The perceptions of professional nurses about the introduction of the National Health Insurance in a private hospital in Gauteng
- Molokomme, Victoria Khabonina
- Authors: Molokomme, Victoria Khabonina
- Date: 2018
- Subjects: Health insurance Hospitals Primary health care
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: http://hdl.handle.net/10353/13057 , vital:39444
- Description: The National Health Insurance is a relatively new concept in South Africa currently being piloted to ensure that all citizens have access to quality and affordable health care regardless of their socio-economic status. This study was prompted by concerns regarding the introduction of the NHI and its implications on the South African health system. Therefore it seeks to determine the professional nurses concerns about the introduction of the NHI in a private hospital in Gauteng and to describe recommendations based on these perceptions. This study used a qualitative, exploratory and descriptive design. Data was collected using a semi-structured individual interview schedule. The sample was purposive consisting of professional nurses employed in a private hospital in Gauteng. Thematic data saturation determined the number of professional nurses interviewed. Data analysis was done with the aid of Creswell’s theory (2014:1996). Ethical considerations were observed and trustworthiness maintained. The results of the study outlined that professional nurse’s perception about the NHI is centred on equal distribution of health services to benefit all South Africans. However, concerns were based on its financial implications for those mandated to pay towards the fund. The feasibility of its implementation in the midst of staff shortage, inadequate resources and its impact on the public health sector was seen as a major challenge. The notion of a joint effort between public and private health sector in creating one health system was anticipated by most participants. The NHI implementation raised concerns about the impact it will have on the private sectors viability in the future. Professional nurse’s non-involvement in policy making, poor communication, lack of transparency, concerns about governance and management were perceived to be stumbling blocks towards efficient and effective implementation of the NHI.
- Full Text:
- Date Issued: 2018
- Authors: Molokomme, Victoria Khabonina
- Date: 2018
- Subjects: Health insurance Hospitals Primary health care
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: http://hdl.handle.net/10353/13057 , vital:39444
- Description: The National Health Insurance is a relatively new concept in South Africa currently being piloted to ensure that all citizens have access to quality and affordable health care regardless of their socio-economic status. This study was prompted by concerns regarding the introduction of the NHI and its implications on the South African health system. Therefore it seeks to determine the professional nurses concerns about the introduction of the NHI in a private hospital in Gauteng and to describe recommendations based on these perceptions. This study used a qualitative, exploratory and descriptive design. Data was collected using a semi-structured individual interview schedule. The sample was purposive consisting of professional nurses employed in a private hospital in Gauteng. Thematic data saturation determined the number of professional nurses interviewed. Data analysis was done with the aid of Creswell’s theory (2014:1996). Ethical considerations were observed and trustworthiness maintained. The results of the study outlined that professional nurse’s perception about the NHI is centred on equal distribution of health services to benefit all South Africans. However, concerns were based on its financial implications for those mandated to pay towards the fund. The feasibility of its implementation in the midst of staff shortage, inadequate resources and its impact on the public health sector was seen as a major challenge. The notion of a joint effort between public and private health sector in creating one health system was anticipated by most participants. The NHI implementation raised concerns about the impact it will have on the private sectors viability in the future. Professional nurse’s non-involvement in policy making, poor communication, lack of transparency, concerns about governance and management were perceived to be stumbling blocks towards efficient and effective implementation of the NHI.
- Full Text:
- Date Issued: 2018
The perceptions of provincial EMS managers regarding the management of the millennial employees in the nelson Mandela Bay Health District
- Authors: Huysamen, Pieter Johannes
- Date: 2018
- Subjects: Emergency medical services -- Nelson Mandela Bay Municipality , Personnel management Employees -- Management -- 21st century
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/30341 , vital:30932
- Description: Literature on generational theory has paid much attention to the differences in values and work ethics between employees from different generational cohorts, but more specifically between managers and the Millennial Generation. These differences in values and ethics affect the way in which multigenerational employees perceive one another, which often leads to conflict and demotivation in the workplace. In an attempt to explore the perceptions of managers of the Emergency Medical Services regarding the management of the Millennial Generation, the researcher undertook a qualitative, descriptive, exploratory and contextual study. Data were gathered through 11 in-depth semi-structured interviews with managers of provincial Emergency Medical Services in the Nelson Mandela Bay Health District. Data were analysed by using Tesch’s steps in data analysis. During the data analysis, the following four main themes emerged: The employees from the Millennial Generation lacked the discipline required for working in emergency services. The employees from the Millennial Generation had up-to-date knowledge, but had little practical experience. Specific attributes of the Millennial Generation were identified. The managers indicated that the employees from the Millennial Generation were in need of management support. The researcher found that many of the participants’ perceptions were inaccurate and influenced by preconceived generational stereotypes and prejudices. The research ended with recommendations, which should assist managers to manage employees from the Millennial Generation in the Emergency Medical Services more effectively. Recommendations were also made for further research. It is acknowledged that the research study had limitations, which included the fact that the data were only collected from one of the eight districts in the Eastern Cape and that the study did not include the private ambulance services in the Nelson Mandela Bay Health District.
