A best practice guideline for a healthy work environment for professional nurses working in the South African Military Health Service
- Authors: Mabona, Jean Fezeka Madi
- Date: 2018
- Subjects: Nurses -- Employment -- South Africa , Medicine, Military -- South Africa South Africa -- National Defence Force -- Medical care , Work environment -- National Defence Force -- Medical care
- Language: English
- Type: Thesis , Doctoral , DCur
- Identifier: http://hdl.handle.net/10948/30811 , vital:31146
- Description: Governments, internationally and nationally, are becoming aware of the importance of healthy work environments within their health departments, environments that are caring and supportive to health professionals. This awareness is brought about by the mounting evidence that healthy work environments are critical to recruiting and retaining health professionals. On the other hand, unhealthy work environments can contribute to medical errors, ineffective delivery of care, and conflict and stress among health professionals in the clinical setting and faculty shortage that can compromise academic excellence in the academic setting. The professional nurses working in the South African Military Health Service (SAMHS), a branch of the South African National Defence Force (SANDF) could experience the military environment as unhealthy because it is rigid and controlled. The hierarchical rank structure could deprive them of their autonomy as the decision-making powers are directly proportional to the rank. Stressful conditions could be experienced when these professional nurses are taken away from the well equipped hospital environment to the deployment areas away from home. There was, however, no evidence found on the work environment of professional nurses in the SAMHS during literature review. The aim of the study is therefore to explore and describe the experiences of professional nurses working in the SAMHS and their understanding of a healthy work environment and the scope and nature of a best practice guideline, then to integrate the evidence generated to the evidence emanating from the critical appraisal of the existing best practice guidelines from other health settings in order to develop a best practice guideline for a healthy work environment for nurses in the SAMHS. The study adopted a qualitative, exploratory, descriptive and contextual research design. The research study was made up of three phases. In Phase 1, semi-structured interviews were conducted with professional nurses to collect information on their experiences of working in the SAMHS and their understanding of evidence-based best practice guidelines. The interviews were transcribed by an independent transcriptionist and data analyzed using the eight steps of data analysis as suggested by Tesch. Themes were identified and grouped together to form new categories. The process of coding was supported by an independent coder. Lincoln and Guba’s model of Page | vii trustworthiness consisting of credibility, transferability, dependability and confirmability was used to ensure the validity of the study. An integrative literature review was conducted where the existing evidence-based best practice guidelines for healthy work environment for nurses were searched for, appraised, had data extracted and were synthesized in Phase 2. In Phase 3, evidence generated in Phase 1 and Phase 2 was triangulated, forming recommendations that were utilized to develop a best practice draft guideline for a healthy work environment for professional nurses working in the SAMHS. The draft guideline was sent to five expert reviewers for their comments and recommendations. These were considered in the development of the final guideline. The final guideline consists of several recommendations in four themes: the need for effective leadership to create an empowering environment; effective communication amongst members of the health team; a culture that supports team work, and; the need for an environment that promotes professional autonomy. Further recommendations were made to address factors that impact negatively on enhancement of a healthy work environment. The guideline is intended for use by SAMHS’ leadership, at Levels 2, the strategic level, Level 3, the formation level and Level 4, the unit level (hospitals, sickbays and clinics and nursing college) and all professional nurses working in all the military health institutions of the SAMHS, including the military clinics, sickbays and hospitals irrespective of positions. However, the guideline may also be adapted by nursing institutions outside the military such as public and private hospitals and clinics where they find it applicable. Results
- Full Text:
- Date Issued: 2018
- Authors: Mabona, Jean Fezeka Madi
- Date: 2018
- Subjects: Nurses -- Employment -- South Africa , Medicine, Military -- South Africa South Africa -- National Defence Force -- Medical care , Work environment -- National Defence Force -- Medical care
- Language: English
- Type: Thesis , Doctoral , DCur
- Identifier: http://hdl.handle.net/10948/30811 , vital:31146
- Description: Governments, internationally and nationally, are becoming aware of the importance of healthy work environments within their health departments, environments that are caring and supportive to health professionals. This awareness is brought about by the mounting evidence that healthy work environments are critical to recruiting and retaining health professionals. On the other hand, unhealthy work environments can contribute to medical errors, ineffective delivery of care, and conflict and stress among health professionals in the clinical setting and faculty shortage that can compromise academic excellence in the academic setting. The professional nurses working in the South African Military Health Service (SAMHS), a branch of the South African National Defence Force (SANDF) could experience the military environment as unhealthy because it is rigid and controlled. The hierarchical rank structure could deprive them of their autonomy as the decision-making powers are directly proportional to the rank. Stressful conditions could be experienced when these professional nurses are taken away from the well equipped hospital environment to the deployment areas away from home. There was, however, no evidence found on the work environment of professional nurses in the SAMHS during literature review. The aim of the study is therefore to explore and describe the experiences of professional nurses working in the SAMHS and their understanding of a healthy work environment and the scope and nature of a best practice guideline, then to integrate the evidence generated to the evidence emanating from the critical appraisal of the existing best practice guidelines from other health settings in order to develop a best practice guideline for a healthy work environment for nurses in the SAMHS. The study adopted a qualitative, exploratory, descriptive and contextual research design. The research study was made up of three phases. In Phase 1, semi-structured interviews were conducted with professional nurses to collect information on their experiences of working in the SAMHS and their understanding of evidence-based best practice guidelines. The interviews were transcribed by an independent transcriptionist and data analyzed using the eight steps of data analysis as suggested by Tesch. Themes were identified and grouped together to form new categories. The process of coding was supported by an independent coder. Lincoln and Guba’s model of Page | vii trustworthiness consisting of credibility, transferability, dependability and confirmability was used to ensure the validity of the study. An integrative literature review was conducted where the existing evidence-based best practice guidelines for healthy work environment for nurses were searched for, appraised, had data extracted and were synthesized in Phase 2. In Phase 3, evidence generated in Phase 1 and Phase 2 was triangulated, forming recommendations that were utilized to develop a best practice draft guideline for a healthy work environment for professional nurses working in the SAMHS. The draft guideline was sent to five expert reviewers for their comments and recommendations. These were considered in the development of the final guideline. The final guideline consists of several recommendations in four themes: the need for effective leadership to create an empowering environment; effective communication amongst members of the health team; a culture that supports team work, and; the need for an environment that promotes professional autonomy. Further recommendations were made to address factors that impact negatively on enhancement of a healthy work environment. The guideline is intended for use by SAMHS’ leadership, at Levels 2, the strategic level, Level 3, the formation level and Level 4, the unit level (hospitals, sickbays and clinics and nursing college) and all professional nurses working in all the military health institutions of the SAMHS, including the military clinics, sickbays and hospitals irrespective of positions. However, the guideline may also be adapted by nursing institutions outside the military such as public and private hospitals and clinics where they find it applicable. Results
- Full Text:
- Date Issued: 2018
A best practice guideline for clinical teaching at a public college of nursing
- Authors: Gcawu, Sybil Nyameka
- Date: 2018
- Subjects: Nursing -- Study and teaching , Clinical medicine Medicine -- Study and teaching
- Language: English
- Type: Thesis , Doctoral , DCur
- Identifier: http://hdl.handle.net/10948/30194 , vital:30860
- Description: Clinical teaching is a critical component of the education and training of undergraduate nursing students. It determines the level of clinical competence that nursing students achieve during their studies. It should be informed by current best practice evidence available in the nursing care literature (Emanuel, Day, Diegnan & Prys-Muller, 2011:21-22). Clinical teaching is centred around provision of patient care in clinical practice. It takes place through an interaction between the nurse educator and the nursing students. During this process nursing students are moulded so they can demonstrate minimum competency in order to be registered by the regulatory body. Nursing students learn to become competent nurses in the clinical learning environment (Baxter 2006; Nash, 2007 in Franklin, 2013:35). In South Africa nurse educators are required to be fully responsible for clinical teaching through the use of appropriate teaching approaches and learning facilitation techniques (RSA DoH, 2013:91). The overall purpose of the current research study was to explore and describe the current clinical teaching practices of nurse educators; to search, appraise, extract and synthesise literature related to clinical teaching in nursing; and to develop A Best Practice Guideline for Clinical Teaching at a Public College of Nursing in the Eastern Cape Province. This had to be realized in three phases. In Phase One a quantitative, exploratory, descriptive and contextual study was conducted. A structured questionnaire was used to collect data from the nurse educators involved in clinical teaching within the Diploma in Nursing (General, Community, Psychiatric) and Midwifery programme. The data analysed was used as the basis of Phase Two—namely, an integrative literature review of evidence pertaining to the clinical teaching practices of nurse educators doing clinical teaching within the undergraduate programmes. The evidence from Phases One and Two was used to develop a draft Best Practice Guideline. The draft guideline was reviewed by a group of expert reviewers and their suggestions were incorporated in the final guideline. Ethical considerations were maintained throughout the research study. The rigour of the research process was ensured by cognitive testing of the questionnaire, and by critical appraisal of the literature accessed from an integrative literature review. The v authenticity of critical appraisal was ensured by having the critical appraisal done by the researcher and an independent reviewer.
- Full Text:
- Date Issued: 2018
- Authors: Gcawu, Sybil Nyameka
- Date: 2018
- Subjects: Nursing -- Study and teaching , Clinical medicine Medicine -- Study and teaching
- Language: English
- Type: Thesis , Doctoral , DCur
- Identifier: http://hdl.handle.net/10948/30194 , vital:30860
- Description: Clinical teaching is a critical component of the education and training of undergraduate nursing students. It determines the level of clinical competence that nursing students achieve during their studies. It should be informed by current best practice evidence available in the nursing care literature (Emanuel, Day, Diegnan & Prys-Muller, 2011:21-22). Clinical teaching is centred around provision of patient care in clinical practice. It takes place through an interaction between the nurse educator and the nursing students. During this process nursing students are moulded so they can demonstrate minimum competency in order to be registered by the regulatory body. Nursing students learn to become competent nurses in the clinical learning environment (Baxter 2006; Nash, 2007 in Franklin, 2013:35). In South Africa nurse educators are required to be fully responsible for clinical teaching through the use of appropriate teaching approaches and learning facilitation techniques (RSA DoH, 2013:91). The overall purpose of the current research study was to explore and describe the current clinical teaching practices of nurse educators; to search, appraise, extract and synthesise literature related to clinical teaching in nursing; and to develop A Best Practice Guideline for Clinical Teaching at a Public College of Nursing in the Eastern Cape Province. This had to be realized in three phases. In Phase One a quantitative, exploratory, descriptive and contextual study was conducted. A structured questionnaire was used to collect data from the nurse educators involved in clinical teaching within the Diploma in Nursing (General, Community, Psychiatric) and Midwifery programme. The data analysed was used as the basis of Phase Two—namely, an integrative literature review of evidence pertaining to the clinical teaching practices of nurse educators doing clinical teaching within the undergraduate programmes. The evidence from Phases One and Two was used to develop a draft Best Practice Guideline. The draft guideline was reviewed by a group of expert reviewers and their suggestions were incorporated in the final guideline. Ethical considerations were maintained throughout the research study. The rigour of the research process was ensured by cognitive testing of the questionnaire, and by critical appraisal of the literature accessed from an integrative literature review. The v authenticity of critical appraisal was ensured by having the critical appraisal done by the researcher and an independent reviewer.
- Full Text:
- Date Issued: 2018
A best practice guideline for patient-centred care in public hospitals in Nelson Mandela Bay
- Authors: Jardien-Baboo, Sihaam
- Date: 2014
- Subjects: Patient-centered health care -- South Africa -- Nelson Mandela Bay Municipality , Evidence-based medicine -- South Africa -- Nelson Mandela Bay Municipality , Public health nurses -- South Africa -- Nelson Mandela Bay Municipality , Public hospitals -- South Africa -- Nelson Mandela Bay Municipality
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: vital:10063 , http://hdl.handle.net/10948/d1020370
- Description: In South Africa, the quality of health care is directly related to the concept of patient-centred care and the enactment of the Batho Pele Principles and the Patients’ Rights Charter. The quality of health care delivery has dropped drastically, and reports in the media indicate that public hospitals in the Eastern Cape Province are on the brink of collapse, with thousands of patients being treated in condemned hospitals. Receiving and rendering health care in the face of such challenges, the question arose: “Are patients receiving patient-centred care in public hospitals?” The answer to this rhetorical inquiry appeared to be obvious, but this research study explored and described professional nurses’ perceptions of patient-centred care in public hospitals and their understanding of evidence-based practice and best practice guidelines. The proposed study followed a qualitative, exploratory, descriptive and contextual design. The research population included professional nurses who are employed in public hospitals in Nelson Mandela Bay, and consisted of nurse managers and nurses who work in the wards. The research study consisted of three phases. In Phase 1, semi-structured interviews and focus groups were conducted with nurse managers and professional nurses working in the wards in order to collect data about their perceptions of patient-centred care and their understanding of evidence-based practice and best practice guidelines. The interviews were transcribed and Tesch’s eight steps of data analysis were followed to create meaning from the data collected. Themes were identified and grouped together to form new categories. The researcher ensured the validity of the study by conforming to Lincoln and Guba’s model of trustworthiness, which consists of the following four constructs: credibility, transferability, dependability and confirmability. An independent coder assisted with the coding process. In Phase 2, an integrative literature review was conducted in order to identify previous guidelines regarding best practice for patient-centred care. Relevant guidelines were selected, critically appraised, data was extracted and synthesised for the development of a best practice guideline for patient-centred care. An independent appraiser critically appraised the guidelines, thereby ensuring trustworthiness. In Phase 3, the data in Phase 1 and Phase 2 were integrated to formulate a draft best practice guideline for patient-centred care. The guideline was submitted to an expert panel for review and was modified according to the recommendations of the panel, whereby the best practice guideline for patient-centred care in public hospitals in Nelson Mandela Bay was finalized.
