Dissertations / Theses on the topic 'Nursing – Botswana'

Background: Cataract is the leading cause of blindness globally. In Botswana about 60% of blindness is due to cataract. Health services in Botswana are free, as are cataract services. Despite the free health services offered, the Batswana do not fully utilize the available eye care services especially the cataract services. Many Batswana access health care in public hospitals, where patients may have to wait for long periods for clinic appointments and surgery. Research question: What are the perceptions that elderly persons in Mathangwane village in Botswana, have of cataracts and cataracts services? Aim: To explore and describe the perceptions of elderly persons in Mathangwane about cataracts and cataract services. Objectives: 1. Explore and describe elderly persons' perceptions of cataracts; 2. Explore and describe elderly persons' perceptions of cataract services; 3. Explore reasons for use and non-use of current cataract services. Methods: Qualitative exploratory descriptive methods were used. A qualitative study design with purposeful sampling was used to identify participants for interviews and focus group discussion. Semi-structured interviews with seven participants aged sixty-five years and older with diagnosed cataract as well as a focus group with six of the seven participants were conducted. Data was analysed using a content analysis approach. Results: Five themes emerged from the interviews and a focus group discussion: i. Cataract as the 'spider web'; ii. Curing cataract with traditional herbs; iii. Cataract a problem of the elderly caused by modem food; iv. The burden of cataract blindness: 'mealie on the fire'; v. The ambivalent voice of elderly persons about cataract services. Conclusion: Findings from this study show that the participants had a general understanding of what cataract is and they had a particular description for this. Both positive and negative feelings were expressed in relation to the services available. Although cataract surgery was perceived to restore vision a major concern of the elderly persons was in relation to delays they experienced while waiting for the cataract to fully mature. Despite the free services offered at community level there is a great need for affordable and accessible transportation services for elderly persons utilising the cataract services.

Includes bibliographical references (leaves 79-89).<br>The purpose of this study was to explore the experiences of Botswsana women who are diagnosed with both HIV/AIDS and cervival cancer. A phenomenological descriptive qualitative research design was therefore appropriate to answer the research question.

Thesis (MPhil)--Stellenbosch University, 2012.<br>Background: Preceptorship refers to a teaching and learning approach through which a well experienced clinician is contracted to provide clinical teaching, supervision, role‐modeling of professional and clinical practice skills and assessment of students in a clinical setting. This approach often involves three groups of people, namely: faculty, students, and clinicians (preceptors). The preceptor in this study refers to a registered nurse who supervises and conducts clinical assessment of students in a clinical area, while at the same time is responsible for patient care. The focus of this study was to explore preceptors’ opinions regarding the implementation of preceptorship in the diploma in the nursing curriculum diploma in the nursing curriculum in Botswana. Emphasis was placed on seeking information on how preceptorship is implemented, the strengths and challenges regarding its implementation and suggestions as to how it should be strengthened to contribute positively towards teaching and learning of students. Methodology: A mixed cross‐sectional descriptive design, using a survey was used. . The design was adopted because of its ability to provide a broad understanding of the concept under study by allowing participants to share their experiences and opinions about a specified situation. Both the qualitative and quantitative data were collected simultaneously. A standardized self‐developed structured questionnaire using both closed ended and few open ended questions and consisting of scaled self‐report items and checklists was used to collect data from forty‐four (44) preceptors and three (3) third year level coordinators from the three (3) health training institutions. Quantitative data were analyzed using SPSS, while the qualitative data were analyzed for frequency of common themes. Descriptive statistics in the form of frequency tables and charts, as well as measures of central tendencies, were used in the analysis of quantitative data. Results: The findings revealed that preceptorship program was not well coordinated as there were no preceptorship manuals to guide the implementation of preceptorship program. On the positive side, however, preceptors felt comfortable and competent to supervise and assess students, despite the fact that most of them had not received preceptorship training or orientation. With regard to preceptor support, it was evident that there was need for major support in regard to improved communication between preceptor and faculty, improved support by the health facility manager and the need for strengthening preceptor training and orientation. The majority of the respondents have recommended for preceptorship orientation /training targeted at addressing some of the following topics: Student and preceptor roles, curriculum requirements, clinical teaching and assessment skills, leadership skills and how to access resources from the health training institutions. A significant number of preceptors felt that it was important to receive feedback about students’ progress from faculty and to receive feedback from students regarding their experiences in the clinical internship sites. Lastly, preceptors also felt that there was need for introducing incentives into the preceptorship program Conclusion The key areas that emerged from the study indicated an uncoordinated and unstructured preceptorship program in the diploma nursing curriculum. Preceptor support is limited as evidenced by report of lack of training or orientation of preceptors to their preceptorship role. To ensure sustainability of preceptorship program there is need to improve the following areas: preceptorship training and orientation, and preceptorship support by both the health training institution and the health facility managers. Key words: Preceptors, preceptorship, orientation, socialization, student assessment, and faculty support, clinical teaching, mentor, clinical supervisor.

