The purpose of this study was to determine the efficacy of infant feeding choices and support provided in the current PMTCT programme in KwaZulu-Natal. A case study format was utilised. Follow-up was done over six months with ten HIV positive women enrolled in the PMTCT programme at St. Apollinaris Hospital. Transcripts of interviews were made, pattern-matching was done, and the process of replication was used to develop a cross-case report as the final analysis of the study. All of the women decided to and intended to exclusively breastfeed for between four and six months at the time of the first interview. There was a poor rate of return for follow-up interviews, therefore the actual feeding practice of half of the women after six weeks could not be determined. The case studies were developed with the information available, and thus conclusions were reached during cross-case analysis. Decision-making ability and the capacity to overcome the barriers to the maintenance of their original feeding choice were related to the women's educational levels, employment status, financial and social circumstances and support systems, knowledge and experience of HIV/AIDS, quality of PMTCT education and support, cultural beliefs, and parenting and family values. The age of respondents and differences in marital status had no obvious correlation to maintenance of feeding choice. Parity and level of education had only a limited effect on maintenance of feeding choice. Cues to mixed feeding included a fatalistic view and a loss of hope for preventing transmission of HIV to their infants. Some of the women did not seem to believe that maintaining a specific infant feeding regime was enough to prevent transmission of HIV to their infants. Fear of stigmatisation due to disclosure of their positive HIV status led to non-disclosure of many women, and this in turn led to a lack of support for their feeding choice. Cues to exclusive feeding included an internal pressure to succeed and so decrease the chances of HIV transmission to her infant. Those women who disclosed their HIV status to a significant other and established a good support system were more likely to maintain their original decision. Although none of the women enjoyed good social circumstances, those who were more financially secure, employed, and who had a stable home environment were more likely to maintain their exclusive feeding regime. / Thesis (M.N.)-University of KwaZulu-Natal, Durban, 2004.

This was an exploratory, descriptive survey employing both qualitative and quantitative approaches. The aim of the was to explore and describe the experiences of nontraditional students enrolled in the registered nursing program in Zambia in order to facilitate an understanding of their meaning perspectives of the program. A total of 13 participants took part in the qualitative part of the survey. Qualitative data were collected by means of semi-structured interviews. The interviews were audio taped then transcribed. The data were then analysed according to categories and themes derived from respondents' statement. Unit of analysis was the whole statement. Each unit of meaning was categorized and transformed into themes that express its implicit or explicit meaning. The transformed statements were synthesized into statements of the participants' experiences. As a way of validating the results, a questionnaire was then designed from the themes of the qualitative part of the survey. The questionnaire comprised of 16 statements, to which conversion students in the other three nursing schools, which did not participate in the qualitative component, were requested to respond. The questionnaires were mailed to 55 students and the response rate was 71%. Descriptive statistics was used to anlyse the data and this was done by means of frequencies and percentage. The results of the survey have shown that participants went through transformed meaning perspective and appreciated their participation in the program. They viewed the program as providing them with new knowledge and an opportunity for personal and professional development. Technical support from teachers and clinical staff, collaborative learning, family support and availability of facilities such as the library were seen as facilitating factors to learning. The hindering factors identified were inadequate clinical supervision, lack of material resources and limited access in the library as this did not allow for search of information after working hours. / Thesis (M.N.)-University of Natal, Durban, 2004.

Substance abuse is a major problem amongst the youth worldwide. The goal of this study was to explore the knowledge and perceptions on the dangers of substance abuse among the affected youth attending St John of God Community Services, in Mzuzu, Malawi. The participants in the study were selected on the basis that they had been diagnosed as having a substance induced psychotic disorder and are currently receiving treatment from the hospital either as hospitalised or as outpatients. The study used both quantitative and qualitative research designs. The purposive sampling method was used to identify the quantitative sample while the qualitative sample was selected by using the theoretical sampling method. Forty-five participants completed the questionnaire to provide the quantitative data and 7 participants were interviewed to provide the qualitative data. The quantitative data was analysed by using Statistical Package for Social Sciences (SPSS) and the results were presented in tables and graphs. The qualitative data was analysed manually and the results were presented by using the participants' direct quotes. The findings of the study revealed that lack of knowledge and perceptions of the dangers of substance abuse are not the only contributing fac tors to substance abuse amongst the youth. As the results showed, that the youth had vast knowledge on the dangers of substance abuse and they also perceived these dangers negatively. However, it was found that other factors such as the enjoyment aspect and unemployment influenced the youth to start abusing substances. / Thesis (M.N.)-University of KwaZulu-Natal, 2005.

