Introduction. MRSA is a major healthcare problem with particular relevance to morbidity and mortality in ICU (Byers & Decker 2008). Due to the increased infection risks associated with cardiac surgery, MRSA screening and surveillance is widely used as a standard preoperative Investigation In many settings (Teoh, Tsim & Yap, 2008). The results, in conjunction with appropriate hygiene precautions, are used to control and prevent infection with MRSA. Following an outbreak of MRSA in cardiac patients an MRSA protocol (MRSAP) was implemented In the cardiac intensive care unit in this study. Purpose. To evaluate how nurses implement the MRSAP in the surgical cardiac intensive care unit in this study, and to evaluate the change in MRSA infection rates following implementation of the MRSAP. From the results obtained, to identify any areas for improvement in nursing practice with respect to the MRSAP. Methods. Nursing staff knowledge with respect to the MRSAP was assessed using a survey questionnaire. Their compliance with required Infection control practice for control of MRSA was assessed through periods of observation on the unit. Screening compliance and reduction in infection rates were investigated using a retrospective records review. Results. The survey revealed good awareness of the MRSAP (88%, n=23), but knowledge of the detailed content was variable. Most staff were apparently satisfied with the existing standards of infection control in CICU (84.6%, n=22). Observation revealed that, compliance with routine hygiene measures was good (66% correct contacts, n=144) by the standard of other studies, but, given the high risk of postoperative infection for these patients improvements are required. Inadequate data in sampled records prevented meaningful analysis of screening compliance, and hence the systems for handling screening swabs and results need to be reviewed. The change in infection rates between the pre and post MRSAP periods, which incorporated use of infection risk stratification data to demonstrate comparability of the two groups of patients, revealed that despite the high MRSA infection rate in 2005 (1.18%), and subsequent drop post MRSAP (0.35%), the actual number of cases found was too small to test statistically for significant difference. An incidental finding was that female cardiac surgery patients were getting significantly younger (p<0.01). There was a significant decrease in hospital MRSA infection rates for matched periods (p<0.0001 ). Conclusions. Evidence was found to support the efficacy of the MRSAP in the reduction of MRSA infections. Deficits in staff knowledge and infection control practice were identified and feedback has been implemented in order to improve compliance with the MRSAP and maintain the improved infection rates. Further research with respect to implementation of, and compliance with, infection control measures could both improve quality of patient care and decrease the burden of preventable infectious disease such as health care associated infections (HAls) in South Africa. / Thesis (M.N.)-University of KwaZulu-Natal, Durban, 2008.

AIM: The aim of the study is to explore the factors that contribute to job satisfaction among registered nurses at KFH and to determine factors associated with job dissatisfaction among registered nurses at KFH. METHODOLOGY: A quantitative, descriptive, exploratory study was conducted to explore the factors that contribute to job satisfaction among Registered nurses at King Faisal Hospital. A non probability convenience sampling technique was used to include all the available registered nurses doing bedside nursing in the study. A criterion for inclusion into the study was to be a registered nurse working in the area for at least 6 months full time employment. Data was obtained through a questionnaire survey using Job Satisfaction Survey (JSS), to assess factors influencing job satisfaction among nurses at KFH, Kigali-Rwanda. Data were analysed by SPSS 15.0 for Windows. FINDINGS: The findings of this investigation was that the factors, namely; supervIsIOn, coworkers, nature of work and communication were factors that contributed to a greater job satisfaction of registered nurses (45.5%); while factors such as pay, promotion, fringe benefit, contingent reward and operation procedures, were factors that caused moderate job satisfaction (55.5%). Simultaneously, the research found that these results also indicated, to some degree, that these factors are contributing to job dissatisfaction, albeit small. The study recommends strategies that management can utilise by improving income (salary, benefits and rewards), job promotion and working conditions may increase RNs' job satisfaction and therefore improve the overall well being of nursing personnel and quality of health services. These strategies may be used as a tool to keep employees satisfied and motivated in their jobs. It also recommends ways by which management can reduce job dissatisfaction amongst employees by improving and simplifying the hospital policy and administrative matters. CONCLUSION: The results of this study revealed that registered nurses are moderately satisfied with their job. The nurse administrators will know that they need to do more to improve nurses' job satisfaction since registered nurses are only moderately satisfied. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2008.

