Masters Degrees (Nursing)

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Professional nurses knowledge and understanding of AIDS/HIV infection.
(1993) Chamane, Nomusa Joyce.; Kortenbout, Wilhelmina Petronella.
This study examines the Professional nurses' knowledge and understanding of AIDS/HIV infection. The Professional nurses that participated in the study, are those working in a specialised institution which caters for tuberculosis and psychiatric patients, and those suffering from oesophageal and lung cancer; and the patients with orthopaedic problems. Knowledge explored is specifically related to AIDS/HIV infection, which includes the causes, mode of spread of infection, symptoms, diagnostic tests available, prevention, complications and identification of high risk groups. The sample was formed by 53 Professional nurses; 27 being those that have done the AIDS counselling course, and 26 who have not done the course. To collect data, questionnaires were sent to the participants. Apart from the questionnaires, focus group interviews (21 participants) were done to elicit any information that may not be obtained through the use of a questionnaire. The theoritical framework used is a combination of two theories, Cognitive Dissonance Theory and Fear of Contagion Theory. Cognitive Dissonance Theory assumes that people want to maintain consistency with their beliefs, attitudes, values and behaviour. People confronted with examples of their own inconsistency in these areas, will experience psychological discomfort and be motivated to eliminate the inconsistency. Fear of Contagion Theory developed as a response to perceived threat of catching the disease/infection. Three behaviours characterise this fear:- avoidance, taking extreme precautions, and verbal expression of fear regarding the disease. As a result, apart from looking at factual knowledge, one had to identify the behaviors that relate to this theoretical framework. These included fear, avoidance, taking extreme precautions and dissonance/discomfort. These areas are covered in the questionnaire as well as in the interview with the focus group. The results show high knowledge of general information, including the mode of spread. Lack of knowledge in identification of high risk groups, symptoms, diagnostic tests and use of universal precautions in specific areas was identified. Fears and dissonance are found to be caused by lack of knowledge, aggravated by the fact that the disease is incurable, as it was expressed by the focus groups. Uncertanty was marked with regard to the use of protective clothing. Some participants responded in a manner that showed the use of extreme precautions, while others were unsure in such a way that in the end they indentified different protective clothing for the similar situations. In areas where knowledge deficit was identified, it was discovered that the Trained AIDS Counsellors had better knowledge than those that have not done the course except for universal precautions. On looking at the programme it was discovered that the use of universal precautions was not included in the programme and this might be the cause for the uncertainty. The difference between the two groups might have been in the understanding gained from knowledge acquired during the counselling course, since both groups were exposed to the same enviroment, policies and circulars regarding caring for HIV infected patients. Although the results showed the numerical differences, it was surprising that in certain sections when these differences were tested statistically, no statistical difference was shown between the two groups. This might have been due to the small sample used. There are respondents that showed a negative attitude towards caring for AIDS/HIV infected patients; unfortunately no further questions were asked to explore this aspect. This is a shortfall of this study. It is clear that AIDS/HIV infection is a challenge to all professionals, since it has become one of the leading causes of death. It is then believed that nurses should be equipped with adequate knowledge so as to be able to care for those suffering from AIDS/HIV infection. In conclusion it was clear that AIDS/HIV infection is a challenge for all professionals.
The experiences of infertile African women in Durban.
(1994) Ndaba, Nelisiwe Dorcas.; Brookes, H. B.
