Thesis (MCur)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: The alarming rate of teenage pregnancies among South Africans became a driving force for the researcher to investigate this particular phenomenon. The goal of this study was to explore and describe the experiences of pregnant teenagers about their pregnancy. Guided by the research question “ What are the experiences of pregnant teenagers about their pregnancy?” a scientific investigation was undertaken. The objectives set for the study were to determine their experience of their current pregnancy; to determine their knowledge of contraceptives; and to explore their experience regarding the services delivered by the health care workers. A phenomenological descriptive design with a qualitative approach was the most suitable scientific method to describe the experiences of pregnant teenagers who attend an antenatal clinic in Chatsworth, Kwazulu Natal. An interview guide or protocol that includes a list of open-ended questions based on the objectives, the literature review, and the professional experience of the researcher was designed and used to explore during each interview. The final sample consisted of ten participants. Experts in the field of nursing and research methodology were consulted to determine the feasibility and content of the study, to evaluate the research process and outcome. The researcher collected the data personally. Data was collected by means of individual interviews. The researcher did the transcription of the interviews. Ethical approval was obtained from Stellenbosch University and the relevant health authorities. Informed written consent was obtained from the participants. Parental permission was obtained for participants under the age of 18 years. Participants younger than 18 years of age also completed an assent form. Data that emerged from the data analysis was coded and categorised into sub-themes and themes. The researcher compiled a written account of the interpretations that emerged from the data analysis. In addition, member checking was done with each participant after individual interviews, to validate the transcribed data. The conceptual framework for this study was adapted from Maslow (1968). The findings suggest that there is a need for parental intervention as far as teenage pregnancy is concerned, financial difficulties associated with poverty was identified as one of the major contributing factor to teenage pregnancy, and attitudes of providers of contraceptives led to teenagers, not using contraceptives in some cases. It is recommended that services at the clinic be improved; health care workers undergo extensive training and education regarding teenage health and sexuality needs. Furthermore review and revitalisation of education programs at schools, to meet the needs of teenagers, which are constantly changing according to the times, are recommended. The involvement of parents and the community in combating issues surrounding teenage pregnancy is vital. Further research is recommended to find solutions to alleviate this problem of teenage pregnancy. All stakeholders need to work together to remedy this social problem as it is not an issue that can be dealt with in isolation. / AFRIKAANSE OPSOMMING: Die veronrustende voorkoms van tienerswangerskappe onder Suid-Afrikaners was die motiverende faktor vir die navorser om die studie te onderneem. Die doel van die studie was om die ervaringe van swanger tieners ten opsigte van hul swangerskap te identifiseer en te beskryf. Die wetenskaplike ondersoek is gelei deur die navorsingsvraag, “wat is die ervaringe van swanger tieners betreffende swangerskap?” Die doelwitte vir die studie was om te bepaal: die ervaringe van die huidige swangerskap; kennis betreffende voorbehoedmiddels sowel as die ervaring ten opsigte van die dienste soos gelewer deur die gesondheidswerkers. 