Thesis (MPH) -- University of Limpopo, 2010. / Background Namibia is one of the country most affected by HIV/AIDS epidemic in the world and in Sub¬Sahara Africa with an adult prevalence of 19,7 %, and 210.000 people estimated to be living with HIV/AIDS at the end of 2003. The Caprivi region adult prevalence in adult pregnant wom~n is estimated at 43%. The health care services are overstrained with patients and home-based care (HBC) is seen a possible solution. The scale up of HBC and expansion of coverage to patients has lessened the burden of public hospitals to deal with all these chronically ill patients. The challenges that volunteers are facing impact in the quality of care people living with HIV I AIDS receive. Objectives This study assessed the utilization of home-based care service, knowledge and perception of People living with HIV and AIDS (PL WHA) toward home-based care services. The views of volunteers towards home-based care service are also reported. Methods This is a qualitative study that utilized Focus Group Discussions (FGDs) for the home-based care-givers and in-depth interview with the clients accessing antiretroviral treatment at Katima State Hospital. A total of four focus group discussions were organized with care-givers comprising 31 adult participants (15 males and 16 females) and 18 in-depth interviews were conducted with the people living with HIV and AIDS accessing antiretroviral treatment (ART) at Katima State Hospital. All FGDs were tape recorded and one-to-one interview was hand written. Result The study demonstrates that most of the participants have positive attitudes toward utilization of HBC service. However, few people are still afraid to disclose their health status. In general, the community participation has tremendously reduced stigmatization. The self-reported health status by the HBC givers in order to have access to nutrition support may have played a role in reducing the stigma associated with HIV and thus increased the number of people utilizing the HBC service. The HIV -positive participants valued the assistance received from the volunteers and volunteers appreciate the training received to enable them to undertake their duties with more confidence. The dress code of volunteers when visiting patients was perceived to disclose HIV status but did not influence patient attitude to access the service. Conclusion The improvement in community knowledge about HIV and HBC service has enhanced the positive attitude toward utilization of home-based care service which has consequently reduced the stigma associated with HIV. Advocacy is required to improve the working condition of volunteer care-givers home-based care by policy markers. The collaboration between different stakeholders will advance and sustain the HBC service in focusing on prevention of HIV infection.

Thesis (M Med (Family Medicine)) -- University of Limpopo, 2010. / Background: Many patients move from one healthcare provider to another, disturbing the continuity of holistic patient care. Objectives: The aim of this study is; to investigate the reasons why patients leave their nearest clinic, and to determine if these patients are able to use the provided care when they need to. Methods: A cross-sectional, quantitative study was conducted during the winter of 2010. Questionnaires were given to 350 patients attending Karen Park Clinic. Patients completed the questionnaires in the presence of the researcher, who was able to assist where needed. Variables addressed in the questionnaire included: place where they stay; if they visited their nearest clinic; what services there are at their nearest clinic; would they go back to their nearest clinic and if not, what would be the reasons. Results: The majority of respondents stayed in Soshanguve, 153 (43.7%), Mabopane 92(26.3%)Garankuwa, 29(8.3%)and Hebron 20(5.7%), Most ofthe respondents were females 271(77.4%), with 177 (50.6%)aged between 26 and45years. Eighty percent of patients indicated that they visited their nearest clinic and 191(54.6%) said that they will not return to that clinic. The reasons for not returning to the nearest clinic were: - no medication, 39(11.1%); long queues, 59(16.9%); rude staff, 59(16.9%); long waiting time to be helped, 88(25.1%) and other, 63(18.0%). Conclusion: The researcher found that many patients, who first attended their nearest clinic, opted not to return. Reducing long waiting times and long queues at a primary health care centre can be achieved. Satisfied health care providers would provide quality service to patients. Training courses for management committee members could lead to improving the health center's management and patients could be redirected to their nearest clinic by giving them referrals or transfer letters. Purchasing enough medicine will reduce the problem of no medication and increase the capability of the health center. Staff should receive training about health care practices, to reduce the rude behaviors that drive patients away.

Thesis (M Med (Family Medicine)) -- University of Limpopo,2011.

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No description available.

No description available.

