Browsing by Author "Coetzee, Minette"

Now showing 1 - 15 of 15
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    Are children really different from adults in critical care settings?
    (2005) Coetzee, Minette
    Four years ago a Nursing Standards Generating Body (SGB) was established to gather wide input and formulate national educational standards for nursing. Possibly for the first time in South Africa this process offered a platform to consider how paediatric critical care is different from adult critical care. During the course of the 3-year SGB process, the Critical Care Society of South Africa (CCSSA) coordinated an exceptional response after having garnered wide participation from South African critical care nurses, educators and clinicians. It was an excellent opportunity to contribute to the issues around the nature and length of education programmes as well as the outcomes. The recommendations were thoroughly debated and offered a unique opportunity to influence policy and standards of critical care nursing education. This debate could also challenge assumptions, and it was in this process that the often misunderstood question of the differences between adult and child critical care could be tackled.
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    Beyond the feeding relationship: mothers' descriptions of interaction within the mother-child dyad
    (2009) Barbard, Penelope Jane; Coetzee, Minette; Mayers, Pat
    The mother-child relationship is a key determinant of child health. Current evidence acknowledges that impaired mother-child interaction affects social, emotional, cognitive and behavioural development in infants. Disrupted interaction within the mother-child dyad can be caused by a variety of factors including prolonged separation, illness, abusive relationships, maternal stress and other psychosocial disturbances. Post-Partum Depression (PPD), in particular, compromises mother-child interaction. Despite the fact that recent studies have demonstrated that the prevalence of PPD in low-income communities is approximately three times that found in first world countries, mother-child interaction is seldom evaluated and facilitated in primary care. Physical growth is often the only measure of infant health and development. The objectives of this qualitative study were to explore the mother's description of mother-child interaction; the importance that the mother ascribes to this interaction; and the mother's perception of the factors which facilitated interaction within the mother-child dyad. First-time mothers were purposively sampled and semi-structured interviews were conducted. After general inductive analysis of the verbatim transcriptions of the interviews, five main themes emerged. These were: (2)"What I expected" which described expectations around the birth and the impact on mother-child interaction, (2) "Isn't one supposed to feel ... ?" explored the mothers concerns regarding interaction, emotions and adaptation, (3) "Connecting with my baby" described a process of physical connectedness which enhanced emotional connectedness, (4)"We reflect each other's feelings " illustrated how feelings are echoed between mother and baby and empathy developed, and (5) "That helped/hindered our interaction " described factors which eased the fluency of mother-child interaction. These findings are discussed in relation to neuro-scientific developmental theories; namely Porges' Polyvagal Theory of subconscious adaptation for social behaviour and security strategies, and The Mirror Neuron Theory which describes mechanisms of imitation and the development of empathy. Factors which enhanced mother-child interaction are discussed within the context of a changing society. The findings suggest the potential value of including the facilitation of mother-child interaction in the practice of health professionals, particularly midwives and other workers in maternal and child health. This may include training in non-directive counselling of mothers, the recognition of disengaged mother-child interaction, and relationship facilitation. This study emphasizes the importance of mother-child interaction and that health professionals need to be aware of the potential for maternal mental health problems after birth, and the long-term consequences of poor mother-child interaction on infant health.
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    Community health workers & professional nurses : a descriptive study of their relationship in two Western Cape communities
    (2000) Doherty, Tanya; Coetzee, Minette
    Bibliography: leaves 151-160.
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    Developing family-friendly signage in a South African paediatric healthcare setting
    (AOSIS OpenJournals, 2014-11) Leonard, Angela; Verster, Anchen; Coetzee, Minette
    *Background: Multiple renovations and changing flow in a tertiary children’s hospital in Cape Town resulted in numerous signs being posted in the corridors and units, making wayfinding extremely complex. A request from nursing management prompted the formation of a learning collaborative of nurses from all departments to improve wayfinding signage. *Objectives: The project aimed to contribute to a family-friendly environment by reviewing the current situation and developing signage to improve wayfinding and convey essential information to parents, caregivers and patients. *Methods: A participative action research method followed a four-stage process to facilitate the development of family-friendly signage. Nurse participants reviewed existing signage and collaboratively developed new signage templates and posted signs. The signage was then evaluated using a rapid appraisal questionnaire involving 50 parents and nurse respondents. At each stage of data collection, thematic content analysis was used to analyse data gathered in process meetings and the reflections of participating nurses. *Results: A design template and then 44 new signs were developed and used to replace old signage. Respondents reported that the new signs were noticeable, looked attractive and were easily understandable. *Conclusion: Intentional and active participation of nurses in clinical paediatric settings ensured collaborative data gathering and analysis. An inclusive research design allowed for insights into the words and tone of posted signs that nurse participants had not noticed previously. The participative redesign of signage resulted in a sense of ownership of the signs. The support and involvement of hospital management throughout ensured that the resulting signage received wide acceptance.
