published_or_final_version / Public Administration / Master / Master of Social Sciences

published_or_final_version / Social Work / Master / Master of Social Sciences

The purpose of this study is to explore and describe the knowledge, attitudes and experiences of health care workers who care for patients receiving treatment under DOTS strategy at public health facilities in the Windhoek District of the Khomas Region. A qualitative explorative, descriptive and contextual research design was used in this study. A purposive sampling was used to select participants who met the inclusion criteria for the study. The inclusion criteria was to be a health care worker who at the time of the study was working with patients who are on DOT for at least 6 months. A semi-structured interview guide was used to collect data. The study was conducted in the Windhoek district of the Khomas region, with a sample of 14 health care workers. Data was analysed by means of content analysis, a process of organizing and integrating narrative, qualitative data according to emerging themes and concepts. The three themes, which emerged from data analysis, were the knowledge of health care workers regarding the implementation of DOTS, the attitudes of health care workers towards patients on DOT which may affect the success of their treatments, and the experiences of health care workers when attending to patients on DOTS. The findings from the study may be used to engage stakeholders to address the shortcomings that exist in the implementation of the DOTS strategy in the district. / Health Studies / M.A. (Nursing Science)

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).

Wong Shun-wah. / Thesis submitted on: December 2002. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2003. / Includes bibliographical references (leaves 84-91). / Abstract --- p.i / Acknowledgements --- p.iii / Contents --- p.v / Chapter Chapter 1 --- Introduction --- p.1 / Chapter 1.1 --- Empirical Puzzle and Theoretical Questions / Chapter 1.2 --- Casing a Case: Hospital as a Critical Case for Studying Gender and Professional Authority / Chapter 1.3 --- The Methodology / Chapter 1.4 --- Overview of the Thesis / Chapter Chapter 2 --- Literature Review and Theoretical Framework --- p.10 / Chapter 2.1 --- Professional dominance and Professional Dependency / Chapter 2.2 --- Enthographic Studies of Resistance / Chapter 2.3 --- Gender and Organization / Chapter Chapter 3 --- Gendering Occupation in the Health Care Sector and the Gendered Occupational Structure of Hospitals --- p.16 / Chapter 3.1 --- Gender Segregation in the Health Care Workplace / Chapter 3.2 --- Hospital Setting: A Gendered Organization / Chapter Chapter 4 --- Resistance of Nurses --- p.45 / Chapter 4.1 --- Resistance Strategies of Women Nurses Mothering Gossip Symbolic Giving Explicit Resistance / Chapter 4.2 --- Strategies of Men Nurses: Resistance and Dilemma / Chapter 4.3 --- Divided and Not Organized / Chapter Chapter 5 --- Restrictive Authority of Doctors --- p.70 / Chapter 5.1 --- The Dependency of Doctors on Nurses in the Gendered Organizational Structure of Hospital / Chapter 5.2 --- Men Doctors' Means to Gain the Compliance of Nurses / Chapter 5.3 --- Women Doctors' Means to Gain the Compliance of Nurses / Chapter Chapter 6 --- Conclusion --- p.80 / Chapter 6.1 --- The Consequences of the resistance of women nurses: Accommodation and the Reproduction of Gender / Chapter 6.2 --- The Contribution of this Research and Issues for Future Study / Bibliography --- p.84

The focus of this study was the exploration of parents and caregivers experiences of raising children with ADHD and their experiences of services at a public sector hospital. There is a paucity of scholarly studies conducted on this topic in South Africa. The context of the study is the public sector hospital where the researcher is employed as a social worker. Through her interactions with the parents and caregivers of ADHD affected children she became aware of the challenges that they were exposed to and this prompted her to undertake the study. This was a qualitative study and a purposive sample was used. Semi-structured interviews were conducted with 21 participants and one focus group was conducted as a method of triangulation, with six participants. This study was guided by two theoretical frameworks, namely the bio-psychosocial and ecosystems approaches. The main conclusions drawn from the findings of the study were that many participants experienced a lack of support from their families and from the hospital. Participants did not have sufficient knowledge of the comprehensive treatment plan available in the management of ADHD. Health care professionals failed to engage in mutual decision making with participants, related to ADHD treatment and they neglected to address the concerns of participants regarding their children. A further finding was that the referral process to allied health professionals was inconsistent. Participants also experienced difficulties with the hospital administrative processes. Based on the findings, the recommendations include the need for more comprehensive support which includes medical and psychosocial support for participants. The limited knowledge base of participants with regard to the nature, causes and the use of medication for ADHD should be addressed by the health care providers. This could be achieved through participant education on the disorder at the initial stages of diagnosis. ADHD should be managed in a more collaborative and co-ordinated manner at the health care facility through an actively interdependent team. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2010.

