The shortage of healthcare workers and doctors in the developing world compared to the developed world is a problem, and will continue to be so, due to the continual migration of qualified professionals and the inability of the state to remedy these shortfalls. A shortage of healthcare workers and specialist doctors will seriously hamper the Government’s National Health Insurance (NHI) plan, as well as the sustainability of the private health care sector. In addition, the duration of medical training in South Africa is exceptionally long. The three major hospital groups and other private corporates have over the last number of years taken limited initiative to fund education projects in conjunction with the academic institutions. However, these projects have been poorly focused and have been managed in an unstructured and detached manner. There is a desire from the private sector to get involved in these projects on a much larger scale through more formalised structures. Given this background, the primary objective of this research is to develop a business model for medical subspecialty training to complement the current academic subspecialty training in South Africa. A trial model for training subspecialists in reproductive medicine was developed as a first attempt to address the threatening shortages and training duration. This trial programme is the basis of this research. A two-phased process was used in collecting data. In Phase 1 data was collected from stakeholder groups. The results of this survey assisted in generating variables to include in the measuring instrument for the survey in Phase 2. In Phase 2 the perceptions and expectations of sub-specialists (reproductive subspecialists and cardiologists) regarding sub-specialty training was collected. The results of the demographic variables confirm the aging profile of subspecialist and the need to ensure succession. The results further showed that cardiologists and reproductive subspecialist expectations of the training of subspecialists are very similar except for their expectations on the training duration. Reproductive subspecialist respondents agreed more than cardiology subspecialist respondents that the training duration is too long. The biggest gap between perceptions and expectations is also with the factor training. The results showed that the expectations of subspecialists are not met for training. From these results a business model for the training of medical subspecialists is proposed. This proposed business model can play a complementary role to the existing state controlled system and form the bases of Public Private Partnerships (PPP) in medical training. This proposed business model will fit a developing country were the focus is on primary healthcare, with financial and capacity constraints. The proposed model would require role players to bring about change to accommodate a larger scale Public Private Partnership (PPP) to ensure the implementation of the model. The proposed decentralised business model for training subspecialists would allow the trainee subspecialist to practise as a specialist thus maintaining an acceptable income, and enable an expedited completion and lead to a wider dissemination of medical expertise that can be delivered in a wider national foot print. It further will provide for a structured Public Private Partnership.

