The lived experiences of professional nurses with regards to end-of-life issues in the Intensive Care Unit
- Authors: Clifford, Ilzé
- Date: 2013
- Subjects: Intensive care units , Death
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10055 , http://hdl.handle.net/10948/d1018572
- Description: Professional nurses working in an intensive care unit (ICU) are faced with the death of critically ill patients frequently. Modern day medicine and technology have made it possible for advanced life-sustaining measures to be implemented on patients who, without medical intervention, would otherwise not have survived. The question is raised: is modern technology preserving life and prolonging the dying process, or is it in the best interest of the patient for treatment to be withdrawn? Nurses, caring for these patients and their families, are practicing at the bedside of these dying patients and are thus often faced with end-of-life issues, particularly withdrawal of treatment. The primary functions of critical care nurses are toward their patients. Physicians are responsible for making decisions regarding withdrawal of treatment. However, the nurses in the ICU are responsible for implementing the decisions made; sometimes contradicting what they believe in. The experience of end-of-life issues, namely withdrawal of treatment, is a cause of distress for the professional nurse. Little research has been done on how the ICU nurses deal with end-of-life issues and what support structures are required to assist nurses in dealing with end-of-life issues (Hov, Hedelin & Athlin, 2006:204) The objectives of the study were to explore and describe the professional nurses‟ lived experiences of end-of-life issues in the intensive care unit. The study aimed to make recommendations regarding support strategies to assist professional nurses in dealing with end-of-life issues in the intensive care unit. The researcher has selected a qualitative research approach with an explorative, descriptive and contextual design in order to conduct the study. Data was collected by means of semi-structured interviews. Data was analysed using the steps as illustrated by Tesch‟s method. Ethical principles were maintained throughout the research study. The findings of this study are to be presented in a journal publication.
- Full Text:
- Date Issued: 2013
Experiences of operating room nurses in their work environment at a state hospital in Ethiopia
- Authors: Woldehawariat, Negat
- Date: 2012
- Subjects: Operating room nurses -- Ethiopia , Operating rooms -- Ethiopia , Work environment -- Ethiopia
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10024 , http://hdl.handle.net/10948/d1008177 , Operating room nurses -- Ethiopia , Operating rooms -- Ethiopia , Work environment -- Ethiopia
- Description: Operating room nursing skills are some of the most demanding skills in the nursing profession. At the moment nurses trained in operating room technique are in very short supply in Ethiopia, due to the exodus of nurses to better working environments with more reasonable payment. This is especially noticeable in one of the state hospitals in Addis Ababa, Ethiopia, as emerged in conversations with the head nurse of the operating room in this hospital about the high turnover rate, as well as the high absenteeism rate amongst the nurses working in the operating room. Nurses working in the operating room also expressed unhappiness in their work environment which could cause them to look for other jobs or to be absent from duty. The nurses were facing numerous problems in their work environment such as work overload due to staff shortage, stress due to shortage of supplies because they are not able to do their job as much as the need requires. The researcher identified the need to explore the challenges that the operating room nurses are experiencing in their work environment. The researcher used the following questions to meet the research objectives: What are the experiences of the operating room nurses in their work environment?; What potential assistance would such nurses need to better cope with the problems they experience in their work environment? The research study aimed to explore and describe the experience of operating room nurses in their work environment and on the basis of the findings to develop guidelines to assist the operating room nurses in coping more effectively with their work environment. The researcher used a qualitative approach with an explorative, descriptive and contextual design. Fifteen registered nurses were selected using purposive sampling. Informed consent was obtained from the participants and permission from the Ethics Committee of the Nelson Mandela Metropolitan University, as well as Yekatit 12 Hospital. Data were gathered using face to face interviews and field notes were taken to determine the experiences of the participants. Data were analyzed using Tesch's method of descriptive data analysis (in Creswell, 2003:13). Two main themes with two sub-themes related to the experience of the registered nurses working in the operating room of the state hospital were identified. Main theme one focused on the non-conducive work environment and it focused on the lack of support from management and the problems experienced in the environment. It was found that OR nurses had good working relationships among the nursing staff. Main theme two focused on the limited training opportunities in OR techniques. The sub-themes described the limited exposure to new technology and the quality of nursing education which the participants felt was not taken seriously in Ethiopia. Based on the identified themes guidelines were formulated to assist the registered nurses working in the operating room of a state hospital in Ethiopia. Utilization of these guidelines should assist the registered nurses to cope more effectively with their work environment. Recommendation were made, further research and limitations identified.
- Full Text:
- Date Issued: 2012
Motherhood experiences of teenagers : a Xhosa perspective
- Authors: Mlotana, Pumla Princess
- Date: 2012
- Subjects: Motherhood , Midwifery
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10058 , http://hdl.handle.net/10948/d1019998
- Description: In South Africa and worldwide high rates of teenage pregnancy and motherhood remains a concern. According to Mkhwanazi (2010:349) most of teenage pregnancy occurs among poor black and coloured communities. The majority of these pregnancies are unwanted and unplanned resulting teenage mother experiencing problems with motherhood. The relationship in family peers and communities are adversely affected. Teenage motherhood seen as to be socially economically and physically delirious for the teenage mother and her baby. Teenage motherhood became a burden not only on the teenage mother but also to the family and the State. Cultural issues aggravated the situation in which the teenage mother finds herself in which is the lack of support from the communities in which they live. This results to the teenage mother having a feeling being alienated. The researcher as a midwife working in labour ward observed that the teenagers of younger ages are frequently admitted in labour wards in one of the hospitals in Nelson Mandela Metropolitan Municipality. The researcher became interested to conduct a study on mother hood experiences of teenage mothers: A Xhosa Pespective. The first objective of the study was to explore and describe the motherhood experiences of Xhosa teenagers. The second objective was to make recommendations to assist the midwives to help teenage mothers cope with motherhood. These recommendations could be used by health professionals to address the research findings. A qualitative, explorative descriptive and contextual research design was used to reach the objectives of the study. The research population consisted of Xhosa speaking teenage mothers who were residing at Kwazakhele Township and whose age was between 12 -16 years. Teenage mothers who gave birth to live babies during the last 6-12 months. Ethical considerations were maintained throughout the research study .Semi- structured interviews were conducted before data saturation was reached. The data collected during the interviews were transcribed and analyzed using Tech’s model of data analysis. The aspect of trustworthiness according to Guba’s model was implemented in the research study and included credibility, applicability, consistency and neutrality.
