Continuous support during intrapartum is undeniably beneficial. It increases the mother‟s chance of giving spontaneous vaginal birth, which is not physically traumatic.This indicates the effectiveness of continuous support during intrapartum. According to a Cochrane review conducted such support has no identified adverse effects (Hodnett et al., 2009:2). It is important that implementation of continuous intrapartum support should be promoted by the midwives in order to improve the quality of care given to labouring women. The objective of the study is to explore and describe the challenges in implementing continuous intrapartum support in public hospitals in the North West Province. The findings of this study will contribute to the formulation of recommendations to promote continuous intrapartum support in public hospitals in the North West Province. Focus group interviews were conducted to collect data from 33 (thirty-three) registered midwives who have worked in labour rooms for 2 years or more who are able to give in-depth and rich expressions of opinion. The focus group interviews were conducted in a natural setting in the labour unit to avoid inconvenience. An explorative, descriptive and contextual qualitative approach using a non-experimental research design was used in order to reach the aim of the study, being to promote continuous support during intrapartum in public hospitals in the North West Province. The study revealed that midwives have an understanding of the benefits of continuous intrapartum support, but its implementation is hindered by challenges. Recommendations are made to inform the different stakeholders involved in curbing the challenges in order for the implementation of continuous intrapartum support to be a success. These recommendations are directed at the nursing practice, nursing (midwifery) education, nursing research and policy. / MCur, North-West University, Potchefstroom Campus, 2014

Continuous support during intrapartum is undeniably beneficial. It increases the mother‟s chance of giving spontaneous vaginal birth, which is not physically traumatic.This indicates the effectiveness of continuous support during intrapartum. According to a Cochrane review conducted such support has no identified adverse effects (Hodnett et al., 2009:2). It is important that implementation of continuous intrapartum support should be promoted by the midwives in order to improve the quality of care given to labouring women. The objective of the study is to explore and describe the challenges in implementing continuous intrapartum support in public hospitals in the North West Province. The findings of this study will contribute to the formulation of recommendations to promote continuous intrapartum support in public hospitals in the North West Province. Focus group interviews were conducted to collect data from 33 (thirty-three) registered midwives who have worked in labour rooms for 2 years or more who are able to give in-depth and rich expressions of opinion. The focus group interviews were conducted in a natural setting in the labour unit to avoid inconvenience. An explorative, descriptive and contextual qualitative approach using a non-experimental research design was used in order to reach the aim of the study, being to promote continuous support during intrapartum in public hospitals in the North West Province. The study revealed that midwives have an understanding of the benefits of continuous intrapartum support, but its implementation is hindered by challenges. Recommendations are made to inform the different stakeholders involved in curbing the challenges in order for the implementation of continuous intrapartum support to be a success. These recommendations are directed at the nursing practice, nursing (midwifery) education, nursing research and policy. / MCur, North-West University, Potchefstroom Campus, 2014

Diabetes mellitus is a complex disease that requires constant patient compliance to diet, life style, glucose level monitoring and medication. Non-compliance to medication can be associated with the development of complications, avoidable hospitalization, disease progression, premature disability and death. Noncompliance is also very costly and therefore compliance to medication regimens is very important. A promising, yet under-explored approach to compliance is self-regulation. Selfregulation refers to the process of goal setting and striving. Self-regulation has specifically been associated with success in reaching one’s goals. The key selfregulation processes include goal establishment, planning, striving towards a goal and revising it. Although a large number of studies have been conducted on compliance related to diabetes, there is a lack of research findings from a selfregulation perspective. The aim of this study is to investigate the relationship between self-regulation and patient compliance to type I and type II medication. Specific aims are (a) to determine whether there is a significant difference in the mean self-regulation scores for participants high and low in compliance and (b) to determine whether there are significant differences in the mean self-regulation scores between compliant and non-compliant participants within different gender and age groups. The participants consisted of an availability sample of 50 (31 female and 19 male) type I and type II