Philosophiae Doctor - PhD / Midwives play a critical role in the care of pregnant women from the first antenatal visit, through to the delivery and the postpartum period. The education of midwives has however become a concern, not only in South Africa but in many countries for a multitude of reasons. Evidence suggests that South Africa is devoted to reducing the maternal mortality rates as reflected in the Negotiated Service Delivery Agreement, signed in 2010, which identifies reductions in maternal and child/neonatal mortality rates as key strategic outcomes for the South African Health sector. However, by 2015 the set Millennium Development goals, specifically goal 4 (to reduce child mortality) and 5 (to improve maternal health) were not met and were replaced by Sustainable Development Goals, specifically goal 3 (to ensure healthy lives and promote wellbeing for all at all stages). This lag in meeting the indicators for improving the health of the population is associated in some respects to the education and training of health professionals.

Masters of Public Health - see Magister Public Health / Background: There is evidence that nurses are leaving their profession to seek better working environments and high salaried professions worldwide. This increases the scarcity of skilled nurses in health systems. In Mozambique, nursing staff is increasingly pursuing education out of nursing, which means that they intent to leave the nursing career. Aim: To find out why so many nurses are pursuing education out of nursing: Objectives, to explore: (1) nurses’ experiences of working at the Maputo Central Hospital; (2) the links between nurses’ future education outside of nursing and their job satisfaction; (3) the links between nurses’ future education, their job satisfaction and their intention to leave the profession, and (4) nurses’ and key informants’ opinions on which factors would improve nurse retention at MCH. Study Design: Exploratory qualitative Study. Methods: Focus Group Discussion with nurses and in-depth interviews with key informants, in order to explore perceptions regarding factors influencing nurses’ to pursue education out of nursing. Analysis: The content of focus group discussion and all interviews were recorded, transcribed, coded and analyzed by identifying recurring themes. Ethics: The author was aware that this study would raise sensitive topics in nurses’ lives, and he took great care to be alert and responsive to ethical issues which might arise. Thus, all nurses and key informants participated in the study voluntarily. They were provided with a letter explaining the research purpose, requesting their participation and assuring them of confidentiality and anonymity, and they were asked to sign a consent form which was explained to them in detail. The study was presented to, and approved by the Ethics Committee of the University of the Western Cape. Results: Study results revealed job dis-satisfaction and its essential components as the main factors influencing nurse’s intention to quit their profession. Further, the issue of nursing image and status were found to be most important factors contributing to nurses’ future education in other courses rather than nursing. Conclusions: Findings from this research are relatively consistent with previous studies in terms of identifying common factors that influence nurses’ decisions to quit nursing and pursue other professions, and also worrying as nursing is immersed in deep trouble because many nurses are quitting, and the current prevailing nurse image and status is not attractive for replacements, what will impact negatively on health care delivery. Relevance of study: It is expected that this study will contribute to the implementation of appropriate measures to improve nurses’ working experience at the Maputo Central Hospital, meantime, encouraging their retention. / World Health Organization

The delivery of quality care has been a priority for the health care industry in the United States. Researchers have established positive correlations between the levels of emotional intelligence of registered nurses and their clinical performances. However, new evidence suggests the need to enhance the use of emotional intelligence (EI) in high-risk clinical units. With the intent to understand the use of EI, a phenomenological research approach was used to identify the emergency room nurse's understanding of EI. The Four-branch Model of Emotional Intelligence was used as the theoretical framework, while the research question identified the emergency room nurse's perception of EI. Eight emergency room nurses from two facilities participated in the study. The inclusion criteria consisted of emergency room nurses with one to ten years of experience, nurses that worked thirty-six hours or more per week, and were not in leadership roles. The data were collected through face-to-face interview sessions and analyzed using the Colaizzi's Method of Data Analysis. All participants reported unfamiliarity with the concept of EI. Nevertheless, evidence that indicated the presence of all elements of this concept such as the ability to perceive emotions, understand emotions, use emotions to enhance reasoning, and manage emotions, were apparent in the stories shared by the nurses. The results of the study indicated a potential influence toward positive social change at the organizational and professional level. The implementation of educational activities to improve the use of this concept and the modification of current health care policies to incorporate emotional intelligence as clinical competencies are actions that can influence positive social change.

