Assessment of clinical learning is imperative in order to ensure that those who become registered nurses are safe and competent practitioners. Assessment of clinical skills requires evaluation of the development of appropriate knowledge, skills and attitudes. Literature however reveals that the measurement of clinical skills performance continues to pose a challenge for nurse educators, the debate around the best assessment method in clinical learning, as well as, validity and reliability in assessing clinical learning is ongoing. This study was therefore aimed at exploring and describing current practices in assessment of clinical learning in a nursing diploma programme in Kigali Health Institute in Rwanda. The study was a quantitative descriptive exploratory design. Data were collected through the use of questionnaires. Nurse educators, students and external examiners were asked to report on the assessment strategies commonly used in Kigali Health Institute, their views about assessment strategies, and the strengths and weaknesses of clinical assessment strategies used in a nursing diploma programme in assessing practical competences of nursing students. The total number of participants who returned questionnaires in this study was 117. The results of this study revealed the commonly used assessment strategies included OSCEs (100%), case presentations (66%), direct observations (38%), standardized patients (31 %) and reflective diaries (2%). Furthermore, assessments were based on clinical learning outcomes. Assessments were conducted formatively and summatively to ensure validity in assessments and to ensure that a variety of clinical learning areas were assessed. Although there was no documented structured process of conducting clinical assessments, the findings revealed that the process included a number of phases; planning, preparation, implementation and evaluation phases. There were measures in place to ensure validity and reliability in assessments. The need for a policy on clinical learning assessment emerged so as to serve as a guide to ensure consistency in conducting assessments. The need to build the capacity of nurse educators and external examiners also came up as very few had educational preparation for their roles. Most of them were specialists in the discipline not in nursing education. The findings also revealed that not all nurse educators were involved in decision making regarding clinical assessments for quality assurance purposes. Issues such as welcoming of students on the assessment day, giving of instructions to students, time spent on performing tasks, feedback to students, returning to tasks which were not completed and improvising during assessments due to limited resources emerged as areas of concern. Recommendations made are related to the assessment process, the building of capacity of nurse educators and external examiners, preparation of students for clinical learning assessment, and further research for the in-depth exploration of this area. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2007.

A study was done to examine factors that facilitate adherence to haemodialysis therapy amongst patients with chronic renal failure and the sources of support available to them. A self developed questionnaire was used to collect data from the respondents. The respondents were purposive and conveniently selected according to the set criteria. The sample consisted of 118 respondents that were selected from four hospitals, two provincial hospitals and two private hospitals. Permission to conduct the study was requested by means of written letters to all people concerned. Letters granting permission were obtained from the two provincial hospitals. The Heads of the Renal Units of the two private hospitals gave verbal permission. Data was analyzed using the Statistical Package for the Social Sciences (SPSS 11.5). Demographic data was analysed through frequency counts. Crosstabulations using Chi-square analysis was performed to test the relationship between the factors that facilitate adherence to haemodialysis therapy and the indicators for adherence. The results were presented in the form of Tables and Figures (Graphs). From the findings the researcher concluded that in order for a haemodialysis patient to adhere to therapy restrictions, the following should be adequate: physical factors, socio-economic factors, psychosocial factors which also encompasses cultural factors. Health education proved to be having a very good impact. Higher level of education is not that essential as long as the patient can read, write and understand the instructions. Religious factors did not have much effect on facilitation of adherence to haemodialysis therapy. / Thesis (M.A.)-University of KwaZulu- Natal, Durban, 2004.

