Masters Degrees (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.
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.
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.
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
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.
Effects of psychoeducation on medication compliance and symptom management for clients with bipolar affective disorder attending community psychiatric clinics in Ethekwini health district .
(2005) Ng'oma, Mwawi Agnes.; Mahlungulu, Sarah Nomalizo.
This study was aimed at evaluating effects of psycho education on medication compliance and symptom management for clients with bipolar affective disorder attending community psychiatric clinics in the Ethekwini Health District of KwaZulu-Natal Province. A quantitative study was done using a quasi-experimental design. A one group pre-test and post-test design was used to assess the effects of psycho education. The population of the study were all clients with bipolar affective disorder attending Escoval House community psychiatric clinic and its satellite clinic (Austerville). Systematic sampling was used to select clients to participate in the study and a total of forty clients were selected. Two self-administered questionnaires were used to collect data. Clients were assessed in areas of their knowledge, medication compliance and symptom management (Pre-test). The group was then exposed to six sessions of psycho education, and they were assessed again a week after the psycho education (post-test) using the same instruments. The data was analyzed using the Statistical Package for Social Sciences (SPSS). Descriptive statistics were used to analyse participants' characteristics and some selected variables. Cross tabulations, chi-squares and paired t-tests were used on dependent variables and on social variables of interest to compare the changes in scores and means respectively and lastly to determine the relationship of social variables and the dependent variables. The findings of this study revealed that psycho education improved respondents' knowledge about their illness and symptom management techniques (with P-values ranging from 0.0001- 0.03), psycho education also improved medication compliance with P-value =0.000, but it did not affect the respondents' ability to use new techniques in managing their symptoms (with P-values ranging from 0.125- 0.75).
An analysis of the assessment of clinical learning in a nursing diploma programme in Kigali Health Institute in Rwanda.
(2007) Kayihura, Camille N.; Mtshali, Ntombifikile Gloria.
Assessment of clinical learning is imperative in order to ensure that those who become registered nurses are safe and competent practitioners. Assessment of clinical skills requires evaluation of the development of appropriate knowledge, skills and attitudes. Literature however reveals that the measurement of clinical skills performance continues to pose a challenge for nurse educators, the debate around the best assessment method in clinical learning, as well as, validity and reliability in assessing clinical learning is ongoing. This study was therefore aimed at exploring and describing current practices in assessment of clinical learning in a nursing diploma programme in Kigali Health Institute in Rwanda. The study was a quantitative descriptive exploratory design. Data were collected through the use of questionnaires. Nurse educators, students and external examiners were asked to report on the assessment strategies commonly used in Kigali Health Institute, their views about assessment strategies, and the strengths and weaknesses of clinical assessment strategies used in a nursing diploma programme in assessing practical competences of nursing students. The total number of participants who returned questionnaires in this study was 117. The results of this study revealed the commonly used assessment strategies included OSCEs (100%), case presentations (66%), direct observations (38%), standardized patients (31 %) and reflective diaries (2%). Furthermore, assessments were based on clinical learning outcomes. Assessments were conducted formatively and summatively to ensure validity in assessments and to ensure that a variety of clinical learning areas were assessed. Although there was no documented structured process of conducting clinical assessments, the findings revealed that the process included a number of phases; planning, preparation, implementation and evaluation phases. There were measures in place to ensure validity and reliability in assessments. The need for a policy on clinical learning assessment emerged so as to serve as a guide to ensure consistency in conducting assessments. The need to build the capacity of nurse educators and external examiners also came up as very few had educational preparation for their roles. Most of them were specialists in the discipline not in nursing education. The findings also revealed that not all nurse educators were involved in decision making regarding clinical assessments for quality assurance purposes. Issues such as welcoming of students on the assessment day, giving of instructions to students, time spent on performing tasks, feedback to students, returning to tasks which were not completed and improvising during assessments due to limited resources emerged as areas of concern. Recommendations made are related to the assessment process, the building of capacity of nurse educators and external examiners, preparation of students for clinical learning assessment, and further research for the in-depth exploration of this area.
Acceptability, knowledge and perceptions of pregnant women towards HIV testing in pregnancy at Ilembe district.
(2005) Dube, Faith Nana.; Nkosi, Zerish Zethu.