'n Fenomenologiese, beskrywende ontwerp met 'n kwalitatiewe benadering is as die mees geskikte wetenskaplike metode beskou om die ervaringe van swanger tieners wie 'n voorgeboorte-kliniek in Chatsworth, KwaZulu-Natal bywoon, te beskryf. Die navorser het gebruik gemaak van 'n vooraf opgestelde onderhoud gids, protokol bestaande uit 'n lys van oop vrae gebaseer op die doelwitte, die literatuuroorsig en die professionele ervaring van die navorser. Die finale steekproef was tien deelnemers. Kundiges op die gebied van verpleging en navorsingsmetodologie is geraadpleeg ten opsigte van die haalbaarheid, inhoud van die studie sowel, as om die proses en uitkoms van die navorsing te evalueer. Die data is persoonlik deur die navorser versamel. Data is ingesamel deur middel van individuele onderhoude. Transkripsie van die onderhoude is deur die navorser self-gedoen. Etiese goedkeuring is vooraf verkry vanaf die Universiteit van Stellenbosch sowel as die betrokke gesondheidsowerhede. Ingeligte skriftelike toestemming is verkry van die deelnemers sowel as van die ouers in geval van minderjaige tieners. Tydens die data-analise is data gekodeer en in temas en sub- temas kategoriseer. 'n Skriftelike verslag is saamgestel ooreenkomstig die interpretasie uit die data-analise. Die navorser het na transkripsie met elke onderskeie deelnemer gekontroleer ten einde geldigheid van die data te verseker. Maslow (1968) se teorie is gebruik as konseptuele raamwerk vir die studie. Die bevindinge dui daarop dat daar 'n behoefte is aan ouerlike tussentrede betreffende tienerswangerskappe. Finansiële probleme in verband met armoede is ïdentifiseer as een van die groot bydraende faktore tot tienerswangerskappe, sowel as dat houdings van diegene wat kontrasepsie verskaf daartoe kan lei dat tieners nie wil gebruik maak van voorbehoedmiddels nie. Dit word aanbeveel dat die dienste by die kliniek moet verbeter; gesondheidswerkers uitgebreide opleiding en onderrig moet kry ten opsigte van tienergesondheid en seksualiteit behoeftes. Hersiening en vernuwing van opvoedkundige programme by skole om in die voortdurende veranderende behoeftes van tieners, te voldoen. Die betrokkenheid van ouers en die gemeenskap in die bestryding van kwessies rondom tienerswangerskappe is noodsaaklik. Verdere navorsing word aanbeveel om oplossings te vind om hierdie probleem van tienerswangerskappe aan te spreek. Alle belanghebbendes moet saamwerk om hierdie sosiale probleem op te los.

Thesis (MCur)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: Mycobacterium Tuberculosis (TB) continues to rank among the world’s most serious problems despite biomedical achievement of effective prophylaxis and chemotherapy. In South Africa, TB is directly linked to the country’s high HIV prevalence rate and other related factors. The required knowledge, as well as people’s attitude towards a better understanding of TB are prerequisites for motivating them to seek early treatment. This study aims to explore the knowledge about and attitude towards TB among non- TB infected clinic attendees. More specifically, this study used a qualitative descriptive design to explore and describe clinic attendees’ knowledge of the cause, symptoms and treatment of TB and to explore their attitude towards the disease. A semi-structured interview technique was used to gather data. Ten clinic attendees between 20-40 years old, able to communicate in English and who had no past history of TB were conveniently sampled. Manual data analysis was done using an inductive approach. Thereafter, a deductive approach using the Health Belief Model was used to guide the discussion of the findings. Nine major themes were identified. The results confirm a gap in participants’ knowledge of the cause, symptoms and treatment of TB. Despite these gaps participants perceived that they were susceptible to TB, the dangers TB could cause and the benefits of completing the treatment. Participants indicated that they would seek medical help if they experienced TB symptoms. However, their fear was their ignorance of TB symptoms on the one hand and the fear of being stigmatized, discriminated against, as well as the quality of health service deliveries on the other hand. The findings highlight the need for on-going education about the cause of TB, transmission, symptoms and treatment at clinics and within the community. Media including radio, television, as well as schools and family should be included in TB education programmes. Immigrants should also be targeted to be included in TB education campaigns. Keys terms: Tuberculosis, Non-TB infected patients, Knowledge and attitude, Health Belief Model. / AFRIKAANSE OPSOMMING: Mycobacterium Tuberkulose (TB) word steeds gekenmerk as een van die ernstigste gesondheidsprobleme ter wệreld, ten spyte van deurbrake met betrekking tot meer doeltreffende profilakse