The purpose of the study was to determine whether it was possible to predict the socio-demographic characteristics of physicians who adopt a new paradigm in medicine, wellness. A major objective of the research was to test the "marginal man" hypothesis. The literature suggested that there are at least three types of innovations: technological, organizational, and paradigmatic. Literature on the diffusion of innovations in medicine showed that high status physicians adopt technical innovations; more marginal, particularly young physicians and those of a liberal political orientation, most often adopt organizational innovations. Few studies dealing with paradigmatic innovations were found. Historical evidence supports the notion that family practitioners might be more accepting of the new paradigm. Physicians in Tucson, Arizona were surveyed concerning their attitudes and practices in the areas of health education and wellness, examples of the new paradigm in medicine. They were also asked about hospital-based health education services and competition between physicians and hospitals, examples of organizational innovation. The analyses revealed that family practitioners, women and government physicians were most supportive of wellness, affirming the research hypothesis and the "marginal man" hypothesis. The analysis also suggested that younger and more liberal physicians were more favorably disposed toward hospital involvement in health education. Liberal physicians were also not concerned about competition in health education service. These findings are similar to those found by other researchers of organizational innovations in medical care. Several methodological problems were noted, which render the findings suggestive rather than conclusive. The findings do suggest, however, that physician resistance to wellness will continue because of a medical paradigm conflict.

Objective To conduct an evaluation of the pilot implementation of the World Health Organization Health Promoting Hospitals initiative and its self-assessment tool in public hospitals in KwaZulu-Natal in 2004/2005 Study design This evaluation utilised a cross-sectional design that incorporated both qualitative and quantitative research methods. Main measures Throughout the Health Promoting Hospital pilot project the opinions and responses of those with a legitimate interest in the initiative were monitored. Data collection methods utilised in this evaluation included participant observation, the World Health Organisation metaevaluation questionnaire, records of workshops and feedback meetings and secondary analysis of all data collected by the six pilot hospitals during the implementation of the project in KwaZulu-Natal. Results Major constraints were found to be time, human and financial resources, lack of training and expertise and insufficient support for the project. The self-assessment tool was found to be insufficiently adapted and not all outcomes were found to be reliable and useful. Despite this, institutional staff found the Health Promoting Hospital project to be capacity building and morale boosting. Relationships between health service levels improved. All hospitals who participated recommended that other hospitals become Health Promoting Hospitals. Conclusion If the World Health Organisation Health Promoting Hospital initiative with its selfassessment tool is to be rolled out to the rest of KwaZulu-Natal province, then substantial changes have to be made to the process. Amongst these are: further adaptation of the selfassessment tool, improved methods of data collection, provision of sufficient resources and increased and sustained provincial support for the project. In addition it is imperative that outcome and impact evaluations be done. / Thesis (M.Med.)-University of KwaZulu-Natal, 2008.

M.Cur. / In a changing South-Africa new challenges regarding multiculturality emerge. In psychiatric nursing the psychiatric nurse also faces new challenges. During a cultural discussion, the personnel of a private psychiatric clinic realised that culture has numerous different meanings. (that numerous different meanings may be attached to culture). Culture has an interesting nature and certain expectations exist around culture. I have described this discussion in order to present a qualitative, descriptive, singular case study, within the paradigm of the Theory for Health promotion in Nursing. The data was processed according to the recommendations of Tesch (in Creswell, 1994:155). The discussion is presented according to certain themes. No guidelines have been set, but I have made certain recommendations that may be utilised in training of psychiatric nurses as well as in practise and research in the field of psychiatric nursing. The discussion was important because the participants were able to develop a sensitivity toward culture. This lead to the promotion of co-operation, productivity, and mutual understanding and respect within the context. The importance of the description of the discussion lies in the information that has been generated. This information will be available and will be incorporated as part of the body of knowledge in psychiatric nursing.

As the Human Immunodeficiency Virus (HIV) prevalence rises, uninfected Basotho face an increased risk of exposure. This necessitates strengthening of strategies that prevent exposure, and where exposure has occurred, measures that prevent infection. One such measure is Human Immunodeficiency Virus (HIV) Post-Exposure Prophylaxis (PEP). Awareness and knowledge of HIV PEP is therefore of paramount importance. The purpose of this study was to assess knowledge, attitudes and utilisation of HIV PEP among adults in Roma, Lesotho. A quantitative cross-sectional study was conducted among 96 adult outpatients at St Joseph’s Hospital. Data were collected by means of structured questionnaire and analysed using SPSS version 23.0. Results were presented using charts and tables. Awareness of HIV PEP among the respondents was found to be very low and for most respondents’ knowledge of HIV PEP was either non-existent or very poor. Utilisation was also found to be very low. Attitudes towards HIV PEP were, however, found to be favourable. More studies should be conducted throughout the country to further explore Basotho’s knowledge, attitude and use of HIV PEP. / Health Studies / M.A. (Nursing Science)