bluuebunny/crossref_metadata_2025 huggingface dataset:
A value clarification on quality within Nursing Colleges in Gauteng
Authors: Armstrong S. , Muller M.
Published: November 2012

Quality assurance in higher education has been legislated. It is therefore necessary to develop a quality audit system for Nursing Colleges in Gauteng. The process of developing such a system is complex and needs to foster ownership by all the stakeholders. The first step in this process is to conduct a value clarification on quality. The purpose of this article is to explore and describe a value clarification on quality within the Nursing Colleges in Gauteng. An explanatory and descriptive qualitative research design was utilised. The results are grouped into structure, process and outcome values. Comparisons between the views of the different role-players are also presented. It is recommended that these results be utilised as the basis of a conceptual framework for the quality audit system for Nursing Colleges in Gauteng, as well as the development of quality indicators for Nursing Education Institutions in South Africa.
Assessment of a post-basic nursing education programme
Authors: Du Rand P. , Viljoen M.J.
Published: November 2012

A post-basic nursing education programme was introduced by the School of Nursing, University of the Free State, in 1999. The main aim o f the programme is to offe r vocationally directed specialisation and continuing educational opportunities to registered nurses. Qualifications, exit possibilities, the learning programme and the teaching- learning methods are described. A year after the programme was introduced student evaluation of the programme took place by means of questionnaires. The survey method was used to obtain the opinion of students via questionnaires. A convenience sample was applied and 82% of the questionnaires were returned. Although students appeared to be satisfied, they found some modules difficult. Twenty-three per cent found the lecturers helpful and considerate and 93% found contact with lecturers to be essential. The greatest advantage of the programme, however, is that it offers registered nurses an opportunity to qualify as clinical experts, because the programme focuses mainly on clinical specialisation. Tutorial staff are compelled by student estimates to examine the relevancy of curricula on a regular basis.
To report or not to report, that is the question - the phlebotomist’s perspective
Authors: Butkovic A.D. , Venter F.H.J.
Published: November 2012

Late and non-reporting of injuries amongst phlebotomists in South Africa is a problem. With the high incidence of the infectious and eventually fatal diseases of HIV, Hepatitis B and C in South Africa, this problem had to be explored in order that all health care workers obtain timeous treatment (medicinally, socially & psychologically) in the future.
A poster presentation as an evaluation method to facilitate reflective thinking skills in nursing education
Authors: Chabeli M.M.
Published: November 2012

This article seeks to establish whether the poster presentation of a specific theme can facilitate the student’s thinking skills in nursing education. A qualitative, exploratory, descriptive and contextual research design where twenty students volunteered to take part in the study by signing an informed consent was followed. Descriptive naïve sketches were used for data collection followed by individual interviews to validate the findings. Data was analysed by means of the descriptive method of open coding of Tesch (in Creswell, 1994:155). DENOSA’s ethical standards for research (1998:7) were considered.
A sociological study of children with albinism at a special school in the Limpopo province
Authors: Gaigher R.J. , Lund P.M. , Makuya E.
Published: November 2012

This article maintains that it is the social context, as much as, and sometimes more than the physical condition, that largely structures and limits the lives of people with albinism. It deals with albinism from a sociological, rather than a medical perspective. Viewed as such the problems experiencing by affected people stem primarily not from their physical differences but from the way others respond to those differences and from the social and physical environments they have to cope with. The article is based on a study of 32 children with albinism from a special school in the Limpopo province. Educational, health and social problems, attitudes and perceptions about albinism were tested by way of structured interviews. The data reveal an acute lack of information about the causes and consequences of albinism. It projects it as a condition still deeply immersed in myths and superstition resulting in the stigmatising and rejection of affected people. It also discloses a physical environment which is preventing rather than supporting people with albinism from reaching their potential. It calls for a reorientation in dealing with albinism -away from just medical intervention to treating it as a social construct requiring a holistic approach.
Expectations of stakeholders regarding home care provision in rural Namibia
Authors: Lipinge S.N. , Botes A.C.
Published: November 2012

As in many countries, the disease pattern in Namibia has changed, health problems are increasing and outweigh the capacity of the existing health resources. Government health facilities in Namibia have limited capacity to accommodate all sick people, especially those who are chronically and terminally ill. Many hospitals in rural Namibia are overcrowded, patients sleep on the floors and, in some cases, children share beds. Morbidities relating particularly to AIDS, chronic conditions and other physical and emotional disabilities are likely to require longterm home care. In most instances, the health system is also not prepared to provide home care, nor provide the support that is required by the caregivers of disabled, chronically sick people. To ease the burden of care felt by the state at health facilities, the Ministry of Health and Social Services in Namibia has, on several occasions, called upon the community and other stakeholders in health care to assist in caring for their loved ones at home (NBC, 1996; MOHSS, 1996).
Student nurses’ perceptions of the development of interpersonal relationships
Authors: Solombela P.W. , Ehlers V.J.
Published: November 2012