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- Date Issued: 2012
Professional nurses experiences of a team nursing care framework in critical care units in a private healthcare group
- Authors: Dunsdon, Jeananne
- Date: 2011
- Subjects: Intensive care nursing -- South Africa , Intensive care units -- South Africa , Team nursing -- South Africa , Nurses -- Job stress -- South Africa
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10022 , http://hdl.handle.net/10948/1444 , Intensive care nursing -- South Africa , Intensive care units -- South Africa , Team nursing -- South Africa , Nurses -- Job stress -- South Africa
- Description: A critical care unit is a dynamic and highly technological environment. Professional nurses who have been working in the critical care unit for a period of time are passionate about the environment in which they work. They find their on duty time challenging and stimulating. The critical care environment is slowly changing. Due to the fact that there are fewer professional nurses with an additional qualification in critical care available to work in the critical care units. The utilisation of an increasing number of agency nurses leads to an increase in sub-standard nursing care as well as dissatisfied doctors and patients. The shortage of critical care staff has resulted in the need to find an alternative human resources framework and still provide cost effective, safe quality patient care. This leads to the design and implementation of a team nursing care framework for critical care. The research objectives for this study were: - To explore and describe the experiences of professional nurses with regard to a team nursing care framework in private critical care units. - Develop guidelines to optimize the team nursing care framework in critical care units in a private hospital group. The research is based on a qualitative, explorative, descriptive and contextual research design. The study is based on a phenomenological approach to inquiry. Eleven in-depth semi structured face-to-face phenomenological interviews were utilized as the main means of collecting data. A purposive, criterion based, sampling method was used. Specific inclusion criteria were met and consent was obtained from the participants and from the management of the private clinic where the research was conducted. Two central themes were identified:- Theme One: The professional nurses experienced the team nursing care framework in the critical care unit as a burden. Six sub-themes were identified. - Theme Two: Professional nurses made recommendations for improvement of the team nursing care framework in the critical care unit. By describing the lived experiences of the professional nurses in the critical care units, based on research interviews, the researcher painted a clear picture of the team nursing care framework in the critical care unit. Guidelines were developed based on the identified themes. The broad guidelines are aimed at ensuring that the nurses are competent to care for critical care patients prior to them commencing work in the critical care unit. The researcher concludes this study by making recommendations for Nursing practice, education and research.
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- Date Issued: 2011
Professional nurses' knowledge regarding weaning the critically ill patient from the mechanical ventilation
- Authors: Demingo, Xavier Preston
- Date: 2011
- Subjects: Artificial respiration , Respiratory therapy , Critical care medicine , Respirators (Medical equipment) , Artificial respiration -- Nursing
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10026 , http://hdl.handle.net/10948/1323 , Artificial respiration , Respiratory therapy , Critical care medicine , Respirators (Medical equipment) , Artificial respiration -- Nursing
- Description: Mechanical ventilation (MV) is one of the most frequently used treatment modalities in the intensive care unit (ICU) (Burns, 2005:14). Up to 90% of critically ill patients in ICUs globally are connected to a mechanical ventilator. Although mechanical ventilation is a lifesaving intervention, it is expensive and is associated with diverse complications (Mclean, Jensen, Schroeder, Gibney & Skjodt, 2006: 299). Ventilator-associated pneumonia (VAP) accounts for 25% of all infections in ICU, with global crude mortality figures estimated at 20-70% (Craven, 2006:251). Minimising the time that a patient is connected to a mechanical ventilator to the absolute minimum can have considerable benefits in terms of decreased mortality and morbidity, as well as a decreased length of ICU stay and lower hospital costs. Critically ill patients therefore need to be weaned from the mechanical ventilator as soon as their condition that warranted the need for mechanical ventilation is stabilized. The process of weaning the critically ill patient from mechanical ventilation constitutes a significant proportion of total ventilator time. As professional nurses attend to the mechanically ventilated patient 24 hours a day, they have a vital role to play in the collaborative management of the patient requiring weaning from mechanical ventilation. The objectives of this study were to explore and describe the professional nurses’ knowledge regarding weaning the critically ill patient from mechanical ventilation. Based on the results, recommendations in the form of a protocol were made in order to improve the professional nurses’ knowledge and enhance the care of the mechanically ventilated patient. A quantitative design, which was exploratory, descriptive and contextual in nature, was utilised for the study. The data collection instrument of choice was a self-administered questionnaire. Convenience, non-probability sampling was the sampling method chosen for the purpose of this study. Collected data were analysed with the assistance of a statistician using descriptive and inferential statistics. Results were displayed in the form of graphs and tables. The results obtained in the study, combined with data from the literature review, were used to develop recommendations to enhance vi professional nurses’ knowledge regarding weaning the critically ill patient from mechanical ventilation. The recommendations were presented in the form of a protocol based on the available evidence. Ethical principles as they relate to conducting research were adhered to throughout the study.