- Full Text:
- Date Issued: 2014
- Authors: Jardien-Baboo, Sihaam
- Date: 2014
- Subjects: Patient-centered health care -- South Africa -- Nelson Mandela Bay Municipality , Evidence-based medicine -- South Africa -- Nelson Mandela Bay Municipality , Public health nurses -- South Africa -- Nelson Mandela Bay Municipality , Public hospitals -- South Africa -- Nelson Mandela Bay Municipality
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: vital:10063 , http://hdl.handle.net/10948/d1020370
- Description: In South Africa, the quality of health care is directly related to the concept of patient-centred care and the enactment of the Batho Pele Principles and the Patients’ Rights Charter. The quality of health care delivery has dropped drastically, and reports in the media indicate that public hospitals in the Eastern Cape Province are on the brink of collapse, with thousands of patients being treated in condemned hospitals. Receiving and rendering health care in the face of such challenges, the question arose: “Are patients receiving patient-centred care in public hospitals?” The answer to this rhetorical inquiry appeared to be obvious, but this research study explored and described professional nurses’ perceptions of patient-centred care in public hospitals and their understanding of evidence-based practice and best practice guidelines. The proposed study followed a qualitative, exploratory, descriptive and contextual design. The research population included professional nurses who are employed in public hospitals in Nelson Mandela Bay, and consisted of nurse managers and nurses who work in the wards. The research study consisted of three phases. In Phase 1, semi-structured interviews and focus groups were conducted with nurse managers and professional nurses working in the wards in order to collect data about their perceptions of patient-centred care and their understanding of evidence-based practice and best practice guidelines. The interviews were transcribed and Tesch’s eight steps of data analysis were followed to create meaning from the data collected. Themes were identified and grouped together to form new categories. The researcher ensured the validity of the study by conforming to Lincoln and Guba’s model of trustworthiness, which consists of the following four constructs: credibility, transferability, dependability and confirmability. An independent coder assisted with the coding process. In Phase 2, an integrative literature review was conducted in order to identify previous guidelines regarding best practice for patient-centred care. Relevant guidelines were selected, critically appraised, data was extracted and synthesised for the development of a best practice guideline for patient-centred care. An independent appraiser critically appraised the guidelines, thereby ensuring trustworthiness. In Phase 3, the data in Phase 1 and Phase 2 were integrated to formulate a draft best practice guideline for patient-centred care. The guideline was submitted to an expert panel for review and was modified according to the recommendations of the panel, whereby the best practice guideline for patient-centred care in public hospitals in Nelson Mandela Bay was finalized.
- Full Text:
- Date Issued: 2014
A best practice guideline for screening and managing chorioamnionitis
- Authors: Du Plessis, Allison Herlene
- Date: 2020
- Subjects: Bacterial diseases
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: http://hdl.handle.net/10948/46374 , vital:39575
- Description: Due to the complex nature of chorioamnionitis, women are often misdiagnosed, undiagnosed or only diagnosed after birth when it is too late to prevent maternal and neonatal complications. A lack of a comprehensive best practice guidelinefor screening and managing women withchorioamnionitis resultsin delayed treatment and management that could minimise maternal and neonatal complications. Saving Babiesreported that unexplained intra-uterine deathsremained the main primary (obstetric) cause of death for babies with a weight above 1000g (24.4%of all deaths). Of these unexplained uterine deaths, 33% are of normal birth weight (>2500g), and,therefore,most likely term gestation. Saving Babies further reported that 22.9% of all live births in South Africa was premature and 22.8% of birthswere unexplained intra-uterine deaths. Prematurity is one major complication of chorioamnionitis. When susceptibility for chorioamnionitis is considered during early pregnancy, it is possible to intervene and prevent or even reduce the incidences and complications of chorioamnionitis.A qualitative research study was conducted in three phases. In Phase One(Part One), a theoretically constructed patient scenario of chorioamnionitis was presented to ten midwives,and semi-structured individual interviews were done to elicit information regarding how they screen for and manage chorioamnionitis. In Phase One(Part Two), experienced medical practitioners in the field of obstetrics and gynaecology were individually interviewed, also using semi-structured individual interviewsto gain their views regarding chorioamnionitis as a contributing factor to maternal morbidity and mortality. Qualitative findings in Phase Oneindicated that there is a general lack of knowledge regarding chorioamnionitis among midwives, resulting ininadequate screening, misdiagnosis and mismanagement of the condition. Experienced medical practitioners confirmed that chorioamnionitis is underdiagnosed, misdiagnosed or undiagnosed and underreported,and they hold views that it is difficult to treat and control pregnancy-related infections according to current practice.An integrative literature review was conductedin Phase Twoand literature regarding diagnostic biomarkers, screening options to diagnose chorioamnionitis and management of chorioamnionitis were extracted. After evidence synthesisofPhase Oneand Phase Twodata, a best practice guidelinefor screening and managing viiwomen withchorioamnionitiswas developed usingthe National Institute for Health and Clinical Excellence guideline development approach in Phase Three. The purpose of the best practice guideline for screening and managing women with chorioamnionitis was to provide a guideline onhow to manage women who are at risk and those who present with signs and symptoms of chorioamnionitis at any stage during their pregnancy. Five recommendations were made that involve screening for chorioamnionitisand causative factors, biomarkers to diagnose chorioamnionitis, management of chorioamnionitis that includes pharmacological and non-pharmacological management, and health education to women.Ethics for this research study were guided by the ethical principles and guidelines of the Belmont Report. The trustworthiness of this research study was adopted from Ravitch and Carl,and was based on criticality, reflexivity, collaboration, and rigour. An independent coder and reviewer wereto verify the data that were included in the best practice guideline. Expert reviewersappraised the best practice guidelineusing Appraisal of Guidelines for Research and Evaluation II tools.
- Full Text:
- Date Issued: 2020
- Authors: Du Plessis, Allison Herlene
- Date: 2020
- Subjects: Bacterial diseases
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: http://hdl.handle.net/10948/46374 , vital:39575
- Description: Due to the complex nature of chorioamnionitis, women are often misdiagnosed, undiagnosed or only diagnosed after birth when it is too late to prevent maternal and neonatal complications. A lack of a comprehensive best practice guidelinefor screening and managing women withchorioamnionitis resultsin delayed treatment and management that could minimise maternal and neonatal complications. Saving Babiesreported that unexplained intra-uterine deathsremained the main primary (obstetric) cause of death for babies with a weight above 1000g (24.4%of all deaths). Of these unexplained uterine deaths, 33% are of normal birth weight (>2500g), and,therefore,most likely term gestation. Saving Babies further reported that 22.9% of all live births in South Africa was premature and 22.8% of birthswere unexplained intra-uterine deaths. Prematurity is one major complication of chorioamnionitis. When susceptibility for chorioamnionitis is considered during early pregnancy, it is possible to intervene and prevent or even reduce the incidences and complications of chorioamnionitis.A qualitative research study was conducted in three phases. In Phase One(Part One), a theoretically constructed patient scenario of chorioamnionitis was presented to ten midwives,and semi-structured individual interviews were done to elicit information regarding how they screen for and manage chorioamnionitis. In Phase One(Part Two), experienced medical practitioners in the field of obstetrics and gynaecology were individually interviewed, also using semi-structured individual interviewsto gain their views regarding chorioamnionitis as a contributing factor to maternal morbidity and mortality. Qualitative findings in Phase Oneindicated that there is a general lack of knowledge regarding chorioamnionitis among midwives, resulting ininadequate screening, misdiagnosis and mismanagement of the condition. Experienced medical practitioners confirmed that chorioamnionitis is underdiagnosed, misdiagnosed or undiagnosed and underreported,and they hold views that it is difficult to treat and control pregnancy-related infections according to current practice.An integrative literature review was conductedin Phase Twoand literature regarding diagnostic biomarkers, screening options to diagnose chorioamnionitis and management of chorioamnionitis were extracted. After evidence synthesisofPhase Oneand Phase Twodata, a best practice guidelinefor screening and managing viiwomen withchorioamnionitiswas developed usingthe National Institute for Health and Clinical Excellence guideline development approach in Phase Three. The purpose of the best practice guideline for screening and managing women with chorioamnionitis was to provide a guideline onhow to manage women who are at risk and those who present with signs and symptoms of chorioamnionitis at any stage during their pregnancy. Five recommendations were made that involve screening for chorioamnionitisand causative factors, biomarkers to diagnose chorioamnionitis, management of chorioamnionitis that includes pharmacological and non-pharmacological management, and health education to women.Ethics for this research study were guided by the ethical principles and guidelines of the Belmont Report. The trustworthiness of this research study was adopted from Ravitch and Carl,and was based on criticality, reflexivity, collaboration, and rigour. An independent coder and reviewer wereto verify the data that were included in the best practice guideline. Expert reviewersappraised the best practice guidelineusing Appraisal of Guidelines for Research and Evaluation II tools.
- Full Text:
- Date Issued: 2020
A best-practice guideline for facilitating adherence to anti-retroviral therapy for persons attending public hospitals in Ghana
- Authors: Agyeman-Yeboah, Joana
- Date: 2017
- Subjects: HIV infections -- Treatment -- Ghana , Health services administration -- Ghana Public health -- Ghana Hospital care -- Ghana
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: http://hdl.handle.net/10948/13603 , vital:27256
- Description: The retention of persons on an HIV programme has been a global challenge. The success of any strategy to optimize adherence to anti-retroviral therapy (ART) depends on the intensive and effective adherence counselling and strategies. It is important to research whether persons receiving anti-retroviral therapy in public hospitals in Ghana are receiving the needed service that would optimize their adherence to the anti-retroviral therapy. Therefore, this study explored and described the experiences of healthcare professionals providing care, support and guidance to persons on ART at public hospitals in Ghana, as well as the best-practice guideline that could contribute to facilitating the ART adherence of patients. This study also explored and described the experiences of persons living with Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) on ART, regarding their adherence to the therapy. The study was organized into three phases. In Phase One: a qualitative, exploratory, descriptive and contextual design was employed. The research population included healthcare professionals, providing services at the HIV clinic at the public hospitals in Ghana, namely the Korle-Bu Teaching Hospital; the 37 Military Hospital and the Ridge Hospital. The healthcare professionals comprised of doctors, nurses, pharmacists and trained counsellors employed in any of the three public hospitals. Persons receiving ART at any of the three public hospitals were also part of the research population. Semi-structured interviews were conducted with healthcare professionals and persons receiving ART. Data were collected from healthcare professionals in relation to their experiences regarding the provision of ART services, their understanding of evidence-based practice and best-practice guidelines, as well as data on the experiences of persons receiving ART in relation to their adherence to the therapy. The data were analysed using Creswell’s six steps of data analysis; and the coding of the data was done according to Tesch’s eight steps of coding. Trustworthiness was ensured by using Lincoln and Guba’s framework which comprised credibility, transferability, dependability, confirmability and authenticity. Ethical principles such as beneficence and non-maleficence, respect for human dignity, justice, veracity, privacy and confidentiality were considered in the study. In phase two, the literature was searched by using an integrative literature review approach and critically appraising the methodological quality of the guidelines in order to identify the best available evidence related to adherence to ART. In Phase Three, a best-practice guideline for facilitating adherence to ART was developed for public hospitals in Ghana based on the findings of the empirical research of Phase One and the integrative literature review in Phase Two. The guideline was submitted to an expert panel for review; and it was modified, according to the recommendations of the panel.
- Full Text:
- Date Issued: 2017
- Authors: Agyeman-Yeboah, Joana
- Date: 2017
- Subjects: HIV infections -- Treatment -- Ghana , Health services administration -- Ghana Public health -- Ghana Hospital care -- Ghana
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: http://hdl.handle.net/10948/13603 , vital:27256
- Description: The retention of persons on an HIV programme has been a global challenge. The success of any strategy to optimize adherence to anti-retroviral therapy (ART) depends on the intensive and effective adherence counselling and strategies. It is important to research whether persons receiving anti-retroviral therapy in public hospitals in Ghana are receiving the needed service that would optimize their adherence to the anti-retroviral therapy. Therefore, this study explored and described the experiences of healthcare professionals providing care, support and guidance to persons on ART at public hospitals in Ghana, as well as the best-practice guideline that could contribute to facilitating the ART adherence of patients. This study also explored and described the experiences of persons living with Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) on ART, regarding their adherence to the therapy. The study was organized into three phases. In Phase One: a qualitative, exploratory, descriptive and contextual design was employed. The research population included healthcare professionals, providing services at the HIV clinic at the public hospitals in Ghana, namely the Korle-Bu Teaching Hospital; the 37 Military Hospital and the Ridge Hospital. The healthcare professionals comprised of doctors, nurses, pharmacists and trained counsellors employed in any of the three public hospitals. Persons receiving ART at any of the three public hospitals were also part of the research population. Semi-structured interviews were conducted with healthcare professionals and persons receiving ART. Data were collected from healthcare professionals in relation to their experiences regarding the provision of ART services, their understanding of evidence-based practice and best-practice guidelines, as well as data on the experiences of persons receiving ART in relation to their adherence to the therapy. The data were analysed using Creswell’s six steps of data analysis; and the coding of the data was done according to Tesch’s eight steps of coding. Trustworthiness was ensured by using Lincoln and Guba’s framework which comprised credibility, transferability, dependability, confirmability and authenticity. Ethical principles such as beneficence and non-maleficence, respect for human dignity, justice, veracity, privacy and confidentiality were considered in the study. In phase two, the literature was searched by using an integrative literature review approach and critically appraising the methodological quality of the guidelines in order to identify the best available evidence related to adherence to ART. In Phase Three, a best-practice guideline for facilitating adherence to ART was developed for public hospitals in Ghana based on the findings of the empirical research of Phase One and the integrative literature review in Phase Two. The guideline was submitted to an expert panel for review; and it was modified, according to the recommendations of the panel.
- Full Text:
- Date Issued: 2017
A chronic care coordination model for HIV-positive children requiring antiretroviral therapy
- Authors: Williams, Margaret
- Date: 2013
- Subjects: HIV-positive children -- Care -- South Africa , HIV-positive persons -- Care -- South Africa
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: vital:10062 , http://hdl.handle.net/10948/d1020346
- Description: The human immunodeficiency virus / acquired immune deficiency syndrome pandemic (HIV/AIDS) continues to increase in prevalence worldwide, particularly in South Africa. There is a concurrent and distinct increase in the prevalence of HIV/AIDS and HIV-related diseases in the paediatric population in South Africa, particularly those using public sector health services, with a corresponding increase in morbidity and mortality rates (Abdool Karim & Abdool Karim, 2010:363), which impacts greatly on paediatric healthcare services. Adding to this, the provision of paediatric antiretroviral care has numerous stumbling blocks, not least of which is lack of decentralisation of facilities to provide treatment. There is the additional shortage of staff, which includes staff that are comfortable dealing with children, lack of training programmes on the provision of antiretroviral therapy to children, and minimal on-site mentorship of staff regarding HIV/AIDS disease in children. This lack of capacity in the healthcare system means that not all of those who require treatment will be able to access it, and this is particularly pertinent to paediatric patients (Meyers et al., 2007:198). Therefore the purpose of this research was to develop a nursing model that would assist healthcare professionals, in particular professional nurses, to optimise the comprehensive treatment, care and support for HIV-positive children who require antiretroviral therapy at PHC clinics. To achieve the purpose of this study, a theory-generating design based on a qualitative, explorative, descriptive and contextual approach was implemented by the researcher to gain an understanding of how the healthcare professionals and parents/caregivers of HIV-positive children experienced the comprehensive treatment, care and support provided at primary healthcare clinics. The information obtained was used to develop a chronic care coordination model for the optimisation of comprehensive treatment, care and support for HIV-positive children requiring antiretroviral therapy. The study design comprised the following four steps: Step One of the research design focused on the identification, classification and definition of the major concepts of the study. This involved describing and selecting the research population and the sampling process prior to conducting the field work which comprised in-depth interviews with two groups of participants, namely healthcare professionals and parents/caregivers who accompany their HIV-positive children to PHC clinics in order to receive antiretroviral therapy. Step Two of the research design focused on the development of relationship statements in order to bring clarity and direction to the understanding of the phenomenon of interest. Step Three of the design concentrated on the development and description of the chronic care coordination model for optimising comprehensive treatment, care and support for HIV-positive children who require antiretroviral therapy in order to ensure a well-managed child on ART. A visual representation of the structure of the model for chronic care coordination was given and described as well as a detailed description of the process of the model. Step Four was the last step of the research design and its focus was the development of guidelines for the operationalisation of the model for chronic care coordination for the optimisation of comprehensive treatment, care and support for HIV-positive children requiring antiretroviral therapy at PHC clinics. Guidelines and operational implications for each of the five sequential steps of the model were developed. The evaluation criteria of Chinn & Kramer (2008:237‒248) were used to evaluate the model. It is therefore concluded that the researcher succeeded in achieving the purpose for this study because a chronic care coordination model that is understandable, clear, simple, applicable and significant to nursing practice has been developed for use by healthcare professionals, particularly professional nurses, in order to optimise the comprehensive treatment, care and support for HIV-positive children requiring antiretroviral therapy at primary healthcare clinics.
