Thesis (MPH.) -- University of Limpopo, 2019 / The purpose of this study was to investigate the challenges faced by health care workers caring for patients diagnosed with Tuberculosis at Tertiary 1 Military Hospital, Gauteng Province, South Africa. The quantitative research study was conducted and data was collected from 56 respondents who participated in this study conducted at Tertiary 1 Military Hospital, Gauteng Province, South Africa. Self-administered questionnaires were used to collect data from the respondents through a self-administered questionnaire. Data was then analysed using statistical STATISTICA 7, Software SPSS 23, as well as Microsoft Excel for presentation of tables and graphs. Respondents consisted of 59% females, compared to 41% of males. Majority of respondents (76.4%) were between the ages of 23-32. Respondents who were single were 66% compared to 32.1% married and 1.8% widowed. The findings of this study indicates that the health care workers, work in challenging environment with a lack of resources and need to be supported, as they experience more negative than positive experiences whilst caring for patients diagnosed with TB, further, revealed that, the health care workers did not get support from management. The analysis of the data has shown that management seemed not to understand fully what health care workers at grass-roots level are experiencing. Furthermore, findings of this research revealed that health care workers have never received any formal training on management of patients diagnosed with TB, wherein at times they have questions they have to ask their colleagues/friends, which at times they felt frustrated, the findings of this study furthermore revealed the lack of in-service training. The study concluded that, the respondents fears contracting TB from patients diagnosed of TB: there is compromised TB infection control measures, such as failure to wear protective masks (N95), and lack of adequate resources was also revealed by several respondents. The general findings of this research demonstrate that there should be adequate resources allocated to healthcare workers caring for TB, there should also be an initiatives to establish the health care worker‟s training regarding TB management and regular in-service training especially on TB management. This was also demonstrated in the study conducted by Chung et al, 2005, on the experiences of nurses while caring for Severe Acute Respiratory Syndrome (SARS) patients, the findings revealed a variety of emotions that were experienced, whereby, health care workers considered themselves vulnerable and at risk of contracting the disease themselves especially airborne diseases.

Thesis (MPH.) -- University of Limpopo, 2017. / Background: Ante natal care (ANC) service is a very important intervention to track the progress and to identify complications that might arise during pregnancy. The first ANC visit at a health facility is even more important as health providers are able to identify whether there are any risks to the mother and the unborn child and it should be initiated at the 1st trimester of pregnancy. Objectives: The study aim was to establish the knowledge and perceptions about ANC services among pregnant women in the Julesburg Local Area in the Mopani District of Limpopo Province. Methods: A quantitative cross-sectional research approach was used at six primary health care facilities in the Julesburg Local Area of the Mopani District in Limpopo Province. Stratified random sampling was used. Data were collected from 293 pregnant women using a self-administered questionnaire. . Data analysis was done using the International Business Management Statistical Package for Social Sciences 23 (SPSS 23). Results: The results reveal that a high percentage of pregnant women have adequate knowledge with regard to ANC services. The results further show that knowledge level of pregnant women has no association with educational level (P=0.488). With regard to perception, half of the respondents have positive perceptions of ANC services, while a further half have negative perceptions of these services. Conclusion: ANC service is of great importance to further reduce maternal and neonatal deaths as most of these deaths are avoidable. There is a need to strengthen the training programme of staff by providing further training exposure and health information to pregnant women with regard to the important of early ANC initiation and frequency of ANC visit need to be intensified. Keywords: Health care workers, antenatal care, knowledge, perception, initiation, utilization.

Violence and threats of violence is described as a common and relevant issue in various care units. Mental health care workers often feel frustrated and unsatisfied in their work with mentally ill patients. Experienced mental health care workers find that learning how to treat and cope with violent patients is beneficial. The aim of this study was to gain knowledge and understanding of mental health care workers experiences and perspectives on workplace violence. The method used was qualitative semi-structured interviews with mental health care workers ofdifferent care facilities. The results found that the patients’ illness appear to be the source of the violence. The environment can also be a source of violence. Violence was common in caring situations, particularly when mental health careworkers were physically close to their patients. The mental health care workers experienced feelings of anger, humiliation, remorse, and helplessness. The participants expressed that they questioned their own abilities and at times believed that their ability to communicate with patients and relax them was inadequate. Colleagues, relatives, and friends were perceived to be the most supportive, and the most common way of coping with violence in the workplace. Furthermore, the conclusion of the study is that the environment must be adjusted to meet the needs of the mental health care workers in meetings with threatful and violent patients. Mental health care workers need education and guidance on how to proceed as well as encouragement to report violent incidents.

