The legalising of abortion in many countries has given women the choice or right to decide to terminate pregnancy. The Choice on Termination of Pregnancy Act (Act No 92 of 1996) was promulgated in 1997. This legislation promotes reproductive rights including to choose between having an unwanted pregnancy terminated early, safely and legally. The legislation affects both the women who choose to terminate pregnancy and the staff involved in the termination of pregnancy (TOP) procedures. This exploratory, descriptive and contextual qualitative study was designed to gain insight into the experiences of registered nurses in the procedure for termination of pregnancy and to explore recommendations based on these experiences. The researcher adopted a phenomenological approach. Participants were drawn from registered nurses providing TOP services at Soshanguve Community Health Centre near Pretoria. Registered nurses have the right to refuse to participate in TOP, those that do provide the service are exposed to emotional and psychological trauma. / Health Studies / M.A.

The purpose of the study was to determine how professional nurses perceive their roles in patient centered care in various units, in three regional hospitals in Mpumalanga Province. The main objectives of this study were to determine * whether the working environment in provincial hospitals is supportive of patient centered care * what factors could hinder the provision of patient centered care * the extent to which patient centered care is provided to patients in provincial hospitals * professional nurses' perception of their role in patient-centered care The researcher used the descriptive exploratory method. A questionnaire with closed and open-ended questions was used to collect data from professional nurses in the three hospitals. Seventy- two (72) respondents returned the completed questionnaires. The findings indicated that the professional nurses perceived patients' and nurses' lack of knowledge as the biggest hindrance to patient centered care. Patients and relatives seemed to be less involved in their own care and the lack of information given to patients by professional nurses subsequently contributed to patients' inability to make / Health Studies / M.A. (Health Studies)

The Choice on Termination of Pregnancy Act (no 92 of 1996) was implemented during 1997. This study attempted to investigate professional nurses' attitudes towards rendering these services in the Carletonville area of South Africa. The research results, obtained from questionnaires completed by professional nurses, indicated that most professional nurses would prefer:  women to be at least 16 years of age to access these services  not to allow repeated terminations of pregnancy to the same women  to administer pills rather than to use vacuum aspirations  to work in these services by choice only  to have better equipment, more resources and more staff members in units offering these services  more support from their families, friends, managers and communities Some professional nurses experienced guilt, depression, anxiety and religious conflicts as a result of the nature of their work. / Health Studies / M.A. (Health Studies)

Aim of the study is to explore the role caring practices within the nurse-patient relationship, in facilitating effective chronic pain management in the primary health care context. Objectives are to analyse the current caring practices within the nurse-patient relationship during the management of patients with chronic pain within primary health care services; explore the challenges experienced by nurses in primary health care services when managing patients with chronic pain; observe the caring practices within the nurse patient interaction for the patients suffering from chronic pain within the Primary health care setting and explain the nurses‟ caring practices when managing their chronic pain in the primary health care setting. Method The research design for this study is sequential, explanatory and mixed method, which is more appropriate due to the complexity of the phenomenon under study. Findings: Although the survey measured the caring practices subjectively which other studies had done consistently, generally nurses associated caring as their core function within the health profession. Nurses do not actively involve the patients in the development of a treatment plan and as a result the caring behaviours that are intended to benefit the patients are not realised and, thus patients report nurses as not being caring. The results indicated that lack of an inclusive treatment plan, which can only be discovered through the development of the therapeutic NPR, is not given priority in the management of patients with chronic pain Conclusions: Caring should not be seen as concrete execution of the set of activities towards the patient but rather as a joint venture between the nurse and the patient. The strength of the model developed in this study is the identification of the nurses‟ internal readiness to create a caring environment by experiencing the love, faith and hope before engaging with the patient. / Health Studies

Department of Advanced Nursing Science / MCur

MCur / Department of Advanced Nursing Science / Survival of children with HIV/AIDS has increased considerably with the use of effective antiretroviral therapy. However, the benefits of this therapy are limited by the difficulty of adherence to the treatment. This study sought to explore the role of professional nurses on anti-retroviral therapy adherence among children in Lejweleputswa district: Free State, South Africa. An exploratory descriptive qualitative research design was used to identify and describe role of professional nurses toward anti-retroviral therapy adherence among children. Population for this study included seventeen (17) professional nurses working in four purposively sampled Primary Health Care clinics invited to participate in the study. Four focus group discussions were conducted in which each group had 6 participants. The transcribed data was analysed using the framework approach of data analysis. Professional nurses in Lejweleputswa district report poor knowledge of parents/caregivers of children, perceived poverty, stigma and discrimination, inappropriate care approaches, and parental dynamics as factors influencing poor ART adherence. Recommendations for enhancing children ART adherence levels in Lejweleputswa district included: mainstreaming adherence counselling in children ART and adopting a comprehensive family centered care approach were identified as measures for improving children ART adherence. Other measures included integration of ART services into Primary Health Care (PHC) services, parental empowerment, development of a programme to reduce stigma and discrimination in the community.

