Nursing

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An inquiry into student support mechanisms in postgraduate nursing programmes at the University of KwaZulu-Natal : a students' perspective.
(2010) Mugarura, John.; Mtshali, Ntombifikile Gloria.
Background: Literature on postgraduate student throughput and success suggests a mismatch between registration, throughput and success rates among postgraduate students. Purpose of the Study: This study aimed at exploring and describing mechanisms used to increase throughput and success rates in Postgraduate Nursing Programmes at the University of KwaZulu-Natal. Conceptual Framework: The theoretical framework used in this study was derived from Tinto's proposed Theory ofInstitutional Action (2005). This theory is based on the assumption that learners' behaviour which is manifested in persistence or departure is never fully understood because only the act of leaving or staying is observed, not the underlying intentions behind the action. Research Methodology: Using a mixed methods paradigm, the whole target population of 83 participants was sampled for the quantitative aspect and 2 focus groups each consisting about 12 participants for the qualitative aspect were used. Data were collected using a questionnaire and an interview guide. Descriptive statistics and were used for quantitative data, while thematic content analysis was used for qualitative data. Results: This study revealed that the support mechanisms for increasing student throughput and success rates are structured in three phases: the pre-enrolment phase, the integration phase, and the engagement phase. During the pre-enrolment phase, support is offered in form of information to help students understand what is expected of them, inform students about the programmes offered, the cost of the programmes, duration of the programs and the available support services. During the integration phase, the support provided includes guidance about the registration process, information about programmes and disciplines offered, counselling regarding curriculum design, modules to select and required credits for completion, orientation, and helping international students with visa extension with repatriation issues. During the engagement phase, the support provided includes academic, psychosocial and financial services. Facilitating factors reported include: student interaction with academic staff to monitor and provide feedback, a responsive curriculum to learning needs through the teaching and assessments methods utilised, active student involvement, personal effort, prior learning and working experience, and enough learning resources. Barriers reported were inadequate information, insufficiency of student-lecturer interaction time, unsuitable psychosocial support for adult learners, lack of mentorship and academic advising services, lack of time to participate in co-curricular activities, limited time for studying, ineffective use of learning resources, and language barrier. Recommendations: The study revealed a need to provide a balance mixture the available support mechanisms because academic support dominated the support services offered. Findings also showed the necessity to adapt the psychosocial support to the needs of all categories of students including adult postgraduate students.
Analysis of cognitive levels of examination questions set in the Bachelor of Nursing programme at the University of KwaZulu-Natal.
(2010) Garekwe, Masaitsiweng.; Mtshaji, N.G.
Background: 'The literature reveals that a large percentage of teachers ask questions aimed at lower cognitive levels irrespective of the underpinning philosophy. They fail to set challenging questions at higher order levels when setting examination papers. Purpose of the Study: This study is aimed at describing and analysing the examination questions set over a four year academic period, at the University of KwaZulu-Natal School of Nursing, in terms of Bloom's levels of cognitive domains. Research Methodology: A quantitative approach and content analysis was used. A total of 1319 questions were examined, SOUTCed from 39 examination papers, from 2003-2007. These questions were independently reviewed by two coders according to Bloom's taxonomy's template. Research Results: The findings revealed that all six categories of the cognitive domains in Bloom's taxonomy were used across the four levels in the Bachelor of Nursing (BN) programme. Overall about 57 % of the questions were aimed at lower level (knowledge, recall and comprehension) whilst only 43.4% were aimed at higher levels (application, analysis, synthesis and evaluation). In the first year lower order questions averaged at 62% with higher order questions at 51 %. In second year the lower order questions took up 51% of the paper \\~th higher order questions at 49%. During third year there was an equal (50/50) split between higher order and lower order questions. In fourth year there was the highest percentage of lower level questions (66%) was seen, with only 34% of questions being of the higher order. Regarding the increase in the complexity of questions within the programme, a change of 13% was seen between first and second year. Whilst there was an increase of 1% reported between second and third year. However, there was a significant drop (16%) in the complexity ofquestions in the fourth year, with lower order questions clearly dominating. Recommendations: The nursing education curriculum, and staff development progranune, should pay special attention towards developing educators in the setting of questions ensuring appropriate examination criteria are met. Exercises during the capacity building initiatives should cover aspects such as how to plan an assessment for the whole programme ensuring the appropriate increases in complexity as the programme progresses, as well as setting, or critiquing, of examination papers and coming up with recommendations to improve the quality of questions. Special attention should be given to how to align teaching and assessment in such a way that the level ofcomplexity increases as the students' progress through the programme. Lastly, further research should be conducted, using mixed methods, to explore the assessment of learning and in order to address certain questions which could not be answered quantitatively; for example questions regarding the construction of questions, because it impacts the nature of the question Also it should be noted that there was a disjuncture between the scenario and the questions in some cases.