This survey attempted to investigate: • whether significant differences existed between the first and fourth year students’ perceptions about the espousal of positive interpersonal relationships • student nurses’ perceived role of tutors, preceptors and professional nurses in fostering the development of students nurses’ positive interpersonal relationships • student nurses’ espousal of positive interpersonal relationships with colleagues, patients, friends and relatives of patients .
The evolution of the hospital from antiquity to the end of the middle ages
Authors: Cilliers L. , Retief F.P.
Published: November 2012

The evolution of the hospital is traced from its onset in ancient Mesopotamia towards the end of the 2nd millennium to the end of the Middle Ages. Reference is made to institutionalised health care facilities in India as early as the 5th century BC, and with the spread of Buddhism to the east, to nursing facilities, the nature and function of which are not known to us, in Sri Lanka, China and South East Asia. Special attention is paid to the situation in the Graeco-Roman era: one would expect to find the origin of the hospital in the modem sense of the word in Greece, the birthplace of rational medicine in the 4th century BC, but the Hippocratic doctors paid house-calls, and the temples of Asclepius were visited for incubation sleep and magico-religious treatment. In Roman times the military and slave hospitals which existed since the 1st century AD, were built for a specialized group and not for the public, and were therefore also not precursors of the modem hospital. It is to the Christians that one must turn for the origin of the modem hospital. Hospices, initially built to shelter pilgrims and messengers between various bishops, were under Christian control developed into hospitals in the modem sense of the word. In Rome itself, the first hospital was built in the 4th century AD by a wealthy penitent widow, Fabiola. In the early Middle Ages (6th to 10th century), under the influence of the Benedictine Order, an infirmary became an established part of every monastery. During the late Middle Ages (beyond the 10th century) monastic infirmaries continued to expand, but public hospitals were also opened, financed by city authorities, the church and private sources. Specialized institutions, like leper houses, also originated at this time. During the Golden Age of Islam the Muslim world was clearly more advanced than its Christian counterpart with magnificent hospitals in various countries.
Treatment utilisation and trauma characteristics of child and adolescent inpatients with posttraumatic stress disorder
Authors: Traut A. , Kaminer D. , Boshoff D. , Seedat S. , Hawkridge S. , Stein D.J.
Published: November 2012

Objective. Few empirical studies have addressed the impact of trauma exposure and posttraumatic stress disorder (PTSD) on treatment utilisation and outcome in South African youth. This study was undertaken to document demographic, clinical, and treatment characteristics of child and adolescent inpatients with PTSD. Design. A retrospective chart study of all patients presenting to a child and adolescent inpatient unit was conducted between 1994-1996. For children and adolescents diagnosed with PTSD; demographic, diagnostic and treatment variables, including trauma type, family history, and delays in treatment seeking, were documented. Setting. Child and Adolescent Psychiatric Inpatient Unit, Tygerberg Hospital, Cape Town. Subjects. Children and adolescents (2 to 18 years) presenting to an inpatient unit (n=737). Results. 10.3% (n=76) met diagnostic criteria for PTSD. Gender differences were clearly evident: PTSD was six times more prevalent in girls (65 with PTSD were female and 11 were male); girls were most likely to have experienced rape or sexual abuse while boys were most likely to have witnessed a killing. Psychotherapy was the most common intervention for PTSD, followed by treatment with a tricyclic antidepressant. 97.4% of children and adolescents who were treated demonstrated significant improvement. Delays in seeking treatment and problems with the primary support group were highly prevalent. Conclusion. PTSD is a common disorder that is responsive to treatment with psychotherapy and/or tricyclic antidepressants in child and adolescent inpatients. These findings underscore the importance of early identification and treatment of childhood PTSD in mental health settings, in particular tertiary service institutions.
Essential managerial attributes of the nowadays nursing service manager in the South African context
Authors: Jooste K
Published: November 2012

Nursing service managers need certain essential managerialattributes in taking the lead in effective management ofthe nowadays health care organisations in South Africa.Major changes in restructuring and human resources planningare taking place through transformation of health servicesand specific managerial attributes are needed in thisscenario. Without nursing service managers with the necessarymanagerial attributes, change in the health care environmentwill be hampered and planning, organising, directingand control of the delivering of quality care will benegatively influenced.
Journaling: A quasi-experimental study of student nurses’ reflective learning ability
Authors: Fakude LP
Published: November 2012

