Masters Degrees (Nursing and Midwifery)

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    Perceptions of primary healthcare nurses about the effectiveness of their working environment for integrated primary healthcare service delivery in Nelson Mandela Bay Health District
    (Stellenbosch : Stellenbosch University, 2024-03) Baartman, Zubrina; Young, Cornelle; Baron, Justine Carla; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Nursing & Midwifery.
    ENGLISH SUMMARY: Background: An effective working environment is imperative to provide successful integrated primary healthcare (IPHC) services to the community. Such an environment comprises a collaborative primary healthcare team, functional organisational support, and effective cooperation among team members and with the community. Healthcare efficiency, accessibility, and equity are increased through a working environment which positively affects IPHC delivery. Without an effective working environment and with recurrent patient visits causing overcrowding, subsequent patient dissatisfaction and complaints are experienced. A loss of trust in the primary healthcare (PHC) system are thus encountered. Therefore, it was necessary to explore the perceptions of PHC nurses on the effectiveness of their working environment in enabling IPHC service delivery in the Nelson Mandela Bay Health District, sub-district B in the Eastern Cape Province. Methods: A qualitative research methodology was used with an exploratory research design. The study population comprised nine PHC nurses. Semi- structured interviews were conducted, using an interview guide with open-ended questions, and data was analysed using thematic analysis. Results: Findings of the study indicated that staff shortages and a lack of training opportunities act as barriers to a conducive working environment for IPHC delivery. This situation is exacerbated by inadequate internal and external infrastructure: sub- standard provision of utilities such as water, sewerage, and electricity, the lack of equipment and pharmacy stock, and unreliable transportation of patients for referrals. High patient loads, ineffectual teamwork within the clinic, and insufficient management support are more impediments in the setting towards an effective working environment for IPHC services. Conclusion: Primary healthcare nurses identified challenges within their current working environment to render effective IPHC service. A favourable working environment should be established to increase comprehensive and integrative PHC service delivery as a quality component of South African healthcare.
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    Structural empowerment to ease the transition of new nurse graduates : exploring the experiences of operational managers in primary healthcare clinics
    (Stellenbosch : Stellenbosch University, 2024-03) Nzimande, Londiwe; van Schalkwyk, Talita; Van der Heever, Mariana; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Nursing & Midwifery.
    ENGLISH SUMMARY: Introduction: Operational Managers, the first-line nurse managers in the clinical setting, have a duty to empower new nurse graduates during the transitional phase from being nursing students to functioning as qualified nurse practitioners, referred to as professional nurses in South Africa. Little is known about the role of operational managers in supporting new nurse graduates’ transition to practice through access to information, resources, support, and opportunities to learn and develop in the context of the primary health Care (PHC) clinics in the SA public healthcare sector. The study aimed to explore the experiences of operational managers on the use of structural empowerment to ease new nurse graduate’s transition to practice to practice in PHC clinics. Methods: A descriptive qualitative approach was applied to attain the aim of the study. The population comprised fifteen operational managers (OMs) working at the PHC clinics within uMhlathuze local municipality in KwaZulu Natal province of South Africa. The final sample comprised eight participants who were purposively selected and met the inclusion criteria. Individual interviews were conducted using a self-developed semi-structured interview guide. Thematic data analysis was conducted on the results. Trustworthiness was achieved by ensuring credibility, dependability, confirmability, and transferability. Ethical approval was obtained from the Stellenbosch University Health Research Ethics Committee. Permission to conduct the study was granted by the KZN Department of Health Ethics Committee. The ethical principles of self-determination, beneficence, and justice were adhered to. Results: Four major themes emerged from data analysis: 1) minimal orientation, 2) outplay of the professional development process, 3) use of human and material resources, and 4) barriers to new nurse graduate’s empowerment process. The themes were further divided into nine sub-themes that described the experiences of how OMs facilitated access to structural empowerment elements to ease the transition to the practice of new nurse graduates working under their care in PHC clinics. It emerged that minimal orientation was provided to new nurse graduates through the induction and orientation processes. Such processes were sub-optimal and primarily focused only on introducing the students to the clinical guidelines. In addition, professional development of non-clinical competencies such as management and leadership skills were not considered during the transitional phase. The clinical competencies were role-modelled by senior professional nurses. The rollout of informal continuous professional development for new nurse graduates happened through in-service training workshops and informal training in the different primary healthcare streams. Coordination of access to human and material resources needed for professional development coordinated by the OMs requires innovation due to time and resource constraints. Staff shortages and busy clinic workloads were found to be barriers that hindered the empowerment process, which led to inconsistent on-site mentorship by senior professional nurses and new nurse graduates receiving inadequate feedback about their performance. Conclusion: OMs appear to have limited capacity to coordinate effective professional development opportunities and support structures for new nurse graduates. These findings suggest the development of formal policies guiding the implementation of effective professional development and orientation programs for the new nurse graduates during the transition to practice phase.