This study investigates the uniqueness and importance of the Australian National Competency Committee (ANCI) competencies to nurses and other health professionals. Very few Australian studies (Battersby, 1994; Hearn, Smith, Southerly & Close, 1995) have addressed this issue. Although there is widespread confusion of the term "competency", professional bodies regard competency standards as a process for supporting the integrity and control of their respective professions. The problem is that there is confusion across the health professions about competencies and their agenda. ANCI suggest that the nursing competencies reflect unique characteristics of nursing as well as those common with other professions. However, competencies that are unique to nursing have not been identified. ANCI have also not identified how competencies can enhance the development of nursing as a profession. The identification of differences in perceptions of uniqueness and importance of the ANCI competencies within nursing and across health professional groups may contribute to the debate on what is needed to achieve competence and those factors that may influence nursing autonomy, education, and future professional development. This study is important to assist in the identification of nursing as a profession in its own right. It will assist the arguments for and against economic reform in professional education courses and transfer of skills and competence across professions. This study compares the perceptions of nurses, physiotherapists, speech pathologists, and occupational therapists about the uniqueness and importance of the ANCI competencies to their professions. Participants completed a questionnaire that listed the ANCI competencies. They were asked to rate each competency first on uniqueness to their profession, and second, on importance to their profession. Two surveys were conducted; one in 1997 and the second in 2000. Surveys examined any change in perception over time by different cohort groups. The study takes a quantitative approach to data collection and analysis. Inferential analysis determined statistically significant differences and similarities of the four participating health professional groups. The differences are examined in relation to the characteristics that define a profession and implications for nursing are examined in relation to research, autonomy, and patient advocacy within an evidence-based practice framework. Eight hundred and thirty-one of questionnaires distributed were used in this study. The results showed that nursing emerged as significantly different to the other three health professions on perception of uniqueness of the competencies. Nineteen of the sixty-five competencies were perceived by nurses to be more unique to the nursing profession. This perception of uniqueness was found across all the four domains of the ANCI competencies. Although ANCI (2000) claimed that the competencies reflect the unique characteristics of nursing these characteristics have not previously been identified. This finding provides some support for the claim made by ANCI by identifying those competencies nurses perceive as more unique. The study findings showed also that the four participating health professions rated the ANCI competencies as important. However, there was a significant difference between nurses and the other three professional groups on the ratings of importance of the competencies of professional and ethical practice. The study found that nurses rated the competencies of this domain as more important than the other three professions rated these competencies. The findings indicate that the rank orders of importance of the competencies are different across the four professions. This reflects and indicates the different priorities and work roles of each of the four professional groups. It is interesting as well as being of concern to nursing that the participating nurses ranked research and management of care as being the least important of all of the competencies. This finding may help to explain why nursing research has been slow to develop in spite of changes to nursing education. Nurses have a subordinate past and are often described as doers rather than thinkers. It appears that this may not have changed. Current practice also reflects a dependency on other health professions such as the medical profession (Adamson & Harris, 1996). Finally, the study found that there was no change in nurses' perceptions of uniqueness over time. However, there was a slight increase in the nurses' ratings of importance of Critical Thinking and Analysis. There were no statistical significant differences for age, gender, year of graduation, state of residence, and employment status. The discussion chapter commences with an outline of the perceived importance of the competencies across the different health professions. Discussion compares the findings and methods of two important Australian studies of competencies (Battersby, 1994; Hearn et al. 1995, 1996) to this study. Discussion examines professionalism and identifies areas where nursing's perceptions of the competencies meet the criteria of a profession and where the four health professions