A qualitative, exploratory, descriptive and contextual study was conducted to explore health care unit managers’ view of their role as leader-managers, and to determine the challenges they experience and the skills they need to be effective leader-managers in the 21st century, the Quantum Age. Semi-structured interviews were conducted with eight health care unit managers from a selected public hospital in the Western Cape Province. The findings revealed that health care unit managers experience workforce challenges, with staff shortage being a serious concern; personal challenges, such as an increased workload and role diversity; and organisational challenges with regard to the management of equipment. Desired attributes and skills for leader-managers as indicated by unit managers concur with Shelton’s (1999) Quantum Skills Model. Recommendations were made for nursing practice, education and research, including recommendations on the development of the seven quantum skills. / Health Studies / M.A. (Health Studies)

The purpose of this study was to investigate the Isoniazid preventive therapy (IPT) initiation amongst eligible HIV positive patients at health facilities in the Polokwane subdistrict to identify key features in the knowledge and practice of health professionals as well as available resources at the health facilities. A quantitative non-experimental, descriptive, cross-sectional design was used to describe the practice of IPT initiation in health facilities. Data were collected using a structured questionnaire with medical doctors, operational managers and registered nurses from the district’s 34 health care facilities. The census sample was 124. Data were captured and analysed using Statistical Package for the Social Sciences (SPSS) Version 24. The results showed that the health care professionals knew the policy and procedures for the implementation of IPT but lacked knowledge on patient screening. The findings further suggest that record keeping and data capturing was not implemented sufficiently. Resources at the facilities were found to be sufficient. / Health Studies / M. P. H.

A qualitative, exploratory, descriptive and contextual study was conducted to explore health care unit managers’ view of their role as leader-managers, and to determine the challenges they experience and the skills they need to be effective leader-managers in the 21st century, the Quantum Age. Semi-structured interviews were conducted with eight health care unit managers from a selected public hospital in the Western Cape Province. The findings revealed that health care unit managers experience workforce challenges, with staff shortage being a serious concern; personal challenges, such as an increased workload and role diversity; and organisational challenges with regard to the management of equipment. Desired attributes and skills for leader-managers as indicated by unit managers concur with Shelton’s (1999) Quantum Skills Model. Recommendations were made for nursing practice, education and research, including recommendations on the development of the seven quantum skills. / Health Studies / M.A. (Health Studies)

In this study the researcher attempted to determine the current role expectations of a clinic manager in a primary health care setting, to identify factors determining and influencing the role of a clinic manager, to determine what effect the current role expectations had on the management of primary health care services rendered at the clinic, to establish the developmental needs of clinic managers to enable them to adhere to their role expectations, and to identify and recommend measures to support clinic managers in the execution of their managerial role by addressing the identified deficiencies. The researcher selected a quantitative, exploratory, descriptive and contextual design. Clinic managers of fixed clinics in the Free State province were randomly selected to participate in the study and a questionnaire was utilised as data-collection instrument. The study found that the clinic manager's role is comprehensive and varies from telephonic booking patients to assessment of the quality of primary health care programmes. A number of non-managerial functions were identified, such as consultation of patients, management of medicine, dispensing of medicine and ordering of stock. It was also found that the respondents were not involved in a number of management functions such as financial and human resource management, and adherence to the implementation of standards. Factors that negatively influenced the clinic managers' management role included: * Lack of time due to the large number of patients they had to consult due to the shortage of staff. * Shortage of staff. * The execution of non-managerial tasks. Although it was found that the current role of the clinic manager was confusing as it entailed much more than just clinic management, it is foreseen that the role of the clinic manager could in future be clarified if the recommendations are implemented. / Health Studies / D. Litt. et Phil. (Health Studies)

