Until recently, the health professions have largely followed a medical model, which seeks to treat patients by focusing on medicine and surgery, and gives less importance to beliefs and to the faith in healing, in the physician, and in the doctor-patient relationship. This reductionist view of patients being only material body is no longer satisfactory. Patients and healthcare professionals have begun to value the role of elements such as faith, spirituality, hope and compassion in the healing process. The effect of such spiritual elements in health and quality of life has led to research in this field in an attempt to move towards a more holistic view, which included the non-material dimension. The goal of this study was to explore the understanding of spirituality among healthcare professionals and patients at the CHBAH. The primary research question, which this study attempted to answer, was: What is the understanding of spirituality among the healthcare professionals and patients at CHBAH? In view of this primary research question, the following secondary research questions were formulated: * What does a literature review produce regarding spirituality in healthcare and what are the current practices related to spirituality in healthcare. * What are the views of healthcare professionals and patients concerning the relevance of spirituality in their day-to-day lives and healthcare interventions? * What are the spiritual needs of patients and to what extent does spirituality contribute towards their coping with health-related issues? * Which practical and scientific recommendations can be offered to healthcare professionals regarding including/incorporating spirituality in healthcare services in CHBAH? In view of the aim, the researcher identified the following specific objectives for this study: * To explore spirituality in healthcare by means of a literature review; * To explore and describe the views of medical social workers and other healthcare professionals about the relevance of spirituality in a healthcare setting; * To explore and describe the understanding of spirituality among healthcare professionals and patients in CHBAH; * To propose a protocol as an organizational framework on the incorporation of spirituality in healthcare at CHBAH. This protocol should be implemented during social workers‟ and other healthcare professionals‟ interactions with patients. Chapter 1 provides an introduction, problem formulation, goal, research question and the objectives of this study and a brief overview of the methodology. Chapter 2 focuses on the description of research methodology that was utilised in this study. Chapter 3 is composed of a literature study on spirituality and the religions identified and explored in CHBAH, as well as existing practices related to spirituality in health care. In Chapter 4, the data generated through narratives from focus-group discussions and healthcare professionals‟ spiritual journey is processed and reported. In Chapter 5 a proposed protocol for inclusion of spirituality in healthcare services in CHBAH is presented and discussed in detail Chapter 6 consists of the conclusions and summary of this study. / PhD (Social Work), North-West University, Potchefstroom Campus, 2014

Until recently, the health professions have largely followed a medical model, which seeks to treat patients by focusing on medicine and surgery, and gives less importance to beliefs and to the faith in healing, in the physician, and in the doctor-patient relationship. This reductionist view of patients being only material body is no longer satisfactory. Patients and healthcare professionals have begun to value the role of elements such as faith, spirituality, hope and compassion in the healing process. The effect of such spiritual elements in health and quality of life has led to research in this field in an attempt to move towards a more holistic view, which included the non-material dimension. The goal of this study was to explore the understanding of spirituality among healthcare professionals and patients at the CHBAH. The primary research question, which this study attempted to answer, was: What is the understanding of spirituality among the healthcare professionals and patients at CHBAH? In view of this primary research question, the following secondary research questions were formulated: * What does a literature review produce regarding spirituality in healthcare and what are the current practices related to spirituality in healthcare. * What are the views of healthcare professionals and patients concerning the relevance of spirituality in their day-to-day lives and healthcare interventions? * What are the spiritual needs of patients and to what extent does spirituality contribute towards their coping with health-related issues? * Which practical and scientific recommendations can be offered to healthcare professionals regarding including/incorporating spirituality in healthcare services in CHBAH? In view of the aim, the researcher identified the following specific objectives for this study: * To explore spirituality in healthcare by means of a literature review; * To explore and describe the views of medical social