This study was undertaken to investigate the practice of Traditional Birth Attendants (TBA) during pregnancy, labor, and the postpartum period. The overall goal of this study was to promote safe motherhood. This study was conducted in Abaqulusi, a sub-district of KwaZulu-Natal, Zululand Health District 26, in four rural communities. A descriptive design with structured interview schedule guided the process. A convenient sample of forty-eight actively practicing trained Traditional Birth Attendants and forty-eight mothers attended by these Traditional Birth Attendants were interviewed. Of these 48 TBAs 47 were women, and one interestingly, was a man. Their age range was from 20 to over 70. Fifty percent of the mothers attended by the TBAs were between 15 and 24 years old. This finding is significant because the result shows that most of the mothers who are attended and delivered by TBAs are a high risk group. Data generated was quantitatively and qualitatively analyzed. The study revealed that the TBAs attended the mothers during the pregnancy, labor, and postpartum periods. All TBAs examined mothers with their hands, gave education on the importance of good nutrition, child spacing, and follow up care. The study showed that during labor 100 % of TBAs deliver babies on the floor with an old blanket, in the lithotomy position and encouraged the mother to empty her bladder before and during labor. They wore gloves or plastic bags. They examined mothers before delivery was done. They measured the umbilical cord, tied it with string and cut it. They cleaned the baby's mouth, nose, and eyes with a clean cloth, and wrapped the baby up and put it near the mother. They delivered the placenta, checked it to see if all was out. They washed the mother and put her on her bed. During the postpartum period, 100 % of the TBAs visited the mother at her home for one week to assess and care for the mother and her baby. The TBAs examined the mother, checked the umbilical cord and bathed the baby. They educated the mother about breastfeeding, caring for her breast, and eating balanced meals to produce adequate breast milk. The study revealed that the mothers perceived the TBAs as caring. The mothers loved the TBAs because the TBAs were easily accessible, even at night. The conclusion reached in this study is that TBAs are of great value to the rural communities of South Africa. They need to be supported by the health professionals so thal tbeir practice can be recognized. They form part of the maternal and child health care. Their practice is indispensable. / Thesis (M.N.)-University of Natal,Durban, 2004.

This research is a follow up of a "Breast Week" which was organized in Freetown, Sierra Leone. The specific objective of this study was to assess the effectiveness of the knowledge and teachings given to the women who participated in this project. The unrecorded cases of breast lumps and breast cancer observed in women in Sierra Leone prompted the researcher to undertake this present study. A quantitative approach was adopted and a structured interview schedule and an observational checklist guided the data collection process. A sample size of 120 women (10%) who participated in the "breast week" was obtained through systematic sampling. The first part of the study involved assessment of the theoretical background of the research topic followed by the second phase during which the women demonstrated Breast Self-Examination to detect abnormalities of the breasts. Discussions and analysis of the findings are presented in three sections. Texts from open ended questions were categorized and explained in numerical terms as the study was quantitative in nature. The data was processed through use of SPSS and Microsoft Excel. Frequency counts were applied to the data, use of non-parametric tests on the number of women who practiced Breast Self-Examination before and after the breast week showed a statistically significant difference in the number of women now practicing BSE as a screening method for breast cancer after receiving the health education. It was found that the majority of the women linked breast cancer to the signs and symptoms associated with it and were able to describe the disease as one that kills women if not promptly detected and/or treated appropriately. Findings indicate that the majority of the women (78.3%) had previously had mmor breast problems. An assessment of the effectiveness of knowledge on breast cancer showed that these women could identify breast cancer as a disease that affects women and may cause deaths if not detected on time or treated promptly. These women were able to demonstrate to the researcher how they examine their breasts to exclude abnormalities. Three women had breast lumps detected through examination of the breasts during the breast week. Two of them had had the lumps removed and are currently on medication. One of the women who had a breast lump detected was financially constrained and could not afford the cost of surgery. The number of women who can now perform BSE increased (95.0%) after having the knowledge on breast cancer and BSE. The majority of the women (97.4%) received information on how to examine their breasts for breast cancer through the information provided during the breast week. It is thus concluded that the objectives of the breast week were met. / Thesis (M.N.)-University of Natal, Durban, 2004.

