Magister Curationis - MCur / Aggressive and violent behaviour in inpatient mental health facilities is found worldwide and is a frequent and serious clinical and nursing care problem. Despite the importance of international research findings and recommendations, it appears that patients perceptions of the possible contributing factors toward aggressive and violent behaviour in mental health facilities is an area of enquiry that has not been widely explored in South Africa in general, or in the Western Cape, in particular. It is against this background that this study endeavoured to investigate the external and situational contributing to patients aggressive and violent behaviour in mental health facilities in Cape Town, as seen from patients perspectives. / South Africa

MCur / Department of Advanced Nursing Science

Bibliography: pages 299-316. / Professional staff attached to Child Welfare in Cape Town are aware of the lack of academic attainment of a large number of children in alternative care. The current research investigated the relationship between scholastic performance and neuropsychological functioning in a sample of institutionalised children from culturally deprived families. A multiple case study of 21 children, ranging in age from 6 to 16 years, comprising 10 girls and 11 boys attending the same primary school, provided data on neuropsychological, behavioural and family history dimensions. A multi-model assessment approach tapped diverse sources of evidence, including the following 5 parameters: 1) The Sensory Parameter: Snellen's Visual Acuity test, and either Merryweather & Steenkamp's or Wepman's Auditory Discrimination tests. 2) The Motor Parameter: Denckla's Revised Neurological Examination for Subtle Signs and the Purdue Pegboard fine motor speed and coordination tests. 3) The Language Parameter: The UCT Graded Reading, Speed Reading and Graded Spelling tests. 4) The Integrative Parameter: Visuographic functioning included the Beery Developmental Test of Visual-Motor Integration, the Goodenough-Harris Drawing Test and the WISC-R Mazes subtest. General intelligence was assessed using the Wechsler Intelligence Scale for Children - Revised. Memory function was gauged both by the Benton Visual Retention Test (multiple choice format) and the WISC-R Digit Span subtest. Concentration was examined by combining 3 WISC-R subtest measures (Arithmetic, Digit Span & Coding) to yield a "Freedom from Distractibility" index. 5) The Personal Parameter: This included details of the children's heights and weights, as well as information regarding their self-concepts, measured by the Attitudes Towards Self Scale, a semantic differential self-report scale, developed by Nieuwoldt & Cronje. Written responses to 2 projective techniques, which included Wish fulfilment and Incomplete sentences, provided material for content analyses that yielded insights into attitudes to a variety of topics, including school, family life, hopes and fears.

The purpose of this study was to explore the role of family members in support of their relatives who are mentally ill and to develop guidelines for the support of mentally ill relatives by their families in a rural community. The research design was qualitative, explorative, descriptive and contextual. The research population consisted of families of mentally ill relatives collecting their monthly medications at the Jane Furse Gateway Clinic. Purposive sampling was used to draw the sample. Data was collected by individual in-depth semi-structured interviews that were tape-recorded. The study revealed that families provide physical, psychosocial, financial and developmental support to their relatives. Furthermore, families are faced with frustrations when providing support to their mentally ill relatives / Health Studies / M.A. (Health Studies)

This study was undertaken to identify the biographical characteristics, attitudes and perceptions of informal family care-givers caring for patients with mental illness in Dennilton. Data were gathered from 48 care-givers by using a cross-sectional survey approach in which structured questionnaires were completed. The results revealed that a sizeable proportion of the care-givers were 60 years and older. Only 10% were employed and a quarter married, suggesting that the care burden influenced their life choices. Many care-givers were mothers or female family members. Half of the patients cared for suffered from depression. Violent, aggressive behaviour was reported as a symptom that care-givers found difficult to deal with. Less than half of the care-givers reported that the patients accepted their health situation. / Sociology / M.A. Soc.

