The role of the community pharmacist has changed over the past two decades. The traditional specialist roles of pharmacists, such as compounding and preparation of medications, are now infrequent activities and the profession has moved to a more patient-centred focus. Furthermore, pharmaceutical care has been developed and adopted as a practice philosophy to add value and bring care for patients back into the profession. However, there is still much debate in academic and policy literature concerning the reluctance of community pharmacists to adopt and implement pharmaceutical care in practice environments. Empirical evidence has suggested that the professional identity of pharmacists is both ambiguous and multifaceted. However, the practice of pharmaceutical care has been demonstrated to increase organisational identity of pharmacists, as well as their job satisfaction. In addition, pharmacists in a clinical role have been shown to have higher levels of job satisfaction than their counterparts in nonclinical roles. This study has identified, described and analysed the self-perceived professional identities of community pharmacists within a South African context. Furthermore, it sought to determine their current levels of job satisfaction. The relationships between professional identity, job satisfaction and role were analysed in an attempt to understand the influence of professional identity on job satisfaction and behaviour of pharmacists. This study made use of a mixed method of inquiry, online questionnaire, administered to a large sample, which allowed the researcher to take a broad view of the research foci at a specific moment in time. This study found the existence of six professional identities amongst South African Community Pharmacists; namely the practitioner, the jaded pharmacist, the social carer, the professional, the medicine supplier and the entrepreneur. South African community pharmacists were, generally, satisfied with their jobs, professed to practice pharmaceutical care and adopted it as a practice philosophy. South African Community pharmacists were, in general, committed to their profession. Correlation between a pharmacist’s professional identity and their job title, job satisfaction and their commitment were found to be statistically significant. A pharmacist’s level of job satisfaction was statistically correlated to their practice of pharmaceutical care. No statistically significant relationship was found to exist between a pharmacist’s identity and their work load or tasks performed. Characterising South African community pharmacists’ identities is of great significance in an effort to better understand the forces that drive our profession of pharmacy. In doing so, have found that identity affects many elements of work life such as job satisfaction, professional commitment and the practice of patient care.

Submitted in fulfillment of the requirements for the Degree of Master of Health Sciences: Nursing, Duban University of Technology, Durban, South Africa, 2018. / Introduction: The shortage of skilled health professionals in public health care facilities is the main reason why compulsory community service was started by the South African government. The change in the disease pattern over the past two decades coupled with the mass exodus of health care professionals to overseas countries resulted in severe staff shortages especially in rural areas. Nursing community service practitioners (NCSPs) lack experience in dealing with complex clinical problems especially at primary health care level. They need experienced health professionals to offer clinical support to them. Aim of study: The aim of the study was to establish the degree of clinical support that is offered to NCSPs who are placed for compulsory community service within the Ugu district. Methodology: A qualitative study was conducted using an exploratory­ descriptive design. Purposive sampling was utilized to select eight NCSPs from a regional hospital and a community health centre. Semi-structured interviews were conducted and data was recorded verbatim for accurate analysis. Content analysis of data was employed where data was analyzed into meaningful themes. Results: The study revealed gaps in the clinical support offered to NCSPs. Lack of clinical support was reported more in the hospital than at the community health centre.·organizational problems such as lack of orientation, absence of in-service education and lack of proper rotation to different departments were some of the main concerns that were reported. Conclusion: Nursing community service practitioners need clinical support from experienced health professional to guide and teach them until they develop confidence. / M

D.Cur. / A qualitative approach was followed to conduct a case study. Data was collected through participative observation, document analysis and interviewing of team members representing seven different disciplines. The practice model of Dickoff, James and Wiedenbach (1986:415-435) was utilized as theoretical framework to explore and describe the role players involved in team functioning within the context of primary health care. Team objectives and processes relevant to team functioning as well as the dynamics of team work were described and compared to a guide for team functioning, the elements which were derived from a literature study. The credibility of the research was enhanced through long term involvement in the activities of the study case as participative observer, through triangulation of methods to collect and verify data and through peer evaluation and auditing. It was determined that within the context of a home care service at primary health care level, it was mainly the nurse, being the team member with whom the patient and family have continued personal contact, who acts as team leader and initiates involvement of members from other disciplines. The decisions regarding whom to involve and how and when to involve them, are based on the knowledge and skills of the nurse in relation to the situation he/she has to manage, the acceptability of the team approach and compliance by the patient and family, the attitude, commitment and perception of other team members as well as the availability of facilities and infrastructure to enable team functioning. The organizational and philosophical framework within which service is delivered have a direct impact on team functioning. Community involvement and its acceptance of responsibility for health, enhances quality team functioning, but is dependant on effective empowerment strategies, a sound trust relationship and a reliable support system. Clear and agreed upon goals and objectives for team functioning are essential for effective team work. Innovative and creative strategies are necessary to enable team members representing different disciplines, who function in the context of primary health care, to have sufficient contact with each other to discuss objectives, give feedback and communicate effectively. Processes for and dynamics in team functioning are complex in nature and need to be identified, evaluated and, if necessary, adapted on a regular basis to promote effective team functioning. The objectives of the research, namely to explore and describe team functioning at primary health care level and to formulate guidelines for effective team functioning, were realized. A structure for working from the basis of a core team was proposed, as well as interdisciplinary training of team members, commencing at undergraduate level and continuing throughout professional life. The researcher recommends that the guidelines formulated with regard to the role players, context, objectives, processes and dynamics of team functioning at primary health care level be implemented. Aspects related to team functioning to be further researched have been identified, namely: assessing the quality of team functioning at primary health care level; the effect of interdisciplinary training on team functioning; the relationship between team functioning and the health status of communities; cost-efficiency of team functioning; utilizing latest technological developments for communication between and support for team members at primary health care level; the relationship between community empowerment, community involvement and interdisciplinary team functioning and the design of a model for team functioning at primary health care level. The research report is written in Afrikaans, but the conclusions reached in each of the nine chapters have also been translated into English to enhance the accessibility of research findings.

