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Browsing School of Nursing by Author "Botma, Y."
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Item Open Access Adapting to and implementing a problem- and community-based approach to nursing education(AOSIS, 2000) Fichardt, A. E.; Viljoen, M. J.; Botma, Y.; Du Rand, P. P.English: The process of change, implemented by the School of Nursing at the University of the Orange Free State so that a paradigm shift in approaches to nursing education at undergraduate level could be achieved, is outlined. The necessity to change, the identification of external and internal variables that impact on change, the founding of a support system, the process of overcoming resistance to change, the evaluation of the process of change and options for the future, are discussed. The rationale for the implementation of a problem-based teaching strategy and the phasing in of a community-based approach to teaching as the heart of the process of change are discussed.Item Open Access Algemene voetversorging van die bejaarde(AOSIS, 1985) Botma, Y.; Viljoen, M. J.The role of the nurse in the prevention of problems of the feet in the elderly is discussed, and the common foot problems that could be caused by negligence and ignorance are referred to. Routine foot care including care of the skin, nails, choice of shoes and massaging of the feet is discussed, and exercises that the elderly can do to prevent foot problems are illustrated.Item Open Access Beliefs of grade six learners' regarding adolescent pregnancy and sex(AOSIS, 2007) Grobler, C.; Botma, Y.; Jacobs, A. C.; Nel, M.Escalating adolescent pregnancy and risky sexual behaviour is becoming more common amongst young adolescents and especially amongst black adolescents in South Africa. Statistics confirm that South African adolescents as young as fourteen are already sexually active and become pregnant. The decision to become sexually active with resulting adolescent pregnancy whether planned or not, are directly influenced by the teenager’s beliefs. A person’s beliefs consist of a person’ own individual beliefs or attitude as well as what the individual subjective norm which the individual perceive as other people’s beliefs regarding the same object of reason. The aim of the study was to describe the attitude of black grade six learners under the age of fourteen, towards adolescent pregnancy and sex. A quantitative descriptive research design was used. Results were clustered according to demographic variables as well as beliefs that consist of attitude and subjective norm. Findings provided insight into the beliefs of grade six learners regarding sex and adulthood, the roll of peer pressure, relationships of adolescent parents, social interaction of teenage parents, ability of adolescent parent’s ability to provide in the needs of the baby, the adequacy of a child support grant to raise a baby as well as the levels of education of adolescent parents. This article provide a detailed reflection on these results and propose off a doll parenting intervention strategy as means of modification of attitude and subjective norms of grade six learners in order to alter sexual behaviour.Item Open Access Beskrywing van gesondheidsorgdiens wat aan MIV-blootgestelde/-positiewe kinders in die Vrystaatse publieke gesondheidsorgsektor gelewer word(University of the Free State, 2009-11) Spies, Cynthia; Botma, Y.; Reid, M.English: This study was conducted to describe the type of health service rendered by professional nurses to HIV exposed and HIV positive children in the public health care setting of the Free State province. Three objectives were set to achieve this, namely: to describe the type of service rendered to HIV exposed and HIV positive children by professional nurses in the Free State; to determine to what degree national and provincial guidelines are implemented in the management of HIV exposed and HIV positive children in the Free State; and to use the findings to make recommendations for effective service delivery to HIV exposed and HIV positive children. The researcher made use of a quantitative descriptive design to achieve the aim of the study. Data was gathered by means of structured interviews. Professional nurses, who deliver a service to children within public health care facilities, and who met the inclusion criteria, were approached to participate in the study. Data obtained showed that treatment components with regard to HIV exposed and HIV positive children were mainly rendered at primary health care facilities. In contrast herewith, it was found that treatment components in the pediatric sections of hospitals were not implemented to the same degree. Research further reflected a need for professional nurses to undergo additional training regarding the correct management of HIV affected children. Discrepancies pertaining to effective service delivery to HIV exposed and HIV positive children were also revealed. Suggestions were made with regard to approaches which could enhance service delivery. A subsequent research project regarding the quality of service which is presently being offered to HIV exposed and HIV positive children in the public health care sector of the Free State, could be of great value.Item Open Access The effect of three types of endotracheal tubes on ventilator-associated pneumonia(University of the Free State, 2004-11) Phillips, Maria Jacoba Johanna; Botma, Y.English: Ventilator-associated pneumonia is associated with a high mortality, morbidity and medical cost and is common and has major complications. Prevention of ventilator-associated pneumonia is dependent on how well we understand the pathogeneses of the disease. The pathogeneses starts with the colonization of the upper airway and the gastrointestinal tract, pooling of secretions in the subglottic space and aspiration of this