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Fluid balance monitoring in critically ill patientsDiacon, Annette 12 1900 (has links)
Thesis (MCur)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: Motivation. Homeostasis is a dynamic and balanced process that must be maintained in order to for health to be sustained (Scales & Pilsworth, 2008:50-57). In critically illness, homeostasis is disrupted and along with inadequate tissue perfusion potentially leads to multiple organ failure (Elliot, Aitken & Chaboyer, 2007:437). The fluid balance of a patient is essential for preserving homeostasis and to maintain optimal tissue perfusion, thus monitoring fluid balance plays an important role in the managing a critically ill patient. Current literature and best nursing practice emphasise the importance of accurate and correct fluid balance monitoring in critically ill patients including recording fluid intake and output on a purpose designed fluid balance sheet.
Research has shown that the patient’s outcome after critical illness is influenced by the fluid balance management including fluid balance monitoring (Vincent, Sakr, Sprung, Ranieri, Reinhart, Gerlach, Moreno, Carlet, Le Gall & Payen, 2006:344-353), while several studies have questioned accuracy of fluid balance calculation in various acute care settings (Johnson & Monkhouse, 2009:291; Smith, Fraser, Plowright, Dennington, Seymour, Oliver & MacLellan, 2008:28-29).
In an informal audit performed in a local critical care unit, seven out of ten fluid balances were incorrectly calculated. Clinical experience of nurses’ inattention to fluid balance monitoring, together with the informal audit data, reveals that fluid balance monitoring is generally not performed correctly or accurately by nurses working in critical care units. The aim of the study was to describe the perspectives and practices of registered nurses in critical care units with regard to fluid balance monitoring.
Methods. A quantitative approach in the form of an audit was applied to establish the current practice of fluid balance monitoring. A survey was conducted among registered nurses to gain insight into their perspectives and knowledge of fluid balance monitoring.
The sample for the audit was drawn from fluid balance records, which met the study inclusion criteria. The survey was conducted with a sample of participants from registered nurses in critical care units from a particular hospital group, in compliance with the inclusion criteria. The researcher collected the data using a purpose designed audit tool and questionnaire.
Results. The audit revealed that 90 % of the sampled fluid balance records were inaccurate (tolerated deviation 0-10ml) and 79% were inaccurate if a deviation of 50ml would be tolerated. Furthermore the inaccuracy in calculation was larger in patients whoreceived diuretics. The questionnaire data revealed that registered nurses considered fluid balance monitoring as an important part of patient nursing care and were aware that inaccuracy can pose a risk to the patient. The nurses feel responsible for performing fluid balance monitoring. In addition the nurses gave recommendations for the practice.
Discussion. The results of this study are similar to other studies done internationally. The nurses are aware of the importance of the fluid balance, and recognise the inaccuracies. With our limited resources, both financial and in terms of nursing staff, the solutions have to be very basic and practical.
Key words: fluid balance, critical care, accuracy and auditing, best practice / AFRIKAANSE OPSOMMING: Motivering. Homeostase is ’n dinamiese en gebalanseerde proses wat onderhou moet word vir gesondheid om handhaaf te word (Scales & Pilsworth, 2008:50-57). Onder toestande van kritieke siekte, word homeostase onderbreek en kan dit saam met onvoldoende weefselperfusie moontlik tot veelvuldige orgaanmislukking lei (Elliot, Aitken & Chaboyer, 2007:437). Die vloeistofbalans van ’n pasiënt is van die uiterste belang vir die preservering van homeostase en om optimale weefselperfusie te onderhou, en dus speel die monitering van vloeistofbalans ’n belangrike rol in die bestuur van die pasiënt wat kritiek siek is. Die huidige literatuur en beste verpleegkundige praktyk beklemtoon die belangrikheid van akkurate en korrekte vloeistofbalansmonitering in pasiënte wat kritiek siek is, insluitend die aantekening van vloeistofinname en -afskeiding op ’n vorm wat vir die doel pasgemaak is.
Navorsing het getoon dat die pasiënt se uitkoms ná kritiese siekte deur vloeistofbalansbestuur, insluitend vloeistofbalansmonitering, beïnvloed word (Vincent, Sakr, Sprung, Ranieri, Reinhart, Gerlach, Moreno, Carlet, Le Gall & Payen, 2006:344-353), terwyl verskeie studies die akkuraatheid van die vloeistofbalansberekening in ’n verskeidenheid kritiekesorgeenhede bevraagteken het (Johnson & Monkhouse, 2009:291; Smith, Fraser, Plowright, Dennington, Seymour, Oliver & MacLellan, 2008:28-29).
In ’n informele oudit wat in ’n plaaslike kritiekesorgeenheid uitgevoer is, is daar gevind dat sewe uit tien vloeistofbalanse verkeerdelik bereken is. Kliniese ervaring van verpleërs se agtelosigheid met betrekking tot vloeistofbalansmonitering, tesame met die data vanuit die informele oudit, wys dat vloeistofbalansmonitering oor die algemeen nie korrek of akkuraat deur verpleërs in die kritiekesorgeenheid uitgevoer word nie. Die doelwit van hierdie studie was om die perspektiewe en praktyke van geregistreerde verpleërs in kritiekesorgeenhede met betrekking tot vloeistofbalansmonitering te beskryf.
Metodes. ’n Kwantitatiewe benadering in die vorm van ’n oudit is gebruik om die huidige praktyk van vloeistofbalansmonitering te bepaal. ’n Opname is onder geregistreerde verpleërs gedoen om insig te bekom oor hulle perspektiewe oor en kennis van vloeistofbalansmonitering.
Die steekproef vir die oudit is geneem uit vloeistofbalansrekords wat aan die studiekriteria voldoen het. Die opname is gedoen onder ’n steekproef van geregistreerde verpleërs in ’n kritiekesorgeenheid van ’n spesifieke hospitaalgroep, in ooreenstemming met die insluitingskriteria. Die navorser het die data met ’n pasgemaakte ouditinstrument en vraelys versamel.
Resultate. Die oudit het gewys dat 90% van die vloeistofbalansrekords in die steekproef onakkuraat was (toleransie verskil 0-50ml) en 79% was onakkuraat als een verskil van 50 ml was tolereer. Verder was die onakkuraatheid in die berekenings groter in pasiënte wat urineermiddels ontvang het. Die data vanaf die vraelys het gewys dat geregistreerde verpleërs vloeistofbalansmonitering as ’n belangrike deel van die verpleging van ’n pasiënt beskou en daarvan bewus is dat onakkuraatheid ’n risiko vir die pasiënt kan inhou. Die verpleërs voel daarvoor verantwoordelik om die vloeistofbalansmonitering uit te voer. Hulle het ook aanbevelings vir die praktyk gemaak.
Bespreking. Die resultate van hierdie studie is baie soortgelyk aan dié van ander internasionale studies. Die verpleërs is bewus van die belangrikheid van die vloeistofbalans en is bewus van die onakkuraathede. Met ons beperkte hulpbronne, beide finansieel en in terme van verpleegpersoneel, is dit noodsaaklik dat die oplossings baie basies en prakties is.