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    Development of a process to support stakeholder engaged children's nursing workforce planning for high-need, lower-resourced Primary Health Care systems in Malawi
    (2023) North, Natasha; Coetzee, Minette; Brysiewicz, Petra
    Background: Effective workforce planning requires stakeholders to agree about the desired roles and contributions of advanced and specialist nurses across different tiers of service delivery. Role descriptions can help to reduce role confusion and inform workforce planning if stakeholders use them to establish a shared contextual basis for defining roles within their health service or system. There is a scarcity of rigorously developed role descriptions worldwide, especially role descriptions accurately reflecting the work of advanced and specialist nurses in Africa. Aim: Malawi is one of many African countries investing in establishing a specialist children's nursing workforce as part of globally advocated strategies to improve child health. This study aimed to develop a replicable process to assist stakeholders with specialist nursing workforce planning, informed by understanding the roles and contributions of children's nurses in the context of Malawi's health system. Methods: This study used a multiple methods approach with four phases. Design principles of stakeholder engaged research were incorporated into all research activities, which included: 1) a systematic scoping review to inform stakeholder identification; 2) a situational analysis; and 3) focus groups and interviews with 41 children's nurses in Malawi about their roles. Following qualitative content analysis of interview and focus group data, 4) concept mapping was used to integrate characteristics of the roles of children's nurses in Malawi and published role descriptions of other African specialist and advanced nursing roles with global frameworks for advanced nursing roles. Results: The study generated a framework for systematic identification of nursing HRH stakeholders; a situational analysis; and richly descriptive accounts of the roles of children's nurses in Malawi. The major product of the study was a flexible framework proposing four role domains and associated categories of activity for specialist and advanced practice children's nurses in Malawi, also applicable to other specialisations and other African health systems. Conclusions: The flexible framework is a distinctive response to the needs of African health systems. Advanced and specialist nurses in Africa are establishing their newly introduced roles into health systems in transition, within challenged and challenging practice contexts which demand high levels of adaptability. The framework is positioned to form part of a replicable process for stakeholder engaged nursing workforce planning. It is hoped that it will assist nurses and other stakeholders to manage the development of advanced and specialist roles at the levels of individual nurses, institutions and health systems.
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    Development of Woman-Centred Midwife-led Model of Care through Participatory Methods for the Uasin Gishu County Hospital, Kenya
    (2020) Rotich, Everlyne Chepkemoi; Coetzee, Minette; Clow, Sheila
    Background: The concept woman-centred care is gaining currency in maternity care and is increasingly being used to guide provision of quality care. The midwifery philosophy supports woman-centred care and is associated with positive pregnancy and birth outcomes. Development of a woman-centred midwife-led model of care requires involvement of the users (women), service providers (midwives), and health administrators to ensure representativeness of the model. Purpose: The purpose of this study was to explore, through participatory methods, the views of women midwives and health service managers on current maternity care, and describe desired maternity care and develop a woman-centred maternity care model for Uasin Gishu County, Kenya. Methodology: Appreciative Inquiry 4-D cycle was used in the study. The Human Scale Development framework guided the study. Thirty two midwives, 85 women attending maternity and well-baby services at the facility, and four facility and three county health service managers participated in the study. Focus group discussions and interviews were carried out from May 2015 to April 2016 using the four phases of the Appreciative Inquiry cycle. Phase one “discovered” what best maternity care looks like, phase two “dreamt” what best maternity care would look like, phase three “designed” the model, and phase four “destiny” was used for development of implementation strategies. Data was analysed using thematic analysis augmented by thematic networks analysis and NVIVO 11 software. Ethical approval was obtained from the University of Cape Town and the Moi University and Moi Teaching and Referral Hospital Research Ethics Committees. Individual's participation was voluntary, informed consent was obtained and confidentiality maintained. There was no compensation for participation.
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    Distinctive nursing practices in working with mothers to care for hospitalised children at a district hospital in KwaZulu-Natal, South Africa: a descriptive observational study
    (2020-04-19) North, Natasha; Leonard, Angela; Bonaconsa, Candice; Duma, Thobeka; Coetzee, Minette
    Background The presence of family members and their active involvement in caring for hospitalised children is an established practice in many African paediatric settings, with family members often regarded as a resource. This aspect of African paediatric nursing practice lacks formal expression or a clear conceptual basis, and difficulties arise when applying concepts of family involvement originating from the culturally distinct practice environments of higher resourced settings including Europe and America. The aim of this study was to articulate a nurse-led practice innovation intended to facilitate family involvement in the care of hospitalised children, observed in a paediatric inpatient ward in a district hospital in rural KwaZulu-Natal, South Africa. Methods A qualitative case study design was used. Data collection included visual research methods (graphic facilitation, sociograms and photo-elicitation) as well as a focus group, interviews and practice observation. Activities associated with 20 nurses and 22 mother-child dyads were observed. Data were subjected to content analysis, with Standards for Reporting Qualitative Research (SRQR) applied. Results Findings relate to six aspects of practice, categorised thematically as: preserving the mother-child pair; enabling continuous presence; psychological support and empathy; sharing knowledge; mothers as a resource; and belief and trust. Conclusion The nursing practices and organisational policies observed in this setting relating to the facilitation of continuous maternal presence represent a distinctive nursing practice innovation. This deliberate practice contrasts with models of care provision which originate in higher resourced settings including Europe and America, such as Family Centred Care, and contrasts with informal practices in local African settings which tolerate the presence of mothers in other settings, as well as local institutional policies which limit mothers’ presence to varying extents.
