Doctoral Degrees (Nursing and Midwifery)

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Browsing Doctoral Degrees (Nursing and Midwifery) by Subject "Nursing home care -- Tanzania"

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    Development and validation of healthcare standards and criteria that contribute to the care of residents in homes for the elderly in Tanzania
    (Stellenbosch : Stellenbosch University, 2022-04) Mathias, Victor; Stellenberg, Ethelwynn; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Nursing & Midwifery.
    ENGLISH SUMMARY: Introduction: The problems experienced in homes for the elderly in Tanzania highlighted the need to develop healthcare standards to guide the provision of quality care to residents thus influencing healthcare outcomes. Study goal: Developing and validating healthcare standards and the associated criteria to contribute to quality care for residents in homes for the elderly in Tanzania. Objectives: i.To determine whether any healthcare standards are applied to ensure safe, qualitycare for residents in homes for the elderly in Tanzania. ii.To develop and validate quality healthcare standards to provide safe, quality careto residents in homes for the elderly in Tanzania based on the results of objective(i). iii.To develop validated measuring criteria to measure the validated healthcarestandards for safe, quality care for residents in homes for the elderly in Tanzania. Conceptual framework: The Donabedian quality model was applied to develop healthcare structure standards and the associated criteria. Methodology: The study was conducted in three phases: Phase 1: A situational analysis was conducted by applying a quantitative research approach with an exploratory research design aligned with objective (i). Validity Efforts were made to strengthen construct, content and face validity of all data collections tools. Reliability The alpha coefficient for the audit instrument was .983 and the Likert questionnaire was .928 indicating a high internal consistency. Phase 2: Drafted standards and associated criteria were developed based on the findings of phase one and the relevant literature aligned with objective (ii). Phase 3: The developed drafted standards and criteria were validated applying the Delphi technique which was applied quantitatively aligned with objective (iii). Ethical considerations: Approval was sought from Stellenbosch University (S19/02/048) and from Tanzania (NIMR/HQ/R.8a/Vol. IX/3191). Informed consent was obtained from managers of homes and participants. Results: Phase 1: All the homes for the elderly in the country N=32 (100%) were audited using an audit instrument which included seven fields, 26 drafted standards, four sub-standards and 262 associated criteria. All staff, N=65 (100%), from homes for the elderly completed a Likert scale questionnaire which was based on the items of the audit instrument which showed that all homes were non-compliant with all the standards and the criteria. Phase 2: Development of the drafted standards and associated criteria followed the COHSASA model. All 26 drafted standards and 257 (98%) of associated criteria were agreed upon by the experts, only 5 (2%) of the criteria underwent modifications which were then also accepted. Phase 3: Two rounds of the Delphi technique were conducted to validate the drafted standards and associated criteria. All 26(100%) healthcare standards reached consensus among the experts, including 258 (98.5%) criteria at a cut-off point of ≥ 80%. Four criteria were modified according to experts’ comments and included in round two, achieving consensus of 96%. Recommendation Based on the researcher’s observation and study findings, revealing poor care to residents in the homes for the elderly, the Government should respond to the plight of the elderly and urgently introduce the validated standards and criteria.