An exploration of adolescents knowledge, perceptions and behaviors regarding sexual reproduction and sexual reproductive health services in Botswana.
(2009) Dingi, Keineetse.; Naidoo, Joanne K.
The study aimed to explore adolescents knowledge, perceptions and behaviors regarding sexual reproduction and sexual reproductive health services in community junior school in Tutume Botswana. A descriptive exploratory design using both the qualitative and quantitative approach was used to guide the research process. Data was collected by means of a self administered questionnaire and two focus group discussions. A total of 76 participants answered the questionnaire and 2 focus group discussions one consisting of the 15 to 17 year olds and the other one consisting of 12 to 15 year olds were conducted. The results of the survey highlighted adequate levels of knowledge regarding sexual matters among adolescents in the school with the bulk of the information being provided by the teacher. Parents, nurses, siblings, peers and the media played a low key role in providing adolescents with information regarding sexual reproduction and sexual reproductive health services. The results of the focus group discussion showed marked underutilization of the local clinic for curative, preventive and promotive services by adolescents. The poor utilization resulting mainly from perceived barriers such as provider attitudes, subjective norms, cultural taboos, inadequacy of the clinic, judgmental attitudes from provider and parents as well as lack of encouragement from authority figures like parents and teachers. Adolescents in the focus group discussion perceive themselves as being susceptible to HIV but did not appreciate the benefits of using preventive measures even though the survey group showed sound knowledge on contraception. Improving the services to align them to adolescent friendly services, improving the delivery of information through other means apart from the teacher and reducing the barriers that discourage adolescents from reaching the reproductive health services will go a long way in improving the utilization of the services by adolescents.
An exploration of the nurses perception on causes of and management of in-patient aggression in a psychiatric institution in Botswana.
(2009) Kealeboga, Kebope Mongie.; Middleton, Lyn Elizabeth.
Inpatient aggression in mental health settings is a significant concern because it compromises the quality of care provided by health care workers. Nurses are one of the groups most affected by inpatient aggression because they are usually the client's first contact on admission. A number of studies have found that nurses are the most frequently assaulted professional group both inside and outside of the hospital setting, are more frequently assaulted than doctors and most are likely to experience some form of aggression in their career. The causes of inpatient aggression are frequently conceptualised as multidimensional and involving factors internal to the client e.g. age, factors relating to the environment such as inflexible ward routines and factors relating to the quality of the interaction between nursing staff and clients. Research studies suggest that nurses generally respond reactively and rely heavily on physical control strategies rather than on interpersonal strategies in managing inpatient aggression. Contemporary literature suggests that the perceptions nurses hold about aggression and its causes influences their management of the event and that this process is mediated by a number of client, environment and nurse-related variables including age, education, gender, nursing experience, perceptions of aggression and its causes. Although the causes and management of inpatient aggression in nursing is well documented in the United Kingdom and some other West European countries, this is not the case for Africa and in the case of this study, for Botswana. No studies have attempted to find the nurses' perception, perception on the cause, and management of inpatient aggression in Africa and more so in Botswana. Aim: The purpose of the study was to explore how nurses' demographic characteristics, their perceptions of aggression and its causes, influence the management of inpatient aggression by nurses in the main psychiatric institution in Botswana. Method: A descriptive, exploratory non-experimental design was used. Perception of inpatient aggression was captured by a Perception of Aggression Scale (POAS) and the perception on the cause and management of inpatient aggression was collected with Management of Aggression and Violence Attitude Scale (MAVAS).The sample comprised of 71 nurses, 48 of whom were females and 23 males. The mean age of the nurse respondents was 36 years. Of the 71 respondents 50 were registered nurses only while 20 were psychiatric registered nurses. More than two thirds of the respondents had a diploma in nursing, one had a masters degree and the remainder, a degree in nursing. The average nursing and psychiatric nursing experience of the respondents were 12.1 and 6.87 years respectively. ANNOVA test and t-tests were done to find the associations between the nurses' demographic variables, their perception, perception on the cause and management of inpatient aggression. Findings: The respondents In this study perceived inpatient aggression as both negative and positive. There was an overall agreement with the perception of aggression as always negative and as an action of physical violence against a nurse (81.73%). Nurses saw the cause of inpatient aggression as emanating from the internal, external and situational/interactional factors. The use of traditional methods of aggression dominated as shown by a high mean score of 80.5 as compared to interpersonal management with a mean score of 60.5. A statistical difference was found between gender, perception of aggression and perception of aggression and the traditional management of aggression while age, nursing and psychiatric nursing experience were statistically associated with the use of interpersonal management of aggression. Conclusion: The study provided insight into the nurses' perceptions, perceptions on the cause and management of inpatient aggression in a mental institution in Botswana. Nurses in this study hold predominantly negative perceptions of aggression and generally favour traditional management strategies. However, older, more experienced nurses tended to favour interpersonal techniques. Recommendations for nursing practice, education and research to address this issue centre around further and targeted education and training in mental health and specifically, in the comprehensive management of aggression which includes communication skills, use of de-escalation, use of medication and cautious physical restraint.