Bakgrund: En god munhälsa är av stor vikt för att uppehålla en adekvat näringstillförsel samt förebyggandet av eventuella sjukdomar till följd av förändringar i munnen. Patienten kan eventuellt drabbas av smärta, parodontit, påverkan av smak och aptit samt sjukdomar som exempelvis lunginflammation om munhälsan bortses av vårdpersonal. Syfte: Syftet är att beskriva vårdpersonals attityd till och kunskap om munhälsa vid den kirurgiska akutvårdsavdelningen (KAVA) i Skaraborgs sjukhus Skövde. Metod - En enkätstudie med mixad metod. Resultat: I resultatet framkom tidsbrist, ansvarsfördelning, möjligheten att med klinisk blick bedöma en patients munhälsa samt aspekten om resursfördelning. Konklusion - Studien visar att kunskap om tidsbrist, ansvarsfördelning och material kan generera en bättre munvård för KAVAS patienter. / Background: A good health of the mouth is essential for nutrition status and the prevention of possible diseases due to changes in the mouth. The patient can suffer pain, periodontitis, change of taste and appetite, and pneumonia if the health care workers neglect mouth care. Aim: This study investigates the attitudes and knowledge of the health care workers at the emergency surgical ward (KAVA) at Skaraborg hospital. Method: a mixed-method survey study. Result: In the result, the findings of lack of time, division of responsibilities, the nurse's clinical eye to assess a patient's mouth status, and the allocation of resources. Conclusion: The study shows that knowledge about lack of time, division of responsibilities, and the knowledge about materials can generate better mouth care for the patients of KAVA.

The South African National Development Plan (NDP) (National Planning Commission, 2011, p. 1) provides the road map for a reformed public health system by 2030. The proposed health system will be facilitated by, amongst others, training an appropriate balance of healthcare professional s including a cadre of community health workers (CHWs) that have a broad skills mix suited to reaching a larger number of people with first level intervention. With this in mind, a pilot group of CHWs were up-skilled as Rehabilitation Care Worker s (RCWs). The training program was a joint project between the Division of Disability Studies and the Departments of Occupational Therapy, Physiotherapy and Speech and Language Therapy at UCT. Problem: Little is known about the perspectives of RCWs on the benefits and challenges of additional training in rehabilitation and disability related skills. Rationale: To inform the curriculum for a rehabilitation care worker (RCW) training program and the Western Cape Department of Health (WCDoH) of ways in which this cadre of worker could contribute to the realization of the 2030 Healthcare Plan. Aim: To describe the outcomes of a pilot RCW training program from the perspective of the pilot group of graduates. The objectives were to identify the areas of practice where RCWs feel competent/incompetent, to identify aspects of the health services where RCWs believe they can contribute the most/the least and to identify the facilitators/barriers they experienced when deployed in the health field. Methodology: A qualitative descriptive study was conducted. Method: Focus groups were carried out with three groups of six participants. Findings: The plot that permeated the participants’ perspectives revolved around how the RCWs were pioneers in breaking new ground for the Western Cape Department of Health (WCDoH). Two themes informed the plot: "we move health services to a new level" and "we manage change in new ways". Discussion: It is argued that the pilot RCW curriculum achieved its’ objective of equipping a cadre of worker with basic rehabilitation, care and disability inclusion skills. While the envisaged role of RCWs in the health service and in making the NDP a reality is supported, it is argued that attention needs to be given to supervision structures and to training of all other health workers in order to promote inter professional practice. Conclusions: The pilot group of RCWs believe that they have acquired a new and large variety of skills that have enabled them to make a broad and positive impact in their places of work, at home and in the broader community.

