Theses and Dissertations

Permanent URI for this collectionhttp://hdl.handle.net/20.500.11837/251

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'Student life' discourse and the perception of risk for HIV infection among undergraduate nursing students, at a university, Eastern Cape province, South Africa
(2014) Mnwana, Sindiswa Millicent
There is evidence that the HIV prevalence rates among South African university students remains low at 3.4 %. However, the vulnerability of young people to HIV/AIDS continues to be a serious concern as the prevalence of sexual risk behaviour among students in South African universities is reported to reach 68% in heterosexual relationships. Some analysts argue that so far little is known about the influence of the university culture (the so called “student life”) in this behaviour. The purpose of this study was to explore the perceptions of the risk for HIV infection amongst undergraduate nursing students at an institution of higher learning (university) in East London, Eastern Cape. More specifically, the study examined the ways in which the ‘student life’ discourse functions to influence students’ perceptions of the risk to HIV infection at the selected institution of higher learning. An explorative and descriptive qualitative design was used. The purposive sampling technique was used to select participants. In total, 12 one to one interviews and four focus group discussions (n=35) were conducted. An interview guide was used and a voice recorder to record interviews. Through in-depth interviews and focus group discussions, the research sought to provide insight into the perceptions of risk for HIV infection. The data were analysed using thematic analysis and the themes identified formed the basis for discussion in this study. Among the key findings, that emerged from this study was that knowledge about potential risks to HIV/AIDS did not seem to influence the general sexual behaviour of students. A majority of the participants, 90% that were interviewed individually perceived themselves to be at “little or no” risk of contracting HIV/AIDS despite the high prevalence of HIV risk indicators among them. One of the main findings was that the students’ values that they bring from home were seriously challenged by the student life when they arrived at the university. Therefore in this regard undergraduate nursing students should be equipped by the university with aspects of sexual behaviour such as sexual negotiation and sexual decision making. This would equip them with the necessary skills to resist peer pressure.
Factors contributing to non adherence among pregnant women on antiretroviral treatment at Amathole district, Eastern Cape
(University of Fort Hare, 2014) Dekeda, Kolelwa Felicia
During the beginning of the HIV epidemic in 1981 25 million people have died. The introduction of ART therefore has promising developments to reduce mortality rates and new infections. Nevertheless there is still a challenge with adherence to ART worldwide and in South Africa. The purpose of the study was to determine the factors contributing to non-adherence to ART among HIV positive pregnant women.The study involved a non- probability sample of 70 HIV pregnant women on ARTattending antenatal care clinics at the tertiary hospital and two community healthcentres,in Buffalo City, Amathole District, Eastern Cape. A coded questionnaire wasused as an instrument for data collection.Ethical procedure was followed and a consentform was signed by each participant. Data was collected for a period of two monthsThe demographic data reveals that the majority of the participants were knowledgeable about ART and employed. That is evident in the adherence to ART in all age groups except age 40 and above. The majority of HIV positive pregnant women on ART whoparticipated in the study were single 50% (n=35) which suggests that they may lack emotional support from partners and may have difficulty in disclosing their status.Level of adherence revealed that 27% (n=19) of participants missed ART because of forgetfulness, and 16% (n=12) and others were feeling healthy due to frequent follow ups and complying with the ART. Poor follow up, too sick, side effects pill burden, fear of stigma, lack of finances and taking alcohol hinders the proper management of HIV positive pregnant women and is risky to the unborn baby.
