Browsing by Author "Stellenberg, Ethelwynn L."

Now showing 1 - 6 of 6
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    Barriers to quality patient care in rural district hospitals
    (AOSIS Publishing, 2012-05) Eygelaar, Johanna E.; Stellenberg, Ethelwynn L.
    Currently barriers exist in delivering quality health care. This study aimed to investigate such barriers in the eight rural district hospitals of the West Coast Winelands Region, three type A and five type B hospitals. A quantitative descriptive design was applied which included the total population of nursing staff (n = 340) working at the time of data collection. A self-administered questionnaire was distributed with a response rate of 82%. Reliability of the instrument was verified using the Cronbach alpha coefficient and a pilot study. The validity, specifically construct and content validity, were assured by means of an extensive literature review, pilot study and use of experts. Ethics approval was obtained from the relevant stakeholders. Results showed that 272 participants (97%) disagreed that provision of staff was adequate, with staff above 40 years of age more likely to disagree (p = 0.01). A statistically significant association was shown between availability of doctors and staff not being able to cope with emergencies (p = <0.01). Most participants (n =212; 76%) indicated that they were not receiving continuing education, with the registered nurses more likely to disagree (÷² test, p = 0.02). Participants in both hospital types A (n = 131; 82%) and B (n = 108; 91%) also disagreed that provision of equipment and consumables was adequate. The research showed that inadequacies relating to human resources, professional development, consumables and equipment influenced the quality of patient care. Urgent attention should be given to the problems identified to ensure quality of patient care in rural hospitals.
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    Ethical issues that confront nurses in private hospitals in the Western Cape Metropolitan area
    (AOSIS Publishing, 2014-06) Stellenberg, Ethelwynn L.; Dorse, Alta J.
    Background: Nurses are faced daily with a variety of ethical issues which could be as a result of budget cuts, target setting, the shortage of nurses and expertise. Objectives: The objectives of the study were to identify ethical issues related to patient care, to describe ethical issues related to patient diversity, rights and human dignity. To describe ethical issues related to caring in nursing and to the workplace environment. Method: A quantitative explorative descriptive research design was applied. A stratified sample of (n = 142/5%) was drawn from all nurses and caregivers (N = 2990) working in a selected group of eight private hospitals. Self-administered questionnaires were used to collect the data. Statistical tests were applied to determine statistical relationships between variables. Results: Results included (95%) of respondents provided safe and committed care to their patients, (99%) loved to care for their patients and (93%) believed in the Nurses’ Pledge of Service. Fifty percent (50%) of the respondents indicated verbal abuse from patients and only (59%) experienced openness and transparency in the work environment. Analysis further identified that the caregivers did not respect the noble tradition of the profession and experienced the most verbal abuse. Conclusion: This study has identified ethical issues which may give rise to conflict within the workplace environment if not adequately addressed by management. The study further showed that the use of caregivers not regulated in nursing practice may pose as a threat to the safety of the patient
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    Integrating HIV care and treatment into primary healthcare : are clinics equipped?
    (AOSIS Publishing, 2014-08-28) Crowley, Talitha; Stellenberg, Ethelwynn L.
    Background: The demand for HIV care and treatment services is increasing rapidly and strategies to sustain long-term care should be employed. The decentralisation and integration of HIV care and treatment services into primary healthcare (PHC) is vitally important in order to ensure optimal access to life-saving antiretroviral therapy and ongoing chronic care. Conversely, the PHC system is fraught with the current burden of disease. Setting: The study was conducted in PHC clinics in the uMgungundlovu district, Kwa-Zulu Natal. Aim: The objectives of the study were to assess whether PHC clinics were equipped to deliver integrated HIV services and to evaluate the availability of resources as well as support systems for HIV care and treatment in PHC clinics. Methods: A quantitative, cross-sectional descriptive study was undertaken in 20 randomlyselected, eligible clinics in the uMgungundlovu district, KwaZulu-Natal, South Africa. An evaluation instrument was completed through observations and review of the clinic data records. Criteria were based on the World Health Organization’s guide to indicators for antiretroviral programmes as well as South African HIV standards for PHC facilities. Results: None of the clinics were equipped adequately. Clinics with a higher patient load had poorer scores, whilst clinics providing antiretroviral therapy were better equipped in terms of human resources and infrastructure. Conclusion: HIV services are an essential part of primary healthcare and clinics need to be equipped adequately in order to render this service. It is unlikely that the over-burdened health system would be able to cope with an increased number of patients on antiretroviral therapy in the long term, whilst maintaining quality of services, without support being given to PHC clinics.
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    Knowledge of midwives about hypertensive disorders during pregnancy in primary healthcare
    (AOSIS Publishing, 2016-04) Stellenberg, Ethelwynn L.; Ngwekazi, Nompumelelo L.
    Background: Many factors or medical conditions may influence the outcome of pregnancy,which in turn, may increase infant and maternal morbidity and mortality. One such condition is an increase in blood pressure (BP). Setting: The study was conducted in maternity obstetrical units (MOUs) in primary healthcare clinics (PHCs) in the Eastern Cape, South Africa. Objectives: To determine the knowledge about hypertensive disorders during pregnancy (HDPs) of registered midwives working in MOUs in PHCs. Methods: A quantitative descriptive correlation research design was applied. A simple random sample of 43 (44%) rural and urban clinics was selected, and all registered midwives (n = 101) working in these clinics completed a self-administered questionnaire. Data were collected over a period of 1 month. The reliability and validity of the methodology were supported by experts and a pilot study. Descriptive statistics including various statistical tests to determine any associations between variables using a 95% confidence interval were applied. Results: A gap in the knowledge of midwives about HDPs was identified. Only 56.4% of the participants correctly answered the questions on the clinical manifestations of severe pre-eclampsia and 68.3% on the factors affecting BP, whereas 27.7% had no understanding about pre-eclampsia. Significant statistical differences were identified in the knowledge of staff in clinics where doctors visit regularly versus those in clinics where there are no visits (p = 0.04), and between experience of midwives and management of HDPs (p = 0.02). Conclusion: The knowledge of midwives is deficient regarding HDPs. Continuous professional development is critical in midwifery both in theory and in clinical practice.
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    Prevalence of and factors influencing postnatal depression in a rural community in South Africa
    (AOSIS Publishing, 2015-11) Stellenberg, Ethelwynn L.; Abrahams, Johanna M.
    Background: Knowledge about postnatal depression (PND) and associated risk factors whichin fluence the development of PND is vital for early detection, intervention and prevention. Setting: The study was conducted in primary health care clinics (PHC) in the Witzenberg subdistrict, a rural community in South Africa.Objectives: Objectives of this study were to determine the prevalence of PND and to identify the contributing risk factors associated with PND. Methods: A descriptive cross sectional research design with a quantitative approach was applied. The target population was mothers, 18 years and older. A convenience sampling method was used to select a sample of 159 (10%) from a population of 1605 live births. Th eEdinburgh Postnatal Depression Scale (EPDS) and Beck Depression Inventory (BDI), two validated self-rating questionnaires, including a questionnaire based on demographical, psychosocial and obstetrical data, were applied. The data was analysed using various statistical tests to determine statistical associations between variables using a 95% confidence interval. Results: PND was a serious health problem with 50.3% of the mothers who suffered from PND. A BDI analysis showed that of the participants who had PND, 28.8% was severe, 48.8% moderate and 22.5% mild. Factors influencing the development of PND included most participants (63.5%) were unmarried, 61.3% were unemployed and the majority (53.8%) had a history of a psychiatric illness. Significant associations between PND and unplanned and unwelcome babies (p < 0.01); partner relationship (p < 0.01); were identified. Conclusion: Prevention, early detection, appropriate referral and treatment of PND are critical in managing maternal, child and family well-being.
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    The role of patient care workers in private hospitals in the Cape Metropole, South Africa
    (AOSIS Publishing, 2017) Aylward, Louise A.; Crowley, Talitha; Stellenberg, Ethelwynn L.
    Background: Nursing managers have to meet expectations of patients despite economic pressures, an increasing burden of disease and nursing shortages. Shifting health care-related tasks to lower categories of staff, including non-nursing support staff, has become one solution to address this dilemma. Patient care workers are a specific group of non-nursing support staff working in South African hospitals. Although patient care workers have been used for several years and their numbers are increasing, there are controversial opinions about the role of patient care workers, ranging from praise for their contribution towards patient care to serious concerns about the impact of their role on patient safety. Objective: The study objective was to explore and describe the role of patient care workers in private hospitals. Methods: A qualitative, descriptive design was applied to explore the role of patient care workers. Purposive sampling was used to select unit managers, nurses and patient care workers from medical and surgical wards of three private hospitals. Fifteen semi-structured interviews were conducted and transcribed verbatim. The researcher applied interpretative data analysis to move from the participants’ descriptions of their experiences to a synthesis of all participants’ descriptions. Results: Patient care workers are involved in direct patient care and spend much time with patients, often not working under direct supervision of registered nurses despite limited training and lack of regulation. Their contribution, however, is valued by nurses. Conclusion: Patient care workers are well-integrated into the patient care team and are mostly seen as nurses. Yet, there are concerns about their evolving role despite their limited training and the lack of direct supervision. Regulating the work of patient care workers is recommended.