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Aversive Racism and Inequality in Health Care

Aversive racism is a subtle and indirect type of racism that can contribute to unequal treatment in a variety of settings and situations including, but not limited to, health care access for minority racial and ethnic groups. Individuals who engage in aversive racism say they support the principle of racial equality and do not believe they are prejudiced. However, they also possess subconscious negative feelings and beliefs about specific racial and/or ethnic groups. Aversive racism often results in a majority group’s failure to help a minority group, even though they do not intentionally cause harm. Aversive racism may be a contributing factor to poor quality health care for some minorities.

To prepare for this Assignment:

· Review the Section III, “Framework Essay,” and Reading 31 in the course text. Pay particular attention to aversive racism and health care access.

· Review the article, “Psychiatrists’ Attitudes Toward and Awareness About Racial Disparities in Mental Health Care,” and focus on methods for reducing aversive racism.

· Take the Race Implicit Bias test at the Project Implicit website.

· Identify two examples of racial or ethnic inequality in health care in the United States.

· Think about how aversive racism contributes to the examples that you identified.

· Consider methods for reducing aversive racism in your examples.

The Assignment (3–pages):

· Describe two examples of racial or ethnic inequality in health care in the United States.

· Explain how aversive racism contributes to the inequality illustrated in the examples (and thus in health care) you described.

· Explain methods for reducing aversive racism in your examples. Be specific and provide examples to support your explanation.

· Discuss how implicit bias might impact health care in the United States.

Support your Assignment with specific references to all resources used in its preparation.

THIS INFORMATION WAS UNDER RESOURCES FOR THE WEEK:

https://implicit.harvard.edu/implicit/takeatest.html

https://ps-psychiatryonline-org.ezp.waldenulibrary.org/doi/full/10.1176/ps.2010.61.2.173

Published Online:1 Feb 2010https://doi-org.ezp.waldenulibrary.org/10.1176/ps.2010.61.2.173

Persons from racial-ethnic minority groups have disproportionately poor mental health status, experience more barriers to and receive lower quality mental health care, and are underrepresented in mental health research ( 1 , 2 ). The relatively lower socioeconomic status of most racial-ethnic minority groups explains some variation—that is, persons from racial-ethnic minority groups are more likely to be uninsured or underinsured, to be less educated and have lower income, and to reside in areas where medical services are less available ( 3 , 4 ). Moreover, persons from racial-ethnic minority groups may be more distrustful of health care providers, have lower health literacy, be less likely to seek care, and prefer fewer services ( 5 , 6 ). Nonetheless, disparities persist even after controlling for such factors. Some of this variation is likely due to differences based on race-ethnicity in physician-patient interactions ( 7 ,8 , 9 , 10 ).

Race-ethnicity has been shown to influence physician-patient communication during clinical encounters and physician decision making ( 10 , 11 ). Physicians tend to view patients from minority groups as less intelligent, less effective communicators, less compliant, more likely to abuse alcohol and drugs, and less likable than white patients ( 8 , 12 ). Although distressing, these facts are consistent with social categorization (or social cognition) theory ( 10 , 12 ). This theory, originating in the social psychology literature, posits that humans use categorization to make vast amounts of social information manageable. Characteristics are unconsciously assigned to social groups (for example, racial-ethnic groups), and those characteristics are then unconsciously applied to individuals through stereotyping ( 13 ). Physicians may be especially vulnerable to stereotyping because of time pressures and the need to make rapid assessments—that is, physicians have more social information to process, so rely more heavily on social categorization ( 14 ).

Social categorization and racial-ethnic stereotyping likely influence physician behavior and decision making. However, because these are unconscious processes, physicians may be unaware of them and may underestimate their own contributions to racial-ethnic disparities. Understandably, physicians may be reluctant to explore their unconscious biases; it would be difficult for most physicians, who have dedicated their careers to helping others, to confront their own contributions to racial-ethnic inequality ( 10 ). Nonetheless, attempts to eliminate disparities will not be successful as long as health care providers believe that the sources of disparities are entirely external to themselves. Physicians must become aware of their own unconscious biases in order to change the behaviors that contribute to racial-ethnic inequalities.

We hypothesized that there are several prerequisites for changing physician behavior: physicians must be aware that racial-ethnic disparities exist, physicians must believe that they may contribute to disparities, and physicians must be motivated to change their behavior. The purpose of this study was to evaluate the extent to which psychiatrists have achieved these prerequisites and to identify factors that are associated with achievement of each.

Methods

Study sample

Data were collected through an online survey of American Psychiatric Association (APA) members conducted from April 2006 to August 2006. The survey was also distributed at the APA’s Institute on Psychiatric Services in October 2006. For the online portion of the study, names and addresses of 2,000 randomly selected member psychiatrists were purchased from the APA. A letter of introduction and unique access code were mailed to each; a printed survey was available. A maximum of three contact attempts were made. Of the 2,000 individuals identified, a correct address could not be obtained for 24 and seven were retired or deceased. Of the final sample of 1,969 eligible members, 186 psychiatrists (9%) completed the survey online.

Surveys were also distributed from an exhibit hall booth at the 58th Institute on Psychiatric Services, a national professional conference. Respondents were compensated with a $5 specialty coffee gift card. Of the 190 psychiatrists who completed the survey at the conference, two had previously participated, and only their responses to the online survey were used. The final sample for this study was 374 individuals.

The University of Rochester Research Subjects Review Board reviewed this study and determined that it was exempt from institutional review board review.

Survey

Content of our survey was informed by a survey developed by the Kaiser Family Foundation ( 15 ) that was subsequently modified by Lurie and colleagues ( 16 ) for use with cardiologists. The survey included questions about familiarity with racial disparities research, perceived awareness of psychiatrists about racial disparities, and changes in awareness over the past decade. To measure perceived determinants of quality of care, physicians rated the extent to which 12 patient factors (including race) affect quality of psychiatric care, both in general and in their own practice setting. A “difference” variable was calculated by subtracting the perceived influence of race in the participant’s practice from the perceived influence of race in general. Finally, respondents were asked whether they had participated in the past year in any program designed to reduce racial disparities in health care or whether they would be interested in participating in such a program; they were also asked whether they believed such programs were likely to reduce health disparities. Most items were measured on 5-point Likert scales. Key terms, such as quality of care, were defined.

Sociodemographic variables included gender, race, ethnicity, years in practice, practice setting and size, proportion of patient population that is non-Hispanic white (referred to as “white” in this article) versus other (referred to as “nonwhite” in this article), and number of professional meetings attended annually. A copy of the survey is available on request.

Analyses

Univariate statistics were generated for all variables in the data set. Most data were treated as categorical, and most bivariate analyses were conducted with chi square analysis or Fisher’s exact test, as appropriate. Multivariate analyses were conducted using logistic regression. Analyses were guided by a priori hypotheses to limit type II error, and they were conducted using two-sided tests with α =.05. Analyses were performed using SAS, version 9.1.

Results

Participants

As shown in Table 1 , most participants were male (62%) and white (63%). Most (77%) had been in practice for 15 years or more, and almost half (48%) worked in small practices (less than ten physicians). Almost one-third of participants (32%) worked in community hospitals or community mental health centers (CMHCs), and most others worked in university hospitals (21%) or private practice (24%). The racial-ethnic makeup of respondents’ patient populations varied widely, but in many respondents’ practices (48%), at least half of the patients were from racial-ethnic minority groups.