The current literature suggests one of the challenges of nursing today is to meet the health care needs of the growing older population, people over the age of 65. Quality of nursing is important for acutely ill older people who are the largest group of patients in terms of hospital admissions. The ageing population is a major focus for social and economic planners and policy makers. There is an increasing need for health systems to change their focus to more closely assess strategies used to manage the acutely ill older hospital population. The main aim of this study was to improve the quality of nursing care for older, acutely ill, hospitalised medical patients. The study used a mixed method triangulated approach that utilised quantitative and qualitative methods to survey perceived needs of older patients, their family members/carers and the nursing staff, in the process of developing, implementing and evaluating a new model of care using a participatory action research (PAR) process. There were three specific objectives. The first was to evaluate which aspects of nursing care were considered most important for older patients during acute hospitalisation from the perspective of older patients, their family members/carers and their nurses. The second was to develop and implement a model of care that addressed the identified nursing care needs and priorities of older patients through the PAR process. The third was to determine whether employing a PAR process, the chosen model of care addressed the identified nursing care needs and priorities and resulted in increased patient satisfaction and improved health care for older patients. This study demonstrated the implementation of a PAR process to motivate nursing staff, utilising an evidence-based model of care approach, resulted in changes to clinical nursing practice that impacted positively on older patients’ and nursing staff’s satisfaction with care provided, patient knowledge and final health outcomes. It is recommended that the findings of this study be applied to develop guidelines for acutely hospitalised medical patients, particularly for issues relating to educational sessions to increase the patient’s functional activities and knowledge levels of their medication regimes prior to discharge. / Master of Health Science (Hons)

In today’s hectic society, opportunities to receive pastoral care and to participate in relevant adult or continuing education are greatly valued by organisational employees. For the police community in the English-speaking world, police chaplains have emerged as a group of professionals in police organisations providing specialised pastoral care and associated education to their constituents. As a relatively new community of practitioners, little is known about the emergence of this group in terms of its needs for learning, education and support and processes of acquisition of knowledge and skills. Major purposes of this study were to explicate the learning engaged in by police chaplains to become a professional practitioner and to project the role for future sustainability for all stakeholders. This is the first doctoral thesis to examine the development and practice of police chaplaincy in New South Wales (Australia), New Zealand and the United Kingdom. It was argued that neither police chaplains themselves nor the police communities they serve understand the potential of the role and implications for future learning and performance of that role. Prior to this study, there were no strategies in place to assess consequences of change, to address work-related problems or to determine future training. Consequently, this study explored how police chaplains perform their role so they could better justify the value of their roles for multiple stakeholders and make suitable professional development plans and strategies to improve services, address work-related problems adequately and respond appropriately to social changes. In order to understand and articulate the experiences of police chaplains, a reflective analysis was provided of the work of practising police chaplains in New South Wales, Australia, and a comparative study of police chaplains in New Zealand and the United Kingdom. The qualitative research design was interpretive and used ethnography and autoethnography as methodologies. The researcher is a police chaplain herself and is a current member of this professional group in New South Wales and was for a period of time in New Zealand. Four key objectives guided the inquiry and were addressed in determining an explanatory framework in the literature review and in the findings and discussion chapters. The first objective was to investigate the nature of the professional police chaplain. The findings suggested that police chaplains were male or female, ordained or lay, highly educated and pastoral and have a passion for policing. They are professional in nature from their qualifications as a minister, practising professionalism in their role as minister and chaplain and behaving appropriately as a professional. It was discovered in this study that because police chaplains largely act alone they have developed four distinct ‘walking styles’ of having a presence and performing their role in a police station or other venues. The second objective to explicate the nature of police chaplaincy culture focused on kinship among police chaplains and incorporated notions of community of practice, culture and identity. The findings showed that kinship was a useful explanatory concept for analysing the culture of police chaplaincy. It became evident in the study that learning, belonging, connecting, participating and knowing were essential in the police chaplain’s role in complex and diverse communities of practice and various community and organisational cultures that influenced their identities as a minister, chaplain and pastoral carer. The third objective was to identify the major challenges faced by police chaplains. The findings indicated that police chaplains consistently faced challenges in representing the spiritual to police, managing their time, finding best practices, being credible and understanding others relationally as well as attending critical incidents in their ongoing honorary position. Senior Chaplains played an important role providing the support and training that police chaplains require for their ongoing practice while mentors and/or spouses also provided necessary time to listen to the police chaplain’s challenging day. The fourth objective was to examine the professional development and training of police chaplains. The findings revealed that training offered to the honorary police chaplain was minimal and did not meet the police chaplains’ needs. Strategies including a program of continuing professional education have been suggested to enhance training and development for the future of police chaplaincy. Police chaplains interviewed for this research have given a broad range of perspectives making this exploratory study a significant contribution towards capturing the culture of police chaplaincy for the first time. This exposition of the work of police chaplains contributes to setting future directions for police chaplaincy practice and research enabling a better service for police officers and staff of police services worldwide.

