ORIGINAL RESEARCH

 

The health care needs of the physically disabled patient in a home-based care environment: Implications for the training of ancillary health care workers

 

 

Karien Jooste; Mary Chabeli; Monica Springer

Department of Nursing, University of Johannesburg, South Africa

Correspondence

 

 

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ABSTRACT

According to existing literature, ancillary health care workers (AHCWs) often do not meet the health care needs of patients with physical disabilities (physically disabled patients) in a home-based environment, because of inadequate training programmes. The purpose of this research study was to explore the health care needs of physically disabled patients in long-term, home-based care in the northern suburbs of Johannesburg and, based on results, to offer recommendations for the training of AHCWs. Qualitative, exploratory, descriptive and contextual means were employed in data collection and analysis. The population consisted of eight physically disabled participants who employed an AHCW to assist them with their long-term home care. Purposive sampling was used with subsequent snowballing to identify further participants for the study. Individual interviews were conducted, where participants had to answer the questions (1)'What are your health care needs?' and (2) 'How should these be met?' Data saturation was ensured, after which Tesch's method of data analysis was followed. Three categories of health care needs were identified (1) physical health care needs, (2) interpersonal relationship needs and (3) social needs, and 12 themes were derived from these categories. These categories of health care needs should be addressed in the training of AHCWs. From the themes, recommendations were described for the training of AHCWs on the health care needs of the home-based physically disabled patients. The AHCW should assist in the adaptation of the environment to the patient's individual needs, and should use knowledge and critical thinking skills to ensure a patient-centred care setting.

Keywords: experiences; guidelines; health care worker; nursing; training needs

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OPSOMMING

Volgens die literatuur kan assistentgesondheidsorgwerkers (AGWs), as gevolg van ontoereikende opleiding, nie altyd aan die behoeftes van fisies gestremde pasiënte in 'n tuisopset voldoen nie. Die doel van hierdie navorsingstudie was om die gesondheidsorgbehoeftes van langtermyn, tuisgebaseerde fisies gestremde pasiënte in die noordelike voorstede van Johannesburg te verken en te beskryf, en om hieruit aanbevelings vir die opleiding van AGWs voor te stel. Kwalitatiewe, verkennende, beskrywende en kontekstuele metodes is gebruik om die data in te samel en die analise te doen. Die studiepopulasie het uit agt fisies gestremde deelnemers bestaan wat 'n AGW aangestel het om hulle met hul langtermyntuisversorging by te staan. Doelbewuste steekproefneming met die daaropvolgendesneeubalmetode is gebruik om verdere deelnemers vir die studie te identifiseer. Individuele onderhoude is gevoer waartydens deelnemers die volgende vrae moes beantwoord (1) 'Wat is jou gesondheidsorgbehoeftes?' en (2) 'Hoe behoort hieraan voldoen te word?' Datasaturasie is verseker, waarna Tesch se data-analisemetode gevolg is. Drie kategorieë van gesondheidsorgbehoeftes is geïdentifiseer (1) fisiese gesondheidsorgbehoeftes, (2) interpersoordike verhoudingsbehoeftes en (3) sosiale behoeftes, en 12 temas is van hierdie kategorieë afgelei. Hierdie gesondheidsorgkategorieë behoort aandag tydens die opleiding van AGWs te kry. Aan die hand van die temas is aanbevelings gemaak vir die opleiding van AGWs in tuisgebaseerde sorg van fisies gestremde pasiënte. AGWs behoort ondersteuning te bied om die omgewing by die individuele behoeftes van die pasiënt aan te pas, en moet hul kennis en kritiese denkvaardighede kan toepas om n pasiëntgesentreerde omgewing te verseker.

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REFERENCES

Ancillary Health Care Standards Unit, 2003, Government Gazette 455(24815), viewed 02 May 2003, from www.saqa.org.za        [ Links ]

Angus, J., Kontos, P., Dyck, I., Mckeever, P. & Poland, B., 2005, 'The personal significance of home: Habitus and the experience of receiving long-term home care', Sociology of Health and Illness 27(2), 161-187.         [ Links ]

'Choose a career in home care', The Teacher/Daily Mail and Guardian, 03 August, 2000, n.p.         [ Links ]

Babbie, E. & Mouton, J., 2002, The practice of social research, Oxford University Press, Southern Africa.         [ Links ]

Baillie, L., 2001, Developing practical nursing skills, Arnold, London.         [ Links ]

Blackwell, M., 2005, Journal of Consciousness Studies 7(11-12), 145-176.         [ Links ]

Bromley, I., 1998, Tetraplegia and paraplegia - a guide for physiotherapists, 5th edn., Edinburgh, Churchill Livingstone.         [ Links ]

Brunner, L.S. & Suddarth, D.S., 1986, The Lippincott manual of nursing practice, 4th edn., Lippincott Co., Philadelphia.         [ Links ]

Burns, N. & Grove, S.K., 1995, The practice of nursing research: Conduct, critique & utilization, 2nd edn., WB Saunders, Philadelphia.         [ Links ]

Chabeli, M.M., 2004, 'Character - a virtue and moral foundation for the nursing profession', Nursing Update, 28(5), 42-43.         [ Links ]

Collins, W., 2004, Collins English dictionary - desktop edn + CD-rom, HarperCollins, Glasgow.         [ Links ]

