This study was designed to evaluate the quality of informed consent practiced by healthcare professionals in South Africa using an empirical quantitative methodology combined with medicolegal analysis to produce an interdisciplinary thesis on bioethics and medical law. Informed consent is an ethical and legal doctrine derived from the principle of respect for autonomy, whereas the rights to bodily integrity, privacy and human dignity are constitutionally protected in South Africa. The National Health Act 61 of 2003 codified requirements for informed consent by stipulating that healthcare providers must inform healthcare users about diagnosis, risks, benefits, treatment options, and the right of refusal, while taking into consideration users language and literacy levels. However, African communities are inherently challenged by problems of poverty, poor education, power asymmetry, and unfamiliarity with libertarian rights-based autonomy, which could affect informed consent practice. An empirical study was conducted at randomly selected public hospitals in EThekwini metropolitan municipality involving 927 participants; comprising 168 medical doctors, 355 professional nurses, and 404 patients. The study showed that healthcare professionals had limited knowledge regarding ethical and legal requirements for informed consent, and were partially compliant with current informed consent regulations. Barriers to informed consent identified were language, poor education, workload, and lack of interpreters. Most patients attending public hospitals were indigent, but preferred full information disclosure, and a shift from informed to shared-healthcare decision-making. The study recommends that a corps of trained interpreters should be introduced at public hospitals. This will improve providerpatient communications and minimize workloads, increase job satisfaction, and the overall quality of healthcare service delivery. Analysis of recent South African case law on informed consent revealed vacillations between the “reasonable doctor” and “prudent patient” standards of information disclosure which are inconsistent with the jurisprudence from comparative foreign common law jurisdictions. Therefore, South African court judgments on informed consent ought to be re-evaluated to establish a uniform standard of information disclosure consistent with international jurisprudence, current legislation, and constitutional protections relating to human dignity and security of the person. / Jurisprudence / LL. D.

The purpose of this research was to investigate the level of food safety knowledge, attitudes and food handling practices of employees in hospitals in the Capricorn District Municipality (CDM), Limpopo Province, South Africa. Purposeful sampling was followed to sample 210 respondents from nine hospitals in CDM. Respondents were individuals who are 18 years or more, employed in these hospitals and are involved in the food handling duties. Data collection was done by means of questionnaires and interviews. The results showed that 99% and 70% of the food handlers are black females and are health care staffs. Up to 71% have not attended any food safety-training course. Many food handlers are not knowledgeable about HACCP and the correct temperature and duration for receiving and storing temperature controlled for safety (TCS) foods respectively. The vast majority of food handlers are not knowledgeable on minimum internal cooking temperature for poultry, seafood, egg and the best way of thawing of frozen meat. The majority of food handlers do not know that Salmonella is the main foodborne bacteria pathogen mostly associated with poultry products and that food borne bacteria will grow quickly in food at a temperature of 37 ˚C. The majority of food handlers possess adequate food safety knowledge regarding the safe food handling practices and the prevention of contamination. Respondents with higher academic qualifications do not possess more food safety knowledge than those with lower academic qualifications. Food handlers who are health care staff have less food safety knowledge when compared to food service managers, food service supervisors and chefs. / Business Management / M.A. (Consumer Science)

The hospice volunteer is viewed as an integral member of a multidisciplinary team, with various roles directed at enhancing the quality of life of patients and their families. The purpose of this study is to provide an integrated picture of the hospice volunteer, their role, the human dimensions of this role and the impact this has on their lives as not much has been written in literature about this specific sub-group of hospice workers. The context of the study is a hospice in Gauteng where the researcher works as a volunteer. The ethnographic case study has been chosen as an appropriate research design as it explores the above phenomenon from the volunteers' point of view. The subjects are three volunteers who have been active at the hospice for at least twelve months. Evidence in terms of specific interviews and observations are used to draw conclusions. The interviews are based on a minimal number of open-ended questions. The primary method of analysis is the examination of transcripts from these in-depth interviews. A thematic analysis is carried out in which a detailed description of the emerging themes are given. Four major themes are identified and explored: Description of the role; The experience of being a volunteer; A way of coping; and The influence of the hospice culture. Sub-themes that emerge within each case study vary due to the individual nature of the experience of the role. Themes are explored in light of current theory and findings. This was to note the similarities and differences of this specific sub-group of volunteers compared to others found in the literature reviewed for this study. As there is a scarcity of literature pertaining specifically to hospice volunteers, the study depends mostly on writings pertaining to hospice staff and volunteers in general. A summary and integration of the core findings of the three case studies is given and their similarities and differences are explored. How some of the different themes interlink is also discussed. Although various sub-themes found in the individual case studies are significant to the individual cases, some of them can be incorporated into common themes when looking at the volunteers as a group. The strengths and limitations of the study are discussed as well as recommendations for the hospice organisation and further research. / Psychology / M.A. (Psychology)