Sleutelwoorde: vloeistofbalans, kritieke sorg, akkuraatheid en ouditering, beste praktyk
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Factors affecting quality of care in a midwifery practiceGcawu, Luleka Patricia 12 1900 (has links)
Thesis (MCurr)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: The midwives are the backbone of midwifery practice with needs and opportunities to create a tradition of caring in midwifery. However, there are problems that affect the midwifery practice. These problems include the increased maternal and perinatal mortality rate, shortage of material and human resources and poor implementation of policies and guidelines. The purpose of this study was to investigate factors that affect quality of care in a midwifery practice at a hospital complex in the Eastern Cape Province, South Africa.
The objectives of the study focused on the structure and process standards. - 1 Structure Standards: To determine whether
• policies and procedure manuals are available and updated
• support from the supervisor is available
• there is adequate staff
• the required qualifications were available
• the required experience of registered midwives were available
• in-service training was being given - 2 Process standards : To determine whether
• patients were assessed according to the national guidelines for maternity care
• patients were diagnosed according to the national guidelines for maternity care
• patients’ care plans were formulated according to the national guidelines for maternity care The descriptive research design with a quantitative approach was applied in this study. The target population (N=172) were the registered midwives working in the maternity department at a particular hospital in the Eastern Cape Province. A specific sampling method was not applied in this study as the total population of 155 was included and17 in the pilot study with a response rate of 81.3%.
A self-administered structured questionnaire was used to collect the data. The researcher distributed the questionnaires personally to all respondents who met the criteria.
Reliability and validity were assessed by means of a pilot study and the use of experts in Nursing Education, Midwifery, Research Methodology and Statistics. Ethical approval was obtained from Stellenbosch University and all other relevant parties. Computerized data analysis software namely the SPSS programmes and Stastica version 9 were used to analyze the data. The results of the study were interpreted, discussed and presented in tables and frequencies. The data was predominantly presented in a quantitative form with responses to a few close-ended questions.
A confirmatory analysis to test the quality of properties across a level of variables was carried out. The Chi-square test was used to test association of variables between demographic data and the responses of midwives to factors affecting quality of care.
A p-value of p< 0.05 represents statistical significance in hypothesis testing and 95% confidence intervals were used to describe the estimation of unknown parameters.
Results showed that the majority of respondents had an experience of 2 to 5 years (n=34/27.0%) and (n=32/25.4%) more than 14 years working in the maternity department. The minority of respondents were those that are highly skilled. Only (n=4/3.2 %) of the midwives were registered in neonatology nursing and (n=9/7.1%) in advanced midwifery. The majority of respondents (n=118/93.7%) recorded that there was not enough staff to provide quality nursing care. Some respondents recorded that comprehensive in-service education was not offered in the hospital (n=18/14.3%). Recommendations include improvement of staffing, adherence to policies and guidelines, proper implementation of staff development and quality improvement programmes.
In conclusion, in order to reduce high infant and maternal mortality rates and to reach the millennium development goals, shortcomings in midwifery should urgently be addressed. / AFRIKAANSE OPSOMMING: Die vroedvroue is die ruggraat van die verloskunde-praktyk met behoeftes en geleenthede om ’n tradisie van versorging in verloskunde te skep. Nietemin is daar uitdagings wat die praktisering van verloskunde beïnvloed. Hierdie uitdagings sluit in die toenemende moeder en perinatale mortaliteit, ’n tekort aan materiële en menslike hulpbronne, en die swak toepassing van beleid en riglyne. Die doel van hierdie studie was om die faktore te ondersoek wat die kwaliteit van sorg in ’n verloskunde-praktyk by ’n hospitaalkompleks in die Oos-Kaap in Suid-Afrika, beïnvloed.
Die doelwitte van die studie was op struktuur en proses standaarde gefokus. - 1 Struktuur standaarde: Om te bepaal of
• beleid en prosedure handleidings beskikbaar en opgedateer is
• daar ondersteuning van die toesighouer is
• daar voldoende personeel is
• daar voldoen is aan die vereiste kwalifikasies
• die vereiste ondervinding van geregistreerde vroedvroue teenwoordig
• is indiensopleding gegee - 2 Proses standaarde: Om te bepaal of
• pasiënte assesseer is volgens die nasionale riglyne vir verloskunde
• pasiënte gediagnoseer is volgens die nasionale riglyne
• pasiëntversorgingsplanne geformuleer is volgens die nasionale riglyne vir verloskunde. Die beskrywende navorsingsontwerp met ’n kwantitatiewe benadering is in hierdie studie toegepas. Die teikenbevolking (N=172) is die geregistreerde vroedvroue wat in die kraamafdeling van die spesifieke hospitaal in die provinsie van die Oos-Kaap werk. ‘n Spesifieke steekproefmetode is nie vir die studie toegespas nie maar wel die hele populasie is betrek van 155 en 17 in die lootsstudie met ‘n respons van 81.3%.
’n Self-geadministreerde gestruktureerde vraelys is gebruik om die data te versamel. Die navorser het die vraelyste persoonlik aan al die beskikbare respondente wat aan die kriteria voldoen het, versprei.
Betroubaarheid en geldigheid is geassesseer deur middel van ’n loodsondersoek en deur gebruik te maak van spesialiste in Verpleegopleiding, die Navorsingssentrum en Statistiek. Etiese goedkeuring is verkry van die Universiteit Stellenbosch en al die ander relevante partye. Gerekenariseerde data-analise sagteware, naamlik die SPSS programme en Statistica uitgawe 9 is gebruik om die data te analiseer. Die resultate van die studie is geïnterpreteer, bespreek en aangebied in tabelle en frekwensies. Die data is oorwegend in ’n kwantitatiewe formaat aangebied met response op ’n paar geslote vrae. ’n Bekragtigingsanalise om die eienskappe oor ’n vlak van veranderlikes te toets, is gedoen. Die Chi-kwadraat toets is gebruik om assosiasie van veranderlikes te toets tussen demografiese data en die response van vroedvroue vir faktore wat die kwaliteit van versorging beïnvloed.
’n P-waarde van p<0.05 verteenwoordig statistiese beduidendheid in hipotese-toetsing en 95% sekerheidsintervalle is gebruik om die beraming van onbekende parameters te beskryf. Resultate dui aan dat die meerderheid van respondente 2 tot 5 jaar werkervaring (n=34/27.0%) het en (n=32/25.4%) meer as 14 jaar in die kraamafdeling het. Die minderheid respondente is diegene wat hoogsbekwaam is. Alleenlik (n=4/1.0%) vroedvroue is in neonatale verpleging gereistreer en (n=9/7.1%) in gevorderde verloskunde geregistreer is. Die meeste respondente (n=118/93.7%) het aangedui dat daar nie voldoende personeel is om kwaliteit verpleegsorg te gee nie. Sommige respondente het aangedui dat omvattende indiensopleiding nie in die hospitaal aangebied is nie (n=18/14.3%). Aanbevelings sluit in die verbetering van personeelvoorsiening, die nakoming van beleid en riglyne, behoorlike implementering van personeelontwikkeling en gehalte verbeteringsprogramme.
