https://www.um.edu.mt/library/oar/handle/123456789/31649 Wed, 08 Apr 2026 20:00:32 GMT 2026-04-08T20:00:32Z https://www.um.edu.mt/library/oar/handle/123456789/127463 Title: The hospital medical superintendent in the Maltese health care system and the hospital unit general manager in the British health care system : contrasts and comparisons Abstract: Health care managers in Britain, or administrators, as they are known in Malta, are a leading force in implementing health care programmes. Whether they succeed or not depends on various aspects. Using a compare-and-contrast approach this study interviews several of them in Malta and Britain and examines the difference between them. It takes into account the situational background involved since managerial behaviour is both a function of the persons involved and the surrounding situations. It discovers that although both the Maltese and the British are optimistic about recent government policies which are meant to encourage change, the Maltese have a longer way to go to uproot themselves from their current status quo situation. In the first chapter, the author evaluates the main issues, comments about present and future trends in health care, and explains the significance of this study. The second chapter deals with the health care situation in Malta and England. Health care administration in Malta is an offshoot of the British one with the ties between the two countries dating back many years when Malta was a British colony. However, during the latter part of this century Britain took a radical approach with regards to its health care programmes whereas Malta held firmly to tradition. In the third and fourth chapters, the author goes about interviewing British hospital unit general managers and Maltese hospital medical superintendents. In comparing and contrasting their answers, major differences surface in important areas such as management styles, quality standards and budget processes. The final chapter contains a summary of the differences and similarities observed. The author recommends support for the new governmental policies in both countries which offer a fresh approach for the health care profession, as well as suggests academic areas which deserve further attention in shaping the managers of the future. Finally, areas which deserve future research are proposed. Description: M.A.HEALTH SERVICES MANGT.; FOREIGN THESIS Mon, 01 Jan 1990 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/127463 1990-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/77955 Title: Nurses' job satisfaction in Maltese long-term care institutions : a Husserlian phenomenological study Abstract: Nurses working in long-term care of older people are faced with doing routine tasks, and working with the same residents all year round. The aim of this study is to discover the lived experience of enrolled and staff nurses working with older people being placed in such a work environment. This study was planned using a phenomenological theory as influenced by Husserl. The focus of Husserlian phenomenology is that human experience is based on perceptions and the ways in which human beings ascribe meaning to what they experience. The researcher in this study does not take a position and as a result does not subscribe to a specific view. Bracketing was achieved by not looking at literature prior to data collection. This has helped to avoid directing respondents towards a predefined answer. Respondents were asked to verify transcribed interviews, and research supervisor to be a critical reader to ensure that a priori position is not taken. The respondents could confirm that the interpretation to what they actually said in the interview was correct and was not changed by the researcher. This study was conducted in one of the largest residence for the elderly in Malta with a total of 1033 residents. Ten nurses from ten different units within the residence were interviewed. Interviews lasted for one, to one and a half hours each. Nurses were asked to describe phenomena, as they are experienced. The respondents had the freedom to respond in any way they felt is right for them. According to their response, questions were extended and refocused on job satisfaction. Interviews were transcribed and analysed manually and the main terms identified and categorised. Rough codes identified became categories when similar experiences or explanations offered by other participants were identified. Due to limitations with the sample size, findings cannot be generalised to the whole nursing population, but gives a good idea of what may be the cause of job satisfaction/dissatisfaction within the residence. This study has revealed the feeling of uncertainty or low self-esteem by respondents. Long-term care paradoxically requires commitment and hard work but which challenges the practitioner less than a fast changing acute adult care. Management should find a solution to the problem of staff shortage impeding staff vacation leave. Continued professional development should focus on nursing staff needs rather then organisational needs. Description: M.SC.NURSING Sat, 01 Jan 2005 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/77955 2005-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/47625 Title: An exploration of specialist nurses in Malta: a qualitative case study. Abstract: The concept of specialist nursing and advanced nursing practice has been extensively debated in the literature internationally but to date no consensus exists on the preparation, titling and regulation of these nurses worldwide. The introduction of specialist nurses in Malta in 2003, now titled ‘practice nurses’, was seen as an evolution in nursing practice and launched in response to gaps in services and developments in health policy. This was perceived as a much needed career advancement option for nurses; an alternative to traditional