workers and other healthcare professionals about the relevance of spirituality in a healthcare setting; * To explore and describe the understanding of spirituality among healthcare professionals and patients in CHBAH; * To propose a protocol as an organizational framework on the incorporation of spirituality in healthcare at CHBAH. This protocol should be implemented during social workers‟ and other healthcare professionals‟ interactions with patients. Chapter 1 provides an introduction, problem formulation, goal, research question and the objectives of this study and a brief overview of the methodology. Chapter 2 focuses on the description of research methodology that was utilised in this study. Chapter 3 is composed of a literature study on spirituality and the religions identified and explored in CHBAH, as well as existing practices related to spirituality in health care. In Chapter 4, the data generated through narratives from focus-group discussions and healthcare professionals‟ spiritual journey is processed and reported. In Chapter 5 a proposed protocol for inclusion of spirituality in healthcare services in CHBAH is presented and discussed in detail Chapter 6 consists of the conclusions and summary of this study. / PhD (Social Work), North-West University, Potchefstroom Campus, 2014

The practice environment of nurses plays a very important role in the delivery of quality health care. However, there is limited knowledge on what positive practice environments entail with specific reference to the primary health context of the public health care sector of South Africa. Nurses in this context are the frontline health personnel and are affected not only by nursing shortages, but also high workloads as the public health care sector serves 83% of the South African population and the private health care sector only 17%. In this study the researcher decided to conduct a study to explore the practice environment of nurses in the primary health care context as no studies have previously been undertaken in this regard. The researcher used a case study design with quantitative and qualitative approaches and implemented descriptive, explanatory and contextual strategies. This design, together with the findings of objectives one, two and three, the World Health Organization Strengthening of Health Systems and Fourteen Forces of Magnetism Frameworks and inductive and deductive logic enabled the researcher to achieve the overarching aim, which is objective four, of this study. Descriptive statistics, confirmatory factor analysis and Cronbach’s alpha assisted the researcher in assessing the demographic profile (objective 1) and the status of the practice environment of community health centres in North West Province (objective 2). Thereafter, the researcher was also able to identify the community health centre with the most favourable practice environment in order to conduct semi-structured individual interviews (objective 3). The descriptive data of objective 1 revealed that community health centres in the North West Province are located on average 36 km from the nearest referral hospital to which an average of five patients per day are referred. The average number of patients consulted per month is 3 545 of which the nurse consults an average of 40 and the physician 15 patients per day. In the community health centres the average age of nurses is 40, with 10 years of nursing experience. There were more female than male nurses of which 65% of the registered nurses had a diploma in nursing and had only started their careers at 31 years of age. There is an average of eleven registered nurses, five auxiliary and one enrolled nurse in the community health centres of which only four of the registered nurses (36%) had a qualification in Clinical Health Assessment, Treatment and Care. The overall staff turnover rates were very low and the satisfaction levels were high. The factor analysis of objective 2 revealed that the Practice Environment Scale of the Nursing Work Index’s sub-scales staffing and resource adequacy and nurse participation in primary health care/community health centre affairs had means below 2.5, indicating that nurses were not in agreement with these sub-scales. However, nurse manager ability, leadership and support; collegial nurse-physician relationships and nursing foundations for quality of care had a mean above 2.5 indicating that the nurses were in agreement with these sub-scales. Lastly, the qualitative findings indicated that although the community health centres with the most favourable practice environment were affected by factors that decrease quality of care which included a lack of resources, limited infrastructure, limited support from pharmacy and staff shortages. These mentioned factors were not in the control of the community health centres. Although the community health centres were affected by the above-mentioned factors these community health centres excelled in support, leadership and governance, collegial nurse-physician relationships and factors influencing quality of care which were in the control of the community health centre. / Thesis (PhD (Nursing))--North-West University, Potchefstroom Campus, 2013.

