Dissertations / Theses on the topic 'Nurses – Social aspects'

Many researchers believe that nurses live in a dual structure, encompassing both the social and nursing worlds. They contend that these two worlds have contrasting views toward nurses. This is, while nurses are guided to establish professional status, society still expects them to remain in a dependent role. This conflict is assumed to have a negative impact on nurses’ psychological and functional states (Kalisch & Kalisch, 1983 & 1987). However, this assumption has not yet been explored sufficiently. The aim of this descriptive correlational study was therefore to investigate the relationships among the public image of nurses, nurses’ self concept, personal and collective self-esteem, job satisfaction, and performance. A total of eighty registered nursing students were invited to participate in this study by completing seven types of questionnaires (see Appendix C). The data were analysed by Pearson correlation and One-Way Analysis of Variance. The results of this study supported contention of the contemporary nursing scholars that the stereotypical public image of nurses could negatively affect nurses’ self-concept, self-esteem, job satisfaction and performance. The results, however, also demonstrated that the professional socialisation and cultivation of nurses’ personal self-esteem would help to buffer the negative effects of the public stereotypes on nursing practice. Based on these findings, this study suggests countermeasures to deal with the negative impacts of the public stereotypes. These strategies include public education, monitoring the media, changing nurses’ attitudes, encouraging professional socialisation, empowering nurses, and boosting nurses’ self-esteem. This study is expected to help nurses overcome the potential effects of the public stereotypes. The results of the study are also dedicated to nurses who have endeavoured to facilitate the process of professionalization in nursing.

Abortion is a highly controversial subject that has again come into the spotlight in South Africa due to the legalisation of abortion on demand in 1996. The results of various studies conducted since the Choice on Termination of Pregnancy Act 92 of 1996 was implemented, have indicated that abortion providers have met with a great deal of negativism and ostracism. This study focused on the implications of abortion work on nurses' social relationships with family, friends, colleagues and their communities. Recent literature was reviewed on the subject. The researcher however, found little information on this specific aspect of abortion. The study was conducted with abortion nurses from two government designated hospitals in the East London area responsible for abortion services. Thus, results cannot be generalised. This is a qualitative study that aimed at obtaining firsthand information regarding the personal experiences of abortion nurses. A non-probability sampling technique was used viz. criterion sampling. The Interview Guide Approach was used whereby in-depth, semi-structured interviewed were conducted with the guidance of a set of questions in the form of an Interview Schedule. The ten respondents were asked to share their recommendations as to possible measures that could address the challenges mentioned during their interviews. The researcher came to the conclusion that nurses' social relationships and lives are definitely impacted by abortion work. This impact is largely negative as the majority of respondents experience labelling, stigmatization and ostracism from family, friends, and their colleagues. Abortion nurses also experience a lack of social support, ambivalent feelings with regard to abortion, and a range of negative emotions ranging from stress and depression to frustration and anger. A number of repeat abortions are being done and there seems to be a general lack of contraception. The need exists for nurses to go to Value Clarification Workshops and also to get support in terms of compulsory, continuous, counselling. Separate wards should be set up for abortions whilst sex education should be included in school curriculums at both primary and secondary schools. Family planning and facts about the abortion process should also be included in these sex education programmes. Overall. the need exists for family planning initiatives to promote contraception and deter women from using abortion as a means of contraception. As this study reveals, conducting abortions has come at a great cost for the majority of nurses who lack social support and bear the brunt of anti-abortion sentiment expressed by significant others in their lives. The latter being the people who would normally be the one's they would turn to for help, counsel, support and assistance

The purpose of the research was to describe the relationships between social support and role strain and preventative health behaviors. The sample consisted of 62 critical care nurses employed in three southwest acute care facilities. Subjects completed instruments measuring social support, role strain, and four preventative health care behaviors. Pearson correlations revealed significant positive relationships between social support and personal/household roles women perform and ways women handle stress. Additional significant negative relationships existed between marital/relationship roles women perform and leisure physical activities, a subset of preventative health behaviors. The parental roles, obligations, and responsibilities women perform were also significantly related with leisure physical activities. Conclusions drawn indicate that the critical care nurses did not perceive themselves susceptible to cardiovascular disease and therefore did not participate in preventative health care activities, regardless of perceived helpful social support and an absence of role strain.

Psychosocial support is said to be an inherent component of nursing care and a major focus of palliative care. Literature exists which outlines perceptions of the psychosocial needs of patients and how psychosocial support should be provided. However, there is a lack of empirical evidence on how psychosocial support is operationalised in practice. This study provides a valuable and substantial new contribution to the evidence on the psychosocial needs expressed by patients in a hospice ward and how nurses immediately respond to these needs within their everyday practice. A study gathering data via observations with matched interviews of patients and nurses, organisational, documentary, and demographic variables, was conducted over an eight month period. Thirty-eight nurses (registered and auxiliary) and 47 patients were included in a maximum variation sampling strategy. Data was analysed using constant comparative qualitative techniques. Patients expressed a wide variety of psychosocial needs, often only signalling them whilst receiving care for other reasons. Considering these needs in relation to Maslow’s (1943) hierarchy of needs suggests that in-patients more commonly express prerequisites to physiological care and ‘lower level’ safety needs rather than the more thoroughly researched and espoused ‘higher’ level psychosocial needs. The nurses reacted to these psychosocial needs with a range of responses which indicated a diminishing level of immediate support: ‘dealing’, ‘deferring’, ‘diverting’ and ‘ducking’. The majority of the nurses were observed using each of these responses at some point during data collection. A variety of the responses were used for each type and context of psychosocial need. These responses were influenced by the ward’s workplace culture. This study demonstrates a requirement for more thorough consideration of the true psychosocial needs of patients, which appear to vary dependent on the context of care. Consideration should be v given to workplace culture and its influence over psychosocial support, with nurses being supported to expand their response repertoire so that patients’ psychosocial needs are acknowledged more. Increasing nurses’ knowledge of the reality of psychosocial support through education and research will encourage formalisation of the place of psychosocial support in the planning, documentation and provision of care. This study shows that ward nurses can offer psychosocial support as an inherent component of their everyday work. Findings derived from this research indicate that developing an understanding of how patients express psychosocial needs in practice, through a consideration of Maslow’s (1943) hierarchy of needs, may increase recognition and support of psychosocial needs and enable nurses to respond more comprehensively.

