Thesis (MCur)--University of Stellenbosch, 2005. / ENGLISH ABSTRACT: The critical care nurse works in an environment where patient need often shifts the parameters within which she or he practices. It is expected of a skilled critical care nurse to be able to make independent decisions and take action regarding patient care based on her or his knowledge and skills without discounting the parameters of her or his scope of practice. Practice experience has indicated that the critical care nurse is often uncertain about whether her or his clinical activities are protected by the regulations provided by the Nursing Council. This is more specifically true in the private hospital industry where medical advice or assistance is not always easily available. This situation led to the following research question: Do the available professional and legal guidelines provide an appropriate foundation to guide the practice of the registered critical care nurse in the private hospital sector critical care environment? A non-experimental descriptive study with a qualitative orientation was conducted in 19 private hospitals in the Western Cape. Through nonprobability, random sampling, 71 registered critical care nurses were included in the study. A questionnaire was designed and validated to collect the data. Quantitative data was analysed through Excel® while qualitative data was analysed thematically. It was found that the legal and professional guidelines in place at present do provide a foundation for the clinical activities of critical care nursing in the private hospital sector. It is suggested that it is rather the critical care nurses’ interpretation of the Scope of Practice (No.R.2598 of 30/11/1984 as amended) that limits their practice as opposed to the wording of the regulations. It is recommended that critical care nurses must determine nursing care parameters based on patient need, using the regulations as a foundation for critical, analytical and reflective practice rather than as a set of rules to be followed. Key words: Scope of practice, critical care practice, ICU nursing care, private hospital nursing practice. / AFRIKAANSE OPSOMMING: Die kritiekesorgverpleegkundige werk in ‘n omgewing waar pasiëntebehoeftes gereeld die parameters waarin sy of hy praktiseer, verskuif. Dit word van ’n bekwame kritiekesorgverpleegkundige verwag dat sy of hy onafhanklike besluite en aksies met betrekking tot pasiëntesorg, gebaseer op haar of sy kennis en vaardighede, sal neem sonder om die parameters van haar of sy bestek van praktyk te oorskry. Praktykondervinding het getoon dat die kritiekesorgverpleegkundige dikwels onseker is oor watter van haar of sy optredes deur die Regulasies, soos deur die Raad op Verpleging gespesifiseer word, beskerm word. Dit is nog meer spesifiek van toepassing in die privaathospitaal-industrie waar geneeskundige advies en bystand nie altyd maklik beskikbaar is nie. Die situasie het tot die volgende navorsingsvraag aanleiding gegee: Voorsien die beskikbare professionele en wetlike riglyne ’n geskikte grondslag om die praktyk van ’n geregistreerde kritiekesorgverpleegkundige in die privaatsektor- kritiekesorgomgewing te rig? ’n Nie-eksperimentele, beskrywende studie met ’n kwalitatiewe oriëntasie is in 19 hospitale in die Wes-Kaap onderneem. Deur nie-waarskynlikheids-, toevallige steekproefneming is 71 geregistreerde kritiekesorgverpleegkundiges in die studie ingesluit. ’n Vraelys is ontwerp en gevalideer om inligting in te samel. Kwantitatiewe data is deur middel van Excel ontleed terwyl kwalitatiewe data tematies ontleed is. Daar is gevind dat die wetlike en professionele riglyne wat tans beskikbaar is, ‘n grondslag bied vir die kliniese aktiwiteite van kritiekesorgverpleegkundiges in die privaathospitaal.. Dit word voorgestel dat dit die kritiekesorgverpleegkundige se interpretasie van die Bestek van Praktyk (No.R.2598 of 30/11/1984 soos aangepas) is wat hulle praktyk beperk, eerder as die bewoording van die regulasie self.

Study project (BCur)--University of Stellenbosch, 2007. / ENGLISH ABSTRACT: Problem statement: The abortion regulation was implemented in 1997 before the necessary infrastructure was in place. The shortage of educated healthcare providers in abortion facilities led to uninformed women. Aims for this research was exploratory-describing of nature and was aimed on pre-abortion counselling to women with unwanted pregnancies in the state facilities in the Western Cape metropole to be evaluated from a nursing perspective. Methodology: Two samplings was done namely a 50% randomized, proportional stratified sampling from the State Health facilities in the Western Cape Metropole which offer abortion care service, as well as the non-randomized convenient sampling of pregnant women that received pre-abortion counselling. Data was gathered with the help of self compiled questionnaires. Quantitative data was analyse with the help of Statistika 7 and qualitative data according to Tesch’s approach. Results: Of the respondents 79% was between the age 16 and 30 and 72% was single. Although the Department of Health strives that abortion care services should be offered by a level 1 health facility, only 43% have been counselled through a registered nurse. While 49% consider preabortion counselling as important, 39% of the respondents received no, or information in groups regarding the termination of the pregnancy, 77% received information with regarding to the procedure and 50% was informed when they could go forth with normal activities. Approximately 54% received no information regarding post-abortion complications and 59% did not received a follow-up date. Approximately 68% of the respondents received information regarding family planning. Conclusion: It seems that pre-abortion counselling is not done according to guidelines and there is many gaps in the existing counselling methods in the different health facilities. Recommendations: Counselling should be based on the WHO and the Department of Health’s guidelines for abortion care. Nurses should be more involved in education programs. Abortion care facility’s should promote the total spectrum of abortion care and counsellors should receive special training and annually be re-evaluated. / AFRIKAANSE OPSOMMING: Probleemstelling: Die aborsiewetgewing is in 1997 geïmplementeer voordat die nodige infrastruktuur in plek was. Die tekort aan doeltreffend-opgeleide gesondheidswerkers in aborsiesorgdienste het tot gevolg gehad dat vroue oningelig is met betrekking tot aborsiesorgdienste. Doelwitte vir hierdie navorsing was ondersoekend-beskrywend van aard en daarop gerig om preaborsie berading aan vroue met ongewenste swangerskappe in staatsaangewysde fasiliteite in die Wes-Kaapse metropool te evalueer vanuit ‘n verpleegkundige perspektief. Metodologie: Twee steekproefnemings is gedoen, naamlik ‘n 50% ewekansige, proporsionele, gestratifiseerde steekproefneming van die staatsgesondheidsfasiliteite in die Wes-Kaapse metropool wat aborsiesorgdienste aanbied, sowel as ‘n nie-waarskynlike, gerieflikheidssteekproefneming van swanger vroue wat pre-aborsie berading ontvang. Data is met behulp van selfopgestelde vraelyste ingesamel. Kwantitatiewe data is ontleed met behulp van Statistica 7 en die kwalitatiewe data deur middel van Tesch se benadering. Resultate: Van die respondente was 79% tussen die ouderdom van 16 en 30 jaar en 72% was enkellopend. Alhoewel die Departement van Gesondheid strewe dat aborsiesorgdienste by ‘n vlak 1 gesondheidsfasiliteite aangebied word, het slegs 43% hul berading hier deur geregistreerde verpleegkundiges ontvang. Terwyl 94% pre-aborsie berading beskou as belangrik, het 39% óf geen, óf inligting in groepe ontvang betreffende die beëindiging van die swangerskappe, 77% het inligting ontvang met betrekking tot die prosedure en 50% was ingelig wanneer hul kon voortgaan met normale aktiwiteite. Sowat 54% het geen inligting ontvang betreffende post-aborsie komplikasies nie en 59% het nie ‘n opvolgdatum gekry nie. Sowat 68% van die respondente het wel inligting ontvang oor gesinsbeplanning. Slotsom: Dit blyk dus dat pre-aborsie berading nie volgens riglyne gedoen word nie en dat daar baie leemtes is in die bestaande beradingsmetodes in die verskillende gesondheidsfasiliteite. Aanbevelings: Berading moet gebaseer word op die WGO en die Departement van Gesondheid se riglyne vir aborsiesorg. Verpleegkundiges moet meer betrokke raak by voorligtingsprogramme. Aborsiesorgfasiliteite moet die totale spektrum van aborsiesorg kan behartig en aborsiesorgberaders moet spesiale opleiding ontvang en jaarliks her-evalueer word.

