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, Tendani S. Ramukumba
Published: 28 February 2017
Journal: Curationis
Abstract:
Social support refers to the assistance people receive from others, and it is divided into four types of support. Given the increasing mortality and morbidity rates of mothers and neonates postpartum, this study intended to determine whether the social support needs of the first-time mothers were met after early discharge from health care facilities. The objective of the study was to explore the lived experiences and social support needs of the first-time mothers after an early discharge from health care facilities in the City of Tshwane, Gauteng. A qualitative explorative study was conducted to explore the lived experiences and social support needs of the first-time mothers. The population were first-time mothers who had a vaginal delivery and were discharged within 6–12 hours of delivery from health care facilities. Purposive sampling was performed and 14 semi-structured interviews were conducted, with those mothers who came for the prescribed three postnatal check-ups at the three health care facilities identified according to maternity services provided. Saturation of data for the three health care facilities was reached at the 14th interview. Data analysis was performed using the hermeneutic interpretive approach. Almost all participants had completed grades 11 or 12, but most were unemployed. The needs identified included the need for social support, lack of confidence, knowledge and skill to care for themselves and their newborn babies after early discharge. There is need to identify alternative types of social support for the first-time mothers, to ensure a normal adjustment to motherhood.
, Barbara M. Dube
Published: 28 February 2017
Journal: Curationis
Abstract:
The quality of nursing care rendered today is markedly reducing and the amount of time spent with patients listening to and explaining issues concerning their conditions is gradually diminishing. The therapeutic touch and the listening ear of the nurse are no longer accessible to the patient. Understanding what non-technical skills are and their relevance for healthcare practitioners has become a new area of consideration. Although recent literature has highlighted the necessity of introducing soft skills training and assessment within medical education, nursing education is yet to fully embrace this skills training. The aim of this study was to explore nursing students’ understanding of the concept of soft skills and to acquire their perception on the need for soft skills training to promote quality nursing care. A quantitative research design with descriptive and explorative strategies was used. One hundred and ten nursing students were sampled after permission to conduct the study was requested and obtained from the University of KwaZulu-Natal Ethics Committee. The results indicated that a majority (68.8%) of respondents understood the concept of soft skills and agreed with the definition of ‘soft skills’. They furthermore agreed that soft skills should be part of the training that student nurses receive during their professional training. The study revealed that there is a need for nursing students to be educated in soft skills and that this will enhance their job performances in the clinical environment and improve the way in which they communicate with their clients.
Published: 28 February 2017
Journal: Curationis
Abstract:
Background: Studies have investigated burnout and compassion fatigue among nurses and effects in the nursing profession. However, there are limited investigations of burnout and compassion fatigue among undergraduate nursing students in South Africa, as nursing students may experience distressful situations during their nursing education course, which may have an impact during their training and in their profession as they graduate.Purpose: The purpose of this descriptive study was to describe compassion satisfaction, compassion fatigue and burnout among undergraduate nursing students at a tertiary nursing institution.Methods: A quantitative descriptive study was conducted to describe compassion satisfaction, compassion fatigue and burnout among undergraduate nursing students at a tertiary nursing institution in KwaZulu-Natal. Convenience sampling was used.Results: Sixty-seven undergraduate students (26 third-year and 41 fourth-year nursing students) took the self-test Professional Quality of Life Scale (ProQOL). The study results indicate that undergraduate students experienced average levels of compassion fatigue, burnout and compassion satisfaction.Conclusion: As shown in the study, some of the undergraduate students are experiencing compassion fatigue and burnout, associated with relieving suffering of others. Therefore, knowledge of compassion fatigue and burnout and the coping strategies should be part of nursing training.
Kathleen K. Direko,
Published: 28 February 2017
Journal: Curationis
Abstract:
Professional nursing in South Africa is obtained through a 4-year diploma offered at nursing colleges, or a 4-year degree in universities, and the South African Nursing Council (SANC) registered both for professional nursing. New SANC legislation now requires a bachelor’s degree for registration as professional nurse. The aim of the study was to explore and describe perceptions of nurse educators and stakeholders to develop a model of collaboration for joint education and training of nursing professionals by colleges and universities through a bachelor’s degree. A mixed methods approach was used to explore perceptions of nurse educators utilising a questionnaire, and perceptions of other nurse training stakeholders through interviews, about a model of collaboration between the college and the university. Themes that emerged from the interviews included identifying collaboration goals, establishing a conducive environment, maximising exchange of resources, role clarification and perceived challenges. Quantitative results showed high agreement percentages (84.13%–100%) on most basic concepts and themes. A model of collaboration was developed indicating a framework, agents, recipients, procedure, dynamics, and terminus. A model of collaboration was acceptable to the majority of nurse education stakeholders. Other implications are that there was a need for the improvement of scholarship among nurse educators and clinical mentors, sharing rare skills, and addressing perceived challenges.
