Thesis (Ph.D.)--Duquesne University, 2008. / Title from document title page. Abstract included in electronic submission form. Includes bibliographical references (p. 121-126) and index.

The study aimed to develop, monitor and explore the process and outcomes of guided reflection and its impact on enabling practitioners to achieve desirable and effective caring practice. A secondary focus of the study was to monitor and explore the process and outcomes of guided reflection as a form of critical action research which may generate theoretical insights regarding its use in clinical supervisory practices. The process referred to as 'guided reflection' was developed and used to guide this study. Guided reflection represents a form of social action research which was framed within an ontology and process of critical and reflexive phenomenology of experience between practitioners and their supervisors over a period of four years. Whilst each guided reflection relationship was written as a critical narrative to illuminate the reflexive development of effective practice, these narratives became a secondary level of analysis to construct meta-narratives of the nature of effective work and dynamics of guided reflection. Various frameworks were developed and tested within a reflexive process that was appropriately informed and juxtaposed with extant theory to adequately interpret and present the process and ou.tc omes of the study. The method and process of guided reflection generated two major empirical and theoretical insights. • 'The 'Being available' framework to know effective caring practice, presented as one major exemplar of 'Pru'. • Meta-reflection of methods and process of guided reflection. Three frameworks in particular are significant: . • 'Being available' as a parallel framework for effective supervision practice. This parallel framework supports the coherence between developmental and research processes. • The Model for Structured Reflection as an heuristic device for knowing reflection. • 'Framing perspectives' as a series of integrated lenses to focus on discrete layers of learning within reflection. The insights gained through the study have considerable significance for informing and guiding the future development of reflective practice within nursing curriculum, clinical supervision within practice, and the future development of nursing knowledge. The development of nursing knowledge is of particular significance in understanding the meaning and nuances of holistic nursing as a lived reality and have significantly contributed to the reflexive development of the Burford NDU Model: Caring in Practice. The study has become a springboard for research to gain further insight into the factors that facilitate or constrain the efficacy of guided reflection in enabling practitioners to know and realise desirable practice within everyday practice.

Thesis (M.S.)--Florida State University, 2004. / Advisor: Dr. Jeanne Flannery, Florida State University, School of Nursing, Dept. of Graduate Studies. Title and description from dissertation home page (viewed Sept 27, 2004). Includes bibliographical references.

The purpose of this research was to ascertain how primary nursing care is perceived by both the elderly infirm living in the community and their district nurses. How the perceptions of needs for care were translated into action and the sort of expectations they had and results they achieved. The research also examined whether or not differences in nursing care patterns occurred between those nurses working within a primary health care team and those aligned to a number of single-handed general practices. The main research instrument was in the form of interview schedules. These contained structured and open ended questions as well as Likert assessment scales, and were administered by the researcher to patients, nurses and general practitioners at various stages of care. Over a period of 18 months a total of two-hundred patients and their district nurses and general practitioners from one health district participated. The results were analysed with the help of a computerised statistical package for social science. The findings indicate that district nurses' perception of patient needs is illness focused and, as such, prescribe and give nursing care on the basis of the medical model. The patients' perceive their state of health mainly in terms of discomfort and disability and their effects. As their problems manifest themselves to a great extent in multiple health as well as social issues as a legacy of past life events, a shift from the medical towards the social model of care seems, therefore, of prime importance. There is little doubt that where district nurses become involved with the elderly infirm person she becomes the focal health care professional support. It seems that this emphasis on the district nurse becoming the key member of the primary health care team produces a whole new set of values. This approach has implications not only for post basic nurse training but also demands a change of attitude towards organisational support. As the role of the district nurses as a fully participant health care team member in Attachment schemes has not been established conclusively in this research it is important to consider professional support by strengthening the peer reference group. These findings and their limitations are discussed and areas of further research identified.

Thesis (Ph. D.)--University of Rhode Island, 2004. / Typescript. Includes bibliographical references (leaves 112-120).

Primary nursing is a system of delivering nursing care when one nurse is responsible and accountable for the assessment of the patient's needs as well as the planning, implementing and evaluating of the nursing care throughout the patient's hospitalization. These activities are done in collaboration with the patient and other members of the health team. This system is a relatively recent development in the field of nursing. There has been little research done to either describe or evaluate primary nursing, particularly in the area of psychiatry. This study was an attempt to include both patients and nurses in such an evaluation. A validated and reliable questionnaire was developed by the author to obtain data related to patients' and nurses’ perceptions of the occurrence, importance and satisfaction of specific primary nursing behaviours. The questionnaire was administered to twenty-nine patients and their primary nurses during the last week of the patient's hospitalization. Nurses and patients reported that primary nursing behaviours related to discharge had a low occurrence rate. However, they attributed a high degree of importance to these same behaviours. Both groups reported a low occurrence and importance score for primary nursing behaviours related to family involvement with the primary nurse and the patient's treatment program. Both nurses and patients agreed on the occurrence and importance of most of the primary nursing behaviours. There was less agreement in the area of satisfaction. / Applied Science, Faculty of / Nursing, School of / Graduate

Thesis (MCurr)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: The imbalance between job demands and available resources could cause burnout which may impact quality patient care. A scientific investigation was conducted to evaluate burnout amongst primary health care (PHC) nurses. The objectives for the study were to identify the prevalence of burnout amongst PHC nurses and to explore the contributing factors to burnout in PHC settings. The Job Demands-Resources (JD-R) model (Bakker and Demerouti, 2007:309) was used as a conceptual framework for the study. A non-experimental, descriptive cross-sectional design with a quantitative approach was applied. The population and sample consisted of professional nurses (PN) and clinical nurse practitioners (CNP) (n=72) in the Eden District of the Western Cape. A self-report questionnaire was used to collect the data in an uncontrolled, natural environment. Analysis of the results exposed high levels of burnout amongst PHC nurses. Nurses in PHC facilities all had an equal chance to develop burnout, regardless of their level of experience. The occurrence of burnout is equal in community health centres and in community clinics, although a trend was observed that subjects in community clinics may experience more emotional exhaustion. Work pressure, workload or an increase in job demands, lack of organisational support and management problems were rated as the main factors contributing to burnout. Recommendations were made to improve the working environments of PHC nurses in order to increase motivational levels, job satisfaction and to foster work engagement, as well as to reduce levels of burnout. Opportunities for further research are recommended. / AFRIKAANSE OPSOMMING: Die wanbalans tussen beroepseise en beskikbare hulpbronne kan uitbranding veroorsaak en gevolglik kwaliteit patiëntsorg beïnvloed. ‘n Wetenskaplike studie is gedoen om uitbranding onder primêre gesondheidsorg (PGS) verpleegkundiges te evalueer. Die doelstellings van die studie was om die voorkoms van uitbranding onder PGS-verpleegkundiges te identifiseer, en om die bydraende faktore wat aanleiding gee tot uitbranding in PGS-instellings, te ondersoek. Die Beroepseise-Hulpbronne model (Bakker and Demerouti, 2007:309) is as ‘n konsepsuele raamwerk vir die studie gebruik. 'n Nie-eksperimentele, beskrywende dwarssnit studie met 'n kwantitatiewe benadering, is toegepas. Die populasie en die steekproef het bestaan uit professionele verpleegkundiges en kliniese verpleeg praktisyns (n=72) in die Eden Distrik van die Wes-Kaap. ‘n Self-rapport vraelys was gebruik om data in ‘n ongekontroleerde, natuurlike omgewing te versamel. Die analisering van resultate het hoë vlakke van uitbranding onder verpleegkundiges in PGS-dienste ontbloot. Verpleegkundiges in PGS-fasiliteite het almal 'n gelyke kans om uitbranding te ontwikkel, ongeag die vlak van ondervinding. Die voorkoms van uitbranding is dieselfde in gemeenskaps-gesondheidsentrums en gemeenskapsklinieke, alhoewel daar ‘n neiging sigbaar was dat personeel in gemeenskapsklinieke meer emosionele uitputting ervaar. Werkdruk, werklas of toename in beroepseise, die gebrek aan organisatoriese ondersteuning en bestuursprobleme is aangewys as die hoof redes wat aanleiding gee tot uitbranding. Voorstelle is gemaak om die werksomgewing van PGS-verpleegkundiges te verbeter en om motiveringsvlakke en werkstevredenheid te herstel. Dit sal werksverbintenis versterk en die voorkoms van uitbranding beperk. Geleenthede vir verdere navorsing is aanbeveel.

The reduction of the maternal mortality rate is part of the priority agenda of governments in Africa, including South Africa. Research shows that a large portion of maternal deaths are preventable because they are largely due to lack of inappropriately prepared staff. In South Africa, outcome studies on the quality of comprehensive prepared nursing graduates reflect some concerns regarding their levels of competence. These studies, however, are general; they did not directly target the competence of these graduates in their midwifery practice, therefore, the purpose of this study was to explore and describe the perceived level of competence of newly qualified-midwives functioning in midwifery units. Based on the positivist paradigm, an exploratory descriptive design, using a quantitative approach, was adopted in this study. Two structured questionnaires were used to collect data: one for the newly-qualified midwives and one for the supervisors. A total of 48 newly-qualified midwives and 26 supervisors from five hospitals at eThekwini District participated in this study. Ethics principles and other considerations were observed throughout the study. Data were analyzed statistically using a computer Software Package (SPSS, version 15.0) and a variety of statistical tests were carried out. . From the findings there was a positive congruence between graduates and their supervisors' ratings of the newly-qualified midwives clinical competencies. There were, however, significant differences in a few skills with graduates tending to rate themselves higher than did their supervisors. On the whole though one can conclude that although VI the findings in this study are not conclusive, compared to the previous studies in this area, there is an improvement in the level of competence of newly-qualified midwives. The improvement was noted in their level of competence in midwifery clinical practice, clinical teaching, management and research. The findine;s, however, revealed some areas that need special attention in the theory and clinical preparation of midwives. Recommendations included reviewing the curriculum and strengthening the research component. In midwifery clinical practice there needs to be more attention paid to neonatal care skills, problem solving and record keeping. Further research is also recommended. / Thesis (M.N.)-University of KwaZulu-Natal, Durban, 2011.

M.Cur. (Nursing Administration) / Please refer to full text to view abstract

Att vara sjuksköterskestudent innebär mycket klinisk praktik. Möjlighet erbjuds att känna på hur det dagliga arbetet organiseras på klinikerna. Erfarenheter av detta gav inspiration till denna studie. Hur upplever människor att vara del av en organisation? Syftet med studien var att sammanställa beskrivningar av upplevelser från beprövade sätt att organisera omvårdnadsarbetet inom sjuksköterskans område. En litteraturstudie grundad på kvalitativa artiklar genomfördes. Resultaten kopplades till fyra klassiska metoder för organiserat omvårdnadsarbete och mynnade ut i tre teman. Ledarskap, arbetsmiljö och gruppdynamik återfanns som huvudteman som speglade upplevelser av respektive organisationsmodell hos personal, patienter och anhöriga. / How do persons experience being part of an organisation? To be a nursing student includes much time spent in clinical practice. Opportunity to get a sense of how the daily work is organised is provided. Experiences of this kind gave inspiration to this study. The aim of the study was to put together descriptions of experiences from classic modes of care in nursing. A literature review founded on qualitative studies was performed. The results were linked to four classic modes of organised care and led to three themes. Leadership, work environment and group dynamics were found as main themes that reflected experiences of each organisational model from staff, patients and relatives.