PhD (Psychology) / Department of Psychology / Background: South Africa has world’s highest prevalence of HIV-positive people with approximately 7.06 million HIV-positive people with 110 000 HIV- related deaths reported by Statistics South Africa in 2017. South Africa has expanded access to anti-retroviral therapy services, from urban centers to resource-constrained rural communities. The rate of loss, however, to follow-up for patients on anti-retroviral treatment continues to increase. Aim of the Study: The aim of this study was to determine patient and nurse perspectives on loss to follow up among HIV-positive patients in Sekhukhune District of Limpopo Province, South Africa. The findings of the study guided the development of a proposed strategy to decrease loss to follow up among HIV-positive patients. Method: A qualitative research design was used with non-probability purposive sampling and with probability systematic sampling. The sample of patients comprised 30 HIV-positive people classified as lost to follow-up from clinics with high prevalence rates of lost to follow-up patients. Eight nurses, four from clinics with high rates and four from clinics with low lost to follow-up rates comprised the sample of nurses. Semi-structured interviews were conducted using the study research questions as a guide. Eight interviews were conducted with nurse clinic managers and 30 with the patients. Content analysis was used to analyze the data. Results: The key themes that emerged from the study included patients’ and nurses` perspectives on factors contributing to loss to follow up among HIV- positive patients; and Patients’ and nurses’ perspectives on strategies that would address barriers to loss to follow up among HIV- positive patients. Sub-themes on patients’ and nurses’ perspectives on factors contributing to loss to follow up among HIV- positive patients included: Lack of understanding of anti-retroviral treatment; fearful to disclose HIV status; lack of confidentiality; negative side effects; use of traditional medicine; self-transfer from one clinic to another. Patients’ and nurses’ elicited the strategies that would assist patients to remain in care and to take antiretroviral treatment consistently. The strategies included: providing patients with health education; working as a team; implementing social support group programme; providing nurses with in-service education on ethics and ethos. Informed by various intervention models in HIV care: Information Motivational Behavioural model; Health Belief Model; Social Action Theory and Social Cognitive Theory; I proposed a strategy that may reduce the rate of non-adherence and loss to follow up among patients with HIV in Limpopo Province. / HWSETA

MCur / Departrment of Advanced Nursing Science / In mental health, a Maximum-Security Ward is a special setting for care of patients who are unique and exceptional. People who have committed crimes due to their mental conditions are admitted for care, treatment and rehabilitation. Patients admitted in this ward are verbally and physically aggressive, violent, unpredictable, unmanageable and at times manipulative. Professional nurses working in the Maximum-Security Ward are at risk of suffering from occupational stress, burnout, lack motivation and are anxious. The aim of this study is to investigate the experiences of professional nurses working in the Maximum-Security Ward at Hayani hospital. A qualitative approach using a descriptive, exploratory and contextual design was used. A purposive, convenient sampling was used to sample professional nurses working in the Maximum-Security Ward of Hayani hospital. In-depth interviews were used to collect data. A voice recorder was utilised to record all data and the researcher being the main instrument for data collection. Dependability, confirmability and transferability were upheld to ensure trustworthiness of the findings. Data was analysed using Tech’s eight steps approach. Three themes with their categories and subcategories emerged after data analysis. The themes were as follows: the participants’ views on type of patients admitted in the ward, participants’ views on safety in the ward and participants’ views on staff interaction. The study recommended the following: Emotional counselling and debriefing sessions to be conducted at regular intervals or after a traumatic incident. Motivational and team building activities to be organised for professional nurses. Safety of professional nurses must be of significant value. More support is needed in times of emotional difficulties. Development of a model to support professional nurses. / NRF

