Dissertation (PhD)--University of Stellenbosch, 2005. / ENGLISH ABSTRACT: The Saudi Arabian Government has implemented a nation-wide policy to prepare its people for the workforce and has directed that the Saudi Council for Health Specialties (SCHS) be established. Under the SCHS umbrella the Saudi Nursing Board (SNB) has been formed for the purpose of regulating the nursing profession. While Saudi Arabia has for many years been dependent on the international community for nurses, it is now establishing its own nursing workforce. One challenge for the SCHS and the SNB is to ensure that practice standards are developed, since ultimately nursing practice affects the quality of the patient services and patient health outcomes. The Saudi nursing profession has a responsibility to develop its social mandate and provide a full range of services to the Saudi public. Systems and education programmes are required for all aspects of the regulatory process, including continuing professional development. Effective regulation systems are not based on a “one size fits all” approach. Furthermore, nurses need to insist on high quality education to develop both basic and ongoing competence and should be able to depend on the profession for social status and credibility. The purpose of this research was to develop, implement, validate and evaluate a continuing professional development learning programme for nurses working in Saudi Arabia. The learning programme was built from a vision of nurses (regardless of country) engaging in lifelong learning for the purpose of ensuring quality patient care and population health. The development of a continuing professional development learning programme is an initial step in fulfilling the need for educational structures to support standards of practice. The overall outcome of the research was functional by nature in that the knowledge of continuing professional development in nursing was generated and applied to nursing practice in Saudi Arabia. In view of the nature of the question, a mixed methodology was selected. Although the qualitative aspect was dominant, both the qualitative and quantitative aspects were used simultaneously. The design included exploratory and descriptive aspects. Furthermore, the researcher employed qualitative methods to develop, implement and evaluate the provisional learning programme and quantitative methods to validate the provisional programme, resulting in a partial explanation of the research phenomenon. The primary theoretical drive was inductive, as the purpose was to discover rather than to test the learning programme contents. Botes’ Research Model and King’s Theory of Goal Attainment were utilised. They complemented each other, as they both support a comprehensive, dynamic scientific approach to learning (health) outcomes influenced by the quality of nursing practice and practice environment. The research, which was outcomes–based, was carried out in the context of quality patient care (population health) and nursing practice situated within the Saudi Arabian setting, where the nursing regulatory system is emerging. As the questionnaire mean ( X ) results revealed scores of 3.0 to 3.9, data saturation was achieved during the first round of the Delphi technique. Fourteen experts from six different countries were asked to validate the provisional learning programme, which was duly done. The programme was implemented in a tertiary research hospital in Saudi Arabia. Formative and summative evaluations were also conducted. The results of the implementation and evaluation affirmed the effectiveness of the learning programme. Boyer’s Model for Scholarship was used to triangulate the research findings. These results formed the basis for the recommendations and final summary. The five broad recommendations that emerged from the research were that nurses should take on self-regulatory and leadership responsibilities; that they should engage in continuing professional development collaboration; that the nursing profession’s self-regulation responsibilities be acknowledged; that a healthy (quality) workplace environment be ensured; and that further research be done in this field. / AFRIKAANSE OPSOMMING: Die regering van Saoedi-Arabië het ʼn landwye beleid geïmplementeer om die mense van die land vir die arbeidsmag voor te berei en het opdrag gegee vir die stigting van die Saudi Council for Health Specialties (SCHS,) ʼn raad wat spesifiek met gesondheidsdienste gemoeid is. Die Saoedi Raad vir Verpleging (Saudi Nursing Board oftewel SNB) is