Theses and dissertations (Health Sciences)

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Assessment of vicarious post-traumatic stress in nurses caring for victims of sexual abuse in Thuthuzela Care Centres in KwaZulu-Natal
(2024) Hlomuka, Nonhlanhla; Orton, Penelope Margaret
The aim of this study was to determine whether nurses working in Thuthuzela Care Centres experience vicarious post-traumatic stress. Thuthuzela is a Xhosa word which means comfort. The word comfort awakens feelings of warmth, freedom from emotional and physical concerns, safety, security, being pampered and above all reinforcing dignity, hope and positive expectations for the victims Thuthuzela Care Centres are one stop facilities that have been introduced as a critical part of South Africa’s anti –rape strategy. There have been a number of studies exploring vicarious post-traumatic stress for health care workers other than nurses caring for victims’ sexual abuse but little is known about the risk for nurses. A non-experimental descriptive survey design was used to assess vicarious post-traumatic stress of nurses caring for victims of sexual abuse who report to the Thuthuzela Care Centres in KwaZulu Natal. 6.Data was collected in this quantitative study through the administration of a questionnaire. The professional quality of life (ProQol) questionnaire was used to answer the research questions. In this study a convenience method of sampling was used. A convenience sampling is referred to as availability sampling and it involves the choice of readily available respondents for the study. The sample included all nurses working in Thuthuzela Care Centres irrespective of their category following repeated exposure and listening to different scenarios while executing their duty of caring for victims of sexual abuse in KwaZulu Natal. 10. The sample size was 31 nurses working in Thuthuzela Care Centres. The data collection instrument of this study measured all the aspects included in vicarious post-traumatic stress, secondary traumatic stress, compassion satisfaction and burnout. All of these being in line with the objectives of the study. Factor analysis with Promax rotation was applied to the 30 items measuring the three constructs (compassion satisfaction, burnout and secondary traumatic stress) in order to elicit the latent structure that applies to the current study. The KMO (Kaiser-Meyer-Olkin) measure of sampling adequacy yielded a relatively low value of .521 which was likely due to the limited sample size. It is, however, considered by some to be adequate and indicates adequacy of the data. Bartlett’s test of sphericity was significant thus indicating that the variables are related and therefore suitable for factor analysis. Rotation converged in 5 iterations. The reliability of compassion satisfaction and secondary traumatic stress are shown to be adequate. Cronbach’s alpha of .567 for burnout indicates that results need to be interpreted with a little caution Data was analysed using SPSS version 17. The data derived from this study revealed that a little over half of respondents 54.8% (n=17) working in Thuthuzela Care Centres are very often happy about nursing victims of sexual abuse. Less than a half 38.7% (n = 12), of respondents indicated that they are not productive at work because they are losing sleep related to traumatic experiences of the people they nurse. Less than a half of the respondents 45.2% (n=14) reported that they sometimes, have intrusive, and/or frightening thoughts related to caring for victims of sexual abuse. (p<.005). In this study the respondents were protected from any harm by a full explanation about the aim of the study, their rights to voluntarily participate and their freedom to withdraw from the study at any time during the study. This study attended the ethical principle related to right to fair treatment because ethical approval was sought from and granted by DUT Institutional Research Ethics Committee to the researcher before the research was commenced. In this study, the participants were not required to give their personal details to the researchers. The researcher used numbers to identify questionnaire distributed to the respondents. Recommendations Recommendations arising from this study are 22. (a) a mandatory programme of psychological intervention for the nurses is necessary. 23. (b) a psychologist should be readily available at the Thuthuzela Care Centres for counselling sessions, and 24. (c) all health districts should have Thuthuzela Care Centres. 25.Wellbeing of the nurses allocated to work in Thuthuzela Care Centres should be considered. Conclusion 26.Findings from this data can be used to strengthen awareness programs and emphasize self-care techniques to minimize vicarious trauma in nurses caring for victims of sexual abuse in Thuthuzela Care Centres. 27.Consistent training and ongoing discussions about signs of vicarious trauma are important for nurses and other health professionals caring for victims of sexual abuse
Experiences of non-critical care trained professional nurses deployed to work in the intensive care units during the Coronavirus 2019 (COVID-19) pandemic
(2023-05) Sivnarain, Rena; Naidoo, V.; Zikalala, Nomusa Penicca
