Letteratura scientifica selezionata sul tema "Medical personnel Salaries, etc. Australia"

This article is devoted to V.V. Trofimov, Minister of Health of the RSFSR, an outstanding health care manager, who tried to introduce the modern methods of self-financing, automated information systems, etc., into the management of medical science during the period 1962-1983. At the initiative of V.V. Trofimov, for the first time in the country, the Main Department of research institutes and coordination of scientific research was established, the purpose of which was to ensure a scientific breakthrough in medicine through the development and implementation of innovative methods. The experience of joint work of health authorities, medical universities, and research institutions began to accumulate. It allowed solving problems of improving the quality of medical care according to united comprehensive plans. The material and technical base for public health protection was developed. During the tenth five-year plan alone, 20 large multi-specialty hospitals were built for 600-1200 beds, 88 polyclinics for 750-1200 visits per shift, 80 maternity hospitals and departments for 8849 beds were put into operation, 24 women’s consultations for 1000 visits per shift, and 13 multi-specialty children’s hospitals. The availability of medical personnel increased from 34.8 in 1975 to 40.0 in 1980 (per 10,000 population). The reform of the financing of medical institutions included the transfer of hospitals and polyclinics to economic accounting. The reform was introduced to enhance medical workers’ financial incentives to improve medical care, as savings increased doctors’ and nurses’ salaries. In essence, it was an anti-pod to the extensive, expensive way of conducting the national economy adopted in the country. As the first Editor-in-Chief of the journal “Health Care of the Russian Federation” and he prioritized innovative research in editorial policy for many years to come.

"The study provides the documentation for the first public version of the database Digital Framework for the History of the Austrian Military Border in Transylvania by means of a detailed description and user manual. It includes: a short overview of the historical context of the establishment of the Austrian military border in this province, references to the international and Romanian state of the art, the detailing of primary sources issued by the military environment and starting from which the database was built and the main principles of construction and operation of the latter. The information in the database is extracted from the records of the military and administrative personnel of the Transylvanian border regiments between 1763 and 1850, including monthly staff records, information on salaries, enrollments, transfers, desertions, medical certificates, etc. The lists of conduct of the officers should also be mentioned, each of them including a detailed physical and psychological description of the respective person. The database serves two aims. On the one hand, to boost the use of and access to documents generated by the Austrian military and with this to bring the Romanian historical writing on the military border in Transylvania closer to the primary sources. On the other hand, to complement, for the territory of the former military border, the vital registration data provided by parish registers with social history data that can improve life course reconstruction and analysis. Keywords: Historical databases, Austrian Military Border, Transylvania, Habsburg Monarchy, Military history "

Abstract Background Medicine is a high-status, high-skill occupation which has traditionally provided access to good quality jobs and relatively high salaries. In Ireland, historic underfunding combined with austerity-related cutbacks has negatively impacted job quality to the extent that hospital medical jobs have begun to resemble extreme jobs. Extreme jobs combine components of a good quality job—high pay, high job control, challenging demands, with those of a low-quality job—long working hours, heavy workloads. Deteriorating job quality and the normalisation of extreme working is driving doctor emigration from Ireland and deterring return. Methods Semi-structured qualitative interviews were conducted with 40 Irish emigrant doctors in Australia who had emigrated from Ireland since 2008. Interviews were held in July–August 2018. Results Respondents reflected on their experiences of working in the Irish health system, describing hospital workplaces that were understaffed, overstretched and within which extreme working had become normalised, particularly in relation to long working hours, fast working pace, doing more with less and fighting a climate of negativity. Drawing on Hirschman’s work on exit, voice and loyalty (1970), the authors consider doctor emigration as exit and present respondent experiences of voice prior to emigration. Only 14/40 respondent emigrant doctors intend to return to work in Ireland. Discussion The deterioration in medical job quality and the normalisation of extreme working is a key driver of doctor emigration from Ireland, and deterring return. Irish trained hospital doctors emigrate to access good quality jobs in Australia and are increasingly likely to remain abroad once they have secured them. To improve doctor retention, health systems and employers must mitigate a gainst the emergence of extreme work in healthcare. Employee voice (about working conditions, about patient safety, etc.) should be encouraged and used to inform health system improvement and to mitigate exit.