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- Date Issued: 2011
The experiences of pregnant teenagers as related to ante-natal care
- Authors: Pienaar, Nadine
- Date: 2011
- Subjects: Pregnant teenagers -- South Africa -- Nelson Mandela Metropolitan Municpality , Prenatal diagnosis
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10028 , http://hdl.handle.net/10948/1321 , Pregnant teenagers -- South Africa -- Nelson Mandela Metropolitan Municpality , Prenatal diagnosis
- Description: The experiences of pregnant teenagers as related to ante-natal care were researched. The primary objective of the study was to explore and describe the experiences pregnant teenagers had of their ante-natal care. The researcher recommended measures based on the findings of the study to midwives to encourage ante-natal care clinic attendance amongst pregnant teenagers. The recommendations were such that even nurses at Primary Health Care clinics could utilise them as they also come into contact with pregnant teenagers. An increasing number of pregnant teenagers in the Nelson Mandela Metropolitan Municipality area are admitted to referral hospitals with complications during pregnancy and labour. Some of these teenagers are un-booked or had only a few ante-natal clinic visits. The researcher therefore wanted to obtain first hand information related to the reluctance of pregnant teenagers to attend ante-natal care clinics. Attendance at ante-natal care clinics plays an important part in enabling the staff to screen pregnant mothers for health problems and so limit complications. Hence the concern and need to develop measures to motivate pregnant teenagers to attend ante-natal clinics.
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- Date Issued: 2011
Registered nurses' knowledge of infection control and sterile technique principles in the operating room complex of private hospitals
- Authors: Malan, Kim
- Date: 2009
- Subjects: Infection -- Prevention and control , Infection -- Nursing , Hospitals buildings -- Disinfection
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10034 , http://hdl.handle.net/10948/1079 , Infection -- Prevention and control , Infection -- Nursing , Hospitals buildings -- Disinfection
- Description: Infections are a major source of morbidity and cause of mortality during the post-operative phase for patients. Wound infections are the second most commonly encountered type of nosocomial, hospital-acquired, infection in the United States (Nichols, 2007:8). Owing to the fact that wound infection may be induced, such as, by not applying infection control and sterile technique principles in the operating room complex, it is imperative to implement infection control principles and apply sterile technique principles. The researcher noticed that some of the sterile technique principles were not carried out in the operating room complex which lead to the necessity to assess the knowledge of registered nurses’ regarding the implementation of infection control and sterile technique principles. The main goal of the study was to explore and describe the knowledge of registered nurses’ in two private hospitals in the Nelson Mandela Metropole, related to infection control and sterile technique principles in the operating room complex. Following the analysis of the data, the researcher made recommendations for changes to be made to the existing infection control guidelines in the operating room complex. The research design was quantitative, explorative, descriptive and contextual in nature. The sample consisted of all the registered nurses known as scrub nurses, in the operating room complex. The unit managers were excluded from the study, because the researcher utilized their assistance with the handing out and collecting of the questionnaires because, not all scrub nurses were at work at the same time. Firstly a pilot study was conducted (in both private hospitals) to confirm the reliability of the data collection instrument. Data was collected by means of a questionnaire that was self-administered and consisted out of three sections: Section A – Biographical Data; Section B – Knowledge Base Related to Infection Control Principles and Section C – Knowledge Base Related to the Principles of Asepsis. The researcher consulted experts to ensure the reliability and validity of the questionnaires and to ensure that the iv questionnaires would measure what it is intended to measure and that it will remain consistent. The data obtained from the questionnaires was analyzed by means of statistical and inferential analysis and included descriptive statistics with the assistance of a statistician. Following the analysis of the data, recommendations for changes to be made to the existing infection control guidelines in the operating room complex was made. This was done with relevant literature and the guidelines were discussed with experts in the field. The researcher ensured that all the legal and ethical requirements, such as the participants’ right to privacy, were maintained throughout the study.
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- Date Issued: 2009
The experiences of people living with HIV-AIDS with regard to the comprehensive antiretroviral therapy management received from registered nurses at selected public primary heathcare clinics in Nelson Mandela Bay
- Authors: Jackson, Dawne Shirley
- Date: 2009
- Subjects: Antiretroviral agents -- South Africa , Stigma (Social psychology) , Nurses -- South Africa -- Attitudes , HIV-positive persons -- Counseling of -- South Africa , AIDS (Disease) -- Treatment -- South Africa , HIV infections -- Treatment -- South Africa
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10032 , http://hdl.handle.net/10948/1253 , Antiretroviral agents -- South Africa , Stigma (Social psychology) , Nurses -- South Africa -- Attitudes , HIV-positive persons -- Counseling of -- South Africa , AIDS (Disease) -- Treatment -- South Africa , HIV infections -- Treatment -- South Africa
- Description: Currently South Africa has the highest number of persons living with HIV-AIDS (PLWAs) in the world. Focus-group discussions conducted by Moon (2005:3) in the Eastern Cape indicated that people may not want to get tested for HIV or to access antiretroviral therapy (ART) for fear of disclosure of their HIV-positive status and of stigmatization. These findings prompted the researcher to conduct a study in this field. The objectives of this study are to explore and describe the experiences of PLWAs with regard to the comprehensive ART management received from registered nurses at selected public primary healthcare clinics in Nelson Mandela Bay; and to develop guidelines for registered nurses that could facilitate them in rendering appropriate comprehensive ART management. The research study is based on a qualitative, explorative, descriptive, phenomenological and contextual research design. The research population comprised of HIV-positive patients who received treatment at the selected public primary healthcare clinics. Criterion-based, purposive sampling was used to select participants for the interviews. Ten in-depth unstructured interviews were conducted. Data was then transcribed and coded. One central theme identified the fact that PLWAs experienced both positive and negative experiences at the clinics. The main findings of this research included evidence of various forms of stigma experienced by the PLWAs; distrust of the lay health counselors; but also that PLWAs were generally well-treated and satisfied with the service they had received. Broad guidelines for registered nurses was formulated that could facilitate them in rendering appropriate comprehensive ART management. The study concludes with recommendations made with regards to the areas of nursing practice, education and research. Throughout the study the researcher abided by the ethical considerations. The aspects of trustworthiness implemented in this study, included dependability, credibility, transferability and confirmability (Holloway & Wheeler, 2002:354).