Thesis (MCur)--Stellenbosch University, 2011. / ENGLISH ABSTRACT: The impact of infant feeding practices in the prevention of mother-to-childtransmission of HIV raised concerns in the field of health services. Breast feeding adds an additional 15-30% risk of HIV transmission to the infant; therefore, mothers who are HIV-positive are in need of information regarding safe infant feeding. A descriptive design for this particular study was applied with a primary quantitative approach. A convenient sample of sixty (n=60) participants between the ages of 15 – 37 were taken from subjects that enrolled in the prevention of mother-to-child transmission (PMTCT) programme in Onandjokwe district. The sample formed 85% of the target population (N=71). A structured questionnaire with closed and openended questions was used and completed by the researcher. Ethical approval for the study was obtained from the Ethics Committee at the Faculty of Health Sciences, University of Stellenbosch. Permission to conduct the research was obtained from the Ministry of Health and Social Services, Namibia, and the Onandjokwe district Hospital. A pilot study was conducted that constituted 25% of the sample. Validity and reliability was insured by the pilot study and the consultation of an expert in HIV research and an expert in nursing research. The presentation of results was mostly descriptive in nature by using frequency tables and a pie chart. The results showed that all participants (n=60/100%) were offered HIV counselling and testing during antenatal care. Mothers who were HIV positive knew that there is a possibility that the baby might be infected through breast milk. Furthermore, the study found that 70% (n=42) of participants used breast feeding exclusively, 20% (n=12) used replacement feeding and 10% (n=6) used mixed feeding practices. It was concluded that pregnant women and mothers known to be HIV-infected should be informed of the infant feeding practice recommended by the national or subnational authority to improve HIV-free survival of HIV-exposed infants. This includes information about the risks and benefits of various infant feeding options based on local assessments and guidance in selecting the most suitable option for their own situation. / AFRIKAANSE OPSOMMING: Die invloed van voedingspraktyke vir babas by die voorkoming van moeder-na-kindoordrag van die menslike immuungebrekvirus (MIV) het kommer op die gebied van gesondheidsdienste laat ontstaan. Borsvoeding dra ’n addisionele 15–30% risiko van MIV-oordrag tot die baba by en daarom benodig moeders wat MIV-positief is inligting ten opsigte van veilige voeding van hulle babas. 'n Beskrywende ontwerp vir hierdie besondere studie is gebruik tesame met 'n primêr kwantitatiewe benadering. 'n Gerieflikheidsteekproef van sestig (n=60) deelnemers tussen die ouderdomme 15–37 jaar is gekies uit persone wat ingeskryf het vir die voorkoming van moeder-na-kind-oordrag (VMNKO) program in Onandjokwe-distrik. Die steekproef het 85% van die teikenpopulasie (N=71) uitgemaak. 'n Gestruktureerde vraelys met geslote en oop vrae is gebruik en deur die navorser voltooi. Etiese goedkeuring vir die studie is verkry van die Etiese Kommitee van die Fakulteit Gesondheidswetenskappe, Universiteit Stellenbosch. Toestemming om die navorsing te doen, is verkry van die Ministerie van Gesondheid en Maatskaplike Dienste, Namibië, en die Onandjokwe Distrikshospitaal. 'n Loodsstudie is onderneem wat 25% van die steekproef behels het. Geldigheid en betroubaarheid is verseker deur die loodsstudie en oorlegpleging met 'n kundige op die gebied van MIV-navorsing en 'n kundige in verpleegnavorsing. Die aanbieding van resultate was meestal deskriptief van aard deur van frekwensietabelle en 'n sektordiagram gebruik te maak. Die resultate het getoon dat MIV-berading en -toetsing gedurende voorgeboortesorg aan alle deelnemers (n=60/100%) aangebied is. Moeders wat MIV-positief is, het geweet dat daar 'n moontlikheid bestaan dat die baba moontlik deur moedersmelk geïnfekteer kan word. Verder het die studie bevind dat 70% (n=42) van deelnemers uitsluitlik borsvoeding gebruik, 20% (n=12) gebruik ’n vervanging vir moedersmelk en 10% (n=6) gebruik gemengde voedingspraktyke. Daar is tot die slotsom gekom dat swanger vroue en moeders van wie bekend is dat hulle MIV-geïnfekteer is, ingelig behoort te word oor die babavoedingspraktyk aanbeveel deur die nasionale of subnasionale owerheid vir die verbetering van MIVvrye oorlewing van babas wat aan die MIV blootgestel is. Dit sluit in inligting oor die risiko’s en voordele van verskeie babavoedingsopsies gebaseer op plaaslike assesserings en leiding ten opsigte van die kies van die geskikste opsie vir hulle eie situasie.