Background South Africa has been greatly affected by the Coronavirus Disease 2019 (COVID19) pandemic causing a crippling effect on the country’s healthcare system as it was not adequately prepared in terms of staffing, equipment and disaster planning. Due to the nature of the COVID-19 outbreak and subsequent mitigation plans, nonspecialist nurses were deployed to the intensive care units (ICUs) to assist with patient care, control sophisticated therapeutic assist devices and assume multiple roles that were beyond their scope of practice. Aim of the study The aim of the study was to describe the experiences of non-critical care trained nurses, deployed to work in the ICUs during the COVID-19 pandemic, at a private hospital in the KwaZulu-Natal region. Methodology A qualitative, descriptive design guided the study. Fifteen non-critical care trained nurses were purposively sampled and interviewed using a semi-structured interview guide. Audio-recordings were transcribed verbatim and analysed using Braun and Clarke’s (2006) thematic analysis framework. Findings The experiences of non-critical care trained nurses deployed to work in the ICUs during the COVID-19 pandemic yielded four main themes, namely, deployed nurses working in an unfamiliar environment; nurses lack of ICU experience, skills and knowledge; the lack of supervision, mentorship and leadership for the deployed nurses and the psychosocial impact of the deployment of nurses to the ICUs during the COVID-19 pandemic. Conclusion Nurses deployed to work during the COVID-19 pandemic endured overwhelming responsibilities while they provided care to the critically ill and infected patients in the ICU. These roles were executed without proper intensive care training, qualification, skills and leadership. Thus, there is a dire need for disaster management training for all staff, especially nurses in the healthcare setting. Supervision, peer-mentorship and support systems such as counselling should be readily available during disaster management.
The relationship between occupational coping self- efficacy of nurses and patient satisfaction scores in a private hospital in KwaZulu-Natal
(2022-05-09) Ghirdhari, Sewak; Orton, Penelope Margaret; Naidoo, Vasanthrie; Orton, Penelope; Naidoo, Va
Brief background of the Study The nursing profession is faced with high levels of work stress such as staff shortages, poor working conditions, lack of resources, job dissatisfaction and burnout, which tends to compromise quality of care rendered to patients. The research was to establish whether nurses’ occupational coping self- efficacy had any association with patient satisfaction scores. Aim of the study The aim of this research was to describe any relationship between occupational coping self- efficacy of nurses and patient satisfaction scores in a selection of wards in a private hospital in KwaZulu-Natal. Methodology A quantitative, cross-sectional, descriptive survey design was used to conduct the study. Data was collected using questionnaires. The quantitative data was analysed statistically. The statistics used included descriptive statistics such as frequencies, measures of central tendency and measures of dispersion. Factor analysis was used to explore the structure of the data and in order to test for significant trends in the data, inferential statistics were applied. Results The results revealed that although the recording was done objectively, the outcome was not positively achieved due to the unforeseen covid-19 pandemic. Results were skewed due to all wards unable to participate in research. The nurses completed their tool but unable to meet the expected patient ratio. Sample realization of 100% was achieved.
Exploring the working environment of enrolled nursing auxiliaries in private hospitals in the eThekwini District
(2020-10) Ramiah, Vanitha; Ngxongo, Thembelihle Sylvia Patience; Naidoo, V.
Background: The nursing professionals are recognised worldwide as being critical to the delivery of high quality, efficient nursing management and patient care in the healthcare services. However, shortage of skilled nurses in most countries, including South Africa, has led to an overburdened healthcare system with certain nursing categories doing much more than they are trained to do. The enrolled nursing auxiliaries (ENAs) are junior members of the nursing team who, on completion of a one-year basic nursing certificate programme, work either in public or private healthcare sectors. Aim of the study: The aim of the study was to explore the working environment of ENAs, in private hospitals in the eThekwini District, KwaZulu-Natal, South Africa. Methodology: An exploratory descriptive design was used. Data was collected by in-depth one-on-one interviews with ENAs, Registered Nurses (RNs) and Unit Managers (UMs) working in the medical and surgical units of the selected healthcare institutions and were analysed using Tesch’s method of data analysis. Findings: Three major themes that emerged from the data analysis were a) working experiences of the ENA, b) challenges experienced by the ENA, c) supervision of the ENA. This study found that due to the shortage of skilled nurses in the country, brain drain and cost containment in the private health sector, the dynamic healthcare environment resulted in ENAs endangering their professional status by functioning out of their scope of practice and performing a role for which they were never intended or academically prepared. The ENAs under study were dissatisfied by a lack of clear career development pathways from the private healthcare group to assist them with transitioning to the next level of qualification. They also felt that they were not recognised or rewarded for their contributions to nursing. Conclusion The private healthcare group under study should, as a priority, communicate to ENAs the plans for career development and funding which will allow ENAs to undertake training to the next level of qualification. The nursing agency utilisation should decrease from 40% to the benchmark of 25% to ensure sufficient numbers of skilled staff are working in the general nursing units. The emphasis by nursing leadership must be on teamwork to build a motivated workforce.
