It is important for nurses to show acceptable behaviour when interacting with the patients. The purpose of this study was to explore and describe the factors that contribute to nurses’ negative behaviour when rendering patient care and to determine the effects of nurses’ behaviour on patient outcomes. The study used a non-experimental explorative and descriptive quantitative design. Data collection was done using a structured questionnaire. The sample comprised of 64 respondents which consisted of 25 registered nurses and 39 enrolled nurses. The study found that besides the known contributing factor, that is, the shortage of nurses, further identified contributing factors to nurses’ negative behaviour when rendering patient care are failure to retrain nurses identified with negative behaviours, poor condition of employment and patients’ behaviours and cultural beliefs. These results suggested a need to train more nurses, improve conditions of employment, as well as support and retrain nurses identified with negative behaviours. / Health Studies / M.A. (Public Health)

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 development ofNursing and Nursing Education in Venda is intimately related to the work of the early missionaries, Western education and medical developments. The growth of nursing and health services had a reciprocal relationship. One was not possible without the other, viz the history of missionary education, hospitals, health services, sociocultural and political development. Each stage ofthese developments was an important step in laying the foundation of modem professional nursing and nursing education. Before contact with Western medicine, health and midwifery services were provided by traditional healers, nurses and midwives. Divination was used to: diagnose disease, identify the witch, determine medicines to cure the disease. Western nursing developed through stages of: lay nursing, hospital certificated, auxiliary nurses and midwives, registered nurses and midwives, comprehensive general nurse and midwife. The history of Nursing and Nursing Education is thus part and parcel of the social developments of the country it serves. / Health Studies / M.A. (Nursing Science)

Within the nursing profession, the transition from the student to a graduate nurse is a common rite of passage that marks the end of initial educational preparation in the discipline and the beginning of a professional journey as a nurse and a member of the multidisciplinary team (Nash, Lemcke & Sacre. 2009:48). This is a period of adjustment, stress, growth and development and the transitional nurse is likely to feel uncomfortable, fearful and may experience feelings of inadequacy. This study was undertaken to explore and describe the experiences of final year nursing students at a public college of nursing in the Eastern Cape regarding their preparedness to become registered nurses, with the aim to identify gaps and make recommendations on strategies to close the gaps. The objectives were to explore and describe the experiences of final year nursing students at the public college of nursing in the Eastern Cape Province with regard to their preparedness to become registered nurses and to recommend strategies to improve the preparation of nursing students for transition to become registered nurses. To answer the research question “What are the experiences of final year nursing students at a public college of nursing in the Eastern Cape Province with regard their preparedness to become registered nurses”, a qualitative, explorative and descriptive design was used as a framework for the study. Data were collected by means of unstructured focus group interviews with a purposively selected sample of 27 final year nursing students at the particular college of nursing. Data were analysed using Tesch’s method of analysis for qualitative research. Two themes emerged, revealing that participants at the college experienced preparedness and lack of preparedness to assume the role of a professional nurse. This related to certain aspects that had an impact on the preparation of the final year nursing students for practice and included: curriculum-related aspects; clinical teaching and learning support; learning opportunities; interpersonal relationships between lecturers, students and clinical staff; equipment; and library resources. It was concluded that the learning needs of the nursing students were not adequately catered for, leading to lack of preparedness. Through the involvement of nursing students in the evaluation of their learning, shortfalls in both education and practice areas could therefore be detected. Recommendations regarding strategies to be used to promote preparedness of final year nursing students included: continuous feedback on student performance in the form of exit evaluations on the part of students to identify learning needs; writing of progress reports on the part of clinical practice; and the employment of clinical preceptors with clear role specifications between the lecturers, ward sisters and preceptors to avoid role confusion.

