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)

This thesis was born from a concern the researcher had with regard to negative reports in the media emanating from 4 babies that died at Cecilia Makiwane Hospital Peadiatric ICU unit due to power supply failure. The most significant of these negative reports was in 2007 when the Daily Dispatch ran a series of articles regarding what they termed avoidable deaths over the last 14 years. The ease with which staff communicated with the media together with the high absenteeism rate and high turnover was a cause for concern. When the researcher analysed the history of the problem, it immerged from the respondents’ responses that the rationalistion process undertaken by the Eastern Cape Department of Health (ECDoH) was a significant root cause to the problem. The literature review focused on three areas viz.: Organisational Culture, Organisational Change, Foundations of Satisfaction. This focus was used to confine the problem to a manageable project but secondly each of the aspects are interwoven. Routledge (2010) notes that culture is the reflection of the values advocated by a founder or leader by way of his/her day to day actions. This is done by the leader creating a perception or viewpoint that assists the employees to achieve the organisation’s mission, vision and goals. In any organisation change is a constant and it needs to be effectively managed. With government institutions like the East London Hospital Complex (ELHC) directives come from the top and are implemented by an unprepared and untrained leadership and management cadre and clear communication of vision and objective of the desired outcomes never happens. The aim of the research was to: describe the existing Organisational Culture present at ELHC (Perform an organisational diagnosis); describe the impact of change (rationalisation) and to analyze why there was such a high staff turnover. It is clear from the results of the survey conducted that significant dissatisfaction prevailed relating to how the institution was managed. Dissatisfaction amongst the health professionals was general but also specific to the following: leadership and management issues, fairness, remuneration and lack of resources. The recommendations therefore focused on developing management and leadership within the proposal of Dubrin’s model (2001).

This study investigated the leadership challenges encountered by nurse unit managers and factors enhancing leadership in their units. Currently in South Africa’s private hospitals, nurse unit managers face challenges such as financial management, cultural diversity, new roles and technology. The aim of the study was to develop a support strategy for unit managers to achieve success in their leadership role. This study was conducted at a private hospital in Gauteng Province, South Africa. A qualitative research approach was followed. Data were gathered using semi structured individual interviews with a purposive sample of six operational unit managers with one and more years working experience as unit managers. Qualitative open coding for data analysis methods and presentation were employed. Three themes emerged from the findings namely, factors influencing the leadership role of the unit manager, the challenges encountered by unit managers in their leadership role and the needs of unit managers. The factors influencing the leadership and management roles were related to the challenges encountered by nurse unit managers in running their units. The findings indicate that a key need required of the unit manager is support and direction from executive management. From the needs expressed by the nurse unit managers, ideas were formulated by the researcher to support the development of a strategy to support the unit managers in their leadership role. The strategy includes eight key elements and is presented in the section that follows. / Health Studies / M.A. (Nursing Science)

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.

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)

The aim of the study was to explore the perceptions of nurses regarding communication with nurse managers in the workplace. The design of the study was a generic qualitative. The methodology of choice was qualitative, explorative method. The sample was non-probability and the approach or technique used was purposive sampling method. It comprised of thirty nurses, ten of each category. The category was a component of professional nurses, enrolled nurses and enrolled nursing auxiliary nurses. The data collection method used in the study was in-depth interviews using a self-designed interview guide. Face to face interviews was conducted in a quiet room within the hospital ward as a natural setting. Data was collected using a voice recorder for the sake of protecting the missing of information which may be important. The data analysis was with the help of employing transcribing and coding of voice recorded data and observation noted during the collection of data. The data collection method used in the study was in-depth interviews using a self-designed interview guide. Face to face interviews was conducted in a quiet room within the hospital ward as a natural setting. Data was collected using a voice recorder for the sake of protecting the missing of information which may be important. The data analysis was with the help of employing transcribing and coding of voice recorded data and observation noted during the collection of data. The findings showed that there were dynamics in communication from all nurse categories and that also indicated that there was a need to conduct a research so that the root cause may be identified and suggestions to be put in place to curb the challenges. In conclusion it showed that communication is the key problem of all and it is a worldwide problem. / Health Studies / M.A. (Health Studies)

