Working in a township is a challenging but also rewarding way of living. In this dissertation the researcher, in collaboration with the co-searchers, explore ways to mentor one another as they learn how to deal with trauma, either by experiencing trauma directly or witnessing secondary trauma. This leads to new ways of being 'in the moment', coping with trauma, forming a community of care and learning to be in an aware and empowered position. The responsibility of practical theology and the commitment to pastoral care are explored in the context of theology, and spesifically feminist theology, contributing to 'do hope' in Mamelodi. / Philosophy, Practical & Systematic Theology / M.Th. (Pastoral Therapy)

A group of four widows undertook this research journey with me. They reflected on their widowhood experiences. Narrative and participatory practices guided our conversations. Participatory, contextual, postmodern, liberational feminist theology, poststructuralism and the social construction theory of reality informed this work. Reflective and summarising letters after each group meeting played a central part in the research. The letters were structured to make visible the "taken-for-granted" which informed the widows about who and what they are. The alternative stories of preferred widowhood practices that emerged during and between sessions were centralised in the letters. Elements of transformation, hope and empowerment surfaced as counter stories to the culture of oppression, providing the scaffolding for re-storying their lives. The group formed Chiedza Widows Association in order to support other widows who are still marginalised. / Practical Theology / (M.Th - Specialisation Pastoral Therapy))

The study aimed to explore and described the assessment of patient’s satisfaction with the quality of health care services rendered by the Crossroads Community Health Centre (CHCC). The target population comprised of adult male and female patients who have attended the clinic more than once. One hundred and twenty patients participated in the study. The convenience sampling method was used to select the respondents. A questionnaire was used to collect data. Validity and reliability were ensured. The Chronbach’s alpha reliability test was used to measure the internal consistency of the likert scale questionnaire items and was less than 0.4 for sections B-F, and 0.675 for section E. Descriptive and inferential data analysis was conducted using the Statistical Package for the Social Sciences 16.0 for Windows, release 16.0.1 with the assistance of a statistician. The findings indicated a positive perception of the quality of health care services rendered by the Crossroads CHCC. It was concluded that despite a positive perception of the health care services, there was a percentage of the respondents that rated the quality of the service as poor in relation to environmental cleanliness, staff attitudes, long waiting times, medications shortage, the complaints system reporting and health care service drainage to other CHCC where patient’s resided. The issue of quality improvement in these aspects was noted to be crucial and recommendations were made to improve the quality of the health care service at Crossroads CHCC. / Healh Studies / M.A. (Health Studies)

Working in a township is a challenging but also rewarding way of living. In this dissertation the researcher, in collaboration with the co-searchers, explore ways to mentor one another as they learn how to deal with trauma, either by experiencing trauma directly or witnessing secondary trauma. This leads to new ways of being 'in the moment', coping with trauma, forming a community of care and learning to be in an aware and empowered position. The responsibility of practical theology and the commitment to pastoral care are explored in the context of theology, and spesifically feminist theology, contributing to 'do hope' in Mamelodi. / Philosophy, Practical and Systematic Theology / M.Th. (Pastoral Therapy)

A group of four widows undertook this research journey with me. They reflected on their widowhood experiences. Narrative and participatory practices guided our conversations. Participatory, contextual, postmodern, liberational feminist theology, poststructuralism and the social construction theory of reality informed this work. Reflective and summarising letters after each group meeting played a central part in the research. The letters were structured to make visible the "taken-for-granted" which informed the widows about who and what they are. The alternative stories of preferred widowhood practices that emerged during and between sessions were centralised in the letters. Elements of transformation, hope and empowerment surfaced as counter stories to the culture of oppression, providing the scaffolding for re-storying their lives. The group formed Chiedza Widows Association in order to support other widows who are still marginalised. / Philosophy, Practical and Systematic Theology / (M.Th - Specialisation Pastoral Therapy))

The study aimed to explore and described the assessment of patient’s satisfaction with the quality of health care services rendered by the Crossroads Community Health Centre (CHCC). The target population comprised of adult male and female patients who have attended the clinic more than once. One hundred and twenty patients participated in the study. The convenience sampling method was used to select the respondents. A questionnaire was used to collect data. Validity and reliability were ensured. The Chronbach’s alpha reliability test was used to measure the internal consistency of the likert scale questionnaire items and was less than 0.4 for sections B-F, and 0.675 for section E. Descriptive and inferential data analysis was conducted using the Statistical Package for the Social Sciences 16.0 for Windows, release 16.0.1 with the assistance of a statistician. The findings indicated a positive perception of the quality of health care services rendered by the Crossroads CHCC. It was concluded that despite a positive perception of the health care services, there was a percentage of the respondents that rated the quality of the service as poor in relation to environmental cleanliness, staff attitudes, long waiting times, medications shortage, the complaints system reporting and health care service drainage to other CHCC where patient’s resided. The issue of quality improvement in these aspects was noted to be crucial and recommendations were made to improve the quality of the health care service at Crossroads CHCC. / Healh Studies / M.A. (Health Studies)