Andelen äldre personer ökar i Sverige och världen vilket innebär att efterfrågan av vård ökar, men all vård behöver inte ske på sjukhus. Insatser som kan förhindra undvikbar slutenvård bör vara viktiga att arbeta fram dels ur ett hållbarhetsperspektiv, men även viktigt för att minska den påfrestning, förvirring och försämrad hälsostatus en sjukhusvistelse kan innebära för den äldre sköra patienten. Mobila närsjuksvårdsteam som utgår från sjukhusen är en relativt ny vårdform i Sverige och introducerades i Västra Götalandsregionen för ungefär 10 år sedan. Mobila närsjukvårdsteam gör insatser för sköra patienter med komplexa behov i hemmet och i teamen arbetar bland annat sjuksköterskor. Inom sjuksköterskans kompetensområde ingår att självständigt kunna ansvara för omvårdnad av patienter, inneha förmågan att se hela patientens livsvärld samt arbeta för en säker vård.  Syftet med den här studien är att belysa sjuksköterskans arbete med sköra patienter i mobila närsjukvårdsteam. Denna studie har genomförts som kvalitativ metod med induktiv ansats och bygger på intervjuer som datainsamlingsmetod. Vi har intervjuat sjuksköterskor verksamma på tre olika mobila närsjukvårdsteam. Resultatet av vår studie har visat att sjuksköterskan i mobila närsjukvårdsteam har en viktig roll då de utför avancerad vård i hemmet genom samverkan i team och med andra vårdaktörer. Sjuksköterskan har ett helhetsperspektiv med patienten i fokus och på så sätt kan andelen onödiga sjukhusinläggningar minska. Vår studie visar att snabb uppföljning i hemmet av sköra patienter som skrivs ut från sjukhus skapar trygghet samt minskar återinläggningar. Dessutom är rätt vård av sköra äldre patienter en organisatorisk fråga och vården behöver bedrivas av rätt kompetens. Sjuksköterskans arbete i mobila närsjukvårdsteam innebär att arbeta med hållbar utveckling genom att konsumtion av slutenvård minskar. / The proportion of older people is increasing in Sweden and the world, which means that the demand for care is increasing, but all care need not executed in hospitals. Efforts that can prevent avoidable outpatient care should be important to work on from a sustainability perspective, but also important to reduce the stress, confusion and deteriorating health status a hospital stay can cause for the older fragile patient. Mobile local health care teams executed from the local hospital are a relatively new form of care in Sweden. Mobile local health care teams were introduced in the Västra Götaland region about 10 years ago. Mobile local health care teams makes efforts for fragile patients with complex needs in their home.  The registered nurse’s expertise includes being able to independently be responsible for the care of patients, having the ability to see the entire patient's needs and working for patient's safety. The aim of this study is to illustrate the nurse's work with fragile older patients in mobile local health care teams. This study has been conducted as a qualitative method with an inductive approach and is based on interviews as a data collection method. We have interviewed nurses working on three different mobile local health care teams. The result has shown that the registered nurse in mobile local health care teams plays an important role as they carry out advanced care in the home through collaboration in teams and with other healthcare players. The registered nurse has a holistic perspective with the patient in focus, unnecessary hospitalizations and re-admission can be reduced. This study shows that fast follow-up in the home of fragile patients who are discharged from hospitals creates security and reduces re-admissions. In addition, proper care of fragile elderly patients is an organizational issue and care needs to be conducted by the right expertise. Registered nurse's work in mobile local health care teams means working with sustainable development by reducing the consumption of inpatient care.

Bakgrund Trycksår definieras som ett sår orsakat av ischemi i vävnaden och kan indelas i olika kategorier. I Sverige beräknades omkring 11% av alla patienter utveckla sjukhusförvärvade trycksår och beräknas kosta runt 450 miljoner svenska kronor avseende förlängda vårdtider inom somatisk specialistvård. Förutom förlängda vårdtider skapar även trycksår ett stort lidande och sänkt livskvalitet för den drabbade. Kunskapen om trycksårsprevention och möjligheten till utbildning gällande trycksår tycks skilja sig runt om i världen. Säker vård handlar om att förebygga vårdskador och risk för vårdskador, säker vård är en del sjuksköterskans kärnkompetenser. Syfte Syftet med litteraturstudien är att identifiera hinder i det preventiva arbetet av trycksår inom sjukhusvård Metod En strukturerad litteraturstudie med inslag av den metodologi som används vid systematiska översikter. Resultat Hindren som identifierats för trycksårsförebyggande arbete var kunskapsbrist, organisatoriska faktorer, patienter och det praktiska utförandet. Kunskapsbrist identifierades av majoriteten av de länder som ingick i