In the context of recent shifts in South African national health policies that integrate mental health care into primary health care, the family rather than the institution has become the primary site of ongoing care for psychiatric clients. The purpose of this qualitative phenomenological study was to describe how caring is rendered at home for the mentally ill person by family caregivers, living in Northdale, Pietermaritzburg. Purposeful sampling was used to recruit six family caregiver participants from the psychiatric clinic waiting room. These were caregivers who had accompanied their family member with mental illness for treatment on that particular day. Data generated from in-depth interviews with these participants provided personal experiences of their caregiving practices, behaviours, and problems. Data analysis was based on descriptive phenomenology and Colaizzi’s method of data analysis and data representation. Significant statements were extracted and grouped to form larger units or clusters. The clusters were then organised into nine themes, with associated significant statements made by the caregivers: Theme 1: Family as support system. These aspects related to daily maintenance of nutrition, hygiene and grooming for the family member with mental illness. The participants indicated that the maintenance of these activities f daily living were very important in the care of the SMI individual at home. Theme 2: Commitment to care. Evident throughout the interviews were issues of how caregivers perceived and sustained the ongoing responsibilities of home care for the mentally ill. There was a willingness and complete commitment to caring for the SMI family member with all its responsibilities. Theme 3: Disruption to family life. Details emerged from the interviews about how families adjusted to the constant needs of care provision, supervision, and vigilance demanded by home care giving. The participants accepted that problem behaviours were part of caring. Theme 4: Value in contributing to care. The interviews revealed various aspects of how caregivers drew reassurance and a sense of positive accomplishment from successes in teaching, supervising and managing a mentally ill relative at home. There were positive aspects to caring in that the SMI individuals could be of help to the caregivers. Simple tasks such as empting of bins, shopping and dish washing were part of the daily routine which proved beneficial to the caregiver and the family member with mental illness. Theme 5: Maintaining hope. Various implications emerged in the study such as being hopeful, and having a positive outlook as caregiver, despite the behaviour problems and chronic nature of the client’s mental illness. Participants indicated that despite the fact that they have a responsibility to care they are hopeful that one day the family member would be as normal as any other person. Theme 6: Support and Guidance: Ongoing assistance. Several issues emerged in relation to the involvement of the community psychiatric clinic professional staff in giving support and guidance to the individual caregivers, such as provision of information about side effects of medication, especially drowsiness, impaired communication and inactivity, guidance on how to cope with taking of substances by the client, and assistance with preparing for lifelong care of the family member with mental illness. Theme 7: Concern for Continuity of care. There was the need to look at what would be the outcome if the parents were not there to care for the SMI individual. Even though this is something to think about and had been broached at one time with the psychiatrist the family and care giver are hopeful that another family member will step into the caring role should they not be there. Theme 8: Fears and difficulties experienced in caring. Problem behaviours and danger to self and others is always upper most in the minds of the care givers, this resulted in even limiting friends because the SMI individual could be influenced into taking drugs. Care giving involved taking steps to ensure the family member does not hurt himself or herself. Theme 9: Misuse of Social Grant. Financial burdens were experienced by the family of the mentally ill individual. Social grants were being used to maintain the whole family for food, lights and rent. Sometimes the caregivers are forced to hand over the social grant to the MHCU just to ensure that there will be no problems at home if they were refused. Money is used to purchase cigarettes and drugs. Fear that the grant would be stopped results in the family not willing to report the abuse to the clinic staff. Implications for psychiatric nursing practice that the study highlighted included need for intervention by the community psychiatric nurses in regard to side-effects of medication, management of problem behaviours, and education for caregivers concerning the illness and especially its progressive signs and symptoms. Further research might explore current supportive programmes available in the community to keep pace with societal changes, with particular focus on whether. caregivers are included in the visits to the clinic with the mentally ill family member and what attention is given to their needs and problems so that they feel appreciated and valued. / Thesis (M.N.)-University of KwaZulu-Natal, Durban, 2012.

Background: The health care systems across are characterised by the gross shortage of nurses. A number of initiatives have been reported which seek to address this challenge. Literature shows that males remain an inadequately tapped source, They remain a minority in nursing compared to their female counterparts. Literature also shows that gender-based barriers for male nurses exist. The purpose of this study was to explore gender-related constructs that influence the recruitment and retention of men in nursing as experienced by male nurses in three selected hospitals in the eThekwini district. Research Methodology: A qualitative, explorative and descriptive design was used in this study to illuminate the views of male nurses regarding their recruitment and retention in nursing .. Purposive sampling was used to select male nurses from three hospitals for interviews and a total of 37 participants participated in this study. The participants were drawn from private and public hospitals. Data was collected through individual and focus group interviews and was analyzed qualitatively. Research Findings: Four major themes emerged from data. These included the journey to nursing, experiences of males in the nursing profession, retention of male nurses and strategies to recruit and retain males in nursing. Findings from the groups and categories of males in nursing in different hospitals showed similarities which reflected that the barriers faced by men in the nursing profession were still pervasive, consistent and had undergone few changes over time. Recommendations: Recommendations were categorised into community, general education, nursing education, nursing practice and nursing research. / Thesis (M.N.)-University of KwaZulu-Natal, Durban, 2011.

