Thesis (MCur)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: The alarming rate of teenage pregnancies among South Africans became a driving force for the researcher to investigate this particular phenomenon. The goal of this study was to explore and describe the experiences of pregnant teenagers about their pregnancy. Guided by the research question “ What are the experiences of pregnant teenagers about their pregnancy?” a scientific investigation was undertaken. The objectives set for the study were to determine their experience of their current pregnancy; to determine their knowledge of contraceptives; and to explore their experience regarding the services delivered by the health care workers. A phenomenological descriptive design with a qualitative approach was the most suitable scientific method to describe the experiences of pregnant teenagers who attend an antenatal clinic in Chatsworth, Kwazulu Natal. An interview guide or protocol that includes a list of open-ended questions based on the objectives, the literature review, and the professional experience of the researcher was designed and used to explore during each interview. The final sample consisted of ten participants. Experts in the field of nursing and research methodology were consulted to determine the feasibility and content of the study, to evaluate the research process and outcome. The researcher collected the data personally. Data was collected by means of individual interviews. The researcher did the transcription of the interviews. Ethical approval was obtained from Stellenbosch University and the relevant health authorities. Informed written consent was obtained from the participants. Parental permission was obtained for participants under the age of 18 years. Participants younger than 18 years of age also completed an assent form. Data that emerged from the data analysis was coded and categorised into sub-themes and themes. The researcher compiled a written account of the interpretations that emerged from the data analysis. In addition, member checking was done with each participant after individual interviews, to validate the transcribed data. The conceptual framework for this study was adapted from Maslow (1968). The findings suggest that there is a need for parental intervention as far as teenage pregnancy is concerned, financial difficulties associated with poverty was identified as one of the major contributing factor to teenage pregnancy, and attitudes of providers of contraceptives led to teenagers, not using contraceptives in some cases. It is recommended that services at the clinic be improved; health care workers undergo extensive training and education regarding teenage health and sexuality needs. Furthermore review and revitalisation of education programs at schools, to meet the needs of teenagers, which are constantly changing according to the times, are recommended. The involvement of parents and the community in combating issues surrounding teenage pregnancy is vital. Further research is recommended to find solutions to alleviate this problem of teenage pregnancy. All stakeholders need to work together to remedy this social problem as it is not an issue that can be dealt with in isolation. / AFRIKAANSE OPSOMMING: Die veronrustende voorkoms van tienerswangerskappe onder Suid-Afrikaners was die motiverende faktor vir die navorser om die studie te onderneem. Die doel van die studie was om die ervaringe van swanger tieners ten opsigte van hul swangerskap te identifiseer en te beskryf. Die wetenskaplike ondersoek is gelei deur die navorsingsvraag, “wat is die ervaringe van swanger tieners betreffende swangerskap?” Die doelwitte vir die studie was om te bepaal: die ervaringe van die huidige swangerskap; kennis betreffende voorbehoedmiddels sowel as die ervaring ten opsigte van die dienste soos gelewer deur die gesondheidswerkers. 'n Fenomenologiese, beskrywende ontwerp met 'n kwalitatiewe benadering is as die mees geskikte wetenskaplike metode beskou om die ervaringe van swanger tieners wie 'n voorgeboorte-kliniek in Chatsworth, KwaZulu-Natal bywoon, te beskryf. Die navorser het gebruik gemaak van 'n vooraf opgestelde onderhoud gids, protokol bestaande uit 'n lys van oop vrae gebaseer op die doelwitte, die literatuuroorsig en die professionele ervaring van die navorser. Die finale steekproef was tien deelnemers. Kundiges op die gebied van verpleging en navorsingsmetodologie is geraadpleeg ten opsigte van die haalbaarheid, inhoud van die studie sowel, as om die proses en uitkoms van die navorsing te evalueer. Die data is persoonlik deur die navorser versamel. Data is ingesamel deur middel van individuele onderhoude. Transkripsie van die onderhoude is deur die navorser self-gedoen. Etiese goedkeuring is vooraf verkry vanaf die Universiteit van Stellenbosch sowel as die betrokke gesondheidsowerhede. Ingeligte skriftelike toestemming is verkry van die deelnemers sowel as van die ouers in geval van minderjaige tieners. Tydens die data-analise is data gekodeer en in temas en sub- temas kategoriseer. 'n Skriftelike verslag is saamgestel ooreenkomstig die interpretasie uit die data-analise. Die navorser het na transkripsie met elke onderskeie deelnemer gekontroleer ten einde geldigheid van die data te verseker. Maslow (1968) se teorie is gebruik as konseptuele raamwerk vir die studie. Die bevindinge dui daarop dat daar 'n behoefte is aan ouerlike tussentrede betreffende tienerswangerskappe. Finansiële probleme in verband met armoede is ïdentifiseer as een van die groot bydraende faktore tot tienerswangerskappe, sowel as dat houdings van diegene wat kontrasepsie verskaf daartoe kan lei dat tieners nie wil gebruik maak van voorbehoedmiddels nie. Dit word aanbeveel dat die dienste by die kliniek moet verbeter; gesondheidswerkers uitgebreide opleiding en onderrig moet kry ten opsigte van tienergesondheid en seksualiteit behoeftes. Hersiening en vernuwing van opvoedkundige programme by skole om in die voortdurende veranderende behoeftes van tieners, te voldoen. Die betrokkenheid van ouers en die gemeenskap in die bestryding van kwessies rondom tienerswangerskappe is noodsaaklik. Verdere navorsing word aanbeveel om oplossings te vind om hierdie probleem van tienerswangerskappe aan te spreek. Alle belanghebbendes moet saamwerk om hierdie sosiale probleem op te los.