Table 1Demographic characteristics of 374 psychiatrists who completed a survey on racial disparities in mental health careEnlarge table

Awareness of disparities

Most respondents were not at all or a bit familiar with research on racial inequalities in psychiatric care (N=190 of 370, 51%), and approximately one-third of respondents were moderately familiar (N=136 of 370, 37%), and only 12% were familiar or very familiar (N=44 of 370). Compared with their respective comparison groups, respondents were more likely to be familiar or very familiar with this research if they were nonwhite ( χ2 =6.9, df=2, p=.03) or if they treated a greater proportion of patients from minority groups ( χ2 =6.9, df=2, p=.03). Those who attended more professional meetings annually also reported greater familiarity ( χ2 =18.0, df=6, p=.006). Familiarity was not associated with the physician’s gender, practice setting, or years in practice.

A majority of respondents believed that, compared with ten years ago, there is somewhat more or much more awareness of racial inequalities in psychiatric care among psychiatrists in general (N=272 of 368, 74%). Less than one-fifth of respondents felt that awareness has remained the same (N=69 of 368, 19%), and only 7% (N=27 of 368) felt that awareness has decreased. Most felt that psychiatrists, compared with other types of physicians, are more aware of racial disparities in health care. Specifically, 275 of 365 respondents (75%) believed that psychiatrists are somewhat or much more aware than physicians in other fields, whereas 64 of 365 respondents (18%) felt that psychiatrists are no more or less aware. Only 26 of 365 (7%) felt that psychiatrists are somewhat or much less aware than physicians in other fields.

Beliefs about disparities

When asked to rate the effect of 12 patient factors on quality of psychiatric care, respondents generally reported that race has less of an impact on quality than other factors, both in general and in the respondents’ own practices ( Table 2 ). In both scenarios, only gender was rated as having less influence on quality of care.

Table 2Psychiatrists’ perceptions of the influence of patient factors in quality of psychiatric careEnlarge table

For every patient factor, participants believed overall that the factor has a stronger influence on quality of care in general than on quality of care in their own practices (p<.001 for all). In regard to race, 222 of 369 respondents (60%) believed that race has a stronger influence on quality of care in general than in their own practices, whereas 127 of 369 respondents (34%) believed that race is equally influential in both instances. Only 20 of 369 respondents (5%) said that race has more of an influence on quality of care in their own practices than on quality of care in general.

Most white respondents (N=165 of 227, 73%) believed that race has more influence on quality of care outside of their practice than within it, whereas nonwhite respondents were more likely to perceive that patient race is equally influential in both settings (N=65 of 130, 50%; χ2 =32.3, df=2, p<.001). Those who had been in practice longer also tended to believe that race has more influence on quality of care in general than in their own practices (p<.001, by Fisher’s exact test). Respondents were more likely to believe that race has a stronger influence on quality of care in general than in their own practices if they attended the fewest professional meetings annually (no meetings or one meeting) (N=37 of 58, 64%) or the most meetings (more than five) (N=64 of 96, 67%), compared with those who attended two to three meetings (N=76 of 132, 58%) or four or five meetings (N=42 of 70, 60%) (p<.001 by Fisher’s exact test). Gender, practice setting, proportion of the respondent’s patient population that is white, and familiarity with racial disparities research were not associated with whether the respondent perceived a different influence of race in general and in the respondent’s own practice.

Logistic regression was used to model the likelihood that a respondent believed that race is more influential on quality of care in general than in the respondent’s own practice. After the analysis controlled for covariates, the only variables that were significantly associated with belief were the respondent’s race and length of time in practice ( Table 3 ). Compared with nonwhite respondents, white respondents were more likely to feel that race is more influential in quality of care generally than in their own practice. Additionally, respondents who had been in practice for more than 15 years were more likely than those who had been in practice for five years or less to believe that race has a stronger influence on quality of care in general than in their own practices.

Table 3Logistic regression modeling probability that psychiatrists believe that race is more influential on quality of care in general than in their own practicesEnlarge table

Interest in educational programs

Almost one-quarter of respondents (N=86 of 368, 23%) had participated in an educational program to reduce racial disparities in health care. Of the 282 remaining respondents, 174 (62%) stated they would be interested in participating in such a program. Moreover, most (N=279 of 366, 76%) felt that raising awareness of racial disparities would be somewhat or very effective in reducing such disparities.

Respondents who were not interested in participating in an educational program were compared with those who had participated or would be interested in participating. In bivariate analysis, more nonwhite respondents than white respondents were interested in participating in an educational program ( χ2 =10.4, df=1, p=.001). Respondents who worked in a university setting were more likely than respondents who worked in other settings to be interested in participating ( χ2 =15.7, df=3, p=.001). Respondents who had been in practice longer were less likely to be interested ( χ2=8.8, df=3, p=.03). Self-reported familiarity with the racial disparities literature was positively associated with interest ( χ2 =12.4, df=2, p=.001). Interest was not associated with gender, racial-ethnic makeup of the respondent’s patient population, or number of professional meetings attended annually.

Logistic regression was used to model the likelihood that a respondent was interested in or had participated in a disparities-reduction education program. After controlling for covariates, we found that respondents’ race-ethnicity, practice setting, and familiarity with the racial disparities literature were independently associated with interest in an educational program ( Table 4 ). Nonwhite respondents were more likely than white respondents to be interested in participating in an educational program, as were those who practiced in a university setting and those who were moderately or very familiar with the racial disparities literature.

Table 4Logistic regression modeling probability that psychiatrists are interested in participating in a disparities-reduction programEnlarge table

Discussion

This study contributes insights into the challenges to achieving racial-ethnic equality in mental health care. Specifically, our findings suggest that many psychiatrists are unfamiliar with the body of literature on racial disparities and that, even among those who are knowledgeable about disparities, psychiatrists may be reluctant to acknowledge their own role in contributing to inequalities. Moreover, although most psychiatrists felt that increasing awareness of disparities would help eliminate inequality, a significant proportion was not interested in participating in disparities-reduction programs.

Although most respondents felt that psychiatrists had become more aware of racial disparities in the past decade, fewer than one in eight reported familiarity with research on racial disparities. This may suggest that psychiatrists are aware that disparities exist but are not well-versed in the academic literature. Additional research is warranted to determine how physicians learn about health care disparities, as well as to objectively determine physicians’ knowledge. Identifying gaps in knowledge, as well as identifying preferred sources of information, will help guide the design of future interventions.

Knowing that disparities exist is, by itself, an insufficient impetus to change. Health care providers will be more motivated to change their behavior if they believe their behavior may contribute to racial-ethnic disparities. Troublingly, not only did respondents in this study believe that disparities were more likely to exist in other providers’ practices than in their own, but they also generally believed that disparities were more prevalent in other medical fields than in their own, a finding that is consistent with other research ( 16 ). We posit that this trend reflects a natural discomfort that results when health care providers are asked to consider their own contributions to racial-ethnic inequalities. Although it is distressing to address others’ contributions to disparities, it is almost certainly more difficult to consider our own discriminatory and racially driven behavior, particularly when that behavior arises from unconscious beliefs and assumptions ( 10 ).

