Thesis (MCurr)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: Exposure to the clinical learning environment forms an essential part of nursing education. Being a nurse lecturer in the private sector, the researcher observed that bridging course learners do not always perform academically as satisfactorily as they should. For the purpose of the current study, the researcher investigated enrolled bridging course learners’ perspectives related to factors influencing their learning in the clinical environment. The study focused on bridging course learners in the private sector. The objectives of the study were to determine whether the following was valid for the population under consideration: - a shortage of staff is a barrier to learning in the clinical environment; - an orientation programme has been implemented for bridging course learners in the clinical environment; - bridging course learners in the clinical environment have to take charge of wards; - the attitude of staff members is a barrier to the learners’ learning experience. - there is a learner/mentor relationship in the clinical environment; - opportunities to gain practical competence exist in the clinical environment. An exploratory descriptive design with a predominantly quantitative approach was applied. The population for the study consisted of bridging course learners at the three private nursing colleges in the Cape metropolitan area (N = 89). Due to the small size of the population, all available learners who voluntarily gave consent were included in the study. The sample size for this study constituted 62% (n = 55) of the target population. A semi-structured questionnaire was used to collect data, and both open and closed ended questions were used. Reliability and validity were assured by means of a pilot study and the use of experts in the field of nursing education and statistics. Data were collected personally by the researcher. Ethical approval was obtained from the Committee for Human Science Research at the Faculty of Medicine and Health Sciences at Stellenbosch University. Statistical associations were determined using the Spearman and Mann-Whitney U tests. The results of this study are presented in percentages and tables. The majority (n = 46/84%) of the participants disagreed that the staffing in units was sufficient. Most (n = 40/73%) participants disagreed with the statement that working conditions were conducive to learning. Qualitative analysis revealed that the participants perceived the clinical environment to be hostile, and the majority (n = 47/85%) of the participants agreed that staff members had a negative attitude towards them. Furthermore, only five (n = 5/9%) participants indicated that they always spent time with their mentor, and the majority (n = 36/65%) of the participants disagreed with the statement that they could achieve specific outcomes before moving to another ward. A shortage of staff, being placed in charge of wards in the absence of a registered nurse, negative attitudes of staff members, and the lack of a mentor–learner relationship were identified as factors that impacted negatively on learning in the clinical environment. Several recommendations, grounded in the study findings, were identified, including: - Sufficient staff should be on duty to improve the learning environment, in order for learners to achieve their outcomes according to the curriculum. - Learners should receive adequate supervision and support. - Sufficient time should be allocated for practical procedures, such as releasing learners on practical days to practise procedures. Factors influencing enrolled bridging course learners’ learning experiences in the clinical environment were identified. Strategies to address these factors may improve their clinical experiences and ultimately their clinical competence. / AFRIKAANSE OPSOMMING: Blootstelling aan kliniese leer omgewing is ’n grondliggende deel van verpleegonderrig. As ’n verpleeglektrise in die privaat sektor, het die navorser tot die gevolgtrekking gekom dat oorbruggingsleerders nie akademies na wense presteer nie. Vir die doel van hierdie studie het die navorser die faktore geëvalueer wat die kliniese onderrig van oorbruggingsleerders gedurende hul plasing in die kliniese omgewing beïnvloed. Die ondersoek konsentreer op oorbruggingsleerders wat in die privaat sektor werk. Die oogmerke van die studie was om te bepaal of: - ’n personeeltekort onderrig in die kliniese omgewing belemmer; - daar ’n oriënteringsprogram vir oorbruggingsleerders bestaan; - oorbruggingsleerders die bevel oor eenhede moet oorneem; - leerders personeelgesindhede as ’n hindernis ervaar; - daar ’n leerder/mentor-verhouding in die kliniese omgewing is; - geleenthede vir praktiese onderrig geskep word. ’n Beskrywende, verkennende studie met ’n oorwegend kwantitatiewe benadering is uitgevoer. Die studiebevolking was oorbruggingsleerders (N = 89) wat die drie privaat verpleegkolleges in die Kaapse metropool verteenwoordig. As gevolg van die klein populasie het alle leerders wat vrywillig hul toestemming verleen het, aan die studie deelgeneem. Gevolglik is ’n steekproef (n = 55/62%) van die teikenpopulasie geneem. Die navorser het ’n semi-gestruktureerde vraelys gebruik om data in te win en beide oop en toe vrae was gevra. Betroubaarheid en geldigheid is deur middel van ’n proefstudie sowel as die gebruik van deskundiges op die gebied van verpleegonderrig en statistiek verseker. Die navorser het die data persoonlik ingesamel. Etiese goedkeuring is van die Gesondheidsnavorsingsetiekkomitee van die Fakulteit Geneeskunde en Gesondheidswetenskappe van die Universiteit Stellenbosch verkry. Statistiese korrelasies is met behulp van die Spearman- en Mann-Whitney-U-toetse ondersoek. Die resultate van die studie word in die vorm van persentasies en tabelle aangebied. Die meeste deelnemers (n = 46/84%) reken daar is nie voldoende personeel in die sale nie. Voorts dink die meeste (n=40/73%) ook dat werksomstandighede nie onderrig bevorder nie. Kwalitatiewe ontleding toon dat die deelnemers die kliniese omgewing as bedreigend beskou, en die meeste (n = 47/85%) is dit ook eens dat personeel ’n negatiewe houding teenoor hulle openbaar. Slegs vyf deelnemers (n = 5/9%) het aangedui dat hulle altyd tyd saam met hulle mentor deurbring, terwyl die meeste (n = 36/65%) erken dat hulle nie hulle studie-uitkomste bereik alvorens hulle na ’n ander saal oorgeplaas word nie. Die studie bevind dat ’n personeeltekort, om in bevel van eenhede geplaas te word in die afwesigheid van ‘n geregistreerde verpleegkundige, personeel se negatiewe houding, en die gebrek aan ’n mentor/leerder-verhouding van die faktore is wat onderrig in die kliniese omgewing benadeel. Verskeie aanbevelings word op grond van die studiebevindinge gedoen. Dit sluit die volgende in: - Daar behoort genoegsame personeel aan diens te wees om die onderrigomgewing vir leerders te verbeter en hulle sodoende in staat te stel om hul studie-uitkomste volgens die kurrikulum te behaal. - Behoorlike toesig oor leerders moet verseker word. - Leerders behoort op praktiese dae van ander werk vrygestel te word ten einde hul prosedures te voltooi. Faktore wat die leer ervaring van oorbruggings leerders in die kliniese omgewing beinvloed was identifiseer. Strategieë wat hierdie faktore adresseer, kan hulle kliniese ervaring asook hul kliniese vaardigheid verbeter.