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- Date Issued: 2009
The experiences of registered nurses' of their work environment in a critical care unit
- Authors: Adams, Bernardene Lucreshia
- Date: 2009
- Subjects: Intensive care nursing -- South Africa , Intensive care units , Nurses -- Job stress -- South Africa
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10013 , http://hdl.handle.net/10948/1057 , Intensive care nursing -- South Africa , Intensive care units , Nurses -- Job stress -- South Africa
- Description: Critical care nursing is a vital and significant part of health care provision to critically ill patients. It is a specialty area of nursing that requires registered nurses who are highly motivated, knowledgeable and skilled to provide optimal care to critically ill patients. These patients are nursed in a complex environment consisting of specialised equipment (such as ventilators, defibrillators, intravenous pumps, and cardiac monitors) that is not found in any other field of nursing. Collegial support and an adequate registered nurse: patient ratio is vital in critical care units in order to provide optimal quality care to critically ill patients. However, an understaffed work environment, the demands of critical care nursing and other work-related problems, such as conflict with physicians, inadequate remuneration packages and an increased workload can cause serious distress and dissatisfaction amongst registered nurses in this specific environment (Carayon & Gürses, 2005:287). The objectives of this study therefore are to explore and describe the experiences of registered nurses of their work environment in a critical care unit and to make recommendations that will assist registered nurses working in a critical care unit. A qualitative, explorative, descriptive and contextual research design will be utilised. Data will be collected by means of semi-structured interviews and analysed according to the framework provided by Tesch (in Cresswell, 2003:192). Purposive sampling will be used to select a sample of registered nurses working in a critical care environment. Guba’s model (in Krefting, 1991) will be utilised to verify data and to ensure trustworthiness of the study. Ethical considerations will be adhered to throughout the study. Once data has been analysed, recommendations will be made that will assist registered nurses working in a critical care unit.
- Full Text:
- Date Issued: 2009
Effectiveness of the basic antenatal care package in primary health care clinics
- Authors: Snyman, J S
- Date: 2007
- Subjects: Pregnant women -- Health and hygiene , Hospitals -- Maternity services -- South Africa -- Port Elizabeth -- Evaluation , Maternal health services
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10037 , http://hdl.handle.net/10948/728 , Pregnant women -- Health and hygiene , Hospitals -- Maternity services -- South Africa -- Port Elizabeth -- Evaluation , Maternal health services
- Description: Pregnancy challenges the health care system in a unique way in that it involves at least two individuals – the woman and the fetus. The death rates of both pregnant women (maternal mortality) and newborns (perinatal mortality) are often used to indicate the quality of care the health system is providing. In terms of maternal and perinatal outcomes South Africa scores poorly compared to other upper-middle income countries (Penn-Kekana & Blaauw, 2002:14). The high stillbirth rate compared to the neonatal death rate reflects poor quality of antenatal care. Maternal and perinatal mortality is recognised as a problem and as a priority for action in the Millennium Development Goals (Thieren & Beusenberg, 2005:11). The Saving Mothers (Pattinson, 2002: 37-135) and Saving Babies (Pattinson, 2004:4-35) reports describe the causes and avoidable factors of these deaths with recommendations on how to improve care. The quality of care during the antenatal period may impact on the health of the pregnant woman and the outcome of the pregnancy, in particular on the still birth rate. In primary health care services there are many factors which may impact on and influence the quality of antenatal care. For example with the implementation of the comprehensive primary health care services package (Department of Health, 2001a:21-35) changes at clinic level resulted in a large number of primary health care professional nurses having to provide antenatal care, who previously may only have worked with one aspect of the primary health care package such as minor ailments or childcare. Because skills of midwifery or antenatal care, had not been practiced by some of these professional nurses, perhaps since completion of basic training, their level of competence has declined, and they have not been exposed to new developments in the field of midwifery. The practice of primary health care nurses is also influenced by the impact of diseases not specifically related to pregnancy like HIV/AIDS and tuberculosis. The principles of quality antenatal care are known (Chalmers et al. 2001:203) but despite the knowledge about these principles the maternal and perinatal mortality remains high. The Basic Antenatal Care quality improvement package is designed to assist clinical management and decision making in antenatal care. The implementation of the BANC package may influence the quality of antenatal care positively, which in turn may impact on the outcome of pregnancy for the mother and her baby. The aim of this study was to evaluate the effectiveness of the Basic antenatal care (BANC) package to improve the quality of antenatal care at primary health care clinics.
