Postnatal women's experiences of the prevention of mother-to-child transmittion of HIV programme
- Authors: Links, Nomvuyiseko
- Date: 2007
- Subjects: AIDS (Disease) in pregnancy -- South Africa , HIV infections -- Children -- Transmission -- Prevention , Children -- Diseases -- Prevention , HIV infections -- Transmission , Maternal health services
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10042 , http://hdl.handle.net/10948/545 , http://hdl.handle.net/10948/d1011704 , AIDS (Disease) in pregnancy -- South Africa , HIV infections -- Children -- Transmission -- Prevention , Children -- Diseases -- Prevention , HIV infections -- Transmission , Maternal health services
- Description: This research study endeavoured to explore and describe the experiences of women who participated in the Prevention of Mother-To-Child Transmission (PMTCT) of HIV Programme. Data relating to evaluation of the PMTCT Programme in the piloted sites compiled by other researchers in the Department of Health focus on the process, progress and extent of service implementation. There appears to be a dearth of information available from women participants in the PMTCT Programme. The objectives of the study were to: · Explore and describe postnatal women’s experiences of the PMTCT Programme offered in the East London Hospital Complex. · Propose recommendations into the existing guidelines for midwives who implement the PMTCT Programme in the health services to ensure optimal implementation of this programme. The research population included postnatal women who participated in the PMTCT of HIV Programme at the East London Hospital Complex (Frere site). Permission to conduct the research was obtained from the Eastern Cape Department of Health Ethics Committee, Chief Executive Officer of the hospital complex and the Advanced Degrees Committee and Human Ethics Committee at the Nelson Mandela Metropolitan University. The research study was qualitative, exploratory, descriptive and contextual in design. Data collection was carried out by face-to-face semi-structured interviews with postnatal women at the East London Hospital Complex (Frere site). The tape-recorded interviews were transcribed verbatim with the aid of field notes. Data analysis was done according to Tesch’s method of data analysis (in De Vos et al, 2000:343). Themes were identified from the transcriptions and finalised after consensus discussions with an independent coder who was experienced in qualitative research. Literature control, guided by the themes identified in the interviews, was carried out to compare and verify the findings of the study. Three major themes with sub-themes were identified during data analysis. The major themes were identified as follows: · The participants expressed feelings of being devastated by the results that confirmed their HIV positive status. · The participants expressed a thirst for knowledge on how to live with the diagnosis and on how to continue with the PMTCT Programme. · The physical environment where counselling and testing were done, as well as the practical arrangements, were not conducive to the full implementation of the PMTCT Programme at the antenatal clinic. Conclusions were drawn and recommendations were made in the form of additional guidelines for midwives implementing the PMTCT Programme in the antenatal clinic health services. Guidelines for further midwifery-related research were formulated.
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- Date Issued: 2007
Resilience in families where a member is living with schizophrenia
- Authors: Haddad, Jason
- Date: 2007
- Subjects: Schizophrenia , Schizophrenia -- South Africa -- Family relationships , Resilience (Personality trait)
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:9928 , http://hdl.handle.net/10948/654 , Schizophrenia , Schizophrenia -- South Africa -- Family relationships , Resilience (Personality trait)
- Description: Schizophrenia cuts across all racial, gender, and socioeconomic lines. Schizophrenia affects 1 percent of the population in Ireland: 35000 people (Schultz & Andreason, 1999); and affects 1.4 - 4.6 percent per 1000 people in the USA: 2.8 million - 9.8 million people (Jabelensky, 2004). In South Africa the figure is approximately 1 percent of the population or 500 000 people (Nicholas, Malcolm, Krosigk & Pillay, 2003). The median age of onset is 21.4 years for men and 26.8 years for women (Daubenton & van Rensburg, 2001), with only 10-20 percent recovering fully after the first psychotic episode (Saddock & Saddock, 2003). The schizophrenic patient is often unable to continue life as before diagnosis, and may progressively need more care as the years pass. Deinstitutionalization over the course of a number of decades has resulted in responsibility for care of mentally-ill individuals shifting to the individual’s family. The struggles faced by such a family can be overwhelming as they struggle with this responsibilty due to lack of training, lack of knowledge and insufficient professional support (Winefield & Harvey, 1994). The stress on the caregivers is often magnified as their support structures around them may ‘shut down’ out of fear of the schizophrenic illness (Williams & Mfoafo-M’Carthy, 2006). The characteristic symptoms used to define schizophrenia include various forms of delusions, hallucinations, thought disorders and abnormalities in emotional expression, social interaction, attention, volition and drives. The functional decline of the schizophrenic individual leads not only to social difficulties, but also economic difficulties that may cripple a family (Fadden, Bebbington & Kuipers, 1987). When first diagnosed, some families may be so overwhelmed by the ‘label’ given to their family member, that they see little hope or way to move forward. One explanation is offered by an American psychiatrist whose own son was diagnosed with schizophrenia, “We experience this terrible feeling of loss and grief for the son we knew. There is also this terrible loss of expectations. We feel cheated out of watching him mature…it is a mourning without end because, of course, Gary is not dead at all. He is very much still with us, seeming eternally twelve years old, needing constant care and attention” (Willick, 1994, p.14). Providing such care is associated with high levels of distress. Accordingly, much attention has been given to understanding the pressures faced by family members, with the hope of understanding how coping resources may be strengthened to sustain these care-giving relationships (Harvey, Burns, Fahy, Manley & Tattan, 2001). However, despite gains in understanding the needs of a schizophrenic family member once out of the hospital environment, care-giving relationships can still break down. The individual with the illness is often left more vulnerable to relapse, recurrent hospitalizations, homelessness and other negative outcomes (Jewel & Stein, 2002). The stress of not only interacting with the afflicted family member, but also with the grief associated with the illness, places an incredible strain on the day-to-day functioning of that family (Pollio, North, Reid, Miletic & McClendon, 2006). From the brief review provided, it is evident that research has been conducted regarding the stressors, strains and difficulties of caregivers of schizophrenic family members. However, the strengths of these families are under-investigated, and the current study will attempt to start filling this void.
