ETD Collection

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    The needs of family members accompanying patients into a trauma casuality
    (2014-08-26) Johnson, Meghan
    Introduction and Background Trauma Casualty is an environment of constant unpredictability which has an impact on the both the casualty staff, the patient and family. Family members are usually not prepared for the sudden crisis of having a loved one injured. The Trauma Nurse therefore, has a very important role with regards to meeting the needs of the family of patients brought into the unit. The needs of family members in the Intensive Care or Critical Care setting has been extensively researched using the critical care family needs inventory (CCFNI), however very little has been researched in the setting of a trauma or emergency setting. The needs of family members in the emergency setting has been researched in Australia, but no work has been done in South Africa. There is, therefore, a need for research in this area. Purpose of the study The aim of the study was to determine the needs of family members accompanying patients into trauma casualty, in order of importance as perceived by them, and to determine if these needs are being met. Identification of needs will inform the role of the nurse with regard to holistic nursing care including care of the family of the patient. Research Method The study made use of a quantitative descriptive exploratory design. The population (n=97) included family members of patients brought into casualty. The sample size was determined in consultation with a statistician from the Medical Research Council. The inclusion Criteria incorporated family members, over the age of 18, who were willing to complete a self administered questionnaire. Family members of patients who had died in the unit were excluded. An Australian developed instrument, using a Likert Scale to categorise and quantify needs statements, was used. The tool was validated by review of a panel of experts and an inter rater agreement of 90% established. The tool was adapted for the South African context and validated on a subscale level using the Cronbach Alpha correlation test. Five major themes make up the critical care family needs inventory, these consist of “Meaning”, “Proximity”, “Communication”, “Comfort”, and “Support”. Two questionnaires were used, comprised of the same needs statements, however CCFNI-1 was used to determine the level of importance of needs statements, while CCFNI-2 sought to determine the level of satisfaction of needs met. The study setting made use of a Level 1 Trauma Casualty in a Public Tertiary Academic Hospital, in which the pilot study was conducted before data collection in the same setting. The data analysis process made use of descriptive statistics. After cleaning and coding, the data were exported to STATA statistical software for values to be calculated and interpreted. Data were analysed in three steps, namely analysis of demographic data, thematic organisation of analysed data and content analysis of open ended questions. Main Findings The main findings highlighted the importance of needs relating to the themes “Meaning” and “Communication”, while satisfaction was highest in the theme “Meaning”. A concerning finding was the low level of satisfaction with needs being met related to communication.
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    Perceptions of family functioning and its impact on juvenile offending.
    (2009-03-20T07:13:37Z) Harrison, Leandra
    Crime committed by youth within South Africa is a problem of growing concern. Family environments are seen as powerful putative factors in the development of offending behaviour. On the basis of family systems theory, it was postulated that juveniles are influenced by the reciprocal interactions amongst family members as it shapes their development. Kohlberg’s theory of moral development illustrates that the formation of morals is influenced by the quality of relationships within family units. This study therefore explored juvenile delinquent’s perceptions of their families and the impact it had on their offending behaviour. The subjective world of these offenders was focused upon within the qualitative paradigm through an exploration of their experiences. This method was deemed significant as it attempted to understand these delinquents in terms of their own definitions of their family lives in order to provide an in-depth and insightful account into how they perceived their families to have influenced their behaviour. Eleven juvenile offenders, aged between 15 and 21 attending a diversion programme participated in the study. The research was conducted in the form of semi-structured individual interviews where various themes relating to the family were explored. The participants’ responses were recorded and analysed utilising thematic content analysis. The participants perceived their families to potentially act as a contributing factor in the development of their criminal behaviour. Specific aspects, namely different family forms, family relationships, patterns and response styles, as well as families levels of emotional involvement were all perceived to have impacted on their delinquent behaviour. Although none of these factors can be considered in isolation, a complex interplay of these family characteristics may significantly contribute to the development of asocial behaviour. In contrast to these findings, areas of contestation also arose from participants’ talk. Despite their delinquency and the potential contribution of the family, some participants identified the family to act as a protective factor and thus not influencing their involvement in criminal acts. Aside from the family, other influences such as peer groups and community violence were also identified as potential risk factors for juvenile delinquency. Therefore although an important contributing factor, the family cannot be considered in isolation when attempting to identify what may lead these juveniles to engage in criminal acts.
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    Money, conflict and reciprocity in rural black families in South Africa.
    (2009-03-03T09:09:39Z) Gouveia, Joanne Ailsa
    There is a rich body of literature examining multiple aspects of money in the social sciences yet the role of money in organising and shaping family interactions in the South African context appears limited. The aims of this research were to explore money and its link to conflict in the family and develop an understanding of how money is organised in and influenced by culture and gender in rural Black families in South Africa. Ten women undergraduate students were selected, using nonprobability snowball sampling, to participate in individual semi-structured interviews. Detailed biographical information was collected alongside responses to ten open ended money related questions. Interviews were transcribed and thematic content analysis was used to identify and analyse themes in the data both within and across the ten interviews. The research was dominated by five key findings the most significant being a relative lack of conflict between the interviewees’ family members in general and specifically with regard to money. This was influenced by the shared hierarchy of priorities within the family that informs and directs the allocation of resources. The authority of parents related to a particular set of social and cultural norms determined familial interaction influencing the limited expression of conflict. The presence and significance of reciprocity in the interviewees’ families was widely accepted within an extended family structure and exhibited no striking generational differences in adherence to the generalised norm of reciprocity. The interviewees’ families also displayed a marked lack of gendered difference in the allocation of resources among family members. The study while achieving its goal of providing some understanding of how money works in a particular group of rural Black families highlights the need for further exploration of money and conflict in the family in the South African context.