Aim: The aim of this study was to explore the attitudes and practices of the emergency staff working in the level one emergency departments in the province of KwaZulu-Natal, with regard to witnessed resuscitation. Methodology: A qualitative approach was used to explore the attitudes and practices of the staff. Two semi - structured interviews were conducted with each participant, an initial and a verifying interview, with each interview lasting between 15 - 30 minutes long. The researcher applied the principle oftheoretical saturation and a total ofsix participants from two of the four level one emergency departments were included in this study. One provincial and one private emergency department were chosen. All of the interviews were taped and transcribed prior to manual analysis, in which categories and themes were identified from the data. Findings: The emergency staff disliked the idea of witnessed resuscitation. They believed it to be a harmful experience for the witnesses, a threat to the resuscitation process, threatening for the emergency staff, and impossible to implement in their emergency departments that are already short of staff and space. Although these were their dominant feelings, there were subtle references made during the interviews that revealed that there were some aspects of witnessed resuscitation that they liked once they had considered the practice. There were no written policies to dictate how the relatives were handled, but all the staff agreed that the relatives were asked to wait outside-of the resuscitation area, they were kept informed and then brought in when the patient was stable or had died. A number of recommendations are suggested for education, practice and further research in an attempt to introduce witnessed resuscitation as an option in KwaZulu-Natal's emergency departments. / Thesis (M.Cur.)-University of Natal, Durban, 2001.

Stress among nurses is still perceived as a challenge experienced by the nursing profession. Several studies have shown the negative impact of stress on both nurses and patients. However, little is known about the factors influencing stress among nurses in Rwanda. Aim: The overall aim of the study was to explore the factors contributing to nurses’ stress and related coping strategies used by nurses in the University Teaching Hospital of Butare (UTHB), Rwanda. Methods: The researcher used a non-experimental, descriptive study to explore the factors contributing to nurses’ stress and related coping strategies used by nurses in the University Teaching Hospital of Butare, Rwanda. This study was informed by a stress and coping theoretical framework. A questionnaire was used to collect the demographic characteristics of participants, while nurses’ stressors were assessed using the questionnaire of nurse’s stressors previously developed by Bianchi. The ways of coping were evaluated using the ways of coping elaborated by Folkman & Lazarus. A convenient sampling of 85 registered nurses, working at UTHB, participated in this study. Permission to conduct the study was requested and obtained from the University of KwaZulu-Natal Ethics Committee, the Kigali Health Institute -Institutional Review Board and the management of UTHB. The data was analysed using the Statistical Package for Social Sciences (SPSS), version 15, and was summarized using descriptive statistics. The results were presented in tables and graphs. Results: The findings of the study revealed that registered nurses at UTHB face a variety of stressors such as shortages of staff and materials, facing death and dying, dissatisfaction with the work environment, work overload and time spent on bureaucratic activities. It was shown that consequences of stress vis-à-vis registered nurses could be low quality of care, job dissatisfaction and burnout syndrome. Among the major strategies of coping with stress, registered nurses have indicated problem solving, social support and accepting responsibility. This study indicates that stress can be prevented and managed by using vi nursing strategies such as team work, effective communication improving work conditions and fostering the managerial nursing strategies in working unit. Conclusion: Drawing from these findings, it can be inferred that nurses’ stressors need to be addressed in order to create a working environment conducive to high quality of care and also to enhance nursing staff morale, satisfaction, motivation and retention. / Thesis (M.N.)-University of KwaZulu-Natal, Durban, 2011.

