Counselor educators are continually improving the quality of their training programs. The purpose of the present study was to investigate counseling students’ practicum experiences and development in community-based and department-based settings. The framework for this study was based on Stoltenberg’s integrated developmental model, which describes stages of counselor development and supervision conditions needed for a learning environment (Stoltenberg & Delworth, 1987; Stoltenberg & McNeill, 2010; Stoltenberg, McNeill, & Delworth, 1998) A nation-wide study was conducted utilizing counselor education practicum students enrolled in programs listed in the CACREP program directory (2008) and Counselor Preparation: Programs, Faculty, Trends (12th ed.; Schweiger, Henderson, Clawson, Collins, & Nuckolls, 2008), and subscribed to three listserves COUNSGRAD, CESNET, and COUNSLINK. A total of 435 responses were collected electronically with a completion rate of 70% (N = 305). The Demographic and Experience Questionnaire and the Supervision Level Questionnaire Revised (SLQ-R) were used. The results of this study indicated that practicum students’ experiences differed in community-based versus department-based settings. Students in department-based settings reported their settings were more structured than did students in community-based settings. Students who rated their settings as more structured also reported they were more satisfied with the amount of structure. Direct supervision modalities were utilized more often in department-based settings than in community-based settings. Students in community-based settings were supervised by licensed professional counselors, licensed professional counselor – supervisors, and licensed clinical social workers. Students in department-based settings were supervised by counseling professors, licensed professional counselors, licensed professional counselor – supervisors, and counseling doctoral students. Despite the differences in structure, supervision modalities, and supervisors, practicum students reported similar experiences in client population types and client issues. Additionally, no differences were found in counseling practicum students’ SLQ-R scores in community-based versus department-based settings, and no differences in students’ SLQ-R scores were found in direct supervision in comparison to indirect supervision. The number of supervision modalities used in practicum settings was not related to students’ SLQ-R scores. Significant relationships were found in two of the sub-scales on the SLQ-R: self and others awareness and autonomy with practicum students’ number of credit hours completed.

published_or_final_version / Medical Sciences / Master / Master of Medical Sciences

The purpose of the study was to explore and describe the professional nurse's perception of working in remote rural clinics in Limpopo Province. The research design was qualitative, exploratory, descriptive and contextual. The research population was the professional nurses working in remote rural clinics in Limpopo Province. Purposive sampling was used and data collected by means of tape-recorded in-depth semi-structured individual interviews. The study revealed that the professional nurses perceived working in the remote rural clinics both positively and negatively and had concerns. / Health Studies / M.A. (Health Studies)

The ability to monitor client change in psychotherapy over time is vital to quality assurance in service delivery as well as the continuing improvement of psychotherapy research. Unfortunately, there is not currently a comprehensive, affordable, and easily utilized outcome measure for psychotherapy specifically normed and standardized for use in psychology training clinics. The current study took the first steps in creating such an outcome measure. Following development of an item bank, factor analysis and item-response theory analyses were applied to data gathered from a stratified sample of university (n = 101) and community (n = 261) participants. The factor structure did not support a phase model conceptualization, but did reveal a structure consistent with the theoretical framework of the research domain criteria (RDoC). Suggestions for next steps in the measure development process are provided and implications discussed.

For many years the officials of the College of the Pacific and the Chairman of the Speech Department have expressed a desire to review the growth and development of the Speech and Hearing Clinic since its inception in the summer of 1937. Statement of the Problem: The purpose of this study is to ascertain the factors concerned with the growth and development of the College of the Pacific Speech and Hearing Clinic. Importance of the study: To present to the College of the Pacific Speech Department a compilation concerning the growth and development of the Speech and Hearing Clinic so that past operations may be evaluated and plans for the future formulated.

