Professional Documents
Culture Documents
ADVANTAGES:-
i) The work load of a Ward can be equally divided among all the staffs.
ii) Good interpersonal relationship is developed between the Nurse and the patient.
iii) The Nurse can identify the problems of the patient properly as she is taking
total care of the patient.
iv) The nurses can develop their knowledge more by studying about the case,
related to the patient.
DISADVANTAGES:-
i) In a staff crisis situation, it is difficult to manage a ward.
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ADVANTAGES:-
DISADVANTAGES:-
i) No one is bothered much about patient’s problem as everyone is busy with their
own function.
iii)Nurses can’t increase their skill and knowledge , as they are doing same duty
daily.
(iv)The team leader can develop her knowledge and skill daily while leading the
team.
DISADVANTAGES:-
ADVANTAGES:-
i) As the nurse is taking total care of the patient from the beginning so, she is more
knowledgeable about the patient’s problem.
ii) Any patient can rely on a nurse as she/he is looking total process of the patient
of the patient in the hospital.
DISADVANTAGES:-
iii) Need more expert or efficient nurses to handle the total treatment process of a
patient.
GOALS:-To identify the goals of nursing service department, we must find out:-
a) To provide quality of health care to the all the patients irrespective of age , sex
caste , socio-economic conditions etc.
b) To find out the needs for the client, whether he/she is totally dependent or
partially dependent to nursing care.
c) To look after, wheather the physician’s orders are strictly followed or not.
d) To encourage staffs for in service education classes for their own update.
f) To provide job- description to all the nursing staffs, so that they can feel their
self actualization and job satisfactions.
PRINCIPLES:-
i)The basic principles of nursing service department is to provide care to all the
clients irrespective of it’s age, sex, socio- economic condition, Nationality etc.
ii) The nursing department must have to maintain good interpersonal relationship
with any other department in the hospital. To maintain a good standard of the
hospital. It is very important to maintain good nursing intervention.
iii) There are some particular code of ethics in nursing. Every nursing department
must follow the ethics while treating patients.
iv) Not only in hospital setup but also in community area the nursing services
should be increased.
v) The nurses should empathetic to the patients but not to be sympathetic, while
giving care.
3) Nursing is the act of utilizing the environment of the patient to assist him in his
recovery. Nursing is all about management and art.
iii) UNITY OF COMMAND:- While working in any department the nursing staffs
should follow a particular command from any of their subordinates. If there is
various commands, then everybody become confused. It is the responsibility of the
nursing department to make a single decision and that must be followed. Nursing
supervisors should discuss with each other that who will convey the decision
among subordinates. Every time one supervisor should convey the decision to
avoid further confusion and chaos.
iv) UNITY OF DIRECTION:- It is also same like the previous principle , that
nurses should follow. The nursing department should take decision about which
direction supposed to be followed and only then instruct the staffs.
v) SELF MANAGEMENT:- Every nurses should know the self management. They
must be empathetic for their patient but not be sympathetic. They must respect the
various patient’s religious beliefs, values and Nationality. They must know how to
behave and what to do in an emergency situation.
SECONDARY HEALTH CARE DELIVERY:- It is the first referral unit for the
primary health care system. Secondary health care delivery provides, care for the
antenatal mothers, normal vaginal delivery, medical aseptic dressing etc. These are
done by Sub-Divisional Hospital, District hospital etc.
TERTITARY HEALTH CARE DELIVERY:- All the critical patients from both
primary and secondary health care delivery can be referred to here. The services,
that are provided here are lower uterine caesarean section, any surgical procedure,
medical emergencies etc. mainly any medical College and Hospitals are
responsible for providing these services.
PRIMARY HEALTH CARE:- Primary health care is essential health care made
universally accessible to individuals and acceptable to them, through their full
participation and at a cost the community and Country can afford.
PRINCIPLES:- i) The basic principle for primary healthcare is equitable
distribution. The services should be provided to every individuals irrespective of
its age, sex or socio- economic condition.
ii) Later in the 20th century, there was some specialization for courses like
Pediatrician, Psychiatrist , Medical, surgical etc. Physicians in their
specialization courses gave treatment to their patients.
iii) Last in the 20th century there was no boundaries in patient care. For any
treatment, patient can avail hospital (24x7). Hospitals are becoming more and
more technology based day by day. There are super -specialty and multispecialty
hospitals in every big cities even in the towns also.
v) Attitude of the peoples are also changing day by day. They prefer any accredit
or standard hospital for their relative’s treatment. Money is not a bar now-a-days
for treatment.
organizations or hospitals are providing best possible health care to us. Their
principle is to do the optimum level of cost but without compromising the quality.
