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Thesis (MCurr)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: Background: Research supervision forms an essential part of higher education. The emergence of global trends in the production and dissemination of knowledge is compelling universities and university of technologies in South Africa to become more market-orientated, competitive and entrepreneurial. The supervision process is vital to successful completion of the research component of master’s degrees and consequently increase throughput in higher education. Successful and meaningful supervision contribute largely to mutual satisfaction and professional development between supervisors and students. Good supervision should be an integral component of quality research governance. Objective: The aim of this study was to explore research supervision needs and experiences of the master’s students in nursing. Methodology: A descriptive phenomenological research design was used with a qualitative research approach. A non-probability, purposive sampling method was used to select respondents in this study. The target population includes all nursing science master’s students enrolled at University of Stellenbosch in the past three years (N=109). A sample size of twelve students was included in the study, whereby all twelve face to face interviews were conducted using the semi-structured interview guide. The inclusion criterium for students was that they were all currently registered students who initially enrolled for the Masters in Nursing degree program between 2008 and 2010 in the division of Nursing at Stellenbosch University. Results: Eight themes arose from the interviews. These included: isolation; lack of skills/ time management; family dynamics/personal circumstances; supervisor support; student and supervisor roles and responsibilities; workplace dynamics and support; financial and institutional support and implications; and motivation to complete studies. Conclusions: Successful completion of research undertaken on postgraduate level and supervision at a master’s level depend on a healthy and productive relationship between the supervisor and the student. Exploring and implementing the guidance and suggestions in this paper will assist students in considering supervision preferences. This in turn will result in achieving a good supervisory relationship which is the key to successful master studies. / AFRIKAANSE OPSOMMING: Agtergrond: Navorsing toesighouding vorm ‘n belangrike deel van hoer onderwys. Die opkomende wêreldtendense in die toename en verspreiding van kennis verplig Resultate: Ag temas het vanuit die onderhoude voortgespruit. Dit het ingesluit: isolasie; gebrek aan vaardighede/tydsbestuur; familie-dinamika/persoonlike omstandighede; ondersteuning van toesighouer; rolle van student en toesighouer, asook verantwoordelikhede; werkplek dinamika/ondersteuning; finansiële en institusionele ondersteuning/implikasies en motivering om die studie te voltooi. Gevolgtrekking: Die suksesvolle voltooiing van die navorsing wat onderneem word op nagraadse vlak en toesig is afhanklik van ’n gesonde en produktiewe verhouding tussen die toesighouer en die student. Die nagaan en implementering van die leiding en voorstelle in hierdie studie sal die studente help in die oorweging van toesighouer voorkeure. Dit sal gevolglik aanleiding gee tot die bereiking van ’n goeie toesighoudende verhouding wat die sleutel is tot die suksesvolle voltooiing van magistergraad studies. universiteite en universiteite van tegnologie in Suid-Afrika om meer markgeoriënteerd, kompeterend en ondernemend te word. Suksesvolle en betekenisvolle toesig maak hoofsaaklik n bydra tot die onderlinge bevrediging en professionele ontwikkeling tussen toesighouers en studente. Goeie toesig behoort ’n integrale komponent van kwaliteit begeleiding in navorsing te wees. Doelwit: Die doel van hierdie studie was om die behoeftes van navorsingtoesig en ervaring van die magisterstudent in verpleging te ondersoek Metodologie: ’n Beskrywende, fenomenologiese navorsingsontwerp met ’n kwalitatiewe navorsingsbenadering is gebruik. ’n Nie-waarskynlike, doelbewuste steekproefmetode is gebruik om respondente vir hierdie studie te selekteer. Die teikenbevolking sluit in alle magisterstudente wat ingeskryf is vir verpleegwetenskap aan die Universiteit van Stellenbosch oor die afgelope drie jaar (N=109). ’n Steekproefgrootte van twaalf studente is ingesluit in hierdie studie, waaronder daar met al twaalf van aangesig tot aangesig onderhoude gevoer is deur gebruik te maak van die semi-gestruktureerde onderhoudsgids. Insluitingskriteria vir die studente was dat hulle almal bestaande geregistreerde studente moes wees wat aanvanklik ingeskryf het vir die program vir die Meestersgraad in Verpleging tussen 2008 en 2010 in die afdeling van Verpleging aan die Universiteit van Stellenbosch.

