Doctoral Degrees (DNS)

Permanent URI for this collection

http://hdl.handle.net/11070/3442

Browse

Browsing Doctoral Degrees (DNS) by Subject "Educational programme"

Now showing 1 - 2 of 2
  • Thumbnail Image
    Item
    An educational programme for nurses to facilitate cardiac rehabilitation of patients who had heart valve repair or replacement surgery in Namibia
    (University of Namibia, 2025) Masule, Lilian Sinte; Amakali, K
    Heart valve disease is a critical global public health issue, contributing to cardiovascular morbidity and mortality worldwide. It serves as an indication for heart valve repair and replacement surgeries, which are invasive procedures that can potentially compromise patients’ quality of life. Therefore, patients who have had heart valve surgery require cardiac rehabilitation to prevent potential complications and to improve patients’ quality of life. Recognizing the need for enhanced post surgery care, there is a compelling need for the development of an educational programme for nurses to facilitate cardiac rehabilitation of patients following heart valve surgery. This initiative not only would improve the patient’s quality of life but also provide support to caregivers in their roles. The study was aimed at the development of an educational programme for nurses to facilitate the cardiac rehabilitation of patients who have had a heart valve repair or replacement surgery at the Windhoek Central Hospital’s Cardiac Unit. The objectives of the study were to: describe the knowledge, attitudes, and practices of nurses regarding the cardiac rehabilitation of patients after heart valve surgery, explore and describe the challenges experienced by nurses when providing cardiac rehabilitation services to patients after heart valve surgery, explore and describe patient’s experiences of recovery and coping after heart valve surgery, explore and describe caregivers’ experiences in providing support and care to family members after heart valve surgery. The study followed a structured approach with four distinct Phases: Phase one was a situational analysis comprising four objectives, Phase two was about conceptual framework development based on Dickoff’s theory of practice-oriented; Phase three, was about the educational programme development and Phase four was about the programme implementation, evaluation, and validation. A sequential explanatory mixed method design was employed, encompassing quantitative data collection and analysis in Phase One to determine nurse’s knowledge, attitudes, and practices in cardiac rehabilitation. This was followed by qualitative data collection and analysis on the challenges experienced by nurses when providing cardiac rehabilitation services, patients' experience in recovery and coping, and caregivers’ experiences in supporting and caring for family members after heart valve surgery. Quantitative data were collected using self-administered questionnaires from a sample of twenty-three (23) nurses, out of the total study population of twenty-nine (29) ii nurses. Data were analysed using the Statistical Software Program SPSS (version 27). The descriptive statistics analysis, Fisher’s exact test, to describe the association between demographic characteristics and variables of knowledge, attitudes, and practices was performed. Qualitative data were collected through in-depth individual face-to-face semi-structured interviews using an interview guide for all three (3) objectives. A non-probability, purposive sampling method was used to select participants, resulting in a total of ten (10) nurses, twelve (12) patients, and eight (8) caregivers who consented to and participated in the study. Data collection continued until data saturation was achieved. Qualitative data were analysed using Tesch’s eight steps of coding. The quantitative findings show that the majority of nurses, 20 (87%), had a high level of knowledge, with only 3 (13%) having average knowledge about CR. Similarly, the majority of nurses, 21 (91.3%), displayed positive attitudes while only 1 (4.3%) had a negative attitude. However, the findings on practices indicated that only half of the nurses, 13 (56.5%), showed good practice, while 8 (34.8%) had average practice, and 1 (4.3%) had poor practice in cardiac rehabilitation. Despite the high level of knowledge, respondents displayed a lack of knowledge specifically about the indications, benefits, phases, and core components of cardiac rehabilitation. In the qualitative findings, regarding nurses’ challenges, two main themes and eleven (11) subthemes highlighted the challenges experienced by nurses in delivering cardiac rehabilitation interventions and their opinions on the importance of rehabilitation programmes after heart valve surgery. Regarding patients’ experiences, two main themes and nine subthemes emerged indicating the challenges patients experienced (physical, emotional, psychological, and social factors) during recovery and coping after heart valve surgery as well as challenges regarding the support and care from nurses and family members after heart valve surgery. Regarding caregivers’ experiences, two main themes and eight sub-themes emerged regarding the emotional disturbances and demand for care, along with varying experiences regarding the support and care provided by healthcare providers. Based on these findings, recommendations were put forth among others to the Ministry of Health and Social Services (MoHSS) for the development of a cardiac rehabilitation programme for nurses, improvement of nursing practice, as well as recommendations on future research in this area
  • Thumbnail Image
    Item
    An educational programme to facilitate reflective practice for registered nurses in training hospitals in Windhoek
    (2013) Nelumbu, Lucia N.
    Illness is an evitable part of life for the vast majority of people. The nurses’ reactions to people who are ill or who are in need of health care are influenced and shaped by their own personal qualities, such as sensitivity, understanding and honesty as well as the professional attributes, skills, competencies, attitudes and cognitive abilities necessary for effective practice. Problems or incidents occurring in clinical settings are often seen as indicators of poor nursing care and even indicators of a lack of reflective practice skills. The purpose of the study was to explore and describe how reflection is practised by registered nurses. The objectives of the study were to explore and describe how reflection is practiced and conceptualised by registered nurses in Namibia. A qualitative, explorative, phenomenological, descriptive and contextual approach was used. Data were collected from the population, including all registered nurses purposively selected from different disciplines in training hospitals, through in-depth interviews. The data were analysed according to themes based on the ideas of Tesch’s model, and revealed inadequate knowledge of reflective practice among registered nurses as they only expressed the execution of their daily activities without paying attention to how they reflect in daily practice Hence the reflective practice programme was developed and implemented to offer knowledge and skills to effectively address the clinical challenges which registered nurses may encounter in terms of reflection. The evaluation of the programme was conducted sixteen weeks (4 months) after the programme implementation, with the overall results showing that reflective practice would assist registered nurses to think critically and to engage in reflection upon professional practice activities that would lead to the improvement of their performances. The main recommendations made were among others, that nursing education in Namibia must make reflective practice a compulsory competency of registered nurses and all health care providers, and should be included in the curriculum of all student nurses.