Introduction Patient safety IS fundamental to quality health and nursmg care and the ongomg improvement of patient safety is one of the most urgent issues facing health care today. Quality health and nursing care is a process which can be monitored, but which requires ongoing evaluation and change. The poor quality of patient care is a major problem of many hospitals in Rwanda and the University Central Hospital of Kigali, (CHUK), is no exception, especially in the Intensive Care Unit, (ICU). (Rwanda Ministry of Health Report, 2005). Pmpose of study The purpose of this study was to describe and explore the structure and processes of quality patient care at CHUK Intensive Care Unit, using the JFICM minimum standards, in order to improve the current quality of patient care and to further highlight gaps that might exist in this care for further research. Methodology The research was conducted in the Intensive Care Unit at CHUK. A checklist and self-reporting questionnaires, which were developed by the researcher, guided by the Joint Faculty ofIntensive Care Medicine (2003), constituted the instrument for this study. The sample consisted of 41 participants who were health care workers in the ICU and 20 of the patient's files. These files were used for researcher's observations during the period of data collection being 20thJune to 20th July 2008. A descriptive quantitative design was used. Results Design: While the ICU was in a self contained area with easy access to other departments the actual work environment did not comply with the recommendations of the JFICM (2003) minimum standards ofICU. ICU staffing: The staff consisted of only 1 medical doctor consultant and three specialist anesthetists. There were 11 Registered nurses (RNs) and 16 Enrolled nurses (ENs). A physiotherapist and dietician were available, but there was no biomedical engineer. The quantity of equipment was not adequate for the workload in the unit. There were no guidelines or protocols for nursing care and the unit had neither in-service training programmes nor research programmes available to the medical and nursing staff. While vital signs, ECG and oxygen were well monitored by using the nursing file (Appendix 10), the monitoring of patients was done without any guidelines or written procedures. The nursing reports, also, did not follow any guideline or procedure. Communications were generally poor because of the lack of equipment. The phone was not working for most of the time and there was no biotechnical engineer available to monitor the material and equipment. Conclusion According to the analysis of the structure and process standard based on JFICM (2003), the minimum standard of quality of ICU patient care at CHUK needs to be improved because the unit does not comply with an appropriate design, fulfil the staffing and operational requirements, or have the necessary equipment. Due to the shortage of qualified staff, plus the unavailability of protocols or guidelines, the processes of quality patient care were inadequate and need to be improved. / Thesis (M.N.)-University of KwaZulu-Natal, Durban, 2009.

