Perceptions of clients regarding family planning service delivery in a clinic of the Greater Johannesburg Metropolitan Council.

Unwanted pregnancies with their negative impact on both women and children occur on an ongoing basis in Gauteng, South Africa. One way to prevent unwanted pregnancies is to use areliable contraceptive method available free of charge from primary health care clinics providing family planning services throughout Gauteng Province. A literature review was completed on women and access to family planning services and an interview schedule (questionnaire) was developed. The purpose of this study was to describe guidelines to meet the expectations of clients accessing family planning services provided by a clinic in Region F, Area 28 of the Greater Johannesburg metropolitan council. This quantitative, exploratory, descriptive and comparative study measured the gaps between the expectations of participants on service delivery and the extent to which these expectations were met. A convenience sample was conducted and consisted of 50 women of reproductive age (ages 15 to 49) attending the family planning clinic. Pre-testing of the instrument was conducted. Structured interviews with a interview schedule were conducted before and after women attended a family planning service. Inferential statistics indicated that there was a significant gap between the client expectations of family planning service delivery and the extent to which these expectations were met. Of the sixty-four items where women indicated the extent of their expectations the findings on only three items were not statistically significant. These gaps were addressed by proposing managerial guidelines to be implemented by the nurse manager in charge of the facility, on which this article will focus. Validity and reliability principles were ensured in the study. Ethical principles were adhered to during the research process.

The Health Care Needs of the Physically Disabled Patient in a Home-Based Care Environment: Implications for the Training of Ancillary Health Care Workers

According to existing literature; ancillary health care workers (AHCWs) often do not meet the health care needs of patients with physical disabilities (physically disabled patients) in a home-based environment; because of inadequate training programmes. The purpose of this research study was to explore the health care needs of physically disabled patients in long-term; home-based care in the northern suburbs of Johannesburg and; based on results; to offer recommendations for the training of AHCWs. Qualitative; exploratory; descriptive and contextual means were employed in data collection and analysis. The population consisted of eight physically disabled participants who employed an AHCW to assist them with their long-term home care. Purposive sampling was used with subsequent snowballing to identify further participants for the study. Individual interviews were conducted; where participants had to answer the questions (1)'What are your health care needs?' and (2) 'How should these be met?' Data saturation was ensured; after which Tesch's method of data analysis was followed. Three categories of health care needs were identified (1) physical health care needs; (2) interpersonal relationship needs and (3) social needs; and 12 themes were derived from these categories. These categories of health care needs should be addressed in the training of AHCWs. From the themes; recommendations were described for the training of AHCWs on the health care needs of the home-based physically disabled patients. The AHCW should assist in the adaptation of the environment to the patient's individual needs; and should use knowledge and critical thinking skills to ensure a patient-centred care setting

Managerial guidelines to support parents during the hospitalisation of their children in a private paediatric unit.

The purpose of this article is to describe managerial guidelines to support parents with the hospitalisation of their child in a private paediatric unit. The hospitalisation of a child is regarded as a major stressor for both parents and child. The role of the family in participating in a child's illness is slowly being recognised (Kibel & Wagstaff 2001:544), but the South African government per se has not yet issued any formal reports on parental participation in the hospitalisation process. The study explored and described the nursing care experiences of parents regarding the hospitalisation of their child in a paediatric unit; managerial guidelines to support parents with their lived experiences of their child's hospitalisation in a paediatric unit. To achieve the purpose and the objectives of the research, an interpretive-phenomenological qualitative approach was used in the research design and methods. Research was conducted through unstructured individual interviews, narrative diaries and field notes and data were analysed through open-coding (Tesch, 1990). Parents were asked to respond to the question "How did you experience your child's hospitalisation in the paediatric ward", followed by probing when the responses of the parents were ambiguous. Purposive sampling was used to achieve saturation of data and seven parents were interviewed and fifteen parents completed narrative diaries. The model of Lincoln and Guba (1985) was used to ensure trustworthiness. Ethical considerations were maintained throughout the study and consent was obtained from the respondents. The recommendations of the research were that attention should be given to 1) empowering parents to participate in their child's care; 2) guiding nursing personnel to plan the discharge process; 3) including parents in the unit routine; 4) fostering a trusting relationship with parents; 5) promoting the communication of information; and 6) creating a therapeutic environment for parents.

