The question the researcher set out to answer during this research is: How is a caring concern maintained by the (student nurse) as caregiver? It stemmed from unresolved plausible hypotheses stated during a previous qualitative study into the phenomenon caring, from media reports on the "poor care" rendered in health institutions in South Africa, and a concern about the Tylerian rationale in nursing education. The theory generation required was achieved through Wertz's Empirical Psychological Reflection and existential phenomenology. Heidegger's theory of"Care as the essence of being" constituted a central concept in this research. A linguistic epistemology and expanded definition of the term empirical were also pertinent in this research. The literature review focussed on the methodology, ontology (caring and maintenance) and epistemology, serving a purpose towards bracketing. A purposive sample of informants was extracted according to students' performance on the Personal Orientation Inventory (POI). Sixteen qualitative research interviews were conducted. Analysis was conducted through open coding, categorisation and axial coding. At the idiographic level, twelve individual psychological profiles were constructed serving the purpose of imaginative variation. At the nomothetic level four major themes emerged, namely: The Caring Phenomenon (Contextualisation); Factors Eroding a Caring Concern; Factors in the Maintenance of a Caring Concern; and Core Experiences. The dialogue among the four intra-psychic processes of Care, will, meaning attribution and conscience accounts for all events encountered in the data. This dialogue results in either reason or intuition, displaying caring and the maintenance of a caring concern. Positing will and conscience as thesis and antithesis, the resulting synthesis postulates the basic ethical concepts of autonomy, authority, responsibility and accountability as existentially inherent to being and existence, and to the maintenance of a caring concern. The final manifestation of the object ofintention, maintenance, is proposed as an anthropological model. When extended to the fields of (nursing) education, human motivation and the teaching of (nursing) ethics, emotional intelligence, social intelligence, the self-science curriculum and life-skills training become imperative to (nursing) curricula. It is also proposed that human caring be studied as a manifestation of human motivation. / Health Studies / D. Litt et Phil. (Advanced Nursing Sciences)

The purpose of this study was to determine the contribution of unit managers towards the training of student nurses coming to their units for clinical practica. The sample consisted of students training in the four nursing colleges in the Cape Peninsula, and unit managers working in health services accommodating students for clinical practica in the same area. The findings revealed that the majority of unit managers were teaching students whenever they had the opportunity. Generally unit managers were prepared for their teaching function, but many students were not satisfied with some clinical learning opportunities presented to them, for example drawing up patients' care plans, discussing patients' treatment plans when handing over report, giving assistance regarding patient care decisions and lending support when students are confronted with patient care problems. There appears to be a need to educate unit managers regarding these and other aspects of the students' training programme. / Health Studies / M.A. (Nursing Science)

The purpose of this study was to explore and describe the experiences of Recognition of Prior Learning (RPL) nursing candidates related to the four-year comprehensive nursing training programme at a Nursing Education Institution in Gauteng. To this end an exploratory descriptive qualitative research design was undertaken. The research sample comprised of 13 purposefully selected participants. Face-to-face individual interviews, using open-ended questions (Grand tour), were used to collect data, which was analysed using Tesch’s approach. Findings from the study highlighted the challenges faced by nursing RPL candidates as adult students. These included challenges related to their theoretical learning as well as their clinical facility experiences. Based on the study results, recommendations were formulated in assisting them to successfully and timeously complete their nursing programme / Health Studies / M.A. (Nursing Science)