A comprehensive healthcare managerial framework that explicates the manner in which workload factors influence the nurses’ well-being : a case study of a Saudi Arabian hospital
(2021-05-27) Chetty, Krishnavellie; Sibiya, M. N.; Naidoo, V.
The shortage of specialized intensive care unit (ICU) nurses is a workload factor that negatively influences the provision of quality nursing care by compromising workplace productivity and job satisfaction. Work pressures are evident in health systems throughout the world, where there is growing concern over a nursing shortage in relation to the country's disease profile, population increases, chronic disease growth and increased life expectancies. Although workload plays a fundamental role in staff and patient well-being, minimal research has been conducted on the evaluation of workload effects and its impact on nurses' wellbeing among Saudi Arabian ICU nurses. Aim The aim of the study were to determine the various workload factors that influence the well-being of ICU nurses working in a Saudi Arabian Hospital and to develop a comprehensive healthcare managerial framework that explicates the way workload factors influence nurses’ well-being. Methodology Using a convergent parallel mixed methods design, data were collected by means of semi structured interviews, with 20 participants in the qualitative phase. A survey questionnaire, that was developed and adapted from the Job Demand Resource (JDR) Model, was used to collect to data from 200 participants. The quantitative data were analysed using the latest version 25 of SPSS and qualitative data were analysed using Tesch’s method of data analysis. Findings The findings from the study were aligned to the JDR Model and provided evidence that ICU nurses experienced various workload factors that influenced their well-being and productivity. It was found that the high job demands cause strain and health impairment, which are associated with decreased job satisfaction of staff working in the ICUs of Saudi Arabian hospitals. On the basis of these findings, the researcher proposed and developed guidelines for the implementation of a comprehensive managerial framework that explicated workload factors that influence the well-being of the ICU nurses. The proposed framework can be utilized as an interactive tool that will set out clear actionable steps, providing ongoing guidelines on how healthcare organisations should plan and implement suitable workloads, efficiently and effectively, to ensure staff health and well-being.
Assessment of nurses' hand hygiene practices in primary health care clinics of eThekwini Municipality
(2018) Mufamadi, Ntheno Grace; Sibiya, Maureen Nokuthula
Background Hands of heath care workers are known to be the main vehicle in the transmission of infectious agents in the health care setting. Hand hygiene is an essential, cheap, simple, effective and the corner stone in infection and control strategies, and it plays a major role in reduction of health care associated infections. The focus on hand hygiene has been hospital based because of the health care associated infections within those settings. The high utilization of the primary health care (PHC) clinics, the complexity and comprehensiveness of the services rendered in PHC clinics, the more invasive procedures that are being performed in PHC clinics and the studies on hand hygiene that were focused mainly in hospitals setting motivated the study on the assessment of hand hygiene practices in PHC clinics. Aim of the study The aim of the study was to assess hand hygiene practices of nurses in the PHC facilities of eThekwini municipality. Methodology This study was a descriptive, observational and survey study design in a quantitative paradigm, conducted in three PHC clinics with high caseload. The non-probability, purposive sampling method was used to select PHC clinics. The study population were the nurses from the three selected PHC clinics. An adapted Infection Control Self-Assessment Tools for PHC Facilities was used to collect data. An adapted self-reported World Health Organisation Hand Hygiene Knowledge Questionnaire for Health Care Workers Assessment Tool was used to assess knowledge and training in hand hygiene. Data was analysed using SPSS version 22.0. Inferential statistics were used to determine the relationship between the variables. Results The results showed that in all the three PHC clinics, hand hygiene was performed more frequently after contact with patients than before contact with patients in both invasive and non-invasive procedures. The commonly used method of hand hygiene was hand rubbing with alcohol hand rub than hand washing. In observing whether the hand rubbing steps were followed, this was done significantly less than half the time (p=<.0005). The average knowledge score across all questions was 73.64% and there was no significant correlation between knowledge and percentage of time using HH.
