Experiences of health care professionals at Mdantsane sub-district primary health care clinics regarding the unavailability of medicines
- Authors: Mpengesi, Luvokazi
- Date: 2017
- Subjects: Physician and patient -- South Africa -- East London Primary care (Medicine) -- South Africa -- East London , Communication in medicine
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/19619 , vital:28907
- Description: Medicine unavailability, also known as stock-outs is a global problem. South Africa is not exempt from this problem which impacts negatively on the way in which healthcare services are rendered, more especially in the public sector. Communities are complaining about the unavailability of medicines at public health facilities particularly in primary health care clinics. In an effort to address this problem, the Minister of Health has declared medicine availability as one of the six priorities of the Department of Health. The aim of this study was to explore and describe the experiences and perceptions of healthcare professionals practicing at primary healthcare clinics in a peri-urban area of the Eastern Cape regarding the unavailability of medicines. Understanding the experiences and perceptions was expected to assist in addressing the problem at hand and help management in developing ways to address the problem and support the employees. Semi-structured interviews were conducted with healthcare professionals working at primary health care clinics in and around Mdantsane Township in the Eastern Cape. The main findings of the study can be divided into the following topics: perceived causes of medicine stock-outs, the implications of stock shortages, actions taken in the case of stock-outs and the role to play by in mitigating the impact of stock shortages. The limitations of the study include the research sample which was not truly representative of all healthcare professionals working at Mdantsane sub-district primary healthcare clinics. The study recommends various strategies that management should follow to assist in addressing medicine shortages. The researcher recommends further research to describe the experiences of healthcare professional regarding medicine unavailability.
- Full Text:
- Date Issued: 2017
- Authors: Mpengesi, Luvokazi
- Date: 2017
- Subjects: Physician and patient -- South Africa -- East London Primary care (Medicine) -- South Africa -- East London , Communication in medicine
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/19619 , vital:28907
- Description: Medicine unavailability, also known as stock-outs is a global problem. South Africa is not exempt from this problem which impacts negatively on the way in which healthcare services are rendered, more especially in the public sector. Communities are complaining about the unavailability of medicines at public health facilities particularly in primary health care clinics. In an effort to address this problem, the Minister of Health has declared medicine availability as one of the six priorities of the Department of Health. The aim of this study was to explore and describe the experiences and perceptions of healthcare professionals practicing at primary healthcare clinics in a peri-urban area of the Eastern Cape regarding the unavailability of medicines. Understanding the experiences and perceptions was expected to assist in addressing the problem at hand and help management in developing ways to address the problem and support the employees. Semi-structured interviews were conducted with healthcare professionals working at primary health care clinics in and around Mdantsane Township in the Eastern Cape. The main findings of the study can be divided into the following topics: perceived causes of medicine stock-outs, the implications of stock shortages, actions taken in the case of stock-outs and the role to play by in mitigating the impact of stock shortages. The limitations of the study include the research sample which was not truly representative of all healthcare professionals working at Mdantsane sub-district primary healthcare clinics. The study recommends various strategies that management should follow to assist in addressing medicine shortages. The researcher recommends further research to describe the experiences of healthcare professional regarding medicine unavailability.
- Full Text:
- Date Issued: 2017
The experiences of being trans-racially adopted: the voice of the adoptee
- Authors: Bowen, Carrie
- Date: 2017
- Subjects: Interracial adoption -- South Africa Interethnic adoption -- South Africa , Adoption -- South Africa
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/14719 , vital:27831
- Description: rans-racial adoption was first legalised in South Africa in 1991, and remains a contentious issue within a society in which the ramifications of apartheid are still felt. The study was borne of recognition of the need for clear understanding of the phenomenon of trans-racial adoption in the unique South African context, from the perspective of the adoptees themselves. The phenomenological approach was employed in this qualitative study, in order to gain an understanding of the meaning and sense that trans-racial adoptees ascribe to their lived experiences. The population for the study was trans-racially adopted individuals within South Africa, aged 18 years or older, who have been legally adopted during infancy or early childhood, after 1991. Snowball sampling was determined to be the most appropriate sampling method for the study. Individual, in-depth interviews were conducted with six trans-racial adoptees. These interviews were led by the question "Tell me the story of your experience of growing up as a trans-racially adopted child, and the meaning that this has for you?" The data collected through the interview process was analysed using thematic data analysis. The trustworthiness of the research process and findings was achieved through employing theoretically prescribed data verification strategies. The rich accounts offered by the participants provided insight into their experiences. The most significant study findings revealed that the participants experienced emotional security within their adoptive families, but encountered racism and discrimination within society. The findings further indicated that ambivalence developed during the process of identity formation. In making sense of their experiences, the participants reflected on their uniqueness and individuality, and highlighted gains related to their upbringing. It was evident that quality parental care and the participants’ own resilience contributed to their success in navigating these challenges. Based on the research findings, the study concluded with recommendations for enhancing outcomes in trans-racial adoption.
- Full Text:
- Date Issued: 2017
- Authors: Bowen, Carrie
- Date: 2017
- Subjects: Interracial adoption -- South Africa Interethnic adoption -- South Africa , Adoption -- South Africa
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/14719 , vital:27831
- Description: rans-racial adoption was first legalised in South Africa in 1991, and remains a contentious issue within a society in which the ramifications of apartheid are still felt. The study was borne of recognition of the need for clear understanding of the phenomenon of trans-racial adoption in the unique South African context, from the perspective of the adoptees themselves. The phenomenological approach was employed in this qualitative study, in order to gain an understanding of the meaning and sense that trans-racial adoptees ascribe to their lived experiences. The population for the study was trans-racially adopted individuals within South Africa, aged 18 years or older, who have been legally adopted during infancy or early childhood, after 1991. Snowball sampling was determined to be the most appropriate sampling method for the study. Individual, in-depth interviews were conducted with six trans-racial adoptees. These interviews were led by the question "Tell me the story of your experience of growing up as a trans-racially adopted child, and the meaning that this has for you?" The data collected through the interview process was analysed using thematic data analysis. The trustworthiness of the research process and findings was achieved through employing theoretically prescribed data verification strategies. The rich accounts offered by the participants provided insight into their experiences. The most significant study findings revealed that the participants experienced emotional security within their adoptive families, but encountered racism and discrimination within society. The findings further indicated that ambivalence developed during the process of identity formation. In making sense of their experiences, the participants reflected on their uniqueness and individuality, and highlighted gains related to their upbringing. It was evident that quality parental care and the participants’ own resilience contributed to their success in navigating these challenges. Based on the research findings, the study concluded with recommendations for enhancing outcomes in trans-racial adoption.
- Full Text:
- Date Issued: 2017
Medication errors in a private hospital closed intensive care unit: a retrospective analysis of process change
- Authors: Cruickshank, Deborah Claire
- Date: 2017
- Subjects: Medication errors
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10948/15501 , vital:28259
- Description: Healthcare professionals should be concerned about the safety of the patients in their care and the references to patient safety go back as far as the Hippocratic Oath. Study of literature however shows that medical errors are still of concern and the majority of medical errors are medication errors. The aim of the study was to determine whether process changes introduced reduced both the medication prescribing and medication administration errors in the intensive care unit, thereby contributing to an increase in overall patient safety in the intensive care unit. This study retrospectively analysed the effect of the process changes on medication prescribing and administration errors. The research objectives were to: Identify the number and type of prescribing medication errors prior to the implementation of process changes; Identify the number and type of administration medication errors prior to the implementation of process changes; Identify the process changes implemented; o Determine number and type of prescribing medication errors post the implementation of process changes; Determine number and type of administration medication errors post the implementation of process changes; Assess whether the process changes affected the number and type of prescribing medication errors; and o Assess whether the process changes affected the number and type of administration medication errors. In the Phase One (1 November 2013 to 31 January 2014) 534 patient prescription charts for 172 patients were examined. Medication error rates of 57.6% (n=99) of individual patients reviewed and 18.4% of total patient prescription charts reviewed were found. A total of 69 medication prescribing errors were found in Phase One. This equates to an error percentage of 12.9% per patient chart reviewed and 40.1% per patient reviewed. Thirty medication administration errors were identified in Phase One of the study representing 17.4% of patients reviewed and 5.6% of patient prescription charts reviewed. Medication administration errors included both errors of commission, incorrect doses administered, (n=19) and omission, dose missed, (n=11). Process changes were then introduced and the results of these changes analysed in Phase Two (1 April 2014 to 31 December 2014) show an overall reduction in total medication errors with relation to number of patients reviewed from 57.6% in Phase One to 40.5% in Phase Two. In relation to number of prescription charts reviewed the medication error rate in Phase One was 18.4% and in Phase Two 14.4%. Prescribing errors in relation to number of patients reviewed reduced from 40.1% in Phase One to 26.19% in Phase Two. Overall reductions in percentage of errors were seen in all categories of prescribing errors except duplication of therapy which showed a slight increase. Based on the number of patients reviewed a reduction of prescribing errors was seen in the following categories: transcription errors (13.3% to 7.6%), anticoagulant not prescribed when indicated (3.5% to 2.4%), medication safety (5.2% to 2.9%), dose errors (9.3% to 6.6%) and duration of therapy (6.3% to 3.6%). An increase in the duplication of therapy error rate was seen (2.3% to 3.1%). There was also a reduction in administration errors in relation to number of patients reviewed with a total number of errors of 17.4% in Phase One and 15.8% in Phase Two. The number of prescribing errors per medication chart in Phase Two showed a statistically significant reduction (p=.002). A statistically significant reduction was also seen when the number of errors per patient was reviewed (p=.008). The total number of medication administration errors per medication chart showed a significant reduction (p=.042) as did the number of administration errors per patient (p=.003). When combining the total number of medication errors (both prescriobing and administration) a significant reduction was seen for both the number of charts reviewed (p=.001) and the number of patients reviewed (p=.002). These results indicate that the desired goal of increasing patient safety with regard to medication errors has been achieved but ongoing study is required to ensure the sustainability of the process changes.
- Full Text:
- Date Issued: 2017
- Authors: Cruickshank, Deborah Claire
- Date: 2017
- Subjects: Medication errors
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10948/15501 , vital:28259
- Description: Healthcare professionals should be concerned about the safety of the patients in their care and the references to patient safety go back as far as the Hippocratic Oath. Study of literature however shows that medical errors are still of concern and the majority of medical errors are medication errors. The aim of the study was to determine whether process changes introduced reduced both the medication prescribing and medication administration errors in the intensive care unit, thereby contributing to an increase in overall patient safety in the intensive care unit. This study retrospectively analysed the effect of the process changes on medication prescribing and administration errors. The research objectives were to: Identify the number and type of prescribing medication errors prior to the implementation of process changes; Identify the number and type of administration medication errors prior to the implementation of process changes; Identify the process changes implemented; o Determine number and type of prescribing medication errors post the implementation of process changes; Determine number and type of administration medication errors post the implementation of process changes; Assess whether the process changes affected the number and type of prescribing medication errors; and o Assess whether the process changes affected the number and type of administration medication errors. In the Phase One (1 November 2013 to 31 January 2014) 534 patient prescription charts for 172 patients were examined. Medication error rates of 57.6% (n=99) of individual patients reviewed and 18.4% of total patient prescription charts reviewed were found. A total of 69 medication prescribing errors were found in Phase One. This equates to an error percentage of 12.9% per patient chart reviewed and 40.1% per patient reviewed. Thirty medication administration errors were identified in Phase One of the study representing 17.4% of patients reviewed and 5.6% of patient prescription charts reviewed. Medication administration errors included both errors of commission, incorrect doses administered, (n=19) and omission, dose missed, (n=11). Process changes were then introduced and the results of these changes analysed in Phase Two (1 April 2014 to 31 December 2014) show an overall reduction in total medication errors with relation to number of patients reviewed from 57.6% in Phase One to 40.5% in Phase Two. In relation to number of prescription charts reviewed the medication error rate in Phase One was 18.4% and in Phase Two 14.4%. Prescribing errors in relation to number of patients reviewed reduced from 40.1% in Phase One to 26.19% in Phase Two. Overall reductions in percentage of errors were seen in all categories of prescribing errors except duplication of therapy which showed a slight increase. Based on the number of patients reviewed a reduction of prescribing errors was seen in the following categories: transcription errors (13.3% to 7.6%), anticoagulant not prescribed when indicated (3.5% to 2.4%), medication safety (5.2% to 2.9%), dose errors (9.3% to 6.6%) and duration of therapy (6.3% to 3.6%). An increase in the duplication of therapy error rate was seen (2.3% to 3.1%). There was also a reduction in administration errors in relation to number of patients reviewed with a total number of errors of 17.4% in Phase One and 15.8% in Phase Two. The number of prescribing errors per medication chart in Phase Two showed a statistically significant reduction (p=.002). A statistically significant reduction was also seen when the number of errors per patient was reviewed (p=.008). The total number of medication administration errors per medication chart showed a significant reduction (p=.042) as did the number of administration errors per patient (p=.003). When combining the total number of medication errors (both prescriobing and administration) a significant reduction was seen for both the number of charts reviewed (p=.001) and the number of patients reviewed (p=.002). These results indicate that the desired goal of increasing patient safety with regard to medication errors has been achieved but ongoing study is required to ensure the sustainability of the process changes.
