Issue 1, 2000 Health SA Gesondheid - Volume 5,
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Assessment and evaluation of education, practice and research of health professionals are necessary in order to provide quality health services to our communities, country and internationally.
Beraming en evaluering van ondenig, praktyt en navorsing van gesondheidsberoepsgroepe is noodsaaklik om kwaliteit gesondheidsdienste te lewe raan ons gemeenskappe, land en internasionaal.
Evaluation of arguments in research reports : overview
Health SA Gesondheid 5, pp 3 –9 (2000)
Some authors on research methodology are of the opinion that research reports are based on the logic of reasoning and that such reports communicate with the reader by advancing logical, coherent arguments (Bvhme, 1975:206; Mouton, 1996:69). This view implies that researchers draw certain conclusions and that such conclusions be justified by means of reasoning (Doppelt, 1988:105; Giere, 1984:26; Harre, 1965:11; Lehrer & Wagner: 1981:3; Pitt, 1988:7). The structure of research reports, therefore, consists mainly of conclusions and the reasons for such conclusions (Booth, Colomb & Williams, 1995:97). From this, it becomes clear that justification by means of reasoning constitutes a standard procedure in research and research reports. Despite the fact that the logic of research is based on reasoning, that the justification of research findings by means of reasoning appears to be a standard procedure and that the structure of research reports consists of arguments, the evaluation or assessment of research, as described in most textbooks on research methodology (Barns & Grove, 1993:647; Creswell, 1994:193; LoBiondo-Wood & Habel; 1994:441/481), does not focus on the arguments used in research. The criteria for evaluation set out in these textbooks, however, have relevance to the manner in which the research process was executed and focus on the measures taken to ensure internal, external, theoretical, measurement and inferential validity. This means that the criteria for the evaluation of research reports are comprehensive and that these criteria must be very specific for each type of research for example, qualitative or quantitative research). Should the evaluation of research reports focus on arguments and logic, one universal set of standards against which to assess all types of human-science research reports could possibly be accepted. Such universal set of standards could possibly simplify and facilitate the evaluation of research reports in the human sciences by virtue of the fact that such standards could be used to assess all the critical aspects of research reports.
Sommige skrywers oor navorsingsmetodologie is van mening dat navorsingsverslae op die logika van argumentasie berus en dat somige verslae met die leser kommunikeer deur logiese, samehangende argumente aan te voer (Buhme, 1975:206; Mouton, 1996:69). Hierdie beskouing impliseer dat novorsers bepaalde gevolgtrekkings aflei en dan sodanige gevolgtrekkings by wyse van argumentasie gestaaf word (Doppelt, 1988:105; Giere, 1984:26; Harre, 1965:11; Lehrer & Wagner: 1981:3; Pitt, 1988:7). Die struktuur van navorsingsverslae bestaan dus hoojsaaklik uit gevolgtrekkings en redes vir sommige gevolgtrekkings (Booth, Colomb & Williams, 1995:97). Hieruit blyk dat stawing by wyse van argumentasie &apos;n standard prosedure in navorsirig en navorsingsverslae. Ten spyte daarvan dat die logika van navorsing op argumentasie berus, dat die stawing van navorsingsuitsprake by wyse van argumentasie &apos;n standaardprosedure blyk te wees en dat die struktuur van navorsingsverslae uit argumente bestaan, fokus die evaluering of beoordeling van navorsing, soos in die meeste navorsingsmetodologie-handboeke beskryf (Burns & Grove, 1993:647; Cresrvell, 1994:193; LoBiondo-Wood & Habel: 1994:441/481), nie op die argumente van navorsing nie. Die evalueringskriteria vir navorsingsverslae, wat in hierdie handboeke gestel is, hou egter verband met die wyse waarop die navorsingsproses uitgevoer is en fokus op die maatreëls wat getref is om interne, eksterne, teoretiese, metings- en inferensiële geldigheid te verseker.
Riglyne vir die kliniese begeleiding van studentverpleegkundiges deur die kliniese begeleidspan : navorsing
Engela Du Plessis and
Health SA Gesondheid 5, pp 10 –21 (2000)
In &apos;n vorige artikel getiteld : "Die belewenis van die kliniese begeleidingspan van hul betrokkenheid by die kliniese begeleiding van studentverpleegkundiges" is &apos;n oorsig van die probleemstelling, doelwitte, navorsingsontwerp en -metode, resultate en aanbevelings van hierdie navorsing verskaf. In die navorsing is bevind dat die betrokkenheid van die lede van die kliniese begeleidingspan wissel, met &apos;n versteuring in die vennootskapsverhouding, met die gevolg dat kliniese begeleiding nie tot sy volle reg kom nie. Die fokus van hierdie artikel is op die spesifieke riglyne wat vanuit die navorsingsbevindinge en literatuur geformuleer is. Die riglyne is geformuleer met betrekking tot die implementering van die kliniese begeleidingsproses, effektiewe interpersoonlike verhoudinge, indiensopleiding in die onderrigleerbeginsels en uitbreiding van die student se praktykvaardigheid. Die outeurs is van mening dat die implementering van die riglyne moontlik kan lei tot &apos;n vennootskapsverhoudng in die kliniese begeleidingspan, wat betrokkenheid by kliniese begeleiding kan bevorder en sodoende kan lei tot die fasilitering van die studentverpleegkundige se strewe om &apos;n selfstandige professionele praktisyn te word wat goeie gehalte verpleging lewer.