Thesis (MA)--University of Stellenbosch, 2002. / ENGLISH ABSTRACT: The aim of this pilot study was to do a needs analysis with a selected group of nurses with regard to the following three aspects: nurses' experiences of their involvement in termination of pregnancy (TOP) services, the effects of their involvement in TOP service provision on a personal, familial and career level, as well as their needs with regard to support. An important aspect of the needs analysis was to develop a questionnaire which can be used as basis for future research purposes. A qualitative, explorative, descriptive and contextual research design was applied in order to conduct this study. Participants were recruited from a health care facility in the Western Cape, v~ and the small sample group (seven out of a possible fifteen) consisted of a selected group of nurses who are currently involved in performing TOPs, as well as nurses involved in pre- and/or post-procedure care of patients. Each participant completed a self-administered biographical dataand semi-structured questionnaire, which was compiled specifically for the purpose of the pilot study. Specific guidelines according to previous research findings were incorporated. The results of the pilot study revealed that most of the participants experience some sort of cognitive, emotional and/or behavioural reaction before, during and after TOP procedures are performed. -Feelings of anxiety, sadness, anger, depression and guilt were reported in some cases, as well as moral-ethical conflicts. With regard to the effect on a personal, familial and career level, it was confirmed that the work has an effect on the majority of respondents' personal life and career to a certain extent, although family life did not seem te be affected significantly. The results conveyed that the majority of the nurses experienced that the impact of their work with TOPs seemed to be different from that of their other nursing duties. It was found that participating nurses are in need of some sort of support service, and that the practicality of the services which are currently provided, should be investigated further. Although the ability to generalise the results, was limited by the small research sample, valuable information was gained with regard to nurses' needs for support, as confirmed by other South African research findings. Suggestions for improvements in the questionnaire, as well as other further research possibilities, are provided. / AFRIKAANSE OPSOMMING: Die doel van hierdie loodsstudie was om 'n behoeftebepaling te doen met 'n geselekteerde groep verpleegpersoneel met betrekking tot die volgende drie aspekte: verpleegpersoneel se ervaring van hul betrokkenheid by terminasie van swangerskap (TOP) dienste, die effek van hul betrokkenheid by TOP diensvoorsiening op 'n persoonlike, gesins- en beroepsvlak, sowel as hul behoeftes met betrekking tot ondersteuning. 'n Belangrike aspek van die behoeftebepaling was om 'n vraelys saam te stel wat as basis vir toekomstige navorsingsdoeleindes sou kon dien. 'n Kwalitatiewe, eksploratiewe, beskrywende en kontekstuele navorsingsontwerp is toegepas ten einde hierdie loodsstudie uit te voer. Deelnemers is gewerf by 'n gesondheidsorgfasiliteit in die Wes-Kaap en die klein steekproef (sewe uit 'n moontlike vyftien) het bestaan uit 'n geselekteerde groep verpleegpersoneel wat tans betrokke is by die uitvoering van terminasie van swangerskappe, sowel as verpleegsters wat betrokke is in pre- en/of post-prosedurele versorging van pasiente. Elke respondent het 'n selfgeadministreerde biografiese en semi-gestrulctureerde vraelys voltooi, wat spesifiek vir die doel van die loodsstudie saamgestel is. Spesifieke riglyne op grond van vorige navorsingsbevindinge is geinkorporeer. Die resultate van die loodsstudie het aan die lig gebring dat die meeste van die respondente een of ander kognitiewe, emosionele en/of gedragsreaksie ervaar voor, tydens en na die uitvoering van TOP prosedures. Gevoelens van angs, hartseer, woede, depressie en skuld is gerapporteer in sornmige gevalle, sowel as moreel-etiese konflikte. Wat betref die effek op 'n persoonlike, gesins- en beroepsvlak, is dit ook bevestig dat die werk 'n effek blyk te he op respondente se persoonlike en beroepslewe tot 'n sekere mate, alhoewel dit geblyk het dat gesinslewe nie beduidend bemvloed word nie. Dit het ook uit die resultate van die studie geblyk dat die meerderheid van verpleegsters die impak van hul werk met TOP as anders as die van hul ander verplegingstake ervaar. Daar is bevind dat deelnemende verpleegpersoneel 'n behoefte het aan een of ander tipe ondersteuningsdiens en dat die praktiese aspekte van die dienste wat tans voorsien word, verder ondersoek behoort te word. Alhoewel die veralgemeenbaarheid van die resultate deur die klein steekproef beperk word, is waardevolle inligting bekom met betrekking tot verpleegpersoneel se behoeftes aan ondersteuning, soos bevestig deur ander Suid-Afrikaanse navorsingsbevindinge. Aanbevelings vir verbeteringe aan die vraelys, sowel as verdere navorsingsmoontlikhede word gemaak.

The system of care for persons suffering from schizophrenia is in a state of upheaval and the community in general is visibly frightened of an illness it knows little about except for the information acquired often from media reporting. Considering persons suffering from schizophrenia as holistic beings, this study explored and assessed the needs of these persons residing in the Mogoto Village, Zebediela District in the Northern Province. The primary purpose of the study was to explore and describe the holistic needs of persons suffering from schizophrenia thus facilitating the planning of care and care facilities for these individuals to enable them to function optimally in the community. To accomplish this purpose, specific objectives were formulated. A quantitative, exploratory and descriptive study based on the Nursing Theory for the Whole Person was carried out. Through purposive sampling 60 respondents were selected. A questionnaire was administered to the respondents. Data from questionnaires revealed that despite the diagnosis of schizophrenia, the respondents were still regarded as valuable members of the community by those who cared for them. There was also an indication that the needs of persons suffering from schizophrenia in the Mogoto Village did not differ from the needs of other persons in the rest of the world. Like any unique person they have specific needs. There was also an indication that mental illness is still rated low in the prioritisation of health problems, hence the lack of resources and support needed for the rehabilitation of persons suffering from schizophrenia, especially in the rural areas. / Advanced Nursing Sciences / M.A.(Nursing Science)

