This study was conducted to describe the type of health service rendered by professional nurses to HIV exposed and HIV positive children in the public health care setting of the Free State province. Three objectives were set to achieve this, namely: to describe the type of service rendered to HIV exposed and HIV positive children by professional nurses in the Free State; to determine to what degree national and provincial guidelines are implemented in the management of HIV exposed and HIV positive children in the Free State; and to use the findings to make recommendations for effective service delivery to HIV exposed and HIV positive children. The researcher made use of a quantitative descriptive design to achieve the aim of the study. Data was gathered by means of structured interviews. Professional nurses, who deliver a service to children within public health care facilities, and who met the inclusion criteria, were approached to participate in the study. Data obtained showed that treatment components with regard to HIV exposed and HIV positive children were mainly rendered at primary health care facilities. In contrast herewith, it was found that treatment components in the pediatric sections of hospitals were not implemented to the same degree. Research further reflected a need for professional nurses to undergo additional training regarding the correct management of HIV affected children. Discrepancies pertaining to effective service delivery to HIV exposed and HIV positive children were also revealed. Suggestions were made with regard to approaches which could enhance service delivery. A subsequent research project regarding the quality of service which is presently being offered to HIV exposed and HIV positive children in the public health care sector of the Free State, could be of great value.

The purpose of this study was to determine the levels and causes of stress amongst nurses in private hospitals within the Gauteng Province. Specific focus was drawn to three nursing categories: professional- and staff nurses as well as nursing auxiliaries. The specific objectives were to determine the perceived levels of stress in concurrence with diverse socio-demographic characteristics, influence of non-work-related causes of stress, work-related factors contributing to stress within the work environment as well as the methods of coping utilised. The levels and factors of stress amongst the different nursing categories, including suggestive recommendations, to the organisation involved, also formed part of the objectives for this study. The study design was an analytical, cross-sectional research design involving the three specified nursing categories. From these three categories 588 respondents were selected according to a convenience or availability sample from similar wards within four predetermined hospitals of the selected private hospital group: 370 professional nurses, 157 staff nurses and 61 nursing auxiliaries. The Experience of Work and Life Circumstances Questionnaire (WLQ) were used as measuring instrument and were preceded by a section regarding socio-demographic questions. The number of complete and unspoiled questionnaires received was calculated at 116 (59.18%) professional nurses, 45 (22.96%) staff nurses and 35 (17.86%) nursing auxiliaries. Skewed or asymmetrical data were obtained and thus lead to the use of only non-parametric methods. The only possible significant correlations with the level of stress, as revealed by the analysis, involved race, in particular Black/African nurses, non-work related causes of stress, causes of stress within the work environment with specific reference to organizational functioning, task characteristics, the physical working environment itself and social matters. These results were however not statistically significant for a specific nursing category. It is suggested that further research is conducted to facilitate the design of a comprehensive model and questionnaire specifically for nurses. Further research should also include nursing students into the nursing population and investigate the level of stress of Black nurses within South Africa. It is also suggested that the organisation, that were selected for the purpose of this study, should focus on all statistical significant areas as previous mentioned for the prevention, combating and management of all causes of work-related stress.

Several research studies suggest that final year nursing students do not consider psychiatric nursing as a popular career option. There is an international and widespread concern about the nursing shortages in psychiatry. The demand for psychiatric services continues to grow and there is a need for strategies to recruit nurses for this specialization. The purpose of this study was to identify the factors that prevent undergraduate nursing students from choosing psychiatric nursing as a career. A qualitative, explorative and descriptive research design was used. Data was collected through the Nominal Group Technique. A sample of convenience consisted of nursing students from the School of Nursing from the University of the Free State as well as the Free State School of Nursing. This unit of analysis comprised of four nominal groups. Two of the groups were from the School of Nursing at the University of the Free State, of which each had eight members. The other two groups were from the Free State School of Nursing and comprised alternatively of five and six members. The four nominal groups were managed by an experienced facilitator. The following main causal categories emerged from the content analysis of the data, presented in the order that they were prioritized: Personal factors, working environment, unprofessional behaviour, learning environment and an unclassified category. Each category was divided into relevant themes. The themes in the category of personal factors included the loss of skills, emotional draining, poor prognosis of the patients, emotionally over-involvement, limited career opportunities and career choice. Significant of the working environment was the participantsâ opinion that psychiatry was unsafe and boring. Noteworthy in the category of unprofessional behaviour was the lack of professional discipline and the abuse of patients reported by the participants. The learning environment was depicted as stagnant and rife with the incorrect nursing care of the staff. Lastly there is the unclassified category with unclassified themes. In regard to the abovementioned categories, the researcher has made a variety of recommendations. Firstly the focus falls on teaching strategies in the undergraduate nursing curriculum that need to transform. Secondly, the clinical practice would require certain changes. In the third place, the focus would be on the branding of psychiatric nursing as an acceptable future career for young people. Finally, there is a need for further research concerning the nursing students in other provinces, and whether they share the same opinions regarding a career in psychiatry. Lastly, research would also be required to identify those factors that positively influence the attitudes of those students that decide on a career in psychiatric nursing.