As a social worker at the Desmond Tutu Child and Youth Care Centre in Gauteng province, the researcher noticed an increase in the number of applications for adolescents’ admission to the Centre due to a breakdown in their foster care placements. This raised a question regarding the factors contributing to this breakdown. The aim of the study was to develop an in-depth understanding of factors contributing to the breakdown of foster care placements from the perspectives of the adolescents who were fostered and from those of their foster parents. The qualitative research approach was used applying an explorative, descriptive and contextual design. Purposive sampling was used to select the participants. Data was collected using semi-structured interviews and was analysed according to the framework provided by Tesch (in Creswell, 2009:186). For data verification, Guba’s model (in Krefting (1990:214-220) was applied. Conclusions are drawn and recommendations made about foster care involving adolescents. / Social Work / M.A. (Social Work)

Dissertation submitted in fulfillment of the requirements for the Degree in Masters of Technology: Nursing, Durban University of Technology, 2011. / Background South Africa is burdened by consistently high maternal and perinatal mortality rates. In a move to alleviate this burden the South African National Department of Health (DoH) instructed the adoption of the Basic Antenatal Care (BANC) approach in all antenatal care (ANC) facilities. Whereas many facilities have begun the implementation of the BANC approach, in the eThekwini district, not all of the facilities have been successful in doing so. The study was conducted in those eThekwini Municipality Primary Health Care (PHC) facilities that have been successful in order to identify the factors influencing their success in implementing BANC. Methods The facilities that had been successful in implementing BANC were identified, followed by a review of the past records of the patients who had completed their ANC and had given birth. This was done in order to establish whether the facilities that were said to be implementing BANC, were in fact, following BANC guidelines. The factors that influenced successful implementation of BANC were identified based on information obtained from the midwives who were working in the ANC facilities that were successfully implementing BANC. The sample size was comprised of 18 PHC facilities that were successfully implementing BANC from which a total of 59 midwives were used as the study participants. Results Several positive factors that influenced successful implementation of BANC were identified. These factors included; availability and accessibility of BANC services: Policies, Guidelines and Protocol; various means of communication; a comprehensive iii package of services and the integration of services; training and in-service education; human and material resources and the support and supervision offered to the midwives by the PHC supervisors. Other factors included BANC programme supervisors’ understanding of the programme and the levels of experience of midwives involved in implementation of BANC. There were, however, certain challenges and negative factors that were identified and these included: shortage of staff; lack of cooperation from referral hospitals; lack of in-service training; problems in transporting specimens to the laboratory; lack of material resources; lack of management support and the unavailability of BANC guidelines.

Thesis (MBA)--Stellenbosch University, 2005. / ENGLISH ABSTRACT: This thesis researches World Class Manufacturing Techniques (WCMT) and their applicability in a Non-Production Environment such as an inbound call centre in the financial services sector. These WCMT involve a set of innovative techniques and principles, which are applied by foremost manufacturing companies. These techniques however, are not sacred and one always needs to refer back to the objectives of World Class Manufacturing, namely to (a) Eliminate waste, (b) Improve quality, (c) Shorten lead times, (d) Reduce costs, and (e) Improve morale and seek other improvements. The importance lies in attaining the objectives in the context of the necessary manufacturing tasks. Companies applying these techniques demonstrate significant productivity gains, production synergies, reduced rework and more reliable on-time delivery. In the highly competitive global market, these offer a competitive advantage for such companies. A critical and essential element of a company's strategic vision is a clearly defined and healthy competitive advantage. It is imperative that a company's vision is clearly aligned to its business objectives and goals. The WCMT is a tool that aligns the business vision and strategic objectives to realize its competitive advantage. By aligning the vision to its competitive advantage, it is crucial that the company challenge its existing production processes and the way in which it operates. Existing production processes need to be continuously reviewed and adjusted where necessary to sustain the competitive advantage. This paper is a practical example of how a non-production organisation can apply these WCMT to sustain its competitive advantage. The WCMT such as Theory of Constraints (TOC), Just in Time (JIT) and Total Quality Management (TQM) are discussed and applied in the inbound call centre of a medical aid administration company. In a relatively short time span, some remarkable sustainable productivity improvements were achieved. This would imply that these WCMT could be applied in traditional non-production environments. / AFRIKAANSE OPSOMMING: Hierdie navorsings werkstuk ondersoek Wêreld Klas Vervaardigings Tegnieke (WCMT) en die moontlike toepassing daarvan in 'n nie-vervaardigings omgewing, soos 'n inbeldienssentrum in die finansiële dienste sektor. Hierdie WCMT omsluit 'n groep innoverende tegnieke wat huidiglik aangewend en toegepas word in die meeste vervaardigings ondernemings. Hierdie tegnieke is nie beperk nie en verwys altyd terug na die doelstellings van WCMT naamlik (a) Vermindering van afval, (b) Verbetering van kwaliteit, (c) Verkorting van wag periodes, (d) Verlaging van kostes, en (e) Verbeterende personeel moraal en die voortdurende soeke na ander verbeteringe. Die belangrikheid van WCMT lê in die bereiking van hierdie bogenoemde doelwitte binne die konteks van die noodsaaklike vervaardigings metodes. Ondernemings wat hierdie tegnieke toepas vind groot produksiekapasiteit verbeteringe, produksie sinergie, 'n verlaging in die oordoen van foutiewe werk en ondervind ook grotendeels meer gereelde op-tyd aflewering. In die hoogs kompeterende globale mark bied die WCMT die broodnodige mededingende voordeel aan hierdie ondernemings. Die kritieke en belangrike bestanddeel van 'n onderneming se strategie en visie is die onderneming se vermoë om 'n deeglike en gesonde mededingende voordeel bo sy mededingers te hê. Dit is van kardinale belang dat die onderneming se visie behoorlik in lyn is met die onderneming se strategiese doelwitte. Hierdie WCMT is 'n instrument wat die onderneming kan aanwend ten einde sy visie en strategiese doelwitte, asook sy kompeterende voordeel, te bereik. Dit is krities belangrik dat 'n onderneming se visie en sy kompeterende doelwitte gesinkroniseer en gelykgestel is en verder dat die onderneming ook sy huidige produksie prosesse herevalueer, asook die manier waarop die onderneming opereer. Huidige produksie prosesse moet voortdurend geherevalueer en aangepas word waar nodig, ten einde die onderneming se voortdurende kompeterende voordeel te behou. Hierdie navorsings stuk is 'n voorbeeld van die praktiese toepassing van WGMT en hoe hierdie tegnieke 'n onderneming behulpsaam kan wees ten einde sy kompeterende voordeel te behou. Die WGMT soos die Teorie van Beperkings (TOC), Net Betyds (JIT) en Totale Kwaliteit Beheer (TQM) word deeglik ondersoek en bespreek. Die navorser ondersoek voorts die moontlikheid om hierdie tegnieke toe te pas in 'n in beldienssentrum by 'n administrateur van mediese fondse. In 'n relatiewe kort periode het die navorser noemenswaardige en voortdurende produksie verbetering teweeg gebring deur die toepassing van WGMT. Die navorser het afgelei dat hierdie WGMT nie net beperk is tot die vervaardigings sektor nie, maar dat dit ook in die nie-vervaardigings sektor doeltreffend aangewend kan word.