Thesis (MCurr)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: Background Diarrhoea (frequent, loose, watery stools) is one of the major causes of morbidity and mortality globally and affects mainly infants and children under the age of five years. Unhygienic feeding practices and feeding utensils contribute to diarrhoeal incidences. The most common causes of acute gastroenteritis worldwide are infectious agents, such as viruses, bacteria and parasites Aim The aim of the study was to investigate which out of three particular sterilising methods is the most effective for sterilising feeding bottles and cups. Methods An experimental quantitative approach was most appropriate for the current study. An in vitro experimental study with a descriptive design was utilised under controlled laboratory conditions. The study was conducted at the University of the Western Cape (UWC) in April 2009. Results The sample size consisted of 16 samples, of which two were used for each method of sterilisation, namely: two (2) bottles and two (2) cups for sunlight; two (2) bottles and two (2) cups for Milton™; two (2) bottles and two (2) cups for Sunlight™ dishwashing liquid; and control utensils that consisted of two (2) bottles and two (2) cups. The target population for the study comprised infant feeding bottles and feeding cups. The analysis for the APC cultures that was compared in the cups vs. bottles, in order to see whether there was a significant difference between the mean bacteria counts, shows that the average bacteria count (on the ln scale) was 6 cfu/ml and 9 cfu/ml for the cups and bottles, respectively. The t-value was -1.17524. As the ρ-value was 0.2595, no significant difference was found between the cups and bottles. The E. coli cultures were compared in the cups vs. bottles to see whether there was a significant difference between the mean bacteria counts. The results show that the average bacteria count (on the ln scale) was 7 cfu/ml and 7.6 cfu/ml for cups and bottles, respectively. The t-value was -0.211902. The ρ-value was 0.835237, and therefore there was no significant difference between cups and bottles. Conclusion The current study showed no significant difference between the sterilising methods or between the use of either bottles or cups. Therefore, a study with a larger sample size is recommended for further research. Recommendations The researcher recommends that future researchers conduct broader studies, with a larger sample size on the topic. Studies with a larger sample size enabled the real differences to be large enough to be significant. The use of sunlight is recommended as a sterilisation method for infant feeding utensils, as it is both time- and cost-effective. Sunlight is an inexpensive and readily available method of sterilisation; therefore, it can be used by relatively under resourced socio-economic communities. / AFRIKAANSE OPSOMMING: Agtergrond Diarree (gereelde, los, waterige stoelgang) is een van die hoofoorsake van morbiditeit en sterflikheid wêreldwyd en affekteer hoofsaaklik suigelinge en kinders onder die ouderdom van vyf jaar. Onhigiëniese voedingspraktyke en -gereedskap dra by tot die voorkoms van diarree-gevalle. Die mees algemene oorsake van akute gastroënteritus wêreldwyd word veroorsaak deur aansteeklike agente soos virusse, bakterieë en parasiete. Doel Die doel van hierdie studie is om ondersoek te doen na watter van die drie bepaalde steriliseringsmetodes die mees effektiewe is vir die sterilisering van bottels en koppies. Metodes ’n Eksperimentele kwantitatiewe benadering is die mees geskikte een vir die huidige studie. ’n In vitro-eksperimentele studie met ’n deskriptiewe ontwerp is onder gekontroleerde laboratorium omstandighede aangewend. Die studie is by die Universitet van die Wes-Kaap (UWK) in April 2009 uitgevoer. Resultate Die steekproefgroote het bestaan uit 16 monsters waarvan twee gebruik is vir elke steriliseringsmetode, naamlik: twee (2) bottels en twee (2) koppies vir sonlig; twee (2) bottels en twee (2) koppies vir Milton™; twee (2) bottels en twee (2) koppies vir Sunlight™ skottelgoedopwasmiddel; en kontrole gereedskap wat bestaan het uit twee (2) bottels en twee (2) koppies. Die teikenbevolking vir die studie het bestaan uit voedingsbottels en -koppies vir suigelinge. Die analise vir die APC-kulture wat vergelyk is in die koppies vs. bottels om te bepaal of daar ’n beduidende verskil is tussen die gemiddelde bakterie-tellings, toon dat die gemiddelde bakterie-telling (op die In-skaal) is 6 cfu/ml en 9 cfu/ml vir die koppies en bottels respektiewelik. Die t-waarde is -1.17524. Aangesien die p-waarde 0.2595 is, is daar geen beduidende verskil gevind tussen die koppies en die bottels nie. Die E. coli-kulture is vergelyk in die koppies vs. bottels om te bepaal of daar ’n beduidende verskil tussen die gemiddelde bakterie-tellings is. Die uitslae wys dat die gemiddelde bakterie-telling (op die In-skaal) is 7cfu/ml en 7.6 cfu/ml vir koppies en bottels respektiewelik. Die t-waarde is -0.211902. Die p-waarde is 0.835237 en dus is daar geen beduidende verskil tussen koppies en bottels nie. Gevolgtrekking Die huidige studie toon dat daar geen beduidende verskil tussen die steriliseringsmetodes of tussen die gebruik van of bottels of koppies is nie. Dus, ’n studie met ’n groter steekproefgrootte word aanbeveel vir toekomstige navorsing. Aanbevelings Die navorser beveel aan dat toekomstige navorsers meer omvattende studies met ’n groter steekproefgrootte oor die onderwerp uitvoer. Studies met ’n groter steekproefgrootte sal veroorsaak dat die werklike verskille vanweë hul grootte genoegsaam sal wees, om beduidend te wees. Die gebruik van sonlig as ’n steriliseringsmetode vir die gereedskap van suigelinge word aanbeveel, aangesen dit beide tyd- en kostebesparend is. Sonlig is ’n goedkoop en maklik verkrygbare metode van sterilisasie; dus kan dit gebruik word deur gemeenskappe wat nie oor die nodige middele beskik nie, vanweë hul sosio-ekonomiese situasies.

Thesis (MCurr)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: Unnoticed deterioration in the clinical condition of children in ward areas can lead to near or actual cardiopulmonary arrest. Children suffering from a cardiac arrest in hospital often display abnormal physiological parameters hours prior to this event occurring (i.e., within a 24 hour period). Prevention of cardiopulmonary arrest in the wards lies in the ability of nursing and medical staff to be able to identify these abnormal physiological parameters, i.e., early signs of deterioration, and to intervene prior to this event. This study aimed to identify nurses’ experiences with regards to current knowledge, clinical practice and training in the recognition of clinical deterioration in children. It could then be determined whether a formal guideline on the early recognition of clinical deterioration in children would be perceived as being beneficial by the respondents in this study. The research question that guided this study was “what are the perceptions and experiences of registered professional nurses working in paediatric wards with regards to their recognition of unexpected clinical deterioration in children?” An exploratory descriptive study, utilising a qualitative approach was applied. The target population consisted of all registered professional nurses working in paediatric wards in academic hospitals in the Western Cape, South Africa. Ethical approval was obtained. Informed written consent was obtained from the participants. The purposive sampling method was used to select the participants (n=17) who met the criteria. Five focus group interviews were conducted to collect the data, using an interview guide. The planned methodology with its instrumentation and procedures was verified through a pilot study that was conducted on the first focus group interview. The steps of the research process included transcribing the collected data verbatim from the audio recordings and the field notes, and then analysing the data by summarising and packaging the data, identifying themes and trends in the data and verifying and drawing conclusions. The analysis themes identified were based on Donabedian’s conceptual framework, comprising Structure (the environment in which the care takes place), Process (method by which the care takes place), and Quality Assurance (the planned, organised evaluation of the patient care which has been rendered). The findings showed that the increased level of severity of illness of children nursed in paediatric wards, as well as staff shortages, gaps in training on resuscitation and clinical deterioration, limited ICU beds and staff, lack of adequate monitoring and emergency equipment in the wards, and inexperienced staff are all factors that were identified that increase the risk of staff not being able to detect clinical deterioration in children nursed in paediatric wards. Teamwork among nursing staff and other medical professionals, as well as parental involvement in the care of the children, assisted staff in being able to detect clinical deterioration. Most participants were unfamiliar with ‘early warning systems’ and reported that there are no paediatric ‘early warning scores’ (PEWS) in place. They believed such a system would be beneficial; however they had concerns regarding the time it would take to score a patient, the training involved, and the ease of use of such a tool and system. Recommendations for addressing non-recognition of clinical deterioration by nurses in paediatric wards such as appropriate knowledge and skill updating, were put forward in the study. / AFRIKAANSE OPSOMMING: ‘n Kliniese verswakking by kinders wie in