Our results indicate that recently trained psychiatrists are more likely to perceive racial disparities as equally prevalent in their own practices as in other providers’ practices. This may reflect an increased focus in medical education on issues of race-ethnicity, or it may reflect a more general shift in cultural beliefs about race and racial inequality among younger generations. Somewhat contradictorily, however, physicians who were more familiar with the disparities literature were more likely to see disparities as more prevalent in other physicians’ practices, suggesting that education about racial-ethnic disparities may have an effect that is opposite of what is intended. Physicians who are more educated about disparities may believe they have been able to achieve equality in their own practices, and this is indeed a valid possibility but one that should be tested empirically. Another possibility is that familiarity with the research on racial disparities does not itself render physicians more willing to accept their role in perpetuating inequalities. Understanding the complex relationships between these various factors requires longitudinal studies that measure changes in physicians’ attitudes, beliefs, and behaviors over time.

A limitation of this study is that our sample may not be representative of all psychiatrists practicing in the United States, because members of the APA and psychiatrists who attend APA meetings may be systematically different from other psychiatrists. Our response rate was adequate for this type of study, but response bias may limit the generalizability of our results—that is, we cannot determine whether psychiatrists who elected to participate in the study are systematically different from those who did not respond. Moreover, all data were collected by self-report, which may make comparisons less reliable. We attempted to standardize responses by defining all key terms, but our findings must be interpreted as stemming from respondents’ subjective beliefs. Finally, the cross-sectional study design prevents us from drawing conclusions as to causation. Longitudinal research is needed to clarify the direction of the relationships that we have reported.

Conclusions

Once physicians have begun to consider their own role in perpetuating racial-ethnic disparities and have expressed an interest in changing their behaviors, what are the most effective interventions? Increasing awareness of racial-ethnic disparities is useful but insufficient ( 17 ). When educational interventions are undertaken, they may be most effective when presented from within the provider community—for example, educational information presented by the APA or other national or local professional groups may be deemed more authoritative and believable than information from other sources ( 16 ).

Ideally, programs to reduce disparities should include a component to demonstrate the existence of disparities within the physicians’ own practices ( 17 ). For example, hospitals or CMHCs may collect data on patient outcomes or patient satisfaction and examine these findings for correlations with race-ethnicity. Reporting these findings to the treating physicians may help physicians to understand and accept the pervasive nature of racial-ethnic disparities ( 13 ). In the authors’ personal experience, however, a major limitation of this approach is that such feedback may be met with skepticism by physicians who are not yet prepared to confront their own role in the existence of disparities. Broaching this topic with physicians in a nonaccusatory and collaborative manner is essential for success.

In addition to providing information, programs to reduce disparities in clinical care should also emphasize cultural sensitivity and cultural competence. Cultural sensitivity refers to one’s insight into his or her own cultural beliefs and experiences (13 ), whereas cultural competence refers to one’s ability to understand and respond effectively to others’ cultural needs and to establish interpersonal relationships bridging cultural differences ( 7 ). Several components of effective cultural sensitivity and cultural competence training programs have been described. First, programs should help clinicians understand how their own experiences affect their perceptions of other races ( 13 , 18 ). Second, programs should help clinicians become aware of the circumstances that activate racial-ethnic stereotyping ( 13 ). Third, programs should introduce communication techniques that help clinicians approach their patients as individuals; the “patient-centered communication” approach is perhaps the most widely described and advocated of these techniques ( 7 , 9 , 13 , 19 ). Finally, programs should help clinicians learn to attend selectively to relevant racial-ethnic and cultural information and screen out irrelevant information ( 20 ). Relevant information may include cultural differences in health beliefs, medical practices, attitudes toward medical care and the medical system, and levels of trust of physicians ( 3 ). Relevant information may also include differences in incidence and prevalence of certain illnesses among specific groups and differences in pharmacokinetics and pharmacodynamics (ethnopharmacology) ( 3 , 21 ).

Ultimately, racial-ethnic disparities in health care will persist as long as there are inequalities in our society. Physicians, nonetheless, have the special opportunity and obligation as leaders within the health care community to improve the quality of care and health outcomes of patients from racial-ethnic minority groups. High-quality, empirically driven interventions may help physicians and other health care providers come one step closer to the goal of health equality.

Acknowledgments and disclosures

The Committee to Aid Research to End Schizophrenia (CARES) sponsored this study.

The authors report no competing interests.

At the time of the study, Ms. Mallinger was a student at the Georgetown University Law Center, Washington, D.C. Dr. Lamberti is with the Department of Psychiatry, University of Rochester, Rochester, New York. Send correspondence to Ms. Mallinger in the care of Dr. Lamberti at the Department of Psychiatry, University of Rochester, 300 Crittenden Blvd., Box PSYCH, Rochester, NY 14642 (e-mail: ).

References

1.Institute of Medicine: Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. Washington DC, National Academies Press, 2003Google Scholar

2.Mental Health: Culture, Race, and Ethnicity: A Supplement to Mental Health: A Report of the Surgeon General. Washington, DC, Department of Health and Human Services, US Public Health Service, 2001Google Scholar

3.Betancourt JR, Green AR, Carrillo JE, et al: Defining cultural competence: a practical framework for addressing racial/ethnic disparities in health and health care. Public Health Reports 118:293–302, 2003Google Scholar

4.Pincus T, Esther R, DeWalt DA, et al: Social conditions and self-management are more powerful determinants of health than access to care. Annals of Internal Medicine 129:406–411, 1998Google Scholar

5.Blendon RJ, Scheck AC, Donelan K, et al: How white and African Americans view their health and social problems: different experiences, different expectations. JAMA 273:341–346, 1995Google Scholar

6.Gamble VN: Under the shadow of Tuskegee: African Americans and health care. American Journal of Public Health 87:1773–1778, 1997Google Scholar

7.Cooper LA, Hill MN, Powe NR: Designing and evaluating interventions to eliminate racial and ethnic disparities in health care. Journal of General Internal Medicine 17:477–486, 2002Google Scholar

8.Street RL Jr, Gordon H, Haidet P: Physicians’ communication and perceptions of patients: is it how they look, how they talk, or is it just the doctor? Social Science and Medicine 65:586–598, 2007Google Scholar

9.Ashton CM, Haidet P, Paterniti DA, et al: Racial and ethnic disparities in the use of health services: bias, preferences, or poor communication? Journal of General Internal Medicine 18:146–152, 2003Google Scholar

10.Van Ryn M, Fu SS: Paved with good intentions: do public health and human service providers contribute to racial/ethnic disparities in health? American Journal of Public Health 93:248–255, 2003Google Scholar

11.Schulman KA, Berlin JA, Harless W, et al: The effect of race and sex on physicians’ recommendations for cardiac catheterization. New England Journal of Medicine 340:618–626, 1999Google Scholar

12.Van RM, Burke J: The effect of patient race and socio-economic status on physicians’ perceptions of patients. Social Science and Medicine 50:813–828, 2000Google Scholar

13.Whaley AL: Racism in the provision of mental health services: a social-cognitive analysis. American Journal of Orthopsychiatry 68:47–57, 1998Google Scholar

