The experiences and perceptions of midwives at Provincial Hospitals in the Nelson Mandela Metropolitan Municipality regarding exclusive breastfeeding by HIV positive first-time mothers
- Authors: Moobi, Emily Keadimilwe
- Date: 2006
- Subjects: Breastfeeding -- South Africa -- Port Elizabeth , Midwives -- South Africa -- Port Elizabeth -- Attitudes , HIV infections -- South Africa -- Port Elizabeth -- Prevention
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10016 , http://hdl.handle.net/10948/427 , Breastfeeding -- South Africa -- Port Elizabeth , Midwives -- South Africa -- Port Elizabeth -- Attitudes , HIV infections -- South Africa -- Port Elizabeth -- Prevention
- Description: The Department of Health in South Africa, as in many countries, has developed a policy guideline and recommendations for feeding of infants of HIV positive mothers. This is aimed at providing midwives with detailed and sound information about HIV and infant feeding practices based on current understanding of HIV and exclusive breastfeeding for the first six months of the infant’s life. The policy states that breastfeeding is a significant and preventable mode of HIV transmission to infants and there is an urgent need to educate, counsel and support women and families, so that they can make decisions about how best to feed infants in the context of HIV (http://www.doh.gov.za/aids/doc/feeding/html.2005-03-07). Speaking to midwives from the Provincial Hospitals in the Nelson Mandela Metropole, the researcher became aware of the midwives’ often-expressed unhappiness about the new policy from the Department of Health on exclusive breastfeeding. Midwives complained about the dilemma with which they are faced regarding infant feeding practices. They could not understand the advocacy of exclusive breastfeeding, when breastfeeding is recognised as one of the modes of Mother-to-Child Transmission (MTCT) of HIV. The aim of the study was to help, support and encourage midwives to implement the policy of exclusive breastfeeding. The objectives of the study were to: • Explore and describe the experiences and perceptions of midwives related to promoting exclusive breastfeeding in HIV positive first-time mothers. • Make recommendations to the Department of Health regarding the support and help that can be given to midwives to encourage their implementation of the exclusive breastfeeding policy. The researcher made use of a qualitative, phenomenological, descriptive, explorative and contextual design. Permission for conducting the research was iv obtained from relevant authorities, and participants were asked to sign a consent form before the researcher proceeded with the study. Collection of data was done by means of unstructured interviews using an audiotape recorder. Once data was saturated, the interviews were transcribed verbatim and analysed, using the steps described by Tesch’s (1990 in Creswell, 1994: 153) method of descriptive analysis. Field notes were also taken to record non-verbal communication during the interviews. In order to ensure trustworthiness of the study, the ethical principles of Guba’s model (in Krefting, 1991:215), namely truth-value, applicability, consistency and neutrality were used. The services of an independent coder were utilised and a consensus meeting was held between the researcher and the independent coder in order to discuss the identified themes. Prior to the consensus meeting, the independent coder was provided with interview transcripts and a protocol to guide the data analysis. Following the data analysis, a literature control was undertaken to highlight the similarities and differences found in the data analysis. Three themes with sub-themes were identified. The participants expressed positive views on the policy of exclusive breastfeeding in HIV positive first-time mothers. They were satisfied with the policy and viewed the policy of exclusive breastfeeding as an effective contribution to feeding options of babies born of HIV positive first-time mothers. However, the participants identified several factors hindering the effective implementation of the policy of exclusive breastfeeding in HIV positive first-time mothers. Factors identified were staffshortages, lack of cooperation among staff members regarding promotion of exclusive breastfeeding, lack of information regarding the CD4 count of patients on admission in the ward, cultural beliefs, lack of training among staff members and inadequate counseling facilities to ensure privacy and confidentiality for mothers. Participants also experienced a variety of emotions related to exclusive breastfeeding such as happiness, confidence, helplessness, frustration, worry and concern, stress and exhaustion. Based on the findings of the study, guidelines were developed and recommendations made concerning nursing practice, nursing education and nursing research.