This research worked toward a general aim of analysing the role of salutogenic functioning as moderator variable in coping and noncoping. A sample of forty-one community service doctors (N = 41) employed in KwaZulu-Natal hospitals was obtained. According to the literature, salutogenic properties are expected to act as generalised resistance resources. Based on this assertion, it was assumed that: degree of salutogenic functioning = degree of coping = degree of stress and burnout. The results demonstrated high levels of stress and depersonalisation burnout. Salutogenic functioning tended to be low, especially for sense of coherence. The results indicated, no significant relationship between stress/burnout and salutogenic functioning. Salutogenic functioning was unable to differentiate between copers and noncopers. These results contradicted the literature assertion that high scores on salutogenic functioning correlate with low scores on stress/burnout. It was concluded that variables other than personality moderated for the high levels of stress and burnout in the sample. / Industrial and Organisational Psychology / M.A. (Industrial Psychology)

The purpose of this quantitative, descriptive study was to identify shortcomings in the implementation of the Batho Pele Principles in a public hospital. Findings were obtained from a range of patients who had been admitted to specific units for three or more days, and more evidence was gathered from articles in mass media. Data was collected through a structured questionnaire from one hundred respondents (n=100) and analysed by means of descriptive statistics. The research findings revealed that none of the Batho Pele Principles were implemented effectively and that patients in general were not satisfied with treatment in public hospitals. Shortcomings are attributed to insufficient management skills and knowledge on different levels of the health care system, as well as a lack of awareness among patients of their rights and responsibilities in health care. / Health Studies / M.A. (Public Health)

Text in English / The purpose of this study was to explore and describe the experiences of community members regarding their participation in hospital boards in Dr Kenneth Kaunda district, North West Province. A qualitative exploratory-descriptive research was conducted on a purposively selected sample of community members who served in the board for a minimum period of two years. Data were collected by means of individual interviews and analysed by means of thematic data analysis. Three themes that emerged from data analysis were creation of opportunities, benefits and challenges. A mix of positive and negative experiences was expressed by community representatives regarding their participation in hospital boards. Participants described their experiences as enjoyable and empowering while others described it as a learning experience through which they acquired knowledge and new skills. The challenges experienced whilst serving in hospital boards included ineffective communication, poor relations and role conflict as a result of lack of role clarification. The findings from the study may be used to enhance the effectiveness of hospital governing boards through the participation of community members. / Health Studies / M.A. (Public Health)

Text in English / The contribution of general diagnostic imaging in the diagnosis and clinical management of patients in rural hospitals of South Africa is enormous. To provide high quality diagnostic imaging services for specific contexts requires radiographers who have up-to-date skills and expertise. Thus, rural radiographers require, over and above traditional radiographic expertise, additional competencies which are unique to rural practice. To date, however, little is known about additional core competencies and skills needed by radiographers working in rural areas. Previous studies have focused more attention primarily on other rural health professionals such as doctors and nurses. The aim of this mixed methods study was to investigate and identify additional core competencies required by radiographers working in rural district hospitals of KZN in order to propose a CPD strategy aimed at rural radiographers. An exploratory sequential design was utilised. There were seven participants in the qualitative phase of the study. In the quantitative phase a convenient sample of 109 respondents was surveyed using a structured questionnaire. Three major themes and seven categories emerged from Phase I of the study. These themes and categories were then used to develop a data collection instrument for Phase II of the study. Collectively, the findings of this mixed methods research revealed that there were a number of additional core competencies such as, but not limited to, teamwork, ability to do basic obstetric ultrasound scans, leadership, management, attitude and behaviours, and reporting on plain x-ray films, all of which are required by rural radiographers. Supporting evidence from the study indicated that the majority of these competencies were either partially or not at all covered in the audited curriculum. The study further revealed that the audited curriculum and the scope of radiography in its current form appear to focus attention on minimum competencies that do not promote the expansion and extension of the role of radiographers in rural areas. The study results also revealed a number of challenges faced by rural radiographers. / Health Studies / D. Litt. et Phil. (Health Studies)

