Thesis & Dissertations - ތީސީސް އަދި ޑެޒަޓޭޝަން
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Item Factors affecting nurse turnover in public hospitals in Male’, Maldives: a phenomenological study to understand why nurses resign(School of Nursing, The Maldives National University, 2022-01-29) Rameez, Rafaahath; ރަފާހަތް ރަމީޒުNurses leaving their jobs or leaving the profession, commonly known as turnover, is a significant issue of concern universally (Dewanto & Wardhani, 2018). Nationwide, the average registered nurse turnover rate is estimated to be 15% to 36% per year (Halter et al., 2017). Shortages of nurse’s due to high turnover lead to burnout and job dissatisfaction among nurses, decreases in staff morale, a decline in consideration for patients, increased errors and patient dissatisfaction related to new inexperienced staff (Gess et al., 2017). Therefore, it is significant for health care organizations to identify the main causes of turnover and promote effective interventions to reduce nurse turnover (Yamaguchia et al., 2016). The purpose of this qualitative, phenomenological study is to explore the experiences of nurses in order to identify the main factors that contributed to leaving their job in public hospitals in Male’. An advantage of identifying these contributing factors is that it could help healthcare organizations to implement successful strategies and workplace solutions in order to improve nurse retention, which will also save organizations costs on nurse recruitment, motivate present employees enhancing their job satisfaction and improve the standard of care given to patients in in public hospitals in Male’. Chapter 1 of this research study will consist of a brief background of the topic along with relevance and justification, problem statement and conceptual definitions of some of the main terms used in the study.Item Knowledge, attitude and practice wards management of Gestational Diabetes Mellitus (GDM) among antenatal women visiting for antenatal care at reproductive health center, Indira Gandhi Memorial Hospital(School of Nursing, 2022-12) Sheeza, AishathBACKGROUND: Gestational diabetes mellitus (GDM) is a global health problem compromising maternal and fetal health. The aim of this study is to examine the level of knowledge, attitude and practice towards management of GDM among antenatal women. METHODS: This is a cross-sectional descriptive correlational study involving 197 antenatal women visiting for antenatal care at Reproductive Health Center (RHC) of Indira Gandhi Memorial Hospital (IGMH). Participants were selected using random sampling in one-month period between August to September 2022. Pearson correlation was used to evaluate relationship between knowledge, attitude and practice towards management of GDM. RESULTS: Research findings indicate 68% respondents had low knowledge, 16.8% and only 15.2% had high knowledge of GDM. Majority of 80.2% had moderate attitude whereas 16.2% and 3.6% antenatal women were found to have high and low attitude towards GDM respectively. Practice level towards management of GDM were found to be poor in 59.9% participants and good in only 1% of participants. Pearson product correlation indicated significant and moderately positive correlation (r = .404, p < .001) between knowledge and attitude, statistically significant and weakly positive correlation (r = .284, p < .001) between attitude and practice. No correlation was found between knowledge and practice towards management of GDM. CONCLUSION: The results of this study can aid healthcare professionals in developing effective strategies to raise awareness of GDM prevention in the Maldives and in carrying out health promotion activities related to GDM successfullyItem The experiences of Treetop Hospital (TTH) nurses in covid-19 pandemic in the Maldives(School of Nursing, 2020) Simany, KhadhiyyaThis paper aims to explore nurses' experiences in providing nursing care for COVID-19 patients in the TTH COVID-19 facility. The study examined the preparation of nursing care, nursing