tot stand gebring met die doel om die verpleegdiens in die land te reguleer. Nadat Saoedi-Arabië vir baie jare van die internasionale gemeenskap vir verpleegkundiges afhanklik was, word ʼn eie verpleegkorps nou in die land gevestig. Een van die uitdagings waarmee die SCHS en die SNB te kampe het, is die noodsaaklikheid om te verseker dat standaarde vir die praktyk ontwikkel word, aangesien die verpleegpraktyk inderdaad die gehalte van pasiënte-diens en gesondheidsuitkomste beïnvloed. Die verpleegberoep in Saoedi-Arabië is daarvoor verantwoordelik om sy maatskaplike mandaat te ontwikkel en ʼn volledige reeks dienste aan die mense van die land beskikbaar te stel. Stelsels en opvoedkundige programme is nodig vir alle aspekte van die reguleringsproses. Dit sluit voortgesette professionele ontwikkeling in. Vir ʼn reguleringstelsel om werklik doeltreffend te wees moet dit op spesifieke behoeftes gerig wees en kan een stelsel nie aan al die vereistes van diverse instellings voldoen nie. Dit is noodsaaklik dat verpleegkundiges op onderrig van ʼn hoë gehalte aandring ten einde basiese en voortgaande bevoegdheid te ontwikkel. Daarbenewens behoort hulle op die beroep te kan steun vir sosiale status en geloofwaardigheid. Die doel van hierdie navorsing was om ʼn voortgesette leerprogram vir die professionele ontwikkeling van verpleegkundiges wat in Saoedi-Arabië werk, te ontwikkel, te implementeer, te valideer en te evalueer. Die leerprogram het onstaan uit ʼn visie van verpleegsters (ongeag hulle land van oorsprong) wat hulle met lewenslange leer besig hou met die doel om diens van ʼn hoë gehalte aan pasiënte asook bevolkingsgesondheid te verseker. Met die ontwikkeling van ʼn leerprogram vir voortgesette professionele ontwikkeling is die eerste stap gedoen om in die behoefte aan opvoedkundige strukture ter ondersteuning van praktykstandaarde te voorsien. Die algehele uitkoms van die navorsing was funksioneel van aard deurdat die kennis van voortgesette professionele ontwikkeling in verpleging deur die verpleegpraktyk in Saoedi-Arabië gegenereer en ook daarop toegepas is. Vanweë die aard van die navorsingsvraag is besluit om ʼn gemengde metodologie, dit is kwalitatiewe en kwantitatiewe aspekte gelyktydig te gebruik, met die kwalitatiewe aspek as die dominante metode. Sowel verkennende as beskrywende aspekte is in die ontwerp ingesluit. Daarbenewens het die navorser kwalitatiewe metodes gebruik om die voorlopige leerprogram te ontwikkel, te implementeer en te evalueer, en kwantitatiewe metodes om die voorlopige program te valideer. Die navorsingsverskynsel is deur middel van ʼn gedeeltelike verklarende metode ontleed. Die primêre teoretiese dryfkrag was induktief, aangesien dit die doel van die navorsing was om die leerprogram se inhoud te ontdek eerder as om dit te toets. Daar is van Botes se Navorsingsmodel en King se Teorie van Doelbereiking (Theory of Goal Attainment) gebruik gemaak. Hulle het mekaar aangevul aangesien albei ʼn omvangryke, dinamiese wetenskaplike benadering tot leer- (gesondheid-) uitkomste, wat deur die gehalte van verpleegpraktyk en die praktykomgewing beïnvloed word, ondersteun. Die navorsing, wat uitkomsgebaseerd was, is uitgevoer binne die konteks van pasiëntediens van gehalte (bevolkingsgesondheid) en verpleegpraktyk, gesetel in die Saoedi-Arabiese milieu, waar die reguleringstelsel vir verpleegkunde aan die ontwikkel is. Data saturasie is reeds bevestig tydens die eerste rondte van die Delphi tegniek met gemiddelde tellings van ( X ) 3,0 en 3,9. Die navorsingsontwerp is daardeur verder versterk. Veertien deskundiges van ses verskillende lande is gevra om die voorlopige leerprogram te valideer, wat hulle ook gedoen het. Die program is in ʼn tersiêre navorsingshospitaal in Saoedi-Arabië geïmplementeer. Formatiewe en summatiewe evaluering is gedoen en die resultate van die implementering en evaluering het die doeltreffendheid van die leerprogram bevestig. Boyer se Wetenskaplikheidsmodel (Model for Scholarship) is gebruik om die navorsingsbevindinge te staaf. Hierdie resultate het die grondslag gelê vir die aanbevelings en die finale opsomming. Die vyf breë aanbevelings wat uit die navorsing voortgekom het was dat verpleegkundiges selfregulerende en leierskapverantwoordelikhede aanvaar; dat hulle aan samewerkingsaksies ten opsigte van voortgesette professionele ontwikkeling deelneem; dat die verpleegberoep se verantwoordelikhede ten opsigte van selfregulering erken word; dat ʼn gesonde (gehalte-) werkomgewing verseker word; en dat verdere navorsing op hierdie gebied gedoen word.