Background: The demand for and retention of talent worldwide is aggravated by revolutionary trends that include global competition, demographic changes and technological advances. In South Africa this phenomenon according to Frost (2002) is further challenged by the emigration of skilled people; the relative scarcity of specialist and managerial employees; employment equity and affirmative action procedures. But the development of strategies first requires an understanding of the factors which influence decisions to leave or stay particularly in rural and remote areas. St. Andrews Hospital is a rural district hospital in Ugu District, KZN. Its remoteness from urban areas and the lack of resources contributes towards challenges of attracting and retaining health care professionals to the area. It is the aim of this study to identify the ten most prevalent turnover and retention factors in a rural district hospital with the intention of making recommendations towards strategies to mitigate turnover and improve retention of health care professionals. This study will not only serve the local Human Resource Department but may also be used to inform district and provincial policies as well as departments’ decisions in the design or the review of current retention strategies aimed at reducing turnover. Method: The survey method was used to collect the primary data by distribution of self-administered questionnaires to Health Care Professionals at St. Andrews Hospital. Of the one hundred and fifty questionnaires distributed, one hundred and seven were returned (71% response rate) and formed the basis of the study. Results: Based on the impact scores, the top three turnover factors identified were, the way the organisation is led by top management (0.934); the size of the workload (0.862); and the way problems are dealt with by managers in the organisation (0.817). No statistically significant relationships were found between turnover factors and biographical variable. Availability of quality health services was ranked as the external factor that had the highest influence (78%) on turnover, while geographical location was ranked the lowest. The main reason given by respondents for leaving their previous employment was promotion, followed by distance and personal/family reasons. The top three retention factors identified from the impact scores were the quality of relationships with colleagues (1.698); the amount of support received from managers and colleagues (1.484); and the level of engagement and involvement with the job (1.390). This demonstrates that the salary package often thought to be a first priority factor Mobley, Horner and Hollingsworth (1978); Mobley (1982) and Herzberg (2003) is far less of a determining factor at St. Andrews Hospital than management support, job involvement and person-organisation fit as well as the social relationships formed in the workplace. A positive relationship was found between leadership and job dimension factors at the 1% level of significance. This supports the strong social bond (person-organisation fit) formed in the work environment between management and colleagues that supports retention and increases level of commitment. An important result of the study was that 46% of the respondents were thinking of leaving the town within the year while 29% were considering resigning from St. Andrews Hospital within the year. Conclusion: The results reveal a complex interaction of factors impacting on turnover and retention. The Human Resource Management function has a pivotal role to play in improving its ability to attract and retain professionals through developing comprehensive strategies based on external and internal and environmental factors. The study conveys to the St. Andrews Hospital management that turnover and retention factors are unique to the location and the working environment and differs amongst Health Care Professionals – this should be deliberated on when formulating Hospital Human Resource retention policies.

