Curationis - Volume 32, Issue 2, 2009
Volume 32, Issue 2, 2009
Author N.S. GweleSource: Curationis 32, pp 4 –10 (2009)More Less
Diversity management is not a numbers game. Diversity management is a holistic and strategic intervention aimed at maximizing every individual's potential to contribute towards the realization of the organization's goals through capitalizing on individual talents and differences within a diverse workforce environment. Managing interpersonal relationships within a diverse workforce environment presents a number of challenges related to changes in the social, legal and economic landscape, individual expectations and values as well as the inevitable change in organizational culture (Chartered Institute of Personnel and Development 2005: 1-7). Whether or not organizations are effective in managing diversity is a function of senior managements' commitment, and the perceived centrality of diversity management by all those who populate the institution's workspace. Above all it should be clear to all employees, irrespective of race, gender, or vocational/professional status, that each and every one of them has something of value to contribute towards the realization of the institution's mission and goals.
It is crucial to determine clear and manageable success indicators, focusing not only on compliance with legal obligations to include and/or increase the number of employees from the underrepresented and designated groups, but also on strategic intervention strategies to be used to promote and nurture individual talent and potential toward the realization of both individual aspirations and organizational goals re-quality patient outcomes.
Effect of a staffing strategy based on voluntary increase in working hours on quality of patient care in a hospital in KwaZulu-Natal : research articleSource: Curationis 32, pp 11 –20 (2009)More Less
Two of the issues facing the South African Health Care System are the shortage of nursing staff and a lack of adequate skills to provide quality patient care. The hospital under study experienced a critical shortage of applications from professional registered nurses, consequently a staffing strategy was implemented to overcome the shortage of nurses and to maintain quality patient care. The strategy introduced encouraged nurses to voluntarily work an additional ten hours per week with remuneration.
A non-experimental, descriptive design with a quantitative approach was applied to investigate the effect of a staffing strategy aimed at improving the quality of care in a hospital in Kwa-Zulu Natal based on voluntarily increasing staff working hours. The investigation compared the quality of nursing care before and after the implementation of the staffing strategy through retrospective audits of randomly selected patient files 372 (11%) of the total population of 3400 files were audited.
A random sample of 4 boxes each containing a 100 patient files, of a total of 34 boxes, was selected from the hospital filing system. Descriptive statistical analyses were performed and correlations between various variables using the Chi-square test.
No statistically significant differences (p<0.05) were found between the quality of nursing care before and after the implementation of the management strategy, even though deterioration of results after the implementation was observed.
The study shows that the quality of nursing care in most wards deteriorated after implementation. The staffing strategy failed to improve or maintain the quality of nursing care.
Recommendations included Strict control of nurses working extra hours per week, preventing the use of "moonlighters". Introduction of a quality assurance committee to monitor the quality of patient care, developing critical analytical thinking skills of staff to improve patient care and standardization of the nursing process documentation.
A reflection on the application of grounded theory in the exploration of the experiences of informal carers : research articleAuthor J.D. JeggelsSource: Curationis 32, pp 21 –30 (2009)More Less
The aim of this paper is to reflect on the application of a qualitative research method that presents novice researchers with a variety of challenges. It is suggested that prospective users of the grounded theory method should seek guidance from experts in the field. However, to find these experts has proved to be quite challenging. The research topic lends itself to a qualitative study in general using the grounded theory method in particular.
A qualitative approach was followed to describe the experiences of informal carers within their unique contexts. The guidelines of Strauss and Corbin (1990,1998) formed the basis for the development of the grounded theory. The challenges that will be described in a fair amount of detail in this paper include: an understanding of interpretive research paradigms, the philosophical underpinning of the method; its focus on social context; the inductive data analysis processes that allows for the emergence of a substantive theory from empirical data. Prospective scholars should also recognize that grounded theorists follow different approaches to the application of the method. Some subscribe to the traditions of the founders (Glaser & Strauss, 1967), while others choose the analytical rules and procedures proposed by the followers of the method (Strauss & Corbin, 1990,1998).
In this paper I reflect on the application of the grounded theory method to explore the experiences of informal carers during the transition of the elderly from hospital to home. The research outcomes showed that informal carers were facilitating care during the transition of the elderly from hospital to home by revealing the link between facilitating care, the basic social process, and other categories associated with informal health care. These categories include: the prior relationship between the carer and the elderly, the traumatic incident, the need for role fitting, maintenance- and repair care, as well as, the consequences of facilitating care, i.e. connected or disconnected care.
It is recommended that informal carers be recognized as essential community assets and that they are included in the health care system of the country; that they need information as well as financial and material resources and that they require the support of family, home-based workers and professionals alike.
An analysis of the meaning of integrated Primary Health Care from the KwaZulu-Natal Primary Health Care context : research articleSource: Curationis 32, pp 31 –37 (2009)More Less
In South Africa, integration of services policy was enacted in 1996 with the aim of increasing health service utilization by increasing accessibility and availability of all health care services at Primary Health Care (PHC) level. Integration of PHC services continues to be seen as a pivotal strategy towards the achievement of the national goals of transformation of health services, and the attainment of a comprehensive and seamless public health system. Although the drive behind the integration of PHC services was to improve accessibility of services to the community, the problem however, arises in the implementation of integrated PHC (IPHC) as there is no agreed upon understanding of what this phenomenon means in the South African context. To date no research studies have been reported on the meaning of the integration of PHC services. Hence, there is a need for shared views on this phenomenon in order to facilitate an effective implementation of this approach.