Ten slotte, om die hoê insidensie in moeder en kind mortaliteit te verminder en die millennium ontwikkelingsdoelwitte te bereik, moet die tekortkomings in verloskunde dringend aangespreek word.
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Critical thinking : perspectives and experiences of critical care nursesHendricks, Lucia Elizabeth 12 1900 (has links)
Thesis (MCurr)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: The increasingly complex role of the critical care nurse in an intensive care environment demands a much higher level of critical thinking and clinical judgment skill than ever before. Critical thinking in nursing practice may be defined as the cognitive ability to analyse, predict and transform knowledge, ensuring quality nursing care. To reason from a nurse’s perspective requires that we learn the content of nursing; this includes the concepts, ideas and theories of nursing. The aim and objectives of the study were to explore critical care nurses’ perspectives and experiences with regards to the concept of critical thinking, facets influencing the application of critical thinking skills in clinical practice and how these impact on the delivery of quality nursing care.
A qualitative approach, using a case study design was utilised. A sample of six participants, who met the study inclusion criteria and consented to participate, were interviewed individually. Subsequently, five of these six participants took part in a focus group discussion to capture additional data to clarify and enrich the individual interview data. A field worker was present during the interviewing processes to note non-verbal data and later verify transcribed data. Feasibility of the proposed study was established by conducting a pretest which elicited relevant information. Ethical approval for the study was obtained from the Health Research Ethics Committee at the Faculty of Medicine and Health Sciences, Stellenbosch University. Permission and consent was obtained from the relevant hospital group to interview nurses working in the intensive care units.
Qualitative content analysis, which focuses on the content or contextual meaning, was used to analyse interview data. Coding of the data through emergent themes and sub-themes was done by the researcher and supported through independent coding to verify and strengthen the analysis and interpretation of the researcher. .
The results depicted how the participants personally understood the concept of critical thinking and the components influencing the application of critical thinking skill in clinical practice. The study of the participants’ perspective of the concept of critical thinking and portrayed how they experience analytical and independent thinking, competence and confidence, as well as knowledge, skill and expertise, to influence the quality of patient care.
The data revealed several themes that facilitated critical thinking in critical care nurses. These themes were ‘team support’, ‘experience and exposure’ and ‘empowering the mind’. Emergent themes elaborating the limitations of critical thinking included ‘being stressed’, ‘professional boundaries’ and ‘being busy’.
Several recommendations and suggestions for future research were offered. / AFRIKAANSE OPSOMMING: Die toenemende komplekse rol van die kritieke-sorgverpleegster in ’n intensiewe-sorg omgewing verg ’n veel hoër vlak van kritiese denke en ’n kliniese oordeelvaardigheid as ooit tevore. Kritiese denke in ’n verplegingspraktyk kan gedefinieer word as die kognitiewe vermoë om te kan analiseer, om vooruit situasies te kan bepaal en die vermoë om kennis te omskep sodat kwaliteit verpleegsorg verseker kan word. Om soos ’n verpleegster te kan dink, stipuleer dat die inhoud van verpleging geleer moet word wat konsepte, idees en teorieë daarvan insluit.
Die doel en oogmerke van die studie is om die ervarings en perspektiewe van kritieke-sorgverpleegsters te ondersoek, met betrekking tot die konsep van kritiese denke, fasette wat die toepassing van kritiese denkvaardighede in ’n kliniese praktyk beïnvloed en die impak daarvan op die lewering van kwaliteit verpleegsorg.
Die metodologie wat toegepas is, is ’n kwalitatiewe benadering deur middel van ’n gevalle-studie ontwerp. ’n Steekproefgrootte van ses deelnemers wat aan die inklusiewe kriteria voldoen het, is mee onderhoude individueel gevoer en daarna is met vyf van hierdie ses deelnemers in ’n fokusgroep onderhoude gevoer ten einde data op te neem wat andersins verlore kon geraak het. ’n Veldwerker was teenwoordig gedurende die proses van onderhoudvoering om die opgeneemde en getranskribeerde data te verifieer. Die data-insamelingsinstrument is in die vorm van ’n onderhoudsgids ontwikkel om die navorser gedurende die onderhoudvoering te help. ’n Loodsondersoek is uitgevoer om die haalbaarheid van die voorgestelde studie te ondersoek en is sodoende geskep om relevante inligting te onthul. Etiese goedkeuring vir die studie is verkry van die Gesondheidsnavorsing Etiese Komitee aan die Fakulteit van Geneeskunde en Gesondheidswetenskappe, Universiteit Stellenbosch. Goedkeuring en toestemming is van die hospitaalgroep aan wie die hospitaal behoort verkry, waar die studie onderneem is om sodoende onderhoude te kan voer met verpleegsters wat in die intensiewe-sorgeenhede werk.
’n Primêre, kwalitatiewe inhouds analise is gebruik om omderhoud data te analiseer wat fokus op die inhoud of kontekstuele betekenis daarvan. Kodering van die data deur die toepassing van die temas en sub-temas wat voorgekom het, is deur die navorser gedoen. Die data is onafhanklik gekodeer om die analise en interpretasie van die navorser te verifieer en te bekragtig ten einde die akkuraatheid en getrouheid in die formulering van die betekenis en interpretasie van gebeure met juiste weergawe daarvan, te verseker.
Die resultate wat as hooftemas vanuit die individuele onderhoude voortgespruit het, asook die van die fokusgroep het die deelnemers se eie begrip van die konsep van kritiese denke en komponente wat die toepassing van kritiese denkvaardigheid in ’n kliniese praktyk beïnvloed, getoon. Die konsep van kritiese denke het die wyse waarop analitiese en onafhankilke denke, bevoegdheid en selfvertroue, asook kennis, vaardigheid en kundigheid die kwaliteit van pasiëntsorg beïnvloed, uitgebeeld.
Die voortkomende data het daartoe aanleiding gegee dat die faktore wat die fasilitering en beperking van kritiese denke beïnvloed, bespreek kon word. Data rakende fasilitering het getoon hoedat die ondersteuning van die span, ervaring, blootstelling en die verruiming van die gees, kritieke-sorgverpleegsters positief kan beïnvloed om kritiese denke in hulle daaglikse verplegingsaktiwiteite effektief te kan toepas. Data wat verband hou met beperkings het getoon hoedat stres, professionele kwessies en besigwees kritieke-sorgverpleegsters negatief kan beïnvloed in die toepassing van kritiese denke gedurende daaglikse verplegingsaktiwiteite. Verskeie aanbevelings vir toekomstige navorsing is voorgestel.
