The research has worked towards the general aim of generating a synthesis of burnout in the nursing profession, and also towards coming to a synthesis of burnout in nursing from the perspective of the salutogenic paradigm. Existing knowledge from the literature has been consolidated and integrated, and 'new knowledge' of the phenomenological experience of the causes and symptoms of burnout and how nurses stay healthy, were presented. Firstly was discovered that burnout, over time is caused by various factors that are individual and personal and therefore not easily discovered by other than the phenomenological method, where the life world of each individual is described. Secondly, the study ofthe strengths that nurses exhibit in order to manage the tension and stress in their lives and not to succumb to illness, proved to be a sound and descriptive paradigm with great utilisation possibilities. Three answers to the salutogenic question, namely sense of coherence, hardiness and learned resourcefulness were presented in great detail. Thirdly, it was stated that the individual nurses and the nursing practice in general be made aware of: (1) the existence of burnout, (2) the contributing factors to burnout, (3) the various manifestations ofburnout at work and in the organisation, and (4) the coping strategies available to counter this problem in a positive and salutogenic manner. The phenomenological results of this research revealed a number of issues that have implications for both the prevention and treatment of burnout in nurses. The results especially established how nurses can operationalise their inherent salutogenic qualities. Specific salutogenic coping strategies emerged via the respondents. The research took a broad view of personality in health research. It studied the psychological processes underlying the observed connections between psychological variables and health outcomes. In order to study the operationalisation of these processes, a phenomenological, person-based approach was followed. They study focussed on health phenomena and the individual nurse was retained as the unit of analysis. This approach represented a movement away from a fragmented science, infatuated with technology and linked to a singular epistemology, towards a focus on the process and dynamics of personal experience. / Psychology / D. Litt. et Phil. (Psychology)

The purpose of the study was to explore and describe the lived experiences of neophyte professional nurses working in ICU during their first year post graduation with the aim to discover strategies to support the nurse in critical care unit. An explorative, descriptive, interpretative qualitative design was conducted to uncover the nurse’s experiences. A purposive sampling was used which is based on belief that the researcher’s knowledge about the population can be used to hand pick sample elements. Data was collected through in-depth unstructured interviews and written narratives. Collaizi’s method of data analysis was used. The study findings revealed that neophyte professional nurses experienced difficulties and challenges in adjusting to the unit because of lack of mentors emanating from the shortage of staff. Nurses experienced mixed feelings regarding the relationship with colleagues in terms of support received. / Health Studies / M.A. (Health Studies)

The key objective of this study was to determine the relationship between burnout (measured by the Maslach Burnout Inventory – Human Services Survey (MBI-HSS)), work engagement (measured by the Utrecht Work Engagement Scale), and sense of coherence (measured by the Orientation of Life Questionnaire developed by Antonovsky (1987)). A quantitative study using a cross-sectional survey research design was conducted on a randomly selected sample (N = 178) of nurses at a central hospital in Kwa-Zulu Natal. A theoretical relationship was established between the variables. The empirical relationship revealed statistically significant negative relationship between burnout and work engagement. A statistically significant negative relationship was also established between burnout and SOC. The findings add valuable knowledge to industrial and organisational psychology and can be applied to promote employee and organisational wellness. / Industrial and Organisational Psychology / M. Com. (Industrial and Organisational Psychology)

