The purpose of this longitudinal study was to evaluate the enrolled nurse/registered nurse (EN/RN) programme to determine the extent to which the graduates of the programme had acquired knowledge and skills to provide primary health care services to communities using the Stufflebeam CIPP model as a framework. The study determined the extent to which the graduates perceived that their knowledge and skills in provision of primary health care services have been strengthened and the extent to which their supervisors perceived the improvement of the graduates' knowledge and skills in provision of primary health care services in clinical and primary health care settings. The programme used two models for upgrading: one year full-time residential and two year distance education. The study used methodological triangulation for data collection. Data collection tools comprised of self-administered questionnaires to the EN/RN upgrade graduates, structured group interviews to their supervisors from the hospitals and district health teams and the review of the students' examination records from Institute of Health Sciences/University of Botswana (IHS/UB). Data were collected and analyzed from the one year full-time residential graduates who completed the programme from 1995-2000 and from the two year part-time distance education graduates who completed the programme 1996-2000. The findings from the academic records indicated that out of the 1116 enrolled nurses that were admitted into the EN/RN upgrade programme between 1994-2000 nine (0.8%) withdrew from the programme due to ill health or personal reasons before writing the final examinations. This is indicative of a high retention rate in the programme. In the one year full-time residential programme, out of the 695 enrolled nurses were admitted in the programme from 1995-2000 period five (0.7%) withdrew from the programme before writing the final examinations, 690 students sat for the final examination and 640 (92.8%) passed. In the two year part-time distance education programme, out of the 421 enrolled nurses were admitted in the programme from 1996-2000 period four (0.9%) withdrew from the programme before writing the final examinations, 417 students sat for the final examinations and 402 (96.4%) passed. Out of the 1107 students from both the one year full-time residential and the two year part-time distance education programme that sat for the final IHS/UB examinations, 1042 (94.1%) passed. The academic records revealed that the programme was efficient and effective because 1042 (94.1%) out of 1107 students completed the programme in one year and two years as planned because the programme was not repetitive and there were replacement costs. This high pass rate (94.1%) is an indication that the graduates did acquire knowledge and skills for provision of primary health care services. Data analysis from the self-administered questionnaires of the graduates also revealed that the graduates perceived that their knowledge and skills for provision of primary health care services have been strengthened because of the acquisition of the new knowledge in primary health care. This complemented the high academic performance of the graduates that the graduates knowledge and skills to deliver primary health care had been strengthened. Data analysis from the structured group interviews of the supervisors of the graduates further revealed that the supervisors perceived that the knowledge of the graduates in providing primary health care services in the hospitals and the district health teams had improved. The supervisors indicated that the graduates were now providing primary health care services with less supervision in the hospitals and the health districts. / Health Studies / D.Litt et Phil. (Health Studies)

Background: Comprehensive oral care is an evidence-based, cost effective, essential routine nursing intervention that nurses ought to provide with good knowledge/understanding as it prevents and controls nosocomial infections especially Ventilator Associated Pneumonia (VAP) that is associated with increased morbidity and mortality in critically ill patients in Intensive Care Units (ICU). Aim of study: To determine ICU nurses’ knowledge, describe their practices and identify their perceptions regarding comprehensive oral health care to critically ill patients in order to refine or develop evidence based oral care protocol. Methods: A quantitative approach with a descriptive, exploratory survey was used for this study. A non probability convenience sample of thirty-four (34) ICU nurses from two public referral hospitals participated in this study. A questionnaire with a combination of open and closed ended questions was used to collect data on comprehensive oral care to critically ill patients. Results Thirty-four nurses responded to the questionnaire (response rate 89%). Only 18% (n=6) were knowledgeable about important aspects of oral care, while the majority, 82% (n=28) lacked knowledge on important aspects of oral care. Fifty-nine percent (59%) n=20 had received training on comprehensive oral care at basic nursing training and 44% (n=15) had orientation at unit level. Ninety-seven percent (97%) n=33 of the participants requested further updates on comprehensive oral care. No significant relationships were found between nurses’ demographic characteristics and knowledge of comprehensive oral care. All (100%) n=34 of nurses gave oral care a high priority and 91% ranked it very important for critically ill patients. Toothbrushes and toothpaste were used by 85% (n=29) of nurses and only 50% (n=17) used mouthwashes. The reason for non- use of mouthwashes was lack of supplies and not having been foreseen in unit protocol although neither of the units had an oral care protocol in place. / Thesis (M.N.)-University of KwaZulu-Natal, Durban, 2011.