- Full Text:
- Date Issued: 2006
- Authors: Moobi, Emily Keadimilwe
- Date: 2006
- Subjects: Breastfeeding -- South Africa -- Port Elizabeth , Midwives -- South Africa -- Port Elizabeth -- Attitudes , HIV infections -- South Africa -- Port Elizabeth -- Prevention
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10016 , http://hdl.handle.net/10948/427 , Breastfeeding -- South Africa -- Port Elizabeth , Midwives -- South Africa -- Port Elizabeth -- Attitudes , HIV infections -- South Africa -- Port Elizabeth -- Prevention
- Description: The Department of Health in South Africa, as in many countries, has developed a policy guideline and recommendations for feeding of infants of HIV positive mothers. This is aimed at providing midwives with detailed and sound information about HIV and infant feeding practices based on current understanding of HIV and exclusive breastfeeding for the first six months of the infant’s life. The policy states that breastfeeding is a significant and preventable mode of HIV transmission to infants and there is an urgent need to educate, counsel and support women and families, so that they can make decisions about how best to feed infants in the context of HIV (http://www.doh.gov.za/aids/doc/feeding/html.2005-03-07). Speaking to midwives from the Provincial Hospitals in the Nelson Mandela Metropole, the researcher became aware of the midwives’ often-expressed unhappiness about the new policy from the Department of Health on exclusive breastfeeding. Midwives complained about the dilemma with which they are faced regarding infant feeding practices. They could not understand the advocacy of exclusive breastfeeding, when breastfeeding is recognised as one of the modes of Mother-to-Child Transmission (MTCT) of HIV. The aim of the study was to help, support and encourage midwives to implement the policy of exclusive breastfeeding. The objectives of the study were to: • Explore and describe the experiences and perceptions of midwives related to promoting exclusive breastfeeding in HIV positive first-time mothers. • Make recommendations to the Department of Health regarding the support and help that can be given to midwives to encourage their implementation of the exclusive breastfeeding policy. The researcher made use of a qualitative, phenomenological, descriptive, explorative and contextual design. Permission for conducting the research was iv obtained from relevant authorities, and participants were asked to sign a consent form before the researcher proceeded with the study. Collection of data was done by means of unstructured interviews using an audiotape recorder. Once data was saturated, the interviews were transcribed verbatim and analysed, using the steps described by Tesch’s (1990 in Creswell, 1994: 153) method of descriptive analysis. Field notes were also taken to record non-verbal communication during the interviews. In order to ensure trustworthiness of the study, the ethical principles of Guba’s model (in Krefting, 1991:215), namely truth-value, applicability, consistency and neutrality were used. The services of an independent coder were utilised and a consensus meeting was held between the researcher and the independent coder in order to discuss the identified themes. Prior to the consensus meeting, the independent coder was provided with interview transcripts and a protocol to guide the data analysis. Following the data analysis, a literature control was undertaken to highlight the similarities and differences found in the data analysis. Three themes with sub-themes were identified. The participants expressed positive views on the policy of exclusive breastfeeding in HIV positive first-time mothers. They were satisfied with the policy and viewed the policy of exclusive breastfeeding as an effective contribution to feeding options of babies born of HIV positive first-time mothers. However, the participants identified several factors hindering the effective implementation of the policy of exclusive breastfeeding in HIV positive first-time mothers. Factors identified were staffshortages, lack of cooperation among staff members regarding promotion of exclusive breastfeeding, lack of information regarding the CD4 count of patients on admission in the ward, cultural beliefs, lack of training among staff members and inadequate counseling facilities to ensure privacy and confidentiality for mothers. Participants also experienced a variety of emotions related to exclusive breastfeeding such as happiness, confidence, helplessness, frustration, worry and concern, stress and exhaustion. Based on the findings of the study, guidelines were developed and recommendations made concerning nursing practice, nursing education and nursing research.
