Scielo RSS <![CDATA[Curationis]]> vol. 31 num. 4 lang. pt <![CDATA[SciELO Logo]]> <![CDATA[<b>Policy makers' perceptions and attitudes regarding incorporation of traditional healers into the national health care delivery system</b>]]> Based on mixed perceptions which were both negative and positive the policy makers have not been vocal about the process to incorporate traditional healers into the National Health Care Delivery System of South Africa. Negative views were related to the denial that traditional healing does provide a cure and the positive views were identified in the passing of policies from 1994. These policies passed initiated recognition of the existence of traditional healers, but failed to address the important aspect of incorporating the traditional healers into the National Health Care Delivery System. It is these mixed perceptions as well as lack of appropriate policy to facilitate incorporation of traditional healers that urged the researcher to explore the perceptions and attitudes of policy makers regarding this incorporation process, as well as their views on how it should be achieved. An exploratory, descriptive and contextual qualitative research design was followed. Participants were selected by non-probable, purposive voluntary sample. Data was collected by means of conducting semi-structured interviews, as well as taking field notes. Data analysis was achieved by analysing transcriptions through open coding involving a co-coder until consensus was achieved. Results reflect that policy makers are in favour of incorporation. In conclusion incorporation was seen as a process that needs to be undertaken by both traditional healers and biomedical personnel through communication. That government should be responsible for this process by policy formulation, which should clarify terms and conditions for incorporation. <![CDATA[<b>The nurses'experience of possible HIV infection after injury and/or exposure on duty</b>]]> The purpose of the research was to describe the experience of nurses in the studied hospital who had been exposed to possible HIV infection during injury or exposure on duty. A qualitative phenomenological descriptive study was used to describe the emotions and non-verbal reactions of the twelve participants during two subsequent in-depth interviews. These were conducted post-exposure, and after counselling and prophylactic treatment took place. The nursing staffs from a selected private hospital were included in the study after exposure of blood and/or human body fluid. After completion of the study, it was found that the exposed staff's experience had two main categories. Firstly, they were grieving for the loss of the concept of being healthy and invincible, blessed with nursing skills and definite goals in life. The bereavement process included phases of denial, anger, anxiety and fear, with recurring thoughts regarding the adverse events, as well as acceptance which developed with time. The bereavement process and shock of the exposure had wider consequences to the family, as well as an impact on the working environment. Most participants reported that they experienced genuine support and compassion from colleagues, at home and in the community. The second category of experience was the physical side effects which participant's developments developed due to the prophylactic antiretroviral therapy. Some participants experienced severe difficulties due to the treatment, while other had fewer problems. Some proposals to adjust and possibly improve the hospital's exposure surveillance system were developed from the research results, including that a 24-hour crisis management system be implemented for exposed staff members; that support groups be started for staff, colleagues and family members; that all staff receive orientation and support during unfamiliar procedures or placement in unknown departments; that all exposures-on-duty be investigated and studied so that pro-active or preventive measures may be devised; and that problems with staffing and working climate be resolved. All the findings and proposals were subsequently addressed to the relevant members of the Hospital Management. If healthcare services wish to retain nursing staff in future, more will need to be done to prevent all types of exposure-on-duty and, if they do occur, to anticipate, manage and shorten the subsequent period of the professional nurse or learner's bereavement. <![CDATA[<b>The experiences of informal care givers in home-based care in the ODI Sub-District area in the North West Provice</b>]]> The purpose of this study was to explore and describe the experiences of informal caregivers in home-based care in the Odi Sub-District area in the Province of the North West. A qualitative, exploratory and descriptive study was followed to collect data from the selected population. The study population consisted of informal caregivers who conduct home visitations in the Odi Sub-District area. Participants were purposively selected. Data were collected from the participants by means of focus group interviews, which were guided by the group moderator. The experiences of informal caregivers were shared through the participants' responses to a central research question. Tesch's qualitative method of data analysis was used to analyse the data. The experiences of informal caregivers were related to emotions, social