- Full Text:
- Date Issued: 2017
Exploring maternal parenting styles and methods of discipline in relation to autistic children's challenging behaviour in the home environment
- Authors: Ramjee, Prashana
- Date: 2017
- Subjects: Autistic children -- South Africa -- Discipline , Mentally ill children -- South Africa -- Discipline Parenthood -- South Africa -- Psychological aspects Parent and child -- South Africa
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/20570 , vital:29323
- Description: Autism Spectrum Disorder is not a modern phenomenon. Researchers have been studying children with “autism-like” characteristics for over one hundred years and only now it has become recognised, as it is a growing phenomenon. Autism is a vast and complex disorder with a range in which a child’s “autism-like” characteristics fall. Although, the primary distress of autism falls mainly on the child’s shoulders, primary caregivers such as mothers, are faced with many challenges due to the core behavioural characteristics. These challenging behaviours often leave mothers blaming themselves and defending their parenting skills. There are extensive publications regarding parenting that have been published through the years on children who do not have any diagnosed conditions, but limited research and publications exist in the area of parenting children on the autistic spectrum in general and in the South African context. The aim of this study was to explore and describe the maternal parenting styles and methods of discipline in relation to autistic children’s challenging behaviour. The present study incorporated Diana Baumrind’s Parenting Style Model as a framework to better understand the maternal parenting styles and methods of discipline. This study was explorative and descriptive in nature and a biographical questionnaire and a semi-structured interview schedule was utilised to gather data until saturation had been reached. A non-probability purposive sampling technique was employed to obtain participants and thematic analysis was used to analyse data and to extract themes. This study seeks to contribute to psychology's existing body of knowledge by conducting research on parenting styles of learners on the autistic spectrum in South Africa. By conducting this study the researcher hopes to be able to assist parents and helping Exploring Maternal Parenting Styles and Methods of Discipline in Relation to Autistic Children’s Challenging Behaviour in the Home Environment professionals with an understanding of the parenting styles and the methods that are being used to discipline the autistic child’s behaviour in the home environment.
- Full Text:
- Date Issued: 2017
- Authors: Ramjee, Prashana
- Date: 2017
- Subjects: Autistic children -- South Africa -- Discipline , Mentally ill children -- South Africa -- Discipline Parenthood -- South Africa -- Psychological aspects Parent and child -- South Africa
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/20570 , vital:29323
- Description: Autism Spectrum Disorder is not a modern phenomenon. Researchers have been studying children with “autism-like” characteristics for over one hundred years and only now it has become recognised, as it is a growing phenomenon. Autism is a vast and complex disorder with a range in which a child’s “autism-like” characteristics fall. Although, the primary distress of autism falls mainly on the child’s shoulders, primary caregivers such as mothers, are faced with many challenges due to the core behavioural characteristics. These challenging behaviours often leave mothers blaming themselves and defending their parenting skills. There are extensive publications regarding parenting that have been published through the years on children who do not have any diagnosed conditions, but limited research and publications exist in the area of parenting children on the autistic spectrum in general and in the South African context. The aim of this study was to explore and describe the maternal parenting styles and methods of discipline in relation to autistic children’s challenging behaviour. The present study incorporated Diana Baumrind’s Parenting Style Model as a framework to better understand the maternal parenting styles and methods of discipline. This study was explorative and descriptive in nature and a biographical questionnaire and a semi-structured interview schedule was utilised to gather data until saturation had been reached. A non-probability purposive sampling technique was employed to obtain participants and thematic analysis was used to analyse data and to extract themes. This study seeks to contribute to psychology's existing body of knowledge by conducting research on parenting styles of learners on the autistic spectrum in South Africa. By conducting this study the researcher hopes to be able to assist parents and helping Exploring Maternal Parenting Styles and Methods of Discipline in Relation to Autistic Children’s Challenging Behaviour in the Home Environment professionals with an understanding of the parenting styles and the methods that are being used to discipline the autistic child’s behaviour in the home environment.
- Full Text:
- Date Issued: 2017
Culturally informed conceptions of traumatic experience and coping strategies among the mole-dagbon of Ghana
- Authors: Thompson, Sandra
- Date: 2017
- Subjects: Cultural psychiatry -- Ghana , Post-traumatic stress disorder -- Ghana , Dagbani (African people)
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/9327 , vital:26578
- Description: Culture is important to an individual’s understanding of traumatic events and the symptoms that ensue after such events. Cultural understandings also inform how individuals cope with the traumatic stress symptoms they experience. A great deal is known about the understanding of traumatic experiences and effective coping mechanisms used in Western cultures, but non-Western cultures are generally understudied. Valuable lessons are learnt from conducting studies with understudied non-Western cultures. The research sought to explore and describe the culturally informed conceptions of traumatic experience and coping strategies in one such understudied population - the Mole-Dagbon of Ghana. The research used a qualitative exploratory descriptive interpretive methodology. Purposive nonprobability sampling was used to gain access to individuals who could comment on the knowledge objectives of the study. Data was collected using focus group discussions with cultural leaders, and semi-structured interviews with traumatized individuals. All interviews were audio-recorded, transcribed, translated and analyzed using interpretive phenomenological analysis. The findings indicated that traumatic experiences and the coping strategies are influenced by a number of cultural factors. Participants’ understanding of traumatic experiences and symptoms relied heavily on normative traditional African cultural understandings, but explanations also utilized monotheistic (from Islam and Christianity) worldviews. It was also evident that not all explanations were purely spiritual and events and symptoms were also explained using a natural/scientific framework. Some aspects of this system indicated parallels with the Western cognitive understanding of traumatic stress symptoms. The Mole-Dagbon did not focus naturally on explaining the events and symptoms and in the current sample such explanations were often deferred to authoritative individuals in the society (especially the soothsayers from the Traditional African Religion). However, there was an easy focus on coping with the symptoms after a traumatic event and in this last aspect there was a great degree of agreement between participants. A clear hierarchy of coping emerged with community and family social support being considered the most important aspect. Irrespective of religious affiliation, individuals also considered a visit to the soothsayer and completing prescribed rituals as important in the process. Even where an individual did not wish to include this practice from African Traditional Religion because of religious affiliation, they acknowledged the existence and effectiveness of these practices. Finally, it was thought important that a traumatized individual consult a religious leader for counselling (again irrespective of the actual religion). While there were elements of cognitive understanding and a recognition of counselling by religious leaders, Western based treatment modalities were not mentioned as options for the treatment of the symptoms of PTSD. Practitioners that come into contact with the Mole-Dagbon may need to use collaborative treatment strategies that respects and utilizes cultural treatment strategies for PTSD. One interesting element that needs further exploration is whether the cognitive understandings of the Mole-Dagbon can be used in a cognitive therapeutic paradigm. Even though these cognitive appraisals are present in explaining symptoms, there are no direct cultural remedies that rely on them.
- Full Text:
- Date Issued: 2017
- Authors: Thompson, Sandra
- Date: 2017
- Subjects: Cultural psychiatry -- Ghana , Post-traumatic stress disorder -- Ghana , Dagbani (African people)
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/9327 , vital:26578
- Description: Culture is important to an individual’s understanding of traumatic events and the symptoms that ensue after such events. Cultural understandings also inform how individuals cope with the traumatic stress symptoms they experience. A great deal is known about the understanding of traumatic experiences and effective coping mechanisms used in Western cultures, but non-Western cultures are generally understudied. Valuable lessons are learnt from conducting studies with understudied non-Western cultures. The research sought to explore and describe the culturally informed conceptions of traumatic experience and coping strategies in one such understudied population - the Mole-Dagbon of Ghana. The research used a qualitative exploratory descriptive interpretive methodology. Purposive nonprobability sampling was used to gain access to individuals who could comment on the knowledge objectives of the study. Data was collected using focus group discussions with cultural leaders, and semi-structured interviews with traumatized individuals. All interviews were audio-recorded, transcribed, translated and analyzed using interpretive phenomenological analysis. The findings indicated that traumatic experiences and the coping strategies are influenced by a number of cultural factors. Participants’ understanding of traumatic experiences and symptoms relied heavily on normative traditional African cultural understandings, but explanations also utilized monotheistic (from Islam and Christianity) worldviews. It was also evident that not all explanations were purely spiritual and events and symptoms were also explained using a natural/scientific framework. Some aspects of this system indicated parallels with the Western cognitive understanding of traumatic stress symptoms. The Mole-Dagbon did not focus naturally on explaining the events and symptoms and in the current sample such explanations were often deferred to authoritative individuals in the society (especially the soothsayers from the Traditional African Religion). However, there was an easy focus on coping with the symptoms after a traumatic event and in this last aspect there was a great degree of agreement between participants. A clear hierarchy of coping emerged with community and family social support being considered the most important aspect. Irrespective of religious affiliation, individuals also considered a visit to the soothsayer and completing prescribed rituals as important in the process. Even where an individual did not wish to include this practice from African Traditional Religion because of religious affiliation, they acknowledged the existence and effectiveness of these practices. Finally, it was thought important that a traumatized individual consult a religious leader for counselling (again irrespective of the actual religion). While there were elements of cognitive understanding and a recognition of counselling by religious leaders, Western based treatment modalities were not mentioned as options for the treatment of the symptoms of PTSD. Practitioners that come into contact with the Mole-Dagbon may need to use collaborative treatment strategies that respects and utilizes cultural treatment strategies for PTSD. One interesting element that needs further exploration is whether the cognitive understandings of the Mole-Dagbon can be used in a cognitive therapeutic paradigm. Even though these cognitive appraisals are present in explaining symptoms, there are no direct cultural remedies that rely on them.
- Full Text:
- Date Issued: 2017
Experiences of analogue-trained radiographers utilising digital imaging in projection radiography
- Authors: Campbell, Sydney
- Date: 2017
- Subjects: Radiography, Medical -- Digital techniques Angiography , Image processing -- Digital techniques Radiography
- Language: English
- Type: Thesis , Masters , MTech
- Identifier: http://hdl.handle.net/10948/14796 , vital:27851
- Description: The professional work of a radiographer encompasses both patient care and the use of technology. The technology employed could either be analogue or digital technology. Since 1973, the analogue imaging system has slowly been replaced by digital radiography imaging systems. Despite the many advantages of digital imaging it does present the radiographer with added responsibilities. Furthermore, analogue-trained radiographers have found adjusting to digital imaging especially challenging. The aim of the study was to explore and describe the experiences of analogue-trained radiographers utilising digital imaging in projection radiography with the intention of developing guidelines to equip radiography managers to assist analogue-trained radiographers to better utilise digital imaging. The researcher used Schlossberg’s Transition Theory as a lens to look at the experiences of analogue-trained radiographers using digital imaging to produce radiographs. The research study used a qualitative design which was explorative, descriptive and contextual in nature. The target population included all diagnostic radiographers (public and private) in the local municipality who were registered with the Health Professions Council of South Africa. Purposive sampling was employed to select the radiographers that represented all radiographers in the Nelson Mandela Bay Health District. The sample included all radiographers who fulfilled the identified selection criteria. The selected participants were recruited to take part in in-depth, semi-structured individual interviews. The data was analysed using a computer-aided qualitative data analysis software package, ATLAS.ti. The trustworthiness of this study was ensured by applying Guba’s model of trustworthiness that includes credibility, transferability, dependability and confirmability. The ethical principles of respect for persons, beneficence and justice, as espoused by the Belmont Report, were adhered to in order to ensure that the study was conducted in an ethical manner. Two themes emanated from the data, namely the evolution of the radiographer when faced with the advances in technology as well the role that the work environment played in the manner that the participants experienced the change. The experiences of the participants were described using direct quotations from the interviews and a literature control was used to verify the participants’ experiences. Evidence was found of radiographer indifference towards exposure selection, dose optimisation and placement of anatomical side markers when utilising digital imaging. Finally, guidelines were developed to equip radiography managers to assist analogue-trained radiographers to better utilise digital imaging. In addition, the guidelines will assist all other radiographers to better utilise digital imaging.
