Professional Autonomy Research Articles

SPECIFIC FEATURES OF INTERACTION BETWEEN DOCTORS AND ELDERLY PATIENTS IN RURAL AREAS(A CASE STUDY OF THE LENINGRAD REGION)

The article deals with care for older people in rural areas as part of communication between doctors and pa-tients, including during appointments. Care is analyzed from two positions (from the position of rural doc-tors and the elderly themselves), their differences are analyzed. Basing on interviews conducted in the Lu-zhsky district of the Leningrad region, the paper makes an attempt to contextualize views on professional care from both sides. The article examines how, in the context of the «dense texture»and importance of ru-ral communities, doctoral care for older people becomes more personalized and what features of such care affect the professional autonomy of doctors, the communication of older rural residents with medical profes-sionals. The separation of care and autonomy raises the question of the role of rural doctors in the rural community as well as the specific features of care, which is more personalized and shown by paramedics at rural outpatient clinics or first aid stations. The paper concludes that within the framework of doctor –pa-tient communication, when doctors and patients interact, doctors consider care as an instrumental opportuni-ty to establish more trusting communication, interaction with the elderly. However, the elderly themselves remain dissatisfied with this form of care. More personalized care is provided by rural paramedics and doc-tors, who are most integrated into the rural community and are an important part of it, which determines the specific features of care for older people provided by different professionals.

Investigation of factors related to the professional autonomy of short-time nurses working in general wards of national university hospitals

Investigation of factors related to the professional autonomy of short-time nurses working in general wards of national university hospitals

The Effects of Professional Autonomy, Job Satisfaction, and Perceived Patient-Safety Culture on Nurses' Patient-Safety Management Activities: A Cross-Sectional Study

The Effects of Professional Autonomy, Job Satisfaction, and Perceived Patient-Safety Culture on Nurses' Patient-Safety Management Activities: A Cross-Sectional Study

Perception and Deception in Nurses’ Clinical and Work-Related Professional Autonomy: Case Study for a Hospital in Romania

The continuous expansion of the nursing scope of practice, the undeniable growth of the nurses’ role in the healthcare crisis, the shortage of labor, especially in rural areas and marginalized urban csommunities, and last but not least, the lack of literature on Romanian nursing autonomy are some of the background factors in this study. This study’s purpose is to assess nurses’ perceptions of their medical care independence. The main hypothesis is that more advanced levels of education generate a greater inclination toward autonomous interventions. The quantitative research is based on a survey using a self-designed questionnaire as a tool (based on a nurse-focused structure and process indicators following the Donabedian model) applied in a Romanian clinical hospital. Based on a literature review, three composite indicators were developed and tested for reliability using the Cronbach alpha coefficient. These indicators reflect autonomy from three perspectives: clinical practice independence, autonomy in relation to work, and autonomy through digitalization. This scientific approach revealed a major impact of the regulatory framework on nurses’ perceptions of their autonomy, below the expectations of use, and the acceptance of digital technologies among nurses. Finally, it was observed that college graduate nurses perceive lower levels of independence than post-secondary ones.

A Study on the Psychological Contract of Administrative Personnel in Vocational Education Institute

Previous studies consistently identified that psychological contract played a crucial role to facilitate people’s loyalty and commitment, job dedication, and finally career achievement. Its influential factors and enhancement approaches consequently attracted broad attention of professorates in the business world and educational fields. This study was conducted to identify the traits and internal structure of psychological contract for administrative personnel in vocational education institutes at higher educational level. The questionnaire was employed to collect research data from a sample of 165 administrative personnel of the vocational institutes located in the central Taiwan. Undertakenwere a series of data analyses including reliability and validity analyses, descriptive statistics, CFA factor analysis, and SEM statistics according to the research purpose. These data analyses led to the following conclusions: 1) These administrative personnel, who traditionally pursued academic achievement and professional autonomy, possessed a middle level of the psychological contract for overall; 2) Their psychological contract of this group was characterised with the significant and positive relationships among the three major domains; 3)this academic personnel were inclined to the transactional psychological contract rather than relational one; they are more practical and pragmatic to manage their professional careers; and 4) The domain factor of reciprocal commitment and obligations was approved to play the crucial role of the mediator between job recognition and relationships. Based on the conclusions, this study finally provided several practical suggestions to foster faculty members’ career development and university efficacy.