Thesis (MCur)--Stellenbosch University, 2000. / ENGLISH ABSTRACT: Against the background of the approach to make the follow up care to oncology patients more accessible and with the emphasis on quality care, it was indicated that this service needs to be evaluated. A study based on a combination of qualitative and quantitative methods (also called triangulation) was conducted to formulate structure, process and outcome standards for a comprehensive follow up care for the oncology patients and to evaluate this service according these standards. The most important results are: • The quality of care relating to the structure standards was optimal regarding the organization of the patient's visits, follow up treatment and referrals. A suboptimal standard was found regarding the general management system. • In the process standards focusing on the physical and psychosocial needs of the patient, a suboptimal standard was found regarding all aspects. Nursing practice leading to subobtimal care of patients is a major cause for concern. • With the outcome standards reflecting in patient satisfaction, positive as well as negative opinions and perceptions were found. Recommendations include: • Upgrading of management systems • Empowerment of the nurses with knowledge and scientific competencies • Attention to the opinions and perceptions of the patients to completely involve the patient in the service and treatment process. Keywords: Oncology follow up service I formulation of structure, process and outcome standards. / AFRIKAANSE OPSOMMING: Teen die agtergrond van die benadering om opvolgdienste meer toegangklik te maak vir onkologiese pasiënte, met die beklemtoning van gehaltesorg, is dit aangedui dat hierdie diens geëvalueer moes word. 'n Studie gebaseer op 'n kombinasie van kwalitatiewe en kwantitatiewe metodes (genoem triangulasie) is uitgevoer om struktuur, proses en uitkomsstandaarde vir 'n omvattende opvolgdiens aan onkologiepasiënte te formuleer en die diens aan die hand daarvan te evalueer. Die belangrikste resultate is: • Die gehalte van sorg wat verband hou met die struktuurstandaarde was net optimaal ten opsigte van die organisasie van die pasiënt se besoeke, opvolgbehandeling en verwysings. 'n Suboptimale standaard is gevind ten opsigte van die algemene bestuurstelsel. • In die prosesstandaarde wat fokus op die fisiese en psigososiale behoeftes van die pasiënt, is 'n suboptimale standaard in alle aspekte gevind. Verpleegpraktyk wat lei tot suboptimale sorg van pasiënte is 'n groot bron van kommer. • Met die uitkomsstandaarde wat reflekteer in pasiënttevredenheid is positiewe maar ook negatiewe opinies en persepsies gevind. Aanbevelings sluit in: • Verbetering van bestuurstelsels • Bemagtiging van die verpleegkundige met kennis en wetenskaplike vaardighede • Aandag aan pasiënte se opinies en persepsies ten einde die pasiënt ten volle te betrek by die hele diens en behandelingsproses. Sleutelwoorde : Onkologiese opvolgdiens / formulering van struktuurproses en uitkomsstandaarde.