Thesis (MCur)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: Differences were observed in clinical demonstration and assessment techniques of clinical supervisors involved with the supervision of undergraduate nursing students at an institution of higher education. These differing techniques displayed by the clinical supervisors may have implications for the standard of nursing care provided by the students and the throughput of these students. A qualitative approach with a descriptive design was applied to explore the perceptions and experiences of the undergraduate nursing students’ on clinical supervision. Nine (n=9) students were deliberately selected by means of purposive sampling from each year to participate in focus group interviews. Nine 1st year students, nine 2nd year students, nine 3rd year students and nine 4th year students respectively constituted the groups that were interviewed. Thus the total sample consisted of n=36 nursing students. Consent to conduct the study was obtained from the Health Research Ethical Committee at Stellenbosch University, as well the institution under study. Informed consent was obtained from all the participants. Data collection was completed by two trained fieldworkers who were not affiliated with the institution under study. The interviews were analysed through content analysis. Six themes emerged from the data. These included support, professionalism, realities of supervision, student preferences regarding supervisors, experiences that relate to abusive behaviour and the clinical supervision process. The findings indicated negative and positive experiences on clinical supervision. Recommendations were proposed to enhance clinical supervision and the learning experiences of student nurses. Key words: Clinical supervision, undergraduate nursing, clinical supervisor, clinical practice, differing techniques. / AFRIKAANSE OPSOMMING: Verskille was waargeneem in kliniese demonstrasie- en assesseringstegnieke van kliniese toesighouers wat betrokke is met die supervisie van voorgraadse verpleegstudente by 'n institusie van hoër onderwys. Die verskille in tegnieke gedemonstreer deur die kliniese toesighouers mag implikasies hê vir die standaard van verpleegsorg gelewer deur die studente en die slaagsyfer van hierdie studente. 'n Kwalitatiewe benadering met 'n beskrywende ontwerp was toegepas om die persepsies en ervaringe van die voorgraadse verpleegstudente oor kliniese supervisie te verken. Nege (n = 9) studente vanuit elke jaargroep was bewustelik gekies by wyse van doelgerigte steekproefneming om deel te neem in fokusgroep onderhoude. Nege 1ste jaar studente, nege 2de jaar studente, nege 3de jaar studente en nege 4de jaar studente het onderskeidelik die groepe gevorm waarmee onderhoude gevoer was. Die totale steekproef het uit n=36 verpleegstudente bestaan. Toestemming om die studie te doen was vanaf die Etiese Komitee vir Gesondheidsnavorsing by Stellenbosch Universiteit, asook die instelling ter ondersoek verkry. Ingeligte toestemming is van al die deelnemers verkry. Data insameling was deur twee opgeleide veldwerkers gedoen wat nie geaffilieer is met die instelling ter ondersoek nie. Die onderhoude was deur inhoudsontleding geanaliseer. Ses temas het uit die data ontstaan. Dit sluit in ondersteuning, professionaliteit, realiteite van supervisie, student voorkeure ten opsigte van toesighouers, ervaringe wat verband hou met mishandelende gedrag en die kliniese supervisie-proses. Die bevindinge het negatiewe en positiewe ervaringe oor kliniese supervisie getoon. Aanbevelings is voorgestel om kliniese supervisie en die leerervaring van die studentverpleegsters te verbeter. Sleutelwoorde: Kliniese supervisie, voorgraadse verpleging, kliniese toesighouer, kliniese praktyk, teenstrydige tegnieke.

Thesis (doctoral)--Rijksuniversiteit te Utrecht. / Description based on print version record.

