Health SA Gesondheid - Volume 10, Issue 1, March 2005
Volume 10, Issue 1, March 2005
Author T. Kluyts
Source: Health SA Gesondheid 10 (2005)
Author Marie Poggenpoel
The relationship experiences of professional nurses with nurse managers : research
Authors: Sindiwe Valencia James, Wilhelmina J. Kotze and Dalena Van Rooyen
Source: Health SA Gesondheid 10, pp 4 –14 (2005)
This qualitative study was undertaken to explore and describe the experiences of professional nurses in their relationships with nurse managers. Concerns about declining nursing care standards have been expressed in radio newsbulletins, television interviews and newspapers. This decline is thought to come from the pressures brought about by rapid changes in political, socio-economic and technological spheres. It therefore became important to the researcher to acquire knowledge about the manner in which nurses support each other during these times of change. Data were collected by means of individual interviews. Interviews were audiotaped and field notes were taken to provide the researcher with complementary information. Data analysis was done using the data analysis method described by Tesch (in Creswell, 1994:155). Results revealed that professional nurses experience a breakdown in their relationships with nurse managers and that the professional nurses&apos; expectations relating to the work environment are not being met. The experiences manifested in feelings of anger, pain and disillusionment and led to demotivation of the professional nurses. Guidelines were proposed to address the aforementioned experiences.
Hierdie kwalitatiewe studie is onderneem om die belewenisse van professionele verpleegkundiges ten opsigte van hulle verhoudings met verpleegbestuurders te verken en te beskryf. Kommer oor verpleegstandaarde wat verswak is in radio -en televisienuusberigte asook koerantberigte uitgespreek. Die agteruitgang van standaarde kan toegeskryf word aan die druk wat deur die veranderende politieke, sosio-ekonomiese en tegnologiese sfere meegebring word. Dit het daarom vir die navorser noodsaaklik geword om kennis in te win oor die wyse waarop verpleegkundiges mekaar in hierdie tye van verandering ondersteun. Data is deur middel van individuele onderhoude ingesamel. Onderhoude is op band opgeneem en veldnotas is geneem om sodoende aanvullende inligting aan die navorser te verskaf. Data analise het plaasgevind deur van Tesch se metode (in Creswell, 1994:155) gebruik te maak. Die resultate van die studie het aan die lig gebring dat professionele verpleegkundiges beleef dat hulle verhoudings met verpleegbestuurders nie na wense is nie en dat daar nie aan hulle verwagtinge ten opsigte van hulle werksomgewing voldoen word nie. Die belewenisse het gemanifesteer in gevoelens van aggressie, pyn en ontnugtering en het tot die demotivering van professionele verpleegkundiges gelei. Riglyne is voorgestel om genoemde belewenisse aan te spreek.
Experiences of registered midwives assisting with termination of pregnancies at a tertiary level hospital : research
Authors: Pat M. Mayers, Briony Parkes, Beryl Green and Judy Turner
Source: Health SA Gesondheid 10, pp 15 –25 (2005)
The implementation of the Choice on Termination of Pregnancy Act, Act No. 92 of 1996 brought many challenges for the registered nurses/midwife assisting in the termination of pregnancy. In the gynaecological wards at a tertiary level hospital, registered nurses/midwives assist with the termination of pregnancies for women in the second trimester (13-20 weeks), using an oral medication, Misoprostol. A qualitative phenomenological study of the experiences of registered midwives who assist in termination of pregnancies was conducted. Registered nurses/midwives, each with at least six months experience in the assistance of terminations of pregnancies participated in this study. Indepth interviews were conducted with the participants. The audiotaped interviews were transcribed and analysed for themes and patterns within the transcriptions. Five theme categories emerged: obstacles experienced by the registered midwives, feelings evoked by the experiences, conflicts encountered, the coping mechanisms utilised and the need for support systems. Recommendations include the provision of support structures for registered midwives working in this setting.