The aim of the study was to discover, describe and analyze factors related to the perceived acceptance of male nurses in the practice of midwifery in the Seychelles as perceived by nurses, pregnant women and their partners. A descriptive study using the qualitative approach was used. Theoretical sampling was employed and thirty-four participants comprising nurses, pregnant women and their partners were interviewed using an interview guide. Probing was done throughout. The nurses, the pregnant women and their partners were interviewed both in focus groups and individually. Participants taking part in individual interview were different from those taking part in focus group interview. The focus groups were homogeneous comprising professional nurses and consumers of service (pregnant women and their husbands) respectively. The findings revealed multitude of factors associated with the perceived acceptance of males in the practice of midwifery. These were classified as positive, negative and ambivalent. The major positive themes were unconditional acceptance, conditional acceptance, and equitable treatment, by all three groups of informants while traditional belief was the major negative theme. Other positive themes by the nurses were change of attitudes over time, and males as caring professionals, while for pregnant women; it was viewed as prior acceptance of male obstetrician. Both the nurses and partners saw the intimate nature of midwifery as a negative factor while only the nurses identified fear of competition and religious belief. Lack of trust was another negative factor identified by the partners/husbands. Professionals and the husbands identified societal versus individual readiness as an ambivalent factor while the pregnant women and professionals saw conditional acceptance as an ambivalent factor. Recommendations made from this study have implications for nursing research, nursing practice, and nursing education. The study could also be helpful for decision makers at different levels in the health care system. / Thesis (M.Cur.)-University of Natal, Durban, 2001.

Purpose: The of this study was to explore the knowledge, level of practice, and the frequency of problems met during the use of CTSS amongst intensive care unit (ICU) nurses and suggest ways to improve the use of the system. Design: A non experimental exploratory design using a descriptive survey approach was employed. Sample: The sample of participants were taken from three governmental hospitals in Abu Dhabi chosen randomly. It included all nurses in the ICUs of three hospitals who happened to be working at the time of the study. The response was Eighty three staff nurses, three charge nurses, and one respiratory therapist. Instrument: A questionnaire consisting of twenty one questions was used to explore the ICU nurses' knowledge, experience, practice, and difficulties met by nurses. Averages, tables, figures, and correlation coefficient were used to analyze the data. Results: Results showed a positive correlation (+0.0433) between the level of knowledge and length of use of the system but the effect is minimal. Again the knowledge and the frequency of use on ventilated patients were minimally positive (+0.0898). On the other hand, the relation between the frequency of use and the years of experience was more positively related than the frequency of use and the knowledge. Conclusion: There is a need to set a plan aiming at making the system more frequently used. Not only that , but it should be used safely and appropriately and supported by policy and procedure guidelines. / Thesis (M.Cur.)-University of Natal, Durban, 2001.

It has been suggested that a unique feature of some mental health nurses' work is exposure through their role as therapists to clients' descriptions of, and reactions to, trauma, and that these experiences may actually indirectly cause distress and traumatization to the nurse. This proposed phenomenon has been termed "secondary traumatic stress" and is the focus of the current study. Aim: The aim of this study was to explore secondary traumatic stress experienced by nurses working in mental health services in Rwanda. Methods: The research was conducted in Ndera Psychiatric Hospital. The questionnaire consisted of items of the Trauma Attachment Belief Scale (T ABS), demographic characteristics of participants, personal trauma history, work related aspects and support systems. A convenient sampling of 50 nurses who provide a mental health care to trauma survivors and mentally ill patients in the Ndera Psychiatric Hospital was adopted. Results: Results of the study indicate that there is belief disruption in the respondents. The mean scores of most of the respondents were high in all areas of cognitive believe. Of the respondents, 98% (n=49) had T -score of 80 for other-safety which was extremely high. The nurses identified the psychiatric nurses and a psychiatrist as their main support systems in dealing with secondary traumatic stress and generally believed in the usefulness of supervision. Conclusion: In summary, this study expanded on knowledge into the effects of secondary traumatization, particularly with concern to mental health clinicians, a population often ignored. This study was considered to be a contribution to trauma literature as it provides much needed empirical evidence. / Thesis (M.Cur.)-University of KwaZulu-Natal, Durban, 2008.