A descriptive study of the structure and process standards in the intensive care unit (ICU) at the University Central Hospital of Kigali (CHUK) in Rwanda.
(2009) Twahirwa, Timothee Shahidi.
Introduction Patient safety IS fundamental to quality health and nursmg care and the ongomg improvement of patient safety is one of the most urgent issues facing health care today. Quality health and nursing care is a process which can be monitored, but which requires ongoing evaluation and change. The poor quality of patient care is a major problem of many hospitals in Rwanda and the University Central Hospital of Kigali, (CHUK), is no exception, especially in the Intensive Care Unit, (ICU). (Rwanda Ministry of Health Report, 2005). Pmpose of study The purpose of this study was to describe and explore the structure and processes of quality patient care at CHUK Intensive Care Unit, using the JFICM minimum standards, in order to improve the current quality of patient care and to further highlight gaps that might exist in this care for further research. Methodology The research was conducted in the Intensive Care Unit at CHUK. A checklist and self-reporting questionnaires, which were developed by the researcher, guided by the Joint Faculty ofIntensive Care Medicine (2003), constituted the instrument for this study. The sample consisted of 41 participants who were health care workers in the ICU and 20 of the patient's files. These files were used for researcher's observations during the period of data collection being 20thJune to 20th July 2008. A descriptive quantitative design was used. Results Design: While the ICU was in a self contained area with easy access to other departments the actual work environment did not comply with the recommendations of the JFICM (2003) minimum standards ofICU. ICU staffing: The staff consisted of only 1 medical doctor consultant and three specialist anesthetists. There were 11 Registered nurses (RNs) and 16 Enrolled nurses (ENs). A physiotherapist and dietician were available, but there was no biomedical engineer. The quantity of equipment was not adequate for the workload in the unit. There were no guidelines or protocols for nursing care and the unit had neither in-service training programmes nor research programmes available to the medical and nursing staff. While vital signs, ECG and oxygen were well monitored by using the nursing file (Appendix 10), the monitoring of patients was done without any guidelines or written procedures. The nursing reports, also, did not follow any guideline or procedure. Communications were generally poor because of the lack of equipment. The phone was not working for most of the time and there was no biotechnical engineer available to monitor the material and equipment. Conclusion According to the analysis of the structure and process standard based on JFICM (2003), the minimum standard of quality of ICU patient care at CHUK needs to be improved because the unit does not comply with an appropriate design, fulfil the staffing and operational requirements, or have the necessary equipment. Due to the shortage of qualified staff, plus the unavailability of protocols or guidelines, the processes of quality patient care were inadequate and need to be improved.
Exploring the factors that contribute to job satisfaction among registered nurses at King Faisal Hospital, Kigali, Rwanda.
(2008) Nkomeje, Aurelie.
AIM: The aim of the study is to explore the factors that contribute to job satisfaction among registered nurses at KFH and to determine factors associated with job dissatisfaction among registered nurses at KFH. METHODOLOGY: A quantitative, descriptive, exploratory study was conducted to explore the factors that contribute to job satisfaction among Registered nurses at King Faisal Hospital. A non probability convenience sampling technique was used to include all the available registered nurses doing bedside nursing in the study. A criterion for inclusion into the study was to be a registered nurse working in the area for at least 6 months full time employment. Data was obtained through a questionnaire survey using Job Satisfaction Survey (JSS), to assess factors influencing job satisfaction among nurses at KFH, Kigali-Rwanda. Data were analysed by SPSS 15.0 for Windows. FINDINGS: The findings of this investigation was that the factors, namely; supervIsIOn, coworkers, nature of work and communication were factors that contributed to a greater job satisfaction of registered nurses (45.5%); while factors such as pay, promotion, fringe benefit, contingent reward and operation procedures, were factors that caused moderate job satisfaction (55.5%). Simultaneously, the research found that these results also indicated, to some degree, that these factors are contributing to job dissatisfaction, albeit small. The study recommends strategies that management can utilise by improving income (salary, benefits and rewards), job promotion and working conditions may increase RNs' job satisfaction and therefore improve the overall well being of nursing personnel and quality of health services. These strategies may be used as a tool to keep employees satisfied and motivated in their jobs. It also recommends ways by which management can reduce job dissatisfaction amongst employees by improving and simplifying the hospital policy and administrative matters. CONCLUSION: The results of this study revealed that registered nurses are moderately satisfied with their job. The nurse administrators will know that they need to do more to improve nurses' job satisfaction since registered nurses are only moderately satisfied.