Thesis (MCur)--Stellenbosch University, 2011. / ENGLISH ABSTRACT: The quality of care nurses provide to patients is done with the expectation that skills and knowledge of each registered nurse will result in quality patient care. Compliance statistics for quality indicators (level of service indicators) or (LSI’s) in the tertiary health care institution in Saudi Arabia varies, raising the following questions: “Do nurses understand the importance of quality indicators in clinical nursing and do they know how to use them to improve patient care?” No studies done on registered nurses’ knowledge and opinions of quality indicators could be found thus indicate the necessity of a research study to determinine the knowledge and opinions of registered nurses on quality indicators in clinical nursing in the tertiary healthcare system in Saudi Arabia. This is the focus of this research. The objectives of the study were: - To determine the current knowledge and opinions of the professional nurses regarding quality indicators in a tertiary hospital in Saudi Arabia - To identify the factors that influence identification of quality indicators in clinical nursing - To identify the need for a training program regarding nurse sensitive quality indicators Data was collected through a questionnaire handed to more than 200 nurses working in general wards and intensive care areas in a single Saudi Arabian hospital. Participants were selected through a randomised list. The registered nurses who have participated in the pilot study’s responses were excluded from the final data analysis. No patients were included or involved in the study. A descriptive design with a quantitative approach was applied to investigate the professional nurses’ knowledge and opinions on quality indicators (level of service indicators) or (LSI’s) in clinical nursing in Saudi Arabia. Research data suggests that the knowledge and opinions of registered nurses in the tertiary health care institution in Saudi Arabia are not supporting the expectations of quality assurance in clinical nursing. Registered nurses have strong opinions of quality indicators in clinical nursing but do not have the knowledge to support those opinions. Improving initial and recurring training on quality indicators provided to nursing staff with diverse backgrounds and high turnover was recommended as an essential component in using quality indicators to drive improvements in patient care. / AFRIKAANSE OPSOMMING: Die kwaliteit verpleegsorg wat verpleegkundiges op ‘n daaglikse basis aan kliente bied gaan gepaard met die verwagting dat hulle oor die kennis en bevoegtheid moet beskik om kwaliteit verpleegsorg aan te wend wat ‘n langdurige positiewe uitkoms met verwysing na pasientsorg kan bied. Die kwaliteits aanwyser statistieke in die tersiere gesondheidsorg sisteem verskil maandeliks en het die navorser geinspireer om ‘n studie te doen om te bepaal of geregistreerde verpleegkundiges verstaan wat die belangrikheid van kwaliteits aanwysers is en of hulle die kennis het oor die gebruik daarvan, in watter opsigte dit gebruik kan word en wat die voordele inhou wanneer kennis en applikasie daarvan vir kliniese verpleging toegepas word. Literatuur met betrekking tot vorige studies omtrent kennis en opinies van geregistreerde verpleegkundiges tot kwaliteits aanwysers in kliniese verpleeging kon nie deur die navorser gevind word wat gebruik kon word as agtergrond of ondersteuning tot die studie nie. Die fokus van die navorsings studie was om geregistreerde verpleegkundiges se kennis en opinies te bepaal met betrekking tot kwaliteits aanwysers in kliniese verpleging in die tersiere gesondheidsorg sisteem in Saudi Arabie. Die doelwitte van die studie was om: - Die huidige kennis en opinies van geregistreerde verpleegkundiges met betrekking tot kwaliteits aanwysers in die tersiere gesondheidsorg sisteem in Saudi Arabie te bepaal - Om faktore wat ‘n invloed op identifikasie van kwaliteits aanwysers het te identifiseer - Om die nodigheid van ‘n opleidings program met betrekking tot kwaliteits aanwysers te bepaal Die data van die studie was ingesamel deur middel van ‘n vraelys wat aan die geregistreerde verpleegkundiges meesal werksaam is in algemene sale of intensiewe sorgeenhede. Deelnemers was gekies deur middel van ‘n alternatiewe lys. Die deelnemers aan die loots studie was ge-ellimineer van die finale data analise. Geen pasiente was betrokke by die studie nie. ‘n Beskrywende ontwerp met ‘n kwantitatiewe benadering was toegepas om geregistreerde verpleegkundiges se kennis en opinies omtrent kwaliteits aanwysers in kliniese verpleging in die tersiere gesondheidsorg sisteem in Saudi Arabie te toets. Die navorsing het bewys dat die kennis en opinies van geregistreerde verpleegkundiges in die tersiere gesondheidsorg sisteem in Saudi Arabie nie op ‘n aanvaarbare standard kan geklassifiseer word nie asook nie die nodige kwaliteits versekering in kliniese verpleging ondersteun nie. Die studie bewys dat geregistreerde verpleegkundiges beskik oor genoegsame opinies omtrent kwaliteitaanwysers maar nie noodwendig oor die kennis om hulle opinies daaroor te ondersteun nie. Die studie is ook uitkoms gebaseerd omtrent die nodigheid van ‘n opleidings program met betrekking tot kwaliteits versekering in kliniese verpleegkunde te implimenteer, insluitend die vakgebied van kwaliteits aanwysers in kliniese verpleeging.