Die implementering van die Wet op die Beëindiging van Swangerskap, Wet Nr. 92 van 1996, het baie uitdagings meegebring vir die geregistreerde verpleegkundige wat met die beëindiging van swangerskap behulpsaam is. In die ginekologiese sale in &apos;n tersiêre hospitaal, is geregistreerde vroedvroue behulpsaam met die beëindiging van swangerskappe vir vroue in die tweede trimester (13-20 weke), deur van &apos;n mondelikse medikasie Misoprostol gebruik te maak.&apos;n Kwalitatiewe fenomenologiese navorsingstudie oor die belewenisse van geregistreerde vroedvroue wat behulpsaam is met die beeïndiging van swangerskap is onderneem . Geregistreerde vroedvroue, wat elk ten minste ses maande ondervinding met die beeïndiging van swangerskappe gehad het, het aan die studie deelgeneem. Indiepte onderhoude is met die deelnemers gevoer. Die analise van die onderhoude wat op band geneem is, is getranskribeer en geanaliseer. Patrone en temas is uit die transkripsies gelig. Vyf temas het uit die data tevoorskyn getree: struikelblokke wat deur die vroedvroue beleef is; gevoelens wat deur die ondervindinge opgeroep is; konflikte wat beleef is, die hanteringsmeganismes wat gebruik is en die noodsaaklikheid van ondersteuningstrukture. Aanbevelings sluit in die voorsiening van ondersteuningstrukture vir vroedvroue wat in hierdie kliniese omgewing werksaam is.
Factors influencing the utilisation of prevention of mother-to-child-transmission (PMTCT) services by pregnant women in the Eastern Cape, South Africa : research
Authors: Karl Peltzer, Donald Skinner, Sakhumzi Mfecane, Olive Shisana, Ayanda Nqeketo and Thabang Mosala
Source: Health SA Gesondheid 10, pp 26 –40 (2005)
Die doel van die studie was om faktore te identifiseer wat die benutting van die Voorkoming van Moeder-tot-Kind Oordrag (VMTKO) beïnvloed in &apos;n omgewing in Suid-Afrika wat arm is aan hulpbronne. &apos;n Steekproef van 186 swanger vroue (29.6% MIV-positief, en 70.4% negatief) in vier klinieke in &apos;n plattelandse distrik in die Oos-Kaap het as deel van die VMTKO-program aan onderhoude deelgeneem nadat hulle die resultate van hulle MIV-toetse ontvang het. Wat die infrastruktuur betref het die meeste vroue nie vervoer gehad na &apos;n gesondheidsfasiliteit nie en ook geen kommunikasie daarmee gehad nie. Meer as 90% van die vroue was tevrede met die MIV-berading wat hulle ontvang het. Meeste vroue (54%) was van mening dat hulle gedurende swangerskap hoofsaaklik ondersteuning van hulle moeders en/of eggenoot/gesel (50%) ontvang het. Meeste swanger vroue (92%) het verkies om in die hospitaal geboorte te skenk terwyl 8% verkies het om by die huis die lewe te skenk, meestal met die hulp van &apos;n tradisionele helper by geboortes. Twee-derdes van die MIV-positiewe vroue het gemeld dat hulle hulle babas slegs met formulemelk sou voed. Die houding van die gemeenskap teenoor persone wat met MIV / VIGS leef is meestal as negatief waargeneem. Faktore wat die benutting van VMTKO beïnvloed (dit is die aanvaarding van antiretrovirale terapie aan HIV-positiewe vroue, &apos;n fasiliteitsgebaseerde bevalling, en die verkleefdheid aan "neem huistoe" ART wat vir die moeder en pasgeborene geïdentifiseer is), sluit in: (1) MIV-berading deur gesondheidsorgpersoneel, (2) fisiese toegang tot &apos;n gesondheidsfasiliteit, (3) gesin- en gemeenskapsondersteuning, (4) stigma, (5) verlossingsvoorkeur, en (6) voedingsvoorkeure van die suigeling.
The aim of the study was to identify factors influencing the utilisation of Prevention of Mother-to-Child Transmission (PMTCT) in a resource poor setting in South Africa. A sample of 186 pregnant women (29.6% HIV positive and 70.4% HIV negative) in four clinics in a rural district in the Eastern Cape were interviewed as part of the PMTCT programme after they had received their HIV test results. Regarding infrastructure, most women lacked transport to and communication with a health facility. More than 90% felt that they had received adequate information on most of the components of the PMTCT programme. About 90% of the women were satisfied with the HIV counselling they had received. Most women (54%) felt they would receive support during their pregnancy mainly from their mothers, and/or husband/partner (50%). Most pregnant women (92%) preferred to give birth in hospital, while 8% prefer to deliver at home, mostly with the assistance of a traditional birth attendant (TBA). Two-thirds of the HIV positive women stated they would feed their babies with formula milk only. Community attitudes towards people living with HIV / AIDS were mostly perceived as negative. Factors influencing the utilisation of PMTCT (that is the acceptance of antiretroviral therapy to HIV positive women, facility-based delivery, and adherence to "take-home" ART identified for mother and newborn), included: (1) HIV counselling by health care staff, (2) physical access to a health facility, (3) family and community support, (4) stigma, (5) delivery preference, and (6) infant feeding preferences.
