Scielo RSS <![CDATA[Health SA Gesondheid (Online)]]> http://www.scielo.org.za/rss.php?pid=2071-973620080001&lang=en vol. 13 num. 1 lang. en <![CDATA[SciELO Logo]]> http://www.scielo.org.za/img/en/fbpelogp.gif http://www.scielo.org.za <![CDATA[<b>Editorial Comments</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362008000100001&lng=en&nrm=iso&tlng=en <![CDATA[<b>Good-bye to Liselle Viljoen</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362008000100002&lng=en&nrm=iso&tlng=en <![CDATA[<b>The experiences of first-time mothers with colic infants who seek help from medical professionals</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362008000100003&lng=en&nrm=iso&tlng=en The purpose of this study was to describe the experiences of first-time mothers with colic infants. The research design was qualitative, exploratory, descriptive and contextual. Data were collected by means of in-depth, semi-structured, phenomenological interviews and a descriptive analysis was done. The results show that the real experience of having a baby did not meet mothers' expectations. Furthermore, colic babies were anxiety-provoking and mothers struggled with feelings of failure. They searched for an explanation for the colic, but felt disillusioned with the medical profession. Mothers exhibited a need for a containing figure. They also reflected on their relationship with their mothers. Mothers felt ambivalent towards their babies and marital relationships became strained. Lastly, mothers renegotiated their identity. Based on the results, suggestions for mental health professions were made with regard to providing parent-child therapy, support for the mother and strengthening the marital relationship. The importance of psychological interventions was emphasised as a source of support for these mothers.<hr/>Die doel van hierdie studie was om die ervarings van eerstekeermoeders met koliekbabas te beskryf. Die navorsingsontwerp was kwalitatief, ondersoekend, beskrywend en kontekstueel van aard. Data is ingesamel deur middel van indiepte, semi-gestruktureerde, fenomenologiese onderhoude en 'n beskrywende ontleding is gedoen. Die resultate het getoon dat die beleefde ervarings om 'n koliekbaba te hê, nie aan die moeders se verwagtinge voldoen het nie. Voorts veroorsaak koliekbabas angs en moeders stry teen gevoelens van mislukking. In hul soeke na 'n verklaring vir die koliek, voel hulle ontnugter met die mediese professie. Moeders het 'n behoefte aan 'n ondersteunende persoon uitgedruk en gereflekteer op hul verhouding met hulle eie ma's. Moeders het ambivalent oor hul babas gevoel en hul huweliksverhoudings het gespanne geword. Laastens het moeders hulle identiteit as moeders heroorweeg. Op grond van die resultate word voorstelle vir professionele geestesgesondheidwerkers met betrekking tot ouer-kindterapie, ondersteuning aan die moeder en versterking van die huweliksverhouding, gemaak. Laastens word die belangrikheid van sielkundige intervensies in die hantering van koliek as 'n hulpbron vir hierdie moeders beklemtoon. <![CDATA[<b>Health promotion needs of Hammanskraal families with adolescents orphaned by HIV/AIDS</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362008000100004&lng=en&nrm=iso&tlng=en Health promotion is regarded as the cornerstone of good health. It is the action expected from individuals and families in order to better their own health situation. Health promotion is an art and science (Edelman & Mandle, 2002:16) that is integrated into the primary health care to reduce existing health problems. The purpose of the research on which this article is reporting, was to explore and describe the health promotion needs of families with adolescents orphaned by human immunodeficiency virus or acquired immune deficiency syndrome (HIV/AIDS). The research was located within a qualitative paradigm that is both exploratory and descriptive. Eight families who were purposely selected participated in the research process. Qualitative methods, such as group interviews and field notes were utilised to collect data. The health promotion needs of the families with adolescents orphaned by HIV/AIDS were explored and described. Tesch's analysis process, which entails a series of steps, was followed (Creswell, 2003:192). Themes, categories and subcategories that form the central focus of health promotion needs emerged during the data analysis. These themes,categories and subcategories are used to develop guidelines for health promotion.