The system of care for persons suffering from schizophrenia is in a state of upheaval and the community in general is visibly frightened of an illness it knows little about except for the information acquired often from media reporting. Considering persons suffering from schizophrenia as holistic beings, this study explored and assessed the needs of these persons residing in the Mogoto Village, Zebediela District in the Northern Province. The primary purpose of the study was to explore and describe the holistic needs of persons suffering from schizophrenia thus facilitating the planning of care and care facilities for these individuals to enable them to function optimally in the community. To accomplish this purpose, specific objectives were formulated. A quantitative, exploratory and descriptive study based on the Nursing Theory for the Whole Person was carried out. Through purposive sampling 60 respondents were selected. A questionnaire was administered to the respondents. Data from questionnaires revealed that despite the diagnosis of schizophrenia, the respondents were still regarded as valuable members of the community by those who cared for them. There was also an indication that the needs of persons suffering from schizophrenia in the Mogoto Village did not differ from the needs of other persons in the rest of the world. Like any unique person they have specific needs. There was also an indication that mental illness is still rated low in the prioritisation of health problems, hence the lack of resources and support needed for the rehabilitation of persons suffering from schizophrenia, especially in the rural areas. / Advanced Nursing Sciences / M.A.(Nursing Science)

The purpose of the study was to describe the support services available for nurses who care for patients with human immunodeficiency virus / acquired immune-deficiency syndrome (HIV/AIDS) in Pretoria urban pubic hospitals. Problems faced by nurses in HIV/AIDS care support preferences were also investigated. The study was conducted between March and April 2003, using a descriptive design. Respondents comprised eighty-seven (87) nurses who were conveniently selected from five (5) hospitals. Results reveal that support available is inadequate in both quality and coverage of nurses. Other significant findings are inadequate job preparation, shortage of nurses and that nurses prefer to receive support from both within and outside the hospital. It has been recommended that management should work with nurses to design support interventions that match the identified problems/needs. Nurses need to take an active role in caring for themselves and more in-service training opportunities need to be created for nurses. / Health Studies / MA (Health Studies)

The purpose of the study was to describe the support services available for nurses who care for patients with human immunodeficiency virus / acquired immune-deficiency syndrome (HIV/AIDS) in Pretoria urban pubic hospitals. Problems faced by nurses in HIV/AIDS care support preferences were also investigated. The study was conducted between March and April 2003, using a descriptive design. Respondents comprised eighty-seven (87) nurses who were conveniently selected from five (5) hospitals. Results reveal that support available is inadequate in both quality and coverage of nurses. Other significant findings are inadequate job preparation, shortage of nurses and that nurses prefer to receive support from both within and outside the hospital. It has been recommended that management should work with nurses to design support interventions that match the identified problems/needs. Nurses need to take an active role in caring for themselves and more in-service training opportunities need to be created for nurses. / Health Studies / MA (Health Studies)

The system of care for persons suffering from mental retardation is in a state of upheaval. Considering the mentally handicapped as holistic beings, this study explored and assessed the needs of those residing in the community of District 22 (sub-district 222), KwaZulu-Natal, thus facilitating the planning of care and care facilities for these individuals to enable them to function optimally in the community. To accomplish this purpose, specific objectives were formulated. A quantitative, exploratory and descriptive study based on Maslow's hierarchy of needs theory was carried out, using 167 respondents. The study revealed that despite being mentally retarded, they were still regarded as valuable members of the community, their needs did not differ from the needs of others in the rest of the world and that mental retardation is still rated low in the prioritization of health problems, hence the lack of resources and support needed for the rehabilitation of such persons. / Health Studies / M.A. (Health Studies)