The purpose of this qualitative study was to explore how psychiatric nurses working with psychiatric clients in the EThekwini District understand the spiritual dimension of holistic psychiatric nursing practice. Descriptive phenomenology informed the study design, data collection and analysis. Integrating spiritual and psychiatric care is an important contemporary issue for psychiatric nursing if the profession is to continue to define itself as a holistic and client-centered activity and to provide socially responsive care (Greasley et al 2001; Mohr, 2006). Local data about how nurses understand and practice spirituality in their working encounters with clients would be an important first step in enhancing holistic, patient-centered psychiatric nursing care in the South African context. Purposeful sampling was used to select the seven psychiatric nurses working in psychiatric settings in the EThekwini District. These participants were selected from the advanced psychiatric nursing classes of the School of Nursing of the University of KwaZulu-Natal for 2008/2009 and 2009/2010. Data were collected through in-depth interviews lasting for 45minutes to lhour and were audio-taped and later transcribed to facilitate easy analysis. The Colaizzi Method of data analysis and representation was utilized. The following four themes emerged during the analysis of the data. Each theme had between three and twenty one associated significant statements. Theme 1 revolved around the higher power of spirituality, religion and their relationship. The participants conceptualized spirituality in a variety of ways, linking spirituality to religion and to cultural values, daily moral and interpersonal experiences with self and others that provide direction and meaning in life. Spirituality was conceived of as "the glue that brings people together" and as a primary source of meaning making in daily life that provides people, nurses and patients with a sense of belonging and of joy, hope, and comfort in both difficult and happy times. The second theme "Central to but forgotten in psychiatric nursing practice" concurs with the literature view that spirituality and psychiatric nursing care are related, although spirituality is often forgotten in psychiatric nursing practice. Participants linked spirituality specifically to Maslow's Hierarchy of needs. The third theme entitled "Psychiatric nursing for the spirit: Enabling and limiting factors identifies a number of factors which influence how psychiatric nurses engage with this dimension of holistic psychiatric nursing practice. This theme focuses on factors which influence psychiatric nurses in providing spiritual care for their patients. Enabling factors include psychiatric' nurses own spiritual orientation and knowledge about spiritual care enables them to provide spiritual care whereas limiting factors include the lack of spiritual education and spiritual knowledge in providing this care. The final theme highlights what these nurses see as important for developing their ability to provide spiritual assistance and includes education in method of spiritual assessment and intervention as the basis for providing holistic psychiatric nursing practice. A number of recommendations for psychiatric nursing practice, education, research and policy-making based on the data from the study were made to relevant stakeholders. If accepted and implemented will go a long way in augmenting psychiatric nursing intervention to be holistic wherein psychiatric nursing care will include not only the biological, psychological and social care but also the spiritual care. / Thesis (MN)-University of KwaZulu-Natal, Durban, 2010.

Thesis (MCur)--Stellenbosch University, 2011. / ENGLISH ABSTRACT: Understanding the incidence and prevalence of HIV/AIDS is important in addressing the ongoing epidemic. Understanding which factors influence the rate of transmission of the virus is critical in attempting to contain and ultimately eradicate the disease. Determining which factors influence a person’s decision to disclose his/her positive status to others, particularly the sexual partner, is essential in understanding this complex process and thereby improving disclosure rates. The aim of the study was to investigate which factors influence the disclosure of someone’s HIV positive status. The objectives were to determine whether aspects such as socio-demographic factors, stigma and discrimination, religion, culture, fear of abandonment and rejection as well as knowledge of the disease influences disclosure rates. These objectives were met through an in-depth descriptive correlational research design with a quantitative approach. The target population (N = 1200/100%) consisted of all the HIV infected clients who attended a Community Health Clinic (CHC) for HIV management in the Cape Metropolitan area. The convenience sampling method was used to select the sample of participants (n = 150/12.5%) who met the criteria and voluntarily agreed to participate in the study. A self-administered questionnaire was used consisting of mainly closed-ended questions, with a limited number of open-ended questions. Ethics approval for the study was obtained from the Health Research