Published: 9 May 2012
Journal: Curationis
Abstract:
Supervisors at Higher Education Institutions are challenged to shorten throughput of Master’s degree students in nursing as researchers are needed to improve the art and science of the nursing profession. Globally the completion time for a postgraduate degree in the health sciences varies between 4.7 and 5.5 years. The purpose of the study was to describe strategies that were implemented to shorten completion time and attrition rate of postgraduate students. A cyclic technical, scientific collaborative mode within an action research methodology was used to identify factors impeding completion time in this study. Contrary to other studies, supervision was not an inhibiting factor in this study. Physical, technical, academic and financial aspects were identified by postgraduate students through questionnaires and informal discussion groups with supervisors as well as progress reports. Strategies were implemented to address these. Following implementation of all strategies, 42% of the postgraduate students in the School of Nursing completed their Master’s degree within two years. This implies a 34% improvement. Although the completion rate improved it was still unsatisfactory and new challenges were identified during the second cycle, for example, the number of inexperienced supervisors increased and they needed mentoring. Speed mentoring is a possible solution to the problem.
Thanyani G. Lumadi
Published: 28 February 2017
Journal: Curationis
Abstract:
Audit and feedback is regarded as the cornerstone of clinical teaching to guarantee good practice and to correct poor performance. Feedback given to health professionals assists in narrowing the gap between the actual and the desired information. The findings of the research study on perceptions of midwives on audit and feedback highlighted aspects that needed improvement to address challenges on the use and documentation of the partogram. The objectives of this article were to explore and describe the perceptions of midwives on auditing of the partogram by health professionals and to explore and describe the perceptions of midwives on the feedback that was given after audit was done. A qualitative, exploratory and descriptive study was conducted to answer the two research objectives. Semi-structured face-to-face interviews were conducted with 17 midwives who were working in the labour wards of three hospitals. Eight steps of qualitative data analysis as indicated by Tesch were used to analyse the data. The findings revealed that auditing and feedback is sometimes done by midwives themselves, midwives’ managers and district managers. Audit is done monthly or on a daily basis and sometimes inconsistently because of shortage of staff. Challenges indicated were lack of knowledge on the use of the partogram and lack of encouragement and praise when documentation was done correctly and that emphasis was mostly placed on negative aspects. The findings revealed that auditing and feedback and in-service education is done at the three hospitals, although challenges such as inconsistency in auditing because of shortage of staff, lack of knowledge on partogram use and on principles of giving feedback were highlighted.
Rhudzani V. Mafune, , Livhuwani H. Nemathaga
Published: 28 February 2017
Journal: Curationis
Abstract:
Background: Children depend solely on caregivers who can be either parents or guardians for drug administration to enhance adherence to antiretroviral treatment (ART), which might pose any number of challenges.Purpose: The purpose of this study was to explore and describe the challenges faced by caregivers of children on ART at Mutale Municipality, Vhembe District, Limpopo Province.Research design and method: The research design was qualitative, explorative, descriptive and contextual in nature. The population consisted of 16 caregivers who were 18 years of age and above, and mentally capable, irrespective of educational qualifications, caring for children aged between 0 and 15 years who were on ART between April 2013 and October 2014. Non-probability, purposive sampling was used to select the 16 caregivers. Required permission, approval and ethical clearance were obtained from the University of Venda Higher Degree Committee, Limpopo Provincial Health Department and relevant institutions. An in-depth, individual, unstructured interview method was used to collect data. One central question was asked: ‘What are the challenges you experience when caring for a child on antiretroviral treatment?’ Subsequent questions were based on the participants’ responses to the central question. Qualitative data were analysed by means of Tesch’s open-coding method.Results: The findings of this study revealed that participants, that is, caregivers of children on ART, experienced financial burdens because of transport costs needed to comply with follow-up dates and insufficient of money for food, clothing the child in need of care, pocket money for lunch boxes during school hours and time lost while waiting for consultations. Participants reported some level of stigmatisation against children on ART by family members, especially the husbands or in-laws of the secondary caregivers. Many primary and secondary caregivers seemed to have given up seeking support from government and community structures.Conclusion: The conclusions drawn from this research are that caregivers hardly receive any support from family members or the community. Fear of disclosing the HIV-positive status of children resulted in the delay of financial support from the government, thus leading to serious financial burden on the caregivers.
Mahlasela A. Rakhudu, Mashudu Davhana-Maselesele, Ushonatefe Useh
Published: 28 February 2017
Journal: Curationis
Abstract:
Background: The idea of collaboration between key stakeholders in nursing education for the implementation of problem-based learning (PBL) may have far-reaching implications for the institutions and students.Main objective: To develop a model of collaboration to facilitate the implementation of PBL in nursing education.Methodology: An exploratory sequential design was used. Qualitative data were collected from purposively recruited nurse educators from three universities in South Africa offering PBL and nurse managers from all the three hospitals in North West Province where PBL students are placed for clinical learning. A questionnaire was used to obtain data from respondents who were conveniently recruited. Model development, concept analysis, construction of relationships, description and evaluation were followed.Results: This model has six elements: higher education and nursing education (context), institutions initiating PBL, clinical services, colleges affiliated to PBL universities, students and healthcare users (recipients), champions in PBL (agents), effective implementation of PBL (terminus), collaboration (process) and commitment, communication, trust and respect (dynamics).Conclusion: Collaboration in implementing PBL can be a functional reality in the delivery of quality educational experiences and has far-reaching implications for the institutions and students. The implementation of the model in South African nursing education institutions may be necessary for the light of the revision of the preregistration qualifications.Recommendations: Managerial commitment, training of collaborators on PBL and collaboration skills, memorandum of agreement, monitoring and evaluation are critical. More research is required to pilot the model and evaluate collaboration in implementing PBL at different levels of operations.
