The purpose of this study was to describe the perceptions of the bridging programme graduates regarding their preparedness to manage a nursing unit .Quantitative; descriptive survey design was used with a structured questionnaire as data collection instrument. The sample included 58 bridging programme graduates who had completed their training at a private nursing school and was working at seven private hospitals in KwaZulu Natal. The graduates reported competence in performing some but not all management competencies addressed by this survey. Some graduates reported they were placed in charge of the nursing unit, in spite of not feeling competent, as early as in their first month. Recommendations with regard to nursing education, nursing practice and further research, specifically relating to improvement of management competencies for new graduates, were made / Health Studies / M.A. (Health Studies)

This prospective descriptive study describes the referral patterns to the Red Cross War Memorial Children's Hospital. The study was conducted from 1st July to 31st December 1987 and entailed the collection of all referral letters presented (9288) to the hospital and the analysis of a sample of these letters (4702). The results indicated: * The patients are similar in terms of age and sex to those attending the Outpatients Department except that relatively fewer referred patients are Black. * The private sector, i.e. general practitioners, is the largest referral agency followed by Day Hospitals. * Most patients were ref erred to the Outpatients Department without an appointment. * Of the specialist clinics, the surgical clinics, i.e. Ophthalmology and Ear, Nose and Throat Clinics, were utilised the most. * The majority of patients (84,90%) were not admitted. * The contact made by the hospital with referral agents was poor (only in 30,30%). * The quality of information in referral letters was generally poor and did not contribute to patient care. Recommendations are made to the hospital and relevant health authorities.

MCur / Department of Advanced Nursing Science / Background: Perinatal and neonatal mortality rates remain high in South Africa especially in rural areas and townships where the majority of poor people live. With regard to perinatal and neonatal mortality, South Africa like many other developing countries has failed to achieve MDG 4 and 5 by 2015 regardless of many efforts by the governments. To achieve the SDG which replaced MDGs for child health, it is necessary for the South African public and private health care to reduce substantially perinatal and new born deaths, particularly in rural areas. There are many factors that contribute to a high perinatal mortality rate in public hospitals in rural areas. To understand these factors, a study was conducted with midwives from selected public hospitals in Limpopo, Vhembe district which experiences the highest perinatal mortality rates in South Africa. Purpose and methodology: The purpose of this research study was to assess factors contributing to high perinatal mortality rates in the selected public hospitals in Vhembe district. A quantitative, descriptive, exploratory and cross-sectional design was used to collect data from the sampled hospitals in the Vhembe district. Hospitals were purposively sampled based on the statistics of monthly deliveries. The target population consisted of all registered midwives who had been working in the maternity units for at least two years. Cochrane's formula was used to determine the sample from the target population for each hospital. A random sample of 110 respondents was selected upon which a questionnaire was administered to each by the researcher. Responses from the close-ended and open-ended questions was grouped and analysed quantitatively by means of Statistical Package for Social Sciences 23.0 (SPSS). Results and findings: Results were presented in frequency tables and graphs revealed that most of the midwives lacked knowledge and skills in a number of key areas needed for them to operate efficiently in the maternity wards. There was also high staff turnover which led to a few midwives being overworked. The utilisation of guidelines and protocols in maternity was left to individual midwives as the hospitals did not evaluate the use of it. Conclusions: Lack of key skills in assisting women in labour, and poor use of guidelines and understaffing were the main contributing factors to high perinatal mortality rates in the selected public hospitals of Vhembe district. Midwife attitudes were not a contributory factor. / NRF

