The purpose of this study was to determine case managers’ understanding of their role in a managed care organisation and to develop recommendations for the improvement of case management practice. Quantitative descriptive research was conducted to explore perceptions of case managers regarding their role. A self-administered questionnaire was used as a formal data collection instrument and 25 respondents participated in the study. The findings revealed that the majority of case managers know what is expected of them in their job but that they do experience some barriers. There appears to be uncertainty with quite a number of respondents regarding certain aspects of their role. Recommendations were made for improved case management practice.

Health communication is a vital part of health care and treatment. For patients living with HIV, effective health communication is crucial. This study aimed at describing health communication from the perspective of HIV-positive patients by uncovering their experiences as they interacted with various medical staff members at Stanger Hospital. Guided by a review of various health communication models, data were collected via individual interviews and non-participant observation. The findings showed that interactive communication was favoured by all the respondents, especially communication that was patient-centred. Such communication encompassed education on how to live and cope with HIV. Obstacles to effective communication such as power differentials, lack of time and privacy at public health care clinics were identified. The study found that the different medical staff members at the clinic to various degrees addressed distinctive communication needs of HIV-positive patients. This study contributed to effectively understating the communication process as a whole. / Sociology / M.A. (Social Behaviour Studies in HIV/AIDS)

HIV/AIDS is a global challenge and its impact is evident. This places a burden on hospitals and health professionals. To ease this burden there are home-based care programmes which, through home-based caregivers, provide patients living with HIV/AIDS with physical and palliative care. However, these HBCGs face various challenges such as poverty, discrimination and stigma when caring for PALHIV, and their own emotional strain, which becomes burdensome without sufficient support from the home-based care centre. The qualitative study undertaken investigates the challenges and coping mechanisms of the HBCGs. Thirteen research participants were drawn from a centre in Mamelodi. Data was gathered through interviews and observations, categorised into themes and analysed. Major findings revealed that social challenges faced by HBCGs include poverty, stigmatisation and discrimination. Emotions experienced by HBCGs include guilt, anger, hopelessness, but they have spiritual reliance through prayer as one of their coping mechanisms. / Sociology / M.A. (Social Behaviour Studies in HIV/AIDS)

The backlog in foster care applications has been an issue in the Department of Health and Social Development, Johannesburg office, for the last number of years, resulting in foster care placement applications accumulating and families’ quality of life being affected and compromised. The service providers are inundated with high caseloads. Foster care applications could take up to a year or longer before they are processed and finalised at the Children’s Court. The aim of the study was to explore and describe the factors contributing to the foster care backlog from the service providers’ perspective and to provide suggestions to address this continuing backlog. The researcher employed a qualitative research approach and an explorative, descriptive and contextual research design. Factors such as high caseloads, lack of resources and lack of support and training from management were identified as contributing to the backlog. Recommendations made are the immediate filling of vacant posts, induction of new social workers, provision of adequate resources and infrastructure as well as the division of foster care services. / Social Work / M.A. (Mental Health)

Since 1994 a number of health reforms took place in furthering democracy. These changes included the decentralisation of Primary Health Care Services. This study is a phenomenological research that chronicles the Primary Health Care decentralisation experiences in the Bophirima District of the North-West Province. Using a descriptive phenomenological orientation, the purpose of this study was to describe the experiences of participants associated with decentralisation in the Bophirima District. Also, to illustrate how the participants perceive these experiences in relation to Primary Health Care services. Furthermore, to provide scientific evidence regarding factors related to the decentralisation of PHC services in the Bophirima District. These and other issues remain of paramount importance given the current state of health care in the South Africa. This study took place in the outskirts of the semi-rural area of Bophirima and Central District in the North-West Province. The investigation followed qualitative research design that was descriptive, exploratory, contextual and phenomenological in nature. The sampling procedure involved non-probability purposive, sampling technique with a sample size of five participants. Data was collected by using an unstructured interview technique. The modified Giorgi method of analysis was used for qualitative data analysis. These are contained in Burns and Grove (2001:596) and Polit and Beck (2004:394) are fully explicated in Chapter Four. Guba model (in Babbie & Mouton, 2001:180) was utilised to ensure the trustworthiness of the study. Ethical requirements were considered throughout and these are reflected in chapter four of the thesis.Three forms of decentralisation: deconcentration, delegation and devolution were identified in the findings. The investigation further indicated that the integration of primary health care services was also underway at the time of decentralisation. This integration triggered different psychological and emotional states amongst research participants. Most importantly, the research revealed that the interest of leadership across three spheres of government played a key role in the decentralisation of PHCs and integration of PHCs, while highlighting the importance of community participation in health service delivery (CP). In conclusion, the decentralisation process was generally perceived as empowering although, nationally, leadership needs to be strengthened to support provinces and districts regarding major policy issues such decentralisation. Key recommendations were made and further research was suggested. / Health Studies / D. Litt. et Phil. (Health Studies)

