Are ethics committees always ethical?
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Conflict of Interest↗
Biomedical subjects
Leana R Uys
Publications and source records attributed to Leana R Uys.
The effect of two models of supervision on selected outcomes.
PURPOSE: To evaluate the effect of training in two different supervisory models on the supervision itself, the quality of care, and job satisfaction of nurses in different service settings in a district health service (DHS) in South Africa. DESIGN: As part of a larger health systems study, the results of supervision training were evaluated. The quantitative study was done in three health districts in South Africa. METHODS: The modified matrix (MM) model of supervision was taught and implemented in District A, the Centre for Health and Social Studies (CHESS) model in District B, and the control was District C. Checklists based on direct observation and record reviews were used to measure quality of care (quality of hand-over between shifts, nursing records, management of chronic diseases, and implementation of universal precautions). Questionnaires were used to measure perception of supervision and patient satisfaction. Chi-square analysis was done. FINDINGS AND CONCLUSIONS: Supervision ratings before and after the interventions differed significantly in the total sample, but not by district. In the district with the MM model, care for people with chronic diseases improved significantly, but other measures did not. The supervision training had some influence, but more measures of effectiveness of supervision training are needed.
Attitude of Health Personnel↗
A Survey of the quality of nursing care in several health districts in South Africa.
BACKGROUND: South Africa is currently focusing strongly on human resource development. The purpose of this study was to describe and compare the quality of nursing service and care in three health districts in the KwaZulu Natal Province. To identify deficiencies which could be addressed by education and training, it might be useful to measure the quality of care given by nurses. METHODS: From March to August 2002 a survey was done in six hospitals and six clinics in three health districts of the KwaZulu-Natal province of South Africa. Five different aspects of care was evaluated; hand-over from one nursing shift to another, implementation of universal precautions, patient satisfaction, nursing records, management of chronic illnesses. All these aspects were evaluated using checklists based on record reviews or direct observation, except for patient satisfaction, which was evaluated by questionnaires. RESULTS: The average scores on the different aspects varied from 11% (for nursing records) to 73% (for management of chronic diseases). Specific problems became evident. In one district three out of four hand-overs between shifts of nurses scored less than 50%. In all three districts the use of protective gear scored low (43%). While the average score for management of chronic illnesses were high at 73%, the blood pressures of only 23% was within the target range, and the blood sugar of only 38% of patients were controlled. Patient satisfaction averaged 72% across the three districts. CONCLUSION: The quality of care measurements identified specific training needs, but other management strategies are probably also indicated.
Journal Article↗
Problem-solving competency of nursing graduates.
AIM: This paper reports a study describing and evaluating the outcomes of problem-based learning (PBL) programmes in nursing schools in South Africa in terms of the competence of graduates to solve problem in actual clinical settings, and comparing this competence with that of graduates from non-PBL programmes. BACKGROUND: The nursing literature tends to equate problem-solving with patient-centred problems or the nursing process. However, it is also a skill used in managing the work role, working in a team and managing a health care unit. Problem-solving refers to the process of selectively attending to information in a patient care setting. The investigation of problem-solving in nursing is complicated by the complex relationships between different cognitive processes. METHODS: A qualitative evaluation study, descriptive and comparative in nature, was carried out. In-depth interviews were held with graduates and their supervisors, asking them to identify problem-solving incidents in which they had been involved. Template analysis style and Benner's interpretive approach were used to analyse the data. FINDINGS: The majority of the incidents described by the graduates (84%) were graded at the advanced beginner level or above. The majority of incidents at the novice level came from the non-PBL group. 'Using people skills' and 'being assertive' were the two problem-solving strategies most often used. The PBL group fared better than the non-problem-based group in the level of their problem-solving ability. CONCLUSION: The findings of this study suggest that further research is warranted into the problem-solving abilities of PBL graduates, their personal development over time and at different stages of practice. In addition, it would be interesting to follow the development of their problem-solving abilities over time.
Adult↗
The KwaZulu-Natal health promotion model.
PURPOSE: To describe a health promotion model aimed at assisting primary health care nurses to incorporate health promotion into their practice. ORGANIZING STRUCTURE: The model is based on empowering people through a systematic, planned, needs-driven curriculum with comprehensive content, using interactive teaching in small groups, and linking the groups with external resources. The process involves identifying and engaging partners, planning the project, implementing it, and then disengaging. METHODS: The implementation of this model in a province of South Africa, KwaZulu-Natal, in a collaborative project involving two universities and the state health services, changed the practice of the primary health care nurses involved. They worked with women's groups over 3 years and changed both their own perspectives and the lives of the women. CONCLUSIONS: Unless nurses have an implementation model available to them, they frequently focus only on illness needs of people and do not participate in health promotion.
Black People↗
The competence of nursing graduates from problem-based programs in South Africa.
Although a significant body of research regarding problem-based learning (PBL) programs has been conducted during the past 2 decades, most of it relates to medical students and their curricula. There has also been very little research in the context of developing countries. In South Africa, most of the students who are admitted into nursing programs are from disadvantaged backgrounds, and it is important to assess the extent to which process-based curricula are appropriate for this group. The purpose of this study was to describe and evaluate the outcomes of PBL programs in nursing schools in South Africa in terms of the actual clinical practice and competence of graduates, and to compare these outcomes with those of graduates from conventional programs. The objectives of the study were to identify the characteristics of practice of graduates from PBL and conventional schools of nursing in South Africa, as described by the graduates and their supervisors, and secondly, to compare the practice characteristics of the two groups.
Clinical Competence↗
HIV/AIDS nursing research in the African context.
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Africa, Southern↗
Aspects of the care of people with HIV/AIDS in South Africa.
The study was aimed at exploring the realization of counseling, palliative care, and terminal care in the care of people with HIV/AIDS in seven settings in South Africa. A descriptive study was performed in seven sites where a model of home-based care was implemented that links hospitals, clinics, and home-based care in a continuum. Data was collected from people with HIV/AIDS (PWA), their caretakers, health care workers, and community members using semistructured interviews, observation, taping of onsite meetings, and completion of questionnaires. Descriptive and nonparametric statistics were used to analyze the quantitative data, and the template approach was used to analyze the qualitative data. There is a need to extend counseling before and after diagnostic testing to counseling about living with HIV/AIDS. There is also a need to equip counselors to deal with children. Fifty-seven percent of patients died at home or in hospice. There is a significant relationship between a "good" death and dying at home. Palliative care in the formal health services was generally poor due mainly to lack of specific training in this field and the stigma associated with this diagnosis. Health care providers can change the experience of illness and death for PWA through adequate counseling, palliative care, and terminal care that meet professional standards.
Adolescent↗