The focus of this study was to investigate work-family conflict, social support and gender ideologies of professional/registered nurses in the South African context, specifically within the Cacadu District (Eastern Cape). The study had four aims: (a) to investigate the construct validity of the measuring instrument, (b) to investigate the relationship between social support provided by family and family interference with work (FIW), (c) to ascertain the influence of shift work on perceived work-family conflict, and lastly, (d) to determine whether there is a difference between the number of children in households and nurses’ perceptions of work-family conflict. A quantitative research design was used in the study. The sample (N = 106) was taken from five district hospitals in the Cacadu District, Eastern Cape. The measuring instrument consisted of three scales, namely the Multi-dimensional Work-Family Conflict Scale (Carlson, Kacmar, & Williams, 2000), the Social Support Questionnaire (Sarason, Sarason, Shearin, & Pierce, 1987), and an adapted Gender Ideology Scale (Tsai, 2008). The results indicated that the construct validity of the Multi-dimensional Work-Family Conflict scale was satisfactory. However, analysis of the Social Support Questionnaire and Gender Ideology scales both suggested that these scales have not been validated for use with diverse samples outside the contexts in which they were developed. The results also indicated that there is a relationship between social support provided by families and behaviour-based family interference with work. Additionally, there appeared to be a difference between the shifts worked by nurses and their perceived work-family conflict, except for strain-based work interference with family. And lastly, the only significant difference between the number of children in the household and work-family conflict was reported for strain-based work interference with family. The implications of the results for future research suggest the importance of developing and validating work-family conflict, social support and gender ideology scales that are dependent on the context of the research. In so doing, the constructs of the scale are made meaningful. Additionally, the findings provide preliminary evidence of tailoring work-family initiatives that address the needs of the nursing profession and the context of healthcare institutions

Introduction The clinical community in Western society has long practised medicine as organized by "two dominant principles: 1) the principle of essentialism which states that there is a fixed "natural" border between disease and health, and 2) the principle of specific treatment which states that having revealed a disease, the doctor can, at least in principle, find the one, correct treatment. These principles have served as the legitimization of the traditional, hierarchical organization of health-care" (Jensen, 1987:19). A main feature of medical practices based on these principles has been to address specific kinds of problems impeding or decaying health. This research is centrally concerned with essentialism and the institutional fixation of problems as two important nodal points of Canada's biomedical value and belief system. More specifically, I hope to show in an organized way how these principles shape staff knowledge of client and culture in a community health centre (CHC) in Lethbridge, Alberta. My analysis is based on four guiding points: 1) that in our polyethnic society health care institutions are massively challenged with actual and perceived cultural diversity and cross cultural barriers to which their staff feel increasingly obliged to respond with their services; 2) while the client cultural diversity is "real", institutional responses depend primarily on how that diversity is imagined by staff -often as a threat to a health institution's sociocultural world; 3) that problem-specific, medicalized thinking is central in this community health centre, even though its mandate is health promotion and this problem orientation often combines with medical essentialism to reduce "culturally different" to a set of client labels, some of which are problematic; and 4) while a "lifestyle model" and other models for health promotion are at present widely advocated and are to be found centrally in this institution's (CHC) charter, they have led to little institutional accomodation to cultural diversity. In this thesis my aim is to present an ethnographic portrait of a community health centre, where emphasis is given to the distinctive formal and informal "formative processess" (Good 1994) of social construction of certain perceived common core challenges facing the Canadian biomedical community today - challenges concerning cultural difference and its incorporation into health care perception and practice. I am particularly interested in institutions subscribing to a "health promotion model" of health care, a term I have borrowed from Ewles and Simnett (1992). Ewles and Simnett descrive the meaning of "health promotion" as earlier defined by WHO (World Health Organization): this perspective is derived from a conception of "health" as the extent to which an individual or group is able, on the on hand, to realise aspirations and satisfy needs; and, on the other hand, to change or cope with the environment. Health is, therefore seen as a resource for everyday life, not the objective of living; it is a positive concept emphasising social and personal resources, as well as physical capacities (Ewles & Simnett, 1992:20) Health is therefore concerned with "a state of complete physical, mental and social wellbeing, and not merely the absence of disease and infirmity" (Ewles and Simnett, 1992:6), I am interested in determing how threats to this defintion prevail in a community health centre's ideology of preventive care, and how that ideology encodes dimensions of diversity. I, however, want to go much further than this by exploring everyday staff discourse and practice, to understand how client cultural diversity is formed and informed by what staff do and say. How, in short, do individuals based in a health promotion organization socially construct their clients as objects of institutional concern? We need, as Young (1982) suggest, "to examine the social condition of knowledge production" in an institutionalized health care service provision subculture. There are, I believe, also practical reasons for conducting this research. Over the past ten years the Canadian health care system increasingly has had to focus on two potentially contradictory goals: reducing costs, and lessening persistent inequalities in health status among key groups and categories of persons in the Canadian population. Many now argue that one of the most central dimensions of the latter - of perisistent health inequalities in Canada - is ethnocultural. Few would seriously argue, for example, that Canadian First Nation health statistics are anything but appalling. Moreover, radical changes in immigration patterns over the past three decades have greatly increased urban Canadian cultural diversity. Caring "at home" now assumes international dimensions (McAdoo, 1993; Butrin, 1992; Buchignani, 1991; Indra, 1991, 1987; Galanti, 1991; Dobson, 1991; Waxler-Morrison, 1990; Quereshi, 1989). A growing voiced desire to provide more pluralistic health care and health care promotion has become persistently heard throughout the clinical community in Canada (Krepps and Kunimoto, 1994; Masi, 1993). Even so, for many health professionals cultural difference evidently remians either irrelevant or a threat to the established order of things. Applied research on health care institutions undertaken to investigate how better to meet these challenges nevrtheless remains very incomplete and highly concentrated in two broad areas. One of these is structural factors within the institution that limit cross-cultural access (Herzfeld, 1992; Hanson, 1980). Some of these studies have shown the prevalence of a strictly conservative institutional culture that frequently makes frontline agency workers gate-keeprs, who actively (if unconsciously) maintain client-institution stratification (Ervin, 1993; Demain, 1989; Ng, 1987; Murphy, 1987; Foster-Carter, 1987; de Voe 1981). In addition, extensive research has been conducted on disempowered minority groups. This research has examined the frequency, effectiveness and manner with which ethnic and Native groups make use of medical services. Some institutional research on cross-cultral issues shows that under appropriate conditions health professional like nurses have responded effectively to client needs by establishing culturally sensitive hiring and training policies and by restructuring their health care organizations (Terman, 1993; Henderson, 1992; Davis, 1992; Henkle, 1990; Burner, 1990). Though promising, this research remains radically insufficient for learning purposes. In particular, little work has been done on how such institutions come to "think" (Douglas, 1986) about cultural difference, form mandates in response to pressure to better address culturally different populations and work them into the institution's extant sub-cultral ideas and practice (Habarad, 1987; Leininger, 1978), or on how helping instiutions categorize key populations such as "Indians" or "Vietnamese" as being culturally different, or assign to each a suite of institutionally meaningful cultural attributes (as what becomes the institution's working sense of what is, say, "Vietnamese culture"). This is so despite the existence of a long and fruitful ethnographic institutional research tradition, grounded initially in theories of status and role (Frankel, 1988; Taylor, 1970; Parson, 1951), symbolic ineractionism (Goffman, 1967, 1963, 1961), ethnomethodology (Garfinkle, 1975), and organizational subcultures (Douglas, 1992, 1986, 1982; Abegglen & Stalk, 1985; Ohnuki-Tierney, 1984; Teski, 1981; Blumers, 1969). More recent work on anthropological social exchange theory (Barth, 1981), on institutional and societal discipline (Herzfeld, 1992; Foucault, 1984, 1977), on the institution-client interface (Shield, 1988; Schwartzman, 1987, Ashworth, 1977, 1976, 1975), and on framing the client (Hazan, 1994; Denzin, 1992; Howard, 1991; Goffman, 1974). I also hope that this study makes a contribution to the study of health care and diversity in southern Alberta. Small city ethnic relations in Canada have been almost systematically ignored by researchers, and similar research has not been conducted in this part of Alberta. Local diversity is significant: three very large Indian reserves are nearby, and the city itself has a diverse ethnic, linguistic and ethno-religious population. Also, significant province wide restructuring of health care delivery was and is ongoing, offering both the pitfalls and potentials of quick institutional change. Perhaps some of the findings can contribute to making the future system more responsive to diversity than the present one.
202 p. ; 29 cm.