Thesis (MCur)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: Mycobacterium Tuberculosis (TB) continues to rank among the world’s most serious problems despite biomedical achievement of effective prophylaxis and chemotherapy. In South Africa, TB is directly linked to the country’s high HIV prevalence rate and other related factors. The required knowledge, as well as people’s attitude towards a better understanding of TB are prerequisites for motivating them to seek early treatment. This study aims to explore the knowledge about and attitude towards TB among non- TB infected clinic attendees. More specifically, this study used a qualitative descriptive design to explore and describe clinic attendees’ knowledge of the cause, symptoms and treatment of TB and to explore their attitude towards the disease. A semi-structured interview technique was used to gather data. Ten clinic attendees between 20-40 years old, able to communicate in English and who had no past history of TB were conveniently sampled. Manual data analysis was done using an inductive approach. Thereafter, a deductive approach using the Health Belief Model was used to guide the discussion of the findings. Nine major themes were identified. The results confirm a gap in participants’ knowledge of the cause, symptoms and treatment of TB. Despite these gaps participants perceived that they were susceptible to TB, the dangers TB could cause and the benefits of completing the treatment. Participants indicated that they would seek medical help if they experienced TB symptoms. However, their fear was their ignorance of TB symptoms on the one hand and the fear of being stigmatized, discriminated against, as well as the quality of health service deliveries on the other hand. The findings highlight the need for on-going education about the cause of TB, transmission, symptoms and treatment at clinics and within the community. Media including radio, television, as well as schools and family should be included in TB education programmes. Immigrants should also be targeted to be included in TB education campaigns. Keys terms: Tuberculosis, Non-TB infected patients, Knowledge and attitude, Health Belief Model. / AFRIKAANSE OPSOMMING: Mycobacterium Tuberkulose (TB) word steeds gekenmerk as een van die ernstigste gesondheidsprobleme ter wệreld, ten spyte van deurbrake met betrekking tot meer doeltreffende profilakse en chemoterapie. In Suid-Afrika, word TB direk gekoppel aan die land se hoë voorkoms van MIV en ander verwante faktore. Die nodige kennis, sowel as ‘n beter begrip van mense se gesindhede teenoor TB, is voorvereistes vir die motivering wat hulle gedrag sal beïnvloed om vir vroeë behandeling te gaan. Hierdie studie het ten doel om die kennis en gesindhede teenoor tuberkulose van ongeïnfekteerde TB-pasiënte in ‘n Kaapstadse kliniek te ondersoek. In die besonder ondersoek die studie, deur ‘n kwalitatiewe beskrywende benadering, die kennis van ‘n spesifieke groep individue wat die kliniek besoek, met betrekking tot die oorsake, simptome en behandeling van TB, asook hulle houding ten opsigte van die siekte. Die studie beklemtoon ook enige vooroordele oor die siekte en identifiseer moontlike redes vir pasiënte se laat-aanmelding van TB by ‘n kliniek. ‘n Semi-gestruktureerde tegniek vir onderhoudvoering is gebruik. Tien pasiënte wat die kliniek besoek tussen die ouderdomme 20-40 jaar oud, wat in staat is om in Engels te kommunikeer, en wat geen vroeëre geskiedenis van TB het nie, is gerieflikheidshalwe per steekproef gebruik. Data is per hand versamel deur gebruik te maak van ‘n induktiewe benadering. Hierna is ‘n deduktiewe benadering gevolg, en die “Health Belief Model” is gebruik om die gesprekke te lei in die bevindinge. Nege hooftemas is geïdentifiseer. Die resultate bevestig ‘n gaping in die kennis van deelnemers oor die oorsake, simptome en behandeling van TB. Ten spyte van die gapings, was deelnemers wel bewus van die feit dat hulle blootgestel is om TB op te doen en oor wat die gevare is wat deur TB veroorsaak kan word, sowel as wat die voordele is om TB-behandeling te voltooi. Deelnemers het aangedui dat hulle mediese hulp sal vra, sou hulle die simptome van TB bespeur. Desnieteenstaande was hulle vrees enersyds oor die onkundigheid van die simptome van TB, en om gestigmatiseer teen gediskrimineer te word, asook die standaard van mediese dienste beskikbaar andersyds. Die bevindinge beklemtoon die behoefte aan voortgesette opvoeding oor die oorsake, oordrag, simptome en behandeling van TB in klinieke en binne gemeenskappe. Media soos radio en televisie, asook skole en families behoort ingesluit te word in sodanige opvoedingsprogramme. Immigrante behoort ook ingesluit te word by massa opvoedingsprojekte. Sleutelterme: Tuberkulose, ongeïnfekteerde TB-pasiënte, Kennis en gesindhede, “Health Belief Model”.

Thesis (MCur)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: The importance of maintaining maternal wellbeing during the antenatal period is mandatory to the mother and the baby. Although asymptomatic maternal tachycardia could be seen as part of the physiological changes during pregnancy, it could also be a sign of a serious underlying condition. Previous studies have shown that maternal deaths could occur in women with pre-existing cardiac conditions (Naidoo, Desai & Moodley, 2002:17). The concern that many conditions associated with maternal tachycardia pass through the health care system without being noticed or investigated motivated the researcher to undertake this study. The study aimed to determine the prevalence of maternal tachycardia during late pregnancy and its association with anaemia, major cardiac diseases and/or complications and adverse maternal and perinatal outcomes. A case-control retrospective study design within a prospective study was employed with a quantitative approach. A total sample size of 204 participants, constituting 14.3% of the study population (N=1431) was purposefully selected from the Monica AN24™ recordings of the Safe Passage Study at Tygerberg Hospital to collect the data. Ethical approval was obtained from the Health Research Ethics Committee of the Faculty of Medicine and Health Sciences, Stellenbosch University and a waiver of consent had been granted. A group of 16 participants, who met the inclusion criteria, constituting 7.8% of the total sample, was selected for the pilot study. Reliability and validity was ensured by the pilot study and pre-testing the data collection instrument as it was tested under the exact circumstances as the actual study experts in the field of nursing and medical research and statistics were used. The data was analyzed by the use of the STATISTICA version 9 programme. The results show a 7.1% (n=102) prevalence of maternal tachycardia in late pregnancy. There were no pre-existing cardiac conditions in any of the groups and no maternal cardiac complications during pregnancy and delivery. The case group had a higher incidence (55.0%) of haemoglobin values lower than 11.0 g/dL than the control group (47.0%), however the Mann-Whitney U test revealed no statistically significant difference of the Hb values at 28 to 38 weeks between the case and the control groups. The participants presenting with anaemia (Hb < 11.0 g/dL) were classified as mild anaemia (Hb value of 7.0 – 10.9 g/dL). There were no participants that presented with severe anaemia (Hb value of < 7.0g/dL). There was an increased prevalence (9.1%) of infection in the participants presenting with maternal tachycardia, although this difference was not significant between the two groups. The infant outcome revealed an increased mean birth weight of 194g for the case group that presented with maternal tachycardia. Several recommendations were identified that were grounded in the study findings. The findings reveal that the current antenatal care practice in terms of not recording the maternal heart rate is sufficient. / AFRIKAANSE OPSOMMING: Die belangrikheid van die handhawing van moederlike welsyn gedurende die voorgeboorte tydperk is noodsaaklik vir die moeder en die baba. Alhoewel asimptomatiese moederlike tagikardie gesien kan word as deel van die fisiologiese veranderinge tydens swangerskap, kan dit ook 'n teken wees van 'n ernstige onderliggende toestand. Vorige studies het aangetoon dat moederlike sterftes kan voorkom in vroue met voorafgaande harttoestande (Naidoo, Desai & Moodley, 2002:17). Die kommer dat verskeie toestande wat verband hou met moederlike tagikardie, deur die gesondheidsorg stelsel kan deurglip sonder om opgemerk te word, het die navorser gemotiveer om hierdie studie te onderneem. Die studie is daarop gemik om die voorkoms van moederlike tagikardie tydens laat swangerskap en sy verbintenis met anemie, ernstige hartsiektes en/of komplikasies en ongunstige moederlike en perinatale uitkoms te bepaal. 