The experiences of African women with primary infertility were explored. These women were from Durban and surrounding rural areas, in KwaZulu / Natal. The aims of the study were to describe their perception of infertility using King's (1981) Interacting Systems Model and to describe the actions they undertook in response to their problem of primary infertility. A purposive sample of the first ten consenting women with primary infertility, five from the academic hospital and five from a private gynaecological practice were selected on the day when they attended either health centre. Case studies were conducted using in-depth interviews. Women's personal, interpersonal and social systems were adversely affected by their problem of being unable to conceive. For example in the taped discussions, all ten participants had a low self-image in regard to their personal system which was reflected in all but four, when measured with Rosenberg's Self-Esteem Scale (Rosenberg, 1979). All women were found to be at various stages in the grief process, only one having attained acceptance (Kubler-Ross, 1969). Eight women were married and the remaining two were single. Four of the married participants had experienced problems with "in-laws", which has led to poor interpersonal relationships, unlike the other four married participants. Despite not being major decision-makers in the household, all the participants were allowed to make their own decisions about whom they saw in regard to infertility. All the women concerned made use of formal medical facilities but four participants made use of traditional and/or faith healers as well. Some of the problems identified were the lack of emotional support from nursing personnel as well as their own lack of understanding of causes, investigations and treatment of female infertility. Recommendations regarding effective nursing care of women with infertility and the possible formation of support groups, were made. As all the participants were literate, informative pamphlets could be developed. Areas of further research were identified.
Gender conflict amongst adolescents at the Rossburgh High School, Durban.
(2000) Chetty, Ravani.; Uys, Leana Ria.
In 1998 the Faculty of Community and Development Disciplines (CADD) embarked on a project to prevent and reduce crime involving school children. A needs assessment was conducted in the three schools where the project was to have its main focus. One of the problems that came out of the Rossburgh High School was the conflict that appeared to exist between male and female learners at the school. Male learners were observed to 'bully' their female counterparts. Given the high statistic of violence against women in South Africa, this seemingly 'small' problem could have relevance later on in the lives of these adolescents. In order to intervene successfully it was first necessary to understand the problem that existed. By means of focus groups male and female adolescents provided information around the phenomenon. From data obtained, it appeared that fighting was predominantly due to boyfriend/girlfriend relationships. The problem was explored in depth and recommendations were made with regards to intervention programmes and future research.
Mental health care provided by nurses in the primary health care clinics in Swaziland.
(2000) Hlatshwayo, Makhosazana Zanele.; Ganga-Limando, Richard Makombo.
The study was designed to examine and describe mental health care provided by the nurses in the primary health care settings of Swaziland. The study sought to answer one main questions namely: • what was the nature of mental health care provided by nurses in the primary health care clinics? A sample of 31 primary health care clinic nurses was used to generate data for the study. The sample consisted of registered nurses with only one having a mental health qualification. The study used both qualitative and quantitative methods for data collection. Data analysis involved simple frequency and percentage counts using SPSSmanual as well as descriptive narratives using NVIVO computer analysis methods. Findings revealed that mental health care in the primary health care clinics was mainly traditional involving immunizations, family planning and antenatal services, Limited mental health care was provided by the only mental health nurse involved in the study, Nurses stated that the care they provided was in line with their job descriptions, The study concluded that the mental health care provided at the primary health care clinics was based on the traditional approach that did no encompass mental health care, Recommendations made were related to the promotion of the integration of mental health care into the services provided in the primary health care scttings with nurses being prepared for the role.
Exploring the extent of cultural sensitivity among the nursing students doing the four year diploma at Addington hospital in KwaZulu-Natal province.
(2000) Mafanya, Busisiwe Benedicta.; Khanyile, Thembisile.; Moletsane, Relebohile.
This study was undertaken to explore the extent of cultural sensitivity among the nursing students of Kwa Zulu - Natal Province. A qualitative. ethnographic, explorative design was utilized. A quantitative approach was also used. Subjects were second, third and fourth year students registered for the four year Comprehensive Diploma in Nursing leading to registration as a Nurse (General, Psychiatry, Community Health) and Midwife. To ensure measures of trustworthiness, Guba's model in (Krefting 1991) was implemented. Narrative statements in the form of scenarios and questionnaires were employed to explore, to examine and to describe the extent to which the nursing students are sensitive towards cultures of groups that are different from theirs. The data was analyzed based on the developmental stages of cultural sensitivity by (Bennett 1986). Tesch's method was used to analyze the qualitative data and the Statistical Analysis System (SAS) was used to analyze the quantitative data. Based on the findings. the following conclusions were drawn:- Some students were unable to acknowledge variations that exist among cultures. Problems emanating from cultural differences still exist between nurses and patients due to the ethnocentric views held by some nurses. The study revealed that the students were at varying stages of levels of development of cul tural sensitivity, which means that they ranged from lack of cultural sensitivity to cultural sensitivity. Nursing students, therefore. need more preparation by their program in order to provide culturally congruent nursing care to all.
