Text in English / This study explores and describes the perceptions of student nurses regarding professional nurses as role models in the clinical learning environment. An exploratory-descriptive qualitative approach was followed. The population for this study was the final year students in the programme: Bridging course for enrolled nurses leading to registration as a general nurse. Nonprobability, quota sampling was done. The study was conducted at two Gauteng campuses of a private nursing education institution. Two “World Café” conversations were conducted where after data saturation was achieved. The three major themes that emerged were professionalism of the professional nurse, the need for student support and the teaching and learning environment. From the students’ feedback it was evident that professional nurses should be aware of the important role they play in the professional and personal development of students. Professional nurses as role models should portray the professional behaviours and attitudes required by the profession. Students have a vision of how they expect to be when they qualify as professional nurses. Recommendations from this study relate to the three themes identified and clearly indicate that students have a realistic expectation of and a need for visible role models in the clinical learning environment. / Health Studies / M.A. (Health Studies)

Compassionate care is a crucial component of patient care in nursing practice in the broad context of holistic care. However, it is seemingly difficult for nurses to identify what exactly comprises compassionate care and how to provide it to patients. The purpose of the study was to explore the experiences of professional nurses on how they provide compassionate patient care. A qualitative descriptive study design based on narrative analysis was used. Thirteen professional nurses (PNs) from a private hospital were purposefully recruited to participate. Data was collected using written stories and professional lifelines. Data was analysed using thematic and narrative analysis. The following themes were identified such as treating the patient as a whole, inadequate knowledge and skills, and barriers to providing compassionate care. Future research using quantitative approach and large samples was recommended. / Health Studies / M.A. (Health Studies)

The purpose of the study was to investigate the perceived lack of empowerment of registered nurses in the Mpumalanga Province. To determine the reasons for the perceived lack of empowerment and the effect thereof on professional conduct after which empowerment guidelines would be developed which managers can apply in order to enhance the empowerment of registered nurses in their service, and in turn cultivate confident nurse leaders. The main study objectives were to describe what empowerment entails, and its effect on professional conduct in the workplace; explore the level of empowerment among nurse managers and registered nurses; ascertain the effect of perceived powerlessness on the professional conduct and behaviour of nurse managers and registered nurses; establish the reasons for the perceived lack of empowerment among nurse managers and registered nurses; determine if there is a difference in the way in which nurse managers and registered nurses perceive the existing empowerment in their public hospitals and to develop empowerment guidelines for nurse managers and registered nurses. Kanter’s Theory of Structural Empowerment formed the basis of the study and guided the structure of the report. This theory contains three components, each with several dimensions resulting in 14 factors to be tested. A quantitative research approach, with an exploratory and descriptive design was used. Using a researcher-developed questionnaire as the data collection instrument. The site population consisted of one randomly selected district containing eight public hospitals in the Mpumalanga Province. All nurse managers and registered nurses in these hospitals were invited to participate in the study. The researcher delivered the questionnaires to the respondents of the eight hospitals that met the inclusion criteria. Two hundred and sixty seven (267) completed questionnaires were collected upon completion resulting in a response rate of 30.2%. Descriptive and inferential statistics were used to analyse the data. Generally, the results indicated that the majority of the respondents felt empowered with the dimensions contained under the structural empowerment, psychological empowerment and positive work behaviours and attitudes components of Kanter’s Theory. However the respondents noted that they had limited resources. According to the results those nurse managers and registered nurses who felt empowered, scored strongly in the areas of structural and psychological empowerment. The empowerment guidelines were developed for dimensions which were found to be non-empowering to assist nurse managers and registered nurses in creating workplace environments that could enhance the empowerment of registered nurses in their hospitals. / Health Studies / D. Litt. et Phil. (Health Studies)

Text in English / Little is known about the current practice of the nurse practising as an independent private practitioner in South Africa. There is also limited information available about his/her needs for establishing and maintaining a private practice. In this exploratory, descriptive study the AFFIRM model was applied and specific data regarding the practice and needs of the nurse in private practice was collected through a questionnaire. Based on the analysed data, it would appear that the majority of private nurse practitioners are married females and fall into the age group below 44 years. Although a variety of nursing services are offered, quality control appears to be minimal. It was found that private nurse practitioners have specific learning needs particularly regarding business management skills, quality control and current nursing practices. Recommendations were made for the maintenance of standards in private practices and the introduction of short courses for nurses in private practice. / Health Studies / M.A. (Nursing Science)