studien. Organisatoriska problem som fanns var bristen på riktlinjer, teamarbete, materialbrist, arbetsmiljö och utbildning. Patienter kunde även ses som ett hinder i arbetet med trycksårsprevention, det kunde då handla om exempelvis sjukdomstillstånd. Utförandet av trycksårsprevention sågs som bristfällig i flertalet studier där personal inte utförde riskbedömningar på patienter i riskzonen, det framkom även att all personal inte utför trycksårsprevention av oklar anledning vilket är ett hinder. Slutsats Denna litteraturstudie beskriver hinder i det trycksårsförebyggande arbetet. En stor del av problemen berör organisationer, det finns potential till förbättring inom området trycksårsprevention. / Background Pressure ulcer is defined as a wound caused by ischemia in the tissue and can be seperated into different categories. In Sweden around 11% of all patients were estimated to develop hospital aquired pressure ulcers, these were estimated to cost around 450 million swedish crowns in regard somatic specialty care. Disregarding length of care pressure ulcers also casues great patient suffering and lowers quality of life. The knowledge about pressure ulcer and the possibility to recieve training about pressure ulcers seems to vary between different countries. Safe care is used to prevent healthcare injuries and near miss healthcare injuries. Safe care i one of the core competencies for registered nurses. Aim The aim of the study is to identify barriers of pressure ulcer prevention in hospital care. Method A structured litterature review with elements of the methodology used in systematic reviews. Results The barriers wich were identified to pressure ulcer prevention were lack of knowledge, organisational factors, patients and in the practical work. Lack of knowledge were identified in the majority of studies included in the review. Organisational barriers were lack of guidelines, flaws in teamwork, lack of material, working environment and in education. Patients could be seen as a barrier to pressure ulcer prevention, such barrier could for example be the patients condition. The practical use of pressure ulcer prevention was viewed as flawed, in mulitple studies the personel did not use risk assessement tools on patients with a risk of pressure ulcer development, in some cases there appeared to be no reason as to why some personel did not use any risk assesment tools. Conclusions This litterature review describes barriers to pressure ulcer prevention. A large part of the problem is located in organizations, there is room for improvement in the field.

The aim of this study was to describe the nurses‘ perception of termination of pregnancy and her perception of her conduct towards clients that request termination of pregnancy guided by Kings‘ Systems Approach and Goal Attainment Theory. A non-experimental quantitative descriptive correlational design was used. A non-probability purposive sampling method was used consisting of institutions in the Western Cape, available to participate in this study, which deliver termination of pregnancy services, gov ernment health care institutions (21) and Marie Stopes clinics (3). Non-probability convenience sampling was used consisting of registered nurses who are working in termination of pregnancy units in these facilities (N=82). Data were collected through the administration of a self-designed questionnaire. The main findings of the study indicate that respondents (personal system) appear to feel positive about the work they are doing. Formal improvement and development are however not utilised optimally. Regarding the interpersonal system, respondents also show a positive orientation to both the woman opting for termination of pregnancy and the foetus. The potential towards transaction and ultimately goal attainment reside within this system. The respondents are also positive about legislation, employers and policies (social system) relating to termination of pregnancy. This orientation creates a milieu that is conducive to transactions, interactions and goal attainment.The main recommendation is that three systems as proposed by King be continuously integrated within the termination of pregnancy setup through, amongst other measures: values clarification, management support, in service education, the inclusion of termination of pregnancy in undergraduate programmes, focus groups and the like. / Die doel van hierdie studie was om die verpleegkundige se persepsie van terminasie van swangerskap en haar persepsie van haar houding en gedrag teenoor kliёnte wat terminasie van swangerskap versoek, aan die hand van King se Sisteembenadering en Doelwitbereikingsteorie te ondersoek en te beskryf. `n Nie-eksperimentele kwantitatiewe beskrywende korrelasie navorsingsontwerp was gebruik. `n Nie-waarskynlike doelbewuste-steekproefneming van die staatsgesondheidsorg-instansies wat terminasie van swangerskapdienste aanbied, is geneem en wat beskikbaar vir hierdie studie was (21) asook die Marie Stopesdienste (3), in die Wes-Kaap. `n