Thesis (DPhil)--University of Stellenbosch, 2005. / ENGLISH ABSTRACT: The focus of my study was to investigate an existing professional development programme for HIV/AIDS education in schools using e-learning as a delivery method. I investigated aspects of pedagogy that provide efficient workplace training for educators, such as constructivist approaches to adult teaching and learning, assessment strategies, creating opportunities for communication and a focus on learners’ voices as crucial elements of in-service training. I reviewed the advantages and disadvantages of e-learning as a delivery method and discussed the trade-off between richness and reach in education. I focused on interpreting and making meaning from the experiences of the educators who participated in the e-learning pilot study. I scrutinised the participants’ electronically submitted journals in which they documented their experiences of the HIV/AIDS and Education module. My aim was to interpret their descriptions of how they experienced their growth as educators and to analyse their views on how the module enabled them to implement courses on HIV/AIDS across the curriculum. My research methodology was a combination of interpretative and critical research, focusing on interpreting and making meaning from the experiences of the individuals who took part in the study. To produce data I used a cyclical process where the participants performed key roles, giving regular feedback, recording their experiences and contributing to the upgrading of the programme. HIV/AIDS and its possible impact on education have changed the rules of many aspects of classroom learning programme development, including sex and sexuality education. The Department of Education alone can therefore not sustain quality HIV/AIDS education, and it is imperative that departmental efforts should be augmented by tapping into existing professional development programmes offered by higher education institutions. I also support the international tendency that integrates aspects of HIV/AIDS education into all the Learning Areas because HIV/AIDS affects all aspects of life. / AFRIKAANSE OPSOMMING: Die fokus van hierdie studie was om ’n bestaande professionele ontwikkelingsprogram, vir MIV/vigs-onderrig in skole te ondersoek. E-leer as ’n geskikte onderrigmetode het deel van hierdie ondersoek gevorm. Ek het verskeie pedagogiese aspekte ondersoek wat geskikte indiensopleiding vir opvoeders bied, onder andere konstruktivistiese benaderings tot volwasse onderrig-en-leer, assesseringstrategieë, die skep van kommunikasiegeleenthede asook ’n besinning oor die belangrikheid van deelnemers se opinies. Die voordele en nadele van e-leer as ’n geskikte onderrigmetode en die balans wat tussen reikwydte (“reach”) en volheid (“richness”) gehandhaaf moet word, is krities bespreek. Ek het die elektronies ingehandigde joernale, waarin deelnemers hulle ervarings van die HIV/AIDS and Education-module gedokumenteer het, bestudeer om hulle ervarings te ontleed en te vertolk. My doel was om hulle sienings oor hulle persoonlike groei as opvoeders en hoe die module hulle bemagtig het om MIV/vigs-onderrig in alle leerareas oor die kurrikulum heen te kan implimenteer, te dokumenteer. My navorsingsmetodologie was ’n kombinasie van interpretatiewe en kritiese metodologie en ek het gefokus op die interpretasie en meningvorming van die deelnemers na aanleiding van hulle ervarings. Om data te genereer (produce) het ek ’n sikliese proses gebruik waarin deelnemers sleutelrolle vervul het, soos om gereelde terugvoer te lewer, ervarings aan te teken en bydraes te lewer om die program te verbeter. MIV/vigs en die moontlike impak wat dit op onderwys en onderrig kan hê, het die reëls van leerprogramontwikkelling verander, met inbegrip van onderrig oor seks en seksualiteit. Die Nationale Departement van Onderwys (NDvO) kan nie alleen MIV/vigs-onderrig van gehalte verseker nie, dit is dus noodsaaklik dat die NDvO se pogings ondersteun moet word. Die NDvO behoort gebruik te maak van bestaande hoër opvoedkundige instansies se professionele ontwikkelingsprogramme. Ek ondersteun ook die internasionale tendens waar MIV/vigs-onderrig in alle leerareas geïnkorporeer word, aangesien MIV/vigs ’n impak op alle aspekte van die lewe het.