have similar and different perspectives and qualities. Six characteristics of a profession that are discussed in relation to the perceptions of the ANCI competencies are: high intellectual functioning, special body of knowledge, responsibility and accountability, code of ethics, autonomy, and collegiality. The third part of the discussion highlights the implications of this studies' findings in relation to ANCI competencies as an evaluation tool, the empowerment of nurses, generic courses, scope of nursing, professional development, and curriculum development. The thesis concludes by arguing that 1) The ANCI competencies have the potential to increase the professionalism of nursing; 2) Nurses value accountability and responsibility, the code of ethics, and collegiality; 3) Nurses appear uncomfortable with the concept of autonomy; 4) Nurses undervalue high intellectual functioning and the importance of a body of knowledge; and 5) Perceptions are influenced by the context of competencies. The final chapter highlights a number of recommendations for nursing practice that include the need for further investigation of the uniqueness of the ANCI competencies. It is argued that there is a need for a number of changes to the ANCI competency list as well as a greater emphasis on research and management of care and support for discipline specific courses.It is apparent from the findings of this study that nursing education and clinical practice would benefit from the placement of more emphasis on the importance of research. Furthermore, nurses need to take better responsibility for pursing opportunities and funding for research and practice management. It is concluded that nursing research will increase the body of knowledge for the profession and will also increase professional autonomy with an outcome of better client care. Nurses need encouragement from administrators and educators to value management of care and the nursing process, as this will also encourage independence and quality of care provision. It is argued that commonalities in the perception of uniqueness and importance of competencies are not grounds for politicians to suggest the implementation of generic health professional courses. The commonality of the competencies being important to all four professions can be attributed to the complex nature of nursing practice, which captures aspects of other health professional roles and many of the competencies contribute to the characteristics that define a profession. There are differences in the rankings that can be attributed to the nature of knowledge, context, and priorities of the different professions. Each profession has its own governing body that ensures its members obtain an acceptable standard of professional competence and education. It has, and always will be, the responsibility of the profession to shape the service it provides (Pyne, 1998). This study highlights nurses' perceptions of competencies. The recognition of these perceptions could be used to guide nursing's strive toward autonomy, professional development, and recognition as a profession in its own right.

In a Swedish context this thesis deals with male integration in the profession of nursing during the last 50 years of the twentieth century. I focus on four different topics. At first the pioneer era is discussed, that is in the beginning of the 50s, when men were allowed to enter the nursing profession and become nurses. Here I discuss on the Swedish Society of Nursings (Svensk Sjuksköterskeförening, SSF)) standpoint on the matter of men’s ability to participate in a sphere so closely connected with professional values as well as feminine values of caring and support. The second topic deals with the question of using the concept ‘sjuksköterska’ (nurse), in Sweden a feminine marked word, as a title for both men and women. The result of a long and keen debate is that a lot of imaginative titles were refused and that still today both women and men use the female title ‘sjuksköterska’. This might be one reason for men not seeking the profession of nursing. In the third place I look at the pecuniary result for nurses especially after 1986 when a new individual oriented wage determination was launched. The local investigation comprises four different clinics at the University hospital in Malmö (Universitetssjukhuset Malmö allmänna sjukshus, UMAS) and takes a special interest in earnings between male and female nurses. In countries with long experience of individual wage systems male nurses usually earn more than their female counterparts. The question I ask is if the same tendency is about to happen in Sweden. Finally, the possibilities of making a career in the profession of nursing is analyzed. The local investigation stresses that female nurses seem to prefer an administrative career in an increasing extent than men do. Male nurses, on the other hand, made union careers in the 70s and 80s and especially the post as ombudsman is popular. In the mid 90s the male appointment to union position is growing weaker probably connected to an increasing feminine consciousness among female nurses. Also the professionalisation process of the nurse corps is shortly examined.