Nie-waarskynlike gerieflikheidsteekproefneming is van verpleegkundiges geneem wat swangerskappe in hierdie afdelings termineer of moet termineer (N=82). Data is met behulp van `n selfontwerpte vraelys ingesamel. Die hoofbevindings van die studie dui daarop dat respondente (persoonlike sisteem) positief voel oor hul werk. Formele ontwikkelingshulpbronne word egter nie optimaal deur die sisteem benut nie. Wat die interpersoonlike sisteem betref, toon respondente ook ‗n positiewe oriëntasie tot beide die vrou wat terminasie van swangerskap aanvra en die fetus. Die potensiaal tot transaksie-sluiting en uiteindelike doelwitbereiking is binne hierdie sisteem geleë. Die respondente is ook positief oor wetgewing en die werkgewer en beleid (sosiale siteem) ten opsigte van terminasie van swangerskap. Hierdie oriëntering laat ‗n milieu wat bevorderlik is vir transaksie-sluiting, interaksie en doelwitbereiking. Die hoofaanbeveling is dat voortdurend gepoog moet word na die integrasie van King se drie sisteme binne die terminasie van swangerskapafdelings deur onder meer: waarde-uitklaringswerkswinkels, ondersteuning van bestuur, indiensopleiding, die insluiting van terminasie van swangerskap in voorgraadse kurrikula, fokusgroepe en so meer. / Health Studies / D. Litt. et Phil. (Gesondheidstudies)

The aim of this study was to describe the nurses‘ perception of termination of pregnancy and her perception of her conduct towards clients that request termination of pregnancy guided by Kings‘ Systems Approach and Goal Attainment Theory. A non-experimental quantitative descriptive correlational design was used. A non-probability purposive sampling method was used consisting of institutions in the Western Cape, available to participate in this study, which deliver termination of pregnancy services, gov ernment health care institutions (21) and Marie Stopes clinics (3). Non-probability convenience sampling was used consisting of registered nurses who are working in termination of pregnancy units in these facilities (N=82). Data were collected through the administration of a self-designed questionnaire. The main findings of the study indicate that respondents (personal system) appear to feel positive about the work they are doing. Formal improvement and development are however not utilised optimally. Regarding the interpersonal system, respondents also show a positive orientation to both the woman opting for termination of pregnancy and the foetus. The potential towards transaction and ultimately goal attainment reside within this system. The respondents are also positive about legislation, employers and policies (social system) relating to termination of pregnancy. This orientation creates a milieu that is conducive to transactions, interactions and goal attainment.The main recommendation is that three systems as proposed by King be continuously integrated within the termination of pregnancy setup through, amongst other measures: values clarification, management support, in service education, the inclusion of termination of pregnancy in undergraduate programmes, focus groups and the like. / Die doel van hierdie studie was om die verpleegkundige se persepsie van terminasie van swangerskap en haar persepsie van haar houding en gedrag teenoor kliёnte wat terminasie van swangerskap versoek, aan die hand van King se Sisteembenadering en Doelwitbereikingsteorie te ondersoek en te beskryf. `n Nie-eksperimentele kwantitatiewe beskrywende korrelasie navorsingsontwerp was gebruik. `n Nie-waarskynlike doelbewuste-steekproefneming van die staatsgesondheidsorg-instansies wat terminasie van swangerskapdienste aanbied, is geneem en wat beskikbaar vir hierdie studie was (21) asook die Marie Stopesdienste (3), in die Wes-Kaap. `n Nie-waarskynlike gerieflikheidsteekproefneming is van verpleegkundiges geneem wat swangerskappe in hierdie afdelings termineer of moet termineer (N=82). Data is met behulp van `n selfontwerpte vraelys ingesamel. Die hoofbevindings van die studie dui daarop dat respondente (persoonlike sisteem) positief voel oor hul werk. Formele ontwikkelingshulpbronne word egter nie optimaal deur die sisteem benut nie. Wat die interpersoonlike sisteem betref, toon respondente ook ‗n positiewe oriëntasie tot beide die vrou wat terminasie van swangerskap aanvra en die fetus. Die potensiaal tot transaksie-sluiting en uiteindelike doelwitbereiking is binne hierdie sisteem geleë. Die respondente is ook positief oor wetgewing en die werkgewer en beleid (sosiale siteem) ten opsigte van terminasie van swangerskap. Hierdie oriëntering laat ‗n milieu wat bevorderlik is vir transaksie-sluiting, interaksie en doelwitbereiking. Die hoofaanbeveling is dat voortdurend gepoog moet word na die integrasie van King se drie sisteme binne die terminasie van swangerskapafdelings deur onder meer: waarde-uitklaringswerkswinkels, ondersteuning van bestuur, indiensopleiding, die insluiting van terminasie van swangerskap in voorgraadse kurrikula, fokusgroepe en so meer. / Health Studies / D. Litt. et Phil. (Gesondheidstudies)