Die belewenis van die pasiënt en die verpleegkundige tydens tuberkulose-onderrig

Abstract

Although tuberculosis is regarded as a curable disease, it was declared a global emergency by the World Health Organization in 1993. One of the factors with a detrimental effect on the struggle against tuberculosis, is the fact that patients suffering from tuberculosis often stop taking their prescribed medicine for two or more months during or at the end of the minimum treatment period of six months. The result is that these chronic "half-cured and half-ill " patients, who are known as defaulters, then infect other people. Although various factors could possibly contribute towards the non compliance of patients, this research will focus only on the teaching-learning situation. The experience of both the primary health nurse and the patient suffering from tuberculosis during the teaching-learning situation in tuberculosis education has been explored and described within the context of the North West Province with the following aims: * to explore and describe the experience of the nurse and the patient suffering from tuberculosis in the teaching-learning situation in tuberculosis education; \8 to set guidelines for the implementation of adult-teaching principles in the teaching-learning situation with regard to tuberculosis, which might possibly contribute towards a decrease in the number of defaulters among patients suffering from tuberculosis and would encourage the facilitation of such patients' desire to be cured. Phenomenological interviews were conducted with seven primary health nurses and six patients suffering from tuberculosis and the following questions asked in each respective category. The nurses were asked: "How did you experience the situation during education given to patients with tuberculosis?" and the patients: "How did you experience the situation during education received for tuberculosis?". Interviews were recorded on tape and transcribed verbatim. A combination of Kerlinger (1986:477-483) and Giorgi's (Ornery, 1983:57-58) method of content analysis was used in cooperation with an independent encoder to analyse and encode the data. This research has proven that adult - teaching principles have not been established in the teaching-learning situation and that the parent-child ego states predominates in communication. The nurse is inclined to assume the role of parent with specific defence mechanisms in place. She is not motivated and is dominated by guilt feelings, rage and negative perceptions of teaching. On the other hand, the patient is inclined to assume the role of the child by acting in a passive, frightened, dependent and irresponsible way with misconceptions of tuberculosis education. Both parties focus mainly on medication with the result that they are unable to perceive the total scope of the support system in the correct perspective. A therapeutic relationship is absent. Guidelines have been formulated for nurses to apply as adult-teaching principles in the teaching-learning situation with regard to tuberculosis in order to promote the nurse's knowledge and skills concerning: interpersonal relations, subject knowledge, a task versus patient oriented nursing approach, the motivation of the nurse, social support systems, stimulation of the patient's motivation, recovery from the patient's breast centredness and the acceptance of responsibility for his own health as well as the affirmation of the role of the nurse.