In today’s world healthcare all over the world is profoundly challenged by rapid technological advancements, violence, terrorism, diverse cultures, proliferating chronic diseases, and the worst nursing shortage. In addition to these complex and daunting challenges healthcare continue to focus the attention on hospitals to review and modify the way care is delivered to patients. As key role players and consistent members of the multidisciplinary team critical care nurses are uniquely positioned to modify and review the quality of patient care through synergy between the patients’ needs, the nurses’ competencies, and the critical care environment. A collaborative approach towards enhancing synergy in a CCU was undertaken in a CCU in a private hospital in Gauteng. The study was guided by the American Association for Critical Care Nurses Synergy Model for Patient Care and conducted within the critical social theory paradigm. The nature of the research was descriptive, explorative and contextual and both qualitative and quantitative approaches were used. Action research cycles were followed to assess existing synergy between the patients’ needs, the nurses’ competencies and the characteristics of the environment in the CCU. An action plan was formulated and implemented towards enhancing synergy in the CCU. The implemented plan was adjusted based on observations and reflections following each of the five cycles of the project / 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)

South African palliative care volunteer caregivers play a crucial role in caring for people living with HIV and Aids, but frequently do not receive the support and respect that they deserve. The current study explored the psychosocial challenges and coping mechanisms of palliative care volunteer caregivers for people living with HIV and Aids. The researcher conducted in-depth interviews with 24 participants who also filled in questionnaires. The aim was to explore their experiences, their challenges, and coping mechanisms. Although these volunteer caregivers shared many positive experiences, they also faced multiple challenges in the workplace, their personal lives, financial challenges as well as psychological and emotional ones. Despite these challenges, the caregivers showed only moderate levels of stress on the stress scale. Recommendations for overcoming these challenges were provided to caregivers, organisations and the Department of Health / Psychology / M. Sc. (Psychology)

M.Cur. / The purpose of this study is to describe guidelines for a Community Based Curriculum in Psychiatric Nursing Science for a nursing college in KwaZulu Natal. The study consists of 4 phases. To reach the purpose of the study, a situational analysis was done in 3 phases to identify the principles for a Community Based Curriculum in Psychiatric Nursing Science. In Phase I - a document analysis of relevant government policies and legislation was conducted to obtain the principles of mental health care. In Phase H - the statistics of the psychiatric diagnoses of patients from two community psychiatric clinics and one psychiatric hospital admission unit were collected. From the prevalence of the mental disorders, the mental health needs and problems were identified. These were the principles of Phase II. Phase III - was the focus group interviews with the psychiatric nurse educators of a nursing college in KwaZulu Natal to ascertain their viewpoints on a Community Based Curriculum in Psychiatric Nursing Science. From the findings of the focus group interviews, a literature control and conceptual framework were done. Thereafter, the principles of mental health care from this phase were identified. The principles of Phase I, II and III were used to formulate Phase IV, which was the guidelines for the operationalisation of Community Based Curriculum in Psychiatric Nursing Science. The outcomes based approach was used in the Community Based Curriculum in Psychiatric Nursing Science in accordance with the National Qualifications Framework of the South African Qualifications Authority. Recommendations concerning nursing practice, nursing education and further study were made at the end of the study including the limitations affecting the study

Submitted in fulfilment of the requirements for the Master of Health Sciences in Nursing, Durban University of Technology, 2017. / Tuberculosis (TB) is South Africa’s greatest community health problem. Nurses have a critical role in supporting patients in the TB treatment process. An estimated 480 000 new cases of Multidrug-Resistant Tuberculosis (MDR-TB) and 190 000 people died in 2014. An estimated 43 million lives were saved between 2000 and 2014 with effective diagnosis and treatment of TB. Despite these measures TB remains one of the world’s biggest threats. In an attempt to improve the practice of nurses in the prevention of MDR-TB, the knowledge of nurses with regards to the prevention of MDR-TB is essential. Aim of the Study The aim of the study was to describe the practice of the nurses in the prevention of MDR-TB and to determine whether the practice was effective in the prevention of MDR-TB. Methodology Quantitative, descriptive survey was used to conduct the study. Purposive sampling method was employed to select six primary health care clinics at uThungulu District. The target population consisted of professional nurses and enrolled nurses working in these clinics. The sample size was 122. The questionnaire was used to collect data. Descriptive statistics was used to describe the data graphically. In order to test for significant trends in the data, inferential statistics were applied. Results The findings of the study revealed that nurses were implementing measures of preventing MDR-TB like tracing of patients who interrupted TB treatment although there were inconsistencies with implementation of other measures. There were gaps related to attendance of TB courses by TB staff. Nurses were working in an overcrowded environment where it was difficult to implement measures for preventing MDR-TB. There was an increase in the workload due to the high number of patients having TB. Conclusion In this study, the majority of nurses working in primary health care clinics scored well in infection control measures with regard to practicing cough hygiene, placing patients in a well-ventilated area, collection of sputum from patients suspected of having TB and giving of health education to patients with TB and relatives but there areas that need improvement. The findings indicate knowledge gap with regard to TB. There is a need for attendance of short courses in TB, increase of staff attending to TB patients so as to cope with the workload and efficient allocation of resources. / M

