of the nature and extent of the discipline, and accompanying notes were developed through wide consultation with the discipline and profession nationally. They have been considered and debated by ADBED on a number of occasions and have, in their fi nal form, been strongly endorsed by the Deans. ADBED formed the core of the Architecture Reference Group (chaired by an ADBED member) that drew together representatives of every peak organisation for the profession and discipline in Australia. The views of the architectural education community and profession have been provided both through individual submissions and the voices of a number of peak bodies. Over two hundred individuals from the practising profession, the academic workforce and the student cohort have worked together to build consensus about the capabilities expected of a graduate of an Australian Master of Architecture degree. It was critical from the outset that the Statement should embrace the wisdom of the greater ‘tribe’, should ensure that graduates of the Australian Master of Architecture were eligible for professional registration and, at the same time, should allow for scope and diversity in the shape of Australian architectural education. A consultation strategy adopted by the Discipline Scholar involved meetings and workshops in Perth, Melbourne, Sydney, Canberra and Brisbane. Stakeholders from all jurisdictions and most universities participated in the early phases of consultation through a series of workshops that concluded late in October 2010. The Draft Architecture Standards Statement was formed from these early meetings and consultation in respect of that document continued through early 2011. This publication represents the outcomes of work to establish an agreed standards statement for the Master of Architecture. Significant further work remains to ensure the alignment of professional accreditation and recognition procedures with emerging regulatory frameworks cascading from the establishment of the Tertiary Education Quality and Standards Agency (TEQSA). The Australian architecture community hopes that mechanisms can be found to integrate TEQSA’s quality assurance purpose with well-established and understood systems of professional accreditation to ensure the good standing of Australian architectural education into the future. The work to build renewed and integrated quality assurance processes and to foster the interests of this project will continue, for at least the next eighteen months, under the auspices of Australian Learning and Teaching Council (ALTC)-funded Architecture Discipline Network (ADN), led by ADBED and Queensland University of Technology. The Discipline Scholar gratefully acknowledges the generous contributions given by those in stakeholder communities to the formulation of the Statement. Professional and academic colleagues have travelled and gathered to shape the Standards Statement. Debate has been vigorous and spirited and the Statement is rich with the purpose, critical thinking and good judgement of the Australian architectural education community. The commitments made to the processes that have produced this Statement reflect a deep and abiding interest by the constituency in architectural education. This commitment bodes well for the vibrancy and productivity of the emergent Architecture Discipline Network (ADN). Endorsement, in writing, was received from the Australian Institute of Architects National Education Committee (AIA NEC): The National Education Committee (NEC) of the Australian Institute of Architects thank you for your work thus far in developing the Learning and Teaching Academic Standards for Architecture In particular, we acknowledge your close consultation with the NEC on the project along with a comprehensive cross-section of the professional and academic communities in architecture. The TLOs with the nuanced levels of capacities – to identify, develop, explain, demonstrate etc – are described at an appropriate level to be understood as minimum expectations for a Master of Architecture graduate. The Architects Accreditation Council of Australia (AACA) has noted: There is a clear correlation between the current processes for accreditation and what may be the procedures in the future following the current review. The requirement of the outcomes as outlined in the draft paper to demonstrate capability is an appropriate way of expressing the measure of whether the learning outcomes have been achieved. The measure of capability as described in the outcome statements is enhanced with explanatory descriptions in the accompanying notes.

Perceptions of physical versus virtual design studio education

While the studio environment has been promoted as an ideal educational setting for project-based disciplines associated with the art and design, few qualitative studies have been undertaken in a comprehensive way, with even fewer giving emphasis to the teachers and students and how they feel about changing their environment. This situation is problematic given the changes and challenges facing higher education, including those associated with new technologies such as online learning. In response, this paper describes a comparative study employing grounded theory to identify and describe teachers’ and students’ perceptions of the physical design studio (PDS) as well as the virtual design studio (VDS) of architectural students in an Australian university. The findings give significance to aspects of design education activities and their role in the development of integrated hybrid learning environments.