Abstracts in English, Southern Sotho and Xhosa / Previous studies evidenced the association between work ethics climate, retention factors and organisational commitment separately. However, research combining all these variables have not yet been done. The purpose of the study was to investigate the relationship between work ethics climate, retention factors and organisational commitment of nurses in a South African public hospital. A quantitative research design was followed and a probability stratified sample (N=208) of nurses participated in the study. The results indicate significant relationships between work ethics climate and retention factors. Furthermore, the results indicate significant relationships between work ethics climate and organisational commitment. Moreover, the results indicate that work ethics climate moderates the relationship between training and development components of retention factors and organisational commitment. These findings provide new knowledge for the design of retention strategies, which adds value to the body of knowledge in relation to work ethics climate. Recommendations for further research and for the implementation of the results of the study by human resource professionals were made in terms of improving the ethical climate, the retention factors and organisational commitment of their employees. / Dinyakišišo tše di fetilego di file bohlatse bja kamano magareng ga seemo sa maitshwaro ka mošomong, mabaka a go tšwela pele le boikgafo ka fao go aroganego. Le ge go le bjale, dinyakišišo tšeo di kopanyago mehuta ye ka moka ga se tša hlwa di dirwa. Maikemišetšo a dinyakišišo tše e bile go nyakišiša kamano magareng ga seemo sa maitshwaro ka mošomong, mabaka a go tšwela pele le boikgafo bja bja baoki ka sepetleleng sa setšhaba sa Afrika Borwa. Tlhamo ya dinyakišišo tša boleng e dirišitšwe gomme sampole ya baoki ye e arogantšwego (N=208) ba kgathile tema ka dinyakišišong. Dipoelo di laetša kamano ye kgolo magareng ga seemo sa maitshwaro ka mošomong le mabaka a go tšwela pele. Godimo ga fao, dipoelo di laetša dikamano tše kgolo magareng ga seemo sa maitshwaro ka mošomong le boikgafo bja ka mokgatlong. Godimo ga fao, dipoelo di aletša gore seemo sa maitshwaro se lekanyetša kamano magareng ga dikarolo tša tlhahlo le tša tlhabollo tša mabaka a go tšwela pele le boikgafo bja ka mokgatlong. Dikutollo tše di fana ka tsebo ye mpsha ya tlhamo ya mekgwa ya go tšwela pele, yeo e tlišago boleng go tsebo mabapi le seemo sa maitshwaro a ka mošomong. Ditšhišinyo tša dinyakišišo go tšwela pele le tša go phethagatša dipoelo tša dinyakišišo ka bašomi ba sephrofešenale ba merero ya bašomi di dirilwe mabapi le go kaonafatša seemo sa maitshwaro, mabaka a go tšwela pele le boikgafo bja ka mokgatlong bja bašomi ba yona. / Amarhubhululo zesikhathi esidlulileko zifakazele itjhebiswano eliphakathi kobujamo bemigomo yokusebenza, imithelela yokubamba abasebenzi bangakhambi kanye nokuzibophelela kwihlangano ngendlela ehlukanisiweko. Nanyana kunjalo, ngokwerhubhululo ukuhlanganiswa kwazo zoke lezi zinto akhange kweziwe. Ihloso yaleli rhubhululo bekukuphenya itjhebiswano eliphakathi kobujamo bemigomo yokuziphatha emsebenzini, ukubamba abasebenzi bangakhambi kanye nokuzibophelela kuhlangano kwabahlengikazi esibhedlela sombuso eSewula Afrika. Ihlelo lerhubhululo elidzimelele kuzinga lekulumo lilandelwe kanti nesampula yabahlengikazi I (N=208) labadlale indima kurhubhululo lisetjenzisiwe.Imiphumela iveza itjhebiswano eliqakathekileko phakathi kobujamo bemigomo yokusebenza kanye nemithelela yokubanjwa kwabasebenzi bangakhambi. Ukuragela phambili, imiphumela iveza itjhebiswano eliqakathekileko phakathi kobujamo bemigomo yokusebenza kanye nokuzibophelela kwehlangano. Ngaphezu kwalokho, lemiphumela iveza ukobana ubujamo bemigomo yokuziphatha ilinganisa itjhebiswano phakathi kweengaba ezibandulako nezithuthukisako, iingaba ezimalungana nemithelela yokubamba abasebenzi bangakhambi kanye nokuzibophelela kwehlangano. Leli lwazi elitholakeleko linikela ilwazi elitjha malungana nokudizayinwa kwamasu wokubamba abasebenzi bangakhambi, okuyinto engezelela ivelu kumthombo welwazi malungana nobujamo bemigomo yokuziphatha emsebenzini. Iincomo ezinye ezimalungana nokuragela phambili nerhubhululo kanye nokusetjenziswa kwemiphumela yerhubhululo elimalungana nabasebenzi bomnyango wezokuqatjhwa kwabasebenzi zenziwe ngokuthi kuthuthukiswe ubujamo bemigomo yokuziphatha, imithelela yokubamba abasebenzi bangakhambi kanye nokuzibophelela kwabasebenzi kuhlangano. / Human Resource Management / M. Com. (Business Management)

Department of Advanced Nursing Science / MCur