'n Gevalkontrole retrospektiewe studie-ontwerp binne 'n voornemende studie is gebruik met 'n kwantitatiewe benadering. 'n Totale steekproefgrootte van 204 deelnemers, wat 14.3% van die populasie (N=1431) uitmaak is op ‘n doelgerigte manier uitgekies uit die Monica AN24™ opnames van die Veilige Geboorte Studie by Tygerberg Hospitaal om die data in te samel. Etiese goedkeuring is verkry van die Mensnavorsing Etiese komitee komitee van Fakulteit van Geneeskunde en Gesondheidswetenskappe van die Universiteit Stellenbosch en 'n kwytskelding van toestemming is verleen. 'n Groep van 16 deelnemers, wat voldoen aan die insluitingskriteria, wat 7,8% van die totale steekproef bestaan, is geselekteer vir die loodsstudie. Betroubaarheid en geldigheid is verseker deur die loodsstudie en die voorafgaande toets van die data-insamelingsinstrument onder presies dieselfde omstandighede as die werklike studie sowel as die gebruik van kenners in die gebied van verpleging en mediese navorsing en statistiek. Die data is ontleed deur die gebruik van die Statistica weergawe 9 program. Die resultate toon 'n 7,1% (n=102) voorkoms van moederlike tagikardie in laat swangerskap. Daar was geen onderliggende harttoestande in enige van die groepe en geen moederlike hartkomplikasies tydens swangerskap en geboorte nie. Die gevalgroep het 'n hoër voorkoms (55,0%) van Hb waardes laer as 11.0 g/dl as die kontrole groep (47.0%) gehad, maar die Mann-Whitney U-toets toon geen statisties beduidende verskil in die Hb waardes by 28-38 weke tussen die geval en die kontrolegroepe nie. Die deelnemers met anemie (Hb < 11.0 g/dl) is geklassifiseer met ligte bloedarmoede (Hb waarde van 7.0-10.9 g/dl). Daar was geen deelnemers wat erge bloedarmoede (Hb waarde van < 7.0g/dL) getoon het nie. Daar was verhoogde voorkoms (9,1%) van infeksie in die deelnemers met moederlike tagikardie, hoewel die verskil nie beduidend tussen die twee groepe was nie. Die baba uitkoms toon 'n toename in gemiddelde geboortegewig van 194g vir die gevalgroep wat met moederlike tagikardie gediagnoseer is. Verskeie aanbevelings is geïdentifiseer wat in die studie se bevindinge gegrond is. Die bevindinge dui daarop dat die huidige voorgeboortelike sorgpraktyk in terme van nie rekordering van die moederlike hartspoed voldoende is.

Thesis (MCur)--Stellenbosch University, 2011. / ENGLISH ABSTRACT: Understanding the incidence and prevalence of HIV/AIDS is important in addressing the ongoing epidemic. Understanding which factors influence the rate of transmission of the virus is critical in attempting to contain and ultimately eradicate the disease. Determining which factors influence a person’s decision to disclose his/her positive status to others, particularly the sexual partner, is essential in understanding this complex process and thereby improving disclosure rates. The aim of the study was to investigate which factors influence the disclosure of someone’s HIV positive status. The objectives were to determine whether aspects such as socio-demographic factors, stigma and discrimination, religion, culture, fear of abandonment and rejection as well as knowledge of the disease influences disclosure rates. These objectives were met through an in-depth descriptive correlational research design with a quantitative approach. The target population (N = 1200/100%) consisted of all the HIV infected clients who attended a Community Health Clinic (CHC) for HIV management in the Cape Metropolitan area. The convenience sampling method was used to select the sample of participants (n = 150/12.5%) who met the criteria and voluntarily agreed to participate in the study. A self-administered questionnaire was used consisting of mainly closed-ended questions, with a limited number of open-ended questions. Ethics approval for the study was obtained from the Health Research Ethics Committee at the Faculty of Health Sciences, Stellenbosch University. Permission was obtained from the City of Cape Town: City Health, to conduct the research. Informed consent was obtained from each participant. Reliability and validity were supported by a pilot study which was conducted on (n=15/10%) of participants at this CHC to assure the feasibility of the study. The data was analysed with the support of a statistician and was presented with histograms and frequency tables. Statistical associations were determined between the various variables. The qualitative data obtained from the open-ended questions were grouped in trends and analysed thematically and then these trends were quantified. The results show that there are numerous factors which influenced HIV status disclosure. The fear of stigmatisation was identified as a factor which influences HIV disclosure to others, especially among the male participants. The results revealed that this was the major reason for delayed or non-disclosure, as well as the fear of rejection and blame. The results showed that awareness of the sexual partner’s HIV status remained relatively low (n = 64/43%), with awareness of the partner’s status highest among married participants. The recommendations were to assure that HIV positive individuals have access to support groups and are given an opportunity to attend multiple counselling sessions. Community based initiatives are needed to reduce stigmatisation of individuals with HIV and to improve access to social support systems. It was concluded that disclosure is a multifaceted process and one particular factor does not necessarily influence disclosure of a HIV positive status but most often a combination of factors. / AFRIKAANSE OPSOMMING: Dit is belangrik om die verspreiding en voorkoms van MIV/VIGS te verstaan om die gesprek rondom die voortdurende epidemie aan te roer. Kennis van watter faktore die snelheid beïnvloed waarteen die virus oorgedra word, is krities in ’n poging om dit onder beheer te hou en uiteindelik uit te wis. Om te bepaal watter faktore ’n mens se besluit beïnvloed om jou positiewe status van MIV aan andere bekend te maak, veral aan ’n seksuele maat, is dit belangrik om die kompleksiteit van die proses te begryp en sodoende die pas van bekendmaking te verbeter. Die doel van die studie is om te bepaal watter faktore beïnvloed die bekendmaking van ’n MIV positiewe status. Die doelwitte is om vas te stel of aspekte soos sosio-demografiese faktore, stigma en diskriminasie, godsdiens, kultuur, vrees vir verlating en verwerping en kennis van die siekte, die insidensie van bekendmaking beïnvloed. ’n Beskrywende korrelatiewe navorsingsontwerp met ’n kwantitatiewe benadering is toegepas. Die teikengroep (N=1200/100%) het bestaan uit al die MIV geïnfekteerde persone wat ’n Gemeenskapgesondheidskliniek vir die bestuur van MIV in die Kaapse Metropolitaanse area besoek het. Die gerieflikheidssteekproef metode is gebruik om die steekproef van deelnemers (n=150/12.5%) te kies wat vrywillig