- Full Text:
- Date Issued: 2017
- Authors: Campbell, Sydney
- Date: 2017
- Subjects: Radiography, Medical -- Digital techniques Angiography , Image processing -- Digital techniques Radiography
- Language: English
- Type: Thesis , Masters , MTech
- Identifier: http://hdl.handle.net/10948/14796 , vital:27851
- Description: The professional work of a radiographer encompasses both patient care and the use of technology. The technology employed could either be analogue or digital technology. Since 1973, the analogue imaging system has slowly been replaced by digital radiography imaging systems. Despite the many advantages of digital imaging it does present the radiographer with added responsibilities. Furthermore, analogue-trained radiographers have found adjusting to digital imaging especially challenging. The aim of the study was to explore and describe the experiences of analogue-trained radiographers utilising digital imaging in projection radiography with the intention of developing guidelines to equip radiography managers to assist analogue-trained radiographers to better utilise digital imaging. The researcher used Schlossberg’s Transition Theory as a lens to look at the experiences of analogue-trained radiographers using digital imaging to produce radiographs. The research study used a qualitative design which was explorative, descriptive and contextual in nature. The target population included all diagnostic radiographers (public and private) in the local municipality who were registered with the Health Professions Council of South Africa. Purposive sampling was employed to select the radiographers that represented all radiographers in the Nelson Mandela Bay Health District. The sample included all radiographers who fulfilled the identified selection criteria. The selected participants were recruited to take part in in-depth, semi-structured individual interviews. The data was analysed using a computer-aided qualitative data analysis software package, ATLAS.ti. The trustworthiness of this study was ensured by applying Guba’s model of trustworthiness that includes credibility, transferability, dependability and confirmability. The ethical principles of respect for persons, beneficence and justice, as espoused by the Belmont Report, were adhered to in order to ensure that the study was conducted in an ethical manner. Two themes emanated from the data, namely the evolution of the radiographer when faced with the advances in technology as well the role that the work environment played in the manner that the participants experienced the change. The experiences of the participants were described using direct quotations from the interviews and a literature control was used to verify the participants’ experiences. Evidence was found of radiographer indifference towards exposure selection, dose optimisation and placement of anatomical side markers when utilising digital imaging. Finally, guidelines were developed to equip radiography managers to assist analogue-trained radiographers to better utilise digital imaging. In addition, the guidelines will assist all other radiographers to better utilise digital imaging.
- Full Text:
- Date Issued: 2017
Perceptions of unit managers regarding competencies of newly qualified registered nurses in East London health services
- Authors: Bengu, Phindiwe Faith
- Date: 2017
- Subjects: Nurses -- In-service training -- South Africa -- Eastern Cape Community health nursing -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10353/13597 , vital:39683
- Description: The South African Nursing Council requires registered nurses to have the necessary knowledge, skills, attitudes and values which will enable them to render an efficient service (Morolong and Chabeli, 2005:39). The South African Education and training system, through its policy of outcomes- based education and training, has tabled competency as a national priority. In support of this, the South African Nursing Council (SANC) requires that the newly qualified registered nurse possess competency on the core functions of a registered nurse. The health system also demands competent nurse practitioners to ensure quality nursing care. Due to the fact that competency is a national priority and a statutory demand, the research question that guided the study is what are the perceptions of unit managers regarding competencies of newly qualified registered nurses in East London Health Care services. The study was aimed at describing the perceptions of unit managers regarding the competencies of newly qualified registered nurses in order to propose the recommendations to improve the competencies of such newly qualified registered nurses and to provide quality patient care. A quantitative descriptive non experimental design was used to evaluate the perceptions of unit managers regarding competencies of newly qualified registered nurses from a public nursing college. The sampling method of probability convenience sampling was used in this study. Data were collected by means of a questionnaire administered to ninety unit managers and only eighty one unit managers participated in the study. Data were analysed using the Statistical Package for the Social Sciences (SPSS) version 22 software. Statistical methods enabled the researcher to reduce, summarize, organise, manipulate, evaluate, interpret and communicate quantitative data. Data were cleaned and coded and spoilt data were checked. Findings from the software were displayed in graphs or tables. Concerning the eighty one unit managers who participated in the study, age and sex matched respondents were selected according to their availability.The results showed that there is agreement that competence of the nurses affects the image, mission and staff utilisation in their units and/or institutions. There was no dominant opinion on the possible association between competency and environmental, physical and technological factors. There was unanimous agreement that newly qualified nurses need constant supervision and in-service training. There was moderate agreement on the use of acquired knowledge and skills by nurses and there was no dominant opinion about how newly qualified nurses tolerate differences and handle misunderstandings and shortcomings of other professions. In conclusion newly qualified registered nurses need coaching, mentoring, n-service training and constant supervision. Recommendations regarding strategies to be used to improve competencies of newly qualified registered nurses included exit evaluations of community service practitioners, stipulating the competency framework of newly qualified nurses and assessment criteria of competency. Mentoring and coaching of newly qualified registered nurses during community service, monthly or quarterly meetings with the community service candidate in order to identify their challenges were also recommended. Motivation strategies in order to boost their morale so that they can deliver quality patient care. The newly qualified registered nurses should hold meetings with the unit managers regarding the challenges the unit managers face when assessing competencies of newly qualified registered nurses.
- Full Text:
- Date Issued: 2017
- Authors: Bengu, Phindiwe Faith
- Date: 2017
- Subjects: Nurses -- In-service training -- South Africa -- Eastern Cape Community health nursing -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10353/13597 , vital:39683
- Description: The South African Nursing Council requires registered nurses to have the necessary knowledge, skills, attitudes and values which will enable them to render an efficient service (Morolong and Chabeli, 2005:39). The South African Education and training system, through its policy of outcomes- based education and training, has tabled competency as a national priority. In support of this, the South African Nursing Council (SANC) requires that the newly qualified registered nurse possess competency on the core functions of a registered nurse. The health system also demands competent nurse practitioners to ensure quality nursing care. Due to the fact that competency is a national priority and a statutory demand, the research question that guided the study is what are the perceptions of unit managers regarding competencies of newly qualified registered nurses in East London Health Care services. The study was aimed at describing the perceptions of unit managers regarding the competencies of newly qualified registered nurses in order to propose the recommendations to improve the competencies of such newly qualified registered nurses and to provide quality patient care. A quantitative descriptive non experimental design was used to evaluate the perceptions of unit managers regarding competencies of newly qualified registered nurses from a public nursing college. The sampling method of probability convenience sampling was used in this study. Data were collected by means of a questionnaire administered to ninety unit managers and only eighty one unit managers participated in the study. Data were analysed using the Statistical Package for the Social Sciences (SPSS) version 22 software. Statistical methods enabled the researcher to reduce, summarize, organise, manipulate, evaluate, interpret and communicate quantitative data. Data were cleaned and coded and spoilt data were checked. Findings from the software were displayed in graphs or tables. Concerning the eighty one unit managers who participated in the study, age and sex matched respondents were selected according to their availability.The results showed that there is agreement that competence of the nurses affects the image, mission and staff utilisation in their units and/or institutions. There was no dominant opinion on the possible association between competency and environmental, physical and technological factors. There was unanimous agreement that newly qualified nurses need constant supervision and in-service training. There was moderate agreement on the use of acquired knowledge and skills by nurses and there was no dominant opinion about how newly qualified nurses tolerate differences and handle misunderstandings and shortcomings of other professions. In conclusion newly qualified registered nurses need coaching, mentoring, n-service training and constant supervision. Recommendations regarding strategies to be used to improve competencies of newly qualified registered nurses included exit evaluations of community service practitioners, stipulating the competency framework of newly qualified nurses and assessment criteria of competency. Mentoring and coaching of newly qualified registered nurses during community service, monthly or quarterly meetings with the community service candidate in order to identify their challenges were also recommended. Motivation strategies in order to boost their morale so that they can deliver quality patient care. The newly qualified registered nurses should hold meetings with the unit managers regarding the challenges the unit managers face when assessing competencies of newly qualified registered nurses.
- Full Text:
- Date Issued: 2017
Perceptions and current practices of Namibian midwives regarding the use of the cardio-tocograph as an informative labour monitoring tool for labouring women
- Authors: Uusiku, Laura Ingashipwa
- Date: 2017
- Subjects: Fetal heart rate monitoring Midwives -- Namibia , Midwifery -- Namibia Hospital patients -- Namibia -- Attitudes Medical care -- Namibia
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10948/21318 , vital:29477
- Description: Labour is a vital period for the labouring mothers, as it should bring with it the fulfilment of an expectation of having the baby that has been awaited. The health of the foetus which is to be born and that of the labouring mother are inextricably linked with each other which is why the labouring mother needs to be assessed and monitored carefully. The cardio-tocograph, which is a globally accepted method of diagnosis and assessment of the foetal status during labour is preferred to be used in monitoring labouring mothers, especially high- risk patients. Despite the evidence and information regarding the effectiveness of the use of the cardio-tocograph, midwives are still found not to be using it correctly, the reasons given that the women not always co-operate; do not keep the electrode and belt in place or cite the discomfort they experience from contraction. The objectives of this study were to: explore and describe the perceptions and current practice of Namibian midwives regarding the use of the cardio-tocograph as an informative labour- monitoring tool. Explore and describe how midwives working in labour wards in Namibia perceive informing laboring women of the use of the cardio-tocograph as an informative labour- monitoring tool and based on the results, develop an instruction guide for midwives working in the labour ward in intermediate hospital in Namibia that would serve as a guide on how to teach labouring women about the use of the cardio-tocograph as a labour- monitoring tool and enhance positive labor and delivery outcomes The study was conducted between May and June 2016, using a qualitative, explorative, descriptive and contextual design, following the necessary university approval and approval from other relevant authorities. The research population was midwives who work in labour wards at a public hospital in Namibia. Semi-structured interviews were used to collect data from purposively sampled participants using set criteria. A voice recorder was used to capture the interview with the permission of the participants. Seventeen midwives were interviewed of whom two were used for the pilot study. Data saturation determined the sufficient sample size. The collected data was analyzed using Tesch’s spiral method of data analysis with the assistance of an independent coder From the research findings, it emerged that midwives had varying perceptions regarding the use of the CTG machine. Midwives still perceive CTG interpretation as a challenge as a labour -monitoring tool and expressed a need for updates. Furthermore, midwives expressed the fact that they had limited communication with labouring women regarding the use of CTG. Based on the research findings and guided by Health Belief Model principles, three main guidelines were developed for midwives working in the labour ward in a public hospital in Namibia. These guidelines will serve as a tool to assist midwives in their teaching of labouring women about the use of the cardio-tocograph as a labour- monitoring tool, and the role to be played by labouring women during that monitoring period. Furthermore, recommendations for clinical nursing practice, nursing education and nursing research were developed. The researcher used literature control to ensure validation and integrity of the study. Trustworthiness, which was used to ensure rigour of the study, was guided by the principles of truth-value, transferability, dependability and confirmability. Ethical considerations were guided by the Belmont report adopting the principles of beneficence, respect for human dignity, justice and non-maleficence.
- Full Text:
- Date Issued: 2017
- Authors: Uusiku, Laura Ingashipwa
- Date: 2017
- Subjects: Fetal heart rate monitoring Midwives -- Namibia , Midwifery -- Namibia Hospital patients -- Namibia -- Attitudes Medical care -- Namibia
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10948/21318 , vital:29477
- Description: Labour is a vital period for the labouring mothers, as it should bring with it the fulfilment of an expectation of having the baby that has been awaited. The health of the foetus which is to be born and that of the labouring mother are inextricably linked with each other which is why the labouring mother needs to be assessed and monitored carefully. The cardio-tocograph, which is a globally accepted method of diagnosis and assessment of the foetal status during labour is preferred to be used in monitoring labouring mothers, especially high- risk patients. Despite the evidence and information regarding the effectiveness of the use of the cardio-tocograph, midwives are still found not to be using it correctly, the reasons given that the women not always co-operate; do not keep the electrode and belt in place or cite the discomfort they experience from contraction. The objectives of this study were to: explore and describe the perceptions and current practice of Namibian midwives regarding the use of the cardio-tocograph as an informative labour- monitoring tool. Explore and describe how midwives working in labour wards in Namibia perceive informing laboring women of the use of the cardio-tocograph as an informative labour- monitoring tool and based on the results, develop an instruction guide for midwives working in the labour ward in intermediate hospital in Namibia that would serve as a guide on how to teach labouring women about the use of the cardio-tocograph as a labour- monitoring tool and enhance positive labor and delivery outcomes The study was conducted between May and June 2016, using a qualitative, explorative, descriptive and contextual design, following the necessary university approval and approval from other relevant authorities. The research population was midwives who work in labour wards at a public hospital in Namibia. Semi-structured interviews were used to collect data from purposively sampled participants using set criteria. A voice recorder was used to capture the interview with the permission of the participants. Seventeen midwives were interviewed of whom two were used for the pilot study. Data saturation determined the sufficient sample size. The collected data was analyzed using Tesch’s spiral method of data analysis with the assistance of an independent coder From the research findings, it emerged that midwives had varying perceptions regarding the use of the CTG machine. Midwives still perceive CTG interpretation as a challenge as a labour -monitoring tool and expressed a need for updates. Furthermore, midwives expressed the fact that they had limited communication with labouring women regarding the use of CTG. Based on the research findings and guided by Health Belief Model principles, three main guidelines were developed for midwives working in the labour ward in a public hospital in Namibia. These guidelines will serve as a tool to assist midwives in their teaching of labouring women about the use of the cardio-tocograph as a labour- monitoring tool, and the role to be played by labouring women during that monitoring period. Furthermore, recommendations for clinical nursing practice, nursing education and nursing research were developed. The researcher used literature control to ensure validation and integrity of the study. Trustworthiness, which was used to ensure rigour of the study, was guided by the principles of truth-value, transferability, dependability and confirmability. Ethical considerations were guided by the Belmont report adopting the principles of beneficence, respect for human dignity, justice and non-maleficence.