The purpose of the study is to contribute to the development of a tool that can support the rehabilitation care worker towards intervention planning and the monitoring of their clients. The National Health Insurance and the Framework and Strategy for Disability and Rehabilitation of the South African Department of Health are strategies to work towards accessible, affordable, equitable and quality health care, which includes health promotion, disease prevention, curative, rehabilitation and palliative services for all South Africans. Both strategies emphasise the use of community health workers and mid-level workers as a key component of primary health care. In the Western Cape provincial Department of Health a new cadre, namely the rehabilitation care worker has been introduced as a member of the rehabilitation team. The introduction of the rehabilitation care worker is still in the pilot phase. The rehabilitation care workers face many barriers to providing effective care. One such challenge is the lack of a contextually relevant resource tool to collect information on the rehabilitation and health needs of persons with disabilities. The aim of the study was to develop a contextually relevant resource tool that would support the rehabilitation care worker in understanding and documenting how the rehabilitation and related health needs of persons with disabilities are met in home- and community-based settings. Three specific objectives were defined: i) to develop the content and domains of the rehabilitation and health information tool; ii) to establish the validity (face and content) of the rehabilitation and health information tool; and, iii) to test the application of the rehabilitation and health information tool on a sample of persons with disabilities. This study was an exploratory descriptive study adopting a sequential mixed methods design. There were two phases in this study. Phase 1 involved qualitative research methods in the development of the rehabilitation and health information tool through the use of document review and a focus group discussion with experts. Phase 2 of the study involved quantitative research methods in the field testing of the rehabilitation and health information tool by the rehabilitation care workers on a sample of persons with disabilities. The results of phase 1 included the development of the rehabilitation and health information tool, which was deemed by the experts to be a comprehensive, contextually relevant tool with face and content validity and could be easily administered by the rehabilitation care worker. The conceptual framework of the International Classification of Functioning, Disability and Health provided domains that could comprehensively document the multidimensional needs of persons with disabilities. The result was a draft rehabilitation and health information tool with 17 questions ranging across the domains of activities of daily living, sexual health, health behaviours, barriers and facilitators to good health, finance and understanding of disability. Changes were proposed to the wording, layout and flow of the tool and the persons with disabilities’ goals were included as an element . The inclusion of the end users as experts in the development resulted in a richer understanding needed for the shaping of this tool. The results of phase 2 highlighted that the rehabilitation and health information tool was able to describe the rehabilitation and health needs of persons with disabilities. Additionally the tool was able to document the specific goals of the persons with disabilities which is useful to plan and monitor intervention. The rehabilitation care workers reported the tool to be useful, easy to use, and provided a structured manner to collect information. They also reported that it was useful in stimulating conversations on sensitive topics. However, it was indicated that it took too long to complete and there were components that were incomplete. The rehabilitation and health information tool requires further refinement, validation and further follow-up testing before it can be formally adopted and implemented as part of the rehabilitation care worker’s standard practice.

Bakgrund:Humor har positiva effekter på människors fysiska och psykiska hälsa. Humor är individuellt och är ett sätt för människor att kommunicera. Ett av sjuksköterskans viktigaste verktyg i mötet med patienter är kommunikation. I vårdrelationen använder vårdpersonal erfarenhet och kunskap för att skapa en god grund för vårdandet. Syfte:Syftet var att belysa humorns betydelse för vårdrelationen mellan vuxna patienter och vårdpersonal. Metod:Metoden som användes var allmän litteraturöversikt. Litteratursökningen gjordes i databaserna MEDLINE och CINAHL. Tio vetenskapliga artiklar granskades och analyserades. Artiklarna analyserades genom att författarna läste dem individuellt och gemensamt. Likheter och skillnader identifierades för att sedan sammanställas i olika teman. Resultat:Resultatet visade att humor används av både vårdpersonal och patienter. Humor kunde användas som ett sätt att stärka vårdrelationen både av patienter och vårdpersonal, men när humor användes på fel sätt kunde det leda till negativa konsekvenser för vårdrelationen. Då humor är individuellt och används för att påvisa identitet så skapades spänningar i vårdrelationen när patientinitierad humor inte blev uppmärksammad. I resultatet framkom även könsskillnader i användningen av humor. Diskussion:Resultatet diskuterades utifrån tidigare forskning samt Joyce Travelbees teori Interpersonal aspects of nursing. Resultatdiskussionen belyste konsekvenser av obesvarad patientinitierad humor, humor som maktfaktor samt professionellt förhållningsätt till humor. / Background:Humor have positive effects on humans physical and mental health. Humor is individual and is a way for humans to communicate. One of nurse´s most important tool in meetings with patients is communication. In the care relationship, care workers use experience and knowledge to create a good foundation for care. Aim:The aim was to illustrate the meaning of humor in the care relation between adult patients and care workers. Method:The method was a general literature review. The literature search was conducted in the databases MEDLINE and CINAHL. Ten scientific articles were reviewed and analyzed. The articles were analyzed by the authors by reading the articles individually and jointly. Similarities and differences were identified and then compiled into different themes. Results:The result showed that humor is used by both care workers and patients. Humor could be used as a way to strengthen the care relationship both by patients and care workers, but when humor is used incorrectly it could lead to negative consequences for the care relationship. Since humor is individual and used to demonstrate identity, tension was created in the care relationship when patient-initiated humor was not noticed. The result also revealed gender differences in the use of humor. Discussion:The result was discussed based on previous research, as well as Joyce Travelbee’s theory Interpersonal aspects of nursing. The result discussion highlighted the consequences of unanswered patient-initiated humor, humor as a power factor and professional approach to humor.