The South African health industry can be divided into public and private health institutions. The public health institutions are subsidised by the South African government, whereas the private institutions generate income from medical aids and out-of-pocket payments. Three major groups currently control the private health sector and include Medi-Clinic, Life Healthcare and Netcare. Due to the competitiveness of the private health sector with limited role players, institutions need to differentiate themselves on the service quality provided by these institutions. The purpose of the study was to measure service quality in a private hospital. This was done by setting the following objectives: Determining the importance of service quality, determining the current standard of service quality, determining the gap between the importance and satisfaction of service quality dimensions as well as the influence of gender on the perception of service quality. The literature consisted of two topics, which included the private healthcare sector and the standards of service quality. The private health care sector lightens the load on the current overburdened public sector, but in doing so utilises the majority of qualified personnel as well as half of the financial resources available. Medical schemes are the main contributor the private institutions and are only available to the individuals privileged enough to afford these schemes. Service quality pertains to the ability of the service provider to meet or exceed the expectations of the customer. Thus, the importance of such ability lies in the fact that institutions can use this to differentiate them from other role players in this highly competitive market. Several models exist to evaluate service quality, but the SERVQUAL model has been utilised in various health institutions. Furthermore, gender could also have an effect on the manner in which customers perceive service quality. The study made use of the SERVQUAL model, with a 38-item survey questionnaire forming the basis of the data collecting technique. The 38 items were divided into seven sections, which included premises/employees, doctors‟ medical services, diagnostics, nursing medical services, admissions, meals and wards. A response rate of 71% was obtained. The demographic profile of the study resembled the current demographic of the town and 35.85% of the respondents were male with 64.15% being female. The validity and the reliability of the study were confirmed by means of an exploratory factor analysis and Chronbach alpha coefficients. The analysis of the difference in means of the various factors indicated that tangibles 2 and responsiveness 1 required attention from management to improve customer satisfaction. The analysis of data pertaining to gender indicated that no difference in satisfaction levels was evident. In conclusion, management needs to focus on the factors highlighted during the study, with proper maintenance and improvement of the appearance of the facility and providing training to staff to promote patient relationships. Furthermore, the recommendations include that the model is used in all institutions to evaluate service quality levels to highlight possible shortfalls, thus providing management with ability to address these shortfalls, in an effort to improve the level of service quality across the whole health sector. / MBA, North-West University, Potchefstroom Campus, 2014

The practice environment of nurses plays a very important role in the delivery of quality health care. However, there is limited knowledge on what positive practice environments entail with specific reference to the primary health context of the public health care sector of South Africa. Nurses in this context are the frontline health personnel and are affected not only by nursing shortages, but also high workloads as the public health care sector serves 83% of the South African population and the private health care sector only 17%. In this study the researcher decided to conduct a study to explore the practice environment of nurses in the primary health care context as no studies have previously been undertaken in this regard. The researcher used a case study design with quantitative and qualitative approaches and implemented descriptive, explanatory and contextual strategies. This design, together with the findings of objectives one, two and three, the World Health Organization Strengthening of Health Systems and Fourteen Forces of Magnetism Frameworks and inductive and deductive logic enabled the researcher to achieve the overarching aim, which is objective four, of this study. Descriptive statistics, confirmatory factor analysis and Cronbach’s alpha assisted the researcher in assessing the demographic profile (objective 1) and the status of the practice environment of community health centres in North West Province (objective 2). Thereafter, the researcher was also able to identify the community health centre with the most favourable practice environment in order to conduct semi-structured individual interviews (objective 3). The descriptive data of objective 1 revealed that community health centres in the North West Province are located on average 36 km from the nearest referral hospital to which an average of five patients per day are referred. The average number of patients consulted per month is 3 545 of which the nurse consults an average of 40 and the physician 15 patients per day. In the community health centres the average age of nurses is 40, with 10 years of nursing experience. There were more female than male nurses of which 65% of the registered nurses had a diploma in nursing and had only started their careers at 31 years of age. There is an average of eleven registered nurses, five auxiliary and one enrolled nurse in the community health centres of which only four of the registered nurses (36%) had a qualification in Clinical Health Assessment, Treatment and Care. The overall staff turnover rates were very low and the satisfaction levels were high. The factor analysis of objective 2 revealed that the Practice Environment Scale of the Nursing Work Index’s sub-scales staffing and resource adequacy and nurse participation in primary health care/community health centre affairs had means below 2.5, indicating that nurses were not in agreement with these sub-scales. However, nurse manager ability, leadership and support; collegial nurse-physician relationships and nursing foundations for quality of care had a mean above 2.5 indicating that the nurses were in agreement with these sub-scales. Lastly, the qualitative findings indicated that although the community health centres with the most favourable practice environment were affected by factors that decrease quality of care which included a lack of resources, limited infrastructure, limited support from pharmacy and staff shortages. These mentioned factors were not in the control of the community health centres. Although the community health centres were affected by the above-mentioned factors these community health centres excelled in support, leadership and governance, collegial nurse-physician relationships and factors influencing quality of care which were in the control of the community health centre. / Thesis (PhD (Nursing))--North-West University, Potchefstroom Campus, 2013.