Background: The prevalence of overweight and obesity is an increasing health problem among adolescents due to unhealthy eating habits and inadequate physical activity. There are 434,000 (21%) adolescents aged 10-19 years in Botswana. The prevalence of overweight among adolescents aged 12-18 years in 2011 in urban private secondary schools in Botswana was 27.1% (192/702) and 13.1% (93/702) in public secondary schools. There is, however, a paucity of data on eating habits and physical activity behaviours and no published evidence was located on the prevalence of overweight among 13-15 year old adolescents in public junior urban secondary schools in Botswana. The determinants of adopting a healthy lifestyle such as information (knowledge), motivation (intentions) and behavioural skills (self-efficacy) have been identified in cross-sectional studies in other countries, but not in Botswana. A culturally suited lifestyle intervention program aimed at motivating adolescents to adopt a healthy lifestyle was not located in the published literature. In the absence of such a lifestyle intervention program for adolescents, the development, implementation and evaluation of the intervention for this study was guided by the Information, Motivation and Behavioural skills (IMBs) model to measure change in eating habits and physical activity behaviours of adolescents in Botswana. Methods: A 2-part study was conducted from 1 November 2015 to18 March 2016. Study One - three research designs were employed: 1) a descriptive design for development of a 3-part questionnaire from existing published literature; 2) a mixed methods approach to validate the prototype questionnaire by determining the index of content validity (n=10 respondents), face validity by cognitive interviewing (n=33 respondents who were scholars), and reliability by test-retest pilot testing (same 33 respondents); and 3) a cross-sectional survey by validated questionnaire of n= 252 respondents' (scholars) eating habits, physical activity behaviours and weight, height and waist circumference to determine the prevalence of overweight. Results from the cross-sectional survey provided baseline data for Study Two. For Study Two a descriptive design was employed to develop and describe a lifestyle intervention movement (LIMO) program followed by a pragmatic randomised controlled trial for implementing and evaluating the effectiveness of the LIMO program (n=25 respondents in the intervention trial arm; n=21 in the control arm from Study One). Null hypothesis: A lifestyle intervention movement (LIMO) program guided by the Information, Motivation and Behavioural skills (IMBs) model will not result in less fatty and sugar intake, an increase in fruit and vegetable consumption, engaging in physical activity 6 or more times a week and doing exercises, a reduction in sedentary behaviour and an increase in nutrition knowledge (P≥0.05). Alternate hypothesis: A lifestyle intervention movement (LIMO) program guided by the Information, Motivation and Behavioural skills (IMBs) model will result in less fatty and sugar intake, an increase in fruit and vegetable consumption, engaging in physical activity 6 or more times a week and doing exercises, a reduction in sedentary behaviour and an increase in nutrition knowledge (P≥0.05). Results: Study One: Good response rate of 95%. The mean age of the respondents was 14.3 years (SD 0.79); mean body mass index (BMI) was 20.1 kg/m2 (SD 3.9) and mean waist circumference score was 71.2 cm (SD 8.71). There were more females in the sample (147/252, 58.3%) than males (105/252, 41.7%). Most of the respondents (153/252, 53.6%) had a low socio-economic status as categorised by the present study. The majority (188/252, 74.6%) had a normal BMI and few (22/252, 8.7%) were underweight. Twenty-seven (10.7%) respondents were overweight, 4/252 (1.6%) were obese and 11/252 (4.4%) were obese with risk. Although few respondents had an abnormal waist circumference (females 17/252, 6.7%; males 14/252, 5.6%) more females (131/252, 52%) than males (90/252, 35.7%) had a normal waist circumference. The most frequently eaten foods were sweets (132/252, 52.4%) and snacks (92/252, (38.1%). Television adverts were sometimes (137/252, 62.3%) considered to be honest. Parents controlled slightly more than half (128/252, 50.8%) of the respondents' food choices whereas peers had little influence (21/252, 8.3%). Of the food types, most ate breakfast comprising of coffee and bread (115/252, 45.6%). Dinner was mostly eaten at home with the whole family (181/252, 71.8%). Of the listed foodstuffs, the majority preferred foods that contained sugar (41/252, 16.3%). Slightly more than half (135/252, 53.6%) of the respondents walked 6 or more times per day each week and more (150/252, 58.7%) reported that they did get exercise. Many intended to change their eating habits (220/252, 87.3%) and physical activity behaviours (143/252, 56.7%) and reported self-efficacy to do so (180/252, 71.4% and 174/252, 69.1% respectively). The majority of respondents (142/252, 56.3%) failed (≤49%) the nutrition knowledge test. The prevalence of overweight was 16.7% (42/252) by body mass index (BMI) and 12.3% (31/252) by waist circumference (WC) respectively. Study Two: There was no statistically significant difference in eating habits between the trial arms (fruit P=0.275, vegetables P= 0.604, sweets P=0.066, fatty foods P=0.402); although there was a difference in sugar consumption this was not statistically significant. There was no statistically significant difference in physical activity (walking 6 times or more a day each week) between trial arms (P=0.267), in doing exercise (P=0.288) and in sedentary behaviour (P=0.362). There was a difference in nutrition knowledge between trial arms but it was not statistically significant (P=0.079). Conclusion and recommendations: Although adolescents had good intentions and self-efficacy to change their eating and physical activity behaviours they engaged in unhealthy behaviours. The LIMO program demonstrated minimal but promising effects on changing behaviours. However further research is needed to determine the best intervention to impact behaviour change.