Meaning-making of a group of South Africans in their experience of living with HIV : a phenomenological study : research
Authors: H.G. Pretorius, N. Goldstein and A.D. Stuart
Source: Health SA Gesondheid 10, pp 41 –51 (2005)
With the primary focus of disease specific studies on the medical and biological transmission and progression of HIV / AIDS, the lived experience and meaning-making of individuals who live with this disease, is a literary scarcity. Similarly, the idiosyncratic meaning-making of middle class citizens diagnosed with HIV / AIDS appears largely unexplored. Addressing these concerns, the aim of this article is to explore the lived experience and meaningmaking of four middle-class South Africans diagnosed with HIV. Open-ended questions were formulated and used to elicit the rich idiosyncratic meaning of the complex experiences of the participants. The research indicates that HIV / AIDS is experienced as an intrusive violation of one&apos;s way of being-in-the-world in relation to one&apos;s self and others and involves a complex process consisting of overwhelming and intense feelings. The research also indicates that, in the experience of living with HIV / AIDS, a space is created for the rediscovery of spirituality, religion and compassion. Consequently, an appreciation for life, a need for belongingness, community, and also a transcendence of the mundane by positive embrace of one&apos;s time on earth is facilitated in the experience of living with this disease. This positive shift in what it means to live with HIV / AIDS in South Africa might have important implications for the helping professions and from which many therapeutic benefits might derive.
Met die primêre fokus van siektespesifieke studies op die mediese en ook biologiese oordrag en progressie van MIV / VIGS, is daar &apos;n literêre skaarste oor die geleefde ondervinding en betekenisgewing van individue wat met hierdie siekte leef. Insgelyks, die idiosinkratiese betekenisgewing van middelklas individue wat met MIV / VIGS gediagnoseer is blyk asof dit nog nie ondersoek is nie. In &apos;n poging om hierdie leemte aan te spreek, verken die studie die geleefde ervaring en betekenisgewing van vier middelklas Suid-Afrikaners wat met MIV+ gediagnoseer is. Oopeinde vrae is geformuleer en gebruik om die ryk idiosinkratiese betekenisgewing van die komplekse ervarings van die deelnemers aan die lig te bring. Die navorsing dui aan dat MIV / VIGS &apos;n indringende skending van persone se in-die-wêreld-wees in verhouding met hulleself en ander ervaar word, en dat dit &apos;n komplekse proses van oorweldigende en intense emosie behels. Die navorsing dui verder daarop dat, in die ervaring van leef met MIV / VIGS, daar &apos;n ruimte geskep word vir die herontdekking van spiritualiteit, religie en medelye. Op hierdie wyse word &apos;n waardering vir die lewe, &apos;n behoefte aan &apos;n gevoel van behoort-aan, en ook &apos;n uitstyging bo die alledaagse deur die positiewe aanvaarding van &apos;n persoon se tyd op hierdie aarde gefasiliteer deur die ervaring van leef.
Nurses perceptions of difficult patients : research
Author Janetta H. Roos
Source: Health SA Gesondheid 10, pp 52 –61 (2005)
The purpose of this article was to explain and describe how professional nurses in the health services experience difficult patients. A qualitative, descriptive research design was adopted. Data were collected by means of narratives, written by professional nurses who met the sampling criteria. The data analysis was done according to the protocol suggested by Tesch. Four major categories were identified. The first major category, namely patient factors, brought the following sub-categories to the fore: physical aspects and appearance; psychological factors; attitude factors; social factors and knowledge of the patient. The second major category, namely nursing factors, includes the following sub-categories: skills and experience, training and attitude. The third category, namely the situational factor, exists of the sub-category management, while the fourth category exists of one sub-category, namely that difficult patients do not exist. A literature control was done to verify the results. Conclusions and recommendations were made.
