This study explored the existing planning systems that nurse managers in health institutions in the Lusaka district in Zambia used to plan staff development activities, with a view to developing a model suitable for a staff development plan for all nurses in Zambia. The learning organization and transformational learning theory frameworks were used to guide the study. The learning organization framework was based on Senge (1990), The Fifth Discipline, which addressed five components, namely, systems thinking, personal mastery, mental models, building shared vision and team learning. The transformational learning theory framework was based on (Gravette 2000), which addressed the reflective and constructive processes that employees go through during their learning. A survey and action research methods were used to explore the planning systems which nursing managers in the Lusaka district used to plan staff development activities. The total population of nurses designated as nursing managers, registered nurses and enrolled nurses working in the central hospital (734 nurses), in the specialized hospital (128 nurses), and in 31 health centres (980 nurses) in the Lusaka district constituted the target population. Systematic sampling was used to select a total of 614 participants; only 368 nurses returned completely filled questionnaires. A staff development tool jointly developed with the participants also served as a means of generating data for the study. The quantitative data were analyzed according to the Statistical Package of Social Sciences (SPSS) 11.5 version, using frequencies and percentage distributions. Framework analysis was used to analyze the collected qualitative data. The major findings of the study revealed that nursing staff in the urban district of Lusaka were not using systematic methods based on any known approach in planning staff development activities. Using a learning organization framework, a model of staff development was jointly developed with the participants, as well as a checklist for assessing staff when utilizing the model in a Zambian setting. The study concluded that the developed learning organization model was capable of facilitating the development of culture of lifelong learning among nurses and midwives in Zambia. / Thesis (Ph.D.)-University of KwaZulu-Natal, Durban, 2006.

The Limpopo MCWH Directorate, concerned about the high perinatal and maternal mortality rates arising from the poor quality of maternal health care provided at primary level, commissioned this study to explore what would be the appropriate interventions that could be applied province-wide to improve the quality of maternal health care at municipal and district level. Thus the study aimed to develop a useable and replicable model of intervention with Reproductive Health Management Teams (RHMTs) at municipal and district level that would lead to improvements in the quality of maternal health care. The study objectives were to: 1. Identify indicators and the method for a baseline assessment of the quality of maternal health care at municipal and district level. 2. Identify indicators that would permit an analysis of the factors that influence the key issues emerging from the baseline assessment. 3. Develop a programme of intervention, with its monitoring and evaluation procedures, that would address the factors that influence the key issues. 4. Recommend a strategy for replicating the intervention programme. An action-research approach was adopted in this study, and was implemented in a series of cyclical action-research steps in cooperation with the RHMTs. The study was implemented in 25 municipalities in Limpopo Province and was implemented over a period of 28 months, from December 2001 to March 2004. Both qualitative and quantitative methodologies were used. Indicators were identified to conduct a baseline assessment of the quality of maternal health care; the tools were developed to collect the data necessary to calculate these indicators; the indicators were applied to achieve a baseline assessment of the quality of care, and the information analysed to identify priority key issues affecting the quality of maternal health care. These key issues were identified as: the poor quality of the 1st ANC visit and poor management of labour. These key issues were analysed in order to identify what were the most important influencing factors affecting the quality of maternal health care. Staffing, supervision, referral systems, support services and the planning and organisation of the health facilities were found to be the most influential factors. Indicators were developed to measure these factors, with the data collection tools required to collect the data necessary to calculate the indicators. The indicators were measured to describe the current situation with regards to each. Once the influencing factors had been identified, interventions were identified, prioritised and planned for implementation in each municipal area. The priority interventions that could be implemented at municipal level were: in-service training in antenatal care and the management of labour; supervision of antenatal care and labour; audit of the service and improving referral systems. Tools were developed to monitor the implementation of these interventions and the outcomes of monitoring reported. The model to improve the quality of maternal health care developed in Limpopo Province is possible to implement within the context of health services in South Africa. A limiting factor to full implementation may well be staffing shortages, although this study did not set out to establish the degree of influence that staffing shortages do actually exert. The real challenge to full implementation, however, lies in the ability of managers at different levels to work together to support quality service delivery, and for providers to deliver an integrated, comprehensive service to pregnant women. Municipal and district level Reproductive Health Management Teams, with a full mandate and good leadership, managerial, clinical and public health skills, have the potential to address the most critical factors at the local level that are influencing the quality of care. / Thesis (Ph.D.)-University of KwaZulu-Natal, Durban, 2005.

