Health SA Gesondheid - Volume 5, Issue 2, January 2000
Volume 5, Issue 2, January 2000
Authors: Marie Poggenpoel and Annatjie Botes
Source: Health SA Gesondheid 5 (2000)
We as health professionals are facing multiple challenges in our changing South African society. Some of these challenges and possible solutions are described by authors in different articles in this edition of Health SA Gesondheid.
Daar is verskeie uitdagings in ons veranderende Suid-Afrikaanse samelewing wat ons as gesondheidsberoepsgroepe in die gesig staar. Sommige van hierdie uitdagings en moontlike oplossings word beskryf deur skrywers in verskillende artikels in hierdie uitgawe van Health SA Gesondheid.
Facilitators&apos; perceptions of problem-based learning and community-based education : research
Authors: Annali E. Fichardt and Paula P. Du Rand
Source: Health SA Gesondheid 5, pp 3 –10 (2000)
In 1997 the School for Nursing, University of the Orange Free State, changed from the traditional lecture method of teaching to problem-based learning and from a curative to a community-based approach. Lecturers from a traditional environment became facilitators and new skills such as listening, dialogue, negotiation, counselling and problem-solving were expected from them. Besides the role change, the environment changed from a structural classroom to an unstructured community. The aim of this research was to determine the perceptions and experiences of facilitators in problem-based learning and community-based education. In this explorative and descriptive study a qualitative design was followed. The study population of ten first and second year facilitators were included in the research. Data was collected by means of two focus groups by an independent person. Focus groups were tape recorded and content analysis was done. Facilitators identified problems and needs, but positive aspects of the new teaching methodology were also emphasised. The research showed that a paradigm shift from the traditional teaching method to an innovative method leads to distinctive problems and makes more demands on facilitators. The re-education and continuous support of academic staff are essential for a problem-based learning and community-based education programme.
In 1997 het die Skool vir Verpleegkunde, Universiteit van die Oranje-Vrystaat, van &apos;n tradisionele lesingmetode na probleemgebaseerde leer en van &apos;n kuratiewe na &apos;n gemeenskapsgebaseerde benadering verander. Lektore vanuit die tradisionele benadering is as fasiliteerders aangewend en nuwe vaardighede soos luister, dialoog, onderhandeling, berading en probleemoplossing is van hulle vereis. Benewens die rolverandering, het die omgewing vanaf &apos;n gestruktureerde lesinglokaal na die ongestruktureerde gemeenskap verander. Die doel van hierdie navorsing was om die persepsies van fasiliteerders in probleemgebaseerde leer en gemeenskapsgebaseerde onderrig te bepaal. In hierdie verkennende en beskrywende studie is van &apos;n kwalitatiewe ontwerp gebruik gemaak. Die totale populasie van tien eerste- en tweedejaar fasiliteerders is by die studie ingesluit. Data is versamel deur middel van twee fokusgroeponderhoude deur &apos;n onafhanklike persoon. Die fokusgroeponderhoude is op band opgeneem en inhoudsanalise is gedoen. Die fasiliteerders het probleme en behoeftes geïdentifiseer, maar positiewe aspekte van die nuwe onderrig metodologie is ook beklemtoon. Die navorsing het aangetoon dat die paradigma verskuiwing vanaf die tradisionele onderrigmetode na &apos;n innoverende onderrigmetode tot bepaalde probleme lei en meer vereistes aan fasiliteerders stel. Die heropleiding en volgehoue ondersteuning van akademiese personeel is essensieël vir &apos;n probleemgebaseerde leer en gemeenskapsgebaseerde onderrigprogram.
Developmental level of Black first-year nursing students : research
Authors: Paula P. Du Rand and Marlene J. Viljoen
Source: Health SA Gesondheid 5, pp 11 –17 (2000)
Black first-year nursing students hailing from a historically disadvantaged educational situation may experience various problems at the university. It is therefore important to support these students. If, however, it should prove possible to determine the exact nature of the backlogs in their development, the lecturer would be able to offer meaningful support.
During this research the students&apos; development was determined with the aid of the Student Development Task and Lifestyle Questionnaire at the beginning of the year and again at the end of the year. The questionnaire is based on Chickering&apos;s (1972) seven vectors model and was designed by Winston, Miller and Price (1979). The survey method was used and the aim was to determine the developmental level of the students and to adjust inputs to them accordingly. Feedback sessions were held with students and they were provided with a guide showing them how to stimulate their own development.
The students achieved higher than average scores for the task of establishing and clarifying purpose. Their level of development with regard to cultural participation was average. Unfortunately their developmental level regarding mature interpersonal relationships, was below average. Students ought to benefit by the development of this subtask in order to enter into successful communication with patients / clients.
Once deficiencies in the student&apos;s developmental level have been pinpointed, meaningful support should be offered that would contribute to the student&apos;s development. Regular feedback to students is therefore important. The most important benefit of this questionnaire is that students acquire insight in their own level of development.
