The purpose of this research study is to formulate guidelines to counteract unethical behaviour of auxiliary nurses and care workers in homes for the older persons. Opsomming Die doel van hierdie navorsing is om riglyne te beskryf wat die onetiese gedrag van hulpverpleegkundiges en sorgwerkers in ouetehuise kan bekamp. *Please note: This is a reduced version of the abstract. Please refer to PDF for full text.
This study's objectives were: (1) to describe and explore the ethical dilemmas surrounding the HIV-positive person in the workplace in South Africa; and (2) to describe the Rational Interaction for Moral Sensitivity (RIMS) approach as a possible mechanism for solving these ethical dilemmas. A qualitative, exploratory and descriptive research design was used. The target populations were HIV-positive employees and occupational health nurses working for a South African company. Data collected through individual HIV-positive employee interviews and occupational health nurse workgroups were analysed. The ethical dilemmas were conceptualized and described within the theoretical framework of the principles of ethics, namely, autonomy, beneficence, justice and confidentiality. To elicit a solution to the dilemmas, the data were recontextualized using the RIMS approach, a group decision-making strategy designed for the business environment.
The purpose of this study is to describe the profile of the B.Cur. graduates who completed their studies in 1997 at the Rand Afrikaans University. Theoretical points of departures were used, such as Muller's career management description (Muller, 1998: 353-362) and Northeastern University's five-step model career services (Northeastern University, sa:1). After taking all the factors into consideration that play a role in career management, the researcher will be able to compile a complete profile of the B.Cur. graduates of 1997. It is important to the nursing education institution to know the profile of the graduates, in order to adapt the programme to the needs of the students. With a quantitative survey design, data was gathered telephonically, through a self-composed questionnaire. The structured questionnaire has content validity in terms of conceptualization. Of the thirty-one students, data was gathered on twenty-nine of them. Descriptive statistics were used to analyze the data. The profile of the graduates is described according to fourteen factors from the questionnaire.
Concepts are the basic building blocks of scientific knowledge or theoretical frameworks for any discipline. The strength of the theories that guide a discipline is dependent on the quality of the concept analysis. Thus, the utilisation of poorly understood concepts in research and theory development will result in questionable reliability and validity. Concept analysis is associated with the research design of philosophical inquiry. The purpose of philosophical inquiry is to perform research using intellectual analysis to clarify meaning. Traditionally, no empirical (qualitative or quantitative) investigations were used to clarify the meaning of concepts. The lack of empirical investigation to clarify concepts, results in certain limitations in the methodology of concept analysis. It seems that methodological innovations for enhancing concept analysis is urgently required. The purpose of this article is to describe the utilisation of qualitative and quantitative strategies with literature review in concept analysis as a possible solution to limitations. This article will firstly, describe the limitations in the traditional Wilsonian methods of concept analysis and will secondly demonstrate how the introduction of qualitative and quantitative methods with literature review can overcome some of the limitations. An example a research study on quality of life (Ferrans, 1997:110) will be used to demonstrate how qualitative and quantitative empirical methods with literature review can enhance the quality of concept analysis.
Selection of learners implies that candidates are assessed according to criteria with the purpose of selecting the most suitable learners for the course. A magister qualification is on level 8A of the National Qualifications Framework (NQF). The purpose of a magister qualification in Nursing is the development of advanced research, clinical, professional, managerial, educational, leadership and consultative abilities (knowledge, skills, values and attitudes) for the promotion of individual, family, group and community health. From the above introduction it becomes clear that there is a high expectations of a person with a magister qualification. Such a person should be a specialist, scientist, leader and role model in the profession. A magister programme is human-power intensive as well as capital intensive for both the learner and higher education institutions. It is therefore important to select learners with the ability to achieve the outcomes of the programme. Limited research has been conducted on the selection of post graduate learners. This leads to the question whether the current selection criteria (undergraduate mark and the mark in Research Methodology) are reasonable predictors of success for the magister programmes. In order to answer this question, hypotheses with the following variables were formulated. Achievement/success in the magister programme as reflected by The mark for the dissertation or mini-dissertation. The level of input by the supervisor during the magister programme. The quality of the research article reflecting the research in the magister programme. Undergraduate mark Mark for Research Methodology In order to test the hypotheses a quantitative correlation design was used incorporating documented data of 74 magister graduates. Descriptive and inferential data analysis (Pearson's correlation coefficient, ANOVA and multivariate test) were used. The findings showed Research Methodology to be the best indicator of success in the magister programmes.
