Knowledge of breast cancer in women in Sierra Leone.

Breast cancer has been described as one of the life-threatening diseases affecting women and is a major problem in women's health issues. The unrecorded number of cases of breast lumps and breast cancer observed in women in Sierra Leone prompted the researcher to organize a "Breast Week" during which 1,200 women were educated on breast cancer and the importance of breast health. This research is a follow up of the "Breast Week" which was organized in Freetown, Sierra Leone The specific objective of this study was to assess whether the knowledge and teachings given to the women who participated in this project was fully understood. A sample size of 120 women (10%) who participated in the "Breast Week" was obtained through systematic sampling. A quantitative approach was adopted and a structured interview schedule guided the data collection process. The data were processed through use of SPSS and Microsoft Excel. Texts from open ended questions were categorized and frequency counts were applied to the data. It was found that the majority (96.6%) of the women had some knowledge of breast cancer. They linked breast cancer to the signs and symptoms associated with it and were able to describe the disease as one that kills women if not promptly detected and/or treated appropriately. Findings indicate that the majority of the women are aware of the dangers of the disease and had knowledge of someone who had died of breast cancer (59.2%). An assessment of the effectiveness of knowledge on breast cancer showed that these women could identify breast cancer as a disease that affects women and may cause death if not detected on time.

Hospital workplace experiences of registered nurses that have contributed to their resignation in the Durban metropolitan area.

TITLE: Hospital workplace experiences of registered nurses that have contributed to their resignation in the Durban Metropolitan Area. AIM: The purpose of this research was to explore and describe the hospital workplace experiences that had contributed to the resignations of Registered Nurses in the Durban Metropolitan Area. METHODOLOGY: The broad perspective governing this research is qualitative in nature. The researcher employed a phenomenological approach specifically because the researcher was interested in identifying, describing and understanding the subjective experiences of individual nurses at the two Private and two Provincial health care institutions selected to participate in the study - in respect of their decision (s) to resign from their employment, and/or to leave the nursing profession. Two semistructured interviews were conducted with each participant by the researcher. The researcher applied the principle of theoretical saturation and a total of fifteen participants were interviewed and thirty interviews were conducted. Experiential themes and subthemes in the data were identified by a process of meaning condensation, and the data were managed by means of a qualitative software package - NVIVO (QSR - NUD*IST). FINDINGS: The resignations of registered nurses in the Durban Metropolitan Area were found to be linked to their respective hospital workplace experiences. These experiences related to their physical working conditions and environment and included the following: unsupportive management structures, autocratic and dehumanizing management styles, negative stereotypy of nurses and the nursing profession, lack of autonomy in the workplace, professional jealousies and fractures within the profession, sub-optimal physical working conditions and shortage of staff, equipment and lack of appropriate surgical supplies, concerns regarding occupational safety e.g. the increasing exposure of health care personnel to HIV and AIDS; lack of opportunities for promotion or continuing one's professional education, the experience of workplace violence--predominantly in the form of verbal and psychological abuse, inaccurate systems of performance assessment (Joint Performance Management, Reports, Personal Profile systems)--compounded by favouritism and racism; and inadequate remuneration. CONCLUSION: In terms of the findings of this study, the participants' lived experiences in terms of their respective hospital workplace experiences indicated that neither the maintenance factors nor the motivator factors were optimally represented, experienced or enjoyed in their respective workplaces. In terms of Herzberg's Motivator-Maintenance theory, the registered nurses who participated in this study may be described as being 'not satisfied' and 'dissatisfied' with their hospital workplace experiences, physical conditions and environment. A number of recommendations pertaining to strategies for the retention of registered nurses were made for the consideration of both Provincial and Private health care authorities, hospital management structures and the nursing profession respectively. Recommendations for further nursing research were also made.

A pilot study of death competency amongst health workers in the Uthukela District in Kwazulu-Natal.