Exploration of factors that influence the utilisation of HIV/AIDS prevention mehtods among University of KwaZulu-Natal students residing in a selected campus.
(2009) Ndabarora, Eleazar.
In this study, the researcher is interested in the utilization of HIV/AIDS prevention methods among university students. The purpose of this study was to explore factors that influence the utilization of existing HIV/AIDS prevention methods amongst students at the University of KwaZulu-Natal residing in a selected campus. Four residences within the selected campus were randomly selected and participants were conveniently selected from each of sampled residences. There was a total of 335 respondents and 261 (78%) completed the manual questionnaires while 74 (22%) completed online questionnaires. The study used quantitative approach and was descriptive-exploratory in nature. Data was analyzed using the Statistical Package for Social Sciences (SPSS) version 15. The majority of respondents were young people with the mean age of 22.9 years. The sample comprised 278 (78%) undergraduate and 57 (17%) post graduate students. Study findings showed that the factors which influenced the utilization of HIV/AIDS prevention methods varied and that they were mainly influenced by the awareness of the existing university-based HIV/AIDS prevention strategies. It also emerged that the mostly utilized HIV prevention methods were VCT services and free condoms. Perceived susceptibility and the perceived threat of HIV/AIDS score was also found to be correlated with HIV Risk Index score. Furthermore, there was Correlation between perceived susceptibility and perceived threat of HIV/AIDS and self-efficacy on condoms and their utilization. However, there seemed to be no relationship between utilization of HIV/AIDS prevention methods and these variables. In conclusion, the findings of this study suggest that most of Health Beliefs Model (HBM) variables were not predictors of the utilization of HIV/AIDS prevention methods among students. Intervention aiming to improve the utilization of HIV/AIDS prevention methods among students at the UKZN should focus on removing identified barriers, promoting HIV/AIDS prevention services and providing correct knowledge on HIV for behavioral change.
Exploring how psychiatric nurses working with psychiatric clients in the eThekwini district understand the spiritual dimension of holistic psychiatric nursing practice : a descriptive phenomenological study.
(2010) Tokpah, Mulbah Massaquoi.
The purpose of this qualitative study was to explore how psychiatric nurses working with psychiatric clients in the EThekwini District understand the spiritual dimension of holistic psychiatric nursing practice. Descriptive phenomenology informed the study design, data collection and analysis. Integrating spiritual and psychiatric care is an important contemporary issue for psychiatric nursing if the profession is to continue to define itself as a holistic and client-centered activity and to provide socially responsive care (Greasley et al 2001; Mohr, 2006). Local data about how nurses understand and practice spirituality in their working encounters with clients would be an important first step in enhancing holistic, patient-centered psychiatric nursing care in the South African context. Purposeful sampling was used to select the seven psychiatric nurses working in psychiatric settings in the EThekwini District. These participants were selected from the advanced psychiatric nursing classes of the School of Nursing of the University of KwaZulu-Natal for 2008/2009 and 2009/2010. Data were collected through in-depth interviews lasting for 45minutes to lhour and were audio-taped and later transcribed to facilitate easy analysis. The Colaizzi Method of data analysis and representation was utilized. The following four themes emerged during the analysis of the data. Each theme had between three and twenty one associated significant statements. Theme 1 revolved around the higher power of spirituality, religion and their relationship. The participants conceptualized spirituality in a variety of ways, linking spirituality to religion and to cultural values, daily moral and interpersonal experiences with self and others that provide direction and meaning in life. Spirituality was conceived of as "the glue that brings people together" and as a primary source of meaning making in daily life that provides people, nurses and patients with a sense of belonging and of joy, hope, and comfort in both difficult and happy times. The second theme "Central to but forgotten in psychiatric nursing practice" concurs with the literature view that spirituality and psychiatric nursing care are related, although spirituality is often forgotten in psychiatric nursing practice. Participants linked spirituality specifically to Maslow's Hierarchy of needs. The third theme entitled "Psychiatric nursing for the spirit: Enabling and limiting factors identifies a number of factors which influence how psychiatric nurses engage with this dimension of holistic psychiatric nursing practice. This theme focuses on factors which influence psychiatric nurses in providing spiritual care for their patients. Enabling factors include psychiatric' nurses own spiritual orientation and knowledge about spiritual care enables them to provide spiritual care whereas limiting factors include the lack of spiritual education and spiritual knowledge in providing this care. The final theme highlights what these nurses see as important for developing their ability to provide spiritual assistance and includes education in method of spiritual assessment and intervention as the basis for providing holistic psychiatric nursing practice. A number of recommendations for psychiatric nursing practice, education, research and policy-making based on the data from the study were made to relevant stakeholders. If accepted and implemented will go a long way in augmenting psychiatric nursing intervention to be holistic wherein psychiatric nursing care will include not only the biological, psychological and social care but also the spiritual care.