This research article follows on a previous article where the results of a concept analysis of intuition were reported. Opsomming Hierdie artikel volg op ‘n vorige een waarin die resultate van ‘n konsepanalise van intuïsie beskryf is. *Please note: This is a reduced version of the abstract. Please refer to PDF for full text.
The idea of community participation in health and research can be found in all major international and national declarations, including South Africa. Opsomming Gemeenskapsbetrokkenheid in gesondheid en in navorsing word internasionaal en nasionaal, insluitende Suid-Afrika, in verskeie verklarings van voorneme gereflekteer. *Please note: This is a reduced version of the abstract. Please refer to PDF for full text.
The parameters of the problem within which the principal aim of the present article will be addressed can be described as follows. When making ethical decisions there are different perspectives that health care professionals may use. This may lead to conflict and insufficient co-operation between the members of the health team. Two of these perspectives are the ethics of justice and the ethics of care. The ethics of justice constitutes an ethical perspective in terms of which ethical decisions are made on the basis of universal principles and rules, and in an impartial and verifiable manner with a view to ensuring the fair and equitable treatment of all people. The ethics of care, on the other hand, constitutes an ethical approach in terms of which involvement, harmonious relations and the needs of others play an important part in ethical decision-making in each ethical situation. To seek some sort of way of avoiding conflict and promoting a mutual understanding about ethical decisions in the health team, there is a need to examine the ethics of justice and ethics of care. In order to understand the ethics of justice and ethics of care, the purpose of this article is to compare the two ethical perspectives. It is argued that the ethics of justice and the ethics of care represent opposite poles. If the members of the health team were to use only one of these two perspectives in their ethical decision-making, certain ethical dilemmas would almost certainly remain unresolved. Both the fair and equitable treatment of all people (from the ethics of justice) and the holistic, contextual and need-centred nature of such treatment (from the ethics of care), ought therefore to be retained in the integrated application of the ethics of justice and the ethics of care.
The purpose of the research study was to describe guidelines to improve the community health clinics as a learning context conductive to learning. The objectives of the study commenced by getting the perception of student nurses from a nursing college in Gauteng; community sisters from ten community health clinics in the Southern Metropolitan Local Council and college tutors from a college in Gauteng. The research design and method used, consisting of a qualitative, exploratory, descriptive and contextual approach and the design was divided into two phases. Phase one consisted of a field/empirical study and phase two of conceptualization. In all the samples follow-up focus group interviews were conducted to confirm the findings. To ensure trustworthiness, Lincoln and Guba's model (1985) was implemented and data analysis was according to Tesch's model (1990 in Creswell 1994:155) based on a qualitative approach. The conceptual framework discussed, indicating a body of knowledge, was based on the study and empirical findings from phase one to give clear meaning and understanding regarding the research study.
This research forms part of a larger interdisciplinary research project on the termination of pregnancies. The focus of this part of the project is on the ethical issues related to termination of pregnancies. The practice of the professional nurse is confronted with ethical dilemmas and disputes. Whether the nurse chooses to participate in the termination of pregnancies or not, the core function of the nurse is that of counseling and ethical decision-making. Effective counseling requires empathy, respect for human rights and unconditional acceptance of a person. Making ethical decisions implies making critical decisions. It is self-evident, therefore, that such decisions should be based on sound arguments and logical reasoning. It is of vital importance that ethical decisions can be justified on rational ground. Decision-making is a critical thinking approach process for choosing the best action to meet a desired goal. The research question that is relevant for this paper is: Are nurses thinking critically about ethical issues like the termination of pregnancies? To answer the research question a qualitative, exploratory, descriptive design was used (Mouton, 1996:103-169). Registered nurses were selected purposively (Creswell, 1994:15). 1200 registered nurses completed the open-ended questionnaires. Focus group interviews were conducted with 22 registered nurses from a public hospital for women and child health services. Data analysis, using secondary data from open-ended questionnaires and transcribed focus group interviews, were based on the approach of Morse and Field (1994:25-34) and Strauss and Corbin (1990). The themes and categories from open coding were compared, conceptualized and linked with theories on critical thinking (Paul, 1994; Watson & Glaser, 1991 and the American Philosophical Association, 1990). The measures of Lincoln and Guba (1985) and Morse (1994) related to secondary data analysis were employed to ensure trustworthiness. Based on these findings the researcher concluded that nurses are not thinking critically when making ethical decisions concerning the termination of pregnancies. Recommendations are made as a possible solution for this problem.