ingestem het om aan die kriteria vir die studie te voldoen. ’n Self-geadministreerde vraelys was gebruik wat hoofsaaklik uit geslote vrae met ’n beperkte aantal ope vrae bestaan. Etiese goedkeuring vir die studie is verkry van die Gesondheidsnavorsing se Etiese Komitee by die Fakulteit van Gesondheidswetenskappe, Universiteit van Stellenbosch. Toestemming is verkry van die stad Kaapstad: Stad Gesondheid, om die navorsing uit te voer. Ingeligte toestemming is van die deelnemers verkry. Betroubaarheid en geldigheid is ondersteun deur ’n loodsstudie wat op (n=15/10%) van die deelnemers beoefen is by die Gemeenskapsgesondheidkliniek om die uitvoerbaarheid van die studie te verseker.Die data is geanaliseer met die ondersteuning van ’n statistikus en is deur histogramme en frekwensie-tabelle voorgestel. Statistiese assosiasies is vasgestel tussen die verskeie veranderlikes. Die kwalitatiewe data is geneem vanuit ope vrae wat gegroepeer is in neigings en tematies geanaliseer is en die neigings is hierna gekwantifiseer. Die uitslae bewys dat daar heelwat faktore is wat die bekendmaking van MIV statusstatus beïnvloed. Die vrees vir stigmatisering is geïdentifiseer as ’n faktor met betrekking tot die bekendmaking van MIV aan andere, veral onder die manlike deelnemers. Die uitslae bewys dat dit die hoofrede vir terughoudendheid of nie-bekendmaking van die siekte is, asook die vrees vir ververwerping en blaam. Die resultate bewys dat die bewustheid van die seksuele maat se MIV statusstatus relatief laag bly (n=64/43%) met bewustheid van die maat se status die hoogste onder getroude deelnemers. Die aanbevelings is om te verseker dat MIV positiewe individue toegang het tot ondersteuningsgroepe en dat hulle geleentheid gegee word om veelvuldige voorligtingsessies by te woon. Gemeenskapgebaseerde inisiatiewe is nodig om stigmatisering van individue met MIV te verminder en vir die verbetering van toegang tot maatskaplike ondersteuningsisteme. Ter samevatting kan die gevolgtrekking gemaak word, dat; die bekend making van MIV positiewe status word nie noodwendig beïnvloed deur ʼn spesifieke faktor of meervlakkige besluitnemings proses nie, maar eerder deur ʼn kombinasie van faktore.

Thesis (MCur)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: The researcher has identified in her place of work that the multicultural views and work experience of the staff negatively impacts on optimal team coherence and patient care. Given the pivotal role that teamwork plays in an OR, it is required of the peri-operative (PO) nurses working in a Middle Eastern hospital, to develop a high cultural sensitivity and awareness of each other's values. The goal of the study through the hermeneutic inquiry was to identify the PO participants’ meanings of their perceptions and experiences within a multicultural workforce in the OR environment. A phenomenological interpretative research design was used to illuminate the phenomenon of team coherence and to answer the question, “What are the perceptions and experiences of a multicultural PO nursing team in a Middle Eastern hospital.” A purposive sample of n=13 was drawn from a population of 107 PO nurses. A semi-structured interview guide was designed and validated before data collection. Ethical approval and permission to conduct the research was obtained from the Ethics Committee at the Faculty of Health Sciences, University of Stellenbosch and the Institutional Review Board of the Hospital. The data that emerged from the data analysis was coded and categorized into themes and constitute patterns. The four patterns were multiculturalism within PO nurse teams contributes to complex group dynamics; the pervasive influence of the medical model and power struggle on group cohesion; dominance renders the PO nurses powerless; and empowerment is the panacea to improving team communication. The researcher compiled a written account of the interpretations that emerged from the data analysis and verified it with an external research reviewer. In, addition, member checking was done on two (2) of the participants from the individual interviews to validate the transcribed data. The Conceptual Theoretical Framework of Habermas on Critical Social Theory and Freire’s model of Oppressed Group Behavior supports the findings of the study. The findings suggest that cultural values clarification should change the behavior of the PO nurses and team building activities should enhance group cohesion. Policies on disruptive behavior will create an awareness to illuminate fear and reiterate selfworth. However, empowerment through education, reflection in action and active communication was to liberate powerless PO nurses in a multicultural environment. The pervasive influence of the medical model can be overcome with strong leadership. Furthermore, culturally sensitive leadership might be essential to sustain a supportive and growth producing culture. Further research is recommended. / AFRIKAANSE OPSOMMING: In die navorsers' werksarea het sy geindentifiseer dat die multikultirele uitkyk en werkservaring van die personeel optimale span koheise en pasientsorg negatief beinvloed. Gegee die deurslaggewende rol wat spanwerk in die operasiesaal speel, word dit van die teater verpleegkundiges in n hospitaal in die Midde Ooste verwag om n hoe kulturele sensitiwiteit te kweek. Die doel van die studie, deur hermeneutiese navraag, was om die persepsies en ervaringe van multikulturele PO verpleegkundiges in die operasiesaal te identifiseer. n Kwalitatiewe benadering met n fenomenologiese interpreterende navorsingsonderwerp was toegepas om die fenomenoom van span kohesie te illumineer deur die vraag te beantwoord, " Wat is die persepsies en ervaringe van 'n multikulturele PO verpleegspan in a hospitaal in die Midde Ooste". n Doelbewuste steekproef van n=13 is geneem vanuit n totale bevolking van 107 teater verpleegkundiges. n Semi-gestruktureerde onderhoudsgids was ontwerp en geldig verklaarg voor die insameling van data. Etiese goedkeuring vir die studie was verkry van die Etiese Komitee van die Fakultiet van Gesondheidswetenskappe, Stellenbosch Universiteit. Goedkeuring om die navorsing te doen, was verkry van die IRB, en toestemming was op skrif geplaas. Die data wat voortspruit uit die analise, was geenkodeer en gekategoriseer in temas en omvattende patrone. Die vier (4) pattrone was, multikulturalisme dra by tot komplekse groep dinamika te midde van die teater verpleegkundiges; die persewerende invloed van die mediese model en onderlinge struweling op groeps kohesie; dominering veroorsaak weerlose teater verpleegkundiges; en bemagtiging is die redding om komminuksie in die span te bewerkstellig. Die navorser het n geskrewe verslag saamgestel van die weergawe van die data analise en is deur n eksterne navorsingskundige geverifieer. Bykomend is kontrole van lede van twee (2) van die deelnemers vanuit die individuele onderhoude gedoen, om die getransskribeerde data se geldigheid te verklaar. Die Konseptuele Teoretiese Raamwerk van Habermas se Kritiese Sosiale Teorie en Freire se model van onderdrukte groeps gedrag het die bevinding van hierdie studie gerigsteun. Die bevindinge beveel aan dat kulturele waarde uitklaring gedrag sal verander, en spanbou aktiwiteite groeps kohesie sal bewerkstellig. Die opstel van beleide wat ontwrigte gedrag identifiseer om sodoende 'n bewustheid te kweek wat vrees verminder en selfwaardigheid herstel. Bemagtiging, deur onderrig, refleksie in aksie en aktiewe kommunikasie was as sleutel elemente aangewys om weerlose PO verpleegkunidiges werksaam in die multikulturele omgewing, te bevry. Die aanhoudende invloed van die mediese model kan oorkom word deur sterk leierskap. Voorts mag kulturele sensitiewe leierskap essentiel wees om n ondersteunende, produserende en groeiende kultueer te bewerkstellig. Verdere navorsing word aanbeveel.

