The purpose of this quantitative, descriptive study was to identify shortcomings in the implementation of the Batho Pele Principles in a public hospital. Findings were obtained from a range of patients who had been admitted to specific units for three or more days, and more evidence was gathered from articles in mass media. Data was collected through a structured questionnaire from one hundred respondents (n=100) and analysed by means of descriptive statistics. The research findings revealed that none of the Batho Pele Principles were implemented effectively and that patients in general were not satisfied with treatment in public hospitals. Shortcomings are attributed to insufficient management skills and knowledge on different levels of the health care system, as well as a lack of awareness among patients of their rights and responsibilities in health care. / Health Studies / M.A. (Public Health)

Abstracts in English, Southern Sotho and Xhosa / Previous studies evidenced the association between work ethics climate, retention factors and organisational commitment separately. However, research combining all these variables have not yet been done. The purpose of the study was to investigate the relationship between work ethics climate, retention factors and organisational commitment of nurses in a South African public hospital. A quantitative research design was followed and a probability stratified sample (N=208) of nurses participated in the study. The results indicate significant relationships between work ethics climate and retention factors. Furthermore, the results indicate significant relationships between work ethics climate and organisational commitment. Moreover, the results indicate that work ethics climate moderates the relationship between training and development components of retention factors and organisational commitment. These findings provide new knowledge for the design of retention strategies, which adds value to the body of knowledge in relation to work ethics climate. Recommendations for further research and for the implementation of the results of the study by human resource professionals were made in terms of improving the ethical climate, the retention factors and organisational commitment of their employees. / Dinyakišišo tše di fetilego di file bohlatse bja kamano magareng ga seemo sa maitshwaro ka mošomong, mabaka a go tšwela pele le boikgafo ka fao go aroganego. Le ge go le bjale, dinyakišišo tšeo di kopanyago mehuta ye ka moka ga se tša hlwa di dirwa. Maikemišetšo a dinyakišišo tše e bile go nyakišiša kamano magareng ga seemo sa maitshwaro ka mošomong, mabaka a go tšwela pele le boikgafo bja bja baoki ka sepetleleng sa setšhaba sa Afrika Borwa. Tlhamo ya dinyakišišo tša boleng e dirišitšwe gomme sampole ya baoki ye e arogantšwego (N=208) ba kgathile tema ka dinyakišišong. Dipoelo di laetša kamano ye kgolo magareng ga seemo sa maitshwaro ka mošomong le mabaka a go tšwela pele. Godimo ga fao, dipoelo di laetša dikamano tše kgolo magareng ga seemo sa maitshwaro ka mošomong le boikgafo bja ka mokgatlong. Godimo ga fao, dipoelo di aletša gore seemo sa maitshwaro se lekanyetša kamano magareng ga dikarolo tša tlhahlo le tša tlhabollo tša mabaka a go tšwela pele le boikgafo bja ka mokgatlong. Dikutollo tše di fana ka tsebo ye mpsha ya tlhamo ya mekgwa ya go tšwela pele, yeo e tlišago boleng go tsebo mabapi le seemo sa maitshwaro a ka mošomong. Ditšhišinyo tša dinyakišišo go tšwela pele le tša go phethagatša dipoelo tša dinyakišišo ka bašomi ba sephrofešenale ba merero ya bašomi di dirilwe mabapi le go kaonafatša seemo sa maitshwaro, mabaka a go tšwela pele le boikgafo bja ka mokgatlong bja bašomi ba yona. / Amarhubhululo zesikhathi esidlulileko zifakazele itjhebiswano eliphakathi kobujamo bemigomo yokusebenza, imithelela yokubamba abasebenzi bangakhambi kanye nokuzibophelela kwihlangano ngendlela ehlukanisiweko. Nanyana kunjalo, ngokwerhubhululo ukuhlanganiswa kwazo zoke lezi zinto akhange kweziwe. Ihloso yaleli rhubhululo bekukuphenya itjhebiswano eliphakathi kobujamo bemigomo yokuziphatha emsebenzini, ukubamba abasebenzi bangakhambi kanye nokuzibophelela kuhlangano kwabahlengikazi esibhedlela sombuso eSewula Afrika. Ihlelo lerhubhululo elidzimelele kuzinga lekulumo lilandelwe kanti nesampula yabahlengikazi I (N=208) labadlale indima kurhubhululo lisetjenzisiwe.Imiphumela iveza itjhebiswano eliqakathekileko phakathi kobujamo bemigomo yokusebenza kanye nemithelela yokubanjwa kwabasebenzi bangakhambi. Ukuragela phambili, imiphumela iveza itjhebiswano eliqakathekileko phakathi kobujamo bemigomo yokusebenza kanye nokuzibophelela kwehlangano. Ngaphezu kwalokho, lemiphumela iveza ukobana ubujamo bemigomo yokuziphatha ilinganisa itjhebiswano phakathi kweengaba ezibandulako nezithuthukisako, iingaba ezimalungana nemithelela yokubamba abasebenzi bangakhambi kanye nokuzibophelela kwehlangano. Leli lwazi elitholakeleko linikela ilwazi elitjha malungana nokudizayinwa kwamasu wokubamba abasebenzi bangakhambi, okuyinto engezelela ivelu kumthombo welwazi malungana nobujamo bemigomo yokuziphatha emsebenzini. Iincomo ezinye ezimalungana nokuragela phambili nerhubhululo kanye nokusetjenziswa kwemiphumela yerhubhululo elimalungana nabasebenzi bomnyango wezokuqatjhwa kwabasebenzi zenziwe ngokuthi kuthuthukiswe ubujamo bemigomo yokuziphatha, imithelela yokubamba abasebenzi bangakhambi kanye nokuzibophelela kwabasebenzi kuhlangano. / Human Resource Management / M. Com. (Business Management)

