Masters Degrees (Nursing)

Permanent URI for this collectionhttps://hdl.handle.net/10413/6965

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Acceptability, knowledge and perceptions of pregnant women towards HIV testing in pregnancy at Ilembe district.
(2005) Dube, Faith Nana.; Nkosi, Zerish Zethu.
This research study aimed at investigating the acceptability, knowledge and perceptions ofpregnant women towards IDV testing in pregnancy in Ilembe District. An exploratory research design guided the study. A systematic random sampling was used to select fourty pregnant women who were attending clinic for the first time in their current pregnancy. Self-administered questionnaires with close-ended questions were used in the collection ofdata. The questions included the women's demographic details, their views towards IDV testing, knowledge and acceptability ofIDV testing. Forty questionnaires were distributed and they were all returned. Quantitative method was used to analyse data. The fmdings ofthe study revealed that women in the sample were relatively young (18-25) with the percentage of45% and most ofthem were unmarried (90%). The majority ofwomen (92.5%) said testing was a good idea and 85% said it is necessary. However only 52.5% said they will opt for HIV testing. Uptake ofHIV testing was found to be low. Eighty-seven and a half percent (87.5%) women were ofthe opinion that IDV testing in pregnancy was ofbenefit to the mother and her baby. Women in the study were found to have good understanding and good perceptions towards IDV testing in pregnancy, but thus was not consistent with their behaviour. Meaning that in spite of their good understanding and good perceptions towards IDV testing in pregnancy, only a small percentage (52%) of respondents said they will opt for the IDV test. The researcher's expectations were one hundred percent response.
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.
Alarms in ICU : a study investigating how ICU nurses respond to alarm limits for patient safety.
(2015) Ramlaul, Amy.; Brysiewicz, Petra.
Introduction There is a need to identify alarm management challenges in South African ICU units, to revise and structure educational and training programmes to ensure ICU nurses utilise technological resources for patient safety and to deliver quality patient care. Aim This research study is aimed to investigate the responses of ICU nurses to alarm limits in their ICU environment for patient safety. Research methods This descriptive survey study was conducted with permanent and sessional ICU nurses at a private healthcare institution in Durban, KwaZulu-Natal. A quantitative design was used with a structured questionnaire as the data collection instrument. The total of 120 ICU registered and enrolled nurses were chosen as the sample population and a total of 91 questionnaires were completed and returned. Results The results indicated that the challenges with alarm management experienced were related to inadequate education and training on alarm management and the distraction of managing frequent and numerous false alarms in the ICU facility contributed to delayed responses of the ICU nurses to alarming limits. Recommendations Recommendations included reviewing the current content and methods of education and training of alarm management and medical equipment that was done on a frequent basis. Conclusion Alarm specific training is required to keep ICU nurses updated with changes in technology so that they are better equipped to ensure patient safety and quality of care.
Analysing cognitive levels of final examination questions for the Diploma Nursing programme using the revised bloom’s taxonomy at a selected nursing college in Eastern Cape.
(2017) Fayilane, Nontlantla Isabella.; Pakkies, Edith Ntefeleng.
Background: The main objective of the current reform is the production of graduates capable of facing challenges and adapt to changes that may be encountered post-graduation. According to the ICN (2009), employers perceived that graduates were not prepared for the realities of practice nor did they have the competencies needed for health care services. That necessitates higher education to prepare students to be competent graduates through teaching content and transferable skills. Appraised literature reveals that employing Bloom’s Taxonomy in class and integrating learning outcomes and assessment strategies, leads to production of graduates that are competent with skills expected from a professional. Previous literature also indicates that poor alignment of curriculum objectives with assessment strategies deprive students‟ development of crucial skills as well. Purpose: The purpose of the study was to analyse the cognitive levels of final examination questions for the Diploma Nursing Programme using the Revised Bloom’s Taxonomy at a selected nursing college in Eastern Cape. Methodology: The quantitative descriptive approach was adopted for the study where content analysis was used to analyse final examination questions. The study population consisted of the selected nursing modules’ examination question papers for a four-year Diploma Nursing Programme; selected from first year to fourth year level for the period of 2011-2015, for summative and supplementary examinations. A non-probability, convenience sampling method was adopted for the study and the sample consisted of a total of 1709 questions from 95 examination question papers which were analysed. Data collection was done using a template incorporating the six cognitive levels of the Revised Bloom’s Taxonomy. Questions were examined according to template and coding was done for single word, the action verb used in questioning, coded for frequency. Statistical Package for Social Sciences version 24 was used for data analysis. Findings: The results revealed that the highest percentage of questions set for the Diploma of Nursing Programme dealt with lower cognitive levels(remember, understand, and apply) of which, understand’ obtained the highest percentage across all levels in all modules, the higher order cognitive levels (analyse, evaluate, and create) were less assessed in the examination questions papers. Recommendations: The study recommends that the nurse educators who are curriculum developers should revise the assessment strategies and align it to curriculum and learning outcomes as well as to the changing health care systems and complexities of patients‟ care demands. The development of assessment guide is highly recommended, which will be in line with the current instruction methods. Further, for the college management, staff development is recommended in terms of assessment strategies through in-service trainings, workshops, and seminars conducted by assessment experts, to improve in the construction of examination questions in order to develop student’s required crucial skills
Analysing the nursing students’ perceptions with regards to academic dishonesty at selected university in KwaZulu-Natal.