AIM The purpose of the research study was to explore and to describe stereotypes associated with serious mental illness and the effects of familiarity on the serious mental illness stigma process in potential employer informants in the greater Durban area, eThekwini district, KwaZulu-Natal. Methods A quantitative non-experimental cross sectional survey relational research design was used to describe firstly, the stereotyping and individual discriminatory behavior (desire for social distance) of potential employers to a person with a SMI, and secondly, the effect of familiarity and other person variables (culture, age and gender) on the stigma components of stereotyping, emotional reaction and individual discriminatory behavior (desire for social distance). The population included potential employers of the SMI person in the greater Durban area, eThekwini District, KwaZulu-Natal. The target population was all students enrolled for a part-time management course at two academic institutions in the Durban central area. Non-randomized, non-probability purposive sampling was used. Demographic data and four self report tools were compiled into one self report questionnaire to collect data. Results The sample was evenly distributed amongst male and female within the various age groups. All cultural groups were represented but this representation was not a perfect fit with national or provincial population statistics. Just less than half of the participants (48% n=55), both genders and across all cultural groups, had intimate and or personal contact with persons with a serious mental illness. Demographic associations suggest that male participants had greater perceptions of dangerousness, unpredictability and incompetence and a greater desire for social distance. The statistical results indicated limited correlations between emotional reactions and desire for social distance, stigmatizing attitudes and desire for social distance, and evidence of no significant relationship between familiarity and other components within the stigmatizing path. Fear was associated with a desire for social distance and with perceptions of limited potential for recovery. Stigmatizing attitudes were most negative towards persons who had a previous admission to a psychiatric hospital and the least negative towards 'bipolar mood disorder'. Stigmatising attitudes were recorded for all serious mental illness labels (including that of bipolar) with 75% of participants scoring closer to the negative polar adjective of stigmatizing attitude. Conclusion and Recommendations In conclusion, the supposed lack of desire for social distance, the dependent variable in this study, may reflect political policy and current ideology but the strength of the negative stereotypes suggests that changing policy is easier than changing attitudes. It is suggested that the stigmatizing stereotype of limited potential for recovery may have more salience in developing countries such as South African than the developed western world. Limited potential for recovery has financial and emotional implication within a developing country and to this extent, desire for social distance and fear are correlated to perceptions of limited potential for recovery. Recommendations include additional research include measures of social desirability bias to clarify the relationship between familiarity, emotional reaction and social distance. Secondly, intervention studies, specifically with potential employers, are required to obtain empirical data related to the combine effectiveness of disconfirming information and contact with people with a serious mental illness. Further, that health departments actively engage in evidence based anti-stigma initiatives. Lastly it is recommended nursing curricula recognise the importance of student psychiatric nurses developing a balanced view of mental health care users assigned the serious mental illness labels through a balanced clinical exposure to recovered, as well as acutely ill mental health care users. That the new undergraduate nursing degree curricula strengthen content related to recovery and psychosocial rehabilitation, specifically nursing interventions / strategies to facilitate rehabilitation in all the areas of study, socialization, community living, and specifically in the area of work. / Thesis (MN)-University of KwaZulu-Natal, Durban, 2010.

The experiences of African women with primary infertility were explored. These women were from Durban and surrounding rural areas, in KwaZulu / Natal. The aims of the study were to describe their perception of infertility using King's (1981) Interacting Systems Model and to describe the actions they undertook in response to their problem of primary infertility. A purposive sample of the first ten consenting women with primary infertility, five from the academic hospital and five from a private gynaecological practice were selected on the day when they attended either health centre. Case studies were conducted using in-depth interviews. Women's personal, interpersonal and social systems were adversely affected by their problem of being unable to conceive. For example in the taped discussions, all ten participants had a low self-image in regard to their personal system which was reflected in all but four, when measured with Rosenberg's Self-Esteem Scale (Rosenberg, 1979). All women were found to be at various stages in the grief process, only one having attained acceptance (Kubler-Ross, 1969). Eight women were married and the remaining two were single. Four of the married participants had experienced problems with "in-laws", which has led to poor interpersonal relationships, unlike the other four married participants. Despite not being major decision-makers in the household, all the participants were allowed to make their own decisions about whom they saw in regard to infertility. All the women concerned made use of formal medical facilities but four participants made use of traditional and/or faith healers as well. Some of the problems identified were the lack of emotional support from nursing personnel as well as their own lack of understanding of causes, investigations and treatment of female infertility. Recommendations regarding effective nursing care of women with infertility and the possible formation of support groups, were made. As all the participants were literate, informative pamphlets could be developed. Areas of further research were identified. / Thesis (M.Cur.)-University of Natal, Durban, 1994.