Descriptive surveys were employed to investigate the competencies of newly qualified nurses (NQNs) as viewed by senior professional nurses (SPNs). The study used questionnaires for collecting data. Questionnaires were delivered by the researcher and also collected by the researcher after completion. SPNs working at thirteen hospitals, that is, six in the former Gazankulu, three in the fonner Venda, and four in the form.er Lebowa health services (falling within the Northern Province of the RSA since April 1994) constituted the subjects of this study. Scientific sampling techniques were not employed as the total population of 396 SPNs was studied. This study obtained responses from 259 SPNs. Findings indicated that specific cognitive, affective and psychomotor competencies were expected ofNQNs upon entering the work setting, as perceived by SPNs. NQNs were perceived to be competent in performing numerous, but not all, clinical competencies which were outlined in the four groups' questionnaires. Application of stages of the nursing process (problem solving and clinical judgement), research, management and administration of a clinical unit, nursing ethics and critical care were perceived by the SPNs to be the central focus ofNQNs' incompetency in all four clinical nursing units, namely community, psychiatric, midwifery and general units. Nevertheless, SPNs were aware that they should provide guidance and support to NQNs. An attempt to elicit SPNs' views on the competencies NQNs should have in the practical situation, could benefit NQNs at grassroots level. Such information could provide curriculum developers with realistic input which would assist in the delineation and refinement of the professional competencies expected of nurses trained in the comprehensive course leading to registration as a nurse (general, psychiatric, and community) and midwife. The identified competencies could improve the quality of care and the nursing standards if they could be mastered by NQNs in the health services included in this research. On the basis of these research findings, the expected competencies, which were perceived by the SPNs to be incompetently performed by NQNs, were used to compile an orientation list of competencies to be mastered by NQNs in their first professional position (Annexure D). / Health Studies / D.Litt. et Phil. (Advanced Nursing Science)

M.Cur. (Maternal and Child Nursing Science) / The implementation of the PMTCT programme was conceptualised in 2000. The aim of this study was to determine the views of midwives regarding the implementation of the PMTCT programmes in the public health centres in Soweto. Data was collected from midwives involved in the implementation of PMTCT in antenatal clinics by means of semi-structural interviews. Of the 20 midwives (N=20) interviewed, only five (5) midwives attended formal training. The discussion of the views of midwives regarding the implementation of PMTCT centered around the lack of formal training, lack of resources, lack of infrastructure, negative attitude of the community, lack of budgeting, lack of support by colleagues and poor management support, language barriers in communication and religious beliefs. This study found that midwives need to go for formal training on PMTCT programmes and that more research need to be done in this field. Moreover, the findings from this study have implications for clinical practice. In addition, guidelines were formulated to help midwives and other health care practitioners to implement the PMTCT programmes in antenatal care.

In South Africa, the quality of health care is directly related to the concept of patient-centred care and the enactment of the Batho Pele Principles and the Patients’ Rights Charter. The quality of health care delivery has dropped drastically, and reports in the media indicate that public hospitals in the Eastern Cape Province are on the brink of collapse, with thousands of patients being treated in condemned hospitals. Receiving and rendering health care in the face of such challenges, the question arose: “Are patients receiving patient-centred care in public hospitals?” The answer to this rhetorical inquiry appeared to be obvious, but this research study explored and described professional nurses’ perceptions of patient-centred care in public hospitals and their understanding of evidence-based practice and best practice guidelines. The proposed study followed a qualitative, exploratory, descriptive and contextual design. The research population included professional nurses who are employed in public hospitals in Nelson Mandela Bay, and consisted of nurse managers and nurses who work in the wards. The research study consisted of three phases. In Phase 1, semi-structured interviews and focus groups were conducted with nurse managers and professional nurses working in the wards in order to collect data about their perceptions of patient-centred care and their understanding of evidence-based practice and best practice guidelines. The interviews were transcribed and Tesch’s eight steps of data analysis were followed to create meaning from the data collected. Themes were identified and grouped together to form new categories. The researcher ensured the validity of the study by conforming to Lincoln and Guba’s model of trustworthiness, which consists of the following four constructs: credibility, transferability, dependability and confirmability. An independent coder assisted with the coding process. In Phase 2, an integrative literature review was conducted in order to identify previous guidelines regarding best practice for patient-centred care. Relevant guidelines were selected, critically appraised, data was extracted and synthesised for the development of a best practice guideline for patient-centred care. An independent appraiser critically appraised the guidelines, thereby ensuring trustworthiness. In Phase 3, the data in Phase 1 and Phase 2 were integrated to formulate a draft best practice guideline for patient-centred care. The guideline was submitted to an expert panel for review and was modified according to the recommendations of the panel, whereby the best practice guideline for patient-centred care in public hospitals in Nelson Mandela Bay was finalized.

The purpose of the study was to explore and describe the experiences of male community service officers during midwifery clinical training. A qualitative, explorative, descriptive and contextual design was used in order to achieve the study objectives. Data was collected by means of semi-structured interviews. Data analysis elucidated analogous themes and categories which translated into the overall experiences of the participants. The study found that whilst the experience was described as beneficial, there were overwhelming challenges in providing intimate care to female clients, dealing with ethno-cultural aspects, meeting clinical practice requirements and the right to choose to be part of midwifery clinical training. Recommendations to nurse educators, clinical midwives and midwifery clinical supervisors with regard to better support for male nurses during midwifery clinical training emanated from the study findings / Health Studies / M.A. (Health Studies)

Department of Advanced Nursing Science / MCur

Mahole, E / MPM / Oliver Tambo Institute of Governance and Policy Studies