- Full Text:
- Date Issued: 2013
- Authors: Williams, Margaret
- Date: 2013
- Subjects: HIV-positive children -- Care -- South Africa , HIV-positive persons -- Care -- South Africa
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: vital:10062 , http://hdl.handle.net/10948/d1020346
- Description: The human immunodeficiency virus / acquired immune deficiency syndrome pandemic (HIV/AIDS) continues to increase in prevalence worldwide, particularly in South Africa. There is a concurrent and distinct increase in the prevalence of HIV/AIDS and HIV-related diseases in the paediatric population in South Africa, particularly those using public sector health services, with a corresponding increase in morbidity and mortality rates (Abdool Karim & Abdool Karim, 2010:363), which impacts greatly on paediatric healthcare services. Adding to this, the provision of paediatric antiretroviral care has numerous stumbling blocks, not least of which is lack of decentralisation of facilities to provide treatment. There is the additional shortage of staff, which includes staff that are comfortable dealing with children, lack of training programmes on the provision of antiretroviral therapy to children, and minimal on-site mentorship of staff regarding HIV/AIDS disease in children. This lack of capacity in the healthcare system means that not all of those who require treatment will be able to access it, and this is particularly pertinent to paediatric patients (Meyers et al., 2007:198). Therefore the purpose of this research was to develop a nursing model that would assist healthcare professionals, in particular professional nurses, to optimise the comprehensive treatment, care and support for HIV-positive children who require antiretroviral therapy at PHC clinics. To achieve the purpose of this study, a theory-generating design based on a qualitative, explorative, descriptive and contextual approach was implemented by the researcher to gain an understanding of how the healthcare professionals and parents/caregivers of HIV-positive children experienced the comprehensive treatment, care and support provided at primary healthcare clinics. The information obtained was used to develop a chronic care coordination model for the optimisation of comprehensive treatment, care and support for HIV-positive children requiring antiretroviral therapy. The study design comprised the following four steps: Step One of the research design focused on the identification, classification and definition of the major concepts of the study. This involved describing and selecting the research population and the sampling process prior to conducting the field work which comprised in-depth interviews with two groups of participants, namely healthcare professionals and parents/caregivers who accompany their HIV-positive children to PHC clinics in order to receive antiretroviral therapy. Step Two of the research design focused on the development of relationship statements in order to bring clarity and direction to the understanding of the phenomenon of interest. Step Three of the design concentrated on the development and description of the chronic care coordination model for optimising comprehensive treatment, care and support for HIV-positive children who require antiretroviral therapy in order to ensure a well-managed child on ART. A visual representation of the structure of the model for chronic care coordination was given and described as well as a detailed description of the process of the model. Step Four was the last step of the research design and its focus was the development of guidelines for the operationalisation of the model for chronic care coordination for the optimisation of comprehensive treatment, care and support for HIV-positive children requiring antiretroviral therapy at PHC clinics. Guidelines and operational implications for each of the five sequential steps of the model were developed. The evaluation criteria of Chinn & Kramer (2008:237‒248) were used to evaluate the model. It is therefore concluded that the researcher succeeded in achieving the purpose for this study because a chronic care coordination model that is understandable, clear, simple, applicable and significant to nursing practice has been developed for use by healthcare professionals, particularly professional nurses, in order to optimise the comprehensive treatment, care and support for HIV-positive children requiring antiretroviral therapy at primary healthcare clinics.
- Full Text:
- Date Issued: 2013
A co-constructed practice model for supporting parents of children in conflict with the law
- Authors: Abdulla, Zurina
- Date: 2019
- Subjects: Children's rights -- South Africa , Children -- Legal status, laws, etc --South Africa , Parent and child -- Research -- South Africa , Social work with youth -- South Africa
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: http://hdl.handle.net/10948/30474 , vital:30949
- Description: The unique historical stressors linked to South Africa’s apartheid legacy, continues to manifest in the form of economic exclusion, social exclusion, inequality and poverty, with parents being subjugated to service users and extenders rather than included as service advocates, particularly in the child justice system. Furthermore, policies and practices do not include, engage and support parents on an intra and interpersonal level. Parents of children in conflict with the law, experience their children’s charge or arrest as well as their subsequent journey through the child justice system as a crisis resulting in their need for emotional, informational, practical and professional support during the child justice process. The similarities and differences between the contexts of child protection and child justice in supporting parents illuminates the existing gaps in child justice legislation, policy and practice resulting in a lack of support for parents during the child justice process. In the Children’s Act 38 of 2005, it is recognised that parents have a legal responsibility towards their children and that in fulfilling this responsibility parents can access support services to assist them when they face challenges in fulfilling this responsibility. In contrast, despite 80 percent of children in conflict with the law being released into parental care and parents expressing the need for support in fulfilling their parental responsibility, in this regard the Child Justice Act 75 of 2008 fails to make provision for parents to access support services. The child justice system’s narrow focus on parents as service extenders contributes to parents’ being excluded from targeted support services resulting in parents’ support needs not being addressed. The lack of programmes and services aimed at supporting parents highlight the need for coordinated services that address the multiple stressors parents are exposed to. To this end, this study was aimed at coconstructing a practice model for supporting parents of children in conflict with the law. The theoretical lenses employed in the current study namely; the Ecological systems model and the Buffering effect model describes the various systems parents need support from and the type of support they need from their family, community and professionals. Guided by a qualitative approach, the present study integrated applied research, in particular intervention design and development with participatory action research as it allowed systematic collaboration during the research process to ensure rigour. This study involved participants from two research sites namely, the Nerina One- Stop Child Justice Centre in Port Elizabeth and the Reception, Assessment and Referral office at the Uitenhage magistrates’ court. Employing a non-probability purposive sampling method, this study facilitated the participation of parents of children in conflict with the law and child justice officials who met the inclusion criteria, in the co-design and development of a practice model for supporting parents of children in conflict with the law. Participants assumed an expert and collaborative role, which enabled the co-construction of knowledge, meaning and innovation of the practice model. Qualitative data collection methods namely, twelve focus groups and thirty two participant observations, were used to explore, co-construct, describe and design a practice model for supporting parents of children in conflict with the law during the child justice process. Thematic analyses was employed to condense the data, search for codes, categories, themes, relationships and patterns in the data. Due to the research approach and design, data analysis was ongoing and informed design and development of the practice model. Based on the thematic analysis and synthesis both descriptive and analytic themes emerged. To ensure trustworthiness, this study employed various strategies to strengthen commitment, rigour, transparency and coherence. In addition, the participative research process, the inclusion of multiple forms of qualitative inquiry and the significance of the study contributed to the validity and quality of the study. Ethical considerations applicable to the study included participants’ voluntary participation, their informed consent and ensuring participants’ privacy or maintaining confidentially. Various strategies were employed to prevent or minimise risk to participants. The findings showed that formal sources of support, in particular, offer opportunities for parents to access individual and family counselling, parenting advice, and peer support. The study also highlighted the importance of recognising parents as a subsystem in the child justice system offers potential opportunities for inclusion of parents as co-facilitators of parenting programmes or support groups, as peer supporters during the child justice process. Parents’ inclusion as a partner in the child justice system is highlighted as an opportunity for parents to be able to vi participate in child justice fora, oversight committees and accreditation committees to influence policy, services and budget allocations for services to support parents of children in conflict with the law. This study’s contribution to the existing body of knowledge is an integrated, multidisciplinary, multi-phase co-constructed practice model that would enable inclusion of, and support for, parents of children in conflict with the law prior to, during and after the child justice. The co-constructed practice model (a) involves a continuum of parent-centred support for and inclusion of parents prior to, during and after the child justice process; (b) advances an inclusive and collaborative child justice system that views parents as important stakeholders in determining the type of services they need and being involved in developing practice; and (c) promotes parents as equal partners in decision making and policy making to influence legislation, policy and practice in the child justice system.
- Full Text:
- Date Issued: 2019
- Authors: Abdulla, Zurina
- Date: 2019
- Subjects: Children's rights -- South Africa , Children -- Legal status, laws, etc --South Africa , Parent and child -- Research -- South Africa , Social work with youth -- South Africa
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: http://hdl.handle.net/10948/30474 , vital:30949
- Description: The unique historical stressors linked to South Africa’s apartheid legacy, continues to manifest in the form of economic exclusion, social exclusion, inequality and poverty, with parents being subjugated to service users and extenders rather than included as service advocates, particularly in the child justice system. Furthermore, policies and practices do not include, engage and support parents on an intra and interpersonal level. Parents of children in conflict with the law, experience their children’s charge or arrest as well as their subsequent journey through the child justice system as a crisis resulting in their need for emotional, informational, practical and professional support during the child justice process. The similarities and differences between the contexts of child protection and child justice in supporting parents illuminates the existing gaps in child justice legislation, policy and practice resulting in a lack of support for parents during the child justice process. In the Children’s Act 38 of 2005, it is recognised that parents have a legal responsibility towards their children and that in fulfilling this responsibility parents can access support services to assist them when they face challenges in fulfilling this responsibility. In contrast, despite 80 percent of children in conflict with the law being released into parental care and parents expressing the need for support in fulfilling their parental responsibility, in this regard the Child Justice Act 75 of 2008 fails to make provision for parents to access support services. The child justice system’s narrow focus on parents as service extenders contributes to parents’ being excluded from targeted support services resulting in parents’ support needs not being addressed. The lack of programmes and services aimed at supporting parents highlight the need for coordinated services that address the multiple stressors parents are exposed to. To this end, this study was aimed at coconstructing a practice model for supporting parents of children in conflict with the law. The theoretical lenses employed in the current study namely; the Ecological systems model and the Buffering effect model describes the various systems parents need support from and the type of support they need from their family, community and professionals. Guided by a qualitative approach, the present study integrated applied research, in particular intervention design and development with participatory action research as it allowed systematic collaboration during the research process to ensure rigour. This study involved participants from two research sites namely, the Nerina One- Stop Child Justice Centre in Port Elizabeth and the Reception, Assessment and Referral office at the Uitenhage magistrates’ court. Employing a non-probability purposive sampling method, this study facilitated the participation of parents of children in conflict with the law and child justice officials who met the inclusion criteria, in the co-design and development of a practice model for supporting parents of children in conflict with the law. Participants assumed an expert and collaborative role, which enabled the co-construction of knowledge, meaning and innovation of the practice model. Qualitative data collection methods namely, twelve focus groups and thirty two participant observations, were used to explore, co-construct, describe and design a practice model for supporting parents of children in conflict with the law during the child justice process. Thematic analyses was employed to condense the data, search for codes, categories, themes, relationships and patterns in the data. Due to the research approach and design, data analysis was ongoing and informed design and development of the practice model. Based on the thematic analysis and synthesis both descriptive and analytic themes emerged. To ensure trustworthiness, this study employed various strategies to strengthen commitment, rigour, transparency and coherence. In addition, the participative research process, the inclusion of multiple forms of qualitative inquiry and the significance of the study contributed to the validity and quality of the study. Ethical considerations applicable to the study included participants’ voluntary participation, their informed consent and ensuring participants’ privacy or maintaining confidentially. Various strategies were employed to prevent or minimise risk to participants. The findings showed that formal sources of support, in particular, offer opportunities for parents to access individual and family counselling, parenting advice, and peer support. The study also highlighted the importance of recognising parents as a subsystem in the child justice system offers potential opportunities for inclusion of parents as co-facilitators of parenting programmes or support groups, as peer supporters during the child justice process. Parents’ inclusion as a partner in the child justice system is highlighted as an opportunity for parents to be able to vi participate in child justice fora, oversight committees and accreditation committees to influence policy, services and budget allocations for services to support parents of children in conflict with the law. This study’s contribution to the existing body of knowledge is an integrated, multidisciplinary, multi-phase co-constructed practice model that would enable inclusion of, and support for, parents of children in conflict with the law prior to, during and after the child justice. The co-constructed practice model (a) involves a continuum of parent-centred support for and inclusion of parents prior to, during and after the child justice process; (b) advances an inclusive and collaborative child justice system that views parents as important stakeholders in determining the type of services they need and being involved in developing practice; and (c) promotes parents as equal partners in decision making and policy making to influence legislation, policy and practice in the child justice system.
- Full Text:
- Date Issued: 2019
A comprehensive support programme for professional nurses performing HIV counselling and testing at primary health care clinics in the rural Eastern Cape
- Authors: Madolo, Agrinette Nomboniso
- Date: 2019
- Subjects: HIV-positive persons -- Counseling of , AIDS (Disease) -- Patients -- Counseling of , Primary health care -- South Africa -- Eastern Cape , Community health nursing -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Doctoral , DCur
- Identifier: http://hdl.handle.net/10948/40746 , vital:36232
- Description: The increase in global rates of human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) has had far reaching effects on healthcare services around the world. According to the 2017 statistics released by UNAIDS, South Africa has the largest HIV epidemic in the world. The South African Department of Health provides an HIV counselling and testing (HCT) service to patients in order that they may know their HIV status and endeavours to educate patients so that they may adapt their behaviours and lifestyles. The goal of this study is to develop a support programme for nurses to assist them in coping emotionally with their day-to-day activities when providing HCT services to patients attending primary healthcare clinics. The paradigm used as a lens to view the phenomenon is Kinlaw’s cyclical growth of empowerment theory. The researcher used a qualitative,explorative, descriptive and contextual design. The study involves three phases: (a) empirical research that explores nurses’ experiences of performing HCT in primary healthcare rural clinics, (b) the development of a conceptual framework for a support programme using the survey list of Dickoff et al. (1968:427). (c) the formalisation of the Comprehensive Support Programme to help nurses to cope emotionally with working with HCT on a long-term basis. Chinn and Kramer (2005118) were used to evaluate the programme. . The empirical findings revealed registered nurses experienced HCT both positively and negatively. They felt overwhelmed by the expectation that all patients attending primary healthcare clinics should be offered HCT routinely and the time constraints involved. They described how the emotional trauma attached to HCT affected their work patterns, leading to low productivity, and affected them outside work, leading to stress and sleep disturbances. They feltl disturbed that even when informed, people choose not to adopt safer sex practices and that how patients responded to a positive diagnosis cannot be predicted. Participants showed signs of stress, frustration, despair and sadness because most tested clients show positive test results and the number of clients testing positive is increasing. While participants felt helpless to improve the situation, at the same time, HCT was experienced as rewarding because it enabled diagnosis of medical conditions of which people weree not aware. The goal of the study was achieved with the development and formalisation of an extensive, relevant and applicable Comprehensive Support Programme for implementation for registered nurses to enable them cope emotionally when conducting HCT based on the empirical findings.