This survey was conducted to describe the awareness, attitudes and behaviours regarding HIV Voluntary Counselling and Testing (VCT) among students of the University of KwaZulu-Natal in the Howard College Campus residences. A quantitative descriptive study design and a simple random sampling technique were used in this study. One hundred and seventy - eight students who lived in residences of Howard College Campus voluntarily participated in the study and completed the anonymous questionnaires. The questions in the questionnaire were designed to collect the demographics information of the participants and to address their awareness, attitudes and behaviours regarding VCT. Analysis of findings revealed that the level of awareness of VCT was high among the students. The majority of the participants have heard of VCT before this survey and knew that campus clinic provided VCT service. To students, the two most major sources of VCT information were TV/radio and friends/classmates. A positive attitude towards VCT was found among the students. The participants perceived the benefits and importance of undergoing VCT as well as the value of counselling. Sixteen percent of all participants have received VCT and twenty - two percent intended to go for VCT within the following 6 months. The main reasons cited by students for undergoing VCT included: to know their health status, to recognize the risk to be exposed to HIV, and to seek for information about maintaining health. The main reasons for not seeking VCT were assuming their HIV status negative and unlikely exposure to HIV because they always practised safe sex. A need for VCT information was found in this study. Some barriers to VCT existed, such as perception of negative consequences of uptake of VCT (e.g. HIV - related stigma), low risk perception to HIV infection, and lack of VCT information. The findings suggest that there is a need for communication campaigns at the University of KwaZulu-Natal, to address knowledge gaps, reduction of stigma, and promoting awareness of vulnerability to HIV. The findings of this study could be used to assist to plan HIV prevention programme at the University of KwaZulu-Natal. / Thesis (M.A.)-University of KwaZulu-Natal, 2005.

No abstract available.

As adults spend the major portion of their lives at work, it is essential that the reciprocal relationship between their work and health be recognised. In this regard, occupational nurses have an important function, through the provision of effective occupational health programmes in the workplace, although this is a challenging task and programmes often bear little relevance to health needs. The process of identifying health needs involves the measurement of health status, requiring a clear understanding of the nature of health and how it is determined. However, conceptualisations of health in relation to work tend to be inadequate as they deal with it on an individualistic basis, often as a negative measure, do not include the various dimensions of health, and fail to take account of the influences of the wider community. This study sets out to overcome these problems. A model of aggregate (collective) health in the workplace was developed from a conceptual framework, to expain how influences inter-relate and contribute to health in this setting. Health is conceived in positive terms, with the individual represented as the core, passing through the organisation and community, thereby depicting the interrelationships between their health. At the aggregate level four sets of factors, human biology, environment, lifestyle and health care organisation, are shown to influence health. The subjective, objective, physical, psychological and social dimensions of health are incorporated, whilst the potential of work as a stressor or health strengthening influence on health is recognised. Concepts from the model have been operationalised into composites of variables, for the assessment of aggregate health status. A measurement strategy was then devised, involving the analysis of data collected by means of an examination of organisational records, interviews with key people, a survey of a random stratified sample of members, health hazard identification in the workplace and an assessment of the provision of health care in the wider community. The survey instrument, consisting of an interview and questionnaire, was developed and subjected to a field test. The model, strategy and instrument were revised according to the results. / Thesis (Ph.D.)-University of Natal, Durban, 1993.