Introduction: Bubbles and Sport The ephemeral materiality of bubbles – beautiful, spectacular, and distracting but ultimately fragile – when applied to protect or conserve in the interests of sport-media profit, creates conditions that exacerbate existing inequalities in sport and society. Bubbles are usually something to watch, admire, and chase after in their brief yet shiny lives. There is supposed to be, technically, nothing inside them other than one or more gasses, and yet we constantly refer to people and objects being inside bubbles. The metaphor of the bubble has been used to describe the life of celebrities, politicians in purpose-built capital cities like Canberra, and even leftist, environmentally activist urban dwellers. The metaphorical and material qualities of bubbles are aligned—they cannot be easily captured and are liable to change at any time. In this article we address the metaphorical sporting bubble, which is often evoked in describing life in professional sport. This is a vernacular term used to capture and condemn the conditions of life of elite sportspeople (usually men), most commonly after there has been a sport-related scandal, especially of a sexual nature (Rowe). It is frequently paired with connotatively loaded adjectives like pampered and indulged. The sporting bubble is rarely interrogated in academic literature, the concept largely being left to the media and moral entrepreneurs. It is represented as involving a highly privileged but also pressurised life for those who live inside it. A sporting bubble is a world constructed for its most prized inhabitants that enables them to be protected from insurgents and to set the terms of their encounters with others, especially sport fans and disciplinary agents of the state. The Covid-19 pandemic both reinforced and reconfigured the operational concept of the bubble, re-arranging tensions between safety (protecting athletes) and fragility (short careers, risks of injury, etc.) for those within, while safeguarding those without from bubble contagion. Privilege and Precarity Bubble-induced social isolation, critics argue, encourages a loss of perspective among those under its protection, an entitled disconnection from the usual rules and responsibilities of everyday life. For this reason, the denizens of the sporting bubble are seen as being at risk to themselves and, more troublingly, to those allowed temporarily to penetrate it, especially young women who are first exploited by and then ejected from it (Benedict). There are many well-documented cases of professional male athletes “behaving badly” and trying to rely on institutional status and various versions of the sporting bubble for shelter (Flood and Dyson; Reel and Crouch; Wade). In the age of mobile and social media, it is increasingly difficult to keep misbehaviour in-house, resulting in a slew of media stories about, for example, drunkenness and sexual misconduct, such as when then-Sydney Roosters co-captain Mitchell Pearce was suspended and fined in 2016 after being filmed trying to force an unwanted kiss on a woman and then simulating a lewd act with her dog while drunk. There is contestation between those who condemn such behaviour as aberrant and those who regard it as the conventional expression of youthful masculinity as part of the familiar “boys will be boys” dictum. The latter naturalise an inequitable gender order, frequently treating sportsmen as victims of predatory women, and ignoring asymmetries of power between men and women, especially in homosocial environments (Toffoletti). For those in the sporting bubble (predominantly elite sportsmen and highly paid executives, also mostly men, with an array of service staff of both sexes moving in and out of it), life is reflected for those being protected via an array of screens (small screens in homes and indoor places of entertainment, and even smaller screens on theirs and others’ phones, as well as huge screens at sport events). These male sport stars are paid handsomely to use their skill and strength to perform for the sporting codes, their every facial expression and bodily action watched by the media and relayed to audiences. This is often a precarious existence, the usually brief career of an athlete worker being dependent on health, luck, age, successful competition with rivals, networks, and club and coach preferences. There is a large, aspirational reserve army of athletes vying to play at the elite level, despite risks of injury and invasive, life-changing medical interventions. Responsibility for avoiding performance and image enhancing drugs (PIEDs) also weighs heavily on their shoulders (Connor). Professional sportspeople, in their more reflective moments, know that their time in the limelight will soon be up, meaning that getting a ticket to the sporting bubble, even for a short time, can make all the difference to their post-sport lives and those of their families. The most vulnerable of the small minority of participants in sport who make a good, short-term living from it are those for whom, in the absence of quality education and prior social status, it is their sole likely means of upward social mobility (Spaaij). Elite sport performers are surrounded by minders, doctors, fitness instructors, therapists, coaches, advisors and other service personnel, all supporting athletes to stay focussed on and maximise performance quality to satisfy co-present crowds, broadcasters, sponsors, sports bodies and mass media