Factors influencing attendance by diabetic patients for their yearly opthalmic reviews at a private opthalmic practice in East London, South Africa
(University of Fort Hare, 2016) Arnolds, Nadine Chrystal
Introduction: Diabetic retinopathies is a complication of diabetes mellitus causing blindness globally, and as patients live longer, cases of diabetic retinopathy increases. Despite efforts to educate patients at their eye visits, yearly follow up visits is still a major challenge. Key words: Diabetes, Diabetic retinopathy, health systems, non-attendance, knowledge, attitude, behaviour, gender, fear and anxiety Objectives: The objectives of the study were to investigate the reasons for non-compliance by determining the relationship among the selected factors (knowledge/ confidence/ fear and anxiety) and adherence to yearly reviews. Methods: Data were collected from adult diabetic patients who attended the private practice for an eye review by the ophthalmologist. The instrument used was a semi- structured questionnaire with sections covering demographics, statements regarding diabetes and diabetic eye care and one section with an open ended question to determine the reasons for non- attendance. Data analysis: Measures of central tendency were checked and expressed in terms of percentages and tables. The inferential statistics was also conducted to determine the relationship amongst variables. Chi square tests were used to determine the relationship amongst the categorical variables and eye reviews. Spearman’s correlation analysis was carried out to determine the association amongst variables, (behaviour, control, stigma and satisfaction). The open ended question was used to analyse the reason for non-compliance. Results: A total of 300 diabetic patients were randomly selected for the study. The participants were sampled in a stratified way such that each level of compliance is equally represented. The dataset was acceptably complete with very few missing values. The distribution of the participants across the different biographical variables was cross tabulated by compliance with annual reviews. Of the 300 participants, 151 (50.3 percent) were compliant. The results show that there were more females than males 166 (56.3 percent), more Africans than any other ethnic group 168 (57.1 percent), more married viii people than any other marital status group 183 (61.0 percent), more Christians than any other religion 227 (92.3 percent), and more living with their families than any other living arrangement 223 (74.8 percent). Of these variables 5 (1.7 percent) missing values were recorded for gender, 6 (2 percent) for ethnicity, and 2 (0.7 percent) for living arrangements, while marital status and religion were complete. The majority of the participants had a secondary school education 130 (43.3 percent), and most felt that they were in good health 148 (49.3 percent). As for payment of medical expenses, 255 (87 percent) had a medical aid, and yet 147 (51.6 percent) last visited a doctor more than a year from the date of data collection. Conclusion: Compliance with doctor’s visits was found to be associated with positive behaviour and more knowledge and control. Knowledgeable patients were more satisfied with the medical services. Fear of stigma associated with diabetes mellitus was found to be associated with demographic variables such as gender, race, marital status, employment status and educational level. The main reasons for non-compliance were lack of information, negligence, busy work schedules and lack of finance. These results suggested there is a need to raise awareness of eye health and access to affordable medical services.
Perceptions of professional nurses about the bridging course programme in alleviating shortage of staff at health services in the Amathole sub-district, Eastern Cape Province.
(University of Fort Hare, 2014) Hlabahlaba, Ivy Fuyiwe
The study focuses on the perceptions of professional nurses concerning the Bridging Course programme for the alleviation of shortage of staff at health care facilities of the Amathole sub-district, specifically, Mnquma Local Municipality in the Eastern Cape Province, South Africa. The Amathole sub-district is situated in the most remote rural areas of the then Transkeian homeland comprising the three magisterial districts, Nqamakwe, Butterworth and Centane. The health services in this area are experiencing a gross shortage of professional nurses. The aim of the study is to describe the perceptions of professional nurses about the Bridging Course programme in the alleviation of the shortage of staff at health care facilities of the Amathole sub-district in the Eastern Cape. The research question that guided this study was.," What role does the Bridging Course play in the alleviation of the shortage of staff at health care services in the Amathole sub-district in the Eastern Cape?" The objective of the study was to determine and describe the perceptions of professional nurses about the Bridging programme for alleviating the shortage of staff at health care services of Amathole sub-district in the Eastern Cape Province. The research design was quantitative and descriptive. The population consisted of the 289 Registered Nurses currently employed in the two District Hospitals and 16 Primary Health Care (PHC) clinics situated in this sub-district. The simple stratified sample of 149 Registered Nurses used was taken from the above population. Data were collected quantitatively using a closed-ended questionnaire. Quantitative data were analysed using the Statistical Package of Social Sciences (SPSS version 20). Ethical considerations were ensured by means of assuring privacy, confidentiality and anonymity as far as the participants are concerned. Prior to conducting the study, approval was sought from the University of Fort Hare Research Committee, the Eastern Cape Health Research Committee, the District Manager for PHC services and the Nursing Service Managers of the two District Hospitals concerned. The study revealed that the Bridging Course students indeed are playing a vital role in this rural area by being a present help during placement in clinical areas, thereby alleviating shortage of staff. Nurses are critical to the quality and safety of the healthcare system hence the need for the presence of the Bridging Course students in clinical areas of this rural area. In conclusion, the findings were used to attract the attention of the relevant stakeholders so as to influence the decision of the South African Nursing Council on abolishing the Bridging Course programme in the hope of retaining the Bridging Course in this rural area. The researcher recommends the preservation of the Bridging Course programme in this remote and rural area with a gross shortage of nurses.
Attitudes, knowledge and behaviour of HIV positive pregnant women attending antenatal care in buffalo city metropolitan district east London towards prevention of mother to child transmission (PMTCT).
