Browsing by Author "Klopper, Hester C."
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Item Clinical supervisors’ understanding of spirituality and spiritual care in nursing: A South African perspective (part 2)(Elsevier, 2021) Linda, Ntombizodwa S.; Deliwe, Phetlhu, René; Klopper, Hester C.The article provides findings of understanding of clinical supervisors (CSs) on spirituality and spiritual care in nursing practice. These participants who taught nursing skills to nursing students who were registered for R425 SANC Nursing Curriculum. Revealed uncertainties regarding their implementation of spiritual care in clinical nursing. They expressed concernes that despite South African Nursing Council’s espoused holistic approach to nursing, a gap still exist in SANC’s holistic philosophy. This view is supported and by the lack of guidelines from the SANC. According to the participants lack of guidelines indicates failure of SANC in embracing spiritual care as a vital component of “holistic nursing”.Item A programme to facilitate quality client-centred care in Primary Health Care clinics of the rural West Coast District(University of the Western Cape, 2018) Eygelaar, Johanna Elizabeth; Klopper, Hester C.; Jooste, KarienIntroduction: The overall aim of this study was to develop a programme to facilitate quality client-centred care in Primary Health Care clinics of the rural West Coast District. Research design and -method: Both quantitative and qualitative methods were applied for this study . Phase 1, a situational analysis collected and analysed quantitative data from the perspective of clients and clinical nurse practitioners via structured questionnaires. The population included all clients 18 years and older (N=137 991) of the fixed clinics (N=25) in the five subdistricts of the West Coast District. According to the Cochran formula a sample of (n=383) should be adequate to represent the population. Non-proportional sampling was applied to estimate the number of participants per clinic. An all-inclusive sample of (n=64) clinical nurse practitioners participated in the study. Phase 2, the qualitative part of the situational analysis, applied five focus group discussions to explore and describe the managers and allied health professionals’ perceptions about quality client-centred care. A semi-structured interview schedule was compiled to guide the focus group discussions. An all-inclusive sample was utilised to include all the managers and allied health professionals of the five subdistricts (N=43). Phase 3 included the development of the programme based on the study findings and literature. Quantitative results: The analysis revealed the following quality client-centred care challenges, namely: Patient Rights (Domain 1) were not always respected and adhered to as these were characterised by: language (statistical p<0.001 and practical significant with a large effect size d=0.74); Satisfaction and Safety (statistical p<0.001 and practical significant with a medium effect size d=0.55); Referral Procedures (statistical significant p<0.001); Waiting Times (statistical p<0.001 and practical significant with a medium effect size d=0.47) and Confidentiality difficulties (statistical p<0.001 and practical significant with a medium effect size d=0.68). The Domain 2, Clinical Governance, Care and Safety showed shortcomings as highlighted by the Client and his/her Family (statistical p<0.001 and practical significant with a large effect size d=0.77). Clinical Support Services, Domain 3, revealed inadequacies regarding the continuous availability of medication (statistical significant p<0.008) and the reporting of side-effects (statistical significant p<0.001). Furthermore, Public Health Domain 4, showed that clients identified community health promotion and disease prevention events (statistical p<0.01 and practical significant with a large effect size d=0.79), and home visits by the community healthcare workers (statistical p<0.001 and practical significant with a large effect size d=1.09) as both a “problem” and a “gap”. Leadership and Corporate Governance, Domain 5 was characterised by the lack of: visible organograms (clients mean 2.40), community communication (clients mean 2.12 & clinical nurse practitioners mean 2.36), visibility of goals, values and future plans of the Western Cape Department of Health (statistical p<0.001 and practical significant with a medium effect size d=0.59) and role and function of the clinic committees (statistical significant p<0.008). Moreover, Domain 6, Operational Management was challenged by inadequate staffing levels (statistical significant p<0.003). Lastly, Domain 7: Infrastructure was characterised by the lack of drinking water in the waiting areas (clients mean 2.08 & clinical nurse practitioners mean 2.02), inadequate clinic space (clients mean 2.10 & clinical nurse practitioners 2.23); maintenance not up-to-date (statistical significant p<0.002); physical appearance of the clinic (statistically significant p<0.001) did not have a positive effect on staff morale and evacuation plans (statistical p<0.001 and practical significant with a medium effect size d=0.54) were not visible. In addition, correlations between the domains showed that the domains are not in silos, but are interdependent on another. Qualitative results The qualitative, thematic data analysis revealed various inadequacies regarding quality client-centred care. Theme One about the Patient Rights revealed that patients were not always treated with the necessary respect and dignity. Theme Two concerning Patient Care, revealed that focus group participants were well-informed on what the concept client-centred care entailed. However, patients and or clients did not always experience their care as client-centred. Theme Three about the Clinical Support Services, indicated shortages of medication and medical equipment; long waiting time for specialists and rehabilitation referral appointments. Theme Four, referring to the Public Health confirmed that health promotion and prevention activities are limited, due