diabetes patients collecting their medication at the Clicks Pharmacy in Potchefstroom and Trans 50 retirement villages in Pretoria, Bloemfontein and Kimberley. The ages of the participants ranged between 20 and 87 years. Compliance was measured by investigating the participants’ repeat scripts as well as the Clicks Medication Therapy Management Questionnaire (MTM-Q), developed in 2009 by pharmacists at Clicks to measure patients’ self-report of compliance. Selfregulation was measured with the Shortened Self-Regulation Questionnaire (SSRQ) (Carey, Neal, & Collins, 2004). The study used the factor structure proposed by Potgieter and Botha (2009), based on a factor analysis of the SSRQ in the South- African context. Data capturing and analysis was done in consultation with the Statistical Consultation Services of the North-West University. A total number of 28 (56%) participants in this study were classified as compliant, which is lower than compliance figures reported in most international studies. Differences between compliant and non-compliant participants were primarily noted with regard to Mindful Awareness, Monitoring and Decision making. No differences were noted between any of the groups regarding Learning from mistakes, Perseverance, or Self-evaluation. Compliant participants in the total, female and older groups scored higher on Mindful Awareness than non-compliant participants. For older participants, this difference was practically significant. Compliant participants in the female and older group also obtained higher scores on Monitoring, with the difference in the female group practically significant. Surprisingly, noncompliant female participants scored higher on Decision Making than compliant female participants. Compliant and non-compliant male and younger participants, however, did not differ on any of the self-regulation factors. The study emphasizes the fact that diabetes is perceived as a significant challenge to the current goals of the patient. Subsequently, this study confirms, to a large extent, the importance of self-regulation in compliance to type I and type II diabetes medication, providing support for international studies that emphasise the importance of behavioural factors in diabetes. Mindfulness and Monitoring emerged as important factors in this study, and was explained in relation to compliance as a challenge to one’s perceptual awareness and ability to continuously generate feedback regarding one’s health status. The reason for gender and age related differences in the relationship between compliance and self-regulation, however, is not totally clear and needs to be explored in further research. An important limitation of the study is the small sample size that was used. Future research should explore the trends emerging from this study in larger, random samples. / MA (Research Psychology), North-West University, Potchefstroom Campus, 2014

Diabetes mellitus is a complex disease that requires constant patient compliance to diet, life style, glucose level monitoring and medication. Non-compliance to medication can be associated with the development of complications, avoidable hospitalization, disease progression, premature disability and death. Noncompliance is also very costly and therefore compliance to medication regimens is very important. A promising, yet under-explored approach to compliance is self-regulation. Selfregulation refers to the process of goal setting and striving. Self-regulation has specifically been associated with success in reaching one’s goals. The key selfregulation processes include goal establishment, planning, striving towards a goal and revising it. Although a large number of studies have been conducted on compliance related to diabetes, there is a lack of research findings from a selfregulation perspective. The aim of this study is to investigate the relationship between self-regulation and patient compliance to type I and type II medication. Specific aims are (a) to determine whether there is a significant difference in the mean self-regulation scores for participants high and low in compliance and (b) to determine whether there are significant differences in the mean self-regulation scores between compliant and non-compliant participants within different gender and age groups. The participants consisted of an availability sample of 50 (31 female and 19 male) type I and type II diabetes patients collecting their medication at the Clicks Pharmacy in Potchefstroom and Trans 50 retirement villages in Pretoria, Bloemfontein and Kimberley. The ages of the participants ranged between 20 and 87 years. Compliance was measured by investigating the participants’ repeat scripts as well as the Clicks Medication Therapy Management Questionnaire (MTM-Q), developed in 2009 by pharmacists at Clicks to measure patients’ self-report of compliance. Selfregulation was measured with the Shortened Self-Regulation Questionnaire (SSRQ) (Carey, Neal, & Collins, 2004). The study used the factor structure proposed by Potgieter and Botha (2009), based on a factor analysis of the SSRQ in the South- African context. Data capturing and analysis was done in consultation with the Statistical Consultation Services of the North-West University. A total number of 28 (56%) participants in this study were classified as compliant, which is lower than compliance figures reported in