circumstances and support. The participants placed emphasis on emotions of love and caring, fulfilment, frustration, exploitation, anger and helplessness, fear, rejection, shame and denial. Social circumstances regarding finance, antagonism and stigma were also emphasised. The participants raised the issue of the necessity of the support of the family, community and clinic during home-based care. It was recommended that this support group should assist families in dealing with fear, stigma and discrimination. Furthermore, it was recommended that the government should provide the services for developing and empowering informal caregivers in home-based care. <![CDATA[<b>An evaluation of the implementation of tuberculosis policies at a regional hospital in the Limpopo Province</b>]]> The current rate of tuberculosis infections as a result of new infections, as well as reinfections of patients is of concern to the disease control and policy-making bodies of South Africa. Questions regarding the effectiveness of tuberculosis policies and programmes emerge all the time. This study intended to evaluate the extent to which tuberculosis policies are implemented in a regional hospital in the Vhembe district in the Limpopo Province. The study was conducted using a qualitative, descriptive, exploratory and contextual design. A purposive sample of professional nurses who work in medical wards was selected, and voluntary participation was ensured. Data was collected through individual interviews, which were audiotaped and then transcribed verbatim. The researcher used an observation checklist to find out which policies were available and accessible that dealt with the management of tuberculosis. Findings revealed that tuberculosis policies were not available in the medical wards and not accessible on shelves. Participants expressed lack of knowledge about the existing tuberculosis policies. Lack of information was attributed to insufficient policy information dissemination associated with lack of in-service training and reporting mechanisms after workshops. Shortage of treatment was also indicated as a deterrent to effective policy implementation. The conclusion was reached, based on the findings of the research, that unless there was ongoing monitoring and evaluation of tuberculosis policies at local clinic level, including hospital level, tuberculosis policies would continue to be talked about at a broader (global) level without the focus on implementation at grassroots level. Strategies should be put in place to encourage professional nurses' ownership of policies. <![CDATA[<b>Interdepartmental communication at tertiary hospital campus in the Limpopo Province</b>]]> Interdepartmental communication in a hospital setting is fundamental to the provision of quality patient care. Effective communication modes are important because they result in the improvement of patient care (Tappen, 1995:181). Preliminary investigations into the main problems that underscore patients' dissatisfaction have identified, among others, the failure of health professionals to communicate effectively. In this study an attempt was made to describe experiences of health professionals with regard to inter-departmental communications , define inter-departmental communication in selected departments of a tertiary hospital campus in the Limpopo Province and lastly, to formulate inter-departmental communication guidelines for health professionals. A qualitative, exploratory, descriptive and contextual research method was followed as a holistic approach in research for participants to describe their experiences regarding the phenomenon in question (Brink, 2006:113). Data were collected through individual unstructured interviews in all selected departments for each participant. The researchers employed the principles of Guba and Lincoln (1985) in De Vos (1998:331) relating to trustworthiness and adhered to the ethical standards as set by DENOSA (1998) to ensure the quality of the study. Three themes and categories emerged from the data analysis using Tech's open coding approach (1990) as outlined in De Vos (1998:343), namely, existence versus non-existence of inter-departmental meetings, inter-departmental communication barriers and limited communication guidelines. The guidelines were developed using Ellis, Gates and Kenworthy's model of effective communication (1995:59) that includes the establishment of interdepartmental meetings, using effective communication modes, providing accurate and constant reporting, establishing staff development programmes, creating an effective communication environment and using skills for effective communication. <![CDATA[<b>Clinical supervision and support for bridging programme students in the greater Durban area</b>]]> Reviewed literature revealed that clinical supervision is a conceptually sound learning model, which, unfortunately, is flawed by problems of implementation. Some of the more glaring problems include limited emphasis upon problem-solving, lack of clear expectations for student performance, inadequate feedback to students, inappropriate role models in clinical settings and inadequately prepared clinical teachers. The purpose of the study was to explore and describe the nature of clinical supervision and support provided to bridging programme students in the clinical settings. Participants were drawn from three nursing