Hospitals are experiencing a critical shortage of qualified registered nurses. While traditional research explored reasons why nurses choose to leave their jobs, this study examined why nurses may choose to stay. Inter-relationships among cognitive, affective, and demographic variables and their impact on hospital nurses’ affective commitment to their current jobs were assessed. Participants included 134 full-time registered nurses in Dallas, Texas. They were asked about their tenure and educational degree, and completed the following measures online: Nurses’ Affective Commitment to Their Current Jobs; Nursing Stress Scale; Work Climate Questionnaire; and Coping Response Inventory. The results supported previous findings that nurses’ affective commitment to their current jobs was positively related to perceived autonomy support, percentage of reported coping approach strategies, and number of years worked in their current hospital unit. Furthermore, nurses’ affective commitment was negatively related to the two stress-related variables: number of chronic stressors (NCS) and intensity of stressors. In the primary analysis of the proposed Model of Nurses’ Affective Commitment to Their Current Jobs, a significant three-way interaction was found among perceived autonomy support and percentage of reported coping approach strategies (RCAS) on the relationship between NCS, and nurses’ affective commitment. A post hoc analysis found that nurses with a low level of RCAS had a significant change in the relationship between NCS and nurses’ affective commitment, depending on their level of perceived autonomy support. There was a negative relationship between NCS and nurses’ affective commitment for nurses’ with low levels of perceived autonomy support; whereas, there was a positive relationship between NCS and nurses’ affective commitment for nurses’ with high levels of perceived autonomy support. In addition, a secondary analysis on the model revealed that, for nurses working in their units less than six years, there was a varying degree of a positive relationship between RCAS and nurses’ affective commitment to their current jobs depending on the level of perceived autonomy support. However for nurses working more than six years, there was a negative relationship between RCAS and nurses’ affective commitment to their current jobs for nurses with low levels of perceived autonomy support. / text

The social phenomenon of stress and workplace burnout has spanned over five decades. Despite a plethora of literature that exists, there still remain problematic issues that neither scientific investigation or government legislation have been able to resolve. The literature examined throughout this research is extensive and does reflect this 50-year period. It demonstrates that studies into this phenomenon have attempted to define stress, identify causal factors of workplace stress, workplace burnout and environmental congruence; and discusses strategies (focused on both the individual and organizational levels) that have been implemented to effect beneficial outcomes for individuals affected by any one of these. As this thesis continues, the more recent literature gives a greater recognition to violence in the workplace and legislative enactments as preventative measures to reduce the heavy burden of costs, both physical and financial, to organizations. This extensive literature review indicates no answer to the problem has been identified to date and that this phenomenon remains, giving a clear indication that further scientific investigation is required to find a solution to what was described as the most serious health issue of the 20th century. Based on the literature examined this health issue has now gone well beyond the 20th century, giving relevance to the research study described in this thesis. The investigation is validated as vital and should be used as a basis for further research. This study undertook a collaborative social process, action research, empowering participants to identify and change stressful factors identified within their practice indicative to rural remote community mental health teams. A critical social theory arose out of the problems within the context of the research setting, based on the ideal that the significant issues for this group of individuals within this organization could be solved through the action research process. The group ‘existed’ within the issues indicative to this rural remote area, however these issues were outside their control. Through the implementation of the action research process courses of actions were undertaken that provided enlightenment in self-knowledge with dialogue heightening collective empowerment to effect change within their practice. The action research process, being a holistic process, facilitated this change in practice, developed and refined theory as it proceeded in a cyclic fashion within this local setting. It concerned actual not abstract practices in the social world in which these participants practice. This methodology facilitated examining the significant stressors identified by the Community Mental Health Support Team (CMHST) that caused distress, allowing them to implement changes in their practice. The forum provided an avenue that could reduce stressors significantly and prevent ongoing occupational stress that contributes to workplace burnout. It offered an opportunity to work with a group of participants in a nonhierarchical and non-exploitative manner and enabled members