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    Effects of decreasing maternal separation of under 6-month old infants directly before and after surgery on allostatic load and outcomes : a randomised control trail [i.e. trial]
    (2014) Ssenyonga, Lydia V N; Coetzee, Minette; Bergman, Nils
    The current understanding is that infants below six months old do not show separation anxiety (Bretherton, 1985). The objective of the study was to measure the evidence of stress using heart rate variability and impedance cardiograph as indicators of autonomic nervous system activation in order to determine whether decreasing maternal separation of under 6-month-old infants directly before and after surgery decreases their stress experience. The hypothesis was a mother’s presence makes a difference to the autonomic response to stress in infants under six months old undergoing elective hernia surgery.
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    Learning to Engage Children: Towards a model for Undergraduate Students in Nursing - a Grounded Theory study
    (2000) Coetzee, Minette; Thompson, Rosalie
    In South Africa, paediatric nursing practice has traditionally been seen as a speciality. Yet in 1998, while a staggering 45% of the population were younger than 18 years, still only 2.4 % of all registered nurses held a Paediatric qualification1 and the reality of the size of the population of children, continued to impact Health Service provision. The challenge of facilitating undergraduate students learning a traditionally post-basic nursing discipline led to this study in the Department of Nursing at the University of Cape Town. Here the philosophical approach is health based; whole-person orientated and family centred and the programme includes a distinct children's nursing component. The purpose of the study was to discover how student nurses learn to nurse children. Participants came from four consecutive student groups in their third year of undergraduate study. The use of grounded theory methodology allowed a rich understanding of the process to emerge. Data included participant observation and student descriptions, both private in reflective journals and narratives and corporate, in focus groups. In the wealth and variation of experience and learning, analysis of data confirmed the complex relational nature of students' learning. The relationships students establish with the children they encounter in the course of their learning emerged as central to their learning. Findings indicate that puzzling out connection is the students' basic social process in learning to nurse children. Students' experiences of childhood and parenting influence their expectations, interactions and application of learning. The various conditions that affect how students choose to engage children have been extensively explored and described. Students in this study engage children in four distinctive modes; which have been described as playful 1 connecting, dutiful safeguarding, in relay with the child's mother and distant doing. The findings of this study contribute to the understanding of how students learn to nurse, especially in the life stage of late adolescence. This is essential for structuring the learning environment and experiences of students learning to care for children.
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    Optimising nursing shift handover in Paediatric Intensive Care
    (2013) Davis, Clare; Coetzee, Minette; Kyriacos, Una
    Includes abstract. Includes bibliographical references.
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    Optimising stabilisation of the critical ill child in the medical emergency unit at the Red Cross War Memorial Children's Hospital : an enthnographic study
    (2013) Bonaconsa, Candice Hilda; Coetzee, Minette; Argent, Andrew
    Includes abstract. Includes bibliographical references.
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    Re-envisioning paediatric nurse training in a re-engineered health care system
    (AOSIS OpenJournals, 2014-10) Coetzee, Minette
    *Background: South African’s infant and child mortality rates remain high and at the current rate of decline will not meet the Millennium Development Goals of a two thirds decrease by 2015. At the latest available count, there were fewer than 1500 qualified paediatric nurses on the National South African Nursing Council register, with only about 100 nurses graduating with this qualification from South African nursing schools annually. It is not clear, however, if current paediatric nurse training programmes adequately equip nurses to make a real impact on reducing the under-5 mortality rate. In their 2011 interim report, the Ministerial Committee on Morbidity and Mortality in Children under 5 years recommended strengthening paediatric nurses’ training as a strategy to reduce the under-5 mortality rate. *Method: In response to the Committee on Morbidity and Mortality in Children recommendation, a colloquium was convened as a national forum for schools of nursing, departments of health, health care facilities, clinicians and regulatory bodies to advance children’s nursing in South Africa. *Objectives: The goals of the colloquium were to thoroughly investigate the situation in South Africa’s paediatric nurse training, plot ways to strengthen and expand postgraduate paediatric programmes to meet priority child health needs, and to build relationships between the various schools and stakeholders. *Results: Outcomes included the clarification and strengthening of a ‘stakeholder grid’ in nurse training, recognition of the need for more active teaching and learning strategies in curricula linked to national child health priorities, as well as the need to develop and support clinical nursing practice in facilities.
