Curationis - Volume 36, Issue 1, 2013
Volume 36, Issue 1, 2013
Factors contributing to sleep deprivation in a multidisciplinary intensive care unit in South Africa : original researchSource: Curationis 36, pp 1 –8 (2013) http://dx.doi.org/http://dx.doi.org/10.4102/curationis.v36i1.72More Less
Patients in intensive care units require rest and sleep to recuperate, but might suffer from sleep deprivation due to ongoing unit activities. The study aimed to identify and describe the factors contributing to sleep deprivation in one multi-disciplinary intensive care unit (MDICU) in a private hospital in South Africa. Quantitative, descriptive research was conducted to identify factors contributing to sleep deprivation in the research setting, and to make recommendations to enhance these patients' abilities to sleep. Structured interviews were conducted with 34 adult non-ventilated patients who had spent at least one nightin the MDICU and who gave informed consent. Out of the 34 interviewed patients 70.6% (n= 24) indicated that they suffered from sleep deprivation in the MDICU. The five major factors contributing to sleep deprivation in a MDICU were, (1) not knowing nurses' names, noise caused by alarms, (2) stress, (3) inability to understand medical terms, and (3) blood pressure cuffs that restricted patients' movements and smelled badly. Patients' abilities to sleep were enhanced by reassuring nurses whose names they knew and with whom they could communicate. By attending to the identified five major factors, patients' abilities to sleep in a MDICU could be enhanced enabling patients to recuperate faster. The implementation of such measures need not incur financial costs for the MDICU concerned.
The needs of health promoters on a health promotion programme for families with adolescents orphaned by HIV and AIDS : original researchSource: Curationis 36, pp 1 –8 (2013) http://dx.doi.org/http://dx.doi.org/10.4102/curationis.v36i1.70More Less
The South African communities has shown to have a challenge in accessing health services especially in rural areas; hence the national strategic objective 1.7 aimed at strengthening community systems to expand access to services using the community-based care programmes (NSP 2012â??2016). The programmes enhance access to health services whilst promoting health and educating the community to improve health knowledge and work towards attaining a healthy living (NSP 2012â??2016). However, the health promoters from the rural Hammanskraal region in the North West Province of South Africa often found themselves rendering the health promotion services in their communities with limited resources. This study aimed at exploring and describing the challenges faced by health promoters in implementing health promotion programmes for families with adolescents orphaned by HIV and AIDS. The study followed a qualitative design. Data was collected using focus group interviews. Participants were purposely selected by the social worker and the health promotion coordinator working at Hammanskraal. The process of data analysis was adapted from the eight steps of Tesch method of data analysis where categories, sub-categories and themes were isolated. The following categories emerged as the needs of health promoters on health promotion programmes for families with adolescents orphaned by HIV and AIDS, (1) financial needs, (2) resources, (3) basic life needs, (4) educational needs and (5) health promoter's needs. It is therefore recommended that equal distribution of resources: including medicine, equipment and finances, should be maintained in order to ensure non-interrupted services.
Minibus taxi drivers' sexual beliefs and practices associated with HIV infection and AIDS in KwaZulu-Natal, South AfricaSource: Curationis 36, pp 1 –6 (2013) http://dx.doi.org/http://dx.doi.org/10.4102/curationis.v36i1.59More Less
Risky sexual behaviours in South Africa are a major contributing factor to the spread of HIV infection and AIDS. HIV infection amongst minibus taxi drivers is a concern, because these people belong to an occupational group that exhibits risky behaviours due to the demands of their work. Given the high vulnerability of minibus taxi drivers, exploring the sexual beliefs and health-related sexual practices of this group will assist in planning targeted interventions.
The objectives of this study were to assess the level of knowledge, beliefs and practices regarding HIV infection and AIDS amongst minibus taxi drivers. An exploratory descriptive study was conducted using a pre-tested questionnaire to explore and describe sexual beliefs and practices associated with HIV infection and AIDS in a convenience sample of 175 minibus taxi drivers. Permission to undertake the study was obtained from the KwaZulu-Natal Taxi Alliance and individuals who participated in the study. Data analysis were analysed using the Statistical Package for Social Sciences 13.0. The study revealed that minibus taxi drivers are one of the high-risk groups in the spread of HIV infection and AIDS; they lack necessary education and need attention in relation to control and prevention of the spread of HIV and AIDS. Multiple sexual partners are relatively common amongst the minibus taxi drivers. Violence against women and even forceful sexual intercourse in the belief that women should tolerate it to keep the family together was reported. There is a need for intervention programmes with a focus on minibus taxi drivers and similar high-risk groups. Prevention activities should incorporate the distribution of condoms amongst this group and HIV prevention educational programmes, as well as creating mechanisms for accessing circumcision by the minibus taxi drivers.
