Background: The nursing process is a widely accepted method and has been suggested as a scientific method to guide procedures and qualify nursing care. More recently, the process has been defined as a systematic and dynamic way to deliver nursing care. This process is performed through five interrelated steps, namely: assessment, diagnosis, planning, implementation and evaluation, with subsequent modifications used as feedback mechanisms that promote the resolution of the nursing diagnoses. The Lesotho Nursing Council (LNC) adopted the nursing process over a decade ago and the LNC mandated nurse training institutions and clinical settings to utilise this methodology. However, there is a reluctance to implement the nursing process despite its importance in nursing care (LNC, 2009:7). Purpose: The primary purpose of this research was to explore and describe the perceptions and experiences of nurses in implementing the nursing process in a district public hospital in Lesotho. On the grounds of these findings, the researcher ultimately makes recommendations for nursing education, nursing practice and nursing research. Methodology: To explore and describe the perceptions and experiences of nurses implementing the nursing process in a district public hospital in Lesotho, the researcher chose a qualitative, exploratory, descriptive and contextual research design. The researcher used voluntary purposive sampling to identify participants who complied with the set selection criteria. The sample comprised of professional nurses with varying years of working experience and qualifications. The data was collected by means of narratives and two focus group interviews; n=10 and n=6. The data was captured on a digital audio recorder and was transcribed verbatim. The researcher took field notes during each focus group. Both the researcher and independent co-coder analysed the narratives and transcribed data together, using narrative analysis and open coding (Creswell, 2009:185). Three main themes and nine subthemes emerged from the data collected from the narratives and focus groups. The researcher illustrated these themes through direct quotes by the participants. Each of these themes was discussed accompanied by relevant data obtained from literature, and reduced to conclusive statements, which serve as a basis for the derived recommendations to nursing education, nursing practice and nursing research. Trustworthiness was ensured in accordance with the principles of credibility, transferability, dependability and confirmability. Conclusions: The researcher reached a number of conclusions. The participants perceived several factors and experienced them as interfering with the efficient implementation of the nursing process. Operational difficulties experienced in the systematisation of nursing care in practice, are amongst others a lack of knowledge of the steps involved in the process, an excessive number of tasks assigned to the nursing team, the poor quality of professional education, insufficient reports on the physical examination related to the disease and difficulty to formulate the nursing diagnosis. The research report concluded with the researcher’s evaluation of the research and recommendations for nursing practice, nursing education and nursing research with the purpose of improving the implementation of the nursing process. / MCur, North-West University, Potchefstroom Campus, 2014

This is a qualitative study, the aim of which is to explore the experiences of student nurses regarding the bursary system in KwaZulu Natal. During 2010 nursing education was confronted with restructuring of student nurses from having a supernumerary status to being bursary holders (DOH, 2010:68). This study describes the experiences of changes that have emanated from introduction of the new bursary system. The experiences of students in this new system were explored. These include the legacy of institutional factors and benefits that have now been removed from the students which could hamper students‟ sense of belonging. The research was conducted in an attempt to make a significant contribution to the bursary subsidisers specifically in awareness of what student experiences have been in relation to introduction of the bursary system in KwaZulu Natal (KZN); and also to provide recommendations on how the bursary requirements could possibly be improved to enhance the student academic, clinical and socio-economic needs. A qualitative study design was used and data was collected using focus group interviews. Purposive sampling was used to select participants who represent the target population. The sample used for the study included first-, second- and third- year male and female nursing students who are studying towards the Diploma in Nursing (General, Psychiatric, Community) and Midwifery. A total of seven focus group interviews were conducted until data saturation was achieved. To ensure trustworthiness the principles of credibility, transferability, dependability and confirmability were maintained. A digital voice recorder was utilised to capture all data and data was transcribed verbatim. Data was analysed by the researcher and an independent co-coder. Two (2) main themes and eight (8) sub-themes were identified. The findings indicated that most of the experiences of being in the bursary system as opposed to having supernumerary status has had many effects and has negatively impacted on students‟, socio-economic, psychological, clinical, academic and family demands. A very small amount of students responded positively. Many concerns related to staffing attitudes, shortages and staff demands on the students during clinical practice were highlighted. Conclusions drawn from the study are that the bursary system is not viewed as being of benefit to students as students feel they are not receiving the full complement of benefits from being bursary holders. Furthermore, there is no consideration made to them for support in clinical and academic areas considering the employee hours they have to work. The recommendations indicate that there is a great need to have the bursary system reviewed. The study is concluded with the final recommendations for policy-making, nursing practice, nursing research and nursing education. From this it is hoped that the students‟ needs are identified, resulting in enhancement of their training. / MCur, North-West University, Potchefstroom Campus, 2015