Critical thinking skills development among the diploma nursing students in a case-based curriculum.
(2001) de El-Kantar, Lina Abi Faker.; Adejumo, Oluyinka.
Faculty members in many schools of nursing have been urged to include critical thinking in all aspects of the nursing curriculum. The faculty at the Institutes of Nursing in the United Arab Emirates, have adopted in the academic year I998 a case-based curriculum that teaches nursing courses by using case studies, which represent a terrific and non-threatening method to use to teach and learn either critical thinking skills or clinical decision-making (Robinson, 1998; Glendon and Ulrich, 1992, 1997). The development of critical thinking skills in a case-based curriculum was investigated. A randomly selected, cross-sectional sample of nursing students at the Abu Dhabi Institute of Nursing (N= 88) was studied. Three groups (n=30) from each level of a three-level-diploma nursing program were measured for development of critical thinking skills using the Test of Everyday Reasoning (TER). Relationships were investigated between TER scores, the level of the program and other socio-demographic and academic achievement determinants. Critical thinking ability did not change significantly among the three levels during the educational experience in a case-based curriculum; however, the participants in the highest level of the program were able to get a higher mean TER scores from the other two levels. One of the conclusions that could be drawn from this study was that critical thinking might not change as an associated factor with a case-based curriculum at this premature phase of its implementation until some time after the graduates of this program become practicing nurses where clinical decision-making would be in action. The other conclusions focused on the necessity of unfolding the utilized cases in the curriculum and on determining whether the construct of critical thinking has been incorporated in them.
Pathways to mental health care in Kwazulu-Natal province South Africa.
(2001) Mkize, Lungiswa Patience.; Uys, Leana Ria.
The understanding of the pathways that clients take prior to admission to a mental health institution, is a vital factor in planning to reduce delays in seeking treatment. Studying the pathways may also help in the identification of sources of delays in the receiving of care and suggest possible improvements. Although western medicine plays an important role in the control of disease, traditional medicine continues to play an important role in the health care of black African communities. They, therefore possess unique attitudes, values and beliefs, about health and illness, which integrally infiuence their health behaviour. This study aims to increase the understanding by health professionals of pathways to care taken by clients before they are admitted to a mental health institution, so as to enhance heath service planning. It also aims to determine the socio-cultural and economic factors, as well as satisfaction with different service providers. The sample in this study consisted of 15 clients, who were between the ages of ten and fifty-nine years. These clients were males and females who were admitted for the first time in a mental health institution (MHI) (TownHill Hospital, Pietermaritzburg). The interview questionnaire, was administered, by the researcher.This study has demonstrated that, Africans still believe in traditional and faith healers as their first port of call when they are mentally ill. Their help seeking behaviour is determined by their cultural beliefs and values. The study also demonstrated the high involvement of the South African Police Services (SAPS) in the pathway to mental health institution by intervening to protect family or public and also transporting the client to a mental health institution. The Primary Health Care (PHC) is very seldom used Economic factors like unemployment strongly infiuence the mental health of people and also affect their social functioning, as it is shown by the high levels of unemployment in the sample. Some of these clients resort to living on the streets, because they cannot find employment and are homeless. The study has also shown the importance of education and training of health professionals in PHC, in identifying the first signs of mental illness when clients present themselves and making available the psychotropic drugs at the PHCC as this is the first port of call for clients. Psycho education of traditional healers, spiritual healers, SAPS and community should be implemented on when and how to refer clients, how to handle mentally ill clients.