Thesis (MCur)--Stellenbosch University, 2011. / ENGLISH ABSTRACT: Parents and/or caregivers all over the world are expected to comply with existing childhood immunisation programmes in order to prevent outbreaks of preventable childhood diseases. The most important justification for this study was the 2010 measles outbreak in the Western Cape province of South Africa. This outbreak correlated with the study conclusions of Corrigall, Coetzee and Cameron (2008:41) as they found the immunisation coverage in the Western Cape to be insufficient to prevent outbreaks of preventable childhood diseases. From the literature, it seemed that attitudes and factors that influence parent and/or caregiver compliance with the routine childhood immunisation schedule in the Witzenberg sub-district of the Western Cape persist. In doing this study, the researcher’s purpose was to discover what those factors were. The aim was to determine, understand and describe the attitudes and factors influencing parent and/or caregiver compliance with the routine childhood immunisation schedule, and the nature thereof. The set objectives were to gain knowledge of and insight into the factors influencing participants’ adherence with routine childhood immunisation; and participants’ feelings, attitudes, and experiences surrounding immunisation within the context of their health care environment. A quantitative research approach, with a smaller qualitative component, was selected for this study which had an exploratory descriptive design. The population targeted for data collection included parents and/or caregivers of children aged 0 to 60 months in the Witzenberg sub-district (N=8374), as well as in community health centres (CHCs) that provided immunisation and/or other primary health care services in the mentioned subdistrict (N=16). The non-probability convenience sampling of parents and/or caregivers consisted of 376 participants (n=376), while 8 CHCs (n=8) were selected through systematic sampling. The measuring instrument used as the data collection technique for this study was a selfadministered questionnaire. A pilot study was conducted to pre-test the questionnaire, and its reliability and validity were further ensured by submitting it for review to research experts in methodology and nursing. A combination of quantitative and qualitative methods was used to analyse the study data. MS Excel was used to capture the quantitative data after which it was analysed using descriptive statistics by means of STATISTICA version 9-software. Tesch’s approach to qualitative data analysis was used as a guideline with the purpose of identifying and categorising the essential qualitative data and grouping it together in one descriptive framework. The main findings were that parents and/or caregivers involved in this study were positive about immunisation and their experiences within the health service environment. They also felt that health workers were playing an important role in their decision-making process. However, their knowledge regarding the purpose of and contra-indications for immunisation were insufficient, and most parents reported that their children experienced side effects after immunisation. Key recommendations on conclusion of the study include clear, accurate and specific information to parents about the purpose of immunisation and its contra-indications and side effects. Vaccinators and managers should be informed about the persistent problem with mild vaccination side effects and refresher courses should be provided with regard to infection control, administration techniques and the reporting of adverse effects. / AFRIKAANSE OPSOMMING: Daar word van ouers en/of versorgers oor die wêreld verwag om aan bestaande kinderimmunisasieprogramme te voldoen ter voorkoming van vaksien-voorkombare siektes. Die belangrikste regverdiging vir die studie was die masel-uitbreking in die Wes-Kaapprovinsie van Suid-Afrika in 2010. Die uitbraak het die studiebevindinge ondersteun van Corrigall, Coetzee en Cameron (2008:41), wat bevind het dat immunisasiedekking in die Wes-Kaap onvoldoende was om ʼn uitbreking van voorkombare kindersiektes te verhoed. Volgens die literatuur het dit voorgekom asof die gesindhede en faktore wat ouers en/of versorgers se houding jeens die roetine- kinder-immunisasieskedule in die Witzenberg sub-distrik van die Wes-Kaap beïnvloed, voortduur. Die navorser het met hierdie studie ten doel gehad om die faktore te ontdek, ten einde die gesindhede en faktore wat ‘n invloed uitoefen te bepaal, te verstaan en te omskryf. Die doelwitte was om kennis in te win oor en insig te verkry in die faktore wat ouers en/of versorgers se aanhanklikheid met routine kinder immunisering beinbloed; en in ouers en/of versorgers se gevoelens, houdings en ondervindings ten opsigte van immunisasie in hulle gesondheidsorg-omgewing. ‘n Kwantitatiewe navorsingsbenadering met ‘n kleiner kwalitatiewe komponent is geselekteer vir die studie wat ‘n ondersoekend-beskrywende navorsingsontwerp gehad het. Die populasie wat geteiken is vir data-insameling was ouers en/of versorgers van kinders van 0 tot 60 maande in die Witzenberg sub-distrik (N=8374), asook gemeenskapsgesondheidsentrums wat immunisasie en/of ander primêre gesondheidsorgdienste in die genoemde sub-distrik aanbied (N=16). Die nie-waarskynlike gerieflikheidsteekproef van ouers en/of versorgers het uit 376 deelnemers (n=376) bestaan, terwyl 8 (n=8) gemeenskapsgesondheidsentrums deur middel van sistematiese steekproefbepaling geselekteer is. Die meetinstrument vir data-insameling in die studie was self-geadministreerde vraelyste. ‘n Loodsstudie is uitgevoer as vooraf-toetsing van die vraelys en die geldigheid en betroubaarheid daarvan is verder verseker deur die vraelys aan navorsingskenners in navorsingsmetodologie en verpleging te onderwerp. ‘n Kombinasie van kwantitatiewe en kwalitatiewe metodes is gebruik vir die analisering van die studie-data. Die kwantitatiewe data is op MS Excel ingevoer waarna beskrywende statistieke deur middel van Statistica weergawe 9-sagteware gebruik is om dit te analiseer. Tesch se benadering tot kwalitatiewe data-analise is as riglyn gebruik met die doel om belangrike data te identifiseer, te kategoriseer en in ‘n beskrywende raamwerk te groepeer. In die studie is daar hoofsaaklik bevind dat ouers en/of versorgers positief is oor immunisasie en hul ondervinding binne die gesondheidsorgomgewing, en dat gesondheidswerkers ʼn belangrike rol in hul besluitnemingsproses speel. Hul kennis aangaande die doel van en kontra-indikasies vir immunisasie was egter onvoldoende en die meeste ouers en/of versorgers het gerapporteer dat hul kinders ná immunisasie probleme met newe-effekte ondervind het. Die hoofaanbevelings wat uit die studie voortgespruit het, was dat duidelike, akkurate en spesifieke inligting aan ouers en/of versorgers verskaf moet word aangaande die doel van immunisasie en die kontra-indikasies daarvoor. Immuniseerders en bestuurders moet ook ingelig word oor die voortdurende voorkoms van newe-effekte sodat opknappingskursusse oor infeksiebeheer, korrekte toedieningstegnieke en die rapportering van newe-effekte aangebied kan word.