PhD / Department of Public Health / See the attached abstract

Submitted in fulfillment of the requirements for the degree of Master of Health Sciences (Nursing), Durban University of Technology, Durban, South Africa, 2017. / BACKGROUND: Quiet often when students return from clinical placement, complain of being abused by patients and their relatives. Student nurses view clinical placement as an anxiety producing part of the nursing programme (Magnavita and Heponiemi 2011: 208). As a result, some resign and leave nursing fearing for their lives. AIM OF THE STUDY: To determine the extent and types of violence experienced by student nurses from patients and their relatives or friends in public hospitals in KwaZulu-Natal, and whether this leads to intentions to leave the nursing profession. METHODOLOGY: A quantitative, descriptive cross sectional survey approach conducted amongst student nurses (n=421) at KwaZulu-Natal College Nursing R425 Program starting from their first year of training up to the midwifery module. Self-Administered Questionnaires (SAQ) were used to collect data and data analysed using SPSS version 23. RESULTS: All respondents (n=421) completed the SAQ (annexure B). Many student nurses, especially female students, are victims of intimidation, bullying and verbal abuse as opposed to physical and sexual abuse by patients’ relatives and patients. The workplace violence against student nurses resulted in anger and absenteeism. The majority have not reported any abuse and they were not even aware of any policy that exists in their institutions against any form of violence. DISCUSSION: Findings in this study revealed that student nurses, like all other nurses, were also at a high risk of workplace violence. This may be because nurses have the closest contact with patients and their relatives; hence they are at high risk of exposure to violence. Since all settings are potentially high risk for violence, it is therefore necessary for the management to improve security in all high-risk areas for the student nurses to be safe. RECOMMENDATIONS: Public hospitals and the Department of Health (DOH) needs to formulate clear policies regarding violence against student nurses, and information on how to report the occurrence. There is a need for development or improvement of policies, procedures and intervention strategies. The DOH needs to address the issues of violence by implementing strategies to create a supportive environment that facilitates empowerment for the positive emotional wellbeing of student nurses. Managers have the responsibility to create and maintain zero tolerance regarding workplace violence. Public hospitals need to employ Managers with required skills and higher education to deal with workplace violence. There is a need for further research and more details on workplace violence and its cause. / M

In South Africa, the quality of health care is directly related to the concept of patient-centred care and the enactment of the Batho Pele Principles and the Patients’ Rights Charter. The quality of health care delivery has dropped drastically, and reports in the media indicate that public hospitals in the Eastern Cape Province are on the brink of collapse, with thousands of patients being treated in condemned hospitals. Receiving and rendering health care in the face of such challenges, the question arose: “Are patients receiving patient-centred care in public hospitals?” The answer to this rhetorical inquiry appeared to be obvious, but this research study explored and described professional nurses’ perceptions of patient-centred care in public hospitals and their understanding of evidence-based practice and best practice guidelines. The proposed study followed a qualitative, exploratory, descriptive and contextual design. The research population included professional nurses who are employed in public hospitals in Nelson Mandela Bay, and consisted of nurse managers and nurses who work in the wards. The research study consisted of three phases. In Phase 1, semi-structured interviews and focus groups were conducted with nurse managers and professional nurses working in the wards in order to collect data about their perceptions of patient-centred care and their understanding of evidence-based practice and best practice guidelines. The interviews were transcribed and Tesch’s eight steps of data analysis were followed to create meaning from the data collected. Themes were identified and grouped together to form new categories. The researcher ensured the validity of the study by conforming to Lincoln and Guba’s model of trustworthiness, which consists of the following four constructs: credibility, transferability, dependability and confirmability. An independent coder assisted with the coding process. In Phase 2, an integrative literature review was conducted in order to identify previous guidelines regarding best practice for patient-centred care. Relevant guidelines were selected, critically appraised, data was extracted and synthesised for the development of a best practice guideline for patient-centred care. An independent appraiser critically appraised the guidelines, thereby ensuring trustworthiness. In Phase 3, the data in Phase 1 and Phase 2 were integrated to formulate a draft best practice guideline for patient-centred care. The guideline was submitted to an expert panel for review and was modified according to the recommendations of the panel, whereby the best practice guideline for patient-centred care in public hospitals in Nelson Mandela Bay was finalized.

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)