Thesis (MCur (Nursing Science))--University of Stellenbosch, 2010. / Thesis presented in partial fulfilment of the requirements for the degree of Master of Nursing at Stellenbosch University / ENGLISH ABSTRACT: The trend towards specialisation in nursing has resulted in the development of the role of the Clinical Nurse Specialist (CNS) since the 1960s and 1970s in North America and the United Kingdom respectively. A Clinical Nurse Specialist should demonstrate excellent skills in leadership, communication, critical thinking, clinical and collaborative ethical decision-making, as well as mentoring. Research done internationally has shown that advanced practice nursing leads to higher patient satisfaction and compliance, fewer hospitalisations and shorter length of stays. The development of the CNS role in SA is slow in implementation. The South African Qualifications Authority has only recently published qualification rules for a master’s certificate and master’s degree in Nursing for advanced specialist nurses in SA. This situation led to the following research question: What is the expected role of the Critical Care Clinical Nurse Specialist in private hospitals in the northern and southern suburbs of the Cape Peninsula, South Africa? A non-experimental, explorative, descriptive study with a quantitative orientation was conducted in eight private hospitals in the Cape Peninsula. Through non-probability sampling 73 critical care health professionals (critical care professional nurses, clinical nurse specialists, nursing managers, unit managers, nurse educators, clinical facilitators, clinical coordinators and doctors) out of a population of 170 critical care health professionals participated in the study. A survey tool was designed and validated to collect the data. Quantitative data was analysed through Statistica® and qualitative data was analysed thematically. It was found that 81% of the participants agreed that Clinical Nurse Specialists should be appointed in the South African critical care environment as soon as possible to improve patient outcomes, to contribute to safer nursing care, to relieve work stress of shift leaders and bedside nurses and to improve the professional status of nursing. It is recommended that greater awareness regarding the Clinical Nurse Specialist should be developed. The relevant educational requirements should be finalised and a clear job description should be compiled. Nursing managers should appoint Clinical Nurse Specialists in each critical care unit as soon as possible. / AFRIKAANSE OPSOMMING: Die rol van die Kliniese Verpleegspesialis het as uitvloeisel van spesialisering in verpleging sedert 1960 en 1970 in Noord-Amerika en Groot-Brittanje onderskeidelik ontwikkel. `n Kliniese Verpleegspesialis behoort die volgende eienskappe te openbaar: uitmuntende vaardighede met betrekking tot leierskap, kommunikasie, kritiese denke, kliniese en etiese besluitneming en mentorskap. Internasionale navorsing het aangetoon dat gevorderde verpleegkunde tot `n hoër vlak van pasiënttevredenheid en nakoming van behandelingsvoorskrifte, minder hospitalisasie en korter hospitaalverblyf aanleiding gee. Die ontwikkeling van die rol van die Kliniese Verpleegspesialis in Suid- Afrika geskied langsaam. Die Suid-Afrikaanse Kwalifikasie-Outoriteit (SAKO) het eers onlangs die reëls vir `n meestersertifikaat en meestersgraad in Verpleegkunde vir gevorderde spesialisverpleegkundiges gepubliseer. Hierdie situasie het tot die onderstaande navorsingsvraag aanleiding gegee: Wat is die verwagte rol van die Kritiekesorg- Kliniese Verpleegspesialis in privaathospitale in die noordelike en suidelike voorstede van die Kaapse Skiereiland, Suid-Afrika? `n Nie-eksperimentele, beskrywende studie met `n kwantitatiewe benadering is in agt hospitale in die Kaapse Skiereiland onderneem. Deur nie-waarskynlikheids-, toevallige steekproefneming is 73 professionele betrokkenes by kritiekesorggesondheid (professionele kritiekesorgverpleegkundiges, kliniese verpleegspesialiste, verpleegbestuurders, eenheidsbestuurders, opvoeders in verpleegkunde, kliniese fasiliteerders, kliniese koördineerders en dokters) uit `n populasie van 170 professionele betrokkenes by kritiekesorggesondheid in die studie ingesluit. `n Vraelys is ontwerp en gevalideer vir die insameling van data. Kwantitatiewe data is deur middel van Statistica® ontleed terwyl die kwalitatiewe data tematies ontleed is. Daar is gevind dat die meerderheid van die deelnemers saamgestem het dat Kliniese Verpleegspesialiste so gou moontlik in die kritiekesorgomgewing in Suid-Afrika aangestel behoort te word. Die Kliniese Verpleegspesialis dra by om pasiëntuitkomste te verbeter, om tot veiliger verpleegsorg by te dra, om werkspanning van skofleiers en verpleegsters te help verlig en om die professionele status van verpleging te verbeter. Daar word aanbeveel dat daar groter bewusmaking aangaande die Kliniese Verpleegspesialis moet wees. Vereistes vir opleiding behoort gefinaliseer te word en `n duidelike werksbeskrywing moet opgestel word. Verpleegbestuurders behoort Kliniese Verpleegspesialiste so gou moontlik in die kritiekesorgomgewing aan te stel.