An exploratory study of suicide amongst adolescents in Umzimkulu district high schools.
(2001) Jozana, Noluthando Edith.; Uys, Leana Ria.
High school adolescent's suicidal behaviour caused a concern to the Umzimkulu community and the multi - disciplinary team in the local Psychiatric institution during the years 1997 - 1999 . The purpose the study was to identify and describe the charactics of adolescents who committed suicide. Rutter's (1995) model of risk. resilience and recovery has been used as a theoretical frame work for the study. A descriptive, exploratory case study design is most suitable for the incidence of suicide at Umzimkulu District .The case study approach was best suited as it assists in an indepth study focussing on contemporary phenomena with sum real life contexts . The distinctive need for the case study design arises out the desire to understand complex psycho-social phenomena of adolescent suicide (Yin, 1989).Each adolescent who committed suicide over the last two years in Umzimkulu District will form a case . All data about the particular person will be the case description Adolescents who committed suicide were identified from the records at the police intelligence office of Umzimkulu Police Station. Parents, identified friends, teachers and health workers who had known the adolescents. Semi structured interviews with open ended questions were used. Interview schedules for teachers, parents and close friends differed slightly. A tape recorder for later transcription was utilised. To analyse the data, Ruttter's model was utilised to do cross case analysis. Results according to Rutter's model, were that, due to inconstant support received by the adolescents, high levels of stress in early child hood, had left them insuffiently resilient to with stand the problems they encountered during adolescence.
Witnessed resuscitation exploring the attitudes and practices of the emergency staff working in the level one emergency departments in the province of Kwa-Zulu Natal.
(2001) Goodenough, Toni Jennifer.; Brysiewicz, Petra.
Aim: The aim of this study was to explore the attitudes and practices of the emergency staff working in the level one emergency departments in the province of KwaZulu-Natal, with regard to witnessed resuscitation. Methodology: A qualitative approach was used to explore the attitudes and practices of the staff. Two semi - structured interviews were conducted with each participant, an initial and a verifying interview, with each interview lasting between 15 - 30 minutes long. The researcher applied the principle oftheoretical saturation and a total ofsix participants from two of the four level one emergency departments were included in this study. One provincial and one private emergency department were chosen. All of the interviews were taped and transcribed prior to manual analysis, in which categories and themes were identified from the data. Findings: The emergency staff disliked the idea of witnessed resuscitation. They believed it to be a harmful experience for the witnesses, a threat to the resuscitation process, threatening for the emergency staff, and impossible to implement in their emergency departments that are already short of staff and space. Although these were their dominant feelings, there were subtle references made during the interviews that revealed that there were some aspects of witnessed resuscitation that they liked once they had considered the practice. There were no written policies to dictate how the relatives were handled, but all the staff agreed that the relatives were asked to wait outside-of the resuscitation area, they were kept informed and then brought in when the patient was stable or had died. A number of recommendations are suggested for education, practice and further research in an attempt to introduce witnessed resuscitation as an option in KwaZulu-Natal's emergency departments.
Critical thinking in a case-based and a traditional nursing education program.
(2001) Kaddoura, Mahmoud Ali.; Gwele, Nomthandazo S.