In this study, the researcher is interested in the utilization of HIV/AIDS prevention methods among university students. The purpose of this study was to explore factors that influence the utilization of existing HIV/AIDS prevention methods amongst students at the University of KwaZulu-Natal residing in a selected campus. Four residences within the selected campus were randomly selected and participants were conveniently selected from each of sampled residences. There was a total of 335 respondents and 261 (78%) completed the manual questionnaires while 74 (22%) completed online questionnaires. The study used quantitative approach and was descriptive-exploratory in nature. Data was analyzed using the Statistical Package for Social Sciences (SPSS) version 15. The majority of respondents were young people with the mean age of 22.9 years. The sample comprised 278 (78%) undergraduate and 57 (17%) post graduate students. Study findings showed that the factors which influenced the utilization of HIV/AIDS prevention methods varied and that they were mainly influenced by the awareness of the existing university-based HIV/AIDS prevention strategies. It also emerged that the mostly utilized HIV prevention methods were VCT services and free condoms. Perceived susceptibility and the perceived threat of HIV/AIDS score was also found to be correlated with HIV Risk Index score. Furthermore, there was Correlation between perceived susceptibility and perceived threat of HIV/AIDS and self-efficacy on condoms and their utilization. However, there seemed to be no relationship between utilization of HIV/AIDS prevention methods and these variables. In conclusion, the findings of this study suggest that most of Health Beliefs Model (HBM) variables were not predictors of the utilization of HIV/AIDS prevention methods among students. Intervention aiming to improve the utilization of HIV/AIDS prevention methods among students at the UKZN should focus on removing identified barriers, promoting HIV/AIDS prevention services and providing correct knowledge on HIV for behavioral change. / Thesis (MN)-University of KwaZulu-Natal, Durban, 2009.

Aim: The aim of this study was to explore perceptions and practices of ICD nurses, when supporting families of critically ill patients, in two hospitals in Blantyre, Malawi. Methodology: A descriptive qualitative approach was used to explore perceptions and practices of ICD nurses, when supporting families of critically ill patients. Simpson's Conceptual Framework was used to guide this study. Purposive sampling was done where five nurses from a public and five from a private hospital were interviewed until data saturation. Repeat interviews were conducted at two week intervals, for data depth and verification. Each interview lasted 25-40 minutes. All interviews were tape recorded and transcribed. Manual data analysis was used to identify themes and categories. Documents used for family support care were also reviewed. Findings: The study revealed that nurses acknowledged that families experienced stress due to critical illness and ICD admission of their loved ones. The study also reiterated that families have psychological, social and spiritual needs, including the need for information, comfort and proximity to their loved ones. Nurses met the families' needs through empathy, dedication and commitment, inclusion of families in patient care and decision making and information giving to promote understanding and endurance during the stressful period. ICD nurses encountered some challenges when they provided support care to families, which included families' interference from wanting to be with their loved ones all the time, lack of clear policies to guide family support care, limited time to attend to the relatives due to shortage of nurses and nurses' own stress, especially when they did not have enough information to answer questions from families, when communication was inadequate from physicians to families. In addition all participants did not have formal training except "on the job" orientation, which was not enough to prepare them for family support care. Recommendations: Recommendations have been suggested for improvements m nursing practice, nursing management, nursing education and future nursing research. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2009.

Thesis (MCur (Nursing Science))--University of Stellenbosch, 2008. / ENGLISH ABSTRACT: The purpose of this study was to determine the knowledge of Universal Precautions Policy by Registered Nurses at Kenyatta National Hospital (Kenya) and their perception of occupational risk of exposure to blood-borne pathogens. The study also assessed management of blood and body fluids of patients and identified the types and frequency of occupational exposure common among these Registered Nurses. A structured 24-item, self-administered questionnaire was distributed to 185 randomly sampled Registered Nurses in selected departments at this hospital. Compliance with Universal Precautions practices was also observed using a checklist. Data analysis was done by use of a computer software package, Statistical Package for Social Sciences (SPSS) version 11.0. The study findings suggest: 1) lack of continuous education demonstrated by a high level of non-response about knowledge of Universal Precautions Policy with only 19% of the respondents having attended an in-service course in Universal Precautions Policy, and 2) inaccurate understanding of transmission modes of blood-borne pathogens. The majority of nurses surveyed were using Universal Precautions; with indications that nurses were not as familiar with Universal Precautions as they think they were. Respondents admitted modifying personal protection habits based on subjective judgment regarding patient’s perceived blood-borne infectious state. Non-compliant behaviours with barrier precautions were identified, which included failure to use gloves, gowns and protective eyewear, failure to wash hands, and recapping used needles. Compliance with barrier precautions was associated with patients’ perceived blood-borne status. The study revealed a high level of occupational exposures, of which the majority went unreported. Although respondents were aware of the risk of occupationally acquired blood-borne infections, their irregular practice of Universal Precautions Policy is likely to perpetuate the risks. The findings suggest a need for more educational interventions, which may result into integration of concepts into practice. Educational programmes should focus on the epidemiology of occupationally acquired blood-borne pathogens and their modes of transmission, risk of occupationally acquired blood-borne infections at work place, and with emphasis on the principle and practice of Universal Precautions Policy and current protocol of reporting mechanisms in Kenya.