The use of journaling or journal writing in clinical education is one of the strategies used to develop critical thinking. Reflective journal writing, as it is commonly known, can nurture many qualities of a critical thinker and promote thoughtful nursing practice. Using a quasi-experimental design in this study, reflective journaling was introduced to a sample of first year Bridging Course student nurses at a Private Nursing Education Institution, to assess its effectiveness in reflective learning.
A job analysis of selected health workers in a district health system in KwaZulu Natal - Part two: Job analysis of nurses in primary health care settings
Authors: Mbambo S
Published: November 2012

The aim of this descriptive survey was to do a job analysis of different categories of nurses in a District Health System in order to clarify job expectations, describe current practice of nurses in hospitals and clinics and to make recommendations about skills mix in district services. This article deals with the clinics only.
Nursing students’ experiences during a rural community placement programme in Namibia - 2001
Authors: Lipinge SN
Published: November 2012

The reviewed nursing curriculum in Namibia incorporated issues related to Primary Health Care and diversification in the practical field for student nurses. This means that the students are exposed more to their communities than before. Nurses identify, manage and refer, if need be, the problems at this level. The curriculum facilitates and strengthens problem-solving skills and enhances the ability of nurses to adapt a comprehensive and family centred approach.
Health professionals’ knowledge of prevention strategies and protocol following percutaneous injury
Authors: Bodkin C
Published: November 2012

Prevention strategies and protocols for the management of percutaneous injuries are developed for the purpose of preventing transmission of HIV and other infections. However, implementation thereof requires health professionals to be conversant with the content of protocols and ways to prevent percutaneous injuries. The purpose of the study was to determine health professionals’ knowledge of prevention strategies and protocols following percutaneous injury. The purpose was addressed within a quantitative survey design. Data were collected by means of a self-administered questionnaire. The study was conducted at a public-sector tertiary academic hospital in Gauteng. Seven units within the hospital were randomly selected for investigation. These included, trauma, intensive care, medical, surgical, maternity, theatre and paediatrics. A population of 800 health professionals worked within the sampled units. Health professionals were stratified according to the following three categories, doctors, registered and enrolled nurses and medical and nursing students. A sample size of 200 health professionals was purposively selected of which a response rate of 79.5% (n= 159) was achieved. The sample consisted of 76.7 % (n=122) registered and enrolled nurses, 13.2% (n=21) doctors and 8.8% (n=14) medical and nursing students; 1.3% (n=2) did not specify their health professional category.
Perceptions about Epilepsy in the Limpopo Province of the Republic of South Africa
Authors: Mangena-Netshikweta ML
Published: November 2012

In rural African communities, there are widespread beliefs that epilepsy is due to possession of bewitchment by evil spirits or the devil. There is also a belief that the transmission of the disease is by physical contact, such as by saliva (Osuntokun 1990:106). In central Africa, as well as in Sub-Saharan Africa, epilepsy is attributed to the presence of a lizard in the brain, and epileptic fits occur whenever the lizard moves ( Haddock 1993:118 ; Nyame 1997:143 ). Such perceptions toward epilepsy and a person with epilepsy, in indigenous Africa, are invariably unfavourable and unfounded as they reflect mythical beliefs about the disease.
Hand decontamination practices in paediatric wards
Authors: Jelly S
Published: November 2012

The purpose of this study was to determine and describe hand decontamination practices of health care professionals in the paediatric wards of an academic hospital in Johannesburg. The purpose was addressed within a survey design and through the use of descriptive and comparative methods. Data were collected through direct observation conducted with the use of a researcher-administered checklist. A sample of sixtysix health professionals was obtained through convenience sampling.
Characteristics of female sex workers and their HIV/AIDS/STI knowledge, attitudes and behaviour in semi-urban areas in South Africa
Authors: Peltzer K. , Seoka P. , Raphala S.
Published: November 2012

The aim of this study was to investigate characteristics of female sex workers and their HIV/AIDS/STI knowledge, attitudes and behaviour in semi-urban areas in South Africa. The sample included 70 female sex workers from the Tzaneen and Phalaborwa area in the Limpopo Province. A modified form of snowball sampling known as “targeted” sampling was used for identifying female sex workers. Results showed an inadequate knowledge of HIV prevention methods and some incorrect beliefs about AIDS transmission. Most sex workers reported condom use with their last sex client, inconsistent condom use with paying partners, and had poor condom use with regular partners. One third were drinking alcohol daily, one quarter had had voluntary HIV tests, and three quarters had been exposed to HIV interventions. Findings are discussed and implications for HIV interventions outlined.
Cultural health practices of South African Vatsonga people on the home care of children with measles
Authors: Lebese R.T. , Netshandama V.O. , Shai-Mahoko N.S.
Published: November 2012