(2017) Maloka, Mosimotsana Jeanett.; Dube, Barbara Makhosazane.
Background: Academic dishonesty is a growing problem globally and represents unethical behaviour which results in students not acquiring the expected knowledge. Putting preventative measures in place would ameliorate the effects of academic dishonesty, but there was no idea of the prevalence of academic dishonesty in the School of Nursing at the University of KwaZuluNatal (UKZN). Accurate figures of the prevalence of this phenomenon were therefore not available for academic decision making at the university level, where the interventions were planned. In South Africa a study of this was only previously conducted in the Western Cape, and this is the reason why the researcher conducted the study. Methodology: A non-experimental, descriptive, exploratory design was used to guide the research process. 226 nursing students as participants. Data was collected by means of a questionnaire, and data analysis was performed using the SPSS version 24 software. Descriptive statistics and co-relational procedures were used to analyse the data. Results: The results showed that there was a significant relationship between gender and academic dishonesty. Evidence revealed that males were more likely to engage in cheating behaviour than females. Cheating behaviours associated with plagiarism, assignments when completing the workbooks and bringing and using unauthorised crib notes into tests and examinations were identified as the main problems. Recommendations: Nursing students at the selected institution were generally engaged in this academic dishonesty because of peer pressure and a lack of knowledge regarding the academic policies on the matter. It was recommended that the institution, together with the students, develop honour codes to accompany the existing academic policies and procedures. If students were included in the process they would become part of it, and if allowed ownership it would become easier for them to implement and abide by the honour code and reinforce the academic policies, and it would become easier for the faculty to inforce the policies. Key words academic dishonesty, nursing students, perception.
Analysing utilisation of a self-directed clinical skills laboratory by undergraduate nursing students in higher education: a mixed methods design.
(2016) Laari, Luke.; Dube, Barbara Makhosazane.
Background Nursing qualifications at institutions of higher learning have a strong focus on knowledge acquisition to ensure that the students are well equipped to know both how and why to maximise patient care. This knowledge needs to be balanced with clinical skills, acquired through both supervised and self-directed experiences, the latter being an increasingly important part of student learning in higher education institutions clinical skills laboratories. Aim The study aimed to analyse the utilisation of the self-directed clinical skills laboratory by undergraduate nursing students in a selected higher institution, and make recommendation on how teaching and learning in this area can be strengthened as a learning space. Methods A non-experimental convergent parallel design was used. A sample of 118 nursing students was collected through systematic random sampling for the quantitative questionnaire survey, semi-structured interviews were conducted using purposive sampling of six clinical facilitators, and focus group discussions were conducted with 32 nursing students, one group from each of the 4 undergraduate years. Results The findings suggested that students using the self-directed clinical skills laboratory applied the self-directed learning principles in their learning. The learning space is perceived to be used in line with the South African Nursing Council requirement, and the students using the learning space were positive about its use as a learning environment. Conclusion While both staff and students found the self-directed clinical skills laboratory to be a useful learning environment, its use would be improved by providing adequate human and material resources, and ensuring that what was taught was in line with clinical practices in hospitals.
An analysis of clinical supervsion [sic] and support for bridging programme students in the clinical settings in the greater Durban area.
(2005) Pillay, Padmini.; Mtshali, Ntombifikile Gloria.
The purpose of the study was to describe the nature of clinical supervision and support provided to bridging programme students in the clinical settings. A descriptive and an exploratory design were most appropriate. There were one hundred-and-twenty-two participants in the study. Data was collected by means of a questionnaire and a critical incident report. The questionnaires included semi-structured questions where the respondents were able to discuss the effects of clinical supervision and teaching behaviours that would enhance learning during clinical accompaniment. The subjects were the second year students in the bridging programme. Only those students who consented participated in the study. The campuses that were used were the Prince Mshyeni College of Nursing, Netcare Nursing Academy and Afrox College of Nursing. These campuses were conveniently selected because they were in the greater Durban area and were thus easily accessible to the researcher. Students described the positive and negative experiences they received from the clinical supervisor and the ward staff. Positive experiences included the feelings of confidence, and the gaining of interpersonal skills. Gaining self- confidence as a nurse is an essential aspect of the student nurse's professional development. The negative experiences were that the students were treated as the normal workforce because of their experience as enrolled nurses. The challenges of clinical supervision are to help the student to evaluate critically the effect of actions taken, to assist him/her to perform procedures skilfully and to enable him/her to relate to patients in an ethical and caring manner. The critical incident analysis revealed that the student nurses continued to use informal support networks as well as their supervision sessions to discuss clinical issues. Respondents reported an enthusiasm for the opportunity to talk meaningfully to a trusted colleague about personal circumstances at work. Such opportunities were particularly welcomed by nurses who wished to reflect upon their own practices with patients, especially when dealing with clinical conditions that were upsetting, or otherwise challenging. Respondents pointed out that more time would make clinical supervision sessions longer and more effective.