, Catherine H. Thurling, Susan J. Armstrong
Published: 28 February 2017
Journal: Curationis
Abstract:
Background: Clinical facilitation is an essential part of the undergraduate nursing curriculum. A number of studies address the issue of clinical facilitation in South Africa, but there remains a lack of knowledge and understanding regarding what students perceive as best practice in clinical facilitation of their learning.Objective: To determine what type of clinical facilitation undergraduate students believe should be offered by clinical facilitators (nurse educators, professional nurses and clinical preceptors) in the clinical area in order to best facilitate their learning.Method: A qualitative, exploratory and descriptive study was conducted. Purposive sampling was performed to select nursing students from the second, third and fourth year of studies from a selected nursing education institution in Johannesburg. The sampling resulted in one focus group for each level of nursing, namely second, third and fourth year nursing students. Interviews were digitally recorded and transcribed verbatim, thematic data analysis was used and trustworthiness was ensured by applying credibility, dependability, confirmability and transferability.Main findings: The data revealed that participants differentiated between best practices in clinical facilitation in the clinical skills laboratory and clinical learning environment. In the clinical skills laboratory, pre-contact preparation, demonstration technique and optimising group learning were identified as best practices. In the clinical learning environment, a need for standardisation of procedures in simulation and practice, the allocation and support for students also emerged.Conclusion: There is a need for all nurses involved in undergraduate nursing education to reflect on how they approach clinical facilitation, in both clinical skills laboratory and clinical learning environment. There is also a need to improve consistency in clinical practices between the nursing education institution and the clinical learning environment so as to support students’ adaptation to clinical practice.
Oliva Bazirete, Nomafrench Mbombo,
Published: 28 February 2017
Journal: Curationis
Abstract:
Background: Maternal mortality continues to be a global burden, with more than 200 million women becoming pregnant each year and a large number dying as a result of complications of pregnancy or childbirth. The World Health Organisation has recommended use of the partogram to monitor labour and delivery in order to improve healthcare and reduce maternal and foetal mortality rates.Objective: This study described factors affecting utilisation of the partogram among nurses and midwives in selected health facilities of Rwanda.Method: A descriptive quantitative and cross-sectional research design was used. The population comprised 131 nurses and midwives providing obstetric care in 15 health institutions (1 hospital and 14 health centres). Data collection was through a self-administered questionnaire, and a pre-test of the data collection instrument was carried out to enhance validity and reliability. The Statistical Package for Social Sciences (version 21) was used to capture and analyse data. Ethical clearance was obtained from the University of the Western Cape (Republic of South Africa) and from the Institutional Review Board of Kigali Health Institute (Rwanda). Patricia Benner’s model of nursing practice was used to guide the study.Results: It was found that 36.6% of nurses and midwives did not receive any in-service training on how to manage women in labour. Despite fair knowledge of the partogram among nurses and midwives in this study, only 41.22% reported having used the partogram properly, while 58.78% reported not having done so.Conclusion: Nurses’ and midwives’ years of professional experience and training in managing pregnant women in labour were found to be predictors of the likelihood of proper use of the partogram. In-service training of obstetric caregivers in the Eastern Province of Rwanda is recommended to improve use of the partogram while managing women in labour.
, , Ethelwynn L. Stellenberg
Published: 28 February 2017
Journal: Curationis
Abstract:
Background: Nursing managers have to meet expectations of patients despite economic pressures, an increasing burden of disease and nursing shortages. Shifting health care-related tasks to lower categories of staff, including non-nursing support staff, has become one solution to address this dilemma. Patient care workers are a specific group of non-nursing support staff working in South African hospitals. Although patient care workers have been used for several years and their numbers are increasing, there are controversial opinions about the role of patient care workers, ranging from praise for their contribution towards patient care to serious concerns about the impact of their role on patient safety.Objective: The study objective was to explore and describe the role of patient care workers in private hospitals.Methods: A qualitative, descriptive design was applied to explore the role of patient care workers. Purposive sampling was used to select unit managers, nurses and patient care workers from medical and surgical wards of three private hospitals. Fifteen semi-structured interviews were conducted and transcribed verbatim. The researcher applied interpretative data analysis to move from the participants’ descriptions of their experiences to a synthesis of all participants’ descriptions.Results: Patient care workers are involved in direct patient care and spend much time with patients, often not working under direct supervision of registered nurses despite limited training and lack of regulation. Their contribution, however, is valued by nurses.Conclusion: Patient care workers are well-integrated into the patient care team and are mostly seen as nurses. Yet, there are concerns about their evolving role despite their limited training and the lack of direct supervision. Regulating the work of patient care workers is recommended.
Gaboipolelwe M. Masilo, Mashudu Davhana-Maselesele
Published: 28 February 2017
Journal: Curationis
Abstract:
Background: South Africa is reported to have the highest rate of sexual assault in the world with over 40% of cases occurring among children. Children who are sexually abused have support programmes and policies to assist them in coping, but there are no support programmes for mothers or caretakers. Caretakers need support for themselves and assisting them will incrementally benefit children under their care. Often mothers of these children experience shock, anger, disbelief and suffer secondary trauma such as depression and post-traumatic stress disorder (PTSD) following their children’s sexual abuse disclosure and yet there are no guidelines for support to these mothers within North-West province (NWP)Objectives: The study seeks to develop guidelines for support to mothers of sexually abused children in NWP.Methods: Concurrent convergence triangulation mixed method design was employed in this study. The population consisted of mothers of sexually abused children (SAC) (n = 17 participants for the qualitative component and n = 180 participants for the quantitative component). A sample of mothers of SAC was purposely selected.Results: The participants indicated significant levels of depression because of lack of support by stakeholders. Guidelines for support to assist mothers cope with their secondary trauma were developed based on the literature review, study findings as well as an ecological model of the impact of sexual assault on women’s mental health. The results also showed extreme PTSD (47.8%), little support (38.8%), not coping (76.1%) and depression (36.1%).Conclusion: The stakeholders should consider a positive approach to support mothers whose children are sexually abused.