pediatriese sale verpleeg word, wat nie betyds waargeneem word nie, kan dit lei tot ‘n amperse of werklike kardio-pulmonale arres. Kardio-pulmonale arres in kinders word dikwels voorafgegaan deur ‘n verandering in die fisiologiese parameters (so vroeg as 24-uur voor die arres). Die voorkoming van saalverwante kardio-pulmonale arres berus op die vermoeë van verpleeg- en mediese personeel om die abnormale fisiologiese tekens so vroeg as moontlik waar te neem en daadwerklik op te tree voordat die arres plaasvind. Die doel van hierdie studie was om die ondervindige van verpleegkundiges te identifiseer met betrekking tot die bestaande protokolle, opleiding en hulpbronne wat beskikbaar is vir die waarneming van die kliniese agteruitgang in kinders. ‘n Bepaling sal gevolglik gemaak kan word of die studie-respondente ‘n amptelike riglyn rakende die vroegtydige waarneming van kliniese agteruitgang in kinders voordelig sou vind al dan nie. Die rigtinggewende navorsingvraag vir die studie was “wat is die sieninge en ondervings van geregistreerde verpleegkundiges in pediatriese sale rakende die herkening van onverwagte kliniese agteruitgang in kinders?” ‘n Verkennende, beskrywende navorsingsmetodologie, met ‘n kwalitatiewe aanslag, is gebruik. Die teikenpopulasie het bestaan uit alle geregistreerde professionale verpleegkundiges, werksaam in die pediatriese sale van die akademiese hospitale in die Wes Kaap, Suid-Afrika. Etiese toestemming, asook ingeligte, skriftelike toestemming is vooraf verkry van elke deelnemer. ‘n Doelbewuste steekproefnemings metode is gebruik om die studie deelnemers, wat aan die navorsingskriteria voldoen het, te kies. Vyf fokusgroep onderhoude is gevoer om data in te samel en ‘n onderhoudsgids is gebruik vir dié onderhoude. Om die navorsingmetodologie, instrumentasie and prosedures te bevestig, is ‘n voortoets tydens die eerste fokusgroep onderhoud gedoen. Die stappe van die navorsingproses is gevolg om die ingesamelde data, bestaande uit klankopnames en veldnotas, woord-vir-woord oor te skryf. Die data is hierna ontleed deur middel van opsomming en samevoeging, terwyl temas en neigings geïdentifiseer is en afleidings geverifieër en gefinaliseer is. Die geïdentifiseerde ontledingstemas is basseer op Donabedian se konsepsuele raamwerk, bestaande uit Struktuur (die versorgingsomgewing), Proses (die versorgingsmetodes) en Kwaliteitsversekering (die doelbewuste en beplande evaluering van gelewerde verpleegsorg). Die navorsingsbevindinge het daarop gedui dat verskeie faktore ‘n rol speel in die risiko-toename wat verband hou met personeel wat nie die kliniese agteruitgang in kinders wat in pediatriese sale verpleeg word, waarneem nie. Die faktore sluit in: die kinders se graad van siekte, personeeltekorte, opleidings tekortkominge ten opsigte van resussitasie- en die identifikasie van kliniese agteruitgang by kinders, tekorte aan genoegsame moniterings- en noodtoerusting in die sale, en onervare personeel. Die waarneming van kliniese agteruitgang is wel bevorder deur spanwerk onder verpleegkundiges en ander mediese personeel, asook ouers wat betrokke was by die versorging van hulle kinders. Die meerderheid van die navorsingdeelnemers was nie vertroud met ‘vroeë waarskuwingsstelsel’ nie, en het aangedui dat geen ‘pediatriese vroeë waarskuwingsstelsels’ beskikbaar is nie. Alhoewel hulle van mening was dat so ‘n stelsel voordelig kon wees, het hulle bedenkinge gehad oor die tyd wat dit in beslag sou neem om die dokumentasie te voltooi, die opleiding wat hulle sou moes ontvang, en wat die moeilikheidsgraad van so ‘n stelsel sou wees. Die voortvloeiende aanbevelings van hierdie studie, wat die nie-herkenning van kliniese agteruitgang deur verpleegkundiges in pediatriese sale aanspreek, sluit in toepaslike kennis- en vaardigheids opdatering.

Thesis (MCurr)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: Saudi Arabia has experienced a number of changes due to revolutionary new findings and technologies, discoveries and new research in the health care arena, which has proven and contradicted a new approach to health care delivery. Demands by patients who have become more educated, the emergence of new or modern disease profiles which demand a new way of approach and a quickening in the pace of change, hurled unfamiliar and often demanding and challenging conditions at management One such change, as addressed in this study, is the change from a paper-based patient record system to a computer based patient information system to which all healthcare professionals in the multidisciplinary team had access to. However, not all change is welcomed, accepted or viewed as necessary by those who have to carry out or use new technologies. Change is harsh, and part of the problem is identifying factors that influence change initiatives. This study addresses the perceptions of nursing personnel of the process of change from a paper-based to a computer based (Quadramed) patient record system. The study design used a quantitative and descriptive approach in which a structured, self-designed questionnaire was used to obtain data from 117 professional nurses at a selected healthcare facility in the Eastern province of the Kingdom of Saudi Arabia. The theoretical framework used for this study was the Model for Change Management as designed by the Prosci Institute for Research, also referred to as the ADKAR Model of Change Management (Awareness, Desire, Knowledge, Ability and Reinforcement). The major findings of this study revealed that 97.44% of the respondents were non-Saudi individuals, and were mainly from the Philippines (69.24%), with (95.65% being female with an average age of 37-42 years. Most (47%) were in possession of specialty qualifications in medical, surgical nursing and experience between 8-10 years, of which 2-3 years had been in Saudi Arabia. In regard to 61.3% of the respondents it was found that they had no prior knowledge of computerised patient records. The nurse managers played a vital role in providing the most information and support to adjust to the system. With reference to the aspect of patient safety, positive feedback about the QCPR was provided by the majority of respondents. Most of the respondents experienced change positively, and 70% indicated that being involved played a major role in their positive attitude. Recommendations include that reasons for change should be more clearly communicated, suggestions for change should be valued more by managers and rumours and uncertainties about change should be addressed as and when appropriate. / AFRIKAANSE OPSOMMING: Saoedi-Arabië het 'n aantal veranderinge ondervind as gevolg van revolusionêre nuwe bevindings en tegnologie, ontdekkings en nuwe navorsing in die gesondheidsorg arena, wat 'n nuwe benadering tot die lewering van gesondheidsorg bewys en weerspreek. Eise deur pasiënte wat meer geletterd is, en nuwe en moderne siekte profiele eis 'n nuwe benadering tot verandering. Die versnelling in die tempo van verandering is dikwels onbekend, veeleisend en uitdagende vir die bestuur van gesondheidsinstellings. Een so 'n verandering, soos dit in hierdie studie aangespreek word, is die verandering van 'n papier-gebaseerde na 'n rekenaar-gebaseerde pasiënt inligting stelsel wat aan alle lede van die multidissiplinêre gesondheidsorg span toegang verleen. Nogtans word nie alle verandering verwelkom, aanvaar of as nodig beskou deur diegene wat die dienste uitvoer of die nuwe tegnologie moet gebruik nie. Verandering is gekompliseerde proses, en deel van die probleem is die identifisering van faktore wat 'n invloed op die veranderings inisiatiewe het. Hierdie studie fokus op die persepsies van die verpleegpersoneel tydens die proses van verandering van 'n papier-gebaseerde tot 'n rekenaar gebaseerde (Quadramed) pasiënt rekord stelsel. Die studie-ontwerp gebruik 'n kwantitatiewe, beskrywende benadering wat 'n gestruktureerde, self-ontwerpte vraelys gebruik om data te verkry van 117 professionele verpleegsters by 'n geselekteerde gesondheidsorg fasiliteit in die Oostelike Provinsie van die Koninkryk van Saoedi-Arabië. Die teoretiese raamwerk wat gebruik word vir hierdie studie was die model vir veranderingsbestuur soos ontwerp deur die Prosci Instituut vir Navorsing, waarna ook verwys word as die “ADKAR Model of Change Management” (Awareness, Desire, Knowledge, Ability and Reinforcement). Die belangrikste bevindings van hierdie studie het aan die lig gebring dat 97,44% van die respondente was nie-Saoedi-individue nie, en was hoofsaaklik van die Filippyne (69,24%), met (95,65%) vroue met 'n gemiddelde ouderdom van 37-42 jaar. Die meeste (47%) was in besit van gespesialiseerde kwalifikasies in mediese, chirurgiese verpleeging. Die meeste van die respondente het tussen 8-10 jaar ervaring in verpleegkunde gehad, waarvan 2-3 jaar in Saoedi-Arabië was. Met betrekking tot 61,3% van die respondente dit is gevind dat hulle geen vorige kennis van die gerekenariseerde pasiënt rekords gehad het nie. Die saal bestuurder het 'n belangrike rol gespeel in die verskaffing van die meeste inligting en ondersteuning om aan te pas tot die nuwe stelsel. Met verwysing na die aspek van die veiligheid van pasiënte, is positiewe terugvoer oor die QCPR voorsien deur die meerderheid van die respondente. Die meeste van die respondente het ook die verandering positief ervaar, en 70% het aangedui dat hul betrokkenheid 'n belangrike rol gespeel het in hul positiewe gesindheid. Aanbevelings sluit in dat die redes vir verandering duidelik gekommunikeer behoort te word, voorstelle vir verandering moet erkenning kry deur bestuurders en gerugte en onsekerhede oor verandering moet aangespreek word soos en wanneer toepaslik.