contaminated secretions past the endotracheal cuff (endogenous source of pathogens). As the host’s defences are overcome, tventilator-associated pneumonia develops. Newer types of endotracheal tubes were designed with a dorsal lumen for the removal of subglottic secretions. This prevents the aspiration of contaminated secretion into the lower sterile airways. The aim of this research was to determine the effect of three types of endotracheal tubes on ventilator-associated pneumonia. A single center, blind, prospective, controlled clinical trial has been selected to investigate the effect of three types of endotracheal tubes on ventilator-associated pneumonia. Prior to the commencement of the study, approval for the performance of the study was obtained from the Ethics Committee of the Faculty of Health Sciences of the University of the Free State, the Universitas hospital, the manager of the intensive care units and neurosurgical intensive care unit as well as from the head of the neurosurgical department. Informed consent was obtained from candidates or if the candidates were unable to provide consent from their spouse, child or parent and information regarding the purpose, procedure, and possible adverse effects relevant to the study, were provided. Written consent was obtained. If the candidates was unable to give consent themselves and their family was unavailable, the researcher obtained telephonic consent from above-mentioned family members. The consent forms were available in Afrikaans, English and South-Sotho. If the subject did not understand English or Afrikaans, the researcher made use of a registered nurse as a translator to explain the purpose, procedure, and possible adverse effects relevant to the study. A witness co-signed all consent forms. Seventy-one candidates that met the inclusion criteria were screened for enrolment into the study. Thirty-four of these candidates were successfully enrolled. Subjects were consecutively allocated into three study groups. Each study group was intubated with the type of endotracheal tube for the specific study group and studied for the development of ventilator-associated pneumonia. The two experimental groups were subjected to two hourly subglottic suctioning. One experimental group’s cuff pressures were measured and maintained within normal limits, whereas a Lanz™ valve maintained the other experimental group’s cuff pressures. The control group was intubated with the conventional type of endotracheal tube. The implementation took place over a period of 18-months. Data was statistically analysed and presented by means of frequencies, medians and comparison of 95% confidence intervals. This study has found that none of the subjects in the experimental groups (received subglottic suctioning) developed late-onset ventilator-associated pneumonia compared to 16.67% in the control group. The incidence of early-onset ventilator-associated pneumonia was also much higher (75%) in the control group than the experimental groups. The relative risk for late-onset ventilator-associated pneumonia indicated that subglottic suctioning was not a preventative factor in the prevention of late-onset ventilator-associated pneumonia in the experimental groups. The time of intubation of the control group was longer than the two experimental groups. No significant difference was found in the morbidity and the mortality of the three study groups. Recommendations are that the study should be repeated with a larger study group and the subjects should be ventilated for a longer period. The benefits of subglottic suctioning may present it more clearly. The benefits of the LanzTM valve have not been investigated sufficiently in this study. In closing a repetition of some wise words: “Keep an open mind toward pneumonia. Our grandchildren will be interested and are likely to have as many differences of opinion…as we have.” William Osler. 1900 (Craven & Steger, 1995:1S)Item Open Access Evaluation of problem-based learning in an undergraduate nursing education programme(University of the Free State, 1999-05) Becker, Susanna; Viljoen, M. J.; Botma, Y.English: The aim of this study was to evaluate problem-based learning in an undergraduate nursing education programme. The School of Nursing at the University of the Orange Free State implemented problem-based learning as a teaching and learning strategy in the undergraduate programme in 1997. The 1998 course was evaluated to determine the success of this innovative method of instruction. It was done by administration of an audit to determine whether the methodology and process of PBL were followed; all the variables (internal and external) were considered during programme development, and whether requirements for outcomes as required by the South African Qualifications Authority were met. Student satisfaction was determined by means of a perception questionnaire and changes that took place in learning styles were determined by means of a learning style inventory that was developed in Lancaster. The grades students obtained in problem-based learning subjects were compared to the grades they obtained in subjects that were instructed by means of traditional lectures, as well as their grade 12 results secondary schooling. The audit revealed that this course was carefully planned and implemented to be one of exceptional quality. An action research model was used to monitor the integrated curriculum model with an emphasis on the PBL philosophy. This curriculum was found to be successful in portraying the South African health context in a lifelike and comprehensive manner, as the design was community-based. This curriculum addressed the tendency to overload and divided curricula in the disciplines, which bears little resemblance to the reality of the South African health context. A deficiency found is the lack of a formal quality