Analysis of cognitive levels of examination questions set in the Bachelor of Nursing programme at the University of KwaZulu-Natal.
(2010) Garekwe, Masaitsiweng.; Mtshaji, N.G.
Background: 'The literature reveals that a large percentage of teachers ask questions aimed at lower cognitive levels irrespective of the underpinning philosophy. They fail to set challenging questions at higher order levels when setting examination papers. Purpose of the Study: This study is aimed at describing and analysing the examination questions set over a four year academic period, at the University of KwaZulu-Natal School of Nursing, in terms of Bloom's levels of cognitive domains. Research Methodology: A quantitative approach and content analysis was used. A total of 1319 questions were examined, SOUTCed from 39 examination papers, from 2003-2007. These questions were independently reviewed by two coders according to Bloom's taxonomy's template. Research Results: The findings revealed that all six categories of the cognitive domains in Bloom's taxonomy were used across the four levels in the Bachelor of Nursing (BN) programme. Overall about 57 % of the questions were aimed at lower level (knowledge, recall and comprehension) whilst only 43.4% were aimed at higher levels (application, analysis, synthesis and evaluation). In the first year lower order questions averaged at 62% with higher order questions at 51 %. In second year the lower order questions took up 51% of the paper \\~th higher order questions at 49%. During third year there was an equal (50/50) split between higher order and lower order questions. In fourth year there was the highest percentage of lower level questions (66%) was seen, with only 34% of questions being of the higher order. Regarding the increase in the complexity of questions within the programme, a change of 13% was seen between first and second year. Whilst there was an increase of 1% reported between second and third year. However, there was a significant drop (16%) in the complexity ofquestions in the fourth year, with lower order questions clearly dominating. Recommendations: The nursing education curriculum, and staff development progranune, should pay special attention towards developing educators in the setting of questions ensuring appropriate examination criteria are met. Exercises during the capacity building initiatives should cover aspects such as how to plan an assessment for the whole programme ensuring the appropriate increases in complexity as the programme progresses, as well as setting, or critiquing, of examination papers and coming up with recommendations to improve the quality of questions. Special attention should be given to how to align teaching and assessment in such a way that the level ofcomplexity increases as the students' progress through the programme. Lastly, further research should be conducted, using mixed methods, to explore the assessment of learning and in order to address certain questions which could not be answered quantitatively; for example questions regarding the construction of questions, because it impacts the nature of the question Also it should be noted that there was a disjuncture between the scenario and the questions in some cases.
An analysis of patients' awareness and attitude concerning end of life issues.
(2002) Khanyile, Bathini Purity.; Ncama, Busisiwe Purity.; Bhengu, Busisiwe Rosemary.
This study was conducted using a qualitative descriptive approach. It was based on an analysis that was done to determine awareness and attitude of patients in end of life issues. The semi-structured interviews were conducted for data collection. A sample of ten patients, five inpatient and five outpatient, was purposively chosen. Permission was obtained from the hospital superintendent and heads of departments, and also consent from patients, for the study. Data was analyzed, using the NVIVO program, a computer software, for data coding, and a conceptual model for categorization. From the findings, the researcher concluded that poor communication causes lack of knowledge in patients, which in turn limits the capacity for decision making in patients. The researcher also noted that participants were not aware of their autonomy in decision-making.
An analysis of quality improvement by nurses at a selected tertiary healthcare facility in Rwanda.
(2017) Batunga, Antoinette.; Kerr, Jane.