The purpose of this research study was to identify the cultural health practices of the Vatsonga in relation to the home care of children with measles. It was undertaken in the Giyani District of the Limpopo Province, in the Republic of South Africa. The qualitative, explorative and contextual design was used to conduct this project. Data was collected from nine key informants and nineteen general informants. Data was collected using individual interviews with key-informants and focus group interviews with general informants. Observations were also made.
‘n Kruiskulturele ondersoek na eensaamheid onder studente van die Universiteit van die Vrystaat
Authors: Le Roux A.
Published: November 2012

Many young people today are lonely and hopeless, and feel that life has no meaning. The existing literature indicates that this phenomenon is taking on near-epidemic proportions in industrialised Western countries. A considerable amount of cross-cultural investigations have already been conducted overseas between different population groups, in order to determine what the causes of this phenomenon are and whether culture plays an important role in the development of loneliness. As far as this type of research is concerned South Africa is currently far behind the rest of the world. Serious efforts shall have to be made to determine whether loneliness is taking on the same proportions locally and if certain population groups are more vulnerable than others, because it could have far-reaching consequences on their physical as well as psychological health. South Africa has a rich population variety which could enable researchers to investigate emotional constructs like loneliness that could contribute to the unravelling of this multifaceted phenomenon. The purpose of this investigation was therefore to determine whether students from different cultural backgrounds at the University of the Free State differ from each other, as far as their experience of loneliness is concerned. Questionnaires were distributed among students and 270 respondents, of which 122 were white and 148 black, took part in this study. A factorial analysis of variance was applied on the data, with loneliness as dependent variable, and cultural background, gender and age as independent variables. The results firstly show that cultural background is a very important variable as far as loneliness is concerned. Black students are significantly more lonely than white students while no gender and age differences between the groups were found.
Experiences by student nurses during clinical placement in psychiatric units in a hospital
Authors: Van Rhyn W.J.C. , Gontsana M.R.
Published: November 2012

An exploratory study was conducted with the aim of discovering and describing experiences of psychiatric nursing students during clinical placement in a psychiatric unit. For the purpose of the study an unstructured interview was conducted with each participant during their first placement in a psychiatric unit to identify the factors experienced as stressful. The results indicated that all eight participants experienced average to high stress. Sources of stress identified included, among others, ineffective teaching and learning programmes, poor managerial governance of the service, detachment of professional nurses from their teaching role, poor relationships among staff, overreliance on the medical model of care and patient neglect. Psychiatric nursing students sampled indicated universal support for in-service education and training for professional nurses, attitude change of professional nurses towards students, support for student initiatives, student involvement in patient care and adequate allocation of resources for patient care and nurse training. The exploration and description of experiences of the psychiatric nursing students will help nurse educators plan clinical learning opportunities in such a way that they are less stressful, thus ensuring that psychiatric nursing students are equipped to utilise themselves as therapeutic instruments.
Nursing attrition and the work environment in South African health facilities
Authors: Hall E.J.
Published: November 2012

A number of media reports appeared on the shortages of professional health workers in the public health sector. Unsatisfactory working conditions in health facilities were mentioned as one of the key aspects responsible for the shortages. Literature indicates that stress caused by unsatisfactory work environments may play a major role in employees’ decision to resign their jobs, in spite of enjoying the nature of their work. The aim of this article is to explore the current human resource situation in nursing i.e. to determine if a shortage of nursing skills exists, to establish the challenges that nurses have to face in performing their duties and to establish the potential effect of the work environment on attrition.
In-service education and training as experienced by registered nurses
Authors: Norushe T.F. , Van Rooyen D. , Strumpher J.
Published: November 2012

Nursing is a dynamic profession that is subject to rapid changes in health care provision, hence the need for inservice training programmes for nurses. Newly employed registered nurses require in-service training in order to update them regarding the latest developments in nursing practice. The researcher noted that some newly appointed registered nurses were not competent in all aspects relating to their tasks. This could have been due to a knowledge deficit relating to either new developments or of the procedure relating to a specific task. In some institutions newly-appointed registered nurses on probation reported not receiving in-service training for six months or longer, yet they were still expected to perform their tasks efficiently. The objectives of the study were to, firstly, explore and describe the experiences of registered nurses regarding in-service training programmes in their institutions and, secondly, to make recommendations to Nursing Service Managers relating to the development of effective inservice training programmes in their institutions. A qualitative, exploratory, descriptive design was implemented. Data was analysed using Tesch’s descriptive approach.
Clinical teaching of student nurses by unit managers of selected hospitals in Limpopo Province
Authors: Murathi LA , Davhana-Maselesele M , Netshandama VO
Published: November 2012