La profession infirmière, ayant grandement évoluée depuis plusieurs années, place aujourd’hui les infirmières comme des acteurs clés dans l’amélioration des services de santé tant au niveau de l’accessibilité que de la qualité et de la sécurité des soins et des services offerts à la population. Au Québec, on estime que 15 à 20 % des enfants âgés entre 0 et 5 ans naissent et grandissent dans des familles vivant en contexte de vulnérabilité. Afin d’aider ces familles à améliorer leur santé, depuis 2003, tous les centres intégrés de santé et de services sociaux offrent des services intégrés en périnatalité et pour la petite enfance (SIPPE). Le contexte dans lequel vivent ces familles nécessite souvent une approche interdisciplinaire et une collaboration interprofessionnelle. Au cours de leur formation, les infirmières développent des compétences tant biomédicales que psychosociales. En raison de l’éventail de leurs champs de compétences, il appert que les infirmières occupent un rôle central dans l’équipe des SIPPE. Or, pour répondre à la complexité des besoins des familles, les infirmières doivent exercer à leur pleine étendue de pratique. Cependant, les résultats issus de plusieurs recherches menées dans divers milieux au cours des dernières années tendent vers une conclusion commune soit que les infirmières ne parviennent pas à déployer leur étendue de pratique de façon optimale. Puisqu’aucune étude n’a été menée dans le contexte spécifique des SIPPE, l’objectif de cette recherche qualitative consiste à explorer l’étendue effective de la pratique infirmière dans les SIPPE. Afin de mieux comprendre ce phénomène, les facteurs influençant le déploiement optimal de l’étendue de la pratique infirmière (ÉPI) dans les SIPPE ont également été explorés. Cette présente étude prend appui sur le modèle théorique Public health nursing practice de Smith et Bazini-Barakat (2003). Selon ce modèle, le rôle de l’infirmière dans un programme de santé publique, comme les SIPPE, repose principalement sur l’évaluation, la planification des soins, l’enseignement à la clientèle et aux familles ainsi que sur la communication et la coordination des soins avec l’équipe interprofessionnelle. En combinant les notions de ce modèle aux activités professionnelles de l’ÉPI de D’Amour et al. (2012), il a été possible de collecter des données sur l’étendue effective de la pratique infirmière dans les SIPPE. Des entrevues individuelles semi-structurées ont été menées auprès de quatre participantes soit trois infirmières œuvrant dans les SIPPE et leur assistante-infirmière chef. Les résultats démontrent que les infirmières occupent un rôle important auprès des familles vivant en contexte de vulnérabilité. Actuellement, elles semblent être en mesure de mettre en œuvre plusieurs activités professionnelles liées à l’évaluation et la planification des soins ainsi que pour l’enseignement à la clientèle et aux familles. Toutefois, les résultats sous-entendent que la pratique infirmière dans les SIPPE n’est pas optimale pour les activités professionnelles liées à la communication et la coordination des soins. Plusieurs facteurs semblent actuellement influencer la capacité des infirmières à mettre en œuvre les activités de leur étendue de pratique. / The nursing profession has evolved considerably over the past several years, and today nurses are key players in improving health services in terms of accessibility, quality and safety of care and services offered to the population. In Quebec, it is estimated that 15 to 20 % of children between the ages of 0 and 5 are born and grow up in families living in a vulnerable context. In order to help these families improve their health, since 2003, all the integrated health and social services centers have been offering integrated perinatal and early childhood services (IPECS). The context in which families live often requires an interdisciplinary approach and interprofessional collaboration. During their training, nurses develop both biomedical and psychosocial skills. Because of their wide range of knowledge and skills, nurses have a central role in the IPECS team. To meet the complexity of families’ need, nurses must practice to their full scope of practice. However, the results of several research studies conducted in recent years point to the common conclusion that nurses are not achieving optimal scope of practice. Since no studies have been conducted in the specific context of IPECS, the purpose of this qualitative research was to explore the actual scope of nursing practice in IPECS. To better understand this phenomenon, factor influencing the optimal deployment of scope of nursing practice (SNP) in IPECS were also explored. This study is based on Smith and Bazini-Barakat (2003) theoretical model of public health nursing practice. According to this model, the nurse’s role in a public health program, such as IPECS, is primarily based on assessment, care planning, client and family teaching, communication and coordination of care with the interprofessional team. By combining the concepts of this model with the professional activities of D’Amour et al. (2012), it was possible to collect data on the actual scope of nursing practice in IPECS. Semi-structured individual interviews were conducted with four participants: three nurses and their assistant nurse. The results show that nurses pay an important role with families living in a vulnerable context. Currently, they seem to be able to carry out several professional activities related to assessment and care planning as well as teaching clients and families. However, the results suggest that nursing practice in IEPCS is not optimal for professional activities related to communication and care coordination. Several factors currently appear to influence nurses ‘ability to implement their full scope of practice.