Why Merit Pay Fails: Comparison of Public and Private School Practices in Shenzhen, China

Purpose Accounts for failures of merit pay in educational settings were stagnated by the “political obstruction hypothesis,” which blamed teacher unions for impeding the merit pay schemes from proper function. It required stronger evidence from both public and private schools to refute this hypothesis. Design/Approach/Methods Accountability typology was conceptualized to uncover the power relations underpinning merit pay schemes, and teachers’ motivational status was described from the perspective of Self-Determination Theory (SDT) to analyze the corresponding consequences. One public school and three private schools were purposefully sampled, and data included principal interviews, teacher interviews, school documents, and relevant policy documents. Findings Our findings suggested an opposite conclusion to the “political obstruction hypothesis” that the more dependent on market, the more intense the conflict between external accountabilities and the nature of teaching. Thus, we supported the “nature of teaching hypothesis” that merit pay was inapplicable in educational settings due to the inherent contradictions between market accountability and professional accountability. Originality/Value Policymakers and school administrators had been misled by the neoliberal initiative of borrowing merit pay into educational settings to promote the quality of teaching. Our findings provided strong evidence to refute this hypothesis and to restore the appreciation of professional autonomy.

A agenda de pesquisa da burocracia de nível de rua no contexto da pandemia: Uma revisão integrativa

The implementation of public policies in crisis situations is a scarce field of study, especially at the street level, in which there is interaction between the State and the citizen. The pandemic as a crisis affected the autonomy of frontline professionals and shaped their behavior, especially influenced by organizational and relational factors. This way, the study explores the research agenda in the context of the pandemic, available in the Web of Science database, seeking to understand its influence on street-level implementation of public policies, using the integrative review method for this purpose. Additionally, an attempt was made to understand how the use of software contributes to data analysis, pointing out its advantages and limitations. For this, VOSviewer 1.6.17 was used. The main results revealed that crisis contexts such as the pandemic profoundly influence the implementation of public policies at the street level with negative impacts on user service. The research focus defined has limitations due to the lack of advances in the number of data analyzed, but contributes to a better understanding of the influences of crises for implementation of public policies at the street level. Investigations on the emotional consequences to the front line and the approach to action during the crisis by professionals who deal daily with emergency situations such as firefighters and professionals of mobile vehicles of the medical emergency network are indicated.

Responsible autonomy: The interplay of autonomy, control and trust for knowledge professionals working remotely during COVID-19

This article revisits the concept of responsible autonomy, analysing the interplay of employee autonomy, management control and trust experienced by knowledge professionals in the UK compelled to work remotely during the coronavirus pandemic. The authors theorise about the tensions and paradoxes of responsible autonomy in the contemporary context of the COVID-19 crisis, drawing on empirical findings gathered in May 2020 and May 2021. Many participants experienced increased autonomy and discretion, but also work intensification and blurred work–life boundaries. Interestingly, many accepted this paradox as a palatable trade-off for the autonomy of being able to work from home, particularly where there was reciprocal trust between employee and manager. Trust is the glue in responsible autonomy, yet exists in tension with intrusive managerial control.

The profession of social work: comparing Germany and Singapore

ABSTRACT Using a comparative approach the professional characteristics of social work in Germany and Singapore were analysed. The literature about the profession in both countries was reviewed according to eight criteria suggested by Weiss-Gal and Welbourne (The professionalisation of social work: A cross-national exploration. International Journal of Social Welfare, 17, 281–290, 2008): (1) public recognition, (2) monopoly over social care, (3) professional autonomy, (4) specific knowledge base, (5) educational system, (6) social work organisations, (7) code of ethics, and (8) status and prestige. Our analysis yielded similarities and differences in social work as a profession between the two countries. Common to Germany and Singapore is the existence of a body of knowledge, the professional training of social workers in higher education, the establishment of professional organisations, and the adoption of a code of ethics. The full definition of being a profession with respect to professional monopoly and autonomy is not reached by either one of the two countries. While extended education since the Bologna reform may lead to enhanced public recognition in Germany, relatively low salaries indicate a low status and prestige of the profession. In Singapore, the government just recently intentionally increased social workers’ remuneration to improve public recognition and to tackle social problems more effectively.

The Effects of Work Satisfaction and Work Flexibility on Burnout in Nurses.