Proefschrift Rijksuniversiteit Limburg, Maastricht. / Auteursnaam op omslag: Marjan Groen. Lit. opg.: p. 139-146. - Met een samenvatting in het Nederlands.

This study is a secondary analysis which compared the psychosocial and functional adjustment of MI couples who manifest different patterns of psychological distress. Data were collected on 130 couples two months after the husband's MI. Couples were categorized into four groups based on their scores on a psychological distress measure, the General Health Questionnaire (GHQ). Husbands and wives completed the demographic questionnaire, the Dyadic Adjustment Scale (DAS), the Social Support Questionnaire (SSQ6), and the three subscales (domestic adjustment. sexual relationship, social adjustment) of the Psychosocial Adjustment to Illness Scale (PAIS). In addition, husbands completed the Cardiac Symptoms List (CSL) and wives completed the Caregiving Involvement Questionnaire (CIQ). Data were analyzed using One-Way Multivariate Analysis of Variance with four groups followed by Tukey's Post Hoc Test. Relevant extraneous variables (cardiac symptoms, number of prescribed medications, social support satisfaction of the husband and the wife) were controlled using One-Way Multivariate Analysis of Covariance. Nursing assessment to detect the presence of emotional distress and to identify the affected member(s) in the couple should be an integral part of nursing care. (Abstract shortened by UMI.)

Many patients experience psychological distress following a myocardial infarction (MI). Emotional problems can interfere with a return to family, social and work-related activities, and are associated with poor cardiac prognosis. Although many psychosocial intervention programs designed for this population have been evaluated, little is known about which components of the interventions are effective. The major aim of the present secondary analysis was to identify the types of patient-nurse interactions associated with a reduction in psychological distress in post-MI patients who participated in the Montreal Heart Attack Readjustment Trial (M-HART) randomized controlled study of home-based psychosocial nursing interventions. / The sample for the present study included 431 patients (36.2% female) in the treatment group who received at least two home nursing visits over a two-month period. The types of concerns experienced by patients (those related to symptoms, treatment, uncertainty, interpersonal roles, and work/finance) and the types of nursing approaches undertaken during the first two home visits (cognitive, educational, emotionally supportive including reassurance/encouragement, listening and providing advice, and managerial) were examined in relationship to short-term changes in distress. These relationships were examined in the sample as a whole and also in subgroup analyses where gender and baseline level of depressive symptoms were taken into account. / In the sample as a whole, reassurance/encouragement and listening were related to a reduction in distress, but mainly for patients who had physical symptoms and treatment-related concerns. The provision of advice for psychologically-related concerns such as fears was not associated with better outcomes. However, nursing approaches that were more directive (educational, cognitive and advice) appeared to have been linked to better outcomes in men, but less so in women, while listening was associated with reductions in distress in women, but not in men. Reductions in distress after the two visits was less common in patients with higher baseline levels of depressive symptoms, and those who presented psychologically-related concerns. Finally, patients who showed short-term reductions in distress had lower death rates, lower readmission rates, and a lower risk of reporting depressive symptoms at one year. / These results highlight the importance of determining the types of intervention approaches that may be most effective in men and in women, and identifying patients who are more and less likely to benefit from psychosocial interventions such as those provided in M-HART. It is also particularly notable that post-MI patients whose short-term psychological distress is reduced by individualized psychosocial interventions appear to have improved cardiac prognosis and reduced depressive symptoms in the longer term.

