The aim of this study was to develop an empowerment model that could be used to enhance nurse leaders’ participation in health policy development. The study explored the extent of nurse leaders’ participation in health policy development; built consensus on: essential leadership attributes and facilitators and barriers to nurse leaders participation in health policy development. A Delphi survey was applied which included the following criteria: expert panelists, iterative rounds, statistical analysis, and consensus building. The expert panelists were purposively selected and included national nurse leaders in leadership positions at the nursing professional associations, nursing regulatory bodies, ministries of health and universities in East Africa. The study was conducted in three iterative rounds. There were 78 expert panelists invited to participate in the study, the response rate was 47% for the first round, 65% for the second round and 100% for the third round. The data collection was done with the use of semi structured (first round) and structured questionnaires (second and third rounds). Data analysis for the first round was done by examining the data for the most commonly occurring categories. The second and third rounds were quantitative and descriptive statistics were used. The consensus accepted for the second round was 90%, and for the third round consensus was 70%. The findings of the study indicate that nurse leaders participate in health policy development though participation is limited and not consistent across all the stages of health policy development. The study revealed consensus on essential leadership attributes required for nurse leaders’ participation in health policy development, including transformational attributes, political skills, interpersonal and communication skills. The facilitators to nurse leaders’ participation in health policy development pertain to: knowledge and skills, involvement, image of nursing, support, structures and processes. Whereas, the barriers relate to: involvement, image of nursing, structures and processes. An empowerment model for nurse leaders participation in health policy development was developed. Implementation of the model may lead to enhance nurse leaders participation in health policy development. / Health Studies / D. Litt. et Phil. (Health Studies)

Indiana University-Purdue University Indianapolis (IUPUI) / Caring relationships established between nurse managers and staff nurses promote positive work environments. However, research about staff nurses' perceptions of nurse manager caring behaviors is limited. A 94-item Caring Assessment Tool-Administration (CAT-adm©) was developed to measure staff nurses' perceptions of nurse managers' caring behaviors; however, it lacked robust psychometric testing. This study was undertaken to establish the CAT-adm© survey as a reliable and valid tool to measure staff nurses' perceptions of nurse managers' caring behaviors. The Quality-Caring Model® (QCM®) served as the theoretical framework. Specific aims were to 1) evaluate construct validity of the CAT-adm© survey by describing factors that account for variance in staff nurses' perceptions of nurse manager caring, 2) estimate internal consistency, and 3) conduct item reduction analysis. Four research questions were: 1) Will the factor structure of observed data fit an 8-factor solution? 2) What is the internal consistency reliability of the CAT- adm©? 3) What items can be reduced while maintaining an acceptable factor structure? and 4) What are staff nurses' perceptions of nurse manager caring behaviors? A cross-sectional descriptive design was used. A sample of 703 staff nurses from Midwestern, Midatlantic and Southern Regions of the U.S. completed the CAT-adm© survey electronically. Analysis included Confirmatory Factor Analysis (CFA), Exploratory Factor Analysis (EFA), univariate analysis, and descriptive statistics. CFA did not support an 8-factor solution. EFA supported a two-factor solution and demonstrated significant shared variance between the two factors. This shared variance supported a one-factor solution that could conceptually be labeled Caring Behaviors. Random selection reduced the scale to 25-items while maintaining a Cronbach's Alpha of .98. Using the new 25-item scale, the composite score mean of staff nurses' perceptions of nurse manager caring behaviors indicated a moderately high level of caring. Suggestions for nursing administration, nurse manager practice, leadership, education and for future research were given. The new 25-item CAT-adm© survey has acceptable reliability and validity. The 25-item CAT-adm© survey provides hospital administrators, nurse managers, and researchers with an instrument to collect valuable information about the caring behaviors used by nurse managers in relationship with staff nurses.