Background: Elder abuse is a relatively new phenomenon that has remained a hidden and taboo subject throughout history, not only in South Africa, but globally. It is however, emerging as a growing social problem. The problem of elder abuse remains hidden behind the non disclosure of family incidents and institutional incidents (Wolf, 1992). According to Beaulieu and Blanger (1995) elder abuse is a very complex issue with diverse definitions, types and names, has been very slow to capture the public eye and public policy. It is manifested at many levels including physical, psychological, legal and social levels and requires the involvement of different types of professionals. South Africa is amongst countries with disproportionately large population of elderly adults. According to the Department of Health (2000) this situation is due to the impact of Human Immunodeficiency Virus and Acquired Immune Deficiency Syndrome pandemic on members of the younger generations which has altered the age structure of populations in severely affected countries. South Africa is one such country with KwaZulu-Natal province reported to have an extremely high incidence of the disease. A 2002 report by the World Health Organization revealed that older people were taking on new roles by providing care and financial support to orphaned children and fulfilling child-rearing roles within their extended families. Elder abuse is widespread in South Africa but the definition of abuse remains problematic. While some types of abuse fit with Western typologies, others (such as the rape of women by sons and grandsons to extort pension money, or accusations of witchcraft to seize assets) do not fit the Western typology hence an expanded typology is needed (Ferreira, v 2008). In spite of the progress that has been made in explaining how and why elder abuse occurs, it still remains a poorly understood problem. The purpose of this study was therefore to explore the types and patterns of elder abuse and the extent of the problem in a selected hospital in Durban. Research methodology: Guided by the positivist paradigm, a quantitative, descriptive and explorative design was adopted in this study. As a result, data was collected through a structured questionnaire and analyzed statistically using an SPSS package, version 15.0. The whole population of elderly patients (N=1000) in the selected setting was requested to participate in this study. A total of 150 elderly people were used as a research sample which is 10% of the population. All elderly who participated returned completed questionnaires, thus setting the response rate at 100%. Results: The results indicated that the elderly experienced physical abuse more than any type of abuse. The most common types of physical abuse experienced by the elderly included pinching, force-feeding, hitting, biting and slapping, burning, kicking, prevention from access to food and medication, prevention from access to health aids such as eyeglasses, hearing aids and restraining. The abuse was most commonly committed by close relatives, loved ones and carers. It was also found that the elderly were abused financially. It also emerged that the elderly were treated like children and were sometimes accused of witchcraft and labeled within the community as witches. Recommendations: This study recommends a multidisciplinary approach to elder care and management. Because of the growing number of elderly in our society and because they are a vulnerable group which needs special nursing care, it is recommended that the nursing curriculum should include a detailed geriatric syllabus A future qualitative study is recommended that will explore the views of elderly on abuse. Further research that would explore each type of abuse as it occurs in the community is recommended, this will add on the existing limited literature. In South Africa there are national guidelines on the prevention of elderly abuse but these are frequently not implemented to safeguard the health and well being of the elderly. It is recommended that these guidelines should be disseminated to provinces and municipalities and the implementation of guidelines should be monitored and evaluated. / Thesis (M.N.)-University of KwaZulu-Natal, Durban, 2011.

Background: Within nursing and other health professional education, clinical mentorship is an integral part of students’ clinical learning experiences. Clinical mentorship is a widely relied upon strategy to ensure that students benefits positively in the clinical placements and is perceived as not just as a support mechanism for students but also as the main vehicle for the activities associated with learning, teaching and assessment of practice. In South Africa, mentoring in the clinical settings is not yet formalized, there are no guidelines from the regulatory body to serve as a guide to mentors in clinical settings and mentors do not undergo special preparation and it is not yet a common practice in South African nursing. Purpose: This study was aimed at exploring and describing the phenomenon of clinical mentoring as perceived and experienced by the student nurses and clinical mentors in a selected hospital in Durban. Methodology: A qualitative approach guided by the naturalist interpretive paradigm was used in this study. The research designed used was a descriptive phenomenological approach. The total population for this study was 48 registered nurses working in medical and surgical wards at a selected nursing college campus in Durban, and 47 first and second year students who were doing the Diploma in Nursing (General, Psychiatry, Community) and Midwifery. The sample size consisted of eight mentors and eight mentees working at the selected wards in the selected hospital. Individual interviews were conducted to collect data. Findings: The findings revealed that mentorship in nursing education and training remains an integral part for student’s clinical learning experiences. The nature and vi quality of the relationship between the mentor and the student continues to be of vital important for an effective mentoring process. It emerged that the assistance and guidance that the clinical mentors are offering to students are most crucial for growth and the development of students and gain of quality clinical skills. While the befriending role of clinical mentors perceived as useful to facilitate students’ settling into the clinical milleu. The roles of mentors emerged as assisting, supporting, teaching, motivating, befriending and advising students. The ability to give feedback, experience, availability of time and a positive attitude were the elements considered important qualities for a good clinical mentor. The benefits of clinical mentoring outweighed the drawbacks. The benefits of mentoring were both for the student and for the mentor. For mentors, benefits were immaterial and included closer follow-up of new developments, teaching and sharing of experiences. For the students, benefits are based on the level and quality of grooming and nurturing students gets that help to bridge theory-practice gap, motivating students to be highly interested to what they do in the clinical settings. Challenges included limitations on time, shortage of resource, dual responsibilities of patient care and student teaching, high workload and lack of formalised mentoring programmes. Recommendations: This study suggests that the educational and clinical settings needs to work together to ensure that a formalised mentorship programme is put in place where clinical mentors will be trained for the role and formally appointed to the roles. Further research is suggested where the operational management staff of the organisations and academic college staff will participate to understand how mentoring is done in the clinical settings, and what criteria the clinical mentors use to measure the student performance who properly or poorly mentored. / Thesis (M.N.)-University of KwaZulu-Natal, Durban, 2011.