Background This study attempted to identify as far as possible the extent of the children’s nursing workforce in five selected countries in the sub-Saharan African region. Strengthening children’s nursing training has been recommended as a primary strategy to reduce the underfive mortality rate in African nations, including South Africa and Malawi. The current level of data monitoring capacity worldwide means that it is not possible to disaggregate the children’s nursing workforce in countries in the World Health Organisation African Region from the data provided by the WHO Global Atlas of the Health Workforce database. Yet developing an accurate depiction of the specialist children’s nursing workforce is a necessary step towards optimizing children’s health service delivery. Methods In attempting to respond to this need, this study adheres to a collaborative research philosophy, using a convergent parallel mixed methods design, incorporating a scoping documentary review, together with quantitative (surveys and case study compilation) and qualitative (interview) components collected independently and then integrated during analysis and interpretation, to generate data addressing three related questions: how many children’s nurses are believed to be in practice nationally; how many such nurses are recorded on the nursing register nationally; and how many children’s nurses are being produced through training. Results Findings suggest there are approximately 3 728 children’s nurses across the five countries in this study. A combined total of 260 children’s nurses are produced through training each year across the five countries on average. Survey responses, interview data and content analysis of items identified through the scoping review suggest that adequate information regarding the children’s nursing workforce is not currently available to inform decision-making. Conclusion In conclusion, it is hoped that the data generated might contribute towards identifying the size of the children’s nursing workforce, as a first step towards identifying what would represent a viable and sustainable regional children’s nursing workforce for the future.

A non-experimental, explorative, descriptive, quantitative study was undertaken. The purpose was to explore and describe the views of preceptors and preceptees regarding the fulfillment of the role of the preceptor in selected clinical nursing practice settings in the Botswana context. The study included 72 preceptors and 200 nursing students/preceptees who voluntarily agreed to participate in the study. A questionnaire was used to collect data. Data was analysed by using descriptive and inferential statistics. The findings of this study indicated that there were numerous constraints that interfered with the preceptor role in accompaniment of the preceptee. These constraints included the lack of desirable characteristics and time to plan learning opportunities, inadequate use of teaching strategies and inadequate knowledge on preceptee evaluation. Recommendations were stated for improvements in the future role of the preceptor in clinical practice settings Limitations of this study were also highlighted.<br>Health Studies<br>M.A.(Health studies)