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- Date Issued: 2007
Exploring the construct-related validity of the personal-social subscale of the Griffiths Mental Development Scales-extended revised (GMDS-ER)
- Authors: Moosajee, Shaheda
- Date: 2007
- Subjects: Psychological tests for children , Griffiths Scales of Mental Development
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: vital:9934 , http://hdl.handle.net/10948/572 , http://hdl.handle.net/10948/d1011708 , Psychological tests for children , Griffiths Scales of Mental Development
- Description: Child assessment has become imperative today as parents and teachers recognize the need for early diagnostic assessments to adequately cater for children’s’ diverse and growing needs so that children can benefit from services and attention in a psychological or educational setting. The Griffiths Mental Development Scales, an established and well-researched instrument is reported to be one of the most carefully designed measures of child development . Studies in various parts of the world have demonstrated that the Griffiths Scales are applicable to diverse populations and that they tap experiences that are common to different cultures. The recent revision and restandardisation of the Griffiths Mental Developmental Scales-Extended Revised (GMDS-ER) has necessitated investigations into its psychometric properties. In view of the important role that assessment measures play in the early identification of developmental delays, it is important that assessment measures are reliable and valid for their intended purpose(s). This study, which is part of a larger research project, attempted to explore and add further evidence of the construct validity of one of the six Subscales of the GMDS-ER, namely the Personal-Social Subscale (Subscale B). An exploratory-descriptive design using a triangulation approach was utilized to explore the construct validity of the Personal-Social Subscale. A nonprobability purposively selected sample of 18 experts working with children participated in the facet analysis to identify the constructs underlying Subscale B (the qualitative aspect of the study). The sample for the quantitative aspects of this study (i.e., the empirical validation of the identified constructs) was collected as part of the broader restandardisation and represented a stratified random sample of 1026 children between the ages of 3 and 8 years from across the United Kingdom and Eire. Three measures, namely a biographical questionnaire, the GMDS-ER and a construct evaluation form were used to gather the qualitative and quantitative data. The qualitative data was analysed by means of facet analysis and literature control. The quantitative data was analysed by using exploratory common factor analysis using oblique (DQUART) rotation to empirically verify the qualitatively identified construct model by specifying a onefactor solution for each underlying construct.
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- Date Issued: 2007
The impact of pharmaceutical care services on the management of asthma patients in a primary health care clinic
- Authors: Mostert, Zhan
- Date: 2007
- Subjects: Asthma -- Treatment -- South Africa -- Eastern Cape , Pharmacist and patient -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: vital:10154 , http://hdl.handle.net/10948/574 , http://hdl.handle.net/10948/d1011711 , Asthma -- Treatment -- South Africa -- Eastern Cape , Pharmacist and patient -- South Africa -- Eastern Cape
- Description: Optimal management of a chronic disease, like asthma, requires the active participation of patients. To achieve this, patients require education about asthma. Many of the recommended components of asthma care and management might not be effective without adequate patient education. Pharmacists in community, hospital and clinic practice are well placed to provide continued information and reinforcement of key messages, in order to improve compliance with medication and the outcomes of asthma management plans. Pharmacists may be able to increase medication adherence with patient counselling and monitoring systems and by facilitating communication with physicians. However, regardless of this, it remains uncertain whether pharmacist-patient interactions improve patient outcomes, and in spite of recommendations for teamwork and a multidisciplinary approach in the education of asthma patients, medical doctors and nurses are still largely responsible for carrying out the greatest part of patient education. The objectives of this study were therefore to determine the impact of pharmaceutical care services at a primary health care level on the management and well-being of asthmatic patients; to determine the effect of complex or multi-faceted pharmaceutical interventions, in patients with asthma, on lung function, asthma knowledge, attitudes and perceived self-management efficacy, asthma related quality of life and asthma control; and to determine the extent to which pharmacotherapeutic interventions, with regards to medication changes and dosage changes, are accepted and implemented by doctors. A randomised-control study was conducted at a primary health care clinic in the Eastern Cape. A total of 120 patients were allocated to two groups of sixty patients each (a Control Group and an Intervention Group). Baseline values were measured and follow-up interviews and post-intervention data collection were conducted three months afterwards for each group. Patients in the Control Group were attended to by the clinic staff as usual. Patients in the Intervention Group were educated on their disease by a pharmacist. The use of a customised 500ml plastic bottle as a spacer was suggested and each patient’s medication was evaluated against the Standard Treatment Guidelines for the management of asthma in adults at the primary health care level and where necessary, prescribing recommendations were made. Following assessment of the medication regimens of the patients in the Intervention Group, a total of 49 prescribing recommendations were made, of which 73 percent were accepted by both the doctor and patient. After educating the patients in the Intervention Group on inhaler technique, a significant improvement in technique was observed at the 3-month follow-up assessment (p<0.05). Using a short form of the Asthma Quality of Life Questionnaire (AQLQ(S)), a significant improvement post-intervention in mean total quality of life score (p<0.05) and mean average quality of life score (p<0.05) in the Intervention Group, were demonstrated. An improvement in mean activity limitation score in the Intervention Group post-intervention was also recorded for the activity limitation subscale of the AQLQ(S) (p<0.05). On measuring changes in asthma related knowledge, attitudes and self-efficacy, using a questionnaire (KASE-AQ), a significant improvement in mean knowledge score in the Intervention Group after the intervention (p<0.05) was also shown. With regards to lung function, both vital capacity (percent FVC) and expiratory flow volumes (percent FEV1) improved significantly in the Intervention Group (p<0.05). This study therefore demonstrated that multi-faceted pharmacist interventions, including medication assessment, asthma education, education on inhaler technique and the provision of medication aids in the form of spacers, can significantly improve the management of asthma patients and improve their well-being and quality of life.