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Research supervision needs and experiences of master's students in nursingBock, Evelyn Marieta 03 1900 (has links)
Thesis (MCurr)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: Background: Research supervision forms an essential part of higher education. The emergence of global trends in the production and dissemination of knowledge is compelling universities and university of technologies in South Africa to become more market-orientated, competitive and entrepreneurial. The supervision process is vital to successful completion of the research component of master’s degrees and consequently increase throughput in higher education. Successful and meaningful supervision contribute largely to mutual satisfaction and professional development between supervisors and students. Good supervision should be an integral component of quality research governance.
Objective: The aim of this study was to explore research supervision needs and experiences of the master’s students in nursing.
Methodology: A descriptive phenomenological research design was used with a qualitative research approach. A non-probability, purposive sampling method was used to select respondents in this study. The target population includes all nursing science master’s students enrolled at University of Stellenbosch in the past three years (N=109). A sample size of twelve students was included in the study, whereby all twelve face to face interviews were conducted using the semi-structured interview guide. The inclusion criterium for students was that they were all currently registered students who initially enrolled for the Masters in Nursing degree program between 2008 and 2010 in the division of Nursing at Stellenbosch University.
Results: Eight themes arose from the interviews. These included: isolation; lack of skills/ time management; family dynamics/personal circumstances; supervisor support; student and supervisor roles and responsibilities; workplace dynamics and support; financial and institutional support and implications; and motivation to complete studies.
Conclusions: Successful completion of research undertaken on postgraduate level and supervision at a master’s level depend on a healthy and productive relationship between the supervisor and the student. Exploring and implementing the guidance and suggestions in this paper will assist students in considering supervision preferences. This in turn will result in achieving a good supervisory relationship which is the key to successful master studies. / AFRIKAANSE OPSOMMING: Agtergrond: Navorsing toesighouding vorm ‘n belangrike deel van hoer onderwys. Die opkomende wêreldtendense in die toename en verspreiding van kennis verplig Resultate: Ag temas het vanuit die onderhoude voortgespruit. Dit het ingesluit: isolasie; gebrek aan vaardighede/tydsbestuur; familie-dinamika/persoonlike omstandighede; ondersteuning van toesighouer; rolle van student en toesighouer, asook verantwoordelikhede; werkplek dinamika/ondersteuning; finansiële en institusionele ondersteuning/implikasies en motivering om die studie te voltooi.
Gevolgtrekking: Die suksesvolle voltooiing van die navorsing wat onderneem word op nagraadse vlak en toesig is afhanklik van ’n gesonde en produktiewe verhouding tussen die toesighouer en die student. Die nagaan en implementering van die leiding en voorstelle in hierdie studie sal die studente help in die oorweging van toesighouer voorkeure. Dit sal gevolglik aanleiding gee tot die bereiking van ’n goeie toesighoudende verhouding wat die sleutel is tot die suksesvolle voltooiing van magistergraad studies. universiteite en universiteite van tegnologie in Suid-Afrika om meer markgeoriënteerd, kompeterend en ondernemend te word. Suksesvolle en betekenisvolle toesig maak hoofsaaklik n bydra tot die onderlinge bevrediging en professionele ontwikkeling tussen toesighouers en studente. Goeie toesig behoort ’n integrale komponent van kwaliteit begeleiding in navorsing te wees.
Doelwit: Die doel van hierdie studie was om die behoeftes van navorsingtoesig en ervaring van die magisterstudent in verpleging te ondersoek
Metodologie: ’n Beskrywende, fenomenologiese navorsingsontwerp met ’n kwalitatiewe navorsingsbenadering is gebruik. ’n Nie-waarskynlike, doelbewuste steekproefmetode is gebruik om respondente vir hierdie studie te selekteer. Die teikenbevolking sluit in alle magisterstudente wat ingeskryf is vir verpleegwetenskap aan die Universiteit van Stellenbosch oor die afgelope drie jaar (N=109). ’n Steekproefgrootte van twaalf studente is ingesluit in hierdie studie, waaronder daar met al twaalf van aangesig tot aangesig onderhoude gevoer is deur gebruik te maak van die semi-gestruktureerde onderhoudsgids. Insluitingskriteria vir die studente was dat hulle almal bestaande geregistreerde studente moes wees wat aanvanklik ingeskryf het vir die program vir die Meestersgraad in Verpleging tussen 2008 en 2010 in die afdeling van Verpleging aan die Universiteit van Stellenbosch.
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Factors influencing the throughput of master degree nursing students at a university in South AfricaLoubser, Helena Wilhelmina 03 1900 (has links)
Thesis (MCurr)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: Scientific evidence based practices are essential to efficient health service delivery. Continuous education to Master’s Degree level is the springboard to future research projects, but the throughput of Master’s Degree students is however a concern. The poor attainment rate of Master’s Degree in nursing delays improvement in evidence based nursing practices and impedes the availability of academia.
This study aimed to identify factors that influence the throughput of Master’s Degree nursing students in a distance education programme at a university in South Africa. The objective was to identify influencing factors related to
• the individual
• the Higher Education Institution
• the employer
A non-experimental, descriptive research design was applied with a quantitative approach. The target population was all the enrolled Master’s Degree Nursing students between 2004 and 2010 at the university under study. A structured electronic questionnaire was implemented for data collection. The questionnaire was presented to (n = 201) with a response rate of (n = 46/23%).
Ethical approval was obtained from Stellenbosch University to conduct this study. Permission was obtained from the university under study to utilize the contact details on the data base of the target population.
Reliability and validity was assured by two pilot studies to test the instrument and the use of experts in nursing research, methodology and statistics. The electronic instrument allowed automatic data capturing. The collected data was archived in the accessed controlled electronic data surveys pool of Stellenbosch University.
Data analysis was done with the support of a statistician and was expressed as frequencies and in tables. Descriptive statistics and tests for statistical associations were also performed.
The individual related outcomes showed that respondents had a mean age of 42 years and (n = 22/48%) had 21 to 40 years experience as a professional nurse. The majority of respondents were female (n = 45/98%) and married (n = 30/54%). Results indicated that the management of family and studies was not easy (n = 30/65%), but respondents experienced their family as an effective support (n = 37/80%) during their studies. Respondents who left their studies indicated the main reason to be a lack of a supporting network (n = 7/19%). Impeding factor results from the Higher Education Institution showed that WebCT was not an effective communication instrument (n = 19/42%) and (n = 22/48%) respondents had difficulty to access their supervisors. Enhancing factors related to study outcomes that were easy to comprehend (n = 39/85%) and efficiency of face-to-face workshops (n = 21/88%) provided support. All the respondents were employed at the time of study (n = 46/100%). Results showed that service demands were the reason why (n = 4/11%) non-completing respondents left their studies. Employers required from (n = 22/48%) respondents to do overtime during their studies. Employer demands influenced the studies of (n = 16/65%) respondents.