Within the nursing profession, the transition from the student to a graduate nurse is a common rite of passage that marks the end of initial educational preparation in the discipline and the beginning of a professional journey as a nurse and a member of the multidisciplinary team (Nash, Lemcke & Sacre. 2009:48). This is a period of adjustment, stress, growth and development and the transitional nurse is likely to feel uncomfortable, fearful and may experience feelings of inadequacy. This study was undertaken to explore and describe the experiences of final year nursing students at a public college of nursing in the Eastern Cape regarding their preparedness to become registered nurses, with the aim to identify gaps and make recommendations on strategies to close the gaps. The objectives were to explore and describe the experiences of final year nursing students at the public college of nursing in the Eastern Cape Province with regard to their preparedness to become registered nurses and to recommend strategies to improve the preparation of nursing students for transition to become registered nurses. To answer the research question “What are the experiences of final year nursing students at a public college of nursing in the Eastern Cape Province with regard their preparedness to become registered nurses”, a qualitative, explorative and descriptive design was used as a framework for the study. Data were collected by means of unstructured focus group interviews with a purposively selected sample of 27 final year nursing students at the particular college of nursing. Data were analysed using Tesch’s method of analysis for qualitative research. Two themes emerged, revealing that participants at the college experienced preparedness and lack of preparedness to assume the role of a professional nurse. This related to certain aspects that had an impact on the preparation of the final year nursing students for practice and included: curriculum-related aspects; clinical teaching and learning support; learning opportunities; interpersonal relationships between lecturers, students and clinical staff; equipment; and library resources. It was concluded that the learning needs of the nursing students were not adequately catered for, leading to lack of preparedness. Through the involvement of nursing students in the evaluation of their learning, shortfalls in both education and practice areas could therefore be detected. Recommendations regarding strategies to be used to promote preparedness of final year nursing students included: continuous feedback on student performance in the form of exit evaluations on the part of students to identify learning needs; writing of progress reports on the part of clinical practice; and the employment of clinical preceptors with clear role specifications between the lecturers, ward sisters and preceptors to avoid role confusion.

The focus of this study was to explore reasons for the failure of student nurses to present themselves for assessment of clinical skills at a public nursing college in the Eastern Cape. The objectives were to explore and describe reasons why these student nurses were not presenting themselves for such assessment of clinical skills; to develop strategies to motivate them to present themselves for clinical skills assessment; and to make recommendations for assessment of clinical skills. The population of the study was the second and the third-year student nurses undergoing a four-year comprehensive diploma course at a public college of nursing in the Eastern Cape. Non-probability convenience sampling was used. The research questions were, firstly, why the student nurses were not presenting themselves for assessment of clinical skills? Secondly, what recommendations could be made to motivate the student nurses to present themselves for clinical skills assessment? A qualitative, explorative, descriptive and contextual research design was used. Focus group interviews with six participants per group were used to collect data. The total number of participants five focus groups was 30 by the time data saturation was reached. Data were collected following the research question, “Why are you not presenting yourselves for clinical skill assessment?” Their responses were recorded using audiotape and notes with the help of an experienced colleague. Data was analysed following Teschʼs method. Findings presented one theme, being the reason for students not presenting themselves for feedback or delaying to do so. Categories indicated that students were afraid and overwhelmed with anxiety; had too much work to do; unpreparedness for learnt skills; equipment and resources; lack of confidence; and busy ward schedules. Subcategories included lecturersʼ attitude; unfamiliarity to lecturers accompanying them; having to study to master a lot of theory; having to prepare for many tests; unavailability of lecturers to mentor them; unavailability of unit professional nurses to guide them; reluctance of patients to be used for practising skills; a tendency not to practise skills; too many students; being used as work force; placement objectives; use of dolls for demonstration; tools used to support learning making reference to obsolete equipment; all skills demonstrated at the same time; lecturers improvising when they are demonstrating some skills, and not being released for practising of skills. The focus of this study was to explore reasons for the failure of student nurses to present themselves for assessment of clinical skills at a public nursing college in the Eastern Cape. The objectives were to explore and describe reasons why these student nurses were not presenting themselves for such assessment of clinical skills; to develop strategies to motivate them to present themselves for clinical skills assessment; and to make recommendations for assessment of clinical skills. The population of the study was the second and the third-year student nurses undergoing a four-year comprehensive diploma course at a public college of nursing in the Eastern Cape. Non-probability convenience sampling was used. The research questions were, firstly, why the student nurses were not presenting themselves for assessment of clinical skills? Secondly, what recommendations could be made to motivate the student nurses to present themselves for clinical skills assessment? A qualitative, explorative, descriptive and contextual research design was used. Focus group interviews with six participants per group were used to collect data. The total number of participants five focus groups was 30 by the time data saturation was reached. Data were collected following the research question, “Why are you not presenting yourselves for clinical skill assessment?” Their responses were recorded using audiotape and notes with the help of an experienced colleague. Data was analysed following Teschʼs method. Findings presented one theme, being the reason for students not presenting themselves for feedback or delaying to do so. Categories indicated that students were afraid and overwhelmed with anxiety; had too much work to do; unpreparedness for learnt skills; equipment and resources; lack of confidence; and busy ward schedules. Subcategories included lecturersʼ attitude; unfamiliarity to lecturers accompanying them; having to study to master a lot of theory; having to prepare for many tests; unavailability of lecturers to mentor them; unavailability of unit professional nurses to guide them; reluctance of patients to be used for practising skills; a tendency not to practise skills; too many students; being used as work force; placement objectives; use of dolls for demonstration; tools used to support learning making reference to obsolete equipment; all skills demonstrated at the same time; lecturers improvising when they are demonstrating some skills, and not being released for practising of skills. The researcher concluded that students had valid reasons for not presenting themselves for assessment of clinical skills but this could be rectified through the involvement of lectures, ward staff as well as students themselves. The researcher recommended that effective communication between the staff in clinical areas and the college is needed. Clinical laboratories needed laboratory managers and had to be well equipped. A revision of the student-lecturer ratio form feed-back on skills is also suggested.The researcher concluded that students had valid reasons for not presenting themselves for assessment of clinical skills but this could be rectified through the involvement of lectures, ward staff as well as students themselves. The researcher recommended that effective communication between the staff in clinical areas and the college is needed. Clinical laboratories needed laboratory managers and had to be well equipped. A revision of the student-lecturer ratio for feed-back on skills is also suggested.