Lietuvos sveikatos priežiūros įstaigose operacinių slaugytojų pasitenkinimas darbu - mažai nagrinėta sritis. Slaugos specialistų trūkumas beveik visose Europos šalyse (toliau ES) virsta visuotine problema ir tai tapo aktualu, mūsų valstybei įstojus į Europos Sąjungą, kai slaugytojams atsivėrė daug platesnės rinkos perspektyvos. Darbo tikslas. Įvertinti slaugytojų, dirbančių operacinėse, pasitenkinimą darbu. Uždaviniai. Ištirti slaugytojų, dirbančių operacinėse, pasitenkinimą darbu, nustatyti jį lemiančius veiksnius ir pateikti rekomendacijas pasitenkinimui darbu didinti. Tyrimo metodai. Vienmomentinė anoniminė operacinės slaugytojų anketinė apklausa. Statistinė tyrimo duomenų analizė atlikta SPSS 17.0 programa, grafiniam tyrimo rezultatų vaizdavimui naudota MS Excel 2007 programa. Rezultatai. Didžioji dalis operacinėse dirbančių slaugytojų yra patenkinti savo darbu (82,9 proc.) ir daugiau nei du trečdaliai (70,7 proc.) respondentų iš naujo pasirinktų slaugytojo profesiją. Dauguma apklaustų operacinės slaugytojų (78,9 proc.) patenkinti darbo grafiku, du trečdaliai patenkinti vadovavimo kokybe operacinėje (69,9 proc.), atlyginimu (69,2 proc.), darbo krūviu (66,7 proc.) bei galimybe tobulėti ir kelti kvalifikaciją (66,7 proc.), daugiau nei pusę operacinėje dirbančių slaugytojų (60,2 proc.) tenkina darbo organizavimas operacinėje bei komandinis darbas (51,2 proc.) ir tik šiek tiek daugiau nei trečdalis slaugytojų (38,2 proc.) patenkinti gydytojų požiūriu į juos bei santykiais... [toliau žr. visą tekstą] / Introduction: Operating room nurses’ job satisfaction in Lithuanian health care institutions is little examined area. Nursing shortage becomes a global problem in almost all European countries including Lithuania. Much broader market perspectives have opened for nurses as Lithuania joined the European Union. Objective: To evaluate operating room nurses’ job satisfaction. Specific aims: To investigate operating room nurses’ job satisfaction, to determine factors that cause job satisfaction and to make recommendations to increase job satisfaction. Methods: Single-step anonymous questionnaire survey for operating room nurses. The statistical analysis performed using SPSS 17.0 program. MS Excel 2007 was used for graphical depiction of the test results. Results: Most of the operating room nurses are satisfied with their job (82.9%) and more than two-thirds (70.7%) of respondents would choose nursing career again. The majority (78.9%) of operating room nurses are satisfied with the work schedule. Two-thirds satisfied with the quality of operating room management (69.9%), salary (69.2%), workload (66.7%), opportunity of training and qualification improvement (66.7%). More than a half of operating nurses (60.2%) are satisfied with teamwork and organization of work in operating room (51.2%). Only a little bit more than a third of respondents (38.2%) are satisfied with doctors’ attitude towards operating room nurses and relationship among employee (37.4%). Higher salary (63.4%), good... [to full text]

Background: Antigua and Barbuda is a Caribbean nation consisting of two islands with a total of 94,298 inhabitants. It is a high-income country, yet healthcare is resource-limited. The nursing process is an evidence-based approach to systematically care for patients in a person-centered way. Having limited resources affects the application of the nursing process. The nursing process and the nursing role are understudied areas in Antigua and Barbuda. Aim: The aim was to describe nurses’ experiences of applying the nursing process in their daily work in Antigua and Barbuda. Method: A qualitative interview study was conducted by interviewing four nurses at a public hospital in Antigua. The data was analyzed using Braun and Clarke’s thematic analysis. Results: Three themes were identified: Empowering the patient, Applying the nursing competence, and Utilizing available resources. Conclusion: The nurses were highly competent and used the nursing process with emphasis on family involvement, however, the lack of staffing was evident. The result of staffing shortage created a stressful working environment. The nurse’s expertise was not always recognized in interprofessional collaboration. Therefore, the nursing role must be strengthened, and the number of nurses must increase to improve person-centered nursing care. / Bakgrund: Antigua och Barbuda är ett land i Karibien bestående av två öar med totalt 94 298 invånare. Det är ett höginkomstland, trots detta har sjukvården begränsat med resurser. Omvårdnadsprocessen är ett evidensbaserat arbetssätt för att systematiskt vårda patienter på ett personcentrerat sätt. Till följd av begränsade resurser påverkas tillämpningen av omvårdnadsprocessen. I Antigua och Barbuda är omvårdnadsprocessen och sjuksköterskerollen områden med begränsad forskning. Syfte: Syftet var att beskriva sjuksköterskors upplevelser av att tillämpa omvårdnadsprocessen i sitt dagliga arbete i Antigua och Barbuda. Metod: En kvalitativ intervjustudie genomfördes genom att intervjua fyra sjuksköterskor på ett offentligt sjukhus i Antigua. Data analyserades med Braun och Clarkes tematiska analys. Resultat: Tre teman identifierades: Stärkande av patienten, Tillämpande av sjuksköterskekompetensen och Utnyttjande av tillgängliga resurser. Slutsats: Sjuksköterskorna var högkompetenta och arbetade utifrån omvårdnadsprocessen, där stor vikt lades på att involvera familjen, trots tydlig brist på personal. Konsekvenserna av personalbristen skapade en stressframkallande arbetsmiljö. Inom det interprofessionella samarbetet beaktades inte alltid sjuksköterskors expertis. Sjuksköterskerollen måste därför stärkas och antalet sjuksköterskor bör öka för att förbättra personcentrerad omvårdnad.