Experiences of parents during the hospitalisation of their child in a private paediatric unit.

A change in the health of a child is regarded as a major stressor for parents which further increases when the child is admitted to a hospital (Kaplan & Sadock, 1998:799). The role of the family in a child's illness is slowly being recognised (Kibel & Wagstaff, 2001:544), but the South African government per se has not yet issued any formal reports on parental participation in the hospitalisation process. The purpose of the study was to describe recommendations to support parents with the hospitalisation of their child in a private paediatric unit. An interpretive-phenomenological qualitative approach was followed through unstructured individual interviews, narrative diaries and field notes. Purposive sampling was used to achieve saturation of data. Seven parents were interviewed and 15 parents completed narrative diaries. Trustworthiness and ethical considerations were maintained throughout the study. The transcribed interviews, narrative diaries and field notes were analysed through open-coding. Recommendations focus on 1) empowering parents to participate in their child's care; 2) guiding nursing personnel to plan the discharge process; 3) including parents in the unit routine; 4) fostering a trusting relationship with parents; 5) promoting the communication of information; and 6) creating a therapeutic environment for parents.

Working conditions that contribute to absenteeism among nurses in a provincial hospital in the Limpopo Province.

Absenteeism results in an increased workload for nurses who stand in for colleagues and can lead to situations in which a lack of motivation among nurses and a lowering of the quality of patient care may occur. The researcher observed that certain conditions, such as inflexible working schedules, were given as reasons for the absenteeism in units in a provincial hospital. A non-experimental, descriptive, quantitative study was undertaken. The purpose of the article was to describe the working conditions that contribute to absenteeism among the professional and sub-professional nurses at a provincial hospital in the Limpopo province of South Africa. The sample included 107 professional nurses and 163 sub-professional nurses who voluntarily agreed to participate in the study. A questionnaire was used to collect data, which was analysed by using descriptive and inferential statistics. The findings of this study indicated that personal and managerial characteristics, and organisational and working conditions may lead to absenteeism in the workplace. This article focuses on the working conditions that are constraints, namely inadequate group cohesion, inadequate delegation of autonomy, role ambiguity, ineffective routinisation and the effect of the workload in the workplace. Recommendations are made for improving working conditions to combat absenteeism among nurses. The limitations of this study are highlighted.

The leadership characteristics of the preceptor in selected clinical practice settings in Botswana.

A non-experimental, explorative, descriptive, quantitative study was undertaken. The purpose was to explore and describe the views of preceptors and preceptees regarding the fulfilment of the role of the preceptor in selected clinical nursing practice settings in the Botswana context. The study included 72 preceptors and 200 nursing students/preceptees who voluntary agreed voluntarily to participate in the study. A questionnaire was used to collect data, which was analyzed by using descriptive and inferential statistics. The findings of this study indicated that the preceptor lacked leadership characteristics in the accompaniment of the preceptee. These constraints included the lack of desirable characteristics such as intellectual, emotional, physical and other traits that are common to all good leaders. Recommendations were stated for improvements in selecting preceptors with certain leadership skills for the clinical practice settings. The limitations of this study were highlighted.

The career goals of nurses in some health care settings in Gauteng.

In nursing, purposeful career planning is essential if nurse practitioners want to make the right decisions about their work in order to strive towards and accomplish a meaningful quality of working life. Nurses should identify their career goals to be able to investigate their different career opportunities in their field of interest and direct their work according to a work strategy for years ahead. The purpose of this study was to explore and describe the career goals of post-basic nursing students with the aim of describing management strategies to guide the future career of post-basic nursing students in climbing the career ladder effectively and obtaining their set career goals. An explorative, descriptive, qualitative design was selected where the researcher worked inductively to explore and describe the needs (goals) and future planned actions of the participants regarding their career management as viewed for a period of five years. The researcher purposively and conveniently identified the sample as all the post-basic nursing students, namely 250 students, who were registered for the first, second and third year of nursing management courses in that period at a South African residential university. Two structured, open questions were developed. Each participant received the questions in writing and was asked to answer them. The QSR NUD*IST program was used for the qualitative management (categorization) of data. The results of the research questions related to five categories, namely becoming empowered, being promoted, being educated and professionally developed, partaking in research and taking up new projects.