BACKGROUND: Improving and maintaining the quality of care in healthcare institutions is not easy and has become a continuous challenge. Though quality improvement continues to be a global issue, the Government of Rwanda, guided by its Vision 2020, has made significant progress in the health field, especially in providing accessible quality care and services to all Rwandan citizens. Furthermore, the Rwanda Ministry of Health, through its 2015 health policy, has introduced a number of interventions to improve quality of care, such as promoting customer care, ongoing training and capacity building of the staff in the health sector, and decentralising health care infrastructures. A number of constraints have been noted which hinder effective quality improvement, such as shortage of human and material resources. It has become important to analyse quality improvement by nurses at a selected tertiary healthcare facility in Rwanda. Purpose of the study: The purpose of this study was to analyse quality improvement by nurses; in order to develop guidelines for nurses on effective quality practices at a selected tertiary healthcare facility in Rwanda. Methodology: A concurrent mixed methods approach (quantitative and qualitative), was used in this study. Data were collected by the researcher over a two month period. In a quantitative approach, data were collected using a checklist to conduct an audit of quality improvement activities by nurses and purposive sampling was used to identify 13 quality improvement documents in 11 units/departments. In a qualitative approach, data were collected from registered nurses and patients who were seeking healthcare services at the time of data collection. Interview guides were used. Purposive sampling was used to identify 15 registered nurses; and 17 patients for the qualitative data collection and 12 nurse managers and experts in guideline development to participate in guideline development process. Quantitative data were analysed using SPSS version 23, while qualitative data were analysed using thematic content analysis. Nominal group technique was used to develop guidelines for nurses to improve the quality of care at the selected facility. Findings: Out of 11 departments from the selected hospital, the majority (90.9 %) of departments had incident reporting documents. Seventy-two per cent of departments reported having an audit tool for measuring the quality of care that was available and accessible to users. It was found that 36.6 % had a copy of quality policy document; 18.2% reported having registration books for complaints, however it was found that these complaints books were not used on a daily basis. Furthermore, it was noted that only 18.2% of departments had a copy of the quality action plan. Concerning annual quality report findings indicated that of 11 departments, none had a copy of the annual quality report. Findings from qualitative data in this study revealed a number of factors related to quality improvement, which were grouped into three categories: organisational resources, managerial roles, and customer care. Regarding the organisation resources, a number of subthemes emerged in this study: lack of materials and equipment, shortages of nurses and doctors, lack of guidelines to guide nurses on improving the quality of nursing care and lack of sufficient drugs in the hospital pharmacy (reported by both nurses and patients). Construction and renovation of buildings has been happening which has reduced congestion for patients. Regarding managerial role, factors that hindered quality improvement were nurses’ resistance to change, lack of knowledge concerning quality improvement, lack of supervision, and lack of health education for patients. Regarding customer care, patients were dissatisfied with the lack of sufficient drugs, long waiting times, lack of sufficient beds and rooms. Although a number of challenges were reported that hinder quality of care, patients appreciated effective performance and care from their healthcare workers that increased their satisfaction with the quality of care provided. Proper explanations and orientation made it easy for patients to seek healthcare services in the different departments and pharmacy turn around time has improved. It was also noted that nurses recognised that career development and support was helping them to improve the quality of care. Based on the findings from this study, quality improvement guidelines for nurses have been developed for the selected tertiary hospital where this study was conducted. Recommendations: Increase in-service training on quality improvement to raise employees’ knowledge and skills levels. Emphasise proper staffing and staff management of employees to avoid work overload in some units. Reduce waiting times and provide sufficient essential drugs in the hospital pharmacy reducing the need for patients to buy drugs from private pharmacies. Remedy lack of equipment and materials to enable nurses to work in a suitable environment. Conclusion: Despite challenges faced by the healthcare facility, there has been remarkable progress in quality improvement through response to needs in human and material resources. Improvement of quality care is a cornerstone in the health of the population of Rwanda. Keywords: Quality improvement, Quality of care, Standards of care, Patient Satisfaction.
Analysis of sickness presenteeism prevalence among nurses working in selected health facilities in Swaziland.
(2016) Mdziniso, Bawinile Treasure.; Kerr, James.
Sickness presenteeism occurs when employees go to work when they would be justified in taking time off for complaints and ill health that can either be physical or mental or both (Johns, 2010; Demerouti, Le Blanc, Bakker, Schaufeli and Hox, 2009; Aronsson, Gustafsson, and Dallner, 2000; Jourdain and Vézina, 2013). Sickness presenteeism has drastic effects to the organization or employer, the health of the employee, the safety of the health care consumers (clients and patients) and families of the employees (Roelen, Jensen, Stapelfeldt Groothoff, Nielsen and Bültmann, 2014;Sendén, Løvseth, Schenck-Gustafsson and Fridner, 2013). Sickness presenteeism has been discovered to be prevalent among human service organizations such as nursing (Johansen, Aronsson, and Marklund, 2014; Leineweber, Westerlund, Hagberg, Svedberg and Alexanderson, 2012; Aronsson et. al., 2000). High job demands, inability to adjust amount and type of work to do in a given period of time, lack of social support and experiencing health problems are cited as some of the predisposing factors of sickness presenteeism (Jourdain and Vézina, 2013; Linnerud, 2013; Demerouti et. al., 2009 and Theorell, 1996). Amongst studies conducted, sickness presenteeism has been assessed based on varying degrees of nurse staffing levels and nursing work schedules of various shifts (Linnerud, 2013 and Zirwatul, Ibrahim, and Ohtsuka, 2012).