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- Date Issued: 2007
Social workers' experiences on the transformation of social welfare from a remedial approach to a developmental approach
- Authors: Mashigo, Boipuso Stephina
- Date: 2007
- Subjects: Social service -- South Africa
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:9990 , http://hdl.handle.net/10948/559 , Social service -- South Africa
- Description: When the new democratic government came into power, much legislation, policies and strategies were transformed, included was the welfare system that was imbalanced, unjust, discriminatory and inappropriate. It was replaced by a developmental approach that is more just, equitable and appropriate system contained in the White Paper for Social Welfare (1997). Social workers were expected to reform their method of intervention. Consequently, this study will focus on the experiences of social workers as changes were brought into the approaches used in service delivery. The goal of the study is to explore and describe social workers’ experiences on the transformation of social welfare from a traditional remedial approach to a developmental approach. The study was conducted using the qualitative research approach. The research study made use of an explorative, descriptive and contextual design. The researcher used purposive and theoretical non-probability sampling methods to draw the sample. Data was collected through semi- structured interviews. The data was analyzed using Tesch’s eight steps in Creswell (1994:155) and was verified against four criteria that Guba in (Krefting, 1991) developed for testing the trustworthiness of a qualitative study. Based on the findings and conclusion of the study, recommendations were made to the management of the department of social development on how to address the challenges facing social workers on the implementation of the developmental approach. The results will be disseminated by means of a written research report.
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- Date Issued: 2007
Women's perceptions and experiences of antenatal care rendered by midwives
- Authors: Mxoli, Winnifred Nonkonzo
- Date: 2007
- Subjects: Prenatal care -- South Africa -- Eastern Cape , Midwives -- South Africa -- Eastern Cape , Maternal health services -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10041 , http://hdl.handle.net/10948/575 , Prenatal care -- South Africa -- Eastern Cape , Midwives -- South Africa -- Eastern Cape , Maternal health services -- South Africa -- Eastern Cape
- Description: The general health status of pregnant women depends largely on the quality of the antenatal services available to them. The provision of good antenatal services ensures early detection and prompt management of any complication or disease that may adversely affect pregnancy outcome. In order to ensure high quality care, antenatal services need to be evaluated at regular intervals, both from provider and client perspective, to ensure their effectiveness in improving the health status of pregnant women. The midwife, as the first contact person for most pregnant women attending antenatal clinics in South Africa, has the potential to play a major role in improving the health status of these women. However, for the midwife to be effective in achieving this, antenatal services need to be effectively utilized by women. One of the factors that affect utilization of any service is client satisfaction with the service being rendered. This study, therefore, explores the perceptions that pregnant women have of the care that they receive from midwives at the selected antenatal clinics. The objectives of the study are to: {u100083} Explore and describe the perceptions and experiences of pregnant women attending antenatal clinic regarding the care they receive from midwives. {u100083} Make recommendations to assist registered midwives in optimizing the accompaniment of women during the antenatal period. A qualitative, descriptive, exploratory and contextual design was used for the study. The sample was chosen from the target population by means of purposive sampling and data was collected through unstructured interviews with the participants. Before data collection, permission was obtained from the Eastern Cape Department of Health and the Nursing Service Manager of the Gateway clinic, in the district hospital where the research was conducted. The Nursing Service Manager was acting as a Medical Superintendent at the time of the study. Written, informed consent was obtained from all participants before conducting interviews. Trustworthiness was ensured by means of Guba’s model throughout the study, and the aspects of truth value, applicability, consistency and neutrality were considered. Tesch’s eight steps of data analysis were used to analyze the data collected, and four main themes were identified namely: • Women perceive midwives as considerate and knowledgeable • Women perceive midwives as lazy and rude • Women experience mixed emotions about the care they receive from midwives • Though their experiences, women identified certain needs in the services and care they received at the clinic. Conclusions were drawn and recommendations for midwifery practice made based on the results of the study, with the aim of improving antenatal services rendered to pregnant women.
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- Date Issued: 2007
Resilience in families living with a Type I diabetic child
- Authors: Coetzee, Mariska
- Date: 2007
- Subjects: Diabetes in children -- South Africa , Diabetes -- Prevention , Stress (Psychology) , Adjustment (Psychology)
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:9922 , http://hdl.handle.net/10948/665 , Diabetes in children -- South Africa , Diabetes -- Prevention , Stress (Psychology) , Adjustment (Psychology)
- Description: Type I diabetes has the ability to promote change in the family. In truth, although the child with diabetes is the diagnosed patient, the whole family has diabetes. While the challenges that families have to face are many, families seem to have the ability to “bounce back” (i.e., they have resilience). Research on the construct of resilience, and more specifically, family resilience has surged in recent times. However, South African research on family resilience is limited. This study aimed to explore and describe the factors that facilitate adjustment and adaptation in families that include a child living with Type I diabetes. The Resiliency Model of Stress, Adjustment and Adaptation, developed by McCubbin and McCubbin (2001) served as a framework to conceptualise the families’ adjustment and adaptation process. Non-probability purposive and snowball sampling techniques were employed. Sixteen families participated in this study, providing a total of 31 participants. Participants consisted of the caregivers of a family living with a child between the ages of four and 12 with Type I diabetes. The study was triangular in nature, with an exploratory, descriptive approach. A biographical questionnaire with an open-ended question was used in conjunction with seven other questionnaires to gather data. These questionnaires were: The Family Hardiness Index (FHI), the Family Time and Routine Index (FTRI), the Social Support Index (SSI), the Family Problem-Solving Communication (FPSC) Index, the Family Crises-Oriented Personal Evaluation Scales (F-COPES), the Relative and Friend Support Index, and the Family Attachment and Changeability Index 8 (FACI8). Descriptive statistics were used to describe the biographical information. Quantitative data were analysed by means of correlation and regression analysis, and a content analysis was conducted to analyse the qualitative data. The results of the quantitative analysis indicated three significant positive correlations with the FACI8. These variables were family hardiness (measured by the FHI), family problem-solving communication (measured by the FPSC), and family time and routines (measured by the FTRI). The results of the qualitative analysis revealed that social support, the caregivers’ acceptance of the condition, and spirituality and religion were the most important strength factors that contributed to the families’ adjustment and adaptation. Although the study had a small sample and many limitations, the study could be used as a stepping-stone for future research on resilience in families living with chronic medical conditions and will contribute to family resilience research in the South African context.