en chemoterapie. In Suid-Afrika, word TB direk gekoppel aan die land se hoë voorkoms van MIV en ander verwante faktore. Die nodige kennis, sowel as ‘n beter begrip van mense se gesindhede teenoor TB, is voorvereistes vir die motivering wat hulle gedrag sal beïnvloed om vir vroeë behandeling te gaan. Hierdie studie het ten doel om die kennis en gesindhede teenoor tuberkulose van ongeïnfekteerde TB-pasiënte in ‘n Kaapstadse kliniek te ondersoek. In die besonder ondersoek die studie, deur ‘n kwalitatiewe beskrywende benadering, die kennis van ‘n spesifieke groep individue wat die kliniek besoek, met betrekking tot die oorsake, simptome en behandeling van TB, asook hulle houding ten opsigte van die siekte. Die studie beklemtoon ook enige vooroordele oor die siekte en identifiseer moontlike redes vir pasiënte se laat-aanmelding van TB by ‘n kliniek. ‘n Semi-gestruktureerde tegniek vir onderhoudvoering is gebruik. Tien pasiënte wat die kliniek besoek tussen die ouderdomme 20-40 jaar oud, wat in staat is om in Engels te kommunikeer, en wat geen vroeëre geskiedenis van TB het nie, is gerieflikheidshalwe per steekproef gebruik. Data is per hand versamel deur gebruik te maak van ‘n induktiewe benadering. Hierna is ‘n deduktiewe benadering gevolg, en die “Health Belief Model” is gebruik om die gesprekke te lei in die bevindinge. Nege hooftemas is geïdentifiseer. Die resultate bevestig ‘n gaping in die kennis van deelnemers oor die oorsake, simptome en behandeling van TB. Ten spyte van die gapings, was deelnemers wel bewus van die feit dat hulle blootgestel is om TB op te doen en oor wat die gevare is wat deur TB veroorsaak kan word, sowel as wat die voordele is om TB-behandeling te voltooi. Deelnemers het aangedui dat hulle mediese hulp sal vra, sou hulle die simptome van TB bespeur. Desnieteenstaande was hulle vrees enersyds oor die onkundigheid van die simptome van TB, en om gestigmatiseer teen gediskrimineer te word, asook die standaard van mediese dienste beskikbaar andersyds. Die bevindinge beklemtoon die behoefte aan voortgesette opvoeding oor die oorsake, oordrag, simptome en behandeling van TB in klinieke en binne gemeenskappe. Media soos radio en televisie, asook skole en families behoort ingesluit te word in sodanige opvoedingsprogramme. Immigrante behoort ook ingesluit te word by massa opvoedingsprojekte. Sleutelterme: Tuberkulose, ongeïnfekteerde TB-pasiënte, Kennis en gesindhede, “Health Belief Model”.

Thesis (MCur)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: The importance of maintaining maternal wellbeing during the antenatal period is mandatory to the mother and the baby. Although asymptomatic maternal tachycardia could be seen as part of the physiological changes during pregnancy, it could also be a sign of a serious underlying condition. Previous studies have shown that maternal deaths could occur in women with pre-existing cardiac conditions (Naidoo, Desai & Moodley, 2002:17). The concern that many conditions associated with maternal tachycardia pass through the health care system without being noticed or investigated motivated the researcher to undertake this study. The study aimed to determine the prevalence of maternal tachycardia during late pregnancy and its association with anaemia, major cardiac diseases and/or complications and adverse maternal and perinatal outcomes. A case-control retrospective study design within a prospective study was employed with a quantitative approach. A total sample size of 204 participants, constituting 14.3% of the study population (N=1431) was purposefully selected from the Monica AN24™ recordings of the Safe Passage Study at Tygerberg Hospital to collect the data. Ethical approval was obtained from the Health Research Ethics Committee of the Faculty of Medicine and Health Sciences, Stellenbosch University and a waiver of consent had been granted. A group of 16 participants, who met the inclusion criteria, constituting 7.8% of the total sample, was selected for the pilot study. Reliability and validity was ensured by the pilot study and pre-testing the data collection instrument as it was tested under the exact circumstances as the actual study experts in the field of nursing and medical research and statistics were used. The data was analyzed by the use of the STATISTICA version 9 programme. The results show a 7.1% (n=102) prevalence of maternal