Background: Comprehensive oral care is an evidence-based, cost effective, essential routine nursing intervention that nurses ought to provide with good knowledge/understanding as it prevents and controls nosocomial infections especially Ventilator Associated Pneumonia (VAP) that is associated with increased morbidity and mortality in critically ill patients in Intensive Care Units (ICU). Aim of study: To determine ICU nurses’ knowledge, describe their practices and identify their perceptions regarding comprehensive oral health care to critically ill patients in order to refine or develop evidence based oral care protocol. Methods: A quantitative approach with a descriptive, exploratory survey was used for this study. A non probability convenience sample of thirty-four (34) ICU nurses from two public referral hospitals participated in this study. A questionnaire with a combination of open and closed ended questions was used to collect data on comprehensive oral care to critically ill patients. Results Thirty-four nurses responded to the questionnaire (response rate 89%). Only 18% (n=6) were knowledgeable about important aspects of oral care, while the majority, 82% (n=28) lacked knowledge on important aspects of oral care. Fifty-nine percent (59%) n=20 had received training on comprehensive oral care at basic nursing training and 44% (n=15) had orientation at unit level. Ninety-seven percent (97%) n=33 of the participants requested further updates on comprehensive oral care. No significant relationships were found between nurses’ demographic characteristics and knowledge of comprehensive oral care. All (100%) n=34 of nurses gave oral care a high priority and 91% ranked it very important for critically ill patients. Toothbrushes and toothpaste were used by 85% (n=29) of nurses and only 50% (n=17) used mouthwashes. The reason for non- use of mouthwashes was lack of supplies and not having been foreseen in unit protocol although neither of the units had an oral care protocol in place.<br>Thesis (M.N.)-University of KwaZulu-Natal, Durban, 2011.

Thesis (MPH.) --University of Limpopo, 2018<br>Background: Employee morale is a critical factor in any organization either be locally and or globally and Botswana is no exception. Mental health nurses have been considered professionals that assist people to regain a sense of coherence over what is occurring to them - be it a result of trauma or some other form of mental distress. Good morale among staff on inpatient psychiatric wards is an important requirement for the maintenance of strong therapeutic alliances and positive patient experiences, and for the successful implementation of initiatives to improve service delivery. The aim of the study was to determine the factors influencing nursing staff morale at S’brana Psychiatric Hospital (SPH) in Botswana. Methods: A quantitative, cross sectional study was conducted on 147 respondents. Self-administered questionnaire was used for data collection and it was closed ended. Data was collected at S’brana Psychiatric Hospital (SPH) and stratified random sampling technique was used to select nurses according to their categories. Data were analyzed through SPSS Software v21.0. Results: The results revealed that the majority of the nurses were aged between 26 - 30 years and most of them were females compared to males. It is evident from the results that, there was strong association between number of years and nursing position (χ2(15) = 72.34, p = .000). Also, there was positive correlation between respondents highest qualification in nursing and training received to do the job well (r = .312, n = 147 and p = .000.). Multiple regression analysis showed a statistically significant, F(3, 143) = 46.69, p = .000, and accounted for 70.3% of the variance. Conclusion: This study has revealed that nurses’ morale in SPH can be affected by a number of factors irrespective of their age, work experience, nursing position and ward they work in. The consequences of low staff morale are detrimental to health professionals (nurses) and patients, therefore, it is important for healthcare managers to address the shortcomings in order to counteract the negative effects of low staff morale

M.Cur. (Nursing Education)<br>Performance appraisal is a continuous process for identifying, evaluating and developing the work performance of nurse educators so that the goals and objectives of the college are more effectively achieved, while at the same time benefiting individual nurse educators in terms of reward and recognition of performance, professional development and career guidance. Performance appraisal entails structured formal interaction between an appraiser and appraisee, which usually takes the form of a periodic interview (annual or semiannual), in which the work performance of the appraisee is examined and discussed with a view to identifying weaknesses and strengths as well as opportunities for improvement and skills development. The challenge faced by the nurse educators is the lack of knowledge in execution of the performance appraisal. The purpose of the study is to describe guidelines to improve the performance appraisal system of nurse educators at all eight nursing colleges in Botswana. The research design is qualitative, exploratory and descriptive. Purposive sampling was used in this study to recruit nurse educators to participate in individual semistructured interviews. A qualitative open coding data analysis method was used. The researcher ensured the trustworthiness of the study by using Lincoln and Guba’s model of trustworthiness, which is based on four strategies: credibility, dependability, transferability and conformability. Inadequate knowledge among the nurse educators regarding performance appraisal emerged as the only main theme from the semi-structured interviews. Two subthemes that emerged from this theme were: inadequate knowledge of the appraisers and appraisees regarding the performance appraisal process and inadequate knowledge of the appraisers regarding mentoring and coaching of appraisees during the performance appraisal period. The theme and the sub-themes are conceptualised within the existing relevant literature, and guidelines to improve the performance appraisal system at the eight iv nursing colleges in Botswana are then described. Recommendations are made with regard to nursing education, nursing practice and nursing research. It is recommended that the nurse educators be trained in performance appraisal with emphasis on the performance appraisal process and the application of coaching and mentoring strategies throughout the performance appraisal period.