When making ethical decisions there are different perspectives that health care professionals may use. This may lead to conflict and insufficient co-operation between the members of the health team. Two of these perspectives are the ethics of justice and the ethics of care. In a bid to gain a better understanding of the nature of ethical decision-making in the health team, a comparison was drawn between the ethics of justice and the ethics of care. The investigation into and comparison between the ethics of justice and the ethics of care revealed that the deficiencies in each of the two perspectives in isolation, in fact, necessitate the application of a combination of both perspectives. The aim of the article is to describe how the members of the health team can, in an integrated manner, apply both the ethics of justice and the ethics of care in their ethical decision-making. The central argument of the article is based on the following premises: (1) the inadequacy of the ethics of justice and the ethics of care in isolation necessitates that both these perspectives be applied; (2) the application of both these perspectives again requires an extended rationality and discourse and (3) discourse, in its turn, requires that the emphasis falls on a specific telos and that the participants in the discourse be endowed with certain virtues in order to abide by the rules of discourse.
Nursing is a true profession, distinguished by its philosophy of care, its full-time commitment to human wellbeing, its particular blend of knowledge and skills and its valuable service to the community (Curtin & Flaherty, 1982:92). Ethics is vital to nursing. Being a professional implies ethical behaviour and knowledge of what it means to be ethical (Pera & Van Tonder, 1996:v). Ethics is the foundation of committed service to humankind. When nurses practice is an ethical manner they should adhere to ethical principles like autonomy, beneficence, justice, veracity, fidelity, confidentiality and privacy. From this conceptual framework two questions can be asked, namely: Does the behaviour of nurses in health services in South Africa comply with the principles of ethics? How can ethical behaviour be facilitated in nurses in South Africa? The first question was answered by doing a critical analysis of thirty-two case studies of recent ethical phenomena in health services. The ethical principles will be used as criteria for this analysis. Some of the ethical case studies will be presented in this paper to indicate the problems in relation to autonomy, beneficence, justice, veracity and fidelity. It will be demonstrated that from deontological ethical theories nurses are not doing their duty as advocates for the vulnerable patient and from utilitarianism the poor and uneducated patients are being exploited. To empower patients in developing countries it is of vital importance for nurses to behave in an ethical manner. From a literature study a program for rational interaction for moral sensitivity (Rossouw, 1995) and virtue-based ethics in Nursing Education is identified to facilitate moral behaviour amongst nurses in developing countries.
From experience and observation of decision-making in intensive care units, the following has been observed in respect of clinical decision-making. Nurses in intensive care units take clinical decisions they can justify, and other decisions they cannot justify. Nurses in intensive care units sometimes refer to the unjustified clinical decisions as gut-feelings or intuition. The observation regarding clinical decision-making further indicates that clinical decision-making, based on intuition is effective and contributes to better and more complete problem-solving capabilities in intensive care units. From the preceding problem statement the following question arose, namely: What is intuition? The objective of the study is to analyze the concept intuition. A philosophical analytical research design was implemented in order to reach this objective. The concept intuition was analyzed by means of concept-analysis. The goal of concept analyses was to respectively describe the characteristics of intuition and developing a theoretical definition for the study regarding these characteristics. From the concept-analysis of intuition the following categories and characteristics of intuition realized namely situational factors of intuition, intuition as a process and intuition as a product. The situational factors of intuition refer to the factors that must be in place in order for intuition to occur, namely knowledge and experience, empathy, as well as incomplete data and uncertain situations. The second group characteristics of intuition has to do with the process of intuition, which is speedy, more synthetical-analogical than analytical, interpretative, holistic, irrational and goal-directed. The third category characteristics of intuition has to do with intuition as a product which include problem-solving and the rational justification of intuition by means of reflection.