Online or not? A comparison of students' experiences of an online and an on-campus class : original researchAuthor Tennyson MgutshiniSource: Curationis 36, pp 1 –7 (2013) http://dx.doi.org/http://dx.doi.org/10.4102/curationis.v36i1.73More Less
Educational discourse has long portrayed online, or e-based, learning and all non-campus-based learning options as second best to traditional face-to-face options. Critically much of the research and debate in this area of study has focused on evidence relating to student performance, attrition and retention with little consideration of the total learning experience, which values both the traditional learning outcome measures side-by-side with student-centered factors, such as students' satisfaction with their learning experience. The objective of this study was to present a synchronous head-to-head comparison between online and campus-based students' experiences of an undergraduate course. This paper reports on a qualitative comparative cross-sectional study, which used multiple data collection approaches to assess student learning and student satisfaction of 61 students who completed a semester of an undergraduate course. Of the 61 students, 34 were enrolled purely as online students, whilst the remaining 27 students studied the same material entirely through the traditional face-to-face medium. Methods included a standardised student satisfaction survey and an 'achievement of learning outcomes' measurement tool. Students on the online cohort performed better in areas where 'self-direction' in learning was indicated, for example self-directed problem-based tasks within the course. Online students gave less positive self-assessments of their perceived content mastery than their campus-based counterparts, despite performing just as well in both summative and formative assignments. A multifactorial comparison shows online students to have comparable educational success and that, in terms of student satisfaction, online learners reported more satisfaction with their learning experience than their campus-based counterparts.
Factors that guide nurse managers regarding the staffing of agency nurses in intensive care units at private hospitals in Pretoria : original researchSource: Curationis 36, pp 1 –10 (2013) http://dx.doi.org/http://dx.doi.org/10.4102/curationis.v36i1.115More Less
Staffing needs affect the nursing department's budget, staff productivity, the quality of care provided to patients and even the retention of nurses. It is unclear how the role players (the nursing agency manager, the nurse manager and the agency nurse) perceive the staffing of agency nurses in intensive care units (ICUs). The purpose of this study was to explore and describe the factors that guide nurse managers regarding the staffing of agency nurses in ICUs at private hospitals in Pretoria. A quantitative exploratory and descriptive design was used. A survey by means of a structured questionnaire was carried out. Probability sampling was implemented to obtain a study sample (n = 124). One similar self-administered 5-point scale instrument was completed by the participants. Data was analysed by means of descriptive and inferential statistics. The principles of validity and reliability were adhered to and ethical considerations were also taken into account. The results indicated limitations in the determining of posts, recruitment and advertising, as well as the selection and appointment of agency nurses in ICUs at private hospitals in Pretoria. Recommendations on staffing are made to nurse managers in ICUs.
Factors influencing successful implementation of the basic antenatal care approach in primary health care facilities in eThekwini district, KwaZulu-Natal : original researchSource: Curationis 36, pp 1 –7 (2013) http://dx.doi.org/http://dx.doi.org/10.4102/curationis.v36i1.92More Less
Background : In a move to alleviate the burden of consistently high maternal and perinatal mortality rates, the South African National Department of Health (DoH) introduced Basic Antenatal Care (BANC) in all Primary Health Care facilities that were providing antenatal care services. However, not all facilities in the eThekwini district have successfully implemented the approach. The aim of the study was to identify the factors that influence successful implementation of the BANC approach.
Objectives : The objectives were to identify facilities that had successfully implemented the BANC approach and the factors that influenced successful implementation of the BANC approach, in order to make recommendations on these factors.
Method : A descriptive quantitative design was used. Firstly, primary health care facilities that were successful in implementing the BANC approach were identified through a retrospective record auditing. A total of 27 facilities were identified, of which 18 facilities were included in the study. This was followed by data collection from 59 midwives in order to identify the factors that influenced successful implementation of the BANC approach. The data was analysed using version 19 of the Statistical Package for the Social Sciences.