(University of Fort Hare, 2014) Skoti, Florence Nozakhe
Background: The National HIV and AIDS and STI strategic plan for South Africa, 2007-2011 aims to reduce the rate of mother to child transmission to less than 5% by 2011. On the World Aids day in 2009, the Honorable President Jacob Zuma announced the intervention to improve antiretroviral therapy (ARV), access to priority group’s in order to decrease the disease burden, to address maternal and child mortality, and to improve life expectancy (PMTCT Guidelines: 2010). According to the literature reviewed, accepting attitudes may indicate better knowledge and understanding of HIV and AIDS. Marking a change in South Africa’s history of HIV the South African Government launched a major HIV Counseling and Testing program campaign (HCT) in 2010. For the PMTCT program to work and be acceptable, it needs to be known by its clients. It helps the individual to know about their status so that they make important choices for self and others. Amongst the important choices, medications for opportunistic medications, ARV’S, behavior change, etc, are included (Project Literacy 2006:40). Aim and Objectives: The study assessed the knowledge that the pregnant women have towards the prevention of mother to-child transmission which includes HIV testing, antiretroviral prophylaxis during pregnancy, labour, and post natal and feeding options. Methods: A quantitative descriptive method was used for this study. The questionnaires developed by the researcher were used for data collection. The items on the questionnaire were divided into four (4) subsections. The questionnaire was administered to all positive pregnant women coming for follow up visit and those available at the time of data collection. Conclusion: In this study evaluation of the level of knowledge and attitude of positive pregnant women with regard to PMTCT in 5 Buffalo City Municipality clinics was conducted. It was found that some of positive pregnant women have better knowledge about PMTC though there were still those that need further education. Recommendations: The service providers, who are the professional nurses, should be provided with proper training on PMTCT program to improve their standard of service delivery and to capacitate them with knowledge and skills. Integration of HIV related health aspects during assessment and treatment of pregnant women should be strengthened, as the purpose of implementation of PMTCT was to reduce mortality rate by 50%, and also to reach the 4th Millennium Development Goal of reducing these deaths by two-thirds by 2015.
Experiencesof critical care unit nurses concerning the withdrawal of life-sustaining treatment
(University of Fort Hare, 2015) Kupa-Mesa Nororia, Peliswa Prudence
The purpose of the study was to identify, describe and explore the experiences of nurses in a critical care unit (CCU) on the withdrawal of life -sustaining treatment to patients in Buffalo City Metropolitan, South Africa. A qualitative study was conducted in the critical care units from two institutions in the Eastern Cape. A non-probability purposively sampled seven critical care unit nurses was used. Ethics in the study were considered and the pilot study done in one participant which was not part of the study. Few highlights in the interview guide were noted and taken care of. Unstructured in-depth interviews were used as an instrument for data collection. Five main themes emerged from data analysis: • Decision making by doctors concerning withdrawal of treatment from a critically ill patient in a CCU; • Doctor-nurse relationship regarding withdrawal of treatment from to critical ill patients in CCU; • Nurses’ experiences regarding the process of withdrawal of lifesupport treatment from a critically ill patient in CCU; • Nurses’ responsibilities as health professionals towards the patients regarding their profession; and • Coping strategies regarding the withdrawal of life- support treatment from a critically ill patient. Recommendations were put forward to try and reduce the moral distress suffered by nurses in CCUs.
Strategies used to implement the national guidelines on preventing and early management of multi-drug resistant tuberculosis (MDR-TB) at the Buffalo City Municipality clinics in East London Eastern Cape Province.