- Full Text:
- Date Issued: 2017
Discovering the root of obesity through the symbology of food: a historical and cultural exploration
- Authors: Jacobs, Nadine
- Date: 2017
- Subjects: Obesity -- Psychological aspects , Obesity -- Research Behavior modification Psychophysiology
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/17569 , vital:28379
- Description: Obesity is fast becoming a worldwide issue with detrimental health consequences. The increasing availability of effective nutritional strategies, physical exercise regimes and behaviour modification approaches to weight loss do not offer a satisfactory explanation as to why only two to five percent of people who have lost weight successfully manage to retain the weight loss over the long term. By referring to several concepts on how the symbols of food originate in the unconscious and end up becoming the unconscious impetus for conscious thought and dietary behaviours relating to food, the complexity of food pathologies, with specific reference to obesity is explored. The study presents a narrative review of the available literature on symbols in a variety of cultural-historical contexts through the theoretical lens of the psychoanalytic framework. The study contributed to the current treatment approaches to obesity, by highlighting how the unconscious content of the psyche serve to compromise conscious efforts to address the problem of obesity. Also, the need for further research into the development of a model that, by incorporating the psychoanalytic approach to obesity, will support the long-term success of weight loss intervention by addressing the underlying issues, is emphasised.
- Full Text:
- Date Issued: 2017
Discovering the root of obesity through the symbology of food: a historical and cultural exploration
- Authors: Jacobs, Nadine
- Date: 2017
- Subjects: Obesity -- Psychological aspects , Obesity -- Research Behavior modification Psychophysiology
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/17569 , vital:28379
- Description: Obesity is fast becoming a worldwide issue with detrimental health consequences. The increasing availability of effective nutritional strategies, physical exercise regimes and behaviour modification approaches to weight loss do not offer a satisfactory explanation as to why only two to five percent of people who have lost weight successfully manage to retain the weight loss over the long term. By referring to several concepts on how the symbols of food originate in the unconscious and end up becoming the unconscious impetus for conscious thought and dietary behaviours relating to food, the complexity of food pathologies, with specific reference to obesity is explored. The study presents a narrative review of the available literature on symbols in a variety of cultural-historical contexts through the theoretical lens of the psychoanalytic framework. The study contributed to the current treatment approaches to obesity, by highlighting how the unconscious content of the psyche serve to compromise conscious efforts to address the problem of obesity. Also, the need for further research into the development of a model that, by incorporating the psychoanalytic approach to obesity, will support the long-term success of weight loss intervention by addressing the underlying issues, is emphasised.
- Full Text:
- Date Issued: 2017
Primary health care nurses' knowledge regarding symptoms of mental illness in HIV-positive patients
- Authors: Jantjies, Anderson Phumezo
- Date: 2017
- Subjects: Psychiatric nursing -- South Africa -- Eastern Cape Primary health care -- South Africa -- Eastern Cape , HIV infections -- Treatment -- South Africa -- Eastern Cape Nurses -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10948/18860 , vital:28739
- Description: Human Immunodeficiency Virus (HIV) positive patients are at increased risk for developing mental health problems when compared with the general population. The identification and management of symptoms of mental illness in HIV-positive patients is thus crucial in reducing the risk to developing severe mental illness. The severe mental illness may lead to poor adherence to anti retro-viral drugs resulting in increased morbidity and mortality. The primary health care nurses are largely responsible for managing the treatment of HIV-positive patients as they spend the greatest degree of their time with these patients as compared to other health care professionals. Consequently it is important for primary health care nurses to identify symptoms of mental illness. However, it was unclear to the researcher, a professional psychiatric nurse, as to the level of knowledge among primary health care nurses concerning symptoms of mental illness in HIV-positive patients. Therefore, the aim of this study was to determine the knowledge of primary health care nurses regarding symptoms of mental illness in HIV-positive patients attending primary health care services. In addition, recommendations were developed for primary health care nurses for the purpose of improving their competence in the identification of symptoms of mental illness in HIV-positive patients attending primary health care services. The researcher has utilised quantitative, explorative, descriptive and contextual design. Bloom’s Taxonomy was used as a theoretical lens, to explore the primary health care nurse’s knowledge regarding symptoms of mental illness in HIV-positive patients. The study was conducted in the primary health care services situated in the Nelson Mandela Metropolitan area. The research population consisted of the primary health care nurses working with HIV-positive patients in these primary health care services. The researcher utilised census survey to recruit participants. A structured questionnaire, with 3 sections was used in this study. The necessary principles of reliability and validity were exercised to ensure research of the highest quality. The data was analysed by using descriptive and inferential statistics. All ethical considerations pertaining to beneficence, maleficence, justice, autonomy and obtaining permission from relevant structures to conduct the study were strictly adhered to.
- Full Text:
- Date Issued: 2017
- Authors: Jantjies, Anderson Phumezo
- Date: 2017
- Subjects: Psychiatric nursing -- South Africa -- Eastern Cape Primary health care -- South Africa -- Eastern Cape , HIV infections -- Treatment -- South Africa -- Eastern Cape Nurses -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10948/18860 , vital:28739
- Description: Human Immunodeficiency Virus (HIV) positive patients are at increased risk for developing mental health problems when compared with the general population. The identification and management of symptoms of mental illness in HIV-positive patients is thus crucial in reducing the risk to developing severe mental illness. The severe mental illness may lead to poor adherence to anti retro-viral drugs resulting in increased morbidity and mortality. The primary health care nurses are largely responsible for managing the treatment of HIV-positive patients as they spend the greatest degree of their time with these patients as compared to other health care professionals. Consequently it is important for primary health care nurses to identify symptoms of mental illness. However, it was unclear to the researcher, a professional psychiatric nurse, as to the level of knowledge among primary health care nurses concerning symptoms of mental illness in HIV-positive patients. Therefore, the aim of this study was to determine the knowledge of primary health care nurses regarding symptoms of mental illness in HIV-positive patients attending primary health care services. In addition, recommendations were developed for primary health care nurses for the purpose of improving their competence in the identification of symptoms of mental illness in HIV-positive patients attending primary health care services. The researcher has utilised quantitative, explorative, descriptive and contextual design. Bloom’s Taxonomy was used as a theoretical lens, to explore the primary health care nurse’s knowledge regarding symptoms of mental illness in HIV-positive patients. The study was conducted in the primary health care services situated in the Nelson Mandela Metropolitan area. The research population consisted of the primary health care nurses working with HIV-positive patients in these primary health care services. The researcher utilised census survey to recruit participants. A structured questionnaire, with 3 sections was used in this study. The necessary principles of reliability and validity were exercised to ensure research of the highest quality. The data was analysed by using descriptive and inferential statistics. All ethical considerations pertaining to beneficence, maleficence, justice, autonomy and obtaining permission from relevant structures to conduct the study were strictly adhered to.
- Full Text:
- Date Issued: 2017
Experiential learning in an undergraduate BPHARM programme: impact of an intervention on academic achievement
- Authors: McCartney, Jane Alison
- Date: 2017
- Subjects: Pharmacy -- Study and teaching -- South Africa Experiential learning -- South Africa , Academic achievement -- South Africa
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: http://hdl.handle.net/10948/19037 , vital:28767
- Description: The extended role of today’s pharmacist with the emphasis on patient-focused care has highlighted the need for increased exposure of undergraduate pharmacy students to experiential learning in patient-centred environments, and additional skills development in therapeutics, problem solving and clinical decision making. At the Nelson Mandela Metropolitan University (NMMU), final year pharmacy students complete a university-coordinated, hospital-based, structured experiential learning programme (ELP) for the exit-level module, Pharmacology4. However, the students consistently experience difficulties in the application of pharmacological knowledge during the transition from lecture-based learning to the patient-focused clinical setting. The student population at the NMMU is diverse, with varied cultural, ethnic, language and secondary level education backgrounds, as well as different learning preferences and approaches. The extent to which these factors affect academic achievement in the experiential learning environment is unknown. Central research question The central research question for this study was therefore, “What would be the effect of an intervention aimed at supporting undergraduate pharmacy students during clinical placements, on academic achievement in, and student attitudes towards, experiential learning programmes (ELP)?” In order to explore the research question, several factors which may influence academic achievement in ELPs were investigated, namely: academic achievement (pre-university, in the BPharm programme and, in pharmacology); the admission route into the BPharm programme and the subsequent rate of academic progression; English reading comprehension ability; learning styles; problem solving ability; the extent to which students are prepared for application of knowledge in the ELP, in terms of assessment methods used prior to the final year and previous pharmacy work-based experience. In addition, the students’ lived experience of the ELP was explored, and the need for, and nature of, an intervention was determined. The research was based in a pragmatic paradigm, using an advanced mixed methods approach. An intervention-based, two-phase, quasi-experimental design was employed with an initial exploratory Preliminary Phase (in 2013) preceding the larger experimental framework (Phases One and Two, in 2014 and 2015 respectively). The research design was primarily quantitative, with pre- and post- testing conducted before and after the ELP. The ELP was completed by the comparator cohort in Phase One and the experimental cohort in Phase Two. Supplementary qualitative data was collected before, during and after the ELP. The intervention, in the form of supplementary academic support sessions, was developed from the qualitative data using an iterative approach, and implemented during the ELP in Phase Two. Attitudes and expectations of the students towards the hospital-based ELP were generally positive and realistic. Areas of concern included the difficulties experienced in the application and integration of pharmacological knowledge, both in the clinical setting and the clinical case study-based assessments; students feeling overwhelmed, inadequate and inferior in the clinical environment, compounded by an absence of clinical pharmacists as role models; and feeling unprepared for patient-focused care. The qualitative data strongly supported the need for supplementary academic support sessions. The intervention was developed and implemented in Phase Two, using patient case-based, active learning strategies. The majority of students (91.0%; n = 104) reported improved case analysis skills. A statistically significant (p = .030, Cohen’s d = 0.34) improvement was noted in the summative Pharmacology4 assessment marks obtained by the experimental cohort post-intervention, although of small practical significance. Predictors of academic achievement in the ELP were found to be language, specifically English reading comprehension skills, academic achievement in the BPharm programme and pharmacology, the university admission score, the rate of academic progression, and problem solving ability. Previous pharmacy-based work experience and assessment questions requiring application of knowledge were also found to influence achievement in the ELP. The need for an intervention in the form of supplementary academic support sessions was confirmed. The intervention was subsequently developed and successfully implemented, with student-reported self-perceived improvements in patient case analysis skills. These positive findings were supported by quantitative data which showed a statistically significant improvement in academic achievement in the ELP. Several predictors of academic achievement in the ELP were identified, and invaluable insight was gained into the nature of the difficulties experienced by pharmacy students in the transition from lecture-based learning to experiential learning in patient-focused environments.
- Full Text:
- Date Issued: 2017
- Authors: McCartney, Jane Alison
- Date: 2017
- Subjects: Pharmacy -- Study and teaching -- South Africa Experiential learning -- South Africa , Academic achievement -- South Africa
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: http://hdl.handle.net/10948/19037 , vital:28767
- Description: The extended role of today’s pharmacist with the emphasis on patient-focused care has highlighted the need for increased exposure of undergraduate pharmacy students to experiential learning in patient-centred environments, and additional skills development in therapeutics, problem solving and clinical decision making. At the Nelson Mandela Metropolitan University (NMMU), final year pharmacy students complete a university-coordinated, hospital-based, structured experiential learning programme (ELP) for the exit-level module, Pharmacology4. However, the students consistently experience difficulties in the application of pharmacological knowledge during the transition from lecture-based learning to the patient-focused clinical setting. The student population at the NMMU is diverse, with varied cultural, ethnic, language and secondary level education backgrounds, as well as different learning preferences and approaches. The extent to which these factors affect academic achievement in the experiential learning environment is unknown. Central research question The central research question for this study was therefore, “What would be the effect of an intervention aimed at supporting undergraduate pharmacy students during clinical placements, on academic achievement in, and student attitudes towards, experiential learning programmes (ELP)?” In order to explore the research question, several factors which may influence academic achievement in ELPs were investigated, namely: academic achievement (pre-university, in the BPharm programme and, in pharmacology); the admission route into the BPharm programme and the subsequent rate of academic progression; English reading comprehension ability; learning styles; problem solving ability; the extent to which students are prepared for application of knowledge in the ELP, in terms of assessment methods used prior to the final year and previous pharmacy work-based experience. In addition, the students’ lived experience of the ELP was explored, and the need for, and nature of, an intervention was determined. The research was based in a pragmatic paradigm, using an advanced mixed methods approach. An intervention-based, two-phase, quasi-experimental design was employed with an initial exploratory Preliminary Phase (in 2013) preceding the larger experimental framework (Phases One and Two, in 2014 and 2015 respectively). The research design was primarily quantitative, with pre- and post- testing conducted before and after the ELP. The ELP was completed by the comparator cohort in Phase One and the experimental cohort in Phase Two. Supplementary qualitative data was collected before, during and after the ELP. The intervention, in the form of supplementary academic support sessions, was developed from the qualitative data using an iterative approach, and implemented during the ELP in Phase Two. Attitudes and expectations of the students towards the hospital-based ELP were generally positive and realistic. Areas of concern included the difficulties experienced in the application and integration of pharmacological knowledge, both in the clinical setting and the clinical case study-based assessments; students feeling overwhelmed, inadequate and inferior in the clinical environment, compounded by an absence of clinical pharmacists as role models; and feeling unprepared for patient-focused care. The qualitative data strongly supported the need for supplementary academic support sessions. The intervention was developed and implemented in Phase Two, using patient case-based, active learning strategies. The majority of students (91.0%; n = 104) reported improved case analysis skills. A statistically significant (p = .030, Cohen’s d = 0.34) improvement was noted in the summative Pharmacology4 assessment marks obtained by the experimental cohort post-intervention, although of small practical significance. Predictors of academic achievement in the ELP were found to be language, specifically English reading comprehension skills, academic achievement in the BPharm programme and pharmacology, the university admission score, the rate of academic progression, and problem solving ability. Previous pharmacy-based work experience and assessment questions requiring application of knowledge were also found to influence achievement in the ELP. The need for an intervention in the form of supplementary academic support sessions was confirmed. The intervention was subsequently developed and successfully implemented, with student-reported self-perceived improvements in patient case analysis skills. These positive findings were supported by quantitative data which showed a statistically significant improvement in academic achievement in the ELP. Several predictors of academic achievement in the ELP were identified, and invaluable insight was gained into the nature of the difficulties experienced by pharmacy students in the transition from lecture-based learning to experiential learning in patient-focused environments.