Swart eerstejaar verpleegkunde studente wat uit &apos;n histories benadeelde onderrigsituasie kom, kan verskeie probleme op universiteit ervaar. Dit is dus belangrik om hierdie studente te ondersteun. Indien daar egter vasgestel kan word waar die leemtes in hul ontwikkeling gesetel is, kan die dosent sinvolle ondersteuning bied.
In hierdie navorsing is die studente se ontwikkeling aan die begin van die jaar en aan die einde van die jaar met behulp van die Student Ontwikkelings en Lewensstyl Vraelys bepaal. Die vraelys is gebaseer op Chickering (1972) se sewe vektore model en ontwerp deur Winston, Miller en Price (1979). Die opname metode is gebruik en die doelstelling was om die ontwikkelingsvlak van die studente te bepaal en dan volgens insette aan studente te lewer. Terugvoersessies is aan studente verskaf en &apos;n gids is aan hulle oorhandig wat aksies aandui van hoe om ontwikkeling te stimuleer.
Studente het bo gemiddelde tellings in die vasstelling en verheldering van doelwitte taak behaal. Ten opsigte van kulturele deelname is die vlak van ontwikkeling gemiddeld. Ongelukkig is die vlak van ontwikkeling by volwasse interpersoonlike verhoudings ondergemiddeld. Studente behoort baart te vind by die ontwikkeling van hierdie subtaak sodat suksesvolle kommunikasie met pasiënte / kliënte aangeknoop kan word. Nadat leemtes in die student se ontwikkelingsvlak uitgewys is, behoort sinvolle ondersteuning gebied te word wat tot die student se ontwikkeling bydra. Gereelde terugvoer aan studente is dus belangrik. Die belangrikste voordeel van hierdie vraelys is dat studente insig verwerf in hul eie vlak van ontwikkeling.
Authors: Sonya Beukes, A.G.W. Nolte and E. Gross
Source: Health SA Gesondheid 5, pp 18 –28 (2000)
Gesondheidsvoorligting is &apos;n belangrike komponent van gesondheidsbevordering wat gemoeid is met die gesondheidstatus van individue en die gemeenskap. Gesondheidsvoorligting vind daagliks plaas en word deur die verpleegkundige en pasiënt heplan ten einde hom/haar in staat te stel om vrywillig ingeligte gesondheidskeuses uit te oefen op grond van sy/haar eie keuses. Indien die verpleegkundige die pasiënt voorsien met inligting en kennis ten opsigte van gesondheid- en siektegedrag en dit stem nie ooreen met sy/haar kulturele agtergrond nie, sal die verpleegkundige nie daarin slaag om die pasiënt te bemagtig om ingeligte keuses te maak nie, aangesien die inligting nie kultuurkongruent is nie. Ten einde kultuurkongruente gesondheidsvoorligting te gee moet daar spesifieke aandag aan die beraming van die pasiënt se gekommunikeerde behoeftes gegee word. Beide die verpleegkundige en die pasiënt betree die voorligtingsaksie vanuit hul eie kulturele konteks. Die verpleegkundige se sentrale fokus moet die kulturele agterergrond van die pasiënt wees. Die doel van hierdie studie is om te bepaal tot watter mate gesondheidsvoorligting wat deur finalejaar B. Cur studente op die Phelophepa trein gegee word, kultureel kongruent is. Gesondheidsvoorligtingaksies is geëvalueer ten opsigte van kultuurkongruensie en na aanleiding van die bevinding is riglyne vir kultuurkongruente gesondheidsvoorligting beskryf. Vir die doeleindes van hierdie studie is daar gebruik gemaak van &apos;n verkennende beskryywende en kontekstuele ontwerp. Gesondheidsvoorligting is verken deur video-opnames en geëvalueer aan die hand van naïewe sketse deur kundige evalueerders. Bevindinge is met die literatuur gekontroleer en aan die hand hiervan is riglyne vir kultuurkongruente gesondheidsvoorligting in gemeenskapsverpleegkunde beskryf. Die algemene bevindinge dui daarop dat gesondheidsvoorligting nie kultuurkongruent is nie. Die drie hoofkategorieë wat geïdentifiseer is, is &apos;n leemte in kulturele agtergrondsberaming, waardeverheldering en oneffektiewe kultuurkongruente kommunikasie. Die drie hoofkategorieë word ondersteun deur die drie beginsels vir kultuurkongruensie wat deur Chrisman beskryf is naamlik kennis, wedersydse respek en onderhandeling. Riglyne vir kultuurkongruente gesondheidsvoorligting is aan die hand van &apos;n modelgeval beskryf.