The study was undertaken to deepen understanding of living with a spinal cord injury (SCI) in the rural communities of the Eastern Cape Province, South Africa (RSA). The OR Tambo District Municipality, which was selected for its accessibility to the researcher, is virtually rural, the infrastructure is poorly developed and there is low socio-economic activity in the rural areas of the old Transkei. In the RSA services for management and rehabilitation of SCIs varies from province to province. A Heideggerian phenomenological approach was used to interpret the meaning of living with SCI persons in a rural community. The purpose was to describe and interpret what being-in the-world as a spinal cord injured person meant to the particpants. A key assumption in phenomenology is that understanding human beings and their actions is best achieved through examination of human experiences. Experience, including experience with living with SCI, offers itself as a record of human encounters, the interface between persons and their world, and experience can only be understood in terms of background and the social context of the experience (Pateman & Johnson 2000: 51). Phenomenological interviews with ten people living with SCI explored their experience. The overall goal was to increase awareness of their experiences of living with SCI, and to encourage incorporation of knowledge gained into nursing practice. The central question in the study was `What is it like to live with a spinal cord injury in a rural community? Data were analysed according to Heideggerian hermeneutic phenomenology. Two main themes were identified, namely reconceptualising being-in-the-world as a person with a disability; and being-with-each-other: experiencing being excluded, objectified and marginalized. The participants engaged in a process of reconstructing their identities following the traumatic loss of sensory and motor functioning. Data reflect the social and economic context in which living with SCI is experienced. The respondents' life experiences were influenced by socio-political, economic and historical factors, namely geographic location, poor infrastructure, poverty, low educational status, and unemployment and the community at large. It was noted that participants experienced difficulties in several areas in their daily life realm; naming, coping with health and disability problems, family interactions and relationships, and non-accessibility of amenities, including their own dwellings. In addition, being a person living with an SCI in the rural communities of the OR Tambo District Municipality carries a high physical and social risk due to lack of resources. The inability to live up to generally expected social roles led to role dissatisfaction. There is an urgent need for social support to overcome the negative societal attitudes experienced. They are forced into isolation with a limited social life and are poorly integrated into the communities in which they live. Most of what the participants raised pointed towards inadequate preparation for the outside world. Therefore, a holistic approach to rehabilitation is recommended, as holism means addressing the physical, social, emotional and cognitive needs. Accordingly, the researcher developed guidelines for facilitating community integration. In conclusion, understanding how people experience living with SCI in a rural community is an essential prerequisite to the development of appropriate strategies to facilitate community integration. / Health Studies / D. Litt et Phil (Health Studies)

The study was undertaken to deepen understanding of living with a spinal cord injury (SCI) in the rural communities of the Eastern Cape Province, South Africa (RSA). The OR Tambo District Municipality, which was selected for its accessibility to the researcher, is virtually rural, the infrastructure is poorly developed and there is low socio-economic activity in the rural areas of the old Transkei. In the RSA services for management and rehabilitation of SCIs varies from province to province. A Heideggerian phenomenological approach was used to interpret the meaning of living with SCI persons in a rural community. The purpose was to describe and interpret what being-in the-world as a spinal cord injured person meant to the particpants. A key assumption in phenomenology is that understanding human beings and their actions is best achieved through examination of human experiences. Experience, including experience with living with SCI, offers itself as a record of human encounters, the interface between persons and their world, and experience can only be understood in terms of background and the social context of the experience (Pateman & Johnson 2000: 51). Phenomenological interviews with ten people living with SCI explored their experience. The overall goal was to increase awareness of their experiences of living with SCI, and to encourage incorporation of knowledge gained into nursing practice. The central question in the study was `What is it like to live with a spinal cord injury in a rural community? Data were analysed according to Heideggerian hermeneutic phenomenology. Two main themes were identified, namely reconceptualising being-in-the-world as a person with a disability; and being-with-each-other: experiencing being excluded, objectified and marginalized. The participants engaged in a process of reconstructing their identities following the traumatic loss of sensory and motor functioning. Data reflect the social and economic context in which living with SCI is experienced. The respondents' life experiences were influenced by socio-political, economic and historical factors, namely geographic location, poor infrastructure, poverty, low educational status, and unemployment and the community at large. It was noted that participants experienced difficulties in several areas in their daily life realm; naming, coping with health and disability problems, family interactions and relationships, and non-accessibility of amenities, including their own dwellings. In addition, being a person living with an SCI in the rural communities of the OR Tambo District Municipality carries a high physical and social risk due to lack of resources. The inability to live up to generally expected social roles led to role dissatisfaction. There is an urgent need for social support to overcome the negative societal attitudes experienced. They are forced into isolation with a limited social life and are poorly integrated into the communities in which they live. Most of what the participants raised pointed towards inadequate preparation for the outside world. Therefore, a holistic approach to rehabilitation is recommended, as holism means addressing the physical, social, emotional and cognitive needs. Accordingly, the researcher developed guidelines for facilitating community integration. In conclusion, understanding how people experience living with SCI in a rural community is an essential prerequisite to the development of appropriate strategies to facilitate community integration. / Health Studies / D. Litt et Phil (Health Studies)