- Full Text:
- Date Issued: 2018
- Authors: Huysamen, Pieter Johannes
- Date: 2018
- Subjects: Emergency medical services -- Nelson Mandela Bay Municipality , Personnel management Employees -- Management -- 21st century
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/30341 , vital:30932
- Description: Literature on generational theory has paid much attention to the differences in values and work ethics between employees from different generational cohorts, but more specifically between managers and the Millennial Generation. These differences in values and ethics affect the way in which multigenerational employees perceive one another, which often leads to conflict and demotivation in the workplace. In an attempt to explore the perceptions of managers of the Emergency Medical Services regarding the management of the Millennial Generation, the researcher undertook a qualitative, descriptive, exploratory and contextual study. Data were gathered through 11 in-depth semi-structured interviews with managers of provincial Emergency Medical Services in the Nelson Mandela Bay Health District. Data were analysed by using Tesch’s steps in data analysis. During the data analysis, the following four main themes emerged: The employees from the Millennial Generation lacked the discipline required for working in emergency services. The employees from the Millennial Generation had up-to-date knowledge, but had little practical experience. Specific attributes of the Millennial Generation were identified. The managers indicated that the employees from the Millennial Generation were in need of management support. The researcher found that many of the participants’ perceptions were inaccurate and influenced by preconceived generational stereotypes and prejudices. The research ended with recommendations, which should assist managers to manage employees from the Millennial Generation in the Emergency Medical Services more effectively. Recommendations were also made for further research. It is acknowledged that the research study had limitations, which included the fact that the data were only collected from one of the eight districts in the Eastern Cape and that the study did not include the private ambulance services in the Nelson Mandela Bay Health District.
- Full Text:
- Date Issued: 2018
The Q bell: experiences of patients with disabilities utilising a new call bell system
- Authors: Sithole, Siphiwo
- Date: 2018
- Subjects: Self-help devices for people with disabilities , People with disabilities -- Means of communication -- Technological innovations Communication devices for people with disabilities People with disabilities -- Rehabilitation
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/35543 , vital:33755
- Description: The Q-bell is a newly developed call bell system that aims to simplify the lives of people living with disabilities by providing a means for them to easily summon assistance from caregivers when needed. The product is designed to be hands free so that a patient only must exert minimal pressure on the device with any part of the body such as the cheek to call for attention. The aim of this study was to explore and describe the experiences of disabled participants regarding the functionality of the Q-bell systems during their stay in a care facility. To achieve this aim, an exploratory, descriptive, contextual, qualitative design was decided upon. There was a paucity of similar studies and this method was deemed the most effective method to fully grasp, contextualize and interpret the experiences of the research participants following the use of the Q-bell. The research population included all people with disabilities who were in care facilities. A purposive sampling method was used to identify a small number of disabled participants in care facilities to use the Q-bell. The researcher approached selected facilities and the residents in their care who had limited to no function of their hands and arms to test the Q-bell. The participants were given the Q-bell to use for 2-3 days, after which semi-structured interviews with participating individuals were conducted. Due to difficulties the researcher had with the infrastructure at the facilities eight participants were approached and interviewed in this study. All the interviews were conducted in private, but face to face, at the bedside of each participant, in the facilities of care. Digital voice recordings of these interviews were made after informed consent being sought from the participants. Verbatim transcripts of the recordings were made and a thematic analysis using Tesch’s method, was performed by the researcher followed by a consensus meeting with the independent coder. Ethical considerations such as beneficence, justice, autonomy, informed consent was adhered to by the researcher. Trustworthiness was achieved by following Guba’s principles of credibility, applicability, consistency and neutrality. Three themes emerged from the data analysis. Theme one highlighted the participants’ experiences whilst using the Q-bell. Theme two reflected the positive characteristics of the Q-bell when compared to other call devices the participants might have used while theme three posed possible recommendations the participants had to possibly improve on the design of the Q-bell. The research report concludes with the research limitations and recommendations.
- Full Text:
- Date Issued: 2018
- Authors: Sithole, Siphiwo
- Date: 2018
- Subjects: Self-help devices for people with disabilities , People with disabilities -- Means of communication -- Technological innovations Communication devices for people with disabilities People with disabilities -- Rehabilitation
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/35543 , vital:33755
- Description: The Q-bell is a newly developed call bell system that aims to simplify the lives of people living with disabilities by providing a means for them to easily summon assistance from caregivers when needed. The product is designed to be hands free so that a patient only must exert minimal pressure on the device with any part of the body such as the cheek to call for attention. The aim of this study was to explore and describe the experiences of disabled participants regarding the functionality of the Q-bell systems during their stay in a care facility. To achieve this aim, an exploratory, descriptive, contextual, qualitative design was decided upon. There was a paucity of similar studies and this method was deemed the most effective method to fully grasp, contextualize and interpret the experiences of the research participants following the use of the Q-bell. The research population included all people with disabilities who were in care facilities. A purposive sampling method was used to identify a small number of disabled participants in care facilities to use the Q-bell. The researcher approached selected facilities and the residents in their care who had limited to no function of their hands and arms to test the Q-bell. The participants were given the Q-bell to use for 2-3 days, after which semi-structured interviews with participating individuals were conducted. Due to difficulties the researcher had with the infrastructure at the facilities eight participants were approached and interviewed in this study. All the interviews were conducted in private, but face to face, at the bedside of each participant, in the facilities of care. Digital voice recordings of these interviews were made after informed consent being sought from the participants. Verbatim transcripts of the recordings were made and a thematic analysis using Tesch’s method, was performed by the researcher followed by a consensus meeting with the independent coder. Ethical considerations such as beneficence, justice, autonomy, informed consent was adhered to by the researcher. Trustworthiness was achieved by following Guba’s principles of credibility, applicability, consistency and neutrality. Three themes emerged from the data analysis. Theme one highlighted the participants’ experiences whilst using the Q-bell. Theme two reflected the positive characteristics of the Q-bell when compared to other call devices the participants might have used while theme three posed possible recommendations the participants had to possibly improve on the design of the Q-bell. The research report concludes with the research limitations and recommendations.
