MCur / Department of Advanced Nursing Science / See the attached abstract below

MCur / Department of Advanced Nursing Science / See the attached abstract below

MPH / Department of Public Health / See the attached abstract below

PhDH / Department of Advanced Nursing Science / Introduction and background Professional nurses are responsible to supervise student nurses in the clinical areas in order to assist them in achieving the learning outcomes, develop clinical skills and competence; however, this role is overlooked as pinned to different factors influencing clinical supervision, including the related challenges regarding supervision. This study aimed to explore and describe professional nurses’ and student nurses’ perceptions of clinical supervision in training hospitals of Limpopo Province, South Africa. Research methodology The study used convergent parallel mixed methods design. The population in this study was professional nurses and student nurses working in seven training hospitals of Mopani and Vhembe district of Limpopo Province. Purposive sampling was used to sample districts, hospitals and student nurses whereas, convenience sampling was used to sample professional nurses. Self-administered questionnaires and focus group interviews were used in data collection. Quantitative data was v analysed using Statistical Package of Social Science (SPSS), version 22.0 and Tesch’s’ method was used to analyse qualitative data. Findings Perceptions of professional nurses and student nurses revealed several factors influencing supervision and challenges such as staff shortages, high number of student nurses allocated in clinical areas, heavy workload, inadequate material resources, poor communication and inadequate support. The findings were used in formulation of clinical supervision guidelines. Recommendations The recommendations of this study were based on the study findings. Intervention on the challenges of clinical supervision is recommended by utilisation of the formulated guidelines. This will assist in closing the existing gap regarding clinical supervision. / NRF

The purpose of the study is to explore past and current professional nursing organisations by means of historical inquiry and to explain the factors that influenced the development of such organisations, as well as the contribution that these organisations made to the professional development of South African nursing in the period between 1914 and 2014. The researcher conducted a literature review and collected data from archival primary and secondary sources. A priori codes provided structure and historical context, yet allowed flexibility. Philosophically critical realism guided the research and enabled the researcher to explain and critique the social world in which South African nursing organisations historically functioned and exerted their professional influence. The findings revealed that in the past one hundred years political, economic and cultural factors present in the social world influenced the nature of South Africa’s professional nursing organisations. Determined to create a female professional image, status and educational exclusivity, South African nursing leaders of the 20th century opted to establish the South African Trained Nurses’ Association (SATNA), a professional nursing association. Influential associations such as SATNA and the South African Nursing Association (SANA) guided the profession to develop a nursing culture based on philosophical and ethical principles of practice. The result was a recognised, respected and trained nursing corps. Over time, however, a social class system, religion, political ideology and nurses’ economic needs reshaped South Africa’s nursing associations and consequently the profession. By the end of the 20th century, South African nursing leaders accepted that nurses needed their socio-economic welfare to be prioritised and therefore the Democratic Nursing Organisation of South Africa (DENOSA), a professional organisation with a trade unionist stance, was established. The result was a trained, politicised, fragmented nursing corps struggling to find its collective professional voice. The greatest legacy bestowed on South African nursing by its first influential organisations is the professional associations evident today. Over time, the South African Nursing Association’s discussion groups that had been established in the 1950s to discuss nursing-related topics evolved into the specialist groups and associations that were present in 2014. / Health Studies / D. Litt et Phil.

Workplace violence directed at student nurses in training in psychiatric institutions is a significant concern as it negatively affects the quality of learning and causes the students to have a negative perception of nursing as a profession. The absence of scientific data describing the perceptions of student nurses about workplace violence and their clinical learning outcome motivated the researcher to conduct the study. Quantitative, descriptive research was conducted to explore the influence that workplace violence will have on clinical learning outcomes of student nurses who are studying psychiatric nursing at psychiatric institutions in KwaZulu-Natal, in South Africa. Data was gathered using a 71 question questionnaire, which was adapted from the one used by Hewett (2010). With the necessary permission from the health authorities, the campus principals and the nursing students, a group of 4th year student nurses (n=163) from 6 campuses of the KwaZulu-Natal College of Nursing (KZNCN) who have worked in psychiatric units for at least 3 months and longer participated in the study. The study highlighted the types of workplace violence encountered by student nurses, the effects of workplace violence on students’ academic performance and the barriers to the reporting of workplace violence encountered by the student nurses. The study revealed that there is a large amount of non-physical, some physical and a few incidents of sexual violence directed towards the student nurses at the psychiatric institutions, and that it has a negative impact on student learning. The recommendations emanating from the study support the idea of a shared responsibility between healthcare and education institutions and the focus is on preparing and equipping the student psychiatric nurses to confront, withstand and break the cycle of workplace violence. / Health Studies / M.A. (Nursing Science)