Aim: The aim of the study is to explore the perceptions of the nurses’ CPD and its contribution to quality patient care in the Gauteng province of the Republic of South Africa. Significance of the study: The significance of the study is to highlight the importance of CPD as one of the contributing factors to the quality of patient care through on-going competence. The researcher hopes the recommendations from the study may serve as a motivation to health institutions that are not actively involved in continuing professional development. Method and data analysis: Quantitative descriptive explorative design was used to achieve the objectives of the study. The study involved registered professional nurses (n =105) and enrolled nurses (n=56) employed in a state health institution. Data was collected by means of a structured questionnaire.A total of 200 questionnaire were distributed and 162 completed questionnaires were returned, giving a response rate of 162/200=81%. Statistical analysis was conducted using the SAS software version 9.3.The internal and external validity was enhanced by selecting a large homogenous sample. Ethical issues: An information leaflet indicating the key elements of the study such as the research title, the purpose of the study, voluntary participation and when to withdraw from the study was distributed to all the participants. Results: The study found that nurses participate in CPD activities to maintain their professional competence, thereby contributing to quality patient care. The findings are consistent with the findings from other studies / Health Studies / M.A. (Health Studies)

Transcultural nursing refers to the provision of nursing care to patients whose values, beliefs and life-style differ from those of the nurse. To enable nurses to honour their ethical obligation to provide quality care, they must have the necessary knowledge to nurse patients across cultural boundaries. This study was conducted to determine the nurse's knowledge of and attitudes towards the culturally different patient. A questionnaire was used to collect the data. Although nurses see it as a challenge to nurse patients from different cultures, it was found that they do not have the necessary knowledge to provide culture-sensitive care. Other factors, such as the nurse's attitude towards culturally different patients, communication problems, mistrust, prejudice and a lack of understanding of cultural uses and traditions, contribute to the lack of culture-sensitive care. The nursing profession should pay attention to these problems. / Health Studies / Van Tonder, Sally / M.A. (Nursing)

Adolescent reproductive health services (ARHS) in Gauteng Province are not meeting the reproductive health needs of adolescents. There is also no formalised adolescent/youth policy laid down to assess the quality of care given to adolescents attending these clinics although the policy is currently in the process of being finalised. The purpose of the study therefore was to critically analyse the ARHS in Gauteng Province to determine which adolescents attended the clinics, whether the clinics were accessible and available and whether they provided comprehensive care, gave information and counselling to the adolescent and whether the clinics \\·ere adolescent-friendly. Using the quality care model as the conceptual framework for the study, the following research questions were asked to determine the quality of care in terms of the adolescent's needs at these clinics: Who is the adolescent using ARHS in Gauteng Province') Are the ARHS in Gauteng Province accessible and available to adolescents? Do the ARHS in Gauteng Province provide comprehensive care to adolescents? Are adolescents receiving information and counselling from the ARHS in Gauteng Province? Are the ARHS in Gauteng Province adolescent-friendly? A quantitative cross-sectional exploratory, descriptive research design using a self-administered, researcher­ designed questionnaire was used to collect data from a 203 nonprobability convenient sample, at selected ARHS in Gauteng Province. The analysed data indicated that females in the older age group. ie 18-19 years used the ARHS more than the female adolescents in the younger age group and males. Findings also indicated that the ARHS in Gauteng Province are geographically accessible and available to adolescents. However, there appeared to be a need to extend the days and hours of functioning of the ARHS so as to make them more accessible and available to adolescents. Comprehensive care is not given to adolescents attending ARHS. Adolescent gave contradictory mformation especially with regard to the attitudes of service providers. Recommendations made include management strategies that will attract the adolescent in the younger age group and in particular the male adolescent. This necessitated that service providers at ARHS be equipped with the appropriate information given in an outcome-based format in adolescent care. / Health Studies / D. Litt. et Phil. (Advanced Nursing Science)