routine changes, and the challenges in providing nursing care. Based on the research paradigm and supportive literature, the author employed a descriptive phenomenological approach of inquiry. The author conducted semi-structured face-to-face interviews using purposive convenience sampling of nurses with nursing experience in the TTH COVID-19 facility. The nursing experience of the TTH nurses during the pandemic is identified through this study. The significant themes developed was; preparation for the new challenge, combatting infection control, meeting daily patient needs, challenges in caring and rising above and psychological impact of working in a pandemic. The study’s findings are supported through literature as nursing in a pandemic is more focused on infection control and requires polices and guidelines. The findings also suggest the need to have practical skill and knowledge development for nurses. Furthermore, the study recommends developing of mentally and physically healthy nurses, to assess nurses prior to pandemic nursing care, during care and post care. The study recommends adaptation to challenges in nursing care and use of innovate tools for nursing care. It also emphasize on empowering nurses, creating support systems for nurses and motivate nurses through supportive leadershipItem Knowledge, attitude, and perceived barriers to medication administration error reporting among registered nurses in a private hospital(School of Nursing, 2023-05) Azeemath, MariyamTopic: knowledge, attitude, and perceived barriers to medication administration error reporting (MAER) among registered nurses in a private hospital in the Maldives. Background: The failure to report medication administration errors (MAE) is a worldwide problem associated with patient safety. The first step towards increasing the reporting rate is recognizing nurses' attitudes toward errors and perceived barriers to reporting. Hence, this study explores the knowledge, attitude, and perceived barriers to medication administration error reporting from the nurses’ perspective. Methods: In this descriptive, correlational study, a structured, self-administered questionnaire was distributed to a sample of 172 randomly selected nurses at ADK hospital, Maldives. IBM® SPSS Statistics (Version 26) was used to analyze the data and level of knowledge and attitude were categorized using Bloom’s cut-off point. Results: Total of 164 nurses participated in this study, with a response rate of 95.93%. 87.8% (n=144) of the participants had a good to excellent level of knowledge. There was a positive attitude towards reporting medication administration errors among 54.9% (n=90) of the participants. A 50.5% (n=83) of the participants agreed or highly agreed that "Nurses could be blamed if something happens to the patient because of the medication error" as a barrier to medication error reporting. The results showed a statistically significant strong negative relationship between MAER attitude and perceived barriers to MAER, r (163) = -.818, p = <. 01. While there was a statistically significant weak negative relationship between MAER attitude and perceived barriers to MAER, r (163) = -.187, p = < .05. Conclusions: The findings revealed that most of the participants possessed good to excellent levels of knowledge in MAE and had a positive attitude toward medication administration error reporting. Blame due to adverse events to patients were considered the top-ranked barrier to MAER among nurses in the study. Thus, efforts to enhance MAER by creating a safe organizational culture and developing a confidential, anonymous, fast, and simple-to-use reporting system is crucial to eliminating these barriers.Item Exploring the factors contributing nurses turnover in Indhira Gandhi Memorial Hospital(School of Nursing, 2019-02-02) Waheed, HasrathOBJECTIVE : Objective of this study was to explore the factors contributing nurses turnover in Indhira Ghandhi Memmorial Hospital METHOD : The design selected for research was descriptive qualitative