Background: The gap between theory and practice in nursing has long been regarded as controversial and has been a much debated subject in literature. The disparity between theory and practice in nursing education has been attributed to, among other factors, the move of nursing education from hospital-based training to higher education. Attempts to bridge the gap have been recorded in literature, including the introduction and use of problem-solving learning approaches that are regarded as reflective; learner-centred and promote lifelong learning. With this transition, there is confusion concerning the role of the nurse educator in clinical teaching which further compounds the problem of integrating theory and practice in nursing education. Nursing education in Swaziland has also experienced the transition from the hospital-based model to higher education in the late nineties. Issues regarding the competence of nurses have emerged with complaints from the local media and the general public about nursing services declining in quality. Purpose: This study was aimed at exploring and describing the perceptions of students and nurse educators regarding the integration of theory and practice in nursing education in a Higher Education Institution in Swaziland. The ways in which theory and practice integration is facilitated in this university were explored with the perceived barriers that are thought to deter the integration. Methodology: A quantitative approach was employed in this study with a total of 167 participants. Of these, 151 were students and 16 were nurse educators. Two self-administered questionnaires were developed for each group. Reliability and validity of these instruments was measured and the α-coeffient of 0.74 and 0.83 were achieved for the students' and educators' instruments respectively. Data were collected and then analysed using the SSPS package, Version 15.0. Findings: Results of this study revealed the existence of the gap between theory and practice in nursing education in Swaziland. Clinical nursing education was found to be an essential component in the training of nurses, however the role of the nurse educator in the integration of theory and practice remained contentious. It was also discovered that no clear guidelines or protocol regarding clinical supervision were available in the country, hence nurse educators conducted clinical supervision as they saw fit. Barriers to the integration of theory and practice were explored, and it was established that the lack of resources and supplies, more particularly in the practice setting stood out as the primary obstacle. It emerged from the study that problem-solving pedagogic approaches are essential in the integration of theory and practice. Furthermore, inadequate student support structures in the clinical setting also emerged as barriers coupled with poor communication and professional relations between the university and the practice settings. Recommendations: The establishment of a university hospital or a partnership with a health care institution where the value of clinical practicum for students would be enforced was one of the recommendations. Furthermore, it was suggested that the nursing department use process-based curricular approaches to teaching and learning which may enable students to be more reflective and more self-directed in their learning process. It was also suggested that the clinical skills laboratory be more self-directed, with students learning how to conduct clinical skills with minimum guidance from the facilitator. / Thesis (M.N.)-University of KwaZulu-Natal, Durban, 2011.