Background: The study described the perspectives and experiences of women and health care providers with regard to use of postnatal care and reasons why some women do not attend postnatal care in order to identify strategies for improving postnatal care services. Methods: An explorative, descriptive, and contextual research design was used. In step one data was collected with semi-structured interviews with seventeen (17) women who attended postnatal care. The second sample consisted of ten (10) women who did not attend postnatal care but brought their babies for well-baby clinic. Focus groups were conducted with midwives who offered postnatal care to women. The midwives of the first focus group worked in the hospital while the second focus group worked at a filter clinic. Results: In step one, some women indicated positive experiences but most women had negative experiences about postnatal care. The positive experiences were related to the satisfaction of the women with good services received and not encountering problems with staff's care. Common concerns mentioned in step one and two about postnatal care were shortage of skilled midwives, need for staff to be trained on postnatal care services, lack of confidentiality, poor infrastructure and non-integration of maternal and child services. Reasons for not attending postnatal care that were mentioned by women in step three were inaccessibility of the health care facilities, poor roads infrastructure, lack of knowledge about postnatal services and socio-cultural factors. Conclusion: Based on the findings, strategies to improve postnatal care were developed: Firstly, the midwives need to be trained on postnatal care and highlighted on current postnatal policies and guidelines. Secondly, woman and baby should attend the postnatal care at the health facility. Thirdly, community health nurses and trained community health workers should visit the women at home soon after birth of the babies. Fourthly, postnatal care should be provided at the family and community level by a trained and skilled midwife during the early postnatal period. Fifthly, combination of care facility and home visit - when the woman and baby are discharged from the hospital, follow- up need to be done at home by the midwife. Lastly, a comprehensive integration of postnatal services with other programmes needs to be enforced and supported by the programme management and policy makers. / MCur, North-West University, Potchefstroom Campus, 2015

Background: The nursing process is a widely accepted method and has been suggested as a scientific method to guide procedures and qualify nursing care. More recently, the process has been defined as a systematic and dynamic way to deliver nursing care. This process is performed through five interrelated steps, namely: assessment, diagnosis, planning, implementation and evaluation, with subsequent modifications used as feedback mechanisms that promote the resolution of the nursing diagnoses. The Lesotho Nursing Council (LNC) adopted the nursing process over a decade ago and the LNC mandated nurse training institutions and clinical settings to utilise this methodology. However, there is a reluctance to implement the nursing process despite its importance in nursing care (LNC, 2009:7). Purpose: The primary purpose of this research was to explore and describe the perceptions and experiences of nurses in implementing the nursing process in a district public hospital in Lesotho. On the grounds of these findings, the researcher ultimately makes recommendations for nursing education, nursing practice and nursing research. Methodology: To explore and describe the perceptions and experiences of nurses implementing the nursing process in a district public hospital in Lesotho, the researcher chose a qualitative, exploratory, descriptive and contextual research design. The researcher used voluntary purposive sampling to identify participants who complied with the set selection criteria. The sample comprised of professional nurses with varying years of working experience and qualifications. The data was collected by means of narratives and two focus group interviews; n=10 and n=6. The data was captured on a digital audio recorder and was transcribed verbatim. The researcher took field notes during each focus group. Both the researcher and independent co-coder analysed the narratives and transcribed data together, using narrative analysis and open coding (Creswell, 2009:185). Three main themes and nine subthemes emerged from the data collected from the narratives and focus groups. The researcher illustrated these themes through direct quotes by the participants. Each of these themes was discussed accompanied by relevant data obtained from literature, and reduced to conclusive statements, which serve as a basis for the derived recommendations to nursing education, nursing practice and nursing research. Trustworthiness was ensured in accordance with the principles of credibility, transferability, dependability and confirmability. Conclusions: The researcher reached a number of conclusions. The participants perceived several factors and experienced them as interfering with the efficient implementation of the nursing process. Operational difficulties experienced in the systematisation of nursing care in practice, are amongst others a lack of knowledge of the steps involved in the process, an excessive number of tasks assigned to the nursing team, the poor quality of professional education, insufficient reports on the physical examination related to the disease and difficulty to formulate the nursing diagnosis. The research report concluded with the researcher’s evaluation of the research and recommendations for nursing practice, nursing education and nursing research with the purpose of improving the implementation of the nursing process. / MCur, North-West University, Potchefstroom Campus, 2014

