Investigation into factors influencing nursing values in South Africa

Van Schalkwyk, Talita (2012-03)

Thesis (MCur)--Stellenbosch University, 2012.

Thesis

ENGLISH ABSTRACT: Nursing is influenced by the values of each nurse (Mellish & Paton, 1999: 6). Values form an integral part of human reality; they predict thoughts, feelings, actions and perceptions. Nursing in South Africa, is defined as a "caring profession” (Act No. 33 of 2005) and forms a subculture of the South African population, with nurses coming from different cultural and ethnic groups, being of various ages and both genders. It was identified that a need exists to understand nursing values and the factors influencing these values. Consequently, together with the lack of research data regarding values in South Africa and the factors influencing them, the importance to do an investigation into the factors influencing nursing values was identified. The aim was to do an in-depth study into the factors influencing nursing values of nurses working in nursing facilities in the Paarl district employed by the Provincial Administration of the Western Cape, in the West Coast Winelands Region of the Western Cape. The objectives were to determine the main reason for entering the nursing profession for nurses working in these facilities; to identify the most important part of nursing practice; to identify the core nursing values; to determine the factors influencing nursing values and the factors influencing nursing care. A quantitative research design using a descriptive, explorative survey was conducted. The population included the three categories of nurses, with a total population of 470 nurses (N = 470). Research questionnaires were distributed to 388 participants working on the days of data collection in all nursing departments, excluded nurses not permanently employed by the Provincial Administration Western Cape, including nursing agency staff, students doing practica and personnel on leave. The return rate was 60.56% (n = 235). The questionnaire was based on a literature review and the objectives, and a pilot test ensured reliability and validity. The results of the pilot study (n =10) were included in the findings, leading to 245 respondents (n = 245) being included in the main study. The questionnaire consisted of four sections and was validated by an expert in nursing science and research methodology, a biostatistician, a quality assurance manager and ethical committees. Four open-ended questions were included to provide richer and more diverse data. Only the researcher was involved in data collection that took place during day and night duty. Descriptive statistics and appropriate inferential statistical tests were used in analysing the data. Ethical approval was obtained. Anonymity and confidentiality of respondents were observed and written consent was obtained from respondents. It was identified that nurses enter the nursing profession due to altruism and the most important part of nursing encompasses caring. Differences in values important for behaviour of a nurse, patient care and ethical decision making were identified. Findings depicted that age, years of experience, qualification obtained, job description and department influence different values. Results identified that political and social factors, as well as motivation influence nursing practice. Recommendations include setting a clear value structure for nursing in South Africa; attention to the evaluation of staff performance and management; enhancing motivation of staff and the development of a management-for-nurse strategy.

AFRIKAANSE OPSOMMING: Verpleging word beïnvloed deur die waardes van elke verpleegster (Mellish & Paton, 1999:6). Waardes vorm ’n integrerende deel van die menslike realiteit, dit voorspel gedagtes, gevoelens, handelinge en gewaarwordinge. Verpleging in Suid-Afrika word gedefinieer as ’n versorgingsberoep (Wet No. 33 van 2005) en vorm ’n subkultuur van die Suid-Afrikaanse bevolking, met verpleegsters van verskillende kulturele en etniese groepe wat verskeie ouderdomme en albei geslagte insluit. Dit is geïdentifiseer dat ’n behoefte bestaan om verplegingswaardes en die faktore wat hierdie waardes beïnvloed, te verstaan. Gevolglik, gesamentlik met die gebrek aan navorsingsdata aangaande verpleegwaardes en die faktore wat dit beïnvloed, in Suid-Afrika, is die belangrikheid geïdentifiseer om ’n ondersoek te doen aangaande die faktore wat verpleegwaardes beïnvloed. Die doel was om ’n dieptestudie te doen van die faktore wat die verpleegwaardes van verpleegsters beïnvloed wat in verpleeg instansies in die Paarl-distrik werk in diens van die Provinsiale Administrasie van die Wes-Kaap, in die Weskus Wynlandstreek van die Wes-Kaap. Die doelwitte was om die hoofrede te bepaal waarom verpleegsters wat in hierdie fasiliteite werk die verpleegberoep betree het; om die belangrikste aspek van die verpleegpraktyk te identifiseer; die kern verplegingswaardes te identifiseer; en die faktore te bepaal wat verplegingswaardes en verpleegsorg beïnvloed. ’n Kwantitatiewe navorsingsontwerp is toegepas deur van ’n beskrywende, ondersoekende opname gebruik te maak. Die bevolking het die drie kategorieë van verpleegsters ingesluit, met ’n totale bevolking van 470 verpleegsters (N=470). Navorsingsvraelyste is versprei aan 388 deelnemers wat op die dae van data-insameling gewerk het in die verpleegdepartemente en het verpleegsters uitgesluit wat nie permanent indiens was van die Provinsiale Administrasie van die Wes-Kaap, asook verpleegagentskap personeel, studente wat praktika verrig en personeel op verlof. Die terugkeerkoers was 60.56% (n=235). Die vraelys was gebaseer op ’n literatuurstudie en die doelwitte van die studie, ’n loodsstudie het betroubaarheid en geldigheid verseker. Die resultate van die loodsstudie (n=10) is ingesluit in die bevindinge, wat gelei tot 245 respondente (n=245) in die hoof studie. Die vraelys het bestaan uit vier afdelings en is geldig verklaar deur ’n spesialis op die gebied van verpleegkunde en navorsingsmetodologie, ’n biostatistikus, ’n kwaliteitversekeringsbestuurder en etiese komitees. Vier oop-vrae is ingesluit om omvattende en meer uiteenlopende data te voorsien. Slegs die navorser was betrokke by data-insameling wat gedurende dag en nag skofte plaasgevind het. Beskrywende statistiek en geskikte afleibare statistiese toetse is gebruik in die analisering van die data. Etiese goedkeuring is verkry. Anonimiteit en vertroulikheid van respondente is behou en geskrewe toestemming is verkry van respondente. Bevindinge het getoon dat verpleegsters die verpleegberoep betree weens hul onbaatsugtigheid en dat die belangrikste aspek van verpleging versorging is. Verskille in waardes wat belangrik is vir die gedrag van ’n verpleegster/verpleër, pasiënt versorging en etiese besluitneming is geïdentifiseer. Daar is bevind dat ouderdom, ondervinding in jare, kwalifikasies behaal, posbeskrywing en die departement verskillende waardes beïnvloed. Resultate het bewys dat politieke en sosiale faktore, asook motivering verpleegpraktyk beïnvloed. Aanbevelings sluit die daarstelling van ’n duidelike struktuur van verpleegwaardes in Suid-Afrika; die nodigheid vir aandag aan die evaluering van personeelprestasie en -bestuur; die verheffing van personeelmotivering en die ontwikkeling van ’n bestuur-vir-verpleegster strategie.

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