Text in Afrikaans / Summaries in Afrikaans and English / Bemagtiging van verpleegkundiges in gesondheidsdienste in Suid-Afrika bly 'n voortdurende kwessie en die mate waartoe verpleegbestuur verpleegkundiges bemagtig om outonoom op te tree, is onbekend. Wanneer verpleegkundiges bemagtig is, lei dit tot verbeterde pasientsorg deur middel van verhoogde produktiwiteit en werktevredenheid. Die wyse waarop bemagtiging van verpleegkundiges meet geskied is nog nie in SuidAfrika in diepte ondersoek nie. Die doel van hierdie studie was om daardie elemente wat vir die verpleegbestuurder noodsaaklik is om verpleegkundiges te kan bemagtig, te identifiseer. Deur middel van 'n beskrywende, ontdekkende studie wat van 'n vraelys gebruik gemaak het om inligting te bekom, is die nodige elemente gei'soleer. Verpleegbestuurders in gesondheidsdienste in die Gauteng-area het as teikengroep gedien. Definisies van bestuursbemagtiging is geanaliseer ten einde 'n konseptuele raamwerk te ken saamstel. Ses konsepte het die raamwerk vir hierdie studie gevorm, naamlik: • die bydrae van bestuurstrukture tot die bemagtiging van verpleegkundiges; • die rel van magsdeling in die bemagtiging van verpleegkundiges; • deelnemende besluitneming in die bemagtiging van verpleegkundiges; • die verpleegbestuurder se vaardighede en verantwoordelikhede in haar daaglikse taakontwerp en bestuur wat tot die bemagtiging van verpleegkundiges bydra; • motivering- en beloningstrategiee wat tot bemagtiging bydra; en • eienskappe wat kenmerkend van 'n bemagtigende verpleegbestuurder is. Uit die ontleding van die data het die volgende belangrike elemente ender andere na vore gekom: • Daar behoort gedesentraliseerde verspreiding van mag na die laagste moontlike vlak in die gesondheidsdiens plaas te vind; • Die voorstelle van verpleegkundiges behoort erken en indien aanvaarbaar, geimplementeer te word; • Gesag behoort op so n wyse gedelegeer te word dat onafhanklike besluitneming bevorder word; • Verpleegkundiges se take behoort sodanig ontwerp te word dat onafhanklike optrede in die werkplek bevorder word. Die bevindinge van hierdie studie het getoon dat verpleegbestuurders positief ingestel is betreffende die bemagtiging van verpleegkundiges. Hulle beskou dit as deel van hulle bestuursfunksie. 'n Uitdaging waarmee die bestuurder van die toekoms te kampe sal he, is die van 'n omvattende begrip vir personeellede en om van beheer deur middel van streng burokratiese reels, af te sien. / Empowerment of nurses in health services in South Africa remains an ongoing issue, but the extent to which nursing management empowers nurses to act autonomously is not known. When nurses are empowered patient care and nursing services improve through enhanced productivity and job satisfaction. The way in which nurses could be empowered by management has yet to be addressed by researchers in South Africa. The aim of the present study was to identify those essential elements through which nurse managers can empower nurses. By making use of a descriptive exploratory study, utilizing a questionnaire to acquire the necessary information, the essential elements were isolated. Nurse managers in health services in the Gauteng region formed the target group. Definitions of empowerment in management were analyzed and from this a conceptual framework regarding empowerment was formulated. Six concepts served as the basis of this study: • the contribution of management structures, towards the empowerment of nurses; • the role of power-sharing in the empowerment of nurses; • participative decision making in the empowerment of nurses; • the management skills and responsibilities of the nurse manager in her daily task design and management that contribute to the empowerment of nurses; • motivation and reward strategies that contribute towards empowerment; • attributes which characterise an empowered nurse manager. From the analysis of. the data the following important elements among others emerged: • Decentralization of the distribution of power to the lowest possible level should take place in the health services; • The suggestions of nurses should be acknowledged and if found acceptable, to be implemented; • Authority should be delegated in such a way that independent decision making by nurses is enhanced; • Nurses' tasks should be designed in a way that promote independent performance in the work place. The findings of this study revealed that nurse managers are favourably disposed towards the empowerment of nurses. They see this as part of their managerial function. A challenge which confronts the manager of the future is that of comprehensively understanding staff members, and setting aside control through bureaucratic behaviour. / Health Studies / D. Litt. et Phil.

In this study the researcher attempted to determine the current role expectations of a clinic manager in a primary health care setting, to identify factors determining and influencing the role of a clinic manager, to determine what effect the current role expectations had on the management of primary health care services rendered at the clinic, to establish the developmental needs of clinic managers to enable them to adhere to their role expectations, and to identify and recommend measures to support clinic managers in the execution of their managerial role by addressing the identified deficiencies. The researcher selected a quantitative, exploratory, descriptive and contextual design. Clinic managers of fixed clinics in the Free State province were randomly selected to participate in the study and a questionnaire was utilised as data-collection instrument. The study found that the clinic manager's role is comprehensive and varies from telephonic booking patients to assessment of the quality of primary health care programmes. A number of non-managerial functions were identified, such as consultation of patients, management of medicine, dispensing of medicine and ordering of stock. It was also found that the respondents were not involved in a number of management functions such as financial and human resource management, and adherence to the implementation of standards. Factors that negatively influenced the clinic managers' management role included: * Lack of time due to the large number of patients they had to consult due to the shortage of staff. * Shortage of staff. * The execution of non-managerial tasks. Although it was found that the current role of the clinic manager was confusing as it entailed much more than just clinic management, it is foreseen that the role of the clinic manager could in future be clarified if the recommendations are implemented. / Health Studies / D. Litt. et Phil. (Health Studies)

