Thesis (PhD)--University of Stellenbosch, 2005. / ENGLISH ABSTRACT: The South African primary health care (PHC)system is in a period of transition. This,
and the growing HIV epidemic, place tremendous strain on PHCworkers in public
health services. Staff morale is low and this results in turnover and poor quality of
care. Therefore, staff need to be supported, so that they are better equipped to
provide quality care for patients.
This dissertation describes a process of action research that aimed to explore
possibilities for staff-support interventions to health teams in the public PHCsector.
Data were collected through in-depth interviews, group interviews, focus group
discussions and consultation sessions, with health staff and middle managers. Data
were analysed using a grounded theory approach, with the assistance of the Atlas.ti
4.1 software package.The interpretation of data was informed by psychoanalytic and
open systems theories.
Four cycles of action research were conducted. The first action stage involved a
qualitative assessment of the nature of stressors in the PHC system. The second
action stage describes the experiences of two staff teams from a health prevention
clinic and a day hospital (curative service) as they prepared to merge and integrate
aspects of service delivery. In the third action stage the research team explored the
feasibility of a short programme aimed at building capacity amongst middle and
facility level managers to act as containers for staff stresses. However, due to
external factors the programme was not completed. The final action stage describes
interviews with selected participants to reflect on the effects of the current action
research process on them and their work.
The current research suggests that a psychodynamic approach may be a useful
component of action research in health settings. This approach makes room for
interpretation of unconscious processes in the stress experiences of health workers,
and has the potential to move health staff and management to alternative modes of
functioning and coping. / AFRIKAANSE OPSOMMING: Primêre gesondheidsdienste in Suid Afrika is tans in 'n proses van transisie. Die
toenemende druk wat die VIGS-epidemie op gesondheidsdienste plaas, maak dit
eweneens moeilik vir gesondheidswerkersom aan te pas by 'n gedurig-veranderende
stelsel. Dit bring mee dat moraal laag is, baie werkers die publieke sektor verlaat en
gehalte van dienslewering verswak. Hierdie situasie noodsaak dat programme
ontwikkel moet word om gesondheidswerkerste ondersteun in hul werk, sodat hulle
beter toegerus is om kwaliteit sorg aan pasiënte te verleen.
Hierdie proefskrif beskryf aksienavorsing wat gedoen is met die doelom
ondersteuningsprogramme vir gesondheidswerkers en hulpwerkers in openbare
primêre gesondheidsdienste te ontwikkel. Individuele en in-groepsverband in-diepte
onderhoude, asook fokusgroepbesprekings en konsultasies met gesondheidswerkers
en middelvlak-bestuurders is gevoer om data in te samel. Data-ontleding was
gedoen volgens die gegronde teorie aanslag en die Atlas.ti 4.1 sagteware pakket Is
vir hierdie doel gebruik. Teorieë van psigoanalise en oop stelsels is deurgans
geraadpleeg met die interpretasie van bevindinge.
Die navorsingsproses bestaan uit vier siklusse van aksienavorsing. In die eerste
navorsingsiklus is ~ie aard van stress in the publieke primêre gesondheidstelsel
ondersoek. Die tweede siklus behels 'n beskrywing van die ervaringe van twee
personeelgroepe soos hulle gereed gemaak het om aspekte van hulonderskeie
dienslewering te integreer met die oprigting van 'n gemeenskaplike
gesondheidsentrum. Die derde siklus beskryf die implementering van 'n kort program
wat gerig is daarop om middel-vlak en diens-bestuurdersvaardighede aan te leer om
personeel beter te ondersteun. Eksterne invloede het meegebring dat hierdie
opleidingsprogram nie ten volle uitgevoer kon word nie. In die finale siklus is
onderhoude met geselekteerde deelnemers gevoer om te bepaal hoe deelname aan
die aksienavorsingsproses hulle in hul persoonlike hoedanigheid asook In die
uitvoering van hul pligte beïnvloed het.
Die huidige navorsing stel voor dat die psigodinamiese benadering 'n gepaste
komponent van aksienavorsing in publieke gesondheidsomgewingskan wees, omdat
hierdie benadering Insig kan verleen tot die onbewuste prosesse wat gesondheidswerkersse belewenis van stres beïnvloed, en verder ook die potensiaal
het om gesondheidswerkers en bestuurders tot alternatiewe funksionering en
hantering van stres te motiveer.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:sun/oai:scholar.sun.ac.za:10019.1/50294 |
| Date | 12 1900 |
| Creators | Van Wyk, Brian Eduard |
| Contributors | Swartz, Leslie, Stellenbosch University. Faculty of Arts and Social Sciences. Dept. of Psychology. |
| Publisher | Stellenbosch : Stellenbosch University |
| Source Sets | South African National ETD Portal |
| Language | en_ZA |
| Detected Language | Unknown |
| Type | Thesis |
| Format | 264 pages : ill. |
| Rights | Stellenbosch University |
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