Factors leading to disruptive behaviours at central hospitals in Harare Metropolitan Province: Radiography managers perspectives.

BACKGROUND: The negative consequences of disruptive behaviours involving healthcare workers threatens the institution's image, staff morale, finances, and patient safety. While all kinds of health organisations or settings are potentially exposed to disruptive behaviours, some are at higher risk than others because of both environmental and cultural factors. Such risk should be assessed having regard to the specific situation and conditions in which each healthcare organization operates. AIM: The aim of this study was to explore radiography manager's perspectives on the environmental and cultural factors leading to DBs involving radiographers at central hospitals in Harare Metropolitan Province. METHODS: An exploratory qualitative study employing in-depth interviews with 11 radiography managers across five departments at three central hospitals selected by criterion purposive sampling was done. The interview data were analysed using Tesch's method of qualitative analysis. RESULTS: The key environmental and cultural factors identified included three themes: power hierarchy, work environment and reporting framework. Power hierarchy comprised categories, superiority, professional boundaries and representation. The work environment incorporated categories, trust in leadership, burnout and fatigue and remuneration. Lastly, reporting framework included categories, lack of protocol and reporting culture. CONCLUSION: Radiography managers believe that environmental factors play a bigger role in leading to disruptive behaviours that involve radiographers at central hospitals in Harare Metropolitan Province. This underscores the need for hospital and radiography managers to pay particular emphasis on these when formulating policies and procedures to address these behaviours. Addressing DBs ensures that healthy work environments are promoted which in turn ensures that patients receive optimum and safe care. IMPLICATIONS FOR PRACTICE: The paper provides an insight into the environmental and cultural dynamics that may trigger disruptive behaviours involving radiographers. This information is invaluable in formulating policies and procedures for addressing these unprofessional behaviours.

Antecedents of disruptive behaviours involving radiographers at central hospitals in Harare Metropolitan Province, Zimbabwe.

INTRODUCTION: Although disruptive behaviours (DBs) are universal in healthcare, each healthcare setting, profession or department presents unique DBs antecedents. Gaining better insights into the antecedents of DBs is crucial in order to put together a tailor-made program designed to raise awareness, establish accountability, and provide resources to mitigate their impact. There are, however, a few studies exploring antecedents of DBs involving radiographers, more so in low resource settings like Africa. The aim of the study was to determine the antecedents of DBs involving radiographers employed by central hospitals in Harare Metropolitan Province, Zimbabwe. METHODS: A descriptive cross-sectional survey was carried out from January to March 2021 at central hospitals in Harare Metropolitan Province, Zimbabwe. A self-administered questionnaire was used to capture the views of 100 randomly selected radiographers. RESULTS: There was a significant agreement that the following are antecedents of DBs: frustration due to poor working conditions (Mean = 3.93.p < .0005); long waiting times for patients (Mean = 3.91.p < .0005); a sense of privilege and status for those at the top (Mean = 3.87.p < .0005); burnout or fatigue (Mean = 3.79.p < .0005); narcissism (Mean = 3.79.p < .0005); differences in communication styles (Mean = 3.68.p < .0005); divergence of opinions or thoughts (Mean = 3.59.p < .0005); personal conflicts or family problems (Mean = 3.57.p < .0005); self-protection against feelings of inadequacy (Mean = 3.42.p < .0005); dysfunctional organizational culture (Mean = 3.38.p < .0005) and cultural, generational or gender bias (Mean = 3.32.p < .0005). CONCLUSION: This study identifies the antecedents of DBs involving radiographers at central hospitals in Harare Metropolitan Province. It is crucial that any attempts at finding solutions to address the behaviours should be based on evidence of the antecedents in the setting concerned. IMPLICATIONS FOR PRACTICE: This will help in the understanding of the antecedents of DBs involving radiographers so that context specific interventions to address these behaviours are formulated.

Benchmarking of Emotional Intelligence in radiography students within KwaZulu- Natal, South Africa.

INTRODUCTION: Emotional Intelligence (EI) is an important skill within the various health care professions, and a higher level of EI is associated with better patient care, communication, empathy and teamwork. Within the Republic of South Africa, there is limited literature on EI within the health care sector, and specifically within radiography. METHODS: The Trait EI Questionnaire Short Form (TEIQue-SF) was used to record the EI scores of 247 BHSc Radiography students in all four disciplines over the four years of study at the selected University of Technology (UoT) in Kwazulu-Natal (KZN), South Africa. The TEIQue-SF yields a Global EI score and the four factors of EI. RESULTS: The study benchmarked the TEI scores of the radiography cohort. The male participants scored significantly higher in Global EI (p = 0.020 and 0.029) and the Self-control factor (p = 0.000) of EI compared to the female participants. The younger participants scored significantly higher in three of the five factors of TEI, namely: Global EI (p = 0.003), Well-being (p = 0.003) and Self-control (p = 0.010), which was an unexpected finding and against the norm. Racially (0.010 and 0.009) and culturally (P = 0.022 and 0.026), the Black participants and the Zulu participants scored significantly higher in the Self-control factor of TEI. CONCLUSION: This study benchmarked the TEI scores of radiography students within KZN and compared these TEI scores to the demographic variances of the students with interesting results. This study has highlighted the TEI level of the students at a selected UoT, which can be used to ensure that better prepared, well-rounded and employable graduates enter the workplace. This can be achieved by the implementation of the recommendations, which includes the levels of EI to be developed and relevant EI training required. Further research is required within the field of TEI and Radiography in the South African context to strengthen this study's findings. IMPLICATION FOR PRACTICE: This study has highlighted the EI scores of a cohort of radiography students. The results of this study have made the institution more aware of the students' TEI which will allow the institution to ensure students are better prepared and are employable graduates within their chosen profession by including EI training within the health faculty curriculum.