In conclusion, this study showed specific factors that influence the throughput of Master’s Degree in Nursing students at the university under study. Recommendations were made to influence policy makers and stakeholders to reconsider their present practices regarding continuous education and support to their clients. / AFRIKAANSE OPSOMMING: Wetenskaplikgefundeerde uitkomsgebaseerde praktyke is noodsaakik vir doeltreffende gesondheidsdienslewering. Voortgesette onderrig tot die vlak van ’n Magistergraad is die vertrekpunt vir toekomstige navorsingsprojekte, maar die voltooiing van Magistergrade is egter ‘n bekommernis. Die gebrekkige verwerwing van Meestersgrade in Verpleegkunde het nie net ’n sleureffek op die verbetering van uitkomsgebaseerde verpleegpraktyke nie, dit strem ook die beskikbaarheid van akademici.
Die studie het ten doel gehad om faktore te identifiseer wat die voltooiing van die Magistergraad in Verpleegkunde vir studente van die afstandsonderrigprogram, aan ‘n universiteit in Suid-Afrika, beïnvloed. Die doelwit behels die identifisering van faktore wat te make het met
• die individu
• die Hoëronderwys Instansie
• die werkgewer
’n Nie–eksperimentele, beskrywende navorsingsontwerp met ’n kwantitatiewe benadering is gevolg. Die teikengroep is al die ingeskrewe Magisterstudente in Verpleegkunde tussen 2004 en 2010 aan die teiken-universiteit.
’n Gestruktureerde elektroniese-vraelys is gebruik vir dataversameling. Die vraelys is aangebied aan (n = 201) kandidate en ‘n (n = 46/23%) voltooiingrespons is verkry.
Etiese goedkeuring om die studie te doen is van die Universiteit Stellenbosch verkry. Toestemming is ook van die teiken-universiteit verkry om die kontakbesonderhede van die teikenbevolking vanuit die databasis te benut. Betroubaarheid en geldigheid is deur twee loodsstudies verseker en vakkundiges in verpleegnavorsing, metodologie en statistiek is betrek by die studie. Die elektroniese instrument het voorsiening gemaak vir outomatiese datavaslegging met voltooiing. Die versamelde data is in die toegangsbeheerde elektroniese-navorsingsdatabank van die Universiteit Stellenbosch geberg.
Die data is ontleed met die hulp van ‘n statistikus en is as frekwensies en tabelle weergegee. Beskrywende statistiek en toetse vir statistiese verhoudings is ook uitgevoer.
Die bevindings rakende die individu dui daarop die gemiddelde ouderdom van deelnemers 42 jaar was en dat (n = 22/45%) tussen 21 en 40 jaar ervaring as professionele verpleegkundiges het. Die meeste van die deelnemers was vroulik (n = 45/98%) en getroud (n = 30/54%). Bevindings toon dat die hantering van familie en studies nie maklik was nie (n = 30/65%), maar deelnemers het egter hul familie as goeie ondersteuning (n = 37/80%) gedurende hul studies beleef. Deelnemers wat hul studies gestaak het, het as die hoofrede ’n gebrek aan ‘n ondersteuningsnetwerk aangevoer (n = 7/19%). Bevindings wat verwys na stremmende faktore van die Hoëronderwysinstelling hou verband met WebCT wat ondoeltreffend was as kommunikasie-instrument (n = 19/42%) en studieleiers wat moeilik deur deelnemers bereik kon word (n = 22/48%). Versterkende faktore was verwant aan studiedoelwitte wat maklik verstaanbaar was (n = 39/85%) en die ondersteuningsukses van aangesig tot aangesig werkswinkels (n = 21/88%). Al die deelnemers was in diens tydens hul studie (n = 46/100%). Bevindings toon dat diensverwagtinge die rede was waarom (n = 4/11%) deelnemers hul studies gestaak het. Werkgewers het van (n = 22/48%) deelnemers verwag om oortyd te werk tydens hul studies terwyl (n = 16/65%) deelnemers aangedui het dat hul studies beïnvloed was deur hul werkgewer se eise.
Ten slotte, hierdie studie het getoon dat spesifieke faktore die voltooiing van Magisterstudies in Verpleegkunde aan die teiken-universiteit beïnvloed. Aanbevelings is gemaak om beleidmakers en belangegroepe te beïnvloed om hul bestaande praktyke rakende voortgesette onderrig en ondersteuning aan hul kliënte te heroorweeg.
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Patient experiences and perceptions of non-compliance with TB treatmentShasha, Alethea Christina N. 03 1900 (has links)
Thesis (MCurr)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: Non-compliance with (tuberculosis) TB treatment is a problem at the Nyanga Clinic in the Western Cape Province. Non-compliance is defined as when a patient interrupted TB treatment for more than two months consecutively, at any time during the treatment period.
The aim of the study was to explore the patient experiences and perceptions of non-compliance regarding their TB treatment.
The following research question was posed by the researcher as a guide for this study: “What are the patient experiences and perceptions of non-compliance with TB treatment?”
The objectives of this study were to determine the:
- patients’ experiences and perceptions of non-compliance with TB treatment
- non-compliant patients’ knowledge regarding TB
- reasons why patients are not compliant with TB treatment. A qualitative, explorative, descriptive and contextual design was applied. The target population included the 354 non-compliant with TB treatment patients from March 2010 until May 2011. A purposive, non-random sampling technique was used to select participants for the study. Every tenth participant who, according to the TB register, was colour-coded as non-compliant with TB treatment, was selected for interviewing until data saturation should occurred. A sample of fourteen (14) participants was realised. A semi-structured interview schedule was developed based on the objectives of the study, which was validated by experts in nursing and approved by the Human Resources Ethics Committee of the Faculty of Health Sciences of the University of Stellenbosch. Data was collected personally by the researcher. Informed written consent was obtained from the participants. One patient who was not included in the main study was selected at random to pre-test the semi-structured interview. The pilot study revealed no pitfalls.
Trustworthiness of the research was enhanced by adhering to the principles of credibility, confirmability, transferability and dependability. Credibility was ensured by member checking, data saturation, triangulation and involvement of an experienced research supervisor. Confirmability was enhanced through member checking and the leaving of an audit trail. Transferability through keeping an intensive description of all the processes and dependability by using an interview schedule and by submitting the transcribed tape-recorded data and field notes to the research supervisor for verification.
The quantitative data was summarised in a table format to enhance clarity and facilitate a rapid overview of the results. The qualitative data was analysed manually with the findings coded and divided into subthemes and themes. Four themes emerged, namely: health system, client-related, social-economic and therapy factors. These themes identified the impeding factors regarding the non-compliance with TB treatment. The main conclusion is that there is a need to educate the community regarding the lengthy duration of the TB treatment, its side-effects, its curability and the spread of the infection as well as the consequences of inadequate treatment to empower the community at large about the disease.
The National Department of Health framework of contributing to non-compliance with TB treatment was used as the conceptual framework for this study. The researcher applied the problem-solving approach of Faye Glen Abdellah’s theory. According to this theory it is anticipated that by solving the problems or needs of patients, through appropriate and organised health strategies the client will be moved towards ultimate health. / AFRIKAANSE OPSOMMING: Onderbreking van tuberkulose (TB) behandeling is ’n probleem by die Nyanga-kliniek in die Wes-Kaap Provinsie. Onderbreking kan gedefinieer word wanneer’n pasiënt vir twee of drie opeenvolgende maande TB behandeling onderbreek het (Jaggarajamma, Sudha, Chandrasekaran, Nirupa, Thomas, Santha, Muniyandi & Narayanan, 2007:131).