This study is a need assessment for the establishment of an HIV and AIDS support group within the South African Police Services (SAPS), Head Office Divisions and the purpose was to explore the extent to which an HIV and AIDS support group was needed for HIV and AIDS-infected and affected personnel within the South African Police Services (SAPS). The SAPS employees as well as HIV and AIDS programme managers participated in the study. A combination of quantitative and qualitative data was used in the study. The former was obtained from a survey of 90 SAPS personnel based at the SAPS Head Office Divisions in Pretoria. The latter, on the other hand, was obtained from in-depth interviews with five SAPS HIV and AIDS programme managers, also based at Head Office Divisions in Pretoria.The overall results showed that an internal workplace HIV and AIDS support group for infected and affected employees was seen as necessary to deal with the psycho-social and emotional needs of the personnel. The study participants were generally of the view that such a support group would go a long way in addressing some of the challenges and obstacles – such as stigma, discrimination, judgement and so forth – faced by HIV and AIDS-infected and faced employees within the SAPS. In general, it was envisaged that a workplace support group would create a warm and caring environment that would enable employees to feel safe and supported by their colleagues – including commanders and managers – in dealing with their HIV and AIDS situations. / Health Studies / M.A. (Social Behaviour Studies in HIV and AIDS)

Text in Afrikaans / Summaries in Afrikaans and English / Hierdie verhandeling beskryf 'n taalkonstruktivistiese benadering tot die behoeftebepalingsproses in gemeenskapswerk. Taalkonstruktivisme vorm dee! van konstruktivisme. Taalkonstruktivisme word verduidelik in terme van 'n aantal beginsels en hoe dit toegepas kan word op die behoeftebepalingsfase. Dit fokus op die volgende: - Die belangrikheid van taal en betekenis in die gemeenskapswerker se eie denke en interpretasies van 'n gemeenskap se behoeftes. - Die belangrikheid van taal en betekenis en die verbalisering van 'n gemeenskap se behoeftes. - Die versigtigheid waarmee die kommunikasieproses met 'n gemeenskap benader moet word. - Die skep van idees wat in taal plaasvind en ook verander kan word wanneer daar behoeftebepaling in 'n gemeenskap gedoen word. Hierdie beskrywing van die taalkonstruktivistiese beginsels vind plaas aan die hand van 'n gevallestudie vanuit die navorser se praktiese werk wat uitgevoer is as gedeeltelike vereiste ter vervulling van die Meestersgraad. Dit beklemtoon die implikasies van die toepassing van taalkonstruktivisme op gemeenskapswerk. / This dissertation describes a language constructivist approach to the phase of needs assessment in community work. Language constructivism is part of constructivism. Language constructivism is explained in terms of certain principles and how they can be applied to needs assessment. The focus is on the following: - The part language performs in the community worker's own thoughts and interpretations of a community's needs. - The importance of language and meaning when a community verbalises its needs. - The care with which the communication process with a community should be approached. - The creation of ideas which can take place and change in language when a community's needs are being assessed. This description of the principles of language constructivism is done according to a case study of the researcher's practical work which was done as part of the requirements in fulfillment of the Master's degree. It emphasizes the application of language constructivism to community work. / Social work / M.A. (Social Sciences)

This study is a need assessment for the establishment of an HIV and AIDS support group within the South African Police Services (SAPS), Head Office Divisions and the purpose was to explore the extent to which an HIV and AIDS support group was needed for HIV and AIDS-infected and affected personnel within the South African Police Services (SAPS). The SAPS employees as well as HIV and AIDS programme managers participated in the study. A combination of quantitative and qualitative data was used in the study. The former was obtained from a survey of 90 SAPS personnel based at the SAPS Head Office Divisions in Pretoria. The latter, on the other hand, was obtained from in-depth interviews with five SAPS HIV and AIDS programme managers, also based at Head Office Divisions in Pretoria.The overall results showed that an internal workplace HIV and AIDS support group for infected and affected employees was seen as necessary to deal with the psycho-social and emotional needs of the personnel. The study participants were generally of the view that such a support group would go a long way in addressing some of the challenges and obstacles – such as stigma, discrimination, judgement and so forth – faced by HIV and AIDS-infected and faced employees within the SAPS. In general, it was envisaged that a workplace support group would create a warm and caring environment that would enable employees to feel safe and supported by their colleagues – including commanders and managers – in dealing with their HIV and AIDS situations. / Health Studies / M.A. (Social Behaviour Studies in HIV and AIDS)