Human Immunodeficiency Virus (HIV) positive patients are at increased risk for developing mental health problems when compared with the general population. The identification and management of symptoms of mental illness in HIV-positive patients is thus crucial in reducing the risk to developing severe mental illness. The severe mental illness may lead to poor adherence to anti retro-viral drugs resulting in increased morbidity and mortality. The primary health care nurses are largely responsible for managing the treatment of HIV-positive patients as they spend the greatest degree of their time with these patients as compared to other health care professionals. Consequently it is important for primary health care nurses to identify symptoms of mental illness. However, it was unclear to the researcher, a professional psychiatric nurse, as to the level of knowledge among primary health care nurses concerning symptoms of mental illness in HIV-positive patients. Therefore, the aim of this study was to determine the knowledge of primary health care nurses regarding symptoms of mental illness in HIV-positive patients attending primary health care services. In addition, recommendations were developed for primary health care nurses for the purpose of improving their competence in the identification of symptoms of mental illness in HIV-positive patients attending primary health care services. The researcher has utilised quantitative, explorative, descriptive and contextual design. Bloom’s Taxonomy was used as a theoretical lens, to explore the primary health care nurse’s knowledge regarding symptoms of mental illness in HIV-positive patients. The study was conducted in the primary health care services situated in the Nelson Mandela Metropolitan area. The research population consisted of the primary health care nurses working with HIV-positive patients in these primary health care services. The researcher utilised census survey to recruit participants. A structured questionnaire, with 3 sections was used in this study. The necessary principles of reliability and validity were exercised to ensure research of the highest quality. The data was analysed by using descriptive and inferential statistics. All ethical considerations pertaining to beneficence, maleficence, justice, autonomy and obtaining permission from relevant structures to conduct the study were strictly adhered to.

This study explores environmental understanding among the health care practitioners serving a rural community in the Eastern Cape Province in South Africa. During the preliminary phases of the research, the decision was made to adopt a participatory approach to the inquiry as far as was possible. Semi-structured interviews, participant observation and focus group discussions were the techniques chosen to focus the participants' thinking about: the meaning of environment, environmental issues and problems which impact on health, and, environmental education in practice. Comparisons between the recently transformed health education idea proposed by the World Health Organization (WHO), known as "health promotion", and a popular environmental education model are made. It is argued that many of the obstacles to effective health education described by the participants in the study can be overcome by using environmental educationlhealth promotion approaches. The findings show that the health practitioners studied relate to a wide range of environmental issues with varying levels of engagement. They are influenced by changing values, their feelings about indigenous knowledge, and their notions about how people should respond to the environment. An urgent need for more and better communication among the different levels of health practitioners is identified. Finally, it is recommended that health care practitioners be supported with opportunities for professional development which can lead to a confident, seIfreflective approach to health education.

The shortage of skilled professionals in the health sector has been an ongoing problem. This has resulted in poor service delivery and ultimately increased patient deaths. The primary objective of this study was to develop a conceptual model to retain scarce skilled professional workers in the health sector. An exploratory study was conducted which included both professionals and non-professionals in the pathology sector. Recruitment was done from a population of 207 employees. In total 188 employees responded, of which 116 were professionals and a comparator group of 72 being the non-professionals. The study was conducted in three phases. In the first phase, quantitative data collection methods such as the job diagnostic survey, career orientation inventory, organisational commitment questionnaire and intention to quit questionnaire were used to assess the characteristics of the groups of interest. The relationship between the independent and dependent variables were calculated. The results revealed that only a few of the traditional predictors influenced retention in the professional group. The predictors worked much better for the non-professional group. It was concluded that traditional retention strategies are not suitable to retain professionals in the health sector. The second and third phases utilised qualitative methods. The second part of the study related to identifying factors which retain professional staff. Following interviews with 15 professionals, ten themes were identified which relate to the retention of professionals. The third phase of the study consisted of interviews with 3 managers, and this was to determine what the managers can do to influence retention. A retention model for the professionals was then developed. This model not only contributes to the body of knowledge, but is also a useful managerial tool to manage professionals in the health sector / Graduate School of Business Leadership (SBL) / D.B.L. (Business Leadership)