Of the 61 studies that met the inclusion criteria, higher cost was
associated with better quality of carein34% indicating a positive or mixed positive
association between the two. In 18 studies(30%) the association was negative or
mixed negative (lower cost was associated with higher quality) and in 22 studies
( 36%) the association was non existents, mixed, imprecise or indeterminate.
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Still more data are needed for clinicians and policy makers to make
effective decisions that effect the clinical and fiscal health of the Nation. Payers
should reconsider the extent to which they shift financial risk onto provider
organizations and incentives for quality targets should be offered to promote
process of care that are well supported by evidence or conversely to discourage
care shown to be inappropriate or of poor value.
iv) Financing.
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Diagnostic Procedure.
PARTICIPATION OF PEOPLE:-
Utilization of services
Varies from Country to Country Indian system is more cost effective if health
workers are skilled and effectively supervised.
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MODULE-2
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should follow particular rules and regulations to work together. For example: In
hospital every nurses should wear uniform while doing their duty. They should
come to their duty on proper time. Without prior information they can’t take leave.
These are the disciplines.
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vii) ORDER:- the principle of management is to do any job or duty in any arranged
and organized manner. If there is no organized or ordered way to do the functions
then chaos or confusion will arose. For example:- While checking the store or
available resources in the ward or department the nursing- In-charge must note
down what are in crisis and what are needed extremely in daily basis, then only she
can do the indent. Without checking the store the indent will be of no use. So,
everybody should do their duties in orderly manner.
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xiii) INITIATIVE:- Employees should give freedom to conceive and carry out
their ideas and plans, even if there are mistakes in their work. This will encourage
them to innovate and take decisions.
xiv) ESPRIT DECORPS:- Promoting team spirit will give the organization a sense
of unity and unity in strength. Fayol says that even small factors should help to
develop team spirit. He suggested use of verbal communication to develop team
spirit.
Thus Fayol for the first time systemized the managerial behavior. He
focused on total organizational management. Fayol advocated that management
can be taught and need not be inborn.
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vii) EVALUTION:- After thinking for alternative course of action, the planner
must evaluate the planning. He/she must look after every steps of it. Once the
planning is implemented, it can’t be changed.
viii)IMPLEMENTATION OFPLANNING:- Once the course of action is finalized,
plans are drawn/ formulated to derive it. Now, it lies the main action, operations
and process. Usually it is done by middle and lower level of management.
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iii) CONCEPTUAL SKILL:- It means the ability to know the concept of the job.
This skill is necessary mainly for the top level of the managers. It is the ability to
take broad and futuristic view, to analyze various forces and ability to assess
environment and deciding about the changes to be implemented. It is the creative
and innovative ability and having a vision. These skills enable them toset for
themselves the organizations and the people.
All these skills are necessary for all the managers, their relative importance
depends mainly upon the rank of the manager in the organization.
c) SWOT ANALYSIS:- SWOT analysis is the best way to identify one’s own
strength, weakness opportunities as well as threats. It is generally used in business,
deals and large organizations but it can be used by individual also to find out his
personal views. Here
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S- STRENGTH
W- Weakness
O- Opportunities
T- Threats
i) If you can’t find any strength for your organization or your business product then
write down the characteristics of it. Definitely one can find strength from it.
ii) Look at your competitor and the strength of his/her product. It will help to find
out own strength.
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It’s best to be realistic now, and face any unpleasant truths as soon as
possible.
OPPERTUNITIES:-
Useful opportunities can come from such things as:- Changes in technology
and markets on both abroad and narrow scale.
Changes in Govt. policy related to your field.
Changes in social patterns, population profiles, life style changes and so on.
Local events
THREATS:-
i) What obstacles do you face?
ii) What your competitors are doing?
iii) Are quality standards or specifications for your job, products or services
changing?
iv) Do you have bad debt or cash-flow problems?
v) Could any weakness seriously threatening your business?