This research study aimed at investigating the acceptability, knowledge and perceptions ofpregnant women towards IDV testing in pregnancy in Ilembe District. An exploratory research design guided the study. A systematic random sampling was used to select fourty pregnant women who were attending clinic for the first time in their current pregnancy. Self-administered questionnaires with close-ended questions were used in the collection ofdata. The questions included the women's demographic details, their views towards IDV testing, knowledge and acceptability ofIDV testing. Forty questionnaires were distributed and they were all returned. Quantitative method was used to analyse data. The fmdings ofthe study revealed that women in the sample were relatively young (18-25) with the percentage of45% and most ofthem were unmarried (90%). The majority ofwomen (92.5%) said testing was a good idea and 85% said it is necessary. However only 52.5% said they will opt for HIV testing. Uptake ofHIV testing was found to be low. Eighty-seven and a half percent (87.5%) women were ofthe opinion that IDV testing in pregnancy was ofbenefit to the mother and her baby. Women in the study were found to have good understanding and good perceptions towards IDV testing in pregnancy, but thus was not consistent with their behaviour. Meaning that in spite of their good understanding and good perceptions towards IDV testing in pregnancy, only a small percentage (52%) of respondents said they will opt for the IDV test. The researcher's expectations were one hundred percent response.
Hospital workplace experiences of registered nurses that have contributed to their resignation in the Durban Metropolitan area.
(2005) King, Lisa.; McInerney, Patricia A.
Aim: The purpose of this research was to explore and describe the hospital workplace experiences that had contributed to the resignations of Registered Nurses in the Durban Metropolitan Area. Methodology: The broad perspective governing this research is qualitative in nature. The researcher employed a phenomenological approach specifically because the researcher was interested in identifying, describing and understanding the subjective experiences of individual nurses at the two Private and two Provincial health care institutions selected to participate in the study - in respect of their decision (s) to resign from their employment, and lor to leave the nursing profession. Two semi-structured interviews were conducted with each participant by the researcher. The researcher applied the principle of theoretical saturation and a total of fifteen participants and thirty interviews were done. Experiential themes and sub-themes in the data were identified by a process of meaning condensation, and the data were managed by means of a qualitative software package - NVIVO (QSRNUD* IST). Findings: The resignations of registered nurses in the Durban Metropolitan Area were found to be linked to their respective hospital workplace experiences. These experiences related to their physical working conditions and environment and included the following: unsupportive management structures, autocratic and dehumanizing management styles, negative stereotypy of nurses and the nursing profession, lack of autonomy in the workplace, professional jealousies and fractures within the profession, sub-optimal physical working conditions and shortage of staff, equipment and lack of appropriate surgical supplies, concerns regarding occupational safety e.g. the increasing exposure of health care personnel to RIV and AIDS; lack of opportunities for promotion or continuing one's professional education, the experience ofworkplace violencepredominantly in the form of verbal and psychological abuse, inaccurate systems of performance assessment (Joint Performance Management, Reports, Personal Profile systems) - compounded by favouritism and racism; and inadequate remuneration. Conclusion: In terms of the findings of this study, the participants' lived experiences in terms of their respective hospital workplace experiences indicated that neither the maintenance factors nor the motivator factors were optimally represented, experienced or enjoyed in their respective workplaces. In terms of Rerzberg's Motivator-Maintenance theory, the registered nurses who participated in this study may be described as being 'not satisfied' and 'dissatisfied' with their hospital workplace experiences, physical conditions and environment. A number of recommendations pertaining to strategies for the retention of registered nurses were made for the consideration of both Provincial and Private health care authorities, hospital management structures and the nursing profession respectively. Recommendations for further nursing research were also made.
The perceptions of HIV negative pregnant women towards HIV preventative sexual behaviour in one of the regional hospitals in Durban.
(2005) Msebeni, Sibongile.; Bhengu, Busisiwe Rosemary.; Myeza, T. T.
The aim of the study was to explore the perceptions of the HIV negative pregnant women, after their hiv negative results, towards preventive sexual behaviour. Methodology: A qualitative approach was used in exploring the perceptions of hiv negative pregnant women and describing their behaviour according to the findings. Fifteen participants were interviewed. Two semi - structured interviews were conducted with each participant, an initial interview and a verifying interview, for the purpose of saturation and verification. Each interview lasted for 20 - 30 minutes. The interviews were recorded and transcribed. Manual data analysis was used to identify categories and themes. Findings: The study revealed that the participants knew what the negative status entailed. They were also aware that there is a chance of hiv negative person being infected by hiv virus if they do not engage in preventive sexual behaviour. Furthermore, they had also disclosed their hiv negative status to their partners and most of the partners refused to go for testing. Though the participants believed that it was necessary to use condoms even if they were hiv negative, most of them had not use condoms during their last sexual intercourse. Reasons for not engaging in preventive sexual behaviour were revealed by the study. Recommendations were suggested for clinical practice, nursing education, management and research.

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