A holistic healthcare model for higher education campus health services
- Authors: Ricks, Esmeralda Jennifer
- Date: 2008
- Subjects: College students -- Health and hygiene -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Doctoral , DCur
- Identifier: vital:10038 , http://hdl.handle.net/10948/666 , College students -- Health and hygiene -- South Africa -- Eastern Cape
- Description: Most students are adolescents and young adults, a group characterized by a new-found sense of independence, experimentation with sex and sometimes drugs and a feeling of invincibility (Gayle, Richard, Keeling, Garcia-Tunon, Kilbourne, Narkunas, Ingram, rogers and Curran, 1990:1538). These behavioural, developmental and environmental issues may contribute to premature morbidity, mortality and reduced quality of life for university students (Patrick et al., 1992:260). The ages of staff on the other hand range from young adults to retirement age. The types of health problems that exist among staff who use the campus health service include First Aid treatment on site for injuries on duty and more chronic health problems such as, for example, hypertension and diabetes mellitus. To date there is very little evidence as to whether or not the healthcare needs of students and staff are being met comprehensively or whether the practitioners rendering the service are knowledgeable and complying with the PHC norms and standards developed by the department of Health’s Quality Assurance Directorate. The lack of such empirical data can contribute to misconceptions and hamper the management of public health problems experienced in SA, for example sexually transmitted infections and the transmission of HIV. Thus the purpose of this research was to develop a model that would assist registered nurses employed at a higher education campus health service in the Western Region of the Eastern Cape Province to render a healthcare service relevant to the healthcare needs of the students and staff on campus.
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- Date Issued: 2008
Inter-level health service referral of women in labour
- Authors: Jantjes, Louisa
- Date: 2008
- Subjects: Childbirth -- South Africa , Medical referrals -- South Africa , Midwives -- South Africa , Labor (Obstetrics) -- Complications
- Language: English
- Type: Thesis , Doctoral , DCur
- Identifier: vital:10010 , http://hdl.handle.net/10948/986 , Childbirth -- South Africa , Medical referrals -- South Africa , Midwives -- South Africa , Labor (Obstetrics) -- Complications
- Description: Although it is considered an everyday occurrence, childbirth is nonetheless an important and dramatic experience in the life of every woman. Childbirth, a normal physiological state in the life of a woman, can be an awe-inspiring and exciting experience, but sometimes disconcerting experiences may also occur. Women sometimes see labour as the end to a long drawn out process following pregnancy and therefore attribute great significance to all occurrences during labour. When complications occur in a usually uncomplicated process of labour, the health care provider must be able to make quick and effective management decisions and implement appropriate interventions. This may include the referral of women in labour to a level of care where complications can be dealt with more effectively, thereby ensuring the best maternal and neonatal outcomes. Patient referral is regarded as a fundamental component of the health care system therefore a well functioning system should ensure that patients are treated in the appropriate manner at the appropriate place at the lowest possible cost to the health system. The goal of this research study was to explore and describe the inter-level health service referral of women in labour by midwives, in order to design guidelines for midwives and other relevant health care providers involved in inter-level health service referral of women in labour in the South African public health care sector. The research design used for this study is a combination of qualitative and quantitative approaches. The paradigmatic perspective of this study was based on the World Health Organization’s Health for All Model. Appropriate data collection and analysis strategies were used for the different stages of the study. Data collection commenced only after permission to conduct the research had been obtained from relevant authorities and University of Port Elizabeth and the Nelson Mandela Metropolitan University structures. Informed consent was obtained from participants included in the study. In stage 1 of this research project, a profile of midwives at lower level maternity care centres was compiled and the perceptions and experiences of midwives working at lower level maternity services, who are responsible for inter-level health referrals of women in labour, were described. Stage 2 described, by means of analysis of maternity case records, aspects of the inter-level referral of women in labour including the profiles of women admitted to midwife obstetric units (MOUs) who are v referred to higher levels of care. Of significance in this study is the appropriateness of midwifery referrals and the maternity care implemented by health care providers during inter-level health service referral of women in labour. In stage 3 clinical guidelines for midwives and other relevant maternity care providers, to assist them in the inter-level health service referral of women in labour, were developed. Findings from stage 1 of this research study revealed that midwives were generally well qualified and sufficiently experienced in the management of women in labour who need referral. Disconcerting findings relating to human and material resource shortages were discovered; these included major problems with patient transportation and difficulties with communication relating to inter-level health service referral of women. These shortages adversely affected midwives’ ability to efficiently care for women during the inter-level health service referral of women in labour in the research area. Stage 2 of the study yielded results of questionable standards of care to women and infants included in the study. A further disturbing finding from the study is the poor state of record keeping. The development of the provisional guidelines in stage 3 of the study was informed by the four main themes identified from the research findings. Before embarking on guideline development, the researcher familiarized herself with theory related to the clinical guidelines. These included clarifying the concept ‘clinical guidelines’, justifying the need for developing clinical guidelines as well as giving consideration to concerns about clinical guidelines. The research findings as well as literature related to these findings informed the researcher on the development of the guidelines. Provisional guidelines were therefore developed on responsibilities of role players in inter-level health service referral of women in labour at first level of referral, namely the midwife obstetric units, transport personnel and maternity care providers at the referral hospital. Steps were taken throughout the study to adhere to ethical standards of research. The researcher will ensure that the research report is available to all health authorities involved, the participants included in the study and the health care providers who may benefit from the research findings.
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- Date Issued: 2008