- Full Text:
- Date Issued: 2017
Perceptions of nurses with regard to staffing in the operating rooms of a private hospital
- Authors: Kriel, Dora Jenice
- Date: 2017
- Subjects: Primary health care -- South Africa -- Eastern Cape Hospitals -- South Africa -- Eastern Cape -- Personnel management , Nursing services -- South Africa -- Eastern Cape Nurses -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/18014 , vital:28560
- Description: Despite a number of research studies showing the correlation between higher nurse staffing levels and improved outcomes, RCN members continues to report lower nurse-to-patient ratios than what research results suggests (RCN, 2011:1). This reflected a general concern within the nursing profession. The operating room requires appropriate staffing which is critical to the safety of surgical patients and quality of patient care. The research study was motivated by the researcher’s own experiences while working in an OR in a private hospital where continuous discussions were held with management about the shortage of skilled staff; and where a shortage of OR nurses resulted in the use of Central Sterilizing Department (CSD) staff to do OR duties. The objective of the study was to explore and describe the perceptions of nurses regarding staffing in the operating rooms of a private hospital in the Nelson Mandela Bay Health District. The researcher used qualitative methods and designs to explore and described the perception of nurses regarding staffing in the operating room (OR) of a private hospital in the Nelson Mandela Bay Health District. The research population of the study included all the nurses working in the OR of a private hospital. The total number of 20 OR nurses was individually interviewed by means of semi-structured interviews. Three main themes emerged that includes nurses ‘perceptions with regard to the implications of inadequate staffing in the OR; nurses experiences towards top management with regard to staffing in the OR and recommendations from participants to improve staffing in the OR. Research findings concluded that nurses have a perception that shortage of OR nurses causes lack of communication, physical, emotional and psychological strain. They also perceived OR nurses to work under unrealistic conditions and to receive added responsibilities due to staff shortages, which affect the overall delivery of quality patient care. Comments included failure of management to attend to staff complaints and the perception of high staff turnover due to a lack of recognition and acknowledgement of overworked staff.
- Full Text:
- Date Issued: 2017
- Authors: Kriel, Dora Jenice
- Date: 2017
- Subjects: Primary health care -- South Africa -- Eastern Cape Hospitals -- South Africa -- Eastern Cape -- Personnel management , Nursing services -- South Africa -- Eastern Cape Nurses -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/18014 , vital:28560
- Description: Despite a number of research studies showing the correlation between higher nurse staffing levels and improved outcomes, RCN members continues to report lower nurse-to-patient ratios than what research results suggests (RCN, 2011:1). This reflected a general concern within the nursing profession. The operating room requires appropriate staffing which is critical to the safety of surgical patients and quality of patient care. The research study was motivated by the researcher’s own experiences while working in an OR in a private hospital where continuous discussions were held with management about the shortage of skilled staff; and where a shortage of OR nurses resulted in the use of Central Sterilizing Department (CSD) staff to do OR duties. The objective of the study was to explore and describe the perceptions of nurses regarding staffing in the operating rooms of a private hospital in the Nelson Mandela Bay Health District. The researcher used qualitative methods and designs to explore and described the perception of nurses regarding staffing in the operating room (OR) of a private hospital in the Nelson Mandela Bay Health District. The research population of the study included all the nurses working in the OR of a private hospital. The total number of 20 OR nurses was individually interviewed by means of semi-structured interviews. Three main themes emerged that includes nurses ‘perceptions with regard to the implications of inadequate staffing in the OR; nurses experiences towards top management with regard to staffing in the OR and recommendations from participants to improve staffing in the OR. Research findings concluded that nurses have a perception that shortage of OR nurses causes lack of communication, physical, emotional and psychological strain. They also perceived OR nurses to work under unrealistic conditions and to receive added responsibilities due to staff shortages, which affect the overall delivery of quality patient care. Comments included failure of management to attend to staff complaints and the perception of high staff turnover due to a lack of recognition and acknowledgement of overworked staff.
- Full Text:
- Date Issued: 2017
Teaching strategies to facilitate active learning in a private nursing education institution
- Authors: Choonara, Shereen Mohammed
- Date: 2017
- Subjects: Nursing -- Study and teaching -- South Africa Nursing schools -- South Africa , Nurses -- In-service training -- South Africa College teaching -- South Africa
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10948/14829 , vital:27878
- Description: Nurse educators are the custodians of nursing education and are faced with the task of providing quality nursing education in a way that inspires and enhances learning. The approach to teaching has moved away from the traditional teacher centre approach to a more student centred, active learning approach. Nurse educators are faced with many challenges, such as creating a learning environment that is conducive to a new and diverse generation of students who have different needs, learning styles and expectations. It is therefore important that the nurse educators strive to enhance the overall learning experience by incorporating teaching strategies that engage students as active participants in the learning process. This study followed a quantitative, descriptive, exploratory and contextual research design in order to determine the activities, educational resources and teaching strategies used to facilitate active learning in a private nursing education institution. The target population was comprised of student nurses registered at the private nursing education institution. The data was collected by means of a self-administered questionnaire from 721 participants at learning centres throughout the country. The statistician used Statistica Version 12 to obtain both a descriptive and a statistical summary of the data. Descriptive statistics were used to describe the common features of the data used and the findings were discussed and summarized in tables and graphs. The ethical principles of informed consent, confidentiality and anonymity, beneficence, non-maleficence, veracity and justice have been maintained throughout this study. This study was conducted in one private nursing education institution in South Africa and only focussed on student nurses. The findings were that the greater majority of the students were encouraged to actively participate in the classroom. Students voiced their preference regarding the activities and teaching strategies utilized. There is disparity and inequality regarding the availability of educational media, resources and facilities. A variety of teaching strategies were utilized in the classrooms of the private NEI, but the use of technology based teaching strategies was limited. Information obtained from nurse educators could provide clarity on their use of teaching strategies to facilitate active learning in the classroom or at least highlight gaps in their knowledge that could help to facilitate training for nurse educators. Based on the findings of the study, recommendations for nursing practice, research and nursing education were made. The main recommendations for nursing education include the continuation of active learning activities given by the nurse educators in the classroom. Nurse educators to take cognisance of the students’ preferences and justify their selection of teaching strategies. The private NEI should ensure the availability and accessibility of educational resources, multimedia and facilities that are essential in teaching students to become self-directed, independent practitioners. Opportunities should be made available for nurse educators to attend seminars or workshops on the use of technology-based teaching strategies and undergo training in the utilization of different strategies that can enhance active learning. This could be included as a mandatory module of the nurse educators’ continuous professional development.
- Full Text:
- Date Issued: 2017
- Authors: Choonara, Shereen Mohammed
- Date: 2017
- Subjects: Nursing -- Study and teaching -- South Africa Nursing schools -- South Africa , Nurses -- In-service training -- South Africa College teaching -- South Africa
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10948/14829 , vital:27878
- Description: Nurse educators are the custodians of nursing education and are faced with the task of providing quality nursing education in a way that inspires and enhances learning. The approach to teaching has moved away from the traditional teacher centre approach to a more student centred, active learning approach. Nurse educators are faced with many challenges, such as creating a learning environment that is conducive to a new and diverse generation of students who have different needs, learning styles and expectations. It is therefore important that the nurse educators strive to enhance the overall learning experience by incorporating teaching strategies that engage students as active participants in the learning process. This study followed a quantitative, descriptive, exploratory and contextual research design in order to determine the activities, educational resources and teaching strategies used to facilitate active learning in a private nursing education institution. The target population was comprised of student nurses registered at the private nursing education institution. The data was collected by means of a self-administered questionnaire from 721 participants at learning centres throughout the country. The statistician used Statistica Version 12 to obtain both a descriptive and a statistical summary of the data. Descriptive statistics were used to describe the common features of the data used and the findings were discussed and summarized in tables and graphs. The ethical principles of informed consent, confidentiality and anonymity, beneficence, non-maleficence, veracity and justice have been maintained throughout this study. This study was conducted in one private nursing education institution in South Africa and only focussed on student nurses. The findings were that the greater majority of the students were encouraged to actively participate in the classroom. Students voiced their preference regarding the activities and teaching strategies utilized. There is disparity and inequality regarding the availability of educational media, resources and facilities. A variety of teaching strategies were utilized in the classrooms of the private NEI, but the use of technology based teaching strategies was limited. Information obtained from nurse educators could provide clarity on their use of teaching strategies to facilitate active learning in the classroom or at least highlight gaps in their knowledge that could help to facilitate training for nurse educators. Based on the findings of the study, recommendations for nursing practice, research and nursing education were made. The main recommendations for nursing education include the continuation of active learning activities given by the nurse educators in the classroom. Nurse educators to take cognisance of the students’ preferences and justify their selection of teaching strategies. The private NEI should ensure the availability and accessibility of educational resources, multimedia and facilities that are essential in teaching students to become self-directed, independent practitioners. Opportunities should be made available for nurse educators to attend seminars or workshops on the use of technology-based teaching strategies and undergo training in the utilization of different strategies that can enhance active learning. This could be included as a mandatory module of the nurse educators’ continuous professional development.