This project investigated the subjective perceptions of family reported by people who have experienced long-term foster care. Foster care involves removal from their biological family of children deemed to be in need of care, and their placement in alternative homes. Foster children may spend varying amounts of time in care, and may have multiple caretakers. The research began with three broad questions: Who do people who have experienced long-term foster care think of as their family? How close do they feel to them? How would they like their family to be? Two exploratory studies were conducted. In Study 1, 43 children in long-term family foster care (CFFC participants) aged between 8 and 15, who had been in care for more than one year, and 42 matched controls, completed the Kvebaek Family Sculpture Technique (KFST). They chose figures to represent family members and placed them on a chess board, using the squares to indicate emotional closeness or distance from each figure. A representation of their �ideal� family was also obtained. Most CFFC participants nominated their foster family as their family, and few changed their ideal representation. In Study 2, 39 adults aged between 19 and 65 (AFCC participants), who had been in either family foster care or cottage homes for at least one year, and a comparison group of 39 matched controls, completed the KFST according to perceptions of family now, as children, and an ideal family. An in-depth, semi structured interview on perceptions of family followed. For the majority of AFCC participants, connections to foster family when they were children had dissipated over time. Nevertheless, about half of the AFCC participants were still strongly and positively attached to one set of foster parents. The major determinant of attachment to foster parents appeared to be a nurturing environment, while a non-nurturing environment was the most prominent feature of failure to attach to foster parents. Visiting by biological parents contributed to continued attachment to them, however, relationships with biological parents were reported as ambivalent, distant, and unsupportive. Foster care participants appeared similar to those in other studies, however, the two samples were small, and may not be representative in terms of ideas about family membership. Caution is necessary in any attempt to generalise from the findings to a wider foster care population. Implications for theory, policy, and clinical applications are discussed, and suggestions made for further research.

In today’s hectic society, opportunities to receive pastoral care and to participate in relevant adult or continuing education are greatly valued by organisational employees. For the police community in the English-speaking world, police chaplains have emerged as a group of professionals in police organisations providing specialised pastoral care and associated education to their constituents. As a relatively new community of practitioners, little is known about the emergence of this group in terms of its needs for learning, education and support and processes of acquisition of knowledge and skills. Major purposes of this study were to explicate the learning engaged in by police chaplains to become a professional practitioner and to project the role for future sustainability for all stakeholders. This is the first doctoral thesis to examine the development and practice of police chaplaincy in New South Wales (Australia), New Zealand and the United Kingdom. It was argued that neither police chaplains themselves nor the police communities they serve understand the potential of the role and implications for future learning and performance of that role. Prior to this study, there were no strategies in place to assess consequences of change, to address work-related problems or to determine future training. Consequently, this study explored how police chaplains perform their role so they could better justify the value of their roles for multiple stakeholders and make suitable professional development plans and strategies to improve services, address work-related problems adequately and respond appropriately to social changes. In order to understand and articulate the experiences of police chaplains, a reflective analysis was provided of the work of practising police chaplains in New South Wales, Australia, and a comparative study of police chaplains in New Zealand and the United Kingdom. The qualitative research design was interpretive and used ethnography and autoethnography as methodologies. The researcher is a police chaplain herself and is a current member of this professional group in New South Wales and was for a period of time in New Zealand. Four key objectives guided the inquiry and were addressed in determining an explanatory framework in the literature review and in the findings and discussion chapters. The first objective was to investigate the nature of the professional police chaplain. The findings suggested that police chaplains were male or female, ordained or lay, highly educated and pastoral and have a passion for policing. They are professional in nature from their qualifications as a minister, practising professionalism in their role as minister and chaplain and behaving appropriately as a professional. It was discovered in this study that because police chaplains largely act alone they have developed four distinct ‘walking styles’ of having a presence and performing their role in a police station or other venues. The second objective to explicate the nature of police chaplaincy culture focused on kinship among police chaplains and incorporated notions of community of practice, culture and identity. The findings showed that kinship was a useful explanatory concept for analysing the culture of police chaplaincy. It became evident in the study that learning, belonging, connecting, participating and knowing were essential in the police chaplain’s role in complex and diverse communities of practice and various community and organisational cultures that influenced their identities as a minister, chaplain and pastoral carer. The third objective was to identify the major challenges faced by police chaplains. The findings indicated that police chaplains consistently faced challenges in representing the spiritual to police, managing their time, finding best practices, being credible and understanding others relationally as well as attending critical incidents in their ongoing honorary position. Senior Chaplains played an important role providing the support and training that police chaplains require for their ongoing practice while mentors and/or spouses also provided necessary time to listen to the police chaplain’s challenging day. The fourth objective was to examine the professional development and training of police chaplains. The findings revealed that training offered to the honorary police chaplain was minimal and did not meet the police chaplains’ needs. Strategies including a program of continuing professional education have been suggested to enhance training and development for the future of police chaplaincy. Police chaplains interviewed for this research have given a broad range of perspectives making this exploratory study a significant contribution towards capturing the culture of police chaplaincy for the first time. This exposition of the work of police chaplains contributes to setting future directions for police chaplaincy practice and research enabling a better service for police officers and staff of police services worldwide.