Thesis (MCurr)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: In view of the escalating shortage of nurses, attention is focused on the emerging workforce and efforts to retain new nurse graduates. The aim of this study was to investigate possible factors that could influence the retention of new nurse graduates currently employed within the public sector in the Cape Winelands District of the Western Cape. The objectives of the study were to determine whether the retention of new nurse graduates is influenced by: • the mentoring programme • leadership in the workplace • workload pressure and stress • complexity of care • staff shortages A quantitative approach with a descriptive design was applied. The total population (N=73) consisted of all new nurse graduates who had registered with the South African Nursing Council within the last three years, and who were employed at one of the 6 provincial hospitals included in the study. Since the total population was relatively small, no specific sampling method was employed but the whole population served as the sample. A self-administered questionnaire was used for data collection. Ethical approval to conduct the study was obtained from the Health Research Ethical Committee at Stellenbosch University. Permission to conduct the study at the specific hospitals was obtained from the provincial government of the Western Cape. Informed consent was obtained from all the respondents. A pilot test was completed, prior to the initiation of the main study, during which the questionnaire was issued to n=7 respondents who were not part of the total population utilized in the actual study. Data was presented in the form of tables, histograms and frequencies. The results revealed diminished implementation of mentoring and orientation programmes for new graduates. Most respondents, however, indicated that they had received appropriate day to day guidance in the workplace. Unit managers had provided guidance relating to the development of leadership, problem-solving and conflict management skills. The new graduate nurses had not been sufficiently exposed to managerial duties such as supervising the budget and scheduling of off-duties. Most respondents reported that they had experienced work-related stress due to work overload associated with shortage of staff. Furthermore, respondents reported that they would be likely to resign due to issues that relate to complexities in patient care; for example, limited numbers of trained staff in specialization units, too little support and direction and the presence of low levels of motivation and burnout among staff. Recommendations: • Mentoring and orientation programmes for new nurse graduates should be reviewed or initiated. • New nurse graduates should be exposed to all leadership activities. • Staffing management issues should be reviewed to address issues such as work overload, burnout and unrealistic nurse-patient ratios. • Managers should focus on the strengths of new nurse graduates and structure a workforce that will support the new graduate with professional duties in order to reduce complexities of care. In conclusion, implementation of the transformational leadership approach and Herzberg’s Two-Factor Theory are proposed to ensure motivation, productivity and job satisfaction, which will ultimately improve the retention of new nurse graduates in the public sector. / AFRIKAANSE OPSOMMING: In die lig van die toenemende tekort aan verpleegsters, word die aandag gevestig op die ontluikende werksmag en pogings om nuutgegradueerde verpleegsters te behou. Die doel van die studie was om moontlike faktore te ondersoek wat die behoud van nuutgegradueerde verpleegsters wat tans in die diens van die openbare sektor in die Kaapse Wynland-distrik van die Wes-Kaap staan, te ondersoek. Die doelwitte van hierdie studie was om vas te stel of die behoud van nuutgegradueerde verpleegsters beïnvloed word deur • die mentorprogram • leierskap binne die werksplek • werksdruk en stres • die kompleksiteit van pasiëntsorg • personeeltekorte. ’n Kwantitatiewe benadering met ’n beskrywende ontwerp was toegepas. Die totale teikengroep (N=73) het bestaan uit alle nuutgegradueerde verpleegsters wat by die Suid- Afrikaanse Raad van Verpleging binne die afgelope drie jaar geregistreer is en wat in diens was by een van die ses provinsiale hospitale wat in hierdie studie ingesluit is. Aangesien die totale teikengroep relatief klein is, is geen spesifieke steekproefmetode toegepas nie, maar die hele teikengroep het as steekproef gedien. ’n Selfgeadministreerde vraelys was vir data-insameling gebruik. Etiese goedkeuring om die navorsing te doen is van die Gesondheidsnavorsing se Etiese Komitee aan die Universiteit van Stellenbosch verkry. Toestemming om die studie by die spesifieke hospitale te doen, is van die Provinsiale Regering van die Wes-Kaap verkry. Ingeligte toestemming is van al die deelnemers verkry. ’n Loodsstudie is voor die aanvang van die hoofstudie voltooi waartydens die vraelys uitgereik is aan n=7 deelnemers wat nie deelgevorm het van die totale teikengroep wat in die eintlike studie gebruik is nie. Data is aangebied in die vorm van tabelle, histogramme en frekwensies. Die resultate het verminderde implementering van mentorskap en oriënteringsprogramme vir nuutgegradueerdes getoon. Die meeste deelnemers het nietemin saamgestem dat hulle gepaste leiding daagliks binne die werksplek ontvang. Eenheidsbestuurders het leiding verskaf wat te make het met die ontwikkeling van leierskap, probleemoplossing en konflikbestuursvaardighede. Die nuutgegradueerde verpleegsters was nie genoegsaam blootgestel aan bestuurspligte soos die begroting en skedulering van afdienste/diensroosters nie. Die meeste deelnemers het rapporteer dat hulle werksverwante stres ervaar weens werksoorlading wat met personeeltekorte geassosieer word. Voorts het deelnemers rapporteer dat hulle sal bedank as gevolg van aangeleenthede wat met kompleksiteit van siekeversorging verband hou.Dit is,beperkte hoeveelhede van opgeleide personeel veral in gespesialiseerde eenhede, te min ondersteuning en leiding, asook die aanwesigheid van uitputting en lae vlakke van motivering onder personeel. Aanbevelings: • Mentorskap en oriënteringsprogramme vir nuutgegradueerdes moet hersien of ingestel word. • Nuutgegradueerde verpleegsters moet blootgestel word aan alle leierskap aktiwiteite. • Personeelbestuur kwessies moet hersien word om die faktore soos werksoorlading, ooreising en onrealistiese verpleeg-pasiënt ratio’s te adresseer. • Bestuurders moet fokus op die sterk punte van nuutgegradueerdes en ’n werksmag struktureer wat die nuutgegradueerdes met professionele pligte sal ondersteun ten einde die kompleksiteit van siekeversorging te verminder. Ten slotte, die transformasie leierskap benadering en Herzberg se Twee-Faktor Teorie word voorgestel om motivering, produktiwiteit en werksbevrediging wat uiteindelik die behoud van nuutgegradueerdes binne die openbare sektor sal verbeter, te verseker.