SWOT analysis is a simple but useful framework for analyzing
organization’s strength and weakness and the opportunities and threats that
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can be faced. It will help to focus on the strengths, minimize weakness and
threats and help for greatest possible advantage of opportunities.
When carrying out this analysis, one should be realistic and vigorous.
It should be applied at the right level and supplement it with other option
generation tools where appropriate.
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and specialized activities of different units to create unity in the midst of
diversity.
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c) resistance to change.
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ii) ABSENCE OF COORDINATION:- It will lead to
a) Chaos
b) Confusion
c) Inefficiency.
d) Expenditure on time, money and energy.
e) Either goals are not reached or difficulties are encountered in achieving
the goals.
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This again saves money by preventing investment in unnecessary stock and
reducing the need to replace old stock.
DISADVANTAGES:-
i) RISK OF RUNNING OUT OF STOCK:- By not carrying much stock, it is
imperative. We have the correct procedures in place to ensure stock can
become readily available and quickly. To do this we need to have a god
relationship with the supplier. JIT means that one become extremely reliant
on the consistency of supply chain.
ii) LACK OF CONTROL OVER TIME FRAME:- Having to rely on the
timeliness of suppliers for each order puts one at risk of delaying the
customer’s receipt of goods. If anyone don’t meet customer’s expectations,
they could take their business elsewhere, which would have a huge impact
on business.
iii) MORE PLANNING IS NEEDED:- With JIT inventory management, it’s
imperative that companies understand their sales trends and variances in
close detail. Therefore one need a factor that in to planning for inventory
levels, ensuring supplies are able to meet different volume requirements at
different times.
If run properly JIT inventory management is seen as one of the best
ways of managing inventory. While it is not without risks, it has significant
rewards and is ideal for those who are able to plan carefully in advance and
build strong relationship with suppliers.
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MODULE-3
The financial manager must have to follow various activities. These are:-
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term use. When an organization spent money for their regular use or any
short term investment, then it is known as revenue expenditure. For
Example:- Paying electricity bills, buying any new materials etc.
Now let us concentrate on the concept of Depreciation. Depreciation
means gradual, continuous and permanent decline of the value of any asset.
In any organization depreciation is charged in the fixed assets. The amount
of depreciation is then taken as an expense. So, it reduces the profits in the
profit & loss account.
OBJECTIVES OF DEPRECIATION:-
To calculate proper profits.
To show the assets at its reasonable value.
To maintain the original monetary investment of the asset intact.
Provision of depreciation results in some incidental advantages also.
Depreciation is permitted to be deducted from profits for Tax purposes.
CAUSES OF DEPRECIATION:-
INTERNAL CAUSES:- Wear & tear maintenance, change in production,
restriction of production, reduced demand.
EXTERNAL CAUSE:-Obsolescence and effluxion of time.
Annuity Method.
Depreciation fund Method
Depletion Method.
An example of depreciation is:- If a company purchase a delivery
truck of Rs. 1,00,000/- and the expected use of the said truck is 5 years, the
business might depreciate the asset under depreciation expense of Rs.
20,000/- every year for a period of 5 years.
For the purpose of keeping books of account, the choice of amount of
depreciation is with the management. For companies, the minimum amount
of depreciation is suggested by schedule 14 of the Companies Act, 1956.
This is the minimum to be charged. A business could change different rates
for different assets, based on life, use and other factors.
i) In every organization, investment is done to achieve some amount
of profit. There is a financial manager in every organization and his
responsibility is to analyze various financial activities and plan for further
investment accordingly. For that reason basic financial statements are used
very commonly. These are:-
* Balance sheet
* Profit and loss statement.
Total:
The total of both source and application must be same.
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VERTICAL BALANCE SHEET:-
Liabilities Amount Assets Amount
Total: Total:
Here also the total of both the column must be same.
Now various terminologies are used in balance sheet. Let us
concentrate on that:-
b) RESERVES:- The profit that is done from the total investment of the
money, that is added up with the capital amount, it is known as reserves.
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* CAPITAL EXPENDITURE:- When the money is used for any long term
purpose, then it is known as Capital Expenditure. For Example:- buying a land
buying a machinery etc.
* REVENUE EXPENDITURE:- When the money is used for any short
term investment by the organization or for any regular purpose then it is known as
revenue expenditure. For example:- paying electric bills etc.