Results : The positive factors that influenced successful implementation of the BANC approach included: the availability and accessibility of BANC services, policies, guidelines and protocol; various means of communication; a comprehensive package of and the integration of primary health care services; training and in-service education; human and material resources; the support and supervision offered to the midwives by the primary health care supervisors; supervisors' understanding of the approach and the levels of experience of midwives involved in implementation of the BANC approach.
Conclusion : The success that the facilities had achieved in implementing BANC approach was attributed to these positive factors.
Source: Curationis 36, pp 1 –8 (2013) http://dx.doi.org/http://dx.doi.org/10.4102/curationis.v36i1.108More Less
Background : Professional nurses play a vital role in the provision of health care globally. The performance of health care workers, including professional nurses, link closely to the productivity and quality of care provision within health care organisations. It was important to identify factors influencing the performance of professional nurses if the quality of health care delivery was to improved.
Objectives : The aim of the present study was to identify factors affecting the performance of professional nurses in Namibia.
Method : A quantitative, descriptive survey was used to collect data by means of a questionnaire. A random sample of 180 professional nurses was selected from six hospitals in three regions of Namibia.
Results : Factors affecting the performance of nurses negatively were identified such as: lack of recognition of employees who are performing well, quality performance outcomes and an absence of a formal performance appraisal system and poor working conditions. Various factors contribute to both the positive and negative performance of professional nurses in Namibia. Strategies were developed for addressing the negative factors that could positively affect the performance of professional nurses in Namibia.
Conclusions : This study emphasises the importance of developing strategies to promote the performance of nurses; build knowledge and expertise; develop mechanisms for improving the performance of nurses; expand leadership and management capacity; and generate information and knowledge through research.
Misoprostol for prevention and treatment of postpartum haemorrhage : a systematic review : original researchSource: Curationis 36, pp 1 –10 (2013) http://dx.doi.org/http://dx.doi.org/10.4102/curationis.36i1.57More Less
Background : Postpartum haemorrhage (PPH) is a leading cause of maternal mortality especially in the developing world. Misoprostol, a highly effective drug is highly effective in inducing uterine contractions and has been proposed as a low-cost, easy-to-use intervention for PPH.
Objective : This study assessed evidence of the effectiveness of misoprostol for the prevention and treatment of PPH.
Method : Databases searched included MEDLINE, PUBMED, CINHAL, Google Scholar, Cochrane Central Register of Controlled Trials (CENTRAL) and EMBASE. Reference lists and conference proceedings were also searched for more studies. Three studies included in the meta-analysis were limited to randomised controlled trials (RCT). Two reviewers independently screened all articles for methodological quality using a standardised instrument adapted from the Cochrane Collaboration website. Data were entered in Review Manager 5.1 software for analysis.
Results : Three trials (n = 2346) compared misoprostol to a placebo. Misoprostol was shown not to be effective in reducing PPH (risk ratios [RR] 0.65; 95% confidence interval [CI] 0.40-1.06). Only one trial reported on the need for a blood transfusion (RR 0.14; 95% CI 0.02-1.15). Shivering (RR 2.75; 95% CI 2.26-3.34) and pyrexia (RR 5.34; 95% CI 2.86-9.96) were significantly more common with misoprostol than with a placebo.
Conclusion : The use of misoprostol was not associated with any significant reduction in the incidence of PPH. Therefore, in order to verify the efficacious use of misoprostol in the treatment of PPH, specialised investigations of its dose and routes of administration for clinically significant effects and acceptable side effects are warranted.
Source: Curationis 36, pp 1 –2 (2013) http://dx.doi.org/http://dx.doi.org/10.4102/curationis.v36i1.1132More Less
For South Africa, the continent and the world as a whole, formal health literacy begins at school. Higher Education in South Africa is challenged to take heed of the World Health Organization's (WHO) (1996) definition of school health. For the WHO, school health is not merely hygiene, health promotion, health literacy or health education but a 'combination of services ensuring the physical, mental and social well-being of learners so as to maximize their learning capabilities'. The WHO Expert Committee on School Health asserts that school health can advance public health, education, social and economic development, and that the global expansion of school health attests to the value placed internationally on such programmes (WHO 1996).