Thesis (MCurr)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: Literature suggests that job satisfaction and retention of nurses can be improved by empowering nurses in decision making (Mark, Lindley & Jones, 2009:120; Mangold, Pearson, Schmitz, Scherb, Specht & Loes, 2006:266; Manojlovich, 2007; and Scherb, Specht, Loes & Reed, 2010:2). Positive work environments such as those found in Magnet® accredited hospitals and those where management models have flat hierarchical structures, support the decisional involvement of registered nurses. Decisional involvement is described as “the pattern of distribution of authority for decisions and activities that govern nursing practice policy and the practice environment” (Havens & Vasey, 2005:377). The purpose of this study was to explore the decisional involvement of registered nurses in a tertiary hospital in Saudi Arabia. It is hypothesized that an empowering shared governance structure will result in a high level of decisional involvement of registered nurses who provide direct patient care. A quantitative study with a descriptive exploratory design was chosen to answer the research objectives. Through simple random sampling, n=140 registered nurses who provide direct patient care (target population N=672) and through non-probability purposive sampling n=18 nurse managers (target population N=21), participated in the study. A self-administered questionnaire was designed which included a validated tool, namely the Decisional Involvement Scale (Havens & Vasey, 2003:333). A pilot study was completed to test the validity of the self-designed sections of the questionnaire. Numerical data was analysed using STATISTICA v. 11.5 while the open-ended questions were analysed and placed into themes. It was found that registered nurses who provide direct patient care have low levels of actual and preferred decisional involvement, implying that the authority for decisional involvement lies with managers. The hypothesis that empowering shared governance structures will result in a high level of decisional involvement is not supported. There was no statistical difference identified between bedside Registered Nurses (bedside RNs) and nurse managers in the overall perception of decisional involvement. Factors that were identified to impact on decisional involvement included educational level, experience, leadership styles, the work environment and a culture of shared decision making. It is recommended that the focus to improve the decisional involvement of registered nurses who provide direct patient care should be on addressing those activities where more decisional involvement is preferred, while concurrently addressing those factors that were identified which would impact on the decisional involvement of all registered nurses. / AFRIKAANSE OPSOMMING: Literatuurstudies dui aan dat bemagtiging van verpleegkundiges in die proses van besluitneming tot meer werksbevrediging en retensie sal lei. Positiewe werksomgewings soos die by Magnet geakkrediteerde hospitale en die met plat hiërargiese bestuursmodelle dra by tot betrokkenheid van geregistreerde verpleegkundiges in besluitneming. Betrokkenheid by besluitneming word beskryf as ‘die wyse waarop outoriteit versprei is sodat besluite en akwiteite wat verpleegpraktykbeleid en die praktykomgewing bepaal, uitgevoer kan word’ (Havens & Vasey, 2005:377). Die doel van die studie was om die betrokkenheid te bepaal van geregistreerde verpleegkundiges by besluitneming in ‘n tersiêre hospitaal in Saoedi-Arabië. Die hipotese is dat ‘n bemagtigende, gedeelde bestuurstruktuur sal lei tot ‘n hoë vlak van deelnemende besluitneming by geregistreerde verpleegkundiges verantwoordelik vir direkte verpleegsorg. Die navorsingsdoelwitte is beantwoord deur middel van ‘n kwantitatiewe studie met ‘n beskrywende, ondersoekende ontwerp. Geregistreerde verpleegkundiges (n=140) wat direkte verpleegsorg lewer (teikengroeppopulasie N=672) is gebruik as deelnemers in die studie. Verpleegdiensbestuurders (n=18) is ook gebruik as deelnemers en gekies deur nie-waarskynlike, doelbewuste steekproefneming (teikenpopulasie N=21). ’n Self-toegepasde vraelys is ontwerp, met insluiting van ‘n geldig verklaarde Besluitnemende Betrokkenheidskaal (Havens & Vasey, 2003:333). ‘n Loodsstudie om die geldigheid van die selfontwerpte deel te bepaal, is voltooi Numeriese data is ontleed deur middel van STATISTICA v. 11.5. Oop-einde vrae is ontleed en in kategorieë georganiseer. Daar is gevind dat geregistreerde verpleegkundiges wat direkte pasiëntsorg lewer, laer vlakke van werklike en verkose betrokkenheid het in besluitneming, wat aandui dat die outoriteit vir besluitnemende betrokkenheid by bestuurders lê. Die hipotese dat bemagtigende gedeelde bestuurstrukture tot ‘n hoë vlak van deelneming in besluitneming sal lei, word nie ondersteun nie. Daar was nie ‘n beduidende statistiese verskil tussen geregistreerde verpleegkundiges wat by die bed betrokke is en verpleegdiensbestuurders met algehele waarnemingsbetrokkenheid by besluitneming nie. Geïdentifiseerde faktore wat ‘n rol speel by betrokkenheid by besluitneming behels opvoedkundige vlak, ondervinding, leierskapstyle, die werkomgewing en ‘n kultuur van gedeelde besluitneming. Daar word aanbeveel dat aktiwiteite waarby geregistreerde verpleegkundiges wat direkte pasiëntsorg lewer, verkies om meer betrokke by te wees tydens besluitneming, aangespreek word. Terselfdertyd moet geïdentifiseerde faktore wat ‘n rol speel in die betrokkenheid van besluitneming van alle geregistreerde verpleegkundiges ook aangeroer word.