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    Knowledge, attitude and practices regarding legal and ethical standards in nursing practice among nurses at district hospitals in Namibia
    (Stellenbosch : Stellenbosch University, 2024-03) Munenguni, Elise Taati; Hector, Dawn; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Nursing & Midwifery.
    ENGLISH SUMMARY: Background: At district hospitals in Namibia, it remains a concern regarding the practices of the legal and ethical standards among nurses. This concern may be associated with the adherence and level of knowledge and attitude regarding the legal and ethical standards in nursing. In order to provide safe and high-quality care to patients it is deemed necessary for the nurses to possess adequate knowledge, favourable attitude as well as excellent level of implementing practices regarding the legal and ethical standards in nursing. It is for this reason that the aim of the study was to investigate the knowledge, attitude and practices regarding the legal and ethical standards in nursing practice among nurses at district hospitals in Namibia. Methods: A quantitative, cross-sectional descriptive design was applied in the study. The total study population of 239 who met the criteria were given the opportunity to partake in this study to target 161 participants for the study. Ethical clearance was granted by the Health Research Ethics Committee of Stellenbosch University en health ministry of Namibia. The data were collected using a self-administered questionnaire tested with Cronbach Alpha score 0.847. Hundred and fifty-one nurses agreed to partake in the study however only 144 questionnaires were completed and returned. Stata statistical software, version 17 was used to analyse the data and to determine comparisons between the variables. Results: The study revealed that the participants had good knowledge as the mean knowledge score was 80.63%. However, the participants had an unfavourable attitude towards the legal and ethical standards in nursing with a mean score of 52.77%. In addition, the participants had poor practices regarding the legal and ethical standards in nursing with a mean score of 67.31%, which is <80%. The Two-sample t-test shows significance when comparing knowledge with the gender ( females scored higher) and nursing categories (registered nurses scored higher); the Pearson chi-square and Fisher’s exact tests show a significance in the association of attitude and practice with age, nursing categories, qualification and work experience; ANOVA test result show significance in the participants qualification and the their knowledge score and Bonferonni post-hoc results found statistically significant between a two year Certificate in enrolled nursing and midwifery and a 4-year Diploma in comprehensive nursing and midwifery science ( p<0.05). Conclusion: The study revealed that the nurses' attitudes are unfavourable towards the legal and ethical standards in nursing. Although they possessed sufficient knowledge, they had poor application practices in relation to the legal and ethical standards in nursing. Therefore, it is recommended that stakeholders of nursing practice at the district hospitals increase awareness and strengthen the culture of legal and ethical standards of the profession.
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    The perception of wellness of undergraduate nursing students at a nursing education institution
    (Stellenbosch : Stellenbosch University, 2024-03) van Papendorp, Cristelle; van Schalkwyk, Talita; Jordan, P. J., (Portia Janine); Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Nursing & Midwifery.