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- Date Issued: 2007
A drug utilisation review of Isotretinoin in the management of acne
- Authors: Burger, Solé
- Date: 2007
- Subjects: Acne -- Treatment , Isotretinoin
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: vital:10147 , http://hdl.handle.net/10948/673 , Acne -- Treatment , Isotretinoin
- Description: Acne is a common, chronic disorder that affects many adolescents. The most effective acne medication is systemic isotretinoin. It provides a permanent cure for many patients, but has various side effects. A South African Acne Treatment Guideline was introduced in 2005. Adherence to this guideline could lead to safer, more effective acne management. The primary aim of this study was to investigate the appropriateness of medications prescribed in the treatment of acne in South Africa, and to evaluate the safety and efficacy of systemic isotretinoin utilised by patients in the Nelson Mandela Metropole (NMM). A drug utilisation study (including 18 803 South African acne patients’ chronic prescription data between 2000 and 2005) and a patient questionnaire survey (including information from 57 patients in the NMM who used systemic isotretinoin) were conducted. Basic descriptive and interferential statistics were calculated. The drug utilisation study revealed that systemic antibiotics were the acne treatment prescribed to most (43.3 percent) patients, followed by 42.1 percent of patients on systemic isotretinoin, 33.2 percent on hormonal therapy and 18.9 percent on topical therapy. Topical retinoids were underused. The questionnaire survey indicated a lack of compliance by prescribers with guideline recommendations regarding the prescription (and accompanying counselling and monitoring) of isotretinoin. Incorrect cumulative doses were frequently prescribed, and a lack of proper implementation of pregnancy prevention measures was evident. The majority of isotretinoin patients reported a high efficacy of isotretinoin in clearing their acne.
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- Date Issued: 2007
Social workers' experiences of HIV and AIDS intervention in Botswana
- Authors: Kesamang, Lefhoko
- Date: 2007
- Subjects: AIDS (Disease) -- Botswana , AIDS (Disease) -- Botswana -- Epidemiology , AIDS (Disease) -- Botswana -- Prevention
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:9987 , http://hdl.handle.net/10948/532 , AIDS (Disease) -- Botswana , AIDS (Disease) -- Botswana -- Epidemiology , AIDS (Disease) -- Botswana -- Prevention
- Description: This study endeavoured to explore and describe the experiences of social workers in their intervention with HIV and AIDS clients within the Department of Clinical Services of the Ministry of Health in Botswana. The researcher undertook a qualitative research study, using an exploratory, descriptive and contextual design to explore these experiences as perceived by the social workers. The method of data collection included semi-structured face-to-face interviews, as this was deemed most appropriate to the nature of the study. Data analysis was undertaken according to the outline of Tesch (1990), as stated in Creswell (1994:155). The findings were reported as themes, sub-themes and categories emanating from the data-analysis process. In ensuring the trustworthiness of the findings, the researcher adhered to Guba’s (1981) model (in Krefting, 1991:251). The research findings were subjected to a literature control, and culminated in the compiling of the research report. The research findings centred around the following five themes: · experiences of intervention with HIV and AIDS clients; · challenges in HIV and AIDS intervention; · measures to alleviate challenges of HIV and AIDS intervention; · intervention strategies utilised by social workers; and · suggestions and advice to new social workers. The recommendations resulting from this research project proposed inter alia that social workers need to be trained in specific and specialised areas related to HIV and AIDS intervention in the health setting, and that the support structures and a holistic multidisciplinary service delivery approach need to be put in place to assist social workers to be able to meet the needs of the clients as well as their own needs. Key Words: participants, clients/patient, qualitative, HIV and AIDS, experiences, intervention, strategies.
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- Date Issued: 2007
The psychofortology of post-graduate learners in the Faculty of Health Sciences at the Nelson Mandela Metropolitan University
- Authors: Smith, Greg
- Date: 2007
- Subjects: Nelson Mandela Metropolitan University -- Graduate students , Graduate students -- Psychology , Adjustment (Psychology)
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:9931 , http://hdl.handle.net/10948/606 , http://hdl.handle.net/10948/d1011705 , Nelson Mandela Metropolitan University -- Graduate students , Graduate students -- Psychology , Adjustment (Psychology)
- Description: The years spent studying towards a degree represent many challenges to the learner1. These pressures increase once that learner moves into the post-graduate level of professional study. Faced with the pressure of having to perform suitably in order to remain on the programme, the learner finds himself or herself under conditions which may present as stress or illness, depending upon the availability of coping resources and strategies. This study adopted a psychofortigenic2 approach and explored and described the coping (i.e., coping resources and sense of coherence) and subjective well-being (i.e., satisfaction with life, happiness and general psychiatric health) of post-graduate learners in the following six departments of the Faculty of Health Sciences at the Nelson Mandela Metropolitan University (NMMU): Psychology; Human Movement Science and Sport Management; Environmental Health and Social Development Professions (incorporating MA Health and Welfare Management); Pharmacy; Nursing Science; Biomedical Technology and Radiography. An exploratory descriptive research design was used and the participants were selected by means of non-probability, convenience sampling. The sample consisted of 60 male and female masters and doctoral post-graduate learners in the Faculty of Health Sciences. Biographical data was gathered by means of the administration of a questionnaire. Hammer and Marting’s (1988) Coping Resources Inventory was used to measure the students’ available coping resources. Furthermore, Antonovsky’s (1987) Orientation to Life Scale was used to measure the construct of Sense of Coherence. The Satisfaction with Life Scale by Diener, Emmons, Larson and Griffin (1985) was used to assess the respondents’ overall satisfaction with life. Kamman and Flett’s (1983) Affectometer-2 was used to measure participants’ subjective global happiness. The General Health Questionnaire of Goldberg and Williams (1988) was used to measure the psychiatric morbidity or general psychiatric health of the participants. The data was analyzed using both descriptive statistics and cluster analysis. A Hotellings T² was computed with subsequent t-tests to draw inferences about differences in the means of established groups across the five measures. The results indicated that the participants were generally coping and experiencing subjective well-being. The results indicated two clusters to significantly differ from one another across the five measures. The first cluster could be characterized as high in psychofortology and presented with better coping and subjective well-being. The second cluster could be characterized as low in psychofortology and presented with poorer coping and subjective well-being.