An analysis of the assessment of clinical learning in a nursing diploma programme in Kigali Health Institute in Rwanda.
(2007) Kayihura, Camille N.; Mtshali, Ntombifikile Gloria.
Assessment of clinical learning is imperative in order to ensure that those who become registered nurses are safe and competent practitioners. Assessment of clinical skills requires evaluation of the development of appropriate knowledge, skills and attitudes. Literature however reveals that the measurement of clinical skills performance continues to pose a challenge for nurse educators, the debate around the best assessment method in clinical learning, as well as, validity and reliability in assessing clinical learning is ongoing. This study was therefore aimed at exploring and describing current practices in assessment of clinical learning in a nursing diploma programme in Kigali Health Institute in Rwanda. The study was a quantitative descriptive exploratory design. Data were collected through the use of questionnaires. Nurse educators, students and external examiners were asked to report on the assessment strategies commonly used in Kigali Health Institute, their views about assessment strategies, and the strengths and weaknesses of clinical assessment strategies used in a nursing diploma programme in assessing practical competences of nursing students. The total number of participants who returned questionnaires in this study was 117. The results of this study revealed the commonly used assessment strategies included OSCEs (100%), case presentations (66%), direct observations (38%), standardized patients (31 %) and reflective diaries (2%). Furthermore, assessments were based on clinical learning outcomes. Assessments were conducted formatively and summatively to ensure validity in assessments and to ensure that a variety of clinical learning areas were assessed. Although there was no documented structured process of conducting clinical assessments, the findings revealed that the process included a number of phases; planning, preparation, implementation and evaluation phases. There were measures in place to ensure validity and reliability in assessments. The need for a policy on clinical learning assessment emerged so as to serve as a guide to ensure consistency in conducting assessments. The need to build the capacity of nurse educators and external examiners also came up as very few had educational preparation for their roles. Most of them were specialists in the discipline not in nursing education. The findings also revealed that not all nurse educators were involved in decision making regarding clinical assessments for quality assurance purposes. Issues such as welcoming of students on the assessment day, giving of instructions to students, time spent on performing tasks, feedback to students, returning to tasks which were not completed and improvising during assessments due to limited resources emerged as areas of concern. Recommendations made are related to the assessment process, the building of capacity of nurse educators and external examiners, preparation of students for clinical learning assessment, and further research for the in-depth exploration of this area.
An analysis of the mental health of families affected by HIV/AIDS in Rwanda.
(2004) Uwizeye, Glorieuse.; Mkize, Lungiswa Patience.
HIV/AIDS is no longer seen as an individual problem as it also affects the family as a whole. The purpose of this study is to purpose of analysing the mental health of family affected by HIV/AIDS in Rwanda. It should be noted that there were not studies conducted on the mental health of the affected families in Rwanda. A qualitative approach using case study design was used to describe the mental health of affected family in Rwanda. HIV/AIDS-related stressors, emotional reactions of family members and coping strategies they adopt to deal with those stressors and emotional reactions were studied. The effects of those reactions and strategies on the infected family member as well as the entire family were analysed. A purposive sampling was used to select two families from Mwana Ukundwa Association for the study. The findings of the study showed multiple losses, care, and socio-economic demands as the main stressors for both cases. Emotional reactions to those stressors included shock, anger, sadness, hopelessness, depression, fear and shame. Participants reported using both emotional and problem-focused coping strategies. Compassion, caring and showing concern had positive effects on the infected and affected as well as family members, whereas emotional reactions such as anger, unhappiness, and discouragement had negative effects on the entire family. Positive effects of family reactions and strategies to cope were associated with coping strategies such as; having opportunity to talk: to someone, distraction, family relationships, spiritual support, treatment, and socio-economic support. Ineffective strategies included family communication dysfunction due to withdrawal behaviour, alcohol abuse and going to nightclubs. These strategies had negative effects on both infected and affected family members. The results suggest that health professionals such as nurses, doctors and other healthcare providers should use a holistic approach in caring for infected family members. They should not only provided family care, but also include the family in planning to care for the infected family member. This will empower them to play a more effective role in home care-based.
An analysis of the nurse managers' interpretation of the National Health Insurance Policy, its implications for implementation in healthcare facilities in the eThekwini district.
(2012) Mthembu, Nozipho Nokwazi Henrietta.; Bhengu, Busisiwe Rosemary.