assurance programme, which will enhance the maintenance of the high standard. Students in the course were under a lot of stress as they had to leave the comfort zones of traditional learning and some reacted with anger and resentment. Learning did take place in spite of all the hurdles students were confronted with. Superiority in meaning orientation, intrinsic motivation, deep approaches and comprehension learning was detected by the LAS! when results were compared to the scores of similar studies done in first-world countries (see Appendix J). Unfortunately a decrease in student-centredness took place, which could be ascribed to group sizes that were too large, fear of failure (as bursaries would be forfeited if students did not perform up to certain standards) and a heavy workload. Assessment results of PBL subjects were very positive in spite of students' indications that they found the course difficult. Assessment scores were much higher for PBL subjects than for traditional lecturing subjects, as well as Anatomy, which was instructed by means of video-assisted instruction. Nearly half the students obtained better assessment results in PBL than in their matriculation examinations. The most positive aspect of the first-year nursing course was the fact that students became self-directed learners and that a pattern of lifelong learning was created to equip them for the challenges that lie ahead in the 21st century.Item Open Access Evaluation of the sexual and reproductive health module as implemented by the Department of Health(University of the Free State, 2005-11) Reid, Marianne; Botma, Y.English: The aim of this study was to evaluate the Sexual and Reproductive Health Module as implemented by the Department of Health. Five objectives were set in order to meet the aim namely to: describe the reaction, knowledge and skills primary health care clinicians displayed during sexual reproductive health training; compare the competence primary health care clinicians rendering sexual reproductive health services displayed after sexual reproductive health training had been completed with those clinicians who had not undergone sexual reproductive health training; and to describe the perception the supervisors and primary health care clinicians had of the effect sexual reproductive health training had on sexual reproductive health services. The study followed a descriptive comparative, quasi-experimental, post-test-only design, as the study examined and described the differences and variables in two groups. Although reactionnaires used were not well constructed, learners rated the content, relevance of content and mode of presentation used when presenting the course as very good and excellent. Seventy three percent of the multiple-choice-questions used in the pre- and post-tests did not adhere to set criteria for these types of questions. Learners who underwent the Sexual Reproductive Health training scored markedly higher in their post-tests than in their pre-tests and scored an average of 94% during their assessment using the Competency Based Skills Assessment Tool. Trained sexual reproductive health primary health care clinicians scored significantly better in identified questions related to knowledge, skills and attitude, using the Adapted Competency Based Skills Assessment Tool and Client Exit Interview. The number of questions reflecting scores of less than 50%, measuring knowledge, attitude and skills does however suggest that limited transfer of learning took place. Data obtained to identify whether the pap smear policy was implemented after sexual reproductive health training were not usable. During the nominal group discussion participants perceived their quality of service, client assessment techniques and skills to have bettered after the sexual reproductive health training. The group also perceived that their relationship with their clients had bettered and that they were in a position to give more comprehensive information to their clients. Staff shortage and a lack of time to spend with clients were perceived to impede learning transfer. The data obtained from this group discussion was triangulated with data compiled throughout the rest of the study.Item Open Access A framework to expand public health services to HIV exposed and HIV positive children(University of the Free State, 2009-07) Reid, Marianne; Botma, Y.The aim of this study was to develop a framework to expand public health care services to HIV exposed and HIV positive children in the Free State. The objectives set in order to meet the aim were to identify strategies to expand health care services to these children and to then develop a framework to expand health care services to them within the Free State public health sector. The study consisted of various component projects, depicted as phases. The researcher conducted two components, Phase 1b and Phase 2 which links to the fore mentioned objectives of the study. A colleague, conducting research as Master student, conducted Phase 1a of the study, describing health care services rendered to HIV exposed and HIV positive children in the Free State public health sector. The researcher was intimately involved in Phase 1a, as she was acting as co-study leader. Health policy research was used, which is a type of health systems research, in an effort to inform higher levels of health on policy choices. Health managers were therefore active stakeholders in the development of the framework. The identification of strategies to expand health care services to HIV exposed and HIV positive children were one such activity where stakeholders assisted in the development of the framework. The Nominal Group Technique was used to identify mentioned strategies. A draft framework was developed using the Theory-of-Change Logic model as theoretical underpinning of the framework, with the empirical