study. Sampling method chosen for the study was purposive convenient sampling method. Population of the study was Maldivian registered nurses who have resigned from IGMH last five years. This study was carried out in Indhira Gandhi Memorial Hospital Male, Maldives. Total numbers of seven nurses were included in the study. Data collection method was face to face interview. Semi structured interview guide was used to collect data. All the interviews were audio taped and field notes were made during the interview. The length of interviews varied from 10 to 20 minutes. Participants who has given interview in Dhivehi language was translated to English with the help of translator. Data in this study was analyzed by using Collaizi’s (1978) method. RESULT : From the analysis of this study five themes were identified. They are lack of opportunities for job advancement and career development, in adequate support from practice environment, Low pay and compensation practices, Heavy workload and unconventional working hours and difficulty in balancing family and work life. CONCLUSION: Findings from the research revealed that there are many factors that contribute nurses turnover. It was identified that salary and allowances are unsatisfactory, training and development opportunities are not adequate, workload is too high and there were no supportive working environment. Moreover study indicated lack of recognition, appreciation and rewarding systems makes staff to leave the organization. These factors need to be adequately addressed and proper management system and retention strategies to be formulated to retain nurses.Item Socio-economic, political and social capital factors that influence the state expenditure: a comparison of rural communities in the Maldives(School of Public Administration : National Institute of Development Administration, Bangkok, 2019-10) Zahir, Mohamed; މުހައްމަދު ޒާހިރުThe Maldives is a nation in the Indian Ocean that includes approximately 1200 coral islands in 21 clusters known as atolls. For administrative purposes, these atolls are grouped into seven provinces located geographically in the Central, Northern, and Southern areas. These island communities operate as groups, which explains to some extent the unequal allocation of resources among the rural communities and Central city, as many studies have supported. Therefore, to understand the unequal distribution of wealth in rural communities, it is very important to determine the factors associated with the provision of public funding as a whole. This study’s goal was to use multidimensional variables to estimate the factors that determine the provision of public funding, and economic, political, and social capital factors were combined to determine their relation to the Maldives’ total expenditures. More interestingly, after 2010, many rural areas have made huge improvements in their education level, healthcare services, and infrastructure development. The constitutional reform in 2008 that mandates multiparty democratic elections are suspected to be the root cause of these improvements. Ideally, citizen participation and engagement are intended to foster any state’s development. The Maldives government always has been criticized for its process of electing government officials, specifically influences on the part of candidates and other stakeholders, either by mutual benefits or malfeasance. However, it is clear that there is an expectation on both sides’ part. This basically indicates that public spending will be higher when it caters to the public’s demands. However, to what extent is this statement true in the case of rural development? Therefore, this study attempted to analyze the provision of public funding at both the island and provincial levels, and two models were developed to investigate these relations.Item An exploratory study of the interplay between teachers, beliefs, instructional practices & professional development(The University of Auckland, 2006) Mohamed, Naashia; ނާސިހާ މުހައްމަދުPrevious research has