tachycardia in late pregnancy. There were no pre-existing cardiac conditions in any of the groups and no maternal cardiac complications during pregnancy and delivery. The case group had a higher incidence (55.0%) of haemoglobin values lower than 11.0 g/dL than the control group (47.0%), however the Mann-Whitney U test revealed no statistically significant difference of the Hb values at 28 to 38 weeks between the case and the control groups. The participants presenting with anaemia (Hb < 11.0 g/dL) were classified as mild anaemia (Hb value of 7.0 – 10.9 g/dL). There were no participants that presented with severe anaemia (Hb value of < 7.0g/dL). There was an increased prevalence (9.1%) of infection in the participants presenting with maternal tachycardia, although this difference was not significant between the two groups. The infant outcome revealed an increased mean birth weight of 194g for the case group that presented with maternal tachycardia. Several recommendations were identified that were grounded in the study findings. The findings reveal that the current antenatal care practice in terms of not recording the maternal heart rate is sufficient. / AFRIKAANSE OPSOMMING: Die belangrikheid van die handhawing van moederlike welsyn gedurende die voorgeboorte tydperk is noodsaaklik vir die moeder en die baba. Alhoewel asimptomatiese moederlike tagikardie gesien kan word as deel van die fisiologiese veranderinge tydens swangerskap, kan dit ook 'n teken wees van 'n ernstige onderliggende toestand. Vorige studies het aangetoon dat moederlike sterftes kan voorkom in vroue met voorafgaande harttoestande (Naidoo, Desai & Moodley, 2002:17). Die kommer dat verskeie toestande wat verband hou met moederlike tagikardie, deur die gesondheidsorg stelsel kan deurglip sonder om opgemerk te word, het die navorser gemotiveer om hierdie studie te onderneem. Die studie is daarop gemik om die voorkoms van moederlike tagikardie tydens laat swangerskap en sy verbintenis met anemie, ernstige hartsiektes en/of komplikasies en ongunstige moederlike en perinatale uitkoms te bepaal. 'n Gevalkontrole retrospektiewe studie-ontwerp binne 'n voornemende studie is gebruik met 'n kwantitatiewe benadering. 'n Totale steekproefgrootte van 204 deelnemers, wat 14.3% van die populasie (N=1431) uitmaak is op ‘n doelgerigte manier uitgekies uit die Monica AN24™ opnames van die Veilige Geboorte Studie by Tygerberg Hospitaal om die data in te samel. Etiese goedkeuring is verkry van die Mensnavorsing Etiese komitee komitee van Fakulteit van Geneeskunde en Gesondheidswetenskappe van die Universiteit Stellenbosch en 'n kwytskelding van toestemming is verleen. 'n Groep van 16 deelnemers, wat voldoen aan die insluitingskriteria, wat 7,8% van die totale steekproef bestaan, is geselekteer vir die loodsstudie. Betroubaarheid en geldigheid is verseker deur die loodsstudie en die voorafgaande toets van die data-insamelingsinstrument onder presies dieselfde omstandighede as die werklike studie sowel as die gebruik van kenners in die gebied van verpleging en mediese navorsing en statistiek. Die data is ontleed deur die gebruik van die Statistica weergawe 9 program. Die resultate toon 'n 7,1% (n=102) voorkoms van moederlike tagikardie in laat swangerskap. Daar was geen onderliggende harttoestande in enige van die groepe en geen moederlike hartkomplikasies tydens swangerskap en geboorte nie. Die gevalgroep het 'n hoër voorkoms (55,0%) van Hb waardes laer as 11.0 g/dl as die kontrole groep (47.0%) gehad, maar die Mann-Whitney U-toets toon geen statisties beduidende verskil in die Hb waardes by 28-38 weke tussen die geval en die kontrolegroepe nie. Die deelnemers met anemie (Hb < 11.0 g/dl) is geklassifiseer met ligte bloedarmoede (Hb waarde van 7.0-10.9 g/dl). Daar was geen deelnemers wat erge bloedarmoede (Hb waarde van < 7.0g/dL) getoon het nie. Daar was verhoogde voorkoms (9,1%) van infeksie in die deelnemers met moederlike tagikardie, hoewel die verskil nie beduidend tussen die twee groepe was nie. Die baba uitkoms toon 'n toename in gemiddelde geboortegewig van 194g vir die gevalgroep wat met moederlike tagikardie gediagnoseer is. Verskeie aanbevelings is geïdentifiseer wat in die studie se bevindinge gegrond is. Die bevindinge dui daarop dat die huidige voorgeboortelike sorgpraktyk in terme van nie rekordering van die moederlike hartspoed voldoende is.