foundation being based on triangulated data obtained from literature findings, Phase1a and Phase 1b of the study. During a workshop with stakeholders, the framework was finalized, providing stakeholders the opportunity to validate the identified problem, namely that of fragmented care being delivered to HIV exposed and HIV positive children, due to over-verticalisation of programs. The validation of the framework was completed by confirming the desired results, possible influential factors that could impact on the results, as well as strategies that could be followed to expand health care services to fore mentioned children. Since health policy research only informs policy choices, the extent to which the framework will actually inform policy is in the hands of the Free State Department of Health.Item Open Access Informed consent: a post-operative assessment(University of the Free State, 2011-11) Kruger, Roger; Botma, Y.English: The researcher’s observation that patients do not always understand what they are consenting to was confirmed by various sources. According to Northouse and Northouse (1998: 270) and the South African Department of Health (2006: 11) patients’ lack of comprehension in the process of informed consent is a general phenomenon taking place in every hospital setting due to factors such as lack of interpersonal relationships between the health care professional and the patient cultural practices as well as language. A quantitative, descriptive study design was used to describe the process of obtaining informed consent prior to a surgical procedure in a hospital in the Northern Cape. Specific objectives were to: (1) describe the current practice of obtaining informed consent prior to a surgical procedure or an operation; and (2) make recommendations to relevant stakeholders for the purpose of improving the process of informed consent for an operation or procedure and thus the quality of health care. A structured interview, based on a questionnaire, was used to gather information using convenient sampling as the primary sampling method because it was feasible and affordable. A pretest was done before the main data collection process, but the results were not included in the final results. Data collection took place over a period of 90 days and included 150 participants who all met the inclusion criteria determined by the researcher. The researcher was assisted by a biostatistician who made use of Statistical Analyses Software (SAS) in order to analyze the data. Descriptive statistics namely means and standard deviations or medians and percentiles were calculated for continuous data. Frequencies and percentages were calculated for categorical data, and the analysis was done by a biostatistician. The researcher organized the study results according to tenets of capacity to consent to give meaning to the data and make it easy to understand. Figures and tables were used to present the large amount of detailed information concisely and clearly. More than one third of the sample was vulnerable due to their low educational level and unawareness of their rights as patients. Unfortunately no effort was made to ensure that they fully comprehended what they were consenting to. Recommendations focused on strategies to improve understanding by patients and to inform patients of their rights and responsibilities.Item Open Access Integration of study material in the problem-based learning method(AOSIS, 2003) Becker, S.; Viljoen, M. J.; Botma, Y.; Bester, I. J.English: Throughout the world educators are starting to realise that integrated curricula reflect the “real world”. Students learn how to integrate theory appropriately with practice and it stimulates higher order thinking skills. Problem-based learning (PBL) was used as a learning strategy in an integrated undergraduate programme. A quantatative nonexperimentald design, a survey, was used to determine how problem-based learning influences integration of learning by the students. Using a purposive sampling method all the first-year nursing students (43) at the University of the Free State participating in the programme were included in the study. Data was collected by means of a student perception questionnaire (SPQ). PBL does contribute to an integration of learning. All the students agreed that community problems were brought to the classroom and that theory and practice were complementary. Students also indicated that PBL enhanced gathering of information from various sources and a holistic view of a situation. Problem-based learning also increased the ability to consider problems from various viewpoints and taught students clinical reasoning. Certain aspects of integration still seem to be a problem as 42 % of the students indicated that subjects were not related, 21 % that subjects were not integrated and 37 % that scenarios were not realistic. This might be attributed to the fact that only the nursing subjects were taught by means of PBL. It is recommended that scenarios be revised to make them more realistic and that traditional subjects such as Anatomy, Microbiology and Chemical Science be integrated with nursing subjects by means of problem-solving themes, to form a meaningful core curriculum.Item Open Access An integrative review of educational strategies that promote the clinical judgement ability of students in health care(University of the Free State, 2014-07) Olivier, Nora Frances; Botma, Y.English: The plethora of literature available on the practice-theory gap, learning transfer and the continuous search for better methods of educating healthcare students emphasises the fact that an educational problem exists. The best available evidence informs clinical practice, and educators in healthcare should base educational decisions on the best evidence supporting educational strategies. The purpose of the study is to determine the