This is a qualitative study, the aim of which is to explore the experiences of student nurses regarding the bursary system in KwaZulu Natal. During 2010 nursing education was confronted with restructuring of student nurses from having a supernumerary status to being bursary holders (DOH, 2010:68). This study describes the experiences of changes that have emanated from introduction of the new bursary system. The experiences of students in this new system were explored. These include the legacy of institutional factors and benefits that have now been removed from the students which could hamper students‟ sense of belonging. The research was conducted in an attempt to make a significant contribution to the bursary subsidisers specifically in awareness of what student experiences have been in relation to introduction of the bursary system in KwaZulu Natal (KZN); and also to provide recommendations on how the bursary requirements could possibly be improved to enhance the student academic, clinical and socio-economic needs. A qualitative study design was used and data was collected using focus group interviews. Purposive sampling was used to select participants who represent the target population. The sample used for the study included first-, second- and third- year male and female nursing students who are studying towards the Diploma in Nursing (General, Psychiatric, Community) and Midwifery. A total of seven focus group interviews were conducted until data saturation was achieved. To ensure trustworthiness the principles of credibility, transferability, dependability and confirmability were maintained. A digital voice recorder was utilised to capture all data and data was transcribed verbatim. Data was analysed by the researcher and an independent co-coder. Two (2) main themes and eight (8) sub-themes were identified. The findings indicated that most of the experiences of being in the bursary system as opposed to having supernumerary status has had many effects and has negatively impacted on students‟, socio-economic, psychological, clinical, academic and family demands. A very small amount of students responded positively. Many concerns related to staffing attitudes, shortages and staff demands on the students during clinical practice were highlighted. Conclusions drawn from the study are that the bursary system is not viewed as being of benefit to students as students feel they are not receiving the full complement of benefits from being bursary holders. Furthermore, there is no consideration made to them for support in clinical and academic areas considering the employee hours they have to work. The recommendations indicate that there is a great need to have the bursary system reviewed. The study is concluded with the final recommendations for policy-making, nursing practice, nursing research and nursing education. From this it is hoped that the students‟ needs are identified, resulting in enhancement of their training. / MCur, North-West University, Potchefstroom Campus, 2015

Background: The study described the perspectives and experiences of women and health care providers with regard to use of postnatal care and reasons why some women do not attend postnatal care in order to identify strategies for improving postnatal care services. Methods: An explorative, descriptive, and contextual research design was used. In step one data was collected with semi-structured interviews with seventeen (17) women who attended postnatal care. The second sample consisted of ten (10) women who did not attend postnatal care but brought their babies for well-baby clinic. Focus groups were conducted with midwives who offered postnatal care to women. The midwives of the first focus group worked in the hospital while the second focus group worked at a filter clinic. Results: In step one, some women indicated positive experiences but most women had negative experiences about postnatal care. The positive experiences were related to the satisfaction of the women with good services received and not encountering problems with staff's care. Common concerns mentioned in step one and two about postnatal care were shortage of skilled midwives, need for staff to be trained on postnatal care services, lack of confidentiality, poor infrastructure and non-integration of maternal and child services. Reasons for not attending postnatal care that were mentioned by women in step three were inaccessibility of the health care facilities, poor roads infrastructure, lack of knowledge about postnatal services and socio-cultural factors. Conclusion: Based on the findings, strategies to improve postnatal care were developed: Firstly, the midwives need to be trained on postnatal care and highlighted on current postnatal policies and guidelines. Secondly, woman and baby should attend the postnatal care at the health facility. Thirdly, community health nurses and trained community health workers should visit the women at home soon after birth of the babies. Fourthly, postnatal care should be provided at the family and community level by a trained and skilled midwife during the early postnatal period. Fifthly, combination of care facility and home visit - when the woman and baby are discharged from the hospital, follow- up need to be done at home by the midwife. Lastly, a comprehensive integration of postnatal services with other programmes needs to be enforced and supported by the programme management and policy makers. / MCur, North-West University, Potchefstroom Campus, 2015