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

This study, using qualitative exploratory, descriptive and contextual research design, explored and described student nurses’ perspectives of the high failure rate in biological sciences. The study was conducted at one of the campuses of the school of nursing in the Free State province of South Africa. A purposively selected sample of 1st and 2nd year student nurses registered for the programme of education and training leading to registration as a nurse (general, psychiatric and community) and Midwife (R425, 1985; paragraph (iii) as amended) at the selected campus of the School of Nursing in the Free State was used. World café was utilized for data collection. Thematic analysis of data done using Braun and Clarke (2006) and for world café participants’ created documents, Blakeman, Samuelson and McEvoy (2012) method of document analysis was applied. The findings identified the internal and external causes of high failure rate in biological. Internal causes included students-related factors, which included difficulty in understanding the content and lack of motivation. The external causes involved content overload, inadequate utilisation of available limited resources, ineffective teaching methods and unfair assessment practices. Suggestions that were made by the students to improve the success rate in biological sciences were based on the perceived causes. Recommendations made included in-service education on interactive, evidence-based teaching learning methods in anatomy and physiology, provision of support for students with no background knowledge of biological sciences. / Health Studies / M.A. (Nursing Science)

The purpose of midwifery nursing education is to prepare midwives who are fully qualified to provide high-quality, evidence-based mother and child health care services. A quantitative descriptive explorative design was used to identify and explore midwifery students’ experiences of clinical teaching at Sovenga Campus, (Limpopo College of Nursing), Limpopo province. Structured questionnaires were used to collect data. The research sample consisted of fifty (50) midwifery students from Sovenga Campus. Ethical principles were adhered to. Validity and reliability were maintained. The findings showed that learning opportunities are being utilised and clinical accompaniment by tutors has improved. The findings indicated that clinical teaching in midwifery units does not include implementation of the maternity guidelines and protocols’ being used .A recommendation was that tutors be included in student orientation and the planning of monthly unit in-service programmes. / Health Studies / M.A. (Nursing Science)

