The general aim of this study was to determine the experiences of a sample of terminally ill patients in using spiritually focused psychotherapy. This was a qualitative study conducted to a sample of 2 terminally ill patients from hospice in Grahamstown, South Africa. The research was conducted in 3 phases: an initial in-depth interview conducted to determine the participants' level of spirituality as well as the extent to which their terminal illnesses had affected their functioning. This was followed by a minimum of 6 spiritually focused therapy (SFT) sessions as a second phase of the research. To determine the participants' experiences of SFT, 2-3 in-depth interviews were conducted during the 3m phase of the research study. The research revealed that a belief in a higher power helps terminally ill patients cope better with their illness and that social disconnectedness is related to HIV / AIDS stigma. It also revealed that terminal illness is co-morbid with other psychiatric symptoms such as depression, evokes existential concerns, results in a change in the level of spirituality and affects the whole family. Participants blamed themselves for their illness, but found that engaging in the process of forgiveness of self and others brought about psychological healing for them. They experienced SFT as a coping resource that assisted them to deal with the fear of death as well as increased insight into the development of psychopathology and spiritual blockages. It is recommended that a comprehensive and holistic assessment during intake be undertaken so that where spiritual needs are available, therapy can be spiritually augmented to ensure that such needs/ struggles are addressed. / KMBT_363 / Adobe Acrobat 9.54 Paper Capture Plug-in

Dissertation submitted in fulfillment of the requirements for the Degree in Masters of Technology: Nursing, Durban University of Technology, 2011. / Background Working in the intensive care unit can be traumatic for nursing personnel. Critical care nurses are faced with repeated exposure to death and dying as they are involved in caring for patients who are actively dying or who have been told that they have a terminal illness and are faced with the possibility of impending death. Critical care nurses relate in different ways to the phenomena of death and dying within their nursing profession and their scope of practice. These nurses often have a difficult time coping with the stress that comes with caring for those who are dying or relating to loved ones of those that are dying. Aim of the study The aim of the study was to explore the critical care nurse’s experiences of death and dying. Methodology A qualitative, descriptive phenomenological approach was used to guide the study. Four nurses were recruited and rich descriptions of their experiences were gained through individual face-to-face interviews. One broad question was asked: ‘What are your experiences regarding death and dying of your patients in ICU?’ iii Results The findings of this study revealed that issues such as communication, multicultural diversity, education and coping mechanisms relating to caring for the critically ill and dying patient are essential in nursing education and practice. Critical care nurses need to have support networks in place, not only to assist in providing care, but also for their own emotional support / M

The hospice volunteer is viewed as an integral member of a multidisciplinary team, with various roles directed at enhancing the quality of life of patients and their families. The purpose of this study is to provide an integrated picture of the hospice volunteer, their role, the human dimensions of this role and the impact this has on their lives as not much has been written in literature about this specific sub-group of hospice workers. The context of the study is a hospice in Gauteng where the researcher works as a volunteer. The ethnographic case study has been chosen as an appropriate research design as it explores the above phenomenon from the volunteers' point of view. The subjects are three volunteers who have been active at the hospice for at least twelve months. Evidence in terms of specific interviews and observations are used to draw conclusions. The interviews are based on a minimal number of open-ended questions. The primary method of analysis is the examination of transcripts from these in-depth interviews. A thematic analysis is carried out in which a detailed description of the emerging themes are given. Four major themes are identified and explored: Description of the role; The experience of being a volunteer; A way of coping; and The influence of the hospice culture. Sub-themes that emerge within each case study vary due to the individual nature of the experience of the role. Themes are explored in light of current theory and findings. This was to note the similarities and differences of this specific sub-group of volunteers compared to others found in the literature reviewed for this study. As there is a scarcity of literature pertaining specifically to hospice volunteers, the study depends mostly on writings pertaining to hospice staff and volunteers in general. A summary and integration of the core findings of the three case studies is given and their similarities and differences are explored. How some of the different themes interlink is also discussed. Although various sub-themes found in the individual case studies are significant to the individual cases, some of them can be incorporated into common themes when looking at the volunteers as a group. The strengths and limitations of the study are discussed as well as recommendations for the hospice organisation and further research. / Psychology / M.A. (Psychology)

This study addresses the effectiveness of communication between the team (doctors, sisters and social workers) and patients at the Breast Cancer Clinic of the Johannesburg Hospital. Tue needs of patients were highlighted, as well as the role of care-giver, both as a group and in their separate disciplines, in attempting to meet these needs. Tue empirical survey was carried out through the use of questionnaires as well as interview schedules. Patients, doctors, nurses and social workers were used as respondents. Results indicated that the majority of patients' needs for information and support were met by the team in general; however, a need for further social work intervention seemed to be apparent. In addition, several barriers were found to inhibit both team-patient and inter-team communication. Tue researcher used the information gathered in this study to make recommendations that will facilitate improved communication in the clinic, with specific reference to the role of the social worker. / Social Work / M.A.(Social Science: Mental Health)