M.Cur.<br>The overall objective of this study is to measure the level of work satisfaction among nurses at Athlone, Lobatse Mental and Scottish Livingstone hospitals, and develop guidelines for the nursing service manager to facilitate work satisfaction. The nursing service manager is responsible and accountable for quality personnel management. Personnel management involves the adequate provision and utilisation of personnel as well as the retention and development of personnel. In view of existing problems such as high turnover rates, too much work and the public's concerns about the standard of nursing, there is need to regularly evaluate the level of work satisfaction among nurses. Hence the study address the formulation of guidelines for the nursing service manager to facilitate work satisfaction and empower nurses. Emanating from the above the following questions are relevant: What is the level of work satisfaction among nurses in the three government hospitals ? What measures need to be put in place in order to increase work satisfaction among nurses ?

Against the perspectives of the mental health needs of the people of Africa, this study explored and compared the models of psychiatric-mental health nursing education in two sub-Saharan African countries - Botswana and Nigeria. The primary purpose of the study was to assess the design, the implementation, the factors that influence and the perceived usefulness of psychiatric-mental health nursing education programmes in developing African countries, using Nigeria and Botswana as examples. A self-reporting questionnaire, administered to psychiatric nurse educators from the two countries of concern, provided the primary source of data. A curriculum evaluation checklist based on Horan, Knight, McAtee and Westrick (1984) was used to assess the components of the existing psychiatric nursing education curricula from the two countries. Discussions were also held with practising psychiatric nurses and officials of the nursing regulatory bodies from the two countries. Data from both countries revealed that participants used various terms to describe the same model for psychiatric-mental health nursing education adopted in their countries. Botswana, however, adopted a more functional generalist basic diploma nursing education approach which encouraged a more advanced post-basic diploma specialisation and practice in community psychiatric-mental health nursing. Nigeria's model leaned towards a hospital centred basic specialisation with no defined role for the generalist nurse within the psychiatric-mental health nursing care system. Community theme occurred in both countries' curricula with varying degrees of emphasis, as all the programmes claimed the intent to make psychiatric-mental health nursing service available to individuals, families and the communities at all levels of care. Psychiatric-mental health nursing education programmes of the two countries had been influenced at different times by war, colonial history, changing standards of health care delivery, government health policies, economic status of the country, professional status of nursing and the changing standard of education. A model that streamlined psychiatric-mental health nursing education within the general system of education in both countries was proposed. It was stressed that one key concept that must underlie the development of psychiatric-mental health nursing education was the need to create a mental health nursing role that would be appropriate for people's health needs rather than the needs of the health care system.<br>Advanced Nursing Science<br>D.Litt. et Phil.

According to the Ministry of Health (1996:26), the most common chronic/terminal illnesses were cardiovascular disorders, diabetes, cancer, mental disorders, HIV/AIDS, tuberculosis and asthma. Long term treatment and care and the growing incidence of these conditions necessitated the introduction of home-based care (HBC). Consequently, family care givers play a major role in the provision of care to chronically/terminally ill patients and professional health care providers adopt a supervisory role. This study examined the quality of home care services provided in Botswana. The availability and accessibility of home-based care services and resources have a direct bearing on the quality of home-based care delivery system. The researcher used systems theory was used as the conceptual framework for this study. The study aimed to • determine the accessibility and availability of home-based care services in Molepolole East • investigate what the perspectives and experiences of family care givers, patients and professional health care providers of Botswana home-based care are • determine the roles of professionals health care providers, patients, and family care givers and their relationships in the context of home- based care • identify the needs of chronically/terminally ill patents and family care givers • determine the type of support given to family care givers and patients by professional health care providers and make recommendations for the improvement of home-based care • develop a model to prepare family care givers The research design combined quantitative and qualitative research methods. A sample of convenience was used to obtain information from patients' family care givers and professional health care providers. Interviews and questionnaires were used. A proposed care giving preparedness model is presented to meet needs of the family care givers. The study found that family care givers needs are neither known nor catered for by the professional health care provider. The family care givers were not adequately prepared before adopting the care-giving role. It is recommended that • The proposed preparedness care giving training model is considered for training of patients and family care givers before discharge and during HBC. • Increase patients and family care givers decision-making<br>Health Studies<br>D.Litt. et Phil. (Health Studies)