Ethics Committee at the Faculty of Health Sciences, Stellenbosch University. Permission was obtained from the City of Cape Town: City Health, to conduct the research. Informed consent was obtained from each participant. Reliability and validity were supported by a pilot study which was conducted on (n=15/10%) of participants at this CHC to assure the feasibility of the study. The data was analysed with the support of a statistician and was presented with histograms and frequency tables. Statistical associations were determined between the various variables. The qualitative data obtained from the open-ended questions were grouped in trends and analysed thematically and then these trends were quantified. The results show that there are numerous factors which influenced HIV status disclosure. The fear of stigmatisation was identified as a factor which influences HIV disclosure to others, especially among the male participants. The results revealed that this was the major reason for delayed or non-disclosure, as well as the fear of rejection and blame. The results showed that awareness of the sexual partner’s HIV status remained relatively low (n = 64/43%), with awareness of the partner’s status highest among married participants. The recommendations were to assure that HIV positive individuals have access to support groups and are given an opportunity to attend multiple counselling sessions. Community based initiatives are needed to reduce stigmatisation of individuals with HIV and to improve access to social support systems. It was concluded that disclosure is a multifaceted process and one particular factor does not necessarily influence disclosure of a HIV positive status but most often a combination of factors. / AFRIKAANSE OPSOMMING: Dit is belangrik om die verspreiding en voorkoms van MIV/VIGS te verstaan om die gesprek rondom die voortdurende epidemie aan te roer. Kennis van watter faktore die snelheid beïnvloed waarteen die virus oorgedra word, is krities in ’n poging om dit onder beheer te hou en uiteindelik uit te wis. Om te bepaal watter faktore ’n mens se besluit beïnvloed om jou positiewe status van MIV aan andere bekend te maak, veral aan ’n seksuele maat, is dit belangrik om die kompleksiteit van die proses te begryp en sodoende die pas van bekendmaking te verbeter. Die doel van die studie is om te bepaal watter faktore beïnvloed die bekendmaking van ’n MIV positiewe status. Die doelwitte is om vas te stel of aspekte soos sosio-demografiese faktore, stigma en diskriminasie, godsdiens, kultuur, vrees vir verlating en verwerping en kennis van die siekte, die insidensie van bekendmaking beïnvloed. ’n Beskrywende korrelatiewe navorsingsontwerp met ’n kwantitatiewe benadering is toegepas. Die teikengroep (N=1200/100%) het bestaan uit al die MIV geïnfekteerde persone wat ’n Gemeenskapgesondheidskliniek vir die bestuur van MIV in die Kaapse Metropolitaanse area besoek het. Die gerieflikheidssteekproef metode is gebruik om die steekproef van deelnemers (n=150/12.5%) te kies wat vrywillig ingestem het om aan die kriteria vir die studie te voldoen. ’n Self-geadministreerde vraelys was gebruik wat hoofsaaklik uit geslote vrae met ’n beperkte aantal ope vrae bestaan. Etiese goedkeuring vir die studie is verkry van die Gesondheidsnavorsing se Etiese Komitee by die Fakulteit van Gesondheidswetenskappe, Universiteit van Stellenbosch. Toestemming is verkry van die stad Kaapstad: Stad Gesondheid, om die navorsing uit te voer. Ingeligte toestemming is van die deelnemers verkry. Betroubaarheid en geldigheid is ondersteun deur ’n loodsstudie wat op (n=15/10%) van die deelnemers beoefen is by die Gemeenskapsgesondheidkliniek om die uitvoerbaarheid van die studie te verseker.Die data is geanaliseer met die ondersteuning van ’n statistikus en is deur histogramme en frekwensie-tabelle voorgestel. Statistiese assosiasies is vasgestel tussen die verskeie veranderlikes. Die kwalitatiewe data is geneem vanuit ope vrae wat gegroepeer is in neigings en tematies geanaliseer is en die neigings is hierna gekwantifiseer. Die uitslae bewys dat daar heelwat faktore is wat die bekendmaking van MIV statusstatus beïnvloed. Die vrees vir stigmatisering is geïdentifiseer as ’n faktor met betrekking tot die bekendmaking van MIV aan andere, veral onder die manlike deelnemers. Die uitslae bewys dat dit die hoofrede vir terughoudendheid of nie-bekendmaking van die siekte is, asook die vrees vir ververwerping en blaam. Die resultate bewys dat die bewustheid van die seksuele maat se MIV statusstatus relatief laag bly (n=64/43%) met bewustheid van die maat se status die hoogste onder getroude deelnemers. Die aanbevelings is om te verseker dat MIV positiewe individue toegang het tot ondersteuningsgroepe en dat hulle geleentheid gegee word om veelvuldige voorligtingsessies by te woon. Gemeenskapgebaseerde inisiatiewe is nodig om stigmatisering van individue met MIV te verminder en vir die verbetering van toegang tot maatskaplike ondersteuningsisteme. Ter samevatting kan die gevolgtrekking gemaak word, dat; die bekend making van MIV positiewe status word nie noodwendig beïnvloed deur ʼn spesifieke faktor of meervlakkige besluitnemings proses nie, maar eerder deur ʼn kombinasie van faktore.