The study aimed to explore and describe the experiences of people treated for multidrug resistant tuberculosis (MDR-TB) in Omaheke region, Namibia in order to make relevant recommendations regarding their management. A descriptive qualitative design approach was used. Data was collected using in-depth individual interviews with six participants. The interview transcripts were analysed using thematic content analysis. Three themes emerged namely (1) Stressors related to MDR-TB diagnosis and treatment which involved nature of disease and compulsory hospitalisation (2) Impact of being treated for MDR-TB which related to emotional , social , spiritual and financial impact (3) Support structures for people treated for MDR-TB which included family members, health care professionals and friends. Systemic practical patient-centred, staff-centred and community-centred recommendations are suggested as well as recommendations for future research and an appraisal of the limitations of this study. / Health Studies / M.A. (Public Health)

Bakgrund: Hjärt-kärlsjukdomar är den vanligaste dödsorsaken bland kvinnor i Sverige och drabbar tiotusentals kvinnor årligen. Både män och kvinnor kan drabbas av en hjärtinfarkt, men forskning visar att symtom i den akuta fasen och efterföljande konsekvenser kan skilja mellan kvinnor och män. Syfte: Syftet med litteraturstudien var att belysa kvinnors erfarenheter av att ha drabbats av hjärtinfarkt. Metod: Elva kvalitativa studier har analyserats, kvalitetsgranskats och sammanställts till ett resultat. Resultatet har sammanställts i kategorier och underkategorier. Resultat: Resultatet visar att kvinnor upplever att livet förändras efter en hjärtinfarkt och de måste lära sig att omprioritera vardagen. Stora förändringar sker i familjerollerna och behovet av stöd och information om sjukdomen är stor. Efter en hjärtinfarkt följer livsstilsförändringar för att förhindra ett återinsjuknande, och dessa kan medföra svårigheter för kvinnorna. Att efter en hjärtinfarkt uppleva olika fysiska och psykiska förändringar som fatigue, svaghet och utmattning samt en påtaglig oro över att döden varit så nära och att drabbas av ytterligare en hjärtinfarkt, påverkar kvinnors livskvalitet negativt. Konklusion: Att som kvinna drabbas av en hjärtinfarkt innebär stora livsomställningar. Brist på information leder till oro och ångest samt svårigheter att genomföra livsstilsförändringar. Stöd av familj, vänner och sjuksköterskan är en viktig del i återhämtningsprocessen. En viktig uppgift för sjuksköterskan är att identifiera egenvårdskapaciteten hos patienten och därefter kunna ge ändamålsenligt stöd. / Backround: Cardiovascular disease is the leading cause of death among women in Sweden, affecting tens of thousands of women yearly. Both men and women can be diagnosed with heart attack, but research shows that symptoms in the acute phase and subsequent impact may vary among women and men. Aim: The purpose of this study was to highlight women's experiences of having suffered a heart attack. Method: Eleven qualitative studies have been analyzed, quality reviewed and compiled to a result. The results have been compiled into categories and subcategories. Results: The results show that women feel that life is altered after a heart attack and they must learn to repriotize every-day life. Major changes occur in family roles and the need for support and information about the disease is extensive. After a heart attack follows lifestyle changes to prevent relapse, and these changes may cause difficulties. The fact that after a heart attack live trough a variety of physical and psychological changes such as fatigue, weakness and substantial concern that death was so close and to suffer another heart attack, affects women’s quality of life negatively. Conclusion: As a woman, suffer from a heart attack means major life changes. Lack of information leads to anxiety and difficulties to implement lifestyle changes. The support from family, friends and the nurse is an important part of the recovery process. An important task for the nurse is to identify the patients self-treatment capacity and subsequently be able to implement effective support.

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