A report on the development and implementation of a preceptorship training programme for registered nurses : original researchSource: Curationis 36, pp 1 –6 (2013) http://dx.doi.org/http://dx.doi.org/10.4102/curationis.v36i1.106More Less
Background : Clinical supervision represents an important aspect in the development of nursing students' clinical skills. At the School of Nursing (SoN) the clinical supervisors employed by the University of the Western Cape (UWC) have limited contact sessions with students in the clinical setting. However, with the increase in student numbers a need was identified to strengthen the support given to nursing students in the service setting.
Objective : A preceptorship training programme for nurses was developed in 2009, aimed at improving the clinical teaching expertise of professional nurses. The planning phase, based on a preceptorship model, represents a collaborative undertaking by the higher education institution and the nursing directorate of the Provincial Government Western Cape.
Method : A two-week, eight credit, short course was approved by the university structures and presented by staff members of the school. The teaching and learning strategies included interactive lectures, small group activities and preceptor-student encounters in simulated and real service settings. Some of the course outcomes were: applying the principles of clinical teaching and learning within the context of adult education, understanding the preceptor role and managing.
Results : To date, fifty-four participants have attended the course. Following an internal review of the pilot programme in 2010, relevant adjustments to the programme were made.
Conclusion : It is recommended that all the stakeholders be involved in the development and implementation of a contextually relevant preceptorship training programme. It is further recommended that the school embarks on an extensive programme evaluation.
Criteria to facilitate the implementation of woman-centred care in childbirth units of Limpopo Province, South Africa (Part 2) : original researchSource: Curationis 36, pp 1 –7 (2013) http://dx.doi.org/http://dx.doi.org/10.4102/curationis.v36i1.50More Less
Background : Facilitation of mutual participation, respectful and egalitarian relationship between the mother and the midwife during childbirth is a critical aspect. This article delineated the criteria that would facilitate the implementation of woman-centred care in childbirth units of the Limpopo Province in South Africa, following a concept analysis described in Part 1. Empirical referents or indicators were used to measure the concept woman-centred care and to validate its existence in reality. These empirical referents were referred to as measurable properties that further verified the concept.
Objective : The objective of this article was to formulate criteria that would facilitate implementation of woman-centred care in childbirth units of Limpopo Province in South Africa.
Method : Criteria to facilitate the implementation of woman-centred care were formulated by the gathering of information about the topic under review and the use of resources to define the key elements of the criteria which were integrated into the Batho Pele principles. The criteria were then validated by selecting with a vested interest in the successful development and implementation of the criteria.
Results : Criteria were formulated to facilitate the implementation of woman-centred care that was integrated within the framework of Batho Pele principles.
Conclusion : These formulated criteria for woman-centred care will be used as an institutional self-evaluation tool to enhance implementation of the Batho Pele principles in childbirth units. These criteria will give direction and provide guidelines for the performance of midwifery staff and will also help supervisors to guide staff to improve performance.
Source: Curationis 36, pp 1 –8 (2013) http://dx.doi.org/http://dx.doi.org/10.4102/curationis.v36i1.49More Less
'Woman-centred care' in childbirth is a process in which a woman makes choices and is involved in and has control over her care and relationship with her midwife. The aim of this paper is to study the concept of woman-centred care through analysis in the context of childbirth. The attributes, antecedents and consequences of this concept are identified, and a model case, a borderline case and a contrary case constructed to achieve conceptual clarity. A concept analysis was undertaken as described by Walker and Avant (2011), with an extensive exploration of domain-specific literature and evidence from various disciplines.
It was established from the concept analysis that 'woman-centred care' was complex and experienced individualistically. The analysis indicated that mothers' participation is supposed to be based on a more collaborative relationship and partnership. Participation is exhibited by open communication and the mother's involvement in decision-making, consultation and collaboration with the attending midwife, further characterised by mutual respect and the midwife listening to the mother's views. There is also an exchange of complete and unbiased information, recognition and honouring of cultural diversity and making of informed choices. Through an inductive discovery approach and drawing on inferences, attributes were clustered in an attempt to identify the apparent essence of the concept.
From the results of the concept analysis described in this study, the researchers recommend the formulation of criteria that could facilitate implementation and evaluation of woman-centred care and its empirical referents in the context of the Batho Pele principles (Part 2).