- Full Text:
- Date Issued: 2018
The relationship between attribution style, rural vs urban status and traumatic stress severity in Kiambu and Nyeri counties, Kenya
- Authors: Ndungu, Jane Wagithi
- Date: 2018
- Subjects: Post-traumatic stress disorder -- Kenya , Post-traumatic stress disorder -- Patients -- Interviews -- Kenya Rural conditions -- Psychological aspects -- Kenya Rural mental health services -- Kenya Community psychology -- Kenya
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/32793 , vital:32363
- Description: Traumatic exposure and posttraumatic stress in Kenya is a common experience. Despite this prevalence, an investigation of the dynamic influence of variables (such as cultural differences) on posttraumatic stress has received little attention in the country. This means that a relatively narrow understanding of traumatic stress exists in the Kenyan context. This study therefore investigated the relationship between attribution style, rural vs. urban status and posttraumatic stress severity. The exploration and description of these relationships contributed to creating a more nuanced understanding of traumatic stress. Such a nuanced understanding would be useful to a variety of fields of practice. The study utilised a sample from a rural and urban area of Kenya. A purposive convenience sample of 178 rural and 176 urban individuals was used. The study employed a biographical questionnaire and 2 quantitative measures, namely, the Attribution Style Questionnaire (ASQ) and the PTSD Checklist for DSM-5 (PCL-5). Descriptive and inferential statistics were used to analyse the data. Results indicated that posttraumatic stress severity in the urban area was significantly higher than in the rural area. The urban sample was significantly more likely to attribute negative events to internal (rather than external) and specific (rather than global) causes than the rural sample. A regression analysis showed that a negative internal attribution style and educational level had a significant relationship with posttraumatic stress severity.
- Full Text:
- Date Issued: 2018
- Authors: Ndungu, Jane Wagithi
- Date: 2018
- Subjects: Post-traumatic stress disorder -- Kenya , Post-traumatic stress disorder -- Patients -- Interviews -- Kenya Rural conditions -- Psychological aspects -- Kenya Rural mental health services -- Kenya Community psychology -- Kenya
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/32793 , vital:32363
- Description: Traumatic exposure and posttraumatic stress in Kenya is a common experience. Despite this prevalence, an investigation of the dynamic influence of variables (such as cultural differences) on posttraumatic stress has received little attention in the country. This means that a relatively narrow understanding of traumatic stress exists in the Kenyan context. This study therefore investigated the relationship between attribution style, rural vs. urban status and posttraumatic stress severity. The exploration and description of these relationships contributed to creating a more nuanced understanding of traumatic stress. Such a nuanced understanding would be useful to a variety of fields of practice. The study utilised a sample from a rural and urban area of Kenya. A purposive convenience sample of 178 rural and 176 urban individuals was used. The study employed a biographical questionnaire and 2 quantitative measures, namely, the Attribution Style Questionnaire (ASQ) and the PTSD Checklist for DSM-5 (PCL-5). Descriptive and inferential statistics were used to analyse the data. Results indicated that posttraumatic stress severity in the urban area was significantly higher than in the rural area. The urban sample was significantly more likely to attribute negative events to internal (rather than external) and specific (rather than global) causes than the rural sample. A regression analysis showed that a negative internal attribution style and educational level had a significant relationship with posttraumatic stress severity.
- Full Text:
- Date Issued: 2018
The relationship between psychological capital,life satisfaction and employee retention
- Authors: Van Greuning, Hester
- Date: 2018
- Subjects: Employee Retention , Work -- Psychological aspects , Job satisfaction
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/45712 , vital:38957
- Description: South African organisations are faced with the challenge of retaining key and critical employee cohorts. externally focused methods and models of turnover and retention fail to comprehensively explain the lack of highly skilled employees and the inability of organisations to successfully retain these employee groupings. This nonexperimental correlational study investigated the relationship and interaction between the positive psychological constructs of psychological capital and life satisfaction and employee turnover intention of a South African sample of specialist and management level employees (n=150). The survey method was utilised to gather data for the study with a biographical questionnaire, the Psychological Capital Questionnaire-12 (PCQ-12), the Satisfaction with Life Scale (SWLS) and the Turnover Intention Scale-6 (TIS-6). Data analysis was conducted in the form of descriptive and inferential statistics including frequency tables, Cronbach’s Alpha testing, exploratory factory analysis, correlation analysis, t-tests, analysis of variance and structural equation modelling. The results indicated that significant relationships exist between psychological capital, life satisfaction and employee turnover intention. A substantial negative relationship was found between psychological capital and employee turnover intention, as well as a small, yet definite negative relationship between life satisfaction and turnover intention. Even though the results indicated a substantial positive relationship between psychological capital and life satisfaction, the relationship with employee turnover intention was insignificant when the two variables were correlated. This study adds to the current body of knowledge regarding employee retention in South Africa, and allows for a number of future research avenues to be explored.
- Full Text:
- Date Issued: 2018
- Authors: Van Greuning, Hester
- Date: 2018
- Subjects: Employee Retention , Work -- Psychological aspects , Job satisfaction
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/45712 , vital:38957
- Description: South African organisations are faced with the challenge of retaining key and critical employee cohorts. externally focused methods and models of turnover and retention fail to comprehensively explain the lack of highly skilled employees and the inability of organisations to successfully retain these employee groupings. This nonexperimental correlational study investigated the relationship and interaction between the positive psychological constructs of psychological capital and life satisfaction and employee turnover intention of a South African sample of specialist and management level employees (n=150). The survey method was utilised to gather data for the study with a biographical questionnaire, the Psychological Capital Questionnaire-12 (PCQ-12), the Satisfaction with Life Scale (SWLS) and the Turnover Intention Scale-6 (TIS-6). Data analysis was conducted in the form of descriptive and inferential statistics including frequency tables, Cronbach’s Alpha testing, exploratory factory analysis, correlation analysis, t-tests, analysis of variance and structural equation modelling. The results indicated that significant relationships exist between psychological capital, life satisfaction and employee turnover intention. A substantial negative relationship was found between psychological capital and employee turnover intention, as well as a small, yet definite negative relationship between life satisfaction and turnover intention. Even though the results indicated a substantial positive relationship between psychological capital and life satisfaction, the relationship with employee turnover intention was insignificant when the two variables were correlated. This study adds to the current body of knowledge regarding employee retention in South Africa, and allows for a number of future research avenues to be explored.