- Full Text:
- Date Issued: 2006
The extent of discharge planning by nurses for patients who have undergone valvular surgery
- Authors: Verwey, Oriana
- Date: 2006
- Subjects: Heart -- Surgery -- Nursing -- South Africa , Heart valves -- Surgery -- South Africa , Heart valves -- Surgery , Heart -- Surgery -- Patients -- Rehabilitation -- South Africa , Hospitals -- Admission and discharge -- South Africa
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10015 , http://hdl.handle.net/10948/445 , Heart -- Surgery -- Nursing -- South Africa , Heart valves -- Surgery -- South Africa , Heart valves -- Surgery , Heart -- Surgery -- Patients -- Rehabilitation -- South Africa , Hospitals -- Admission and discharge -- South Africa
- Description: Valvular disorders can be corrected by means of surgery, after which very comprehensive discharge planning should be implemented to prevent the occurrence of post-operative complications. Advances in medical technology and intellect instigate earlier discharge for patients after they have undergone valvular surgery. The aim of this research study is to establish the extent of discharge planning by nurses for patients who have undergone valvular surgery, so that practice guidelines in the form of an in-service educational framework can be compiled for nurses in the management of these patients post-operatively. Patients, many of whom are from rural areas, are discharged without an adequate referral system. There are, currently, no set guidelines or referral persons to direct these patients during their rehabilitation period. Based on the researcher’s personal observations, it is evident that many patients suffer from bacterial endocarditis or clotted valves due to poor post-surgery management. However, both of these conditions could be avoided if proper health education was given to these patients. The study will take the form of a quantitative, exploratory, descriptive and contextual survey. Data will be collected by means of a structured questionnaire that will be completed by the nurses working in the cardiac general ward and the cardiac clinic. Findings of the research study will be used to assist the researcher in developing an in-service educational framework for staff that are both nursing and preparing post valvular surgery patients for discharge. The goal is to prevent complications such as clot formation and endocarditis and to enable patients to deal effectively with their rehabilitation period.
- Full Text:
- Date Issued: 2006
- Authors: Verwey, Oriana
- Date: 2006
- Subjects: Heart -- Surgery -- Nursing -- South Africa , Heart valves -- Surgery -- South Africa , Heart valves -- Surgery , Heart -- Surgery -- Patients -- Rehabilitation -- South Africa , Hospitals -- Admission and discharge -- South Africa
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10015 , http://hdl.handle.net/10948/445 , Heart -- Surgery -- Nursing -- South Africa , Heart valves -- Surgery -- South Africa , Heart valves -- Surgery , Heart -- Surgery -- Patients -- Rehabilitation -- South Africa , Hospitals -- Admission and discharge -- South Africa
- Description: Valvular disorders can be corrected by means of surgery, after which very comprehensive discharge planning should be implemented to prevent the occurrence of post-operative complications. Advances in medical technology and intellect instigate earlier discharge for patients after they have undergone valvular surgery. The aim of this research study is to establish the extent of discharge planning by nurses for patients who have undergone valvular surgery, so that practice guidelines in the form of an in-service educational framework can be compiled for nurses in the management of these patients post-operatively. Patients, many of whom are from rural areas, are discharged without an adequate referral system. There are, currently, no set guidelines or referral persons to direct these patients during their rehabilitation period. Based on the researcher’s personal observations, it is evident that many patients suffer from bacterial endocarditis or clotted valves due to poor post-surgery management. However, both of these conditions could be avoided if proper health education was given to these patients. The study will take the form of a quantitative, exploratory, descriptive and contextual survey. Data will be collected by means of a structured questionnaire that will be completed by the nurses working in the cardiac general ward and the cardiac clinic. Findings of the research study will be used to assist the researcher in developing an in-service educational framework for staff that are both nursing and preparing post valvular surgery patients for discharge. The goal is to prevent complications such as clot formation and endocarditis and to enable patients to deal effectively with their rehabilitation period.
- Full Text:
- Date Issued: 2006
The knowledge and attitudes of registered nurses in public hospitals related to the prevention of HIV and AIDS transmission
- Authors: Mo, Yabin
- Date: 2006
- Subjects: Nurses -- South Africa -- Attitudes , AIDS (Disease) -- Nursing -- South Africa , HIV infections -- Nursing -- South Africa , Nurse and patient -- South Africa
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10018 , http://hdl.handle.net/10948/571 , Nurses -- South Africa -- Attitudes , AIDS (Disease) -- Nursing -- South Africa , HIV infections -- Nursing -- South Africa , Nurse and patient -- South Africa
- Description: Human Immunodeficiency Virus (HIV) and Acquired Immuno-Deficiency Syndrome (AIDS) have brought about a global epidemic far more extensive than was predicted even a decade ago (van Rensburg, 2002:1). South Africa has one of the highest HIV prevalence rates in the world (South African Department of Health, 2000: 5), it still increase yearly. Before a vaccine and/or effective treatment become available, effective education and information campaigns are necessary for preventing the spreading of HIV and AIDS (WHO (the World Health Organization), 1988:21). According to WHO and ICN (International Council of Nurses) (1988:12), Nurses can play a pivotal role in the education of patients, their families and friends with regard to the prevention of HIV and AIDS transmission, so as to control the spread of this disease. In South Africa, more than 60 percent of the healthcare human resources comprise professional nursing practitioners (Muller, 2002: 95). Therefore, the education and training of nurses is one of the effective methods to preventing further spread of HIV and AIDS infection in South Africa. Accordingly, nurses need to reduce both personal and occupational risk of becoming