- Full Text:
- Date Issued: 2019
- Authors: Madolo, Agrinette Nomboniso
- Date: 2019
- Subjects: HIV-positive persons -- Counseling of , AIDS (Disease) -- Patients -- Counseling of , Primary health care -- South Africa -- Eastern Cape , Community health nursing -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Doctoral , DCur
- Identifier: http://hdl.handle.net/10948/40746 , vital:36232
- Description: The increase in global rates of human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) has had far reaching effects on healthcare services around the world. According to the 2017 statistics released by UNAIDS, South Africa has the largest HIV epidemic in the world. The South African Department of Health provides an HIV counselling and testing (HCT) service to patients in order that they may know their HIV status and endeavours to educate patients so that they may adapt their behaviours and lifestyles. The goal of this study is to develop a support programme for nurses to assist them in coping emotionally with their day-to-day activities when providing HCT services to patients attending primary healthcare clinics. The paradigm used as a lens to view the phenomenon is Kinlaw’s cyclical growth of empowerment theory. The researcher used a qualitative,explorative, descriptive and contextual design. The study involves three phases: (a) empirical research that explores nurses’ experiences of performing HCT in primary healthcare rural clinics, (b) the development of a conceptual framework for a support programme using the survey list of Dickoff et al. (1968:427). (c) the formalisation of the Comprehensive Support Programme to help nurses to cope emotionally with working with HCT on a long-term basis. Chinn and Kramer (2005118) were used to evaluate the programme. . The empirical findings revealed registered nurses experienced HCT both positively and negatively. They felt overwhelmed by the expectation that all patients attending primary healthcare clinics should be offered HCT routinely and the time constraints involved. They described how the emotional trauma attached to HCT affected their work patterns, leading to low productivity, and affected them outside work, leading to stress and sleep disturbances. They feltl disturbed that even when informed, people choose not to adopt safer sex practices and that how patients responded to a positive diagnosis cannot be predicted. Participants showed signs of stress, frustration, despair and sadness because most tested clients show positive test results and the number of clients testing positive is increasing. While participants felt helpless to improve the situation, at the same time, HCT was experienced as rewarding because it enabled diagnosis of medical conditions of which people weree not aware. The goal of the study was achieved with the development and formalisation of an extensive, relevant and applicable Comprehensive Support Programme for implementation for registered nurses to enable them cope emotionally when conducting HCT based on the empirical findings.
- Full Text:
- Date Issued: 2019
A holistic healthcare model for higher education campus health services
- Authors: Ricks, Esmeralda Jennifer
- Date: 2008
- Subjects: College students -- Health and hygiene -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Doctoral , DCur
- Identifier: vital:10038 , http://hdl.handle.net/10948/666 , College students -- Health and hygiene -- South Africa -- Eastern Cape
- Description: Most students are adolescents and young adults, a group characterized by a new-found sense of independence, experimentation with sex and sometimes drugs and a feeling of invincibility (Gayle, Richard, Keeling, Garcia-Tunon, Kilbourne, Narkunas, Ingram, rogers and Curran, 1990:1538). These behavioural, developmental and environmental issues may contribute to premature morbidity, mortality and reduced quality of life for university students (Patrick et al., 1992:260). The ages of staff on the other hand range from young adults to retirement age. The types of health problems that exist among staff who use the campus health service include First Aid treatment on site for injuries on duty and more chronic health problems such as, for example, hypertension and diabetes mellitus. To date there is very little evidence as to whether or not the healthcare needs of students and staff are being met comprehensively or whether the practitioners rendering the service are knowledgeable and complying with the PHC norms and standards developed by the department of Health’s Quality Assurance Directorate. The lack of such empirical data can contribute to misconceptions and hamper the management of public health problems experienced in SA, for example sexually transmitted infections and the transmission of HIV. Thus the purpose of this research was to develop a model that would assist registered nurses employed at a higher education campus health service in the Western Region of the Eastern Cape Province to render a healthcare service relevant to the healthcare needs of the students and staff on campus.
- Full Text:
- Date Issued: 2008
- Authors: Ricks, Esmeralda Jennifer
- Date: 2008
- Subjects: College students -- Health and hygiene -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Doctoral , DCur
- Identifier: vital:10038 , http://hdl.handle.net/10948/666 , College students -- Health and hygiene -- South Africa -- Eastern Cape
- Description: Most students are adolescents and young adults, a group characterized by a new-found sense of independence, experimentation with sex and sometimes drugs and a feeling of invincibility (Gayle, Richard, Keeling, Garcia-Tunon, Kilbourne, Narkunas, Ingram, rogers and Curran, 1990:1538). These behavioural, developmental and environmental issues may contribute to premature morbidity, mortality and reduced quality of life for university students (Patrick et al., 1992:260). The ages of staff on the other hand range from young adults to retirement age. The types of health problems that exist among staff who use the campus health service include First Aid treatment on site for injuries on duty and more chronic health problems such as, for example, hypertension and diabetes mellitus. To date there is very little evidence as to whether or not the healthcare needs of students and staff are being met comprehensively or whether the practitioners rendering the service are knowledgeable and complying with the PHC norms and standards developed by the department of Health’s Quality Assurance Directorate. The lack of such empirical data can contribute to misconceptions and hamper the management of public health problems experienced in SA, for example sexually transmitted infections and the transmission of HIV. Thus the purpose of this research was to develop a model that would assist registered nurses employed at a higher education campus health service in the Western Region of the Eastern Cape Province to render a healthcare service relevant to the healthcare needs of the students and staff on campus.
- Full Text:
- Date Issued: 2008
A model of support for divorced professional nurses in the Eastern Cape, South Africa
- Authors: Murray, Daphne
- Date: 2018
- Subjects: Divorce counseling -- South Africa -- Eastern Cape Divorce -- Social aspects -- South Africa -- Eastern Cape Employees -- Counseling of -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Doctoral , Nursing
- Identifier: http://hdl.handle.net/10353/10028 , vital:35293
- Description: The purpose of this research study was to develop a support model for divorced professional nurses in the health-care facilities of the Department of Health, Eastern Cape, with guidelines to operationalise the model. Divorce is a process with psychological as well as social implications, and with a series of economic causes it also has implications in terms of the society and culture in which individuals operate. The main causes for divorce are adultery and domestic violence, especially against women and children (Lurea, 2011:99). A need for support from managers in the health-care facilities of the Department of Health, Eastern Cape during the process of divorce was identified by divorced professional nurses, since a lack of support and all the negativity that encompasses divorce could lead to severe depression, which will later have a negative effect on work performance (Abdul Kadir & Bifulco, 2010:858). The literature in this field of study, along with experience, indicates that it is imperative for divorced professional nurses to be supported in the workplace to help them to cope emotionally with their work demands, as prescribed by the South African Nursing Council. An explorative, descriptive and contextual qualitative design with theory generation was used to achieve the purpose of the study. Snowball sampling was employed to select participants, namely divorced professional nurses who were unknown to the researcher. A sample of 21 divorced professional nurses who work in health-care facilities in the Buffalo City Metropolitan Municipality in the Eastern Cape participated in the study. Data was collected by means of individual face-face interviews with divorced professional nurses. The interviews continued until data saturation was reached. Field notes supplemented data that could not be portrayed by audio-taped interviews, such as non- verbal communication in observed interactions. Data analysis was done using Tesch’s approach to open coding in qualitative research. Themes, categories and sub-categories emerged from the data analysis and were fully discussed, becoming fundamental units in the development of the conceptual framework as well as in the model. The researcher did a thorough literature review to conceptualise the identified concepts on which the model was based. The description and evaluation of the model, along with guidelines to operationalise the model, were done in accordance with the method described by Chinn and Kramer (2011:197). The justification of the research, the limitations, and the recommendations for operationalisation of the model of support for divorced professional nurses working in the Buffalo City Metropolitan Municipality of the Department of Health, Eastern Cape Province, and South Africa were indicated accordingly.
- Full Text:
- Date Issued: 2018
- Authors: Murray, Daphne
- Date: 2018
- Subjects: Divorce counseling -- South Africa -- Eastern Cape Divorce -- Social aspects -- South Africa -- Eastern Cape Employees -- Counseling of -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Doctoral , Nursing
- Identifier: http://hdl.handle.net/10353/10028 , vital:35293
- Description: The purpose of this research study was to develop a support model for divorced professional nurses in the health-care facilities of the Department of Health, Eastern Cape, with guidelines to operationalise the model. Divorce is a process with psychological as well as social implications, and with a series of economic causes it also has implications in terms of the society and culture in which individuals operate. The main causes for divorce are adultery and domestic violence, especially against women and children (Lurea, 2011:99). A need for support from managers in the health-care facilities of the Department of Health, Eastern Cape during the process of divorce was identified by divorced professional nurses, since a lack of support and all the negativity that encompasses divorce could lead to severe depression, which will later have a negative effect on work performance (Abdul Kadir & Bifulco, 2010:858). The literature in this field of study, along with experience, indicates that it is imperative for divorced professional nurses to be supported in the workplace to help them to cope emotionally with their work demands, as prescribed by the South African Nursing Council. An explorative, descriptive and contextual qualitative design with theory generation was used to achieve the purpose of the study. Snowball sampling was employed to select participants, namely divorced professional nurses who were unknown to the researcher. A sample of 21 divorced professional nurses who work in health-care facilities in the Buffalo City Metropolitan Municipality in the Eastern Cape participated in the study. Data was collected by means of individual face-face interviews with divorced professional nurses. The interviews continued until data saturation was reached. Field notes supplemented data that could not be portrayed by audio-taped interviews, such as non- verbal communication in observed interactions. Data analysis was done using Tesch’s approach to open coding in qualitative research. Themes, categories and sub-categories emerged from the data analysis and were fully discussed, becoming fundamental units in the development of the conceptual framework as well as in the model. The researcher did a thorough literature review to conceptualise the identified concepts on which the model was based. The description and evaluation of the model, along with guidelines to operationalise the model, were done in accordance with the method described by Chinn and Kramer (2011:197). The justification of the research, the limitations, and the recommendations for operationalisation of the model of support for divorced professional nurses working in the Buffalo City Metropolitan Municipality of the Department of Health, Eastern Cape Province, and South Africa were indicated accordingly.
- Full Text:
- Date Issued: 2018
A positive clinical psychology approach to developing resilience among state employed nurses
- Authors: Plumb, Sarah
- Date: 2015
- Subjects: Nurses -- Job stress , Nursing -- Psychological aspects , Resilience (Personality trait)
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: vital:9955 , http://hdl.handle.net/10948/d1018879
- Description: Nurses are confronted with numerous work-related stressors that can result in burnout. This can contribute to absenteeism and high turn-over rates in the nursing profession. A review of the literature indicated that psycho-educational interventions to increase resilience could be an effective way of addressing this problem. The study aimed to develop a positive clinical-psychology approach to increasing resilience in State employed nurses. The study used a mixed-method approach to determine the current psychological functioning of a sample of 87 nurses. Quantitative data on personality traits, character strengths and levels of resilience were obtained, using the NEO PI-R, VIA – IS, and Resilience Scale. Qualitative data on the coping responses of nurses were obtained through the thematic analysis of focus groups. These data were integrated to create a positive clinical psychology conceptualisation of resilience and to develop therapeutic guidelines for a group psycho-educational intervention. The results of the study indicated a struggling psychological profile. This was defined as the ability to deal with work-related stressors – but with the potential risk of developing symptoms of burnout. The moderate levels of resilience were attributed to elevated character strengths in the sample. The distribution of personality traits indicated that the nurses in the sample were at risk of developing burnout; and this prevented them from flourishing. These data were synthesised to create therapeutic guidelines for developing resilience aimed: (1) increasing emotional stability and invulnerability; (2) increasing agreeableness; and (3) increasing conscientiousness. These guidelines were based on the personality traits that were deemed to negatively impact the resilience of the nurses. These personality traits were correlated with several character strengths that displayed strong relationships with resilience. This indicated that resilience could be developed through the cultivation of the following character strengths: perspective; perseverance; fairness; forgiveness; leadership; love; zest; hope; curiosity; and appreciation of beauty and excellence. These character strengths were identified to facilitate the positive adaptation of the personality traits identified in the therapeutic guidelines. A group psycho-educational intervention was developed, using the positive clinical psychology conceptualisation of resilience. The literature was reviewed to identify techniques to cultivate the ten character strengths specified in the therapeutic guidelines. These techniques were adapted to create experiential learning processes for the intervention. This psycho-educational programme can be applied as a secondary and tertiary intervention. It can be used to increase resilience to prevent burnout among nurses. It can also be used to psychologically empower nurses that have existing symptoms of burnout.
