The purpose of this study W8S to explore and describe the experience of waiting for coronary artery bypass graft (CABG) surgery from the perspective of the individual who h8s a prolonged wait for this surgery. A phenomenological approach was used to guide the study. Data were collected through 17 semi-structured, audio-taped interviews with 7 men and 2 women awaiting CABG surgery. Analysis occurred concurrently with data collection. It was found that there were three interrelated core facets of the experience: the illness, the prospective surgery, and the wait. Each facet held distinct meaning: the illness represented a loss of normalcy and a threat to life; the surgery, both an opportunity to regain normalcy and a threat; and the wait, a "no control" situation which enhanced the losses and threats of the other facets, engendered further losses, and delayed the expected gain from surgery. Within each facet, representative emotional reactions, and coping strategies were identified. The findings indicate that these clients require regular contact and that nursing care must address all three facets of the experience. / Applied Science, Faculty of / Nursing, School of / Graduate

The purpose of this study was to explore the relationship of belief in control and commitment to life to the adult cancer patient's inclination to use unproven cancer therapies. A convenience sample of 40 lung cancer patients completed the Wallston's Multidimensional Health Locus of Control Scale, Crumbaugh's Purpose in Life Scale, Hiratzka's Alternative Therapy Scale, and a patient information sheet. The majority of participants exhibited a strong internal locus of control orientation and a strong commitment to life. Belief in control, commitment to life, and the degree of inclination to use unproven cancer therapies were not significantly associated. However, age was negatively correlated with inclination to use unproven cancer therapies. The majority of participants had heard of five or more unproven cancer remedies, and exhibited a strong inclination to use these unorthodox therapies. The most frequently used unproven therapies were anti-medicines - imagery, faith-healing, megadose vitamins, and taheebo. The rising popularity of these anti-medicines has been reported in the literature. The findings were discussed in relation to theoretical expectations, other research studies, and the methodological problems inherent in the study. Implications of the findings for nursing practice, theory, and education were suggested. Recommendations for further nursing research were made. / Applied Science, Faculty of / Nursing, School of / Graduate

An exploratory study was conducted on 25 male and female patients who were admitted to a 29-bed surgical unit of a 450-bed general hospital, for diagnostic testing. The purpose of the study was to answer the following questions: (1) What situations does the patient perceive as helping him feel comfortable while he is experiencing the diagnostic regime? (2) What situations does the patient perceive as making him feel uncomfortable while he is experiencing the diagnostic regime? (3) What coping responses does the patient utilize in adapting to discomfort promoting situations during the diagnostic regime? The data for the study were collected through the utilization of a structured questionnaire for the initial visit and taped interviews with the selected patients. During the interviews, particular emphasis was placed upon exploring the patients' concerns by the use of Orlando's Open-Ended Interview Technique and a modified version of the Critical Incident Technique. The results were then categorized into themes of patient responses, tabulated, and analyzed. The results of the study revealed that the situations the patient perceived as promoting comfort or discomfort were dependent upon two significant variables: (1) The degree to which the patient's personal value system needs were met during the diagnostic regime; (2) The patient's ability to mobilize adaptive coping responses to deal with the stresses created by the diagnostic regime. The coping responses utilized by the patients in adapting to discomfort promoting experiences in hospital were numerous and highly diversified. It was noted that the patients' ability to cope adaptively was primarily influenced by their evaluation of what was happening to them. In turn, this evaluation was affected by their past experience, their present biopsychosocial state, and the duration of the uncomfortable experience. / Applied Science, Faculty of / Nursing, School of / Graduate

Thesis (M.A. (Nursing Science) -- University of Limpopo, 2020 / Background Patient’s awareness of the patients’ rights charter was assessed as it was not known and strategies were developed to improve patients’ awareness in the selected hospitals of the Limpopo Province. Aim To assess, describe and explore patients’ awareness of their rights and to develop strategies to improve patients’ awareness of their rights. Study methodology A qualitative exploratory and descriptive research approach were used. Data were collected from 30 patients using semi-structured face-to-face interviews. Data were audiotaped and field notes were taken. The Turfloop Research Ethics Committee gave ethical clearance. The Department of Health permitted for the study to be conducted in the selected hospitals. Ethical considerations and measures to ensure trustworthiness were observed. Results Results showed that patients lacked awareness of the Patients’ Rights Charter and they could not give examples or name the rights they have as patients. The study revealed that sources of information regarding the Patients’ Rights were limited. Patients indicated that Patients’ Rights implementation was situational. Patients also experienced disrespect regarding their rights. In addition, strategies to improve patients’ awareness regarding the Patients’ Rights Charter were developed from the themes that emerged from this study.

