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No abstract available. / Thesis (MPA)-University of Durban-Westville, 2004.

This thesis traces the developments of imaging technologies used for medical diagnosis. Giddens' sociological theory of modernity serves as a basis for the consideration of the bureaucratisation of medicine and the use of the patient file as source of information about health. The importance of 'inscriptions', in relation to scientific knowledge and power, is analysed through Bruno Latour's theory. Donna Haraway's call to rethink objectivity, not as a quality of universal knowledge, but as a given point of view, also influence the approach of this discussion of diagnostic practices. / The author demonstrates the need for abstract concepts of patient and disease to achieve modern medicine. The links between theoretical notions (anatomical pathology, in particular) and diagnostic practices, as well as the concept of objectivity underlying the use of technology to gather information about health are examined. The effects of the biostatistical method used to evaluate health are also discussed. Finally, the importance of context in the experience of illness is noted.

Thesis (M.Tech.: Emergency Medical Care)- Dept. of Emergency Medical Care and Rescue, Durban University of Technology, 2008. xvii, 198 leaves. / The purpose of the study was to assess ambulance infection control in an emergency medical service in the Ilembe District of KwaZulu-Natal, by determining the prevalence of bacteria and fungi in ambulances, including those that are potentially pathogenic, and evaluating the knowledge and practices of staff in infection control.

The current legislation in South Africa, namely the White Paper on Transformation of the Public Sector published on the 15 November 1995 by the Department of Public Service and Administration, addresses the need for transformation in the delivery of Public Services. The aim of this transformation process is to improve the efficiency and effectiveness of the way in which public services should be rendered, with the emphasis on customer focused ways of working. The South African Military Health Services (SAMHS) as a public service healthcare organisation within the South African Department of Defence (SANDF) is also governed by the White Paper on transformation, and is constantly reminded of the call for improved service delivery to its clientele. According to Schenke (2001:8) it is critical to understand that an interdependent relationship exists between employee satisfaction and customer satisfection, and therefore an organisation would need to focus on both these assets. An integral part of optimising service delivery in the SAMHS and improving customer satisfection, would be to ensure job satisfection among the healthcare professionals who render the services. Spytak, Marsland and Ulmer (1999:26) noted that satisfied employees tend to be more productive, creative and committed to their jobs. A study was therefore undertaken to review job satisfection among health care professionals in a sample population in the SAMHS. The study examined the main contributing factors that affected job satisfection, and determined if there were differences in terms of job satisfection across the demographic variables of age, gender, marital status, employees with or without children and tenure. Finally it explored the correlation between job satisfection levels and intention to leave. The study constituted a comparative cross-sectional study of 61 healthcare professionals based at Area Military Health Unit KwaZulu Natal (AMHU KZN). The research methodology adopted in this study was a quantitative survey. Statistical analyses were completed using ANOVA'S, Pearson's Correlations and Factor Analysis. The results of the study indicated that there were four major contributing factors affecting job satisfection and these included, career management, strategic management and support, the nature of the work itself and interpersonal dynamics. There were no differences noted in job satisfection across the demographic variables of age, gender, marital status, employees with or without children and tenure. However results did indicate that there was a strong correlation between total job satisfaction and propensity to leave. A strong correlation was also found with each of the four main components affecting job satisfection, namely career management, strategic management and support, the nature of the work itself, interpersonal dynamics, and propensity to leave. Recommendations were made to the SAMHS with regard to job enrichment, compensation systems, staffing and promotions, and management style. The implementation of these recommendations could assist in improving the levels of job satisfection among health care professionals. The study also recommended further research to better understand issues that could impact on job satisfection of health care professionals in the military environment. / Thesis (M.B.A.)-University of KwaZulu-Natal, Pietermaritzburg, 2006.

The effectiveness of a training workshop to combat burnout in nurses was investigated in this study. An attempt also was made to determine whether or not benefits of that workshop would be maintained over a three month period.Burnout is a phenomenon which affects those in the helping professions. Much has been written of a descriptive nature but little has been done to empirically determine procedures which might reduce burnout in those who are already experiencing it.Ninety-five staff nurses, representing two hospitals, volunteered to participate in this study. One hospital was a neuropsychiatric facility and the other was a general medical hospital.The dependent variable for this study was a burnout score as determined by the Staff Burnout Scale for Health Professionals (SBS-HP). This is a 30 item self-assessment inventory, which addresses cognitive, emotional, behavioral, and physiological reactions.Subjects were randomly assigned to either a treatment condition or a control condition. The experimental group attended a 7 ½ hour workshop which utilized didactic presentations, group discussion and problem solving, audio-visual material, self-assessment, training in progressive relaxation, an introduction to cognitive restructuring, and the development of social support systems.The research design chosen was a one-way or single factor design utilizing a test and retest of the SBS-HP. The method of data analysis was a one-way multivariate analysis of variance with a step-down F test. The selected level of significance was .05.The null hypothesis was not rejected. There was no significant difference between the treatment group and the control group on the long-term posttest after covarying the short-term posttest scores. Also, there was no significant difference between the treatment group and the control group on the short-term posttest.