This study examines the Professional nurses' knowledge and understanding of AIDS/HIV infection. The Professional nurses that participated in the study, are those working in a specialised institution which caters for tuberculosis and psychiatric patients, and those suffering from oesophageal and lung cancer; and the patients with orthopaedic problems. Knowledge explored is specifically related to AIDS/HIV infection, which includes the causes, mode of spread of infection, symptoms, diagnostic tests available, prevention, complications and identification of high risk groups. The sample was formed by 53 Professional nurses; 27 being those that have done the AIDS counselling course, and 26 who have not done the course. To collect data, questionnaires were sent to the participants. Apart from the questionnaires, focus group interviews (21 participants) were done to elicit any information that may not be obtained through the use of a questionnaire. The theoritical framework used is a combination of two theories, Cognitive Dissonance Theory and Fear of Contagion Theory. Cognitive Dissonance Theory assumes that people want to maintain consistency with their beliefs, attitudes, values and behaviour. People confronted with examples of their own inconsistency in these areas, will experience psychological discomfort and be motivated to eliminate the inconsistency. Fear of Contagion Theory developed as a response to perceived threat of catching the disease/infection. Three behaviours characterise this fear:- avoidance, taking extreme precautions, and verbal expression of fear regarding the disease. As a result, apart from looking at factual knowledge, one had to identify the behaviors that relate to this theoretical framework. These included fear, avoidance, taking extreme precautions and dissonance/discomfort. These areas are covered in the questionnaire as well as in the interview with the focus group. The results show high knowledge of general information, including the mode of spread. Lack of knowledge in identification of high risk groups, symptoms, diagnostic tests and use of universal precautions in specific areas was identified. Fears and dissonance are found to be caused by lack of knowledge, aggravated by the fact that the disease is incurable, as it was expressed by the focus groups. Uncertanty was marked with regard to the use of protective clothing. Some participants responded in a manner that showed the use of extreme precautions, while others were unsure in such a way that in the end they indentified different protective clothing for the similar situations. In areas where knowledge deficit was identified, it was discovered that the Trained AIDS Counsellors had better knowledge than those that have not done the course except for universal precautions. On looking at the programme it was discovered that the use of universal precautions was not included in the programme and this might be the cause for the uncertainty. The difference between the two groups might have been in the understanding gained from knowledge acquired during the counselling course, since both groups were exposed to the same enviroment, policies and circulars regarding caring for HIV infected patients. Although the results showed the numerical differences, it was surprising that in certain sections when these differences were tested statistically, no statistical difference was shown between the two groups. This might have been due to the small sample used. There are respondents that showed a negative attitude towards caring for AIDS/HIV infected patients; unfortunately no further questions were asked to explore this aspect. This is a shortfall of this study. It is clear that AIDS/HIV infection is a challenge to all professionals, since it has become one of the leading causes of death. It is then believed that nurses should be equipped with adequate knowledge so as to be able to care for those suffering from AIDS/HIV infection. In conclusion it was clear that AIDS/HIV infection is a challenge for all professionals. / Thesis (M.Cur.)-University of Natal, Durban, 1993.

In the past, clinical skills were wholly performed at bedside in which patients were used as teaching aids. The profound change in professional education and health care systems had made this teaching method less effective. Therefore clinical skills laboratory (CSL) is widely adopted as a strategy to support student development of clinical skills. However, there is little empirical evidence about perceptions of students and nurse educators engaged in day to day learning and teaching in the CSLs. This study was therefore aimed at exploring the perceptions of students and nurse educators about teaching and learning in the clinical laboratory in Kigali Health Institute in Rwanda. This study was a quantitative descriptive exploratory design. Data were collected trough the use of questionnaires. Students, nurse educators were asked to rate their views on a 5 points Likert scale about antecedents, teaching and learning strategies used in the CSL, teaching and learning process, benefits of the teaching and learning in the CSL and limitations. Three open ended questions were asked to nurse educators about the benefits of teaching and learning in the CSL, limitations and their recommendations for effective use of the CSL. A document review was done to complete data. The total number of participants who returned questionnaires in this study was 214 students and 17 nurse educators. The results of this study revealed that students and nurse educators view the teaching and learning valuable, the location of the CSC was important factor in students teaching and learning, resources were available and the CSL administration ensured smooth running of the CSL. However there was a lack of enough staff for effective teaching and learning in the CSL. The findings revealed that innovative teaching and learning strategies (demonstration, peer learning, small group, reflective learning and self directed learning) were used in the CSL. The CSL was accessed through booking and time tabled sessions and students support from nurse educators was ensured. The CSL was seen by both students and nurse educators as a learning environment which supports the linking of theory and practice, ensure students practicing skills, offer to student a safe environment to learn. However there was a gap in teaching and learning communication skills. There was limitation for teaching and learning as it is costly in staffing resources and maintenance, not clearly stated in the curriculum and KHI academic policy, time consuming for nurse educators and requires expertise from nurse educators to cope with students needs. The findings espouse many previous study findings in nursing education domain. The results reflected that the location or accessibility of the CSL, as well as the availability of material and human resources, having a CSL coordinators is critical to ensure effecting teaching and learning in the CSL, the teaching and learning process favour innovative teaching strategies, other researches in the area revealed benefits and limitation of the CSL. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2009.