- Full Text:
- Date Issued: 2018
The role of empathy in emotionally intelligent leadership: an integrative review
- Greyling, Candice, De Jager, Marina
- Authors: Greyling, Candice , De Jager, Marina
- Date: 2018
- Subjects: Emotional intelligence -- Leadership
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/22123 , vital:29842
- Description: Empathy is regarded as a fundamental interpersonal skill. Interpersonal skills are the life skills that we make use of every day to communicate and interact with other people, both individually and in groups. In this study, empathy is given prominence as a component of emotional intelligence. The concept emotional intelligence has enjoyed great popularity in recent years. In this study leadership denotes any person in a leadership position within an organisation. Extensive research has been done on the impact of emotional intelligence on organisations and leadership. Therefore, the aim of this study is to critically analyse the available evidence and to provide a clear review and synthesis of the role that empathy plays in emotionally intelligent leadership. The methodology used in this study will be that of an integrative review. An integrative review summarises the best-quality empirical evidence of the benefits and limitations of a specific practice to provide recommendations for future research. Data to be reviewed include articles in scholarly journals, books, theses and computerised databases. International and national literature involving both quantitative and qualitative research studies will be reviewed. As both qualitative and quantitative research studies will be of focus in this integrative review, rigour in both research methods was considered. The reviewer also considered four ethical considerations, namely: quality, transparency, honesty and plagiarism.
- Full Text:
- Date Issued: 2018
- Authors: Greyling, Candice , De Jager, Marina
- Date: 2018
- Subjects: Emotional intelligence -- Leadership
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/22123 , vital:29842
- Description: Empathy is regarded as a fundamental interpersonal skill. Interpersonal skills are the life skills that we make use of every day to communicate and interact with other people, both individually and in groups. In this study, empathy is given prominence as a component of emotional intelligence. The concept emotional intelligence has enjoyed great popularity in recent years. In this study leadership denotes any person in a leadership position within an organisation. Extensive research has been done on the impact of emotional intelligence on organisations and leadership. Therefore, the aim of this study is to critically analyse the available evidence and to provide a clear review and synthesis of the role that empathy plays in emotionally intelligent leadership. The methodology used in this study will be that of an integrative review. An integrative review summarises the best-quality empirical evidence of the benefits and limitations of a specific practice to provide recommendations for future research. Data to be reviewed include articles in scholarly journals, books, theses and computerised databases. International and national literature involving both quantitative and qualitative research studies will be reviewed. As both qualitative and quantitative research studies will be of focus in this integrative review, rigour in both research methods was considered. The reviewer also considered four ethical considerations, namely: quality, transparency, honesty and plagiarism.
- Full Text:
- Date Issued: 2018
Therapists’ perception of the healing variables of animal assisted intervention
- Authors: Torghi, Parnaz Salmani
- Date: 2018
- Subjects: Animals -- Therapeutic use , Pets -- Therapeutic use Human-animal relationships Psychotherapy -- Alternative treatment
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/36705 , vital:34045
- Description: The significance of the bond that is formed through animal companionship can be found in narratives throughout history. In fact, often a pet is viewed as an integral part of the family and valued as deeply as a member if not more. This has resulted in numerous studies regarding the incorporation of animals within the therapeutic environment and the unique positive impact of their presence on the client. This study aimed to highlight the healing variables of Animal Assisted Intervention (AAI) as perceived by therapists that actively and purposefully incorporated animals into the therapeutic milieu. A qualitative research approach was utilised for the purpose of this study and semistructured interviews were conducted with a sample of five participants selected through a nonprobability purposive and snowball sampling strategy. Participants included registered Psychologists and Counsellors that had incorporated an animal into the therapeutic environment on at least three separate occasions in order to facilitate the therapeutic process. The participants revealed that the presence of the animal within the therapeutic environment acted as a social lubricant for therapy. This allowed for increased interaction between the therapist and the client, thereby facilitating the process of rapport building and the formation of a therapeutic relationship between the therapist and the client. The presence of the animal was observed as influential in increasing clients’ self-esteem. Likewise, the animal’s presence acted as an instrument in teaching social skills, namely, empathy and responsibility. Clients were additionally observed as more present within the here and now, further enabling the therapist to gain more in-depth information regarding the client’s relational interaction outside of the therapeutic setting. The therapy animal also provided the client with therapeutic touch and affection, a source of distraction, a form of a transitional object or object of projection, as well as a buffer that enabled clients to access and express emotions more freely. This study adds to the body of knowledge available on AAI within the South African context.
- Full Text:
- Date Issued: 2018
- Authors: Torghi, Parnaz Salmani
- Date: 2018
- Subjects: Animals -- Therapeutic use , Pets -- Therapeutic use Human-animal relationships Psychotherapy -- Alternative treatment
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/36705 , vital:34045
- Description: The significance of the bond that is formed through animal companionship can be found in narratives throughout history. In fact, often a pet is viewed as an integral part of the family and valued as deeply as a member if not more. This has resulted in numerous studies regarding the incorporation of animals within the therapeutic environment and the unique positive impact of their presence on the client. This study aimed to highlight the healing variables of Animal Assisted Intervention (AAI) as perceived by therapists that actively and purposefully incorporated animals into the therapeutic milieu. A qualitative research approach was utilised for the purpose of this study and semistructured interviews were conducted with a sample of five participants selected through a nonprobability purposive and snowball sampling strategy. Participants included registered Psychologists and Counsellors that had incorporated an animal into the therapeutic environment on at least three separate occasions in order to facilitate the therapeutic process. The participants revealed that the presence of the animal within the therapeutic environment acted as a social lubricant for therapy. This allowed for increased interaction between the therapist and the client, thereby facilitating the process of rapport building and the formation of a therapeutic relationship between the therapist and the client. The presence of the animal was observed as influential in increasing clients’ self-esteem. Likewise, the animal’s presence acted as an instrument in teaching social skills, namely, empathy and responsibility. Clients were additionally observed as more present within the here and now, further enabling the therapist to gain more in-depth information regarding the client’s relational interaction outside of the therapeutic setting. The therapy animal also provided the client with therapeutic touch and affection, a source of distraction, a form of a transitional object or object of projection, as well as a buffer that enabled clients to access and express emotions more freely. This study adds to the body of knowledge available on AAI within the South African context.