Thesis (DPhil (Sociology and Social Anthropology))--University of Stellenbosch, 2009. / ENGLISH ABSTRACT: The World Health Organisation recognises intimate partner violence (IPV) to be of major consequence to women’s mental and physical health, yet in South Africa it remains a neglected area of care. Within a professional action research framework, this study implemented a previously recommended South African protocol for the screening and holistic management of IPV in women in order to test its feasibility and to adapt it for use in the primary health care (PHC) sector of the Western Cape. It also aimed to identify the current nature of care offered to female survivors of IPV. Thirdly, it aimed to learn from the process of training and supporting (nurse) researchers who were new to the action research paradigm and methodology. Successfully implementing and evaluating a complex health intervention in the current PHC scenario required a flexible methodology which could enable real engagement with, and a creative response to, the issues as they emerged. Guided by the British Medical Research Council’s framework for development and evaluation of randomised controlled trials for complex health interventions (Medical Research Council, 2000, p.3), this study was positioned within the modelling phase. Professional action research used a co-operative inquiry group process as the overarching method with the usual cycles of action, observation, reflection and planning. Altogether five co-researchers were involved in implementing the protocol and were members of the inquiry group. A number of techniques were used to observe and reflect on experience, including participant interviews, key informant interviews, focus groups with health care providers at each site, quantitative data from the medical records and protocol, field notes and academic literature. / AFRIKAANSE OPSOMMING: Die Wêreld Gesondheidsorganisasie erken dat geweldpleging in intieme verhoudings (“intimate partner violence”, of IPV) ‘n groot impak het op vroue se geestes- en fisiese gesondheid, terwyl dit ʼn verwaarloosde area van sorg in Suid-Afrika is. Binne ‘n professionele aksie-navorsingsraamwerk, implementeer hierdie studie ‘n voorheen aanbevole Suid-Afrikaanse protokol vir die sifting en holistiese hantering van IPV by vroue om die uitvoerbaarheid daarvan te toets en om dit aan te pas vir gebruik in die primêre gesondheidsorgsektor (PGS) van die Wes-Kaap. Die projek poog ook om die huidige aard van sorg wat aan vroulike oorlewendes van IPV beskikbaar is, te identifiseer. Derdens het dit ook ten doel om te leer van die proses van opleiding en ondersteuning van (verpleeg-) navorsers vir wie die aksie-navorsingsparadigma en methodologie nuut was. Suksesvolle implementering en evaluering van ‘n komplekse gesondheidsintervensie in die huidige PGS scenario vereis ‘n buigsame methodologie wat betrokkenheid met, en ‘n kreatiewe respons tot, kwessies soos wat dit ontwikkel, moontlik maak. Gelei deur die Britse Mediese Navorsingsraad se raamwerk vir die ontwikkeling en evaluering van ewekansige gekontroleerde proewe vir komplekse gesondheidsintervensies (Mediese Navorsingsraad, 2000, bl.3), was hierdie studie binne die modelleringsfase geposisioneer. Professionele aksienavorsing het ‘n gekoördineerde ondersoekgroep as die oorkoepelende metode - met die normale siklusse van aksie, waarneming, reflektering en beplanning - gebruik. Altesaam vyf mede-navorsers wat lede van die ondersoekgroep was, was betrokke in die implementering van die protokol. ‘n Aantal tegnieke is gebruik om waar te neem en te reflekteer op ervarings, insluitend deelnemersonderhoude, sleutel-informant onderhoude, fokusgroepe met gesondheidsorgverskaffers by elke fasiliteit, kwantitatiewe data van die mediese verslae en protokol, veldnotas en akademiese literatuur.