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- Date Issued: 2007
Experiences of parents whose children have completed a diversion programme
- Authors: Mankayi, Andile
- Date: 2007
- Subjects: Juvenile delinquents -- Rehabilitation -- South Africa -- Eastern Cape , Juvenile delinquents -- Family relationships -- South Africa -- Eastern Cape , Community-based corrections -- South Africa -- Eastern Cape , Youth -- Conduct of life , Social work with juvenile delinquents -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:9986 , http://hdl.handle.net/10948/556 , Juvenile delinquents -- Rehabilitation -- South Africa -- Eastern Cape , Juvenile delinquents -- Family relationships -- South Africa -- Eastern Cape , Community-based corrections -- South Africa -- Eastern Cape , Youth -- Conduct of life , Social work with juvenile delinquents -- South Africa -- Eastern Cape
- Description: The goal of this research study was to explore and describe the experiences of parents whose children have completed the diversion programme in order to make recommendations to probation officers, social workers and people who facilitate the diversion programmes. The study focused on the Youth Empowerment Scheme programme (YES Programme) because it is the diversion programme mostly used in the Eastern Cape. The aim of the programme is to divert young people in trouble with the law away from the criminal justice system and to rehabilitate the young offenders by providing them with essential life skills that can address the offenders’ real problems. In the study the researcher made use of a qualitative research approach in an attempt to explore the experiences of parents whose children have completed the YES programme. The permission of the gatekeeper was sought before the study commenced. The researcher used purposive sampling to recruit participants. Data was collected by means of semi-structured interviews. In analysing the data, the researcher used the steps for qualitative data analysis as stated in Creswell (2003:192). Three main themes along with sub-themes and categories were identified during the process of data analysis. The main findings that emanated from this study were: the seemingly upcoming culture of lack of respect for authority on the part of the youth of today. Another major finding of this study is that the traditional function of families, notably, socialisation of young people within the family structure is on the wane. The recommendations that emanated from this study are: that the YES programme needs to be adjusted to address the specific needs of children that are referred to the YES programme and those of their families and communities. Family life should be strengthened through community development programmes that seek to address family problems of any nature, namely, material, psycho-social, economic, to mention just a few. Community development programmes should address fragile families through community development approaches that are comprehensive and integrated.
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- Date Issued: 2007
Development of an antiretroviral solid dosage form using multivariate analysis
- Authors: Nqabeni, Luxolo
- Date: 2007
- Subjects: Analysis of variance , Experimental design , Multivariate analysis , Antiretroviral agents -- South Africa
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: vital:10145 , http://hdl.handle.net/10948/705 , Analysis of variance , Experimental design , Multivariate analysis , Antiretroviral agents -- South Africa
- Description: The aim of pharmaceutical development is to design a quality product and the manufacturing process to deliver the product in a reproducible manner. The development of a new and generic formulation is based on a large number of experiments. Statistics provides many tools for studying the conditions of formulations and processes and enables us to optimize the same while being able to minimize our experimentation. The purpose of this study was to apply experimental design methodology (DOE) and multivariate analysis to the development and optimization of tablet formulations containing 150 mg lamivudine manufactured by direct compression.
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- Date Issued: 2007
Exploring normal South African and British children: a comparative study utilizing the Griffiths Mental Development Scales- extended revised
- Authors: Van Heerden, Rivca
- Date: 2007
- Subjects: Psychological tests for children -- Cross-cultural studies , Children -- Intelligence testing -- Cross-cultural studies , Griffiths Scales of Mental Development
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:9929 , http://hdl.handle.net/10948/629 , Psychological tests for children -- Cross-cultural studies , Children -- Intelligence testing -- Cross-cultural studies , Griffiths Scales of Mental Development
- Description: The health status of a substantial number of South African children can be classified as “children at risk” (Luiz, 1999) as the majority of children are influenced by factors such as poverty, poor living conditions and the HIV/AIDS epidemic. These are only some of the influences that contribute significantly to the health status of South African children and consequently their development. It can thus be argued that developmental assessment is imperative in the South African context. One of the most important reasons are that children with special needs in South Africa can be identified and given the opportunity to catch up developmentally and cope successfully as opposed to those who are identified much later (Foxcroft & Roodt, 2006). Furthermore, children in South Africa must begin Grade one in the year in which they turn seven. They may only enter grade one if the school has an opening and if the necessary evidence is provided to the Department of Education that the child will be able to cope with the demands of formal schooling (Department of Education, 2002). Developmental assessment measures therefore needs to be appropriate, accurate and informative in the modern South African context. The need for a measuring instrument to assess children’s overall development and thus their developmental readiness to cope with the demands of formal schooling could be satisfied by the Griffiths Mental Development Scales – Extended Revised (GMDS-ER). This recently revised measure has not been normed on a representative, contemporary South African sample. The purpose of the study was therefore to generate information on the applicability of British norms for the contemporary South African population. This study compared and explored the performance of South African and British children aged 5-years and 6-years on the Griffiths Mental Development Scales - Extended Revised (GMDS-ER). A contemporary South African sample was obtained by testing children between the ages of 5-years and 6-years on the GMDS-ER, whilst the British sample was drawn from the United Kingdom and Eire standardization sample. The British sample was screened for normality and a similar process was followed to establish normality for the South African sample. A matched simple frequency distribution technique (taking into account age, socioeconomic status and gender as variables) was employed to approximate the equivalence between the samples. The profiles were compared by conducting an independent sample t-test with subsequent post hoc analyses to explore potential differences in the performance of the two samples. The major findings of the present study were as follows: 1. There is a significant difference between the South African and British children’s overall developmental profiles (as measured by the GMDS-ER). 2. Generally, South African children performed better on the Locomotor subscale and the Personal Social Subscale (although not statistically significant), whilst British children performed statistically better on the Language, Eye and Hand Co-ordination, and Practical Reasoning Subscales. 3. No significant differences were found for the Performance Subscale which could indicate that South African and British children’s performances on this scale are similar. Further investigations into the applicability of the GMDS-ER for the contemporary South African context are recommended and the establishment of South African norms for clinical utilization is essential. Caution with regard to the utilization of the British–based norms in the South African context is final recommendations.
