M.Cur. / With the changes in health care occuring in South Africa, new concepts and functions concerning the community health nurse are being presented. The role of the community health nurse is altering, and with his/her grassroot involvement with the community, the researcher was concerned about what contribution he/she should make on health committees. The goal of the study was to explore and describe the role of the community health nurse on health committees. The objectives were to: - explore and describe the role the community health nurse should play on health committees; explore and describe the role the community health nurse is playing on health committees and - to develop guidelines to describe the role of the community health nurse on health committees. The study was conducted in three phases: PHASE 1: After conducting a literature study, six categories were identified as the role of the community health nurse on health committees. Thereafter a questionnaire was presented to community health nurses to find out what their perceptions were about the role of the community health nurse on health committees. The results of Phase One were used to develop a central question. Individual categories relevant to the role of the community health nurse on health committees were identified and an interview schedule was drafted for presentation to selected members of health committees. ii PHASE 2: Personal interviews based on the results of Phase One were conducted with selected health committee members to find out their perceptions of the same. PHASE 3: ' Guidelines describing the role of the community health nurse on health committees were developed based on the findings of the study. It was found that the literature, the community health nurses and the health committee members all concured as to what the community health nurse should be doing on health committees. This study stresses the importance of the community health nurse's involvement on health committees. It should lead to the implementation of community health nurses being allowed to accept their rightful role on health

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.A. / Currently there is great emphasis on community development. The researcher was motivated to do the study due to the community centre in Krugersdorp that concentrates on community development. The main goal of this dissertation is to prmulate criteria which community centres can use to function successfully. For the purpose of this study the fallowing objectives were identified: To gather information regarding the functioning qf the community centre in Krugersdorp; to compare this information with the literature on community and social development; from these findings to compile a guideline in connection with the functioning of a community centre based on the development paradigm; and to determine the role of the social worker at the community centre. The role of the social worker at the community centre is determined from information that has been received from interviews as well as a literature study. The community centre works according to R 17 P principles

D.Cur. / The impressive growth in the extent and range of psychiatric services provided by general hospitals in South Africa, creates stress among nurses employed in these settings which manifests its self in the negative attitudes displayed towards mentally ill people, refusal of dual diagnosis patients transferred from medical surgical units and poor intra-institutional relationships between nurses in medical-surgical units and those who are in the psychiatric unit. This has led to the research study aimed at describing a model for support to assist general hospital nurses mobilize appropriate resources in the process of nursing mentally ill people. The research methodology followed the research model in nursing proposed by Botes (1995). A theory generative, qualitative, explorative, descriptive and contextual design was followed. The research methods were dealt with in four steps of theory generation in the following manner: Step 1: Concept analysis: This step was dealt with in two phases which are concept identification and concept definition. During concept identification, a qualitative research strategy which is explorative, descriptive and contextual was used. This was attained through field research conducted in an urban general hospital. A sample of twelve professional was selected from a population of 800 professional nurses employed in a general hospital using a purposive sampling technique. This sample size was determined by saturation of data in themes. Both semi-structured individual phenomenological interviews and observations were used as methods of data collection. The field work was conducted without any preset theoretical framework of reference by using "bracketing" and "intuiting". Giorgi's (1986) method of descriptive data analysis was used. After data analysis, the results were reflected within the Nursing for the Whole Person Theory. Four themes emerged from the results of the study which were:1) the experience with the perception of the mentally ill people, 2) the experience with interpersonal communication patterns, 3) nurses' experience of violence and lastly, 4) the experience of inappropriate patient behaviours. It became clear that the experience of nursing mentally ill people was negative and affected the social, psychological and the physical dimensions of nurses. The results were validated through literature control. The major concept of model was identified as "facilitation of communication". The concept was analysed thoroughly by looking at the dictionary and subject usage. The defining attributes were identified and synthesised through a definition. The other related concepts were identified and classified using a survey list of Dickoff, James & Wiedenbach (1968:430). Step 2: Step 2 dealt with the creation of interrelationship statements between concepts identified in step 1, so that concepts were able to stand in relation to one another. Step 3: dealt with the description of the model using strategies proposed Chin & Kramer (1991). Step 4: dealt with the description of guidelines for model operationalization in practice, education and research. The evaluation of model operationalization will be carried out in future research. To ensure valid results, a model trustworthiness proposed by Guba (Lincoln & Guba, 1985) was used. The following criteria for trustworthiness was applied in all the steps of theory generation: truth value, applicability, consistency and neutrality.