- Full Text:
- Date Issued: 2015
- Authors: Plumb, Sarah
- Date: 2015
- Subjects: Nurses -- Job stress , Nursing -- Psychological aspects , Resilience (Personality trait)
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: vital:9955 , http://hdl.handle.net/10948/d1018879
- Description: Nurses are confronted with numerous work-related stressors that can result in burnout. This can contribute to absenteeism and high turn-over rates in the nursing profession. A review of the literature indicated that psycho-educational interventions to increase resilience could be an effective way of addressing this problem. The study aimed to develop a positive clinical-psychology approach to increasing resilience in State employed nurses. The study used a mixed-method approach to determine the current psychological functioning of a sample of 87 nurses. Quantitative data on personality traits, character strengths and levels of resilience were obtained, using the NEO PI-R, VIA – IS, and Resilience Scale. Qualitative data on the coping responses of nurses were obtained through the thematic analysis of focus groups. These data were integrated to create a positive clinical psychology conceptualisation of resilience and to develop therapeutic guidelines for a group psycho-educational intervention. The results of the study indicated a struggling psychological profile. This was defined as the ability to deal with work-related stressors – but with the potential risk of developing symptoms of burnout. The moderate levels of resilience were attributed to elevated character strengths in the sample. The distribution of personality traits indicated that the nurses in the sample were at risk of developing burnout; and this prevented them from flourishing. These data were synthesised to create therapeutic guidelines for developing resilience aimed: (1) increasing emotional stability and invulnerability; (2) increasing agreeableness; and (3) increasing conscientiousness. These guidelines were based on the personality traits that were deemed to negatively impact the resilience of the nurses. These personality traits were correlated with several character strengths that displayed strong relationships with resilience. This indicated that resilience could be developed through the cultivation of the following character strengths: perspective; perseverance; fairness; forgiveness; leadership; love; zest; hope; curiosity; and appreciation of beauty and excellence. These character strengths were identified to facilitate the positive adaptation of the personality traits identified in the therapeutic guidelines. A group psycho-educational intervention was developed, using the positive clinical psychology conceptualisation of resilience. The literature was reviewed to identify techniques to cultivate the ten character strengths specified in the therapeutic guidelines. These techniques were adapted to create experiential learning processes for the intervention. This psycho-educational programme can be applied as a secondary and tertiary intervention. It can be used to increase resilience to prevent burnout among nurses. It can also be used to psychologically empower nurses that have existing symptoms of burnout.
- Full Text:
- Date Issued: 2015
A programme of academic support for students at the public nursing college of the Eastern Cape Province in South Africa
- Senti, Nomandithini Innocent
- Authors: Senti, Nomandithini Innocent
- Date: 2018
- Subjects: Nursing -- Study and teaching Nursing -- Study and teaching -- Simulation methods
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: http://hdl.handle.net/10353/10997 , vital:36128
- Description: A comprehensive academic support at the public nursing college is important. Despite this, there is no such support in public nursing colleges in the Eastern Cape Province of South Africa. The aim of the study was to develop an academic support programme for students in order to improve their success in Higher Education. The study endeavoured to answer the following questions: What are the academic support needs of students at the public nursing college in the Eastern Cape of South Africa? What conceptual framework can be developed for the academic support programme of students? What academic support programme can be developed for students at the public nursing college? What guidelines can be developed for implementation of academic support programme of students? The objectives were: to describe academic support needs of students at the public nursing college in the eastern Cape Province of South Africa; to develop a conceptual framework for the academic support programme for students at the public nursing college in the Eastern Cape of South Africa; to develop an academic support programme for students at the public nursing college in the Eastern Cape in south Africa and lastly to describe guidelines for implementation and evaluation of the academic support programme. The research design used in this study was quantitative, qualitative, descriptive, evaluative, and theory generation. The study was conducted according to four phases. Phase one focussed on academic supports needs of the student. Phase two focussed on development of conceptual framework for the students at the public nursing college in Eastern Cape Province. Phase three focussed on the development of the academic support programme for the students, whereas phase four focussed on description of guidelines for implementation and evaluation of the academic support programme. The population of the study consisted of students undergoing training in a four-year programme at the Public Nursing College. The target population was the students in the same programme from level one to level four of training. The sampling technique used was a probability sampling with multi-stage and cluster sampling techniques being utilized. The total sample was n=333 participants. A quantitative self-developed questionnaire was used to collect empirical data. The questionnaire consisted of eight sections. Descriptive data was analysed using Statistic Package of Social Sciences (SPSS) version 24. Exploratory factor analysis was conducted on the descriptive data collected in phase one. Concept analysis and identification were done through the utilisation of exploratory factor analysis. The conceptual framework for the academic support programme was identified through the analysed factors. Fifteen factors were derived from the descriptive data. The conceptual framework of the academic support programme discussed in Chapter 5 was used also in the development of the academic support programme. It is in this chapter that assumptions, context, stakeholders, process, outcome, dynamics and, lastly, the recipient were discussed, along with a description of the programme. The programme was evaluated in accordance with the criteria for programme evaluation. The recommendations brought forward for the academic support programme were: The guidelines have to be tested for the implementation of the programme; benchmarking should be done to compare with other institutions of higher learning regarding their academic support programmes; an academic brochure regarding academic support must be available in the college and should be given to students on arrival as part of a package; and neutral researcher should conduct the same research in the same college.
- Full Text:
- Date Issued: 2018
- Authors: Senti, Nomandithini Innocent
- Date: 2018
- Subjects: Nursing -- Study and teaching Nursing -- Study and teaching -- Simulation methods
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: http://hdl.handle.net/10353/10997 , vital:36128
- Description: A comprehensive academic support at the public nursing college is important. Despite this, there is no such support in public nursing colleges in the Eastern Cape Province of South Africa. The aim of the study was to develop an academic support programme for students in order to improve their success in Higher Education. The study endeavoured to answer the following questions: What are the academic support needs of students at the public nursing college in the Eastern Cape of South Africa? What conceptual framework can be developed for the academic support programme of students? What academic support programme can be developed for students at the public nursing college? What guidelines can be developed for implementation of academic support programme of students? The objectives were: to describe academic support needs of students at the public nursing college in the eastern Cape Province of South Africa; to develop a conceptual framework for the academic support programme for students at the public nursing college in the Eastern Cape of South Africa; to develop an academic support programme for students at the public nursing college in the Eastern Cape in south Africa and lastly to describe guidelines for implementation and evaluation of the academic support programme. The research design used in this study was quantitative, qualitative, descriptive, evaluative, and theory generation. The study was conducted according to four phases. Phase one focussed on academic supports needs of the student. Phase two focussed on development of conceptual framework for the students at the public nursing college in Eastern Cape Province. Phase three focussed on the development of the academic support programme for the students, whereas phase four focussed on description of guidelines for implementation and evaluation of the academic support programme. The population of the study consisted of students undergoing training in a four-year programme at the Public Nursing College. The target population was the students in the same programme from level one to level four of training. The sampling technique used was a probability sampling with multi-stage and cluster sampling techniques being utilized. The total sample was n=333 participants. A quantitative self-developed questionnaire was used to collect empirical data. The questionnaire consisted of eight sections. Descriptive data was analysed using Statistic Package of Social Sciences (SPSS) version 24. Exploratory factor analysis was conducted on the descriptive data collected in phase one. Concept analysis and identification were done through the utilisation of exploratory factor analysis. The conceptual framework for the academic support programme was identified through the analysed factors. Fifteen factors were derived from the descriptive data. The conceptual framework of the academic support programme discussed in Chapter 5 was used also in the development of the academic support programme. It is in this chapter that assumptions, context, stakeholders, process, outcome, dynamics and, lastly, the recipient were discussed, along with a description of the programme. The programme was evaluated in accordance with the criteria for programme evaluation. The recommendations brought forward for the academic support programme were: The guidelines have to be tested for the implementation of the programme; benchmarking should be done to compare with other institutions of higher learning regarding their academic support programmes; an academic brochure regarding academic support must be available in the college and should be given to students on arrival as part of a package; and neutral researcher should conduct the same research in the same college.
- Full Text:
- Date Issued: 2018
A psycho-educational programme to facilitate the mental health of adolescent girls who are victims of verbal bullying
- Authors: Jacobs, Ruwayda
- Date: 2012
- Subjects: Teenage girls -- Mental health -- South Africa , Psychoanalysis , Bullying
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: vital:9946 , http://hdl.handle.net/10948/d1014579
- Description: Bullying appears to be a worldwide phenomenon. It occurs within schools, homes, and in the community too. Bullying is a form of aggressive behaviour. Female bullying is not so easily noticed, as girls hardly ever use physical forms of aggression. Bullying can have a detrimental effect on the mental health of the victim. The victims of bullying experience symptoms of mental discomfort, which include low self esteem, feelings of helplessness, feelings of worthlessness and inferiority, lack of confidence, isolation, self-conscientiousness; and lastly, this can lead to suicide. Some form of intervention is necessary to provide adolescents with skills to combat bullying and help them to become mentally healthy again. The overall goal of the study was to develop, implement and evaluate a psycho-educational programme for female adolescents in a secondary school setting, in order to assist them in coping with bullying. The objectives of the research study were to: Conduct asituational analysis to identify the mental health needs of adolescent girls, as victimsof bullying. Develop a psycho-educational programme to facilitate the promotion of mental health of those adolescent girls who are victims of bullying. Implement the psycho-educational programme to facilitate coping by adolescent girls who are victims of bullying. Assess whether the adolescent girls have benefitted from attending the psycho-educational programme. The researcher used a qualitative, explorative, descriptive and contextual design. The research methodology consisted of four phases. In phase one of the research, a situational analysis was done; and the characteristics of mental discomfort exhibited by the victim were identified. The needs of the adolescent girl who has been bullied have already been described. Phase two involved the development of a psycho-educational programme. The information from the situational analysis was used to develop the conceptual framework. The six concepts in the survey list of Dickoff et al. (1968:422) were described as follows: the recipient is the adolescent girl who has been bullied, the agent is an advanced psychiatric nurse, the context is the community and the secondary school where bullying takes place, the dynamics of the intervention constitute the mental discomfort experienced by the adolescent girl. This is what motivates her to participate in the programme. The procedure was identified as the psycho-educational programme, while the terminus or outcome of the intervention for the adolescent girl would be for her to experience mental health after being exposed to the psycho-educational programme. The relationship between the concepts was used to form the mind map of the conceptual framework. This guided the development of the psycho-educational programme. The content of the programme has already been described. In phase three the psycho-educational programme is implemented and in phase four the programme is evaluated. The psycho-educational programme taught the teenage girls skills and it provided them with knowledge to cope better with the bullying. Attending the programme made the teenagers aware that they needed to change to experience mental health and happiness. The empirical study took place in phase four. The data-gathering method in phase four included the conducting of semi-structured interviews with the adolescent girls who participated in the programme, as well as the teachers of these adolescent girls and their parents. Naïve sketches, reflective journals, observations made and field notes formed part of this database. The data was analyzed by means of Tesch‟s descriptive analysis (in Creswell, 2003:192). The participants had to comment on how they were coping after the implementation of the psycho-educational programme. In conclusion, an intervention in the form of the psycho-educational programme was shown to be beneficial to adolescent girls who were victims of bullying, to assist them in coping with the aftermath of being bullied. Recommendations were made to enhance nursing practice, as well as nursing education and nursing research. Keywords: Adolescent girls, bullying, secondary schools, advanced psychiatric nurse, psycho-educational programme, mental health.
- Full Text:
- Date Issued: 2012
- Authors: Jacobs, Ruwayda
- Date: 2012
- Subjects: Teenage girls -- Mental health -- South Africa , Psychoanalysis , Bullying
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: vital:9946 , http://hdl.handle.net/10948/d1014579
- Description: Bullying appears to be a worldwide phenomenon. It occurs within schools, homes, and in the community too. Bullying is a form of aggressive behaviour. Female bullying is not so easily noticed, as girls hardly ever use physical forms of aggression. Bullying can have a detrimental effect on the mental health of the victim. The victims of bullying experience symptoms of mental discomfort, which include low self esteem, feelings of helplessness, feelings of worthlessness and inferiority, lack of confidence, isolation, self-conscientiousness; and lastly, this can lead to suicide. Some form of intervention is necessary to provide adolescents with skills to combat bullying and help them to become mentally healthy again. The overall goal of the study was to develop, implement and evaluate a psycho-educational programme for female adolescents in a secondary school setting, in order to assist them in coping with bullying. The objectives of the research study were to: Conduct asituational analysis to identify the mental health needs of adolescent girls, as victimsof bullying. Develop a psycho-educational programme to facilitate the promotion of mental health of those adolescent girls who are victims of bullying. Implement the psycho-educational programme to facilitate coping by adolescent girls who are victims of bullying. Assess whether the adolescent girls have benefitted from attending the psycho-educational programme. The researcher used a qualitative, explorative, descriptive and contextual design. The research methodology consisted of four phases. In phase one of the research, a situational analysis was done; and the characteristics of mental discomfort exhibited by the victim were identified. The needs of the adolescent girl who has been bullied have already been described. Phase two involved the development of a psycho-educational programme. The information from the situational analysis was used to develop the conceptual framework. The six concepts in the survey list of Dickoff et al. (1968:422) were described as follows: the recipient is the adolescent girl who has been bullied, the agent is an advanced psychiatric nurse, the context is the community and the secondary school where bullying takes place, the dynamics of the intervention constitute the mental discomfort experienced by the adolescent girl. This is what motivates her to participate in the programme. The procedure was identified as the psycho-educational programme, while the terminus or outcome of the intervention for the adolescent girl would be for her to experience mental health after being exposed to the psycho-educational programme. The relationship between the concepts was used to form the mind map of the conceptual framework. This guided the development of the psycho-educational programme. The content of the programme has already been described. In phase three the psycho-educational programme is implemented and in phase four the programme is evaluated. The psycho-educational programme taught the teenage girls skills and it provided them with knowledge to cope better with the bullying. Attending the programme made the teenagers aware that they needed to change to experience mental health and happiness. The empirical study took place in phase four. The data-gathering method in phase four included the conducting of semi-structured interviews with the adolescent girls who participated in the programme, as well as the teachers of these adolescent girls and their parents. Naïve sketches, reflective journals, observations made and field notes formed part of this database. The data was analyzed by means of Tesch‟s descriptive analysis (in Creswell, 2003:192). The participants had to comment on how they were coping after the implementation of the psycho-educational programme. In conclusion, an intervention in the form of the psycho-educational programme was shown to be beneficial to adolescent girls who were victims of bullying, to assist them in coping with the aftermath of being bullied. Recommendations were made to enhance nursing practice, as well as nursing education and nursing research. Keywords: Adolescent girls, bullying, secondary schools, advanced psychiatric nurse, psycho-educational programme, mental health.