educational strategies that promote clinical judgement of students in healthcare through an integrative literature review of studies published from January 2000 to October 2013. Multiple databases and search methods were used to identify studies that met the inclusion criteria for an integrative literature review. The search strategies identified 897 records of which seven were identified for critical appraisal according to the inclusion criteria. Three researchers independently critically appraised the articles according to the standardised CASP and QaulSyst, appraisal tools. Four of the seven studies were used for analysis. Although an integrative review allows for qualitative studies, all four articles were randomised control studies. This review was unable to provide conclusive evidence regarding appropriate educational techniques promoting clinical judgement. All four studies differed regarding sample size, duration, type of interventions and the outcome measurement tools. The four trials used high fidelity simulation, case-based learning and web-based learning as educational strategies. Shared educational design factors of the educational strategies were found, such as authenticity, active student engagement, cooperative learning, learner focussed and scaffolding, providing a shared base for educational strategies improving learning transfer and clinical judgement. Two of the studies indicated sequencing of the interventions improved clinical judgement. Due to the paucity of evidence, no conclusion as to which educational strategies promote clinical judgment could be made. However, there is evidence suggesting that high fidelity simulation, case-based learning and web-based learning may promote transfer of learning. Recommendations for further research include a standardised measurement of clinical judgement and that more educational strategies should be tested for their ability to promote transfer of learning.Item Open Access An integrative review of supportive clinical learning environment strategies for undergraduate students in health sciences(University of the Free State, 2020-09) Orton, Annelie Magrietha; Pienaar, M. A.; Botma, Y.The clinical learning environment is essential for the development of healthcare students’ clinical training, clinical competence and professional identity. A supportive clinical learning environment is needed to provide the opportunity for students to integrate their theoretical knowledge with the clinical practice. The aim of the study was to critically synthesise the best available evidence describing strategies for a supportive clinical learning environment for undergraduate students in health sciences. An integrative review was chosen as research method, as studies with various methodologies can be incorporated in an integrative review. The researcher followed the five stages as stated by Whittemore and Knafl (2005:548552), namely problem identification, literature search, data evaluation, data analysis and presentation. The PICO-format (Population, Intervention, Comparative intervention and Outcome) was used to compile the review question, which again led the integrative review. EBSCOHost served as a platform to search for electronic data in 13 databases. Google Scholar was also used as a database to allow for the identification of relevant grey literature. The electronic database search strategy identified 500 potential studies, and after the filtering process, 11 studies were identified for critical evaluation. A critical evaluation was conducted in the form of a round table consensus by the researcher, the supervisor, the co-supervisor and a senior reviewer with experience in conducting integrative reviews. During the critical evaluation, 10 studies were selected for analysis. The selected studies were heterogenous and so a meta-analysis was not feasible. The results of the thematic analysis culminated in a conceptual framework of a supportive clinical learning environment. Three concluding statements, as stated below, summarise the findings of the study: 1) A variety/network of student supporters, who have been carefully selected, may be allocated specific clinical responsibilities while supporting the undergraduate student in the clinical learning environment. 2) The relationship between the student, the student supporter and the clinical staff is crucial to create a sense of belonging, self-efficacy and selfdirectedness. The relationship depends on the roster and ratio of students per student supporter, as well as appropriate learning opportunities. 3) Higher education institutions and healthcare providers (such as healthcare facilities) should support students through formal collaboration/partnerships, with student supporters employed by the institutions, and these institutions should support the student supporters in various ways. A few recommendations made by the researcher include: 1) Higher education institutions and healthcare providers should attempt to forge beneficial relationships in order to support the students. 2) Higher education institutions should support student supporters in the clinical learning environment with adequate and timely information regarding student placement, the students’ level of competence and the students’ outcomes, and also with training and support regarding student problems. 3) Healthcare providers should assist the higher education institutions by providing placement, opportunities for students to learn, and by supporting the students in clinical learning. 