The delivery of cultural care by health professionals among the hospitalized AmaXhosa male initiates of traditional circumcision in the Eastern Cape.
(2009) Ntsaba, Mohlomi Jafta.
Traditional male circumcision is a rite of passage among the AmaXhosa in South Africa. According to the custom of male traditional circumcision, initiates should remain in the bush for the entire seclusion period. The AmaXhosa male initiates encounter complications due to a ritual that has gone wrong. Common complications are penile sepsis, dehydration, penile amputations and septicaemia. As a last resort, when the AmaXhosa male initiates do not improve from complications associated with the custom they are referred to hospital for admission (Meintjes, 1998; Warren-Brown, 1998). The main purposes of this study were, first to explore and describe the delivery of care to the hospitalized AmaXhosa male initiates whilst in the hands of healthcare professionals and professional care system. Second, to describe what constitutes culturally appropriate care for hospitalized AmaXhosa male initiates. This study took place in three research sites, that included one rural hospital and two urban hospitals which admitted the AmaXhosa male initiates of traditional circumcision. A total of 13 hospitalized AmaXhosa male initiates and nine health professionals took part in this study. Leininger's ethnonursing qualitative research approach was used to guide this study. Data were collected, using purposive sampling, by means of unstructured interviews using guides, tape-recorder, and field notes. The study was first piloted at Umlamli Hospital using the same data collecting strategies as for the major study. Data from key and general informants were analysed separately using Leininger's (1991) four-phase method. This was carried out in order to answer the research questions and research purposes. Major themes and patterns emerged from this process.
The use of love medicine among black Africans in KwaZulu-Natal and risks of HIV transmission to both men and women in South Africa.
(2010) Kunene, Mirriam Busisiwe.; Mtshali, Ntombifikile Gloria.
No abstract available.
Responsiveness of nursing education programmes at Lilitha Nursing College to the needs of the Eastern Cape Population.
(2008) Mbatha, Nomawethu Adelicia.; Mtshali, Ntombifikile Gloria.
Background: Reviewed literature revealed a number of responses to the calls to reform nursing education to respond to the priority health needs of the country. The 1997 National Health Care Policy served as the basis for the reforms in nursing education. Some of the nursing schools in South Africa embarked on a process of recurriculating to community based, problem based education long before the tabling of the 1997 National Health Care Policy with the aim to respond to priority health needs. Literature however showed that no research has been conducted to explore the concept responsive education within the South African context, especially in nursing education and whether nursing programmes are responding to the needs of the South Africa population. Therefore the purpose of the study was to explore the concept responsive education and responsiveness of the Nursing Education Programmes at Lilitha College of Nursing to the health needs of the Eastern Cape population. Research Methodology: A qualitative research approach with an ethnography design was used to guide the research process in this study. Purposive and convenient sampling was used to select the participants. The participants included policy makers from the Department of Health (Eastern Cape), lecturers and campus heads of Lilitha's three campuses (Umthatha, Port Elizabeth and East London), the professional nurses and the graduates at the primary health clinics, as well as the college principal. Initially, data collection and data analysis took place concurrently, Findings: Responsive education in this study was characterized by relevance to the health needs of the community, responding to national policies, community involvement and participation, use of health priorities to update the curriculum and graduates who can provide quality care. Cultural themes that emerged under responsive nursing programmes included; the special nature of the curriculum used, the innovative teaching strategies used, clinical learning sites which are congruent with the programme outcomes, the role played by all stakeholders in the programme, and assessment strategies used which are in line with the programme outcomes. A number of factors emerged as barriers to the production of responsive graduates. The findings in this study also revealed competencies of graduates from a responsive nursing programme, which included practical and transferable life skills. Recommendations: These included reviewing of existing nursing programmes with the aim of ensuring that they respond to the health needs of the community, revisiting teaching strategies used, building capacity of lectures in the area of innovative teaching and revisiting graduate competencies in nursing programmes to that they are in line with what the community demands.
How nurse educators promote reflective thinking in a college of nursing in KwaZulu-Natal.
(2007) Naidoo, Maniya.; Mtshali, Ntombifikile Gloria.
There is a great deal of literature and a number of research studies that have been carried out on reflective practice, models and frameworks of reflection and teaching strategies that successfully promote reflective thinking. This study addresses the need to adopt teaching - learning approaches in nursing education that develop a link between theory and practice in a meaningful way. Reflective thinking is one such approach which is gaining popularity. Reflection is claimed as a goal in many teacher education programmes but the application of reflective teaching strategies has been problematic. This study was aimed at exploring how nurse educators of the Nursing Colleges in KwaZulu-Natal promoted reflective thinking in their teaching. Three of the four Nursing Colleges chosen for data collection were from the greater Durban Metropolitan area because of the accessibility of the participants. There were seventy-two participants in the study. A quantitative design was used, followed by statistical analysis of the data. Data was collected by means of a questionnaire which included structured and semi-structured questions. What emerged in this study is the need for Nurse Educators to take cogniscance of determining appropriate teaching strategies that would develop reflective thinking skills amongst learners. However, the findings indicate that most Nurse Educators do utilize teaching strategies that promote reflective thinking, but a large percentage still use the lecture method as the primary teaching strategy.