Dans les pays industrialisés tels que le Canada, les maladies chroniques non transmissibles comme le diabète et les maladies cardiovasculaires sont responsables de la majorité de la mortalité prématurée. Les comportements liés à la santé, comme le tabagisme, ont un impact majeur sur le développement de ces maladies. Les infirmières et les infirmiers , par le biais d’une approche motivationnelle nommée counseling bref en changement de comportement (CBCC), peuvent soutenir les patients dans le changement de comportement lié la santé. Toutefois, les études soulignent des barrières inhérentes à la mise en œuvre du CBCC par les infirmières en milieu hospitalier, comme le manque d’habiletés et des normes sociales défavorables. Cette thèse par articles présente les résultats d’une étude visant à (1) développer un programme de formation numérique adaptatif basé sur la théorie portant sur le CBCC pour la promotion de la cessation tabagique, l’adoption de saines habitudes alimentaires et l’adhésion aux traitements médicamenteux (E_MOTIVA) et (2) évaluer son effet auprès d’infirmières et d’étudiantes en sciences infirmières par un essai clinique à répartition aléatoire (ECR) en comparaison avec un programme de formation numérique standardisé partiellement basé sur la théorie (E_MOTIVB). Le programme E_MOTIVA a été développé selon une démarche systématique en fonction d’appuis empiriques et théoriques, incluant la Théorie du Comportement Planifié, la Théorie de la Charge Cognitive et le concept d’engagement. Le contenu du programme E_MOTIVA a été développé de manière à cibler les barrières et les déterminants théoriques associés à la mise en œuvre du CBCC chez des infirmières et des étudiantes en sciences infirmières (p. ex., attitude, normes subjectives, connaissances, intention). L’adaptation du programme E_MOTIVA a été opérationnalisée à différents moments lors du parcours d’apprentissage afin d’optimiser la charge cognitive et l’engagement des infirmières et étudiantes. Le programme E_MOTIVA incluait trois sessions de formation durant respectivement un maximum de 50, 60 et 20 minutes. Il pouvait être complété en ligne depuis un téléphone intelligent, une tablette ou un ordinateur. Nous avons mené un ECR à deux groupes parallèles en simple aveugle auprès de 102 infirmières et étudiantes inscrites dans un programme de baccalauréat en sciences infirmières au Canada afin d’évaluer le programme E_MOTIVA (groupe expérimental ; n = 51) en comparaison avec le programme E_MOTIVB (groupe contrôle ; n = 51). L’effet des programmes a été évalué sur 1) le changement dans l’intention de mettre en œuvre du CBCC pour la promotion de la cessation tabagique, l’adoption de saines habitudes alimentaires et l’adhésion aux traitements médicamenteux (H1) ; 2) les changements dans les variables de la Théorie du Comportement Planifié (H2 à H7) ; 3) la charge cognitive (H8 à H10) ; et 4) l’engagement (H11, H12). Les analyses de covariance n’ont indiqué aucune différence significative dans les scores de changement dans l’intention de mettre en œuvre du CBCC entre deux groupes de l’étude. Cependant, le score de changement dans l’intention était plus élevé dans le groupe expérimental (10,22 ± 3,34) que dans le groupe contrôle (9,04 ± 2,80) (p = 0,787). Il n’y avait pas de différence significative entre les groupes quant aux changements sur le plan des autres variables de la Théorie du Comportement Planifié. Dans les deux groupes, les scores d’intention (H1), d’attitude (H2), de normes subjectives (H3), de contrôle comportemental perçu (H4), de croyances comportementales (H5) et de croyances de contrôle (H7) se sont tous améliorés de manière significative entre les mesures de base et finales. Aucune différence significative n’a été observée entre les groupes concernant la charge cognitive et l’engagement. Cette étude a permis de développer un programme de formation numérique adaptatif basé sur la théorie (E_MOTIVA) portant sur le CBCC destiné aux infirmières et aux étudiantes en sciences infirmières. Les résultats suggèrent que les programmes E_MOTIVA et E_MOTIVB ont eu des effets positifs similaires sur le plan de l’intention de mettre en œuvre du CBCC chez les infirmières et les étudiantes. Des recommandations sont formulées à l’effet d’orienter la recherche vers la distinction entre l’approche basée sur la théorie et le processus d’adaptation et d’explorer des avenues de recherche visant la transformation de l’intention de mettre en œuvre du CBCC en sa mise en œuvre effective en pratique. / In industrialized countries such as Canada, chronic noncommunicable diseases such as diabetes and cardiovascular disease are the cause of most premature mortality. Unhealthy behaviors, such as smoking, have a major impact on the development of these diseases. Nurses can support patients in initiating and sustaining health behavior change through a motivational and collaborative approach called brief behavior change counseling (BBCC). However, studies highlight several barriers to nurses’ implementation of BBCC in hospitals, including lack of skills and unfavorable social norms. This thesis by articles presents the result of a study aiming to (1) develop a theory-based adaptive e-learning program on BBCC for the promotion of smoking cessation, the adoption of healthy eating habits and medication adherence (E_MOTIVA), and then (2) to evaluate its effect with nurses and nursing students in a randomized controlled trial (RCT) compared with a standardized e-learning program partially based on theory (E_MOTIVB). The E_MOTIVA program was developed following a systematic approach and informed by empirical data and theory, including the Theory of Planned Behavior, Cognitive Load Theory and the concept of engagement. The content of the E_MOTIVA program has been developed in such a way as to target the barriers and theoretical determinants of BBCC implementation in nurses and nursing students (e.g., attitude, subjective norms, knowledge, intention). The adaptation of the E_MOTIVA program was operationalized at different times during learning to optimize cognitive load and engagement in nurses and students. The E_MOTIVA program included three training sessions lasting respectively a maximum of 50, 60 and 20 minutes. It could be completed over the Internet from a smartphone, tablet or computer. We then conducted a two group, single blind, RCT with 102 nurses and students enrolled in a baccalaureate nursing program in Canada to evaluate the E_MOTIVA program (experimental group; n = 51) compared to the E_MOTIVB standardized e-learning program partially based on theory (control group; n = 51). The effect of the programs was assessed on: 1) change in intention to implement BBCC for promoting smoking cessation, adoption of healthy eating habits, and medication adherence (H1); 2) changes in the theoretical variables of the Theory of Planned Behavior (H2 to H7); 3) cognitive load (H8 to H10); and 4) experiential and behavioral engagement (H11, H12). Analyzes of covariance indicated no significant difference in the scores of change in intention to provide BBCC between the two study groups. However, the change in intention score was higher in the experimental group (10.22 ± 3.34) than in the control group (9.04 ± 2.80) (p = 0.787). There was also no significant difference between the two groups in the changes in the other variables of the Theory of Planned Behavior. In both groups, scores for intention (H1), attitude (H2), subjective norms (H3), perceived behavioral control (H4), behavioral beliefs (H5) and control beliefs (H7) all improved significantly between baseline and final measures. No significant difference was observed between groups in cognitive load and engagement. This study led to the development of a theory-based adaptive e-learning program (E_MOTIVA) on BBCC for nurses and nursing students. The results suggest that the E_MOTIVA and E_MOTIVB programs had similar positive effects in terms of intention to implement BBCC in nurses and students. Recommendations are made to guide future research towards the distinction between the theory-based approach and the adaptation process and to explore research avenues related to the transformation of the intention to provide BBCC into its actual provision in clinical practice.

