M.Cur. (Advanced Midwifery and Neonatal Nursing Science) / The aim of this study was to explore and describe antenatal education needs of low-risk pregnant clients receiving basic antenatal care in the public health setting, in a health care facility in Tshwane. Very little antenatal education is being given to pregnant clients receiving basic antenatal care in the public health setting, in contrast to antenatal education provided to women who make use of private health care facilities during their pregnancy and attend private antenatal classes. The need for antenatal education of clients receiving care in the public health setting may well be intensified due to the often marginalised circumstances from which these clients originate and a lack of informal learning opportunities on childbirth, coupled with the possibly aggravating influence of cultural practices which may be harmful to both mother and child. Not having access to this education may negatively affect the pregnancy, birth, and postnatal period. The lack of antenatal education often causes woman to unnecessarily seek medical help at already overloaded clinics, which could be prevented if the women received proper antenatal education. The opposite is also true: many women do not seek medical help in time because of a lack of antenatal education. Through a qualitative study, antenatal educational needs of clients receiving basic antenatal care in a community health setting in Tshwane within the public health setting, were explored and described. The specific needs which should be addressed were identified by the clients through individual interviews, as well as by the health care workers caring for them, through focus group interviews. Both the interviews and focus groups were audio-taped, transcribed and analysed using Tesch’s steps to qualitative data analysis. An independent coder was used to ensure trustworthiness. This analysed data was compared to the relevant available literature and was found to be corresponding. The identified needs were then utilised to make recommendations for midwifery practice to meet the antenatal educational needs, including a proposed programme to be presented in the public health setting in Tshwane to clients receiving basic antenatal care. The programme suggests three education classes which can be presented, addressing all the needs identified through the study. Recommendations for midwifery education and further research were additionally presented.

It is essential that neonatal practitioners are able to use their theoretical knowledge in clinical practice in an appropriate manner, in order to render competent quality care to the critically ill neonate. However, theory and practice integration is also very difficult to achieve. Managers of neonatal units and neonatal students had voiced concerns regarding the integration of theory and practice in the neonatal programme offered by an Institution of Higher Education (IHE). Therefore the purpose of this research was to develop standards and criteria to facilitate the integration of theory and practice in the IHE Neonatal Programme A combined qualitative/quantitative exploratory, descriptive, contextual approach was followed, based on Muller's Model for the Development of Nursing Standards (1990:49-55). The design consisted of a development phase and a quantification phase. Standard development began with conceptualisation, that is, the definition of the research concepts and the integration of the study into existing theoretical frameworks. The legislative frameworks used for the study were those of the South African Qualifications Authority and the South African Nursing Council, that govern nursing education and nursing practice. The theoretical frameworks promote theory/practice integration. Standards and criteria were developed from the legislative and theoretical frameworks in order to facilitate the theory/practice integration of the IHE neonatal programme. Ten experts who met specific criteria for inclusion in the study were then asked to validate the standards. The quantification phase consisted of the statistical determination of the content validity of the standards, using a questionnaire. The original ten experts together with another forty participants who complied with specific inclusion criteria, were asked to evaluate the standards, using a four-point rating scale. A standard or criterion with a content validity index of 3.5 to 4. 0 was accepted as valid. The results of the data analysis for the fifty participants showed that all criteria had a mean score of over 3. 5 and thus could be considered valid and useful as a guideline for neonatal programmes. However it was evident from standard deviation scores that the expert group showed greater consensus than the additional participants regarding the validity of the standards. Further research may therefore be required in order to confirm the validity of the standards and criteria.

Thesis (M.Tech.: Nursing)-Durban Institute of Technology, 2005 1 v. : ill. ; 30 cm / An exploratory descriptive research design was used for this study which investigated the underutilisation of a rural clinic’s labour ward by low risk pregnant women (LRPW). The study took place in Maputaland, Northern KwaZulu-Natal. Rosenstock’s health belief model (HBM) modified by Becker et al, in 1977 was adapted as a framework for this study.

The purpose of this study was to examine the effect of an educational intervention using Swanson’s (1991) caring theory on (a) nurses’ knowledge and caring behavior to late preterm infants (LPIs) and their families, and (b) the incidence of LPIs’ hospital visits and readmission rates for hyperbilirubinemia and dehydration in the first 30 days of life. The study began with the initial testing of the two instruments used and there were no inconsistencies identified in the content being measured. A convenient sample of nursery and postpartum nurses was recruited from two hospitals within a healthcare system. The nurses completed the consents and the surveys online via Survey Monkey®. Instruments used in the survey included a demographic, knowledge, and caring questionnaires. The participants’ inclusion criteria were nurses who have: a) completed at least one year experience working with well newborns, b) attended the educational intervention, and c) completed tests at the three intervals. SPSS for Windows (version 21) was used to analyze data using statistical techniques and ANOVA repeated measures. Study findings support improved knowledge for all participants; however, there was decreased retention of knowledge noted one month later. There was a 37% increase in knowledge from the baseline mean scores to the posttest mean scores (52% to 89%), although there was a 20% knowledge decrease from the posttest to one month later (89%- 69%). There remained a true knowledge gain since knowledge increased between the baseline measurements to the 1-month follow-up assessment (52% to 69%). Infant outcomes related to hyperbilirubinemia and dehydration also demonstrated patterns of improvement in the direction of statistical significance. The study added to the body of nursing science regarding educational intervention as a tool in increasing nurses’ knowledge. / Includes bibliography. / Dissertation (Ph.D.)--Florida Atlantic University, 2014. / FAU Electronic Theses and Dissertations Collection

Ball State University LibrariesLibrary services and resources for knowledge buildingMasters ThesesThere is no abstract available for this thesis.

