PhD (Nursing Science) / Department of Advanced Nursing Science / State patients are admitted to the psychiatric hospital after being declared as such by a court of law in South Africa. After successful rehabilitation of state patients at the psychiatric hospital, they need to be reintegrated into their families. Perceptions of family members of male state patients regarding reintegration including development of a model to support such reintegration, is not largely explored in the scientific body of knowledge. The aim of this study was to develop a model to support reintegration of state patients into their families in Limpopo Province, South Africa. A qualitative approach using descriptive, explorative, and contextual designs was adopted for this study. The study population was family members whose relatives are male state patients admitted and recorded in the admission register of Hayani Hospital, in Limpopo Province. The study was conducted in two phases of which phase one was a situational analysis, and phase two was the development of the model to reintegrate male state patients into their families. This study was conceptualized within the Social Ecological Model (SEM) of human behaviour (Stokols, 2013), the grounded theory for model development outlined in Dickoff et al. (1968), and the approaches outlined in Chinn and Kramer (2008); Walker and Avant (1995). Model evaluation was done by a group of health professionals, some of whom are advanced psychiatric nurses who are doing masters and doctoral studies, and one doctoral graduate who is also an advanced psychiatric nurse. Presentations were made to this group during peer review sessions who in turn gave critical comments regarding the developed model to support reintegration of male state patients until the final model was accepted. Non-probability purposive and convenient sampling were used to sample a hospital and 10 family members of Venda-speaking male state patients. In-depth individual interviews were used as the instrument to collect data which was pretested on one family member who did not form part of the study. Data was analysed using thematic analysis approach. Data was co-coded by an independent doctoral degree graduate to ensure trustworthiness. Conducting home visits by health professionals came up strongly during data analysis. Credibility, dependability, confirmability and transferability to ensure trustworthiness of the study, as well as ethical considerations were adhered to. The findings of the study yielded two themes, being perceptions of participants regarding reintegration of male state patients, and perceptions of participants regarding the support needed from family members to reintegrate male state patients. During phase one, the results indicated that family members accept reintegration and also that they indicated the kind of support needed, that lead to phase two of developing a model to reintegrate male state patients. The study was restricted to only one hospital in the Vhembe District out of the five districts of the Limpopo Province.The researcher acknowledges that this study was contextual and that only family members of male state patients were interviewed, the perceptions of family members of female state patients were not heard. The study concluded that there are perceptions that family members of male state patients have regarding reintegration of these patients into their families. Furthermore, family members of male state patients can describe the kind of support that they need in order to reintegrate male state patients into their families. This should be done using the developed model that should involve family members and the community. The study recommends that psychiatric hospitals should implement the model involving family members of male state patients. Furthermore, a longitudinal study should be conducted for a period of 3-5 years to check the effectiveness of the model. / NRF

Public demands have forced countries to explore new ways of rendering primary health care to reach the poor who are not within reach of the modern health care systems. New categories of health care personnel, like lay health workers emerged. There are vast differences in the roles of these lay health workers as was revealed with an extensive literature search. The phenomenology qualitative research method was used to investigate perceptions of farm lay health workers regarding their roles in rural areas. A convenience, non-random sample (N=5) was used for focus group discussions and in-depth interviews to collect data. The latter revealed five main themes associated with the role of farm lay health workers: (1) community link; (2) carer; (3) community developer; (4) counsellor and (5) role model. Guidelines were formulated to enhance the role of lay health workers in the rural Western Cape Province and to improve the quality of care to rural communities / Health Studies / M.A. (Health Studies)

The purpose of this study was to investigate the possibility of implementing community based care for moderately mentally retarded persons in a specific centre in the Port Elizabeth area. The objectives of the study were to identify • the needs of the moderately mentally retarded children. • the physical, psychosocial and vocational rehabilitation means of meeting these needs. • how involved the communities, parents and government were in the care of moderately mentally retarded children. A quantitative, exploratmy and descriptive design was used. A sample of 50 moderately mentally retarded children was utilised. Data were collected by means of questionnaires and semi-structured interviews. The major research findings indicate that community care for MMRPs could only be feasible with sufficient resources, expertise and community involvement. All these aspects appeared to be lacking in the centre where this research was conducted raising questions as to benefits which the mentally retarded children and their parents and the community could derive from these services. However recommendations were made on identified shortcomings, problems and needs. / Health Science / M.A.(Nursing Science)