<hr/>Die bevordering van gesondheid is die hoeksteen van gesondheid. Dit is die aksie wat van individue en familie verwag word, sodat hulle hul eie gesondheidstoestand kan verbeter. Die bevordering van gesondheid is 'n kuns en 'n wetenskap, wat geïntegreer is in primêre gesondheidsorg, om bestaande gesondheidsprobleme te verminder (Edelman & Mandle, 2002:16). Die doel van die navorsing, waarna in hierdie artikel verwys word, was om uit te vind wat die gesondheidsorgbehoeftes van families, met adolessente wat wees gelaat is as gevolg van menslike immunogebrek virus of verworve immuungebrek sindroom (MIV/VIGS), is, en dit te beskryf. Die navorsing was binne die raamwerk van 'n kwalitatiewe paradigma, wat eksplorerend en beskrywend is. Agt families, wat vir die doel geselekteer is, het aan die navorsing deelgeneem. Kwalitatiewe metodes, soos groepsonderhoude en veldnotas, is gebruik om data in te samel. Die gesondheidsorgbehoeftes van die families, met adolessente wat wees gelaat is as gevolg van MIV/VIGS, is ondersoek en beskryf. Tesch se analiseproses, wat uit 'n aantal stappe bestaan, is gevolg (Creswell, 2003:192). Temas, kategorieë en sub-kategorieë, wat die sentrale fokus van die gesondheidsorgbehoeftes vorm, het uit die data-analise na vore gekom. Hierdie temas, kategorieë en sub-kategorieë, is gebruik om riglyne te ontwikkel vir gesondheidsbevordering. <![CDATA[<b>Caregiver experiences and perceptions of stroke</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362008000100005&lng=en&nrm=iso&tlng=en With the increasing prevalence of people in developing countries who suffer strokes, the long-term care of people who have had a stroke and who are living with disabilities has substantial consequences for caregivers and their respective families. As the caregiver plays a pivotal role in the rehabilitation of the people who have had a stroke, the objectives of this study constitute an investigation into the complexities of caregiving, including both perceptions and experiences of the healthcare system. Semi-structured interviews were utilised to elicit post-stroke experiences of six caregivers. The challenge the South African context adds to these experiences was probed. The data were analysed qualitatively by thematic and content analysis. Prominent themes associated with caregiving included: role changes and relationship disruptions within the family, occupational and social implications, fatigue, anxiety, depression, loneliness, frustration as well as financial problems. Caregiver experiences were exacerbated by the inadequate support structures available. The results are interpreted within a biopsychosocial approach, concluding with the concerns raised by caregivers on the support they require from the healthcare system in order to provide home-based care.<hr/>Met die toenemende voorkoms van beroerte in ontwikkelende lande bring die langdurige versorging van pasiënte met gestremdheid beduidende gevolge vir sorggewers en hulle onderskeie gesinne mee. Aangesien die sorggewer 'n sleutelrol in die rehabilitasie van die beroertepasiënt speel, behels die doelstellings van hierdie studie 'n ondersoek na die verwikkeldhede van versorging, wat sowel persepsies as ondervinding van die gesondheidsorgstelsel insluit. Semi-gestruktureerde onderhoude is aangewend om die na-beroerte ondervindings van ses sorggewers te peil. Die uitdaging wat die Suid- Afrikaanse konteks tot hierdie ondervindings meebring is ondersoek. Die data is kwalitatief deur middel van tematiese en inhoudsanalise ontleed. Prominente temas wat verbandhou met sorggewing sluit in: rolverandering en verhoudingsteurnisse binne die huisgesin, beroeps- en sosiale implikasies, uitputting, angs, depressie, eensaamheid, frustrasie sowel as finansiële probleme. Die probleme van sorggewers word vererger deur ontoereikende steunstrukture. Die resultate word binne 'n biopsigososiale benadering ontleed, en saamgevat met probleme wat sorggewers uitspreek ten opsigte van die steun wat hulle van die gesondheidsorgstelsel benodig om tuisgebaseerde sorg te kan voorsien. <![CDATA[<b>Outpatients' experiences of quality service delivery at a teaching hospital in Gauteng</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362008000100006&lng=en&nrm=iso&tlng=en Quality service delivery to the consumer of health is a legal reality as it is emphasised in the White Paper on the Transformation of Public Service delivery (South Africa, 