- Full Text:
- Date Issued: 2018
Towards the development of a conceptual framework for hospital performance assessment of a South African public hospital in the Eastern Cape province
- Authors: Wagner, Rolene Margaret
- Date: 2018
- Subjects: Public hospitals Hospital care Hospitals -- Administration
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: http://hdl.handle.net/10353/12249 , vital:39223
- Description: An integrated conceptual framework for measuring and comparing the performance of a South African teaching hospital in the Eastern Cape Province with other hospitals, is not available. The aim of this study was therefore to contribute to the development of a conceptual framework for assessing the performance of a SA public hospital in the Eastern Cape Province. The systematic literature review included all black and grey literature that relate to one of the two main themes- the purpose of measuring hospital performance and the methodology of assessing hospital performance. Relevant studies were identified through a Google search using the following descriptors: “Hospital Performance”, and “Hospital Performance Assessment”. There were 369 scholarly articles with the exact descriptors anywhere in the article with 59 articles released during the period 2012 to 2016. Ultimately, 7 articles met all the inclusionary criteria and described enterprise wide assessments of hospital performance. Other relevant articles, inclusive of grey literature, are included. Two of the studies in Morocco and Costa Rica were systematic reviews of hospital performance and covered the period 2000-2011. The Botswana case study assessed the use of the WHO PATH tool to measure the performance of its public hospitals. The Iranian, United States and Malaysian studies reflected on single aspect measures of hospital performance such as efficiency; the effect of weighting hospital performance indicators for patient harm on hospital profiles and payment; and Bed Occupancy rates, respectively. The review of the challenges associated with developing a hospital performance assessment framework was not found to be as useful as the other articles. The WHO PATH tool provides a high level integrated conceptual framework for measuring and comparing the performance of a South African teaching hospital in the Eastern Cape Province with other hospitals. This, however, needs to be adapted to the South African context with specific indicators being selected by local stakeholders that will promote best possible patient outcomes and a positive experience of patient-centred care at effective and efficient public health facilities. Lessons can be drawn from other countries’ experiences that have implemented hospital performance assessments and tested specific performance indicators.
- Full Text:
- Date Issued: 2018
- Authors: Wagner, Rolene Margaret
- Date: 2018
- Subjects: Public hospitals Hospital care Hospitals -- Administration
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: http://hdl.handle.net/10353/12249 , vital:39223
- Description: An integrated conceptual framework for measuring and comparing the performance of a South African teaching hospital in the Eastern Cape Province with other hospitals, is not available. The aim of this study was therefore to contribute to the development of a conceptual framework for assessing the performance of a SA public hospital in the Eastern Cape Province. The systematic literature review included all black and grey literature that relate to one of the two main themes- the purpose of measuring hospital performance and the methodology of assessing hospital performance. Relevant studies were identified through a Google search using the following descriptors: “Hospital Performance”, and “Hospital Performance Assessment”. There were 369 scholarly articles with the exact descriptors anywhere in the article with 59 articles released during the period 2012 to 2016. Ultimately, 7 articles met all the inclusionary criteria and described enterprise wide assessments of hospital performance. Other relevant articles, inclusive of grey literature, are included. Two of the studies in Morocco and Costa Rica were systematic reviews of hospital performance and covered the period 2000-2011. The Botswana case study assessed the use of the WHO PATH tool to measure the performance of its public hospitals. The Iranian, United States and Malaysian studies reflected on single aspect measures of hospital performance such as efficiency; the effect of weighting hospital performance indicators for patient harm on hospital profiles and payment; and Bed Occupancy rates, respectively. The review of the challenges associated with developing a hospital performance assessment framework was not found to be as useful as the other articles. The WHO PATH tool provides a high level integrated conceptual framework for measuring and comparing the performance of a South African teaching hospital in the Eastern Cape Province with other hospitals. This, however, needs to be adapted to the South African context with specific indicators being selected by local stakeholders that will promote best possible patient outcomes and a positive experience of patient-centred care at effective and efficient public health facilities. Lessons can be drawn from other countries’ experiences that have implemented hospital performance assessments and tested specific performance indicators.