audiences. The shield offered by the sporting bubble supports the teleological win-at-all-costs mentality of professional sport. The stakes are high, with athlete and executive salaries, sponsorships and broadcasting deals entangled in a complex web of investments in keeping the “talent” pivotal to the “attention economy” (Davenport and Beck)—the players that provide the content for sale—in top form. Yet, the bubble cannot be entirely secured and poor behaviour or performance can have devastating effects, including permanent injury or disability, mental illness and loss of reputation (Rowe, “Scandals and Sport”). Given this fragile materiality of the sporting bubble, it is striking that, in response to the sudden shutdown following the economic and health crisis caused by the 2020 global pandemic, the leaders of professional sport decided to create more of them and seek to seal the metaphorical and material space with unprecedented efficiency. The outcome was a multi-sided tale of mobility, confinement, capital, labour, and the gendering of sport and society. The Covid-19 Gilded Cage Sociologists such as Zygmunt Bauman and John Urry have analysed the socio-politics of mobilities, whereby some people in the world, such as tourists, can traverse the globe at their leisure, while others remain fixed in geographical space because they lack the means to be mobile or, in contrast, are involuntarily displaced by war, so-called “ethnic cleansing”, famine, poverty or environmental degradation. The Covid-19 global pandemic re-framed these matters of mobilities (Rowe, “Subjecting Pandemic Sport”), with conventional moving around—between houses, businesses, cities, regions and countries—suddenly subjected to the imperative to be static and, in perniciously unreflective technocratic discourse, “socially distanced” (when what was actually meant was to be “physically distanced”). The late-twentieth century analysis of the “risk society” by Ulrich Beck, in which the mysterious consequences of humans’ predation on their environment are visited upon them with terrifying force, was dramatically realised with the coming of Covid-19. In another iteration of the metaphor, it burst the bubble of twenty-first century global sport. What we today call sport was formed through the process of sportisation (Maguire), whereby hyper-local, folk physical play was reconfigured as multi-spatial industrialised sport in modernity, becoming increasingly reliant on individual athletes and teams travelling across the landscape and well over the horizon. Co-present crowds were, in turn, overshadowed in the sport economy when sport events were taken to much larger, dispersed audiences via the media, especially in broadcast mode (Nicholson, Kerr, and Sherwood). This lucrative mediation of professional sport, though, came with an unforgiving obligation to generate an uninterrupted supply of spectacular live sport content. The pandemic closed down most sports events and those that did take place lacked the crucial participation of the co-present crowd to provide the requisite event atmosphere demanded by those viewers accustomed to a sense of occasion. Instead, they received a strange spectacle of sport performers operating in empty “cathedrals”, often with a “faked” crowd presence. The mediated sport spectacle under the pandemic involved cardboard cut-out and sex doll spectators, Zoom images of fans on large screens, and sampled sounds of the crowd recycled from sport video games. Confected co-presence produced simulacra of the “real” as Baudrillardian visions came to life. The sporting bubble had become even more remote. For elite sportspeople routinely isolated from the “common people”, the live sport encounter offered some sensory experience of the social – the sounds, sights and even smells of the crowd. Now the sporting bubble closed in on an already insulated and insular existence. It exposed the irony of the bubble as a sign of both privileged mobility and incarcerated athlete work, both refuge and prison. Its logic of contagion also turned a structure intended to protect those inside from those outside into, as already observed, a mechanism to manage the threat of insiders to outsiders. In Australia, as in many other countries, the populace was enjoined by governments and health authorities to help prevent the spread of Covid-19 through isolation and immobility. There were various exceptions, principally those classified as essential workers, a heterogeneous cohort ranging from supermarket shelf stackers to pharmacists. People in the cultural, leisure and sports industries, including musicians, actors, and athletes, were not counted among this crucial labour force. Indeed, the performing arts (including dance, theatre and music) were put on ice with quite devastating effects on the livelihoods and wellbeing of those involved. So, with all major sports shut down (the exception being horse racing, which received the benefit both of government subsidies and expanding online gambling revenue), sport organisations began to represent themselves as essential services that could help sustain collective mental and even spiritual wellbeing. This case was made most aggressively by Australian Rugby League Commission Chairman, Peter V’landys, in contending that “an Australia without rugby league is not Australia”. In similar vein, prominent sport and media figure Phil Gould insisted, when describing rugby league fans in Western Sydney’s Penrith, “they’re lost, because the football’s