most international studies. Differences between compliant and non-compliant participants were primarily noted with regard to Mindful Awareness, Monitoring and Decision making. No differences were noted between any of the groups regarding Learning from mistakes, Perseverance, or Self-evaluation. Compliant participants in the total, female and older groups scored higher on Mindful Awareness than non-compliant participants. For older participants, this difference was practically significant. Compliant participants in the female and older group also obtained higher scores on Monitoring, with the difference in the female group practically significant. Surprisingly, noncompliant female participants scored higher on Decision Making than compliant female participants. Compliant and non-compliant male and younger participants, however, did not differ on any of the self-regulation factors. The study emphasizes the fact that diabetes is perceived as a significant challenge to the current goals of the patient. Subsequently, this study confirms, to a large extent, the importance of self-regulation in compliance to type I and type II diabetes medication, providing support for international studies that emphasise the importance of behavioural factors in diabetes. Mindfulness and Monitoring emerged as important factors in this study, and was explained in relation to compliance as a challenge to one’s perceptual awareness and ability to continuously generate feedback regarding one’s health status. The reason for gender and age related differences in the relationship between compliance and self-regulation, however, is not totally clear and needs to be explored in further research. An important limitation of the study is the small sample size that was used. Future research should explore the trends emerging from this study in larger, random samples. / MA (Research Psychology), North-West University, Potchefstroom Campus, 2014

This study focuses on self care among patients with hypertension visiting primary health care clinics in the Naledi sub-district in the North-West Province. Hypertension is one of the chronic diseases that shorten the life expectancy of many people globally and remains the most common and rapid growing cardiovascular disease, affecting 20 million people in sub-Saharan Africa. Hypertension is one of the quadruple burdens of disease associated with risky lifestyle behaviours like unhealthy diets with excessive energy intakes, physical inactivity and tobacco use. Although taking the mentioned common modif iable factors and the fact that hypertension is a manageable condition into consideration, the reality remains that the hypertension. A non-experimental, quantitative research was used to reach the aim of the study namely to identify and describe the self care abilities of patients diagnosed with hypertension, as well as explore and describe their knowledge and perceptions on hypertension. This was done by means of objectives to explore and describe self care abilities, knowledge and perceptions among patients diagnosed with hypertension; if there is an association between self care, knowledge and perception in relation to the level of education, age, income and time period and if there was association between self care and knowledge and perception of patients with hypertension visiting PHC clinics in Naledi sub-district in the North-W est Province. A literature review was first conducted for a clear understanding of self care and hypertension. Thereafter a structured questionnaire, consisting of demographical information, and questions on self care, knowledge and perception among patients with hypertension, was employed. Trained field workers assisted in data collec tion. A number of 142 questionnaires were completed by patients visiting PHC clinics. The demographic data was first analysed with results shown in the frequency table. The exploratory factor analyses were done for data reduction on self care, knowledge and perception among patients with hypertension. Descriptive statistics and Cohen effect sizes for factors on self care, knowledge and perception in relation to the level of education, age, income and other chronic illnesses of patients diagnosed with hypertension, correlational descriptive statistics between self care and knowledge and perception were done. The results revealed that patients with hypertension with low levels of education lack information with regard to hypertension. The higher the income of patients with hypertension, the better their self care abilities compared to those with low income. Patients who are English and Afrikaans speaking have more internal positive power and have better management abilities of hypertension than those who are Setswana speaking. Younger patients have more internal positive power, which declines with age. Those patients who are newly diagnosed with hypertension have more information on management abilities than those who have been diagnosed more than two years. The conclusion regarding the relationship of self care and knowledge and perception of hypertension is that the patients diagnosed with hypertension need knowledge on hypertension in order to adhere to self care abilities. The more knowledge patients have the better they will be able to adhere to self care activities. / Thesis (MCur)--North-West University, Potchefstroom Campus, 2013.