administrative/educational roles; and a drive towards improving patient access and quality care. However there was still a paucity of information and evaluation of the nurses’ role in Malta. The aim of this study was to explore the perceptions of the roles, development and preparation of specialist nurses in Malta, an island with its own historical, political and social context. Using a qualitative case study design, a deep understanding of the complex issues surrounding specialist nurses was gained from multiple data sets using purposive sampling techniques. Data included a survey of the total specialist nurse population (N=27), in-depth interviews with a group of specialist nurses (N=9) and four focus groups with key professionals and policy stakeholders (total N=28). Data was collected between 2013 and 2015 and analysed using thematic analysis. The main themes that emerged from the findings including concepts of advanced nursing practice, role boundaries, preparation, regulation and autonomy to practice. In spite of the very positive views on the roles and practice of these specialist nurses, a number of barriers to their future development were exposed. Barriers comprised the lack of understanding and support for their role and the paucity of evaluation research on their role. Additional areas affecting their advancement included the organisational and political systems that were seen to affect leadership, and power in nursing to achieve the ultimate aim of consistent provision of good quality nursing care. The study provides the first research-based insights into the role and development of specialist nurses in Malta, and concludes by highlighting the need for a legally accepted set of definitions, preparation and evaluation of the specialist nurse role from a national policy perspective. Description: PH.D.; FOREIGN THESIS Sun, 01 May 2016 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/47625 2016-05-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/45914 Title: The use of anti-fetal haemoglobin antibodies for the enrichment of fetal cells from the maternal circulation. Abstract: In today's world prenatal diagnosis is becoming more and more important. At present all reliable tests that can be offered involved a small but definite risk to the pregnancy and therefore cannot be universally employed. The non-invasive isolation of fetal cells from the maternal circulation and the use of these cells for prenatal diagnosis in the first trimester of pregnancy is the ideal answer to the situation. If the test offered was simple, reliable and risk free, than the threshold of future parents and health care advisors to request prenatal diagnosis will certainly be much lower than at present. The setting up of such a protocol has been a long-sought goal that has met with as many encouraging results as with frustrations but has survived them all to remain a very intensely researched field of Medicine. Focus has turned on to different types of fetal cells that have been enriched using different techniques. At present one of the most promising fetal cell to look for is the nucleated red blood cell (N RBC) - these are not very common in the circulation of an adult but are known to be abundant in the circulation of a fetus especially in the first trimester of pregnancy. It is also known to have a short life span and is unlikely to still be present from a previous pregnancy. Besides, this cell harbours one of the most important differences between fetal and adult cells - fetal cells produce haemoglobin F (Hb F) while in normal individuals, adult cells produce mostly haemoglobin A thus making it a stronger candidate for fetal cell isolation from the maternal circulation. In view of the small numbers of fetal cells suspected to be present in maternal blood, blood samples are usually first enriched for a selected cell type before being subjected to DNA analysis. Magnetic cell sorting (MACS) is probably one of the most ingeniously simple and effective methods of enrichment and will be used in the following experiments. On the one hand 'enrichment' is very helpful in that it eliminates numerous contaminating cells but it also has the disadvantage that cells are lost in the various steps and washes of the enrichment protocol. If the search for fetal cells could be done on whole blood then one would ensure that very few fetal cells have been lost in the preparatory part of the experiment. Possibilities for this have been studied in this work using flow cytometric methods in the hope that a fast automated scanner with high resolution would be able to identify fetal cells from whole maternal blood. Molecular biological techniques are nowadays used both to confirm the fetal origin of the enriched cells as well as for diagnosis. In situ hybridisation with fluorescence markers (FISH) is particularly suitable for both the identification of male cells together with the diagnosis of aneuploidies. If a reliable fetal cell marker were available than multi-colour FISH could be used for the simultaneous prenatal diagnosis of chromosomal aberrations in all pregnancies. Although other techniques also exist, this is the method employed in this thesis. Much progress has been made in the endeavour of fetal cell isolation from maternal blood for prenatal diagnosis and some successes have already been reported. However despite all this, numerous problems still exist - the most important one being the extreme scarcity of fetal cells in maternal blood and the second being the lack of a fetal specific cell marker. The aim of this work is to investigate the suitability of Hb F as such a marker. Description: lnaugural dissertation to obtain the doctorate of the entire medical science submitted to the Medical Faculty of the University of Basel; FOREIGN THESIS Mon, 01 Jan 1996 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/45914 1996-01-01T00:00:00Z