The South African health industry can be divided into public and private health institutions. The public health institutions are subsidised by the South African government, whereas the private institutions generate income from medical aids and out-of-pocket payments. Three major groups currently control the private health sector and include Medi-Clinic, Life Healthcare and Netcare. Due to the competitiveness of the private health sector with limited role players, institutions need to differentiate themselves on the service quality provided by these institutions. The purpose of the study was to measure service quality in a private hospital. This was done by setting the following objectives: Determining the importance of service quality, determining the current standard of service quality, determining the gap between the importance and satisfaction of service quality dimensions as well as the influence of gender on the perception of service quality. The literature consisted of two topics, which included the private healthcare sector and the standards of service quality. The private health care sector lightens the load on the current overburdened public sector, but in doing so utilises the majority of qualified personnel as well as half of the financial resources available. Medical schemes are the main contributor the private institutions and are only available to the individuals privileged enough to afford these schemes. Service quality pertains to the ability of the service provider to meet or exceed the expectations of the customer. Thus, the importance of such ability lies in the fact that institutions can use this to differentiate them from other role players in this highly competitive market. Several models exist to evaluate service quality, but the SERVQUAL model has been utilised in various health institutions. Furthermore, gender could also have an effect on the manner in which customers perceive service quality. The study made use of the SERVQUAL model, with a 38-item survey questionnaire forming the basis of the data collecting technique. The 38 items were divided into seven sections, which included premises/employees, doctors‟ medical services, diagnostics, nursing medical services, admissions, meals and wards. A response rate of 71% was obtained. The demographic profile of the study resembled the current demographic of the town and 35.85% of the respondents were male with 64.15% being female. The validity and the reliability of the study were confirmed by means of an exploratory factor analysis and Chronbach alpha coefficients. The analysis of the difference in means of the various factors indicated that tangibles 2 and responsiveness 1 required attention from management to improve customer satisfaction. The analysis of data pertaining to gender indicated that no difference in satisfaction levels was evident. In conclusion, management needs to focus on the factors highlighted during the study, with proper maintenance and improvement of the appearance of the facility and providing training to staff to promote patient relationships. Furthermore, the recommendations include that the model is used in all institutions to evaluate service quality levels to highlight possible shortfalls, thus providing management with ability to address these shortfalls, in an effort to improve the level of service quality across the whole health sector. / MBA, North-West University, Potchefstroom Campus, 2014

Objective: The primary objective is to determine the preferred organisational characteristics and remuneration types for pharmacists and university students in South Africa. The primary objective will be realised and supported by meeting the secondary objectives, which are: * What organisational characteristics and remuneration types exist in the literature that could influence the employee’s perception of the organisation? * How do these characteristics and remuneration types differ between students and pharmacists? * How do these characteristics and remuneration types differ between different age groups? * How do these characteristics and remuneration types differ between different levels of experience? Methods: The research of this study will be conducted by means of a comparative literature review and a quantitative empirical study. The literature review will discuss the staffing situation in the pharmacy as it is currently experienced, as well as the aspects that might influence potential applicants in the future. The empirical investigation will be done by analysing pharmacists currently employed by a retail pharmacy chain organisation and the final-year pharmacy student class of a South African university. Quantitative research will be conducted by way of an anonymous questionnaire. Part one will be used to determine the demographics of the study populations. Part two will determine the current level of motivation as well as aspects pertaining to their preferred organisational characteristics and will include the following: * To determine the current organisational characteristics sought after by the pharmacists and pharmacy students in the study population; and * To determine the most preferred remuneration types for the pharmacists and pharmacy students in the study population. Results: It was noted that many organisational characteristics could influence the employee perceptions. From the analysed questionnaires, characteristics that include growth opportunities inside the organisation, using your pharmaceutical skills, physical working location, as well as manageable intensity of work were cited as the most important characteristics. The