Thesis (MCurr)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: The issue of attrition of undergraduate participant nurses has remained a concern for an extremely long time. Attrition has been labelled as complex and in order to understand attrition it is important to pay attention to the rate, reasons and trends in South Africa. To understand attrition in South Africa, the trends internationally need to be taken into account to determine whether South Africa has a unique problem. Due to the enormous financial cost to the state and the students’ self-confidence, as well as their belief and understanding of why all the systems that have been put into place fail, it has become a concern. The reasons why students choose nursing and their academic progress throughout secondary schooling should give a clear indication to the educational authorities how successful the students could be. The aim of this study was to determine possible reasons for attrition in students who do the undergraduate diploma nursing course. The objective was to determine the attrition rate of students in the undergraduate course. Reasons for attrition involve a close investigation into age, home language, subjects taken in secondary school, family support, reasons for going into nursing, problems experienced, reasons for not completing the course and how these affected them. The objectives was met through a descriptive study with a quantitative approach. The target population (N=260/100%) consisted of all students that had not completed their undergraduate diploma nursing course over four years between the years 2007-2010, from a Nursing College in the Western Cape. The sample population (n=58/22%) voluntarily agreed to participate in the study. A telephonic questionnaire was administered with closed-ended questions and a small section which had a likert scale. Data was collected by the researcher and a trained field worker. Ethical approval was obtained from the Health Research Ethics Committee at the Faculty of Health Sciences, Stellenbosch University. Permission was also obtained from the Western Cape Provincial Administration to conduct the research. Informed consent was obtained from the students. Reliability and validity was supported by a pilot study conducted on (n=10/10%) of the students at the Western Cape College of Nursing to ensure feasibility of the study. The data was analysed by a statistician and presented in tables and graphs. Statistical analysis was determined by ordinal and nominal data. The results showed that there were numerous factors that contributed to the attrition of undergraduate nursing diploma students. The results showed that the majority of the students’ home language was Xhosa 43% (n=25/58) with the majority being female, single with one child. The main reasons for choosing nursing was because it was a vocation/calling. The recommendations were to ensure that all nursing colleges be integrated into institutions of higher education, thereby ensuring more stringent selection criteria. There needs to be a bridging year where the students are taught to improve their literacy and numeracy so that this will give the students a better understanding of the lectures being delivered in English. There needs to be systems in place to assist the students that are mediocre or struggling. The conclusion was that attrition is complex and requires more concrete systems to stem the rate. A total reformation of undergraduate diploma nursing programmes needs to be addressed. / AFRIKAANSE OPSOMMING: Die kwessie van attrisie by voorgraadse diploma student verpleegsters is al vir ’n geruime tyd kommerwekkend. Attrisie word as kompleks bestempel en om dit te begryp, is dit noodsaaklik om aandag te skenk aan die tempo waarteen dit vookom, asook die redes en tendense in Suid-Afrika te bepaal. Om attrisie in Suid-Afrika te kan begryp, moet die internasionale tendense in ag geneem word om te bepaal of Suid-Afrika ’n unieke probleem het. Weens die enorme finansiële onkoste wat die staat het ten opsigte hiervan en die student se selfvertroue, asook hulle geloof en begrip in al die sisteme wat in plek is wat gefaal het, word dit ’n bekommernis. Die redes waarom studente kies om verpleging te doen en hulle akademiese vordering gedurende hulle sekondêre skoolopleiding, behoort ’n duidelike aanduiding aan die onderwysowerhede te wees hoe suksesvol die studente kan wees. Die doel van hierdie studie is om die moontlike redes vir attrisie by studente wat die voorgraadse diploma kursus in verpleging volg, te bepaal. Die doelwit is om die attrisie-tempo by studente in die voorgraadse diploma kursus, te bepaal. Redes vir attrisie verg ’n indringende ondersoek van die ouderdom, huistaal, vakke geneem in die sekondêre skool, familie-ondersteuning, redes waarom verpleging as loopbaan gekies word, probleme wat ondervind word, redes waarom die kursus nie voltooi word nie en hoedat dit hulle geaffekteer het. Die doelwitte is behaal deur ’n beskrywende studie met ’n kwantitatiewe benadering te volg. Die teikenbevolking (N=260/100%) het bestaan uit alle studente wat nie hulle voorgraadse verpleegkursus binne vier jaar tussen die jare 2007-2010 aan ’n verpleegkollege in die Wes-Kaap voltooi het nie. Die steekproef bevolking (n=58/22%) het vrywillig ingestem om aan die studie deel te neem. ’n Telefoniese vraelys met geslote vrae is geadministreer en ’n klein gedeelte het ’n likertskaal bevat. Data is gekollekteer deur die navorser en ’n opgeleide veldwerker. Etiese goedkeuring is verkry van die Gesondheidsnavorsing se Etiese Komitee aan die Fakulteit van Gesondheidswetenskappe, Universiteit van Stellenbosch. Toestemming is ook verkry van die Wes-Kaapse Provinsiale Administrasie om die navorsing te doen. Ingeligte toestemming is van die deelnemers verkry. Betroubaarheid en geldigheid is ondersteun deur ’n loodsondersoek wat uitgevoer is op (n=10/10%) van die deelnemers aan die Wes-Kaap Kollege vir Verpleging om die uitvoerbaarheid van die studie te verseker. Die data is geanaliseer deur ’n statistikus en in tabelle en grafieke aangebied. Statistiese analise is bepaal deur ordinale en nominale data. Die uitslae het bewys dat daar ’n aantal faktore is wat bygedra het tot die attrisie van voorgraadse studente wat die verpleegdiploma doen. Die uitslae het bewys dat die meerderheid van die studente se huistaal Xhosa 43% (n=25/58) is, waarvan die meerderheid vroulik en enkel met een kind is. Die hoofredes waarom verpleging gekies is as loopbaan, is omdat dit ’n beroep/roeping is. Die aanbevelings is om te verseker dat alle verpleegkolleges geïntegreer word by instellings vir hoër onderwys, daardeur word strenger seleksie-kriteria verseker. Daar behoort ’n oorbruggingsjaar vir participante te wees om hulle geletterdheid en syfervaardigheid in so ’n mate te verbeter dat hulle lesings in Engels verstaan wanneer dit aangebied word. Daar behoort sisteme in plek te wees om participante te help wat gemiddeld presteer of sukkel. Die gevolgtrekking is dat attrisie kompleks is wat meer konkrete sisteme verg om die tempo waarteen dit plaasvind, die hoof te bied. ’n totale transformasie van voorgraadse diploma verplegingsprogramme behoort aangeroer te word.