The purpose of this study was to investigate the possibility of implementing community based care for moderately mentally retarded persons in a specific centre in the Port Elizabeth area. The objectives of the study were to identify • the needs of the moderately mentally retarded children. • the physical, psychosocial and vocational rehabilitation means of meeting these needs. • how involved the communities, parents and government were in the care of moderately mentally retarded children. A quantitative, exploratmy and descriptive design was used. A sample of 50 moderately mentally retarded children was utilised. Data were collected by means of questionnaires and semi-structured interviews. The major research findings indicate that community care for MMRPs could only be feasible with sufficient resources, expertise and community involvement. All these aspects appeared to be lacking in the centre where this research was conducted raising questions as to benefits which the mentally retarded children and their parents and the community could derive from these services. However recommendations were made on identified shortcomings, problems and needs. / Health Science / M.A.(Nursing Science)

South African health systems are struggling to cope with the HIV/AIDS pandemic. Home based care has become an invaluable resource that relieves overburdened and under-resourced hospitals. Home based carers provide basic nursing care and support to patients and their families, in the patient's home. Little is know about what motivates home based carers. Minimal research has been undertaken to investigate the expectations and experiences of these noble voluntary helpers. This study was conducted with a sample of home based carers at Community Outreach Centre, St Mary's, Mariannhill. Being field focused it used a qualitative research approach and participatory action research methodology. Focus group discussions were conducted with home based carers to explore their needs, motivations and expectations of Community Outreach Centre. The study enlightens us about issues related to home based care that directly affect them. Despite the painful realities of their lives, they appeared positive about serving as volunteer home based carers. / Social work / M.A. Social Science (Social Work)

Curative primary health care nurses are the first level of contact with health personnel the patient has when entering the district-driven health system of South Africa. It is imperative that these nurses are competent, or patients may suffer. Several factors exist as barriers to competent curative care. Donabedian's structure-process-outcome framework has been used in the study of these factors. Literature were selected from international and national studies of nursing to discover barriers and enablers in general nursing care but also specifically in curative primary health care. The curative primary health care nurses in the Southern Cape/Karoo region were used as a sample for the study. Data gained from questionnaires were organised to present the findings: Barriers to a curative PHC service seem to be multifactorial, with scarce resources causing great stress for the workforce. This have a negative impact on relationships between employer and employee, CPHCNs and their patients, the type of managing that take place, and the quality of the examination and treatment of patients. Slow changes frustrates workers, causing more stress and poor attitudes, feelings of not being valued, and not being motivated (internally and externally). Enablers examined showed that although the workforce may be discontented and overworked, they still try to deliver their best, with few medical mistakes. Patients still have a lot of respect for their healthcare deliverers, but this trend may not continue for much longer. Patients are already returning more often to clinics, causing even more stress for staff. / Health Studies / M.A. (Health Studies)

Text in English / The aim of this study was to gain understanding of community service nurses’ experiences of health care services at Tshwane district public hospital. This qualitative study followed an Interpretative Phenomenological Analysis (IPA) approach to explore the community services nurses’ experiences of health care services at Tshwane district public hospital. Data were collected from 11 purposively selected community service nurses using a semi-structured interview format. Data was analysed using Interpretative Phenomenological Analysis framework for data analysis. Four super-ordinates emerged from data analysis: (1) Resources, (2) Work environmental relations, (3) Supervision and support and, (4) Impact of community service experiences. The study revealed that the health care services rendered at the hospital studied are substandard. Community service nurses reported several challenges experienced during their placement in the hospital under study. Lack of human and material resources, supervision and support contributed to hindrance of smooth acquisition of their clinical skills and experience. These challenges resulted in the psychological and emotional drain of the participants. There is a need for development of guidelines to ensure constant and adequate support to all the community service nurses placed at Ratanang Hospital. / Health Studies / M.A. (Nursing Science)