- Full Text:
- Date Issued: 2018
Weight gain in hospitalised low birth weight (LBW) premature infants receiving breast milk or breast milk with human milk fortifier in the Nelson Mandela Bay Health District
- Authors: Wicomb, Ra-eesa
- Date: 2018
- Subjects: Premature infants -- South Africa -- Nelson Mandela Bay Municipality , Birth weight, Low -- South Africa -- Nelson Mandela Bay Municipality Birth weight -- South Africa -- Nelson Mandela Bay Municipality Infants -- Nutrition Children -- Nutrition -- Research
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: http://hdl.handle.net/10948/23327 , vital:30529
- Description: Rationale: Worldwide, hospitals with premature units have one generalised objective, i.e. to achieve postnatal growth and body composition similar to that of a normal foetus of similar gestational age. Optimal nutrition leads to optimal neurodevelopment and breastfeeding (BF) is known as the golden standard for infant nutrition. Human breast milk (BM) has significant value for preterm and term infants and is of special benefit to HIV infected mothers. Maternal supplementation is provided as part of the standard protocol in certain hospitals in the Eastern Cape province to those mothers who breastfeed their low birth weight (LBW) infants after delivery. human milk fortifier (HMF) is a nutritional supplement that is added to expressed breast milk for feeding preterm infants in order to meet their high energy and protein needs and therefore supporting the recommended growth velocity of 10g/kg/day-15g/kg/day. Some hospitals within South Africa provide HMF to preterm infants as part of their standard nutritional protocol in order for the infant to gain weight if BM only failed to produce adequate results. To date, little to no South African studies support or discourage the use of HMF for LBW infants. This study aimed to describe the effect of maternal supplementation compared with breast milk with HMF, or a combination of maternal supplementation and breast milk with HMF, on growth velocity in hospitalised LBW premature infants within the Nelson Mandela Bay health district. The proposed study design followed a longitudinal, observational, descriptive study in a cohort of LBW infants. The study was analytical using quantitative empirical data. Study participants were selected, by using convenience sampling, at Dora Nginza Hospital, Zwide between October 2015 and August 2016 (ethics approval: EC_2016RP27_564). Quantitative data on anthropometric measurements was collected from study participants. Primary care givers provided written informed consent. Registered nurses were trained and performed anthropometrical measurements according to standardised methods. A structured questionnaire was completed by the principal reasarcher as a source of data collection. Numerical data was described using means and standard deviations. Chi squares were used to describe the associations between maternal risk factors and birth weight outcomes. ANOVA was used to determine the relationship between growth velocity and the various supplementation groups. A sample size of 91 LBW preterm infants and mother pairs were entered into this study. The majority of mothers, 64% (n=58) fell in the age category of 20-35 years old. Of the total maternal sample (n=88), 35% (n=31) were classified in the at risk age category, i.e. <20years old and >36years old. Out of the total infant sample (n=91), 65% (n=59) was classified as VLBW, 22% was LBW and 22% (n=20) was ELBW. No statistically significant association was found between infant growth velocity and maternal risk factors. The group receiving BM with HMF had a mean growth velocity of 19.75 g/kg/day (SD=6.45) that was statistically significantly (p<0.05) more than the other groups. The maternal supplementation only group and the maternal supplementation and BM fortification group showed mean growth velocities of 12.26 g/kg/day (SD=5.41) and 12.29 g/kg/day (SD=6.97) respectively. A post hoc test was done between growth velocity in the supplementated groups and the length of hospital stay. These results reveal that the group receiving BM with HMF had a significantly (p<0.05) shorter mean length of hospital stay of 11.29 days (SD=7.02), compared with the group on the combination of maternal supplementation and BM with HMF. In this study, infants receiving HMF with BM showed the highest growth velocity with the shortest hospital stay before discharge. In this group, infants were already receiving an adequate BM intake of 150-180 ml/kg/day prior to participation in the study. This meant that the HMF group consisted of more stable preterm infants compared to the rest of the supplementated groups. However, a large proportion of participants in the maternal supplementation group also showed adequate to good growth velocity. The researcher recommends the implementation of maternal supplementation only, as standard of care for all hospitalised lactating women. Furthermore, timeous addition of HMF to expressed BM is necessary for infants with growth velocities <15 g/kg/day. This may save costs to the hospital as the use of HMF allowed for better weight gain and earlier discharge.
- Full Text:
- Date Issued: 2018
- Authors: Wicomb, Ra-eesa
- Date: 2018
- Subjects: Premature infants -- South Africa -- Nelson Mandela Bay Municipality , Birth weight, Low -- South Africa -- Nelson Mandela Bay Municipality Birth weight -- South Africa -- Nelson Mandela Bay Municipality Infants -- Nutrition Children -- Nutrition -- Research
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: http://hdl.handle.net/10948/23327 , vital:30529
- Description: Rationale: Worldwide, hospitals with premature units have one generalised objective, i.e. to achieve postnatal growth and body composition similar to that of a normal foetus of similar gestational age. Optimal nutrition leads to optimal neurodevelopment and breastfeeding (BF) is known as the golden standard for infant nutrition. Human breast milk (BM) has significant value for preterm and term infants and is of special benefit to HIV infected mothers. Maternal supplementation is provided as part of the standard protocol in certain hospitals in the Eastern Cape province to those mothers who breastfeed their low birth weight (LBW) infants after delivery. human milk fortifier (HMF) is a nutritional supplement that is added to expressed breast milk for feeding preterm infants in order to meet their high energy and protein needs and therefore supporting the recommended growth velocity of 10g/kg/day-15g/kg/day. Some hospitals within South Africa provide HMF to preterm infants as part of their standard nutritional protocol in order for the infant to gain weight if BM only failed to produce adequate results. To date, little to no South African studies support or discourage the use of HMF for LBW infants. This study aimed to describe the effect of maternal supplementation compared with breast milk with HMF, or a combination of maternal supplementation and breast milk with HMF, on growth velocity in hospitalised LBW premature infants within the Nelson Mandela Bay health district. The proposed study design followed a longitudinal, observational, descriptive study in a cohort of LBW infants. The study was analytical using quantitative empirical data. Study participants were selected, by using convenience sampling, at Dora Nginza Hospital, Zwide between October 2015 and August 2016 (ethics approval: EC_2016RP27_564). Quantitative data on anthropometric measurements was collected from study participants. Primary care givers provided written informed consent. Registered nurses were trained and performed anthropometrical measurements according to standardised methods. A structured questionnaire was completed by the principal reasarcher as a source of data collection. Numerical data was described using means and standard deviations. Chi squares were used to describe the associations between maternal risk factors and birth weight outcomes. ANOVA was used to determine the relationship between growth velocity and the various supplementation groups. A sample size of 91 LBW preterm infants and mother pairs were entered into this study. The majority of mothers, 64% (n=58) fell in the age category of 20-35 years old. Of the total maternal sample (n=88), 35% (n=31) were classified in the at risk age category, i.e. <20years old and >36years old. Out of the total infant sample (n=91), 65% (n=59) was classified as VLBW, 22% was LBW and 22% (n=20) was ELBW. No statistically significant association was found between infant growth velocity and maternal risk factors. The group receiving BM with HMF had a mean growth velocity of 19.75 g/kg/day (SD=6.45) that was statistically significantly (p<0.05) more than the other groups. The maternal supplementation only group and the maternal supplementation and BM fortification group showed mean growth velocities of 12.26 g/kg/day (SD=5.41) and 12.29 g/kg/day (SD=6.97) respectively. A post hoc test was done between growth velocity in the supplementated groups and the length of hospital stay. These results reveal that the group receiving BM with HMF had a significantly (p<0.05) shorter mean length of hospital stay of 11.29 days (SD=7.02), compared with the group on the combination of maternal supplementation and BM with HMF. In this study, infants receiving HMF with BM showed the highest growth velocity with the shortest hospital stay before discharge. In this group, infants were already receiving an adequate BM intake of 150-180 ml/kg/day prior to participation in the study. This meant that the HMF group consisted of more stable preterm infants compared to the rest of the supplementated groups. However, a large proportion of participants in the maternal supplementation group also showed adequate to good growth velocity. The researcher recommends the implementation of maternal supplementation only, as standard of care for all hospitalised lactating women. Furthermore, timeous addition of HMF to expressed BM is necessary for infants with growth velocities <15 g/kg/day. This may save costs to the hospital as the use of HMF allowed for better weight gain and earlier discharge.