The purpose of this longitudinal study was to evaluate the enrolled nurse/registered nurse (EN/RN) programme to determine the extent to which the graduates of the programme had acquired knowledge and skills to provide primary health care services to communities using the Stufflebeam CIPP model as a framework. The study determined the extent to which the graduates perceived that their knowledge and skills in provision of primary health care services have been strengthened and the extent to which their supervisors perceived the improvement of the graduates' knowledge and skills in provision of primary health care services in clinical and primary health care settings. The programme used two models for upgrading: one year full-time residential and two year distance education. The study used methodological triangulation for data collection. Data collection tools comprised of self-administered questionnaires to the EN/RN upgrade graduates, structured group interviews to their supervisors from the hospitals and district health teams and the review of the students' examination records from Institute of Health Sciences/University of Botswana (IHS/UB). Data were collected and analyzed from the one year full-time residential graduates who completed the programme from 1995-2000 and from the two year part-time distance education graduates who completed the programme 1996-2000. The findings from the academic records indicated that out of the 1116 enrolled nurses that were admitted into the EN/RN upgrade programme between 1994-2000 nine (0.8%) withdrew from the programme due to ill health or personal reasons before writing the final examinations. This is indicative of a high retention rate in the programme. In the one year full-time residential programme, out of the 695 enrolled nurses were admitted in the programme from 1995-2000 period five (0.7%) withdrew from the programme before writing the final examinations, 690 students sat for the final examination and 640 (92.8%) passed. In the two year part-time distance education programme, out of the 421 enrolled nurses were admitted in the programme from 1996-2000 period four (0.9%) withdrew from the programme before writing the final examinations, 417 students sat for the final examinations and 402 (96.4%) passed. Out of the 1107 students from both the one year full-time residential and the two year part-time distance education programme that sat for the final IHS/UB examinations, 1042 (94.1%) passed. The academic records revealed that the programme was efficient and effective because 1042 (94.1%) out of 1107 students completed the programme in one year and two years as planned because the programme was not repetitive and there were replacement costs. This high pass rate (94.1%) is an indication that the graduates did acquire knowledge and skills for provision of primary health care services. Data analysis from the self-administered questionnaires of the graduates also revealed that the graduates perceived that their knowledge and skills for provision of primary health care services have been strengthened because of the acquisition of the new knowledge in primary health care. This complemented the high academic performance of the graduates that the graduates knowledge and skills to deliver primary health care had been strengthened. Data analysis from the structured group interviews of the supervisors of the graduates further revealed that the supervisors perceived that the knowledge of the graduates in providing primary health care services in the hospitals and the district health teams had improved. The supervisors indicated that the graduates were now providing primary health care services with less supervision in the hospitals and the health districts. / Health Studies / D.Litt et Phil. (Health Studies)

According to the Ministry of Health (1996:26), the most common chronic/terminal illnesses were cardiovascular disorders, diabetes, cancer, mental disorders, HIV/AIDS, tuberculosis and asthma. Long term treatment and care and the growing incidence of these conditions necessitated the introduction of home-based care (HBC). Consequently, family care givers play a major role in the provision of care to chronically/terminally ill patients and professional health care providers adopt a supervisory role. This study examined the quality of home care services provided in Botswana. The availability and accessibility of home-based care services and resources have a direct bearing on the quality of home-based care delivery system. The researcher used systems theory was used as the conceptual framework for this study. The study aimed to • determine the accessibility and availability of home-based care services in Molepolole East • investigate what the perspectives and experiences of family care givers, patients and professional health care providers of Botswana home-based care are • determine the roles of professionals health care providers, patients, and family care givers and their relationships in the context of home- based care • identify the needs of chronically/terminally ill patents and family care givers • determine the type of support given to family care givers and patients by professional health care providers and make recommendations for the improvement of home-based care • develop a model to prepare family care givers The research design combined quantitative and qualitative research methods. A sample of convenience was used to obtain information from patients' family care givers and professional health care providers. Interviews and questionnaires were used. A proposed care giving preparedness model is presented to meet needs of the family care givers. The study found that family care givers needs are neither known nor catered for by the professional health care provider. The family care givers were not adequately prepared before adopting the care-giving role. It is recommended that • The proposed preparedness care giving training model is considered for training of patients and family care givers before discharge and during HBC. • Increase patients and family care givers decision-making / Health Studies / D.Litt. et Phil. (Health Studies)