The three phased study aimed to develop policy guidelines for workplace health promotion based on an exploration of the current status of health promotion in South African workplaces. In the first phase of the study a case study approach was used to analyse the current situation of health promotion in the workplace. For this phase of the study the particular aim was to determine to what extent the participating workplaces were involved in health promotion, or were salutogenic in nature. A total of 6 organizations participated in the first phase of the study, with a total of 258 participants. The second phase aimed at developing policy guidelines for health promotion in the workplace. The consensus method, using the Delphi technique, was used in this phase, involving seven participants who were experts in the field of occupational health and health promotion. The third phase was an observation of the implementation of the policy guidelines. Implementation analysis, which is part of evaluation research, was the methodology used. Two organizations from phase one participated in the implementation phase. In summarising the findings on the current situation of employee health promotion programs the study showed that none of the participating organizations emerged as health promoting workplaces. Organizations that offered employee health promotion/wellness programs mainly focused on individual health and on HIV/AIDS and none of them was found to provide comprehensive holistic programs that aimed at providing healthy work environments. In phase 2 of the study it emerged that there was a very strong concurrence between the findings from the experts and literature in terms of what needs to be included in health promotion policy guidelines. The key elements for health promotion policy documents were (1) organizational philosophy (2) stakeholder involvement and (3) the description of programs to be included in the policy. During the policy implementation process it emerged that different strategies were used in the policy development process. This process was largely influenced by such factors as organizational size, type and internal structures. Recommendations include an emphasis on more legislative support for health promotion in the workplace, and for more concrete aids such as policy guidelines and educational preparation of occupational health professionals for this component of their role. / Thesis (Ph.D.)-University of KwaZulu-Natal, Durban, 2007.

Aim: This study appraised the CQI mechanisms and processes in the clinical nursing divisions of five selected teaching hospitals located in South-West Nigeria and developed quality care indicators to measure and monitor quality of care amongst clinical based nurses in these teaching hospitals. Background: Studies have been done on evaluation of quality care to determine what good care is; whether the care nurses give is proper and effective, and whether the care provided is good quality. Several authors have asserted that evaluating the quality of nursing care is an essential part of professional accountability. Literature also suggests that in providing high quality care, it is important that nurses develop appropriate evaluative measurement tools to ensure professional aspect of nursing. Conversely, it is a concern that in the clinical nursing division of some teaching hospitals in SW Nigeria, CQI mechanisms/processes (such as a structured auditing, monitoring and measuring quality of nursing care, established systems of continuing professional learning/ In-service Education Unit) were not more evident, particularly when these teaching hospitals were supposed to be seen as models for providing quality care services. It was not certain what CQI activities were present in similar hospitals, and if such activities were present, there was uncertainty as to how these activities were performed. In addition, the type of instrument/tools available for nursing care measurement was uncertain. There is a paucity of published evidence relating to the quality of nursing care measurement in the teaching hospitals in SW Nigeria. Gaps identified in the study would form the basis for future training and education of nurses involved in care-giving to promote quality care. Findings from the study provided evidenced-based scientific rationale for practice in relation to quality nursing care measurement in the health care institutions, thus adding to the body of knowledge of quality improvement. The methodology employed in the study is an action research; with a mixed method-Sequential explanatory incorporated. Quantitative data was collected and analysed, followed by the collection and analyses of qualitative data. The study was done in five cycles which included a survey that elicited responses from the participants on general knowledge and perceptions about CQI. Cycle two included generating promising solutions and an action plan. In cycle three, established quality-care indicators were analysed, developed and thereafter, the newly adapted instrument for nursing care measurement was tested for applicability to settings. Participants reflected on the testing of the new tool in the fourth cycle and lastly, implementation/testing outcomes were evaluated in the fifth cycle. Conclusion: Established quality-care indicators were adapted in each of the five hospital settings for quality nursing care measurement. The newly adapted quality care indicators were tested for applicability on two acute-care wards in three of the five participating hospitals. The results of the study could be used in Nigeria and elsewhere as a means to protect the rights of the patient; by measuring and monitoring the quality of nursing care. / Thesis (Ph.D.)-University of KwaZulu-Natal, Durban, 2009.