The study aimed to explore adolescents knowledge, perceptions and behaviors regarding sexual reproduction and sexual reproductive health services in community junior school in Tutume Botswana. A descriptive exploratory design using both the qualitative and quantitative approach was used to guide the research process. Data was collected by means of a self administered questionnaire and two focus group discussions. A total of 76 participants answered the questionnaire and 2 focus group discussions one consisting of the 15 to 17 year olds and the other one consisting of 12 to 15 year olds were conducted. The results of the survey highlighted adequate levels of knowledge regarding sexual matters among adolescents in the school with the bulk of the information being provided by the teacher. Parents, nurses, siblings, peers and the media played a low key role in providing adolescents with information regarding sexual reproduction and sexual reproductive health services. The results of the focus group discussion showed marked underutilization of the local clinic for curative, preventive and promotive services by adolescents. The poor utilization resulting mainly from perceived barriers such as provider attitudes, subjective norms, cultural taboos, inadequacy of the clinic, judgmental attitudes from provider and parents as well as lack of encouragement from authority figures like parents and teachers. Adolescents in the focus group discussion perceive themselves as being susceptible to HIV but did not appreciate the benefits of using preventive measures even though the survey group showed sound knowledge on contraception. Improving the services to align them to adolescent friendly services, improving the delivery of information through other means apart from the teacher and reducing the barriers that discourage adolescents from reaching the reproductive health services will go a long way in improving the utilization of the services by adolescents.<br>Thesis (M.N.)-University of KwaZulu-Natal, Durban, 2009.

The post natal home visit care program is a maternal and newborn home visit care program, designed to address the needs of the childbearing families following delivery and early discharge, irrespective of the place of delivery. The study was undertaken to determine the factors influencing the implementation of the post natal home visit care program by nurses and to make suggestions to resolve the problem in an urban health district in Botswana. A descriptive exploratory study, using both quantitative and qualitative methods guided the process. Two methods were used to collect data, namely, the developed checklist and four focus group discussions. Twelve clinics were sampled and checklists were completed for the twelve clinics by the researcher. A total of twenty eight Registered Nurses and Registered/Enrolled Nurse Midwives were recruited from the participating twelve clinics through purposive sampling. This included nursing managers and senior nursing staff. The findings reflect the post natal home visit care program deficits. Protocols and logistics such as transport and staff for the program were not in place. Furthermore, the results also reflect various factors such as lack of motivation, lack of support from management and co-workers, distance and fear of stigmatisation as reasons for not implementing the post natal home visit care program. The participants felt that there was need to implement the program and attached merit to its importance. Finally, the participants made suggestions to overcome the deficit such as team work, commitment to work, academic development and improvement of management and supervision. In conclusion, failure to implement the program represents a health delivery deficit. There is need for improved management and supervision to balance the needs of Registered/Enrolled Nurse Midwives and the needs of the organization in order to attain better results. There is also a need for the provision of logistics needed for the post natal home visit care program such as transport and manpower. Finally, there is need for the coordination of the post natal home visit program by the District Health Team to aid implementation so as to provide the essential service.<br>Thesis (M.N.)-University of KwaZulu-Natal, 2006.

This study explored how the well-being of the gays, lesbians and bisexuals (GLBs} in Botswana could be promoted. The health and human rights approach that places dignity before rights was selected as a framework for investigation. The respondents' (n=47) levels of well-being were assessed through a questionnaire with 76 items that included the General Well-Being Schedule. The findings indicated that varying degrees of distress were experienced by 64 % of the GLBs in this study. The GLBs identified a need for HIV/AIDS education and had concerns about their general health, discrimination and vulnerability for violence including sexual attacks. Their levels of well-being were influenced by both positive internal acceptance of their sexual orientation and negative external acceptance by society. Levels of involvement of health professionals was poor, and linkage between health and human rights was proposed to reduce dignity violations and improve the quality of life of the GLBs in Botswana.<br>Health Studies<br>M.A. (Nursing Science)