Creswell, J.W., 1994, Research design: qualitative and quantitative approaches, Simon & Shuster, London.         [ Links ]

Department of Health, 2000a, Policy statement: The primary health care package for South Africa - a set of norms and standards: Community based rehabilitation, Government Printer, Pretoria.         [ Links ]

Department of Health, 2000b, Policy statement: The primary health care package for South Africa - a set of norms and standards: Community level home-based care, Government Printer, Pretoria.         [ Links ]

Department of Health, 2000c, Policy Statement: The primary health care package for South Africa - a set of norms and standards. Part 1. Norms and standards for health clinics: Batho Pele - people first, Government Printer, Pretoria.         [ Links ]

Department of Health, 2000d, Policy statement: The primary health care package for South Africa - a set of norms and standards: Patient's Rights Charter, Government Printer, Pretoria.         [ Links ]

Du Gas, B.W., 1983, Introduction to patient care - a comprehensive approach to nursing, 4th edn., Saunders, Philadelphia.         [ Links ]

Edelman, C.L. & Mandle, C.L., 2006, Health promotion throughout the lifespan, 6th edn., Mosby Inc., St. Louis.         [ Links ]

Eliopoulous, C., 2005, Gerontological nursing, 6th edn., Lippincott Williams & Wilkins, Philadelphia.         [ Links ]

Farvis, M., 2003, 'Residential aged care and a home-like environment', Australian Nursing Journal 11(5), 19-21.         [ Links ]

Freshwater, D. & Maslin-Prothero, S.E., 2005, Blackwell's nursing dictionary, 2nd edn., Prentice Hall International, New Jersey.         [ Links ]

Jacobs, P.L. & Nash, M.S., 2004, 'Exercise recommendations for individuals with spinal cord injury', Sports Medicine 34(11), 727-751.         [ Links ]

John, R. & Salvini, M.L., 1996, 'Training in support of the American Indian Eldercare campaign: replication of an American Indian homecare training program', Educational Gerontology 22(8), 723.         [ Links ]

Larner, S., 2005, 'Common psychological challenges for patients with newly acquired disability', Nursing Standard 19(28), 33-38.         [ Links ]

Leininger, M. & Mcfarlane, M.R., 2002, Transcultural nursing, 3rd edn., McGraw-Hill, Toronto.         [ Links ]

Lincoln, Y.S. & Guba, E.G., 1985, Naturalistic inquiry, Sage, London.         [ Links ]

Mnyaka, M. & Motlhabi, M., 2005, 'The African concept of Ubuntu/Botho and its socio-moral significance', Black Theology 3(2), 215-237.         [ Links ]

Mouton, J., 2002, Understanding social research, 3rd edn., Van Schaik, Pretoria.         [ Links ]

Nicol, M., Bavin, C, Bedford-Turner, S, Cronin, P. & Rawlings- Anderson, K., 2000, Essential nursing skills, Mosby, Edinburgh.         [ Links ]

Orem, D.E., 1995, Nursing: concepts of practice, 5th edn., Mosby, St Louis.         [ Links ]

Quinn, F.M., 1991, The principles and practice of nurse education, 2nd edn., Chapman Hall, London.         [ Links ]

Rimmer, J.H., 2002, 'Health promotion for individuals with disabilities: The need for a traditional model in service delivery', Disease Management and Health Outcomes 10(6), 337-343.         [ Links ]

Sadock, B.J. & Sadock, V.A., 2003, Synopsis of psychiatry: Behavioral sciences/clinical psychiatry, 9th edn., Lippincott Williams & Wilkins, Philadelphia.         [ Links ]

SA Government, 1998, Employment Equity Act, Act No. 55 of 1998, Chapter II: Prohibition of unfair discrimination, 7, Medical Testing, Government Printer, Pretoria.         [ Links ]

SA Government, 2005, The Nursing Act, Act No. 33 of 2005, Government Printer, Pretoria.         [ Links ]

Smart, J.F. & Smart, D.W., 2006, 'Models of disability; implications for the counseling profession. Journal of Counseling and Development 84, 29-40.         [ Links ]

Smith, C.M. & Maurer, F. A., 2000, Community health nursing theory and practice, WB Saunders Co., Philadelphia.         [ Links ]

Stanhope, M. & Lancaster, J., 1988, Community health nursing - process and practice for promoting health, Mosby, St Louis.         [ Links ]

Uys, L.R., 2004, Fundamental nursing, Maskew Miller, Cape Town.         [ Links ]

Venter, E., 2004, 'The notion of Ubuntu and communalism in African educational discourse', Studies in Philosophy and Education 23, 149-160.         [ Links ]

University of Johannesburg, 2009, Department of Nursing Paradigm, Johannesburg.         [ Links ]

World Health Organization (WHO), 2003, Long-term care in developing countries: ten case studies, ed. J. Brodsky, J. Habib & M. Hirschfeld, WHO, Geneva.         [ Links ]

 

 

Correspondence:
Karien Jooste
University of Johannesburg
PO Box 100477
Moreleta Plaza 0167
South Africa
email: kjooste@uj.ac.za

Received: 18 Oct. 2009
Accepted: 01 July 2010
Published: 09 Nov 2010