Aim: The aim of the study was to describe the forensic role behaviour and expectations of the nurses working in the emergency departments. Design: An exploratory descriptive survey was used, using the quantative approach. The respondents comprised of registered and enrolled nurses who were registered with South African Nursing Council (SANC) and had the minimum of 6 months experience in the emergency department (ED). The emergency departments of two provincial and two private hospitals as well as two comprehensive care clinics were used. Instrument: A survey was conducted using a questionnaire consisting of forty items. The questionnaire was designed to describe the forensic role behaviour and expectations of nurses working in the ED. Data analysis: The quantative data was analysed using the Statistical Package for Social Sciences (SPSS) program version 11.5 Findings: The findings revealed that the emergency department (ED) nurses were not certain about their role regarding forensic nursing. Most of the tasks to be performed by the ED nurses were rated as never done or seldom done. The reason was due to lack of training and knowledge in the field of forensic nursing. The ED nurses strongly felt that forensic nursing was very important to their daily activities especially in the emergency departments where they handle the trauma victims and suspects. Recommendations were suggested for the nursing practice, nurse educators and for future research in an attempt to expose the emergency nurses to forensic practice. / Thesis (M.A.)-University of KwaZulu-Natal, 2006.

The post natal home visit care program is a maternal and newborn home visit care program, designed to address the needs of the childbearing families following delivery and early discharge, irrespective of the place of delivery. The study was undertaken to determine the factors influencing the implementation of the post natal home visit care program by nurses and to make suggestions to resolve the problem in an urban health district in Botswana. A descriptive exploratory study, using both quantitative and qualitative methods guided the process. Two methods were used to collect data, namely, the developed checklist and four focus group discussions. Twelve clinics were sampled and checklists were completed for the twelve clinics by the researcher. A total of twenty eight Registered Nurses and Registered/Enrolled Nurse Midwives were recruited from the participating twelve clinics through purposive sampling. This included nursing managers and senior nursing staff. The findings reflect the post natal home visit care program deficits. Protocols and logistics such as transport and staff for the program were not in place. Furthermore, the results also reflect various factors such as lack of motivation, lack of support from management and co-workers, distance and fear of stigmatisation as reasons for not implementing the post natal home visit care program. The participants felt that there was need to implement the program and attached merit to its importance. Finally, the participants made suggestions to overcome the deficit such as team work, commitment to work, academic development and improvement of management and supervision. In conclusion, failure to implement the program represents a health delivery deficit. There is need for improved management and supervision to balance the needs of Registered/Enrolled Nurse Midwives and the needs of the organization in order to attain better results. There is also a need for the provision of logistics needed for the post natal home visit care program such as transport and manpower. Finally, there is need for the coordination of the post natal home visit program by the District Health Team to aid implementation so as to provide the essential service. / Thesis (M.N.)-University of KwaZulu-Natal, 2006.

Premature birth occurs before parents have had time to prepare for the birth of the infant. This survey was conducted to describe the responses of fathers of preterm low birth weight babies (PTLBW) and their involvement in the care of those babies in a neonatal intensive care unit. A quantitative descriptive non-experimental study design using purposive sampling (a non -probability method of sampling) was adopted. Fifty fathers of PTLBW babies of less than 2500grams, who visited and were involved in the care of their babies in NICU, voluntarily participated in the study by completing a self-administered questionnaire. The questionnaire was designed to collect the demographic information of the participants and to address their responses and their involvement in the care of the baby. Analysis of the findings revealed that fathers reacted positively on the birth of their babies as the majority of the fathers indicated that they were happy despite the fact that their babies were born before time. Fathers in this study experienced varying reactions to the equipment that they saw being used on their babies, 76% mentioned that they were frightened. Moreover, the research findings revealed that a high percentage of fathers, 88%, in the study mentioned that talking to their wives, partners or spouses as well as talking to nurses and doctors in NICU was the main strategies that they had used to cope with their feelings. Teaching is part of the support available to fathers as a tool to enhance their psychological well being and increase their interdependence relationship. Fathers in this study indicated they received information about their babies during visits. Thirty four (68%) of the fathers in the study acknowledged that nurses gave the most teaching about the baby, baby's care, baby's progress and about their overall role while the baby is in NICU. The fathers also in the same manner demonstrated that the information that they received on the NICU environment has helped them to participate in the care of the baby. / Thesis (M.A.)-University of KwaZulu-Natal, 2007.