The purpose of this study was to explore first year student nurses’ experiences of encounters with death and dying of a patient during clinical practice so as to make recommendations on increase support for first year student nurses. Qualitative research which was explorative, descriptive and contextual was conducted. Data collection was done using in-depth unstructured interview. Nine participants were interviewed and data was analysed. The findings revealed that lack of knowledge, emotional trauma, low self-esteem and nutritional disorder are the results of dealing with death and dying of patients for first year student nurses. Negative attitudes of clinical professionals, shortage of staff and congested block programme were identified as some aspects worsening the situation. Incidental learning that occurs with negative experience encountered was also identified. The findings show the need for review of curriculum for first year student nurses and the need for change of attitudes of clinical professionals / Health Studies / M.A. (Health Studies)

The purpose of this study was to explore first year student nurses’ experiences of encounters with death and dying of a patient during clinical practice so as to make recommendations on increase support for first year student nurses. Qualitative research which was explorative, descriptive and contextual was conducted. Data collection was done using in-depth unstructured interview. Nine participants were interviewed and data was analysed. The findings revealed that lack of knowledge, emotional trauma, low self-esteem and nutritional disorder are the results of dealing with death and dying of patients for first year student nurses. Negative attitudes of clinical professionals, shortage of staff and congested block programme were identified as some aspects worsening the situation. Incidental learning that occurs with negative experience encountered was also identified. The findings show the need for review of curriculum for first year student nurses and the need for change of attitudes of clinical professionals / Health Studies / M. A. (Health Studies)

The hospice volunteer is viewed as an integral member of a multidisciplinary team, with various roles directed at enhancing the quality of life of patients and their families. The purpose of this study is to provide an integrated picture of the hospice volunteer, their role, the human dimensions of this role and the impact this has on their lives as not much has been written in literature about this specific sub-group of hospice workers. The context of the study is a hospice in Gauteng where the researcher works as a volunteer. The ethnographic case study has been chosen as an appropriate research design as it explores the above phenomenon from the volunteers' point of view. The subjects are three volunteers who have been active at the hospice for at least twelve months. Evidence in terms of specific interviews and observations are used to draw conclusions. The interviews are based on a minimal number of open-ended questions. The primary method of analysis is the examination of transcripts from these in-depth interviews. A thematic analysis is carried out in which a detailed description of the emerging themes are given. Four major themes are identified and explored: Description of the role; The experience of being a volunteer; A way of coping; and The influence of the hospice culture. Sub-themes that emerge within each case study vary due to the individual nature of the experience of the role. Themes are explored in light of current theory and findings. This was to note the similarities and differences of this specific sub-group of volunteers compared to others found in the literature reviewed for this study. As there is a scarcity of literature pertaining specifically to hospice volunteers, the study depends mostly on writings pertaining to hospice staff and volunteers in general. A summary and integration of the core findings of the three case studies is given and their similarities and differences are explored. How some of the different themes interlink is also discussed. Although various sub-themes found in the individual case studies are significant to the individual cases, some of them can be incorporated into common themes when looking at the volunteers as a group. The strengths and limitations of the study are discussed as well as recommendations for the hospice organisation and further research. / Psychology / M.A. (Psychology)

This study addresses the effectiveness of communication between the team (doctors, sisters and social workers) and patients at the Breast Cancer Clinic of the Johannesburg Hospital. Tue needs of patients were highlighted, as well as the role of care-giver, both as a group and in their separate disciplines, in attempting to meet these needs. Tue empirical survey was carried out through the use of questionnaires as well as interview schedules. Patients, doctors, nurses and social workers were used as respondents. Results indicated that the majority of patients' needs for information and support were met by the team in general; however, a need for further social work intervention seemed to be apparent. In addition, several barriers were found to inhibit both team-patient and inter-team communication. Tue researcher used the information gathered in this study to make recommendations that will facilitate improved communication in the clinic, with specific reference to the role of the social worker. / Social Work / M.A.(Social Science: Mental Health)

South African health systems are struggling to cope with the HIV/AIDS pandemic. Home based care has become an invaluable resource that relieves overburdened and under-resourced hospitals. Home based carers provide basic nursing care and support to patients and their families, in the patient's home. Little is know about what motivates home based carers. Minimal research has been undertaken to investigate the expectations and experiences of these noble voluntary helpers. This study was conducted with a sample of home based carers at Community Outreach Centre, St Mary's, Mariannhill. Being field focused it used a qualitative research approach and participatory action research methodology. Focus group discussions were conducted with home based carers to explore their needs, motivations and expectations of Community Outreach Centre. The study enlightens us about issues related to home based care that directly affect them. Despite the painful realities of their lives, they appeared positive about serving as volunteer home based carers. / Social work / M.A. Social Science (Social Work)

South African health systems are struggling to cope with the HIV/AIDS pandemic. Home based care has become an invaluable resource that relieves overburdened and under-resourced hospitals. Home based carers provide basic nursing care and support to patients and their families, in the patient's home. Little is know about what motivates home based carers. Minimal research has been undertaken to investigate the expectations and experiences of these noble voluntary helpers. This study was conducted with a sample of home based carers at Community Outreach Centre, St Mary's, Mariannhill. Being field focused it used a qualitative research approach and participatory action research methodology. Focus group discussions were conducted with home based carers to explore their needs, motivations and expectations of Community Outreach Centre. The study enlightens us about issues related to home based care that directly affect them. Despite the painful realities of their lives, they appeared positive about serving as volunteer home based carers. / Social work / M.A. Social Science (Social Work)