Social connection is important to one's health and longevity. However, not only do people need others to survive, we need others to thrive. Researchers call for deeper examination of the functions and processes through which our social partners help us to prosper and thrive, such as through increased physical health and well-being. Over three studies, I examined phenomena theorized to contribute to long-term thriving including positive emotions (i.e., gratitude and positive affect fluctuation), responsive support, affectionate touch, and physical health (i.e., sleep) within the context of nursing work (Study 1) and military relationships (Study 2 & 3). Study 1 provides support for the benefits of received gratitude expressions, an understudied component of gratitude interactions. Specifically, nurses receiving more thanks within their work week were associated with feeling more satisfied with their patient care and in turn positive physical health outcomes including higher sleep quality, for example. Thus, not only is feeling grateful important to well-being but receiving thanks from others benefits one's physical health as well. Study 2 extended research describing the impact of the dynamic and fluctuating nature of emotion and physical health to close relationships by examining how positive affect variability (intra-individual standard deviation) and instability (differences between each successive day's mood) promotes or hinders intimacy. The second study found that greater fluctuations in positive affect over time were associated with greater reports of closeness within military couples. Recent research indicates that variability in positive and negative mood contributes to reduced psychological and physical well-being; however, when applied to the study of close relationships, Study 2 suggests that variation in positive mood may instead benefit military couples. Finally, Study 3 investigated the degree to which affectionate touch enhances the interrelationships among negative event support, gratitude, and sleep within Veterans and their partners over time. Results offer limited support; however, one key finding indicates that Veteran daily reports of affectionate touch were associated with increased sleep quality for their spouses. In addition, Veteran reports of affectionate touch strengthened the degree to which spouses' perceived responsive support predicted Veteran grateful mood. Study 3 supports research showing that positive interactions with one's partner, such as physical touch and responsive support, contribute to sleep and positive relationship maintenance emotions, such as gratitude. Taken together, these studies offer support for the integral role our social connections play in thriving, particularly within the contexts of nursing and military relationships.

Theoretical speculation implies Adult Children of Alcoholics (ACOAs) are drawn in disproportionate numbers to caretaking occupations. This study compared the prevalence of ACOAs between nursing and noncaretaking occupations. A cover letter, demographic questionnaire, and Children of Alcoholics Screening Test (CAST) were distributed to a random sample of 196 registered nurses and 184 noncaretaking employees at a large metropolitan hospital. Seventy-nine nursing and 104 noncaretaking occupations respondents completed the questionnaires.Comparison of demographic data for nursing and noncaretaking occupations revealed similar composition regarding age, number of marriages, and race. There were more male, divorced, widowed, and first born respondents in noncaretaking occupations than in nursing.ACOAs were identified in 21.5% of nursing respondents and 19.2% of noncaretaking occupation respondents. Chi-square showed no significant difference between the proportion of ACOAs in nursing and noncaretaking occupations at the .05 level of confidence. Thus, the null hypothesis was not rejected. This study found ACOAs are not drawn in disproportionate numbers to nursing.
School of Nursing

Divorce is a phenomenon that affects the emotional, physical and social wellbeing of the divorcees and those close to them. The situation becomes complicated if the affected person has a responsibility of providing caring and nurturing services to the sick, either as a manager or as a practitioner. The extent of how the impact of divorce affects the performance of professional nurses in their roles as carers and as managers was unknown. The nature and quality of services that they render to their patients, their coping strategies and the support systems were unknown. The purpose of the study was to describe and explore the impact of divorce on work performance of professional nurses at the East London Hospital Complex with the aim of ensuring high quality patient care. The objectives of the study were to: explore and describe the lived experiences of female divorced professional nurses with regard to the impact of divorce on their work performance; identify their coping strategies and their support systems. An exploratory descriptive and contextual qualitative research design was used. A phenomenological approach was used. The participants were twelve (12) divorced female professional nurses. The purposive and snowball sampling as non-probability sampling techniques were used. An interview guide was used to conduct the interviews. Audiotape was used for recording the data. Tesch’s steps (1990) of analyzing qualitative data guided the data analysis process. According to the lived experiences of the participants, divorce is traumatic and painful with emotional, physical, financial and social impact. It had a negative impact on the professional nurses’ work performance. The coping strategies included acceptance of the reality, studying, involvement with club and church activities. Support was available from the families, church, friends, and colleagues. Recommendations are that: the employee assistance program be marketed more effectively by hospital management and be included in the hospital, departmental and unit orientation programmes; that a dedicated psychologist, as well as preventive intervention programs, be made available to employees dealing with divorce.

Artificiell intelligens (AI) är en teknik som blir allt vanligare inom en rad områden, inte minst i syfte att effektivisera. I Sverige har kritik riktats mot vårdbranschen och de långa vårdköer som tynger den. Undersökningen syftar till att undersöka AI:s potential inom vårdbranschen i allmänhet och 1177 Vårdguiden i synnerhet. Genom en attitydanalys baserad på fyra intervjuer med 1177 Vårdguidens sjuksköterskor, kommer undersökningen fram till att AI har en viss potential när det gäller administrativa ärenden. Vad gäller vårdärenden är attityden inför AI mer negativ och dess potential tros inte vara tillräcklig för att ersätta den mänskliga faktorn.
Artificial intelligence is a technology that is becoming increasingly common in a number of fields, not least in order to streamline. In Sweden criticism has been directed at the healthcare industry and the long queues that overburden it. The study aims to investigate AI's potential in the healthcare industry in general and 1177 Vårdguiden in particular. Through an attitude analysis based on four interviews with 1177 Vårdguiden nurses, the survey concludes that AI has some potential in terms of administrative matters. When it comes to care-related cases, the attitude towards AI is more negative and its potential is not believed to be sufficient in order to replace the human factor.

M.Cur.
An exploratory descriptive study was undertaken, focusing on sexually transmitted diseases among teenagers. The aim of the study was to explore and describe the possible reasons for the high rate of sexually transmitted diseases in teenagers. The knowledge, attitudes and opinions of teenagers and community nurses involved in the teenage clinic in a specific predominantly black area were assessed. Twenty teenagers and five community nurses in a specific predominantly black area, were participants in the study. Focus group interviews are used. The study is conducted in two phases: teenagers representing phase one (1) and community nurses as phase two (2). It can be concluded that the attitudes of community nurses may have an influence on the high rate of sexually transmitted diseases, and the knowledge of the teenagers about sexually transmitted diseases is based on myths and misconceptions. The recommendations made are that the training standards for all community nurses should be reviewed and adapted to meet the needs of teenagers attending the teenage services. The policy on in-service training must be reviewed and monitored. Community nurses' intensive training on teenage service delivery and sexually transmitted diseases services should be in correlation with the principles of Primary Health Care. Community nurses need to attend intensive courses on interpersonal skills specifically related to teenagers. Selection procedures for recruiting community nurses to attend specifically to teenagers should be researched. The attitude of community nurses and teenagers should be the core of the service delivery. Teenagers should be involved in planning programmes and the teenage clinic should be evaluated frequently to improve the standards. The availability of teenage services should result in a decrease in sexually transmitted diseases among teenagers.