of this group to identify their roles as effective practitioners, empowering them to effect the changes they deemed as essential criteria to reduce the stress they were experiencing indicative to their remoteness. Critical reviewing throughout the data collection attempted to understand and redefine these significant issues. It aimed to acknowledge the way things were relative to how things could be improved from organizational, personal and wider community perspectives. Simple principles and guidelines of action research were followed potentiating acceptance as a rigorous research approach from a positivist perspective whilst retaining the attributes that characterise action research. There are solutions to the dilemma of the employee overcoming the debilitating effects of stress leading to workplace burnout. This includes the cooperation of managers, policy makers, academic researchers and government officials working collaboratively to reduce the impact of occupational stress. Through this collaborative process, changes can be effected to ensure the health of the nation improves and that relevant recognition is given to the fact that there is a significant threat to a healthy workforce. Examining the nursing profession from a social perspective provides alternatives to medicalising workplace injuries and illnesses. / Thesis (Ph.D.) - University of Adelaide, School of Population Health and Clinical Practice, 2008

Thesis (MCom)--Stellenbosch University, 2015. / ENGLISH ABSTRACT: South Africa has a population of just over 50 million people. However, there are only approximately 260 698 nurses according to the register of the South African Nursing Council. The nursing shortage is not only limited to South Africa, but is a global phenomenon, and this shortage is getting worse every day. Various factors can be blamed for the increasing nursing shortage. Every day nurses face demanding working hours, stressful work environments and a large shortage of resources. Nurses from private hospitals regard themselves as "overworked money-making machines". Nevertheless, the health care needed by the population of South Africa is rapidly increasing. The high prevalence of HIV/AIDS is also a challenging contributor, worsening the nursing shortage crisis. The current dysfunctional nursing situation in the healthcare facilities of South Africa reflects a negative image of the nursing profession. Consequently, the number of individuals considering nursing as a profession is decreasing. The nursing shortage is not only a threat to the wellbeing of nurses, but to the lives of millions of South Africans who need health care. A common phenomenon amongst nurses is burnout, which leads to decreased quality of care and high turnover rates and contributes to the nursing shortage. Also, other nurses experience work engagement and display organisational citizenship behaviour in the same working environments than the nurses who experience burnout. Work engagement (WE) and organisational citizenship behaviour (OCB) are ideal outcomes. This study investigated distinguishing factors between nurses that allow them to experience WE and exhibit OCB. The Job Demands-Resources model played an integral role in the study. Therefore, the specific focus of the study was job and personal resources, as well as job demands, as factors contributing to WE and OCB amongst nurses. Servant leadership (SL) as job resource, psychological capital (PsyCap) as personal resource, and IT (Illegitimate tasks) as job demand were identified as possible factors that explain the variance in WE and OCB. A literature review was conducted in which prominent antecedents of WE and OCB were identified. A number of hypotheses were formulated and tested by means of an ex post facto correlation design. The unit of analysis was nurses from two of the largest private hospital groups in South Africa. The nurses were employed at one hospital in Gauteng and three hospitals in the Western Cape. Data was collected from 208 nurses located within the chosen hospitals. Data collection on all five variables, namely work engagement, organisational citizenship behaviour, servant leadership, psychological capital and IT, was conducted by means of self-administered questionnaires. The measurements included in the self-administered questionnaire were selected in terms of their validity and reliability. The following measurements were included; Utrecht Work Engagement Scale (UWES), Organisational Citizenship Checklist (OCB-C), Servant Leadership Questionnaire (SLQ), Psychological Capital Questionnaire (PCQ) and the Bern Illegitimate Task Scale (BITS). The data collected was analysed by means of item analyses and structural equation modelling. A PLS path analysis was conducted to determine the model fit. The most significant findings were that SL, as a job resource, and PsyCap, as a personal resource, were positively related to WE amongst nurses. The results also revealed