The development and implementation of policy guidelines for health promotion in the workplace.
(2007) Mchunu, Gugu Gladness.; Uys, Leana Ria.
The three phased study aimed to develop policy guidelines for workplace health promotion based on an exploration of the current status of health promotion in South African workplaces. In the first phase of the study a case study approach was used to analyse the current situation of health promotion in the workplace. For this phase of the study the particular aim was to determine to what extent the participating workplaces were involved in health promotion, or were salutogenic in nature. A total of 6 organizations participated in the first phase of the study, with a total of 258 participants. The second phase aimed at developing policy guidelines for health promotion in the workplace. The consensus method, using the Delphi technique, was used in this phase, involving seven participants who were experts in the field of occupational health and health promotion. The third phase was an observation of the implementation of the policy guidelines. Implementation analysis, which is part of evaluation research, was the methodology used. Two organizations from phase one participated in the implementation phase. In summarising the findings on the current situation of employee health promotion programs the study showed that none of the participating organizations emerged as health promoting workplaces. Organizations that offered employee health promotion/wellness programs mainly focused on individual health and on HIV/AIDS and none of them was found to provide comprehensive holistic programs that aimed at providing healthy work environments. In phase 2 of the study it emerged that there was a very strong concurrence between the findings from the experts and literature in terms of what needs to be included in health promotion policy guidelines. The key elements for health promotion policy documents were (1) organizational philosophy (2) stakeholder involvement and (3) the description of programs to be included in the policy. During the policy implementation process it emerged that different strategies were used in the policy development process. This process was largely influenced by such factors as organizational size, type and internal structures. Recommendations include an emphasis on more legislative support for health promotion in the workplace, and for more concrete aids such as policy guidelines and educational preparation of occupational health professionals for this component of their role.
A description of the forensic nursing role in the emergency departments in Durban Metro.
(2006) Abdool, Nomusa N. T.; Brysiewicz, Petra.
Aim: The aim of the study was to describe the forensic role behaviour and expectations of the nurses working in the emergency departments. Design: An exploratory descriptive survey was used, using the quantative approach. The respondents comprised of registered and enrolled nurses who were registered with South African Nursing Council (SANC) and had the minimum of 6 months experience in the emergency department (ED). The emergency departments of two provincial and two private hospitals as well as two comprehensive care clinics were used. Instrument: A survey was conducted using a questionnaire consisting of forty items. The questionnaire was designed to describe the forensic role behaviour and expectations of nurses working in the ED. Data analysis: The quantative data was analysed using the Statistical Package for Social Sciences (SPSS) program version 11.5 Findings: The findings revealed that the emergency department (ED) nurses were not certain about their role regarding forensic nursing. Most of the tasks to be performed by the ED nurses were rated as never done or seldom done. The reason was due to lack of training and knowledge in the field of forensic nursing. The ED nurses strongly felt that forensic nursing was very important to their daily activities especially in the emergency departments where they handle the trauma victims and suspects. Recommendations were suggested for the nursing practice, nurse educators and for future research in an attempt to expose the emergency nurses to forensic practice.
A comparative analysis of adolescent sexual and reproductive health programmes in two African countries : Ghana and South Africa.
(2007) Shepherd, Joan Hannah Elizabeth Estella.; Adejumo, Oluyinka.