, Jeanette Steenkamp,
Published: 28 February 2017
Journal: Curationis
Abstract:
Background: Burnout has been implicated as one of the reasons for key healthcare personnel, such as nurses, leaving their profession, resulting in insufficient staff to attend to patients. Objective: We investigated the predictors of three dimensions of burnout, namely emotional exhaustion, depersonalisation and personal accomplishment, among nurses in South Africa attending to patients living with HIV. Method: Participants were recruited at a large tertiary hospital in the Western Cape region, with the help of the assistant director of nursing at the hospital. They completed the Maslach Burnout Inventory, the Quantitative Workload Inventory, the Interpersonal Conflict at Work Scale, the Organisational Constraints Scale, the Death and Dying subscale of the Nursing Stress Scale, and the HIV and AIDS Stigma Instrument – Nurse. Results: We found elevated levels of burnout among the sample. Workload, job status and interpersonal conflict at work significantly explained more than one-third of the variance in emotional exhaustion (R² = 0.39, F(7, 102) = 9.28, p = 0.001). Interpersonal conflict, workload, organisational constraints and HIV stigma significantly explained depersonalisation (R² = 0.33, F(7, 102) = 7.22, p = 0.001). Job status and organisational constraints significantly predicted personal accomplishment (R² = 0.18, F(7, 102) = 3.12, p = 0.001). Conclusion: Factors such as workload, job status and interpersonal conflict in the work context, organisational constraints and stigma associated with HIV were found to be predictors of burnout in the sample of nurses. Our recommendations include developing and testing interventions aimed at reducing burnout among nurses, including reducing workload and creating conditions for less interpersonal conflict at work.
L. Coetzee, M.E. Muller, M. Vermaak
Published: 26 September 1989
Journal: Curationis
Abstract:
Hospitalisasie beteken die oorgang van ’n bekende na ’n onbekende omgewing en ontketen ’n behoefte aan leer en of gedragsverandering ten opsigte van sy gesondheidstoestand by die pasiënt. Dit is ’n integrale deel van die verpleegkundige se onafhanklike funksie om ook in hierdie behoefte van die pasiënt te voorsien. Navorsers dui op ’n aantal positiewe gevolge van pasiëntonderrig (Devine 1986, p 99-100) (Wilson-Barnett 1983, p 37) en dit is duidelik dat pasiëntonderrig uiteindelik sal lei tot effektiewer pasiëntsorg. Ten spyte van baie duidelike voordele word hierdie funksie van die geregistreerde verpleegkundige tot ’n groot mate oorgeneem deur paramediese personeel (Brownlee, 1983 p 102). Ander navorsers bevind dat die aard en kwaliteit van pasiëntonderrig wat wel gedoen word nie na wense is nie (Pera, 1986) (Muller, 1986 p 148-150). Hierdie ontkenning van die pasiëntonderrigfunksie deur die verpleegkundige word onder andere versterk deur ’n gebrek aan pasiëntonderrigstandaarde. Geformuleerde standaarde wat as maatstaf van kwaliteit dien sal die verpleegkundige weereens bewus maak van haar funksie in hierdie verband.
Lr. Uys, S.W. Booyens
Published: 26 September 1989
Journal: Curationis
Curationis, Volume 12, pp 29-31-31; https://doi.org/10.4102/curationis.v12i1/2.221

Abstract:
In this project standards for nursing records in general hospitals were formulated and then validated by a group o f nurses. An instrument was then designed to evaluate to what extent the standards are reached in a particular hospital. The instrument was then tested in a sample o f nine hospitals. The reliability and validity o f the instrument is discussed.
Susanne W. Booyens, Leana R. Uys
Published: 26 September 1989
Journal: Curationis
Curationis, Volume 12, pp 26-28-8; https://doi.org/10.4102/curationis.v12i1/2.219

Abstract:
An investigation was undertaken with the aim o f establishing standards for the documentation o f nursing care. Nursing care records in the medical and surgical units o f private and general hospitals in the PWV-area and the Cape Peninsula were audited. A considerable number o f deficiencies were identified in the daily record keeping o f nursing care.
M. Steyn, K. Steyn
Published: 26 September 1989
Journal: Curationis
Curationis, Volume 12, pp 22-25-5; https://doi.org/10.4102/curationis.v12i1/2.216

Abstract:
As a part of a comprehensive coronary risk factor study among the coloured population of the Cape Peninsula (the CRISIC study), the media use and preference of the population were examined with a view to suggesting appropriate media for conveying health messages. A stratified sample (N = 976) was randomly drawn from the coloured population in the age group 15 to 64 years in the Cape Peninsula. Data were collected by means of a pre-tested questionnaire. Analysis of the data showed that information on the prevention of heart disease was obtained in greater measure from the mass media than from interpersonal communication. As far as media preference is concerned, television was considered the most effective medium for conveying information to the community, followed by instruction given to school children. Greater use of health educators to convey health messages, as well as a multi-media approach, is suggested for a successful intervention programme.