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- Date Issued: 2007
Operating room nursing science learning programmes in South Africa
- Authors: Prince, Jacqueline Yvonne
- Date: 2007
- Subjects: Operating room nursing -- Study and teaching -- South Africa
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10047 , http://hdl.handle.net/10948/594 , http://hdl.handle.net/10948/d1012880 , Operating room nursing -- Study and teaching -- South Africa
- Description: Operating room nurses form the corner-stone of the operating room because perioperative care of the patient rests mainly in the hands of the nursing personnel. Unique challenges face nurses functioning in the stressful surgical environment where anticipation to prevent or cope with life-threatening situations is the order of the day. The operating room nurse must be knowledgeable, skilled and alert, as he/she is held accountable for all acts of commission and omission. To ensure that nurses are appropriately educated and trained and able to keep trend with the changing technology in the operating room, it is essential that learning programmes meet the minimum standards for registration as prescribed by the South African Nursing Council. Reviewing and evaluating learning programmes on a regular basis by specialist nursing educationists, are therefore essential to ensure that the standards of education and training are maintained and upgraded if required. The aim of this study is to explore and describe the various Operating Room Nursing Science Learning Programmes offered at accredited Higher Education Institutions, utilized for the education and training of the operating room nursing students in South Africa. The proposed research is based on a qualitative paradigm and the theoretical grounding is found in Bergman’s model for professional accountability (Bergman, 1982:8). A document analysis of five approved comprehensive Operating Room Nursing Science Learning Programmes from higher education institutions in South Africa (nursing colleges and universities) was carried out, together with a sixth programme, the Operating Theatre Learning Programme, as suggested by the Standard Generating Body. Requests for permission were forwarded to the management of the selected colleges or universities for inclusion of the respective programmes in the study. The researcher formulated and utilized thirty-four essential criteria derived from three documents, the first being a document entitled “Proposed Standards for Nursing and Midwifery Qualifications” submitted to the SANC and SAQA by the SGB for Nursing and Midwifery (2001-2004). The second document entitled the Public and Private Higher Education Institutions format template for criteria for the Generation and Evaluation of Qualifications and Standards within the National Qualifications Framework was also utilized (SAQA, 1430/00) and thirdly the researcher included the most relevant criteria from the list of criteria for curriculum development as indicated by the South African Nursing Council. Various tables were compiled, to reflect the findings of the document analysis according to the thirty-three criteria indicated above, to provide a clear and broad overview of the specific data in the respective six Operating Room Nursing Science Learning Programmes utilized in the study. In conclusion recommendations for a broad macro-curriculum were made to facilitate formulation of programmes in Operating Room Nursing Science relevant to the South African context.
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- Date Issued: 2007
Postnatal women's experiences of the prevention of mother-to-child transmittion of HIV programme
- Authors: Links, Nomvuyiseko
- Date: 2007
- Subjects: AIDS (Disease) in pregnancy -- South Africa , HIV infections -- Children -- Transmission -- Prevention , Children -- Diseases -- Prevention , HIV infections -- Transmission , Maternal health services
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10042 , http://hdl.handle.net/10948/545 , http://hdl.handle.net/10948/d1011704 , AIDS (Disease) in pregnancy -- South Africa , HIV infections -- Children -- Transmission -- Prevention , Children -- Diseases -- Prevention , HIV infections -- Transmission , Maternal health services
- Description: This research study endeavoured to explore and describe the experiences of women who participated in the Prevention of Mother-To-Child Transmission (PMTCT) of HIV Programme. Data relating to evaluation of the PMTCT Programme in the piloted sites compiled by other researchers in the Department of Health focus on the process, progress and extent of service implementation. There appears to be a dearth of information available from women participants in the PMTCT Programme. The objectives of the study were to: · Explore and describe postnatal women’s experiences of the PMTCT Programme offered in the East London Hospital Complex. · Propose recommendations into the existing guidelines for midwives who implement the PMTCT Programme in the health services to ensure optimal implementation of this programme. The research population included postnatal women who participated in the PMTCT of HIV Programme at the East London Hospital Complex (Frere site). Permission to conduct the research was obtained from the Eastern Cape Department of Health Ethics Committee, Chief Executive Officer of the hospital complex and the Advanced Degrees Committee and Human Ethics Committee at the Nelson Mandela Metropolitan University. The research study was qualitative, exploratory, descriptive and contextual in design. Data collection was carried out by face-to-face semi-structured interviews with postnatal women at the East London Hospital Complex (Frere site). The tape-recorded interviews were transcribed verbatim with the aid of field notes. Data analysis was done according to Tesch’s method of data analysis (in De Vos et al, 2000:343). Themes were identified from the transcriptions and finalised after consensus discussions with an independent coder who was experienced in qualitative research. Literature control, guided by the themes identified in the interviews, was carried out to compare and verify the findings of the study. Three major themes with sub-themes were identified during data analysis. The major themes were identified as follows: · The participants expressed feelings of being devastated by the results that confirmed their HIV positive status. · The participants expressed a thirst for knowledge on how to live with the diagnosis and on how to continue with the PMTCT Programme. · The physical environment where counselling and testing were done, as well as the practical arrangements, were not conducive to the full implementation of the PMTCT Programme at the antenatal clinic. Conclusions were drawn and recommendations were made in the form of additional guidelines for midwives implementing the PMTCT Programme in the antenatal clinic health services. Guidelines for further midwifery-related research were formulated.