Thesis (MCur (Interdisciplinary Health Sciences. Nursing Science))--Stellenbosch University, 2008. / One of the greatest challenges in the world today is fighting the HIV/AIDS pandemic. Life expectancy in developing countries, especially those in sub-Saharan Africa, decreased to 46 years while in developed countries the average life expectancy is 78 years. World Health Organisation(WHO) indicates that HIV/AIDS, now the world's leading cause of death in adults aged 15 to 59 years, is killing almost 5 000 men and women in this age group, and almost 1 000 of their children, every 24 hours in sub- Saharan Africa. In South Africa today, employees operate in an increasingly complex legal environment with regard to HIV/AIDS in the workplace. Despite the legal protection against employees affected by HI/AIDS and vigorous campaigns to combat HIV/AIDS in support of affected employees, the researcher has observed that management and co-workers show no compassion, empathy or understanding for the needs of these affected employees. An in-depth literature review of quality of life was completed. The goal of this study was to investigate whether the quality of life of the employee affected by HIV/AIDS is adversely affected. The following objectives were set: • To determine the family history of the employee affected by HIV/AIDS • To determine occupational history of the employee affected by HIV/AIDS • To determine the symptoms of the employee affected by HIV/AIDS • To determine the effectiveness of the anti-retroviral treatment programme of the employee affected by HIV/AIDS A descriptive qualitative research design using the case study method was applied to investigate whether the quality of life of the employee affected by HIV/AIDS was adversely affected. The population of this study were HIV/AIDS-affected employees working at a food and beverage company. Ten employees who gave consent participated in the study. The trustworthiness of this study was assured with the use of Lincoln and Guba’s criteria of credibility, transferability, dependability and confirmability. A pre-test study was also completed. All ethical principles were met. Data was collected through an interview using an interview guide designed for use in a semi-structured interview. Data analysed show that the basic needs of the employee affected by HIV/AIDS are not adequately met and that the employee therefore does not experience quality of life. Recommendations include the improvement in public–private partnerships; in-service training and continuous refresher courses for all employees, supervisors and management; employee assistance programmes; involvement of church and communities; support circle; holistic approach in nursing care and further research. The findings play a role in understanding the importance of remaining at work for as long as possible when one is affected by HIV/AIDS. The findings of this study further validate the concepts in basic needs and that QOL is perceived differently by each individual.

