The purpose of this qualitative study was to explore and describe the extent to which registered nurses’ practice was affected by emergency department overcrowding. Participants were recruited from a tertiary hospital by using the purpose sampling method. Data collection was done using a semi-structured interview guide. Individual interviews were conducted with eight registered nurses working in the paediatric emergency department. Data analysis was conducted using thematic content analysis and Yin’s (2003:178) five-phase cycle. The study findings revealed that the lack of professional nurse leadership and the difficult existing relationship with the physicians were obstacles that had to be obviated if the paediatric ED were to function optimally and best practice were to be achieved. It was revealed that a problematic issue in the setting was that the most critical decisions on allocating where patients should be treated were made by physicians who have more authority than nurses. It was recommended that the ED need to be clearly defined in the policies as an outpatient, emergency care or as an episodic patient care area as “Admission” can mean admission to the ED or admission as an inpatient/boarded patient. / Health Studies / M.A. (Health Studies)

The objectives of the study were to: 1) determine how the variables of occupational stress, job satisfaction, work engagement and social support conceptualised in literature, 2) describe the levels of occupational stress, job satisfaction, work engagement and social support, 3) determine the relationship between occupational stress, job satisfaction, work engagement and social support, 4) assess the predictive value of occupational stress on job satisfaction and work engagement, 5) determine the mediating role of social support on the effects of occupational stress on job satisfaction and work engagement. The research questions following on from the objectives were as follows: 1) how are the variables of occupational stress, job satisfaction, work engagement and social support conceptualised in literature? 2) what are the levels of occupational stress, job satisfaction, work engagement and social support among nurses? 3) what is the relationship between occupational stress, job satisfaction, work engagement and social support among nurses? 4) what is the predictive value of occupational stress on job satisfaction and work engagement among nurses? 5) what is the mediating role of social support on the effects of occupational stress on job satisfaction and work engagement among nurses? In order to answer the research objectives, this study used a cross sectional design. The present research study used a quantitative approach. The convenience sampling method was used for the purposes of data collection. Data was gathered from the wards of a public hospital in Durban. A sample of 120 voluntary participants was obtained, comprising of 109 females and 11 males. Data was collected using survey questionnaires which included the following five parts: 1) Biographical Information Questionnaire, 2) the Nursing Stress Indicator, 3) the Minnesota Satisfaction Questionnaire, 4) the Utrecht Work Engagement Scale, 5) and the Social Support Questionnaire. All data were analysed using SPSS version 19.0 for Windows. The results of the study showed that the nurses experienced high levels of occupational stress, low levels of job satisfaction and work engagement; and moderate levels of social support. There was a significant relationship between occupational stress, job satisfaction, work engagement and social support among the nurses. The results showed that occupational stress predicts the levels of job satisfaction and work engagement. The results also showed that social support mediates the effect of occupational stress on job satisfaction and work engagement. Recommendations and the value added by the study was also stated. The limitations of this study were also noted. / Thesis (M.Soc.Sc.)-University of KwaZulu-Natal, Durban, 2012.