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2)b) The determinants of working capital are not uniform in all enterprises
and therefore factors responsible for a particular size of working capital in one
company are different than in other enterprise. Therefore a set pattern of factors
determining the optimum size of working capital is difficult to suggest. Some of
more important working capital are:-
i) NATURE OF BUSINESS:- It is an important factor for determining the
amount of working capital needed by various companies. The trading or
manufacturing concerns will require more amount of working capital along with
their fixed investment of stock, raw materials and finished products.
Public utilities and railway Companies with huge fixed investment usually
the lowest needs for current assets, partly because of cash, nature of their business
and partly due to their selling a service instead of a commodity.
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That is why, in a cotton textile mill or in a sugar mill, huge funds are
required for this purpose.
v) USE OF MANUAL LABOUR OR MECHANISATION:- In labour
intensive industries, larger working capital will be required than in the highly
mechanized ones. The latter will have a large proportion of fixed capital. It may be
remembered however, that to some extent the decision to use manual labour or
machineries lies with the management. Therefore it is possible in most cases to
reduce the requirements of working capital and increase investments in fixed assets
and vice-versa.
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MODULE-4
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of pain. But when nurse ‘B’ is inserting, patient is feeling pain and she is doing it
in her second/ third prick. So, automatically, while doing performance appraisal
nurse ‘A’ will get more grade. This is possible only due to her personal
competence.
iii) GENERIC:- These are competencies that are considered essential for all
staff members regardless of their function like communication, processing tools
etc.
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iv) To provide the optimum level of health care facilities to the patients.
i) PURCHASE COST:- For buying every items, some particular amount of cost
must be paid by the organization to the supplier. This is called Purchase cost.
ii) CARRYING COST:- It means the cost of interest of any product like insurance
cost, Staff involved in buying the product etc.
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iii) STOCK OUT COST:- It means end of the stock. If any emergency situation
arises at the time of stock out ,then it is much costlier to arrange the drug or
product as early as possible than to preserve it as stock earlier.
i) ABC ANALYSIS:- Here all the necessary drug items are stored. A items are
20% of all the drugs but it costs 70% of the total costs of drugs. So, it should be
handled by top level of the management very carefully.
B items are 20% of all the drugs and costs 20% of the total costs of drugs. It can
be managed by middle level managers.
C items are the 70% of all the drugs and it costs only 20% of the costs of drugs. So,
it can be handled by lower level of management.
V items includes various equipments and articles, dressing materials, life saving
drugs etc. without which the hospital can’t run a single moment.
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E items includes some essential antibiotics and others without which a hospital can
run 2-3 days. But as early as possible these items should be arranged.
CATEGORY- I:- These are the most important articles and drugs needed in a
hospital like life saving drugs, equipments and others. These are to be kept in
double safety method under top level management control system.
CATEGORY-II:- These are important items but not more than category –I. These
are the medium cost items and without these items hospital can continue it’s duty
for 1-2 days.
CATEGORY_III:- These are least important items and can be controlled by lower
level of management system. Other classifications of inventory control are:-
i) FSN CLASSIFICATION:- These are fast moving, slow moving and non-moving
items.
ii) HML CLASSIFICATION:- High, medium and low based unit price.
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ii) Some items should be stored in reverse stock for safety. This is called as safety
stock.
iii) If there is any improper procurement system, then safety stok should be
increased for emergency need.
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PROCESS OF CREDENTIALING AND PRIVILEGING:- In the process of ‘C’ &
‘P’, the first step is collection of information. It means the organization collects all
the necessary documents from the health care practioner for verification of it’s
reliability.
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Step-2:- FORM FILLING STEP:- It is the step in which a form is given to
the applicant from the organization to give the details of his/her formal
training, internship, experience etc. If it is found reliable by the HR
department, then it is forwarded furtherly for next procedure.
The head of the medical practioner assessed all the details of the documents
and if found reliable after his verification, then call the applicant for
interview.
The organization arrange a structural interview for the applicant in a
particular date.
If he/she performs well in the interview then the organizations grant the
authority of the applicant to perform his/her schedule duty.
It is the responsibility of the organization to check, if there is any medico
legal case or not against the staff.