not on … . It holds their families together. People don’t understand that … . Their life begins in the second week of March, and it ends in October”. Despite misgivings about public safety and equality before the pandemic regime, sporting bubbles were allowed to form, re-form and circulate. The indefinite shutdown of the National Rugby League (NRL) on 23 March 2020 was followed after negotiation between multiple entities by its reopening on 28 May 2020. The competition included a team from another nation-state (the Warriors from Aotearoa/New Zealand) in creating an international sporting bubble on the Central Coast of New South Wales, separating them from their families and friends across the Tasman Sea. Appeals to the mental health of fans and the importance of the NRL to myths of “Australianness” notwithstanding, the league had not prudently maintained a financial reserve and so could not afford to shut down for long. Significant gambling revenue for leagues like the NRL and Australian Football League (AFL) also influenced the push to return to sport business as usual. Sport contests were needed in order to exploit the gambling opportunities – especially online and mobile – stimulated by home “confinement”. During the coronavirus lockdowns, Australians’ weekly spending on gambling went up by 142 per cent, and the NRL earned significantly more than usual from gambling revenue—potentially $10 million above forecasts for 2020. Despite the clear financial imperative at play, including heavy reliance on gambling, sporting bubble-making involved special licence. The state of Queensland, which had pursued a hard-line approach by closing its borders for most of those wishing to cross them for biographical landmark events like family funerals and even for medical treatment in border communities, became “the nation's sporting hub”. Queensland became the home of most teams of the men’s AFL (notably the women’s AFLW season having been cancelled) following a large Covid-19 second wave in Melbourne. The women’s National Netball League was based exclusively in Queensland. This state, which for the first time hosted the AFL Grand Final, deployed sport as a tool in both national sports tourism marketing and internal pre-election politics, sponsoring a documentary, The Sporting Bubble 2020, via its Tourism and Events arm. While Queensland became the larger bubble incorporating many other sporting bubbles, both the AFL and the NRL had versions of the “fly in, fly out” labour rhythms conventionally associated with the mining industry in remote and regional areas. In this instance, though, the bubble experience did not involve long stays in miners’ camps or even the one-night hotel stopovers familiar to the popular music and sport industries. Here, the bubble moved, usually by plane, to fulfil the requirements of a live sport “gig”, whereupon it was immediately returned to its more solid bubble hub or to domestic self-isolation. In the space created between disciplined expectation and deplored non-compliance, the sporting bubble inevitably became the scrutinised object and subject of scandal. Sporting Bubble Scandals While people with a very low risk of spreading Covid-19 (coming from areas with no active cases) were denied entry to Queensland for even the most serious of reasons (for example, the death of a child), images of AFL players and their families socialising and enjoying swimming at the Royal Pines Resort sporting bubble crossed our screens. Yet, despite their (players’, officials’ and families’) relative privilege and freedom of movement under the AFL Covid-Safe Plan, some players and others inside the bubble were involved in “scandals”. Most notable was the case of a drunken brawl outside a Gold Coast strip club which led to two Richmond players being “banished”, suspended for 10 matches, and the club fined $100,000. But it was not only players who breached Covid-19 bubble protocols: Collingwood coaches Nathan Buckley and Brenton Sanderson paid the $50,000 fine imposed on the club for playing tennis in Perth outside their bubble, while Richmond was fined $45,000 after Brooke Cotchin, wife of team captain Trent, posted an image to Instagram of a Gold Coast day spa that she had visited outside the “hub” (the institutionally preferred term for bubble). She was subsequently distressed after being trolled. Also of concern was the lack of physical distancing, and the range of people allowed into the sporting bubble, including babysitters, grandparents, and swimming coaches (for children). There were other cases of players being caught leaving the bubble to attend parties and sharing videos of their “antics” on social media. Biosecurity breaches of bubbles by players occurred relatively frequently, with stern words from both the AFL and NRL leaders (and their clubs) and fines accumulating in the thousands of dollars. Some people were also caught sneaking into bubbles, with Lekahni Pearce, the girlfriend of Swans player Elijah Taylor, stating that it was easy in Perth, “no security, I didn’t see a security guard” (in Barron, Stevens, and Zaczek) (a month later, outside the bubble, they had broken up and he pled guilty to unlawfully assaulting her; Ramsey). Flouting the rules, despite stern threats from government, did not lead to any bubble being popped. The sport-media machine powering sporting bubbles continued to run, the attendant emotional or health risks accepted in the name of national cultural therapy, while sponsorship, advertising