- Full Text:
- Date Issued: 2017
Management of endotracheal tube cuff pressure in mechanically ventilated adult patients in intensive care units in Malawi
- Authors: Mpasa, Ferestas
- Date: 2017
- Subjects: Intensive care nursing -- Malawi Respiratory intensive care -- Malawi , Patient monitoring -- Malawi
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: http://hdl.handle.net/10948/19673 , vital:28930
- Description: Patients who are critically ill get often admitted to intensive care units (ICUs). The majority of these patients require support with their breathing and are thus connected to a mechanical ventilator. One aspect to consider in the mechanically ventilated patient is endotracheal tube cuff pressure (ETT) management. The management of ETT cuff pressure entails that nurses working in ICUs have the responsibility of ensuring that ETT cuff pressure is kept within normal range of 20-30 cmH20 for the safety of the patients in order to avoid complication of over and under inflation. Poor management of ETT cuff pressure places the mechanically ventilated patients under risk of tracheal injury. Tracheal injury may also be caused by over or under inflation of the ETT cuff. Over inflation of the ETT cuff can lead to the occlusion of capillaries lining the trachea at the cuff site, tracheal stenosis, and can also lead to the death of mucus membranes around the area, just to mention a few. On the other hand, under inflation of the ETT cuff, can lead to air leaks as well as aspiration of gastric contents into the tracheal tree. Therefore, in order to maintain ETT cuff pressure within normal ranges, evidence-based guidelines related to the management of ETT cuff pressure should be used. However, in Malawi the management of endotracheal tube cuff pressure in mechanically ventilated adult patients by nurses in ICUs is not well explored and it is not clear whether this practice is based on evidence-based guidelines. Furthermore, strategies on how to implement evidence-based guidelines in the ICU might not be known and poorly defined because of the complexity of the context. The study is therefore aimed at implementing and evaluating the effect of an evidence-based guideline on the management of ETT cuff pressure in mechanically ventilated adult patients by nurses in ICUs in Malawi using active (printed educational materials and monitoring visits) and passive (printed educational materials only) implementation strategies. The research study used a quantitative approach with multi-designs. Four phases were used in order to achieve the four objectives that were set. Phase one was the pre-test and used a survey design, two was the expert panel review of the evidence-based guideline, three was the implementation of the reviewed evidence-based guideline using a randomised controlled trial design and phase four was the post-test which used a survey design. The RCT included 25 participants from the control and 27 from the intervention group. Each group had three ICUs of which one in each group was from a private hospital and the other were government. Data collection in phases one and four was by a hand delivered pre-and post-questionnaire. In phase two the expert panel members with experience in critical care used the AGREE II Instrument to review the evidence-based guideline that was implemented. In order to gather data during the monitoring visits, the researcher recorded field notes. The applications that were developed by the University statistician consultant using visual basic applications in excel were used to analyse data. Two different implementation strategies were used to implement the evidence-based guideline. The control group used passive implementation strategy which was printed educational materials thus the evidence-based guideline and algorithm. The intervention group used both active and passive implementation strategies which was the printed educational materials thus the evidence-based guideline and algorithm plus monitoring visits by the researcher. In order to establish the effect of the implemented evidence-based guideline on the nursing care practice for the management of endotracheal tube cuff pressure an evaluative posttest survey was conducted in phase four of the research study. The results revealed that the majority of participants had gaps in both groups regarding nursing care practice for the management of endotracheal tube cuff pressure for the mechanically ventilated adult patients in the pretest but improved in the posttest. In the control group 52% had very low knowledge score, 16% had low score, 28% average, and 4% high score while in the category of very high score there was nobody. However, in the posttest those in the very low score were only 44% while the percentage in the low score remained 16%. There was an improvement in the average scores in the posttest such that only 44% were in this category. There was no one in the high and very high score in the pretest. On the other hand, in the intervention group, 78% had a very low score, 9% low score, and 13% were in the category of average score, while in the high and very high score category there was zero percent in the pretest. However, there was also an improvement in the posttest such that only 44% a very low knowledge score. But 19% had a low score, there were 37% in the average category and no one was in the high and very high score. Statistical analysis revealed that the results were not significantly different between and within groups. Improvements were observed in the two groups regarding the scientific knowledge scores for the nursing care practices in the posttest. Upon qualitative analysis of the data from the open-ended question, two main themes emerged thus the need for documentation of endotracheal tube cuff and the process of implementation the evidence-based guidelines. Sub themes such as lack of documentation; no part of routine care and monitoring not done at all were identified under the main theme of the need for documentation of ETT cuff pressure. The Guideline itself need to be clear; implementation strategies; follow up; incentives; supervision; incentives; time factor; resources or equipment required for successful implementation; nurses buy-in critical for the implementation; training detrimental to EBP implementation; nurses attitude crucial to implementation of EBGs and knowledge of nurses for guideline essential for the implementation were the sub themes identified under the main theme of the process of implementing the evidence-based guideline. All appropriate ethical considerations such as principles of autonomy and self-determination, confidentiality and anonymity, voluntary participation, right to receive treatment, informed consent, were adhered to throughout the research study. The research study was unique in nature because it was the first of its kind in Malawi and it contributed to the awareness of the recommended practice for management of endotracheal tube cuff pressure in the ICUs in the country by implementing an evidence-based guideline. The unique contribution of the study is that it is a challenge to implement evidence-based guideline in poor and resource constraint countries like Malawi.
- Full Text:
- Date Issued: 2017
- Authors: Mpasa, Ferestas
- Date: 2017
- Subjects: Intensive care nursing -- Malawi Respiratory intensive care -- Malawi , Patient monitoring -- Malawi
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: http://hdl.handle.net/10948/19673 , vital:28930
- Description: Patients who are critically ill get often admitted to intensive care units (ICUs). The majority of these patients require support with their breathing and are thus connected to a mechanical ventilator. One aspect to consider in the mechanically ventilated patient is endotracheal tube cuff pressure (ETT) management. The management of ETT cuff pressure entails that nurses working in ICUs have the responsibility of ensuring that ETT cuff pressure is kept within normal range of 20-30 cmH20 for the safety of the patients in order to avoid complication of over and under inflation. Poor management of ETT cuff pressure places the mechanically ventilated patients under risk of tracheal injury. Tracheal injury may also be caused by over or under inflation of the ETT cuff. Over inflation of the ETT cuff can lead to the occlusion of capillaries lining the trachea at the cuff site, tracheal stenosis, and can also lead to the death of mucus membranes around the area, just to mention a few. On the other hand, under inflation of the ETT cuff, can lead to air leaks as well as aspiration of gastric contents into the tracheal tree. Therefore, in order to maintain ETT cuff pressure within normal ranges, evidence-based guidelines related to the management of ETT cuff pressure should be used. However, in Malawi the management of endotracheal tube cuff pressure in mechanically ventilated adult patients by nurses in ICUs is not well explored and it is not clear whether this practice is based on evidence-based guidelines. Furthermore, strategies on how to implement evidence-based guidelines in the ICU might not be known and poorly defined because of the complexity of the context. The study is therefore aimed at implementing and evaluating the effect of an evidence-based guideline on the management of ETT cuff pressure in mechanically ventilated adult patients by nurses in ICUs in Malawi using active (printed educational materials and monitoring visits) and passive (printed educational materials only) implementation strategies. The research study used a quantitative approach with multi-designs. Four phases were used in order to achieve the four objectives that were set. Phase one was the pre-test and used a survey design, two was the expert panel review of the evidence-based guideline, three was the implementation of the reviewed evidence-based guideline using a randomised controlled trial design and phase four was the post-test which used a survey design. The RCT included 25 participants from the control and 27 from the intervention group. Each group had three ICUs of which one in each group was from a private hospital and the other were government. Data collection in phases one and four was by a hand delivered pre-and post-questionnaire. In phase two the expert panel members with experience in critical care used the AGREE II Instrument to review the evidence-based guideline that was implemented. In order to gather data during the monitoring visits, the researcher recorded field notes. The applications that were developed by the University statistician consultant using visual basic applications in excel were used to analyse data. Two different implementation strategies were used to implement the evidence-based guideline. The control group used passive implementation strategy which was printed educational materials thus the evidence-based guideline and algorithm. The intervention group used both active and passive implementation strategies which was the printed educational materials thus the evidence-based guideline and algorithm plus monitoring visits by the researcher. In order to establish the effect of the implemented evidence-based guideline on the nursing care practice for the management of endotracheal tube cuff pressure an evaluative posttest survey was conducted in phase four of the research study. The results revealed that the majority of participants had gaps in both groups regarding nursing care practice for the management of endotracheal tube cuff pressure for the mechanically ventilated adult patients in the pretest but improved in the posttest. In the control group 52% had very low knowledge score, 16% had low score, 28% average, and 4% high score while in the category of very high score there was nobody. However, in the posttest those in the very low score were only 44% while the percentage in the low score remained 16%. There was an improvement in the average scores in the posttest such that only 44% were in this category. There was no one in the high and very high score in the pretest. On the other hand, in the intervention group, 78% had a very low score, 9% low score, and 13% were in the category of average score, while in the high and very high score category there was zero percent in the pretest. However, there was also an improvement in the posttest such that only 44% a very low knowledge score. But 19% had a low score, there were 37% in the average category and no one was in the high and very high score. Statistical analysis revealed that the results were not significantly different between and within groups. Improvements were observed in the two groups regarding the scientific knowledge scores for the nursing care practices in the posttest. Upon qualitative analysis of the data from the open-ended question, two main themes emerged thus the need for documentation of endotracheal tube cuff and the process of implementation the evidence-based guidelines. Sub themes such as lack of documentation; no part of routine care and monitoring not done at all were identified under the main theme of the need for documentation of ETT cuff pressure. The Guideline itself need to be clear; implementation strategies; follow up; incentives; supervision; incentives; time factor; resources or equipment required for successful implementation; nurses buy-in critical for the implementation; training detrimental to EBP implementation; nurses attitude crucial to implementation of EBGs and knowledge of nurses for guideline essential for the implementation were the sub themes identified under the main theme of the process of implementing the evidence-based guideline. All appropriate ethical considerations such as principles of autonomy and self-determination, confidentiality and anonymity, voluntary participation, right to receive treatment, informed consent, were adhered to throughout the research study. The research study was unique in nature because it was the first of its kind in Malawi and it contributed to the awareness of the recommended practice for management of endotracheal tube cuff pressure in the ICUs in the country by implementing an evidence-based guideline. The unique contribution of the study is that it is a challenge to implement evidence-based guideline in poor and resource constraint countries like Malawi.
- Full Text:
- Date Issued: 2017
Evaluation of self-efficacy in clinical performance of nurses initiate and management of anti-retroviral therapy by South African professional nurses
- Authors: Mangi, Nozuko Glenrose
- Date: 2017
- Subjects: Nursing assessment -- South Africa -- Eastern Cape Self-efficacy Nursing -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: http://hdl.handle.net/10353/4492 , vital:28344
- Description: Self-efficacy in clinical performance is a very important aspect in quality of health care, because it is the ability of the person to produce the desired outcomes. The aim of the study was to evaluate self-efficacy in clinical performance of NIMART programme by professional nurses in Buffalo City Metropolitan in Eastern Cape Province South Africa. A quantitative, descriptive survey design was used to examine self-efficacy in clinical performance during implementation of NIMART programme. A purposive sample of 358 NIMART programme trained professional nurses was included in the study. Analysis of the finding was done using SPSS version 21.0. Descriptive statistics (frequencies, percentage, mean and standard deviations) were used to analyse categorical variables. To reduce data volume, factor analysis was used to identify six variable clusters: Evaluation; planning, assessment, implementation, and patient care mentoring. Factor 1 (evaluation) was highly loaded on patient driven results (0.63); nursing interventions (0.70); breakdown point location (0.80); prognosis based care decisions (0.79); prognosis based outcome monitoring (0.70); and prognosis based settings adjustment (0.70). These items collectively define evaluation of self-efficacy clinical performance of the participants. Factor 2 (planning) was termed planning of patient care in a clinical setting was significantly loaded on these items: data driven nursing diagnosis (0.51); patient driven nursing diagnosis (0.52); settings based nursing diagnosis (0.49); overall care plan formulation (0.52); short-term patients care formulation (0.58); long-term patient care formulation (0.66); goal based measurable outcomes (0.80); goal based daily patient care plan (0.79); settings based daily patient care plan (0.73). Factor 3 (assessment) which was termed assessment in clinical performance was not significantly loaded in some of the items: physical assessment (0.64); patient history (0.65); energy restoration (0.56); time management (0.71); objective patient health data (0.61); subjective patient health data (0.49); data collection documentation (0.44). Factor 4 (implementation) data source correlation; patient health data analysis (0.45); patient strength (0.46); nurse-patient/family communication (0.55); nurse patient collaboration (0.64); Experience driven decision making (0.58). Factor 5 (patient care) patient care plan adherence (0.65); setting based overall patient care (0.74); resource based overall patient care (0.59). Factor 6 (mentoring) patient’s concerns identification (0.48); patient problems prioritisation (0.46); mentor/colleague advice (0.43); mentor/colleague feedback use (0.61); patient discharge strategies (0.71); continuous reporting/documenting (0.63). The mean scores produced by the Kruskal-Wallis test showed the lowest scoring pattern as follows: 20122013201120142010. This order was the same for all the variables, confirming that the 2010 group scored significantly higher than any other group on all the variables. The overall results of the study revealed that professional nurses have high self-efficacy in clinical performance in implementation of NIMART programme, except in evaluation aspect of self-efficacy where they scored lessor. Professional nurses trained by FPD scored higher in the aspects of self-efficacy in clinical performance compared to RTC trained; but scored lower in evaluative ability of self-efficacy in both institutions (FPD and RTC). The findings of this study showed that the overall self-efficacy of the professional nurses trained on NIMART programme performed clinically satisfactorily. It is recommended that in-service education or continuous professional development for professional nurses working in PHC’s should not only concentrate on updating clinical skills, but also create opportunity for reflection and strengthening of professional nurses’ self-efficacy in clinical performance. Also, further study on other processes of goal realisation will aid our understanding of self-efficacy in achieving the desirable goals of the professional nurses for patient quality care. Further research is also needed to evaluate clients’ satisfaction during care based on the NIMART intervention programme.