Peter Jacobs, Lucille Wood
Published: 26 September 1989
Journal: Curationis
Curationis, Volume 12, pp 18-21-21; https://doi.org/10.4102/curationis.v12i1/2.213

Abstract:
The slow progression of both chronic granulocytic and lymphocytic leukaemia, when compared to their acute counterparts, has been used as an argument to support less aggressive therapy or even, in some instances, a watch-and-wait policy. This conservative approach is bolstered by a number of observations including the ease with which haematologic control can initially be achieved, the older age of patients with the lymphocytic variant and the paucity of controlled data showing that long disease-free survival or cure can result from the use of aggressive treatment. Given these circumstances, it is not surprising that many such individuals are managed outside specialised centres using a variety of agents and schedules, both of which may, on occasions, be inappropriate. Accumulating evidence suggests a need to reconsider these practices since cure is now possible in selected patients with chronic granulocytic leukaemia while the use of multi-drug regimens in the lymphatic form can significantly improve survival. These advances are the result of carefully conducted clinical trials involving many individuals the world over and constitute the basis fo r advocating early referral to those institutions where all the necessary expertise is available.
H. I. L. Brink
Published: 26 September 1989
Journal: Curationis
Curationis, Volume 12, pp 13-17-7; https://doi.org/10.4102/curationis.v12i1/2.210

Abstract:
The aim of this study was to determine how the registered nurse tutor in the Republic of South Africa perceives her role and how her role perception compares with the role expectations laid down by nurse leaders. A further question was whether a discrepancy existed between the tutors ideal role perceptions and her perceptions of whether the roles are actually performed. A survey by questionnaire was the method of investigation used. A random sample stratified by population group and gender was selected from all nurses who had the additional qualification of nurse tutor entered against their name in the register of the S.A. Nursing Council. The responding sample comprised 233 registered nurse tutors. Both descriptive and inferential statistics were used for the analysis of the responses. The findings suggested that the majority of registered nurse tutors perceived most of the role activities advocated by nurse leaders as ideal rote activities. However, a considerable number of respondents still consider the traditional teacher-centered role as ideal. Only one-half of the respondents considered the scholarly role to be a distinct role component of the nurse tutor. Statistically significant differences between ideal and actually practised role perception scores were found on almost all role activities.
W.J. Kotze
Published: 26 September 1989
Journal: Curationis
Curationis, Volume 12, pp 1-4-4; https://doi.org/10.4102/curationis.v12i1/2.209

Abstract:
At their annual meeting during 1987, the heads of the Departments of Nursing at South African Universities discussed the sub-division of Nursing Science. They identified the following problems in this regard:
Lucille Wood
Published: 26 September 1990
Journal: Curationis
Abstract:
I have recently had the opportunity to present departmental research at the International Bone Marrow Transplantation Meetings and to visit a number of academic centres overseas. This report summarises those experiences, with particular emphasis on the role of the professional nurse in research and development as it applies to contemporary haematology.
Hilla Brink
Published: 26 September 1990
Journal: Curationis
Curationis, Volume 13, pp 38-43-43; https://doi.org/10.4102/curationis.v13i1/2.296

Abstract:
Despite the fact that caring is the heart of nursing, there is growing evidence that nurses are not as effective as they ought to be in their caring role. This signifies that more attention needs to be given to the teaching of caring. The aim of this study was to pave the way to initiate the process of research on teaching caring, by suggesting priority areas. The needs assessment design was used for the study. Five steps were involved to achieve the aims. The first was to explore the nature and meaning of caring as presented in the literature. The second was to review completed research on aspects of caring within the nursing context. The third was to investigate the position of caring in the present nursing education system. The fourth was to investigate ways of promoting the teaching of caring as advocated in the literature and the final step based on inferences made from the first four steps was to suggest priority areas for research on teaching caring in nursing.
M.S. Mabaso, L.R. Uys
Published: 26 September 1990
Journal: Curationis
Abstract:
Miss O is a 23 year old unmarried sister of an 8 year old boy diagnosed as having microcephaly. The family lives in a shanty house (‘Umjondolo’) at Kwa Makhutha but uses a relative’s house for the official address because the family is not entitled to health care locally if they are not registered as residents. Miss O’s parents died when her brother was only 6 months old and she was 15. “We were 8 in the family, 4 boys and 4 I am the eldest and this boy was my mother’s last child. I was not aware that the baby had a problem when he was still very small. As I grew older 1 noticed that his head was small but I thought he just had a small head which was relatively normal. I had to assume the responsibility of taking care of my younger brothers and sisters as the older sister.
M.S. Mabaso, L.R. Uys
Published: 26 September 1990
Journal: Curationis
Curationis, Volume 13, pp 33-36-6; https://doi.org/10.4102/curationis.v13i1/2.292

Abstract:
The reaction of Black families to the birth and care of a baby with profound congenital defects was researched using twenty case studies. It was found that the families went through stages of the grieving process, that they shifted from the Western/Christian viewpoint to the traditional viewpoint in their struggle to cope and that they find the existing services grossly inadequate.