This study is about the exploration of the concept of community, using the Mamelodi Counselling Clinic as the context for the exploration. The members who got involved in different phases in the running of the clinic, went through the process of defining and redefining the concept. This process was based on their experiences and their coevolved reality of what the concept means. These experiences will be discussed and in the end, a punctuated end product of the coevolved meanings will given. Furthermore, an account will be given as to how the running of the clinic evolved with the changes in meaning. The author's perception of the division between clinical and community psychology was altered as a result of the findings in the study and this will also be discussed. / Psychology / M.A. (Clinical Psychology)

Thesis (M.Tech.:Chiropractic)-Dept. of Chiropractic, Durban Institute of Technology, 2006 x, 65 leaves, Annexures A-H / Patient satisfaction is an important, desired measure of quality of care and has a significant influence on the perceived quality of care and outcome of treatment, and for this reason, it holds great value to the treating clinician. Satisfied patients are more likely to comply with treatment instructions and advice, remain with their service provider and refer others. Dissatisfaction, in the event of an unfavourable outcome, can result in legal action and complaints to regulatory bodies. Studies have indicated a high level of satisfaction with chiropractic care; however, none have been in a student clinic setting even in view of the suggested importance in the literature. In view of this significance and lack of understanding of the patients’ satisfaction / dissatisfaction in the history of DIT’s clinic operation the question remains as to what extent the students at the DIT Chiropractic Day Clinic satisfy their patients. This study evaluated the patient satisfaction at the DIT Chiropractic Day Clinic in order to establish a baseline for future comparison. Cronbach’s alpha scores were used to determine questionnaire reliability in a South African student context.

Submitted in fulfilment of the requirements for D.Tech: Nursing in the Faculty of Health Sciences, Durban University of Technology, 2009. / BACKGROUND In South Africa, Integration of Services Policy was enacted in 1996 with the aim of increasing health service utilization by increasing the accessibility of all services at Primary Health Care (PHC) level. However, the problem with the policy arises in the implementation of integrated PHC (IPHC) as there is no agreed upon understanding of what this phenomenon means in the South African context. Hence, there is a need for shared views on this phenomenon. METHODS A cross-sectional study, using a qualitative approach was employed in this study in order to analyze IPHC in KwaZulu-Natal (KZN). A grounded theory approach was selected as it is a method known for its ability to make the greatest contribution in areas where little research has been done and when new viewpoints are needed to describe the familiar phenomenon that is not clearly understood. Policy makers and co-ordinators of PHC at national, provincial and district levels as well as PHC nurses at functional level participated in the study. The data was collected by means of observations and interviews. The sample size for interviews was comprised of 38 participants. RESULTS It emerged that there were three core categories that were used by the participants as discriminatory dimensions of IPHC in South Africa. These core categories were (a) comprehensive health care, (b) supermarket approach and (c) one stop shop. Based on the findings of the study, it was concluded that the phenomenon, IPHC meant different things in different contexts. / Durban University of Technology, Research Post Grad Development and Support Departments