1997). The guiding philosophy adopted within this framework is that of Batho Pele, which means placing the consumer at the centre of healthcare service delivery. Increasing attention has been paid to hospital processes from a quality perspective. By analogy, outpatient departments can be viewed as industrial plants where technological know-how is transferred to patients through service delivery, which is a cornerstone of a hospital's business. Outpatients, as consumers of healthcare, draw conclusions about the quality of service delivery based on their experiences of such services. In this vein, an outpatient's experience of a particular service is an indicator of his/her level of satisfaction with the quality of that service. No South African study can be found in the literature on out-patients' experiences of quality service delivery. This study's purpose is to explore and describe outpatients' experiences of the quality of service delivery at a teaching hospital in Gauteng. A qualitative, explorative, descriptive study that was contextual in nature was conducted to achieve this aim. Focus group interviews were conducted with outpatients who met the selection criteria. Open coding was used to analyse the contents from the transcripts and field notes typed verbatim. Strategies for trustworthiness, namely co-coding, prolonged engagement, triangulation and adequate referencing, were employed to ensure the credibility of the study and research findings. The results reflect themes that were reduced into two main categories, namely positive and negative experiences. The positive experiences reflect outpatients' experience of their relationship with medical staff and their satisfaction with the quality of medical care. Negative experiences relate predominantly to a lack of service commitments, unethical context, and inter-personal relationship difficulties that render them powerless and dehumanised. Recommendations are made to improve the quality of service delivery at outpatient departments.<hr/>Gehalte dienslewering aan die verbruiker van gesondheidsorg is 'n wetlike realiteit wat in die Witskrif op die Transformasie van die Openbare Dienste (South Africa, 1997) beklemtoon word. Die rigtinggewende filosofie wat in hierdie raamwerk aangeneem word is die van Batho Pele, wat beteken dat die verbruiker van gesondheidsorg op die voorgrond geplaas word. Vanuit 'n gehalte perspektief word daar toenemend aandag aan hospitaalprosesse gegee. Analogies, kan 'n buite-pasiëntdepartement gesien word as 'n industriële area waar die tegnologiese kennis aan pasiënte oorgedra word deur dienslewering, wat 'n hoeksteen van die besigheid van 'n hospitaal is. Buitepasiënte as verbruikers van gesondheidsorg maak gevolgtrekkings oor gehaltedienslewering op die basis van hulle belewenisse van sodanige dienste. In dié opsig, is 'n pasiënt se belewenis van 'n bepaalde diens 'n aanwysing van sy/haar vlak van tevredenheid met die gehalte van daardie diens. Geen Suid-Afrikaanse studie oor buite-pasiënte se belewenisse van gehaltedienslewering kon in die literatuur gevind word nie. Die doelstelling van die studie is om buite-pasiënte se belewenisse van die gehalte van dienslewering by 'n opleidingshospitaal te verken en te beskryf. 'n Kwalitatiewe, verkennende, beskrywende studie wat binne 'n spesifieke konteks plaasvind, is uitgevoer. Fokusgroeponderhoude is gevoer met buite-pasiënte wat aan die seleksie-kriteria voldoen het. Oop-kodering is gebruik om die inhoud van die verbatim getranskribeerde transkripsies en veldnotas te analiseer. Strategieë vir vertrouenswaardigheid, naamlik mede-kodering, verlengde betrokkenheid, kruisvalidasie en voldoende verwysing is toegepas om die geloofwaardigheid van die studie en navorsingsbevindinge te verseker. Resultate reflekteer temas wat binne twee hoofkategorieë gereduseer is, naamlik positiewe en negatiewe belewenisse. Positiewe belewenisse reflekteer buite-pasiënte se belewenisse van hulle verhoudings met mediese personeel asook hulle tevredenheid met die gehalte van mediesesorg. Negatiewe belewenisse hou hoofsaaklik verband met 'n gebrek aan diensleweringverbintenisse, 'n onetiese konteks, asook interpersoonlike verhoudingsprobleme wat hulle magteloos en verontmenslik laat voel. Aanbevelings word gemaak om die gehalte van dienslewering binne buite-pasiënte-afdelings te verbeter. <![CDATA[<b>Mothers' experiences of labour in a tertiary care