Background: Since 1849, Catholic religious have provided health services in South Africa. They have established hospitals, clinics, and have provided community-based preventive and curative services throughout the country. Today faith-based organizations (FBOs) continue to play an important role in healthcare delivery and are crucial to the goal of providing universal access to antiretroviral therapy (ART). In order to scale up HIV care and treatment, there is a need to describe and analyze ART models of care (MOC) that address the challenges faced by developing countries. The South African Catholic Bishopsâ Conference (SACBC) manages twenty ART clinics in medically underserved South African communities, where the need is great, but the resources limited. These SACBC managed ART clinics operate on different MOC. A study to describe, analyze and compare the different MOC can inform future directions in healthcare delivery in resource-constrained settings. Method: A single case-study design was used to describe, analyze and compare four different MOC (managed by the SACBC) for ART delivery, as embedded units of analysis. A mixed method approach was used, incorporating qualitative and quantitative information. Data were collected using structured interviews (n=1,006 adult ART patients), file audits (n=1,006 files of the respondents), semistructured interviews (n=27 healthcare workers) and nominal groups (n=12 groups with Home Based Care-workers). Descriptive and inferential data analyses were conducted by a biostatistician from the Department of Biostatistics at the University of the Free State and the researcher. Findings: In the study, patients accessed care late (CD4=119 cells/mm3). Decentralized care provided better access. Family members are a potential source of support because disclosure rates to relatives and others were high (95.63%). Nurse-driven, doctor supported care was not inferior to doctor-driven care. Task-shifting to registered nurses and HBC-workers can be implemented successfully with support. Differences exist between the South African Government (SAG) -managed model and the FBOâmanaged models. Partnership between the SAG and FBO strengthened the SAG-managed MOC, while capitalizing on the sustainability of the government services. Functional information systems, developed by the FBO, were implemented at all the MOC in 2009. All the MOC focused on acute care. Conclusions: Nurse-driven decentralized service can most effectively and appropriately address the chronic nature of HIV and strengthen the healthcare system by a paradigm shift to a chronic care model. Based on the findings, a chronic care model was adapted for South Africa that has seven elements: (1) an integrated, decentralized chronic care system based within a primary health setting; (2) partnerships with NGOs; (3) an effective information management system; (4) patients and their families; (5) self-management support to patients; (6) provider decision support and (7) delivery system redesign. Implications for the nursing profession include adaptation of focus and training, as well as the recognition of the nurse practitioners/specialist role in South Africa.

The researcherâs observation that patients do not always understand what they are consenting to was confirmed by various sources. According to Northouse and Northouse (1998: 270) and the South African Department of Health (2006: 11) patientsâ lack of comprehension in the process of informed consent is a general phenomenon taking place in every hospital setting due to factors such as lack of interpersonal relationships between the health care professional and the patient cultural practices as well as language. A quantitative, descriptive study design was used to describe the process of obtaining informed consent prior to a surgical procedure in a hospital in the Northern Cape. Specific objectives were to: (1) describe the current practice of obtaining informed consent prior to a surgical procedure or an operation; and (2) make recommendations to relevant stakeholders for the purpose of improving the process of informed consent for an operation or procedure and thus the quality of health care. A structured interview, based on a questionnaire, was used to gather information using convenient sampling as the primary sampling method because it was feasible and affordable. A pretest was done before the main data collection process, but the results were not included in the final results. Data collection took place over a period of 90 days and included 150 participants who all met the inclusion criteria determined by the researcher. The researcher was assisted by a biostatistician who made use of Statistical Analyses Software (SAS) in order to analyze the data. Descriptive statistics namely means and standard deviations or medians and percentiles were calculated for continuous data. Frequencies and percentages were calculated for categorical data, and the analysis was done by a biostatistician. The researcher organized the study results according to tenets of capacity to consent to give meaning to the data and make it easy to understand. Figures and tables were used to present the large amount of detailed information concisely and clearly. More than one third of the sample was vulnerable due to their low educational level and unawareness of their rights as patients. Unfortunately no effort was made to ensure that they fully comprehended what they were consenting to. Recommendations focused on strategies to improve understanding by patients and to inform patients of their rights and responsibilities.

Thesis (M.S.)--Boston University, 1960. Includes bibliographical references (leaf 56)

Thesis (M.S.)--Boston University

Thesis (M.S.)--Boston University, 1953

Thesis (M.S.)--Boston University

Thesis (M.S.)--Boston University Includes bibliographical references (leaves 48-50).