most important remuneration packages in the studied population were analysed to be: * A basic plus benefit system was preferred * A skills-based pay as the base of the remuneration package * A performance-based incentive system where benefits are rewarded according to merit * Incentives calculated from amount of personal output and not by business unit or organisational profit * Share options were popular as an added benefit It should be noted that the preferred remuneration packages do differ between students, pharmacists, pharmacy managers, different age groups and experience groups and can be personalised for each group. Conclusion: This study highlighted preferred organisational characteristics and remuneration types for retail pharmacists and final-year pharmacy students. It is recommended that a more in-depth study of the preferred organisational characteristics and remuneration types for retail pharmacists should be conducted. This study should also include the cost implications of hiring the most suitable candidate for a position versus the least suitable candidate. / MBA, North-West University, Potchefstroom Campus, 2014

Objective: The primary objective is to determine the preferred organisational characteristics and remuneration types for pharmacists and university students in South Africa. The primary objective will be realised and supported by meeting the secondary objectives, which are: * What organisational characteristics and remuneration types exist in the literature that could influence the employee’s perception of the organisation? * How do these characteristics and remuneration types differ between students and pharmacists? * How do these characteristics and remuneration types differ between different age groups? * How do these characteristics and remuneration types differ between different levels of experience? Methods: The research of this study will be conducted by means of a comparative literature review and a quantitative empirical study. The literature review will discuss the staffing situation in the pharmacy as it is currently experienced, as well as the aspects that might influence potential applicants in the future. The empirical investigation will be done by analysing pharmacists currently employed by a retail pharmacy chain organisation and the final-year pharmacy student class of a South African university. Quantitative research will be conducted by way of an anonymous questionnaire. Part one will be used to determine the demographics of the study populations. Part two will determine the current level of motivation as well as aspects pertaining to their preferred organisational characteristics and will include the following: * To determine the current organisational characteristics sought after by the pharmacists and pharmacy students in the study population; and * To determine the most preferred remuneration types for the pharmacists and pharmacy students in the study population. Results: It was noted that many organisational characteristics could influence the employee perceptions. From the analysed questionnaires, characteristics that include growth opportunities inside the organisation, using your pharmaceutical skills, physical working location, as well as manageable intensity of work were cited as the most important characteristics. The most important remuneration packages in the studied population were analysed to be: * A basic plus benefit system was preferred * A skills-based pay as the base of the remuneration package * A performance-based incentive system where benefits are rewarded according to merit * Incentives calculated from amount of personal output and not by business unit or organisational profit * Share options were popular as an added benefit It should be noted that the preferred remuneration packages do differ between students, pharmacists, pharmacy managers, different age groups and experience groups and can be personalised for each group. Conclusion: This study highlighted preferred organisational characteristics and remuneration types for retail pharmacists and final-year pharmacy students. It is recommended that a more in-depth study of the preferred organisational characteristics and remuneration types for retail pharmacists should be conducted. This study should also include the cost implications of hiring the most suitable candidate for a position versus the least suitable candidate. / MBA, North-West University, Potchefstroom Campus, 2014

Many patients suffer from dermatological diseases throughout the world. Literature about this problem is emphasizing that it is getting worse. Factors such as poor hygiene, poverty and diseases such as HIV/AIDS, have increased the prevalence of dermatological diseases in developing countries such as Namibia. Understanding the different dermatological diseases and studying their prevalence will aid in ensuring patients better quality of life. The aim of the study was to investigate the prevalence and medicinal treatment patterns of dermatological diseases in the private healthcare sector of Namibia, with special reference to Windhoek. The research methodology was divided into two sections, namely a literature analysis and an empirical study. The literature analysis has been done to ensure knowledge about dermatological conditions before the empirical study was started. The empirical study was divided into two phases and data were collected from the community pharmacy environment (Phase 1) and a dermatologist (Phase 2). A total number of 507 patients participated in this study. In the community pharmacy environment, data were gathered from dermatological prescriptions of general practitioners (Phase 1A) and from pharmacist-initiated therapy prescriptions (Phase 1B). The data collected from the dermatologist (Phase 2), were collected from patients files at the dermatologist‘s practise. Phase 1A indicated that urticaria (n=36) had the highest prevalence followed by eczema (n=28) and contact dermatitis (n=28). 