- Full Text:
- Date Issued: 2017
- Authors: Mangi, Nozuko Glenrose
- Date: 2017
- Subjects: Nursing assessment -- South Africa -- Eastern Cape Self-efficacy Nursing -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: http://hdl.handle.net/10353/4492 , vital:28344
- Description: Self-efficacy in clinical performance is a very important aspect in quality of health care, because it is the ability of the person to produce the desired outcomes. The aim of the study was to evaluate self-efficacy in clinical performance of NIMART programme by professional nurses in Buffalo City Metropolitan in Eastern Cape Province South Africa. A quantitative, descriptive survey design was used to examine self-efficacy in clinical performance during implementation of NIMART programme. A purposive sample of 358 NIMART programme trained professional nurses was included in the study. Analysis of the finding was done using SPSS version 21.0. Descriptive statistics (frequencies, percentage, mean and standard deviations) were used to analyse categorical variables. To reduce data volume, factor analysis was used to identify six variable clusters: Evaluation; planning, assessment, implementation, and patient care mentoring. Factor 1 (evaluation) was highly loaded on patient driven results (0.63); nursing interventions (0.70); breakdown point location (0.80); prognosis based care decisions (0.79); prognosis based outcome monitoring (0.70); and prognosis based settings adjustment (0.70). These items collectively define evaluation of self-efficacy clinical performance of the participants. Factor 2 (planning) was termed planning of patient care in a clinical setting was significantly loaded on these items: data driven nursing diagnosis (0.51); patient driven nursing diagnosis (0.52); settings based nursing diagnosis (0.49); overall care plan formulation (0.52); short-term patients care formulation (0.58); long-term patient care formulation (0.66); goal based measurable outcomes (0.80); goal based daily patient care plan (0.79); settings based daily patient care plan (0.73). Factor 3 (assessment) which was termed assessment in clinical performance was not significantly loaded in some of the items: physical assessment (0.64); patient history (0.65); energy restoration (0.56); time management (0.71); objective patient health data (0.61); subjective patient health data (0.49); data collection documentation (0.44). Factor 4 (implementation) data source correlation; patient health data analysis (0.45); patient strength (0.46); nurse-patient/family communication (0.55); nurse patient collaboration (0.64); Experience driven decision making (0.58). Factor 5 (patient care) patient care plan adherence (0.65); setting based overall patient care (0.74); resource based overall patient care (0.59). Factor 6 (mentoring) patient’s concerns identification (0.48); patient problems prioritisation (0.46); mentor/colleague advice (0.43); mentor/colleague feedback use (0.61); patient discharge strategies (0.71); continuous reporting/documenting (0.63). The mean scores produced by the Kruskal-Wallis test showed the lowest scoring pattern as follows: 20122013201120142010. This order was the same for all the variables, confirming that the 2010 group scored significantly higher than any other group on all the variables. The overall results of the study revealed that professional nurses have high self-efficacy in clinical performance in implementation of NIMART programme, except in evaluation aspect of self-efficacy where they scored lessor. Professional nurses trained by FPD scored higher in the aspects of self-efficacy in clinical performance compared to RTC trained; but scored lower in evaluative ability of self-efficacy in both institutions (FPD and RTC). The findings of this study showed that the overall self-efficacy of the professional nurses trained on NIMART programme performed clinically satisfactorily. It is recommended that in-service education or continuous professional development for professional nurses working in PHC’s should not only concentrate on updating clinical skills, but also create opportunity for reflection and strengthening of professional nurses’ self-efficacy in clinical performance. Also, further study on other processes of goal realisation will aid our understanding of self-efficacy in achieving the desirable goals of the professional nurses for patient quality care. Further research is also needed to evaluate clients’ satisfaction during care based on the NIMART intervention programme.
- Full Text:
- Date Issued: 2017
A phenomenological study of problematic internet use with massively multiplayer online games
- Authors: Bopp, Stacey-Lee
- Date: 2017
- Subjects: Computer games -- Psychological aspects , Internet games -- Psychological aspects Internet addiction
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/13757 , vital:27305
- Description: Massively multiplayer online games (MMOG’s) are a specific form of online computer games that allow for millions of people to simultaneously play online at any time. This form of online gaming has become a huge phenomenon worldwide both as a popular past time and a business endeavour for many individuals. There are more than 16 million people worldwide who subscribe to fantasy role-playing online games. Although such games can provide entertainment for many people, they can also lead to problematic Internet use (PIU). PIU has also been referred to as Internet addiction, and can cause significant problems in an individual’s functioning. The study aimed to enhance a greater understanding of the phenomenon of male adults’ experiences PIU with MMOG’s. More specifically the study aims to identify if PIU with MMOG’s can be considered a form of Internet addiction within South Africa. Furthermore, assisting in the further development of online addiction diagnosis and treatment strategies. The study utilised an interpretive phenomenological approach (IPA) and participants were purposively sampled. The data was collected using semi-structured individual interviews. Furthermore, Braun and Clarks thematic analysis was used during data analysis while incorporating the four major processes in phenomenological research, namely 1) epoche, 2) phenomenological reduction, 3) imaginative variation and, 4) synthesis. Themes that emerged from the analysis of the participants’ experiences included, initial description of use, motives for continued use of MMOG’s, consequences of PIU with MMOG’s, perceptions of PIU with MMOG’s, and treatment considerations. This study provided a thick description of South African and international literature and combines the literature with the themes that emerged from the participants experiences in order to produce discussions based on the findings of this qualitative study. Conclusions, recommendations, and limitations of this study informed future research on cyber citizenship by providing a detailed understanding of the context of South African male adults’ experiences of PIU with MMOG’s.
- Full Text:
- Date Issued: 2017
- Authors: Bopp, Stacey-Lee
- Date: 2017
- Subjects: Computer games -- Psychological aspects , Internet games -- Psychological aspects Internet addiction
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/13757 , vital:27305
- Description: Massively multiplayer online games (MMOG’s) are a specific form of online computer games that allow for millions of people to simultaneously play online at any time. This form of online gaming has become a huge phenomenon worldwide both as a popular past time and a business endeavour for many individuals. There are more than 16 million people worldwide who subscribe to fantasy role-playing online games. Although such games can provide entertainment for many people, they can also lead to problematic Internet use (PIU). PIU has also been referred to as Internet addiction, and can cause significant problems in an individual’s functioning. The study aimed to enhance a greater understanding of the phenomenon of male adults’ experiences PIU with MMOG’s. More specifically the study aims to identify if PIU with MMOG’s can be considered a form of Internet addiction within South Africa. Furthermore, assisting in the further development of online addiction diagnosis and treatment strategies. The study utilised an interpretive phenomenological approach (IPA) and participants were purposively sampled. The data was collected using semi-structured individual interviews. Furthermore, Braun and Clarks thematic analysis was used during data analysis while incorporating the four major processes in phenomenological research, namely 1) epoche, 2) phenomenological reduction, 3) imaginative variation and, 4) synthesis. Themes that emerged from the analysis of the participants’ experiences included, initial description of use, motives for continued use of MMOG’s, consequences of PIU with MMOG’s, perceptions of PIU with MMOG’s, and treatment considerations. This study provided a thick description of South African and international literature and combines the literature with the themes that emerged from the participants experiences in order to produce discussions based on the findings of this qualitative study. Conclusions, recommendations, and limitations of this study informed future research on cyber citizenship by providing a detailed understanding of the context of South African male adults’ experiences of PIU with MMOG’s.
- Full Text:
- Date Issued: 2017
Role of midwives in facilitating the choice of delivery mode for labouring women in public sector birthing units in the Nelson Mandela Bay Municipality and Sarah Baartman District
- Authors: Muthige, Noluthando
- Date: 2017
- Subjects: Midwives -- South Africa -- Eastern Cape Midwifery -- South Africa -- Eastern Cape , Delivery (Obstetrics) Infants -- Care -- South Africa -- Eastern Cape Public hospitals -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10948/19375 , vital:28860
- Description: The World Health Organization (WHO) recommends that of all the live births per year no more than 10-15% of these should be delivered by caesarean section. Despite this recommendation there has been a global increase in the percentage of caesarean section deliveries over the past few decades. In South Africa the percentage is as high as 70% in certain health care institutions which is of concern to midwives. Caesarean section deliveries are needed when the life of the baby, mother or both are at stake. However, this method of delivery bears more disadvantages than advantages to the baby and mother. Despite these disadvantages, some women request a caesarean section in their birth plans while others are influenced by health professionals to request a caesarean section. Therefore, there is a need for labouring women to be guided where possible to have vaginal birth because of its many advantages. This study sought to explore and describe the perceptions of the midwives regarding their role in facilitating the choice of delivery mode for labouring women in public hospitals and midwifery obstetric units (MOUs) of the Nelson Mandela Bay and Sarah Baartman districts. Based on the results of the study, guidelines for midwives in this role were developed. Maputle’sWoman-Centred Childbirth Model (2010) was used as the theoretical lens through which this study was viewed. The researcher selected a quantitative survey design using an explorative, descriptive and contextual research approach. The population consisted of midwives who were working in labour wards at public hospitals and midwife-led MOUs. A non-probability convenience sample was used to collect data using a structured, self-administered questionnaire. The reliability and validity of the data collection instrument were ensured by using various means including a pre-test and an expert panel. Altogether, 300 questionnaires were distributed and 288 were returned. This number excluded the pilot study. Data was collected over a period of three months using the assistance of two fieldworkers. Data was captured and analysed under the supervision of the statistician and supervisors. Analysis was done by means of descriptive analyses that involved the production of frequencies and presented using charts, figures and tables. The major findings of the study are: -The midwives perceived themselves as the main facilitators of a suitable decision by the labouring woman for a safe delivery method - The midwives emphasised the importance of the delivery position preferred by the labouring woman -The midwives indicated that a collaboration between doctors, senior midwives, midwives and midwives in management positions could assist with a decision for a suitable delivery mode option. -The midwives agreed that the culture of the labouring woman should be considered when deciding on a delivery mode and therefore midwifery curriculum should include lessons about cultural diversity. Three principal guidelines were developed, namely: 1. Create an environment that promotes acceptance of a woman’s choice of a delivery mode. 2. Create an environment promoting a collaborative health care relationship 3. Create an environment that is sensitive to cultural needs in the maternity unit Ethical considerations in this study were upheld by maintaining the principles of beneficence, maleficence, autonomy and justice.
- Full Text:
- Date Issued: 2017
- Authors: Muthige, Noluthando
- Date: 2017
- Subjects: Midwives -- South Africa -- Eastern Cape Midwifery -- South Africa -- Eastern Cape , Delivery (Obstetrics) Infants -- Care -- South Africa -- Eastern Cape Public hospitals -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10948/19375 , vital:28860
- Description: The World Health Organization (WHO) recommends that of all the live births per year no more than 10-15% of these should be delivered by caesarean section. Despite this recommendation there has been a global increase in the percentage of caesarean section deliveries over the past few decades. In South Africa the percentage is as high as 70% in certain health care institutions which is of concern to midwives. Caesarean section deliveries are needed when the life of the baby, mother or both are at stake. However, this method of delivery bears more disadvantages than advantages to the baby and mother. Despite these disadvantages, some women request a caesarean section in their birth plans while others are influenced by health professionals to request a caesarean section. Therefore, there is a need for labouring women to be guided where possible to have vaginal birth because of its many advantages. This study sought to explore and describe the perceptions of the midwives regarding their role in facilitating the choice of delivery mode for labouring women in public hospitals and midwifery obstetric units (MOUs) of the Nelson Mandela Bay and Sarah Baartman districts. Based on the results of the study, guidelines for midwives in this role were developed. Maputle’sWoman-Centred Childbirth Model (2010) was used as the theoretical lens through which this study was viewed. The researcher selected a quantitative survey design using an explorative, descriptive and contextual research approach. The population consisted of midwives who were working in labour wards at public hospitals and midwife-led MOUs. A non-probability convenience sample was used to collect data using a structured, self-administered questionnaire. The reliability and validity of the data collection instrument were ensured by using various means including a pre-test and an expert panel. Altogether, 300 questionnaires were distributed and 288 were returned. This number excluded the pilot study. Data was collected over a period of three months using the assistance of two fieldworkers. Data was captured and analysed under the supervision of the statistician and supervisors. Analysis was done by means of descriptive analyses that involved the production of frequencies and presented using charts, figures and tables. The major findings of the study are: -The midwives perceived themselves as the main facilitators of a suitable decision by the labouring woman for a safe delivery method - The midwives emphasised the importance of the delivery position preferred by the labouring woman -The midwives indicated that a collaboration between doctors, senior midwives, midwives and midwives in management positions could assist with a decision for a suitable delivery mode option. -The midwives agreed that the culture of the labouring woman should be considered when deciding on a delivery mode and therefore midwifery curriculum should include lessons about cultural diversity. Three principal guidelines were developed, namely: 1. Create an environment that promotes acceptance of a woman’s choice of a delivery mode. 2. Create an environment promoting a collaborative health care relationship 3. Create an environment that is sensitive to cultural needs in the maternity unit Ethical considerations in this study were upheld by maintaining the principles of beneficence, maleficence, autonomy and justice.