4) Student supporters should have certain qualities that enhance clinical teaching and student supporters should be willing to spend time with students. The comprehensive synthesis of the best available evidence has led to new insights regarding creating and maintaining supportive clinical learning environment strategies for undergraduate students in health sciences. These strategies may be implemented in innovative ways to provide the students with the best clinical learning opportunities.Item Open Access Learners' knowledge and perceptions of voluntary counselling and testing for HIV and AIDS in the Free State Province(AOSIS, 2007) Botma, Y.; Motiki, Z. D.; Viljoen, M. C.English: The study investigated the perceptions of the youth regarding Voluntary Counselling and Testing (VCT) and sexual aspects related to HIV and AIDS. The study was grounded in qualitative methodology, using 4 focus group interviews for data collection - triangulating the results with field notes and literature. The participants of the four focus groups proved to be well informed on the topic and had clear perceptions concerning several aspects. They were very positive regarding the advantages of VCT for the prevention and management of HIV and AIDS. The participants recognised the need for the youth to be better informed about VCT and HIV and AIDS. They were much concerned by the lack of parental involvement in sexual education as well as the permissiveness o f the youth who partook in alcohol and drug abuse as well as prostitution. Participants o f the study stated that this problem was exacerbated by poverty and poor socio economic conditions.Item Open Access Models of care for antiretroviral treatment delivery : a faith-based organization's response(University of the Free State, 2012-04-14) Wilke, Marisa; Botma, Y.; Stark, R.; Van Rensburg, H. C. J.Background: Since 1849, Catholic religious have provided health services in South Africa. They have established hospitals, clinics, and have provided community-based preventive and curative services throughout the country. Today faith-based organizations (FBOs) continue to play an important role in healthcare delivery and are crucial to the goal of providing universal access to antiretroviral therapy (ART). In order to scale up HIV care and treatment, there is a need to describe and analyze ART models of care (MOC) that address the challenges faced by developing countries. The South African Catholic Bishops’ Conference (SACBC) manages twenty ART clinics in medically underserved South African communities, where the need is great, but the resources limited. These SACBC managed ART clinics operate on different MOC. A study to describe, analyze and compare the different MOC can inform future directions in healthcare delivery in resource-constrained settings. Method: A single case-study design was used to describe, analyze and compare four different MOC (managed by the SACBC) for ART delivery, as embedded units of analysis. A mixed method approach was used, incorporating qualitative and quantitative information. Data were collected using structured interviews (n=1,006 adult ART patients), file audits (n=1,006 files of the respondents), semistructured interviews (n=27 healthcare workers) and nominal groups (n=12 groups with Home Based Care-workers). Descriptive and inferential data analyses were conducted by a biostatistician from the Department of Biostatistics at the University of the Free State and the researcher. Findings: In the study, patients accessed care late (CD4=119 cells/mm3). Decentralized care provided better access. Family members are a potential source of support because disclosure rates to relatives and others were high (95.63%). Nurse-driven, doctor supported care was not inferior to doctor-driven care. Task-shifting to registered nurses and HBC-workers can be implemented successfully with support. Differences exist between the South African Government (SAG) -managed model and the FBO–managed models. Partnership between the SAG and FBO strengthened the SAG-managed MOC, while capitalizing on the sustainability of the government services. Functional information systems, developed by the FBO, were implemented at all the MOC in 2009. All the MOC focused on acute care. Conclusions: Nurse-driven decentralized service can most effectively and appropriately address the chronic nature of HIV and strengthen the healthcare system by a paradigm shift to a chronic care model. Based on the findings, a chronic care model was adapted for South Africa that has seven elements: (1) an integrated, decentralized chronic care system based within a primary health setting; (2) partnerships with NGOs; (3) an effective information management system; (4) patients and their families; (5) self-management support to patients; (6) provider decision support and (7) delivery system redesign. Implications for the nursing profession include adaptation of focus and training, as well as the recognition of the nurse practitioners/specialist role in South Africa.Item Open Access Motivation of students in higher education to transfer learning: a scoping review(University of the Free State, 2021-01) Bredenkamp, Doreen; Botma, Y.; Nyoni, C. N.Background: Motivation is a critical factor in students’ performance, productivity and transfer of learning. Even when students have the right skills, education, and support from peers and or educators, they would not be able to use knowledge learned in one context to solve a problem in a new context without motivation. Purpose: The purpose of this scoping review was to describe and summarise the literature on motivation to transfer learning in higher education and to identify the gaps regarding the research topic. Methodology: Scoping reviews are used to determine the extent, range, and nature of the scientific literature. The nine-step descriptive, analytical method of conducting a scoping review was used, as described by Peters et al. (2020: 413) in the methodology manual of the Joanna Briggs Institute (JBI). The researcher used an organised process with the help of an experienced librarian and two co-researchers to identify articles that included all the words in the title of the research. The studies were