to various organizational factors and community healthcare workers’ activities which are limited to home-based care activities. Theme Five, Corporate Governance and Leadership matters were characterised by too many processes or “red tape” resulting in inefficient procurement processes, inadequate staffing and inactive health committees. Theme Six, Operational Management highlighted the severe pressure under which the operational managers have to work, resulting from their twofold role of being the clinic manager and at the same time operate as a clinical nurse practitioner. Theme Seven refers to Infrastructure and Facilities and is characterised by inadequate maintenance and lack of space according to the number of clients and package of care. To summarise: The situational analysis revealed 81 problems. These problems form the evidence base for the development of the programme to facilitate quality client-centred care in primary helth care clinics of the rural West Coast District.Item Significance of literature when constructing a theory: a selective literature review(AFAHPER-SD, 2014) Phetlhu, Deliwe R.; Klopper, Hester C.; Linda, Ntombizodwa S.The issues around use of literature in theory construction are often a source of confusion, especially for novice researchers. The very nature of the process of theory construction remains blurred due to lack of consensus among researchers. Novice researchers are often confronted with questions of whether or not a literature review should be conducted when constructing a theory. These questions seeking to justify what a credible methodology is when constructing a theory not only challenge novice researchers but also experienced researchers. This article explores different perspectives regarding the significance of literature review in theory construction. A selective literature review was used to access and interrogate selected arguments from published peer-reviewed work. Narrative analysis was used to analyse selected text. It is concluded that literature plays a pivotal role in theory construction, whether by active review in the case of novice researchers or being sensitised by virtue of discipline interest and prolonged exposure in experienced researchers. However, it is important not to disregard the view that it is not necessary to incorporate literature review in certain specific designs due to assumed influence on the outcome of the new theory.Item Students’ voices on spiritual care at a Higher Education Institution in the Western Cape(Curationis, 2015) Ntombizodwa, Linda S.; Klopper, Hester C.; Deliwe, PhetlhuBACKGROUND: Nurses have a moral obligation to ensure holistic care of patients, inclusive of the spiritual dimension. However, there seems to be a void in the teaching and learning of spiritual care in nursing curricula. Despite the South African Nursing Council being in favour of holistic nursing, there are no measures in place to ensure implementation of spiritual care, hence its practice is not standardised in nursing education in South Africa. Currently, the undergraduate nursing curriculum does not provide clear direction on how spiritual care in nursing should be integrated and the reason for this is not clear. It appears that the lack of professional regulation, difficulties in definition and the personalised nature of spiritual practice are partly responsible for the practice being barely enforced and scarcely practised by students in clinical placements. The aim of the study was to develop a practice theory for teaching–learning of spiritual care in the undergraduate nursing programme. OBJECTIVES: The study objective was to describe and explore the students’ experiencs of teaching–learning of spiritual care in the undergraduate nursing programme. Methods: A qualitative, explorative, descriptive and contextual design with purposive sampling was used. The sample consisted of undergraduate nursing students at a University in the Western Cape Province. Measures for trustworthiness were applied. RESULTS: The findings indicated a need to provide support, a conducive learning environment and structure for teaching, learning and practice of spiritual care. CONCLUSION: There is a need for formal education regarding spiritual care in nursing.Item Students’ voices on spiritual care at a Higher Education Institution in the Western Cape(AOSIS, 2015) Linda, Ntombizodwa S.; Klopper, Hester C.; Phetlhu, Deliwe R.BACKGROUND: Nurses have a moral obligation to ensure holistic care of patients, inclusive of the spiritual dimension. However, there seems to be a void in the teaching and learning of spiritual care in nursing curricula. Despite the South African Nursing Council being in favour of holistic nursing, there are no measures in place to ensure implementation of spiritual care, hence its practice is not standardised in nursing education in South Africa. Currently, the undergraduate nursing curriculum does not provide clear direction on how spiritual care in nursing should be integrated and the reason for this is not clear. It appears that the lack of professional regulation, difficulties in definition and the personalised nature of spiritual practice are partly responsible for the practice being barely enforced and scarcely practised by students in clinical placements. The aim of the study was to develop a practice theory for teaching–learning of spiritual care in the undergraduate nursing programme. OBJECTIVES: The study objective was to describe and explore the students’ experiences of teaching–learning of spiritual care in the undergraduate nursing programme. METHODS: A qualitative, explorative, descriptive and contextual design with purposive sampling was used. The sample consisted of undergraduate nursing students at a University in the Western Cape Province. Measures for trustworthiness were applied. Results: The findings indicated a need to provide support, a conducive learning environment and structure for teaching, learning and practice of spiritual care. CONCLUSION: There is a need for formal education regarding spiritual care in nursing