The Role Played by Recruitment Agencies in the Emigration of South African Nurses

Active recruitment of foreign nurses might offer solutions to many countries' nursing shortages. During 1999; the International Council of Nurses (ICN) expressed concerns regarding the aggressive international recruitment of nurses.The ICN maintained that internationally recruited nurses might be particularly at risk of exploitation or abuse. The ICN denounced unethical recruitment practices that might exploit nurses (ICN; 1999a:1-6). Many nurses who leave the Republic of South Africa might use recruitment agencies' assistance. These concerns raised by the ICN indicated the need for obtaining information about the emigration of South African nurses and the role played by recruitment agencies. The purpose of this study was to explore and describe how recruitment agencies contributed to the emigration of South African nurses. Both qualitative and quantitative approaches were used. A purposive sample of recruitment agencies that recruited South African nurses to practise in foreign countries (N=4) was drawn. The second sample; a purposive sample selected through snowball sampling consisted of South African registered nurses who were practising in foreign countries (N=27). The findings obtained from structured interviews conducted with recruitment agencies were supported by findings from e-mail responses from nurses working in foreign countries. These research results indicated that recruitment agencies in South Africa provided professional services to nurses who wanted to work in foreign countries. Contrary to research reports published in other countries; no evidence was found of nurses being exploited by recruitment agencies in South Africa

The Contribution of the Clinical Nurse Instructor to the Development of Critical Thinking Skills of the Student Nurse in Namibia

A quantitative; non-experimental and exploratory study was undertaken to determine the contribution by the clinical nurse instructor to develop critical thinking skills of student nurses in Namibia. The study was conducted at the training hospitals of Namibia; namely Windhoek; Oshakati and Onandjokwe State hospitals. Clinical nurse instructors from all disciplines were included in the study; as well as student nurses in their second; third and fourth year of undergraduate nursing study. The findings of the study revealed that; although the clinical instructors in the training hospitals of Namibia are aware of their responsibility; they do not focus on the development of critical thinking of student nurses in Namibia. A need for in-service programmes to emphasise the development of critical thinking skills of both clinical nurse instructors and student nurses was identified

The managerial duties of the nurse in charge of a unit in combating the spreading of HIV/AIDS.

The charge sister has an essential role to play in combating the spreading of the HIV in the environment of the nursing unit. The HIV/AIDS dilemma is a reality in the health care environment. On a daily basis nurses is treating patients with the HIV. Through the basic conceptual framework of the management process, the charge sister can play her part and contribute in keeping the disease under control in her work environment. An explorative, descriptive study was done through a structured questionnaire with four open questions. This study was aimed at developing and formulating guidelines to be included in a policy to be used in the combating of spreading of HIV in the health care unit by the charge sister and her staff. The results indicate the absence of policy regarding the prevention of the spreading of the HIV, necessary for orientation and in service training of staff.

Essential managerial attributes of the nowadays nursing service manager in the South African context.

Nursing service managers need certain essential managerial attributes in taking the lead in effective management of the nowadays health care organisations in South Africa. Major changes in restructuring and human resources planning are taking place through transformation of health services and specific managerial attributes are needed in this scenario. Without nursing service managers with the necessary managerial attributes, change in the health care environment will be hampered and planning, organising, directing and control of the delivering of quality care will be negatively influenced. The research problem was addressed in the following question that guided the study: Which essential attributes/characteristics should a nursing service manager possess to run a health care service effectively? It was unclear what the opinions of all level of nurse managers were regarding the necessary managerial attributes the health services manager currently need to run the current health care services effectively. This study aimed at highlighting the necessary attributes of the nowadays nursing service manager in running a health care institution in the current health care environment of South Africa. Purposive sampling was done and forty-five functional, middle and top-level managers registered for a second year degree course in Health Services Management at a South African university participated in the study. The findings indicated important managerial and leadership attributes, which the current nursing service manager should possess. This article will only discuss the important managerial attributes needed. A conceptual framework came to the fore according to which an example of a self-evaluation instrument was compiled for nursing service managers for future use. The results of the data analysis indicated that the nursing service manager should promote good interpersonal relationships with colleagues, subordinates and patients through the attributes of openness, being inviting and empowering behavior. The purpose of this article is to make nursing service managers more aware of the necessary attributes they should possess and should develop to manage nursing services more effectively.