that PsyCap was positively related to OCB. Lastly, it was found that IT, as a job demand, are negatively related to WE amongst nurses. These results support the assumptions of the JD-R model that specific job and personal resources lead to WE. The results provide guidelines regarding practical managerial implications and strategies to address the challenges experienced by nurses. The results, together with the managerial implications, made it possible to provide valuable insights and recommendations for industrial psychologists, as well as for further studies. / AFRIKAANSE OPSOMMING: Suid-Afrika het ‘n bevolking van net oor die 50 miljoen mense. Daar is egter volgens die register van die Suid-Afrikaanse Verpleegkunderaad net omtrent 260 698 verpleërs. Die tekort aan verpleërs is nie net tot Suid-Afrika beperk nie, maar is ‘n globale fenomeen, en die tekort word elke dag groter. Verskeie faktore kan vir die toenemende verpleërtekort blameer word. Verpleërs word elke dag gekonfronteer met veeleisende werksure, stresvolle werksomstandighede en ‘n groot tekort aan hulpbronne. Verpleërs by privaat hospitale beskou hulleself as “oorwerkte geldmaakmasjiene”. Nietemin neem die gesondheidsorg wat deur die Suid-Afrikaanse bevolking benodig word, vinnig toe. Die hoë voorkoms van MIV/VIGS is ook ‘n uitdagende bydraer wat die verpleërtekort vererger. Die huidige wanfunksionele verpleegtoestand in die gesondheidsorgfasiliteite van Suid-Afrika word weerspieël in die negatiewe beeld van die verpleegberoep. Gevolglik verminder die getal mense wat verpleging as ‘n beroep oorweeg. Die verpleërtekort bedreig nie net die welstand van verpleërs nie, maar ook die lewens van miljoene Suid-Afrikaners wat gesondheidsorg benodig. ‘n Algemene verskynsel onder verpleërs is uitbranding (burnout), wat lei tot ‘n afname in die kwaliteit van sorg en hoë omsetkoerse en bydra tot die verpleërtekort. Ander verpleërs ervaar egter werksbetrokkenheid (work engagement) en vertoon organisatoriese burgerskapsgedrag (organisational citizenship behaviour) in dieselfde omgewing waar verpleërs uitbranding ervaar. Werksbetrokkenheid en organisatoriese burgerskapsgedrag is ideale uitkomstes. Hierdie studie het onderskeidende faktore onder verpleërs ondersoek wat hulle toelaat om werksbetrokkenheid te ervaar en organisatoriese burgerskapsgedrag te vertoon. Die model van werkseise en hulpbronne (Job Demands-Resources (JD-R) model) het ‘n integrale rol in die studie gespeel. Die spesifieke fokus van die studie was dus op werks- en persoonlike hulpbronne, sowel as werkseise, as faktore wat bydra tot werksbetrokkenheid en organisatoriese burgerskapsgedrag onder verpleërs. Dienaarleierskap en sielkundige kapitaal as werkshulpbronne, en illegitieme take as werkseis, is geïdentifiseer as moontlike faktore wat die verskil in betrokkenheid en organisatoriese burgerskapsgedrag verklaar. ‘n Literatuuroorsig is onderneem waarin belangrike antesedente van betrokkenheid en organisatoriese burgerskapsgedrag geïdentifiseer is. ‘n Aantal hipoteses is geformuleer en deur middel van ‘n ex post facto korrelasie-ontwerp getoets. Die eenheid van analise was verpleërs werksaam by twee van die grootste privaathospitaalgroepe in Suid-Afrika. Die verpleërs was werksaam by een hospitaal in Gauteng en drie hospitale in die Wes-Kaap. Data is by 208 verpleërs in die gekose hospitale versamel. Dataversameling oor al vyf veranderlikes, naamlik werksbetrokkenheid, organisatoriese burgerskapsgedrag, dienaarleierskap, sielkundige kapitaal en illegitieme take, is deur middel van selftoepasvraelyste versamel. Die volgende metings is ingesluit: Utrecht Work Engagement Scale (UWES), Organisational Citizenship Checklist (OCB-C), Servant Leadership Questionnaire (SLQ), Psychological Capital Questionnaire (PCQ) en die Bern Illegitimate Task Scale (BITS). Die versamelde data is deur middel van item-ontleding en struktuurvergelykingsontleding geanaliseer. ‘n Gedeeltelike kleinstekwadrate-baananalise (partial least squares path analysis) is onderneem om die passing van die model te bepaal. Die belangrikste bevindinge was dat dienaarleierskap, as ‘n werkshulpbron, en sielkundige kapitaal, as ‘n persoonlike hulpbron, positief verband hou met werksbetrokkenheid onder verpleërs. Die resultate toon ook dat sielkundige kapitaal positief verband hou met organisatoriese burgerskapsgedrag. Laastens is bevind dat illegitieme take, as ‘n werkseis, negatief verband hou met werksbetrokkenheid onder verpleërs. Hierdie resultate ondersteun die aannames van die model van werkseise en hulpbronne (J-DR) dat spesifieke werks- en persoonlike hulpbronne lei tot werksbetrokkenheid. Die resultate verskaf riglyne vir praktiese bestuursimplikasies en strategieë om die uitdagings wat deur verpleërs ervaar word, aan te spreek. Die resultate, tesame met die bestuursimplikasies, het dit moontlik gemaak om waardevolle insigte en aanbevelings vir bedryfsielkundiges, asook vir verdere studies, te maak.