Background: The government of South Africa has focused on Primary Health Care and implementation of the National Health Insurance (NHI) as part of the plan to reform the South African health care system. This is based on the principle of the right to healthcare and the right to access health care facilities. Aim: The aim of this study was to analyse the Nurse Managers’ interpretation of the National Health Insurance Policy and, its implications for implementation on their roles and responsibilities in health care facilities. Methodology: The sequential mixed method approach was conducted. There was direct interaction (semi structured interviews) with the Nurse Managers as well as a survey (questionnaires) for both qualitative and quantitative phases. Qualitative data was collected and analysed first, and an instrument was developed based on the analysed data from the qualitative phase to collect quantitative data. Setting: EThekwini district comprising of two district hospitals, three Community Health Centres (CHC) and four Private healthcare facilities were selected. Participants: Nurse Managers in the public Primary Health Care facilities and private hospitals in the EThekwini district. These were Nurse Managers (top middle and lower levels) from the public healthcare facilities (district hospitals, Community Health Centres, primary health clinics) middle and lower levels in the private facilities. Data Analysis: A thematic analysis was used in the qualitative phase. Descriptive statistic was used in the quantitative phase to describe and synthesize data (Polit and Beck 2004) as well as inferential numeric analysis (Creswell 2009). Findings: The findings in both the qualitative and quantitative data revealed that the participants demonstrated a general impression on the NHI rather than specific understanding; hence the researcher believes that there was more general than specific knowledge and interpretation of the NHI policy. The participants’ display of lack of knowledge and understanding of the concept NHI and the implementation process was an indication that there was lack of personal development in relation to expectations from the nurse managers concerning NHI though there is a lot of publicity in this respect from the government and media. There are national policies and guidelines for all citizens to access. Recommendations: The recommendations were made for sharing with the policy makers and seniors in the healthcare facilities in order to improve nursing management, nursing education and nursing research.
Assessment of knowledge, attitude, and practice of pregnant women in respect of prevention of Mother-To-Child Transmission (PMTCT) of HIV/AIDS at a selected antenatal clinic in Durban, South Africa.
(2015) Haghdoost, Samira Navazandeh.; Kerr, Jane.
Background: South Africa is one of the sub-Saharan African countries with high rates of HIV/AIDS infection and Kwazulu-Natal province has a particularly high rate of HIV prevalence. Mother-To-Child Transmission (MTCT) of HIV, which can occur during pregnancy, labour, or breastfeeding, is one of the causes of the high rate of HIV and AIDS among children in this region. One of the best strategies to reduce the rate of infection among children is the Prevention of Mother-To-Child Transmission (PMTCT) during pregnancy, labour, and the postnatal period by giving antiretroviral drugs to pregnant women who are HIV-positive. The reasons for an increasing MTCT of HIV might include lack of knowledge of mothers of the risk of MTCT, benefits of preventive interventions, such as prophylactic ARV drugs and infant feeding options. Studies conducted in Sub-Saharan African countries showed that there was a low level of knowledge in mothers about MTCT and PMTCT services. Proper implementation of these services however, requires adequate knowledge and appropriate attitudes and practices of pregnant women toward PMTCT. As there was no published study covering KwaZulu-Natal province to demonstrate the relationship between these factors and PMTCT, it was considered necessary to conduct this study to identify the current level of knowledge of pregnant women and the effective factors impacting on their participation in the PMTCT program. Objective: The objective of this study was to assess the level of knowledge, attitude, and practice of pregnant women toward the PMTCT program and associated factors in a selected antenatal clinic in South Africa. Methods: This was an institution-based, cross-sectional study conducted among pregnant women attending an antenatal care clinic in eThekwini district, South Africa during August 2015. A simple random sampling technique was used to select 345 antenatal care attendees. Data were collected through use of a structured pre-tested questionnaire. Information was then entered into Statistical Package for the Social Sciences (SPSS), Version 22, and were analysed. Finally, data were explored through graphic displays, analysed, interpreted, and summarized. Results: In this research, 345 voluntary pregnant women were studied. The mean age was 26.3 years and the majority (66.3%) had secondary education or above. Of the respondents, 52.7% were single, 38.7% had a regular boyfriend, 8.0% were married and 0.6% were separated. In addition, 29.2% were employed and 70.8% did not have any occupation. This study found that 58.5% had poor, 26.9% had moderate and 14.6% had good basic HIV/AIDS knowledge. On the other hand, 20.4% had poor, 67.6% had moderate and 12.0% had good knowledge on MTCT of HIV and its prevention and they obtained information from health care workers (89.4%) followed by television and radio (22.4%). It was found that age, level of education and occupation had a significant effect on the level of knowledge of respondents. Despite their moderate knowledge concerning PMTCT, 97.6% had a good attitude towards the PMTCT program and 83.1% would support it. Furthermore, it was found that 98.5% did the HIV test and of those who shared the test result, 42.8% were HIV-positive and 52% were HIV-negative. Of respondents, 93.3% discussed having an HIV test with their male partner and 71.0% of partners wanted a couple testing, 15.7% wanted woman to be tested alone and 3.3% did not want the woman to be tested. This study also revealed that 51.9% had antenatal clinic (ANC) visits in their previous pregnancy, but 29.7% did not. It was found that the knowledge level of participants significantly correlated with their ANC visits. In addition, 30.6% did not receive PMTCT counselling upon arrival at the antenatal clinic, but 69.4% received it and 89.8% of them were convinced to continue using PMTCT services. Conclusion: The study showed that the knowledge of pregnant women about PMTCT was moderate, but there were some gaps found in their basic knowledge about HIV/AIDS. Moreover, their knowledge was significantly dependant on their age and education level. On the other hand, the majority had a good attitude and practice towards the PMTCT program. However, it is recommended that the PMTCT counselling should be extended to improve the knowledge of HIV/AIDS and PMTCT strategies in pregnant women through community mobilization.