49% of the patients that participated in this phase were seeking treatment for the same condition the second time. In Phase 1B, contact dermatitis (n=15) showed the highest prevalence with eczema (n=14) and urticaria (n=8) second and third respectively. 77% of the patients participating in this phase of the research study did not have a family history of the same dermatological diseases. Phase 2 indicated that the highest prevalence of dermatological diseases was acne vulgaris (n=30) and melasma (n=19). The treatment duration that occurred most often in this phase was 180 days. Over all, the data indicated that eczema was the dermatological disease with the highest incidence of 11.2% (n=57). Other diseases that played a significant part were acne vulgaris (10.5%), urticaria (9.0%), contact dermatitis (8.6%) and melasma (7.1%). Rare dermatological diseases such as Kaposi sarcoma showed relatively high prevalence (n=9). It was concluded that this could be due to the fact that the dermatologist consulted, had been the only dermatologist claiming directly from the government medical aid, and that most of the patients diagnosed with Kaposi sarcoma during this research study were government employees. Many dermatological diseases were not specifically defined or diagnosed, but still treated with topical corticosteroids which may suggest that the term eczema is undefined and easily used by different healthcare practitioners for dry-skin related conditions. It is concluded in this research study that the three most prevalent dermatological diseases in the private healthcare sector of Namibia are eczema, acne vulgaris and urticaria. These conditions are not considered to be life-threatening, but they do have a significant effect on the quality of life of patients. / MPham (Pharmacy Practice), North-West University, Potchefstroom Campus, 2014

Many patients suffer from dermatological diseases throughout the world. Literature about this problem is emphasizing that it is getting worse. Factors such as poor hygiene, poverty and diseases such as HIV/AIDS, have increased the prevalence of dermatological diseases in developing countries such as Namibia. Understanding the different dermatological diseases and studying their prevalence will aid in ensuring patients better quality of life. The aim of the study was to investigate the prevalence and medicinal treatment patterns of dermatological diseases in the private healthcare sector of Namibia, with special reference to Windhoek. The research methodology was divided into two sections, namely a literature analysis and an empirical study. The literature analysis has been done to ensure knowledge about dermatological conditions before the empirical study was started. The empirical study was divided into two phases and data were collected from the community pharmacy environment (Phase 1) and a dermatologist (Phase 2). A total number of 507 patients participated in this study. In the community pharmacy environment, data were gathered from dermatological prescriptions of general practitioners (Phase 1A) and from pharmacist-initiated therapy prescriptions (Phase 1B). The data collected from the dermatologist (Phase 2), were collected from patients files at the dermatologist‘s practise. Phase 1A indicated that urticaria (n=36) had the highest prevalence followed by eczema (n=28) and contact dermatitis (n=28). 49% of the patients that participated in this phase were seeking treatment for the same condition the second time. In Phase 1B, contact dermatitis (n=15) showed the highest prevalence with eczema (n=14) and urticaria (n=8) second and third respectively. 77% of the patients participating in this phase of the research study did not have a family history of the same dermatological diseases. Phase 2 indicated that the highest prevalence of dermatological diseases was acne vulgaris (n=30) and melasma (n=19). The treatment duration that occurred most often in this phase was 180 days. Over all, the data indicated that eczema was the dermatological disease with the highest incidence of 11.2% (n=57). Other diseases that played a significant part were acne vulgaris (10.5%), urticaria (9.0%), contact dermatitis (8.6%) and melasma (7.1%). Rare dermatological diseases such as Kaposi sarcoma showed relatively high prevalence (n=9). It was concluded that this could be due to the fact that the dermatologist consulted, had been the only dermatologist claiming directly from the government medical aid, and that most of the patients diagnosed with Kaposi sarcoma during this research study were government employees. Many dermatological diseases were not specifically defined or diagnosed, but still treated with topical corticosteroids which may suggest that the term eczema is undefined and easily used by different healthcare practitioners for dry-skin related conditions. It is concluded in this research study that the three most prevalent dermatological diseases in the private healthcare sector of Namibia are eczema, acne vulgaris and urticaria. These conditions are not considered to be life-threatening, but they do have a significant effect on the quality of life of patients. / MPham (Pharmacy Practice), North-West University, Potchefstroom Campus, 2014