Die doel van die studie is om die pasiënte se ervaringe en persepsies betreffende die onderbreking in TB behandeling te ondersoek.
Die navorser het die volgende navorsingsvraag as riglyn vir hierdie studie gestel: “Wat is die pasiënte se ervaringe en persepsies wat TB-behandeling onderbreek het?”
Die doelwitte van die studie was om te bepaal wat die:
- pasiëntervaringe en persepsies is wat TB-behandeling onderbreek
- kennis van pasiënte is wat TB-behandeling onderbreek
- redes is waarom pasiënte TB-behandeling onderbreek.
’n Kwalitatiewe navorsingsontwerp met’n ondersoekende, beskrywende en kontekstuele benadering is aangewend. ’n Doelbewuste, lukrake steekproef is gebruik om deelnemers te selekteer. ‘n Steekproef van veertien (14) deelnemers uit ’n totale populasie van 354 hetrealiseer en sluit pasiënte in wat behandeling onderbreek het vanaf Maart 2010 tot en met Mei 2011. ’n Semi-gestruktureerde onderhoudsgids is ontwerp, gebaseer op die doelwitte van die studie en gevalideer deur kundiges in verpleegkunde en die Etiese Komitee van die Fakulteit van Gesondheidswetenskappe aan die Universiteit van Stellenbosch. Die data is persoonlik deur die navorser ingesamel. Ingeligte skriftelike toestemming is van die deelnemers verkry. Een deelnemer wat nie ingesluit is by die hoofstudie nie, is lukraak gekies om die semi-gestruktureerde onderhoud te toets. Die loodsondersoek het geen tekortkominge aangedui nie.
Betroubaarheid van die studie is verseker deur die beginsels van objektiwiteit, bevestiging, veralgemening en neutraliteit te verseker. Getranskribeerde data is gekontroleer met die deelnemers, volledige beskrywings van alle prosesse is bygehou, ’n onderhoudsgids is gebruik om te verseker dat vir al die deelnemers dieselfde vrae gevra word, en ’n ervare navorsing toesighouers was deurgaans teenwoordig wat alle data gevalideer het.
Kwantitatiewe data is in ’n tabel opgesom ten einde goeie oorsig te bied. Kwalitatiewe data-analise is met die hand gedoen. Die data wat uit die analise na vore gekom het, is geënkodeer en in subtemas en temasgekategoriseer. Die vier temas wat hieruit voortspruit, is faktore betreffende die gesondheidsorgsisteem, kliënte, sosio-ekonomiese en terapie-verwante faktore. Die navorser het n geskrewe verslag saamgestel betreffende die weergawe van die data-analise ten einde te verseker dat belangrike data nie verlore gaan. Die belangrikste bevindinge van die studie dui daarop dat die gemeenskap ’n behoefte aan opleiding het betreffende die onderbreking in TB behandeling, die langdurige tydperk van behandeling, newe-effekte van die medikasie, geneesbaarheid daarvan, hoe die siekte versprei en die gevolge betreffende onvoldoende medikasie ten einde die gemeenskap te bemagtig betreffende die siekte.
Die raamwerk van die Nasionale Departement van Gesondheid (2009:45) betreffende die faktore wat bydra tot onderbreking in TB-behandeling is gebruik as konseptuele raamwerk vir die studie. Faye Abdellah se teorie (George, 2002:173-1830)verduidelik verpleging as ’n omvattende diens wat insluit: identifisering van die pasiënt se verplegingsprobleme, die besluit van ’n toepaslike plan van aksie, sowel as die voortgesette sorg betreffende die individu se totale behoeftes.
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The management of blood and body fluids in a Kenyan university hospital : a nursing perspectiveNgesa, Anna Adhiambo 03 1900 (has links)
Thesis (MCur (Nursing Science))--University of Stellenbosch, 2008. / ENGLISH ABSTRACT: The purpose of this study was to determine the knowledge of Universal Precautions Policy by Registered Nurses at Kenyatta National Hospital (Kenya) and their perception of occupational risk of exposure to blood-borne pathogens. The study also assessed management of blood and body fluids of patients and identified the types and frequency of occupational exposure common among these Registered Nurses. A structured 24-item, self-administered questionnaire was distributed to 185 randomly sampled Registered Nurses in selected departments at this hospital. Compliance with Universal Precautions practices was also observed using a checklist. Data analysis was done by use of a computer software package, Statistical Package for Social Sciences (SPSS) version 11.0. The study findings suggest: 1) lack of continuous education demonstrated by a high level of non-response about knowledge of Universal Precautions Policy with only 19% of the respondents having attended an in-service course in Universal Precautions Policy, and 2) inaccurate understanding of transmission modes of blood-borne pathogens. The majority of nurses surveyed were using Universal Precautions; with indications that nurses were not as familiar with Universal Precautions as they think they were. Respondents admitted modifying personal protection habits based on subjective judgment regarding patient’s perceived blood-borne infectious state. Non-compliant behaviours with barrier precautions were identified, which included failure to use gloves, gowns and protective eyewear, failure to wash hands, and recapping used needles. Compliance with barrier precautions was associated with patients’ perceived blood-borne status. The study revealed a high level of occupational exposures, of which the majority went unreported. Although respondents were aware of the risk of occupationally acquired blood-borne infections, their irregular practice of Universal Precautions Policy is likely to perpetuate the risks. The findings suggest a need for more educational interventions, which may result into integration of concepts into practice. Educational programmes should focus on the epidemiology of occupationally acquired blood-borne pathogens and their modes of transmission, risk of occupationally acquired blood-borne infections at work place, and with emphasis on the principle and practice of Universal Precautions Policy and current protocol of reporting mechanisms in Kenya.
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Investigation into the quality of life of an employee affected by HIV/AIDSVollenhoven, Salome Minky 03 1900 (has links)
Thesis (MCur (Interdisciplinary Health Sciences. Nursing Science))--Stellenbosch University, 2008. / One of the greatest challenges in the world today is fighting the HIV/AIDS pandemic.
Life expectancy in developing countries, especially those in sub-Saharan Africa,
decreased to 46 years while in developed countries the average life expectancy is 78
years. World Health Organisation(WHO) indicates that HIV/AIDS, now the world's
leading cause of death in adults aged 15 to 59 years, is killing almost 5 000 men and
women in this age group, and almost 1 000 of their children, every 24 hours in sub-
Saharan Africa.
In South Africa today, employees operate in an increasingly complex legal environment
with regard to HIV/AIDS in the workplace.
Despite the legal protection against employees affected by HI/AIDS and vigorous
campaigns to combat HIV/AIDS in support of affected employees, the researcher has
observed that management and co-workers show no compassion, empathy or
understanding for the needs of these affected employees.