The early professional history of black South African nurses has not been the principal focus of local historians. Consequently, a qualitative historical inquiry was conducted into the available literature on the economic, social, political and cultural factors that influenced the professional development of black South African nurses from 1908–1994. Non-probability, purposive sampling assisted in assembling a corpus of historically rich data for analysis using time-specific a priori codes. The findings revealed that; culturally, black South African nurses had to adapt to a Western-dominated scientific health view; educationally, they had to master specialised formal Western terminology presented in a ‘foreign’ language (English) and, socio-politically, they had to adapt to being regarded as an elitist middle-class in the black community while remaining marginalised in the white-dominated workplace. Recommendations include expanding the historical research base, designing more effective strategies for promoting cultural sensitivity, and prioritising the focus on teaching and student retention.
Health Studies
M.A. (Health Studies)

The online convenience sample of 249 nurses all treated COVID-19 patients in the past year—with 45.0% in the emergency department and 36.9% in intensive care. Nurses were 68.7% female with a mean age of 32.17 years, as well as mostly white (69.1%). Some 28.5% had COVID-19, with 16.1% testing positive more than once in the past year. Using paired t-tests comparing scores for before versus during the pandemic, their physical health status and mental/emotional status were each significantly worse during the pandemic, their level of self-efficacy for performing nursing tasks was significantly worse during the pandemic, and their fear level was significantly higher during the pandemic. Nurses negotiated the pandemic with just moderate social support, while having moderate work setting concerns (e.g., safety), and rating the work climate as “to some extent” less favorable than before the pandemic. Nurses suffered moderate burnout using the Oldenburg Burnout Inventory—while females suffered higher burnout than males (p = .000) and non-whites higher burnout than whites. Past month mean Perceived Stress Scale scores were moderate. Nurses used alcohol/drugs closest to 30% of the time to cope with stress, while 35.7% increased use during the pandemic. They reported moderate mental distress over the past year, while 61.0% reported insomnia, 57.4% anxiety, 39.0% depression, 35.7% trauma, and 27.3% received counseling. Nurses reported moderate well-being over the past two weeks, and moderately high satisfaction with life. Backward stepwise regression found higher burnout significantly predicted by: fewer years working in nursing; higher Body Mass Index; more concerns at work (e.g., safety); higher past month perceived stress; higher past year mental distress; and, lower past two weeks’ well-being—with 52.2% of the variance predicted. Qualitative data reinforce important recommendations.

Nurses constitute the largest professional group in South Africa's health care services. Factors contributing to South African nurses' emigration were studied qualitatively by analysing expatriate nurses' responses to open-ended questions, and quantitatively by analysing newly registered nurses' responses to structured questionnaires. These results were contextualised within Maslow's Hierarchy of Needs Theory, revealing that nurses' inability to meet their physiological needs, due to inadequate remuneration, was the major factor contributing to nurses' emigration potential. While improved salaries might enable more nurses to remain in South Africa, expatriate nurses would not return to South Africa unless certain esteem and self-actualisation needs could also be satisfied. Improving nurses' salaries is essential to address South African nurses' emigration potential. However, improved working conditions, enhanced workplace security, improved levels of job satisfaction and the appointment of nurses into currently frozen posts are also necessary, as is governmental and public recognition of the value of the profession. The South African nursing profession, health care services, Government and society should urgently address factors contributing to South African nurses' emigration potential; otherwise a serious shortage of nurses could cause the collapse of this country's health care services.
Health Studies
DLITT ET PHIL (HEALTH ST)

Submitted in fulfilment of the requirements of the degree of Master of Technology: Nursing, Durban University of Technology, 2014.
South Africa has a high prevalence of obesity, and many people live with diseases where dietary adaptations are part of the management of the disease. Nurses are important in the facilitation of people obtaining dietary advice. While nutrition education is part of the nursing curriculum, student nurses’ knowledge of nutrition was not known, nor was their dietary intake and nutritional health status. The purpose of the study was to assess the nutrition knowledge of students at a nursing college, and to assess their dietary diversity. A quantitative study was used, with random sampling chosen for selection of campuses and convenience sampling for student group selection. Students of the KwaZulu-Natal College of Nursing were invited to complete a General Nutrition Knowledge Questionnaire. A Food Frequency Questionnaire was completed to assess dietary diversity, and respondents’ anthropometric measurements were recorded to assess Body Mass Index and Waist to Height Ratio. The results showed that a significant percentage of student nurses were overweight or obese. While students had a satisfactory knowledge of dietary recommendations and sources of different nutrients, their ability to make correct food choices, as well as their knowledge of diet-disease relationships was poor. They displayed good dietary diversity in their food intake. There were no statistically significant correlations between the students’ Body Mass Index and their knowledge, which assumes that the individual’s knowledge of nutrition does not directly influence their own food intake. It is recommended that aspects of the content in the nutrition curriculum be emphasised during the training of nurses in order to increase nutrition awareness in areas where knowledge was found to be lacking.

Indiana University-Purdue University Indianapolis (IUPUI)
The PeerSpirit Circle is a non-hierarchical, intentional, and relationship-centered practice of collaboration. There is a lack of scientific knowledge about the phenomenon of the PeerSpirit Circle in nursing or its potential impact on nursing practice, education, research, and the evolution of the profession and health care. The health care milieu is often entrenched in ways of being that do not support sustained change. For vitality to prosper and creativity to abound, paradigmatic shifts and new models of practice that emphasize collaboration are being called for. The purpose and aims of this phenomenological research study are to explore and give voice to the experiences of nurses who have participated in the PeerSpirit Circle model of practice with other nurses. The study includes interviews from five registered nurses from Canada and the United States conducted from 2009–2010 and interpreted from a Gadamerian philosophical hermeneutic perspective. The research findings reveal three themes: (1) experiencing the Circle container” where participants begin to understand the value of intentional preparation of the interpersonal space for safe human interaction and stronger collaboration—there are experiences of gathering, protecting, appreciating ritual, and sharing stories; (2) Experiencing space where protected space seems to be the essential element to inspire the presencing of participants with self and other, which in turn engenders genuine dialogue, a sense of sacred space, and freedom to be authentic; and (3) Experiencing our humanity, an unfolding theme, where participants experience reconnection with and understanding of their deeper humanity, stronger congruence with their core values, deeper experiences of caring and courage, personal and professional growth, and a profound appreciation for belonging to a lineage of nurses. The findings inspire a deeper understanding of barriers to congruence between values and action in nursing and nurses’ need to acknowledge, honor, support, and protect each other’s vulnerability. The implications for nursing practice, education, and research show that the PeerSpirit Circle model is a beneficial for use in all settings.