Thesis (MCur (Interdisciplinary Health Sciences. Nursing Science))--University of Stellenbosch, 2010. / ENGLISH ABSTRACT: Workplace violence in health care is a worldwide phenomenon. In nursing, the nature of workplace violence is predominantly non-physical in nature. Literature reveals the devastating consequences for the individual nurse, both physically and / or emotionally, depending on the nature of the violence. The consequences for the organisation / institution and the profession are equally devastating, manifesting in reduced standards of patient care and increased attrition from the profession. The pervasiveness of this problem indicates that to date, remedial and protective measures have been unsuccessful. However, most of the research done on workplace violence in nursing has been conducted amongst qualified nurses. The purpose of this study was to investigate the extent of workplace violence, targeting student nurses in clinical areas. The setting was the Western Cape College of Nursing and the population was second, third and fourth-year, pre-registration students. The research objectives addressed various aspects, for example, type, prevalence, perpetrators, consequences and management of workplace violence. A quantitative research design, utilising a survey, was chosen for the study. A probability sample of n = 255 students was selected, using stratified, random sampling as the sampling method. The variables selected for stratification were gender and year of study. A self reported, anonymous questionnaire, guided by the literature review and by the research objectives, was utilised for data generation. Summary statistics were used to describe the variables, whilst distributions of variables were presented in the form of histograms and frequency tables. Where appropriate, the relationships between demographic and research variables were described, using suitable statistical analyses. The findings revealed that the perpetration of non-physical violence against student nurses is widespread, particularly that perpetrated by co-workers, more specifically registered, staff- and assistant nurses. The under reporting of workplace violence was a common finding. Student nurses suffer grave emotional consequences as a result of workplace violence. Almost half of the respondents admitted that they had considered leaving nursing due to workplace violence and that it had negatively affected their standard of patient care. The overall conclusion was that, in accordance with a worldwide trend amongst all categories of nurses, student nurses are targets of workplace violence in the clinical areas. These findings have particular implications for the management of nursing education institutions. The fact that student nurses are targeted to the extent revealed in this study indicates that existing preventive measures in the clinical areas have not been effective. The recommendations arising from this study therefore focus on equipping the vulnerable trainee with the tools to withstand workplace violence. As such, the recommendations are directed at the management of the nursing education institution, to create awareness around the problem, to empower students to confront and cope with workplace violence and to support students traumatised by workplace violence. Finally, this study suggests avenues for further research, for example, research in the same setting after implementation of the recommendations, or further research into the dynamics of workplace violence, targeting student nurses from the perspective of qualified nursing staff or patients. / AFRIKAANSE OPSOMMING: Geweld in die gesondheidsdienste werksplek is ‘n wêreldwye verskynsel. In verpleging is geweld in die werksplek oorwegend nie-fisies van aard. Die literatuur wys op die ingrypende fisiese en / of emosionele gevolge vir die individuele verpleegkundige, afhangend van die aard van die geweld. Die gevolge vir die organisasie of instelling, asook vir die verpleegberoep, is eweneens ingrypend en manifesteer in verlaagde standaarde in pasiëntsorg en ‘n toename in verpleegkundiges wat die beroep verlaat. Die algemene verskynsel van die problem dui aan dat regstellende en beskermende maatreëls tot dusver onsuksesvol was. Die meeste navorsing oor geweld in verpleging is egter tot dusver onder gekwalifiseerde verpleegkundiges gedoen. Die doel van hierdie studie was om die omvang van werksplek-geweld, met studenteverpleegkundiges as teikengroep, in die kliniese areas na te vors. Die studie is by die Wes-Kaap Kollege van Verpleging uitgevoer en die populasie was al die tweede, derde en vierde-jaar, voor-registrasie studente. Die geformuleerde navorsingsdoelwitte vir die studie het verskeie aspekte aangespreek, soos byvoorbeeld, tipe, frekwensie, die uitvoerders van geweld, gevolge en die hantering van werksplek-geweld. ‘n Kwantitatiewe navorsingsontwerp, met gebruikmaking van ’n opname, is vir die studie geselekteer. ‘n Waarskynlikheidsteekproef van n = 255 studente is deur middel van gestratifiseerde, ewekansige steekproefneming geselekteer. Geslag en jaar van studie was as die veranderlikes vir stratifikasie gekies. Die instrument vir data-insameling was ‘n self-voltooide vraelys, gebaseer op die literatuurstudie en gerig deur die navorsingsdoelwitte. Opsommende statistieke is aangewend om die veranderlikes te beskryf, terwyl die verspreidings van veranderlikes in die vorm van histogramme of frekwensie-tabelle aangebied is. Waar toepaslik, is die verhoudings tussen demografiese en navorsingsveranderlikes met behulp van toepaslike statistiese analises beskryf. Die bevindinge het onthul dat die pleeg van nie-fisiese geweld teenoor studenteverpleegkundiges algemeen voorkom, veral daardie deur mede-personeel, meer spesifiek geregistreerde, staf– en assistent verpleegundiges. Die onderrapportering van werksplek-geweld was ‘n algemene bevinding. Studenteverpleegkundiges ly aan erge emosionele gevolge, as gevolg van werksplek-geweld. Byna die helfte van die respondente het erken dat hulle oorweeg het om die beroep te verlaat en dat sodanige geweld hul standaard van pasiëntsorg negatief beinvloed het. Die oorkoepelende gevolgtrekking was dat studenteverpleegkundiges, in ooreenstemming met ‘n wêreldwye neiging onder alle kategorieë van verpleegkundiges, die teiken van werksplek-geweld in die kliniese areas is. Hierdie bevindinge hou spesifieke implikasies vir die bestuur van verpleegonderriginrigtings in. Die feit dat studenteverpleegkundiges tot die mate, soos in die studie onthul, geteiken word, het aangetoon dat bestaande voorkomende maatreëls in die kliniese areas oneffektief is. Die voorstelle vanuit hierdie studie is dus daarop gerig om die ontvanklike nuweling toe te rus om werksplek-geweld teë te staan. As sulks is die voorstelle gemik op die bestuur van die verpleegonderrig-inrigting, om bewustheid rondom die probleem te skep, om studente te bemagtig om geweld te konfronteer en te hanteer, en om studente, wat as gevolg van werksplek-geweld getraumatiseer is, te ondersteun. Laastens word moontlikhede vir verdere navorsing voorgestel, soos byvoorbeeld, navorsing in dieselfde omgewing na die implementering van die voorstelle, of verdere navorsing in die dinamika van werksplek-geweld teenoor studenteverpleegkundiges, vanuit die perspektief van gekwalifiseerde verpleegpersoneel of pasiënte.