- Full Text:
- Date Issued: 2012
A psychobiographical case study: Amelia Dyer in a search for glory
- Authors: April, Heather
- Date: 2020
- Subjects: Serial murderers--Psychology
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: http://hdl.handle.net/10948/50857 , vital:43008
- Description: The study is a psychobiographical case study based on the life of a Victorian baby farmer Amelia Dyer (1837-1896). She was executed for the murder of babies who were placed in her care over a period of 30 years. Psychobiography is a qualitative method of enquiry which explores the life of a unique individual subject through the lens of a psychological theory for the purpose of creating a coherent psychological case study. The psychoanalytic theoretical lens of Karen Horney was used to trace the evolution of Amelia Dyer’s sense of self within the Victorian culture of respectability. Baby farming referred to an unregulated business of adoption and fostering of infants, mostly illegitimate infants for a fee. Insufficient social structures and support for unwed mothers and children encouraged the business practice as women had very little choice for childcare. Baby farming was open to abuse and exploitation and hundreds of babies lost their lives due to insufficient care or infanticide. Amelia Dyer showed special talents and creativity from a young age, was ambitious and wanted to be self-reliant in a culture that did not provide women with opportunities to live out their ambitions. Baby farming became a business venture for her in the early stages of her life which later evolved into sadistic abuse and murder of the infants. Her evolution from a creative and hardworking young girl to a sadistic murderer of children is what qualifies her as a suitable subject for the exploration of Karen Horney’s dynamic theory of neuroses and the development of the neurotic self within culture. Extensive biographical data was collected and processed into salient themes. The study integrates the theory of Karen Horney, the life experiences of Amelia Dyer and Victorian respectability and demonstrates the value of using psychobiography as the method of inquiry into the exploration of the unique individual. The findings of the study demonstrated that Amelia Dyer and her social context were inextricably bound by a vicious cycle of psychic and emotional vi conflicts related to fear, control and self-hatred by the internalization of gender stereotypes and norms. The contribution of the study as a whole rests with its demonstration of the value of a holistic and reflexive exploration of the unique individual woman. It demonstrates the value of Horney’s in-depth theoretical understanding of the ambivalent core of selfhood that lies behind observable acts of behavior. The study as a whole contributes towards building upon holistic and integrative therapeutic frameworks in the understanding of diversity amongst women and mothers in culture.
- Full Text:
- Date Issued: 2020
- Authors: April, Heather
- Date: 2020
- Subjects: Serial murderers--Psychology
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: http://hdl.handle.net/10948/50857 , vital:43008
- Description: The study is a psychobiographical case study based on the life of a Victorian baby farmer Amelia Dyer (1837-1896). She was executed for the murder of babies who were placed in her care over a period of 30 years. Psychobiography is a qualitative method of enquiry which explores the life of a unique individual subject through the lens of a psychological theory for the purpose of creating a coherent psychological case study. The psychoanalytic theoretical lens of Karen Horney was used to trace the evolution of Amelia Dyer’s sense of self within the Victorian culture of respectability. Baby farming referred to an unregulated business of adoption and fostering of infants, mostly illegitimate infants for a fee. Insufficient social structures and support for unwed mothers and children encouraged the business practice as women had very little choice for childcare. Baby farming was open to abuse and exploitation and hundreds of babies lost their lives due to insufficient care or infanticide. Amelia Dyer showed special talents and creativity from a young age, was ambitious and wanted to be self-reliant in a culture that did not provide women with opportunities to live out their ambitions. Baby farming became a business venture for her in the early stages of her life which later evolved into sadistic abuse and murder of the infants. Her evolution from a creative and hardworking young girl to a sadistic murderer of children is what qualifies her as a suitable subject for the exploration of Karen Horney’s dynamic theory of neuroses and the development of the neurotic self within culture. Extensive biographical data was collected and processed into salient themes. The study integrates the theory of Karen Horney, the life experiences of Amelia Dyer and Victorian respectability and demonstrates the value of using psychobiography as the method of inquiry into the exploration of the unique individual. The findings of the study demonstrated that Amelia Dyer and her social context were inextricably bound by a vicious cycle of psychic and emotional vi conflicts related to fear, control and self-hatred by the internalization of gender stereotypes and norms. The contribution of the study as a whole rests with its demonstration of the value of a holistic and reflexive exploration of the unique individual woman. It demonstrates the value of Horney’s in-depth theoretical understanding of the ambivalent core of selfhood that lies behind observable acts of behavior. The study as a whole contributes towards building upon holistic and integrative therapeutic frameworks in the understanding of diversity amongst women and mothers in culture.
- Full Text:
- Date Issued: 2020
A psychobiography of Viktor Emil Frankl
- Authors: Bushkin, Hanan
- Date: 2020
- Subjects: Frankl, Viktor Emil
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: http://hdl.handle.net/10948/46440 , vital:39566
- Description: The first study conducted in South Africa of a prominent figure traces back as far as 1939. Since then, extensive research has been done in the field of psychobiography, resulting in a growing interest in this field and evolving into an established research genre in South Africa. Despite the increase in the use of psychobiographies as a research approach internationally and specifically in South Africa, its use is still considered relatively under-utilised and, therefore, the pursuit of further development of psychobiographies in South Africa is required. In light of South Africa’s effort to promote and advance the use of psychobiographies, South African researchers may be motivated to continue studying significant and exceptional lives in South Africa and abroad. Viktor Frankl was selected for this study based on his uniqueness, significance and his interesting life. He is also considered an exceptional individual who has shaped modern psychological thinking. Frankl had written over 40 books on his theory and many studies have been conducted based on his existential theory. Frankl’s contribution to the academic world has been recognised and acknowledged by significant institutions through his own and others’ research. Although much has been written on the life and work of Frankl, none of the literature utilises specific psychological focus and no psychobiographical study of the life of Frankl exists. Therefore, the researcher selected Frankl as the subject for this psychobiography through purposive sampling. The aim of the study was to provide a psychological exploration and description of Frankl’s life against the backdrop of his socio-cultural context. In order to achieve this aim, the researcher employed two psychological frameworks to guide in the description and exploration of his life. The psychological frameworks included Levinson’s life structure theory of adult development and Frankl’s existential theory. The study aimed to describe Frankl’s development with the use of Levinson’s theory while describing how he attained meaning in his life with the use of his own existential theory. Due to the exploratory-descriptive nature of this study, the objective fell within the inductive research approach. The researcher utilised a systematic coding method to arrange the data. The theoretical framework of Levinson’s life structure theory guided the coding system, as well as the key concepts of Frankl’s existential theory. In addition, the researcher utilised Alexander’s guidelines for the extraction of salient data, together with McAdam’s methods and recommendations for managing the data. Lastly, the researcher followed the 12-step method of conducting a psychobiography, as proposed by Du Plessis. Findings from this study found a correlation between Frankl’s life and the eras and transitional periods as theorised by Levinson’s theory. The findings of this study, therefore, support the use of Levinson’s theory with regards to the time frames and its use in understanding Frankl’s development. Also, the researcher found that Levinson’s theory was useful in understanding Frankl’s personality development within his context throughout his lifespan. With regards to Frankl’s existential theory, the researcher found that the use of the theory was suitable in understanding Frankl’s search for meaning. Frankl’s concepts of freedom of will, will to meaning, meaning of life, existential vacuum, supra-meaning, dimensional ontology, the three triads and noö-dynamics assisted in explaining Frankl’s drive to find meaning in his life, take responsibility to attain such meaning and to strive for transcendence beyond his suffering. The researcher found Frankl’s theory useful in explaining his drive, motives, needs and patterns of behaviour within this context. The holistic and integrative approach of the study allowed for an in-depth exploration and description of Frankl’s life and development within his socio-historical context. In addition to contributing to the existing body of knowledge on Frankl, his life and his theory, the study also contributed to the growing field of psychobiographical research. The study acknowledged and highlighted that further in-depth examination of the lives of extraordinary personalities could significantly contribute to psychobiographical studies. Based on the psychological frameworks used to explore and describe Frankl’s life, recommendations are made for future research.
- Full Text:
- Date Issued: 2020
- Authors: Bushkin, Hanan
- Date: 2020
- Subjects: Frankl, Viktor Emil
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: http://hdl.handle.net/10948/46440 , vital:39566
- Description: The first study conducted in South Africa of a prominent figure traces back as far as 1939. Since then, extensive research has been done in the field of psychobiography, resulting in a growing interest in this field and evolving into an established research genre in South Africa. Despite the increase in the use of psychobiographies as a research approach internationally and specifically in South Africa, its use is still considered relatively under-utilised and, therefore, the pursuit of further development of psychobiographies in South Africa is required. In light of South Africa’s effort to promote and advance the use of psychobiographies, South African researchers may be motivated to continue studying significant and exceptional lives in South Africa and abroad. Viktor Frankl was selected for this study based on his uniqueness, significance and his interesting life. He is also considered an exceptional individual who has shaped modern psychological thinking. Frankl had written over 40 books on his theory and many studies have been conducted based on his existential theory. Frankl’s contribution to the academic world has been recognised and acknowledged by significant institutions through his own and others’ research. Although much has been written on the life and work of Frankl, none of the literature utilises specific psychological focus and no psychobiographical study of the life of Frankl exists. Therefore, the researcher selected Frankl as the subject for this psychobiography through purposive sampling. The aim of the study was to provide a psychological exploration and description of Frankl’s life against the backdrop of his socio-cultural context. In order to achieve this aim, the researcher employed two psychological frameworks to guide in the description and exploration of his life. The psychological frameworks included Levinson’s life structure theory of adult development and Frankl’s existential theory. The study aimed to describe Frankl’s development with the use of Levinson’s theory while describing how he attained meaning in his life with the use of his own existential theory. Due to the exploratory-descriptive nature of this study, the objective fell within the inductive research approach. The researcher utilised a systematic coding method to arrange the data. The theoretical framework of Levinson’s life structure theory guided the coding system, as well as the key concepts of Frankl’s existential theory. In addition, the researcher utilised Alexander’s guidelines for the extraction of salient data, together with McAdam’s methods and recommendations for managing the data. Lastly, the researcher followed the 12-step method of conducting a psychobiography, as proposed by Du Plessis. Findings from this study found a correlation between Frankl’s life and the eras and transitional periods as theorised by Levinson’s theory. The findings of this study, therefore, support the use of Levinson’s theory with regards to the time frames and its use in understanding Frankl’s development. Also, the researcher found that Levinson’s theory was useful in understanding Frankl’s personality development within his context throughout his lifespan. With regards to Frankl’s existential theory, the researcher found that the use of the theory was suitable in understanding Frankl’s search for meaning. Frankl’s concepts of freedom of will, will to meaning, meaning of life, existential vacuum, supra-meaning, dimensional ontology, the three triads and noö-dynamics assisted in explaining Frankl’s drive to find meaning in his life, take responsibility to attain such meaning and to strive for transcendence beyond his suffering. The researcher found Frankl’s theory useful in explaining his drive, motives, needs and patterns of behaviour within this context. The holistic and integrative approach of the study allowed for an in-depth exploration and description of Frankl’s life and development within his socio-historical context. In addition to contributing to the existing body of knowledge on Frankl, his life and his theory, the study also contributed to the growing field of psychobiographical research. The study acknowledged and highlighted that further in-depth examination of the lives of extraordinary personalities could significantly contribute to psychobiographical studies. Based on the psychological frameworks used to explore and describe Frankl’s life, recommendations are made for future research.
- Full Text:
- Date Issued: 2020
A strategy to enhance the role of the church as a social service delivery agent in fighting poverty in contemporary South Africa
- Lujabe, Busisiwe Tando Tabiso
- Authors: Lujabe, Busisiwe Tando Tabiso
- Date: 2018
- Subjects: Community-based social services Community development
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: http://hdl.handle.net/10948/17876 , vital:28477
- Description: The possible role and involvement of the Church in social development has reemerged as an important focus of contemporary academic and religious development discourse in South Africa. There are strong voices arguing for churches and other Faith-Based Organisations to be regarded as strategic in contributing to addressing the challenge of poverty as agents of social development. Yet, as church congregations multiply throughout South Africa, they appear to be less responsive to the challenge of poverty facing South African communities, contrary to the rich history of churches in the past. The need for churches to be involved in sustainable community-driven development initiatives to fight poverty in their local communities cannot be denied nor be met with just rhetoric and scholarly dissertations by theologians and academics. The vicious cycle of poverty in our communities must be eradicated as it represents a social injustice in terms of South Africa‘s Constitution and speaks to deep structural inequalities inherent in our society. Whilst researchers have made several proposals for churches to move from social welfare and relief, there appears to be little research with a clear practical strategy which congregations can implement to enhance their social service delivery role from social relief to sustainable community development. This has left a considerable gap which the current research sought to address. This study thus responds to the call by previous research for churches to implement strategies other than mere relief. Hence, this study contributes to the religious development discourse in South Africa, by developing a strategy to enhance Church-based social service delivery initiatives from social relief efforts which are not sustainable, to community development efforts which are sustainable and which will be consistent with the current social development policy context and contextually relevant to the socio-economic challenges of poverty and its consequences in South Africa. The study was conducted in two phases. During phase one, the main purpose was to gain a deeper understanding of the historical and current involvement of the Church in providing social services which address poverty in communities, to enhance understanding of the factors which influence the provision of social services by churches, as well as to understand participants views of how church-based social service delivery can be improved in order to fight poverty. For phase two, the goal was to develop a strategy to enhance church-based social service delivery from being social relief to being community development oriented. The following objectives guided the research process: To review selected and applicable literature to gain a deeper understanding of the historical and current involvement of the Church in the delivery of social services in order to fight poverty; To explore and describe the perceptions of church leaders and congregation members of the historical and current involvement of the Church in the delivery of social services in order to fight poverty; To explore and describe the factors which influence Church-based social service delivery in fighting poverty; To explore the views of church leaders and congregation members on how church-based social service delivery can be improved in their churches to inform the development of a strategy to enhance church-based social service delivery in fighting poverty. This study employed a qualitative research approach grounded in the interpretivist social science paradigm. The qualitative research approach necessitated an exploratory, descriptive and contextual method of inquiry. A descriptive case study method was also used, with the Methodist Church of Southern Africa selected as the main case of focus. The target population in this research comprised of Christian churches with a historical involvement in social service delivery in pre-apartheid South Africa. Purposeful sampling of 5 churches was undertaken, namely; Roman Catholic Church (RCC), Anglican Church (AC), Dutch Reformed Church (DRC), KwaSizabantu Mission (KSB) and Methodist Church of Southern Africa (MCSA). Data collection was conducted in two phases. Phase one comprised a literature review; Phase two comprised gathering empirical evidence by conducting face to face semi-structured interviews with clergy and from conducting one focus group interview with congregants. The information obtained from participants was transcribed, coded and analysed using content analysis and by a computer-assisted qualitative data analysis software (CAQDAS), namely ATLAS.ti. Findings revealed a marked difference between the historical and current churchbased social service delivery suggestive of decline, accompanied by the lack of empowerment opportunities for current church leaders and congregation members in community development facilitation. Further evidence suggest the lack of cooperation between church leaders and congregation members; as well as the lack of sustainability of interventions owing to an absence of resources and the lack of capacity to create sustainable economic opportunities. Findings also revealed that church congregations are rich with people with various assets - skills, strengths, capabilities, passions, gifts, talents in various fields, which they can share with one another as congregations and communities. The discussion of findings reflected that historically, Church-based social service provision involved holistic intervention mechanisms, empowerment, collaborations and sustainability of interventions suggestive of second generation strategies of community development, while currently, Church-based social service provision involves mostly social relief and social welfare efforts suggestive of first generation strategies. The findings suggest a holistic strategy for ―reawakening the co-operativeness‖ of congregations to facilitate sustainable Church-based social service delivery towards fighting poverty in local communities. The strategy which was then developed and described with its sub-strategies, namely: Establishment of collaborative relationships Creation of empowerment opportunities Facilitation of holistic interventions The goal of the strategy is to guide church leaders and congregation members in facilitating sustainable Church-based social service programmes to fight poverty.
