This study was motivated by my desire to understand participants’ perceptions about the effectiveness of learner support services and their contribution to distance learners’ progress and programme completion in the DPE programme in Botswana. The investigation was carried out to find out why despite the provision of learner support services, there were low completion rates and high incomplete rates in the final year (2002/2003 cohort) of the DPE programme. The study also intended to understand the strengths and weaknesses of learner support services and make recommendations for improvement. A qualitative case study research design was applied. Group and individual interviews were conducted with participants. Data were analysed using Atlas ti computer software which simplified the management of the large corpus of data generated during the fieldwork. The study found that there was need for sustained learner-tutor and learner-learner interaction and regular communication with the supporting institution during the learning process. This would require planning and aligning learner support services to identified learner needs, access to learning resources including the existence and application of effective monitoring and supervision mechanisms for academic, counselling and administrative support in order to ensure commitment and accountability of learner support providers. In order to reduce isolation which is created by the physical separation between learners and service providers, the study recommended a structure for the provision of decentralized learner support services that are as close as possible to where distance learners live and work for ease of access. The study further found that there is need for policy guidelines and management structures to facilitate the provision of effective learner support services for the benefit of distance learners. / Thesis (PhD)--University of Pretoria, 2012. / Education Management and Policy Studies / unrestricted

I bakgrunden presenteras sjuksköterskans och distriktssköterskans ansvarsområde, att arbetet ska utgå från ett etiskt och holistiskt förhållningssätt och främja hälsa genom exempelvis rådgivning. Forskning beskrev att arbetet med telefonrådgivning upplevdes stimulerande samtidigt som det var svårt att vara både grindvakt och vårdare. Som en hjälp i det arbetet kunde beslutsstöd användas, det sågs som ett skyddsnät som kompletterade sjuksköterskans erfarenheter. Det sågs även som ett kvalitétshöjande instrument samt att rädslan för att ta fel beslut och anmälas minskade. Syftet med studien var att beskriva sjuksköterskors och distriktssköterskors erfarenheter av att arbeta med telefonrådgivning utifrån det webbaserade rådgivningsstödet på vårdcentral. För att få fram beskrivningarna användes halvstrukturerade intervjuer som analyserades genom kvalitativ innehållsanalys med induktiv ansats. I resultatet beskrevs det att stödet skapade trygghet då det var en källa till kunskap, ett stöd vid behov, ett bra hjälpmedel och gav bekräftelse. Stödet sågs som otillräckligt och svårarbetat då det var svårnavigerat, tidskrävande, språket satte gränser, det kunde inte ersätta den kliniska blicken och stämde inte med verkligheten. Slutligen beskrevs det att den egna erfarenheten styr hur stödet används. Erfarenheterna var övervägande positiva, men omvårdnadsfokus minskade då dyrbar tid användes till att hantera rådgivningsstödet. / In the background we present the responsibilities of nurses and district nurses, namely that the duties will begin with an ethical and holistic point of view, and to promote health through for example giving advice. Research described that working with telephone counselling was perceived as stimulating, though hard being both a gatekeeper and a caretaker. One kind of help in that task could be decision support, it was seen as a safety net and a complement to the experience of the nurse. It was also seen as an instrument to improve quality, as well as reducing the fear of making the wrong decisions and being reported. The purpose of the study was to describe the experience of nurses and district nurses to work with telephone counselling using the web-based counselling support in health centres. To get the descriptions half structured interviews were used, which were analyzed by qualitative content analysis with an inductive approach. It was described in the result that the support created a sense of assurance, because it was a source of knowledge, a support when needed, a good aid, and gave confirmation. The support was also seen as insufficient and not user-friendly, since it was hard to navigate, time consuming, had a language barrier, it could not replace the clinical “eye”, and did not correspond with reality. Lastly it was said that the experience of each individual was a key in how the support was used. Most had positive experiences, but focus from taking care of patients was lost due to valuable time being used for handling the counselling support.