and gambling revenue continued to accumulate mostly for the benefit of men. Gendering Sporting Bubbles Designed as biosecurity structures to maintain the supply of media-sport content, keep players and other vital cogs of the machine running smoothly, and to exclude Covid-19, sporting bubbles were, in their most advanced form, exclusive luxury camps that illuminated the elevated socio-cultural status of sportsmen. The ongoing inequalities between men’s and women’s sport in Australia and around the world were clearly in evidence, as well as the politics of gender whereby women are obliged to “care” and men are enabled to be “careless” – or at least to manage carefully their “duty of care”. In Australia, the only sport for women that continued during the height of the Covid-19 lockdown was netball, which operated in a bubble that was one of sacrifice rather than privilege. With minimum salaries of only $30,000 – significantly less than the lowest-paid “rookies” in the AFL – and some being mothers of small children and/or with professional jobs juggled alongside their netball careers, these elite sportswomen wanted to continue to play despite the personal inconvenience or cost (Pavlidis). Not one breach of the netballers out of the bubble was reported, indicating that they took their responsibilities with appropriate seriousness and, perhaps, were subjected to less scrutiny than the sportsmen accustomed to attracting front-page headlines. National Netball League (also known after its Queensland-based naming rights sponsor as Suncorp Super Netball) players could be regarded as fortunate to have the opportunity to be in a bubble and to participate in their competition. The NRL Women’s (NRLW) Premiership season was also completed, but only involved four teams subject to fly in, fly out and bubble arrangements, and being played in so-called curtain-raiser games for the NRL. As noted earlier, the AFLW season was truncated, despite all the prior training and sacrifice required of its players. Similarly, because of their resource advantages, the UK men’s and boy’s top six tiers of association football were allowed to continue during lockdown, compared to only two for women and girls. In the United States, inequalities between men’s and women’s sports were clearly demonstrated by the conditions afforded to those elite sportswomen inside the Women’s National Basketball Association (WNBA) sport bubble in the IMG Academy in Florida. Players shared photos of rodent traps in their rooms, insect traps under their mattresses, inedible food and blocked plumbing in their bubble accommodation. These conditions were a far cry from the luxury usually afforded elite sportsmen, including in Florida’s Walt Disney World for the men’s NBA, and is just one of the many instances of how gendered inequality was both reproduced and exacerbated by Covid-19. Bursting the Bubble As we have seen, governments and corporate leaders in sport were able to create material and metaphorical bubbles during the Covid-19 lockdown in order to transmit stadium sport contests into home spaces. The rationale was the importance of sport to national identity, belonging and the routines and rhythms of life. But for whom? Many women, who still carry the major responsibilities of “care”, found that Covid-19 intensified the affective relations and gendered inequities of “home” as a leisure site (Fullagar and Pavlidis). Rates of domestic violence surged, and many women experienced significant anxiety and depression related to the stress of home confinement and home schooling. During the pandemic, women were also more likely to experience the stress and trauma of being first responders, witnessing virus-related sickness and death as the majority of nurses and care workers. They also bore the brunt of much of the economic and employment loss during this time. Also, as noted above, livelihoods in the arts and cultural sector did not receive the benefits of the “bubble”, despite having a comparable claim to sport in contributing significantly to societal wellbeing. This sector’s workforce is substantially female, although men dominate its senior roles. Despite these inequalities, after the late March to May hiatus, many elite male sportsmen – and some sportswomen - operated in a bubble. Moving in and out of them was not easy. Life inside could be mentally stressful (especially in long stays of up to 150 days in sports like cricket), and tabloid and social media troll punishment awaited those who were caught going “over the fence”. But, life in the sporting bubble was generally preferable to the daily realities of those afflicted by the trauma arising from forced home confinement, and for whom watching moving sports images was scant compensation for compulsory immobility. The ethical foundation of the sparkly, ephemeral fantasy of the sporting bubble is questionable when it is placed in the service of a voracious “media sports cultural complex” (Rowe, Global Media Sport) that consumes sport labour power and rolls back progress in gender relations as a default response to a global pandemic. Covid-19 dramatically highlighted social inequalities in many areas of life, including medical care, work, and sport. For the small minority of people involved in sport who are elite professionals, the only thing worse than being in a sporting bubble during the pandemic was not being in one, as being outside precluded their participation. Being inside the bubble was a privilege, albeit a dubious