The purpose of the study was to explore and describe the lived experiences of general nurses working at Standerton hospital medical wards which also admit psychiatric patients. A qualitative, descriptive phenomenological approach was used for the study. The study population consisted of seven general nurses working in medical wards at Standerton hospital. Purposive sampling was used to select participants who met the inclusion criteria. Researcher used in-depth face to face interviews to collect data until data saturation was achieved. Tesch’s method of qualitative data analysis was utilised to identify themes. Three themes and five sub-themes emerged from the study: theme1: perceived danger due to aggression sub-themes stress for medical patients, stress for medical patients’ families and stress for nurses. Theme 2: lack of skills in dealing with psychiatric patients’ sub- theme use of restrains. Theme 3: self fulfilling prophecy subtheme reported incidences. The study findings demonstrate the plight of general nurses who are not trained to work with psychiatric patients but continue to do so. Findings further accentuate what is already known about the labelling that goes with psychiatric patients and aggression as a resultant effect. Recommendations were made for future research, policy makers, nursing education and practice. / Health Studies / M.A. (Health Studies)

Text in Afrikaans / Summaries in Afrikaans and English / Bemagtiging van verpleegkundiges in gesondheidsdienste in Suid-Afrika bly 'n voortdurende kwessie en die mate waartoe verpleegbestuur verpleegkundiges bemagtig om outonoom op te tree, is onbekend. Wanneer verpleegkundiges bemagtig is, lei dit tot verbeterde pasientsorg deur middel van verhoogde produktiwiteit en werktevredenheid. Die wyse waarop bemagtiging van verpleegkundiges meet geskied is nog nie in SuidAfrika in diepte ondersoek nie. Die doel van hierdie studie was om daardie elemente wat vir die verpleegbestuurder noodsaaklik is om verpleegkundiges te kan bemagtig, te identifiseer. Deur middel van 'n beskrywende, ontdekkende studie wat van 'n vraelys gebruik gemaak het om inligting te bekom, is die nodige elemente gei'soleer. Verpleegbestuurders in gesondheidsdienste in die Gauteng-area het as teikengroep gedien. Definisies van bestuursbemagtiging is geanaliseer ten einde 'n konseptuele raamwerk te ken saamstel. Ses konsepte het die raamwerk vir hierdie studie gevorm, naamlik: • die bydrae van bestuurstrukture tot die bemagtiging van verpleegkundiges; • die rel van magsdeling in die bemagtiging van verpleegkundiges; • deelnemende besluitneming in die bemagtiging van verpleegkundiges; • die verpleegbestuurder se vaardighede en verantwoordelikhede in haar daaglikse taakontwerp en bestuur wat tot die bemagtiging van verpleegkundiges bydra; • motivering- en beloningstrategiee wat tot bemagtiging bydra; en • eienskappe wat kenmerkend van 'n bemagtigende verpleegbestuurder is. Uit die ontleding van die data het die volgende belangrike elemente ender andere na vore gekom: • Daar behoort gedesentraliseerde verspreiding van mag na die laagste moontlike vlak in die gesondheidsdiens plaas te vind; • Die voorstelle van verpleegkundiges behoort erken en indien aanvaarbaar, geimplementeer te word; • Gesag behoort op so n wyse gedelegeer te word dat onafhanklike besluitneming bevorder word; • Verpleegkundiges se take behoort sodanig ontwerp te word dat onafhanklike optrede in die werkplek bevorder word. Die bevindinge van hierdie studie het getoon dat verpleegbestuurders positief ingestel is betreffende die bemagtiging van verpleegkundiges. Hulle beskou dit as deel van hulle bestuursfunksie. 'n Uitdaging waarmee die bestuurder van die toekoms te kampe sal he, is die van 'n omvattende begrip vir personeellede en om van beheer deur middel van streng burokratiese reels, af te sien. / Empowerment of nurses in health services in South Africa remains an ongoing issue, but the extent to which nursing management empowers nurses to act autonomously is not known. When nurses are empowered patient care and nursing services improve through enhanced productivity and job satisfaction. The way in which nurses could be empowered by management has yet to be addressed by researchers in South Africa. The aim of the present study was to identify those essential elements through which nurse managers can empower nurses. By making use of a descriptive exploratory study, utilizing a questionnaire to acquire the necessary information, the essential elements were isolated. Nurse managers in health services in the Gauteng region formed the target group. Definitions of empowerment in management were analyzed and from this a conceptual framework regarding empowerment was formulated. Six concepts served as the basis of this study: • the contribution of management structures, towards the empowerment of nurses; • the role of power-sharing in the empowerment of nurses; • participative decision making in the empowerment of nurses; • the management skills and responsibilities of the nurse manager in her daily task design and management that contribute to the empowerment of nurses; • motivation and reward strategies that contribute towards empowerment; • attributes which characterise an empowered nurse manager. From the analysis of. the data the following important elements among others emerged: • Decentralization of the distribution of power to the lowest possible level should take place in the health services; • The suggestions of nurses should be acknowledged and if found acceptable, to be implemented; • Authority should be delegated in such a way that independent decision making by nurses is enhanced; • Nurses' tasks should be designed in a way that promote independent performance in the work place. The findings of this study revealed that nurse managers are favourably disposed towards the empowerment of nurses. They see this as part of their managerial function. A challenge which confronts the manager of the future is that of comprehensively understanding staff members, and setting aside control through bureaucratic behaviour. / Health Studies / D. Litt. et Phil.