Thesis (MCur)--University of Stellenbosch, 2011. / ENGLISH ABSTRACT: Background: In her clinical practice as nursing manager the researcher was concerned about incomplete and inaccurate documentation of patients diagnosed with tuberculosis (TB) which were compromising the management of these patients. The primary care nurses endorsed these concerns. Goals and Objective: The goal of this study was to audit nursing documentation according to the phases of the nursing process and the discharge planning of patients diagnosed with TB discharged from TB hospitals in the Western Cape. The objectives for the study were to determine whether the patients were adequately assessed and diagnosed, whether nursing care plans were formulated based on the assessment and whether they were implemented and evaluated according to the nursing process - including the discharged planning. Ethics approval was obtained from the Committee of Human Research Science at Stellenbosch University and permission was also obtained from the respective institutions. Methodology: A descriptive design with a quantitative approach was applied for the purpose of this study. The total population for the study was N=1768. A systematic random sample of 12% from each hospital was drawn: n=214, hospital A (n=142) and hospital B (n=72). Criteria included:  all adult patients older than 18 years  patients who were discharged between 01 January 2007 and 31st December 2007  all discharged patients from the two hospitals specializing in patients diagnosed with TB. Instrumentation: An audit instrument based on the objectives of the study was approved as the data collection tool. Guided by the proposed study a 10% (n=21) of the number of discharged patient files were drawn for the purpose of a pilot study. Reliability and validity was ensured through the use of experts in the field of nursing, research methodology and statistics. A pilot study was also conducted to support the reliability and validity of the study. Data collection: The researcher collected the data personally with the support of five trained field workers who only assisted at hospital B and was reluctant to assist at the second hospital. Data analysis: Data was analysed with the support of a statistician and expressed in frequencies and tables. Results: All phases of the nursing process showed a low compliance. Results showed that only n=90(42%) of the registered professional nurses checked and signed the initial assessment, furthermore only n=53(34%) showed that a recording was made of all referral documentation to the patient’s follow-up clinic. Recommendations: Recommendations based on the scientific evidence obtained from the study include the implementation of a quality assurance programme namely standardisation, auditing, case management of patients, education and training, rewarding of staff and further research. Conclusion: In conclusion guided by the research question “Are the audited discharged patient files at hospitals specialising in the management of patients with TB in the WCDoH compliant?” The researcher concludes that the discharged patient files are not compliant. / AFRIKAANSE OPSOMMING: Agtergrond: In haar kliniese praktyk as verpleegbestuurder is die navorser besorgd oor die onvolledige en onakkurate dokumentasie van pasiënte wat met tuberkulose (TB) gediagnoseer is en wat dus die versorging van hierdie pasiënte in gevaar stel. Hierdie besorgdhede is deur die primêre sorg verpleegsters bevestig. Doel en Doelwitte: Die doel van die studie is om die verpleegdokumente te ouditeer volgens die fases van die vepleegproses, asook die ontslagbeplanning van die pasiënte gediagnoseer met TB van die hospitale in die Wes-Kaap. Die doelwitte is om te bepaal of die pasiënte korrek geassesseer en gediagnoseer is en of verpleegsorgplanne opgestel is, wat gebaseer is op die assessering en versorgingsplanne wat geïmplementeer en geëvalueer is volgens die verpleegproses, insluitende die ontslagbeplanning. Etiese goedgekeuring is toegestaan deur die Komitee vir Menslike Navorsingswetenskap van die Universiteit van Stellenbosch en toestemming is ook ontvang van die onderskeie instansies. Metodologie: ’n Beskrywende ontwerp met ’n kwantitatiewe benadering is toegepas vir die doel van die studie. Die totale bevolking vir die studie is N=1786. ’n Sistematiese ewekansige geselekteerde steekproef van 12% van elke hospitaal is geneem: n=214, hospitaal A (n=142) en hospitaal B (n=72). Die kriteria sluit in:  alle volwasse pasiënte ouer as 18 jaar  pasiënte wat gedurende die periode 01 Januarie 2007 tot 31 Desember 2007 ontslaan is  alle ontslag pasiënte van die twee hospitale wat spesialiseer in pasiënte wat gediagnoseer is met TB. Instrumentasie: ‘n Ouditinstrument gebaseer op die doelwitte is goedgekeur as die dataversamelingsinstrument. Na aanleiding van die voorgestelde studie is 10% (n=21) van die aantal ontslag pasiëntlêers getrek vir die doel van die loodsondersoek. Betroubaarheid en geldigheid is verseker deur gebruik te maak van deskundiges in die verplegingsveld, die navorsingsmetodologie en statistiek. Die loodsondersoek is ook uitgevoer om die betroubaarhied en geldigheid van die studie te rugsteun. Dataversameling: Die navorser het die data persoonlik gekollekteer met die bystand van vyf opgeleide veldwerkers wat slegs hulp verleen het by hospital B en wat teësinnig was om hulp te verleen by die tweede hospitaal. Data-analise: Data is geanaliseer met die hulp van ’n statistikus en is uitgedruk in frekwensies en tabelle. Resultate: Alle fases van die verpleegproses het nie voldoen aan die vereistes nie. Resultate dui daarop dat slegs n=90 (42%) van die geregistreerde professionele verpleegsters die aanvanklike assessering nagegaan en onderteken het, vervolgens het slegs n=53 (34%) getoon dat ’n opname gemaak was van alle verwysde dokumentasie van die pasiënt se opvolgbesoek aan die kliniek. Aanbevelings: Aanbevelings is gebaseer op die wetenskaplike bewys wat verkry is van die studie vir die implementering van ’n gehalte versekeringsprogram, naamlik standardisering, ouditering, gevallebestuur van pasiente, opvoeding en opleiding, erkenning aan die personeel, en voortgesette navorsing. Samevatting: Ter afsluiting gelei deur die navorsering’s vraag nl. “Is die geouditeerde verpleegdokumente in hospitale wat spesialiseer in die bestuur van pasiente gediagnoseer met TB in die Weskaap se Department van Gesondheid bygehou?” Die navorser bevestig dat die verpleegdokumente nie bygehou was nie.

Thesis (MCur)--University of Stellenbosch, 2011. / ENGLISH ABSTRACT: During the period 2006-2008 more than 50% of midwifery students at the college under study failed the midwifery training programme. The academic performance of students can be attributed to various factors, ranging from personal uniqueness and institutional aspects to the course content itself. Accordingly, this study aims to explore the perceptions and experiences of student midwives with reference to their training programme. The objectives set for the study were set to determine the perceptions and experiences of the student midwives with regard to: • guidance in the practical field, • classroom experiences • assessment procedures and • whether the students attribute their academic successes or failures to the training programme. A qualitative approach with a descriptive design was applied to determine the perceptions and experiences of the undergraduate midwifery students concerning their training programme. The population of this study was fourth-year students who have successfully completed their midwifery-training programme. Nineteen students consented to participate in the study. The trustworthiness of this study was assured by using the Lincoln and Guba’s criteria of credibility, transferability, dependability and conformability. A pre-test was completed. All ethical principles were met. Data was collected through focus group interviews, using an interview guide. The analysis of the data revealed that students attributed their academic failures and success to guidance received in the theoretical as well as the practical field. The findings displayed the frustration that the students experienced with the lecture method as a teaching strategy. Discontentment was perceived among the participants regarding the demarcation, which