The purpose of this study was to describe and compare the perceptions of the registered nurses and the nurse managers regarding the role of the registered nurse in integrated primary health care. Quantitative, descriptive research was conducted to determine if there were any discrepancies between role perceptions and role expectations. Data collection was done using structured questionnaires. Two groups of respondents participated in the study. The registered nurse group (n=40) provided direct clinical care in integrated primary health care settings. The second group was composed of nurse managers (n=20) managing integrated primary health care services. The findings revealed that there are some areas where there is lack of congruence between the perceptions of registered nurses and nurse managers regarding the functions that registered nurses perform. These differences may result in confusion and role conflict among registered nurses, which can ultimately impede the attainment of integrated primary health care goals. / Advanced Nursing Sciences / M.A.(Nursing Science)

The purpose of this study was to describe and explore the organisational climate as a cause of job dissatisfaction among nursing staff in selected hospitals within Mpumalanga Province. The major objectives were to determine what organisational climate encompasses; ascertain which factors related to organisational climate can cause dissatisfaction among nurses; determine whether there is a difference in the way nursing management and the nursing staff perceive the existing organisational climate; and make recommendations for health service managers to improve the organisational climate in order facilitate greater job satisfaction among their subordinates. The descriptive exploratory survey method was used. A questionnaire with closed-ended and open-ended questions were distributed and collected from one hundred and fourty (140) respondents. The results indicated that the nursing management and the nursing staff are happy with the intrinsic factors of the job, but dissatisfied with the extrinsic factors of the organisational climate. The outcome of this research affirms that there are extrinsic factors within the work climate that affect the nursing management and the nursing staff negatively. Recommendations are made to promote job satisfaction in selected hospitals within the Mpumalanga province. / Health Studies / M.A. (Nursing Science)

In hierdie beskrywende studie is die belang van sorg in verpleegbestuur ondersoek. Die Nyberg Caring Assessment Scale (Nyberg 1989) is benut om die data in te samel. Die doel van die studie was om die sienings van verpleegbestuurders en die ervarings van verpleegkundiges betreffende sorgkonsepte te bepaal. Die data is deur middel van vraelyste by private hospitale in Pretoria ingesamel. Die data-analise het getoon dat verpleegbestuurders en verpleegkundiges sorg as belangrik in verpleegbestuur beskou. Daar is verskille betreffende die sienings van verpleegbestuurders en die ervarings van verpleegkundiges aangaande sorg in verpleegbestuur waargeneem. Dit blyk dat verpleegbestuurders en verpleegkundiges 'n behoefte aan opleiding betreffende sorg in verpleegbestuur benodig en 'n kort kursus is ontwerp om hierdie behoeftes aan te spreek / In this study the importance of caring in nursing management was researched. The Nyberg Caring Assessment Scale (Nyberg 1989) was used to collect data. The purpose of the study was to investigate viewpoints of nurse managers and experiences of nurses regarding caring concepts. The data was collected by means of questionnaires at private hospitals in Pretoria. It was clear from the data analysis that nurse managers and nurses regard caring important in nursing management. Perceptions of nurse managers and the experiences of nurses on caring in nursing management, differ. It was clear that nurse managers and nurses experience a need for training with regard to caring in nursing management and a short coarse was design to address the need / Health Studies / M.A. (Verpleegkunde)

Patient and public criticism of care in many South African public hospitals has resulted in negative media reports. The purpose of the study was to determine the effect of appointing Quality Assurance Nurse Managers (QANMs) on the provision of quality patient care in selected public hospitals of the Limpopo Province and to make recommendations where appropriate. The study was quantitative, exploratory and descriptive in nature. Data was collected by means of a self-developed questionnaire from 112 respondents, consisting of 10 QANMs and 102 Quality Assurance Team members (QAT). The response rate was 100% for the QANMs and 57% for the QAT members. The study found that most of the ten selected hospitals have a good QA foundation with a vision, mission and goals, QA programme and manual. Moreover, the appointment of the QANMs had a positive impact on the nursing care. Regarding the improvement and change in the provision of nursing care, the majority of the respondents indicated that patients’ complaints about nursing care had declined considerably; the in-service training assisted in improving nursing care, and patients were nursed in totality because of the quality guidelines in the QA manuals. However, the study found that the shortage of equipment, which interferes with the delivery of quality patient care, is a serious problem that hinders the QA programme and needs to be tackled. Recommendations were made for practice and further research. / Health Studies