Lived experiences of a community regarding its involvement in a university community-based education programme : original researchSource: Curationis 36, pp 1 –13 (2013) http://dx.doi.org/http://dx.doi.org/10.4102/curationis.v36i1.78More Less
Background : Community involvement is one of the crucial principles in the implementation of successful community-based education programmes. However, a gap continues to exist between the rhetoric of this principle and the reality of involving or engaging communities in the education of health professionals.
Objectives : This study investigated the experiences of a community regarding its involvement in a community-based education programme offered by a university nursing school in Durban, South Africa.
Methods : An interpretive existentialist-phenomenological design was employed for its richness in extracting human experiences. Individual interviews were held with school teachers and coordinators from non-government organisations, whilst focus groups were used for school children and community health workers. Although focus group discussions are not well suited for phenomenological studies, they can promote active participation and reduce possible intimidation by providing support through group interaction. Analysis of data was guided by Schweitzer's model for analysing phenomenological data.
Results : Themes that emerged from the data include: (1) Community experience of unmet expectations; (2) Benefits to the community from its involvement in the University Nursing School community-based education programme; (3) Existing partnership between the community and the university; (4) Sharing in the case-based learning activities; (5) Awareness of available services, human rights and self-reliance.
Conclusion : The researched community indeed benefited in its participation in the University Nursing School (UNS) CBE programme. However, there is a need to improve the communication between partners to make the partnership more sustainable through close relationships and interaction. There is also a need for further research on related aspects of the community's involvement.
The role of social support in the relationship between mental health and posttraumatic stress disorder amongst orthopaedic patients : original researchSource: Curationis 36, pp 1 –7 (2013) http://dx.doi.org/http://dx.doi.org/10.4102/curationis.v36i1.122More Less
Background : Some life-event experiences such as injuries in car accidents, gun shots and the like, can be life changing and traumatic.
Objectives : The article investigated the relationship between mental health and post-traumatic stress disorder (PTSD) symptoms after orthopaedic trauma, and attempted to understand whether social support moderates the relationship between mental health and PTSD.
Method : A cross-sectional research model was used. Two hundred participants were selected using simple randomisation within a hospital complex in Gauteng, South Africa. The sample consisted of 110 men and 90 women (x̄= 37.8 years, s.d. = 12.9 years). Data were collected using the Revised Civilian Mississippi Scale for PTSD, the Multidimensional Scale of Perceived Social Support (MSPSS), and the General Health Questionnaire version 28.
Results : The findings of the study indicated that there is a statistically significant relationship between mental health and PTSD after orthopaedic trauma, and a positive correlation between poor mental health and PTSD (r = 0.52, n = 200, p < 0.05). However, perceived social support did not moderate mental health or PTSD, indicating that perceived social support did not significantly influence mental health or PTSD, (MSPSS B = 0.07, p = 0.66). Those with high scores on social support had a lower regression coefficient (B = 0.19) for mental health and PTSD than those who reported low social support (B = 0.26).
Conclusion : There is a significant relationship between mental health and PTSD of orthopaedic patients, and social support did not moderate the relationship between mental health and PTSD.
Source: Curationis 36, pp 1 –7 (2013) http://dx.doi.org/http://dx.doi.org/10.4102/curationis.v36i1.121More Less
Background : People diagnosed with diabetes mellitus are increasing in sub-Saharan Africa and prompt care seeking depends on perceptions of the illness.
Objective : The objective was to explore perceptions of diabetes in rural areas.
Method : We conducted a qualitative, explorative and descriptive study in rural eastern Uganda. Eight focus group discussions with community members were conducted. Community members were presented with a story about a person with diabetes symptoms and their perceptions of the diagnosis and treatment elicited. Four focus group discussions with people with diabetes and seven key informant interviews with health workers were conducted. Respondents were asked how the community interpreted symptoms of diabetes, its causes and whether it was curable. Manifest content analysis was used.
Results : Some respondents thought people with diabetes symptoms had HIV or were bewitched. Causes of diabetes mentioned included consuming too much fatty food. Some respondents thought diabetes is transmitted through air, sharing utensils with or sitting close to people with diabetes. Some respondents thought that diabetes could heal fast whilst others thought it was incurable.
Conclusion : Misdiagnosis may cause delay in seeking proper care. Preventive programmes could build on people's thinking that too much fatty food causes diabetes to promote diets with less fat. The perception of diabetes as a contagious disease leads to stigmatisation and affects treatment seeking. Seeing diabetes as curable could create patient expectations that may not be fulfilled in the management of diabetes. Rural communities would benefit from campaigns creating awareness of prevention, symptoms, diagnosis and management of diabetes.