    ENGLISH SUMMARY: Introduction and problem statement: Addressing the misalignment of wellness within the higher education environment is vital for student success. It has therefore been recommended to implement holistic wellness programmes as part of the curriculum. Society’s expectation that nursing professionals should be role models for wellness indicate the need to examine the effectiveness of the wellness approach within current nursing programmes and the wellness support provided to the students. Exploring undergraduate nursing students’ personal wellness practices and possible wellness barriers offers insight into the overall wellness perceptions among this population. The available wellness support within the undergraduate nursing programme at a nursing education institution in South Africa and the undergraduate students’ unique wellness needs and challenges were identified. Methods: A qualitative, exploratory, descriptive, and contextual research design was applied in this study, focusing on the undergraduate nursing students’ unique perceptions. The study was conducted at a nursing education institution in the Western Cape province of South Africa. A purposive sampling method was applied, comprising a sample of twenty-six undergraduate nursing students, enrolled in a 4-year Bachelor of Nursing programme. One focus group interview was conducted for each academic year group. The first-year group consisted of four participants, the second-year group of five participants, the third-year group of ten participants, and the fourth-year group of seven participants selected from the target population. A semi structured interview guide was used to collect narrative data from the participants during focus group interviews. Qualitative reflexive thematic analysis was used to analyse the data collected. Ethical approval was obtained from the Health Research Ethics Committee of Stellenbosch University, and institutional permission was obtained from the Division for Information Governance at the chosen nursing education institution. The study adhered to the principles of ensuring trustworthiness and ethical standards. Results: Four overarching themes and 13 sub-themes emerged through the data. The findings showed that the participants in this study were familiar with the concept of wellness and made conscious efforts to incorporate wellness practices within their own lives. The overall findings suggests that each individual’s perceptions of wellness are unique, and their wellness needs and goals depend on their wellness knowledge, personal experience, and unique circumstances. The participants were overall satisfied with their personal wellness choices across the wellness dimensions, but various wellness barriers were reported. The main wellness barriers linked to the academic programme were diverse teaching strategies, inconsistent academic schedules, and language barriers. Additional wellness barriers identified were inaccessible resources, time constraints, campus culture, financial constraints, and additional responsibilities. The findings revealed that the participants in the first academic year group particularly struggled with academic transition and the peer mentoring structure within the academic programme provided valuable support during this period of transition. The findings suggest that although wellness support structures and resources were available in the academic programme, challenges were reported with the accessibility of important resources. Conclusion: In conclusion, to incorporate wellness initiatives and support structures into an academic programme requires precision to address the variety of wellness needs, barriers, and the uniqueness of each individual within the specific population it serves.
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    Exploring the role of the nurse educator, at a nursing education institution in Cape Town, on preparing undergraduate nursing students to provide compassionate nursing care
    (Stellenbosch : Stellenbosch University, 2024-03) Lotz, Claudette; Robertson, Anneline; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Nursing & Midwifery.
    ENGLISH SUMMARY: Background: Compassionate nursing care (CNC) involves recognizing and understanding an individual's vulnerability, going beyond the clinical aspect, to embrace a patient-centred approach with respect, empathy, kindness, and care. It is an approach that acknowledges humanity and alleviating suffering with understanding. Nurse educators are largely responsible to facilitate nursing students to provider CNC, but the lack of clarity on specific program curricula poses a challenge. To effectively produce nurses capable of providing CNC, detailed teaching strategies need to be implemented. This study explored the role of the nurse educator, at a Nursing education institution in Cape Town, on preparing undergraduate nursing students to provide compassionate nursing care. Methods: A qualitative explorative design was used to explore the nurse educators’ views on their role in, preparing an undergraduate nursing student to provide compassionate nursing care. Ethical approval was obtained from the Health Research Ethics Committee at the Stellenbosch University, Western Cape Department of Health and the selected NEI, before data collection commenced. Convenience sampling was used to select nurse educators, who had experience in undergraduate nursing education between six and 21 years. Eight in depth interviews were performed using a semi structured interview guide. The interviews were transcribed and analysed using transcript coding, by identifying key messages in each transcript, categorised on an Excel spreadsheet. The data that was collected from the interviews were unpacked, observed, and compared to reveal patterns, comparisons, and diversities. Subsequently, the themes that inherently supported the identified data were categorized into specific themes and subthemes. Results: Four themes emerged: Defining CNC, providing compassionate nursing care, CNC and the curriculum, and the role of the nursing educator in teaching and assessment of CNC.16 Sub themes emerged. The educator’s definition of compassionate care involves recognizing and comprehending the vulnerability of an individual and their circumstances, and it entails demonstrating respect, empathy, a kind approach, caring, and sensitivity. These attributes may be expressed as awareness of a situation when a person is vulnerable and suffering, physically or emotionally. Participants expressed that CNC is accepting and respecting the patient’s culture, understanding what a person is experiencing and then responding with empathy and sensitivity to their needs, thereby providing person centred care. Ethical principles, including autonomy and confidentiality, are introduced early in the program, seamlessly integrated throughout the curriculum. Compassionate care is taught from the first semester and remains a consistent element in every module. The educators noted varying student capacities for learning and delivering compassionate care, with some displaying immediate aptitude and others gaining confidence gradually over time. Conclusion: The findings revealed that, the nurse educator has a key role in preparing nursing students to be competent in providing CNC through theoretical and clinical assessments. Various factors in the students’ journey contribute to their development into becoming competent providers of compassionate nursing care. The participants expressed that integrating a compassion module on CNC in the undergraduate program will benefit both the students and patients.