Thesis (M.P.H.)--University of Texas Health Science Center at Houston, School of Public Health, 2008. / Source: Masters Abstracts International, Volume: 46-04, page: 2059. Adviser: Ross Shegog. Includes bibliographical references.

Introduction: Licensed medical personnel (henceforth LMP) experience ethical problems related to undertaking care duties in combat zones. When employed in the Armed Forces they are always under the command of tactical officers (henceforth TOs). Aim: The overall aim was to explore everyday ethical problems experienced by military medical personnel, focusing on licensed medical personnel in combat zones from a descriptive and normative perspective. A further aim was to explore leadership challenges in leading licensed medical personnel. Methods: For the research descriptive, explorative (inductive and abductive) and normative designs were used. Data collection was undertaken by using different methods. Altogether 12 physicians, 15 registered nurses, seven combat lifesavers and 15 tactical officers were individually interviewed. The participants were selected by strategic (I), purposive (II) and theoretical sampling (III). The interviews were analyzed by using qualitative content analysis. Study III used classic grounded theory and study IV was a normative analysis of an ethical problem based on the idea of a wide reflective equilibrium. Results: We found that LMP experience ethical problems related to dual loyalty when serving in combat zones. They give reasons for undertaking, or not, military duties that can be seen as combat duties. Sometimes they have restricted reasons for undertaking these military duties. Furthermore, LMP are under the command of TOs who found it challenging when leading LMP, since TOs have to unify LMP in the unit. The unifying makes it difficult since LMP experience dual loyalty. Conclusions: LMP experience dual loyalty in combat zones. The reason maybe that humanitarian law and the medical ethical codes are not clear-cut or explicit about how to be interpreted around these everyday ethical problems in internal military operations. In order to fit in todays context humanitarian law needs to be revised. Furthermore, LMP need further training in parallel with reflections on ethical problems in order to adapt to the combat zones of today.

The provision of psychological services is vital considering the complex nature of psychosocial issues facing people today. Nevertheless, the provision and utilization of psychological services has not been given due recognition in most African countries, including Botswana. Botswana is one of the countries faced by the challenges of the HIV/AIDS pandemic and other mental health problems, as well as poverty and unemployment. To date statistics on the magnitude of the HIV/AIDS epidemic in Botswana, published annually by the National AIDS Coordinating Agency (NACA) reflect an increased rate of mental illness and psychosocial problems. Considering the complex nature of issues that impact negatively on people in Botswana, there is a need for awareness and the provision of psychological services in the primary health care system. There is little research on the place of psychology and psychological services in Botswana. The availability of such information is crucial for the planning of effective community-based psychological services. The present study employed a quantitative research method to explore and describe awareness and attitudes towards psychological services and referral practices in relation to psychological problems, of health care providers in Botswana. The participants in the study were chosen, based on a non-probability, purposive sampling method. The sample consisted of ninety-six persons and constituted medical doctors, nurses, psychiatrists, psychiatric nurses and clinical social workers from governmental and non-governmental institutions from Gaborone and Francistown in Botswana. Data were analyzed by means of descriptive statistics in order to identify the mean, ranges and standard deviations. Frequency counts and percentages of the participants’ responses were computed. The results of the study revealed an awareness of available psychological services, positive attitudes towards psychology and psychological services and a reasonable percentage of referrals to psychological services. The results also revealed that available psychological services were limited and not easily accessible to patients. There was also an indication of a shortage of trained professionals to offer psychological services in health care centres, which resulted in psychological problems being referred to social workers.

This project surveyed 21 respondents to determine whether family medicine physician assistants' medical education and training while in residency is sufficient to assess or identify domestic violence. The project found that although family medicine physician assistants do receive education and training on domestic violence, it is insufficient because victims may still go undetected and unserved.