The comprehensive nature of nurse training needs the involvement of almost all health team personnel, including unit managers to gain practical experience and learn to correlate theory and practice. The overall aim of the study was to explore and describe the experiences of unit managers regarding teaching of student nurses in the clinical area and to develop recommendations that will enhance clinical teaching, for the production of competent future nurse practitioners who will render quality care to patients. A qualitative design, which is explorative, descriptive and contextual in nature, was employed, utilizing a phenomenological approach to capture the experiences of unit managers regarding teaching of student nurses at selected hospitals, where students are allocated for their clinical exposure. Ethical measures as well as measures to ensure trustworthiness were adhered to. In-depth phenomenological interviews were conducted with unit managers who shared their experiences regarding clinical teaching of student nurses. Data analysis was done according to Tesch’s (1990) open coding method. One major theme emerged, namely that unit managers experienced problems when doing clinical teaching of student nurses. Based on the findings the following recommendations were made: Colleges should open a two-way communication with unit managers, involvement of unit managers in the activities that take place at the college like courses, seminars and workshops on clinical teaching, learning contracts should be developed for the students and issues of clinical learning should be addressed and unit managers should be included in both summative and formative evaluations.
An evaluation of the relevance and appropriateness of post-basic nursing programmes offered by the University of Zululand in meeting graduates’ needs
Authors: Kubheka BA , Nzimande PN
Published: November 2012

This article aims at evaluating the relevance and appropriateness of post-basic nursing programmes of the University of Zululand Nursing Science Department in meeting the educational needs of the graduates in the Province. An explanatory descriptive survey was conducted in the hospitals,clinics, nursing colleges, nursing schools and the University of Zululand where the nursing graduates worked. Two sets of interview schedules were designed, one for nursing graduates and one for their supervisors. These interview schedules consisted of open and closed-ended questions. The total number of graduates was 75 and 29 supervisors. The respondents were purposively and conveniently selected according to the availability of post-basic nursing graduates in each health and nursing education institution. The study revealed that post-basic nursing programmes of the University of Zululand catered for the changing learning needs of the graduates. This was due to the comprehensiveness of the programmes and their focus on community based and primary based health care from 1996. Based on the findings of the research it was recommended that a continuous evaluation of the post-basic nursing programmes is done , in order to check if they still meet the changing learning needs of the graduates. It was further recommended that the Nursing Science Department should develop more advanced clinical nursing programmes in order to cater for the recent learning needs of the graduates.
The quality of integrated reproductive health services: perspectives of clients in KwaZulu-Natal, South Africa
Authors: Maharaj P , Munthree C
Published: November 2012

The focus of family planning programmes has shifted away from an emphasis on controlling fertility towards helping individuals achieve their reproductive goals. This article seeks to expand knowledge about the quality of integrated services from the perspective of clients at health facilities in KwaZulu-Natal. The results from 300 structured interviews with clients visiting health facilities found that overall quality of services was relatively high. However, the quality of services varied somewhat between rural and urban areas. Clients visiting urban health facilities reported greater satisfaction with services than clients visiting rural health facilities. The interviews with clients suggests that existing efforts to integrate services has had limited success. Clients were rarely offered an expanded range of services during their visit. In most cases, clients only received services for which they presented at the health facility.
Facilitating phenomenological interviewing by means of reflexology
Authors: Ross E , Schulze S , Van Niekerk, Petro M
Published: November 2012

The aim of this article is to show how reflexology could facilitate phenomenological interviewing by probing the lifeworld of individual participants. It presents a hybrid study of phenomenological interviewing and reflexology as a holistic method of health care. In this sense, it is an interparadigmatic study, since it rests on the interface of Western and Oriental thought. This article reports on seven cases which were included in the qualitative, empirical investigation. During the sessions, reflexological readings served as impetus for inquiry into the experiences of the participants, as congestions on reflex points and along meridians were interpreted in terms of physical organs and functions. These readings were related to corresponding emotions as accepted within the reflexology paradigm. It was, however, up to the participants to inform the researcher of events and/or circumstances that caused the emotions. Thus, nonverbal data communicated information that facilitated verbal exchange concerning the life-world of each individual participant.
The meaning of community involvement in health: the perspective of primary health care communities
Authors: Mchunu GG , Gwele NS
Published: November 2012