Up to 1998, the Institutes of Nursing in the United Arab Emirates have been using the traditional lecture-based teaching/learning process in their graduate-nursing program. In 1998, however, these Institutes adopted a new approach; namely, the case-based learning (CBL) for the education of their nursing students. This approach emphasizes the use of self-directed and cooperative learning that is supposed to help students increase their critical thinking (CT) level. As the students were experiencing changes in the teaching practices, it was important to determine the effect of the teaching and learning approaches on students' CT abilities, and to describe suggestions needed for improvement. Empirically, very little is known regarding the influence of CBL on a student's CT. The question then remains, as to whether students who have undergone case-based learning, differ significantly in their CT abilities from those who studied in the traditional method. This study investigates the critical thinking skills in relation to two types of nursing educational programs: (a) the traditional teaching and (b) the case-based learning. The professed purpose of the study in hand is to measure and compare the level of critical thinking in participants from each of the two programs. The instrument of measurement guiding this study is the model developed by Facione and Facione (1998). The design has been a comparative descriptive survey. The critical thinking abilities were measured by the CCTST, which was administered to 38 participants from the traditional curriculum and 65 from the case-based learning curriculum who agreed to participate in the study. When the scores were analyzed by using the independent sample 1- test, this study found that, in general, participants from both programs performed badly on the CCTST. Nevertheless, the CBL program participants performed significantly better when compared to the traditional program participants in all aspects of the CCTST.
Knowledge and practices of smoking among students of the University of Natal on Durban campus residences.
(2001) Kamanzi, Desire G.; Adejumo, Oluyinka.
The Health Belief Model developed by Becker ( 1984) cited in Katzenellenbogen et al. ( 1999) guided this study. The model attempts to identify beliefs and the way they may interact to influence individuals' conscious decisions to undertake certain healthrelated actions. "The most important health beliefs that influence actions are thought to be: • The person's perceived vulnerability to a particular condition or illness, • The person' s perceptions of the severity or effects of the condition or illness, • The Person's perception of the efficacy, costs, and benefits of any proposed actions" (Katzenellenbogen, joubert & Karim, 1999: 169). The three points mentioned above guided systematically the whole study as follows: 1. The students' perceived vulnerability to a particular cond ition or illness in this case guided the researcher to describe and to understand students' personal perceptions of the risk of diseases they run by smoking or that they can cause to other people in their surroundings. It was also necessary to find out whether or not non-smokers were aware of the consequences in terms of diseases of being permanently exposed to tobacco smoke. 2. Once smokers as well as non-smokers have agreed that smoking increases the risk of diseases, the following step was to ensure whether or not they continue to neglect and run the same risk. because smoking consequences occur only after a long period of time. 3. The last step was to ensure that students who smoked could actually accept and put into practices some available strategies for giving up smoking. after being sensitised or on their own initiative, in order to remain in good health.
A survey of medical doctor's views on cadaveric organ donation and transplantation.
(2001) Dickson, Lindy.; Dada, M. A.
The views of medical doctors regarding organ donation and transplantation in the Durban Metropolitan Region were examined in an exploratory and explanatory study, which included a descriptive, convenience sampled study of 43 graduate and postgraduate professionals, practicing in the private and provincial sectors. Characteristics were obtained from a 1 D6-item questionnaire that were later divided into component contributions according to Fazio's attitude to behavior process model (Fazio, 1989; Fazio & RoskosEewoldson, 1994). Variables which were analysed included personal demographics, personal views, knowledge and skills, practice-related issues, attitudes and perceptions as well as future recommendations. Analysis of the information revealed that most medical doctors approved of organ donation practices and viewed transplantation as a significant roleplayer in both the community and medical sectors. However, a knowledge and skills deficit combined with religious presumptions and general uncertainty regarding issues surrounding the practical, legal and emotional concepts of brain death may be responsible for the relatively low personal dedication and practice participation rate among the sample. Medical doctors from the provincial sector appeared to have considerable concerns which included: time constraints; a perceived lack of support from colleagues, nurses and hospital administrators; a lack of medico-Iegal awareness relating to organ donation and brain death and a scarcity of experience and insight into the transplant process. In order to address the paucity of awareness pertaining to brain death and organ donation activities, the findings indicate that formal and interactive education programs during the undergraduate, postgraduate and medical development phases are required in which issues surrounding death and dying can be explored by a multidisciplinary team. It appears that this team must comprise of doctors, lawyers, religious leaders, psychologists, administrators, nurses, donor families and transplant co-ordinators. This development may serve to emphasize the professional importance of holistic bereavement counseling, improve doctor and patient satisfaction, increase organ donation referrals and transplantation rates as well as diminish medico-Iegal concerns.