According to the Ministry of Health (1996:26), the most common chronic/terminal illnesses were cardiovascular disorders, diabetes, cancer, mental disorders, HIV/AIDS, tuberculosis and asthma. Long term treatment and care and the growing incidence of these conditions necessitated the introduction of home-based care (HBC). Consequently, family care givers play a major role in the provision of care to chronically/terminally ill patients and professional health care providers adopt a supervisory role. This study examined the quality of home care services provided in Botswana. The availability and accessibility of home-based care services and resources have a direct bearing on the quality of home-based care delivery system. The researcher used systems theory was used as the conceptual framework for this study. The study aimed to • determine the accessibility and availability of home-based care services in Molepolole East • investigate what the perspectives and experiences of family care givers, patients and professional health care providers of Botswana home-based care are • determine the roles of professionals health care providers, patients, and family care givers and their relationships in the context of home- based care • identify the needs of chronically/terminally ill patents and family care givers • determine the type of support given to family care givers and patients by professional health care providers and make recommendations for the improvement of home-based care • develop a model to prepare family care givers The research design combined quantitative and qualitative research methods. A sample of convenience was used to obtain information from patients' family care givers and professional health care providers. Interviews and questionnaires were used. A proposed care giving preparedness model is presented to meet needs of the family care givers. The study found that family care givers needs are neither known nor catered for by the professional health care provider. The family care givers were not adequately prepared before adopting the care-giving role. It is recommended that • The proposed preparedness care giving training model is considered for training of patients and family care givers before discharge and during HBC. • Increase patients and family care givers decision-making / Health Studies / D.Litt. et Phil. (Health Studies)

A non-experimental, explorative, descriptive, quantitative study was undertaken. The purpose was to explore and describe the views of preceptors and preceptees regarding the fulfillment of the role of the preceptor in selected clinical nursing practice settings in the Botswana context. The study included 72 preceptors and 200 nursing students/preceptees who voluntarily agreed to participate in the study. A questionnaire was used to collect data. Data was analysed by using descriptive and inferential statistics. The findings of this study indicated that there were numerous constraints that interfered with the preceptor role in accompaniment of the preceptee. These constraints included the lack of desirable characteristics and time to plan learning opportunities, inadequate use of teaching strategies and inadequate knowledge on preceptee evaluation. Recommendations were stated for improvements in the future role of the preceptor in clinical practice settings Limitations of this study were also highlighted. / Health Studies / M.A.(Health studies)

The study aimed to assess factors affecting the uptake of community-based Tuberculosis care (CTBC) as experienced by patients in Lobatse in order to make recommendations to enhance the uptake of CBTC in this area. A cross-sectional study was conducted, using structured interviews amongst 101 TB patients in Lobatse who registered for directly observed treatment (DOT) for TB in the GOB’s health facilities from January 2011 to August 2013. The SPSS (version 21) was used to analyse the data. Univariate logistic regression models were used. Participation in CTBC was an outcome. The main predictors for participation in CBTC included, knowledge and attitudes towards CTBC (p=0.0003), perceived barriers and enablers towards this programme (p=0.0279), and patient satisfaction with this programme (p=0.0315). The research findings pertain to TB services in Lobatse, because the study was conducted in government health facilities implementing the Botswana National Tuberculosis Programme (BNTP) CTBC guidelines only in Lobatse / Health Studies / M.A. (Public Health)

The study aimed to assess factors affecting the uptake of community-based Tuberculosis care (CTBC) as experienced by patients in Lobatse in order to make recommendations to enhance the uptake of CBTC in this area. A cross-sectional study was conducted, using structured interviews amongst 101 TB patients in Lobatse who registered for directly observed treatment (DOT) for TB in the GOB’s health facilities from January 2011 to August 2013. The SPSS (version 21) was used to analyse the data. Univariate logistic regression models were used. Participation in CTBC was an outcome. The main predictors for participation in CBTC included, knowledge and attitudes towards CTBC (p=0.0003), perceived barriers and enablers towards this programme (p=0.0279), and patient satisfaction with this programme (p=0.0315). The research findings pertain to TB services in Lobatse, because the study was conducted in government health facilities implementing the Botswana National Tuberculosis Programme (BNTP) CTBC guidelines only in Lobatse / Health Studies / M. A. (Public Health)

A non-experimental, explorative, descriptive, quantitative study was undertaken. The purpose was to explore and describe the views of preceptors and preceptees regarding the fulfillment of the role of the preceptor in selected clinical nursing practice settings in the Botswana context. The study included 72 preceptors and 200 nursing students/preceptees who voluntarily agreed to participate in the study. A questionnaire was used to collect data. Data was analysed by using descriptive and inferential statistics. The findings of this study indicated that there were numerous constraints that interfered with the preceptor role in accompaniment of the preceptee. These constraints included the lack of desirable characteristics and time to plan learning opportunities, inadequate use of teaching strategies and inadequate knowledge on preceptee evaluation. Recommendations were stated for improvements in the future role of the preceptor in clinical practice settings Limitations of this study were also highlighted. / Health Studies / M.A.(Health studies)

Health Studies / D. Litt. et Phil. (Advanced Nursing Science)