1 online resource (vii, 138 leaves : ill.) / Following an awareness of an increased turn over of staff in the eating disorder unit as compared with other specialised units, in a psychiatric hospital in Johannesburg, South Africa, Tara Hospital, the researcher was motivated to investigate the issue. An exploratory, descriptive based research was chosen to explore and gain information about the topic and its implications. A qualitative research approach was used to gain insight into the perceptions and needs of the team working on the unit. The case study method was used. A pilot study was undertaken to test the validity of the interview schedules. The sampling category was a non- probability one. Individuals were selected from the population of staff working on the unit. Participants were selected from two groups, those who were presently working on the unit and those who had previously worked on the unit and now working in other units. Interview procedure involved personal semi-structured interviews conducted by the researcher and analysed qualitatively and a structured interview questionnaire analysed quantitatively. The researchers assumption that many staff members move from working in an eating disorders unit was confirmed and is due to the following: Staff turnover is due to constant exposure to occupational stress and burnout. Feelings of helplessness, a sense of being unappreciated and excessive exposure to conflict from the patients. In addition, staff experience minimum rewards leading to lowered job satisfaction due to the patients slow recovery rates and a poor prognosis of the illness. Staff also experience a change in their eating patterns and an increased awareness around food and food issues. Recommendations to the staff include: * Psycho-education on eating disorders. * Implementation of strategies to provide supportive care for all staff members. * Education on stress management and strategies to prevent staff burnout and lowered job satisfaction. * A multidisciplinary teamwork approach by the staff, when working in the unit. / Social Work / M. A. (Social Science in Mental Health)

Abortion is a highly controversial subject that has again come into the spotlight in South Africa due to the legalisation of abortion on demand in 1996. The results of various studies conducted since the Choice on Termination of Pregnancy Act 92 of 1996 was implemented, have indicated that abortion providers have met with a great deal of negativism and ostracism. This study focused on the implications of abortion work on nurses' social relationships with family, friends, colleagues and their communities. Recent literature was reviewed on the subject. The researcher however, found little information on this specific aspect of abortion. The study was conducted with abortion nurses from two government designated hospitals in the East London area responsible for abortion services. Thus, results cannot be generalised. This is a qualitative study that aimed at obtaining firsthand information regarding the personal experiences of abortion nurses. A non-probability sampling technique was used viz. criterion sampling. The Interview Guide Approach was used whereby in-depth, semi-structured interviewed were conducted with the guidance of a set of questions in the form of an Interview Schedule. The ten respondents were asked to share their recommendations as to possible measures that could address the challenges mentioned during their interviews. The researcher came to the conclusion that nurses' social relationships and lives are definitely impacted by abortion work. This impact is largely negative as the majority of respondents experience labelling, stigmatization and ostracism from family, friends, and their colleagues. Abortion nurses also experience a lack of social support, ambivalent feelings with regard to abortion, and a range of negative emotions ranging from stress and depression to frustration and anger. A number of repeat abortions are being done and there seems to be a general lack of contraception. The need exists for nurses to go to Value Clarification Workshops and also to get support in terms of compulsory, continuous, counselling. Separate wards should be set up for abortions whilst sex education should be included in school curriculums at both primary and secondary schools. Family planning and facts about the abortion process should also be included in these sex education programmes. Overall. the need exists for family planning initiatives to promote contraception and deter women from using abortion as a means of contraception. As this study reveals, conducting abortions has come at a great cost for the majority of nurses who lack social support and bear the brunt of anti-abortion sentiment expressed by significant others in their lives. The latter being the people who would normally be the one's they would turn to for help, counsel, support and assistance