independently screened for eligibility by the researcher and co-researchers during three rounds of review (title, abstract and full-text). Results: The results of this scoping review were presented in a descriptive, diagrammatic and tabular format that aligns with the review question and objective. Of the 84 articles identified, 60 titles, 4 abstracts, and 20 full-text articles were screened for eligibility. The review included 8 studies. Findings and limitations: Findings – A combination of the various of factors, influencing the motivation to transfer learning is proposed, suggesting further research to build a strong transfer theory in higher Background: Motivation is a critical factor in students’ performance, productivity and transfer of learning. Even when students have the right skills, education, and support from peers and or educators, they would not be able to use knowledge learned in one context to solve a problem in a new context without motivation. Purpose: The purpose of this scoping review was to describe and summarise the literature on motivation to transfer learning in higher education and to identify the gaps regarding the research topic. Methodology: Scoping reviews are used to determine the extent, range, and nature of the scientific literature. The nine-step descriptive, analytical method of conducting a scoping review was used, as described by Peters et al. (2020: 413) in the methodology manual of the Joanna Briggs Institute (JBI). The researcher used an organised process with the help of an experienced librarian and two co-researchers to identify articles that included all the words in the title of the research. The studies were independently screened for eligibility by the researcher and co-researchers during three rounds of review (title, abstract and full-text). Results: The results of this scoping review were presented in a descriptive, diagrammatic and tabular format that aligns with the review question and objective. Of the 84 articles identified, 60 titles, 4 abstracts, and 20 full-text articles were screened for eligibility. The review included 8 studies. Findings and limitations: Findings – A combination of the various of factors, influencing the motivation to transfer learning is proposed, suggesting further research to build a strong transfer theory in higher education, including the full spectrum of factors on the transfer of learning model. The review highlighted the development of instruments to assess the same concepts and variables, and test the multidimensionality of the motivation to transfer learning in higher education more completely. Furthermore, the review proposes a concept analysis of motivation to transfer learning be done in higher education as part of health sciences to ensure that educators and researchers are able to characterise and understand what motivate students to transfer learning to improve the quality of education and healthcare delivered. Limitations – Prior research studies relevant to the scope of this review were limited. This limitation can be considered as a significant opportunity for this review to identify new gaps in the prior literature and to present the need for further development in the area of this review. Practical implications: The current literature highlights many factors influencing the transfer regime in the context of human resource development, but unfortunately, not much work has been done in higher education, especially in the field of health sciences. To improve the effectiveness of transfer of learning, we advocate that more in-depth qualitative research is required that involves other stakeholders such as students and educators. Further research should also investigate which variables make a difference in the complex process of motivation of students in higher education to transfer learning. A better understanding of the concept of motivation to transfer learning, the variables, and developing a theory, including the spectrum of variables influencing motivation to transfer learning, will assist educators to design more structured and evidence activities that ensure the motivation of students to transfer learning to the workplace, improving the delivery of healthcare. Value: This scoping review contributes to the dormant higher education transfer literature by prosed a combination of variables that provides a theoretical basis for building a strong theory/model on motivation to transfer learning for higher education.Item Open Access 'n Bepaling van die behoefte aan voetversorging by 'n groep bejaardes(AOSIS, 1985) Bothma, Y.; Botma, Y.; Viljoen, M. J.A survey was done to determine the demand for foot care amongst groups of elderly people in old age homes. A history was taken and a clinical examination was done according to criteria on an evaluation scale to determine the extent of foot-problems amongst the sample. The results indicated that 93 % of the elderly had foot-problems and that 46,51 % of these people tried to take care of their own feet.Item Open Access Peer support guidelines for nurse educators during curriculum innovation in Lesotho(University of the Free State, 2020-06) Shawa, Mirriam; Botma, Y.Background: The curriculum for the education of nurses and midwives in Lesotho was transformed through the adoption of competency-based education. Competency-based education promotes the capabilities of the students. Transforming the curriculum challenged educators’ skills, necessitating new sets of facilitation and assessment skills to enable appropriate enactment of the student-centred curriculum. Such major changes imposed by the curriculum innovation required commensurate professional development and ongoing support for the educators. The absence of ongoing supportive strategies during a curriculum innovation naturally led to unstructured support among educators. However, unstructured peer support