Delayed access to antenatal care (ANC) has been linked to maternal and foetal mortality and morbidity. Early and regular attendance of antenatal care by pregnant women is very important as it could identify birthing complications and includes amongst others, measuring of blood pressure to exclude pregnancy induced hypertension and measuring of weight to exclude intrauterine growth restriction. The purpose of the study was to explore the factors contributing to late antenatal booking around Thulamahashe local area so that interventions can be done to ensure that all pregnant women start antenatal care as soon as they miss a period, at twelve weeks at the most or before 20 weeks of gestation. The study was conducted at Thulamahashe local area which consists of 4 eight hour clinics and 1 twenty- four hours community health centre, at Bushbuckridge sub district, Ehlanzeni district, Mpumalanga province in South Africa. Data was collected using a researcher designed questionnaire which is a list of questions which were asked from respondents and which gave indirect measures of the variables under investigation. The structured questionnaire consisted of both open and close ended questions, which were used to collect information directly from pregnant women. The population of the study was pregnant women who had started antenatal care after 20 weeks of gestation, who were 18 years and above. The sample size consisted of 25 pregnant women who had booked late for antenatal care who were drawn from each facility by simple random sampling method and the total sample size was 127 respondents. The results indicated that most women initiated ANC later than the recommendations by World Health Organization (WHO) which is less than twelve weeks of gestation. Factors that were identified as associated with late antenatal booking were midwives’ attitude distance to the clinic, poor infrastructure, unplanned pregnancy, lack of education and unemployment. / Health Studies / M.A. (Health Studies)

The study aimed to explore and describe factors which impacted on the satisfaction of patients using the curative component of primary health care in the Ekurhuleni Metropolitan area. A qualitative, explorative and contextual design was followed in this study. Focus group interviews were used to collect data from clients, nurse clinicians and community health committee members. Findings indicated that there was lack of facilities, resources and supplies, lack of safety and security measures, negative attitudes of nurse clinicians, lack of community involvement and lack of clinic management involvement. Suggestions were made by the groups on how to improve the curative primary health care service and intervention strategies were identified from the suggestions made. The implementation of these strategies will help with the improvement of the service delivery at the clinic for primary health care. / Health Studies / (M.A. (Health Studies)

The study aimed at describing patients’ satisfaction with health care services provided in the city of Johannesburg. The research sample consisted of adult male and female patients who visited region E clinics for health services. Questionnaires were used to collect data and descriptive statistics for data analysis. Findings indicated that patients were generally satisfied with health care services provided. Recommendations included ongoing staff training to improve quality of health care and public information and education campaigns to foster community awareness and understanding of health services, develop a sense of ownership thereof, and encourage positive participation. / Health Studies / M.A. (Health studies)

Text in Afrikaans / Die huisouermodel word tans internasionaal in kinderhuise gevolg. ’n Huisouer of huisouerpaar tree as surrogaatouer(s) op en woon saam met die kinders in ’n huis in ’n gewone woonbuurt, weg van die hoofkampus van die kinderhuis. Direkte waarneming van die daaglikse funksionering van huisouers binne die huisouermodel het die navorser bewus gemaak van die kompleksiteit van die huisouer(s) se take. Die doel van hierdie navorsing was gevolglik om ’n verkennende studie te onderneem, ten einde te bepaal watter bydrae kernrolspelers kan lewer om huisouers binne die huisouermodel van ’n kinderhuis in die uitvoering van hulle take te ondersteun. Om hierdie doel te bereik is ’n kwalitatiewe navorsingstudie uitgevoer waartydens semi-gestruktureerde onderhoude met huisouers en kernrolspelers van drie satelliethuise van ’n kinderhuis, as data-insamelingsmetode benut is. Die kwalitatiewe data is geanaliseer en die bydrae wat kernrolspelers kan lewer om huisouers in die uitvoering van hulle take te ondersteun, is beskryf. / Internationally, children’s homes follow the houseparent model. A houseparent or houseparent couple act as surrogate parent(s) and live with children in a home, away from the main campus of the children’s home. Direct observation of the functioning of houseparents within the houseparent model brought awareness with regards to the complexity of houseparents’ tasks. The goal of this research was to conduct an exploratory study to determine what contribution key role players can make to support houseparents within the houseparent model with the fulfilment of their tasks. To achieve this goal, data was gathered through the application of a qualitative research study, utilising semi-structured interviews that were conducted with houseparents and key role players within three satellite homes. The qualitative data was analysed and the contribution that key role players can make to support houseparents in the fulfilment of their duties was described. / Social Work / M. Diac. (Spelterapie-rigting)