This investigation explored the relationship of demographic, social network, social support, and stroke-related factors to depressive symptomatology and well-being in 50 elderly individuals who had recently suffered a first, completed stroke and their partners. Data were gathered at two points in time, with interviews scheduled six months apart. Outcome measures included the CES-D depression scale and the Index of Psychological Well-Being. Data were analyzed using descriptive statistics, correlational procedures, multiple regression, and change-focused regression analyses. For the caregivers, lower depression levels at Time 1 were associated with better subjective health, less concern about being able to care for the patient in the future, higher levels of patient ADL functioning, greater perceived pre-stroke instrumental support, and greater patient optimism. At Time 2, lower caregiver depression scores were associated with lower levels of perceived burden, fewer health problems or negative changes in health status, fewer negative network interactions, greater network density, greater frequency of network contacts, and fewer perceived personality and behavior changes in the patient. Best predictors of depression score for the caregivers at Time 1 were subjective health rating, the patient's level of ADL functioning, degree of concern about ability to care for the patient in the future, the proportion of the network providing instrumental support, and the percent of reciprocal confiding relationships reported. At Time 2, best predictors of depression were level of perceived caregiver burden, objective health score, and network density. The best predictor of caregiver depression level over time was Time 1 depression level. Perceived caregiver burden was also a strong predictor of depression score. For the patients, higher depression scores at Time 1 were associated with whether they felt they could have done anything to prevent the stroke, higher levels of concern about their partner's ability to care for them in the future, and greater reported frequency of pre-stroke disagreement with their partners. At Time 2, higher levels of depressive symptomatology were associated with decreased satisfaction with amount of social contact, a greater proportion of friends in the post-stroke network, a greater degree of perceived negative health change, and change in employment status.

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The literature on stroke reveals an increasing interest in the role played by social and emotional factors in rehabilitation after stroke. A comprehensive literature survey shows profiles of spontaneous recovery, the significance of a team approach to rehabilitation, patterns of prognostic significance for long-term recovery and adaptation and formulations of rehabilitation models for the Western world. The importance of depression as a major factor in demotivation to participate in rehabilitation and achieve long-term quality of life post-stroke emerges. From the literature survey a research design was formulated for the ecological study of a sample of 51 stroke patients at Ga-Rankuwa Hospital near Pretoria. The questionnaire was structured according to the Synchronous Systems Model, and data gathered from the biological, personal and environmental spheres of patients. Data was collected by a multidisciplinary team at three assessment times, three days, two weeks and three months post-stroke. These corresponded to the acute physical phase of stroke, the end of the hospitalisation period, and an assessment of patients once they had been discharged back into the community. Descriptive statistics were obtained on all variables and principle axis factor analysis was performed to verify the factorial structure of the tests. In order to establish whether group scores changed between assessments, t-tests for dependent measures were applied. Pearson Product Moment correlations were computed for the purpose of establishing relationships between variables. The results revealed dramatically differing biographical characteristics of the sample of stroke patients both premorbidly and at three months after the stroke. Significant recovery profiles emerged in both the physical and neuropsychological spheres at both the 14 day and 3 month assessments. Depression and the functioning at home and at work social sphere of role emerged as profiles of deterioration. At 14 days, depression was related to physical and cerebral functioning. This changed at three months, with depression also being significantly related to aspects of social functioning. On the basis of these results, depression after stroke was conceptualised as a severance of relational connectedness in the social ecological functioning of stroke patients. An ecological approach to rehabilitation is proposed that would seek to reframe the identity of stroke patients and establish relational connectedness post-stroke. / Psychology / D. Litt. et Phil. (Psychology)

published_or_final_version / Speech and Hearing Sciences / Master / Master of Science in Audiology