14.Stangor C, Duan C: Effects of multiple task demands upon memory for information about social groups. Journal of Experimental Social Psychology 27:357–378, 1991Google Scholar

15.Race, Ethnicity and Medical Care: A Survey of Public Perceptions and Experiences. Menlo Park, Calif, Kaiser Family Foundation, 1999Google Scholar

16.Lurie N, Fremont A, Jain AK, et al: Racial and ethnic disparities in care: the perspectives of cardiologists. Circulation 111:1264–1269, 2005Google Scholar

17.Stewart A, Walker RD, Bell C, et al: Reducing Mental Health Disparities for Racial and Ethnic Minorities: A Plan of Action. Arlington, Va, American Psychiatric Association, 2004. Available at Google Scholar

18.Jacobs EA, Kohrman C, Lemon M, et al: Teaching physicians-in-training to address racial disparities in health: a hospital-community partnership. Public Health Reports 118:349–356, 2003Google Scholar

19.Like RC, Steiner P, Rubel AJ: Recommended core curriculum guidelines on culturally sensitive and competent health care. Family Medicine 28:291–297, 1996Google Scholar

20.Ridley CR, Mendoza DW, Kanitz BE, et al: Cultural sensitivity in multicultural counseling: a perceptual schema model. Journal of Health and Social Behavior 25:14–23, 1994Google Scholar

21.Mallinger JB, Lamberti JS: Clozapine: should race affect prescribing guidelines? Schizophrenia Research 83:107–108, 2006Google Scholar

 

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“A Journey” Short story Analysis

She lay in her berth, staring at the shadows overhead, the rush of the wheels was in her brain, driving her deeper and deeper into circles of wakeful lucidity. The sleeping-car had sunk into its night-silence. Through the wet window-pane she watched the sudden lights, the long stretches of hurrying blackness. Now and then she turned her head and looked through the opening in the hangings at her husband’s curtains across the aisle….

She wondered restlessly if he wanted anything and if she could hear him if he called. His voice had grown very weak within the last months and it irritated him when she did not hear. This irritability, this increasing childish petulance seemed to give expression to their imperceptible estrangement. Like two faces looking at one another through a sheet of glass they were close together, almost touching, but they could not hear or feel each other: the conductivity between them was broken. She, at least, had this sense of separation, and she fancied sometimes that she saw it reflected in the look with which he supplemented his failing words. Doubtless the fault was hers. She was too impenetrably healthy to be touched by the irrelevancies of disease. Her self-reproachful tenderness was tinged with the sense of his irrationality: she had a vague feeling that there was a purpose in his helpless tyrannies. The suddenness of the change had found her so unprepared. A year ago their pulses had beat to one robust measure; both had the same prodigal confidence in an exhaustless future. Now their energies no longer kept step: hers still bounded ahead of life, preempting unclaimed regions of hope and activity, while his lagged behind, vainly struggling to overtake her.

When they married, she had such arrears of living to make up: her days had been as bare as the whitewashed school-room where she forced innutritious facts upon reluctant children. His coming had broken in on the slumber of circumstance, widening the present till it became the encloser of remotest chances. But imperceptibly the horizon narrowed. Life had a grudge against her: she was never to be allowed to spread her wings.

At first the doctors had said that six weeks of mild air would set him right; but when he came back this assurance was explained as having of course included a winter in a dry climate. They gave up their pretty house, storing the wedding presents and new furniture, and went to Colorado. She had hated it there from the first. Nobody knew her or cared about her; there was no one to wonder at the good match she had made, or to envy her the new dresses and the visiting-cards which were still a surprise to her. And he kept growing worse. She felt herself beset with difficulties too evasive to be fought by so direct a temperament. She still loved him, of course; but he was gradually, undefinably ceasing to be himself. The man she had married had been strong, active, gently masterful: the male whose pleasure it is to clear a way through the material obstructions of life; but now it was she who was the protector, he who must be shielded from importunities and given his drops or his beef-juice though the skies were falling. The routine of the sick-room bewildered her; this punctual administering of medicine seemed as idle as some uncomprehended religious mummery.

There were moments, indeed, when warm gushes of pity swept away her instinctive resentment of his condition, when she still found his old self in his eyes as they groped for each other through the dense medium of his weakness. But these moments had grown rare. Sometimes he frightened her: his sunken expressionless face seemed that of a stranger; his voice was weak and hoarse; his thin-lipped smile a mere muscular contraction. Her hand avoided his damp soft skin, which had lost the familiar roughness of health: she caught herself furtively watching him as she might have watched a strange animal. It frightened her to feel that this was the man she loved; there were hours when to tell him what she suffered seemed the one escape from her fears. But in general she judged herself more leniently, reflecting that she had perhaps been too long alone with him, and that she would feel differently when they were at home again, surrounded by her robust and buoyant family. How she had rejoiced when the doctors at last gave their consent to his going home! She knew, of course, what the decision meant; they both knew. It meant that he was to die; but they dressed the truth in hopeful euphuisms, and at times, in the joy of preparation, she really forgot the purpose of their journey, and slipped into an eager allusion to next year’s plans.

At last the day of leaving came. She had a dreadful fear that they would never get away; that somehow at the last moment he would fail her; that the doctors held one of their accustomed treacheries in reserve; but nothing happened. They drove to the station, he was installed in a seat with a rug over his knees and a cushion at his back, and she hung out of the window waving unregretful farewells to the acquaintances she had really never liked till then.

The first twenty-four hours had passed off well. He revived a little and it amused him to look out of the window and to observe the humours of the car. The second day he began to grow weary and to chafe under the dispassionate stare of the freckled child with the lump of chewing-gum. She had to explain to the child’s mother that her husband was too ill to be disturbed: a statement received by that lady with a resentment visibly supported by the maternal sentiment of the whole car….

That night he slept badly and the next morning his temperature frightened her: she was sure he was growing worse. The day passed slowly, punctuated by the small irritations of travel. Watching his tired face, she traced in its contractions every rattle and jolt of the tram, till her own body vibrated with sympathetic fatigue. She felt the others observing him too, and hovered restlessly between him and the line of interrogative eyes. The freckled child hung about him like a fly; offers of candy and picture- books failed to dislodge her: she twisted one leg around the other and watched him imperturbably. The porter, as he passed, lingered with vague proffers of help, probably inspired by philanthropic passengers swelling with the sense that “something ought to be done;” and one nervous man in a skull-cap was audibly concerned as to the possible effect on his wife’s health.

The hours dragged on in a dreary inoccupation. Towards dusk she sat down beside him and he laid his hand on hers. The touch startled her. He seemed to be calling her from far off. She looked at him helplessly and his smile went through her like a physical pang.

“Are you very tired?” she asked.

“No, not very.”

“We’ll be there soon now.”

“Yes, very soon.”

“This time to-morrow–“

He nodded and they sat silent. When she had put him to bed and crawled into her own berth she tried to cheer herself with the thought that in less than twenty-four hours they would be in New York. Her people would all be at the station to meet her–she pictured their round unanxious faces pressing through the crowd. She only hoped they would not tell him too loudly that he was looking splendidly and would be all right in no time: the subtler sympathies developed by long contact with suffering were making her aware of a certain coarseness of texture in the family sensibilities.