(University of Fort Hare, 2013) Giyose, Patela
The purpose of the study was to explore and describe the strategies used by nurses to implement the national treatment guidelines to prevent, detect and manage multi-drug resistant tuberculosis (MDR-TB) patients. Tuberculosis remains one of the leading infectious diseases and the major cause of death worldwide with estimates of 9.2 million new TB cases in 2008 and 1.7 deaths including 200 000 in clients co-infected with HIV. South Africa is currently ranked 3rd among the 22 high TB burden countries in the world. The HIV/AIDS epidemic contributes significantly to the upward trend in TB morbidity and it is estimated that more than 50% of TB patients are also HIV positive (South African Department of Health 2009:10). The current rate of tuberculosis infections as a result of new infections as well as re-infections of patients is of concern to the disease control and policy making bodies of South Africa. Questions regarding the effectiveness of tuberculosis policies and programmes emerge at all times (Luhulima, Netshandama and Davhana-Maselesele, 2008: 36). Patients with multidrug-resistant (MDR) tuberculosis (TB) are at high risk of treatment failure. It is anticipated that early identification of MDR-TB and appropriate treatment will improve patient outcome and disease control. This study intends to explore the effectiveness of health systems in the prompt identification and management of MDR patients. This study was conducted using a qualitative, explorative and descriptive design. A purposive sample of clinics and professional nurses was selected, and voluntary participation was ensured. The data was collected through individual interviews which were audio taped and then transcribed verbatim. Findings revealed that MDR-TB guidelines were available at the clinics. The professional nurses implemented the guidelines to prevent, detect and manage multi-drug resistant tuberculosis, by screening and testing symptomatic high risk groups, contact tracing and monitoring, providing initial counselling and education to patients and family, preparing patients for admission when indicated and coordinating referrals to the centralised MDR-TB unit. However, there were notable constraints with regards to the management of MDR-TB patients and the overall TB programme. These included MDR-TB specific training, staff shortages, dysfunctional community DOT programme, shortage of beds at the MDR-TB treatment centres, and patient factors like defaulting, migration for various reasons, alcoholism. All these constraints call for intensified strategic management at both policy and facility level. It is also necessary that all policies related to patient management need extensive scientific study to monitor and evaluate their effectiveness. More research studies are required on policy analysis and utilization.
Factors contributing to non adherence among pregnant women on antiretroviral treatment at Amathole District, Eastern cape.
(University of Fort Hare, 2014) Dekeda, Kolelwa Felicia
During the beginning of the HIV epidemic in 1981 25 million people have died. The introduction of ART therefore has promising developments to reduce mortality rates and new infections. Nevertheless there is still a challenge with adherence to ART worldwide and in South Africa. The purpose of the study was to determine the factors contributing to non-adherence to ART among HIV positive pregnant women. The study involved a non- probability sample of 70 HIV pregnant women on ART attending antenatal care clinics at the tertiary hospital and two community health centres,in Buffalo City, Amathole District, Eastern Cape. A coded questionnaire was used as an instrument for data collection. Ethical procedure was followed and a consent form was signed by each participant. Data was collected for a period of two months The demographic data reveals that the majority of the participants were knowledgeable about ART and employed. That is evident in the adherence to ART in all age groups except age 40 and above. The majority of HIV positive pregnant women on ART who participated in the study were single 50% (n=35) which suggests that they may lack emotional support from partners and may have difficulty in disclosing their status. Level of adherence revealed that 27% (n=19) of participants missed ART because of forgetfulness, and 16% (n=12) and others were feeling healthy due to frequent follow ups and complying with the ART. Poor follow up, too sick, side effects pill burden, fear of stigma, lack of finances and taking alcohol hinders the proper management of HIV positive pregnant women and is risky to the unborn baby. HIV positive pregnant women on ART exhibited a good knowledge and use of ART. This is encouraging and should be sustained by continuous community awareness campaigns to empower the communities about HIV/AIDS, PMTCT programme and ART and extensive training of health care providers.
Professional nurses’ perceptions on quality patient care in one of the Eastern Cape state hospitals
(University of Fort Hare, 2014) Somahela, Khanyisa Judith
The focus of this study was to explore the perceptions of professional nurses in the quality of care rendered by nurses in the public hospitals. Nursing is a challenging, demanding, and yet fulfilling profession, whose goal is to provide quality care to individuals, families and communities. However, there are inconsistencies regarding the quality of care rendered by nurses in the public hospitals. The media and the public portray nurses as providing poor quality care in the health care facilities. Conversely, the nurses view that they are doing their best, considering the challenging circumstances under which they work in public institutions. The study followed a qualitative approach and an exploratory descriptive design. A purposive sample of 13 professional nurses participated in the study. The sample size was not pre-determined. Data were collected until data saturation, when the interviews yielded no new information. The study was conducted in a state hospital in the Eastern Cape, using an interview guide. Responses were recorded using a tape recorder. No incentives were given to participants. Data were collected and analysed following the Tesch’s method. Prior to conducting the study, the researcher obtained ethical clearance from the University of Fort Hare research ethics committee. The perceptions of the professional nurses who participated in this study were inconsistent. The majority pointed out that the quality of patient care was deteriorating which means the patient care is poor. whereas some participants indicated that the quality of patient care was still the same; it had not changed or deteriorated, The contributing factors to the poor quality patient care were indicated as; shortage of staff, shortage of resources such as equipment, inadequate empowerment of staff, insufficient training of students, staff arriving late for duties, lack of passion their work, skipping and missing of routines, support service that was not working hand in hand with the nursing staff, increased hospitalization of patients and the Eastern cape Department of Health failing to remunerate the nurses as promised.