A distressing consequence of the HIV/AIDS pandemic and of the increasing numbers of orphans and decreasing numbers of caregivers is the emergence in ever larger numbers of child-headed households (CHHs). The complexity of issues affecting CHHs and the lack of research on this subject means that CHHs are not well understood. This sometimes prompts support agencies to provide emotionally driven recommendations suggesting that it is better for a child to be in an orphanage than to live in a CHH. This exploratory study, involving heads of 105 CHHs over a 12 month period and 142 participants in various focus group discussions (FGD) and interviews, suggests the need for a change in perspective. It addresses the question of CHH quality of life, coping strategies and household functioning and attempts to bring this into a productive dialogue with community child care activities, NGO and statutory support and child care and protection policies. Research data suggests that the key determining factor contributing towards the creation of a CHH is `pre-parental illness' family conflict. Another contributing factor is that siblings want to stay together after parental death. Quality of life assessments indicate that despite significant adversities, over 69% of CHHs reported a 'medium' to 'satisfactory' quality of life and demonstrate high levels of resilience. As regards vulnerability to abuse, it is found that while CHH members are more vulnerable to external abuse, they experience little within their household. Contrary to public perceptions about CHHs lacking moral values, CHH behaviour might actually be more responsible than non-CHH peer behaviour as their negative experiences appear to galvanize them into adopting responsible behaviour. Community care and neighbourhood support in older townships are better established compared with newer suburbs. Sufficient community care capacity enables CHHs to function, thus avoiding a situation where households disintegrate and household members end up as street children. CHH coping responses seem to be mainly influenced by individual and community factors, and by social, spiritual and material support. The interplay between these and the CHH's ability to engage in the required coping task impacts on the coping outcome at household level. National and international government and non-governmental child service providers in Southern Africa need to recognize that an adequately supported CHH is an acceptable alternative care arrangement for certain children in communities with high adult AIDS mortality and where adult HIV-prevalence exceeds 10%. / Development Studies / D. Ltt. et Phil. (Development Studies)

The study sought to explore professional nurses' perceptions of the roles of home and community-based carers in the Capricorn district of the Limpopo province as well as the problems they experienced and make recommendations to improve the quality of home and community-based care. A qualitative approach with non-probability, purposeful sampling was used in this study. The sample consisted of professional nurses serving as focal points for home-based care in the area of the study. The findings indicated that professional nurses believe that carers have a role in providing care to the community and serve as the extended hands of their services. However, challenges exist, which impact on the quality of service delivery. Recommendations included the strengthening of existing elements, such as improving relationships, communication, and the care of carer's programme, carer training, reporting, and monitoring and carer distribution. / Health Studies / M.A. (Health Studies)

A distressing consequence of the HIV/AIDS pandemic and of the increasing numbers of orphans and decreasing numbers of caregivers is the emergence in ever larger numbers of child-headed households (CHHs). The complexity of issues affecting CHHs and the lack of research on this subject means that CHHs are not well understood. This sometimes prompts support agencies to provide emotionally driven recommendations suggesting that it is better for a child to be in an orphanage than to live in a CHH. This exploratory study, involving heads of 105 CHHs over a 12 month period and 142 participants in various focus group discussions (FGD) and interviews, suggests the need for a change in perspective. It addresses the question of CHH quality of life, coping strategies and household functioning and attempts to bring this into a productive dialogue with community child care activities, NGO and statutory support and child care and protection policies. Research data suggests that the key determining factor contributing towards the creation of a CHH is `pre-parental illness' family conflict. Another contributing factor is that siblings want to stay together after parental death. Quality of life assessments indicate that despite significant adversities, over 69% of CHHs reported a 'medium' to 'satisfactory' quality of life and demonstrate high levels of resilience. As regards vulnerability to abuse, it is found that while CHH members are more vulnerable to external abuse, they experience little within their household. Contrary to public perceptions about CHHs lacking moral values, CHH behaviour might actually be more responsible than non-CHH peer behaviour as their negative experiences appear to galvanize them into adopting responsible behaviour. Community care and neighbourhood support in older townships are better established compared with newer suburbs. Sufficient community care capacity enables CHHs to function, thus avoiding a situation where households disintegrate and household members end up as street children. CHH coping responses seem to be mainly influenced by individual and community factors, and by social, spiritual and material support. The interplay between these and the CHH's ability to engage in the required coping task impacts on the coping outcome at household level. National and international government and non-governmental child service providers in Southern Africa need to recognize that an adequately supported CHH is an acceptable alternative care arrangement for certain children in communities with high adult AIDS mortality and where adult HIV-prevalence exceeds 10%. / Development Studies / D. Ltt. et Phil. (Development Studies)