The study explored moral and ethical dilemmas experienced by Black nurses in a local community clinic. In particular, it examined the influences of the concept of self or personhood in nurses' ethical and moral decision-making. Influences of culture and family on morality were also investigated. Using the interview methodology developed by Gilligan (1982), nurses were asked to tell stories involving moral dilemmas in their work. Interviews were analysed using the voicecentred relational method. This method involves reading the interview narratives a number of times, each reading focusing on a particular aspect of a respondent's narrative. Results show that nurses often find themselves caught between two opposing moral and ethical viewpoints in their practices. On the one hand are hospital procedures, which are informed by universalist approaches to the person and the moral. From these are derived ethical principles emphasizing individual autonomy and choice. On the other hand, the majority of patients subscribe to a communal view . ofpersonhood. From this perspective, to be moral entails knowing one's position and responsibilities within family and community. Dilemmas arose from nurses' identification with patients' moral perspectives while realizing that this could lead to "unethical" conduct, (given , their training and current codes of ethics). It is recommended that moral and ethical deiiberations should dialogue with alternative, marginalised, viewpoints, in order to be culturally responsive. It is further recommended that ethics be conceptualised as a practical-moral engagement, rather than a detached application of knowledge.
Thesis (M.Soc.Sc.)-University of Natal, Pietermaritzburg, 2000.

The purpose of the study was to explore and describe the lived experiences of neophyte professional nurses working in ICU during their first year post graduation with the aim to discover strategies to support the nurse in critical care unit. An explorative, descriptive, interpretative qualitative design was conducted to uncover the nurse’s experiences. A purposive sampling was used which is based on belief that the researcher’s knowledge about the population can be used to hand pick sample elements. Data was collected through in-depth unstructured interviews and written narratives. Collaizi’s method of data analysis was used. The study findings revealed that neophyte professional nurses experienced difficulties and challenges in adjusting to the unit because of lack of mentors emanating from the shortage of staff. Nurses experienced mixed feelings regarding the relationship with colleagues in terms of support received.
Health Studies
M.A. (Health Studies)

Compassionate care is a crucial component of patient care in nursing practice in the broad context of holistic care. However, it is seemingly difficult for nurses to identify what exactly comprises compassionate care and how to provide it to patients. The purpose of the study was to explore the experiences of professional nurses on how they provide compassionate patient care. A qualitative descriptive study design based on narrative analysis was used. Thirteen professional nurses (PNs) from a private hospital were purposefully recruited to participate. Data was collected using written stories and professional lifelines. Data was analysed using thematic and narrative analysis. The following themes were identified such as treating the patient as a whole, inadequate knowledge and skills, and barriers to providing compassionate care. Future research using quantitative approach and large samples was recommended.
Health Studies
M.A. (Health Studies)

The purpose of the study was to develop a short course to inculcate the spirit of Ubuntu amongst the student nurses at Limpopo College of Nursing at Limpopo Province. A sequential explanatory research design was used and data was collected from one hundred and fifteen student nurses at the three (3) campuses for quantitative phase by means of structured interviews and ten (10) level III student nurses from each campus for qualitative phase by means of focus group discussions and reflective diaries. Ten (10) lecturers at the three campus participated in focus group discussions. Quantitative data analysis was done through descriptive analysis and findings were presented in frequencies, tables and charts. The qualitative data analysis was done through Tesch’s eight steps. There were similarities and differences in the themes and subthemes that were presented by all participants. There were also conflicting views from the same participants during qualitative and quantitative phases. The excerpts were presented to support all themes. The study found that Ubuntu needs to be inculcated through formal teaching and mentoring and that Ubuntu should be included in curriculum. Limpopo College of Nursing consists of student nurses from diverse cultures most of which are: Tsonga, Venda and Northern Sotho. They render nursing care to people of diverse cultures as globalisation has encouraged people to travel to different places. Media portrayal of the nursing care in public hospitals and clinics in South Africa is that of negativity. This is partially valid because, for example, the deterioration in nursing care in the public hospitals and clinics is as well evident in Limpopo Province in Mopani District (Bond 2002:1; Mohale & Mulaudzi 2008:61). Furthermore, Ubuntu is not effective if there is no correlation of theory and practice and evaluation of it in the clinical areas. Based on the findings and conclusion of the study, a short course on Ubuntu was developed after the consensus was reached among the participants and the experts who were consulted.
Health Studies
D. Lit. et Phil. (Health Studies)

The South African government promulgated the Choice on Termination of pregnancy Act (CTOP Act, 92 of 1996). This was a dramatic declaration of intent unprecedented in the African continent and globally. This act changed the outlook of the practice of termination of pregnancy by ensuring that services play a critical role in the delivery of the service. This study, which is qualitative in nature, explored the experiences of Termination of Pregnancy service providers working in three designated public health institutions in the Limpopo Province. Interviews were conducted with six service providers to look at how they construct their practice of providing termination of pregnancy services. The information was analyzed and interpreted by means of a thematic analysis method. Major themes that emerged from the participants’ experiences centred on their relationship with family, colleagues, management, clients, and the community reflecting a sense of alienation and lack of adequate infrastructural support. Inadequate support has been found to greatly contribute to the loss of interest in the work around abortion.
Psychology
M. A. (Clinical Psychology)

Nursing is a female dominated profession; making it difficult for men in the profession to excel in their caring capacities as nurses. This study aimed at identifying and describing male and female nurses' insights into and perceptions of socio-cultural influences on the recruitment and retention of men in the nursing profession and also explores their experiences in providing intimate care to patients of opposite gender. The study adopted a qualitative research methodology: 16 male and 11 female nursing students were purposively sampled and were interviewed using semi-structured questions. Themes of nursing seen as women's work; low status; stigma; caring and helping others were developed. Feelings of embarrassment and discomfort; fear and refusal of care were experienced when providing intimate care to patients of opposite gender; this has led male participants to develop strategies to protect themselves from sexual accusations. The Nursing Education Institutions (NEIs) have insufficient toilets for male nursing students; there is a lack of male role models and feminine pronouns are used when relating to professional nurses. Evidently socio-cultural perceptions of nursing enforce a negative image. The difficulties experienced by male and female nurses when providing intimate care and lack of male-friendliness in NEIs were discussed. These factors will lead to a further decline in the recruitment and retention of men in nursing; skilled and intelligent nurses are leaving the profession.
Health Studies
M.A. (Nursing Science)