Text in English / With the Acquired Immune Deficiency Syndrome (AIDS), first recognised in 1981 as a new disease that subsequently took on pandemic proportions, home-based caregivers became instrumental to ensure that, notwithstanding the encumbered health care systems, people living with HIV and AIDS (PLWHA) receive care, support and treatment within their households to live prolonged dignified lives. Despite their pivotal role in the field of HIV and AIDS care, there seems to be a dearth of literature, and research locally and internationally, from the ambit of Social Work on the topic of how HBCGs manage and cope with the work-related challenges they experience when caring for PLWHA and their need for Social Work support. Through this exploratory, descriptive, contextual and phenomenological qualitative study, I scrutinised the HBCGs’ experiences and associated challenges and the coping strategies they employ to address these challenges as well as their views on how social workers could support them in overcoming these challenges in the specific case on home-based care to PLWHA. Twenty-five HBCGs were identified and recruited through purposive and snowball sampling techniques from twelve home-based care organisations in South African provinces, namely, North West, Limpopo and Gauteng. Data was collected through individual face-to-face semi-structured interviews using an interview-guide. Data analysis was conducted through Tesch’s eight steps (in Creswell 2014:189) while Guba’s model (in Shenton, 2004) was adopted for data verification. Cast against Loretta Williams’ (2014) middle range theory of caregiving dynamics (Williams 2014), the coping theory of Lazarus and Folkman (1984) and the strength-based perspective (Saleebey, 2013) adopted as theoretical frameworks for this study, the following findings were revealed. The HBCGs were motivated by, among other factors, their mere desire to care for PLWHA; their personal experiences of caring for an ill relative; and future career aspirations to become involved in this care work. HBCGs were found to face various work-related challenges in connection with reactions from community members, the patients and their relatives; their unsafe working conditions; as well as from their colleagues, other role players and their own organisations. It was found that for most of the HBCGs their care work saddened, pained and discouraged them. In the midst of feeling sorry for their patients, they feared getting infected themselves, in addition to their work-related challenges that caused them to experience feelings of failure. The strategies adopted to cope with their work-related challenges included getting support from employers, receiving counselling and becoming involved in support groups. Finally, several suggestions were directed to the management structures of HBC organisations, the HBCGs themselves and social workers on how they could address the work-related challenges. Based on the research findings, some recommendations are forwarded concerning guidelines for Social Work support directed at work practice, policies and programmes; associated education and training endeavours; and continuous professional development initiatives, as well as avenues for further research. / Social Work / D. Phil. (Social Work)