Thesis (MCurr)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: Haematopoietic stem cell transplantation has become an increasingly popular treatment option for persons with life-threatening blood related diseases such as leukemia, lymphoma, myeloma and certain forms of anaemia. Due to this new therapy the use of bone marrow from a healthy individual also called a living donor for transplantation is inevitable. These living donors can experience psychological and economic issues and these components needs to be addressed in the transplant protocol. The researcher described the psychosocial factors that influenced sibling donors during allogeneic bone marrow transplantation at a public sector hospital in Cape Town, whether the transplant team members explained the administrative process of the transplant in an understandable manner and language and the effect of the psychosocial factors and administrative process of the allogeneic bone marrow transplantation on the sibling donors. A quantitative research approach with a descriptive design was used in this study. The sample was selected by means of full population sampling. The final sample size of (n=64) stem cell sibling donors over 18 years of age participated in the study. A self-reporting questionnaire was used to gather data, inclusive of four open-ended questions to establish an in depth sense of what the donor experiences during the bone marrow donation process. Descriptive statistics used to describe the variables included frequency distributions in the form of histograms and frequency tables. The Pearson chi-square statistical analysis test was used to test for relationships amongst groups. The study drew on the Roy Adaptation Model (RAM) as the theoretical framework to explain the phenomena surrounding the psychosocial and administrative effect of the transplantation process on the sibling donor. Based on the findings the haematopoietic stem cell donors coped with the psychosocial impact of the donation process by making use of their coping mechanism to adapt to their situation according to the Roy Adaptation Model. This model also offers guidance to the nurses to apply this model to nursing practice. Results revealed that sibling donors developed feelings of anxiety in relation to the invasive procedures that cause them to experience physical pain. Most respondents claimed that they were not psychologically affected by the donation process. The moral obligation the sibling donor has towards his sister or brother outweighed the physical pain or discomfort experienced during the donation process. Results revealed that the responding donors claimed they were well informed regarding the donation process and understood the treatment plan of the recipient. However, results revealed that there was a lack in visual donor information such as books, pamphlets as well as internet information. Results concerning the demographics revealed that (n=29) respondents had no schooling and some respondents had some schooling which can give an indication of how to bridge the knowledge and information gap between them and the donor in terms of language. Statistical significance results regarding the emotional state and economic situation of the donors was found. Some of the respondents were responsible for their own transport and their own accommodation, some of those that are employed were responsible for leave without pay. An organ donation policy needs to be developed to prevent live organ donors from losing valuable working hours that could result in loss of salary and should provide other financial incentives. Furthermore, a lack in a post-donation follow-up medical to alleviate and detect post-donation complications was identified. Further nursing research can help nurses to understand living donation for transplantation, also how the nurses that practice in organ transplant units experience and deal with the psychosocial factors that influence them particularly. / AFRIKAANSE OPSOMMING: Hematopoïetiese stamseloorplanting het ’n toenemend gewilde-behandelingsopsie vir persone met lewensgevaarlike bloedverwante siektes soos leukemie, limfoom, miëloom en sekere soorte anemie geword. Vir hierdie tipe terapie word die beenmurg van ’n gesonde individu, ook bekend as ’n lewende skenker, vir oorplanting gebruik. Lewende skenkers kan sielkundige en ekonomiese probleme ervaar en hierdie kwessies moet in die oorplantingsprotokol hanteer word. In hierdie studie is ondersoek ingestel na die psigososiale faktore wat bloedverwante skenkers tydens allogeneïese beenmurgoorplanting by ’n openbare hospitaal in Kaapstad beïnvloed, of die oorplantingspan die administratiewe proses van die oorplanting op ’n verstaanbare manier en in verstaanbare taal verduidelik het, en wat die uitwerking wat die psigososiale faktore en administratiewe proses is op die bloedverwante skenkers tydens allogeneïese beenmurgoorplanting. ’n Kwantitatiewe benadering met ’n beskrywende navorsingsontwerp is in hierdie studie gebruik. Die steekproef is op grond van volledige populasiesteekproefneming gekies. ’n Finale steekproefgrootte van stamselskenkers (n=64) ouer as 18 jaar het aan die navorsing deelgeneem. ’n Selfverslaggewende vraelys is gebruik om data in te samel, wat vier oop vrae ingesluit het om grondige begrip te verkry van wat die skenker tydens die beenmurgskenkingsproses ervaar. Beskrywende statistiek wat gebruik is om die veranderlikes te beskryf, sluit in frekwensie-verspreidings in die vorm van histogramme en frekwensie-tabelle. Die Pearson chi-kwadraat- statistieseanalise is gebruik om die verwantskappe onder groepe te toets. Die Roy Adaptation Model (RAM) is as die teoretiese raamwerk vir die studie gebruik om die verskynsels betrokke by die psigososiale en administratiewe ervaring van die oorplantingsproses vir die bloedverwante skenker te verklaar. Op grond van die bevindinge het die hematopoïetiese stamselskenkers die psigososiale impak van die skenkingsproses hanteer deur gebruik te maak van hulle hanteringsmeganisme om by hulle situasie aan te pas, wat met die RAM ooreenstem. Hierdie model bied ook leiding aan verpleegkundiges om dit in die verplegingspraktyk toe te pas. Resultate het getoon dat bloedverwante skenkers gevoelens van angs ontwikkel het vanweë die indringende prosedures, wat fisiese pyn veroorsaak het. Die meeste deelnemers het aangedui dat hulle nie sielkundig deur die skenkingsproses geraak is nie. Die morele verpligting wat die bloedverwante skenker het teenoor sy of haar broer of suster het die fisiese pyn of ongemak gedurende die skenkingsproses oortref. Resultate het getoon dat die deelnemende skenkers aangedui het dat hulle goed ingelig was oor die skenkingsproses en die behandelingsplan van die ontvanger verstaan het. Die resultate dui egter daarop dat daar ’n gebrek was aan visuele skenkersinligting soos boeke, pamflette en internet-inligting. Resultate rakende die demografie het bewys dat van die deelnemers (n=29) ongeskoold en sommige deelnemers laag geskoold is, wat ’n aanduiding kan gee van hoe die kennis- en inligtingsgaping tussen hulle en die skenker ten opsigte van taal oorbrug kan word. Statisties beduidende resultate rakende die emosionele toestand en ekonomiese situasie van die skenkers is gevind. Sommige deelnemers was verantwoordelik vir hulle eie vervoer en verblyf. Diegene wat werk, het verlof sonder betaling geneem. ’n Orgaanskenkingsbeleid moet ontwikkel word om te verhoed dat lewende orgaanskenkers kosbare werksure verloor, wat kan lei tot ’n verlies aan salaris. Ander finansiële aansporings behoort ook gegee te word. Voorts is ’n gebrek aan opvolg mediese behandeling vir skenkers om skenkingskomplikasies vas te stel en te verlig, geïdentifiseer. Voortgesette navorsing kan verpleegkundiges help om begrip te verkry van die implikasies van lewende orgaanskenking. Verpleegkundiges wat in hierdie orgaanoorplantings- eenhede werksaam is, kan ‘n beter begrip kry van die psigososiale faktore wat hierdie skenkers spesifiek beïnvloed.

Thesis (MCurr)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: The university environment provides many opportunities to be sexually active. University students are reported as tending to engage in high-risk behaviours related to sex, alcohol and drugs. First-year university students are reported to be most vulnerable, as they lack experience to make good and risk-aware decisions when it comes to sexual liaisons. Available initiatives aimed at improving sexual behaviours of students are reported as being implemented simply because they work well somewhere else, without prior assessment of the needs/characteristics of the target population. This can negatively affect their effectiveness. The following question motivated the study: What factors influence sexual behaviours of first-year students on a university campus? This study sought to describe the perceptions of first-year students about engaging in sexual behaviours at a university campus. To answer the research question, theory of planned behaviour (TPB) was applied as the framework of the study. The study was descriptive in nature. Data were collected by means of a self-administered questionnaire from a conveniently selected sample of 240 first-year university students from one campus in the Eastern Cape. The measuring instruments were constructed from the constructs of the TBP, namely attitudes (ATT), perceived social norms (PSN), perceived behavioural control (PBC), and behavioural intentions (BI). The SPSS was used to analyse data for frequencies of responses and multiple regression. Most participants reported being sexually active (85.3%) and the lack of provision of information on sexual issues from adults (parents (23.3%) and church authorities (10.8%) was apparent. Perceived social norms were the most prominent factor that showed to be predictive of sexual behaviours with three significant predictor variables, namely partner age difference (beta = .059, ρ< .040), number of sexual partners in 3 months (beta = .238, ρ< .008) and condom use (beta = .095, ρ< .014). Behavioural intentions also showed some prediction, to a lesser extent, with one predictor variable, namely age at first willing intercourse (beta = .86, ρ< .001). The results from this study suggested that targeting social norms in intervention efforts aimed at improving sexual behaviours of first-year university students in the target population could be beneficial. More studies to explore available social norms in this target group and intervention to change negative norms are recommended. / AFRIKAANSE OPSOMMING: Die universiteitsomgewing bied studente meer geleenthede om seksueel aktief te wees. Daarbenewens is universiteitstudente na bewering geneig om hoërisikogedrag met betrekking tot seks, alkohol en dwelmmiddels te openbaar. Eerstejaarstudente word as die kwesbaarste beskou, aangesien hulle die ervaring kortkom om goeie, risikobewuste besluite oor seksuele verhoudings te neem. Tog word die beskikbare inisiatiewe vir die verbetering van seksuele gedrag onder studente blykbaar slegs in werking gestel omdat dit elders goed werk, sonder om eers die behoeftes/kenmerke van die teikenpopulasie te bepaal. Dít kan die doeltreffendheid van dié inisiatiewe benadeel. Die vraag wat as beweegrede vir hierdie studie gedien het, was: Watter faktore beïnvloed die seksuele gedrag van eerstejaars op ’n universiteitskampus? Die navorsing wou dus ondersoek instel na eerstejaars se opvattings oor seksuele gedrag en seksuele verhoudings op ’n universiteitskampus. Om hierdie navorsingsvraag te beantwoord, is ’n teorie van beplande gedrag (TPB) as studieraamwerk gebruik. Die studie was beskrywend van aard. Data is met behulp van ’n vraelys van ’n gerieflik gekose steekproef van 240 eerstejaar-universiteitstudente op ’n enkele kampus in die Oos- Kaap ingesamel. Die deelnemers het self die vraelys ingevul. Die meetinstrumente is saamgestel uit die verskillende konstrukte van die TPB, naamlik houdings (ATT), waargenome sosiale norme (PSN), waargenome gedragsbeheer (PBC) en gedragvoornemens (BI). SPSS-sagteware is gebruik om die data vir die frekwensie van response en meervoudige regressie te ontleed. Die meeste deelnemers het aangedui dat hulle seksueel aktief is (85,3%), en die gebrek aan inligting oor seksuele kwessies vanaf volwassenes (ouers 23,3%) en die kerk (10,8%) blyk duidelik. Waargenome sosiale norme het as die sterkste voorspeller van seksuele gedrag na vore getree, met drie beduidende voorspellerveranderlikes, naamlik ouderdomsverskil met bedmaats (Beta = .059, p< .040), aantal bedmaats in drie maande (Beta = .238, p< .008) en kondoomgebruik (Beta = .095, p< .014). Gedragvoornemens het ook ’n mindere mate van voorspellingsvermoë getoon, met een voorspellerveranderlike, naamlik ouderdom met eerste gewillige seksuele omgang (Beta = .86, p< .001). Die resultate van hierdie studie dui daarop dat intervensiepogings om seksuele gedrag onder eerstejaar-universiteitstudente te verbeter, by ’n klem op sosiale norme kan baat vind. Verdere studies oor die bestaande sosiale norme van hierdie teikengroep, sowel as intervensie om negatiewe norme te verander, word aanbeveel.