A.S. Koorts, A.J. Marais
Published: 26 September 1990
Journal: Curationis
Abstract:
The purpose of this study was to determine whether changes had occurred in the work satisfaction of nursing services after the establishment of private initiative in health care due to the deregulation program currently conducted by the government. In a survey conducted in the latter part of 1988 700 questionnaires were sent out of which 213 were returned which gives a response of 30,43 percent. The analysis was based on this data. The attitudes of the members of the nursing services ranged from antipathy to lively enthusiasm. It was, however, clear from the response that there exists a strong negative view amongst the nursing profession regarding remuneration, communication, training and promotion. These are tendencies that can harm the profession as a whole on the long run and should therefore receive special managerial attention. Recommendations include market related remuneration, continued nursing training, and planned career paths, as well as an appeal that only minimum admission requirements should be accepted as preconditions to training in order to cope with the growing Third World demands on health care services.
Kate Grieve
Published: 26 September 1990
Journal: Curationis
Abstract:
Preterm birth constitutes a potential risk factor for infant development. There is evidence that parental sensitivity and responsivity can compensate for biological risk. Since the birth of a preterm infant often constitutes a crisis for parents, they may be impaired in their ability to relate appropriately to their infants. The nursing staff can play a vital role in enhancing the interaction between parents (in particular mothers) and their preterm infants, thereby indirectly promoting optimal infant development. This paper describes the psychological tasks faced by mothers of preterm infants, parents’ experiences of preterm birth and suggestions as to what the nursing staff can do to facilitate healthy relationships between parents and their preterm infants, thereby preventing possible pathological development.
Noelle B. Hunt, Leana R. Uys
Published: 26 September 1990
Journal: Curationis
Curationis, Volume 13, pp 21-23-3; https://doi.org/10.4102/curationis.v13i1/2.283

Abstract:
An investigation was undertaken to establish standards for the care of the frail aged and to develop an instrument to measure this care. In this process the care in 12 institutions was monitored. In general, the care was found to be o f good quality, with an average o f 74,3%, but there are residences where the percentage is up to 10% lower. The influence o f some internal and external factors on the quality o f care were investigated.
L.R. Uys, B.N. Hunt
Published: 26 September 1990
Journal: Curationis
Curationis, Volume 13, pp 19-20-20; https://doi.org/10.4102/curationis.v13i1/2.277

Abstract:
In this project standards for the nursing care of the institutional care of the frail aged were formulated and then validated by groups of nurses. An instrument was then designed to measure to what extent these standards are reached. The instrument was then tested for reliability and validity in a sample o f 12 institutions in the Eastern Cape and Natal.
M. Kumalo, L. R. Uys
Published: 26 September 1990
Journal: Curationis
Curationis, Volume 13, pp 15-18-8; https://doi.org/10.4102/curationis.v13i1/2.275

Abstract:
The health needs of Black elderly in rural and urban KwaZulu was investigated through a survey. Interviews with 240 elderly was done, looking at the first and second level of the health facilities plan, as well as social support and health indicators. It was found that urban elderly are generally better off than rural elderly and a profile of need is described.
Marlene J. Viljoen, Marie E. Muller, Leana R. Uys
Published: 26 September 1990
Journal: Curationis
Abstract:
Standards for the making o f a community diagnosis were formulated and validated on a national basis. These standards can be utilised by the community health nurse to improve the quality o f community diagnoses. The quality o f community diagnosis by community health nurses, was analysed by means o f a retrospective audit. Incomplete diagnosis were observed in the compilation o f a community profile and data resources were inadequately utilised. Important health indicators were not taken into account during the interpretation of data and planning strategies were incomplete. It appears as if the community health nurse tends to pay more attention to data that is readily available or can be utilised fo r quick results in his/her community planning.
L.R. Uys, M.J. Viljoen, M.V. Vermaak, M. Muller, L Coetzee
Published: 26 September 1990
Journal: Curationis
Abstract:
A lack o f patient education standards was identified and the researchers attempted in this study to develop standards for patient education. An instrument fo r the evaluation o f patient knowledge was also developed.
Mariana Steyn, Marlene Viljoen
Published: 26 September 1990
Journal: Curationis
Abstract:
This study was part o f a comprehensive research project undertaken at the request o f the SANTA Health Education Committee to evaluate the tuberculosis guidance programme. The aim o f the research was to examine factors influencing black people's health perceptions and intentions concerning the combating o f tuberculosis as well as vaccination o f their children. Data were collected by means o f a questionnaire based on the Health Belief Model. The research was conducted in selected areas o f the OFS, the Transvaal and Natal (N=l 198). It was found that factors indicating a greater degree o f development o f the individual (e.g. literacy) were positively associated with positive health perceptions such as that medical treatment can cure TB completely. Some positive associations were also found between perceptions!modifying factors and intentions/vaccination. Indications were also found o f an inability on the part o f health personnel to influence the public positively.
Hentie Boshoff
Published: 26 September 1989
Journal: Curationis
Curationis, Volume 12, pp 72-76-6; https://doi.org/10.4102/curationis.v12i3/4.259

Abstract:
To address this problem, one has to look at (i) societal changes and future developments, (ii) changes in health care as such and (iii) the linkage between these two. In this respect we must realize that we are living in an era where economic, technological, demographic, social and political changes are accelerating. The interface between these changes results in the age of discontinuities as far as individual trends are concerned. To work therefore with projected futures amounts to brain gymnastics. A more realistic approach is to define the key drivers or trends and structures shaping the future of society and health care, and from this deduct the possible implications for health professions. Societal key drivers affecting change The process of societal change evolves around economic, technological, demographic, political and societal change.