The World Health Organization has encouraged improving working conditions for nurses to decrease turnover and increase nurse staffing and nursing capacity. The International Council of Nurses has pointed out that a positive work environment can improve satisfaction and decrease burnout in nurses. However, the effects of working conditions and work satisfaction on burnout in nurses remain unclear. The purpose of this study was to explore the effects of working-condition-related flexibility and work satisfaction on burnout in nurses. A cross-sectional design was employed, and 450 nurses from a single medical center participated in this study. In addition to demographic information, three survey instruments, including the Taiwanese Hospital Nurses' Job Satisfaction Scale, the Working Conditions and Flexible System Scale, and the Maslach Burnout Inventory-Chinese Version, were used to measure working condition flexibility, work satisfaction, and burnout. Descriptive statistics, the Pearson correlation coefficient, and hierarchical linear regression were used to analyze the data. Four hundred thirty-five nurses were enrolled as participants. Most were female, with a mean age of 29 years. Over four fifths (83.1%) were unmarried, and 65.5% had at least 2 years of prior experience working at other hospitals. Although the participants reported experiencing burnout several times per month, they reported feeling satisfied with their work. They noted flexibility related to working conditions, especially task-related flexibility, as important. Four variables (satisfaction/professional autonomy, interpersonal interaction, workload, and working condition flexibility/task flexibility) were found to be significant predictors of emotional exhaustion (adjusted R2 = 0.212). However, only professional autonomy was found to significantly predict a sense of low personal accomplishment (adjusted R2 = .077), whereas nursing competence significantly predicted depersonalization (adjusted R2 = .086). Work satisfaction and flexibility related to working conditions were shown to relate negatively to burnout. Nursing managers should improve the level of satisfaction related to professional autonomy, interpersonal interaction, and workload as well as task flexibility for nurses.

Relationship between Professional Image and Autonomy among Staff Nurses

Relationship between Professional Image and Autonomy among Staff Nurses

간호사의 전문직자율성의 개념분석

Purpose: This study sought conceptual understanding of professional autonomy in nursing science. The underlying ideas and properties of professional autonomy in nursing were analyzed and compared with definitions used in diverse individual studies. Methods: Concepts were analyzed using the conceptual method of Walker & Avant. Results: Four attributes of nurses’ professional autonomy were identified: job performance, effective communication, decision-making, and responsibility. The leading factors were ‘nursing education and clinical experience from 4 years of nursing school,’ ‘critical thinking,’ and ‘insight.’ The result factors of this study were ‘personal growth,’ ‘self-leadership,’ and ‘patient safety’. Conclusion: Professional autonomy as defined in this study is completion of education and training based on the professional knowledge and responsibility of nurses, which support rational decision-making through smooth communication in the performance of nursing tasks.

유치원 교사가 인식하는 코로나19 이후 근무환경과 직업관, 교직전문성 및 디지털리터러시 역량 간의 구조적 관계

Objectives The purpose of this study is to find out the structural relationship between the post-COVID-19 working environment, occupational perspective, teaching professionalism, and digital literacy recognized by kindergarten teachers.
 Methods For this, the research was conducted on 217 teachers working in kindergartens. It was analyzed by the structural equation and Pearson's correlation using SPSS 23.0 and AMOS 22.0. Total effect and direct/indirect effect were analyzed by bootstrap.
 Results These are the main findings. First, it showed that computer literacy, information literacy, and knowledge literacy, which are sub-variables of digital literacy had a statistically significant positive correlation with occupational perspective and intellectual skills, professional autonomy, and the sense of service of teaching professionalism. On the other hand, after COVID-19, it showed that the relationship factors between working environment and the superiors had a statistically significant negative correlation with computer literacy, and there was no statistically significant correlation with information literacy and knowledge literacy. There was no statistically significant correlation between working factors and computer literacy, information literacy, and knowledge literacy. Individual and organizational relationship factors showed statistically significant negative correlation with information literacy, but had no statistically significant correlation with computer literacy and knowledge literacy. Second, the measurement model was found to be suitable. As a result of analyzing the structural model, it was found that the working environment after COVID-19 affects the path of “occupational perspective → teaching professionalism → digital literacy” and the path of “teaching professionalism → digital literacy”.
 Conclusions Based on the research results, it is intended to promote adaptation in the changed early childhood education field by suggesting ways to strengthen digital literacy.