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    The role of the children’s nurse in optimising autonomic regulation: the Regul8 framework
    (2020) Coetzee, Minette
    The Regul8 framework represents an approach to providing fundamental children’s nursing care developed by Associate Professor Minette Coetzee at the Child Nursing Practice Development Initiative (CNPDI) in the Department of Paediatrics and Child Health at the University of Cape Town between 2008 and 2019. Originally known as the Seven Steps, and then the Seven (Plus One) Steps, the impetus for the work was to align emerging understandings and research outcomes with current children’s nursing practice. Concepts were developed through continuous exploration of emerging scientific fields and refined through a decade of teaching and learning alongside children’s nursing students, practitioners and educators from across Africa. The framework is designed to comprehensively address the major influences on regulatory function through an intentionally Afrocentric guide to children’s nursing care planning.
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    The children’s nursing workforce in Kenya, Malawi, Uganda, South Africa and Zambia: generating an initial indication of the extent of the workforce and training activity
    (2019-05-07) North, Natasha; Shung-King, Maylene; Coetzee, Minette
    Background This study sought to identify, as far as possible, the extent of the specialist children’s nursing workforce in five selected African countries. Strengthening children’s nursing training has been recommended as a primary strategy to reduce the under-five mortality rate in African nations. However, information about the extent of the specialist children’s nursing workforce in this region is not routinely available. Developing an accurate depiction of the specialist children’s nursing workforce is a necessary step towards optimising children’s health service delivery. Methods This study used a convergent parallel mixed methods design, incorporating quantitative (surveys) and qualitative (questionnaire and interview) components, to generate data addressing three related questions: how many children’s nurses are believed to be in practice nationally, how many such nurses are recorded on the national nursing register and how many children’s nurses are being produced through training annually. Results Data provide insights into reported children’s nursing workforce capacity, training activity and national training output in the five countries. Findings suggest there are approximately 3728 children’s nurses across the five countries in this study, with the majority in South Africa. A total of 16 educational programmes leading to a qualification in paediatric nursing or child health nursing are offered by 10 institutions across the countries in this study, with Kenya, Malawi and Zambia having one institution each and South Africa hosting seven. Data suggest that existing human resources for health information systems do not currently produce adequate information regarding the children’s nursing workforce. Analysis of qualitative data elicited two themes: the role of children’s nurses and their position within health systems, and the capacity of HRH information systems to accurately reflect the specialist children’s nursing workforce. Conclusion The data generated provide an initial indication of the size of the children’s nursing workforce in these five countries, as well as an overview of associated training activity. We hope that they can start to inform discussion about what would represent a viable and sustainable regional children’s nursing workforce for the future.
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    What is the capacity of the children's nursing workforce in seven selected Sub-Saharan African countries? Gathering insights from Botswana, Kenya, Namibia, Malawi, South Africa, Uganda and Zambia
    (2018) North, Natasha; Coetzee, Minette; King, Shung Maylene
    Background This study attempted to identify as far as possible the extent of the children’s nursing workforce in five selected countries in the sub-Saharan African region. Strengthening children’s nursing training has been recommended as a primary strategy to reduce the underfive mortality rate in African nations, including South Africa and Malawi. The current level of data monitoring capacity worldwide means that it is not possible to disaggregate the children’s nursing workforce in countries in the World Health Organisation African Region from the data provided by the WHO Global Atlas of the Health Workforce database. Yet developing an accurate depiction of the specialist children’s nursing workforce is a necessary step towards optimizing children’s health service delivery. Methods In attempting to respond to this need, this study adheres to a collaborative research philosophy, using a convergent parallel mixed methods design, incorporating a scoping documentary review, together with quantitative (surveys and case study compilation) and qualitative (interview) components collected independently and then integrated during analysis and interpretation, to generate data addressing three related questions: how many children’s nurses are believed to be in practice nationally; how many such nurses are recorded on the nursing register nationally; and how many children’s nurses are being produced through training. Results Findings suggest there are approximately 3 728 children’s nurses across the five countries in this study. A combined total of 260 children’s nurses are produced through training each year across the five countries on average. Survey responses, interview data and content analysis of items identified through the scoping review suggest that adequate information regarding the children’s nursing workforce is not currently available to inform decision-making. Conclusion In conclusion, it is hoped that the data generated might contribute towards identifying the size of the children’s nursing workforce, as a first step towards identifying what would represent a viable and sustainable regional children’s nursing workforce for the future.