Lucille Wood
Published: 26 September 1989
Journal: Curationis
Curationis, Volume 12, pp 67-71-71; https://doi.org/10.4102/curationis.v12i3/4.256

Abstract:
Myeloma is a malignancy o f plasma cells which are terminally differentiated B-lymphocytes. The diagnosis may he made incidentally at routine blood testing, when an abnormality is found in the plasma proteins on electrophoresis. More usually the patients are symptomatic, with bone pain, anaemia, evidence o f renal failure, or the metabolic abnormalities associated with increased plasma calcium and urate levels. Effective treatment will extend survival from 7 to approximately 30 months and at the same time improve the quality o f life. Treatment is multidisciplinary, prominently involves the professional nurse and may arbitrarily be divided into two stages. Firstly, reversible lesions, such as dehydration and plasma hyperviscosity must be corrected, hypercalcaemia and hyperuricaemia improved and, if necessary, renal dialysis undertaken. Secondly, but o f equal importance, is the need for specific therapy to be directed against the tumour itself, and both cytotoxic agents and irradiation have an important role to play. More recently, newer approaches have included high dose chemotherapy and bone marrow transplantation.
H.I.L. Brink
Published: 26 September 1989
Journal: Curationis
Curationis, Volume 12, pp 62-66-6; https://doi.org/10.4102/curationis.v12i3/4.253

Abstract:
The purpose o f this study was two-fold, namely: I) to obtain clarity on the meaning o f the term preceptor, and 2) to establish how the term preceptor is interpreted in the nursing colleges o f the RSA and to ascertain whether this interpretation is consistent with the general connotation o f the term in contemporary nursing literature. Dictionaries and relevant contemporary nursing literature formed the unit o f analysis fo r obtaining clarity on the meaning o f the term preceptor, while the unit o f analysis fo r the second section o f the study comprised responses o f nursing college principals to a questionnaire. The data obtained in the investigation indicate that the term has acquired a specific connotation within the international nursing context and that specific defined attributes distinguishes it from the broad and general definition found in standard dictionaries. Within the South African nursing context the term preceptor has not yet acquired a specific connotation, but appears to mean different things to different people.
H.L.L Brink
Published: 26 September 1989
Journal: Curationis
Abstract:
In this exploratory study nine masters programmes in nursing were surveyed to establish the types o f programmes available, the growth o f masters students over the years and the policies governing each programme. Data were collected by means o f a questionnaire developed by the investigator. From the findings it could be established that considerable variation existed in the type o f form o f degree offered, that growth was steady but slow and that both similarities and differences existed in the policies o f the departments. Several areas were identified for additional research.
Annali Basson, Annatjie Botes
Published: 26 September 1989
Journal: Curationis
Abstract:
Students applying to follow the B. Cur. degree at the Rand Afrikaans University are subjected to a selection process. In spite o f the selection process the drop-out rate is high. An attempt is being made to evaluate the present academic selection process. The amended Smeltzer method is used as a point o f departure to correlate with the model proposed by the University administration. The academic predictions are implemented on the Swedish formula and a cut-off point is obtained according to a sliding scale proposed fo r academic selection. With the abovementioned two methods it appears that the selected population has the most successful academic results if the cut-off point o f the amended Smeltzer method and the Swedish formula is 60 and 15 respectively.
I. Wannenburg, W.J. Kotzé
Published: 26 September 1989
Journal: Curationis
Abstract:
The outcome of any system of evaluation has a considerable impact on the daily lives of students in a variety of educational settings. Hence, it was attempted to illustrate the complexity of the problem when evaluating the performance skills of first year students in the clinical environment of the general hospital. The choice of the research field originated from the increasing concern of the researcher about the reliability of the current evaluation practices in the formative assessment of first year student nurses. The impression gained is that nurse educators are more concerned with the end results of evaluation than with the teaching-learning process needed to reach this goal. Due to the many variables that can influence its results, the implementation of the evaluation process in clinical nursing is extremely complicated. In the course of studying the literature relevant to the research field, the researcher identified aspects that can be considered as of critical importance in the assessment of student performance in clinical nursing.
M. Steyn, A.S.P. Swanepoel, L.J. Rossouw, M.L. Langenhoven, P.L. Jooste
Published: 26 September 1989
Journal: Curationis
Abstract:
During the past ten years a comprehensive research project has been undertaken to develop a guidance programme in three adjacent communities in the South- Western Cape with the aim o f lowering the high incidence o f coronary heart disease. The purpose o f this substudy was to determine whether the guidance provided in the different communities had any influence on the knowledge o f and attitudes towards the nutrition o f pregnant women, babies and infants as well as breast-feeding practices o f the women who gave birth during the period 1980 to 1986. In the first community guidance was provided by means o f small mass media and interpersonal communication whereas only the small mass media were employed in the second. The third served as the control community. The findings suggest that the combined interpersonal and mass media programme was more successful than the mass media programme alone.
