A best practice guideline for patient-centred care in public hospitals in Nelson Mandela Bay
- Authors: Jardien-Baboo, Sihaam
- Date: 2014
- Subjects: Patient-centered health care -- South Africa -- Nelson Mandela Bay Municipality , Evidence-based medicine -- South Africa -- Nelson Mandela Bay Municipality , Public health nurses -- South Africa -- Nelson Mandela Bay Municipality , Public hospitals -- South Africa -- Nelson Mandela Bay Municipality
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: vital:10063 , http://hdl.handle.net/10948/d1020370
- Description: In South Africa, the quality of health care is directly related to the concept of patient-centred care and the enactment of the Batho Pele Principles and the Patients’ Rights Charter. The quality of health care delivery has dropped drastically, and reports in the media indicate that public hospitals in the Eastern Cape Province are on the brink of collapse, with thousands of patients being treated in condemned hospitals. Receiving and rendering health care in the face of such challenges, the question arose: “Are patients receiving patient-centred care in public hospitals?” The answer to this rhetorical inquiry appeared to be obvious, but this research study explored and described professional nurses’ perceptions of patient-centred care in public hospitals and their understanding of evidence-based practice and best practice guidelines. The proposed study followed a qualitative, exploratory, descriptive and contextual design. The research population included professional nurses who are employed in public hospitals in Nelson Mandela Bay, and consisted of nurse managers and nurses who work in the wards. The research study consisted of three phases. In Phase 1, semi-structured interviews and focus groups were conducted with nurse managers and professional nurses working in the wards in order to collect data about their perceptions of patient-centred care and their understanding of evidence-based practice and best practice guidelines. The interviews were transcribed and Tesch’s eight steps of data analysis were followed to create meaning from the data collected. Themes were identified and grouped together to form new categories. The researcher ensured the validity of the study by conforming to Lincoln and Guba’s model of trustworthiness, which consists of the following four constructs: credibility, transferability, dependability and confirmability. An independent coder assisted with the coding process. In Phase 2, an integrative literature review was conducted in order to identify previous guidelines regarding best practice for patient-centred care. Relevant guidelines were selected, critically appraised, data was extracted and synthesised for the development of a best practice guideline for patient-centred care. An independent appraiser critically appraised the guidelines, thereby ensuring trustworthiness. In Phase 3, the data in Phase 1 and Phase 2 were integrated to formulate a draft best practice guideline for patient-centred care. The guideline was submitted to an expert panel for review and was modified according to the recommendations of the panel, whereby the best practice guideline for patient-centred care in public hospitals in Nelson Mandela Bay was finalized.
- Full Text:
- Date Issued: 2014
- Authors: Jardien-Baboo, Sihaam
- Date: 2014
- Subjects: Patient-centered health care -- South Africa -- Nelson Mandela Bay Municipality , Evidence-based medicine -- South Africa -- Nelson Mandela Bay Municipality , Public health nurses -- South Africa -- Nelson Mandela Bay Municipality , Public hospitals -- South Africa -- Nelson Mandela Bay Municipality
- Language: English
- Type: Thesis , Doctoral , DPhil
- Identifier: vital:10063 , http://hdl.handle.net/10948/d1020370
- Description: In South Africa, the quality of health care is directly related to the concept of patient-centred care and the enactment of the Batho Pele Principles and the Patients’ Rights Charter. The quality of health care delivery has dropped drastically, and reports in the media indicate that public hospitals in the Eastern Cape Province are on the brink of collapse, with thousands of patients being treated in condemned hospitals. Receiving and rendering health care in the face of such challenges, the question arose: “Are patients receiving patient-centred care in public hospitals?” The answer to this rhetorical inquiry appeared to be obvious, but this research study explored and described professional nurses’ perceptions of patient-centred care in public hospitals and their understanding of evidence-based practice and best practice guidelines. The proposed study followed a qualitative, exploratory, descriptive and contextual design. The research population included professional nurses who are employed in public hospitals in Nelson Mandela Bay, and consisted of nurse managers and nurses who work in the wards. The research study consisted of three phases. In Phase 1, semi-structured interviews and focus groups were conducted with nurse managers and professional nurses working in the wards in order to collect data about their perceptions of patient-centred care and their understanding of evidence-based practice and best practice guidelines. The interviews were transcribed and Tesch’s eight steps of data analysis were followed to create meaning from the data collected. Themes were identified and grouped together to form new categories. The researcher ensured the validity of the study by conforming to Lincoln and Guba’s model of trustworthiness, which consists of the following four constructs: credibility, transferability, dependability and confirmability. An independent coder assisted with the coding process. In Phase 2, an integrative literature review was conducted in order to identify previous guidelines regarding best practice for patient-centred care. Relevant guidelines were selected, critically appraised, data was extracted and synthesised for the development of a best practice guideline for patient-centred care. An independent appraiser critically appraised the guidelines, thereby ensuring trustworthiness. In Phase 3, the data in Phase 1 and Phase 2 were integrated to formulate a draft best practice guideline for patient-centred care. The guideline was submitted to an expert panel for review and was modified according to the recommendations of the panel, whereby the best practice guideline for patient-centred care in public hospitals in Nelson Mandela Bay was finalized.