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- Date Issued: 2007
The coping resources and subjective well-being of dual-career Hindu mothers
- Authors: Prag, Hanita T
- Date: 2007
- Subjects: Women -- India , Women -- Employment -- India , Hindu women -- Social life and customs
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:9932 , http://hdl.handle.net/10948/593 , Women -- India , Women -- Employment -- India , Hindu women -- Social life and customs
- Description: With the increasing number of women entering the labour force internationally, the role of women is changing. Consequently, researchers are pressed to investigate how females of all cultures balance their work and family responsibilities. Amongst Hindu couples, this issue can either be a source of tension or positive support. An overview of literature indicates that the psychological aspects of dual-career Hindu women have received little attention in South Africa. The current study aimed to explore and describe coping resources and the subjective well-being of full-time employed Hindu mothers. The study took the form of a non-experimental exploratory-descriptive design. Participants were selected through nonprobability convenience sampling. The sample of the study consisted of sixty full-time employed Hindu mothers between the ages of 25 and 45 years of age who had at least one dependent primary school child aged between 7 to 12 years. Various questionnaires were used to collect data for this study. These included a Biographical Questionnaire, The Coping Resources Inventory (CRI), The Satisfaction with Life Scale (SWLS), and The Affectometer 2 (AFM2). Data was analysed by means of descriptive statistics. Cronbach’s coefficient alphas were utilised to calculate the reliability of the scores of each questionnaire. A multivariate technique was used to determine the amount of clusters formed. A non-hierarchical partitioning technique known as K-means cluster analysis was utilised in this study. An analysis of variance (ANOVA) was utilised in order to compare the mean scores of the various clusters. A post-hoc analysis using the Scheffé test was computed to test for significant differences. Cohen’s d statistics was subsequently used to determine the practical significance of the differences found between the cluster means on each of the measures. The cluster analysis indicated three clusters that differed significantly from one another on all three measures. The results of the CRI indicated that the participants used cognitive and spiritual resources to assist them to cope with the transition from traditional to modern contemporary roles. It was also found that the participants with low coping resources had inferior subjective well-being compared to those who had average and high CRI scores. The findings indicated that the participants were generally satisfied with their lives and experienced high levels of positive affect and low levels of negative affect. However, as a group there was a trend for the participants to have experienced slightly lower levels of global happiness or slightly negative affect. The results of this study broadens the knowledge base of positive psychology with respect to the diverse cultures and gender roles within South Africa. Overall, this study highlighted the value and the need for South African research on the coping resources and subjective well-being of dual-career Hindu mothers.
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- Date Issued: 2007
The experience of AIDS orphans living in a township
- Authors: Frood, Sharron
- Date: 2007
- Subjects: Orphans -- South Africa , Children of AIDS patients -- South Africa
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:10078 , http://hdl.handle.net/10948/505 , Orphans -- South Africa , Children of AIDS patients -- South Africa
- Description: One of the challenges facing health care professionals today is the phenomenon of rendering care to children who have been orphaned in the AIDS pandemic. The number of AIDS orphans in South Africa has risen out of all proportion and is causing existing health and social structures to become stretched in providing care to this vulnerable population of children. The objectives of this study are to explore and to describe the lived experience of children living in a township who have become AIDS orphans and to develop broad guidelines for Primary Health Care Nurses (PHCN’s), related professionals and partners involved in the care of AIDS orphans living in a township. The theoretical grounding of this study is found in Kotze’s Theory on Nursing Accompaniment (Kotzé, 1998:3). The proposed research design was based upon a qualitative study using an explorative, descriptive, contextual and phenomenological strategy of inquiry. Data was collected by means of in-depth interviews from a purposively selected sample and then analysed using the steps of qualitative data analysis proposed by Tesch (in Creswell, 1994). Guba’s model was used to assess the trustworthiness of the qualitative data. Based upon the findings, guidelines were developed to assist PHCN’s related professionals and partners involved in the care of AIDS orphans living in a township. Through this study the goal of the researcher was to give a voice to AIDS orphans living in a township and to represent accurately their lived experience.
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- Date Issued: 2007
Accelerated staff turnover among professional nurses at a district hospital
- Authors: Toni, Gladys Nosisana
- Date: 2007
- Subjects: Labor turnover -- South Africa -- Eastern Cape , Nurses -- Employment -- South Africa -- Eastern Cape , Hospitals -- South Africa -- Eastern Cape -- Personnel management
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:10039 , http://hdl.handle.net/10948/620 , Labor turnover -- South Africa -- Eastern Cape , Nurses -- Employment -- South Africa -- Eastern Cape , Hospitals -- South Africa -- Eastern Cape -- Personnel management
- Description: The study emanated from the researcher’s experience and involvement in clinical nursing and nursing management. The researcher noted how heavy losses of recruited professional nurses might have had an influence on the quality of service delivery. It is a costly and time-consuming task to recruit enough nurses into the profession and retention of staff is especially difficult. There had been a significant increase in the number of professional nurses leaving the district hospitals either to primary health care service, private hospitals or other countries. Before the commencement of the study the turnover rate at the district hospital where the study was conducted, almost doubled the accepted norm, which was ten percent of the staff. For those reasons the researcher decided to conduct a study named, “Accelerated staff turnover among professional nurses at a district hospital.” The constant heavy losses of qualified nurses from the profession constitute one of the serious challenges for nursing managers. The researcher wanted answers to the following question: “What were your experiences of your job as a professional nurse at the district hospital?” The objectives of the study were: · to explore and describe factors leading to high staff turnover of professional nurses at a district hospital · to develop guidelines to help retain professional nurses. The design of this study, which was conducted in one of the district hospitals in the Makana Local Service Area in the Eastern Cape, is qualitative, descriptive and contextual. Informed permission for conducting the research was obtained from relevant authorities and participants were asked to sign a consent form before the researcher proceeded with the study. Participants that met the selection criteria were selected by means of purposive sampling. Data was obtained by means of semi-structured telephonic interviews that were audio-taped and later transcribed verbatim. To ensure trustworthiness of the study, the researcher applied the four strategies as proposed by Lincoln and Guba (De Vos, 2002:351) namely, credibility, transferability, dependability and confirmability. Collected data was analysed according to the descriptive method proposed by Tesch (in Creswell, 1994:154). The services of an independent coder, who was provided with transcripts and a protocol to guide data analysis, were utilised. A consensus meeting was held between the researcher and the independent coder to discuss the identified themes and sub-themes. Following the data analysis, a literature control was undertaken to highlight the similarities to and differences in comparison between this and previous studies. Four major themes and sub-themes were identified through analysis.