AIM: The aim of this study was to investigate the registered nurses abilities to cope with the death of their clients and to determine if there was any improvement after attending a workshop designed to address this issue. NULL HYPOTHESIS: Using the Coping with Death Scale by Bugen (1980--1981) cited in Neimeyer (1994), respondents' pre-test scores are equal to their post-test scores. METHODOLOGY: An exploratory survey was used to investigate the registered nurses' death competencies before and after the scheduled workshops. Although these workshops were initially planned for registered nurses, a great variety of health workers (nurses, pharmacists, oral hygienists, physiotherapists and HIV community workers) expressed interest and were thus accommodated in the workshops. Data were collected from the Death Education Workshops held at three sites, and fifty-one respondents completed the questionnaire before the workshop and fifty-six on completion of the workshop. The tool that was used in this research was Bugen's (1980--1981) Coping with Death Scale, cited in Neimeyer (1994). This scale consists of 30 items assessing the participant's sense of competence in handling death and their concrete knowledge concerning preparation for death. FINDINGS: Analysis of the pre and post tests revealed a move from a neutral stance to one where the respondents tended to have a more definite opinion about the statement. This was usually towards agreeing with the statement. Applying the two sampled T-Test to compare the scores of the two related groups (that is the pre-workshop and post-workshop variables), the results yielded were t =0.00, 95% confidence level. Thus there was a significant difference between the two groups, and the null hypothesis is therefore rejected.

Selected outcomes of community-oriented, problem-based nursing programmes in South Africa.

UNLABELLED: Whilst there is a significant body of research on the outcomes of problem-based learning (PBL) programmes (Albanese and Mitchell, 1993; Vernon and Blake, 1993), there is little information regarding the outcomes of community-oriented programmes (COL) for nursing students. Between 1994 and 1997, four university schools of nursing implemented problem-based, community-oriented learning (COL) programmes. This research sought to describe, evaluate and compare the outcomes of graduates from these four universities with graduates who had followed conventional programmes. RESEARCH OBJECTIVES: These were to describe and explore the incorporation of illness prevention and health promotion of graduates from PBL/COL programmes and non-PBL/COL programmes in South Africa, as described by the graduates and their supervisors. Secondly, to describe whether and how the graduates from PBL/COL and non-PBL/COL programmes engaged themselves in continued learning. RESEARCH METHODOLOGY: This was a qualitative evaluation study, which is descriptive and comparative in nature. In-depth interviews were held with the graduates and their supervisors about six months after completion of their training. Use was made of Miller and Crabtree's (1994) Template Analysis Style and of Benner's (1984) interpretative approach to analyze data. Analysis was done using the NVIVO computer programme. This programme was used to manage the categories which were developed with regard to each concept as the analysis proceeded. FINDINGS: Both the graduates and the supervisors appeared to have difficulty describing activities relating to health promotion and illness prevention. Only three types of health promotion were described--mass education, increasing personal skills and creating a supportive environment. The most commonly mentioned means of illness prevention were health education and medical-surgical asepsis. A few graduates described activities which indicated that they had taken context into consideration during patient care.

The knowledge and practices of primary care givers regarding home-based care of HIV/AIDS children in Blantyre (Malawi).

Knowledge is one of the major factors that promotes adherence to treatment regimens. With the current trends worldwide of home and community-based services for the management of HIV/AIDS patients, knowledge of care givers about the home care of these patients will determine the success of the programs. The purpose of this descriptive study was to explore the knowledge and practices of primary care givers of HIV/AIDS children in the provision of home care services. In this study an attempt was made to describe the factors which are associated with knowledge. Thirty-six primary care givers were randomly selected from three major home based care centres in Blantyre City, Malawi. A structured interview schedule was used to collect data. Data were analysed manually and by computer, using the Statistical Package for Social Science (SPSS). The findings revealed a gap in knowledge since in many instances taking a child to the hospital for the management of minor ailments was the action of choice, thus perpetuating the problem of overburdening hospital resources. Lack of prior preparation for home based care was found to be the major factor contributing to the lack of knowledge. Recommendations proposed include the need to put into place mechanisms that will ensure that all the primary care givers are adequately prepared in good time for home care service. Ensuring regular home visits was also thought to be helpful for efficient and effective supervision and reinforcement of information given to fill the gaps in knowledge wherever necessary.

Recurriculating to a problem-based learning curriculum: the Wits experience.

The reasons for changing from a traditional curriculum to a problem-based learning curriculum are outlined. The process used in preparing for this change is described. The planning phase made use of workshops, core committees and international workshops and visits. Preparation of the necessary resources are enumerated, as are the preparation of the human resources with which the department is affiliated. The early implementation phase describes some of the problems which were encountered and the solutions which were ascribed. Finally an informal evaluation of the first experiences of problem-based learning is presented.