A study of descriptive data for orphans and non-orphans on key criteria of economic vulnerability in two municipalities in South Africa : original researchSource: Curationis 36, pp 1 –8 (2013) http://dx.doi.org/http://dx.doi.org/10.4102/curationis.v36i1.105More Less
Background : It is generally assumed that orphan status increases the risk to children of a range of negative outcomes. In South Africa, death of parents due to HIV-related illness is contributing to a rapid increase in the prevalence of orphans. This paper presents descriptive data from two South African communities, namely Kopanong, in the Free State and Kanana in the North West province, characterising the differences between orphans (double, maternal and paternal) and non-orphans on key criteria of social vulnerability.
Objectives : The objective was to obtain a better understanding of how different types of orphans and non-orphans may differ in these key areas as a crucial starting point for addressing the devastating consequences the AIDS epidemic has on these children's lives. While the study focuses on two specific areas these will provide insight into the general situation of orphans in South Africa.
Methods : A cross-sectional census survey was conducted in the two communities of Kopanong, comprising n = 5254 households and Kanana, comprising n = 12 984 households.
Results : In Kopanong, 8.2% of children had lost both parents, 19.1% had lost their father and 6.5% their mother only, whilst in Kanana the results were 6.5%, 28.1% and 3.7% respectively. Loss of both parents appeared to have a consistent impact on material need, including access to food, clothing and essential services, whilst loss of a single parent seems to have a more variable impact. At present, there are very few child headed households, but this constitutes a risk in the longer term.
Conclusions : Orphans appear to be more vulnerable in terms of material need. Children assessed in this study as being most in need were not accessing adequately many services directed at them. There is a need to extend understanding and measurement of emotional need and abuse.
Conceptualisation of knowledge construction in community service-learning programmes in nursing education : original researchSource: Curationis 36, pp 1 –10 (2013) http://dx.doi.org/http://dx.doi.org/10.4102/curationis.v36i1.69More Less
Background : Practices in higher education have been criticised for not developing and preparing students for the expertise required in real environments. Literature reports that educational programmes tend to favour knowledge conformation rather than knowledge construction; however, community service learning (CSL) is a powerful pedagogical strategy that encourages students to make meaningful connections between the content in the classroom and real-life experiences as manifested by the communities. Through CSL, learning is achieved by the active construction of knowledge supported by multiple perspectives within meaningful real contexts, and the social interactions amongst students are seen to play a critical role in the processes of learning and cognition. This article reflects facilitators' perspective of the knowledge construction process as used with students doing community service learning in basic nursing programmes.
Objectives : The aim of this article was to conceptualise the phenomenon of knowledge construction and thereby provide educators with a shared meaning and common understanding, and to analyse the interaction strategies utilised by nurse educators in the process of knowledge construction in community service-learning programmes in basic nursing education.
Method : A qualitative research approach based on a grounded theory research design was used in this article. Two nursing education institutions were purposively selected. Structured interviews were conducted with 16 participants.
Results : The results revealed that the knowledge construction in community service-learning programmes is conceptualised as having specific determinants, including the use of authentic health-related problems, academic coaching through scaffolding, academic discourse-dialogue, interactive learning in communities of learners, active learning, continuous reflection as well as collaborative and inquiry-based learning. Upon completion of an experience, students create and test generated knowledge in different contextual health settings.
Conclusion : It was concluded that knowledge is constructed by students as a result of their interaction with the communities in their socio-cultural context and is mediated by their prior concrete experiences. The implication of this is that students construct knowledge that can be applied in their future work places.
Experiences of Fast Queue health care users in primary health care facilities in eThekwini district, South Africa : original researchSource: Curationis 36, pp 1 –8 (2013) http://dx.doi.org/http://dx.doi.org/10.4102/curationis.v36i1.60More Less
Background : Comprehensive Primary Health Care (PHC), based on the principles of accessibility, availability, affordability, equity and acceptability, was introduced in South Africa to address inequalities in health service provision. Whilst the Fast Queue was instrumental in the promotion of access to health care, a major goal of the PHC approach, facilities were not prepared for the sudden influx of clients. Increased access resulted in long waiting times and queues contributing to dissatisfaction with the service which could lead to missed appointments and non-compliance with established treatment plans.