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the organization of the formal training. Some of the health care practioners
don’t have the so called formal training from any recognized organizations,
but they have much experiences of working, so sometimes it become
difficult to rely.
b) HUGE PAPER WORKS:- In the total process of ‘C’ &’P’, the HR
department must do a huge number of paper works. They are responsible
for document verification, assessment of all. For doing all these ,they must
maintain paper work.
c) DIFFICULT CALL:- It means to deny any applicant for his/her post. For
example:- A practioner may not have that formal training but he/she has
huge working experiences and record shows that his/her performance is
good. But the organization will not accept him/her for the lack of formal
training. So, it is difficult to announce it.
d) URGENT RECRUITMENT:- Sometimes the HR department has pressure
from the top level management to make immediate recruitment of staffs. To
perform all the procedures immediately is quite impossible.
e) UP DATES RULES:- There are various certifying agencies that update
the terms & conditions for a practioner to remain in practice. One needs to
be evaluated on these terms & conditions. Credentialing committee also
evaluate on the same points.
So, while doing the staffing, the nurse administrator must follow
various principles;-
i) Every staff should have adequate knowledge, skill and positive attitude.
ii) The nurse manager must know that if the nurses are more experienced
and skillful then they can handle various emergency situations.
iii) Nurse administrator should strive to meet the technical and humanistic
care of the critically ill patient.
iv) Nurse administrator should maintain the principle of knowledge of the
nurses, to meet the health teaching and rehabilitation of chronically ill
patients.
v) Nurse administrators ensures that patient assessment, work qualification
and jobs analysis are used to determine the number of personnel in each
category to be assigned to the care of patients of each type ( such as
coronary care, renal failure etc.
vi) Nurse administrators ensures that there is a master staffing plan and
policies to be implemented in all units and this is to be developed centrally
by the nursing head of the hospital.
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vii) Nurse administrators must ensure that the staffing plan details such as
shift time, the number of staff members assigned on holidays and the
member of employees assigned to each shift can be modified to
accommodate the unit’s work load and work flow.
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clearly defining roles and responsibilities, being responsive to changes in
staffing.
iii) COLLABORATIVE AND INTERPERSONAL TEAMING:- It is
another effective site of having proper human resources planning. These
help in team structure, sometimes called collaborative practice or
interdisciplinary collaboration, encourage partnership and a multi
disciplinary approach to patient care.
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TOP DOWN APPROACH:- It is called top-down approach because the
budgets are made by the top executed and then the money is passeddown the
line to various departments. This approach is applied in affordable method
percentage of sales, competitive parity method of budgeting (ROI)
ii) BOTTOM UP BUDGETING:- In this method promotion adjectives are set for
the tasks to be performed. All the necessary activities to achieve the objectives are
planned. The cost of these activities are ascertained and budgeted. The total
promotion budget is then approved by top management. This is also known as the
buildup approach of budgeting.
BOTTOMUP BUDGETING
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COST OF PROMOTION ESTIMAT
AFFORDABLE METHOD:- This simply means what the firm can afford after
meeting all their expenses. The firm allocates the amounts to be spent on
production and after that allocation is done for advertising and promotions. The
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tasks to be performed by advertising is not considered. In this method there can be
chances of overspending or understanding.
OBJECTIVE &TASK METHOD:- In this method objectives are defined and the
specific strategies are formulated to achieve them. The cost of implementing these
strategies is estimated. The strategies may include advertising in various media and
other elements of promotion mix. Then the cost of various media chosen is
estimated. It is also necessary to monitor the expenses and evaluate the results.
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MODULE-5
1)Nursing service is the heart of the health care services. The customer’s
satisfaction depends largely upon the nursing services and care towards the
patients. Nursing department is the only department in any health care organization
that must maintain interpersonal relations among all the departments in the
organization.
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iii) NURSING BUDGET:- Budget is a statement of plan for nursing services,
expressed in accounting terms; it is one segment of the overall hospital budget. The
nursing service budget is concerned primarily with four budget forms: salary,
supplies, equipment and capital expenditure. Steps involved in preparation of the
budget includes analyzing past operations and anticipating factors that will affect
future income and expense. The analysis of operations required in budget- making
help the director of nursing services weigh values and established priorities for the
nursing programmes.