Thesis (MCur)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: The researcher has identified in her place of work that the multicultural views and work experience of the staff negatively impacts on optimal team coherence and patient care. Given the pivotal role that teamwork plays in an OR, it is required of the peri-operative (PO) nurses working in a Middle Eastern hospital, to develop a high cultural sensitivity and awareness of each other's values. The goal of the study through the hermeneutic inquiry was to identify the PO participants’ meanings of their perceptions and experiences within a multicultural workforce in the OR environment. A phenomenological interpretative research design was used to illuminate the phenomenon of team coherence and to answer the question, “What are the perceptions and experiences of a multicultural PO nursing team in a Middle Eastern hospital.” A purposive sample of n=13 was drawn from a population of 107 PO nurses. A semi-structured interview guide was designed and validated before data collection. Ethical approval and permission to conduct the research was obtained from the Ethics Committee at the Faculty of Health Sciences, University of Stellenbosch and the Institutional Review Board of the Hospital. The data that emerged from the data analysis was coded and categorized into themes and constitute patterns. The four patterns were multiculturalism within PO nurse teams contributes to complex group dynamics; the pervasive influence of the medical model and power struggle on group cohesion; dominance renders the PO nurses powerless; and empowerment is the panacea to improving team communication. The researcher compiled a written account of the interpretations that emerged from the data analysis and verified it with an external research reviewer. In, addition, member checking was done on two (2) of the participants from the individual interviews to validate the transcribed data. The Conceptual Theoretical Framework of Habermas on Critical Social Theory and Freire’s model of Oppressed Group Behavior supports the findings of the study. The findings suggest that cultural values clarification should change the behavior of the PO nurses and team building activities should enhance group cohesion. Policies on disruptive behavior will create an awareness to illuminate fear and reiterate selfworth. However, empowerment through education, reflection in action and active communication was to liberate powerless PO nurses in a multicultural environment. The pervasive influence of the medical model can be overcome with strong leadership. Furthermore, culturally sensitive leadership might be essential to sustain a supportive and growth producing culture. Further research is recommended. / AFRIKAANSE OPSOMMING: In die navorsers' werksarea het sy geindentifiseer dat die multikultirele uitkyk en werkservaring van die personeel optimale span koheise en pasientsorg negatief beinvloed. Gegee die deurslaggewende rol wat spanwerk in die operasiesaal speel, word dit van die teater verpleegkundiges in n hospitaal in die Midde Ooste verwag om n hoe kulturele sensitiwiteit te kweek. Die doel van die studie, deur hermeneutiese navraag, was om die persepsies en ervaringe van multikulturele PO verpleegkundiges in die operasiesaal te identifiseer. n Kwalitatiewe benadering met n fenomenologiese interpreterende navorsingsonderwerp was toegepas om die fenomenoom van span kohesie te illumineer deur die vraag te beantwoord, " Wat is die persepsies en ervaringe van 'n multikulturele PO verpleegspan in a hospitaal in die Midde Ooste". n Doelbewuste steekproef van n=13 is geneem vanuit n totale bevolking van 107 teater verpleegkundiges. n Semi-gestruktureerde onderhoudsgids was ontwerp en geldig verklaarg voor die insameling van data. Etiese goedkeuring vir die studie was verkry van die Etiese Komitee van die Fakultiet van Gesondheidswetenskappe, Stellenbosch Universiteit. Goedkeuring om die navorsing te doen, was verkry van die IRB, en toestemming was op skrif geplaas. Die data wat voortspruit uit die analise, was geenkodeer en gekategoriseer in temas en omvattende patrone. Die vier (4) pattrone was, multikulturalisme dra by tot komplekse groep dinamika te midde van die teater verpleegkundiges; die persewerende invloed van die mediese model en onderlinge struweling op groeps kohesie; dominering veroorsaak weerlose teater verpleegkundiges; en bemagtiging is die redding om komminuksie in die span te bewerkstellig. Die navorser het n geskrewe verslag saamgestel van die weergawe van die data analise en is deur n eksterne navorsingskundige geverifieer. Bykomend is kontrole van lede van twee (2) van die deelnemers vanuit die individuele onderhoude gedoen, om die getransskribeerde data se geldigheid te verklaar. Die Konseptuele Teoretiese Raamwerk van Habermas se Kritiese Sosiale Teorie en Freire se model van onderdrukte groeps gedrag het die bevinding van hierdie studie gerigsteun. Die bevindinge beveel aan dat kulturele waarde uitklaring gedrag sal verander, en spanbou aktiwiteite groeps kohesie sal bewerkstellig. Die opstel van beleide wat ontwrigte gedrag identifiseer om sodoende 'n bewustheid te kweek wat vrees verminder en selfwaardigheid herstel. Bemagtiging, deur onderrig, refleksie in aksie en aktiewe kommunikasie was as sleutel elemente aangewys om weerlose PO verpleegkunidiges werksaam in die multikulturele omgewing, te bevry. Die aanhoudende invloed van die mediese model kan oorkom word deur sterk leierskap. Voorts mag kulturele sensitiewe leierskap essentiel wees om n ondersteunende, produserende en groeiende kultueer te bewerkstellig. Verdere navorsing word aanbeveel.