The scale of people being infected by HIV/AIDS (Human Immunodeficiency Virus /Acquired Immune Deficiency Syndrome) has meant that the family and the community have had to become involved in caring for the sick (Van Dyk, 2005). This has inevitably led to the emergence of informal caregivers in the form of family members caring for their relatives (Kipp, Nkosi, Laing & Jhangri, 2006). The research investigated the social learning of women caregivers looking after people living with HIV/AIDS, with emphasis on caregiving practices related to how they use traditional foods and medicinal plants. The research was undertaken in Grahamstown at the Raphael Centre and in Hamburg at Keiskkamma Health Centre and Art Project, Eastern Cape, South Africa. Data was collected using interviews, focus group discussions and diaries written by participants. The data was analyzed in two phases: the first phase involved reading the interview transcripts and collating the responses into analytical memos that were captured into broad categories, while the second phase made use of the community of practice analytical framework to further analyze the data to get better understanding of the social learning processes. This study reveals that participating in a community of practice like Raphael Centre and Keiskamma Health Centre enables caregivers to learn about caregiving. It also reveals that within these communities of practice there are varied learning processes that take place, such as observational and collaborative learning. The research also revealed that caregivers learn from the communities from which they come, for example caregivers learn about traditional food and medicinal plants which they use from their family members, friends, other caregivers as well as non governmental organizations. The research found that caregivers are influenced in their learning and practices by a number of factors which include their own experiences, ambivalent messages from different stakeholders concerned with fighting HIV/AIDS and exposure to new information. The research recommends that diverse learning processes in a community of practice and outside a community of practice should be encouraged and strengthened. It also recommends that HIV/AIDS caregiving options should be strengthened by drawing on experience and knowledge of caregivers. Caregivers should be encouraged to be selfsustaining to improve their caregiving practices. Stakeholders in the field of HIV/AIDS should be alert to and address ambivalence on use of medicinal plants. Existing programmes that enable women to learn about new information on HIV/AIDS should be strengthened.

M.A. (Social Work) / The lack of relevant therapeutic programmes suitable for pre-school children staying in children's homes became apparent whilst the researcher was working in children's homes, as well as during discussions with colleagues. The inability of the pre-school child to converse fluently leads to a continuous search for quality interventions. In an attempt to resolve this need, two therapeutic programmes namely Viola Brody (1975) Developmental Touch Therapy Programme as well as a developmental group work programme developed by the researcher are implemented in a children's home. An exploratory, evaluating study, with two groups of four pre-school children each, are conducted in a children's home. An adapted experimental design is used to compare the results of the two groups. The children's behaviour are monitored and reported on in case studies. A singlesystem design is used to arrange the data, compare the two groups with each other and to monitor individual behaviour changes. The study is an exploratory probe into the viability / workableness and effectiveness of the two interventions with pre-school children in a children's home. The objective is to establish whether the programmes can be implemented in a children's homes and whether it will lead to a change in the general functioning of the children involved. The study concluded that both programmes is viable / workable. In addition, the Developmental Touch Therapy programme prove effective in the development of self concept as well as improving their general functionality, especially in developing positive behaviour. The developmental group work programme is marginal successful in respect of developing positive behaviour but unsuccessful in developing self concept.