다국적 기업의 현지화 광고 제작 과정에서 나타난 체육계 전문가의 문화 매개 경험

The purpose of this study is to examine how Nike, the main body of global media, and the autonomy of local Sports Professionals in the production of glocalized advertisements for multinational companies, are balanced, and to explore the role and limitations of sports workers as cultural intermediaries. The study's findings are listed below. First, the study participants participated in the production of glocalization advertisements for Nike, a multinational corporation, from an outsider called a sports expert to an insider called a cultural intermediaries. Second, Participants in the study were found to carry out cultural mediation activities such as changing sports, simplifying physical activities, and sharing data to actively reproduce the sports culture as cultural intermediaries, and trying to project the essence of sports into glocalization advertisements. They also attempted to project the essence of sports into glocalization advertisements. Third, it was noted that study participants felt left out from cultural mediation activities because of their ability to participate as cultural intermediaries was limited by multinational corporations.

Geography teacher educators’ identity, roles and professional learning in a volatile, uncertain, complex and ambiguous world

Globally, teacher educators work in contexts which are shaped and informed by persistent policy reform and global environmental crises which we argue, combine to create a professional life that is volatile, uncertain, complex and ambiguous (VUCA). Through a case study of geography teacher educators (GTEs) based in England, we explore the experiences, knowledge and professional growth of teacher educators. Our findings draw on data from responses to an online questionnaire (n = 51), a practitioner workshop and 11 semi-structured interviews. We find that GTEs have multi-faceted identities which are shaped by professional, social and personal realms through engagement with a diverse community of practice. The VUCA context of teacher education is visible in the professional identities of GTEs in both affirming and deleterious ways which we argue, are linked to perceptions of professional autonomy. We argue that the professional role of teacher educators is to bravely engage with policy making as part of their contribution to a socially and environmentally just future for all.

Analysis on Effects of Curriculum and Assessments on Professional Autonomy of Secondary History Teachers in UK and US

The research aimed to compare how the differences in curriculum and assessment frameworks of the U.K. and the U.S. affect the professional autonomy of secondary history teachers. This study conducted semi-structured interviews with ten teachers, and the collected data was analyzed through thematic coding. The analyses showed that there are many contrasting influences on teacher autonomy on everyday school practices, specifically, decision-making, self-examination and modification, and the integration of personal experiences and values. Although the history curriculum of England (the U.K.) is broad without much specification of the contents and standards, teachers had limited autonomy as they had a strong responsibility to prepare students for national examination. On the contrary, despite the fact that Massachusetts’ (the U.S.) history curriculum is much more detailed, teachers are able to practice greater autonomy because they are exempt from the duty to prepare students for a state assessment. Therefore, the research demonstrates that the curriculum alone cannot grant increased autonomy for teachers, for it is not the curriculum that sets the agenda for teaching but high-stakes assessments.

Advancing cluster randomised trials in children’s therapy: a survey of the acceptability of trial behaviours to therapists and parents

BackgroundRandomised controlled trials of non-pharmacological interventions in children’s therapy are rare. This is, in part, due to the challenges of the acceptability of common trial designs to therapists and service users. This study investigated the acceptability of participation in cluster randomised controlled trials to therapists and service users.MethodsA national electronic survey of UK occupational therapists, physiotherapists, speech and language therapists, service managers, and parents of children who use their services. Participants were recruited by NHS Trusts sharing a link to an online questionnaire with children’s therapists in their Trust and with parents via Trust social media channels. National professional and parent networks also recruited to the survey. We aimed for a sample size of 325 therapists, 30 service managers, and 60 parents. Trial participation was operationalised as three behaviours undertaken by both therapists and parents: agreeing to take part in a trial, discussing a trial, and sharing information with a research team. Acceptability of the behaviours was measured using an online questionnaire based on the Theoretical Framework of Acceptability constructs: affective attitude, self-efficacy, and burden. The general acceptability of trials was measured using the acceptability constructs of intervention coherence and perceived effectiveness. Data were collected from June to September 2020. Numerical data were analysed using descriptive statistics and textual data by descriptive summary.ResultsA total of 345 survey responses were recorded. Following exclusions, 249 therapists and 40 parents provided data which was 69.6% (289/415) of the target sample size. It was not possible to track the number of people invited to take the survey nor those who viewed, but did not complete, the online questionnaire for calculation of response rates. A completion rate (participants who completed the last page of the survey divided by the participants who completed the first, mandatory, page of the survey) of 42.9% was achieved. Of the three specified trial behaviours, 140/249 (56.2%) therapists were least confident about agreeing to take part in a trial. Therapists (135/249, 52.6%) reported some confidence they could discuss a trial with a parent and child at an appointment. One hundred twenty of 249 (48.2%) therapists reported confidence in sharing information with a research team through questionnaires and interviews or sharing routine health data. Therapists (140/249, 56.2%) felt that taking part in the trial would take a lot of effort and resources. Support and resources, confidence with intervention allocation, and sense of control and professional autonomy over clinical practice were factors that positively affected the acceptability of trials. Of the 40 parents, twelve provided complete data. Most parents (18/40, 45%) agreed that it was clear how trials improve children’s therapies and outcomes and that a cluster randomised trial made sense to them in their therapy situation (12/29, 30%).ConclusionsUsing trials to evaluate therapy interventions is, in principle, acceptable to therapists, but their willingness to participate in trials is variable. The willingness to participate may be particularly influenced by their views related to the burden associated with trials, intervention allocation, and professional autonomy.