Nursing care of the patient undergoing alcohol detoxification.

Nurses are challenged with the task of holistic care for the alcohol dependent patient. The objective of the study was to explore and describe the opinions of male patients regarding the holistic care in a selected detoxification unit in Gauteng. A quantitative, explorative and descriptive design was employed utilizing interviews with a structured questionnaire as method of data collection. After the data was analysed (frequencies were used) the results were presented according to the five client variables of the Neuman Systems Model. Positive and negative results on the physiological, psychological, socio cultural, developmental and spiritual needs of the client were identified. This article aims at identifying crucial holistic aspects of nursing care of the alcohol dependent patient.

Caring attributes, professional self concept and technological influences in a sample of Registered Nurses in eleven countries.

Caring, the theoretical foundation of nursing, is identified as one of the core values by Hospital Authorities world-wide to be actualised in clinical practice. Exactly how caring attributes relate to nurses' professional self image and quality nursing service in the context of a contemporary technological environment have yet to be operationalised. In total, 1957 Registered Nurses from 11 different countries were involved in the study which aimed to: develop an understanding of and compare the responses to items relating to caring, professional self concept and technological influences. To collect data an instrument containing 104 Likert items was administered to RNs working in general hospitals. The instrument contained sections which examined professional self concept, technological influences and caring attributes. Descriptive and inferential statistics revealed that many of the Asian nurses in the sample were younger, had less experience yet were more qualified than their 'western' colleagues. The mean scores for the caring attributes for nurses from the Philippines, Sweden and South Africa were significantly higher than those from China (Beijing), Korea, China (Hong Kong) and Scotland. The Korean sample demonstrated the lowest mean score for professional self concept while the New Zealand sample the highest. The Australian, Canadian, NZ, Scotland and Swedish samples were strongly of the opinion that the increase in technology has not brought about the any more spare time in nursing and generally had a more negative opinion about the influence of technology when compared to those from China (Beijing), Philippines, China (Hong Kong) and Singapore. The results are discussed in the light of the cultural differences in the sample and recommendations for future research are considered.

[The empowerment of nurses in health services--a conceptual framework]. / Bemagtiging van verpleegkundiges--'n konseptuele raamwerk.

In a study of the empowerment of nurses in health services the conceptual framework served as departure in a survey of empowerment in health services in Gauteng. The aim with this part of the research methodology and the development of the conceptual framework was mainly to determine if theorists in the literature agree about the interpretation of the concept empowerment and the concepts underlined in the descriptions and definitions of the term "empowerment".

[Expectations of the professional nurse concerning the preceptor's role]. / Die verwagtinge van die professionele verpleegkundige ten opsigte van die rol van die preseptor.

In a study completed in 1991, the focus was on the role fulfillment of the preceptor in staff development in training hospitals in Namibia. An instrument was developed to determine how the nurse experiences this role. After completion of the data gathering process, a factor analysis was done, which proved the construct validity of this instrument. Based on this factor analysis, a conceptual framework for staff development in training hospitals was constructed that could be used as a point of departure in a future study.

[The nurse as preceptor in personnel development in teaching hospitals in Namibia]. / Die verpleegkundige as preseptor in prersoneelontwikkeling in opleidingshospitale in Namibië.

A study undertaken in 1991 focused on the role fulfilment of the preceptor in staff development in training hospitals in Namibia. As in the case in many countries the nursing service climate in Namibia is characterised by constant change in the practice of professional nurses. The preceptor must accompany the professional nurses in their personal and professional development.