- Full Text:
- Date Issued: 2018
Women's knowledge and attitudes towards discontinuation of the Long-acting reversible contraceptive (Implanon) in Buffalo City Municipality, South Africa
- Authors: Mrwebi, Khungelwa Patricia
- Date: 2018
- Subjects: Contraceptives Birth control Women's health services
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: http://hdl.handle.net/10353/11206 , vital:37231
- Description: Unintended pregnancy remains a public health concern worldwide despite the availability of many contraceptives options. The South Africa Government introduced Implanon —a Long-acting Reversible Device— with aim to cost effectively prevent unplanned pregnancy. There are concerns that the implementation of this contraceptive option was without prior piloting to test for level of acceptance and attitude towards this contraception. Also, there is paucity of evidence on knowledge of women and their attitude to implanon as well as duration of use and reasons for discontinuation of implanon in South Africa. The present study address this gap by assessing the women’s knowledge of and attitude to implanon as well as reasons for implanon discontinuation in Buffalo City Municipality in South Africa. This prospective observational study administered a pre-validated questionnaire to 189 women who had removed implanon in the reproductive health clinic in one regional hospital and a primary health centre in Buffalo City Municipality. Descriptive statistics were used to analysis the study data. The average duration for implanon use among the participants was 11.2 months. Most participants had poor knowledge of implanon and implanon knowledge was significantly associated was with age. Most participants opined that implanon use is associated with heavy bleeding (60.7), irregular frequent bleeding (84.3percent), and weight gain (67percent). The main reason for implanon discontinuation was its side effects (71.3 percent). Other reasons for discontinuation of implanon are poor or wrong positioning (3.2percent), want to become pregnant (4.3percent). Some participants discontinued implanon because they were on treatment; 24 participants on ARV drug, one on antipsychotic drugs, and one on TB drugs. Experience of heavy bleeding (39.9percent) was the most stated side of implanon leading to implanon discontinuation. The study concluded that women, even though adopted implanon, lack knowledge of implanon mechanism of action and side effects. Poor knowledge of implanon side effects could explain its early discontinuation among women in South Africa. Provider should prioritise comprehensive counselling of clients on implanon side effects and mechanism of action in order to realise the benefit of implanon in this population.
- Full Text:
- Date Issued: 2018
- Authors: Mrwebi, Khungelwa Patricia
- Date: 2018
- Subjects: Contraceptives Birth control Women's health services
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: http://hdl.handle.net/10353/11206 , vital:37231
- Description: Unintended pregnancy remains a public health concern worldwide despite the availability of many contraceptives options. The South Africa Government introduced Implanon —a Long-acting Reversible Device— with aim to cost effectively prevent unplanned pregnancy. There are concerns that the implementation of this contraceptive option was without prior piloting to test for level of acceptance and attitude towards this contraception. Also, there is paucity of evidence on knowledge of women and their attitude to implanon as well as duration of use and reasons for discontinuation of implanon in South Africa. The present study address this gap by assessing the women’s knowledge of and attitude to implanon as well as reasons for implanon discontinuation in Buffalo City Municipality in South Africa. This prospective observational study administered a pre-validated questionnaire to 189 women who had removed implanon in the reproductive health clinic in one regional hospital and a primary health centre in Buffalo City Municipality. Descriptive statistics were used to analysis the study data. The average duration for implanon use among the participants was 11.2 months. Most participants had poor knowledge of implanon and implanon knowledge was significantly associated was with age. Most participants opined that implanon use is associated with heavy bleeding (60.7), irregular frequent bleeding (84.3percent), and weight gain (67percent). The main reason for implanon discontinuation was its side effects (71.3 percent). Other reasons for discontinuation of implanon are poor or wrong positioning (3.2percent), want to become pregnant (4.3percent). Some participants discontinued implanon because they were on treatment; 24 participants on ARV drug, one on antipsychotic drugs, and one on TB drugs. Experience of heavy bleeding (39.9percent) was the most stated side of implanon leading to implanon discontinuation. The study concluded that women, even though adopted implanon, lack knowledge of implanon mechanism of action and side effects. Poor knowledge of implanon side effects could explain its early discontinuation among women in South Africa. Provider should prioritise comprehensive counselling of clients on implanon side effects and mechanism of action in order to realise the benefit of implanon in this population.