Thesis (MCur (Nursing Science))--University of Stellenbosch, 2010. / Thesis presented in partial fulfilment of the requirements for the degree of Master of Nursing at Stellenbosch University / ENGLISH ABSTRACT: The trend towards specialisation in nursing has resulted in the development of the role of the Clinical Nurse Specialist (CNS) since the 1960s and 1970s in North America and the United Kingdom respectively. A Clinical Nurse Specialist should demonstrate excellent skills in leadership, communication, critical thinking, clinical and collaborative ethical decision-making, as well as mentoring. Research done internationally has shown that advanced practice nursing leads to higher patient satisfaction and compliance, fewer hospitalisations and shorter length of stays. The development of the CNS role in SA is slow in implementation. The South African Qualifications Authority has only recently published qualification rules for a master’s certificate and master’s degree in Nursing for advanced specialist nurses in SA. This situation led to the following research question: What is the expected role of the Critical Care Clinical Nurse Specialist in private hospitals in the northern and southern suburbs of the Cape Peninsula, South Africa? A non-experimental, explorative, descriptive study with a quantitative orientation was conducted in eight private hospitals in the Cape Peninsula. Through non-probability sampling 73 critical care health professionals (critical care professional nurses, clinical nurse specialists, nursing managers, unit managers, nurse educators, clinical facilitators, clinical coordinators and doctors) out of a population of 170 critical care health professionals participated in the study. A survey tool was designed and validated to collect the data. Quantitative data was analysed through Statistica® and qualitative data was analysed thematically. It was found that 81% of the participants agreed that Clinical Nurse Specialists should be appointed in the South African critical care environment as soon as possible to improve patient outcomes, to contribute to safer nursing care, to relieve work stress of shift leaders and bedside nurses and to improve the professional status of nursing. It is recommended that greater awareness regarding the Clinical Nurse Specialist should be developed. The relevant educational requirements should be finalised and a clear job description should be compiled. Nursing managers should appoint Clinical Nurse Specialists in each critical care unit as soon as possible. / AFRIKAANSE OPSOMMING: Die rol van die Kliniese Verpleegspesialis het as uitvloeisel van spesialisering in verpleging sedert 1960 en 1970 in Noord-Amerika en Groot-Brittanje onderskeidelik ontwikkel. `n Kliniese Verpleegspesialis behoort die volgende eienskappe te openbaar: uitmuntende vaardighede met betrekking tot leierskap, kommunikasie, kritiese denke, kliniese en etiese besluitneming en mentorskap. Internasionale navorsing het aangetoon dat gevorderde verpleegkunde tot `n hoër vlak van pasiënttevredenheid en nakoming van behandelingsvoorskrifte, minder hospitalisasie en korter hospitaalverblyf aanleiding gee. Die ontwikkeling van die rol van die Kliniese Verpleegspesialis in Suid- Afrika geskied langsaam. Die Suid-Afrikaanse Kwalifikasie-Outoriteit (SAKO) het eers onlangs die reëls vir `n meestersertifikaat en meestersgraad in Verpleegkunde vir gevorderde spesialisverpleegkundiges gepubliseer. Hierdie situasie het tot die onderstaande navorsingsvraag aanleiding gegee: Wat is die verwagte rol van die Kritiekesorg- Kliniese Verpleegspesialis in privaathospitale in die noordelike en suidelike voorstede van die Kaapse Skiereiland, Suid-Afrika? `n Nie-eksperimentele, beskrywende studie met `n kwantitatiewe benadering is in agt hospitale in die Kaapse Skiereiland onderneem. Deur nie-waarskynlikheids-, toevallige steekproefneming is 73 professionele betrokkenes by kritiekesorggesondheid (professionele kritiekesorgverpleegkundiges, kliniese verpleegspesialiste, verpleegbestuurders, eenheidsbestuurders, opvoeders in verpleegkunde, kliniese fasiliteerders, kliniese koördineerders en dokters) uit `n populasie