Text in Afrikaans / Summaries in Afrikaans and English / Bemagtiging van verpleegkundiges in gesondheidsdienste in Suid-Afrika bly 'n voortdurende kwessie en die mate waartoe verpleegbestuur verpleegkundiges bemagtig om outonoom op te tree, is onbekend. Wanneer verpleegkundiges bemagtig is, lei dit tot verbeterde pasientsorg deur middel van verhoogde produktiwiteit en werktevredenheid. Die wyse waarop bemagtiging van verpleegkundiges meet geskied is nog nie in SuidAfrika in diepte ondersoek nie. Die doel van hierdie studie was om daardie elemente wat vir die verpleegbestuurder noodsaaklik is om verpleegkundiges te kan bemagtig, te identifiseer. Deur middel van 'n beskrywende, ontdekkende studie wat van 'n vraelys gebruik gemaak het om inligting te bekom, is die nodige elemente gei'soleer. Verpleegbestuurders in gesondheidsdienste in die Gauteng-area het as teikengroep gedien. Definisies van bestuursbemagtiging is geanaliseer ten einde 'n konseptuele raamwerk te ken saamstel. Ses konsepte het die raamwerk vir hierdie studie gevorm, naamlik: • die bydrae van bestuurstrukture tot die bemagtiging van verpleegkundiges; • die rel van magsdeling in die bemagtiging van verpleegkundiges; • deelnemende besluitneming in die bemagtiging van verpleegkundiges; • die verpleegbestuurder se vaardighede en verantwoordelikhede in haar daaglikse taakontwerp en bestuur wat tot die bemagtiging van verpleegkundiges bydra; • motivering- en beloningstrategiee wat tot bemagtiging bydra; en • eienskappe wat kenmerkend van 'n bemagtigende verpleegbestuurder is. Uit die ontleding van die data het die volgende belangrike elemente ender andere na vore gekom: • Daar behoort gedesentraliseerde verspreiding van mag na die laagste moontlike vlak in die gesondheidsdiens plaas te vind; • Die voorstelle van verpleegkundiges behoort erken en indien aanvaarbaar, geimplementeer te word; • Gesag behoort op so n wyse gedelegeer te word dat onafhanklike besluitneming bevorder word; • Verpleegkundiges se take behoort sodanig ontwerp te word dat onafhanklike optrede in die werkplek bevorder word. Die bevindinge van hierdie studie het getoon dat verpleegbestuurders positief ingestel is betreffende die bemagtiging van verpleegkundiges. Hulle beskou dit as deel van hulle bestuursfunksie. 'n Uitdaging waarmee die bestuurder van die toekoms te kampe sal he, is die van 'n omvattende begrip vir personeellede en om van beheer deur middel van streng burokratiese reels, af te sien. / Empowerment of nurses in health services in South Africa remains an ongoing issue, but the extent to which nursing management empowers nurses to act autonomously is not known. When nurses are empowered patient care and nursing services improve through enhanced productivity and job satisfaction. The way in which nurses could be empowered by management has yet to be addressed by researchers in South Africa. The aim of the present study was to identify those essential elements through which nurse managers can empower nurses. By making use of a descriptive exploratory study, utilizing a questionnaire to acquire the necessary information, the essential elements were isolated. Nurse managers in health services in the Gauteng region formed the target group. Definitions of empowerment in management were analyzed and from this a conceptual framework regarding empowerment was formulated. Six concepts served as the basis of this study: • the contribution of management structures, towards the empowerment of nurses; • the role of power-sharing in the empowerment of nurses; • participative decision making in the empowerment of nurses; • the management skills and responsibilities of the nurse manager in her daily task design and management that contribute to the empowerment of nurses; • motivation and reward strategies that contribute towards empowerment; • attributes which characterise an empowered nurse manager. From the analysis of. the data the following important elements among others emerged: • Decentralization of the distribution of power to the lowest possible level should take place in the health services; • The suggestions of nurses should be acknowledged and if found acceptable, to be implemented; • Authority should be delegated in such a way that independent decision making by nurses is enhanced; • Nurses' tasks should be designed in a way that promote independent performance in the work place. The findings of this study revealed that nurse managers are favourably disposed towards the empowerment of nurses. They see this as part of their managerial function. A challenge which confronts the manager of the future is that of comprehensively understanding staff members, and setting aside control through bureaucratic behaviour. / Health Studies / D. Litt. et Phil.