- Full Text:
- Date Issued: 2018
Young adults’ perceptions of the psychosocial factors impacting upon self-disclosure online
- Authors: Edwards, Megan
- Date: 2018
- Subjects: Self-disclosure , Young adults -- psychological aspects Interpersonal relations
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/29882 , vital:30788
- Description: Online communication has become a universal phenomenon, and a significant consequence of computer mediated communication (CMC) is the influence it has on self-disclosure. The aim of the present study was to explore and describe young adults’ perceptions of online self-disclosure, specifically what young adults’ self-disclose online and what psychosocial factors impact upon self-disclosure online. Bronfenbrenner’s Bioecological Systems Theory and the Johari Window were utilised as the theoretical framework of the study. The present study utilised a qualitative approach and was exploratory and descriptive in design. The sample size of the present study was 13, and semi-structured interviews were utilised as the method of data collection. The data obtained was analysed using thematic analysis, as outlined by Braun and Clarke. Six main themes were identified, namely Types of Online Experience, Online Self-disclosure, Information Disclosed Online, Differences between Online and Offline Self-disclosure, Privacy and Online Regrets. The findings of the present study will generate a better understanding of young adults’ online self-disclosure and can be utilised for future research.
- Full Text:
- Date Issued: 2018
- Authors: Edwards, Megan
- Date: 2018
- Subjects: Self-disclosure , Young adults -- psychological aspects Interpersonal relations
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/29882 , vital:30788
- Description: Online communication has become a universal phenomenon, and a significant consequence of computer mediated communication (CMC) is the influence it has on self-disclosure. The aim of the present study was to explore and describe young adults’ perceptions of online self-disclosure, specifically what young adults’ self-disclose online and what psychosocial factors impact upon self-disclosure online. Bronfenbrenner’s Bioecological Systems Theory and the Johari Window were utilised as the theoretical framework of the study. The present study utilised a qualitative approach and was exploratory and descriptive in design. The sample size of the present study was 13, and semi-structured interviews were utilised as the method of data collection. The data obtained was analysed using thematic analysis, as outlined by Braun and Clarke. Six main themes were identified, namely Types of Online Experience, Online Self-disclosure, Information Disclosed Online, Differences between Online and Offline Self-disclosure, Privacy and Online Regrets. The findings of the present study will generate a better understanding of young adults’ online self-disclosure and can be utilised for future research.
- Full Text:
- Date Issued: 2018
An (auto)-biographical account of nursing transformation: 1970-2018
- Authors: Ricks, Esmeralda Jennifer
- Subjects: Nursing -- Study and teaching , Nursing -- South Africa
- Language: English
- Type: text , An (auto)-biographical account of nursing transformation: 1970-2018 , Lectures
- Identifier: http://hdl.handle.net/10948/21055 , vital:29434
- Description: This lecture provides a description of how nursing education and practice, research and technology has transformed over the past 48 years. The information provided in this lecture is based on personal experience and own research, and research of various other authors. The first part of the lecture provides an overview of the era in which I trained and is used as a benchmark to compare current day practices. The changes in nursing education and practice with regard to the Nursing Act and regulations over the past 48 years are highlighted, depicting the number of times that the different nursing acts and regulations were amended with regard to all basic nursing qualification programmes. This lecture also includes a brief discussion of the new nursing education programme that will be implemented soon, as well as its opportunities and challenges. A detailed description is provided with regard to how nursing research has evolved over the past 48 years because of the dedication and vision that nurse leaders have for the profession. A national nursing strategy has been developed to enhance collaborative, rigorous scientific enquiry that builds a significant body of knowledge in order to improve the health of the people of South Africa. It is envisaged that the research strategy will contribute significantly to directing future nursing research development in South Africa. It is evident in this lecture that the use of technology in nursing has truly evolved and can be seen as a major driver of changes in the nursing profession. There are huge shifts in how patient records are maintained, how medications are tracked and ordered, how care is passed from one provider to another, how blood and X-ray results are retrieved and how information is being accessed at the point of care in nursing. In today’s healthcare system technology is the foundation of the future. Today’s nurses must not only know how to care for patients, but how to use technology safely and appropriately in their day-to-day work. It is evident that nursing has transformed in many ways since 1970 and that nurses have always been the drivers of nursing transformation.
- Full Text:
- Authors: Ricks, Esmeralda Jennifer
- Subjects: Nursing -- Study and teaching , Nursing -- South Africa
- Language: English
- Type: text , An (auto)-biographical account of nursing transformation: 1970-2018 , Lectures
- Identifier: http://hdl.handle.net/10948/21055 , vital:29434
- Description: This lecture provides a description of how nursing education and practice, research and technology has transformed over the past 48 years. The information provided in this lecture is based on personal experience and own research, and research of various other authors. The first part of the lecture provides an overview of the era in which I trained and is used as a benchmark to compare current day practices. The changes in nursing education and practice with regard to the Nursing Act and regulations over the past 48 years are highlighted, depicting the number of times that the different nursing acts and regulations were amended with regard to all basic nursing qualification programmes. This lecture also includes a brief discussion of the new nursing education programme that will be implemented soon, as well as its opportunities and challenges. A detailed description is provided with regard to how nursing research has evolved over the past 48 years because of the dedication and vision that nurse leaders have for the profession. A national nursing strategy has been developed to enhance collaborative, rigorous scientific enquiry that builds a significant body of knowledge in order to improve the health of the people of South Africa. It is envisaged that the research strategy will contribute significantly to directing future nursing research development in South Africa. It is evident in this lecture that the use of technology in nursing has truly evolved and can be seen as a major driver of changes in the nursing profession. There are huge shifts in how patient records are maintained, how medications are tracked and ordered, how care is passed from one provider to another, how blood and X-ray results are retrieved and how information is being accessed at the point of care in nursing. In today’s healthcare system technology is the foundation of the future. Today’s nurses must not only know how to care for patients, but how to use technology safely and appropriately in their day-to-day work. It is evident that nursing has transformed in many ways since 1970 and that nurses have always been the drivers of nursing transformation.
- Full Text: