The knowledge of registered nurses regarding skin integrity, foot care and nutrition of a diabetic client with a stroke

Jordaan, Danielle Nicolene (2004-04)

Thesis (MPhil)--Stellenbosch University, 2004.

Thesis

ENGLISH ABSTRACT: One of the proposals of the Bi-Ministerial Task Team (BTT) was that primary health care services in the Western Province should be nurse-driven (Department of Health and Social Services, 2000). This implied that nurses at the primary level of care (see definition of terms, page vii) should have a comprehensive knowledge regarding a variety of fields, e.g., preventive, promotive and curative services and rehabilitation. In the Helderberg area, which is the study area, it has been noted that there is a steady increase in the number of clients with diabetes and hypertension attending the eight community health centres (CHC's)/clinics. Diabetes and hypertension are interlinked and preventable diseases of life style (Provincial Government of the Western Cape (PGWC), 1999). These two conditions are commonly accompanied by a sequel of complications, such as skin breakdown, foot ulcers, stroke and nutritional deficiencies. These complications can further lead to disability when not managed appropriately. Historically the focus of the nurse has been on curative care, with little emphasis on prevention and rehabilitation. There is also a misconception among the medical staff and the clients that the management of complications of diseases of life style, as mentioned in the previous paragraph, is the responsibility of the rehabilitation specialists, e.g., the physiotherapist and the occupational therapist. With the vision of the BTT, the rise in the number of clients with diseases of life style, and the current focus of the nurse, the researcher is questioning the knowledge of the registered nurse at primary level of care in the Helderberg area in respect of skin integrity, foot care and nutrition of a diabetic client with a stroke. In order to answer this question, a descriptive study was done, making use of a self-administered questionnaire. The Helderberg area with approximately 50 registered nurses working at the eight different CHC's/clinics was chosen as the study area. Of the 50 registered nurses actively working, 44 completed the questionnaire, giving the researcher a return rate of 88%. The data was analysed using both quantitative and qualitative methods. Results showed that the overall average score for registered nurses on the three aspects, namely knowledge of skin integrity, foot care and nutrition of a diabetic client who has suffered a stroke, was 80%, the highest % score being 91% for aspects related to nutritional status and the lowest % score was 70% for aspects related to the prevention of skin breakdown, leaving a knowledge deficit of 20%. Not a single registered nurse scored 100% on the three aspects mentioned. Recommendations are made to all the role players, e.g., the registered nurses, the area managers in the Helderberg area and the rehabilitation staff.

AFRIKAANSE OPSOMMING: Een van die voorstelle van die Bi-Ministeriële Taakspan (BIT) was dat primêre gesondheidsorg in die Wes-Kaap verpleeg-aangedrewe moet wees (Department of Health and Social Services, 2000). Dit impliseer dat verpleegkundiges op primêre vlak 'n omvattende kennis moet hê van die verskillende aspekte van verpleging waarin hulle werk, byvoorbeeld, voorkomende, bevorderende, en kuratiewe dienste, asook rehabilitasie. Diabetes en hipertensie hou verband met mekaar en is voorkombare toestande verwant aan lewenstyl (Provincial Government of the Western Cape (PGWC), 1999). Hierdie twee toestande gaan dikwels gepaard met komplikasies soos velafbraak, voet-ulkusse, beroerte, en voedingsgebreke. Hierdie komplikasies kan verder lei tot gestremdheid indien nie behoorlik gehanteer nie. Histories was die fokus van die verpleegkundige op kuratiewe sorg, met min klem op voorkoming en rehabilitasie. Daar bestaan ook wanopvattings onder mediese personeel sowel as kliënte dat die hantering van komplikasies as gevolg van toestande verwant aan lewenstyl die verantwoordelikheid van die rehabilitasiespesialiste, byvoorbeeld fisioterapeute en arbeidsterapeute is. Met die visie van die Bi-Ministeriële Taakspan, die toename in die aantal kliënte met toestande verwant aan lewenstyl, en die huidige fokus van die verpleegkundige, bevraagteken die navorser die kennis van die primêre vlak verpleegkundige op in die Helderberg-, oor aspekte soos velintegriteit, voetsorg, en die voedingstatus van 'n diabetiese kliënt wat 'n beroerte gehad het. In 'n poging om die vraag te beantwoord, is 'n beskrywende navorsingstudie gedoen en 'n selfgeadministreerde vraelys is gebruik. Die Helderberg-area, met ongeveer 50 geregistreerde verpleegkundiges, wat in agt verskillende plaaslike owerhede klinieke/gemeenskapsgesondheidsentra werksaam is, is gekies as die navorsingsarea. Van die 50 geregistreerde verpleegkundiges wat aktief werksaam is in die area, het 44 die vraelys voltooi, wat die navorser 'n terugvoer persentasie van 88% gegee het. Data is ontleed deur van beide kwantitatiewe en kwalitatiewe metodes gebruik te maak. Resultate het getoon dat die algehele gemiddeld behaal deur die verpleegkundiges oor kennis van die drie aspekte, naamlik velintegriteit, voetsorg, en voeding van 'n diabetiese kliënt wat 'n beroerte gehad het, 80% was. Die hoogste persentasie behaal was 91% vir aspekte rakende voedingstatus en die laagste persentasie behaal was 70% vir aspekte rakende velatbraak, wat 'n kennis leemte van 20% kennis los. Geen verpleegkundige het 100% behaal vir die drie genoemde aspekte nie. Aanbevelings is aan die rolspelers gemaak, byvoorbeeld, die geregistreerde verpleegkundiges, die area bestuurders in die Helderberg area en die rehabilitasie personeel.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/50167
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