The purpose of this longitudinal study was to evaluate the enrolled nurse/registered nurse (EN/RN) programme to determine the extent to which the graduates of the programme had acquired knowledge and skills to provide primary health care services to communities using the Stufflebeam CIPP model as a framework. The study determined the extent to which the graduates perceived that their knowledge and skills in provision of primary health care services have been strengthened and the extent to which their supervisors perceived the improvement of the graduates' knowledge and skills in provision of primary health care services in clinical and primary health care settings. The programme used two models for upgrading: one year full-time residential and two year distance education. The study used methodological triangulation for data collection. Data collection tools comprised of self-administered questionnaires to the EN/RN upgrade graduates, structured group interviews to their supervisors from the hospitals and district health teams and the review of the students' examination records from Institute of Health Sciences/University of Botswana (IHS/UB). Data were collected and analyzed from the one year full-time residential graduates who completed the programme from 1995-2000 and from the two year part-time distance education graduates who completed the programme 1996-2000. The findings from the academic records indicated that out of the 1116 enrolled nurses that were admitted into the EN/RN upgrade programme between 1994-2000 nine (0.8%) withdrew from the programme due to ill health or personal reasons before writing the final examinations. This is indicative of a high retention rate in the programme. In the one year full-time residential programme, out of the 695 enrolled nurses were admitted in the programme from 1995-2000 period five (0.7%) withdrew from the programme before writing the final examinations, 690 students sat for the final examination and 640 (92.8%) passed. In the two year part-time distance education programme, out of the 421 enrolled nurses were admitted in the programme from 1996-2000 period four (0.9%) withdrew from the programme before writing the final examinations, 417 students sat for the final examinations and 402 (96.4%) passed. Out of the 1107 students from both the one year full-time residential and the two year part-time distance education programme that sat for the final IHS/UB examinations, 1042 (94.1%) passed. The academic records revealed that the programme was efficient and effective because 1042 (94.1%) out of 1107 students completed the programme in one year and two years as planned because the programme was not repetitive and there were replacement costs. This high pass rate (94.1%) is an indication that the graduates did acquire knowledge and skills for provision of primary health care services. Data analysis from the self-administered questionnaires of the graduates also revealed that the graduates perceived that their knowledge and skills for provision of primary health care services have been strengthened because of the acquisition of the new knowledge in primary health care. This complemented the high academic performance of the graduates that the graduates knowledge and skills to deliver primary health care had been strengthened. Data analysis from the structured group interviews of the supervisors of the graduates further revealed that the supervisors perceived that the knowledge of the graduates in providing primary health care services in the hospitals and the district health teams had improved. The supervisors indicated that the graduates were now providing primary health care services with less supervision in the hospitals and the health districts.<br>Health Studies<br>D.Litt et Phil. (Health Studies)

M.Cur.<br>An explorative, descriptive, contextual qualitative design was employed in an endeavour to unravel experiences of mothers with infants in the NICU regarding emotional support that they received from the nurses while nursing their infants in the unit. The sample of the study comprised eight (8) mothers who were selected through purposive sampling. Data were collected through the use of semi- structured questions. All the interviews were audiotaped. Data were collected in the Neonatal Intensive Care Unit (NICU) of Princess Marina Hospital, Botswana. Data were analysed through the use of Tesch's method of data analysis, which is based on thematic content analysis. Themes which emerged were acceptance of the infant, encouragement to keep on visiting the infant every three hours, information provided on caring for the infant, encouragement on giving the infant motherly love e.g. cuddling, nurses having no time for the mothers, nurses' mistrust of mothers and finally neglect. The results of the study revealed that mothers did receive the emotional support that they needed, perceived as an important aspect to mothers nursing infants in the Neonatal Intensive Care Unit. It was found that some nurses did provide emotional support to mothers while other nurses had no time to support the mothers in need.