This research study aimed at determining the relationships between nurse staffing and nurse sensitive outcomes (urinary tract infection, pressure ulcers, pneumonia, missed dose, wrong dose, and wrong drug) in the University Central Teaching Hospital of Kigali. A retrospective, descriptive design guided the study. A purposive sampling method was used to select the unit of study. Patient files were selected (n =797) and reviewed from the medical and surgical wards in February and March 2006. A checklist format was used to collect the data. The first instrument for data collection on staffing included the shifts, the categories of nurses, the total number of nurses and the patient census. The second instrument on adverse events included all events under study. Data collection was done by the researcher. A quantitative method was used to analyze data. The results indicated a statistically significant relationship between pressure ulcers, pneumonia, and phlebitis and number of registered nurses. Risk of wound infection was statistically significant between both increased numbers of enrolled nurse and registered nurses as well as nurse: patient ratio. The findings also revealed a statistically significant protective relationship between pneumonia, missed dose, and phlebitis with increased nurse: patient ratio. The findings of this study revealed no statistically significant relationship were found between urinary tract infection, pneumonia, phlebitis, and missed medication dose and the mean number of enrolled nurses. There was no statistically significant relationship between urinary tract infection and missed medication dose and the mean number of registered nurses. The result of this study suggests that there is an impact of nursing workload and expertise on patient outcomes. / Thesis (M.A.)-University of KwaZulu-Natal, 2006.

AIM: The purpose of the study was to explore the reasons that influence Rwandan nurses to change employment status. METHODOLOGY: The study used quantitative, exploratory, and descriptive design. A convenient sample size of eighty-eight (88) nurses, purposively selected using snowballing method, participated in the study from CAMERWA and RAMA organizations. Data was collected by use of a self -administered questionnaire, which had closed and open ended questions. Data were analyzed by SPSS 13.0 for Windows. FINDINGS: Low salary payments (53.8%),lack of policies and procedures( 42.5%), poor staffing in health care facilities (54.8%)and some respondents said they never choose to be nurses (31 %), and therefore they did not want to remain in nursing(23 .9%.) Reasons included lack of autonomy (65.9%), lack of promotion criteria (52.3%) Lack of career advancement and training were among the major reasons for change of employment status. Nurses however recommended that if the salary is increased, and opportunities for training and further education are improved then retention can be improved, CONCLUSION: Intrinsic and extrinsic factors were both identified as factors that influenced the nurses to change employment status, it is the government and the relevant healthcare facilities to pay attention to what motivates nurses, since they are the major role players in the health sector. / Thesis (M.N.)-University of KwaZulu-Natal, Durban, 2006.

The aim of this study was to describe and compare the needs of families of critically ill patients in two adult ICUs from both the family and the nurses' perspectives. A non-experimental descriptive survey design with a quantitative approach was used to explore the family members' needs in an ICU situation. For this study, a non-probability convenience sample of 50 critical care nurses and 50 family members from adult Intensive Care Units (ICUs) in two tertiary hospitals was used. The Critical Care Family Need Inventory (CCFNI) (Molter, 1979) was used as a data collection instrument. There were different perceptions of family needs between families and nurses. Nurses were accurate with 21 (47%) of the 45 families' need items which was less than half of their perceived family needs compared to family members' perceptions despite the fact that the two groups were in agreement with 5 of the first 10 most important needs. Recommendations for future practice included incorporation of educational programmes for critical care nurses concerning family needs in ICU settings, and the provision of specific in-service training to improve communication skills. Critical care unit, critical care nurse, critically ill patient, family, family member, needs, perception, critical care nursing. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2010.