An in-depth literature review of quality of life was completed. The goal of this study was
to investigate whether the quality of life of the employee affected by HIV/AIDS is
adversely affected. The following objectives were set:
• To determine the family history of the employee affected by HIV/AIDS
• To determine occupational history of the employee affected by HIV/AIDS
• To determine the symptoms of the employee affected by HIV/AIDS
• To determine the effectiveness of the anti-retroviral treatment programme of the
employee affected by HIV/AIDS
A descriptive qualitative research design using the case study method was applied to
investigate whether the quality of life of the employee affected by HIV/AIDS was
adversely affected.
The population of this study were HIV/AIDS-affected employees working at a food and
beverage company. Ten employees who gave consent participated in the study. The
trustworthiness of this study was assured with the use of Lincoln and Guba’s criteria of
credibility, transferability, dependability and confirmability. A pre-test study was also completed. All ethical principles were met. Data was collected through an interview
using an interview guide designed for use in a semi-structured interview. Data analysed
show that the basic needs of the employee affected by HIV/AIDS are not adequately met
and that the employee therefore does not experience quality of life.
Recommendations include the improvement in public–private partnerships; in-service
training and continuous refresher courses for all employees, supervisors and
management; employee assistance programmes; involvement of church and
communities; support circle; holistic approach in nursing care and further research.
The findings play a role in understanding the importance of remaining at work for as long
as possible when one is affected by HIV/AIDS. The findings of this study further validate
the concepts in basic needs and that QOL is perceived differently by each individual.
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The effect of teaching methods used as experienced and perceived by student nurses at a nursing college in the Western Cape provinceFurst, Laetitia Nicole 12 1900 (has links)
Thesis (MCur)--Stellenbosch University, 2011. / ENGLISH ABSTRACT: The 21st century teaching environment is unique in its diversity, and challenges
academic staff to create a teaching environment that is conducive to all current
learners. Various teaching methods are available and affordable, but technology
remains an essential investment for the future of higher education institutions.
The goal of the study was to evaluate the perceptions of student nurses regarding
the effectiveness of the teaching methods which they experienced at a nursing
college in the Western Cape Province.
The objectives included an evaluation of the effectiveness of teaching methods as
perceived and experienced by students of:
- The traditional (green/whiteboard) lecture
- Group activity
- Self-activity
- The use of technology such as PowerPoint presentations and video clips.
An explorative descriptive research design was applied with a quantitative approach.
The target population (N=1238) consisted of nursing students following the
programme leading to registration as a professional nurse. Stratified random
sampling was used to select the sample of participants (n=267).
Data was collected personally by the researcher with a self-administered
questionnaire which consisted of predominantly closed questions.
Ethics approval to conduct this study was obtained from Stellenbosch University
including permission from all other relevant parties.
Reliability and validity of the study were assured through a pilot study, consultation
with experts in nursing, education and statistics. The reliability of the questions were
tested using the Cronbach alpha coefficient test which varied between .89 and .94.
The data was analysed with the support of a statistician and was expressed as
frequencies in tables and histograms. Descriptive statistics and post-hoc analyses
including tests for statistical associations were performed.
Results include a significant difference in generation X participants and the
green/whiteboard teaching methods (Spearman p-value = 0.02) and their preference of the traditional lecture as a teaching method (Spearman p-value = <0.01). The
perceived effectiveness of the teaching methods on student performance varied
between very helpful and not helpful. Only (n = 49/19%) of participants experienced
the traditional lecture as being very helpful on their general academic performance, in
comparison to the effect of group work (n = 69/26%) and self-activity (n = 102/39%).
Furthermore, no significant results were obtained between the participants and the
perceived effect of the teaching methods.
Open-ended questions showed that participants regarded the teaching strategies as
boring and ancient and that much of the unhappiness expressed stems from the
difference in the needs of millennials and the lack of change and obstinacy existing
amongst academics.
Recommendations include an increase in the use of technology, a blended approach
to teaching, the re-training of academic staff, measures in counteracting a boring
classroom environment, orientation for neophyte academics and students, workload
perception of students and class size.
In conclusion should recommendations be implemented a complete transformation of
the college under study will result. It may force the education institution to move out
of complacency, to a more vigorous and dynamic education environment that
enables them to emerge as an Higher Education Institution (HEI) of good standing. / AFRIKAANSE OPSOMMING: Die een-en-twintigste-eeuse onderwysomgewing is uniek wat betref diversiteit en
daag akademiese personeel uit om teenswoordig ’n onderwysomgewing te skep wat
bevorderlik is vir alle leerders. Verskeie onderwysmetodes is beskikbaar en
bekostigbaar, maar tegnologie bly ’n noodsaaklike belegging vir die toekoms van
hoër onderwysinstansies.
Die doel van hierdie studie was om die effektiwiteit van die gebruik van
onderwysmetodes wat waargeneem en ondervind word deur
studentverpleegkundiges by ’n spesifieke Verpleegkollege in die Wes-Kaap, te
evalueer. Die doelwitte sluit in die evaluering aangaande die effektiwiteit soos
waargeneem en ondervind deur studente van die volgende onderwysmetodes:
- Die tradisionele groen/witbord lesing
- Groepaktiwiteit
- Selfaktiwiteit
- Die gebruik van tegnologie soos PowerPoint-aanbiedings en video-insetsels.
’n Ondersoekende, beskrywende navorsingsontwerp met ’n kwantitatiewe
benadering is toegepas. Die teikengroep is (n=1238) wat uit verpleegstudente
bestaan wat die program vir die van ’n geregistreerde professionele verpleegster
volg. ’n Gestratifieerde ewekansige steekproef is gebruik om die deelnemers (n=267)
te selekteer.
Data is self deur die navorser ingesamel deur gebruik te maak van ’n selfgeadministreerde
vraelys wat hoofsaklik uit geslote vrae bestaan het.
Etiese goedkeuring om die studie na te vors, is verkry van die Universtiteit van
Stellenbosch, asook die van al die betrokke partye.
Betroubaarheid en geldigheid van die studie is verseker deur ’n loodsondersoek,
sowel as raadpleging met deskundiges op die gebied van Verpleging, Opvoedkunde
en Statistiek. Die betroubaaarheid van die vrae is getoets deur gebruik te maak van
die Cronbach-alpha koëffisiënt toets wat tussen .89 en .94 gevarieer het.
Die data is geanaliseer met die ondersteuning van ’n statistikus en word voorgestel
as frekwensies in tabelle en histogramme. Beskrywende statistieke en post-hoc
analises, insluitende toetse vir statistiese assossiasies, is uitgevoer. Resultate sluit in ’n beduidende verskil in generasie x-deelnemers en die groen- of
witbord onderwysmetodes (Spearman p-waarde = 0.02) en hul voorkeur vir die
tradisionele lesing as ’n onderrigmetode (Spearman p-aarde >0.01). Die effektiwiteit
van die onderwysmetodes op studenteprestasies wat waargeneem is, varieer tussen
baie waardevol en van geen waarde nie.