M.E. Muller, A.G.W. Nolte, J.C. Roux
Published: 26 September 1989
Journal: Curationis
Abstract:
The transport o f ill neonates between hospitals and/or health care centres, plays an important role in the mortality rate o f these seriously ill neonates. It is therefore important that the ill neonate is transported under optimal conditions. A lack o f standards in this regard hampers the evaluation o f the quality o f inter hospital transport o f ill neonates. The purpose o f this study is to formulate valid standards fo r the transport o f seriously ill neonates between hospitals (and/or other health care institutions) to form the basis fo r the evaluation o f the quality o f this service. Factors that need to be considered in the transport o f ill neonates include the ambulance, equipment and stock, the transport personnel and communication. These factors were systematically explored and described and standards were formulated accordingly.
J.C. Roux, A.G.W. Nolte, M.E. Muller
Published: 26 September 1989
Journal: Curationis
Abstract:
The quality o f the inter hospital transport o f ill neonates, by selected ambulances in the Witwatersrand area, was investigated by means o f the case study method. O f the fifteen case studies investigated, eleven neonates were transported by a private ambulance and four by provincial ambulances. Data regarding the maternal- and neonatal history, the optimal maintenance o f the neonate's condition, the communication system, as well as aspects relating to the transport personnel, were collected by means o f a structured instrument. Retrospective auditing o f records, structured interviewing and direct observation/inspection were utilised as the research techniques. The quality o f the inter hospital transport o f ill neonates, especially by the private ambulance, is not up to standard. Deterioration o f the neonate’s body temperature, heart and respiration rates, as well as the serum glucose values after transport, were o f the more important findings. The lack o f equipment, especially in the private ambulance, increases the risk o f transport. Staff development and form al control by a local committee, as well as a national control body, are recommended.
Jean Bowen Jones
Published: 26 September 1989
Journal: Curationis
Abstract:
A two month study to investigate the incidence o f nosocomial infection was conducted in a paediatric gastroenteritis ward o f a black academic hospital. Enteric pathogens were identified on admission in 61 (47,2%) o f 129 patients; 56 bacterial and 25 viral. Six per cent o f patients had a combination o f bacterial and viral pathogens. Enteric pathogens most frequently identified on admission were Campylobacter jejuni in 22%, Rotavirus in 19,3%, EPEC in 10,8% and Shigella spp. in 6,9% patients. Twenty six (20%) patients had more than 1 enteric pathogen. The nosocomial infection rate was recorded at 17,1%. EPEC occurred most commonly in 5,3% patients, Salmonella typhimurium in 4,6% and Shigella spp. in 2,3%. Nosocomial infections increased the mean length o f hospital stay from 7,2- 20,2 days. Contributory factors to the spread o f nosocomial infection were the unsatisfactory methods o f bathing patients and giving naso-gastric feeds.
Johanna M. Dreyer
Published: 26 September 1989
Journal: Curationis
Abstract:
The aim o f this study was to determine and describe the role and functions o f the community health nurse in the health services o f local authorities o f the larger cities within the framework o f legislation regarding health and the health service structure o f the Republic o f South Africa. A questionnaire was used to gather data in connection with the present role and functions o f the community health nurse who is responsible fo r direct client I patient care in the local authority areas o f Greater Cape Town, Port Elizabeth, Durban, Pretoria, Johannesburg and Bloemfontein. The information gained from the questionnaires was followed up by personal observations o f the services tendered in Greater Cape Town, Durban and Johannesburg, after it had been computed. The study indicates that the community health nurse in the urban, local authority health services o f the Republic makes a very important contribution to the delivery o f services within the provisions o f the Health Act, no. 63 of 1977. The analysis o f the computed data and personal observations showed that the community health nurse in the large cities must carry out a certain percentage o f the administrative, educational, preventive, promotive, curative and rehabilitative activities in the services.
J.H. Booyens
Published: 26 September 1989
Journal: Curationis
Abstract:
This article contains a general overview o f cultural perceptions o f diarrhoeal disease amongst infants as expressed by Tswanaspeaking urbanites. Attention is mainly given to the perception o f gastro-enteritis. The research on which this article is based was concluded during 1984. The article indicates that a majority o f respondents maintains the view that aeliologically it is possible to distinguish between three categories o f illness, viz. illness o f sorcery, illness o f the shades or ancestors and “natural” illness or illness that “ju st happens " Within this general aetiological frame, aeious diarrhoeal disease o f infants is tally seen as sorcery related. Contact o f infants with people regarded as ritually polluted is seen as a major causal agency. It is conceptualised as infants being “stepped u p on"by “tracks". It causes an illness known as “phogwane", which can he interpreted as “sunken fontanelle The concept "kokwana", which can be interpreted as "intestinal snake", is however also used to indicate serious diarrhoeal illness. In the case o f "kokwana"it is said that the snake, "sent” to the child through witchcraft, "eats " the child’s fo o d and the child itself. Although many o f the respondents were in doubt, the majority were o f the opinion that Western doctors do not really understand the treatment o f these dangerous illnesses. The author believes that nursing practitioners who are involved in health education services should take note o f these popular conceptions o f gastroenteritis. Knowledge o f these views should be used during education session in a meaningful way, to tactfully dissipate “misconceptions ".
J.C.N. Mentz
Published: 26 September 1989
Journal: Curationis
Abstract:
The aim of this paper is to give a brief description of the utilization of community health workers (CHWs) in Gazankulu. The general policy framework in which these health workers function is described briefly, and the way in which these workers function evaluated. This paper is intended as a modest contribution to evaluation research in the field of community health.
Editorial Office
Published: 26 September 1989
Journal: Curationis
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