Commitment and the Emigration Intentions of South African Professional Nurses

The emigration of skilled nurses from South Africa exacerbates the crisis in the provision of public health services. A descriptive; quantitative design was applied to investigate the relationship between intention to emigrate and employee commitment. Over 400 registered nurses (N = 419); working within public sector tertiary hospitals in the Western Cape; responded to a cross-sectional survey questionnaire. Three foci of employee commitment (organisational; professional and national) were examined but only national commitment significantly helped predict intention to emigrate from South Africa in the regression model (beta = -0.0525; p 0.0001). The implications of the results obtained in this study are discussed

Value-Sensitive Clinical Accompaniment in Community Nursing Science

Clinical community health facilities where undergraduate students are placed for their practical work in community nursing science are dynamic and have undergone major transformation over the past few years. In the clinical field; community nurses and undergraduate students are representative of the different races and language and ethnic groups in the South African population; with each group espousing different value systems. Both parties - students and community nurses - report that; due to these differences; value conflicts are experienced during clinical accompaniment and that this has negative effects on clinical learning in community nursing science. The goal of this study was to explore and describe the experiences of students with regard to value-sensitive clinical accompaniment in the community nursing environment. An exploratory; descriptive and contextual design was used. Interactions between community nurses and students during clinical accompaniment were explored for value sensitivity by means of video recordings; participant observation and focus group interviews. Data were collected by means of video recordings; participant observation and focus group interviews. The data were analysed and coded by the researcher and the external coder; using an inductive descriptive method to identify important segments of the regularity of behaviour. The focus group interviews were transcribed; analysed and coded by the researcher and the external coder; using Tesch's steps of analysis (Creswell 1994:155-156). Lincoln and Guba's criteria (1985:290) for trustworthiness were applied to the study. The general findings indicate that clinical accompaniment in community nursing is not value sensitive and; as a result; guidelines for value-sensitive clinical accompaniment need to be developed for undergraduate students in the community nursing environment. The following values (values for which guidelines need to be developed) were identified: respect during clinical accompaniment; value-sensitive communication and sensitivity to the quality of clinical accompaniment. People's thoughts often focus on the suicide victim immediately after a completed suicide. Yet; the real victims of such an event are those individuals who are left behind to cope with the aftermath of the suicide. This phenomenological psychological study explored the lived experiences of lateadolescent suicide survivors; particularly those negative experiences that seemed to worsen in the weeks and months after a significant other's completed suicide. The research participants were five female late-adolescents (aged 17-22 years) who were recruited by means of purposive sampling at a South African tertiary institution and at youth camps. Data collection consisted of collagefacilitated; face-to-face phenomenological interviews. In addition; some participants provided documentary material in the form of personal diaries; letters and poems. The data analysis was conducted according to Giorgi's phenomenological method. The following salient experiences emerged during the data analysis: guilt; self-blame; blaming others or God; anger; loss or restriction of 'self'; depression; suboptimal behavioural coping patterns; changes in relationship dynamics; and suicidality. The results of this study can be used by mental health professionals and caregivers to support adolescent suicide survivors effectively; in the midst of their mourning

Nursing within the primary health care context

The nurse's function in Primary Health Care requires a high level of communication and interpersonal relationship skills and reorientation focus on the whole community served rather than just the sick individual

Report

The purpose of the workshop was to give the registered community health nurses an opportunity to strengthen their skills at community assesment and diagnosis

A comparative and descriptive study of the role of the community health nurse in the provision of maternal and child health care before and after the introduction of the supermarket approach in the health services in Zimbabwe

The supermarket approach of providing Maternal and Child Health Care (MCH) was introduced in 1983/84. This strategy meant that the clients could get comprehensive promotive; preventive; curative and rehabilitative health care from one clinic at first contact within the health care system at any level. This study sought to determine how the introduction of the supermarket approach affected the apportionment of time between clinic work and community home visits by the Community Health Nurses (CHNs). The findings were that currently CHNs in Harare and Bulawayo City Health Departments are practicing clinic focused community care; due to the constraints put on the CHNs to provide skills essential for effective supermarket approach and the shortage of staff with these skills. Further findings are that for the supermarket approach and community visiting to co-exist; there is need to increase the current staffing levels and to equip all the health personnel with the pre-requisite skills and knowledge. The concept of routine visiting was not well understood by some CHNs in the sample. The study concluded that the type of care being rendered by the CHNs in the studied areas negates the concept of holistic care and disregards those at risk who have not identified their health needs or are apathetic about seeking health care. The lack of appropriate combination of skills by significant number of health staff in strategic areas like the rural areas has an adverse effect on the provision of high quality of community nursing care. Finally; the study suggested the readjustments; re-orientation and re-organisation that is necessary to ensure the co-existence of both the supermarket approach and community fucus in the provision of health care to the communities

A study to provide baseline data for a home based care programme to recommend strategies which meet the needs of people with HIV (PWHIV) and their care givers

The study was conducted in Umzingwane District; in the urban; rural; farming; and mining communities from January to May 1993. HIV/AIDS and the caring of people with HIV (PWHIV) is of great concern in the country. However not much is known about home based care; in particular the needs of PWHIV and their care givers. Home visits to PWHIV in Umzingwane District were initiated when it became clear that numbers of PWHIV were rising and that in future their care would prove to be difficult in health institutions. There were no well defined objectives nor targets for these home visits. It was in this context that it was found necessary to redefine the objectives to focus on baseline information; which will help to formulate strategies for home based care system that will meet the needs of PWHIV and their care givers. The study is explanatory qualitative in nature. The variables studied were; needs of PWHIV; knowledge needs and skills to cope in home based care. Study population comprised PWHIV who are in the district AIDS register and have agreed to home visits. Care givers were identified by the PWHIV as their care giver. Health workers were those who had a basic input on home based care. Members of the community were chosen for focus group discussion and consisted of traditional healers; traditional midwives; church women and Ward Development Committee. Structured interviews were held with PWHIV care givers. Health Workers were sent self administered questionnaires. Focus group discussions were held with community members