Summaries in English, Afrikaans and Zulu / South Africa is facing an ongoing public health crisis with increasing and alarming human immunodeficiency virus (HIV) statistics. Farmworkers in South Africa are highly vulnerable and susceptible to HIV. This study involved the farmworker community on a farm in the North West province of South Africa. The purpose of this study was to explore the perceptions and acceptance of home-based HIV counselling and testing (HBHCT) in a rural farming community, using an interactive World Café method to stimulate creative discussions around questions that matter. Thirty-one farmworkers participated in the World Café. This study had an explorative approach and qualitative design. The study did not investigate the number of HIV infections or sexual practices on the farm, and did not offer an HIV test or any other medical treatment to any participant. Data were collaboratively analysed by the researchers and the participants. Content analysis of data was conducted. The findings indicated that majority of the farmworkers had a positive perception of HBHCT, and that there was a serious need for HIV prevention and intervention in this community. Some concerns were raised among the participants regarding the confidentiality of HBHCT, attention should therefore be paid to these concerns. More research is needed to establish linkage to care after HBHCT. It remains unclear whether the migrant farmworker population would be effectively linked to HIV care and treatment without legal identification documentation. The acceptance of HBHCT in the farming community by farmers, should be explored. The study found that there would be a high level of acceptability if HBHCT were to be offered to farmworkers in this region. This study created insight into the HIV care and prevention needs of the local farmworker community, as well as highlighted the barriers the farmworkers face in attending primary healthcare (PHCs) clinics for HIV testing. / Suid-Afrika staar ’n voortdurende openbare gesondheidskrisis in die gesig met toenemende en onrusbarende menslike immuungebrekkige virus (MIV)-statistieke. Plaaswerkers in Suid-Afrika is uiters kwesbaar en vatbaar vir MIV. Hierdie studie het die plaaswerkergemeenskap van ’n plaas in die Noordwes-provinsie van Suid-Afrika geteiken. Die doel van hierdie studie was om die sieninge en aanvaardingsvlakke van tuis-gebaseerde MIV-berading en -toetsing (TSMBT) te ondersoek, deur gebruik te maak van die “World Café”-metode om kreatiewe bespreking rondom belangrike vrae te stimuleer. Een-en-dertig plaaswerkers het deelgeneem aan die “World Café”. Hierdie studie het nie die aantal MIV-infeksies of seksuele praktyke op die plaas ondersoek nie, en ook nie ’n MIV toets of enige ander mediese behandeling vir enige deelnemer aangebied nie. Die studie het gevind dat die meerderheid van die plaaswerkers ’n positiewe persepsie van TSMBT gehad het, en dat daar ’n dringende behoefte aan MIV-voorkoming en - ingryping in hierdie gemeenskap is. Bekommernis is uitgespreek deur die deelnemers rakende die konfidensialiteit van TSMBT, dus moet aandag hieraan geskenk word. Die studie het gevind dat daar ’n hoë vlak van aanvaarding van TSMBT sal wees as dit aan die plaaswerkers in hierdie streek gebied word. Hierdie studie skep insig in die MIVsorg- en -voorkomingsbehoeftes van die plaaslike plaaswerkergemeenskap, en beklemtoon die hindernisse vir plaaswerkers om die primêre gesondheidsorgkliniek te besoek vir MIV-toetsing. / INingizimu-Afrika ibhekene nokuqhubeka kokukhula kwenkinga yezempilo, kanye nokudlondlobala okushaqisayo kwezibalo zegciwane lesandulela ngculazi (HIV). Abasebenzi basemapulazini eNingizimu-Afrika ibona abasengozini enkulu yokutheleleka ngegciwane lesandulela ngculazi. Lolucwaningo lwenziwe emphakathini wabasebenzi basemapulazini esifundazweni sase-North West eNingizimu-Afrika. Inhloso yalolucwaningo bekuwukubona imibono kanye nezinga lokwamukela ukululekwa nokuhlolela igciwane lesandulela ngculazi emakhaya(i-HBHCT) emphakathini wasemapulazini kusetshenziswa Isizinda sokucobelelana ngolwazi (i- World Cafe) ukukhuthaza izingxoxo ezakhayo nokubuza imibuzo esemqoka. Bangama- 31 abasebenzi basepulazini ababambe iqhaza esizindeni sokucobelelana ulwazi (i- World Cafe). Lolucwaningo aluzange luphenye izibalo zabantu abatheleleke ngegciwane lesandulela ngculazi kanye nezinga labo lokuzibandakanya ocansini, futhi aluzange lunike abebebambe iqhaza ithuba lokuhlolela igciwane lesandulela ngculazi(HIV) kanye nokulashwa kwanoma iluphi uhlobo. Imiphumela iveze ukuthi iningi labasebenzi basemapulazini babe nemibono emihle mayelana nosizo lokululekwa nokuhlolela igciwane lesandulela nngculazi (HIV) emakhaya (HBHTC), futhi kunesidingo esikhulu sokuthi kungenelelwe kulomphakathi ukuze kuvikelwe igciwane lesandulela ngculazi (HIV). Kube nokukhathazeka kwababebambe iqhaza mayelana nezimfihlo zokulekelelwa ngokwelulekwa kanye nokuhlolela igciwane lesandulela ngculazi emakhaya(HBHCT),ngalokhoke kufanele kubhekelelwe lokho kukhathazeka. Ucwaningo luveza ukuthi kuzokwamukelwa ukuqala usizo lokwalulekwa nokuhlolela igciwane lesandulela ngculazi (HBHCT) kubasebenzi basemapulazini kulesisifundazwe. Lolucwaningo luveze ngokujulile izidingo zokunakekela kanye nokuvikela igciwane lesandulela ngculazi (HIV) emphakathini wabasebenzi basemapulazini kulendawo, laphinde lwaveza nezithiyo (Barriers) abasebenzi basemapulazini abahlangana nazo mabevakasha emitholampilo (PHCs) ukuyohlola igciwane lesandulela ngculazi. / Health Studies / M.P.H. (Public Health)