Suddenly she thought she heard him call. She parted the curtains and listened. No, it was only a man snoring at the other end of the car. His snores had a greasy sound, as though they passed through tallow. She lay down and tried to sleep… Had she not heard him move? She started up trembling… The silence frightened her more than any sound. He might not be able to make her hear–he might be calling her now… What made her think of such things? It was merely the familiar tendency of an over-tired mind to fasten itself on the most intolerable chance within the range of its forebodings…. Putting her head out, she listened; but she could not distinguish his breathing from that of the other pairs of lungs about her. She longed to get up and look at him, but she knew the impulse was a mere vent for her restlessness, and the fear of disturbing him restrained her…. The regular movement of his curtain reassured her, she knew not why; she remembered that he had wished her a cheerful good-night; and the sheer inability to endure her fears a moment longer made her put them from her with an effort of her whole sound tired body. She turned on her side and slept.

She sat up stiffly, staring out at the dawn. The train was rushing through a region of bare hillocks huddled against a lifeless sky. It looked like the first day of creation. The air of the car was close, and she pushed up her window to let in the keen wind. Then she looked at her watch: it was seven o’clock, and soon the people about her would be stirring. She slipped into her clothes, smoothed her dishevelled hair and crept to the dressing-room. When she had washed her face and adjusted her dress she felt more hopeful. It was always a struggle for her not to be cheerful in the morning. Her cheeks burned deliciously under the coarse towel and the wet hair about her temples broke into strong upward tendrils. Every inch of her was full of life and elasticity. And in ten hours they would be at home!

She stepped to her husband’s berth: it was time for him to take his early glass of milk. The window-shade was down, and in the dusk of the curtained enclosure she could just see that he lay sideways, with his face away from her. She leaned over him and drew up the shade. As she did so she touched one of his hands. It felt cold….

She bent closer, laying her hand on his arm and calling him by name. He did not move. She spoke again more loudly; she grasped his shoulder and gently shook it. He lay motionless. She caught hold of his hand again: it slipped from her limply, like a dead thing. A dead thing? … Her breath caught. She must see his face. She leaned forward, and hurriedly, shrinkingly, with a sickening reluctance of the flesh, laid her hands on his shoulders and turned him over. His head fell back; his face looked small and smooth; he gazed at her with steady eyes.

She remained motionless for a long time, holding him thus; and they looked at each other. Suddenly she shrank back: the longing to scream, to call out, to fly from him, had almost overpowered her. But a strong hand arrested her. Good God! If it were known that he was dead they would be put off the train at the next station–

In a terrifying flash of remembrance there arose before her a scene she had once witnessed in travelling, when a husband and wife, whose child had died in the train, had been thrust out at some chance station. She saw them standing on the platform with the child’s body between them; she had never forgotten the dazed look with which they followed the receding train. And this was what would happen to her. Within the next hour she might find herself on the platform of some strange station, alone with her husband’s body…. Anything but that! It was too horrible–She quivered like a creature at bay.

As she cowered there, she felt the train moving more slowly. It was coming then–they were approaching a station! She saw again the husband and wife standing on the lonely platform; and with a violent gesture she drew down the shade to hide her husband’s face.

Feeling dizzy, she sank down on the edge of the berth, keeping away from his outstretched body, and pulling the curtains close, so that he and she were shut into a kind of sepulchral twilight. She tried to think. At all costs she must conceal the fact that he was dead. But how? Her mind refused to act: she could not plan, combine. She could think of no way but to sit there, clutching the curtains, all day long….

She heard the porter making up her bed; people were beginning to move about the car; the dressing-room door was being opened and shut. She tried to rouse herself. At length with a supreme effort she rose to her feet, stepping into the aisle of the car and drawing the curtains tight behind her. She noticed that they still parted slightly with the motion of the car, and finding a pin in her dress she fastened them together. Now she was safe. She looked round and saw the porter. She fancied he was watching her.

“Ain’t he awake yet?” he enquired.

“No,” she faltered.

“I got his milk all ready when he wants it. You know you told me to have it for him by seven.”

She nodded silently and crept into her seat.

At half-past eight the train reached Buffalo. By this time the other passengers were dressed and the berths had been folded back for the day. The porter, moving to and fro under his burden of sheets and pillows, glanced at her as he passed. At length he said: “Ain’t he going to get up? You know we’re ordered to make up the berths as early as we can.”

She turned cold with fear. They were just entering the station.

“Oh, not yet,” she stammered. “Not till he’s had his milk. Won’t you get it, please?”

“All right. Soon as we start again.”

When the train moved on he reappeared with the milk. She took it from him and sat vaguely looking at it: her brain moved slowly from one idea to another, as though they were stepping-stones set far apart across a whirling flood. At length she became aware that the porter still hovered expectantly.

“Will I give it to him?” he suggested.

“Oh, no,” she cried, rising. “He–he’s asleep yet, I think–“

She waited till the porter had passed on; then she unpinned the curtains and slipped behind them. In the semi-obscurity her husband’s face stared up at her like a marble mask with agate eyes. The eyes were dreadful. She put out her hand and drew down the lids. Then she remembered the glass of milk in her other hand: what was she to do with it? She thought of raising the window and throwing it out; but to do so she would have to lean across his body and bring her face close to his. She decided to drink the milk.

She returned to her seat with the empty glass and after a while the porter came back to get it.

“When’ll I fold up his bed?” he asked.

“Oh, not now–not yet; he’s ill–he’s very ill. Can’t you let him stay as he is? The doctor wants him to lie down as much as possible.”

He scratched his head. “Well, if he’s _really_ sick–“

He took the empty glass and walked away, explaining to the passengers that the party behind the curtains was too sick to get up just yet.

She found herself the centre of sympathetic eyes. A motherly woman with an intimate smile sat down beside her.

“I’m real sorry to hear your husband’s sick. I’ve had a remarkable amount of sickness in my family and maybe I could assist you. Can I take a look at him?”

“Oh, no–no, please! He mustn’t be disturbed.”

The lady accepted the rebuff indulgently.

“Well, it’s just as you say, of course, but you don’t look to me as if you’d had much experience in sickness and I’d have been glad to assist you. What do you generally do when your husband’s taken this way?”

“I–I let him sleep.”

“Too much sleep ain’t any too healthful either. Don’t you give him any medicine?”

“Y–yes.”

“Don’t you wake him to take it?”

“Yes.”

“When does he take the next dose?”

“Not for–two hours–“

The lady looked disappointed. “Well, if I was you I’d try giving it oftener. That’s what I do with my folks.”

After that many faces seemed to press upon her. The passengers were on their way to the dining-car, and she was conscious that as they passed down the aisle they glanced curiously at the closed curtains. One lantern- jawed man with prominent eyes stood still and tried to shoot his projecting glance through the division between the folds. The freckled child, returning from breakfast, waylaid the passers with a buttery clutch, saying in a loud whisper, “He’s sick;” and once the conductor came by, asking for tickets. She shrank into her corner and looked out of the window at the flying trees and houses, meaningless hieroglyphs of an endlessly unrolled papyrus.

Now and then the train stopped, and the newcomers on entering the car stared in turn at the closed curtains. More and more people seemed to pass–their faces began to blend fantastically with the images surging in her brain….