Background: Work-related stress can negatively affect the health of newly graduated nurses, whichcan have consequences such as a shortage of nurses. If factors are identified that can lead to work-related stress, it also opens up the possibility of preparing newly graduated nurses for the work-related stress that may occur in their new profession. Aim: The aim was to investigate factors that can lead to work-related stress in newly graduated nurses. Method: A literature review with a qualitative approach that included 10 articles. Results: Factors that can lead to work-related stress in newly graduated nurses were presented with two themes: work environment and transition. Four subthemes were formed to describe the experiences of newly graduated nurses: responsibility, feeling inadequate, self-confidence and competence. Conclusion: Work-related stress can be linked to the work environment and affect patient safety, it canalso lead to mental illness or that nurses leave the profession during the transition period. Work-relatedstress in the first years of the new profession may be linked to a lack of support from colleagues andmanagers. With the help of a satisfactory introduction and mentoring program, where experiencednurses act as support for the newly graduated nurses, work-related stress can be reduced. / Bakgrund: Arbetsrelaterad stress kan påverka nyexaminerade sjuksköterskors hälsa negativt vilket kan få konsekvenser så som sjuksköterskebrist. Identifieras faktorer som kan leda till arbetsrelaterad stress öppnar det också upp möjligheten att förbereda nyexaminerade sjuksköterskors för den arbetsrelaterade stressen som kan förekomma i deras nya profession. Syfte: Syftet var att undersöka faktorer som kan leda till arbetsrelaterad stress hos nyexaminerade sjuksköterskor.   Metod: En litteraturstudie med kvalitativ ansats som inkluderade 10 artiklar. Resultat: Faktorerna som kan leda till arbetsrelaterad stress hos nyexaminerade sjuksköterskor presenterades med två teman vilka är arbetsmiljö och transition. Fyra subteman bildades för att beskriva nyexaminerades sjuksköterskors upplevelser dessa var: ansvar, att känna sig otillräcklig, självförtroende och kompetens. Slutsats: Arbetsrelaterad stress kan kopplas till arbetsmiljön och kan påverka patientsäkerheten samt omvårdnadsarbetet, den kan också leda till att nyexaminerade sjuksköterskor upplever psykisk ohälsa eller lämnar sjuksköterskeyrket under transitionsperioden. Arbetsrelaterad stress hos nyexaminerade sjuksköterskor under de första åren i det nya yrket kan vara kopplat till bristande stöd från kollegor och chefer. Med hjälp av en tillfredställande introduktion och mentorprogram, där erfarna sjuksköterskor/handledare agerar stöd till de nyexaminerade sjuksköterskorna, kan känslan av arbetsrelaterad stress hos de nyexaminerade sjuksköterskorna minska.