Patient and public criticism of care in many South African public hospitals has resulted in negative media reports. The purpose of the study was to determine the effect of appointing Quality Assurance Nurse Managers (QANMs) on the provision of quality patient care in selected public hospitals of the Limpopo Province and to make recommendations where appropriate. The study was quantitative, exploratory and descriptive in nature. Data was collected by means of a self-developed questionnaire from 112 respondents, consisting of 10 QANMs and 102 Quality Assurance Team members (QAT). The response rate was 100% for the QANMs and 57% for the QAT members. The study found that most of the ten selected hospitals have a good QA foundation with a vision, mission and goals, QA programme and manual. Moreover, the appointment of the QANMs had a positive impact on the nursing care. Regarding the improvement and change in the provision of nursing care, the majority of the respondents indicated that patients’ complaints about nursing care had declined considerably; the in-service training assisted in improving nursing care, and patients were nursed in totality because of the quality guidelines in the QA manuals. However, the study found that the shortage of equipment, which interferes with the delivery of quality patient care, is a serious problem that hinders the QA programme and needs to be tackled. Recommendations were made for practice and further research. / Health Studies

The purpose of this study was to conduct evaluation research on the implementation of the Baby and Mother Friendly Initiative in Namibia in order to identify its successes and failures, as well as to develop guidelines for the strengthening of the programme. An evaluation research design using a sequential mixed-methods approach to collect qualitative and quantitative data was conducted. In phase 1, qualitative data were collected through face-to-face interviews. Participants were the chief health programme officer for nutrition at national level and nurse managers in charge of the baby and mother friendly hospitals. In phase 2, quantitative data were collected from 391 registered and enrolled nurses/midwives working in the baby and mother friendly hospitals through a self-administered questionnaire. Both phases 1 and 2 indicated partial implementation of the Baby and Mother Friendly Initiative programme. Factors influencing the implementation positively or negatively were identified. The integrated findings formed the basis of guidelines to strengthen the programme. Nine guidelines were developed and validated. / Health Studies / D.Litt. et Phil. (Health Studies)

The purpose of this study was to describe and compare the perceptions of the registered nurses and the nurse managers regarding the role of the registered nurse in integrated primary health care. Quantitative, descriptive research was conducted to determine if there were any discrepancies between role perceptions and role expectations. Data collection was done using structured questionnaires. Two groups of respondents participated in the study. The registered nurse group (n=40) provided direct clinical care in integrated primary health care settings. The second group was composed of nurse managers (n=20) managing integrated primary health care services. The findings revealed that there are some areas where there is lack of congruence between the perceptions of registered nurses and nurse managers regarding the functions that registered nurses perform. These differences may result in confusion and role conflict among registered nurses, which can ultimately impede the attainment of integrated primary health care goals. / Advanced Nursing Sciences / M.A.(Nursing Science)

The purpose of this study was to describe and explore the organisational climate as a cause of job dissatisfaction among nursing staff in selected hospitals within Mpumalanga Province. The major objectives were to determine what organisational climate encompasses; ascertain which factors related to organisational climate can cause dissatisfaction among nurses; determine whether there is a difference in the way nursing management and the nursing staff perceive the existing organisational climate; and make recommendations for health service managers to improve the organisational climate in order facilitate greater job satisfaction among their subordinates. The descriptive exploratory survey method was used. A questionnaire with closed-ended and open-ended questions were distributed and collected from one hundred and fourty (140) respondents. The results indicated that the nursing management and the nursing staff are happy with the intrinsic factors of the job, but dissatisfied with the extrinsic factors of the organisational climate. The outcome of this research affirms that there are extrinsic factors within the work climate that affect the nursing management and the nursing staff negatively. Recommendations are made to promote job satisfaction in selected hospitals within the Mpumalanga province. / Health Studies / M.A. (Nursing Science)