M.Cur. / Health Education is an important component of health promotion, which is concerned, with the health status of both the individual and the community. Health education takes place daily and is planned by the health worker and the patient in order to enable the latter to willingly make independent informed decisions about health and to practice these of her own choice. If the health workers provides the patient with information and knowledge concerning health and illness management and this information is not compatible with her cultural background, the health worker will not succeed in enabling the patient to make informed choices, as the information is not congruent with the prevailing cultural milieu. In order to provide culture-congruent health information, specific attention must be given to the planning of the patient's communicated needs. Both the health worker and the patient approach the education process from their own cultural context. The health worker's central focus must be the cultural context of the patient. The aim of this study is to determine to what extent health education given by final year B. Cur students on the Phelophepa train is culture-congruent. Health education sessions are evaluated. Health education is evaluated for culture congruence and as a result of the findings guidelines for culture congruent health education is described. For the purposes of this study, use was made of a exploratory, descriptive and contextual design. Health education was explored on videotapes and evaluated by means of naive sketches by expert evaluators. These results were compared with the literature and as a result of this, guidelines for culture-congruent health education in community nursing were developed.

M.Cur. / One of the most important qualities of the primary health care nurse is to possess the necessary psychomotor , cognitive, affective and specific managerial skills to enable her to perform her diagnostic, therapeutic and interpersonal activities. These skills enable the primary health care nurse to provide quality care through physical examination, prescribing and storing drugs and keeping the necessary written records and statistics. The White Paper on Transformation of Health Care Services recommends that . the Department of Health trains primary health care personnel according to the appropriate level of care. Primary health care nurses fall under the categories of health care providers that are regarded by the department of health as a training pnonty. This training also needs to be coordinated and, if necessary, rationalised. Particular emphasis should be placed on training personnel for rendering effective primary health care. If the curriculum for the training of primary health care nurses is to be reviewed successfully, it should reflect community needs more accurately and the teaching should place more emphasis on community-and outcome-based programmes. This research was undertaken to explore and describe the perceptions held about health assessment, treatment and care programmes by primary health care nurses ·to assist those involved in the provision of health care to render quality care. The aim of this study was to explore and describe whether primary health care nurses are equipped with the skills they require in health assessment, treatment and care. The researcher used an exploratory, descriptive and contextual, design to do this. The data was obtained through focus group interviews with community nurses in the first phase, and with patients in the second phase of data collection respectively. In the. third phase, guidelines were compiled from the data obtained in phases one and two to outline how primary health care nurses should function in health assessment, treatment and care of their patients. The results of this research show that the community nurses and patients perceive primary health care nurses to be skilful in psychomotor, cognitive and attitude aspects.