revealed the influential role of teachers’ beliefs in determining their professional behaviour. Teachers’ beliefs affect not only their teaching, but also filter new input, suggesting significant implications for the implementation of educational innovations and teacher development. This study explores the interconnections between teachers’ beliefs, their instructional practices and professional development, examining the extent to which the introduction of an innovative teaching approach impacts teachers’ beliefs and behaviour. It focuses particularly on grammar instruction in the context of English teaching in secondary schools of the Maldives. Combining descriptive ethnography with a quasi-experimental design, the study was implemented in two phases. Phase One, based on questionnaire data from 197 teachers from 51 schools, explored teachers’ beliefs and their self reported practices. Findings indicated that teachers placed great emphasis on grammar and that they were unfamiliar with inductive approaches to grammar instruction. In Phase Two, inductive grammar teaching methods were introduced to 14 teachers from two schools, in a 12 week professional development programme. Drawing largely on data from observations and interviews, the results from this phase showed that although teachers were observed to generally follow their pedagogic beliefs, several points of difference between their beliefs and practices existed. While the professional development may have increased their understanding of inductive approaches to grammar instruction at the level of awareness, only limited changes to beliefs and practices were observed. Changing instructional practice appeared to be a difficult task with only two teachers uptaking the innovation. Some subsidiary changes were however observed in the practices of several other teachers. Various impediments constrained change efforts, including teachers’ lack of openness to change, their low professional motivation and the lack of a supportive school culture. Contextual factors such as large classes and difficult working conditions also negatively affected the change process. Findings indicate that development activities which provided regular one-on-one support for the teachers were more likely to lead to uptake than those involving mainly workshops. The individual nature of the uptake process, its lack of uniformity and the challenges faced by the teachers are discussed, as are the implications for the provision of professional development.Item The power of small : the diplomacy of small states in regional organizations(The Australian National University, 2012-01) Mohamed, Ali Naseer; އަލީ ނަސީރު މުހައްމަދުHow can small states influence the conflict management activities of regional or ganisations? The conventional wisdom in the literature of International Relations holds that small states lack the ability to shape the preferences of other actors. In recent years, some small-state scholars have challenged this view. They argue that some small states make bold initiatives and succeed in influencing institutions like the European Union. These studies are, however, mostly single-country case studies, focusing almost exclusively on European small states in the European Union. They do not, therefore, reveal what is unique to that case, and what can be generalised to small states in other parts of the world. Moreover, these studies have not examined adequately international-level factors such as the role of the dominant power in the regional organisations, in helping or hindering the initia tives of the small states. This study aims to fill that gap. It seeks to understand the national and interna tional-level factors that determine the abilities of small states to influence the con flict management activities of regional organisations. The study also seeks to expand our understanding of small-state diplomacy by examining non-European small states. It analyses seven case studies involving six small states in five regional organisations, located in four different parts