Slegs (n=49/19%) van die deelnemers het die tradisionele lesing as baie waardevol
vir hul algemene akademiese prestasie ervaar, in vergelyking met die effek van
groepwerk (n=69/26%) en self-aktiwiteit (n=102/39%). Vervolgens, is geen
beduidende resultate verkry tussen die deelnemers en die effek van die
onderrigmetodes wat waargeneem is nie.
Ope vrae bewys dat deelnemers die onderwysstrategieë as vervelig en verouderd
beskou en dat baie van die ongelukkigheid wat deurgevoer is, voortspruit uit die
verskil in die behoeftes van die milleniums en die gebrek aan geneentheid, asook
halsstarrigheid by akademici om te verander.
Aanbevelings sluit in ’n toename in die gebruik van tegnologie, ’n saamgestelde
benadering tot onderrig, die heropleiding van akademiese personeel, maatstawwe
om ’n vervelige klaskameratmosfeer teen te werk, oriëntering vir neofiet akademici
en studente se persepsie van werklading en klasgrootte.
Ten slotte, indien aanbevelings geïmplementeer word, sal ’n volslae transformasie
van die kollege onder die soeklig, plaasvind. Dit mag die opvoedkundige instansie
forseer om te beweeg vanuit ’n toestand van gemaksugtigheid na ’n meer
ondernemende en dinamiese onderrigomgewing wat in staat sal wees om as ’n Hoër
Onderwysinstansie van formaat te funksioneer.
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Experiences and perceptions of primary health care students utilizing simulation laboratoriesNel, Natalie 12 1900 (has links)
Thesis (MCur)--Stellenbosch University, 2011. / ENGLISH ABSTRACT: Simulation refers to a teaching method that is used to teach students clinical skills. The
use of mannequins is the most common type of simulation. Given the pivotal role that
simulation plays in teaching students clinical skills, it is important to understand the
experience and perceptions students have utilizing simulation laboratories. The aim of the
study was to explore the experience and perceptions of primary health care students
utilizing simulation laboratories.
The researcher posed the following research question as a guide for this study: “What are
the experiences and perceptions of primary health care students utilizing simulation
laboratories?” A qualitative approach with a phenomenological research design was
applied. A purposive sample of n=10 and a focus group of 7 participants was drawn from a
total population of 232 primary health care students. An interview guide was designed
based on the objectives of the study and validated by experts in Nursing, Education and
the Ethics Committee at the Faculty of Health Sciences, Stellenbosch University. Experts
in the field of teaching and learning, nursing and research methodology were consulted to
determine the feasibility and content of the study, to evaluate the research process and
outcome. Two (2) trained fieldworkers were responsible for collecting the data. Data was
collected by means of individual interviews and by interviewing a focus group. The
transcription of the interviews was done by the researcher.
The data that emerged from the data analysis was coded and categorised into themes and
subthemes. The five themes that emerged were simulation as a teaching method; a
mannequin offering effective learning; confidence in clinical practice; structure of the
course; and a support system. The researcher compiled a written account of the
interpretations that emerged from the data analysis and verified this with the fieldworkers.
In addition, member checking was done on two (2) of the participants from the focus group
as well as two (2) of the participants from the individual interviews, to validate the
transcribed data.
The Conceptual Theoretical Framework of Bloom supports the findings of this study. The
findings suggest that the mannequins should be upgraded regularly and should be able to
register a response. It is recommended that a mannequin should be designed which is
computer programmed according to different conditions which will include the signs and
symptoms of those diseases for example tuberculosis. The participants need to be placed
in the clinical environment at a much earlier stage in their programme. Peer group
teaching and assessment should be introduced in the programme. Further research is
recommended since institutions and disciplinaries working with simulation were not
included in the study. / AFRIKAANSE OPSOMMING: Simulasie verwys na ’n onderrigmetode wat gebruik word om studente kliniese
vaardighede aan te leer. Die gebruik van mannekyne is die mees algemene vorm van
simulasie. Gegee die deurslaggewende rol wat simulasie speel in die onderrig van kliniese
vaardighede aan studente, is dit belangrik om die ervaring en persepsies van studente wat
gebruik maak van simulasie-laboratoriums, te wete te kom. Die doel van hierdie studie
was om die ervaring en persepsies van primêre gesondheidssorgstudente wat van
simulasie-laboratoriums gebruik maak, te ondersoek.
Die navorser het die volgende navorsingsvraag as ’n riglyn vir hierdie studie gestel: “Wat
is die ervaringe en persepsies van primêre gesondheidssorgstudente wat simulasielaboratoriums
gebruik?” ’n Kwalitatiewe benadering met ’n fenomenologiese
navorsingsontwerp is toegepas. ’n Doelbewuste steekproef van n=10 en ’n fokusgroep
van 7 deelnemers is geneem vanuit ’n totale bevolking van 232 primêre
gesondheidsorgstudente. ’n Onderhoudgids is ontwerp, gebaseer op die doelwitte van die
studie en gevalideer deur kundiges in Verpleging, Opvoedkunde en die Etiese Komitee
van die Fakulteit van Gesondheidswetenskappe aan die Universiteit van Stellenbosch.
Kundiges op die gebied van onderrig en leer, verpleging en navorsingsmetodologie is
geraadpleeg om die haalbaarheid en inhoud van die studie te bepaal vir die evaluering
van die navorsingsprosedure en uitkomste. Twee (2) opgeleide veldwerkers was
verantwoordelik om die data te versamel. Die data was versamel deur middel van
individuele onderhoude en ‘n onderhoud met ‘n fokus groep. Die onderhoude was
getranskribeer deur die navorser.
Die data wat uit die analise gekom het, is geënkodeer en gekategoriseer in temas en
subtemas. Die vyf temas wat hieruit voortgespruit het, is simulasie as ’n onderrigmetode;
’n mannekyn wat effektiewe leer bied; vertroue in die kliniese praktyk; die struktuur van die
kursus; en ’n ondersteuningssisteem. Die navorser het ’n geskrewe verslag saamgestel
van die weergawe van die data-analise wat saamgestel en deur die veldwerker geverifieer
is. Bykomend is die kontrole van lede van twee (2) van die deelnemers van die
fokusgroep, asook twee (2) van die deelnemers vanuit die individuele onderhoude
gedoen, om die getranskribeerde data se geldigheid te verklaar.
Die Konseptuele Teoretiese Raamwerk van Bloom rugsteun die bevindinge van hierdie
studie. Die bevindinge beveel aan dat die mannekyne gereeld opgegradeer behoort te
word en dat hulle ’n respons moet kan registreer. Dit word aanbeveel dat ’n mannekyn
ontwerp behoort te word wat rekenaar geprogrammeerd is volgens die verskillende
toestande wat die tekens en simptome van siektes soos tuberkulose insluit. Die
deelnemers behoort in ’n baie vroeë stadium van die program in die kliniese omgewing geplaas te word. Verdere navorsing word aanbeveel, aangesien inrigtings en dissiplines
wat met simulasie gemoeid is, nie in hierdie studie ingesluit is nie.
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