The purpose of the study was to develop and test a self-report instrument that describes the frequency that intrapartum nurses perform labor support and physiologic interventions and the nurses' beliefs of the helpfulness of their interventions. The Labor Support and Physiologic Intervention Scale (LSPIS) uses a Likert-style format in a 5-category range of answer options to collect data on nurses' practices to enhance the progress and process of women's labors. Social support theory and physiologic theory provided a conceptual foundation, while the scientific literature on labor support and intrapartum care provided a basis for the original 57 items used in the pilot (n=10) and the Phase I study (n=307). Five labor support experts evaluated the items, with an interrater agreement of .95 and a content validity index of .93. The 57-item LSPIS had an internal reliability of .93 and .95 for the frequency and helpfulness portions (respectively). Exploratory factor analysis identified a 6-factor solution accounting for 48% of the variance that matched the social support and labor support dimensions. The LSPIS was revised and shortened to 26 items based upon the Phase I data analyses. The Phase II study had 472 respondents recruited from two professional listserves. The internal consistency reliability of the revised LSPIS was .90 and .91 for the frequency and helpfulness portions (respectively). Construct validity was evaluated by exploratory factor analysis, which found several acceptable factor solutions that were consistent with the theoretical framework. A six-factor solution accounted for 59% of the variance and had the following components: instrumental or physical support, emotional support, partner support & information/advice, advocacy, mother-directed pushing, and sustenance. Known groups technique and content analysis of nurses' responses to open-ended questions further evaluated construct validity, while discriminant validity was ascertained using a short version of the Marlowe-Crowne Social Desirability Scale. Further data analyses explored relationships among LSPIS scores and various organizational, geographic, and provider variables. In both phases, instrument psychometrics were acceptable and the scale demonstrated acceptable content and construct validity. Further revisions and future uses of the instrument can be guided by the recommendations provided. / text

Background The Millennium Development Goals call for two-third and three-quarter reductions in Perinatal Mortality Rates and Maternal Mortality Ratios. The main strategy towards achieving these reductions is to increase access to skilled attendance. However, it cannot be confirmed that all health professionals are skilled in managing women in labour, nor that they are functioning in enabling environments. To measure the provision of skilled attendance, this study was undertaken in five Level 1 Hospitals in the uThungulu Health District of KwaZulu-Natal. The objectives of the study were: 1. To establish perinatal outcomes for each Level 1 Hospital in uThungulu Health District. 2. To evaluate the quality of intrapartum care provided in Level 1 Hospitals in uThungulu Health District. 3. To evaluate the obstetric knowledge of health workers attending births in Level 1 Hospitals in uThungulu Health District. 4. To evaluate the obstetric skills of health workers attending births in Level 1 Hospitals in uThungulu Health District. 5. To evaluate the environment in which births are attended in Level 1 Hospitals in uThungulu Health District. 6. Compare the quality of care, the knowledge, skills and environment with perinatal outcomes. Methods Perinatal outcomes (PNMR, FSBR, ENNDR and PCI) were calculated for each hospital; maternity case records of women who have delivered in these Level 1 Hospitals were audited to assess the quality of intrapartum care; obstetric knowledge and skills of midwives were assessed; as was the enabling environment within which midwives worked, which included a measurement of their workload. A correlation between perinatal outcomes and the quality of intrapartum care, knowledge and skills and the enabling environment was performed to determine whether variables were associated. Results The overall PNMR for five hospitals in uThungulu Health District was 31 per 1000 births. Three hospitals demonstrated PNMRs below 30 per 1000, while the other two showed rates above 45 per 1000. The combined FSBR for the five hospitals was 6 per 1000 births, the combined ENNDR was 12 per 1000 live births. The PCI in all hospitals ranged between 3 and 4. An audit of maternity case records revealed that all hospitals have a high overall mean percentage score per record. However, analysis of subsets showed good performance in recordings on the labour graph, but poor performance in the admission assessment and in the management of labour. The Kruskal-Wallis Non-Parametric Test showed a statistically significant difference in overall scores amongst hospitals (p=0.01), suggesting differences in performance in all five hospitals in terms of the quality of care provided. Overall, all hospitals scored poorly on tests of obstetric knowledge and skills. There were no statistically significant differences in the overall knowledge median scores and subsets median scores amongst hospitals (p=0.07), indicating that all five hospitals performed on a similar level in terms of obstetric knowledge. However, all hospitals performed differently in relation to obstetric skills, as there was a statistically significant difference in the overall skill median scores amongst hospitals (p=0.002). Three hospitals met the enabling environment standard. All hospitals but one scored poorly on referral, and the availability of supervision on both shifts. One hospital scored poorly on drugs and supplies. Overall no hospitals reported the presence of all the elements of the enabling environment. Three hospitals had acceptable workloads. No association could be detected between variables. However, there were trends that can be traced in different hospitals. Conclusions In South Africa, from the Demographic and Health Survey, 84% of deliveries are assisted by skilled attendant. While an attendant may be present, one cannot say that skilled attendance has been provided, as it has been shown for uThungulu Health District. / Thesis (MMed.)-University of KwaZulu-Natal, Durban, 2010.

Thesis (M.Tech.: Nursing)-Durban Institute of Technology, 2005 1 v. : ill. ; 30 cm / An exploratory descriptive research design was used for this study which investigated the underutilisation of a rural clinic’s labour ward by low risk pregnant women (LRPW). The study took place in Maputaland, Northern KwaZulu-Natal. Rosenstock’s health belief model (HBM) modified by Becker et al, in 1977 was adapted as a framework for this study.

Thesis (M.S.)--University of Michigan, 1993.

Thesis (M.S.)--University of Michigan, 1993.