PhDPH
Department of Public Health
Substance use/abuse is a persistent public health problem in tertiary institutions around South Africa. Alcohol and illegal drugs are the most commonly-used substances by youths in tertiary institutions, including student nurses at the Limpopo College of Nursing (LCN). This study sought to develop a model to prevent substance use/abuse by student nurses at the LCN, South Africa. A convergent parallel mixed-method was used to collect and interpret the data. A phenomenological research approach was utilized for gathering data from the lecturers, student affairs officers and student nurses in the qualitative design which was explorative and descriptive in nature. The population comprised of student nurses, lecturers and student affairs officials who were purposefully selected. Data were collected through unstructured in-depth interviews and analyzed through Tesch’s open-coding steps for qualitative empirical research to develop themes and categories. Data generated the following themes: The Consequences of Socialization Factors on the Incidence of Substance Use/Abuse by Student Nurses and The Effect of Environmental Factors on the Incidence of Substance Use/Abuse by Student Nurses. Within each theme, sub-themes emerged. Trustworthiness of the collected data were ensured. A quantitative design was employed to collect data from all student nurses in five campuses of LCN. A stratified sampling technique was used to select respondents and structured questionnaires were used to collect data. A total of 445 questionnaires were collected. Quantitative data were analyzed numerically and through descriptive and correlation statistics using the Statistical Package for the Social Sciences (SPSS) version 24. The results showed that substance use/abuse is more prevalent among students of the age group of between 21 and 24 years that represented the majority in LCN. Data were analyzed independently for which a convergent analytic approach was used to merge the data sets. Validity and reliability were ensured. Ethical considerations were adhered to. The overall findings highlighted that substance use/abuse by the student nurses was widespread. Various factors, including behavioural, environmental and student earning stipend, have contributed to the problem. The concept “prevention” was analyzed using Walker & Avant’s (2014) steps. The results of both the empirical study and concept analysis formed the basis for model development. The framework of Dickoff, James and Wiedenbach (1963) was used to develop a model. The developed model was validated by the group using a close-ended checklist, analyzed using simple descriptive statistics. The model was in accordance with the legislative provisions of the LCN lease agreement, Higher Education Act as well as the National Institute on Drug Abuse (NIDA, 2003).
NRF

The purpose of the study was to determine professional nurses’ knowledge of culture- competent care at selected medical and oncology wards and outpatient departments in Mopani District, Limpopo Province. A quantitative descriptive design was used and data collected from one hundred and five professional nurses by means of a structured questionnaire. The study found that cultural knowledge needs to be nurtured through continuing education and mentoring and that culture-competent care should be included in the curriculum. Furthermore, cultural knowledge is not effective if there is no correlation of theory and practice and early clinical placement of student nurses during their basic training
Health Studies
M. A. (Health Studies)

Abstracts in English, Afrikaans and Zulu
This research investigated work as a calling, the relationship with work engagement and the effect on burnout in the Namibian health care sector. A quantitative survey was conducted on a convenient sample of nurses (N = 261) employed by government and private hospitals in Namibia. Kendall's tau_b correlation analysis indicated a positive correlation between job/calling orientation and total work engagement, and a negative correlation with the burnout sub-dimensions of exhaustion and cynicism/ depersonalisation. The results of this study also suggest that both job/calling and work engagement are statistically related to the respondents’ positive world view, which is an important attribute for quality of life. Additionally, the study revealed that burnout had a partial mediation effect on the interaction between job/calling and work engagement. Selected demographic characteristics had a partial moderation effect on the relationship between job/calling orientation, work engagement and burnout. These findings may provide new knowledge for the design of workplace practices that assess calling orientation, and may enhance work engagement. The study provided a deepened understanding of the interrelationships between work as a calling, work engagement and burnout. On a practical level, the recommendations provided can be used by human resource management practitioners, nurse managers and health care providers to motivate health care workers to become more productive in the provision of quality health care, and to improve the management of employees throughout their employment life cycle.
In hierdie studie is werk as ʼn roeping en die verband tussen werkverbintenis en die uitwerking van ooreising in die Namibiese gesondheidsorgsektor ondersoek. ʼn Kwantitatiewe opname is onder ʼn geriefsteekproef van verpleegsters (N = 261) by private en staatshospitale in Namibië gedoen. Volgens Kandall se tau_b-korrelasieanalise is daar ʼn positiewe korrelasie tussen pos/roepingsgerigtheid en totale werkverbintenis, en ʼn negatiewe korrelasie met die ooreisingsubdimensies van uitputting en sinisme/ontpersoonliking. Die uitslag van hierdie studie dui daarop dat sowel pos/roeping as werkverbintenis statisties met die respondente se positiewe wêreldbeskouing, ʼn belangrike kenmerk vir lewenskwaliteit, verband hou. Afgesien hiervan dui die uitslag daarop dat ooreising ʼn gedeeltelike mediasie-effek op die wisselwerking tussen pos/roeping en werkverbintenis het. Die gekose demografiese kenmerke het ʼn gedeeltelik matigende effek op die verband tussen pos/roepingsgerigtheid, werkverbintenis en ooreising. Hierdie bevindings is nuwe kennis vir die ontwerp van werkplekpraktyke wat roepingsgerigtheid evalueer en dit kan werkverbintenis verbeter. Hierdie studie bied groter insig in die onderlinge verbande tussen werk as ʼn roeping, werkverbintenis en ooreising. Op ʼn praktiese vlak kan mensehulpbronbestuurders, verpleegsterbestuurders en gesondheidsorgverskaffers die aanbevelings gebruik om gesondheidsorgwerkers te motiveer sodat hulle produktiewer in die lewering van goeie gesondheidsorgdienste raak. Dit kan eweneens gebruik word om gesondheidsorgwerkers hulle hele werkslewensiklus deur beter te bestuur.
Lolu cwaningo beluphenya umsebenzi njengobizo lomsebenzi, ubudlelwano bokuzibandakanya emsebenzini kanye nomthelela wokukhathala kakhulu kwabasebenzi emkhakheni wezempilo eNamibia. Isaveyi eyencike kumanani iye yenziwa ngokuthi kuthathwe isampuli efanele yabahlengikazi (N = 261) abaqashwe yizibhedlela zikahulumeni kanye nezibhedlela zangasese eNamibia. Uhlaziyo lukaKendall lwe-tau_b luveze ubudlelwano obuhle obuphakathi kobizo/kokufundiswa umsebenzi kanye nokuzibandakanya ngokugcwele emsebenzini, kanye nobudlelwano obubi bokukhathala kwezigatshana ezincane zokudangala kanye nokwenza into ngesizathu sokuzinceda wena wedwa/ukuqeda ukuzibheka wena wedwa. Imiphumela yalolu cwaningo nayo iphakamisa ukuthi kokubili umsebenzi/nobizo lomsebenzi kanye nokuzibandakanya emsebenzini ngokwamanani kuhlobene nombono omuhle wabaphenduli bemibuzo mayelana nomhlaba, okungumthelela obalulekile kwizinga elihle lempilo. Ngaphezu kwalokho, ucwaningo luveze ukuthi ukukhathala kakhulu ngakolunye uhlangothi kunomphumela omuhle wokuxazulula kahle lapho kuhlangana khona umsebenzi/ubizo lomsebenzi kanye nokuzibandakanya emsebenzini. Izimpawu ezikhethiwe zedemografi ngakwenye ingxenye zinomthelela wozinzisa kahle ubudlelwano obuphakathi kohlelo lokungeniswa emsebenzi/obizweni lomsebenzi, kokuzibandakanya emsebenzini kanye nokukhathala kakhulu emsebenzini. Lolu lwazi olutholakele lungaletha ulwazi olusha olumayelana nedizayini yezingqubo zendawo yomsebenzi, okuyizingqubo ezihlola ukufundiswa ngobizo lomsebenzi kanti lokhu kungaqinisa ukuzibandakanya emsebenzini. Empilweni yangempela, izincomo zingasetshenziswa abasebenzi bomnyango wezokuqhashwa kwabasebenzi, abaphathi babahlengikazi kanye nabahlinzeki bezempilo ngesizathu sokukhuthaza abasebenzi bezempilo ukuba babe abasebenzi abaqotho mayelana nokunikezwa kwezinsiza zempilo zezinga eliphezulu, kanyenokuthuthukisa nohlelo lokuphathwa kwabasebenzi empilweni yabo yonke yokusebenza.
Business Management
D. Com. (Business Management)

