Department of Nursing and Midwifery

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Browsing Department of Nursing and Midwifery by browse.metadata.advisor "Cramer, Jenna Morgan"

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    Communication experiences of expatriate midwives providing maternity care in a military hospital in Saudi Arabia
    (Stellenbosch : Stellenbosch University, 2018-03) Govender, Nelanie; Cramer, Jenna Morgan; Lourens, Guin; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Nursing & Midwifery.
    ENGLISH SUMMARY: Background In Saudi Arabia, maternity care is provided by expatriate midwives. The official language of Saudi Arabia is Arabic. The labour ward communication amongst expatriate midwives and Saudi patients was unique as the first language of expatriate midwives is not Arabic. The limited research focuses on the expatriate nurses’ communication experiences in Saudi Arabia. The aim of the study was to explore and describe the communication and the communication experiences of expatriate midwives while caring for pregnant woman in the labour and delivery ward of a military hospital in Saudi Arabia. Methods A qualitative descriptive methodology was used to explore the views of expatriate midwives regarding effective communication with patients in the labour and delivery ward. The study applied purposive sampling to select participants from the labour and delivery ward of a military hospital in Saudi Arabia. The Health Research and Ethics Committee of Stellenbosch University and the Research and Ethics Department of the hospital granted permission to conduct the study. Seven semi-structured interviews were conducted, transcribed and analysed using Creswell’s framework. Four themes emerged from the data. Results The themes that emerged were: communication methods, communication challenges, communication rationale and communication solutions. Participants expressed their unique communication styles, even though they were not fluent speaking the Arabic language. They stressed the importance of communication in a maternity setting as they provide care for the Saudi nationals and their unborn babies. Conclusion Communication is an integral component of providing quality maternity care in the labour and delivery ward. With the assistance of higher management of the hospital, support systems can be in place to bridge the communication gaps between expatriate midwives and the pregnant woman.
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    The knowledge of basic neonatal resuscitation among midwives at district hospitals
    (Stellenbosch : Stellenbosch University, 2017-03) Ndzima-Konzeka, Florence Fezeka; Cramer, Jenna Morgan; Crowley, Talitha; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Nursing & Midwifery.
    ENGLISH SUMMARY : Background:Globally there is an increase of neonatal deaths resulting in part from intra-partum asphyxia or hypoxia related to ineffective neonatal resuscitation at birth. Midwives can play a pivotal role in reducing neonatal deaths. The researcher was concerned about an increasing rate of early neonatal deaths, in the Chris Hani Health District, Eastern Cape. Consequently, a multi-pronged approach was put into place by the district, to address neonatal mortality by means of training midwives in basic neonatal resuscitation. The resulting question was whether the Chris Hani Health District midwives have the ability to conduct deliveries with the required knowledge in neonatal resuscitation, which could improve neonatal outcomes. Aim and objectives: The study aimed to determine the knowledge level of registered midwives with regards to basic neonatal resuscitation, in the Chris Hani Health District Hospitals in the Eastern Cape. The focus was on the identification of midwives’ training, qualifications and experience in neonatal resuscitation; determining the knowledge of midwives on neonatal resuscitation at birth; and describing the relationships among the afore-mentioned. Methods: A quantitative approach with a descriptive correlational design was adopted. The sample included 110 registered midwives allocated in the maternity wards of the 13 district hospitals of the Chris Hani Health District. A structured self-administered questionnaire was developed specifically to determine the extent of midwives knowledge with regards to the resuscitation of neonates at birth. Data was analysed with STATA (version 13) programme. Results: The knowledge score of the participants ranged from 63% to 97%, with a mean of 79% (SD 7.8). An acceptable knowledge level was 80% or more. Though there were no relationships found between midwives’ training, qualifications and their knowledge; years of experience as a midwife were found to be associated with knowledge of basic neonatal resuscitation. Although the knowledge scores were high, some midwives did not have adequate knowledge on critical components of neonatal resuscitation. Conclusion: The study underpins knowledge in empowering midwives to carry out basic neonatal resuscitation. Recommendations of the study include a retention strategy for advanced midwives; equipping advanced and / or experienced midwives to train and mentor young midwives in the profession; and a review of the need for training of midwives on neonatal resuscitation and its impact on their knowledge. These study findings and recommendations may strengthen the health systems that are in place to end preventable neonatal deaths; through imparting updated basic neonatal resuscitation knowledge to midwives.
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    Midwives’ views on delivery method decision making in private sector labour wards of Namibia
    (Stellenbosch : Stellenbosch University, 2018-03) Mlambo, Sarah; Cramer, Jenna Morgan; Young, Cornelle; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Nursing & Midwifery.
    ENGLISH SUMMARY: Background: The views of midwives regarding decision making in the Namibian private sector hospital labour wards are investigated in this study. The high prevalence of caesarean sections in the Namibian private sector has been the motivation to attempt to understand this phenomenon. Midwives are an integral part in the care of women as prioritised patients, before, during and after childbirth. The objectives of the study included the midwives’ views on how women in the labour wards decide on a birthing method, whether the Robson classification for doing caesarean section was being applied in their workplaces, and what their perceived role as advocates entails during the women’s decision making of her birthing mode. Methods: The study used a qualitative design with an exploratory approach. Purposive sampling was applied in the selection of research participants. Permission was granted by the Health Research Ethics Committee of Stellenbosch University and the management of the two hospitals selected for the study. Seven individual interviews for allowing the phenomenon to be explored in-depth were conducted in two private hospitals in Windhoek. Data analysis was done using the six steps by Creswell. Results: The seven midwives who participated in this study reported that the decisions in the labour wards are affected by a myriad of factors. These include the relationship the midwife has with the doctor, the patient and the institution; trust among and between health professionals, and the availability of adequate antenatal information for the women to make informed decisions about the mode of birth. The following themes and subthemes (in brackets) emerged from the study: midwife (dependent, interdependent and independent role functions); doctor (dependent, interdependent and independent role functions; instrumental and expressive roles; motivations for caesarean sections); patient (antenatal care and expectations of pain management in labour; presence of support or birthing partner); and hospital (policies and guidelines; Robson classification). The study found that women are not well informed about the choices they have for childbirth, about the advantages and disadvantages of the chosen mode of delivery, as well as what to expect during the active stages of labour. The notion that some decisions are influenced by convenience also emerged in this study. Midwives’ roles in the Namibian private sector context were found to include decreased independent and increased interdependent functions due to the enlarged role of the private doctor as the primary care-giver, as well as expectations of the institution and the doctor. Conclusion: Decision making in the labour wards is important, as it determines the birthing method outcome for every woman in the labour ward. Health information during antenatal care needs to be improved to empower women with knowledge, for them to make informed decisions regarding the mode of delivery. The views of midwives emphasised the advocacy role on the part of the midwife, who needs to be more assertive in this role to benefit women in labour. Further studies need to be done in the same context and public hospital settings, to compare the views of women on decision making in the labour wards.