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- Date Issued: 2007
The experiences of caregivers in formal institutions caring for terminal AIDS patients
- Authors: Williams, Margaret
- Date: 2007
- Subjects: AIDS (Disease) -- Nursing -- Psychological aspects , HIV-positive persons -- Care -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10033 , http://hdl.handle.net/10948/644 , AIDS (Disease) -- Nursing -- Psychological aspects , HIV-positive persons -- Care -- South Africa -- Eastern Cape
- Description: One of the greatest challenges facing sub-Saharan Africa, which incorporates South Africa, is the AIDS pandemic. The devastation wrought by this disease is unsurpassed in recent times. The health and social development structures, already overburdened, are totally overwhelmed by the needs of povertystricken households and communities affected by AIDS. Caregivers attempting to support those affected and infected are also facing unique challenges and demands, particularly relating to dealing with the large numbers of deaths due to this disease. Experiences for these caregivers are likely to be varied, ranging on a continuum from positive to negative, for instance, the recovery of patients versus the death of patients. The objectives of this study are to explore and describe the lived experiences of caregivers working with AIDS patients, particularly patients who die from this disease whilst resident in a formal institution. The research is based on a qualitative, explorative, descriptive and contextual research design. The study is grounded in a phenomenological approach to inquiry. Caregivers working fulltime in a formal institution caring for patients who are dying from AIDS were interviewed in an in-depth, unstructured manner in order to gather spontaneous, rich descriptions of their experiences. Through this study the researcher wants their voices to be heard, the potential richness of their reflections acknowledged and the generated data to be applied to the benefit of the field of HIV/AIDS – both for staff and patients. Thirteen in-depth, unstructured interviews provided saturated data, which was then transcribed and coded to yield the central and sub-themes that were identified in this study. One central theme identified the fact that in their daily duties (at their place of work), caregivers experience various challenges as a result of having to deal with the death and dying of their patients suffering from AIDS. These caregivers face the death of their patients daily, from a disease that causes untold suffering to the patient, family members and to the caregivers themselves, who wish they could prevent the anguish, the pain and the inability of the medical profession to do more than they are at present towards curing this disease. ii By describing the lived experiences of these caregivers by means of the research interviews, the researcher gained a clear picture of the AIDS environment. The information shared by the participants formed the foundation of the broad guidelines that were formulated. These are intended to provide support for the caregivers centering around the equipping of mentors of the caregivers, to enable them to support the caregivers in their daily task of caring for patients dying from AIDS. These caregivers, thus supported, will then be in a position to provide optimal care for these dying patients. These broad guidelines are intended to provide support by focusing firstly on the physical environment in which these caregivers work; secondly in providing education for the caregivers to enable them to fulfill their duties, and thirdly to provide adequate counselling to ensure that they do not succumb to caregiver fatigue/burnout, a constant threat in this type of environment. The study concludes with recommendations regarding the areas of nursing practice, education and research.
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- Date Issued: 2007
Women's perceptions and experiences of antenatal care rendered by midwives
- Authors: Mxoli, Winnifred Nonkonzo
- Date: 2007
- Subjects: Prenatal care -- South Africa -- Eastern Cape , Midwives -- South Africa -- Eastern Cape , Maternal health services -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10041 , http://hdl.handle.net/10948/575 , Prenatal care -- South Africa -- Eastern Cape , Midwives -- South Africa -- Eastern Cape , Maternal health services -- South Africa -- Eastern Cape
- Description: The general health status of pregnant women depends largely on the quality of the antenatal services available to them. The provision of good antenatal services ensures early detection and prompt management of any complication or disease that may adversely affect pregnancy outcome. In order to ensure high quality care, antenatal services need to be evaluated at regular intervals, both from provider and client perspective, to ensure their effectiveness in improving the health status of pregnant women. The midwife, as the first contact person for most pregnant women attending antenatal clinics in South Africa, has the potential to play a major role in improving the health status of these women. However, for the midwife to be effective in achieving this, antenatal services need to be effectively utilized by women. One of the factors that affect utilization of any service is client satisfaction with the service being rendered. This study, therefore, explores the perceptions that pregnant women have of the care that they receive from midwives at the selected antenatal clinics. The objectives of the study are to: {u100083} Explore and describe the perceptions and experiences of pregnant women attending antenatal clinic regarding the care they receive from midwives. {u100083} Make recommendations to assist registered midwives in optimizing the accompaniment of women during the antenatal period. A qualitative, descriptive, exploratory and contextual design was used for the study. The sample was chosen from the target population by means of purposive sampling and data was collected through unstructured interviews with the participants. Before data collection, permission was obtained from the Eastern Cape Department of Health and the Nursing Service Manager of the Gateway clinic, in the district hospital where the research was conducted. The Nursing Service Manager was acting as a Medical Superintendent at the time of the study. Written, informed consent was obtained from all participants before conducting interviews. Trustworthiness was ensured by means of Guba’s model throughout the study, and the aspects of truth value, applicability, consistency and neutrality were considered. Tesch’s eight steps of data analysis were used to analyze the data collected, and four main themes were identified namely: • Women perceive midwives as considerate and knowledgeable • Women perceive midwives as lazy and rude • Women experience mixed emotions about the care they receive from midwives • Though their experiences, women identified certain needs in the services and care they received at the clinic. Conclusions were drawn and recommendations for midwifery practice made based on the results of the study, with the aim of improving antenatal services rendered to pregnant women.
- Full Text:
- Date Issued: 2007
A model for the facilitation of intergenerational reconciliation during teenage pregnancy a Xhosa perspective
- Authors: James, Sindiwe Valencia
- Date: 2006
- Subjects: Teenage pregnancy -- South Africa -- Psychological aspects , Xhosa (African people) -- South Africa -- Family relationships
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10043 , http://hdl.handle.net/10948/458 , Teenage pregnancy -- South Africa -- Psychological aspects , Xhosa (African people) -- South Africa -- Family relationships
- Description: Teenage pregnancy is an international phenomenon with girls falling pregnant from as early as 14 years of age. In South Africa teenage pregnancies are also on the increase (Kaiser, 2000:18; Statistica SA, 2006:5;). Teenage pregnancy may have negative effects for the teenager in that it can force the teenager to drop out of school prematurely as well as shortening her educational career which might limit future career possibilities. It also predisposes both the mother and the child to health risks. Finally, teenage pregnancy also leads to family destabilisation. Within the Xhosa communities family destabilisation becomes even more severe as it is culturally and traditionally related. Traditionally, teenage pregnancy in the Xhosa communities is stigmatized. The family suffers from embarrassment and disappointment and the effects of these experiences can manifest in outrage on the part of the parents towards the pregnant teenager resulting in non-communication with her and ultimately rejection (Boult & Cunningham, 1991:36). This results in no or minimal support from the family (Nxumalo, 1997:16). The research design and method to achieve the objective of the study was a theory-generative design based on a qualitative, phenomenological, explorative, descriptive and contextual research approach utilizing the four steps of theory generation. During the step of concept analysis, which is the first step of the process of theory generation, data was collected by means of individual interviews with the pregnant Xhosa teenagers, parents and grandparents. The interviews were audio-taped and transcribed verbatim. The sample for the study was selected purposively to ensure indepth information.