Department of Advanced Nursing Science / MCur

MCur / Department of Advanced Nursing Science / Background: Perinatal and neonatal mortality rates remain high in South Africa especially in rural areas and townships where the majority of poor people live. With regard to perinatal and neonatal mortality, South Africa like many other developing countries has failed to achieve MDG 4 and 5 by 2015 regardless of many efforts by the governments. To achieve the SDG which replaced MDGs for child health, it is necessary for the South African public and private health care to reduce substantially perinatal and new born deaths, particularly in rural areas. There are many factors that contribute to a high perinatal mortality rate in public hospitals in rural areas. To understand these factors, a study was conducted with midwives from selected public hospitals in Limpopo, Vhembe district which experiences the highest perinatal mortality rates in South Africa. Purpose and methodology: The purpose of this research study was to assess factors contributing to high perinatal mortality rates in the selected public hospitals in Vhembe district. A quantitative, descriptive, exploratory and cross-sectional design was used to collect data from the sampled hospitals in the Vhembe district. Hospitals were purposively sampled based on the statistics of monthly deliveries. The target population consisted of all registered midwives who had been working in the maternity units for at least two years. Cochrane's formula was used to determine the sample from the target population for each hospital. A random sample of 110 respondents was selected upon which a questionnaire was administered to each by the researcher. Responses from the close-ended and open-ended questions was grouped and analysed quantitatively by means of Statistical Package for Social Sciences 23.0 (SPSS). Results and findings: Results were presented in frequency tables and graphs revealed that most of the midwives lacked knowledge and skills in a number of key areas needed for them to operate efficiently in the maternity wards. There was also high staff turnover which led to a few midwives being overworked. The utilisation of guidelines and protocols in maternity was left to individual midwives as the hospitals did not evaluate the use of it. Conclusions: Lack of key skills in assisting women in labour, and poor use of guidelines and understaffing were the main contributing factors to high perinatal mortality rates in the selected public hospitals of Vhembe district. Midwife attitudes were not a contributory factor. / NRF