An investigation into factors associated with the development of lower back pain in nurses in the Durban metropolitan area, with particular reference to manual work
(2007) Dasappa, Rozanne; Mac Dougall, Tarryn
The objectives of this study were: To determine how the frequency of manual work contributes to low back pain in nurses in state versus private hospitals in the Durban area. To determine how the frequency of manual work contributes to low back pain in nurses in state versus private hospitals in the Durban area. Hospital nurses have a high prevalence of low back pain (LBP) (Smedley et al., 2003). It has been found that nursing personnel ranked fifth in occupations claiming worker compensation for low back injuries (Owen and Garg, 1994). A number of studies have also indicated a strong association between musculoskeletal disorders and work related factors (Maul, 2002). An epidemiological study by Smedley et al (1997) has suggested that repetitive lifting, frequent bending and twisting play a role in the development of LBP, and that heavy physical workload has played a major role in the development of LBP in nurses. LBP is therefore a serious problem in the nursing field with a relatively high prevalence worldwide. It causes increased absenteeism from work and could impact on patient care. This study was a survey, which was quantitative in nature. Data was collected by means of a questionnaire. The questionnaires were handed out in randomly selected hospitals in the Durban Metropolitan area. The names of all state and private hospitals in the Durban Metropolitan area were put into two boxes and three names were picked from each box. A letter requesting permission to carry out this research was sent out to each hospital and a positive response was received from one state hospital, R.K Khan Hospital and two private hospitals, Westville and Entabeni hospitals. Questionnaires were handed out to the nurses by the researcher, as requested by the hospitals, and collected at a later time by the researcher. Questionnaires were handed out at each ward in the hospitals to nurses who met the criteria for the study and agreed to participate in this study. Questionnaires were also handed out to nurses in the nurses lounge during lunch breaks. The questionnaire was developed as combination of; a pre-validated questionnaire made available by Yip (2001), questions on socio-demographic data, work history, patient handling activities and LBP. The compiled questionnaire was tested for face and construct validity through a focus group, and piloted before being used in the study. A total of 500 questionnaires were handed, 250 to state hospitals and 250 to private hospitals. Participants consisted of nurses (registered, enrolled and student) between the ages of 18 and 45 years, both male and female. Nurses from all hospital wards were allowed to participate in this study. A total of 124 questionnaires were received back, ( 50 from private hospitals and 74 from the state hospital), from the nurses in all the hospitals. Data was then collected from these questionnaires and was analysed using the statistical package SPSS version 13 (SPSS Inc. Chicago, Illinois, USA). A p value of <0.05 was considered as significant. The data collected from the questionnaires was analysed and the results obtained were as follows: The prevalence of work related LBP in this study was 59.7%. Of the 74 nurses with LBP, only 7 (9.5%) reported having LBP before working as a nurse. 35.1% of participants reported that they experienced pain on a daily basis while 62.2% described their LBP as moderate and 27% described their pain as severe. The median duration of LBP was 3.5hours per episode. Of all the participants in this study, 64,9% had needed bed rest due to their LBP with 43.2% having taken sick leave from work for LBP. Back pain in nurses has been found to be a major cause of days lost due to sickness (French et al., 1997). The majority of nurses (93.2%) reported lifting to be the cause of their LBP, standing and bending were also found to be important causes. Low Back injury was reported in 31.1% of participants with up to 51.4% receiving treatment for their injuries, the main choice of treatment was from a hospital or General practitioner. With regards to the frequency of manual work on LBP, there was found to be a slight tendency toward LBP with more frequent manual activity, however this was viii found to be non significant. In those respondents with LBP, the activity associated with the most intense LBP was carrying or lifting patients. Time spent; standing, holding up hands and bending were found to be higher in the group which reported LBP. Having 1-2 children was also associated with increased LBP. The prevalence of LBP was found to be higher in the state hospital (67.6%) than in the private hospitals (48%). The aim of this study was to determine the association between frequency and intensity of manual work on LBP in nurses. The results showed that frequently performed manual activities were associated with LBP but not significantly. In terms of intensity of manual work, carrying or lifting patients was found to be most associated with LBP, standing and bending were also significantly associated with LBP. This study also aimed to determine any difference in LBP between state and private hospitals and a significant difference in LBP prevalence was noted between state and private hospitals. The findings of this study suggest that LBP is a common problem among hospital nurses. The results of this study were also found to be within the same prevalence rates of international studies, which ranged from 35.9% in New Zealand to 66.8% in the Netherlands (Nelson et al., 2003). As was found in the literature (French et al., 1997 and Smedley et al., 1997), lifting was reported to be a major cause of LBP.

Theses and dissertations (Health Sciences)

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