Factors enhancing readmission of mental health care users to a mental health unit in East London as described by their caregivers
(University of Fort Hare, 2014) Mahashe, Nozizwe Patricia
Readmission of mental healthcare users is a global challenge and concern which is associated with high costs. Readmission has negative effects as it is believed to promote dependency, demoralize patients and cause workload for staff. Readmissions also bring a burden to caregivers and affect the caregiver’s health. In the light of this background, the aim of the study was to explore and describe factors enhancing readmission of mental health care users (MHCUs) to a mental health unit in East London as described by their caregivers. The objectives of the study were to: explore factors enhancing readmission of mental health care users in a mental health unit in East London as described by their caregivers and to document recommendations elicited from the findings of the study. A qualitative approach was used to collect and analyze data. The study used a descriptive and explorative design. Sampling was done using the purposive nonprobability method. Unstructured face- to- face interviews were conducted using an interview guide. Fifteen (15) caregivers of MHCUs who had been readmitted to a mental health unit in East London were interviewed .The interviews were recorded and transcribed verbatim. The findings of this study suggest that non adherence to treatment, refusing to take treatment, defaulting treatment, denial, indulging in substance abuse, stigma, effects of disease, violence and aggressive behavior are the factors enhancing readmission of MCHUs to a mental health unit in East London. A better understanding of readmission of MHCUs can lead to early intervention and early planning of care. It is envisaged that psycho education, home visits and collaboration of clinic staff with
An investigation on the effectiveness of lifestyle modification interventions for hypertensive patients in a public health clinic, in the Eastern Cape Province
(University of Fort Hare, 2014) Katiya, Lulama Pearl
mortality rates of hypertensive patients are occuring in spite of hypertensive patients being taught about lifestyle modification (De Haan, 2006:55). According to the fifth South African Guidelines (2011:60), hypertension is a global health burden affecting developed and developing countries including South Africa. In 2003, the South African District Health Statistics showed that in the Eastern Cape, 221 females over 15 years of age and 101 males over 15 years of age had moderate hypertension and 92 males over 15 years had severe hypertension. Hypertension is a `silent killer` because it seldom gives rise to any symptoms (De Haan, 2006:66). The objectives of the study were to: investigate the effectiveness of lifestyle modification intervention on hypertensive patients, and to determine the strategies used in order to ensure the effectiveness of lifestyle modification by hypertensive patients. The research question was: what is the level of effectiveness of lifestyle modification on hypertensive patients in Alice? A descriptive quantitative research design was used in this study. This design allowed the researcher to investigate the effectiveness of lifestyle modification of hypertensive patients in Alice area. A convenience sample was used to sample the target population for the study on the criteria and a total of 169 respondents served as a size of the sample. A pre-test of the tool was carried out on 16 participants to validate the tool before the actual data collection commenced. Ethical approval was obtained from University of Fort Hare, the Department of Health, as well as Victoria Hospital and clinics. Data were collected by means of self-administered questionnaires. The Statistical Package for Social Science (SPSS) version 21.0 software for windows reference was used to analyse the data. The results were presented in tables, graphs and pie charts. The results revealed that 77% (n=125) reported to know nothing about hypertension. Twenty three percent of the participants (n=37) knew about hypertension, they mentioned that it is when the heart has too much blood that is overloading the heart due to problems of the heart, then the blood flow through the heart is disturbed. Furthermore participants stated that it is important that every hypertensive patient engage in lifestyle modification. The study recommended that the Department of Health should emphasise the use of Hypertension Guidelines where all nurses in public clinics should be trained in educating and doing counselling to all hypertensive patients, including those who are pre-hypertensive that are visiting the clinics. Health education about risk factors and complications of hypertension must be done. All patients visiting public clinics must be educated regardless of their problems.
An exploration of nurse educators’ experiences of assessment in a multi-campus nursing college in the Eastern Cape Province
(University of Fort Hare, 2015) Hammond, Sindiswa
Assessment is central to teaching and learning and yet it remains a challenge in most academic institutions. Both teachers and students experience assessment differently because of the different factors affecting them. In this study, internal institutional systems- centralization system of summative assessments, multiple learning sites within a single nursing college, individual assessor and student characteristics were investigated. The study used a qualitative exploratory research design using eight focus group interviews of fifty two nurse educators (n=52) to explore and describe their experiences of a centralised summative assessment in a multi campus nursing college. The study exposed major constraints within the nursing education system, the assessors’ and the students’ personalities challenges of the centralised multi-campus summative assessment process, ranging from questioning, invigilation, marking and scoring to cribbing and low nurse educator morality. Specifically low quality assessment questioning, large numbers of students, unreliable marking including biased marking, lack of proper supervision and support by academic managers resulting in burn out by nurse educators were observed. Recommendations of this study focussed on boosting nurse educators’ morale through motivational, support, professional development programmes improving resource availability at campuses and accountability of nurse educators as assessors and as specialists.
