Department of Curriculum Studies
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- Item'n Opleidingsraamwerk gerig op gehalte aborsiesorg vir verpleegkundiges aan hoëronderwysinstellings in die Wes-Kaap(Stellenbosch : Stellenbosch University, 2008-12) Smit, Ilze; Bitzer, E. M.; Steyn, D. W.; Boshoff, E. L. D.; Stellenbosch University. Faculty of Education. Dept. of Curriculum Studies.ENGLISH ABSTRACT: Before the implementation of abortion legislation in South Africa in February 1997, illegal abortions were the only way out for women with unwanted pregnancies. Because of the high morbidity and mortality rate of the women concerned, abortion legislation was implemented with the aim of ending illegal abortions in South Africa by having abortions carried out legally on request in designated health care facilities. The abortion legislation stipulates that registered nurses who have undergone the proposed abortion care training may terminate a pregnancy upon request of a woman during the first twelve weeks of the gestation period of her pregnancy. Although legislation authorises registered nurses to carry out first trimester abortions, an inadequate number of nurses are being trained in the Western Cape to provide pregnant women with guidance and counselling services, carry out the abortions and/or refer problem cases. Since the implementation of the abortion legislation no real attempts have been made by higher education institutions in the Western Cape to offer abortion care training for nurses. A need has therefore been identified to develop a comprehensive training framework for higher education institutions in the Western Cape for the training of nurses in abortion care. The case study was used as research design and the specific unit of analysis on which the researcher focused were the registered nurses who had received training in abortion care and the context in which they provide abortion care at the various levels of service provision in the different regions of the Western Cape. A random, stratified sample (non-proportional) was taken of the designated state health care facilities in the Western Cape, as well as a non-probability purposive sampling of registered nurses who provide abortion care, a non-probability convenience sample of women who have received abortion care and a non-probability purposive sampling of final-year pre-registration nursing students. Data was generated by means of questionnaires to the women who received abortions and/or counselling, the registered nurses who carried out abortions as well as final-year preregistration nursing students. A checklist was used to observe the abortions that were carried out by registered nurses in an objective and non-participatory manner and semi-structured interviews were conducted with various role-players in abortion care and training. The main findings of this study indicate that the necessary infrastructure within which the services could be provided according to the abortion legislation was adequate, but that the ongoing shortage of trained health care practitioners hampers the abortion care services. Only 10 (n=10) of the 15 certified nurses employed in state health care facilities actively offered abortion care services in the various designated facilities in the Western Cape. Deficiencies were identified in the existing provincial protocol and it was clear that some of the guidelines are either not in use or have become obsolete in the light of new research findings. It was found that midwives with appropriate and effective training are the ideal category of health practitioner for the provision of abortion care. The certified nurses who have been trained by the various regional offices of the Department of Health: Western Cape are skilled in carrying out the abortion procedure, but the other aspects of abortion care, that are mainly carried out by other categories of nurses, will probably require greater attention. The recommendations, which are based on a thorough literature study as well as on the findings and conclusions that arose from the empirical part of this study, have been included in a training framework. The researcher recommends that the training framework provide the basis for the development of a formal programme or programmes for the training of nurses in abortion care at higher education institutions. The purpose of the proposed framework is therefore to determine the context within which curriculation ought to take place, and to provide a focus or format for those who develop the curriculum for prospective students.