South African health systems are struggling to cope with the HIV/AIDS pandemic. Home based care has become an invaluable resource that relieves overburdened and under-resourced hospitals. Home based carers provide basic nursing care and support to patients and their families, in the patient's home. Little is know about what motivates home based carers. Minimal research has been undertaken to investigate the expectations and experiences of these noble voluntary helpers. This study was conducted with a sample of home based carers at Community Outreach Centre, St Mary's, Mariannhill. Being field focused it used a qualitative research approach and participatory action research methodology. Focus group discussions were conducted with home based carers to explore their needs, motivations and expectations of Community Outreach Centre. The study enlightens us about issues related to home based care that directly affect them. Despite the painful realities of their lives, they appeared positive about serving as volunteer home based carers. / Social work / M.A. Social Science (Social Work)

Curative primary health care nurses are the first level of contact with health personnel the patient has when entering the district-driven health system of South Africa. It is imperative that these nurses are competent, or patients may suffer. Several factors exist as barriers to competent curative care. Donabedian's structure-process-outcome framework has been used in the study of these factors. Literature were selected from international and national studies of nursing to discover barriers and enablers in general nursing care but also specifically in curative primary health care. The curative primary health care nurses in the Southern Cape/Karoo region were used as a sample for the study. Data gained from questionnaires were organised to present the findings: Barriers to a curative PHC service seem to be multifactorial, with scarce resources causing great stress for the workforce. This have a negative impact on relationships between employer and employee, CPHCNs and their patients, the type of managing that take place, and the quality of the examination and treatment of patients. Slow changes frustrates workers, causing more stress and poor attitudes, feelings of not being valued, and not being motivated (internally and externally). Enablers examined showed that although the workforce may be discontented and overworked, they still try to deliver their best, with few medical mistakes. Patients still have a lot of respect for their healthcare deliverers, but this trend may not continue for much longer. Patients are already returning more often to clinics, causing even more stress for staff. / Health Studies / M.A. (Health Studies)