PhD (Nursing Science) / Department of Advanced Nursing Science / State patients are admitted to the psychiatric hospital after being declared as such by a court of law in South Africa. After successful rehabilitation of state patients at the psychiatric hospital, they need to be reintegrated into their families. Perceptions of family members of male state patients regarding reintegration including development of a model to support such reintegration, is not largely explored in the scientific body of knowledge. The aim of this study was to develop a model to support reintegration of state patients into their families in Limpopo Province, South Africa. A qualitative approach using descriptive, explorative, and contextual designs was adopted for this study. The study population was family members whose relatives are male state patients admitted and recorded in the admission register of Hayani Hospital, in Limpopo Province. The study was conducted in two phases of which phase one was a situational analysis, and phase two was the development of the model to reintegrate male state patients into their families. This study was conceptualized within the Social Ecological Model (SEM) of human behaviour (Stokols, 2013), the grounded theory for model development outlined in Dickoff et al. (1968), and the approaches outlined in Chinn and Kramer (2008); Walker and Avant (1995). Model evaluation was done by a group of health professionals, some of whom are advanced psychiatric nurses who are doing masters and doctoral studies, and one doctoral graduate who is also an advanced psychiatric nurse. Presentations were made to this group during peer review sessions who in turn gave critical comments regarding the developed model to support reintegration of male state patients until the final model was accepted. Non-probability purposive and convenient sampling were used to sample a hospital and 10 family members of Venda-speaking male state patients. In-depth individual interviews were used as the instrument to collect data which was pretested on one family member who did not form part of the study. Data was analysed using thematic analysis approach. Data was co-coded by an independent doctoral degree graduate to ensure trustworthiness. Conducting home visits by health professionals came up strongly during data analysis. Credibility, dependability, confirmability and transferability to ensure trustworthiness of the study, as well as ethical considerations were adhered to. The findings of the study yielded two themes, being perceptions of participants regarding reintegration of male state patients, and perceptions of participants regarding the support needed from family members to reintegrate male state patients. During phase one, the results indicated that family members accept reintegration and also that they indicated the kind of support needed, that lead to phase two of developing a model to reintegrate male state patients. The study was restricted to only one hospital in the Vhembe District out of the five districts of the Limpopo Province.The researcher acknowledges that this study was contextual and that only family members of male state patients were interviewed, the perceptions of family members of female state patients were not heard. The study concluded that there are perceptions that family members of male state patients have regarding reintegration of these patients into their families. Furthermore, family members of male state patients can describe the kind of support that they need in order to reintegrate male state patients into their families. This should be done using the developed model that should involve family members and the community. The study recommends that psychiatric hospitals should implement the model involving family members of male state patients. Furthermore, a longitudinal study should be conducted for a period of 3-5 years to check the effectiveness of the model. / NRF

This study investigated the attitudes and perceptions of nurse managers regarding cost containment issues in selected public hospitals in the Port Elizabeth metropole of the Eastern Cape. Four hospitals participated in the study, and 211 nurse managers completed questionnaires. The results obtained from the participants’ responses indicated that: ✦ Nurse managers are ill-prepared for many responsibilities regarding cost containment, and need appropriate orientation and preparation both during their initial formal, and during their nurse management and in service training in order to fulfil their “financial” or cost containment role more effectively. ✦ Nurse managers perceived the relationship between the productivity of staff and cost containment positively, but were reportedly unable to • prevent nurses from leaving their points of duty • curb the rate of absenteeism among nurses • reduce the number of resignations ✦ Nurse managers suggested that more effective hospital cost containment efforts should ensure that • effective security checks are performed to curb losses of stock and equipment • more public telephones are installed in hospitals • stricter controls regarding wheelchairs are implemented The rationalisation of staff and services, as well as specialised equipment among the four public hospitals could enhance these hospitals’ cost containment results. However, this would necessitate reorganising these hospitals’ services at provincial level. The nurse managers required more knowledge about hospitals’ financial management and cost containment issues. Guidelines for such a course were developed addressing: analysis of monthly variance reports; budgeting for manpower; balance statement; calculations for the supplies and expenses budget; income statements; the hospital’s budgetary cycle; break-even analysis; analysis of cost-effectiveness and cost-benefit analysis. / ADVANCED NURSING SCIENCES / D.Litt. et Phil.

Recognising the enormous challenges in South Africa confronting the nursing of the mentally ill, the project was conducted in a public hospital in Gauteng. The purpose of the research was to describe professional nurses' perception of nursing mentally ill people in a general hospital setting and was carried out amongst a sample size of 124 professional nursing staff using a self-administered tool. The study looked at four different types of perceptions guided by categories of conceptual framework proposed by Mavundla (2000:1569-1570), namely perception of self, perception of patients, perception of environment and perceived feelings. The study found that the majority of professional nurses have a predominantly positive self- perception of nursing mentally ill people in a general hospital, although a significant number have a negative perception of patients, the nursing environment and perceived feelings. Lack of knowledge, skill and experience affect the nursing care of mentally ill people in the general hospital. / Health Studies / M.A. (Health Studies)