Inpatient aggression in mental health settings is a significant concern because it compromises the quality of care provided by health care workers. Nurses are one of the groups most affected by inpatient aggression because they are usually the client's first contact on admission. A number of studies have found that nurses are the most frequently assaulted professional group both inside and outside of the hospital setting, are more frequently assaulted than doctors and most are likely to experience some form of aggression in their career. The causes of inpatient aggression are frequently conceptualised as multidimensional and involving factors internal to the client e.g. age, factors relating to the environment such as inflexible ward routines and factors relating to the quality of the interaction between nursing staff and clients. Research studies suggest that nurses generally respond reactively and rely heavily on physical control strategies rather than on interpersonal strategies in managing inpatient aggression. Contemporary literature suggests that the perceptions nurses hold about aggression and its causes influences their management of the event and that this process is mediated by a number of client, environment and nurse-related variables including age, education, gender, nursing experience, perceptions of aggression and its causes. Although the causes and management of inpatient aggression in nursing is well documented in the United Kingdom and some other West European countries, this is not the case for Africa and in the case of this study, for Botswana. No studies have attempted to find the nurses' perception, perception on the cause, and management of inpatient aggression in Africa and more so in Botswana. Aim: The purpose of the study was to explore how nurses' demographic characteristics, their perceptions of aggression and its causes, influence the management of inpatient aggression by nurses in the main psychiatric institution in Botswana. Method: A descriptive, exploratory non-experimental design was used. Perception of inpatient aggression was captured by a Perception of Aggression Scale (POAS) and the perception on the cause and management of inpatient aggression was collected with Management of Aggression and Violence Attitude Scale (MAVAS).The sample comprised of 71 nurses, 48 of whom were females and 23 males. The mean age of the nurse respondents was 36 years. Of the 71 respondents 50 were registered nurses only while 20 were psychiatric registered nurses. More than two thirds of the respondents had a diploma in nursing, one had a masters degree and the remainder, a degree in nursing. The average nursing and psychiatric nursing experience of the respondents were 12.1 and 6.87 years respectively. ANNOVA test and t-tests were done to find the associations between the nurses' demographic variables, their perception, perception on the cause and management of inpatient aggression. Findings: The respondents In this study perceived inpatient aggression as both negative and positive. There was an overall agreement with the perception of aggression as always negative and as an action of physical violence against a nurse (81.73%). Nurses saw the cause of inpatient aggression as emanating from the internal, external and situational/interactional factors. The use of traditional methods of aggression dominated as shown by a high mean score of 80.5 as compared to interpersonal management with a mean score of 60.5. A statistical difference was found between gender, perception of aggression and perception of aggression and the traditional management of aggression while age, nursing and psychiatric nursing experience were statistically associated with the use of interpersonal management of aggression. Conclusion: The study provided insight into the nurses' perceptions, perceptions on the cause and management of inpatient aggression in a mental institution in Botswana. Nurses in this study hold predominantly negative perceptions of aggression and generally favour traditional management strategies. However, older, more experienced nurses tended to favour interpersonal techniques. Recommendations for nursing practice, education and research to address this issue centre around further and targeted education and training in mental health and specifically, in the comprehensive management of aggression which includes communication skills, use of de-escalation, use of medication and cautious physical restraint.<br>Thesis (M.N.)-University of KwaZulu-Natal, Durban, 2009.

The study aimed to assess factors affecting the uptake of community-based Tuberculosis care (CTBC) as experienced by patients in Lobatse in order to make recommendations to enhance the uptake of CBTC in this area. A cross-sectional study was conducted, using structured interviews amongst 101 TB patients in Lobatse who registered for directly observed treatment (DOT) for TB in the GOB’s health facilities from January 2011 to August 2013. The SPSS (version 21) was used to analyse the data. Univariate logistic regression models were used. Participation in CTBC was an outcome. The main predictors for participation in CBTC included, knowledge and attitudes towards CTBC (p=0.0003), perceived barriers and enablers towards this programme (p=0.0279), and patient satisfaction with this programme (p=0.0315). The research findings pertain to TB services in Lobatse, because the study was conducted in government health facilities implementing the Botswana National Tuberculosis Programme (BNTP) CTBC guidelines only in Lobatse<br>Health Studies<br>M.A. (Public Health)

Text in English<br>The purpose of this study, was to identify and describe factors, which facilitate or impede learning in clinical learning settings. The study adopted an exploratory descriptive approach, incorporating both quantitative and qualitative designs. Data collection tool, comprised of two sections: Section 1 focused on demographic characteristics. While section 2 addressed study variables of clinical setting, staffing, patient care/ practice standards, nurse manager's commitment and interpersonal relationships. The last section had two parts; part 1 being close ended Likert type scale ranging from strongly agree to strongly disagree. Part 2, was open ended, and solicited respondents' feelings opinions and experiences on factors they perceived to facilitate or impede clinical learning. The findings indicate that the majority of settings studied did not provide adequate factors to facilitate clinical learning. Factors such as availability of learning experiences, acceptable unit organization, space and resource availability, and accessibility to students, adequate staffing with qualified staff who actively participate in teaching, appropriate and quality patient care role modelled, lecturer availability and involvement in clinical teaching, team building and inclusion of students in the team, committed nurse managers involved in students' learning, conducive relationships among staff, students and patients, comfort relationships, advocacy and creating conducive relationship by the nurse manager, were identified as necessary for learning. These factors however, were found to be either lacking, inadequate or inaccessible to students. Findings were based on data from a quota sample of 202 participants proportionately drawn from students, nurse managers and nurse lecturers. The study made recommendations to improve and enhance the conduciveness of clinical practice settings used for learning in Botswana.<br>Health Studies<br>D.Litt. et Phil. (Advanced Nursing Science)