Health Education is an important component of health promotion, which is concerned, with the health status of both the individual and the community. Health education takes place daily and is planned by the nurse and the patient in order to enable the latter to willingly make independent informed decisions about health and to practice those of his/her own choice. The nurse provides the patient with information and knowledge concerning health and illness management and if this information is not compatible with his/her cultural background the nurse will not succeed in enabling the patient to make informed choices, as the information is not congruent with the prevailing cultural milieu. In order to provide culture-congruent health information, specific attention must be given to the planning of the patient&apos;s communicated needs. Both the nurse and the patient approach the education process from their own cultural context. The nurse&apos;s central focus must be the cultural context of the patient. The aim of this study is to determine to what extent health education given by final year B. Cur students on the Phelophepa train is culture-congruent. Health education sessions were evaluated. Health education is evaluated for culture congruence and as a result of the findings, guidelines for culture-congruent health education are described. For the purposes of this study, use was made of an exploratory, descriptive and contextual design. Health education was explored on video tapes and evaluated by means of naive sketches by expert evaluators. These results were compared with the literature and as a result of this, guidelines for culture-congruent health education in community nursing were developed. The general findings indicate that health education is not culture-congruent. The three main categories that were identified are : a lack in cultural background assessment, value clarification and ineffective culture-congruent communication. These three main categories are supported by the three principles for culture-congruent care described by Chrisman, namely knowledge, mutual respect and negotiation. Guidelines for culture-congruent health verification have been illustrated by means of a model case.
Nurses as advocates between western and traditional health practices in RSA : overview
Source: Health SA Gesondheid 5, pp 29 –36 (2000)
The RSA, like most African countries, have two health care systems. The most visible one is the Westernised hospital and/or clinic based treatment of diseases. This system was introduced by the colonisers and perpetuated by the current formal education programmes of most health care professionals in the RSA. Traditional African medicine has existed since time immemorial and continues to treat vast numbers of people. Both these health care systems will be briefly discussed. Then the role of nurses in the RSA&apos;s health care systems will be examined. Most professional nurses have knowledgeable about both Western and Traditional health care systems, and can thus serve as advocates between the Western health care system (frequently provided by foreigners), and the traditional healers) as well as to the patients/clients, together with their families. Although all health care providers need to assume responsibility for providing comprehensive health care, the professional nurses in the RSA seem to occupy the pivotal position in the health care system, to be able to co-ordinate all available health care services to the benefit of the clients and the country. However, only nurses who are knowledgeable about these prospects and who are sufficiently empowered to make and implement meaningful decisions, will be able to succeed in providing the best possible accessible and acceptable health care services to the largest number of clients - to the ultimate benefit of the entire county.
Die RSA, soos die meeste Afrika lande, het twee gesondheidstelsels. Die Westerse hospitaal en/of kliniekgebaseerde behandeling van siektes is die mees opsigtelike een, wat deur die kolonialiste daargestel is. Tradisionele Afrika medisyne bestaan sedert die vroegste tye denkbaar en behandel steeds groot getalle persone. Albei die gesondheidsorgstelsels sal kortliks bespreek word. Dan sal die rol van die verpleegkundiges in die RSA se gesondheidsorgstelsel(s) aangespreek word. Aangesien die meeste verpleegkundiges oor kennis beskik van beide die Westerse (wat dikwels deur vreemdes verskaf word), sowel as die Tradisionele gesondheidsorgstelsels, kan hulle optree as advokate tussen die Westerse en die Tradisionele gesondheidsorgstelsels, asook tussen die pasiënte/kliënte en hulle families. Alhoewel alle gesondheidsorgverskaffers verantwoordelikheid moet aanvaar om &apos;n omvattende gesondheidsdiens daar te stel, blyk dit dat die professionele verpleegkundiges in die RSA die sleutelposisie beklee ten einde alle beskikbare gesondheidsdienste te koördineer tot voordeel van die kliënte en die land. Dit word egter beklemtoon dat slegs verpleegkundiges wat oor die kennis beskik, en wat voldoende bemagtig is om betekenisvolle besluite te neem asook om dit uit te voer, suksesvol kan wees om die beste moontlike toeganklike en aanvaarbare gesondheidsorgdienste aan die meeste kliënte te verskaf - tot uiteindelike voordeel van die land.
Factors affecting condom use among junior secondary school pupils in South Africa : research
Source: Health SA Gesondheid 5, pp 37 –44 (2000)
The aim of the study is to investigate factors affecting condom use among junior Secondary School pupils in South Africa. The sample included 446 Grade 10 Secondary School pupils, 200 (44.896) males and 246 (55.2%) females within the age range of I0 to 30 years (M age 16.6 years, SD = 2.5) from three rural schools in one region of the Northern Province in South Africa. Main outcome measures included sexual activity and condom use (12 items), source of &apos;condom&apos; information (12 items), knowledge of correct condom use (10 items), a 16-item AIDS Health Belief Scale and a 28-item Condom Use Self-efficacy Scale. Results indicated that more than half of the sexually active males (56%) and almost one third (18.6%) of the females reported, have never used condoms. About 80% levels of correct answers were found for the items of "protection against AIDS" and "expiry date of condoms". About 30% of the females were not aware that condoms offer protection against AIDS and sexually transmitted diseases. The AIDS Health Belief Scale was related to past and current condom use as well as to self-efficacy in condom use but not with condom use intentions. Self-efficacy of condom use was not related to past, current and future condom use. Subjective norms about condoms were found to predict condom use intention and AIDS susceptibility predicted lifetime condom use and condom self-efficacy. Findings have relevant implications and are discussed in the context of developing an educational or intervention programme.
Authors: Lizeth Roets and Diana Du Plessis
Source: Health SA Gesondheid 5, pp 55 –63 (2000)