In a previous article titled : "Die belewenis van die kliniese begeleidingspan van hul betrokkenheid by die kliniese begeleiding van studentverpleegkundiges" an overview was given of the problem statement, objectives, research design, research methodology, results and recommendations of this research. It was found that the involvement of the members of the clinical accompaniment team varied, with a disturbance in the partnership relationship, so that clinical accompaniment did not come fully into its own. The focus of this article is on the specific guidelines formulated from the research findings and literature. These guidelines were formulated in respect of the implementation of the clinical accompaniment process, effective interpersonal relations, in-service training in teaching-learning principles and the expansion of the lecturer&apos;s skills in practice. The authors believe that the implementation of the guidelines could possibly lead to a partnership relationship in the clinical accompaniment team, which could enhance involvement in clinical accompaniment and could thus lead to the facilitation of the student nurse&apos;s quest to become an independent professional practitioner who renders high quality nursing.
Strike action by nurses/midwives in a nursing service
Elsie Mabange and
Health SA Gesondheid 5, pp 22 –37 (2000)
Strike action by nurses/midwives in a health service could have substantial implications for the patients, the health service management, the staff and the nursing profession at large. The nursing service manager has a legal obligation to prevent strike action by nurses/midwives by means of quality human resource management. The purpose of this research is to develop a strategy to prevent strike action by nurses/midwives in a nursing service. A qualitative research strategy was employed to explore and describe the reasons for strike action by nurses/midwives in a selected research hospital, the experience of those nursing/midwifery staff involved in the strike action, as well as a possible strategy to prevent future strike action. The data was collected by means of phenomenological interviews and a content analysis was conducted, followed by the development of a strategy to prevent strike action by nurses, based on the principles of quality human resource management within the legislative context in South Africa. The main reasons for strike action by nurses/midwives in the research hospital relate to dissatisfaction with remuneration, other conditions of employment and unfulfilled promises. Both positive and negative experiences by the nurses/midwives and nursing service managers were identified. A strategy to prevent strike action is described, based on the legal principles of human resource management and the results derived from this study. It is recommended that the strategy is implemented and evaluated, the quality of human resource management in South African nursing services be evaluated and further research on this topic be conducted.
Stakings deur verpleegkundiges/vroedvroue in &apos;n gesondheidsdiens het substansiële nagevolge vir die pasient, die gesondheidsdiensbestuur die personeel en die verplegingsprofessie. Die verpleegdiensbestuurder het &apos;n wetlike verpligting om stakings deur verpleegkundiges en vroedvroue, deur middel van gehalte-personeelbestuur te voorkom. Die doel met hierdie navorsing is die ontwikkeling van &apos;n strategie vir die voorkoming van stakings deur verpleegkundiges/vroedvroue in &apos;n verpleegdiens. &apos;n Kwalitatiewe navorsing-strategie is nagevolg om die oorsake van stakings deur verpleegkundiges en vroedvroue, hul ervarings tydens &apos;n stakingsaksie, asook moontlike strategieë vir die voorkoming van stakings, te verken en te beskryf. Die data is deur middel van fenomenologiese onderhoude ingesamel en &apos;n inhoudsontleding van die data is uitgevoer. Vervolgens is &apos;n strategie vir die voorkoming van stakings deur verpleegkundiges/vroedvroue in &apos;n verpleegdiens opgestel. Die hoofredes vir stakings deur verpleegkundiges en vroedvroue in die navorsingshospitaal, hou verband met hul ontevredenheid met vergoeding, ander basiese diensvoorwaardes en onvervulde beloftes. Beide positiewe en negatiewe ervaringe is deur die deelnemers aangedui. &apos;n Strategie vir die voorkoming van staking deur velpleegkundiges en vroedvroue in &apos;n verpleegdiens is opgestel, gebaseer op die fundamentele menseregte, wetlike beginsels van menslike hulpbronbestuur en die resultate van hierdie studie. Daar word aanbeveel dat die strategie geïmplementeer en beoordeel word, die gehalte van menslike hulpbronbestuur in Suid-Afrikaanse verpleegdienste ondersoek word, asook die uitvoering van verdere navorsing in hierdie verband.