- Full Text:
- Date Issued: 2014
(Re-)inventing our selves/ourselves : identity and community in contemporary South African short fiction cycles.
- Authors: Marais, Susan Jacqueline
- Date: 2014
- Subjects: South African fiction (English) -- History and criticism , Matlou, Joël -- Criticism and interpretation , Magona, Sindiwe -- Criticism and interpretation , Vladislavić, Ivan, 1957- -- Criticism and interpretation , Wicomb, Zoë -- Criticism and interpretation
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: vital:2326 , http://hdl.handle.net/10962/d1016357
- Description: In this study I focus on a number of collections of short fiction by the South African writers Joël Matlou, Sindiwe Magona, Zoë Wicomb and Ivan Vladislavić, all of which evince certain of the characteristics of short story cycles or sequences. In other words, they display what Forrest L. Ingram describes as “a double tendency of asserting the individuality of [their] components on the one hand and of highlighting, on the other, the bonds of unity which make the many into a single whole”. The cycle form, thus defined, is characterised by a paradoxical yet productive and frequently unresolved tension between “the individuality of each of the stories and the necessities of the larger unit”, between “the one and the many”, and between cohesion and fragmentation. It is this “dynamic structure of connection and disconnection” which singularly equips the genre to represent the interrelationship of singular and collective identities, or the “coherent multiplicity of community”. Ingram, for example, asserts that “Numerous and varied connective strands draw the co-protagonists of any story cycle into a single community. … However this community may be achieved, it usually can be said to constitute the central character of a cycle”. Not unsurprisingly, then, in its dominant manifestations over much of the twentieth century the short story cycle demonstrated a marked inclination towards regionalism and the depiction of localised enclaves, and this tendency towards “place-based short story cycles” in which topographical unity is a conspicuous feature was as pronounced in South Africa as elsewhere. However, the specific collections which are my concern here increasingly employ innovative and self-reflexive narrative strategies that unsettle generic expectations and interrogate the notions of regionalism and community conventionally associated with the short story cycle. My investigation seeks to explain this shift in emphasis, and its particular significance within the South African context.
- Full Text:
- Date Issued: 2014
- Authors: Marais, Susan Jacqueline
- Date: 2014
- Subjects: South African fiction (English) -- History and criticism , Matlou, Joël -- Criticism and interpretation , Magona, Sindiwe -- Criticism and interpretation , Vladislavić, Ivan, 1957- -- Criticism and interpretation , Wicomb, Zoë -- Criticism and interpretation
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: vital:2326 , http://hdl.handle.net/10962/d1016357
- Description: In this study I focus on a number of collections of short fiction by the South African writers Joël Matlou, Sindiwe Magona, Zoë Wicomb and Ivan Vladislavić, all of which evince certain of the characteristics of short story cycles or sequences. In other words, they display what Forrest L. Ingram describes as “a double tendency of asserting the individuality of [their] components on the one hand and of highlighting, on the other, the bonds of unity which make the many into a single whole”. The cycle form, thus defined, is characterised by a paradoxical yet productive and frequently unresolved tension between “the individuality of each of the stories and the necessities of the larger unit”, between “the one and the many”, and between cohesion and fragmentation. It is this “dynamic structure of connection and disconnection” which singularly equips the genre to represent the interrelationship of singular and collective identities, or the “coherent multiplicity of community”. Ingram, for example, asserts that “Numerous and varied connective strands draw the co-protagonists of any story cycle into a single community. … However this community may be achieved, it usually can be said to constitute the central character of a cycle”. Not unsurprisingly, then, in its dominant manifestations over much of the twentieth century the short story cycle demonstrated a marked inclination towards regionalism and the depiction of localised enclaves, and this tendency towards “place-based short story cycles” in which topographical unity is a conspicuous feature was as pronounced in South Africa as elsewhere. However, the specific collections which are my concern here increasingly employ innovative and self-reflexive narrative strategies that unsettle generic expectations and interrogate the notions of regionalism and community conventionally associated with the short story cycle. My investigation seeks to explain this shift in emphasis, and its particular significance within the South African context.
