A model for health professionals to facilitate a wellness program in the state health facilities of Oshikoto region, Namibia
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Date
2022
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Publisher
University of Namibia
Abstract
The purpose of this study was to develop a model for health professionals to facilitate a wellness program in the state health facilities of Oshikoto Region in Namibia. A significant number of health professionals experience psychosocial, physical and personal challenges in the workplace, which has necessitated the development of this proposed model. However, the development of the model required concepts that are derived from empirical data. To achieve that, the study design involved a convergent mixed method approach which required both quantitative and qualitative methods of data collection and analysis. The study was conducted in four phases. Phase 1 involved identification and analysis of concepts focusing on: (1) assessing the state health facilities in terms of the facilitation of wellness programs, using a checklist, (n=3) which were purposely selected; (2) describing knowledge, practices and experiences of health professionals with regard to the facilitation of a wellness programs, using self-administered questionnaires, nurses (n=147) who were randomly selected through stratified sampling; doctors (n=17) who were conveniently sampled and (3) exploring and describing perceptions of health professional managers regarding facilitation of wellness programs, using in-depth interviews, (n=6) which were purposely selected and all- inclusively sampled. The findings revealed that health professionals are faced with organizational challenges such as unavailability of wellness policies, unavailability of wellness program and lack of consultation for staff recruitment; resource challenges such as staff shortage, inadequate facilities and equipment; psychosocial challenges such as insufficient support from management, stress, scope of practice issues and workload; and personal challenges such as inadequate knowledge on wellness program, illnesses and lack of self-care in the work environment that hinder the facilitation of wellness programs. Using the WHO Framework and model (2010), psychosocial, physical and personal environment concepts were identified as the main central concepts and as a guiding tool to develop this model. These concepts form the basis of model development. The WHO framework and model (2010) guided the identification and analysis of concepts; and the Practice Oriented theory of Dickoff, James and Wiedenbach (1968) was used to describe the identified concepts. Phase 2 involved the construction of the relationships statement. To achieve this, the Practice Oriented theory of Dickoff et al. (1968), WHO framework and model (2010); and Fayol’s Management theory (1920) were adopted to guide the construction of the relationships statements v that formed the basis for the development of a model. Phase 3 involved the description and evaluation of the model. A model for health professionals to facilitate wellness programs was described according to Chinn and Kramer’s descriptive components in terms of its purpose, structure (assumptions, definitions of concepts, relation statements and nature) and process. Three phases of the model were identified, namely: needs assessment, managing and maintaining a conducive environment and outcome. The model was evaluated using Fawcett’s six criteria (significance, internal consistency, parsimony, testability, empirical adequacy, and pragmatic adequacy) of evaluating nursing theories. Phase 4 involved the development of guidelines for operationalization of the model, based on the needs identified from the study findings, to guide the Ministry of Health and Social Services (MoHSS), health professionals and all stakeholders in the facilitation of wellness programs. Guidelines were developed to direct the effective implementation of the model that would facilitate the wellness program in the state health facilities. Based on the study findings, recommendations were made to the policymakers, regulatory body, MoHSS and management respectively, to develop a comprehensive and inclusive wellness policy to institute a wellness program in the state health facilities; revise the scope of practice for nurses; establish a wellness directorate at the national level; advocate for and facilitate psychosocial, physical and personal support to enable health professionals cope with challenges in their work environment. Future research is recommended on implementation and evaluation of the effectiveness of the model and guidelines that has been developed.
Description
A dissertation submitted in fulfilment of the requirements for the Degree of Doctor of Philosophy (Public Health)
Keywords
Health professionals, Wellness program, Oshikoto region