A cross-sectional study, using a qualitative approach was employed in this study in order to analyze the phenomenon, IPHC in KwaZulu-Natal and the meaning attached to it in different levels of the health system. A grounded theory was selected as it is a method known for its ability to make greatest contribution in areas where little research has been done and when new viewpoints are needed to describe the familiar phenomenon that is not clearly understood. Policy makers and co-ordinators of PHC at national, provincial and district levels as well as PHC nurses at functional level participated in the study. The data was collected by means of observations, interviews and document analysis. The sample size for interviews was comprised of 38 participants. Strauss and Corbin's process of data analysis was used. It emerged that there were three core categories that were used by the participants as discriminatory dimensions of IPHC in South Africa. These core categories were (a) comprehensive health care, (b) supermarket approach and (c) one stop shop.
Source: Curationis 32, pp 38 –45 (2009)More Less
According to the experience of the researcher, an oncology nurse, women living in the rural areas of Thulamela municipality in the Limpopo Province, have many different perceptions of breast cancer. Perceptions are based on previous disease experiences. As with previous illnesses, changes in the breast caused by breast cancer are self-managed and treated. When these women seek medical advice for breast cancer related problems, they already have advanced cancer. The purpose of the study was to investigate if women are knowledgeable of the signs and symptoms of breast cancer, breast self-examination, as well as appropriate health care to take responsibility to prevent admission with advanced breast cancer. The research study was an exploratory and contextual survey. The sampling method was convenient (n=200). Data were gathered during a structured interview using a checklist. Data analysis was done by means of descriptive statistics. The results of the study indicated a low level of knowledge regarding the signs and symptoms of breast cancer. The average level of knowledge for the signs and symptoms of breast cancer was less than 10% (n=20). With regards to breast self-examination the results varied between 8.5% (n=17) and 13% (n=26). Biomedical medicine was the preferred treatment choice for the majority of the respondents. The study provided evidence that women were unable to take responsibility for their breast health. Their lack of knowledge of the signs and symptoms of breast cancer and breast self-examination would not enable them to prevent presenting with advanced disease. A breast health care strategy for women living in Thulamela should be designed, implemented and evaluated to prevent presentation with advanced breast cancer.
Author H.B. RosSource: Curationis 32, pp 46 –52 (2009)More Less
When women are pregnant, some plan to have waterbirths and other plan to have traditional bedbirths. Therefore some neonates will be born under water and other neonates out of the water on a bed. It is unclear what the outcomes for the neonates are after these two types o f deliveries. The research goals of this study were to explore and describe the outcomes for neonates after waterbirths (group A) and traditional bedbirths (group B) and to generate hypotheses based on the outcomes for neonates after waterbirths and traditional bedbirths that need to be tested in subsequent research studies. The design was an explorative descriptive survey. The mothers were purposefully selected to participate in the research study. They had to be healthy, low-risk pregnant women with a single pregnancy and a cephalic presentation. They had to be 37 to 42 weeks pregnant. Group A delivered their neonates at two private hospitals in Gauteng and group B delivered their neonates at a government hospital in Gauteng. Data was collected during labour, just after the delivery, two hours after the delivery and 14 days after the delivery. A data collection instrument was used. The following neonatal outcomes were measured: Apgar score at one and five minutes, axillary temperature, pH-, haemoglobin- and sodium levels of the umbilical cord blood, the neurological condition of the neonate as reflected by the primitive reflexes and neonatal morbidity until 14 days after birth. Descriptive analysis was used to analyse the data. It appeared if group A had higher Apgar scores, neonatal temperatures and umbilical cord blood haemoglobin levels and lower sodium umbilical cord blood levels than group B. The umbilical cord blood pH levels, neonatal morbidity and primitive reflexes of both groups appeared equal. Group B needed more resuscitation of the neonate directly after birth than group A. Hypotheses were generated that need to be tested in subsequent research.
Associated syndromes and other genetic variations at a South African cleft lip and palate clinic : research articleSource: Curationis 32, pp 53 –58 (2009)More Less
A retrospective study was done of data on all patients registered at one of the largest cleft lip and palate clinics in South Africa (n = 3174). The associated syndromes and other genetic variations [(abbreviation:) ASGV] found in the population of persons suffering from facial cleft deformities (FCD) were analysed. 832 (26.2%) cleft lip and/or palate patients presented with ASGV. Fifty-seven different types of syndromes were recorded of which the Fairbairn-Robin appearance (FRA) (or Pierre Robin sequence) 169 (5.3%), the Demarque-van der Woude syndrome 40 (1.3%), and the holoprosencephaly sequence cases 32 (1.0%) were the three most common ones. The three most common genetic variations found in the non-syndromic patients, were heart involvement 53 (1.7%), club foot 42 (1.3%) and various eye problems 39 (1.2%).
The main facial cleft deformity, namely the cleft lip, alveolus and palate (CLAP), was found in 26.2% of the ASGV-group. This particular cleft deformity was recorded at 39.7% in the FCD clinic. On the other hand, the hard and soft palate cleft (hPsP) group was found in 32.9% of patients who also had ASGV; in the total group of patients registered at the clinic, it accounted for only 16.6%. This means that ASGV occur less commonly in the CLAP group of patients, than in the hPsP group of patients.