one. But, as in wider society, not all sporting bubbles are created equal. Some are more opulent than others, and the experiences of the supporting and the supported can be very different. The surface of the sporting bubble may be impermanent, but when its interior is opened up to scrutiny, it reveals some very durable structures of inequality. Bubbles are made to burst. They are, by nature, temporary, translucent structures created as spectacles. As a form of luminosity, bubbles “allow a thing or object to exist only as a flash, sparkle or shimmer” (Deleuze, 52). In echoing Deleuze, Angela McRobbie (54) argues that luminosity “softens and disguises the regulative dynamics of neoliberal society”. The sporting bubble was designed to discharge that function for those millions rendered immobile by home confinement legislation in Australia and around the world, who were having to deal with the associated trauma, risk and disadvantage. 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The assessment of the motivational value of rewards in the world of work is interesting but difficult to understand. Variations in research reports and inadequate comprehension of the efficiency and motivational value of rewards have brought about confusions, controversies and contradictions among authors, researchers, consultants and practitioners in the field of Industrial and Organisational Psychology (Mangham, 2007; Muula, 2006; Muula & Maseko, 2005; Palmer, 2006; World Bank, 2004). As a consequence, organisations are applying theories and models of motivation selectively depending on their beliefs, ideological framework of values and assumptions (Dzimbiri, 2009). The study was therefore carried out as a positive contribution to the existing knowledge and debate on the motivational value of rewards for health professionals in the public health sectors of the developing countries. Through a systematic sampling method, 571 health professionals were sampled for the study. Data were collected through the use of a self-administered questionnaire which was composed based on the data collected from desk research/literature review, focus group discussions and interviews. The findings of the study revealed that the Malawi‟s Ministry of Health (MoH) is failing to attract, motivate and retain health professionals; there is perception of inequity of the rewards among the health professionals; health professionals develop coping strategies to supplement their monthly financial rewards; health professionals engage in corrupt practices to supplement their monthly financial rewards; and there is erosion of industrial democracy in the Malawi‟s Public Health Sector. While the statistical testing of the hypothesized model proved a lack of fit between the variables, the statistical testing of the re-specified model suggests that there is a positive relationship between financial rewards and reward-related problems being faced by health professionals in the Malawi‟s MoH. Through the Structural Equation Modeling (SEM) exercise, an inverse (negative) relationship between financial and non-financial rewards was deduced, and scientifically and graphically demonstrated. Both the re-specified and graphical models symbolize a pragmatic departure from the theoretical model whose authors (Franco, Bennett, Kanfer & Stubblebine, 2004) are largely inclined to the use of non-financial rewards and suggest that financial rewards should be used with caution. These findings also reject the Herzberg‟s two factor theory (Herzberg, 1960) which claims that financial rewards (salaries) are not a motivator. The major recommendations of the study are that the Franco et al.‟s (2004) model should be adopted and adapted in the Malawi‟s MoH with the view that the value of both financial and non-financial rewards (as motivators) varies from individual to individual due to individual differences and prevailing factors/forces in both the work environment and wider society in which the MoH operates; a hybrid reward system combining the strengths of time-based, performance-based and competence-based reward systems should be developed and implemented; the results of scientifically testing the re-specified model and the inverse (causal) relationship established between financial and non-financial rewards (as demonstrated in a graphic model) should be re-tested with other samples in the public health sectors of the developing countries; and the motivational value of non-financial rewards should be scientifically established and compared with the motivational value of financial rewards used independent of each other in business organisations to make an objective conclusion on the rewards-motivation debate.

Includes bibliographical references. Electronic publication: Full text available in PDF format; abstract in HTML format. Private practice as a career option for nurses has been slowly increasing since the 1980's. However, the reasons for this development have not been fully investigated so that it can be understood and placed within the changing contexts of health care and health services. The expansion and extension of nurses' roles is a contemporary topic in health care reform and therefore one that deserves investigation. The aims of this study were to develop a theory on private practice nursing and to describe the characteristics and work of the self-employed nurse in Australia. Electronic reproduction.[Australia] :Australian Digital Theses Program,2001.xvii, 350 leaves : ill. (some col.) ; 30 cm.