Closed suctioning system of endotracheal tube (CTSS) : the practice and perception of intensive care nurses.
(2001) Ali, Ahmad Mousa.; Uys, Leana Ria.
Purpose: The of this study was to explore the knowledge, level of practice, and the frequency of problems met during the use of CTSS amongst intensive care unit (ICU) nurses and suggest ways to improve the use of the system. Design: A non experimental exploratory design using a descriptive survey approach was employed. Sample: The sample of participants were taken from three governmental hospitals in Abu Dhabi chosen randomly. It included all nurses in the ICUs of three hospitals who happened to be working at the time of the study. The response was Eighty three staff nurses, three charge nurses, and one respiratory therapist. Instrument: A questionnaire consisting of twenty one questions was used to explore the ICU nurses' knowledge, experience, practice, and difficulties met by nurses. Averages, tables, figures, and correlation coefficient were used to analyze the data. Results: Results showed a positive correlation (+0.0433) between the level of knowledge and length of use of the system but the effect is minimal. Again the knowledge and the frequency of use on ventilated patients were minimally positive (+0.0898). On the other hand, the relation between the frequency of use and the years of experience was more positively related than the frequency of use and the knowledge. Conclusion: There is a need to set a plan aiming at making the system more frequently used. Not only that , but it should be used safely and appropriately and supported by policy and procedure guidelines.
Comparative analysis of the effects of two curricular approaches to the development of clinical reasoning abilities in nursing students following comprehensive basic nursing programmes.
(2001) Mfidi, Faniswa Honest.; Khanyile, Thembisile.
A comparative analysis was undertaken using descriptive survey and cross-sectional design to explore the effects of two curricular approaches ( Problem-based learning and traditional) used in Comprehensive basic nursing programme on the development of, clinical reasoning abilities of nursing students was undertaken, Triple Jump Exercise as the data collection instrument was used to evaluate students' abilities, in clinical reasoning, Using quota sampling technique, a convenience sample of 87 subjects was selected from two nursing institutions using these two approaches, These were student nurses in their 1st, 2nd and 4th year levels of study, Using individual interviews, subjects were required to think aloud and verbalize their clinical reasoning after being presented with a clinical scenario, Subjects' verbalizations were quantified, based on the criteria specified in the evaluation form of the data collecting instrument, and total scores were obtained, Analysis using computer software package (SAS) was done to provide for descriptive and statistical summarisation, Though descriptive analysis through mean scores of clinical reasoning showed slight differences resulting from the curricular approaches used. this was not confirmed statistically as the two factor ANOVA and Tukey's method revealed no significant differences by approaches nor their interaction with level of study, Only levels of study had significant differences at p=O,OOO I, with senior levels outperforming their juniors, These findings therefore conclude that PBL and the traditional approach perfonn on a similar level in clinical reasoning. Nurse educators are therefore challenged to identify effective strategies to enhance and nurture clinical reasoning, One strategy, which this study recommends, is the use of case-based approaches in CBNP.
The acceptance of males in midwifery practice in the Seychelles.
(2001) Agricole, Winifred Jeanneton.; Gwele, Nomthandazo S.; Cassimjee, Rabia.
