No description available.

The post natal home visit care program is a maternal and newborn home visit care program, designed to address the needs of the childbearing families following delivery and early discharge, irrespective of the place of delivery. The study was undertaken to determine the factors influencing the implementation of the post natal home visit care program by nurses and to make suggestions to resolve the problem in an urban health district in Botswana. A descriptive exploratory study, using both quantitative and qualitative methods guided the process. Two methods were used to collect data, namely, the developed checklist and four focus group discussions. Twelve clinics were sampled and checklists were completed for the twelve clinics by the researcher. A total of twenty eight Registered Nurses and Registered/Enrolled Nurse Midwives were recruited from the participating twelve clinics through purposive sampling. This included nursing managers and senior nursing staff. The findings reflect the post natal home visit care program deficits. Protocols and logistics such as transport and staff for the program were not in place. Furthermore, the results also reflect various factors such as lack of motivation, lack of support from management and co-workers, distance and fear of stigmatisation as reasons for not implementing the post natal home visit care program. The participants felt that there was need to implement the program and attached merit to its importance. Finally, the participants made suggestions to overcome the deficit such as team work, commitment to work, academic development and improvement of management and supervision. In conclusion, failure to implement the program represents a health delivery deficit. There is need for improved management and supervision to balance the needs of Registered/Enrolled Nurse Midwives and the needs of the organization in order to attain better results. There is also a need for the provision of logistics needed for the post natal home visit care program such as transport and manpower. Finally, there is need for the coordination of the post natal home visit program by the District Health Team to aid implementation so as to provide the essential service. / Thesis (M.N.)-University of KwaZulu-Natal, 2006.

The purpose of this study was, first, to further our understanding of the experience of dying in a long-term care (LTC) facility from the perspective of family members and second, to identify the relationships between the various factors which may influence satisfaction with end-of-life care. Using a sequential mixed methods design, a convenience sample of 87 family members completed a survey interview using a modified version of the Toolkit of Instruments to Measure End-of-life Care (TIME) Nursing Home Version in the first phase of the study. Findings from the parametric and non-parametric analyses indicated that family satisfaction with end-of-life care was best predicted by contact and communication with nursing staff, feeling that care provided at the end of life met expectations, staff providing consistent care, feeling that the health care aide listened to their concerns about care and that respondents felt they had received enough emotional support. Being transferred to hospital in the last month of life, dying in a place other than the LTC facility, and respondent age and employment status were all associated with significant mean differences in satisfaction scores. In the second phase, three focus groups were conducted to further explore areas of satisfaction and dissatisfaction with end-of-life care. Focus groups provided confirmation of the findings of the first phase of the study and were instrumental in developing a list of ten recommendations for improvements in end-of-life care delivery. Recommendations for future research are made based on the study results.

A qualitative study was carried out to explore foster carers’ perceptions of respite care and their perceptions of the psychosocial effects of this service for the children in their care. In order to achieve this aim an Interpretative Phenomenological Analysis approach was utilised for data collection and analysis. This yielded six themes: carers’ perceptions being influenced by variants of the respite care environment, respite care being beneficial and necessary, concerns about agency provision of respite, factors carers attribute as contributing to its psychosocial effects on foster children, the observed psychosocial effects on foster children, and ways respite care could be improved. An additional finding was also reported, as foster carers’ views of fostering and their foster children appeared to be a modifying variable influencing carers’ perceptions of respite care. These findings illustrated that there are differential effects of respite for carers compared with foster children in some cases, resulting in a tension between meeting carers’ needs and the needs of the children in their care. Comparisons and corroboration of findings from existing literature is included in the discussion as well as the implications of these findings and future research directions.