The goal of this study was to establish the understanding and appreciation of the essence of PHC principles in the two Primary Health Care (PHC) communities. The PHC communities in this study referred to the people who were involved in the operation of the phenomenon, that is health professionals working in the health care centers and the communities served by these health care centers. It was hoped that the study would enhance the understanding of the importance of community involvement in health (CIH) in health care delivery, for both community members and health professionals. A case study method was used to conduct the study. Two community health centers in the Ethekwini health district, in Kwa Zulu Natal, were studied. One health center was urban based, the other was rural based. A sample of 31 participants participated in the study. The sample comprised of 8 registered nurses, 2 enrolled nurses, 13 community members and 8 community health workers. Data was collected using individual interviews and focus groups, and was guided by the case study protocol. The findings of the study revealed that in both communities, participants had different, albeit complementary, understanding of the term ‘Community Involvement in Health’ (CIH). Essentially, for these participants, CIH meant collaboration, co-operation and involvement in decision-making.
A conceptual framework for teaching research in nursing
Authors: Wright SCD
Published: November 2012

Though research is often referred to the lifeblood, hallmark or cornerstone in the development of a profession (Brink, 1996:2), teaching research in Nursing is a challenge. The challenge does not just lie in teaching the subject, but in resistance and unwillingness of students to engage in the subject. In the experience of the researcher, registered nurses identify themselves with being a nurse and a caregiver; the role of researcher has never been internalised. The challenge is to achieve the outcome envisaged, namely, nurses who are knowledgeable consumers of research as well as continuous productive scholars in their application of nursing. Research generates knowledge and knowledge is the basis of caring with excellence. Nursing is an art and a science and the science must produce the knowledge upon which the art is based. The purpose of this article is to propose a conceptual framework of how to teach research in order to achieve such a successful outcome. The conceptual framework proposed in this article is based on four pillars, theoretical knowledge of research, scientific writing, psychological support and experiential learning. The importance of the research facilitator, not just as a teacher but also as a positive role model, is also described.
Verbal abuse of nurses by physicians in a private sector setting
Authors: Joubert E , Du Rand A , Van Wyk N
Published: November 2012

The aim of the study was to determine whether physicians in a private sector setting verbally abuse nurses, and to what extent. A review of the literature showed that verbal abuse by physicians accounts for the highest incidence of aggression towards nurses in health care, and that it is strongly related to turnover rates. It has also been reported in recent studies that within the context of verbally abusive episodes, patient care, work productivity, morale and job satisfaction have been negatively affected. Of the 120 questionnaires that were distributed among registered and enrolled nurses, 83 were returned in time to be used, which was a response rate of 69%. This response rate is consistent with previous studies and is exactly the same as for a study that was done in Turkey (Uzun, 2003:81). The questionnaire used was one that has been adapted from the Verbal Abuse Scale developed by Manderino and Berkey (1997:50) and the Revised Conflict Tactics Scale (CTS 2) as described by Little (1999:24), and was in the form of a 4-point Likert-scale with one open ended question. The results showed that 79% of the nurses admitted that verbal abuse was taking place. Forms of direct verbal abuse included 81 % that felt they were criticised unjustly, 76% that were screamed at in front of others, and 81 % that felt physicians vented their frustration on them. The results obtained in the study were consistent with previous studies done elsewhere and it indicated that nurses still experience high levels of verbal abuse in the workplace.
Virtue ethics: an approach to moral dilemmas in nursing
Authors: Arries E
Published: November 2012

Nurses are increasingly confronted with situations of moral difficulty, such as not to feed terminally ill patients, whistle blowing, or participation in termination of pregnancy. Most of these moral dilemmas are often analyzed using the principle-based approach which applies the four moral principles of justice, autonomy, beneficence, and nonmalificence. In some instances, consequentialism is considered, but these frameworks have their limitations. Their limitations has to do with a consideration for the interpersonal nature of clinical nursing practice on the one hand, and is not always clear on how to judge which consequences are best on the other hand. When principles are in conflict it is not always easy to decide which principle should dominate. Furthermore, these frameworks do not take into account the importance of the interpersonal and emotional element of human experience. On the contrary, decision making about moral issues in healthcare demands that nurses exercise rational control over emotions. This clearly focuses the attention on the nurse as moral agent and in particular their character. In this article I argue that virtue ethics as an approach, which focus of the character of a person, might provide a more holistic analysis of moral dilemmas in nursing and might facilitate more flexible and creative solutions when combined with other theories of moral decision-making. Advancing this argument, firstly, I provide the central features of virtue ethics. Secondly I describe a story in which a moral dilemma is evident. Lastly I apply virtue ethics as an approach to this moral dilemma and in particular focusing on the virtues inherent in the nurse as moral agent in the story.
Dietary intake of pregnant women and their infants in a poor black South African community
Authors: Mostert D , Steyn NP
Published: November 2012