The aim of the study was to discover, describe and analyze factors related to the perceived acceptance of male nurses in the practice of midwifery in the Seychelles as perceived by nurses, pregnant women and their partners. A descriptive study using the qualitative approach was used. Theoretical sampling was employed and thirty-four participants comprising nurses, pregnant women and their partners were interviewed using an interview guide. Probing was done throughout. The nurses, the pregnant women and their partners were interviewed both in focus groups and individually. Participants taking part in individual interview were different from those taking part in focus group interview. The focus groups were homogeneous comprising professional nurses and consumers of service (pregnant women and their husbands) respectively. The findings revealed multitude of factors associated with the perceived acceptance of males in the practice of midwifery. These were classified as positive, negative and ambivalent. The major positive themes were unconditional acceptance, conditional acceptance, and equitable treatment, by all three groups of informants while traditional belief was the major negative theme. Other positive themes by the nurses were change of attitudes over time, and males as caring professionals, while for pregnant women; it was viewed as prior acceptance of male obstetrician. Both the nurses and partners saw the intimate nature of midwifery as a negative factor while only the nurses identified fear of competition and religious belief. Lack of trust was another negative factor identified by the partners/husbands. Professionals and the husbands identified societal versus individual readiness as an ambivalent factor while the pregnant women and professionals saw conditional acceptance as an ambivalent factor. Recommendations made from this study have implications for nursing research, nursing practice, and nursing education. The study could also be helpful for decision makers at different levels in the health care system.
The relationship between learning styles, stages of self-direction in learning and academic performance in a case-based nursing program.
(2001) Hassanein, Nada Abou.; Gwele, Nomthandazo S.
The Institutes of Nursing in the United Arab Emirates adopted a new approach for educating and training the Diploma Nursing students in 1997. This approach emphasized the use of case-based learning, which was characterized by self-directed and cooperative learning. As the students were experiencing changes in the educational setting and teaching practices it was important to determine the impact of the teaching and learning approaches on students' learning, and to describe suggestions needed for improvement. The purposes of this study were to determine the learning styles and stages of self-direction in learning for students at Abu Dhabi Institute of Nursing, and to investigate whether there was a relationship between learning style, stage of self-direction and academic performance in courses taught by the case-based method. This study was guided by Kolb's theory of Experiential Learning, and Grow's theory of the Staged Self-Directed Learning Model. Kolb's learning style inventory and a self designed tool to measure stages of self-direction were administered to 186 students, who agreed to participate in the study. The design was a descriptive correlational one, and data was analyzed by descriptive, correlation, and inferential statistics methods. The assimilator learning style was the most predominant learning style (35.5%) followed by the converger (29.6%). Accommodators and divergers had equal percentage (17%) for each. As for the stages in self-direction, most of the students rated themselves in the moderate stages of self-direction (67.2%), however, Diploma III had the higest percentage of high self-directed learners (57%). Significant relationship was found between learning styles and academic performance, where convergers and divergers scored higher than assimilators and accommodators. Also a significant relationship was found between the stage of self-direction in learning and academic performance, where students in higher stages of self-direction had higher mean scores compared to students in low and moderate stages of self-direction.
Nursing students' perceptions of the learning environment in case-based and traditional learning classrooms.
(2002) Sadek, Ghada.; Gwele, Nomthandazo S.
This study describes the perceptions of 110 diploma nursing students regarding the learning environment in case based and traditional classrooms. The study was conducted in Sharjah and Abu Dhabi Institutes ofNursing in UAE. Sixty Level I and fifty Level II students were randomly selected from the two institutes to participate in this study. The purpose of this study was to examine nursing students' perceptions regarding the classroom learning environment in courses that are taught by case studies and those that are taught by traditional method, and to compare their perceptions toward conventional and CBL learning environments. The questionnaire used was the College and University Classroom Environment Inventory (CUCEI). The students in the CBL class had more positive perceptions toward their learning environment on the subscales Involvement , Innovation , and Individualization. A significant difference emerged favoring traditional classroom environment on the Task orientation subscale. There was no significant difference between the participants' ratings for the case-based and traditional classroom learning environments on the subscales of Personalization, Cohesiveness, and Satisfaction. Thus, the study results support the superiority ofCBL environment regarding the students' perception of Involvement, Innovation, and individualization. Moreover, the study results indicated that students perceived class activities to be more task oriented in traditional than in case based classroom environments.
Consumer satisfaction with mental health service delivery in Durban.
(2002) Almeida, Renee.; Oluyinka, Adejumo.