This case study investigated the quality of supervisor- employee communication and its impact on employee job satisfaction, self-esteem and trust, as well as the link to program quality in a center-based childcare setting. Three research questions guided the study with the purpose of examining communication as a means to improve job satisfaction, diminish staff turnover and strengthen program quality. Fifteen employees from a non-profit childcare center in San Joaquin County volunteered for the study. Data was collected from face to face and telephone interviews. Transcripts of the interviews revealed three themes- feedback, active listening and supervisor support. Responses were coded and categorized by theme, and then each theme was sorted into high quality supervisor communication responses and low quality supervisor communication responses. High quality supervisor communication was characterized by frequent and constructive feedback, self-motivation, openness and freedom to speak. The results of the study indicated high quality supervisor communication increased job satisfaction. Low quality supervisor communication was characterized by minimal feedback, the perception of favoritism, interference of work routine, low morale and increased absenteeism. The study found low quality supervisor communication hindered job satisfaction. The results of the study indicated that high quality communication between supervisor and employee had a positive impact on job performance, job satisfaction and organizational outcomes. Feedback, active listening and support were important communication behaviors sustaining job satisfaction. Passion for children proved to be intrinsic motivation to enhance program quality. Suggestions for developing program quality are provided.

This study examined the relationship between subordinates perception of the quality of leader-member exchange (LMX) relationship, dyadic demographic factors and turnover intent in rehabilitation agencies. The sample consisted of 152 direct care employees that work with individuals with disabilities at rehabilitation organizations in the state of Illinois. In particular, the focus was on determining the best fit model that predicts turnover intent among quality of LMX, dyadic age, gender, educational level, ethnicity and duration and their two-way interactions with LMX. Participants were asked to complete the team Leader-Member Exchange scale (LMX-SLX), Turnover Intent Scale (TIS) and a demographic questionnaire. Results of the regression analysis showed that LMX significantly predicted turnover intent, β = -.272, t=-3.298, Sig. F Change = .001. None (dyadic educational level, β = -.146; dyadic ethnicity, β = .068; dyadic gender, β = .100; dyadic duration, β = -.076) of the demographic factors except dyadic age, significantly predicted turnover intent (Sig. F Change = .112). Dyadic age, β = .258, t= 2.502, p= .014 was a significant predictor, although the overall model was not significant. All (dyadic educational level_LMX, β = -.60; dyadic ethnicity_LMX, β = .037; dyadic gender_LMX, β = -.130; dyadic age_LMX, β = .071; dyadic duration_LMX, β = .071), of the interactions significantly predicted turnover intent, although the overall model was not significant. In addition, implications, limitations and delimitation, and recommendations for future research are discussed.

The project aimed to understand how collaboration during the planning of work among care workers at an elderly care home can be supported with a digital tool. This topic is essential, especially considering Sweden's e-Health Vision 2025 to become a global leader in implementing welfare technologies. With rapid technological changes, it is crucial to understand the experiences and perspectives of the individuals using these technologies. The project conducted a literature review, user research, and user testing with care workers in Lund municipality established in design criteria. The design proposals focused on utilizing Welfare Technology to foster collaboration and were evaluated through a prototype created in Figma. Four design proposals were formulated as a result of the project: a large shared viewing screen, enhanced task information and clarity, task ownership, and providing an overview.