Thesis (PhD)--University of Stellenbosch, 2006 / ENGLISH ABSTRACT: Zambia is reported to have high levels of maternal morbidity and mortality due to low contraceptive prevalence rates, over 50% of births not being attended to by skilled persons, and teenage pregnancies. A number of organisations (stakeholders) have invested in the training of adolescent reproductive health peer educators with the aim of empowering them to be role models to their peers in reproductive health, but Zambia does not have a generic and locally developed training programme for peer educators. The purpose of this study was to develop a training programme that would produce competent and more effective peer educators for Zambia. The objectives were to determine the characteristics of the ideal peer educator. Further objectives were to ascertain the factors that contribute to or impair the development of the ideal peer educator, and to determine whether training programmes that were being used were producing ideal peer educators and enhancing healthy lifestyle behaviours. Key stakeholders participated in group interviews were they presented and critiqued their training programmes. Emerging out of this process was a draft training programme, developed by the stakeholders. Focus Group Discussions (FGDs) were held with adolescent peer educators from Lusaka, Kafue, Livingstone and Maheba refugee camp. Data were analysed by triangulating the outcomes of the group interviews (with the stakeholders) with the outcomes of the FGDs and reviewed literature. The FGDs highlighted the characteristics of an ideal peer educator as well as factors that contribute towards his/her competence development. Numerous factors were reported that had a negative impact on the development of an ideal peer educator. The peer educators reported that their training had had a positive effect on their lifestyle behaviours. While they had gained more knowledge on HIV and AIDS, they recommended more training on other health issues. The study found that at community level, peer educators were not being given adequate respect because the concept of voluntary work was not readily accepted and they were regarded as failures in life. Major demotivating factors were the lack of payment of incentives and the fact that peer educators were not certified. Peer educators did not receive sufficient support from programme managers/coordinators to enable them to become more effective at community level. Weaknesses in the way the training programmes were conducted were also discerned. Based on the findings of this study, it is recommended that more life skills’ development be promoted for peer educators. Training should be contextualised for the communities in which the peer educators work. The developed training programme, which should be used as a guide, should be repackaged to suit the profiles (e.g. values) of the different communities. Adolescents and various social sectors (inclusive of indicated stakeholders) ought to be involved in diagnosing community needs so as to influence both peers and communities in a way that would promote adolescent reproductive health. This study also recommends a more informal way of practising peer education, which would produce trainees who would be peer educators and role models in any given setting. / AFRIKAANSE OPSOMMING: Na berig word is die hoë siekte- en sterftesyfers onder moeders in Zambië daaraan te wyte dat voorbehoedmiddels nie algemeen gebruik word nie, dat meer as 50% van geboortes plaasvind sonder die bystand van bekwame persone, en dat daar ‘n hoë voorkoms van tienerswangerskappe is. ‘n Aantal