Experiences of professional nurses related to caring for chronic mentally ill patients at rural primary healthcare clinics
- Authors: Sam, Noluthando
- Date: 2014
- Subjects: Mentally ill -- Rehabilitation , Chronically ill -- Rehabilitation , Hospitals -- Case management services , Mentally ill -- Care
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10068
- Description: Since the deinstitutionalisation of chronic mentally ill patients, there has been an increase in the number of relapsed chronic mentally ill patients who become acutely mentally ill and need to be re-admitted for acute care in psychiatric institutions. Professional nurses working at rural primary healthcare clinics find it difficult to care for these individuals because they lack the necessary knowledge and skills. Chronic mentally ill patients who have been admitted to acute care facilities are stabilised by rendering care, treatment and rehabilitation and then released into the care of the professional nurses working at rural primary healthcare clinics. These patients live in the community and have to make use of the primary healthcare clinics nearest to their homes to provide them with their prescribed medication and care. Furthermore the patients’ mental conditions do not always remain stable, possibly because of a knowledge deficit, at times about their mental status. Patients may become non-compliant, resulting in the recurrence of symptoms, and thus need to be re-admitted to the acute care facility. However, the problem leading to re-admission is not clear for all admissions. It may be that patients do not make use of the primary healthcare clinics. It also seems that the professional nurses in the primary healthcare clinics are unfamiliar in dealing with chronic mentally ill patients living in rural communities. The aim of this study was therefore, to explore and describe the experiences of these professional nurses in caring for chronic mentally ill patients living in a rural community. The researcher used qualitative, explorative, descriptive, and contextual research design. The research population consisted of professional nurses working at primary healthcare clinics. Non-probability purposive sampling was used to identify participants for inclusion in the study. Data collection was conducted using one-on-one, semi structured interviews, observations and field notes and interviews were tape-recorded and transcribed. Data analysis was conducted using Tesh’s method of content analysis to identify themes and sub-themes. A literature control was done to compare the findings to the current published research. Trustworthiness was ensured by using Gubas’s model (1985) of trustworthiness. A pilot study, conducted by interviewing a small sample prior to the start of the main study, determined whether the sampling and interviewing techniques of the researcher as well as the research questions were adequate for data collection. The researcher ensured that the study was of a high ethical standard by taking into consideration values that guide the principles of autonomy, beneficence, non-maleficence and justice. The findings of the study was categorised into three main themes and 13 sub-themes. The main themes were as follow: Professional nurses experience problems when they have to take care of psychiatric patients attending rural primary healthcare clinics. This theme had six sub-themes which were discussed in details in chapter three. The second theme was that professional nurses experience that psychiatric patients in rural communities experience problems which affected their well-being. This second theme has got five sub-themes which were discussed further in chapter three. The last theme was that professional nurses have positive experiences when caring for psychiatric patients in rural communities. This theme has got two sub-themes as well discussed further in chapter three.
- Full Text:
- Date Issued: 2014
- Authors: Sam, Noluthando
- Date: 2014
- Subjects: Mentally ill -- Rehabilitation , Chronically ill -- Rehabilitation , Hospitals -- Case management services , Mentally ill -- Care
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10068
- Description: Since the deinstitutionalisation of chronic mentally ill patients, there has been an increase in the number of relapsed chronic mentally ill patients who become acutely mentally ill and need to be re-admitted for acute care in psychiatric institutions. Professional nurses working at rural primary healthcare clinics find it difficult to care for these individuals because they lack the necessary knowledge and skills. Chronic mentally ill patients who have been admitted to acute care facilities are stabilised by rendering care, treatment and rehabilitation and then released into the care of the professional nurses working at rural primary healthcare clinics. These patients live in the community and have to make use of the primary healthcare clinics nearest to their homes to provide them with their prescribed medication and care. Furthermore the patients’ mental conditions do not always remain stable, possibly because of a knowledge deficit, at times about their mental status. Patients may become non-compliant, resulting in the recurrence of symptoms, and thus need to be re-admitted to the acute care facility. However, the problem leading to re-admission is not clear for all admissions. It may be that patients do not make use of the primary healthcare clinics. It also seems that the professional nurses in the primary healthcare clinics are unfamiliar in dealing with chronic mentally ill patients living in rural communities. The aim of this study was therefore, to explore and describe the experiences of these professional nurses in caring for chronic mentally ill patients living in a rural community. The researcher used qualitative, explorative, descriptive, and contextual research design. The research population consisted of professional nurses working at primary healthcare clinics. Non-probability purposive sampling was used to identify participants for inclusion in the study. Data collection was conducted using one-on-one, semi structured interviews, observations and field notes and interviews were tape-recorded and transcribed. Data analysis was conducted using Tesh’s method of content analysis to identify themes and sub-themes. A literature control was done to compare the findings to the current published research. Trustworthiness was ensured by using Gubas’s model (1985) of trustworthiness. A pilot study, conducted by interviewing a small sample prior to the start of the main study, determined whether the sampling and interviewing techniques of the researcher as well as the research questions were adequate for data collection. The researcher ensured that the study was of a high ethical standard by taking into consideration values that guide the principles of autonomy, beneficence, non-maleficence and justice. The findings of the study was categorised into three main themes and 13 sub-themes. The main themes were as follow: Professional nurses experience problems when they have to take care of psychiatric patients attending rural primary healthcare clinics. This theme had six sub-themes which were discussed in details in chapter three. The second theme was that professional nurses experience that psychiatric patients in rural communities experience problems which affected their well-being. This second theme has got five sub-themes which were discussed further in chapter three. The last theme was that professional nurses have positive experiences when caring for psychiatric patients in rural communities. This theme has got two sub-themes as well discussed further in chapter three.