Thesis (MCurr)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: The focus of the study is on clients’ experiences of substance abuse recovery in a faith-based programme in the Western Cape. In describing the nature and extent of the substance abuse problem at an Imbizo on substance abuse, the speech of the Minister of Social Development, Benjamin (2006:1) stated that there are major challenges in rendering services to people who abuse substances. These challenges exist particularly with regard to prevention, rehabilitation and treatment of abusers. Baumann (1998: 238) stated that drug misuse is widespread and a growing problem in Southern Africa. This epidemic will have an increasing impact on mental and physical health. The focus of the literature review is to highlight the escalation of the problem over the last decade or so. Substance abuse is classified as a mental health illness, which could be healed in the application of various modalities of care. Little is understood and documented about the role of FBO programmes in substance abuse recovery in the Western Cape. The researcher hopes to add to the body of nursing research knowledge by conducting the study to answer the research question by understanding the experiences of clients accessing this level of care. The objective of the study is to explore, describe and interpret clients’ experiences of substance abuse recovery in a faith-based (FBO) programme in the Western Cape. An explorative, descriptive, interpretive, phenomenological, qualitative research design was chosen for this study. The population for this study comprised males and females, aged 18 years and older, who were admitted as in-patients in the 6-month residential substance abuse recovery facility, who followed the programme. The researcher used purposive sampling to recruit 7 participants who met the inclusion and exclusion criteria, until saturation of data was reached. The primary data collection tool used was in-depth semi-structured recorded interviews and field notes. The researcher used Nola Pender’s (1996) Health Promotion model (HPM) as the conceptual framework for the study as described The Braun and Clarke’s inductive thematic analysis (2006) was used to conduct the data analysis which yielded two overarching themes, namely, the positive recovery experience and the modified future experience. Recommendations were made based on the HPM assumptions and the thematic analysis. Ethical principles were followed in conducting the study and participants were advised that they are helping researchers to answer the research questions by participating in the study. / AFRIKAANSE OPSOMMING: Die studie fokus op kliënt-ervaringe van dwelmmisbruik-herstel in 'n geloof-gebaseerde programme in die Wes-Kaap. In die beskrywing van die aard en omvang van die dwelmmisbruikprobleem by 'n Imbizo op dwelmmisbruik tydens ‘n toespraak van die Minister van Maatskaplike Ontwikkeling (2006:1), is verklaar dat groot uitdagings heers met betrekking tot die lewering van dienste aan persone wat dwelmmidels misbruik. Hierdie uitdagings het veral betrekking op die voorkoming, rehabilitasie en behandeling van misbruikers. Baumann (1998: 238) verklaar dat dwelmmisbruik tans ‘n wydverspreide en groeiende probleem in Suider-Afrika is. Hierdie epidemie hou 'n toenemende impak op die geestelike en fisiese gesondheid van misbruikers in. Die fokus van die literatuuroorsig is om die verhoogde effek van die probleem uit te lig wat oor die laaste dekade voorgekom het. Die misbruik van dwelmmiddels word geklassifiseer as 'n geestesgesondheidsiekte wat gebruik kan word in die toepassing van verskeie modaliteite van gesondheidsorg. Daar is tans onvoldoende inligting beskikbaar om die rol van die FBO programme in die herstel van dwelmmisbruik in die Wes- Kaap behoorlik te kan ontleed en verstaan. Die navorser beoog om met die uitvoer van die studie die navorsingsvraag te kan beantwoord en sodoende ‘n meer ingeligte en in-diepte oorsig te kan vorm oor die ervaringe van kliente wat toegang het tot hierdie vlak van sorg. Die doel van die studie is om kliënt-ervaringe van dwelmmisbruik-herstel in 'n geloof-gebaseerde (FBO) programme in die Wes-Kaap te verken, beskryf en te interpreteer. Daar is besluit op 'n ondersoekende, beskrywende, verklarende en fenomenologiese kwalitatiewe navorsingsontwerp vir die studie. Die populasie vir hierdie studie het mans en vrouens in die ouderdom van 18 jaar en ouer ingesluit wat as kliente in die 6-maande residensiële dwelmmisbruik-herstel fasiliteit se progam toelating verkry het en wat deelgeneem het aan die programme. Die navorser het gebruik gemaak van ‘n doelgerigte steekproeftrekking en sodoende 7 deelnemers gewerf wat aan die insluitings en uitsluitings kriteria voldoen het. Die proses is gevolg totdat ‘n versadigingvlak van die data bereik is. Die primêre data insamelingsinstrument het die gebruik van ‘n in-diepte, ongestruktureerde onderhoud-metode behels, wat die neem van veldnotas en bandopnames ingesluit het. Die navorser het gebruik gemaak van die Pender se ‘Health Promotion Model’ (HPM) as die konseptuele raamwerk vir die studie. Die Braun en Clarke’s induktiewe tema-analise (2006) is gebruik om die data analise uit te voer wat twee oorkoepelende temas ingesluit het, naamlik, die positiewe herstelervaringetema en die gewysigde toekomstige ervaringe tema. Aanbevelings is gemaak wat op die HPM aannames en die tema analise gebaseer is. Etiese beginsels is streng gevolg en deelnemers is in kennis gestel dat hul deelname aan die studie die navorser instaat sou stel om die nodige data in te samel om sodoende die navorsingsvraag van die studie te kan beantwoord.