Thesis (MCur)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: Background Informed Consent (IC) has been proposed as the optimal method for ensuring the ethical entry of patients into clinical trials. IC is a vital part of the research process and as such entails more than obtaining a signature on a form. The IC must be given freely, without coercion, and must be based on a clear understanding of what participation involves. Aim The overall aim of this study was to attain an understanding of participants' knowledge regarding informed consent when participating in a research project. Methods The study was conducted at two public hospitals in a city in the Eastern Cape Province of South Africa. The quantitative study used descriptive survey design. A self administered questionnaire was used as a tool for data collection. Results The sample size consisted of 170 women with an average of 25.9 years. The majority had completed secondary level education. More than half of the participants did not have knowledge of the purpose of the original study. The majority of participants did not have knowledge of their responsibilities. Forty-two percent gave uninformative responses and 26% indicated they did not know their responsibilities. None of the participants understood the concept of randomization. The majority (85.9%) of participants indicated that information provided on the IC forms was sufficient for them to decide to participate. Conclusion Despite extensive efforts to ensure that participants understood their participation in the original studies, this study found poor recall of vital information for IC. A signed informed consent does not guarantee that participants understand information given. Recommendations The existing methods of communicating and obtaining of an informed consent seem to be insufficient for participants to make an informed decision. A new approach with more interactive features such as combination of audio-visual techniques might increase the possibilities of the understanding. / AFRIKAANSE OPSOMMING: Agtergrond Ingeligte toestemming (IT) is voorgestel as die optimale metode om die etiese toelating van die pasiënte vir kliniese toetse te verseker. IT is 'n belangrike deel van die navorsingsproses en as sodanig behels dit meer as die verkryging van 'n handtekening op 'n vorm. Die IT moet vrylik gegee word, sonder dwang en moet gebaseer wees op 'n duidelike begrip van wat die deelname behels. Doel Die algemene doel van hierdie studie is om 'n begrip van die deelnemers se kennis met betrekking tot ingeligte toestemming te bepaal, wanneer hulle deelneem aan 'n navorsingsprojek. Metodes Die studie is uitgevoer by twee openbare hospitale in ’n stad in die Oos-Kaap in Suid-Afrika. Die navorsingsontwerp is beskrywend van aard en ’n kwantitatiewe benadering is toegepas. ‘n Self-geadministreerde vraelys is as 'n instrument gebruik om data in te samel. Resultate Die steekproefgrootte het bestaan uit 170 vroue met 'n gemiddelde ouderdom van 25.9 jaar. Die meerderheid van die vroue het opleiding tot op sekondêre vlak. Meer as die helfte van die deelnemers het geen kennis van die doel van die oorspronklike studie gehad nie. Die meerderheid van die deelnemers het ook nie kennis van hul verantwoordelikhede gehad nie. Twee-en-veertig persent het nie toepaslike antwoorde gegee nie en 26% het aangedui dat hulle nie weet wat hul verantwoordelikhede in die studie is nie. Nie een van die deelnemers het die konsep van verewekansiging verstaan nie. Die meerderheid (85.9%) van die deelnemers het aangedui dat die inligting wat deur die IT verskaf word voldoende was om te besluit of hulle aan die studie wou deelneem. Gevolgtrekking Ten spyte van uitgebreide pogings om te verseker dat deelnemers hulle deelname verstaan het in die oorspronklike toetsing, het hierdie studie die swak herroeping van belangrike inligting aangaande IT bewys. ‘n Ondertekende ingeligte toestemming gee geen waarborg dat die deelnemers die inligting waarvoor toestemming geteken is, verstaan nie. Aanbevelings Die bestaande metodes van die kommunikasie en verkryging van ingeligte toestemming blyk onvoldoende te wees om deelnemers ingeligte besluite te laat neem. ‘n Nuwe benadering met meer interaktiewe eienskappe soos ’n kombinasie van oudio-visuele tegnieke mag die moontlikhede om te verstaan, meer duidelik maak.

Thesis (MCur)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: Burnout is one of the challenges that nurses are faced with in their stressful and rapidly changing work environment. The vulnerability of nurses to burnout remains a major concern which affects both the individual and institution. Knowledge about burnout and associated risk factors which influence the development of burnout is vital for early recognition and intervention. The research question which guided this study was: “What are the factors influencing the degree of burnout experienced by nurses working in neonatal intensive care units?” The objectives included determining which physical, psychological, social and occupational factors influenced the degree of burnout experienced by nurses. A descriptive, explorative research design with a quantitative approach was applied. The target population consisted of (n=105) permanent nursing staff members working in the neonatal units of two different hospitals. A convenience sampling method was used. Participants (n=102) who gave voluntary consent to participate was included in the study. Validity and reliability was supported through the use of a validated questionnaire, Maslach Burnout Inventory – General Survey including a section based on demographical information and a section based on physical, psychosocial, social and occupational factors. Validity of the questionnaire was supported by the use of a research methodologist, nurse expert and a statistician in the particular field. A pilot study was done to test the feasibility of the study and to test the questionnaire for any errors and ambiguities. Ethics approval was obtained from Stellenbosch University and permission from the Heads of the hospitals where the study was conducted. The data was analyzed with the assistance of a statistician and these are presented in histograms, tables and frequencies. The relationship between response variables and nominal input variables was analysed using analysis of variance (ANOVA). Various statistical tests were applied to determine statistical associations between variables such as the Spearman test, using a 95% confidence interval. Results have shown that participants experienced an average level of emotional exhaustion, a high level of professional efficacy and a low level of cynicism. Further analyses have shown that there is a statistical significant difference between emotional exhaustion and the rank of the participant (p=<0.01), highest qualification (p=0.05) and a high workload (p=0.01). Furthermore a statistical significant difference was found between professional efficacy and rank of participants (p=<0.01). In addition a statistical significant difference was found between cynicism and the number of years participants were in the profession (p=0.05). Multiple factors were determined in