Sex and sexuality issues are still sensitive and controversial subjects despite the growing numbers of sexual and reproductive health (SRH) programmes for adolescents in subSaharan African countries (WHO, 2002; Department ofInternational Development (DFID), 2004). The purpose of this study was to examine and analyze the structure and procedural mechanisms adopted by adolescent sexual and reproductive health (SRH) programmes in two African countries. This study also explored the adolescents' perceived usefulness and relevance of these programmes in addressing their SRH needs. The study was conducted in Ghana (West Africa) and South Africa (Southern Africa) as a cross-national study in these two sub-Saharan African countries. A comparative case study design was adopted involving the use of both quantitative and qualitative approaches to data collection and analysis. Snowballing, critical case, and purposive sampling methods were used. A wide range of personnel from both countries including programme directors, managers, nurse/midwives, peer educators and youth counselors (n=48) were interviewed within the context of adolescent sexual and reproductive health (ASRH) programmes and adolescents (n=247) participated through client exit surveys and focus group discussions. Records review, document analysis and observation of the facilities were employed through a checklist. A Tri-dimensional conceptual framework adapted from Donabedian (1980) and WHO (2001) for: (1) Structure, (2) Process, and (3) Output of ASRH programmes, guided the study and served as the frame for analysis and comparison. Qualitative data were transcribed and analyzed using framework analysis and quantitative data through use of SPSS Version 13.0. Findings of the study revealed that both Ghana and South Africa have established ASRH structures through development of programmes and policies for young people. They also shared common features related to programme focus and philosophy on ASRH matters. Both countries face several challenges associated with sexuality issues, inadequate human and material resources. Religious, socio-cultural, logistical and structural factors were identified as barriers, which hindered access and use of the facilities. These barriers were found to have a profound influence on programme implementation, achievement of objectives and future development. Adolescents in the two countries are confronted with a range of issues affecting their sexual health and general well-being for which they seek services from ASRH programmes. These programmes in both countries were generally perceived as relevant and important by youth utilizing the facilities. The need for changes in the attitude of service providers, structural layout, logistical improvement and staffing composition was expressed. Despite efforts made, there are still programmatic issues needing attention, for which specific recommendations towards improvement were made on the basis of findings from both countries. Findings from this study have implications for nursing practice, management, education, research and relevant stakeholders involved with adolescent health, including policy makers. Recommendations are made that may contribute to the development of an effective model of "Adolescent-Friendly" programmes in the two countries.
The factors influencing the implementation of the post-natal home visit program by nurses in an urban health district, Botswana.
(2006) Mouti, Omphemetse Sephala.; McInerney, Patricia A.
The post natal home visit care program is a maternal and newborn home visit care program, designed to address the needs of the childbearing families following delivery and early discharge, irrespective of the place of delivery. The study was undertaken to determine the factors influencing the implementation of the post natal home visit care program by nurses and to make suggestions to resolve the problem in an urban health district in Botswana. A descriptive exploratory study, using both quantitative and qualitative methods guided the process. Two methods were used to collect data, namely, the developed checklist and four focus group discussions. Twelve clinics were sampled and checklists were completed for the twelve clinics by the researcher. A total of twenty eight Registered Nurses and Registered/Enrolled Nurse Midwives were recruited from the participating twelve clinics through purposive sampling. This included nursing managers and senior nursing staff. The findings reflect the post natal home visit care program deficits. Protocols and logistics such as transport and staff for the program were not in place. Furthermore, the results also reflect various factors such as lack of motivation, lack of support from management and co-workers, distance and fear of stigmatisation as reasons for not implementing the post natal home visit care program. The participants felt that there was need to implement the program and attached merit to its importance. Finally, the participants made suggestions to overcome the deficit such as team work, commitment to work, academic development and improvement of management and supervision. In conclusion, failure to implement the program represents a health delivery deficit. There is need for improved management and supervision to balance the needs of Registered/Enrolled Nurse Midwives and the needs of the organization in order to attain better results. There is also a need for the provision of logistics needed for the post natal home visit care program such as transport and manpower. Finally, there is need for the coordination of the post natal home visit program by the District Health Team to aid implementation so as to provide the essential service.
The responses and involvement of fathers of pre-term low birth weight babies in a neonatal intensive care unit at a tertiary hospital in Durban.
(2007) Soniyi, Afolake Felicia.; Cassimjee, Rabia.
Premature birth occurs before parents have had time to prepare for the birth of the infant. This survey was conducted to describe the responses of fathers of preterm low birth weight babies (PTLBW) and their involvement in the care of those babies in a neonatal intensive care unit. A quantitative descriptive non-experimental study design using purposive sampling (a non -probability method of sampling) was adopted. Fifty fathers of PTLBW babies of less than 2500grams, who visited and were involved in the care of their babies in NICU, voluntarily participated in the study by completing a self-administered questionnaire. The questionnaire was designed to collect the demographic information of the participants and to address their responses and their involvement in the care of the baby. Analysis of the findings revealed that fathers reacted positively on the birth of their babies as the majority of the fathers indicated that they were happy despite the fact that their babies were born before time. Fathers in this study experienced varying reactions to the equipment that they saw being used on their babies, 76% mentioned that they were frightened. Moreover, the research findings revealed that a high percentage of fathers, 88%, in the study mentioned that talking to their wives, partners or spouses as well as talking to nurses and doctors in NICU was the main strategies that they had used to cope with their feelings. Teaching is part of the support available to fathers as a tool to enhance their psychological well being and increase their interdependence relationship. Fathers in this study indicated they received information about their babies during visits. Thirty four (68%) of the fathers in the study acknowledged that nurses gave the most teaching about the baby, baby's care, baby's progress and about their overall role while the baby is in NICU. The fathers also in the same manner demonstrated that the information that they received on the NICU environment has helped them to participate in the care of the baby.
