This study features an examination of the effects of working with traumatised individuals, namely vicarious traumatisation. Predictor variables such as age, career longevity, personal trauma history and workload were correlated with vicarious trauma. Support systems used by nurses were explored. The questionnaire consisted of items of the TSI Belief Scale, demographic characteristics of persons with a personal trauma history, work related aspects and support systems. Participants were 37 nurses (30 female and 7 male) who render a community mental health service in the Cape Metropole. Results of the study indicate that the variables age and career longevity were statistically significantly related to vicarious trauma. There was no relationship between personal trauma history, workload and vicarious trauma. The nurses identified the psychiatrist and psychologist as their main support systems in dealing with vicarious trauma. Recommendations were made to assist the organisation and nurses on how to deal with vicarious trauma. / Health Studies / M.A. (Health Studies)

Text in English / The purpose of the study was to explore the registered nurse’s perceptions with regard to the use of authority by nurse managers in the workplace. A qualitative approach using phenomenological descriptive design was used. Data was collected by means of audio-taped individual interviews and field notes. The sample included registered nurses aged 25-45 years with more than two years’ experience. Ethical issues were adhered to. The data was analysed using content analysis as proposed by Creswell (2013). Five themes and seventeen subthemes emerged from the data. The findings revealed that the registered nurses were unhappy with the way authority is being used, their non-involvement in decision-making; lack of two way communication between nurses and managers; poor relationship between nurses and health service managers which hindered nurses’ opportunity for growth. Autonomy is a major determinant of nurse job satisfaction, and failure to apply it may lead to high turnover and absenteeism. / Health Studies / M.A. (Health Studies)

Thesis (MMed)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: Introduction: The morbidity and mortality associated with tuberculosis (TB) disease is of grave consequences for the health and employment of afflicted individuals. Healthcare workers are identified amongst high risk groups in communities. The prevalence/incidence of TB is dependent on the presence of associated risk factors which varies in diversity and intensity in different communities and workplaces. Understanding the risk factors operating in any given environment is indispensable to any tuberculosis control programme. Objective: The objective of this study was to describe the occurrence and trends of TB disease as well as to determine the risk factors associated with the disease among Tygerberg hospital employees. Method: A cross-sectional descriptive study design with a nested case-control component was used to determine the occurrence (and trends) and risk factors of TB disease respectively. Occurrence and trends of tuberculosis: The frequencies, distribution and trends of TB disease from 2008 to 2011 were obtained by calculating and comparing the annual incidence rates for each variable. Cases were identified from the occupational health clinic TB register, while the various denominator data were obtained from the Human Resource database. Determination of risk factors: Cases were recruited from the occupational health clinic TB register and controls were randomly selected from unaffected workers during the study period. Self-administered risk factor questionnaires were completed by both cases and controls. Multivariate logistic regression analysis was used to determine the association between known and suspected risk factors and the occurrence of TB disease amongst employees. Results: Sixty six cases of TB disease occurred in the workforce during the study period resulting in an annual average incidence rate of 397/100,000 population (95% CI: 307/100,000-505/100,000). Twenty three (34.8%) of the 66 cases occurred in Housekeeping staff, making them the most affected sub-group [1181/100,000 population (95% CI: 747/100,000-1768/100,000)]. The rate of TB disease in nurses was 1.7 times (95%CI: 1.4-2.0) that of doctors. Workers in the 40-49 years age-group experienced the highest incidence [490/100,000 population (95%CI: 329.6/100,000-706.8/100,000)] of TB disease compared to the other age-groups. There was no obvious difference in gender occurrences. Disease rates varied among different racial groups, with the highest rate in black employees [1473/100,000 population, (95%CI: 924/100,000-1981/100,000)]. Distribution of TB disease in the institution was widespread, with security department being the most affected [2500/100,000 population (95%CI: 311/100,000- 9262/100,000)]. There was a downward but statistically insignificant (annual range 9-23; p=0.28) trend in the rate of disease occurrence over the study period. No previous training on TB prevention (OR: 2.97, 95% CI: 1.15 - 7.71), HIV (OR: 67.08, 95% CI: 7.54 – 596.64) and working without knowledge of TB risk profile of the workplace (OR: 8.66, 95% CI: 1.10 – 67.96) were associated with TB disease occurrence. Conclusion: Occurrence of TB disease among Tygerberg hospital employees was low compared to that of the general population of its drainage areas. Disease occurrence in the facility was wide and varied with respect to occupational groups, workplaces and time. Well-established risk factors for TB infection (and disease) were found to be determinants of disease occurrence in the facility.