The research has worked towards the general aim of generating a synthesis of burnout in the nursing profession, and also towards coming to a synthesis of burnout in nursing from the perspective of the salutogenic paradigm. Existing knowledge from the literature has been consolidated and integrated, and 'new knowledge' of the phenomenological experience of the causes and symptoms of burnout and how nurses stay healthy, were presented. Firstly was discovered that burnout, over time is caused by various factors that are individual and personal and therefore not easily discovered by other than the phenomenological method, where the life world of each individual is described. Secondly, the study ofthe strengths that nurses exhibit in order to manage the tension and stress in their lives and not to succumb to illness, proved to be a sound and descriptive paradigm with great utilisation possibilities. Three answers to the salutogenic question, namely sense of coherence, hardiness and learned resourcefulness were presented in great detail. Thirdly, it was stated that the individual nurses and the nursing practice in general be made aware of: (1) the existence of burnout, (2) the contributing factors to burnout, (3) the various manifestations ofburnout at work and in the organisation, and (4) the coping strategies available to counter this problem in a positive and salutogenic manner. The phenomenological results of this research revealed a number of issues that have implications for both the prevention and treatment of burnout in nurses. The results especially established how nurses can operationalise their inherent salutogenic qualities. Specific salutogenic coping strategies emerged via the respondents. The research took a broad view of personality in health research. It studied the psychological processes underlying the observed connections between psychological variables and health outcomes. In order to study the operationalisation of these processes, a phenomenological, person-based approach was followed. They study focussed on health phenomena and the individual nurse was retained as the unit of analysis. This approach represented a movement away from a fragmented science, infatuated with technology and linked to a singular epistemology, towards a focus on the process and dynamics of personal experience. / Psychology / D. Litt. et Phil. (Psychology)

Divorce is a phenomenon that affects the emotional, physical and social wellbeing of the divorcees and those close to them. The situation becomes complicated if the affected person has a responsibility of providing caring and nurturing services to the sick, either as a manager or as a practitioner. The extent of how the impact of divorce affects the performance of professional nurses in their roles as carers and as managers was unknown. The nature and quality of services that they render to their patients, their coping strategies and the support systems were unknown. The purpose of the study was to describe and explore the impact of divorce on work performance of professional nurses at the East London Hospital Complex with the aim of ensuring high quality patient care. The objectives of the study were to: explore and describe the lived experiences of female divorced professional nurses with regard to the impact of divorce on their work performance; identify their coping strategies and their support systems. An exploratory descriptive and contextual qualitative research design was used. A phenomenological approach was used. The participants were twelve (12) divorced female professional nurses. The purposive and snowball sampling as non-probability sampling techniques were used. An interview guide was used to conduct the interviews. Audiotape was used for recording the data. Tesch’s steps (1990) of analyzing qualitative data guided the data analysis process. According to the lived experiences of the participants, divorce is traumatic and painful with emotional, physical, financial and social impact. It had a negative impact on the professional nurses’ work performance. The coping strategies included acceptance of the reality, studying, involvement with club and church activities. Support was available from the families, church, friends, and colleagues. Recommendations are that: the employee assistance program be marketed more effectively by hospital management and be included in the hospital, departmental and unit orientation programmes; that a dedicated psychologist, as well as preventive intervention programs, be made available to employees dealing with divorce.