The research study on "Nurses' views on which factors cause nurse absenteeism in a selected hospital, Durban, South Africa", was conducted utilizing a quantitative, non-experimental, simple survey design. The study was conducted at a provincial hospital in Durban. There were sixty nurses, which were involved in the study. The nurse study sample comprised ten Registered Nurses on day duty and ten Registered Nurses on night duty; ten Enrolled Nurses on day duty and ten Enrolled Nurses on night duty; ten Enrolled Nurse Assistants on day duty and ten Enrolled Nurse Assistants on night duty. Nurses consented to be apart of the study, following completion of the study questionnaire, The study was guided by the conceptual framework by Taunton, Hope Woods and Bott. (1995: 218). Independent variables of the nurse, nurse manager, work and organization and their associated characteristics were the main aspects of the study. These were investigated using separate methods of closed-ended and open-ended questions, to determine factors that caused absenteeism. The closed-ended questions consisted of questions to either responses of either an agree or disagree. There were open-ended, simple survey, questions. Statistical methods of A Exact Binomial Test of Significance were used to analyze the quantitative data of the closed-ended data collected. Content analysis, using a coding technique, with descriptive analysis techniques of frequency counts and frequency distributions, were utilized for data analysis for the open-ended data collected. There emerged many reasons for nurse absenteeism, employing two research designs, some of which were unknown until this research was complete and some reasons, which were known but now emphasized. Once the hospital management view upon all reasons for nurse absenteeism, there can possibly an understanding of nurse absenteeism, reducing nurse absenteeism and allowing for a better-managed workforce. / Theses--Nursing. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2009.

This study was conducted to determine the level of knowledge and perceptions of Type Two Diabetes Mellitus (T2DM) among people in Rwamagana District. A quantitative descriptive design and a cluster multistage sampling technique were used in this study. Out of a sample of 355 people, 301 voluntary participated in the study and completed the anonymous questionnaires. The response rate was 85%. The questions in the questionnaire were designed to collect socio-demographic information of the participants, their knowledge of diabetes and their perceptions of diabetes. Analysis of findings revealed that the level of knowledge of diabetes was inadequate and low among participants. Very few participants were able to answer properly the questions aimed to explore their knowledge of the meaning, signs/symptoms, causes, risk factors, management and prevention of diabetes. In addition many participants answered that they had no knowledge about any of the aspects of diabetes explored in our questionnaire. The perceptions were also poor and inadequate, especially perceptions of diabetes management at the community level and of diabetes prevention. The perceived risk of developing diabetes was low and many participants felt that behaviour change was of no importance in the prevention of diabetes, since the majority reported that they were not planning any behaviour change in the future. The findings suggest that there is a need for education campaigns in Rwamagana district to raise public knowledge about all aspects of diabetes. There is a need also to train the community health workers of this district to enable them to offer proper advice at the community level about diabetes prevention and management. The findings from this study could be used to assist in the planning of diabetes prevention and management programs in Rwamagana district. / Thesis (M.N.)-University of KwaZulu-Natal, Howard College, 2010.