The dualistic South African health system is divided into a private and public health care sector. The core difference between these two sectors is that private hospitals are based on a business model with a profit motive, while public hospitals offer a free service, accessible to all citizens of South Africa and is nurse-driven. The increased need towards higher quality health care is evident in the launching of the National Health Insurance system. The pilot of this system was activated in ten sub-districts in South Africa and will become the mechanism to enhance quality and safety of patient care in the private and public sectors. Registered nurses’ reporting of quality and safety of patient care is an important factor in quality-related research and has been linked with international studies on quality of care. As the registered nurses are directly involved in all the facets of patient care, this population serves as a valuable contribution in the assessment of quality care. In this research quality of care refers to quality, patient safety and adverse events. Quality of care refers to the extent to which actual care is in conformity with the present criteria for good care. Patient safety is a parameter used to monitor and enhance quality. Through enhanced patient safety, adverse events can be prevented. Adverse events refer to all the incidents that can affect a patient during hospitalisation that is not due to the patient’s illness, such as hospital acquired infections, medication safety and patient falls with injury. This research aimed to explore and describe the nurse reported differences in quality of care, patient safety and adverse events in the adult medical and surgical units of private and public hospitals in the Free State and North West Provinces. This study was conducted within the RN4CAST research programme, an international consortium of fifteen countries working together towards the formulation of nurse workforce forecasting models. A quantitative, correlational, explorative, descriptive and contextual design was followed. The population consisted of registered nurses employed for at least one year in the selected private and public hospitals in the two participating provinces. Private hospitals with more than 100 beds were included. The public hospitals had a level three status. An all-inclusive sampling was conducted (n=332) after participants gave informed consent. Data was collected through the completion of the National Nurse Survey that covered four sections of which quality of care, patient safety and adverse events was one. Field workers were utilised during data collection. Data capturing was conducted by means of EpiData 3.1. Secondary data analysis was utilised by means of SPSS 16.0. Descriptive statistics were extracted with regard to the demographic status of the participants. The descriptive statistics were congruent with the demographic profile of nursing in South Africa. The inferential statistics included the difference in quality of care, patient safety and adverse events between the private and public hospitals in the selected provinces. Both the t-test based on the quality of care and patient safety as well as the Mann-Whitney test on adverse events indicated an insignificant difference between nurse reported quality of care, patient safety and adverse events between the private and public hospitals. Reliability and validity were assured and recommendations were formulated for nursing education, practice and research. / MCur, North-West University, Potchefstroom Campus, 2013

This study focuses on self care among patients with hypertension visiting primary health care clinics in the Naledi sub-district in the North-West Province. Hypertension is one of the chronic diseases that shorten the life expectancy of many people globally and remains the most common and rapid growing cardiovascular disease, affecting 20 million people in sub-Saharan Africa. Hypertension is one of the quadruple burdens of disease associated with risky lifestyle behaviours like unhealthy diets with excessive energy intakes, physical inactivity and tobacco use. Although taking the mentioned common modif iable factors and the fact that hypertension is a manageable condition into consideration, the reality remains that the hypertension. A non-experimental, quantitative research was used to reach the aim of the study namely to identify and describe the self care abilities of patients diagnosed with hypertension, as well as explore and describe their knowledge and perceptions on hypertension. This was done by means of objectives to explore and describe self care abilities, knowledge and perceptions among patients diagnosed with hypertension; if there is an association between self care, knowledge and perception in relation to the level of education, age, income and time period and if there was association between self care and knowledge and perception of patients with hypertension visiting PHC clinics in Naledi sub-district in the North-W est Province. A literature review was first conducted for a clear understanding of self care and hypertension. Thereafter a structured questionnaire, consisting of demographical information, and questions on self care, knowledge and perception among patients with