This study investigated the registered nurses' perceptions of the bureaucratic view of power in health care services in the Tshwane metropolitan region. The study further sought to describe how power affects the role of registered nurses in an organisation that is perceived to be predominantly bureaucratic in its' approach to management. A quantitative descriptive exploratory approach was adopted. Data was drawn from 121 respondents by random distribution of questionnaires to three selected health care services in the Tshwane metropolitan region. The findings revealed that registered nurses were largely divided in their perception of the bureaucratic view of power in health care services. Almost half of the respondents indicated that great strides had been taken by organisations in transforming health care services in accordance with the White Paper (1997) on Transformation of the Health System in South Africa and the recommendations of the 2001 Health Summit. The others indicated that registered nurses still needed to break out of the restraints of their dependant role towards taking ownership of health care services by equally bearing the burden of the organisation with management. / Health Studies / M.A.(Health Studies)

This study features an examination of the effects of working with traumatised individuals, namely vicarious traumatisation. Predictor variables such as age, career longevity, personal trauma history and workload were correlated with vicarious trauma. Support systems used by nurses were explored. The questionnaire consisted of items of the TSI Belief Scale, demographic characteristics of persons with a personal trauma history, work related aspects and support systems. Participants were 37 nurses (30 female and 7 male) who render a community mental health service in the Cape Metropole. Results of the study indicate that the variables age and career longevity were statistically significantly related to vicarious trauma. There was no relationship between personal trauma history, workload and vicarious trauma. The nurses identified the psychiatrist and psychologist as their main support systems in dealing with vicarious trauma. Recommendations were made to assist the organisation and nurses on how to deal with vicarious trauma. / 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).

Text in English / The purpose of the study was to explore the registered nurse’s perceptions with regard to the use of authority by nurse managers in the workplace. A qualitative approach using phenomenological descriptive design was used. Data was collected by means of audio-taped individual interviews and field notes. The sample included registered nurses aged 25-45 years with more than two years’ experience. Ethical issues were adhered to. The data was analysed using content analysis as proposed by Creswell (2013). Five themes and seventeen subthemes emerged from the data. The findings revealed that the registered nurses were unhappy with the way authority is being used, their non-involvement in decision-making; lack of two way communication between nurses and managers; poor relationship between nurses and health service managers which hindered nurses’ opportunity for growth. Autonomy is a major determinant of nurse job satisfaction, and failure to apply it may lead to high turnover and absenteeism. / Health Studies / M.A. (Health Studies)

Thesis (MPH.) -- University of Limpopo, 2016 / Introduction The aim of the study was to determine the knowledge and practices of health care workers on medical waste disposal at George Masebe Hospital, Waterberg District, Limpopo Province, South Africa. Method A cross sectional study was conducted and simple random sampling was used to select participants. Data was collected using self-administered questionnaire which where total of 141 participants were sampled using the Slovin formula. Data were analyzed using the IBM SPSS Version 22 and both descriptive and inferential statistics were used to answer the study objectives. Results The study shows that 43% of the respondents had good knowledge on medical waste disposal, 13% were not sure and 44% had insufficient knowledge. Forty nine percent (49%) of the respondents practiced safe medical waste disposal, 4, 3% were moderate in practice and 46, 1% had insufficient practice in place. There was no statistical significant relationship between knowledge and practice of medical waste disposal control measures of health care workers. Conclusion The study concluded that knowledge of the respondents on medical waste disposal was insufficient, there were satisfactory medical waste practices and there was no relationship between knowledge and practice.

Department of Advanced Nursing Science / MCur

MPH / Department of Public Health