van 170 professionele betrokkenes by kritiekesorggesondheid in die studie ingesluit. `n Vraelys is ontwerp en gevalideer vir die insameling van data. Kwantitatiewe data is deur middel van Statistica® ontleed terwyl die kwalitatiewe data tematies ontleed is. Daar is gevind dat die meerderheid van die deelnemers saamgestem het dat Kliniese Verpleegspesialiste so gou moontlik in die kritiekesorgomgewing in Suid-Afrika aangestel behoort te word. Die Kliniese Verpleegspesialis dra by om pasiëntuitkomste te verbeter, om tot veiliger verpleegsorg by te dra, om werkspanning van skofleiers en verpleegsters te help verlig en om die professionele status van verpleging te verbeter. Daar word aanbeveel dat daar groter bewusmaking aangaande die Kliniese Verpleegspesialis moet wees. Vereistes vir opleiding behoort gefinaliseer te word en `n duidelike werksbeskrywing moet opgestel word. Verpleegbestuurders behoort Kliniese Verpleegspesialiste so gou moontlik in die kritiekesorgomgewing aan te stel.

Thesis (MCur (Interdisciplinary Health Sciences. Nursing Science))--University of Stellenbosch, 2010. / ENGLISH ABSTRACT: Workplace violence in health care is a worldwide phenomenon. In nursing, the nature of workplace violence is predominantly non-physical in nature. Literature reveals the devastating consequences for the individual nurse, both physically and / or emotionally, depending on the nature of the violence. The consequences for the organisation / institution and the profession are equally devastating, manifesting in reduced standards of patient care and increased attrition from the profession. The pervasiveness of this problem indicates that to date, remedial and protective measures have been unsuccessful. However, most of the research done on workplace violence in nursing has been conducted amongst qualified nurses. The purpose of this study was to investigate the extent of workplace violence, targeting student nurses in clinical areas. The setting was the Western Cape College of Nursing and the population was second, third and fourth-year, pre-registration students. The research objectives addressed various aspects, for example, type, prevalence, perpetrators, consequences and management of workplace violence. A quantitative research design, utilising a survey, was chosen for the study. A probability sample of n = 255 students was selected, using stratified, random sampling as the sampling method. The variables selected for stratification were gender and year of study. A self reported, anonymous questionnaire, guided by the literature review and by the research objectives, was utilised for data generation. Summary statistics were used to describe the variables, whilst distributions of variables were presented in the form of histograms and frequency tables. Where appropriate, the relationships between demographic and research variables were described, using suitable statistical analyses. The findings revealed that the perpetration of non-physical violence against student nurses is widespread, particularly that perpetrated by co-workers, more specifically registered, staff- and assistant nurses. The under reporting of workplace violence was a common finding. Student nurses suffer grave emotional consequences as a result of workplace violence. Almost half of the respondents admitted that they had considered leaving nursing due to workplace violence and that it had negatively affected their standard of patient care. The overall conclusion was that, in accordance with a worldwide trend amongst all categories of nurses, student nurses are targets of workplace violence in the clinical areas. These findings have particular implications for the management of nursing education institutions. The fact that student nurses are targeted to the extent revealed in this study indicates that existing preventive measures in the clinical areas have not been effective. The recommendations arising from this study therefore focus on equipping the vulnerable trainee with the tools to withstand workplace violence. As such, the recommendations are directed at the management of the nursing education institution, to create awareness around the