Die doel van hierdie artikel was om te verduidelik en te beskryf hoe professionele verpleegkundiges in gesondheidsdienste moeilike pasiënte ervaar. &apos;n Kwalitatiewe, beskrywende navorsingsontwerp is gebruik. Data is ingesamel deur die gebruikmaking van narratiewe deur professionele verpleegkundiges wat aan die steekproefkriteria voldoen het. Die analise van die data het aan die hand van Tesch se voorgestelde protokol plaasgevind. Vier hoofkategorieë is geïdentifiseer. Die eerste hoofkategorie, naamlik pasiënt-faktore, bring die volgende subkategorieë na vore: fisiese aspekte en voorkoms; psigologiese faktore; houdingsfaktore; sosiale faktore en kennis van die pasiënt. Die tweede hoofkategorie, naamlik verpleegkundige faktore, sluit die volgende subkategorieë in: vaardighede en ondervinding; opleiding en houding. Die derde hoofkategorie, naamlik situasionele faktore, bestaan uit die subkategorie bestuur, terwyl die vierde hoofkategorie een enkele subkategorie behels, naamlik dat daar nie moeilike pasiënte bestaan nie. &apos;n Literatuurkontrole is gedoen om die navorsingsresultate te verifeer. Gevolgtrekkings en aanbevelings is gemaak.
From learner to therapist : a story of transcendence and transformation : research
Authors: Hester G. Pretorius, Anne-Marie Lydall, Rahima Mohamed-Patel, Antoinette Rikhotso and Grant W. Evans
Source: Health SA Gesondheid 10, pp 62 –71 (2005)
Therapeutic interventions are guided as much by a therapist&apos;s philosophy as they are by an understanding of psychological and therapeutic principles. An individual gravitates toward specific philosophical assumptions largely because they resonate with personal, subjective themes in this person&apos;s life. This paper explores according to the phenonemenological approach of the training of a group of four trainee Gestalt therapists from four different traditions in the context of a culturally and racially diverse South Africa in the opening years of the third millennium.The intention of the authors was to focus specifically on their lived experience with a view to observing how the different historically situated contexts have influenced the incremental shift in the acquisition of the skills of the Gestalt therapist. It is the authors&apos; contention that Gestalt therapeutic training needs to transcend the Western and Eurocentric traditions in which it is historically sited in order to become relevant to the multi-ethnic and multi-cultural realities of the global village characterised as it is by diversity. As such the benefits of Gestalt therapy, as experienced by the group, have implications that are broadly applicable.
Terapeutiese intervensies word net soveel gerig deur &apos;n terapeut se lewensfilosofie, as deur &apos;n begrip van sielkundige en terapeutiese beginsels. &apos;n Individu is geneig om na sekere filosofiese veronderstellings aan te hang, hoofsaaklik omdat hulle aanklank vind by persoonlike, subjektiewe temas in die persoon se lewe. Hierdie artikel ondersoek volgens die fenomenologiese benadering die opleiding van &apos;n groep van vier leerling Gestaltterapeute uit vier verskillende tradisies binne die konteks van &apos;n kultureel en rasse-diverse Suid-Afrika in die beginjare van die derde millenium. Die skrywers het beoog om spesifiek op hulle beleefde ervaring te fokus. Die doel daarvan was om waar te neem hoe die verskeie histories gesitueerde kontekste, die toenemende verskuiwing in die verwerving van die vaardighede van die Gestalt-terapeut beinvloed het. Die skrywers is van mening dat Gestalt terapeutiese opleiding die Westerse en Eurosentriese tradisies, waarin dit histories gesitueerd is, behoort te transendeer, om sodoende toepaslik te kan wees in die multi-etniese en multi kulturele werklikheid van die "global village", soos wat dit deur diversiteit gekenmerk word. As sulks, het die voordele van Gestalt-terapie, soos wat dit deur die groep ondervind is, implikasies wat op &apos;n wye spectrum van toepassing is.
Primary care as a means of decreasing health care cost, Health SA Gesondheid, 9(4) Dec 2004 pp.76-87 : erratum
Authors: Martie M. (nee Seymore) Van Deventer, Susan P. Hattingh and Marthie C. Bezuidenhout