differed among lecturers. Students were of the opinion that certain content of the curriculum was intended for the doctors, and they indicated a need for the extension of class time, for the instruction of the theory, as the curriculum was perceived as “content heavy”. Guidance in the clinical field, by the clinical educators, was perceived as being positive, yet the student-clinical educator ratio was proving to be a challenge. Marking of tests and examination answer sheets was perceived as too strict. Recommendations Students must be active participants in the learning process, not passive recipients of information. Teaching methods (such as role-play, brainstorming, case studies, simulations, and group work), that expand and reinforce basic communication, intellectual and interpersonal skills, should be employed. Uniformity amongst midwifery facilitators, in terms of content selection, demarcations, classroom activities and assessment techniques, should be agreed upon prior to the commencement of a block period. / AFRIKAANSE OPSOMMING: Tydens die periode 2006-2008 was meer as 50% van die verloskunde studente by die kollege waar die studie gedoen was, onsuksesvol in die verloskunde program. Akademiese prestasie van studente kan aan verskillende faktore toegeskryf word. Hierdie kwessies wissel van persoonlike uniekheid en institusionele aspekte tot die kursus inhoud self. Dus poog hierdie studie om die persepsies en ervaringe van die student vroedvroue ten opsigte van hul opleidingsprogram te verken. Die doelwitte van die studie was om die persepsies en ervaringe van die student vroedvroue met betrekking tot: • praktiese leiding, • klaskamerondervinding, • assesseringsprosedures te bepaal en • of die studente hul akademiese suksesse en mislukkings aan die opleidingsprogram toe skryf. ʼn Kwalitatiewe benadering met ʼn beskrywende strategie was gebruik om die persepsies en ervaringe van die voorgraadse studente rakende hul opleidingsprogram vas te stel. Die populasie van hierdie studie was studente, in hul vierde jaar, wat reeds die verloskunde opleidingsprogram suksesvol voltooi het. Negentien studente het ingestem om aan die studie deel te neem. Die vertrouenswaardigheid van die navorsing is verseker deur van die Lincoln en Guba kriteria – geloofwaardigheid, oordraagbaarheid, betroubaarheid en bevestiging – gebruik te maak. ʼn Voorafgaande toets is voltooi. Al die etiese beginsels is nagekom. Data is ingesamel deur onderhoude met fokusgroepe te voer. ’n Onderhoudsgids is vir die doeleinde gebruik. Die data-ontleding het getoon dat studente hul akademiese mislukkings en suksesse aan die leiding wat hulle op teoretiese en praktiese gebiede ontvang het, toeskryf. Die bevindinge het die frustrasie wat die studente met die lesmetode as ’n onderrigstrategie ervaar, getoon. Ontevredenheid rakende die werkafbakening, wat verskil van lektor tot lektor, is ook waargeneem. Studente voel dat dele van die kurrikuluminhoud vir dokters bedoel is. Hulle is van mening dat meer klastyd nodig is om teorie te onderrig, aangesien die kurrikulum oorvol is. Hoewel die leiding op kliniese gebied, deur die kliniese opvoeders, positief ervaar is, is die student-opvoeder verhouding as ʼn uitdaging beskou. Die studente het gevoel dat hul toetse en eksamenantwoordstelle te streng nagesien was. Aanbevelings: Studente moet aktief by die leerproses betrek word en moet nie bloot passiewe ontvangers van inligting wees nie. Onderrigmetodes, wat basiese kommunikasie-, intellektuele en interpersoonlike vaardighede aanvul en versterk (soos byvoorbeeld rolspel, dinkskrums, gevallestudies, simulasies en groepwerk), moet ingespan word. Die fasiliteerders moet ooreenkom en ʼn eenvormige beleid, betreffende die kurrikuluminhoud, afbakening van werk, klaskameraktiwiteite en assesseringsmetodes, voor die aanvang van die blokperiode, daarstel.

Thesis (MCur)--University of Stellenbosch, 2011. / ENGLISH ABSTRACT: Breastfeeding is considered as the most preferable method of infant feeding to fulfill babies’ nutritional needs important to the growth and development of babies. Unfortunately, there were babies not breastfed due to numerous reasons including infant illness and hospitalization. The purpose of this research was to describe the experiences and perceptions of nurses regarding breastfeeding in a pediatric setting of an academic hospital in the Province of the Western Cape. A descriptive study design with a qualitative approach was used to explore the experiences and perceptions of auxiliary nurses regarding breastfeeding. Purposive sampling was utilized to consciously select thirteen auxiliary nurses to participate in the study. Semi-structured interviews were used to collect data. Data analysis involved the transcribing of tape recorded interviews, the generating of themes and sub-themes, coding of the data, interpretation and organization of data and the drawing of conclusions. According to the auxiliary nurses’ perceptions, most of the babies in the pediatric setting were not being breastfed. Breastfeeding was being supplemented with formula milk when mothers chose not to breastfeed, experienced breastfeeding problems, were not with the baby or the baby was too sick to breastfeed. The babies’ illness, the hospital environment and lack of resources were challenging auxiliary nurses when supporting breastfeeding mothers. Not all health professionals were supportive of breastfeeding. Interrelated factors including, shortage of staff, time constraints, heavy work-loads, auxiliary nurses’ breastfeeding knowledge and experience, their confidence to support breastfeeding and communication regarding breastfeeding, influenced auxiliary nurses’ ability to support breastfeeding babies and mothers. The research findings indicate that there was a need for breastfeeding promotion in the pediatric setting. Recommendations included a written breastfeeding policy, breastfeeding training for all health care professionals, better breastfeeding education and support for mothers, the maintenance and of breastfeeding during the babies’ illness, adequate accommodation for breastfeeding mothers and the support of breastfeeding mothers who are HIV positive. / AFRIKAANSE OPSOMMING: Borsvoeding is beskou as die mees verkieslike voeding metode vir babas om hul te voorsien aan die nodige voedingsbehoeftes belangrik vir die groei en ontwikkeling van babas. Die doel van hierdie studie was om die ervarings en persepsies van verpleeg assistente met betrekking tot borsvoeding in ‘n pediatriese instelling in ‘n akademiese hospitaal in die Provinsie van die Weskaap te beskryf. ‘n Beskrywende studie ontwerp met ‘n kwalitatiewe benadering was gebruik ver die doel van die studie. Streekproeftrekking was gebruik om doelbewus drie assistant verpleegkundiges te selekteer om deel te neem aan die studie. Semi-gestruktureerde onderhoude was gebruik om data in te samel. Die data-analise behels die transkibering van band opgeneemde onderhoude, die opwekking van temas en subtemas onderverdeel, kodering van die data, interpretasie an organisasie van die data en die opstel van gevolgtrekkings. Dit was bevind na gelang van die assistant verpleegkundiges se persepsies, dat meeste van die babas in die hospitaal was nie geborsvoed. Borsvoeding was aangevul met formule melk wanneer moeders verkies om nie te borsvoed, ervaar borsvoeding probleme, was nie met die babas, of die baba was te siek om the voed aan die bors. Baba siektes, die hospitaal omgewing en die gebrek aan hulpbronne was uitdagend vir assistant verpleegkundiges om borsvoeding moeders te ondersteun. Interafhanklike faktore insluitend, ‘n tekort aan personeel, tyd beperkinge, swaar werk-vragte, borsvoeding kennis en ondervinding, die vertroue om borsvoeding te ondersteun en kommunikasie met betrekkking tot borsvoeding, het die borsvoeding ondersteuning van assistant verpleegkundiges beinvloed. Die navorsingsbevindinge dui daarop dat daar ‘n behoefte was aan borsvoeding bevordering in die hospitaal. Aanbevelings sluit in ‘n skriftelike borsvoeding beleid, borsvoeding opleiding vir alle gesondheidspersoneel, beter borsvoeding inligting en ondersteuning vir moeders, die instandhouding van borsvoeding tydens hospitalisasie, voldoende akkomodasie vir borsvoeding moeders and die ondersteuning van borsvoeding moeders wat MIV-positief is.