M.Cur. / Please refer to full text to view abstract

D.Cur. (Intensive General Nursing) / Critical care nursing is cost-effective quality nursing to the critical ill patient. This nursing is inftuenced by certain expectations as well as the professional-ethical authorisation. The aim ofthis study is to describe and explore the expectations and the professional-ethical authorisation of the functions of the critical care nurse to enable the formulation ofguidelines for the scope of practice for the critical care nurse within South African context. Phase I was to determine the expectations of the critical care nurse, the nursing service managers and the doctors with regard to the functions of the critical care nurse. A focus group interview was held with a group of experts in the field of critical care. The results were used to compile a questionnaire. This questionnaire was sent to the critical care nurses, the nursing service managers and the doctors in South Africa for completion. From these results the functions of the critical care nurse were determined. Phase 2 is to analyse the expectations (Phase 1) according to the professional-ethical authorisation of the critical care nurse. Firstly, literature was explored and described to determine the professional ethicalauthorisation regarding the accountability ofthe critical care nurse. Secondly, the functions were analysed according to the professional-ethical authorisation. The analysis showed that except for prescribing medication, altering medication dosages and drawing blood samples from the critical ill patient, the critical care nurse is practicing within her professional-ethical authorisation. Phase 3 was to formulate guidelines for the scope of practice for the critical care nurse within a South African context. Through usage of the data (Phase I and 2) the scope of practice was formulated. Guidelines were formulated for the practise, education and research regarding the limitations of the professional-ethical authorization and the implementation of the scope of practice for the critical care nurse.

M.Cur. (Psychiatric Nursing) / With modern psychiatric treatment, patients usually come into contact with as many as six different team members. These team members have their own particular treatment plans for patients. This has prompted the question: "How do patients experience their treatment by the interprofessional health team?" The aims of this study are as follows: • To explore psychiatric patients' experiences of their treatment by the interprofessional health team in a particular private psychiatric clinic. • To set basic guidelines which will promote the optimisation of treatment of psychiatric patients by the interprofessional health team, in order to prevent the aggravation of mental illness, emphasising the contribution of the psychiatric nurse.

M.Cur. / Man, as seen from a Christ-centred approach, was not only created in the image of God, but God also gave him the responsibility of acting as His representative on earth and of making full use of his God-given gifts, talents and potential. In this way man could become what God intended him to be. Man is a relationship creature, and when he accepts God as his personal Saviour, he should implement these God-given abilities in his relationship with himself, others, the community, nature and the biosphere, in such a way that the Spirit of Christ is embodied in it. Then the spiritual becomes the guideline, principal and motivator for meaningful human existence in the process of self-actualization. Because the Christian psychiatric nurse functions from this frame of reference, it is also applicable to her. The psychiatric nurse who today finds herself in psychiatric practice, is frequently subjected to fatigue and stress. The expectations that she sets herself and also the expectations the patient, family and community have of her, are enormous. Under the guidance of the Holy Spirit she needs to change the science of psychiatric nursing into an enriching and skillful art so that the qualities of Jesus Christ are embodied in the fulfillment of her task, and so that she can answer her calling and duty - empathy with her fellow-man towards fulfillment, wholeness and maturity of faith. The purpose of this research is to establish whether the presentation of a structured enrichment programme, from a Christ-centred approach by the psychiatric nurse specialist, can enhance the process of self-actualization in the psychiatric nurse. A one-day .enrichment programme was presented to two groups of final-year student nurses to facilitate the process of self-actualization. An explanatory experimental research approach was used. The two groups were randomly divided int experimental and control groups. Pre- and post-tests were done on both experimental and control groups by completion of the POI measuring instrument. The Intervention, namely the structured enrichment programme, was done on the experimental groups only...

M.Cur. / Child development is a subject that is increasingly becoming the focus of discussion. The interest in this subject, however dates back to the twenties when Arnold Gesell started researching this field. Over the years scales were developed to make the measurement of the level of child development easier ...