problem, to empower students to confront and cope with workplace violence and to support students traumatised by workplace violence. Finally, this study suggests avenues for further research, for example, research in the same setting after implementation of the recommendations, or further research into the dynamics of workplace violence, targeting student nurses from the perspective of qualified nursing staff or patients. / AFRIKAANSE OPSOMMING: Geweld in die gesondheidsdienste werksplek is ‘n wêreldwye verskynsel. In verpleging is geweld in die werksplek oorwegend nie-fisies van aard. Die literatuur wys op die ingrypende fisiese en / of emosionele gevolge vir die individuele verpleegkundige, afhangend van die aard van die geweld. Die gevolge vir die organisasie of instelling, asook vir die verpleegberoep, is eweneens ingrypend en manifesteer in verlaagde standaarde in pasiëntsorg en ‘n toename in verpleegkundiges wat die beroep verlaat. Die algemene verskynsel van die problem dui aan dat regstellende en beskermende maatreëls tot dusver onsuksesvol was. Die meeste navorsing oor geweld in verpleging is egter tot dusver onder gekwalifiseerde verpleegkundiges gedoen. Die doel van hierdie studie was om die omvang van werksplek-geweld, met studenteverpleegkundiges as teikengroep, in die kliniese areas na te vors. Die studie is by die Wes-Kaap Kollege van Verpleging uitgevoer en die populasie was al die tweede, derde en vierde-jaar, voor-registrasie studente. Die geformuleerde navorsingsdoelwitte vir die studie het verskeie aspekte aangespreek, soos byvoorbeeld, tipe, frekwensie, die uitvoerders van geweld, gevolge en die hantering van werksplek-geweld. ‘n Kwantitatiewe navorsingsontwerp, met gebruikmaking van ’n opname, is vir die studie geselekteer. ‘n Waarskynlikheidsteekproef van n = 255 studente is deur middel van gestratifiseerde, ewekansige steekproefneming geselekteer. Geslag en jaar van studie was as die veranderlikes vir stratifikasie gekies. Die instrument vir data-insameling was ‘n self-voltooide vraelys, gebaseer op die literatuurstudie en gerig deur die navorsingsdoelwitte. Opsommende statistieke is aangewend om die veranderlikes te beskryf, terwyl die verspreidings van veranderlikes in die vorm van histogramme of frekwensie-tabelle aangebied is. Waar toepaslik, is die verhoudings tussen demografiese en navorsingsveranderlikes met behulp van toepaslike statistiese analises beskryf. Die bevindinge het onthul dat die pleeg van nie-fisiese geweld teenoor studenteverpleegkundiges algemeen voorkom, veral daardie deur mede-personeel, meer spesifiek geregistreerde, staf– en assistent verpleegundiges. Die onderrapportering van werksplek-geweld was ‘n algemene bevinding. Studenteverpleegkundiges ly aan erge emosionele gevolge, as gevolg van werksplek-geweld. Byna die helfte van die respondente het erken dat hulle oorweeg het om die beroep te verlaat en dat sodanige geweld hul standaard van pasiëntsorg negatief beinvloed het. Die oorkoepelende gevolgtrekking was dat studenteverpleegkundiges, in ooreenstemming met ‘n wêreldwye neiging onder alle kategorieë van verpleegkundiges, die teiken van werksplek-geweld in die kliniese areas is. Hierdie bevindinge hou spesifieke implikasies vir die bestuur van verpleegonderriginrigtings in. Die feit dat studenteverpleegkundiges tot die mate, soos in die studie onthul, geteiken word, het aangetoon dat bestaande voorkomende maatreëls in die kliniese areas oneffektief is. Die voorstelle vanuit hierdie studie is dus daarop gerig om die ontvanklike nuweling toe te rus om werksplek-geweld teë te staan. As sulks is die voorstelle gemik op die bestuur van die verpleegonderrig-inrigting, om bewustheid rondom die probleem te skep, om studente te bemagtig om geweld te konfronteer en te hanteer, en om studente, wat as gevolg van werksplek-geweld getraumatiseer is, te ondersteun. Laastens word moontlikhede vir verdere navorsing voorgestel, soos byvoorbeeld, navorsing in dieselfde omgewing na die implementering van die voorstelle, of verdere navorsing in die dinamika van werksplek-geweld teenoor studenteverpleegkundiges, vanuit die perspektief van gekwalifiseerde verpleegpersoneel of pasiënte.