Introduction: It was previously established that mental health workers in Rwanda experience secondary traumatic stress when working with trauma survivors. The effects of secondary traumatic stress can be serious and permanent in mental health workers when working with traumatized clients. It interferes with mental health worker’s ability to do their work effectively. Aim: This study aimed to explore STS and to develop an intervention model to manage secondary traumatic stress in mental health workers in Kigali, Rwanda. Methodology: This study was carried out into five cycles using action research approach. In the first cycles of the study a quantitative design was used to explore secondary traumatic stress in mental health workers in Rwanda. For this cycle, the particular aim was to determine the extent of the secondary traumatic stress in mental health workers in Rwanda. A total of 180 participants were selected using convenience sampling to be part of the quantitative study. In the second cycle of the study a qualitative design was used to explore mental health workers’ experiences of secondary traumatic stress. For this cycle 30 unstructured interviews were conducted. The third cycle aimed at developing the model to manage secondary traumatic stress. Action research approach was used in this phase. Experts from mental health services involved in the study were asked to participate in the study based on their availability as research team members. The fourth cycle of the study consisted of implementing the model in one mental health service and the fifth cycle consisted evaluation of the implementation of the model after six weeks period. The main aim of this cycle was an observation of the model implantation. Results: A diagrammatical model to manage secondary traumatic stress was developed by mental health professionals. In the model development cycle of the study, it emerged that there are very strong concurrence between the findings from experts in mental health care system and literature in terms of what needs to be included in the intervention model to manage secondary traumatic stress in mental health workers in Rwanda. The key elements to include in the model were based on preventive, evaluative and curative strategies to manage secondary traumatic stress in mental health workers in Rwanda. During the evaluation of the implementation, it emerged that participant noticed a change in coping strategies when facing the stressful incident in the practice. Recommendations: include an emphasis on more psychological support for mental health professional in their workplace and for more concrete aids such as supervision, guidelines on stress management on workplace, education on secondary traumatic stress management and implementation of counseling service for mental health workers. Conclusion: The model developed in the present study outlined different ways to manage STS at the individual, social and organizational levels. There is a need to translate the interventions to manage STS into active ongoing coping activities to be conducted at the individual, group and organizational levels. Organizational responses, such as creating a supportive organizational culture that acknowledges the potential for secondary traumatic stress, may help mental health workers to deal with workplace related secondary traumatic stress. / Thesis (Ph.D.)-University of KwaZulu-Natal, Durban, 2010.

INTRODUCTION: Providing sufficient quality nurses in resource strapped countries is a human resource management challenge which nurse managers’ experience on a daily basis. THE PURPOSE of this study was to analyse and to determine the issues which affect the the human resources management of nurse managers in selected hospitals in the eThekwini District of the Province of KwaZulu-Natal, South Africa, and to formulate draft guidelines to assist nurse managers with human resource management. METHODOLOGY: A constructionist, reflexive ethnographic approach was used. The ethnographer spent two years in the field collecting data from informants, who were nurse managers, in four (4) selected district hospitals. Data was collected using unstructured informant interviews, non-participant observation and confirmatory document analysis. Data analysis led to eliciting codes from the data, searching for semantic relationships, performing componential analyses and discovering the themes for discussion within the final ethnographic report. A nominal group process was used to develop the draft guidelines. FINDINGS: The findings showed that the human resources management around sick nurses is a complex task. The themes of nurse managers’ experiences were a “burden” of maintaining confidentiality, as well as an emotional burden. Administratively, they experience the burden of absenteeism and the burden of policy compliance. The final theme is the burden of the deaths of HIV and Tuberculosis affected/infected nurses. CONCLUSION AND RECOMMENDATIONS: Organizations should create a non-judgmental work environment where non- disclosure by employees is respected in order to promote disclosure. They should have an awareness of the emotional effect on nurse managers and provide them with support. Emphasis needs to be placed on an HIV and AIDS policy and programme, incapacity leave workplace strategies and return to work policies. It is also recommended that contingency plans be provided when the death or prolonged absence of an employee impacts the staffing of the organization; consideration to be given to piloting and refining the draft guidelines; the management of employees on prolonged sick leave be included in the Nursing Administration Curricula taught to future nurse managers; and further research be conducted to assess employee reluctance to report needle stick injuries (sharps injuries) as well as the related phenomenon of stigmatization. / Thesis (Ph.D.)-University of KwaZulu-Natal, Durban, 2014.

The aim of this study is to explore and describe the coping skills of registered nurses in a changed working environment. The research is conducted in the City Health clinics. The objectives of the study are:  to identify strategies which nurses use to cope with the changes in the health care services;  to explore appropriate support systems that will enhance the coping skills of registered nurses in clinics in the City Health Department; and  to deduce guidelines on how to support staff from the literature study and the results of the research. The research problem is the following: nurses in primary health care facilities do not adequately cope with major changes in health care delivery. A qualitative approach for the research was chosen. Personal interviews and focus group discussions were used to identify the coping skills of registered nurses. Data analysis was done manually. Transcriptions of recordings of the individual interviews and group discussions were done. Themes were organized and categorized into meaningful links and relationships. The findings indicate that the following factors improve the coping skills of registered nurses:  team-work and support;  to voice your opinion when necessary and good communication between staff;  regular breaks during working hours;  inherent factors for example strong spiritual and emotional strength that assist registered nurses to cope;  family support;  the provision of quality care is rewarding;  the assistance and support from the church (congregation);  the effective re-organisation of health services;  continuous support programs for staff; and  continuous education to develop skills of registered nurses. / Advanced Nursing -- Psychological aspects / M.A.