organisasies (belanghebbers) het in die opleiding van adolessent- portuurgroep-opvoeders in reproduktiewe gesondheid belê ten einde hierdie portuurgroep-opvoeders te bemagtig om as rolmodelle in reproduktiewe gesondheid op te tree. Zambië het egter nie ‘n eie generiese, plaaslik-ontwikkelde opleidingsprogram vir portuurgroep-opvoeders nie. Die doel van hierdie studie was om ‘n opleidingsmodel en opleidingsprogram te ontwikkel wat bekwame en meer effektiewe portuurgroep-opvoeders vir Zambië sou kon oplewer. Die doelstellings was om die kenmerke van ‘n ideale portuurgroep-opvoeder te bepaal en om die faktore te identifiseer wat óf tot die ontwikkeling van ‘n ideale portuurgroep-opvoeder bydra óf sy/haar ontwikkeling strem. Daar moes ook vasgestel word of bestaande opleidingsprogramme ideale portuurgroep-opvoeders oplewer en gevolglik gesonde leefstylgedrag bevorder. Die navorser het groeponderhoude gebruik en betekenisvolle belanghebbers genooi om hulle opleidingsprogramme aan te bied, te beoordeel en krities te bespreek. ‘n Konsepopleidingsprogram wat deur die belanghebbers ontwikkel is, het uit hierdie proses ontstaan. Fokusgroepbesprekings (Engels: Focus Group Discussions of FGDs) is met adolessente portuurgroep-opvoeders van Lusaka, Kafue, Livingstone en die Maheba-vlugtelingekamp gehou. Data is ontleed deur die uitkomste van die groeponderhoude (met die deelhebbers) met die uitkomste van die fokusgroepbesprekings en die bespreekte literatuur te trianguleer. Die fokusgroepbesprekings het die soeklig op die kenmerke van die ideale portuurgroepopvoeder asook op die faktore wat tot sy/haar bekwaamheidsontwikkeling bydra, laat val. Talle faktore wat ‘n negatiewe uitwerking op die ontwikkeling van ‘n ideale portuurgroep-opvoeder het, is ook vasgestel. Die portuurgroep-opvoeders het bevestig dat hul opleiding ‘n positiewe invloed op hul lewenstylgedrag gehad het. Terwyl hulle genoem het dat hulle meer kennis oor MIV en VIGS opgedoen het, het hulle aanbeveel dat daar ook meer klem op ander gesondheidskwessies behoort te wees. In hierdie studie is daar bevind dat portuurgroepopvoeders op gemeenskapsvlak nie met voldoende respek behandel word nie. Die begrip van vrywillige werk word nie geredelik aanvaar nie, en die opvoeders word as mislukkings beskou. Faktore wat besonder ontmoedigend inwerk is die gebrek aan ‘n aansporingsloon en die feit dat portuurgroep-opvoeders nie sertifikate ontvang nie. Portuurgroep-opvoeders het ook nie voldoende ondersteuning van programbestuurders/- koördineerders ontvang om hulle in staat te stel om meer effektief op gemeenskapsvlak op te tree nie. Daar is voorts swakhede opgemerk in die wyse waarop die opleidingsprogramme uitgevoer is. Gegrond op die bevindinge van hierdie studie, word daar aanbeveel dat die ontwikkeling van lewensvaardighede tot ‘n groter mate bevorder word. Opleiding behoort gekontekstualiseer te word vir die gemeenskappe waarbinne die opvoeders werk. Die bestaande opleidingsprogram, wat as ‘n riglyn gebruik behoort te word, behoort herstruktureer te word om by die profiele (bv. die waardes) van die verskillende gemeenskappe in te pas. Adolessente en verskillende sosiale sektore (insluitend die aangeduide belanghebbers) behoort betrokke te wees by die bepaling van die gemeenskap se behoeftes ten einde beide portuurgroepe en gemeenskappe so te beïnvloed dat adolessente- reproduktiewe gesondheid bevoordeel sal word. Hierdie studie beveel ook aan dat portuurgroep-opvoeding op ‘n informeler grondslag beoefen behoort te word sodat die kwekelinge uiteindelik in enige gegewe omgewing suksesvolle portuurgroepopvoeders en rolmodelle sal kan wees.