Later in the day a fat man detached himself from the mist of faces. He had a creased stomach and soft pale lips. As he pressed himself into the seat facing her she noticed that he was dressed in black broadcloth, with a soiled white tie.

“Husband’s pretty bad this morning, is he?”

“Yes.”

“Dear, dear! Now that’s terribly distressing, ain’t it?” An apostolic smile revealed his gold-filled teeth.

“Of course you know there’s no sech thing as sickness. Ain’t that a lovely thought? Death itself is but a deloosion of our grosser senses. On’y lay yourself open to the influx of the sperrit, submit yourself passively to the action of the divine force, and disease and dissolution will cease to exist for you. If you could indooce your husband to read this little pamphlet–“

The faces about her again grew indistinct. She had a vague recollection of hearing the motherly lady and the parent of the freckled child ardently disputing the relative advantages of trying several medicines at once, or of taking each in turn; the motherly lady maintaining that the competitive system saved time; the other objecting that you couldn’t tell which remedy had effected the cure; their voices went on and on, like bell-buoys droning through a fog…. The porter came up now and then with questions that she did not understand, but that somehow she must have answered since he went away again without repeating them; every two hours the motherly lady reminded her that her husband ought to have his drops; people left the car and others replaced them…

Her head was spinning and she tried to steady herself by clutching at her thoughts as they swept by, but they slipped away from her like bushes on the side of a sheer precipice down which she seemed to be falling. Suddenly her mind grew clear again and she found herself vividly picturing what would happen when the train reached New York. She shuddered as it occurred to her that he would be quite cold and that some one might perceive he had been dead since morning.

She thought hurriedly:–“If they see I am not surprised they will suspect something. They will ask questions, and if I tell them the truth they won’t believe me–no one would believe me! It will be terrible”–and she kept repeating to herself:–“I must pretend I don’t know. I must pretend I don’t know. When they open the curtains I must go up to him quite naturally–and then I must scream.” … She had an idea that the scream would be very hard to do.

Gradually new thoughts crowded upon her, vivid and urgent: she tried to separate and restrain them, but they beset her clamorously, like her school-children at the end of a hot day, when she was too tired to silence them. Her head grew confused, and she felt a sick fear of forgetting her part, of betraying herself by some unguarded word or look.

“I must pretend I don’t know,” she went on murmuring. The words had lost their significance, but she repeated them mechanically, as though they had been a magic formula, until suddenly she heard herself saying: “I can’t remember, I can’t remember!”

Her voice sounded very loud, and she looked about her in terror; but no one seemed to notice that she had spoken.

As she glanced down the car her eye caught the curtains of her husband’s berth, and she began to examine the monotonous arabesques woven through their heavy folds. The pattern was intricate and difficult to trace; she gazed fixedly at the curtains and as she did so the thick stuff grew transparent and through it she saw her husband’s face–his dead face. She struggled to avert her look, but her eyes refused to move and her head seemed to be held in a vice. At last, with an effort that left her weak and shaking, she turned away; but it was of no use; close in front of her, small and smooth, was her husband’s face. It seemed to be suspended in the air between her and the false braids of the woman who sat in front of her. With an uncontrollable gesture she stretched out her hand to push the face away, and suddenly she felt the touch of his smooth skin. She repressed a cry and half started from her seat. The woman with the false braids looked around, and feeling that she must justify her movement in some way she rose and lifted her travelling-bag from the opposite seat. She unlocked the bag and looked into it; but the first object her hand met was a small flask of her husband’s, thrust there at the last moment, in the haste of departure. She locked the bag and closed her eyes … his face was there again, hanging between her eye-balls and lids like a waxen mask against a red curtain….

She roused herself with a shiver. Had she fainted or slept? Hours seemed to have elapsed; but it was still broad day, and the people about her were sitting in the same attitudes as before.

A sudden sense of hunger made her aware that she had eaten nothing since morning. The thought of food filled her with disgust, but she dreaded a return of faintness, and remembering that she had some biscuits in her bag she took one out and ate it. The dry crumbs choked her, and she hastily swallowed a little brandy from her husband’s flask. The burning sensation in her throat acted as a counter-irritant, momentarily relieving the dull ache of her nerves. Then she felt a gently-stealing warmth, as though a soft air fanned her, and the swarming fears relaxed their clutch, receding through the stillness that enclosed her, a stillness soothing as the spacious quietude of a summer day. She slept.

Through her sleep she felt the impetuous rush of the train. It seemed to be life itself that was sweeping her on with headlong inexorable force– sweeping her into darkness and terror, and the awe of unknown days.–Now all at once everything was still–not a sound, not a pulsation… She was dead in her turn, and lay beside him with smooth upstaring face. How quiet it was!–and yet she heard feet coming, the feet of the men who were to carry them away… She could feel too–she felt a sudden prolonged vibration, a series of hard shocks, and then another plunge into darkness: the darkness of death this time–a black whirlwind on which they were both spinning like leaves, in wild uncoiling spirals, with millions and millions of the dead….

* * *

She sprang up in terror. Her sleep must have lasted a long time, for the winter day had paled and the lights had been lit. The car was in confusion, and as she regained her self-possession she saw that the passengers were gathering up their wraps and bags. The woman with the false braids had brought from the dressing-room a sickly ivy-plant in a bottle, and the Christian Scientist was reversing his cuffs. The porter passed down the aisle with his impartial brush. An impersonal figure with a gold-banded cap asked for her husband’s ticket. A voice shouted “Baig- gage express!” and she heard the clicking of metal as the passengers handed over their checks.

Presently her window was blocked by an expanse of sooty wall, and the train passed into the Harlem tunnel. The journey was over; in a few minutes she would see her family pushing their joyous way through the throng at the station. Her heart dilated. The worst terror was past….

“We’d better get him up now, hadn’t we?” asked the porter, touching her arm.

He had her husband’s hat in his hand and was meditatively revolving it under his brush.

She looked at the hat and tried to speak; but suddenly the car grew dark. She flung up her arms, struggling to catch at something, and fell face downward, striking her head against the dead man’s berth.

A Journey was featured as The Short Story of the Day on Mon, Aug 31, 2015

A Journey is featured in Short Stories for High School II

 

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INFLUENCE OF THRIVING AND JOB SATISFACTION ON TURN OVER INTENTION: MEDIATING ROLE OF JOB SATISFACTION

In current scenario, every organization wants to get over competitors. Every organization wants to thrive and get edge over competitors. Data were collected from 2 banks and 2 schools, 106 respondents took part in survey. In current study, we examined positive effect of thriving on job satisfaction and negative relation with turn over intention. All results are significant. Thriving has negative effect on turnover intention and positive effect on job satisfication.Job satisfaction mediates the effect on thriving and turnover intention.

Key words: Thriving, job satisfaction and turn over intention.

Introduction

In current cooperate world, there are lot of factors which determine the performance of an employee. Oragnizations seek the factors to compete in the organization. Now a days most important problem organizations face, employee is willing to get better chance to move and the turn over intention of an employee, If employee wants to move from organization to avail better opprountunity, he will not be goal oriented.

Thriving

According to (Porath, Spreitzer, Gibson, & Garnett, 2012) Thriving is defined “as the psychological state in which individuals experience both a sense of vitality and learning.”