Crime in South Africa is currently a high priority topic discussed by politicians, professionals and the general public since violence has become part of everyday life. Trauma has become a fact of life. When trauma hits, it is usually sudden and unexpected. Traumatic events could include acts of human cruelty, a car or plane crash, an untimely death or natural disasters like a tornado or a flood. A traumatic incident abruptly rips a person out of their comfort zone and thrusts that person into the depths of loss and despair. Unfortunately many people live their lives under the shadows of trauma. Trauma does not have to be a life sentence, it can be healed, through intensive counselling (as the researcher experienced at the trauma centre where she is affiliated). There are individuals who are thankful that they have survived their traumatic experience. These individuals would often like to help and support others who have gone through similar experiences. These individuals are often linked to a centre or organisation that renders a service to a victim with the aim of empowering and equipping him/her if he/she was exposed to a similar situation. It was the willingness of these individuals to help and the researcher’s involvement at a trauma centre that motivated her to undertake this research study. The researcher became aware, in her everyday contact with these willing individuals who wanted to help others who were traumatised through crime, how important it was that these people should be recruited, screened and trained. These “volunteers” should be under the supervision of a manager of a victim empowerment programme. Therefore, the focus of this research study was on the volunteer who renders a service to the traumatised victim of crime. The primary goal of this study was to evaluate the impact of service rendering within the victim empowerment programmes on the victim of crime, with the emphasis on the role of the volunteer. To achieve this goal the researcher established the following objectives: • To explore the literature with regard to stress, crisis and trauma, with specific reference to the definitions of stress, crisis and trauma, as well as their related signs and symptoms, as specifically related to victims of crime • To discuss victim empowerment services in South Africa, with specific reference to Gauteng • To explore the available literature with regard to the recruiting, screening, training and supervision of volunteers in general, but with specific reference to volunteers who render a service to victims of crime • To evaluate qualitatively the recruiting, screening, training and supervision of volunteers who rendered a service to victims of crime • To evaluate quantitatively the effect of intervention by volunteers on the victims of crime, in terms of: the level of satisfaction with the victim of crime was experiencing with regard to the services rendered by the volunteer the level of satisfaction the victim of crime was experiencing with regard to the services rendered by the professional (although this aspect was included as an objective of this study, the focus of this study was on the volunteer who renders a service to the traumatised victim of crime) the symptoms the victim of crime was experiencing when the volunteers rendered trauma debriefing services • Based on the results, to formalise guidelines for the managers of the victim empowerment programmes, who manage volunteers, to improve their service rendering to victims of crime. The methodology of programme evaluation, as a combined quantitative and qualitative research approach, was implemented to achieve the goal and objectives set for this research study. The quantitative data was collected by questionnaires that were completed by victims who utilised the services rendered by various victim empowerment centres. This data was then analysed by utilising the SPSS computer programme. Frequencies between the variables was described and interpreted. The qualitative data was collected through interview schedules. Interviews were conducted with 10 management members and 10 volunteers from 10 selected centres in Gauteng, which utilised volunteers to render services to victims of crime. The qualitative data was analysed by identifying various responses and placing these responses into categories and themes. All the responses were transcribed. The main results derived from the quantitative data indicated that the victims were satisfied with the level of service rendering from the volunteers. The main results from the qualitative data indicated that volunteers who rendered services to victims of crime were recruited, screened, trained and supervised according to the requirements of the specific victim empowerment programme where this service was rendered. Victims of crime that received trauma debriefing appeared to experience less symptoms, with specific reference to physiological symptoms (reliving the trauma), than those who did not receive trauma debriefing. From the three literature chapters of this study the following main conclusions were made, namely: • Trauma (Chapter 2) It was imperative to discuss stress, crisis and trauma as they lie on a continuum of severity. The volunteer had to be aware of this and the effects thereof. Since each individual experienced the effects differently, knowledge of the effects would determine the volunteers’ level of service delivery to the victims of crime. • Victim Empowerment (Chapter 3) The victim empowerment literature for this study was relevant, since victim empowerment programmes are seen as the “umbrella” of the services rendered to victims of crime. • Volunteers (Chapter 4) The researcher wanted to highlight that the research results proved that volunteers played an imperative role in service delivery to victims of crime. The lack of relevant literature and research that has been completed with specific reference to the recruitment, screening, training and supervision of volunteers who rendered a service to victims of crime limited the study, especially with regard to the compilation of the guidelines for the managers of the victim empowerment programmes. These guidelines include advice on the recruitment, screening, training and supervision of volunteers who render a victim empowerment service to victims of crime. This advice is focussed on the mangers of the victim empowerment programmes that were responsible for the volunteers who rendered a service to victims of crime. With the completion of the guidelines, the researcher added value to the social work profession, since this profession increasingly utilises volunteers in their service rendering to victims of crime. / Prof. J.B.S. Nel Dr. E. Oliphant