This investigation examined the self-efficacy beliefs of medical professionals towards medically-related tasks. Although several instruments existed that measured different aspects of career self-efficacy, none of them was relevant nor appropriate to people who have already chosen their occupational field of choice. The typical scales utilized in assessing career self efficacy are generalized across occupations and not relevant to someone who was already employed in a profession. The purpose of the present study was to develop a new scale, Medical Tasks Self-Efficacy (MTSE), to measure the self-efficacy beliefs of a specific employed population toward their occupational tasks. The analysis of the MTSE was conducted using respondents (N=307) of medical professionals, specifically physicians and nurses. The reliability and validity of the scale was analyzed through four phases of scale development.Phase one consisted of item development which included the generation of an item pool from special occupational books and interviews with medical professionals (N=8). Additional experts (N=3) in scale construction were also consulted during this phase. Thirty-two items were developed originally and then, through consultation, reduced to 27 items. Phase two involved a pilot study with respondents from various medical settings in the midwest (N=34). The pilot study helped to provide preliminary reliability information and to modify the necessary demographic information. One more item was dropped from the scale during this phase and thus the revised MT SE consisted of 26 items.Phase three consisted of a major investigation (N=209) to test the initial factor structure of the MTSE and to examine the internal consistency. Using a principal components extraction, the MTSE yielded a two factor solution which seemed to best fit the data both in terms of statistical configuration and theoretical soundness. Factor One constituted tasks involving “medical content competencies" and held an alpha coefficient of .93. Factor Two constituted tasks involving "interpersonal process competencies" and held an alpha coefficient of .87.The fourth and final phase (N=64) was conducted to test the convergent and discriminant validity of the scale and to examine the test-retest reliability. Convergent and discriminant validity were tested using the Task Specific Occupational Self-Efficacy Scale (TSOSS) and the Beck Depression Inventory (BDI). The MTSE was hypothesized to demonstrate convergent validity with the TSOSS. Both factors of the MTSE were significantly correlated with the overall TSOSS, and additionally correlated with the four factors of the TSOSS, with one exception. Only Factor Two ("interpersonal process competencies") of the MTSE did not correlate significantly with factor four of the TSOSS. The BDI was used to test discriminant validity. The BDI did not correlate significantly with either of the factors of the MT SE. Thus, the MTSE demonstrated both convergent and discriminant validity with the instruments utilized in this study. The two-week test-retest correlation was .80, additionally demonstrating a stable reliability estimate in the MT SE. Limitations and implications for future research of the MT SE were provided. / Department of Counseling Psychology and Guidance Services

From day's ceremonial, the nursing profession, was held in high esteem and was the most cherished health career amongst the black community. The profession popularised by Florence Nightingale, alias, "The lady with the lamp," highly emphasised absolute virtues, such as selflessness, dedication and hard work, to mention just a few. Some individuals like the late Sister Lekgetha and Cecilia Makiwana later became epitome of the health profession and were marvelled by the community at large. The paradigm has shifted somewhat, unfortunately, with today's nurses capable of leaving their death-bed-ridden patients in hospital wards, to take to the streets in demand of salary increases. Their hostile attitudes are perceived in community circles as irresponsible and uncaring, culminating in poor health service deliveries at health centres. Nurses, on the other hand, cite a number of issues that have rendered the health profession a disaster, in which it find itself. These range from the working conditions to the job description as rolled out by the supervisor and the Department. It is for this reason that a study at the Mafikeng Provincial Hospital was prompted, to try and reach the bottom of the truth. / M. Admin (HRM) North-West University, Mafikeng Campus, 2006

This study evaluated the ability of subjects at 3 levels of expertise, expert physicians, residents and medical students, in the acquisition, representation, and utilization of patient information in the context of solving a complex medical problem. Each subject interviewed a volunteer medical outpatient and was subsequently requested to provide a differential diagnosis. The doctor-patient dialogue was analyzed using cognitive methods of discourse analysis. These methods were used to characterize differences in the content and nature of the history-taking process and in the development of problem representations. The study characterized differences at two levels of representation, observations and findings. Observations are the minimal semantic units of the doctor patient discourse. Findings are higher order units that derive meaning in specific medical contexts. / Differences were found between groups of subjects in the accuracy of diagnoses and in the qualitative nature of representations. These differences were manifested most clearly in terms of a series of efficiency measures designed to characterize the ability of subjects to generate findings. In general, the expert physicians were more selective in the elicitation and processing of critical and relevant findings. An attempt is made to characterize these differences in terms of the strategies used to acquire and represent patient information.

Thesis (M.S.)--University of Hawaii at Manoa, 2005. / Includes bibliographical references (leaves 32-35). / vii, 35 leaves, bound 29 cm