Private practice as a career option for nurses has been slowly increasing since the 1980's. However, the reasons for this development have not been fully investigated so that it can be understood and placed within the changing contexts of health care and health services. The expansion and extension of nurses' roles is a contemporary topic in health care reform and therefore one that deserves investigation. The aims of this study were to develop a theory on private practice nursing and to describe the characteristics and work of the self-employed nurse in Australia. Nurses working in a variety of settings have been able to provide information on being self-employed. In doing so, this study was able to describe the persona of the nurse entrepreneur, explore the reasons why nurses and midwives in Australia establish private fee-for-service practices, identify the factors which have influenced this action and describe the scope of practice of nurses and midwives in private practice. This combined Delphi technique and Grounded Theory study is the first in-depth study of Australian nurses and midwives in private practice. The study enables nurses to provide direct information on being self-employed and enhances the profession's ability to articulate about this area of nursing. The significance of the research is in increasing the understanding of this area of practice development and affords greater insight into its efforts to improve and maintain quality nursing services within the Australian health care system. One hundred and six nurses and midwives were invited to participate in the study, in which participants completed two rounds of semi-structured postal questionnaires. Delphi technique was applied to rate responses on Likert scales to ascertain respondents' consensus on certain topics. Participants were also provided the opportunity to make additional comments. Results indicated that nurses in private practice are well experienced with an average of 21 years nursing experience and hold several qualifications. Job satisfaction, being able to be more involved in achieving quality health outcomes and maximising skills and abilities are significant influences for private practice. These results suggest that private practice nursing can contribute effectively to broadening the range of primary health services available to the population and to addressing the issues of retention and recruitment of nurses. Self-employed nurse entrepreneurs push the boundaries of the profession and expand the realm of nursing practice. Entrepreneurship is a path for the future of nursing as it offers expanded career opportunities for nurses and opportunities for increased ambulatory health services. In addition, the broad, expert knowledge nurses hold on many aspects of health can be disseminated throughout the health sector to the advantage of corporate health partners. There is further development required in this innovative and expanding area of the nursing profession.
Thesis (Ph.D.)--Department of Clinical Nursing, 2003.

Bibliography: pages 273-351
The context of this research is the occupational wellbeing of employees in the healthcare industry in South Africa. The purpose of this study was to identify occupational wellbeing types that cluster as a result of variables (burnout, work engagement, workaholism and job satisfaction) which can be plotted on the circumplex model of wellbeing, and determining the extent of type differences in as far as it pertains to psychosocial antecedent variables (age, job demands, job resources and work-related sense of coherence), as well as positive and negative outcome variables (comprising organisational commitment and turnover intention). A quantitative survey was conducted on a convenience sample of healthcare workers (N = 461). The population consisted of predominately black African females, aged between 31 and 45 from the nursing profession. Cluster analysis using k-means found statistically significant support for three occupational wellbeing types, namely, Exhausted, Engaged and Burned-Out. Results from MANOVA revealed a difference between all occupational wellbeing types and the psychosocial antecedent variables of job demands, job resources and work-related sense of coherence. The occupational wellbeing types did not however differ, based on the age of the participants. Multinomial logistic regression analysis revealed that age was additionally not a significant predictor of the occupational wellbeing types, whilst Work-SoC predicted the engaged type, and job demands and job resources predicted the engaged and exhausted types in comparison to the burned-out type. Hierarchical moderated regression analysis concluded that each of the occupational wellbeing types played a significant role by moderating the relationship between the psychosocial antecedent variables of job resources and work-related sense of coherence, and the positive and negative outcomes of organisational commitment and turnover intention. Theoretically the study highlighted the importance of addressing the occupational wellbeing concerns and challenges faced by healthcare employees in South Africa face. The empirical value of the study was the identification of the occupational wellbeing types and a potential nomological net. The knowledge derived from the relationship between the variables may be valuable in informing a holistic affective wellbeing model which could direct practices within the healthcare industry in South Africa.
Industrial and Organisational Psychology
D. Phil. (Psychology)