this study that influences the degree of burnout nurses experience. The majority of participants (n=56/55%) experienced decreased job satisfaction and accomplishment, (n=52/51%) of participants experienced that their workload is too much for them and (n=63/62%) participants received no recognition for their work. Recommendations are based on preventative measures, because preventing burnout is easier and more cost-effective than resolving burnout once it has occurred. In conclusion, the prevention strategies, early recognition of work stress and appropriate interventions are crucial in addressing the problem of burnout. / AFRIKAANSE OPSOMMING: Uitbranding is een van die uitdagings waarmee verpleegsters te kampe het in hulle stresvolle en vinnig veranderende werkomgewing. Die kwesbaarheid van verpleegsters vir uitbranding bly ’n kritieke bekommernis wat beide die individu en die inrigting affekteer. Kennis omtrent uitbranding en verwante risiko faktore wat die ontwikkeling van uitbranding beïnvloed, is deurslaggewend vir vroeë opsporing en intervensie. Die navorsingsvraag wat hierdie studie gelei het, is: “Wat is die faktore wat die mate van uitbranding beïnvloed wat deur verpleegsters ondervind word wat in neonatale intensiewe sorgeenhede werk?” Die doelwitte wat ingesluit is, is om te bepaal watter fisiese, sielkundige, maatskaplike en beroepsfaktore die mate van uitbranding wat deur verpleegsters ervaar word, beïnvloed. ’n Beskrywende, ondersoekende navorsingsontwerp met ’n kwantitatiewe benadering is toegepas. Die teikengroep het bestaan uit (n=105) permanente verpleegpersoneel wat in die neonatale eenhede van twee verskillende hospitale werk. ’n Gerieflikheidsteekproef metode is gebruik. Deelnemers (n=102) wat vrywillige toestemming gegee het om deel te neem, is ingesluit in die navorsingstudie. Geldigheid en betroubaarheid is ondersteun deur die gebruik van ’n geldige vraelys van “Maslach Burnout Inventory – General Survey”, asook ’n afdeling gebaseer op demografiese inligting en ’n afdeling gebaseer op fisiese, sielkundige, maatskaplike en beroepsfaktore. Geldigheid van die vraelys is ondersteun deur ’n navorsingsmetodoloog, ’n verpleegspesialis en ’n statistikus op die navorsingsgebied. ’n Loodsondersoek is gedoen om die haalbaarheid van die studie te toets en om die vraelys te toets vir enige foute en dubbelsinnighede. Etiese goedkeuring is verkry van die Universiteit van Stellenbosch en goedkeuring van die Hoofde van die hospitale waar die studie uitgevoer is. Die data is geanaliseer met die hulp van ’n statistikus en is aangebied in histogramtafels en frekwensies. Die verwantskap tussen responsveranderlikes en nominale insetveranderlikes is geanaliseer deur gebruik te maak van die analise van variansie (ANOVA). Verskeie statistiese toetse is toegepas om statistiese assosiasies tussen veranderlikes te bepaal, soos deur van die Spearmantoets gebruik te maak, met ’n 95% betroubaarheidsinterval. Resultate het bewys dat deelnemers ’n gemiddelde vlak van emosionele uitputting, ’n hoë vlak van professionele effektiwiteit en ’n lae vlak van sinisme ervaar. Verdere analise het bewys dat daar ’n statistiese beduidende verskil tussen emosionele uitputting en die rang van die deelnemers (p=<0.01) is, hoogste kwalifikasie (p=0.05) en ’n hoë werklading (p=0.01). Verder is ’n statistiese beduidende verskil gevind tussen professionele effektiwiteit en rang van deelnemers (p=<0.01). Saam hiermee is ’n statistiese beduidende verskil gevind tussen siniesheid en die aantal jare wat deelnemers in die beroep is (p=0.05). Voorts, is veelvuldige faktore bepaal in hierdie studie wat die mate van uitbranding beïnvloed wat verpleegsters ervaar. Die meeste van die deelnemers (n=56/55%) het ’n afname in werksbevrediging en -verrigting ervaar, (n=52/51%) deelnemers het ervaar dat hul werklading te veel is vir hulle en (n=63/62%) deelnemers het geen erkenning vir hulle werk ontvang nie. Aanbevelings is gebaseer op voorkomende maatreëls, want om uitbranding te voorkom, is makliker en meer koste-effektief as om uitbranding te probeer oplos as dit alreeds begin het. Ten slotte, die voorkomende strategieë, vroeë identifisering van werkstres en geskikte intervensies is deurslaggewend om die probleem van uitbranding aan te spreek.

Thesis (MCur)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: Research indicates that human touch plays an integral role in an infant’s ability to thrive and grow, with a correlation existing between tactile stimulation and optimal physical, emotional, cognitive, and social development. The aim of this study was to explore the level of knowledge of first time mothers attending Mowbray Maternity Hospital (MMH) regarding the importance of tactile stimulation during infancy and early childhood. A descriptive, non-experimental, research design was employed, using a pilot tested structured questionnaire for data collection during face-to-face interviews conducted by the Principal Investigator. Questions were divided into four domains: knowledge about the impact of tactile stimulation on the bonding domain, the emotional domain, physical domain and the social domain of infants and children. The inclusion of one open-ended question allowed participants to suggest recommendations for improved knowledge and care. A sample of 41 participants, constituting 40% of the study population (N=101) was randomly selected from MMH. Prior ethical approval was obtained from the Human Research Ethics Committee of Stellenbosch University, and operational approval from the Western Cape Department of Health, and the Research Committee and Senior Management of MMH. Written informed consent was obtained from the study participants. The quantitative data was analysed using Statistica (Version 10) with the assistance of a statistician. The qualitative data yielded from the one open-ended question was analysed thematically and then quantified. The findings show that 90% (n=37) of the participants were knowledgeable about tactile stimulation strategies, 81% (n=33) knew about the impact of tactile stimulation on the bonding domain, 75% (n=31) on the emotional domain, 52% (n=21) on the physical domain and 43% (n=18) on the social domain. Although all participants had reported for out-patient antenatal care on four and more occasions, 73% (n=30) indicated that they had improved their knowledge regarding pregnancy, labour, birth, and parenting by reading magazines, 20% (n=8) reported that a health care worker had spoken to them about the benefits of tactile stimulation, and 15% (n=6) had received literature on the benefits of tactile stimulation. The open-ended question generated several findings which included suggestions to enhance healthcare by providing information and training about tactile stimulation and perinatal matters when attending antenatal clinic; by offering assistance with infant feeding during the postnatal period; and by improving the attitude and professional stance of health care workers. The study findings suggest that first time mothers at MMH are not adequately knowledgeable about the importance of tactile stimulation during infancy and early childhood. Grounded in the empirical findings and