An assessment of the effectiveness of knowledge of breast cancer and breast self-examination in women in Sierra Leone.
(2004) Shepherd, Joan Hannah Elizabeth Estella.; McInerney, Patricia A.
This research is a follow up of a "Breast Week" which was organized in Freetown, Sierra Leone. The specific objective of this study was to assess the effectiveness of the knowledge and teachings given to the women who participated in this project. The unrecorded cases of breast lumps and breast cancer observed in women in Sierra Leone prompted the researcher to undertake this present study. A quantitative approach was adopted and a structured interview schedule and an observational checklist guided the data collection process. A sample size of 120 women (10%) who participated in the "breast week" was obtained through systematic sampling. The first part of the study involved assessment of the theoretical background of the research topic followed by the second phase during which the women demonstrated Breast Self-Examination to detect abnormalities of the breasts. Discussions and analysis of the findings are presented in three sections. Texts from open ended questions were categorized and explained in numerical terms as the study was quantitative in nature. The data was processed through use of SPSS and Microsoft Excel. Frequency counts were applied to the data, use of non-parametric tests on the number of women who practiced Breast Self-Examination before and after the breast week showed a statistically significant difference in the number of women now practicing BSE as a screening method for breast cancer after receiving the health education. It was found that the majority of the women linked breast cancer to the signs and symptoms associated with it and were able to describe the disease as one that kills women if not promptly detected and/or treated appropriately. Findings indicate that the majority of the women (78.3%) had previously had mmor breast problems. An assessment of the effectiveness of knowledge on breast cancer showed that these women could identify breast cancer as a disease that affects women and may cause deaths if not detected on time or treated promptly. These women were able to demonstrate to the researcher how they examine their breasts to exclude abnormalities. Three women had breast lumps detected through examination of the breasts during the breast week. Two of them had had the lumps removed and are currently on medication. One of the women who had a breast lump detected was financially constrained and could not afford the cost of surgery. The number of women who can now perform BSE increased (95.0%) after having the knowledge on breast cancer and BSE. The majority of the women (97.4%) received information on how to examine their breasts for breast cancer through the information provided during the breast week. It is thus concluded that the objectives of the breast week were met.
Attitude of psychiatric nurses to de-escalation as a strategy for management of psychiatric patient aggression in a Nigerian psychiatric hospital.
(2016) Oyelade, Oyeyemi Olujamoke.; Smith, Amanda April Heather.; Jarvis, Mary Ann.
Aim The aim of this study was to present an intervention and describe the response of psychiatric hospital-based South West Nigerian mental health nurses. Methods A content analysis qualitative approach, using audio recordings of pre- and post- intervention focus group discussions was adopted. The intervention -one oral and visual de-escalation presentation - bisected the focus group discussions. The objective for the pre-intervention focus group: to describe participants’ current experiences and practices towards verbal aggression and violence management in order to inform relevant application of information within the intervention. The objective of the post-intervention focus group discussion: to describe participants’ responses to the intervention. Purposive sampling, comprised of nurses at unit or ward manager level, yielded eight participants. Results Participants felt betrayed by all role players within the mental health care service system, were disappointed that de-escalation was considered the evidence-based practice, and hopeless about its introduction. Participants’ fears for their safety are suggested to have informed a more militant approach to the management of aggression to strengthen nurses’ control over patients’ physical and emotional welfare, as well as their own. Review of Nigerian mental health legislation to set the context for human rights of both nurses and mental health patients is recommended. A need exists for further research utilizing a participatory action research approach that addresses ‘on the spot’ management of verbal aggression and includes trauma counselling and support for nurses.
The attitudes and perceptions of health care professionals to alternatives to blood transfusion : a case with Jehovah's Witnesses patients in a critical care setting.
(2004) Mjoli, Vuyiswa Yvonne.; Bhengu, Busisiwe Rosemary.