According to (Qingguo Zhai, Saifang Wang, 2017) supervisor and coworker support mediated by thriving increases job satisfaction of an employee. If employee thrives at work place, it means he is ready to learn more and is energetic about his work. Thriving has many antecedents which enables employee to thrive. Thrives employee reduces turnover intention (Abid et al. 2016).Thriving mediates the effect of LMX outcomes affective commitment and job performance (“Jie LI,” 2015). Thriving associates with behavioral outcomes (Mushtaq, Abid, Sarwar, & Ahmed, 2017) thriving is the most discussed phenomena in current scenario, every organization which wants to excel in the cooperate world tries to achieve the level where his employees thrive. Scholarly interest has been increasing in thriving at workplace (Abid and Ahmed, 2016).

Job satisfaction

Job satisfaction is how an employee feels during his work (Salem et al. 2010).Job satisfaction is basically analyze after complete study of job attributes (Brayfield & Rothe, 1951).job satisfaction can be measured by different ways like job involvement, job commitment, work engagement etc. Job satisfaction means how employee takes his job .if employee is satisfied, he enjoys work. Employee empowerment leads to job satisfaction as well and improve his mental health (Spreitzer, G.M. 1996). job satisfaction is need of time, satisfied employee gives his/her full input to achieve the goal of an organization. Supervisor support and coworker support also stick employee to organization,commited employee is satisfied employee and there are many factors which effects the satisfaction level of an employee(Tepper et al., 2004).Leader or boss attitudes effect employee level of satisfaction (Hidayat, 2016). Satisfaction means how much you are willing to input in your work.

Turn over Intention

Turn over Intention means employee willingness to leave the job, there can be many factors which can effect employee thinking to quite the job(working condition,co worker support, supervisor support etc).Turn over Intention can be influenced by many factors (Harrison, D. A., Newman, D. A., & Roth, 2006;Tett, R. P., & Meyer, 1993).In last decades (2001-2009) companies downsize their employees ,which increases the job insecurity among employees and increases turnover intention for better and handsome outcomes(Mgedezi, SiphoRaymond Toga, 2014).According to (Abid, Zahra, et al., 2016)supportive environment reduces the turnover intention of an employee,If employee thrives at workplace he feels energetic and he tries to give his maximum input. Work mindfulness decreases the employee turnover intention(Dane & Brummel, 2013).Turn over intention decreases by supportive ethical leadership approach(Akdogan A. Asuman, 2015).

Objective

The purpose of this research is to see the effect of thriving on turn over intension, if employee thrives it reduces the turn over intention of an employee and it increases the job satisfaction of employee.

Significance

In previous researches we see the relationship of thriving with turnover and job satisfaction(Abid, Zahra, et al., 2016),(Zopiatis, Constanti, & Theocharous, 2014),(Tzeng, 2002),(Porath et al., 2012).Relationship between these three articles have not been seen before. Job satisfaction mediates the effect of thriving and turnover intention.

Research Gap

In this research we are going to see how the thriving effects the employee job satisfaction and turn over intention. The organizations in Pakistan are not worked too much on these three variables collectively.

Theoretical Model

Hypotheses Development

Thriving and turnover Intention

If employee is thrive at work place ,he learns more and feel more energetic during his work. If an employee feels alert and energetic at his work place he reduces his intention to leave the organization(Shihong et al., 2018).

Hypothesis 1: Thriving is negatively related to Turnover Intention Thriving and Job satisfaction

If an employee thrives at work place ,it increases his level of job satisfication.Satisfied employee enjoys his job and learns more. If an employee does not satisfied with his job ,he gets tired from what he does ,satisfied employees enjoys his work. Sometimes employees needs to be feel energetic(Mushtaq et al., 2017).

Hypothesis2:Thriving is positively related to job satisfaction.

Job Satisfaction and Turnover Intention

Job satisfaction motivates employee to keep carry on the current organization((Sukriket, 2014 ;Huei-ling liu, 2018;Sector & Zaraket, 2017; Knapp, Smith, & Sprinkle, 2017),job satisfaction effects turnover intention. Thriving have a negative relation with turnover intention.

Hypothesis3: job satisfaction negatively effect turnover intention Job satisfaction mediating the effect on thriving and turnover intention.

Methodology

Measures

Thriving at work

Ten items scale was used to measure thriving at work developed by ((Porath et al., 2012)on five point Likert scale ranging from (1=strongly disagree to 5=strongly agree).The sample item of learning is “I continue to learn more and more as time goes by” and for vitality dimension “I feel alive and vital”.

Job satisfaction

Three items scale was adapted to measure job satisfaction(Cammann, C., Fichman, M., Jenkins, D., & Klesh, 1979).on five Likert scale,it ranging from (1=strongly disagree to 5=strongly agree).All in all, I do not like my job,2;iam satisfied with my job.

Turnover Intention

The three items scale were used to measure the turnover intention by(Mitchell, T.R., Holtom, B.C., Lee, T.W., Sablynski, C.J.,&Erez, 2001).These items ranging from (1=strongly disagree to 2=strongly agree).The sample items are 1; I think a lot about leaving the organization.2: As soon as possible, I will leave the organization.

Sample Size

All data were collected through convenient sampling. 150 questionnaire distributed but only 106 responses were received.

Population

Data was collected from private sector. All data was collected from Lahore ,Punjab,Pakistan,south Asia. All data was collected from 2 banks and 2 schools.

Pilot Study

Pilot study was conducted,15 questionnaire were distributed to see the problems, if anyone will face. This study is not conducted to check the hypothesis, just to see which hurdle one can face while filling the questionnaire.

ANALYSIS

Correlation table

Data Analysis and Interpretations

Table 1 provides bivariate correlations among all study variables. The correlations coefficients are in the anticipated directions and provide initial support for the study hypotheses. Consistent with our hypotheses, the bivariate correlations indicate that thriving at work is negatively associated with turnover intention( r =-.219·, P> 0.05),Thriving is positively associated with job satisfaction ( r = .701··., P > 0.01),turn over intention is negatively associated with job satisfaction ( r =- 0.381··, P > 0.01).

We used Andrew Hayes spss (version 24) for analysis. Regression analysis run to know the impact of thriving on job satisfaction (B=.5648,t=9.9700,t=9.9700,LLCI=.4525,ULCI=.6722).In second model we see job satisfaction is effecting negatively turn over intention(B=-.4666,t=-3.4923,t=-3.4923).These results shows our two hypotheses(H2 ,H3)are acceptable.

(B=.5648,se= .1077,t=7383,LLCI=-.1341,ULCI=.2931)In third model we see thriving is not effecting turnover intention negatively.Our third hypothesis (H1)is not acceptable, as we saw in past, thriving effecting turnover intention negatively but in current study we see they do not have the same effect.