hospital</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362008000100007&lng=en&nrm=iso&tlng=en The purpose of the study was to explore and describe experiences of mothers during childbirth in a tertiary hospital in the Limpopo Province. This was achieved through a qualitative research study which was exploratory, descriptive, contextual and inductive in nature. A sample of 24 mothers participated in this study. Data obtained from unstructured in-depth interviews were analysed according to the protocol by Tesch (1990, cited in Cresswell, 1994:155). Five themes were identified, namely mutual participation and responsibility sharing, dependency and decision-making; information sharing and empowering autonomy and informed choices; open communication and listening; accommodative/non-accommodative midwifery actions; and maximising human and material infrastructure. The themes indicated experiences that foster or promote dependency on midwifery care. Guidelines on how to transform this dependency into a mother-centered care approach during childbirth are provided.<hr/>Die doel van die studie was om moeders se belewenis van kindergeboorte in 'n tersiêre hospitaal in die Limpopo Provinsie te verken en te beskryf. Dit is gedoen deur middel van kwalitatiewe navorsing wat verkennend, beskrywend, en kontekstueel was. 'n Steekproef van 24 moeders het aan die studie deelgeneem. Inligting is verkry deur middel van ongestruktureerde in-diepte onderhoude. Hierdie inligting is geanaliseer aan die hand van Tesch (1990: aangehaal in Creswell, 1994:155) se protokol. Die volgende kategorieë is geïdentifiseer, wedersydse deelname en gedeelde verantwoordelikhede, afhanklikheid en besluitneming, deel van inligting, bemagtiging tot outonomie en ingeligte keuse, oop kommunikasie en luister, akkommoderende/nie-akkommoderende vroedvrou-aksies en bevordering van menslike en materiële infrastrukture. Die resultate van die onderhoude het belewenisse blootgelê wat dui op die bevordering van afhanklikheid in vroedvrouversorging. Riglyne om hierdie afhanklikheid te verander in 'n moedergesentreerde benadering word verskaf. <![CDATA[<b>Organisational culture of hospitals to predict turnover intentions of professional nurses</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-97362008000100008&lng=en&nrm=iso&tlng=en The objective of this study was to determine if organisational culture predicts turnover intentions of professional nurses. A predictive model with organisational culture and various proposed mediating variables, namely knowledge sharing, organisational commitment, organisational citisenship behaviour and job satisfaction, as well as various demographic variables was developed to determine turnover intentions through applying General Linear Modelling. A correlational design with questionnaires was used. A sample of professional nurses (N = 530) in private and provincial hospitals was obtained. The results indicate that organisational culture has a significantly negative correlation with turnover intentions. Organisational culture also interacted with job satisfaction, knowledge sharing, and the white professional nurses' category to decrease turnover intentions and with Organisational Citisen Behaviours to increase turnover intentions in a final predictive model. It is therefore recommended that nursing employers seriously embark on strategies to improve the organisational culture to retain their talent.<hr/>Die doel van die studie was om te bepaal of organisasiekultuur arbeidsomset-voornemens van professionele verpleegkundiges voorspel. 'n Voorspellingsmodel met organisasiekultuur en verskeie voorgestelde tussenkomende veranderlikes, naamlik kennisdeling, organisasieverbintenis, organisasie-burgerskapsgedrag en werkstevredenheid, asook verskeie demografiese veranderlikes was ontwikkel deur Algemene Liniêre Modellering. 'n Korrelasie-ontwerp met behulp van vraelyste is gebruik. 'n Steekproef van professionele verpleegkundiges (N = 530) in private en provinsiale hospitale is verkry. Die resultate toon dat organisasiekultuur betekenisvol negatief korrelleer met arbeidsomsetvoornemens. Organisasiekultuur het ook in interaksie met werkstevredenheid en kennisdeling, asook die kategorie blanke verpleegkundiges in 'n finale model arbeidsomsetvoornemens verlaag en saam met organisasie-burgerskapsgedrag arbeidsomsetvoornemens verhoog. Daar word aanbeveel dat werkgewers oorweging skenk aan intervensies wat die organisasiekultuur gunstiger maak om personeel te behou.