Thesis (MCur)--Stellenbosch University, 2011. / ENGLISH ABSTRACT: The 21st century teaching environment is unique in its diversity, and challenges academic staff to create a teaching environment that is conducive to all current learners. Various teaching methods are available and affordable, but technology remains an essential investment for the future of higher education institutions. The goal of the study was to evaluate the perceptions of student nurses regarding the effectiveness of the teaching methods which they experienced at a nursing college in the Western Cape Province. The objectives included an evaluation of the effectiveness of teaching methods as perceived and experienced by students of: - The traditional (green/whiteboard) lecture - Group activity - Self-activity - The use of technology such as PowerPoint presentations and video clips. An explorative descriptive research design was applied with a quantitative approach. The target population (N=1238) consisted of nursing students following the programme leading to registration as a professional nurse. Stratified random sampling was used to select the sample of participants (n=267). Data was collected personally by the researcher with a self-administered questionnaire which consisted of predominantly closed questions. Ethics approval to conduct this study was obtained from Stellenbosch University including permission from all other relevant parties. Reliability and validity of the study were assured through a pilot study, consultation with experts in nursing, education and statistics. The reliability of the questions were tested using the Cronbach alpha coefficient test which varied between .89 and .94. The data was analysed with the support of a statistician and was expressed as frequencies in tables and histograms. Descriptive statistics and post-hoc analyses including tests for statistical associations were performed. Results include a significant difference in generation X participants and the green/whiteboard teaching methods (Spearman p-value = 0.02) and their preference of the traditional lecture as a teaching method (Spearman p-value = <0.01). The perceived effectiveness of the teaching methods on student performance varied between very helpful and not helpful. Only (n = 49/19%) of participants experienced the traditional lecture as being very helpful on their general academic performance, in comparison to the effect of group work (n = 69/26%) and self-activity (n = 102/39%). Furthermore, no significant results were obtained between the participants and the perceived effect of the teaching methods. Open-ended questions showed that participants regarded the teaching strategies as boring and ancient and that much of the unhappiness expressed stems from the difference in the needs of millennials and the lack of change and obstinacy existing amongst academics. Recommendations include an increase in the use of technology, a blended approach to teaching, the re-training of academic staff, measures in counteracting a boring classroom environment, orientation for neophyte academics and students, workload perception of students and class size. In conclusion should recommendations be implemented a complete transformation of the college under study will result. It may force the education institution to move out of complacency, to a more vigorous and dynamic education environment that enables them to emerge as an Higher Education Institution (HEI) of good standing. / AFRIKAANSE OPSOMMING: Die een-en-twintigste-eeuse onderwysomgewing is uniek wat betref diversiteit en daag akademiese personeel uit om teenswoordig ’n onderwysomgewing te skep wat bevorderlik is vir alle leerders. Verskeie onderwysmetodes is beskikbaar en bekostigbaar, maar tegnologie bly ’n noodsaaklike belegging vir die toekoms van hoër onderwysinstansies. Die doel van hierdie studie was om die effektiwiteit van die gebruik van onderwysmetodes wat waargeneem en ondervind word deur studentverpleegkundiges by ’n spesifieke Verpleegkollege in die Wes-Kaap, te evalueer. Die doelwitte sluit in die evaluering aangaande die effektiwiteit soos waargeneem en ondervind deur studente van die volgende onderwysmetodes: - Die tradisionele groen/witbord lesing - Groepaktiwiteit - Selfaktiwiteit - Die gebruik van tegnologie soos PowerPoint-aanbiedings en video-insetsels. ’n Ondersoekende, beskrywende navorsingsontwerp met ’n kwantitatiewe benadering is toegepas. Die teikengroep is (n=1238) wat uit verpleegstudente bestaan wat die program vir die van ’n geregistreerde professionele verpleegster volg. ’n Gestratifieerde ewekansige steekproef is gebruik om die deelnemers (n=267) te selekteer. Data is self deur die navorser ingesamel deur gebruik te maak van ’n selfgeadministreerde vraelys wat hoofsaklik uit geslote vrae bestaan het. Etiese goedkeuring om die studie na te vors, is verkry van die Universtiteit van Stellenbosch, asook die van al die betrokke partye. Betroubaarheid en geldigheid van die studie is verseker deur ’n loodsondersoek, sowel as raadpleging met deskundiges op die gebied van Verpleging, Opvoedkunde en Statistiek. Die betroubaaarheid van die vrae is getoets deur gebruik te maak van die Cronbach-alpha koëffisiënt toets wat tussen .89 en .94 gevarieer het. Die data is geanaliseer met die ondersteuning van ’n statistikus en word voorgestel as frekwensies in tabelle en histogramme. Beskrywende statistieke en post-hoc analises, insluitende toetse vir statistiese assossiasies, is uitgevoer. Resultate sluit in ’n beduidende verskil in generasie x-deelnemers en die groen- of witbord onderwysmetodes (Spearman p-waarde = 0.02) en hul voorkeur vir die tradisionele lesing as ’n onderrigmetode (Spearman p-aarde >0.01). Die effektiwiteit van die onderwysmetodes op studenteprestasies wat waargeneem is, varieer tussen baie waardevol en van geen waarde nie. Slegs (n=49/19%) van die deelnemers het die tradisionele lesing as baie waardevol vir hul algemene akademiese prestasie ervaar, in vergelyking met die effek van groepwerk (n=69/26%) en self-aktiwiteit (n=102/39%). Vervolgens, is geen beduidende resultate verkry tussen die deelnemers en die effek van die onderrigmetodes wat waargeneem is nie. Ope vrae bewys dat deelnemers die onderwysstrategieë as vervelig en verouderd beskou en dat baie van die ongelukkigheid wat deurgevoer is, voortspruit uit die verskil in die behoeftes van die milleniums en die gebrek aan geneentheid, asook halsstarrigheid by akademici om te verander. Aanbevelings sluit in ’n toename in die gebruik van tegnologie, ’n saamgestelde benadering tot onderrig, die heropleiding van akademiese personeel, maatstawwe om ’n vervelige klaskameratmosfeer teen te werk, oriëntering vir neofiet akademici en studente se persepsie van werklading en klasgrootte. Ten slotte, indien aanbevelings geïmplementeer word, sal ’n volslae transformasie van die kollege onder die soeklig, plaasvind. Dit mag die opvoedkundige instansie forseer om te beweeg vanuit ’n toestand van gemaksugtigheid na ’n meer ondernemende en dinamiese onderrigomgewing wat in staat sal wees om as ’n Hoër Onderwysinstansie van formaat te funksioneer.