Exploration of indigenous knowledge and practices of the relatives of mental health care users regarding management of mental disorders in Malawi
(University of Fort Hare, 2014) Kavalo, Yasinta
Topic: Exploration of indigenous knowledge and practices of the relatives of mental health care users regarding the management of mental disorders. This study was conducted to explore the management of mental disorders amongst the indigenous people of the Dedza District in Malawi. The government of Malawi declared public mental health services to be free of charge, as a strategy to reduce the burden of disease to the country. Yet despite the free health care services, the indigenous people of Malawi did not take advantage of these free mental health care services, as they regarded them to be culturally incongruent. Instead they used traditional healing systems for mental disorders and consulted the Western health systems only when the traditional systems had failed, the mental health condition had become worse and the mental health care user had become unmanageable. This study was then conducted to explore what the Malawians regarded as culturally sensitive public mental health services. Method: A qualitative phenomenological research approach was adopted to explore the views of the relatives of mental health care users about culturally sensitive public mental health care services. A purposeful sampling method was used to select information rich participants amongst the relatives of mental health care users of indigenous Malawian origin. An unstructured interview guide was used to gather data through face to face interviews. Saturation of data was reached after interviewing fifteen (15) relatives. The verbatim transcribed data from the participants were content analyzed to identify the themes, categories and subcategories. Themes that emerged were: community beliefs; perceived causes, delayed decision making and health system factors. Findings: The community beliefs about the management of mental disorders were on traditional and religious health systems. The traditional healers were consulted in cases where mental illness was believed to be caused by witchcraft and spiritual healers were consulted where mental illness was believed to be caused by ancestral wrath. Even such consultations were delayed as the decisions on the type of healer to be used to manage the mental health care user, had to come from the extended family members. These processes took place during the acute phase of the mental illness and thus explain the delays in consulting with the Western mental health care systems. Such delays had a potential to contribute to the chronicity and the related complications of the illness. The Western health care services were only consulted when the indigenous healing systems were unsuccessful. Yet even the western healing systems were not the best option due to the negative and disrespectful attitudes of health care professionals, the impersonal nature of services, the use of foreign language and delays in service delivery. The recommendations were that the results of this study should be used as guidelines to develop strategies for culturally congruent mental health care services to the indigenous Malawians as the development of the strategies was beyond the scope of this study. The focus of the guidelines to ensure the development of evidence-based nursing practices in rendering culturally congruent mental health services to the indigenous Malawians. Firstly, there should be an integration of both the Western and the traditional healing systems to ensure a holistic patient centered approach to the care of the indigenous people of Malawi; secondly to use the nursing process phases, starting with the assessment, the formulation of the nursing diagnosis, the expected outcomes, the development and implementation of the nursing interventions and the discharge plans to incorporate the belief systems of the indigenous Malawians as identified in this study.
Experiences of HIV positive clients defaulting isoniazid preventive therapy (IPT) in King Williams Town area under the Buffalo City municipality in the Eastern Cape Province
(University of Fort Hare, 2014) Williams, Nelisa Colleen
This qualitative study using a phenomenological design, aimed at exploring and describing and exploring the experiences of HIV positive clients defaulting Isoniazid Preventive Therapy services in the Bhisho Primary Health Care Services. The emphasis was on the factors leading clients to default. An in- depth unstructured face to face interviews were done on 14 participants from 4 clinics or facilities under Bhisho Primary Health Care Services. From the respondents’ responses it can be noted that work and family related issues, ignorance of patients, side effects, and negligence of nurses and denial of HIV status were identified as reasons for defaulting. Having knowledge about the treatment and health providers’ attitudes to patients also played a role in patients defaulting their treatment. Many suggestions were then put forward by the respondents to curb defaulting among patients. These included the use of text message reminders, not to discrimination HIV patients because of their status, to use consulting rooms for privacy and also nurses and caregivers to control their attitudes when dealing with patients.