The purpose of the study was to explore and describe leadership at Matlala District Hospital in Limpopo, a province of South Africa. The study was critical for a better understanding of leadership styles adopted in different situations (hospital, district or province) at Matlala District Hospital in the Sekhukhune district. The main objectives of the study were described in chapter 1 on leadership styles (transformational and transactional), to determine how best to investigate leadership styles at Matlala District Hospital, to determine what the current leadership style at Matlala District Hospital is and to propose the most appropriate leadership style for Matlala District Hospital. A mixed-methods approach was used with an exploratory and descriptive design. In terms of the qualitative methodology, purposive sampling was used as the managers were selected on their knowledge of the issues under investigation. Firstly, an interview schedule was developed and used to collect data at Matlala District Hospital. The sample size was 82. Interviews were conducted with 12 members of the executive committee who were regarded as senior managers of the hospital. Secondly, the researcher distributed the questionnaires to participants of the hospital that met the inclusion criteria. Seventy participants completed questionnaires, which were collected upon completion. A 100% response rate was reached. Thematic analysis was used to assess the qualitative data. With regard to quantitative data analysis, descriptive, frequency tables and charts and inferential statistics were used. According to the results, those managers who felt that resources had be provided felt strongly that leadership at the hospital should be improved. Accordingly, guidelines for improving leadership at Matlala District Hospital have to be developed to ensure that mitigating factors are in place for the improvement of the situation at the hospital. / Public Administration and Management / M. P. A. (Public Administration)

I examined the factors that led to the rise and fall of psychiatric hospitals and its impact on two select groups of individuals: adults and older adults with severe mental illness. To explore the reasons behind these fluctuations, the State of Texas was used as a case study. Additionally, the fluctuations occurred for different reasons in public vs. for-profit investor-owned psychiatric hospitals. Using an investor-owned psychiatric hospital organization as a case study, I investigated the differences in factors that influenced the growth and/or demise in public vs. investor-owned psychiatric hospitals. Evolution and devolution of psychiatric hospitals was assessed during select time periods: 1700 to1930, 1940 to1970, 1980 to 2000, and 2000 to present. Time period selections were relevant to the important drivers of the span of time that influenced the psychiatric hospitals. Historical review and trend analysis was used to identify the total number of psychiatric hospitals and/or total number of psychiatric hospital beds and psychiatric hospitals by type. Analysis showed there was a cyclical pattern of evolution and devolution of psychiatric hospitals and each cycle altered the form, function, and role of the psychiatric hospital along with altering the location of care for adults and older adults with severe mental illness. The research results suggest a long-stay residential facility, specializing in evidence-based treatment for adults and older adults with severe mental illness, to counter the dire shortage of psychiatric hospital beds.

Text in English / The aim of this study was to gain understanding of community service nurses’ experiences of health care services at Tshwane district public hospital. This qualitative study followed an Interpretative Phenomenological Analysis (IPA) approach to explore the community services nurses’ experiences of health care services at Tshwane district public hospital. Data were collected from 11 purposively selected community service nurses using a semi-structured interview format. Data was analysed using Interpretative Phenomenological Analysis framework for data analysis. Four super-ordinates emerged from data analysis: (1) Resources, (2) Work environmental relations, (3) Supervision and support and, (4) Impact of community service experiences. The study revealed that the health care services rendered at the hospital studied are substandard. Community service nurses reported several challenges experienced during their placement in the hospital under study. Lack of human and material resources, supervision and support contributed to hindrance of smooth acquisition of their clinical skills and experience. These challenges resulted in the psychological and emotional drain of the participants. There is a need for development of guidelines to ensure constant and adequate support to all the community service nurses placed at Ratanang Hospital. / Health Studies / M.A. (Nursing Science)

Text in English / The aim of this study was to gain understanding of community service nurses’ experiences of health care services at Tshwane district public hospital. This qualitative study followed an Interpretative Phenomenological Analysis (IPA) approach to explore the community services nurses’ experiences of health care services at Tshwane district public hospital. Data were collected from 11 purposively selected community service nurses using a semi-structured interview format. Data was analysed using Interpretative Phenomenological Analysis framework for data analysis. Four super-ordinates emerged from data analysis: (1) Resources, (2) Work environmental relations, (3) Supervision and support and, (4) Impact of community service experiences. The study revealed that the health care services rendered at the hospital studied are substandard. Community service nurses reported several challenges experienced during their placement in the hospital under study. Lack of human and material resources, supervision and support contributed to hindrance of smooth acquisition of their clinical skills and experience. These challenges resulted in the psychological and emotional drain of the participants. There is a need for development of guidelines to ensure constant and adequate support to all the community service nurses placed at Ratanang Hospital. / Health Studies / M.A. (Nursing Science)