D.Cur. / The impressive growth in the extent and range of psychiatric services provided by general hospitals in South Africa, creates stress among nurses employed in these settings which manifests its self in the negative attitudes displayed towards mentally ill people, refusal of dual diagnosis patients transferred from medical surgical units and poor intra-institutional relationships between nurses in medical-surgical units and those who are in the psychiatric unit. This has led to the research study aimed at describing a model for support to assist general hospital nurses mobilize appropriate resources in the process of nursing mentally ill people. The research methodology followed the research model in nursing proposed by Botes (1995). A theory generative, qualitative, explorative, descriptive and contextual design was followed. The research methods were dealt with in four steps of theory generation in the following manner: Step 1: Concept analysis: This step was dealt with in two phases which are concept identification and concept definition. During concept identification, a qualitative research strategy which is explorative, descriptive and contextual was used. This was attained through field research conducted in an urban general hospital. A sample of twelve professional was selected from a population of 800 professional nurses employed in a general hospital using a purposive sampling technique. This sample size was determined by saturation of data in themes. Both semi-structured individual phenomenological interviews and observations were used as methods of data collection. The field work was conducted without any preset theoretical framework of reference by using "bracketing" and "intuiting". Giorgi's (1986) method of descriptive data analysis was used. After data analysis, the results were reflected within the Nursing for the Whole Person Theory. Four themes emerged from the results of the study which were:1) the experience with the perception of the mentally ill people, 2) the experience with interpersonal communication patterns, 3) nurses' experience of violence and lastly, 4) the experience of inappropriate patient behaviours. It became clear that the experience of nursing mentally ill people was negative and affected the social, psychological and the physical dimensions of nurses. The results were validated through literature control. The major concept of model was identified as "facilitation of communication". The concept was analysed thoroughly by looking at the dictionary and subject usage. The defining attributes were identified and synthesised through a definition. The other related concepts were identified and classified using a survey list of Dickoff, James & Wiedenbach (1968:430). Step 2: Step 2 dealt with the creation of interrelationship statements between concepts identified in step 1, so that concepts were able to stand in relation to one another. Step 3: dealt with the description of the model using strategies proposed Chin & Kramer (1991). Step 4: dealt with the description of guidelines for model operationalization in practice, education and research. The evaluation of model operationalization will be carried out in future research. To ensure valid results, a model trustworthiness proposed by Guba (Lincoln & Guba, 1985) was used. The following criteria for trustworthiness was applied in all the steps of theory generation: truth value, applicability, consistency and neutrality.

Negative events encountered in daily life influence individual well-being. Individuals vary in their reactivity to these events, the extent to which they are behaviorally, physiologically, and psychologically influenced by them (Almeida, 2005; Neupert, Almeida, & Charles, 2007). Reactivity to events in the form of changes in health behavior could represent either an attempt at coping (Cooper, Frone, Russell, & Mudar, 1995) or a stressor-related failure of self-control (Muraven & Baumeister, 2000). Such changes in behavior could have later effects on health. Although a great deal of attention has been paid to both the immediate and long-term effects of stressors on individuals, little is understood about the potential relationship between these immediate and long-term consequences. Exploration of this connection could not only expand the understanding of the relationships between stressors, behavior, and well-being, but also inform intervention strategies. One important domain in which stressors occur is work; certain occupations such as nursing expose individuals to a greater likelihood of experiencing stressors simply by nature of the tasks and/or environment involved. As a nursing shortage continues, stress is in fact one of the most-often cited reasons for nurses to leave the profession (Cangelosi, Markham, & Bounds, 1998). Using a sample drawn from the Oregon Nurse Retention Project and the relatively novel statistical method of slopes-as-predictors, I examined the relationships between work stressors and nurses' health behaviors (alcohol consumption, diet, exercise) and then used those relationships as predictors of follow-up outcomes (depression, life satisfaction, perceived health). Significant variability was found for five combinations of stressors and health behaviors, indicating that varying patterns of health behavior reactivity were indeed present in this sample; moreover four of those five stressor-behavior (reactivity) slopes emerged as significant predictors of later health and well-being. Notably, reactivity in the form of increased days of exercise during weeks of greater demands or negative events was associated with lower depression scores, and reactivity in the form of increased days of exercise during weeks of greater conflicts was associated with greater satisfaction with life. Implications of these findings, including the importance of exercise in maintaining well-being, are discussed.