This research presents a consumer evaluation of the delivery and aspects of services provided at three community run mental health centres. The purpose of this research is to describe the satisfaction levels of consumers with mental health service delivery in Durban, with a view to using this information to improve the services in future for quality assurance. The current investigation takes a look at how a comprehensive community mental health centre is perceived by its consumers. The subjects totalling one hundred and eleven clients who were attending psychiatric community health clinics during the study period. Using client self report questionnaires, the study investigates clients' perceptions of several aspects of their clinical care in community mental health service. In addition to assessing the clients' level of overall satisfaction and degree of acceptability of the services to the clients, the researcher was also interested in determining the expectation of consumers and how the clients perceived the effectiveness of health care service delivery. Additional information provided was the clients' views of the quality and outcome oftherapy. As further measures of the clinic's effectiveness and client satisfaction, questions relative to other help seeking actions, future behaviour in similar situations and recommendations ofthe clinic to others were asked. In addition to asking a wide variety of satisfaction-related questions, sociodemographic detail (i.e. age, gender, race, educational level, employment status, length of visits to the clinic) were asked. Most participants were unemployed men. Analysis of findings indicated that most participants were satisfied with the health service provided. Recommendations were, however, further made for improving quality of care and towards additional studies in other settings to include appropriate proportions of all racial groups in South Africa.
Nursing studies self-efficacy and motivation in a case-based learning program.
(2002) Maalouf, Mireille.; Gwele, Nomthandazo S.
In 1998 the Institutes of Nursing in the United Arab Emirates adopted a new approach of Case-Based learning in their three year nursing program. This categorical change created a need to examine the development of nursing students' self-efficacy and motivation under this new curriculum. The aims of this study were to investigate whether the students in the final year of the program will evidence higher levels of motivation and self-efficacy compared to those in the second and first year of the program, and to demonstrate that the higher the level of self-efficacy, the more internal, unstable and controllable the attributions for success and/or failure. This study was based on Bandura's theory of self-efficacy. A randomly selected cross-sectional survey involving nursing students in the three-year diploma nursing program of Abu-Dhabi and AI Ain Institutes was studied (N=178). The participants of this study involved a total of 86 (48.3%) enrolled in year one diploma, 51 (28.7%) enrolled in year two and 41 (23.0%) in year three diploma. On the whole the participants' levels of motivation and self-efficacy were high, but both ANOVA and Kruskall Wallis tests did not support any level increase by year of education as was expected. However, the Spearman's rho (r) test yielded low but positive and significant correlations between the levels of self-efficacy and students attribution for success and/or failure.
The knowledge and practice of ICU practitioners with regard to the instillation of normal saline solution during endotracheal suctioning.
(2002) El-Hussein, Mohammed Toufic.; Uys, Leana Ria.
Background Instillation of nonnal saline before suctioning is a common nursing intervention although little research supports the practice. Objectives To detennine when and how often saline is used during suctioning and to assess the knowledge of nurses and respiratory therapists of the advantages and dangers of using saline during endotracheal suctioning. Methods A survey of nurses and respiratory therapists working in adult and neonatal intensive care units was conducted in three large teaching hospitals in the UAE. Results Of the 81 respondents, 38 (47%) rarely instil saline before suctioning, whereas 20 (25%) frequently use saline. Seventy-four percent use saline to enhance retrieval of secretions, and 72% use it to stimulate cough. Nurses and respiratory therapists differ in their use and understanding of saline instillation. Most nurses (56%) rarely use saline before suctioning, whereas most respiratory therapists (37%) frequently use saline. Respiratory therapists (93%) were more aware than were nurses (61%) of the benefit of using nonnal saline to stimulate a cough. Respiratory therapists considered oxygen desaturation as a major adverse effect of saline instillation in comparison to nurses who stressed on pulmonary infection as a major side effect. Conclusion The results of the survey indicates that the practice of these professionals are not in line with most recent research results in the area and indicate a need for in-service education.

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