The aims of this study were (i) to determine the dietary intake of women in a poor rural area during pregnancy and lactation, and (ii) to determine the nutritional status and dietary intake of their infants at age 6 months. We recruited 46 women, below 40 years old, in their 2nd trimester of pregnancy. The subjects were living in a rural area of Limpopo Province. Their heights and weights were recorded, as were their diets during pregnancy and for the first 6 months after delivery. We also recorded weights, lengths, and dietary intake of the infants at 3 and 6 months after birth. The subjects were living in severe poverty: none had running water and almost all did their cooking over an open fire. None of the subjects smoked and only one consumed alcohol. The diets of the subjects consisted mainly of maize, brown bread, sweetened beverages (cold drink and tea), and small amounts of vegetables and chicken. The diets were adequate in protein but were marginal in energy and in dietary fibre, and may be deficient in numerous micronutrients, particularly calcium, iron, zinc, niacin, folate, and vitamins A, C, E, and B6. This was seen during pregnancy and lactation. Blood analysis 6 months after birth revealed normal levels of vitamins A and E and an absence of anaemia. Body mass index (BMI) of the women was 23.9 } 5.3 kg/m2 (mean } SD) when measured 6 months after birth. Those above 25 years old had a higher BMI than did younger subjects (25.5 vs. 22.2; p= 0.028). Overall, 24% were overweight (BMI 25-30) while 9% were obese (BMI > 30). Most infants (93%) were breastfed for at least 6 months but exclusive breastfeeding was only done by 65% of mothers. One-third of breastfed infants also received formula. The use of formula while breastfeeding was twice as common among mothers aged above 25 years (46% vs. 23%). Early introduction of solid foods was very common in this group. Younger mothers introduced solids in the first month (51%) more often compared with older mothers who tended to introduce solids at 2-3 months (64%). The most common solid food given was maize meal porridge (by 78% of all mothers). Mean BMI was low at birth (< 15), but this reached a normal value by 6 months. A significant fraction of the infants was underweight or short (i.e., stunted), based on being below the 3rd percentile compared with NCHS standards. Underweight was seen in 15% at birth, falling to 10% at 6 months, whereas 15% had a short length at birth, rising to 35% at 6 months. Underweight tended to be more common in boys and short length in girls. This study found that pregnant and lactating women had diets low in energy and micronutrients as reflected by the high prevalence of underweight at birth. Most infants were exclusively breastfed, but the benefit of this was offset by the early introduction of solid foods having a low energy and nutrient density. By 6 months, the prevalence of stunting had more than doubled.
The patient relationship and therapeutic techniques of the South Sotho traditional healer
Authors: Pinkoane MG , Greeff M , Williams MJS
Published: November 2012

Until 1996 the practice of traditional healers was outlawed in South Africa and not afforded a legal position in the community of health care providers. In 1978 the World Health Organization (WHO) identified traditional healers as those people forming an essential core of primary health care workers for rural people in the Third World Countries. However in 1994 the new South African government identified traditional healers as forming an essential element of primary health care workers. It is estimated that 80% of the black population uses traditional medicine because it is deeply rooted in their culture, which is linked to their religion. The traditional healer shares with the patient a world view which is completely alien to biomedical personnel. Therapeutic techniques typically used in traditional healing conflict with the therapeutic techniques used in biomedicine. The patients’ perceptions of traditional healing, their needs and expectations, may be the driving force behind their continuous persistence to consult a traditional healer, even after these patients may have sought the therapeutic techniques of biomedical personnel. The operation of both systems in the same society creates a problem to both providers and recipients of health care. Confusion then arises and the consumer consequently chooses the services closer to her. The researcher aimed at investigating the characteristics of the relationship between the traditional healers and the patients, explored the therapeutic techniques that are used in the South Sotho traditional healing process, and investigated the views of both the traditional healers and the patients about the South -Sotho traditional healing process, to facilitate incorporation of the traditional healers in the National Health Care Delivery System. A qualitative research design was followed. Participants were identified by means of a non-probable, purposive voluntary sample. Data was collected by means of a video camera and semi-structured interviews with the six traditional healers and twelve patients, as well as by taking field notes after each session. Data analysis was achieved by means of using a checklist for the video recordings, and decoding was done for the interviews. A co-coder and the researcher analysed the data independently, after which three consensus discussions took place to finalise the analysed data. The researcher made conclusions, identified shortcomings, and made recommendations for application to nursing education, nursing research and nursing practice. The recommendations for nursing practice are reflected in the form of guidelines for the incorporation of the traditional healers in the National Health Care Delivery System.
Professional nurses’ attitudes towards providing termination of pregnancy services in a tertiary hospital in the North West province of South Africa
Authors: Mokgethi NE , Ehlers VJ , Van der Merwe MM
Published: November 2012