Thesis (MCur)--University of Stellenbosch, 2004. / ENGLISH ABSTRACT: Research and in certain instances the lack of research as well as extensive experience of the researcher in this field of study convinced the researcher that a scientific study / exploration is critical on the different aspects of adolescent sexual health. A study, based on a combination of qualitative and quantitative methods (triangulation), was conducted to identify and describe the factors playing a role in adolescents’ experiencing problems in maintaining their sexual health. Adolescents are at risk of contracting Sexually Transmitted Diseases including HIV/AIDS because of their sexual behaviour. Initiation of early sexual relations contributing to possible multiple sexual partners and failure to consistently use condoms contribute to this risk. Failure to continuously use a reliable contraceptive method also enhances the risk of unintended pregnancies and consequent exposure to the risks involved in termination of pregnancy or the psychological effects of giving the baby up for adoption, the hardship of raising the baby as a single parent or being forced to marry at a young age. Thus the physical-, emotional-, and social well being of the adolescent is at risk when they are not equipped to maintain their sexual health.The study concludes that adolescents that are sexually active and have multiple sexual partners have a higher probability of not maintaining their sexual health. Based on the outcome of this study the researcher feels strongly that the following needs to be addressed in order to promote the maintenance of adolescent sexual health: • Professional nurses need to be trained and sensitized to guide and manage adolescents seeking sexual or reproductive advice; • Sexuality programmes need to be integrated into school curricula; • Positive use of the mass media to promote healthy lifestyles; and • Training programmes for parents and adolescents. / AFRIKAANSE OPSOMMING: Navorsing en in sekere gevalle die gebrek daaraan sowel as ekstensiewe ondervinding van die navorser in die studieveld, het die navorser oortuig dat ‘n wetenskaplike studie / eksplorasie oor die veskillende aspekte van adolessente seksuele gesondheid krities was. ‘n Studie, gebaseer op ‘n kombinasie van kwalitatiewe en kwantitatiewe metodes (triangulasie), was uitgevoer om die faktore wat ‘n rol speel in adolessente se vermoëns om hul seksuele gesondheid te handhaaf, te identifiseer en te bepreek. Adolessente se risiko is hoog om Seksueel Oordraagbare siektes, insluitend MIV/VIGS, op te doen weens hul seksuele gedrag. Die aanvang van vroeë seksuele verhoudings dra by tot moontlike meervoudige seksmaats en die gebrek aan konsekwente gebruik van kondome verhoog die risiko. Gebrek aan die aaneenlopende gebruik van ‘n betroubare kontraseptiewe metode verhoog ook die risiko van ‘n ongewensde swangerskap en gevolglike blootstelling aan die risiko’s verbonde aan terminasie van swangerskap of die psigologiese effekte wat gepaard gaan met aanneming, enkel ouerskap en geforseerde trou op ‘n vroeë ouderdom. Derhalwe word die fisiese-, emosionele- en sosiale welsyn van die adolessent bedreig as hulle nie toegerus is om hul seksuele gesondheid te handhaaf nie.Die gevolgtrekking van die studie is dat adolessente wat seksueel aktief is en meervoudige seksmaats het, ‘n hoër waarskynlikheid het om nie hul seksuele gesondheid te handhaaf nie. Gebaseer op die uitkoms van die studie is die navorser van mening dat die volgende aangespreek moet word ten einde die handhawing van adolessente seksuele gesondheid te bevorder: • Geregistreerde vepleegkundiges moet opgelei en gesensitiseer word om adolessente te hanteer en van leiding te voorsien; • Seksualitiet programme moet in die skool kurrikulum integreer word; • Positiewe gebruik van die massa media om gesonde lewenstyle te bevorder; en • Opleidingsprogramme vir ouers en adolessente.

Thesis (MCur)--University of Stellenbosch, 2005. / ENGLISH ABSTRACT: The critical care nurse works in an environment where patient need often shifts the parameters within which she or he practices. It is expected of a skilled critical care nurse to be able to make independent decisions and take action regarding patient care based on her or his knowledge and skills without discounting the parameters of her or his scope of practice. Practice experience has indicated that the critical care nurse is often uncertain about whether her or his clinical activities are protected by the regulations provided by the Nursing Council. This is more specifically true in the private hospital industry where medical advice or assistance is not always easily available. This situation led to the following research question: Do the available professional and legal guidelines provide an appropriate foundation to guide the practice of the registered critical care nurse in the private hospital sector critical care environment? A non-experimental descriptive study with a qualitative orientation was conducted in 19 private hospitals in the Western Cape. Through nonprobability, random sampling, 71 registered critical care nurses were included in the study. A questionnaire was designed and validated to collect the data. Quantitative data was analysed through Excel® while qualitative data was analysed thematically. It was found that the legal and professional guidelines in place at present do provide a foundation for the clinical activities of critical care nursing in the private hospital sector. It is suggested that it is rather the critical care nurses’ interpretation of the Scope of Practice (No.R.2598 of 30/11/1984 as amended) that limits their practice as opposed to the wording of the regulations. It is recommended that critical care nurses must determine nursing care parameters based on patient need, using the regulations as a foundation for critical, analytical and reflective practice rather than as a set of rules to be followed. Key words: Scope of practice, critical care practice, ICU nursing care, private hospital nursing practice. / AFRIKAANSE OPSOMMING: Die kritiekesorgverpleegkundige werk in ‘n omgewing waar pasiëntebehoeftes gereeld die parameters waarin sy of hy praktiseer, verskuif. Dit word van ’n bekwame kritiekesorgverpleegkundige verwag dat sy of hy onafhanklike besluite en aksies met betrekking tot pasiëntesorg, gebaseer op haar of sy kennis en vaardighede, sal neem sonder om die parameters van haar of sy bestek van praktyk te oorskry. Praktykondervinding het getoon dat die kritiekesorgverpleegkundige dikwels onseker is oor watter van haar of sy optredes deur die Regulasies, soos deur die Raad op Verpleging gespesifiseer word, beskerm word. Dit is nog meer spesifiek van toepassing in die privaathospitaal-industrie waar geneeskundige advies en bystand nie altyd maklik beskikbaar is nie. Die situasie het tot die volgende navorsingsvraag aanleiding gegee: Voorsien die beskikbare professionele en wetlike riglyne ’n geskikte grondslag om die praktyk van ’n geregistreerde kritiekesorgverpleegkundige in die privaatsektor- kritiekesorgomgewing te rig? ’n Nie-eksperimentele, beskrywende studie met ’n kwalitatiewe oriëntasie is in 19 hospitale in die Wes-Kaap onderneem. Deur nie-waarskynlikheids-, toevallige steekproefneming is 71 geregistreerde kritiekesorgverpleegkundiges in die studie ingesluit. ’n Vraelys is ontwerp en gevalideer om inligting in te samel. Kwantitatiewe data is deur middel van Excel ontleed terwyl kwalitatiewe data tematies ontleed is. Daar is gevind dat die wetlike en professionele riglyne wat tans beskikbaar is, ‘n grondslag bied vir die kliniese aktiwiteite van kritiekesorgverpleegkundiges in die privaathospitaal.. Dit word voorgestel dat dit die kritiekesorgverpleegkundige se interpretasie van die Bestek van Praktyk (No.R.2598 of 30/11/1984 soos aangepas) is wat hulle praktyk beperk, eerder as die bewoording van die regulasie self.

Study project (BCur)--University of Stellenbosch, 2007. / ENGLISH ABSTRACT: Problem statement: The abortion regulation was implemented in 1997 before the necessary infrastructure was in place. The shortage of educated healthcare providers in abortion facilities led to uninformed women. Aims for this research was exploratory-describing of nature and was aimed on pre-abortion counselling to women with unwanted pregnancies in the state facilities in the Western Cape metropole to be evaluated from a nursing perspective. Methodology: Two samplings was done namely a 50% randomized, proportional stratified sampling from the State Health facilities in the Western Cape Metropole which offer abortion care service, as well as the non-randomized convenient sampling of pregnant women that received pre-abortion counselling. Data was gathered with the help of self compiled questionnaires. Quantitative data was analyse with the help of Statistika 7 and qualitative data according to Tesch’s approach. Results: Of the respondents 79% was between the age 16 and 30 and 72% was single. Although the Department of Health strives that abortion care services should be offered by a level 1 health facility, only 43% have been counselled through a registered nurse. While 49% consider preabortion counselling as important, 39% of the respondents received no, or information in groups regarding the termination of the pregnancy, 77% received information with regarding to the procedure and 50% was informed when they could go forth with normal activities. Approximately 54% received no information regarding post-abortion complications and 59% did not received a follow-up date. Approximately 68% of the respondents received information regarding family planning. Conclusion: It seems that pre-abortion counselling is not done according to guidelines and there is many gaps in the existing counselling methods in the different health facilities. Recommendations: Counselling should be based on the WHO and the Department of Health’s guidelines for abortion care. Nurses should be more involved in education programs. Abortion care facility’s should promote the total spectrum of abortion care and counsellors should receive special training and annually be re-evaluated. / AFRIKAANSE OPSOMMING: Probleemstelling: Die aborsiewetgewing is in 1997 geïmplementeer voordat die nodige infrastruktuur in plek was. Die tekort aan doeltreffend-opgeleide gesondheidswerkers in aborsiesorgdienste het tot gevolg gehad dat vroue oningelig is met betrekking tot aborsiesorgdienste. Doelwitte vir hierdie navorsing was ondersoekend-beskrywend van aard en daarop gerig om preaborsie berading aan vroue met ongewenste swangerskappe in staatsaangewysde fasiliteite in die Wes-Kaapse metropool te evalueer vanuit ‘n verpleegkundige perspektief. Metodologie: Twee steekproefnemings is gedoen, naamlik ‘n 50% ewekansige, proporsionele, gestratifiseerde steekproefneming van die staatsgesondheidsfasiliteite in die Wes-Kaapse metropool wat aborsiesorgdienste aanbied, sowel as ‘n nie-waarskynlike, gerieflikheidssteekproefneming van swanger vroue wat pre-aborsie berading ontvang. Data is met behulp van selfopgestelde vraelyste ingesamel. Kwantitatiewe data is ontleed met behulp van Statistica 7 en die kwalitatiewe data deur middel van Tesch se benadering. Resultate: Van die respondente was 79% tussen die ouderdom van 16 en 30 jaar en 72% was enkellopend. Alhoewel die Departement van Gesondheid strewe dat aborsiesorgdienste by ‘n vlak 1 gesondheidsfasiliteite aangebied word, het slegs 43% hul berading hier deur geregistreerde verpleegkundiges ontvang. Terwyl 94% pre-aborsie berading beskou as belangrik, het 39% óf geen, óf inligting in groepe ontvang betreffende die beëindiging van die swangerskappe, 77% het inligting ontvang met betrekking tot die prosedure en 50% was ingelig wanneer hul kon voortgaan met normale aktiwiteite. Sowat 54% het geen inligting ontvang betreffende post-aborsie komplikasies nie en 59% het nie ‘n opvolgdatum gekry nie. Sowat 68% van die respondente het wel inligting ontvang oor gesinsbeplanning. Slotsom: Dit blyk dus dat pre-aborsie berading nie volgens riglyne gedoen word nie en dat daar baie leemtes is in die bestaande beradingsmetodes in die verskillende gesondheidsfasiliteite. Aanbevelings: Berading moet gebaseer word op die WGO en die Departement van Gesondheid se riglyne vir aborsiesorg. Verpleegkundiges moet meer betrokke raak by voorligtingsprogramme. Aborsiesorgfasiliteite moet die totale spektrum van aborsiesorg kan behartig en aborsiesorgberaders moet spesiale opleiding ontvang en jaarliks her-evalueer word.