Diabetes Mellitus (DM) is on the increase globally, with further increases expected in developing countries, such as South Africa. World Health Organization (Medical Chronicle, 2006:14) estimations indicate that the number of DM sufferers will double over the next 30 years. This increasing number of diabetics is expected to have enormous economical implications. One of the consequences of the increase in DM sufferers is the increase in deaths due to diabetes related complications. In 2000, 3.2 million people died of DM and diabetes related complications compared with 3 million who died from HIV/AIDS related illnesses (William & Pickup, 2004:64). Health services are financially burdened by DM complications that result in heavy demands in both direct costs of hospitalization and medication as well as indirect costs such as manpower of staff involved in the care of the patient (Leuner, 2000:410). Diabetic ketoacidosis (DKA) is a prominent life-threatening complication of type 1 diabetes mellitus and, if not treated medically, it can lead to coma and death. DKA accounts for 14 per cent of all diabetic related hospital admissions and has a mortality rate of 5 to 10 per cent (Pickup & Williams, 2003:1). Rapid identification of DKA is necessary to improve patient care. George- Gray and Chernecky (2002:96) suggest patient outcomes are affected by the nurse’s ability to recognize the clinical features of DKA. It is important, therefore, for the nurses to understand the signs and symptoms and treatment of this diabetes related complication. National health policies and treatment guidelines should be aimed at addressing DKA treatment through setting guidelines for diabetic care (Peters, 2004:22). The main goal of this study was to determine registered nurses’ knowledge of DKA and to develop guidelines to assist registered nurses in providing adequate and effective health care to prevent DKA reoccurrence. The research study is based pm Bergam’s model on quality of care and accountability. Bergman claims that several preconditions must be filled in order to be accountable, including: • Accountability • Responsibility • Authority • Ability (Bergman (1982:8) emphasizes that ability reflects the registered nurses’ accountability, which is composed of values, knowledge and skills.) The study was divided into two phases. Phase one determined registered nurses’ knowledge related to the management of DKA. Phase two of the study included the developing guidelines to assist registered nurses in providing adequate and effective health care to patients with DKA. The design of the study is quantitative, explorative, descriptive and contextual; a survey was performed using a questionnaire based on a literature study. Ethical principals were maintained throughout the study. Permission to the study was sought from the Local Health Authorities and the heads of department where the research was undertaken. Findings of the research were analysed and discussed in the research. The knowledge of the majority of the respondents was found to be average. Out of the thirty- two respondents 52.8 percent possessed adequate knowledge the management of DKA and 63.4 percent possessed adequate knowledge on the management of DM. Two recommendations to assist registered nurses in the implementation of guidelines of the recommendations were also provided.

M.Cur. (General Nursing) / Child development is a subject that is increasingly becoming the focus of discussion. The interest in this subject, however dates back to the twenties when Arnold Gesell started researching this field. Over the years scales were developed to make the measurement of the level of child development easier. The community health nurse should have a thorough knowledge of the use of child development scales. This will enable her to identify, diagnose and refer possible cases of retarded development found at healthy baby and toddler clinics. During this investigation the use of the child development scales by community health nurses, within the municipal boundries of Johannesburg, is evaluated. It was found that a lack of time during normal clinic hours, elaborate record-keeping systems, differences in community priorities, the training of community health nurses in the use of these scales, as well as the ignorance on parents regarding child development, influence the way in which the child development scales are used for community health purposes.

In South Africa, mental health care is being integrated into primary health care services. The integration of services was aimed at increasing the accessibility and availability of all health care services at primary health care level. The integration was well intentioned, and it was hoped that mentally ill clients would benefit from having a service near their homes. However, the process of integration is fraught with challenges, for instance, staff shortages, which lead to ineffective nursing management of mentally ill clients at the primary health care clinics. As a result, one professional nurse is often allocated to manage the clinic services on a daily basis with the assistance of an enrolled nurse or auxiliary nurse. The professional nurses therefore experience high levels of stress due to gross staff shortages and lack of time to conduct proper nursing assessments. This led to the research question: “What are the experiences of professional nurses with regards to the nursing management of mentally ill clients in rural primary health care clinics in the O.R. Tambo District in the Eastern Cape?’’ The proposed objectives of the study were to explore and describe the experiences of professional nurses working in rural primary health care clinics with regard to the nursing management of mentally ill clients. The researcher thereafter made recommendations to the district managers regarding effective nursing management of mentally ill clients in rural primary health care clinics. A qualitative, exploratory, descriptive and contextual design was used. The research population comprised of professional nurses working in rural primary health care clinics in the O.R. Tambo District in the Eastern Cape. Purposive sampling was used to identify participants and the sample number was determined by data saturation. Unstructured interviews and observation notes were used to collect data. The eight steps of data analysis suggested by Tesch were utilized to analyze the data. The researcher conducted an in-depth literature review in order to identify research gaps pertaining to the study. To ensure that a high level of validity and reliability was exercised throughout the study, the researcher conformed to Lincoln and Guba’s model of trustworthiness. The study was conducted in an ethical manner and ethical principles were adhered to. Findings: Three themes with subthemes emerged. The study showed that professional nurses experienced challenges related to the nursing management of mentally ill clients. These challenges included shortage of staff, a heavy workload, and lack of resources, lack of in-service training and workshops related to mental health issues coupled with lack of support from the supervisors. Due to the challenges, the mentally ill clients were not getting quality nursing care leading to complications and relapse. Conclusion: It emerged from the study that matters pertaining to mental illness and mental discomfort were still a serious problem in rural areas. The problems were related to the challenges which prevented professional nurses from providing quality nursing care to mentally ill clients with subsequent complications and relapse. Recommendations: Recommendations were made as an effort to ensure that the nursing management of mentally ill clients in rural primary health care clinics is improved. These recommendations were categorized as related to nursing practice, nursing education and nursing research.

