Gisela Hildegard Van Rensburg

Challenges in the management of support and care programmes for child‐headed households in South Africa

human s.p. & van rensburg g.h. (2011) Journal of Nursing Management19, 959–966 Challenges in the management of support and care programmes for child-headed households in South Africa Aims  The present study reports on data collected in a larger study on ‘A situational analysis of child-headed households in South Africa’. The purpose of this study was to explore the management and control of available and required services, resources and safety nets for children in child-headed households. Background  The significance of having a better understanding of the challenges, limitations but importance for government structures to manage and control programmes will enhance the implementation and maintenance of focused and sustainable support structures and programmes which will effectively address the needs of child-headed households. Method  An exploratory and descriptive, quantitative survey was conducted to provide information on government structures at a national level and the nine provinces in South Africa. The population consisted of the Departments of Social Development, Education, Health and Agriculture, at both national and provincial levels. Results  The main findings included a lack of clarity regarding the concept and definition of a child-headed household, lack of empirical data, a diversity of needs and challenges in terms of location and geographical distribution of available infrastructure and support systems; programmes that are not inclusive and integrated; and contradictions in the stipulations and implementation of existing policies and capacity and human resources shortages. Conclusions  It was concluded that the magnitude, uniqueness and complexity of the phenomenon necessitate effective and sound scientific management principles. This is achieved by providing legal clarity of the concept; developing relevant policies and ensuring effective implementation thereof; rigorous monitoring and evaluation based on comprehensive empirical data; and protecting the rights and safety of these children and ensuring an enabling environment for all stakeholders to address needs and challenges. Implications for nursing management  The role of the nurse manager is to ensure a holistic approach to children living in child-headed households by acting as a facilitator, advocate, leader, coordinator and consultant.

Bridging the gap between self-directed learning of nurse educators and effective student support

Background Self-directed learning requires the ability to identify one’s own learning needs, develop and implement a plan to gain knowledge and to monitor one’s own progress. A life-long learning approach cannot be forced, since it is in essence an internally driven process. Nurse educators can, however, act as role models to empower their students to become independent learners by modelling their own self-directed learning and applying a number of techniques in supporting their students in becoming ready for self-directed learning. Objectives The aim of the article is to describe the manifestations and implications of the gap between self-directed learning readiness of nurse educators and educational trends in supporting students. Method An instrumental case study design was used to gain insight into the manifestations and implications of self-directed learning of nurse educators. Based on the authentic foci of various critical incidents and literature, data were collected and constructed into a fictitious case. The authors then deductively analysed the case by using the literature on self-directed learning readiness as departure point. Four constructs of self-directed learning were identified, namely internal motivation, planning and implementation, self-monitoring and interpersonal communication. Supportive strategies were identified from the available literature. Results Nine responses by nurse educators based on the fictitious case were analysed. Analysis showed that readiness for self-directed learning in terms of the identified constructs was interrelated and not mutually exclusive of one other. Conclusion The success of lifelong learning is the ability to engage in self-directed learning which requires openness to learning opportunities, good self-concept, taking initiative and illustrating independence in learning. Conscientiousness, an informed acceptance of a responsibility for one’s own learning and creativity, is vital to one’s future orientation towards goal-directed learning. Knowledge and understanding of one’s own and students’ self-directed learning abilities are critical for nurse educators. In the nursing profession, it has been shown that self-directed learning by the nurse educators has a direct relationship towards the development of a lifelong learning approach by their students. Supporting students towards becoming self-directed learners throughout their professional life, in turn, will impact directly on the quality of nursing and midwifery practice.

AN EXPLORATION OF THE PROFESSIONAL SOCIALISATION OF STUDENT NURSES

Desirable levels of knowledge and skills or appropriate values and beliefs of the nursing profession are not manifested in all students who become professional nurses. The aim of the study was to explore the perceptions of professional nurses regarding their role in the professional socialisation of student nurses and the experiences of the students as members of the nursing profession. A qualitative design was applied to collect data from two purposively selected samples, professional nurses and students. Focus-group interviews (two with sample 1 and 5 with sample 2) were conducted. Findings revealed that a lack of exemplary role models, an unfavourable environment and students’ own reasons of career choice influenced the professional socialisation of students. Exemplary role modelling, supportive learning environments, the empowerment of professional nurses and the commitment to professional values of nursing are vital to develop well-socialised professional practitioners.

A Systems Orientation to Research Capacity Development: A South African Perspective

Research capacity development is essential for quality and cost-effective healthcare, and well-prepared healthcare professionals. This case study used an exploratory design to gain insight into the contributions that a novice researcher programme makes towards research capacity development. Data were collected from reports to the board of a professional organisation acting as custodian of the project and three reflection workshops. The case was deductively analysed using the literature on research capacity development as the point of departure. The Cooke integrated framework for research capacity building in healthcare was used to evaluate the development that took place. The findings of the analysis are described and discussed according to the eight dimensions of the Cooke integrated framework indicating that this novice programme fulfilled all the dimensions of the framework.

Non-disclosure of HIV-positive status to a partner and mother-to-child transmission of HIV: Evidence from a case–control study conducted in a rural county in Kenya

Background Many factors contribute to an enhanced risk of infant HIV acquisition, two of which may include failure of a mother to disclose her HIV-positive status to her partner and exclusion of male partners in preventing mother-to-child transmission of HIV (PMTCT) interventions. To justify why HIV programmes need to integrate male partner involvement and partner disclosure, we need to establish an association between the two factors and infant HIV acquisition. Objective To determine whether failure to disclose an HIV-positive status to a male partner is associated with increased risk of infant HIV acquisition, and whether part of the association is explained by exclusion of male partner in PMTCT programmes. Methods Using a case–control study design, we identified a total of 180 mother–baby pairs with HIV-exposed infants. Thirty-six pairs with HIV-positive babies (cases) were compared to 144 pairs with HIV-negative babies (controls) on whether the mothers had disclosed their HIV status to their partner in order to determine whether a disclosure or lack of it contributed to increased risk of mother-to-child transmission of HIV (MTCT). Each case pair was matched to four control pairs from the same facility. Results Overall, 16.7% of mothers had not disclosed their HIV status to their partners, the proportion being significantly more among cases (52.8% vs. 7.6%, p < 0.001). Non-disclosure was significantly associated with infant HIV acquisition (aOR 9.8 (3.0–26.3); p < 0.001) and male partner involvement partially mediated the effect of non-disclosure on infant HIV acquisition (indirect coefficient = 0.17, p < 0.005). Conclusions Failure of an HIV-positive woman to disclose her status to her male partner and exclusion of male partners in PMTCT programmes are two social factors that may curtail success of interventions towards the goal of eliminating MTCT.

SUPERVISION OF POST-GRADUATE STUDENTS IN HIGHER EDUCATION

Knowledge transfer is an inevitable process in higher education where research outputs are largely associated with the production of Masters’ and Doctoral graduates. The supervision of postgraduate students at universities is therefore one of the core responsibilities of academics and is considered a measure of academic output. Supervision not only transfers research and related skills, but is also an intensive and interconnected form of educator-student engagement. The role of the supervisor in providing a supportive, constructive and engaged supervision process is important in the development of next generation practitioners who have the correct educational and skills mix to fulfil the future needs of the profession. The underlying principle of student support during supervision is that an experienced supervisor will be able to move through the learning processes with the student as this becomes appropriate. As the student gains competence in the basic skills of conducting research in a particular field of study, he or she will move to a deeper understanding of the nature and reality of that field. Research and, ultimately, high quality supervision of students, plays a pivotal role in the scholarship of discovery and the development of evidence-based practice.