of the world. To my knowledge, it is one of the first scholarly attempts to understand the factors-both at national and international levels-that determine the abilities of small states to exert influ ence in regional organisations. In doing so, I hope to make a contribution to the study of diplomacy in general, and the diplomacies of small states in particular. The thesis examines the seven case studies with the help of a theoretical frame work that identifies five factors as necessary for small states to be able to exert in fluence in conflict management activities of regional organisations. The factors are: small states' credibility, norm entrepreneurship, diplomatic resilience, the in- xiii stitutional mechanisms within the regional organisation, and the role of the re gional power. The empirical analysis of the case studies shows that all five factors are necessary for small states to exert influence. Yet it also shows that each of the five factors has varying degrees of impact on the abilities of small states to exert influence. There is evidence from the case studies to suggest that the role of re gional power is a necessary, but not a sufficient condition for determining whether small states can exert influence in regional organisations. Second, small states could influence the shaping of a regional power's preferences if the farmer's diplomacy is sufficiently resilient. Small states derive their diplomatic resilience from the strength of the foreign policy bureaucracy, the persuasive power of dip lomats, and niche diplomacy. Third, small states exert influence by pursuing norm entrepreneurship in regional organisations: seeking to generate new and in novative ideas to solve common problems. Fourth, small states' ability to influ ence depends on whether the institutional mechanisms within the regional organisation allow sufficient space for these states to manoeuvre. Finally, small states can exert influence if they have credibility derived from a non-threatening foreign policy posture and from persistent activism and expertise in a given issue. Thus, small states can exert influence in regional organisations if their diplomacy is sufficiently resilient. The findings of this study reveal that with the right poli cies, small states can increase their diplomatic resilience. For size alone does not determine destiny; persuasive diplomacy doesItem Reaching the community through community radio : readjusting to the new realities : a case study investigating the changing nature of community access and participation in three community radio stations in three countries New Zealand, Nepal and Sri Lanka(University of Canterbury, 2012) Nafiz, Ahmed Zaki; އަހުމަދު ޒަކީ ނާފިޒުCommunity radio is often described as a medium that celebrates the small community life and where local community members plan, produce and present their own programmes. However, many believe that the radio management policies are now increasingly sidelining this aspect of the radio. This is ironic given the fact that the radio stations are supposed to be community platforms where members converge to celebrate their community life and discuss issues of mutual interest. In this case study, I have studied three community radio stations- RS in Nepal, KCR in Sri Lanka and SCR in New Zealand- investigating how the radio management policies are positively or negatively, affecting community access and participation. The study shows that in their effort to stay economically sustainable, the three stations are gradually evolving as a ‘hybrid’; something that sits in-between community and commercial radio. Consequently, programmes that are produced by the local community are often replaced by programmes that are produced by full-time paid staff; and they are more entertaining in nature and accommodate more advertisements. The radio stations also actively seek the sale of airtime to wellfunded NGOs, giving agency-driven programmes priority over local community programmes. This means the stations have become vehicles that help agency