The Choice on Termination of Pregnancy Act (no 92 of 1996) was implemented during 1997. This study attempted to investigate professional nurses’ attitudes towards rendering termination of pregnancy (TOP) services at a tertiary hospital in the North West Province of South Africa. A quantitative descriptive research design was used to study professional nurses’ attitudes towards providing TOP services. The research results, obtained from questionnaires completed by professional nurses, indicated that most professional nurses’ attitudes included that women should be at least 16 years of age to access these services; women should not be able to access repeated TOPs; nurses would prefer to administer pills rather than to use vacuum aspirations; nurses should work in TOP services by choice only. TOP centers should have better equipment, more resources and more staff members. Nurses working in TOP services would appreciate receiving more support from their families, friends, managers and communities. Some professional nurses experienced guilt, depression, anxiety and religious conflicts as a result of providing TOP services. Despite the legalisation of TOPs, these services remained stigmatised. Professional nurses did not want to work in these services and also did not want to be associated with them.
Training nurses to save lives of malnourished children
Authors: Puoane T , Sanders D , Ashworth A , Ngumbela M
Published: November 2012

A qualitative study with a pre- and post-intervention component was undertaken among 66 professional nurses at 11 hospitals in the Eastern Cape to assess their perceptions and attitudes towards severely malnourished children and their mothers/ caregivers. Nurses’ attitudes were compared before and after attending a 5-day training course to improve the management of malnutrition along with implementing World Health Organization (WHO) guidelines. Severe malnutrition is a major cause of death among paediatric patients in many hospitals in South Africa. A qualitative study with a pre- and post-intervention component was undertaken among 66 professional nurses at 11 hospitals in the Eastern Cape to assess their perceptions and attitudes towards severely malnourished children and their mothers/caregivers. Nurses’ attitudes were compared before and after attending a 5-day training course to improve the management of severe malnutrition through implementing the World Health Organisation (WHO) guidelines. Focus group discussions were conducted in isiXhosa following a semi-structured discussion guide. Three themes emerged from these discussions, i.e. nurses placed blame on the mothers for not giving adequate care at home; nurses valued malnourished children less than those with other conditions; and nurses felt resentment towards caregivers. Underlying reasons for the negative attitudes towards severely malnourished children and their caregivers were misunderstandings of the causes of malnutrition, misinterpretation of clinical signs, especially poor appetite, and high mortality during treatment. However, the training course and successful application of the treatment guidelines altered these perceptions and helped nurses to have a better understanding of the causes of the presenting clinical signs. These nurses have begun advocating for raised awareness of the physiological differences that occur in malnutrition and the need to include the WHO Ten Steps of treatment in the nursing curricula and inservice training. A cadre of volunteer nurse-trainers has been formed in Eastern Cape. Experience in this province has shown that in-service training changes attitudes to malnutrition and treatment practices, as well as saving lives.
Medical practice in Graeco-Roman antiquity
Authors: Cilliers L , Retief FP
Published: November 2012

The roots of modem medicine can be traced back to the 5th century BC when Hippocratic rational medicine originated on the Greek islands of Cos and Cnidos. In this study we examine the way in which practitioners conducted their profession in Graeco-Roman times, as well as their training. Medical training was by way of apprenticeship with recognized doctors, but no qualifying examinations existed and the standard of practice thus varied enormously. Even in the Roman era the vast majority of medical doctors were Greek and in private practice as itinerant physicians. Civic doctors in the paid service of local communities appeared in Greek society from the 5th century BC onwards, but much later in Rome - probably as late as the 4th century AD. Rome’s unique contributions to medicine lay in public health measures (e.g. their aqueducts, public baths and sewages systems) and an excellent medical service for their armies and navy. Hospitals (valetudinaria) were established for military purposes and for slaves on large Roman estates from the 1st century BC, but civic hospitals for the general public originated as late as the 4th century AD. The Greek medical schools of Cos and Cnidos were eventually superseded by the school of Alexandria in Egypt and towards the end of the Roman Empire by that of Carthage in northern Africa. Its gradual demise in the Christian era lowered the curtain on original medical endeavours during antiquity.
Becoming a mother: teenage mothers’ experiences of first pregnancy
Authors: Maputle MS
Published: November 2012

The purpose of this study was firstly to explore and describe the experiences of teenage mothers of first pregnancy. Secondly, to develop guidelines of a support programme that is contextual and relevant to the needs of teenage mothers. The guidelines are aimed at assisting midwives in meeting the needs of teenage mothers. An exploratory, descriptive, contextual and qualitative design was used. The phenomenological approach was implemented to collect and analyze data from a purposively selected sample of fourteen (14) teenage mothers who were pregnant for the first time. The model of Guba and Lincoln (1985: 301-318) was implemented to ensure trustworthiness in this qualitative study. Five themes emerged from the analysis of the data. Guidelines and recommendations for support programme were developed.