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- Date Issued: 2007
Optimisation of pharmacological management of diabetes mellitus in a primary health care setting
- Authors: Dickason, Beverley Janine
- Date: 2007
- Subjects: Diabetes , Diabetes -- Treatment
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: vital:10161 , http://hdl.handle.net/10948/846 , http://hdl.handle.net/10948/d1012902 , Diabetes , Diabetes -- Treatment
- Description: Levels of diabetic care in primary health care settings in South Africa have been found to be sub-optimal. Knowledge deficits and inadequate practices have been implicated in the poor quality of local diabetes care. Type 2 diabetes and hypertension are commonly associated chronic conditions hence to optimise diabetic care, tight control of blood pressure is essential. Although guidelines for the overall management of diabetes in a primary health care setting have been published (Working Group of the National Diabetes Advisory Board, 1997; Society for Endocrinology, Metabolism and Diabetes of South Africa, 2002a), adherence to these guidelines has not yet been optimised in the primary health care setting. The objectives of the study were: to design and implement an educational intervention aimed at nursing staff, based on the South African guidelines for type 2 diabetes and hypertension, at a public sector primary health care clinic; to determine the impact of the educational intervention on the level of knowledge and attitudes of the nursing staff, and on the level of diabetic and blood pressure control achieved in the patient population, and to determine the impact of the educational intervention on pharmacological management of patients. A questionnaire was used to quantitatively assess the nursing staffs’ knowledge of the management of type 2 diabetes and hypertension at a primary health care level. A qualitative evaluation of the nursing staff attitudes was obtained using focus group interviews. The educational intervention, in the form of lectures and based on national diabetes and hypertension guidelines (Working Group of the National Diabetes Advisory Board, 1997; Society for Endocrinology, Metabolism and Diabetes of South Africa, 2002a; Milne et al., 2003), was then implemented and directed at the nursing staff at a primary health care clinic. A post-intervention evaluation was performed after four months by repeating the questionnaire and focus group interviews. Comparisons between the pre- and post-intervention questionnaire and focus group interviews evaluated the impact of the educational intervention on the knowledge and attitudes of nursing staff towards the management of type 2 diabetes. Pre- and post-intervention patient data was collected from patient medical files and compared to determine if the management of diabetes and hypertension improved in the patient population after the implementation of the educational intervention. The patient population consisted of 103 patients. The educational intervention resulted in an extremely significant improvement in the level of knowledge of the nursing staff [93 correct responses (28.3 percent; n = 329 (pre-intervention)) vs 223 correct responses (67.8 percent; n = 329 (post-intervention)); p < 0.0001, Fisher’s Exact test]. The educational intervention resulted in improved attitudes of nursing staff towards the management of diabetes. Ideal random blood glucose concentrations improved significantly [16 percent; n = 100 (pre-intervention) vs 22 percent; n = 100 (post-intervention); p = 0.0003; Student t test]. The number of patients with a compromised HbA1c level (> 8 percent) decreased by 2 [51; 49.5 percent, n = 103 (pre-intervention) vs 49, 47.5 percent, n = 103 (post-intervention)] which was not a significant improvement. Ideal blood pressure control improved by one from 38 patients [36.9 percent; n = 103 (pre-intervention)] to 39 patients [37.9 percent; n = 103 (post-intervention)] which was not significant. Optimal change of pharmacological management following the referral of an uncontrolled diabetic patient was only noted for 18 patients (20.2 percent, n = 89) referred in the post-intervention phase. Clinical inertia was identified as a major limitation to the optimisation of diabetes care. Implementation of an educational intervention based on the South African diabetes and hypertension guidelines at a public sector primary health care clinic was successful in improving the knowledge levels and attitudes of nursing staff
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- Date Issued: 2007
Referral of pregnant women from district hospitals to a reigonal hospital in the Eastern Cape Province
- Authors: Mugerwa-Sekawabe, Edward
- Date: 2007
- Subjects: Medical referral -- South Africa -- Eastern Cape , Medical referral
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:10002 , http://hdl.handle.net/10948/831 , Medical referral -- South Africa -- Eastern Cape , Medical referral
- Description: There is a perception that some of the pregnant women referred from district to regional hospitals should have been managed at the former hospitals. To establish the truth of this perception, a quantitative, exploratory, descriptive and contextual study was undertaken to determine to what extent pregnant women admitted to a regional hospital are appropriately referred from district hospitals according to criteria described in the Guidelines for Maternity Care in South Africa and in the Primary Health Care Package for South Africa. Maternity case records of two hundred and eighty pregnant women admitted to a regional hospital in the Eastern Cape Province following referral from district hospitals between 1 July 2005 and 31 December 2005 were reviewed and analysed. The majority of these women were referred for medical complications, previous caesarean section, failure to progress in labour, obstructed labour, preterm baby and eclampsia. The commonest reasons cited for the transfer of these patients were shortage of maternity care providers in maternity units and lack of expertise at district hospital level. A lack of drugs and equipment were less commonly cited as the reason. Criteria for referral from district to regional hospitals were fulfilled in only 78 (34.2%) of the referrals. This low level of fulfillment of the criteria is attributed to the apparent lack of feedback processes between district and regional hospitals. This in turn limits the opportunity to develop competencies and skills of staff at these maternity units. To address this issue a referral strategy for implementation in the Eastern Cape Province was developed and presented in this study.