Thesis (MCur)--Stellenbosch University, 2011. / ENGLISH ABSTRACT: The impact of infant feeding practices in the prevention of mother-to-childtransmission of HIV raised concerns in the field of health services. Breast feeding adds an additional 15-30% risk of HIV transmission to the infant; therefore, mothers who are HIV-positive are in need of information regarding safe infant feeding. A descriptive design for this particular study was applied with a primary quantitative approach. A convenient sample of sixty (n=60) participants between the ages of 15 – 37 were taken from subjects that enrolled in the prevention of mother-to-child transmission (PMTCT) programme in Onandjokwe district. The sample formed 85% of the target population (N=71). A structured questionnaire with closed and openended questions was used and completed by the researcher. Ethical approval for the study was obtained from the Ethics Committee at the Faculty of Health Sciences, University of Stellenbosch. Permission to conduct the research was obtained from the Ministry of Health and Social Services, Namibia, and the Onandjokwe district Hospital. A pilot study was conducted that constituted 25% of the sample. Validity and reliability was insured by the pilot study and the consultation of an expert in HIV research and an expert in nursing research. The presentation of results was mostly descriptive in nature by using frequency tables and a pie chart. The results showed that all participants (n=60/100%) were offered HIV counselling and testing during antenatal care. Mothers who were HIV positive knew that there is a possibility that the baby might be infected through breast milk. Furthermore, the study found that 70% (n=42) of participants used breast feeding exclusively, 20% (n=12) used replacement feeding and 10% (n=6) used mixed feeding practices. It was concluded that pregnant women and mothers known to be HIV-infected should be informed of the infant feeding practice recommended by the national or subnational authority to improve HIV-free survival of HIV-exposed infants. This includes information about the risks and benefits of various infant feeding options based on local assessments and guidance in selecting the most suitable option for their own situation. / AFRIKAANSE OPSOMMING: Die invloed van voedingspraktyke vir babas by die voorkoming van moeder-na-kindoordrag van die menslike immuungebrekvirus (MIV) het kommer op die gebied van gesondheidsdienste laat ontstaan. Borsvoeding dra ’n addisionele 15–30% risiko van MIV-oordrag tot die baba by en daarom benodig moeders wat MIV-positief is inligting ten opsigte van veilige voeding van hulle babas. 'n Beskrywende ontwerp vir hierdie besondere studie is gebruik tesame met 'n primêr kwantitatiewe benadering. 'n Gerieflikheidsteekproef van sestig (n=60) deelnemers tussen die ouderdomme 15–37 jaar is gekies uit persone wat ingeskryf het vir die voorkoming van moeder-na-kind-oordrag (VMNKO) program in Onandjokwe-distrik. Die steekproef het 85% van die teikenpopulasie (N=71) uitgemaak. 'n Gestruktureerde vraelys met geslote en oop vrae is gebruik en deur die navorser voltooi. Etiese goedkeuring vir die studie is verkry van die Etiese Kommitee van die Fakulteit Gesondheidswetenskappe, Universiteit Stellenbosch. Toestemming om die navorsing te doen, is verkry van die Ministerie van Gesondheid en Maatskaplike Dienste, Namibië, en die Onandjokwe Distrikshospitaal. 'n Loodsstudie is onderneem wat 25% van die steekproef behels het. Geldigheid en betroubaarheid is verseker deur die loodsstudie en oorlegpleging met 'n kundige op die gebied van MIV-navorsing en 'n kundige in verpleegnavorsing. Die aanbieding van resultate was meestal deskriptief van aard deur van frekwensietabelle en 'n sektordiagram gebruik te maak. Die resultate het getoon dat MIV-berading en -toetsing gedurende voorgeboortesorg aan alle deelnemers (n=60/100%) aangebied is. Moeders wat MIV-positief is, het geweet dat daar 'n moontlikheid bestaan dat die baba moontlik deur moedersmelk geïnfekteer kan word. Verder het die studie bevind dat 70% (n=42) van deelnemers uitsluitlik borsvoeding gebruik, 20% (n=12) gebruik ’n vervanging vir moedersmelk en 10% (n=6) gebruik gemengde voedingspraktyke. Daar is tot die slotsom gekom dat swanger vroue en moeders van wie bekend is dat hulle MIV-geïnfekteer is, ingelig behoort te word oor die babavoedingspraktyk aanbeveel deur die nasionale of subnasionale owerheid vir die verbetering van MIVvrye oorlewing van babas wat aan die MIV blootgestel is. Dit sluit in inligting oor die risiko’s en voordele van verskeie babavoedingsopsies gebaseer op plaaslike assesserings en leiding ten opsigte van die kies van die geskikste opsie vir hulle eie situasie.

Thesis (MCur)--Stellenbosch University, 2011. / ENGLISH ABSTRACT: The quality of care nurses provide to patients is done with the expectation that skills and knowledge of each registered nurse will result in quality patient care. Compliance statistics for quality indicators (level of service indicators) or (LSI’s) in the tertiary health care institution in Saudi Arabia varies, raising the following questions: “Do nurses understand the importance of quality indicators in clinical nursing and do they know how to use them to improve patient care?” No studies done on registered nurses’ knowledge and opinions of quality indicators could be found thus indicate the necessity of a research study to determinine the knowledge and opinions of registered nurses on quality indicators in clinical nursing in the tertiary healthcare system in Saudi Arabia. This is the focus of this research. The objectives of the study were: - To determine the current knowledge and opinions of the professional nurses regarding quality indicators in a tertiary hospital in Saudi Arabia - To identify the factors that influence identification of quality indicators in clinical nursing - To identify the need for a training program regarding nurse sensitive quality indicators Data was collected through a questionnaire handed to more than 200 nurses working in general wards and intensive care areas in a single Saudi Arabian hospital. Participants were selected through a randomised list. The registered nurses who have participated in the pilot study’s responses were excluded from the final data analysis. No patients were included or involved in the study. A descriptive design with a quantitative approach was applied to investigate the professional nurses’ knowledge and opinions on quality indicators (level of service indicators) or (LSI’s) in clinical nursing in Saudi Arabia. Research data suggests that the knowledge and opinions of registered nurses in the tertiary health care institution in Saudi Arabia are not supporting the expectations of quality assurance in clinical nursing. Registered nurses have strong opinions of quality indicators in clinical nursing but do not have the knowledge to support those opinions. Improving initial and recurring training on quality indicators provided to nursing staff with diverse backgrounds and high turnover was recommended as an essential component in using quality indicators to drive improvements in patient care. / AFRIKAANSE OPSOMMING: Die kwaliteit verpleegsorg wat verpleegkundiges op ‘n daaglikse basis aan kliente bied gaan gepaard met die verwagting dat hulle oor die kennis en bevoegtheid moet beskik om kwaliteit verpleegsorg aan te wend wat ‘n langdurige positiewe uitkoms met verwysing na pasientsorg kan bied. Die kwaliteits aanwyser statistieke in die tersiere gesondheidsorg sisteem verskil maandeliks en het die navorser geinspireer om ‘n studie te doen om te bepaal of geregistreerde verpleegkundiges verstaan wat die belangrikheid van kwaliteits aanwysers is en of hulle die kennis het oor die gebruik daarvan, in watter opsigte dit gebruik kan word en wat die voordele inhou wanneer kennis en applikasie daarvan vir kliniese verpleging toegepas word. Literatuur met betrekking tot vorige studies omtrent kennis en opinies van geregistreerde verpleegkundiges tot kwaliteits aanwysers in kliniese verpleeging kon nie deur die navorser gevind word wat gebruik kon word as agtergrond of ondersteuning tot die studie nie. Die fokus van die navorsings studie was om geregistreerde verpleegkundiges se kennis en opinies te bepaal met betrekking tot kwaliteits aanwysers in kliniese verpleging in die tersiere gesondheidsorg sisteem in Saudi Arabie. Die doelwitte van die studie was om: - Die huidige kennis en opinies van geregistreerde verpleegkundiges met betrekking tot kwaliteits aanwysers in die tersiere gesondheidsorg sisteem in Saudi Arabie te bepaal - Om faktore wat ‘n invloed op identifikasie van kwaliteits aanwysers het te identifiseer - Om die nodigheid van ‘n opleidings program met betrekking tot kwaliteits aanwysers te bepaal Die data van die studie was ingesamel deur middel van ‘n vraelys wat aan die geregistreerde verpleegkundiges meesal werksaam is in algemene sale of intensiewe sorgeenhede. Deelnemers was gekies deur middel van ‘n alternatiewe lys. Die deelnemers aan die loots studie was ge-ellimineer van die finale data analise. Geen pasiente was betrokke by die studie nie. ‘n Beskrywende ontwerp met ‘n kwantitatiewe benadering was toegepas om geregistreerde verpleegkundiges se kennis en opinies omtrent kwaliteits aanwysers in kliniese verpleging in die tersiere gesondheidsorg sisteem in Saudi Arabie te toets. Die navorsing het bewys dat die kennis en opinies van geregistreerde verpleegkundiges in die tersiere gesondheidsorg sisteem in Saudi Arabie nie op ‘n aanvaarbare standard kan geklassifiseer word nie asook nie die nodige kwaliteits versekering in kliniese verpleging ondersteun nie. Die studie bewys dat geregistreerde verpleegkundiges beskik oor genoegsame opinies omtrent kwaliteitaanwysers maar nie noodwendig oor die kennis om hulle opinies daaroor te ondersteun nie. Die studie is ook uitkoms gebaseerd omtrent die nodigheid van ‘n opleidings program met betrekking tot kwaliteits versekering in kliniese verpleegkunde te implimenteer, insluitend die vakgebied van kwaliteits aanwysers in kliniese verpleeging.

Thesis (MCur)--Stellenbosch University, 2011. / ENGLISH ABSTRACT: Parents and/or caregivers all over the world are expected to comply with existing childhood immunisation programmes in order to prevent outbreaks of preventable childhood diseases. The most important justification for this study was the 2010 measles outbreak in the Western Cape province of South Africa. This outbreak correlated with the study conclusions of Corrigall, Coetzee and Cameron (2008:41) as they found the immunisation coverage in the Western Cape to be insufficient to prevent outbreaks of preventable childhood diseases. From the literature, it seemed that attitudes and factors that influence parent and/or caregiver compliance with the routine childhood immunisation schedule in the Witzenberg sub-district of the Western Cape persist. In doing this study, the researcher’s purpose was to discover what those factors were. The aim was to determine, understand and describe the attitudes and factors influencing parent and/or caregiver compliance with the routine childhood immunisation schedule, and the nature thereof. The set objectives were to gain knowledge of and insight into the factors influencing participants’ adherence with routine childhood immunisation; and participants’ feelings, attitudes, and experiences surrounding immunisation within the context of their health care environment. A quantitative research approach, with a smaller qualitative component, was selected for this study which had an exploratory descriptive design. The population targeted for data collection included parents and/or caregivers of children aged 0 to 60 months in the Witzenberg sub-district (N=8374), as well as in community health centres (CHCs) that provided immunisation and/or other primary health care services in the mentioned subdistrict (N=16). The non-probability convenience sampling of parents and/or caregivers consisted of 376 participants (n=376), while 8 CHCs (n=8) were selected through systematic sampling. The measuring instrument used as the data collection technique for this study was a selfadministered questionnaire. A pilot study was conducted to pre-test the questionnaire, and its reliability and validity were further ensured by submitting it for review to research experts in methodology and nursing. A combination of quantitative and qualitative methods was used to analyse the study data. MS Excel was used to capture the quantitative data after which it was analysed using descriptive statistics by means of STATISTICA version 9-software. Tesch’s approach to qualitative data analysis was used as a guideline with the purpose of identifying and categorising the essential qualitative data and grouping it together in one descriptive framework. The main findings were that parents and/or caregivers involved in this study were positive about immunisation and their experiences within the health service environment. They also felt that health workers were playing an important role in their decision-making process. However, their knowledge regarding the purpose of and contra-indications for immunisation were insufficient, and most parents reported that their children experienced side effects after immunisation. Key recommendations on conclusion of the study include clear, accurate and specific information to parents about the purpose of immunisation and its contra-indications and side effects. Vaccinators and managers should be informed about the persistent problem with mild vaccination side effects and refresher courses should be provided with regard to infection control, administration techniques and the reporting of adverse effects. / AFRIKAANSE OPSOMMING: Daar word van ouers en/of versorgers oor die wêreld verwag om aan bestaande kinderimmunisasieprogramme te voldoen ter voorkoming van vaksien-voorkombare siektes. Die belangrikste regverdiging vir die studie was die masel-uitbreking in die Wes-Kaapprovinsie van Suid-Afrika in 2010. Die uitbraak het die studiebevindinge ondersteun van Corrigall, Coetzee en Cameron (2008:41), wat bevind het dat immunisasiedekking in die Wes-Kaap onvoldoende was om ʼn uitbreking van voorkombare kindersiektes te verhoed. Volgens die literatuur het dit voorgekom asof die gesindhede en faktore wat ouers en/of versorgers se houding jeens die roetine- kinder-immunisasieskedule in die Witzenberg sub-distrik van die Wes-Kaap beïnvloed, voortduur. Die navorser het met hierdie studie ten doel gehad om die faktore te ontdek, ten einde die gesindhede en faktore wat ‘n invloed uitoefen te bepaal, te verstaan en te omskryf. Die doelwitte was om kennis in te win oor en insig te verkry in die faktore wat ouers en/of versorgers se aanhanklikheid met routine kinder immunisering beinbloed; en in ouers en/of versorgers se gevoelens, houdings en ondervindings ten opsigte van immunisasie in hulle gesondheidsorg-omgewing. ‘n Kwantitatiewe navorsingsbenadering met ‘n kleiner kwalitatiewe komponent is geselekteer vir die studie wat ‘n ondersoekend-beskrywende navorsingsontwerp gehad het. Die populasie wat geteiken is vir data-insameling was ouers en/of versorgers van kinders van 0 tot 60 maande in die Witzenberg sub-distrik (N=8374), asook gemeenskapsgesondheidsentrums wat immunisasie en/of ander primêre gesondheidsorgdienste in die genoemde sub-distrik aanbied (N=16). Die nie-waarskynlike gerieflikheidsteekproef van ouers en/of versorgers het uit 376 deelnemers (n=376) bestaan, terwyl 8 (n=8) gemeenskapsgesondheidsentrums deur middel van sistematiese steekproefbepaling geselekteer is. Die meetinstrument vir data-insameling in die studie was self-geadministreerde vraelyste. ‘n Loodsstudie is uitgevoer as vooraf-toetsing van die vraelys en die geldigheid en betroubaarheid daarvan is verder verseker deur die vraelys aan navorsingskenners in navorsingsmetodologie en verpleging te onderwerp. ‘n Kombinasie van kwantitatiewe en kwalitatiewe metodes is gebruik vir die analisering van die studie-data. Die kwantitatiewe data is op MS Excel ingevoer waarna beskrywende statistieke deur middel van Statistica weergawe 9-sagteware gebruik is om dit te analiseer. Tesch se benadering tot kwalitatiewe data-analise is as riglyn gebruik met die doel om belangrike data te identifiseer, te kategoriseer en in ‘n beskrywende raamwerk te groepeer. In die studie is daar hoofsaaklik bevind dat ouers en/of versorgers positief is oor immunisasie en hul ondervinding binne die gesondheidsorgomgewing, en dat gesondheidswerkers ʼn belangrike rol in hul besluitnemingsproses speel. Hul kennis aangaande die doel van en kontra-indikasies vir immunisasie was egter onvoldoende en die meeste ouers en/of versorgers het gerapporteer dat hul kinders ná immunisasie probleme met newe-effekte ondervind het. Die hoofaanbevelings wat uit die studie voortgespruit het, was dat duidelike, akkurate en spesifieke inligting aan ouers en/of versorgers verskaf moet word aangaande die doel van immunisasie en die kontra-indikasies daarvoor. Immuniseerders en bestuurders moet ook ingelig word oor die voortdurende voorkoms van newe-effekte sodat opknappingskursusse oor infeksiebeheer, korrekte toedieningstegnieke en die rapportering van newe-effekte aangebied kan word.

Thesis (MCur)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: Background Informed Consent (IC) has been proposed as the optimal method for ensuring the ethical entry of patients into clinical trials. IC is a vital part of the research process and as such entails more than obtaining a signature on a form. The IC must be given freely, without coercion, and must be based on a clear understanding of what participation involves. Aim The overall aim of this study was to attain an understanding of participants' knowledge regarding informed consent when participating in a research project. Methods The study was conducted at two public hospitals in a city in the Eastern Cape Province of South Africa. The quantitative study used descriptive survey design. A self administered questionnaire was used as a tool for data collection. Results The sample size consisted of 170 women with an average of 25.9 years. The majority had completed secondary level education. More than half of the participants did not have knowledge of the purpose of the original study. The majority of participants did not have knowledge of their responsibilities. Forty-two percent gave uninformative responses and 26% indicated they did not know their responsibilities. None of the participants understood the concept of randomization. The majority (85.9%) of participants indicated that information provided on the IC forms was sufficient for them to decide to participate. Conclusion Despite extensive efforts to ensure that participants understood their participation in the original studies, this study found poor recall of vital information for IC. A signed informed consent does not guarantee that participants understand information given. Recommendations The existing methods of communicating and obtaining of an informed consent seem to be insufficient for participants to make an informed decision. A new approach with more interactive features such as combination of audio-visual techniques might increase the possibilities of the understanding. / AFRIKAANSE OPSOMMING: Agtergrond Ingeligte toestemming (IT) is voorgestel as die optimale metode om die etiese toelating van die pasiënte vir kliniese toetse te verseker. IT is 'n belangrike deel van die navorsingsproses en as sodanig behels dit meer as die verkryging van 'n handtekening op 'n vorm. Die IT moet vrylik gegee word, sonder dwang en moet gebaseer wees op 'n duidelike begrip van wat die deelname behels. Doel Die algemene doel van hierdie studie is om 'n begrip van die deelnemers se kennis met betrekking tot ingeligte toestemming te bepaal, wanneer hulle deelneem aan 'n navorsingsprojek. Metodes Die studie is uitgevoer by twee openbare hospitale in ’n stad in die Oos-Kaap in Suid-Afrika. Die navorsingsontwerp is beskrywend van aard en ’n kwantitatiewe benadering is toegepas. ‘n Self-geadministreerde vraelys is as 'n instrument gebruik om data in te samel. Resultate Die steekproefgrootte het bestaan uit 170 vroue met 'n gemiddelde ouderdom van 25.9 jaar. Die meerderheid van die vroue het opleiding tot op sekondêre vlak. Meer as die helfte van die deelnemers het geen kennis van die doel van die oorspronklike studie gehad nie. Die meerderheid van die deelnemers het ook nie kennis van hul verantwoordelikhede gehad nie. Twee-en-veertig persent het nie toepaslike antwoorde gegee nie en 26% het aangedui dat hulle nie weet wat hul verantwoordelikhede in die studie is nie. Nie een van die deelnemers het die konsep van verewekansiging verstaan nie. Die meerderheid (85.9%) van die deelnemers het aangedui dat die inligting wat deur die IT verskaf word voldoende was om te besluit of hulle aan die studie wou deelneem. Gevolgtrekking Ten spyte van uitgebreide pogings om te verseker dat deelnemers hulle deelname verstaan het in die oorspronklike toetsing, het hierdie studie die swak herroeping van belangrike inligting aangaande IT bewys. ‘n Ondertekende ingeligte toestemming gee geen waarborg dat die deelnemers die inligting waarvoor toestemming geteken is, verstaan nie. Aanbevelings Die bestaande metodes van die kommunikasie en verkryging van ingeligte toestemming blyk onvoldoende te wees om deelnemers ingeligte besluite te laat neem. ‘n Nuwe benadering met meer interaktiewe eienskappe soos ’n kombinasie van oudio-visuele tegnieke mag die moontlikhede om te verstaan, meer duidelik maak.