An exploratory study was undertaken of the implementation of permanency planning at a Departemental office. The purpose of the research was to determine the philosophy and the guidelines for permanency planning. A literature study with regard to the philosophy and the guidelines for the implementation of permanency planning was undertaken. Based on this a questionare was compiled and completed from data of the files of 25 children in foster care where permanecy planning have been implemented or is in the process of being implemented. Recommendations have been made for further research and for the institution where the research was done. The most important findings of the research are as follows: Permanency planning is not implimented as a purposeful strategy, but is a long drownout process. The social workers who are responsible for the implementation of permanency planning are unaware of its philosophy and general guidelines. Consequently it is implemented intuitively rather than scientifically. / 'n Eksplorerende studie is onderneem waarin die implementering van permanensiebeplanning by 'n Departementele kantoor geeksploreer is. Die doel van die navorsing was om te bepaal wat die filosofie en die riglyne vir die implimentering van permanensiebeplanning is. 'n Literatuurstudie insake die filosofie en die riglyne vir die implementering van permanensiebeplanning is onderneem. Na aanleiding hiervan is 'n vraelys opgestel en uit 25 leers van pleegkinders by wie permanensiebeplanning ge1mplimenteer is of word voltooi. Voorspruitend hieruit is aanbevelings vir verdere navorsing en vir die instansie waar die navorsing onderneem is, gemaak. Die belangrikste bevindinge van die empiriese ondersoek dui op die volgende: Permanensiebeplanning word nie doelgerig ge1mplimenteer nie, maar is 'n lang uitgerekte proses. Die maatskaplike werkers wat die permanensiebeplanning moet implimenteer is onbewus van die filosofie en algemene riglyne vir die implimentering van permanensiebeplanning en daaromword dit volgens intuisie eerder as 'n wetenskaplike proses geimplimenteer. / M.A.(Social Work)

South African nurses have accepted the challenge that was brought about by the Health Reform Policy of 1990 which opened health service centres to people of all racial and cultural groups. However, recent studies on multicultural nursing have revealed that problems have occurred when delivering care across cultural barriers. Most of these studies have approached these problems from the patients point of view, where issues of dehumanized care, labelling and discrimination have been reported. Therefore, this study was an attempt to look into these problems from the nurses point of view, by exploring the source of these problems, their effect on health care delivery and possible solutions. The researcher focussed on three critical issues, namely, lack of cultural knowledge, negative attitudes, as well as difficulty in communication. Through focus group interviews (FGI) and responses to given scenarios, student nurses who had experienced problems with culturally different patients were given a chance to reflect on their experiences, report on these experiences and recommend possible solutions to the experienced problems. The results revealed that: 1. The major source of the problems was lack of experience due to inadequate exposure to culturally diverse groups which in tum led to inappropriate decisions and actions at care delivery level. 2.Difficult perceptions and negative attitudes lead to the formation of stereotypes which block the delivery of culturally congruent care. 3 .Inability to communicate due to differences in spoken language lead to difficulty in building the trust relationship and hence inadequate care delivery. / Health Studies / M.A. (Nursing Science)

The study sought to analyse the referrals received by a psychiatric unit in a general hospital in the Western Cape by studying the referral letters and the referral responses. The study sought to determine which departments were referring patients and which patients were being referred. The completeness and appropriateness of the referrals were also studied. The major inferences drawn from this study are that health care workers have a poor concept of what information the psychiatric units needs and about the scope and function of the unit. The poor feedback from the psychiatric unit to the referral source is indicative of the poor communication amongst the health care team members. / Health Studies / M.A. (Advanced Nursing Sciences)