- Full Text:
- Date Issued: 2018
- Authors: Lujabe, Busisiwe Tando Tabiso
- Date: 2018
- Subjects: Community-based social services Community development
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: http://hdl.handle.net/10948/17876 , vital:28477
- Description: The possible role and involvement of the Church in social development has reemerged as an important focus of contemporary academic and religious development discourse in South Africa. There are strong voices arguing for churches and other Faith-Based Organisations to be regarded as strategic in contributing to addressing the challenge of poverty as agents of social development. Yet, as church congregations multiply throughout South Africa, they appear to be less responsive to the challenge of poverty facing South African communities, contrary to the rich history of churches in the past. The need for churches to be involved in sustainable community-driven development initiatives to fight poverty in their local communities cannot be denied nor be met with just rhetoric and scholarly dissertations by theologians and academics. The vicious cycle of poverty in our communities must be eradicated as it represents a social injustice in terms of South Africa‘s Constitution and speaks to deep structural inequalities inherent in our society. Whilst researchers have made several proposals for churches to move from social welfare and relief, there appears to be little research with a clear practical strategy which congregations can implement to enhance their social service delivery role from social relief to sustainable community development. This has left a considerable gap which the current research sought to address. This study thus responds to the call by previous research for churches to implement strategies other than mere relief. Hence, this study contributes to the religious development discourse in South Africa, by developing a strategy to enhance Church-based social service delivery initiatives from social relief efforts which are not sustainable, to community development efforts which are sustainable and which will be consistent with the current social development policy context and contextually relevant to the socio-economic challenges of poverty and its consequences in South Africa. The study was conducted in two phases. During phase one, the main purpose was to gain a deeper understanding of the historical and current involvement of the Church in providing social services which address poverty in communities, to enhance understanding of the factors which influence the provision of social services by churches, as well as to understand participants views of how church-based social service delivery can be improved in order to fight poverty. For phase two, the goal was to develop a strategy to enhance church-based social service delivery from being social relief to being community development oriented. The following objectives guided the research process: To review selected and applicable literature to gain a deeper understanding of the historical and current involvement of the Church in the delivery of social services in order to fight poverty; To explore and describe the perceptions of church leaders and congregation members of the historical and current involvement of the Church in the delivery of social services in order to fight poverty; To explore and describe the factors which influence Church-based social service delivery in fighting poverty; To explore the views of church leaders and congregation members on how church-based social service delivery can be improved in their churches to inform the development of a strategy to enhance church-based social service delivery in fighting poverty. This study employed a qualitative research approach grounded in the interpretivist social science paradigm. The qualitative research approach necessitated an exploratory, descriptive and contextual method of inquiry. A descriptive case study method was also used, with the Methodist Church of Southern Africa selected as the main case of focus. The target population in this research comprised of Christian churches with a historical involvement in social service delivery in pre-apartheid South Africa. Purposeful sampling of 5 churches was undertaken, namely; Roman Catholic Church (RCC), Anglican Church (AC), Dutch Reformed Church (DRC), KwaSizabantu Mission (KSB) and Methodist Church of Southern Africa (MCSA). Data collection was conducted in two phases. Phase one comprised a literature review; Phase two comprised gathering empirical evidence by conducting face to face semi-structured interviews with clergy and from conducting one focus group interview with congregants. The information obtained from participants was transcribed, coded and analysed using content analysis and by a computer-assisted qualitative data analysis software (CAQDAS), namely ATLAS.ti. Findings revealed a marked difference between the historical and current churchbased social service delivery suggestive of decline, accompanied by the lack of empowerment opportunities for current church leaders and congregation members in community development facilitation. Further evidence suggest the lack of cooperation between church leaders and congregation members; as well as the lack of sustainability of interventions owing to an absence of resources and the lack of capacity to create sustainable economic opportunities. Findings also revealed that church congregations are rich with people with various assets - skills, strengths, capabilities, passions, gifts, talents in various fields, which they can share with one another as congregations and communities. The discussion of findings reflected that historically, Church-based social service provision involved holistic intervention mechanisms, empowerment, collaborations and sustainability of interventions suggestive of second generation strategies of community development, while currently, Church-based social service provision involves mostly social relief and social welfare efforts suggestive of first generation strategies. The findings suggest a holistic strategy for ―reawakening the co-operativeness‖ of congregations to facilitate sustainable Church-based social service delivery towards fighting poverty in local communities. The strategy which was then developed and described with its sub-strategies, namely: Establishment of collaborative relationships Creation of empowerment opportunities Facilitation of holistic interventions The goal of the strategy is to guide church leaders and congregation members in facilitating sustainable Church-based social service programmes to fight poverty.
- Full Text:
- Date Issued: 2018
A strategy to facilitate renewed resilience to re-establish meaning for persons with spinal cord injuries
- Authors: Willemse, Hermanus Barend
- Date: 2013
- Subjects: Spinal cord -- Wounds and injuries , Spinal cord -- Wounds and injuries -- Rehabilitation
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: vital:10021 , http://hdl.handle.net/10948/d1008119 , Spinal cord -- Wounds and injuries , Spinal cord -- Wounds and injuries -- Rehabilitation
- Description: Census estimates in 2010 indicated that 6,3 percent South Africans aged 5 years and older are currently classified as disabled in five of the nine provinces in the country. The national figure for 2005 was 5 percent, with the figure for females (6,5 percent) slightly higher than that for males (6,1percent). Spinal cord injured persons and their significant others experience a range of emotions which affect their relationships with themselves, others and their environment. To deal with the life-changing consequences of the injury and regain control, these persons not only require a variety of coping strategies but rediscovery of resilience is inevitable if the experience of personal purpose and meaningful existence is ever to be regained. In the Nelson Mandela Bay Municipal area, Port Elizabeth, South Africa – the geographical area in which this research study was undertaken - persons with spinal cord injuries have many challenges to face due to the shortcomings the existing resource for health care delivery in the post-discharge phase. The research objectives identified for the study were, firstly, to explore and describe the lived experiences of persons with spinal cord injuries; secondly, to explore and describe the lived experiences of the significant others of persons with spinal cord injuries; and thirdly, to develop a strategy to guide the professional nurse and the health care team in facilitating the health care of persons with spinal cord injuries. The study was a qualitative, exploratory, descriptive, and contextual method of inquiry. The data obtained was used to formulate the strategy with its three sub-strategies to guide professional nurses and the health care team to facilitate renewed resilience and the re-establishment of meaning for persons with spinal cord injuries. Although the experiences of the significant others were explored in order to thicken the description of the experiences of persons with spinal cord injuries, the strategy developed was limited to the persons with spinal cord injuries. Although it is well documented that there are significant physical needs, the themes that emerged from the current research mostly related to psychological and social aspects. In acknowledging the human being as unitary multi-dimensional being, the researcher in his discussions and quest to address the issue of renewed resilience in spinal cord injured persons towards finding purpose and re-establishing meaning in their lives, focused on their psychological, spiritual and social health. The outcome of the study is a strategy constructed to facilitate renewed resilience, and three sub-strategies ‘addressing experienced emotions’, ‘facilitating meaningful relationships’ and ‘facilitating effective coping’. The strategy has as purpose the empowering of spinal injured persons in their efforts to re-establish meaning by serving as a tool to guide professional nurses and members of the health care team in their facilitating of renewed resilience in persons with spinal cord injury. It is envisaged that the co-ordination of the strategy will take place from the health care delivery facility nearest to the spinal cord injured individual concerned. In order for persons with spinal cord injuries to become accountable members of society, all levels and aspects of care aimed at physical, psychological, spiritual and social well-being need to be holistically addressed. The front-line role of the professional nurse is vital as the professional nurse acts as the co-ordinator for the health care team in ensuring that persons with spinal cord injuries receive quality and holistic care in order to deal meaningfully with the life-altering consequences of a spinal cord injury. Through this study, valuable insight was gained with regard to experiences of both persons with spinal cord injuries and that of their significant others. Recommendations were made for nursing practice, nursing education and nursing research.
- Full Text:
- Date Issued: 2013
- Authors: Willemse, Hermanus Barend
- Date: 2013
- Subjects: Spinal cord -- Wounds and injuries , Spinal cord -- Wounds and injuries -- Rehabilitation
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: vital:10021 , http://hdl.handle.net/10948/d1008119 , Spinal cord -- Wounds and injuries , Spinal cord -- Wounds and injuries -- Rehabilitation
- Description: Census estimates in 2010 indicated that 6,3 percent South Africans aged 5 years and older are currently classified as disabled in five of the nine provinces in the country. The national figure for 2005 was 5 percent, with the figure for females (6,5 percent) slightly higher than that for males (6,1percent). Spinal cord injured persons and their significant others experience a range of emotions which affect their relationships with themselves, others and their environment. To deal with the life-changing consequences of the injury and regain control, these persons not only require a variety of coping strategies but rediscovery of resilience is inevitable if the experience of personal purpose and meaningful existence is ever to be regained. In the Nelson Mandela Bay Municipal area, Port Elizabeth, South Africa – the geographical area in which this research study was undertaken - persons with spinal cord injuries have many challenges to face due to the shortcomings the existing resource for health care delivery in the post-discharge phase. The research objectives identified for the study were, firstly, to explore and describe the lived experiences of persons with spinal cord injuries; secondly, to explore and describe the lived experiences of the significant others of persons with spinal cord injuries; and thirdly, to develop a strategy to guide the professional nurse and the health care team in facilitating the health care of persons with spinal cord injuries. The study was a qualitative, exploratory, descriptive, and contextual method of inquiry. The data obtained was used to formulate the strategy with its three sub-strategies to guide professional nurses and the health care team to facilitate renewed resilience and the re-establishment of meaning for persons with spinal cord injuries. Although the experiences of the significant others were explored in order to thicken the description of the experiences of persons with spinal cord injuries, the strategy developed was limited to the persons with spinal cord injuries. Although it is well documented that there are significant physical needs, the themes that emerged from the current research mostly related to psychological and social aspects. In acknowledging the human being as unitary multi-dimensional being, the researcher in his discussions and quest to address the issue of renewed resilience in spinal cord injured persons towards finding purpose and re-establishing meaning in their lives, focused on their psychological, spiritual and social health. The outcome of the study is a strategy constructed to facilitate renewed resilience, and three sub-strategies ‘addressing experienced emotions’, ‘facilitating meaningful relationships’ and ‘facilitating effective coping’. The strategy has as purpose the empowering of spinal injured persons in their efforts to re-establish meaning by serving as a tool to guide professional nurses and members of the health care team in their facilitating of renewed resilience in persons with spinal cord injury. It is envisaged that the co-ordination of the strategy will take place from the health care delivery facility nearest to the spinal cord injured individual concerned. In order for persons with spinal cord injuries to become accountable members of society, all levels and aspects of care aimed at physical, psychological, spiritual and social well-being need to be holistically addressed. The front-line role of the professional nurse is vital as the professional nurse acts as the co-ordinator for the health care team in ensuring that persons with spinal cord injuries receive quality and holistic care in order to deal meaningfully with the life-altering consequences of a spinal cord injury. Through this study, valuable insight was gained with regard to experiences of both persons with spinal cord injuries and that of their significant others. Recommendations were made for nursing practice, nursing education and nursing research.
- Full Text:
- Date Issued: 2013
An assessment of school food and nutrition environments for strengthening the integrated school health policy in the Eastern Cape, South Africa
- Authors: Okeyo, Alice Phelgona
- Date: 2019
- Subjects: Nutrition policy -- South Africa -- Eastern Cape School health services -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: http://hdl.handle.net/10353/17039 , vital:40836
- Description: The 2012 Integrated School Health Policy (ISHP) offers a framework for adequate school food environment. It aims to contribute to the improvement of the general health of school-going children and to address health barriers to learning in order to improve education outcomes. This study assessed the school food and nutrition environment and critically appraised the position of nutrition within ISHP in order to make recommendations for best practice and promotion of healthy-eating in quintiles 1 – 3 secondary school learners of the Eastern Cape, South Africa. Areas evaluated included the school food environment (National School Food Nutrition Programme, NSNP, tuck-shop, vendor, lunch box, and school vegetable garden); eating practice; nutrition knowledge; and nutrition status. A quantitative and qualitative cross-sectional design was applied in data collection. Data was collected from 1,357 learners at 18 secondary schools in three districts: Buffalo City Metropolitan Municipality, Chris Hani and OR Tambo, using semi-structured questionnaires. Five major food items provided in the school food and nutrition environment included: beans, pap, sour-milk, rice, and samp (maize) (NSNP); chips, sandwich, pap, biscuits, and cake (tuck-shop); chips, sandwich, pap, cake, and pop-corn (vendor); and samp (maize), noodles, fat-cake, chips, and Russian/Viennas (lunch boxes). Only three of the 16 schools had school vegetable gardens which produced vegetables and no fruits. Five most frequently eaten foods for breakfast were porridge, rusks, stiff-pap, bread-with-spread, eggs, and polony. Learners from quintile 3 (60.8percent) significantly ate more cooked porridge than learners from quintiles 1 and 2 (51.9percent) (p = 0.015). Leaners from quintile 3 (59.4percent) significantly ate more brown bread-with-spread than learners from quintiles 1 and 2 (50.4) (p = 0.022). The majority of learners (72.7percent) ate breakfast; more male learners (24.4percent) than female learners (29.1percent) skipped breakfast. The majority (62.2percent) of learners had poor nutritional knowledge; significantly, more male (35percent) than female (27percent) learners had poor nutritional knowledge (p = 0.003). Nutritional knowledge increased with age; significantly more grade 8 learners had poor (42.6percent) nutritional knowledge than grade 12 learners (14.1percent) (p < 0.001). Leaners from quintile 3 had good (23.5percent) nutritional knowledge than learners from quintiles 1 and 2 (15.7percent) (p < 0.001). School lessons, books and television were the most important source for nutritional information to learners. The most significant source was lessons (72.0percent; p < 0.001); followed by television (69.4percent; p < 0.001) and books (67.8percent; p = 0.014), in that ranking order. The majority of learners (64percent) had normal body weight. The prevalence of underweight, overweight and obesity was 13.0percent, 15.0percent and 8.0percent, respectively. The prevalence of overweight and obesity was higher in females than males (21.3percent vs 5.3percent; overweight; p < 0.001)) and (11.6percent vs 1.2percent; obesity; p < 0.001), respectively; while the prevalence in terms of underweight was significantly higher in male (21.3percent) learners than in female learners (8.1percent); p < 0.001. The study indicated that the school food environment was not supported by ISHP. The Integrated School Health Policy did not include on-site package for nutritional assessment, thus, there is need to offer nutritional interventions in schools.