based on the suggestions offered by the participants, several recommendations, including improved information and training, were identified toward strengthening tactile stimulation knowledge and practice at both the parental and health care provider levels. / AFRIKAANSE OPSOMMING: Studies toon dat menslike aanraking ‘n belangrike rol in ‘n baba se algemene vermoëns om te groei speel, terwyl ‘n positiewe korrelasie tussen koestering en optimale fisiese, emosionele, kognitiewe en sosiale ontwikkeling bestaan. Die doel van hierdie studie was om vas te stel of moeders, wat vir die eerste keer geboorte geskenk het, en geskeduleer was om by Mowbray Kraamhospitaal geboorte te skenk, ingelig was aangaande die belangrikheid van streling tydens babaskap en die vroeë kinderjare. ‘n Beskrywende, nie-eksperimentele navorsingstudie is uitgevoer, deur van ‘n gestruktureerde, onderhoudsvraelys vir die insameling van data gebruik te maak. Vrae was opverdeeld in die volgende seksies: kennis rakende die impak van babastreling op die band tussen moeder en baba, kennis rakende die impak op die emosienele dimensie, en kennis rakende die impak van babastreling op die fisiese en sosiale dimensies van babas en kinders. Die ewekansige gekose studie-groep van een-enveertig deelneemers het 40% van die studie-populasie uitgemaak. Voorafgaande etiese en operationele toestemming is vanaf die Menslike Etiese Kommittee van die Universiteit van Stellenbosch, die Wes-Kaapse Departement van Gesondheid en vanaf die Navorsings kommittee en Bestuur van Mowbray Kraamhospitaal verkry. Geskrewe toestemming is voor aanvang van die een-tot-een onderhoude vanaf die deelneners verkry. Die kwantitiewe data is met die hulp van ‘n statistikus deur die gebruik van die sagteware, Statistica (Weergawe10) geanaliseer. Die kwalitiewe data wat na aanleiding van die oop-eindigende vraag verkry is, is tematies geanaliseer en gekwantifiseer. Die resultate het getoon dat meeste 90% (n=37) van die deelnemers met die algemene praktyke van babastrelingstrategië gedurende babaskap bekend was. Die persentasie vir deelnemers se kennis rakende die impak van babastreling op die band tussen moeder en baba was 81% (n=33), en vir kennis omtrent die emosienele dimensie 75% (n=31), die impak van babastreling op die fisiese 52% (n=21) en die sosiale 43% (n=18) dimensies van babas en kinders. Alhoewel alle deelneemers vir voorgeboorte kliniek gerapporteer het, het 73% (n=30), terugvoer dat hulle hulle kennis omtrent swangerskap, geboorte en ouerskap verbreed het deur tydskrifte te lees, 20% (n=8) van die deelnemers gerapporteer het dat ‘n gesondheidswerker met hulle omtrent die voordele van babastreling gepraat het, terwyl 15% (n=6) leesmaterial rakende die voordele van babstreling ontvang het. Die oop-eindigende vraag het verskeie bevindings opgelewer met voorstelle met betrekking tot die verbetering van gesondheidsorg en opleiding, opleiding aangaande die voorgeboortelike sorg wat hulle ontvang het en aangaande perinatale aangeleenthede en stimulasie van babas deur streling. Deelneemers het ook voorgestel dat verpleegsters hulp aan moeders behoort te verleen met die voeding van hul babas in die periode na geboorte en dat gesondheidsorgwerkers hulle professionaliteit en gesindhede jeens pasiënte behoort te verbeter. Ten slotte het die uitkomste van hierdie studie aangedui dat, moeders wat vir die eerste keer geboorte geskenk het by Mowbray Kraamhospitaal, onvoldoende kennis dra oor die belangrikheid van stimulasie van hulle babas en jong kinders deur streling. Gegrond in die empiriese bevindings en gebaseer op die voorstelle van deelnemers, is verskeie aanbevelings geïdentifiseer vir die moontlike verbetering van kennis rakende streling op die ouer- en gesondheidswerkervlakke.

Thesis (NCur (Nursing Science))--University of Stellenbosch, 2008. / The current shortage of nurses has reached crisis proportions in South Africa and the effects of decreased numbers of health professionals are enormous. This results in far-reaching consequences for the health industry. An increased use of less-skilled personnel, in an attempt to meet the health care needs, impacts negatively on quality care. Personnel are often utilised outside their scope of practice, creating a high-risk therapeutic environment for the patients and health care workers alike. Consequently, the nursing managers and employers of nurses are currently faced with major challenges in ensuring that the nurses practise their profession within a safe and healthy environment, and within the legal and ethical framework of the nursing profession. For the purpose of this study the researcher decided to explore legal and ethical aspects influencing the clinical practice of the nurse. Specific objectives were set for the study. • Are nurses functioning outside their scope of practice? • Do nurses exercise their nursing right? • Do nurses function within ethical and legal guidelines? • Do caregivers function as nurses? • Do nurses still believe in the nursing philosophy? • Are nurses exploited in their area of work? • How much overtime do nurses work? These objectives were met through an in-depth explorative descriptive research design with a quantitative approach to explore legal and ethical aspects in the nursing practice. A stratified sample was drawn of all categories of nurses in selected private hospitals in the Western Cape Metropolitan area. Through the use of a questionnaire, data was collected personally by the researcher. Data analysis techniques that were used were based on descriptive and explorative procedures. Data was compressed in frequencies, percentages, means and standard deviations. The Chi-square test was applied. Findings include the following: • 53% of enrolled nursing assistants do not function under indirect supervision. • 40% of caregivers assist nurses with interventional nursing care. • Nurses still believe in the philosophy of the nursing profession. • The nurse’s rights are in contradiction with the patient’s rights (p = 0.08). • Nurses feel exploited in certain areas of work, depending on their qualifications. • Nurses do recommend the profession (p = 0.043). • Enrolled nursing assistants do not respect other religions (p = 0.04). • Nurses feel free to discuss the patient’s progress with the doctor depending on the nurses’ years of experience (p = 0.03). • 23% of nurses love to care for their patients. Recommendations were made based on the findings. • The patient approach should be respectful, not judgemental, accepting the patient’s right to self-autonomy. • Nurses should realise their autonomous role in addressing concerns. • A staff mix should be utilised that facilitates safe and professional nursing care. • Unfavourable or unsociable working conditions in some units such as the theatre should be addressed. • Managers should match the work load with a proper skills mix and competency. • Nursing practice should take place within the professional and statutory scope of practice of the nurse. • Nurses should keep up to date with knowledge through continuous professional development. • Caregivers should be regulated, installing the nursing philosophy and ethics into their practice.