The purpose of this cross-sectional study was to explore the relationships in the perceived quality of the parental relationship, coping strategies, received support, and well-being in adolescents from separated/divorced and married parents. Two hundred and forty-four matched adolescents from separated/divorced and married households were drawn from an initial sample of 1044 students who were tested at five colleges and three high schools of a large metropolitan and rural area. Regression analyses supported the hypothesis that a perceived poor parental relationship, and not family status, was associated with low life satisfaction and sense of future, and high anxiety in adolescents of divorced and intact households. Path analytic techniques revealed that coping strategies and received support did not mediate the association between a perceived poor parental relationship and low levels of well-being in adolescents from divorced and intact households. However, in both groups, problem-focused coping mediated by nondirect support was associated with more life satisfaction and sense of future, and less anxiety than the direct effects of problem-focused coping alone. In addition, emotion-focused coping mediated by direct guidance was associated with higher levels of well-being than the direct effects of emotion-focused coping alone. In contrast, problem-focused coping in conjunction with direct guidance was associated with the lowest levels of adolescent well-being. The findings contribute to the field of adolescent stress and coping by suggesting that coping strategies may influence the type of support received by adolescents. The study extends current research findings by considering the combined effects of coping and received support in relation to measures of well-being. Finally the study contributes to the field of nursing by demonstrating that personal and social mediators may enhance the health oriented aspects of well-being.

The diagnosis and management of cancer evokes profound questions about one's understanding of the self, the world, and one's purpose in life. The stress and coping literature suggest that the process of meaning-making provides a suitable framework to study such existential questions, as well as an ideal method of intervention. Through a series of manuscripts, this thesis examines the construct of meaning-making within the specific domain of cancer, describes the development of a meaning-making intervention, and assesses the impact of meaning-making coping on psychological adjustment to cancer. The recent proliferation of studies on the concept of meaning that includes the adult cancer experience has been conceptualized and operationalized in a variety of ways. To better understand and use the meaning-making concept within the cancer experience, a systematic review of the literature was conducted to synthesize the current level of knowledge and determine where research should be directed. This review of the empirical and qualitative findings suggested that the successful ability to construct a sense of meaning in illness may lead to positive psychological outcomes. Thus a novel meaning-making intervention (MMI) for cancer patients was developed, and its applicability as well as its effects on psychological adjustment to cancer were explored in a pilot study with a heterogeneous group of patients. Significant improvements in self esteem and self-efficacy were reported in a small, uncontrolled sample and encouraged the need for further confirmatory testing. Guided by the pilot study results, a randomized controlled trial tested the effect of the MMI on levels of self-esteem, optimism, and self-efficacy in a homogeneous sample of newly diagnosed breast or colorectal cancer patients. After controlling for baseline differences on each outcome variable, participants in the experimental group (n=35) who received the MMI were found to have significantly improved percep

The purpose of this study was to (a) describe the physiological and behavioural responses of premature infants to a tissue-damaging stimulus and (b) determine how severity of illness and behavioural state influenced these responses. A convenience ample of 124 premature infants between 32 and 34 weeks gestational age was obtained from one neonatal unit in a Montreal teaching hospital. Physiological (heart rate, oxygen saturation, intracranial pressure) and behavioural (facial expression and cry) data were collected during the baseline, warming, stick and squeeze phases of a routine heelstick procedure. Behavioural state and severity of illness were assessed using instruments by Prechtl (1974) and Georgieff, Mills and Bhatt (1989). Demographic data were collected from the medical record. Data analysis was performed utilizing repeated measures multivariate analysis of variance (RM MANOVA), multivariate analysis of variance (MANOVA) and repeated measures multivariate analysis of covariance (RM MANOVA). There were significant differences in physiological and behavioural parameters between baseline and stick including: (a) an increase in maximum heart rate, (b) a decrease in minimum oxygen saturation, (c) an increase in intracranial pressure and (d) an increase in the proportion of all facial actions. For those infants who cried during both the stick and squeeze phase, the fundamental frequency, harmonic structure and peak spectral energy were significantly increased during the stick as compared to the squeeze. Behavioural state was found to modify the facial expression variables and severity of illness modified the acoustic cry variables. An interaction between behavioural state and severity of illness influenced maximum heart rate. There was no significant relationship between physiological and behavioural outcomes. Both categories of outcomes provide important but different information about the premature infant's response to a tissue-damaging stimulus. A multidimen