Knowledge and practice of condom use in an urban adult community sample of the northern province, South Africa : research
Health SA Gesondheid 5, pp 38 –44 (2000)
There is a paucity of data concerning condom use, especially regarding knowledge about the correct use of condoms in South Africa. Therefore, the aim of tile study is to investigate knowledge and sexual practices with reference to correct use of condoms among an urban adult community in the Northern Province. A cross-sectional face-to-face interview questionnaire was conducted. Sampling was done by systematic sampling. The samples consisted of 98 participants, 40 female and 58 male, the mean age was 27.2 years (SD=5.4), with a range from 18 to 45 years. Results indicated about 90% levels of correct answers for the items of &apos;expiry date of condoms&apos;, &apos;condom be put on before contact with vagina&apos;, and &apos;re-using condoms&apos;. More than 15% were not aware that condoms offer protection against Sexually Transmitted Diseases or AIDS. The most common mistakes with respect to condom use were ignorance about the correct moment to put on a condom, inability to put on a condom properly, when to take off a condom, and the use of oil-based lubricants, in this order. A significant relationship was found between age, sex, and frequency of sexual encounters in the last three months and condom knowledge. Findings are discussed in view of condom promotion programmes.
Daar is &apos;n skaarste aan data oor die gebruik van kondome, meer spesifiek is daar &apos;n gebrek aan kennis oor die korrekte gebruik van kondome in Suid-Afrika. In die lig van bogenoemde is die doel van die navorsing om kennis en seksuele praktyte meer spesifiek ten opsigte van die korrekte gebruik van kondome deur stedelike volwassenes in die Noordelike Provinsie na te vors. Daar is gebruik gemaak van die dwarssnee metode. &apos;n Vraelys is gebruik in een-tot-een onderhoude. Steekproeftrekkings is sistematies gedoen. Die steekproef het besiaan uit 98 proefpersone waaruit 40 vroulik en 58 manlik was. Die gemiddelde ouderdom was 27.2 jaar (standaardafwyking = 5.4) met &apos;n verspreiding van 18 tot 45 jaar. Die resultate het 90% korrekte antwoorde getoon vir die items soos die volgende : vervaldatum van kondome, &apos;kondoom moet aangesit word voor kontak met die vagina&apos;, en &apos;hergebruik van kondoom&apos;. Meer as 15% van die proefpersone was nie bewus dat kondome beskerming gee teen seksueel oordraagbare siektes of Vigs nie. Die grootse gebrek aan kennis gaan oor die volgende : regte oomblik om die kondoom aan te sit, onvermoë om die kondoom korrek aan te sit, wanneer om die kondoom af te haal, en die gebruik van kondome met &apos;n oliebasis, spesifiek in die bogenoemde volgorde. &apos;n Betekenisvolle korrelasie is bevind ten opsigte van ouderdom, geslag, frikwensie van seksuele omgang in die laaste drie maande en kennis van kondome. Die bevindinge word bespreek in die lig van programme om kondome te bevorder.
Standard for clinical/nursing unit management in South Africa : research
Health SA Gesondheid 5, pp 45 –54 (2000)
The nursing unit manager is responsible and accountable for quality management of a clinical unit to facilitate quality nursing/midwifery care and education. The unit manager therefore requires practice guidelines on nursing unit management, reflecting excellence and presented in the form of standards and criteria in the form of a user-friendly instrument. The purpose of this research is to formulate standards for quality nursing unit management in South Africa and to develop an instrument for the evaluation of the quality of nursing unit management. A quantitative research design was followed. The standards were developed by the researcher, validated and tested by 391 appraisers in 137 different nursing units in Gauteng, over a period of four years. Construct/criterion validity and intra-class/rater reliability were statistically confirmed. The recommendations include further national validation of the standards and instrument, as well as the utilisation of these standards and instrument in the learning and education of students in nursing unit management, and as part of a quality improvement programme in a nursing service.
Die eenheidsbestuurder is verantwoordelik en aanspreeklik vir gehalte-bestuur van &apos;n kliniese eenheid om gehalte-verpleging en -onderrig in die eenheid te fasiliteer. Die eenheidsbestuurde benodig dus praktykriglyne oor enheidsbestuur wat voortreflikheid reflekteer en in die vorm van &apos;n gebruikersvriendelike instrument aangebied word. Die doel met hierdie navorsing is die formulering van standaarde vir gehalte-eenheidsbestuur in Suid-Afrika. &apos;n Kwantitatiewe navorsingsontwerp is gevolg. Die standaarde is deur die navorser ontwikkel en deur 391 evalueerders in 137 verskillende verplegingseenhede in Gauteng oor &apos;n tydperk van vier jaar gevalideer en getoets. Konstruk/kriteriumgeldigheid en intra-klas/ beoordeings-betroubaarheid is statisties bevestig. Die aanbevelings sluit die volgende in : &apos;n verdere nasionale validering van die standaarde en instrument, asook die benutting van die standaarde en instrument as &apos;n leer/onderrighulpmiddel vir studente in verplegings-eenheidsbestuur. Die instrument kan ook benut word in die gehalteverbeteringsprogram van &apos;n verpleegsdiens.