- Full Text:
- Date Issued: 2006
Experiences of the Xhosa diabetic patient
- Authors: Ngamlana, Zodumo Princess
- Date: 2006
- Subjects: Diabetes -- Treatment -- South Africa , Diabetics -- Rehabilitation -- South Africa , Xhosa (African people) -- South Africa
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10014 , http://hdl.handle.net/10948/465 , Diabetes -- Treatment -- South Africa , Diabetics -- Rehabilitation -- South Africa , Xhosa (African people) -- South Africa
- Description: This study will be focussing on the experiences of Xhosa-speaking patients with DM utilising the NMMM public hospitals complex. In the OPD patients are assessed and treated for all chronic conditions including DM, and patients are seen at monthly intervals or when necessary. The OPD serves the neighbouring black population from the surrounding townships as well as the informal settlements. The effects of urbanisation have resulted in this area having a semi–rural, semi-urban population that is mostly Xhosa speaking. The bulk of the population is unemployed, while others are living on a minimal income. Unemployment in the Eastern Cape ranges from 40% in rural areas, rising to 50 - 60% in the urban areas (Proposed aluminium Pechiney smelter within the Coega IDZ, 2002:4-8). In some homes there is no or little money to buy food, and even less to make use of a health service. Some people live on either a social grant for the elderly, a grant for young children or a disability grant and most people in this area have an income below the level at which payment of taxes for contribution to the economy is possible.
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- Date Issued: 2006
Reflections of South African nurses migrating to the Kingdom of Saudi Arabia a framework for support
- Authors: Telford-Smith, Colette
- Date: 2006
- Subjects: Nurses -- Supply and demand -- Saudi Arabia , Nurses -- Employment -- Foreign countries , Saudi Arabia -- Emigration and immigration , Brain drain -- South Africa
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10017 , http://hdl.handle.net/10948/401 , Nurses -- Supply and demand -- Saudi Arabia , Nurses -- Employment -- Foreign countries , Saudi Arabia -- Emigration and immigration , Brain drain -- South Africa
- Description: The last decade has seen an exodus of South African nurses migrating to "greener pastures". As a result of this migration, the South African Healthcare Service has been drained of one of its most essential resources – nurses. Subsequently, the crippling flight of nurses has thrown the nursing profession into a state of crisis. The Kingdom of Saudi Arabia is one of the more popular destinations for South African nurses, the main reason being the attractive financial rewards. One agency reports that they send an average of thirty nurses a month to various hospitals within the Kingdom of Saudi Arabia. Saudi Arabia is an Islamic country. Due to the uniqueness of the enforcement of the Islamic faith and the Saudi culture, many restrictions are imposed, particularly on women. The challenges and problems facing the South African nurses were, therefore, unique compared to elsewhere in the world. This research study had a primary and a secondary objective: The primary objective of this study was to explore and describe the lived experiences of South African nurses related to living and working in Saudi Arabia; The secondary objective of this study was to develop orientation guidelines to support South African nurses working and living in Saudi Arabia. The researcher utilized a qualitative, explorative, descriptive and contextual design based on a phenomenological approach to inquiry, in an attempt to answer the question: "What are the professional and personal experiences of the South African registered nurses working and living in Saudi Arabia?" Eleven registered nurses were selected to participate by means of purposive sampling. These nurses had been living in Saudi Arabia between three and six months. Consent was obtained from participants and the ethics committee of both the Nelson Mandela Metropolitan University and King Faisal Specialist Hospital and Research Centre. The central theme emanating from the study was recognized as being 'Cultural Diversity'. The sub-themes identified related to the registered nurses’: - Religious/spiritual adaptation - Environmental adaptation - Emotional/psychological adaptation - Professional adaptation Based on the identified themes, guidelines were formulated to assist South African registered nurses when migrating to Saudi Arabia. Utilization of these should assist the South African registered nurse in assimilating into both the cultural and working environment. However, in reality, the outcome showed that no one can be prepared fully for what awaits them in Saudi Arabia.