Health communication is a vital part of health care and treatment. For patients living with HIV, effective health communication is crucial. This study aimed at describing health communication from the perspective of HIV-positive patients by uncovering their experiences as they interacted with various medical staff members at Stanger Hospital. Guided by a review of various health communication models, data were collected via individual interviews and non-participant observation. The findings showed that interactive communication was favoured by all the respondents, especially communication that was patient-centred. Such communication encompassed education on how to live and cope with HIV. Obstacles to effective communication such as power differentials, lack of time and privacy at public health care clinics were identified. The study found that the different medical staff members at the clinic to various degrees addressed distinctive communication needs of HIV-positive patients. This study contributed to effectively understating the communication process as a whole. / Sociology / M.A. (Social Behaviour Studies in HIV/AIDS)

Workplace violence directed at student nurses in training in psychiatric institutions is a significant concern as it negatively affects the quality of learning and causes the students to have a negative perception of nursing as a profession. The absence of scientific data describing the perceptions of student nurses about workplace violence and their clinical learning outcome motivated the researcher to conduct the study. Quantitative, descriptive research was conducted to explore the influence that workplace violence will have on clinical learning outcomes of student nurses who are studying psychiatric nursing at psychiatric institutions in KwaZulu-Natal, in South Africa. Data was gathered using a 71 question questionnaire, which was adapted from the one used by Hewett (2010). With the necessary permission from the health authorities, the campus principals and the nursing students, a group of 4th year student nurses (n=163) from 6 campuses of the KwaZulu-Natal College of Nursing (KZNCN) who have worked in psychiatric units for at least 3 months and longer participated in the study. The study highlighted the types of workplace violence encountered by student nurses, the effects of workplace violence on students’ academic performance and the barriers to the reporting of workplace violence encountered by the student nurses. The study revealed that there is a large amount of non-physical, some physical and a few incidents of sexual violence directed towards the student nurses at the psychiatric institutions, and that it has a negative impact on student learning. The recommendations emanating from the study support the idea of a shared responsibility between healthcare and education institutions and the focus is on preparing and equipping the student psychiatric nurses to confront, withstand and break the cycle of workplace violence. / Health Studies / M.A. (Nursing Science)

Submitted in fulfillment of the requirements of the degree of Master of Technology: Nursing, Durban University of Technology, Durban, South Africa, 2015. / Aim The aim of this study was to evaluate the use of nursing care plans in the management of patient care and to recommend guidelines for improving the quality of planned nursing care at a level 3 hospital in the Umgungundlovu district of KwaZulu-Natal. Method The case study was based on the conceptual model of care planning and employed both quantitative and qualitative research designs. The quantitative phase involved a retrospective audit of charts, using an itemised checklist to determine whether items relating to the phases of the nursing process were in evidence within the charts. The qualitative phase consisted of face-to-face interviews with registered nurses, who were asked about their understanding and use of the nursing process. Data derived were analysed using Nvivo 10 and presented as graphs, tables and written text extracts. Results The results show that the use of the standardised care plans at the study hospital had an impact on the understanding of the importance of the nursing process and the successful implementation of the care plans. Factors that had an impact on this included the registered nurses who failed to nurture the junior nurses, lack of understanding of the care plans and what was expected of the staff, staff attitudes and the heavy workload. Conclusion It was suggested that nurse leaders support the implementation and continued use of individualised care plans in order to improve critical thinking skills of nurses by implementing teaching and in-service programs, employing knowledgeable registered nurses, by developing and enforcing adherence to policies that favour care planning and nursing documentation.

The purpose of the study was to explore and describe the experiences of male community service officers during midwifery clinical training. A qualitative, explorative, descriptive and contextual design was used in order to achieve the study objectives. Data was collected by means of semi-structured interviews. Data analysis elucidated analogous themes and categories which translated into the overall experiences of the participants. The study found that whilst the experience was described as beneficial, there were overwhelming challenges in providing intimate care to female clients, dealing with ethno-cultural aspects, meeting clinical practice requirements and the right to choose to be part of midwifery clinical training. Recommendations to nurse educators, clinical midwives and midwifery clinical supervisors with regard to better support for male nurses during midwifery clinical training emanated from the study findings / Health Studies / M.A. (Health Studies)