Discussion

In this study we see the results that thriving directly effects job satisfaction if employee is satisfied he thrives more. Simultanously, job satisfaction effects turnover Intention of an employee. Thriving have a insignificant effect upon turnover intention. Job satisfaction is negatively related with turnover intention (Mcinerney, Korpershoek, Wang, & Morin, 2018). Thriving at workplace is very important, effects the overall performance of an employee (Walumbwa, Muchiri, Misati, Wu, & Meiliani, 2017). In this study, we explore the relationship of thriving.(Abid, Zahra, et al., 2016). Thriving has a positive effect on job satisfaction (Abid, Khan and Michelle Chia-Wei Hong, 2017). which means people are more energetic and gives more output ,if they enjoy work. Job satisfaction reduces the effect of intention to quite, and our study supports it(Sukriket, 2014). In previous studies (Shihong et al., 2018) used to say that thriving has a positive effect on turn over intention ,but our study contradict it, this study shows that thriving is not reducing the effect of turn over intention, it means there are many other confounding variables or factors which effect turn over intention. This study shows the partial full mediatation.

LIMITATIIONS

There are many limitation for future study. Firstly sample size is very small, if we increase the sample size results would be much better.secondly,we collected the data only from private sector, data can be collected from public sector as well.Lastly,we can consider more variables for better understanding. There are many confounding and some important variables which effects and need to study.

References

References

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Abid, G., Khan, B., & and Michelle Chia-Wei Hong. (2017). No Title. Academy of Management Proceedings, 2016(1).

Abid, G., Zahra, I., & Ahmed, A. (2016). Promoting thriving at work and waning turnover intention : A relational perspective. Future Business Journal, 2(2), 127-137.

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Cammann, C., Fichman, M., Jenkins, D., & Klesh, J. (1979). U. of M. (1979). No Title. The Michigan OrganizationalAssessment Questionnaire. , , Ann Arbor, Unpublishe.

Dane, E., & Brummel, B. J. (2013). Examining workplace mindfulness and its relations to job performance and turnover intention. Sage Journals, 67(1), 105-128.

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Zopiatis, A., Constanti, P., & Theocharous, A. L. (2014). Job involvement , commitment , satisfaction and turnover: Evidence from hotel employees in Cyprus. Tourism Management, 41, 129-140.

Abid, G., Author, C., & Ahmed, A. (2016). MULTIFACETEDNESS OF THRIVING : ITS COGNITIVE , AFFECTIVE , AND BEHAVIORAL DIMENSIONS, 8(3), 121-130.

Abid, G., Khan, B., & and Michelle Chia-Wei Hong. (2017). No Title. Academy of Management Proceedings, 2016(1).

Abid, G., Zahra, I., & Ahmed, A. (2016). Promoting thriving at work and waning turnover intention : A relational perspective. Future Business Journal, 2(2), 127-137.

Akdogan A. Asuman, O. D. (2015). No Title. Journal of Business Ethics, 130(1), pp 59-67. Retrieved from The Effect of Ethical Leadership Behavior on Ethical Climate, Turnover Intention, and Affective Commitment

Brayfield, A. H., & Rothe, H. F. (1951). Journal of Applied Psychology, 35(5), 307-311.

Cammann, C., Fichman, M., Jenkins, D., & Klesh, J. (1979). U. of M. (1979). No Title. The Michigan OrganizationalAssessment Questionnaire. , , Ann Arbor, Unpublishe.

Dane, E., & Brummel, B. J. (2013). Examining workplace mindfulness and its relations to job performance and turnover intention. Sage Journals, 67(1), 105-128.

Harrison, D. A., Newman, D. A., & Roth, P. L. (2006). No Title. How Important Are Job Attitudes? Meta- Analytic Comparisons of Integrative Behavioural Outcomes and Time Sequences. Academy of Management Journal, 49((2)), 305-325.

Hidayat, S. (2016). The Authentic Leadership is Source of Intrinsic Motivation in Work Engagement with Moderating Role of Overall Trust ( Cognitive and Affective Trust ), 18(2013), 18-25.

Huei-ling liu, V. hwei lo. (2018). No Title. Asian Journal of Communication, 28(2), pages 153-169. Jie LI. (2015). Journal of Administrative Science, 28(1), 39-51.

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A prestigious university has recently implemented a consolidation strategy that will require it to centralize their student records

Due Week 3 and worth 120 points

A prestigious university has recently implemented a consolidation strategy that will require it to centralize their student records. In order to move forward, the local university will need to develop a data model that will retain student records and perform various data extract transform and load (ETL) processes. Imagine that you have been hired as a database consultant to assist in the development of a data design strategy for the student records. 

You met with various university subject matter experts and have determined the following after performing various business analysis processes:

  • Faculty groups are divided by core competencies that the university offers. For example, there are groups such as the Art Faculty, Computer Technology Faculty, Language Faculty, and Science Faculty. Each faculty member has an assigned Dean and is designated to teach at one particular campus and school. They are able to teach as many courses as required.
  • Courses are categorized by course code and title. Certain courses have prerequisites and the university has asked for this to be cataloged as well.
  • There are various schools within each campus. For example, the Los Angeles campus holds the following schools: School of Science, School of Law, and School of Computer Technology. Additionally, each school offers different professional study programs such as Forensic Computer Science, Marine Biology, Business Management, and Civil Engineering to name a few. 
  • The study path for students requires that they be enrolled in a specific professional study program. The professional study program requires the students to complete a specific set of core courses. The university also requires that an online grade book be available. The online grade book should show grades awarded to students for specific courses and the term they completed the course.
  • The university identifies each student by his or her name, date of birth, social, and professional study program.

Using these findings, write a three to four (3-4) page paper in which you:

  1. Analyze the university’s requirements and provide a proposal to organize all the required data elements. The proposal should include the following:
    1. Provide an Entity Relationship Model (ERM) that will describe the data structure that will store all data elements. Note: The graphically depicted solution is not included in the required page length.
    2. Describe any assumptions or limitations for each relationship. For example, professors are able to teach more than one course or students can only be enrolled in one program.
  2. Create the primary key and foreign keys using a UML Class diagram for each table.
  3. Suggest at least four (4) types of business intelligence reports that could help the university in course management, student enrollment, or historical tracking. Support your answer by providing specific business functions that these reports could assist executives of the university.
  4. As an alternative for development of the database, you are considering outsourcing the functions above. Research the Internet and other media sources for vendors who develop registrar and school management database systems.
    1. Suggest three (3) vendors that developed and are employing efficient registrar and school management database systems and support your reasons to choose from one (1) of these three (3) vendors.
    2. Compare and contrast the key aspects that each system offers. Examples of system aspects include but not limited to cloud based, pricing model, open source, etc.
  5. Use at least three (3) quality resources in this assignment. Note: Wikipedia and similar Websites do not qualify as quality resources.

Your assignment must follow these formatting requirements:

  • Be typed, double spaced, using Times New Roman font (size 12), with one-inch margins on all sides; citations and references must follow APA or school-specific format. Check with your professor for any additional instructions.
  • Include a cover page containing the title of the assignment, the student’s name, the professor’s name, the course title, and the date. The cover page and the reference page are not included in the required assignment page length.
  • Include charts or diagrams created in any chart or drawing tools with which you are familiar. The completed diagrams / charts must be imported into the Word document before the paper is submitted.

The specific course learning outcomes associated with this assignment are:

  • Describe the role of databases and database management systems in managing organizational data and information.
  • Recognize the historical development of database management systems and logical data models.
  • Design and implement a database solution to solve a proposed business problem.
  • Use technology and information resources to research issues in the strategic implications and management of database systems.
  • Write clearly and concisely about topics related to the strategic planning for database systems using proper writing mechanics and technical style contentions.

 

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