- Full Text:
- Date Issued: 2006
Registered nurses' knowledge related to the management of patients with diabetic keto-acidosis (DKA)
- Authors: Fourie, René
- Date: 2006
- Subjects: Diabetic acidosis -- Nursing -- South Africa , Nurses -- South Africa
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10046 , http://hdl.handle.net/10948/448 , Diabetic acidosis -- Nursing -- South Africa , Nurses -- South Africa
- Description: Diabetes Mellitus (DM) is on the increase globally, with further increases expected in developing countries, such as South Africa. World Health Organization (Medical Chronicle, 2006:14) estimations indicate that the number of DM sufferers will double over the next 30 years. This increasing number of diabetics is expected to have enormous economical implications. One of the consequences of the increase in DM sufferers is the increase in deaths due to diabetes related complications. In 2000, 3.2 million people died of DM and diabetes related complications compared with 3 million who died from HIV/AIDS related illnesses (William & Pickup, 2004:64). Health services are financially burdened by DM complications that result in heavy demands in both direct costs of hospitalization and medication as well as indirect costs such as manpower of staff involved in the care of the patient (Leuner, 2000:410). Diabetic ketoacidosis (DKA) is a prominent life-threatening complication of type 1 diabetes mellitus and, if not treated medically, it can lead to coma and death. DKA accounts for 14 per cent of all diabetic related hospital admissions and has a mortality rate of 5 to 10 per cent (Pickup & Williams, 2003:1). Rapid identification of DKA is necessary to improve patient care. George- Gray and Chernecky (2002:96) suggest patient outcomes are affected by the nurse’s ability to recognize the clinical features of DKA. It is important, therefore, for the nurses to understand the signs and symptoms and treatment of this diabetes related complication. National health policies and treatment guidelines should be aimed at addressing DKA treatment through setting guidelines for diabetic care (Peters, 2004:22). The main goal of this study was to determine registered nurses’ knowledge of DKA and to develop guidelines to assist registered nurses in providing adequate and effective health care to prevent DKA reoccurrence. The research study is based pm Bergam’s model on quality of care and accountability. Bergman claims that several preconditions must be filled in order to be accountable, including: • Accountability • Responsibility • Authority • Ability (Bergman (1982:8) emphasizes that ability reflects the registered nurses’ accountability, which is composed of values, knowledge and skills.) The study was divided into two phases. Phase one determined registered nurses’ knowledge related to the management of DKA. Phase two of the study included the developing guidelines to assist registered nurses in providing adequate and effective health care to patients with DKA. The design of the study is quantitative, explorative, descriptive and contextual; a survey was performed using a questionnaire based on a literature study. Ethical principals were maintained throughout the study. Permission to the study was sought from the Local Health Authorities and the heads of department where the research was undertaken. Findings of the research were analysed and discussed in the research. The knowledge of the majority of the respondents was found to be average. Out of the thirty- two respondents 52.8 percent possessed adequate knowledge the management of DKA and 63.4 percent possessed adequate knowledge on the management of DM. Two recommendations to assist registered nurses in the implementation of guidelines of the recommendations were also provided.
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- Date Issued: 2006
Registered nurses' perceptions of factors causing stress in the intensive care environment in state hospitals
- Authors: Beau, S P
- Date: 2006
- Subjects: Intensive care nursing -- South Africa , Nurses -- Job stress -- South Africa , Stress management -- South Africa
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10044 , http://hdl.handle.net/10948/457 , Intensive care nursing -- South Africa , Nurses -- Job stress -- South Africa , Stress management -- South Africa
- Description: The complex environment of an intensive care unit is associated with a considerable amount of stress. Intensive care nurses are confronted daily with increasing work demands, emanating from the growing numbers of critically-ill patients; the introduction of highly sophisticated technologies in the intensive care environment; increasing competition between health care institutions; increased work loads; and limited career opportunities caused by, among other things, budget cuts by the government (Janssen, De Jonge & Bakker, 1999:1360). Research has shown that such stressors can result in mental, physical and behavioural stress reactions among nurses (Demerouti, Bakker, Nachreiner and Schaufeli, 2000:454). The objective of this study is to explore and describe registered nurses’ perceptions of factors causing stress in intensive care environments of state hospitals. The main purpose of the study is to develop guidelines for a stress management programme, to assist registered nurses to cope with the stressors in an intensive care environment. The research design is placed within a quantitative, explorative and descriptive contextual framework. Validity and reliability in testing and evaluating the research questionnaire are discussed, as well as the ethical and legal considerations relating to this research study. Findings of the research study will be utilized to assist the researcher in developing guidelines for a stress management programme to assist registered nurses in coping with stress in an intensive care environment
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- Date Issued: 2006
The experience of adolescense girls regarding verbal bullying in secondary school
- Authors: Jacobs, Ruwayda
- Date: 2006
- Subjects: Teenage girls -- Mental health -- South Africa , Bullying in schools -- South Africa , Psychiatric nursing -- South Africa
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10045 , http://hdl.handle.net/10948/449 , Teenage girls -- Mental health -- South Africa , Bullying in schools -- South Africa , Psychiatric nursing -- South Africa
- Description: The experience of verbal bullying at school may cause a female adolescent much distress. This distress can result in the adolescent experiencing life as traumatic and may influence her sense of well being negatively. Verbal bullying usually takes the form of name-calling, put-downs and insults. This can be very traumatic for adolescents and can lower their self-esteem, which may eventually lead to mental illness. The parents of adolescent learners often have the misconception that bullying is a normal part of a teenager’s life and are unaware of the distress it may cause the adolescent. The victimized adolescent should, therefore, be provided with support in order to avert the occurrence of mental illness. The goals of this study were to: • Explore and describe the experiences of adolescent girls regarding verbal bullying in secondary school settings. • Develop guidelines to assist mental health nursing specialists in helping adolescent girls to cope with bullying in secondary schools. The researcher used a qualitative, explorative, descriptive and contextual design with a phenomenological approach. The research population consisted of female learners in a secondary school setting. Purposive sampling was used in this study to identify participants. Data was collected by means of naïve sketches, one-to-one-interviews and field notes based on observations. Data was analyzed using Tesch’s method (in Creswell, 1994:190) of descriptive analysis. The identified themes were compared to available literature. The data collected from this study was used to develop guidelines to aid mental health nursing specialists to help adolescents to cope with verbal bullying.
- Full Text:
- Date Issued: 2006