Community perceptions of biomedical health care in a rural area in the northern province South Africa
Health SA Gesondheid 5, pp 55 –63 (2000)
The success of strategies to revitalize primary health care services such as those advocated by the Bamako Initiative requires a response adapted to the expectations of the population, especially in terms of quality. The goal of this study was to investigate community perceptions of availability, accessibility, acceptability and affordability of biomedical health care services in a rural of the Northern Province in South Africa. A multi-stage cluster sampling method was used to ensure random inclusion of respondents. The sample consisted of 85 men (49%) and 89 women (51%), the age ranged from 18-88 years with a mean of 32.8 (SD = 13.9). Participants were interviewed face-to-face with a structured questionnaire on demographic and health facility data, health status, accessibility, affordability, availability and quality of health care, and a Health Beliefs Questionnaire. Results indicate a low acceptability of biomedical health care : 78% felt that the medical services are poor. There was a significant relationship between not being member of a medical scheme, poorer health status and availability of health care services. The poorer health status was also significantly related with acceptability of health services. Illness attributes, employment status, gender and health beliefs were not related to any of the health services parameters. It is suggested that primary health care policy takes cognisance of the existing differences like that of acceptability and affordability in attitudes toward biomedical health care.
Die sukses van strategie om primêre gesondheidsorgdienste soos die wat deur die Bamako Inisiatief voorgestaan word, hang af van &apos;n reaksie wat rekening hou met die verwagting van die gemeenskap, spesifiek ten opsigte van kwaliteit. Die doel van die navorsing was om die persepsies van die gemeenskap na te vors ten opsigte van beskikbaarheid, toegankliklieid, en bekostigbaarheid van biomediese gesondheidsorgdienste in &apos;n plattelandse gebied in die Noordelike Provinsie in Suid-Afrka. Daar is van bondelsteekproeftrekking in fases gebruik gemaak om ewekansigheid te verseker. Die steekproef het bestaan uit 85 mans (49 %) en 89 vroue (51 %) met &apos;n verspreiding van 8 tot 88 jaar met &apos;n gemiddelde ouderdom van 32.8 (standaardafwyking van 13.9). Daar is gebruik gemaak van &apos;n gestruktureerde vraelys waarvan die inligting deur een-tot-een onderhoude bekom is. Inligting oor die voolgende faktore is bekom : demoografiese en gesondheidsorginligting, gesondheidstatus, toeganklikheid, bekostigbaarheid, beskikhaarheid, kwaliteit van die gesondheidsorg, en &apos;n vraelys oor meanings oor gesondheid. Die resultate toon &apos;n lae aanvaarbaarheid van biomediese gesondheidsorg : 78% het aangetoon dot die mediese dienste swak is. Daar was &apos;n betekenisvolle verhouding tussen faktore soos : om nie lid van &apos;n mediese fonds te wees nie, swakker gesondheid en beskikbaarheid van gesondheidsdienste. Swakker gesondheid korreleer ook met die aanvaarhaarheid van gesondheidsdienste. Die volgende faktore toon geen verband met gesondheidsorg nie : siektes, geslag, gelowe oor gesondheid en werkloosheid al dan nie. Die gevolgtrekking waartoe diestudie kom dat die beleid ten opsigte van primêre gesondheidsorg kennis moet neem van die bestaande verskille soos die aanvaarbaarheid en bekostigbaarheid in die houdings ten opsigte van biomediese gesondheidsorgdienste.
Getting the love you want. A guide for couples, Harville Hendrix : book review
Dr Harville Hendrix is one of the world&apos;s leading marital therapists. He began his career as a therapist counseling both individuals and couples. He mentioned that he felt competent and effective with individuals, but saw the marital relationship as a complex system and he was not always capable of dealing with couples effectively. He ended up doing what most therapists did : problem-orientated contractual marriage counseling. This approach was not always useful or effective. His interest in relationship therapy started out of his own despair and disappointment after his divorce, and he had a compelling desire to make sense out of his dilemma.
Visit to the National University, San Diego, USA : 30 July 1999 : report
Health SA Gesondheid 5, pp 64 –66 (2000)
During the International Council of Nurses (ICN) Centennial Conference in London (27 June till 1 July 1999), Dr Mary Hazzard, Professor in the Department of Nursing at the National University, San Diego extended an invitation to Dr Ehlers to visit the National University in San Diego during her planned study tour of California.