The investigation of perceptions of professional nurses regarding care of mental health care users in a general hospital setting
(University of Fort Hare, 2015) Manona- Nkanjeni, Nonkanyiso Yvonne
This study sought to explore the perceptions of professional nurses regarding care of stabilised mental health care users in a general hospital setting. A qualitative, explanatory, descriptive and contextual design was used for the study. A non-probability, purposive sampling method was used to select 12 participants from the Cecilia Makiwane Hospital in Mdantsane. Data were collected through semi-structured interviews. The services of an independent interviewer were used to avoid any bias as interviews took place where the researcher is employed. The services of an editor were also used for language control (see Annexure H). The researcher repeatedly listened to the tapes used for data collection until completely satisfied with the interpretation of verbatim data. The research study was conducted in an ethically reflective manner and trustworthiness was ensured at all times. Four themes emerged from the analysis of the interviews: fear, stigma, myths and training. The researcher utilised the services of an independent coder who verified the identified major themes. The findings revealed that participants were fearful due to lack of knowledge, experience and psychiatric nursing skills. Participants feared because they lack knowledge about psychiatric medication and because mental health care users may have relapse. The participants also attached a stigma to mental health care users, which resulted in poor communication between participants and the stabilised mental health care user; a negative attitude towards mental health care users; and non-acceptance. Participants believed in myths about mental illness; they regarded it as contagious; and perceived mental health care users as dangerous. The participants strongly recommended that training should be provided to improve their knowledge and skills to enable them to care for stabilised mental health care users in a general hospital setting. The following should be facilitated: in-service training; adoption of a positive attitude; dispersal of myths and fear; education about referral systems; and allocation of specialist psychiatric nurses to medical wards for referral purposes with regard to complicated cases.
Exploration of factors contributing to the tuberculosis default rate in the East London area of Buffalo City Metropolitan Municipality
(University of Fort Hare, 2014) Mlatsheni, Nomakorinte Elizabeth
Tuberculosis (TB) kills approximately three million people per year worldwide. Of the estimated two billion people infected with tuberculosis, eight million develop the disease annually. The present global tuberculosis situation indicates that both the disease and default burdens are still very high, especially in developing countries. Defaulting from treatment has been one of the major obstacles to treatment management and an important challenge for tuberculosis control. The main purpose of this study was to explore factors that contribute to the high default rate of tuberculosis in the East London area of the Buffalo City Metropolitan. In this study the researcher used the qualitative approach whereby the participants were given an opportunity to express their lived experiences on the factors contributing to defaulting on tuberculosis treatment. The population consisted of all TB clients who were defaulting treatment from January to December 2012 in Zanempilo, Gonubie and Chris Hani clinics in the East London Primary Health care facilities under the Buffalo City Metropolitan Municipality (BCMM). The researcher used the non-probability purposive sampling method. TB registers from January to December 2012 were used as a source of information to get the names and addresses of TB defaulters. The study was conducted in the East London area of Buffalo City Metropolitan Municipality. East London is a city on the south east coast of Buffalo City Metropolitan Municipality in the Eastern Cape Province. The East London health care system is operating under the Buffalo City Metropolitan Municipality (health district). It is composed of 35 fixed clinics, six mobile clinics, two community health centres, one specialized hospital, one regional hospital and three private hospitals. In-depth unstructured face-to-face interviews were used to collect data from 14 participants. In this study the researcher identified factors such as patient behaviour, sickness, feeling better, nurses’ attitudes, work issues and temporary change of residence as reasons why patients stopped taking their treatment. It is imperative to understand predictive factors for treatment default so that programs can implement specific measures to target the population at risk, since other strategies such simpler treatment regimens and Directly Observed Treatment Short course (DOTS) have not given enough satisfactory results.
Patients’ perceptions regarding commencement of treatment following diagnosis with breast cancer at Frere Hospital, Buffalo City, Eastern Cape.
(University of Fort Hare, 2014) Matwele, Caroline Ntombekaya; Magadla, N.I. N.
The aim of the study was to: explore and describe patient’s perceptions regarding commencement of treatment following diagnosis with breast cancer at Frere Hospital in Buffalo City Metropolitan Municipality in the Eastern Cape, South Africa. Reasons why patients diagnosed with breast cancer delay in the commencement of the treatment were to be elicited and strategies for curbing the problem were looked into. A qualitative approach was used, with an exploratory, descriptive and contextual design. The purposive sampling technique was used. The sample comprised 15 participants, 14 Black Africans and 1 Coloured lady. Data were collected using an interview guide from female patients diagnosed with breast cancer whose age ranged from 18-72 years. Interviews were recorded on a tape. Tesch’s (1990) steps of qualitative data analysis guided the analysis process. The results revealed that being diagnosed with breast cancer is perceived as a traumatic and painful experience with negative emotional, social, physical impact and unbearable side effects of from the treatment. Fear of undergoing treatment emerged as a barrier for taking prompt treatment. In exploring, one needs to use empathy, particularly that the researcher engaged in bringing to surface painful information. With the use of understanding and broad mindedness, participants opened up. Recommendations were made regarding strategies for care.