Submitted in partial compliance with the requirements for a Master Degree in Technology: Chiropractic at the Durban University of Technology, 2009. / Background: Research has indicated the majority of bacteria on chiropractic adjustment beds (beds), can persist on dry inanimate surfaces for months. Thus, insufficient disinfection procedures create continuous sources of pathogens endangering patients and healthcare workers alike. This research study aimed to assess the beds as reservoirs for micro-organisms, at a chiropractic teaching clinic (clinic) in South Africa. Method: A selection of samples obtained from the headrests and armrests of the beds were serially diluted, plated in duplicate (using the spread plate technique) and incubated for 24-48 hours at 37°C. After inspection for the presence of micro-organisms, those present were enumerated to determine their quantities, the microbial build-up throughout the day, as well as the degree of the transmission from the patients to the beds during treatment. The incidence of the micro-organisms was established, along with their identities, using microscopic and macroscopic characteristics. These micro-organisms were also used to assess the efficacy of the disinfectant currently in use by the clinic. Results: Microbial growth was present on 89.4% of the beds sampled. The quantities of the micro-organisms increased significantly (p=0,027) from 7:30 am to 16:30 pm, with the median increasing from 25 colony forming units (cfu) / cm2 to 714 792 cfu/ cm2. The microbial build-up was highly significant (p<0.001), with a median of 346 cfu/ cm2 at 7:30 am and 10:30 am; increasing to 162 291 cfu/ cm2 by 13:30 pm and 250 million cfu/ cm2 by 16:30 pm. There was also a significant increase (p<0.001) in the quantity of micro-organisms during treatment with a median of 0 cfu/ cm2 before treatment that rose to 23 479 cfu/cm2 after treatment, indicating that the micro-organisms present on the beds were being deposited by the patient`s skin during the treatment. The most prevalent micro-organisms identified were Staphylococci and Serratia, with an average of 59% and 40% of colonies; while Micrococci and Bacilli were relatively uncommon. No growth was evident after 5 minutes of exposure to the disinfectant during the growth inhibition test. For the Kirby Bauer test, the average size of the zone of inhibition increased as the dilution decreased. The disinfectant is effective but more so against the Gram-positive than the Gram-negative bacteria. The disinfectant was 5,0, 5,5 and 5,6 times more effective than phenol in eradicating Staphylococci, Serratia and Bacilli, respectively. Conclusions and Recommendations: This study showed that micro-organisms were present on the beds. Staphylococci and Serratia have been implicated in many healthcare associated infections. The present disinfectant is effective, but should be used in between every patient. A different or additional disinfectant that is more effective against the Gram-negative bacteria should be considered for future use.

Dissertation submitted in partial compliance with the requirements of the Master's Degree in Technology: Homoeopathy, Durban University of Technology, 2010. / In collaboration with Lifeline, Durban University of Technology (DUT) established its first satellite homoeopathic community clinic; Ukuba Nesibindi Homoeopathic Clinic (UNHC). UNHC provides a free homoeopathic primary healthcare service on the third floor of the LifeLine building in Warwick junction, Durban, an area which is classified as being disadvantaged with high crime rates, prostitution, violence, small, informal business and low cost housing. The clinic is run by 4th and 5th year homoeopathic students under the supervision of a qualified homoeopathic practitioner and funded totally by the Department of Homoeopathy – DUT. The purpose of this retrospective clinical audit of UNHC was to determine a patient demographic and disease prevalence profile, as well as identify and describe the major medicines prescribed. Methodology The study used a retrospective, explanatory, and descriptive design method by means of a clinical audit, to determine a patient demographic and disease prevalence profile, as well as identify and describe the various homoeopathic treatment modalities. All the patient files from June 2004 – June 2008 were included for analysis and the data collection spreadsheet (Appendix D) was compiled respectively. IV The data collection form was divided into patient demographics, information on number of consultations and follow-ups, clinical diagnoses, urine dipstick analysis, patient referral information and medicines prescribed. The researcher captured the data, which was analysed and various means of descriptive statistics applied using Excel from Microsoft Office® 2007. Results UNHC opened in 2004 and initially only operated two afternoons per week; in order to cope with the demand for this service which grew rapidly in 2006 an additional consultation afternoon was added. A total number of 862 patients were seen between June 2004 and June 2008, 497 being new patients and 365 being follow up patients. On average 56% of patients came back for more than one follow up consultation during the study period. The majority of patients who attended UNHC during the study period were African females between 40 and 64 years of age who were unemployed and single. Of the 5 most prevalent systemic disorders encountered at UNHC infectious disorders were the most frequent along with cardiovascular, dermatological, psychological and musculoskeletal disorders. Conclusion The significant increase in patient numbers at UNHC and the relatively high percentage of patients who returned for more than one follow up consultation are positive trends and suggestive of UNHC’s success in providing homoeopathic primary healthcare as well as the positive impact it has had on the surrounding community. With additional funding UNHC can improve service provision further; dedicated translators as well as various equipment to facilitate administration will streamline the consultation process significantly and allow for more patients to be seen. Expansion of the scope of diagnostic services provided such as pregnancy and glucose testing will reduce the need for referral for such basic services. V Future studies should formally measure patient benefit in response to treatment in the form of a patient benefit survey; qualitative measures of patient satisfaction with the service provided by UNHC are also warranted.