Thesis (MCur)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: Burnout is one of the challenges that nurses are faced with in their stressful and rapidly changing work environment. The vulnerability of nurses to burnout remains a major concern which affects both the individual and institution. Knowledge about burnout and associated risk factors which influence the development of burnout is vital for early recognition and intervention. The research question which guided this study was: “What are the factors influencing the degree of burnout experienced by nurses working in neonatal intensive care units?” The objectives included determining which physical, psychological, social and occupational factors influenced the degree of burnout experienced by nurses. A descriptive, explorative research design with a quantitative approach was applied. The target population consisted of (n=105) permanent nursing staff members working in the neonatal units of two different hospitals. A convenience sampling method was used. Participants (n=102) who gave voluntary consent to participate was included in the study. Validity and reliability was supported through the use of a validated questionnaire, Maslach Burnout Inventory – General Survey including a section based on demographical information and a section based on physical, psychosocial, social and occupational factors. Validity of the questionnaire was supported by the use of a research methodologist, nurse expert and a statistician in the particular field. A pilot study was done to test the feasibility of the study and to test the questionnaire for any errors and ambiguities. Ethics approval was obtained from Stellenbosch University and permission from the Heads of the hospitals where the study was conducted. The data was analyzed with the assistance of a statistician and these are presented in histograms, tables and frequencies. The relationship between response variables and nominal input variables was analysed using analysis of variance (ANOVA). Various statistical tests were applied to determine statistical associations between variables such as the Spearman test, using a 95% confidence interval. Results have shown that participants experienced an average level of emotional exhaustion, a high level of professional efficacy and a low level of cynicism. Further analyses have shown that there is a statistical significant difference between emotional exhaustion and the rank of the participant (p=<0.01), highest qualification (p=0.05) and a high workload (p=0.01). Furthermore a statistical significant difference was found between professional efficacy and rank of participants (p=<0.01). In addition a statistical significant difference was found between cynicism and the number of years participants were in the profession (p=0.05). Multiple factors were determined in this study that influences the degree of burnout nurses experience. The majority of participants (n=56/55%) experienced decreased job satisfaction and accomplishment, (n=52/51%) of participants experienced that their workload is too much for them and (n=63/62%) participants received no recognition for their work. Recommendations are based on preventative measures, because preventing burnout is easier and more cost-effective than resolving burnout once it has occurred. In conclusion, the prevention strategies, early recognition of work stress and appropriate interventions are crucial in addressing the problem of burnout. / AFRIKAANSE OPSOMMING: Uitbranding is een van die uitdagings waarmee verpleegsters te kampe het in hulle stresvolle en vinnig veranderende werkomgewing. Die kwesbaarheid van verpleegsters vir uitbranding bly ’n kritieke bekommernis wat beide die individu en die inrigting affekteer. Kennis omtrent uitbranding en verwante risiko faktore wat die ontwikkeling van uitbranding beïnvloed, is deurslaggewend vir vroeë opsporing en intervensie. Die navorsingsvraag wat hierdie studie gelei het, is: “Wat is die faktore wat die mate van uitbranding beïnvloed wat deur verpleegsters ondervind word wat in neonatale intensiewe sorgeenhede werk?” Die doelwitte wat ingesluit is, is om te bepaal watter fisiese, sielkundige, maatskaplike en beroepsfaktore die mate van uitbranding wat deur verpleegsters ervaar word, beïnvloed. ’n Beskrywende, ondersoekende navorsingsontwerp met ’n kwantitatiewe benadering is toegepas. Die teikengroep het bestaan uit (n=105) permanente verpleegpersoneel wat in die neonatale eenhede van twee verskillende hospitale werk. ’n Gerieflikheidsteekproef metode is gebruik. Deelnemers (n=102) wat vrywillige toestemming gegee het om deel te neem, is ingesluit in die navorsingstudie. Geldigheid en betroubaarheid is ondersteun deur die gebruik van ’n geldige vraelys van “Maslach Burnout Inventory – General Survey”, asook ’n afdeling gebaseer op demografiese inligting en ’n afdeling gebaseer op fisiese, sielkundige, maatskaplike en beroepsfaktore. Geldigheid van die vraelys is ondersteun deur ’n navorsingsmetodoloog, ’n verpleegspesialis en ’n statistikus op die navorsingsgebied. ’n Loodsondersoek is gedoen om die haalbaarheid van die studie te toets en om die vraelys te toets vir enige foute en dubbelsinnighede. Etiese goedkeuring is verkry van die Universiteit van Stellenbosch en goedkeuring van die Hoofde van die hospitale waar die studie uitgevoer is. Die data is geanaliseer met die hulp van ’n statistikus en is aangebied in histogramtafels en frekwensies. Die verwantskap tussen responsveranderlikes en nominale insetveranderlikes is geanaliseer deur gebruik te maak van die analise van variansie (ANOVA). Verskeie statistiese toetse is toegepas om statistiese assosiasies tussen veranderlikes te bepaal, soos deur van die Spearmantoets gebruik te maak, met ’n 95% betroubaarheidsinterval. Resultate het bewys dat deelnemers ’n gemiddelde vlak van emosionele uitputting, ’n hoë vlak van professionele effektiwiteit en ’n lae vlak van sinisme ervaar. Verdere analise het bewys dat daar ’n statistiese beduidende verskil tussen emosionele uitputting en die rang van die deelnemers (p=<0.01) is, hoogste kwalifikasie (p=0.05) en ’n hoë werklading (p=0.01). Verder is ’n statistiese beduidende verskil gevind tussen professionele effektiwiteit en rang van deelnemers (p=<0.01). Saam hiermee is ’n statistiese beduidende verskil gevind tussen siniesheid en die aantal jare wat deelnemers in die beroep is (p=0.05). Voorts, is veelvuldige faktore bepaal in hierdie studie wat die mate van uitbranding beïnvloed wat verpleegsters ervaar. Die meeste van die deelnemers (n=56/55%) het ’n afname in werksbevrediging en -verrigting ervaar, (n=52/51%) deelnemers het ervaar dat hul werklading te veel is vir hulle en (n=63/62%) deelnemers het geen erkenning vir hulle werk ontvang nie. Aanbevelings is gebaseer op voorkomende maatreëls, want om uitbranding te voorkom, is makliker en meer koste-effektief as om uitbranding te probeer oplos as dit alreeds begin het. Ten slotte, die voorkomende strategieë, vroeë identifisering van werkstres en geskikte intervensies is deurslaggewend om die probleem van uitbranding aan te spreek.