This study explores and examines the roles of caregivers within rest home facilities in New Zealand; and specifically, how they unpack and deal with managing the tensions associated with end of life (EOL) care. It adopted a qualitative perspective to enable an exploration of how the experiences of caregivers help guide their practice and understanding of their roles in relation to EOL care. A grounded theory framework was utilised in order to explore how caregivers make meaning and find value in the roles they perform within rest home facilities. This study offers insights into some of the tensions that caregivers face in a working environment where life and death occur simultaneously. It was apparent that caregivers are aware of the many social taboos they must negotiate in order to conduct their work. It was also apparent that they understood that others might perceive their work as dirty but that this did not prevent them from finding job satisfaction and create meaning in their work. Instead, they created meaning by using the conceptual tool the imagination of care. This involved utilising their imagination and past experiences to enable EOL care which represented the dying rites of individual residents but also fitted within their ethic of care.

There is no abstract available for this dissertation.

The purpose of this study was, first, to further our understanding of the experience of dying in a long-term care (LTC) facility from the perspective of family members and second, to identify the relationships between the various factors which may influence satisfaction with end-of-life care. Using a sequential mixed methods design, a convenience sample of 87 family members completed a survey interview using a modified version of the Toolkit of Instruments to Measure End-of-life Care (TIME) Nursing Home Version in the first phase of the study. Findings from the parametric and non-parametric analyses indicated that family satisfaction with end-of-life care was best predicted by contact and communication with nursing staff, feeling that care provided at the end of life met expectations, staff providing consistent care, feeling that the health care aide listened to their concerns about care and that respondents felt they had received enough emotional support. Being transferred to hospital in the last month of life, dying in a place other than the LTC facility, and respondent age and employment status were all associated with significant mean differences in satisfaction scores. In the second phase, three focus groups were conducted to further explore areas of satisfaction and dissatisfaction with end-of-life care. Focus groups provided confirmation of the findings of the first phase of the study and were instrumental in developing a list of ten recommendations for improvements in end-of-life care delivery. Recommendations for future research are made based on the study results.

Objective – Some of the most vulnerable children and youths in our country are those in out of home care, and these children demonstrate higher rates of psychopathology and fare more poorly in school and in social relationships than their peers. Typically, when studying at risk populations, negative outcomes are examined, thereby ignoring those who do well despite their vulnerability. These children, who demonstrate positive patterns of functioning and development despite their exposure to adversity, are considered resilient. The objective of this study was to identify factors associated with a resilient outcome among children and youths in out of home care. Method – The study sample was comprised of 417 children 10 to 15 years old in Ontario who had been removed from their homes of origin and placed in out of home care. Predictor variables were selected based on previous research findings in the area of resilient outcome. In the cross-sectional study, a series of sequential logistic regression analyses were conducted to identify factors associated with a resilient outcome among children in out of home care. These children were then followed one year later. In the longitudinal study, another series of sequential logistic regression analyses were used to identify variables that were related to future resilient outcomes among the same children in out of home care. Results – The findings showed that many of the independent variables predicted resilient outcome on the different dimensions. Furthermore, overall resilient outcome was best predicted by the foster parental report of high sociability. Conclusion – The findings in the present study confirmed that there exists a subset of resilient children among children in out of home care. The findings allowed for the identification of some factors related to resilient outcome among this population. The practical implications of these findings are discussed.

No description available.

Spirituality is an integral part of a persons wholeness and therefore has an effect on and plays an important role in health and illness. Nurses are required by national and international nursing bodies as well as hospital accreditation agencies, to identify patients spiritual needs and intervene by integrating spiritual care into their nursing care. However, to date, no nursing studies have described Tanzanian nurses experiences of spirituality and spiritual care. The qualitative method of interpretive description was used. A purposive sample of fifteen registered nurses who were engaged in direct clinical practice at one of the private not-for-profit hospitals in Dar es Salaam, Tanzania was drawn. In-depth interviews using open-ended questions were carried out, tape-recorded, and transcribed verbatim. The data collection and analysis occurred concurrently. The transcripts were coded using inductive analysis. Themes related to spirituality and spiritual care that emerged from data were: meaning of spirituality, meaning of spiritual care, recognition of spiritual needs, interventions to respond to spiritual needs, challenges addressing spiritual care, and factors positively influencing the provision of spiritual care. Several recommendations for enhancing spiritual caregiving practices were given by participants. The findings from this study offer a basis for assessment, planning, and intervention strategies that nurses can apply in integrating spiritual care in clinical practice.