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- Date Issued: 2007
An investigation into the introduction of process analytical technology, using near infrared analysis, to selected pharmaceutical processes
- Authors: Naicker, Krishnaveni
- Date: 2007
- Subjects: Near infrared spectroscopy , Pharmaceutical chemistry
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: vital:10153 , http://hdl.handle.net/10948/577 , http://hdl.handle.net/10948/d1011710 , Near infrared spectroscopy , Pharmaceutical chemistry
- Description: Introduction: Process analytical technologies are systems for the analysis and control of manufacturing processes to assure acceptable end-product quality. This is achieved by timely measurements of critical parameters and performance attributes of raw material and in-process material and processes. The introduction of process analytical technology using near infrared analysis was investigated in three areas, namely incoming raw material analysis, blend uniformity analysis and moisture determination in the fluid bed dryer. Methodology: Incoming raw material identification - The FOSS XDS rapid content analyzer was used for the development of a NIR method for the identification and material qualification of starch maize and lactose monohydrate. Blend uniformity analysis – The SP15 Laboratory Blender fitted with near infrared probe was utilized for the study. Two types of blend experiments were designed to monitor the distribution of magnesium stearate (lubricant) in the blend, namely, a powder blend utilizing lactose monohydrate and a granule blend utilizing Ridaq® granule. Software methods were developed to monitor the standard deviation of the absorbance at the wavelengths that were specific for lactose monohydrate, Ridaq® granule and magnesium stearate. To confirm the prediction of end-point using near infrared, results were verified using an atomic absorption method for magnesium stearate. The blends were sampled at the selected time intervals corresponding to three states of the blend, namely, before end-point, at end-point and after end-point using a sampling plan. An additional six blends were conducted for the granule blend and sampled when the standard deviation had reached a value below 3 x 10-6 at the magnesium stearate wavelength at four consecutive data points (standard deviation value extrapolated from blends carried out to predetermined time intervals). Moisture determination in the fluid bed dryer – Moisture values for two products (Product A and Product B) were retrospectively collected from past production batches. A process capability study was conducted on the moisture values to determine if the current process was in a state of control. Results and Discussion: Incoming raw material identification – The algorithms used for the spectral library were able to distinguish between the raw materials selected. The spectral library positively identified the starch maize and lactose monohydrate samples that were not present in the library. The negative challenge with pregelatinised starch and tablettose demonstrated that the spectral library was able to differentiate between closely related compounds. Blend uniformity analysis – Blends sampled at the predetermined time intervals demonstrated a homogeneous state when the standard deviation of the absorbance was low and a non-homogeneous state when the standard deviation of the absorbance was high, thus near infrared prediction on the state of the blend was confirmed by the standard analytical methods. The series of Ridaq® granule and magnesium stearate blends sampled when the standard deviation was below 3 x 10-6 were homogeneous with the exception of one blend that was marginally out of specification. Blend durations were significantly lower than the standard blend durations used in the facility and ranged from 112 to 198 seconds. Moisture determination in the fluid bed dryer – From the process capability study of the two products it was noted that Product A is stable but can still be optimized while Product B is at a desirable state. The statistical evaluation of the moisture values for Product A and Product B demonstrated that the use of the product temperature to monitor the moisture gave consistent results. The current process is stable and capable of producing repeatable results although near infrared provides a means for continuously monitoring the product moisture and allows one to take action to prevent over-drying or under-drying. Conclusion: From the investigations conducted, it can be seen that there is definitely a niche for process analytical technology at this pharmaceutical company. The implementation is a gradual process of change, which may take time, probably several years (Heinze & Hansen 2005).
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- Date Issued: 2007
Operating room nursing science learning programmes in South Africa
- Authors: Prince, Jacqueline Yvonne
- Date: 2007
- Subjects: Operating room nursing -- Study and teaching -- South Africa
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10047 , http://hdl.handle.net/10948/594 , http://hdl.handle.net/10948/d1012880 , Operating room nursing -- Study and teaching -- South Africa
- Description: Operating room nurses form the corner-stone of the operating room because perioperative care of the patient rests mainly in the hands of the nursing personnel. Unique challenges face nurses functioning in the stressful surgical environment where anticipation to prevent or cope with life-threatening situations is the order of the day. The operating room nurse must be knowledgeable, skilled and alert, as he/she is held accountable for all acts of commission and omission. To ensure that nurses are appropriately educated and trained and able to keep trend with the changing technology in the operating room, it is essential that learning programmes meet the minimum standards for registration as prescribed by the South African Nursing Council. Reviewing and evaluating learning programmes on a regular basis by specialist nursing educationists, are therefore essential to ensure that the standards of education and training are maintained and upgraded if required. The aim of this study is to explore and describe the various Operating Room Nursing Science Learning Programmes offered at accredited Higher Education Institutions, utilized for the education and training of the operating room nursing students in South Africa. The proposed research is based on a qualitative paradigm and the theoretical grounding is found in Bergman’s model for professional accountability (Bergman, 1982:8). A document analysis of five approved comprehensive Operating Room Nursing Science Learning Programmes from higher education institutions in South Africa (nursing colleges and universities) was carried out, together with a sixth programme, the Operating Theatre Learning Programme, as suggested by the Standard Generating Body. Requests for permission were forwarded to the management of the selected colleges or universities for inclusion of the respective programmes in the study. The researcher formulated and utilized thirty-four essential criteria derived from three documents, the first being a document entitled “Proposed Standards for Nursing and Midwifery Qualifications” submitted to the SANC and SAQA by the SGB for Nursing and Midwifery (2001-2004). The second document entitled the Public and Private Higher Education Institutions format template for criteria for the Generation and Evaluation of Qualifications and Standards within the National Qualifications Framework was also utilized (SAQA, 1430/00) and thirdly the researcher included the most relevant criteria from the list of criteria for curriculum development as indicated by the South African Nursing Council. Various tables were compiled, to reflect the findings of the document analysis according to the thirty-three criteria indicated above, to provide a clear and broad overview of the specific data in the respective six Operating Room Nursing Science Learning Programmes utilized in the study. In conclusion recommendations for a broad macro-curriculum were made to facilitate formulation of programmes in Operating Room Nursing Science relevant to the South African context.
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- Date Issued: 2007