Background and purpose. The purpose of the study was to determine the costs incurred on the average length of stay (ALOS) on patients with Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) related illnesses admitted in hospital and whether there are any other significant costs involved. Method. A quantitative approach was used to collect data; analysed; interpretation and report writing. Purposive sampling and data collection was done using data collection sheet. This was a retrospective cost analysis data from in-patients records (record review) of ages from 15 years to 49 years both gender. Data analysis and presentation of information was presented by the use of tables; different types of graphs and the interpretation thereof. Results. The study found that males (63%) with HIV Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) related illnesses had longer average length of stay in a hospital compared to females. However, females illustrated higher in-patient costs but majority of patients had costs of between R0–R17 500. Patients with longer hospital stay (>3 days of hospitalisation) had higher in-patient costs. Conclusion. The findings also showed that in-patient care costs were directly proportional to length of stay with higher costs for HIV and AIDS patient management care. Our findings are consistent with other studies regarding higher economic implications of care for HIV infected persons being almost as twice as people who are HIV negative due to longer periods of hospitalisation. / Health Studies / M.A. (Public Health)

Made available in DSpace on 2011-05-04T12:36:16Z (GMT). No. of bitstreams: 0 Previous issue date: 2009 / O presente trabalho teve por objetivo examinar os vínculos simbólicos e imaginários que os trabalhadores do maior hospital geral do Estado mantêm com a organização e com seu trabalho, discutindo, a partir desse conhecimento, possíveis dispositivos para o cotidiano da gestão que favoreçam a criatividade e a responsabilização desses trabalhadores para com seu trabalho e com a instituição. Ao apreender o imaginário organizacional e as representações psíquicas dos trabalhadores acerca da organização, tenta-se contribuir para a explicitação dos fatores que condicionam o estabelecimento dos vínculos à organização, interessando-nos mais especificamente a adesão, e identificar quais desafios os vínculos e o imaginário organizacional observado impõem para os processos e dispositivos de gestão. Elegeu-se como estudo de caso o setor de pediatria do hospital, tomando-se como referenciais teóricos para tal estudo a abordagem da Psicossociologia francesa sobre as organizações, e a Psicodinâmica do Trabalho. Na apresentação dos resultados desta investigação, discutem-se os sentidos do trabalho, a partir de uma aproximação do imaginário organizacional, das representações dos trabalhadores sobre o seu trabalho, da sua visão sobre a gestão, e a dinâmica prazer versus sofrimento no trabalho. Na análise dos vínculos que os trabalhadores estabelecem com o trabalho e com a instituição, emergem os desafios para o cotidiano de gestão do hospital. A tão esperada mudança nos nossos serviços de saúde parece não poder prescindir de uma reflexão crítica sobre o que temos hoje, e do reconhecimento quanto à importância da dimensão subjetiva, e intersubjetiva, como determinante dos modos de ser e de agir dos trabalhadores. / This study intends to analyze the imaginary and symbolic links that the workers from the largest hospital in the state remain with the organization and their work, based on this knowledge, a discussion will be made about the possible devices for the daily management to encourage creativity and the responsibility of these workers with their work and with the institution. From the worker’s organizational idea and the psychological representations of workers about the organization, a study about the factors that influence the establishment of links to the organization will be made, focused on the membership, and to identify the challenges that the organizational idea and the links observed are require to the processes and management arrangements. Was selected as a case study the pediatric section of the hospital, using as theoretical reference for this study the approach of the French Psychosociology on organizations, and the psychodynamics of work. In the results of this investigation, is discussed the meaning of the work, from an organizational approach, representation of the workers on their work, their vision on the management, and dynamic pleasure versus pain at work. In the analysis of the links that workers provide with work and with the institution, can be found challenges for the hospital daily management. The long-awaited change in our health services cannot be done without a critical reflection on what we have today, and the importance of the subjective and intersubjective, as a determinant of the ways that the employees are and behave.