objectives. Hence, although ‘hybrid’ initiatives have merits financially, while depicting as local community representatives, they are marginalising the voices and interests of the very people that gave the radio stations their community characteristics and identity. Hence, in the interest of earning more revenue to secure market survival, the ‘hybrid’ initiatives are in fact, settling for a lesser community role. This study also shows that although management policy decisions aimed at greater financial sustainability have impacted on local community access and participation in the way they used to be, by readjusting to the new realities of modern-day communications, the three stations are also providing a second ‘hybrid’ pathway, a new interactive radio environment enabling stronger community access and participation. As this new platform facilitates unhindered local community access and participation in the radio, it is also viewed as a solution that will help them to utilise more of their on-air time for revenue-generating programmes. The new platform is also seen as the answer to reach the new generation youth and increase their participation, thereby, in fact, further strengthening community participation in the radio.Item ސިޔާސީ މީހުންގެ ވާހަކަދެއްކުމުގައި މެޓަފަރ ބޭނުންކުރަނީ ކިހައިވަރަކަށް އަދި ކޮން ބޭނުމަކު ހެއްޔެވެ؟(ފެކަލްޓީ އޮފް އާރޓްސް, 2015-11) ސަޢީދާ, މަރްޔަމް; Saeeda, Maryamދިވެހިރާއްޖެއަށް ޑިމަކްރަސީ ތަޢާރަފުވުމާ ގުޅިގެން، ސިޔާސީ ޕާރޓީތަކާއި ސިޔާސީ މީހުންނާއި ސިޔާސީ މީހުނގެ ވަހަކަތައް ދިވެހީންގެ ތެރޭގައި މަޤްބޫލުވުމުގެ ސަބަބުން ސިޔާސީ ފަރާތްތަކަށްދައްކާފައި ހުންނަ ވާހަކަތަކާއި ބުނުންތަކަށްވެސް އާއްމުންގެ ސަމާލުކަން ލިބެމުންދެއެވެ. ބައެއް ފަހަރު މިފަދަ ބުނުންތަކުގެ ސަބަބުން، އެބުނުން ބުނި ފަރާތަށް އާއްމުންގެ ތަޢުރީފުގެ ބަސްތައް ލިބޭފަދައިން ބައެއްފަހަރު މަލާމާތުގެ ބަސްތައްވެސް ލިބޭކަން ފާހަގަ ކުރެވެއެވެ. ވުމާއެކު، މިދިރާސާ އަމާޒުކުރެވިފައިވަނީ، ސިޔާސީ މީހުންގެ ވާހަކަދެއްކުމުގައި މެޓަފަރ ބޭނުންކުރާ މިންވަރާއި، މެޓަފަރ ބޭނުންކުރާ ބޭނުން ދެނެގަތުމަށެވެ. މިގޮތުން މިދިރާސާގެ މައިގަނޑު މަޤްޞަދަކީ، ސިޔާސީ ފަރާތްތަކުން، ސިޔާސި ޕޯޑިއަމްގައި ތިބެގެން ދައްކާ ވާހަކައިގައި، މެޓަފަރ ބޭނުންކުރާ މިންވަރާއި، މެޓަފަރ ބޭނުންކުރ ބޭނުން ހޯދައި ދެނެގަތުމެވެ. ވުމާއެކު ސިޔާސީ ފަރާތްތަކުން، ރައްޔިތުންގެ ރުހުމާއި ތާއީދު ހޯދުމަށްޓަކައި، ވާހަކަ ދައްކަމުންދާއިރު ބަސްމަގު ހުންނަ ގޮތް ދެނެގަތުމަށާއި، މިފަދަ މީހުންގެ ވާހަކަދެއްކުމުގައި މެޓަފަރ ބޭނުންކުރަނީ ކިހައި މިންވަރަކަށްކަމާއި ކޮން ބޭނުމަކުކަންވެސް އެނގިގެންދާނީ މިފަދަ ދިރސާއަކުން ކަމަށްވާތީ މިއީ ކުރުން މުޙިއްމު ދިރާސާއެއްކަން ގައިމެވެ. މިދިރާސާއަށް ބޭނުންވާ މަޢުލޫމާތު ހޯދުމަށް މިދިރާސާ ކުރެވުނީ މިކްސް މެތަޑް އެޕްރޯޗުންނެވެ. މިދިރާސާ ކުރުމަށްޓަކައި، 2013 ވަނައަހަރުގެ ރިޔާސީ އިންތިޚާބުގެ ދުވަސްވަރު ސިޔާސި ފަރާތްތަކުން ދައްކާފައި ހުރި ވާހަކަތަކުގެ ތެރެއިން، ތެރެއިން 6 މީހުންގެ ވާހަކަދެއްކުމަށް ބެލުނެވ. ހަމަމިއާއިއެކު، ސިޔާސީ ޕޯޑިއަމްތަކުގައި ވާހަކަދައްކާ ފަރާތްތަކުގެ ތެރެއިން 5 ފަރާތަކާ ސެމީ-ސްޓްރަކްޗާރޑް އިންޓަރވިއުވެސް ކުރެވުނެވެ. މިދިރާސާއަށް ސާމްޕަލް ނަގާފައިވަނީ ޕާޕޯސިވް ސާމްޕަލިންގް ދަށުންނެވެ. ދިރާސާގެ ހުރިހާ ބައިވެރިންވެސް މެޓަފަރ ބޭނުންކުރާކަމާއި، މެޓަފަރގެ ވައްތަރުތަކުގެ ތެރެއިން ފަސް ވައްތަރެއްވެސް ބޭނުންކުރާކަން ހާމަވިއެވެ. ބައެއް ފަރާތްތަކުން ގަސްތުގައި މެޓަފަރ ބޭނުންކުރާއިރު، ގަސްތަކާއި ނުލާ މެޓަފަރ ބޭނުންކުރާ ފަރާތްތައްވެސް ވާކަން މިދިރާސާއިން ފާހަގަ ކުރެވުނެވެ. ހަމަމިއާއިއެކު، ސިޔާސީ ފަރާތްތަކުގެ ވާހަކަދެއްކުމުގައި، އަންނައުނާއި ހަށިގަނޑުގެ އިތުރުން ދަތުރުފަތުރާއި ސިޔާސީ މީހުންގެ ވާހަކަދެއްކުމުގައި މެޓަފަރ ބޭނުންކުރަނީ ކިހައި މިންވަރަކަށް އަދި ކޮން ބޭނުމަކު ހެއްޔެވެ؟ ފުޓުބޯޅައާ ގުޅުވައިގެން މެޓަފަރ ބޭނުންކުރާކަންމި ދިރާސާއިން ދައްކައެވެ. މެޓަފަރ ބޭނުންކުރަނީ، ދައްކާ ވާހަކައިގެ އަސަރާއި ފޯރި ގަދަކުރުމަށް ކަމަށްވެފައި، މިކަމަށްޓަކައި ހާލަތާ ގުޅުވައިގެން މެޓަފަރ ބޭނުންކުރުމަކީ ކުރަންޖެހޭ ކަމެއްކަން ދިރާސާއިން ހާމަވިއެވެ. މީގެ އިތުރުން ސިޔާސީ މީހުންގެ ވާހަކަތަކުގައި މެޓަފަރ ބޭނުންކުރުމުގެ ސަބަބުން ބައެއް ފަހަރު، ނޭދެވޭ އަސަރު ކުރާކަންވެސް މިދިރާސައިން ހާމަވިއެވެ. އެހެންކަމުން، ސިޔާސީ ފަރާތްތަކުން ވާހަކަތައް އަޑުއަހައި އެފަދަ ވާހަކަތައް ބައްޓަންކޮށްފައި ހުންނަ ގޮތާމެދު ވިސްނުން ގެންގުޅޭ ފަރާތްތަކަށް، މިދިރާސާއަކީ ބޭނުންތެރި އެއްޗަކަށް ވާނެއެވެ.