The aim of this study was to investigate whether patients were satisfied with midwifery services rendered at the two Community Health Centres in the Eastern Cape Province.The study sites were Empilweni Gompo and Nontyatyambo Community Health Centres. Descriptive quantitative study design was employed, using a questionnaire with closed and open ended questions as the data collecting tool. Likert Scale was used to measure the following variables: quality care variables to measure level of satisfaction with midwifery services rendered and to determine positive and negative perceptions regarding quality of care received during antenatal, labour and postnatal period. Non-random convenience sampling of sixty pregnant women, thirty from each Community Health Centre, with two or more antenatal subsequent visits and forty postpartum women, twenty from each health facility, six hours after delivery if there were no complications. Out of 60 participants interviewed n=60 (100 percent) agreed that individual counseling and importance of HIV testing was explained.The majority of participants n=53(88 percent) disagreed that they were educated about focused antenatal visits. Out of 60 participants interviewed n=41(68 percent) agreed that delivery plan formed part of their ANC visits and n=18 (30 percent) disagreed. Of the 60 participants interviewed n=11(18 percent) agreed that they were told that they had the right to choose labour companions and n=48 (80 percent) disagreed.Out of 60 participants interviewed n=23 (38 percent) stated that they waited a long period of time without being attended to by midwives. In general, the study revealed high satisfaction level with intrapartum and postnatal care due to functional accessibility of both Community Health Centres. Both health centres delivered normal healthy babies and mothers. However, the participants were dissatisfied with antenatal care rendered at the two facilities. The researcher’s recommendations were based on the closing of gaps that were identified with regard to the implementation of Basic Antenatal Care; birth companions: health education deficiency; community involvement and participation.

D.Cur. / The occupation of the SOS mother, which involves long-term care for orphaned and abandoned children under the SOS Children's Villages organisation, is unique and peculiar in many respects. She is expected to play a dual role of being a foster parent and a childcare professional, at the same time. The latter presents challenges of its own because the professional status is only recognised internally by the organisation. In one way or another, most of the children for which the SOS mother is responsible, have been exposed to some form of trauma. The problems of caring and parenting such children are well documented in the literature. These include learning and behaviour problems. For this reason, the mental health of the SOS mother, who is the focus of this study, should be of special interest to mental health practitioner. The motivation for this study arises out of a change that the organisation is trying to enforce in the work of the SOS mother. This change comes with the release of the new quality standards to guide village work. One of these standards, the SOS mother's autonomy, requires the SOS mother, like any mother in the community to take full responsibility for her SOS family, including the development of the children under her care. When she needs help, she seeks expert advice from village co-workers and from the community. In addition, the career of the SOS mother has to be developed so that she functions like a childcare professional and that her training is recognised by the government and other training institutions. This represents a big change from how most SOS villages have been operating. Up to this point, village co-workers made important decisions about the SOS family and the children while the SOS mother did the caring part. The change is expected to affect the interactions between SOS mothers and their co-workers and consequently, their mental health. For this reason, it was felt that there was a need to facilitate the implementation of the SOS mother's autonomy standard, which would also promote the mental health of the SOS mothers. The purpose of this research was, therefore, to develop and describe a model that would serve as a framework for the advanced psychiatric nurse practitioner to promote the mental health of SOS mothers by facilitating the implementation of the SOS mother's autonomy within SOS Children's Villages of Southern Africa Region 11. The research also focused on developing guidelines for the implementation of the model in practice.

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)

See the attached abstract below