A model to enhance job satisfaction for radiographers in the public healthcare system in Gauteng province, South Africa.

INTRODUCTION: The World Health Organization seeks to address the maldistribution of healthcare professionals which results in inequitable services to underserved communities (World Health Organization (WHO), 2015). In South Africa, the underserved areas are the public sector hospitals and the rural areas. Radiographers, like other healthcare professionals, are also unequally distributed between the public and private sector hospitals, and between the rural and urban areas. Since one of the perceived factors for maldistribution is job satisfaction, it is essential to explore factors that contribute to job satisfaction/dissatisfaction amongst radiographers to develop a model to attract and retain radiographers in the public sector. METHODS: The study used exploratory sequential mixed methods approach to explore job satisfaction amongst radiographers, employed by public tertiary hospitals in the Gauteng province, South Africa. In phase one of the study (qualitative), individual and focus group interviews were used to collect data, and in phase two (quantitative), a self-developed questionnaire was used. The data collected was analyzed in sequential order, where thematic analysis was performed for phase one of the study, and SPSS version 23 was used in phase two. RESULTS: In phase one, five themes emerged, namely the influence of government policies on job satisfaction, lack of career pathing, poor remuneration, working conditions, and the role of the human resources department. In phase two, the Pearson's correlation test was performed which showed that there was a significant correlation of intent to leave, p = .005 with the following factors: government policy on Occupational Specific Dispensation (OSD) and Performance Management Development System (PMDS), working conditions, supervision, equipment and infrastructure, and poor remuneration. CONCLUSION: Government policies, working conditions, and poor remuneration play a significant role in job satisfaction amongst radiographers employed by public tertiary hospitals in the Gauteng province. IMPLICATIONS FOR PRACTICE: The proposed model could enhance job satisfaction for radiographers employed by the public sector hospitals and ultimately increase attraction and retention rates of radiographers for this sector.

A model for the integration of primary health-care services in the province of KwaZulu-Natal, South Africa.

AIMS: To analyse integrated primary health care and ultimately develop a model for integrated care. BACKGROUND: In South Africa, Integration of Services Policy was enacted in 1996 with the aim of increasing health service utilization. However, the problem with the policy arises in the implementation of integrated primary health care as there is no agreed understanding of what this phenomenon means in the South African context. METHOD: A cross-sectional study, using Strauss and Corbin's grounded theory approach was utilised. Policy makers as well as primary health care nurses at functional level participated in the study. The data was collected by means of observations and interviews. The sample size for interviews comprised 38 participants. RESULTS: Integrated primary health care was understood either as comprehensive health care, supermarket approach or one-stop shop. CONCLUSION: It was concluded that integrated primary health care meant different things in different contexts. IMPLICATIONS FOR NURSING MANAGEMENT: Integrated primary health care, if implemented, would advance health equity in all countries rich and poor and, as a result, promote human and national development. This model could be used to guide policy formulation and implementation of integrated primary health care at provincial and national levels.

An assessment of the implementation of the provincial cervical screening programme in selected Primary Health Care Clinics in the Ilembe Region, KwaZulu-Natal.

Cervical cancer is almost completely preventable, yet it is the second most prevalent cancer amongst women in South Africa. KwaZulu-Natal (KZN) in particular has a high mortality rate of cervical cancer and 1: 40 women die from cancer of the cervix. Therefore, in 1997 a cervical screening policy and programme was implemented in the province. The purpose of the study was to evaluate the implementation of selected aspects of the Provincial cervical screening programme in selected Primary Health Care (PHC) clinics in Ilembe Region, KZN. Results indicated that there was a lack of resources needed for implementing the programme in rural clinics compared to urban clinics. However, all clinics in the study had an adequate supply of the drugs needed for the treatment of abnormal smears. On reviewing the records, the researcher noted that most of the results indicated that smears had adequate cells needed for analysis. However, the results indicated that there was a problem with follow-up of clients with abnormal smears. Feedback to the clinics from the referral hospital regarding the outcome of the visit was inadequate. The results indicated that the mechanisms of record keeping were inadequate. Therefore, the above results indicate that problems exist at the selected PHC clinics that may result in ineffective implementation of the cervical screening programme.