infected with HIV themselves, as well as provide education to patients and their families. Before effective and efficient in-service education guidelines on the prevention of HIV and AIDS transmission can be developed, any knowledge deficit and negative attitudes of registered nurses regarding the prevention of HIV and AIDS transmission should be identified. Thus, it is important to survey the knowledge and attitudes of nurses in healthcare institutions related to the prevention of HIV and AIDS transmission. The main goal of the study was to explore and describe the knowledge and attitudes of registered nurses in public hospitals related to the prevention of HIV and AIDS transmission. The secondary objective was to develop in-service education guidelines for registered nurses in public hospitals to optimise both personal and occupational prevention measures relating to HIV and AIDS transmission. The research was conducted using a quantitative, explorative, descriptive and contextual design. The purposive sampling method was used to select the participants and a self-administered questionnaire was used to collect data. This data was analysed by inferential statistics and descriptive statistics and areas of deficits concerning knowledge and negative attitudes were identified. In this study there were deficits concerning the knowledge and negative attitudes regarding the prevention of HIV and AIDS transmission to a greater or lesser degree in all the subgroups of the questionnaire. In general, the registered nurses with the attendance of HIV and AIDS training program, experience in caring for HIV and AIDS patients made the level of certain knowledge related to the prevention of HIV and AIDS transmission different; Working experience as a registered nurses and the attendance of HIV and AIDS training programmes did not make attitudes towards the prevention of HIV and AIDS transmission significantly different. The registered nurses with experience of caring for HIV and AIDS patients had more positive attitudes than those without the experience. This information was used to compile in-service education guidelines for registered nurses concerning the prevention of HIV and AIDS transmission. The in-service education guidelines will be given to clinical facilitators at public hospitals. It is envisaged that this will guide them as to what to include in their in-service education programmes concerning the prevention of HIV and AIDS transmission for registered nurses.
- Full Text:
- Date Issued: 2006
- Authors: Mo, Yabin
- Date: 2006
- Subjects: Nurses -- South Africa -- Attitudes , AIDS (Disease) -- Nursing -- South Africa , HIV infections -- Nursing -- South Africa , Nurse and patient -- South Africa
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10018 , http://hdl.handle.net/10948/571 , Nurses -- South Africa -- Attitudes , AIDS (Disease) -- Nursing -- South Africa , HIV infections -- Nursing -- South Africa , Nurse and patient -- South Africa
- Description: Human Immunodeficiency Virus (HIV) and Acquired Immuno-Deficiency Syndrome (AIDS) have brought about a global epidemic far more extensive than was predicted even a decade ago (van Rensburg, 2002:1). South Africa has one of the highest HIV prevalence rates in the world (South African Department of Health, 2000: 5), it still increase yearly. Before a vaccine and/or effective treatment become available, effective education and information campaigns are necessary for preventing the spreading of HIV and AIDS (WHO (the World Health Organization), 1988:21). According to WHO and ICN (International Council of Nurses) (1988:12), Nurses can play a pivotal role in the education of patients, their families and friends with regard to the prevention of HIV and AIDS transmission, so as to control the spread of this disease. In South Africa, more than 60 percent of the healthcare human resources comprise professional nursing practitioners (Muller, 2002: 95). Therefore, the education and training of nurses is one of the effective methods to preventing further spread of HIV and AIDS infection in South Africa. Accordingly, nurses need to reduce both personal and occupational risk of becoming infected with HIV themselves, as well as provide education to patients and their families. Before effective and efficient in-service education guidelines on the prevention of HIV and AIDS transmission can be developed, any knowledge deficit and negative attitudes of registered nurses regarding the prevention of HIV and AIDS transmission should be identified. Thus, it is important to survey the knowledge and attitudes of nurses in healthcare institutions related to the prevention of HIV and AIDS transmission. The main goal of the study was to explore and describe the knowledge and attitudes of registered nurses in public hospitals related to the prevention of HIV and AIDS transmission. The secondary objective was to develop in-service education guidelines for registered nurses in public hospitals to optimise both personal and occupational prevention measures relating to HIV and AIDS transmission. The research was conducted using a quantitative, explorative, descriptive and contextual design. The purposive sampling method was used to select the participants and a self-administered questionnaire was used to collect data. This data was analysed by inferential statistics and descriptive statistics and areas of deficits concerning knowledge and negative attitudes were identified. In this study there were deficits concerning the knowledge and negative attitudes regarding the prevention of HIV and AIDS transmission to a greater or lesser degree in all the subgroups of the questionnaire. In general, the registered nurses with the attendance of HIV and AIDS training program, experience in caring for HIV and AIDS patients made the level of certain knowledge related to the prevention of HIV and AIDS transmission different; Working experience as a registered nurses and the attendance of HIV and AIDS training programmes did not make attitudes towards the prevention of HIV and AIDS transmission significantly different. The registered nurses with experience of caring for HIV and AIDS patients had more positive attitudes than those without the experience. This information was used to compile in-service education guidelines for registered nurses concerning the prevention of HIV and AIDS transmission. The in-service education guidelines will be given to clinical facilitators at public hospitals. It is envisaged that this will guide them as to what to include in their in-service education programmes concerning the prevention of HIV and AIDS transmission for registered nurses.