Thesis (MCur)--Stellenbosch University, 2011. / ENGLISH ABSTRACT: Simulation refers to a teaching method that is used to teach students clinical skills. The use of mannequins is the most common type of simulation. Given the pivotal role that simulation plays in teaching students clinical skills, it is important to understand the experience and perceptions students have utilizing simulation laboratories. The aim of the study was to explore the experience and perceptions of primary health care students utilizing simulation laboratories. The researcher posed the following research question as a guide for this study: “What are the experiences and perceptions of primary health care students utilizing simulation laboratories?” A qualitative approach with a phenomenological research design was applied. A purposive sample of n=10 and a focus group of 7 participants was drawn from a total population of 232 primary health care students. An interview guide was designed based on the objectives of the study and validated by experts in Nursing, Education and the Ethics Committee at the Faculty of Health Sciences, Stellenbosch University. Experts in the field of teaching and learning, nursing and research methodology were consulted to determine the feasibility and content of the study, to evaluate the research process and outcome. Two (2) trained fieldworkers were responsible for collecting the data. Data was collected by means of individual interviews and by interviewing a focus group. The transcription of the interviews was done by the researcher. The data that emerged from the data analysis was coded and categorised into themes and subthemes. The five themes that emerged were simulation as a teaching method; a mannequin offering effective learning; confidence in clinical practice; structure of the course; and a support system. The researcher compiled a written account of the interpretations that emerged from the data analysis and verified this with the fieldworkers. In addition, member checking was done on two (2) of the participants from the focus group as well as two (2) of the participants from the individual interviews, to validate the transcribed data. The Conceptual Theoretical Framework of Bloom supports the findings of this study. The findings suggest that the mannequins should be upgraded regularly and should be able to register a response. It is recommended that a mannequin should be designed which is computer programmed according to different conditions which will include the signs and symptoms of those diseases for example tuberculosis. The participants need to be placed in the clinical environment at a much earlier stage in their programme. Peer group teaching and assessment should be introduced in the programme. Further research is recommended since institutions and disciplinaries working with simulation were not included in the study. / AFRIKAANSE OPSOMMING: Simulasie verwys na ’n onderrigmetode wat gebruik word om studente kliniese vaardighede aan te leer. Die gebruik van mannekyne is die mees algemene vorm van simulasie. Gegee die deurslaggewende rol wat simulasie speel in die onderrig van kliniese vaardighede aan studente, is dit belangrik om die ervaring en persepsies van studente wat gebruik maak van simulasie-laboratoriums, te wete te kom. Die doel van hierdie studie was om die ervaring en persepsies van primêre gesondheidssorgstudente wat van simulasie-laboratoriums gebruik maak, te ondersoek. Die navorser het die volgende navorsingsvraag as ’n riglyn vir hierdie studie gestel: “Wat is die ervaringe en persepsies van primêre gesondheidssorgstudente wat simulasielaboratoriums gebruik?” ’n Kwalitatiewe benadering met ’n fenomenologiese navorsingsontwerp is toegepas. ’n Doelbewuste steekproef van n=10 en ’n fokusgroep van 7 deelnemers is geneem vanuit ’n totale bevolking van 232 primêre gesondheidsorgstudente. ’n Onderhoudgids is ontwerp, gebaseer op die doelwitte van die studie en gevalideer deur kundiges in Verpleging, Opvoedkunde en die Etiese Komitee van die Fakulteit van Gesondheidswetenskappe aan die Universiteit van Stellenbosch. Kundiges op die gebied van onderrig en leer, verpleging en navorsingsmetodologie is geraadpleeg om die haalbaarheid en inhoud van die studie te bepaal vir die evaluering van die navorsingsprosedure en uitkomste. Twee (2) opgeleide veldwerkers was verantwoordelik