- Full Text:
- Date Issued: 2017
Attitutes of professional nurses towards the dimensions of quality care in the community health centres of the King Sabatha Dalindyebo sub-district, Eastern Cape
- Authors: Ntuku, Nonzukiso Sheila
- Date: 2017
- Subjects: Community health services -- South Africa -- Eastern Cape Nursing services -- South Africa-- Eastern Cape
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10353/13989 , vital:39737
- Description: The study focused on attitudes of professional nurses towards the dimensions of quality care. Quality care is the main focus of the Department of Health in the Republic of South Africa. The researcher believes that professional nurses form the backbone of the whole health care fraternity; hence they are central to the study of quality care dimensions. The aim of the study was to determine and describe the attitudes of professional nurses towards the dimensions of quality care in the community health centres of the KingSabatha Dalindyebo sub-district. A quantitative descriptive design was employed to meet the objectives of the study. The non-probability purposive sampling method was used to select participants to provide information on the attitudes of professional nurses towards the dimensions of quality care in the community health centres of the King Sabatha Dalindyebo sub-district, Eastern Cape. From the target of 84 professional nurses who were employed at the five community health centres of King Sabatha Dalindyebo sub-district of the O.R. Tambo District, Eastern Cape Province, 70 (83,3percent) professional nursesresponded to the questionnaires. A self-administered questionnaire written in simple English was used to collect data from the professional nurses regarding their attitudes towards dimensions of quality care. The researcher adhered to the ethical standards of nursing research as described by the Democratic Nursing Organisationof South Africa regarding anonymity, confidentiality, privacy and quality research, according to which the names of professional nurses were not recorded on the questionnaires. The data were analysed using the Statistical Package for the Social Sciences (SPSS) computer software. The distribution of the results has been presented in tables and a bar graph. The results of the study revealed that the professional nurses of these community health centres had positive attitudes towards the dimensions of quality care.
- Full Text:
- Date Issued: 2017
- Authors: Ntuku, Nonzukiso Sheila
- Date: 2017
- Subjects: Community health services -- South Africa -- Eastern Cape Nursing services -- South Africa-- Eastern Cape
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: http://hdl.handle.net/10353/13989 , vital:39737
- Description: The study focused on attitudes of professional nurses towards the dimensions of quality care. Quality care is the main focus of the Department of Health in the Republic of South Africa. The researcher believes that professional nurses form the backbone of the whole health care fraternity; hence they are central to the study of quality care dimensions. The aim of the study was to determine and describe the attitudes of professional nurses towards the dimensions of quality care in the community health centres of the KingSabatha Dalindyebo sub-district. A quantitative descriptive design was employed to meet the objectives of the study. The non-probability purposive sampling method was used to select participants to provide information on the attitudes of professional nurses towards the dimensions of quality care in the community health centres of the King Sabatha Dalindyebo sub-district, Eastern Cape. From the target of 84 professional nurses who were employed at the five community health centres of King Sabatha Dalindyebo sub-district of the O.R. Tambo District, Eastern Cape Province, 70 (83,3percent) professional nursesresponded to the questionnaires. A self-administered questionnaire written in simple English was used to collect data from the professional nurses regarding their attitudes towards dimensions of quality care. The researcher adhered to the ethical standards of nursing research as described by the Democratic Nursing Organisationof South Africa regarding anonymity, confidentiality, privacy and quality research, according to which the names of professional nurses were not recorded on the questionnaires. The data were analysed using the Statistical Package for the Social Sciences (SPSS) computer software. The distribution of the results has been presented in tables and a bar graph. The results of the study revealed that the professional nurses of these community health centres had positive attitudes towards the dimensions of quality care.
- Full Text:
- Date Issued: 2017
Development of antibiotic loaded liposomal hydrocolloid dressings for application in wound healing
- Authors: Ntsalu, Vuyiseka
- Date: 2017
- Subjects: Wound healing -- South Africa Liposomes Hydrocolloid surgical dressings -- South Africa
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: http://hdl.handle.net/10948/13957 , vital:27361
- Description: Wound healing, as a normal biological process in the human body, is achieved through four precise and highly programmed phases: hemostasis, inflammation, proliferation, and remodeling. For a wound to heal successfully, all four phases must occur in the proper sequence and time frame. However, many factors can interfere with one or more of these phases, thus causing improper or impaired wound healing. Maintaining a moist wound environment is crucial in facilitating the wound-healing process. The beneficial effects of a moist versus a dry wound environment include re-epithelization, tissue granulation, and repair. The use of hydrocolloid occlusive dressings in maintaining a moist wound environment has proven to be a useful adjunct in facilitating wound healing. Although hydrocolloid dressings have been widely used clinically in wound management, bacterial resistance, poor solubility and sustained drug release remain to be a problem for many of the drugs used in wound therapy. In chronic wound management, where patients normally undergo long treatments and frequent dressing changes, a system that delivers drugs into a wound site in a controlled fashion can improve patient compliance and therapeutic outcomes. Liposomes are small phospholipid vesicles that have been widely investigated as drug carriers for the delivery of therapeutic agents. They are spherical lipid vesicles consisting of phospholipid bilayers that improve the efficacy of the drugs by fusing with biological membranes, and eventually releasing their entrapped content into the cells or bacteria. The aim of this study therefore, is to develop a new bacitracin-based controlled release hydrocolloid dressing, with good absorptive properties for improving the efficacy of antibiotics in wound healing. HPLC (high-pressure liquid chromatography) assay of bacitracin was performed for quantification of the drug. Liposomes were prepared using thin film hydration and extrusion methods. Liposomes were also characterized based on their ideal particle size and encapsulation efficiency, and then incorporated into the different ratios of chitosan/gelatin hydrocolloid films. The films were prepared with increase in gelatin concentration and were evaluated for folding endurance, tensile strength, water absorption capacity, morphology, drug release kinetics, antimicrobial activity and stability. The morphology of these films was found to be very smooth and homogeneous proving a good compatibility between the two polymers. With increase in gelatin concentration, folding endurance, water absorption capacity, tensile strength, drug release kinetics and antimicrobial activity were increased. The antibacterial activity against various bacterial species was improved in the bacitracin loaded hydrocolloid films as compared to the blank films. Based on the findings above, it can be concluded that chitosan/gelatin films at 1:3 proportion is a successful wound dressing for wound management with improved wound healing properties than other formulations. This formulation is a potential candidate for the development of alternative pharmaceutical dosage forms, for the treatment of bacterial infected wounds, based on the activity of the eco-friendly chitosan matrix added to the bacitracin activity. In this work, chitosan also demonstrated a great potential as a dressing for advanced wound therapy and confirmed its good biocompatibility and potential to provide, in combination with liposomes, sustained drug release which is highly beneficial for wound treatment. The addition of gelatin improved the water affinity of the films and facilitated water mediated cross-linking process.
- Full Text:
- Date Issued: 2017
- Authors: Ntsalu, Vuyiseka
- Date: 2017
- Subjects: Wound healing -- South Africa Liposomes Hydrocolloid surgical dressings -- South Africa
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: http://hdl.handle.net/10948/13957 , vital:27361
- Description: Wound healing, as a normal biological process in the human body, is achieved through four precise and highly programmed phases: hemostasis, inflammation, proliferation, and remodeling. For a wound to heal successfully, all four phases must occur in the proper sequence and time frame. However, many factors can interfere with one or more of these phases, thus causing improper or impaired wound healing. Maintaining a moist wound environment is crucial in facilitating the wound-healing process. The beneficial effects of a moist versus a dry wound environment include re-epithelization, tissue granulation, and repair. The use of hydrocolloid occlusive dressings in maintaining a moist wound environment has proven to be a useful adjunct in facilitating wound healing. Although hydrocolloid dressings have been widely used clinically in wound management, bacterial resistance, poor solubility and sustained drug release remain to be a problem for many of the drugs used in wound therapy. In chronic wound management, where patients normally undergo long treatments and frequent dressing changes, a system that delivers drugs into a wound site in a controlled fashion can improve patient compliance and therapeutic outcomes. Liposomes are small phospholipid vesicles that have been widely investigated as drug carriers for the delivery of therapeutic agents. They are spherical lipid vesicles consisting of phospholipid bilayers that improve the efficacy of the drugs by fusing with biological membranes, and eventually releasing their entrapped content into the cells or bacteria. The aim of this study therefore, is to develop a new bacitracin-based controlled release hydrocolloid dressing, with good absorptive properties for improving the efficacy of antibiotics in wound healing. HPLC (high-pressure liquid chromatography) assay of bacitracin was performed for quantification of the drug. Liposomes were prepared using thin film hydration and extrusion methods. Liposomes were also characterized based on their ideal particle size and encapsulation efficiency, and then incorporated into the different ratios of chitosan/gelatin hydrocolloid films. The films were prepared with increase in gelatin concentration and were evaluated for folding endurance, tensile strength, water absorption capacity, morphology, drug release kinetics, antimicrobial activity and stability. The morphology of these films was found to be very smooth and homogeneous proving a good compatibility between the two polymers. With increase in gelatin concentration, folding endurance, water absorption capacity, tensile strength, drug release kinetics and antimicrobial activity were increased. The antibacterial activity against various bacterial species was improved in the bacitracin loaded hydrocolloid films as compared to the blank films. Based on the findings above, it can be concluded that chitosan/gelatin films at 1:3 proportion is a successful wound dressing for wound management with improved wound healing properties than other formulations. This formulation is a potential candidate for the development of alternative pharmaceutical dosage forms, for the treatment of bacterial infected wounds, based on the activity of the eco-friendly chitosan matrix added to the bacitracin activity. In this work, chitosan also demonstrated a great potential as a dressing for advanced wound therapy and confirmed its good biocompatibility and potential to provide, in combination with liposomes, sustained drug release which is highly beneficial for wound treatment. The addition of gelatin improved the water affinity of the films and facilitated water mediated cross-linking process.
- Full Text:
- Date Issued: 2017
Evaluation of medicine safety reporting systems in South Africa
- Thornborrow-Geswind, Kirsten
- Authors: Thornborrow-Geswind, Kirsten
- Date: 2017
- Subjects: Drugs -- Side effects -- Research -- South Africa Pharmacoepidemiology -- Research -- South Africa , Medicine -- South Africa -- Safety measures Public health -- South Africa
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10948/21439 , vital:29517
- Description: Pharmacovigilance is “the science and activities relating to the detection, assessment, understanding and prevention of adverse effects or any other drug-related problem”. To date, no comprehensive study has been performed to evaluate the pharmacovigilance system in the public health sector in South Africa. The primary aim of this study was to evaluate the current status of pharmacovigilance systems within the public healthcare sector in South Africa, and the level of functioning of these systems, in order to provide relevant recommendations, where necessary, for improvement, using the Indicator-based Pharmacogivilance Assessment Tool (IPAT). National and provincial entities were deemed compulsory (n=14), while facilities were selected via random, stratified sampling to obtain a representation at each facility level (n=101). The IPAT was amended for relevance at each level of data collection. Indicators are classified as core and supplementary and compliance with core indicators shows the level of functioning National entities obtained an IPAT score of 36 out of a maximum of 72, achieving 50% compliance. Province D and Province G obtained overall IPAT scores of 29 and 12 respectively out of a maximum of 40, achieving an overall 72.5% and 30% compliance respectively Results at provincial and facility levels were not fully representative due to a limited response rate of 22.2% and 65.3% respectively. Regional/tertiary facilities and district facilities displayed increased awareness and implementation of pharmacovigilance activity than the lower levels of Community Health Centres (CHCs) and Primary Health Centres (PHCs). South Africa”s public healthcare system possesses the infrastructure for a well functioning pharmacovigilance system. However there are gaps in level of functioning at a national, provincial and facility level. Addressing these gaps would show a marked improvement in the system and go a long way towards the contribution of medicine safety information not only locally, but to aid other developing nations.
- Full Text:
- Date Issued: 2017
- Authors: Thornborrow-Geswind, Kirsten
- Date: 2017
- Subjects: Drugs -- Side effects -- Research -- South Africa Pharmacoepidemiology -- Research -- South Africa , Medicine -- South Africa -- Safety measures Public health -- South Africa
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10948/21439 , vital:29517
- Description: Pharmacovigilance is “the science and activities relating to the detection, assessment, understanding and prevention of adverse effects or any other drug-related problem”. To date, no comprehensive study has been performed to evaluate the pharmacovigilance system in the public health sector in South Africa. The primary aim of this study was to evaluate the current status of pharmacovigilance systems within the public healthcare sector in South Africa, and the level of functioning of these systems, in order to provide relevant recommendations, where necessary, for improvement, using the Indicator-based Pharmacogivilance Assessment Tool (IPAT). National and provincial entities were deemed compulsory (n=14), while facilities were selected via random, stratified sampling to obtain a representation at each facility level (n=101). The IPAT was amended for relevance at each level of data collection. Indicators are classified as core and supplementary and compliance with core indicators shows the level of functioning National entities obtained an IPAT score of 36 out of a maximum of 72, achieving 50% compliance. Province D and Province G obtained overall IPAT scores of 29 and 12 respectively out of a maximum of 40, achieving an overall 72.5% and 30% compliance respectively Results at provincial and facility levels were not fully representative due to a limited response rate of 22.2% and 65.3% respectively. Regional/tertiary facilities and district facilities displayed increased awareness and implementation of pharmacovigilance activity than the lower levels of Community Health Centres (CHCs) and Primary Health Centres (PHCs). South Africa”s public healthcare system possesses the infrastructure for a well functioning pharmacovigilance system. However there are gaps in level of functioning at a national, provincial and facility level. Addressing these gaps would show a marked improvement in the system and go a long way towards the contribution of medicine safety information not only locally, but to aid other developing nations.
- Full Text:
- Date Issued: 2017