The purpose of this study was to develop and test a measuring instrument based on the Gibb’s Defensive Communication Climate Paradigm (1961) to assess the communication climate focus of professional nurses in selected public hospitals in the Gauteng province. This focus involves the communication behaviour orientation of the professional nurses and their perceptions of the communication behaviour orientation of their operational managers. The Gibb’s model comprises six bipolar conceptual continuums, namely Evaluation-Description, Control-Problem orientation, Strategy-Spontaneity, Neutrality-Empathy, Superiority-Equality and Certainty-Provisionalism Continuums. The study consisted of a non-experimental design, including a developmental phase and a testing phase. During the developmental phase the researcher developed a measuring instrument (a Semantic Differential Scale questionnaire); used a simple, random sample method to pre-test the instrument; analysed the data by applying Cronbach’s Alpha reliability analysis and refined the instrument. Further refinement of this new instrument by future researchers is recommended. During the testing phase the researcher also used a simple, random sample, consisting of professional nurses (N = 270) from three selected public hospitals in Gauteng; tested the items against the biographical data and the three research questions and analysed the obtained data by utilising both descriptive and inferential statistics. A Delphi panel of experts were involved in both phases of the study. The results of the study indicated that although the respondents had a predominantly supportive communication behaviour orientation, they were more focused on the communication behaviour of their operational managers than on their own. Furthermore, the results indicated no significant differences in the influencing factors: age, tenure (periods in hospital), gender, language and institution (public hospital), in terms of the six conceptual continuums. Significant differences were found only in the factor: unit/ward, indicating that the supportiveness of the communication behaviour of professional nurses could be dependent on their specific work environment. Guidelines aimed at the development of a supportive climate were drawn up for the National Department of Health, Gauteng Department of Health, public hospitals, operational managers and professional nurses. It is recommended that implementation of the newly developed guidelines be pivotal for public hospitals, to refocus their communication climates towards supportive communication.
Health Studies
D. Litt. et Phil. (Health Studies)

Introduction: Despite being one of the most preventable diseases, TB still remains a serious and largely neglected disease. Nurses as compared to the general population are at greater risk of acquiring nosocomial TB. This study was conducted to describe the perceptions of nurses on the underlying contributory factors that may lead to the spread of TB in the clinics treating TB patients. Methods: Quantitative, non – experimental, descriptive, exploratory and cross sectional design was used. A structured and pretested questionnaire was used. Findings: The key contributory factors identified were insufficient TB training for staff and lack of knowledge on the TB legislative framework and TB policy directives. Conclusion: The findings indicate the need for a comprehensive TB infection prevention and control policy, with associated standards for provision and practice.
Health Studies
M.A. (Public Health)

The aim of this study was to describe the nurses‘ perception of termination of pregnancy and her perception of her conduct towards clients that request termination of pregnancy guided by Kings‘ Systems Approach and Goal Attainment Theory. A non-experimental quantitative descriptive correlational design was used. A non-probability purposive sampling method was used consisting of institutions in the Western Cape, available to participate in this study, which deliver termination of pregnancy services, gov ernment health care institutions (21) and Marie Stopes clinics (3). Non-probability convenience sampling was used consisting of registered nurses who are working in termination of pregnancy units in these facilities (N=82). Data were collected through the administration of a self-designed questionnaire. The main findings of the study indicate that respondents (personal system) appear to feel positive about the work they are doing. Formal improvement and development are however not utilised optimally. Regarding the interpersonal system, respondents also show a positive orientation to both the woman opting for termination of pregnancy and the foetus. The potential towards transaction and ultimately goal attainment reside within this system. The respondents are also positive about legislation, employers and policies (social system) relating to termination of pregnancy. This orientation creates a milieu that is conducive to transactions, interactions and goal attainment.The main recommendation is that three systems as proposed by King be continuously integrated within the termination of pregnancy setup through, amongst other measures: values clarification, management support, in service education, the inclusion of termination of pregnancy in undergraduate programmes, focus groups and the like.
Die doel van hierdie studie was om die verpleegkundige se persepsie van terminasie van swangerskap en haar persepsie van haar houding en gedrag teenoor kliёnte wat terminasie van swangerskap versoek, aan die hand van King se Sisteembenadering en Doelwitbereikingsteorie te ondersoek en te beskryf. `n Nie-eksperimentele kwantitatiewe beskrywende korrelasie navorsingsontwerp was gebruik. `n Nie-waarskynlike doelbewuste-steekproefneming van die staatsgesondheidsorg-instansies wat terminasie van swangerskapdienste aanbied, is geneem en wat beskikbaar vir hierdie studie was (21) asook die Marie Stopesdienste (3), in die Wes-Kaap. `n Nie-waarskynlike gerieflikheidsteekproefneming is van verpleegkundiges geneem wat swangerskappe in hierdie afdelings termineer of moet termineer (N=82). Data is met behulp van `n selfontwerpte vraelys ingesamel. Die hoofbevindings van die studie dui daarop dat respondente (persoonlike sisteem) positief voel oor hul werk. Formele ontwikkelingshulpbronne word egter nie optimaal deur die sisteem benut nie. Wat die interpersoonlike sisteem betref, toon respondente ook ‗n positiewe oriëntasie tot beide die vrou wat terminasie van swangerskap aanvra en die fetus. Die potensiaal tot transaksie-sluiting en uiteindelike doelwitbereiking is binne hierdie sisteem geleë. Die respondente is ook positief oor wetgewing en die werkgewer en beleid (sosiale siteem) ten opsigte van terminasie van swangerskap. Hierdie oriëntering laat ‗n milieu wat bevorderlik is vir transaksie-sluiting, interaksie en doelwitbereiking. Die hoofaanbeveling is dat voortdurend gepoog moet word na die integrasie van King se drie sisteme binne die terminasie van swangerskapafdelings deur onder meer: waarde-uitklaringswerkswinkels, ondersteuning van bestuur, indiensopleiding, die insluiting van terminasie van swangerskap in voorgraadse kurrikula, fokusgroepe en so meer.
Health Studies
D. Litt. et Phil. (Gesondheidstudies)

This study aimed at exploring chronic illness from both the perspectives of the patient, living with the illness and the professional, treating the illness. The epistemological framework is social constructionism. Qualitative research was selected as the research approach. Three in-depth interviews with three patients, suffering with a chronic illness were conducted, as well as three interviews with professionals, who had experience with patients diagnosed with chronic illnesses. Thematic analysis was the method used for the analysis of data. The stories of the participants were reconstructed in terms of themes. A comparative analysis for both participants groups was done, and linked to the relevant literature This study created an understanding of the complexity of chronic illness. The themes identified, highlighted the importance of the patient-professional relationship, specifically in the context of chronic illness.
Psychology
M.A. (Clinical Psychology)