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vii) WRITTEN JOB DESCRIPTIONS:- Written job descriptions and job
specification will help all the nurses to perform their regular duties. Qualification
of each category of personnel are defined in terms of responsibilities to be
assumed. These job descriptions and specifications help assure the objective
selection of personnel.
i) Assess the patient:- Start with the patient- a clinical problem or question arises
from the care of the patient.
ii) ASK THE QUESTION:- Construct a well built clinical question derived from
the case.
iv) APPRAISE THE EVIDENCE:- Appraise that evidence for it’s validity
(Closeness to the truth) and applicability(usefulness in clinical practice)
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vi) SELF EVALUATION:- Evaluate the performance with this patient.
ii) LOWER COST OF CARE:- Roughly one in four Americans are living with
multiple chronic illnesses and the cost of caring for these patients can often be
substantial. Using EBN’s patient centered approach may help eliminate
unnecessary costs linked to treating chronically ill patients as well as reduce
expenses for healthier patients too.
Nurses are heart of the health care system. In any health care
organization, staff nurses are the main health care workers for providing care to
the patients. So, the staff nurses should follow responsibilities in many aspects.
These are:-
a) Providing care for daily day to day activities for the patient.
b) Administration of medication.
g) Write the reports of patients accurately and handing over to the next shift.
h) Inform the patient about his/her treatment progress and take consent before any
invasive procedure.
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k) Maintain good interpersonal relationship with patient and make proper nursing
diagnosis.
a) Check inventory periodically and inform the stock out to the supervisor.
e) Check the available medicines and equipments of assigned patients and write to
superior for further indent to the supervisor.
g) Talk politely with all the clients to maintain the silence of the unit.
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e) Guide new joiners or juniors ,whenever needed.
f) Avoid rigging.
Nurses must take as many precautions as they can during their daily shifts.
Recording, documenting and reporting daily routines and decisions is one of the
most common ways to make sure on track with patience and in the right.
i) It provides a frame work for establishing which nursing actions in the care of
client are legal.
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Public Laws are designed to protect the public. When these Laws are
broken, a nurse can be punished by paying a fine, losing her license or being
incarcerated .
Civil laws deal with problems occurring between a nurse and a client. For
example:- If a nurse catheterizing a client perforates the bladder, the client sustain
injury. No Law affecting the populations as a whole has been broken, but the client
may bring a Civil Suit against the nurse. The client may receive compensations for
injuries, but the nurse receives no jail time.
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Implied consent exists when the clients non-verbal behavior indicates agreement
such as in positioning their bodies for an injection or when their vital signs are
recorded.
ii) The consent must be given by a client, who is capable and competent to
understand.
iii) The client must be given enough information to be the ultimate decision-
manner.
The nurse is not responsible for explaining the medical or surgical procedure
but for witnessing the client’s signature on the consent form. The nurse’s signature
means:-
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FACTORS AFFECTING DECISION MAKING IN ORGANIZATION:-
Whenever we are involved in making decisions a number of factors can
affect the process we follow and ultimately the decision we make.
They can be organized in to three major groups:-
Perception issues
Organizational issues
Environmental issues.
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Many organization have formalized policies and procedures which
have been developed to resolve common problems and to guide managers
when making decisions. For example:-
Many organizations have documented disciplinary procedures which
guide managers through a process of resolving issues with staff members.
Organizational hierarchy refers to the management structure of the
organization. Most organizations have different levels of management which
carry with them different degrees of authority. The degree of authority
directly impacts on the nature of the decisions an individual can make.
Organizational politics refers to behaviors displayed by individuals
and groups which is designed to influence others. Individuals and team will
often use politics to:- Advance their careers, advance their interests and
ideas, increase their rewards. Organizations are made up of individuals with
different believes, values and interests. These differences are often driving
forces behind organizational politics.
ENVIRONMENTAL ISSUES:- These are the external factors that affect the
organization. The types of external factors that can have an affect on decision
making include:- The market in which the organizations operates
The Economy
Government legislation
Customer’s reaction to the organization’s products and services.
Other factors include personal factors ( like age, gender, stages in life- cycle,
education, occupation, economic position etc.) Personal psychographics
includes(life style, attitudes, self concept, concern about status, value system,
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beliefs etc.) Cultural factors(Culture combined resulted of factors like
Religion, traditions, taboos , languages, education, upbringing, established pattern
of social behavior, values etc.) Influence of reference group (e-g family, friends,
peer groups, close colleagues, close knit, organizations) psychological
factors(Motivation, perception, learning process, memory process).