Perceptions of indigenous people regarding mental illness at Cacadu district in the Eastern Cape province of South Africa
(University of Fort Hare, 2015) Tilolo, Lwazi Romeo
Indigenous people tend to consult traditional healers when a family member manifests change in behaviour, whilst conventional treatment disregards spirituality when preserving mental health. The aim of the study was to explore the perceptions of indigenous people and the role of traditional healers in the management of mentally ill persons within the Cacadu District in the Eastern Cape Province of South Africa. The study has adopted a qualitative approach which was exploratory and descriptive in nature. The sample consisted of nine relatives of mental health care users (MHCUs) and six traditional healers. Ethical principles were also taken into consideration by the researcher during the process of conducting the study. Data were collected from two strata, namely, relatives of the MHCUs and the traditional healers and an interview guide was used to conduct in-depth face-to-face interviews. Data were analysed using Tesch’s method of data analysis. Four themes emerged from the data categories and sub categories were identified. According to the themes participants indicated the negative impact of mental illness; as a result they portrayed great desperation regarding the means of accessing a cure for mental illness. Some participants showed insufficient knowledge regarding mental illness and had different perceptions and beliefs regarding the origin of mental illness. Available literature was used to emphasise and support the views that were expressed by both traditional healers and relatives of MHCUs. It has been highlighted from this study that indigenous people of Cacadu District view mental illness as spiritual in origin but they include Western medication for the benefit of the mentally ill. In addition, the relatives of the MHCUs highlighted the economic burden as the major problem that results from mental illness.
Professional behaviour among nursing students at a college in the Eastern Cape
(University of Fort Hare, 2013) Magopeni, Sibongile Nomvuyo
The focus of the study was to explore and describe reasons for poor professional behaviour among nursing students at a public nursing college in the Eastern Cape. The objectives of the study were to explore and describe the reasons for poor professional behaviour among nursing students and to describe strategies to improve poor professional behaviour. The study has significance for the college management, staff, nursing students, registered nurses and everyone involved in professional development of nursing students. The population for this study consisted of third-year nursing students following the four-year comprehensive basic course for registration leading to the Diploma in Nursing (General, Community & Psychiatry) and Midwifery at a public nursing college. The research questions were: What do you understand by professional behaviour? What are the reasons for poor professional behaviour among nursing students? What could be done to improve professionalism among college nursing students? A qualitative, explorative, descriptive and contextual design was used as a framework for the study. Permission to conduct the study was obtained from the University of Fort Hare ethics committee and other relevant authorities as indicated in the study. Ethical principles were maintained and informed consent obtained. Data collection was done using focus groups and an audiotape with a purposefully sampling of 30 third-year nursing students at the public college of nursing. Data were analysed using Tesch’s method of analysis for qualitative research. Three major themes emerged: students’ understanding of professional behaviour, reasons for poor professional behaviour and methods to improve poor professional behaviour. It was concluded that poor professional behaviour has an effect on professionalism and it should be addressed and corrected for protecting the professional image. Recommendations: Policies regarding inappropriate professional behaviour at the college should be in place and easily accessible to every staff member and nursing student. Department of Health should conduct reflective courses and seminars on professionalism and these should begin at the same time as the academic programme.
Experiences of critical care unit nurses concerning the withdrawal of life-sustaining treatment
(2015) Kupa-Mesa, Phelisa Prudence
in the Eastern Cape. A non-probability purposively sampled seven critical care unit nurses was used. Ethics in the study were considered and the pilot study done in one participant which was not part of the study. Few highlights in the interview guide were noted and taken care of. Unstructured in-depth interviews were used as an instrument for data collection. Five main themes emerged from data analysis: • Decision making by doctors concerning withdrawal of treatment from a critically ill patient in a CCU; • Doctor-nurse relationship regarding withdrawal of treatment from to critical ill patients in CCU; • Nurses’ experiences regarding the process of withdrawal of lifesupport treatment from a critically ill patient in CCU; • Nurses’ responsibilities as health professionals towards the patients regarding their profession; and • Coping strategies regarding the withdrawal of life- support treatment from a critically ill patient. Recommendations were put forward to try and reduce the moral distress suffered by nurses in CCUs.

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