om die data te versamel. Die data was versamel deur middel van individuele onderhoude en ‘n onderhoud met ‘n fokus groep. Die onderhoude was getranskribeer deur die navorser. Die data wat uit die analise gekom het, is geënkodeer en gekategoriseer in temas en subtemas. Die vyf temas wat hieruit voortgespruit het, is simulasie as ’n onderrigmetode; ’n mannekyn wat effektiewe leer bied; vertroue in die kliniese praktyk; die struktuur van die kursus; en ’n ondersteuningssisteem. Die navorser het ’n geskrewe verslag saamgestel van die weergawe van die data-analise wat saamgestel en deur die veldwerker geverifieer is. Bykomend is die kontrole van lede van twee (2) van die deelnemers van die fokusgroep, asook twee (2) van die deelnemers vanuit die individuele onderhoude gedoen, om die getranskribeerde data se geldigheid te verklaar. Die Konseptuele Teoretiese Raamwerk van Bloom rugsteun die bevindinge van hierdie studie. Die bevindinge beveel aan dat die mannekyne gereeld opgegradeer behoort te word en dat hulle ’n respons moet kan registreer. Dit word aanbeveel dat ’n mannekyn ontwerp behoort te word wat rekenaar geprogrammeerd is volgens die verskillende toestande wat die tekens en simptome van siektes soos tuberkulose insluit. Die deelnemers behoort in ’n baie vroeë stadium van die program in die kliniese omgewing geplaas te word. Verdere navorsing word aanbeveel, aangesien inrigtings en dissiplines wat met simulasie gemoeid is, nie in hierdie studie ingesluit is nie.

Thesis (MCur)--Stellenbosch University, 2011. / ENGLISH ABSTRACT: Mental health is still the step-child of Health Services, although many studies show the serious negative impact it has on the mother, baby and the family. Knowledge about Postnatal Depression (PND) and associated risk factors which influence the development of PND is vital for early detection and intervention. Worldwide PND affects on average 10-15% of women after giving birth regardless of socio-economic status, race or education. Studies also reveal that the prevalence of PND is as high as 40-60% amongst women after giving birth. The goal of the study was to investigate the prevalence and factors influencing PND in a rural setting, in the Witzenberg Sub-district. The objectives included determining the prevalence of PND and identifying the contributing risk factors associated with PND. A descriptive explorative research design with a quantitative approach was applied. The target population was (N=1605) mothers, 18 years and older who gave birth in this Sub-district in one year, a convenience sampling method was used to select the study sample of (n=159/10%) participants who met the criteria and who gave voluntary permission to take part in the study. Validity and reliability was supported through the use of validated questionnaires EPDS and BDI including a questionnaire based on demographical, psychosocial and obstetrical data. In addition experts in statistics, nursing and psychiatry were consulted including language experts who validated the correctness of the Afrikaans and Xhosa translated questionnaires. A pilot study was conducted to test the feasibility of the study and all data was collected personally by the researcher with the support of two trained field workers. Ethics approval was obtained from Stellenbosch University and permission from the Department of Health, Provincial Government of the Western Cape, including informed written consent from each participant. The data was analysed with the assistance of a statistician and are presented with histograms and frequency tables. The relationship between continuous 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 chi-square tests using a 95% confidence interval. Non-parametric tests such as the Mann-Whitney U–test or Kruskal-Wallis test were used for randomised design. Levene’s test was used for Homogeneity of Variance and the Bonferonni test of probability. The study revealed that 50.3% of the mothers, who participated in the study, had PND. Various risk factors were determined in this study that influences the development of PND. Results include statistical associations between PND and the following: - unplanned babies and unwelcome babies (p=<0,01) - life events (p=0.01) - partner relationship (p=<0.01) - family and social support (p=<0.1) Furthermore, the majority of the participants (53.8%) with PND (n=80) had a history of a psychiatric illness which was shown with significance (p=<0.01), the majority of the participants (63.5%) were unmarried and 23.8% were teenagers who suffered from PND. Recommendations include promoting healthy lifestyles, empowerment of women, prevention of teenage pregnancies, early and holistic assessment for symptoms of PND and approriate referral. In conclusion the prevention and promotive measures, early detection of PND and appropriate referrals and treatment are critical in managing maternal, child and family well being. / AFRIKAANSE OPSOMMING: Geestesgesondheid blyk die stiefkind van gesondheidsdienste te wees, ten spyte daarvan dat navorsing die negatiewe impak wat dit op moeder, baba en die gesin het bevestig. Kennis van postnatale depressie (PDN) en verwante risiko faktore wat die ontwikkeling van PND beïnvloed is van uiterste belang vir die vroeë opsporing en ingryping daarvan. PND affekteer gemiddeld 10%-15% van vroue wêreldwyd wat dit ervaar nadat hulle geboorte geskenk het, ongeag sosio-ekonomiese status, ras of opleiding. Navorsing dui daarop dat die voorkoms van PND so hoog is soos 40%-60% onder vrouens nadat hulle geboorte geskenk het. Die doel van hierdie studie was om die prevalensie van PND en die faktore wat PND beïnvloed in ’n landelike nedersetting in die Witzenberg Subdistrik te ondersoek. Die doelwitte sluit die bepaling van die prevalensie van PND in en die identifisering van die risiko faktore wat daartoe aanleiding gegee het. ’n Beskrywende verkennende navorsingsontwerp met ’n kwantitatiewe benadering is toegepas. Die teikengroep was (N=1605) moeders, 18 jaar en ouer wat geboorte geskenk het in hierdie subdistrik binne een jaar. ’n Gerieflikheidssteekproef metode is gebruik om die deelnemers (n=159/10%) te selekteer wat aan die kriteria voldoen het en vrywillig toestemming gegee het om aan die studie deel te neem. Geldigheid en betroubaarheid is gerugsteun deur die gebruik van geldige vraelyste, naamlik EPDS en BDI wat ’n vraelys insluit wat gebaseer is op demografiese, psigososiale en verloskundige data. Hierbenewens is deskundiges in statistiek, verpleegkunde en psigiatrie geraadpleeg, asook taalkundiges wat die taalkorrektheid van Afrikaans en Xhosa vertaalde vraelyste nagegaan het. ’n Loodsondersoek is uitgevoer om die haalbaarheid van die navorsing te toets en alle data is persoonlik deur die navorser met die hulp van ’n opgeleide veldwerker ingesamel. Etiese goedkeuring is verkry van die Universiteit van Stellenbosch en toestemming van die Departement Gesondheid, die Provinsiale Regering van die Wes-Kaap, asook skriftelike toestemming van elke deelnemer. Die data is ontleed met die bystand van ’n statistikus en is deur frekwensie tabelle aangebied. Die verhouding tussen volgehoue/aaneenlopende respons veranderlikes en nominale inset/invoer veranderlikes is ontleed deur gebruik te maak van die analise van variansie (ANOVA). Verskeie statistiese toetse is toegepas om die statistiese assosiasies tussen veranderlikes vas te stel soos die chi-kwadraat toetse deur ’n 95% betroubaarheidsinterval te gebruik. Nie-parametriese toetse soos die Mann-Whitney U-toets of Kriskal-Wallis toets is gebruik vir ewekansige ontwerp. Levene se toets is gebruik vir homogeniteit van variansie en die Bonferonni toets vir waarskynlikheid. Die toets het bewys dat 50.3% van die moeders wat aan die studie deelgeneem het, het PND. Verskeie risiko faktore is in hierdie studie vasgestel wat die ontwikkeling van PND beïnvloed. Resultate sluit statistiese assosiasie tussen PND en die volgende in: - onbeplande babas en onwelkome babas (p=<0,01) - lewensgebeure (p=0.01) - lewensmaat verhoudings (p=<0.01) - familie en maatskaplike ondersteuning (p=<0.1) Vervolgens het die meeste van die deelnemers (53.8%) met PND (n=80) ’n geskiedenis van ’n psigiatriese siekte met ’n beduidenis (p=<0.01), die meeste van die deelnemers (63.5%) is ongetroud en 23.8% is tieners wat aan PND ly. Aanbevelings sluit die bevordering van gesonde leefstyle, die bemagtiging van vrouens, voorkoming van tienerswangerskappe, vroeë en holistiese assessering van simptome van PND in en die aangewese verwysing. Daar kan tot die slotsom gekom word dat voorkoming- en bevorderingsmaatstawwe, vroeë opsporing van PND en aangewese verwysings en behandeling, krities is in die hantering van moeder-, kind- en gesinswelstand.