Objectives : Firstly to describe the experiences of clients using the Fast Queue strategy to access routine healthcare services and secondly, to determine how the clients' experiences led to satisfaction or dissatisfaction with the Fast Queue service.
Method : A descriptive qualitative survey using content analysis explored the experiences of the Fast Queue users in a PHC setting. Setting was first identified based on greatest number using the Fast Queue and geographic diversity and then a convenience sample of health care users of the Fast Queue were sampled individually along with one focus group of users who accessed the Queue monthly for medication refills. The same interview guide questions were used for both individual interviews and the one focus group discussion. Five clinics with the highest number of attendees during a three month period and a total of 83 health care users of the Fast Queue were interviewed. The average participant was female, 31 years old, single and unemployed.
Results : Two themes with sub-themes emerged: health care user flow and communication, which highlights both satisfaction and dissatisfaction with the fast queue and queue marshals, could assist in directing users to the respective queues, reduce waiting time and keep users satisfied with the use of sign posts where there is a lack of human resources.
Conclusion : Effective health communication strategies contribute to positive experiences by health care users and these can be effected by: (1) involvement of health care providers in planning the construction of health facilities to give input about patient flow, infection prevention and control and provision of privacy, (2) effective complaints mechanisms for users to ensure that complaints are followed up and (3)encouraging users to arrive at the facility throughout the day, rather than the present practice where all users arrive at the clinic early in the morning.
Mothers' expectations of midwives' care during labour in a public hospital in Gauteng : original researchAuthor Malmsey SenganeSource: Curationis 36, pp 1 –9 (2013) http://dx.doi.org/http://dx.doi.org/10.4102/curationis.v36i1.320More Less
Background : Mothers develop expectations regarding midwives' care during labour and when these are not met mothers become dissatisfied and eventually have negative experiences of their labour. It is only when mothers' voices are heard by midwives in the labour ward that efficient and quality care will be provided. To ensure mothers have a positive experience of labour, midwives should include mothers' expectations when caring for them.
Objective : The purpose of the study on which this article is based was to determine mothers' expectations of midwives' care during labour. To achieve this purpose the researcher sought to explore and describe mothers' expectations of midwives' care during labour in a specific public hospital in Gauteng.
Method : A qualitative, exploratory, descriptive and contextual study design was used. Face-to-face, in-depth individual interviews were conducted with mothers about their expectations of midwives' care during labour. Data were then analysed with an open descriptive method of coding (Tesch's eight steps) that is appropriate for qualitative research to identify categories. The data was also analysed by an independent coder. The categories were subsequently placed within a holistic health promotive nursing theory that encompasses body, mind and spirit.
Results : The findings revealed the provision of comfort and support as the two main aspects that the mothers expected from the midwives' care. The mothers expected midwives to improve their communication skills with them (mothers) as well as with fathers or partners if they were available. The mothers expected midwives to facilitate bonding between mother, father and baby, and also encouraged the midwives to improve their (midwives') knowledge, skills and morale.
Conclusion : The results of this study should assist midwives in providing holistic quality care to mothers during labour, thus providing satisfaction and positive experiences of the mothers' labour.
Do nursing students know and practise the Universal Precautions to prevent transmission of infectious agents? : original researchSource: Curationis 36, pp 1 –7 (2013) http://dx.doi.org/http://dx.doi.org/10.4102/curationis.v36i1.99More Less
Background: Nursing students, like other healthcare students, are at high risk of occupational exposure to blood and bodily fluids. Studies have shown that use of the Universal Precautions (UPs) lowers this risk, but do students know and practise these precautions?
Objectives: This study investigated the knowledge and practice of undergraduate nursing students regarding the UPs, and whether there was a correlation between knowledge of the UPs and their practice.
Method: This was a descriptive quantitative study amongst undergraduate nursing students in years 2-4 (n = 253), who were selected by means of stratified random sampling. A questionnaire was administered to the participants by the researcher. The data collected were analysed through use of the Statistical Package for Social Sciences (SPSS 16.0) and content analysis.
Results: It was established that there was indeed a lack of knowledge regarding the UPs, and that the students' self-reported practice of the UPs was poor. There was no statistically significant correlation between knowledge and practice of the UPs.
Conclusion: More structured educational programmes are needed to improve both knowledge and practice of the UPs. These programmes should be offered across all nursing student study years as continuous professional development.