M.Cur. / This research study is on the acceptability of clinical community nursing skills in mobile health services. It is aimed at highlighting whether the skills of community nurses working in mobile health services at a certain area in KwaZulu-Natal are accepted by the community they serve. This was of concern to the researcher because it was discovered that a significant number of people in the community in this area flock to the hospitals, private doctors and traditional healers when there are mobile services which travel to various communities, in order to attend to the health needs of their residents. Interviews were conducted with the patients attending the mobile health services to obtain their views, especially on the community nursing skills. Observations were also conducted after the interviews by the researcher on the skills of the community nurses in the mobile health services. The observations were conducted to verify the results of the interviews. Findings from both data collection methods revealed that some community nursing skills are acceptable and others are unacceptable. Guidelines were formulated to render the mobile health services more user friendly.

M.Cur. / The purpose of the research study was to describe guidelines to improve the community health clinics as a learning context conducive to learning. The objectives of the study commenced by getting the perception of student nurses, community sisters and college tutors, to explore and describe the problems experienced in relation to community health clinics as a learning context for student nurses, especially when they are allocated for their clinical practicals to prepare them to become competent. The research design and method used, consisted of a qualitative approach to achieve the intended goal of the research study. The design was divided into two phases: Phase one consisted of a field/empirical study and phase two consisted of conceptualization. Phase one has three steps where each step indicates the research method, population and sampling, data collection and data analysis. Population and sampling for step I included all the fourth year students from a nursing college in Gauteng, who are in an educational programme leading to registration as a nurse (general, psychiatric and community) and midwife. Population and sampling for step II consisted of community sisters from ten community health clinics in the Southern Metropolitan Local Council. Population and sampling for step III consisted of community college tutors from a college in Gauteng; the sample size consisted of the whole population. In all the steps follow-up interviews were conducted to confirm the findings. To ensure trustworthiness Lincoln and Guba's (1985) model was implemented, and data analysis were according to Tesch's (1990 in Creswell, 1994:155) method, based on a qualitative approach. The major problems reflected in the research findings based on Step I, II, II indicate similarities and Step III only indicates some uniqueness. The conceptual framework was discussed, indicating a body of knowledge, based on the study and empirical findings from phase I, to give clear meaning and understanding regarding the research study. Problems from all the steps were used in an integrated manner as research findings and were compared with existing literature within the framework, to determine similarities and differences as literature control method. Guidelines were then formulated from phases I and II, to solve the indicated problems, based on the three different sample groups. Guidelines were supported by the conclusion statement from chapter four and the problem statement from chapter three. Essential actions were indicated for operationalisation. Ethical consideration was maintained throughout the research study. The study has been evaluated by means of positive and negative issues related to the actual research process. Recommendations related to nursing education, nursing practice and nursing research were indicated accordingly.

Indiana University-Purdue University Indianapolis (IUPUI) / A study design has been developed that employs a dual modeling approach to identify factors associated with facility-level cancer screening improvement and how this is mediated by the use of clinical decision support. This dual modeling approach combines principles of (1) Health Informatics, (2) Cancer Prevention and Control, (3) Health Services Research, and (4) Organizational Change/Theory. The study design builds upon the constructs of a conceptual framework developed by Jane Zapka, namely, (1) organizational and/or practice settings, (2) provider characteristics, and (3) patient population characteristics. These constructs have been operationalized as measures in a 2005 HRSA/NCI Health Disparities Cancer Collaborative inventory of 44 community health centers. The first, statistical models will use: sequential, multivariable regression models to test for the organizational determinants that may account for the presence and intensity-of-use of clinical decision support (CDS) and information systems (IS) within community health centers for use in colorectal, breast, and cervical cancer screening. A subsequent test will assess the impact of CDS/IS on provider reported cancer screening improvement rates. The second, computational models will use a multi-agent model of network evolution called CONSTRUCT® to identify the agents, tasks, knowledge, groups, and beliefs associated with cancer screening practices and CDS/IS use to inform both CDS/IS implementation and cancer screening intervention strategies. This virtual experiment will facilitate hypothesis-generation through computer simulation exercises. The outcome of this research will be to identify barriers and facilitators to improving community health center facility-level cancer screening performance using CDS/IS as an agent of change. Stakeholders for this work include both national and local community health center IT leadership, as well as clinical managers deploying IT strategies to improve cancer screening among vulnerable patient populations.