The relationship between health education and health compromising behaviour among South African adolescents attending an institution of tertiary education.
(2006) Ussher, Ingrid Linnea.; Mtshali, Ntombifikile Gloria.; Mathe, Lindiwe.
In South Africa statistics of mortality and morbidity, pertaining to the consequences of risk taking behaviour among the country's youth, remain unacceptably high. Many of these behaviours have long as well as short term consequences, thereby, giving rise to many illnesses, lifestyle diseases, and other problems. The risk-taking activities confining this study include those that are known to concur and co-vary namely: unprotected, indiscriminate sex; nicotine use; alcohol and other drug/substance abuse; and unsafe travelling practices. The problem is that it is unknown whether South African adolescents are receiving health education that reduces risk-taking tendencies, and if they are, whether they are benefiting from the exposure. Little is known about the relationship between health-education and health-compromising behaviour in South Africa; nor the influence of other variables on this relationship. The purpose of the study was to describe and explore this relationship, among South African adolescents, attending an institution of tertiary education in the province of KwaZulu Natal. All aspects of the research were underpinned by Rosenstock's Health Belief Model (1974). The research was approached from a quantitative perspective using a descriptive/exploratory design. A sample of 155 students from all the main ethnic groups, of both sexes, aged between 17 and 24 years, who were raised and educated in South Africa, was taken from the Howard College Campus of the University of KwaZulu Natal. The sampling technique used was non-random quota sampling in order to meet the above mentioned inclusion criteria. The
A social constructionist analysis of talk in episodes of psychiatric student nurse-psychiatric client community clinic based interaction.
(2007) Middleton, Lyn Elizabeth.; Uys, Leana Ria.
The study seeks to explore and to offer a critical account for the 'discursive doings' of student psychiatric nmsing practice as they are jointly constructed in the episodes of conversation between the nmse and client-speakers within the context of the communitybased psychiatric clinic. The study is built around a social constructionist framework and is concerned with the analysis of the discursive activities present within seven (7) transttibed, audio-recordings of student nurse-psychiatric client interactions. A thick and sometimes critical description of three of the contextual forces back grounding/foregrounding the discursive processes of psychiatric nursing is given. These include the public health psychiatric care context, the problem-solving approach of the undergraduate psychiatric nursing curriculum and the assumption and effects of modem psychiatric nursing theory. The first level of analysis is an aspect of the methodology and offers a descriptive and interpretive analysis of the talk in the texts. Various conversational discourse analytic tools were used here to transform talk into text and to develop the starting point for the subsequent positioning theory analysis. The second level of analysis is a positioning theory analysis of happenings within these texts. Some of the textual descriptions generated in the first level of analysis are used to illuminate and to add substance to the accounts of these positioning theory happenings. The analysis has shown that from a social constructionist positioning perspective, the unfolding nurse-client dialogue in these texts operates in four potentially distinct ways - highlighting, herding, hectoring and heeding - with specific effects for their going on together in conditions of relationship. These ways of talking are shown to be contrary to the person-eentered rhetoric of modem psychiatric nursing and more aligned with the bio-medical format of talk in helping contexts. Can these activities be dismissed as non-nursing activities? The implications for a modem psychiatric nursing theory that holds the person-centred approach to be its quintessential essence are considered and a number of ideas for how client-authorised expressions may be jointly manifest in conversations situated in this practice context are offered.
The relationship between nurse staffing and selected patient outcomes.
(2006) Mbabazi, Perpetua.; Lee, Marilyn.
This research study aimed at determining the relationships between nurse staffing and nurse sensitive outcomes (urinary tract infection, pressure ulcers, pneumonia, missed dose, wrong dose, and wrong drug) in the University Central Teaching Hospital of Kigali. A retrospective, descriptive design guided the study. A purposive sampling method was used to select the unit of study. Patient files were selected (n =797) and reviewed from the medical and surgical wards in February and March 2006. A checklist format was used to collect the data. The first instrument for data collection on staffing included the shifts, the categories of nurses, the total number of nurses and the patient census. The second instrument on adverse events included all events under study. Data collection was done by the researcher. A quantitative method was used to analyze data. The results indicated a statistically significant relationship between pressure ulcers, pneumonia, and phlebitis and number of registered nurses. Risk of wound infection was statistically significant between both increased numbers of enrolled nurse and registered nurses as well as nurse: patient ratio. The findings also revealed a statistically significant protective relationship between pneumonia, missed dose, and phlebitis with increased nurse: patient ratio. The findings of this study revealed no statistically significant relationship were found between urinary tract infection, pneumonia, phlebitis, and missed medication dose and the mean number of enrolled nurses. There was no statistically significant relationship between urinary tract infection and missed medication dose and the mean number of registered nurses. The result of this study suggests that there is an impact of nursing workload and expertise on patient outcomes.

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