published_or_final_version / abstract / Industrial and Manufacturing Systems Engineering / Master / Master of Philosophy

published_or_final_version / Community Medicine / Master / Master of Public Health

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No description available.

This thesis examines the development of the Edinburgh Royal Maternity Hospital in the context of medical care in Edinburgh during the period 1844-1914. It is based primarily on casebooks of the hospital and, in particular, on in-depth micro-studies of all of the hospital's Indoor and Outdoor cases in four discrete years, at approximately 20-year intervals. The central argument of the thesis is that Over the period 1844- 1914, professionals and patients at the hospital came to understand birth as a medical rather than a social event, and that this had repercussions for both groups as well as the institution itself. Chapter 1 places the thesis in the context of other secondary uork on the development of maternity hospitals and care, and examines the use of casebooks as primary sources. Chapter 2 considers the hospital and its staff in relation to the city and the Edinburgh medical community in particular. Chapter 3 examines the patients who attended. It argues that, in the nineteenth century, their perception of the hospital was as a place of social shelter. However, by 1912 a greater number attended for otherwise unaffordable medical care at birth. Chapter 4 examines the medical treatment given to patients. It argues that there was increasing acceptance of medicalisation by patients in the period studied, and increasing confidence in giving such treatment by the professionals involved. Chapter 5 discusses the staff and male and female trainees at the hospital. It suggests that, prior to the introduction of national requirements, the provision of training was driven by commercial concerns, and therefore varied throughout the period studied, particularly in the amount of practical experience offered. The relationship between the different grades of staff and the treatment they offered, described in the chapter, suggests increasing stratification in the roles of doctors and nurses at delivery and during the puerperium. The increase in nursing care following the birth indicates the creation of a professional role that among the poor had previously been undertaken by family members. The role played by increasing anxiety over infection following the introduction of strict antiseptic measures is discussed. The thesis concludes that in Edinburgh the medicalisation of childbirth among the poor was well-advanced by 1912, and suggests that this was a result of increasing patient acceptance combined with the increasing professionalisation of care.

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No description available.

Dissertation in partial compliance with the requirements for a Master's Degree in Technology: Chiropractic, in the Department of Chiropractic, Durban University of Technology, 2010. / Background: Chiropractic in South Africa seems to be gaining acceptance by medicine with increased recognition from the private healthcare sector. This trend is reflected by the recognition of private healthcare providers of chiropractic services. Integration would accelerate the growth of the chiropractic profession in this country. It is therefore important to understand how chiropractic is currently perceived with respect to integration into the KwaZulu-Natal (KZN) healthcare system. As well as to determine factors perceived to facilitate or hinder this integration. Objectives: To explore and describe the perceptions of selected stakeholders about the integration of the chiropractic profession into the KZN healthcare system. Method: The sample included ten selected stakeholders within the KZN healthcare sector. Each participant participated in a semi-structured interview. Questions included participants‟ experience of chiropractic, the role and scope of chiropractic practice, and key developmental issues affecting integration. Interviews were captured on a digital voice recorder and transcribed into text. Data was analysed by the use of NVivo software (NVivo 8, developed and designed in Australia, copyright 2008 QSR International Pty Ltd. ABN 47 006 357 213). Results: The majority of participants (n = 7) had a positive experience of chiropractic, but few (n= 2) recognised the diagnostic role of chiropractic. All participants, except two doctors, believed that integrating chiropractic into the public healthcare system would benefit the healthcare fraternity, the chiropractic profession and patients. However, hindering factors perceived by the participants included: chiropractors practicing non-evidence based techniques; chiropractic being registered with a different council and being taught at a different institution to conventional medical professionals; and most importantly a lack of knowledge of the profession. Facilitating factors were III perceived to be: increased education of stakeholders about chiropractic; improved communication between chiropractors and medical doctors; improved marketing strategy; and lastly improved patient management. Conclusions: A positive experience of chiropractic is directly affected by a positive exposure to the profession. The profession itself is responsible for dispelling some of the confusion it has created, by collectively practicing evidence based medicine, and marketing a united message to stakeholders. / M

Submitted in fulfillment of requirements for the Degree of Master of Health Sciences: Nursing, Durban University of Technology, Durban, South Africa, 2016. / Introduction Through centuries the birth of a baby has been considered as a deeply felt spiritual experience. Childbirth is not merely a physiological experience; it also embraces social, emotional, psychological, spiritual and religious aspects. In most Western societies the sacred moment of birth dissipates within the context of a pressured hospital environment. Whilst literature and empirical research has proliferated on midwifery very little has been done to explore how women experience childbirth personally and more importantly how spirituality interfaces within the context of the childbirth experience and midwifery care. There is a growing body of literature on spiritually sensitive care. However, there remained a need to inquire about mother’s personal experience and how spirituality interfaces with the childbirth experience in the hospital context. Problem statement Whilst empirical research in the field of midwifery, has grown, research pertaining to the spiritual aspects related to women’s diverse spiritual needs during childbirth is sparse (Crowther and Hall 2015). Furthermore little attention has been paid to issues relating to how women experienced childbirth in the public sector, and how religion and spirituality influence and impact on childbirth. It is against this background that the current study was conceived. Purpose of the Study The purpose of this study was to explore and describe the experience of childbirth amongst women from diverse spiritual or religious backgrounds viz. Christianity, Islam, African Traditional Religion and Hinduism, at public hospitals in the uMgungundlovu District of KwaZulu-Natal. Methodology A qualitative, explorative, descriptive and contextual study design was used. A total sample of twenty-two postnatal mothers from the following common spiritual backgrounds in South Africa viz. Christianity, Islam, African Traditional Religion and Hinduism were purposively chosen. Data was collected until saturation. Participants were selected from three public hospitals in the uMgungundlovu District of KwaZulu-Natal. Data was collected by means of semi-structured interviews conducted six weeks post-delivery at the six-week health check, but within three months of delivery. Interviews were transcribed manually; the data was analysed through thematic analysis. Findings The main themes drawn from the data reflected that childbirth was a deeply personal and meaningful experience. It was seen as a spiritual experience and spirituality was seen as a vital support system in enabling mothers to cope better with pain and other challenges. Emotional and comfort needs were also identified by mothers as being very important to cope with pain and an easier delivery. The presence of midwives and the need for partner and family support were also seen to be important. More importantly the study found that their spirituality and spiritually based activities and rituals were an important aspect of the overall birth experience. The study found a diverse range of spiritual practices and rituals that were salient across all the spiritual worldviews during childbirth and post-delivery. It also found that mothers often resorted to alternate and traditional therapies to help cope with labour and delivery all of which have salience to midwifery practice that is both respectful and sensitive to the diverse worldviews of mothers. Conclusion Collectively the data reflected that childbirth was a holistic experience that cannot be separated also from partner, family and medical support. Whilst traditionally effective midwifery practice may have been so to focus on primarily physical care, the study found that the physical component is interrelated with the psychological, social and cultural aspects as well. Hence effective and ethical midwifery practice is inseparable from these facets but most importantly inseparable from the spiritual worldviews that most mothers follow and ascribe to. Contemporary education needs to recognize the current move towards spiritual care and provide knowledge and skill to deal with patients from diverse spiritual backgrounds. Finally it needs to recognize as this study has found, that childbirth is a multifaceted experience which is spiritual in nature. Viewed in this way both midwives and the management of public hospitals should then make every effort to create spiritually sensitive care during the childbirth experience. / M

Call number: LD2668 .P7 1974 D35