hypertension, was employed. Trained field workers assisted in data collec tion. A number of 142 questionnaires were completed by patients visiting PHC clinics. The demographic data was first analysed with results shown in the frequency table. The exploratory factor analyses were done for data reduction on self care, knowledge and perception among patients with hypertension. Descriptive statistics and Cohen effect sizes for factors on self care, knowledge and perception in relation to the level of education, age, income and other chronic illnesses of patients diagnosed with hypertension, correlational descriptive statistics between self care and knowledge and perception were done. The results revealed that patients with hypertension with low levels of education lack information with regard to hypertension. The higher the income of patients with hypertension, the better their self care abilities compared to those with low income. Patients who are English and Afrikaans speaking have more internal positive power and have better management abilities of hypertension than those who are Setswana speaking. Younger patients have more internal positive power, which declines with age. Those patients who are newly diagnosed with hypertension have more information on management abilities than those who have been diagnosed more than two years. The conclusion regarding the relationship of self care and knowledge and perception of hypertension is that the patients diagnosed with hypertension need knowledge on hypertension in order to adhere to self care abilities. The more knowledge patients have the better they will be able to adhere to self care activities. / Thesis (MCur)--North-West University, Potchefstroom Campus, 2013.

The dualistic South African health system is divided into a private and public health care sector. The core difference between these two sectors is that private hospitals are based on a business model with a profit motive, while public hospitals offer a free service, accessible to all citizens of South Africa and is nurse-driven. The increased need towards higher quality health care is evident in the launching of the National Health Insurance system. The pilot of this system was activated in ten sub-districts in South Africa and will become the mechanism to enhance quality and safety of patient care in the private and public sectors. Registered nurses’ reporting of quality and safety of patient care is an important factor in quality-related research and has been linked with international studies on quality of care. As the registered nurses are directly involved in all the facets of patient care, this population serves as a valuable contribution in the assessment of quality care. In this research quality of care refers to quality, patient safety and adverse events. Quality of care refers to the extent to which actual care is in conformity with the present criteria for good care. Patient safety is a parameter used to monitor and enhance quality. Through enhanced patient safety, adverse events can be prevented. Adverse events refer to all the incidents that can affect a patient during hospitalisation that is not due to the patient’s illness, such as hospital acquired infections, medication safety and patient falls with injury. This research aimed to explore and describe the nurse reported differences in quality of care, patient safety and adverse events in the adult medical and surgical units of private and public hospitals in the Free State and North West Provinces. This study was conducted within the RN4CAST research programme, an international consortium of fifteen countries working together towards the formulation of nurse workforce forecasting models. A quantitative, correlational, explorative, descriptive and contextual design was followed. The population consisted of registered nurses employed for at least one year in the selected private and public hospitals in the two participating provinces. Private hospitals with more than 100 beds were included. The public hospitals had a level three status. An all-inclusive sampling was conducted (n=332) after participants gave informed consent. Data was collected through the completion of the National Nurse Survey that covered four sections of which quality of care, patient safety and adverse events was one. Field workers were utilised during data collection. Data capturing was conducted by means of EpiData 3.1. Secondary data analysis was utilised by means of SPSS 16.0. Descriptive statistics were extracted with regard to the demographic status of the participants. The descriptive statistics were congruent with the demographic profile of nursing in South Africa. The inferential statistics included the difference in quality of care, patient safety and adverse events between the private and public hospitals in the selected provinces. Both the t-test based on the quality of care and patient safety as well as the Mann-Whitney test on adverse events indicated an insignificant difference between nurse reported quality of care, patient safety and adverse events between the private and public hospitals. Reliability and validity were assured and recommendations were formulated for nursing education, practice and research. / MCur, North-West University, Potchefstroom Campus, 2013