In South Africa statistics of mortality and morbidity, pertaining to the consequences of risk taking behaviour among the country's youth, remain unacceptably high. Many of these behaviours have long as well as short term consequences, thereby, giving rise to many illnesses, lifestyle diseases, and other problems. The risk-taking activities confining this study include those that are known to concur and co-vary namely: unprotected, indiscriminate sex; nicotine use; alcohol and other drug/substance abuse; and unsafe travelling practices. The problem is that it is unknown whether South African adolescents are receiving health education that reduces risk-taking tendencies, and if they are, whether they are benefiting from the exposure. Little is known about the relationship between health-education and health-compromising behaviour in South Africa; nor the influence of other variables on this relationship. The purpose of the study was to describe and explore this relationship, among South African adolescents, attending an institution of tertiary education in the province of KwaZulu Natal. All aspects of the research were underpinned by Rosenstock's Health Belief Model (1974). The research was approached from a quantitative perspective using a descriptive/exploratory design. A sample of 155 students from all the main ethnic groups, of both sexes, aged between 17 and 24 years, who were raised and educated in South Africa, was taken from the Howard College Campus of the University of KwaZulu Natal. The sampling technique used was non-random quota sampling in order to meet the above mentioned inclusion criteria. The / Thesis (M.N.)-University of KwaZulu, Natal. 2006.

Inpatient aggression in mental health settings is a significant concern because it compromises the quality of care provided by health care workers. Nurses are one of the groups most affected by inpatient aggression because they are usually the client's first contact on admission. A number of studies have found that nurses are the most frequently assaulted professional group both inside and outside of the hospital setting, are more frequently assaulted than doctors and most are likely to experience some form of aggression in their career. The causes of inpatient aggression are frequently conceptualised as multidimensional and involving factors internal to the client e.g. age, factors relating to the environment such as inflexible ward routines and factors relating to the quality of the interaction between nursing staff and clients. Research studies suggest that nurses generally respond reactively and rely heavily on physical control strategies rather than on interpersonal strategies in managing inpatient aggression. Contemporary literature suggests that the perceptions nurses hold about aggression and its causes influences their management of the event and that this process is mediated by a number of client, environment and nurse-related variables including age, education, gender, nursing experience, perceptions of aggression and its causes. Although the causes and management of inpatient aggression in nursing is well documented in the United Kingdom and some other West European countries, this is not the case for Africa and in the case of this study, for Botswana. No studies have attempted to find the nurses' perception, perception on the cause, and management of inpatient aggression in Africa and more so in Botswana. Aim: The purpose of the study was to explore how nurses' demographic characteristics, their perceptions of aggression and its causes, influence the management of inpatient aggression by nurses in the main psychiatric institution in Botswana. Method: A descriptive, exploratory non-experimental design was used. Perception of inpatient aggression was captured by a Perception of Aggression Scale (POAS) and the perception on the cause and management of inpatient aggression was collected with Management of Aggression and Violence Attitude Scale (MAVAS).The sample comprised of 71 nurses, 48 of whom were females and 23 males. The mean age of the nurse respondents was 36 years. Of the 71 respondents 50 were registered nurses only while 20 were psychiatric registered nurses. More than two thirds of the respondents had a diploma in nursing, one had a masters degree and the remainder, a degree in nursing. The average nursing and psychiatric nursing experience of the respondents were 12.1 and 6.87 years respectively. ANNOVA test and t-tests were done to find the associations between the nurses' demographic variables, their perception, perception on the cause and management of inpatient aggression. Findings: The respondents In this study perceived inpatient aggression as both negative and positive. There was an overall agreement with the perception of aggression as always negative and as an action of physical violence against a nurse (81.73%). Nurses saw the cause of inpatient aggression as emanating from the internal, external and situational/interactional factors. The use of traditional methods of aggression dominated as shown by a high mean score of 80.5 as compared to interpersonal management with a mean score of 60.5. A statistical difference was found between gender, perception of aggression and perception of aggression and the traditional management of aggression while age, nursing and psychiatric nursing experience were statistically associated with the use of interpersonal management of aggression. Conclusion: The study provided insight into the nurses' perceptions, perceptions on the cause and management of inpatient aggression in a mental institution in Botswana. Nurses in this study hold predominantly negative perceptions of aggression and generally favour traditional management strategies. However, older, more experienced nurses tended to favour interpersonal techniques. Recommendations for nursing practice, education and research to address this issue centre around further and targeted education and training in mental health and specifically, in the comprehensive management of aggression which includes communication skills, use of de-escalation, use of medication and cautious physical restraint. / Thesis (M.N.)-University of KwaZulu-Natal, Durban, 2009.