- Full Text:
- Date Issued: 2014
Take my word for it: a new approach to the problem of sincerity in the epistemology of testimony
- Authors: Dewhurst, Therese
- Date: 2010
- Subjects: Sincerity Philosophy Terminology Knowledge, Theory of Honesty
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:2707 , http://hdl.handle.net/10962/d1002837
- Description: The epistemological problem of sincerity in testimony is often approached in the following way: We, as a matter of fact, accept utterances as sincere. We do so in the face of knowledge that people lie and deceive,and yet we still count these beliefs as good beliefs. Therefore there must be some reason or argument that we can cite in order to justify our acceptance of the sincerity of the speaker. In this thesis I will argue, contra this, that there is no reason, per se, that justifies our of a speakers sincerity: this is because recognition of the obligation to accept the sincerity is a necessary condition on the possibility of communication and interpretation. In the first three of the thesis I will argue against three of the main approaches to the problem by focusing on what I believe to be the strongest accounts of each: Elizabeth Fricker's reductionism, Tyler Burge's non-reductionism, and Paul Faulkner's trust account of testimony. In the final chapter I will put forward my positive account. I will argue that it is a constitutive rule of language that a speaker be sincere, and then make the further claim, that it is a constitutive rule of interpretation that the hearer take an utterance as sincere. On my account, successful communication does not just depend on a speaker making sincere utterances,but just as importantly,, on the hearer recognising an obligation to take those utterances as being sincere.
- Full Text:
- Date Issued: 2010
- Authors: Dewhurst, Therese
- Date: 2010
- Subjects: Sincerity Philosophy Terminology Knowledge, Theory of Honesty
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:2707 , http://hdl.handle.net/10962/d1002837
- Description: The epistemological problem of sincerity in testimony is often approached in the following way: We, as a matter of fact, accept utterances as sincere. We do so in the face of knowledge that people lie and deceive,and yet we still count these beliefs as good beliefs. Therefore there must be some reason or argument that we can cite in order to justify our acceptance of the sincerity of the speaker. In this thesis I will argue, contra this, that there is no reason, per se, that justifies our of a speakers sincerity: this is because recognition of the obligation to accept the sincerity is a necessary condition on the possibility of communication and interpretation. In the first three of the thesis I will argue against three of the main approaches to the problem by focusing on what I believe to be the strongest accounts of each: Elizabeth Fricker's reductionism, Tyler Burge's non-reductionism, and Paul Faulkner's trust account of testimony. In the final chapter I will put forward my positive account. I will argue that it is a constitutive rule of language that a speaker be sincere, and then make the further claim, that it is a constitutive rule of interpretation that the hearer take an utterance as sincere. On my account, successful communication does not just depend on a speaker making sincere utterances,but just as importantly,, on the hearer recognising an obligation to take those utterances as being sincere.
- Full Text:
- Date Issued: 2010
Non-payment of municipal rates and service charges with reference to the Nelson Mandela Metropolitan municipality
- Authors: Ngxongo, Malusi
- Date: 2003
- Subjects: Collecting of accounts , Municipal default -- South Africa -- Port Elizabeth , Public utilities -- South Africa -- Port Elizabeth
- Language: English
- Type: Thesis , Masters , MTech (Public Management)
- Identifier: vital:10772 , http://hdl.handle.net/10948/258 , Collecting of accounts , Municipal default -- South Africa -- Port Elizabeth , Public utilities -- South Africa -- Port Elizabeth
- Description: The local government sphere is comprised of municipalities whose functions include the provision of consumer services. A substantial portion of municipal revenue, which is also used for service provision, is derived from rates and service charges. Through the billing process, the municipality stipulates the amount due to be paid by each account holder. In the case of rates and consumer tariffs, this usually occurs on a monthly basis. Towards the end of 2002, overdue rates and service charges in the Nelson Mandela Metropolitan Municipality amounted to over R800 million. In spite of various attempts undertaken by the municipality to collect overdue amounts, some residents are struggling to pay. Various reasons have been advanced for this scenario. However non-payment of rates and service charges has a negative impact on municipal budget and service delivery. Probably, if alternatives to the current credit control and revenue collection processes could be found, non-payment of rates and service charges could be eliminated.
- Full Text:
- Date Issued: 2003
- Authors: Ngxongo, Malusi
- Date: 2003
- Subjects: Collecting of accounts , Municipal default -- South Africa -- Port Elizabeth , Public utilities -- South Africa -- Port Elizabeth
- Language: English
- Type: Thesis , Masters , MTech (Public Management)
- Identifier: vital:10772 , http://hdl.handle.net/10948/258 , Collecting of accounts , Municipal default -- South Africa -- Port Elizabeth , Public utilities -- South Africa -- Port Elizabeth
- Description: The local government sphere is comprised of municipalities whose functions include the provision of consumer services. A substantial portion of municipal revenue, which is also used for service provision, is derived from rates and service charges. Through the billing process, the municipality stipulates the amount due to be paid by each account holder. In the case of rates and consumer tariffs, this usually occurs on a monthly basis. Towards the end of 2002, overdue rates and service charges in the Nelson Mandela Metropolitan Municipality amounted to over R800 million. In spite of various attempts undertaken by the municipality to collect overdue amounts, some residents are struggling to pay. Various reasons have been advanced for this scenario. However non-payment of rates and service charges has a negative impact on municipal budget and service delivery. Probably, if alternatives to the current credit control and revenue collection processes could be found, non-payment of rates and service charges could be eliminated.
- Full Text:
- Date Issued: 2003
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