Factors affecting job satisfaction of advanced practice registered nurses in Korea

Background & Aim: The activities of advanced practice registered nurses in Korea have expanded, but studies on their job satisfaction are lacking. This study aimed to determine the factors influencing job satisfaction among Korean advanced practice registered nurses.
 Methods & Materials: A cross-sectional correlational study was conducted with 142 APRNs selected from three tertiary hospitals in Korea from December 2020 to January 2021. Job satisfaction and the factors influencing it were investigated using structured questionnaires; factors affecting job satisfaction were identified by multiple regression analysis. Data analysis was processed using the SPSS/WIN 25.0 program.
 Results: Advanced practice registered nurses’ sex (β=.15, p=0.004), satisfaction with workload (β=.24, p<0.001), professional visibility (β=. 21, p=0.004) and APRN-physician relations in the work environment (β=.38, p<0.001), and clinical decision-making ability (β=.17, p=0.004) were identified as the factors influencing job satisfaction, which together explained 67% of the variance in job satisfaction.
 Conclusion: To increase advanced practice registered nurses' job satisfaction, nurse managers must consider strategies for providing administrative and educational support for workload control, recognition of professional identity and autonomy, and improving the work environment to encourage efficient interaction with physicians and improved clinical decision-making ability.

Exploring the Relationship Between School Autonomy and School Responsiveness as Perceived by Heads of Primary Schools in Malta

This paper presents the outcomes of a research study on the perspective of Heads of primary schools in Malta about the relationship between school autonomy and school responsiveness. Knowing whether, and how, school autonomy is related to school responsiveness can provide a key to action for improvement in the Maltese education system. A mixed methods approach allowed the collection and analysis of data from a relatively large proportion of the target population and its interpretation through the participation of a sample from the same population. Most Heads were found to believe that greater school autonomy, especially in the curriculum and instruction domain, would help increase responsiveness. Most were also personally in favour of increased autonomy, especially in the mentioned domain. Acknowledging the complexity of the subject matter, the paper suggests an iterative approach to change that prioritises the professional autonomy of school-based educators as the guiding principle.

Benefits and Risks of Teleworking from Home: The Teleworkers’ Point of View

Using a qualitative research-based approach, this study aimed to understand (i) the way home-based teleworkers in France perceive and organize their professional activities and workspaces, (ii) their teleworking conditions, (iii) the way they characterize the modalities and the nature of their interactions with their professional circle, and more broadly (iv) their quality of life ‘at work’. We performed a lexical and morphosyntactic analysis of interviews conducted with 28 teleworkers (working part-time or full-time from home) before the COVID-19 crisis and the associated establishment of emergency telework. Our results confirm and complement findings in the literature. Participant discourses underlined the beneficial effects of teleworking in terms of professional autonomy, flexibility, concentration, efficiency, performance, productivity, and being able to balance their professional and private lives. Nevertheless, they also highlighted the deleterious effects of teleworking on temporal workload, setting boundaries for work, work-based relationships and socio-professional integration. Despite the study limitations, our findings highlight the need for specific research-based and practical strategies to support the implementation of a sustainable telework organization in the post-COVID-19 pandemic era.