Introduction: Bums are senous health problems associated with high mortality and morbidity. Bum deaths include bums from residential fires and scalds, clothing bums, industrial injuries, electrical injuries, among other sources of thermal energy. Aim: The aim of the study was to identify risk factors and describe characteristics of bum injuries in Rwanda. Ninety eight patients of all ages were selected and stratified by age, sex, bum size, causes of bum, and province of residence. Most of the patients (54.5%) were below the age of 12. Among children, 6% were aged between 0 and 11 months, 38% were aged between I and 5 years, 11% were between 13 and 21 years, 34% were adult between 22 and 49 years, and 3% were senior persons of above 50 years. The male population accounted for 55% of the total sample population, whereas the female population accounted for 41 %. Method: A quantitative retrospective descriptive survey was used in this study intended at reporting the characteristics and risk factors of bums in Rwanda. Results: The study finds a statistical correlation between gender and agent since 90% of contact bums occurred among the female population, although more male persons were affected by chemical bums (73%) in comparison to incidence among the female population (27%). Scalds were the most common type ofbum among children of 0 to 5 years of age as well as among adults. Flame bums predominated in older children. Large bum size was the strongest predictor of mortality. Among the twenty eight resultant deaths observed, twenty (71.4%) had a TBSA> 20%. Bum patients from rural areas had a higher mortality rate compared to patients that came from the urban context of the city of Kigali. The Southern Province recorded the highest mortality rate (l00%) followed by the Northern Province (62.5%) and the Eastern Province (45.4%). The city of Kigali has a mortality rate of 19%, notwithstanding its high frequency rate in terms of hospital admission (34.7%). Moreover, the study found that 25% of patients from the city of Kigali with major (more than 20%) TBSA recovered without disability, while none (0%) from the rural areas survived. Large bum size was the strongest predictor of mortality, followed by the rural factor (residence), and by the presence of inhalation injury. Infants and young children had the highest risk of death from bum injury. Bums smaller than 20% TBSA, without an inhalation injury (such as small scald injuries), are occasionally lethal in bums for both adults and children. Conclusion: The consequences of fire and bum injuries are so large and potentially devastating that efforts for their prevention should be proportionally much greater than reflected in mortality statistics. Some individuals feel that large bums are a worse fate than death (MacKenzie et al 1989). The scars of bum victims should remind us that prevention of these injuries must have high priority and attention now than they have had in the past. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2009.

The purpose of the study was to explore the role of spirituality in the lives of people living with HIV/AIDS, which was aimed at exploring the different spiritual beliefs held by that group of people and the importance of those beliefs in helping them to live with HIV/AIDS. A qualitative approach, using an exploratory research design was undertaken using twenty-five purposefully selected participants from the support group of people living with HIV/AIDS at Philani Clinic in King Edward VIII Hospital in Durban. Data were collected by utilizing focus-group interviews followed by one-on-one individual interviews. An audio tape recorder was used to record the interviews. Field notes and memos were also kept to strengthen the data and to ensure trustworthiness. The socio-demographic characteristics of participants were analyzed using the Statistical Package for Social Sciences (SPSS 11.5) for Windows; the results are displayed in the form of tables, graphs, percentages and presented in the methodology section of chapter three. The qualitative data were transcribed and analyzed manually by assembling the transcript from each interview and utilized to form major themes, sub-themes, categories and sub-categories that emerged from the data. In this study spirituality was described as a four-dimensional cognitive (mental) relationship with the transcendent being/higher power/ultimate reality, a relationship of love, forgiveness and connectedness that is reinforced by one's belief system. The result of this relationship is the achievement of inner peace, which produced a general sense of wellness that is usually subjective. General wellness could be physical health, mental health, acceptance of things that one cannot change and quality of life. Common themes identified from the sample included spirituality, defined as a personal relationship with God or a higher power that facilitates love, forgivingness and connectedness; taking precaution, respecting the elders and believing in God for everything. HIV/AIDS was found not to be a curse from God, but an ordinary illness, even though other participants believed that it was God's plan to bring humanity back to Him, while others believed that it was a blessing. The study also found that HIV/AIDS could be prevented through the continuous use of condoms, faithfulness in marriage and abstinence, but some believed that its cure could only come from God after the accomplishment of the purpose for which He allowed the infection. However some study participants believed that the cure would be discovered through research. The benefit of the spiritual belief that helped participants to cope with the infection was the achievement of inner peace, which was achieved through restoration of relationships. / Thesis (M.N.)-University of KwaZulu-Natal, Durban, 2006.