'n Opleidingsraamwerk gerig op gehalte aborsiesorg vir verpleegkundiges aan hoëronderwysinstellings in die Wes-Kaap

[摘要] ENGLISH ABSTRACT: Before the implementation of abortion legislation in South Africa in February 1997, illegalabortions were the only way out for women with unwanted pregnancies. Because of the highmorbidity and mortality rate of the women concerned, abortion legislation was implementedwith the aim of ending illegal abortions in South Africa by having abortions carried out legallyon request in designated health care facilities. The abortion legislation stipulates thatregistered nurses who have undergone the proposed abortion care training may terminate apregnancy upon request of a woman during the first twelve weeks of the gestation period ofher pregnancy.Although legislation authorises registered nurses to carry out first trimester abortions, aninadequate number of nurses are being trained in the Western Cape to provide pregnantwomen with guidance and counselling services, carry out the abortions and/or refer problemcases. Since the implementation of the abortion legislation no real attempts have been madeby higher education institutions in the Western Cape to offer abortion care training for nurses.A need has therefore been identified to develop a comprehensive training framework forhigher education institutions in the Western Cape for the training of nurses in abortion care.The case study was used as research design and the specific unit of analysis on which theresearcher focused were the registered nurses who had received training in abortion care andthe context in which they provide abortion care at the various levels of service provision in thedifferent regions of the Western Cape.A random, stratified sample (non-proportional) was taken of the designated state health carefacilities in the Western Cape, as well as a non-probability purposive sampling of registerednurses who provide abortion care, a non-probability convenience sample of women who havereceived abortion care and a non-probability purposive sampling of final-year pre-registrationnursing students.Data was generated by means of questionnaires to the women who received abortions and/orcounselling, the registered nurses who carried out abortions as well as final-year preregistrationnursing students. A checklist was used to observe the abortions that were carriedout by registered nurses in an objective and non-participatory manner and semi-structuredinterviews were conducted with various role-players in abortion care and training.The main findings of this study indicate that the necessary infrastructure within which theservices could be provided according to the abortion legislation was adequate, but that theongoing shortage of trained health care practitioners hampers the abortion care services.Only 10 (n=10) of the 15 certified nurses employed in state health care facilities activelyoffered abortion care services in the various designated facilities in the Western Cape.Deficiencies were identified in the existing provincial protocol and it was clear that some of theguidelines are either not in use or have become obsolete in the light of new research findings.It was found that midwives with appropriate and effective training are the ideal category ofhealth practitioner for the provision of abortion care. The certified nurses who have beentrained by the various regional offices of the Department of Health: Western Cape are skilledin carrying out the abortion procedure, but the other aspects of abortion care, that are mainlycarried out by other categories of nurses, will probably require greater attention.The recommendations, which are based on a thorough literature study as well as on thefindings and conclusions that arose from the empirical part of this study, have been includedin a training framework. The researcher recommends that the training framework provide thebasis for the development of a formal programme or programmes for the training of nurses inabortion care at higher education institutions. The purpose of the proposed framework istherefore to determine the context within which curriculation ought to take place, and toprovide a focus or format for those who develop the curriculum for prospective students.

[发布机构] Stellenbosch University