Magister Scientiae (Physiotherapy) - MSc(Physio) / Stroke is the third leading cause of death and a major cause of disability in most societies. Individuals with physical disabilities are at risk of secondary complications due to the impact of the disability, which may be exacerbated by poor lifestyle choices. Although disabled persons desire to engage in wellnessenhancing activities, limited programmes based on their health promotion needs’ assessment have been developed. The aim of the present study is to determine the health promotion needs of stroke patients accessing selected Community Health Centres in the Metropole region of the Western Cape. A cross-sectional survey, utilizing a self-administered questionnaire and in depth interviews with a purposively selected sample was used to collect the data. The quantitative data was analysed using Microsoft Excel ®. Means, standard deviations and percentages were calculated for descriptive purposes and the chi-square test was used to test for associations between socio-demographic and health-related variables. Audiotape interviews were transcribed verbatim, the emerging ideas were reduced to topics, categories and themes and finally interpreted. In order to qualify for between-method triangulation used in the study, complementary strengths were identified by comparing textual qualitative data with numerical quantitative results and vice versa. The quantitative analysis revealed that the participants were engaging in health risk behaviours such as physical inactivity, substance usage, non-compliance to medication use and inappropriate diet modification. Lack of financial resources, facilities and access to information predisposed them to involvement in risky health behaviours. In-depth interviews supported the quantitative findings and revealed that numerous participants’ suffered from depression and frustration as a result of having a stroke. The necessary ethical considerations were upheld. The outcome of the study could contribute to the need to develop, encourage and promote wellness-enhancing behaviours and activities to improve the participants’ health status and ultimate quality of life. / South Africa

Master of Public Health - MPH / This research investigated the availability and nature of the rehabilitation service at primary health care level rendered by rehabilitation staff in the Metropole district health services. The aim of the study was to determine the extent to which selected elements of the rehabilitation components of the primary health care service package are currently being implemented. In doing so, the study aimed to identify obstacles within the district management as perceived by rehabilitation therapists that hinder the implementation of the rehabilitation programme, so as to make recommendations for future planning. / South Africa

Purpose of this treatise- This Paper aims to investigate the Sustainability of Health Facility Committees in the Nelson Mandela Bay Health District. Design/methodology/approach – This study consists of a literature review and a pilot study. Qualitative research approach was used in order to obtain descriptive data from the targeted group. The primary sources of data collection the researcher used were from the members of the committee, health facility manager, chairperson and the health promoter who are members of the health committees. Focus group discussions with health committees were conducted to provide rich in-depth data. Literature and journal articles were also used to provide secondary data to corroborate findings. Research limitations- A major limitation to this study is that due to the nature of the nature of the research report it was not possible to assess the sustainability of health Facility Committees from other areas in the Nelson Mandela Bay Health District. Findings-The study has revealed that Community Health committees are sustained by the commitment and passion members have for the work done in the facilities and health committees. The study also revealed that social cohesion plays a major part in the sustainability of Community Health Committees (CHC). Lack of involvement by ward councilors, support from the Health Department, uncertainty of responsibilities by the health committees and limited skills were indicated as major setbacks threatening the sustainability of Community Health Committees. It can thus be concluded that these limitations must be properly addressed in order to enable and uphold the sustainability of Community Health Committees. Original/value -So far, there has been limited research which has been undertaken with regards to the subject of Sustainability of Health Facility Committees in Nelson Mandela Bay Health District. This study will aid in enabling a better understanding of what sustains Community Health Committees and the Challenges facing such communities in order to enable individuals and the parties involved to better formulate solutions to overcome these challenges in Nelson Mandela Bay.

A contemporary view of health and health care has arisen, out of the broadened social understandings of the later half of this century, which recognizes the individual as a whole person (rather than a clinical object), and which recognizes the local community as the preferable locus of care. The community health center model has emerged as a response to this contemporary view. It is a community-specific model of health care delivery, health promotion, and community action. Its services cover a full range of primary health care needs (from social work to urgent care), utilizing a multi-disciplinary team approach. While the response of facility planning and programming to the contemporary view of health and health care has been explored to great depth over the past twenty five years, the response of architecture has not. The intent of this thesis was, therefore, to create an architectural design that may serve as a model of the multiservice community health center, and as a source of architectural ideas which respond to the contemporary view of health and health care. A rural site was selected as the most appropriate setting for a new purpose-built facility. The design solution specifically sought to countermand the alienation, stress, loss of sense of personal control, unfamiliarity, sterility, and institutional qualities of the common medical environment - particularly, from the experiential viewpoint of the client. The design also sought to stand on its own as a legitimate work of architecture. Towards these ends, the building was bound to the community via prominence, accessibility and familiarity in the activities of daily life. A concept of democratic space sought to extend the public realm and a sense of public ownership into the facility. A marketplace vocabulary and communitycontrolled space contributed towards this end. The building was bound to place via architectural expression and explorations of processional qualities; responding to the nature of its island place, to the forest environment, and to local vernacular architecture. The design sought to establish a relationship with nature, or natural order, via an interstitial relationship with the forest, the use of natural materials, a truthful structural expression, a presence of natural light, and, at the conceptual level, an interplay between order and aggregation. As a representation of health care architecture, the design sought to express the notion of a community of services, rather than that of an untouchable institution. It also sought to achieve all of this in accord with efficient functioning and way-finding, and to achieve it at costs comparable to existing facilities (if not less expensive), via strategic choices regarding systems and construction. / Applied Science, Faculty of / Architecture and Landscape Architecture (SALA), School of / Graduate