Thesis (Ph.D. (Psychology)) -- University of Limpopo, 2022 / This thesis is about evaluating the effectiveness of a self-care programme for intervention in burnout and compassion fatigue among nurses working in critical care areas. A convenient sampling method of all the nurses who work in the critical care areas as per the operational definition of terms for this study was used. A total of 154 nurses in a critical care area participated in this pre-post study, of which (n=83) were CTOP Nurses and (n=71) were Forensic Nurses. The nurses completed a biographical questionnaire, the Professional Quality of Life Scale (ProQOL R-IV), the Empathy Assessment Index Scale (EAI). Nurses were divided into groups of 6 to 10 people for focus group discussions on their work experiences. The results of the current study indicated moderate to high levels of burnout and compassion fatigue occurring with high compassion satisfaction among the nurses. However, the mean burnout scores for CTOP nurses and Forensic nurses and details indicated lack of statistically significant difference post-intervention (p>0.05). The study utilized the Context Process Outcome (CPO) model as its framework. The proximal outcomes centred around safe holding, development of awareness and self-care. Intermediate outcomes consisted of drop in burnout and compassion fatigue and the distal outcomes showed increase in empathy and revived motivation to continue work in critical areas as well as a drop in distress and increase in compassion satisfaction. The project was ground-breaking work of research with nurses in the critical areas with regards to health promotion with promise in healthier ways of caring for the carers and their empowerment and intervention outlook on the challenges around working environment stressors and interventions. Such work could in future benefit health care professionals by predicting possible decrease in their productivity by measuring other non-invasive constructs like empathy which has shown probable predictive power on development of burnout and compassion fatigue as well as improvement of satisfaction. Future research is recommended for inclusion of other health professions in such work and not only nurses, as well as doing evaluation that allows intermittent re-alignment whenever indicated in the process of intervention

Thesis (M. Nursing) -- University of Limpopo, 2022 / Background: Emergency departments (EDs) as the hospitals' front door have a critical role in ensuring access to and efficient care of acute illness and injuries in the healthcare system. The environment in EDs is physically and emotionally demanding and burdened by complex patient loads, long shifts, and administrative challenges resulting in high pressure and high volume workloads amongst the staff members. Purpose: The study aimed to develop support strategies for the resuscitation team in EDs of Mankweng and Pietersburg public hospitals in Limpopo Province, South Africa. Study method: A descriptive, phenomenological, and explorative research design was used to explore the resuscitation team's experiences and the available strategies to support them. Purposive and convenience sampling methods were used to select five Medical doctors and twelve Professional nurses to participate in the study. The sample size was determined by the depth of the information obtained from the participants.Data was collected through semi-structured individual interviews. Interview guide was developed to guide with organised line of questioning and thinking. Qualitative data analysis using Tesch's approach was then followed. The quality of data was ensured by applying four elements; credibility, transferability, dependability, and confirmability. Turfloop Research Ethics Committee, the Limpopo Department of Health, and the Mankweng/Pietersburg Ethics Committee permitted the study. The study's details were explained to potential participants, who then agreed to be part of the study and signed consent forms. Results: The following themes emerged: Challenges related to the shortage of resources in the ED, challenges related to lack of standardized procedures and policies for handling the resuscitation process, psychological challenges of resuscitation failure, leadership, and managerial support challenges, and challenges related to education and training of the resuscitation team. Conclusion: This study's results indicated that the resuscitation teams of EDs from Mankweng and Pietersburg Public Hospitals face challenges that cause them stress and burnout. The challenges result from an increased overload of work with no personnel and material resources. They become demoralized by being engaged in failed resuscitation with no psychological support from the management. They don't receive any debriefing or counseling post failed resuscitation and no educational backing of the management. The study's findings guided the researcher in developing strategies to support the resuscitation teams in the EDs of Mankweng and Pietersburg Public Hospitals.

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)