Thesis (MCur (Nursing Science))--University of Stellenbosch, 2009. / ENGLISH ABSTRACT: Every patient comes to a hospital with the expectation of getting quality care. It is not always within the ability of nursing personnel to give quality care in the work situation. Guided by the research question “What are the factors influencing the quality of nursing care in district hospitals in the West Coast Winelands Region of the Western Cape?” a scientific investigation was undertaken. The goal of this study was to identify the factors which influence the quality of nursing care in the eight (8) district hospitals of the West Coast Winelands Region of the Western Cape. The objectives set for the study were:  to determine whether staffing is adequate for all activities;  to evaluate what the perceptions of the nursing staff is about their current working situation;  to determine what the effect of the absence of full time doctors are on the management of patient care;  to evaluate whether adequate equipment is available for the execution of nursing care and to evaluate whether adequate provisions for the execution of nursing care is done. A descriptive non-experimental design with a quantitative approach was applied. The population for this study was all the nursing staff available at the time of data collection, working in the eight district hospitals of the West Coast Winelands Region. A structured questionnaire was used to collect the data. The final sample of nursing staff was N= 280 of a total population of 340 – all the members were invited to participate. Reliability and validity were assured by means of a pilot study and the use of experts in nursing research, methodology and statistics. Data were collected personally by the researcher. Ethical approval was obtained from Stellenbosch University and various health authorities. Informed written consent was obtained from the participants. The data was analyzed with the support of the statistician; it was expressed in frequencies, tables and histograms. Comparisons between variables were made using either ANOVA (Analysis of variance) techniques or cross-tabulations with the Chi-square test. The 95% confidence interval was applied to determine whether there was an association between the various variables. The analysis shows that participants of the separate wards hospitals N=142 (90%) and the mixed wards type hospitals N=113 (95%) disagree that staff provision (numbers) is adequate. From the analysis it is clear that the patient documentation is not up to standard. A statistical significant correlation between hospital type and adequate time for the completion of written records (Chisquare Test p=0.00) was shown. Management N=13 (100%), registered nurses N=80 (86%), enrolled nurses N=63 (86%) and nursing assistants N= 81 (83%) disagree that it is not necessary to act beyond their scope of practice. The following recommendations were made: Safe staffing levels have to be determined; qualify staff with the necessary skills; where unit managers are still lacking, they have to be appointed; to make personnel development possible for staff; continuous auditing of patient documentation. It is necessary that there is always adequate equipment and consumables. More training is necessary for the effective and efficient implementation of the Batho Pele principles. / AFRIKAANSE OPSOMMING: Elke pasiënt kom na ‘n hospitaal met die verwagting om kwaliteit verpleegsorg te ontvang. Dit is nie altyd binne die vermoë van die verpleegpersoneel om sodanige diens te kan lewer nie. “Watter faktore het ‘n invloed op die lewering van gehalteverpleegsorg in die distrikhospitale van die Weskus Wynlandstreek in die Wes Kaap? het die wetenskaplike ondersoek gelei. Die doel van die studie is om die faktore te identifiseer wat ‘n invloed het op die lewering van gehalteverpleegsorg in die ag (8) distrikhospitale van die Weskus Wynlandstreek in die Wes Kaap. Die doelwitte van die studie is:  om te bepaal of personeelvoorsiening voldoende is vir al die aktiwiteite;  om te evalueer wat die persepsies is van die verpleegpersoneel betreffende hulle huidige werksituasie,  om te bepaal watter effek die afwesigheid van voltydse geneeshere het op pasiënte sorg;  om te evalueer of toerusting voldoende is vir pasiënte sorg;  om te evalueer of daar voldoende voorsiening gemaak is vir die lewering van pasiënte sorg. ‘n Beskrywende, nie-eksperimentele ontwerp as metodologie is gebruik met ‘n kwantitatiewe benadering. Die bevolking betreffende die studie was alle verpleegpersoneel, werksaam tydens die insameling van die data in die ag distrikhospitale van die Weskus Wynlandstreek. ‘n Gestruktureerde vraelys was gebruik om die data te versamel. Die finale steekproef van die verpleegpersoneel was 280 uit die totale bevolking van 340. Betroubaarheid en geldigheid is verseker deur middel van ‘n loodstudie, en deur gebruik te maak van kenners betreffende verpleegnavorsing, metodologie en statistieke. Data is persoonlik deur die navorser ingesamel. Etiese goedkeuring was verkry vanaf die Universiteit van Stellenbosch en die verskeie gesondheidsowerhede. Ingeligde, skriftelike toestemming is van elke deelnemer verkry. Data is ontleed met die ondersteuning van die statistikus en is uitgedruk in die vorm van frekwensies, tabelle en histogramme. Vergelykings tussen die veranderlikes was gedoen deur gebruik te maak van ANOVA (analise met betrekking tot variansie) en kruis-tabulerings met die Chi-kwadraat toets. 95% Betroubaarheidsinterval is toegepas om te bepaal of daar ‘n assosiasie was tussen die onderskeie veranderlikes. Die analise het getoon dat deelnemers betreffende die hospitale met aparte afdelings N=142 (90%) en die gemengde sale hospitale N=113 (95%) verskil, betreffende die stelling dat daar voldoende personeelgetalle is. Dokumentasie is volgens die analise nie op standaard nie. ‘n Statistiese betekenisvolle korrelasie is verkry met betrekking tot die hospitaal tipe en voldoende tyd betreffende volledige geskrewe dokumentasie (Chi-kwadraat Toets p=0.00). Verpleegbestuur N=13 (100%), geregistreerde verpleegkundiges N=80 (86%), stafverpleegsters N=63 (86%) en verpleegassistente N=81 (83%) het verskil met die stelling dat dit nie nodig is om buite bestek van hul praktyk te werk nie. Die volgende aanbevelings is gemaak: die bepaling van veilige personeel vlakke moet gedoen word; voldoende personeel moet gekwalifiseer word met die nodige vaardighede. Eenheidsbestuurders moet aangestel word waar dit ontbreek; personeelontwikkeling moet moontlik wees en deurlopende oudits van dokumentasie moet plaasvind. Voldoende toerusting en voorraad is nodig om kwaliteit verpleegsorg moontlik te maak. Verdere opleiding in die beginsels van Batho Pele is nodig ten einde effektiewe en doeltreffende implementering daarvan moontlik te maak.