- Full Text:
- Date Issued: 2006
The health status of construction workers
- Authors: Deacon, Claire Helen
- Date: 2004
- Subjects: Construction industry -- Employees -- Diseases -- South Africa , Construction workers -- Health and hygiene -- South Africa , Construction workers -- Health risk assessment -- South Africa
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:11025 , http://hdl.handle.net/10948/326 , Construction industry -- Employees -- Diseases -- South Africa , Construction workers -- Health and hygiene -- South Africa , Construction workers -- Health risk assessment -- South Africa
- Description: The construction industry is considered to be an extremely dangerous working environment, and therefore the health status of construction workers needs to be considered prior, during and on leaving the industry. Occupational hazards relative to the construction worker are well researched internationally; however few countries undertake routine medical surveillance to identify the health status of the construction worker relative to these hazards. Employers have a higher duty of care to identify workers who could be a risk at work from non-occupationally related conditions such as hypertension and diabetes mellitus. Work could exacerbate these conditions, leading to absenteeism, poor performance and eventually leaving the industry due to ill health. The dissertation explores, inter alia: the risks to which workers are exposed; the legal aspects; relevant literature regarding medical surveillance, and the use of a medical surveillance instrument used to determine the health status of 142 construction workers who consented to participate in the study. The methodological approach used in this study was a quantitative descriptive design, more specifically, using a randomised cross-sectional survey design. The instrument used to determine health status included a full medical, occupational and social history, as well as a physical examination undertaken by Occupational Health Nursing Practitioners (OHNs). Findings indicate that most construction workers believe they are healthy. However only a small percentage of construction workers did not require referral for further investigation and / or treatment.
- Full Text:
- Authors: Deacon, Claire Helen
- Date: 2004
- Subjects: Construction industry -- Employees -- Diseases -- South Africa , Construction workers -- Health and hygiene -- South Africa , Construction workers -- Health risk assessment -- South Africa
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:11025 , http://hdl.handle.net/10948/326 , Construction industry -- Employees -- Diseases -- South Africa , Construction workers -- Health and hygiene -- South Africa , Construction workers -- Health risk assessment -- South Africa
- Description: The construction industry is considered to be an extremely dangerous working environment, and therefore the health status of construction workers needs to be considered prior, during and on leaving the industry. Occupational hazards relative to the construction worker are well researched internationally; however few countries undertake routine medical surveillance to identify the health status of the construction worker relative to these hazards. Employers have a higher duty of care to identify workers who could be a risk at work from non-occupationally related conditions such as hypertension and diabetes mellitus. Work could exacerbate these conditions, leading to absenteeism, poor performance and eventually leaving the industry due to ill health. The dissertation explores, inter alia: the risks to which workers are exposed; the legal aspects; relevant literature regarding medical surveillance, and the use of a medical surveillance instrument used to determine the health status of 142 construction workers who consented to participate in the study. The methodological approach used in this study was a quantitative descriptive design, more specifically, using a randomised cross-sectional survey design. The instrument used to determine health status included a full medical, occupational and social history, as well as a physical examination undertaken by Occupational Health Nursing Practitioners (OHNs). Findings indicate that most construction workers believe they are healthy. However only a small percentage of construction workers did not require referral for further investigation and / or treatment.
- Full Text: