Thesis (MCur (Interdisciplinary Health Sciences. Nursing Science))--University of Stellenbosch, 2008. / The South African Nursing Council believes that “quality nursing practice is based on adequate knowledge, skills or competencies, ethically and scientifically based comprehensive and holistic patient care, timely, accurate and complete or comprehensive recording” (SANC, n.d.). The aim of professional regulation is to protect the public from unsafe practices and to ensure quality services (SANC, n.d.). A shortage of nursing staff resulted in the implementation of a staffing strategy of increasing the work hours of nurses by ten hours a week. Patient complaints and unacceptable patient incidences resulted in it becoming essential to evaluate the effect of this strategy on patient care. As a goal of this study, the researcher decided to investigate the quality of patient care before the implementation of the strategy and the effect of the strategy on patient care after the implementation. The objectives of the study were set to determine whether • The patients were assessed according to activities of daily living and psychosocial data; • The nursing diagnosis was done • Nursing interventions are prescribed for each problem identified • The patients’ records were utilised to enhance individualised patient care and to ensure responsibility and accountability for patient care • The evaluation of patient progress was done according to the different prescriptions and interventions at least twice in 24 hours • A written final report for discharge criteria and health education was provided • A comparison of the quality of nursing care delivered before and after the implementation of the staffing strategy exist Research question What is the effect of an implemented staffing strategy in a selected hospital in KwaZulu-Natal on the quality of care delivered? Research methodology A non-experimental, descriptive design with a quantitative approach was applied. Population and sampling The target population for the study was patient care records of patients who were hospitalised during 2003. A non-probability convenience sample for a retrospective audit of a total of 372 patient care records over a period of 12 months was audited. An evaluation of the records was done and a comparison was drawn between the results obtained before and after the implementation of the staffing strategy. For both periods, 186 patient records were audited. The pilot study included the audit of 40 files. Reliability and validity were assured with a pilot study and the use of experts in nursing management, quality assurance, research methodology and statistics. The researcher audited the patient files personally. Ethical approval was obtained from Stellenbosch University and the ethics committee of the hospital. All principles related to ethics, such as confidentiality and anonymity, were maintained. Neither patient names were used nor the name of the hospital or wards from which the records were used. Codes were used to identify the hospital wards. The hospital was informed in the letter requesting consent to conduct the research, that the researcher intends publishing the findings of the research. Data analysis and interpretation Statistical associations using Chi-square tests were carried out to determine the significance between the various variables. The results of this study were presented in percentages, tables and histograms. Findings obtained showed that the quality of nursing declined after the strategy. Documentation of patient records was incomplete and did not meet legal requirements. Recommendations The implementation and maintenance of a quality assurance programme, human resource management, the on-going use of the nursing process and record keeping should be emphasised in the clinical practice environment and in the formal education environment.

Thesis (MCur) -- University of Stellenbosch, 2005. / ENGLISH ABSTRACT: A non-experimental descriptive study was conducted in four prisons in the Western Cape. The research focussed on the standard of care within primary health care settings in the purposively selected prisons. No official written standards existed to measure the quality of care. After an in-depth literature study, structure, process and outcome standards were formulated and validated. The main findings of the study indicated that: • Standards in these three dimensions of care did not meet the pre-set level of performance as determined by the researcher; • The clients were generally satisfied with the hygiene in the clinics; • Aspects of concern were the lack of explanation offered to the clients before and after consultations and nursing care interventions. The researcher recommends the implementation of a comprehensive quality care model for the health care of the prisoners with adequate human and nonhuman resources Core words: Qualtiy care, Correctional services health care, Nursing care in prisons. / AFRIKAANSE OPSOMMING: "n Nie-eksperimentele beskrywende studie is in vier gevangenisse in die Wes- Kaap uitgevoer. Die navorsing het gefokus op die gehalte van sorg binne primere gesondheidsorgomgewings in die doelbewuste geselekteerde omgewings. Geen amptelike geskrewe standaarde om die gehalte van sorg te meet, het bestaan nie. Na 'n in-diepte literatuurstudie is struktuur-, proses- en uitkomsstandaarde geformuleer en gevalideer. Die belangrikste bevindings van die studie het aangedui dat: • Standaarde in hierdie drie dimensies van sorg het nie aan die voorafbepaalde vlak van sorg voldoen het nie soos deur die navorser bepaal is; • Die kliente was oor die algemeen tevrede met die higiene in die klinieke; • Kommerwekkende aspekte het ingesluit die gebrek aan voldoende verduidelikings aan kliente voor en na konsultasies en verpleegintervensies. Die navorser bevel aan dat In omvattende gehalteversekeringsmodel vir die gesondheidsorg van gevangenes ingestel word met voldoende beskikbare mensen ander hulpbronne. Kernwoorde: Gehaltesorg, Korrektiewe dienste gesondheidsorg, Verpleegsorg in gevangenisse.

Study project (Mnutr) -- University of Stellenbosch, 2005. / ENGLISH ABSTRACT: Quality nursing care is characterised by clinical decisions based on critical and analytical thinking. The assessment, planning and implementation information which is used as basis for decision making must be recorded in the patient's record/file. The questlon is rai_sed whetherthe patient's record does indeed reflect critical and analytical thinking. The focus on the midwife's practices during professional conduct hearings which relate to intrapartum service delivery, led to the specific choice of population, namely intrapartum services delivery in Levell hospitals in the Western Cape. A non-experimental study whereby qualitative and quantitative data were collected, was performed in six (6) Levell hospitals. Check lists were compiled to evaluate the structure and facilities in which midwifery practice is executed. The records of 128 patients were analysed to specifically investigate the nature and extent of critical and analytical decisionmaking by midwives, and the extent to which the midwife really applies reflective practices. The results showed that record-keeping is not done optimally; that the partogram, which - - ---- is a comprehensive evaluation of the progress of_lab_2~1isJ not used and that the records did not indicate that the midwife applies critical and analytical thinking and acts accordingly. Recommendationsare that the proposals for the improvement of intrapartum service delivery, as made by Odendal (2004: ii-iv) and the Department of Health (2000: 42), are to receive immediate attention. It appears as if protocols and guidelines for emergency action and general safe practices do exist, but are not enforced. Continued inservice training receive priority attention. Core words: critical analytical thinking; midwife's practice and practices; intrapartum care service delivery / AFRIKAANSE OPSOMMING: Gehalte verpleegsorg word deur kliniese besluite wat op kritiese en analitiese denke gegrond word gekenmerk. In die pasient se rekord moet die ramings-, beplannings- en implementeringsgegewens gerekordeer word wat gebruik is as basis vir besluitneming. Die vraag ontstaan egter of die pasient se rekord wei kritiese en analitiese denke weerspieel. Die fokus op die vroedvrou se praktyke in professionele gedragsake wat met intrapartumsorgdienslewering verband hou, het tot die spesifieke keuse van die populasie, naamlik intrapartumsorgdienste in vlak 1-hospitale in die Wes-Kaapaanleiding gegee. 'n Nie-eksperimentele studie waartydens kwalitatiewe en kwantitatiewe data ingesamel is, is in ses (6) vlak 1- hospitale uitgevoer. Kontrolelyste is opgestel om die struktuur en fasiliteite waarbinne vroedvroupraktyke plaasvind, te evalueer. Die rekords van 128 pasiente is ontleed om spesifiek ondersoek in te stel na die aard en omvang van kritiese en analitiese besluitneming deur die vroedvrou, en tot watter mate die vroedvrou wei weldeurdagte praktyke toepas. Die resultate toon dat rekordhouding nie optimaal gedoen word nie; dat die partogram wat 'n omvattende evaluering van die kraamverloop is, nie gebruik word nie, en dat daar uit die rekords nie 'n aanduiding gevind kan word dat vroedvroue wei krities en analities dink en optree nie. Aanbevelings is dat die voorstelle ter verbetering van intrapartumsorgdienslewering 5005 gemaak deur Odendal (2004: iii-v) en die Departement van Gesondheid (2000: 42), indringend aandag moet geniet. Dit wil voorkom asof protokolle en riglyne vir noodoptrede en algemene veilige praktykvoering wei bestaan, maar nie toegepas word nie. Voortgesette indiensopleiding moet as 'n prioritieit aangespreek word. Kernwoorde: kritiese analitiese denke; vroedvroupraktykvoering; vroedvroupraktyke, intrapartumsorgdienslewering.

Thesis (MCur)--Stellenbosch University, 2000. / ENGLISH ABSTRACT: Against the background of the approach to make the follow up care to oncology patients more accessible and with the emphasis on quality care, it was indicated that this service needs to be evaluated. A study based on a combination of qualitative and quantitative methods (also called triangulation) was conducted to formulate structure, process and outcome standards for a comprehensive follow up care for the oncology patients and to evaluate this service according these standards. The most important results are: • The quality of care relating to the structure standards was optimal regarding the organization of the patient's visits, follow up treatment and referrals. A suboptimal standard was found regarding the general management system. • In the process standards focusing on the physical and psychosocial needs of the patient, a suboptimal standard was found regarding all aspects. Nursing practice leading to subobtimal care of patients is a major cause for concern. • With the outcome standards reflecting in patient satisfaction, positive as well as negative opinions and perceptions were found. Recommendations include: • Upgrading of management systems • Empowerment of the nurses with knowledge and scientific competencies • Attention to the opinions and perceptions of the patients to completely involve the patient in the service and treatment process. Keywords: Oncology follow up service I formulation of structure, process and outcome standards. / AFRIKAANSE OPSOMMING: Teen die agtergrond van die benadering om opvolgdienste meer toegangklik te maak vir onkologiese pasiënte, met die beklemtoning van gehaltesorg, is dit aangedui dat hierdie diens geëvalueer moes word. 'n Studie gebaseer op 'n kombinasie van kwalitatiewe en kwantitatiewe metodes (genoem triangulasie) is uitgevoer om struktuur, proses en uitkomsstandaarde vir 'n omvattende opvolgdiens aan onkologiepasiënte te formuleer en die diens aan die hand daarvan te evalueer. Die belangrikste resultate is: • Die gehalte van sorg wat verband hou met die struktuurstandaarde was net optimaal ten opsigte van die organisasie van die pasiënt se besoeke, opvolgbehandeling en verwysings. 'n Suboptimale standaard is gevind ten opsigte van die algemene bestuurstelsel. • In die prosesstandaarde wat fokus op die fisiese en psigososiale behoeftes van die pasiënt, is 'n suboptimale standaard in alle aspekte gevind. Verpleegpraktyk wat lei tot suboptimale sorg van pasiënte is 'n groot bron van kommer. • Met die uitkomsstandaarde wat reflekteer in pasiënttevredenheid is positiewe maar ook negatiewe opinies en persepsies gevind. Aanbevelings sluit in: • Verbetering van bestuurstelsels • Bemagtiging van die verpleegkundige met kennis en wetenskaplike vaardighede • Aandag aan pasiënte se opinies en persepsies ten einde die pasiënt ten volle te betrek by die hele diens en behandelingsproses. Sleutelwoorde : Onkologiese opvolgdiens / formulering van struktuurproses en uitkomsstandaarde.

Community based service-learning is one of the fastest growing reforms in higher education, especially in the field of health care. The increased interest in this phenomenon is based on the demands by government and society that higher education institutions should be more responsive to the needs of the community. Literature, however, reflects that service learning lacks a sound theoretical base to guide teaching and learning due to limited research in this area. This study was, therefore, aimed at exploring the phenomenon knowledge construction in basic nursing programmes in selected South African nursing schools with the intention to generate a middle range theory that may be used to guide the process of knowledge construction in community-based service-learning programmes. This study adopted a qualitative approach and a grounded theory research design by Strauss and Corbin. Two university-based schools of nursing were purposively selected to participate in the study. There were a total number of 16 participants. The collection of data was intensified by the use of multiple sources of data (participant observation, documents analysis and in-depth structured interviews). The data analysis process entailed three phases; open, axial and selective coding. The results of the study revealed that the phenomenon “knowledge construction” is conceptualised as having specific core characteristics, which include the use of authentic health-related problems, academic coaching through scaffolding, academic discourse-dialogue and communities of learners. The findings showed that there are a number of antecedent conditions and contextual circumstances contributing to how knowledge is constructed in a community based service learning programme. The process of knowledge construction emerged as cyclical in nature, with students, facilitators and community members having specific roles to play in the process. A number of intervening variables were identified that had an influence on the expected outcomes on knowledge construction in community based service learning programmes. These findings led to the generation of a conceptual model. Knowledge construction according to this model takes place in an environment which is characterised by interactive learning, collaborative learning, actively learning and inquiry-based learning through continuous reflective learning processes. The main concepts in this conceptual model include concrete learning experiences, continuous reflection, problem posing, problem analysis, knowledge deconstruction and knowledge generation, knowledge verification, knowledge generation, testing of generated knowledge and evaluation of generated knowledge. The sub-concepts include learning through senses, an initial situation, health-related triggers, social interaction, reflection-in action, reflection-on action, hypotheses generation, conceptualisation of learning experiences, information validation and community interventions. Recommendations were categorised into education and training of academic staff, application of the model and further research with regard to quality assurance in CBSL programmes as well as the use of other research designs for similar studies. / Thesis (Ph.D.)-University of KwaZulu-Natal, Durban, 2011.

Aim: The aim of this study was to explore the attitudes and perceptions of health care professionals to alternatives to blood transfusion for Jehovah's Witnesses patients in a critical care setting. Methodology: Quantitative and qualitative approaches were used to explore the attitudes and perceptions of health care professional to alternatives to blood transfusion, in a critical care setting. The study was conducted in four largest hospitals in the Durban Metropolitan area, of which two were public and two private. A questionnaire was used as tool for collecting data. Space was provided to accommodate comments from the respondents in the questionnaire. Analysis of findings was done quantitatively by using a computer programme called SPSS (Statistical Packages for the Social Sciences), version 11.5. Themes that emerged from the participant's responses were classified under categories in the conceptual framework and analysed qualitatively. Findings: Most of the respondents had mixed feelings about using alternatives to blood transfusion. The study revealed, however, that although alternatives to blood transfusions were commonly used in a critical care setting, some of the respondents did not know about the different types of alternatives available. Furthermore, it was evident from the respondent's comments that most of them had a positive attitude to people who refused blood transfusion and preferred alternatives. Research into suitable alternatives to blood transfusion was encouraged by most of the respondents. However, transfusion transmitted diseases emerged as a current concern over and above the religious concerns. Recommendations for the future were made for the health care professionals working in critical care setting, nurse educators and nursing management. / Thesis (M.N.)-University of Natal, Durban, 2004.

The purpose of this Qualitative study was to explore HIV related stigma experienced by women enrolled in the Prevention of Mother to Child (PMTCT) prgramme in the EThekwini District, Kwazulu Natal. Descriptriptive phenomenology informed the study design, data collection and analysis. Despite increasing access to Prevention of Mother to Child Transmission initiatives, including anti-retroviral drugs, the Stigma of being HIV positive, particularly for women, largely outweigh the potential gains from available treatments. HIV/AIDS related stigma drives the epidemic underground and is one of the main reasons that people do not wish to know their HIV status Purposeful sampling was used to select seven women attending PMTCT programme in the EThekwini District. These women were selected in four clinics in the District. Data was collected through in-depth interviews lasting about 45 minutes to an hour. These interviews were tape recorded and later transcribed to aid analysis. The Colaizzi method of data analysis was utilized. Four themes emerge from the data, each with three to eight subthemes confirming the experiences and presence of stigma during programme participation. All participants reported incidence of being stigmatized, particularly in the Health care setting. They took great strides to keep their HIV status confidential to a point of going against programme directives to ensure secrecy of their status thus avoid HIV related stigma. Number of recommendations were made in relation to the PMTCT programme and if accepted will assist in mitigating stigma in HIV related stigma in the PMTCT progarmme and thus reduce vertical transmission. / Thesis (M.N.)-University of KwaZulu-Natal, Durban, 2011.