- Full Text:
- Date Issued: 2019
- Authors: Okeyo, Alice Phelgona
- Date: 2019
- Subjects: Nutrition policy -- South Africa -- Eastern Cape School health services -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: http://hdl.handle.net/10353/17039 , vital:40836
- Description: The 2012 Integrated School Health Policy (ISHP) offers a framework for adequate school food environment. It aims to contribute to the improvement of the general health of school-going children and to address health barriers to learning in order to improve education outcomes. This study assessed the school food and nutrition environment and critically appraised the position of nutrition within ISHP in order to make recommendations for best practice and promotion of healthy-eating in quintiles 1 – 3 secondary school learners of the Eastern Cape, South Africa. Areas evaluated included the school food environment (National School Food Nutrition Programme, NSNP, tuck-shop, vendor, lunch box, and school vegetable garden); eating practice; nutrition knowledge; and nutrition status. A quantitative and qualitative cross-sectional design was applied in data collection. Data was collected from 1,357 learners at 18 secondary schools in three districts: Buffalo City Metropolitan Municipality, Chris Hani and OR Tambo, using semi-structured questionnaires. Five major food items provided in the school food and nutrition environment included: beans, pap, sour-milk, rice, and samp (maize) (NSNP); chips, sandwich, pap, biscuits, and cake (tuck-shop); chips, sandwich, pap, cake, and pop-corn (vendor); and samp (maize), noodles, fat-cake, chips, and Russian/Viennas (lunch boxes). Only three of the 16 schools had school vegetable gardens which produced vegetables and no fruits. Five most frequently eaten foods for breakfast were porridge, rusks, stiff-pap, bread-with-spread, eggs, and polony. Learners from quintile 3 (60.8percent) significantly ate more cooked porridge than learners from quintiles 1 and 2 (51.9percent) (p = 0.015). Leaners from quintile 3 (59.4percent) significantly ate more brown bread-with-spread than learners from quintiles 1 and 2 (50.4) (p = 0.022). The majority of learners (72.7percent) ate breakfast; more male learners (24.4percent) than female learners (29.1percent) skipped breakfast. The majority (62.2percent) of learners had poor nutritional knowledge; significantly, more male (35percent) than female (27percent) learners had poor nutritional knowledge (p = 0.003). Nutritional knowledge increased with age; significantly more grade 8 learners had poor (42.6percent) nutritional knowledge than grade 12 learners (14.1percent) (p < 0.001). Leaners from quintile 3 had good (23.5percent) nutritional knowledge than learners from quintiles 1 and 2 (15.7percent) (p < 0.001). School lessons, books and television were the most important source for nutritional information to learners. The most significant source was lessons (72.0percent; p < 0.001); followed by television (69.4percent; p < 0.001) and books (67.8percent; p = 0.014), in that ranking order. The majority of learners (64percent) had normal body weight. The prevalence of underweight, overweight and obesity was 13.0percent, 15.0percent and 8.0percent, respectively. The prevalence of overweight and obesity was higher in females than males (21.3percent vs 5.3percent; overweight; p < 0.001)) and (11.6percent vs 1.2percent; obesity; p < 0.001), respectively; while the prevalence in terms of underweight was significantly higher in male (21.3percent) learners than in female learners (8.1percent); p < 0.001. The study indicated that the school food environment was not supported by ISHP. The Integrated School Health Policy did not include on-site package for nutritional assessment, thus, there is need to offer nutritional interventions in schools.
- Full Text:
- Date Issued: 2019
An assessment of the motivational value of rewards among health professionals in Malawi's Ministry of Health
- Chanza, Alfred Witness Dzanja
- Authors: Chanza, Alfred Witness Dzanja
- Date: 2012
- Subjects: Employee motivation -- Malawi , Medical personnel -- Salaries, etc. -- Malawi , Medical personnel -- Job satisfaction -- Malawi , Public health -- Malawi
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: vital:9963 , http://hdl.handle.net/10948/d1020330
- Description: The assessment of the motivational value of rewards in the world of work is interesting but difficult to understand. Variations in research reports and inadequate comprehension of the efficiency and motivational value of rewards have brought about confusions, controversies and contradictions among authors, researchers, consultants and practitioners in the field of Industrial and Organisational Psychology (Mangham, 2007; Muula, 2006; Muula & Maseko, 2005; Palmer, 2006; World Bank, 2004). As a consequence, organisations are applying theories and models of motivation selectively depending on their beliefs, ideological framework of values and assumptions (Dzimbiri, 2009). The study was therefore carried out as a positive contribution to the existing knowledge and debate on the motivational value of rewards for health professionals in the public health sectors of the developing countries. Through a systematic sampling method, 571 health professionals were sampled for the study. Data were collected through the use of a self-administered questionnaire which was composed based on the data collected from desk research/literature review, focus group discussions and interviews. The findings of the study revealed that the Malawi‟s Ministry of Health (MoH) is failing to attract, motivate and retain health professionals; there is perception of inequity of the rewards among the health professionals; health professionals develop coping strategies to supplement their monthly financial rewards; health professionals engage in corrupt practices to supplement their monthly financial rewards; and there is erosion of industrial democracy in the Malawi‟s Public Health Sector. While the statistical testing of the hypothesized model proved a lack of fit between the variables, the statistical testing of the re-specified model suggests that there is a positive relationship between financial rewards and reward-related problems being faced by health professionals in the Malawi‟s MoH. Through the Structural Equation Modeling (SEM) exercise, an inverse (negative) relationship between financial and non-financial rewards was deduced, and scientifically and graphically demonstrated. Both the re-specified and graphical models symbolize a pragmatic departure from the theoretical model whose authors (Franco, Bennett, Kanfer & Stubblebine, 2004) are largely inclined to the use of non-financial rewards and suggest that financial rewards should be used with caution. These findings also reject the Herzberg‟s two factor theory (Herzberg, 1960) which claims that financial rewards (salaries) are not a motivator. The major recommendations of the study are that the Franco et al.‟s (2004) model should be adopted and adapted in the Malawi‟s MoH with the view that the value of both financial and non-financial rewards (as motivators) varies from individual to individual due to individual differences and prevailing factors/forces in both the work environment and wider society in which the MoH operates; a hybrid reward system combining the strengths of time-based, performance-based and competence-based reward systems should be developed and implemented; the results of scientifically testing the re-specified model and the inverse (causal) relationship established between financial and non-financial rewards (as demonstrated in a graphic model) should be re-tested with other samples in the public health sectors of the developing countries; and the motivational value of non-financial rewards should be scientifically established and compared with the motivational value of financial rewards used independent of each other in business organisations to make an objective conclusion on the rewards-motivation debate.
- Full Text:
- Date Issued: 2012
- Authors: Chanza, Alfred Witness Dzanja
- Date: 2012
- Subjects: Employee motivation -- Malawi , Medical personnel -- Salaries, etc. -- Malawi , Medical personnel -- Job satisfaction -- Malawi , Public health -- Malawi
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: vital:9963 , http://hdl.handle.net/10948/d1020330
- Description: The assessment of the motivational value of rewards in the world of work is interesting but difficult to understand. Variations in research reports and inadequate comprehension of the efficiency and motivational value of rewards have brought about confusions, controversies and contradictions among authors, researchers, consultants and practitioners in the field of Industrial and Organisational Psychology (Mangham, 2007; Muula, 2006; Muula & Maseko, 2005; Palmer, 2006; World Bank, 2004). As a consequence, organisations are applying theories and models of motivation selectively depending on their beliefs, ideological framework of values and assumptions (Dzimbiri, 2009). The study was therefore carried out as a positive contribution to the existing knowledge and debate on the motivational value of rewards for health professionals in the public health sectors of the developing countries. Through a systematic sampling method, 571 health professionals were sampled for the study. Data were collected through the use of a self-administered questionnaire which was composed based on the data collected from desk research/literature review, focus group discussions and interviews. The findings of the study revealed that the Malawi‟s Ministry of Health (MoH) is failing to attract, motivate and retain health professionals; there is perception of inequity of the rewards among the health professionals; health professionals develop coping strategies to supplement their monthly financial rewards; health professionals engage in corrupt practices to supplement their monthly financial rewards; and there is erosion of industrial democracy in the Malawi‟s Public Health Sector. While the statistical testing of the hypothesized model proved a lack of fit between the variables, the statistical testing of the re-specified model suggests that there is a positive relationship between financial rewards and reward-related problems being faced by health professionals in the Malawi‟s MoH. Through the Structural Equation Modeling (SEM) exercise, an inverse (negative) relationship between financial and non-financial rewards was deduced, and scientifically and graphically demonstrated. Both the re-specified and graphical models symbolize a pragmatic departure from the theoretical model whose authors (Franco, Bennett, Kanfer & Stubblebine, 2004) are largely inclined to the use of non-financial rewards and suggest that financial rewards should be used with caution. These findings also reject the Herzberg‟s two factor theory (Herzberg, 1960) which claims that financial rewards (salaries) are not a motivator. The major recommendations of the study are that the Franco et al.‟s (2004) model should be adopted and adapted in the Malawi‟s MoH with the view that the value of both financial and non-financial rewards (as motivators) varies from individual to individual due to individual differences and prevailing factors/forces in both the work environment and wider society in which the MoH operates; a hybrid reward system combining the strengths of time-based, performance-based and competence-based reward systems should be developed and implemented; the results of scientifically testing the re-specified model and the inverse (causal) relationship established between financial and non-financial rewards (as demonstrated in a graphic model) should be re-tested with other samples in the public health sectors of the developing countries; and the motivational value of non-financial rewards should be scientifically established and compared with the motivational value of financial rewards used independent of each other in business organisations to make an objective conclusion on the rewards-motivation debate.
- Full Text:
- Date Issued: 2012
An exploration of HIV and aids disclosure among HIV-serodiscordant married couples in the Eastern Cape Province, South Africa
- Authors: Ndlela, Joshua Bongani
- Date: 2019
- Subjects: HIV infections -- Psychological aspects -- South Africa -- Eastern Cape , Stigma (Social psychology) , AIDS (Disease) -- Psychological aspects , HIV-positive persons -- Mental health , Disclosure of information , AIDS (Disease) -- Patients -- Family relationships
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: http://hdl.handle.net/10948/41774 , vital:36580
- Description: Sub-Saharan Africa has the highest prevalence and incidence of HIV infection worldwide, mostly attributed to heterosexual transmission. Transmission in HIV-serodiscordant couples who have received joint voluntary counselling and testing ranges from 3% to 7% per year and only about 20% know that they are living in a discordant relationship. Disclosure is seen as a cornerstone for the prevention of HIV transmission between in HIV-serodiscordant married partners. It is argued that numbers of HIV-serodiscordant couples are most likely increasing; however, limited or no support is given to these couples as most because counselling interventions in South Africa do not provide for married heterosexual HIV-serodiscordant couples. The aim of the study was to identify the impact of disclosure of HIV and AIDS status on partners in HIV-serodiscordant married relationships. The second aim was to synthesize the findings to guide the development of contextualized counselling guidelines for married couples in HIV-serodiscordant relationships. Five HIV-serodiscordant married couples and 6 HIV and AIDS counsellors from a variety of settings in Nelson Mandela Bay, participated in this study. In this interpretive qualitative study, non-probability criteria, purposive sampling was used. Both participant groups are isiXhosa-speaking adults between the ages of 21 and 65 years and include both males and females. Qualitative data were gathered by means of audio-recorded semi structured interviews. Thematic analysis was used to analyse the data, while Guba’s guidelines were used to enhance the trustworthiness of the research. Semi-structured interviews with HIV-serodiscordant married couples revealed 5 common themes and were: (a) confused environment of couples in HIV disclosure, (b) inconsistent delivery of healthcare information to HIV-serodiscordant couples, (c) relationship predicaments post disclosure, (d) partner support on sexual intimacy for married couples and (e) reactions of family, children and friends towards the HIV disclosure. The HIV and AIDS counsellors 3 common themes and were: (a) basic HIV and AIDS counselling skills, (b) organisational resources support of HIV counsellors and (c) suggestions to support HIV counsellors.. This study supports the view that further research be done in other related areas (gay, lesbians, bi-sexual relationships) and demystify this unknown or misunderstood notion needs to take place at a larger scale and probably incorporate quantitative surveys to supplement the current qualitative research. Implications for practise and avenues for research are considered in this study.
- Full Text:
- Date Issued: 2019
- Authors: Ndlela, Joshua Bongani
- Date: 2019
- Subjects: HIV infections -- Psychological aspects -- South Africa -- Eastern Cape , Stigma (Social psychology) , AIDS (Disease) -- Psychological aspects , HIV-positive persons -- Mental health , Disclosure of information , AIDS (Disease) -- Patients -- Family relationships
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: http://hdl.handle.net/10948/41774 , vital:36580
- Description: Sub-Saharan Africa has the highest prevalence and incidence of HIV infection worldwide, mostly attributed to heterosexual transmission. Transmission in HIV-serodiscordant couples who have received joint voluntary counselling and testing ranges from 3% to 7% per year and only about 20% know that they are living in a discordant relationship. Disclosure is seen as a cornerstone for the prevention of HIV transmission between in HIV-serodiscordant married partners. It is argued that numbers of HIV-serodiscordant couples are most likely increasing; however, limited or no support is given to these couples as most because counselling interventions in South Africa do not provide for married heterosexual HIV-serodiscordant couples. The aim of the study was to identify the impact of disclosure of HIV and AIDS status on partners in HIV-serodiscordant married relationships. The second aim was to synthesize the findings to guide the development of contextualized counselling guidelines for married couples in HIV-serodiscordant relationships. Five HIV-serodiscordant married couples and 6 HIV and AIDS counsellors from a variety of settings in Nelson Mandela Bay, participated in this study. In this interpretive qualitative study, non-probability criteria, purposive sampling was used. Both participant groups are isiXhosa-speaking adults between the ages of 21 and 65 years and include both males and females. Qualitative data were gathered by means of audio-recorded semi structured interviews. Thematic analysis was used to analyse the data, while Guba’s guidelines were used to enhance the trustworthiness of the research. Semi-structured interviews with HIV-serodiscordant married couples revealed 5 common themes and were: (a) confused environment of couples in HIV disclosure, (b) inconsistent delivery of healthcare information to HIV-serodiscordant couples, (c) relationship predicaments post disclosure, (d) partner support on sexual intimacy for married couples and (e) reactions of family, children and friends towards the HIV disclosure. The HIV and AIDS counsellors 3 common themes and were: (a) basic HIV and AIDS counselling skills, (b) organisational resources support of HIV counsellors and (c) suggestions to support HIV counsellors.. This study supports the view that further research be done in other related areas (gay, lesbians, bi-sexual relationships) and demystify this unknown or misunderstood notion needs to take place at a larger scale and probably incorporate quantitative surveys to supplement the current qualitative research. Implications for practise and avenues for research are considered in this study.
- Full Text:
- Date Issued: 2019