is threatened by chaotic implementation and a possible curriculum drift. Therefore, there is a need for structured peer support through the provision of practice guidelines. Purpose: This study sought to develop guidelines to enhance peer support among nurse educators during a curriculum innovation in Lesotho. Methods: A qualitative approach with multiple data collection methods was used to develop peer support guidelines according to the World Health Organization’s Handbook for Guideline Development. The research was undertaken in three phases. Phase I described the existing peer support strategies through an integrative review. Phase II described the experiences of nurse educators related to unstructured peer support during the implementation of midwifery curriculum innovation through an exploratory descriptive qualitative study. Phase III integrated the findings from phases I and II to develop guidelines for peer support during a curriculum innovation in Lesotho. An international expert panel validated the guidelines through two iterative Delphi rounds. Results: Phase I of the study described the existing peer support strategies through an integrative review. Six themes emerged, namely types of peer support strategies, characteristics of peer supporters, characteristics of an effective peer support strategy, outcomes of effective peer support strategies, challenges of implementing peer support strategies and lessons learnt from the peer support strategies. Phase II of the study described experiences of educators regarding peer support during midwifery curriculum innovation and revealed five themes, namely motivation for educators to participate in peer support, attributes of educators that influence the extent of interaction and uptake of support, unstructured peer support strategies, consequences of peer support among educators and model performance inspires engagement with the new curriculum. The results from the two phases were triangulated and informed the development of the practice guidelines to enhance peer support among nurse educators during curriculum innovation. Five priority areas and seven recommendations were developed. The priority areas were peer supporters, peer support strategies, content/support needs, outcomes of peer support, and monitoring and evaluation of the peer support strategy. External reviewers validated the developed practice guidelines using AGREE II tool and attained an agreement of between 80 and 100% across the items on the tool. Conclusion: Transforming curricula for nursing and midwifery education is inevitable globally. Curriculum changes challenge the capabilities of the implementers and necessitate planned ongoing professional development and support of the implementers of the new curriculum. Such ongoing support strategies may be costly for low- and middle-income countries, such as Lesotho, and could benefit from structured peer support. The absence of such supportive strategies may compromise the fidelity of the implementation of the curriculum change. This study proposes peer support as an affordable intervention to enhance the implementation of a new curriculum, especially in low- and middle-income countries. The effectiveness of such intervention requires the commitment of institutional leaders, experienced and committed peer support providers, a clear modus operandi, tailor-made activities, appropriate resources, and monitoring and evaluation mechanisms. The proposed guidelines may enhance peer support during curriculum innovation.Item Open Access Problematiek van voorgraadse studenteverpleegkundiges se leerervaring in primêre gesondheidsorgklinieke(University of the Free State, 2010-06) MacKenzie, Margaret Juliana; Mulder, M.; Botma, Y.; Seale, I.The aim of this research was to assess the problems that undergraduate nursing students of the University of the Free State encounter during placement in primary health care (PHC) clinics, which have a negative influence on their learning experience. The need for such research became evident from anecdotal feedback and the fact that primary health care is the core of the existing curriculum. A qualitative, explorative and descriptive research design was used, firstly to examine the problems experienced by the participating triad (PHC nurse practitioners, facilitators of the academic nursing school and the students) during the placement of students in PHC clinics. Secondly, the participating triad were requested to offer suggestions to improve or optimise the learning experience of future students in PHC practice. Data was collected mainly by means of nominal group technique (NGT) interviews and documentary analysis. Diverse problems and suggestions were offered. The same five categories were identified in the data of all groups, namely learning environment, professional socialisation, learning opportunities, culture sensitivity and management. However, the priority sequence of the categories as determined by the participating triad differed. The above sequence (from the highest to the lowest) was for the “problems”, but for the “suggestions” it was learning opportunities, learning environment, culture sensitivity, professional socialisation and management. The identified main problems were, among others, lack of support and ineffective communication. Lack of support is closely associated with negative attitudes and inadequate knowledge. Communication among institutions, within institutions and among colleagues must improve. Recommendations were aimed at improving communication with and supporting various role players. Not only must the students be supported, but those who guide them in the practice setting. The training of nursing students must take place within a partnership in which all the partners play an equally important role and discharge their responsibilities with insight and accountability.