This study addresses the effectiveness of communication between the team (doctors, sisters and social workers) and patients at the Breast Cancer Clinic of the Johannesburg Hospital. Tue needs of patients were highlighted, as well as the role of care-giver, both as a group and in their separate disciplines, in attempting to meet these needs. Tue empirical survey was carried out through the use of questionnaires as well as interview schedules. Patients, doctors, nurses and social workers were used as respondents. Results indicated that the majority of patients' needs for information and support were met by the team in general; however, a need for further social work intervention seemed to be apparent. In addition, several barriers were found to inhibit both team-patient and inter-team communication. Tue researcher used the information gathered in this study to make recommendations that will facilitate improved communication in the clinic, with specific reference to the role of the social worker.
Social Work
M.A.(Social Science: Mental Health)

Text in English
Learner pregnancy in secondary schools of South Africa is a public health problem that requires the involvement of parents, teachers and health workers in order to promote maternal and child health and retain learners in school. The aim of this study was to explore and describe the experiences of teachers, parents and pregnant learners regarding facilitation of health for pregnant learners and then develop a model to facilitate social support for pregnant learners attending secondary schools in order to attain and maintain health for the mother and her newborn baby and prevent school dropout. A qualitative, exploratory, descriptive and contextual theory generating study was conducted using semi-structured interviews to collect data from ten pregnant learners, ten teachers and five parents who were purposely selected and voluntarily participated. Data was analysed using Tesch’s open coding method where six themes emerged. The themes were then discussed with literature control. The findings revealed that pregnancy amongst secondary school learners in Limpopo Province is a challenge to teachers, parents and pregnant learners regarding social support for pregnant learners to continue attending school and remaining healthy. A concept analysis was performed and revealed facilitation of social support as the main concept, and then other concepts related to it were identified and classified. The model was developed through the steps of theory generation and was then submitted to a panel of experts for evaluation who found it useful to nursing practice and society in general. The model promotes interaction between the role players in education to address learner pregnancy and can also be useful in addressing other challenges in the schools. It is facilitated by a school health nurse but can also be facilitated by a teacher or a social worker in cases where a school health nurse is not available. The guidelines for the implementation of the model were formulated and described. Pregnant learners, as recipient of social support, should submit themselves to the support offered by the social network and communicate their needs openly to the professional nurse, their parents and teachers, so that they can receive adequate social support.
Health Studies
D. Litt. et Phil. (Health Studies)
1 online resource (xv, 206 pages) : illustrations (some color), maps (some color)

Text in English
The purpose of this research was to investigate occupational health and safety challenges and their impact on health care workers (HCWs) in selected public hospitals from the Gauteng Province, South Africa. Method: A quantitative descriptive cross-sectional survey was conducted among HCWs in the study sites. A two-staged sampling that include purposive sampling of study sites and census sampling of 2000 HCWs was used. Self-administered questionnaires were used to obtain data from HCWs. In addition, two different checklists were used to conduct retrospective records reviews to assess occupational health and safety (OHS) policy compliance and occupational injuries and diseases occurrence. The SAS Release 9.3 was used to analyse data. The Fischer Exact test and Chi-square were also used to determine the association of variables and P-value was set at <0.05 to indicate significant association. Results: A total of eight public hospitals and 926 (46.3%) HCWs who were all females nurses participated in this survey. Major occupational health hazards reported by the participants include: needle-stick injuries 275 (54.67%), slips trips and falls 67 (13.32%) and splashes 57 (11.33%). The analysis of open-ended responses indicated increased workloads, long hours of work and shift work as the most reported psychosocial hazards among HCWs. The reviewed records indicated that back injuries 22 (4.37%), tuberculosis (TB) 17 (3.38%) and asthmatic reactions 8 (1.59%) were the commonly reported occupational injuries and diseases among the HCWs. The records review also revealed a lack in the conducting of adequate medical surveillance among participants. The results showed poor compliance with the OHS policy and a negative impact of biological and psychosocial hazards on the HCWs. Conclusion: There was a high risk of exposures to biological hazards whilst providing care to patients, thus warranting the implementation of robust preventive measures. As a result, the guidelines were developed to promote the health and safety of HCWs with a view to promoting policy compliance and preventing the occurrence of occupational injuries and diseases as well as their impact among HCWs.
Health Studies
D.Litt et Phil. (Health Studies)

The study was undertaken to deepen understanding of living with a spinal cord injury (SCI) in the rural communities of the Eastern Cape Province, South Africa (RSA). The OR Tambo District Municipality, which was selected for its accessibility to the researcher, is virtually rural, the infrastructure is poorly developed and there is low socio-economic activity in the rural areas of the old Transkei. In the RSA services for management and rehabilitation of SCIs varies from province to province. A Heideggerian phenomenological approach was used to interpret the meaning of living with SCI persons in a rural community. The purpose was to describe and interpret what being-in the-world as a spinal cord injured person meant to the particpants. A key assumption in phenomenology is that understanding human beings and their actions is best achieved through examination of human experiences. Experience, including experience with living with SCI, offers itself as a record of human encounters, the interface between persons and their world, and experience can only be understood in terms of background and the social context of the experience (Pateman & Johnson 2000: 51). Phenomenological interviews with ten people living with SCI explored their experience. The overall goal was to increase awareness of their experiences of living with SCI, and to encourage incorporation of knowledge gained into nursing practice. The central question in the study was `What is it like to live with a spinal cord injury in a rural community? Data were analysed according to Heideggerian hermeneutic phenomenology. Two main themes were identified, namely reconceptualising being-in-the-world as a person with a disability; and being-with-each-other: experiencing being excluded, objectified and marginalized. The participants engaged in a process of reconstructing their identities following the traumatic loss of sensory and motor functioning. Data reflect the social and economic context in which living with SCI is experienced. The respondents' life experiences were influenced by socio-political, economic and historical factors, namely geographic location, poor infrastructure, poverty, low educational status, and unemployment and the community at large. It was noted that participants experienced difficulties in several areas in their daily life realm; naming, coping with health and disability problems, family interactions and relationships, and non-accessibility of amenities, including their own dwellings. In addition, being a person living with an SCI in the rural communities of the OR Tambo District Municipality carries a high physical and social risk due to lack of resources. The inability to live up to generally expected social roles led to role dissatisfaction. There is an urgent need for social support to overcome the negative societal attitudes experienced. They are forced into isolation with a limited social life and are poorly integrated into the communities in which they live. Most of what the participants raised pointed towards inadequate preparation for the outside world. Therefore, a holistic approach to rehabilitation is recommended, as holism means addressing the physical, social, emotional and cognitive needs. Accordingly, the researcher developed guidelines for facilitating community integration. In conclusion, understanding how people experience living with SCI in a rural community is an essential prerequisite to the development of appropriate strategies to facilitate community integration.
Health Studies
D. Litt et Phil (Health Studies)