Purpose: The purpose of this integrative literature review is to explore the effectiveness of different training modalities on the acquisition and retention of CPR knowledge and psychomotor skill among undergraduate nursing students. Background: It is well known that standard CPR-training is ineffective at preparing nurses for the rigors of a cardiac arrest event. Survival rates for in-hospital cardiac arrests remain low and the proportion of neurobehavioral sequelae among survivors is very high. Methods: A review of relevant literature published between 2006 and 2016 was conducted using the CINAHL and MEDLINE databases. The following key terms were used in the search: ‘student*’, ‘nurs* student*’, ‘cardiopulmonary resuscitation (CPR)’, ‘Basic Life Support (BLS)’, ‘Advanced Life Support (ALS)’, ‘Advanced Cardiac Life Support (ACLS)’, and ‘Retention’. Results: The initial database search yielded a total of sixty-seven articles; of which, nine articles met the inclusion criteria and were utilized in the final analysis. The articles analyzed explored the effectiveness of different training modalities including: self-directed, CD-based, low-fidelity simulation, high-fidelity simulation, collaborative high-fidelity simulation, and deliberate practice. Conclusion: Current training is ineffective both in promoting long-term retention and in delaying the decay of previously learned information. The most effective training modality identified was high-fidelity simulation in conjunction with deliberate practice. The use of collaborative simulation through ‘mock codes’ maximizes the acquisition and retention of CPR knowledge and skill by providing the highest degree of fidelity. Deliberate practice was the only modality, which resulted in improvement of knowledge and skill over time. The absence of individualized feedback diminishes the effects of repeated practice. Practical experience is also susceptible to the detrimental effects exerted by the lack of feedback.