- Full Text:
- Date Issued: 2014
"I felt that I deserved it" : an Investigation into HIV-related PTSD, traumatic life events, and the personal experiences of living with HIV : a mixed-method study
- Authors: Boulind, Melissa Jane
- Date: 2014
- Subjects: Post-traumatic stress disorder -- Psychological aspects -- Research -- South Africa -- Kwazulu HIV infections -- Psychological aspects -- Research -- South Africa -- Kwazulu HIV-positive persons -- South Africa -- Kwazulu -- Interviews Psychic trauma -- Research Stress (Psychology) -- Research
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: vital:3211 , http://hdl.handle.net/10962/d1012172
- Description: There appears to be a growing body of literature focusing on PTSD and HIV-related PTSD (the diagnosis of HIV being the significant traumatic event) amongst HIV-positive samples, but only a few African studies that attempt to estimate the prevalence of PTSD amongst HIV-positive people, and even fewer that attempt to estimate the prevalence of HIV-related PTSD. The systemic review presented in this study is currently fully inclusive and is the most up-to-date available. Estimates of the prevalence of PTSD and HIV-related PTSD in South Africa range from 0.7 to 54.1% and, 4.2 to 40% respectively. The current cross-sectional study made use of a mixed-method approach to investigate traumatic life events, PTSD and HIV-related PTSD within a primary health-care centre in KwaZulu-Natal. The quantitative sample consisted of 159 adults (18-50 years) who were compliant on ARV medication. Using the CIDI-PTSD module, the adapted CIDI-PTSD module for HIV, and IES-R, findings indicated that 62% had reported some kind of traumatic event in their lifetime, with 29.6% of participants meeting the criteria for lifetime PTSD, and 40.9% meeting the criteria for lifetime HIV-related PTSD. Altogether, 57.9% of individuals met the criteria for some form of PTSD (either regular PTSD or HIV-related PTSD), and 12.6% met the criteria for both PTSD and HIV-related PTSD. Of the different categories of traumatic events, interpersonal violence has the highest rate of PTSD, followed by a diagnosis of and living with HIV, and then disaster. Furthermore, the IES-R was compared for its usefulness as a screening measure for PTSD against both the CIDI, but results suggest that it is an inferior screening measure to the PDS. The qualitative study consisted of six participants who were examined using IPA methodology informed by the Ehlers and Clark (2000) Model of trauma. Their experiences revealed experiences of stigma, a number of negative appraisals, negative emotions and coping behaviours. Some of the latter might serve as compensatory mechanisms to avoid negative judgements. Hypervigilance seems to be a feature of ARV-compliance that might confer added vulnerability to PTSD and other anxiety disorders.
- Full Text:
- Date Issued: 2014
- Authors: Boulind, Melissa Jane
- Date: 2014
- Subjects: Post-traumatic stress disorder -- Psychological aspects -- Research -- South Africa -- Kwazulu HIV infections -- Psychological aspects -- Research -- South Africa -- Kwazulu HIV-positive persons -- South Africa -- Kwazulu -- Interviews Psychic trauma -- Research Stress (Psychology) -- Research
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: vital:3211 , http://hdl.handle.net/10962/d1012172
- Description: There appears to be a growing body of literature focusing on PTSD and HIV-related PTSD (the diagnosis of HIV being the significant traumatic event) amongst HIV-positive samples, but only a few African studies that attempt to estimate the prevalence of PTSD amongst HIV-positive people, and even fewer that attempt to estimate the prevalence of HIV-related PTSD. The systemic review presented in this study is currently fully inclusive and is the most up-to-date available. Estimates of the prevalence of PTSD and HIV-related PTSD in South Africa range from 0.7 to 54.1% and, 4.2 to 40% respectively. The current cross-sectional study made use of a mixed-method approach to investigate traumatic life events, PTSD and HIV-related PTSD within a primary health-care centre in KwaZulu-Natal. The quantitative sample consisted of 159 adults (18-50 years) who were compliant on ARV medication. Using the CIDI-PTSD module, the adapted CIDI-PTSD module for HIV, and IES-R, findings indicated that 62% had reported some kind of traumatic event in their lifetime, with 29.6% of participants meeting the criteria for lifetime PTSD, and 40.9% meeting the criteria for lifetime HIV-related PTSD. Altogether, 57.9% of individuals met the criteria for some form of PTSD (either regular PTSD or HIV-related PTSD), and 12.6% met the criteria for both PTSD and HIV-related PTSD. Of the different categories of traumatic events, interpersonal violence has the highest rate of PTSD, followed by a diagnosis of and living with HIV, and then disaster. Furthermore, the IES-R was compared for its usefulness as a screening measure for PTSD against both the CIDI, but results suggest that it is an inferior screening measure to the PDS. The qualitative study consisted of six participants who were examined using IPA methodology informed by the Ehlers and Clark (2000) Model of trauma. Their experiences revealed experiences of stigma, a number of negative appraisals, negative emotions and coping behaviours. Some of the latter might serve as compensatory mechanisms to avoid negative judgements. Hypervigilance seems to be a feature of ARV-compliance that might confer added vulnerability to PTSD and other anxiety disorders.
- Full Text:
- Date Issued: 2014