This descriptive survey was carried out to gather information that could be used to assist in the development of an HIV/AIDS educational program as a way to promote adolescents' health and prevent diseases in the United Arab Emirates. The study examines the knowledge, attitudes, beliefs and sources of information of high school students in Sharjah city regarding HIV/AIDS. Anonymous questionnaire with five sections: demographics, HIV/AIDS knowledge, sources of information, attitudes and beliefs was administered to 12th grade high school students from four schools in Sharjah. Analysis of findings showed that 87 percent of students knew that AIDS affects the body's immune system and 68 .5 percent knew that it is not inherited .The majority of students were aware of relationship between drug abuse and HIV/AIDS. However, students lacked information in some areas as HIV/AIDS transmission routes. There was generally a negative attitude towards HIV/AIDS infected people. This was shown in students' responses to some statements that AIDS was "a punishment for those infected for their immoral acts". Moreover, students expressed unwillingness to live with HIV/AIDS infected people. Students were positive in applying prevention, facilitating proper treatment for the diseased and believed that HIV/AIDS education in schools is a necessity. Their HIV/AIDS sources of information were mainly from written materials (journals, newspapers and books). It was concluded that, generally, students in this study had a good knowledge, and some positive attitudes about AIDS. However, the concerns they expressed in relation to their fears of sharing, or living with HIV/AIDS infected individuals, and some of their beliefs, need to be addressed more in the education prevention programs. Students need to be more knowledgeable about HIV/AIDS prevention. They indicated desires for more knowledge, especially as they become aware of the increasing risk of HIV/AIDS among adolescents in the Emirates. / Thesis (M.Cur.)-University of Natal, Durban, 2002

The views of medical doctors regarding organ donation and transplantation in the Durban Metropolitan Region were examined in an exploratory and explanatory study, which included a descriptive, convenience sampled study of 43 graduate and postgraduate professionals, practicing in the private and provincial sectors. Characteristics were obtained from a 1 D6-item questionnaire that were later divided into component contributions according to Fazio's attitude to behavior process model (Fazio, 1989; Fazio & RoskosEewoldson, 1994). Variables which were analysed included personal demographics, personal views, knowledge and skills, practice-related issues, attitudes and perceptions as well as future recommendations. Analysis of the information revealed that most medical doctors approved of organ donation practices and viewed transplantation as a significant roleplayer in both the community and medical sectors. However, a knowledge and skills deficit combined with religious presumptions and general uncertainty regarding issues surrounding the practical, legal and emotional concepts of brain death may be responsible for the relatively low personal dedication and practice participation rate among the sample. Medical doctors from the provincial sector appeared to have considerable concerns which included: time constraints; a perceived lack of support from colleagues, nurses and hospital administrators; a lack of medico-Iegal awareness relating to organ donation and brain death and a scarcity of experience and insight into the transplant process. In order to address the paucity of awareness pertaining to brain death and organ donation activities, the findings indicate that formal and interactive education programs during the undergraduate, postgraduate and medical development phases are required in which issues surrounding death and dying can be explored by a multidisciplinary team. It appears that this team must comprise of doctors, lawyers, religious leaders, psychologists, administrators, nurses, donor families and transplant co-ordinators. This development may serve to emphasize the professional importance of holistic bereavement counseling, improve doctor and patient satisfaction, increase organ donation referrals and transplantation rates as well as diminish medico-Iegal concerns. / Thesis (M.Cur.)-University of Natal, Durban, 2001.

Aim The aim of this study was to describe ancillary health care workers’ perceptions of the Ancillary Health Care Learnership programme, and their current employment status within the health care sector. Methods A non-experimental cross sectional survey was used that incorporated complementary mixed method data collection (Balnaves & Caputi, 2001; Polit & Beck, 2010). Quantitative data collected during the first phase, a telephonic interview assisted self-report questionnaire was used to inform semi structured focus group interviews that took place during the second phase to obtain richer descriptions and explore response and results of the phase 1 cross sectional survey (Bell, 2005). A Convenience sample of ninety two (n=92) was achieved for the telephonic interview assisted self- report questionnaire, and was substantially lower that the number of potential participants (N=200). Purposive sampling was used to obtain fifteen (N=15) potential key informant participants, a final sample of nine (n=9) achieved for the focus group interviews. Results The research revealed that majority (69%) of participants had their expectations of the course met. Subjects such as agriculture and business plan were perceived as not valuable and participants recommended that these be removed from the course. Computer course information was seen as and needed addition in order to bridge the skills gap and improve the opportunities for employment.Despite particpants perceptions of the course being met, expectations regarding emplyment were not. Employment rates were low, specifically within the health care sector. Conclusion and Recommendations The Ancillary Health Care Programme has not assisted the graduates in gaining employment. The review of the Ancillary Health Care Programme and some of the unit standards is one of the recommended options that can be done to improve the employment opportunities. / Theses (M.N.)-University of KwaZulu-Natal, Durban, 2014.