Aim: The aim of this study was to explore the attitudes and perceptions of health care professionals to alternatives to blood transfusion for Jehovah's Witnesses patients in a critical care setting. Methodology: Quantitative and qualitative approaches were used to explore the attitudes and perceptions of health care professional to alternatives to blood transfusion, in a critical care setting. The study was conducted in four largest hospitals in the Durban Metropolitan area, of which two were public and two private. A questionnaire was used as tool for collecting data. Space was provided to accommodate comments from the respondents in the questionnaire. Analysis of findings was done quantitatively by using a computer programme called SPSS (Statistical Packages for the Social Sciences), version 11.5. Themes that emerged from the participant's responses were classified under categories in the conceptual framework and analysed qualitatively. Findings: Most of the respondents had mixed feelings about using alternatives to blood transfusion. The study revealed, however, that although alternatives to blood transfusions were commonly used in a critical care setting, some of the respondents did not know about the different types of alternatives available. Furthermore, it was evident from the respondent's comments that most of them had a positive attitude to people who refused blood transfusion and preferred alternatives. Research into suitable alternatives to blood transfusion was encouraged by most of the respondents. However, transfusion transmitted diseases emerged as a current concern over and above the religious concerns. Recommendations for the future were made for the health care professionals working in critical care setting, nurse educators and nursing management.
Awareness, attitudes and behaviours regarding HIV voluntary counselling ad testing (VCT) among students of the University of KwaZulu-Natal on Howard College Campus.
(2005) Xing, Ying.; Adejumo, Oluyinka.
This survey was conducted to describe the awareness, attitudes and behaviours regarding HIV Voluntary Counselling and Testing (VCT) among students of the University of KwaZulu-Natal in the Howard College Campus residences. A quantitative descriptive study design and a simple random sampling technique were used in this study. One hundred and seventy - eight students who lived in residences of Howard College Campus voluntarily participated in the study and completed the anonymous questionnaires. The questions in the questionnaire were designed to collect the demographics information of the participants and to address their awareness, attitudes and behaviours regarding VCT. Analysis of findings revealed that the level of awareness of VCT was high among the students. The majority of the participants have heard of VCT before this survey and knew that campus clinic provided VCT service. To students, the two most major sources of VCT information were TV/radio and friends/classmates. A positive attitude towards VCT was found among the students. The participants perceived the benefits and importance of undergoing VCT as well as the value of counselling. Sixteen percent of all participants have received VCT and twenty - two percent intended to go for VCT within the following 6 months. The main reasons cited by students for undergoing VCT included: to know their health status, to recognize the risk to be exposed to HIV, and to seek for information about maintaining health. The main reasons for not seeking VCT were assuming their HIV status negative and unlikely exposure to HIV because they always practised safe sex. A need for VCT information was found in this study. Some barriers to VCT existed, such as perception of negative consequences of uptake of VCT (e.g. HIV - related stigma), low risk perception to HIV infection, and lack of VCT information. The findings suggest that there is a need for communication campaigns at the University of KwaZulu-Natal, to address knowledge gaps, reduction of stigma, and promoting awareness of vulnerability to HIV. The findings of this study could be used to assist to plan HIV prevention programme at the University of KwaZulu-Natal.
Barriers to cervical cancer screening programs among urban and rural women in Blantyre district, Malawi.
(2009) Kamphinda-Banda, Mary Malata.; McInerney, Patricia A.; Mtshali, Ntombifikile Gloria.
Despite the availability, accessibility and affordability of cervical cancer screening (CCS) in Malawi, many women do not utilize the CCS services. This research was conducted in Blantyre district, Malawi. The main objective of the study was to identify factors that act as barriers to the uptake of cervical cancer screening programs among urban and rural women in the Blantyre district of Malawi. A quantitative design was used and convenience sampling was applied in selecting a sample of 196 women from the population of women aged 18 and over in two Reproductive Health clinics, one urban clinic at Queen Elizabeth Central Hospital and one rural clinic at Mlambe hospital in Blantyre district, Malawi. A structured questionnaire was used to collect data. The questionnaire was translated from English into the local Chichewa language so that respondents were interviewed and responded in a language that they were able to comprehend. Analysis and discussion of findings are presented in five sections. Data were processed into numeric values using SPSS version 15.0 and Microsoft Excel to give meaning to the findings of the study. In order to test for statistically significant associations between variables, the Pearson correlation was applied. The study revealed that the main barrier to CCS was that women lack knowledge and information about cervical cancer and there is a lack of publicity about CCS services. Lack of knowledge was found in relation to - risk factors, prevention of, detection of and benefits of cervical cancer screening with a greater knowledge deficit being found in the rural women. Higher levels of education in both the urban and rural groups did not have a positive influence on the screening behaviours of the women. Commencing sexual intercourse at ages 15 to 19 years and having multiple sexual partners were the main risk factors to cervical cancer among the women in the study. It was also found that although rural women perceived themselves being very likely to be at risk of cervical cancer, this perception did not translate into CCS behaviour. v

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