Text in Afrikaans / Summaries in Afrikaans and English / Bemagtiging van verpleegkundiges in gesondheidsdienste in Suid-Afrika bly 'n voortdurende kwessie en die mate waartoe verpleegbestuur verpleegkundiges bemagtig om outonoom op te tree, is onbekend. Wanneer verpleegkundiges bemagtig is, lei dit tot verbeterde pasientsorg deur middel van verhoogde produktiwiteit en werktevredenheid. Die wyse waarop bemagtiging van verpleegkundiges meet geskied is nog nie in SuidAfrika in diepte ondersoek nie. Die doel van hierdie studie was om daardie elemente wat vir die verpleegbestuurder noodsaaklik is om verpleegkundiges te kan bemagtig, te identifiseer. Deur middel van 'n beskrywende, ontdekkende studie wat van 'n vraelys gebruik gemaak het om inligting te bekom, is die nodige elemente gei'soleer. Verpleegbestuurders in gesondheidsdienste in die Gauteng-area het as teikengroep gedien. Definisies van bestuursbemagtiging is geanaliseer ten einde 'n konseptuele raamwerk te ken saamstel. Ses konsepte het die raamwerk vir hierdie studie gevorm, naamlik: • die bydrae van bestuurstrukture tot die bemagtiging van verpleegkundiges; • die rel van magsdeling in die bemagtiging van verpleegkundiges; • deelnemende besluitneming in die bemagtiging van verpleegkundiges; • die verpleegbestuurder se vaardighede en verantwoordelikhede in haar daaglikse taakontwerp en bestuur wat tot die bemagtiging van verpleegkundiges bydra; • motivering- en beloningstrategiee wat tot bemagtiging bydra; en • eienskappe wat kenmerkend van 'n bemagtigende verpleegbestuurder is. Uit die ontleding van die data het die volgende belangrike elemente ender andere na vore gekom: • Daar behoort gedesentraliseerde verspreiding van mag na die laagste moontlike vlak in die gesondheidsdiens plaas te vind; • Die voorstelle van verpleegkundiges behoort erken en indien aanvaarbaar, geimplementeer te word; • Gesag behoort op so n wyse gedelegeer te word dat onafhanklike besluitneming bevorder word; • Verpleegkundiges se take behoort sodanig ontwerp te word dat onafhanklike optrede in die werkplek bevorder word. Die bevindinge van hierdie studie het getoon dat verpleegbestuurders positief ingestel is betreffende die bemagtiging van verpleegkundiges. Hulle beskou dit as deel van hulle bestuursfunksie. 'n Uitdaging waarmee die bestuurder van die toekoms te kampe sal he, is die van 'n omvattende begrip vir personeellede en om van beheer deur middel van streng burokratiese reels, af te sien. / Empowerment of nurses in health services in South Africa remains an ongoing issue, but the extent to which nursing management empowers nurses to act autonomously is not known. When nurses are empowered patient care and nursing services improve through enhanced productivity and job satisfaction. The way in which nurses could be empowered by management has yet to be addressed by researchers in South Africa. The aim of the present study was to identify those essential elements through which nurse managers can empower nurses. By making use of a descriptive exploratory study, utilizing a questionnaire to acquire the necessary information, the essential elements were isolated. Nurse managers in health services in the Gauteng region formed the target group. Definitions of empowerment in management were analyzed and from this a conceptual framework regarding empowerment was formulated. Six concepts served as the basis of this study: • the contribution of management structures, towards the empowerment of nurses; • the role of power-sharing in the empowerment of nurses; • participative decision making in the empowerment of nurses; • the management skills and responsibilities of the nurse manager in her daily task design and management that contribute to the empowerment of nurses; • motivation and reward strategies that contribute towards empowerment; • attributes which characterise an empowered nurse manager. From the analysis of. the data the following important elements among others emerged: • Decentralization of the distribution of power to the lowest possible level should take place in the health services; • The suggestions of nurses should be acknowledged and if found acceptable, to be implemented; • Authority should be delegated in such a way that independent decision making by nurses is enhanced; • Nurses' tasks should be designed in a way that promote independent performance in the work place. The findings of this study revealed that nurse managers are favourably disposed towards the empowerment of nurses. They see this as part of their managerial function. A challenge which confronts the manager of the future is that of comprehensively understanding staff members, and setting aside control through bureaucratic behaviour. / Health Studies / D. Litt. et Phil.

AIM: This study aimed to explore the influences of monitoring and evaluation on the performance of managers in a primary health care setting in Qumbu sub district health department of Oliver Tambo district municipality. METHODS: A Phenomenological approach was adopted in this study. Specifically, an Interpretative phenomenological analysis design was used to explore the influences of monitoring and evaluation on the performance of managers in a primary health care setting in Qumbu sub district health department of Oliver Tambo district municipality. Data were collected using a semi-structured interview format on 8 conveniently selected clinic managers. Data were analysed using Smith’s (2005) Interpretative Phenomenological Analysis framework. RESULTS: Three thematic categories emerged from data analysis: performance of clinic managers, support for clinic managers, and monitoring and evaluation system. The findings of this study have implications for practice, training and research. CONCLUSION: Clinic managers experienced various obstacles, which affect the influence of monitoring and evaluation on their performance. These obstacles have implications in the context of the quality of service provision. / Health Studies / M.P.H.