A critical care unit is a dynamic and highly technological environment. Professional nurses who have been working in the critical care unit for a period of time are passionate about the environment in which they work. They find their on duty time challenging and stimulating. The critical care environment is slowly changing. Due to the fact that there are fewer professional nurses with an additional qualification in critical care available to work in the critical care units. The utilisation of an increasing number of agency nurses leads to an increase in sub-standard nursing care as well as dissatisfied doctors and patients. The shortage of critical care staff has resulted in the need to find an alternative human resources framework and still provide cost effective, safe quality patient care. This leads to the design and implementation of a team nursing care framework for critical care. The research objectives for this study were: - To explore and describe the experiences of professional nurses with regard to a team nursing care framework in private critical care units. - Develop guidelines to optimize the team nursing care framework in critical care units in a private hospital group. The research is based on a qualitative, explorative, descriptive and contextual research design. The study is based on a phenomenological approach to inquiry. Eleven in-depth semi structured face-to-face phenomenological interviews were utilized as the main means of collecting data. A purposive, criterion based, sampling method was used. Specific inclusion criteria were met and consent was obtained from the participants and from the management of the private clinic where the research was conducted. Two central themes were identified:- Theme One: The professional nurses experienced the team nursing care framework in the critical care unit as a burden. Six sub-themes were identified. - Theme Two: Professional nurses made recommendations for improvement of the team nursing care framework in the critical care unit. By describing the lived experiences of the professional nurses in the critical care units, based on research interviews, the researcher painted a clear picture of the team nursing care framework in the critical care unit. Guidelines were developed based on the identified themes. The broad guidelines are aimed at ensuring that the nurses are competent to care for critical care patients prior to them commencing work in the critical care unit. The researcher concludes this study by making recommendations for Nursing practice, education and research.

Human Immunodeficiency Virus (HIV) and Acquired Immuno-Deficiency Syndrome (AIDS) have brought about a global epidemic far more extensive than was predicted even a decade ago (van Rensburg, 2002:1). South Africa has one of the highest HIV prevalence rates in the world (South African Department of Health, 2000: 5), it still increase yearly. Before a vaccine and/or effective treatment become available, effective education and information campaigns are necessary for preventing the spreading of HIV and AIDS (WHO (the World Health Organization), 1988:21). According to WHO and ICN (International Council of Nurses) (1988:12), Nurses can play a pivotal role in the education of patients, their families and friends with regard to the prevention of HIV and AIDS transmission, so as to control the spread of this disease. In South Africa, more than 60 percent of the healthcare human resources comprise professional nursing practitioners (Muller, 2002: 95). Therefore, the education and training of nurses is one of the effective methods to preventing further spread of HIV and AIDS infection in South Africa. Accordingly, nurses need to reduce both personal and occupational risk of becoming infected with HIV themselves, as well as provide education to patients and their families. Before effective and efficient in-service education guidelines on the prevention of HIV and AIDS transmission can be developed, any knowledge deficit and negative attitudes of registered nurses regarding the prevention of HIV and AIDS transmission should be identified. Thus, it is important to survey the knowledge and attitudes of nurses in healthcare institutions related to the prevention of HIV and AIDS transmission. The main goal of the study was to explore and describe the knowledge and attitudes of registered nurses in public hospitals related to the prevention of HIV and AIDS transmission. The secondary objective was to develop in-service education guidelines for registered nurses in public hospitals to optimise both personal and occupational prevention measures relating to HIV and AIDS transmission. The research was conducted using a quantitative, explorative, descriptive and contextual design. The purposive sampling method was used to select the participants and a self-administered questionnaire was used to collect data. This data was analysed by inferential statistics and descriptive statistics and areas of deficits concerning knowledge and negative attitudes were identified. In this study there were deficits concerning the knowledge and negative attitudes regarding the prevention of HIV and AIDS transmission to a greater or lesser degree in all the subgroups of the questionnaire. In general, the registered nurses with the attendance of HIV and AIDS training program, experience in caring for HIV and AIDS patients made the level of certain knowledge related to the prevention of HIV and AIDS transmission different; Working experience as a registered nurses and the attendance of HIV and AIDS training programmes did not make attitudes towards the prevention of HIV and AIDS transmission significantly different. The registered nurses with experience of caring for HIV and AIDS patients had more positive attitudes than those without the experience. This information was used to compile in-service education guidelines for registered nurses concerning the prevention of HIV and AIDS transmission. The in-service education guidelines will be given to clinical facilitators at public hospitals. It is envisaged that this will guide them as to what to include in their in-service education programmes concerning the prevention of HIV and AIDS transmission for registered nurses.