colleges and 122 participants returned questionnaires. College 1:26,2% (n=32), College 2:15,6% (n=19) and the majority, 58, 2 % (n=71) were from College 3. The participants were second year students in the Bridging Programme. Purposive sampling was used for the selection of the hospitals. The researcher purposively selected those hospitals offering the Bridging Programme. The students were randomly sampled. According to Burns and Grove (2001), simple random sampling is the most basic and most effective of the probably sampling methods. Data was collected by means of a questionnaire and a critical incident report. The questionnaire used in this study was adapted from the Manchester Clinical Supervision Instrument. The findings revealed that clinical supervision contributes positively to the academic, professional and personal development of students. Although there was support for clinical supervision by the nursing staff, time for clinical supervision was the main problem. Clinical supervision was viewed as time consuming. Clinical learning emerged as secondary to ward routine. The students functioned as part of the workforce and missed out on some important learning opportunities. Results also showed that some clinical supervisors were not adequately prepared for their roles and responsibilities; as a result there was no significant relationship between clinical supervision sessions and the acquisition of knowledge. The critical incidence revealed positive and negative experiences regarding clinical supervision and the support provided by clinical supervisors and clinical staff. There is a need for clear policies regarding clinical supervision, a structured and well monitored process of clinical supervision, building the capacity of clinical supervisors, and addressing the issues of use of bridging programme students as part of the workforce. <![CDATA[<b>The use of experts and their judgments in nursing research: An overview</b>]]> Experts and their judgments are widely used in the fields of research, education, health care, law, commerce and technology. Expert judgment is known for its subjectivity and its potential for bias, which brings into question the accuracy and authenticity of judgmental data. At the same time there is acknowledgment of the valued contribution of judgmental data towards valid inferences in research and education. Maximizing the use of experts and their judgments has therefore become an endeavour of educationists and researchers alike. Since this is not a research article its purpose is to guide and assist nurse researchers with important methodological and ethical decisions when using experts. Experts must be used in the context of appropriate research methods such as the Delphi and Nominal Group techniques. Sampling of experts and sample size is determined by the type and quality of data and the availability of population data; purposive and maximum variation sampling techniques are recommended as appropriate when sampling experts. Universal research ethics must be applied with particular consideration of aspects which may influence the truth value of consensus among experts and marginalization of minority or extreme viewpoints. Quantification of judgmental data is recommended and is important to minimize bias and to increase the authenticity of research findings. The content includes: design considerations when using experts, sampling issues, ethical rules to be considered when enlisting experts and their judgments, optimal data collection approaches and managing judgmental data. <![CDATA[<b>The qualitative research proposal</b>]]> Qualitative research in the health sciences has had to overcome many prejudices and a number of misunderstandings, but today qualitative research is as acceptable as quantitative research designs and is widely funded and published. Writing the proposal of a qualitative study, however, can be a challenging feat, due to the emergent nature of the qualitative research design and the description of the methodology as a process. Even today, many sub-standard proposals at post-graduate evaluation committees and application proposals to be considered for funding are still seen. This problem has led the researcher to develop a framework to guide the qualitative researcher in writing the proposal of a qualitative study based on the following research questions: (i) What is the process of writing a qualitative research proposal? and (ii) What does the structure and layout of a qualitative proposal look like? The purpose of this article is to discuss the process of writing the qualitative research proposal, as well as describe the structure and layout of a qualitative research proposal. The process of writing a qualitative research proposal is discussed with regards to the most important questions that need to be answered in your research proposal with consideration of the guidelines of being practical, being persuasive, making broader links, aiming for crystal clarity and planning before you write. While the structure of the qualitative research proposal is discussed with regards to the key sections of the proposal, namely the cover page, abstract, introduction, review of the literature, research problem and research questions, research purpose and objectives, research paradigm, research design, research method, ethical considerations, dissemination plan, budget and appendices.