Thesis (MCur)--Stellenbosch University, 2011. / ENGLISH ABSTRACT: Background: Misoprostol, a prostaglandin E1 analogue with its uterotonic properties has entered as an integral part of management of the third stage of labour, helping to prevent postpartum haemorrhage (PPH). Objective: To assess evidence on the effectiveness of misoprostol compared to a placebo for the prevention and treatment of postpartum haemorrhage. Methods: Databases searched included; MEDLINE, Google Scholar and Cochrane Central Register of Controlled Trials (CENTRAL). Other sources were also searched. All articles were screened for methodological quality by two reviewers independently by standardized instrument. Data was entered in Review Manger 5.1 software for analysis. Results: Three Misoprostol studies were included (2346 participants), Oral (2 trials) and sublingual (1 trial). Misoprostol has shown not to be effective in reducing PPH (RR 0.65: 95% CI 0.40-1.06). Only one trial reported on need for blood transfusion (RR 0.14; 95% CI 0.02-1.15). Misoprostol use is associated with significant increases in shivering (RR 2.75; 95% CI 2.26-3.34) and pyrexia (RR 5.34; 95% CI 2.86-9.96) than with placebo. No maternal deaths were reported in included trials. Compared to placebo, misoprostol was coupled with less hysterectomies and additional used of uterotonics (RR 0.45; 95%CI 0.21-0.96) compared to placebo. Conclusion: Results of this review shows that the use of misoprostol in combination with some components of active management was not associated with any significant reduction in incidence of PPH. However oral administration showed a significant reduction in incidence of PPH. For its use for treatment of postpartum haemorrhage, there is a need for research focus in optimal dose and route of administration for a clinically significant effect and acceptable side effects. / AFRIKAANSE OPSOMMING: Agtergrond: Misoprostol, 'n prostaglandien E1 analoog met sy uterotonic eienskappe het ingeskryf as' n integrale deel van die bestuur van die derde stadium van kraam, help postpartum bloeding (PPH) te voorkom. Doelwit: Om bewyse oor die effektiwiteit van Misoprostol in vergelyking met 'n placebo vir die voorkoming en behandeling van postpartum bloeding te evalueer. Metodes: Databases gesoek ingesluit, Medline, CINHAL, Google Scholar en Cochrane Sentrale Register van gecontroleerde studies (Sentraal). Ander bronne is ook deursoek. Alle artikels is gekeur vir die metodologiese kwaliteit deur twee beoordelaars onafhanklik deur die gestandaardiseerde instrument. Data is opgeneem in Review Manger 5.1 sagteware vir ontleding. Hoof Resultate: Drie Misoprostol studies were ingesluit (2346 deelnemers). Mondeling (2 proe) en sublinguale (1 verhoor). Misoprostol het getoon nie doeltreffend te wees in die vermindering van PPH (RR 0,65: 95% CI 0,40-1,06). Slegs een verhoor berig oor die noodsaaklikheid vir 'n bloedoortapping (RR 0,14, 95% CI 0,02-1,15). Misoprostol gebruik word geassosieer met 'n aansienlike toename in bewing (RR 2,75, 95% CI 2,26- 3,34) en koors (RR 5,34, 95% CI 2,86-9,96) as met' n placebo. Geen moederlike sterftes is aangemeld in proewe. In vergelyking met placebo, was Misoprostol tesame met minder hysterectomies en addisionele gebruik van uterotonics (RR 0,45, 95% CI,21-,96) in vergelyking met placebo. Gevolgtrekking: Resultate van hierdie studie toon dat die gebruik van Misoprostol in kombinasie met 'n paar komponente van aktiewe bestuur is wat nie verband hou met' n beduidende afname in die voorkoms van PPH. Vir die gebruik vir die behandeling van postpartum bloeding, daar is 'n behoefte vir navorsing fokus in die optimale dosis en die roete van administrasie vir' n klinies beduidende uitwerking en aanvaarbare neweeffekte.