The World Health Organization (WHO) declared Tuberculosis (TB) to be a global emergency (Baral, Karki & Newell, 2007). In KwaZulu-Natal 5704 TB cases were registered in 2009 (KwaZulu-Natal Uthukela Health District report, 2009). According to Mak, Mo, Cheung and Woo (2006) pulmonary tuberculosis (PTB) has the longest history compared to other two types of infectious diseases which are HIV/AIDS and Severe Acute Respiratory Syndrome (SARS). The purpose of this study was to explore student nurses’ risk perceptions of contracting tuberculosis (TB) during their clinical placement in a selected KwaZulu-Natal College of Nursing campus. The researcher used quantitative descriptive exploratory design. A questionnaire with closed and open ended questions was used to collect data from the respondents. Data was analysed using the Statistical Package for Social Sciences (SPSS) version 15. One hundred and thirty-two respondents participated in the study, 66 (50%) were first year students and 66 (50%) were second year students. The majority of the respondents were females n= 93 (70, 5%). The findings of the study indicated that student nurses perceived TB as a serious disease and they perceived themselves to be susceptible to contracting the disease during clinical placement. They also displayed good knowledge of preventive measures of risk perceptions, the highest mean score was 3, 79. The Fisher’s exact test was performed to establish a relationship between the variables, and it showed that there was a relationship between age and perceived barriers, p-value was 0,039. In conclusion, the respondents displayed relevant knowledge on TB preventive measures and positive perceptions of contracting TB, which will be the predisposing factors for behavioural change. / Thesis (M.N.)-University of KwaZulu-Natal, Durban, 2010.

Faculty members in many schools of nursing have been urged to include critical thinking in all aspects of the nursing curriculum. The faculty at the Institutes of Nursing in the United Arab Emirates, have adopted in the academic year I998 a case-based curriculum that teaches nursing courses by using case studies, which represent a terrific and non-threatening method to use to teach and learn either critical thinking skills or clinical decision-making (Robinson, 1998; Glendon and Ulrich, 1992, 1997). The development of critical thinking skills in a case-based curriculum was investigated. A randomly selected, cross-sectional sample of nursing students at the Abu Dhabi Institute of Nursing (N= 88) was studied. Three groups (n=30) from each level of a three-level-diploma nursing program were measured for development of critical thinking skills using the Test of Everyday Reasoning (TER). Relationships were investigated between TER scores, the level of the program and other socio-demographic and academic achievement determinants. Critical thinking ability did not change significantly among the three levels during the educational experience in a case-based curriculum; however, the participants in the highest level of the program were able to get a higher mean TER scores from the other two levels. One of the conclusions that could be drawn from this study was that critical thinking might not change as an associated factor with a case-based curriculum at this premature phase of its implementation until some time after the graduates of this program become practicing nurses where clinical decision-making would be in action. The other conclusions focused on the necessity of unfolding the utilized cases in the curriculum and on determining whether the construct of critical thinking has been incorporated in them. / Thesis (M.Cur.)-University of Natal, Durban, 2001.

The Institutes of Nursing in the United Arab Emirates adopted a new approach for educating and training the Diploma Nursing students in 1997. This approach emphasized the use of case-based learning, which was characterized by self-directed and cooperative learning. As the students were experiencing changes in the educational setting and teaching practices it was important to determine the impact of the teaching and learning approaches on students' learning, and to describe suggestions needed for improvement. The purposes of this study were to determine the learning styles and stages of self-direction in learning for students at Abu Dhabi Institute of Nursing, and to investigate whether there was a relationship between learning style, stage of self-direction and academic performance in courses taught by the case-based method. This study was guided by Kolb's theory of Experiential Learning, and Grow's theory of the Staged Self-Directed Learning Model. Kolb's learning style inventory and a self designed tool to measure stages of self-direction were administered to 186 students, who agreed to participate in the study. The design was a descriptive correlational one, and data was analyzed by descriptive, correlation, and inferential statistics methods. The assimilator learning style was the most predominant learning style (35.5%) followed by the converger (29.6%). Accommodators and divergers had equal percentage (17%) for each. As for the stages in self-direction, most of the students rated themselves in the moderate stages of self-direction (67.2%), however, Diploma III had the higest percentage of high self-directed learners (57%). Significant relationship was found between learning styles and academic performance, where convergers and divergers scored higher than assimilators and accommodators. Also a significant relationship was found between the stage of self-direction in learning and academic performance, where students in higher stages of self-direction had higher mean scores compared to students in low and moderate stages of self-direction. / Thesis (M.Cur.)-University of Natal, Durban, 2001.