Philosophiae Doctor - PhD / This dissertation documents the attempt to address one of the major problems in nursing education i.e. the existing gap between the educational philosophy of nursing and nursing education practices, by means of an action research project during the period 1991-1996. The research in this dissertation is recorded in three phases. Phase One elaborates on the biographical and professional background of the researcher and the reasons why action research was selected for the purpose of this particular project Since action research provides opportunities for teachers to change and transform their own teaching practices, it was obviously the best choice for the research. The emphasis was on collaboration and participation and the researcher was morally bound to consider and observe all internal and external factors which influence and limit her own teaching practice, in order to initiate change and transformation in teaching. In order to define and contextualize the problem and to describe the situation in which this particular problem has been identified, the role of the statutory body, the South African Nursing Council which governs the profession and basic professional nursing education were explored. The problem is formulated as the existing gap between the educational philosophy on which existing nursing and nursing education practices are theoretically grounded and the way in which both nursing and nursing education practices appear in reality. Phase One also deals with the historical and philosophical foundations and development of nursing and nursing education. In an attempt to describe the researchers's teaching practice appropriately, as a social practice, it was essential to consider not only the professional and social boundaries of nursing education, but also the current situation regarding national education, the existing health system and all factors related to education and health. The dissertation then draws the attention to the essential features and historical context of a progressive and critical pedagogy, as a foundation for action research. In this regard it was especially the contributions of Dewey, Habermas, Freire, Giroux and McLaren, which guided the research to approach nursing education from a critical perspective. Phase Two deals with the research methodology. For this particular research project John Elliotts's Action Research Framework for Self-Evaluation in Schools was used. Within this framework of Elliott the dissertation then describes the research methodology of this particular project: Ideal and Reality in Nursing Education and Nursing Practices in South Africa: An Action Research Approach. The rationale and the development of the project is first described, whereafter action research is discussed as a process which enables nursing .practitioners and tutors to become empowered and to initiate change and establish transformation within their own practices. A major part of the dissertation is dedicated to the project in action with two groups of participants during two action research cycles. Finally Phase Three of this dissertation draws the attention to the conclusions based on the outcomes of the project. with the emphasis on the urgent need for change and transformation within the nursing profession in order to lessen the extensive gap between nursing theory and nursing practices. The existing gap between the philosophy on which nursing practices are based and how existing nursing practices appear in reality, seems to be the major cause of the prevailing discontent in the nursing profession.

El objetivo del estudio fue determinar la imagen social del profesional de enfermería según la percepción de pacientes atendidos en el Centro de Salud de Reque, 2021. Metodología cuantitativa, diseño no experimental, descriptivo, transversal. La población fue de 300 pacientes del Centro de Salud de Reque. Muestra formada por un total de 168 personas, determinada con un muestreo no probabilístico por conveniencia. Se usó una Encuesta virtual para Determinar la Imagen Social del Profesional de Enfermería (EDISPE), con coeficiente de Cronbach de0.95. Los datos fueron procesados mediante estadística descriptiva con el software Microsoft Excel. Los resultados obtenidos demostraron, que la imagen social de enfermería en un 99.4% fue considerada como adecuada; respecto a sus dimensiones: información, campo de representación y actitud, fueron catalogadas como adecuadas, variando ligeramente entre 99.4% y 98.2%. Se concluye, que los pacientes que recibieron atención de salud por parte del profesional de enfermería, la perciben como adecuada en un porcentaje muy elevado, quedando demostrado que su desenvolvimiento profesional es reconocido y produce un impacto positivo, caracterizándola como alguien con liderazgo, capacidad investigativa, que cumple un rol docente, que sus actividades las realiza utilizando un lenguaje claro y sencillo, donde hay entendimiento de los tratamientos y procedimientos que ejecuta en sus cuidados. Entonces, es aceptada socialmente, por la confianza y seguridad que brinda, también hubo buena valoración de su simpatía, carisma, sencillez, entre otros. / The objective of the study was to determine the social image of the nursing professional according to the perception of patients treated at the Reque Health Center, 2021. Quantitative methodology, non-experimental, descriptive, cross-sectional design. The population was 300 patients from the Reque Health Center. Sample made up of a total of 168 people, determined with a non-probabilistic sampling for convenience. A virtual Survey to Determine the Social Image of the Nursing Professional (EDISPE) was used, with a Cronbach coefficient of 0.95. The data was processed through descriptive statistics with Microsoft Excel software. The results obtained showed that the social image of nursing in 99.4% was considered adequate; regarding its dimensions: information, field of representation and attitude, they were classified as adequate, varying slightly between 99.4% and 98.2%. It is concluded that the patients who received health care from the nursing professional perceive it as adequate in a very high percentage, demonstrating that their professional development is recognized and produces a positive impact, characterizing them as someone with leadership, investigative capacity , who fulfills a teaching role, who carries out his activities using clear and simple language, where there is an understanding of the treatments and procedures that he performs in his care. So, he is socially accepted, due to the confidence and security he provides, there was also a good assessment of his friendliness, charisma, simplicity, among others.