The nursing practice is described as a scientific practice, but also as a practice where caring is important. The purpose of nursing education is to provide competent nursing practitioners. This implies that future practitioners must have both critical analytical thinking abilities, as well as empathy and moral values. Reflective thinking could probably accommodate these thinking skills. It seems that the facilitation of reflective thinking skills is essential in nursing education. The research question that is relevant in this context is: "What is reflective thinking?" The purpose of this article is to report on the concept analysis of reflective thinking and in particular on the connotative meaning (critical attributes) thereof. The method used to perform the concept analysis is based on the original method of Wilson (1987) as described by Walker & Avant (1995). As part of the concept analysis the connotations (critical attributes) are identified, reduced and organized into three categories, namely pre-requisites, processes and outcomes. A model case is described which confirms the essential critical attributes of reflective thinking. Finally a theoretical definition of reflective thinking is derived and reads as follows: Reflective thinking is a cyclic, hierarchical and interactive construction process. It is initiated, extended and continued because of personal cognitive-affective interaction (individual dimension) as well as interaction with the social environment (social dimension). to realize reflective thinking, a level of internalization on the cognitive and affective domain is required. The result of reflective thinking is a integrated framework of knowledge (meaningful learning) and a internalized value system providing a new perspective on and better understanding of a problem. Reflective thinking further leads to more effective decision making- and problem solving skills.
Sommige skrywers oor navorsingsmetodologie is van mening dat navorsingsverslae op die logika van argumentering berus en dat sulke verslae met die leser kommunikeer deur logiese samehangende argumente aan te bied (Bóhme 1975:206; Mouton 1996:69). Hierdie beskouing impliseer dat navorsers bepaalde gevolgtrekkings maak en sodanige gevolgtrekkings by wyse van argumentering regverdig word (Doppelt, 1988:105; Giere, 1984:26; Harre, 1965,11; Leherer en Wagner, 1981:3 & Pitt,1988:7). Die struktuur van navorsingsverslae bestaan dus hoofsaaklik uit gevolgtrekkings en redes vir sodanige gevolgtrekkings (Booth, Colomb & Williams, 1995:97). Hieruit blyk dat regverdiging by wyse van argumentering ‘n standaardprosedure in navorsing en navorsingsverslae is.
The question to be addressed in this paper is : How can the ethics of justice and the ethics of care be used complementary to each other in ethical decision making within the health care team? Various arguments are presented that justify the reasons that the ethics of justice and the ethics of care should be used complementary to each other for effective ethical decision making within the health care team. The objective is to explore and describe the compatibility of the ethics of justice and the ethics of care from two perspectives: firstly an analysis of the characteristics of the two ethical theories, and secondly the scientific-philosophical viewpoints of these theories. The two theories are incompatible when viewed from these perspectives. For a probable solution to this incompatibility arguments are presented from the perspectives of reflection and virtue-based ethics.
The existing process of selection that is being followed is labour and cost intensive. Previous research confirmed the predictability of the academic component of the selection process. OpsommingDie huidige keuringsproses wat gevolg word is arbeids- en koste-intensief. Vorige navorsing het die voorspellingswaarde van die akademiese komponent bevestig. *Please note: This is a reduced version of the abstract. Please refer to PDF for full text.
Nursing Science is the knowledge content for nursing. The goal of nursing is to promote, maintain and restore people's health. To provide for the health needs of the South African society Nursing Science must generate the right kind of knowledge. The question of the article is whether Nursing Science needs knowledge or wisdom? The perspectives on knowledge of Maxwell (1988) and Rossouw (1993) are studied. The conclusion is that Nursing Science needs knowledge and wisdom. Arguments are given to support this conclusion.
The conclusion reached at the end of this article is that there is a crisis in the ethics of nursing and that the focus of the ethics of nursing should be on virtues. The reconstruction of a virtue-based ethics in nursing is proposed as a solution for the current crisis in the ethics of nursing. With an analysis conducted on the ethics of nursing the story is told of an individual nurse within nursing in the South African society. Certain concepts to ethics as well as the dimensions of ethics in nursing are explained within the narrative of nursing. The institutionalisation of ethics of nursing is described based on the three ethical traditions that moved from virtues, to responsibility to human rights. An analysis of the moral practice in nursing indicates that a crisis in the ethics of nursing exist within the last tradition of human rights because of the conflict between the rights of the nurse and the patient. Through the analysis it becomes clear that no rules, codes or law can ensure moral behaviour. The control over moral behaviour should rather be internal than external. If a person does not have the virtues he or she does not understands the rules and human rights and responsibilities have a different meaning for them.